IM Doc on Medication/Medical Supply Shortages and Political Backlash

IM Doc weighed in twice this week in Water Cooler on the dire scarcity of some critical medical products in his area, a rich pocket in flyover. While some of them may be significantly the result of being at a remove from big cities, others seemed to reflect wide-spread outages.

We’ve seen less scary versions of this movie before. A few years ago, the US was suffering widespread shortages of the bags used to deliver IV fluids because the factory in Puerto Rico that was close to the sole producer was knocked out in a hurricane.

IM Doc does not have a clear answer as to why these shortages are so numerous. Domestic trucker shortages may be part of the problem. But the US is extremely dependent on China and India for drugs. 80% of the active pharmaceutical ingredients and and 90% of generics are believed to come from them (no one knows for sure because the US does not believe in having the government know anything). So the famed coastal port traffic jams may be contributing to the problem. The Wall Street Journal pointed out in August 2020 that disruptions in product from China had generated shortages in acetaminophen, antibiotics and high blood pressure medications.

IM Doc weighed in on Wednesday and again yesterday and I though it was worth hoisting them to encourage further discussion as well as circulation to friends and colleagues. I’ve edited both comments to focus on the supply issues; he also discussed staffing shortages at his and other hospitals. As his second comment makes clear, at least in the people he treats, there’s a great deal of anger at the Administration, as in the Democrats, for not even acknowledging these potentially life-threatening and also budget-destroying shortages, even among groups like the young and minorities who would otherwise generally be assumed to favor or at least consider Democrats.

I’m amazed that there hasn’t been a backlash against the Tories for their deliberate destruction of the NHS, which has become more catastrophic thanks to Brexit and Covid. But Labour is so enfeebled that it seems unable to find any way to profit from Tory disasters, plus the Brits are a very stoic bunch.

Even though the first discussion, of difficulties in getting liquid nitrogen, is revealing, the meat comes in IM Doc’s second topic, shortages in multiple categories of critically important medications.

From IM Doc on October 27:

I feel that the “troubles” have started in earnest now in medicine in ways I did not see coming just weeks ago. What we in medicine are simply not going to be able to abide right now is a surge like we saw last winter.

First of all, as a PCP, I have always had the ability to zap small non-invasive skin cancers. We do that with liquid nitrogen. We have been out of this for a week or so now. Sourcing a new supply is now virtually impossible. And the amounts being asked for what is left are so astronomically high that we simply cannot afford it. Medicare reimbursement (which is most of these patients) will not even come close to recovering the cost. I understand from the supplier that the same issues are occurring to some degree with dry ice and more ominously liquid oxygen (used in hospitals of patient oxygen). I heard from 2 different suppliers the reason why this seems to be happening – but the reason is so “tin foil” that I am not going to repeat it here until I can confirm this more reliably.

On October 27 from petal:

I run a research lab at a well-known med school. We have a -140 freezer. It was alarming, which is unusual. We had been given 1 regular tank and 1 half tank instead of the usual 2 regular tanks-1 attached and 1 for backup. Both tanks we had were empty, including the attached half tank even though it was showing half full (or half empty, whichever kind of person you are…). Our Airgas guy comes once a week anywhere from Tuesday-Thursday. I emailed the manager, got an out of office reply(great!). Called the #, got a live guy. He said he’d ring the delivery guy and see if he could swing by with a partial tank because it’s an emergency. He said there’s a nationwide shortage of LN2, and they “are having trouble getting it.” Luckily the guy dropped off the partial. I let my friends in a core facility (they have 2 huge -140s) know about the LN2 shortage and they’re freaking out (as was I). We cannot lose what’s in these, and cells can’t be stored at -80 for long before losing viability.

I did a net search, and a bunch of space industry articles came up(this stuff is needed for rockets). They said due to the spike in covid patients being put on vents, there’s a spike in the need for liquid oxygen for the vents, and that trucks that used to carry LN2 are being converted to carry liquid oxygen because the premium is higher than if they deliver a load of LN2. That’s all I found. So if there’s also a shortage of liquid oxygen, I don’t have any ideas, unless it’s the whole trucker shortage thing. Not a clue.

petal later added:

My friends with the core facility that has multiple freezers heard from the hospital’s procurement folks who had tracked down the Airgas manager. “He said there is no shortage of product(LN2) but a shortage of drivers for bulk tank deliveries.”

IM Doc’s reply:

I am in a remote area – that is certainly part of the problem. But the fact we are having these troubles with vital supplies even here should be an early warning indicator that we have issues as a society. The system has thrown a rod – and what used to be reliable no longer is. Fascinating times.

Our supplier is trying very hard to get the now very elevated cost of the transport of these gases passed onto the final user – and there is just no way that is economically feasible in our area. And then another wrinkle at least here is the actual company that puts it in the cans is having trouble getting the equipment and other needs transported to their facility. “We have not had the ability in about a month”. So they do not even have product to send. So we have supply chain problems – and we have delivery chain problems. It seems like everything has a screw loose right now. I do also have multiple patients who are now on emergency oxygen compressors – because the cans of oxygen are no longer available reliably in our area – and I have just not had the time to figure out why that is suddenly happening. The compressor approach is much more expensive and I have no idea how long the insurance companies are going to be willing to pay.

As far as the skin lesions and the liqiud nitrogen, looks like it is back to the old clip them off and put in a stitch. So much more time consuming that it is hardly done anymore.

I am seriously not understanding what happened – it is like all the truck drivers just POOF

From IM Doc on October 29:

I have a feeling we are in for far more serious “troubles” in the medical realm than just nurses in the hospital quitting. Pharma issues are happening – and may reach out and touch any one of you or your family. To be warned is to be prepared.

A very pernicious problem with pharma shortages has begun to set in. For the most part, they seem to be temporary – but they are absolutely devastating to patients financially – and I want all to understand what is going on.

This mainly seems to be happening in insulin products, immunologic agents ( as in Enbrel and Humira) and chemotherapy ( of which I personally deal very infrequently).

I am now up to 11 patients where this has happened just this week alone. All of whom are under 30, diabetic and on insulin or with lupus and on immunomodulating drugs. All are taking their health very seriously.

Most modern pharmaceuticals are distributed with the use of PBMs. big gigantic companies that are middlemen between pharma and consumers. They all have contracts with each product where they get a very good price on 1 particular agent in each class. For example – XYZ PBM has a great price on Lantus Insulin – so they will only distribute Lantus to their patients. If you must have the others – well – you get to pay the 700 dollars a month out of pocket – uncovered by your insurance. It is really quite a racket if some poor soul cannot tolerate the selected drug.

We are now experiencing fairly severe shortages on insulin products and immunoproducts. Again – they seem to be temporary – but 10 days is life or death to a Type I DM. So when their refill comes up – and their particular PBM contracted insulin type is unavailable – they get to pay full freight on another in the class – often 500-700 dollars a month. The PBMs are absolutely heartless – will not budge an inch – knowing in full that the shortage is beyond the patient’s control – and also that they are completely dependent. So the patients pay the 500 dollars for an alternative – only to find out that 7 days later – their “covered” insulin is available again. But it may not be when it comes time for a refill. And because their “great” insurance (It’s a big f@#ckin’ deal! – remember that?) that Obamacare delivered to the land has often 10 or 15 thousand dollar deductibles – they get to pay the full amount.

I have no idea why these shortages are happening. It is however constant. Again – not just insulin – the arthritis drugs are a real problem as well. My office staff is spending large chunks of time on this. Nothing like this has happened before in my career. This is new territory.

500-700 dollars is a lot of cash for these young people – and they are struggling under the load. I have not experienced young fathers crying in my office like I have this week. Again, the “troubles” have just begun.

We have here a pharmacy from a national corporation and also a local owned and operated pharmacy. The national chain basically tells the kids to pound sand. The local owned outfit, whose owner is in multiple civic organizations is giving them their alternative at his cost – and indeed I think he is giving it to them at his own expense as well. This fact is not going unnoticed in the community at large – and who do you think the goodwill is being bestowed upon? And who is getting the evil eye? I do not find it strange that we are suddenly seeing many prescription requests transferred to the local guy.

Furthermore, these young under 30s, black white and Hispanic – historically in the Dems back pocket – are now repeatedly discussing their politics with me. Unsolicited. I hear “FJB” all day long now.

I am very sad to report that the coddling of Big Pharma, the year of one lie after another from our medical leadership, the disaster that Obamacare actually is on the ground, the promise to “follow the science” and then clearly act more political than anything before, and the raping that our populace is getting from these PBMs is absolutely causing a sea change in where I have normally seen young people politically. Again many minorities as well. They are very angry. Right or wrong, they perceive the Dems and people like Biden and Pelosi as directly responsible. And I live in a mostly blue area.

And I do not blame them for a minute. One man explained to me very kindly that he had to be discharged from his federal job because of the vaccine mandate – and reported to me with great contempt that Biden had him fired – but was going to hand out half a million dollars to all kinds of illegal immigrants. “I voted for Obama twice, Clinton and Biden – but they can suck it if they think I am voting for them again.” I simply do not engage politics in my office. If they bring it up, I listen. Clearly, the kids are indeed beginning to realize what is at stake in their future.

As a life-long Dem, I am very concerned that we may be seeing another Whig implosion. The thing that bothers me is I do not see any evidence whatsoever that anyone in the Dem leadership even cares. They have anchored themselves to some very troubling things that really affect people in their daily lives – and the bill is coming due. Again – I am seeing enough tragic things being ignored and lied about that for the first time in my life, I will be voting a straight GOP ticket until the bad apples are rooted out. I do not think in my life I have ever seen a group of politicians that need some time in the wilderness more urgently.

Needless to say, the fact that problems of this seriousness are happening and aren’t even being acknowledged means that the situation can and likely will get much worse.

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  1. IM Doc

    I have not even had time to process the outrage I have for the next problem – but I thought this was about as good a place to share it – I am just dumbfounded by what I am seeing going on.

    I have now had 2 different patients in the past week with the same problem. They are both young fathers. They are both Roman Catholic. They are both profoundly healthy as are their wives and young kids. They both are employed by 2 different multi-national corporations who have imposed vaccine mandates on ALL their employees. These 2 young men both work from home in front of a computer all day. They never encounter anyone outside of their family and grocery stores, etc.

    Because both have very traditional Catholic views, both have declined the COVID vaccines because of the fetal tissue problems. I have always been under the impression that religious freedom was a bedrock of our Republic.

    Both corporate HR departments have now sent both of these patients emails demanding further “clarification” of their religious views.

    Interestingly, both emails from 2 different companies with HQ thousands of miles from one another, contain a very interesting statement. It is slightly different between the 2 – but I will paraphrase it – “Since you are claiming a religious exemption based on your objection to fetal tissue being used in the vaccine development, please discuss how you also plan to deal with your objection when using common drugs like aspirin, tums, ibuprofen, and tylenol…….

    Both emails had the SAME 4 DRUGS listed – but the question was written in different language in both.

    That is when I knew that games were being played. It is very clear to me that some entity has been pushing this out for all the corporations to send out. And whoever sent this out is literally as dumb as bricks.

    Fetal tissue being used in the development of these drugs? Are you fucking serious?

    Tums is basically chalk – as in chalkboard. A simple chemical compound.

    Aspirin was developed before the Civil War. Tylenol or its forebears date back to the late 1800s and ibuprofen came of its own in the 1960s.

    ALL FOUR OF THESE HAVE NOTHING WHATSOEVER TO DO WITH HUMAN FETAL CELL LINES. They are all old drugs. Fetal cell lines were really not a thing until after Roe v Wade in the 1970s once the procurement procedure became legal.

    After consulting with their priest, I have sent the HR people in both companies the following letter –

    Dear XXX,

    Patient XYZ has been under my care for X years. I have gotten to know him very well. As a practicing Roman Catholic, who espouses the traditional aspects of his religion, he is opposed in every way to the practice of abortion and certainly to the use of the fruits of what he considers an immoral act.

    Because of the tone and flippancy of your letter to him, I have to conclude that you are not serious in addressing his concerns. Since we are indeed discussing the livelihood of a young man and his wife and young kids, I feel that everything we do in this matter should be done with good faith.

    I am therefore asking of you a simple request. I need you to back up your assertions in the email you sent him that aspirin, tylenol, ibuprofen and tums were engineered with the use of human fetal cell lines. I have been a physician for decades and have never heard any such thing about these drugs. I am however open to learning new things. Please provide me with those sources so I can discuss your concerns and ramifications with my patient.

    Until such time that proof of your assertions has been provided, I will assume you are not acting in good faith – and I will be sharing my concerns with any attorneys that happen to get involved.

    Warm Regards,
    IM DOC

    I want everyone to understand. When I learned Public Health principles 30 years ago, when my father learned them 60 years ago, there was a bedrock statement – COERCION IN PUBLIC HEALTH NEVER WORKS – IT WILL INSTEAD OFTEN BACKFIRE. It is clear to me that Biden, Pelosi, and Fauci were all keenly aware of this simple fact last fall and winter when they were emphatically stating that mandates did not work and were not going to happen. Unfortunately, that wisdom was not continued – and I fear we are all going to learn that time-honored public health wisdom is not something to be ignored or played with. God help us.

    1. Yves Smith Post author

      I looked at the laws on a cursory basis early on, in terms of religious and Americans With Disabilities exemptions (let’s just assume clear cut ones, like being allergic to the vaccine constituents; even the CDC says “Don’t take it!” in that case). I was surprised. The requirement for private sector employers to provide an accommodation is pretty weak. This is more evenhanded than some write-ups I have seen:

      Nevertheless, the officialdom has succeeded in promulgating the myth (or at best exaggeration) that not being vaccinated = health risk to others, as opposed to self. It’s back to the Big Lie that the vaccines are sterilizing. But the CDC and various officials have made enough statements to that effect that employers can treat that as true.

      And the Feds moving to strong-form mandates (vax only) means an employer can be bullheaded and not offer frequent testing as an accommodation (we’ve said everyone should be tested, this treating the vaccinated as if they can’t transmit has led high vax countries into a world of hurt, see high vaccine rates in Ireland, Iceland, and Israel accompanied by surges, as well as the big study that showed zero correlation between vax rates and contagion rates).

      As for the religious part, the next level of attack by an employer that wants to play hardball is questioning the bona fides of the “religious” belief. The first is demanding proof of their observance. The second is to point out that the Catholic Church has said being vaxxed is “an act of love.” Who are they to question the Pope? The third is to try to argue that the use of fetal cell lines is only super tenuous for Pfizer and Moderna, as in their objection could not be bona fide if they had good information (see here:

      1. IM Doc

        Of course, we must consider that is the same Catholic hierarchy who has been covering up boy raping for decades.

        I guess that is an “act of love” as well.

        I am not Catholic. However, it became immediately apparent when talking to this particular priest that this fetal cell line issue may not be equal between the boy raping hierarchy and the great masses in the hinterlands.

        I am not sure how that all plays out in court.

