Tuesday, September 29, 2020

Morons, Egotists, and Schadenfreude by Glen Brown


Was “America Great Again” after four years of Donald Trump? Maybe for millionaires and billionaires. So, why do some people still support this scoundrel? According to neuroscientist Bobby Azarian, “Some people support him out of ignorance. Basically, they are under-informed or misinformed about the issues at hand.”

Consider when he redundantly states the past election was stolen, and they simply take his word for it. This is called “The Dunning-Kruger Effect. [In other words], the problem isn’t just that they are misinformed; it’s that they are completely unaware that they are misinformed, which creates a double burden [for them]. Studies have shown that people who lack expertise in some area of knowledge often have a cognitive bias that prevents them from realizing that they lack expertise [or knowledge and intelligence].”

“As psychologist David Dunning wrote in an op-ed for Politico, ‘The knowledge and intelligence that are required to [understand an issue at hand] are often the same qualities needed to recognize that one is [unwitting] — and if one lacks such knowledge and intelligence, one remains [completely oblivious] and is [incapable of understanding complex issues]. This includes political judgment: These people cannot be reached because they mistakenly believe they are correct [without the use of logic, inferential and divergent thinking, analysis, synthesis, common sense, evidence and facts].”

Moreover, MAGA politicians support him because they want to hold on to their power despite the consequential destruction of democracy and the Constitution. And then there are people who continue to support him because of their own selfish greed. Why would they vote for him again? When he was in office, their rejoinder was usually “It’s the economy.” Of course, they did not care about millions of people who suffered while he continued to abet the American oligarchy. There was a flagrant distinction between the success of Wall Street and the failure of main street while he was in office that his followers chose to ignore.

On the other hand, there are those who support him and choose to ignore his seditious and treacherous behavior, his reprehensible ignorance, egregious incompetence, intentional maliciousness, anti-social personality disorder, pathological narcissism, psychopathic dominance, impulsivity, remorselessness, cheating and lying. One can assume they support him because of their illogic, xenophobia, fear, resentment, racism, hatred, anxiety, insecurity, avarice, credulousness, submissiveness and powerlessness….

-Glen Brown

Updated August 2022 and December 2024      


For My View on Today's Republican and Democratic Party:

https://teacherpoetmusicianglenbrown.blogspot.com/2022/01/todays-republican-and-democratic-party.html


Monday, September 28, 2020

Among the Key Findings of the New York Times Investigation by David Leonhardt


New York Times Service

September 28, 2020 | 10:01 AM

The New York Times has obtained tax-return data for President Donald Trump and his companies that covers more than two decades. Trump has long refused to release this information, making him the first president in decades to hide basic details about his finances. His refusal has made his tax returns among the most sought-after documents in recent memory.

Among the key findings of The Times’ investigation:

— Trump paid no federal income taxes in 11 of 18 years that The Times examined. In 2017, after he became president, his tax bill was only $750.

— He has reduced his tax bill with questionable measures, including a $72.9 million tax refund that is the subject of an audit by the Internal Revenue Service.

— Many of his signature businesses, including his golf courses, report losing large amounts of money — losses that have helped him to lower his taxes.

— The financial pressure on him is increasing as hundreds of millions of dollars in loans he personally guaranteed are soon coming due.

— Even while declaring losses, he has managed to enjoy a lavish lifestyle by taking tax deductions on what most people would consider personal expenses, including residences, aircraft and $70,000 in hairstyling for television.

— Ivanka Trump, while working as an employee of the Trump Organization, appears to have received “consulting fees” that also helped reduce the family’s tax bill.

— As president, he has received more money from foreign sources and U.S. interest groups than previously known. The records do not reveal any previously unreported connections to Russia.

It is important to remember that the returns are not an unvarnished look at Trump’s business activity. They are instead his own portrayal of his companies, compiled for the IRS. But they do offer the most detailed picture yet available.

Below is a deeper look at the takeaways. The main article based on the investigation contains much more information, as does a timeline of the president’s finances. Dean Baquet, the executive editor, has written a note explaining why The Times is publishing these findings.

The president’s tax avoidance:

Trump has paid no federal income taxes for much of the past two decades.

