Hits: 2

JOHN BAILEY INTERVIEWS COREY BEARAK OF NEW YORKERS AGAINST CONGESTION PRICING

WHY IT IS WRONG FOR NEW YORK

ENVIRONMENTAL ISSUES

UNCONSIDERED ISSUES

ALL YOU WANTED TO KNOW ABOUT CONGESTION PRICING

AND WHAT WE STILL DO NOT KNOW AFTER YEAR

THIS INTERVIEW WAS RECORDED BEFORE GOVERNOR HOCHUL

STOPPED IMPLEMENTATION OF CONGESTION PRICING LAST WEEK

Hits: 228

6-foot rule, Fauci, and the bigger picture

Pandemic revisionism at its finest

KATELYN JETELINA

JUN 11, 2024

(Reprinted with permission)

Last week, Fauci testified before a special House subcommittee.

While the subcommittee’s main focus was Covid-19 origins, other topics snuck in, including the 6-foot social distancing policy during the pandemic. This was a key measure taken to slow down spread, including at schools, businesses, and places of worship.

A level-headed evaluation of decisions and policies made during the pandemic is helpful and needed, but that’s not at all what happened here. Instead, there were empty, unhelpful questions lacking nuance and depth, and at worst, unhinged harassment of public servants.

The result? A dangerous wave of “pandemic revisionism”—headlines and viral social media accounts taking soundbites of the hearing and concluding that pandemic policies were worthless or that public health officials just made stuff up.

Americans deserve (and need) so much better.

6-foot rule: Where did it come from?

Last week, the subcommittee blamed Fauci for the 6-foot policy. Fauci responded saying he was unaware of studies supporting the 6-foot social distancing guidelines. He then clarified that it wasn’t based on randomized control trials.

There are a few problems with this exchange:

1. This wasn’t a Fauci decision. The 6-foot guideline was decided by CDC.
2. This policy wasn’t pulled out of thin air. During the Bush administration, this key strategy was put into the pandemic playbook in 2007 and again in 2017. It was based on our knowledge of flu at the time, which showed droplets as a main form of transmission (rather than aerosols). Given that Covid-19 was a novel virus, pulling from a pandemic playbook was the right decision.
3. Even though 6 feet was not the “perfect distance,” it still helped prevent transmission.

9

4. The mistake was not updating the policy quickly enough. It turns out Covid-19 has droplets, but its main mode of transmission is aerosols (i.e., airborne). In the summer of 2020, more than 200 scientists sent a letter to the WHO urging them to recognize this, as it would impact policy decisions. However, it took over a year for the CDC and WHO to officially recognize it. Why? And why did the U.S. go with 6 feet while the WHO went with 1 meter? Now, these are questions that would be useful to answer.
5. You won’t get a randomized control trial in times of an emergency. We were losing thousands of people per day. We have to move quickly and with suboptimal information. This is why preparedness is so important. Even so, some questions we ethically can’t answer with an RCT.
6. It ignores what we learned. When the world works on one thing, we learn leaps and bounds. One example is how much we learned about the power of air ventilation and filtration.

But these points are coming far too late.

Millions this week received the wrong and dangerous message that the 6-foot rule was based on no science thanks to this botched exchange, erroneous headlines and viral tweets. Clawing back the narrative for the next response—such as bird flu where droplets may be an important driver of a disease — will be incredibly difficult. (!–Editor’s Note)

Attacking scientists is also not the answer.

It’s reasonable to ask Fauci why he made certain decisions, what conversations he was a part of, or what his thinking was at the time. After all, he was one of the key decision-makers.

However, vilifying, attacking, and ripping apart public servants is unacceptable, undeserved, and certainly unhelpful in propelling us forward. Some tweets, like the one below by Elon Musk, was viewed more than 44 million times.

Public health leaders stepped up during a time of great uncertainty using systems too old to succeed while losing, at its peak, 3,500 people a day.

They had to make incredibly difficult decisions, often with incomplete information, many of which were valid decisions based on the data at the time.

Yes, they made mistakes, but their service was heroic and patriotic, too.

We can live with these two truths.

If not, we risk losing public health leaders — why would someone step up when this is how they’re treated?

We need a far better approach.

A proper diagnosis with the breadth, depth, and fairness the Covid-19 emergency deserves, driven by critical thinking and diverse perspectives:

• Why weren’t we prepared?
• What decisions were made, when, why, and by whom?
• What mistakes were unavoidable and avoidable?
• What could have saved more lives?
• How could we have a better balanced, holistic view of health?
• What tangible steps will be taken to do better in the future?

There is precedent for such an approach: the 9/11 Commission. However, a united, national diagnosis seems less likely as the months pass.

Thankfully, some groups have taken it upon themselves to start patching together answers:

• State-level diagnoses, like New Jersey
• Books like Lessons from the Covid-19 War: An investigative report
• Reports from independent organizations, like American Democracy & Health Security: Lighting a Path Forward Amid Pandemic Polarization

Will this be enough for the future? Especially with no funding to make the changes needed?

