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Bitcoin Stops The Bleeding: A Sound Money System Is The Only Cure For What Ails Our Economy

As fiat currencies slowly bleed out in value, they are disincentivizing saving. Bitcoin is a cure for the economic calamities.



As fiat currencies slowly bleed out in value, they are disincentivizing saving. Bitcoin is a cure for the economic calamities.

This is an opinion editorial by Conor Chepenik, a Bitcoin pleb.

When a doctor operates on a wounded patient, the first thing they do is make sure they can stop the bleeding. No point operating if you can’t get the bleeding under control because the patient will die. Money facilitates mutual exchange and helps market actors coordinate price discovery — it is the literal blood of the economy. As fiat currencies slowly bleed out in value, they incentivize fewer people to save. If you want to stop the bleeding in your financial life, you are going to need to find a way to store your wealth in something else. There are plenty of options, but only one that is programmed to stop all bleeding in 2140.

As peoples’ money bleeds out, so too does their education, time and, I’d even argue, their mental sanity. Blood isn’t oozing out egregiously, but rather being siphoned off from tiny cuts, so most people do not even realize it’s happening. This is a hard pill to swallow. Most Western societies teach people not to question authority: raise your hand if you want to ask questions, and trust the experts. Breaking out of this mentality is difficult. Watch this clip of the White House press secretary to get an idea of how those at the top will treat people who dare question the narrative.

Pain Is The Best Teacher

Narrative is everything when trying to coerce the masses to accept a “Great Reset” (if you have no idea what the Great Reset is, you can read about it here). The scope of this article won’t cover what the Davos elite is attempting to impose on the rest of the world, but rather why Bitcoin stops money from bleeding out. Trying to calculate all of the variables that bring about the emergent, complex behavior of society is futile. Governments stole trillions of dollars via quantitative easing and blamed their theft on COVID-19.

It should not be a surprise that what followed has been chaos in the form of protests and supply chain issues. The Federal Reserve is following up its quantitative easing with tightening monetary policy at record paces trying to get inflation under control. This demand destruction is wreaking havoc all over the economy but is necessary to weed out unprofitable businesses.

For better or worse, pain is the best teacher. Hard Money recently reported that Trezor has seen a 300% increase in sales revenue after the FTX debacle. The whole point of Bitcoin is to not trust ,but verify for yourself. Many ignored this because FTX had the stamp of approval from many mainstream news outlets, politicians and celebrities.

In the wake of its blow, FTX created tons of new Bitcoin maximalists who now understand why not verifying Bitcoin with your own node means that you are trusting potentially-corrupt third parties. The mainstream media is not doing itself any favors with puff pieces like the one below. Articles like this only serve to increase the pain of those who were robbed and convince more people that the mainstream narrative is corrupt:


But Self Education Helps Too

The remedy to most of these problems is a better education. Tools like, Udemy and plenty of others have lowered the barrier tremendously. It just requires a desire to learn.

For me, I found that desire by going down the Bitcoin rabbit hole. Ironically, answering one question would lead me to more questions and that number of questions grew exponentially. It made me wonder how much people are not taught intentionally during their traditional schooling. There is only so much time in the day and teachers must prioritize their curriculums accordingly. I just don’t understand why taxes, how to vote and basic financial literacy aren’t at the top of most public school curriculums. The reader can come to their own conclusions. What’s important is finding a teacher who speaks your language and a subject that brings out your natural curiosity. Learning becomes one of the most euphoric feelings in the world when those two needs are met.

The standard way of learning has horrible mental models for teaching people, like memorizing things for a test. Oscar Wilde is quoted as saying, “Experience is merely the name men gave to their mistakes.” People are so focused on learning from the experts that they forget that those who changed the world didn’t ask for permission to do so. They just did it. People want a hero to fix all of their problems but the truth is that no one is coming to save you. I’m not saying one should not find great mentors; it’s super valuable being able to listen to those who have become experts in their fields in order to learn. I’m saying one should not worship people like gods who can’t make mistakes. Just look at Sam Bankman-Friend, who many thought was a hero.


Despite all of the educational content out there, the reality is most people will come to understand the difference between paper bitcoin and bitcoin you actually hold the keys for via an expensive lesson. When the majority of Bitcoiners self custody their coins, and stop blindly trusting their heroes, that is when we will see fireworks in regards to bitcoin’s price action. Every person is different and has various forms of risk tolerance. For those who are discouraged by recent events, remember: Rome was not built in a day. Sometimes the only way to get a lesson through someone’s head is for them to suffer the pain of said mistake.