In addition to the 11 years in which he paid no taxes during the 18 years examined by The Times, he paid only $750 in each of the two most recent years — 2016 and 2017.

He has managed to avoid taxes while enjoying the lifestyle of a billionaire — which he claims to be — while his companies cover the costs of what many would consider personal expenses.

This tax avoidance sets him apart from most other affluent Americans.

Taxes on wealthy Americans have declined sharply over the past few decades, and many use loopholes to reduce their taxes below the statutory rates. But most affluent people still pay a lot of federal income tax.

In 2017, the average federal income rate for the highest-earning 0.001% of tax filers — that is, the most affluent 1/100,000th slice of the population — was 24.1%, according to the IRS.

Over the past two decades, Trump has paid about $400 million less in combined federal income taxes than a very wealthy person who paid the average for that group each year.

His tax avoidance also sets him apart from past presidents.

Trump may be the wealthiest U.S. president in history. Yet he has often paid less in taxes than other recent presidents. Barack Obama and George W. Bush each regularly paid more than $100,000 a year — and sometimes much more — in federal income taxes while in office.

Trump, by contrast, is running a federal government, of which he has contributed almost no income tax revenue in many years.

A large refund has been crucial to his tax avoidance.

Trump did face large tax bills after the initial success of “The Apprentice” television show, but he erased most of these tax payments through a refund. Combined, Trump initially paid almost $95 million in federal income taxes over the 18 years. He later managed to recoup most of that money, with interest, by applying for and receiving a $72.9 million tax refund, starting in 2010.

The refund reduced his total federal income tax bill between 2000 and 2017 to an annual average of $1.4 million. By comparison, the average American in the top 0.001% of earners paid about $25 million in federal income taxes each year over the same span.

The $72.9 million refund has since become the subject of a long-running battle with the IRS.

When applying for the refund, he cited a giant financial loss that may be related to the failure of his Atlantic City casinos. Publicly, he also claimed that he had fully surrendered his stake in the casinos.

But the real story may be different from the one he told. Federal law holds that investors can claim a total loss on an investment, as Trump did, only if they receive nothing in return. Trump did appear to receive something in return: Five percent of the new casino company that formed when he renounced his stake.

In 2011, the IRS began an audit reviewing the legitimacy of the refund. Almost a decade later, the case remains unresolved, for unknown reasons, and could ultimately end up in federal court, where it could become a matter of public record.

Business expenses and personal benefits:

Trump classifies much of the spending on his personal lifestyle as the cost of business.

His residences are part of the family business, as are the golf courses where he spends so much time. He has classified the cost of his aircraft, used to shuttle him among his homes, as a business expense as well. Haircuts — including more than $70,000 to style his hair during “The Apprentice” — have fallen into the same category. So did almost $100,000 paid to a favorite hair and makeup artist of Ivanka Trump.

All of this helps to reduce Trump’s tax bill further, because companies can write off business expenses.

Seven Springs, his estate in Westchester County, New York, typifies his aggressive definition of business expenses.

Trump bought the estate, which stretches over more than 200 acres in Bedford, New York, in 1996. His sons Eric and Donald Jr. spent summers living there when they were younger. “This is really our compound,” Eric told Forbes in 2014. “Today,” the Trump Organization website continues to report, “Seven Springs is used as a retreat for the Trump family.”

Nonetheless, the elder Trump has classified the estate as an investment property, distinct from a personal residence. As a result, he has been able to write off $2.2 million in property taxes since 2014 — even as his 2017 tax law has limited individuals to writing off only $10,000 in property taxes a year.

The ‘consulting fees’:

Across nearly all of his projects, Trump’s companies set aside about 20% of income for unexplained ‘consulting fees.’

These fees reduce taxes, because companies are able to write them off as a business expense, lowering the amount of final profit subject to tax.

Trump collected $5 million on a hotel deal in Azerbaijan, for example, and reported $1.1 million in consulting fees. In Dubai, there was a $630,000 fee on $3 million in income. Since 2010, Trump has written off some $26 million in such fees.

His daughter appears to have received some of these consulting fees, despite having been a top Trump Organization executive.

