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Javier E

Antibody Tests Won't Get Us Back to Normal - The Atlantic - 0 views

www.theatlantic.com/...610762

antibody immunity pandemic

shared by Javier E on 29 Apr 20 - No Cached
  • antibody tests don’t give a snapshot of the present. It can take two weeks for a patient to develop a detectable amount of antibodies in their blood, so antibody surveys are necessarily backward-looking. But when public-health officials are deciding whether schools or businesses are safe to reopen, the key piece of information is the number of people currently infected. “I want to know what is happening now,” Osterholm said, “and antibody testing will not get that to you.”
  • The key strategies for stopping the disease are still the same ones experts have been promoting from the beginning: testing, contact tracing, isolating for those who test positive for COVID-19, and social distancing for everyone else. “There’s going to have to be some level of new normal for a while,”
  • Current antibody surveys are revealing, furthermore, that immunity to COVID-19 can vary widely from location to location
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  • The pandemic may be global but, as Yonatan Grad, an immunologist at Harvard University, told me, “it is made up of hyperlocal epidemics that are differentially impacting communities.” If neighboring cities, states, or countries are at very different points in their outbreak trajectory, it could create difficult questions about when and how to reopen. The places that have best succeeded in stopping COVID-19 will be the ones most vulnerable to infections in the future. Singapore, for example, succeeded in containing the virus early on, only to see a huge surge of cases in March and April. “At some point,” Grad said, “we’re going to need to think about How do we all get to the same place?”
Javier E

Vanquish the Virus? Australia and New Zealand Aim to Show the Way - The New York Times - 0 views

www.nytimes.com/...new-zealand-coronavirus.html

science australia new zealand response pandemic Crisis leadership

shared by Javier E on 24 Apr 20 - No Cached
  • what Australia and New Zealand have already accomplished is a remarkable cause for hope. Scott Morrison of Australia, a conservative Christian, and Jacinda Ardern, New Zealand’s darling of the left, are both succeeding with throwback democracy — in which partisanship recedes, experts lead, and quiet coordination matters more than firing up the base.
  • . Elimination means reducing infections to zero in a geographic area with continued measures to control any new outbreak, and that may require extended travel bans. Other places that seemed to be keeping the virus at bay, such as China, Hong Kong and Singapore, have seen it rebound, usually with infections imported from overseas.
  • compared to Mr. Trump and leaders in Europe, Mr. Morrison and Ms. Ardern responded with more alacrity and with starker warnings.
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  • In both countries, the public initially resisted and then complied, in part because the information flowing from officials at every level was largely consistent.
  • Playing their own versions of explainer in chief, Mr. Morrison has veered toward conservative radio, while Ms. Ardern prefers Facebook Live. But they’ve both received praise from scientists for listening and adapting to evidence.
  • “It’s a case of politicians just not being in the way,” said Ian Mackay, an immunologist at the University of Queensland who has been involved in response planning for the pandemic. “It’s a mix of things, but I think it comes down to taking advice based on expertise.”
  • Australia and New Zealand have squashed the curve
  • Australia, a nation of 25 million people that had been on track for 153,000 cases by Easter, has recorded a total of 6,670 infections and 78 deaths. It has a daily growth rate of less than 1 percent, with per capita testing among the highest in the world.
  • New Zealand’s own daily growth rate, after soaring in March, is also below 1 percent, with 1,456 confirmed cases and 17 deaths. It has just 361 active cases in a country of five million.
  • These figures put the two countries closer to Taiwan and South Korea, which have controlled the virus’s spread for now, than to the United States and Europe — even places seen as success stories, like Germany.
  • It all started with scientists. In Australia, as soon as China released the genetic code for the coronavirus in early January, pathologists in public health laboratories started sharing plans for tests. In every state and territory, they jumped ahead of politicians.
  • The government then opened the budgetary floodgates to support suffering workers and add health care capacity. When infections started climbing, many of the labs and hospitals hired second and third rounds of scientists to help.
  • That collaboration set the tone. Many of the state and local task forces spurred on by Mr. Morrison’s early action have stayed in constant contact, drawing in academics who independently started to model the virus’s spread
  • The newly formed national cabinet has delivered a surprising level of consensus for a country with a loose federal system subject to high levels of discord among state premiers, whose roles and powers resemble those of American governors.
  • Dr. Michael Baker, a physician and professor at the University of Otago in Wellington, became a prominent voice outside the government pushing for elimination of the virus, not just its suppression.
  • In Australia, officials are mostly discussing elimination in private, as a potential side effect of a strategy they still describe as suppression
  • elimination would be a “nirvana” scenario — an achievement that would be tough to maintain without indefinite bans on international travel or 14-day quarantines until a vaccine arrives.
  • Like Dr. Anthony Fauci, the face of the American government’s scientific response, they are known for extensive public health pedigrees, calm demeanors and no-nonsense adherence to facts.
  • He and others like him at the local level are key factors in a revival of trust in government that has appeared in poll after poll lately, even as the two countries’ economies have cratered and people have been told to severely restrict their lives.
  • some scientists wonder if eliminating the virus with good management might rebuild some faith not just in democracy, but also in the value of expertise.
  • “Maybe we’ll see the return of science,” Dr. Mackay added. “I doubt it, but who knows.”
Javier E

Trump isn't the only populist leader losing the battle against the coronavirus - The Wa... - 0 views

www.washingtonpost.com/...ing-battle-against-coronavirus

populism technocracy pandemic response strategies crisis politics policy

shared by Javier E on 07 May 20 - No Cached
  • a few patterns do emerge.
  • Some of the most successful countries in fighting covid-19 are democracies with well-educated populaces, high levels of trust and transparency, and governments that are run by technocrats. They have tested early and often, and they have used contact tracing to isolate carriers.
  • Examples include New Zealand, Australia, the Czech Republic, Germany, South Korea and Taiwan.
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  • Some autocracies with scientifically literate leaders, such as Vietnam, Hong Kong and Singapore, have also performed well.
  • By contrast, governments led by populists, whether elected or not, have generally been much less successful. Populists — who claim to embody the will of the people against the corrupt elites — are suspicious of expert opinion
  • they tend to ignore the advice of scientists, preferring “alternative facts” tailored to their own liking. They specialize in dividing the population, so it’s hard for them to unite against a common threat. And even more so than other leaders, they rely on economic growth for legitimacy; hence they are reluctant to suffer short-term economic costs in the interest of public health.
Javier E

