Hayek at the Hospital: The Use of Knowledge in Hospital Discharge Decisions

A live update from The New York Times on the COVID-19 situation in Peru:

Peru has more than 170,000 confirmed cases, despite taking the virus seriously early on. The president, Martín Vizcarra, ordered one of the first national lockdowns in South America. Though the official virus death toll stands at around 5,000, Peru had 14,000 more deaths than usual in May, suggesting that a growing number of people are dying at home as hospitals struggle to handle a flood of cases.

So should the Peruvians be taking to the streets to express outrage at the incompetence of all those heads of households where excess mortality has taken place? Or alternatively, should Peru’s hospitals just have warehoused up to 14,000 post-acute COVID patients in the excess space they had as they were struggling “to handle a flood of cases”? Continue reading

Cowen on Nursing Homes: A Postscript

I continue to be baffled by Tyler Cowen’s views on the COVID-19 nursing home controversy. Here’s a relevant excerpt from a piece of his that’s just come out in Bloomberg Opinion:

If I have learned one thing over the last few weeks, it is that the psychology of the American public is weirder — and perhaps more flexible — than I ever would have thought.

Consider, as just one example among many, the issue of nursing homes. According to some estimates, about 40% of the deaths associated with Covid-19 have occurred in nursing homes, with more almost certain to come.

You might think that those 40,000-plus deaths would be a major national scandal. But so far the response has been subdued. Yes, there has been ample news coverage, but there are no riots in response, no social movement to “clean up the nursing homes,” no Ralph Nader-like crusader who has made this his or her political cause.

Nor has there been much resulting vilification. There are plenty of condemnations of technology billionaires, but very few of nursing-home CEOs. Many of the state and local politicians who oversee public-sector nursing homes have been rewarded with higher approval ratings.

As if all this weren’t bad enough, of those 40,000 deaths, surely a considerable number are African-American (data by race is hard to come by). This could be an issue for Black Lives Matter, but somehow it isn’t.

Continue reading

Suicidal Tendencies

For decades now, Americans convinced of their moral superiority to the rest of the world have sat around wondering what could possibly motivate someone to engage in suicide bombing. Who could do such a thing? How? Why? The insanity of it all!

Now consider the last few months: under duress, Americans, whether left or right, have taken to the streets to protest various things, oblivious to the fact that in doing so–whether violently or peaceably–they’re likely spreading a lethal disease vector amongst themselves and others. When the right does it, the left attacks them. When the left does it, the right attacks them. But no ideological group seems entirely immune to the temptation to take to the streets in the middle of a pandemic. Continue reading

Coronavirus Diary (61): Tyler Cowen on the Nursing Home Controversy

In a much-read and much-discussed interview in The Atlantic, the economist Tyler Cowen argues that the COVID-19 crisis proves that “the regulatory state is failing us.” Here is his Exhibit A for that claim:

Friedersdorf: What are the most significant failures of America’s regulatory state as it relates to the pandemic?

Cowen: Let me give you a few examples:

  1. New York state regulations, until very recently, forced nursing homes to accept COVID-19-positive patients being discharged from hospitals. Nursing homes, especially in the northeast, have been an epicenter for COVID-19 casualties. By law, they were forced to accept more than 4,500 COVID-19-positive patients, often without proper PPE for their staff.

I don’t find this convincing. Why, exactly, does this very partial description of the issue prove that government failed? And why does Cowen regard the matter as so obvious that a summary this brief should suffice to make the case? Continue reading

Coronavirus Diary (60): The NY/NJ Nursing Home Controversy

I’ve been pressed for time lately, as I do my share to add to the unemployment rate, but I couldn’t resist one thought in the form of a bleg, or query. For a month now, I’ve been seeing social media posts by people I respect (and many I don’t)–left, right, center, libertarian, and otherwise–criticizing Governors Cuomo and Murphy of New York and New Jersey of responsibility for mass death in the case of the the nursing homes in those states. Indeed, Cuomo himself has issued a mea culpa of sorts for doing whatever he’s supposed to have done wrong. Continue reading

COVID-19 Narratives (7): Elegy for a Father

Elegy for My Father
Daniella Mieles

Opening up and discussing my experiences with the COVID-19 pandemic is very difficult, and not something I would ever have expected to do, but perhaps doing so will create more awareness about the dangers of this pandemic to those who still seem to regard it as a joke. People always talk about how life today is so much more advanced than it was in the past, and yet here we face a pandemic disease for which there is no cure. And there seems to be no light at the end of the tunnel for any of us. Continue reading

Suicide Solution

Job description for EMT position with Capital Health in New Jersey, verbatim from LinkedIn:

Responsibilities

  • Responds to dispatched emergency assignments.
  • Implements patient care procedures by using assessment skills pertaining to the illness or injury.
  • Identifies and manages rapidly changing situations of an emergency patient care situation. Assesses patient’s current condition through physical and verbal exam via patient or others present.
  • Collects all available pertinent patient information form patient, family, friends, medical records, and medications.
  • Transfers the patient to care provider and facility providing the receiving staff with a report. Completes all paperwork requirements during patient transfer.
  • Completes patient care record including demographic information, clinical findings, history, medications, allergies treatment rendered, and any changes during transport.
  • Provides a comprehensive written incident report describing any unusual event.

In other words, hurry to the scene of medical emergencies in a big van and save people’s lives. Continue reading

Going Out in Style

After writing some sixty-plus blog posts on the COVID-19 crisis, I now have to go on a bit of a hiatus from blogging. I’m not sure how long it will last. Knowing me, it’ll probably last a day or two, but it’s supposed to last longer than that. I will continue to post entries from my COVID-19 Narrative Project (a few have piled up), and I want to draw attention to a few items I’ve seen online lately. But for the most part, it will (or should) be awhile before I blog at anything like the rate you’ve recently seen.

As a small handful of you may know, this past Friday, I resigned my position at Felician University in protest at what I regard as the egregious malfeasance of the university’s administration–in particular, the malfeasances of the (imminently-departing) Dean of Arts and Sciences, the Vice President for Academic Affairs, and the President, along with the instructor whose egregious delinquency they decided to tolerate and sweep under the rug. Continue reading

Farrell, Brennan, and the Great Debate Over Public Choice

No, don’t expect an attempt at adjudicating the quarrel between Henry Farrell (Crooked Timber) and Jason Brennan (BHL) over public choice here. Not my lane. Just wanted to draw attention to the overall trajectory of the “debate.”

May 5: Henry Farrell writes a post at Crooked Timber critiquing Public Choice theory. There’s a discussion there. It goes on for 89 comments.

May 12: Farrell writes a follow-up post on the same subject at Crooked Timber.  More discussion. By May 14, we’re about twenty-some comments deep into the discussion.

May 14: Clearly pissed at Farrell’s “silliness,” Jason Brennan decides to write a rebuttal of sorts to Farrell at BHL. Discussion commences at BHL, taking this form: Continue reading

Coronavirus Diary (45): An update

Coronavirus Diary 45 was originally a memorial post about Dave Jarvis, a cook in the cafeteria at Felician University. When his death was mentioned at a faculty meeting several weeks ago, we were told that it was due to “COVID-related complications” or something of that nature. I just got a message from a member of his family to the effect that that was incorrect; Dave died of some other causes. I had only meant to write an affectionate piece about Dave, whom I liked, but his family seems to have taken offense at the post. I regret any offense caused, and have deleted it. Continue reading