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Javier E

The Urgent Case for Shrinking the Economy | The New Republic - 0 views

  • A classic example of this dynamic is the advent of the chain saw. A person with a chain saw can cut 10 times as many trees in the same time as a person using older methods. Logging companies did not use this invention, however, to shorten the workweek by 90 percent. They used it to cut 10 times more trees than they otherwise would have. “Lashed by the growth imperative, technology is used not to do the same amount of stuff in less time, but rather to do more stuff in the same amount of time,”
  • The problem, Hickel argues, is explained by the “paradox” first observed by the nineteenth-century economist William Stanley Jevons: In a growth system, gains in efficiency do not translate to higher wages, greater equality, more leisure, or lower emissions; they are plowed right back into the growth cycle
  • Increasing outputs of wind, solar, and other renewables are not leading to a drop in the use of fossil fuels. Instead, renewables and fossil fuels are used to satisfy rising global energy demand. “New fuels aren’t replacing the older ones,” Hickel writes. “They are being added on top of them.”
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  • The economy that Hickel envisions would cease to pursue growth, green or otherwise. Materials and energy will still be consumed, and waste generated, but at much lower levels. All impacts on the natural world will be tethered to the question, “Growth for whom, and to what ends?” In place of an individualistic consumer economy, Hickel’s post-growth economy would direct itself toward the creation of public goods that allow the many to live well—mass transit, health care—rather than to keep a few in luxury.
  • A growing body of research reveals an inverse relationship between “happiness” and growth beyond a certain point.
  • In the rich countries, general contentment peaked in 1950, when GDP and real per capita incomes were fractions of their present size (and inequality near modern historic lows); degrowthers posit that similar happiness levels will be reclaimed on the way back down the economic mountain
  • Hickel describes a post-growth economy defined by stability and equality, and the freedom and leisure possible when the economy is no longer subservient to the god of growth
  • He estimates that the U.S. economy could be scaled down by as much as 65 percent while still improving the lives of its citizens. This includes the metric most often tied to celebrations of endless growth: life expectancy.
  • degrowth will entail a steep reduction across a much wider range of high-energy consumer goods. Keeping a global economy within safe ecological limits is a zero-sum game.
  • When limited resources are directed toward clean energy infrastructure, public health care, and regenerative agriculture, it will still be possible to build and power modern 24-hour hospitals in every city, but not to have Xbox consoles, two-car garages, and giant appliances in every home.
  • would have to redefine it, too.
  • The post-growth economy could not succeed solely by redistributing wealth; it would have to redefine it, too.
  • He argues that short-term growth would have to continue in those countries that have still not achieved the basic levels of sanitation, infrastructure, and education needed for a decent standard of living, to close the gap. Their larger goal, meanwhile, would be to break free from their historical role as a source of natural resources and cheap labor for the north.
  • For degrowth to be just, global, and effective, the sharpest reduction in consumption will have to come from the north, where the greatest damage to the planet is currently being done
  • Ecological economists generally agree that the safe outer limit is eight tons
  • One person in a low-income country has a materials footprint of roughly two tons per year, a measure of total raw materials consumed, including those embodied in imports. In lower-middle–income countries, that number is four tons; in upper-middle–income countries, 12 tons. In the high-income nations of North America, Europe, and Asia, the number leaps to 28
  • The wealthiest 20 percent of the human population is responsible for 90 percent of “overshoot” carbon in the atmosphere (that is, a level of carbon that exceeds the limit needed to keep global temperature rise below 2 degrees Celsius)
  • The planet’s richest one percent has a carbon footprint twice the size of the poorest half of the world’s population combined
  • For the global north, degrowth not only starts at home, it starts with the biggest houses.
  • Less Is More doesn’t end in a poetic appreciation for nature’s majesty, but by teasing out its implications for the political project of preserving a habitable planet. Hickel devotes much of the book to explaining that degrowth must be central to this project, promising not just survival, but real democracy, social abundance, and liberation.
  • Both involve broad social shifts away from private consumption and toward the production of shared public goods.
  • This beautiful coincidence overlaps with policy programs like the Green New Deal in important way
  • In July 1979, shortly after installing a set of solar panels over the West Wing, Jimmy Carter did something peculiar for a peacetime president. He asked Americans to sacrifice: to consume less, take public transit more, value community over material things, and buy bonds to fund domestic energy development, including solar
  • Next to Schumacher’s “Buddhist economics,” Debsian socialism was reformist tinkering. Schumacher didn’t see liberation as a matter of reshuffling the ownership and management structures of the smokestack-powered growth economy. He believed a deeper transformation was needed to maintain a livable planet. This would require new socioecological blueprints “designed for permanence.” As the left and the right battled for control over growth’s levers and spoils, Schumacher pointed out how both had become blind to the rise of growth as its own self-justifying, pan-ideological religion; its patterns of production and consumption, he observed, required “a degree of violence” that did not “fit into the laws of the universe.”
  • They determined that infinite growth was, in fact, impossible on a finite planet. Barring a major course correction, the team projected, growthism would result in an ecological systems breakdown sometime in the middle of the twenty-first century
  • This warning, detailed in the 1972 bestseller The Limits to Growth, has aged better than the scorn heaped on it
  • We are now witnessing what appears to be the beginnings of the collapse predicted nearly 50 years ago
  • In his new book, Less Is More, Jason Hickel, an anthropologist and journalist, attempts to bring a comprehensive critique of growth closer to the center of the conversation, arguing through a sweeping history of capitalism that it’s uncontrolled growth, not its controlled arrest and reversal, that is the preposterous concept.
  • This economic and political revolution was reinforced by a complementary scientific one that displaced the lingering animist cosmology of pre-capitalist Europe. The dualism of Francis Bacon and Descartes held reason to be distinct from and superior to matter.
  • The idea of limitless growth is a relatively recent one. In Less Is More, Hickel traces its origins to the enclosure of the European commons in the sixteenth century
  • Starving refugees were scattered and forced into a new economy defined by neo-feudal servitude and wage labor. Landowners, meanwhile, began amassing great stores of surplus wealth.
  • By the mid-1800s, a new “science” had arisen from these assumptions. Neoclassical economics fully abstracted the economy from the natural world. The economy was geared not toward the creation of a happy and prosperous society, but toward the perpetual growth of wealth as its own end, achieved in an inherently virtuous cycle of converting labor and resources into capital, to be accumulated and reinvested in faster and more productive conversions of labor and resources
  • This ideology subsumed and profaned notions about progress and morality held by the classical economists, until eventually the field even l
  • This process unfolded despite repeated warnings along the way. Classical economists like John Stuart Mill and, to a lesser extent, Adam Smith not only acknowledged the existence of natural limits to growth, but saw economic development as a phase; at some point, they believed, nations would create enough wealth to pursue other definitions of progres
  • the caveats issued by Simon Kuznets, father of the concept adopted in the twentieth century as growth’s universal and signature metric: gross domestic product. Kuznets, Hickel points out, “warned that we should never use GDP as a normal measure of economic progress,” because GDP does not distinguish between productive and destructive behavior
  • Most people encounter the growth debate, if they encounter it at all, through the idea of “green growth.
  • This is a vision for our collective future based on the belief that technological advance will drastically reduce the amount of raw materials needed to sustain growth—a process known as dematerialization—and “decouple” growing GDP from its ecological impacts.
  • boosters of the idea point to the transition by rich countries from manufacturing to service-based economies, as well as efficiency gains in energy and in the use of materials
  • The belief that green growth will save us, also known as “ecomodernism” or “ecopragmatism,” has become a trendy article of faith among elites who acknowledge climate change and the dangers of breaching ecological boundaries
  • n 2017, Barack Obama threw his support behind the idea in an article for Science magazine, maintaining that signs of decoupling in major economies “should put to rest the argument that combatting climate change requires accepting lower growth or a lower standard of living.”
  • The argument that capitalism can grow itself out of the present crisis may be soothing to those who like the world as it is. It also relies on the kind of accounting tricks and rejection of reality
  • By only counting the emissions created within a country that imports most of its cars, washing machines, and computers, you end up pushing the emissions related to their production off the books. When you factor them back in, the picture is much less green. A number of recent studies show no evidence of meaningful decoupling—in energy or materials—even as the world increases its use of renewable energy and finds ways to use some materials more efficiently.
  • Green growth, Hickel concludes, is an ecologically incoherent “fairy tale.”
  • consider what the ecomodernist position asks us to believe. The current system requires annual growth of roughly 3 percent to avoid the shock of recession. This means doubling the size of the economy every 23 years
  • he economy of 2000 must be 20 times larger in the year 2100, and 370 times larger in the year 2200.
  • Hickel is less interested in the macroeconomic details of this future than are growth critics based in economics departments, like Tim Jackson and Kate Raworth, and more focused on the leisure, security, and general human flourish
  • he makes an alluring case that degrowth does not require anything like the “command-and-control fiasco of the Soviet Union, or some back-to-the-caves, hair-shirted disaster of voluntary impoverishment.”
  • Attaining the benefits of the post-growth economy would, however, require what the present consumer society considers “sacrifices.
  • it’s not clear how many of them are ready to give up its superficial pleasures enabled by consumer debt
  • Among nations, there’s also the question of fairness: Wouldn’t it be unjust to impose degrowth across the world, when it’s disproportionately the countries of the global north that have spent centuries burning through the planet’s resources?
  • This output tracks to the one percent’s share of global wealth—a number equal to the GDP of the bottom 169 countries.
  • Even if you accept the argument that inequality would be best addressed by more centuries of trickle-down growth, you keep running up against the simple fact of its impossibility. Even just one more century of growth—which so far has shown no sign of taking a less destructive form—will require multiple earths
  • Hickel is serious about bringing the system critiques of E.F. Schumacher and others out of their traditional cloisters and into the streets, and has sought allies in this effort
  • emphasize what Hickel calls the “beautiful coincidence” of degrowth: that “what we need to do to survive is the same as what we need to do to have better lives.”
  • Both are internationalist in outlook, and see the world through a lens of climate justice as well as climate equilibrium.
  • that is, communicating the many benefits of moving beyond the insecurity and terrors of the current system, and building a new society that is sustainable, stable, democratic, and fundamentally better in every way.
Javier E

Joseph Stiglitz: The problem with Europe is the euro | Business | The Guardian - 0 views

