Healthcare RSS feed for this section

A Daily Test for Models

If models projecting the hospitalizations and deaths in Rhode Island from COVID-19 keep being revised down, they’ll start to get into the range at which deaths from our response are a larger number.


Was That COVID-19 You Had in January?

One of the persistent questions surrounding this outbreak of the COVID-19 coronavirus is whether all of the people who had a bout of some mysterious flu-like illness in the two months or so before the world really started to pay attention to the disease have already had it.  Writing on her Facebook page, Lisa Daft made the excellent observation that Rhode Island saw “a lot of negative flu tests this winter.”

The chart she displays comes from the RI Dept. of Health’s Influenza Surveillance page, which currently offers the following, with the gray sections representing tests that came back negative for the flu, presumably despite flu-like symptoms:



Can the number of those negative results actually be showing us early COVID-19 infections?  Possibly, but finding the same chart in the last few years of the Dept. of Health’s annual report suggests these results aren’t actually unusual (2016, 2017, 2018, 2019).  Here’s the one from two years ago:


These trends are consistent with national experience.  The following chart shows the number of flu-negative tests for the United States from October 2015 through January 2020, as reported by the World Health Organization:



So, while negative tests during this flu season look like they’re going to prove to have been higher than average, they aren’t unusual, and this hasn’t been the worst year on record for negative tests.  Of course, that doesn’t mean the strange illnesses so many people have reported were not COVID-19.  Every year, the number of negative tests could be accounted for by something different, ranging from the amount of attention the media is paying to the flu to the severity of the flu season (making people more inclined to get tested) to an outbreak of some virus that is never identified.

The next question to answer would be how many deaths occur each year due to mysterious illnesses that initially present as the flu.


A Finger Prick to Free Us All

Here’s some encouraging news out of London:

The British government is just “days” away from releasing 3.5 million self-administered finger prick tests that could prove a game-changer in easing the economic fallout from the coronavirus pandemic.

The tests will likely be stocked in retailers like Boots, a major pharmacy chain in the United Kingdom, and available to order online via Amazon, however the first stage of the rollout will be reserved for doctors, nurses and other essential workers.

At first, the tests would be held for critical personnel, but as more are produced, they’ll be available to the general public.

The article emphasizes that people who have the antibodies and are therefore inoculated can get back to work (and, implicitly, economically productive play).  Of course, knowing that they haven’t yet built up an immunity will also help people make decisions about how isolated to make themselves.

This news speaks to a question many families have surely had upon hearing that Massachusetts Governor Charlie Baker has extended the ban on in-person schooling to May 4.  Isn’t that an unnecessarily pessimistic step?  Going forward, a vaccine would be the gold standard relief innovation, but that isn’t the only thing to watch for.  Means of treating the effects of the virus (not only for individuals, but also for hospitals to handle large numbers of cases) are also in the works, and broad availability of tests for live infections and immunity would be hugely helpful in managing the epidemic.

The entire world is focused on this disease.  We’ve already inculcated a sense of the importance of hygiene and social distancing, as well as a practice of self evaluation for symptoms.  If we improve our knowledge about who is infected and who is immune, while we reduce the worst effects for individuals and hospitals or limit the populations who might experience them, restrictions could ease sooner than expected.

Of course, in a situation like this, we shouldn’t count on such outcomes, but we should leave open the possibility.


Decisions and Consequences in a Mortal Life

A Rhode Island family has a child with a disease that requires pretty significant daily treatments and an increased concern about illnesses like the flu.  After receiving the diagnosis, they increased their household emphasis on hygiene, cleanliness, exercise, and health and battled with tricky questions about longevity and quality of life.

When do you pull a child out of school?  What sort of activities can you no longer do?  Water parks might definitely be out, per the doctor, but what about trampoline parks and that sort of thing?  That is for each family to decide.

This year, the child is in a grade that traditionally takes an extended class field trip, which has been a source of anxiety for the parents for months, or even years.  The early weeks of attention to COVID-19 put a sharper point on that anxiety, and it was looking more and more likely that they would have to speak the difficult “no.”