Time will tell, but this is a gamble given that health threats are coming faster.

Bottom line

The United States lost more than 1 million lives—worse per capita than any other developed nation. We deserve to know why and what steps are needed to ensure this doesn’t happen again. However, resorting to unhinged attacks and disingenuous waves of pandemic revisionism will only hurt us in the end.

Love, YLE

Hits: 216

WPCNR THE LETTER TICKER. From The People’s CDC. www.peoplescdc@substack.com JUNE 11, 2024:

 

The comment portal is still open until 11:59 pm EDT! Tell the Centers for Medicare and Medicaid (CMS) that hospitals must report COVID infections and they should give us care, not COVID. Although the text indicates an earlier deadline of 5pm “to be assured consideration,” the comment portal is still open for submissions. If you haven’t already commented, submit one now! CMS is one of the primary funders of US hospitals. 94% of hospitals have at least half of their admissions paid for by Medicare or Medicaid. The CDC recently stopped mandating that healthcare systems report COVID hospitalizations. Since the end of the public health emergency in May 2023, COVID hospitalizations have remained one of the few remaining data indicators. Without this information, the public health and general community will not understand the severity of COVID infections in the US. To address this, CMS has proposed mandatory reporting of COVID infections among hospitalizations beginning October 1, 2024. They need to hear overwhelming public support for this measure. SEE OUR GUIDE BELOW ⬇️ for submitting a public comment, with a sample template to help make your voice heard on this vital patient safety issue. Please submit your comment directly on the Federal Register. In your comment, we recommend telling CMS to allocate financial resources to create capacity for collecting and reporting COVID infections among hospitalized patients. While we remain concerned with the gap in the current reporting period between now and October 1, this is a necessary proposed change to our public health system. We also are advocating for data reporting on demographic, socioeconomic, and disability status to better understand differences in population outcomes. Further, we continue to urge CMS to adopt an approach that deters healthcare-acquired COVID infections. Currently, CMS penalizes hospitals that fail to keep patients safe from other hospital-acquired infections through the Hospital Acquired Condition Reduction (HAC) program. But COVID is not on the list of infections that CMS tries to get hospitals to prevent, unlike, for example, surgical site infections and MRSA blood infections. Hospital-acquired COVID-19 has a mortality rate of 5 to 10% — between a 1-in-10 and 1-in-20 chance of dying if you catch COVID in the hospital! Healthcare systems and other healthcare settings can and should prevent COVID. Join us in also telling CMS to add COVID to the list of infections in the Hospital Acquired Condition Reduction (HAC) program. When the CDC stopped requiring hospitals to maintain crucial COVID-infection control measures like COVID testing upon hospital admission and before elective procedures, we saw hospital outbreaks as a result. Without COVID-19 infection control, hospitals have become high-risk zones for COVID transmission, where people getting care for COVID-19 are very likely to encounter vulnerable patients who could be harmed by COVID. You have nearly a 40% chance of catching COVID-19 if your hospital roommate has it. Who wants to go to the hospital for a heart attack, giving birth, or routine surgery and end up catching COVID? It is especially concerning that hospitals are incentivized to ignore positive COVID cases—which would reduce income from carrying out elective procedures—especially during a “crushing” financial crisis. CMS thus must make the hospitals put patient safety first.  Preventing hospital-acquired COVID is an equity issue. CMS says they want to hear from multiple stakeholders and they are concerned about equity.  Over the course of the pandemic, we have seen marginalized communities. like low-income communities, disabled people, and people of color continue to be disproportionately harmed. These harms continue to persist and are further compounded by the fact that these groups are less likely to have access to boosters and treatment.” Together we can urge CMS to mandate reporting of COVID infections and protect us while making our hospitals safer! SUBMIT YOUR COMMENT How to Comment:  Unique comments in your own words have the greatest impact and are counted with more weight. Select “Healthcare industry” in the “What is your comment about?” dropdown menu. Begin your letter with something personal, stating a fact that informs your interest such as: “I am concerned about this issue because I have lost family members to COVID” or “I am at high risk for severe illness,” or “I am concerned about Long COVID.” If you have a health condition or disability and you feel comfortable sharing, or if you’re a health worker or public health researcher, mention those. Feel free to use and include our sample letter text, references, edited, in part or full, with your public comment, as you see fit. If you prefer you can upload your comment as a PDF. If you have the time and energy, please, upload any supporting references as PDFs. They are required to  read every document uploaded! Here are a few suggestions. Below is a sample template letter you can copy-paste all or in parts for your public comment (but please customize for achieving higher impact).    SUBMIT YOUR COMMENT   Sample template letter: (The hyperlinks below will not transfer to the plain-text box. If you prefer to upload a fully cited version, please save everything below as a PDF and submit as an attachment). To the Leadership of the Centers for Medicare and Medicaid: To reduce the spread of COVID inside healthcare settings, the Centers for Medicare and Medicaid (CMS) must 1) mandate hospitals report COVID infections and 2) include healthcare-acquired COVID infections as part of the Hospital Acquired Condition Reduction Program, CMS-1808-P. The following proposals and changes should be implemented: Hospitals must separately report total COVID, Flu, and RSV infections in healthcare settings on a weekly basis as part of this proposal as part of routine reporting of “respiratory illnesses.” Financial support should be provided to healthcare systems to ensure robust reporting capability. I support the reporting of demographics including additional characteristics such as socioeconomics and disability data. These data should be reported separately by facility name and aggregated at the state level with public access through HealthData.gov. CMS must include COVID in its Hospital-Acquired Condition (HAC) HAC Reduction Program and/or its Value-Based Purchasing Program, to create financial incentives for COVID prevention in inpatient care. CMS should require hospitals to report and decrease hospital-onset COVID, using layered protections, such as universal mask wearing, universal screening testing, and improved air quality to promote patient and staff safety and health equity.  Hospitals should be required to report all hospital-onset COVID cases to CMS and the CDC. These data should be made available through HealthData.gov. Hospital-onset COVID should be defined as infections diagnosed after 5+ days of admission. The CDC currently defines hospital-onset COVID as only those cases diagnosed in people who are still in the hospital after 14 days of hospitalization. This vastly underestimates hospital-acquired COVID, as current variants of COVID only take 2-3 days from exposure to developing symptoms.1,2 Since the average hospital stay is 5.4 days,3 the current criteria of 14-day hospitalization miscount most people. Additional Information and References for the Comment Letter: During the first three months of 2023, US hospitals reported an average of 1231 patients per week that had caught COVID during their stay, with a high of 2287 patients with hospital-acquired COVID in the first week of January 2023 (using the current CDC 14-day definition).4  The UK has documented even higher rates,5 but the UK defines hospital-onset COVID as cases diagnosed after 7 days of hospitalization. The Biden administration never released data showing how prevalent COVID spread has been inside individual hospitals,6 and the CDC stopped requiring hospitals to report hospital-onset COVID in April 2023.7  COVID remains a major cause of death in the US since 2020,8,9 and many of those deaths were likely due to hospital-acquired COVID, which has a 5-10% mortality rate. 10,11 This is significantly higher than several of the other infections CMS includes in its HAC Reduction Program. Catheter-Associated Urinary Tract Infection has a mortality rate of 2.3%,12 Surgical Site Infections for Abdominal Hysterectomy and Colon Procedures have a mortality rate of 3%,13 and Clostridium-difficile infection has a mortality rate of 7.9%.14 Thus, hospital-onset COVID requires more preventive effort. Nearly half of all US residents are concerned about COVID outbreaks.15 Preventing COVID in the hospital is an equity issue. People of color continue to suffer high rates of COVID deaths.16 Amid huge health worker shortages, half of health workers go to work with COVID symptoms.17 CMS needs to protect both patients and health workers. Even when community transmission is low, healthcare settings are the most likely place where people receiving COVID care could encounter vulnerable patients who could be harmed by COVID. COVID outbreaks are already happening in hospitals that stopped requiring masks.18 If your hospital roommate has COVID, you have a 4 in 10 chance of catching it from them.19 No one should be endangered for going to the hospital for a heart attack, elective surgery, or delivering a baby.    Hospitals should be protecting patients under their care from COVID. But since hospitals previously faced a financial crisis23 and positive COVID cases mean loss of income from elective procedures, we are concerned that hospitals are placing priority over profits over patient safety.  Please protect vulnerable patients, prevent health worker shortages, and promote health equity by requiring hospitals to report COVID infections and protect patients from hospital-acquired COVID.

