“Right now Medicare is determining that if you (a doctor) have a Covid-19 admission to the hospital, you get $13,000. If that Covid-19 patient goes on a ventilator you get $39,000, three times as much. Nobody can tell me after 35 years in the world of medicine that sometimes those kinds of things impact on what we do,” Minnesota Senator Dr. Scott Jensen explained.
“The Centers for Disease Control and Prevention (CDC) is encouraging American doctors to over-count coronavirus deaths across the US, he added, showing a 7-page document coaching him to fill out death certificates with a Covid-19 diagnosis without a lab test to confirm the patient actually had the virus,” he said.
“…under the CDC guidelines, a patient who died after being hit by a bus and tested positive for coronavirus would be listed as having presumed to have died from the virus, regardless of whatever damage was caused by the bus,” he added.
Some have called the governor of Pennsylvania a sheep in wolf’s clothing (Thomas Westerman Wolf), and others describe him as a snotty rich guy, who went to private schools (The Hill School), and has no clue about how average folks live.
Both assessments appear true to me.
However, when a book-smart governor (M.Phil from University of London) teams up with an equally education-inebriated anesthesiologist named Dr. Rachel Levine (Belmont Hill School and Harvard College), it gets even worse – an entire state may kiss its prosperity goodbye forever.
Transparency: I live in Montgomery County, PA, one of 840,000 citizens bordering northwest Philadelphia. I grew up in Kensington, the poorest neighborhood in that city of not always brotherly love.
Today, I can’t legally escape my suburban home, because of the Governor and Levine, his Secretary of Health, who have become partners to impose onerous Covid-19 (Wuhan Virus, Coronavirus, China Virus) regulations that may be for the rest of my life at age 78.
Is it time to move to California or South Carolina, where the beaches are open and folks in government have leaders who use at least half their brains? Even Georgia sounds tempting, despite those pesky June beetle bugs.
Wolf may be the dumbest Pennsylvania governor in history.
When deciding on “essential services”, the governor banned online car sales, perhaps not understanding that keyboards cannot be directly connected to auto showrooms, and viruses don’t travel through long wires to a computer.
While the rest of the state is missing its rums and cokes, Levine and Wolf can still enjoy their favorite vintage wine.
He closed all the state liquor stores, including curbside service, but continued to allow unlimited wine sales in supermarkets (for the better class of drunks?).
In a stark moment of reality he also permitted grocery store beer sales, because someone probably described the results of tar and feathers on even a wolf’s naked body. No beer means fast revolution, and aren’t we trying to “flatten the curve” to avoid riots and such?
Levine and Wolf’s biggest mutual sin is their plan to keep Southeaster Pennsylvania a possibly perpetual stay-at-home destination.
The map below shows all regions of the state. Every county will open within two weeks, including where Wolf and Levine go at night. Some freedom for all, except the Southeast – where I live along with 5.2 million other in-home incarcerated citizens.
Montgomery County Commissioner Dr. Valerie Arkoosh, DO, – another not-so-bright bulb – seemed almost gleeful in a recent television interview, explaining the criterion to reopen the SE region.
This will also be viewed as a regional exercise. That is critically important because we all know that this virus doesn’t care about any borders. We know our workforce travels back and forth between counties, she said.
Arkoosh said the requirement is that in each county only 50 reported cases per 100,000 residents will be allowed for an entire 14-day period. If any county goes above that 50 total for two weeks, the region will remain in shutdown. If any single county meets the goal they can’t open unless all the counties in the region do the same.
Does this sound like announcing Nap Time in kindergarten?
For Montgomery County’s 831,000 residents that means a daily average of no more than 30 cases total at various testing centers.
The County’s daily total this past Sunday was 129 cases, which drops the following 13 days to average about 20 cases to meet the Phase 2 standard. In recent weeks the average has been 187 cases daily, making a 20-per-day result seemingly impossible.
Oddly, the first release of Levine and Wolf’s requirements indicated 50 cases each day for 14 days, and not one day exceeding that. When questioned, Levine said she meant 50 cases total for two weeks, and that’s where things stand today.
The federal government is only requiring a downward trajectory for two weeks.
There is another flaw – a big one – in using new cases as a criterion to just begin returning to normal life. Of the 129 cases reported in Montgomery County on Sunday, only 14 were hospitalized. The other 115 went home, but they still count against the threshold of averaging 30 cases daily to move out of the current Red Phase.
In recent findings, New York state had an estimated 2.7 million recovered active cases, so Pennsylvania should have 1.8 million – all of them unreported by testing. By that estimate, Montgomery County alone has some 140,000 unreported, recovered cases so far.
The regulations apply to all counties, and below is the breakdown of goals versus actual in the SE region. Remember that every county has to achieve these results or all the counties will continue in the red phase.