        1. Katniss Everdeen

          If I remember correctly from my early indoctrination into the catholic cult, the pope “speaks for god on earth.” If the pope says the vaxx is ok, then that’s the end of the matter, fetal cells or no.

          It’s usually pretty easy to ignore those parts of “doctrine” that are inconvenient–divorce, adultery, abortion–and still consider oneself “devout,” especially in america, and the “church” doesn’t make too big a deal about it as long as the cash keeps rollin’ in. Buggering little boys is pretty much the accepted standard.

          That the “church” seems to be on the same page as the government and its corporate enforcers does not bode well for so-called religious exemptions. It seems it will ultimately come down to open defiance and acceptance of the consequences or acquiescence and acceptance of those consequences.

          1. Carolinian

            The head of Southwest Airlines has now said that he has no intention of firing anybody and for employees to bring on the medical and religious objections. Also it’s not just about Catholics as there’s a sizable evangelical population and I believe they very much object to the stem cells.

            All of which is to say–IMO–this mandate is simply going to collapse as common sense forces its way into the debate. Biden will be left with egg on his face and an even lower approval rating.

          2. Even keel

            I appreciate the confusion about the papal comment. The main point, for legally speaking, is that the accuracy of the religious belief is immaterial, only it’s sincerity is legally relevant.

            But, my thoughts on the nuance of the Catholic position are below

            My understanding is that the pope is not speaking doctrinally, but exhortationally. That is, his statement is equivalent to saying that he did a moral calculus, and it resolved in favor of the vaccine.

            It is standard doctrine, however, that vaccination should not be required. Nor should anyone be forced to do an act which they, and they alone, have judged to be immoral.

            So, while the pope, “personally” has determined that the social benefit of the vaccine outweighs the evil of any developmental connection to fetal cell lines, it is also the case that he has not made that determination for everyone. Rather, there is a moral duty to promote the public health. If one does not take the vaccine, one should take other measures to protect the public health.

            See, for example,
            the Congregation for the Doctrine of the Faith (CDF), which in december 2020 issued a document on the morality of accepting COVID-19 vaccines.

            The CDF concluded that COVID-19 vaccines developed, researched, or tested utilizing fetal cell lines is morally permissible when no alternative COVID-19 vaccine is available or accessible.

            “It must be considered that, in[the case of pandemic], all vaccinations recognized as clinically safe and effective can be used in good conscience with the certain knowledge that the use of such vaccines does not constitute formal cooperation with the abortion from which the cells used in production of the vaccines derive.”

            “At the same time,” the CDF said, “practical reason makes evident that vaccination is not, as a rule, a moral obligation and that, therefore, it must be voluntary.”

            “From the ethical point of view, the morality of vaccination depends not only on the duty to protect one’s own health, but also on the duty to pursue the common good. In the absence of other means to stop or even prevent the epidemic, the common good may recommend vaccination, especially to protect the weakest and most exposed.”

            “Those who, however, for reasons of conscience, refuse vaccines produced with cell lines from aborted fetuses, must do their utmost to avoid, by other prophylactic means and appropriate behavior, becoming vehicles for the transmission of the infectious agent. In particular, they must avoid any risk to the health of those who cannot be vaccinated for medical or other reasons, and who are the most vulnerable.”

            1. Ellery O'Farrelll

              Not saying whether the vaccine can be required according to Catholic doctrine (the Vatican says it’s a voluntary act of love). But, like many of you, I’m a practicing Catholic and have a couple of comments:
              – If these were cells from a murdered person, killed of course for a different reason than obtaining the cells for research or a vaccine, would there be any ethical objection? Or would people think that the use of the cells to generate a cure for a serious disease would provide a sort of post-mortem mitigation of the horror of the death because it led to a benefit for others? Not that it makes the death better, but that the benefits are a mitigant rather than a fruit of the horrible death
              – Elaborating on Gareth’s comment below, the position of the Catholic church is that the “cooperation in evil” in using fetal tissue obtained from abortions is, consistent with the above, “remote.” (talking about covid vaccines in particular). Short summery, disregarding nuance and dialectic: That tssue from an abortion ultimately helps generate a vaccine that helps people doesn’t make the vaccine immoral. Or make the abortion itself legitimate.
              Nothing in Catholic doctrine is simple.

          3. Objective Ace

            I think you are correct, but the religious exemption does not mean one of the mainstream religious teaching word for word.

            Since various popes have changed their minds on the official teachings and what God says, the “pope speaks for god on earth” (also know as Papal Infallibility) argument cannot possibly be true all of the time (one of the popes must have been incorrect).

            Its completely acceptable (or was) that your religious beliefs diverge slightly from the official ethos your religion and pretty easy to support why they would using the above justification

            1. Gareth

              Papal Infallibility only applies to matters of faith or morals and even then only when the Pope says he is speaking or writing ex cathedra. Francis did say he felt vaccinations were a moral obligation, but he did not say he was speaking ex cathedra. That means it is his personal opinion, not dogma. This is confirmed in the statement from the Congregation for the Doctrine of the Faith, in which they said that in the absence of licit alternatives, the vaccines use of stem cell lines did not bar Catholics from using them and that the vaccines were recommended. However, the statement also said that the issue was a matter of personal conscience and that the vaccines were not required. Specifically, they wrote “At the same time, practical reason makes evident that vaccination is not, as a rule, a moral obligation and that, therefore, it must be voluntary.”

              1. Donna

                I attended Catholic schools starting in 1955 and graduating from high school in 1967. We had 30 minute religious classes everyday. I cannot prove with an expired Catechism; but, I believe that I was taught that God breathes the soul into the body when it can live outside the womb. We learned this not in regards to abortion but in regard to when baptism is necessary. As an adult, I thought that that teaching helped Catholic women who were not allowed to use birth control deal with miscarriages. If the fetus was not viable outside the body it wasn’t a baby and didn’t have a soul. I always thought this was contradictory to their teaching on abortion. If the fetus doesn’t have a soul why not allow abortion? Religion does tend to be fraught with contradictions. But I certainly respect the right of Catholics to reject a vaccine developed with aborted material.

                1. Gareth

                  The moment the soul joins the body has been debated since the early days of the Church, e.g. St. Thomas Aquinas argued for 40 and 90 days after conception. However, the Church has never given a definitive statement regarding when that happens. Currently, the consensus view would be that it happens at the instant of conception. Section 60 of John Paul II’s Evangelium Vitae explains why the Church takes that position.

                  If I were to hazard a guess, the teaching you received regarding baptism may have been meant to protect mothers who suffered miscarriage from the pain inflicted by people who advocated the idea that souls of unbaptized babies must end up in Limbo. Benedict explained why this teaching is incorrect in 2007 with The Hope of Salvation for Infants who Die Without Being Baptized.

          4. Debra

            The Roman Catholic church is divided on the issue of how legitimate the current pope is to represent Catholic christendom, on many issues, and not just the Covid. Papal infallibility is a recent… doctrine. While I am of Protestant origin, I have become interested in the history of the Catholic Church and its institutions of which we are woefully ignorant. The Fraternity of Pie X, a French traditionalist Catholic church which maintains tricky, and volatile ties with Rome, has spoken out, and continues to speak out against François’s betrayal of… Christ, should we say ? on the vaccine issue. It is amazing that François seems not to understand that evangelistic belief in the vaccine is the most recent, and serious challenge issued to the Catholic church, and Christ since Adolf Hitler proclaimed himself the Anté-Christ (against Christ ? BEFORE Christ ?). It would be best to remember the etymology of the Greek word “catholic” which means “universal”. The Fraternity certainly has a site in English translation on which it develops a strong, argumented case against Covid vaccination. The Fraternity’s arguments are theologically solid, convincing, and have authority, in my opinion. They are complex and nuanced. Theology, the mother of modern science, is complex. After all, how many people are out there right now who have solid arguments that they can defend, even in the “scientific” community ?
            Now that the lines are incredibly blurred between “science” and “church”, it’s getting harder and harder to navigate, and to think straight. In my opinion.

        2. Felix_47

          I thought the American Indians started using willow bark which has salicylic acid in it which is aspirin. Obviously has nothing to do with cell culture. You may know more.

    2. petal

      They are making it nearly impossible to get a medical or religious exemption. I fear the next step will be booster requirements, and I couldn’t get a medical exemption before and got very sick. I have been having anxiety attacks recently about not being able to get an exemption if they start requiring boosters. I’m terrified of being sick like that again. All of the windows are being closed tightly and in unison. This is the hill they want to die on, this non-sterilising vaccine for this disease. I fear where it will lead.

      1. The Rev Kev

        Had the first AstraZeneca vaccine recently and within a fortnight had a ‘reaction’ though nowhere near as bad as yours. Went down to the doctor and said what happened and when I told him I suspected that it was vaccine related, he didn’t want to know. He suggested no tests, suggestions for precautions, warnings or anything. I have no idea why he didn’t, you know, act like a doctor and follow up on this but it seems that a years long relation with my doctor has just had the trust knocked from under it.

        1. SE

          I’m sorry to hear that. I know someone who had severe tachycardia and elevated d dimer immediately after first shot. Doc tried to tell her it wasn’t the shot and that she should get the second one. We’ve gone collectively insane.

        2. petal

          I’ve been thinking of the “3 monkeys” often this past couple years. Need to get one of those little sculptures. Had emailed my buddy south of Sydney about what was going on in the US and other countries regarding the vaccines and data etc, and he had had no idea. It was like he had been living in a hermetically-sealed bubble. I read the news from there every day(leftover habit from studying in Newy), and there was a full-court press, repeating the same company lines that had happened over here. It was just delayed, and like watching a re-run 6-8 months later. It has been surreal. “La la la ignore what’s been going on in other countries”. The erosion of trust in the medical profession, public health authorities, and authority in general…reckon it will be a festering problem from now on. Once that window is broken, it’s darn hard to put it back together. Why believe or trust people you know to have lied to you over and over or ignored you?

            1. petal

              hahahaha I like that one! Thanks! If I’m ever fortunate enough to have a mantelpiece, it’ll go right smack in the middle!

            2. synoia

              I’m sorry but because the US is exceptional, these do not apply:

              ‘speak no evil, see no evil, hear no evil, do no evil’.

            1. Helena

              Or read Hitchhikers Guide…

              “Ford!” [Arthur] said, “there’s an infinite number of monkeys outside who want to talk to us about this script for Hamlet they’ve worked out.”

        3. Lunker Walleye

          I got the Moderna booster on Tuesday — with each shot I get sicker and have had nearly all of the side effects listed in the manufacturer’s literature. Still feel poorly after four days post-vaccine and cannot imagine getting suckered into this again.

          1. Joel

            I’m in the Moderna phase III trial and got the first two shots in August and September 2020. No reaction to the first shot, mild fever and headache with the second (yes, I was in the vaccine arm). In September 2021 I got the booster and just had a headache. Compared to getting COVID and COVID long haul, I’d certainly get a booster whenever needed.

            Nobody is being forced to be vaccinated. Nobody should be forced to employ you in a private company if you insist on endangering others because of your religion. Being an adult is about making choices and living with the consequences. But don’t force me to deal with the consequences of your choices.

            1. CW

              “Nobody is being forced to be vaccinated?” By what measure? Threatening unemployment and the loss of healthcare isn’t being ‘forced’ in your world?
              The vaccines do not stop transmission, so your other assertion about endangering others has elements of what was rightly described as the big lie of sterilization.
              Your argument about “choices” is like saying we live in a free market.

            2. drumlin woodchuckles

              Choosing between being vaxed or being fired and rendered un-re-hirable in this No Money = You Die society is being forced. To say otherwise is forced-vaccination hasbara.

              I got accused here recently of making mistatements when I ventured the opinion that being vaxed or not-vaxed had zero effect on your ability to get infected and passalong the virus. So I would like to know: what is the percent difference in the infectability of vaxed versus not-vaxed people? How much does the “not free to endanger others” argument apply or not in this case?

          2. Young

            Three days after getting the second Moderna shot, I woke up 3AM and felt that a screw going through my chest horizontally. Very painful. For the first time in my life, I thought I was going to die.
            I will NOT get the booster and live with the consequences. I am 67 and I have been declining my doctor’s push to take lipitor in the last twenty years, due to my “family history” and high LDL/low HDL.

      2. SE

        I know people who have had SAEs to the first shot inducting myocarditis , yes more than one person, who are not getting medical exemptions. I voted for Biden and have now never been so eager to see someone out of office, not even Trump, who I loathed.

        1. Arizona Slim

          I’m going to venture out on a limb and say that the sudden popularity of the “Brandon” chant has a lot to do with Biden’s vaccine mandate. And, if that’s the hill he wants his presidency to die on, well, he owns that hill now.

          1. SE

            I have to say that is my instinct as well. I am not a Trump supporter, not at all. I have been a left-leaning independent voter who does not in any way believe that Biden stole the election. I was appalled watching the Capitol was overrun. I yet I confess I found that song a little cathartic because Biden and his administrations’s language towards unvaccinated people has been so hateful and aggressive, and has given permission to the rest of the country to hate and blame. So unbelievably toxic. Dems accused Trump scapegoating, but then took it up a notch when the got into power. I sense the feel it is okay because they are doing it to a group that the genuinely believe actually deserves it. All that means is that they are no different.

              1. Felix_47

                Good point. Hillary and her people started this whole thing with stolen elections. And they started it big time. Trump is just hitting back with the same bullshit. The so called insurrection in the capitol was, to my mind, an echo of the Russia crap. The people put up with it. Third parties do fail. No one votes for them. Nader would have been a great candidate. But I do think the election was stolen… South Carolina. South Carolina bothered me a whole lot more than the protesters at the capitol.

      3. Ping

        I’ve been following the messaging very closely. I did not want the vax but eventually “took one for the team” and was very ill with neuroinflammation and neuromuscular symptoms for months (relief came with IVM protocols and strict avoidance of dietary and other triggers).

        Like Wayne Gretsky famously said, “it’s not where the puck is, but where the puck is going to be” so I began documenting everything immediately and, after some challenging, my PC provided a letter that “could” be used to exclude me from booster requirements. And sure enough, already messaging is being slipped in like “the definition of fully vaxxed may change” alluding to booster requirements.

        I did research professionally (real estate private finance) so have consumed vast amounts of credible information and have concluded there is very little about the vax program that is truthful (including the origin which should have been priority to identify and to audit/ restructure NIH etc). Politically, mandates and pressure to vax healthy kids is an ENORMOUS blunder for the dems. They will pay for this.

        I do not know if the letter my PC provided will have any protection for me, at this time I don’t see any mechanism in the system to accommodate medical exemption.

        If that’s true and boosters become a requirement (that will be even more struggle to implement) I’ll be shut out of traveling and other normal functions because I can’t risk another vax. I won’t be isolated quietly either, there will be a protest sign in my front yard and I’ll make noise wherever possible.

