How many Americans have been tested for Covid-19? For some strange reason, nobody knows.

Alexis Madrigal wrote yesterday that, The Official Coronavirus Numbers Are Wrong, and Everyone Knows It:

In total, fewer than 500 people have been tested across the country (although the CDC has stopped reporting that number in its summary of the outbreak). As a result, the current “official” case count inside the United States stood at 43 as of this morning (excluding cruise-ship cases). This number is wrong, yet it’s still constantly printed and quoted. In other contexts, we’d call this what it is: a subtle form of misinformation…

This artificially low number means that for the past few weeks, we’ve seen… only simmering unease domestically… American public-health officials were staring at the writing on the wall that the disease was extremely likely to spread in the U.S., [but] the public-health response was stuck in neutral… Preparing for a sizable outbreak seemed absurd when there were fewer than 20 cases on American soil. Now we know that the disease was already spreading and that it was the U.S. response that was stalled.

Meanwhile, South Korean officials have been testing more than 10,000 people a day, driving up the country’s reported-case count. Same goes for Italy: high test rate, high number of cases. (Now some Italian politicians want to restrict testing.)… That may be cause for reassurance (though not everyone agrees), because the total number of cases is the denominator in the simple equation that yields a fatality rate: deaths divided by cases. More cases with the same number of deaths means that the disease is likely less deadly than the data show…

The point is that every country’s numbers are the result of a specific set of testing and accounting regimes… This is bad. It encourages dangerous behavior such as cutting back testing to bring a country’s numbers down or slow-walking testing to keep a country’s numbers low…

The reality gap between American numbers and American cases is wide. Regular citizens and decision makers cannot rely on only the numbers to make decisions.

So far, with the only testing numbers America has look almost as bad as the testing program in Indonesia.  In the last couple days, America seems to have finally ramped up testing (although no officials have wanted to continue keeping track of precisely how much). The very first day that the FDA allowed New York State to begin its own testing (to bypass the CDC’s incompetence), they discovered community spread had started at least a week ago in New York and we don’t know how far it has gotten.

The wife, son, daughter and neighbor of a midtown Manhattan lawyer who has been hospitalized in critical condition since being diagnosed with the novel coronavirus have now also tested positive…. The 20-year-old son …had been symptomatic prior to his father’s hospitalization… The Westchester patient was first diagnosed at a hospital in the city on Monday, the first day the city was able to conduct such rapid testing locally

Similarly, reports out of Washington State show they have discovered that community spread was going on last week there too and we didn’t know because we weren’t testing.

On Tuesday, officials said that two people who died last week in the Seattle area were infected with coronavirus, suggesting that the illness had spread in that region days earlier than health officials had previously known.

That’s in addition to the first case of community spread discovered in California last week (where it had already been spreading for over a week when it was discovered) and the total number of community-spread cases is now at 16 nationwide with 40 more possible cases under investigation according to the CDC data:

Note that once again the CDC has slightly reduced the amount of data they are sharing (shown in the table above) compared with the table they were publishing two days ago.

Since the CDC doesn’t give as much data anymore, the best source of data about the number of cases seems to be produced by Johns Hopkins. They keep it up to date and for example they added ten cases in America just in the past hour. Here is their current map for America.  Click on the above link for the interactive version.

They report 138 total confirmed cases in the US (although more will show up rapidly as we really start testing people) and 9 deaths. We are also starting to test people who died before we started testing the general public and more deaths will also appear that happened before testing began like the cases reported today in Seattle. The fact that nobody seems to want to bother keeping track of how much testing we are doing doesn’t seem encouraging.

The CDC’s claims that they have enough test kits to test 75,000 people, but other reports say they will only hope to have them “by the end of this week” and the same CDC report that says they have 75,000 test kits also says that they only have the capacity to “test approximately 350 specimens per day” so the number of test kits is irrelevant to their ability to do testing. The CDC also reports that commercial labs are “working to develop their own tests that hopefully will be available soon” now that they have finally been given permission.

Pence claimed that by the end of the week we would have the capability to test 1.5 million samples, but that is hard to believe given any of the more objective numbers we have been getting such as the CDC’s admission that they only have the capacity for up to 350 specimens per day.  Even that seems inflated because, “public health labs say patients typically require at least two samples.” In that case, the CDC would really only have the capacity to test 175 people per day.  That is pathetic.  No wonder they stopped publishing their quantity of testing.

