Red tape and COVID-19
Some of the red tape surrounding the development of new treatments and tests for disease is designed to protect us from rushed and/or botched jobs. But some of it is the result of the natural tendencies of government agencies to become ever more complex and far-reaching (and sometimes counter-productive) in their rule-making.
Anyone who’s been following the COVID-19 story has almost certainly noticed the initial (and in some cases continuing) foot-dragging by such agencies as the CDC and FDA. Part of the reason is that such agencies tend to be cumbersome and hard to turn around, somewhat like the Titanic.
Here’s an important post that describes how the widespread “Certificate of Need” regulations limiting the growth of hospital beds over the years has hampered our response to the crisis.
Here’s another article I recommend reading, on the subject of red tape and the response to COVID-19.
And here’s something that has little to do with the above, but it’s the image that comes to mind when I get angry at red tape. It’s a solo for the vengeful Medea, from the Martha Graham piece called “Cave of the Heart.” Very intense:
A few days ago, I sent an email to one of my Senators requesting that the next Covid recovery bill include funds to build at least three more Navy hospitals – for each coast and the Gulf of Mexico. In addition, we should have more of the field hospitals as well as restocking all of the stockpiles. So,it was nice that the President mentioned the need for more ships.
After my state reaches the peak cases, I’ll also write to the governor and various people to also increase the field hospital capability and stockpiles. As we all can see, with a major pandemic in the US, all of the states are fighting each other for supplies.
I’ve come to believe that every government agency defines themselves by their worst failures.
Therefore, for the FDA, every drug is Thalidomide and every Public Health Response is HIV in the blood supply.
Liz: We could probably pick up some cruise ships cheap and repurpose them.
Saw that performed by the Graham troupe in NYC, 1966 I think. It was in a smallish theater and the dancers were not far away.
I am not a fan of bureaucracy, but I just read a VDH article that discusses the Swine flu epidemic of 1976 when a vaccine was rushed into use and with very unfortunate result.
I don’t believe that the FDA thinks of every drug as the Thalidomide example; but, I am sure that it is on their minds.
They walk a fine line. Still, the President is correct to say that for people for which there is no other recourse, there is no reason not to experiment.
My father had cancer of the “common duct”. He was going to die soon. Family talked him into going to a well known University cancer center, where they treated him with experimental drugs. He died of heart failure. Did the drug contribute to that? We don’t know, and it doesn’t matter. They tried, and maybe they learned something.
Neo, great dance by Takako Asakawa. What is the symbolism of the “tape”? Is it the entrails of her victim? Don’t mess with Japanese women! Her mother’s given name is Chiaki. I do love that name. My wife and I miss the NYC Ballet.
I am not a fan of bureaucracy, but I just read a VDH article that discusses the Swine flu epidemic of 1976 when a vaccine was rushed into use and with very unfortunate result.
The epidemic it was meant to contain never emerged. The vaccine was weakly associated with the onset of Guillain-Barre syndrome.
https://www.cdc.gov/vaccinesafety/concerns/guillain-barre-syndrome.html
60 Minutes got an episode out of it, natch.
Brian Morgan:
I’ve watched that clip many times, and it still gives me the chills. It is actually a terrifying dance. I think the “tape” ( which is a ribbon) is meant to symbolize the Medea figure deliberately pulling her fury out of wherever it might otherwise be hidden, dancing with it, celebrating it, giving herself over to it, devouring it.
Here’s a NY Times review from 1988:
Indeed.
Neo, I am not familiar with Medea but I know that Japanese folklore is powerful in her dance. The following is a rather pedestrian example but you can see the similarities in the jerky motions and crooked head movements in this Japanese-crossover film The Grudge from 2004:
https://youtu.be/uBAXDVB5Q6E?t=69
Sorry about the poor picture quality.
Art Deco, I know the epidemic never emerged. The point is that in anticipation of the epidemic the vaccine was rushed into service. As far as the link to E-B syndrome; VDH cited the link. I have always trusted VDH’s research, and still do.
I stand by the statement that such as FDA often walk a fine line; and the corollary that when all else has failed there should be an impetus to try the experimental treatments–if the patient agrees.