Hits: 208

Hudson River Beaches Reopen Today;
Health Department Advisory Lifted

Swimming can safely resume at Croton Point Park Beach and Philipse Manor Beach Club, and boaters can resume recreational activities in the Hudson River, as the Westchester County Department of Health has lifted its Hudson River advisory.

The advisory was put in place during sewer main repairs on a force main in Ossining, which were completed Friday evening. The advisory was lifted today so that ample tidal movement would allow the partially treated sewage that had been released into the river to be adequately diluted.

For more information on water quality go to https://health.westchestergov.com.

en Español

Las Playas del Río Hudson Reabren Hoy;
Aviso del Departamento de Salud Levantado

Se puede volver a nadar de manera segura en la playa de Croton Point Park y en el Club de Playa de Philipse Manor, y los navegantes pueden reanudar las actividades recreativas en el Río Hudson, ya que el Departamento de Salud del Condado de Westchester ha levantado su advertencia sobre el Río Hudson.

La advertencia se había puesto en lugar durante las reparaciones de la tubería principal de alcantarillado en una tubería de fuerza en Ossining, que se completaron el viernes por la tarde. La advertencia se levantó hoy para que el movimiento de las mareas pudiera permitir que las aguas residuales parcialmente tratadas que se habían liberado en el río se diluyeran adecuadamente.

Para más información sobre la calidad del agua, visite https://health.westchestergov.com.

Hits: 202

WPCNR THE LETTER TICKER. June 8, 2024

Hello Everyone –