FTX And Central Planners Are Not So Different

What’s interesting about watching FTX fail so rapidly is that the same thing would happen with our traditional financial system if we didn’t have central banks acting as lenders of last resort. FTX violated its own terms of service by using customer funds to make bets, but 99.9% of the world just turns a blind eye when banks do this because their terms of service legally allow fractional reserve banking.

In his book “Human Action,” Ludwig von Mises writes:

“The rich, the owners of the already operating plants, have no particular class interest in the maintenance of free competition. They are opposed to confiscation and expropriation of their fortunes, but their vested interests are rather in favor of measures preventing newcomers from challenging their position. Those fighting for free enterprise and free competition do not defend the interests of those rich today. They want a free hand left to unknown men who will be the entrepreneurs of tomorrow and whose ingenuity will make the life of coming generations more agreeable. They want the way left open to further economic improvements. They are the spokesmen of progress.”

Technology getting better should lead to massive deflation from productivity gains. Regulatory moats and monopolies prevent this. Fractional reserve banking creates an inflationary environment where tons of capital is misallocated. In a free market, most commercial banks would be insolvent.

FTX tried to create its own fractional reserve monopoly by lobbying Congress and creating a regulatory moat around its business which would’ve made it impossible for competitors to compete in the crypto ecosystem. The world is fortunate FTX’s system blew up before it was able to get its way with D.C.

Mises was right: It is not the incumbents who will create a more agreeable future, it is entrepreneurs and ideas competing in a free market. Bitcoin has over 10,000 competitors, and that number is growing every day. Many, if not all of these tokens, are Ponzi schemes in my opinion, but the idea that D.C could do a better job deciding this than the free market could is ridiculous.

I understand regulation is difficult when technology is changing things at such rapid rates. The little piece of glass in our pocket allows us to hail a ride, order food or listen to some of the greatest minds on the planet whenever we want. All of these things would seem magical to someone who lived before the creation of smartphones. There are going to be hiccups along the way as humanity tries to come to grips with these new tools. This is why I keep this Hal Finney quote as my Twitter header:


For all of the wonders that technology can do for humanity, it can also drive a whole new level of control. Free markets lead to optimal price discovery. Too much central planning and markets start to break. Price discovery in a free market is like a hash function. It takes inputs of data and spits out an output that only goes one way.

With a normal hash, the algorithm works so that it is unfeasible to reverse-calculate the data. You can verify a hash by making sure the same output is achieved based on the input, but you can’t take the output and figure out the input. In this same vein, a free market will set the price of a good, but you can’t figure out how all of the labor, work, travel and other variables created the price of the good. The function only goes one way.

Market actors get upset when the coercion variable is notched up and price increases happen. The blame is typically pushed on to the producers rather than the central planners who are causing such issues. Sound familiar? Like say the U.S. government, which is calling out greedy fossil fuel companies for raising the price of gas while at the same time advocating for the end of fossil fuel use. If price controls are imposed, price discovery completely breaks down, resulting in shortages. Until the creation of money is no longer heavily intermingled with politics these issues will continue to play out.

Bitcoin Is More Important Now Than Ever

As central bank digital currencies (CBDCs) and digital identities are rolled out, it has never been more important to point out why Bitcoin is the remedy. Bitcoin allows the individual to go down a hero’s journey where they can keep the value of their labor in their head. CBDCs and digital IDs offer governments tools to enact monetary policy at the individual level, be at the center of every transaction and turn off people’s money as they see fit.

Bitcoin offers a better system, one that no one can cheat if they want to be in consensus with the rest of the network. Preston Pysh said it best: “Bitcoin is like the infinity stone.” It takes a great deal of faith to hold on to an asset that has had multiple 70% to 90% drawdowns before recovering to new all-time highs. Not many can hang on to their bitcoin but those who do over long periods of time are greatly rewarded.

The network effects of Bitcoin are insane. There is a Bitcoin website paying people 21,000 satoshis to post a sticker that it ships to you around their cities. Think about that. You can earn sats and increase the value of those sats by helping raise awareness. Bitcoin is full of these win-win scenarios. The tech is exciting, but the passion I see from Bitcoiners in real life is unlike anything I’ve ever seen before.

Bitcoin as a technology, a new form of money and an idea are bringing hope to humans around the world who have been disadvantaged because governments have a monopoly on violence. Bitcoin empowers the individual to fight back like never before. There will be growing pains along the way and more turmoil in the short term for those obsessed with measuring things in fiat. The way to fix that is to orient yourself around the new system.