Old Flyer; Art Deco:
I wrote a fairly long post on the FDA and thalidomide, and the effects of that experience, here.
I’ve been following the numbers for New York State available each evening from “The COVID Tracking Project” website. I input Total Deaths each day and then graph them to watch for a deceleration. It’s happening, not as quickly as I would like, but it is there.
Total Deaths last ten days:
210, 285, 385, 519, 728, 965, 1218, 1550, 1941, 2373
Daily Growth Rate (i.e. Total Deaths Today / Total Deaths Yesterday):
1.36, 1.35, 1.35, 1.40, 1.33, 1.26, 1.27, 1.25, 1.22
Number of Days for Deaths to Double (i.e. 2 / (Daily Growth Rate – 1))
2.8, 2.9, 2.9, 2.5, 3.1, 3.8, 3.7, 4.0, 4.5
I’ve made no attempt at curve-fitting. Please someone poke a hole in my method but it looks to me that:
* Growth is decelerating.
* In the past 10 days we’ve gone from deaths doubling every 2.8 days to now every 4.5 days.
This is for New York State, not the nation.
Red tape? Some doctor was interviewed a few days ago who claimed that he and possibly others had been banging hard on the FDA to permit the trial of blood plasma, from recovered patients, on sick covid-19 patients.
Yesterday, the first NY patient (and the first U.S. patient) was treated with antibody rich blood plasma. Woohoo! Better late than never.
As to red tape:
A friend of mine sells ventilators, masks, etc.
“We are selling to countries other than the US primarily because the product moves quickly and for the most part, US government entities require tons of red tape. If India will buy quickly, India gets the wares. Same with anyplace else.
USGOV put the word out that it is buying ventilators at 2019 prices only…and how many of the world’s supply will go to the US? None. I saw on a press briefing that USGOV will pay $25K for a ventilator. My COST on an SH300 is almost $50K. An S1100A ventilator at COST, FOB China is nearly $60K.”
This is for New York State, not the nation.
It also shows for the nation on the John Hopkins site. Choose “US”, then on the graph of cases choose “Logarithmic” and the line is definitely bending.
@Chuck, The JHU graph shows Confirmed Cases not Deaths.
Worldometers has data on deaths.
The French government today indicated they’d been heretofore been reporting hospital deaths but not deaths in other venues. Today’s report includes 500-odd hospital deaths, but also nearly 900 previously unreported deaths which have occurred in nursing homes over the last x weeks; they indicate that these are incomplete figures, and to expect more installments, so the French time-series reports will have these spikes. Does make you wonder how complete the mortality data is, and how much consistency across jurisdictions. Worldometers closes the books each day at midnight GMT, so their last installments of data should be reported ‘ere long.
Art Deco, I used Worldometers for a long time but I could not get a graph by State, so on the recommendation of someone here I switched to using the Covid Tracking Project. At first it bothered me that I could not get up-to-the-minute totals like Worldometers but it taught me to have patience. There are more productive things I can do with my time than clicking a refresh button.
I hear that Nancy Pelosi is planning on convening a “9/11 Commission” style inquisition, so I’m sure she’ll get to the bottom of it. Thank God for Nancy Pelosi.
The JHU graph shows Confirmed Cases not Deaths.
Yes, but it shows the same bending starting earlier around 3/22 and that should show up in the national deaths after some delay. It is another indicator that something is changing.
I have no criticism of your results, they look good to me.
The resistance of the bureaucracy to treatments using hydroxocloroquine stem from one salient factor. The patent on that drug has long since expired. There is no significant money to be made by the pharmaceutical industry in such a treatment.
Roy Nathanson: “The patent on that drug has long since expired”
Couldn’t Trump, through execution action, reinstate the patent?
When NY state first started blowing out their confirmed case numbers, I started looking at both the number of test administered and the percentage of positive tests on a daily basis. Yancy Ward helped me figure out that yes, NY was doing a lot of tests, and yes NY was very infected, so yes the percentage of positive tests was very high. 35 to 40% positive.
