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Will it be purchase diflucan over counter worth the expense?. Fortunately, in the US, most movie theaters "must provide a means for delivering closed captioning and audio description," according to the Hearing Loss Association of America (HLAA). These rules were issued in 2018 under the Americans with Disabilities Act by the Department of Justice. By purchase diflucan over counter law, movie theaters are supposed to makemovies accessible to people with hearing loss.
The change in the law is good news for people who have severe hearing loss, as it makes it easier to enjoy going to the movies. First, if you wear hearing aids More good news. Most people who wear hearing aids will not need any extra purchase diflucan over counter help. "Many people with mild-to-moderate hearing loss find that they hear quite well in movie theaters when wearing their hearing aids," notes Susanne Jones, a hearing instrument specialist and customer support manager for Healthy Hearing.
"In my clinical experience, most hearing aid wearers felt that they understood speech at the movie theater better than they did while watching TV or movies at home. This is likely purchase diflucan over counter due to the volume, sound system quality and speaker placement." If you're worried the theater volume may be too loud, Jones advises adjusting the volume of your hearing aids slightly, to a more comfortable level. Modern hearing aids have loud noise suppression to keep your hearing safe. If hearing aids aren't enough If you have more severe hearing loss or are Deaf, you may need to find out what accessibility options your local movie theater offers.
Arrive early so you can request purchase diflucan over counter the equipment you need. Also, give yourself time to set it up before the movie starts. If things don't go well, don't be afraid to ask for your money back. Here's an overview of what may be offered to you, and what to expect at major purchase diflucan over counter theater chains.
Caption options at the movies Movie theaters generally offer two types of captioning. Open and closed. "Open captioning" is when the text purchase diflucan over counter appears on the screen, for everyone in the the theater to see. "Closed captioning" refers to a system where the captions are private, transmitted via a personal device.
Open caption screenings are not very common. Sometimes, movie theaters offer special "open caption" viewings for anyone who wants to watch movies with subtitles/captions, or purchase diflucan over counter if you have a large group and request a special screening. And of course, most foreign films screened in the US are subtitled in English. For closed captions, you must request a device that displays the captions at your seat.
The type of device, technology and availability will vary by movie theater chain, so your first step purchase diflucan over counter is to figure out which movie theater chain you're going to be visiting and plan ahead with a little research. You may want to call ahead of time and ask. What can I expect?. Here's what we found from major theater chains on their websites or from online articles purchase diflucan over counter.
Regal Theaters Regal provided the most information, including a helpful accessibility page on their captioning and descriptive video available to customers. They even provide a state-by-state listing of theaters and what accessibility options are available to you locally. Regal exclusively offers Sony Access eyeglasses purchase diflucan over counter with open captions, so viewers can have captions in their direct line of sight. These can be worn over regular eyeglasses.
Regal recommends checking with your local theater to make sure you will have the help you need. Look for movie descriptions purchase diflucan over counter that say "accessibility devices available." AMC Theaters On AMC's accessibility page, this major theater chain says they provide several options. Amplified headsets and assistive listening devices to better hear the audio. A CaptiView device, which attaches to your seat's cupholder and displays the movie's closed captions in front of you.
Cinemark We couldn't find an accessibility page for purchase diflucan over counter Cinemark. Based on online reports, it appears they may offer patrons CaptiView closed captioning devices. This man's 2011 CaptiView review is a good description of the pros and cons of using the device (which may have been updated since his post). Landmark Theaters On their accessibility page, Landmark lists which theaters have assistive listening equipment purchase diflucan over counter and also what they use, which varies by theater, but generally includes.
CaptiView or CCR-100 personal closed captioning devices Wireless amplified headphones audio system Hearing loop technology (only in a handful of theaters) Marcus Theatres This large chain offers similar assistive technology to Landmark. Assistive listening device (ALD) systems Even if your local theater doesnât have the newest captioning technology, they may offer some type of assistive listening device system for people with some residual hearing. Since the enactment of the ADA in 1990, all theaters with fixed seating for 50 patrons purchase diflucan over counter are required to provide an ALD system. Three different systems may be available.
FM/DM systems use radio frequencies to transmit amplified sound through a special receiver customers can borrow for the duration of the film. Infared light systems transmit sound to a special receiver, which can be purchase diflucan over counter adjusted to the desired volume. When available, these receivers are loaned to the patron for the duration of the film. Induction loop systems receive the sound signal through the t-coil in your hearing aid or cochlear implant.
If your theater is wired for induction loops, purchase diflucan over counter youâll want to switch your hearing instrument to t-coil to enjoy the show. Check with your hearing healthcare professional to see if they can recommend the movie theater in town with the best access options for you. If your hearing impairment has been keeping you away from the movie theater, it may be time to venture out. With a purchase diflucan over counter little research and new technology, a night at the movies can be an enjoyable event for everyone in the family.
Share your tips Please contact us if you have advice or tips to share with fellow movie-lovers who have hearing loss, and we can add them here.While life-saving, many cancer chemotherapy drugs come with serious side effects. These include hearing-related side effects such as hearing loss, tinnitus (ringing in your ears) and balance problems. While sometimes these side effects are temporary and get better after treatment ends, purchase diflucan over counter often theyâre permanent. If youâre about to undergo cancer treatmentâor have a child in those circumstancesâhereâs what you need to know.
Cancer treatment typically relies on a trio of treatment options. Radiation, surgery, and chemotherapy, often purchase diflucan over counter performed in conjunctionâfor instance, a person may have surgery followed by a course of radiation and chemotherapy. All three cancer treatment options have the potential to damage hearing, depending on the location of the cancer. Surgery If you have a form of cancer that requires surgery in the brain, ear, or auditory nerve, hearing problems could occur, according to the Canadian Cancer Society (CCS).
Removing a purchase diflucan over counter cancerous tumor, for instance, might cause damage to the ear. Radiation During radiation treatment, high-energy waves or particles are used to destroy or damage cancer cells. If radiation is needed anywhere in the head and neck, it can potentially lead to two types of hearing loss. Conductive hearing loss, a purchase diflucan over counter type of hearing loss that happens when sound doesnât make its way to the inner ear, may occur.
This is due to the ear canal being narrowed, the eardrum thickening, or other ear changes caused by radiation, according to a 2019 article published in the Journal of Neurologic Surgery. A condition called otitis media with effusion (OME), where fluid collects in the middle ear, occurs in nearly half of people who have radiation therapy in the head and neck, per the article. Sensorineural hearing loss, which arises with damage to the inner ear or auditory nerve, can also occur purchase diflucan over counter as a result of radiation. Higher doses of radiation are more likely to cause hearing loss, according to the journal article.
People under age 3 and over age 50 are at a higher risk for this type of hearing loss, as are people being treated with the chemotherapy treatment cisplatin (more on that in a moment). This type purchase diflucan over counter of hearing loss is permanent. Chemotherapy and hearing loss Chemotherapy refers to the use of powerful chemicals that are capable of killing cancer cells. In some cases, chemotherapy drugs can be "ototoxic," which means they are harmful to hearing.
About half of all patients who receive the chemotherapy drug cisplatin develop hearing-related side effects including hearing loss, tinnitus purchase diflucan over counter and vertigo. This is known as ototoxicity. Platinum-based chemotherapy (cisplatin) This is especially the case for chemotherapy known as platinum-based therapy (that is, chemo meds containing the element platinum). The most ototoxic platinum-based chemotherapy is cisplatin, purchase diflucan over counter according to a review article in Cancer Chemotherapy and Pharmacology.
This medication is used to treat bladder, testicular, and ovarian cancer, according to the National Cancer Center. "Not only hearing loss, but also tinnitus and imbalance are common in patients who receive platinum-based chemotherapy, and can cause debilitating effects upon quality of life," the review article states. Hearing-related side effects to this medication purchase diflucan over counter appear fairly common. Permanent hearing loss occurs in about half of all patients who take cisplatin, ASHA notes.
It usually causes high-frequency hearing loss. Scientists are still working to understand purchase diflucan over counter why cisplatin damages hearingâit may be because it easily enters the inner ear (while other drugs are blocked) but doesnât seem to exit it, according to ASHA. Once in the inner ear, the medications may cause damage to hair cells, which are vital to the hearing process. Other platinum-based chemotherapies that treat solid tumors, such as carboplatin and oxaliplatin, are less likely to damage hearing, although they can still cause issues.
For instance, purchase diflucan over counter carboplatin can cause ringing in the ears (tinnitus), notes the Mayo Clinic. Other chemo drugs There are other chemotherapies that donât fall into the platinum-based category that can still cause hearing problems or tinnitus. They include vincristine, doxorubicin, gemcitabine, cyclophosphamide, oxaliplatin, and farmorubicin, notes a 2016 study published in the Brazilian Journal of Otorhinolaryngology. Radiation treatment combined with these ototoxic chemotherapy medications increases the risk for purchase diflucan over counter hearing-related issues.
With higher doses of chemo meds, thereâs a greater risk for hearing problems, according to CCS. Non-cancer drugs can also cause problems Keep in mind, other medications besides chemotherapy taken during cancer treatmentâsuch as pain medications, anti-nausea meds, or antibioticsâcan also lead to hearing problems. There are purchase diflucan over counter at least 200 medications linked to hearing loss, including over-the-counter medications like aspirin. Hearing loss more likely among kids Seventy-five per cent of patients five years old and younger had cisplatin-related hearing loss three years after starting therapy, a 2021 University of British Columbia study shows.
âYoung children [are] particularly vulnerable to the ototoxic effects of cancer therapies,â affirms a 2016 review article in the journal Cancer. This is purchase diflucan over counter because the brain and ears are still forming in young childhood, the article notes. Not only is hearing loss more common in children who take cisplatin, but itâs also more severe, per ASHA. Plus, even small amounts of hearing loss in high frequencies are a big deal to younger children acquiring language.
How to weigh the risks Regular hearing check-ups are importantfor current and purchase diflucan over counter former cancer patients whoreceived treatment linked to hearing loss. Cancer is a life-threatening disease, which is why doctors use powerful treatment methods, despite the host of known side effects. Knowing the potential risks is helpful, since it can help you assess if the risk is worth it to you personally. Talk to your doctor about the drug's side effects and if there are any alternatives.
ASHA recommends following these steps if you are taking known ototoxic medications. Check your hearing. Ideally, do this before the treatment to have a baseline record of your hearing.
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This led to many environmentally beneficial working practices being adopted in Radiology in the South West Peninsula Deanery, and throughout this paper we have evaluated these changes and used our collective experience of these to inform our suggestions on how to improve the environmental sustainability of Medical and Radiological training.Radiology &. ImagingDiagnostic radiologyMedical education &. Training.
AbstractThe environmental impact of training has been poorly recognised for many Ventolin price without insurance years purchase diflucan over counter. With the emergence of high-profile climate activists and a wider appreciation of the need for sustainable healthcare, training within radiology can no longer be excused from its responsibility to consider the environment in its actions. In this paper, we aim to evaluate the environmental impact of the travel undertaken by trainees within the Peninsula training programme, with the aim of developing practices and providing suggestions (evidence-based where possible) on how to improve the impact on the environment of trainee travel. We envisage that many of the lessons and suggestions may be transferrable to other training schemes in the UK and further afield purchase diflucan over counter.
During the early months of 2020, in addition to the environmental crisis, antifungal medication escalated to a diflucan resulting in the alteration of working practices across the UK (and the rest of the world). This led to many environmentally beneficial working practices being adopted in Radiology in the South West Peninsula Deanery, and throughout this paper we have evaluated these changes and used our collective experience of these to inform our suggestions on how to improve the environmental sustainability of Medical and Radiological training.Radiology &. ImagingDiagnostic radiologyMedical education &.
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IntroductionLa Peste (Camus 1947) diflucan 500 has served as a basis for several critical works, including diflucan price no insurance some in the field of medical humanities (Bozzaro 2018. Deudon 1988. Tuffuor and diflucan 500 Payne 2017). Frequently interpreted as an allegory of Nazism (with the plague as a symbol of the German occupation of France) (Finel-Honigman 1978.
Haroutunian 1964), it has also received philosophical readings beyond the sociopolitical context in which it was written (Lengers 1994). Other scholars, on the other hand, have centred their analyses on its literary aspects (Steel 2016).The antifungal medication diflucan has increased general interest about historical diflucan 500 and fictional epidemics. La Peste, as one of the most famous literary works about this topic, has been revisited by many readers during recent months, leading to an unexpected growth in sales in certain countries (Wilsher 2020. Zaretsky 2020).
Apart from that, commentaries about the novel, especially among diflucan 500 health sciences scholars, have emerged with a renewed interest (Banerjee et al. 2020. Bate 2020. Vandekerckhove 2020 diflucan 500.
Wigand, Becker, and Steger 2020). This sudden curiosity is easy to understand if we consider both La Pesteâs literary value, and peopleâs desire to discover real or fictional situations similar to theirs. Indeed, Oran inhabitantsâ experiences are not quite far from our own, even if geographical, chronological and, specially, scientific factors (two diflucan 500 different diseases occurring at two different stages in the history of medical development) prevent us from establishing too close resemblances between both situations.Furthermore, it will not be strange if antifungal medication serves as a frame for fictional works in the near future. Other narrative plays were based on historical epidemics, such as Daniel Defoeâs A Journal of the Plague Year or Giovanni Boccaccioâs Decameron (Wigand, Becker, and Steger 2020.
Withington 2020). The biggest diflucan in the last century, the so-called âSpanish Influenzaâ, has been described as not very fruitful in this sense, even if it produced diflucan 500 famous novels such as Katherine A Porterâs Pale Horse, Pale Rider or John OâHaraâs The Doctor Son (Honigsbaum 2018. Hovanec 2011). The overlapping with another disaster like World War I has been argued as one of the reasons explaining this scarce production of fictional works (Honigsbaum 2018).
By contrast, we may think that antifungal medication is having a global impact hardly overshadowed by other events, and that it will leave a significant mark on the collective memory.Drawing on the reading of La Peste, we point out in this essay diflucan 500 different aspects of living under an epidemic that can be identified both in Camusâs work and in our current situation. We propose a trip throughout the novel, from its early beginning in Part I, when the Oranians are not aware of the threat to come, to its end in Part V, when they are relieved of the epidemic after several months of ravaging disasters.We think this journey along La Peste may be interesting both to health professionals and to the lay person, since all of them will be able to see themselves reflected in the characters from the novel. We do not skip critique of some aspects related to the authoritiesâ management of antifungal medication, as Camus does concerning Oranâs rulers. However, what we want to foreground is La Pesteâs intrinsic value, its suitability to be read now and after antifungal medication has passed, when Camusâs novel endures as a solid art work and antifungal medication remains only as a defeated plight.MethodsWe confronted our own experiences about diflucan 500 antifungal medication with a conventional reading of La Peste.
A first reading of the novel was used to establish associations between those aspects which more saliently reminded us of antifungal medication. In a second reading, we searched for some examples to illustrate those aspects and tried to detect new associations. Subsequent readings of certain parts were done to integrate diflucan 500 the information collected. Neither specific methods of literary analysis, nor systematic searches in the novel were applied.
Selected paragraphs and ideas from Part I to Part V were prepared in a draft copy, and this manuscript was written afterwards.Part ISome phrases in the novel could be transposed word by word to our situation. This one pertaining to its start, for instance, may make us remember the first months of 2020:By now, it will be easy to diflucan 500 accept that nothing could lead the people of our town to expect the events that took place in the spring of that year and which, as we later understood, were like the forerunners of the series of grave happenings that this history intends to describe. (Camus 2002, Part I)By referring from the beginning to âthe people of our townâ, Camus is already suggesting an idea which is repeated all along the novel, and which may be well understood by us as antifungal medicationâs witnesses. Epidemics affect the community as a whole, they are present in everybodyâs mind and their joys and sorrows are not individual, but collective.
For example (and we are anticipating Part II), the narrator says:But, once the gates were closed, they all noticed that they were in the same boat, including the narrator himself, and that they had to adjust diflucan 500 to the fact. (Camus 2002, Part II)Later, he will insist in this opposition between the concepts of âindividualâ, which used to prevail before the epidemic, and âcollectiveâ:One might say that the first effect of this sudden and brutal attack of the disease was to force the citizens of our town to act as though they had no individual feelings. (Camus 2002, Part II)There were no longer any individual destinies, but a collective history that was the plague, and feelings shared by all. (Camus 2002, Part III)This distinction is not trivial, since the diflucan 500 story will display a strong confrontation between those who get involved and help their neighbours and those who remain behaving selfishly.
Related to this, Claudia Bozzaro has pointed out that the main topic in La Peste is solidarity and auistic love (Bozzaro 2018). We may add that the disease is so attached to peopleâs lives that the epidemic becomes the new everyday life:In the morning, they would return to the pestilence, that is to say, to routine. (Camus 2002, Part III)Being collective issues does not mean that epidemics always enhance auism and diflucan 500 solidarity. As said by Wigand et al, they frequently produce ambivalent reactions, and one of them is the opposition between auism and maximised profit (Wigand, Becker, and Steger 2020).
Therefore, the dichotomy between individualism and collectivism, a central point in the characterisation of national cultures (Hofstede 2015), could play a role in epidemics. In fact, concerning antifungal medication, some authors have described a greater diflucan 500 impact of the diflucan in those countries with higher levels of individualism (Maaravi et al. 2021. Ozkan et al.
2021). However, this finding should be complemented with other national culturesâ aspects before concluding that collectivism itself exerts a protective role against epidemics. Concerning this, it has been shown how âpower distanceâ frequently intersects with collectivism, being only a few countries in which the last one coexists with a small distance to power, namely with a capacity to disobey the power authority (Gupta, Shoja, and Mikalef 2021). Moreover, those countries classically classified as âcollectivistâ (China, Japan, South Korea, India, Vietnam, etc.) are also characterised by high levels of power distance, and their citizens have been quite often forced to adhere to antifungal medication restrictions and punished if not (Gupta, Shoja, and Mikalef 2021).
Thus, it is important to consider that individualism is not always opposed to âlook after each otherâ (Ozkan et al. 2021, 9). For instance, the European region, seen as a whole as highly âindividualisticâ, holds some of the most advanced welfare protection systems worldwide. It is worth considering too that collectivism may hide sometimes a hard institutional authority or a lack in civil freedoms.Coming back to La Peste, we may think that Camusâs Oranians are not particularly âcollectivistâ.