By comparison, computational biologist Trevor Bedford estimates that there are at least 500 cases in the Seattle area alone because he estimates that, “the virus has been circulating in the northern part of the state for about six weeks.”  They need testing now, not just test kits.

It was after Pence took over the public health leadership that they stopped releasing information about how many people have actually been tested.   Since then we haven’t had much hard information from the federal government and it is anybody’s guess how well our testing regime is actually going.  Instead we get hopes for the number of “kits” that they “expect” could be available “by the end of the week”.

So our public health officials are putting out inflated, misleading numbers about how many people we potentially could test (someday) through a vast ability to produce ill-defined “kits” and meanwhile they have censored the testing information that matters:  how many people have we actually tested?

Posted in Health

The CDC is hiding its covid-19 testing problem instead of fixing it.

The CDC is in charge of pandemic preparedness for the USA and it has been reporting how many covid-19 tests have been done in the US three times every week, “on Mondays, Wednesdays, and Fridays.” Today they stopped. I predicted this last week because Trump responded to criticisms of his administrations’ public health efforts by putting an expert politician in charge of the effort instead of getting an expert in public health. Pence may be a savvy politician, but he is also known for a history of bad public health decisions. What is Pence’s priority? He immediately started restricting the coronavirus information that is being released.

Last Wednesday, the CDC announced the first covid case in the US that was due to the spread of the virus in the general community rather than any link to foreign cases. I fully expected that testing would surge, but two days later, the Friday CDC report showed that only six more people were tested for covid-19 in two days. That is slower than the very slow rate of testing in the weeks before that. Today I expected that the CDC would either report a huge surge in testing since there are several more community spread victims or if they had not fixed their problem, they would hide the embarrassing lack of testing. They are hiding the problem. For the first time in the epidemic, they simply stopped reporting how many tests they are doing on their reporting page. Thanks for the brave leadership Mike Pence.

This is the current report (which excludes the 48 cases that have been repatriated to the US from abroad):

As of Friday, the CDC reported that a total of only 451 Americans had been tested. That is pathetic. It is less than tiny Scotland had tested and their population is much smaller than the twin cities of Dallas-Fort Worth alone. Plus Scotland had zero cases, so they have had much less to worry about than the US with our 88 cases reported by the CDC today. The CDC isn’t telling us if they have tested more than 500 Americans yet! Pathetic.

The CDC data does show that the disease cases are increasing exponentially in the US though. This disease has a much slower incubation period than the flu, so it moves slowly though populations. What China has shown is that if we can test people rapidly, and take basic public health precautions with infected individuals, we could nearly halt the spread. That is what they have accomplished, but they stopped the disease by being able to process up to 1.65 million tests per week, according to the World Health Organization. That way the know who has it and how to stop it. Here are some recommendations from Bryce Aylward, a public health expert who would be much better than Pence at directing our response because he has first-hand knowledge of the situation in China and is a veteran epidemiologist rather than a veteran politician.

“I think the key learning from China is speed — it’s all about the speed. The faster you can find the cases, isolate the cases, and track their close contacts, the more successful you’re going to be… In China, they have set up a giant network of fever hospitals. In some areas, a team can go to you and swab you and have an answer for you in four to seven hours. But you’ve got to be set up — speed is everything… China took a whole bunch of steps when they realized they had to repurpose big chunks of their hospital systems to [respond to the outbreak]. The first thing is, they said testing is free, treatment is free. Right now, there are huge barriers [to testing and treatment] in the West. You can get tested, but then you might be negative and have to foot the bill. In China, they realized those were barriers to people seeking care, so, as a state, they took over the payments for people whose insurance plans didn’t cover them. They tried to mitigate those barriers… every hospital should test people with atypical pneumonia for Covid. People with flu-like symptoms — test for Covid.”

Costs are an ongoing problem in the US because going to the ER to get a “free” covid test has cost Americans thousands of dollars.

Even bigger than the cost problem, there have been two key problems which have led to our disastrously incompetent testing situation. First, the CDC completely botched the job. On February 14, the CDC announced that they intended to begin monitoring people with influenza-like-illness in five major cities with plans to expand the program into a national surveillance system. None of that plan had not begun as of last Friday, the last date when the CDC was still admitting how few people they were testing.