Today Dr. Birx spoke at some length about the percentage of positive tests we are seeing. NY percentages are still quite high, but places like WA and CA were holding steady at around 8%. Much lower. These percentages are hardly perfect data, but there isn’t any great data.
As Art Deco said, even France is undercounting deaths when they don’t happen in a hospital setting. Italy too I believe. I hope the U.S. is avoiding that pitfall.
Edward R Bonderenka, well it is a national emergency. I don’t know who you are referring to but I hope the government is on them like stink. From what I heard today I think they are now aware of what has been going on; and they are not amused. There was a time in my life time when war profiteering could get you a long stay in a bad place; if not worse. This is as close to a war on our shores as we have seen in a long time.
Roy Nathanson, are you saying that the Federal government is deliberately withholding treatments so that pharma can profit? If so–well never mind. Neo wants us to be civil. But, I will note that the post that I referred to in the paragraph above complained that the government was unwilling to pay inflated prices, so certain citizens were selling over seas for greater profit.
The stories don’t mesh too well. But Pelosi would be interested in hearing from the two of you.
Oldflyer, he is buying in China and selling outside of the States,
It’s not profiteering. It’s capitalism.
Like he said, the government wants to pay less for it than he does.
That’s the salient point.
#1 Determine which components of ventilators are only Made in China.
#2 Create a yuge incentive for American companies to make those components domestically.
#3 Put a 100% tariff on Made in China ventilators.
Roy Nathanson: “The patent on that drug [hydroxychloroquine] has long since expired”
Couldn’t Trump, through execution action, reinstate the patent? — Brian Morgan
_____
That’s an important topic. Reinstate the patent? I’d say that’s a little unorthodox but maybe not impossible.
We are already into the DPA, or Defense Production Act. Do what FDR did in WWII. Everybody gets paid their production cost, plus a gov. fixed profit margin; something in the 5 – 10% range.
Heck, in the first month of production make it a 20% profit, then throttle it back to 10% later. It’s a cheap drug. The cheaper producers should get more orders, if the quality is good.
It is nice that some of these drug companies are giving several million doses away for free. But we probably need a billion doses and we need it fast. So light fire under them with a 20% profit margin.
Thumbs up, Tommy Jay!!
I’ve been following the numbers for New York State available each evening from “The COVID Tracking Project” website.
I’ve been doing the same, also for hospitalizations and cases. All three are slowing in NY state. Even more in the city, which now has a surprisingly good COVID-19 website. The US as a whole is slowing as well, but not as consistently–perhaps because other places like New Orleans and Detroit are becoming new hot spots even as NY cools down.
no your numbers are right…
but instead of the cumulative, take subtract the day before number
then your plotting the deaths per day…
when you do that, you will note that they dropped precipitously a few days ago
IF you use the cumulative, it will not show up so easy as it does if you use actual numbers… (if you want even better, do three day averages then the curves are smoother)
There’s “red tape” and then there’s “blood on your hands red” tape.
https://richardsonpost.com/danielg/16869/hand-sanitiser-shortage/
BUREAUCRATS IN THE USSA CREATE HAND SANITIZER SHORTAGE
By Daniel Greenfield -March 19, 2020
The variety of red tape that’s really green tape (green being the color of money, envy, and greed).
https://nypost.com/2020/04/01/how-ny-greed-kept-mother-cabrini-coronavirus-gift-from-being-larger/
And New York didn’t spend those bonus bucks buying ventilators.
This is just sad. The transport truck crashed and burned. Driver and his dog are ok.
https://nypost.com/2020/04/01/massive-blaze-wipes-out-load-of-toilet-paper-in-texas/
Brian Morgan,
My point was not that it can’t be manufactured. It can… by anyone. It’s very inexpensive.
On April 2, 2020 at 6:33 pm I said:
Number of Days for Deaths to Double (i.e. 2 / (Daily Growth Rate – 1))
I meant to write:
Number of Days for Deaths to Double (i.e. 1 / (Daily Growth Rate – 1))
It was a typo.
