2:00PM Water Cooler 4/27/2023

By Lambert Strether of Corrente.

Bird Song of the Day

House Sparrow, Lori Wilson Park, Brevard, Florida, United States. “Males fighting.”

* * *

Politics

“So many of the social reactions that strike us as psychological are in fact a rational management of symbolic capital.” –Pierre Bourdieu, Classification Struggles

Capitol Seizure

“Prosecutor: Proud Boys viewed themselves as ‘Trump’s army'” [Associated Press] • Including the informers and agents provocateurs?

Biden Administration

Well, all I can say is I hope the neurological damage isn’t significant:

But perhaps that’s a forlorn hope–

“Biden caught with crib notes detailing reporter’s question prior to calling on her during press conference” [FOX]. “As Biden spoke alongside South Korean President Yoon Suk Yeol in the White House Rose Garden, a photographer captured a small cheat-sheet in the president’s hand signaling he had advanced knowledge of a question from Los Angeles Times journalist Courtney Subramanian. The small paper also included a picture of the reporter along with the pronunciation breakdown of her last name. “Question #1″ was handwritten at the top of the sheet, indicating the president should call on her first at the conclusion of his remarks.” • Wowsers. It’s almost as if the entire press conference is scripted. On the bright side, I guess we know how Karine Jean-Pierre makes bank. The photo:

Good staff work, though!

2024

“Biden takes steps to keep progressives unified as he kicks off his re-election bid” [NBC]. “While President Joe Biden’s team was quietly making plans to launch his re-election campaign, top advisers inside and outside the White House started an outreach effort to hold on to a crucial piece of the Democratic coalition: progressives. Roughly a month before his campaign announcement, longtime Biden adviser Anita Dunn invited Faiz Shakir, the campaign manager for Sen. Bernie Sanders’ 2020 bid, to the White House. The meeting was a check-in with Shakir, who remains a political adviser to Sanders, to make sure he and other progressives knew they still had an open line to Biden’s team. The invitation was part of a lengthy outreach effort by senior administration officials to progressive leaders, much of it led by newly minted White House chief of staff Jeff Zients, whose appointment was greeted with a degree of skepticism by some in the progressive wing of the party. Zients has personally reached out to Sanders, I-Vt., Sen. Elizabeth Warren, D-Mass. — two progressive rivals Biden dispatched in the 2020 primaries — and House Progressive Caucus Chair Pramila Jayapal, D-Wash., sources familiar with each of the talks said. All three have said they will support Biden next year.” • So Jeff Zients “reached out.” That was all it took. Ye Gods.

“What Biden has to fear” [Brookings Institution]. “[T]he country is geared up, amidst a fair amount of complaining, for a Biden-Trump rematch. In that scenario Biden probably wins. The biggest complaint about him is his age. It factors into a wide variety of questions about him. And yet, in the two most recent elections, 2020 and 2022, we saw that age didn’t matter much — people can think Biden is too old, they can think someone else should run and yet, when push comes to shove, they voted for Biden and Democrats anyways. That’s because, in a Biden-Trump race many people simply don’t want Trump. Trump continues to rely, as he did throughout his presidency, on the care and feeding of his base which was just big enough in 2016 to elect him and just small enough in 2020 to defeat him. At no point in his short political career has he tried to expand his base — as most politicians do.” • Not so. The Democrats do not, institutionally, seek to expand their base beyond the PMC. What they do is identity-driven one-offs in particular campaigns. Then they shut that effort down, and wait for the next election. Contrast Howard Dean’s 50-state strategy, which actually handed Democrats victory in 2006, and was promptly dismantled by Obama and Rahm Emanuel. They would rather die as a party than change.

“Why Biden may have to forfeit the first contest in his re-election bid to Marianne Williamson or RFK Jr.” [NBC]. “President Joe Biden just announced his re-election campaign, but he’s already on track to sacrifice New Hampshire’s famed primary to a fringe rival like Marianne Williamson or Robert Kennedy Jr. The unusual situation is one of Biden’s own making, thanks to the new primary calendar the Democratic National Committee ratified at his behest in February, which seeks to demote Iowa and New Hampshire and prohibits candidates from campaigning — or even putting their name on the ballot — in a state that jumps the line. The problem is that New Hampshire and Iowa, both of which Biden lost in 2020, plan to disregard the DNC and hold their contests first anyway, most likely forcing Biden to forfeit the first unofficial contests of 2024.” Huh?! More: “The rules apply to Williamson and Kennedy as well, but they’ve indicated they’re willing to accept the DNC’s unspecified penalties for rule violations since they’re running anti-establishment campaigns anyway. While those contests will most likely be inconsequential to the delegate math of Biden’s re-nomination, it may nonetheless be embarrassing for the president of the United States to nominally lose to Williamson, a self-help author who has never held elective office, or Kennedy, an anti-vaccine activist with a famous last name. They are the only other Democrats in the race at the moment. While Biden’s campaign would likely shrug off the outcome of contests it didn’t even compete in, the situation could be nerve-wracking for ever-anxious Democrats and spark new questions about a bigger-name Democrat challenging Biden.” • Ha ha! That’s what Biden gets for paying off Clyburn and putting South Carolina first!

“Hunter Biden’s legal team meets with Justice Department prosecutors” [NBC]. “Hunter Biden’s legal team met with prosecutors at the Justice Department on Wednesday to discuss potential charges against Biden, the president’s son, in the Delaware criminal investigation, two sources familiar with the matter said. The meeting included representation from the U.S. attorney’s office in Delaware and the Justice Department, the sources said. The Justice Department and the Delaware U.S. attorney’s office declined to comment. Hunter Biden’s attorney did not immediately respond to a request for comment. NBC News has reported that federal prosecutors are considering charging the younger Biden with two misdemeanor counts of failure to file taxes, a felony count of tax evasion related to a business expense for a year of taxes and a potential felony gun charge related to a firearms purchase.” • That’s it? Contrasts rather sharply with the full court press on Trump!

“Disney Sues DeSantis Over Control of Its Florida Resort” [New York Times]. “Last year, under pressure from its employees, Disney criticized a Florida education law prohibiting classroom discussion of sexual orientation and gender identity for young students. Almost instantly, Gov. Ron DeSantis of Florida started calling the company ‘Woke Disney’ and vowing to show it who was boss. ‘If Disney wants to pick a fight, they chose the wrong guy,’ Mr. DeSantis wrote in a fund-raising email at the time. Since then, Florida legislators, at the urging of Mr. DeSantis, have targeted Disney — the state’s largest taxpayer — with a variety of hostile measures. In February, they ended Disney’s long-held ability to self-govern its 25,000-acre resort as if it were a county. Last week, Mr. DeSantis announced plans to subject Disney to new ride inspection regulations. Disney has quietly maneuvered to protect itself, enraging the governor and his allies. On Wednesday, however, the company decided enough was enough: Disney filed a First Amendment lawsuit against Mr. DeSantis and a five-member board that oversees government services at Disney World in federal court, claiming ‘a targeted campaign of government retaliation.’ ‘In America, the government cannot punish you for speaking your mind,’ Disney said in its complaint, which was filed in U.S. District Court for the Northern District of Florida. Disney had criticized the Parental Rights in Education law, which opponents labeled ‘Don’t Say Gay’ and which prohibits classroom discussion of sexual orientation and gender identity for students through the third grade. The DeSantis administration recently expanded the ban through Grade 12.” • I’m not finding this controversy very edifying. Why on earth was giving a corporation the powers of a county ever a good idea? And is Disney’s theory of the case novel? Surely a corporation cannot “speak its mind”? Finally, I’m ready to declare the whole “Sex Education” thing — or whatever they call it these days — a failure. Why not delete it from the curriculum entirely and put the resources elsewhere? I realize that would destroy a lucrative consulting industry and zero out some administrative slots, but maybe that’s not such a bad thing?

“Appeals court rejects Trump’s effort to block Pence from testifying in Jan. 6 probe” [NBC]. “The U.S. Circuit Court of Appeals in Washington refused to block Pence’s subpoena after Trump filed an appeal this month to halt a lower court decision ordering Pence to testify. The decision is under seal, but the denial of Trump’s emergency motion was referenced in the court docket. Trump can still appeal to the Supreme Court but has not indicated whether he will…. Pence’s subpoena was issued by special counsel Jack Smith, who was appointed in November by Attorney General Merrick Garland to oversee the Justice Department’s investigations into Trump’s role in Jan. 6 and his alleged mishandling of classified documents after leaving office.”

“Writer tells jury in lawsuit trial: ‘Donald Trump raped me'” [Associated Press]. “Carroll testified that she crossed paths with Trump at the revolving door to Bergdorf Goodman on an unspecified Thursday evening in spring 1996. At the time, she was writing a long-running advice column in Elle magazine, having also written for ‘SNL.’ Trump was a real estate magnate and social figure in New York. She said he asked her advice about selecting a gift for a woman, and she was delighted to oblige. As an advice columnist, to have Trump ask for gift guidance ‘was a wonderful prospect,’ and Carroll figured she would end up with a funny story, she said. She testified that she suggested a hat, but he pivoted to lingerie, and soon they were bantering about the bodysuit. Amused and flirting, she went along, laughing even as he closed the door to the dressing room, perhaps even as he pushed her against a wall. But then, she alleges, Trump stamped his mouth onto hers, yanked down her tights and shoved his hand and then his penis inside her while she struggled against him. She said she finally kneed him off her and fled. Carroll said that for decades, she told no one except two friends because she was afraid Trump would retaliate, because she ‘thought it was my fault’ and because she thought many people blame rape victims for what happened to them.”

