dailysignal--2020-06-15--Reopening of California Justified by Lower Total of COVID-19 Deaths

In the nearly three and a half months since California Gov .
Gavin Newsom declared a state of emergency March 4 , state and county officials have imposed severe lockdowns throughout the state in response to the coronavirus pandemic .
Newsom ’ s declaration gave essentially unlimited powers to health officers , at both the state level and the county level , to control the virus .
Those unprecedented public health powers have been used for the first time in American history to require Californians to stay at home and to completely shut down schools and businesses .
Those orders @ @ @ @ @ @ @ throughout the state .
> > > What ’ s the best way for America to reopen and return to business ?
The National Coronavirus Recovery Commission , a project of The Heritage Foundation , assembled America ’ s top thinkers to figure that out .
So far , it has made more than 260 recommendations .
Learn more here .
On April 12 , Dr. Jeffrey Klausner and I made the case that California ’ s coronavirus policy must be based on all relevant data and must be publicly justified .
On @ @ @ @ @ @ @ that coronavirus policy must consider total mortality as a way of determining its overall health impact .
The March 18 designation of the World Health Organization ’ s International Classification of Diseases ( ICD-10 ) diagnosis code for COVID-19 , U07.1 , has led to inconsistencies in assigning the underlying cause for deaths related to COVID-19 .
However , it has been very difficult to obtain the justification for the lockdowns and recent mortality data .
The California Health and Human Services Agency initially rejected two detailed May 13 Public Records Act requests @ @ @ @ @ @ @ agency produced some relevant documents , including monthly California deaths from 2015 to 2020 .
To properly assess the mortality risk associated with the coronavirus pandemic , it is necessary to examine deaths and death rates from all causes , not just deaths and death rates from COVID-19 .
Weekly COVID-19 and total death data during 2020 is available from the Centers for Disease Control ’ s National Center for Health Statistics .
During January-May 2020 , the CDC and Department of Health and Human Services show about 120,000 total deaths in California @ @ @ @ @ @ @ during January-May 2018 .
Thus , the 2020 total death rates in California can be approximated by the 2018 total death rates , which are in the CDC ’ s WONDER database .
I focus here on those under 65 years of age because they include students and most working-age people , and because COVID-19 deaths comprise only 3 % of the total deaths in this age range during 2020 .
For each of the following geographically defined groups , the approximate annual age-adjusted total death rate for persons ages 0-64 years , @ @ @ @ @ @ @ : Santa Clara County may have the lowest death rate of any sizable U.S. county .
Los Angeles County also has a low death rate .
The low death rate among California Hispanics is consistent with the phenomenon that Hispanics have lower than average total death rates , known as the “ Hispanic Paradox.
” California has a death rate that ’ s lower than the rates in all the other states and far lower than the rates in eight Southern states that are well into reopening .
These low California total death @ @ @ @ @ @ @ healthiness of Californians , a phenomenon that has existed for many years .
This healthiness may be contributing to the fact that the California COVID-19 death rate is only one-third of the U.S. COVID-19 death rate .
In addition , the CDC ’ s “ current best estimate ” is a 0.40 % fatality rate among symptomatic coronavirus cases , which is roughly equivalent to a 0.26 % fatality rate among all infected cases and a 0.10 % fatality rate among infected cases outside of nursing homes .
These infection fatality rates are @ @ @ @ @ @ @ fatality rate for the seasonal flu .
California is a low-risk state for both COVID-19 deaths and total deaths .
The 85 % of Californians who are under 65 years of age are at very low risk for COVID-19 , and those without underlying health conditions have essentially no risk .
These Californians must be allowed to return to school , work , and normal activities as soon as possible .
A return to normal can certainly be done in a way that minimizes coronavirus risk , restores economic activity , minimizes social @ @ @ @ @ @ @ Older Californians and those at high risk for COVID-19 can continue to be sheltered and monitored .
My colleagues , Klausner and Dr. Rajiv Bhatia , have made a compelling case for ending the March 3 emergency order , and most of California is now in various stages of reopening .
Indeed , even Los Angeles County is on its way to reopening .
The very strict May 13 “ Safer at Home Order , ” which was originally projected to last into August , has already been modified several times .
It @ @ @ @ @ @ @ 11 “ Safer at Work Order.
” However , Santa Clara County continues to enforce a very strict June 5 “ Shelter in Place Order.
” California can best deal with the coronavirus pandemic by basing its public health orders on a balanced and transparent assessment of all the relevant health , economic , and social evidence , including accepting input from all qualified experts in California .

In the nearly three and a half months since California Gov. Gavin Newsom declared a state of emergency March 4, state and county officials have imposed severe lockdowns throughout the state in response to the coronavirus pandemic.
Newsom’s declaration gave essentially unlimited powers to health officers, at both the state level and the county level, to control the virus. Those unprecedented public health powers have been used for the first time in American history to require Californians to stay at home and to completely shut down schools and businesses.
Those orders have had devastating economic and social consequences throughout the state.
>>> What’s the best way for America to reopen and return to business? The National Coronavirus Recovery Commission, a project of The Heritage Foundation, assembled America’s top thinkers to figure that out. So far, it has made more than 260 recommendations. Learn more here.
On April 12, Dr. Jeffrey Klausner and I made the case that California’s coronavirus policy must be based on all relevant data and must be publicly justified. On April 23, I made the case that coronavirus policy must consider total mortality as a way of determining its overall health impact.
The March 18 designation of the World Health Organization’s International Classification of Diseases (ICD-10) diagnosis code for COVID-19, U07.1, has led to inconsistencies in assigning the underlying cause for deaths related to COVID-19. However, it has been very difficult to obtain the justification for the lockdowns and recent mortality data.
The California Health and Human Services Agency initially rejected two detailed May 13 Public Records Act requests, but on June 11, the agency produced some relevant documents, including monthly California deaths from 2015 to 2020.
To properly assess the mortality risk associated with the coronavirus pandemic, it is necessary to examine deaths and death rates from all causes, not just deaths and death rates from COVID-19.
Weekly COVID-19 and total death data during 2020 is available from the Centers for Disease Control’s National Center for Health Statistics. During January-May 2020, the CDC and Department of Health and Human Services show about 120,000 total deaths in California, which is similar to the number during January-May 2018.
Thus, the 2020 total death rates in California can be approximated by the 2018 total death rates, which are in the CDC’s WONDER database. I focus here on those under 65 years of age because they include students and most working-age people, and because COVID-19 deaths comprise only 3% of the total deaths in this age range during 2020.
For each of the following geographically defined groups, the approximate annual age-adjusted total death rate for persons ages 0-64 years, in deaths per thousand persons, is:
Santa Clara County 1.17
California Hispanics 1.58
Los Angeles County 1.70
California (lowest state rate) 1.76
United States (average) 2.30
Eight Southern states 3.10 to 3.65
Santa Clara County may have the lowest death rate of any sizable U.S. county. Los Angeles County also has a low death rate.
The low death rate among California Hispanics is consistent with the phenomenon that Hispanics have lower than average total death rates, known as the “Hispanic Paradox.” California has a death rate that’s lower than the rates in all the other states and far lower than the rates in eight Southern states that are well into reopening.
These low California total death rates are a reflection of the overall healthiness of Californians, a phenomenon that has existed for many years. This healthiness may be contributing to the fact that the California COVID-19 death rate is only one-third of the U.S. COVID-19 death rate.
In addition, the CDC’s “current best estimate” is a 0.40% fatality rate among symptomatic coronavirus cases, which is roughly equivalent to a 0.26% fatality rate among all infected cases and a 0.10% fatality rate among infected cases outside of nursing homes.
These infection fatality rates are remarkably low and are similar to the fatality rate for the seasonal flu.
California is a low-risk state for both COVID-19 deaths and total deaths. The 85% of Californians who are under 65 years of age are at very low risk for COVID-19, and those without underlying health conditions have essentially no risk.
These Californians must be allowed to return to school, work, and normal activities as soon as possible. A return to normal can certainly be done in a way that minimizes coronavirus risk, restores economic activity, minimizes social disruption, and restores constitutional rights.
Older Californians and those at high risk for COVID-19 can continue to be sheltered and monitored.
My colleagues, Klausner and Dr. Rajiv Bhatia, have made a compelling case for ending the March 3 emergency order, and most of California is now in various stages of reopening. Indeed, even Los Angeles County is on its way to reopening.
The very strict May 13 “Safer at Home Order,” which was originally projected to last into August, has already been modified several times. It’s now replaced with the June 11 “Safer at Work Order.” However, Santa Clara County continues to enforce a very strict June 5 “Shelter in Place Order.”
California can best deal with the coronavirus pandemic by basing its public health orders on a balanced and transparent assessment of all the relevant health, economic, and social evidence, including accepting input from all qualified experts in California.


dailysignal--2020-06-11--Common Sense on COVID-19 Beats Second-Guessing Every Time

While combating the COVID-19 pandemic , federal and state officials must rely on the best available scientific data , including updated clinical information on the course of this mysterious disease and reliable epidemiological estimates .
Prominent epidemiological models , such as those of the Imperial College in Britain and the University of Washington , have been seriously flawed in predicting millions of deaths .
Sound policy planning based on a reliance on such models is difficult .
> > > What ’ s the best way for America to reopen and return to business ?
The National Coronavirus Recovery Commission @ @ @ @ @ @ @ , assembled America ’ s top thinkers to figure that out .
So far , it has made more than 260 recommendations .
Learn more here .