Why Britain Failed Its Coronavirus Test - The Atlantic - 0 views

www.theatlantic.com/...615166

uk pandemic failure response

shared by Javier E on 14 Aug 20 - No Cached
  • Britain has not been alone in its failure to prevent mass casualties—almost every country on the Continent suffered appalling losses—but one cannot avoid the grim reality spelled out in the numbers: If almost all countries failed, then Britain failed more than most.
  • The raw figures are grim. Britain has the worst overall COVID-19 death toll in Europe, with more than 46,000 dead according to official figures, while also suffering the Continent’s second-worst “excess death” tally per capita, more than double that in France and eight times higher than Germany’s
  • The British government as a whole made poorer decisions, based on poorer advice, founded on poorer evidence, supplied by poorer testing, with the inevitable consequence that it achieved poorer results than almost any of its peers. It failed in its preparation, its diagnosis, and its treatment.
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  • In the past two decades, the list of British calamities, policy misjudgments, and forecasting failures has been eye-watering: the disaster of Iraq, the botched Libyan intervention in 2011, the near miss of Scottish independence in 2014, the woeful handling of Britain’s divorce from the European Union from 2016 onward
  • What emerges is a picture of a country whose systemic weaknesses were exposed with appalling brutality, a country that believed it was stronger than it was, and that paid the price for failures that have built up for years
  • The most difficult question about all this is also the simplest: Why?
  • Like much of the Western world, Britain had prepared for an influenza pandemic, whereas places that were hit early—Hong Kong, South Korea, Singapore, Taiwan—had readied themselves for the type of respiratory illness that COVID-19 proved to be.
  • Britain’s pandemic story is not all bad. The NHS is almost universally seen as having risen to the challenge; the University of Oxford is leading the race to develop the first coronavirus vaccine for international distribution, backed with timely and significant government cash; new hospitals were built and treatments discovered with extraordinary speed; the welfare system did not collapse, despite the enormous pressure it suddenly faced; and a national economic safety net was rolled out quickly.
  • One influential U.K. government official told me that although individual mistakes always happen in a fast-moving crisis, and had clearly taken place in Britain’s response to COVID-19, it was impossible to escape the conclusion that Britain was simply not ready. As Ian Boyd, a professor and member of SAGE, put it: “The reality is, there has been a major systemic failure.”
  • “It’s obvious that the British state was not prepared for” the pandemic, this official told me. “But, even worse, many parts of the state thought they were prepared, which is significantly more dangerous.”
  • When the crisis came, too much of Britain’s core infrastructure simply failed, according to senior officials and experts involved in the pandemic response
  • The human immune system actually has two parts. There is, as Cummings correctly identifies, the adaptive part. But there is also an innate part, preprogrammed as the first line of defense against infectious disease. Humans need both. The same is true of a state and its government, said those I spoke with—many of whom were sympathetic to Cummings’s diagnosis. Without a functioning structure, the responsive antibodies of the government and its agencies cannot learn on the job. When the pandemic hit, both parts of Britain’s immune system were found wanting.
  • The consequences may be serious and long term, but the most immediately tragic effect was that creating space in hospitals appears to have been prioritized over shielding Britain’s elderly, many of whom were moved to care homes, part of what Britain calls the social-care sector, where the disease then spread. Some 25,000 patients were discharged into these care homes between March 17 and April 16, many without a requirement that they secure a negative coronavirus test beforehand.
  • There was a bit too much exceptionalism about how brilliant British science was at the start of this outbreak, which ended up with a blind spot about what was happening in Korea, Taiwan, Singapore, where we just weren’t looking closely enough, and they turned out to be the best in the world at tackling the coronavirus,” a former British cabinet minister told me.
  • The focus on influenza pandemics and the lack of a tracing system were compounded by a shortfall in testing capacity.
  • Johnson’s strategy throughout was one that his hero Winston Churchill raged against during the First World War, when he concluded that generals had been given too much power by politicians. In the Second World War, Churchill, by then prime minister and defense secretary, argued that “at the summit, true politics and strategy are one.” Johnson did not take this approach, succumbing—as his detractors would have it—to fatalistic management rather than bold leadership, empowering the generals rather than taking responsibility himself
  • “It was a mixture of poor advice and fatalism on behalf of the experts,” one former colleague of Johnson’s told me, “and complacency and boosterism on behalf of the PM.”
  • What it all adds up to, then, is a sobering reality: Institutional weaknesses of state capacity and advice were not corrected by political judgment, and political weaknesses were not corrected by institutional strength. The system was hardwired for a crisis that did not come, and could not adapt quickly enough to the one that did.
  • Britain’s NHS has come to represent the country itself, its sense of identity and what it stands for. Set up in 1948, it became known as the first universal health-care system of any major country in the world (although in reality New Zealand got there first). Its creation, three years after victory in the Second World War, was a high-water mark in the country’s power and prestige—a time when it was a global leader, an exception.
  • Every developed country in the world, apart from the United States, has a universal health-care system, many of which produce better results than the NHS.
  • When the pandemic hit, then, Britain was not the strong, successful, resilient country it imagined, but a poorly governed and fragile one. The truth is, Britain was sick before it caught the coronavirus.
  • In asking the country to rally to the NHS’s defense, Johnson was triggering its sense of self, its sense of pride and national unity—its sense of exceptionalism.
  • Before the coronavirus, the NHS was already under considerable financial pressure. Waiting times for appointments were rising, and the country had one of the lowest levels of spare intensive-care capacity in Europe. In 2017, Simon Stevens, the NHS’s chief executive, compared the situation to the time of the health sevice’s founding decades prior: an “economy in disarray, the end of empire, a nation negotiating its place in the world.”
  • Yet from its beginnings, the NHS has occupied a unique hold on British life. It is routinely among the most trusted institutions in the country. Its key tenet—that all Britons will have access to health care, free at the point of service—symbolizes an aspirational egalitarianism that, even as inequality has risen since the Margaret Thatcher era, remains at the core of British identity.
  • In effect, Britain was rigorously building capacity to help the NHS cope, but releasing potentially infected elderly, and vulnerable, patients in the process. By late June, more than 19,000 people had died in care homes from COVID-19. Separate excess-death data suggest that the figure may be considerably higher
  • Britain failed to foresee the dangers of such an extraordinary rush to create hospital capacity, a shift that was necessary only because of years of underfunding and decades of missed opportunities to bridge the divide between the NHS and retirement homes, which other countries, such as Germany, had found the political will to do.
  • Ultimately, the scandal is a consequence of a political culture that has proved unable to confront and address long-term problems, even when they are well known.
  • other health systems, such as Germany’s, which is better funded and decentralized, performed better than Britain’s. Those I spoke with who either are in Germany or know about Germany’s success told me there was an element of luck about the disparity with Britain. Germany had a greater industrial base to produce medical testing and personal protective equipment, and those who returned to Germany with the virus from abroad were often younger and healthier, meaning the initial strain on its health system was less.
  • However, this overlooks core structural issues—resulting from political choices in each country—that meant that Germany proved more resilient when the crisis came, whether because of the funding formula for its health system, which allows individuals more latitude to top up their coverage with private contributions, or its decentralized nature, which meant that separate regions and hospitals were better able to respond to local outbreaks and build their own testing network.
  • Also unlike Britain, which has ducked the problem of reforming elderly care, Germany created a system in 1995 that everyone pays into, avoids catastrophic costs, and has cross-party support.
  • A second, related revelation of the crisis—which also exposed the failure of the British state—is that underneath the apparent simplicity of the NHS’s single national model lies an engine of bewildering complexity, whose lines of responsibility, control, and accountability are unintelligible to voters and even to most politicians.
  • Britain, I was told, has found a way to be simultaneously overcentralized and weak at its center. The pandemic revealed the British state’s inability to manage the nation’s health:
  • Since at least the 1970s, growing inequality between comparatively rich southeast England (including London) and the rest of the country has spurred all parties to pledge to “rebalance the economy” and make it less reliant on the capital. Yet large parts remain poorer than the European average. According to official EU figures, Britain has five regions with a per capita gross domestic product of less than $25,000. France, Germany, Ireland, Austria, the Netherlands, Denmark, and Sweden have none
  • If Britain were part of the United States, it would be anywhere from the third- to the eighth-poorest state, depending on the measure.
  • Britain’s performance in this crisis has been so bad, it is damaging the country’s reputation, both at home and abroad.
  • Inside Downing Street, officials believe that the lessons of the pandemic apply far beyond the immediate confines of elderly care and coronavirus testing, taking in Britain’s long-term economic failures and general governance, as well as what they regard as its ineffective foreign policy and diplomacy.
  • the scale of the task itself is enormous. “We need a complete revamp of our government structure because it’s not fit for purpose anymore,” Boyd told me. “I just don’t know if we really understand our weakness.”
  • In practice, does Johnson have the confidence to match his diagnosis of Britain’s ills, given the timidity of his approach during the pandemic? The nagging worry among even Johnson’s supporters in Parliament is that although he may campaign as a Ronald Reagan, he might govern as a Silvio Berlusconi, failing to solve the structural problems he has identified.
  • This is not a story of pessimistic fatalism, of inevitable decline. Britain was able to partially reverse a previous slump in the 1980s, and Germany, seen as a European laggard in the ‘90s, is now the West’s obvious success story. One of the strengths of the Westminster parliamentary system is that it occasionally produces governments—like Johnson’s—with real power to effect change, should they try to enact it.
  • It has been overtaken by many of its rivals, whether in terms of health provision or economic resilience, but does not seem to realize it. And once the pandemic passes, the problems Britain faces will remain: how to sustain institutions so that they bind the country together, not pull it apart; how to remain prosperous in the 21st century’s globalized economy; how to promote its interests and values; how to pay for the ever-increasing costs of an aging population.
  • “The really important question,” Boyd said, “is whether the state, in its current form, is structurally capable of delivering on the big-picture items that are coming, whether pandemics or climate change or anything else.”
Javier E