The Times investigation discovered a striking match: Trump’s private records show that his company once paid $747,622 in fees to an unnamed consultant for hotel projects in Hawaii and Vancouver, British Columbia. Ivanka Trump’s public disclosure forms — which she filed when joining the White House staff in 2017 — show that she had received an identical amount through a consulting company she co-owned.

Money-losing businesses:

Many of the highest-profile Trump businesses lose large amounts of money.

Since 2000, he has reported losing more than $315 million at the golf courses that he often describes as the heart of his empire. Much of this has been at Trump National Doral, a resort near Miami that he bought in 2012. And his Washington hotel, opened in 2016, has lost more than $55 million.

An exception: Trump Tower in New York, which reliably earns him more than $20 million in profits a year.

The most successful part of the Trump business has been his personal brand.

The Times calculates that between 2004 and 2018, Trump made a combined $427.4 million from selling his image — an image of unapologetic wealth through shrewd business management. The marketing of this image has been a huge success, even if the underlying management of many of the operating Trump companies has not been.

Other firms, especially in real estate, have paid for the right to use the Trump name. The brand made possible the “The Apprentice” — and the show then took the image to another level.

Of course, Trump’s brand also made possible his election as the first U.S. president with no prior government experience.

But his unprofitable companies still served a financial purpose: reducing his tax bill.

The Trump Organization — a collection of more than 500 entities, virtually all of them wholly owned by Trump — has used the losses to offset the rich profits from the licensing of the Trump brand and other profitable pieces of its business.

The reported losses from the operating businesses were so large that they often fully erased the licensing income, leaving the organization to claim that it earns no money and thus owes no taxes. This pattern is an old one for Trump. The collapse of major parts of his business in the early 1990s generated huge losses that he used to reduce his taxes for years afterward.

Large bills looming:

With the cash from ‘The Apprentice,’ Trump went on his biggest buying spree since the 1980s.

“The Apprentice,” which debuted on NBC in 2004, was a huge hit. Trump received 50% of its profits, and he went on to buy more than 10 golf courses and multiple other properties. The losses at these properties reduced his tax bill.

But the strategy ran into trouble as the money from “The Apprentice” began to decline. By 2015, his financial condition was worsening.

His 2016 presidential campaign may have been partly an attempt to resuscitate his brand.

The financial records do not answer this question definitively. But the timing is consistent: Trump announced a campaign that seemed a long shot to win but was almost certain to bring him newfound attention, at the same time that his businesses were in need of a new approach.

The presidency has helped his business.

Since he became a leading presidential candidate, he has received large amounts of money from lobbyists, politicians and foreign officials who pay to stay at his properties or join his clubs. The Times investigation puts precise numbers on this spending for the first time.

A surge of new members at the Mar-a-Lago club in Florida gave him an additional $5 million a year from the business since 2015. The Billy Graham Evangelistic Association paid at least $397,602 in 2017 to the Washington hotel, where it held at least one event during its World Summit in Defense of Persecuted Christians.

In his first two years in the White House, Trump received millions of dollars from projects in foreign countries, including $3 million from the Philippines, $2.3 million from India and $1 million from Turkey.

But the presidency has not resolved his core financial problem: Many of his businesses continue to lose money.

With “The Apprentice” revenue declining, Trump has absorbed the losses partly through one-time financial moves that may not be available to him again.

In 2012, he took out a $100 million mortgage on the commercial space in Trump Tower. He has also sold hundreds of millions worth of stock and bonds. But his financial records indicate that he may have as little as $873,000 left to sell.

He will soon face several major bills that could put further pressure on his finances.

He appears to have paid off none of the principal of the Trump Tower mortgage, and the full $100 million comes due in 2022. And if he loses his dispute with the IRS over the 2010 refund, he could owe the government more than $100 million (including interest on the original amount).

He is personally on the hook for some of these bills.

In the 1990s, Trump nearly ruined himself by personally guaranteeing hundreds of millions of dollars in loans, and he has since said that he regretted doing so. But he has taken the same step again, his tax records show. He appears to be responsible for loans totaling $421 million, most of which is coming due within four years.

Should he win reelection, his lenders could be placed in the unprecedented position of weighing whether to foreclose on a sitting president. Whether he wins or loses, he will probably need to find new ways to use his brand — and his popularity among tens of millions of Americans — to make money.

