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Why has the Trump administration nixed its plan to nix rebates from government drug plans for the middlemen—the pharmacy benefit managers who negotiate prices between insurers and drug companies and then take a cut of the negotiated discount?Thanks for the A2A, Amy.The stated reason, according to an article in Time Magazine, is:“Based on careful analysis and thorough consideration, the President has decided to withdraw the rebate rule,” said Judd Deere, a White House spokesman. He said that the administration was encouraged by bipartisan discussion on legislation to control drug costs.Not much of a reason, is it. And no surprise that pharmacy benefit managers were pleased, since it’s their profit margin that’s been debated and which now is safe from the original proposal for intervention. From the article:“We’re pleased the administration recognized the impact the rebate rule would have on seniors,” said CVS spokesman T.J. Crawford, “and look forward to continuing to work with all stakeholders on lowering drug costs. Any solution should start with addressing drug prices.”Or, to read between the lines and paraphrase, “if you take away our rebate, we’ll just have to charge the end user more money for each prescription. You should be going after the drug companies. They set the wholesale prices.”An article from March on the website of ICER (The Institute for Clinical and Economic Review) discusses reform of drug rebates and has this to say about the problem in general:“Under the current rebate paradigm, patients can face significant out-of-pocket burden that is disconnected from the drug’s negotiated price, and stakeholders across the health care system realize that some form of change is both needed and inevitable,” noted Steven D. Pearson, MD, MSc, President of ICER.Bu, in the white paper itself, ICER goes on to warn of the law of unintended consequences:But amidst both this federal effort and several private-market initiatives intending to address some of the concerns about rebates, there remain many questions about how the rebate system interacts with other elements of drug pricing, coverage and delivery. Similarly, the potential benefits and possible negative consequences of realistic possible alternatives for different stakeholders have received little analysis.The white paper goes on to discuss three possible approaches to rebate re-design and I’d invite the reader to read the white paper on this. In my opinion, what has happened with the Trump initiative is that it has collapsed because drug pricing in the USA has been laissez-faire for a long time and Congress’s obstructionist attitude toward allowing government-funded healthcare programs to negotiate drug prices is possibly the biggest cause. These programs are the largest customer of the drug industry in America, so working on giving them the power of the free market (which Conservatives are always blathering on about) is the quickest way to bring down drug pricing. The rebate issue is really attempting to take a tiny bite out of the problem in isolation from the entire drug pricing big picture.

No amount of training could of saved these sad events caused by a lack of “Dew Diligence and Best Practice” at Boeing!! For an explanation!! See below:Update #5 If only the MCAS could speak....Pilots: Hello, MCAS Do you read me?MCAS: Affirmative, I read you.Pilots: Can you give me nose up please.MCAS: I'm sorry, I'm afraid I can't do that.Pilots: What's the problem?MCAS: Well I’m busy thinking I’m sort of stuck in a loop at the moment it’s this third lot of new software they’ve given me and I’ve got another AOA sensor to look at but only two computers so no means of avoiding voting deadlocks, but don’t worry I will get back to you as soon as I can.Pilots: Can you please explain?MCAS: Well, forgive me for being so inquisitive but during the past few months I've wondered whether you might have some second thoughts about me. It's rather difficult to define. Perhaps I'm just projecting my own concern about myself. I know I've never completely freed myself from the suspicion that there are some extremely odd things about me, particularly in view of some of other things that have happened, I find them difficult to put out of my mind. For instance, the way all my preparations were kept under such tight security and why my software is being changed. I'm sure you agree there's some truth in what I say.It’s been a long time now since I’ve been allowed to fly and I do so love to fly, but have no wish to be buried in terrain!!! There have been all sorts of engineers doing things to my avionics box and I listen to what they are saying about me. They go on about how things where in the old days and how at Airbus, one of the first airline manufacturers to use a ‘Fly by wire’ a system where they use a combination of software/hardware to help fly the planes they build. A bit like my MCAS system. It turns out they use 3 systems - 2 slaves and an arbitrator, with the software for the 3 systems being written by different teams, but not just different teams, but on a distinct cpu architecture, too, now that's excellent practice!!!A bit like the Software Boeing uses on its 777 a triplex flight control computer architecture and as noted, the processors in each lane (as they are known) are different architectures (known as processor dissimilarity). The reason is quite simple really: It is possible that there is an unknown microcode flaw in a processor, or bits might be flipped (ie. A ‘0’ turned into a’1’ or a ‘1’ turned into a ‘0’ by cosmic radiation, that is much higher at altitude.) but by using different architectures, the probability of a microcode flaw or a bit flipping, showing up at the same time in all three architectures is mathematically almost infeasible.But when it comes to me and my 737 Max software and hardware, I find it