Their initial description highlights that they are mainly interested in their own businesses and affairs:Our fellow-citizens work a good deal, but always in order to make money. They are especially interested in trade and first of all, as they say, they are engaged in doing business. (Camus 2002, Part I)And later, we see some of them trying selfishly to leave the city by illegal methods. By contrast, we observe in the novel some examples of more âcollectivisticâ attitudes, such as the discipline of those quarantined at the football pitch, and, over all, the main charactersâ behaviour, which is generally driven by auism and common goals.Turning to another topic, the plague in Oran and antifungal medication are similar regarding their animal origin.
This is not rare since many infectious diseases pass to humans through contact with animal vectors, being rodents, especially rats (through rat fleas), the most common carriers of plague bacteria (CDC. N.d.a, ECDC. N.d, Pollitzer 1954). Concerning antifungals, even if further research about its origin is needed, the most recent investigations conducted in China by the WHO establish a zoonotic transmission as the most probable pathway (Joint WHO-China Study Team 2021).
In Camusâs novel, the animalâs link to the epidemic seemed very clear since the beginning:Things got to the point where Infodoc (the agency for information and documentation, â all you need to know on any subjectâ) announced in its free radio news programme that 6,231 rats had been collected and burned in a single day, the 25th. This figure, which gave a clear meaning to the daily spectacle that everyone in town had in front of their eyes, disconcerted them even more. (Camus 2002, Part I)This accuracy in figures is familiar to us. People nowadays have become very used to the statistical aspects of the diflucan, due to the continuous updates in epidemiological parameters launched by the media and the authorities.
Camus was aware about the relevance of figures in epidemics, which always entail:â¦required registration and statistical tasks. (Camus 2002, Part II)Because of this, the novel is scattered with numbers, most of them concerning the daily death toll, but others mentioning the number of rats picked up, as we have seen, or combining the number of deaths with the time passed since the start of the epidemic:â Will there be an autumn of plague?. Professor B answers.  Noâ â, â One hundred and twenty-four dead.
The total for the ninety-fourth day of the plague.â (Camus 2002, Part II)We permit ourselves to introduce here a list of recurring topics in La Peste, since the salience of statistical information is one of them. These topics, some of which will be treated later, appear several times in the novel, in various contexts and stages in the evolution of the epidemic. We synthesise them in Table 1, coupled with a antifungal medication parallel example extracted from online press. This ease to find a current example for each topic suggests that they are not exclusive of plague or of Camusâs mindset, but shared by most epidemics.View this table:Table 1 Recurring topics in La Peste.
Each topic is accompanied by two examples from the novel and one concerning antifungal medication, extracted from online press.Talking about journalism and the media (one of the topics above), we might say that antifungal medicationâs coverage is frequently too optimistic when managing good news and too alarming when approaching the bad. Mediaâs âexaggeratedâ approach to health issues is not new. It was already a concern for medical journalsâ editors a century ago (Reiling 2013) and it continues to be it for these professionals in recent times (Barbour et al. 2008).
It is well known that media tries to attract spectatorsâ attention by making the news more appealing. However, they deal with the risk of expanding unreliable information, which may be pernicious for the public opinion. Related to the intention of âgarnishingâ the news, Aslam et al. (2020) have described that 82% of more than 100â000 pieces of information about antifungal medication appearing in media from different countries carried an emotional, either negative (52%) or positive (30%) component, with only 18% of them considered as âneutralâ (Aslam et al.
2020). Some evidence about this tendency to make news more emotional was described in former epidemics. For instance, a study conducted in Singapore in 2009 during the H1N1 crisis showed how press releases by the Ministry of Health were substantially transformed when passed to the media, by increasing their emotional appeal and by changing their dominant frame or their tone (Lee and Basnyat 2013). In La Peste, this superficial way of managing information by the media is also observed:The newspapers followed the order that they had been given, to be optimistic at any cost.
(Camus 2002, Part IV)At the first stages of the epidemic in Oran, journalists proclaim the end of the dead ratsâ invasion as something to be celebrated. Dr Rieux, the character through which Camus symbolises caution (and comparable nowadays to trustful scientists, well-informed journalists or sensible authorities), exposes then his own angle, quite far from suggesting optimism:The vendors of the evening papers were shouting that the invasion of rats had ended. But Rieux found his patient lying half out of bed, one hand on his belly and the other around his neck, convulsively vomiting reddish bile into a rubbish bin. (Camus 2002, Part I)Camus, who worked as a journalist for many years, insists afterwards on this cursory interest that some media devote to the epidemic, more eager to grab the noise than the relevant issues beneath it:The press, which had had so much to say about the business of the rats, fell silent.
This is because rats die in the street and people in their bedrooms. And newspapers are only concerned with the street. (Camus 2002, Part I)By then, Oranians continue rejecting the epidemic as an actual threat, completely immersed in that phase that dominates the beginning of all epidemics and is characterised by âdenial and disbeliefâ (Wigand, Becker, and Steger 2020, 443):A pestilence does not have human dimensions, so people tell themselves that it is unreal, that it is a bad dream which will end. [â¦] The people of our town were no more guilty than anyone else, they merely forgot to be modest and thought that everything was still possible for them, which implied that pestilence was impossible.
They continued with business, with making arrangements for travel and holding opinions. Why should they have thought about the plague, which negates the future, negates journeys and debate?. They considered themselves free and no one will ever be free as long as there is plague, pestilence and famine. (Camus 2002, Part I)Probably to avoid citizens' disapproval, among other reasons, the Oranian Prefecture (health authority in Camus' novel) does not want to go too far when judging the relevance of the epidemic.
While not directly exposed, we can guess in this fragment the tone of the Prefectâs message, his intention to convey confidence despite his own doubts:These cases were not specific enough to be really disturbing and there was no doubt that the population would remain calm. None the less, for reasons of caution which everyone could understand, the Prefect was taking some preventive measures. If they were interpreted and applied in the proper way, these measures were such that they would put a definite stop to any threat of epidemic. As a result, the Prefect did not for a moment doubt that the citizens under his charge would co-operate in the most zealous manner with what he was doing.
(Camus 2002, Part I)The relevant role acquired by health authorities during epidemics is another topic listed in our table. Language use, on the other hand, is an issue linkable both with the media topic and with this one. As in La Peste, during antifungal medication we have seen some public figures using words not always truthfully, carrying out a careful selection of words that serves to the goal of conveying certain interests in each moment. Dr Rieux refers in Part I to this language manipulation by the authorities:The measures that had been taken were insufficient, that was quite clear.
As for the â specially equipped wardsâ, he knew what they were. Two outbuildings hastily cleared of other patients, their windows sealed up and the whole surrounded by a cordon sanitaire. (Camus 2002, Part I)He illustrates the need of frankness, the preference for clarity in language, which is often the clarity in thinking:No. I phoned Richard to say we needed comprehensive measures, not fine words, and that either we must set up a real barrier to the epidemic, or nothing at all.
(Camus 2002, Part I)At the end of this part, his fears about the inadequacy of not taking strict measures are confirmed. Oranian hospitals become overwhelmed, as they are now in many places worldwide due to antifungal medication.Part IILeft behind the phases of âdenial and disbeliefâ and of âfear and panicâ, it appears among the Oranians the âacceptance paired with resignationâ (Wigand, Becker, and Steger 2020, 443):Then we knew that our separation was going to last, and that we ought to try to come to terms with time. [â¦] In particular, all of the people in our town very soon gave up, even in public, whatever habit they may have acquired of estimating the length of their separation. (Camus 2002, Part II)In antifungal medication as well, even if border closure has not been so immovable as in Oran, many people have seen themselves separated from their loved ones and some of them have not yet had the possibility of reunion.
This is why, in the actual diflucan, the idea of temporal horizons has emerged like it appeared in Camusâs epidemic. In Spain, the general lockdown in March and April 2020 made people establish the summer as their temporal horizon, a time in which they could resume their former habits and see their relatives again. This became partially true, and people were allowed in summer to travel inside the country and to some other countries nearby. However, there existed some reluctance to visit ill or aged relatives, due to the fear of infecting them, and some families living in distant countries were not able to get together.
Moreover, autumn brought an increase in the number of cases (âthe second waveâ) and countries returned to limit their internal and external movements.Bringing all this together, many people nowadays have opted to discard temporal horizons. As Oranians, they have noted that the epidemic follows its own rhythm and it is useless to fight against it. Nonetheless, it is in human nature not to resign, so abandoning temporal horizons does not mean to give up longing for the recovery of normal life. This vision, neither maintaining vain hopes nor resigning, is in line with Camusâs philosophy, an author who wrote that âhope, contrary to what it is usually thought, is the same to resignation.â (Camus 1939, 83.
Cited by Haroutunian 1964, 312 (translation is ours)), and that âthere is not love to human life but with despair about human life.â (Camus 1958, 112â5. Cited by Haroutunian 1964, 312â3 (translation is ours)).People nowadays deal with resignation relying on daily life pleasures (being not allowed to make further plans or trips) and in company from the nearest ones (as they cannot gather with relatives living far away). Second, they observe the beginning of vaccination campaigns as a first step of the final stage, and summer 2021, reflecting what happened with summer 2020, has been fixed as a temporal horizon. This preference for summers has an unavoidable metaphorical nuance, and their linking to joy, long trips and life in the streets may be the reason for which we choose them to be opposed to the lockdown and restrictions of the diflucan.We alluded previously to the manipulation of language, and figures, as relevant as they are, they are not free from manipulation either.
Tarrou, a close friend to Dr Rieux, points out in this part of the novel how this occurred:Once more, Tarrou was the person who gave the most accurate picture of our life as it was then. Naturally he was following the course of the plague in general, accurately observing that a turning point in the epidemic was marked by the radio no longer announcing some hundreds of deaths per week, but 92, 107 and 120 deaths a day. ÂThe newspapers and the authorities are engaged in a battle of wits with the plague. They think that they are scoring points against it, because 130 is a lower figure than 910.â (Camus 2002, Part II)Tarrou collaborates with the health teams formed to tackle the plague.
Regarding these volunteers and workers, Camus refuses to consider them as heroes, as many essential workers during antifungal medication have rejected to be named as that. The writer thinks their actions are the natural behaviour of good people, not heroism but âa logical consequenceâ:The whole question was to prevent the largest possible number of people from dying and suffering a definitive separation. There was only one way to do this, which was to fight the plague. There was nothing admirable about this truth, it simply followed as a logical consequence.
(Camus 2002, Part II)We consider suitable to talk here about two issues which represent, nowadays, a great part of antifungal medication fears and hopes, respectively. New genetic variants and treatments. Medical achievements are another recurrent issue included in table 1, and we write about them here because it is in Part II where Camus writes for the first time about treatments, and where it insists on an idea aforementioned in Part I. That the plague bacillus affecting Oran is different from previous variants:â¦the microbe differed very slightly from the bacillus of plague as traditionally defined.
(Camus 2002, Part II)Related to antifungal medication new variants, they represent a challenge because of two main reasons. Their higher transmissibility and/or severity and their higher propensity to skip the effect of natural or treatment-induced immunity. Public health professionals are determining which is the actual threat of all the new variants discovered, such as those first characterised in the UK (Public Health England 2020), South Africa (Tegally et al. 2021) or Brazil (Fujino et al.
2021). In La Peste, Dr Rieux is always suspecting that the current bacteria they are dealing with is different from the one in previous epidemics of plague. Since several genetic variations for the bacillus Yersinia pestis have been characterised (Cui et al. 2012), it could be possible that the epidemic in Oran originated from a new one.
However, we should not forget that we are analysing a literary work, and that scientific accuracy is not a necessary goal in it. In fact, Rieuxâs reluctances have to do more with clinical aspects than with microbiological ones. He doubts since the beginning, relying exclusively on the symptoms observed, and continues doing it after the laboratory analysis:I was able to have an analysis made in which the laboratory thinks it can detect the plague bacillus. However, to be precise, we must say that certain specific modifications of the microbe do not coincide with the classic description of plague.
(Camus 2002, Part II)Camus is consistent with this idea and many times he mentions the bacillus to highlight its oddity. Insisting on the literary condition of the work, and among other possible explanations, he is maybe declaring that that in the novel is not a common (biological, natural) bacteria, but the Nazism bacteria.Turning to treatments, they constitute the principal resource that the global community has to defeat the antifungal medication diflucan. Vaccination campaigns have started all over the world, and three types of antifungal medication treatments are being applied in the European Union, after their respective statements of efficacy and security (Baden et al. 2021.
Polack et al. 2020. Voysey et al. 2021), while a fourth treatment has just recently been approved (EMA 2021a).
Although some concerns regarding the safety of two of these treatments have been raised recently (EMA 2021b. EMA 2021c), vaccination plans are going ahead, being adapted according to the state of knowledge at each moment. Some of these treatments are mRNA-based (Baden et al. 2021.
Polack et al. 2020), while others use a viral vector (Bos et al. 2020. Voysey et al.
2021). They are mainly two-shot treatments, with one exception (Bos et al. 2020), and complete immunity is thought to be acquired 2âweeks after the last shot (CDC. N.d.b, Voysey et al.
2021). Other countries such as China or Russia, on the other hand, were extremely early in starting their vaccination campaigns, and are distributing among their citizens different treatments than the aforementioned (Logunov et al. 2021. Zhang et al.
2021).Even if at least three types of plague treatments had been created by the time the novel takes place (Sun 2016), treatments do not play an important role in La Peste, in which therapeutic measures (the serum) are more important than prophylactic ones. Few times in the novel the narrator refers to prophylactic inoculations:There was still no possibility of vaccinating with preventive serum except in families already affected by the disease. (Camus 2002, Part II)Deudon has pointed out that Camus mixes up therapeutic serum and treatment (Deudon 1988), and in fact there exists a certain amount of confusion. All along the novel, the narrator focuses on the prophylactic goals of the serum, which is applied to people already infected (Othonâs son, Tarrou, Grandâ¦).
However, both in the example above (which can be understood as vaccinating household contacts or already affected individuals) and in others, the differences between treating and vaccinating are not clear:After the morning admissions which he was in charge of himself, the patients were vaccinated and the swellings lanced. (Camus 2002, Part II)In any case, this is another situation in which Camus stands aside from scientific matters, which are to him less relevant in his novel than philosophical or literary ones. The distance existing between the relevance of treatments in antifungal medication and the superficial manner with which Camus treats the topic in La Peste exemplifies this.Part IIIIn part III, the plagueâs ravages become tougher. The narrator turns his focus to burials and their disturbance, a frequent topic in epidemicsâ narrative (table 1).
Camus knew how acutely increasing demands and hygienic requirements affect funeral habits during epidemics:Everything really happened with the greatest speed and the minimum of risk. (Camus 2002, Part III)Like many other processes during epidemics, the burial process becomes a protocol. When protocolised, everything seems to work well and rapidly. But this perfect mechanism is the Prefectureâs goal, not Rieuxâs.
He reveals in this moment an aspect in his character barely shown before. Irony.The whole thing was well organized and the Prefect expressed his satisfaction. He even told Rieux that, when all was said and done, this was preferable to hearses driven by black slaves which one read about in the chronicles of earlier plagues. Â Yes,â Rieux said.
 The burial is the same, but we keep a card index. No one can deny that we have made progress.â (Camus 2002, Part III)Even if this characteristic may seem new in Dr Rieux, we must bear in mind that he is the story narrator, and the narration is ironic from time to time. For instance, speaking precisely about the burials:The relatives were invited to sign a register âwhich just showed the difference that there may be between men and, for example, dogs. You can keep check of human beings-.
(Camus 2002, Part III)In Camusâs philosophy, the absurd is a core issue. According to Lengers, Rieux is ironic because he is a kind of Sisyphus who has understood the absurdity of plague (Lengers 1994). The response to the absurd is to rebel (Camus 2013), and Rieux does it by helping his fellow humans without questioning anything. He does not pursue any other goal than doing his duty, thus humour (as a response to dire situations) stands out from him when he observes others celebrating irrelevant achievements, such as the Prefect with his burial protocol.
In the field of medical ethics, Lengers has highlighted the importance of Camusâs perspective when considering âthe immediacy of life rather than abstract valuesâ (Lengers 1994, 250). Rieux himself is quite sure that his solid commitment is not âabstractâ, and, even if he falls into abstraction, the importance relies on protecting human lives and not in the name given to that task:Was it truly an abstraction, spending his days in the hospital where the plague was working overtime, bringing the number of victims up to five hundred on average per week?. Yes, there was an element of abstraction and unreality in misfortune. But when an abstraction starts to kill you, you have to get to work on it.
(Camus 2002, Part II)Farewells during antifungal medication may have not been particularly pleasant for some families. Neither those dying at nursing homes nor in hospitals could be accompanied by their families as previously, due to corpses management protocols, restrictions of external visitors and hygienic measures in general. However, as weeks passed by, certain efforts were made to ease this issue, allowing people to visit their dying beloved sticking to strict preventive measures. On the other hand, the number of people attending funeral masses and cemeteries was also limited, which affected the conventional development of ceremonies as well.
Hospitals had to deal with daily tolls of deaths never seen before, and the overcrowding of mortuaries made us see rows of coffins placed in unusual spaces, such as ice rinks (transformation of facilities is another topic in table 1).We turn now to two other points which antifungal medication has not evaded. s among essential workers and epidemicsâ economic consequences. The author links burials with s among essential workers because gravediggers constitute one of the most affected professions, and connects this fact with the economic recession because unemployment is behind the large availability of workers to replace the dead gravediggers:Many of the male nurses and the gravediggers, who were at first official, then casual, died of the plague. [â¦] The most surprising thing was that there was never a shortage of men to do the job, for as long as the epidemic lasted.
[â¦] When the plague really took hold of the town, its very immoderation had one quite convenient outcome, because it disrupted the whole of economic life and so created quite a large number of unemployed. [â¦] Poverty always triumphed over fear, to the extent that work was always paid according to the risk involved. (Camus 2002, Part III)The effects of the plague over the economic system are one of our recurrent topics (table 1). The plague in Oran, as it forces to close the city, impacts all trading exchanges.
