Friday, January 08, 2021

Covid pandemic could bring 'a lost decade' of economic growth, World Bank says

The global economy could be heading for "a decade of disappointing growth outcomes" after the Covid-19 pandemic triggered one of the worst economic recessions in history, said the World Bank.

In its Global Economic Prospects report, the bank projected that global potential growth — which assumes the economy operating at full employment and capacity — will slow to 1.9% a year from 2020 to 2029.

Before the pandemic, potential growth was expected to be 2.1% a year over the ten-year period, the World Bank said.
© Provided by CNBC A Palestinian youth wearing a face mask rides his bicycle past a mural painting of a nurse injecting a vaccine to a coronavirus in Gaza City, on Dec. 31, 2020.

SINGAPORE — The global economy could be in for "a lost decade" with subdued growth after the Covid-19 pandemic triggered the worst economic recession since World War II, the World Bank said on Tuesday.
"If history is any guide, unless there are substantial and effective reforms, the global economy is heading for a decade of disappointing growth outcomes," the Washington D.C.-based group said in its biannual Global Economic Prospects report.

The bank said economic prospects were already weakening before the pandemic due to an ageing population and low productivity growth. And the global Covid outbreak will likely worsen that slowdown, it added.

The World Bank projected that global potential growth — which assumes the economy operating at full employment and capacity — will slow to 1.9% a year from 2020 to 2029. Before the pandemic, potential growth was expected to be 2.1% a year over the ten-year period, said the bank.

It explained how the pandemic would hold back global economic growth over the long term:
Uncertainties and weak growth expectations may discourage companies from making new investments;
Persistent unemployment and worldwide school closures will result in a loss of knowledge and skills in the labor market.

Such a long-term slowdown in the global economy would come even as it is set to recover in 2021 from last year's slump. After contracting 4.3% in 2020, the global economy is forecast to grow 4% this year, the World Bank estimated.

© Provided by CNBC

But not all is lost. The bank said there are measures that policymakers can take to mitigate or reverse the economic damage from the pandemic.

Possible measures include spending in infrastructure, support to boost female employment and diversifying the economy so that it's not overly reliant on particular sectors, said the World Bank.

Reforms that countries undertake should depend on their respective government finances, priorities and economic structures, it added.

"Reforms to increase investment in physical and human capital and to raise the labor supply could more than reverse the pandemic's damage to potential growth over the 2020s," the World Bank said in its report.

"Investors have typically recognized past reform efforts with upgrades to their long-term growth expectations."

Video: Countries will be at different speeds in getting back to normal: IMF chief economist (CNBC)
As disinformation experts watched a pro-Trump mob storm Capitol Hill on Wednesday, many were astonished — but few were surprised
.
© SAUL LOEB/AFP via Getty Images Supporters of U.S. President Donald Trump, including member of the QAnon conspiracy group Jake A, a.k.a. Yellowstone Wolf (centre), enter the U.S. Capitol on January 6, 2021, in Washington, D.C.

That’s because the events that took place on Wednesday, according to the people who study conspiracy theories for a living, are a “predictable” culmination of the conspiracy theories and disinformation that have taken root in the dark, not-so-hidden corners of social media.

“Anybody can say anything on Twitter and communicate it to seven billion people in the world for free,” explained Russell Muirhead, a professor at Dartmouth University who co-authored the book A Lot of People Are Saying, which explores the impact of conspiracy theories on democracy.

“We have these massive global communication platforms in which anyone can say anything to the whole world for free, and that allows the amplification and dissemination of baseless and extreme views.”

Read more: ‘No question’ that Trump’s words sparked violence at U.S. Capitol: experts

On Wednesday, the baseless views at the core of the riot were that U.S. President Donald Trump had secured a landslide victory, and that the election was being stolen from them.

Video: U.S. Capitol riot: Pelosi accuses Trump of ‘inciting sedition’

Trump had been sharing the unfounded claims of election fraud on Twitter, Facebook and any other platforms for months — only occasionally having a disclaimer added to his tweets.

That changed with the violence on Wednesday, at which point Facebook, Twitter and YouTube began taking down content and ultimately issued a temporary suspension on Trump’s ability to use the platform.

Still, Trump had already urged hordes of his supporters at the rally to “walk down to the Capitol” and resist the certification of President-elect Joe Biden's electoral victory.

“We are going to cheer on our brave senators and congressmen and women,” he said, suggesting the crowd "walk down to the Capitol."

“And we are probably not going to be cheering so much for some of them — because you will never take back our country with weakness.”

Read more: Woman fatally shot at U.S. Capitol was QAnon believer, Air Force vet

As the mob descended upon the Capitol building in a riot that left four of the protestors dead, members of the crowd were heard chanting "Stop the Steal" —

a hashtag used frequently on social media.

It was only at this point, after a woman had been shot and killed, that social media networks started to take action. First, Twitter reduced users’ ability to engage with Trump’s posts, then deleted some of them altogether. YouTube and Facebook also took down a video in which Trump told his supporters to “go home,” all the while reiterating the very claim of election fraud that sent them to Capitol Hill in the first place.

Video: Video shows extent of damage, disarray inside US Capitol building following riot

The “predictable” culmination of Trump’s claim of election fraud, Muirhead said, was the result of a perfect recipe for a viral conspiracy theory.

“The first ingredient is a mode of communication in which there's no gatekeeping function whatsoever,” he explained.

Both Twitter and Facebook, as well as more niche social media platforms such as Parler and 4chan, provided that space for the theory to feed and grow.

“The second ingredient, in the United States, is that the highest official in the land and great popular leader who has the trust and confidence of millions of Americans, President Donald J. Trump, would abuse that trust and confidence by himself disseminating this kind of baseless view,” Muirhead added.

