Author: Art Diamond

“It’s Not Clear What We Are and Aren’t Allowed to Say”

(p. B1) When Gov. Gavin Newsom signed into law a bill that would punish California doctors for spreading false information about Covid-19 vaccines and treatments, he pledged that it would apply only in the most “egregious instances” of misleading patients.

It may never have the chance.

Even before the law, the nation’s first of its kind, takes effect on Jan. 1 [2023], it faces two legal challenges seeking to declare it an unconstitutional infringement of free speech. The plaintiffs include doctors who have spoken out against government and expert recommendations during the pandemic, as well as legal organizations from both sides of the political spectrum.

“Our system opts toward a presumption that speech is protected,” said Hannah Kieschnick, a lawyer for the Northern California branch of the American Civil Liberties Union, which submitted a friend-of-the-court brief in favor of one of the challenges, filed last month in U.S. District Court for the Central District of California.

That lawsuit and another, filed this month in the Eastern District of California, have become an extension of the broader cultural battle over the Covid-19 pandemic, which continues to divide Americans along stark partisan lines.

. . .

(p. B5) The plaintiffs in California have sought injunctions to block the law even before it goes into effect, arguing that it was intended to silence dissenting views.

One of them, Dr. Tracy Hoeg, a physician and epidemiologist who works in Grass Valley, near Sacramento, has written peer-reviewed studies since the pandemic began that questioned some aspects of government policies adopted to halt the spread of Covid-19.

Those studies, on the efficacy of masks for schoolchildren and the side effects of vaccines on young men, exposed her to vehement criticism on social media, she said, partly because they fell outside the scientific consensus of the moment.

She noted that the medical understanding of the coronavirus continues to evolve, and that doctors should be open to following new evidence about treatment and prevention.

“It’s going to cause this very broad self-censorship and self-silencing from physicians with their patients because it’s not clear what we are and aren’t allowed to say,” said Dr. Hoeg, one of five doctors who filed a challenge in the Eastern District. “We have no way of knowing if some new information or some new studies that come out are accepted by the California Medical Board as consensus yet.”

. . .

Dr. Jeff Barke, a physician who has treated Covid patients at his office in Newport Beach in Southern California, said the law was an attempt by the state to impose a rigid orthodoxy on the profession that would rule out experimental or untested treatments.

Those include treatments with ivermectin and hydroxychloroquine that he said he had found to be effective at treating the coronavirus, despite studies suggesting otherwise. “Who determines what false information is?” he said.

. . .

“What comes next?” he said. “How I talk to patients about cancer? How I talk to patients about obesity or diabetes or asthma or any other illnesses? When they have a standard of care that they think is appropriate and they don’t want me going against their narrative, then they’ll say Barke’s spreading misinformation.”

For the full story, see:

Steven Lee Myers. “Law to Stem Medical Misinformation Is Facing a Free Speech Challenge.” The New York Times (Thursday, December 1, 2022): B1 & B5.

(Note: ellipses, and bracketed year, added.)

(Note: the online version of the story has the date Nov. 30, 2022, and has the title “Is Spreading Medical Misinformation a Doctor’s Free Speech Right?”)

Feds Gave Bigger Covid Subsidies to Hospitals Charging Higher Prices

(p. A1) When Covid-19 struck, the U.S. government gave hospitals tens of billions of dollars to help them cope with the strains of the pandemic.

Many of the hospitals didn’t need it.

The aid enriched some well-off systems, while failing to meet the needs of many that were struggling, according to a Wall Street Journal analysis of federal financial-disclosure reports.

The mismatch stemmed in part from the way the federal government determined how much a hospital should get. A main factor used to allocate relief was a hospital’s revenue, rather than Covid caseload or financial distress. The idea was that revenue was a good indicator of a hospital’s size.

Among the recipients were large, wealthy hospital owners—including some nonprofits—that reported profits from patient care during the periods they got aid. Some were well off enough to put money into investment funds, while others spent on new facilities and ex-(p. A10)panded campuses.

Hundreds of other hospitals that got federal funding, however, reported losses. Some were forced to lay off nurses and make other cuts, saying they didn’t get enough aid to overcome their strains. Some served areas that had among the highest Covid death rates.

The revenue-based award system, especially prevalent in the early days of the pandemic, tended to favor hospitals with higher prices.

