Search the KHIT Blog

Friday, February 28, 2020

COVID-19 "Pandemic?" Wall Street freaks out.

Click the Hopkins Coronavirus graphic to enlarge. Defintely spreading worldwide. Update of my prior post.

Whatever the actual current and likely projected severity of the virus impact, the panicky economic upshot has been significant this week. We've quit checking our IRAs. Probably down "on paper" about $35k at this point. Glad we don't need to take any distributions right now. Ugh. Below, DJI year-over-year as of Feb 28th 2020..

Again, whatever the present clinical / epidemiological severity of COVID-19 and I am not a virologist), the supply chains' disruptions are indisputably exigent and worsening. Irrational?
How a Coronavirus Case in Korea Instantly Hit a Small Business in the US
Everyone is trying to figure out how to get around the sudden hurdles.

A small US company that specializes in exporting US frozen and refrigerated food products to Asia, including to South Korea, suddenly got hit by the coronavirus-spread-prevention machinery that is now screwing up businesses around the globe, according to an employee who doesn’t want to be named – and doesn’t want the company to be named – because they’re not authorized to discuss the matter.

The person said that one of their customers in Korea had ordered some frozen product. The US company — let’s call it Company X — in turn ordered it from its supplier in the US, and the supplier shipped it to Company X’s freight forwarder’s cold storage location at a California port. The freight forwarder was waiting for the instructions to place the product in a refrigerated container and ship it to Korea.

Meanwhile, Company X tried to get the letter of credit from its customer in Korea. It won’t ship the product without a letter of credit. With a letter of credit, the buyer’s bank guarantees that the seller gets paid the correct amount on time. It’s a fundamental tool in international trade.

But the person then got an email from the Korean counterpart who explained that there was no letter of credit, that he tried to go to the bank to obtain the letter of credit, as he normally does, but that he couldn’t leave the office building to go to the bank because someone in the building had tested positive for the coronavirus. That was the first email…
Buckle up, folks. We're doin' a stockup CostCo run, making sure all of our meds supplies are adequate, and topping off the gas tanks.

Meanwhile, the President is off to South Carolina today to hold his latest MAGA Rally and brag some more about how great he is (UPDATE: And where he just called the COVID-19 outbreak severity a Democrat and media "hoax").
No, I don't like him. Need one explain? Seriously?
Covid-19 Will Mark the End of Affluence Politics
The possibility of a global pandemic will reveal our inability to make and distribute the things people need—just in time for a presidential election.

On Tuesday, President Donald Trump dismissed concerns about Covid-19. As he put it, the virus is "under control" in the US and the “whole situation will start working out.” But according to Politico, Trump is privately voicing worries that the impact of the virus will undermine his chances of reelection. His panicked actions of late—including preventing an American from being treated in Alabama, at the request of a fearful Senator Richard Shelby—confirm that this virus is a political event of the first magnitude. While few in Washington have internalized it, the coronavirus is the biggest story in the world and is soon going to smash into our electoral politics in unpredictable ways.

…we will, in all likelihood, be locking down travel in some areas of the US for several weeks, as they did in China. People may be advised against gathering in large groups. It's not clear what any of this will mean for campaigning or primary voting, whether most of us will vote by mail or have our votes delayed.

Moreover, the coronavirus is going to introduce economic conditions with which few people in modern America are familiar: the prospect of shortages. After 25 years of offshoring and consolidation, we now rely on overseas production for just about everything. Now in the wake of the coronavirus, China has shut down much of its production; South Korea and Italy will shut down as well. Once the final imports from these countries have worked their way through the supply chains and hit our shores, it could be a while before we get more. This coronavirus will reveal, in other words, a crisis of production—and one that’s coming just in time for a presidential election.

Under the siren song of affluence, we began offshoring critical production capacity in the 1960s for geopolitical reasons. In 1971, economist Nicholas Kaldor noted that American financial policies were turning a "a nation of creative producers into a community of rentiers increasingly living on others, seeking gratification in ever more useless consumption, with all the debilitating effects of the bread and circuses of imperial Rome." Still, Bill Clinton and George Bush accelerated this trend throughout the 1990s and 2000s.

