David J. Phillip/AP Photo
Unsanitized-062920
United Memorial Medical Center in Houston. Long-term complications from coronavirus must be addressed through policy.
First Response
A week ago, I pointed out that official cases were rising in the U.S. while official deaths were falling. That dynamic continued throughout the week; the late reporting of old deaths in Delaware and New Jersey appeared to give the opposite impression, but the downward slope has been unbroken and largely linear. Sunday’s death toll was the lowest since March 24. You can talk about a lag time, but in the states with the biggest caseloads, the numbers have been rising for close to a month, without corresponding deaths.
There are lots of potential theories for this, including changing age demographics, more caution from the elderly, better policies in nursing homes, and superior treatment in hospitals. Whet Moser has a good report on this.
But “deaths” are not the only metric we should be concerned about. Hospitalizations, for example, are way up in selected areas. Houston area hospitals are just no longer updating capacity statistics, a worrying sign, and medical facilities throughout Texas, Florida and Arizona are pinning red. Even younger people can get very sick from COVID-19. And that leads us to a long-term worry of ongoing sickness, and how we’re going to manage it.
Read all of our Unsanitized reports
There are so many “long-haul” coronavirus sufferers, who have been living with symptoms of the disease for months, that they’ve started a 5,000-strong support group on Slack. The disease doesn’t just land in the lungs and stay there. It can attack the liver, the kidneys, the brain, the heart, and other organs. The respiratory functions can linger at a sub-optimal state for indefinite periods. Asymptomatic people can still suffer from lung damage. Rudy Gobert, the Utah Jazz All-Star center whose contraction of COVID-19 led to the shutting down of the NBA, still cannot smell 100 percent, three months after acquiring the disease.
The combination of a younger mix of patients and the potential for long-term damage means that there is likely to be an entire class of people in America and globally living with coronavirus symptoms, maybe for substantial portions of their life. We need to figure out what to do about that. And we should look to recent history for a solution.
The Zadroga bill for 9-11 victims was hard-fought, much more than it ever should have been. But we’re finally in a place where first responders who ran into the rubble at Ground Zero and volunteered to clear the debris, who suffered respiratory and other diseases as a result, are fully covered on their medical bills. Decades earlier, we created the Medicare End Stage Renal Disease Program, based on legislation signed by Richard Nixon, which made kidney dialysis treatment covered through Medicare. This is a nearly universal benefit for everyone with late-stage chronic kidney disease, under a composite rate.
There are problems with both of these models. We let a lot of people die before fully covering 9-11 treatment. And the dialysis business has become a duopoly of outpatient profiteering, chasing guaranteed coverage. But the model, while it needs some guardrails, is there: we should cover everyone suffering from complications due to coronavirus throughout their lives, through either a compensation fund or, better, entry into Medicare.
There might have to be some way to substantiate that factors due to the virus are covered and not a broken leg. Or maybe we don’t care about that and say that everyone who had the misfortune to contract this disease and is experiencing long-haul symptoms is covered, permanently, for their health concerns. That’s what a just society would do.
The people of Libby, Montana have Medicare for All, a rider in the Affordable Care Act that extends permanent Medicare coverage to residents suffering from asbestos poisoning at the W.R. Grace mine in town. I see this as analogous. There are going to be a lot of people with long-term damage from the virus, newly burdened with costs that could affect their entire lives in our for-profit system without assistance. We ought to do something about that. And if you say that’s not fair, that everyone should have access to the same kind of ongoing coverage, paid for through collective burden-sharing, well, I agree with you.
Pledge Week Wrapping Up
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Frack’d
Chesapeake Energy, an early pioneer in natural gas fracking, filed for bankruptcy on Sunday, a victim of the pandemic but also its own business model. Cheaspeake at one point owned drilling rights on a landmass equivalent to the entire state of West Virginia. But it obtained those rights and the various mechanisms for drilling through floating debt, endlessly. Its footprint has been falling precipitously since 2012 and daily production since 2014, as the price of natural gas fell and only those who pivoted to seeking oil in the shale survived (for now, at least).
Chesapeake leaves a legacy of rigging oil leases, a founder who died in a car crash a day after his indictment, and at one point as much as $20 billion in debt (down to $7 billion now).
The debt bubble made it unable for Chesapeake to maneuver when the pandemic ruined demand for energy. The shale industry, which feasted on debt as the only way to speculate on drilling, was already on the way out. It raised only half as much debt last year as it did in 2016, because of falling revenue and little appetite on Wall Street. Even with oil bouncing back to $35 a barrel, that puts 30 percent of shale drillers as insolvent. As many as 200 drilling companies could fall into bankruptcy; Chesapeake was an early domino to fall. Cheaspeake is probably a restructure, but that’s not certain, and the smaller players will almost definitely be liquidated.
The crisis accelerated this slow fracking death. And you said coronavirus was all bad. To think that just this weekend, shale tycoon and Trump supporter Harold Hamm called green energy “not based in reality” and not “sound economics.” Well, reality is knocking, and it says fracking is unsustainable.
Days Without a Bailout Oversight Chair
94.
Today I Learned
- Thirty-four private equity-backed companies have gone bankrupt since March, though the industry has $1.45 trillion in investable funds. The industry excuses for inaction are weak and incorrect. (Wall Street Journal)
- Travel “will never go back to the way it was,” says Airbnb CEO. (Axios)
- Longread on Amazon and its warehouse workers during the crisis. (Recode)
- Longread on Gretchen Whitmer during the crisis. (NYT Magazine)
- The notion of state-based “complementary” currency creeping back into the discourse. Far superior to the alternative. (Interfluidity)
- Trump so rhetorically committed to opposing vote by mail that its lowering Republican turnout. (Washington Examiner)
- One of the more troubling comebacks in the COVID era is the single-use plastic bag. (Wall Street Journal)
- Sacha Baron Cohen at it again. (Daily Beast)