Statistical projections into the past— “ what might have happened if ” —bear scrutiny , even if developed by top-flight researchers at prestigious institutions .
A case in point is the finding of Columbia University researchers that the lives of 35,927 Americans could have been saved if public health authorities had imposed “ social distancing ” restrictions just one week earlier than they did .
That @ @ @ @ @ @ @ disease transmission data over the period March 15 to May 3 .
It should be noted that the Columbia study , though widely reported in the media , has not been peer-reviewed—the “ gold standard ” for academic acceptance in professional journals .
Like all professional analysts , the Columbia team also readily acknowledges the limitations of the study : In the case of the Columbia University study , let us assume that the methodology is rigorous and the math is correct , and that its number—35,927 deaths—is also correct .
Let us @ @ @ @ @ @ @ ” the curve of infection .
But here ’ s the key question : Did this mitigation policy of “ flattening the curve ” prevent SARS-CoV-2 infections and the corresponding cohort of deaths ?
Or did it simply postpone them ?
Going forward , determining how many COVID-19 patients ’ lives could be spared and how many deaths would simply be postponed depends on at least three things : ( a ) the development and effectiveness of a vaccine ; ( b ) the development and effectiveness of therapeutic measures ; and ( @ @ @ @ @ @ @ the disease .
Before politicians seize on the Columbia study to resume the unprecedented lockdowns of social and economic life , they should consult a broader range of empirical evidence .
For example , Heritage Foundation analysts conducted an exhaustive analysis of the data and found that 92 % of America ’ s coronavirus deaths occurred among persons 55 years of age and older ( with 80 % of them over the age of 65 ) , and almost 90 % of the deceased suffered from one or more comorbidities , such as @ @ @ @ @ @ @ In the Columbia analysis , researchers focused on six metropolitan areas , including “ hot spots ” New York and New Orleans .
Heritage analysts also show that the mortality is geographically concentrated , with New York and New Jersey accounting for 44 % of all COVID-10 deaths .
Not surprisingly , nursing home residents account for an estimated 42 % of all COVID-19 mortality .
That ’ s a clear failure of public health policy .
Even assuming the absence of an additional week of “ social distancing , ” as estimated @ @ @ @ @ @ @ of other factors also contributed to this pandemic ’ s mortality .
Just to name a few : communist China ’ s lack of transparency on the nature and spread of the disease during its crucial initial phases ( December and January ) ; the World Health Organization ’ s unforgettable Jan. 14 tweet , based on Chinese sources , that the deadly disease was not transmissible “ human to human ” ; and the stunning regulatory failures of the Centers for Disease Control and Prevention and the Food and Drug Administration in @ @ @ @ @ @ @ testing .
Second-guessing is unproductive .
Going forward , however , we do have to ask ourselves : Are we able to set aside partisan rancor and have civil debate and discussion ?
Can we dispassionately ask ourselves about what worked , what didn ’ t work , and what we could—and should—do better next time ?
Unless and until we can do so , we will not be prepared for that next time .
And there will be a next time .

While combating the COVID-19 pandemic, federal and state officials must rely on the best available scientific data, including updated clinical information on the course of this mysterious disease and reliable epidemiological estimates.
Prominent epidemiological models, such as those of the Imperial College in Britain and the University of Washington, have been seriously flawed in predicting millions of deaths.
Sound policy planning based on a reliance on such models is difficult.
>>> What’s the best way for America to reopen and return to business? The National Coronavirus Recovery Commission, a project of The Heritage Foundation, assembled America’s top thinkers to figure that out. So far, it has made more than 260 recommendations. Learn more here.
Statistical projections into the past—“what might have happened if”—bear scrutiny, even if developed by top-flight researchers at prestigious institutions.
A case in point is the finding of Columbia University researchers that the lives of 35,927 Americans could have been saved if public health authorities had imposed “social distancing” restrictions just one week earlier than they did. That finding was based on an analysis of disease transmission data over the period March 15 to May 3.
It should be noted that the Columbia study, though widely reported in the media, has not been peer-reviewed—the “gold standard” for academic acceptance in professional journals.
Like all professional analysts, the Columbia team also readily acknowledges the limitations of the study:
We note these counterfactual experiments are based on idealized hypothetical assumptions. In practice, initiating and implementing interventions earlier during an outbreak is complicated by factors such as general uncertainty, economic concerns, logistics and the administrative decision process.
In the case of the Columbia University study, let us assume that the methodology is rigorous and the math is correct, and that its number—35,927 deaths—is also correct. Let us also assume that the lockdown “flattened” the curve of infection.
But here’s the key question: Did this mitigation policy of “flattening the curve” prevent SARS-CoV-2 infections and the corresponding cohort of deaths? Or did it simply postpone them?
Going forward, determining how many COVID-19 patients’ lives could be spared and how many deaths would simply be postponed depends on at least three things: (a) the development and effectiveness of a vaccine; (b) the development and effectiveness of therapeutic measures; and (c) progress in clinical understanding of the disease.
Before politicians seize on the Columbia study to resume the unprecedented lockdowns of social and economic life, they should consult a broader range of empirical evidence.
For example, Heritage Foundation analysts conducted an exhaustive analysis of the data and found that 92% of America’s coronavirus deaths occurred among persons 55 years of age and older (with 80% of them over the age of 65), and almost 90% of the deceased suffered from one or more comorbidities, such as cardiac or respiratory problems or diabetes.
In the Columbia analysis, researchers focused on six metropolitan areas, including “hot spots” New York and New Orleans. Heritage analysts also show that the mortality is geographically concentrated, with New York and New Jersey accounting for 44% of all COVID-10 deaths.
Not surprisingly, nursing home residents account for an estimated 42% of all COVID-19 mortality. That’s a clear failure of public health policy.
Even assuming the absence of an additional week of “social distancing,” as estimated by the Columbia researchers, a multiplicity of other factors also contributed to this pandemic’s mortality.
Just to name a few: communist China’s lack of transparency on the nature and spread of the disease during its crucial initial phases (December and January); the World Health Organization’s unforgettable Jan. 14 tweet, based on Chinese sources, that the deadly disease was not transmissible “human to human”; and the stunning regulatory failures of the Centers for Disease Control and Prevention and the Food and Drug Administration in February that inhibited early and aggressive American testing.
Second-guessing is unproductive. Going forward, however, we do have to ask ourselves: Are we able to set aside partisan rancor and have civil debate and discussion? Can we dispassionately ask ourselves about what worked, what didn’t work, and what we could—and should—do better next time?
Unless and until we can do so, we will not be prepared for that next time. And there will be a next time.


dailysignal--2020-06-10--Delivering Better Health and Human Services to Americans

Eric Hargan , deputy secretary of the U.S. Department of Health and Human Services , joins The Daily Signal Podcast to discuss the nation ’ s coronavirus recovery .
Hargan also describes his priorities in cutting red tape at HHS , focusing on values-based health care that is primarily about outcomes and not just services , and making health care records more accessible for Americans .
We also cover these stories : • Senate Majority Leader Mitch McConnell calls out the double standard of liberal Democratic leaders who have praised and even participated in protests over George Floyd ’ s @ @ @ @ @ @ @ religious gatherings and criticized COVID-19 protests just last month .
• The Los Angeles Police Department temporarily prohibits officers from using a “ carotid restraint ” on necks to subdue suspects .
The Daily Signal Podcast is available on Ricochet , Apple Podcasts , Pippa , Google Play , or Stitcher .
All of our podcasts can be found at DailySignal.com/podcasts .
If you like what you hear , please leave a review .
You also can leave us a message at 202-608-6205 or write us at [ email protected ] .
Enjoy @ @ @ @ @ @ @ I ’ m joined today on The Daily Signal Podcast by Eric Hargan .
He ’ s a deputy secretary of the Department of Health and Human Services .
Secretary Hargan , it ’ s great to have you on The Daily Signal Podcast .
Eric Hargan : Great to be here .
Del Guidice : Before we launch into our full discussion , just to start off , can you give us a quick update on what ’ s happening with coronavirus in HHS , how you all are endeavoring to get @ @ @ @ @ @ @ diagnostic testing , and everything else that you all are doing ?
Hargan : Sure .
Well , what we ’ re doing is a subset about what America ’ s doing .
I mean , we are helping out with backing up states , backing up localities , providing guidance to everyone and leadership on this issue .
But a lot of it that ’ s being done is really being done at the state and local levels , private industry , and really individual Americans who are working on this .
@ @ @ @ @ @ @ hygiene and social distancing , we ’ ve implemented the largest public health testing system in the world at this point , over 20 million tests and counting , between ourselves and private industry , really , the greatest mobilization we ’ ve had for production since World War II .
Just recently , we launched Operation Warp Speed , which is an operation , a project here at HHS to work with private industry and several of our other federal counterparts to streamline the development process for vaccines , therapeutics , and @ @ @ @ @ @ @ the first doses of at least the vaccines ready by the end of this year .
So far , the success we ’ ve had is we ’ ve really flattened the curve .
That was the goal we set for ourselves .
Now it ’ s time to get employees back to work , our children back to school , and our nation reopened .
Now that we ’ ve prepared the situation between ourselves and the fantastic productive capacity and the ingenuity of the rest of the country , now we @ @ @ @ @ @ @ is going to be probably adequate ability on hospitals to respond to any appearance of the virus .
So now it ’ s not the health versus the economy .
That ’ s really a false dichotomy at this point .
It ’ s health versus health .