  • Advocates of the euro rightly argue that it was not just an economic project that sought to improve standards of living by increasing the efficiency of resource allocations, pursuing the principles of comparative advantage, enhancing competition, taking advantage of economies of scale and strengthening economic stability. More importantly, it was a political project; it was supposed to enhance the political integration of Europe, bringing the people and countries closer together and ensuring peaceful coexistence.
  • The euro has failed to achieve either of its two principal goals of prosperity and political integration: these goals are now more distant than they were before the creation of the eurozone. Instead of peace and harmony, European countries now view each other with distrust and anger. Old stereotypes are being revived as northern Europe decries the south as lazy and unreliable, and memories of Germany’s behaviour in the world wars are invoked.
  • A single currency entails a fixed exchange rate among the countries, and a single interest rate. Even if these are set to reflect the circumstances in the majority of member countries, given the economic diversity, there needs to be an array of institutions that can help those nations for which the policies are not well suited. Europe failed to create these institutions.
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  • It was not simply that the eurozone was not structured to accommodate Europe’s economic diversity; it was that the structure of the eurozone, its rules and regulations, were not designed to promote growth, employment and stability.
  • The founders of the euro were guided by a set of ideas and notions about how economies function that were fashionable at the time, but that were simply wrong. They had faith in markets, but lacked an understanding of the limitations of markets and what was required to make them work.
  • Market fundamentalists believed, for instance, that if only the government would ensure that inflation was low and stable, markets would ensure growth and prosperity for all. While in most of the world market fundamentalism has been discredited, especially in the aftermath of the 2008 global financial crisis, those beliefs survive and flourish within the eurozone’s dominant power, Germany. These beliefs are held with such conviction and certainty, immune to new contrary evidence, that they are rightly described as an ideology.
  • Germany is talked about as a “success” only by comparison with the other countries of the eurozone.
  • It is perhaps natural that the eurozone’s leaders want to blame the victim – to blame the countries in recession or depression or reeling from a referendum result – for bringing about this state of affairs. They do not want to blame themselves and the great institutions that they have helped create, and which they now head.
  • According to Juncker, Europe is not to be held together because of the benefits that accrue – benefits that far exceed the costs, the economic prosperity, the sense of solidarity, the pride in being a European. No, Europe is to be held together by threats and fear – of what would happen if a country leaves.
  • One of the first lessons of economics is that bygones are bygones. One should always ask: given where we are, what should we do? On both sides of the Channel, politics should be directed at understanding the underlying sources of anger; how, in a democracy, the political establishment could have done so little to address the concerns of so many citizens, and figuring out how to do that now: to create within each country, and through cross-border arrangements, a new, more democratic Europe, which sees its goal as improving the wellbeing of ordinary citizens
  • There are alternatives to the current arrangements that can create a true shared prosperity: the challenge is to learn from the past to create this new economics and politics of the future. The Brexit referendum was a shock. My hope is that the shock will set off waves on both sides of the Channel that will lead to this new, reformed European Union.
Javier E

Guernica / The Storytellers of Empire - 1 views

  • Hiroshima is a book about what happened in Japan, to Japan, in August 1945. It is a book about five Japanese and one German hibakusha, or bomb survivors. It is not a book which concerns itself with what the bombing meant for America in military terms, but rather what it meant for the people of Hiroshima in the most human terms.
  • Inevitably, it also contains within it two Americas. One is the America which develops and uses—not once, but twice—a weapon of a destructive capability which far outstrips anything that has come before, the America which decides what price some other country’s civilian population must pay for its victory. There is nothing particular to America in this—all nations in war behave in much the same way. But in the years between the bombing of Hiroshima and now, no nation has intervened militarily with as many different countries as America, and always on the other country’s soil; which is to say, no nation has treated as many other civilian populations as collateral damage as America while its own civilians stay well out of the arena of war. So that’s one of the Americas in Hiroshima—the America of brutal military power.
  • But there’s another America in the book, that of John Hersey. The America of looking at the destruction your nation has inflicted and telling it like it is. The America of stepping back and allowing someone else to tell their story through you because they have borne the tragedy and you have the power to bear witness to it. It is the America of The New Yorker of William Shawn, which, for the only time in its history, gave over an entire edition to a single article and kept its pages clear of its famed cartoons. It is the America which honored Hersey for his truth telling.
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  • How to reconcile these two Americas? I didn’t even try. It was a country I always looked at with one eye shut. With my left eye I saw the America of John Hersey; with my right eye I saw the America of the two atom bombs. This one-eyed seeing was easy enough from a distance. But then I came to America as an undergraduate and realized that with a few honorable exceptions, all of America looked at America with one eye shut.
  • I had grown up in a country with military rule; I had grown up, that is to say, with the understanding that the government of a nation is a vastly different thing than its people. The government of America was a ruthless and morally bankrupt entity; but the people of America, well, they were different, they were better. They didn’t think it was okay for America to talk democracy from one side of its mouth while heaping praise on totalitarian nightmares from the other side. They just didn’t know it was happening, not really, not in any way that made it real to them. For a while this sufficed. I grumbled a little about American insularity. But it was an affectionate grumble. All nations have their failings. As a Pakistani, who was I to cast stones from my brittle, blood-tipped glass house?
  • Then came September 11, and for a few seconds, it brought this question: why do they hate us?
  • It was asked not only about the men on the planes but also about those people in the world who didn’t fall over with weeping but instead were seen to remark that now America, too, knew what it felt like to be attacked. It was asked, and very quickly it was answered: they hate our freedoms. And just like that a door was closed and a large sign pasted onto it saying, “You’re Either With Us or Against Us.” Anyone who hammered on the door with mention of the words “foreign policy” was accused of justifying the murder of more than three thousand people.
  • I found myself looking to writers. Where were the novels that could be proffered to people who asked, “Why do they hate us?”, which is actually the question “Who are these people and what do they have to do with us?” No such novel, as far as I knew, had come from the post-Cold War generation of writers who started writing after the 1980s when Islam replaced Communism as the terrifying Other. But that would change, I told myself.
  • The writers would write. The novels would come. They didn’t. They haven’t.
  • So where are they, the American fiction writers—and I mean literary fiction—whose works are interested in the question “What do these people have to do with us?” and “What are we doing out there in the world?”
  • I grew up in Pakistan in the 1980s, aware that thinking about my country’s history and politics meant thinking about America’s history and politics. This is not an unusual position. Many countries of the world from Asia to South America exist, or have existed, as American client states, have seen U.S.-backed coups, faced American missiles or sanctions, seen their government’s policies on various matters dictated in Washington. America may not be an empire in the nineteenth century way which involved direct colonization. But the neo-imperialism of America was evident to me by the time I was an adolescent and able to understand these things.
  • why is it that the fiction writers of my generation are so little concerned with the history of their own nation once that history exits the fifty states. It’s not because of a lack of dramatic potential in those stories of America in the World; that much is clear.
  • The stories of America in the World rather than the World in America stubbornly remain the domain of nonfiction. Your soldiers will come to our lands, but your novelists won’t. The unmanned drone hovering over Pakistan, controlled by someone in Langley, is an apt metaphor for America’s imaginative engagement with my nation.
  • Where is the American writer who looks on his or her country with two eyes, one shaped by the experience of living here, the other filled with the sad knowledge of what this country looks like when it’s not at home. Where is the American writer who can tell you about the places your nation invades or manipulates, brings you into those stories and lets you draw breath with its characters?
  • why, when there are astonishing stories out in the world about America, to do with America, going straight to the heart of the question: who are these people and what do they have to do with us?—why are the fiction writers staying away from the stories? The answer, I think, comes from John Hersey. He said of novelists, “A writer is bound to have varying degrees of success, and I think that that is partly an issue of how central the burden of the story is to the author’s psyche.” And that’s the answer. Even now, you just don’t care very much about us. One eye remains closed. The pen, writing its deliberate sentences, is icy cold.
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    Asks why American fiction writers don't write stories about America's effect on countries where it has intervened.
julia rhodes

Other Nations Offer a Lesson to Egypt's Military Leaders - NYTimes.com - 0 views

  • Is the era of the military big man back?
  • The turmoil highlights the central role of the military in some postcolonial Muslim countries, where at least in the fitful early stages of democracy, it forcefully imposes itself as the self-appointed arbiter of power and the guardian of national identity.
  • But a look at other Muslim countries that have struggled with democratic transitions, including two other polestars of the Muslim world, Pakistan and Turkey, should provide a kind of warning to General Sisi.
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  • In Turkey, a court recently imprisoned dozens of senior military officers on charges of plotting to overthrow the government, a punitive reminder to a military once accustomed to reasserting its authority through coups.
  • Though General Sisi is riding a wave of popularity among some Egyptians and neighboring countries, notably Saudi Arabia and Israel, for cracking down on Islamists, the events in Turkey and Pakistan have shown the limits of military power.
  • Military and civilian leaders have been competing for power in Turkey, Pakistan and Egypt for decades. The military has exercised muscular influence in all three countries, openly or behind the scenes, because of weak civilian rule that can be traced to the foundation of the states — in some cases, in a bid to circumscribe Islamist influence.
  • Yet as all three countries climb the ladder toward functioning democracies, the effort is complicated by outside pressure, which often favors the military.
  • Pakistani, Turkish and Egyptian generals profess to love democracy, but they practice it with varying degrees of reluctance.
  • Instead, the military has deeply embedded itself in each state’s DNA, winning privileges and lucrative jobs for its officers, all the while controlling politics in blunt fashion. Pakistan’s generals have mounted four coups over the past 55 years; Turkey has had three. In both Pakistan and Egypt, analysts describe the military as the core of the “deep state.”
  • In all three countries, Islam is often seen as the boogeyman of democracy, Dr. Nasr said. “But that is wrong. The real struggle in the Middle East is between civilian rule and the military.”
  • For years, Turkey was the model of progress for many Muslim countries. But the military’s retreat has been driven, in part, by the country’s desire to join the European Union. And the gloss of civilian rule vanished in June when Prime Minister Recep Tayyip Erdogan violently suppressed a protest movement in central Istanbul, suggesting that one authoritarianism was being replaced with another. This month’s treason trial brought out sharp divisions between secularists and Islamists, underscoring how Turkey’s nation-building model remains a work in progress.
  • Egypt’s generals ousted the monarchy and established a republic in 1952. Turkey’s first president, Mustafa Kemal Ataturk, a military revolutionary, led a fierce secularization drive in the 1920s.
  • His support from Egyptian civic society could evaporate as revulsion grows at the bloodshed against Islamists and the military’s crackdown on other dissenters. If he alienates Western support, financing from the Middle East cannot sustain his country for very long. And, as events in Turkey and Pakistan have shown, the military’s eminence can endure only by strategically ceding space to civilian players — or the use of violent repression.
Javier E

The American Middle Class Is No Longer the World's Richest - NYTimes.com - 0 views

