Where We Stand with the Vaccinations

The vaccine is out there. It’s not being administered fast enough. But now there’s a plan. From The New York Times [with commentary included]:

President Biden’s promise to administer 100 million vaccines by his 100th day in office is no longer a lofty goal; it is attainable at the current pace at which shots are going into arms. In fact, some experts have suggested that the president’s ambition is far too modest. [His ambition is to get the whole country vaccinated; his promise was to do 100 million by late April.]

Federal data shows that the United States is already administering about one million doses a day, and even doubling that rate would not cause the country to fall short of distribution capacity or supply. . . . 

Mr. Biden made the 100-day pledge in early December, before any vaccine had been authorized for use in the United States. At the time, experts called the goal “optimistic” given their concerns about manufacturing and distribution capacity.

Since then, two vaccines have been approved and the United States has secured contracts for deliveries of doses through July. And while some jurisdictions have said that they are running out of doses, states and U.S. territories are using only about half of the shots that the federal government has shipped to them, on average. . . .

Pfizer and Moderna have pledged to deliver a combined 200 million doses by the end of March, with an additional 200 million doses to be delivered by the end of July.

Under those circumstances, it is feasible that up to two million doses could be given per day, and Mr. Biden’s goal of 100 million shots could be reached by early March.

But ramping up vaccinations will not be easy. And national supply and distribution figures do not reflect the often complicated local realities.

“The complexity of administering vaccines may grow over the coming weeks as we open up a lot of new provider sites,” said Dr. Julie Swann, an industrial and systems engineering professor at North Carolina State University who was an adviser to the C.D.C. during the 2009 H1N1 pandemic.

Getting shots in arms has already been hard, Dr. Swann noted. Providers get little notice of how much vaccine they will receive, making it difficult to plan and set up appointments. Estimating demand can be tricky too, which means that vaccines may be used more quickly in some locations than others, leading to wasted doses.

“The administration needs to be both fighting immediate fires and putting in the infrastructure to make this work better, too,” Dr. Swann said [which is what the president and his staff are doing, three days after the inauguration].

Unquote.

The new administration has issued a “National Strategy for the COVID-19 Response and Pandemic Preparedness”. This is the summary of the plan to “mount a safe, effective, comprehensive vaccination campaign”:

The United States will spare no effort to ensure Americans can get vaccinated quickly, effectively, and equitably. The federal government will execute an aggressive vaccination strategy, focusing on the immediate actions necessary to convert vaccines into vaccinations, including improving allocation, distribution, administration, and tracking. Central to this effort will be additional support and funding for state, local, Tribal, and territorial governments — and improved line of sight into supply — to ensure that they are best prepared to mount local vaccination programs. At the same time, the federal government will mount an unprecedented public campaign that builds trust around vaccination and communicates the importance of maintaining public health measures such as masking, physical distancing, testing, and contact tracing even as people receive safe and effective vaccinations. To mount a safe, effective, comprehensive vaccination campaign, the United States will:

  1. Ensure the availability of safe, effective vaccines for the American public.
  2. Accelerate getting shots into arms and get vaccines to the communities that need them most.
  3. Create as many venues as needed for people to be vaccinated.
  4. Focus on hard-to-reach and high-risk populations.
  5. Fairly compensate providers, and states and local governments for the cost of administering vaccinations.
  6. Drive equity throughout the vaccination campaign and broader pandemic response. Launch a national vaccinations public education campaign.
  7. Bolster data systems and transparency for vaccinations.
  8. Monitor vaccine safety and efficacy. Surge the health care workforce to support the vaccination effort.

The plan is only 200 pages long.

Yeah, we’re finally getting an administration that’s competent and wants the government to work. Patience is a virtue.

One Way to Start Fixing the Internet

Yaël Eisenstat has been a CIA officer, White House adviser and Facebook executive. She says the problem with social media isn’t just what users post — it’s what the platforms do with that content. From Harvard Business Review:

While the blame for President Txxxx’s incitement to insurrection lies squarely with him, the biggest social media companies — most prominently my former employer, Facebook — are absolutely complicit. They have not only allowed Txxxx to lie and sow division for years, their business models have exploited our biases and weaknesses and abetted the growth of conspiracy-touting hate groups and outrage machines. They have done this without bearing any responsibility for how their products and business decisions effect our democracy; in this case, including allowing an insurrection to be planned and promoted on their platforms. .  . .