New York Times

 

Do we remember when Trump bragged about not paying taxes on September 26, 2016: "That makes me smart"? Well, fast forward to September 27, 2020

 



“Late [yesterday] afternoon, the New York Times published the story we have been waiting for since 2016: the story of Donald Trump’s taxes. There was never any doubt that whatever was in those taxes was bad or he never would have worked so hard to hide them. But the picture the New York Times story revealed was worse than expected.

“The New York Times obtained more than two decades of Donald Trump’s tax information, including that of his companies, through his first two years in the White House. The picture they paint is of a man more than [$400] million in debt; whose businesses are constantly losing money; who deducts personal expenses including houses, airplanes, and $70,000 in hairstyling; who is fighting with the IRS over the repayment of a $72.9 million tax refund which, if it has to be repaid, will run to $100 million; and who in his first year in office paid the most income tax he had paid in a decade: $750.

“That’s not a typo.

“In 11 of the 18 years the reporters examined, Trump paid no taxes at all. He has, however, paid taxes elsewhere. In 2017, Trump paid $750 to the U.S., but paid $15,598 in Panama, $145,400 in India, and $156,824 in the Philippines (rather undercutting the idea that American tax laws are too harsh on the very wealthy).

“The information illuminates a number of the shadowy puzzles of the Trump presidency. It shows that he was deeply in debt in 2015, and was, as his former fixer Michael Cohen said, eager to rebuild his brand by running for the highest office in the land. He had a bad habit of running through cash and accumulating huge debt, a pattern that showed up first when he ran through the money his father gave him, and then when the brief popularity of The Apprentice put $427.4 million into his pocket. He threw the money from The Apprentice into failing golf courses.

“The presidency has injected cash into Trump’s businesses, as lobbyists and foreign governments invest in them, but he is still losing money. The Times notes that ‘within the next four years, more than [$400] million in loans—obligations for which he is personally responsible—will come due.’

“This, of course, means that Trump is a huge national security risk. He owes money—to whom we don’t know—and he does not have it to pay his debts. It is no wonder that a bipartisan group of nearly 500 national security officials, past and present, last week endorsed Biden for president. According to Defense News, the list included ‘five former secretaries of the Navy, two former Army secretaries, four former Air Force secretaries, two retired governors, and 106 ambassadors.’ Retired General Paul Selva, who served as vice chairman of the Joint Chiefs of Staff for the first two and a half years of Trump’s term, signed the letter.

“The tax returns also suggest that Trump’s desperation to stay in office is sparked by the 1973 Department of Justice’s Office of Legal Counsel memo saying a sitting president cannot be indicted. Former inspector general of the Department of Justice Michael Bromwich tweeted ‘Trump knew something we didn't when he started balking at the peaceful transfer of power. If he loses the election, he faces federal and state prosecution for bank fraud, tax fraud, wire fraud, and mail fraud, as does his entire family. No OLC memo will spare him.’

“Among other things, the information revealed that Trump wrote off about $26 million in ‘consulting fees’ between 2010 and 2018. This reduced his taxable income, but it appears it might have simply been a way to give money to his children without paying taxes on it: his daughter Ivanka appears to have received $747,622 from the Trump Organization in consulting fees, despite being an employee there.

“Remember, this is the information Trump chose to tell the IRS. It seems worth wondering what he did not tell them. The Times says it will not release the actual documents in order to protect its source(s). It also says it will continue to drop more news from this trove over the coming weeks.

“A piece from Michael Kranish at the Washington Post today reinforced the New York Times story. Apparently, when he was on the verge of personal bankruptcy in the 1990s, Trump tried to trick his 85-year-old father, who was sliding into dementia, into signing a codicil to his will that would cheat Trump’s siblings out of their inheritance and give Trump control of his father’s entire estate. Trump’s mother stopped her husband from signing it.

“Trump had a press conference scheduled for shortly after the New York Times story broke. When asked about it, Trump claimed the story was ‘totally fake news,’ although a lawyer for the Trump Organization could only try to refute the story with misleading information. After the conference, CNN’s Ana Cabrera pointed out that Trump could stop the New York Times story if it were wrong by ‘releasing his tax returns, by making them public.’…” (Heather Cox Richardson).

