Archive for the ‘Health’ Category

Forced Flu Vaccinations

October 8, 2020

Not that it’s gotten a lot of mainstream media coverage, but Massachusetts now requires flu vaccines for students attending in-person classes. There are religious exemptions, home-schoolers are also exempt from the mandatory vaccinations. Otherwise as young as six months old, children need to receive annual flu shots. The state is expected to mandate flu shots for certain workers in the state as well.

Although certain states already have mandatory vaccination requirements for students, this is the first time the seasonal flu shot has been made mandatory. Decisions like this are of keen interest to me since much focus is directed to the development and roll-out of a COVID-19 vaccine. Much like the flu vaccine, concerns about COVID antibodies not persisting in the body for more than a few months at a time mean seasonal COVID vaccines could be a reality, and I have concerns about nearly all mandatory vaccination programs, let alone a mandatory vaccination program that is both unpredictable as to it’s efficacy in any given season and for an illness that for the vast majority of infected people results in relatively minor symptoms and effects.

According to case law going back over 100 years, states do have the right to mandate vaccines and impose penalties on those who refuse to get them, an issue that will become more and more pertinent as the argument that public health trumps private health decision-making rights continues to gain momentum. The specter of wide-spread mandatory vaccines is unpalatable to people (even people who believe it’s the best course of action). We don’t like the idea that people could be put in jail or fined for refusing an injection from a stranger. We prefer the more pleasant options of public shaming or exhorting people to ‘voluntarily’ receive a vaccination, but those are just pleasantries the law currently does not require.

Vaccines in and of themselves are not necessarily bad things. But I’m very uneasy with broad assertions that vaccines are more or less completely safe and that concerns to the contrary are some how indicative of a lack of common sense. My concern is less with long-established vaccines with a long-term record (even if difficult to come by) of associated side effects, and more with the avalanche of possible vaccines being developed without benefit of easily available (and readable) discussions of interactions between vaccines or long-term possible side effects. I’m also very wary of mandatory vaccine laws (such as California’s) that don’t define an exclusive list of mandated vaccines, allowing for new vaccinations to be added under the existing law without notifying constituents let alone getting their approval on it.

So I’ll keep digging through the news to see how pushes for more and more mandatory vaccines are going. I’m grateful for advances in medical science, but I’m also all-too aware that even good ideas can have unanticipated consequences and we need to be very sparing in demanding people accede to well-intentioned programs, particularly when the individuals will have to bear the brunt of any problems that develop, with notoriously little support or acknowledgement from the institutions that caused those problems in the first place.

COVID Coping

September 25, 2020

We’re all trying to figure out how to get through this season of COVID. With restrictions on where you can go and what you can do and who you can be with, people are getting a bit stir crazy and I’m no exception. I’ve admitted to being not the smartest guy on the block this summer, an admission some would argue was far overdue and hardly limited to this summer. But as a closing foray into stupidity, last night I took the Paqui One-Chip Challenge.

I’d like to defend myself somewhat. I haven’t eaten Tide Pods or overindulged on cinnamon. I haven’t poured ice water over my head. I’ve never been much of a joiner, and taken more pride than probably reasonable in going against the flow. I’m fairly discerning usually when it comes to common sense. But apparently not always.

Because another source of pride throughout my life has been an affinity for spicy food. The hotter the better. And the more other people back off and avoid it, the more inclined I am to try it. So when I saw a YouTube video for the One-Chip Challenge, I immediately started Googling to see where they could be purchased locally. Just a few hours later I had two small bags of their chips and one of the casket-shaped One-Chip Challenge boxes.

I tried the bag of Fiery Chili Limon chips for lunch. It claims to be Super Hot!, but it was disappointing. I mean, there was some heat to it, but I ate the small bag without the need for water – let alone bread or milk. I make much hotter pico de gallo and while these chips were somewhat respectable by mass produced chip standards, they certainly didn’t live up to the hype.

So when my kids found the box at dinner they naturally assumed I should do it. Right then. And really, why put it off?

Frankly the most impressive thing initially was that this company found a way to keep their chips intact! The small bag of chips was not a bunch of crumbs as is often the case with chips. Almost all of the chips were intact, which was impressive in and of itself. And the One-Chip Challenge was even better insulated to ensure I found it intact. This year’s challenge uses a blue-corn tortilla chip covered in their signature blend of ground chili spices, utilizing the Carolina Reaper chili, the Scorpion Chili, and Sichuan peppercorn. The chip looks black and it’s covered in this black spice. The challenge says you have to eat the entire chip, so I broke it in two and ate it.