The events of last week . . . demand an immediate response. In the absence of any U.S. laws to address social media’s responsibility to protect our democracy, we have ceded the decision-making about which rules to write, what to enforce, and how to steer our public square to CEOs of for-profit internet companies. Facebook intentionally and relentlessly scaled to dominate the global public square, yet it does not bear any of the responsibilities of traditional stewards of public goods, including the traditional media.

It is time to define responsibility and hold these companies accountable for how they aid and abet criminal activity. And it is time to listen to those who have shouted from the rooftops about these issues for years, as opposed to allowing Silicon Valley leaders to dictate the terms.

We need to change our approach not only because of the role these platforms have played in crises like last week’s, but also because of how CEOs have responded — or failed to respond. The reactionary decisions on which content to take down, which voices to downgrade, and which political ads to allow have amounted to tinkering around the margins of the bigger issue: a business model that rewards the loudest, most extreme voices.

Yet there does not seem to be the will to reckon with that problem. Mark Zuckerberg did not choose to block Txxxx’s account until after the U.S. Congress certified Joe Biden as the next president of the United States. . . . And while the decision by many platforms to silence Txxxx is an obvious response to this moment, it’s one that fails to address how millions of Americans have been drawn into conspiracy theories online and led to believe this election was stolen — an issue that has never been truly addressed by the social media leaders.

A look through the Twitter feed of Ashli Babbit, the woman who was killed while storming the Capitol, is eye-opening. A 14-year Air Force veteran, she spent the last months of her life retweeting conspiracy theorists, QAnon followers, and others calling for the overthrow of the government. . . . The likelihood that social media played a significant part in steering her down the rabbit hole of conspiracy theories is high, but we will never truly know how her content was curated, what groups were recommended to her, who the algorithms steered her towards.

If the public, or even a restricted oversight body, had access to the Twitter and Facebook data to answer those questions, it would be harder for the companies to claim they are neutral platforms who merely show people what they want to see. Guardian journalist Julia Carrie Wong wrote in June of this year about how Facebook algorithms kept recommending QAnon groups to her. . . .  The key point is this: This is not about free speech and what individuals post on these platforms. It is about what the platforms choose to do with that content, which voices they decide to amplify, which groups are allowed to thrive and even grow at the hand of the platforms’ own algorithmic help.

So where do we go from here?

I have long advocated that governments must define responsibility for the real-world harms caused by these business models, and impose real costs for the damaging effects they are having on our public health, our public square, and our democracy. As it stands, there are no laws governing how social media companies treat political ads, hate speech, conspiracy theories, or incitement to violence. This issue is unduly complicated by Section 230 of the Communications Decency Act, which has been vastly over-interpreted to provide blanket immunity to all internet companies — or “internet intermediaries” — for any third-party content they host. Many argue that to solve some of these issues, Section 230, which dates back to 1996, must at least be updated. But how, and whether it alone will solve the myriad issues we now face with social media, is hotly debated.

One solution I continue to push is clarifying who should benefit from Section 230 to begin with, which often breaks down into the publisher vs. platform debate. To still categorize social media companies — who curate content, whose algorithms decide what speech to amplify, who nudge users towards the content that will keep them engaged, who connect users to hate groups, who recommend conspiracy theorists — as “internet intermediaries” who should enjoy immunity from the consequences of all this is beyond absurd. The notion that the few tech companies who steer how more than 2 billion people communicate, find information, and consume media enjoy the same blanket immunity as a truly neutral internet company makes it clear that it is time for an upgrade to the rules. They are not just a neutral intermediary.

However, that doesn’t mean that we need to completely re-write or kill Section 230. Instead, why not start with a narrower step by redefining what an “internet intermediary” means? Then we could create a more accurate category to reflect what these companies truly are, such as “digital curators” whose algorithms decide what content to boost, what to amplify, how to curate our content. And we can discuss how to regulate in an appropriate manner, focusing on requiring transparency and regulatory oversight of the tools such as recommendation engines, targeting tools, and algorithmic amplification rather than the non-starter of regulating actual speech.