The possibilities that will come out of this Bitcoin renaissance are endless. Grappling with what this new form of money means is difficult because the world is full of so many paradoxes. When you learn, you become smarter by ending up with more questions. Monopolies have brought about some of the most prosperous and technologically advanced times in human civilizations while also making George Orwell’s “1984” look like a very plausible path for the future. The internet is connecting people like never before and at the same time, loneliness is increasing. Number go up technology is associated with greed and is what initially attracts people to Bitcoin, yet many stay because they realize Bitcoin is the true effective altruism movement. These paradoxes are a bit mind bending but I do think there is value to be had from chewing on these ideas.

It can be easy to get bogged down with all of the bleeding going on in the fiat world. Bitcoin is the Band-Aid to fix it. It gives me a lot of confidence knowing my money is secured by open-source software and math rather than 12 individuals who decide when it is okay to steal and when it’s time to practice fiscal austerity.

I’m glad the Fed has finally decided to do the right thing for the economy but it has manipulated the cost of capital for so long that it now risks destroying the entire system if it keeps tightening. The problem is that the Fed’s only other option is to lower rates again, which causes more bleeding via inflation. Bitcoin offers humanity a way out of this paradox where central planners try to fix the bleeding by siphoning more blood out of the patient. Every time central planners manipulate the cost of capital it becomes more clear that market participants are playing a rigged game. Bitcoin is the fairest game humanity has ever created and the best chance we have of separating money and state.

This is a guest post by Conor Chepenik. Opinions expressed are entirely their own and do not necessarily reflect those of BTC Inc or Bitcoin Magazine.

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New ways to protect food crops from climate change and other disruptions

“There’s no doubt we can produce enough food for the world’s population – humanity is strategic enough to achieve that. The question is whether…



“There’s no doubt we can produce enough food for the world’s population – humanity is strategic enough to achieve that. The question is whether – because of war and conflict and corruption and destabilization – we do,” said World Food Programme leader David Beasley in an interview with Time magazine earlier this year.    

Credit: NMBU

“There’s no doubt we can produce enough food for the world’s population – humanity is strategic enough to achieve that. The question is whether – because of war and conflict and corruption and destabilization – we do,” said World Food Programme leader David Beasley in an interview with Time magazine earlier this year.    

Indeed, projections show that we are not on track to achieve Sustainable Development Goal 2 of Zero Hunger by 2030. As climate and security crises continue to destabilise our food sources, researchers are taking a critical look not just at how we produce food – but at the entire systems behind our food supplies. In this case, the systems behind the seeds that produce our food crops.    

“Whilst adapting crops to climate change and conserving their variation is essential for food security, these measures are meaningless if farmers do not have access to the seeds,” says crop scientist and food system expert Ola Westengen. Westengen leads the team of researchers from the Norwegian University of Life Sciences (NMBU) who recently reviewed the state of seed systems for small-holder farmers in low/middle income countries. Their findings are now published in the Proceedings of the National Academy of Sciences (PNAS).   

What are seed systems?    

Seed systems are the provision, management and distribution of seeds. They cover the entire seed chain, from the conservation of their diversity and variety development, to their production and distribution, and the rules that govern these activities.  In short, they are the structures that make seeds available to farmers so that crops can be sown, harvested and end up on our plates.    

Whilst a well-functioning seed system will ensure seed security for all farmers, the researchers say that, in practice, it is rarely the case that seed systems function as well as they might. Seed systems can be disrupted by conflict and disasters, as well as by problems stemming from social inequality, lack of coordination or inappropriate policies.      

What does this study tell us that we don’t already know?   

“There are recent innovations and investments by governments and donors to improve farmers’ access to diverse crop varieties and quality seeds,” explains Teshome Hunduma, a seed governance researcher and co-author of the study. “For example, there are now more flexible policies and regulations that encourage diversity in the seed systems used by farmers, rather than pushing farmers to switch to commercial seed systems that focus on less diverse commodity crops – which is the norm.” Commodity crops are those grown in large volume and high intensity for the purpose of sale, as opposed to those grown by small-holder farmers for direct processing and consumption.   

“The study highlights emerging initiatives that are helping farmers to secure food supplies, such as participatory plant breeding,” says Teshome. Participatory plant breeding is the development and selection of new crop varieties where the farmers are in control. Farmers, who know the needs of their farms best, work with researchers and others to improve crops and develop plant varieties that are in line with their household needs and culture, and that are resilient to environmental and climate challenges.    