Opinion | Biden Trade Policy Breaks With Tech Giants - The New York Times - 0 views

www.nytimes.com/...google-facebook-ai-trade.html

biden trade policy tech oligopoly

shared by Javier E on 29 Nov 23 - No Cached
  • One reason that the idea of free trade has fallen out of fashion in recent years is the perception that trade agreements reflect the wishes of big American corporations, at everybody else’s expense.
  • U.S. officials fought for trade agreements that protect intellectual property — and drug companies got the chance to extend the life of patents, raising the price of medicine around the world. U.S. officials fought for investor protections — and mining companies got the right to sue for billions in “lost profit” if a country moved to protect its drinking water or the Amazon ecosystem. And for years, U.S. officials have fought for digital trade rules that allow data to move freely across national borders — prompting fears that the world’s most powerful tech companies would use those rules to stay ahead of competitors and shield themselves from regulations aimed at protecting consumers and privacy.
  • That’s why the Biden administration, which came into office promising to fight for trade agreements that better reflect the interests of ordinary people, has dropped its advocacy for tech-friendly digital trade rules that American officials have championed for more than a decade.
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  • Last month, President Biden’s trade representative, Katherine Tai, notified the World Trade Organization that the American government no longer supported a proposal it once spearheaded that would have exported the American laissez-faire approach to tech. Had that proposal been adopted, it would have spared tech companies the headache of having to deal with many different domestic laws about how data must be handled, including rules mandating that it be stored or analyzed locally. It also would have largely shielded tech companies from regulations aimed at protecting citizens’ privacy and curbing monopolistic behavior.
  • The move to drop support for that digital trade agenda has been pilloried as disaster for American companies and a boon to China, which has a host of complicated restrictions on transferring data outside of China. “We have warned for years that either the United States would write the rules for digital trade or China would,” Senator Mike Crapo, a Republican from Idaho, lamented in a press statement. “Now, the Biden administration has decided to give China the pen.”
  • While some of this agenda is reasonable and good for the world — too much regulation stifles innovation — adopting this agenda wholesale would risk cementing the advantages that big American tech companies already enjoy and permanently distorting the market in their favor.
  • who used to answer the phone and interact with lobbyists at the U.S. trade representative’s office. The paper includes redacted emails between Trump-era trade negotiators and lobbyists for Facebook, Google, Microsoft and Amazon, exchanging suggestions for the proposed text for the policy on digital trade in the United States-Mexico-Canada Agreement. “While they were previously ‘allergic to Washington,’ as one trade negotiator described, over the course of a decade, technology companies hired lobbyists and joined trade associations with the goal of proactively influencing international trade policy,” Ms. Li wrote in the Socio-Economic Review.
  • That paper explains how U.S. trade officials came to champion a digital trade policy agenda that was nearly identical to what Google, Apple and Meta wanted: No restrictions on the flow of data across borders. No forced disclosure of source codes or algorithms in the normal course of business. No laws that would curb monopolies or encourage more competition — a position that is often cloaked in clauses prohibiting discrimination against American companies. (Since so many of the monopolistic big tech players are American, rules targeting such behavior disproportionately fall on American companies, and can be portrayed as unfair barriers to trade.)
  • This approach essentially takes the power to regulate data out of the hands of governments and gives it to technology companies, according to research by Henry Gao, a Singapore-based expert on international trade.
  • The truth is that Ms. Tai is taking the pen away from Meta, Google and Amazon, which helped shape the previous policy, according to a research paper published this year by Wendy Li,
  • Many smaller tech companies complain that big players engage in monopolistic behavior that should be regulated. For instance, Google has been accused of privileging its own products in search results, while Apple has been accused of charging some developers exorbitant fees to be listed in its App Store. A group of smaller tech companies called the Coalition for App Fairness thanked Ms. Tai for dropping support for the so-called tech-friendly agenda at the World Trade Organization.
  • Still, Ms. Tai’s reversal stunned American allies and foreign business leaders and upended negotiations over digital trade rules in the Indo-Pacific Economic Framework, one of Mr. Biden’s signature initiatives in Asia.
  • The about-face was certainly abrupt: Japan, Singapore and Australia — which supported the previous U.S. position — were left on their own. It’s unfortunate that U.S. allies and even some American officials were taken by surprise. But changing stances was the right call.
  • The previous American position at the World Trade Organization was a minority position. Only 34 percent of countries in the world have open data transfer policies like the United States, according to a 2021 World Bank working paper, while 57 percent have adopted policies like the European Union’s, which allow data to flow freely but leave room for laws that protect privacy and personal data.
  • Nine percent of countries have restrictive data transfer policies, including Russia and China.
  • The United States now has an opportunity to hammer out a sensible global consensus that gives tech companies what they need — clarity, more universal rules, and relative freedom to move data across borders — without shielding them from the kinds of regulations that might be required to protect society and competition in the future.
  • If the Biden administration can shepherd a digital agreement that strikes the right balance, there’s a chance that it will also restore faith in free trade by showing that trade agreements don’t have to be written by the powerful at the expense of the weak.
Javier E