For the full story, see:

Melanie Evans, Liz Essley Whyte and Tom McGinty. “Covid Aid Went to Hospitals That Didn’t Need the Money.” The Wall Street Journal (Monday, Dec. 5, 2022): A1 & A10.

(Note: the online version of the story has the date December 4, 2022, and has the title “Billions in Covid Aid Went to Hospitals That Didn’t Need It.”)

Venture Capitalist Invested in Mainland But Now Prefers Taiwan’s “Freedom”

(p. B10) TAIPEI—Tim Draper, a venture capitalist known for his early bets in Elon Musk’s Tesla Inc. and SpaceX, is feeling good about his decision to stop investing in China.

In an interview in Taiwan, where he is pursuing new investments, Mr. Draper slammed China’s Xi Jinping, whom he called a “weak leader,” saying the country is going backward after more than four decades of former leader Deng Xiaoping’s “reform and opening up” policy.

“It’s not a place where you invest money to get a return,” he said. “I see China as a place where the government is trying to control everybody.”

An early investor in Baidu Inc.—China’s BIDU equivalent of Google—Mr. Draper said he pulled out completely and froze investment in the country around 2014 after a startup he had invested in was fined by regulators. It was a sign, he said, of the government’s increasing interference in the market.

. . .

Mr. Draper’s fund made its first investments in Taiwan last year, when it bought stakes in Taipei-based digital news company TNL Media Group and other startups. He said he would continue to invest in the island, which he believes will attract frustrated entrepreneurs from China with its openness.

“I’m coming to Taiwan. I’m not going to China,” he said, praising the democracy’s “freedom and trust.”

For the full story, see:

Joyu Wang. “Venture Capitalist Touts His Turning from China.” The Wall Street Journal (Saturday, September 19, 2022): B10.

(Note: ellipsis added.)

(Note: the online version of the story has the date September 18, 2022, and has the title “Tim Draper Touts Decision to Pull Out of China.”)

Standardized Measurements Expedite Honest Exchange

(p. 20) Reading James Vincent’s quietly thrilling new book, “Beyond Measure: The Hidden History of Measurement From Cubits to Quantum Constants,” I began to think that one measure (so to speak) of the human experience might be the number of things we take for granted.

. . .

When people agree on a standard of measurement, they can coordinate their actions. You tell me that the sofa you’re selling is 72 inches wide, and from that bit of information I can see that it will fit in my living room.

. . .

Unlike, say, a simple act of thievery, which caused individual harm, metrological trickery could undermine the entire social order by sowing mistrust. “Measurement is a covenant that binds communities together,” Vincent writes. In addition to its obvious practical benefits — the ancient Egyptians couldn’t have built the Pyramids by eyeballing it — measurement has been embraced “for its ability to create a zone of shared expectations and rules.”

. . .

Metrology’s early history is marked by plurality — different units developing in different places, each one suited to a particular community’s needs. This variability allowed for flexibility, but it also allowed confusion and corruption to flourish. Vincent gives the example of France under the ancien régime, where the unit known as the pinte measured a measly 0.93 liters in Paris and a whopping 3.33 liters in Précy-sous-Thil. Elastic units were “exploited by the rich and powerful.” In exchanges with the peasantry, feudal lords used their authority over weights and measures to their own benefit.

Consequently, the metric system was a radical departure — the brainchild of the French Revolution’s savants, who promised to dispense with arbitrary units like the pied du Roi, or “the king’s foot,” in favor of weights and measures that were rational and impartial because they would be tethered to the Earth itself. A meter was standardized to one ten-millionth of the distance from the North Pole to the Equator. But even that definition turned out to be too “crass,” Vincent writes. Now the meter is defined in terms of something even more constant: the speed of light.

For the full review, see:

Jennifer Szalai. “Fathom That.” The New York Times Book Review (Sunday, December 4, 2022): 20.

(Note: ellipses added.)

(Note: the online version of the review was updated Nov. 21, 2022, and has the title “A History of Humanity in Cubits, Fathoms and Feet.”)

The book under review is:

Vincent, James. Beyond Measure: The Hidden History of Measurement from Cubits to Quantum Constants. New York: W. W. Norton & Company, 2022.

Healthcare Spending Is Still Growing, but More Slowly

(p. A6) WASHINGTON—Growth in U.S. healthcare spending slowed to 2.7% last year after a 2020 surge in federal outlays on the pandemic, according to a new government report.