The formula in my spreadsheet was correct:
Number of Days for Deaths to Double (i.e. 1 / (Daily Growth Rate – 1))
2.8, 2.9, 2.9, 2.5, 3.1, 3.8, 3.7, 4.0, 4.5
A friend wrote to me with a link to a BBC story on the rapid construction of temporary hospital facilities for COVID-19 patients:
https://www.bbc.com/news/health-52125059
He commented that “Someone knows more than they are saying”
My reply: “I’m not so sure. Who’s to say that our leaders aren’t suffering from the same mass hysteria? In fact theirs could be more acute since they are entrusted with the well-being of the citizenry.”
Brian: Roy Nathanson: “The patent on that drug has long since expired”
Couldn’t Trump, through execution action, reinstate the patent?
no need.. that answer that got you to questoin is from someone who believes the medical industry is evil and so on.. TEVA is a company that makes millions making drugs that are off patent.. the whole generics industry is about drugs off patent..
but if your one of the tin hatters that think that the med industry would spend billions to make an almost cure to make money, then your answer is the idiot one… which is why Hep C is a cure.. not an almost… its the whole Malthusian, over pop, global warming, health conspiracy, etc. troop that says otherwise. why? because they are either ignorant or playing on the ignorance of others who have no idea of the costs and processes involved and prefer to be spoon fed dumb answers that confirm their paranoia and suspicion of others rather than otherwise.
Teva to Donate Potential COVID-19 Treatment, Hydroxychloroquine Sulfate Tablets to Hospitals Nationwide
Novartis, Mylan and Teva to supply tens of millions of chloroquine tablets to fight COVID-19
Israel Firm to Donate Potential COVID-19 Treatment
Teva will donate 6 million tablets to hospitals by the end of month and more than 10 million within a month.
so much for not making money is the reason..
they are donating it… hows that for not making money?
that leftist smart thing is sooooooooooooooooo stupid, only they think its common knowlege smart… and others say it too, then cover with a, what i meant was (rather than actually saying what they meant the first time!).
the issue was time… ie… you have production runs and other things all planned out and going..
you dont have machines and supplies sitting in a corner waiting for the once in a century plague
your machines are running full, 24/7 to get the most… your supplies are what you have.. you have to get more, stop the production or finish it, clean everything up, change the molds, change the bins, run tests for quality control, and on and on.. and THEN you have something for the public…
this is why the left thinks that CEOs dont deserve the money, that workers are not paid what they are worth (someone tried that on me and i asked them why dont they quit and become a consultant, and do their own investments, health insurance, vacation savings, tax filing, and more… to whit the socialists groaned that they were getting value back from the company and so, they were getting what they were worth and the reduction had more to do with the services returned which they could quit and avoid if they wanted to)
TEVA makes a lot of money making unpatented drugs..
US $18.9 billion (2018) revenue
personally thats a lot for things people claim are not worth making..
No tin-hatter here. I’m just looking for ways to motivate.
Here’s one:
https://genesiustimes.com/realtors-in-nyc-begin-selling-ventilator-time-shares/
/sarc
Actually Artfldgr, Teva has historically made much of its money with on-patent drugs. Copaxone was/is one of its expensive blockbuster drugs and it shared a patent for it with some other drug company. Just because 80 or 90% of a company’s drug names are generic doesn’t mean they all are, or that 80 or 90% of their profit comes from them.
I believe (almost?) all of Mylan’s portfolio is generic, which is a low profit margin business, which is likely why they chose to leave the U.S. and its then 39% corp. tax, and headquarter in the Netherlands.
Obviously, these companies don’t have a big Plaquenil production machine laying around in disuse waiting to be switched on. Mylan used to make Plaquenil in the U.S. and now they are getting that restarted. They estimate production in mid-April, so that is about a one month startup time.
Companies like Bayer and Teva and others giving away a several million doses each is an expense that can come out of their PR budget, which for them is exactly what it is.
If, those roughly 20-30 million doses (combined) help doctors, experts, and state governors learn the value of this drug quickly, then that will be immensely helpful.
But the U.S. is going to need a billion doses for starters, and the world will multiply that by how much? So many companies will need to produce it, large amounts of factory space will need to be re-configured globally and that will take serious money coming in.