What Americans Keep Ignoring About Finland's School Success - Anu Partanen - The Atlantic - 0 views

www.theatlantic.com/...250564

education Finland pedagogy school teaching equality equity reform

shared by Javier E on 19 Mar 13 - No Cached
  • in recent years Finnish students have been turning in some of the highest test scores in the world.
  • The survey compares 15-year-olds in different countries in reading, math, and science. Finland has ranked at or near the top in all three competencies on every survey since 2000, neck and neck with superachievers such as South Korea and Singapore.
  • Compared with the stereotype of the East Asian model -- long hours of exhaustive cramming and rote memorization -- Finland's success is especially intriguing because Finnish schools assign less homework and engage children in more creative play
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  • "Oh," he mentioned at one point, "and there are no private schools in Finland."
  • Only a small number of independent schools exist in Finland, and even they are all publicly financed. None is allowed to charge tuition fees. There are no private universities, either. This means that practically every person in Finland attends public school, whether for pre-K or a Ph.D.
  • From his point of view, Americans are consistently obsessed with certain questions: How can you keep track of students' performance if you don't test them constantly? How can you improve teaching if you have no accountability for bad teachers or merit pay for good teachers? How do you foster competition and engage the private sector? How do you provide school choice?
  • Finland has no standardized tests. The only exception is what's called the National Matriculation Exam, which everyone takes at the end of a voluntary upper-secondary school, roughly the equivalent of American high school.
  • Instead, the public school system's teachers are trained to assess children in classrooms using independent tests they create themselves. All children receive a report card at the end of each semester, but these reports are based on individualized grading by each teacher.
  • "There's no word for accountability in Finnish," he later told an audience at the Teachers College of Columbia University. "Accountability is something that is left when responsibility has been subtracted."
  • what matters is that in Finland all teachers and administrators are given prestige, decent pay, and a lot of responsibility. A master's degree is required to enter the profession, and teacher training programs are among the most selective professional schools in the country. If a teacher is bad, it is the principal's responsibility to notice and deal with it.
  • "Real winners do not compete." It's hard to think of a more un-American idea, but when it comes to education, Finland's success shows that the Finnish attitude might have merits. There are no lists of best schools or teachers in Finland. The main driver of education policy is not competition between teachers and between schools, but cooperation.
  • Finally, in Finland, school choice is noticeably not a priority, nor is engaging the private sector at all.
  • Decades ago, when the Finnish school system was badly in need of reform, the goal of the program that Finland instituted, resulting in so much success today, was never excellence. It was equity.
  • Since the 1980s, the main driver of Finnish education policy has been the idea that every child should have exactly the same opportunity to learn, regardless of family background, income, or geographic location. Education has been seen first and foremost not as a way to produce star performers, but as an instrument to even out social inequality.
  • this means that schools should be healthy, safe environments for children. This starts with the basics. Finland offers all pupils free school meals, easy access to health care, psychological counseling, and individualized student guidance.
  • In fact, since academic excellence wasn't a particular priority on the Finnish to-do list, when Finland's students scored so high on the first PISA survey in 2001, many Finns thought the results must be a mistake. But subsequent PISA tests confirmed that Finland -- unlike, say, very similar countries such as Norway -- was producing academic excellence through its particular policy focus on equity.
  • the number of foreign-born residents in Finland doubled during the decade leading up to 2010, and the country didn't lose its edge in education. Immigrants tended to concentrate in certain areas, causing some schools to become much more mixed than others, yet there has not been much change in the remarkable lack of variation between Finnish schools in the PISA surveys across the same period.
  • Like Finland, Norway is small and not especially diverse overall, but unlike Finland it has taken an approach to education that is more American than Finnish. The result? Mediocre performance in the PISA survey. Educational policy, Abrams suggests, is probably more important to the success of a country's school system than the nation's size or ethnic makeup.
  • there were 18 states in the U.S. in 2010 with an identical or significantly smaller percentage of foreign-born residents than Finland
  • the goal of educational policy in the U.S. -- as articulated by most everyone from President Obama on down -- is to preserve American competitiveness by doing the same thing. Finland's experience suggests that to win at that game, a country has to prepare not just some of its population well, but all of its population well, for the new economy.
  • Finland's experience shows that it is possible to achieve excellence by focusing not on competition, but on cooperation, and not on choice, but on equity
  • The problem facing education in America isn't the ethnic diversity of the population but the economic inequality of society, and this is precisely the problem that Finnish education reform addressed. More equity at home might just be what America needs to be more competitive abroad.
Javier E

The Right Way to Increase Taxes - NYTimes.com - 1 views

dealbook.nytimes.com/...he-right-way-to-increase-taxes

tax policy economics

shared by Javier E on 20 Oct 12 - No Cached
  • The French proposal is half right. Broadening the tax base is a good idea. But the point is to allow for lower overall tax rates, not to confiscate wealth. We could do more to address inequality by making sure that all income is taxed, rather than increasing rates on the already burdened.
  • The third category is entrepreneurial income, like small-business income, founders’ stock and carried interest for fund managers. The income here is mostly a return on labor, not capital, but it is often lightly taxed as investment income. And this is where the debate tends to get heated.
  • We should start by plucking the low-hanging fruit. Carried interest is labor income, not investment income, and it’s not as mobile as financial capital. Few New York-based fund managers will give up United States citizenship and move permanently to Singapore just to avoid paying tax on carried interest.
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  • The instinct of the French to tax all income at the same rate is a good instinct. The mistake is in setting the rate at 75 percent.
izzerios