  • After-tax middle-class incomes in Canada — substantially behind in 2000 — now appear to be higher than in the United States
  • The poor in much of Europe earn more than poor Americans.
  • The struggles of the poor in the United States are even starker than those of the middle class. A family at the 20th percentile of the income distribution in this country makes significantly less money than a similar family in Canada, Sweden, Norway, Finland or the Netherlands. Thirty-five years ago, the reverse was true.
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  • the most commonly cited economic statistics — such as per capita gross domestic product — continue to show that the United States has maintained its lead as the world’s richest large country. But those numbers are averages, which do not capture the distribution of income.
  • Three broad factors appear to be driving much of the weak income performance in the United States. First, educational attainment in the United States has risen far more slowly than in much of the industrialized world over the last three decades, making it harder for the American economy to maintain its share of highly skilled, well-paying jobs.
  • technology skills that are above average relative to 55- to 65-year-olds in rest of the industrialized world
  • Younger Americans, though, are not keeping pace: Those between 16 and 24 rank near the bottom among rich countries, well behind their counterparts in Canada, Australia, Japan and Scandinavia
  • Finally, governments in Canada and Western Europe take more aggressive steps to raise the take-home pay of low- and middle-income households by redistributing income.
  • Whatever the causes, the stagnation of income has left many Americans dissatisfied with the state of the country. Only about 30 percent of people believe the country is headed in the right direction,
  • both opinion surveys and interviews suggest that the public mood in Canada and Northern Europe is less sour than in the United States today.
  • Elsewhere in Europe, economic growth has been slower in the last few years than in the United States, as the Continent has struggled to escape the financial crisis. But incomes for most families in Sweden and several other Northern European countries have still outpaced those in the United States, where much of the fruits of recent economic growth have flowed into corporate profits or top incomes.
  • Even in Germany, though, the poor have fared better than in the United States, where per capita income has declined between 2000 and 2010 at the 40th percentile, as well as at the 30th, 20th, 10th and 5th.
  • the poor in the United States have trailed their counterparts in at least a few other countries since the early 1980s. With slow income growth since then, the American poor now clearly trail the poor in several other rich countries. At the 20th percentile — where someone is making less than four-fifths of the population — income in both the Netherlands and Canada was 15 percent higher than income in the United States in 2010.
  • By contrast, Americans at the 95th percentile of the distribution — with $58,600 in after-tax per capita income, not including capital gains — still make 20 percent more than their counterparts in Canada, 26 percent more than those in Britain and 50 percent more than those in the Netherlands. For these well-off families, the United States still has easily the world’s most prosperous major economy.
Javier E

A Big Safety Net and Strong Job Market Can Coexist. Just Ask Scandinavia. - NYTimes.com - 0 views

  • It is a simple idea supported by both economic theory and most people’s intuition: If welfare benefits are generous and taxes high, fewer people will work. Why bother being industrious, after all, if you can get a check from the government for sitting around
  • The idea may be backward.
  • The United States and many other nations with relatively low taxes and a smaller social safety net actually have substantially lower rates of employment.
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  • Some of the highest employment rates in the advanced world are in places with the highest taxes and most generous welfare systems, namely Scandinavian countries.
  • In Scandinavian countries, working parents have the option of heavily subsidized child care. Leave policies make it easy for parents to take off work to care for a sick child. Heavily subsidized public transportation may make it easier for a person in a low-wage job to get to and from work. And free or inexpensive education may make it easier to get the training to move from the unemployment rolls to a job.
  • In short, more people may work when countries offer public services that directly make working easier, such as subsidized care for children and the old; generous sick leave policies; and cheap and accessible transportation. If the goal is to get more people working, what’s important about a social welfare plan may be more about what the money is spent on than how much is spent.
  • , it could mean that more direct aid to the working poor could help coax Americans into the labor force more effectively than the tax credits that have been a mainstay for compromise between Republicans and Democrats for the last generation.
  • In Denmark, someone who enters the labor force at an average salary loses 86 percent of earnings to a combination of taxes and lost eligibility for welfare benefits; that number is only 37 percent in the United States. Yet the percentage of Danes between the ages of 20 and 59 with a job is 10 percentage points higher than in the United States.
  • In the United States, the major policies aimed at helping the working poor are devised around tax subsidies that put more cash in people’s pockets so long as they work, most notably through the Earned-income tax credit and Child Tax Credit.
  • There is a solid correlation, by Mr. Kleven’s calculations, between what countries spend on employment subsidies — like child care, preschool and care for older adults — and what percentage of their working-age population is in the labor force.
  • Collectively, these policies and subsidies create flexibility such that a person on the fence between taking a job versus staying at home to care for children or parents may be more likely to take a job.
  • The employment subsidies Mr. Kleven cites surely help coax more Scandinavians into the work force, Mr. Greenstein agrees, but shouldn’t be viewed in isolation.
  • wages for entry-level work are much higher in the Nordic countries than in the United States, reflecting a higher minimum wage, stronger labor unions and cultural norms that lead to higher pay
  • There are countless differences between Northern European countries and the rest of the world beyond child care policies and the like. The Scandinavian countries may have cultures that encourage more people to work, especially women.
  • Every country has a mix of taxes, welfare benefits and policies to promote work that reflects its politics and culture. In the large, diverse United States, there is deep skepticism of social welfare programs and direct government spending, along with a greater commitment to keeping taxes low.
katyshannon

House passes visa waiver reform bill with strong bipartisan support - The Washington Post - 0 views

  • As Republicans squabbled over Donald Trump’s controversial proposal to bar all Muslims from traveling to the United States, the House on Tuesday overwhelmingly passed a bill imposing new restrictions on a visa waiver program that currently welcomes roughly 20 million people into the country each year.
  • The bill, which was approved on a 407 to 19 vote, would increase information sharing between the United States and the 38 countries whose passport-holders are allowed to visit the country without getting a visa, while also attempting to weed out travelers who have visited certain countries where they may have been radicalized.
  • The strong vote in the House could put momentum behind efforts to include changes to the program in the omnibus spending package – a must-pass bill that lawmakers are trying to finalize before government funding expires on Friday
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  • there are key differences between the House bill and a measure from Sens. Dianne Feinstein (D-Calif.) and Jeff Flake (R-Ariz.), which has not yet been scheduled for a vote.
  • House-passed measure received the backing of the U.S. Travel Association, despite initial concerns that Congress would go too far in tightening the waiver program’s security requirements following the Paris terror attacks.
  • The visa waiver program was launched in the 1980s as a way of boosting business travel and tourism to the United States and hundreds of millions of people have taken advantage of the initiative.
  • Democrats and Republicans have sparred over stepped-up security proposals made in the wake of the Paris and San Bernardino, Calif. terror attacks.
  • While an earlier vote to suspend Syrian and Iraqi refugee admissions “showed the country and this body at its worst,” said Rep. Zoe Lofgren (D-Calif.), the ranking member of the Judiciary Committee’s subcommittee on Immigration and Border Security, “Today’s bill makes sensible improvements to the security of the visa waiver program.”
  • The House and Senate bills would require countries participating in the waiver program to issue passports with embedded chips containing biometric data, report information about stolen passports to Interpol and share information about known or suspected terrorists with the United States.
  • The House measure also seeks to prevent Syrian and Iraqi nationals, as well as any passport holder of a waiver country who has traveled to Syria, Iraq, Iran or Sudan since March 1, 2011 – the start of the Syrian civil war – from taking advantage of the program. These individuals would instead be required to submit to the traditional visa approval process, which requires an in-person interview at a U.S. embassy or consulate.
  • The Senate bill would prevent individuals who traveled to Iraq or Syria from using the program for five years. Both bills give the Department of Homeland Security secretary the authority to take countries out of the waiver system.
Javier E

What did the men with Donald Trump do when he spoke of 'shithole countries'? - The Wash... - 0 views

  • These two incidents, in Baltimore and in the Oval Office, seem related — inhumane indifference from a hospital and blatant bigotry from the president
  • They are about who is on what side of the door, or the wall, or any other barrier that defines the primal “us and them” that governs so much of the worst of our human-made world. When Trump called disfavored countries “shitholes,” he was indulging the most lethal and persistent tribalism of all: pure, unabashed racism.
  • After a candidacy and now a presidency marked by implications of racism, the president has grown more comfortable with speaking in overtly racist terms, condemning whole countries and their people for not being more like “Norway,” one of the whitest countries on Earth.
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  • Rather, I weep because the training in moral and civic corruption has already begun, it will inevitably continue, and it is gathering speed. The attack is aimed at the very thing we think should preserve us, our instincts to be kind, to welcome, protect and provide.
  • I’ve seen it happen, once, when I was a young man, and I learned an invaluable lesson. An older guest at a formal dinner said something blatantly anti-Semitic. I was shocked and laughed nervously. Another friend stared at his plate silently. Another excused himself and fled to the bathroom. And then there was the professor, an accomplished and erudite man, who paused for a moment, then slammed his fist on the table and said, “I will never listen to that kind of language, so either you will leave, or I will leave.” The offender looked around the table, found no allies and left the gathering.
  • I weep, not because I doubt the goodness of most of the people among whom I live in this country. There must be more Imamu Barakas than Donald Trumps in this land.
  • What I want to know is how the men in the room with him reacted. This is the dinner table test: When you are sitting and socializing with a bigot, what do you do when he reveals his bigotry?
  • The use of terms like “shithole” imputes personal and moral failure to people who by mere chance live in troubled countries. It extinguishes their humanity and with it, any concern we might have for their well-being.
  • The hospital’s president, Mohan Suntha, has promised a full investigation and said, “We firmly believe what occurred Tuesday night does not reflect who we are.” Of course, what occurred defines who they are, though they may think they are better than that.
  • This is bureaucratic cant and drivel. Worse, it frames the problem in the wrong way. We already know we have a medical system that incentivizes dumping poor patients, excluding the uninsured and pushing intractable cases out the door.
  • What matters more is the moral climate of the institution. Who made it possible, necessary and apparently easy for those security guards to “just do our jobs”? Who made complicity in cruelty part of the daily function of the place?
  • And now, we must ask a few simple questions of the men who sat in the room with a president denigrating predominantly black and brown countries as “shitholes”: What did you say back to the man? And why didn’t you leave? Their answers are fundamental to what we need to know about their character and fitness for office.
brookegoodman

Fact check: Democratic presidential debate with Biden vs. Sanders - CNNPolitics - 0 views

