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As viral infections skyrocket, masks are still a tried-and-true way to help keep yourself and others safe

Decades of research show that respiratory illnesses are dramatically reduced when people wear face masks.

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1 year ago

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Masks are an easy and low-cost way to reduce the amount of virus entering the air and spreading to others. william87/iStock via Getty Images Plus

The cold and flu season of 2022 has begun with a vengeance. Viruses that have been unusually scarce over the past three years are reappearing at remarkably high levels, sparking a “tripledemic” of COVID-19, the flu and respiratory syncytial virus, or RSV. This November’s national hospitalization levels for influenza were the highest in 10 years.

We are infectious disease epidemiologists and researchers, and we have spent our careers focused on understanding how viruses spread and how best to stop them.

To respond to the COVID-19 pandemic, we and our public health colleagues have had to quickly revive and apply decades of evidence on respiratory virus transmission to chart a path forward. Over the course of the pandemic, epidemiologists have established with new certainty the fact that one of our oldest methods for controlling respiratory viruses, the face mask, remains one of the most effective tools in a pandemic.

Day care centers, college dorms and public gatherings can promote superspreader events.

A slew of circulating viruses

Unlike the many past waves of COVID-19 since the spring of 2020, this fall’s surge of respiratory disease is not due to a single novel virus. Rather, now that masks and other measures have gone by the wayside, the U.S. has returned to the classic cold and flu season pattern. In a typical year, many viruses cocirculate and cause similar symptoms, leading to a wave of illness that includes ever-shifting combinations of more than 15 types and subtypes of viruses.

Nowhere is this pattern more obvious than in young children. Our research has shown that classrooms house many viruses at once, and that individual kids can be infected with two or three viruses even during a single illness.

While mere inconveniences for most people, respiratory viruses like the seasonal flu are responsible for missed work and school. In some cases they can lead to severe illnesses, especially in very young children and older adults. After years of fighting one virus, parents are now exhausted by the reality of battling many, many more.

But there is a straightforward way to cut down on the risk for ourselves and others. When it comes to individual decisions, masks are among the most low-cost and most effective steps that can be taken to broadly reduce transmission of a multitude of viruses.

As of early December 2022, the Centers for Disease Control and Prevention is now recommending that people wear masks indoors in five New York counties.

The latest research

Long before the COVID-19 pandemic, researchers were studying the effectiveness of masks at reducing transmission of other respiratory viruses. Meta-analyses of viral spread during the original SARS epidemic in 2002-2003 showed that one infection was averted for every six people wearing a mask, and for every three people who were wearing an N95 mask.

Mask-wearing by health care workers has long been considered a primary strategy for protecting young at-risk infants from RSV infection transmitted in hospital settings. Scientific evaluation of the effectiveness of masks has historically been clouded by the fact that mask-wearing is often used in conjunction with other strategies, such as hand-washing. Nonetheless, the use of personal protective equipment, including masks, as well as gowns, gloves and possibly goggles in the health care setting, has been commonly associated with reduced transmission of RSV.

Similarly, one of the largest pre-COVID-19 randomized studies of mask-wearing, conducted with over a thousand University of Michigan residence hall students in 2006 to 2007, found that symptomatic respiratory illness was reduced among mask-wearers. This was especially true when masks were combined with hand hygiene.

More recently, researchers measured the amount of virus present in exhaled breath from people with respiratory symptoms to study how well masks blocked the release of virus particles. Those who were randomly selected to wear a mask had lower levels of respiratory shedding for influenza, rhinovirus – which causes the common cold – and non-SARS coronaviruses, than those with no mask.

Now, three years into the pandemic, evidence around masks and our experience using them has grown enormously. Laboratory studies and outbreak investigations have shown that masks lower the amount of virus that enters the air and reduce the quantity of viruses that enter our airways when we breathe. Recent studies have shown that wearing a surgical mask in an indoor public setting reduces the odds of testing positive for COVID-19 by 66%, and wearing an N95/KN95 type of mask lowers the odds of testing positive by 83%.

