COVID recession pushed Social Security insolvency up a year

 The sharp shock of the coronavirus recession pushed Social Security a year closer to insolvency but left Medicare’s exhaustion date unchanged, the government reported Tuesday in a counterintuitive assessment that deepens the uncertainty around the nation’s bedrock retirement programs.

The new projections in the annual Social Security and Medicare trustees reports indicate that Social Security’s massive trust fund will be unable to pay full benefits in 2034 instead of last year’s estimated exhaustion date of 2035. For the first time in 39 years the cost of delivering benefits will exceed the program’s total income from payroll tax collections and interest during this year. From here on, Social Security will be tapping its savings to pay full benefits.

The depletion date for Medicare’s trust fund for inpatient care remained unchanged from last year, estimated in 2026.

In the 1980s, financial warnings about Social Security prompted then-President Ronald Reagan and lawmakers of both parties in Congress to collaborate on a long-term solvency plan, but such action is unlikely in today’s bitter political climate. Democrats who control the White House and Congress offered assurances they would protect both programs.

“The Biden-Harris administration is committed to safeguarding these programs and ensuring they continue to deliver economic security and health care to older Americans,” Treasury Secretary Janet Yellen said in a statement.

The latest estimates reflected the push and pull of many factors flowing from the pandemic, and the full impact may take years to sort out. The deep but relatively short recession slashed revenue from payroll taxes. But the death toll from COVID-19, concentrated among older people, reduced future Social Security benefit payouts. Hospitals were stressed by the influx of COVID patients, but Medicare didn’t have to pay for as many knee surgeries, colonoscopies and other more routine procedures. Birth rates and immigration, which tend to bolster the two programs, both fell.

For Social Security, the loss of payroll tax revenue outweighed any savings from what the program would have paid out to people whose lives were lost in the pandemic. The report noted that employment, earnings, interest rates and economic growth plummeted in the second quarter of 2020 after the pandemic hit the United States.

“The finances of both programs have been significantly affected by the pandemic and the recession of 2020,” the trustees said. But “given the unprecedented level of uncertainty” there was no consensus on what the long-lasting effects of the pandemic would be. A looming question for Medicare: Will the population of beneficiaries who survived the pandemic be healthier on the whole, or will a high number suffer from new conditions like long COVID?

Social Security pays benefits to more than 65 million Americans, mainly retirees but also disabled people and survivors of deceased workers. Medicare covers more than 60 million older and disabled people. Together, both programs account for more than 40% of the federal budget, and act as stabilizer not only for families, but for the national economy.

While long-term projections are sobering, in the short run there was some good news for Social Security recipients.

Government economic experts who prepared the Social Security report estimated recent increases in inflation mean the cost-of-living adjustment for 2022 will approach 6%, a whopping jump from the 1.3% COLA awarded for this year.

Some of that may go for higher Medicare costs. The Medicare “Part B” premium for outpatient coverage was projected to rise by $10 a month in 2022, to $158.50 under the report’s intermediate assumptions. The official number won’t be released until later this year.

Social Security and Medicare remain under intense financial pressure with the retirement of millions of baby boomers, who are living longer than previous generations.

When the Social Security trust fund is depleted the government will be able to pay 78% of scheduled benefits, the report said. When Medicare’s trust fund for inpatient care runs short, it will be able to pay only 91% of expected costs, mainly hospital bills.

Because reductions of that magnitude would cause a political uproar, it is likely that a future Congress would find ways to recover the lost benefits, either by hiking the payroll taxes paid by current workers or by increasing government borrowing to cover the shortfall. With Medicare, lawmakers could also raise premiums paid by beneficiaries.

It’s unclear how the Medicare projections will affect the debate on Capitol Hill about authorizing the program to negotiate prescription drug prices and then using projected savings to provide new Medicare coverage for dental, vision and hearing services. Republicans have argued that any savings should go to shore up the underlying program, not expand benefits.

The Medicare report steered clear of making any projections about the new Alzheimer’s drug, Aduhelm, which has a list price of $55,000. Most of the 6 million Americans dealing with Alzheimer’s are covered by the program, though not all would be candidates for the medication.

The trustees’ reports, which have been delayed for months, represent the government’s effort to assess the impact of last year’s pandemic and recession on Social Security and Medicare.