The CDC’s incompetence wouldn’t have been so bad if the CDC and FDA had allowed state public health labs, university research labs and other health providers to begin testing, but until last week, it was illegal for anyone else but the CDC to do the test. Finally, two days ago on February 29, Mike Pence finally allowed New York to do their own testing and presumably more permission will be forthcoming. One of the reasons why South Korea was so much more successful than the US at scaling up their testing program was that their version of the FDA gave early approval to many health labs to develop their testing capability. At the point when the US had only tested 445 people, South Korea had already tested a total of 66,652 and had developed the capability to test about 10,000 per day around the clock.

China, meanwhile has tested millions of people.  They even test pets for the virus.  This has been a cornerstone of their surprising success in beating back the virus.

We still have no idea how bad the spread of covid in the US is because we haven’t been testing in any significant way for a population as large as the US. Actually, it is possible that we have started testing, but if we have then why has the government has started hiding how much our capabilities have improved? You decide which is more likely.

UPDATE:  Axios interviewed some of the CDC people responsible and says that the Trump Administration is investigating the problems and that the administration claims “the U.S. has now tested more than 3,600 people for the virus,”  If so, that would be a dramatic and welcome increase in testing over the weekend.  Science magazine did a story about the administration’s new rules that allow more labs to do testing and claims that, “public health labs will be able to run 10,000 tests a day by the end of next week.”  Hopefully. 

Posted in Medianism

America’s CDC is being willfully ignorant about coronavirus spread.

Updated 2/28/20

Officially we only have 60 cases of covid-19 in the USA, but as of Wednesday, February 26, we have only looked for the virus in a total of a mere 445 Americans out of our population of 330 million. We just aren’t looking for it. See no evil. Hear no evil. Speak no Covid19.  Why is nobody talking about this data from the CDC?

We have only tested a TOTAL of 445 Americans for covid-19 according to the CDC!  That sounds like the pandemic preparedness of a 3rd-world country in the face of a disease that is spreading exponentially.

We don’t know and we can’t know how widespread the virus is in the US because we aren’t testing people.  Why have only 445 people have been tested in the US when we have had 14 confirmed cases discovered in the US plus 45 repatriated Americans who got sick abroad?  Lack of capability is part of the problem.  Last week only 2 CDC labs had the capability to test for the disease and as of Tuesday, still only a dozen health departments in the USA had the capability to do the testing at all!!  Lack of testing was what caught Italy, Korea, and Iran off guard–they didn’t discover the virus until it had already spread out of control.

We only know of one case of covid-19 that isn’t connected to any known foreign contact.  This worrisome case was just announced last night, but there could be many more because we just haven’t been testing. In this recent case, “The person wasn’t tested for the disease for days, despite an immediate request to the CDC”. The victim was hospitalized for a full week before the test was finally finished. The CDC didn’t agree to do the test until the woman became so ill, she was intubated on a ventilator in intensive care.

Asian countries in particular are way ahead of the US in testing capability.  As of this week, China and Singapore have both already developed the capability to test for people who have been exposed in the past without having developed the illness whereas the USA barely has the capability to do the basic test for people who are currently infected with a high virus load. 

The number of people China has already tested has to be in the hundreds of thousands by now and in the city of Hong Kong alone they are testing a thousand people every day.  In Korea, the public health authority has set up drive-through testing facilities in parking lots where people can drive up to temporary mobile health offices in steel shipping containers and get tested.  Check out the aerial photograph at the NYT!  They are way more advanced than we are. 

In contrast, the US has only tested 445 Americans and our testing capacity is so limited that the CDC has been restricting testing to the very few people who both have symptoms AND have had direct contact with people from mainland China (even though the disease is also in 39 other countries too).  According to the CDC’s official criteria, they should never have tested the woman from California who was on a ventilator in intensive care due to the virus.  Such a limited investigation is going to miss a lot of killer viruses.

As of Tuesday, covid-19 had killed 2,700 people worldwide and infected more than 81,000 people in more than 40 countries. It is about twice as contagious as the ordinary flu with an R0 of 2 to 3.11 vs. only 1.3 for the flu.  R0 is the average number of new people each sick person infects.  And covid19 is about 15 times deadlier for those who get it than the flu. The flu has killed an average of over 37,000 annually since 2010 and JAMA reports that, “Influenza and pneumonia constituted the largest single [infectious] disease category, averaging 44.4% of all infectious disease deaths” in the USA during the 20th century.