The analysis from the Centers for Medicare and Medicaid Services says national healthcare spending grew in 2021 to $4.3 trillion.

Overall health spending had risen by 10.3% in 2020, and the more moderate increase last year was largely driven by a drop off in federal spending related to Covid-19.

. . .

The healthcare share of the gross domestic product was 18.3% in 2021, down from 19.7% in 2020.

For the full story, see:

Stephanie Armour. “Healthcare Spending Growth Slows Down.” The Wall Street Journal (Saturday, Dec. 15, 2022): A6.

(Note: ellipsis added.)

(Note: the online version of the story has the date Dec. 14, 2022, and has the title “U.S. Healthcare-Spending Growth Slowed in 2021, Report Finds.”)

Electrical Vehicle (EV) Chargers Are “Often on the Fritz”

(p. A1) One of the biggest roadblocks to the mass adoption of electric vehicles is the troubled business model for the commercial chargers that power them.

The government is pouring billions of dollars into developing a national highway charging network. But businesses aren’t sure how they will make money, and the nascent industry looks messy.

Utility companies and gas stations are at war with each other over who will own and operate EV chargers. Rural states say some charging stations could operate at a loss for a decade or more. (p. A10) New companies that provide charging gear and services are contending with the equipment’s spotty reliability.

. . .

Equipment is often on the fritz. Communications can break down between the car and the charger, the charger and the company operating the charging network, and with payment systems. On occasion, a wasp crawls into the gear and builds a nest. Vandals can strike, sticking gum in the credit card readers and bashing the machines.

. . .   A 2022 study led by the University of California, Berkeley tested all 657 public EV fast chargers in the greater San Francisco Bay Area and found more than a quarter didn’t work.

For the full story, see:

Jennifer Hiller. “Electric Cars Have A Charging Problem.” The Wall Street Journal (Wednesday, Nov. 30, 2022): A1 & A10.

(Note: ellipses added.)

(Note: the online version of the story has the date November 29, 2022, and has the title “Why America Doesn’t Have Enough EV Charging Stations.”)

Funding People Instead of Projects Allows Researchers to Nimbly Pivot in the Light of Unexpected Discoveries

(p. A2) Patrick Collison, the Irish-born co-founder of payments technology company Stripe Inc., has spent a lot of the past five years pondering the problem of declining scientific productivity.

. . .

Clearly, scientific productivity has something to do with how research is done, not how much. One culprit, in the view of Mr. Collison and many others, is that the institutions that fund science have become process-oriented, narrow-minded and risk-averse. Wary of failure, they favor established researchers pursuing narrowly focused, incremental ideas over younger scientists with more heterodox agendas.

. . .

Yet Mr. Collison criticizes the federal government for failing to bring a much deeper and eager pool of talent to bear on a multitude of pandemic challenges. Top virologists “were stuck on hold, waiting for decisions about whether they could repurpose their existing funding for this exponentially growing catastrophe,” he wrote in an essay last year with George Mason University economist Tyler Cowen, and University of California, Berkeley bioengineering professor Patrick Hsu.

Sensing a need, the three in April, 2020 launched Fast Grants, $10,000 to $500,000 awards funded primarily by private donors and approved in 14 days or less.

. . .

When Messrs. Collison, Cowen and Tsu surveyed their recipients about their experiences with traditional funding, 57% told them they spent more than a quarter of their time on grant applications and 78% said they would change their research program a lot if they weren’t constrained in how they spent their current funding.

This reinforces a key insight from metascience, also known as the science of science, namely the value of curiosity-driven research. Heidi Williams, an economist at Stanford University and director of science policy at the Institute for Progress, said grants typically commit a scholar to complete a specific project, even if during the research the project proves less promising than expected.

. . .

In a 2009 paper, Massachusetts Institute of Technology economist Pierre Azoulay and his co-authors demonstrated the benefits of funding people over projects. Researchers backed by the Howard Hughes Medical Institute, which takes such an approach, produce far more widely cited papers—a metric of significance—than similar researchers funded by the National Institutes of Health. Drawing on those lessons, last year, Mr. Collison co-founded the Arc Institute to pre-fund scientists studying complex human diseases for renewable eight-year terms.

For the full commentary, see:

Greg Ip. “CAPITAL ACCOUNT; To Boost Growth, Rethink Science Funding.” The Wall Street Journal (Friday, Nov. 18, 2022): A2.