The U.S. economy lost a staggering 22.4 million jobs in March and April 2020 as the pandemic forced businesses to close or cut their hours and the economy went into recession.

But the recession turned out to be brief and hiring has bounced back as economic growth has resumed. Employers have brought back 16.7 million jobs since April 2020 but that gain still leaves the labor force 5.7 million jobs below where it was before the pandemic hit.

The trustees of Social Security and Medicare include the secretaries of Treasury, Health and Human Services, and Labor, as well as the Social Security commissioner. They are supposed to be joined by two “public trustees,” knowledgeable private citizens who act as the eyes and ears of taxpayers and beneficiaries. But those posts have been vacant since July 2015 — before the end of the Obama administration. And this year there’s no Social Security commissioner either, since President Joe Biden fired Andrew Saul, a holdover appointee from the Trump administration.

https://apnews.com/article/business-medicare-6d527d62acb9a6ee09361d81ccacd36f

State mask bans face federal civil rights inquiries

 The Education Department on Monday opened civil rights investigations into five Republican-led states that have banned or limited mask requirements in schools, saying the policies could amount to discrimination against students with disabilities or health conditions.

The department’s Office for Civil Rights announced the investigations in letters to education chiefs in Iowa, Oklahoma, South Carolina, Tennessee and Utah. Those states have issued varying prohibitions on mask requirements, which the office says could prevent some students from safely attending school.

Education Secretary Miguel Cardona accused the states of “putting politics over the health and education of the students they took an oath to serve.”

“The department will fight to protect every student’s right to access in-person learning safely,” Cardona said in a statement.

It marks a sharp escalation in the Biden administration’s battle with Republican states that say mask-wearing should be a personal choice. President Joe Biden last week asked Cardona to explore possible legal action, prompting the department to examine whether the policies could amount to civil rights violations.

The states under investigation have adopted a range of policies that outlaw or curb mask mandates. A state law in Iowa forbids school boards from mandating mask wearing. In Tennessee, school mask mandates are permitted, but a recent executive order from Gov. Bill Lee allows families to opt out of them.

Those policies conflict with guidance from the Centers for Disease Control and Prevention, which recommends universal mask wearing for students and teachers in the classroom. The CDC issued the guidance in light of the rapid spread of the highly contagious delta variant of COVID-19.

In announcing the investigations, the department said it will examine whether the policies violate a federal law protecting students with disabilities. Under that law, students with disabilities must be given access to a “free appropriate public education” alongside their peers without disabilities.

But states that outlaw mask mandates could be preventing schools from taking necessary steps to protect students with disabilities or medical conditions, the department said.

In its letters, the department said it’s concerned that the states “may be preventing schools from making individualized assessments about mask use so that students with disabilities can attend school and participate in school activities in person.”

Education Department investigations often end with voluntary agreements that remedy alleged violations. But if the agency concludes that states violated civil rights laws, it could issue sanctions as severe as a loss of federal education funding.

The inquiries were launched at the department’s discretion and not in response to complaints from parents. But Cardona said he has heard from families who are concerned that state mask policies could put their children at risk.

Some Republicans quickly denounced the investigations. Iowa Gov. Kim Reynolds said individuals should be trusted to make the best decisions for themselves.

“Iowa was able to reopen schools safely and responsibly over a year ago. President Biden and his team know this, yet they’ve decided to pick a political fight with a handful of governors to distract from his own failures,” Reynolds said in a statement.

A spokesperson for Oklahoma Gov. Kevin Stitt said that, “until every American citizen is safely out of Afghanistan, President Biden shouldn’t spend a single second harassing states like Oklahoma for protecting parents’ rights to make health decisions for their kids.”

But Oklahoma’s education chief, who has said mask mandates should be an option, appeared to share the Education Department’s concerns. In a statement, State Superintendent Joy Hofmeister said the state “is preventing schools from fulfilling their legal duty to protect and provide all students the opportunity to learn more safely in-person.”

In South Carolina, the state’s top education official has similarly clashed with the governor over mask policies. A statement from the state education agency said Superintendent Molly Spearman has “repeatedly implored” lawmakers to reconsider their ban on mask mandates.