In addition, it forbids travellers from arriving to the city, with the economic influence that that entails:This plague was the ruination of tourism. (Camus 2002, Part II)Oranians, who, as we saw, were very worried about making money, are especially affected by an event which jeopardises it. In antifungal medication, for one reason or for another, most of the countries are suffering economic consequences, since the impact on normal life from the epidemic (another recurrent topic) means also an impact on the normal development of trading activities.Part IVIn Part IV we witness the first signals of a stabilisation of the epidemic:It seemed that the plague had settled comfortably into its peak and was carrying out its daily murders with the precision and regularity of a good civil servant. In theory, in the opinion of experts, this was a good sign.
The graph of the progress of the plague, starting with its constant rise, followed by this long plateau, seemed quite reassuring. (Camus 2002, Part IV)At this time, we consider interesting to expand the topic about the transformation of facilities. We mentioned the case of ice rinks during antifungal medication, and we bring up now the use of a football pitch as a quarantine camp in Camusâs novel, a scene which has reminded some scholars of the metaphor of Nazism and concentration camps (Finel-Honigman 1978). In Spain, among other measures, a fairground was enabled as a field hospital during the first wave, and it is plausible that many devices created with other purposes were used in tasks attached to healthcare provision during those weeks, as occurred in Oranâs pitch with the loudspeakers:Then the loudspeakers, which in better times had served to introduce the teams or to declare the results of games, announced in a tinny voice that the internees should go back to their tents so that the evening meal could be distributed.
(Camus 2002, Part IV)Related to this episode, we can also highlight the opposition between science and humanism that Camus does. The author alerts us about the dangers of a dehumanised science, of choosing procedures perfectly efficient regardless of their lack in human dignity:The men held out their hands, two ladles were plunged into two of the pots and emerged to unload their contents onto two tin plates. The car drove on and the process was repeated at the next tent.â Itâs scientific,â Tarrou told the administrator.â Yes,â he replied with satisfaction, as they shook hands. Â Itâs scientific.â (Camus 2002, Part IV)Several cases with favourable outcomes mark Part IV final moments and prepare the reader for the end of the epidemic.
To describe these signs of recovering, the narrator turns back to two elements with a main role in the novel. Rats and figures. In this moment, the first ones reappear and the second ones seem to be declining:He had seen two live rats come into his house through the street door. Neighbours had informed him that the creatures were also reappearing in their houses.
Behind the walls of other houses there was a hustle and bustle that had not been heard for months. Rieux waited for the general statistics to be published, as they were at the start of each week. They showed a decline in the disease. (Camus 2002, Part IV)Part VGiven that we continue facing antifungal medication, and that forecasts about its end are not easy, we cannot compare ourselves with the Oranians once they have reached the end of the epidemic, what occurs in this part.
However, we can analyse our current situation, characterised by a widespread, though cautious, confidence motivated by the beginning of vaccination campaigns, referring it to the events narrated in Part V.Even more than the Oranians, since we feel further than them from the end of the problem, we are cautious about not to anticipate celebrations. From time to time, however, we lend ourselves to dream relying on what the narrator calls âa great, unadmitted hopeâ. antifungal medication took us by surprise and everyone wants to âreorganiseâ their life, as Oranians do, but patience is an indispensable component to succeed, as fictional and historical epidemics show us.Although this sudden decline in the disease was unexpected, the towns-people were in no hurry to celebrate. The preceding months, though they had increased the desire for liberation, had also taught them prudence and accustomed them to count less and less on a rapid end to the epidemic.
However, this new development was the subject of every conversation and, in the depths of peopleâs hearts, there was a great, unadmitted hope. [â¦] One of the signs that a return to a time of good health was secretly expected (though no one admitted the fact) was that from this moment on people readily spoke, with apparent indifference, about how life would be reorganized after the plague. (Camus 2002, Part V)We put our hope on vaccination. Social distancing and other hygienic measures have proved to be effective, but treatments would bring us a more durable solution without compromising so hardly many economic activities and social habits.
As we said, a more important role of scientific aspects is observed in antifungal medication if compared with La Peste (an expected fact if considered that Camusâs story is an artistic work, that he skips sometimes the most complex scientific issues of the plague and that health sciences have evolved substantially during last decades). Oranians, in fact, achieve the end of the epidemic not through clearly identified scientific responses but with certain randomness:All one could do was to observe that the sickness seemed to be going as it had arrived. The strategy being used against it had not changed. It had been ineffective yesterday, and now it was apparently successful.
One merely had the feeling that the disease had exhausted itself, or perhaps that it was retiring after achieving all its objectives. In a sense, its role was completed. (Camus 2002, Part V)They receive the announcement made by the Prefecture of reopening the townâs gates in 2âweeks time with enthusiasm. Dealing with concrete dates gives them certainty, helps them fix the temporal horizons we wrote about.
This is also the case when they are told that preventive measures would be lifted in 1âmonth. Camus shows us then how the main characters are touched as well by this positive atmosphere:That evening Tarrou and Rieux, Rambert and the rest, walked in the midst of the crowd, and they too felt they were treading on air. Long after leaving the boulevards Tarrou and Rieux could still hear the sounds of happiness following them⦠(Camus 2002, Part V)Then, Tarrou points out a sign of recovery coming from the animal world. In a direct zoological chain, infected fleas have vanished from rats, which have been able again to multiply across the city, making the cats abandon their hiding places and to go hunting after them again.
At the final step of this chain, Tarrou sees the human being. He remembers the old man who used to spit to the cats beneath his window:At a time when the noise grew louder and more joyful, Tarrou stopped. A shape was running lightly across the dark street. It was a cat, the first that had been seen since the spring.
It stopped for a moment in the middle of the road, hesitated, licked its paw, quickly passed it across its right ear, then carried on its silent way and vanished into the night. Tarrou smiled. The little old man, too, would be happy. (Camus 2002, Part V)Unpleasant things as a town with rats running across its streets, or a man spending his time spitting on a group of cats, constitute normality as much as the reopening of gates or the reboot of commerce.
However, when Camus speaks directly about normality, he highlights more appealing habits. He proposes common leisure activities (restaurants, theatres) as symbols of human life, since he opposes them to Cottardâs life, which has become that of a âwild animalâ:At least in appearance he [ Cottard ] retired from the world and from one day to the next started to live like a wild animal. He no longer appeared in restaurants, at the theatre or in his favourite cafés. (Camus 2002, Part V)We do not disclose why Cottardâs reaction to the end of the epidemic is different from most of the Oraniansâ.
In any case, the narrator insists later on the assimilation between common pleasures and normality:â Perhaps,â Cottard said, â Perhaps so. But what do you call a return to normal life?. Â â New films in the cinema,â said Tarrou with a smile. (Camus 2002, Part V)Cinema, as well as theatre, live music and many other cultural events have been cancelled or obliged to modify their activities due to antifungal medication.
Several bars and restaurants have closed, and spending time in those who remain open has become an activity which many people tend to avoid, fearing contagion. Thus, normality in our understanding is linked as well to these simple and pleasant habits, and the complete achievement of them will probably signify for us the desired defeat of the diflucan.In La Peste, love is also seen as a simple good to be fully recovered after the plague. While Rieux goes through the ârebornâ Oran, it is loversâ gatherings what he highlights. Unlike them, everyone who, during the epidemic, sought for goals different from love (such as faith or money, for instance) remain lost when the epidemic has ended:For all the people who, on the contrary, had looked beyond man to something that they could not even imagine, there had been no reply.
(Camus 2002, Part V)And this is because lovers, as the narrator says:If they had found that they wanted, it was because they had asked for the only thing that depended on them. (Camus 2002, Part V)We have spoken before about language manipulation, hypocrisy and public figuresâ roles during epidemics. Camus, during Dr Rieuxâs last visit to the old asthmatic man, makes this frank and humble character criticise, with a point of irony, the authoritiesâ attitude concerning tributes to the dead:â Tell me, doctor, is it true that theyâre going to put up a monument to the victims of the plague?. Ââ So the papers say.
A pillar or a plaque.ââ I knew it!. And thereâll be speeches.âThe old man gave a strangled laugh.â I can hear them already.  Our deadâ¦â Then theyâll go and have dinner.â (Camus 2002, Part V)The old man illustrates wisely the authoritiesâ propensity for making speeches. He knows that most of them usually prefer grandiloquence rather than common words, and seizes perfectly their tone when he imitates them (âOur deadâ¦â).
We have also got used, during antifungal medication, to these types of messages. We have also heard about âour old peopleâ, âour youthâ, âour essential workersâ and even âour deadâ. Behind this tone, however, there could be an intention to hide errors, or to falsely convey carefulness. Honest rulers do not usually need nice words.
They just want them to be accurate.We have seen as well some tributes to the victims during antifungal medication, some of which we can doubt whether they serve to victimsâ relief or to authoritiesâ promotion. We want rulers to be less aware of their own image and to stress truthfulness as a goal, even if this is a hard requirement not only for them, but for every single person. Language is essential in this issue, we think, since it is prone to be twisted and to become untrue. The old asthmatic man illustrates it with his âThereâll be speechesâ and his âOur deadâ¦â, but this is not the only time in the novel in which Camus brings out the topic.
For instance, he does so when he equates silence (nothing can be thought as further from wordiness) with truth:It is at the moment of misfortune that one becomes accustomed to truth, that is to say to silence. (Camus 2002, Part II)or when he makes a solid statement against false words:â¦I understood that all the misfortunes of mankind came from not stating things in clear terms. (Camus 2002, Part IV)The old asthmatic, in fact, while praising the deceased Tarrou, remarks that he used to admire him because âhe didnât talk just for the sake of it.â (Camus 2002, Part V).Related to this topic, what the old asthmatic says about political authorities may be transposed in our case to other public figures, such as scholars and researchers, media leaders, businessmen and women, health professionals⦠and, if we extend the scope, to every single citizen. Because hypocrisy, language manipulation and the fact of putting individual interests ahead of collective welfare fit badly with collective issues such as epidemics.
Hopefully, also examples to the contrary have been observed during antifungal medication.The story ends with the fireworks in Oran and the depiction of Dr Rieuxâs last feelings. While he is satisfied because of his medical performance and his activity as a witness of the plague, he is concerned about future disasters to come. When antifungal medication will have passed, it will be time for us as well to review our life during these months. For now, we are just looking forward to achieving our particular âpart Vâ..
IntroductionLa Peste (Camus 1947) has served as a basis for several critical works, including some in the field http://www.ec-hohberg-strasbourg.site.ac-strasbourg.fr/wp/?p=814 of medical humanities (Bozzaro 2018 purchase diflucan over counter. Deudon 1988. Tuffuor and Payne purchase diflucan over counter 2017). Frequently interpreted as an allegory of Nazism (with the plague as a symbol of the German occupation of France) (Finel-Honigman 1978.
Haroutunian 1964), it has also received philosophical readings beyond the sociopolitical context in which it was written (Lengers 1994). Other scholars, on the other hand, have centred their analyses on its literary aspects (Steel 2016).The antifungal medication diflucan has increased purchase diflucan over counter general interest about historical and fictional epidemics. La Peste, as one of the most famous literary works about this topic, has been revisited by many readers during recent months, leading to an unexpected growth in sales in certain countries (Wilsher 2020. Zaretsky 2020).
Apart from that, commentaries purchase diflucan over counter about the novel, especially among health sciences scholars, have emerged with a renewed interest (Banerjee et al. 2020. Bate 2020. Vandekerckhove 2020 purchase diflucan over counter.
Wigand, Becker, and Steger 2020). This sudden curiosity is easy to understand if we consider both La Pesteâs literary value, and peopleâs desire to discover real or fictional situations similar to theirs. Indeed, Oran inhabitantsâ experiences are not quite far from our own, even if geographical, chronological and, specially, scientific factors (two different diseases occurring at two different stages in the history of medical development) prevent us from establishing too close resemblances between both situations.Furthermore, it will not be strange purchase diflucan over counter if antifungal medication serves as a frame for fictional works in the near future. Other narrative plays were based on historical epidemics, such as Daniel Defoeâs A Journal of the Plague Year or Giovanni Boccaccioâs Decameron (Wigand, Becker, and Steger 2020.
Withington 2020). The biggest diflucan in the last century, the so-called âSpanish Influenzaâ, has been described as not very fruitful in this sense, purchase diflucan over counter even if it produced famous novels such as Katherine A Porterâs Pale Horse, Pale Rider or John OâHaraâs The Doctor Son (Honigsbaum 2018. Hovanec 2011). The overlapping with another disaster like World War I has been argued as one of the reasons explaining this scarce production of fictional works (Honigsbaum 2018).
By contrast, we may think that antifungal medication is having a global impact hardly overshadowed by other events, and that it will leave a significant mark on the collective memory.Drawing on the reading of La Peste, we point out purchase diflucan over counter in this essay different aspects of living under an epidemic that can be identified both in Camusâs work and in our current situation. We propose a trip throughout the novel, from its early beginning in Part I, when the Oranians are not aware of the threat to come, to its end in Part V, when they are relieved of the epidemic after several months of ravaging disasters.We think this journey along La Peste may be interesting both to health professionals and to the lay person, since all of them will be able to see themselves reflected in the characters from the novel. We do not skip critique of some aspects related to the authoritiesâ management of antifungal medication, as Camus does concerning Oranâs rulers. However, what we want to foreground is La Pesteâs purchase diflucan over counter intrinsic value, its suitability to be read now and after antifungal medication has passed, when Camusâs novel endures as a solid art work and antifungal medication remains only as a defeated plight.MethodsWe confronted our own experiences about antifungal medication with a conventional reading of La Peste.
A first reading of the novel was used to establish associations between those aspects which more saliently reminded us of antifungal medication. In a second reading, we searched for some examples to illustrate those aspects and tried to detect new associations. Subsequent readings of certain parts were done to purchase diflucan over counter integrate the information collected. Neither specific methods of literary analysis, nor systematic searches in the novel were applied.
Selected paragraphs and ideas from Part I to Part V were prepared in a draft copy, and this manuscript was written afterwards.Part ISome phrases in the novel could be transposed word by word to our situation. This one pertaining to its start, for instance, may make us remember the first months of 2020:By now, it will be easy to accept that nothing could purchase diflucan over counter lead the people of our town to expect the events that took place in the spring of that year and which, as we later understood, were like the forerunners of the series of grave happenings that this history intends to describe. (Camus 2002, Part I)By referring from the beginning to âthe people of our townâ, Camus is already suggesting an idea which is repeated all along the novel, and which may be well understood by us as antifungal medicationâs witnesses. Epidemics affect the community as a whole, they are present in everybodyâs mind and their joys and sorrows are not individual, but collective.
For example (and we are anticipating Part II), the narrator says:But, once the gates were closed, they all noticed that they were in the same boat, including the narrator himself, and that they had to adjust to the fact purchase diflucan over counter. (Camus 2002, Part II)Later, he will insist in this opposition between the concepts of âindividualâ, which used to prevail before the epidemic, and âcollectiveâ:One might say that the first effect of this sudden and brutal attack of the disease was to force the citizens of our town to act as though they had no individual feelings. (Camus 2002, Part II)There were no longer any individual destinies, but a collective history that was the plague, and feelings shared by all. (Camus 2002, Part purchase diflucan over counter III)This distinction is not trivial, since the story will display a strong confrontation between those who get involved and help their neighbours and those who remain behaving selfishly.
Related to this, Claudia Bozzaro has pointed out that the main topic in La Peste is solidarity and auistic love (Bozzaro 2018). We may add that the disease is so attached to peopleâs lives that the epidemic becomes the new everyday life:In the morning, they would return to the pestilence, that is to say, to routine. (Camus 2002, purchase diflucan over counter Part III)Being collective issues does not mean that epidemics always enhance auism and solidarity. As said by Wigand et al, they frequently produce ambivalent reactions, and one of them is the opposition between auism and maximised profit (Wigand, Becker, and Steger 2020).
Therefore, the dichotomy between individualism and collectivism, a central point in the characterisation of national cultures (Hofstede 2015), could play a role in epidemics. In fact, concerning antifungal medication, some authors have described a greater impact of the diflucan in those countries with purchase diflucan over counter higher levels of individualism (Maaravi et al. 2021. Ozkan et al.
2021). However, this finding should be complemented with other national culturesâ aspects before concluding that collectivism itself exerts a protective role against epidemics. Concerning this, it has been shown how âpower distanceâ frequently intersects with collectivism, being only a few countries in which the last one coexists with a small distance to power, namely with a capacity to disobey the power authority (Gupta, Shoja, and Mikalef 2021). Moreover, those countries classically classified as âcollectivistâ (China, Japan, South Korea, India, Vietnam, etc.) are also characterised by high levels of power distance, and their citizens have been quite often forced to adhere to antifungal medication restrictions and punished if not (Gupta, Shoja, and Mikalef 2021).
Thus, it is important to consider that individualism is not always opposed to âlook after each otherâ (Ozkan et al. 2021, 9). For instance, the European region, seen as a whole as highly âindividualisticâ, holds some of the most advanced welfare protection systems worldwide. It is worth considering too that collectivism may hide sometimes a hard institutional authority or a lack in civil freedoms.Coming back to La Peste, we may think that Camusâs Oranians are not particularly âcollectivistâ.
Their initial description highlights that they are mainly interested in their own businesses and affairs:Our fellow-citizens work a good deal, but always in order to make money. They are especially interested in trade and first of all, as they say, they are engaged in doing business. (Camus 2002, Part I)And later, we see some of them trying selfishly to leave the city by illegal methods. By contrast, we observe in the novel some examples of more âcollectivisticâ attitudes, such as the discipline of those quarantined at the football pitch, and, over all, the main charactersâ behaviour, which is generally driven by auism and common goals.Turning to another topic, the plague in Oran and antifungal medication are similar regarding their animal origin.
This is not rare since many infectious diseases pass to humans through contact with animal vectors, being rodents, especially rats (through rat fleas), the most common carriers of plague bacteria (CDC. N.d.a, ECDC. N.d, Pollitzer 1954). Concerning antifungals, even if further research about its origin is needed, the most recent investigations conducted in China by the WHO establish a zoonotic transmission as the most probable pathway (Joint WHO-China Study Team 2021).