Video: ‘A dark day:’ U.S. VP Mike Pence condemns violence at Capitol Hill

This cycle of information being repeated and then legitimized by authority figures cemented the baseless conspiracy as fact in the minds of Trump’s supporters, explained Muirhead.

It’s the cycle that underlies any conspiracy breaking through into the mainstream consciousness or attracting a significant following: repetition, and legitimization by an authority figure.

“Repetition has substituted for validation. Nobody's asking whether something's true anymore. They're just saying, do a lot of people think it, do a lot of people say it? And if enough people say it, that's true enough to say it one more time. So that repetition function is what's substituting for the truth function in democracy,” Muirhead said.

“But you need more than that. You also need public officials who sit on their hands because they like the way the conspiracy theory works for them, and who refuse, therefore, to speak truth to conspiracy. Those two things have to be both happening in order for a conspiracy theory to really get traction.”

There are notable examples of politicians doing the opposite, though. During the 2008 U.S. election, Republican nominee John McCain was met by a round of boos after he swiped the microphone from a supporter who was spreading conspiracy theories about his opponent Barack Obama.

"I have to tell you that he is a decent person, and a person that you don't have to be scared (of) as president of the United States," McCain said.

"He is a decent, family man, citizen, that I just happen to have disagreements with on fundamental issues."

Conspiracy theories can't be contained at the border

Canada is by no means safe from the spread of conspiracy theories, warned Ahmed Al-Rawi, who runs the Disinformation Project at Simon Fraser University.

“As Canadians, we are really connected, linked to the United States in so many ways…and this includes also information. So when it comes to, for example, support for Trump, we see many people yesterday holding rallies and showing support for Trump in cities like Vancouver or Toronto, Calgary and elsewhere,” Al-Rawi explained.

VIDEO Pro-Trump supporters gather in downtown Vancouver

Al-Rawi pointed to the anti-mask movements, which have resulted in protests in Canadians cities, as further evidence that Canadians can just as easily fall prey to misinformation as our American counterparts.

"They believe that wearing a mask, having lockdowns and and social distancing will not be useful for them. And, of course, they might risk their lives and the lives of other people. So that's the danger of conspiracy theory — because it shapes the way they think of the world and what they should do."

Breaking the misinformation cycle

In order to disrupt the cycle of conspiracy, at least one of two parties responsible for the proliferation of baseless claims needs to be addressed.

First, citizens need to ensure they aren't elevating conspiracy theorists to political office, Muirhead said. Second, the social media platforms that provide fertile soil for conspiracy theories to grow must stamp out the users that plant the seeds of disinformation.

Read more: Twitter, Facebook, Instagram suspend Trump’s accounts after Capitol building stormed

In the wake of Wednesday's violence, Twitter, Facebook and Instagram did take steps to prevent Trump from sharing further content they said contained a "risk of violence." Twitter suspended Trump's account for 12 hours, following the storming of Capitol Hill, and Facebook and Instagram have frozen the outgoing president's accounts indefinitely.

"I think Twitter's latest action was mostly a message sent to Trump and his followers that such kind of misinformation or disinformation will not be tolerated anymore. But notice here, this is only happening near the end of his term, which is really sad. It should have happened, they should have been braver, bolder, more courageous in limiting his disinformation a long time ago," Al-Rawi said.

Twitter updates hate speech rules to include race and ethnicity

Muirhead echoed concern that the very platforms needing to quash the spread of conspiracy theories profit off those who flock to their website to share those untruths.

"I think the completely uncurated platforms are the one to worry about. Those are the ones that have absolutely no gatekeeping function whatsoever — and they don't have it because that's how they make money," Muirhead said.

When Global News contacted Twitter on Wednesday as the violence raged on and Trump's account remained active, a spokesperson said they "don't comment on action we may or may not take against individual accounts"

In a statement shared to Twitter, the company said they were "working proactively to protect the health of the public conversation occurring on the service and will take action on any content that violates the Twitter Rules."

Trump's account was later suspended, with Facebook and Instagram following suit.

Video: ‘Have you had enough?’: Stephen Colbert reacts to Capitol riot

There is proof that de-platforming individuals who spread conspiracy theories actually works, Muirhead said. American far-right radio host Alex Jones lost his platforms on Apple, YouTube, Facebook, and elsewhere after the companies said Jones had violated their rules against hate speech.

Jones had a long track record of spreading conspiracy theories, including painful, untrue allegations that the Sandy Hook Elementary School shooting never happened.

"After he made that charge and was sued for libel by the grieving parents of these dead children, it was only after that that YouTube de-platformed him. And since he's been de-platformed, he's been marginalized," Muirhead said.

"He has not been able to access the audience that he did before. His power is now peripheral. So it worked with Alex Jones. But that took an extreme sort of event, for these for these platforms to de-platform him."

Video: U.S. Congress seals Biden’s election victory after chaotic day in Washington

Muirhead said he has hope that social media companies are trending in the direction of increased action.

"I'm optimistic that citizens might learn and elect much better leaders. And I also am optimistic that those who create these great platforms might grow into their true civic responsibility," he said.

And if the social media companies fail to step up, that's when governments must step in.

"I think that these are now the equivalent of public communications monopolies, and I think that the E.U. is going to regulate them, and I think that the E.U. is probably going to get there long before the United States, but the United States is going to regulate them, too," Muirhead said.

"Will it take that? I think that, yes, the shadow of that threat is probably necessary to motivate the CEOs and senior leaders in these corporations to take care not just about profits, but also about their effect on the world."

