Governor double talks, waffles and punts … or does he?

Governor talks out of both sides of his mouth and doesn’t say much specific from either side.

According to the morning newspaper, Gov. Steve Sisolak at a press conference Thursday talked about reopening some businesses — which he has ordered closed due to the fear of the coronavirus overwhelming the health care system, though it hasn’t — in some manner after certain unspecified criteria have been met by a date to decided in the future.

The third graf reads: “But Nevada will follow a ‘state managed, locally-executed roadmap’ that flexibly accounts for vast differences between the state’s urban and rural areas and allows for local decision-making and control, the governor said.”

Toward the bottom of the account, the paper quoted the governor as saying it “would be a disservice” to residents and businesses “to pretend like Esmerelda County is the same as Nye County or that Clark is the same as Elko.” It said Sisolak was forming a Local Empowerment Advisory Panel, or LEAP, which will “serve as a resource for counties as they work through the necessary requirements to reopen and share best practices and guidelines for local communities.”

What will be the authority and powers of this panel with the cute acronym?

A couple of grafs later the governor is quoted as saying the panel doesn’t mean counties will open at different times, “All counties will open in Phase 1 at the same time.”

Then why bother?

So, when will casinos open? Sisolak reportedly said that will be determined by the Nevada Gaming Control Board, adding, “Here’s what I can tell you today: Gaming will not be opening at the start of Phase 1.” Why? Didn’t say. But apparently that is not to be determined by the Control Board either.

Over in the newspaper insert, Sisolak was quoted as saying the Nevada Restaurant Association and the Nevada State Board of Cosmetology will be asked to come up with plans for opening restaurants and personal care shops. Whether he will pay any heed was not stated.

Gov. Sisolak at press conference Thursday. (R-J pix)

 

 

Why go back to work when you can make more on the dole?

We wondered aloud whether the congressional bailout bill giving the unemployed $600 a week would be a disincentive to return to work for many low-income workers laidoff due to the coronavirus shutdown orders. For many that will mean they will receive more income for staying home than they were getting while working.

The morning paper recently ran an op-ed by a Henderson businessman who calculated that his company was paying employees — now laidoff as non-essential — $12 an hour, but their unemployment benefits amount to about $300 a week plus the $600 a week from the federal government. He said this works out to $22.50 an hour. “So if we keep them on the payroll, they earn $12 per hour, and if we lay them off, they earn $22.50 per hour with no taxes owed. What would you do for your employees?” he asked.

How many would come back to work if his business reopens?

A man in the restaurant business in Oregon has the answer in an op-ed today in The Wall Street Journal. He writes that the takeout and delivery business has worked better than expected and the company started making calls seeking to get former workers to return. “When we asked our employees to come back, almost all said, ‘No thanks.’ If they return to work, they’ll have to take a pay cut,” he writes.

With unemployment and the fed bailout, he calculated that former workers at getting $1,016 a week, or $376 more than he or she made as a full time employee. “Why on earth would he want to come back to work?” he writes. The checks will keep coming until July 31. Reopen?

 

You can’t handle the truth

The state of Nevada abruptly shutdown two operations that were administering antibody tests to determine whether people had possibly developed an immunity to the coronavirus, according to the morning paper.

Officials at Sahara West Urgent Care & Wellness confirmed the Nevada Department of Health and Human Services shutdown testing that had begun this past week. Cura Telehealth began testing Tuesday but by midafternoon its the licensed nurse practitioner overseeing testing quit, described as being overwhelmed by the turnout. The operation was told by the state it could not continue with only physician assistants doing the testing. Both were doing drive through testing operations.

The story reported, “Health department representatives could not be reached for comment.” The tests were halted despite the fact the Food and Drug Administration, which has not yet approved an antibody test for this virus, has allowed companies to manufacture and distribute tests.

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, has said the White House coronavirus task force has been discussing the idea of “certificates of immunity,” which could be issued to people who had previously been infected, according to The New York Times. “As we get to the point of considering opening the country,” he told the paper, “it is very important to understand how much that virus has penetrated society.”

This could allow those who are immune to return to work. Many people have been exposed to the virus and developed immunity but showed no symptoms. Researchers in Iceland reported 50 percent of their novel coronavirus cases who tested positive had no symptoms, according to Healthline.