In Camusâs novel, the animalâs link to the epidemic seemed very clear since the beginning:Things got to the point where Infodoc (the agency for information and documentation, â all you need to know on any subjectâ) announced in its free radio news programme that 6,231 rats had been collected and burned in a single day, the 25th. This figure, which gave a clear meaning to the daily spectacle that everyone in town had in front of their eyes, disconcerted them even more. (Camus 2002, Part I)This accuracy in figures is familiar to us. People nowadays have become very used to the statistical aspects of the diflucan, due to the continuous updates in epidemiological parameters launched by the media and the authorities.
Camus was aware about the relevance of figures in epidemics, which always entail:â¦required registration and statistical tasks. (Camus 2002, Part II)Because of this, the novel is scattered with numbers, most of them concerning the daily death toll, but others mentioning the number of rats picked up, as we have seen, or combining the number of deaths with the time passed since the start of the epidemic:â Will there be an autumn of plague?. Professor B answers.  Noâ â, â One hundred and twenty-four dead.
The total for the ninety-fourth day of the plague.â (Camus 2002, Part II)We permit ourselves to introduce here a list of recurring topics in La Peste, since the salience of statistical information is one of them. These topics, some of which will be treated later, appear several times in the novel, in various contexts and stages in the evolution of the epidemic. We synthesise them in Table 1, coupled with a antifungal medication parallel example extracted from online press. This ease to find a current example for each topic suggests that they are not exclusive of plague or of Camusâs mindset, but shared by most epidemics.View this table:Table 1 Recurring topics in La Peste.
Each topic is accompanied by two examples from the novel and one concerning antifungal medication, extracted from online press.Talking about journalism and the media (one of the topics above), we might say that antifungal medicationâs coverage is frequently too optimistic when managing good news and too alarming when approaching the bad. Mediaâs âexaggeratedâ approach to health issues is not new. It was already a concern for medical journalsâ editors a century ago (Reiling 2013) and it continues to be it for these professionals in recent times (Barbour et al. 2008).
It is well known that media tries to attract spectatorsâ attention by making the news more appealing. However, they deal with the risk of expanding unreliable information, which may be pernicious for the public opinion. Related to the intention of âgarnishingâ the news, Aslam et al. (2020) have described that 82% of more than 100â000 pieces of information about antifungal medication appearing in media from different countries carried an emotional, either negative (52%) or positive (30%) component, with only 18% of them considered as âneutralâ (Aslam et al.
2020). Some evidence about this tendency to make news more emotional was described in former epidemics. For instance, a study conducted in Singapore in 2009 during the H1N1 crisis showed how press releases by the Ministry of Health were substantially transformed when passed to the media, by increasing their emotional appeal and by changing their dominant frame or their tone (Lee and Basnyat 2013). In La Peste, this superficial way of managing information by the media is also observed:The newspapers followed the order that they had been given, to be optimistic at any cost.
(Camus 2002, Part IV)At the first stages of the epidemic in Oran, journalists proclaim the end of the dead ratsâ invasion as something to be celebrated. Dr Rieux, the character through which Camus symbolises caution (and comparable nowadays to trustful scientists, well-informed journalists or sensible authorities), exposes then his own angle, quite far from suggesting optimism:The vendors of the evening papers were shouting that the invasion of rats had ended. But Rieux found his patient lying half out of bed, one hand on his belly and the other around his neck, convulsively vomiting reddish bile into a rubbish bin. (Camus 2002, Part I)Camus, who worked as a journalist for many years, insists afterwards on this cursory interest that some media devote to the epidemic, more eager to grab the noise than the relevant issues beneath it:The press, which had had so much to say about the business of the rats, fell silent.
This is because rats die in the street and people in their bedrooms. And newspapers are only concerned with the street. (Camus 2002, Part I)By then, Oranians continue rejecting the epidemic as an actual threat, completely immersed in that phase that dominates the beginning of all epidemics and is characterised by âdenial and disbeliefâ (Wigand, Becker, and Steger 2020, 443):A pestilence does not have human dimensions, so people tell themselves that it is unreal, that it is a bad dream which will end. [â¦] The people of our town were no more guilty than anyone else, they merely forgot to be modest and thought that everything was still possible for them, which implied that pestilence was impossible.
They continued with business, with making arrangements for travel and holding opinions. Why should they have thought about the plague, which negates the future, negates journeys and debate?. They considered themselves free and no one will ever be free as long as there is plague, pestilence and famine. (Camus 2002, Part I)Probably to avoid citizens' disapproval, among other reasons, the Oranian Prefecture (health authority in Camus' novel) does not want to go too far when judging the relevance of the epidemic.
While not directly exposed, we can guess in this fragment the tone of the Prefectâs message, his intention to convey confidence despite his own doubts:These cases were not specific enough to be really disturbing and there was no doubt that the population would remain calm. None the less, for reasons of caution which everyone could understand, the Prefect was taking some preventive measures. If they were interpreted and applied in the proper way, these measures were such that they would put a definite stop to any threat of epidemic. As a result, the Prefect did not for a moment doubt that the citizens under his charge would co-operate in the most zealous manner with what he was doing.
(Camus 2002, Part I)The relevant role acquired by health authorities during epidemics is another topic listed in our table. Language use, on the other hand, is an issue linkable both with the media topic and with this one. As in La Peste, during antifungal medication we have seen some public figures using words not always truthfully, carrying out a careful selection of words that serves to the goal of conveying certain interests in each moment. Dr Rieux refers in Part I to this language manipulation by the authorities:The measures that had been taken were insufficient, that was quite clear.
As for the â specially equipped wardsâ, he knew what they were. Two outbuildings hastily cleared of other patients, their windows sealed up and the whole surrounded by a cordon sanitaire. (Camus 2002, Part I)He illustrates the need of frankness, the preference for clarity in language, which is often the clarity in thinking:No. I phoned Richard to say we needed comprehensive measures, not fine words, and that either we must set up a real barrier to the epidemic, or nothing at all.
(Camus 2002, Part I)At the end of this part, his fears about the inadequacy of not taking strict measures are confirmed. Oranian hospitals become overwhelmed, as they are now in many places worldwide due to antifungal medication.Part IILeft behind the phases of âdenial and disbeliefâ and of âfear and panicâ, it appears among the Oranians the âacceptance paired with resignationâ (Wigand, Becker, and Steger 2020, 443):Then we knew that our separation was going to last, and that we ought to try to come to terms with time. [â¦] In particular, all of the people in our town very soon gave up, even in public, whatever habit they may have acquired of estimating the length of their separation. (Camus 2002, Part II)In antifungal medication as well, even if border closure has not been so immovable as in Oran, many people have seen themselves separated from their loved ones and some of them have not yet had the possibility of reunion.
This is why, in the actual diflucan, the idea of temporal horizons has emerged like it appeared in Camusâs epidemic. In Spain, the general lockdown in March and April 2020 made people establish the summer as their temporal horizon, a time in which they could resume their former habits and see their relatives again. This became partially true, and people were allowed in summer to travel inside the country and to some other countries nearby. However, there existed some reluctance to visit ill or aged relatives, due to the fear of infecting them, and some families living in distant countries were not able to get together.
Moreover, autumn brought an increase in the number of cases (âthe second waveâ) and countries returned to limit their internal and external movements.Bringing all this together, many people nowadays have opted to discard temporal horizons. As Oranians, they have noted that the epidemic follows its own rhythm and it is useless to fight against it. Nonetheless, it is in human nature not to resign, so abandoning temporal horizons does not mean to give up longing for the recovery of normal life. This vision, neither maintaining vain hopes nor resigning, is in line with Camusâs philosophy, an author who wrote that âhope, contrary to what it is usually thought, is the same to resignation.â (Camus 1939, 83.
Cited by Haroutunian 1964, 312 (translation is ours)), and that âthere is not love to human life but with despair about human life.â (Camus 1958, 112â5. Cited by Haroutunian 1964, 312â3 (translation is ours)).People nowadays deal with resignation relying on daily life pleasures (being not allowed to make further plans or trips) and in company from the nearest ones (as they cannot gather with relatives living far away). Second, they observe the beginning of vaccination campaigns as a first step of the final stage, and summer 2021, reflecting what happened with summer 2020, has been fixed as a temporal horizon. This preference for summers has an unavoidable metaphorical nuance, and their linking to joy, long trips and life in the streets may be the reason for which we choose them to be opposed to the lockdown and restrictions of the diflucan.We alluded previously to the manipulation of language, and figures, as relevant as they are, they are not free from manipulation either.
Tarrou, a close friend to Dr Rieux, points out in this part of the novel how this occurred:Once more, Tarrou was the person who gave the most accurate picture of our life as it was then. Naturally he was following the course of the plague in general, accurately observing that a turning point in the epidemic was marked by the radio no longer announcing some hundreds of deaths per week, but 92, 107 and 120 deaths a day. ÂThe newspapers and the authorities are engaged in a battle of wits with the plague. They think that they are scoring points against it, because 130 is a lower figure than 910.â (Camus 2002, Part II)Tarrou collaborates with the health teams formed to tackle the plague.
Regarding these volunteers and workers, Camus refuses to consider them as heroes, as many essential workers during antifungal medication have rejected to be named as that. The writer thinks their actions are the natural behaviour of good people, not heroism but âa logical consequenceâ:The whole question was to prevent the largest possible number of people from dying and suffering a definitive separation. There was only one way to do this, which was to fight the plague. There was nothing admirable about this truth, it simply followed as a logical consequence.
(Camus 2002, Part II)We consider suitable to talk here about two issues which represent, nowadays, a great part of antifungal medication fears and hopes, respectively. New genetic variants and treatments. Medical achievements are another recurrent issue included in table 1, and we write about them here because it is in Part II where Camus writes for the first time about treatments, and where it insists on an idea aforementioned in Part I. That the plague bacillus affecting Oran is different from previous variants:â¦the microbe differed very slightly from the bacillus of plague as traditionally defined.
(Camus 2002, Part II)Related to antifungal medication new variants, they represent a challenge because of two main reasons. Their higher transmissibility and/or severity and their higher propensity to skip the effect of natural or treatment-induced immunity. Public health professionals are determining which is the actual threat of all the new variants discovered, such as those first characterised in the UK (Public Health England 2020), South Africa (Tegally et al. 2021) or Brazil (Fujino et al.
2021). In La Peste, Dr Rieux is always suspecting that the current bacteria they are dealing with is different from the one in previous epidemics of plague. Since several genetic variations for the bacillus Yersinia pestis have been characterised (Cui et al. 2012), it could be possible that the epidemic in Oran originated from a new one.
However, we should not forget that we are analysing a literary work, and that scientific accuracy is not a necessary goal in it. In fact, Rieuxâs reluctances have to do more with clinical aspects than with microbiological ones. He doubts since the beginning, relying exclusively on the symptoms observed, and continues doing it after the laboratory analysis:I was able to have an analysis made in which the laboratory thinks it can detect the plague bacillus. However, to be precise, we must say that certain specific modifications of the microbe do not coincide with the classic description of plague.
(Camus 2002, Part II)Camus is consistent with this idea and many times he mentions the bacillus to highlight its oddity. Insisting on the literary condition of the work, and among other possible explanations, he is maybe declaring that that in the novel is not a common (biological, natural) bacteria, but the Nazism bacteria.Turning to treatments, they constitute the principal resource that the global community has to defeat the antifungal medication diflucan. Vaccination campaigns have started all over the world, and three types of antifungal medication treatments are being applied in the European Union, after their respective statements of efficacy and security (Baden et al. 2021.
Polack et al. 2020. Voysey et al. 2021), while a fourth treatment has just recently been approved (EMA 2021a).
Although some concerns regarding the safety of two of these treatments have been raised recently (EMA 2021b. EMA 2021c), vaccination plans are going ahead, being adapted according to the state of knowledge at each moment. Some of these treatments are mRNA-based (Baden et al. 2021.
Polack et al. 2020), while others use a viral vector (Bos et al. 2020. Voysey et al.
2021). They are mainly two-shot treatments, with one exception (Bos et al. 2020), and complete immunity is thought to be acquired 2âweeks after the last shot (CDC. N.d.b, Voysey et al.
2021). Other countries such as China or Russia, on the other hand, were extremely early in starting their vaccination campaigns, and are distributing among their citizens different treatments than the aforementioned (Logunov et al. 2021. Zhang et al.
2021).Even if at least three types of plague treatments had been created by the time the novel takes place (Sun 2016), treatments do not play an important role in La Peste, in which therapeutic measures (the serum) are more important than prophylactic ones. Few times in the novel the narrator refers to prophylactic inoculations:There was still no possibility of vaccinating with preventive serum except in families already affected by the disease. (Camus 2002, Part II)Deudon has pointed out that Camus mixes up therapeutic serum and treatment (Deudon 1988), and in fact there exists a certain amount of confusion. All along the novel, the narrator focuses on the prophylactic goals of the serum, which is applied to people already infected (Othonâs son, Tarrou, Grandâ¦).
However, both in the example above (which can be understood as vaccinating household contacts or already affected individuals) and in others, the differences between treating and vaccinating are not clear:After the morning admissions which he was in charge of himself, the patients were vaccinated and the swellings lanced. (Camus 2002, Part II)In any case, this is another situation in which Camus stands aside from scientific matters, which are to him less relevant in his novel than philosophical or literary ones. The distance existing between the relevance of treatments in antifungal medication and the superficial manner with which Camus treats the topic in La Peste exemplifies this.Part IIIIn part III, the plagueâs ravages become tougher. The narrator turns his focus to burials and their disturbance, a frequent topic in epidemicsâ narrative (table 1).
Camus knew how acutely increasing demands and hygienic requirements affect funeral habits during epidemics:Everything really happened with the greatest speed and the minimum of risk. (Camus 2002, Part III)Like many other processes during epidemics, the burial process becomes a protocol. When protocolised, everything seems to work well and rapidly. But this perfect mechanism is the Prefectureâs goal, not Rieuxâs.
He reveals in this moment an aspect in his character barely shown before. Irony.The whole thing was well organized and the Prefect expressed his satisfaction. He even told Rieux that, when all was said and done, this was preferable to hearses driven by black slaves which one read about in the chronicles of earlier plagues. Â Yes,â Rieux said.
 The burial is the same, but we keep a card index. No one can deny that we have made progress.â (Camus 2002, Part III)Even if this characteristic may seem new in Dr Rieux, we must bear in mind that he is the story narrator, and the narration is ironic from time to time. For instance, speaking precisely about the burials:The relatives were invited to sign a register âwhich just showed the difference that there may be between men and, for example, dogs. You can keep check of human beings-.
(Camus 2002, Part III)In Camusâs philosophy, the absurd is a core issue. According to Lengers, Rieux is ironic because he is a kind of Sisyphus who has understood the absurdity of plague (Lengers 1994). The response to the absurd is to rebel (Camus 2013), and Rieux does it by helping his fellow humans without questioning anything. He does not pursue any other goal than doing his duty, thus humour (as a response to dire situations) stands out from him when he observes others celebrating irrelevant achievements, such as the Prefect with his burial protocol.
In the field of medical ethics, Lengers has highlighted the importance of Camusâs perspective when considering âthe immediacy of life rather than abstract valuesâ (Lengers 1994, 250). Rieux himself is quite sure that his solid commitment is not âabstractâ, and, even if he falls into abstraction, the importance relies on protecting human lives and not in the name given to that task:Was it truly an abstraction, spending his days in the hospital where the plague was working overtime, bringing the number of victims up to five hundred on average per week?. Yes, there was an element of abstraction and unreality in misfortune. But when an abstraction starts to kill you, you have to get to work on it.
(Camus 2002, Part II)Farewells during antifungal medication may have not been particularly pleasant for some families. Neither those dying at nursing homes nor in hospitals could be accompanied by their families as previously, due to corpses management protocols, restrictions of external visitors and hygienic measures in general. However, as weeks passed by, certain efforts were made to ease this issue, allowing people to visit their dying beloved sticking to strict preventive measures. On the other hand, the number of people attending funeral masses and cemeteries was also limited, which affected the conventional development of ceremonies as well.
Hospitals had to deal with daily tolls of deaths never seen before, and the overcrowding of mortuaries made us see rows of coffins placed in unusual spaces, such as ice rinks (transformation of facilities is another topic in table 1).We turn now to two other points which antifungal medication has not evaded. s among essential workers and epidemicsâ economic consequences. The author links burials with s among essential workers because gravediggers constitute one of the most affected professions, and connects this fact with the economic recession because unemployment is behind the large availability of workers to replace the dead gravediggers:Many of the male nurses and the gravediggers, who were at first official, then casual, died of the plague. [â¦] The most surprising thing was that there was never a shortage of men to do the job, for as long as the epidemic lasted.
[â¦] When the plague really took hold of the town, its very immoderation had one quite convenient outcome, because it disrupted the whole of economic life and so created quite a large number of unemployed. [â¦] Poverty always triumphed over fear, to the extent that work was always paid according to the risk involved. (Camus 2002, Part III)The effects of the plague over the economic system are one of our recurrent topics (table 1). The plague in Oran, as it forces to close the city, impacts all trading exchanges.
In addition, it forbids travellers from arriving to the city, with the economic influence that that entails:This plague was the ruination of tourism. (Camus 2002, Part II)Oranians, who, as we saw, were very worried about making money, are especially affected by an event which jeopardises it. In antifungal medication, for one reason or for another, most of the countries are suffering economic consequences, since the impact on normal life from the epidemic (another recurrent topic) means also an impact on the normal development of trading activities.Part IVIn Part IV we witness the first signals of a stabilisation of the epidemic:It seemed that the plague had settled comfortably into its peak and was carrying out its daily murders with the precision and regularity of a good civil servant. In theory, in the opinion of experts, this was a good sign.
The graph of the progress of the plague, starting with its constant rise, followed by this long plateau, seemed quite reassuring. (Camus 2002, Part IV)At this time, we consider interesting to expand the topic about the transformation of facilities. We mentioned the case of ice rinks during antifungal medication, and we bring up now the use of a football pitch as a quarantine camp in Camusâs novel, a scene which has reminded some scholars of the metaphor of Nazism and concentration camps (Finel-Honigman 1978). In Spain, among other measures, a fairground was enabled as a field hospital during the first wave, and it is plausible that many devices created with other purposes were used in tasks attached to healthcare provision during those weeks, as occurred in Oranâs pitch with the loudspeakers:Then the loudspeakers, which in better times had served to introduce the teams or to declare the results of games, announced in a tinny voice that the internees should go back to their tents so that the evening meal could be distributed.