Initially it wasn’t terribly impressive. But, as chilis sometimes do, the impact grew over time. Still, it wasn’t really all that painful initially. Eventually it was the sides of my tongue that took the brunt of the burning. The rest of my mouth was relatively unaffected. Or perhaps completely numbed. I’ve longed to take spicy challenges for years, but this is the closest I’ve ever come to actually doing one. Beyond the growing burning on my tongue were other physical reactions I’ve watched in other people but never experienced myself. I began perspiring. My eyes started watering and my nose started running. My hands were shaking and my legs were a bit weak. There was a jumbled sense to my thinking, as my brain rapidly occupied itself almost completely with what was going on in my body and how unhappy it was with it.

The challenge grants different levels of recognition depending on how long you can hold out before eating or drinking something after eating the chip. My goal was to last at least five minutes – the lowest level of Featherweight. It’s what I had seen the host do on the YouTube video, and since we had guests for dinner I didn’t feel like drawing it out indefinitely. And, honestly, it hurt. So the glass of milk I had my kids bring me in advance went down pretty quickly but only provided moderate relief. As with the water after. Ice cubes were more effective at numbing my tongue and easing the pain. And with homemade apple crisp with ice cream for dessert, I found the frozen dairy was most effective in helping neutralize and disperse the oils binding the burning to my tongue. Within 15 minutes or so I was feeling mostly back to normal.

I could feel it in my stomach, as the packaging said I would, but it wasn’t anything bad. Until about 30 minutes later. I was sidelined severely by a terrible burning sensation in my stomach that left me almost completely incapacitated for about 10 minutes. Some cold water eventually helped to ease the pain, and within another 15 minutes or so I was fine again. I panicked a little, thinking perhaps the spices had eaten through my stomach or aggravated an ulcer I didn’t know I had. But a few years ago I had a similar (though far less intense) pain from a particularly powerful chili pepper I ate, so I figured it was basically the same reaction this time and it would pass before long.

Blessedly, it did. I was able to sleep without any other side effects and, other than a slight tenderness in my stomach today, I appear to be fine.

This challenge is not for the faint of heart. Visit the web site to see different reactions from customers. I have a good tolerance for heat and rarely find something uncomfortable, but this certainly was. Paqui doesn’t indicate what heat level the chip is, but the Carolina Reaper chili clocks in at 1.5 million on the Scoville scale (a typical jalapeno clocks in at 2500-10,000). So it’s a serious heat!

I’m glad I did it. That being said I feel no need to do it again. And I’ll probably let the small bag of Paqui Haunted Ghost Pepper chips lie untouched for a little while. I know it won’t be anywhere near what the One-Chip Challenge felt like, but still. I’ve had enough heat for the time being.

Cold Comfort

September 21, 2020

What a relief.

If a COVID vaccine in the United States turns out to be dangerous or unsafe, we know who we can blame. Dr. Anthony Fauci has assured MSNBC and the American public that if anything goes wrong with the vaccine process, he’ll take “the heat” for it and make sure we’re kept informed.

I’m sure he will. Whether he should or not is more complicated. But not as complicated as exactly what his taking “the heat” will actually accomplish. I assume at some level it means he’s willing to fall on his sword and resign in disgrace from his position if a vaccine is approved that turns out to be dangerous. Of course, with no long-term clinical studies ahead of time, it may well not be possible to know of potential problems with the vaccine until long after Dr. Fauci has either retired peaceably or even died.

If he has to retire because of the fallout of a bad vaccine roll-out, I have no doubt there are plenty of sympathetic individuals and companies who would be happy to ensure he doesn’t end up homeless in exchange for the relative luster of even a disgraced former immunology expert on their board.

Fauci might take some level of public blame, but that hardly means much. Especially since he’s not a political figure or a political appointee in any substantive manner. Not much comfort – not if you or your child or loved one is affected for life by unanticipated side effects of a vaccine. At the very worst, Fauci can rely on the passage of time and the dustbin of history to remove his name from common parlance and disparagement. But I guess that’s what those who might suffer side effects can count on as well. Nothing lasts forever, certainly not even life itself.

I’m not faulting Dr. Fauci or even MSNBC. This is political talk and it’s expected and perhaps has some place. But let’s be clear about the limitations of such talk. Having a scapegoat hopefully won’t be necessary. But if it is, nobody’s going to be very comforted by knowing who to point the finger at, no matter how willing that person is to be pointed at.

Words Matter

September 19, 2020

As I’ve tried to argue here repeatedly over the last 14 years (!), words matter. Language matters, and we need to pay attention to what is being said and how it’s being said.

For instance, for the first time I can remember, the flu is being called a pandemic. I don’t argue whether or not the flu qualifies as a pandemic. I’m pretty sure it does – it affects a good portion of the world (at least I assume it does – I think press coverage of world health issues is normally pretty light, and since the flu recurs every year, there has been little interest historically in talking about it unless it’s somehow more dangerous or otherwise distinctive) and it affects a good portion of the population (in the neighborhood of 19 million Americans annually (as opposed to the estimated 6.7 million cases of Coronavirus reported in the US after 6 months).