“Farmers prefer and need different types of seeds, based on diverse social, cultural and ecological conditions,” adds ethnobotanist and co-author Sarah Paule Dalle.       

The study discusses various disruptions to farmer’s access to seeds. Social inequality is one such disruption. How so?   

“A seed system that only serves a segment of a farming society contributes to seed insecurity,” replies Teshome. “For example, commercial seed systems deliver high-yielding varieties of quality hybrid seeds. Whilst wealthy farmers can afford such seeds, poor farmers can’t.”    

“Similarly, whilst commercial seed systems that focus on commodity crops may benefit men who might primarily be interested in market value, such systems have little to offer women who want crops that provide household nutrition and meet their cultural preferences.”   

“This means poor farmers and women do not have the same access to seeds that meet their needs. The result is seed, and thus food, insecurity due to social and economic inequality.”     

Political-economic factors have driven the globalization of food systems over the last decades, which also includes seed systems. “Seeds have become big business”, say the researchers. According to studies quoted in the article, the four largest multinational companies in seed trade today control about 60% of the ~50 billion USD global commercial seed market. The large private actors have the power not only to shape markets, but also to influence science and innovation agendas and policy frameworks.     

This can be problematic, say the researchers, when private sector research and development typically focuses on the most profitable crops, such as maize and soy. Crops grown and consumed by subsistence farmers are thus largely neglected, and the potential of crop diversity – the foundation of agriculture – remains largely untapped. Technology that could help develop more robust varieties remains hypothetical.   

How does the ownership of crop diversity threaten food supplies and what can be done?      

The term crop diversity refers both to different crops and different varieties of a crop. According to the Global Crop Diversity Trust (one of the world’s primary international organizations on crop diversity conservation), securing and making available the world’s crop diversity is essential for future food and nutrition security.      

“Plant breeders and scientists use crop diversity to develop new, more resilient and productive varieties that consumers want to eat, that are nutritious and tasty, and that are adapted to local preferences, environments and challenges,” explains Benjamin Kilian, a plant genetics expert at the Global Crop Diversity Trust. The Crop Trust, together with the Norwegian University of Life Sciences, implements the major project from which this study emerged: Biodiversity for Opportunities, Livelihoods and Development (BOLD). Coordinated by Kilian, the project supports the conservation and use of crop diversity to strengthen food and nutrition security on a global scale. It builds on the Crop Wild Relatives project and is funded by the Norwegian government.   

“In the BOLD project, researchers work with genebanks, plant breeders and others in the seed value chain to co-develop seed systems that are both resilient to climate stresses and inclusive of small-holder farmers on the frontline of adaptation,” adds Westengen.     

Will access to seeds in the vulnerable areas that you are studying be improved in time to make a difference?   

“We hope so, if we make the right moves to include small-holder farmers in seed system development,” says Dalle. “A well-functioning seed system should also be resilient. That is, it should withstand shocks such as drought or pandemics and breakdowns or disruptions such as war and conflict.”    

“To do this, the system should promote a diversity of seeds, both local varieties and those improved to better adapt to stresses. It should also involve diverse groups of people such as farmer cooperatives/groups, and both public and private companies to increase the choice of seeds and seed sources. During lockdowns in the COVID-19 pandemic, for example, farmers’ own seed systems enabled access to seeds in developing countries when the activities of private companies and agro-dealers were restricted,” explains Dalle.   

Westengen summarizes: “Our study highlights links between the crucial work of the Global Crop Diversity Trust and the farmers on the frontline of adapting our food systems to climate change. It is an argument for co-designing seed system development in full cooperation with farmers and other actors in the seed system. This way, efforts can meet the needs of various groups of farmers in different agroecological contexts. There is no one-size-fits-all; if there is one natural law in biology, it is that diversity is key to future evolution. That also goes for seed systems – and food system development.”   

Navigating towards resilient and inclusive seed systems by Ola T. Westengen, Sarah Paule Dalle and Teshome Hunduma Mulesa was published in Proceedings of the National Academy of Sciences (PNAS) this week. PNAS is widely considered one of the most prestigious and highly cited multidisciplinary research journals.   

About the Norwegian University of Life Sciences (NMBU)  
NMBU’s research and education enables people all over the world to tackle the big, global challenges regarding the environment, sustainable development, how to improve human and animal health, renewable energy sources, food production, and land- and resource management. 