        1. Mantid

          Ping, spot on. Love your last sentence. I think protesting is a start but strikes are so much more powerful especially when “making noise” and protesting is included. I’m finding various places I can strike and supporting others who are striking such as teachers fighting against the mandates (local walk outs) and various worker strikes across the US. What can each of us “strike” “boycott” or otherwise disrupt that is possible considering ones circumstances? Their only feelings and morals are housed in their pocketbook.

    3. Carolinian

      I read an article–sorry but no longer have the link–where a military objector was quizzed with the same script about aspirin etc. The origin of this bit of boilerplate would make an interesting press report should anyone care to dig it up.

      But if people claiming religious objection are playing games for an excuse then surely Biden himself is playing games with his OSHA announcement of a rule that may never appear (and become subject to legal challenges) and was only designed to goad private employers to do the mandating and firing for him. The bottom line in the entire dispute is that the vax is not a true vax since it still allows infection and transmission. Therefore the claim that the unvaxxed and only the unvaxxed are keeping Covid alive is also false and the claim that the vaccines are completely safe and no longer experimental cannot even be known since they have been in use for such a short time. That supposedly intelligent people like Noam Chomsky can’t see and accept these arguments means that they are either medically uninformed or incapable of accepting a reasonable objection by people they don’t like. Which is to say it is reason itself that is under assault here. Welcome to modern America (and, given our influence, much of the world).

    4. Gareth

      The list of medications seems to have originated with this article by Brother Schneider from January. He claims that Pfizer and Moderna were only safety-tested with human cell lines derived from abortion rather then developed using them. From there he argues that anyone rejecting these vaccines must reject any medication that has ever been subject to research using human cell lines. Thus, if a researcher does an experiment on a medication that is thousands of years old with a human cell line, Bro. Schneider argues the COVID vaccine objector must reject it to be consistent. His argument rests on conflating safety research in development with post-development research.

      The National Catholic Register, on the other hand, questions the claim that the vaccines were merely tested for safety on human cell lines in this article. To summarize, Moderna’s patents for its mRNA delivery system indicate that they used human cell lines in the development process.

    5. Mikel

      This also reminds me of the arguments comparing people’s acceptance of sterilizing vaccines to these non-sterilizing “vaccines”.

      1. Katniss Everdeen

        With regard to “people’s acceptance of sterilizing vaccines to these non-sterilizing ‘vaccines’ “:

        As also noted in Part I of this series, a few months earlier, in October 2019, major players in what would become the Moderna COVID-19 vaccine, particularly Rick Bright and Anthony Fauci, had discussed during a Milken Institute panel on vaccines how a “disruptive” event would be needed to push the public to accept “nontraditional” vaccines such as mRNA vaccines; to convince the public that flu-like illnesses are scarier than traditionally believed; and to remove existing bureaucratic safeguards in the vaccine development-and-approval processes.

        This is a quote from Whitney Webb’s latest investigative piece into the circumstances surrounding the development of the Moderna “vaccine.” It is Part 2 in a three part series. Link to Part 1 is in the article. Both parts are fairly long, revealing, in-depth reports, typical of Webb’s excellent work.

        There is far more to this than meets the eye.

    6. marym

      I have no qualifications to assess this claim about stem cell research and common medicines. While recognizing that people may have religious beliefs that are incomprehensible to me, I’m often skeptical of the use of the legal protections and social deference afforded religion as tools in the pursuit of a political or social agenda.

      That said, if this claim of stem cell use in developing these commonly used medicines is false, I would still favor documentation of embryonic stem cell use in drug development, testing and treatment, and – though maybe it can’t be compelled – an idea of which of these other preventive drugs or treatments would be refused on religious grounds. I think it’s a fair question. (Not asking you to answer, just commenting on it)

    7. Skip Intro

      The question about Tums and Tylenol is just silly. It seems like saying ‘my patient avoids all medications derived from immoral acts’, while obviously impossible under a broad definition of moral, would be simple, sufficient, and not take the bait. I wonder if that irrelevant request pasted from ‘HR Week’ works on anyone, or if it is just the front-row kids feeling smugly clever.

    8. Janie

      Corporations, even large ones, hire consulting groups to structure employee and benefit programs – naturally to corporate benefit. They have boilerplate, and it would crop up in unrelated companies. Just a thought…

    9. Dagnarus

      I am worried that some of the details given in this comment could be used to Dox you. I sincerely hope that the sample email is not given verbatim.

      If this isn’t an issue feel free to delete this comment.

    10. Lambert Strether

      Personally, I’m sick of religious “accommodations” (as, for example, pharmacists not prescribing the morning after pill. If you can’t do your job, get out of the trade!) and I think that the conservative — and, I suppose I may say, Catholic-dominated (thanks, Democrats) — Supreme Court has gone way, way too far in imposing them on the rest of us. The first part of the Establishment Clause reads: “Congress shall make no law respecting an establishment of religion….” but religious accommodations do exactly that. The whole doctrine needs to be hacked back to the original use case of, IIRC, Native Americans taking peyote on the reservation (lawyers will correct me, there).

      That said, I am not sure that IM Doc is 100% correct to say that “coercion in public health never works.” It worked for measles and polio for a good long time. At bottom, that’s what one has a State for: Coercion. That’s what both the rule of law and monopoly of violence are about. Of course, it would be nice if the law were written and violence applied in some reasonably democratic fashion, as it is not these days, things being as they are. And of course persuasion is always the idea, ethically and in every other way (including costs).

      And that said, I am 100% in agreement that coercion for these vaccines is wrong; I think it is right to demand that we know the long-term effects of an untested technology before running an uncontrolled experiment on the entire population without their informed consent (if such a thing were possible, at this point).

      But the issue is no longer public health, because the public health establishment and the dominant factions of the press and political class have, through performance and adherence to neoliberal ideology*, forfeited the right to speak in the name of the public. It pains me to admit it, but in the political realm the issue really is coercion*, as the right claims.

      NOTE * Neoliberalism denies the existence of a public. Hence, for example, Biden’s failure to congratulate or deign to notice the hundreds of millions who indeed acted in the public interest by complying with recommendations for Non-Pharmaceutical interventions,.

      NOTE ** Or, one might say, continuing to “make a market” for vaccines, now no longer through government supporting their development and manufacture by purchasing the product in advance through Operation Warp Speed, but by making “jabs in arms,” and billing for same, a matter of coercion.

      1. JTMcPhee

        On coercion and vaccines: I was born in 1946 and thus grew up with the childhood diseases and their vaccines, and the smallpox inoculation (a needle tattooing the vaccine into your upper arm). Maybe it was just the times, or my call circle, but I do not recall any kind of arm-twisting by “the guvmint” for any of those public health activities. We just accepted that they were necessary. I had friends that ended up in “iron Lungs” thanks to Polio, so a sugar cube with some pink stuff on it was a boon, not some kind of mandate. And of course the vaccines themselves were a lot more vaccine-y than the syrup that is being discharged from the blame cannons of the effing Dems. Pure bad faith and that lust to cheap and unaccountable power displayed by the pelosis, Faucis and other pond scum.

    11. LarryMotuz

      Might I answer that fetal cell lines were never used to develop m-RNA vaccines. Fetal cell lines have, however, been used since the 1980s to test various drugs for efficacy, as animal cell lines are inadequate for determining if human cells might have the same/similar reactions. Many drugs coming to market over the past 40 years have, in fact, used subsequent testing on fetal cell lines.

    12. Still Above Water

      On the shortage of truck drivers: as I recall, a couple of months ago Wukchumni wrote that a truck driver told him that the real problem is a shortage of DEF (Diesel Exhaust Fluid) sensors.

      1. Wukchumni

        My brother in law works for one of the largest trucking firms in the country, and the DEF sensors are still a problem with perhaps as many as 10,000 big rigs sidelined nationwide, and in theory there’s an override fix coming to solve the problem, but for now what was a $300 part is still fetching $4,000 to $4500 on the aftermarket, because markets.

  2. timbers


    “One man explained to me very kindly that he had to be discharged from his federal job because of the vaccine mandate – and reported to me with great contempt that Biden had him fired – but was going to hand out half a million dollars to all kinds of illegal immigrants. “I voted for Obama twice, Clinton and Biden – but they can suck it if they think I am voting for them again.”

    Add to this, the insult of Senator Biden’s #1 priority at the moment seems to be to get thru Congress his big subsidy give-a-way to rich gigantic fossil fuel corporations who run our government…as he blithely drops anything that might be marketed as benefiting us working peasants and carelessly brags “not a penny of new taxes on corporations or the rich”…while at the same time fighting hard to tax the $800/month in cash my tenet pays me in rent….AND…headlines that Senator Biden is considering giving $450,000 to each illegal immigrant.


    I work in a Clean Room manufacturing drugs. Our biggest cash cow seems to be Sublocade, which is used to wean folks off of opioid addiction. So you might say the Shacklers are responsible for my job. He is my immediate list of c-workers. Great folks. Notice the pattern:

    1). A Cambodian. Recent immigrant. Stilted English. I enjoy talking to him about different customs.
    2), A Columbian. Recent immigrant, Latin accent. Patient, is a good trainer as he shows a small group of us the ropes.
    3), An Albanian. Recent immigrant heavy accent. A young bull, he and his wife live with his mother who cooks his lunch for him every day. Has second job a Costco but he may have given it up as overtime flows freely were we work and pay is good.
    4), An older Asian with accent. Says he worked at a restaurant then started at the company as cleaning staff, and asked to get promoted into the “Clean Room.” Been there about 5 years.
    5). A young Dominican and his mother. Guessing they are immigrants as they frequently talk in native language that is not English.

    Then there are the Americans: Me, Shift manager, his manager, 2 other female co-workers on from Massachusetts the other from Kansas, several other American male shift managers.

    There are many others and they generally fit the above day shift composition. I am on First Shift, the day shift. We have 3 shifts plus a backup group that works 12 hour days in sequences that net to 40 hours/week.

    I learned the company is privately owned, and went from public to private recently. It is owned by The Carlyle Group.

    1. Milton

      No one is giving “illegal immigrants” $450,000. Whatever group that is spreading that number around–and I’ve been seeing it on pop-up ads in comment sections–are quantifying the values of gov’t spending that also supposedly benefits undocumented persons in this country such as defense, police and fire, highways, schools,… Etc.
      Bottom line – no Biden checks have gone out, or will go out, to those people that can barely speak English.

      1. timbers

        I suspect as much what you say could be true, but don’t know either way. It could be fake news as they say.

        That’s why I wrote “headlines.”

        Yet interesting the lack of concern on Team Senator Biden, to stamp out such headlines…if in fact they are not grounded?

        That too, seems clueless.

        1. Se

          Biden has unfortunately made this person al by talking about using his own mouth to blame unvaccinated people for all manner of ills. And—surprise!—unvaccinated people feel it personally.

        1. Katniss Everdeen

          Actually, I think it started at the wsj, quoting some of those ever so knowledgeable and reliable “people familiar with the matter,” who have been so helpful in america lately.

          Hopefully these are the same people who will be thrown under the bus when the biden “administration” sees how fast the tar and feathers are coming out.

        2. T_Reg

          That article buries the lede. This suggestion is in response to the thousands of children who were illegally separated from their parents, by agents of the U.S. government. The parents are suing, to the tune of an average of $3.4 million. So, $450K would be saving a lot of money. Biden should just let the cases continue, and even expedite them. Then point out how much money the illegal immigrants are getting.

          1. Fiery Hunt

            Ah, yes …funny how the lawsuit is focused only on the Trump years and completely ignores the 2009-2016 and 2021 “kids” who were put in the same cages.

            None of them should get a dime.

            1. marym

              It’s focused on a specific Trump administration policy and its repercussions. Here’s a link to a report of a years-long investigation by the Trump DOJ.

              “We found that DOJ leadership failed to effectively prepare for implementation of the zero tolerance policy. Then Attorney General Sessions was aware that full implementation of the zero tolerance policy would result in criminal referrals by the U.S. Department of Homeland Security (DHS) of adults who entered the country illegally with children and that the prosecution of these family unit adults would result in children being separated from families…

              Our review found that the Department’s single-minded focus on increasing prosecutions came at the expense of careful and appropriate consideration of the impact that prosecution of family unit adults and family separations would have on children traveling with them and the government’s ability to later reunite the children with their parents…

              On October 20, 2020, the government and plaintiffs in the Ms. L. v. ICE litigation jointly reported to the court that there were 545 children separated from parents in 2017 or 2018 for whom outreach efforts had yet to make contact with the separated parent…”


        3. Bart Hansen

          The Washington Post has had the story up for two days now. It’s under consideration because Biden thinks it’s the right thing to do.

          1. Carolinian

            Or it’s a political move to repair relations with a Dem constituency who are mad that he sent back all those Haitians.

            See, mind reading–everyone can do it.

        4. Felix_47

          I think 5600 are eligible. There are now 900 filed cases. If everyone who can does file, and I expect them to……..who would not……it will be 2.5 billion. And there are plenty of LA lawyer ads in Mexico and poor areas of Honduras. And there are a lot of lawyers with the ACLU who have an explanation for why this is the best course. That looks like 600 million in legal fees. Problem is the dems are locked in with the legal community and vice versa. I worked in Honduras for five years with the poor. We were inundated with children left with us to take to the US. Mothers and families would beg us every day to take their children. The birth rate was astronomical and the men just do not care. They would beat and sometimes kill any of their women who took BC pills so there were no other options. Macho men do not like condoms and if the wife is taking BC pills she is thought to be screwing around. The men screw around with everything and anyone. But it is traditional for Hondurans to ship the kids to the US if they can, and they do. So considering the culture the separation thing is simply ridiculous. And another legal demand is that they all get green cards which seems ok to me. I may be thought to be exaggerating but Honduras is a high femicide nation. The only solution is to come to the USA.

      2. Fiery Hunt

        You do know that ” $450,000 per child ” came from a report in the Wall Street Journal? And was confirmed by the Washington Post and others? And yes, they are literally talking about checks as settlement for pain and suffering.

        It really is part of the intra-agency agenda…not just “Right Wing Talking Points”. The fact you find it unrealistic is but a testament to the stupidity of these people and their “plans”.

        1. Objective Ace

          450,000 per child or familly seperated at the border is a far cry from “every illegal immigrant” which is what Timbers started this chain off saying

            1. Objective Ace

              Direct copied quote “AND…headlines that Senator Biden is considering giving $450,000 to each illegal immigrant”

              ImDoc clearly quoted a patient. Most people wouldn’t take that as a fact like we would a Wallstreet journal report

              1. timbers

                Thank you for correcting you misstatement, which as you note, I did not say “every” as you originally said I did. I said “each.”

                But yes, I stand corrected on a point of grammar/sloppy wording.

                But, it seems you might be missing the point, which IM Doc made more clearly than I, below.

                $450,000 to non US citizens who broke the law when US citizens get far less if anything.

              2. timbers

                And patient quote:

                “Biden… was going to hand out half a million dollars to all kinds of illegal immigrants.”

                I did not say it was a fact. Others did, and I didn’t say “every” YOU said “every” and I didn’t start the chain.