In such circumstances, it might be natural for parents to feel a little bit of guilty relief when they don’t have to say, “no,” because the event itself is canceled.  But circumstances have moved well past that.  The final, decisive end of hope for the trip was closure of the century-old Rhode Island travel company that handled the arrangements from its Cumberland office.

The company opened its doors in 1926.  It survived the Great Depression, World War II, the stagflation of the 1970s, the dot-com bubble, and the Great Recession.  In the face of COVID-19, the announcement on the website of Conway Tours gives the impression that the owners have no plans to re-open or try to start things up again when the wave of this virus has passed.

Without doubt, travel agencies are uniquely vulnerable to the recession that we now face, but the survival of other businesses and industries that live a bit farther from the cliff’s edge will depend on how we, as a society, respond to the crisis. It’s still too early to know what the best response is, right now, but we have to remain mindful that none of our reactions is without a trade-off.

Recent public debates have renewed over the old conflict between security and freedom, but the question is deeper than that.  Civilizations have to make decisions that balance longevity and quality of life, too, because every life begins with a diagnosis of its end.  That is nothing new, and nothing unique to any given family.


Politics This Week with John DePetro: Remarkable & Worrying Times (With Hope!)

My weekly call-in on John DePetro’s WNRI 1380 AM/95.1 FM show, for March 16, included talk about:

  • The Virus and the politicians
  • Britt bends the insider rules
  • RI Women for Freedom & Prosperity
  • Closing the GOP primary

I’ll be on again Monday, March 23, at 12:00 p.m. on WNRI 1380 AM and I-95.1 FM.


The Importance of Sacrifice and Recognizing Differences

This bit of a letter from a young doctor puts a spotlight on one of the weaknesses of our modern culture.  Noting that healthcare workers are still going to be needed no matter what happens with this virus, he asks:

How can we be proactive about protecting our healthcare workers? To start, we need to consider protecting our older colleagues and those with certain preexisting medical conditions. We may even need to decide that only young and healthy doctors and nurses should be triaging and caring for these patients. I’m in. But is this discriminatory or putting too much risk on the young? I’m not sure.

Step out of our times for a moment, and this is an astonishing thing to read.  Not that long ago, it used to be expected that people would sacrifice for others.  Young people, in particular young men, would take risks for the whole community where strength and resilience were needed.  Heretical as it may be to acknowledge, this is so true that we seem to have evolved around the principle.

Yes, maybe that increased risk came with the compensation of some privileges and cultural encouragement, but trying to distribute such things without the prejudices of the past doesn’t have to mean discarding the ability to differentiate.

A society that doesn’t inspire its people to sacrifice will not last, and a grievance culture characterized by identity politics will not inspire anybody.


If the Planners Planned the Medical System

As never-let-a-PANIC-go-to-waste grips the country, we’ve been hearing a lot of insistence that the epidemic proves the need for government-run healthcare.  Typically, this is merely offered as a Twitter-sized assertion, so there isn’t much specific to argue with.  (One suspects that’s by design.)

However, the talk about how our challenge is to keep the incidents within our health system’s capacity rang a bell: specifically, the talk about how the United States has insufficient hospital beds to deal with the potential influx of patients.  Here’s the bell, from a House Finance hearing in 2014 on legislation that would have increased the government’s role in Rhode Island health care.  This particular speaker is Steve Boyle, who was president of the Greater Cranston Chamber of Commerce, who was advocating for the bill, but the same thing could have been said by any of the supporters:

Boyle says the state needs a “coordinated approach.”  “We all know there’s too many hospital beds, but I’m told over and over again that there’s not the political will to close them.”

So, if they didn’t have to worry about “the political will,” the planners at that time would have reduced the number of beds. As it is, our more-socialized health system since Obamacare has overseen a reduction in staffed beds in Rhode Island from 2,535 in August 2012 to 2,424 in August 2018.  That 4.4% reduction means 111 fewer spots if there’s a surge.

Now, I’m not saying that the market is always right or that planners are always wrong, but they do take different things into consideration.  The market works by finding the value of a particular thing to the society in which it is operating, and that value will naturally adjust for subtler reasons than planners can possibly consider.  A culture can remember that its hospital beds filled up at some point in the distant past, while planners might not have the data or might dismiss it.

In times of panic don’t believe people who exploit current circumstances to pretend they would have been able to plan for them if they’d had more power.