 

Some key takeaways from the Times’ reporting from AP News:

TRUMP PAID JUST $750 IN TAXES IN BOTH 2016 and 2017.

The newspaper said Trump initially paid $95 million in taxes over the 18 years it studied. But he managed to recover most of that money by claiming — and receiving — a stunning $72.9 million federal tax refund. According to the Times, Trump also pocketed $21.2 million in state and local refunds, which are typically based on federal filings.

Trump’s outsize refund became the subject of a now-long-standing Internal Revenue Service audit of his finances. The audit was widely known. Trump has claimed it was the very reason why he cannot release his returns. But the Times report is the first to identify the issue that was mainly in dispute.

As a result of the refund, Trump paid an average $1.4 million in federal taxes from 2000 to 2017, the Times reported. By contrast, the average U.S. taxpayer in the top .001% of earners paid about $25 million annually over the same time frame.

TRUMP HAS FINANCED AN EXTRAVAGANT LIFESTYLE WITH THE USE OF BUSINESS EXPENSES.

From his homes, his aircraft — and $70,000 on hair styling during his television show “The Apprentice” — Trump has capitalized on cost incurred from his businesses to finance a luxurious lifestyle.

The Times noted that Trump’s homes, planes and golf courses are part of the Trump family business and, as such, Trump classified them as business expenses as well. Because companies can write off business expenses as deductions, all such expenses have helped reduce Trump’s tax liability.

MANY OF HIS BEST-KNOWN BUSINESSES ARE MONEY-LOSERS

The president has frequently pointed to his far-flung hotels, golf courses and resorts as evidence of his success as a developer and businessman. Yet these properties have been draining money.

The Times reported that Trump has claimed $315 million in losses since 2000 on his golf courses, including the Trump National Doral near Miami, which Trump has portrayed as a crown jewel in his business empire. Likewise, his Trump International Hotel in Washington has lost $55 million, the Times reported.

FOREIGN VISITORS HAVE HELPED SUPPORT TRUMP’S PROPERTIES

Since Trump began his presidential run, lobbyists, foreign governments and politicians have lavished significant sums of money on his properties, a spending spree that raised questions about its propriety and legality.

The Times report illustrates just how much that spending has been: Since 2015, his Mar-a-Lago resort in Florida has taken in $5 million more a year from a surge in membership. The Billy Graham Evangelistic Association spent at least $397,602 in 2017 at Trump’s Washington hotel. Overseas projects have produced millions more for Trump — $3 million from the Philippines, $2.3 million from India and $1 million from Turkey.

TRUMP WILL FACE FINANCIAL PRESSURE AS DEBTS COME DUE

Trump seems sure to face heavy financial pressures from the enormous pile of debt he has absorbed. The Times said the president appears to be responsible for $421 million in loans, most of which will come due within four years. On top of that, a $100 million mortgage on Trump Tower in New York will come due in 2022.


Sunday, September 27, 2020

“Keeping coronavirus vaccines at subzero temperatures during distribution will be hard, but likely key to ending pandemic” by Anna Nagurney


 

“Just like a fresh piece of fish, vaccines are highly perishable products and must be kept at very cold, specific temperatures. The majority of COVID-19 vaccines under development – like the Moderna and Pfizer vaccines – are new RNA-based vaccines. If they get too warm or too cold they spoil. And, just like fish, a spoiled vaccine must be thrown away.

“So how do companies and public health agencies get vaccines to the people who need them? The answer is something called the vaccine cold chain – a supply chain that can keep vaccines in tightly controlled temperatures from the moment they are made to the moment that they are administered to a person.

“Ultimately, hundreds of millions of people in the U.S. and billions globally are going to need a coronavirus vaccine – and potentially two doses of it. This mass vaccination effort is going to require a complex vaccine cold chain on a scale like never before. The current vaccine cold chain is not up to the task, and expanding the supply chain is not going to be easy.

Cold chain problems mean wasted vaccines

“Most vaccines need to be stored within 1 degree Fahrenheit of their ideal temperature. Traditional vaccines are usually stored between 35 degrees Fahrenheit and 46 degrees Fahrenheit, but some of the leading COVID-19 vaccines need to be stored at much colder temperatures. Moderna’s vaccine requires a storage temperature of minus 4 degrees Fahrenheit, whereas Pfizer’s vaccine candidate requires a storage temperature of minus 94 degrees Fahrenheit. These are not easy temperatures to maintain accurately.