Affluence politics is not the politics of being wealthy, though, but rather the politics of not paying attention to what creates wealth in the first place. That is to say, it’s the politics of ignoring our ability to make and distribute the things people need. With the banking collapse in 2008, the election of Trump in 2016 and his mourning of empty factories, and now with Bernie Sanders dominating the early primaries, that era may at last be passing. A pandemic disease outbreak would only hasten this progression and force us back into the politics of production.

With potential shortages of goods, and restrictions on people’s movement, both parties are heading into unknown territory. It is likely Democrats will use this opportunity to further their case for Medicare for All. Pandemic surveillance and medical bureaucracies focused on billing do not mix well—stories about astronomical out-of-pocket costs for Covid-19 testing are already circulating. Republicans are likely to take a more xenophobic approach, emphasizing restrictions on foreigners and infected Americans. When it comes to managing shortages, however, both parties are split, just as they were in 1932, between their Wall Street factions that assume affluence and the less mature populist factions that seek assertive public power…
"Is there gas in the car? Yes, there's gas in the car..."

Erratum: I'm the local ASQ Volunteer Coordinator for the 2020 Baltimore Science Fair, 3 weeks out. Just emailed them to inquire as to whether they have a COVID-19 contingency plan.

Four Reasons Why the Coronavirus Is Such a Terrifying Economic Menace

The financial markets plunged into a state of abject panic this week, thanks to the novel coronavirus. As the rising number of COVID-19 cases fanned fears that a recession could be on the way, stocks fell at record speed. Investors also piled into government bonds, sending yields to new lows, a sign that the world’s money guys are desperate for safe bets as the possibility of a true pandemic becomes real.

Why is the coronavirus such a menacing economic threat?…

Amazon blurb:
"Here is a volume that should be required reading for policy makers and health professionals." - Kirkus Reviews
After four decades of assuming that the conquest of all infectous diseases was imminent, people on all continents now find themselves besieged by AIDS, drug-resistant tuberculosis, cholera that defies chlorine water treatment, and exotic viruses that can kill in a matter of hours. 
Based on extensive interviews with leading experts in virology, molecular biology, disease ecology and medicine, as well as field research in sub-Saharan Africa, Western Europe, Central America and the United States, The Coming Plague takes readers from the savannas of eastern Bolivia to the rain forests of northern Zaire on a harrowing, fifty year journey through our battles with the microbes, and tells us what must be done to prevent the coming plague.


Wocka, wocka. I'm sure the brewer is not amused. Reports are that Corona beer sales are down 35%.

More to come...

Friday, February 21, 2020

"Deliberation Science," meet "Deception Science"

"A government insider exposes the industry playbook for undermining evidence-based policy."

Reviewed in my latest Science Magazine. Had to get it.
At the dawn of a new decade and in a pivotal election year, we face unprecedented challenges that threaten the environment, public health, and security. Meanwhile, dark money is being funneled through powerful lobbyists, plaguing the process of enacting informed, evidence-based policies. David Michaels's new book, The Triumph of Doubt, is a tour de force that examines how frequently, and easily, science has been manipulated to discredit expertise and accountability on issues ranging from obesity and concussions to opioids and climate change.

Michaels is the quintessential voice on the influence of special interests in policy-making and government inaction. An epidemiologist and professor of environmental and occupational health at George Washington University, he spent 7 years leading the U.S. Occupational Safety and Health Administration (OSHA) under President Obama and previously served as President Clinton's assistant secretary of energy for environment, safety, and health.

His book offers account after account of unethical bad actors working against the public good on issues ranging from asbestos to climate change. Powerful firms and individuals seeking personal gain repeat the tactics of a well-worn playbook of denial and misdirection proven effective by Big Tobacco more than 50 years ago. Michaels pulls no punches, naming the corporations and people responsible for fraud, deception, and even what he terms “climate terrorism.” He reveals the dirty ways that industries have succeeded at shaping their own narratives regarding safety and health by producing articles and diversions designed to deny and distort science while confusing the public…

Every chapter is deeply disturbing yet feels familiar because the tactics—and at times even the actors—are the same. The book will, and should, infuriate readers and serve as a call to action to demand more government oversight and regulation on health and safety issues that affect every citizen regardless of party affiliation.

Michaels begins the final chapter by acknowledging that capitalism has the capacity to produce extreme wealth and economic development at a cost to our health and the environment. The book closes with a sense of unease and urgency, offering practical steps to strengthen U.S. regulatory oversight, provide more funding transparency, and increase corporate accountability.