Trump's TPP withdrawal: 5 things to know - CNNPolitics.com - 0 views

www.cnn.com/...trump-tpp-things-to-know

shared by izzerios on 24 Jan 17 - No Cached
  • Donald Trump has begun carrying out his campaign pledges to undo America's trade ties -- starting Monday with executive action to pull the United States out of the Trans-Pacific Partnership.
  • "Great thing for the American worker, what we just did," Trump told reporters
  • Trans-Pacific Partnership -- a 12-nation deal that had been negotiated under former President Barack Obama.
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  • TPP -- its fate was bleak on Capitol Hill no matter what the White House did
  • Nothing changes because of Trump's move.
  • in doing so, he ends all hopes for a deal Obama wanted as a major part of his legacy.
  • Trump's move to withdraw from the TPP is likely to be politically popular.
  • The deal's critics complained that it didn't directly address the issue of currency manipulation.
  • he'd start to renegotiate the North American Free Trade Agreement.
  • is in position to reverse decades of American presidents pushing for lower trade barriers and an interconnected global economy.
  • through his negotiating prowess, force of will and willingness to walk away from the table, he can convince other countries to accept terms that previous presidents -- from George H.W. Bush and Bill Clinton on NAFTA to Barack Obama on the TPP -- have not been able to achieve.
  • TPP -- which has also included Canada, Mexico, Japan, Australia, New Zealand, Chile, Peru, Malaysia, Singapore, Vietnam and Brunei -- would have slashed tariffs for American imports and exports with those countries.
  • Sen. Bernie Sanders -- a leading Trump critic -- praised it, saying he is "glad the Trans-Pacific Partnership is dead and gone."
  • "Now is the time to develop a new trade policy that helps working families, not just multi-national corporations," Sanders said in a statement. "If President Trump is serious about a new policy to help American workers then I would be delighted to work with him."
  • Republicans have long supported free trade -- and now find themselves torn between a protectionist President and a business community that sees Trump's position as detached from the reality that new technology, rising wages and an increasingly interconnected world mean that many manufacturing and low-skill jobs won't return to the United States;
  • "I don't see any benefit in trying to crawl back into our shell as a country," Senate Majority Whip John Cornyn, R-Texas, told CNN.
  • Because the TPP hadn't taken effect, there will be no immediate impact.
  • United States is foregoing by turning down what would have been a deal including countries that make up 40% of the global economy
  • Businesses will also lose access to potential new markets, though. US automakers hoped to see tariffs slashed in Asia. Farmers were set to see the removal of trade taxes that currently prevent them from selling products
  • from Google to cell phone providers, sought to lessen regulations and gain entry into some of the countries involved in the deal.
  • "This decision will forfeit the opportunity to promote American exports, reduce trade barriers, open new markets, and protect American invention and innovation," Arizona Sen. John McCain
  • "We must remain committed to promoting free trade and investment through opening up and say no to protectionism," Chinese President Xi Jinping
  • Obama had pitched the TPP as a way to counter China's growing influence by imposing US-backed labor, environmental and patent protections.
  • The 11 remaining TPP nations are now set to regroup.
  • the United States' withdrawal could mean a major rewrite, or an opening for another global superpower to pursue an alternative agreement.
julia rhodes

U.S. Citizens Renouncing Skyrocket---The Tina Turner Effect - Forbes - 0 views

www.forbes.com/...yrocket-the-tina-turner-effect

economics economic politics US citizens forbes expatriate taxes

shared by julia rhodes on 16 Nov 13 - No Cached
  • America is a great land and lures immigrants worldwide, yet record numbers of U.S. citizens and permanent residents are giving up their citizenship or residency.
  • And this year that trend is up by at least 33%  from the previous high in 2011.
  • Since then, the tax and other consequences do not depend on why one leaves. Yet after Facebook co-founder Eduardo Saverin departed permanently for Singapore with his Facebook IPO riches, there was an angry backlash.
  • ...5 more annotations...
  • Meantime, are people following Tina Turner’s lead? No, and not Eduardo Saverin’s either. Most expatriations are probably motivated primarily by factors such as family and convenience. Many people like Ms. Turner have built a life somewhere else and may not plan to need a U.S. passport.
  • Although statistics are not available for why people say a final good-bye, many now find America’s global income tax compliance and disclosure laws inconvenient and nettlesome.
  • What’s more, U.S. reporting is based on their worldwide income, even though they are paying taxes in the country where they live.
  • . It requires an annual Form 8938 to be filed with income tax returns for foreign assets meeting a threshold. And foreign banks are sufficiently worried about keeping the IRS happy that many simply do not want American account holders. Americans abroad can be pariahs shunned by banks for daily banking activities.
  • To exit, you generally must prove 5 years of tax compliance in the U.S. Plus, if you have a net worth greater than $2 million or have average annual net income tax for the 5 previous years of $155,000 or more (that’s tax, not income), you pay an exit tax.
julia rhodes

Dictators in the Age of Instagram : The New Yorker - 0 views

www.newyorker.com/...s-in-the-age-of-instagram.html

policy culture US crisis syria news assad instagram internet

shared by julia rhodes on 02 Nov 13 - No Cached
  • “So, you want to be a dictator?”
  • Too bad you’re living in this century. “It is tougher to lead an authoritarian regime in the face of democratic ideals, free speech and globalized media.
  • Snyderwine puts forth complex mathematical formulas that show a dictator how to stay in power with cost-benefit analyses of revolutions that take into account factors like bribes and the number of active revolutionaries killed.
  • ...7 more annotations...
  • “The Dictator’s Practical Internet Guide to Power Retention,” is a compilation of tips, gleaned from the experiences of leaders in China, Singapore, Russia, Iran, Pakistan, and other countries, that illustrate just how brutal the modern, connected world can be for a tyrant.
  • Recep Tayyip Erdoğan, recently said that “this thing called social media is a curse on societies.”
  • n Syria, President Bashar al-Assad has proved canny online. Blackouts have shut down the Internet at various moments in the past two years
  • The state news agency blamed one blackout, in May, on “a malfunctioning fibre-optic cable,” but it was not lost on many that it was timed near a vote on a U.N. resolution on Syria.
  • Does it matter if this is a kind of misinformation? What does a social-media company do when a user known to be attacking civilians is blasting out feel-good content?
  • But she explained that, generally speaking, if a user created content that promoted violence, Instagram would remove it and possibly disable the user. Schumer stressed the importance of the context of the image in making those calls—a caption might make an image threatening, for instance—but also said that “context” is generally limited to content on the site.
  • And yet, even within that complex framework, what does it mean to follow a man strongly suggested to be a war criminal, to have a virtual shrine to a dictators’ glory that can fit in our pockets?
Javier E

In PISA Test, Top Scores From Shanghai Stun Experts - NYTimes.com - 0 views

www.nytimes.com/...07education.html

test international comparative education China US

shared by Javier E on 10 Dec 10 - No Cached
  • On the math test last year, students in Shanghai scored 600, in Singapore 562, in Germany 513, and in the United States 487. In reading, Shanghai students scored 556, ahead of second-place Korea with 539. The United States scored 500 and came in 17th, putting it on par with students in the Netherlands, Belgium, Norway, Germany, France, the United Kingdom and several other countries. In science, Shanghai students scored 575. In second place was Finland, where the average score was 554. The United States scored 502 — in 23rd place — with a performance indistinguishable from Poland, Ireland, Norway, France and several other countries.
Javier E

China's Winning Schools? - NYTimes.com - 0 views

www.nytimes.com/...16kristof.html

schools china culture learning

shared by Javier E on 16 Jan 11 - No Cached
  • An international study published last month looked at how students in 65 countries performed in math, science and reading. The winner was: Confucianism!
  • Three of the next top four performers were also societies with a Confucian legacy of reverence for education: Hong Kong, Singapore and South Korea. The only non-Confucian country in the mix was Finland.
  • Education thrives in China and the rest of Asia because it is a top priority
  • ...5 more annotations...
  • In my Chinese-American wife’s ancestral village — a poor community in southern China — the peasant children are a grade ahead in math compared with my children at an excellent public school in the New York area. That seems broadly true of math around the country.
  • In China, school sports and gym just don’t matter.
  • Many Chinese complain scathingly that their system kills independent thought and creativity, and they envy the American system for nurturing self-reliance — and for trying to make learning exciting and not just a chore.
  • the greatest strength of the Chinese system is the Confucian reverence for education that is steeped into the culture. In Chinese schools, teachers are much respected, and the most admired kid is often the brain rather than the jock or class clown.
  • the real challenge is the rise of China’s education system and the passion for learning that underlies it. We’re not going to become Confucians, but we can elevate education on our list of priorities without relinquishing creativity and independent thought.
Javier E