It ’ s getting people back into the hospitals , back into the clinics , back into their doctors ’ offices to take care of the things that mostly kill Americans , which is cancer , heart disease , diabetes , COPD , all the @ @ @ @ @ @ @ in day out cause trouble for Americans , that are the causes of death for people in fatalities .
We have to get people back to taking care of themselves now that we are on the down slope , God-willing , of this coronavirus .
Del Guidice : Thank you so much , Secretary Hargan , for sharing that update .
You ’ re very passionate about deregulations and cutting red tape and have launched what you call a Regulatory Sprint to Coordinated Care .
Can you talk to us a little bit @ @ @ @ @ @ @ .
Well , as you say , I am very passionate about this area .
I came first to HHS as deputy general counsel for regulations , and then as regulatory policy for the department under President [ George W. ] Bush , when I was at HHS on my first tour of duty .
Now I ’ m the chief regulatory officer and in between I was a professor of administrative law in Chicago .
So yes , regulatory initiatives are very close to my heart .
One of the things that @ @ @ @ @ @ @ Regulatory Sprint to Coordinated Care .
It ’ s four different agencies that are revising four different sets of regulations .
… Two of them are about helping unleash information so that providers can share information with patients and with each other , two are about affiliations—how do they deal with each other in affiliation ?
So how does an independent physician group deal with the hospital or anything like that ?
Now it ’ s called “ the sprint ” because we want to gather the necessary information and then we move @ @ @ @ @ @ @ And it ’ s about coordinating care .
So a lot of these regulations are impeding coordination among providers .
They could be delivering lower cost patient care , could be delivering better care , but they ’ re not because , in many ways , while we in the federal government have been asking them to provide value to patients , to provide value to us , we then have these regulations in place that prohibit them from doing so—in many cases , saying that they might get criminal sanctions , jail @ @ @ @ @ @ @ .
That ’ s very scary , obviously , to providers in the space , to doctors , to hospitals , to nurses .
So we ’ re going to revise these four sets of laws , the Anti-Kickback Statute , HIPAA , the Stark Law—or the physician self-referral statute—and then this thing I won ’ t repeat again , 42 CFR Part 2 .
That ’ s only something for those of us in the regulatory arena to really care about .
But two of those are information statutes , two of @ @ @ @ @ @ @ , we ’ re trying to enable Americans to get better access to higher quality care at a lower cost .
We think that this regulatory reform , in many cases , it ’ s been decades since these regulations have been looked at .
It ’ s a complicated process , but it ’ s something that we ’ re dedicated to doing and we ’ re well on our way .
So that ’ s , I think , the great thing .
We ’ ve issued proposals on three out @ @ @ @ @ @ @ seen the draft proposal on the fourth one .
And so , … believe it or not , we ’ ve been working on these all the way through .
A lot of these groups aren ’ t necessarily front and center on the coronavirus pandemic .
So they ’ ve been able to get a lot of work done on their own .
And so watch this space , is what I would say .
Del Guidice : You did throw a lot of things to look out there , but looking @ @ @ @ @ @ @ one regulation that you say has been most harmful , what would that be ?
Hargan : In terms of the pandemic or otherwise ?
Del Guidice : Otherwise , just across HHS ?
Hargan : I would say the thing that we ’ ve seen the biggest uptick on here is really probably the telehealth and telemedicine restrictions .
And I would say that the things that we ’ ve done in the pandemic to respond , to loosen up constraints on telehealth and telemedicine , are the things that have had @ @ @ @ @ @ @ first week of March , we had about 11,000 telehealth beneficiaries in our system .
By the end of the first week of April , it was over 650,000 beneficiaries .
So , a sixtyfold increase in that area .
So I think we ’ ve seen that those were serious restrictions .
If you had to look systemically , I would say we have laws that are in place—the Stark Law and the Anti-Kickback Statute are very important laws that deal with the integrity of the system that we have .
We @ @ @ @ @ @ @ the regulations that have developed in those two areas , those are the things that have been the most complicated and I think those are where we ’ re going to get the biggest bang for the buck to get these regulations .
And they ’ re twinned with each other at this point , even though they ’ re two different agencies .
We ’ re working on them at the same time .
I think those will have the biggest bang for the buck systemically over time , if we can @ @ @ @ @ @ @ .
Del Guidice : You ’ ve also been very involved on the data side of things , trying to engage with technology , to remove outdated regulations or regulations that are no longer necessary .
How have you gone about doing this ?
Hargan : What we did was we took an AI and we ’ d fed our regulations from HHS into the artificial intelligence as data .
And we then instructed the machine , the algorithm , how to read it .
So , we had it read through all @ @ @ @ @ @ @ that were clues for something that was outdated .
So , for example , if there was a mention of telegrams or telegraph , or if there was a requirement for quadruplicate submission of paper copies to the government , these were examples where we found outdated terms that indicated that we could remove those regulations or alter them .
It flagged things like cross-references that no longer exist or laws that don ’ t exist anymore .
We found places where provisions haven ’ t been edited for 30 or 40 years @ @ @ @ @ @ @ and highlighted those provisions that really needed a closer look .
Then we set our team of our staff to look at them , the people that oversee these regulations , and now they ’ re consolidating these reforms that were identified through what turns out to be kind of a human-AI partnership for reforming regulations .
But instead of having teams of lawyers working for years to analyze these regulations , we ’ re just able to feed it into the computer and teach it how to read the relevant parts of @ @ @ @ @ @ @ interested in .
And it was able to produce this in short order , so we could turn to reforming these things .
Del Guidice : When [ Alex ] Azar joined HHS as secretary , one of the big priorities he has been involved with is advancing values-based care , trying to move the needle , so to speak , so that cares about outcomes and not just services .
Can you tell us a little bit about that ?
Hargan : Yeah .
I mean , this is the third administration @ @ @ @ @ @ @ .
In other words , we ’ re trying to move away from what was the elder system , the current dominant system of fee-for-service , to value-based care .
A big part of that is what we just talked about , the Regulatory Sprint to Coordinated Care .
That ’ s to enable there to be more value-based care and get relief from those regulations that keep the elements of the elder system in place somewhat artificially .
So , the president is committed to a health care system of affordable personalized @ @ @ @ @ @ @ in control .
And we think a system that is truly value-based would provide everyone with the affordability that they need , and then the options that they want and the quality they deserve .
And we ’ re proceeding on all of those fronts .
We ’ re doing a quality reform initiative that I had been leading at the department .
We just had the Quality Roadmap that was announced , I think , three weeks ago that we dropped out , that ’ s going to guide us to the @ @ @ @ @ @ @ ’ ve got the Regulatory Sprint moving forward .
That ’ s going to enable a lot of the value-based reforms to take place among private sector actors .
And we ’ ve enabled a lot more options on a number of different fronts , both through the regulatory reforms that we put in place in the middle of the pandemic , and then different things like the interoperability rules , the transparency initiative , the quality initiative , all these things that are focusing on groundwork , really , fundamentals in the @ @ @ @ @ @ @ going to drive toward , radiate outward , and really transform the health care system in a way that ’ s going to be much more patient-focused and much more information-rich for the patients to make decisions for themselves than we ’ ve had so far in the health care system .
Del Guidice : Speaking of being patient-focused , something else you ’ ve been working on , I think you may have touched on very briefly , is working on making electronic records available on mobile devices .
That ’ s @ @ @ @ @ @ @ as well … on top of everything you have on your plate .
So can you tell us how this works and what your vision is for this ?
Hargan : This was one of those areas where I was fortunate we were really focused on it in my office .
My staff , along with two of our agencies , are really focused on this .
And we actually got the final rule out on March 9 , which was just at the beginning of the heavy period of dealing with the @ @ @ @ @ @ @ re right in the middle of it , but I ’ m really glad we got these rules out for it to start percolating through industry that now , in these rules put out by the Office of National Coordinator of Health IT and then [ the Centers for Medicare and Medicaid Services ] had a supplemental rule for this , health care providers are going to be required to provide easy digital access to your records at no additional cost .
So this is going to be available on mobile devices through @ @ @ @ @ @ @ be able to pull all of your health records and your health claims data , no matter which provider they ’ re from , into a single app for you and for your doctor to use .
Now , we think this is going to be a pretty revolutionary step when everyone has their entire medical record and their claims record in a single place on a single device that ’ s theirs to have .
And we think that this unleashing of the information will provide competition that ’ ll allow new @ @ @ @ @ @ @ going to provide novel services , new choices , and also addressing patient privacy concerns .
We had that in mind .
That ’ s always something that comes to an issue .
When you have transmission of information , everyone ’ s always worried , where ’ s it going ?
How are you protecting it ?
We have put in place patient privacy sections of the rule that enable there to be control over these in a way that should protect patient privacy .
But that was in mind when we @ @ @ @ @ @ @ the fruit of the [ 21st Century ] Cures Act , which is almost 4 years old , that we have gotten the final rule in place now , but it focuses on using apps to get patients access to their health records .
Just to be clear , for people who are concerned about privacy , for any patient data to be shared with an application , the patient must give approval for its release .
So we have secure authentication protocols in the final rule .
When the patient wants to @ @ @ @ @ @ @ data electronically , the app follows the same process that ’ s used to access data elsewhere in web portals very commonly .
Also , we ’ re requiring payers , as part of these rules , to provide educational resources to patients , to inform them about their ability to access their data per these policies and what to look for to responsibly and safely choose an app that they want to use .
Del Guidice : Health and Human Services has been one of the biggest agencies , if not the @ @ @ @ @ @ @ cost savings , with having the most cost savings of all the other agencies combined , if I have that right .
