Friday, March 27, 2020

Wrong Diagnosis = Wrong Cure... it's not COVID-19



I’m writing this from the vantage point of the U.S. medical services industry (please note, I’m not falling for the “healthcare” BS).  I’m sick and tired of the constant drumbeat of sob stories about ventilators, gowns, and facemasks.  Too few hospital beds.  Scarcity running amok!

Now mind you, I’m by no means suggesting that hardworking doctors, nurses, EMTs, and staff within the medical field are in fact facing disproportionate burdens courtesy of SARS-CoV-2 (COVID-19) and that some of these burdens include equipment shortfalls. 

But this is not because of a virus.  This is part of a complex medical supply industry problem that seeks to maximize billable dollars (and, as a result, profits) while failing to consider preparation for health crises.  Medical professionals are suffering from an industrial model that seeks to supply high margin products for maximum profit – not for health of patient or staff.  This is made worse by the reality that, in the U.S., nearly 1/3 of all expenditures are directed to hospitals[1] – the very location least equipped to respond to large scale infections.

In one of the few moments that I agree with President Donald Trump, he’s absolutely correct in calling for restraint on Governor Andrew Cuomo’s insistence on needing “30,000” ventilators.  Governors Cuomo and California’s Gavin Newsome have both blindly led the country in recklessly relying upon (and then failing to adjust to the retraction of) UK’s Imperial College Professor Neil Ferguson’s 2006 influenza model published in Nature[2] which set in motion panic-inducing estimates of morbidity and mortality that were baseless.  None of the assumptions on Ferguson’s model have been validated in any transmissible disease and have been categorically disproven in his computer simulation of Pandemic.

There are too many points for me to make in this post but I want to make two.

First, if you’re serious about the plight of the medical staff, stop blaming the virus for material shortages.  With price gouging collusion between suppliers, hospitals, and, most egregiously health insurance companies, there are insufficient supplies in this moment.  MBAs from America’s leading institutions advocate for just-in-time manufacturing, logistics, procurement, and use.  Guess what!  THEY GOT IT WRONG.  Just-in-time got wobbly when Chinese factories shut down in January but none of them got the hint that maybe, a national stockpile of masks, gowns, and gloves would be prudent. 

Motley Fool published a summary of the top health insurance companies in 2019[3] – remember, before the “crisis”.  These charities racked up $454 billion with a ‘medical cost ratio’ of 84%.  And hospitals – you know, the ones who can’t buy masks and gloves – they have seen their profits soar over 27% since 2013.  When you hear about failures to have beds, ventilators, masks, and gowns, ask yourself if any of HCA’s record-breaking revenue could have been directed to preparedness.

In America, we’ve built a system where we have placed inordinate reliance on hospitals as points of care and, while ludicrously profitable with health insurance and medical supply industry collusion, our short term, just-in-time business models have enriched investors and bitten us in our collective respiratory tracts (in this case).

At no point will you hear Governors nor the President point out that it was the business model of medical service delivery – not the virus – that rendered us impotent with the patient onslaught.  And if public officials and medical professionals had thoughtfully critiqued the bullshit science of Imperial College, they wouldn’t have had the run on hospitals that – are you ready for this – overrun hospitals!!!  I’ll tell you I told you so down the road but, here goes… We won’t fix our broken for-profit medical cabal in the wake of SARS-CoV-2 – we’ll make it less effective… and more profitable to the speculators who prey on a populace that stays indoors, eats crap, and goes to the ER when their diseases alarm.

Second, watch out for this…

In a few weeks, we’ll start slapping ourselves on our collective backs with the ridiculous narrative that “social distancing” worked.  It didn’t.  The pandemic model was wrong.  It was wrong when it was promoted, the interventions were draconian and ill informed, the economic devastation is lasting, and we’ll be told that we suffered for the common good. 

Like every other forecast apocalypse, we are using simplistic models of complexity to identify problems, and then, when the sky doesn’t fall, we take credit for that which had nothing to do with our reflexive behavior.

I’ve been an outspoken critic of predictive mathematical modeling for my entire professional life.  It’s flawed in its teaching, implementation, and interpretation.  Tragically, we’ve associated math with intelligence but I heartily commend your reading of my diatribes on the eugenics-inspired “intelligence” obsession that we have in our society.[4]  Suffice it to say that we use numbers – large or precise (and in some cases both) – to bamboozle the public into thinking that someone checked.  Tragically, no one did.  We’re not near an apex of disease – we’re just getting more people tested.  New York’s 23,000 hospital beds are not laden with COVID-19.  In fact, less than 10% are currently conscripted to the coronavirus.  And while there’s no question that this SARS outbreak has tragically cost the lives and livelihoods of many, the thousands of mortalities have not equivalently mattered when it’s other all-cause mortalities at stake.  But what we’ve done as a society to destroy livelihoods of the present workforce and the unaccounted disruption to the education of generation is incalculable.

We’ve just trained a billion school-aged children that fear justifies panic which results in social distancing.  Do you really think a generation addicted to iPhones, SnapChat, and TikTok needed to learn that lesson more?  In a world where our most complex challenges require natural intelligence – the capacity to discern reality and adapt within it – we’ve relied on eugenics artificial intelligence which seeks to simplify complexity into binary code. 

This won’t be the last time politicians and their patrons decide to pull this stunt.  This may be the last time that it occurs without them also disrupting the electronic communications grid which will simply reify our acquiescence to their power… unless we choose a different path.


[1] Andrea M. Sisko and others, “National Health Expenditure Projections, 2018–27: Economic and Demographic Trends Drive Spending and Enrollment Growth,” Health Affairs 38 (3) (2019).


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Thank you for your comment. I look forward to considering this in the expanding dialogue. Dave