  • Washington (CNN)Welcome to CNN's fact check coverage of the eleventh Democratic presidential debate from Washington, DC, ahead of the nation's third super Tuesday, where primaries will be held in Arizona, Florida, Illinois and Ohio on March 17.
  • As Vice President, Biden campaigned with New York Democratic Gov. Andrew Cuomo in 2015 to increase the state minimum wage to $15 an hour.
  • Asked whether he would order a national lockdown to combat the coronavirus pandemic, Biden took a swipe at Sanders' "Medicare for All" proposal. He pointed to Italy, saying that its single-payer health care system hasn't worked to stem the outbreak there.
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  • Facts First: This is partly true. As the experience of Italy and other countries shows, having universal coverage and a government-run health system is not enough on its own to stem the spread of coronavirus. But the US is at a disadvantage in fighting the coronavirus because tens of millions of Americans are uninsured or face high out-of-pocket costs before their insurance kicks in -- which may make people hesitant to seek testing or treatment.
  • "Addressing coronavirus with tens of millions of people without health insurance or with inadequate insurance will be a uniquely American challenge among developed countries," tweeted Larry Levitt, executive vice president for health policy at Kaiser. "It will take money to treat people and address uncompensated care absorbed by providers."
  • President Donald Trump has tweeted his support of the package. The Senate is expected to take up the measure when it returns to session this week.
  • Laboratories in Germany developed tests to detect the coronavirus which the WHO adopted and by last week, the WHO sent out tests to 120 countries. Other countries, like the US and China, chose to develop their own tests, according to the Washington Post.
  • On February 12, the Center for Disease Control reported that some of the coronavirus test kits shipped to labs across the country were not working as they should.
  • Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases and one of the experts leading the administration's response to the coronavirus told Congress Thursday that the US was "failing" when it came to getting Americans tested.
  • In an exchange about how the government bailed out banks during the 2008 financial crisis, Biden asserted that Sanders voted against a bailout for the auto industry.
  • Facts First: Sanders is right, but this needs context. Sanders voted for a bill that would have bailed out the auto industry -- but it failed to pass the Senate. He voted against a different bailout measure, the $700 billion Troubled Asset Relief Program, or TARP, which passed. That program released money to banks -- and a portion of that money eventually went to automakers.
  • Sanders on Sunday cited two figures about the number of people he claimed die because of the inadequacy of the US health care system.
  • Facts First: The true number of Americans who die because they are uninsured or lack adequate coverage is not known. Some studies suggest the number is in the tens of thousands per year, but other experts have expressed skepticism that the number is as high as Sanders says.
  • Biden, who was a US senator at the time of his vote, responded, "I learned that I can't take the word of a President when in fact they assured me that they would not use force. Remember the context. The context was the United Nations Security Council was going to vote to insist that we allow inspectors into determining whether or not...they were, in fact, producing nuclear weapons or weapons of mass destruction. They were not."
  • Facts First: Biden's claim is misleading by omission. Biden was an advocate of ending the Saddam Hussein regime for more than a year before the war began in 2003. While Biden did begin calling his 2002 vote a "mistake" in 2005, he was a public supporter of the war in 2003 and 2004 -- and he made clear in 2002 and 2003, both before and after the war started, that he had known he was voting to authorize a possible war, not only to try to get inspectors into Iraq. It's also unclear whether Bush ever made Biden any kind of promise related to the use of force.
  • During an exchange about Sanders' views on authoritarian countries, Biden claimed that China's income gains have been "marginal."
  • One way to measure standard of living is through a country's gross domestic product per capita at purchasing power parity. In other words, looking at a country's GDP per person in international dollars, a hypothetical currency used to measure purchasing parity between different countries.
  • Fact First: This Sanders' claim needs a lot of context. Biden did repeatedly support freezes in Social Security spending and at times called for raising the retirement age. In 2011, he said "changes" would have to be made to entitlements, saying they wouldn't be sustainable -- but he didn't specify what changes. Overall, the claim leaves out that Biden was typically talking about any changes to entitlements in the context of a broader legislative package.
  • And comments Biden made during a 1995 speech on the Senate floor show he was willing to make cuts to Medicare, but only as part of a broader deal that did not advocate cuts as big as Republicans want.
  • "If we are serious about saving Social Security, not raising taxes on the middle class, and not cutting back on benefits desperately needed by many senior citizens, we must adjust this artificial ceiling on Social Security taxes and make the Social Security tax more progressive."
  • Biden said upon his June 2019 reversal that he made "no apologies" for his past support of the amendment. He argued that "times have changed," since, he argued, the right to choose "was not under attack as it is now" from Republicans and since "women's rights and women's health are under assault like we haven't seen in the last 50 years."
  • Facts First: While it's unclear which ad Sanders was referring to, at least one super PAC connected to Biden, Unite the Country, ran a large television ad campaign that implicitly criticized Sanders without mentioning him by name..
  • For instance, it includes a clip from a Biden speech, in which Biden says" Democrats want a nominee who's a Democrat" -- an apparent challenge to the party bonafides of Sanders, who serves as an independent in the US Senate and describes himself as a democratic socialist.
Javier E

How Will the Coronavirus End? - The Atlantic - 0 views

  • A global pandemic of this scale was inevitable. In recent years, hundreds of health experts have written books, white papers, and op-eds warning of the possibility. Bill Gates has been telling anyone who would listen, including the 18 million viewers of his TED Talk.
  • We realized that her child might be one of the first of a new cohort who are born into a society profoundly altered by COVID-19. We decided to call them Generation C.
  • “No matter what, a virus [like SARS-CoV-2] was going to test the resilience of even the most well-equipped health systems,”
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  • To contain such a pathogen, nations must develop a test and use it to identify infected people, isolate them, and trace those they’ve had contact with. That is what South Korea, Singapore, and Hong Kong did to tremendous effect. It is what the United States did not.
  • That a biomedical powerhouse like the U.S. should so thoroughly fail to create a very simple diagnostic test was, quite literally, unimaginable. “I’m not aware of any simulations that I or others have run where we [considered] a failure of testing,”
  • The testing fiasco was the original sin of America’s pandemic failure, the single flaw that undermined every other countermeasure. If the country could have accurately tracked the spread of the virus, hospitals could have executed their pandemic plans, girding themselves by allocating treatment rooms, ordering extra supplies, tagging in personnel, or assigning specific facilities to deal with COVID-19 cases.
  • None of that happened. Instead, a health-care system that already runs close to full capacity, and that was already challenged by a severe flu season, was suddenly faced with a virus that had been left to spread, untracked, through communities around the country.
  • With little room to surge during a crisis, America’s health-care system operates on the assumption that unaffected states can help beleaguered ones in an emergency.
  • That ethic works for localized disasters such as hurricanes or wildfires, but not for a pandemic that is now in all 50 states. Cooperation has given way to competition
  • Partly, that’s because the White House is a ghost town of scientific expertise. A pandemic-preparedness office that was part of the National Security Council was dissolved in 2018. On January 28, Luciana Borio, who was part of that team, urged the government to “act now to prevent an American epidemic,” and specifically to work with the private sector to develop fast, easy diagnostic tests. But with the office shuttered, those warnings were published in The Wall Street Journal, rather than spoken into the president’s ear.
  • Rudderless, blindsided, lethargic, and uncoordinated, America has mishandled the COVID-19 crisis to a substantially worse degree than what every health expert I’ve spoken with had feared. “Much worse,”
  • “Beyond any expectations we had,” said Lauren Sauer, who works on disaster preparedness at Johns Hopkins Medicine. “As an American, I’m horrified,” said Seth Berkley, who heads Gavi, the Vaccine Alliance. “The U.S. may end up with the worst outbreak in the industrialized world.”
  • it will be difficult—but not impossible—for the United States to catch up. To an extent, the near-term future is set because COVID-19 is a slow and long illness. People who were infected several days ago will only start showing symptoms now, even if they isolated themselves in the meantime. Some of those people will enter intensive-care units in early April
  • The first and most important is to rapidly produce masks, gloves, and other personal protective equipment
  • A “massive logistics and supply-chain operation [is] now needed across the country,” says Thomas Inglesby of Johns Hopkins Bloomberg School of Public Health. That can’t be managed by small and inexperienced teams scattered throughout the White House. The solution, he says, is to tag in the Defense Logistics Agency—a 26,000-person group that prepares the U.S. military for overseas operations and that has assisted in past public-health crises, including the 2014 Ebola outbreak.
  • it would also come at a terrible cost: SARS-CoV-2 is more transmissible and fatal than the flu, and it would likely leave behind many millions of corpses and a trail of devastated health systems.
  • This agency can also coordinate the second pressing need: a massive rollout of COVID-19 tests.
  • These measures will take time, during which the pandemic will either accelerate beyond the capacity of the health system or slow to containable levels. Its course—and the nation’s fate—now depends on the third need, which is social distancing.
  • There are now only two groups of Americans. Group A includes everyone involved in the medical response, whether that’s treating patients, running tests, or manufacturing supplies. Group B includes everyone else, and their job is to buy Group A more time. Group B must now “flatten the curve” by physically isolating themselves from other people to cut off chains of transmission.
  • Given the slow fuse of COVID-19, to forestall the future collapse of the health-care system, these seemingly drastic steps must be taken immediately, before they feel proportionate, and they must continue for several weeks.
  • Persuading a country to voluntarily stay at home is not easy, and without clear guidelines from the White House, mayors, governors, and business owners have been forced to take their own steps.
  • when the good of all hinges on the sacrifices of many, clear coordination matters—the fourth urgent need
  • Pundits and business leaders have used similar rhetoric, arguing that high-risk people, such as the elderly, could be protected while lower-risk people are allowed to go back to work. Such thinking is seductive, but flawed. It overestimates our ability to assess a person’s risk, and to somehow wall off the ‘high-risk’ people from the rest of society. It underestimates how badly the virus can hit ‘low-risk’ groups, and how thoroughly hospitals will be overwhelmed if even just younger demographics are falling sick.
  • A recent analysis from the University of Pennsylvania estimated that even if social-distancing measures can reduce infection rates by 95 percent, 960,000 Americans will still need intensive care.
  • There are only about 180,000 ventilators in the U.S. and, more pertinently, only enough respiratory therapists and critical-care staff to safely look after 100,000 ventilated patients. Abandoning social distancing would be foolish. Abandoning it now, when tests and protective equipment are still scarce, would be catastrophic.
  • If Trump stays the course, if Americans adhere to social distancing, if testing can be rolled out, and if enough masks can be produced, there is a chance that the country can still avert the worst predictions about COVID-19, and at least temporarily bring the pandemic under control. No one knows how long that will take, but it won’t be quick. “It could be anywhere from four to six weeks to up to three months,” Fauci said, “but I don’t have great confidence in that range.”
  • there are three possible endgames: one that’s very unlikely, one that’s very dangerous, and one that’s very long.
  • The first is that every nation manages to simultaneously bring the virus to heel, as with the original SARS in 2003. Given how widespread the coronavirus pandemic is, and how badly many countries are faring, the odds of worldwide synchronous control seem vanishingly small.
  • The second is that the virus does what past flu pandemics have done: It burns through the world and leaves behind enough immune survivors that it eventually struggles to find viable hosts. This “herd immunity” scenario would be quick, and thus tempting
  • The U.S. has fewer hospital beds per capita than Italy. A study released by a team at Imperial College London concluded that if the pandemic is left unchecked, those beds will all be full by late April. By the end of June, for every available critical-care bed, there will be roughly 15 COVID-19 patients in need of one.  By the end of the summer, the pandemic will have directly killed 2.2 million Americans,
  • The third scenario is that the world plays a protracted game of whack-a-mole with the virus, stamping out outbreaks here and there until a vaccine can be produced. This is the best option, but also the longest and most complicated.
  • there are no existing vaccines for coronaviruses—until now, these viruses seemed to cause diseases that were mild or rare—so researchers must start from scratch.
  • The first steps have been impressively quick. Last Monday, a possible vaccine created by Moderna and the National Institutes of Health went into early clinical testing. That marks a 63-day gap between scientists sequencing the virus’s genes for the first time and doctors injecting a vaccine candidate into a person’s arm. “It’s overwhelmingly the world record,” Fauci said.
  • The initial trial will simply tell researchers if the vaccine seems safe, and if it can actually mobilize the immune system. Researchers will then need to check that it actually prevents infection from SARS-CoV-2. They’ll need to do animal tests and large-scale trials to ensure that the vaccine doesn’t cause severe side effects. They’ll need to work out what dose is required, how many shots people need, if the vaccine works in elderly people, and if it requires other chemicals to boost its effectiveness.
  • No matter which strategy is faster, Berkley and others estimate that it will take 12 to 18 months to develop a proven vaccine, and then longer still to make it, ship it, and inject it into people’s arms.
  • as the status quo returns, so too will the virus. This doesn’t mean that society must be on continuous lockdown until 2022. But “we need to be prepared to do multiple periods of social distancing,” says Stephen Kissler of Harvard.
  • First: seasonality. Coronaviruses tend to be winter infections that wane or disappear in the summer. That may also be true for SARS-CoV-2, but seasonal variations might not sufficiently slow the virus when it has so many immunologically naive hosts to infect.
  • Second: duration of immunity. When people are infected by the milder human coronaviruses that cause cold-like symptoms, they remain immune for less than a year. By contrast, the few who were infected by the original SARS virus, which was far more severe, stayed immune for much longer.
  • scientists will need to develop accurate serological tests, which look for the antibodies that confer immunity. They’ll also need to confirm that such antibodies actually stop people from catching or spreading the virus. If so, immune citizens can return to work, care for the vulnerable, and anchor the economy during bouts of social distancing.
  • Aspects of America’s identity may need rethinking after COVID-19. Many of the country’s values have seemed to work against it during the pandemic. Its individualism, exceptionalism, and tendency to equate doing whatever you want with an act of resistance meant that when it came time to save lives and stay indoors, some people flocked to bars and clubs.
  • “We can keep schools and businesses open as much as possible, closing them quickly when suppression fails, then opening them back up again once the infected are identified and isolated. Instead of playing defense, we could play more offense.”
  • The vaccine may need to be updated as the virus changes, and people may need to get revaccinated on a regular basis, as they currently do for the flu. Models suggest that the virus might simmer around the world, triggering epidemics every few years or so. “But my hope and expectation is that the severity would decline, and there would be less societal upheaval,”
  • After infections begin ebbing, a secondary pandemic of mental-health problems will follow.
  • But “there is also the potential for a much better world after we get through this trauma,”
  • Attitudes to health may also change for the better. The rise of HIV and AIDS “completely changed sexual behavior among young people who were coming into sexual maturity at the height of the epidemic,”
  • Pandemics can also catalyze social change. People, businesses, and institutions have been remarkably quick to adopt or call for practices that they might once have dragged their heels on, including working from home, conference-calling to accommodate people with disabilities, proper sick leave, and flexible child-care arrangements.
  • Perhaps the nation will learn that preparedness isn’t just about masks, vaccines, and tests, but also about fair labor policies and a stable and equal health-care system. Perhaps it will appreciate that health-care workers and public-health specialists compose America’s social immune system, and that this system has been suppressed.
  • Testing kits can be widely distributed to catch the virus’s return as quickly as possible. There’s no reason that the U.S. should let SARS-CoV-2 catch it unawares again, and thus no reason that social-distancing measures need to be deployed as broadly and heavy-handedly as they now must be.
  • Years of isolationist rhetoric had consequences too.
  • “People believed the rhetoric that containment would work,” says Wendy Parmet, who studies law and public health at Northeastern University. “We keep them out, and we’ll be okay. When you have a body politic that buys into these ideas of isolationism and ethnonationalism, you’re especially vulnerable when a pandemic hits.”
  • Pandemics are democratizing experiences. People whose privilege and power would normally shield them from a crisis are facing quarantines, testing positive, and losing loved ones. Senators are falling sick. The consequences of defunding public-health agencies, losing expertise, and stretching hospitals are no longer manifesting as angry opinion pieces, but as faltering lungs.
  • After COVID-19, attention may shift to public health. Expect to see a spike in funding for virology and vaccinology, a surge in students applying to public-health programs, and more domestic production of medical supplies.
  • The lessons that America draws from this experience are hard to predict, especially at a time when online algorithms and partisan broadcasters only serve news that aligns with their audience’s preconceptions.
  • In 2030, SARS-CoV-3 emerges from nowhere, and is brought to heel within a month.
  • One could easily conceive of a world in which most of the nation believes that America defeated COVID-19. Despite his many lapses, Trump’s approval rating has surged. Imagine that he succeeds in diverting blame for the crisis to China, casting it as the villain and America as the resilient hero.
  • One could also envisage a future in which America learns a different lesson. A communal spirit, ironically born through social distancing, causes people to turn outward, to neighbors both foreign and domestic. The election of November 2020 becomes a repudiation of “America first” politics. The nation pivots, as it did after World War II, from isolationism to international cooperation
  • The U.S. leads a new global partnership focused on solving challenges like pandemics and climate change.
  • “The transitions after World War II or 9/11 were not about a bunch of new ideas,” he says. “The ideas are out there, but the debates will be more acute over the next few months because of the fluidity of the moment and willingness of the American public to accept big, massive changes.”
  • On the Global Health Security Index, a report card that grades every country on its pandemic preparedness, the United States has a score of 83.5—the world’s highest. Rich, strong, developed, America is supposed to be the readiest of nations. That illusion has been shattered. Despite months of advance warning as the virus spread in other countries, when America was finally tested by COVID-19, it failed.
brickol