                In other words, every thing you said I said, I didn’t say.

          1. IM Doc

            It is also a far cry from what was offered to my aunt after losing her husband in Vietnam and who spent the rest of her life as a single mother raising their kids. It was a fraction of 450,000 in today’s money. Fortunately, she had lots of help from her family members. It was a hard life for them – but fortunately those kids are all adults now and citizens in good standing today.

            What is being proposed is a complete slap in the face to every family or spouse who has had to face such a situation.

            I absolutely understand why these people are pissed off.

            I must face my own feelings and realize I am in concordance with how my patient feels. I will never vote for anyone whose administration has the balls to put anything like this forward – I just simply cannot believe it.

            If there was not some truth to this preposterous story, I would think the White House would be all over the place with the denial cannons. I have seen no such effort.. If any of you have please point me to it.

            1. Basil Pesto

              It’s not really something they’re putting forward out of the clear blue sky; per Lambert’s link below, it’s a legal settlement being negotiated with the ACLU, who are representing the immigrant families where children were forcibly separated from their parents.

              I certainly wouldn’t disagree that drafting young lads to fight in Vietnam wasn’t morally wrong too, but it’s not a legal wrong that you can really sue the government for (I don’t think?)

              But yes, it also strikes me as rather clumsy messaging that the gov’t has $1b to give to these people (who certainly do, I think, deserve recompense for some pretty deeply unpleasant and unnecessarily spiteful government misconduct) on the one hand, and at the same time constantly tell the rest of the citizenry that the gov’t can’t afford “x, y and z” – medicare for all, say – because deficit which, as NC readers largely understand, is crap as taxes don’t fund spending.

      3. Lambert Strether

        > No one is giving “illegal immigrants” $450,000. Whatever group that is spreading that number around

        This is the story on the $450,000:

        Biden administration considering giving $450,000 per person to immigrants separated at the border The Hill

        So it’s a limited use case. It’s a lot like the ObamaPhone rumor before the 2012 election. I don’t know why the right is so good at propagating really virulent memes.

        Incidentally, my first thought was “Now do reparations.” But the right’s hive mind decided to go in a different direction, apparently.

    2. Kurtismayfield

      Timbers.. we are in Massachusetts. We have a very high concentration of STEM degrees. I have to ask, why is your company only hiring immigrants? Is it cost? How much is your position paying if you don’t mind me asking? Seeing how you describe the background of your coworkers, I am guessing it is.

      1. timbers

        Didn’t say they ONLY hired immigrants. They hired me after all! What I did say, is there are a high percentage of recent immigrants my co-workers consist of. And I don’t think that is unique to this company. I make $26/hr plus generous benefits for example health/dental/vision costs only about $125/month out of paycheck. Overtime for the taking which many want. As I am 100% debt free I save much of what I take home. If I had gone into medical manufacturing a few years back instead of wasting time in financial services, I’d likely be making $40-50/hr today.

        1. Kurtismayfield

          Ok so it’s not the pay.

          What I have found is that they want a STEM degree and experience, and will only pay you $20 an hour.. in Boston. No way you can live on that in the city.

    3. Bob

      “It is owned by The Carlyle Group.”

      Better start making an exit plan.
      Save as much as you can.

      These guys will either sell, take public, or loot your company by other means

      1. timbers

        Yes. But is it so different elsewhere? But yes I’m riding the gravy train. My plan is 4 yrs then retire. They have an older Clean Room and you can wince seeing some things that are tolerated, but they are aggressive about hiring and expanding and paying competitive salary. Plus experience only makes you more marketable in this line of work. So I’m here for the ride…for now.

      2. timbers

        Oh…and they are building a larger, new Clean Room for drug manufacturing. So if if Carlyle Group does a Carlyle Group, odds are it passes to new ownership and production continues.

  3. Watt4Bob

    I did a net search, and a bunch of space industry articles came up(this stuff is needed for rockets). They said due to the spike in covid patients being put on vents, there’s a spike in the need for liquid oxygen for the vents, and that trucks that used to carry LN2 are being converted to carry liquid oxygen because the premium is higher than if they deliver a load of LN2.

    The following is a rough outline of a story I read in the book Merchants of Grain;

    The global grain merchants, there are only 4 or 5 I believe, in order to ensure the most profitable distribution of grain, must control much of the worlds shipping.

    They buy up up all the permits that control the movement of ships world-wide. This allows them to profit from market changes by rerouting ships mid ocean, to deliver grain to ports where the price has recently gone up.

    So a ship bound for Europe with a cargo of wheat purchased at one price, can be diverted to Africa where famine has driven the price up.

    This is possible because their monopoly control of shipping means they always have the permits, and thus a ship to immediately replace the one diverted, thus Europe still gets their delivery even though the original ship was diverted.

    It would seem that the drug distribution system in the USA has been impacted by a combination of market arbitrage and the ‘truck shortage‘.

    The forces that have driven drivers out of the industry, low pay and poor working conditions, have contributed to the fragility of supply chains, that in combination with the ‘invisible hand‘ of market arbitrage is bringing delivery of even essential goods to a standstill.

    Contrary to the global grain merchants, who pay the price, and reap the benefit of having ‘surplus’ capacity to deliver, much of our country is supplied by a system that is based on the trucking industry, meaning drivers, who like many American workers have had enough of the relentless pressure that has wrecked their quality of life.

    IMO, government, in lock-step with the business interests that own it, have wrung every bit of flexibility out of our nations infrastructure and its workforce by the operations of what looks to me like central planning.

    America’s business interests, intending to manage the world, have managed us into a dead-end.

    1. Hayek's Heelbiter

      Interesting, during my [Brixton] flat refurb, all of a sudden strips of wood I needed were unavailable. I asked a clerk where had all the wood had gone.
      He explained that there was a full containership of of Canadian wood at anchor in Southampton. The Americans agreed to pay a premium for the wood and the containership went back across the Atlantic!
      I didn’t really believe him, as I couldn’t imagine how bought and paid goods could be diverted like that.
      Now I know.
      The timber shortage has eased somewhat but the prices definitely had not.

  4. Any Cause Will Do

    Very strange stuff going on. Science has been co-opted, but by what? And why?

    Regarding the vaccine mandates:

    As the infected vaccinated may harbor as much virus as the infected unvaccinated and can transmit the virus, why demand proof of vaccination?

    The commercially accessible vaccines in the US create an immune response of limited breadth, i.e., to spike protein sequences. As the natural immune response to the virus is much broader, i.e., not only to the entire spike protein, but the nucelocapsid protein and additional viral antigens, should not vaccine induced immunity be regarded as inferior to natural immunity?

    As vaccine induced antibody titers diminish over time, proof of vaccination is a dangerously inaccurate measurement of protection. And so if proof of vaccination is a prerequisite to entry into the favored class, should not there also be an antibody titer cut-off as well?

    Lastly, how is it possible that a candidate for CDC Director can have only three publications to her name prior to the appointment? Yes, she did go to all the right schools, but….

    1. redleg

      Antibodies resulting from coronavirus infection are not permanent- they wane over time too.
      Too much emphasis is being placed on immunity, and not nearly enough on prevention (as has been discussed on this site from day 1).

    2. Mikel

      Before Covid, I remember the articles and posts here on NC that were talking about the publishing of studies where results couldn’t be replicated.
      Much discussion about the co-option of science was included in those articles and discussions.

    3. Jeremy Grimm

      I believe Philip Mirowski is your best source for explanations of what has happened to science.
      Introduction: STS [Science, Technology, and Society Studies] and
      Neoliberal Science

      The Modern Commercialisation of Science is a Passel of Ponzi Schemes – Philip Mirowski

      A paper selected at random:
      Available here:
      But you will need to ‘quasi-join’, which I highly recommend — no $ cost and access to many research publications you might find of interest. The only cost I have experienced is requests that I join fully and become a part of their academic community for $$ unknown. I am an academic lurker.

      ScienceMart: Privatizing American Science (2011) — I confess I have not read this book, but there are others who comment to this blog who have read this book. I highly recommend “Never Let a Serious Crisis Go to Waste: How Neoliberalism Survived the Financial Meltdown” which is less directly applicable to the enthrallment of Science per se. I have read that book, though I must read it again soon. If nothing else, just reading it helped expand my vocabulary a little [could have helped greatly but for my laziness].

      1. skippy

        Yes some confuse engineering with Science e.g. the prior has a profit incentive and market based mind set where the latter does not.

        I think IMDoc experience over the decades [and passed on knowledge from father] is just the enrichment of the neoliberal paradigm over the timeline becoming impossible to ignore e.g. the distribution is uneven thingy.

        Then again America is largely ground zero for a lot of this stuff as best practices with the only divergence being the administrative views held by both legacy political parties. Per se I have a RCC French neighbor and Australian wife with two girls and both had vaccinations, he’s an electrical lighting engineer, currently working on his French mates [Australian wife with 2 kids] house reno and both are vaccinated. He is a business owner of a few decades in a landscaping business and I’ve had a few chats about economic matters. Wife the other day said Australia has had to high of labour costs. Wellie it took me all about 5 minutes to point out the fallacies of that worn out ideological trope dressed up as economics e.g. were did all that increase in productivity go over the decades and how many economic schools are you aware of and which one drives that meme and for what reasons ….. her response was I did not know that.

        Best bit is when I quoted Hayek’s thoughts on altruism and finding price thingy ….. the look on her face …

        But hay they love the job being done and the effort to do it over the long weekend holiday so the floor sander can come in on Monday and they can have their house back. 3 bedroom, bath, hallway, lounge/kitchen, 12 casement windows and frames, 4 doors and archs, two glass panel front doors and large side light panels, ceilings, walls, all done in 4 days by myself. Want me to do the outside [20K] job but booked out till March and can’t lock in price any further out than that, turning down work and offers to quote. All because of the invasion from the south [NSW/Vic] an the attendant price increase in RE here in Queensland, funny how the cries about Chinese driving up prices is a long forgotten meme – econnomics chortle ….

        Oh and the looks I get when people ask why I don’t have my own business and I respond with why would I do that, I just enjoy the work.

        1. ex-PFC Chuck


          “Yes some confuse engineering with Science e.g. the prior has a profit incentive and market based mind set where the latter does not.”

          Did you watch the first link in JG’s comment:

          Introduction: STS [Science, Technology, and Society Studies] and
          Neoliberal Science

          When you do you might rethink that statement.

          1. skippy

            In the context I use it … engineering is the application of Science post discovery, furthermore during the neoliberal era said engineering is governed by neoliberal tenancies e.g. there is no social construct or good in its administration.

            I would support that view with post WWII government investment in pure science without MBA’s managing it and what was the social benefit until the corporatist ideologues got control and everything had to be an IP based incentive with income streams in perpetuity.

            Then for good measure its all filtered through the market with investor expectations driving the outcomes.

            This is what covid has made clear in its inability to deal with historical events which force majeure is not a limited local or regional event.

      2. flora

        Thanks very much for these links. Mirowski describes how US (and not just US) science, particularly uni science research went from the old cold war model of national government subsidized, impartial, mostly a-political, military focused, and financially non-conflicted work that people trusted, to become instead “the science” of the past 40 years; a commodity bought and sold in the neoliberal market place, paid for by private funding, and market focused. I’ve watched that unfold in my uni. His explanation rings true.

        1. skippy

          This is what I was attempting to say in a hurry this mornings comment, in the gist of engineering under neoliberal mindset. This all goes back to the early days of NC and unpacking the a priori of AET and how neoclassical just slathered on bad maths and physics on it so it could be called a Science, when previously it was known as political theory/natural history.

          If you want to really drill down into what Mirowski is saying you need to listen to him describe the slight of metaphysical hand orthodox pulled with atomistic individualism, as a corner stone to everything else. YS book Econned takes a broader view and scope, but Mirowski gets into the devil details, also why I have linked to Lars Syll in the past. You can see a similarity in how those like Bill Black et al was attended too over the IS-LM Hicks model argument e.g. historically Hicks abandoned his position on the model later in life, but some comported it to esoteric iconography and orthodox can’t think without a model to fixate on. It never was what Keynes said, completely reduced complexity to some bastardized article of faith and stripped of all nuance.

          Its reminiscent of all of old Beardo’s antics here at NC ….

  5. The Rev Kev

    Got no real answer except for a question here. Liquid nitrogen may be important for treating skin cancers, etc. but liquid oxygen is critical from what I have seen to treat Coronavirus victims. Last year they were running short of oxygen tanks in India and patients in hospitals died by the numbers when the oxygen ran out. So would it be worthwhile contacting other industries (sporting actually) where they use oxygen so that you can grab your hospital some bottles? Here I am thinking of suppliers for mountain climbers and deep sea divers. I understand that the stuff, with proper insulation, lasts almost indefinitely but I would not be surprised to see a shortage down the track of oxygen bottles.

    1. IM Doc

      Modern hospitals do not use bottles except during transport of patients from different areas while they are mobile or for brief periods of time in the ER or radiology.

      Every room in the hospital has an oxygen port that is ultimately connected to gigantic tanks of liquid or gas oxygen in the parking lots. They are often stories tall and in the USA are often painted at least partially green.

      The temporary bottles are filled from this source as well.

      In essence, modern hospitals are absolutely dependent on a constant flow of oxygen into those gigantic storage tanks. I have often marveled at how vulnerable this is to an attack. Unfortunately, these tanks are also highly explosive if ignited although I am told that would be very difficult to pull off.

      We often refer to this incident in Oklahoma as to what can happen if these things do ignite. Basically very fast projectile fire bombs.

      There are videos – I just cannot find them at the moment. It happened right next to what appeared to be an interstate.

      Basically, if for whatever reason those big tanks in the hospital parking lots quit being filled, Lord have mercy. They do not even have enough bottles on standby inside to even begin to cover the needs.

      1. Bob

        No, oxygen is NOT EXPLOSIVE.

        Oxygen can and does vigorously accelerate combustion sometimes to the point of an explosion – see Sprengel explosives.

        This is why the pads upon which the LOX tanks sit are concrete rather than asphalt. Asphalt being a combustible petroleum product.

        And it curious that there is a shortage liquid of Nitrogen.
        Although my understanding maybe dated, the classic method of generating liquid oxygen, liquid nitrogen, and other sundry gases (argon, neon, Xeon) is to compress ambient air (the air we breathe), liquify the compressed air, and then fractionally distill it. Since ambient air is some 60% to 70% nitrogen it would be expected that an air plant would produce many times as much nitrogen as oxygen.

        1. IM Doc

          I get the impression from talking to these distributors that there is no issue in compressing gas. It is mainly a matter of the fact that the containers going back and forth have reached a standstill because of a lack of trucking. They have limited supplies of stuff to put the new product. They are apparently working on this issue very diligently and hopefully this will all work out.

          So many of our issues right now seem to be related to a sudden lack of trained truckers. I have not heard a good explanation for this yet.