(Note: ellipses added.)

(Note: the online version of the commentary has the date November 17, 2022, and has the title “CAPITAL ACCOUNT; Stagnant Scientific Productivity Holding Back Growth.”)

The published version of Azoulay’s co-authored 2009 NBER working paper, mentioned above, is:

Azoulay, Pierre, Joshua S. Graff Zivin, and Gustavo Manso. “Incentives and Creativity: Evidence from the Academic Life Sciences.” RAND Journal of Economics 42, no. 3 (Fall 2011): 527-54.

Venturesome Heroes Who Made the “Miracle” of Aviation Possible

(p. 14) Aviation has become just another boring part of modern infrastructure. Some people are afraid of it. Most people endure it. Few people bother to look out the window for a view of Earth that was unimaginable to most of our ancestors, or to reflect on the miracle of technology, engineering and organization that daily airline operations represent. Before the pandemic, roughly three million passengers took flights to or from U.S. airports each day, which averages out to more than one billion passenger journeys per year. (Traffic has nearly returned to that level.) Over the past 13 years, through more than 10 billion passenger journeys, a total of two people have died in U.S. airline accidents.

Among the many virtues of John Lancaster’s delightful “The Great Air Race” is how vividly it conveys the entirely different world of aviation at the dawn of the industry, a century ago. Many airplanes in those days were literal death traps. A biplane known as the DH-4, used as a bomber by Allied forces in World War I, had its gas tank immediately behind the pilot in the cockpit. As Lancaster explains, “Even in relatively low-speed crashes, the tank sometimes wrenched free of its wooden cage, crushing the pilot against the engine.” To get a DH-4 properly balanced for landing, a co-pilot or passenger might have to leap out of the open cockpit and climb back to hang onto the tail. And this was one of the era’s most popular and successful models.

Some planes had no gas gauge, so pilots would learn they had run out of fuel only when the engine stopped. Just a tiny portion of the country was covered by charts; pilots’ navigation tools were a magnetic compass and their own eyes. (Mapping was one of the industries that aviation’s growth fostered.)

. . .

For readers familiar with modern U.S. aerospace pre-eminence — Boeing, despite its problems; governmental and private space programs; military aviation and corporate jets — perhaps the most startling aspect of American aviation a century ago is how uncertain its future seemed.

. . .

I have read a lot about aviation and the aircraft industry over the years, but almost everything in this tale was new to me. You might take it on your next airline flight, pause to look out the window and spare a thought for those who helped make it all possible.

For the full review, see:

James Fallows. “The Wild Blue Yonder.” The New York Times Book Review (Sunday, December 4, 2022): 14.

(Note: ellipses added.)

(Note: the online version of the review has the date Nov. 15, 2022, and has the title “When Flying a Plane Was Thrilling — and Often Fatal.”)

The book under review is:

Lancaster, John. The Great Air Race: Glory, Tragedy, and the Dawn of American Aviation. New York: Liveright, 2022.

Lancet Editorial Praised Chinese Communists’ Covid Policy of “Restricting Public Freedoms”

(p. A17) China’s zero-Covid policies have recently come under criticism from public-health leaders—including those at the World Health Organization—who once held them up as a model for the West.

“China’s success rests largely with a strong administrative system that it can mobilise in times of threat, combined with the ready agreement of the Chinese people to obey stringent public health procedures,” the Lancet editorialized on March 7, 2020. Western countries, it added, “must abandon their fears of the negative short-term public and economic consequences that may follow from restricting public freedoms as part of more assertive infection control measures.”

That hasn’t worn well. The negative social and economic consequences of lockdowns in the West—from learning losses and destroyed small businesses to alcoholism and drug abuse—weren’t “short-term.” Nor were China’s draconian zero-Covid policies, which three years later are only slowly being eased.

For the full commentary, see:

Allysia Finley. “LIFE SCIENCE; Western Scientists Cheered On China’s Covid Repression.” The Wall Street Journal (Monday, Dec. 12, 2022): A17.

(Note: the online version of the commentary has the date December 11, 2022, and has the same title as the print version.)

