Category: Covid-19

“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.”)

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.”)

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?”)

By 2030 mRNA Vaccines May Boost Immune Response of Metastatic Cancer Patients

(p. C4) The cofounders of BioNTech recently announced that vaccines targeting cancer may be available before the end of the decade. Researchers at Duke University are already developing a vaccine that targets mutations commonly arising in people with certain types of advanced breast cancer. Using the same mRNA technology deployed against Covid-19, these types of vaccines would not be administered prophylactically but, rather, used as a treatment to trigger a stronger immune response in patients with locally recurrent or metastatic disease. When it comes to conquering breast cancer, future medical historians will have plenty to write about.

For the full essay, see:

Lindsey Fitzharris. “A Medical Historian Confronts Breast Cancer.” The Wall Street Journal (Saturday, December 3, 2022): C4.

(Note: the online version of the essay has the date December 1, 2022, and has the same title as the print version.)

After Getting $170 Billion in Government Subsidies, Hospitals “Were Major Financial Beneficiaries of the Pandemic”

(p. B12) . . . hospitals . . . were major financial beneficiaries of the pandemic, receiving more than $170 billion in subsidies to defray their operating losses. A study looking at the finances of more than 2,000 hospitals concluded that financial losses from Covid-19 were largely offset by government relief in 2020, keeping profit margins largely intact. What is more, says Dr. Ge Bai, a professor who conducted the study with two other academics, profit rose significantly in 2021 as government aid persisted even as non-Covid activity rebounded.

“Contrary to the public perception, the industry benefited from the pandemic,” says Dr. Bai, a professor of health policy at the Johns Hopkins Bloomberg School of Public Health.

For the full commentary, see:

David Wainer. “A Profitable Prognosis.” The Wall Street Journal (Saturday, November 5, 2022): B12.

(Note: ellipses added.)

(Note: the online version of the commentary has the date November 4, 2022, and has the title “HEARD ON THE STREET; Hospitals Say They’re Still Ailing From Covid-19. Their Investors Feel Better.”)

Collins and Fauci Did Not Seek Open Debate on the Great Barrington Declaration

(p. A15) The Trump Twitter ban almost pales in comparison with the speech limitations routinely enforced on discussion of climate and Covid. Instead of “hate” or “violence,” the elastic pretext for speech restriction here is “settled science.”

The essence of science was once open debate. But that’s no longer true. In a now-infamous 2020 email, National Institutes of Health Director Francis Collins wrote Anthony Fauci that the Great Barrington Declaration, a dissent from Covid-lockdown policy, needed “a quick and devastating published take down,” which soon appeared in the press.

For the full commentary, see:

Henninger, Daniel. “WONDER LAND; They Want to Shut You Up.” The Wall Street Journal (Thursday, December 15, 2022): A15.

(Note: the online version of the commentary has the date December 14, 2022, and has the title “WONDER LAND; They Want to Shut You (and 303 Creative) Up.”)

Dependent, Missionless Resignation Can Be “Fundamentally Degrading”


(p. A13) At the Harvard Business Review, Joseph Fuller and William Kerr wrote this spring that the Great Resignation was an “unprecedented mass exit” but also the reversion to a long-term trend, one we’re “likely to be contending with for years to come.” Quit rates have been rising steadily for a long time. When the pandemic first hit, workers held onto their jobs for fear of layoffs and recession. But by 2021 stimulus money hit the system and uncertainty abated. That’s when the Great Resignation hit. “We’re now back in line with the pre-pandemic trend.”

. . .

. . . political economist Nicholas Eberstadt of the American Enterprise Institute . . . notes that recent workforce changes follow a postwar pattern. Usually after recessions, male labor-force participation drops, and when the recession ends it ticks up, “but never gets back to where it was.” Labor-force participation for both sexes, he notes, peaked in 2000 at 67%. We’re now 5 points lower than that.

The work rate for those in their prime working years, 25 to 54, has been declining since the turn of the century. The economic implications are obvious—slower growth, less expansion—and the personal implications are dire. “By and large, nonworking men don’t ‘do’ civil society,” Mr. Eberstadt says. They stay home watching screens—videogames, social-media sites and streaming services. There is something “fundamentally degrading” in this, and Mr. Ebestadt refers to an “archipelago of disability programs” that help make not working possible.