          FYI I have had more than one patient in my life smoking while on a cannula of oxygen. Maybe explosive is not the best word but I guarantee you it is flammable. And those cans in Oklahoma did not just launch on their own.

          1. Kurtismayfield

            If you put flame next to pure oxygen it burns faster. So it appears that it is flammable, but really the fuel that was burning just burns at a faster rate.

          2. skippy

            “sudden lack of trained truckers”

            Could be the lack of in house training as such was hived off to private trade schools under the auspices of EMH long ago … e.g. an individual has to make a choice to become a driver, spend money to get certified, and then seek employment in the market place.

            Not that running lean labour has not been ratcheted down for yonks, hence overworked punch out, and no slack labour pool to draw from, zero depth to respond. But hay … that is what investors wanted.

            1. Timothy Hess

              A driver for a liquid tanker also fills the customer’s tank, so those guys require special training.

            2. truly

              “sudden lack of trained truckers”
              I heard about a month ago about a poll that suggested up to 40% of truckers might quit working due to vacc mandates. The poll sounded dubious, the reporter covering the story was “low confidence” to me, but if there was a thread of truth there, and even 10% were parking their rigs then the whole system is in trouble?
              Also, low confidence and anecdotal, but a farmer friend bought his own rig this year for the first time in a life time of farming. He said he was forced into it because no one else was available to haul his beans and corn to market. And he had lots of “Covid cash” coming in to cover expenses.

              1. Lambert Strether

                > I heard about a month ago about a poll that suggested up to 40% of truckers might quit working due to vacc mandates.

                If you don’t want to talk about wages and working conditions, you talk about vax mandates. We already had an episode of this with the rapidly mythologized Southwest pilots’ strike, for which the primary evidence seemed to be “what is unseen” (2 Corinthians 4:18).

                1. InThePines

                  To haul compressed gases one must have a hazmat endorsement. Also a tank endorsement for bulk transport. Pay is not commensurate at the moment; barely 30 an hour without time and a half, transportation being exempt from overtime laws. The freight market at the moment is paying quite well and you can make more hauling dry van without the risk of a viking funeral.

        2. Michael McK

          At least with older on-site Oxygen generation for water treatment I am familiar with, perhaps for most O2 generators, the N2 that is produced is used in the cooling cycle to make the O2. The energy used to make the N2 is reclaimed (imperfectly) by using it to pre-chill the air (which also removes water vapor) coming in to the system.

        3. Timothy Hess

          About three times as much. But as gas, not liquid. A liquefier plant can pretty much go from all LO2 to all LN2.

          Three ways to get medical oxygen. Cryogenic distillation (only way to get LO2), Pressure swing adsorption (bigger version of those oxygen concentrators you see on TV), and reverse osmosis.

          When I worked for the industrial gas industry, there was a guy who almost blew his foot off by spilling LO2 on asphalt and then just stepping on that spot.

      2. vlade

        Yes, most of modern hospitals have a single-source gas, stored in massive tanks, with the piping system as you describe.

        The painting green is a standard procedure for gas id . The tanks are not explosive per se, O2 it’s just damn good fire “helper”, so you’d get a massive fireball simply from the oxygenation going on. The only good thing would be it would burn extremely quickly, so there are relatively low chances of secondary fires (except, of course in the immediate vicinity). That’s why you often get those tanks in a separate enclosure (or at least be far enough not to allow secondaries) , which would contain most of the horizontal flare and direct the rest upwards. But that takes a lot of space, so it’s “often” but not “always”.

        If the hospitals start running out of O2, the fatalities will start going through the roof, not just for covid.

        1. B24S

          Rust is slow oxidation. Fire is rapid oxidation, and even steel will burn in the right conditions. A pure oxygen environment is inherently flammable (see Apollo 1), if not explosive. An example; a friend decided that rather than disturb the neighbors on Sunday by turning his compressor on to run the nail gun he was using to roof his mothers’ home, he hooked it up to an oxygen tank. The small amount of lubricating oil in the nail gun decided to oxidize (possibly sparked as the anvil hit a nail), and the resulting explosion (rapid gaseous expansion in a closed container) cost my friend part of a hand and an eye. Tank/regulator/etc. threads are NEVER lubricated for that reason.

          Keep in mind recent accidents in the Middle East, etc., of hospital fires related to oxygen, and the terrible toll they took.

          I also still wear cotton almost exclusively. It doesn’t melt into your skin.

          1. foghorn longhorn

            Was going to point this out myself.
            Mix a little oil with your oxygen and stand by for fireworks.

    2. Gregorio

      There doesn’t seem to be any shortage of liquid oxygen when it comes to launching billionaire joyrides into space.

      1. Mikel

        And with the microchip shortages and all the talk around them and all the chips they banking on being needed for more software in everything, nobody ever talks about the effect on fresh water supplies.

  6. BeliTsari

    Supply-chain issues reflect a marketplace freed of onerous regulation, oversight or enforcement. Bartertown, I believe it was called, by our most prescient & astute prognosticators. Somewhere, between Powell’s Memo & Citizens United, we all became hapless bystanders, as white-flight suburbanite PMC kleptocrats indemnified, legalized, then enforced their 0.01% client’s feeding frenzy, while criminalizing any which way we might try to resist, protect, inform or even discover how our Creative Class was going to blatantly rob & indenture us next.

  7. CH

    Companies have been forcing working-class Americans to pee in a cup (i.e. randomized drug testing) for decades. The only recourse was the same as it is for anti-vaxxers today: if you don’t like it, don’t take the job or quit.

    Now…NOW…the right-wingers are all concerned about “individual freedoms” at work. Give me a f—ing break! Political grandstanding of the highest order.

    As for the Catholics, the Pope himself has been vaccinated, so it seems that would have been a much more rational line of argument:

    1. IM Doc

      With all due respect, being injected with any pharmaceutical and peeing in a cup are two entirely different issues.

      Peeing in a cup does not typically require informed consent and signing a document stating that the process has not been approved and the risks are as yet unknown – which was going on all over America by the millions for months earlier this year.

      For the first time in my life, the risks and benefits counseling of people’s own physicians, familiar with their own medical issues, was replaced by TV doctors with who knows what agenda and conducted in parking lots or stadiums. And all this with an agent which at the time and still even now had not gone through all the usual rigors of trials.

      It is interesting you should bring up that topic of peeing in a cup. While these vaccine mandates are now all the rage, every other want-ad in my local paper is screaming that no drug testing is required.

      We do indeed live in a very interesting time.

      1. Bazarov

        The risks of peeing in one of those cups can be enormously high–let’s say there’s a false positive (or a real positive), and you get branded a junkie. There goes your livelihood! There are few circumstances more detrimental to health than wretched poverty.

        Now, in these times of labor scarcity, workers don’t have to worry about that as much as usual. I hear employers are waiving drug tests and/or looking the other way when employees fake them.

        However, having worked in several “jobs for proles” that require peeing in a cup: it was humiliating and nerve wracking, and I had every reason to expect I’d pass! I’ve been privy to many conversations regarding the anxiety–in some cases, literal terror–that the prospect of such tests can cause. We’re talking mental illness levels of worry that in themselves necessitate, shall we say, “self medication” to address.

        And let’s not even get into the malicious use of drug tests to get out of having to pay workman’s compensation (even if the accident had obviously nothing to do with a little weed in the blood). Those tactics are utterly life destroying.

        So requiring people to take these drug tests in fact entails they participate in a medical procedure with real, serious risks. But it’s the kind of risk that benefits the boss enormously as another way to keep the boot on labor’s neck–so the liberals (classically speaking; both the Democrats and Republicans) and the devout Religious (already all-in on hierarchy) don’t even bother to shed crocodile tears about it.

        1. Glen

          The drug testing has been going on for a long time especially in the rarefied world of the military and security clearances. I personally knew at least one person that at least by his telling, had a false positive (I believed his story, but had no way to determine if it was the truth) resulting in his dishonorable discharge from the service and resulting inability to earn a living.

    2. Glossolalia

      “Now…NOW…the right-wingers are all concerned about “individual freedoms” at work.”

      Since January 6 they’re also now very concerned about the awful state of our prisons and detention facilities :)

    3. Eric377

      Pope Francis is elderly and has one lung. But I also really don’t agree with religious exemption because it should not come to that. If someone says they don’t want this very new, non-sterilizing vaccine, that’s good enough for me. I’m vaxxed and do not fear the unvaxxed at all. These current vaccines have characteristics for which the personal assessment seriously outweighs the collective benefit assessment.

  8. peon

    One wonders why the Biden administration does not wage a “Project Warpspeed” initiative to get the subunit protein vaccine Novavax up and running as an alternative to the current “vaccines” available.
    Surely some that are vaccine hesitant would go for this more traditional vaccine technology.
    I seldom hear anything about this vaccine. Subunit vaccines are reliable and familiar—they have been around for many years. This technology is behind many of the routine childhood vaccinations for whooping cough, diphtheria, tetanus, and hepatitis B.4 They are also more stable and easier to store, unlike mRNA vaccines that require ultra-cold conditions for distribution.

  9. Randall Flagg

    It seems that this whole unholy mess is not going to be over until it all just collapses into a smoldering pile. And it’s way more than just the medial field. It’s an infection that has coursed throughout all of the economy. And I wouldn’t in the slightest feel bad all for the scumbag elites (May they all rot in hell) those that I hope would be hurt the most by it.
    The saddest part of all is that when this big reckoning comes about, the unfortunate reality is all the poor, underdog/working class folks, that are only trying to survive day to day are the ones that will feel the brunt of it all. Pretty much like they already do when I think about it.

    1. Glossolalia

      I don’t know, the poor/underdog/working class probably have developed a toughness and resourcefulness that the elites don’t have (and neither do I, to be honest).

  10. petal

    The supply chain problems getting worse than what they are now worry me. How far is it going to go? What more can I do to try to buffer against it? What do I do when it’s not possible anymore? Who am I supposed to believe? I get brushed off by the airgas manager and it takes the hospital procurement office(a large buyer) to nail down an answer. How much of this is going on elsewhere for other products, companies, industries? Does anyone even know the full extent of the shortages and problems? It seems like those in charge are holding their breath hoping it passes over eventually. The little people on the ground are left to fight the proverbial fires on a daily basis and/or get ground up by the machinery(like the people that need medications and can’t get them).

    The backlash come mid-terms is going to be epic. In a way, I can’t wait to watch it unfold. Talk about screwing up on a massive scale. Here in NH, Senator Maggie Hassan has already been running radio and YT ads like crazy because she is losing in a potential(not even announced yet) matchup against current-Gov. Sununu. It sure smells like panic.

    1. Randall Flagg

      Yes, Hassan has been running those ads already to the point of making one nauseous or changing the station every time they come on. I’m worn out already. It’s going to be a banner year in radio/tv media for political ad revenue.
      Of course over here in the Green Mountain State the big Three seats are and will continue to remain in Democrats hands. They could punch a baby in the middle of Main Street and suffer no consequences. That’s how it works in Vermont, put D after you name on the ballot and your chances are supremely good.
      And yet, no one seems to question our Senators and Reps participation in all this crap in Washington over all these years

        1. Randal Flagg

          Easier to run as an Independent and caucus in Congress than to call yourself a Socialist in this day and age.

        2. VT farmer

          Bernie Sanders is useless. And supremely annoying. He makes a good show of raising his fist and looking all serious, but all he’s really good at is looking out for Bernie Sanders.

      1. VT farmer

        Another Vermonter here sharing your fate in Wokestan, southern Windsor County.

        As for the baby punching thing, I suspect they could burn the baby’s house down too, and suffer no consequences as long as that baby were a) White and b) they did it in the name of one or another of their smarmy SJW goals. Sanity and common sense are in short supply around here and I blame all the PMC-types* who buy up the houses and LARP as rural Vermonters, then vote in all these idiots.

        *Professional Managerial Class. Around here they’ve invaded from some big city: NYC, Boston, or anywhere in NJ or CT, and they all think they know better than rural people how to run things. In reality, they’ve made a muck of it all.

    2. Jeremy Grimm

      The supply chain is only one of many interlocked networks of often hidden and unnoticed systems supporting our present society. How far can things go? Think water, sewer, electric power and ask that question. Think roads and drainage systems as rivers of rain grow more frequent, more ‘common’. Think of all the other subterranean systems our Society rests upon — systems I cannot name or enumerate because I am not aware of them, and might only become aware of them through their failures. We live in interesting and precarious times. I hesitate to contemplate the exogenous threats that the growing discontent may unleash.

      Backlash in the mid-terms!? I feel no comfort replacing democrats with republicans. They are different flavors of the same party. I grow desperate that I have far far less time to find refuge in a distant place than I had thought. Winds of Collapse hasten their speed toward abyss. My age is cold comfort as I contemplate the future I see for my children.

      1. Glossolalia

        And then ask yourself who is going to design and maintain all those subterranean systems in the years to come as we churn out people with degrees in financial engineering, gender studies, and app design.

    3. Jen

      Hassan won her senate seat by 1000 votes last time. She should be panicking. Sununu will beat her like a gong if he runs. Kelly Ayotte would as well. If neither run and the republicans reach from their endless bench of bat guano crazy, she still might lose.

      Her first campaign was awful. Every week I’d pick up my mail at the post office and it would be stuffed with fliers from Hassan screeching that her number one priority was to defeat ISIS. Here I’d thought our problems in NH, which as the former governor one would thing she was well acquainted with were largely around the opioid crisis, but nah. She’s too busy looking for jihadis in her underpants.

      Shaheen’s voting record is every bit as terrible, but she isn’t as tone deaf as Hassan, and her she does a much better job of disguising her contempt for her constituents.

    4. Code Name D

      I predict things will get a lot worse. In fact, I am very fearful there may be no recovery from this collapse, at least not from the current regime. Let me share this observation.
      The video talks about “phantom traffic jams”. They start with a circle filled with cars. It’s dense, but there is enough space between each car for everyone to move at a comfortable 15 MPH. And sure enough, a phantom traffic jam takes form. And despite all efforts to get the flow of traffic to recover, the phantom traffic jam persisted.

      And this isn’t a new or poorly understood concept either, and has similar applications in fluid dynamics. Pluming that is operating close to or at capacity with also develop these “phantom jams”, causing the pipes to vibrate.

      I predict that something similar is at work with the supply chain. A slow down in one sector causes slowdowns in other sectors, which in turn causes more slowdowns in still other adjacent sectors. The system’s attempt to correct the problem by shifting to alternative sources only amplifies the problem as the alternative sources are probably already operating close to maximum capacity. And attempts to ramp production to meet the new demand ends up creating new supply shortages up stream as they fine it difficult to increase capacity to compensate.

    5. VT farmer

      The ‘smells-like-panic’ thing: from your lips to God’s ears.

      Haven’t seen any YT ads (don’t go there), don’t listen to radio, and only occasionally watch TV but we’ve already seen more Maggie Hassan ads than we’d ever want to. The upside? At least we’re not watching Bernie Sanders commercials; he’s infinitely less appealing. She tries to appear pleasant, he never is.