2019 population: 421,164
Population / 100,000: 4.21164
Current Numbers (4/24/20): 14 day – 1,517, Daily Average – 108
Target Numbers: 14 day – 211, Daily Average – 15
Deficit – 93 daily active tests. 14-day: 1,309
2019 Population: 628,270
Population / 100,000: 6.2827
Current Numbers (4/24/20): 14 day – 1,525, Daily Average – 109
Target Numbers: 14 days – 314, Daily Average – 22
Deficit – 87 daily active tests. 14-day: 1,218
2019 Population: 524,989
Population / 100,000: 5.24989
Current Numbers (4/24/20): 14 day – 736, Daily Average – 53
Target Numbers: 14 days – 262, Daily Average – 19
Deficit – 34 daily active tests. 14-day: 475
2019 Population: 566,747
Population / 100,000: 5.66747
Current Numbers (4/24/20): 14 day – 2,126, Daily Average – 152
Target Numbers: 14 days – 283, Daily Average – 20
Deficit – 132 daily active tests. 14-day:1,848
2019 Population: 545,724
Population / 100,000: 5.45724
Current Numbers (4/24/20): 14 day – 1,017, Daily Average – 73
Target Numbers: 14 days – 273, Daily Average – 19
Deficit – 54 daily active tests. 14-day: 756
2019 population: 830,915
Population / 100,000: 8.30915
Current Numbers (4/24/20): 14 day – 2,612, Daily Average – 187
Target Numbers: 14 day – 415, Daily Average – 30
Deficit – 157 daily active tests. 14-day: 2,058
2019 population: 1,584,064
Population / 100,000: 15.84064
Current Numbers (4/24/20): 14 day – 8,286 Daily Average – 592
Target Numbers: 14 day – 792, Daily Average – 57
Deficit – 535 daily active tests. 14-day: 7,490
2019 population: 141,359
Population / 100,000: 1.41359
Current Numbers (4/24/20): 14 day – 232 Daily Average – 17
Target Numbers: 14 day – 71, Daily Average – 5
Deficit – 12 daily active tests. 14-day: 168
Total Southeastern Pennsylvania Region
2019 population: 5,243,232
Population / 100,000: 52.43232
Current Numbers (4/24/20): 14 day – 18,051 Daily Average – 1,291
Target Numbers: 14 day – 2,622, Daily Average – 187
Deficit – 1,104 daily active tests. 14-day: 15,456
All of the SE counties would have to each eliminate their deficits in order to enter Phase 2 (Yellow), which still doesn’t open schools, bars, restaurants, or allow gatherings of more than 25 persons.
There is no word yet from Levine and Wolf on how we will enter the Green phase, which lifts nearly all restrictions, except CDC rules, also unannounced.
The Southeast region has the most testing, most urban city population, and yet the hospitalized cases seem to average about 10% of active cases, and these totals include those both tested and observed as having the virus.
Deaths in Pennsylvania – now either from testing or mere observation by recently diluted CDC rules – totaled 19 on Sunday in a population of more than 12 million. Yesterday was 37.
It’s a problem for me to imagine how Secretary of Health Levine can relate to average working Pennsylvanians.
For example, she regularly appears on television to reassure residents and provide them with updates and health guidelines. In a recent interview Levine described her job:
My day is busy. I get here at 7 and prepare for my day. Our meeting starts at 8, where first I talk with my team for an hour, and then I go and speak with the senior staff of the governor’s office. And then the senior staff, and I, and the FEMA director have a meeting and then it goes from there.
Many meetings, much sitting, talking, earning salary of $600 a day:
I have a daily press conference … sometimes by myself or with the governor to update the public on the status of COVID-19 in Pennsylvania and the response of our administration. I often speak with legislators and other stakeholders. And then we have a 5 o’clock sum-up meeting till 6. And then I go home and do emails.
While the rest of us are stalked by the “stay home” police, Levine is exempt:
No stay at home. And right now it is seven days a week. So we’ve been at this pace for a while. We’re going to do whatever is possible, whatever it takes to protect the public health of Pennsylvania.
If I had any hope that she would ease the testing insanity, this dashed it:
We’re working on expanding testing. So that is testing for priority populations such as health care workers, nursing homes, etc., to our public health laboratory. But then we also have worked with hospitals and health systems to [set] up testing centers.
And a lot of those tests are either done by the health system or through the commercial laboratories such as Quest or LabCorp.
The more testing, the more active (non-hospitalized) cases, and the longer it will take for SE Pennsylvania to open, if ever.
Levine wants everyone to know that life is tough at the top, even when you can go and do what you wish:
I’m trying to get enough sleep and I’m trying to eat well as best I can. I’m trying to practice what my message is, which is stay calm. I can’t stay home because I have to be here, but staying safe.
But really, I’m not going out anywhere except here and then home. So not too much exposure outside of here at the Pennsylvania Emergency Management Association. But it is very important to stay calm and focused in the midst of emergencies.
And you know, that’s what I learned in my clinical years during my training and then at my time at Mount Sinai and then Penn State when we would see very ill children and adolescents. In those emergency clinical situations, it’s important to stay calm, and so that’s what I do now.
Rachel should realize that the state’s residents would explain to her -given the chance – that they don’t care how calm she is, or overworked.
They would tell her to change senseless rules and allow us to quickly get back to normal.
For a starter let’s stop counting “active” cases, and just use real hospitalized ones, not manufactured ones.
Then, have her tell us what are the goals for the final (Green) phase, so that officials don’t change them with each new statistic in order to further extend the shutdown.
Finally, Dr. Levine, please stop trying to be our nanny. All that does is make us dislike you more and more.
And would someone tell Levine we really don’t care about platitudes such as the following:
Hope is such an important thing. I think that we have to have hope for the future. I think we have to have hope for the future of our commonwealth in Pennsylvania, hope for the future of our nation.
And in relation to some of the things we’re talking about, hope for the future for the LGBTQ community. I firmly believe that we have made progress. We have been under challenges and faced a lot of challenges with this current administration.
Note to doctor: the real challenges are for the millions enduring this, and not for the folks at the top, who are causing it.
Late breaking good news for the “better” class of folks.: Governor Wolf just announced the opening of golf courses and yacht marinas, as of May 1. All factories, schools, restaurants, office buildings and other activities will remain closed until further notice and citizens are asked to continue cowering in their homes without jobs. (Will the “essential” country club waiters just serve wine, or sneak in a few cocktails at the clubhouse?)