Only when we begin to recognize the abuse of power that is rampant in decisions that affect the health and safety of our families and communities will we understand our necessary role in demanding scientific integrity in policy-making…
You even get reviewed in Science Magazine, you tend to have presumptive cred; they don't waste space on weak stuff. I'm almost done reading it. Stay tuned. It's excellent.

"Deliberation Science?" Is that a thing?

See also "Define science."

David Michaels concludes:
Regulation Defends Capitalism
The catalog of horrors that has necessitated the growth of America’s public health regulatory system is long. It includes everything from the conditions in Chicago’s slaughterhouses (exposed by novelist Upton Sinclair in The Jungle) to cigarettes and asbestos to climate breakdown and the widespread PFAS contamination of drinking water. In each case, corporations making a product caused damage and externalized the costs. Litigation is typically valuable in redressing the public’s grievance, but it is not sufficient for changing the root issues, in part because litigation always occurs after the fact. By the time the lawsuit is filed, too many people have been sickened, or maimed, or killed—to say nothing of how the environment has been desecrated. 

Our regulatory system is the response to these market failures. The objectives of the new laws and the agencies empowered to enforce them is not only to stop the damage and prevent future harm; it is to maintain and strengthen the free market system. Although many advocates of free market economics refuse to acknowledge this dynamic, law and regulation are the underpinnings of our economic system. They define market structure and property rights while attempting to ensure that property rights don’t intrude on personal liberties. Without the regulatory apparatus of the state, our modern economy could not exist. The state fosters a safe space for market growth.

We all value freedom, in particular the freedom to live the lives we choose. But this is not possible unless we are secure from being harmed by others, and in our modern world we individuals cannot bargain with the factory owner or the manufacturer of contaminated food. We generally have little or no knowledge of the effects of a given exposure, or sometimes that such exposures are even occurring. It is our elected representatives and officials who must enact and enforce laws that protect us from individual and collective harm—from violence and from robbery, but also from dangers posed by tainted food, polluted air and water, unsafe drugs, and dangerous workplace exposures.

Science underpins all of these public health and environmental protections. The basic principle of the regulatory system holds that decisions must be made on the basis of the best evidence available at the time. Product defense science doesn’t just game our free-market system; it prevents our government from accomplishing one of the reasons for its very existence. It is often unrecognized because it is so ingrained in our understanding that a primary government function is to facilitate some individuals (including the owners of corporations) to benefit by producing or performing something that does not impinge on the freedom and well-being of other individuals. This is the basis of the criminal justice system, as well as our system of public health and environmental protections. We want stronger regulation not because we don’t care about freedom, but because we cannot be free without the state’s protection from harm. We need to know that our air is safe to breathe, that our food is safe to eat, and that we can return home from work at the end of our shifts no less healthy than when we walked out the door in the morning. That is both the imperative and, alas, the challenge.

Michaels, David. The Triumph of Doubt (pp. 270-272). Oxford University Press. Kindle Edition.
I will have a lot more to say shortly once I finish.


Finished.  Table of Contents:
  1. Introduction
  2. The Science of Deception
  3. The Forever Chemicals
  4. The NFL’s Head Doctors
  5. A Spirited Denial
  6. The Deal with Diesel
  7. On Opioids
  8. Deadly Dust
  9. Working the Refs
10. Volkswagen’s Other Bug
11. The Climate Denial Machine
12. Sickeningly Sweet
13. The Party Line
14. Science for Sale
15. Future in Doubt

Disclosures and Acknowledgments
An important read. Although my wife and I have worked in highly regulated domains since the 1980s--FAA, EPA, DOE, NRC, OSHA, HHS, OCC, FDIC--and are fairly up to speed on regulatory processes and issues, I learned some great new stuff on the tactics and strategies of the "product defense" lobby industries.

Dr. Michaels is definitely cutting against the current de-regulatory neoliberal grain, which prioritizes the privatization of corporate profits concomitant with the socialization of risks and losses (dramatically accelerated under the Trump administration). I am reminded of a couple of recent reads.

to wit:
In a seminal study, Naomi Oreskes and Erik Conway have reconstructed the attempts of a handful of scientists, aligning themselves with corporate and political interests, to obscure scientific findings and limit their impact on democratic decision-making processes by spreading doubt in the public sphere.48 An essential ploy was to distract people’s attention from the core facts to marginal issues, for example, by discussing the role of volcanos rather than the effects of anthropogenic air pollution. This strategy (involving massive lobbying activities as well as corporate-funded research) was first successfully practiced in the 1950s with regard to the health risks of tobacco and was then reiterated and refined for other issues such as acid rain, the ozone hole, and climate change. It cynically exploits the open-ended nature of scientific discourse to create the impression that it is always too early to make such drastic decisions as prohibiting smoking in certain environments, stopping the use of CFCs, or limiting the emission of greenhouse gases. 