“Former Arkansas Governor Asa Hutchinson formally announces White House bid” [Reuters]. “In his formal announcement speech, Hutchinson did not name Trump, but appeared to break with him on foreign policy by decrying the isolationist approach Trump took to international issues when president. ‘Isolationism only leads to weakness and weakness leads to war,’ Hutchinson said. His formal kick-off speech followed an announcement earlier this month that he was running for president. Hutchinson, who has little name recognition nationally, will present himself to Republican primary voters as a more moderate alternative to Trump and Florida Governor Ron DeSantis, another conservative firebrand who is expected to announce his presidential campaign soon. Moderation is a tough sell in Republican primary battles, which attract mostly conservative voters.” • How is supporting the Ukraine War, which I assume Hutchison’s brave assault on “isolationism” is code for, “moderate”?

Republican Funhouse

“Column: The GOP’s debt ceiling proposal bundles every bad policy idea into one noxious package” [Michael Hiltzik, Los Angeles Times]. “The GOP proposal would gut Medicaid and food stamp eligibility for millions of Americans, including 21 million Medicaid enrollees alone, according to the Department of Health and Human Services. It would turn the clock back on efforts to wean the U.S. from fossil fuels and prepare for the next inevitable pandemic. It would increase the burden on people struggling with student debt and throttle an untold number of nondefense programs such as anti-pollution enforcement and consumer protection. It would roll back tax enforcement, giving the green light to tax evasion by the rich. It is, in short, a one-stop shop for every chuckleheaded idea that Republicans have cooked up to undermine the public interest over the decades.” • It’s so bad you’d almost think the Democrats are good….

Democrats en Déshabillé

Patient readers, it seems that people are actually reading the back-dated post! But I have not updated it, and there are many updates. So I will have to do that. –lambert

I have moved my standing remarks on the Democrat Party (“the Democrat Party is a rotting corpse that can’t bury itself”) to a separate, back-dated post, to which I will periodically add material, summarizing the addition here in a “live” Water Cooler. (Hopefully, some Bourdieu.) It turns out that defining the Democrat Party is, in fact, a hard problem. I do think the paragraph that follows is on point all the way back to 2016, if not before:

The Democrat Party is the political expression of the class power of PMC, their base (lucidly explained by Thomas Frank in Listen, Liberal!). It follows that the Democrat Party is as “unreformable” as the PMC is unreformable; if the Democrat Party did not exist, the PMC would have to invent it. If the Democrat Party fails to govern, that’s because the PMC lacks the capability to govern. (“PMC” modulo “class expatriates,” of course.) Second, all the working parts of the Party reinforce each other. Leave aside characterizing the relationships between elements of the Party (ka-ching, but not entirely) those elements comprise a network — a Flex Net? An iron octagon? — of funders, vendors, apparatchiks, electeds, NGOs, and miscellaneous mercenaries, with assets in the press and the intelligence community.

Note, of course, that the class power of the PMC both expresses and is limited by other classes; oligarchs and American gentry (see ‘industrial model’ of Ferguson, Jorgensen, and Jie) and the working class spring to mind. Suck up, kick down.

* * *

“Democrats’ State-Level Comeback Hits Its Limits” [HuffPo]. “[Democrat Janet] Protasiewicz’s eventual 11-point victory [in Wisconsin’s Supreme Court election] was the latest example of how Democrats have made major progress in clawing back power at the state level, with party leaders in key states effectively turning state-level elections into extensions of national political causes, tying them to the outcome of the next presidential election and hyping up the importance of state-by-state battles over abortion rights. The strategy has fired up college-educated voters, who are more likely to vote in off-year elections, and convinced liberals around the country to pour small-dollar donations into electoral contests once considered far too obscure to merit outside investment. The results of these tactics speak for themselves: 57% of Americans live in a state with a Democratic governor. The 17 states where Democrats have a trifecta ― meaning they control the governorship and both chambers of the state legislature ― equal 41.6% of the country’s population. The 22 Republican trifectas, mostly built in smaller states, amount to just 39.6% of the country. But as the party continues a long slog back from its 2010 wipeout ― when Republicans jumped from 9 trifectas to 22 in a single night and gained control of a redistricting process enabling them to lock Democrats out of power in states across the country ― the chances for further progress are shrinking.” • Once more, the liberal Democrat PMC base is too small for them to govern effectively — or at least democratically — but they will die as a party rather than expand it.

“N.Y.C. Libraries Stave Off Sunday Closings in Adams’s New Budget Plan” [New York Times]. “Mayor Eric Adams announced on Wednesday that he would exempt New York City’s public libraries from his latest round of threatened budget cuts, sparing them from closing many of their branches on weekends.” • Many? Many?! No branches should be closed!

Our Famously Free Press

“Tucker Carlson breaks silence after Fox News departure with Twitter video: ‘See you soon'” [CBS]. “In the video, the controversial former cable host started by addressing the audience with ‘things you notice when you take a little time off,’ like how ‘unbelievably stupid most of the debates you see on television are.’ Carlson made no mention of Fox News or the reasons behind his departure from the network, where he was its most-watched anchor. In his signature delivery, and seated in what seemed like a professional studio, Carlson criticized both political parties and lamented that the ‘big topics get virtually no discussion.’ ‘Both political parties and their donors have reached consensus on what benefits them, and they actively collude to shut down any conversation about it,’ Carlson says. ‘Suddenly, the United States looks very much like a one party state. That’s a depressing realization, but it’s not permanent. The video — which runs a little over two minutes, and was seen by 1.7 million people within the hour after it was posted — is sure to invite more speculation about what’s next for Carlson, an influential figure in conservative media and politics. ‘Where can you still find Americans saying true things? There aren’t many places left, but there are some,’ Carlson said near the end, before signing off with ‘see you soon.'” • Here’s the video:

I actively avoid television news and cable, so I’ve seen Carlson in action very, very rarely. His eyes look a bit fixed to me. I also wish I knew what the framed document on the left is.

Realignment and Legitimacy

“Analysis: ARC Pastors Enriched Through Hillsong ‘Celebrity Preacher’s Scam’ [The Roys Report]. “[Association of Related Churches (ARC) is one of the largest church planting organizations in North America, with over 1,000 churches in its network. Like Hillsong, ARC is charismatic in its theology and has a similar emphasis on growing megachurches with slick programming, youth-oriented worship, and charismatic pastors.” • Lots and lots of whistleblower documents, too. Ugly and reprehensible. Pharisaical.

#COVID19

“I am in earnest — I will not equivocate — I will not excuse — I will not retreat a single inch — AND I WILL BE HEARD.” –William Lloyd Garrison

Resources, United States (National): Transmission (CDC); Wastewater (CDC, Biobot; includes many counties); Variants (CDC; Walgreens); “Iowa COVID-19 Tracker” (in IA, but national data).

Lambert here: Readers, thanks for the collective effort. We are now up to 50/50 states (100%). This is really great! (It occurs to me that there are uses to which this data might be put, beyond helping people with “personal risk assessments” appropriate to their state. For example, thinking pessimistically, we might maintain the list and see which states go dark and when. We might also tabulate the properties of each site and look for differences and commonalities, for example the use of GIS (an exercise in Federalism). I do not that CA remains a little sketchy; it feels a little odd that there’s no statewide site, but I’ve never been able to find one. Also, my working assumption was that each state would have one site. That’s turned out not to be true; see e.g. ID. Trivially, it means I need to punctuate this list properly. Less trivially, there may be more local sites that should be added. NY city in NY state springs to mind, but I’m sure there are others. FL also springs to mind as a special case, because DeSantis will most probably be a Presidental candidate, and IIRC there was some foofra about their state dashboard. Thanks again!

Resources, United States (Local): AK (dashboard); AL (dashboard); AR (dashboard); AZ (dashboard); CA (dashboard; Marin); CO (dashboard; wastewater); CT (dashboard); DE (dashboard); FL (wastewater); GA (wastewater); HI (dashboard); IA (wastewater reports); ID (dashboard, Boise; dashboard, wastewater, Central Idaho; wastewater, Coeur d’Alene; dashboard, Spokane County); IL (wastewater); IN (dashboard); KS (dashboard; wastewater, Lawrence); KY (dashboard, Louisville); LA (dashboard); MA (wastewater); MD (dashboard); ME (dashboard); MI (wastewater; wastewater); MN (dashboard); MO (wastewater); MS (dashboard); MT (dashboard); NC (dashboard); ND (dashboard; wastewater); NE (dashboard); NH (wastewater); NJ (dashboard); NM (dashboard); NV (dashboard; wastewater, Southern NV); NY (dashboard); OH (dashboard); OK (dashboard); OR (dashboard); PA (dashboard); RI (dashboard); SC (dashboard); SD (dashboard); TN (dashboard); TX (dashboard); UT (wastewater); VA (dashboard); VT (dashboard); WA (dashboard; dashboard); WI (wastewater); WV (wastewater); WY (wastewater).

Resources, Canada (National): Wastewater (Government of Canada).

Resources, Canada (Provincial): ON (wastewater); QC (les eaux usées); BC, Vancouver (wastewater).