What I do question is the curious fact that this year, the flu is being called a pandemic. Most of the news stories I see using this terminology are fear-mongering, painting dire possible scenarios since COVID-19 is ongoing as flu season begins. The other common denominator in stories referring to the flu as a pandemic is the emphasis on getting the flu shot.

The overall impact is one of creating fear. Fear is a particularly useful emotion as it is very powerful and hard to resist. It’s also hard to live with over a prolonged period of time (like, say six months or more) without some debilitating psychological, social, spiritual and even physical side effects beginning to manifest in some people. In a situation where one is afraid, the urge to remove the source of fear somehow can become nearly overwhelming.

How do you remove fear of illness? With the flu, the insistence is not on proper rest or diet or hygiene or anything else – it’s almost exclusively on getting the flu shot. It’s not that these other things aren’t recommended, it’s just that you never hear about them. The only thing that appears in the news and media is the importance of getting the flu shot, despite the fact the flu vaccine at best has effectiveness rates of 60% and regularly (four times between 2014 and 2019) still clocks in at less than 40% effectiveness. Still, the answer to easing fears about the flu is to get vaccinated.

Likewise, much emphasis has been placed on a vaccine as the answer to our Coronavirus fears. Certainly, government mandated social distancing and mask wearing is also emphasized, but particularly in the last month or two, the emphasis increasingly turns to vaccines and when they might be available. Part of this is due to the fact that like it or not, most people are resigned to the reality of masks and social distancing. There are mandated signs and other repeated emphases locally to reinforce these measures (though they are, at best, questionable as to the degree of their effectiveness).

So media decides to focus on the vaccine. As a political football (of course), and as the source to the end of our COVID-19 fears. Despite the fact there are nagging suspicions that immunity is short-lived (I’ve seen allegations of someone getting reinfected just a month after recovering from COVID-19. Other reports question anti-body likelihood after 12 months).

Vaccinations are the answer to our health fears. Health fears stoked in large part by incessant and uncontextualized media reporting. Big numbers provided in isolation from other numbers that might give them different meaning. Big numbers intended to create fear, and fear intended to be dealt with by recommended (and eventually, I’m sure, mandated) measures such as vaccinations.

Watch the language, folks. And watch what it does to you. I’m not saying there isn’t anything to be worried about. But what I am saying is the change in the way language is being used this year should be an equal source not just of curiosity but of concern and intrigue to you as well. Stay informed, but recognize that simply watching or reading the news is not enough to accomplish this.

Fear of Self and Others

September 18, 2020

Here’s an article that starts off interesting and wanders basically into a defense of wearing face masks during COVID-19. The initial part of the article is interesting, documenting scientific evidence of what common sense and cultural shifts should make clear to most anybody – human beings are communal creatures and as our contact with others (known or unknown) decreases, our well-being decreases.

Obviously COVID-19 has been a huge source of social isolation. Physical distancing might be helpful in reducing the transmission of the Coronavirus, but it’s definitely harmful in fostering a climate of fear, where anyone who gets to close or – God forbid! – sneezes or brushes against us leaves us feeling violated and endangered. The self-righteous pride some people take in shaming others they think are too close is chilling.

Masks also lead to isolation. Difficulty in reading facial expressions complicates even mundane and traditional interactions. Add to that the added difficulty of being heard and hearing others clearly through masks and another barrier to interaction arises. And for many places who rely not only on masks for both sides of the transaction but also those thin sheets of plastic between everyone? It’s barely possible to communicate a food order or a service request, let alone engage in a conversation.

Those most at risk of complications from COVID-19 are further isolated as assisted living facilities and senior care facilities exclude any access between residents and family members.

And even family members treat one another with distrust and fear these days, demanding COVID testing and other measures just to allow for a family visit. Certainly this is a time of extreme and unhealthy isolation. I won’t bother here whether or not such measures are necessary or useful for reducing transmission of the Coronavirus to some people – let’s assume they are. But let’s also admit and acknowledge they are most definitely detrimental to the psychological and emotional well-being of literally everyone.

But this is only the latest stage in an increasing isolation mentality in American culture. Studies long before COVID-19 indicated Americans were lonelier and reported feeling more isolated, despite a plethora a technological apps and programs that should enable us to be better and more frequently connected with all manner of family and friends. As our ability to connect with others has risen, there has been a corresponding decrease in the desire to do so.

