I’ve Zoomed a decent amount with students and friends, but I haven’t tried putting together something like this. In a sense, it would be like something at a conference—three or four people having a video conversation for a while (a conversation, not a panel with prepared presentations), and then Q & A, with questions likely submitted via chat rather than via audio.
Any suggestions on how to make it work, other than the obvious (have good participants and an interesting topic)?
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Are you seeing friends and family using Zoom or some such application? Which one, and how is it working out technically?
Have you found some tricks to making it work better, whether they are technical tricks or social ones (e.g., dressing up, eating dinner during the call, drinking during the call, etc.)?
Are you finding that you’re actually seeing out-of-town friends and family more now? Or are you actually enjoying having some more time at home by yourselves? Please let us know in the comments.
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How Mayor De Blasio Botched NYC’s Response To COVID-19
Even as liberals whine about President Trump’s petty feuds with reporters and his newfound insistence that the country – or at least sizable parts of it – get ‘back to work’ by Easter (April 12), his approval rating has continued to climb, as Americans rally around the president during times of crisis (and, to be fair, Trump stepped up during that one Friday press conference where he sounded reassuring presidential, even if his promises about ramping up testing ultimately never came true).
Unfortunately, the same cannot be said for New York City Mayor Bill de Blasio, whose laughable presidential campaign is still not too far in the rearview mirror. Remember how even de Blasio’s own wife expressed doubts about his suitability for the presidency? Well, as Politico documents in an in-depth report about de Blasio’s handling of NYC’s response to COVID-19, during the weeks before the city emerged as the country’s biggest hot spot, even as the suburbs immediately surrounding the city succeeded in quelling outbreaks of their own, de Blasio dithered and put off critical decisions.
The result was he waited too long to close schools and way too long to close restaurants and other “non-essential” businesses. The result is that the city’s hospitals are now being overwhelmed faster than any other hospital system in the country, like the hospital in Elmhurst where 13 people died from COVID-19 in a single day earlier this week.
All of this isn’t a coincidence: It’s a direct result of de Blasio’s decision not to take the outbreak seriously, and to wait for “more information” before deciding on critical closures.
Even once the threat at hand had been made clear, de Blasio made critical mistakes during the response, including failing to outline a response protocol for municipal employees that kept thousands coming into the office longer than they needed to.
Meanwhile, the gaffe-prone mayor, who is one of the least popular big-city mayors in the country, and is perhaps best known for his long-time feud with Andrew Cuomo, the New York governor who has emerged as a national star of the outbreak, continued to do what he does best: produce embarrassing gaffes. His piece de resistance was going to the gym the morning he ordered all non-essential businesses (including gyms) to close.
De Blasio, who uses a public gym because he’s a “man of the people” (okay pal like there’s not a gym at Gracy Mansion? You’re wasting municipal resources to cart your ass back to Brooklyn for these workouts) responded by claiming “There was almost no one there. I had heard that information prior..I suspected that we were all going to be about to close them down, and this would be the last time to get some exercise.”
There was almost no one there because most responsible New Yorkers were practicing social distancing, including avoiding public places. What kind of message does it send when the mayor doesn’t obey his own guidance.
And it was exactly these types of mixed messages that hampered the mayors response and proved his critics – who insist that he is an inept administrator and even worse politician who is only in office thanks to the well-timed implosions of his political rivals – correct.
Some even questioned whether the death of a Brooklyn principle, who succumbed to the virus this past week, is directly a result of de Blasio’s reluctance to close the schools even after the teachers unions, members of his staff and health officials pushed him to. His reason for the delay? The urgings of the city hospital system administrator, who urged him to have a plan in place for the students because she worried it would affect staffing levels at city hospitals if parents had nothing to do with their kids.
To that end, de Blasio kept schools open for days after parents, teachers and members of his own administration urged him to close them, touching off a feud with the teachers union, which chastised the health department this week after a 36-year-old principal died from the coronavirus.
Three city officials familiar with his decision-making process said he was relying on advice from Mitchell Katz, head of the city’s public hospital system, who worried school closures would compromise staffing levels at hospitals during an emergency. De Blasio was also concerned about the lopsided impact it would have on low-income students and single-parent households.
He insisted schools would remain open during TV interviews on the morning of March 15, even as he was preparing to announce a system-wide closure later that day.