(Camus 2002, Part IV)Related to this episode, we can also highlight the opposition between science and humanism that Camus does. The author alerts us about the dangers of a dehumanised science, of choosing procedures perfectly efficient regardless of their lack in human dignity:The men held out their hands, two ladles were plunged into two of the pots and emerged to unload their contents onto two tin plates. The car drove on and the process was repeated at the next tent.â Itâs scientific,â Tarrou told the administrator.â Yes,â he replied with satisfaction, as they shook hands. Â Itâs scientific.â (Camus 2002, Part IV)Several cases with favourable outcomes mark Part IV final moments and prepare the reader for the end of the epidemic.
To describe these signs of recovering, the narrator turns back to two elements with a main role in the novel. Rats and figures. In this moment, the first ones reappear and the second ones seem to be declining:He had seen two live rats come into his house through the street door. Neighbours had informed him that the creatures were also reappearing in their houses.
Behind the walls of other houses there was a hustle and bustle that had not been heard for months. Rieux waited for the general statistics to be published, as they were at the start of each week. They showed a decline in the disease. (Camus 2002, Part IV)Part VGiven that we continue facing antifungal medication, and that forecasts about its end are not easy, we cannot compare ourselves with the Oranians once they have reached the end of the epidemic, what occurs in this part.
However, we can analyse our current situation, characterised by a widespread, though cautious, confidence motivated by the beginning of vaccination campaigns, referring it to the events narrated in Part V.Even more than the Oranians, since we feel further than them from the end of the problem, we are cautious about not to anticipate celebrations. From time to time, however, we lend ourselves to dream relying on what the narrator calls âa great, unadmitted hopeâ. antifungal medication took us by surprise and everyone wants to âreorganiseâ their life, as Oranians do, but patience is an indispensable component to succeed, as fictional and historical epidemics show us.Although this sudden decline in the disease was unexpected, the towns-people were in no hurry to celebrate. The preceding months, though they had increased the desire for liberation, had also taught them prudence and accustomed them to count less and less on a rapid end to the epidemic.
However, this new development was the subject of every conversation and, in the depths of peopleâs hearts, there was a great, unadmitted hope. [â¦] One of the signs that a return to a time of good health was secretly expected (though no one admitted the fact) was that from this moment on people readily spoke, with apparent indifference, about how life would be reorganized after the plague. (Camus 2002, Part V)We put our hope on vaccination. Social distancing and other hygienic measures have proved to be effective, but treatments would bring us a more durable solution without compromising so hardly many economic activities and social habits.
As we said, a more important role of scientific aspects is observed in antifungal medication if compared with La Peste (an expected fact if considered that Camusâs story is an artistic work, that he skips sometimes the most complex scientific issues of the plague and that health sciences have evolved substantially during last decades). Oranians, in fact, achieve the end of the epidemic not through clearly identified scientific responses but with certain randomness:All one could do was to observe that the sickness seemed to be going as it had arrived. The strategy being used against it had not changed. It had been ineffective yesterday, and now it was apparently successful.
One merely had the feeling that the disease had exhausted itself, or perhaps that it was retiring after achieving all its objectives. In a sense, its role was completed. (Camus 2002, Part V)They receive the announcement made by the Prefecture of reopening the townâs gates in 2âweeks time with enthusiasm. Dealing with concrete dates gives them certainty, helps them fix the temporal horizons we wrote about.
This is also the case when they are told that preventive measures would be lifted in 1âmonth. Camus shows us then how the main characters are touched as well by this positive atmosphere:That evening Tarrou and Rieux, Rambert and the rest, walked in the midst of the crowd, and they too felt they were treading on air. Long after leaving the boulevards Tarrou and Rieux could still hear the sounds of happiness following them⦠(Camus 2002, Part V)Then, Tarrou points out a sign of recovery coming from the animal world. In a direct zoological chain, infected fleas have vanished from rats, which have been able again to multiply across the city, making the cats abandon their hiding places and to go hunting after them again.
At the final step of this chain, Tarrou sees the human being. He remembers the old man who used to spit to the cats beneath his window:At a time when the noise grew louder and more joyful, Tarrou stopped. A shape was running lightly across the dark street. It was a cat, the first that had been seen since the spring.
It stopped for a moment in the middle of the road, hesitated, licked its paw, quickly passed it across its right ear, then carried on its silent way and vanished into the night. Tarrou smiled. The little old man, too, would be happy. (Camus 2002, Part V)Unpleasant things as a town with rats running across its streets, or a man spending his time spitting on a group of cats, constitute normality as much as the reopening of gates or the reboot of commerce.
However, when Camus speaks directly about normality, he highlights more appealing habits. He proposes common leisure activities (restaurants, theatres) as symbols of human life, since he opposes them to Cottardâs life, which has become that of a âwild animalâ:At least in appearance he [ Cottard ] retired from the world and from one day to the next started to live like a wild animal. He no longer appeared in restaurants, at the theatre or in his favourite cafés. (Camus 2002, Part V)We do not disclose why Cottardâs reaction to the end of the epidemic is different from most of the Oraniansâ.
In any case, the narrator insists later on the assimilation between common pleasures and normality:â Perhaps,â Cottard said, â Perhaps so. But what do you call a return to normal life?. Â â New films in the cinema,â said Tarrou with a smile. (Camus 2002, Part V)Cinema, as well as theatre, live music and many other cultural events have been cancelled or obliged to modify their activities due to antifungal medication.
Several bars and restaurants have closed, and spending time in those who remain open has become an activity which many people tend to avoid, fearing contagion. Thus, normality in our understanding is linked as well to these simple and pleasant habits, and the complete achievement of them will probably signify for us the desired defeat of the diflucan.In La Peste, love is also seen as a simple good to be fully recovered after the plague. While Rieux goes through the ârebornâ Oran, it is loversâ gatherings what he highlights. Unlike them, everyone who, during the epidemic, sought for goals different from love (such as faith or money, for instance) remain lost when the epidemic has ended:For all the people who, on the contrary, had looked beyond man to something that they could not even imagine, there had been no reply.
(Camus 2002, Part V)And this is because lovers, as the narrator says:If they had found that they wanted, it was because they had asked for the only thing that depended on them. (Camus 2002, Part V)We have spoken before about language manipulation, hypocrisy and public figuresâ roles during epidemics. Camus, during Dr Rieuxâs last visit to the old asthmatic man, makes this frank and humble character criticise, with a point of irony, the authoritiesâ attitude concerning tributes to the dead:â Tell me, doctor, is it true that theyâre going to put up a monument to the victims of the plague?. Ââ So the papers say.
A pillar or a plaque.ââ I knew it!. And thereâll be speeches.âThe old man gave a strangled laugh.â I can hear them already.  Our deadâ¦â Then theyâll go and have dinner.â (Camus 2002, Part V)The old man illustrates wisely the authoritiesâ propensity for making speeches. He knows that most of them usually prefer grandiloquence rather than common words, and seizes perfectly their tone when he imitates them (âOur deadâ¦â).
We have also got used, during antifungal medication, to these types of messages. We have also heard about âour old peopleâ, âour youthâ, âour essential workersâ and even âour deadâ. Behind this tone, however, there could be an intention to hide errors, or to falsely convey carefulness. Honest rulers do not usually need nice words.
They just want them to be accurate.We have seen as well some tributes to the victims during antifungal medication, some of which we can doubt whether they serve to victimsâ relief or to authoritiesâ promotion. We want rulers to be less aware of their own image and to stress truthfulness as a goal, even if this is a hard requirement not only for them, but for every single person. Language is essential in this issue, we think, since it is prone to be twisted and to become untrue. The old asthmatic man illustrates it with his âThereâll be speechesâ and his âOur deadâ¦â, but this is not the only time in the novel in which Camus brings out the topic.
For instance, he does so when he equates silence (nothing can be thought as further from wordiness) with truth:It is at the moment of misfortune that one becomes accustomed to truth, that is to say to silence. (Camus 2002, Part II)or when he makes a solid statement against false words:â¦I understood that all the misfortunes of mankind came from not stating things in clear terms. (Camus 2002, Part IV)The old asthmatic, in fact, while praising the deceased Tarrou, remarks that he used to admire him because âhe didnât talk just for the sake of it.â (Camus 2002, Part V).Related to this topic, what the old asthmatic says about political authorities may be transposed in our case to other public figures, such as scholars and researchers, media leaders, businessmen and women, health professionals⦠and, if we extend the scope, to every single citizen. Because hypocrisy, language manipulation and the fact of putting individual interests ahead of collective welfare fit badly with collective issues such as epidemics.
Hopefully, also examples to the contrary have been observed during antifungal medication.The story ends with the fireworks in Oran and the depiction of Dr Rieuxâs last feelings. While he is satisfied because of his medical performance and his activity as a witness of the plague, he is concerned about future disasters to come. When antifungal medication will have passed, it will be time for us as well to review our life during these months. For now, we are just looking forward to achieving our particular âpart Vâ..
Diflucan 200mg tablet
ÂTrump is pushing to slash Medicare benefits.ââ diflucan 200mg tablet Digital and TV campaign ad, Oct. 9, 2020 This story was produced in partnership with diflucan 200mg tablet PolitiFact. This story can be republished for free (details). Itâs a tried-and-true campaign strategy.Candidates go on the attack, claiming their opponent will do harm to Medicare. After all, diflucan 200mg tablet people 65 and older are good about making it to the polls on Election Day.
These voters are also generally motivated to protect the federal health insurance program for seniors.Itâs no surprise, then, that in an ad released this month, former Vice President Joe Bidenâs campaign played the Medicare card.âDonald Trump is lying about Medicare and Social Security,â an ominous, mature, male voice warns viewers in the ad. He goes on to say that âTrumpâs pushing to slash Medicare benefits.âClearly, weâve heard this dire message before â from candidates of diflucan 200mg tablet both parties through the years. Email Sign-Up Subscribe to KHNâs free Morning Briefing. We issued a skeptical rating of a claim that Trump promised to gut Social Security and Medicare if re-elected, noting that diflucan 200mg tablet his deferral of payroll taxes did not mention Medicare at all.
But Trump has not mentioned cuts to Medicare benefits on the trail, and heâs promised to make cuts to the program in the future. So what diflucan 200mg tablet is Bidenâs claim talking about?. As a rationale for the statement, a Biden campaign spokesperson pointed us to the Trump administrationâs support of Republicansâ efforts in a court case, California v. Texas, which seeks to overturn the Affordable Care Act diflucan 200mg tablet.
But the ad does not include any reference or explanation of how the case would affect Medicare benefits.The legal challenge, brought by a group of Republican attorneys general, is pegged to the 2017 tax bill, which zeroed out the tax that functioned as a penalty for not having health coverage â known as the individual mandate. Without this linchpin tax, the Republicans argue, the entire law should be struck down diflucan 200mg tablet. They based that on the Supreme Court decision in 2012 that the law was constitutional because the penalty was a valid use of Congressâ ability to levy taxes.In the current case, lower courts have found the law unconstitutional, and a group of Democratic attorneys general appealed to the Supreme Court.Oral arguments are scheduled for Nov. 10.
The Trump administration filed a brief in support of invalidating the entire law unconstitutional.Though best known for its vast expansion of health coverage through marketplace plans and Medicaid, the ACA also included a range of consumer protections â such as the ban on discrimination against people with preexisting conditions â and an estimated 165 Medicare-related provisions.The Biden spokesperson pointed to one, which ended Medicareâs so-called doughnut hole.We asked experts for their take. Immediately, we found differences in opinion.Thatâs a âperfectly fair claim,â said Nicholas Bagley, a professor at the University of Michigan Law School. Closing the doughnut hole matters to many people, he said.Case Western Reserve University law professor Jonathan Adler took a different view. The argument that Medicare would be affected âis a very aggressive reading of the filing in this case,â he said, referring to the Trump administrationâs brief in support of nullifying the ACA.The next step seemed to be getting a better grasp of whatâs at stake.A Quick Review of the Doughnut Hole, Other Medicare ProvisionsThe Medicare doughnut hole refers to the gap in Part D prescription drug coverage that begins after a beneficiary spends a set amount â usually a few thousand dollars.
Before the ACA, beneficiaries who reached that threshold were responsible for 100% of their medication costs until they spent enough for catastrophic coverage to kick in, which could be more than $1,000 in additional spending. Even with this coverage, beneficiaries were responsible for 5% of their drug expenditures. (If beneficiaries were responsible for 100% of costs today, people with high drug costs would obviously pay a lot more without the ACA provision.)The ACA would have gradually ended that coverage gap. But, in 2018, Congress adopted changes to expedite the process.
As of 2019, the doughnut hole was closed. Adler pointed to that congressional intervention as a step that could keep the doughnut hole closed if the ACA were overturned. Based on this legislative history, the argument could be made that closing the coverage gap was something Congress had an interest in apart from the ACA. Since the doughnut hole is officially closed, some analysts said this provision may not be vulnerable to the upcoming Supreme Court decision on the ACA.
Sources: Biden campaign ad âClear Choice,â released Oct. 9, 2020Email exchanges with Biden campaign spokesperson, Oct. 12, 2020Telephone interview, email correspondence with Tricia Neuman, KFF senior vice president and executive director of the KFFâs program on Medicare policy, Oct. 13, 2020Telephone interview with Nicholas Bagley, professor at the University of Michigan Law School, Oct.
15, 2020Telephone interview with Jonathan Adler, professor at the Case Western Reserve University School of Law, Oct.16, 2020Telephone interview with Paul Van de Water, senior fellow at the Center on Budget and Policy Priorities, Oct. 19, 2020Telephone interview with David Lipschutz, associate director of the Center for Medicare Advocacy, Oct. 20, 2020Telephone interview with Gail Wilensky, senior fellow at Project Hope, Oct. 20, 2020Medicare.gov, accessed Oct.
12KFF, Closing the Medicare Part D Coverage Gap. Trends, Recent Changes, and Whatâs Ahead, Aug. 21, 2018National Committee to Preserve Social Security and Medicare, Overturning the ACA Would Harm Medicare, June 29, 2020Center on Budget and Policy Priorities, Striking Down ACA Would Weaken Medicare, July 8, 2019KHN, Without Ginsburg, Judicial Threats to the ACA, Reproductive Rights Heighten, Sept. 21, 2020KHN, Doughnut Hole Is Gone, But Medicareâs Uncapped Drug Costs Still Bite Into Budgets, March 29, 2019U.S.
Census Bureau, Voter Turnout Rates Among All Voting Age and Major Racial and Ethnic Groups Were Higher Than in 2014, April 23, 2019U.S. Census Bureau, Voting in America. A Look at the 2016 Presidential Election, May 10, 2017Statista, Voter Turnout Rates* Among Selected Age Groups in U.S. Midterm Elections From 1966 to 2018, July 10, 2020U.S.
News &. World Report, Why Older Citizens Are More Likely to Vote, Oct. 5, 2020KFF, Health Tracking Poll â October 2020. The Future of the ACA and Bidenâs Advantage on Health Care, Oct.
16, 2020State of California, et al., Petitioners v. State of Texas, et al., Brief for the Federal Respondents, June 25, 2020AARP, AARP Foundation, Center for Medicare Advocacy and Justice in Aging, Brief of Amici Curiae in Support of Petitioners in No. 19-840 and Non-Executive Branch Respondents in No. 19-1019 âYou can make a lot of claims,â said Gail Wilensky, a former head of the Centers for Medicare &.
Medicaid Services. ÂThat one is really a stretch.âOther ACA provisions tied to Medicare benefits seem more at risk, such as the one that mandated annual wellness visits and certain preventive services, such as mammograms, bone mass measurement for those with osteoporosis, and depression and diabetes screening, with no patient cost sharing.âItâs not clear that the administration actively supports any change to the Medicare benefits with the case before SCOTUS,â said Tricia Neuman, KFF senior vice president and executive director of the KFFâs program on Medicare policy. ÂBut if they didnât explicitly seek to wall off certain provisions, it is at least conceivable â though maybe not likely â that Medicare benefits in the ACA could be collateral damage.â (KHN is an editorially independent program of KFF.)According to an amicus brief filed by the AARP, the Center for Medicare Advocacy and Justice in Aging in 2016, an estimated 40.1 million Medicare beneficiaries received at least one preventive service and 10.3 million had an annual wellness visit with no copay or deductible.Other experts pointed to a troubling implication for Medicare. The nullification of the ACA provisions related to costs and slowing the growth of the programâs spending.
Those efforts had been credited with extending the solvency of the Health Insurance Trust Fund and slowing the growth in Medicare premiums.It âwould impair the financial fitnessâ of the trust fund, said Paul Van de Water, a senior fellow at the Center on Budget and Policy Priorities.Trump âmay not say it is his intent to slash Medicare benefits,â agreed David Lipschutz, associate director of the Center for Medicare Advocacy, but overturning the ACA entirely would âcause chaos writ large.â And, because of the programâs size, that chaos âwould upend the financial markets and the entire health care system,â according to the brief filed by Medicare advocates.What Comes Next Is ComplicatedEnter the concept of severability. Many court watchers are quick to say the high courtâs decision could go beyond upholding the entire law or declaring it unconstitutional. Instead, the justices could separate or sever parts of it not directly related to the zeroed-out tax penalty, the so-called individual mandate.Of course, the Trump administration argued in its brief that the interwoven nature of the ACAâs provisions demanded that the entire law be invalidated.âIf you just go on that basis, they are not arguing for severability,â said Van de Water.But others point out another layer that warrants consideration.âEveryone who comments on this focuses on the administrationâs argument for inseverability,â Adler said. But he said it was more complicated than that.The Trump administrationâs position is âsimultaneously that the entire ACA should be invalidatedâ and also that relief should be provided only where injury to the plaintiffs is shown.