Live Coronavirus News, Updates and Video - The New York Times - 0 views

  • The Tokyo Olympics have been postponed. New York, now the center of the outbreak in America, braces for a flood of patients. The playwright Terrence McNally dies of complications from the coronavirus.
  • tocks rallied on the hope that Washington was close to producing a stimulus bill. Shares soared for airlines and other companies expected to benefit.
  • Trump expressed outrage at having to ‘close the country’ to curb the spread of the virus.
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  • Even as nations from Britain to India declare nationwide economic lockdowns, President Trump said he “would love to have the country opened up, and just raring to go, by Easter,” less than three weeks away, a goal that top health professionals have called far too quick.
  • he expressed outrage about having to “close the country” to curb the spread of the coronavirus and indicated that his guidelines on business shutdowns and social distancing would soon be lifted.
  • “I gave it two weeks,” he said, adding, “We can socially distance ourselves and go to work.”
  • “We are honored to serve and put our lives on the front line to protect and save as many lives as possible,” the American Medical Association, American Hospital Association and American Nurses Association wrote in an open letter. “But we need your help.”
  • Mr. Trump fell back on his comparison of the coronavirus to the flu, saying that despite losing thousands of people to the flu, “We don’t turn the country off.”
  • States including California, Maryland, Illinois and Washington have declared stay-at-home or shutdown orders, but other states have been looking for directives from the Trump administration. And countries in Asia are beginning to see a resurgence of coronavirus after easing up on restrictions.
  • For governors and mayors who have been trying to educate people about the urgent need to stay home and maintain social distance, Mr. Trump’s recent statements suggesting that such measures may be going too far threatened to make their jobs more difficult.
  • Mr. Hogan, the chairman of the bipartisan National Governors Association, said that health officials suggest that the virus’s peak could be weeks or months away. “We’re just trying to take the best advice that we can from the scientists and all the experts, and making the decisions that we believe are necessary for our states,” he said.
  • Both Mr. Trump and Vice President Mike Pence said that a lockdown had never been under consideration for the United States.
  • But the president and vice president were resolute that they want the country reopened. Mr. Pence said the administration’s timeline for trying to get businesses restarted and workers out of their homes was shorter than the period that health experts have said would be necessary to flatten the curve.
  • “We’ll focus on our most vulnerable, but putting America back to work will also be a priority, in weeks not months,” Mr. Pence said.
  • Mr. Pence also said two malaria drugs, chloroquine and hydroxychloroquine, had been approved by the Food and Drug Administration for off-label use treating patients with Covid-19, the disease caused by the coronavirus. The F.D.A. did not immediately confirm that assertion, but two administration health officials said it was not true.
  • India, the world’s second-most populous country, will order its 1.3 billion people to stay inside their homes for three weeks to try to curb the spread of the coronavirus, Prime Minister Narendra Modi declared on Tuesday.
  • Left unclear was how Indians would be able to get food and other needed supplies. Mr. Modi alluded vaguely to the government and civil society groups stepping in to help, but offered no details.
  • Mr. Modi also pledged to spend about $2 billion on medical supplies, isolation rooms, ventilators, intensive care units and training for medical personnel to combat the pandemic.
  • New York’s case count is doubling every three days, the governor says.
  • “We haven’t flattened the curve,” he said. “And the curve is actually increasing.” The governor, appearing in front of piles of medical supplies, spoke in a far more sober tone and delivered notably bleaker news than he has in previous days.The peak of infection in New York could come as soon as two to three weeks, far earlier than previously anticipated, Mr. Cuomo said, which would put even bigger strain on the health care system than officials had feared.
  • The governor said the state now projects that it may need as many as 140,000 hospital beds to house virus patients, up from the 110,000 projected a few days ago. As of now, only 53,000 are available. Up to 40,000 intensive-care beds could be needed. “Those are troubling and astronomical numbers,” he said.
  • In New York City alone, there have been around 15,000 cases.“Look at us today,” he warned the rest of the country. “Where we are today, you will be in four weeks or five weeks or six weeks. We are your future.”
  • Perhaps it was inevitable that New York City and surrounding suburbs would become the epicenter of the coronavirus epidemic in the United States. The population density, reliance on public transportation and constant influx of tourists — all would seem to make the metropolitan area a target.
  • But to stop the virus, scientists have to figure out which factors played a greater role than others. As it turns out, that is not so simple.
  • Perhaps the epidemic in New York had less to do with the virus than with discrete opportunities to spread: In so-called super-spreader events, one patient somehow manages to infect dozens, even scores of others. At one point, half the cases in Massachusetts were attributed to a single initial infection.
Javier E

A German Exception? Why the Country's Coronavirus Death Rate Is Low - The New York Times - 0 views