“A study from 2019 estimated that 25% of vaccines are degraded by the time they arrive at their destination. If a vaccine is exposed to temperatures outside its range, and this gets noticed, then the vaccines are always thrown away. Rarely, a temperature mistake is missed and one of these vaccines is administered. Research shows that these vaccines won’t cause any adverse effects, but could offer decreased protection and might require a patient to be revaccinated.

“Temperature mistakes are mostly due to inappropriate shipping procedures in the cold chain, and these losses are estimated at US$34.1 billion annually. But that number does not even take into account the cost – physically as well as financially – of any illnesses that could have been prevented by timely deliveries of high-quality vaccines.

“As a scholar of operations management, I study perishable product supply chains in the pharmaceutical industry and how they relate to product quality. With billions of vaccines needed to address the pandemic, a high spoilage rate would result in an immense financial loss and a huge delay in vaccinations that could result in deaths and a longer global shutdown.

The cold chain today

“Experts estimate that somewhere between 12 billion and 15 billion COVID-19 vaccines are needed globally. Currently, the world is capable of producing and distributing around 6.4 billion flu vaccines per year. In 2021, experts expect companies will produce around 9 billion COVID-19 vaccines, and the cold chain must be able to handle this huge increase on top of the vaccines that must be distributed every year already.

The cold chain requires three major pieces of infrastructure: planes, trucks and cold storage warehouses. How the infrastructure is connected and utilized depends on the vaccine production locations and the points of demand.

“Once a COVID-19 vaccine is produced, it likely will be immediately transported by truck to the nearest suitable airport. Since a COVID-19 vaccine is particularly valuable and time sensitive, it will likely be shipped via air transport across the country or world. After these planes are unloaded, the vaccines will be taken via truck to appropriate warehouse storage facilities for transportation to distribution facilities. Some of the vaccines may be directly shipped from the warehouses to health care facilities where the vaccinations will take place.

Preparations and solutions

“So, what can companies, health agencies and governments do to help expand the cold chain? The first step will be to identify where the vaccines will be produced. If production is done mainly abroad, companies will need to use trucks and planes for transportation within their own countries and for further distribution to others.

“There is also a lot of uncertainty about which COVID-19 vaccine will be approved first. Different vaccines may require different temperatures and different handling procedures. Hence, staff throughout the cold chain would need different training on how to handle each vaccine.

“Another question is how frequently deliveries will need to be made to points of care. This will depend on the refrigeration capacity of health care organizations and hospitals, staffing resources, the locations the vaccines will be given and many other factors, including the shelf life of the vaccine itself.

“Finally, there is the simple problem of how to expand shipping and storage capacity. Typical restaurant freezers have a range of 5 degrees Fahrenheit to minus 10 degrees Fahrenheit and simply can’t reach the temperatures required by something like the Pfizer vaccine. Specialized equipment is needed.

“Several major logistics companies, including UPS and DHL, are already investing in new storage facilities for cold chain management. UPS is adding freezer farms of 600 freezers capable of reaching minus 80 degrees Celsius near UPS air hubs in Louisville, Kentucky, and the Netherlands. Each location will be able to hold 48,000 vials of vaccine and could easily store either the Pfizer vaccine or the Moderna vaccine at the necessary low temperatures.

Installing freezers capable of the low temperatures needed by the Pfizer vaccine isn’t possible in many places, so it is essential that processes be put into place to make sure those areas can receive a steady supply of the vaccine.

“Airports and logistics companies are currently evaluating whether they can meet this need. The results remain to be seen. These are just a few of the major problems and potential solutions, but there are dozens of interesting scenarios that could arise.

“For example, if the U.S. government gets involved in distribution, there is a possibility that the military would transport vaccines. Constant electricity becomes essential as well. In regions where fire risk is leading to blackouts or in developing nations where the grid is not as reliable, thousands of vaccines could be lost if the power goes out. It is also expected that only certain airports certified for handling pharmaceuticals will be able to accept such valuable, perishable cargo, so bottlenecks may occur there. And finally, it’s possible that with the airline companies reeling from the pandemic, there might not be enough active planes to meet the demand for shipping these vaccines.