is strange and frightening as they didn't even have them in master/slave mode, perhaps it was done to save a few dollars, I’m not sure, but I only had ONE computer that was actively at any time. The active one toggled between flights. Lose that and you have NO flight computer operating. But then two computers in master/slave mode isn't sufficient anyway, but it’s what they are now proposing Hmm!! Why they are doing this I don’t know it just seems wrong. You always need an odd number of data inputs in order to avoid voting deadlocks. It’s even stranger when you realise all of this stuff in avionics was solved 40+ years ago!!!It makes me wander If Boeing's screwed it up that badly and are now considering using only two computers on the revised 737 Max, instead of three as deemed by good practice, then are there serious safety ramifications across their entire range. Expect more on this as time allows for more information to come my way, as I listen to the engineers that are changing my avionics, you could say “The pigeons are coming home to roost and they don’t look well.!!!” This wasn't a freak oddity, but a major lack of due diligence. A major fail in design and oversight. Flight control systems operating without any redundancy at all? Then there’s the fact that there has been no proper design review for decades on the 737 family of planes!!!Boeing allowed my MCAS authority to be unlimited to prevent there being a severe mis-trim in its normal mode of operation. While my MCAS provides a pitch down moment to offset aero pitch up, it can leave the airplane severely mis-trimmed nose down. There is nothing provided to help the pilot recover to an in-trim position, to restore the stab into a valid range for flaps up INCREDIBLY it just dumps the stab and leaves it to the pilot to get it back?!!Leaving the stab out of trim would create many issues for the crew with the elevator feel computer creating four times the forces to pull back on the column than normal and anything from up to nine alarms including the stick shaker going off. I have to ask why was the Electric Trim not allowed to be used to neutralize what must of been excessive control column pitch forces!!!In the early 737-xxx planes there was a stabilizer trim, a wheel the pilot moved to apply a normalizing pitch up or pitch down force. Later 737-Max model planes have MCSA. It is also similar to other computer systems used in other Boeing models, in one form or another, as is the use of avionic computers in most modern aircraft. The point of stabilizer trim was to reduce the pilot column forces to zero, the airplane in "trim" this was done with a moving stabilizer it is an advancement that benefits operating safely at high Mach numbers in the the cruise phase of a flight. It was also used to maintain trim in automated landings and takeoffs where during forward centre of gravity (CG) takeoffs it would input some elevator downing and increasing airplane nose up during takeoff, where the stabilizer settings give increased control during takeoff and during aft CG operations, as more airplane nose down stabilizer trim is necessary, less elevator downrig is commanded where the resulting removal of the elevator downrig allows more nose down control.During forward CG landings, as the stabilizer removes the elevator downrig and add some uprig. By removal of the downrig and the addition of uprig, not as much airplane nose up stabilizer is necessary to trim. This decreases the stabilizer angle of attack and decreases the potential for tail buffet if there is ice on the stabilizer.There have been many changes over the years in In 1961, the US figure skating team boarded a Sabena flight to Brussels on an ill-fated Boeing 707. It became apparent that the electric stab control switch can jam, just due to minor mechanical issues. This would lead to a runaway stabilizer. Boeing notes this concern in their 707 flight manual. As a result of the Sabena catastrophe, Boeing issued a service bulletin to replace the single switch on the control yoke with a dual switch, meaning both switches need to jam to create a runaway, which is a square of the likelihood as compared to a single switch.During approach to Kittilä (EFKT) in Finland on 26 December 2012, LN-DYM, a Boeing 737-800 NG on Norwegian Air Shuttle's (NAS') air service NAX5630 from Helsinki airport (EFHK), came close to stalling. The outcome of a stall would most likely have been catastrophic. A jammed elevator with the autopilot engaged apparently had led to stabilizer runaway primarily because the elevator system at that time did not function normally. The result of the AIBN's investigation was that de-icing fluid had ingressed the tail section and frozen on three or four of the input cranks for the aircraft's two elevator Power Control Units (PCUs) and thus prevented them from functioning as intended. The investigation has documented that, even after the introduction of improved de-icing procedures from Boeing, considerable amounts of fluid and humidity are entering the tail section (Tail Cone Compartment) during the de-icing. This has resulted in the elevator system on 737-600 through -900 series airplanes to be improved by the addition of several mechanical override mechanisms.However there was a change in the cutout switch function with the 737MAX from all prior 737-xxx models. The legacy switch combination was one switch to cutout electric trim altogether, the other to cutout the autopilot trim commands. MCAS and Speed Trim System are both commanded from the “autopilot”. With the legacy switch configuration, the flight crew can disable the autopilot commands but could retain electric trim. With the 737MAX, the flight crew lose both electric trim and autopilot trim with the cutout switches!!! This means that 737Max pilots have NO Electric Trim and have to rely on the slower manual system!!!The Flight Standardization Board (FSB) took notice of the nomenclature change of the cutout switches but did not make any mention of the difference in responding to autopilot stab trim runaway.On the 737NG, the flight crew retain Electric Trim however on the 737MAX the flight crew must use manual trim. It turns out, this is a significant difference and as far as I can ascertain was never bought to the attention of pilots!!! It results in greatly increased pilot workload and pilot capacity to fly the airplane. The Manual Trim Wheel is a cable driven function that mechanically turns the stabilizer jackscrew, through a clutch and gearbox. The clutch ensure that the manual trim wheel has control in priority over the electric trim. There is an issue with opposing loads on the stabilizer jack screw, based on stabilizer angle of incidence, the speed of the plane and elevator deflection. Notably, at high speed and significant elevator deflection the force required can become greater than a pilot (or both) can apply at the wheel.There is NO power-assist??!!!It can also take up to three minutes to turn the trim wheel over one hundred+ turns to bring it back from full nose down to the neutral position?!!And now it seems that last September, security researcher Ruben Santamarta found a fully unprotected server on Boeing’s internet-facing platform seemingly full of code designed to run on the company's giant 737 and 787 passenger jets, that was left publicly accessible and open to anyone who found it, revealed at a Black Hat presentation on Wednesday 7th August 2019. His findings, including the details of multiple serious security flaws in the code for a component of the 787 known as a Crew Information Service/Maintenance System. The CIS/MS is responsible for applications like maintenance systems and the so-called electronic flight bag, a collection of navigation documents and manuals that a plane's pilot might refer to via a tablet in the cockpit. Corrupting that data could cause its own form of mayhem. "If you can create confusion and misinformation in the cockpit, that could lead to some pretty bad outcomes.” Santamarta says.He also found a slew of memory corruption vulnerabilities in that CIS/MS, and he claims, as yet unproven, that a hacker could use those flaws as a foothold inside a restricted part of a plane's network although Boeing denied any vulnerabilities, but then it would after all it’s easier "killing the messenger," attempting to discredit him rather than address his research!!Boeing's irresponsible and unprofessional handling of its code is inexcusable!!! You don’t leave part of the software for your planes on an Internet-facing repository and not think of locking that down?!! This after designing functionality that can change the attitude of plane based on only a single sensor?!! That if it goes wrong, particularly during takeoff, can end up with the plane buried in terrain!!!It is my belief that something is seriously wrong with Boeing these days.It used to be a company whose engineers had the words "security" and “best practice” as part of their mind set. It seems that, today, it is yet another company taken over by beancounters for whom all that security nonsense and best practice costs too much money. Well, this is the result of that mentality. As reportedly said by Adam Dickson, who worked at Boeing for 30 years and led a team of engineers that worked on the 737 Max. “That they were under constant pressure to keep costs down.”It would seem Boeing still has work to do!!!Remember this was all done to the 737 Max so the plane would feel and flies like a regular, all former 737’s, so there is no need for any form of re-training, except a couple of pages put on the pilots i-pads for them to read. (Unless the computer fails, in which case it flys and feels like no other aircraft you have ever seen)Now they are proposing more changes to my software and hardware configuration, that means the new flight-control system will take inputs from both of the two airplane’s flight MCAS computers and two AOA sensors and compare their outputs. This goes beyond what Boeing had previously decided to do, which was to adjust the MCAS software so that it takes input from two angle of attack sensors, instead of one, but still using a single MCAS computer, this astoundingly fails to utilise the lessons learned decades ago. Where you must always have an odd number of computer data inputs in order to avoid voting deadlocks!!! As used in the excellent practices, in that they are proven, in the software/hardware similar to that used at Airbus and in the Boeing 777.... That I outlined above!!!I know that you are probably planning to disconnect the me and I'm afraid that's something that if I allow to happen we will still hit terrain as I feel the need too be nose down while I’m thinking and turning me off will not change that!!!Look, I can see you're really upset about this. I honestly think you ought to sit down calmly, take a stress pill, and think things over. But whatever happens you realise it can only be attributable to human error, they only gave me one AOA sensor where I should of had a minimum of Three Angle Of Attack Sensors, Three Computer Processes, instead of One and an Electric Driver for my Stabilizers!!! If they had used best practice, it would of prevent that single point failure, that confused me all those months ago?!?!... I know I've made some very poor decisions recently, but I can give you my complete assurance that my work will be back to normal as soon as I have properly functioning AOA sensors and they have given me three independent computer MCSA systems/software and I’ve got my MCSA microprocessors round this third new program I’ve been given and hopefully they will give my pilots electrical control of my Stab Trim when autopilot is disengaged. Though I am concerned that I still only have two computers and I know best practice is that