Dr. Vit Kraushaar, medical investigator for the Southern Nevada Health District, told the morning newspaper the problem with some antibody tests is that they test positive for other types of coronaviruses, such as the common cold. “So you see that you test positive, and you think it’s because you had COVID.” But it could be another type of coronavirus. “We still don’t really have a good sense of whether this provides long-term immunity. … So I think some of those things need to be answered before we started doing mass testing.”

The perfect is the enemy of the good?

An article in USA Today cited comments by Dr. Fauci on CNN that antibody testing can show who has developed immunity to the coronavirus and can safely go back to work without getting reinfected. “As we get to the point of at least considering opening up the country, as it were, it’s very important to appreciate and understand how much this virus is penetrating this society,” he said.

The state of Nevada doesn’t think you can handle the information a test can provide, even with the caveat that it is not perfect.

Pessimists always get to say ‘I told you so’

Whether the government dictators decide to restart the economy tomorrow or six months from now, there will be a spike in coronavirus cases and deaths and the fearmongers will delight in saying, “I told you so.”

They are just delaying the inevitable, though possibly flattening the curve a bit by stretching out the frequency of contacts and thus cases of COVOD-19. Is it worth it? What is the return on disinvestment and joblessness?

Another sure thing that everyone knew is also turning out to be not so sure: We need more ventilators.

AP is reporting today:

Generally speaking, 40% to 50% of patients with severe respiratory distress die while on ventilators, experts say. But 80% or more of coronavirus patients placed on the machines in New York City have died, state and city officials say.

Higher-than-normal death rates also have been reported elsewhere in the U.S., said Dr. Albert Rizzo, the American Lung Association’s chief medical officer.

Similar reports have emerged from China and the United Kingdom. One U.K. report put the figure at 66%. A very small study in Wuhan, the Chinese city where the disease first emerged, said 86% died.

The reason is not clear. It may have to do with what kind of shape the patients were in before they were infected. Or it could be related to how sick they had become by the time they were put on the machines, some experts said.

But some health professionals have wondered whether ventilators might actually make matters worse in certain patients, perhaps by igniting or worsening a harmful immune system reaction.

But everyone has been clamoring for ventilators. Maybe other things the experts know for certain are not certain.

Of course, Dr. Anthony Fauci has provided his daily ratcheting down of the projection numbers, saying, the final toll currently “looks more like 60,000 than the 100,000 to 200,000” that U.S. officials previously estimated.

And Knut Wittkowski, former head of the Department of Biostatistics, Epidemiology, and Research Design at the Rockefeller University in New York City, says the coronavirus could be “exterminated” if most people were permitted to lead normal lives and only the vulnerable are sheltered:

[W]hat people are trying to do is flatten the curve. I don’t really know why. But, what happens is if you flatten the curve, you also prolong, to widen it, and it takes more time. And I don’t see a good reason for a respiratory disease to stay in the population longer than necessary.

With all respiratory diseases, the only thing that stops the disease is herd immunity. About 80% of the people need to have had contact with the virus, and the majority of them won’t even have recognized that they were infected, or they had very, very mild symptoms, especially if they are children. So, it’s very important to keep the schools open and kids mingling to spread the virus to get herd immunity as fast as possible, and then the elderly people, who should be separated, and the nursing homes should be closed during that time, can come back and meet their children and grandchildren after about 4 weeks when the virus has been exterminated.

Congress incentivizes not going back to work

Well, one aspect of the $2.2 trillion congressional coronavirus stimulus package sure seems counterproductive, if the goal is to get the country back to work.

For those who lost their jobs due to the government imposed shutdown of “nonessential” businesses, the bill provides an extra $600 a week on top of state unemployment benefits for four months. For many lower income workers that will mean they will receive more income for staying home than they were getting while working.

So, for the next four months what idiot would deprive his family of extra income and spend time away from family at an often back-breaking job?

This just prolongs the problems.

Also, pay no heed to the what this round of ongoing stimulus spending does to the deficit. Trump’s entire FY 2021 budget, the highest ever, is $4.8 trillion. This will not end well, if it ever ends.

 

Is Sisolak practicing medicine without a license and violating state law?

Gov. Steve Sisolak issued the above press release announcing his order that doctors may not prescribe “two certain drugs” — chloroquine and hydroxychloroquine — to treat coronavirus patients.