DOJ eyes undoing some protections for minorities: reports

The Department of Justice (DOJ) is aiming to roll back some protections for minorities under the Civil Rights Act, potentially impacting women, people with disabilities and members of the LGBTQ community, according to a draft proposal obtained by multiple new outlets.

© Greg Nash DOJ eyes undoing some protections for minorities: reports

The potential changes, reported by The New York Times and The Washington Post, would affect how the Justice Department enforces Title VI of the Civil Rights Act, which bars recipients of federal funding, such as housing programs and employers, from discriminating based on race, color or national origin.

Under the proposal submitted to the White House for approval, the agency would no longer enforce the law in cases in which a policy or practice had a "disparate impact" on minority or other groups.

The disparate impact rule has been cited by civil rights groups as one of the most important protections of the law, as it includes practices or policies that may initially appear neutral but end up disproportionately impacting certain minority groups.

According to the Post, the Trump administration has considered adopting the proposed changes for two years, and is submitting it with just two weeks to go until the inauguration of President-elect Joe Biden.

The Times reported that the draft proposal argues that the current enforcement of civil rights protections addressed "a vastly broader scope of conduct" than the statute itself allows.

The document also reportedly states that the changes would "provide much needed clarity to the courts and federal funding recipients and beneficiaries," noting that the Justice Department currently distributes about $6 billion a year in grants or awards.

However, the agency notes in the proposal that it remains unclear how much of the awards or grants would be impacted by the proposed enforcement change, according to the Post.

The Times reported that the department submitted the change to the White House Office of Management and Budget on Dec. 21, making it one of former Attorney General William Barr's final actions before leaving the role.

The Justice Department did not immediately respond to The Hill's request for comment.

Becky Monroe, director of the Fighting Hate and Bias program at the Leadership Conference on Civil and Human Rights, called the DOJ's proposed change "a big deal" for minorities.

"The idea they would use this process at the eleventh hour to undermine civil rights protections is deeply alarming though not surprising," Monroe, who also worked at the Justice Department under the Obama administration, added.

The proposed change would add on other Trump administration efforts to roll back certain regulations and protections for minority groups.

In 2018, the Education and Justice departments announced that they had revoked seven Obama-era policy guidelines on affirmative action, which they argued, "advocate policy preferences and positions beyond the requirements of the Constitution."

In late September, Trump signed an executive order banning federal agencies, contractors and grant recipients from conducting diversity training that he deemed "anti-American," including trainings on race and gender discrimination.

The NAACP Legal Defense Fund, along with a pair of other national civil rights organizations, sued Trump as a result of the order, arguing that it violates freedom of speech while inhibiting progress in the fight against systemic racism and gender discrimination in the workplace.

 

EUROPE

Is Frontex involved in illegal 'pushbacks' in the Balkans?

Refugees and migrants in Greece trying to reach Western Europe have accused EU border protection agency Frontex of taking part in illegal deportations known as "pushbacks." DW reports.

   

Ali al-Ebrahim fled in 2018 from Manbij, a Syrian city that was under Kurdish control, to escape being forced to fight in the conflict.

Al-Ebrahim, now 22, first tried his luck in Turkey. When he arrived in Antakya, not far from the Syrian border, Turkish authorities took his details and sent him back home without citing any reasons, the young Syrian man says in very good English. He explains that this meant he was banned from legally entering Turkey again for five years.

Nevertheless, al-Ebrahim decided to try again, this time with the aim of reaching Greece. He managed to make his way to Turkey's Aegean coastline and eventually reached the Greek island of Leros in a rubber dinghy. When he applied for asylum, however, his application was rejected on the grounds that Turkey was a safe third country. 

But al-Ebrahim was not able to return to Turkey, and certainly not Syria — though this was of no interest to Greek authorities. "The new Greek Prime Minister Kyriakos Mitsotakis is very strict when it comes to migrants," he says. "So I decided to go to Albania."


Ali al-Ebrahim, 22, makes serious allegations against Frontex and Albanian authorities

Uniforms with the EU flag

Al-Ebrahim says that in September 2020, he traveled by bus with five others to the northern Greek city of Ioannina, and then walked to the Albanian border without encountering any Greek police.

But, he says, staff from the EU border protection agency Frontex stopped them in Albania and handed them over to Albanian authorities in the border town of Kakavia. When asked how he knew they were Frontex officials, al-Ebrahim replies, "I could tell from their armbands."

Frontex staff wear light-blue armbands with the EU flag on them.


Passersby in Tirana, Albania

€5,000 to reach Austria

Al-Ebrahim says that he and the other migrants asked the Albanian authorities for asylum but were told that the coronavirus pandemic made it impossible to file any new asylum applications. They were then just sent back to Greece without the Greek authorities being notified, he says.

Al-Ebrahim had more luck on the second attempt. He managed to travel to the Albanian capital, Tirana, and then on to Serbia via Kosovo. 

His interview with DW takes place at a refugee camp in the Serbian city of Sombor, near the Hungarian border. Al-Ebrahim says he wants to travel on through Hungary into Austria, but the traffickers charge €5,000 to get as far as the Austrian border.


Hope Barker coordinates the aid project for migrants Wave-Thessaloniki

Detention instead of asylum

Hope Barker has heard many similar stories before. She coordinates the project "Wave - Thessaloniki," which provides migrants traveling the Balkan route with food, medical care and legal advice. Barker tells DW that the northern Greek city was a safe haven until the new conservative government took office in summer 2019.

In January 2020, a draconian new law came into effect in Greece. According to Barker, it allows authorities to detain asylum seekers for up to 18 months without reviewing their cases — and detention can then be extended for another 18 months.

"So you can be held in detention for three years without any action on your case if you ask for asylum," says Baker.