Hat tips to helpful readers: Art_DogCT, B24S, CanCyn, ChiGal, Chuck L, Festoonic, FM, FreeMarketApologist (4), Gumbo, hop2it, JB, JEHR, JF, JL Joe, John, JM (9), JW, KatieBird, LL, Michael King, KF, LaRuse, mrsyk, MT, otisyves, Petal (5), RK (2), RL, RM, Rod, square coats (11), tennesseewaltzer, Utah, Bob White (3).

* * *

Look for the Helpers

“COVID-19 Nicknames Get a Makeover” [Time]. “Gregory is an evolutionary biologist at Canada’s University of Guelph and the unofficial spokesperson for the small group of scientists fighting for clearer (and catchier) pandemic nomenclature. The team, which includes a science teacher from Indiana and academics across disciplines in Italy, Australia, and more, first assembled on Twitter. There, they’d been assigning creature-based nicknaming efforts for COVID-19 subvariants they deemed significant long before they began receiving media coverage for Kraken; they’d named others Gryphon, Basilisk, and Minotaur, for example. But Kraken drew the first real attention to the project. And not all of that attention was positive. When the name caught on, some experts expressed concern that it could unnecessarily stoke fear because of its monstrous connotations. Meanwhile, the World Health Organization (WHO), which had led (and still does lead) the scientific discourse around COVID-19 nomenclature, remained conspicuously silent on the nickname in interviews at the time. ‘There was a lot of talk like, This is fear mongering, and it’s causing panic,’ Gregory says. ‘And I’m like, ‘None of that happened.” Meanwhile, the [WHO] was saying stuff like it’s the most transmissible variant ever. That’s scarier to me than this goofy mythological name.’ Whether it was goofy or scary, the name Kraken stole enough attention to convince Gregory and his colleagues that maybe they would have been better off using more neutral names. So, on Feb. 13, the team debuted an updated system with an extensive user guide, which utilizes the names of constellations and other celestial objects rather than mythological creatures. And unlike in an ordered system like the Greek alphabet, Gregory is unlikely to run out of names.” • So a team of public-spirited helpers is trying to work with WHO, and WHO — hold onto your hats here, folks, is having none of it.

Variants

“Chasing SARS-CoV-2 XBB.1.16 Recombinant Lineage in India and the Clinical Profile of XBB.1.16 cases in Maharashtra, India” (preprint) [medRxiv]. N = 2,856. “The study reveals that XBB.1.16* lineage has become the most predominant SARS-CoV-2 lineage in India. The study also shows that the clinical features and outcome of XBB.1.16* cases were similar to those of other co-circulating Omicron lineage infected cases in Maharashtra, India.”

Infection

“Are repeat COVID infections dangerous? What the science says” [Nature]. ” Experts estimate that the majority of the world’s population has been infected at least once; in the United States, some estimates suggest that as many as 65% of people have had multiple infections. And it’s likely that in the decades to come, we’re all destined to get COVID-19 many more times.” Good job.” I think there’s a lot of faux “balance” in the post. This on the VA study — “500,000 people who were infected by SARS-CoV-2 once, and about 41,000 who had 2 or more confirmed infections” — seems to me the important passage: “Having COVID-19 more than once is worse than having it just once. ‘It’s not really surprising,’ [Ziyad Al-Aly, an epidemiologist at Washington University School of Medicine in St. Louis, Missouri[ says. If you get hit in the head twice, he says, it will be worse than one blow. People with repeat infections were twice as likely to die and three times as likely to be hospitalized, have heart problems or experience blood clots than were people who infected only once.MR SUBLIMINAL You mean the plan is for people not to get infected once, or twice, but multiple times in their lifetimes. Those hammer blows add up!

Policy

Follow-up on the silent shrink:

Elite Maleficence

Mission accomplished:

Note 1 in 10 infections, not patients. I think this is called a “mass disabling event”?

“As Federal Emergency Declaration Expires, the Picture of the Pandemic Grows Fuzzier” [Government Executive]. “The pandemic gave federal officials expanded power to access crucial data about the spread of COVID-19, but that authority will change when the public health emergency sunsets in May. That, along with the end of popular COVID trackers, will make it harder for policymakers and the public to keep an eye on COVID and other threats.” • Good. Great!

If you’re sick, don’t come to our hospital (unless you’re here for the ratio):

The Jackpot

“The next pandemic could be ‘as infectious as this one but far more lethal’—and make COVID look like a cakewalk, expert warns” [Fortune]. Bob Wachter. Hilarity ensues. Anyhow: “Wachter isn’t the only expert to raise the possibility of an equally transmissible but more lethal pandemic pathogen. COVID’s ability to infect more efficiently has skyrocketed since 2019, soaring from near the bottom of the list of contagious diseases to near the top, where it battles with measles for supremacy. It’s possible that ultra-transmissible Omicron evolves to become more deadly, experts warn—though there’s no telling just how likely this scenario is, or when the transition might occur, if it ever does. That said, such a development may not be far off. Scientists are watching COVID evolution for the potential development of a variant that has Omicron’s transmissibility with the lethality of Delta. Such a scenario, while not a ‘nightmare,’ would be ‘a problem,’ Raj Rajnarayanan, assistant dean of research and associate professor at the New York Institute of Technology campus in Jonesboro, Ark., and a top COVID-variant tracker, recently told Fortune. ‘What’s to say that we’re not going to eventually see a COVID that has both?’ Dr. Michael Osterholm, director of the University of Minnesota’s Center for Infectious Disease Research and Policy (CIDRAP), told Fortune last fall. He was speaking of transmissibility and the lethality of SARS, MERS, or worse. If COVID evolution were to take a turn for the worse, powers that be would need to decide whether it constituted a new pandemic and warranted a new name entirely—perhaps SARS-CoV-3—or if it was simply an extension of the current pandemic, which is still ongoing, according to the World Health Organization.” • Russian Roulette was worse odds. So that’s alright then.

* * *

Looks like “leveling off to a high plateau” across the board. (I still think “Something Awful” is coming, however. I mean, besides what we already know about.) Stay safe out there!

Lambert here: I’m getting the feeling that the “something awful” might be a sawtooth pattern — variant after variant — that averages out to a permanently high plateau (with, of course, deeper knowledge of the sequelae “we” have already decided to accept or, rather, to profit from). That will be the operational definition of “living with Covid.” More as I think on this. In addition, I recurated my Twitter feed for my new account, and it may be I’m creating a echo chamber. That said, it seems to me that the knobs on Covid had gone up to 13, partly because science is popping, which demands more gaslighting, and partly because that “Covid is over” bubble maintenance is, I believe, more pundit-intensive than our betters believed it would be.

Case Data

NOT UPDATED BioBot wastewater data from April 24:

Lambert here: Unless the United States is completely, er, exceptional, we should be seeing an increase here soon.

For now, I’m going to use this national wastewater data as the best proxy for case data (ignoring the clinical case data portion of this chart, which in my view “goes bad” after March 2022, for reasons as yet unexplained). At least we can spot trends, and compare current levels to equivalent past levels.

Variants

NOT UPDATED From CDC, April 22, 2023. Here we go again:

Lambert here: Looks like XBB.1.16 is rolling right along. Though XBB 1.9.1 is in the race as well.

Covid Emergency Room Visits

NOT UPDATED From CDC NCIRD Surveillance, from April 22:

NOTE “Charts and data provided by CDC, updates Wednesday by 8am. For the past year, using a rolling 52-week period.” So not the entire pandemic, FFS (the implicit message here being that Covid is “just like the flu,” which is why the seasonal “rolling 52-week period” is appropriate for bothMR SUBLIMINAL I hate these people so much. Anyhow, I added a grey “Fauci line” just to show that Covid wasn’t “over” when they started saying it was, and it’s not over now. Notice also that this chart shows, at least for its time period, that Covid is not seasonal, even though CDC is trying to get us to believe that it is, presumably so they can piggyback on the existing institutional apparatus for injections.

Positivity

A kind reader discovered that Walgreens had reduced its frequency to once a week. No updates, however, since April 11.

Deaths

NOT UPDATED Death rate (Our World in Data):

Lambert here: WHO turned off the feed? Odd that Walgreen’s positivity shut down on April 11, and the WHO death count on April 12. Was there a memo I didn’t get?

Total: 1,159,662 – 1,159,417 = 245 (245 * 365 = 89,425 deaths per year, today’s YouGenicist™ number for “living with” Covid (quite a bit higher than the minimizers would like, though they can talk themselves into anything. If the YouGenicist™ metric keeps chugging along like this, I may just have to decide this is what the powers-that-be consider “mission accomplished” for this particular tranche of death and disease).

Excess Deaths

NOT UPDATED Excess deaths (The Economist), published April 23:

Lambert here: Based on a machine-learning model. (The CDC has an excess estimate too, but since it ran forever with a massive typo in the Legend, I figured nobody was really looking at it, so I got rid it. )

Stats Watch

GDP: “United States GDP Growth Rate” [Trading Economics]. “The US economy grew by an annualized 1.1 percent in Q1 2023, slowing from a 2.6 percent expansion in the previous quarter and missing market expectations of a 2 percent growth, a preliminary estimate showed. It was the weakest pace of expansion since Q2 2022, as business investment growth slowed down, inventories declined and rising interest rates continued to hurt the housing market.”

Employment Situation: “United States Initial Jobless Claims” [Trading Economics]. “The number of Americans filing for unemployment benefits fell by 16 thousand to 230 thousand on the week ending April 22nd, surprising market expectations of 249 thousand. It was the first decrease in new unemployment claims in three weeks, challenging recent data that pointed to some softening in the labor market and resuming the trend of stubbornly tight labor conditions despite the Federal Reserve’s aggressive rate hikes.”