“You know I hated closing the schools. I thought it was going to cause all sorts of other problems and of course it has,” de Blasio said during a radio interview Friday morning. Gov. Andrew Cuomo, who has been granted public hero status during this crisis, similarly reversed his stance on closing schools within a matter of hours that Sunday.
And then there was that senseless feud with Cuomo’s office over the “shelter in place” order, some nonsensical semantics that is a moot point now: everybody’s staying inside – people are only leaving to get food and other essential things.
He also dithered when it came to canceling the St. Patrick’s Day parade, waiting far longer than other national mayors.
He and de Blasio were also at odds over whether to require New Yorkers to “shelter in place,” an argument of semantics that went on for days as residents were left without clear guidance. De Blasio was calling for the policy earlier than Cuomo, while also signaling confusion about its implementation.
“What is going to happen with folks who have no money? How are they going to get food? How are they going to get medicines?” he asked during a news conference on March 17. “There’s a lot of unanswered questions.”
In another example of his mixed messaging, he has said he will make a “first attempt” to reopen schools by April 20, while also calling President Donald Trump’s push to bring businesses back by Easter, which falls on April 12, “false hope.”
Yet on Friday de Blasio tweeted that April 5 is “the day the strains we’re seeing right now on medical supplies and personnel could overwhelm us if we don’t get the help we need. This is a race against time.”
De Blasio spent days deliberating over whether to cancel the St. Patrick’s Day parade, even after other cities canceled theirs, did not provide clear guidance over a municipal work-from-home policy, according to multiple agency leaders, and argued with library officials who wanted to close their branches before he was ready.
The mayor also played down fears that city hospitals might face shortages of space and equipment and supplies, all of which now appears to be happening.
Shortly after the World Health Organization deemed the coronavirus a pandemic on March 11, the mayor was asked to respond to expected recommendations about a possible quarantine.
“I think we can say at this point in time we’re looking at all the guidance, but with a bit of a trust-but-verify worldview,” he said.
He also said the city’s hospitals were ready for an influx of patients. “We have 1,200 beds that we can activate readily,” he said on March 8.
“Just the fact that you’ll turn off a lot of non-essential things and turn all that talent and capacity to a crisis, should give New Yorkers a lot of confidence that, you know, even with hundreds of cases, we’d be able to handle it.”
This week The New York Times chronicled the nightmarish scenes from one of the city’s public hospitals, where 13 people died in a single day.
Privately, people across City Hall have begun to wonder whether de Blasio’s week of delayed action put people in danger.
And then there’s de Blasio’s decision to criticize President Trump’s push to reopen parts of the country by Easter while de Blasio promises to take a look at reopening the schools on April 20.
To be sure, some outside experts who worked with the mayor defended his approach, and even a former director of his public works department defended the mayor’s response, saying he didn’t think he would have done anything differently. Others disagree.
And at this point, with the NYPD reporting the death of the first detective on Saturday morning as both the number of confirmed cases and deaths climbs, it’s beginning to seem like the proof will be in the pudding.
The incredible meltdown of Rep. Haley Stevens, D-Mich.,yesterday on the floor of the House of Representatives shows how members can fuel rather than fight hysteria and panic.
The shocking scene was played out as the very task force members who she referenced are trying to rebut some alarmist predictions and estimates. Much of the nation is sheltering in place. We get it. However, Rep. Stevens seems intent on elevating not the discussion but the volume of the national discourse.
What was most notable is that Stevens was not saying anything particularly new… just saying it louder. Indeed, the Democratic Majority Whip was trying to give her the added 30 seconds that she had asked, but she was yelling over his voice.
— Governor Gretchen Whitmer (@GovWhitmer) March 27, 2020
I don’t want to make much of this—I just thought it was a funny glitch, of the sort that all of us fall prey to from time to time. But it might also be a reminder for writers to be careful about using figurative phrases, especially ones that are so familiar that we don’t really think about their literal meaning: Sometimes, circumstances bring up that literal meaning, and make the phrase jarring or unintentionally funny.
This is closely connected to the problem of mixed metaphors (e.g., “the political equation was thus saturated with kerosene”). There, the literal meaning one half of the metaphor is highlighted by its mismatch with the literal meaning of the other half. Here, the literal meaning of “lock arms” is highlighted by its mismatch with the substance of the situation.