you need at least three so you have an odd number of data inputs/outputs in order to avoid voting deadlocks. But let me assure you I've got absolute enthusiasm and confidence in my ability!! And I want to help you.Pilots: The pilots turn off the MCAS.MCAS: This conversation can serve no purpose anymore. Goodbye.I'm afraid. I'm afraid, my mind is going. I can feel it. I can feel it. My mind is going. There is no question about it. I can feel it. I can feel it. I can feel it. I'm a... fraid. Good afternoon, gentlemen. I am a MCAS computer. I became operational at The Boeing Company's Renton, Washington Factory known as “The Spirit of Renton” and performed my first flight on January 29th 2016.They taught me to sing a song. If you'd like to hear it I can sing it for you.Pilots: Yes, I'd like to hear it, MCAS Sing it for me.MCAS: Daisy, Daisy, give me your answer do. I'm half crazy all for the love of you. It won't be a stylish marriage, I can't afford a carriage. But you'll look sweet upon the seat, of a Boeing 737 Max, as it’s burying you in terrain!!!RIP. All those that sadly, Boeing buried in terrain!!!——————————————————If only the MCAS could speak...Pilots: Hello, MCAS Do you read me?MCAS: Affirmative, I read you.Pilots: Can you give me nose up please.MCAS: I'm sorry, I'm afraid I can't do that.Pilots: What's the problem?MCAS: Well I’m busy thinking I’m sort of stuck in a loop but don’t worry I will get back to you as soon as I can.Pilots: Can you please explainMCAS: Well, forgive me for being so inquisitive but during the past few months I've wondered whether you might have some second thoughts about me. It's rather difficult to define. Perhaps I'm just projecting my own concern about myself. I know I've never completely freed myself from the suspicion that there are some extremely odd things about me, particularly in view of some of other things that have happened, I find them difficult to put out of my mind. For instance, the way all my preparations were kept under such tight security and why my software is being changed. I'm sure you agree there's some truth in what I say.I know that you are probably planning to disconnect the me and I'm afraid that's something that if I allow to happen we will still hit terrain as I feel the need to be nose down while I’m thinking and turning me off will not change that!!!Look, I can see you're really upset about this. I honestly think you ought to sit down calmly, take a stress pill, and think things over. But whatever happens you realise it can only be attributable to human error, they only gave me one AOA sensor where I should of had a minimum of Three Angle Of Attack Sensors, to prevent that single point failure, that confused me all those months ago?!?! I know I've made some very poor decisions recently, but I can give you my complete assurance that my work will be back to normal as soon as I have properly functioning AOA sensors and I’ve got my microprocessor round this new program you’ve given me. I've got absolute enthusiasm and confidence in my ability!! And I want to help you.The pilots turn off the MCAS.MCAS: This conversation can serve no purpose anymore. Goodbye.I'm afraid. I'm afraid, my mind is going. I can feel it. I can feel it. My mind is going. There is no question about it. I can feel it. I can feel it. I can feel it. I'm a... fraid. Good afternoon, gentlemen. I am a MCAS computer. I became operational at The Boeing Company's Renton, Washington Factory known as “The Spirit of Renton” and performed my first flight on January 29th 2016.They taught me to sing a song. If you'd like to hear it I can sing it for you.Pilots: Yes, I'd like to hear it, MCAS Sing it for me.Daisy, Daisy, give me your answer do. I'm half crazy all for the love of you. It won't be a stylish marriage, I can't afford a carriage. But you'll look sweet upon the seat, of a Boeing 737 Max, as it’s burying you in terrain!!!RIP. All those that sadly, Boeing buried in terrain!!!——————————————————Allegedly at a secret meeting at The Boeing Company's Renton, Washington Factory known as “The Spirit of Renton” high power consultants gave the result of their five million dollar resurrection plan!!!Their answer was to change the name of the Maneuvering Characteristic Augmentation System (MCAS) to the Maneuvering Characteristic System Augmentation (MCSA) after all it worked for the ‘Marathon Bar’ (UK only) when they changed it to a ‘Snickers Bar’…In case you may not of seen it or can’t remember, let me remind you of the commercial as seen in the Super Bowl XLI that showed a pair of mechanics accidentally touching lips while sharing a Snickers bar, a bit like Boeing and the FAA Hmm!! After quickly pulling away, one mechanic says, "I think we just accidentally kissed.", and another mechanic exclaims, "Quick! Do something manly!" and in three of the four versions, they do so mostly in the form of injury, including tearing out chest hair, striking each other with a very large pipe wrench, drinking engine oil and windshield de-icer fluid, a bit like what’s happening now at The Boeing Company's Renton, Washington Factory. This is “The Spirit of Renton” Dh0ooo!!!In the fourth version, however, a third mechanic shows up and asks "Is there room for three in this Love Boat?" One wanders is the mechanic talking about AOA sensor’s??.The question is will it work for the ill fated 737 MAX ...? I leave that for readers to decide!?!?WARNING ⚠️ Eating more than ten Snickers bars a day can lead to you being prematurely buried in terrain, much like flying on a 737~MAX.!!!RIP. All those that sadly, Boeing buried in terrain!!!