South Carolina education officials said they are sensitive to the law’s effect on vulnerable students, and are “acutely aware of the difficult decisions many families are facing concerning a return to in-person instruction.”

Some other states previously outlawed mask mandates, but the policies were overturned by courts or are not being enforced, including in Florida, Texas, Arkansas and Arizona. The Education Department has not opened investigations in those states but said it is watching closely and is prepared to take action.

Masks have emerged as a major source of contention as the nation’s schools start a new school year during a surge in COVID-19 cases. Although most states let schools decide their own policies, some have taken firm stances for or against mandates.

States including California, New York and Louisiana have issued statewide mask requirements inside schools, while Texas, Florida and others moved to prevent schools from requiring masks.

In Florida, which had taken one of the toughest stances against mask mandates, a judge ruled Friday that schools are legally allowed to require masks. The judge overturned an order from Gov. Ron DeSantis that had barred such mandates, ruling that it was unconstitutional and cannot be enforced.

Other states opposing mask mandates face similar legal challenges. In South Carolina, the American Civil Liberties Union last week filed a federal lawsuit over the state’s policy forbidding mask mandates. The suit, filed on behalf of parents and disability rights groups, argues that the ban excludes vulnerable students from public schools.

In Iowa, a mother of twin boys recently sued the state over its ban on school mask requirements. In her suit, Frances Parr said her children were set to start first grade this year, but she is now teaching them at home over fears about their safety.

In the Des Moines school district, which has opposed the state’s policy against mask mandates, officials were encouraged by the support from the federal government. The district is encouraging mask-wearing but is forbidden from requiring it.

“If our state government doesn’t change its position as the pandemic continues then hopefully the federal government will find a legal path that allows us to do more to keep our students and staff safe,” district spokesperson Phil Roeder said in a statement.

https://apnews.com/article/health-education-coronavirus-pandemic-75626804dd993775d292a6b450e13d01

Japan finds another Moderna vial suspected to contain foreign substance

  Japan’s Kanagawa prefecture said it has found another vial of Moderna Inc’s COVID-19 vaccine suspected of containing a foreign substance and has put the rest of the lot on hold.

In a statement on Tuesday, prefectural authorities said a pharmacist found several black particles in one vial upon checking for foreign substances before the vaccine’s use.

Japan suspended the use of 1.63 million doses https://www.reuters.com/world/asia-pacific/japan-withdraws-16-mln-moderna-covid-19-vaccine-doses-over-contamination-nikkei-2021-08-25 of Moderna shots last week after being notified of contamination in some of the supply. Moderna and Spanish pharma company Rovi, which bottles Moderna vaccines, have said the cause could be a manufacturing issue, and European safety regulators have launched an investigation.

Moderna has said no safety or efficacy issues had been identified from the issue.

Kanagawa prefecture said the vaccine’s domestic distributor, Takeda Pharmaceutical Co Ltd , had collected the vial with the suspected contaminant, and that about 3,790 people had already received shots from the same lot.

More Moderna shots were temporarily halted in two regions of Japan this week for what appears to be a separate issue of bits of the vials’ rubber stopper breaking off https://www.reuters.com/world/asia-pacific/japan-health-minister-says-okinawa-vaccine-contaminants-likely-needle-stick-2021-08-31 when needles are incorrectly inserted.

https://wtvbam.com/2021/08/31/japan-finds-another-moderna-vial-suspected-to-contain-foreign-substance/

Texas 6-week abortion ban takes effect, with high court mum

 A Texas law banning most abortions in the state took effect at midnight, but the Supreme Court has yet to act on an emergency appeal to put the law on hold.

If allowed to remain in force, the law would be the most dramatic restriction on abortion rights in the United States since the high court’s landmark Roe v. Wade decision legalized abortion across the country in 1973.

The Texas law, signed by Republican Gov. Greg Abbott in May, would prohibit abortions once a fetal heartbeat can be detected, usually around six weeks and before most women even know they’re pregnant.

Abortion providers who are asking the Supreme Court to step in said the law would rule out 85% of abortions in Texas and force many clinics to close. Planned Parenthood is among the abortion providers that have stopped scheduling abortions beyond six weeks from conception.