But why can this strategy work at all? It profits, first of all, from the highly differentiated division of labor in modern societies. Science is a complex societal subsystem, seemingly of little direct concern to most of the rest of society. One of its visible interfaces with society is an oversimplified image of knowledge shaped by past experiences, as well as by ideologies. In the United States, in particular, it has been influenced by the experience of the Cold War and neoliberal convictions: society-at-large relies on science when it comes to military challenges, to conquering new frontiers, and to securing commercial superiority. Science, essentially, is an asset in competitive situations, where it is expected to produce technical solutions. 

From the perspective of this image of knowledge, the warnings of critical scientists of the unintended side-effects of industrial, technological, or scientific developments appear to be a transgression of their natural sphere of activity; they mingle with politics and create problems, rather than delivering tangible solutions, optimally, in the form of technology. Against this background, it becomes easy for their opponents to cast doubt on their results, and even on their personal integrity, and to call for further, “more serious” research before any actions are taken that do not belong to the sphere of technology but to the sphere of societal regulations. Counteracting the strategic spread of misinformation therefore requires critical engagement with problematic images of science as well as with the economy of knowledge through which scientific knowledge (and misinformation) are shared within society, as has recently also been argued in a contribution to the journal Nature Climate Change:
As science continues to be purposefully undermined at large scales, researchers and practitioners cannot afford to underestimate the economic influence, institutional complexity, strategic sophistication, financial motivation and societal impact of the networks behind these campaigns. The spread of misinformation must be understood as one important strategy within a larger movement towards post-truth politics and the rise of “fake news.” Any coordinated response to this epistemic shift away from facts must both counter the content of misinformation as it is produced and disseminated, and (perhaps more importantly) must also confront the institutional and political architectures that make the spread of misinformation possible in the first place.
As it turns out, only a small fraction of the funds invested into research and development worldwide are dedicated to the augmentation of public knowledge. And even publicly funded research may suffer from constraints and path dependencies imposed by political or economic interests, or by the academic system itself—encouraging, for instance, a concentration of research on mainstream topics, with the danger that precisely the knowledge required to deal with the challenges of the Anthropocene may fail to be generated or publicly shared. What currently prevails is an “oligopolization of knowledge: when few know much, and many know little.” This oligopolization of knowledge is, of course, conditioned by the oligopolization of power—and vice versa. The risk is that the innovations necessary to meet the challenges of the Anthropocene are stymied, in particular when they present themselves in forms that may require locally adapted solutions rather than universal prescriptions. 

One example of the lack of research on key topics is the way in which the global challenges of disease are being addressed. Diseases are not only part of biological evolution; they are also part of cultural evolution, and they are becoming a challenge of epistemic evolution as well. They have emerged, for instance, from contact between humans and animals in domestication processes. One such example is smallpox, which was transferred from rodents to humans some millennia ago in the age of the Neolithic Revolution. Today global traffic, global nutrition chains, and global inequality of living conditions have set a new stage for the emergence and spread of bacterial and viral diseases. Diseases may constitute challenges that affect societies and economies on a global scale, even if they do so in extremely different ways in different parts of the world. While human health is probably better now than at any other time in history, this progress may have come at the price of degrading the environment and thus at the cost of future generations; and it may now be threatened by the consequences of our interventions in the Earth system. Knowledge produced in the traditional mode (as a by-product of cultural evolution through basic research and market-driven innovations) may turn out to be inadequate to cope with these challenges.

Renn, Jürgen. The Evolution of Knowledge (pp. 392-393). Princeton University Press. Kindle Edition.
Human affairs inexorably get "regulated" one way or another. Apologies to my "Libertarian" friends.

A note on law and "regulation." Trump fatuously never tires of touting his talking-point insistence that "for every new regulation issued, at least two existing ones must be eliminated."