The idea of stranger danger that arose in the 80’s has dominated our social awareness and perception of one another. As reporting news from distant locations became easier and cheaper, we perceived a rise in the number of child abductions. The fact that we were hearing about more of them in more locations contributed to this perception, even though statistical data eventually demonstrated there was no increase in the number of abductions (or rather child abductions were decreasing as a whole). Further data also demonstrated that contrary to the stranger danger mantra, which taught (and teaches still) children to be fearful and wary of anyone they don’t know, the vast majority of child abductions were not perpetrated by perverted ice cream truck drivers or other malevolent strangers but rather by trusted family members and friends of family – people the abducted child already knew.

But despite the data, the perception of strangers as a danger persists. We distrust others. We worry excessively about our children in a dangerous world where biking the street or walking to the store are now seen as worrisome activities. My generation wasn’t parented that way, and yet I suffer with a certain degree of anxiety about my children’s safety, despite knowing they need age-appropriate independence to stretch their wings and prepare them for lives as healthy adults.

This also causes ourselves to see ourselves through fearful eyes. We hesitate to reach out to strangers, fearful we will be perceived as a potential threat or danger, because that’s how we would view others – at least momentarily. The fear of being perceived or even called out as inappropriate or pervy or disconcerting pushes us back into our shells, keeps us a safe distance (whatever that means) from others and from life-changing interactions with people – just because we haven’t met them yet.

This is not accidental. As I’ve mentioned before, watching of The Twilight Zone series (or probably any mid-century television series) provides amazing glimpse of an American culture where the stranger was welcomed and indulged to an extent I find incredulous – even when that stranger exhibited odd behavior. No, our fear of others and our fear of ourselves in turn has been cultivated. And while the original intentions might have been good, there is considerably greater harm being done now than mere isolationism.

That fear of the other and the unknown is now be exploited for political ends. We are pitted us against them. We’re no longer Americans but rather ideological marionettes expected to leap and dance in anger and indignation at whatever strings are next tugged. We are expected to view anyone who doesn’t hold with our party not as another thoughtful citizen who might have some good reasons for their perspective, but as a threat and a danger to our way of life or to the well-being of a vague set of marginalized persons. And while good argument can be made we have always tended to do this in American politics (hence our two-party system, despite explicit warnings against such an arrangement by some of our Founding Fathers), the situation has reached a new level of vitriol because of our social isolation from one another and our inability and unwillingness to engage with someone we don’t know and who might disagree with us. Social media has only reinforced this echo chamber effect, further discouraging us from interacting not only with strangers, but with people we know, simply because they don’t agree with us.

We’re designed as social creatures, not simply evolved that way out of some sort of obscure, genetically-driven guide towards greater personal success. To deny both our need for connection to one another as well as our need for connection to the divine is to damage ourselves and by extension those around us. Extreme measures may be necessary for a time to protect against health emergencies and other threats, but the there’s a deeper level of isolation and estrangement that has been at work a lot longer than 2020. Rethinking our relation to the stranger is a good place to start in backtracking to a point that we can talk to not just strangers but people we know full well don’t agree with our parenting styles or our political choices or our belief (or lack thereof) in a higher power.

Food for Thought

September 14, 2020

I know there is no perfect system. But awareness of flaws in a system can help us improve it. Awareness of abuses in a system can help us fine tune it. Awareness of inefficiencies in a system can help us remember we’re likely paying for those inefficiencies, and maybe we should be more concerned about them.

Case in point.

Buyer Beware or Unaware?

August 19, 2020

One of those nagging little facts I retain for no particular reason is a phrase I learned in my high school economics class my senior year – caveat emptor. A Latin phrase which means let the buyer beware. The basic concept is that in any given transaction, the one handing over money for goods or services should beware to the best of their ability they are not being taken advantage of. This could be in purchasing a faulty product or not studying the terms of service carefully (a common problem these days when Terms and Conditions of products can be very lengthy and very small print!). If you aren’t careful about how you buy, you might be taken advantage of. Don’t simply trust blindly.

It’s an important concept, as it presumes the buyer is capable of being wary. That they have the requisite skills and understanding to make decisions regarding who they give their money to and in exchange for what. It was a fundamental, undergirding principle of our country for a long time, though I’m not so sure it is any longer.

Of course the buyer can’t possibly know everything. Laws have been created and passed to give buyers protections. Did that new big-screen TV not work out of the box like promised? The seller or the manufacturer or your credit card company – and likely all three – provide you with some level of protection from the reality that despite best intentions and through no deliberate attempt to defraud, goods and services don’t function the way they should.

That’s a far cry from assuming consumers are too stupid to know what they’re doing. But more and more, the assumption seems to be that consumers shouldn’t be held at all responsible for the decisions they make, and that experts should take that responsibility for them.