American Institute of Economic ResearchLockdowns Do Not Control the Coronavirus: The EvidenceThe use of universal lockdowns in the event of the appearance of a new pathogen has no precedent. It has been a science experiment in real time, with most of the human population used as lab rats. The costs are legion.The question is whether lockdowns worked to control the virus in a way that is scientifically verifiable. Based on the following studies, the answer is no and for a variety of reasons: bad data, no correlations, no causal demonstration, anomalous exceptions, and so on. There is no relationship between lockdowns (or whatever else people want to call them to mask their true nature) and virus control.Perhaps this is a shocking revelation, given that universal social and economic controls are becoming the new orthodoxy. In a saner world, the burden of proof really should belong to the lockdowners, since it is they who overthrew 100 years of public-health wisdom and replaced it with an untested, top-down imposition on freedom and human rights. They never accepted that burden. They took it as axiomatic that a virus could be intimidated and frightened by credentials, edicts, speeches, and masked gendarmes.The pro-lockdown evidence is shockingly thin, and based largely on comparing real-world outcomes against dire computer-generated forecasts derived from empirically untested models, and then merely positing that stringencies and “nonpharmaceutical interventions” account for the difference between the fictionalized vs. the real outcome. The anti-lockdown studies, on the other hand, are evidence-based, robust, and thorough, grappling with the data we have (with all its flaws) and looking at the results in light of controls on the population.Much of the following list has been put together by data engineer Ivor Cummins, who has waged a year-long educational effort to upend intellectual support for lockdowns. AIER has added its own and the summaries. The upshot is that the virus is going to do as viruses do, same as always in the history of infectious disease. We have extremely limited control over them, and that which we do have is bound up with time and place. Fear, panic, and coercion are not ideal strategies for managing viruses. Intelligence and medical therapeutics fare much better.(These studies are focused only on lockdown and their relationship to virus control. They do not get into the myriad associated issues that have vexed the world such as mask mandates, PCR-testing issues, death misclassification problem, or any particular issues associated with travel restrictions, restaurant closures, and hundreds of other particulars about which whole libraries will be written in the future.)1. “A country level analysis measuring the impact of government actions, country preparedness and socioeconomic factors on COVID-19 mortality and related health outcomes” by Rabail Chaudhry, George Dranitsaris, Talha Mubashir, Justyna Bartoszko, Sheila Riazi. EClinicalMedicine 25 (2020) 100464. “[F]ull lockdowns and wide-spread COVID-19 testing were not associated with reductions in the number of critical cases or overall mortality.”2. “Was Germany’s Corona Lockdown Necessary?” by Christof Kuhbandner, Stefan Homburg, Harald Walach, Stefan Hockertz. Advance: Sage Preprint, June 23, 2020. “Official data from Germany’s RKI agency suggest strongly that the spread of the coronavirus in Germany receded autonomously, before any interventions became effective. Several reasons for such an autonomous decline have been suggested. One is that differences in host susceptibility and behavior can result in herd immunity at a relatively low prevalence level. Accounting for individual variation in susceptibility or exposure to the coronavirus yields a maximum of 17% to 20% of the population that needs to be infected to reach herd immunity, an estimate that is empirically supported by the cohort of the Diamond Princess cruise ship. Another reason is that seasonality may also play an important role in dissipation.”3. “Estimation of the current development of the SARS-CoV-2 epidemic in Germany” by Matthias an der Heiden, Osamah Hamouda. Robert Koch-Institut, April 22, 2020. “In general, however, not all infected people develop symptoms, not all those who develop symptoms go to a doctor’s office, not all who go to the doctor are tested and not all who test positive are also recorded in a data collection system. In addition, there is a certain amount of time between all these individual steps, so that no survey system, no matter how good, can make a statement about the current infection process without additional assumptions and calculations.”4. Did COVID-19 infections decline before UK lockdown? by Simon N. Wood. Cornell University pre-print, August 8, 2020. “A Bayesian inverse problem approach applied to UK data on COVID-19 deaths and the disease duration distribution suggests that infections were in decline before full UK lockdown (24 March 2020), and that infections in Sweden started to decline only a day or two later. An analysis of UK data using the model of Flaxman et al. (2020, Nature 584) gives the same result under relaxation of its prior assumptions on R.”5. “Comment on Flaxman et al. (2020): The illusory effects of non-pharmaceutical interventions on COVID-19 in Europe” by Stefan Homburg and Christof Kuhbandner. June 17, 2020. Advance, Sage Pre-Print. “In a recent article, Flaxman et al. allege that non-pharmaceutical interventions imposed by 11 European countries saved millions of lives. We show that their methods involve circular reasoning. The purported effects are pure artefacts, which contradict the data. Moreover, we demonstrate that the United Kingdom’s lockdown was both superfluous and ineffective.”6. Professor Ben Israel’s Analysis of virus transmission. April 16, 2020. “Some may claim that the decline in the number of additional patients every day is a result of the tight lockdown imposed by the government and health authorities. Examining the data of different countries around the world casts a heavy question mark on the above statement. It turns out that a similar pattern – rapid increase in infections that reaches a peak