Manufacturing: “United States Kansas Fed Manufacturing Index” [Trading Economics]. “The Kansas City Fed’s Manufacturing Production index fell to -21 in April 2023 from 3 in the previous month, the lowest since May 2020 and below market expectations of 3. The decline was driven more by nondurable goods plants, especially printing, plastics, paper, and food manufacturing. All month-over-month indexes declined, except for the raw materials prices, finished product prices, average employee workweek, and supplier delivery time indexes.”

* * *

The Bezzle: “There Is Something Very Wrong at Uber” [Slate]. “”What is going on in the product management part of this company?” Emil Michael, Uber’s former chief business officer and no fan of Khosrowshahi, told me on Big Technology Podcast this week. “If I were him, I’d go right to the product management team and some heads would probably roll.'” • What product? It’s a taxi company. What’s to add? Butlers? Ejection seats? Hookers and blow? Maybe it’s time to admit that capital finally got something it wanted from Uber — a whole form of exploitation in the form of gig workers — and shutter the experiment. Win win.

The Economy: “How will we know if the US economy is in a recession?” [Associated Press]. “The government’s report Thursday that the economy grew at a 1.1% annual rate last quarter signaled that one of the most-anticipated recessions in recent U.S. history has yet to arrive. Many economists, though, still expect a recession to hit as soon as the current April-June quarter — or soon thereafter. The economy’s expansion in the first three months of the year was driven mostly by healthy consumer spending, yet shoppers turned more cautious toward the end of the quarter. Businesses also cut their spending on equipment, a trend that has continued. The list of obstacles the economy faces keeps growing. The Federal Reserve has raised its benchmark interest rate nine times in the past year to the highest level in 17 years, thereby elevating the cost of borrowing for consumers and businesses. Inflation has eased slowly but steadily in response. Yet price increases are still persistently high. And last month the collapse of two large banks resulted in a whole new threat: A pullback in lending by the financial system that could weaken growth even further. A report on business conditions by the Fed this month found that banks were tightening credit to preserve capital, which makes it harder for companies to borrow and expand. Fed economists are forecasting a ‘mild recession’ for later this year. Six months of economic decline are a long-held informal definition of a recession. Yet nothing is simple in a post-pandemic economy in which growth was negative in the first half of last year but the job market remained robust, with ultra-low unemployment and healthy levels of hiring.” • So nobody knows anything…

The Economy: “US Import Gain Means Flexport Sees No Recession for Some Months” [Bloomberg]. “A steady increase in consumption and signs that US imports are set to rebound mean the world’s biggest economy isn’t set for a recession — at least for now. That’s according to forecasts released this week by supply-chain technology firm Flexport. ‘A recession may well be on the way, but from the latest data, we’re not seeing it arriving in the next few months,’ said Phil Levy, the San Francisco-based company’s chief economist. The assessment lines up with the views of some key policymakers who’ve spoken in recent days. Federal Reserve Bank of St. Louis President James Bullard said yesterday that recession fears are overblown despite recent banking turmoil, and that more interest-rate hikes are needed to counter persistent inflation. Treasury Secretary Janet Yellen is also among those who think the US can avoid such a contraction.”

The Economy: “Why goods spending isn’t falling” [Financial Times]. “There is an enigma at the centre of the US economy: what’s up with goods spending? The conventional story is well known. Fearing a pandemic depression, Congress and the Federal Reserve unleashed enormous fiscal and monetary stimulus. Everyone was afraid of in-person services businesses, so all that money flooded into the goods sector…. Much ink was spilled about the great goods-to-services rotation: goods spending should return to trend as services spending rises. In the last year or so, it’s been all about inflation and spending in services. But what if that’s wrong? What if real goods spending never falls back to its pre-pandemic trend, but instead plateaus at a higher level? It’s now been three years since lockdowns began and any trend-reversion is hard to spot.”

* * *

Today’s Fear & Greed Index: 57 Greed (previous close: 51 Neutral) [CNN]. One week ago: 63 (Greed). (0 is Extreme Fear; 100 is Extreme Greed). Last updated Apr 26 at 1:37 PM ET.

Healthcare

“Urgent care survey links high expectation for antibiotics with patient satisfaction” [Center for Infectious Disease Research and Policy]. “Antibiotics were prescribed for 53.4% of adult patients and 36.0% of pediatric patients. Logistic regression analysis found that antibiotic prescription had no effect on patient satisfaction among adult patients reporting low expectation scores, but medium-to-very-high expectation scores were associated with higher levels of satisfaction upon receiving antibiotics and with lower levels of satisfaction when antibiotics were not prescribed. No statistically significant association was found for pediatric visits.” • If you think of your patients as, well, patients, that doesn’t matter at all. If you think of them as customers, it matters a lot.

Guillotine Watch

“Elizabeth Holmes delays going to prison with another appeal” [Associated Press]. “Disgraced Theranos CEO Elizabeth Holmes has avoided starting her more than 11-year prison sentence on Thursday by deploying the same legal maneuver that enabled her co-conspirator in a blood-testing hoax to remain free for an additional month. Holmes’ lawyers on Wednesday informed U.S. District Judge Edward Davila that she won’t be reporting to prison as scheduled because she had filed an appeal of a decision that he issued earlier this month ordering her to begin her sentence on April 27.” And: “The news of Holmes’ latest legal maneuver emerged the same day that it was announced one of the federal prosecutors who helped convict her is leaving the U.S. Attorney’s office in San Jose, California. Jeffrey Schenk, who also helped convict Balwani in that trial, will specialize in defending people accused of white-collar crimes as a partner for the law firm Jones Day in Silicon Valley.” • A double-header for les tricoteuses

Class Warfare

“Of Birds and Men: DuPont, Corporate Penalties and the Law” [Confined Space]. “Just over 18 years ago, I wrote a post entitled ‘Of Fish and Men’ where I observed that ‘The penalty for killing fish and crabs is far higher than the penalty for killing a worker.’ That post recounted a 2001 chemical tank explosion at a Motiva refinery in Delaware City, Delaware, where Motiva employee Jeffrey Davis was killed. Davis’s body was dissolved in sulphuric acid that spilled from the tank. Only the steel shanks of his boots were found. OSHA issued a $175,000 OSHA fine against Motiva for violations of the Process Safety Management Standard, which at that time was far higher than normal OSHA penalties for killing workers. EPA, on the other hand, fined Motiva $12 million because spent sulfuric acid from the tank spilled into the Delaware River, resulting in thousands of dead fish and crabs. EPA’s penalty was almost 70 times higher than the OSHA penalty. Almost two decades later, things aren’t much better…. Yesterday, EPA announced a $23 million fine against DuPont after a toxic release killed four employees in 2015 at the Dupont plant in La Porte, Texas…. DuPont’s main crime: violation of the Clean Air Act…. Meanwhile, OSHA had fined the company $99,000 (later raised to $106,000) for the four fatalities: one repeat and several serious violations of the Process Safety Management standard.”

“San Francisco drops case against transient who bashed ex-fire commish with crowbar, says it was ‘self-defense'” [New York Post]. • San Francisco fire commissioner Don Carmignani in action:

Carmignani seems to make a habit of this. Back in the day, I helped serve homeless people dinner, and at one point I was silently shown a Bible page, on which was written: “When somebody says ‘You deserve this, punch them in the face and say “Did you deserve that?”

News of the Wired

“Why Tocqueville matters” [New Statesman]. “Despite accusations that he was ignorant of rapid social change, burgeoning industry and attendant social inequality in America and Britain, Tocqueville’s visits to Manchester and Liverpool in 1835 show an attention to the consequences of industrialisation. In Manchester, he recognised that a new aristocracy had been created out of industry, one that felt no obligations whatsoever to the people it depended on. In the English countryside, Tocqueville readily saw how modernisation had transformed peasants into wage labourers. These observations, not connected to or informed by any broader economic theory, were made ten years before the publication of Engels’ Condition of the Working Class in England.”

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Contact information for plants: Readers, feel free to contact me at lambert [UNDERSCORE] strether [DOT] corrente [AT] yahoo [DOT] com, to (a) find out how to send me a check if you are allergic to PayPal and (b) to find out how to send me images of plants. Vegetables are fine! Fungi and coral are deemed to be honorary plants! If you want your handle to appear as a credit, please place it at the start of your mail in parentheses: (thus). Otherwise, I will anonymize by using your initials. See the previous Water Cooler (with plant) here. From SK:

SK writes: “Our front entrance. It took a few years, but I like how the ‘lawn’ looks like a meadow of blossoms, for now at least…” Big poppies fan here. Also, this photo is beautifully composed, but I can’t really say why…. I think it’s because the mass of red color has a shape of its own…

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About Lambert Strether

Readers, I have had a correspondent characterize my views as realistic cynical. Let me briefly explain them. I believe in universal programs that provide concrete material benefits, especially to the working class. Medicare for All is the prime example, but tuition-free college and a Post Office Bank also fall under this heading. So do a Jobs Guarantee and a Debt Jubilee. Clearly, neither liberal Democrats nor conservative Republicans can deliver on such programs, because the two are different flavors of neoliberalism (“Because markets”). I don’t much care about the “ism” that delivers the benefits, although whichever one does have to put common humanity first, as opposed to markets. Could be a second FDR saving capitalism, democratic socialism leashing and collaring it, or communism razing it. I don’t much care, as long as the benefits are delivered. To me, the key issue — and this is why Medicare for All is always first with me — is the tens of thousands of excess “deaths from despair,” as described by the Case-Deaton study, and other recent studies. That enormous body count makes Medicare for All, at the very least, a moral and strategic imperative. And that level of suffering and organic damage makes the concerns of identity politics — even the worthy fight to help the refugees Bush, Obama, and Clinton’s wars created — bright shiny objects by comparison. Hence my frustration with the news flow — currently in my view the swirling intersection of two, separate Shock Doctrine campaigns, one by the Administration, and the other by out-of-power liberals and their allies in the State and in the press — a news flow that constantly forces me to focus on matters that I regard as of secondary importance to the excess deaths. What kind of political economy is it that halts or even reverses the increases in life expectancy that civilized societies have achieved? I am also very hopeful that the continuing destruction of both party establishments will open the space for voices supporting programs similar to those I have listed; let’s call such voices “the left.” Volatility creates opportunity, especially if the Democrat establishment, which puts markets first and opposes all such programs, isn’t allowed to get back into the saddle. Eyes on the prize! I love the tactical level, and secretly love even the horse race, since I’ve been blogging about it daily for fourteen years, but everything I write has this perspective at the back of it.