One example of this is in the field of health care and insurance. Since costs for health care and healthcare insurance continue to skyrocket (perhaps because the system is faulty?!?), and because more and more health insurance companies are covering procedures that are elective in nature and passing the costs on to others (gender change surgeries, abortions, etc.), it’s an important arena for consumers to be aware in. Sometimes it’s simply a matter of taking whatever your employer provides. Other times, you have options or choices, either through your employer or because you are self-employed. Even with your employer, there are usually various options and plans to select from a given provider, and so the consumer is still required to beware what they are purchasing or paying for is really what they want and need.

For seven years now my family has been a member of a health sharing ministry. This decision was made because of concerns of the changes in health insurance in terms of what they decided they would cover (and therefore what we would be helping to pay for), particularly in terms of abortions. We did our research, I talked with at least one person who had been a member for years already, and we read and reread the fine print. Samaritan Ministries did a good job then and now of clearly stating what we were and were not getting and what was and was not covered. We understood not everything was covered, and we understood that our membership and ability to submit needs for coverage was based on a shared set of Christian principles in terms of how we live our lives.

Had our health situations changed substantially (we’re all basically healthy), this might not have been a good option or an option we needed to leave behind. But we’ve so far not ever regretted the decision to move to Samaritan Ministries, and we genuinely feel good, knowing we are helping other Christians in their needs.

But, caveat emptor. And so when I saw this article pop up in a news feed the other day warning against such programs, I naturally read it. After all, regardless of how I feel about something, I want to be well informed.

Firstly, the article is primarily politically motivated, in opposition to a move by the Internal Revenue Service (IRS) to allow health sharing ministries to be considered a form of health insurance and therefore allowing participants to potentially claim their expenses as deductions on their taxes. The article perceived this as an attack on Obamacare (the Affordable Care Act) since it could entice more people to leave traditional health insurance plans and participate in health sharing ministries instead. This would reduce the number of healthy people paying into insurance plans and drive up insurance costs. The goal of the author is to protect the costs of those participating in health insurance plans, rather than to honestly evaluate whether there might be viable alternatives to such plans that could – using market forces – pause or reverse some of the spiraling costs of health care and health insurance. The author’s irritation that health sharing ministries are less expensive than many health insurance plans is palpable.

One particular critique is that health sharing ministries aren’t as comprehensive in their coverage. This is very true. There are many things our membership with Samaritan Ministries don’t cover. This is part of the appeal for us, in some ways, as we don’t want to be funding abortions if we can help it. In other ways, it does serve as a reinforcement to pay attention to our membership and potential needs. If we developed a health condition not covered by our membership, we’d need to evaluate whether we could remain members or not. Likewise, when I’ve been asked by others about our experience, I’ve emphasized that while it works for us, it may not work for everyone and they need to pay attention very carefully to the fine print.

Also as our needs have changed, I’ve been proactive in asking questions of Samaritan. When our oldest son left home for an internship a few weeks ago, I needed to ensure he was still considered part of our family plan, or else we’d need to help him get his own individual plan with Samaritan (or a different insurance plan if he decided to go that route). In all such communications Samaritan has been clear and forthright and prompt. Sometimes less coverage is exactly what you want, because you know you aren’t ever going to need some of the things that aren’t covered.

Yes, this means that someone with a pre-existing condition who opts for a health sharing ministry could end up with some substantial bills they need to pay on their own. That’s why they need to read the fine print very carefully. Yes, someone could simply see the lower monthly share amount and decide it was best to switch out of traditional health insurance to save some money on a monthly basis, and because they ignored the principle of caveat emptor, they could end up hurting themselves financially when things they assumed would be covered aren’t covered. This isn’t because the health sharing ministry is being dishonest or attempting to defraud people. Rather, it’s because health sharing ministries by default and design cover fewer things than traditional health insurance does. That’s not bad (at least it doesn’t have to be) but it does require paying attention to details.

Not that this keeps people from insulting health sharing ministries and, by extension, those who find them valuable.

The Los Angeles Times ran a rather bitter column on the topic of the proposed IRS changes. “Healthcare experts” are invoked nebulously as disapproving of health sharing ministries because of “substandard coverage”, ignoring the fact some such health sharing ministries are intentionally providing less coverage for certain things deemed necessary and essential by experts, such as abortions and elective surgeries for gender reassignment.

I’ll assume the columns assertions that sometimes these plans are marketed in less than honest ways might sometimes happen. Frankly, I don’t see many advertisements for these plans out there, but still, I’m sure it could conceivably happen. That doesn’t mean the plan or ministry itself is dishonest. Unless of course they’re deliberately misleading people, in which case they should be held accountable as any provider of goods or services should be – and not simply because they’re health sharing ministries.