The humbling of Britain - 0 views

www.newstatesman.com/...humbling-britain

brexit responsibility history uk

shared by Javier E on 10 Apr 19 - No Cached
  • The original sin was that of David Cameron
  • The public was not clamouring for a referendum on EU membership. Cameron called it for the narrow purpose of uniting his party and fending off Ukip. He offered an ill-informed electorate a binary choice on an extraordinarily complex issue of profound constitutional importance without even the safeguard of a 60 per cent threshold for approval.
  • It was one of the most foolish gambles ever taken by a British prime minister, and one that unleashed the charlatans, rogues and demagogues of the Leave campaign.
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  • Worst of all, having defeated Cameron’s hapless Remain campaign, the luminaries of Leave turned out to have no plan whatever for implementing their fairy-tale Brexit.
  • Cameron may be the worst prime minister of modern times, but May runs him close. She is certainly the only one to pursue a goal that she knows to be immensely damaging to her country.
  • The roll of ignominy does not end there. Next up is May’s de facto accomplice, Jeremy Corbyn. He is a covert Leaver masquerading as a Remainer, the opposition leader who refuses to lead, the head not so much of a government-in-waiting than of an “opposition in hiding” as one commentator put it.
  • the deceptively innocuous-sounding European Research Group (ERG), a party within a party, the Tories’ very own Militant Tendency. Led by Jacob Rees-Mogg, with a snarl behind his smile, these right-wing zealots have zero interest in the “people” they profess to champion. They seek to turn Britain into the low-wage, low-regulation Singapore of Europe, which is certainly not what disgruntled blue-collar workers in Stoke or Sunderland voted for.
  • The ERG has been shamefully aided and abetted by much of the British press – most notably the Telegraph, the Sun, the Express and the Daily Mail under its former editor, Paul Dacre.
  • During and since the referendum campaign those papers have abandoned any pretence of impartiality, of seeking to enlighten their readers or of holding our government to account. They pump out propaganda worthy of a second-rate banana republic. They downplay Brexit’s rapidly escalating costs, savage its opponents, and accuse the EU of negotiating in bad faith
Javier E

High-Net-Worth Chinese Nervous About China's Economy - Barron's - 0 views

www.barrons.com/...out-chinas-economy-01547762984

china economy confidence rich migration

shared by Javier E on 21 Jan 19 - No Cached
  • Among the 465 respondents who have a net worth of at least 10 million RMB (about US$1.5 million), 14% said they “lack confidence” in China’s economy, rising from 8% in 2017. It also marks the highest level in 15 years since Hurun, known for its annual rankings of China’s rich, began the survey.Those who were “strongly confident” in the country’s economic prospects dropped 12 percentage points to 34%, the lowest on record. Nearly half of respondents said they were “somewhat confident,” according to the Hurun Chinese Luxury Consumer Survey 2019.
  • About 53% of high-net-worth individuals surveyed said they had no plans to emigrate to other countries, while 38% said they were considering a move abroad. Nearly 9% said they had non-Chinese citizenship or were in the process of application.The top destination for rich Chinese to emigrate was Europe, with 30% of respondents picking the region. Australia and the U.S. tied on the second spot (28%), followed by Canada (27%) and Singapore (11%).
runlai_jiang

Trump actually thinks executing drug dealers would help. That's the problem. - The Wash... - 0 views

www.washingtonpost.com/...s-would-help-thats-the-problem

drugpolicy Trump

shared by runlai_jiang on 04 Mar 18 - No Cached
  • President Trump has been talking up a new strategy in the nation’s struggle against the opioid epidemic: imposing the death penalty on drug dealers, just as they do in Singapore and Rodrigo Duterte’s Philippines.
  • “You have to have strength, and you have to have toughness — the drug dealers, the drug pushers are, they’re really doing damage, they’re really doing damage,
  • Some countries have a very, very tough penalty — the ultimate penalty — and by the way, they have much less of a drug problem than we do.
  • ...6 more annotations...
  • he country has already tried an aggressive enforcement approach to drug crimes — the four-decade-plus war on drugs — and among experts and law enforcement officers , it is almost universally acknowledged as a massive failure in economic and practical terms
  • Even more concerning, the war on drugs has been disproportionately waged against black and brown people . Escalating the possible sentence for drug crimes to death would just amplify the many injustices already present in a broken system.
  • He doesn’t recognize that most of our opioid deaths result from drugs that are made in the United States or shipped in from China 
  • And that self-centered self-assuredness is the slender framework supporting his enthusiasm for adopting the bloodthirsty edicts of a genuine despot and a notoriously repressive quasi-police state
  • hese policy proposals (such as they are) are terrible ideas considered on their own. But it’s something of an accomplishment to have them combine quite as gruesomely as “more firearms in schools” and “shoot all drug dealers” might — at least Singapore’s tougher gun-control laws prevent the kind of “good guy with a gun” vigilantism that Trump regularly invokes
  • the government has got to teach children that they’ll die if they take drugs and they’ve got to make drug dealers fear for their lives.”
  • runlai_jiang on 04 Mar 18
     
    I think this is a reasonable policy though, we need to let the drug dealers feel afraid to deal drugs.
millerco

Trump Pulls Out of North Korea Summit Meeting With Kim Jong-un - The New York Times - 0 views

www.nytimes.com/...north-korea-trump-summit.html

US trump north korea politics

shared by millerco on 25 May 18 - No Cached
  • President Trump on Thursday pulled out of a highly anticipated summit meeting with Kim Jong-un, accusing the North Koreans of bad faith and lamenting that “this missed opportunity is a truly sad moment in history.”
  • The president made his announcement in a remarkably personal, at times mournful-sounding letter to Mr. Kim, North Korea’s leader, in which he cited the North’s “tremendous anger and open hostility” in recent public statements as the specific reason for canceling the meeting.
  • Mr. Trump said later that the meeting, which had been scheduled for June 12 in Singapore, could still happen, and North Korea issued a strikingly conciliatory response, saying it hoped Mr. Trump would reconsider.
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  • The president emphasized that conciliatory tone with a tweet early Friday, saying “the warm and productive statement from North Korea” could lead “hopefully to long and enduring prosperity and peace.”
Javier E