(The administration defines the plaintiffs as the two individuals who signed on to the original challenge.)Another view is that this point in the administrationâs argument is not clear-cut, mostly because it gives no hint as to which programs or provisions would fit into the category of harming the plaintiffs.Ultimately, the fate of the sweeping health law is in the hands of the Supreme Court.âLegal analysts didnât anticipate the case getting as far as it has,â said Lipschutz.But âthe White House threw its weight behind the lawsuit,â said Bagley, at the University of Michigan. ÂSo, they own the consequences. Especially in the context of this presidential campaign.âOur RulingAn attack ad by the Biden campaign states that Trump is âpushing to slash Medicare benefitsâ and ties this charge to the administrationâs position on the pending legal challenge to the ACA.The Biden campaign pointed to an ACA provision that sought to close the Medicare doughnut hole to support this claim. It may not be the best example, though, because some experts suggest it may not be as vulnerable as other parts of the law.Experts outlined a range of other Medicare provisions that either provided new benefits or shored up the programâs financial fitness.
If the whole law were to be nullified, as the administration has advocated, these changes could also be erased â a step that would affect benefits and potentially cause premiums to rise.Overall, the Biden ad seems plausible, even though the link between Trumpâs position on the legal challenge and its impact on Medicare benefits is less straightforward than in similar claims we have checked regarding preexisting conditions.We rate the claim Half True. Related Topics Elections Medicare The Health Law KHN &. PolitiFact HealthCheck Trump AdministrationSOBRE NOTICIAS EN ESPAÃOLNoticias en español es una sección de Kaiser Health News que contiene traducciones de artÃculos de gran interés para la comunidad hispanohablante, y contenido original enfocado en la población hispana que vive en los Estados Unidos. Use Nuestro Contenido Este contenido puede usarse de manera gratuita (detalles).
Molly Wiese estaba perpleja. Sus padres y hermanos viven en el sur de California, y Wiese, abogada de 35 años, ha viajado cada Navidad desde que se mudó a Minnesota en 2007.Por la pandemia, Wiese pensó que esta vez serÃa más prudente quedarse. Pero en junio, el padre de Wiese fue diagnosticado con cáncer en estadio 4 y la familia teme que éstas sean sus últimas fiestas. ¿DeberÃa volar con su esposo y sus dos hijos pequeños a California, poniendo a su padre inmunodeprimido en riesgo de antifungal medication?.
¿O quedarse en casa y perderse la oportunidad de crear recuerdos de estas fiestas?. Sus hijos están en la guarderÃa y el marido de Wiese trabaja en una escuela. No tienen suficiente tiempo de vacaciones para ponerse en cuarentena antes o después de un vuelo, y conducir ocho dÃas de ida y vuelta está fuera de discusión.Teme transmitirle el antifungals a su padre. Pero sus padres, que viven en la ciudad de Yucaipa de Inland Empire, creen que vale la pena correr el riesgo de ver a sus nietos y tener ânuestra Navidad normalâ, contó Wiese.âIdealmente, tendrÃamos una vacunaâ, dijo.
ÂPero no creo que sea una expectativa realistaâ. Pfizer, el aparente lÃder en la carrera para una vacuna contra antifungal medication, dice que ni siquiera estará listo para solicitar la aprobación hasta fines de noviembre, como muy pronto.El padre de Molly Wiese tiene cáncer avanzado y Wiese teme que ésta sea su última temporada de fiestas. Pero duda en viajar al sur de California para visitar a su familia, por temor de ponerlo en riesgo de contraer antifungal medication. De izquierda a derecha.
Molly Wiese, su hijo Calvin, su esposo Phil Wiese, su hijo Bennett, y sus padres, Becky y Bill Miller. (Molly Wiese)Si bien el enigma de Wiese es especialmente importante, su historia ilustra la difÃcil decisión a la que se enfrentan millones de estadounidenses sobre si viajar o no durante las vacaciones de invierno, y cómo hacerlo.La mejor forma de evitar la propagación de enfermedades serÃa evitar los viajes o ampliar los cÃrculos sociales. Para las celebraciones locales, la cuarentena durante dos semanas antes de un evento festivo minimizarÃa el riesgo, pero solo si todos los comensales se comprometieran a seguirla. Pero algunas personas tienen que trabajar fuera de casa.Después de al menos siete meses de estar prácticamente encerrados, las vacaciones de invierno representan una tentación casi insuperable.
Incluso expertos en salud pública y enfermedades infecciosas reconocen el dilema.âHay mucho que ganar con el contacto fÃsico, en la misma sala y no en una pantalla de Zoom o FaceTimeâ, dijo el doctor Peter Chin-Hong, especialista en enfermedades infecciosas y profesor de medicina en la Universidad de California-San Francisco.El doctor Anthony Fauci, la autoridad nacional en enfermedades infecciosas en los Institutos Nacionales de Salud, no es inmune al problema. El 13 de octubre, le dijo a âThe Worldâ que él y sus tres hijas adultas, que viven en distintos estados, todavÃa estaban decidiendo si estar juntos âvaldrÃa la penaâ.Al dÃa siguiente, Fauci le dijo a âCBS Evening Newsâ que la reunión de Acción de Gracias de su familia estaba cancelada, dados los riesgos que plantean los vuelos. ÂPuede que tenga que sacrificar esa reunión social, a menos que esté bastante seguro de que las personas con las que está tratando no están infectadasâ, dijo.El doctor Robert Redfield, director de los Centros para el Control y Prevención de Enfermedades (CDC), y la doctora Deborah Birx, coordinadora del equipo de respuesta a antifungal medication de la administración Trump, advirtieron que las reuniones de Thanksgiving podrÃan propagar el diflucan.En California, funcionarios de salud pública están adoptando un enfoque de âreducción de dañoâ. No están fomentando las reuniones de varias familias, pero han emitido pautas para hacer que las reuniones sean más seguras si se realizan al aire libre y duran menos de dos horas.Funcionarios del condado de Los Ãngeles, que ha visto un aumento en las tasas de transmisión en las últimas semanas, publicaron una guÃa similar, reconociendo que las personas separadas de sus seres queridos durante meses anhelan cada vez más ese contacto.âEstamos tratando de encontrar un balance, pero creo que es apropiado que intentemos llevar a cabo algunas de las actividades que la gente está desesperada por poder hacer, con total apego a la guÃaâ, dijo Barbara Ferrer, directora de del departamento de salud pública del condado, en una conferencia de prensa el 14 de octubre.En todo el mundo, los feriados nacionales han impulsado la propagación de antifungal medication de manera explosiva.
En China, donde comenzó la pandemia, se estima que 5 millones de personas que viajaban por el Año Nuevo chino abandonaron Wuhan, el epicentro del brote, antes de que se promulgara una prohibición de viajar.En Irán, la pandemia se impulsó por Nowruz, una celebración de primavera de dos semanas durante la que viajan millones. En Israel, las fiestas y reuniones religiosas de Purim provocaron una transmisión generalizada a fines de marzo.Las celebraciones de Memorial Day, el 4 de julio y el DÃa del Trabajo impulsaron aumentos repentinos de casos en los Estados Unidos, por eso el DÃa de Acción de Gracias asusta a los funcionarios de salud pública.El año pasado, viajaron más de 55 millones de personas durante los dÃas que rodearon ese cuarto jueves de noviembre.Sin embargo, funcionarios de todo el paÃs están siendo suaves cuando se trata de advertencias.En Minnesota, donde vive Wiese y los casos están alcanzando niveles récord, funcionarios instan al público a evitar las tiendas abarrotadas y las grandes reuniones en interiores con varias familias.Pero dicen que las cenas de Acción de Gracias al aire libre con amigos y familiares locales son menos riesgosas. Su guÃa no explica cómo tolerar un DÃa de Acción de Gracias al aire libre en Minnesota. La temperatura máxima promedio en Minneapolis el 26 de noviembre es de 33 grados.Michael Osterholm, director del Centro de Investigación y PolÃtica de Enfermedades Infecciosas de la Universidad de Minnesota, dice âparemos un pocoâ.Osterholm explicó que si no puedes ponerte en cuarentena durante 10 a 14 dÃas antes del evento, es decir, sin contacto con personas además de los miembros de tu hogar que también están en cuarentena, no vayas a la cena de Acción de Gracias en otra casa.
El estado ya ha visto demasiados ejemplos de personas vulnerables que se enferman y mueren después de asistir a bodas, funerales y cumpleaños.âQue este sea tu año antifungal medicationâ, dijo Osterholm. ÂEs un año muy desafiante, pero no quieres introducir este diflucan en entornos familiares y experimentar las consecuenciasâ.Osterholm y su pareja pasarán el DÃa de Acción de Gracias y la Navidad sin familiares, a pesar de que sus hijos y nietos son todos locales. Debido a que todos sus nietos están en la guarderÃa o en la escuela, no hay suficiente tiempo para que sus familias se pongan en cuarentena antes de disfrutar juntos de una comida navideña.Sintió empatÃa con la difÃcil situación de Wiese. Si decide volar a California, dijo, deberÃa acuartelar a su familia lo más posible durante 10 dÃas antes, y luego no pasar más de dos dÃas con su padre.âIncluso si se infectara, no serÃa más contagiosa hasta probablemente el tercer dÃaâ, dijo.
ÂEntonces, si ella pasa esos dos dÃas con él, puede sentirse relativamente bien por el hecho de que no los puso en riesgoâ.Para aquellos que viajan, conducir es mucho más seguro que volar porque los conductores pueden estar aislados en un compartimento doméstico y evitar la exposición al antifungals renunciando a los restaurantes y desinfectando las manijas del baño y la bomba de gasolina antes de tocarlos.El doctor Iahn Gonsenhauser, director de calidad y seguridad del paciente del Centro Médico Wexner de la Universidad Estatal de Ohio, dijo que planea conducir con su familia, pasando la noche en un hotel en el camino, para pasar el DÃa de Acción de Gracias con la familia de su hermana en Colorado.Ãl y su familia se mantienen aislados y trabajan desde casa tanto como sea posible, dejando la casa solo para compras y mandados básicos mientras evitan restaurantes y centros comerciales, dijo. Si alguien en cualquiera de las familias comenzara a mostrar sÃntomas de antifungal medication, o confirmara la exposición a una persona con antifungal medication positivo, todo el viaje se cancelarÃa instantáneamente.âEs por eso que hacemos todos los planes con una reserva reembolsableâ, dijo. ÂSi las personas no tienen forma de salirse de sus reservas, están más inclinadas a tomar un riesgo aparenteâ.Chin-Hong ofreció este consejo para los viajeros de vacaciones. Házte la prueba antes del vuelo para tu tranquilidad, compra boletos en un avión que deje los asientos del medio vacÃos, usa máscaras N95 altamente protectoras y escudos faciales, y coloca las rejillas de ventilación individuales del avión directamente sobre cada miembro de la familia para romper las posibles partÃculas de diflucan.
Y, por supuesto, lávate las manos con frecuencia.Chin-Hong está adoptando ese enfoque en un viaje familiar planificado a la ciudad de Nueva York para visitar a su madre, que tiene más de 80 años y quiere ver a su hijo, nuera y nietos. Cada visita podrÃa ser la última, dijo Chin-Hong.âPara mÃ, la relación riesgo-beneficio apoya la idea ir a verlaâ.Después de escuchar los consejos de Chin-Hong y otros expertos en enfermedades infecciosas, Wiese decidió el fin de semana pasado comprar boletos de avión para visitar a sus padres.âRealmente nos ayudó a tomar una decisión que me estaba dando mucha ansiedadâ, expresó. Anna Almendrala. aalmendrala@kff.org, @annaalmendrala Related Topics Noticias En Español Public Health States antifungal medication LatinosâThey have 180 million people, families under what he wants to do, which will basically be socialized medicine â you wonât even have a choice â they want to terminate 180 million plans.âPresident Donald Trump during the presidential debate, Oct.
22, 2020 During the final presidential debate, President Donald Trump claimed that 180 million people would lose their private health insurance to socialized medicine if the Democratic presidential nominee, former Vice President Joe Biden, is elected president.âThey have 180 million people, families under what he wants to do, which will basically be socialized medicine â you wonât even have a choice â they want to terminate 180 million plans,â said Trump.Trump has repeated this claim throughout the week, and we thought the linkage of Bidenâs proposed health care plan with socialism was something we needed to check out. Especially since Biden opposed âMedicare for All,â the proposal by Sen. Bernie Sanders (I-Vt.) that would have created a single-payer health system run completely by the federal government, and has long been attacked by Republicans as âsocialist.â Email Sign-Up Subscribe to KHNâs free Morning Briefing. The Trump campaign did not respond to our request asking where the evidence for this claim came from.
Experts called it a distortion of Bidenâs plan.Where the Number Comes FromExperts agreed the number of people who have private health insurance either through an employer-sponsored plan or purchased on the Affordable Care Actâs health insurance marketplace is around 180 million people.KFF, a nonpartisan health policy organization, estimated in 2018 that about 157 million Americans had health insurance through their employer, while almost 20 million had insurance they purchased for themselves. Together, that adds up to about 177 million with private health insurance. (KHN is an editorially independent program of KFF.)What Does Biden Support?. Biden supports expanding the ACA through several measures, including a public option.
Under his plan, this public option would be a health insurance plan run by the federal government that would be offered alongside other private health insurance plans on the insurance marketplace.âThe marketplace is made up of multiple insurers in areas,â said Linda Blumberg, a health policy fellow at the Urban Institute. ÂSometimes there are five or more [plans]. Sometimes there is only one. Biden is talking about adding a public option in the marketplace.
You could pick between these private insurers or you could pick the public option.âGetting rid of the so-called employer firewall is also part of Bidenâs proposal.This firewall was implemented during the rollout of the ACA. It was designed to maintain balance in the insurance risk pools by preventing too many healthy people who have work-based coverage from opting instead to move to a marketplace plan. And it all came down to who qualified for the subsidies that made these plans more affordable.Currently, those who are offered a health insurance plan through their employer that meets certain minimum federal standards arenât eligible to receive these subsidies, which come in the form of tax credits. But that leaves many low-income workers with health care plans that arenât as affordable or comprehensive as marketplace plans.Bidenâs plan would eliminate that firewall, meaning anyone could choose to get health insurance either through their employer or through the marketplace.
Thatâs where many Republicans argue that we could start to see leakage from private health insurance plans to the public option.âThe problem is healthy people leaving employer plans,â said Joseph Antos, a scholar in health care at the conservative-leaning American Enterprise Institute. That could mean the entire workplace planâs premiums would go up. ÂYou could easily imagine a plan where it spirals, the premiums go up, and then even more people start leaving the plans to go to the public option.âBlumberg, though, said that because the marketplace would still include private health insurance plans alongside the public option, it doesnât mean everyone who chooses to leave their employer plan would go straight to the public option.She has done estimates based on a plan similar to the one Biden is proposing. She estimates that only about 10% to 12% of Americans would choose to leave their employer-sponsored plans, which translates to about 15 million to 18 million Americans.
Source List: Email interview with Cynthia Cox, vice president and director for the Program on the ACA at KFF, Oct. 22, 2020Email interview with Larry Levitt, executive vice president for health policy at KFF, Oct. 22, 2020Email interview with Sabrina Corlette, co-director of the Center on Health Insurance Reforms at Georgetown University, Oct. 22, 2020KFF, âHealth Insurance Coverage of the Total Population,â Accessed Oct.
22, 2020KFF, âAffordability in the ACA Marketplace Under a Proposal Like Joe Bidenâs Health Plan,â Sept. 28, 2020Phone interview with Joseph Antos, Wilson H. Taylor resident scholar in health care and retirement policy at the American Enterprise Institute, Oct. 22, 2020Phone interview with Linda Blumberg, institute fellow in the Health Policy Center at the Urban Institute, Oct.
22, 2020Rev.com, âDonald Trump &. Joe Biden Final Presidential Debate Transcript 2020,â Accessed Oct. 23, 2020Twitter, Donald Trump tweet, Oct. 21, 2020Urban Institute, âThe Healthy America Program, an Update and Additional Options,â Sept.
2019Urban Institute, âFrom Incremental to Comprehensive Health Insurance Reform. How Various Reform Options Compare on Coverage and Costs,â Oct. 2019 KFF also did an estimate and found that 12.3 million people with employer coverage could save money by buying on the exchange under the Biden plan.But âitâs not clear all of those people would choose to leave their employer coverage, though, as there are other reasons besides costs that people might want to have job-based insurance,â Cynthia Cox, vice president and director of the program on the ACA at KFF, wrote in an email.Either way, none of the estimates are anywhere close to the 180 million that Trump claimed.Is This Type of Public Option Socialism?. Overall, experts said no, what Biden supports isnât socialized medicine.âSocialized medicine means that the government runs hospitals and employs doctors, and that is not part of Bidenâs plan,â Larry Levitt, executive vice president for health policy at KFF, wrote in an email.
ÂUnder Bidenâs plans, doctors and hospitals would remain in the private sector just like they are today.âHowever, Antos said that, in his view, the definition of socialism can really vary when it comes to health care.âI would argue in one sense, we would already have socialized medicine. We have massive federal subsidies for everybody, so in that sense, weâre already there,â said Antos. ÂBut, if socialized medicine means the government is going to dictate how doctors practice or how health care is delivered, we are obviously not in that situation. I donât think the Biden plan would lead you that way.âAnd in the end, Antos said, invoking socialism is a scare tactic that politicians have been using for years.âItâs just a political slur,â said Antos.
ÂItâs meant to inflame the emotions of those who will vote for Trump and meant to annoy the people who will vote for Biden.âOur Ruling Trump said 180 million people would lose their private health insurance plans to socialized medicine under Biden.While about 180 million people do have private health insurance, there is no evidence that all of them would lose their private plans if Biden were elected president.Biden supports implementing a public option on the health insurance marketplace. It would exist alongside private health insurance plans, and Americans would have the option to buy either the private plan or the public plan. While estimates show that a number of Americans would likely leave their employer-sponsored coverage for the public plan, they would be doing that by choice and the estimates are nowhere near Trumpâs 180 million figure.Experts also agree that the public option is not socialized medicine, and itâs ridiculous to conflate Bidenâs plan with Medicare for All.We rate this claim Pants on Fire. Victoria Knight.
vknight@kff.org, @victoriaregisk Related Topics Elections Insurance The Health Law KHN &. PolitiFact HealthCheck Obamacare Plans Private InsuranceIn the second and final debate of the 2020 presidential race, President Donald Trump and former Vice President Joe Biden sparred over Trumpâs handling of the diflucan and Bidenâs plan to reform health care. In stark contrast to the first debate, there was more policy talk. There was also less interrupting.Trump said a antifungal medication treatment is âreadyâ and will be announced âwithin weeks,â shortly before conceding that it is ânot a guarantee.âBiden said Trump still has no comprehensive plan to deal with the diflucan, even as case counts continue to climb.