Pushbacks by Frontex?

Baker tells DW that the illegal deportation of migrants, known as "pushbacks," happen both at the borders and further inland. Migrants trying to reach western Europe avoid any contact with Greek authorities.

Refugee aid organizations say there have been "lots of pushbacks" at the border with North Macedonia and Albania. Baker says that witnesses have reported hearing those involved speaking German, for example, and seeing the EU insignia on their blue armbands.


German police officers patrol the Greek side of the border with North Macedonia

on behalf of Frontex (May 2020)

Frontex rejects allegations

Baker says that it is, nonetheless, difficult to prove pushbacks at the Greek border because of the confusing situation, but she adds that they know that Frontex is active in Albania and that there are pushbacks on a daily basis across the River Evros that flows through Bulgaria, Greece and Turkey and forms a large part of the border. "We know that pushbacks are happening daily. So, to think that they don't know or are not at all involved in those practices seems beyond belief," says Baker.

A Frontex spokesman told DW that the agency had investigated some of the allegations and "found no credible evidence to support any of them."

Frontex added that its staff was bound by a code of conduct, which explicitly calls for the "prevention of refoulement and the upholding of human rights, all in line with the European Charter of Fundamental Rights."

"We are fully committed to protecting fundamental rights," it added. 


Migrants on the Turkish border looking over the Evros River toward Greece

Border protection from beyond the EU

So why does the European border protection agency protect an external border of the European Union from the Albanian side? "The main aim of the operation is to support border control, help tackle irregular migration, as well as cross-border crime, including migrant smuggling, trafficking in human beings and terrorism, and identify possible risks and threats related to security," said Frontex to DW.

Frontex also said that cooperation with countries in the western Balkans was one of its priorities. "The agency supports them in complying with EU standards and best practices in border management and security," the spokesman said.

Yet it is worthwhile taking a look at another part of Greece's border. While military and police officers are omnipresent at the Greek-Turkish border and are supported by Frontex staff, you seldom encounter any uniforms in the mountains between Greece and Albania. As a result, this route is regarded as safe by refugees and migrants who want to travel onward to western Europe via Greece.


Antoher route: Refugees and migrants seeking to reach western Europe via 

Greece often go through Albania, where the mountainous route is considered safer

The route west

Many migrants travel from Thessaloniki to the picturesque town of Kastoria, about 30 kilometers outside Albania. "There, the police pick us up from the bus and take us to the Albanian border," Zakarias tells DW at the Wave Center in Thessaloniki. He is Moroccan and arrived in Greece via Turkey.

But at this point, these are just rumors. 

That afternoon the men get on the bus. Another Moroccan man, 46-year-old Saleh Rosa, is among them. He has been in Greece for a year and was homeless for a long time in Thessaloniki. "Greece is a good country, but I cannot live here," Rosa tells DW. He aims to reach western Europe via Albania, Kosovo, Serbia and then Hungary.


Zakarias, from Morocco, receives medical care at the Wave Center in Thessaloniki

Ominous police checks

Police stop the bus shortly before its arrival in Kastoria. There is a parked police car with uniformed officers. Two men in plain clothes board the bus, claiming to be police. Without showing any ID, they target the foreigners, detaining Saleh, Zakarias and their companions.

At around 11pm that same evening, the migrants send a WhatsApp message and their Google coordinates. They say that the men in plainclothes have taken them to a place some 15 kilometers from the Albanian border, but within Greece. Later in the Albanian capital, Tirana, DW met with Rosa again, who stresses that his papers were not checked in Greece.


Zakarias (left) and Saleh Rosa (right) on the bus from Thessaloniki to Kastoria

Conflicting accounts

When asked by DW, Greek police authorities confirmed the existence of the plain-clothed officers and the roadside check. But then their account diverges from that of the two men. Police said they wanted to check if the migrants were legally permitted to be in Greece and they were released once this was confirmed.

But the migrants say that Saleh Rosa was the only one with the papers to stay in Greece legally and that the other men were unregistered. Moreover, there is a curfew in Greece because of COVID-19. You are only allowed to travel from one district to another in exceptional cases. Even if they had been carrying papers, the men should have been fined.

The police refused to comment on that.

This article was translated from German.





HEALTHCARE STAKEHOLDERS DISSECT HAVEN DISBANDMENT

ANALYSIS | BY MELANIE BLACKMAN | JANUARY 07, 2021

The disbandment comes only three years after Amazon, Berkshire Hathaway, and JPMorgan Chase formed Haven Healthcare "to create better outcomes, greater satisfaction, and lower costs for their U.S. employees and families."

Haven Healthcare, the joint venture of Amazon, Berkshire Hathaway, and JPMorgan Chase & Co., will disband at the end of February, the company announced earlier this week.


According to the Haven website, which has since been taken offline, the company's original vision was "to create better outcomes, greater satisfaction, and lower costs for their U.S. employees and families."

Despite the end of the much-heralded project, which was first announced in 2018, the three companies will continue to “collaborate informally to design programs tailored to address the specific needs of their own employee populations."


Although Haven initially aimed to disrupt the healthcare sector, the company faced turbulence from the beginning, including losing multiple C-suite leaders in a short timeframe.

COO Jack Stoddard resigned for personal reasons in May 2019, after serving for only nine months. Dr. Atul Gawande stepped down as CEO in May 2020 to serve as chairman of the company's board of directors, after serving for almost two years in the role. Megan McLean resigned as chief of staff in May 2020, after serving for almost 10 months.