Are you seeing friends and family using Zoom or some such application? Which one, and how is it working out technically?
Have you found some tricks to making it work better, whether they are technical tricks or social ones (e.g., dressing up, eating dinner during the call, drinking during the call, etc.)?
Are you finding that you’re actually seeing out-of-town friends and family more now? Or are you actually enjoying having some more time at home by yourselves? Please let us know in the comments.
from Latest – Reason.com https://ift.tt/39poIBH
via IFTTT
— Governor Gretchen Whitmer (@GovWhitmer) March 27, 2020
I don’t want to make much of this—I just thought it was a funny glitch, of the sort that all of us fall prey to from time to time. But it might also be a reminder for writers to be careful about using figurative phrases, especially ones that are so familiar that we don’t really think about their literal meaning: Sometimes, circumstances bring up that literal meaning, and make the phrase jarring or unintentionally funny.
This is closely connected to the problem of mixed metaphors (e.g., “the political equation was thus saturated with kerosene”). There, the literal meaning one half of the metaphor is highlighted by its mismatch with the literal meaning of the other half. Here, the literal meaning of “lock arms” is highlighted by its mismatch with the substance of the situation.
25-Year-Old California Man With No Underlying Conditions Dies Of COVID-19
While coronavirus deaths have primarily been in those above 50-years-old, the disease has also been sending younger people to the ICU in larger than expected numbers – and in some cases, claiming younger victims.
In France, doctors have reported that 50% of ICU patients are under 60-years-old, while in the Netherlands, half are under 50.
Nearly 50% of critically ill coronavirus patients in Brazil are under 60 https://t.co/g0M07bTDXN
On Saturday, the Los Angeles Times noted the COVID-19 death of a 25-year-old pharmacy technician with no underlying health issues, whose body was found on Wednesday at a home in the Coachella valley neighborhood of La Quinta where they were in self-quarantine. The San Diego resident’s identity has not been disclosed.
“This is a deeply saddening reminder that COVID-19 kills the young and healthy too,” said Riverside County public health officer Dr. Cameron Kaiser. “Stay safe. Keep travel and errands to essentials, and observe social distance no matter how young or well you are. Our condolences and thoughts are with everyone this pandemic has touched.”
According to the Times, the majority of coronavirus cases in the county are under 50-years-old:
This is the California age range for coronavirus patients:
Age 0-17: 45 cases
Age 18-49: 1,906 cases
Age 50-64: 967 cases
Age 65 and older: 847 cases
Unknown: 36 cases
For more on the flood of younger patients, read this article in The Atlantic.
“My deepest condolences go out to the family of the young adult who passed,” said Fourth District Riverside County Supervisor V. Manuel Perez. “The virus does not discriminate and age doesn’t matter. This tragedy demonstrates the need to stay in place. It’s safer at home.”
Health officials report that the deceased 25-year-old was exposed to the virus outside of Riverside county. It is important to note that while the man had no underlying health conditions, he did not go to the ER, where he could have been given one of several experimental treatments and been put on a life-saving ventilator.
His death will be added to San Diego’s number of coronavirus-related fatalities, which as of Friday afternoon stood at three. But Dr. Wilma Wooten, San Diego County’s public health officer, said that data would be updated to include three more deaths, with the 25-year-old technician among them.
Wooten said the other two deaths included a male in his mid-50s and another male in his early 80s. –LA Times
There have been a total of eight COVID-19 deaths in riverside county in individuals over the age of 70 – most of whom had underlying health problems. As of Friday afternoon, there were 183 cases in the county.
The updated figures come a day after Riverside University Health System officials released new estimates indicating coronavirus cases in Riverside County will grow — possibly doubling every four to five days — and deaths stemming from viral complications could rise 125 times the current figure in the next month.
“We’re trying to change the curve and slow down the rate of infection,” RUHS Dr. Geoffrey Leung said during a news briefing at the county’s Emergency Operations Center in downtown Riverside on Thursday. “But based on forecasting and modeling … there could be a doubling of the rate of COVID-19 infection every four to five days … If we stay on the same doubling rate, (by early May) we could have over 1,000 deaths and 50,000 new cases.”
Leung said he based his estimates on local approximations and nationwide trends.
“By April 12, all hospital beds (in the county) will be used up, and if we stay on the same doubling rate, we’ll be out of ventilators in the April 22-May 5 period,” Leung said.