The bulk of federal regulations are "statutory" in nature, authorized "as the Secretary shall determine" in passed and signed legislation. Think of laws as "policies" and regulations as "procedures." The policies (laws) set forth the "what" and the "why." The procedures (regulations) specify the "who/how/where/when" actions via which to administer the laws. Federal regulations cannot legally exceed the scopes of the parent laws. When they do, they are quickly challenged and struck down or modified.

Are there ineptly promulgated laws and regulations? Of course. The remedy is to make them more rational, focused, and effective, not simply do away with them. Again, human affairs get regulated one way or another.
If there were only one man in the world, he would have a lot of problems, but none of them would be legal ones. Add a second inhabitant, and we have the possibility of conflict. Both of us try to pick the same apple from the same branch. I track the deer I wounded only to find that you have killed it, butchered it, and are in the process of cooking and eating it. 

The obvious solution is violence. It is not a very good solution; if we employ it, our little world may shrink back down to one person, or perhaps none. A better solution, one that all known human societies have found, is a system of legal rules explicit or implicit, some reasonably peaceful way of determining, when desires conflict, who gets to do what and what happens if he doesn’t.

Friedman, David D.. Law's Order: What Economics Has to Do with Law and Why It Matters (p. 3). Princeton University Press - A. Kindle Edition.

On deck. apropos of this post.
Per The New Yorker.

The Amazon blurb:
How organizations—including Google, StubHub, Airbnb, and Facebook—learn from experiments in a data-driven world.

Have you logged into Facebook recently? Searched for something on Google? Chosen a movie on Netflix? If so, you've probably been an unwitting participant in a variety of experiments—also known as randomized controlled trials—designed to test the impact of different online experiences. Once an esoteric tool for academic research, the randomized controlled trial has gone mainstream. No tech company worth its salt (or its share price) would dare make major changes to its platform without first running experiments to understand how they would influence user behavior. In this book, Michael Luca and Max Bazerman explain the importance of experiments for decision making in a data-driven world.

Luca and Bazerman describe the central role experiments play in the tech sector, drawing lessons and best practices from the experiences of such companies as StubHub, Alibaba, and Uber. Successful experiments can save companies money—eBay, for example, discovered how to cut $50 million from its yearly advertising budget—or bring to light something previously ignored, as when Airbnb was forced to confront rampant discrimination by its hosts. Moving beyond tech, Luca and Bazerman consider experimenting for the social good—different ways that govenments are using experiments to influence or “nudge” behavior ranging from voter apathy to school absenteeism. Experiments, they argue, are part of any leader's toolkit. With this book, readers can become part of “the experimental revolution.”

More to come...

Monday, February 17, 2020

Concerning the Electronic Health Record

Yeah, paper charts were "clearly" better.

None of which is to argue that the EHR is a workflow and outcomes panacea. I've been utterly clear on that multiple times across the years on this blog.




Pretty interesting. Wonder how much Epic made off the Meaningful Use program?

More to come...

Tuesday, February 11, 2020


As tracked at Johns Hopkins:

One week, from Feb 4th to just now, 8 am, Feb 11th. Click either screencap image to enlarge,

Here's the link to the Hopkins site. You can zoom in/out and pan around the map. Frequently updated.

World Health Organization Coronavirus Q&A link.


Spike in the numbers across two days.


More to come...

Tuesday, February 4, 2020

For Sama

Hospital care and daily life in Allepo, Syria.

I watched this in rapt, riveted attention today. Harrowing, heartbreaking, brilliantly and courageously done.

FOR SAMA is both an intimate and epic journey into the female experience of war. A love letter from a young mother to her daughter, the film tells the story of Waad al-Kateab’s life through five years of the uprising in Aleppo, Syria as she falls in love, gets married and gives birth to Sama, all while cataclysmic conflict rises around her.

Her camera captures incredible stories of loss, laughter and survival as Waad wrestles with an impossible choice– whether or not to flee the city to protect her daughter’s life, when leaving means abandoning the struggle for freedom for which she has already sacrificed so much...
If you have any soul, this film will leave you rattled. Wiki entry here.


A number of my delusional fellow citizens never tire of dressing up and arming up with military weaponry to pose as "patriot" paramilitaries, most recently by invading the Kentucky statehouse, to "protest," via show-of-force intimidation, pending gun control legislation.

I'd be shipping these American ISIS wannabe clowns off to Syria so they can truly show off their Stones.

Click to enlarge.


More to come...