  • They call them corona taxis: Medics outfitted in protective gear, driving around the empty streets of Heidelberg to check on patients who are at home, five or six days into being sick with the coronavirus.They take a blood test, looking for signs that a patient is about to go into a steep decline. They might suggest hospitalization, even to a patient who has only mild symptoms; the chances of surviving that decline are vastly improved by being in a hospital when it begins.
  • Heidelberg’s corona taxis are only one initiative in one city. But they illustrate a level of engagement and a commitment of public resources in fighting the epidemic that help explain one of the most intriguing puzzles of the pandemic: Why is Germany’s death rate so low?
  • According to Johns Hopkins University, the country had more than 92,000 laboratory-confirmed infections as of midday Saturday, more than any other country except the United States, Italy and Spain.
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  • But with 1,295 deaths, Germany’s fatality rate stood at 1.4 percent, compared with 12 percent in Italy, around 10 percent in Spain, France and Britain, 4 percent in China and 2.5 percent in the United States. Even South Korea, a model of flattening the curve, has a higher fatality rate, 1.7 percent.
  • There are several answers experts say, a mix of statistical distortions and very real differences in how the country has taken on the epidemic.
  • The average age of those infected is lower in Germany than in many other countries. Many of the early patients caught the virus in Austrian and Italian ski resorts and were relatively young and healthy, Professor Kräusslich said.“It started as an epidemic of skiers,
  • “The reason why we in Germany have so few deaths at the moment compared to the number of infected can be largely explained by the fact that we are doing an extremely large number of lab diagnoses,”
  • Another explanation for the low fatality rate is that Germany has been testing far more people than most nations. That means it catches more people with few or no symptoms, increasing the number of known cases, but not the number of fatalities.
  • But there are also significant medical factors that have kept the number of deaths in Germany relatively low, epidemiologists and virologists say, chief among them early and widespread testing and treatment, plenty of intensive care beds and a trusted government whose social distancing guidelines are widely observed.
  • TestingIn mid-January, long before most Germans had given the virus much thought, Charité hospital in Berlin had already developed a test and posted the formula online.
  • By the time Germany recorded its first case of Covid-19 in February, laboratories across the country had built up a stock of test kits.
  • the average age of contracting the disease remains relatively low, at 49. In France, it is 62.5 and in Italy 62, according to their latest national reports.
  • At the end of April, health authorities also plan to roll out a large-scale antibody study, testing random samples of 100,000 people across Germany every week to gauge where immunity is building up.
  • Early and widespread testing has allowed the authorities to slow the spread of the pandemic by isolating known cases while they are infectious. It has also enabled lifesaving treatment to be administered in a more timely way.
  • Medical staff, at particular risk of contracting and spreading the virus, are regularly tested. To streamline the procedure, some hospitals have started doing block tests, using the swabs of 10 employees, and following up with individual tests only if there is a positive result.
  • If it slows a little more, to between 12 and 14 days, Professor Herold said, the models suggest that triage could be avoided.
  • One key to ensuring broad-based testing is that patients pay nothing for it, said Professor Streeck. This, he said, was one notable difference with the United States
  • By now, Germany is conducting around 350,000 coronavirus tests a week, far more than any other European country
  • Tracking
  • In most countries, including the United States, testing is largely limited to the sickest patients, so the man probably would have been refused a test.
  • Not in Germany. As soon as the test results were in, the school was shut, and all children and staff were ordered to stay at home with their families for two weeks. Some 235 people were tested.“Testing and tracking is the strategy that was successful in South Korea and we have tried to learn from that,” Professor Streeck said.Germany also learned from getting it wrong early on: The strategy of contact tracing should have been used even more aggressively, he said.
  • All those who had returned to Germany from Ischgl, an Austrian ski resort that had an outbreak, for example, should have been tracked down and tested, Professor Streeck said
  • A Robust Public Health Care System
  • Before the coronavirus pandemic swept across Germany, University Hospital in Giessen had 173 intensive care beds equipped with ventilators. In recent weeks, the hospital scrambled to create an additional 40 beds and increased the staff that was on standby to work in intensive care by as much as 50 percent.
  • “We have so much capacity now we are accepting patients from Italy, Spain and France,”
  • All across Germany, hospitals have expanded their intensive care capacities. And they started from a high level. In January, Germany had some 28,000 intensive care beds equipped with ventilators, or 34 per 100,000 people
  • By comparison, that rate is 12 in Italy and 7 in the Netherlands.
  • By now, there are 40,000 intensive care beds available in Germany.
  • The time it takes for the number of infections to double has slowed to about eight days
  • “A young person with no health insurance and an itchy throat is unlikely to go to the doctor and therefore risks infecting more people,” he said.
  • Trust in Government
  • many also see Chancellor Angela Merkel’s leadership as one reason the fatality rate has been kept low.
  • Ms. Merkel has communicated clearly, calmly and regularly throughout the crisis, as she imposed ever-stricter social distancing measures on the country.
  • The restrictions, which have been crucial to slowing the spread of the pandemic, met with little political opposition and are broadly followed.
  • “Maybe our biggest strength in Germany,” said Professor Kräusslich, “is the rational decision-making at the highest level of government combined with the trust the government enjoys in the population.”
anonymous

New Lockdowns In Europe As COVID-19 Cases Soar; Pakistan's PM Tests Positive : Coronavi... - 0 views

  • Several European countries have instituted new lockdown restrictions, while others are considering tightening their rules in order to curb the spread of the coronavirus as case numbers across the continent are surging once again.
  • In France, a new partial lockdown took effect at midnight on Friday. Some 21 million people across 16 regions, including Paris, are affected by the new measures. The French government decided to take the step amid fears of a third wave.The new lockdown is less restrictive than previous ones.
  • non-essential businesses have been forced to shut down, while others, such as hairdressers, can remain open if they follow strict guidelines.
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  • With more than 91,000 deaths, the country has one of the highest death tolls in Europe.
  • More than 4.2 million infections have been reported in France since the start of the pandemic,
  • Traffic jams were reported as thousands of people tried to leave the French capital ahead of the lockdown on Friday. Traffic volume and train reservations were both up 20%
  • Poland is taking its measures a step further and embarking on a nationwide three-week lockdown on Saturday after cases jumped 44% week-over-week. Health officials attribute the recent spike to the U.K. coronavirus variant, according to the country's health ministry.
  • Under the country's lockdown rules, only essential businesses — such as grocery stores and pharmacies — will stay open. The country will also cancel all in-person classes and return to online education over the course of the lockdown.Over 49,000 people have so far died in Poland from the virus,
  • Earlier in the week, Italy — which was the first country in Europe to impose a lockdown last year — issued new national restrictions to stop the spread of the virus. Hungary, Bulgaria and Bosnia have also tightened their restrictions in recent weeks. Other countries, including Germany, have warned of a possible return to stricter measures in the days ahead.
  • German Health Minister Jens Spahn urged residents on Friday to diligently follow coronavirus safety rules, warning that vaccines won't arrive quickly enough to prevent a third wave of the COVID-19 pandemic.
  • With Germany set for a four-day-weekend in early April to mark the Easter holiday, Spahn said the country is not yet ready to relax travel and physical distancing rules. In fact, he said, Germans should be prepared to revert to tighter restrictions.
  • In the United Kingdom, the conversation has turned away from lockdowns as the nation celebrated a milestone in its fight against the virus on Saturday with the news that half of its adult population has received at least one dose of the COVID-19 vaccine.
  • Health Secretary Matt Hancock said the country set a new record for daily vaccinations on Friday.
  • in Pakistan, Prime Minister Imran Khan is self-isolating at home after testing positive for COVID-19, a tweet from his office said.The prime minister is suffering a "slight cough" and the "mildest of fevers," according to two government officials.
  • news of the prime minister's positive test result came just two days after he received his first vaccine dose for the virus.The proximity of those two events could raise concerns that will deepen vaccine hesitation in the country. Health officials have tried to stress that Khan, 68, had likely been infected before he was vaccinated on Thursday.
  • Vaccine hesitancy is an issue in Pakistan, with a poll earlier this month showing that it is also high among healthcare workers. Hours before the announcement, authorities shut down restaurants across the Pakistani capital as the U.K. variant of the virus spreads.
anonymous

Attacks Blaming Asians For Pandemic Reflect Racist History Of Global Health : Goats and... - 0 views

  • The pandemic has been responsible for an outbreak of violence and hate directed against Asians around the world, blaming them for the spread of COVID-19. During this surge in attacks, the perpetrators have made their motives clear, taunting their victims with declarations like, "You have the Chinese Virus, go back to China!" and assaulting them and spitting on them.
  • The numbers over the past year in the U.S. alone are alarming. As NPR has reported, nearly 3,800 instances of discrimination against Asians have been reported just in the past year to Stop AAPI Hate, a coalition that tracks incidents of violence and harassment against Asian Americans and Pacific Islanders in the U.S.
  • Then came mass shooting in Atlanta last week, which took the lives of eight people, including six women of Asian descent. The shooter's motive has not been determined, but the incident has spawned a deeper discourse on racism and violence targeting Asians in the wake of the coronavirus.
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  • This narrative – that "others," often from far-flung places, are to blame for epidemics – is a dramatic example of a long tradition of hatred. In 14th-century Europe, Jewish communities were wrongfully accused of poisoning wells to spread the Black Death. In 1900, Chinese people were unfairly vilified for an outbreak of the plague in San Francisco's Chinatown. And in the '80s, Haitians were blamed for bringing HIV/AIDS to the U.S., a theory that's considered unsubstantiated by many global health experts.
  • Some public health practitioners say the global health system is partially responsible for perpetuating these ideas.According to Abraar Karan, a doctor at the Brigham and Women's Hospital and Harvard Medical School, the notion persists in global health that "the West is the best." This led to an assumption early on in the pandemic that COVID-19 spread to the rest of the world because China wasn't able to control it.
  • China's response was not without fault. The government's decision to silence doctors and not warn the public about a likely pandemic for six days in mid-January caused more than 3,000 people to become infected within a week, according to a report by the Associated Press, and created ripe conditions for global spread. Some of the aggressive measures China took to control the epidemic – confining people to their homes, for example — have been described as "draconian" and a violation of civil rights, even if they ultimately proved effective.
  • But it soon became clear that assumptions about the superiority of Western health systems were false when China and other Asian countries, along with many African countries, controlled outbreaks far more effectively and faster than Western countries did, says Karan.
  • Some politicians, including former President Donald Trump publicly blamed China for the pandemic, calling this novel coronavirus the "Chinese Virus" or the "Wuhan Virus." They consistently pushed that narrative even after the World Health Organization (WHO) warned as early as March 2020, when the pandemic was declared, that such language would encourage racial profiling and stigmatization against Asians. Trump has continued to use stigmatizing language in the wake of the Atlanta shooting, using the phrase "China virus" during a March 16 call to Fox News.
  • A report by researchers at the University of California at San Francisco (UCSF), released this month, directly linked Trump's first tweet about a "Chinese virus" to a significant increase in anti-Asian hashtags. According to a separate report by the Center for the Study of Hate and Extremism, anti-Asian hate crimes in 16 U.S. cities increased 149 percent in 2020, from 49 to 122.
  • Suspicion tends to manifest more during times of vulnerability, like in wartime or during a pandemic, says ElsaMarie D'Silva, an Aspen Institute New Voices fellow from India who studies violence and harassment issues. It just so happened that COVID-19 was originally identified in China, but, as NPR's Jason Beaubien has reported, some of the early clusters of cases elsewhere came from jet setters who traveled to Europe and ski destinations.
  • Karan says we also need to shift our approach to epidemics. In the case of COVID-19 and other outbreaks, Western countries often think of them as a national security issue, closing borders and blaming the countries where the disease was first reported. This approach encourages stigmatization, he says.
  • In the early days of COVID-19, skepticism by Western public health officials about the efficacy of Asian mask protocols hindered the U.S.'s ability to control the pandemic. Additionally, stereotypes about who was and wasn't at risk had significant consequences, says Nancy Kass, deputy director for public health at the Johns Hopkins Berman Institute of Bioethics.
  • According to Kass, doctors initially only considered a possible COVID-19 diagnosis among people who had recently flown back from China. That narrow focus caused the U.S. to misdiagnose patients who presented with what we now call classic COVID symptoms simply because they hadn't traveled from China.
  • It's reminiscent of the HIV/AIDS epidemic in the 1980s, Kass says. Because itwas so widely billed as a "gay disease," there are many documented cases of heterosexual women who presented with symptoms but weren't diagnosed until they were on their deathbeds.
  • That's not to say that we should ignore facts and patterns about new diseases. For example, Kass says it's appropriate to warn pregnant women about the risks of traveling to countries where the Zika virus, which is linked to birth and developmental defects, is present.
  • But there's a difference, she says, between making sure people have enough information to understand a disease and attaching a label, like "Chinese virus," that is inaccurate and that leads to stereotyping.
  • the West is usually regarded as the hub of expertise and knowledge, says Sriram Shamasunder, an associate professor of medicine at UCSF, and there's a sense among Western health workers that epidemics occur in impoverished contexts because the people there engage in primitive behaviors and just don't care as much about health.
  • Instead, Karan suggests reframing the discussion to focus on global solidarity, which promotes the idea that we are all in this together. One way for wealthy countries to demonstrate solidarity now, Karan says, is by supporting the equitable and speedy distribution of vaccines among countries globally as well as among communities within their own borders.Without such commitments in place, "it prompts the question, whose lives matter most?" says Shamasunder.
  • Ultimately, the global health community – and Western society as a whole – has to discard its deep-rooted mindset of coloniality and tendency to scapegoat others, says Hswen. The public health community can start by talking more about the historic racism and atrocities that have been tied to diseases.
  • Additionally, Karan says, leaders should reframe the pandemic for people: Instead of blaming Asians for the virus, blame the systems that weren't adequately prepared to respond to a pandemic.
  • Although WHO has had specific guidance since 2015 about not naming diseases after places, Hswen says the public health community at large should have spoken out earlier and stronger last year against racialized language and the ensuing violence. She says they should have anticipated the backlash against Asians and preempted it with public messaging and education about why neutral terms like "COVID-19" should be used instead of "Chinese virus."
Javier E