How have you worked to do this ?
Hargan : Well , I ’ m the chief regulatory officer here at HHS .
… My whole background is administrative and regulatory law in the health care space .
So , this area is something I ’ m very , very familiar with .
The big push , though , came from the top down , really from the president , who @ @ @ @ @ @ @ and that he would be keeping track of deregulation .
And that is in fact what has happened .
Now , a point of pride for me is , over the last two years , HHS was the No .
1 Cabinet agency in deregulatory actions .
We believe that this is incredibly important .
As everyone knows , the cost of health care has been a flash point for the American public and for everyone in this country for the last many years .
So for us to be able to remove @ @ @ @ @ @ @ and get between doctors and patients , which reduces the quality of care , that ’ s incredibly important .
We ’ ve been leading on this issue the last two years , but we need to because the cost of health care has been an item of constant impact on American patients .
And they have indicated that concern is a top concern of theirs for years and years and years .
So we ’ re addressing it .
From our point of view , we ’ re addressing it from empowering @ @ @ @ @ @ @ overly burdensome regulations that inadvertently drive up the cost of care through the cost of compliance that aren ’ t necessary to achieve safety or quality for patients , and in fact sometimes might do the opposite .
But yeah , we have achieved about the amount that the rest of the government has put together and more so in deregulatory savings and actions at HHS .
As I said , that ’ s a point of pride for me as the chief regulatory officer .
I ’ m glad we ’ ve @ @ @ @ @ @ @ agencies have been great and have been very forward-leaning in terms of bringing forward deregulatory actions and proposals .
So , we ’ re focused on that here at HHS and we did even through the pandemic .
So , that ’ s a great thing .
But as I said , it ’ s from leadership on down .
The president called that out as one of his serious priorities and he and the White House have kept a close eye on it , and we are happy to comply here at @ @ @ @ @ @ @ for sharing that .
Something else you ’ re passionate about is rural health care .
I believe you came from a small town and your mom worked at a hospital and played a big role in where you are today .
So can you tell us a little bit about your story there and your legacy when it comes to why you ’ re so passionate to do what you do ?
Hargan : Yeah .
Well , I grew up underfoot in this rural hospital where my mother worked for 58 @ @ @ @ @ @ @ health care is something that runs deeply in my family .
In fact , five generations deep .
Doc Hargan was a doctor in rural Pulaski County in Illinois in the late 1800s , the same county that I grew up in .
He went out in all elements to see his patients , whether by horse and buggy or a rowboat to see his patients .
He would row across the Ohio River to his patients in Kentucky to provide them with the care that they needed .
And my family , @ @ @ @ @ @ @ day work in rural health care , whether it ’ s doctors , nurses , pharmacists , physical therapists , occupational therapists , what have you .
But I got to see all this firsthand going on call and everything in my mother ’ s career .
So , seeing what happens within the hospital , which is now a clinic , a federally qualified health center , in fact , funded by [ the Health Resources and Services Administration ] , one of our agencies here at HHS .
Even when I @ @ @ @ @ @ @ remember it , but the fact that we didn ’ t have an OB unit or a delivery maternity ward in our local hospital , that it had already been downsized to that extent .
So , my parents had to drive a long time to Cape Girardeau , Missouri , to another state , to find a place that I could be delivered .
So those experiences from actually the very moment of my birth , whether I remember them or not , really give me a very close firsthand look into @ @ @ @ @ @ @ America .
And so that ’ s why it ’ s front and center , really close to my heart in what we ’ re doing here at HHS .
Del Guidice : Thank you so much for sharing that with us .
As we wrap up , is there anything else you are working on at HHS that you would like to highlight ?
Hargan : Some of the things that we ’ re going to be working on pretty closely is , obviously , the lessons learned from this pandemic .
@ @ @ @ @ @ @ preparedness plan many years ago when I was here under Secretary [ Mike ] Leavitt in the Bush administration , where we started laying the framework that unfolded in response to this pandemic .
[ In 2006 ] we created what ’ s now the Assistant Secretary for Preparedness and Response , that agency , and BARDA , which is the [ Biomedical Advanced Research and Development Authority ] , which has been critical in the response that we ’ ve had—through the Strategic National Stockpile , through all the procurement ability that @ @ @ @ @ @ @ , working with [ the Federal Emergency Management Agency ] .
A lot of those groundwork was laid , the Hospital Preparedness Program , which really hardened our hospitals and made it so that they had trained , they had people on staff .
They knew in many cases who they needed to talk to and what they should be doing .
I can see for myself .
I came to HHS in the wake of 9/11 and the SARS outbreak .
And I could see for myself how emergency response was handled @ @ @ @ @ @ @ have a cadre of people who knew how to do preparedness and response in emergency situations .
If you can imagine , how much better the response has been when you have trained professional staff who this is their job day in , day out to do emergency preparedness , to do emergency response .
We were just far better coordinated from the get go .
But obviously , as we ’ ve seen , there are bare patches that are revealed in any emergency situation .
So we ’ re going to @ @ @ @ @ @ @ didn ’ t , what needs to be changed , what doesn ’ t need to be changed as we move forward .
So I say that ’ s something that ’ s in hand right now as lessons learned , building on what worked , the foundational work that was done and kept in place , and then trying to see where things didn ’ t work out as well , and what can be improved of what didn ’ t work .
Del Guidice : Deputy Secretary Hargan , thank you @ @ @ @ @ @ @ Daily Signal Podcast .
Hargan : Thank you very much .

Eric Hargan, deputy secretary of the U.S. Department of Health and Human Services, joins The Daily Signal Podcast to discuss the nation’s coronavirus recovery. Hargan also describes his priorities in cutting red tape at HHS, focusing on values-based health care that is primarily about outcomes and not just services, and making health care records more accessible for Americans.
We also cover these stories:
Senate Majority Leader Mitch McConnell calls out the double standard of liberal Democratic leaders who have praised and even participated in protests over George Floyd’s death, but who continue to limit religious gatherings and criticized COVID-19 protests just last month.
Mourners gather in Houston for George Floyd’s funeral service.
The Los Angeles Police Department temporarily prohibits officers from using a “carotid restraint” on necks to subdue suspects.
The Daily Signal Podcast is available on Ricochet, Apple Podcasts, Pippa, Google Play, or Stitcher. All of our podcasts can be found at DailySignal.com/podcasts. If you like what you hear, please leave a review. You also can leave us a message at 202-608-6205 or write us at letters@dailysignal.com. Enjoy the show.
Rachel del Guidice: I’m joined today on The Daily Signal Podcast by Eric Hargan. He’s a deputy secretary of the Department of Health and Human Services. Secretary Hargan, it’s great to have you on The Daily Signal Podcast.
Eric Hargan: Great to be here.
Del Guidice: Before we launch into our full discussion, just to start off, can you give us a quick update on what’s happening with coronavirus in HHS, how you all are endeavoring to get people back to work, working on diagnostic testing, and everything else that you all are doing?
Hargan: Sure. Well, what we’re doing is a subset about what America’s doing. I mean, we are helping out with backing up states, backing up localities, providing guidance to everyone and leadership on this issue. But a lot of it that’s being done is really being done at the state and local levels, private industry, and really individual Americans who are working on this.
So besides those routine issues of basic hygiene and social distancing, we’ve implemented the largest public health testing system in the world at this point, over 20 million tests and counting, between ourselves and private industry, really, the greatest mobilization we’ve had for production since World War II.
Just recently, we launched Operation Warp Speed, which is an operation, a project here at HHS to work with private industry and several of our other federal counterparts to streamline the development process for vaccines, therapeutics, and diagnostics without compromising safety, to have the first doses of at least the vaccines ready by the end of this year.
So far, the success we’ve had is we’ve really flattened the curve. That was the goal we set for ourselves. Now it’s time to get employees back to work, our children back to school, and our nation reopened.
Now that we’ve prepared the situation between ourselves and the fantastic productive capacity and the ingenuity of the rest of the country, now we’ve flattened the curve and there is going to be probably adequate ability on hospitals to respond to any appearance of the virus.
So now it’s not the health versus the economy. That’s really a false dichotomy at this point. It’s health versus health. It’s getting people back into the hospitals, back into the clinics, back into their doctors’ offices to take care of the things that mostly kill Americans, which is cancer, heart disease, diabetes, COPD, all the things that are the things that day in day out cause trouble for Americans, that are the causes of death for people in fatalities.
We have to get people back to taking care of themselves now that we are on the down slope, God-willing, of this coronavirus.
Del Guidice: Thank you so much, Secretary Hargan, for sharing that update. You’re very passionate about deregulations and cutting red tape and have launched what you call a Regulatory Sprint to Coordinated Care. Can you talk to us a little bit about this initiative?
Hargan: Yeah. Well, as you say, I am very passionate about this area. I came first to HHS as deputy general counsel for regulations, and then as regulatory policy for the department under President [George W.] Bush, when I was at HHS on my first tour of duty. Now I’m the chief regulatory officer and in between I was a professor of administrative law in Chicago. So yes, regulatory initiatives are very close to my heart.
One of the things that I’ve done here is this Regulatory Sprint to Coordinated Care. It’s four different agencies that are revising four different sets of regulations. …
Two of them are about helping unleash information so that providers can share information with patients and with each other, two are about affiliations—how do they deal with each other in affiliation? So how does an independent physician group deal with the hospital or anything like that?
Now it’s called “the sprint” because we want to gather the necessary information and then we move to rule-making as soon as possible. And it’s about coordinating care.