Chart showing the relative odds of testing positive for COVID-19 depending on mask-wearing and mask type.
A study of mask-wearing in public indoor settings found that people who wore surgical masks were 66% less likely to contract COVID-19 than those who wore none. Centers for Disease Control and Prevention

Infections drop when schoolchildren are masked

Our own research has shown the major impact of mask-wearing on transmission of SARS-CoV-2 – the virus that causes COVID-19 – and other viruses. During the circulation of the highly transmissible delta variant in the fall of 2021, we found that schoolwide mask requirements were linked to a reduction in COVID-19 infections. School-age children living in districts without mask requirements were infected at a higher rate that increased faster in the early weeks of the school year than their counterparts in districts with complete or partial mask requirements. Similar patterns occurred in other states coinciding with the lifting of school mask requirements in spring 2022.

Our preliminary work in a community with frequent mask-wearing behavior has found that the rate of non-COVID respiratory illness in families fell by 50% during 2020 and 2021 compared with earlier years. In our study, as participants reported the relaxing of mask-wearing and other mitigation behaviors in early 2022, the viruses that are now gripping the U.S. began to return. This resurgence started, curiously enough, with a reappearance of the four “common cold” seasonal coronaviruses.

A graph showing that COVID-19 infection rates were significantly higher in school districts without mask requirements.
Michigan school districts without mask requirements experienced higher COVID-19 case rates in fall 2021 during the two months after back-to-school. Michigan.gov Data and Modeling Updates, Eisenberg and Martin Research Groups, University of Michigan, Ann Arbor

Unfortunately, vaccines are only available for two of the major causes of respiratory illness: SARS-CoV-2 and influenza. Likewise, antiviral treatments are also more commonly available for SARS-CoV-2 and influenza than for RSV. RSV vaccines, which have been in development for many years, are expected to become available soon, but not in time to stem the current wave of illness.

In contrast, masks can reduce transmission for all respiratory viruses, with no need to tailor the intervention to the specific virus that is circulating. Masks remain a low-cost, low-tech way to keep people healthier throughout the holiday season so that more of us can be free of illness for the time that we value with our family and friends.

Emily Toth Martin receives funding from the National Institutes of Health, the Centers for Disease Control and Prevention, and Flu Lab.

Marisa Eisenberg receives funding from the National Institutes of Health, National Science Foundation, Michigan Department of Health and Human Services, and the Centers for Disease Control and Prevention.

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Buyouts can bring relief from medical debt, but they’re far from a cure

Local governments are increasingly buying – and forgiving – their residents’ medical debt.

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1 hour ago

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March 13, 2024

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Medical debt can have devastating consequences. PhotoAlto/Odilon Dimier via Getty Images

One in 10 Americans carry medical debt, while 2 in 5 are underinsured and at risk of not being able to pay their medical bills.

This burden crushes millions of families under mounting bills and contributes to the widening gap between rich and poor.

Some relief has come with a wave of debt buyouts by county and city governments, charities and even fast-food restaurants that pay pennies on the dollar to clear enormous balances. But as a health policy and economics researcher who studies out-of-pocket medical expenses, I think these buyouts are only a partial solution.

A quick fix that works

Over the past 10 years, the nonprofit RIP Medical Debt has emerged as the leader in making buyouts happen, using crowdfunding campaigns, celebrity engagement, and partnerships in the private and public sectors. It connects charitable buyers with hospitals and debt collection companies to arrange the sale and erasure of large bundles of debt.

The buyouts focus on low-income households and those with extreme debt burdens. You can’t sign up to have debt wiped away; you just get notified if you’re one of the lucky ones included in a bundle that’s bought off. In 2020, the U.S. Department of Health and Human Services reviewed this strategy and determined it didn’t violate anti-kickback statutes, which reassured hospitals and collectors that they wouldn’t get in legal trouble partnering with RIP Medical Debt.

Buying a bundle of debt saddling low-income families can be a bargain. Hospitals and collection agencies are typically willing to sell the debt for steep discounts, even pennies on the dollar. That’s a great return on investment for philanthropists looking to make a big social impact.

And it’s not just charities pitching in. Local governments across the country, from Cook County, Illinois, to New Orleans, have been directing sizable public funds toward this cause. New York City recently announced plans to buy off the medical debt for half a million residents, at a cost of US$18 million. That would be the largest public buyout on record, although Los Angeles County may trump New York if it carries out its proposal to spend $24 million to help 810,000 residents erase their debt.