New U.N. climate report: Massive change already here for world's oceans and frozen regi... - 0 views

www.washingtonpost.com/...e-worlds-oceans-frozen-regions

climate oceans un report

shared by Javier E on 25 Sep 19 - No Cached
  • Climate change is already causing staggering impacts on the oceans and ice-filled regions that encompass 80 percent of the Earth, and future damage from rising seas and melting glaciers is now all but certain, according to a sobering new report from the United Nations.
  • Wednesday’s report on the world’s oceans, glaciers, polar regions and ice sheets finds that such effects only foreshadow a more catastrophic future as long as greenhouse gas emissions remain unchecked.
  • Given current emissions levels, a number of serious impacts are essentially unavoidable
  • ...23 more annotations...
  • Extreme floods that have historically struck some coastal cities and small island nations once every 100 years will become an annual occurrence by 2050
  • if emissions continue to increase, global sea levels could rise by more than three feet by the end of this century — around 12 percent higher than the group estimated as recently as 2013
  • Melting glaciers could harm water supplies, and warming oceans could wreck marine fisheries.
  • “The conclusion is inescapable: The impacts of climate change on the ocean are well underway. Unless we take very serious action very soon, these impacts will get worse — much, much worse.”
  • More than 100 scientists from around the world contributed to the latest report by the IPCC, which found that profound and potentially devastating consequences lie ahead for marine life, Arctic ecosystems and entire human societies if climate change continues unabated.
  • While dozens of smaller nations did unveil plans for coming years, the world’s largest emitters have stopped short of committing to transformational changes.
  • Sea level rise is accelerating, and the world could see 3.6 feet in total sea level rise by the year 2100 in a very high-emissions scenario. In 2013, t
  • The ocean is losing oxygen, growing more acidic, taking up an increasing amount of heat, and becoming more stratified, with warm water at the surface preventing cooler, nutrient rich waters from rising. All of these changes have profound consequences for marine ecosystems.
  • when scientists behind the report looked at an alternative method for gauging how much seas could rise — simply canvassing the views of experts — even larger estimates emerged. The group’s findings only highlight “likely” amounts of sea level rise, meaning they do not represent worst-case scenarios.
  • For some major coastal cities, a historical 100-year flood event will happen annually by the year 2050. That includes large cities such as Jakarta, Manila, Bangkok, Lima, Singapore, Barcelona and Sydney, the report says
  • In the United States, cities facing fast-moving sea-level danger include Los Angeles, Miami, Savannah, Honolulu, San Juan, Key West and San Diego.
  • “The world’s coasts provide a home to around 1.9 billion people and over half of the world’s megacities — all of which are in grave danger if we don’t act immediately to prevent rising temperatures and sea levels,”
  • “Extreme high temperatures, coastal flooding, and more frequent natural disasters are becoming the new normal. ... This is what the climate crisis looks like now.
  • the system could still tip toward very large ice losses from Greenland and Antarctica. If that happens, the rate of sea-level rise could become truly catastrophic, especially by the years 2200 and 2300, when it could exceed 10 feet.
  • Permafrost, which contains enormous amounts of carbon that can be released as it thaws, has warmed to “record high levels.” Summer Arctic sea ice extent is now probably lower than at any time in “at least 1,000 years,” and the oldest, thickest ice has already declined by 90 percent.
  • “Over the 21st century, the ocean is projected to transition to unprecedented conditions,”
  • “Even our language has to adapt: What once was called ‘climate change’ is now truly a ‘climate crisis.’ … We are seeing unprecedented temperatures, unrelenting storms and undeniable science.”
  • One of the most shocking findings involves “marine heat waves,” which have been blamed for mass deaths of corals, kelp forests and other key ocean organisms. The large majority of these events are already directly attributable to climate change, and by the year 2100, they will become 20 times more common in the best case, and 50 times as common in the absolute worst case, compared with the late 1800s
  • Many of these changes to oceans and ice are unfolding in parts of the Earth where few people live, and so the shifts are not always readily visible to most humans. But the changes taking place there ultimately will affect people around the globe, in the form of rising seas and other impacts. And as those impacts worsen, so does the difficulty of adapting to them.
  • the grim findings in Wednesday’s report should be a call to action.
  • "We must not let these climate change impacts paralyze us,” she said in an email. “We must address root causes of climate change by slowing and eventually stopping accumulation of greenhouse gas emissions.”
  • There is much that humans can do to blunt the expected impacts in the meantime, she said, such as restoring mangroves and protecting reefs and marshes to reduce storm impacts on coastal communities.
  • “Alone, these measures cannot meet all the challenges of climate change to oceans and coasts, but they are doable, cost-effective and make a difference,”
Javier E

How to evaluate and eventually ease coronavirus restrictions - The Washington Post - 0 views

www.washingtonpost.com/...onavirus-strategy-economy-plan

restrictions pandemic strategies trump policy response

shared by Javier E on 29 Mar 20 - No Cached
  • In recent days, epidemiologists and infectious disease specialists, as well as former top agency officials, have rushed to put out their own plans — by publishing preprint papers online and sharing ideas on Twitter and in op-eds
  • a consensus of sorts has begun to coalesce around several key ingredients for an American strategy to move forward while minimizing human and economic casualties. They include mounting a large-scale contact tracing effort, widespread testing, building up health care capacity before easing restrictions, making future quarantines more targeted, and allowing those who have recovered and have some immunity to go back to work.
  • The latest proposal is a 19-page plan with a step-by-step timeline, with clear benchmarks states and regions would need to meet to safely move forward to the next step
  • ...29 more annotations...
  • The plan was published Sunday by the American Enterprise Institute. Its lead author — Scott Gottlieb, former Food and Drug Administration commissioner in the Trump administration
  • “The goal is to outline a plan that will allow a gradual return to a more normal way of life without increasing the risk” that the epidemic will resurge.
  • Most economists and health experts say there is no way to restart the economy without addressing the underlying problem of the coronavirus. As long as the pandemic continues to spread, the markets will be in turmoil and any businesses will struggle to stay open, they say.
  • instead of giving false reassurances and deadlines, the White House should tell people the hard truth about the current situation and a coherent strategy they can work toward. “The social distancing, being stuck at home, the deaths we’re going to be seeing. People want to know what it’s for. That there’s a plan.”
  • the road map Gottlieb’s group outlined stresses the need to move away from the current decentralized system and “toward more coordinated execution of response.”
  • The plan divides coming months into four phases and sets “triggers” for states to move from one phase to the next.
  • While overall the peak of the epidemic may occur in late April or early May, the timing may be different in different states.
  • With most of the nation now in phase one of the epidemic, the goal should be a sharp increase in hospital critical care beds and an increase of testing to 750,000 people a week to track the epidemic — a number Gottlieb said could be achieved in the next week or two.
  • For a state to move to phase two, it should see a sustained reduction in new cases for at least 14 days, and its hospitals need to be able to provide care without being overwhelmed.
  • “The reason we set it at 14 days is that’s the incubation period of the virus,” said Rivers of Johns Hopkins. “That way you know the downward trend is certain and not because of a holiday or blip or some other delay in reported cases.”
  • States that have moved into phase two would begin gradually lifting social distancing measures and opening schools and businesses, while increasing surveillance.
  • The key goals thereafter would be accelerating the development of new treatments and deploying tests to determine who has recovered from infection with some immunity and could rejoin the workforce.
  • Phase 3 occurs when the nation has a vaccine or drugs to treat covid-19 in place and the government launches mass vaccinations
  • Phase 4 involves rebuilding the nation’s capacity to deal with the next pandemic by building up its scientific and public health infrastructure.
  • Trump has repeatedly returned to strategies of bans and movement restriction
  • For weeks, World Health Organization officials have stressed such lockdowns are only helpful for slowing down the virus and buying time to deploy more targeted and comprehensive measures, which the U.S. has not yet done.
  • Mike Ryan, WHO head of emergency programs, recently urged countries to focus on finding and isolating infected people and their contacts. “It’s not just about physical distancing, it’s not just about locking down,”
  • Many experts’ recent proposals for a U.S. strategy have similar stressed the importance of large-scale contact tracing — because it was a cornerstone for successful efforts like South Korea and Singapore.
  • as countries have shown success with it against this coronavirus, that thinking has changed.
  • such contact tracing is “impractical now in many places but more practical once case numbers have been reduced and testing scaled up” and “could alleviate the need for stringent social distancing to maintain control of the epidemic.”
  • Rapidly building up that capacity — either with community volunteers or short-term hires — will be crucial in coming months, said Rivers of Johns Hopkins. “If you build capacity up and bring cases down, it starts looking a lot more possible.”
  • Many proposals tackle the problem of the tanking economy.
  • Gottlieb-Johns Hopkins plan, for example, calls for widespread use of blood tests to identify people who have had the infection and now are immune — called serology testing
  • People who are immune could return to work, or take on high-risk roles in the health care system and help people, especially the elderly, who are still quarantined at home.
  • Such serology tests have not been deployed before like this on such a large scale
  • during Ebola outbreaks in Africa, survivors were often the ones who provided care, watched over the children of sick patients and buried the dead.
  • One challenge unaddressed by most proposals and op-eds, however, is how to get such detailed plans adopted by the White House, whose response has weighed down by infighting and unclear leadership ping-ponging in recent weeks among Trump, Pence and health advisers like Anthony S. Fauci and Deborah Birx and others.
  • Health officials and scientists involved in the federal response, especially from the Centers for Disease Control and Prevention, have fought to be heard while straining to avoid offending Trump, who bristles at being publicly contradicted, undercut or overshadowed by praise for ideas or people beside himself, according to people who spoke on the condition of anonymity about sensitive deliberations.
  • On Thursday, Trump unveiled a plan of his own, though scarce in detail. He said he planned to help communities ease their restrictions and reopen for business by using on “robust” surveillance and categorizing counties across America into three “risk levels” — low, medium and high. More details are likely in coming days, White House officials said.
Javier E