So a lot of these regulations are impeding coordination among providers. They could be delivering lower cost patient care, could be delivering better care, but they’re not because, in many ways, while we in the federal government have been asking them to provide value to patients, to provide value to us, we then have these regulations in place that prohibit them from doing so—in many cases, saying that they might get criminal sanctions, jail time for violating these health care regulations.
That’s very scary, obviously, to providers in the space, to doctors, to hospitals, to nurses. So we’re going to revise these four sets of laws, the Anti-Kickback Statute, HIPAA, the Stark Law—or the physician self-referral statute—and then this thing I won’t repeat again, 42 CFR Part 2. That’s only something for those of us in the regulatory arena to really care about.
But two of those are information statutes, two of them are about affiliations. And fundamentally, we’re trying to enable Americans to get better access to higher quality care at a lower cost.
We think that this regulatory reform, in many cases, it’s been decades since these regulations have been looked at. It’s a complicated process, but it’s something that we’re dedicated to doing and we’re well on our way. So that’s, I think, the great thing.
We’ve issued proposals on three out of the four. I’ve seen the draft proposal on the fourth one. And so, … believe it or not, we’ve been working on these all the way through. A lot of these groups aren’t necessarily front and center on the coronavirus pandemic. So they’ve been able to get a lot of work done on their own. And so watch this space, is what I would say.
Del Guidice: You did throw a lot of things to look out there, but looking big picture, if there’s one regulation that you say has been most harmful, what would that be?
Hargan: In terms of the pandemic or otherwise?
Del Guidice: Otherwise, just across HHS?
Hargan: I would say the thing that we’ve seen the biggest uptick on here is really probably the telehealth and telemedicine restrictions. And I would say that the things that we’ve done in the pandemic to respond, to loosen up constraints on telehealth and telemedicine, are the things that have had the largest impact.
We went the first week of March, we had about 11,000 telehealth beneficiaries in our system. By the end of the first week of April, it was over 650,000 beneficiaries. So, a sixtyfold increase in that area. So I think we’ve seen that those were serious restrictions.
If you had to look systemically, I would say we have laws that are in place—the Stark Law and the Anti-Kickback Statute are very important laws that deal with the integrity of the system that we have.
We have to obey those laws, but the regulations that have developed in those two areas, those are the things that have been the most complicated and I think those are where we’re going to get the biggest bang for the buck to get these regulations.
And they’re twinned with each other at this point, even though they’re two different agencies. We’re working on them at the same time. I think those will have the biggest bang for the buck systemically over time, if we can get those put forward in good order.
Del Guidice: You’ve also been very involved on the data side of things, trying to engage with technology, to remove outdated regulations or regulations that are no longer necessary. How have you gone about doing this?
Hargan: What we did was we took an AI and we’d fed our regulations from HHS into the artificial intelligence as data. And we then instructed the machine, the algorithm, how to read it. So, we had it read through all of our regulations, looking for words that were clues for something that was outdated.
So, for example, if there was a mention of telegrams or telegraph, or if there was a requirement for quadruplicate submission of paper copies to the government, these were examples where we found outdated terms that indicated that we could remove those regulations or alter them.
It flagged things like cross-references that no longer exist or laws that don’t exist anymore. We found places where provisions haven’t been edited for 30 or 40 years. So it filtered our entire code and highlighted those provisions that really needed a closer look.
Then we set our team of our staff to look at them, the people that oversee these regulations, and now they’re consolidating these reforms that were identified through what turns out to be kind of a human-AI partnership for reforming regulations.
But instead of having teams of lawyers working for years to analyze these regulations, we’re just able to feed it into the computer and teach it how to read the relevant parts of the regulations that we [are] interested in. And it was able to produce this in short order, so we could turn to reforming these things.
Del Guidice: When [Alex] Azar joined HHS as secretary, one of the big priorities he has been involved with is advancing values-based care, trying to move the needle, so to speak, so that cares about outcomes and not just services. Can you tell us a little bit about that?
Hargan: Yeah. I mean, this is the third administration in a row to promote value-based care. In other words, we’re trying to move away from what was the elder system, the current dominant system of fee-for-service, to value-based care.
A big part of that is what we just talked about, the Regulatory Sprint to Coordinated Care. That’s to enable there to be more value-based care and get relief from those regulations that keep the elements of the elder system in place somewhat artificially.
So, the president is committed to a health care system of affordable personalized care, and that puts the patient in control. And we think a system that is truly value-based would provide everyone with the affordability that they need, and then the options that they want and the quality they deserve. And we’re proceeding on all of those fronts.
We’re doing a quality reform initiative that I had been leading at the department. We just had the Quality Roadmap that was announced, I think, three weeks ago that we dropped out, that’s going to guide us to the next phase of quality reform.
We’ve got the Regulatory Sprint moving forward. That’s going to enable a lot of the value-based reforms to take place among private sector actors.
And we’ve enabled a lot more options on a number of different fronts, both through the regulatory reforms that we put in place in the middle of the pandemic, and then different things like the interoperability rules, the transparency initiative, the quality initiative, all these things that are focusing on groundwork, really, fundamentals in the health care system that we think are going to drive toward, radiate outward, and really transform the health care system in a way that’s going to be much more patient-focused and much more information-rich for the patients to make decisions for themselves than we’ve had so far in the health care system.
Del Guidice: Speaking of being patient-focused, something else you’ve been working on, I think you may have touched on very briefly, is working on making electronic records available on mobile devices. That’s something that has been keeping you busy as well … on top of everything you have on your plate. So can you tell us how this works and what your vision is for this?
Hargan: This was one of those areas where I was fortunate we were really focused on it in my office. My staff, along with two of our agencies, are really focused on this. And we actually got the final rule out on March 9, which was just at the beginning of the heavy period of dealing with the coronavirus.
I mean, we’re right in the middle of it, but I’m really glad we got these rules out for it to start percolating through industry that now, in these rules put out by the Office of National Coordinator of Health IT and then [the Centers for Medicare and Medicaid Services] had a supplemental rule for this, health care providers are going to be required to provide easy digital access to your records at no additional cost.
So this is going to be available on mobile devices through an app. So you’ll be able to pull all of your health records and your health claims data, no matter which provider they’re from, into a single app for you and for your doctor to use.
Now, we think this is going to be a pretty revolutionary step when everyone has their entire medical record and their claims record in a single place on a single device that’s theirs to have.
And we think that this unleashing of the information will provide competition that’ll allow new business models to develop, that is going to provide novel services, new choices, and also addressing patient privacy concerns.
We had that in mind. That’s always something that comes to an issue. When you have transmission of information, everyone’s always worried, where’s it going? How are you protecting it? We have put in place patient privacy sections of the rule that enable there to be control over these in a way that should protect patient privacy. But that was in mind when we put the rule forward.
This was the fruit of the [21st Century] Cures Act, which is almost 4 years old, that we have gotten the final rule in place now, but it focuses on using apps to get patients access to their health records.
Just to be clear, for people who are concerned about privacy, for any patient data to be shared with an application, the patient must give approval for its release. So we have secure authentication protocols in the final rule.
When the patient wants to use an app to access their health data electronically, the app follows the same process that’s used to access data elsewhere in web portals very commonly.
Also, we’re requiring payers, as part of these rules, to provide educational resources to patients, to inform them about their ability to access their data per these policies and what to look for to responsibly and safely choose an app that they want to use.
Del Guidice: Health and Human Services has been one of the biggest agencies, if not the biggest, in the federal government for cost savings, with having the most cost savings of all the other agencies combined, if I have that right. How have you worked to do this?
Hargan: Well, I’m the chief regulatory officer here at HHS. … My whole background is administrative and regulatory law in the health care space. So, this area is something I’m very, very familiar with.
The big push, though, came from the top down, really from the president, who said repeatedly that deregulation was a priority and that he would be keeping track of deregulation. And that is in fact what has happened.
Now, a point of pride for me is, over the last two years, HHS was the No. 1 Cabinet agency in deregulatory actions. We believe that this is incredibly important.
As everyone knows, the cost of health care has been a flash point for the American public and for everyone in this country for the last many years. So for us to be able to remove burdensome regulations that can drive up costs and get between doctors and patients, which reduces the quality of care, that’s incredibly important.
We’ve been leading on this issue the last two years, but we need to because the cost of health care has been an item of constant impact on American patients. And they have indicated that concern is a top concern of theirs for years and years and years. So we’re addressing it.
From our point of view, we’re addressing it from empowering the health care sector by deregulating these overly burdensome regulations that inadvertently drive up the cost of care through the cost of compliance that aren’t necessary to achieve safety or quality for patients, and in fact sometimes might do the opposite.
But yeah, we have achieved about the amount that the rest of the government has put together and more so in deregulatory savings and actions at HHS.
As I said, that’s a point of pride for me as the chief regulatory officer. I’m glad we’ve been able to do it. Our agencies have been great and have been very forward-leaning in terms of bringing forward deregulatory actions and proposals.
So, we’re focused on that here at HHS and we did even through the pandemic. So, that’s a great thing. But as I said, it’s from leadership on down. The president called that out as one of his serious priorities and he and the White House have kept a close eye on it, and we are happy to comply here at HHS.
Del Guidice: Thank you for sharing that. Something else you’re passionate about is rural health care. I believe you came from a small town and your mom worked at a hospital and played a big role in where you are today. So can you tell us a little bit about your story there and your legacy when it comes to why you’re so passionate to do what you do?