Nineteen state attorney generals think the proposed IRS changes are illegal because of a lack of analysis of the outcomes, and because it could be damaging to existing health insurance markets. Why is it that we are guarding against potential competition in this market? Oh yeah, that’s right. Because this is a government mandated and controlled market to some extent now, and the government apparently didn’t consider the possibility of competition messing up the amazing numbers it used to convince our lawmakers to approve it. Gee. I guess we should just stick with the status quo despite there being potentially good alternatives that give the power and decision making back to the people rather than the government.

Because people apparently aren’t capable of being wary or informed in their decision making. So let’s just eliminate options for them. Much simpler. Very American. Not.

The author asserts that my health sharing ministry is offering me junk, and I’m stupid enough to buy it. While that’s always potentially true (even of insurance companies) my experience thus far is that this is not the case. To assert otherwise in such broad brushstrokes displays the very type of willful or unavoidable ignorance the author is accusing me of possessing and seeks to protect me from.

Unfortunate.

The New York Times weighed in as well with an emotional piece about a young boy with a tragic illness. The implication in the article is that this poor family is going to be ruined because they are members of a health sharing ministry instead of an insurance company. The article has multiple compelling photos of the young boy in various stages of health, and essentially paints the picture this family is being left out to dry by their health sharing ministry – Samaritan Ministries, the same one we use.

But nowhere is that specified in the article.

Instead, the severity of the boy’s situation and treatment and the likely costs of such treatment will likely exceed the cap on per incident issues. Ignoring the fact that Samaritan negotiates with healthcare providers for reduced charges because they will be paid via cash rather than having to jump through insurance hoops hoping for reimbursement. And despite the specific fact – mentioned but lost in the shuffle in the article – that Samaritan has a program specifically to help in such extreme situations. The boy’s family hasn’t been cheated or misled or anything, and there’s no certainty yet the bills will exceed the incident cap, or that Samaritan won’t cover up to the cap, and that there may not be additional funds to help them.

But just the possibility that there could be a problem is enough to justify the attack article. Despite the fact the father defends Samaritan in terms of previous issues they’ve submitted for coverage. Still not good enough.

So, after reading these various articles, I come back to to what my high school economics teacher, Mr. Conway, taught me. Caveat emptor. Know what you’re doing to the best of your ability. But also recognize you can’t know everything, and nothing is guaranteed. The authors of these various articles all give the common impression that health insurance coverage is guaranteed, yet I’m sure we all know someone who was told their coverage wouldn’t be as extensive as they were led to believe, or who were denied coverage for a particular issue.

The New York Times article mocks the company’s exhortation for members to trust in God. But that’s just what it’s members do. Not simply a claim of Christian faith is required for membership but also reasonably verifiable evidence of regular church attendance. Members do trust God, and that’s part of the point of Samaritan Ministries – is faith not simply as a pleasant sounding mantra but something that guides the decisions we make and the money we spend and how we spend it.

I pray these authors never run up against the unpleasant truth that health insurance is not a guarantee of financial safety and security. And I pray they might reconsider whether deliberately opting for programs that don’t cover everything is the same thing as receiving “substandard” care, and whether the potential for misunderstanding is the same as duplicity.

Watch Lists

August 17, 2020

Governor Newsom of California introduced the idea of a county watchlist in mid-July as he ordered reimplementation of some of the restrictions placed on the state as a whole in mid-March at the start of the COVID-19 pandemic. In July, it was announced that rather than state-wide restrictions, restrictions would be on a county-by-county basis. The six criteria by which counties would be evaluated are:

  • Are more than 150 COVID-19 tests per day per 100,0000 residents being administered? If yes, this is bad. If no, this is good.
  • Are there more than 100 new cases reported per 100,000 residents over the past 14 days? If so, this is bad. If the numbers are lower, this is good.
  • Are there more than 25 new cases per 100,000 residents, or more than an 8% positivity rate on on tests administered? No is good, yes is bad.
  • Has there been a 10% or greater increase in COVID-19 hospitalized patients over the past three days? No is good, yes is bad.
  • Are Intensive Care Units at 80% capacity or more? Yes is bad, no is good.
  • Are 75% or more of available ventilators being utilized? No is good, yes is bad.

Some of these criteria seem straightforward and others are somewhat nebulous. How many ventilators does my county have? How many could it obtain if needed? Who determines how many tests are administered and on what basis? My county is currently administering more than 200 tests per day on average, as of yesterday. Who decides that and on what basis? The other area of failure for my county is the cases reported per 100,000 residents a day. We’re at ~150 new cases per 100,000.