Politics This Week with John DePetro: Rhode Island’s Civic Infection

My weekly call-in on John DePetro’s WNRI 1380 AM/95.1 FM show, for March 2, included talk about:

  • The degree of confidence in the state government to contain a contagious disease.
  • The effect of distrust on public perception of the Veterans Home debacle.
  • The meaning of Weingarten’s texts to Infante-Green.
  • The ubiquitous Mr. Nee.

I’ll be on again Monday, March 9, at 12:00 p.m. on WNRI 1380 AM and I-95.1 FM.


Casimiro and Vella-Wilkinson on Pending Legislation

Guests: Julie Casimiro, State Representative, H-D 31,
Camille Vella-Wilkinson, State Representative, H-D 21,
Host: Richard August
Topic: Vaping and other pending legislation
Host: Richard August Time: 60 minutes
Representatives Casimiro and Vella-Wilkinson discuss a broad range of pending legislation and other matters, which have their concern. Topics include vaping legislation; a veteran joint oversight committee; pharmacist having birth control prescription authority; reproductive health; firearm legislation; climate control; out of school time learning; early parole for young rehabilitated offenders; military sexual assault trauma; and more. Other matters include the need for a constitutional convention; line item veto; minimum wage; and candidate endorsements.


Iowa Caucuses and UHIP

The campaign manager for President Donald Trump, Brad Parscale, offered a take on the Democrats’ Iowa caucus troubles that probably occurred simultaneously to just about every conservative in the country:

And these are the people who want to run our entire health care system?

A point often gets lost in all the jockeying for control of the American narrative.  When we object to this program or that one, conservatives aren’t typically opposing government-driven solutions regardless of whether they’ll work.  On the flip side, we also aren’t typically saying that the certainty of a fix can always overcome principled objections based on a philosophy of how government should function.

Rather, the conservative position tends to be that, for any given issue, the trade offs are not sufficiently clear, the benefits are not sufficiently certain, and side effects are so excessively probable that humility should be the underlying principle.

The debacle of the 2020 Iowa caucus should be more proof than anybody needs of this principle.  It’s not as if this was the first time Iowa Democrats have caucused, but now (regardless of the reason) there will be lingering doubts about the process, including discord between factions that suspect some sort of political scheme.

To be sure, government and political parties will naturally handle elections-related activities, but they don’t have to handle things like healthcare.  Look at experience with the Unified Health Infrastructure Project (UHIP).  When bureaucrats committed Rhode Island to the scheme during the Chafee administration, they had wide eyes about “one-stop shopping” for government services.  When they rushed ahead with a system that they’d been warned was not ready, no doubt the Raimondo administration was hoping for some sort of PR win.  And we got… a debacle.

This isn’t a claim that Democrats are especially incompetent, but that our political system creates incentives and risks that should advise a strong preference for handling society’s challenges through other institutions than government.


Opioid Solutions When the Government Refuses to Address Problems

In his recent essay on this site, Dr. Stephen Skoly described the consequences of legislation seeking to regulate prescription opioids, but he stopped short of broad conclusions about the politics involved.  As it happens, one such conclusion fit in well with the other topics that John DePetro and I discussed on December 30.

We can, of course, debate whether a new $5 million fee for opioid manufacturers and wholesalers is actually about solving a social problem, rather than finding a new source of revenue.  But taking the politicians at their word for their motivation, one can at least say that such policies infantilize the people, as if our legislators and governor are the only adults in the state and therefore must protect patients from their irresponsible selves and from greedy doctors.

Something milder and, in its way, worse is probably going on, as well.  The theme that John and I happened upon in our segment was that government officials in Rhode Island shy away from addressing actual problems.  They look for all sorts of ways to get at them without actually naming and attacking the root causes.

When it comes to a failing education system, they seek work-arounds and small tweaks like, like shifting authority toward principals, rather than draw attention to the labor-union structure that makes the system all about the remuneration of adults rather than the education of children.  When it comes to teenage fights at a mall, the focus goes to things like community programs to give kids something to do, rather than unraveling the progressive assumptions that lead to gang-friendly policing and suspension-unfriendly school regulations (not to mention identity-group entitlement).