ÂWeâre about to go into a dark winter, and he has no clear plan,â Biden said.Trump claimed Bidenâs health care plan would lead to âsocialized medicine,â conflating Bidenâs proposal to introduce a government insurance option with more progressive proposals that would eliminate private insurance. ÂI support private insurance,â Biden said, promising, âNot a single person with private insurance would lose their insurance under my plan.â Email Sign-Up Subscribe to KHNâs free Morning Briefing. You can read a full fact check for the evening, done in partnership with PolitiFact, here.Meanwhile, we broke down the candidatesâ closing antifungals and other health-related claims so you can do your part. Vote.Here are the highlights:Trump.
ÂWe are rounding the turn [on the diflucan]. We are rounding the corner.âFalse.âRounding the cornerâ suggests that significant and sustained progress is being made in the fight against the antifungals, and thatâs not the case, according to the data.The number of antifungal medication cases is climbing once again, after falling consistently between late July and mid-September. Cases are now at their highest point since early August, with almost 60,000 new confirmed s a day. Thatâs only about 10% lower than the peak in late July.New daily hospitalizations today are lower than in previous spikes, but in the past few weeks there has been a modest increase.
The positivity rate, which measures the percentage of tests that come up positive for the diflucan, has also been going up again in the past few weeks. Higher positivity rates are an indicator of community spread.The one encouraging change is that, since a peak in August, deaths have fallen fairly consistently. Thatâs due to a combination of factors, including improved understanding of how to treat the disease. Yet antifungal medication deaths have settled in at about 800 a day, keeping total deaths per week in the U.S.
Above normal levels.Trump. His administration has done âeverythingâ Biden suggested to address antifungal medication. ÂHe was way behind us.âWe rated a similar claim Pants on Fire. While there are some similarities between Bidenâs and Trumpâs plans to combat antifungal medication, experts told us any diflucan response plan should have certain core strategies.
The Trump administration has released no comprehensive plan to battle the disease, except with regard to the development and distribution of treatments. Trumpâs main intervention was implementing travel restrictions, while efforts to roll out a widespread testing plan faced difficulties.Biden released a public antifungal medication plan. The first draft was published March 12. It included public health measures such as deploying free testing and personal protective equipment, as well as implementing economic measures such as emergency paid leave and a state and local emergency fund.Trump.
ÂAs you know, 2.2 million people were expected to die. We closed the greatest economy in the world to fight this horrible disease that came from China.âHis claim about the estimated deaths rates Mostly False. Trump frequently refers to this number to claim that his administrationâs moves saved 2 million lives. However, the number is from a mathematical model that hypothesized what would happen if, during the diflucan in the U.S., neither people nor governments changed their behaviors, a scenario that experts considered unrealistic.
The U.S. Has the highest death toll from antifungal medication of any country, and one of the highest death rates. Also, credit for shutting down the economy doesnât go primarily to Trump, but rather to states and local jurisdictions. In fact, Trump encouraged states to open back up beginning in May, even when there were high rates of antifungal medication transmission in those areas.Trump.
ÂWe cannot lock ourselves in a basement like Joe does.âWe rated a similar claim False. It is one of Trumpâs favored shots to say Biden isolated himself in his basement. In the first few months of the diflucan, Biden did run much of his campaign from his Delaware home. He built a TV studio in his basement to interact with voters virtually.
But that changed.In September alone, Biden gave remarks and held events in, among other places, Kenosha, Wisconsin. Lancaster, Pennsylvania. Warren, Michigan. Tampa, Florida.
And Charlotte, North Carolina. We counted 14 locations.Trump. Said of Dr. Anthony Fauci, âI think heâs a Democrat, but thatâs OK.âThis is wrong.
Fauci, director of the National Institute of Allergy and Infectious Diseases, is not affiliated with a political party. He hasnât endorsed any parties or candidates.Biden. ÂWe are in a circumstance where the president still has no plan, no comprehensive plan.âThis is largely accurate. When Biden claimed during the first debate that Trump âstill wonât offer a plan,â we noted the Trump administrationâs âOperation Warp Speedâ for treatment development as well as its more detailed plan for treatment distribution.
But the administration has not released a comprehensive plan to address antifungal medication.Trump. ÂThere was a spike in Florida. That is gone. There was a spike in Texas.
That is gone. There was a spike in Arizona. It is gone.â This is inaccurate. Over the summer, Florida, Texas and Arizona experienced record surges in cases that later eased â but now they are all seeing new surges.
Over the past week, The New York Timesâ tracker notes, as of Friday, new s are up 37% in Florida, 13% in Texas and 47% in Arizona, from the average two weeks earlier.Trump. ÂWhen I closed [travel from China], he said I should not have closed. ¦ He said this is a terrible thing, you are a xenophobe. I think he called me racist.
Now he says I should have closed it earlier.âMostly False. Joe Biden did not directly say he thought Trump shouldnât have restricted travel from China to stem the spread of the antifungals.Biden did accuse Trump of âxenophobiaâ in an Iowa campaign speech the same day the administration announced the travel restrictions â Jan. 31 â but his campaign said that his remarks were not related and that he made similar comments before the restrictions were imposed. Biden didnât take a definitive stance on the subject until April 3, when his campaign said he supported Trumpâs decision to impose travel restrictions on China.Trump.
ÂThey have 180 million people, families under what he wants to do, which will basically be socialized medicine â you wonât even have a choice â they want to terminate 180 million plans.â Pants on Fire. About 180 million people have private health insurance. But there is absolutely no evidence that under Bidenâs health care proposal all 180 million would be removed from their insurance plans. Biden supports creating a public option, which would be a government-run insurance program that would exist alongside and compete with other private plans on the health insurance marketplace.Under Bidenâs plan, even people with employer-sponsored coverage could choose a public plan if they wanted to.
And estimates show that only a small percentage of Americans would likely leave their employer-sponsored coverage if a public option were available, and certainly not all 180 million. Experts said it is not socialized medicine.Biden. ÂNot one single person with private insuranceâ lost their insurance âunder Obamacare ⦠unless they chose they wanted to go to something else.âThis is inaccurate. This is a variation of a claim that earned President Barack Obama our Lie of the Year in 2013.
The Affordable Care Act tried to allow existing health plans to continue under a complicated process called âgrandfathering,â but if the plans deviated even a little, they would lose their grandfathered status. And if that happened, insurers canceled plans that didnât meet the new standards.No one determined with any certainty how many people got cancellation notices, but analysts estimated that about 4 million or more had their plans canceled. Many found insurance elsewhere, and the percentage was small â out of a total insured population of about 262 million, fewer than 2% lost their plans. However, that still amounted to 4 million people who faced the difficulty of finding a new plan and the hassle of switching their coverage.This story includes reporting by KHN reporters Victoria Knight and Emmarie Huetteman, and Jon Greenberg, Louis Jacobson, Amy Sherman, Miriam Valverde, Bill McCarthy, Samantha Putterman, Daniel Funke and Noah Y.
Kim of PolitiFact. Related Topics Elections Insurance Public Health The Health Law antifungal medication KHN &. PolitiFact HealthCheck Obamacare Plans Private Insurance Trump AdministrationThis story also ran on MinnPost. This story can be republished for free (details). Molly Wiese was truly stumped. Her parents and siblings live in Southern California, and Wiese, a 35-year-old lawyer, has returned home every Christmas since she moved to Minnesota in 2007.Because of the diflucan, Wiese thought it would be wiser to stay put for once.
But in June, Wieseâs father was diagnosed with stage 4 cancer, and they feared this could be his final holiday season.Should she fly with her husband and two young sons to California, putting her immunocompromised father at risk of antifungal medication?. Or stay home and miss out on making treasured holiday memories with her parents and children?. Her children are in day care, and Wieseâs husband works at a school. They donât have enough vacation time to self-quarantine before or after a flight, and driving eight days round trip isnât practical.She fears giving her father antifungals.
But her parents, who live in the Inland Empire city of Yucaipa, believe itâs worth the risk to see Wieseâs children and have âour normal Christmas,â she said.âIdeally, weâd have a treatment,â she said. ÂBut I donât think thatâs a realistic expectation.â Pfizer, the apparent leader in the antifungal medication treatment race, says it wonât even be ready to apply for treatment approval until late November at the earliest.Molly Wieseâs father has late-stage cancer and she fears this could be his last holiday season. She struggled with whether she and her family should fly to Southern California to visit him for Christmas because she doesnât want to put him at risk of contracting antifungal medication. From left.
Molly Wiese, son Calvin, husband Phil Wiese, son Bennett, and Wieseâs parents, Becky and Bill Miller. (Molly Wiese)While Wieseâs conundrum is especially high-stakes, her story illustrates the tough decision millions of Americans are facing about whether and how to travel for the winter holidays.The best way to avoid spreading disease would be to avoid traveling or widening oneâs social circles. For local celebrations, self-quarantining for two weeks before a holiday event would minimize risk if all those invited committed to doing the same. But some people have to work outside the home.For everyone, after at least seven months of being mostly sequestered, the winter holidays pose an almost insurmountable temptation.
Even public health and infectious disease experts recognize the dilemma.âThereâs so much to be gained by physical touch, by being in that room and not in a two-dimensional Zoom or FaceTime screen,â said Dr. Peter Chin-Hong, an infectious disease specialist and professor of medicine at the University of California-San Francisco. ÂAnd even to embrace, with the right preparation.âDr. Anthony Fauci, the nationâs authority on infectious diseases at the National Institutes of Health, isnât immune to the problem.
He told PRIâs âThe Worldâ on Oct. 13 that he and his three adult daughters, each living in a different state, were still deciding whether being together would be âworth it.âThe next day, Fauci told âCBS Evening Newsâ that his familyâs Thanksgiving reunion was off, given the risks posed by air travel. ÂYou may have to bite the bullet and sacrifice that social gathering, unless youâre pretty certain that the people that youâre dealing with are not infected,â he said.Dr. Robert Redfield, director of the Centers for Disease Control and Prevention, and Dr.
Deborah Birx, the Trump administrationâs senior coordinator in the antifungal medication fight, have both warned that Thanksgiving gatherings could spread the diflucan. Email Sign-Up Subscribe to KHNâs free Morning Briefing. In California, public health officials are taking a âharm reductionâ approach. They arenât encouraging multi-household gatherings, but theyâve issued guidelines to make get-togethers safer if they happen outdoors and last less than two hours.Officials in Los Angeles County, which has seen transmission rates increase in recent weeks, released similar guidance, acknowledging that people separated from their loved ones for months increasingly yearn for that contact.âWe are threading the needle here, but I think it is appropriate for us to try to do some of the activities that people are desperate to be able to do, with absolute adherence to the guidance,â Barbara Ferrer, director of the countyâs public health department, said at an Oct.
14 news conference.Around the world, national holidays have fueled the spread of antifungal medication in explosive ways. In China, where the diflucan started, an estimated 5 million people traveling for Chinese New Year left Wuhan, the epicenter of the outbreak, before a travel ban was enacted. In Iran, the diflucan was aided by Nowruz, a two-week spring celebration that prompted millions to travel. In Israel, parties and religious gatherings for Purim caused widespread transmission in late March.Memorial Day, Fourth of July and Labor Day celebrations fueled surges in the United States, which is why Thanksgiving frightens public health officials.
Last year, more than 55 million people were expected to travel during the days surrounding that fourth Thursday in November.Nevertheless, officials across the nation are using a light touch when it comes to warnings.In Minnesota, where Wiese lives and cases are hitting record highs, officials urge the public to avoid crowded stores and large indoor gatherings with other households, but say outdoor Thanksgiving dinners with local friends and family are less risky. Their guidance doesnât explain how to endure an outdoor Thanksgiving in Minnesota. The average high in Minneapolis on Nov. 26 is 33 degrees.Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, is waving his hands to stop the game.If you canât self-quarantine for 10 to 14 days before the event â that is, no contact with people besides members of your household who are also quarantining â donât go to another householdâs Thanksgiving dinner, he said.
The state has already seen too many examples of vulnerable people becoming sick and dying after attending weddings, funerals and birthday parties.âLet this be your antifungal medication year,â Osterholm said. ÂItâs a very challenging year, but you donât want to introduce this diflucan into family settings and experience the consequences.âOsterholm and his partner will spend Thanksgiving and Christmas without extended family, even though their children and grandchildren are all local. Because all his grandchildren are in day care or school, there isnât enough time for their families to self-quarantine before enjoying a holiday meal together.He was sympathetic to Wieseâs âcompellingâ plight. If she decides to fly to California, he said, she should sequester her family as much as possible for 10 days beforehand, then spend no more than two days with her father.âEven if she got infected, she wouldnât be most infectious until probably day three,â he said.
ÂSo if she spends those two days with him, she can feel relatively good about the fact that she didnât put them at risk.âFor those who do travel, driving is much safer than flying because drivers can be isolated in a household pod and avoid exposure to the antifungals by forgoing restaurants and by disinfecting bathroom and gas pump handles before touching them.Dr. Iahn Gonsenhauser, chief quality and patient safety officer for the Ohio State Universityâs Wexner Medical Center, said he plans to drive with his family â overnighting at a hotel on the way â to spend Thanksgiving with his sisterâs family in Colorado.He and his family keep to themselves and work from home as much as possible, leaving the house only for groceries and basic errands while eschewing restaurants and malls, he said. If anyone in either family began showing antifungal medication symptoms, or had confirmed exposure to a antifungal medication-positive person, the whole trip would be called off instantly.âThis is why we make all plans with a refundable reservation,â he said. ÂIf people have no way of backing out of their reservations, theyâre more inclined to push through an apparent risk.âChin-Hong offered this advice for holiday flyers.
Get tested before the flight for peace of mind, buy tickets on a plane that is leaving middle seats empty, use highly protective N95 masks and possibly face shields, and blast the individual airplane vents directly onto each family member to disrupt potential diflucan particles. And, of course, wash your hands frequently.Chin-Hong is taking that approach on a planned family trip to New York City to visit his mother, who is in her 80s and wants to see her son, daughter-in-law and grandchildren. Every visit they have could be their last, Chin-Hong said.âTo me, the risk-benefit ratio really supports me going to see her.âAfter hearing the advice from Chin-Hong and other infectious disease experts, Wiese decided last weekend to buy plane tickets to visit her parents.âIt really did help us make a decision that was giving me a lot of anxiety,â she said. Anna Almendrala.
aalmendrala@kff.org, @annaalmendrala Related Topics Public Health States antifungal medication.
ÂTrump is pushing to slash purchase diflucan over counter Medicare benefits.ââ Digital and TV campaign ad, Oct. 9, 2020 This story purchase diflucan over counter was produced in partnership with PolitiFact. This story can be republished for free (details). Itâs a tried-and-true campaign strategy.Candidates go on the attack, claiming their opponent will do harm to Medicare. After all, people 65 and older purchase diflucan over counter are good about making it to the polls on Election Day. These voters are also generally motivated to protect the federal health insurance program for seniors.Itâs no surprise, then, that in an ad released this month, former Vice President Joe Bidenâs campaign played the Medicare card.âDonald Trump is lying about Medicare and Social Security,â an ominous, mature, male voice warns viewers in the ad.
He goes on to say that âTrumpâs pushing to slash Medicare benefits.âClearly, weâve heard this dire message before â from purchase diflucan over counter candidates of both parties through the years. Email Sign-Up Subscribe to KHNâs free Morning Briefing. We issued a skeptical rating of a claim that Trump promised to gut Social Security and Medicare if re-elected, noting that his deferral of payroll taxes did not purchase diflucan over counter mention Medicare at all. But Trump has not mentioned cuts to Medicare benefits on the trail, and heâs promised to make cuts to the program in the future. So what is Bidenâs purchase diflucan over counter claim talking about?.
As a rationale for the statement, a Biden campaign spokesperson pointed us to the Trump administrationâs support of Republicansâ efforts in a court case, California v. Texas, which purchase diflucan over counter seeks to overturn the Affordable Care Act. But the ad does not include any reference or explanation of how the case would affect Medicare benefits.The legal challenge, brought by a group of Republican attorneys general, is pegged to the 2017 tax bill, which zeroed out the tax that functioned as a penalty for not having health coverage â known as the individual mandate. Without this linchpin tax, the Republicans argue, the entire law should be struck down purchase diflucan over counter. They based that on the Supreme Court decision in 2012 that the law was constitutional because the penalty was a valid use of Congressâ ability to levy taxes.In the current case, lower courts have found the law unconstitutional, and a group of Democratic attorneys general appealed to the Supreme Court.Oral arguments are scheduled for Nov.
10. The Trump administration filed a brief in support of invalidating the entire law unconstitutional.Though best known for its vast expansion of health coverage through marketplace plans and Medicaid, the ACA also included a range of consumer protections â such as the ban on discrimination against people with preexisting conditions â and an estimated 165 Medicare-related provisions.The Biden spokesperson pointed to one, which ended Medicareâs so-called doughnut hole.We asked experts for their take. Immediately, we found differences in opinion.Thatâs a âperfectly fair claim,â said Nicholas Bagley, a professor at the University of Michigan Law School. Closing the doughnut hole matters to many people, he said.Case Western Reserve University law professor Jonathan Adler took a different view. The argument that Medicare would be affected âis a very aggressive reading of the filing in this case,â he said, referring to the Trump administrationâs brief in support of nullifying the ACA.The next step seemed to be getting a better grasp of whatâs at stake.A Quick Review of the Doughnut Hole, Other Medicare ProvisionsThe Medicare doughnut hole refers to the gap in Part D prescription drug coverage that begins after a beneficiary spends a set amount â usually a few thousand dollars.