 About the Crop Trust 
The Crop Trust is an international organization working to conserve crop diversity and thus protect global food and nutrition security. At the core of Crop Trust is an endowment fund dedicated to providing guaranteed long-term financial support to key genebanks worldwide. The Crop Trust supports the Svalbard Global Seed Vault and coordinates large-scale projects worldwide to secure crop diversity and make it available for use. The Crop Trust is recognized as an essential element of the funding strategy of the International Treaty on Plant Genetic Resources for Food and Agriculture.  

About the BOLD Project 
BOLD (Biodiversity for Opportunities, Livelihoods, and Development) is a major 10-year project to strengthen food and nutrition security worldwide by supporting the conservation and use of crop diversity. The project works with national genebanks, pre-breeding and seed system partners globally. Funded by the government of Norway, BOLD is led by the Crop Trust in partnership with the Norwegian University of Life Sciences and the International Plant Treaty. 

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A Federal Reserve Pivot is not Bullish

An old saying cautions one to be careful of what one wishes for. Stock investors wishing for the Federal Reserve to pivot may want to rethink their logic…



An old saying cautions one to be careful of what one wishes for. Stock investors wishing for the Federal Reserve to pivot may want to rethink their logic and review the charts.

The second largest U.S. bank failure and the deeply discounted emergency sale of Credit Suisse have investors betting the Federal Reserve will pivot. They don’t seem to care that inflation is running hot and sticky, and the Fed remains determined to keep rates “higher for longer” despite the evolving crisis.

Like Pavlov’s dogs, investors buy when they hear the pivot bell ringing. Their conditioning may prove harmful if the past proves prescient.

The Bearish History of Rate Cuts

Since 1970, there have been nine instances in which the Fed significantly cut the Fed Funds rate. The average maximum drawdown from the start of each rate reduction period to the market trough was 27.25%.

The three most recent episodes saw larger-than-average drawdowns. Of the six other experiences, only one, 1974-1977, saw a drawdown worse than the average.  

So why are the most recent drawdowns worse than those before 1990? Before 1990, the Fed was more active. As such, they didn’t allow rates to get too far above or below the economy’s natural rate. Indeed, high inflation during the 1970s and early 1980s forced Fed vigilance. Regardless of the reason, higher interest rates helped keep speculative bubbles in check.

During the last 20 years, the Fed has presided over a low-interest rate environment. The graph below shows that real yields, yields less inflation expectations, have been trending lower for 40 years. From the pandemic until the Fed started raising rates in March 2022, the 10-year real yield was often negative.

real yields wicksell

Speculation often blossoms when interest rates are predictably low. As we are learning, such speculative behavior emanating from Fed policy in 2020 and 2021 led to conservative bankers and aggressive hedge funds taking outsized risks. While not coming to their side, what was their alternative? Accepting a negative real return is not good for profits.

We take a quick detour to appreciate how the level of interest rates drives speculation.

Wicksell’s Elegant Model

A few years ago, we shared the logic of famed Swedish economist Knut Wicksell. The nineteenth-century economist’s model states two interest rates help assess economic activity. Per Wicksell’s Elegant Model:

First, there is the “natural rate,” which reflects the structural growth rate of the economy (which is also reflective of the growth rate of corporate earnings). The natural rate is the combined growth of the working-age population and productivity growth. Second, Wicksell holds that there is the “market rate” or the cost of money in the economy as determined by supply and demand.

Wicksell viewed the divergences between the natural and market rates as the mechanism by which the economic cycle is determined. If a divergence between the natural and market rates is abnormally sustained, it causes a severe misallocation of capital.

The bottom line:

Per Wicksell, optimal policy should aim at keeping the natural and market rate as closely aligned as possible to prevent misallocation. But when short-term market rates are below the natural rate, intelligent investors respond appropriately. They borrow heavily at the low rate and buy existing assets with somewhat predictable returns and shorter time horizons. Financial assets skyrocket in value while long-term, cash-flow-driven investments with riskier prospects languish.

The second half of 2020 and 2021 provide evidence of Wicksell’s theory. Despite brisk economic activity and rising inflation, the Fed kept interest rates at zero and added more to its balance sheet (QE) than during the Financial Crisis. The speculation resulting from keeping rates well below the natural rate was palpable.

What Percentage Drawdown Should We Expect This Time?

Since the market experienced a decent drawdown during the rate hike cycle starting in March 2022, might a good chunk of the rate drawdown associated with a rate cut have already occurred?