  11. HH

    It is not clear to me why there is such intense interest here in the flaws of COVID-19 vaccines and their associated public health policies. As a thought experiment, let us assume no vaccines were available. Is it not obvious that mortality and illness would have been much more damaging? IM Doc posted repeatedly here on the under-counting of vaccine-related deaths, implying that the vaccines were dangerous. Reports of this kind unquestionably contributed to vaccine resistance. Is there any doubt that vaccine resistance has killed more people than vaccine adverse reactions?


    1. Basil Pesto

      this isn’t the point. The point is the danger of the “vaccines + “let ‘er rip”” policy. The vaccines were oversold in terms of what they could do (many people assumed the pandemic would be over months ago. Very few expected breakthrough deaths + serious illness) and this was known and understood to those paying attention from last year. Vaccines certainly have their part to play but they cannot be relied upon exclusively and yet that is what people think they are – a magic bullet, and no need to even consider any of the other things we could be doing. And that is the policy that was sold. This has shifted, inevitably, in recent months to “we have to learn to live with the virus”, a classic shifting of goal posts and a bit of Bernaysian PR to discount even the possibility of elimination (undergirded by, I think, some genuine Panglossian optimism and a belief that we’re much more in control of the virus than we actually are). Living with it also seems to be something we’re doing a pretty piss-poor job of. Thus these particular vaccines themselves may not be dangerous per se, but the policy of relying on them as “the road out of the pandemic” very well could be, in the long run

      Is there any doubt that vaccine resistance has killed more people than vaccine adverse reactions?

      this too is not the point (although greater transparency about the risk of the vaccines, however small, should have been present. The fact that it wasn’t undermines the public health mission generally). The point is not the harm of vaccine adverse reactions – in the short term it was and has been clear to most that the benefits
      of the vaccines outweigh the risks. The point is that 1. immunity wanes over time, sending us back to square one 2. letting the virus circulate freely in a population with leaky vaccines, as I understand it, provides ideal or at least rather propitious conditions for an efficient, immunity-escaping variant to evolve.

      1. GM

        This has shifted, inevitably, in recent months to “we have to learn to live with the virus”, a classic shifting of goal posts and a bit of Bernaysian PR to discount even the possibility of elimination

        These days you often see people, usually “liberal”, viciously attacking those who still advocate for elimination as “anti-vaxxers”…

        1. Basil Pesto

          which of course is stupid. If the vaccines do have a salutary albeit short-term impact on transmission as has been reported, let’s use that as another weapon to reduce transmission and eliminate the virus and get things (relatively) back to normal. Anti-eliminationists seem to think that those in favour of elimination like masks, lockdowns, and having the windows open all day, when it’s the only known way to forestall their necessity (unless widespread death and disease is acceptable)

    2. Gareth

      Are you in possession of 3- and 5-year safety reviews for these vaccines? If so, please share them with the rest of us. We’ve got one to one-and-a-half years of data at most.

        1. Mantid

          Actually, some would argue, “Yes we should have no (non sterilizing) vaccines”. A “true” vaccine as opposed to the current “treatment” vaccines – one that kills the virus – would be a massive improvement. For a scientific justification for “no” see Geert Vanden Bossche’s (DVM, Phd) article here:

          A quote: “Likewise, mass vaccination campaigns (especially non sterilizing tratments) may have a beneficial short-time effect in that they reduce viral spread and protect vulnerable people from disease (e.g., elderly people and those with underlying disease), but will eventually drive the propagation of more infectious variants.”

        2. Bret

          Yes, because without these vaccines there would be no excuse to end quarantines, force people back to work, send them to school, etc. Now the arguments are preoccupied with vaxing vs nonvaxing rather than how badly corps are screwing their workers and how badly gov has fucked up.

          1. tegnost

            It is indeed bizarre that the capitalists have decided unity is required to move the state forward. They’ve become so used to the benefits of socialism they don’t even see them anymore.

        3. anonymous

          Everything about the roll-out of these vaccines was great… until the mandates, and the decision (apparently) of our ruling class to die on that hill.

          I think most of the questions asked here are in truth some version of “Are these vaccines important enough/work well enough/have a convincing enough argument behind them to gamble the future of our country upon them?”

          Whatever the answer ends up being per individual, as a society, the dice have already been rolled. Fingers crossed that we all can avoid the worst outcomes…

    3. Basil Pesto

      To further illustrate your point, let me take your thought experiment and apply it to the Australian context, because it is one Inhave run myself but to illustrate a separate point:

      As a thought experiment, let us assume no vaccines were available. Is it not obvious that mortality and illness would have been much more damaging?

      For Australia, I tweak it slightly. As I’m sure you know, Covid was eliminated here last year. It was threatening to run out of control in Victoria until the effects of a lockdown + lockout in combination with a mask mandate took hold. A couple of months passed and everything in Vic re-opened and was back to normal (which is the state the rest of the country had more or less been in), with occasional short snap lockdowns. This was all pre-vaccine. That changed in June this year. That was the first appearance of delta and we were told, automatically, with no scientific inquiry, that we “couldn’t stop” delta because it was different (more transmissible). No serious efforts were made to stop it in NSW where the outbreak occurred and it was allowed to spread. This all occurred at the time of the vaccine rollout. The vaccines presented themselves as an easy market solution instead of the politically unpalatable (to our idiot political class) policy of income support + lockdown. Of course, they’re a temporary solution, as we know from the countless examples of other countries, and hundred have died (and many more will have to deal with long covid) because of it.

      So my thought experiment has been: without that vaccine promise (“road out of the pandemic” are literally the words used by politicians here, ditto “pandemic of the unvaccinated” which I think originated in the USA), would Australia have so readily abandoned its proven successful strategies? might we not have improved them in the face of a more transmissible variant, instead of abandoning them in favour of a vaccine that wasn’t even developed for that variant? Might we have – on top of offering the vaccines to any and all who wanted them – also, in a similar fashion, used the considerable monetary power of the state to organise the manufacture and/or distribution of N95/P2 masks to all residents here, the exact same way we’re doing now with vaccines, and explained airborne and aerosol spread instead of people walking around with unsealed surgical masks and being urged to slather on the hand sanitiser? So, no, I don’t believe these vaccines are harmful per se, but as a crutch for gormless politicians the world over? no good

      1. GM

        100% this!

        I’ll repeat myself, but it has to be said again and again and again until people understand it.

        The existence of vaccines will kill more people than vaccines will save directly for without vaccines it is politically unacceptable to allow people to get infected and die but with vaccines let-it-rip is easily sold onto the gullible public.

      2. Kfish

        I totally agree. We could have been Covid-free, but our familyblogging economy is built on exploiting temporary foreign workers (9% of the workforce pre-pandemic) and taking money from foreign students. So they had to come back, in large numbers, from China and India.

        1. The Rev Kev

          Just heard on the news this morning how they were looking forward to all those foreign workers come back to work for us and have those students & backpackers come in and pick crops, work restaurant tables, etc. because it will be so great for the economy.

    4. Skip Intro

      The point I think you’re missing is that the vaccines have been vastly oversold, and this deception causes people to engage in risky behavior they believe is safe. Your counterfactual posits no vaccines, but by assuming no other measures were taken, you minimize its utility. I think a more appropriate question would be, If vaccines were sold as reducing your chances of infection and retransmission by about 60%, and public health officials acted accordingly, and emphasized mask and ventilation mandates, rather than telling everyone to just get back to business as usual, would he have had a summer wave?
      In this light, vaccine mandates that presume to allow selected people to gather indoors are dangerously counterproductive.

    5. chris

      Opinions vary quite a bit in the Commentariat but we pretty much all agree that the public is not being given the information they need to understand the risks and benefits of the vaccines. Much like the refusal to plainly state this is a virus spread by aerosols we have been treated to the “vaccines as panacea”. This is dangerous and wrong. It undermines what the vaccines can do and creates a problem with vaccinating the population. And then we have this whole mess with boosters, while we’re short on constituent components for the vaccines, AND we can’t clearly identify the correlates of protection. So we don’t know for sure if high antibody levels are the end-all be-all here, but we’re being treated as if they were. Except, we’re not really being told the truth, because even the CDC says that people without boosters are considered fully vaccinated. Which of course hasn’t stopped millions of people from seeking boosters when we still haven’t helped the rest of the world get their first shots.

      Long story short, I would guess most people on here don’t like being told to “shut up and take it” by people who are too stupid to understand what they’re asking us lowly citizens to put in their bodies. The people doing the pushing are also the least likely to suffer any consequences if the vaccines are harmful in the long term. They’re also the ones most likely to flaunt pandemic restrictions. And none of them have seen their livelihoods suffer from their actions.

      Those people haven’t even apologized for their initial mistakes. Or admitted what we’ve we’ve learned so far. For example, one lesson we learned from this pandemic is that the first places to be shut down in any national health emergency should be all of NY state and all of CA (especially San Francisco). We need to ring fence those areas and prevent any travel in or out ASAP. We need to quarantine anyone who tries to leave the fenced in areas too. But you don’t hear any of our elite admiting that their selfish behavior resulted in spreading the disease through the country. All you hear is that dumb white people should learn to read authorized news sources and get vaccinated.

      Perhaps that’s why there’s all the discussion on here?

    6. MonkeyBusiness

      What stops them from pushing a vaccine with 6 months or less of development time next time? Heck, why not push a vaccine with one week of development time. It’s MRNA right, best of the best.

      Lawsuits? No, because under the EUA, you can’t sue these companies.

    7. Lois

      To this day, I see people on twitter saying that vaccinating 5-11 year olds and more teenagers gets us closer to “herd immunity”. Which assumes a sterilizing vaccine which is not what we have! I’ve got both doses of Moderna, I’m not anti-vax. But all this vaccine will end the pandemic talk from on high is super ridiculous and screams neoliberal incompetence. And a lot of people still think it is valid because it is all they have heard from “authorized sources” for 18 months. The blowback to another wave of COVID at high vaccination levels is going to be intense.

    8. Some Dude

      The fact that this guy is posting like that, alongside saying that he’ll vote GOP straight ticket, and its being elevated to the main posts is making me side eye this blog.

      1. Yves Smith Post author

        It is well documented that some Sanders voters in the 2016 primaries voted for Trump in the general election. What about a protest vote don’t you understand?

    9. Unfinished

      As a thought experiment, let us assume no vaccines were available. Is it not obvious that mortality and illness would have been much more damaging?

      Perhaps not.

      “Neither of these models will be updated going forward. This is due to these models being unable to account for the interventions that would have been implemented in the absence of vaccination. Consequently, over time the state of the actual pandemic and the no-vaccination pandemic scenario have become increasingly less comparable. For further context surrounding this figure and for previous estimates, please see previous vaccine surveillance reports.”

    10. saywhat?

      Is there any doubt that vaccine resistance has killed more people than vaccine adverse reactions? HH

      Yes, there is since the report at 6 months on the Pfizer jab showed one more (15) deaths from all causes than the control group, 14 deaths from all causes.

      So there is room for doubt.

      I’ll be very interested in later reports, assuming Pfizer is required to publish them.

    11. Jeremy Grimm

      Look up the history of the first polio vaccines — then reconsider your question. Remember the history of thalidomide — then reconsider your question.

    12. Elizabeth Oram

      HH, I agree completely. Yes I would have preferred a protein subunit vaccine to an untested platform; those were not on offer for a number of reasons, many having to do with the power of Pharma. People are refusing vaccines because we have just astronomical levels of paranoia and distrust which is typical of societies that are broken and decomposing. People need to get vaccinated, period. These a-hole cops and FDNY and anyone else too stupid to save their own lives can go to hell and they should lose their jobs.

    13. Yves Smith Post author

      We already know that there is no correlation between vaccination levels and Covid cases. So overselling the vaccines has led to an abandonment of the multilayered approach necessary to ACTUALLY, not theoretically, reduce Covid contagion.

    14. GM

      Is there any doubt that vaccine resistance has killed more people than vaccine adverse reactions?

      The bigger issue is that the existence of vaccines will kill more people than vaccines will save directly.

      Because it gives the politicians the excuse to let it rip.

      Without vaccines the daily death toll becomes unacceptable and someone has to do something about it and contain the contagion. Which we know how to do, we just don’t want to.

      With vaccines it either becomes “tolerable” (even if it is nothing but; see the UK) or even if it does break hospitals (as happened in many states in the US in August and is still happening in various places), it can be ignored by blaming the “anti-vaxxers”.

      But in the long term it is the area under the curve that matters.

      It’s been ~550 days of this since the start, the US has recorded 2,300 DPM (deaths per million), so roughly 4 DPM/d. Excess deaths are 20% higher, so 5 DPM/d.

      At the absolute nationwide peak in January it was at ~15 DPM/d.

      Currently it is at around 5 DPM/d again. And we tolerate that, but we absolutely did not tolerate when NYC was at 100 DPM/d, and we did try our best to attempt to ignore the problem but in the end could not when various parts of the country were at 20-30 DPM/d last winter.

      The problem is that NYC was at 100 DPM/d for only a couple weeks (and ended up with 3,500 DPM after that first wave).

      But 5 DPM/d times 2 years, even with no major waves, just a steady constant stream of deaths in the background, gets you to the same point. And we intend to “live with this” indefinitely…

      But it won’t be without major waves, because the products of the selective pressure that vaccines exerted are just starting to pop out and the whole cycle will restart once again very soon.

      Which would have never happened if we had contained the virus.

      But we did not contain it because “we have vaccines”…

  12. Questa Nota

    Old economic theory: In the long run, we are all dead.

    New economic practice: In the short run, some of us are dead.

    The latter may be papered over with platitudes like ‘supply chain adjustment’ but doesn’t seem to cover those supplies of human interaction for the survivors. Too bad more professors and pundits really aren’t eating their own dog food. Empathy was also a supply chain victim.

  13. flora

    I’m starting to think the govt’s handling of the pandemic can not get this much this wrong this consistently without…effort. :-/

  14. Larry Y

    I know of some monoclonal antibodies for approved for COVID whose production has recently been off-shored to Korea.

    And as far as I can tell, there’s no real effort to support more robust domestic production of N95 and other PPE. Republicans either believe the pandemic is over or Trump’s “free markets” approach, and Democrats won’t fight donors and/or neoliberal “markets”.

    1. Shonde

      3M has plants around the world making N95’s. Maybe those world wide plants will be able to provide the extra production needed when the US plants face a reduction in work force from all the unvaccinated employees facing a December 8th deadline for vaccination or they are out.
      Since the 3M N95 is the gold standard for medical use, perhaps it might be good to stock up while they are still widely available or hospitals may once again be facing a shortage.

      Some 3M employees did a YouTube that a niece recently sent to me.

  15. mistah charley, ph.d.

    With respect to Catholic views on vaccines, and other medications, I came across this article from Church Life Journal, published at the University of Notre Dame, so it is likely to be accurate. I should mention that I am in a certain sense a quasi-Catholic or “fellow traveler” – my wife is a committed “cradle Catholic”, and I am committed to her, and I attend and participate – even to the extent of singing in the choir, until the pandemic – although with an unspoken “Unitarian attitude.”