By insisting on real transparency around what these recommendation engines are doing, how the curation, amplification, and targeting are happening, we could separate the idea that Facebook shouldn’t be responsible for what a user posts from their responsibility for how their own tools treat that content. I want us to hold the companies accountable not for the fact that someone posts misinformation or extreme rhetoric, but for how their recommendation engines spread it, how their algorithms steer people towards it, and how their tools are used to target people with it.

To be clear: Creating the rules for how to govern online speech and define platforms’ responsibility is not a magic wand to fix the myriad harms emanating from the internet. This is one piece of a larger puzzle of things that will need to change if we want to foster a healthier information ecosystem. But if Facebook were obligated to be more transparent about how they are amplifying content, about how their targeting tools work, about how they use the data they collect on us, I believe that would change the game for the better.

As long as we continue to leave it to the platforms to self-regulate, they will continue to merely tinker around the margins of content policies and moderation. We’ve seen that the time for that is long past — what we need now is to reconsider how the entire machine is designed and monetized. Until that happens, we will never truly address how platforms are aiding and abetting those intent on harming our democracy.

Making a Difference in People’s Lives

The transition to a new president and a new Congress is always a significant moment, but it’s especially significant this year, there being such a stark difference between the old and the new. Paul Krugman discusses the current state of our politics and a piece of legislation that would make an important difference in the lives of millions of Americans:

. . . Biden will take office in a political environment polluted by lies.

Most important, of course, is the Big Lie: the claim, based on nothing whatsoever, that the election was stolen. Has there been anything in U.S. history like the demand from leading Republicans that Biden pursue “unity” when they won’t even say publicly that he won fairly? And polls showing that a large majority of rank-and-file Republicans believe that there was major election fraud are deeply scary.

But not far behind in importance is what I think of as the Slightly Smaller Lie — the almost universal insistence on the right that the mildly center-left leaders of the incoming administration and Congress are, or at least are controlled by, radical socialists. This allegation was almost the entire substance of Republican campaigning during the Georgia Senate runoffs.

One response to this bizarre claim — and it’s not a bad response — would be a Bidenesque “C’mon, man. Get real!” But I’d like to do a somewhat deeper dive by focusing on one particular issue: Biden’s call, as part of his economic recovery plan, for an increase in the minimum wage to $15 an hour.

Republicans raising objections to Biden’s plan have singled out the minimum wage hike as a prime reason for their opposition, although we all know that they would have found some excuse for objecting no matter what he proposed. What’s striking about this fight — let’s not dignify it by calling it a debate, as if both sides were making real arguments — is that it shows us who the real radicals are.

For what counts as a radical economic proposal? One possible answer would be a proposal that flies in the face of public opinion.

By that criterion, however, Republican politicians are definitely the radicals here. Raising the minimum wage is immensely popular; it’s supported by around 70 percent of voters, including a substantial majority of self-identified Republicans. Or if you don’t believe polls, look at what happened in Florida back in November: even as Trump carried the state, a referendum on raising the minimum wage to $15 won in a landslide.

So the G.O.P. is very much out of step with the public on this issue — it’s espousing what is almost a fringe position. Oh, and it’s a position that is completely at odds with the claim by many Republicans that they’re the true party of the working class.

What if we define radicalism not by opposition to public opinion but by a refusal to accept the conclusions of mainstream economics? Here, too, Democrats are the moderates and Republicans the radicals.

It’s true that once upon a time there was a near-consensus among economists that minimum wages substantially reduced employment. But that was long ago. These days only a minority of economists think raising the minimum to $15 would have large employment costs, and a strong plurality believe that a significant rise — although maybe not all the way to $15 — would be a good idea.

Why did economists change their minds? No, the profession wasn’t infiltrated by antifa; it was moved by evidence, specifically the results of “natural experiments” that take place when an individual state raises its minimum wage while neighboring states don’t. The lesson from this evidence is that unless minimum wages are raised to levels higher than anything currently being proposed, hiking the minimum won’t have major negative effects on employment — but it will have significant benefits in terms of higher earnings and a reduction in poverty.

But evidence has a well-known liberal bias. Did I mention that on Friday, just days before their eviction, Trump officials released a report claiming that the 2017 tax cut paid for itself?