The Coronavirus Brazil Variant Shows the World's Vulnerability - The Atlantic - 0 views

  • Though many questions remain, one plausible explanation is that people who have already been infected by the virus are getting sick—and not mildly so. That possibility has been long feared throughout the pandemic, yet not previously seen on any significant scale
  • Although no known variants have been found to pose an immediate threat to vaccinated people, the capacity for reinfection to any significant degree would reshape the pandemic’s trajectory.
  • The new wave of COVID-19 cases in Manaus occurred about eight months after the initial wave. People might have lost some degree of immunity during that window.
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  • Two important factors seem to be playing a role in Brazil’s resurgence. The first is that, after a COVID-19 infection, the natural immunity that our bodies develop seems to vary in strength and permanence. Protection wanes after infection with most respiratory viruses, including coronaviruses
  • the variant in Brazil, known as the P.1 (or B.1.1.248) lineage, has a potent combination of mutations. Not only does this variant seem to be more transmissible; its lineage carries mutations that help it escape the antibodies that we develop in response to older lineages of the coronavirus.
  • it at least has a capacity to infect people who have already recovered from COVID-19, even if their defenses protect them against other versions of the virus.
  • The mutations that help the virus spread and evade immune responses have arisen independently in multiple places. Combined with waning immunity, these factors underscore the challenge before the world: Populations may still be vulnerable to disaster scenarios just when things seem to be getting better.
  • the virus’s capacity to cause such a deadly second surge in Brazil suggests a dangerous evolutionary potential.
  • New, dangerous variants are all but inevitable when there are extremely high levels of transmission of the virus. As more people gain immunity, the selective pressure on the virus will favor the variants that can most effectively evade immune responses
  • the basic nature of evolutionary biology means that the virus should be expected to evolve in ways that circumvent defense mechanisms. Evidence that it is already doing so has been clear in the latest vaccine trial data.
  • The solution, then, depends on vaccination. The immune response that the vaccines create is generally more robust than the immune response we get after being infected by a virus, and should buy a population more protected time than would a surge in exposure to the virus
  • Wealthy countries have time to avoid a fate like Brazil’s through immediate, efficient vaccination.
  • In most places, however, this is not close to happening. And as of last week, only one of the world’s 29 poorest countries had vaccinated anyone at all. A study in the journal BMJ estimated that vaccines will not be available to more than a fifth of the world’s population until 2022.
  • The coronavirus’s constantly evolving nature is a stark reminder that the entire world is in this crisis together.
  • Vaccine distribution is more than just an issue of justice or morality
  • Ensuring that every human is vaccinated is in everyone’s interest, as global distribution of vaccines is the most effective way to drive down the virus’s capacity to replicate and evolve.
  • The key will be bringing down the global rates of transmission as quickly as possible—not getting any single country to 100 percent vaccination while dozens of countries roil.
  • “It is truly confounding that wealthier nations think that hoarding vaccines is the way to protect their citizens from a global pandemic that doesn’t respect borders,”
  • As the virus currently surges across Africa, some 2.5 million health-care workers are unvaccinated. “Clearly, the failure to address vaccine allocation based on health and epidemiological needs, rather than national interest, is now promising to have a dire impact on the world’s ability to achieve rapid, global control of COVID,”
  • Certain countries will approach herd immunity by vaccinating almost every citizen. Other countries could see mass casualties and catastrophic waves of reinfection—potentially with variants that evolved in response to the immunity conferred by the very vaccines to which these populations do not have access. In the process, these hot spots themselves will facilitate rapid evolution, giving rise to even more variants that could make the vaccinated populations susceptible to disease once again
  • The countries that hoard the vaccine without a plan to help others do so at their own peril.
blythewallick

'Get Over It'? Why Political Influence in Foreign Policy Matters - The New York Times - 1 views

  • A July 25 call between President Trump and the president of Ukraine is the basis for an impeachment inquiry into whether Mr. Trump withheld American military aid until Ukrainian officials investigated former Vice President Joseph R. Biden Jr. and his son, Hunter.
  • “Many countries are rivals of ours and of our democratic system,” Mr. Potter said. He listed as two chief examples China and Russia, countries that Mr. Trump has publicly suggested could help him achieve his political aims. “In some cases, they’re going to want policies that help them and therefore hurt us. In other cases, though, they just want us to fail.”
  • Are protections against this kind of thing in place? Yes. The ability of a foreign nation to gain access and influence over America’s democratic process has been a concern since the early days of the republic.
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  • Mr. Trump has denied any explicit quid pro quo — a favor or advantage granted or expected in return for something — in his call with the Ukrainian president, Volodymyr Zelensky. He has repeatedly referred to it as a “perfect” conversation.
  • So what’s the problem?At its most basic level, asking another government for help — whether a quid pro quo existed or not — means that Mr. Trump would find himself indebted to another country.
  • Isn’t this business as usual?No. Both Republican and Democratic presidential administrations have resisted the idea of enlisting help from foreign powers for political advantage.
  • Is this illegal?Asking a foreigner for aid in an American political campaign is illegal, which Ellen L. Weintraub, the head of the Federal Election Commission, has made clear.
  • The Central Intelligence Agency helped overthrow elected leaders in Iran and Guatemala in the 1950s and backed violent coups in several other countries in the 1960s. It plotted assassinations and supported brutal anti-Communist governments in Latin America, Africa and Asia. The C.I.A. has planted misinformation and, at times, used cash as a way to achieve foreign policy aims.
  • “We often consider ourselves and hold ourselves out as an example of how other countries should conduct themselves,” Mr. Potter said. “When we have internal battles or things have gone wrong here, it is much harder to do that.”
  • Has this happened in previous U.S. elections? Sort of.The only impeachment involving foreign policy came in the case of a senator, William Blount, who was accused in 1797 of scheming to transfer parts of Florida and the Louisiana Territory to Britain. The House impeached Blount, but he fled Washington. The Senate opted to expel him rather than convict him at trial.
  •  
    This article talks about Trump's call with the president of Ukraine which has become the basis of Trumps' impeachment inquiry. This article, talks about the White House chief of staff and how he is investigating the theory that it was Ukraine not Russia who hacked the Democratic Party emails in 2016 which would show that Trump was elected in 2016 without the help of Russia. The Cheif of Staff speaks on how there will always be a big political influence on foreign policy. The negatives of other countries getting involved in our elections start on the basis of other countries' ideals and morals compared to ours. The author, Katie Rogers, states that this has "sort of" happened before in the US but not to this extent. She believes that we as a country need to put a lot of effort into political influence on foreign policy before the next election.
rerobinson03

For Covid-19 Vaccines, Some Are Too Rich - and Too Poor - The New York Times - 0 views

  • A few months from now, a factory in South Africa is expected to begin churning out a million doses of Covid-19 vaccine each day in the African country hardest-hit by the pandemic.
  • The country, which will help manufacture the vaccine and whose citizens have enrolled in clinical trials, does not expect to see the first trickle of doses until around the middle of next year. By then, the United States, Britain and Canada, which have already started, may have vaccinated more than 100 million people.
  • Over the past few months, rich nations like the United States and Britain have cut deals with multiple drug manufacturers and secured enough doses to vaccinate their citizens multiple times over. China and Russia have conducted their own trials and begun mass vaccination programs.
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  • Yet countries like South Africa are in a singular bind because they cannot hold out hope for charity. Although its government is nearly insolvent and half of its citizens live in poverty, South Africa is considered too rich to qualify for cut-rate vaccines from international aid organizations.
  • Poor and middle-income nations, largely unable to compete in the open market, rely on a complex vaccine sharing scheme called Covax.
  • A collaboration of international health organizations, Covax was designed to avoid the inequities of a free-market free-for-all.
  • y the middle of next year, South African officials hope to secure their first vaccine doses under Covax, even as they negotiate to buy supplemental supplies from drug manufacturers. But in a country where luxury estates are walled off from sprawling squatter villages, many expect the newest vaccines to remain a privilege for residents who can pay out of pocket or through supplemental insurance — a program that disproportionately benefits white people
  • The best chance that many South Africans have to get vaccinated anytime soon is to volunteer for a clinical trial and test unproven vaccines on their bodies. But that arrangement has raised ethical questions.
  • The people at the top, they’re going to get the vaccine, the people who have power,” said Mtshaba Mzwamadoda, 42, who lives in a one-bedroom corrugated metal shack with his wife and three children. “Maybe we’ll get the vaccine in 2025.”
  • In 2009, when the world feared a devastating H1N1 flu outbreak, rich countries hoarded the earliest vaccines. While the outbreak was far weaker than expected, it revealed the inequities that exist when countries compete for lifesaving medicine.
  • outh African medical advisers say the Covax system is incredibly important but also deeply frustrating. Governments must pay up front without knowing what vaccine they will receive or getting any guarantees on when the doses will arrive.
  • Many South Africans are deeply skeptical of pharmaceutical companies and wary of rampant government corruption
  • Outraged, health advocates have threatened to sue the country’s government to make the plans public.
  • Ultimately, though, money is the great differentiator. From the outset, South Africa’s government knew it could not afford to order doses before they were tested and approved, as wealthy countries did.
  • My assumption is that unless you get onto a vaccine study, you’re not going to have access to any vaccine anytime soon,” Dr. Gill said, “which is obviously quite heartbreaking.”
  • One example is the HPV vaccine, a drug that can prevent cervical cancer but is in short supply in South Africa. Supplies are so tight that the World Health Organization has recommended that wealthy countries temporarily stop expanding their vaccinating campaigns to cover boys, so other nations can focus at least on covering young girls.
  • Under contract with Johnson & Johnson, Aspen is expected to produce millions of vaccine doses. South African officials have high hopes for the vaccine, which does not need cold storage and promises to require one injection rather than two.
  • n poor and working-class townships, the greater fear is of a new lockdown. The government’s earlier aggressive lockdown devastated the economy and confined many people to tin shacks built an arm’s length apart, with a dozen families sharing an outhouse and many more sharing a water tap.
tsainten