Staying apart, estranged from life and not sharing a larger mission can create “really tragic long term consequences,” Mr. Eberstadt says. These young people aren’t taking chances, leaving a job to start a small business. They aren’t finding themselves. They aren’t even looking.

For the full commentary, see:

Peggy Noonan. “DECLARATIONS; The ‘Great Resignation’ Started Long Ago.” The Wall Street Journal (Saturday, July 23, 2022): A13.

(Note: ellipses added.)

(Note: the online version of the commentary has the date July 21, 2022, and has the same title as the print version.)

Fewer Jobs Require College Degree Than Prepandemic

(p. A3) The tight labor market is prompting more employers to eliminate one of the biggest requirements for many higher-paying jobs: the need for a college degree.

Companies such as Alphabet Inc.’s Google, Delta Air Lines Inc. and International Business Machines Corp. have reduced educational requirements for certain positions and shifted hiring to focus more on skills and experience. Maryland this year cut college-degree requirements for many state jobs—leading to a surge in hiring—and incoming Pennsylvania Gov. Josh Shapiro campaigned on a similar initiative.

U.S. job postings requiring at least a bachelor’s degree were 41% in November [2022], down from 46% at the start of 2019 ahead of the Covid-19 pandemic, according to an analysis by the Burning Glass Institute, a think tank that studies the future of work. Degree requirements dropped even more early in the pandemic. They have grown since then but remain below prepandemic levels.

. . .

Lucy Mathis won a scholarship to attend a women in computer science conference. There, she learned about an IT internship at Google and eventually dropped out of her computer science undergraduate program to work at the company full time. The 28-year-old now makes a six-figure sum as a systems specialist.

“I found out I had a knack for IT,” she said. “I’m not good at academics. It’s not for me.”

More than 100,000 people in the U.S. have completed Google’s online college-alternative program that offers training in fast-growing fields such as digital marketing and project management, the company said. It and 150 other companies are now using the program to hire entry-level workers.

For the full story, see:

Austen Hufford. “Employers Rethink Need for a Degree.” The Wall Street Journal (Monday, Nov. 28, 2022): A3.

(Note: ellipsis added.)

(Note: the online version of the story has the date Nov. 26, 2022, and has the title “Employers Rethink Need for College Degrees.” I am grateful to Zhigang Feng for calling my attention to the article quoted above.)

“Advances in Gene Sequencing” Have Not “Unlocked the Key to Cures for Cancer”

(p. 10) In his new book, “The Song of the Cell,” Siddhartha Mukherjee has taken on a subject that is enormous and minuscule at once. Even though cells are typically so tiny that you need a microscope to see them, they also happen to be implicated in almost anything to do with medicine — and therefore almost anything to do with life.

. . .

If Mukherjee were another kind of storyteller — tidier, if less honest — he could have showcased a more linear narrative, emphasizing how developments in cell research have yielded some truly amazing possibilities. He himself has been collaborating on a project to engineer certain cells in the immune system so that they eat tumors without stirring up an indiscriminate inflammatory response.

But as a practicing physician, he has seen too much suffering and death to succumb to an easy triumphalism. He recalls the “exuberance” of the mid-2000s, when spectacular advances in gene sequencing had made it appear as if “we had unlocked the key to cures for cancer.” Such exuberance turned out to be fleeting; the data from clinical trials were “sobering.”

Many medical mysteries remain unsolved. If the book’s protagonist — our understanding of cell biology — seemed to be riding high again on new advances in immunology, such “self-assuredness” was laid low by the Covid-19 pandemic. Mukherjee presents a string of questions that are still unsettled. “The monotony of answers is humbling, maddening,” he writes. “We don’t know. We don’t know. We don’t know.”

For the full review, see:

Jennifer Szalai. “Building Blocks.” The New York Times Book Review (Sunday, November 13, 2022): 10.

(Note: ellipsis added.)

(Note: the online version of the review was updated Nov. 2, 2022, and has the title “Siddhartha Mukherjee Finds Medical Mystery — and Metaphor — in the Tiny Cell.”)

The book under review is:

Mukherjee, Siddhartha. The Song of the Cell: An Exploration of Medicine and the New Human. New York: Scribner, 2022.