Some Gain-of-Function Bat Coronavirus Research in Wuhan Was Done in Level 2 Biosafety Lab (Instead of Higher Level 3 or 4)

(p. A1) Some scientists and officials in the Biden administration are pushing for more oversight, globally, of risky bioresearch. One focus is laboratory work that enhances a pathogen or endows it with new properties—sometimes called “gain-of-function” research—which is often done to assess its potential to infect humans.

. . .

(p. A12) Scientists and government officials have debated the risks of gain-of-function research since at least 2011, when virologists genetically modified the deadly H5N1 avian-flu virus so it could spread among ferrets.

. . .

Dr. Collins and Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said the risks could be mitigated, and the information might accelerate efforts to develop vaccines or stop outbreaks.

. . .

Then in 2014, the U.S. government declared a pause to gain-of-function research on certain dangerous viruses and set out to develop a new set of rules following incidents including an unintentional exposure of lab workers to anthrax bacteria and a discovery of some decades-old overlooked vials of smallpox virus.

Some research was allowed to continue: work seeking to identify coronaviruses that might jump to humans. Ralph Baric at the Gillings School of Global Public Health at the University of North Carolina at Chapel Hill and colleagues published a study of a bat virus closely related to SARS, or Severe Acute Respiratory Syndrome, a disease that emerged in 2002 and killed nearly 800 people.

. . .

They inserted a portion of the bat virus into a SARS virus adapted for lab tests in mice—creating a novel pathogen—and sought to see whether it would infect human cells. It did, and in mice it caused disease, though less deadly than SARS.

Then, he and his colleagues published research showing that another virus closely related to SARS infected both mice and human airway cells in the lab. They warned it was “poised for human emergence.”

Dr. Baric has said he thinks SARS-CoV-2 most likely evolved naturally to infect humans, yet he joined the scientists who in May [2021] called for serious investigation of the lab-accident hypothesis as well.

Researchers in Wuhan used techniques similar to his to test whether eight SARS-like bat coronaviruses had the potential to infect human cells, according to a paper they published in 2017. It was part of an effort to find out how SARS-like bat viruses might make changes that would render them a danger to humans.

Biosafety levels in laboratory research range from 1—used in high-school or college labs for work that doesn’t pose a disease risk to humans—to 4, reserved for the most dangerous pathogens.

At least some of the bat-coronaviruses work at Wuhan was done in a level-2 lab, which some U.S. scientists say is too low a safety level for that kind of work.

For the full story, see:

Betsy McKay and Amy Dockser Marcus. “Virus Research Explodes, Igniting Worry.” The Wall Street Journal (Saturday, Sept. 25, 2021): A1 & A12.

(Note: ellipses, and bracketed year, added.)

(Note: the online version of the story has the date September 24, 2021, and has the title “Virus Research Has Exploded Since Covid-19 Hit. Is It Safe?”)

Elon’s “Musketeers” Will Gladly Commit to “Long Hours at High Intensity”

(p. A12) Your boss probably hasn’t demanded a loyalty pledge and almost certainly doesn’t own a rocket ship, but the person calling the shots at your company might be more like Elon Musk than you realize.

. . .

What is consistent—and alluring to some bosses—is the billionaire’s unapologetically high standard for employees. He spelled it out last week in an emailed ultimatum, saying that Twitter employees must commit to “long hours at high intensity” or leave with three months’ severance.

. . .

Managers who think the working world has gone soft in recent years, with all the talk of flexibility and work-life balance, say they envy Mr. Musk’s unfiltered style and share his craving for maximum effort—even if they wouldn’t act quite as forcefully as the world’s richest person.

. . .

. . . he is the rare CEO with a fan base—“Musketeers,” as this male-dominated bunch is known—and might be able to fill the company’s ranks with devotees who believe in his vision of a more freewheeling and profitable platform and are willing to grind.

. . .

“He can do whatever he wants, and everyone that has an opinion about it can piss off,” says Derek Grubbs, director of sales development at Crux Informatics, a software company. “If everybody exits from Twitter, there are plenty of other people who will be ready to enter because it pays well, and working for Elon Musk has a flair to it.”

For the full commentary, see:

Callum Borchers. “ON THE CLOCK; The Bosses Who Want to Emulate Elon Musk.” The Wall Street Journal (Wednesday, November 23, 2022): A12.

(Note: ellipses added.)

(Note: the online version of the commentary has the date November 22, 2022, and has the title “ON THE CLOCK; Is Elon Musk Your Boss’s Anger Translator?”)