I’m losing patience with the idea that all our problems would be solved in only pharmaceutical companies didn’t operate on a profit-seeking basis. I don’t see Venezuela, North Korea, and Cuba coming up with generic off-patent cures and distributing them around the globe. The Trump pills are cheap and easy to make, and there are plenty of manufacturers ready to flood the market with them. That’s not the hold-up here.
It’s important to allow companies to temporarily gouge the public when they produce something that is desperately needed. Others notice and jump in, and that sector and the supply zooms.
The US should not be prepared for unusual natural disasters: asteroids, volcanic eruptions, earthquakes and tsunamis, terrific fires. Capital—which is something you put away expecting it will yield a future cash flow—would be wasted as it sat there year after year with almost no hope of being productive. This means we are a poorer nation as we patiently await a disaster, all prepared.
Of course, there might be low cost exceptions….like having a strategic oil reserve purchased when petroleum is dirt cheap…like now.
Apparently, there’s no strategic natural gas reserve. Should there be one? Is it even possible?
I don’t always agree with Tucker Carlson but, in the main, he is doing a terrific job of finding and covering stories and angles that the MSM won’t, or wants buried.
In the case of 3M and their N95 masks, Carlson had a particularly important and informative guest on last night, Jared Moskowitz, the Florida government official tasked with procuring medical supplies for that state, who very frankly told of his personal experiences in trying to procure N95 masks for the increasingly hard hit State of Florida.
He said that there were 20 distributors of 3M’s N95 masks in this country, and that in trying to buy those masks from various distributors he was frozen out, and he was frozen out because the distributors where either jacking up the prices of the masks beyond what he was authorized to pay for them—i.e. price gouging, and/or that they were selling those masks to foreign buyers who were showing up to purchase masks for cash, when he had just a procurement order which involved some paperwork.
At this point, he said, he was willing to pay inflated prices just to get some masks, but he still was pushed to the back of the line by the competition.
He said that he actually spoken to high level management at 3M’s corporate headquarters about what their distributors were doing, and was told that 3M had not/was not going to issue any orders to their distributors stop these practices.
This situation is what apparently prompted President Trump to invoke the Defense Production Act to force 3M to make masks for domestic use.
If this behavior by 3M and its distributors becomes widely known, I’d imagine it would be a huge public relations disaster.
See https://video.foxnews.com/v/6146690215001#sp=show-clips
If this behavior by 3M and its distributors becomes widely known, I’d imagine it would be a huge public relations disaster.
Publish their names. These people are villains.
Here’s an article out today, talking about how 3M was apparently unhappy with Federal government calls for it to make/sell N95 masks for use here in the U.S., and to stop exporting N95 masks and also respirators to Canada and to Latin America, as 3M was trying to justify its sales to other countries by talking about how there were “humanitarian issues” involved.*
Tell me.
Does 3M have it’s own “foreign policy,” and is it a “globalist” foreign policy that gives a higher priority to the interests of the “international community” than it gives to the interests of the U.S., its citizens, and these U.S. citizen’s welfare and survival?
P.S. I see from the news that Canada is already bitching about how it might be cut off from purchasing medical supplies and equipment, if the U.S. implements a sell to “America first” policy in regards to medical equipment and supplies produced by U.S. companies.
* https://nypost.com/2020/04/03/3m-pushes-back-after-trump-orders-it-to-stop-exporting-n95-masks/
In my comment above, on April 3, at 3:59 PM, after reading about the reported actions of multi-national corporation 3M, I asked, tongue in cheek, if 3M had its own “foreign policy,” and if it was a“globalist” foreign policy–prioritizing the needs of the other countries in the world above those of the U.S.
Interestingly enough, last night on Tucker Carlson’s show, Peter Navarro, the Trump Administration’s Director of Trade and Manufacturing Policy and, now, Defense Production Act Policy Coordinator, was on, discussing the problems he was having in dealing with 3M.
Navarro was frustrated, he was not happy, said that in their interactions with the Administration 3M was “dissembling,” and he characterized 3M’s behavior as 3M having the attitude/acting as if it were a “sovereign nation.”
See https://www.foxnews.com/media/peter-navarro-slams-3m-stop-whining