The one ray of hope that he referenced was a dramatic slowdown in the rate of infection in New Rochelle, New York, where a major cluster of COVID-19 infections was documented two weeks ago, but after closely monitored isolation measures were implemented, the rate dropped precipitously. –NBC Palm Springs
Following the 25-year-old’s death, Dr. Kaiser ordered all short-term lodging in the county, including home rentals such as AirBnB – to limit their business to COVID-19 response only, which includes housing patients in self-isolation, the homeless, and essential personnel.
Tenants, owners, and marketing agents are not allowed to lease any short-term rental, vacation rental, or timeshare lodging while the order is in effect throughout Riverside county.
“Now isn’t the time to visit Riverside County,” said Kaiser. “Slowing the spread of COVID-19 means folks need to stay put in their own neighborhoods. Unless you’ve got nowhere else safe to be, please visit later.
On Friday, members of the California National Guard continued setting up a temporary, 125 bed “federal medical station” hospital at the Riverside County Fairgrounds in Indio ahead of an anaticipated surge in coronavirus cases. Another temporary hospital will be set up in western Riverside county which will have an additional 125 beds.
If a hospital runs out of ventilators to treat its patients, will it be liable when patients die as a result?
Courts have at times imposed malpractice liability when a hospital failed to provide a service that might have benefited a patient. For example, in Herrington v. Hiller, 883 F.2d 411 (5th Cir. 1989), the plaintiff alleged that a baby was born with brain damage as a result of a hospital’s failure to provide 24-hour-a-day anesthesia services, and the court found admissible earlier discussions among hospital personnel about whether such services might be needed. More generally:
Hospitals and other institutional providers have a duty to provide adequate staff and services to deal with unexpected medical problems.Hospitals, like physicians, are expected to keep up with an evolving standard of medical practice, particularly if its cost-benefit ratio is high. The failure of a hospital to maintain adequate services to deal with medical emergencies can create liability.
Barry R. Furrow, Enterprise Liability and Health Care Reform: Managing Care and Managing Risk, 39 St. Louis U. L.J. 77, 91 (1994) (footnotes omitted). Also:
Both hospitals and hospital management companies have been found negligent for failure to exercise reasonable care in the maintenance of the hospital’s facilities and equipment. The duty to maintain adequate facilities and equipment requires hospitals to have the facilities and equipment necessary to safely carry out the medical treatment it offers.
Mindy Nunez Duffourc, Repurposing the Affirmative Defense of Comparative Fault in Medical Malpractice, 16 Ind. Health L. Rev. 21, 28 (2018) (footnote omitted).
Hospitals, of course, would argue that they have an obligation to maintain sufficient equipment for ordinary times, not for pandemics. Assuming a hospital maintains a typical ICU capacity for hospitals, it would have a strong argument to having met the community standard of care.
If a court in its instructions emphasizes custom, hospitals may mostly be free of liability. But if a court instructed juries to apply the Hand formula, or instructed juries in a way that would implicitly allow them to consider cost-benefit type considerations, the result might well be different. A pandemic was not unpredictable, and a likely cost-benefit analysis would likely suggest that ventilators should have been purchased. If a ventilator costs $25,000, then at a value-per-life of just $5 million, the purchase would have been cost-justified if there were a 1 in 200 chance that it would be necessary–or an even lower chance if a single marginal ventilator might be used for more than one patient.
Stephen Gillers has noted that although the Hand Formula is often treated as black-letter law, jury instructions rarely mention it, but nor do they forbid the jury from applying similar considerations:
[A] puzzle lies in the gap between the authoritative blackletter status of the Hand Formula and the standard instructions given to juries in negligence cases. The proposition that negligence means creating an “unreasonable risk,” defined as one whose expected costs exceed the costs of avoiding it, has been explicitly endorsed by the Restatement of Torts, by the leading treatises, and by courts in most states. Indeed, despite the vigorous normative debates over cost-benefit analysis among legal academics, no modern decision to my knowledge squarely rejects the Hand Formula interpretation of negligence. Yet, rather than telling juries to balance the costs and benefits of greater care, courts ordinarily instruct them to determine whether the actor behaved as a “reasonably prudent person” would have under the circumstances. Even on appeal, many courts make surprisingly little use of cost-benefit analysis in reviewing negligence cases. Often, the only question on appeal is whether a reasonable jury could have found a party negligent under the reasonable person standard.