Covid-19 is likely to be even worse than that, but data about coronavirus is surprisingly hard to come by (perhaps due to the “say no evil” attitude of our officials).  Here is the biggest data set on coronavirus mortality that I have found so far:

Young adults have a much lower mortality rate compared with any older age. Their mortality rate is 0.2% or one in 500. Suppose you have a group of 650 young adults who get the disease. The binomial probability of at least one person dying in that group of 650 is 73% given the mortality rates we have seen so far in China shown above. In people aged 80 years and older, the mortality rate has been 14.8%. If you had a nursing home with 20 residents who got the disease, the chance that none of them would die is only 4% and the most likely number of deaths would be 3 of them given the mortality data out of China so far.

In the face of those risks, the CDC is doing… not much.  I’d ordinarily predict that this would be Trump’s “heckuva job” moment, but scandals that would sink any other politician just don’t bother him because he has no shame nor empathy for people his actions hurt and he has has always succeeded at convincing his supporters that others should be blamed for every problem he has caused.

UPDATE:

I’m pissed. We are so woefully unprepared for a pandemic. 

Two days after the first “community spread” victim in the USA was discovered, I expected that the CDC would be dramatically increasing their testing rate because there are lots of people that Californian woman came into contact with before she was tested and she had to have gotten it from someone who is still out there.  The White House is in charge of the CDC and when they announced that they put putative second-in-command, Vice-President Pence, in charge of the response, I was thankful that they are finally taking covid19 seriously.  Plus, the situation is getting more serious because virus seems to be spreading exponentially around the world. 

So I fully expected that the rate of testing to dramatically rise over the past two days, but instead I see this morning that the number of new covid19 tests over the past two days was…. SIX!?!  We are in trouble when that is all we can do.  Meanwhile California was monitoring more than 8,400 people for the coronavirus yesterday and 83 New York residents are in quarantine and that is just some of the current number of Americans at risk in only two states. New York state is so frustrated with the CDC’s lack of testing that the state decided to develop their own test independently of the CDC’s efforts. 

After we discovered Wednesday that the disease is spreading in the general community of Americans, Trump put Pence in control and we actually SLOWED DOWN our testing regime?  I mean, the White House just put out a budget two weeks ago that intended to slash CDC funding 16% (and they have repeatedly made cuts in previous years too, including eliminating the the US Pandemic Response Team in 2018), but I thought that by now they would have reversed their attitude towards the NIH and CDC and the would be making a moonshot effort to slow the disease and prevent the worst case scenario. 

Instead, they are keeping us all in the dark by barely looking for the virus. Here is the updated chart with only six more tests since two days ago:

covid19-testing Why isn’t anyone else shocked by this? I hope I’m completely misinterpreting the seriousness of this apparent incompetence and I’ll be very happy to update this post if I’m wrong and there is nothing to fear here.  Can someone with more time and investigative journalism experience please look into this? 

Unfortunately, once the media examines how pathetic the CDC’s testing has been the White House will probably stop them from publishing the data every other day as they have been doing.  When Pence took charge, he immediately started restricting the coronavirus information that is being released and Trump’s chief of staff Mulvaney today advised the American people to just ignore news reports about covid19. 

Posted in Health

The addictive dangers of modernity


For all the millennia of history before modern times, humans had very few options for entertainment and recreation. Food was bland, drugs were scarce, more time was spent making music than listening to it, and most social interaction was done face to face with extended family plus some close neighbors. Media was so scarce that most people never learned to read. Until the 1700s, sugar was as expensive in the West as pearls and many spices like black pepper were worth their weight in gold. Today, food engineers have produced fantastic flavors that don’t exist in nature like the Cool Ranch Dorito Loco.

Today our psychological rewards systems are being tempted and manipulated like never before. Pornography is always a click away. Attention merchants bombard us with sexualized images that are calculated to grab your eye, and we keep inventing new psychoactive drugs. Games are evolving to become more addictive. Video entertainment on demand is always available to stream and sites like YouTube use algorithms to serve up a customized selection of the videos that are the most likely to distract us from the real world and auto-play automatically continuously streams them for us if we don’t tear our attention away and stop it. Movies and TV shows have increasingly more sex, action, and visual candy (increasingly produced by CGI) than in the past to the point that all old movies seem slow-paced and boring by today’s addled standards. Gambling is now available in every gas station and on every cellphone.  Social media hijacks our wanting system and leaves us feeling more depressed (and wanting more consumption to fill the hole) rather than more connected. It is nearly impossible to quit Facebook and the same things that make Facebook unhealthy are essential to the profitability of their business model. The smartphone industry profits from our unhealthy relationship with smartphones and designs them to suck us into their tiny screens.