LACK OF TRACTION TOWARDS GOALS

Jeff Becker, a senior analyst serving eBusiness and channel strategy professionals for Forrester Research told HealthLeaders that the inability to maintain a stable C-suite was "damaging to [their] ability to set a strategy, and then execute on that strategy.” He added that the strategic issues served as a “big red flag” for outsiders looking at the company.

"I think a lot of people saw [the disbandment] coming," Becker said. "There were certainly enough signs that things weren't going as planned. Haven's at three years now and we haven't seen any tangible evidence of traction towards its established goals."

But, while Haven struggled to gain traction, Becker said that Amazon continued to innovate in the healthcare sector.

"[This] led people to start questioning, what's actually coming from Haven?" Becker said. "While Haven was relatively quiet, you saw Amazon Pharmacy, Amazon Care, [and] quite a few things that we would have thought were going to be coming out of Haven, ended up coming out of Amazon proper."

"The Amazon in healthcare story isn't over," he added.


While Haven is wrapping up its operations, Becker said other companies are still interested in disrupting the current healthcare system.

"The cautionary tale is that healthcare is a $3.6 trillion market in the United States, and it's appealing to tech companies, large enterprise organizations to come and try and do better," he said. "But what we see time and time again, is that outside organizations come to healthcare and stake a flag in the ground and try and do better and they just end up turning tail a few years later. There's been a sense among outsiders that they're going to be able to come in and do it better, but I see no evidence or reason why we should continue to think that outsiders will be able to come in and fundamentally do this better."

LACK OF FOCUSED EXECUTION

Elizabeth Mitchell, president and CEO of Pacific Business Group on Health (PBGH) told HealthLeaders that she's disappointed in the news of Haven’s disbandment.

"[Haven] certainly arrived with a lot of fanfare and promise,” Mitchell said. “I do think it was important that three leading CEOs of private businesses said that the current U.S. healthcare system isn't working for employers and for their employees, and something needs to change. I think that was the right position.

Mitchell added that Haven’s most significant hurdles to addressing the institutional issues in healthcare was a lack of “focused execution and, apparently, political will.”

"There is as much demand as ever for new entrants who can tackle the growing problem of lack of affordability, variable quality, and poor experience in the healthcare system,” Mitchell said. “It is going to take concerted effort, not bright shiny objects, [to] figure out how to change an entrenched system that, quite frankly, is happy with the status quo.

Mitchell continued: "That said, there are a lot of innovative provider partners out there who are ready for change. Clearly the pandemic is consuming providers, appropriately so. They need to be focused first and foremost on patient care, but we're also seeing the pandemic put unbearable pressure on primary care when we need it most. We are going to have to rethink the U.S. healthcare system coming out of this pandemic."

TRANSFORMING HEALTHCARE IS COMPLEX

HealthLeaders also received written statements from stakeholders about Haven's disbandment.

Will Hinde, managing director and leader of healthcare and life sciences at West Monroe said in a statement: "Only those directly involved in the joint venture know the exact reasons why the effort was abandoned. That being said, the venture was always light on specifics—including how it was going to tackle historic and incredibly complicated issues like insurance coverage and prescription drug prices.”

Hinde continued: “The fact that three large, successful, and intelligent organizations faced significant challenges in solving these issues illustrates just how complex they are. The venture was an interesting concept in an ecosystem ripe for disruption, but it’s not entirely surprising that it didn’t work out and will join many others who have attempted to evolve and improve healthcare in the U.S."

Paddy Padmanabhan, CEO of Damo Consulting said in a statement: "Haven’s problem may have been internal issues and execution gaps, complicated by the competing interests of its major shareholders. That said, it isn’t easy to simply ‘disrupt’ healthcare by throwing tech and dollars at the problem. I believe a combination of market-driven change and policy action at the federal government level will transform healthcare eventually. This is already happening, as we have seen with the rapid rise in telehealth adoption during the pandemic.”

Padmanabhan added: "Transforming healthcare requires a full-time commitment. The shareholders of Haven are in very different businesses and were not in a position to dedicate themselves completely to the success of the initiative. It is possible that they will individually succeed through a piecemeal approach by addressing specific aspects of the healthcare value chain. For instance, Amazon has made significant progress in the pharma distribution aspect of healthcare services."

Editor's note: This story has been updated.

Related: Amazon-Backed Healthcare Venture Gets Much-Needed Name: Haven

Related: As Amazon builds new health ventures, Haven struggles to gain ground

Related: Haven was supposed to reimagine healthcare. An exodus of talent has gutted it

Related: Reset! Former Haven COO Shares 4 Ways Startup Eden Health Is Changing Healthcare Delivery

Related: Head of Healthcare for Amazon Business on Meeting PPE Demand Amid Flu, COVID


Melanie Blackman is the strategy editor at HealthLeaders, an HCPro brand



USE SCREENING PROTOCOLS TO ENSURE CIVIL UNREST STAYS OUT OF YOUR HOSPITAL


ANALYSIS | BY A.J. PLUNKETT | JANUARY 07, 2021


Frayed nerves from the pandemic will only serve to make things worse and the reality of local civil unrest is now all too common.

Editor's note: This article was originally published by the HCPro Accreditation & Quality Compliance Center.

When civil unrest outside your doors threatens to come inside, be sure staff are trained on screening protocols for identifying people who should not be in your facility or on your property.

Whether it’s high school rivalries, gang activity, or even political unrest, hospitals should be prepared for patients from opposing sides to be in your emergency department (ED).


Frayed nerves from the pandemic will only serve to make things worse.

The reality of local civil unrest is now all too common, says Bryan Warren, MBA, CHPA, CPOI, a longtime hospital and healthcare security professional and now president and chief consultant of WarSec Security. Warren, who responded to questions by email, is also a past president of the International Association for Healthcare Security and Safety.