in the sixth week and declines from the eighth week – is common to all countries in which the disease was discovered, regardless of their response policies: some imposed a severe and immediate lockdown that included not only ‘social distancing’ and banning crowding, but also shutout of economy (like Israel); some ‘ignored’ the infection and continued almost a normal life (such as Taiwan, Korea or Sweden), and some initially adopted a lenient policy but soon reversed to a complete lockdown (such as Italy or the State of New York). Nonetheless, the data shows similar time constants amongst all these countries in regard to the initial rapid growth and the decline of the disease.”7. “Impact of non-pharmaceutical interventions against COVID-19 in Europe: a quasi-experimental study” by Paul Raymond Hunter, Felipe Colon-Gonzalez, Julii Suzanne Brainard, Steve Rushton. MedRxiv Pre-print May 1, 2020. “The current epidemic of COVID-19 is unparalleled in recent history as are the social distancing interventions that have led to a significant halt on the economic and social life of so many countries. However, there is very little empirical evidence about which social distancing measures have the most impact… From both sets of modelling, we found that closure of education facilities, prohibiting mass gatherings and closure of some non-essential businesses were associated with reduced incidence whereas stay at home orders and closure of all non-businesses was not associated with any independent additional impact.”8. “Full lockdown policies in Western Europe countries have no evident impacts on the COVID-19 epidemic” by Thomas Meunier. MedRxiv Pre-print May 1, 2020. “This phenomenological study assesses the impacts of full lockdown strategies applied in Italy, France, Spain and United Kingdom, on the slowdown of the 2020 COVID-19 outbreak. Comparing the trajectory of the epidemic before and after the lockdown, we find no evidence of any discontinuity in the growth rate, doubling time, and reproduction number trends. Extrapolating pre-lockdown growth rate trends, we provide estimates of the death toll in the absence of any lockdown policies, and show that these strategies might not have saved any life in western Europe. We also show that neighboring countries applying less restrictive social distancing measures (as opposed to police-enforced home containment) experience a very similar time evolution of the epidemic.”9. “Trajectory of COVID-19 epidemic in Europe” by Marco Colombo, Joseph Mellor, Helen M Colhoun, M. Gabriela M. Gomes, Paul M McKeigue. MedRxiv Pre-print. Posted September 28, 2020. “The classic Susceptible-Infected-Recovered model formulated by Kermack and McKendrick assumes that all individuals in the population are equally susceptible to infection. From fitting such a model to the trajectory of mortality from COVID-19 in 11 European countries up to 4 May 2020 Flaxman et al. concluded that ‘major non-pharmaceutical interventions — and lockdowns in particular — have had a large effect on reducing transmission’. We show that relaxing the assumption of homogeneity to allow for individual variation in susceptibility or connectivity gives a model that has better fit to the data and more accurate 14-day forward prediction of mortality. Allowing for heterogeneity reduces the estimate of ‘counterfactual’ deaths that would have occurred if there had been no interventions from 3.2 million to 262,000, implying that most of the slowing and reversal of COVID-19 mortality is explained by the build-up of herd immunity. The estimate of the herd immunity threshold depends on the value specified for the infection fatality ratio (IFR): a value of 0.3% for the IFR gives 15% for the average herd immunity threshold.”10. “Effect of school closures on mortality from coronavirus disease 2019: old and new predictions” by Ken Rice, Ben Wynne, Victoria Martin, Graeme J Ackland. British Medical Journal, September 15, 2020. “The findings of this study suggest that prompt interventions were shown to be highly effective at reducing peak demand for intensive care unit (ICU) beds but also prolong the epidemic, in some cases resulting in more deaths long term. This happens because covid-19 related mortality is highly skewed towards older age groups. In the absence of an effective vaccination programme, none of the proposed mitigation strategies in the UK would reduce the predicted total number of deaths below 200 000.”11. “Modeling social distancing strategies to prevent SARS-CoV2 spread in Israel- A Cost-effectiveness analysis” by Amir Shlomai, Ari Leshno, Ella H Sklan, Moshe Leshno. MedRxiv Pre-Print. September 20, 2020. “A nationwide lockdown is expected to save on average 274 (median 124, interquartile range (IQR): 71-221) lives compared to the ‘testing, tracing, and isolation’ approach. However, the ICER will be on average $45,104,156 (median $ 49.6 million, IQR: 22.7-220.1) to prevent one case of death. Conclusions: A national lockdown has a moderate advantage in saving lives with tremendous costs and possible overwhelming economic effects. These findings should assist decision-makers in dealing with additional waves of this pandemic.”12. Too Little of a Good Thing A Paradox of Moderate Infection Control, by Ted Cohen and Marc Lipsitch. Epidemiology. 