Hargan: Yeah. Well, I grew up underfoot in this rural hospital where my mother worked for 58 years before she retired. And rural health care is something that runs deeply in my family. In fact, five generations deep.
Doc Hargan was a doctor in rural Pulaski County in Illinois in the late 1800s, the same county that I grew up in. He went out in all elements to see his patients, whether by horse and buggy or a rowboat to see his patients. He would row across the Ohio River to his patients in Kentucky to provide them with the care that they needed.
And my family, probably about half of them to this day work in rural health care, whether it’s doctors, nurses, pharmacists, physical therapists, occupational therapists, what have you. But I got to see all this firsthand going on call and everything in my mother’s career.
So, seeing what happens within the hospital, which is now a clinic, a federally qualified health center, in fact, funded by [the Health Resources and Services Administration], one of our agencies here at HHS.
Even when I was born, I don’t remember it, but the fact that we didn’t have an OB unit or a delivery maternity ward in our local hospital, that it had already been downsized to that extent. So, my parents had to drive a long time to Cape Girardeau, Missouri, to another state, to find a place that I could be delivered.
So those experiences from actually the very moment of my birth, whether I remember them or not, really give me a very close firsthand look into the state of health care in rural America. And so that’s why it’s front and center, really close to my heart in what we’re doing here at HHS.
Del Guidice: Thank you so much for sharing that with us. As we wrap up, is there anything else you are working on at HHS that you would like to highlight?
Hargan: Some of the things that we’re going to be working on pretty closely is, obviously, the lessons learned from this pandemic.
I was involved in drafting a pandemic preparedness plan many years ago when I was here under Secretary [Mike] Leavitt in the Bush administration, where we started laying the framework that unfolded in response to this pandemic.
[In 2006] we created what’s now the Assistant Secretary for Preparedness and Response, that agency, and BARDA, which is the [Biomedical Advanced Research and Development Authority], which has been critical in the response that we’ve had—through the Strategic National Stockpile, through all the procurement ability that we’ve been able to have, working with [the Federal Emergency Management Agency].
A lot of those groundwork was laid, the Hospital Preparedness Program, which really hardened our hospitals and made it so that they had trained, they had people on staff. They knew in many cases who they needed to talk to and what they should be doing.
I can see for myself. I came to HHS in the wake of 9/11 and the SARS outbreak. And I could see for myself how emergency response was handled back then when we didn’t have a cadre of people who knew how to do preparedness and response in emergency situations.
If you can imagine, how much better the response has been when you have trained professional staff who this is their job day in, day out to do emergency preparedness, to do emergency response. We were just far better coordinated from the get go. But obviously, as we’ve seen, there are bare patches that are revealed in any emergency situation.
So we’re going to be looking into what worked, what didn’t, what needs to be changed, what doesn’t need to be changed as we move forward. So I say that’s something that’s in hand right now as lessons learned, building on what worked, the foundational work that was done and kept in place, and then trying to see where things didn’t work out as well, and what can be improved of what didn’t work.
Del Guidice: Deputy Secretary Hargan, thank you so much for joining us on The Daily Signal Podcast.
Hargan: Thank you very much.


dailysignal--2020-06-04--Extreme Environmentalist Ideology Shouldn’t Undercut CDC’s Coronavirus Guidance

The American people must be able to trust the accuracy of public health information disseminated by the federal government , especially during the coronavirus pandemic .
That ’ s why a reported change by the Centers for Disease Control and Prevention of its guidance on COVID-19 for employers regarding commuters is very disturbing .
In its original guidance issued last week , the CDC recommended that for commuters using public transportation or ride-booking services , employers should consider “ [ offering ] employees incentives to use forms of transportation that minimize close contact with others , such as offering reimbursement @ @ @ @ @ @ @ or single-occupancy rides.
” > > > When can America reopen ?
The National Coronavirus Recovery Commission , a project of The Heritage Foundation , is gathering America ’ s top thinkers together to figure that out .
Learn more here .
The original guidance also included recommendations for employers on how to assist all commuting employees , regardless of whether those employees can drive .
However , the advice about driving , parking , and single-occupancy rides infuriated environmental organizations and transit special interests .
So , they let their feelings be @ @ @ @ @ @ @ response , the Centers for Disease Control and Prevention changed the language to say : “ If feasible , offer employees incentives to use forms of transportation that minimize close contact with others ( e.g.
, biking , walking , driving or riding by car either alone or with household members ) .
” The CDC also added a recommendation for employers to ask employees to follow the agency ’ s guidance on how to protect themselves when using transportation .
( This latter guidance provides information on what to do when using @ @ @ @ @ @ @ transit . )
So the CDC added the qualifier “ if feasible ” to the original guidance , took out the recommendation on parking , and added biking , walking , and driving with household members .
It also added a recommendation suggesting that the agency is less concerned with public transit than was conveyed in the original guidance .
Politics and ideology shouldn ’ t interfere with the government ’ s best COVID-19 guidance , but it clearly did in this case .
Some of the changes arguably still might be consistent @ @ @ @ @ @ @ contacts , but there ’ s no way to know whether those changes are a product of the best public health information or a product of succumbing to political pressure .
Inserting the “ if feasible ” language , removing language related to parking , and adding language to suggest less concern with public transit is inconsistent with the original guidance that showed a preference for driving alone .
This conflating of science , policy , and ideology is nothing new .
For example , environmental activists have been trying to use concerns @ @ @ @ @ @ @ way to change the government ’ s Dietary Guidelines for Americans .
So , instead of federal nutrition policy being based on human health alone , environmental activists want dietary advice to be based on their environmental agenda .
The influential advisory committee that provided recommendations to the government in developing the 2015 Dietary Guidelines did in fact consider those environmental interests .
The committee formed a subcommittee that covered “ food sustainability.
” In a presentation , the subcommittee explained , “ The goal is to develop dietary guidance that supports human @ @ @ @ @ @ @ over time.
” When the federal government released the 2015 Dietary Guidelines , it said environmental considerations didn ’ t inform the document .
Unfortunately , there ’ s no way to know whether that ’ s true .
What we do know is that the government allowed its dietary advisory committee to veer way off its mission .
Fortunately , the 2020 guidelines process doesn ’ t appear to have that same problem .
The extreme effort by some to push their environmental ideology , wherever and however they can , may @ @ @ @ @ @ @ as well .
For example , the Environmental Protection Agency has been taking commendable steps to try to ensure that environmental regulations are based on science that is transparent and can be properly evaluated .
That ’ s a bipartisan objective .
A 2009 memo issued by President Barack Obama argued : “ To the extent permitted by law , there should be transparency in the preparation , identification , and use of scientific and technological information in policymaking.
” Yet , some critics are fighting this commonsense EPA effort to promote transparency @ @ @ @ @ @ @ the science , such actions suggest they care only about ensuring they are allowed to use whatever “ science ” helps them accomplish their environmental agenda .
Public health information and other federally disseminated scientific information—from the CDC to the EPA—must be separated from ideology and be based on science that can be properly evaluated .
That ’ s the only way to ensure accurate information , and information that ’ s deserving of the public ’ s trust .

The American people must be able to trust the accuracy of public health information disseminated by the federal government, especially during the coronavirus pandemic.
That’s why a reported change by the Centers for Disease Control and Prevention of its guidance on COVID-19 for employers regarding commuters is very disturbing.
In its original guidance issued last week, the CDC recommended that for commuters using public transportation or ride-booking services, employers should consider “[offering] employees incentives to use forms of transportation that minimize close contact with others, such as offering reimbursement for parking for commuting to work alone or single-occupancy rides.”
>>> When can America reopen? The National Coronavirus Recovery Commission, a project of The Heritage Foundation, is gathering America’s top thinkers together to figure that out. Learn more here.
The original guidance also included recommendations for employers on how to assist all commuting employees, regardless of whether those employees can drive.
However, the advice about driving, parking, and single-occupancy rides infuriated environmental organizations and transit special interests. So, they let their feelings be known to the CDC.
Apparently in response, the Centers for Disease Control and Prevention changed the language to say: “If feasible, offer employees incentives to use forms of transportation that minimize close contact with others (e.g., biking, walking, driving or riding by car either alone or with household members).”
The CDC also added a recommendation for employers to ask employees to follow the agency’s guidance on how to protect themselves when using transportation. (This latter guidance provides information on what to do when using several modes of transportation, including public transit.)
So the CDC added the qualifier “if feasible” to the original guidance, took out the recommendation on parking, and added biking, walking, and driving with household members.
It also added a recommendation suggesting that the agency is less concerned with public transit than was conveyed in the original guidance.
Politics and ideology shouldn’t interfere with the government’s best COVID-19 guidance, but it clearly did in this case.
Some of the changes arguably still might be consistent with the original guidance to minimize close contacts, but there’s no way to know whether those changes are a product of the best public health information or a product of succumbing to political pressure.
Inserting the “if feasible” language, removing language related to parking, and adding language to suggest less concern with public transit is inconsistent with the original guidance that showed a preference for driving alone.
This conflating of science, policy, and ideology is nothing new.
For example, environmental activists have been trying to use concerns about climate change and sustainability as a way to change the government’s Dietary Guidelines for Americans. So, instead of federal nutrition policy being based on human health alone, environmental activists want dietary advice to be based on their environmental agenda.
The influential advisory committee that provided recommendations to the government in developing the 2015 Dietary Guidelines did in fact consider those environmental interests. The committee formed a subcommittee that covered “food sustainability.”
