Post #953: I emailed my Senators and my Congressman

I’m not going to give directions in how to email your own Senator or Member of Congress.  All of them have email forms that you can use, and it’s easy enough to find them via Google.

Instead, this is the content of what I have sent to Senators Warner and Kaine,  and Congressman Connolly, regarding using Medicare to supply N95 masks (respirators) to the elderly.

As I understand it, the trick is to make it clear what you are asking for, up front.  You are trying to get the attention of the low-paid staff member who will actually be reading this.  Even so, unless they get a flood of letters asking for the same thing, this will likely do little more than add +1 to their count of messages about coronavirus.

That said, you have to try.  So here goes.

Dear Senator Warner:

In this email, I lay out the reasons why the Federal government should supply N95 masks (respirators) to the elderly via the Medicare program.  And I ask that you introduce legislation to make this happen.

You already know that N95 masks (respirators) provide substantially better protection against COVID-19 than cloth masks or surgical/procedure masks.  And that the elderly are at much higher risk of adverse outcomes.

But U.S. citizens cannot obtain N95 masks.  Those were pulled from all normal retail channels during the acute shortage of N95 masks in early 2020.  And now, even though there is no longer a shortage of N95 masks, those are still being withheld from retail sale.

The Federal government already has the infrastructure to get those effective N95 masks into the hands of the elderly.  Both Medicare Part B and Part D routinely deliver monthly supplies (DME and drugs) by mail to tens millions of Medicare beneficiaries.  It would be no strain on the system to deliver (say) three N95 masks per month to every enrollee who wanted them.

To do this, those masks would have to be a covered benefit under Medicare.  That would likely require legislation.  And doing so in a timely fashion would require allowing Medicare to skip parts of the Administrative Procedures Act. Which again would require legislation.

Hence this letter, because this can’t be done without Congressional action.

In the current climate, mask use is one of the things that strongly and visibly separates Democrats and Republicans.  It’s one thing to say “wear a mask”.  It’s a different thing entirely to go to the effort and expense to provide the most vulnerable segment of the U.S. population with an effective mask.  And that means an N95 respirator, via Medicare.

Finally, I note that Germany has already done this.  On 12/15/2020, they instituted a program to provide high-filtration respirators to every person 60 or older.  If the Germans have figured this out, surely we can too.

Sincerely,

 

Post #952: Month-and-a-half left to prepare for the B.1.1.7 British variant of COVID.

Above:  States where the new British B.1.1.7 COVID-19 variant has been detected as of 1/15/2021

Source:   Google search.

There is now a new, more easily spread variant of the COVID virus, first detected in the area around London.  Over the course of about three months, it has out-competed other variants to be come the dominant strain in and around London.  The higher transmission rate for this new virus resulted in rapid increase in cases and sent the Brits into another strict lockdown.  That lockdown now appears to be working, in terms of reducing new cases per day.

That COVID 19 variant is loose in the U.S. and elsewhere in the world.  Near as I can tell, there is no hard information available on how prevalent it is.  All we can do at this point is count the number of states that have announced that it is present in their populations.

The best guess is that this will follow the same course as it did in Britain, and so this will become the dominant strain of COVID-19 in the U.S. sometime this spring.  You can see news reporting to that effect in this articleOr this article.  But they’re making their guesses the same way I am — based on what occurred in Britain.

The consensus is that this new, more infectious strain will become the dominant U.S. strain by March.  So, we have maybe another month-and-a-half or so to get ready for that.

What this means is that if we merely maintain our current COVID-19 hygiene, we’ll see more daily infections.  All other things being equal.  So unless we are well onto the downslope toward herd immunity, we just have to anticipate more stringent measures against COVID-19 spread, a couple of months from now.

As an aside, the more we do other than shutting down commercial establishments, the less we will have to shut down commercial establishments to keep this new variant in check.  Which is why the whole mask-resistance movement makes no sense, unless your point is to inflict as much damage on the U.S. as possible.  I’d rather buy and wear a good mask than (e.g.) have all the movie theaters in the U.S. go bankrupt.  People who rail against masks and against commercial restrictions are simply confused.

The U.S. doesn’t do much to try to find these variants.  The US CDC sequences just 750 virus samples per week, and has now contracted with private labs to sequence another 1750 per week (per this CDC web page).  The CDC is also helping states pay for genetic sequencing of virus samples, but it’s not clear how many samples are sequenced by the states themselves.  That said, overall, the overall impression is that only the tiniest fraction of samples are tested for genetic variants, and so it’s a good guess that the new British (B.1.1.7) is more widespread than we currently know.

The only information we have about prevalence of the new strain is a count of the number of states where this had been identified, at least once, by genetic sequencing.  Which is, per the prior paragraph, almost certainly an undercount of even that crude measure of prevalence.

This new variant was first detected in Colorado in the U.S. (documented in Post #932, 12/20/2020).  Last time I looked (Post #943, 1/9/2020), it was present in eight states.

So it’s time to scan the news and update the count.  After searching Google News for about half an hour, I think I have all the states where it has positively been identified.  So, at present, we’re up to 14 states.  As shown at the top of this posting.

Post #951: Brief trends update

Source data for all graphs:  NY Times Github COVID data repository.  Graphs show data reported through 1/13/2021.

First, a little flattening of the curve?

Second, ND is now sole owner of second place.  Only Hawaii has a lower rate of new cases / 100,000 / day.  As goes ND, so goes the nation.  We hope. Continue reading Post #951: Brief trends update

Post #950: The mask question goes mainstream.

