Unsanitized: The COVID-19 Report for June 29, 2020

Medicare for Coronavirus. Also, COVID upends fracking.

 

United Memorial Medical Center in Houston. Long-term complications from
coronavirus must be addressed through policy. (David J. Phillip/AP
Photo)

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 here

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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 .

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Frack'd

[link removed]

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
.

We Can't Do This Without You

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)

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