Voodoo economics may be the most thoroughly debunked doctrine in the history of economic thought, refuted by decades of experience — and voters consistently say that corporations and the wealthy pay too little, not too much, in taxes. Yet tax cuts for the already privileged are central to the Republican agenda, even under a supposedly populist president.

On economic policy, then, Democrats — even though they have moved somewhat to the left in recent years — are moderates by any standard, while Republicans are wild-eyed radicals. So why does the G.O.P. think that it can get away with claiming the opposite?

Part of the answer is the power of the right-wing disinformation machine, which relentlessly portrays anyone left of center as the second coming of Pol Pot. . . .

In any case, let’s be clear: There is indeed a radical party in America, one that, aside from hating democracy, has crazy ideas about how the world works and is at odds with the views of most voters. And it’s not the Democrats.

It Wouldn’t Be Hard to End Poverty in America

If we were willing to share the wealth. From Jacobin Magazine:

The poor in our nation are often blamed for their own crises, with lawmakers and even service providers citing bad behavior or ignorance as the cause of individual poverty.

In Broke in America, Joanne Goldblum and Colleen Shaddox reject that narrative. US policies that benefit the wealthy cause poverty, they insist — and changes to those policies can end it.

Fran Quigley interviewed Goldblum and Shaddox for Jacobin.


FQ

Almost immediately in this book, you confront the maxim, “Give a man a fish, and you feed him for a day; teach a man to fish, and you feed him for a lifetime”: “Antipoverty efforts should stop making assumptions about people’s fishing abilities,” you write. “It’s past time to stop judging and give that hungry person a fish.” Why did you take that on?

CS

That saying summarizes everything that’s wrong with how the United States addresses poverty: we say the problem is the person, so we need to fix the person and what that person lacks in skills. But does he even have a fishing pole? Is he too weak with hunger to go fish? Is the “he” in question actually a woman, and women aren’t allowed to fish there?

It’s so paternalistic and so horrible. Yet people say it all the time, like they’ve said something wise and caring.

JG

At the policy level, we create systems that actually make it harder for people to be self-sufficient.

For example, many people who are part of the TANF (Temporary Assistance for Needy Families) or workforce development programs are trained to become certified nursing assistants, CNAs. That’s a very important job that we need to do. But it is a poverty-wage job. By and large, people who work in those positions don’t have workplace benefits and are not paid a living wage. But the government trains someone to be a CNA and then it can feel like it’s done something because it’s gotten that person off of the rolls.

FQ

You devote a good deal of the book to reviewing the data and the stories that describe US poverty, but you always circle back to solutions, refuting the idea we often hear that “the poor will always be with us.” Why do you think we can, as your subtitle promises, end poverty in the United States?

JG

Because poverty is simply not having enough money to meet your needs. There is nothing more complicated about it than that. And we live in the richest nation in the world, where there is plenty of money. So if we have the political will, we could end poverty.

There are lots of different ways to do it. A living wage is necessary . . . We talk in the book about universal health care, housing supports, about making water and electricity and heat a public good. Other countries do all this, and there is no reason we could not do so as well. If we just tax people appropriately, we can have the money to do all this.

CS

We write about challenges in affording car insurance in places where you need a car to get to work, the difficulty in keeping the lights on, not being able to afford medicines. Being in poverty is like walking across a rotted floor — there are so many ways you can fall through. And it all comes down to money.

[There] is a lot of money that’s churning around in our economy, but it’s not being shared appropriately. And by “shared,” I don’t mean some generous act. I mean that the worker in the warehouse who is making everything run deserves a fair share of the revenue he is generating. We don’t have that now.

FQ

You both have worked with poor people in the United States for a long time. But you write that it took a while for you to come to your own realizations that our approach to confronting poverty is fundamentally flawed.

JG

I was a social worker doing direct service with chronically homeless families. When they did have homes, they often did not have heat and hot water. One mom who I worked with never had toilet paper and often did not have clean diapers. . . . It turned out there was no choice involved: there was nothing more than the fact that she couldn’t afford these basic necessities. . . .

CS

At the soup kitchen where I worked, you would always have people after the meal asking, “Do you have 75 cents for the bus?” I used to think, gosh, we should teach them planning skills, how to think more long-term. Because they knew when they came to the soup kitchen, they had to get back home. Later on, I realized: they were hungry, and they got 75 cents somehow to come to the soup kitchen to eat in the first place. That was the wise survival strategy.