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

www.theatlantic.com/...608719

strategies effects pandemic culture politics history crisis

shared by Javier E on 25 Mar 20 - No Cached
  • 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,”
  • ...56 more annotations...
  • 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
  • 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.
  • The first and most important is to rapidly produce masks, gloves, and other personal protective equipment
  • 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,”
  • 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.
  • 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.
  • 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,”
  • 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.
  • “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.”
  • 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.
  • In 2030, SARS-CoV-3 emerges from nowhere, and is brought to heel within a month.
  • 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.
Javier E

With Broad, Random Tests for Antibodies, Germany Seeks Path Out of Lockdown - The New Y... - 0 views

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germany pandemic strategies testing policy

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  • Mr. Germann and his girlfriend joined 3,000 households chosen at random in Munich for an ambitious study whose central aim is to understand how many people — even those with no symptoms — have already had the virus, a key variable to make decisions about public life in a pandemic.
  • The study is part of an aggressive approach to combat the virus in a comprehensive way that has made Germany a leader among Western nations figuring out how to control the contagion while returning to something resembling normal life.
  • Other nations, including the United States, are still struggling to test for infections. But Germany is doing that and more. It is aiming to sample the entire population for antibodies in coming months, hoping to gain valuable insight into how deeply the virus has penetrated the society at large, how deadly it really is, and whether immunity might be developing.
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  • The government hopes to use the findings to unravel a riddle that will allow Germany to move securely into the next phase of the pandemic: Which of the far-reaching social and economic restrictions that have slowed the virus are most effective and which can be safely lifted?
  • Other countries like Iceland and South Korea have tested broadly for infections, or combined testing with digital tracking to undercut the spread of the virus. But even the best laid plans can go awry; Singapore attempted to reopen only to have the virus re-emerge.
  • President Trump is in a hurry to restart the economy in an election year, but experts warn that much wider testing is needed to open societies safely.
  • Both Britain and the United States, where some of the first tests were flawed, virtually forfeited the notion of widespread testing early in their outbreaks and have since had to ration tests in places as they scramble to catch up
  • Germany, which produces most of its own high-quality test kits, is already testing on a greater scale than most — 120,000 a day and growing in a nation of 83 million.
  • Merkel, a trained scientist, said this week that the aim was nothing less than tracing “every infection chain.”
  • Every 10 people infected with the virus now pass it to seven others — a sharp decline in the infection rate for a virus that has spread exponentially.
  • The generosity and solidarity on such striking display inside of Europe’s largest and richest economy have been missing in Germany’s response to poorer European nations in the south, which were hit hardest by the virus.
  • the chancellor’s mixture of calm reassurance and clear-eyed realism — as well as her ability to understand the science and explain it to citizens — has been widely praised and encouraged Germans to follow social distancing rules. Her approval ratings are now higher than 80 percent.
  • That broad confidence in government has given Germany a tremendous advantage. It is much of the reason a knock on the door by a police officer and strangers dressed like aliens asking for blood can engender good will rather than alarm
  • “We are leading the thinking of what to do next.”
  • Its most ambitious project, aiming to test a nationwide random sample of 15,000 people across the country, is scheduled to begin next month.
  • “In the free world, Germany is the first country looking into the future,”
  • Nationally, the Robert Koch Institute, the government’s central scientific institution in the field of biomedicine, is testing 5,000 samples from blood banks across the country every two weeks and 2,000 people in four hot spots who are farther along in the cycle of the disease.
  • In Gangelt, a small town of about 12,000 in northwest Germany, tests of a first group of 500 residents found that 14 percent had antibodies to the virus. Another 2 percent tested positive for the coronavirus, raising hopes that about 15 percent of the local population may already have some degree of immunity.
  • “The process toward reaching herd immunity has begun,”
  • t may hold valuable insights for places that lag behind as the pandemic runs its course.
  • The mortality rate in the town, for example, turned out to be 0.37 percent, much lower than the national rate of 2.9 percent which is calculated based only on detected infections.
  • “We are at a crossroads,” said Mr. Hoelscher, the professor. “Are we going the route of loosening more and increasing immunity in the summer to slow the spread of this in the winter and gain more freedom to live public life? Or are we going to try to minimize transmissions until we have a vaccine?
  • “This is a question for politicians, not for scientists,” he added. “But politicians need the data to make an informed risk assessment.”
  • “I thought to myself if we’re going into lockdown, we need to start working on an exit strategy now,”
  • The next day, he said he wrote a short pitch to the Bavarian government. Six hours later, he had the green light. It took another three weeks until the test kits had arrived, a new lab was opened and teams of medics started fanning out across the city.
  • Six days after they first rung his doorbell, a doctor and two medical students came back to Mr. Germann’s apartment, household number 420 out of 3,000.They put on disposable protection suits, gloves and goggles and one of them sat down on a plastic stool they had brought along to take a small vial of his blood. Then they removed and bagged their suits, disinfected the stool and any surface they had touched and left. It took all of 10 minutes.
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