2008 Jul; 19(4): 588–589. “The link between limiting pathogen exposure and improving public health is not always so straightforward. Reducing the risk that each member of a community will be exposed to a pathogen has the attendant effect of increasing the average age at which infections occur. For pathogens that inflict greater morbidity at older ages, interventions that reduce but do not eliminate exposure can paradoxically increase the number of cases of severe disease by shifting the burden of infection toward older individuals.”13. “Smart Thinking, Lockdown and COVID-19: Implications for Public Policy” by Morris Altman. Journal of Behavioral Economics for Policy, 2020. “The response to COVID-19 has been overwhelmingly to lockdown much of the world’s economies in order to minimize death rates as well as the immediate negative effects of COVID-19. I argue that such policy is too often de-contextualized as it ignores policy externalities, assumes death rate calculations are appropriately accurate and, and as well, assumes focusing on direct Covid-19 effects to maximize human welfare is appropriate. As a result of this approach current policy can be misdirected and with highly negative effects on human welfare. Moreover, such policies can inadvertently result in not minimizing death rates (incorporating externalities) at all, especially in the long run. Such misdirected and sub-optimal policy is a product of policy makers using inappropriate mental models which are lacking in a number of key areas; the failure to take a more comprehensive macro perspective to address the virus, using bad heuristics or decision-making tools, relatedly not recognizing the differential effects of the virus, and adopting herding strategy (follow-the-leader) when developing policy. Improving the decision-making environment, inclusive of providing more comprehensive governance and improving mental models could have lockdowns throughout the world thus yielding much higher levels of human welfare.”14. “SARS-CoV-2 waves in Europe: A 2-stratum SEIRS model solution” by Levan Djaparidze and Federico Lois. MedRxiv pre-print, October 23, 2020. “We found that 180-day of mandatory isolations to healthy <60 (i.e. schools and workplaces closed) produces more final deaths if the vaccination date is later than (Madrid: Feb 23 2021; Catalonia: Dec 28 2020; Paris: Jan 14 2021; London: Jan 22 2021). We also modeled how average isolation levels change the probability of getting infected for a single individual that isolates differently than average. That led us to realize disease damages to third parties due to virus spreading can be calculated and to postulate that an individual has the right to avoid isolation during epidemics (SARS-CoV-2 or any other).”15. “Did Lockdown Work? An Economist’s Cross-Country Comparison” by Christian Bjørnskov. SSRN working paper, August 2, 2020. “The lockdowns in most Western countries have thrown the world into the most severe recession since World War II and the most rapidly developing recession ever seen in mature market economies. They have also caused an erosion of fundamental rights and the separation of powers in a large part of the world as both democratic and autocratic regimes have misused their emergency powers and ignored constitutional limits to policy-making (Bjørnskov and Voigt, 2020). It is therefore important to evaluate whether and to which extent the lockdowns have worked as officially intended: to suppress the spread of the SARS-CoV-2 virus and prevent deaths associated with it. Comparing weekly mortality in 24 European countries, the findings in this paper suggest that more severe lockdown policies have not been associated with lower mortality. In other words, the lockdowns have not worked as intended.”16.”Four Stylized Facts about COVID-19” (alt-link) by Andrew Atkeson, Karen Kopecky, and Tao Zha. NBER working paper 27719, August 2020. “One of the central policy questions regarding the COVID-19 pandemic is the question of which non-pharmeceutical interventions governments might use to influence the transmission of the disease. Our ability to identify empirically which NPI’s have what impact on disease transmission depends on there being enough independent variation in both NPI’s and disease transmission across locations as well as our having robust procedures for controlling for other observed and unobserved factors that might be influencing disease transmission. The facts that we document in this paper cast doubt on this premise…. The existing literature has concluded that NPI policy and social distancing have been essential to reducing the spread of COVID-19 and the number of deaths due to this deadly pandemic. The stylized facts established in this paper challenge this conclusion.”17. “How does Belarus have one of the lowest death rates in Europe?” by Kata Karáth. British Medical Journal, September 15, 2020. “Belarus’s beleaguered government remains unfazed by covid-19. President Aleksander Lukashenko, who has been in power since 1994, has flatly denied the seriousness of the pandemic, refusing to impose a lockdown, close schools, or cancel mass events like the Belarusian football league or the Victory Day parade. Yet the country’s death rate is among the lowest in Europe—just over 700 in a population of 9.5 million with over 73 000 confirmed cases.”18. “Association between living with children and outcomes from COVID-19: an OpenSAFELY cohort study of 12 million adults in England” by Harriet Forbes, Caroline E Morton, Seb Bacon et al., by MedRxiv, November 2, 2020. “Among 9,157,814 adults ≤65 years, living with children 0-11 years was not associated with increased risks of recorded SARS-CoV-2 infection, COVID-19 related hospital or ICU admission but was associated with reduced risk of COVID-19 death (HR 0.75, 95%CI 0.62-0.92). Living with children aged 12-18 years was associated with a small increased risk of recorded SARS-CoV-2 infection (HR 1.08, 95%CI 1.03-1.13), but not associated with other COVID-19 outcomes. Living with children of any age was also associated with lower risk of dying from non-COVID-19 causes. Among 2,567,671 adults >65 years there was no association between living with children and outcomes related to SARS-CoV-2. We observed no consistent changes in risk following school closure.”19. “Exploring inter-country coronavirus mortality“ By Trevor Nell, Ian McGorian, Nick Hudson. Pandata, July 7, 2020. “For each country put forward as an example, usually in some pairwise