Several books have recently studied these phenomena.  Nir Eyal celebrated how profitable new addictive technologies are in his book, Hooked: How to Build Habit-Forming Products which shows corporations how to take advantage of our addictive tendencies. David T. Courtwright’s book, The Age of Addiction: How Bad Habits Became Big Business, is more worried about the social consequences of how corporations have been using new technologies to amp up the addictive qualities of their products. Here is an interview Courtwright did with Sean Illing:

Sean Illing

…Courtwright calls [this] “limbic capitalism,” a reference to the part of the brain that deals with pleasure and motivation. As our understanding of psychology and neurochemistry has advanced, companies have gotten better at exploiting our instincts for profit. Think, for example, of all the apps and platforms specifically designed to hijack our attention with pings and dopamine hits while harvesting our data.

We’ve always had some form of limbic capitalism, Courtwright says, but the methods are much more sophisticated now and the range of addictive behaviors are much wider than they used to be. I spoke to Courtwright about the problems this has created, why the battle against limbic capitalism is seemingly endless, and if he thinks we’re destined to live in a consumerist dystopia…

David T. Courtwright

Well, limbic capitalism is just my shorthand for global industries that basically encourage excessive consumption and even addiction. In fact, you could make that even stronger and say not only do they encourage it but now they’ve reached the point where they’re actually designing it.

Sean Illing

And where does that word “limbic” come from?

David T. Courtwright

It’s a reference to the limbic region of your brain, which is the part of your brain that deals with pleasure, motivation, long-term memory, and other functions that are crucial for survival. You couldn’t live without your limbic system and you couldn’t reproduce without it and that’s why it has evolved. And yet that same system is now susceptible to hijacking by corporate interests in a way that actually works against your long-term survival prospects. That’s the paradox… companies offer products that will produce a burst release of dopamine in a way that conditions and ultimately changes the brain and develops certain addictive behaviors, which is to say behaviors that are harmful. Now, people have always peddled products that are potentially addictive. But what’s happened in the last 100 years or so is that more of these commercial strategies come from highly organized corporations that do very sophisticated research and find more ways to market these addictive goods and services.

Sean Illing

It seems to me that capitalism runs on the addictions of consumers, has always run on the addictions of consumers, and therefore this isn’t all that revelatory.

David T. Courtwright

I hear this sort of point all the time, and my answer is that it’s not quite right. I make a distinction between ordinary capitalist enterprises like companies that sell people rakes or plows or nails or whatever — there’s absolutely nothing wrong with that, and, in fact, the free market is very good at distributing those goods. It’s a force for human progress.

But I think of limbic capitalism as capitalism’s evil twin, a really cancerous outgrowth of productive capitalism. There is a certain class of brain-rewarding products that lead to a form of pathological learning that we call addiction and it’s that branch of capitalism that is especially dangerous.

So I’m not anti-capitalism, but am I calling attention to a certain species of capitalism that cultivates addictive behavior for profit.

Sean Illing

What sort of industries or products are we talking about? Who traffics in limbic capitalism?

David T. Courtwright

If you’d asked that question half a century ago I would’ve said we’re mainly talking about alcohol, tobacco, and other drugs. But in the last 20 or 25 years, there’s been a big expansion of the concept of addiction. So now we don’t just speak about addiction to drugs, we speak about addiction to pornography, to computer games, to social media, to food, to all kinds of things…

Sean Illing

The recent controversy around vaping and Juul seems like a good example of how limbic capitalism works in practice.

David T. Courtwright

It’s a perfect example because it captures several features of a limbic capitalist enterprise, both historically and in terms of its current manifestation. So number one, limbic capitalists target the young. This is probably the most politically sensitive aspect of limbic capitalism… Which is what we’ve always seen from Big Tobacco and Big Alcohol: the youth are your best customers because they’ll be around the longest…

It’s about more than just delivering the product, though. One of the discoveries I made is that when you look at the history of potentially addictive pleasures there’s a tendency to blend vices and experiences in ways that increase the addictive qualities of products. Las Vegas is a great example of this. Vegas is not just about gambling; it’s a place where you can booze it up, it’s about nightclubs and big spectacles and all the dazzling amusements — everything is wrapped up in a big hedonic package.

Sean Illing

I’d love to know how you distinguish the manufacture of new demands with the satisfaction of demands that already exist.

David T. Courtwright

That’s a very interesting question. Eating is not a manufactured demand. You have to eat to survive, but you don’t have to eat highly processed food that stimulates the release of dopamine in a way that alters your mood and gives you a rush.