At least 12 other states have enacted bans on abortion early in pregnancy, but all have been blocked from going into effect.

What makes the Texas law different is its unusual enforcement scheme. Rather than have officials responsible for enforcing the law, private citizens are authorized to sue abortion providers and anyone involved in facilitating abortions. Among other situations, that would include anyone who drives a woman to a clinic to get an abortion. Under the law, anyone who successfully sues another person would be entitled to at least $10,000.

Abortion opponents who wrote the law also made it difficult to challenge the law in court, in part because it’s hard to know whom to sue.

Texas has long had some of the nation’s toughest abortion restrictions, including a sweeping law passed in 2013 that the Supreme Court eventually struck down but not before more than half of the state’s 40-plus abortion clinics closed.

Lawmakers also are moving forward in an ongoing special session in Texas with proposed new restrictions on medication abortion, a method using pills that accounts for roughly 40% of abortions in the U.S.

https://news.yahoo.com/texas-6-week-abortion-ban-050126962.html

Novartis to Provide Cholesterol-Fighting Drug Leqvio in UK

 Novartis AG has reached a deal to provide its cholesterol-lowering medicine Leqvio to patients via the U.K.'s National Health Service, the Swiss pharmaceutical company said Wednesday.

Over the course of three years, around 300,000 patients should be treated with Leqvio (inclisiran), Novartis said. The patients targeted are those at high risk of having a second cardiovascular event.

The treatment is part of a population health-management approach and aims to reduce patients' long-term elevated LDL cholesterol, a key modifiable risk factor in cardiovascular disease, the company said.

The collaboration with the NHS follows final recommendation for Leqvio from the U.K.'s medicines regulator, NICE.

https://www.marketscreener.com/quote/stock/NOVARTIS-AG-9364983/news/Novartis-to-Provide-Cholesterol-Fighting-Drug-Leqvio-in-UK-36294364/

Florida changed its COVID-19 data, creating an ‘artificial decline’ in recent deaths

 As the delta variant spreads through Florida, data published by the Centers for Disease Control and Prevention suggest this could be the most serious and deadly surge in COVID-19 infections since the beginning of the pandemic.

As cases ballooned in August, however, the Florida Department of Health changed the way it reported death data to the CDC, giving the appearance of a pandemic in decline, an analysis of Florida data by the Miami Herald and el Nuevo Herald found.

On Monday, Florida death data would have shown an average of 262 daily deaths reported to the CDC over the previous week had the health department used its former reporting system, the Herald analysis showed. Instead, the Monday update from Florida showed just 46 “new deaths” per day over the previous seven days.

The dramatic difference is due to a small change in the fine print. Until three weeks ago, data collected by DOH and published on the CDC website counted deaths by the date they were recorded — a common method for producing daily stats used by most states. On Aug. 10, Florida switched its methodology and, along with just a handful of other states, began to tally new deaths by the date the person died.

If you chart deaths by Florida’s new method, based on date of death, it will generally appear — even during a spike like the present — that deaths are on a recent downslope. That’s because it takes time for deaths to be evaluated and death certificates processed. When those deaths finally are tallied, they are assigned to the actual date of death — creating a spike where there once existed a downslope and moving the downslope forward in time.

Shivani Patel, a social epidemiologist and assistant professor at Emory University called the move “extremely problematic,” especially since it came without warning or explanation during a rise in cases.

Patel said Florida death data now show an “artificial decline” in recent deaths and without an explanation or context, and “it would look like we are doing better than we are.”

The change came the day after the state health department’s official Twitter account posted a series of late-night tweets accusing the CDC of publishing incorrect numbers, but offering little explanation

“As a result of data discrepancies that have occurred, this week, FDOH worked quickly and efficiently with CDC to ensure accurate display of data on their website the same day,” DOH spokesperson Weesam Khoury told the Herald in a statement at the time. “To proactively ensure accurate data is consistently displayed, the Department will begin daily submission of a complete renewed set of case data to CDC, including retrospective COVID-19 cases.”

The health department did not acknowledge the subsequent change in the data structure or its abrupt onset, leaving the public scrambling for answers as more than a year’s worth of data changed from one day to the next.

“It shouldn’t be left to the public, to scientists, national policy makers or the media to guess as to what these numbers are,” Patel said. “We know from the beginning that dates matter and that they tell us different things.”