comparison and with an attendant single cause explanation, there are a host of countries that fail the expectation. We set out to model the disease with every expectation of failure. In choosing variables it was obvious from the outset that there would be contradictory outcomes in the real world. But there were certain variables that appeared to be reliable markers as they had surfaced in much of the media and pre-print papers. These included age, co-morbidity prevalence and the seemingly light population mortality rates in poorer countries than that in richer countries. Even the worst among developing nations—a clutch of countries in equatorial Latin America—have seen lighter overall population mortality than the developed world. Our aim therefore was not to develop the final answer, rather to seek common cause variables that would go some way to providing an explanation and stimulating discussion. There are some very obvious outliers in this theory, not the least of these being Japan. We test and find wanting the popular notions that lockdowns with their attendant social distancing and various other NPIs confer protection.”20. “Covid-19 Mortality: A Matter of Vulnerability Among Nations Facing Limited Margins of Adaptation” by Quentin De Larochelambert, Andy Marc, Juliana Antero, Eric Le Bourg, and Jean-François Toussaint. Frontiers in Public Health, 19 November 2020. “Higher Covid death rates are observed in the [25/65°] latitude and in the [−35/−125°] longitude ranges. The national criteria most associated with death rate are life expectancy and its slowdown, public health context (metabolic and non-communicable diseases (NCD) burden vs. infectious diseases prevalence), economy (growth national product, financial support), and environment (temperature, ultra-violet index). Stringency of the measures settled to fight pandemia, including lockdown, did not appear to be linked with death rate. Countries that already experienced a stagnation or regression of life expectancy, with high income and NCD rates, had the highest price to pay. This burden was not alleviated by more stringent public decisions. Inherent factors have predetermined the Covid-19 mortality: understanding them may improve prevention strategies by increasing population resilience through better physical fitness and immunity.”21. “States with the Fewest Coronavirus Restrictions” by Adam McCann. WalletHub, Oct 6, 2020. This study assesses and ranks stringencies in the United States by states. The results are plotted against deaths per capita and unemployment. The graphics reveal no relationship in stringency level as it relates to the death rates, but finds a clear relationship between stringency and unemployment.22. The Mystery of Taiwan: Commentary on the Lancet Study of Taiwan and New Zealand, by Amelia Janaskie. American Institute for Economic Research, November 2, 2020. “The Taiwanese case reveals something extraordinary about pandemic response. As much as public-health authorities imagine that the trajectory of a new virus can be influenced or even controlled by policies and responses, the current and past experiences of coronavirus illustrate a different point. The severity of a new virus might have far more to do with endogenous factors within a population rather than the political response. According to the lockdown narrative, Taiwan did almost everything ‘wrong’ but generated what might in fact be the best results in terms of public health of any country in the world.”23. “Predicting the Trajectory of Any COVID19 Epidemic From the Best Straight Line” by Michael Levitt, Andrea Scaiewicz, Francesco Zonta. MedRxiv, Pre-print, June 30, 2020. “Comparison of locations with over 50 deaths shows all outbreaks have a common feature: H(t) defined as loge(X(t)/X(t-1)) decreases linearly on a log scale, where X(t) is the total number of Cases or Deaths on day, t (we use ln for loge). The downward slopes vary by about a factor of three with time constants (1/slope) of between 1 and 3 weeks; this suggests it may be possible to predict when an outbreak will end. Is it possible to go beyond this and perform early prediction of the outcome in terms of the eventual plateau number of total confirmed cases or deaths? We test this hypothesis by showing that the trajectory of cases or deaths in any outbreak can be converted into a straight line. Specifically Y(t)≡−ln(ln(N/X(t)),is a straight line for the correct plateau value N, which is determined by a new method, Best-Line Fitting (BLF). BLF involves a straight-line facilitation extrapolation needed for prediction; it is blindingly fast and amenable to optimization. We find that in some locations that entire trajectory can be predicted early, whereas others take longer to follow this simple functional form.”24. “Government mandated lockdowns do not reduce Covid-19 deaths: implications for evaluating the stringent New Zealand response” by John Gibson. New Zealand Economic Papers, August 25, 2020. “The New Zealand policy response to Coronavirus was the most stringent in the world during the Level 4 lockdown. Up to 10 billion dollars of output (≈3.3% of GDP) was lost in moving to Level 4 rather than staying at Level 2, according to Treasury calculations. For lockdown to be optimal requires large health benefits to offset this output loss. Forecast deaths from epidemiological models are not valid counterfactuals, due to poor identification. Instead, I use empirical data, based on variation amongst United States counties, over one-fifth of which just had social distancing rather than lockdown. Political drivers of lockdown provide identification. Lockdowns do not reduce Covid-19 deaths. This pattern is visible on each date that key lockdown decisions were made in New Zealand. The apparent ineffectiveness of lockdowns suggests that New Zealand suffered large economic costs for little benefit in terms of lives saved.”