In a presentation, the subcommittee explained, “The goal is to develop dietary guidance that supports human health and the health of the planet over time.”
When the federal government released the 2015 Dietary Guidelines, it said environmental considerations didn’t inform the document. Unfortunately, there’s no way to know whether that’s true.
What we do know is that the government allowed its dietary advisory committee to veer way off its mission. Fortunately, the 2020 guidelines process doesn’t appear to have that same problem.
The extreme effort by some to push their environmental ideology, wherever and however they can, may help to explain some other recent developments as well.
For example, the Environmental Protection Agency has been taking commendable steps to try to ensure that environmental regulations are based on science that is transparent and can be properly evaluated.
That’s a bipartisan objective. A 2009 memo issued by President Barack Obama argued: “To the extent permitted by law, there should be transparency in the preparation, identification, and use of scientific and technological information in policymaking.”
Yet, some critics are fighting this commonsense EPA effort to promote transparency. As they claim to care about the science, such actions suggest they care only about ensuring they are allowed to use whatever “science” helps them accomplish their environmental agenda.
Public health information and other federally disseminated scientific information—from the CDC to the EPA—must be separated from ideology and be based on science that can be properly evaluated. That’s the only way to ensure accurate information, and information that’s deserving of the public’s trust.


dailysignal--2020-06-03--These States Reopened a Month Ago After COVID-19 Shutdowns. Here’s What Happened.

Among states that reopened their economies about a month ago , most logged about the same number of COVID-19 cases , though some had more cases and others saw a decline .
The closest thing to a discernible pattern is that Western and Midwestern states performed better than Southern states in terms of fewer new cases of the disease caused by the new coronavirus .
Even there , though , some Southern states saw a decline or remained steady in the number of COVID-19 cases , according to data from the Kaiser Family Foundation .
The increase in new diagnosed @ @ @ @ @ @ @ each state is doing .
> > > What ’ s the best way for America to reopen and return to business ?
The National Coronavirus Recovery Commission , a project of The Heritage Foundation , assembled America ’ s top thinkers to figure that out .
So far , it has made more than 260 recommendations .
Learn more here .
In 47 states , hospitalization for COVID-19 either has been flat or has decreased , said Dr. Lee Gross , president of Docs 4 Patient Care , a health care advocacy @ @ @ @ @ @ @ number of confirmed cases will increase , Gross said , and the most notable measurement is of serious cases .
“ The key is not to focus on just the number of cases , but how seriously ill people are , ” Gross , who practices family medicine in North Port , Florida , told The Daily Signal .
“ There are many diseases that don ’ t shut down the economy for months.
” The only three states with increasing hospitalization rates for COVID-19 are Hawaii , Rhode Island , and Wisconsin @ @ @ @ @ @ @ economy May 8 and Rhode Island reopened May 13 .
Hawaii didn ’ t do so until May 31 , so there may not be a clear pattern .
Wisconsin , which came back the earliest of the three , had the biggest increase , Gross said .
The states seeing patients test positive for the coronavirus at a rate of 10 % or higher are Alabama , Nebraska , and Virginia , Gross said , adding that hospitalization rates are flat .
It is difficult to say why some states appear to @ @ @ @ @ @ @ Jennifer Tolbert , director of state health reform at the Kaiser Family Foundation .
“ We are definitely seeing different trends after reopening for about a month in different locations , ” Tolbert told The Daily Signal .
“ I ’ m not sure we know the why.
” A dozen states began phased reopenings in late April , according to Stateline , a project of Pew Charitable Trusts that monitors state governments .
Alaska , which has had 467 COVID-19 cases and 10 deaths , according to the Centers for Disease Control @ @ @ @ @ @ @ reopening April 24 .
Montana , with 523 total cases and 17 deaths , followed the next day .
Then Colorado .
Mississippi was the first Southern state to reopen , on April 27 .
Three days later , it was followed by Alabama , Georgia , Idaho , Kansas , Tennessee , Texas , and West Virginia , according to Pew .
Kaiser Family Foundation measured new cases in states based on a seven-day rolling average on May 5 , by which time a significant number of states had reopened , and @ @ @ @ @ @ @ of the month .
Colorado and Georgia , two of the most permissive states in their reopenings , were widely criticized for taking a far less cautious approach than many other state governments .
Noting again how every state has different dynamics , Kaiser ’ s Tolbert noted that many of the early cases in Colorado began at ski resorts that later were closed down .
On May 5 , Colorado had 436 new cases using the seven-day rolling average .
By May 28 , that number had declined to 274 new cases @ @ @ @ @ @ @ , Colorado has had about 26,000 cases and 1,458 deaths .
Georgia had a more nominal dip , with 710 new cases May 5 and 658 new cases May 28 .
Georgia has had about 48,000 total cases and just over 2,000 total deaths , according to the CDC .
“ These governors who uncaged free people and enterprise were wisely acting to not endanger so many livelihoods while still working to protect the most vulnerable , ” George Allen , a former governor and U.S. senator of Virginia , told The Daily @ @ @ @ @ @ @ the new coronavirus were tragic .
However , the doomsday predictions for states that reopened didn ’ t come true , indicating a problem with computer models on the virus , he said .
“ There was so much hype , ” said Allen , who is also a member of The Heritage Foundation ’ s National Coronavirus Recovery Commission .
“ The fact that so many states opened and cases declined shows how wrong many of the forecasts and models were.
” Allen said he hopes to see more governors and state @ @ @ @ @ @ @ reopening and work to recruit pharmaceutical manufacturers so that America is less reliant on China .
For the state of Texas , new cases of COVID-19 were about the same in early May—1,079—as in late May—1,049—except for a spike in mid-May of 1,305 that was followed by a decline .
Texas , the second most populous state , has had about 65,000 total cases and 1,678 deaths , according to the CDC .
In Alabama , however , new cases nearly doubled from 241 to 463 over that time period , according to @ @ @ @ @ @ @ and 648 deaths in all .
Mississippi also had a spike from 266 new cases to 307 new cases in the three weeks from May 5 to May 28 .
The state has had more than 16,000 cases and 768 deaths , according to the CDC .
Tennessee , however , saw a decrease from 520 new cases in early May to 388 new cases in late May , according to Kaiser .
In all , Tennessee has had 23,709 cases and 369 deaths .
West Virginia saw its already tiny number of @ @ @ @ @ @ @ double to 49 from early to late May .
West Virginia was the last state with zero cases early in the pandemic .
In all , it has had about 2,000 cases and 76 deaths .
On some level , an increase in new COVID-19 cases was expected whenever Americans came out of isolation , Kaiser ’ s Tolbert said : Utah did a partial reopening May 1 , and Missouri followed May 3 .
Utah has had more than 10,000 total cases and 114 deaths .
Missouri has had 13,327 cases and @ @ @ @ @ @ @ , Indiana , and South Carolina began their phased reopenings May 4 .
On May 8 , Rhode Island , which has had about 15,000 cases and 720 deaths , became the first Northeastern state to reopen .
Wisconsin began opening May 13 .
Utah remained about the same , with 158 new cases May 5 , just a few days after its reopening , and 150 new cases May 28 , according to Kaiser .
Indiana had 635 new cases after a seven-day average May 5 , one day after reopening .
@ @ @ @ @ @ @ 28 .
Indiana has had a total of 34,830 cases and 2,142 deaths .
Florida , with the nation ’ s third-largest population , was almost flat with 656 new cases the day after it reopened May 4 and 659 as of May 28 .
In all , Florida has had 55,415 cases and 2,460 deaths .
South Carolina had an increase in new cases from 158 on May 5 to 201 new cases May 28 .
South Carolina has had 12,148 total cases and about 500 deaths .
As an aside , @ @ @ @ @ @ @ t reopen until May 21 according to Stateline , saw a big spike before and after—going from 394 cases May 5 to 755 cases May 28 .
North Carolina has had 29,263 total cases and about 900 deaths .
In Wisconsin , a week before the May 13 reopening , the number of new cases was 325 on May 5 .
That increased to 441 by May 28 , according to Kaiser .
Wisconsin has had about 18,500 cases and 600 deaths .
Seven other states didn ’ t force closure of their @ @ @ @ @ @ @ and individuals .
These states were Arkansas , Iowa , Nebraska , North Dakota , Oklahoma , South Dakota , and Wyoming , according to Stateline .
For the most part , there was no significant difference for these seven states over the period measured .
But Arkansas had an increase from 57 new cases in early May to 182 new cases by late May , according to Kaiser .
Arkansas has had 7,443 total cases and 133 deaths .
Nebraska saw a decline from 408 new cases May 5 to 260 new @ @ @ @ @ @ @ had 14,345 total cases and 178 deaths .
Keeping with the Midwestern trend , Iowa saw a decline from 534 new cases in the seven-day average May 5 to 345 new cases May 28 .
In all , Iowa has had almost 20,000 cases and about 550 deaths .
Oklahoma was steady , with 102 new cases dipping to 100 over that same period .
The state has had about 6,300 total cases and 338 deaths .
For other states , it may be too early to measure the potential effect of reopening @ @ @ @ @ @ @ mid-May include Arizona , Connecticut , Louisiana , Maryland , Nevada , Minnesota , Massachusetts , Ohio , Vermont , and Virginia , according to Stateline .
Delaware , Hawaii , Illinois , Maine , New Hampshire , New Jersey , North Carolina , Washington , and the District of Columbia reopened in late May .
Pennsylvania opens Thursday , June 4 , followed by Michigan on June 12 .