HBO’s John Oliver has collaborated with RIP Medical Debt.

Nationally, RIP Medical Debt has helped clear more than $10 billion in debt over the past decade. That’s a huge number, but a small fraction of the estimated $220 billion in medical debt out there. Ultimately, prevention would be better than cure.

Preventing medical debt is trickier

Medical debt has been a persistent problem over the past decade even after the reforms of the 2010 Affordable Care Act increased insurance coverage and made a dent in debt, especially in states that expanded Medicaid. A recent national survey by the Commonwealth Fund found that 43% of Americans lacked adequate insurance in 2022, which puts them at risk of taking on medical debt.

Unfortunately, it’s incredibly difficult to close coverage gaps in the patchwork American insurance system, which ties eligibility to employment, income, age, family size and location – all things that can change over time. But even in the absence of a total overhaul, there are several policy proposals that could keep the medical debt problem from getting worse.

Medicaid expansion has been shown to reduce uninsurance, underinsurance and medical debt. Unfortunately, insurance gaps are likely to get worse in the coming year, as states unwind their pandemic-era Medicaid rules, leaving millions without coverage. Bolstering Medicaid access in the 10 states that haven’t yet expanded the program could go a long way.

Once patients have a medical bill in hand that they can’t afford, it can be tricky to navigate financial aid and payment options. Some states, like Maryland and California, are ahead of the curve with policies that make it easier for patients to access aid and that rein in the use of liens, lawsuits and other aggressive collections tactics. More states could follow suit.

Another major factor driving underinsurance is rising out-of-pocket costs – like high deductibles – for those with private insurance. This is especially a concern for low-wage workers who live paycheck to paycheck. More than half of large employers believe their employees have concerns about their ability to afford medical care.

Lowering deductibles and out-of-pocket maximums could protect patients from accumulating debt, since it would lower the total amount they could incur in a given time period. But if the current system otherwise stayed the same, then premiums would have to rise to offset the reduction in out-of-pocket payments. Higher premiums would transfer costs across everyone in the insurance pool and make enrolling in insurance unreachable for some – which doesn’t solve the underinsurance problem.

Reducing out-of-pocket liability without inflating premiums would only be possible if the overall cost of health care drops. Fortunately, there’s room to reduce waste. Americans spend more on health care than people in other wealthy countries do, and arguably get less for their money. More than a quarter of health spending is on administrative costs, and the high prices Americans pay don’t necessarily translate into high-value care. That’s why some states like Massachusetts and California are experimenting with cost growth limits.

Momentum toward policy change

The growing number of city and county governments buying off medical debt signals that local leaders view medical debt as a problem worth solving. Congress has passed substantial price transparency laws and prohibited surprise medical billing in recent years. The Consumer Financial Protection Bureau is exploring rule changes for medical debt collections and reporting, and national credit bureaus have voluntarily removed some medical debt from credit reports to limit its impact on people’s approval for loans, leases and jobs.

These recent actions show that leaders at all levels of government want to end medical debt. I think that’s a good sign. After all, recognizing a problem is the first step toward meaningful change.

Erin Duffy receives funding from Arnold Ventures.

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Student Loan Forgiveness Is Robbing Peter To Pay Paul

Student Loan Forgiveness Is Robbing Peter To Pay Paul

Via SchiffGold.com,

With President Biden’s Saving on a Valuable Education (SAVE)…

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3 hours ago

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March 13, 2024

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Student Loan Forgiveness Is Robbing Peter To Pay Paul

Via SchiffGold.com,

With President Biden’s Saving on a Valuable Education (SAVE) plan set to extend more student loan relief to borrowers this summer, the federal government is pretending it can wave a magic wand to make debts disappear. But the truth of student debt “relief” is that they’re simply shifting the burden to everyone else, robbing Peter to pay Paul and funneling more steam into an inflation pressure cooker that’s already set to burst.

Starting July 1st, new rules go into effect that change the discretionary income requirements for their payment plans from 10% to only 5% for undergraduates, leading to lower payments for millions. Some borrowers will even have their owed balances revert to zero.