“Anytime that you are as open to the public as hospitals are, plus you are dealing with people that are not entirely rational, you run the risk of one person or group not agreeing with another. This is magnified when those persons are injured or under some type of additional stress, and you see it all the time in healthcare waiting areas,” notes Warren.

That stress is seen not just in the ED, “but also in maternity units as well as ICUs with end-of-life issues and estranged family members coming together for the patient’s sake,” observes Warren.

Lessons learned


Recently, the Department of Health and Human Services’ Assistant Secretary for Preparedness and Response (ASPR) updated its Technical Resources, Assistance Center, and Information Exchange (TRACIE) site with a four-page set of lessons learned in Minneapolis during the civil unrest after George Floyd died during a police arrest, an event caught on video and widely shared on social medi
a.

According to Civil Unrest During a Pandemic: Notes From Minneapolis, most patients arrived in the ED via local emergency medical services. However, many people fleeing riot scenes sought safety in nearby hospitals and clinic
s.

Keeping opposing sides apart to ensure the civil unrest doesn’t follow people inside begins at your perimeters, advises Warren. Coordinate with your local law enforcement because you may need their help.

“All healthcare organizations should have in their policies and procedures some type of screening protocol which should begin at the perimeter of the facility to identify persons that clearly have no legitimate purpose being inside the building or on the property,” says Warren.

“Appropriate screening and visitor management can also help to differentiate between patients and family members and hopefully provide some direction regarding which waiting areas they will be assigned to (should there be indications that certain patients and their acquaintances may not coexist peacefully),” he says.

“For situations in which such indicators are not readily apparent, it is also important that the facility have a restricted access process so that even if persons of differing viewpoints end up inside the same waiting area, they would not be able to freely enter patient care units or staff-only areas of the facility while restricted access protocols were in effect,” Warren says.

Coordinate with local law enforcement

“This is also an instance in which a strong public/private partnership with local law enforcement is critical so that any persons causing a disruption or negatively impacting the facility’s ability to provide patient care can be quickly removed (within applicable legal and regulatory frameworks),” says Warren. THE PUBLIC IN THIS P3 IS THE COPS HOSPITALS IN THE USA ARE PRIVATE CORPORATIONS

“Not all facilities have the capability to provide separate waiting areas for conflicting parties, so the provision of uninterrupted patient care must be the driving factor in enforcing such decisions, so the hospital is not perceived as ‘taking sides,’ ” he notes.

“For long-term patients, this might result in designated times of day or even days of the week for visitation,” he recommends. For instance, group A can visit Monday, Wednesday and Friday, group B on Tuesday, Thursday, and Saturday, and so on.

“But this is not feasible for emergencies or other dynamic situations. Healthcare organizations should make every attempt to clearly address expectations of conduct to those that are becoming disruptive and then have a plan in place should their removal or relocation be required,” says Warren.

The pandemic has frayed nerves. But it also has provided at least one benefit, notes Warren: “Healthcare facilities do not have nearly as many visitors as usual for patients (even emergency departments).”



That said, “any event that occurs within the community in which people are injured or even think they are injured (the walking worried, for example, protesters exposed to chemical agents) will involve the local hospital or healthcare provider and could create potential disruptions due to rival factions all showing up for treatment or visitation at the same location,” he warns.


“This is why guidelines not only for patient surge events, but also civil unrest events and their consequences should be included in an organization’s emergency preparedness plan,” he advises.

More ASPR-TRACIE resources on civil unrest can be found at https://files.asprtracie.hhs.gov/documents/aspr-tracie-ta-hospitals-and-civil-unreset-resources--6-1-2020.pdf.

A.J. Plunkett is editor of Inside Accreditation & Quality, a Simplify Compliance publication.


Photo credit: Los Angeles, California / USA - May 30, 2020: People in the Fairfax District of Los Angeles protest the brutal police killing of George Floyd. / Editorial credit: Matt Gush / Shutterstock.com

I WAS TRAINED IN SECURITY, RISK ASSESSMENT AND DETERANCE 
FOR PUBLIC SCHOOLS 







Can Free Community College Unite a Divided U.S.?

The incoming Biden-Harris administration wants to launch a new era in higher education that will make it open to everyone


By David Noonan on January 6, 2021 SCIENTIFIC AMERICAN

Jill Biden visits Red Rocks Community College’s campus in Arvada, Colo., to learn about the school’s renewable energy technology programs in 2010. Credit: Andy Cross Getty Images


“The Biden Plan for Education beyond High School,” a platform document circulated by Joe Biden’s team during the 2020 presidential campaign, refers to community colleges as “America’s best kept secret.” While that may come as a surprise to the 8.2 million students enrolled in these institutions (who represent 37 percent of the country’s year-round undergraduates, according to the U.S. Department of Education), it is a point worthy of consideration. Higher education in the U.S. has long meant four-year colleges—and it has become a societal dividing line. In the last two presidential elections, Donald Trump twice won more than 60 percent of non-college-educated white voters.

With President-elect Biden about to take office, the nation’s 942 public two-year colleges are under a spotlight as part of the new administration’s plans for addressing income inequalities that have fostered political divisions. (Incoming first lady Jill Biden has spent years as a community college teacher.) Richard Kahlenberg, a senior fellow at the Century Foundation, who has studied and written about the U.S.’s community colleges, spoke with Scientific American about the prospects for a new era in the nation’s higher education.

[An edited transcript of the interview follows.]



Why do you think the Biden-Harris administration has made community college central to its education plans?