The graph below shows the maximum drawdown from the beginning of rate hiking cycles. The average drawdown during rate hiking cycles is 11.50%. The S&P 500 experienced a nearly 25% drawdown during the current cycle.

rate hikes and drawdowns

There are two other considerations in formulating expectations for what the next Federal Reserve pivot has in store for stocks.

First, the graph below shows the maximum drawdowns during rate-cutting periods and the one-year returns following the final rate cut. From May 2020 to May 2021, the one-year period following the last rate cut, the S&P 500 rose over 50%. Such is three times the 16% average of the prior eight episodes. Therefore, it’s not surprising the maximum drawdown during the current rate hike cycle was larger than average.

rate cuts and drawdowns

Second, valuations help explain why recent drawdowns during Federal Reserve pivots are worse than those before the dot-com bubble crash. The graph below shows the last three rate cuts started when CAPE10 valuations were above the historical average. The prior instances all occurred at below-average valuations.

cape 10 valuations

The current CAPE valuation is not as extended as in late 2021 but is about 50% above average. While the market has already corrected some, the valuation may still return to average or below it, as it did in 2003 and 2009.

It’s tough to draw conclusions about the 2020 drawdown. Unprecedented fiscal and monetary policies played a prominent role in boosting animal spirits and elevating stocks. Given inflation and political discord, we don’t think Fed members or politicians will be likely to gun the fiscal and monetary engines in the event of a more significant market decline.


The Federal Reserve is outspoken about its desire to get inflation to its 2% target. If they were to pivot by as much and as soon as the market predicts, something has broken. Currently, it would take a severe negative turn to the banking crisis or a rapidly deteriorating economy to justify a pivot, the likes of which markets imply. Mind you, something breaking, be it a crisis or recession, does not bode well for corporate earnings and stock prices.

There is one more point worth considering regarding a Federal Reserve pivot. If the Fed cuts Fed Funds, the yield curve will likely un-invert and return to a normal positive slope. Historically yield curve inversions, as we have, are only recession warnings. The un-inversion of yield curves has traditionally signaled that a recession is imminent. 

The graph below shows two well-followed Treasury yield curves. The steepening of both curves, shown in all four cases and other instances before 1990, accompanied a recession.

Over the past two weeks, the two-year- ten-year UST yield curve has steepened by 60 bps!

yield curves rate cuts and recessions

The post A Federal Reserve Pivot is not Bullish appeared first on RIA.

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COVID-19 impacted smoking assessment rates in community health centers, necessitating a closer examination on how procedures can be adapted

COVID-19 Impacted  Smoking Assessment Rates in Community Health Centers, Necessitating a Closer Examination on How Procedures Can be Adapted Credit: Annals…



COVID-19 Impacted  Smoking Assessment Rates in Community Health Centers, Necessitating a Closer Examination on How Procedures Can be Adapted

Credit: Annals of Family Medicine

COVID-19 Impacted  Smoking Assessment Rates in Community Health Centers, Necessitating a Closer Examination on How Procedures Can be Adapted

Researchers from Oregon Health & Science University and OCHIN,  a large nonprofit network of community health centers, extracted electronic health record data from 217 primary care clinics between January 2019 through the end of July 2021, which included telehealth and in-person visits for 759,138 adult patients aged 18 and older years to determine how monthly rates of tobacco assessment had been affected by the COVID-19 pandemic. The team calculated the rates per 1,000 patients. The team found that between March and May 2020, tobacco assessment monthly rates declined from 155.7 per 1,000 patients down to 77.7 per 1,000 patients, a 50% decline. There was a subsequent increase in tobacco assessment between June 2020 and May 2021. However, assessments remained 33.5% lower than pre-pandemic levels. These findings are significant given the fact that tobacco use can increase the severity of COVID-19 symptoms.

What is Known on This Topic: While there is plentiful evidence on the impact that COVID-19 has had on primary health care seeking and delivery, little is known about how the pandemic affected tobacco use assessments and cessation programs.

What This Study Adds: The decline in the rate of tobacco assessments during the onset of the COVID-19 pandemic was substantial and rates have yet to return to pre-pandemic levels. Given that tobacco use can exacerbate COVID-19 symptoms, researchers recommend careful examination of procedural changes to adapt care delivery to support community health centers, specifically tobacco cessation efforts.

.Impact of COVID-19 Pandemic on Assessing Tobacco Status in Community Health Centers

Susan A. Flocke, PhD, et al,
Department of Family Medicine, Oregon Health & Science University, Portland, Oregon
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