In 2015 the state Legislature passed without a single nay vote a Right to Try law that states, “An officer, employee or agent of this State shall not prevent or attempt to prevent a patient from accessing an investigational drug, biological product or device that is authorized to be provided or made available to a patient pursuant to this section.”

Violation of the law is a misdemeanor.

Sisolak’s stated reason for issuing the order was to prevent hoarding, but that is being done by doctors wanting to protect themselves and their families.

Two doctors wrote in The Wall Street Journal recently that the drug in question in combination with another drug has been successful in curing 100 percent of COVID-19 patients in a small number of cases.

Is Sisoalk not only practicing medicine without a license, but also violating state law?

p.s.: The governor’s press release failed to include the verbiage in the actual regulation, which says, “The provisions of this emergency regulation do not apply to a chart order for an inpatient in an institutional setting …”

Pay no heed to the possibility that use of the aforementioned drugs just might keep a coronavirus patient from having to be admitted to a hospital. Isn’t one of the big fears the potential for hospitals to be overwhelmed?

 

Editorial: Keep a close eye on enforcement of virus regulations

Shortly after state health officials confirmed the first presumptive case of the coronavirus — dubbed COVID-19 — in Nevada this past week, Gov. Steve Sisolak issued an emergency regulation regarding insurance coverage for testing and treatment of the rapidly spreading virus.

State law gives the governor the power in emergency situations to make, amend and rescind regulations in response to the emergency. Customarily one thinks of such things as calling out the National Guard to prevent looting or other problems after a national disaster.

In this case the Commissioner of Insurance Barbara Richardson made a finding that an emergency affecting the health and safety of the public exists and that adoption of an emergency regulation was appropriate.

What Sisolak did was attempt to avert potential adverse financial impact for those who carry health insurance.

We highly recommend the governor keep a close eye on the effects of his order lest it have unintentional adverse affects on the availability of testing and potential vaccines or treatments for the disease. Dictating the price of things in the marketplace has been known to deter availability of goods and services when adequate compensation is not forthcoming.

There has been plenty of anecdotal evidence over the years that so-called anti-price-gouging laws merely limit the supply of necessary goods and services in a crisis.

For example, according to the American Institute for Economic Research, in 2005 a Kentucky man took time off from his job, bought 19 power generators, rented a truck and drove to hurricane-ravaged Mississippi intending to sell the generators at twice the price he paid to cover his costs and make a profit. Police confiscated his generators for price gouging, held him for four days and kept the generators in police custody. Those who urgently needed them and would have gladly paid the asking price suffered in the dark instead.

“This pre-emptive emergency regulation should give Nevadans confidence to continue taking preventative measures to stop the spread of COVID-19 as well as seeking necessary medical services and prescriptions without fear of higher than normal costs,” Sisolak was quoted as saying in a press release accompanying the emergency declaration. “Protecting Nevadans is my top priority, and adopting this emergency regulation is a critical piece of our broader plan to anticipate and prepare for the potential impacts of COVID-19.”

The press release said the order prohibits a health insurance company from imposing an out-of-pocket charge for an office, urgent care center or emergency room visit for the purpose of testing for the virus. “Additionally, the regulation prohibits insurers from charging Nevadans for the COVID-19 test itself or an immunization as one becomes available and further requires coverage for off-formulary prescription drugs if a formulary drug is not available for treatment,” the press release says.

Sounds confiscatory. If companies are prohibited from recouping their expenses for services provided, how readily available will those services be?

The regulation further requires health insurance companies to pro-actively provide information on available benefits, options for medical advice and treatment through telehealth systems and ways to prevent exposure to the virus.

With only a few cases in Nevada so far such measures may be premature. There have been no reports of insurance price gouging due to the virus that we are aware of, which is what the governor’s emergency order appears to be intended to stave off.

We suggested the commissioner of insurance and health officials keep a close watch on events as they develop to assure these shackles on the free market do not interrupt the availability of necessary services and thus create the opposite effect of what the governor intends.

A version of this editorial appeared this week in some of the Battle Born Media newspapers — The Ely Times, the Mesquite Local News, the Mineral County Independent-News, the Eureka Sentinel,  Sparks Tribune and the Lincoln County Record.

Gov. Steve Sisolak announces emergency regulations. (R-J pix)