So often we make judgments about poor people’s motivation and cognition that are really a reflection of not having resources. I do a lot of work in the criminal legal system, and motivation is a big deal. Do they show up for their appointments? Do they return phone calls?

Well, to show up for an appointment, you need transportation and childcare. To return phone calls, you need a working phone. The written notices may be written in a language they don’t speak. And on and on. It’s very much like that woman who didn’t have toilet paper: she didn’t need a lecture on being a better parent; she needed toilet paper. And the guys at the soup kitchen that I was making judgments about — they needed 75 cents for the bus.

FQ

You have your own experiences addressing poverty, you spoke with experts, and you did your own policy research. Why did you consider it important to include in the book the stories of people living in poverty?

JG

These stories matter. There is a certain symbolic annihilation of people in poverty in this country. You watch a situation comedy, and everybody lives in a house with a glittering kitchen with granite countertops. We don’t represent poor people in the world in either nonfiction or fiction terribly much. And when we do, we often reduce them to stereotypes. Colleen really insisted that we interview people from all over the country, to make it clear that poverty exists everywhere in the United States, and that it is not one community, one group, one area, one city. You can go anywhere and find people who are experiencing these issues.

FQ

As frontline service providers who have dealt with these practical problems of poverty, why did you include chapters on racism, sexism, and denial of political power?

CS

When you look at any indicator of poverty — who doesn’t have water in their house, who has food insecurity, who dies sooner — you see that race matters. And you can say the same for gender. Women are more likely to be in poverty, more likely to be in extreme poverty. It’s not just that the world is unfair to poor people. It’s doubly unfair when you belong to another oppressed group. There were some communities that are not just left behind, but consciously excluded from prosperity.

JG

That means that part of ending poverty is taking down structures that block access to the political process, educational opportunities, and on and on. For example, we write in the book about redlining and racism in housing policy at all levels. Colleen and I were very intentional about saying these things out loud and clearly, so people cannot pretend that racism and other structural inequalities don’t impact the struggles we are talking about.

FQ

You mention other nations’ approaches to basic needs. The United States has a dramatically higher poverty rate than other wealthy nations and dramatically greater levels of income and wealth inequality. What are other countries doing right that we don’t do here?

JG

They establish some sort of floor. There is no floor in the United States — there is no depth of poverty that you can’t fall to. We have made TANF time-limited, we have enacted policies to make SNAP [Supplemental Nutrition Assistance Program, formerly Food Stamps] time-limited. You can be literally left out in the cold here.

One of the biggest things that’s different about the United States than most other countries is that you can become bankrupt due to medical debt. Not having guaranteed health care and the likelihood of accumulating debt related to health care is uniquely American and incredibly dangerous. . . .You talk to people around the world, and they just are gobsmacked that we allow this. . . .

FQ

What led you down the path of devoting your professional careers to anti-poverty work?

JG

From the time that I can remember, the work that I felt called to do was being a social worker. My mother was a social worker who focused on reproductive rights, and my father was an attorney who did a lot of pro bono work with the ACLU and other causes. . . .

I grew up in New Jersey and was very lucky to go to Hunter College School of Social Work, which teaches what they refer to as Jane Addams social work: not therapy in an office, but changing systems and working to support people.

CS

Probably the defining moment of my life was when I was a very young child, about five or six. My mom was a waitress who worked incredibly hard to support us all. At night, when her feet were just aching, she would put her feet in a tub of Epsom salts. One night I was sitting on the floor playing next to her and I saw the basin fill up with blood because her calluses and blisters had cracked. And I remember thinking: People don’t know how hard her life is, because if they knew they would help. When I grow up, I’m going to write stories about people like my mom. . . .

FQ

I know Colleen is an active Democratic Socialists of America member, and Joanne describes herself as “a little left of liberal.” How far removed from our current U.S. political reality are your prescriptions for ending poverty?

CS

I am a socialist. But you can have onions in a soup without it being onion soup, right? Many of the policies we’re calling for are things that could be labeled socialist, but they’re going on in other capitalist countries. For example, Japan is a very capitalist country where childcare is free. We have just taken capitalism to a really toxic extreme in the United States.