But what does this mean? Are there more than 150 new cases of active COVID-19 cases being discovered per day? Again, according the data provided on a daily basis from our County Public Health Department, no. Tests are administered, large numbers of cases are added to the reported total, but the number of actively infected people has remained constant or decreased since mid-July. Here are the numbers of ACTIVE COVID-19 CASES in our county, as gleaned from the e-mails Public Health sends out:

  • July 15 – 334
  • July 16 – 414
  • July 17 – 401
  • July 20 – 274
  • July 21 – 295
  • July 22 – 350
  • July 23 – 361
  • July 24 – 369
  • July 27 – 308
  • July 28 – 333
  • July 30 – 290
  • July 31 – 249
  • August 4 – 227
  • August 6 – 205
  • August 7 – 198
  • August 10 – 306
  • August 12 – 310
  • August 14 – 290
  • August 17 – 278

Our County reached a peak level of infections in late July, and has remained consistently well below that peak ever since, despite a slight spike the second week of August. An average rate of 304 cases per provided data point from the County. The State of California claims our infection rate per 100,000 residents is just over 150. But that apparently is a measure of all positive test results rather than active, current infections. Why this is the measure I don’t understand, frankly, other than that it’s an attempt to mitigate obvious errors in reporting and other mistakes human beings make all the time, and which California in particular has had a good share of in the past few months, culminating in the resignation of the state’s highest public health official.

Still problematic to me that you would shutter entire industries, curtail Constitutional rights all for an infection that on average over the last month has affected roughly 7% of our county population and resulted in only 80 deaths over the past five months.

What Are We Emphasizing?

July 27, 2020

On Friday I blogged about curious aspects of COVID-19 numbers are local City and County updates provide. Primarily, the issue that the number of reported cases is not the same as the number of new cases or even current, active cases where a person still has the Coronavirus and could be contagious. What is emphasized in the reporting are the number of reported new cases – many of which appear to be from weeks ago because the person is no longer considered infectious.

Here’s a Monday update, with two things to note.

First, in Monday’s e-mail, there was a new explanatory note included defining active cases – a number always reported but never emphasized – as cases that are still infectious. Frankly this is the number we need to be emphasizing. Highlighting large numbers of potentially positive test results that are no longer infectious only confuses the issue, keeps people fearful, and muddies the waters in terms of what is the current risk. This is what most people (rightfully) care about – what is my current risk of contracting COVID-19 based on the number of known infected people in my area.

Between the weekend (183 new reported cases) and Monday (77 new reported cases) there were 260 new reported cases. However the number of active cases – where people are considered to still have the Coronavirus active in their systems and therefore are potentially infectious to others – decreased from 361 on Thursday/Friday to 308. That’s a 14% drop rate in current infections! You’d think that would be cause for celebration but you certainly don’t hear this statistic touted in news articles.

The only local news article reported how the number of cases and hospitalizations have increased while the number of deaths and hospitalizations requiring intensive care unit care have declined. In other words, the impression is given there are more people who are sick or getting sick, but they are not as severely affected. Since they don’t provide us with a level of detail that includes when the various reported cases were actually tested, all we can conclude reasonably is that more people were sick than we realized, but that wasn’t really too big a deal because the vast majority of them got better without requiring hospitalization. Again, demonstrating that the Coronavirus – while still a risk to the elderly and those with underlying health issues – is by and large not nearly as lethal as we initially thought back in the spring.

Don’t just read the numbers, think about them and draw your own conclusions. I’d be interested to know what the data says to you.

What Are We Testing?

July 24, 2020

I continue to lament the difficulty of interpreting the Coronavirus/COVID-19 data pushed at us on a daily basis whether through the media or through government sources of one sort or another. Numbers without context are unhelpful at best, dangerous worst.

Case in point – daily updates on new COVID-19 positive tests in our county.

On nearly a daily basis I receive an e-mail from our city detailing the number of new cases of COVID-19 reported. Presumably through testing. The source of this data is our county public health office, and the news of late has been dire. If you only look at the headline of each e-mail, the very clear and terrible information communicated is that we have 100+ cases of Coronavirus detected in our county on a daily basis.

A compilation of the data communicated just for the last two weeks:

  • July 13 – 56 “new confirmed cases of COVID-19” in our county
  • July 14 – 184 “new confirmed cases of COVID-19” in our county
  • July 15 – 89 “new confirmed cases of COVID-19” in our county
  • July 16 – 224 “new confirmed cases of COVID-19” in our county
  • July 17 – 137 “new confirmed cases of COVID-19” in our county
  • July 20 – 85 “new confirmed cases of COVID-19” in our county
  • July 21 – 135 “new confirmed cases of COVID-19” in our county
  • July 22 – 160 “new confirmed cases of COVID-19” in our county
  • July 23 – 162 “new confirmed cases of COVID-19” in our county

Add these up and one would logically conclude that, as per the e-mail title, there are 1232 new cases of COVID-19 in our county. That’s a big number. Our county population per 2019 census data is 446,499 people. Which means that .00276 percent of our county is infected. That sounds like a much smaller number, but of course small numbers can be very dangerous if we’re dealing with a highly infectious and deadly virus.