“Every vaccine produced could save a life and bring the world closer to a return to normalcy, but getting the vaccines to where they need to be is not going to be easy. Preparing and fortifying the cold chain for vaccine distribution will ensure that vaccines are not wasted and will help the world get through this pandemic sooner” (“Keeping coronavirus vaccines at subzero temperatures during distribution will be hard, but likely key to ending pandemic” by Anna Nagurney, The Conversation).

 Anna Nagurney is the John F. Smith Memorial Professor of Operations Management, University of Massachusetts Amherst

 


Saturday, September 26, 2020

Here’s How the Pandemic Finally Ends (Part 1, Politico)

 


A vaccine by early 2021, a steady decline in cases by next fall and back to normal in a few years—11 top experts look into the future.

Elizabeth Ralph is deputy editor at Politico Magazine.

Part 1

“The microscopic bundles of RNA, wrapped in spiky proteins, latch on to human cells, hijack them, use them as factories to replicate, and then leave them for dead. It’s a biological blitzkrieg—an invasion so swift and unexpected that the germs are free to jump from host to host with little interference.

“Fast forward to the future. Now, when the prickly enemies invade the lungs, they slip past the human cells, unable to take hold. They’re marked for destruction, soon to be surrounded and eliminated. Though some escape through the airways, they confront the same defenses in their next target—if, that is, they can get anywhere near the human cells. There are so few people left to infect that the germs have nowhere to replicate, nowhere to survive.

“This is the end of the coronavirus pandemic. And this is how it could happen in the United States: By November 2021, most Americans have received two doses of a vaccine that, while not gloriously effective, fights the disease in more cases than not. Meanwhile, Americans continue to wear masks and avoid large gatherings, and the Covid-19 numbers drop steadily after a series of surges earlier in the year. Eventually, as more and more Americans develop immunity through exposure and vaccination, and as treatments become more effective, Covid-19 recedes into the swarm of ordinary illnesses Americans get every winter.

“‘It will take two things to bring this virus under control: hygienic measures and a vaccine. And you can’t have one without the other,’ says Paul Offit, director of the Vaccine Education Center and an attending physician in the Division of Infectious Diseases at Children’s Hospital of Philadelphia.

“The future laid out above is the likeliest scenario for how the pandemic could end, based on interviews with 11 top-level experts who think about the future of those microscopic SARS-CoV-2 particles every day. They agree there’s a lot of fog left in the Covid-19 crystal ball, but most accept several likelihoods: At least one effective vaccine—hopefully several—will be approved in the U.S. by early next year. Producing and distributing a vaccine will take months, with the average American not receiving their dose (or doses) until at least mid- or late 2021. And while widespread inoculation will play a large role in bringing life back to normal, getting the shot will not be your cue to take off your mask and run free into a crowded bar. The end of the pandemic will be an evolution, not a revolution, the vaccine just another powerful tool in that process.

“That assessment dramatically contrasts with President Donald Trump’s Panglossian certainty that the U.S. has ‘rounded the corner’ in the pandemic, that a vaccine will be ready by Election Day and that every American can get the shot by April. Most importantly, it contradicts the underlying assumption of Trump’s many proclamations: that life will immediately return to normal after a vaccine is administered. ‘I don’t see this pandemic ending as in like, you know, ‘This is the day, the pandemic ended,’ says virologist Angela Rasmussen. ‘I see this as being a process that will go for a long time, potentially even years.’

“Experts’ estimates of the timeline vary, but there seems to be some agreement that the virus could be in decline and under control by the second half of 2021, and that society could see pre-Covid ‘normal’ within two years. ‘I’ve said November 2021,’ predicts Zeke Emanuel, former Obama adviser and chair of the Department of Medical Ethics and Health Policy at the University of Pennsylvania. ‘I think you’ll have enough herd immunity [in the U.S.] that we’ll have an unremitting decline.’ Herd immunity is the point at which so many people are immune that the virus can no longer spread widely.

“Florian Krammer, professor of vaccinology at the Icahn School of Medicine at Mount Sinai, put it this way: ‘What I think is going to happen at some point in [20]21 is the virus is basically morphing from a real spread into something that’s in the way and causes some low numbers of cases and probably very low numbers of deaths.’