FQ

There have been a lot of books written on poverty, and certainly a lot of media coverage. Who were you aiming to reach with this book?

JG

We wrote this for people who consider themselves to be progressive and may be sympathetic to the poor. But they also have heard the line that poverty is an individual failing or think that it is unsolvable. It’s not.

Starting the Year on a Positive Note

It’s not 100% positive, of course, but it’s something to keep in mind (any port in a storm). From Paul Krugman of The New York Times:

The next few months will be hell in terms of politics, epidemiology and economics. But at some point in 2021 things will start getting better. And there’s good reason to believe that once the good news starts, the improvement in our condition will be much faster and continue much longer than many people expect.

OK, one thing that probably won’t get better is the political scene. Day after day, Republicans — it’s not just Dxxxx Txxxx — keep demonstrating that they’re worse than you could possibly have imagined, even when you tried to take into account the fact that they’re worse than you could possibly have imagined. . . .

But on other fronts there’s a clear case for optimism. Science has come to our rescue, big time, with the miraculously fast development of vaccines against the coronavirus. True, the United States is botching the initial rollout, which should surprise nobody. But this is probably just a temporary hitch, especially because in less than three weeks we’ll have a president actually interested in doing his job [and is an actual human being].

And once we’ve achieved widespread vaccination, the economy will bounce back. The question is, how big will the bounce be?

Our last economic crisis was followed by a sluggish recovery. Employment didn’t return to 2007 levels until 2014; real median household income didn’t regain the lost ground until 2016. And many observers expect a replay of that story, especially if Republicans retain control of the Senate and engage, once again, in economic sabotage under the pretense of being fiscally responsible.

But the crisis of 2020 was very different from the crisis of 2008, in ways that make our prospects look much better this time around.

The last economic crisis involved a Wile E. Coyote moment: The private sector suddenly looked down, realized that there was nothing supporting extravagant housing prices and extremely high levels of household debt, and plunged. The result was an extended period of depressed spending. The only way to have avoided multiple years of high unemployment would have been sustained, large-scale fiscal stimulus — and the [Republicans] prevented that.

This 2020 crisis, by contrast, was brought on by a headwind out of nowhere, in the form of the coronavirus. The private sector doesn’t seem to have been particularly overextended before the pandemic. And while we shouldn’t minimize the hardships faced by millions of families, on average Americans have been saving like crazy, and will emerge from the pandemic with stronger balance sheets than they had before.

So I’m in the camp that expects rapid growth once people feel safe going out and spending money. Mitch McConnell and company will, no doubt, do what they always do when a Democrat occupies the White House, and try to sabotage the recovery. But this time the economy won’t need support as badly as it did during the Obama years.

And I suspect, although with less confidence, that the boom will go on for a long time. Why? Because like a number of other people, I’m getting optimistic about the future of technology.

The years that followed the 2008 crisis weren’t just marked by sluggish job growth. They also coincided with a period of technological disappointment. As [one entrepeneur] put it, it was an era in which we wanted flying cars but got 140 characters instead. . . . That is, we were doing some flashy stuff pushing information around, but not making much progress in the material world, which is still where we mainly live.

Lately, however, I’ve been hearing a lot of buzz around new physical technologies that reminds me of the buzz about information technology in the early 1990s, which presaged the productivity surge from 1995 to 2005. Biotechnology finally seems to be coming into its own — hence those miraculous vaccines. There has been incredible progress in renewable energy; I’m old enough to remember when solar power was considered a hippie fantasy, and now it’s cheaper than fossil fuels. There’s room for more skepticism about the near-term prospects for things like self-driving vehicles and lab-grown meat, but the fact that we’re even talking about such innovations is a good sign for the future.

This new wave of innovation doesn’t have much to do with policy, although progress in renewables can be partly attributed to the Obama administration’s promotion of green energy. But the Biden administration, unlike its predecessor, won’t be anti-science and won’t try desperately to preserve the coal-burning past. That will help us take advantage of progress.

I’m less confident in my techno-optimism than I am in my expectations for a rapid employment recovery once we’ve been vaccinated. But all in all, there’s a pretty good chance that Joe Biden will preside over an economy that surprises many people on the upside.Â