    The article gives the position of the Congregation for the Doctrine of the Faith [two or three name changes ago it was The Inquisition] that “remote” and “passive material cooperation” is justifiable in the case of a global pandemic. To quote the authoritative judgment from the CDF directly:

    All vaccinations recognized as clinically safe and effective can be used in good conscience with the certain knowledge that the use of such vaccines does not constitute formal cooperation with the abortion from which the cells used in production of the vaccines derive.

    1. Gareth

      For completeness’ sake, let’s also include point five from the actual document:

      5. At the same time, practical reason makes evident that vaccination is not, as a rule, a moral obligation and that, therefore, it must be voluntary. In any case, from the ethical point of view, the morality of vaccination depends not only on the duty to protect one’s own health, but also on the duty to pursue the common good. In the absence of other means to stop or even prevent the epidemic, the common good may recommend vaccination, especially to protect the weakest and most exposed. Those who, however, for reasons of conscience, refuse vaccines produced with cell lines from aborted fetuses, must do their utmost to avoid, by other prophylactic means and appropriate behavior, becoming vehicles for the transmission of the infectious agent. In particular, they must avoid any risk to the health of those who cannot be vaccinated for medical or other reasons, and who are the most vulnerable.

  16. chris

    Related to this general topic, are the conveyances we use to get stuff from point A to point B in a processing facility or a building or a dedicated appliance. I’m talking about the least sexy part of any system – pipes.

    I do mechanical and plumbing system inspections on all kinds of systems. I work mainly in the mid-Atlantic states but I travel all over the country. I was one of the essential people still working in person and traveling to do my job at the start of the pandemic. There are lots of engineers who do what I do. We’re all starting to see weird failures. Elbows and tees cracking when they shouldn’t in ways that don’t make sense given the installation method and operating loads. We’re also seeing people substituting parts that were specified in a design for what is available when a repair is needed. Sometimes with bad results.

    We’re seeing people resort to parts suppliers who can’t meet a standard, so, you get cases where the wrong type of thread is mated up with a fitting. Sometimes it ruins the thread and the part needs to be thrown away. Sometimes people try to do something to fix a poor condition that makes it worse, like using a crimp gun to set a fitting when the gun is badly in need of calibration. Sometimes this behavior results in a bad leak because the threads weren’t capable of stopping water. Sometimes it means you get a leak path for fuel gas and that causes a fire or an explosion.

    And of course, there’s the problem of finding a qualified plumber or electrician or appliance tech to come out and service the problems that are being created. I’ve seen an increase in people turning their red tagged furnaces and water heaters back on because they can’t afford a new appliance, or can’t be without heat/hot water for the extended period of time.

    I’m also starting to see a spate of bizarre industrial accidents. Workers who are injured in ways that make no sense. I have no evidence to support this, but I’m left with the nagging feeling that people are starting to injure themselves intentionally on the job to get a payout. I hope I’m wrong about that.

    Anyway, the supply chain issues and problems we’ve been discussing on NC are very real and are impacting a lot of the infrastructure that makes our society work. Things weren’t great going into 2020. I am concerned that we’re going to see things get quite a bit worse as we progress into 2022.

    1. Eclair

      Chris, thank you for your enlightening comment. This is just one reason why NC is so great! People who actually DO stuff, critical stuff, stuff that no-one really pays attention to ….. until …. one day …. the system is no longer working …. comment and explain what they do and how it is such a critical piece of what we like to call ‘civilization.’

      In the years to come, I’m betting that people like you will be the ‘survivors.’ Wow, faced with the choice of you, who knows who pipes work (think about what pipes have been necessary for, in all the past centuries), and ten hedge fund managers …. uh, let me think for a second ….

    2. redleg

      I’m an engineering geologist that works on an assortment of environmental remediation and water supply projects.
      My well drillers have experienced a vast increase in the price of both steel and PVC well casing pipe. Not only that, but they are often unable to get pipe at all even at the ridiculous prices. As an example, for years (2006-2016) the estimate for a municipal water well in the MSP area was $350k which included the pump. I just completed an estimate that came to $800k, without a pump, and none of the drillers I talked to knew whether or not they could get the steel casing even at those prices.

      My construction contractors are suffering from similar issues of price and availability. PVC and HDPE (i.e. plastic) pipe costs are elevated, but we are looking at minimum 6+ month lead times to get the pipe. I can only recall one or two instances of delay for pipe over the last 25 years, and each were days long, not months. As I understand it, this is from the manufacturers, not related to transportation of finished pipe. Adding to that, this year concrete has been especially hard to acquire. There’s always been restrictions, each batch is different and it can’t be set aside for later LOL, but in 25 years I’ve never seen anything like this.

      Politically, this isn’t going to end well.

      1. Mantid

        Go pipe fitters! My father is 96 and was in the pipe fitter’s union for many many years. They treated him good over time and his pension is helping with his medical tremendously. He was in WWII and Korea as a Marine and has not had to tap into his VA medical in all these years. In any case, I teach music to K – 12 students and always stress to them – learn how to fix things (your sax, your bike, your tuba, sew buttons ……). There are lots of things to fix out there that won’t be properly done via AI controlled supply chains and drones sitting in cubicles writing code. A licensed plumber (electrical, drywall installer, carpenter) can garner a 6 digit wage.

      2. chris

        Agreed. It’s one of the things that makes me shake my head when people talk about converting a heating system to geothermal, as if that’s a trivial matter. And don’t get me started on all the complex equipment connected to the pipes we can’t get to fix the problems we didn’t want to admit existed until this year. Had any luck replacing compressors lately? Industrial scale pumps, compressors, variable frequency drives, all of them, are harder to get and harder to fix these days. Ditto for things like power boilers. And if you think finding a good plumber is tough, try replacing a quality boiler engineer or plant maintenance guru who doesn’t want to be vaccinated. Some of those people are essential because they have 20 years of experience on the equipment. You can’t outsource or replace that with a new hire at any wage.

        I’d be more comforted if the reason our pharmaceutical supplies are running low is because the stock is stuck in transit. Given the status of many industrial facilities I’ve been in the last year, plus the supply chain issues I’m seeing work out every day, I suspect a reason why we don’t see the inputs we need to make the drugs we rely on is the system to make those inputs is broken and waiting to be fixed. But the people who own the system either can’t fix it, or don’t have the people who know how to do it anymore.

    3. Jeremy Grimm

      Premiums are paid for high quality parts — parts tested and proven to spec ‘X’. The premiums and relative lack of oversight tempts suppliers to profit from selling less-than-the-best quality parts as high quality. Shortages only amplify the profits and lower the risks. The DoD [Department of Defense] has whinged for decades about the many counterfeit parts finding their way into DoD supply chains. From you comment I infer a similar problem — unsurprisingly — plagues commercial and industrial parts and components.

    4. HotFlash

      I’m talking about the least sexy part of any system – pipes.

      Ah, c’mon Chris — pipes are sexy!

  17. Mantid

    Such a good discussion this day. I’d love to comment on many aspects of this conversation but there are so many interesting points. One that is “interesting” but confused is from HH: “As a thought experiment, let us assume no vaccines were available. Is it not obvious that mortality and illness would have been much more damaging?” No, it is not obvious and in fact is just the inverse. See this (and other) studies. The title is …… No Significant Difference in Viral Load Between Vaccinated and Unvaccinated, Asymptomatic and Symptomatic Groups When Infected with SARS-CoV-2 Delta Variant (preprint) medRvix

    Ergo, Vaccinations make no difference weather one gets Covid or not.

    My main point however is that even Biden, Faucci, product suppliers, the PBMs. (middlemen between pharma and consumers) on down the line are mere pawns. The strings are pulled by “public/private partnerships”. An in-depth exposé on these, the true puppet masters, is in a recent article by Ian Davis out of Britain entitled: What is the “Global Public-Private Partnership”? It’s here:
    His article includes a very clear graphic flow chart wherein he shows the interconnectedness of large corporations, Bank of International Settlements (the bank of banks) and the largest policy makers such as World Economic Forum (Davos set). He shows how they pull the strings and their decisions filter all the way down through governments, MSM, the legal system, the various militaries down to the difficulty in finding 0xygen. With their coordination it’s easier to see how seemingly disparate groups can cut/paste the same text into their vaccine mandate guidelines such as their response to IM Doc’s patient’s request for a religious exemption. It’s a good read and a concept to keep in mind as you question what the Billy Heck is going on and how to respond to our difficulties.

      1. mistah charley, ph.d.

        With regard to that hardworking “ergo” – more specifically, the conclusion our poster draws about whether one becomes infected or not was NOT the question being addressed by the study cited, and the conclusion our poster here draws is contradicted by many other studies.

    1. John L

      That study you’re referencing is comparing viral load between infected vaccinated people and infected unvaccinated people.

      It doesn’t say that vaccines have no impact on whether one gets COVID, or whether it has no impact on rates of serious illness or death if you do have a breakthrough infection.

  18. LaRuse

    Wanted to comment on the loss of truckers. I know we’ve talked about the number of health care workers that died of COVID. Has anyone examined the numbers of death or disability for Long Haul Truckers?
    My dad was a long haul trucker from 1993 until August this year when he retired. In part due to age; he did turn 65 last winter. Part was health – the DOT has fairly rigorous rules regarding blood pressure and my dad always struggled to keep his below the 140/80 DOT cut-off (many truckers struggle with that). He became diabetic in recent years (sedentary life is not conducive to exercise, though he did try to golf when he could). Then came constant back pain from years of being beaten up by the highways.
    I would imagine that drivers with high blood pressure, diabetes, and a penchant for avoiding masks, who, as a job necessity, eat in restaurants every day throughout the pandemic were susceptible to serious risks from the virus.

    Drivers are typically older, too. Dad told me several years ago (long before the current crisis) there were fewer and fewer new drivers. Not too many people want to spend the 3-6 weeks at a time on the road he did for 30 years. There are dedicated routes that have drivers home every night or every other night, but it takes a really special breed to drive between the exact same Point A to Point B route every single day for 8 hours a day forever. It’s mind numbing on the same level I suspect any sort of assembly line work must be and just as dangerous.

    Even if the pay isn’t bad, the job is hard on the body AND the mind. My dad got a little more distant and extreme and weird over the years before finally my parents split after 33 years. Today, Dad is spouting off how the Chinese invented COVID to keep Americans out of Church to make us all Atheist and then the vaccines to poison us all (seriously, we had that conversation in early September). His undercurrent of racism and classist attitudes are now out wide in the open.

    Truckers trade conspiracy theories like baseball cards – in part to fight the serious boredom of driving 8-10 hours a day and in part because they see in living color some of the darkest and nastiest aspects of Late Stage American Capitalism. I have long wondered if the conspiracy theories are just a way of trying to justify or explain some of the hypocrisy and misery they experience on the job. If someone did a poll on the least vaxxed job grouping, I would bet truckers would be at or near the top. My dad is very proud of the fact that he has never worn a mask in the past 18 months. Not for work, not for church, not for delivering to a customer, and sure as heck not to see me or my family. He would flat out rather die than take the vaxx. And I suspect, from my experience being on the roads with him as a teenager and interacting with other truckers and associates of my dad, my dad’s perspective is highly representative of OTR/Long Haul truckers as a whole. If any of the big firms are requiring their drivers to get vaxxed, I guarantee those companies are hemorrhaging drivers.

  19. doug

    ‘After consulting with their priest, I have sent the HR people in both companies the following letter –’
    I hope one day to have .00001 of the patience that you exhibit.

  20. chris

    Here’s one example of what we’re talking about, for air compressors.

    From the CH Reed supplier update: “Due to the COVID-19 pandemic, we are amid a global supply chain shortage of air compressor parts. This means that the parts required to service our customer’s air compressors will continue to get backordered, delaying planned maintenance appointments and raising the cost of items. This issue is not going away anytime soon. In fact, it is only going to get worse before it gets better.”

    For those of you who have never been in an industrial facility before, you need these compressors to have functioning pneumatic systems. You need them to provide you with instrument air at facilities to work gages and even perform tasks like putting bottle caps on. It’s a big deal if your system at a plant stops functioning.

    1. Greg S

      This is not going to end well. If we can not keep even straightforward systems like air compressors running, what is going to happen to the more complex systems that are part of our daily lives?

      1. flora

        This cluster f*ck puts the lie to the neoliberal high priests’ (long con) fast talk about “the Market is the greatest information processor in the history of the world. Defer to the Market forces.”

        right…. emperor, clothes, etc.

      1. chris

        Yes and no.

        In some cases, there is not enough to hoard. Also, hoarding requires cash upfront at inflated prices and a place to store the purchased materials. JIT philosophy has caused a lot of people to downsize their company warehousing to rely on local supply centers instead.

        But if you can hoard? And there’s incentive in the form of passing those costs on to clients who have no choice? Oh yeah. People are doing that if they can.

  21. Marie

    I’ll add in my observations about what has been happening in my neck of the woods.
    I’m an ER Doctor in a community hospital in Canada.
    In the past month we’ve had shortages or outright disappearances of the following equipment:
    Knee Braces
    Plaster Slabs
    The paper sheets we line beds with for hygienic reasons (completely disappeared on my last shift)
    We are also hemorrhaging nurses. I used to know all the faces in my department, and most of the names, and could accommodate and get to know a new face. Now when I walk into work I don’t recognize half the nurses I’m working with – the new folks are a mix of agency (temp) nurses and new grads. This has lead to more medical errors, as it’s difficult for our department to integrate THIS many new folks at once. Also even with their help (and don’t get me wrong, I’m VERY grateful they are here), we are still routinely short 5-6 nurses per shift. The attrition seems to be due to a mix of early retirements, burnout and transfer to other departments, and firings due to the vaccine mandate.
    We are also getting slammed due to increased patient volumes – a percentage of family doctors in the community are still not seeing their patients in person, and not all patients are okay with totally virtual care or they are being sent in by their MDs who think the patient needs a physical exam but won’t do it themselves.
    My question is – what is truly worse: having a nurse who *may* be at increased risk of transmitting Covid because they are unvaccinated, or having no nurse at all?

    1. IM Doc

      Myself and my partner make no bones about seeing any patient that comes in the door. I do virtual visits only if the patient requests it.

      There are a couple docs in my community who just will not see people in person. You cannot even imagine the number of transfers that my partner and I have had.

      The problem though is that eventually the brick wall is hit – you just simply cannot keep it up.

      There is a massive shortage of PCPs in this country. And I suppose in Canada too. There is this big huge push to get nurse practitioners to fill the void. Hysterically, the NPs too avoid primary care like the plague and most of them end up in oncology, ortho, GI or cardiology or general surgery.

      The PCP crisis we have been working on for decades that this pandemic has brought to the forefront has just now started to seriously implode.