Jason Salemi, an epidemiologist at the University of South Florida who has been tracking the state’s COVID data, said reporting by date of death is better for long-term studies of the disease.

“Deaths by date of death curve is the most accurate you can get,” Salemi said. “You know exactly when people died, you know how to construct the curve and exactly when we were experiencing surges in terms of deaths.”

But Florida’s new data structure is less useful for understanding the pandemic in real time, he warned.

“When you have big surges in deaths, the deaths by date reported will always show an increase while deaths by date occurred will go down,” Salemi said.

“Someone could have died yesterday and we may not know about it for a week, or two weeks,” Salemi said. As a result, new death trends as reported by the Florida health department are significantly lower when data are first reported and don’t immediately reflect the actual number of people who died that day.

During surges of cases and deaths, averaging seven days of deaths by report date provides an important early indicator of how many people have recently died of the disease — a number that will eventually be reflected in the data by date of death, Salemi said.

Although deaths by date the person died are not currently reflecting record numbers, trends based on newly reported deaths are currently almost 31% higher than previous peaks in summer of 2020 and over the holidays, the Herald analysis showed. Of the record deaths reported to the CDC between Saturday and Monday, the Herald found that the vast majority of the 902 victims died within the past two weeks.

The Herald also found that during the last two surges the trend lines using date of death showed peaks 25% and 8% higher respectively than the corresponding peaks by report date.

‘STATISTICAL SLEIGHT OF HAND’

The Florida health department has made several, unannounced changes to its data methodology over the span of the pandemic, abruptly switching between including and disregarding non-resident deaths in its total counts, for example. Salemi said such frequent variations make it difficult to report numbers in a consistent and transparent manner that’s easily understood by the public.

Florida hasn’t always depended on the CDC to be the exclusive publishing house for its daily numbers. Until June 4, the department published its own data, available in daily PDF reports and also provided to view and download through an online dashboard.

The downloadable data sets on cases and deaths included the report date as well as the date a person died or got sick, allowing journalists and independent researchers to select the best metric for their purposes. The daily reports showed additional cases and deaths added from one day to the next.

In June, as case numbers dropped and vaccination rates continued to rise, the health department discontinued the dashboard and changed to a weekly report. The only near-daily data was submitted by the health department to the CDC and published on the CDC Trend Tracker website.

At first, the data on the CDC website was updated in a largely predictable manner, similar to the way that the DOH had reported daily changes throughout the pandemic. Then on Aug. 10, without warning or any explanation from the health department or the CDC, the data for nearly every day of the previous year changed. Neither agency immediately explained the changes.

The CDC eventually confirmed what experts had hypothesized after comparing the new data to previous reports — that the Florida Department of Health had begun to report deaths by date of death. The change was also reflected in data about new cases, which went from being counted by date of report to “the date of specimen collection, confirmed COVID-19 laboratory test result, or clinical diagnosis,” according to the CDC website. The case data show less of a dramatic shift than death data because case data are reported more quickly than deaths.

The CDC website listed Florida as one of just 12 jurisdictions — 11 states and New York City — reporting new deaths by date of death as of the end of August. The choice of how to report is determined by each jurisdiction, according to the website.

Florida’s weekly report, published on Fridays, also shows a decline in deaths in recent weeks even as the number of total dead across the state spikes. Last Friday, the DOH report showed 389 COVID-19 deaths for the previous week. But a comparison of cumulative deaths from the report the week before showed that 1,727 additional deaths were logged by the health department over that seven-day period. The DOH chart of deaths shows a decline over the past two weeks.

THE FLORIDA DEPARTMENT OF HEALTH

The DOH weekly report notes “death counts include individuals who meet a standardized national surveillance case definition” but includes no descriptions of how the health department presents the numbers.

“Due to inherent delays in deaths being reported to the [Health] Department, the previous 14 days may be incomplete and are updated over time,” said Khoury, the health department spokesperson, in an Aug. 30 statement to the Herald. “The Department reports deaths by date of death to the CDC upon notification to the Department.”

The Florida health department does not provide that explanation on its website or anywhere in its weekly reports.