97 comments

  1. IM Doc

    Regarding patient satisfaction scores – as referenced in the above article. In the business it is known as a “Press-Ganey” score.

    Just so everyone will know – in our big corporate non-profit medical companies, a compilation of those scores is the largest single driver of a doctor’s bonus or even baseline compensation. Those “happy scores” are the Holy Grail of the MBA class in charge of medicine today. Anything and everything must be done to support these high scores – no matter how lunatic or bad for the patient’s health it is. There are armies of administrative staff looking over these every day. If you are found to be flailing, not only your bonus gets held up, you often get sent to weeks long conferences for re-education.

    And unfortunately, all kinds of unfortunate things happen to patients because of it. For example, we now have throngs of obese, or even not-obese, patients demanding to be placed on Ozempic so they too can look like Kim Kardashian. They almost always get their wish, damn the consequences, because these docs do not want a dent in their “happy scores” – they have kids at Georgetown and the latest BMW to pay for.

    That is but one of lots of examples.

    Contrast this to when I was young. We were explicitly told by our elders – “You are not doing your job correctly if you have not angered several patients daily. You will be the bearer of bad news – LOSE WEIGHT – PUT DOWN THE CANDY BARS – YOU HAVE A VIRAL INFECTION GO HOME AND GO TO BED FOR A FEW DAYS – YOU HAVE GONORRHEA, LET’s TALK ABOUT YOUR RECKLESS BEHAVIOR.”

    But today, it is all about the “happy scores.” — But I am so conflicted – If we have all these excellent happy scores in medicine, I would assume that reflects lots of happy patients….Why then is antidepressant and psych med use at an all time high? It really does not make sense.

    There is indeed a reason why I left that realm and fled to the Hinterlands.

    I guess I am old. Over the hill. Instead of letting them put me out to pasture, I did it to myself. And I could not be more happy actually being a physician rather than a used-car salesman.

    1. Barbara

      A physician friend told me twenty years ago that it took 10 seconds to write script for an antibiotic and 30 minutes to convince the kid’s parent that it wasn’t necessary. He said that he heard from a doc down the street that some of my patients were switching to him and I thought it was something about my manner and/or practice. Turned out it was about the script for antibiotics. And this was before the “happy scores.”

    2. LY

      The big corporate medical companies have Chief Experience Officers. Got to get those KPIs looking good for them.

    3. skippy

      But IM Doc … consumers[tm] are supposed to be Happy and thus spend more, otherwise the ev’bal Sad might spread throughout the market – !!!!! – and spending would go poof … imagine the the loss of all the generations groomed Sir …

      As a 80s vintage MBA and know[tm] these thingys … albeit I started near the top and for some silly reason have been working my way down from there … anywho off to sort some post WWII hardwood chamfer boards I taken back to bare on a house. Its going to look better than new when done.

      1. Mark Gisleson

        “anywho”?

        It’s “anyhoo.”

        People who’ve done post-baccalaureate studies are supposed to know these things!

        [This would be the prescriptive grammarian version of IM Doc’s crustiness : ]

        1. Skippy

          I corrupt it as a reflection of everything else. Hence the old dishevelled qiup in the past.

        2. skippy

          On that note, although, I was talking to a kid working at the corp paint supplier, been going there for yonks, conversation started on how bad and slow their IT system is and snowballed into how he was doing a course in neo/new Keynesian Economics at Uni. Part of a Political study thingy.

          Said they were just using the “Simple” models. Wellie I sorted that out quick smart because models are models and complexity is just injury to insult. That then at about closing time ended up with about a 45 min chat. The rest of the crew were just sitting or standing and listing the whole time as it was slow. He brought up the Sri Lanka et al dramas and China loaning money for national projects and how they take over after the national/private administrators blow the budget to heck. Like its China’s bad and then these nations have political dramas due too it. Then I had to inform he need to check back 10/20 years before that to reconcile all the political issues like IMF et al.

          Like I said anywho …. I then dropped Yves/NC, Lars Syll, PKE, Pilkington, Hudson, and some others names for them to have a look at ….

            1. skippy

              This is something I have been doing for decades Lambert, honed it all along the way. YS and you have just made it a lot easier through the clearing house/archive of information it provides and a simple means to link too. I do this with clients all the time, yes they are PMC, albeit they are not all money grubbing nasty people and for the most part just don’t have critical information to make better sense of the reality that got us all here or how to effect positive change for everyone.

              You should see the looks on some faces when after a gab and I show then the photo I sent you from back in the day in the suit from the early 2000s with the ex. The bloke I work with with, in his 40s now, after 5 years of working and talking to him, took a hard double take when he saw it, the apprentices too, and one called me a chad lol.

              No the praise is for YS and you or the others that you give a voice too … I’m just transmitting that information too others mate.

        3. skippy

          Put it another way Mark …

          IM Doc is having dramas about how to reconcile the present and the past. His upbringing and due to his abilities and efforts whilst being mentoring by people with both high regard for science and personal ethical/moral bearing too be the best person he could be both at work and in society has been corrupted beyond recognition. Too top all that all of he has a very difficult proposition wrt his religious beliefs, sorta held true for a time and then all the sudden all that time and effort has been reduced to nothing – or worse – its a trial/test of faith – sunk costs.

          Personally I hold him in the highest regard even though I don’t share his spiritual foundations, would have him as my personal/family GP as he reminds me of my Grandfather.

          The real drama is the ideology supply by those with money to effect this paradigm which corrupts any social good for a big pay day.

          The focus on that proceeds anything else …

          If IM Doc was a neighbor I would gladly do to his church with his family and offer myself up too it just to make everyone else happy I would, but they are not local churches anymore, they are corporations with balance sheets and income dynamics for the executive of them ….

    4. TimH

      Ozempic: Possible side effects include nausea, diarrhea, vomiting, constipation, abdominal pain, headache, fatigue, indigestion/heartburn, dizziness, bloating (abdominal distension), belching, low blood sugar (hypoglycemia) in patients with type 2 diabetes, gas (flatulence), gastroenteritis, and gastroesophageal reflux disease…

      People insist on this??

    5. flora

      “Contrast this to when I was young. We were explicitly told by our elders – “You are not doing your job correctly if you have not angered several patients daily. ”

      My great old family doc, now passed, must have gone to the same school (of thinking). He was a great doc. Very brusque. “Well, what did you do to yourself ?!”, he asked when I went in with a broken collar bone as a child. Then (I now think) he looked closely to see if I rallied to argue back at his charge. Was that an initial diagnostic test? I don’t know. Pretty sure his patient “happiness” score would have been very low. His patients’ health success scores however…. (he even made house calls if the people in my small town were very sick, too sick to get out. Imagine that.)

      1. flora

        Adding: mom was a smoker, and every year she’d go for her annual checkup and when she came home from her annual checkup she was angry. Really P.O.’ed. Doc had told her *again*, insisted *again* that she needed to give up smoking. That did not make her a happy camper.

        1. flora

          adding, adding (and sorry to go on): the respectfully meant, under the breath joke in my childhood home about Doc was: (question) How about Doc’s bedside manner? (answer) *What* bedside manner?!
          laughter.
          Yet everyone kept going to “no bedside manner doc” because he was very good at diagnosing and treating disease, and in recommending specialists if needed.
          He was good at his job.

          I fear for the newly minted MDs in this our new “profits uber alles” regime. /oy (I’ll stop now.)

    6. Angie Neer

      I always appreciate your perspective, Doc. Without disagreeing, I’ll just point out that the pendulum can also swing too far in an authoritarian direction. I suspect you’ve encountered those practitioners who let their white coat go to their head, so to speak.

      1. IM Doc

        I agree wholeheartedly.

        There is a big difference between being authoritarian and being truthful/assertive/realistic.

        I was trained in, and participate in the tried and true approach of placing myself right in front of the patient. Complete eye contact. Frank discussions that often last up to an hour. Honest and truthful. Complete respect for the patient and what brought them to the place they are. Being honest with each other to identify the problems at hand and how we can achieve health. This was known as “the therapeutic sequence” when I was young. That is no longer even taught in medical school. They spend a lot of time on billing and learning how to game the system, though.

