Wednesday, August 12, 2020


Disinfecting surfaces is ‘hygiene theater'

As a Covid-19 summer surge sweeps the country, deep cleans are all the rage. Restaurants, gyms, offices, and mass transit are all trying to create public confidence by spraying oceans of disinfectants on every square inch of America’s surface area. Sorry, but this may all be a huge waste of time—a piece of “hygiene theater” with no practical purpose. Scientists studying how the coronavirus has spread have concluded that surface transmission is extremely rare. Instead, they have traced nearly all outbreaks to airborne respiratory droplets spread from person to person—large droplets expelled in sneezes and coughs, and smaller aerosolized droplets from speech or even exhalations, which can linger in the air of indoor spaces.

In real-world conditions, scientists say, the virus does not survive on surfaces for very long. We should all still wash our hands when out in public, but studies have concluded that people aren’t getting infected from packages, elevator buttons, or door handles. It’s wearing masks, distancing, and moving activities outdoors that actually keep us safe. Theatrically blasting surfaces with disinfectants builds a false sense of security in indoor spaces, which can ironically lead to more infections.
--Derek Thompson, 
Can virtual visits replace a doctor’s touch?

*****The rise of telemedicine may be a silver lining in the coronavirus pandemic.  With many doctors’ offices closed and people worried about leaving their homes, virtual visits have surged as a way for patients to seek medical advice without stepping outside. Congress approved an expansion of Medicare coverage to include telehealth nationwide, and allocated money for communications services to make sure patients with critical needs can get remote follow-ups. The tech giants have taken notice; Microsoft introduced a new Cloud for Healthcare in May. Now many patients are growing accustomed to the convenience. They might not want to revisit the obstacles that can become excuses for not seeking a doctor.
--Cherlynn Low,

*****Providers are less bullish on the shift, mainly because it’s hard for most small practices to implement. A practice must buy appropriate technology. Clinical schedules need to be changed. Documentation protocols must be updated. And on and on. Some doctors are also leery about taking the plunge” because of concerns about how much insurers, particularly Medicaid, will cover.
--Ateev Mehrotra,

*****As a primary care physician, I think the technology is fine. But I also know it will never replace in-person care. Well-trained clinicians use all their senses and examine the whole patient. Could a Zoom visit detect a lymph node too firm, a spleen or liver too large, or an unexpected prostate nodule?
--David Blumenthal, Harvard Business Review

Look for a ‘blue shift’ in November

The “blue shift” may decide the presidential election. In recent races, Democrats have benefited from a large wave of provisional ballots counted after the polls closed—sometimes changing which candidate won. In the 2018 midterm elections, blue-shift votes tallied after Election Day gave Democrat Kyrsten Sinema a U.S. Senate race in Arizona and helped Democrats win 41 House seats nationally. Amid the pandemic, tens of millions of additional votes will be cast by mail in November, but President Trump has convinced many Republicans that mail-in ballots are tainted. This could lead to a massive blue shift in mail-in votes—and a catastrophic challenge to the results.

Let’s say that when polls close, President Trump holds a narrow lead in one or more swing states that would give him an Electoral College majority. He’ll declare victory. But as mail-in votes are tallied over days and even weeks, Biden emerges as the clear winner in those swing states. Trump cries fraud and insists that he’s the target of a criminal Democratic coup. The country would be plunged into chaos. Unless one candidate wins by a landslide, Election Day will be more like Election Week or Election Month this year
--David Graham, The

The danger of eliminating the filibuster

If Democrats win the White House and the Senate, should they eliminate the filibuster? Former President Obama recently called on his party to get rid of that U.S. Senate tradition, so Democrats could push through sweeping legislative changes with 51 Senate votes. Under current rules, either party can block legislation by invoking the filibuster and requiring 60 votes to resume debate—an important check on the party in power. Many Democrats say that without the filibuster, the party could add Washington, D.C., and Puerto Rico as states, giving Democrats four additional senators and a majority for years to come.

But this shortsighted idea would lead to an escalating “arms race” in altering the rules: When Republicans return to power, as they eventually would, they could divide Republican states in half to create even more states and senators. Anything the Democrats had achieved in the majority would be reversed, with the country veering back and forth between partisan extremes. In the book “How Democracies Die,” Harvard professors Steven Levitsky and Daniel Ziblatt warn that “acts of constitutional hardball” can erase all norms and lead to “politics without guardrails.” Without guardrails, our system of government may go off a cliff.
--Bill Scher,

Going back on our word to trade allies

Tariff Man is back.  With his re-election on the ropes, President Trump returned to his favorite household remedy, re-imposing a 10 percent tariff on Canadian aluminum only a month after his “new NAFTA,” the United States–Mexico-Canada (USMCA) agreement, officially went into effect. The agreement included a provision for levies if imports surged “beyond historic volumes of trade.” That gave the president an opening, and at a visit to a Whirlpool factory in Ohio last week, Trump invoked the clause, claiming our neighbors are “taking advantage of us, as usual.”

That’s not true: Imports of aluminum are actually below the level of 2017. But two well-connected U.S. aluminum producers have lobbied for new tariffs. The Trump administration has obliged them despite the economic harm. The tariffs will raise prices for end users such as beer companies, automakers—and Whirlpool, which complained in 2018 that Trump’s steel and aluminum tariffs had significantly raised production costs. Canada, predictably, responded with $2.7 billion in additional taxes on U.S. exports of aluminum products such as bicycles, golf clubs and refrigerators. This is Trump at his policy worst: He hurts U.S. industry and consumers, while telling America’s friends that his word on trade can’t be trusted.
--Wall Street Journal editorial

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