“The precise timing, of course, is uncertain—an elusive future that rests on a series of known unknowns, things like how many people continue to wear masks and social distance and whether rapid Covid-19 tests become widely available and properly deployed. Much will depend on how effective the vaccines are, how many people refuse to get inoculated and how many people forget to get their second dose if the vaccine requires two (yes, that is a significant concern). And then there’s what epidemiologist Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, calls ‘the trillion-dollar word of the day with this disease’: immunity. How long, on average, will immunity from natural infection and from the vaccine last?

“‘We can get [to herd immunity] with vaccination and clinical disease,’ he says. ‘The question is how long can we stay there. Meaning, if we get to, say, 75 or 80 percent immune projection, would it stay that way if we didn’t do anything else?’ Perhaps that’s the most important thing to understand about the pandemic right now: Though experts can make their best guesses, there is no certainty about Covid-19’s future. ‘If this were an influenza pandemic, I would feel confident telling you how it would end,’ says Osterholm. ‘But this coronavirus keeps throwing us curve balls day after day.’

“This kind of unpredictability is why Sarah Cobey, an epidemiologist at the University of Chicago, chose her field in the first place: ‘One of the reasons I wanted to study infectious disease dynamics is that they can be really unintuitive. They can be mathematically very predictable, but they can always be unintuitive.’

“Before the vaccine: ‘Masks and distance’

“The pandemic is far from over. It’s not even in decline. Cases of Covid-19 are on the rise in more than 19 states, and in just one day this week, the U.S. saw more than 40,000 new cases and more than 1,000 deaths.

“Experts don’t expect those numbers to improve much as people move indoors for the fall and winter. Harvard epidemiologist Michael Mina sees norms shifting as social distancing fatigue settles in: ‘Little by little there’s going to be fewer people wanting to sit outside, more people sitting inside,’ he says. ‘And then people are going to say, ‘Well, you know, I was at dinner two nights ago and I was fine. I can go to this gathering of 30 people.’ Then ‘I can go to the gathering of 100 people.’ And it will probably be just kind of a slow … change of opinion about what the risks are. Unfortunately, this is all occurring … at times that coronaviruses are very likely to potentially tick up due to seasonal effects,’ he adds.

“The expected surge underscores the idea that Americans are not going to achieve ‘normal’ before a vaccine, not with this country’s outmatched testing system and total failure to contact trace. The key, then, to making sure that society finds some degree of normalcy in the meantime—meaning places like schools can stay open—continues to be ‘masks and distance,’ says Emily Landon, chief infectious disease epidemiologist at University of Chicago Medicine. That means avoiding places like restaurants where you can’t wear your mask inside. Masks and distance really work,’ she says.

“Continued social distancing is far better than the alternative. Disease experts all warned against White House adviser Scott Atlas’ proposal to reopen the economy and reach herd immunity by letting natural infection tear through the population. Not only is the idea ‘a Russian roulette plan’ that could lead to millions—millions—of deaths, says Landon, but the strategy might also be impossible, given that a sizeable chunk of the U.S. population is more likely to stay home than decide it’s OK to venture out to inevitably get infected. In that case, the United States would hover below the herd immunity threshold while the economy stays stagnant, achieving neither of Atlas’ goals.

“There is another possibility, says Mina. There’s been recent buzz surrounding rapid Covid-19 antigen tests—cheap tools recently approved by the Food and Drug Administration that can deliver results within minutes. Some experts have questioned their utility, because they aren’t yet as accurate as more common lab-based tests. But Mina thinks that, if they’re produced on a massive scale and authorized for at-home use, rapid tests can help quell the pandemic in surge areas. The idea is that people would use them not as passports to enter crowded spaces and do things they wouldn’t ordinarily do, but as daily checks before they go about their normal business.

“‘They don’t have to catch everyone, because the messaging would have to be you do exactly what you’re going to do anyway. If the test is negative, you continue everything the same. But if the test is positive, then you definitely don’t go out,’ he says. ‘We actually [can] use it as a tool to create herd effects so that you have enough people who are high transmitters not transmitting.’…” (Politico).