Some scholars claim that these practices demonstrate that the actual meaning of negligence in American law is defined by a reasonable person standard that marginalizes or even supplants the Hand Formula. Although these accounts vary in important particulars, their common theme is that the determination of negligence rests on a noneconomic conception of practical reasonableness that looks to community values and norms rather than to any form of cost-benefit analysis.
But the crucial feature of the pattern jury instructions on negligence is that they explicitly adopt neither of these competing theories—nor any other. Juries are told neither that a reasonable person is one who complies with community values and norms nor that a reasonable person is one who balances costs and benefits (or behaves “as if ” balancing them). Instead, the reasonable person standard is given to the jury without elaboration.
A jury would not likely engage in explicit cost-benefit balancing. But it seems to me plausible (though I would welcome comments from those with more immediate experience) that a jury might well conclude that hospitals should have recognized the need to purchase enough ventilators to handle a surge in patient capacity. A plaintiff’s case might be especially strong if a hospital had time between when an emergency loomed and when a patient died to purchase a ventilator that would have saved the patient. Juries, meanwhile, would likely be more sympathetic to hospitals that, early in the emergency, contracted to purchase ventilators (at least simple models) as soon as they were available.
Normatively, I am not sure whether hospitals should be liable. There is a strong argument that if one opens a 1,000 bed hospital, one should not be liable for not opening a 2,000 bed hospital. Liability might create a disincentive for small hospitals to open in the first place. On the other hand, it is difficult to identify an actor in a better position to anticipate potential needs for emergencies or to identify an actor that now will have strong incentives to provide demand for ventilators.
A related but separate question is whether doctors and medical professionals should be held to a lower standard of care during emergencies:
[I]n the wake of events like Hurricane Katrina and the H1N1 pandemic, there have been proposals to change the ordinary standard of care during declared emergencies. This idea is called “altered standards of care,” and suggests that there should be different standards that health care workers are held to during an emergency. Broadly, a public health emergency exists when a health situation’s “scale, timing or unpredictability threatens to overwhelm routine capabilities.” There has been significant research into, and creation of, altered standards of care for volunteers and Good Samaritans who help during emergency situations. Many of these regulations provide immunity to these individuals.
Rebecca Mansbach, Note & Comment, Altered Standards of Care: Needed Reform for when the Next Disaster Strikes, 14 J. Health Care L. & Pol’y 209, 209 (2011) (footnotes omitted). One would not want to discourage a doctor from working during the emergency because the doctor cannot provide care of the same quality as the doctor would ordinarily provide. But that is a different question from whether health care institutions should anticipate emergencies and stock up.
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If a hospital runs out of ventilators to treat its patients, will it be liable when patients die as a result?
Courts have at times imposed malpractice liability when a hospital failed to provide a service that might have benefited a patient. For example, in Herrington v. Hiller, 883 F.2d 411 (5th Cir. 1989), the plaintiff alleged that a baby was born with brain damage as a result of a hospital’s failure to provide 24-hour-a-day anesthesia services, and the court found admissible earlier discussions among hospital personnel about whether such services might be needed. More generally:
Hospitals and other institutional providers have a duty to provide adequate staff and services to deal with unexpected medical problems.Hospitals, like physicians, are expected to keep up with an evolving standard of medical practice, particularly if its cost-benefit ratio is high. The failure of a hospital to maintain adequate services to deal with medical emergencies can create liability.
Barry R. Furrow, Enterprise Liability and Health Care Reform: Managing Care and Managing Risk, 39 St. Louis U. L.J. 77, 91 (1994) (footnotes omitted). Also:
Both hospitals and hospital management companies have been found negligent for failure to exercise reasonable care in the maintenance of the hospital’s facilities and equipment. The duty to maintain adequate facilities and equipment requires hospitals to have the facilities and equipment necessary to safely carry out the medical treatment it offers.
Mindy Nunez Duffourc, Repurposing the Affirmative Defense of Comparative Fault in Medical Malpractice, 16 Ind. Health L. Rev. 21, 28 (2018) (footnote omitted).