        One large problem is the entire system has now inserted computers and AIs into this mix. There are all kinds of incentives for the doctors to leave critical issues completely unaddressed. Eye contact is impossible while messing with a computer. 10 minute visits that are forced upon so many lead to authoritarianism by their very nature. Having frank conversations are critical to this entire process. That has at its foundation a level of complete trust. That trust has been shattered in our world today by greed and grifting and now by all the crazy of the last 3 years. And certainly, trust can never be achieved when you have a different doctor every time. This is encouraged by the modern idea that doctors are just widgets.

        My last patient today was a 37 year old athletic male – father of 2. Unfortunately, he has Crohn’s disease. He came in today because he is having a fairly significant flare. He also is obviously completely stressed out. This is a young man that needs my time today. And he got it. In my old world, I would have gone way over the allotted 10 minutes and made everyone else late that day. I would have had bad “happy scores” for being late. I would have been promptly called to the “happy score” principal’s office the next day for 10 licks from the medical board. Ergo, many if not most doctors in modern systems would therefore have spent just five minutes with him and done the “doctor is always right” approach – the “I don’t have much time – but this ought to work approach – love it or leave it” – the authoritarian approach – and handed him some steroids and xanax – and said come back if this does not work. By the way, you will have to reinvent the wheel, it is very unlikely you will see the same doctor twice. That is oh so common in our world today.

        In my world now, I placed myself right in front of him. I listened to everything he had to say. I quickly realized that he was having multiple profound stressful situations going on to which carbon molecules from Pharma are never a solution. I listened to him as he sobbed his eyes out. I know that often with so many of these patients today – I am the only resource they have for just someone to listen. We came up with concrete ways to deal with his stressors while we do our best to get his bowel under control. He will be seeing me again in a few days, and he will know that I will be there his next visit and not “Wheel of Fortune” doctors doing shift work.

        This is the way it used to be. It is the only way I feel comfortable. Our society has sold its “medical” soul to Big Pharma, Big Insurance and Big Hospital. We have turned our entire profession over to MBAs who have a 180 degree different set of ethics than we do. The results are plain for all to see.

        1. Angie Neer

          Very clarifying comments—thank you again. This is familiar (the rushed visit with the doc staring at the computer thing—not the facing the patient and genuinely listening thing). I did have an appointment a few years ago closer to the model you describe, with my supposedly primary doctor whom I like. But since then it has not been possible to get an appointment with him on less than 6 months notice. Fortunately, I chose my parents well and have made it 60 years without any serious health problems. So far!

        2. flora

          re: “In my world now, I placed myself right in front of him. I listened to everything he had to say.”

          IM, I can only hope you will have many med students to mentor.

        3. Lambert Strether Post author

          > I was trained in, and participate in the tried and true approach of placing myself right in front of the patient. Complete eye contact. Frank discussions that often last up to an hour. Honest and truthful. Complete respect for the patient and what brought them to the place they are. Being honest with each other to identify the problems at hand and how we can achieve health. This was known as “the therapeutic sequence” when I was young. That is no longer even taught in medical school. They spend a lot of time on billing and learning how to game the system, though.

          They actually spend time on billing — i.e., upcoding — in medical school?! Say it’s not so!

          1. IM Doc

            Oh yes.

            This is how it works in academic hospitals. The students and interns are the ones doing all the heavy work. Therefore, in our world today, they are the ones doing all the chart notes. Mainly students in their third year. The attending or elder physician will round with the group – and then COSIGN the note that is already there – and bill it through the insurance or Medicare with what is known as a modifier code.

            Since all the cash register tricks are in how the notes are written and documented, you bet that the students must know exactly how this all works ( in other words, how to game the system) for it is their work that is used.

            I have been astonished over the past few years working with students from various medical schools at how adept they are at this and how willing they are to give “upcoding” advice. Constantly. I honestly cannot remember a single time in my own career as a student, intern, resident that billing mechanics ever came up. That is most definitely NOT how things work today. They are much better at this by the time they get to me than they are at any kind of diagnosis skills.

            1. Lambert Strether Post author

              > I have been astonished over the past few years working with students from various medical schools at how adept they are at this and how willing they are to give “upcoding” advice. Constantly.

              That’s really depressing; I blamed the professional coders, not the doctors. Needs an exposé of some sort. Perhaps some exasperated medical student will get in touch with us…

  2. Screwball

    I wonder if Joe decided to run again to help protect him and Hunter from all the scandals they have so far eluded? Maybe it doesn’t matter, they seem to be above the law anyway. It just chaps my behind this kind of criminal stuff is never punished the way it should, or maybe even worse, covered up.

    So many people think these creeps are as squeaky clean as virgin snow, the news media are truth tellers, and the only thing that’s wrong with the world is the “other” side. As far as I’m concerned the Biden’s are corrupt to the core and should rot in jail. That goes for all the scum that inhabit DC.

    Laws are only for us serfs.

    1. griffen

      As I wrote before, and bears repeating, rules are for the suckers. Added thought, I’ll gladly accept an honest crook against a proven and veritable liar. Politicians are corruptible, and once in power it seems they serve their donors as expected.

      Hunter Biden should be serving on energy and energy exploration boards today with the depth of his Bursima experience! \sarc

        1. Lambert Strether Post author

          > Gonzalo Lira suggested that Hunter be made President because he knows how the world works-

          I would pick Hunter over Buttigieg any day. At least Hunter has lived! In late imperial fashion, I grant. But Hunter wasn’t decanted from a McKinsey vat.

    2. Wukchumni

      If Joe passed away and they did a ‘Weekend at Biden’s’ gig, that would buy Hunter a week, maybe 2 to GTFO.

      Maybe lay low, banging out masterpieces while hiding out @ a Red Roof Inn in Roanoke.

      1. Hepativore

        Now that brings up an interesting scenario…just what would the DNC do if Biden suffered incapacitating or fatal age-related health complications during the 2024 campaign? Would they just have Harris pick up where Biden left off, even though she could not even win her own state in 2020? Who would she pick as a running mate? Sneaky Pete? Would this also mean that it would force the DNC to hold a totally-fair-but-not-really primary as a show appease voters? Or, if something happened to Biden during the presidential candidate phase of the 2024 election, then what?

        I would not rule out the DNC trying to find a body double to pass as Biden for the presidential race if Biden was unable to continue like the movie, Dave, and then the DNC would have the cable news outlets shout down anybody who points out that the new “Biden” is an imposter as being a “Russian propagandist”.

        Should the person posing as “Biden” win, he will then mysteriously resign shortly after taking office to pave the way for Harris.

        1. mac na michomhairle

          I will bet five dollars that Biden is sort of a placeholder.

          If, next year, the DNC and their backers decide it’s important to control the executive branch, Biden’s health will prevent him from following through, and Michelle Obama or someone similar will kindly step in to lead us all back to the Good Times.

        2. Wukchumni

          When Joey’s got those aviators on there’s no way to discern whether he’s alive or not, other than the usual pratfall of the physical or vocal variety.

  3. Carolinian

    Re Tucker–He must have a home studio down there in Florida. Linda Wertheimer and Cokie Roberts pioneered this perk by doing their morning NPR reports from their homes over a special audio line. Since radio they could go live in their bathrobes.

    Of course these days everyone has a TV studio above their laptop screen but sartorial standards have deteriorated.

    1. Pat

      I don’t watch Fox but have to figure that Carlson’s studio was in a lockdowned location. If so that might be the corner of his house set up then. He might have had to buy a better camera and a light or two (assuming Fox took back the equipment they would have provided), but he probably knew exactly what he needed and what to do.

    2. Late Introvert

      That’s not a pro studio, you can tell from the audio, the room reflections are very apparent. The talent lighting is way too flat also, you don’t have only the one light behind the camera. He did have a makeup artist though, clearly! Sorry, I can’t help myself, I have a communications degree, with a focus on Broadcasting & Film (hides under chair emoji).

      Tucker is right there’s no free debate on TV or newspapers any more, and without the Fox staff who knows what he’ll get up to?

      1. Lambert Strether Post author

        > That’s not a pro studio, you can tell from the audio, the room reflections are very apparent. The talent lighting is way too flat also, you don’t have only the one light behind the camera. He did have a makeup artist though, clearly! Sorry, I can’t help myself, I have a communications degree, with a focus on Broadcasting & Film (hides under chair emoji).

        This is great. Please deploy your knowledge as often as you like.

  4. Val

    ‘Where can you still find Americans saying true things?”

    People who have been properly conditioned know that saying true things out loud in the U.S. should be avoided, as it precipitates a variety of florid psychological emergencies.

    1. Lambert Strether Post author

      > true things

      I did notice a certain paucity in claims that Carlson actually thought were true. Topic areas were given. But not claims. I am certain that not everything Carlson believes is true is true.

      1. tevhatch

        Corporate Media “Truth Tellers” Inc. all apparently are taught Churchill, at least the maxim that the ‘Truth is so precious that she should always be attended by a bodyguard of lies.’

        Of course Truth was feminine to Churchill, as he had a hard time understanding it, and it would prefer to flee from him, lest it be made ugly.

        1. flora

          “The heart has its reasons which reason knows nothing of… We know the truth not only by the reason, but by the heart.”

          ― Blaise Pascal, Pensées

          1. flora

            shorter, many variants on this theme, too many to attribute to a specific quote:

            Reason is a good servant but a bad master.

            See also: Artificial Intelligence (AI), wherein boolean truth tables can confound real life, if so programmed.