What the plan doesn’t describe, predictably, is how that burden will be shifted to the rest of the country by stealing value out of their pockets via new taxes or increased inflation, which still simmering well above levels seen in early 2020 before the Fed printed trillions in Covid “stimulus” money. They’re rewarding students who took out loans they can’t afford and punishing those who paid their way or repaid their loans, attending school while living within their means. And they’re stealing from the entire country to finance it.

Biden actually claims that a continuing Covid “emergency” is what gives him the authority to offer student loan forgiveness to begin with. As with any “temporary” measure that gives state power a pretense to grow, or gives them an excuse to collect more revenue (I’m looking at you, federal income tax), COVID-19 continues to be the gift that keeps on giving for power and revenue-hungry politicians even as the CDC reclassifies the virus as a threat similar to the seasonal flu.

The SAVE plan takes the burden of billions of dollars in owed payments away from students and adds it to a national debt that’s already ballooning to the tune of a mind-boggling trillion dollars every 3 months. If all student loan debt were forgiven, according to the Brookings Institution, it would surpass the cumulative totals for the past 20 years for multiple existing tax credits and welfare programs:

“Forgiving all student debt would be a transfer larger than the amounts the nation has spent over the past 20 years on unemployment insurance, larger than the amount it has spent on the Earned Income Tax Credit, and larger than the amount it has spent on food stamps.”

Ironically enough, adding hundreds of billions to the national debt from Biden’s program is likely to cause the most pain to the very demographics the Biden administration claims to be helping with its plan: poor people, anyone who skipped college entirely or paid their loans back, and other already overly-indebted young adults, whose purchasing power is being rapidly eroded by out-of-control government spending and central bank monetary shenanigans. It effectively transfers even more wealth from the poor to the wealthy, a trend that Covid-era measures have taken to new extremes.

As Ron Paul pointed out in a recent op-ed for the Eurasia Review:

“…these loans will be paid off in part by taxpayers who did not go to college, paid their own way through school, or have already paid off their student loans. Since those with college degrees tend to earn more over time than those without them, this program redistributes wealth from lower to higher income Americans.”

Even some progressives are taking aim at the plan, not because it shifts the debt burden to other Americans, but because it will require cutting welfare or sacrificing other expensive social programs promised by Biden such as universal pre-K. For these critics, the issue isn’t so much that spending and debt are totally out of control, but that they’re being funneled into the wrong issues.

Progressive “solutions” always seem to take the form of slogans like “tax the wealthy,” a feel-good bromide that for lawmakers always seems to translate into increased taxes for the middle and lower-upper class. Meanwhile, the .01% continue to avoid taxes through offshore accounts, money laundering trickery dressed up as philanthropy, and general de facto ownership of the system through channels like political donations and aggressive lobbying.

If new waves of college applicants expect loan forgiveness plans to continue, it also encourages schools to continue raising tuition and motivates prospective students to continue with even more irresponsible borrowing.

This puts pressure on the Fed to keep interest rates lower to help accommodate waves of new student loan applicants from sparkly-eyed young borrowers who figure they’ll never really have to pay the money back.

With the Fed already expected to cut rates this year despite inflation not being properly under control, the loan forgiveness scheme is just one of many factors conspiring to cause inflation to start running hotter again, spiraling out of control, as the entire country is forced to pay the hidden tax of price increases for all their basic needs.

Tyler Durden Wed, 03/13/2024 - 06:30

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Analyst reviews Apple stock price target amid challenges

Here’s what could happen to Apple shares next.

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13 hours ago

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March 12, 2024

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They said it was bound to happen.

It was Jan. 11, 2024 when software giant Microsoft  (MSFT)  briefly passed Apple  (AAPL)  as the most valuable company in the world.

Microsoft's stock closed 0.5% higher, giving it a market valuation of $2.859 trillion. 

It rose as much as 2% during the session and the company was briefly worth $2.903 trillion. Apple closed 0.3% lower, giving the company a market capitalization of $2.886 trillion. 

"It was inevitable that Microsoft would overtake Apple since Microsoft is growing faster and has more to benefit from the generative AI revolution," D.A. Davidson analyst Gil Luria said at the time, according to Reuters.