The above is the title of an article from yesterday’s Atlantic.  My wife just forwarded it to me with the comment that this is what I wrote about last week.  But in fact, it touches on things I’ve been writing about for months.

First, note the sub-head:  Cloth masks are better than nothing.  That pretty much sums it up for me.  Ditto for those cheap disposable blue ear-loop surgical masks.

It’s a short article.  You should take a couple of minutes to read it.  There’s almost nothing there that you haven’t read here over the past few weeks.  But it’s heartening to see this in mainstream media. 

And I think it’s worth reiterating the high points.  Which I’m now going to do by copying extensively from that article.  And then maybe use this as an excuse to put together links to my relevant postings on masks, as a separate post.

The author of the Atlantic article doesn’t go on to what I now see as the obvious policy implication:  Supply N95 respirators to the elderly via the Medicare program. 

I think people will eventually get around to that.  You just have to ask whether the pandemic will be over before we finally get our act together on masks. Continue reading Post #950: The mask question goes mainstream.

Post #949: Insurance coverage of masks.

This is a brief note on a rather silly Washington Post article.  The article is here.

The Post article raises an important point:   Why doesn’t your insurance (or your health savings account or flexible spending account) cover the cost of your masks?

The reason I call it silly is that the cost of masks is trivial, as health care expenses go.  It’s hard to think of a legit health care expense that can be measured by dollars in the single digits.  So it didn’t really catch my eye for that.

It caught my eye because I’d just finished writing a post on the German health care system and provision of N95 masks (Post #945).  There, the government is not just providing masks via their insurance plans, it’s providing FFP2 (equivalent to N94) masks. Continue reading Post #949: Insurance coverage of masks.

Post #948: COVID trends through 1/12/2021

Source:  Calculated from NY Times Githib COVID data repository.  All graphs below have the same data source.  Thick blue line is the U.S. average.  Dotted red line is my guess as to trend.  The dips in the blue line are true reductions in reported cases during/following the holidays, as discussed in Post #929.

This post is something of a catch-up.  It’s about current trends, and about the post-Christmas surge.  Which, you might notice, you aren’t reading much about, currently.  And it’s about correcting some recent errors I made.

First, some clean ups. The following posts were wrong:
Continue reading Post #948: COVID trends through 1/12/2021

Post #947: COVID trends through 1/12/2021. Is North Dakota the bellwether?

Source: Calculated from NY Times Github COVID data repository.  Data reported through 1/12/2021.

North Dakota now has the second-lowest rate of new COVID-19 cases in the country.  (Well, maybe third — they are tied with Vermont, rounded to the nearest whole number.)  Only Hawaii has a materially lower rate. Continue reading Post #947: COVID trends through 1/12/2021. Is North Dakota the bellwether?

Post #946: A billion here, a billion there, and pretty soon you’re talking real money.

Image source:  The Dismal Science, A Novel, by Peter Mountford, via Amazon.com

The stimulus fairy came by last week and left $1200 under my pillow. 

I was surprised.  I don’t think of my self as needing stimulus.  Not of that sort, anyway.  And I didn’t get in on the first round of COVID stimulus, because at that time I was still working and had some income.

But now that I’m retired and a drain on society?  Hey presto, free money.

Of course, to an economist, “free” is a four-letter word.  In keeping with The Dismal Science, I immediately began working out all the downsides of that transaction.

And so, after sloughing off that charity payment to an actual charity, I whipped up a batch of hot chocolate.  I sat by my wood stove and put my feet up.  And settled in for a nice, relaxing reading of the Congressional Budget Office Monthly Budget Review, starting with October 2020 edition (for the fiscal year ending 9/30/2020).  With a side order of National Income and Product Accounts data, courtesy of the Bureau of Economic Analysis.

And so this is a post about the COVID stimulus payments, GDP, and why there ought to be better means testing for COVID stimulus money. Continue reading Post #946: A billion here, a billion there, and pretty soon you’re talking real money.

Post #945: Masks, part III: The Germans have the good sense to issue N95s. Medicare should copy.

I have heard it said that whatever bright idea you have, somebody’s already had it, and posted it on the internet.  Twice.

And so it goes with the idea of having the government issue N95 masks to the general public (Post #942).   Based on the recent JAMA-published mask test, use of an N95 respirator results in a roughly 14-fold reduction in virus exposure relative to a typical procedure (surgical) mask or cloth mask.   My guess is, use of N95 respirators in place of cloth or disposable surgical masks is the single most effective step that could be taken to reduce the population’s exposure to cornavirus.

Seems like a no-brainer to me.

Turns out, this idea has not gone unnoticed.  Outside of the U.S. Continue reading Post #945: Masks, part III: The Germans have the good sense to issue N95s. Medicare should copy.

Post #944: Last of the holiday data anomalies

Data through 1/9/2021.

I thought we were past all the data reporting artifacts associated with holidays, but that wasn’t true.  This most recent little “hook” on the trends for many states related back to January 1/January 2.  A lot of states reported zero for January 1, and then reported two days’ worth of counts on January 2.  The most recent seven-day moving average starts with January 3, and so is finally beyond that.  With any luck, there will be no more artifacts in the data.

The fact remains that new case counts in most states are trending modestly upward.  Five geographically-diverse states now have more than 100 new cases/ 100,000/ day:

  • CA
  • AZ
  • UT
  • OK
  • SC
  • RI

But in general, where the first and second waves were marked by growing case rates in a few areas, at present, what’s driving the US total upward is a broad-based steady growth across almost all the states.  That’s clearly visible in the upward slant of the tangle of lines at the right edge of the first graph above.