What we’ve done is we’ve taken things like sugar or salt that were once comparatively scarce and valuable commodities and made these things massively available. So once you get the ingredients that are capable of producing brain reward, then it’s just a matter of designing products that will essentially maximize that brain reward.

So again, the demand, “I’ve got to eat something,” was always there but what the processed food industry does, because it’s so competitive, is create products that will provide the calories and nutrients in ways that act like mood-altering drugs. And that’s where the line between simple marketing and limbic capitalism lies…

[New social technologies are addictive in new ways that humans have never encountered before.] Once upon a time, the internet and internet access were opt-in technologies. In other words, you adopted these things, you learned how to use them. But now I think we’ve reached the point where they’ve become opt-out technologies, where you’re going to have to do something radical or unusual like go off the grid or throw away your smartphone to escape it.

Once you’re in an environment where you’ve got to have this device, you’re in an environment where you will be constantly exposed to what the policy analyst Jonathan Caulkins calls “temptation goods.” You may have a firm resolution to use your smartphone just for email, or just to check the New York Times, or for a handful of other more or less straightforward functions, but sooner or later the convenience of these other devices and other apps will creep up on you and then you’ll become enmeshed in all of it.

Ezra Klein wrote that:

Twitter assessed the competition and went algorithmic, creating a space so toxic the company is now trying to understand how “healthy conversations” work. YouTube ran the numbers and built an algorithm that’s become a powerful force for radicalization. Instagram became attractive to Facebook precisely because it’s so good at being addictive. Tumblr turned out to be so reliant on porn that Pornhub is considering a bid to buy the flailing business.

Douglas Rushkoff says that, “Digital technology is destroying our freedom” both by creating new addictions and by reshaping our social institutions and contributing to the rise of authoritarianism:

consumer advertising wants us to be unsatisfied and disconnected from other people so that we look to products to fill that void. And products can never fill that void, which is great for the marketer, because then we’ll keep buying stuff to fill an ever-expanding void.

So digital technology comes along and, rather than trying to replace our human connections with product purchases, it mediates our human connections in ways that make them less satisfying. So if you engage with someone, certainly via text and email, you’re never going to get fulfilled. If you engage with them even on Skype or video, you don’t get the same rapport.

When you engage with someone in real life, the oxytocin rushes through your blood when you see their pupils getting bigger and their breathing rate syncing up with yours. These are painstakingly evolved mechanisms for achieving social harmony. And we’re losing them by spending all our time buying shit on Amazon or poring over our newsfeeds.

Smartphones are intentionally designed to be addictive using some of the same principles that make gambling addictive as well as simulating social interaction (with automated push notifications) in a way that sucks in our attention. Speaking of gambling, according to Theweek.com, gambling has stealthily become a bigger part of society than Hollywood or Major League Sports:

According to the American Gaming Association, in 2012 the 464 commercial casinos in the U.S. served 76.1 million patrons and grossed $37.34 billion.

Each year gaming revenues in the U.S. yield more profits than the theatrical movie industry ($10.9 billion) and the recorded music industry ($7 billion) combined. Even the $22.5 billion combined revenue of the four major U.S. sports leagues is dwarfed by earnings from the commercial casinos industry.

Anthony Frederick Lucas  estimates that the gambling industry is much bigger than that, claiming that it is taking an estimated $240 billion in the U.S.Note that the gambling industry is trying to avoid the more accurate word “gambling” and prefers to try to confuse people into thinking that it is just like sports and video games by insisting on calling itself the “gaming” industry.  

If gambling were run by small-scale social clubs and church raffles, it wouldn’t be much of a problem, just like tobacco wasn’t such a big social problem for Native Americans before capitalism.  It is the interaction of capitalism and addictive products that is a particularly dangerous problem because entrepreneurial capitalism will always evolve ways to make products more addictive and make them cheaper and easier to buy. 

This is why we should prefer the decriminalization of marijuana rather than full legalization because full legalization will lead to the corporatization of the industry and more addiction due to the power of private corporations who will revolutionize the primitive, artisanal supply and marketing of marijuana.

Most people envision that full legalization of marijuana will just allow the current small-scale producers to thrive, and the production will simply come out of the shadows, but the reality is that the current producers will be crushed by big agribusiness. This is what capitalism does. Their  efficiencies will bring down the prices and sell through corporate retailers like Walmart and Speedway and the entire supply chain will become so efficient that marijuana will become the cheapest intoxicant in the history of the world.