I won’t go into a discussion on whether that’s actually the case or not.

And I’ll ignore that the VAST majority of these confirmed new cases occur roughly 65 miles away in the north end of our county. So our city is roughly 65 miles away from the real problem area for our entire county, yet our city is subject to the same restrictions as this infection epicenter. Despite the fact that our city is only 95 miles from the center of Los Angeles, a distance that traverses another entire county. Since the governor’s current lockdown orders are on a county-by-county basis, it means we’re affected by happenings 65 miles away in our own county, where we wouldn’t be affected by happenings just a little farther away in one of the largest metropolitan areas in the United States.

I’ll ignore that for now. Grudgingly.

The e-mail headlines add up to 1232 new cases of COVID-19 in the last two weeks. That sounds like good reason to panic. But then you open up the e-mail.

The first thing we’re then told is that the county is reporting this number of new cases. Reporting is different than being. Reporting is at least one step removed from the actuality of an infection, because reporting may or may not happen in real-time with the infection. Do the reporting numbers only include tests from this particular day? Could tests from previous days be reported now because they’ve only just had time to process the tests or only just now been able to add those numbers into the mix? We aren’t clear here. A certain number are being reported on this day but there’s no indication that means that certain number were discovered on this day. It’s possible that positive test results are being included from tests conducted at some point in the past.

And it immediately becomes clear this must be the case. Because our county’s current total of confirmed cases is 5,444 since the outbreak began in March. But the number of recovered cases is 5,051. Which means that, taking into account the 32 actual deaths in our county attributed to COVID-19, there are only 361 active cases at the moment. And 162 of those active cases are being reported on this day.

What?

If 1232 cases of COVID-19 have been reported in less than the last two weeks, how can there only be 361 active cases at the moment? And if there were 162 new cases reported yesterday, which are part of those 361 active cases, how could it be that on Tuesday there were allegedly 350 active cases?

The only way that’s possible is if the reported numbers are for cases that were tested so far back that the people have already recovered and are no longer considered active. Indeed, we’re told in the e-mail that 93% of those infected have fully recovered.

So while the e-mail claims it is reporting new, confirmed cases of COVID-19, we need to be cautious in distinguishing this from new, active cases of COVID-19, as that clearly can’t be the case. Apparently, from yesterday to today, despite there being 161 new cases reported, there are really only 11 new active cases. And since there are no new fatalities being reported, it means that of the 161 new cases being reported, 150 of those folks have already recovered. They aren’t currently infected.

I’m not a math major by far, but I think my logic and my arithmetic is good so far. Please point out to me if that’s not the case, or if I’m drawing inappropriate or faulty conclusions from the calculations!

Now let’s just focus on the two reports for 7/22 and 7/23.

On 7/22 I was informed by the city, from the county public health office, that:

  • There were 160 new cases of COVID-19 being reported for the day
  • Two previously reported cases were found to be duplicates and removed from the numbers about to follow
  • There were 5282 positive cases of COVID-19 to date in our county
  • Of these 5282 positive cases, 4900 have already recovered and are no longer active cases
  • There are currently 350 active cases of COVID-19 in our county
  • 160 new cases are included in that 350 number of active cases (this would be the logical, simplest way to interpret this information)
  • 32 people have died thus far
  • 85 people are currently (I believe) hospitalized for COVID-19 related issues
  • 29 of those hospitalized people are in ICU

When I go through those numbers, things appear to add up. Total positive cases to date are 5282, which equals the 4900 recovered folks plus the 350 current active cases and the 32 fatalities. Of the 350 people actively infected at the moment 114 of them are currently hospitalized.

On 7/23 I was informed by the city, from the county public health office that:

  • There were 162 new cases of COVID-19 being reported for the day
  • There were 5444 positive cases of COVID-19 to date in our county (5282 from the previous day’s totals plus the 162 now being reported)
  • Of these 5444 positive cases 5051 are fully recovered and not active cases any longer. The previous day there were 4900 recovered cases noted.
  • There are 361 currently active cases of COVID-19 in the county. The day before there were 350 active cases. Which means that of the 162 new cases reported today, only 11 are active cases. The other 150 reported cases are earlier cases where the person is already recovered
  • There are 86 people now in ICU (up one from the day before)
  • There are 27 people hospitalized in total for COVID-19 related issues, down two from the day before

None of this interpretation is provided or highlighted or summarized in the e-mails. I’d like to better understand how it is our whole county is under lockdown and my parishioners are prohibited from gathering to worship when there are, in reality, only 11 new active cases of COVID-19 reported in our county in a 24 hour period.

Pay attention to the details. Don’t assume that what you’re being given means what you think it means. Look through the data with other people and try to make sense of it. You might be surprised at the picture you arrive at compared to the picture painted for you just through headlines or selected numbers.