The two tech titans have jostled for top spot over the years and Microsoft was ahead at last check, with a market cap of $3.085 trillion, compared with Apple's value of $2.684 trillion.

Analysts noted that Apple had been dealing with weakening demand, including for the iPhone, the company’s main source of revenue. 

Demand in China, a major market, has slumped as the country's economy makes a slow recovery from the pandemic and competition from Huawei.

Sales in China of Apple's iPhone fell by 24% in the first six weeks of 2024 compared with a year earlier, according to research firm Counterpoint, as the company contended with stiff competition from a resurgent Huawei "while getting squeezed in the middle on aggressive pricing from the likes of OPPO, vivo and Xiaomi," said senior Analyst Mengmeng Zhang.

“Although the iPhone 15 is a great device, it has no significant upgrades from the previous version, so consumers feel fine holding on to the older-generation iPhones for now," he said.

A man scrolling through Netflix on an Apple iPad Pro. Photo by Phil Barker/Future Publishing via Getty Images.

Future Publishing/Getty Images

Big plans for China

Counterpoint said that the first six weeks of 2023 saw abnormally high numbers with significant unit sales being deferred from December 2022 due to production issues.

Apple is planning to open its eighth store in Shanghai – and its 47th across China – on March 21.

Related: Tech News Now: OpenAI says Musk contract 'never existed', Xiaomi's EV, and more

The company also plans to expand its research centre in Shanghai to support all of its product lines and open a new lab in southern tech hub Shenzhen later this year, according to the South China Morning Post.

Meanwhile, over in Europe, Apple announced changes to comply with the European Union's Digital Markets Act (DMA), which went into effect last week, Reuters reported on March 12.

Beginning this spring, software developers operating in Europe will be able to distribute apps to EU customers directly from their own websites instead of through the App Store.

"To reflect the DMA’s changes, users in the EU can install apps from alternative app marketplaces in iOS 17.4 and later," Apple said on its website, referring to the software platform that runs iPhones and iPads. 

"Users will be able to download an alternative marketplace app from the marketplace developer’s website," the company said.

Apple has also said it will appeal a $2 billion EU antitrust fine for thwarting competition from Spotify  (SPOT)  and other music streaming rivals via restrictions on the App Store.

The company's shares have suffered amid all this upheaval, but some analysts still see good things in Apple's future.

Bank of America Securities confirmed its positive stance on Apple, maintaining a buy rating with a steady price target of $225, according to Investing.com. 

The firm's analysis highlighted Apple's pricing strategy evolution since the introduction of the first iPhone in 2007, with initial prices set at $499 for the 4GB model and $599 for the 8GB model.

BofA said that Apple has consistently launched new iPhone models, including the Pro/Pro Max versions, to target the premium market. 

Analyst says Apple selloff 'overdone'

Concurrently, prices for previous models are typically reduced by about $100 with each new release. 

This strategy, coupled with installment plans from Apple and carriers, has contributed to the iPhone's installed base reaching a record 1.2 billion in 2023, the firm said.

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Apple has effectively shifted its sales mix toward higher-value units despite experiencing slower unit sales, BofA said.

This trend is expected to persist and could help mitigate potential unit sales weaknesses, particularly in China. 

BofA also noted Apple's dominance in the high-end market, maintaining a market share of over 90% in the $1,000 and above price band for the past three years.

The firm also cited the anticipation of a multi-year iPhone cycle propelled by next-generation AI technology, robust services growth, and the potential for margin expansion.

On Monday, Evercore ISI analysts said they believed that the sell-off in the iPhone maker’s shares may be “overdone.”

The firm said that investors' growing preference for AI-focused stocks like Nvidia  (NVDA)  has led to a reallocation of funds away from Apple. 

In addition, Evercore said concerns over weakening demand in China, where Apple may be losing market share in the smartphone segment, have affected investor sentiment.

And then ongoing regulatory issues continue to have an impact on investor confidence in the world's second-biggest company.

“We think the sell-off is rather overdone, while we suspect there is strong valuation support at current levels to down 10%, there are three distinct drivers that could unlock upside on the stock from here – a) Cap allocation, b) AI inferencing, and c) Risk-off/defensive shift," the firm said in a research note.

Related: Veteran fund manager picks favorite stocks for 2024

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