 

Posted in Health, Labor

When is the middle of winter according to heating degree days? January 18.

Image by TheUjulala from Pixabay

I mostly heat by burning firewood and my wood pile has shrunken quite seriously already this year. I was wondering when the middle of the winter is from an HVAC perspective and I was surprised that I couldn’t find the answer, so I downloaded data from DegreeDays.net for the Findlay Airport weather station for the past three and a half years and did the calculations to discover that yesterday, January 18, was the middle of the winter for Ohio according to the local data.

This year has been a milder than the average for the past couple years which means that I’ve been burning through our firewood faster than usual. Anyhow, if you are wondering how much more firewood you will need for the rest of the year and you know how much firewood you have burnt so far this year, it should be about half of the total amount you will burn for the entire heating season if the rest of the year continues on the same trend.

So we just passed the median day of winter’s heating needs.

(Actually, the rest of this year is more likely to regress to the average temperatures (which are just a bit colder) and so we probably aren’t really quite half way through the fuel we will burn this particular year given that the first half of the heating season has been particularly mild, but this is halfway for the average year.)

Posted in statistics

Ikigai

In 2017-18 there was an ikigai fad in the West. Several new books were simultaneously published and numerous news articles were written.  Even the World Economic Forum got caught up in the fad and published an article about it.  They define ikigai (prounounced ee-kee-guy) as “your reason for getting up in the morning”.  It is, “the idea of having a purpose in life” or “value in living”.


…To find this reason or purpose, experts recommend starting with four questions:

  • What do you love?
  • What are you good at?
  • What does the world need from you?
  • What can you get paid for?

Finding the answers and a balance between these four areas could be a route to ikigai for Westerners looking for a quick interpretation of this philosophy. But in Japan, ikigai is a slower process and often has nothing to do with work or income.

In a 2010 survey of 2,000 Japanese men and women, just 31% of participants cited work as their ikigai. [Which makes sense given that less than half of the Japanese population is working and only 59% of adults are working.  So the majority of Japanese workers got ikigai from their work if that survey was representative.]

Gordon Matthews, professor of anthropology at the Chinese University of Hong Kong and author of What Makes Life Worth Living?: How Japanese and Americans Make Sense of Their Worlds, told the Telegraph that how people understand ikigai can, in fact, often be mapped to two other Japanese ideas – ittaikan and jiko jitsugen. Itaikkan refers to “a sense of oneness with, or commitment to, a group or role”, while jiko jitsugen relates more to self-realization.

Matthews says that ikigai will likely lead to a better life “because you will have something to live for”, but warns against viewing ikigai as a lifestyle choice: “Ikigai is not something grand or extraordinary. It’s something pretty matter-of-fact.”

Doing things for other people (“what the world needs”) is a particularly important hole in how most Americans think about happiness.  Harvard researchers surveyed over 10,000 American students and about 80% said they valued their own happiness over caring for others.  Most kids thought their parents had the same priorities.

The irony is that seeking happiness isn’t necessarily the best way to find happiness.  It is partly by caring for others that we find happiness and purpose in life.  Happiness is one of those things that you can’t get by striving to be happy.  It is produced as a byproduct of how you live your life and if you only do things for the world because you want to be happy, it won’t work as well as if you do things for the world simply because you want to contribute.  It is the joy of contributing to others that brings a happiness that cannot be produced by merely striving to be happy.

Yukari Mitsuhashi reported for the Huffington Post that

There have even been attempts to link ikigai to longevity. Studies have found a correlation between longevity and having a life’s purpose, or ikigai, and Japan has the world’s longest life expectancy, 83.7 years ― five years longer than the U.S. (78.7 years).

In another article, Yukari Mitsuhashi wrote in the BBC that

There are many books in Japan devoted to ikigai, but one in particular is considered definitive: Ikigai-ni-tsuite (About Ikigai), published in 1966.

The book’s author, psychiatrist Mieko Kamiya, explains that as a word, ikigai is similar to “happiness” but has a subtle difference in its nuance. Ikigai is what allows you to look forward to the future even if you’re miserable right now.

Hasegawa points out that in English, the word life means both lifetime and everyday life. So, ikigai translated as life’s purpose sounds very grand. “But in Japan we have jinsei, which means lifetime and seikatsu, which means everyday life,” he says. The concept of ikigai aligns more to seikatsu and, through his research, Hasegawa discovered that Japanese people believe that the sum of small joys in everyday life results in more fulfilling life as a whole…

In a culture where the value of the team supercedes the individual, Japanese workers are driven by being useful to others, being thanked, and being esteemed by their colleagues, says Toshimitsu Sowa… That’s not to say that working harder and longer are key tenets of the ikigai philosophy… Rather, ikigai is about feeling your work makes a difference in people’s lives.