If you look at the Biden platform for changing America, healing America, community colleges line up for a whole variety of reasons. They really are our quintessential institutions for social mobility. They take students from all backgrounds. If you run as Joe Biden did, on a platform of unifying the country, community colleges are an appropriate focus. They appeal to people of all political stripes, I think, because they do play this social mobility role, whereas the elite four-year colleges are seen as kind of gated communities. Community colleges are found in every congressional district, so they’re unifying. And Jill Biden has taught in community colleges for years, often teaching remedial classes, so she knows firsthand what community colleges can do.


You’ve written that community college should be free for all, including those who can afford to pay for it. Why is that important?

As community colleges have increasingly become institutions for less advantaged students, they have become economically segregated and separate from institutions that serve more affluent students. We know that economic segregation in K–12 education is disastrous, and it is also troubling in higher education. You want institutions to educate students from all backgrounds together, in part, because when you have separate institutions for the poor, they tend to be underfunded. And those students are cut off from important networks that are critical to getting jobs. It’s important who your classmates are. More than half of all jobs are filled through some sort of a connection. If community colleges are free to everyone, that can provide an incentive for upper-middle-class students to attend, which will enrich the experience for everyone, including low-income and working-class students.


But making such an education free is only part of the solution, correct?

Free community college is an important shift because it sends a very bright signal to people that this is accessible to everyone. But the big problem with community college today is not that students don’t start; it’s that they start and then don’t complete. That’s why, in addition to making community college free, it’s enormously important to make sure that community colleges have the resources necessary to ensure students are successful. Right now 62 percent of students who enter community college fail to complete a degree or certificate within six years. So the majority don’t succeed. Even more troubling, 81 percent of students entering community colleges say they would like to eventually get a four-year degree. But after six years, only 15 percent do that.


And if you don’t raise that number, making community college free won’t matter as much?
That’s right—which is why Joe Biden also plans to invest $8 billion in community college facilities and technologies. And he’s also got a $50-billion workforce-training program. If he does those two things—makes [a community college education] free and invests—I think the larger societal and political impacts could be enormous.

When you say political impact, what do you mean?

Well, we’ve had a stunning moment in American politics, a moment of intense social turmoil where we elected, in my view, a demagogue. And that was made possible, in part, because social mobility and the American dream have become illusory for so many people. It used to be that if you were born in 1940, you had a 90 percent chance of making more than your parents did. If you were born in 1984—people who are in their mid-30s now—you only have a 50 percent chance of doing better than your parents. So when you don’t have social mobility, you get a highly frustrated population that will seek dramatic change to shake things up—even if it is, in my view, ill-advised change.


So if Biden can reignite social mobility in America, in part, by strengthening the quintessential institution for social mobility, community college, he could restore the American dream for people and thereby bring about a more rational kind of politics in which people aren’t so desperate as to be drawn to politicians spouting antidemocratic rhetoric.

Has higher education itself become politicized?

There used to be broad bipartisan support for higher education. People believed in it as an engine for social mobility, a better life and a general good. And we’ve seen, in recent years, some alarming survey research that suggests that, just as wearing a mask has become politicized, so has the view of American higher education. There’s increased skepticism, on the right, of higher education. But interestingly, that does not extend to community college. And this fits precisely into Biden’s campaign, because you’ll recall that on the campaign trail, he would pointedly note that he would become the first non-Ivy League president in quite some time, going back to Ronald Reagan.


That was part of Biden’s populist appeal—you know, “I’m one of you. I went to public college. I have a wife who teaches at a community college.” It just makes sense. The stars are aligned for community colleges. They fit into what voters liked about Biden—that he wasn’t an elitist, was someone who didn’t look down on other people. Also, with a closely divided House and Senate, Biden is going to be looking for places where he can get bipartisan support. And community colleges line up there as well.

Last month the Wall Street Journal published an opinion piece essentially mocking Jill Biden, who has an Ed.D., for her use of the title “Dr.” And in the same tone, a Yale University graduate named Kyle Smith wrote in the National Review that “she has spent a lot of time teaching remedial English to slow learners in community colleges.” What did you make of all that?
I would say a couple of things. First, there’s been a lot of appropriate focus on the way in which the Wall Street Journal was sexist in going after Jill Biden’s use of the word “doctor.” But just as important is the classist and snobbish aspect of the critique. Because anyone who has taught knows that it’s actually more challenging to teach students who haven’t had opportunities and may bring weaker academic credentials to the classroom. I’m thinking of one law professor I had who said he taught undergraduates periodically because it was so much harder than teaching law students. Kyle Smith got it exactly wrong when he denigrated Jill Biden for teaching students who were in remedial classes. That’s the really challenging work that ought to inspire more respect, not less.





David Noonan is a freelance writer specializing in science and medicine.

Credit: Nick Higgins

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Sabotaged COVID-19 Vaccine More Upsetting Than You Even Knew

Wisconsin pharmacist Steven Brandenburg was arrested last week and charged with intentionally sabotaging 570 doses of the COVID-19 vaccine. He wanted people to receive the spoiled vaccine and falsely believe they were protected from the virus.

According to authorities, Brandenburg is an “admitted conspiracy theorist" who thought the vaccine would harm people by "changing their DNA." He's obviously not a very good pharmacist. Rumors have circulated for a while that the COVID-19 vaccine would alter human DNA and turn us into mindless puppets under Bill Gates's control. This is obviously nonsense, but that's a prerequisite for conspiracy theories.

Over Christmas, Brandenburg removed 57 vials of the vaccine and left them out overnight, rendering them useless. Prosecutors claim the vials are worth between $8,000 and $12,000, which seems to understate their value. The vaccine rollout has been slow and the doses are precious. It's not champagne bottle service at a Vegas nightclub. But they're willing to give him a break: If the vials he left out are tested and still usable, they'll drop the charges to a single misdemeanor. Yes, Brandenburg is white.