The state of New York , which has had the largest number of COVID-19 cases and deaths in the nation , will open @ @ @ @ @ @ @ Control and Prevention measures New York state and New York City separately in logging coronavirus cases .
In all , New York City has had more than 200,000 cases and almost 22,000 deaths .
The rest of New York state has had about 168,000 cases and 8,159 deaths .
Six states have not yet set a date to reopen .
They include the nation ’ s most populous state , California , which has had 113,000 total cases and about 4,250 deaths .
The others are Kentucky , Maine , New Jersey , @ @ @ @ @ @ @ report was updated June 4 to correctly identify Stateline as an initiative of Pew Charitable Trusts .
The accompanying photograph also has been changed .

Among states that reopened their economies about a month ago, most logged about the same number of COVID-19 cases, though some had more cases and others saw a decline.
The closest thing to a discernible pattern is that Western and Midwestern states performed better than Southern states in terms of fewer new cases of the disease caused by the new coronavirus.
Even there, though, some Southern states saw a decline or remained steady in the number of COVID-19 cases, according to data from the Kaiser Family Foundation.
The increase in new diagnosed cases offers only a glimpse of how each state is doing.
>>> What’s the best way for America to reopen and return to business? The National Coronavirus Recovery Commission, a project of The Heritage Foundation, assembled America’s top thinkers to figure that out. So far, it has made more than 260 recommendations. Learn more here.
In 47 states, hospitalization for COVID-19 either has been flat or has decreased, said Dr. Lee Gross, president of Docs 4 Patient Care, a health care advocacy group.
As testing expands, the number of confirmed cases will increase, Gross said, and the most notable measurement is of serious cases.
“The key is not to focus on just the number of cases, but how seriously ill people are,” Gross, who practices family medicine in North Port, Florida, told The Daily Signal. “There are many diseases that don’t shut down the economy for months.”
The only three states with increasing hospitalization rates for COVID-19 are Hawaii, Rhode Island, and Wisconsin, he said.
Wisconsin reopened its economy May 8 and Rhode Island reopened May 13. Hawaii didn’t do so until May 31, so there may not be a clear pattern.
Wisconsin, which came back the earliest of the three, had the biggest increase, Gross said.
‘Different Trends After Reopening’
The states seeing patients test positive for the coronavirus at a rate of 10% or higher are Alabama, Nebraska, and Virginia, Gross said, adding that hospitalization rates are flat.
It is difficult to say why some states appear to be doing better than others, said Jennifer Tolbert, director of state health reform at the Kaiser Family Foundation.
“We are definitely seeing different trends after reopening for about a month in different locations,” Tolbert told The Daily Signal. “I’m not sure we know the why.”
A dozen states began phased reopenings in late April, according to Stateline, a project of Pew Charitable Trusts that monitors state governments.
Alaska, which has had 467 COVID-19 cases and 10 deaths, according to the Centers for Disease Control and Prevention, led the way in reopening April 24.
Montana, with 523 total cases and 17 deaths, followed the next day. Then Colorado.
Mississippi was the first Southern state to reopen, on April 27. Three days later, it was followed by Alabama, Georgia, Idaho, Kansas, Tennessee, Texas, and West Virginia, according to Pew.
Kaiser Family Foundation measured new cases in states based on a seven-day rolling average on May 5, by which time a significant number of states had reopened, and May 28, close to the end of the month.
Colorado and Georgia, two of the most permissive states in their reopenings, were widely criticized for taking a far less cautious approach than many other state governments.
Noting again how every state has different dynamics, Kaiser’s Tolbert noted that many of the early cases in Colorado began at ski resorts that later were closed down.
On May 5, Colorado had 436 new cases using the seven-day rolling average. By May 28, that number had declined to 274 new cases, according to Kaiser. In all, Colorado has had about 26,000 cases and 1,458 deaths.
Georgia had a more nominal dip, with 710 new cases May 5 and 658 new cases May 28. Georgia has had about 48,000 total cases and just over 2,000 total deaths, according to the CDC.
‘So Much Hype’
“These governors who uncaged free people and enterprise were wisely acting to not endanger so many livelihoods while still working to protect the most vulnerable,” George Allen, a former governor and U.S. senator of Virginia, told The Daily Signal.
Allen said 100,000 deaths from the new coronavirus were tragic. However, the doomsday predictions for states that reopened didn’t come true, indicating a problem with computer models on the virus, he said.
“There was so much hype,” said Allen, who is also a member of The Heritage Foundation’s National Coronavirus Recovery Commission. “The fact that so many states opened and cases declined shows how wrong many of the forecasts and models were.”
Allen said he hopes to see more governors and state legislatures provide liability protections for businesses in reopening and work to recruit pharmaceutical manufacturers so that America is less reliant on China.
For the state of Texas, new cases of COVID-19 were about the same in early May—1,079—as in late May—1,049—except for a spike in mid-May of 1,305 that was followed by a decline. Texas, the second most populous state, has had about 65,000 total cases and 1,678 deaths, according to the CDC.
In Alabama, however, new cases nearly doubled from 241 to 463 over that time period, according to Kaiser. Alabama has had 18,438 cases and 648 deaths in all.
Mississippi also had a spike from 266 new cases to 307 new cases in the three weeks from May 5 to May 28. The state has had more than 16,000 cases and 768 deaths, according to the CDC.
Tennessee, however, saw a decrease from 520 new cases in early May to 388 new cases in late May, according to Kaiser. In all, Tennessee has had 23,709 cases and 369 deaths.
West Virginia saw its already tiny number of new cases, 22, more than double to 49 from early to late May. West Virginia was the last state with zero cases early in the pandemic. In all, it has had about 2,000 cases and 76 deaths.
More Testing, Tracing
Other states remained steady after reopening.
On some level, an increase in new COVID-19 cases was expected whenever Americans came out of isolation, Kaiser’s Tolbert said:
As states reopen, the hope is that while, yes, there will be an increase in cases, states will also increase the testing and contact tracing. The whole reason we went into lockdown was never eradication of the virus, but it was to flatten the curve to give the health care system time to respond and not be overwhelmed.
Utah did a partial reopening May 1, and Missouri followed May 3. Utah has had more than 10,000 total cases and 114 deaths. Missouri has had 13,327 cases and 773 deaths.
The states of Florida, Indiana, and South Carolina began their phased reopenings May 4.
On May 8, Rhode Island, which has had about 15,000 cases and 720 deaths, became the first Northeastern state to reopen. Wisconsin began opening May 13.
Utah remained about the same, with 158 new cases May 5, just a few days after its reopening, and 150 new cases May 28, according to Kaiser.
Indiana had 635 new cases after a seven-day average May 5, one day after reopening. That dropped to 445 new cases May 28. Indiana has had a total of 34,830 cases and 2,142 deaths.
Florida, with the nation’s third-largest population, was almost flat with 656 new cases the day after it reopened May 4 and 659 as of May 28. In all, Florida has had 55,415 cases and 2,460 deaths.
South Carolina had an increase in new cases from 158 on May 5 to 201 new cases May 28. South Carolina has had 12,148 total cases and about 500 deaths.
As an aside, neighboring North Carolina, which didn’t reopen until May 21 according to Stateline, saw a big spike before and after—going from 394 cases May 5 to 755 cases May 28. North Carolina has had 29,263 total cases and about 900 deaths.
In Wisconsin, a week before the May 13 reopening, the number of new cases was 325 on May 5. That increased to 441 by May 28, according to Kaiser. Wisconsin has had about 18,500 cases and 600 deaths.
Staying Open
Seven other states didn’t force closure of their economies but issued strong guidelines to businesses and individuals. These states were Arkansas, Iowa, Nebraska, North Dakota, Oklahoma, South Dakota, and Wyoming, according to Stateline.
For the most part, there was no significant difference for these seven states over the period measured. But Arkansas had an increase from 57 new cases in early May to 182 new cases by late May, according to Kaiser. Arkansas has had 7,443 total cases and 133 deaths.
Nebraska saw a decline from 408 new cases May 5 to 260 new cases May 28. The state has had 14,345 total cases and 178 deaths.
Keeping with the Midwestern trend, Iowa saw a decline from 534 new cases in the seven-day average May 5 to 345 new cases May 28. In all, Iowa has had almost 20,000 cases and about 550 deaths.
Oklahoma was steady, with 102 new cases dipping to 100 over that same period. The state has had about 6,300 total cases and 338 deaths.
For other states, it may be too early to measure the potential effect of reopening.
States that had phased reopenings in mid-May include Arizona, Connecticut, Louisiana, Maryland, Nevada, Minnesota, Massachusetts, Ohio, Vermont, and Virginia, according to Stateline.
Delaware, Hawaii, Illinois, Maine, New Hampshire, New Jersey, North Carolina, Washington, and the District of Columbia reopened in late May.
What’s Next?
Pennsylvania opens Thursday, June 4, followed by Michigan on June 12.
The state of New York, which has had the largest number of COVID-19 cases and deaths in the nation, will open June 13.
The Centers for Disease Control and Prevention measures New York state and New York City separately in logging coronavirus cases. In all, New York City has had more than 200,000 cases and almost 22,000 deaths. The rest of New York state has had about 168,000 cases and 8,159 deaths.
Six states have not yet set a date to reopen. They include the nation’s most populous state, California, which has had 113,000 total cases and about 4,250 deaths.
The others are Kentucky, Maine, New Jersey, New Mexico, and Oregon.
This report was updated June 4 to correctly identify Stateline as an initiative of Pew Charitable Trusts. The accompanying photograph also has been changed.