How people find meaning in their work is a topic of much interest to management experts. One research paper by Wharton management professor Adam Grant explained that what motivates employees is “doing work that affects the well-being of others” and to “see or meet the people affected by their work.”

In one experiment, cold callers at the University of Michigan who spent time with a recipient of the scholarship they were trying to raise money for brought in 171% more money when compared with those who were merely working the phone. The simple act of meeting a student beneficiary provided meaning to the fundraisers and boosted their performance.

This applies to life in general. Instead of trying to tackle world hunger, you can start small by helping someone around you, like a local volunteering group.

Diversify your ikigai

Retirement can bring a huge sense of loss and emptiness for those who find their ikigai in work. This can be especially true for athletes, who have relatively shorter careers… When retirement comes, it is helpful to have a clear understanding of why you do what you do beyond collecting a payslip.

By being mindful of this concept, it might just help you live a more fulfilling life.

The focus of Ikigai changes with age.  In particular, for people who live long enough to retire (or those living off of an inheritance), the last of the four questions–“What can you get paid for?”–disappears and those lucky people can just focus on other dimensions. In fact, some authors like Dan Buettner always leave the money question off of the list of dimensions and just focus on the other three. There is some overlap between what the world needs from you and what you can get paid for, but they certainly are not one and the same as the diagram shows.

Hector Garcia wrote a book about ikigai and he said that he associates ikigai with being in a flow state where, “you forget to eat and drink”. Iza Kavedžija interviewed older Japanese and she reported that they focused on the second question which is looking at ikigai as mastery.

There are other dimensions that the above ikigai diagram leaves out that are also important for living a good life such as spirituality, and an explicit recognition of the importance of relationships.  That should be one of the top factors because relationships are what makes life happier and healthier.  One study found that, “The people who were the most satisfied in their relationships at age 50 were the healthiest at age 80.”  According to Robert Putnam and other scholars, neoliberal capitalism and new social networking technologies are weakening the bonds of traditional relationships in modern life.  Perhaps these forces are weakening traditional relationships in Japan and that may be one reason why most Japanese people say they are unsatisfied with their ikigai. today.

The Japanese have a word for quality relationships,  moai, and that they often use it for explaining ikigai, but somehow this concept didn’t make it into the above diagram that became popular a couple years ago.  Similarly, the aforementioned ittaikan is also frequently cited by the Japanese as being crucial for ikigai and that is also all about one’s relationship with a group and role in that group.

Relationships should be stressed more because you can focus on the four dimensions — 1) what the world needs, 2) money, 3) competence, and 4) enjoying tasks — without building close relationships with other individuals and feeling at home in a particular group.

This goes to show that ikigai has more than four dimensions and other writers used completely different ways to explain it.  For example, Japanese writer Ken Mogi defines ikigai using five other ways to achieve it that are almost entirely different from the ikigai diagram above.  But he doesn’t have a clever diagram and these four questions are a great place to start thinking about ikigai.   Then you can pick whatever additional dimensions you want to add on your own.

Posted in Labor

Why is health care so expensive in the United States

The International Federation of Health Plans publishes an international cost comparison of common medical services and its most recent compilation looked at prices in 2017. The result answers the question asked by the NYT:

Why does health care cost so much more in the United States than in other countries? As health economists love to say: “It’s the prices, stupid.”

Most procedures cost less than half as much abroad compared with what Americans pay.

On top of these prices, Americans also pay higher insurance administrative costs than people in other countries, but that only adds a few percentages to the kind of inflated prices shown here.

The UAE does pay more for Kalydeco than Americans pay, but that is one of those rare outliers. The UAE pays less than half what Americans pay for most drugs.

Many people think that Americans pay more for healthcare due to high administrative costs, and it is true that we pay higher prices for healthcare administration than anywhere else, but that is still only about 8% of healthcare spending (according to the OECD), so it is only a tiny part of the overall problem.

As you can see in the graphic, only Mexico and Costa Rica had a higher administrative burden than the US, but because they spend a lot less on healthcare in those countries, the gross administrative burden in the US is still much bigger.  

admin-cost

At the bottom of the graphic are Turkey, Norway and Finland which spend hardly anything on healthcare administration.  

Posted in Health

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