Hospitals, of course, would argue that they have an obligation to maintain sufficient equipment for ordinary times, not for pandemics. Assuming a hospital maintains a typical ICU capacity for hospitals, it would have a strong argument to having met the community standard of care.
If a court in its instructions emphasizes custom, hospitals may mostly be free of liability. But if a court instructed juries to apply the Hand formula, or instructed juries in a way that would implicitly allow them to consider cost-benefit type considerations, the result might well be different. A pandemic was not unpredictable, and a likely cost-benefit analysis would likely suggest that ventilators should have been purchased. If a ventilator costs $25,000, then at a value-per-life of just $5 million, the purchase would have been cost-justified if there were a 1 in 200 chance that it would be necessary–or an even lower chance if a single marginal ventilator might be used for more than one patient.
Stephen Gillers has noted that although the Hand Formula is often treated as black-letter law, jury instructions rarely mention it, but nor do they forbid the jury from applying similar considerations:
[A] puzzle lies in the gap between the authoritative blackletter status of the Hand Formula and the standard instructions given to juries in negligence cases. The proposition that negligence means creating an “unreasonable risk,” defined as one whose expected costs exceed the costs of avoiding it, has been explicitly endorsed by the Restatement of Torts, by the leading treatises, and by courts in most states. Indeed, despite the vigorous normative debates over cost-benefit analysis among legal academics, no modern decision to my knowledge squarely rejects the Hand Formula interpretation of negligence. Yet, rather than telling juries to balance the costs and benefits of greater care, courts ordinarily instruct them to determine whether the actor behaved as a “reasonably prudent person” would have under the circumstances. Even on appeal, many courts make surprisingly little use of cost-benefit analysis in reviewing negligence cases. Often, the only question on appeal is whether a reasonable jury could have found a party negligent under the reasonable person standard.
Some scholars claim that these practices demonstrate that the actual meaning of negligence in American law is defined by a reasonable person standard that marginalizes or even supplants the Hand Formula. Although these accounts vary in important particulars, their common theme is that the determination of negligence rests on a noneconomic conception of practical reasonableness that looks to community values and norms rather than to any form of cost-benefit analysis.
But the crucial feature of the pattern jury instructions on negligence is that they explicitly adopt neither of these competing theories—nor any other. Juries are told neither that a reasonable person is one who complies with community values and norms nor that a reasonable person is one who balances costs and benefits (or behaves “as if ” balancing them). Instead, the reasonable person standard is given to the jury without elaboration.
A jury would not likely engage in explicit cost-benefit balancing. But it seems to me plausible (though I would welcome comments from those with more immediate experience) that a jury might well conclude that hospitals should have recognized the need to purchase enough ventilators to handle a surge in patient capacity. A plaintiff’s case might be especially strong if a hospital had time between when an emergency loomed and when a patient died to purchase a ventilator that would have saved the patient. Juries, meanwhile, would likely be more sympathetic to hospitals that, early in the emergency, contracted to purchase ventilators (at least simple models) as soon as they were available.
Normatively, I am not sure whether hospitals should be liable. There is a strong argument that if one opens a 1,000 bed hospital, one should not be liable for not opening a 2,000 bed hospital. Liability might create a disincentive for small hospitals to open in the first place. On the other hand, it is difficult to identify an actor in a better position to anticipate potential needs for emergencies or to identify an actor that now will have strong incentives to provide demand for ventilators.
A related but separate question is whether doctors and medical professionals should be held to a lower standard of care during emergencies:
[I]n the wake of events like Hurricane Katrina and the H1N1 pandemic, there have been proposals to change the ordinary standard of care during declared emergencies. This idea is called “altered standards of care,” and suggests that there should be different standards that health care workers are held to during an emergency. Broadly, a public health emergency exists when a health situation’s “scale, timing or unpredictability threatens to overwhelm routine capabilities.” There has been significant research into, and creation of, altered standards of care for volunteers and Good Samaritans who help during emergency situations. Many of these regulations provide immunity to these individuals.
Rebecca Mansbach, Note & Comment, Altered Standards of Care: Needed Reform for when the Next Disaster Strikes, 14 J. Health Care L. & Pol’y 209, 209 (2011) (footnotes omitted). One would not want to discourage a doctor from working during the emergency because the doctor cannot provide care of the same quality as the doctor would ordinarily provide. But that is a different question from whether health care institutions should anticipate emergencies and stock up.
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