      And do not get me started on ER docs. God bless em. Just months ago – the venture capitalist firms in the USA that own the group ER practices were laying off the docs right and left. Everyone in America should remember this fact when they go to an ER and take in the just unbelievable chaos. I hope your lot in life in Canada is much better.

  22. Hungry hungry harry

    >I will be voting a straight GOP ticket until the bad apples are rooted out

    lol that’ll show em

  23. Anthony K Wikrent

    Yves comments in her introduction: “…(no one knows for sure because the US does not believe in having the government know anything).”

    I witnessed government statistics being killed off by Reagan. I wrote this as a comment on EuroTrib in 2008:

    Back in the late 1980s early 1990s, when I was a (poorly) paid economics correspondent (one of the first to write about the dangers of derivatives, by the way), I was a constant and regular user of government statistics, and also statistics from the various industry trade associations in the U.S. This is a brief summary of what I learned about government statistics and statistics keeping back then.
    The U.S. Department of Commerce and its Bureau of the Census used to do a fair job tracking the real economy back in the 1950s through 1980s, until Reagan took office and the first wave of privatization was begun. Economic statistics, at that time, were much more than just the Gross Domestic Product. You used to be able to get what were called Current Industrial Reports for such things as Inventories of Steel Producing Mills, Iron and Steel Castings, Knit Fabric Production, and so on. All these Current Industrial Reports were quarterly, and many of the important indicators of basic economic activity, such as cement production, or iron and steel production, were monthly. Most of these Current Industrial Reports have been discontinued, including the first three I mentioned. . Just go through this list and see how many Current Industrial Reports have been discontinued – and for which industries.

    Why is this important? Because the best econometric models of the time used hundreds of inputs such as these to track the economy. These econometric models are probably the best that have ever been developed, but now they probably don’t function very well, because the raw statistics are simply no longer available. So now the Bush administration can claim that GDP grew by 3.8 percent, and that inflation was a feeble three percent or so, and who can gainsay the numbers? The numbers are no longer available – unless you’re willing to pay the private firms and the trade associations that have taken over. Today — and I’ve been looking the past few months, since it seems I’m about the only moron on the planet who has some ideas about these things AND is willing to share it on the blogosphere without any remuneration whatsoever — you can still get most of the trade association reports, but they are all several hundred dollars.

    The Commerce Dept. used to put out an annual tome called The U.S. Industrial Outlook. The contents were pretty much broken down along the lines of the list of Current Industrial Reports I linked to above. Each separate chapter pulled together all the statistics for that particular industry, provided a summary of the past years’ developments in that industry, and listed the sources of information for that industry, including the address and phone number of the Commerce Dept. specialist that wrote that chapter. I used to call those specialists for my economics news articles, and they were founts of information. They were national treasures. And they were all being slowly removed through attrition. The first time I really became aware of the insidiousness of the Reagan assault was when I called the specialist on power generating equipment – the turbines and boilers and pressure vessels that go into electric power generating plants. After getting the industry information I needed for an article, he mentioned he would be retiring at the end of the year. Assuming that he had been given an assistant that he was training to replace him, I asked for the name. There was no name. There was no assistant. There would be no replacement. When this specialist retired, the U.S. government – our government, your and my government – would no longer be following what happened in the power generating equipment industry.

    Think about that for a minute. Have you experienced brown-outs or black outs the past few years? Well, our government has not kept tabs on the one industry vital to rebuilding the electric power generating industry for the past twenty plus years. How can intelligent policy be made if the government is not keeping track of such a vital industry? Well, duhhhh… And this is just ONE example of dozens.

    This dearth of real economic statistics helped facilitate the transformation of the U.S. economy from industrial capitalism to financial capitalism. How could anyone protest the wrecking of the manufacturing economy, if essential facts and statistics were no longer freely available to the public?
    These trends were not reversed nor even slowed down by the Clinton administration.

    At the time I was writing, there was a very careful, deliberate debate going on within the U.S. Labor Department about the labor statistics. There are two sets, one based on surveys of work places, and the other based on surveys of households. I dimly recall that the latter has a sample universe of around 60,000. It was recognized that there were serious shortcomings with the surveys, and with the models used to transform the survey results into accurate and trust worthy snapshots of the entire national labor force. My assessment is that at the time, the people involved were very concerned and dedicated to getting the best data, models, and analysis possible. But, they were slowly but surely leaving, and without being replaced. And that was 15 years ago and more.

    By the way, there is something out there that appears to be the successor to the U.S. Industrial Outlook. I think it’s called the U.S. Trade Outlook. It is compiled, published, and distributed by a private company, and costs, if I recall (I was looking at it – or the ads, actually – online about six months ago) $285 or some other amount that scares me off.

    About the only thing left in the U.S. now that I think is worth looking at (unless you have a few thousand dollars to buy all the private reports) is the annual industry assessments done by the U.S. Industrial College of the Armed Forces. These are online available one year after publication here:

    One other thing I would like to note. The U.S. government used to have all sorts of documents and studies on various manufacturing industries. I remember getting one on gear cutting and making. They were excellent. A lot of these came from the Office of Technology Assessment, which was abolished during Clinton’s tenure. There also used to be lots of private studies and assessments of various manufacturing industries available from trade associations, and a host of companies. From what I’ve seen that past year or so looking for them, they no longer exist. But the really interesting thing to note is that there are now a lot of them available for various manufacturing industries in India.

    Many of these statistics were gathered in an annual US government publication, The Statistical Abstract of the United States, which has been a vital compilation of data since 1878. If an informed citizenry is a bulwark of democracy, then what does it say when one of the most important and unique sources of all types of information about our country is shut down? If you have not ever turned to a Statistical Abstract for information, I can honestly say you don’t know what you’ve been missing. It is an extremely useful and important source for statistical information on voting, government budgets, agricultural and industrial production, summaries of census data, transportation systems and trends, energy production, distribution and consumption, the armed forces, and much, much more. But under Obama, the USA government ceased publishing The Statistical Abstract. As someone asked at the time, “If information is power, what is lack of information?”

    1. vao

      The links you include in your (disheartening) report go nowhere: “Sorry, the page you requested has either been moved or is no longer available on this server.” and “Error 404 – page not found” respectively…

    2. Jeremy Grimm

      The data you described is suggestive of the input-output model for the u.s. economy. I cannot vouch for the quality or coverage of data available — the input-output model appears to be available: Bureau of Economic Analysis, Depart of Commerce: Some of the other data you once relied on may be available there also, although probably in a different form.

      But be that as it may, I agree with the main thrust of your comment. The quality of data such as the unemployment numbers and GDP numbers have become political objects, their definitions and accounting methods adjusted to fit government happy talk. I suspect similar political intentions explain why no one knows for sure how many generics and drug ingredients originate from China and India. I am not sure I agree with the actor Yves suggests in her observation “…the US does not believe in having the government know anything….” Although I am not sure what actor or actors to suggest in place of ‘the US’ — I feel, believe, and hope the Populace does not favor government ignorance. I suppose that raises the question whether the u.s. Populace is part of the ‘the US’.

  24. Iseeyoudock

    To grimms point, there are technical aspects to the epidemiology around this which escape many peoples attention.

    1) the vaccines are keyed to the original strain.
    2) the mutations have altered the threshold at which neutralizing IgG will stop disease negatively.
    3) it is eight fold worse for delta
    4) the temporal benefit of vaccine protection has shortened by result
    5) there are no commercially available vaccines which are keyed to delta

    They were and still are oversold.

    There is no long term safety data

    It is likely that they will continue to loose efficacy given the selection pressure on them within the vaccinated population

  25. Helena

    I have not been to my doctor since Spring of 2018. I never get sick, and I have decided to forego my pap and mammogram until next year, since I have never had a questionable result. He did a phone consultation with me in June about taking the vaccine, and although he said he was perfectly confident about them, he assured me I could use my own judgment relating to my own chronic spasticity and arthritis. He knows I live alone and don’t travel and do mask. I know he is aware of all the BS surrounding corporate medicine these days. I do appreciate you, IM Doc, and my own doctor for carrying on so courageously in these ridiculous times.

  26. Iseeyoudock

    We may need to rely solely, eventually upon old cordon sannitaire type measures if we are to bring this awful thing to heel.

    The waning effectiveness of vaccines and lack of effective therapeutics for mid and late stage disease are unfortunate realities.

    TB was controlled with isolation, quarantine, the use of sanitariums and eventually nearly entirely defeated with isoniazid, parazinimide, ethambutol and other therapeutics before a resurgence coincident with population fluxes more recently. MDR TB or SMDR TB are very bad actors.

    The mechanism of transmission is quite similar between the two diseases with aerosol being primary, and a somewhat similar R0.

    The proxy to that draconian method is adequate PPE.

    A cloth mask may have some effect at reducing the environment innoculum, but does little to provide effective barrier protection for an individual, given the pore size/viron disparity, especially in closed environments over a longer time period. Leaks around mask margins also contribute to the lower efficacy.

    N-95s work if they are well fit. P-100’s better. You must have eye protection.

    How about a two week vacation for all except super essential workers; suit them up like space men and really hammer the lid shut. Everyone else stays home.

    Effective barrier defense. Cordon sannitaire by proxy is both a complimentary or primary method that could work.

    Half measures currently in use are much less effective for true truncation.

  27. Valerie

    Anecdotally, we have a friend in Britain. Reading, as we have, of the combined Brexit/pandemic/supply chain issues, we asked her if we could send her anything from the States. She said normally she wouldn’t ask, but she has digestive issues and her local stores have been out of her usual OTC remedies and when she has seen them they were ridiculously -priced- the equivalent of $23 dollars for a bottle of Tums or nearly $60 for a small bottle of Pepcid. A cursory check of Amazon UK confirmed this. We bought three months worth of what she was looking for at Walmart in our small town for around $20 and spent about as much to mail it to her, but she was thrilled. Hopefully that’s enough to tide her over until the situation improves. We, ourselves, have had difficulties finding some of our medicine cabinet standards throughout the pandemic, but they eventually turned up or we found them in the next town over. What craziness.

    Still having odd shortages here though. This week – canned fruit and large puppy pads. Last week- evaporated milk ,canned corn and country ham. I used to keep at least two weeks of food and supplies in the house as a matter of course. A good ice storm has been known to shut everything down for ten days sometimes. Now I keep a month’s worth at least. My pantry looks like a country store.

  28. peon

    Does anyone know why the Novovax vaccine is being held up? It being a more traditional vaccine tech and with fewer side effects you would think the vaccine advocates would be clamoring for it. It would probably move some vaccine hesitant people to vaccinate.

  29. VietnamVet

    This post and comments are why NC is so great.

    The fatal defect of neoliberalism is its failure to admit to mistakes. It is a cult that must hide its true nature since the goal is the transfer of all of the wealth from the working classes to the oligarchy.

    There are no alternatives because mRNA “vaccines” make money, not cost money like the public health alternatives. Yes, they are treatments that reduce severe infection around 60% but nothing else. The mRNA injections have no effect on transmission, and the effectiveness wanes away after six months and requires repeated booster shots that do have side effects. This pandemic is ultimately worse than Spanish flu outbreak since basic public health science is being ignored when humans should know better. If not addressed, coronavirus pandemic collateral damage threatens western civilization itself.

    The working class is of no concern to the global jet-set. Gasoline, shipping container, and Liquid Nitrogen/Oxygen shortages are directly due to the lack of truckers. Instead, Mayor Pete, Transportation Secretary, is on family leave not addressing the essential shortages. The corporate/state refuses to admit that there is a problem. Good workers are being fired by enforcing a pointless unscientific mRNA jab mandate. The economy is suffering structural failures. Instead, President Joe Biden blames the unvaccinated not himself — not the current political/economic system. Energy and food supply are national security issues. If not addressed, the nation collapses.

    1. Mikel

      Following the money also leads to an additional reason:
      As long as there is an emergency, the central bank money flows and hides a host of issues that even before Covid were brewing in the global economy.
      All the problems you mentioned and the stock market is still at/near all time highs.
      It’s like a measure of misery now.

  30. Eustachedesaintpierre

    DHL now charging around 4 times for air freight, as I discovered on Friday in relation to a package I sent to the US. A guy I had done a commission for a couple of years ago asked me to pick up a bronze sculpture for him, pack it up & send it on to Colorado after checking the piece over. He was OK with the price of £ 839.00 after I horrified checked with him, but the package was roughly the same weight ( 15kg ) & size as the previous one which cost £ 230.00 about 2 years ago. DHL told me that they had been forced to buy 3 new planes due to demand which has risen exponentially due to the problems with sea freight.

    I don’t know whether this effects medicines but it will if it continues likely make it harder for small business in particular to export products as the rising cost would likely result in their products becoming too expensive – the UK also imports 90% of it’s drugs.

    As for the Lab leak I have no idea what the truth is but on the other hand I have no trust in the people who would be involved which makes me suspicious of their motives. It’s not helped by the fact that a while back 27 scientists published in the Lancet a statement that there was most definitely no lab leak. The Telegraph did an investigation into the statement & found that 26 of these people had ties with the Wuhan Institute that they did not declare. Perhaps they were just protecting part of their livelihoods, but why lie ? which does not to my my mind inspire much in the way of confidence.

  31. juneau

    Anecdotal observation: Local big chain pharmacies (suburban NY) aren’t filling prescriptions when the orders are sent in-they wait for the patient to call, and often can’t find the prescription until the doctor calls to verify it. This delays filling of scripts and limits it to patients who know how to get them filled. I wonder if this is a supply chain issue as well. Pharmacies report that it is a longstanding computer system problem which sounds odd to me.

  32. Dave in Austin

    Comments on IM Doc’s original post about shortages have gone far afield, so this will be mixed in with comments about the Catholic church and previous administrations, which is unfortunate.

    But on industrial gasses I can say the following:

    The business of production is highly concentrated because of plant scale. Designing, financing and building new plants takes many years and the fixed costs are so high companies are rightly conservative.

    Linde, AirGas and Air Liquide produce most of industrial gas used in the US. In 2018 Linde combined with the US company Praxair to make the largest producer. To limit the hit to competition caused by going from 4 majors to 3, the FTC forced Linde to divest most of its O an N plants, which had the unintended consequence of temporarily disrupting investment. Then Covid hit and slowed industrial production and apparently the production of new transport tanks. Projections were for the business to grow by 5%/year through 2025, and that didn’t count the bump caused by increased O use in hospitals.

    So a shortage is not unexpected. What is unexpected to me at least is that the monitoring of supply and demand of such important industrial and military commodities by the Defense Department and the Commerce Department is either very weak or the chain of information to decision makers is not working properly, because to the degree that this is an allocation and transport problem the government has the ability to encourage and jawbone the producers, the transporters and the end users to see that critical supplies get where they are needed.

    If there are any NC readers with inside insight into how and why the government response has been so inadequate, I’d encourage them to chime-in.

  33. PressGaneyMustDie

    A lot of pharmacies don’t fill faxed or electronic prescriptions and wait for the whites of the patient’s eyes because many people don’t pick up.

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