Just so, going after fentanyl and heroin on the criminal market would manifest in urban areas and among minorities.  Many people in those communities would be grateful for the improved environment, but the enforcement and incarceration statistics would look bad and draw the attention of groups like the ACLU.  So instead, government tries to find a solution from the other side, making things more difficult (literally more painful) for law-abiding citizens, in the hopes that they can limit the market for the drugs and make the dealers go away for lack of profit.

If that approach also produces a $5 million fee for government, so much the better.


Political Monday with John DePetro: RI’s Avoidance of Real Problems

My weekly call-in on John DePetro’s WNRI 1380 AM/95.1 FM show, for December 30, included talk about:

  • Elorza’s interest in being governor
  • Causes and effects of Providence Mall brawls
  • Disappointment in Raimondo’s failure to succeed
  • Stephen Skoly’s warning about opioid nannyism

Open post for full audio.


A Far-Reaching Conversation on State of the State

State of the State co-host Richard August invited me on for a full hour of the show to cover a broad range of topics, from Tiverton’s recall election to broad political philosophy.

12-9-19 A Different View of Matters from John Carlevale on Vimeo.


Vaping Shows How Quickly They’ll Take Away Rights

Note this, from Guy Bentley on Reason:

The Centers for Disease Control and Prevention (CDC) has finally identified a primary suspect in the wave of vaping-related lung illnesses and deaths.

Examining lung tissue samples of patients hospitalized with vaping-related illnesses, 100 percent tested positive for vitamin e acetate, often used to cut marijuana oils. This was not a surprise to those who have been arguing that the cause of these illnesses is not the commercial e-cigarette market, but the illicit market for THC vapes.

Now recall that Democrat Governor Gina Raimondo moved quickly to hurt Rhode Island businesses by unilaterally banning a legal product that even then looked likely not to be the culprit.

Yes, we’re decades into a campaign by government to create a superstitious dread of nicotine products, but still… part of me can’t help but feel like every incident like this is a test to see how willingly Americans will give up their rights and their freedom.  The results of this test were not encouraging, at least in Southern New England.


Political Monday with John DePetro: A Creature of Their Own Making

My weekly call-in on John DePetro’s WNRI 1380 AM/95.1 FM show, for November 25, included talk about:

  • Insider Alves and the radical caucus
  • The union view of employer responsibility
  • Gaspee versus campaign finance laws
  • Paint on the statute becoming blood on government’s hands
  • Blood on the police officer’s hand gets a slap on the wrist

Open post for full audio.


Freedom… From the Progressive Point of View

Perhaps the most clarifying statement in Rhode Island politics, recently, came from one of the candidates now involved with Matt Brown’s Political Cooperative (which, despite the name, is not an alt-country band):

“Thought I may be the epitome of the American dream I cannot sit around and watch while many of my brothers and sisters are denied a shot at that very dream,″ said Jonathan Acosta, tracing his own story from “first generation American born to undocumented migrants from Colombia″ to the Ivy League.

“I believe that we are not free until we have dismantled structural inequality, developed sustainable clean energy, enacted a $15 minimum wage that pays equal pay for equal work, extended healthcare for all, provide[d] affordable housing, ensured quality public education starting at Pre-K, undergone campaign finance reform, criminal justice reform, and implemented sensible gun control,″ said Acosta, running for the Senate seat currently held by Elizabeth Crowley, D-Central Falls.

So, to Mr. Acosta, we’re not free until we’ve taken from some categories of people to give to others, limited people’s energy options to benefit fashionable technologies, forbidden employers and employees from setting a mutually agreeable value on work to be done, taken money from some people in order to pay for others’ health care (as defined by a vote-buying government) and/or put price controls on what providers can charge, placed restrictions on who can live where and what they can build, tightened the regulation of politics with limits on the donations and privacy of those who become politically active, and reduced the rights guaranteed under the Second Amendment of the United States Constitution.

If that doesn’t match your understanding of “freedom,” you’re not alone.  Indeed, by its mission, this “cooperative” is cooperating against anybody whose understanding of freedom differs, because it cannot possibly cooperate with anybody who disagrees.  You simply can’t hold a definition of freedom that doesn’t have satisfactory outcomes for the interest groups that progressives have targeted.