How the Wealthy World Has Failed Poor Countries During the Pandemic - The New York Times - 0 views

  • On the other side of the world in Washington, two deep-pocketed organizations, the World Bank and the International Monetary Fund, vowed to spare poor countries from desperation. Their economists warned that immense relief was required to prevent a humanitarian catastrophe and profound damage to global prosperity. Emerging markets make up 60 percent of the world economy, by one I.M.F. measure. A blow to their fortunes inflicts pain around the planet.
  • The shutdown of tourism has punished many developing countries.
  • $11 billion going to low-income countries.
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  • ut the World Bank and the I.M.F. have failed to translate their concern into meaningful support, say economists. That has left less-affluent countries struggling with limited resources and untenable debts, prompting their governments to reduce spending just as it is needed to bolster health care systems and aid people suffering lost income.
  • The wealthiest nations have been cushioned by extraordinary surges of credit unleashed by central banks and government spending collectively estimated at more than $8 trillion. Developing countries have yet to receive help on such a scale.
  • A longtime government finance official who worked in the Trump administration’s Treasury Department, he has displayed contempt for the World Bank and the I.M.F.
  • “The World Bank Group intends to respond forcefully and massively,” Mr. Malpass said. At the I.M.F., Ms. Georgieva said she would not hesitate to tap the institution’s $1 trillion lending capacity. “This is, in my lifetime, humanity’s darkest hour,” she declared.
  • Billions of people have lost the wherewithal to buy food, increasing malnutrition. By next year, the pandemic could push 150 million people into extreme poverty, the World Bank has warned, in the first increase in more than two decades.
  • excessive faith in a widely hailed initiative that aimed to relieve poor nations of their debt burdens to foreign creditors. In April 2020, at a virtual summit of the Group of 20, world leaders agreed to pause debt payments through the end of the year.
  • World leaders played up the program as a way to encourage poor countries to spend as needed, without worrying about their debts. But the plan exempted the largest group of creditors: the global financial services industry, including banks, asset managers and hedge funds.
  • As the pandemic spread, Pakistan raised health care spending but cut support for social service programs as it prioritized debt payments.
  • Mr. Summers recently described the debt suspension initiative as “a squirt gun meeting a massive conflagration.”
  • Private creditors maintain that poor countries have not requested relief, recognizing that credit rating agencies may treat debt suspension as a default — a status that jeopardizes their future ability to borrow.
  • the I.M.F. has allocated $500 million to cover the costs of debt suspension, while handing out more than $100 billion in fresh loans. More than $11 billion from the loan proceeds has paid off private creditors, according to a report from the Jubilee Debt Campaign.
Javier E

'I Feel Sorry for Americans': A Baffled World Watches the U.S. - The New York Times - 0 views

  • Myanmar is a poor country struggling with open ethnic warfare and a coronavirus outbreak that could overload its broken hospitals. That hasn’t stopped its politicians from commiserating with a country they think has lost its way.
  • “I feel sorry for Americans,” said U Myint Oo, a member of parliament in Myanmar. “But we can’t help the U.S. because we are a very small country.”
  • “Personally, it’s like watching the decline of the Roman Empire,” said Mike Bradley, the mayor of Sarnia, an industrial city on the border with Michigan, where locals used to venture for lunch.
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  • “The U.S.A. is a first-world country but it is acting like a third-world country,” said U Aung Thu Nyein, a political analyst in Myanmar.
  • Adding to the sense of bewilderment, Mr. Trump has refused to embrace an indispensable principle of democracy, dodging questions about whether he will commit to a peaceful transition of power after the November election should he lose.
  • “It reminds me of Belarus, when a person cannot admit defeat and looks for any means to prove that he couldn’t lose,” said Kiryl Kalbasnikau, a 29-year-old opposition activist and actor. “This would be a warning sign for any democracy.”
  • “We used to look to the U.S. for democratic governance inspiration,” said Eduardo Bohórquez, the director of Transparency International Mexico. “Sadly, this is not the case anymore.”
  • “The world sees the dismantling of social cohesion within American society and the mess in managing Covid,” said Yenny Wahid, an Indonesian politician and activist. “There is a vacuum of leadership that needs to be filled, but America is not fulfilling that leadership role.
  • Ms. Wahid, whose father was president of Indonesia after the country emerged from decades of strongman rule, said she worried that Mr. Trump’s dismissive attitude toward democratic principles could legitimize authoritarians.
  • “Trump inspired many dictators, many leaders who are interested in dictatorship, to copy his style, and he emboldened them,” she said.
  • “They now know what it’s like in other countries: violating norms, international trade and its own institutions,” said Eunice Rendon, an expert on migration and security and the director of Migrant Agenda, a nonprofit organization in Mexico. “The most powerful country in the world all of a sudden looks vulnerable.”
  • In Cambodia, which reports being largely spared by the virus so far, there is a measure of schadenfreude toward the United States. Prime Minister Hun Sen has survived as Asia’s longest serving leader by cracking down on dissent and cozying up to China.
  • “He has many nuclear weapons,” Sok Eysan, a spokesman for Mr. Hun Sen’s Cambodian People’s Party, said of Mr. Trump. “But he is careless with a disease that can’t be seen.”
Javier E

Medical Mystery: Something Happened to U.S. Health Spending After 1980 - The New York T... - 0 views

  • The United States devotes a lot more of its economic resources to health care than any other nation, and yet its health care outcomes aren’t better for it.
  • That hasn’t always been the case. America was in the realm of other countries in per-capita health spending through about 1980. Then it diverged.
  • It’s the same story with health spending as a fraction of gross domestic product. Likewise, life expectancy. In 1980, the U.S. was right in the middle of the pack of peer nations in life expectancy at birth. But by the mid-2000s, we were at the bottom of the pack.
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  • “Medical care is one of the less important determinants of life expectancy,” said Joseph Newhouse, a health economist at Harvard. “Socioeconomic status and other social factors exert larger influences on longevity.”
  • The United States has relied more on market forces, which have been less effective.
  • For spending, many experts point to differences in public policy on health care financing. “Other countries have been able to put limits on health care prices and spending” with government policies
  • One result: Prices for health care goods and services are much higher in the United States.
  • “The differential between what the U.S. and other industrialized countries pay for prescriptions and for hospital and physician services continues to widen over time,”
  • The degree of competition, or lack thereof, in the American health system plays a role
  • periods of rapid growth in U.S. health care spending coincide with rapid growth in markups of health care prices. This is what one would expect in markets with low levels of competition.
  • Although American health care markets are highly consolidated, which contributes to higher prices, there are also enough players to impose administrative drag. Rising administrative costs — like billing and price negotiations across many insurers — may also explain part of the problem.
  • The additional costs associated with many insurers, each requiring different billing documentation, adds inefficiency
  • “We have big pharma vs. big insurance vs. big hospital networks, and the patient and employers and also the government end up paying the bills,”
  • Though we have some large public health care programs, they are not able to keep a lid on prices. Medicare, for example, is forbidden to negotiate as a whole for drug prices,
  • once those spending constraints eased, “suppliers of medical inputs marketed very costly technological innovations with gusto,”
  • , all across the world, one sees constraints on payment, technology, etc., in the 1970s and 1980s,” he said. The United States is not different in kind, only degree; our constraints were weaker.
  • Mr. Starr suggests that the high inflation of the late 1970s contributed to growth in health care spending, which other countries had more systems in place to control
  • These are all highly valuable, but they came at very high prices. This willingness to pay more has in turn made the United States an attractive market for innovation in health care.
  • The last third of the 20th century or so was a fertile time for expensive health care innovation
  • being an engine for innovation doesn’t necessarily translate into better outcomes.
  • international differences in rates of smoking, obesity, traffic accidents and homicides cannot explain why Americans tend to die younger.
  • Some have speculated that slower American life expectancy improvements are a result of a more diverse population
  • But Ms. Glied and Mr. Muennig found that life expectancy growth has been higher in minority groups in the United States
  • even accounting for motor vehicle traffic crashes, firearm-related injuries and drug poisonings, the United States has higher mortality rates than comparably wealthy countries.
  • The lack of universal health coverage and less safety net support for low-income populations could have something to do with it
  • “The most efficient way to improve population health is to focus on those at the bottom,” she said. “But we don’t do as much for them as other countries.”
  • The effectiveness of focusing on low-income populations is evident from large expansions of public health insurance for pregnant women and children in the 1980s. There were large reductions in child mortality associated with these expansions.
  • A report by RAND shows that in 1980 the United States spent 11 percent of its G.D.P. on social programs, excluding health care, while members of the European Union spent an average of about 15 percent. In 2011 the gap had widened to 16 percent versus 22 percent.
  • “Social underfunding probably has more long-term implications than underinvestment in medical care,” he said. For example, “if the underspending is on early childhood education — one of the key socioeconomic determinants of health — then there are long-term implications.”
  • Slow income growth could also play a role because poorer health is associated with lower incomes. “It’s notable that, apart from the richest of Americans, income growth stagnated starting in the late 1970s,”
  • History demonstrates that it is possible for the U.S. health system to perform on par with other wealthy countries
  • That doesn’t mean it’s a simple matter to return to international parity. A lot has changed in 40 years. What began as small gaps in performance are now yawning chasms
  • “For starters, we could have a lot more competition in health care. And government programs should often pay less than they do.” He added that if savings could be reaped from these approaches, and others — and reinvested in improving the welfare of lower-income Americans — we might close both the spending and longevity gaps.
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