The New York Times reports:

The prosecutor, Adam Gerol, said that Mr. Brandenburg was "pretty cooperative and admitted to everything he'd done," and that "he expressed that he was under great stress because of marital problems."

Hold up, this is the prosecutor? Brandenburg's defense counsel will have to step up their game. It's nice that the sick bastard was “pretty cooperative," but why is the prosecutor telling us about the guy's “marital problems"? He's like the combination therapist and DA from that "Law & Order" spin-off I once pitched.

Brandenburg reportedly told his wife, Gretchen, that “the world is crashing down around us." (She was probably trying to vacuum around him while he had his existential crisis, and he didn't even bother picking up his feet.) She's wisely divorcing his ass, and last week, she filed for sole custody of their two daughters, 4 and 6, after discovering he was under investigation for tampering with the vaccine. She said she “feared his reaction if he lost his job." That was a reasonable concern considering that Brandenburg's coworkers claimed he brought a gun to work at least twice.

This is a dangerous man, and the Good Will Hunting-style prosecutor is close to hugging the asshole and telling him it's not his fault.

In her motion, Gretchen Brandenburg said that on Dec. 6, her husband picked up the children and dropped off a water purifier, a large bucket of powdered milk and two 30-day emergency buckets of food.

Of course, he's a survivalist.

"He told me that if I didn't understand by now that he is right and that the world is crashing down around us, I am in serious denial," she said in an affidavit. "He continued to say that the government is planning cyberattacks and plans to shut down the power grid."

Gretchen Brandenburg claims that her husband told their 6-year-old daughter, "This is not our home; heaven is our home," and "All the bad angels and the devil are going to burn in the lake of fire forever." She would prefer that his time with their children is closely supervised.

"I was so concerned about my safety and the safety of our children that I left town for a period of time," she wrote.

See, Mr. Prosecutor, Gretchen Brandenburg and her daughters are the ones under “great stress." She filed for divorce in June and is rightly terrified of her husband. Note what her lawyer, Brian Herro, said at a July hearing.

My understanding is that the respondent is more aligned with the feeling of conspiracy theories ... He has theories about COVID-19. He believes the end of the world is coming. So my client would like him to be out.

Someone with “theories about COVID-19" shouldn't have been within a country mile of the COVID-19 vaccine.

Although family court granted Gretchen Brandenburg full custody of her children on Monday, the criminal court has released Steven Brandenburg "on a promise to pay $10,000 if he did not show up for his next hearing" on January 19. He was ordered to surrender his firearms, and I'm sure he'll get right on that.

Brandenburg fits a similar profile to Anthony Quinn Warner, the unhinged conspiracy theorist who blew up an RV in downtown Nashville. Warner's girlfriend had also sounded alarms about his potential for violence but no one listened. Both men held a clear, if delusional, ideology, which led them to acts of political violence. But don't call them terrorists. That's just rude.

[New York Times]

Follow Stephen Robinson on Twitter.

WONKETTE 

HOSPITALS IN MEDICAID EXPANSION STATES SAW UNCOMPENSATED CARE COSTS DROP, FINANCIAL MARGINS INCREASE

ANALYSIS | BY JACK O'BRIEN | JANUARY 06, 2021

The study's authors conclude that hospitals in states that have not yet expanded Medicaid could benefit from a financial perspective amid the ongoing COVID-19 pandemic.

Hospitals in states that expanded Medicaid under the Affordable Care Act (ACA) saw uncompensated care costs decline while financial margins and Medicaid revenues increased, according to a study published in Health Affairs Tuesday afternoon.

According to two researchers at the Urban Institute, from fiscal year (FY) 2013 to FY 2017, mean annual uncompensated hospital care costs as a share of total expenses dropped by 1.8 percentage points in Medicaid expansion states, while those same uncompensated costs increased by 0.5 percentage points in non-expansion states.

Similarly, hospitals in expansion states saw operating margins increase immediately after the expansion began in 2014, according to the study, rising by 0.54 percentage points in FY 2014 and 2.1 percentage points in FY 2015.

Meanwhile, hospitals in non-expansion states saw operating margins decline by 0.58 percentage points and 0.86 percentage points during the same period.

Related: Coronavirus Threatens Rural Hospitals Already at the Financial Brink

By 2017, the effects of Medicaid expansion on hospital finances were clear.

The expansion was associated with a $6.4 million decline in mean uncompensated care costs, (a 53.3% decrease relative to the FY 2011-13 baseline), and a 2.6 percentage point decline in "mean uncompensated care costs as a percentage of total expenses relative to the 2011–13 pre period."

The study's authors conclude that hospitals in states that have not yet expanded Medicaid could benefit from a financial perspective amid the ongoing COVID-19 pandemic.

"Medicaid could be an even more important source of revenue for hospitals, given the huge financial hit they are taking under COVID-19," the authors wrote. "At the same time, the effect of the pandemic may be so large that it overshadows some of the differences that have emerged between expansion and nonexpansion states in the years since 2014."

Related: Profit Margins Declined for Rural Hospital Types Except Nonprofit Critical Access Hospitals


This study marks the latest analysis produced by the Urban Institute regarding the potential impact of Medicaid expansion during the pandemic.

In June, a study supported by the Robert Wood Johnson Foundation estimated that if 15 states had expanded Medicaid, then an additional 4 million people would have been insured in 2020.
Related: Medicaid Expansion Could Have Covered an Additional 4M People in 2020






Jack O'Brien is the Content Team Lead and Finance Editor at HealthLeaders, an HCPro brand.