In consultation with epidemiologists the Herald continued to report additional cases and deaths added to the total each day in daily updates rather than relying on the number of “new cases” and “new deaths” DOH data attribute to the previous day. However, data still appear inconsistent, as deaths backfill in large semi-weekly batches, rather than in all weekday updates.

“The CDC has started displaying the Department’s submitted retrospective file twice a week on Mondays and Thursdays, which updates previous day deaths that were subsequently reported to the Department,” Khoury explained for the first time in Monday’s statement. The difference can be an addition of eight deaths one day, and 901 the following day, as happened in the middle of last week.

Without context about how data are reported, when recent numbers are low due to reporting lags, “people will think there’s nothing going on,” said Mary Jo Trepka, an infectious disease epidemiologist and professor at Florida International University.

Economist Tim Harford, author of “The Data Detective,” who spoke generally about how data can be manipulated, said that changes in data definitions are unlikely to have long-term negative effects on scientists, but could easily confuse or mislead the layperson.

“When numbers are presented in a flattering light, an expert will generally be able to see through the dazzle quite quickly,” Harford said. “That said, I still think the truthful-yet-deceptive framing of numbers is a serious problem.”

When data are subtly distorted or presented differently than expected — something Harford called “statistical sleight of hand” — it can prompt dangerous levels of general mistrust and cynicism, he said.

“COVID is a matter of life and death and people deserve to have information that is both accurate and understandable without having to decode it,” he said.

HOW SERIOUS IS THIS THIRD WAVE?

Current data from Florida also show that cases and hospitalizations are at record levels, although trends seem to have plateaued over the past week.

“What we’re seeing is an active rise in cases where we can’t keep up, an active rise in deaths that, because of using actual date of deaths, has been shifted back in time and we have no idea where we really are,” said Patel, the epidemiologist from Emory University.

This plateau, she said, might not reflect reality.

“It just looks like Florida is unable to count and report its cases fast enough,” she said.

Patel said data indicate the worst has yet to come for Florida, and it’s likely that deaths will surpass past records. But it’s still too soon to know with certainty, she said.

High levels of hospitalizations also tend to correlate with higher levels of deaths, said Dr. Aileen Marty, an infectious disease professor at FIU’s Herbert Wertheim College of Medicine.

“Ultimately, having a lot of people in the hospital at the same time decreases our overall survival,” Marty said.

The more patients there are in the hospital at the same time, the harder it is for medical staff to give quality care for those patients, Marty said. As the number of patients hospitalized keeps going up, hospitals often start running out of supplies, staff and beds she said.

“The end result is that someone who, if they were the only patient they’d survive, and now might not,” she said.

“We won’t know the true magnitude of the loss of life from this summer’s surge until the fall,” said Trepka.

\https://www.miamiherald.com/news/coronavirus/article253796898.html

Tennessee underreported COVID-19 hospitalizations by about 5,100

 The coronavirus hospitalized about 5,100 more Tennesseans than previously reported over the past 14 months — an increase of more than 20% over prior totals — according to newly backfilled data from the state department of health.

Hospitalizations were underreported by anywhere from one patient to dozens on nearly every day since the start of last summer, according to the new data. The largest share of the unreported hospitalizations occurred during the winter surge.

Tennessee's revised hospitalization total, including the backfilled data, is 29,694.

Sarah Tanksley, a spokesperson for the health department, said the unreported hospitalizations were now revealed because the agency incorporated a new data source from the Tennessee Hospital Association into its COVID-19 tracking efforts.

The hospital association receives patient-level virus data from hospitals, which is more detailed than the facility-level data hospitals provide to the state government, Tanksley said. The health department only recently figured out how to combine the two sources of information, allowing for a more complete accounting of the virus' impact, she said.

Tanksley said a more complete picture of COVID-19 hospitalizations is "helpful in assessing disease severity, impact of vaccination status, demographics of hospitalized patients."

As of Tuesday, Tennessee was reporting an average of about 7,000 infections and 39 deaths from the virus per day. Nearly 3,300 people were hospitalized with the virus, including 79 children. The state is on pace to set a new record for hospitalizations by the end of the week.

https://www.tennessean.com/story/news/health/2021/08/31/tennessee-underreported-covid-19-hospitalizations-5100/5670622001/