            1. Lambert Strether Post author

              I don’t think AI works on truth tables (though there might ultimately be bolted-on kludges to filter out unwelcome results that do). AI as a metastatized autocomplete function might be a useful metaphor from the user perspective.

      2. ChrisFromGA

        Of course not everything Carlson believes is true. It was his open questioning of the narrative, regardless of doctrine (Ukraine, the vaccines) that made him stand out from the usual “controlled opposition” like Hannity or O’Reilly.

        As long as an opinion meister working for the networks sticks to their lane, and never questions anything within that lane, especially when going against the cartoonish stereotype of what conservative/liberal means, they will have job security shilling for the corporate interests.

        Anyone genuinely interested in pursuing the truth, even if misguided, is a threat to those interests.

        1. flora

          Yep. Meanwhile, some fun from 12 years ago. Dancing with the stars. utube. ~6 minutes.

          Tucker Carlson & Elena Grinenko – Cha-Cha-Cha on Dancing with the stars.

          https://www.youtube.com/watch?v=FRTYvygTArs

          or shorter, imo:
          “If I can’t dance to it, it’s not my revolution.” – Emma Goldman. / ;)

          If some say such lightheartedness bespeaks unseriousness, I think it speaks to humanness. imo.

          Cha-cha-cha. / :)

      3. Late Introvert

        Very vague on any one issue, which made it feel way too planned. I think he’s best off-script, and I could see his eyes reading.

        Fascinating stuff, and note to MSNBCNN, nobody watches you but Twitter just works.

  5. Wukchumni

    Being a pretty class oriented system, homeless are our untouchables at the lowest ebb, no doubt about it.

    If you have a car you’re more middle-class homeless, a bulbous boxy but good RV from the late 80’s would grant you practically rock star status, in particular if the roof doesn’t leak, but a tarp will work.

    The former SF Fire Commissioner is probably a good indicator of feelings in regards to our largest growing sector of new ires.

    It’d be a little awkward if new neighbors moved in across the street, my wife would bake a dozen chocolate chip cookies and i’d go to Rite-Aid to get a ‘Welcome to the Neighborhood!’ card, and then we’d stride across the street to knock on the tent, but fabric doesn’t resonate and there was no answer.

    A day in the life in LA where its increasingly nadir y zenith, hanging out.

    1. flora

      The idea of a class stratification within the homeless population is an idea worth exploring, imo.

      Dickens explored this idea over a century ago during the middle and late 1800’s. What could a modern exploration of the topic reveal about our modern times?

    2. Not Again

      DiFi is looking to retire. Maybe the fire commissioner is interested in a gig in DC? He hates poor people; he must be a Democrat.

      1. Lambert Strether Post author

        > He hates poor people; he must be a Democrat.

        I did a cursory search to come up with Carmignani’s political affiliations, and came up with nothing. Hard to imagine a Republican being elected to any office in San Francisco, though. Local readers please correct!)

  6. Henry Moon Pie

    ” powers that be would need to decide whether it constituted a new pandemic and warranted a new name entirely”

    I think they would call the new, more deadly disease a “mild,” no, “very mild” new form of Covid followed by a message to, “Report to your jawb immediately. Repeat: report to your jawb immediately.”

  7. Jason Boxman

    Came across this through a link maze from something posted maybe today?

    The NIH has poured $1 billion into long Covid research — with little to show for it

    Might be a re-post of the STAT story though.

    Long Covid affects an estimated 16 million Americans and the research work by the National Institutes of Health represents the federal government’s most high-profile, and costly, attempt to understand and address the disease. This story explores the taxpayer spending and work thus far by NIH’s RECOVER initiative. This article was co-reported with STAT News, a newsroom focused on health, medicine, and scientific discovery that is produced by Boston Globe Media. Funding for this project also came from Columbia University’s Brown Institute for Media Innovation. Our ongoing series on the Covid-19 pandemic can be republished under a Creative Commons license. For more information, click the republish button below.

  8. Tom Stone

    I’ll be skipping Saturday’s superspreader event. the “Apple Blossom Parade” and fair.
    High school bands, antique tractors and thousands of spectators standing shoulder to shoulder and cheering as they infect each other.
    The kids love it!

    I am still surprised by just how cruel and evil American Society has become, this is inarguably insane behavior and I DO NOT UNDERSTAND how deliberately exposing your children to a dangerous pathogen is considered acceptable behavior by anyone who is not an out and out psychopath.

    1. The Rev Kev

      They are exposing their children to a dangerous pathogen to prove that there is nothing to worry about and that the Pandemic is over. Old Joe told them so and an entire class of people are going along with it.

      1. nippersdad

        The Vanguard was just saying that they suspect Manchin is going to primary Biden because Justice is doing so well against him in his Senate seat. They made a good point; were Manchin to go after Biden it would be very difficult for the DNC to not have debates.

        Which would be very good news for both Kennedy and Williamson. I hope he goes for it, that would be quite the splatterfest.

    1. notabanker

      I watched the Vaccine Mandate video linked here last night and it was pretty good. The panel was very good. Mostly saying things that other were saying a year or two ago. But as we saw with the twitter files, the spooks and HS actively censored it. The ortho surgeon was kinda, eh whatever, but the lawyer and two doctors gave great perspectives. Nothing outlandish as far as I’m concerned. The Kennedy speech was the same one he gave at Hillsdale College, I think that is a better version and that is on YT. I’m open to someone debunking him, but the bottom line is the guy has been suing pharma for a living, so he knows where the bodies are buried. He has Fauci dead to rights.

      He’s not the guy I would pick to be President, unless my only other alternative was a DNC muppet.

    2. Acacia

      Don’t worry, they’ll sheepdog votes into the party, just like Bernie did, and get thrown under the bus by the DNC.

      Works every time.

    1. Lambert Strether Post author

      > a copy of the U.S. Constitution

      Thanks for the image. The whole thing looked typeset to me. (Now it doesn’t. Funny how sometimes you can’t see things ’til you know what they are. Probably some deep psychological principle here.)

  9. Wukchumni

    “Prosecutor: Proud Boys viewed themselves as ‘Trump’s army’” [Associated Press] • Including the informers and agents provocateurs?
    ~~~~~~~~~~~~~~~~~~~~~~
    Proud Boys. Whatcha want, watcha want. Whatcha gonna do. When President Donald Trump vouch for you. Tell me. Whatcha wanna do, whatcha gonna dooo. Yeaheah.

    It was pretty surreal to have a President address them by name and tell them to stand ready, they must have been euphoric.

    ‘Brown Shorts’

  10. Jason Boxman

    Let us not forget, both Bill Clinton and Biden are accused rapists as well. So this seems to be rather common among recent, mostly Democrat, presidents. And Trump was a Democrat, before he was a Republican. And I’m fairly certain that vote blue no matter who will nonetheless apply in this campaign as well.

    1. ChrisFromGA

      Do I detect a trend? Clinton, then a couple of outliers, then Trump, and Biden. We’re giving Rome a run for the money (although to be fair, back then rape was probably not considered a crime, although I am guessing some other form of justice might apply, not to emperors though.)

      Good fiddling skills might be a new requirement for POTUS.

  11. Adam1

    Holy Crap!

    I’ve either lost touch with reality (or just gotten that old) OR someone’s trying to sell me something that sticks like crap?!?!

    https://www.bbc.com/news/world-us-canada-65406559

    I’m supposed to believe that Teixeira received a super top level clearance level AND none of this information had been discovered before hand or was flagged? I mean he’s only 21!?!? I can’t imagine all that much about him has changed in in those 2-3 years.

    This REALLY stinks to high hell OR we need a firing squad to handle all the incompetent people who authorized his clearance. Of course I’m sure that list is a state secret to protect the innocent (or not so innocent).

  12. Wukchumni

    FRESNO, Calif. (KSEE/KGPE) – Fresno County residents, with support from the ACLU, are trying to get the Board of Supervisors to drop its opposition to the name “Yokuts Valley” – and will be gathering at the supervisor’s board meeting on Tuesday to make their position clear.

    Officials with the ACLU say the residents will rally outside the Fresno County Hall of Records to demand that the Fresno County Board of Supervisors drop its opposition to a California law requiring the removal of “squaw” from place names and geographic features across the state.

    Fresno County Supervisors voted 3-2 last month to sue the state over AB 2022, which bans the use of the slur “squaw.” On February 9, county workers reinstalled an unofficial “Welcome to Sqaw Valley” sign that days earlier had been removed from the grounds of the Bear Valley Library.

    Officials say that action was a violation of AB 2022, which prohibits replacing signage containing the derogatory term “squaw” once it has been taken down.

    Last week, the ACLU of Northern California sent a letter urging the Fresno County Board of Supervisors to remove the illegal sign immediately.

    https://www.yourcentralvalley.com/news/local-news/aclu-wants-yokuts-valley-demands-fresno-county-drops-lawsuit/
    ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

    Its kind of reminiscent of Arizona not recognizing MLK Jr., and dare I say, so Fresno

  13. Mark Gisleson

    The usual pundits are saying the Disney suit is a slam dunk but as I’ve been pointing out elsewhere, Florida juries are composed of Floridians. There isn’t a jury selection consultant alive that can navigate that swamp.

      1. Mark Gisleson

        Never been to Florida but I’m guessing that if you live north of Orlando, you hate Disneyworld because of the traffic. I don’t think this lawsuit would fare well in the panhandle either. Any part of central Florida within commuting distance of Orlando would be impossible. Could a judge actually seat jurors who worked for Disney?

        This could be the trial of the century, dmpxotipx-wise. [Wuk–just tumble each letter one click to decipher the mystery word!]

  14. ForFawkesSakes

    My perspective and experience with Florida’s “Don’t Say Gay” legislation.

    This legislation is what it says on the box. There can be no reference to LGBT issues, through conservative interpretation of a ‘woke’ lens.

    As a gay man, when it was applicable to elementary school ages, I did not object. I’m not a fan of book banning in general, but I agree that children should be able to be children as long as possible before being sexualized by the adults around them.

    However, now it’s been extended through high school and I take exception. Middle School, I think there is a place for these discussions because the kids are about as mean as they can be at that age. And bullying usually involves sexualizing and/ or othering of the kid outside of the norm. At this point, adults need to be able to talk about this without a chilling effect.

    In high school however, holy cow, do I disagree! I must disclose that I attended an arts focused high school for theatre. In those four years, acting and directing students sought out LGBT works to explore themselves though artifice. I played a wonderful role in Michael Christofer’s The Shadow Box. I was originally attracted to the part because I identified with his sexuality, but the play’s theme was late stage care for the terminally ill. I learned something I still can’t articulate, as it related to my own experience with losing a grandparent. That show and experience grew my heart and my empathy gland. And it never would have happened if my peers and I hadn’t had a chance to explore what inspired us. This won’t be happening under the “Don’t Say Gay” law. Arts education, already not doing great in this purple state, is going to be devastated by how limited their pool of inspiration will become.

    I’m not sure how to take sides against the evil corporation who ruined copyright and IP or the rotten elite Gov. Meatball Puddingfingers.

    My money is on the mouse.

    1. Lambert Strether Post author

      > I must disclose that I attended an arts focused high school for theatre. In those four years, acting and directing students sought out LGBT works to explore themselves though artifice. I played a wonderful role in Michael Christofer’s The Shadow Box.

      Mercutio might be good, too, at least according to some readings. (And of course, if you want to do racism and colonialism, there are Iago and Othello).

      I would, at one and the same time, abolish the “Sex Education” curriculum, or whatever glozing jargon we’ve invented for it these days, along with its attendant administrative layer, and allow the Humanities to do their work (their social function, in addition to their aesthetic function).

      Pragmatically, when fighting the reactionaries at the school board, I would far rather defend art against censorship then defend a curriculum concocted by successor ideologues against de-accession.

  15. Wukchumni

    The dams along the western slopes of the southern Sierra all date from the mid 50’s to 1962, Isabella Dam is 70 years old and just last year the lake was so low that an old town was popping up out of the mire. The dam works have been a bit rusty in usage as of late and then comes pretty much an endless summer of enormous outflows 24/7 and the machinery gets stressed, resulting in bad vibrations…

    The power plant is being shut down so operators can determine the source of a “vibration,” which began Sunday evening, as reported by SJV Water.

    “They’re not sure why it’s vibrating,” Mulkay said. “It could be a bearing problem inside the plant or it could be trash or debris collected on the intake screen. They won’t know until they shut it down and take a look at it.”

    In a news release issued Tuesday afternoon, the Army Corps states that switching releases from the power plant to the dam’s gates will allow the Corps “… to fully control the rate at which controlled water releases enter the Kern River ahead of increased temperatures and reservoir inflows due to snowmelt runoff. Currently, the hydropower plant controls that rate.”

    The Corps didn’t mention the vibration issue in its release.

    https://www.bakersfield.com/columnists/lois-henry/lois-henry-vibration-in-isabella-dam-power-plant-causes-temporary-halt-of-kern-river-outflows/article_7cde95b0-e3a9-11ed-b955-bf03e7eb87f4.html

  16. IMOR

    “And yet, in the two most recent elections, 2020 and 2022, we saw that age didn’t matter much…”. Hell, *2016* showed it didn’t matter. Sad.

    1. Mark Gisleson

      Made me do the math (and good luck using Google to disprove my numbers!) by my calculations Biden got 32% of the vote from the eligible electorate in 2020.

      The list of Americans who’ve run for POTUS and gotten more than 32% of the eligible vote and still lost is probably a significant number.

      We are looking at an insanely favorable climate for a successful third party/write-in victory thanks to a mainstream media establishment that’s about to collapse and leave voters scrambling for any kind of information and there will be lots of sites to give it to them.

      When Jesse Ventura came from out of nowhere to beat Skip Humphrey and Norm Coleman for Governor of Minnesota, voters were nowhere near as fed up with the duopoly as they are now. I don’t think it will be RFK Jr., but if we make it to New Hampshire without any other challengers to Biden (and somehow Biden is still around), Biden will get thoroughly LBJ’ed in Iowa and NH and that will bring candidates out of the woodwork and the DNC will engage in more Clintonian politics giving us a Buttigieg-quality candidate and at that point even Jesse Ventura could come out of nowhere to win in November. *

      * I am assuming the Democrats will run the filthiest campaign in history and that their news media dip state coalition for freedom will air ads containing extreme pornography and dead people with Trump deepfaked in. I put the odds at 50/50 that a fake dickpic will emerge or (god help us) a real one. At that point we would be at risk of electing Ted Nugent if his was the only other name on the ballot.

    2. Daryl

      Does matter, just in the opposite direction. Can’t have young, inexperienced whippersnappers like George Washington (57) or Abraham Lincoln (52) running things.

    3. ChrisPacific

      I’m half convinced that 30 years from now we’ll be having our 8th rerun of Trump/Biden, with both of them doing exclusively remote appearances, using an AI generated avatar and voiceprint, and delivering lines written by script writers.

      1. The Rev Kev

        Or maybe Barron Trump running against Hunter Biden who the Democrats would have redeemed by then in the same way they did for George Bush

  17. Lex

    Recession: I’ll be awarding a demolition contract for a large project and was chatting with the low bidder this afternoon. He said he left $1M on the table because they need the work and followed that up with, “It’s a recession. Demolition contractors are the first to feel recessions and there’s just no work out there right now.” I’ve known him quite a while and he’s been doing this for a solid 40 years.

      1. Lex

        Absolutely anecdotal but based on how complex all the bidders made the project out to be during the process and then the numbers that actually came in, his statement holds water. The spread on this one was tighter than I expected and even the highest was lower than my “prepare yourself” estimate for the owner and almost exactly my “best case scenario” number. (I’ve been doing it a while too.)

        1. ChrisPacific

          Having worked before in an industry that’s recession sensitive: companies that work below cost go bankrupt more slowly than companies that don’t work at all. If enough of the latter go under, there’s a chance margins may go back up in time to save you from the same fate.

          That’s the thinking, at least, and I have little reason to doubt it, given that it’s not something anybody would do unless driven to it.

        2. griffen

          Interesting data point. Having this exact discussion during the week with older siblings, all worked in finance or accounting over the past 35 to 40 years roughly. One hears similar rumbles from other small shops / closely held businesses.

          It just isn’t great after all. These inflation increases the past 18 months have really caused a dent in things. Insurance coverage has been a whopper, my personal experience.

  18. Wukchumni

    Avian flu, which has devastated chicken flocks across the country, has been blamed for the deaths of at least 10 of 20 California condors from the Utah-Arizona flock, according to the U.S. Fish and Wildlife Service.

    The Arizona-Utah condor population moves throughout northern Arizona and southern Utah, using the landscape within Grand Canyon National Park, Zion National Park, Vermillion Cliffs National Monument, the Kaibab Plateau, and surrounding areas, according to the agency. The range for the endangered condor, the largest bird in North America, also includes Pinnacles National Park in central California.

    As of this past Monday, 20 condors had been found dead.

    https://www.nationalparkstraveler.org/2023/04/california-condors-arizona-utah-flock-dying-avian-flu
    ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

    I’d mentioned only seeing about 100 waterfowl in a 2 day stretch on the Colorado River this past weekend and also a similar amount the weekend before Thanksgiving last year.

    Should’ve seen 1,000 to 2,000 birds each kayak trip if past is prologue, but that was then and this is now.

  19. Pat

    Regarding Carlson’s Twitter message, it struck me as more testing the waters and keeping his face in the public than actually trying to set real parameters for a new venture.
    I do think this blind sided him, and he really is figuring out what’s next. The response to the video did probably give him a decent bargaining chip with the possible social media platforms he might want to land at.
    At some point fairly soon he will have to be less general and vague and give a closer representation of what he thinks his next project will be like, but for now this was a pretty decent punch back at Fox.

    I mourn that the one MSM show presenting serious questions, facts and opinions contrary to the preferred scripts about important subjects is gone. I didn’t agree with everything, and it sure didn’t bite back on all the areas we are being gaslit on, but some is better than none. I will wish Carlson luck in establishing a platform for his work. May we find any means that cannot and will not be shut down by the uniparty.

    1. Carolinian

      I never watched his show–guess I could have seen it on youtube. I did get his book out of the library and it made some good points along with some by the numbers rightwing points.

      But what he said post firing about truth hits home and he taps into a vastly shared “wrong track” view of the state of the nation. The Dems are doing nothing about this….don’t even seem to accept it. Scapegoating the right is their only pitch.

  20. WRH

    “If you think of your patients as, well, patients, that doesn’t matter at all. If you think of them as customers, it matters a lot.”
    Not true. Doctors can be penalized for low patient satisfaction scores.

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