Before the ACA, beneficiaries who reached that threshold were responsible for 100% of their medication costs until they spent enough for catastrophic coverage to kick in, which could be more than $1,000 in additional spending. Even with this coverage, beneficiaries were responsible for 5% of their drug expenditures. (If beneficiaries were responsible for 100% of costs today, people with high drug costs would obviously pay a lot more without the ACA provision.)The ACA would have gradually ended that coverage gap. But, in 2018, Congress adopted changes to expedite the process. As of 2019, the doughnut hole was closed.
Adler pointed to that congressional intervention as a step that could keep the doughnut hole closed if the ACA were overturned. Based on this legislative history, the argument could be made that closing the coverage gap was something Congress had an interest in apart from the ACA. Since the doughnut hole is officially closed, some analysts said this provision may not be vulnerable to the upcoming Supreme Court decision on the ACA. Sources: Biden campaign ad âClear Choice,â released Oct. 9, 2020Email exchanges with Biden campaign spokesperson, Oct.
12, 2020Telephone interview, email correspondence with Tricia Neuman, KFF senior vice president and executive director of the KFFâs program on Medicare policy, Oct. 13, 2020Telephone interview with Nicholas Bagley, professor at the University of Michigan Law School, Oct. 15, 2020Telephone interview with Jonathan Adler, professor at the Case Western Reserve University School of Law, Oct.16, 2020Telephone interview with Paul Van de Water, senior fellow at the Center on Budget and Policy Priorities, Oct. 19, 2020Telephone interview with David Lipschutz, associate director of the Center for Medicare Advocacy, Oct. 20, 2020Telephone interview with Gail Wilensky, senior fellow at Project Hope, Oct.
20, 2020Medicare.gov, accessed Oct. 12KFF, Closing the Medicare Part D Coverage Gap. Trends, Recent Changes, and Whatâs Ahead, Aug. 21, 2018National Committee to Preserve Social Security and Medicare, Overturning the ACA Would Harm Medicare, June 29, 2020Center on Budget and Policy Priorities, Striking Down ACA Would Weaken Medicare, July 8, 2019KHN, Without Ginsburg, Judicial Threats to the ACA, Reproductive Rights Heighten, Sept. 21, 2020KHN, Doughnut Hole Is Gone, But Medicareâs Uncapped Drug Costs Still Bite Into Budgets, March 29, 2019U.S.
Census Bureau, Voter Turnout Rates Among All Voting Age and Major Racial and Ethnic Groups Were Higher Than in 2014, April 23, 2019U.S. Census Bureau, Voting in America. A Look at the 2016 Presidential Election, May 10, 2017Statista, Voter Turnout Rates* Among Selected Age Groups in U.S. Midterm Elections From 1966 to 2018, July 10, 2020U.S. News &.
World Report, Why Older Citizens Are More Likely to Vote, Oct. 5, 2020KFF, Health Tracking Poll â October 2020. The Future of the ACA and Bidenâs Advantage on Health Care, Oct. 16, 2020State of California, et al., Petitioners v. State of Texas, et al., Brief for the Federal Respondents, June 25, 2020AARP, AARP Foundation, Center for Medicare Advocacy and Justice in Aging, Brief of Amici Curiae in Support of Petitioners in No.
19-840 and Non-Executive Branch Respondents in No. 19-1019 âYou can make a lot of claims,â said Gail Wilensky, a former head of the Centers for Medicare &. Medicaid Services. ÂThat one is really a stretch.âOther ACA provisions tied to Medicare benefits seem more at risk, such as the one that mandated annual wellness visits and certain preventive services, such as mammograms, bone mass measurement for those with osteoporosis, and depression and diabetes screening, with no patient cost sharing.âItâs not clear that the administration actively supports any change to the Medicare benefits with the case before SCOTUS,â said Tricia Neuman, KFF senior vice president and executive director of the KFFâs program on Medicare policy. ÂBut if they didnât explicitly seek to wall off certain provisions, it is at least conceivable â though maybe not likely â that Medicare benefits in the ACA could be collateral damage.â (KHN is an editorially independent program of KFF.)According to an amicus brief filed by the AARP, the Center for Medicare Advocacy and Justice in Aging in 2016, an estimated 40.1 million Medicare beneficiaries received at least one preventive service and 10.3 million had an annual wellness visit with no copay or deductible.Other experts pointed to a troubling implication for Medicare.
The nullification of the ACA provisions related to costs and slowing the growth of the programâs spending. Those efforts had been credited with extending the solvency of the Health Insurance Trust Fund and slowing the growth in Medicare premiums.It âwould impair the financial fitnessâ of the trust fund, said Paul Van de Water, a senior fellow at the Center on Budget and Policy Priorities.Trump âmay not say it is his intent to slash Medicare benefits,â agreed David Lipschutz, associate director of the Center for Medicare Advocacy, but overturning the ACA entirely would âcause chaos writ large.â And, because of the programâs size, that chaos âwould upend the financial markets and the entire health care system,â according to the brief filed by Medicare advocates.What Comes Next Is ComplicatedEnter the concept of severability. Many court watchers are quick to say the high courtâs decision could go beyond upholding the entire law or declaring it unconstitutional. Instead, the justices could separate or sever parts of it not directly related to the zeroed-out tax penalty, the so-called individual mandate.Of course, the Trump administration argued in its brief that the interwoven nature of the ACAâs provisions demanded that the entire law be invalidated.âIf you just go on that basis, they are not arguing for severability,â said Van de Water.But others point out another layer that warrants consideration.âEveryone who comments on this focuses on the administrationâs argument for inseverability,â Adler said. But he said it was more complicated than that.The Trump administrationâs position is âsimultaneously that the entire ACA should be invalidatedâ and also that relief should be provided only where injury to the plaintiffs is shown.
(The administration defines the plaintiffs as the two individuals who signed on to the original challenge.)Another view is that this point in the administrationâs argument is not clear-cut, mostly because it gives no hint as to which programs or provisions would fit into the category of harming the plaintiffs.Ultimately, the fate of the sweeping health law is in the hands of the Supreme Court.âLegal analysts didnât anticipate the case getting as far as it has,â said Lipschutz.But âthe White House threw its weight behind the lawsuit,â said Bagley, at the University of Michigan. ÂSo, they own the consequences. Especially in the context of this presidential campaign.âOur RulingAn attack ad by the Biden campaign states that Trump is âpushing to slash Medicare benefitsâ and ties this charge to the administrationâs position on the pending legal challenge to the ACA.The Biden campaign pointed to an ACA provision that sought to close the Medicare doughnut hole to support this claim. It may not be the best example, though, because some experts suggest it may not be as vulnerable as other parts of the law.Experts outlined a range of other Medicare provisions that either provided new benefits or shored up the programâs financial fitness. If the whole law were to be nullified, as the administration has advocated, these changes could also be erased â a step that would affect benefits and potentially cause premiums to rise.Overall, the Biden ad seems plausible, even though the link between Trumpâs position on the legal challenge and its impact on Medicare benefits is less straightforward than in similar claims we have checked regarding preexisting conditions.We rate the claim Half True.
Related Topics Elections Medicare The Health Law KHN &. PolitiFact HealthCheck Trump AdministrationSOBRE NOTICIAS EN ESPAÃOLNoticias en español es una sección de Kaiser Health News que contiene traducciones de artÃculos de gran interés para la comunidad hispanohablante, y contenido original enfocado en la población hispana que vive en los Estados Unidos. Use Nuestro Contenido Este contenido puede usarse de manera gratuita (detalles). Molly Wiese estaba perpleja. Sus padres y hermanos viven en el sur de California, y Wiese, abogada de 35 años, ha viajado cada Navidad desde que se mudó a Minnesota en 2007.Por la pandemia, Wiese pensó que esta vez serÃa más prudente quedarse.
Pero en junio, el padre de Wiese fue diagnosticado con cáncer en estadio 4 y la familia teme que éstas sean sus últimas fiestas. ¿DeberÃa volar con su esposo y sus dos hijos pequeños a California, poniendo a su padre inmunodeprimido en riesgo de antifungal medication?. ¿O quedarse en casa y perderse la oportunidad de crear recuerdos de estas fiestas?. Sus hijos están en la guarderÃa y el marido de Wiese trabaja en una escuela. No tienen suficiente tiempo de vacaciones para ponerse en cuarentena antes o después de un vuelo, y conducir ocho dÃas de ida y vuelta está fuera de discusión.Teme transmitirle el antifungals a su padre.
Pero sus padres, que viven en la ciudad de Yucaipa de Inland Empire, creen que vale la pena correr el riesgo de ver a sus nietos y tener ânuestra Navidad normalâ, contó Wiese.âIdealmente, tendrÃamos una vacunaâ, dijo. ÂPero no creo que sea una expectativa realistaâ. Pfizer, el aparente lÃder en la carrera para una vacuna contra antifungal medication, dice que ni siquiera estará listo para solicitar la aprobación hasta fines de noviembre, como muy pronto.El padre de Molly Wiese tiene cáncer avanzado y Wiese teme que ésta sea su última temporada de fiestas. Pero duda en viajar al sur de California para visitar a su familia, por temor de ponerlo en riesgo de contraer antifungal medication. De izquierda a derecha.
Molly Wiese, su hijo Calvin, su esposo Phil Wiese, su hijo Bennett, y sus padres, Becky y Bill Miller. (Molly Wiese)Si bien el enigma de Wiese es especialmente importante, su historia ilustra la difÃcil decisión a la que se enfrentan millones de estadounidenses sobre si viajar o no durante las vacaciones de invierno, y cómo hacerlo.La mejor forma de evitar la propagación de enfermedades serÃa evitar los viajes o ampliar los cÃrculos sociales. Para las celebraciones locales, la cuarentena durante dos semanas antes de un evento festivo minimizarÃa el riesgo, pero solo si todos los comensales se comprometieran a seguirla. Pero algunas personas tienen que trabajar fuera de casa.Después de al menos siete meses de estar prácticamente encerrados, las vacaciones de invierno representan una tentación casi insuperable. Incluso expertos en salud pública y enfermedades infecciosas reconocen el dilema.âHay mucho que ganar con el contacto fÃsico, en la misma sala y no en una pantalla de Zoom o FaceTimeâ, dijo el doctor Peter Chin-Hong, especialista en enfermedades infecciosas y profesor de medicina en la Universidad de California-San Francisco.El doctor Anthony Fauci, la autoridad nacional en enfermedades infecciosas en los Institutos Nacionales de Salud, no es inmune al problema.
El 13 de octubre, le dijo a âThe Worldâ que él y sus tres hijas adultas, que viven en distintos estados, todavÃa estaban decidiendo si estar juntos âvaldrÃa la penaâ.Al dÃa siguiente, Fauci le dijo a âCBS Evening Newsâ que la reunión de Acción de Gracias de su familia estaba cancelada, dados los riesgos que plantean los vuelos. ÂPuede que tenga que sacrificar esa reunión social, a menos que esté bastante seguro de que las personas con las que está tratando no están infectadasâ, dijo.El doctor Robert Redfield, director de los Centros para el Control y Prevención de Enfermedades (CDC), y la doctora Deborah Birx, coordinadora del equipo de respuesta a antifungal medication de la administración Trump, advirtieron que las reuniones de Thanksgiving podrÃan propagar el diflucan.En California, funcionarios de salud pública están adoptando un enfoque de âreducción de dañoâ. No están fomentando las reuniones de varias familias, pero han emitido pautas para hacer que las reuniones sean más seguras si se realizan al aire libre y duran menos de dos horas.Funcionarios del condado de Los Ãngeles, que ha visto un aumento en las tasas de transmisión en las últimas semanas, publicaron una guÃa similar, reconociendo que las personas separadas de sus seres queridos durante meses anhelan cada vez más ese contacto.âEstamos tratando de encontrar un balance, pero creo que es apropiado que intentemos llevar a cabo algunas de las actividades que la gente está desesperada por poder hacer, con total apego a la guÃaâ, dijo Barbara Ferrer, directora de del departamento de salud pública del condado, en una conferencia de prensa el 14 de octubre.En todo el mundo, los feriados nacionales han impulsado la propagación de antifungal medication de manera explosiva. En China, donde comenzó la pandemia, se estima que 5 millones de personas que viajaban por el Año Nuevo chino abandonaron Wuhan, el epicentro del brote, antes de que se promulgara una prohibición de viajar.En Irán, la pandemia se impulsó por Nowruz, una celebración de primavera de dos semanas durante la que viajan millones. En Israel, las fiestas y reuniones religiosas de Purim provocaron una transmisión generalizada a fines de marzo.Las celebraciones de Memorial Day, el 4 de julio y el DÃa del Trabajo impulsaron aumentos repentinos de casos en los Estados Unidos, por eso el DÃa de Acción de Gracias asusta a los funcionarios de salud pública.El año pasado, viajaron más de 55 millones de personas durante los dÃas que rodearon ese cuarto jueves de noviembre.Sin embargo, funcionarios de todo el paÃs están siendo suaves cuando se trata de advertencias.En Minnesota, donde vive Wiese y los casos están alcanzando niveles récord, funcionarios instan al público a evitar las tiendas abarrotadas y las grandes reuniones en interiores con varias familias.Pero dicen que las cenas de Acción de Gracias al aire libre con amigos y familiares locales son menos riesgosas.
Su guÃa no explica cómo tolerar un DÃa de Acción de Gracias al aire libre en Minnesota. La temperatura máxima promedio en Minneapolis el 26 de noviembre es de 33 grados.Michael Osterholm, director del Centro de Investigación y PolÃtica de Enfermedades Infecciosas de la Universidad de Minnesota, dice âparemos un pocoâ.Osterholm explicó que si no puedes ponerte en cuarentena durante 10 a 14 dÃas antes del evento, es decir, sin contacto con personas además de los miembros de tu hogar que también están en cuarentena, no vayas a la cena de Acción de Gracias en otra casa. El estado ya ha visto demasiados ejemplos de personas vulnerables que se enferman y mueren después de asistir a bodas, funerales y cumpleaños.âQue este sea tu año antifungal medicationâ, dijo Osterholm. ÂEs un año muy desafiante, pero no quieres introducir este diflucan en entornos familiares y experimentar las consecuenciasâ.Osterholm y su pareja pasarán el DÃa de Acción de Gracias y la Navidad sin familiares, a pesar de que sus hijos y nietos son todos locales. Debido a que todos sus nietos están en la guarderÃa o en la escuela, no hay suficiente tiempo para que sus familias se pongan en cuarentena antes de disfrutar juntos de una comida navideña.Sintió empatÃa con la difÃcil situación de Wiese.
Si decide volar a California, dijo, deberÃa acuartelar a su familia lo más posible durante 10 dÃas antes, y luego no pasar más de dos dÃas con su padre.âIncluso si se infectara, no serÃa más contagiosa hasta probablemente el tercer dÃaâ, dijo. ÂEntonces, si ella pasa esos dos dÃas con él, puede sentirse relativamente bien por el hecho de que no los puso en riesgoâ.Para aquellos que viajan, conducir es mucho más seguro que volar porque los conductores pueden estar aislados en un compartimento doméstico y evitar la exposición al antifungals renunciando a los restaurantes y desinfectando las manijas del baño y la bomba de gasolina antes de tocarlos.El doctor Iahn Gonsenhauser, director de calidad y seguridad del paciente del Centro Médico Wexner de la Universidad Estatal de Ohio, dijo que planea conducir con su familia, pasando la noche en un hotel en el camino, para pasar el DÃa de Acción de Gracias con la familia de su hermana en Colorado.Ãl y su familia se mantienen aislados y trabajan desde casa tanto como sea posible, dejando la casa solo para compras y mandados básicos mientras evitan restaurantes y centros comerciales, dijo. Si alguien en cualquiera de las familias comenzara a mostrar sÃntomas de antifungal medication, o confirmara la exposición a una persona con antifungal medication positivo, todo el viaje se cancelarÃa instantáneamente.âEs por eso que hacemos todos los planes con una reserva reembolsableâ, dijo. ÂSi las personas no tienen forma de salirse de sus reservas, están más inclinadas a tomar un riesgo aparenteâ.Chin-Hong ofreció este consejo para los viajeros de vacaciones. Házte la prueba antes del vuelo para tu tranquilidad, compra boletos en un avión que deje los asientos del medio vacÃos, usa máscaras N95 altamente protectoras y escudos faciales, y coloca las rejillas de ventilación individuales del avión directamente sobre cada miembro de la familia para romper las posibles partÃculas de diflucan.
Y, por supuesto, lávate las manos con frecuencia.Chin-Hong está adoptando ese enfoque en un viaje familiar planificado a la ciudad de Nueva York para visitar a su madre, que tiene más de 80 años y quiere ver a su hijo, nuera y nietos. Cada visita podrÃa ser la última, dijo Chin-Hong.âPara mÃ, la relación riesgo-beneficio apoya la idea ir a verlaâ.Después de escuchar los consejos de Chin-Hong y otros expertos en enfermedades infecciosas, Wiese decidió el fin de semana pasado comprar boletos de avión para visitar a sus padres.âRealmente nos ayudó a tomar una decisión que me estaba dando mucha ansiedadâ, expresó. Anna Almendrala. aalmendrala@kff.org, @annaalmendrala Related Topics Noticias En Español Public Health States antifungal medication LatinosâThey have 180 million people, families under what he wants to do, which will basically be socialized medicine â you wonât even have a choice â they want to terminate 180 million plans.âPresident Donald Trump during the presidential debate, Oct. 22, 2020 During the final presidential debate, President Donald Trump claimed that 180 million people would lose their private health insurance to socialized medicine if the Democratic presidential nominee, former Vice President Joe Biden, is elected president.âThey have 180 million people, families under what he wants to do, which will basically be socialized medicine â you wonât even have a choice â they want to terminate 180 million plans,â said Trump.Trump has repeated this claim throughout the week, and we thought the linkage of Bidenâs proposed health care plan with socialism was something we needed to check out.
Especially since Biden opposed âMedicare for All,â the proposal by Sen. Bernie Sanders (I-Vt.) that would have created a single-payer health system run completely by the federal government, and has long been attacked by Republicans as âsocialist.â Email Sign-Up Subscribe to KHNâs free Morning Briefing. The Trump campaign did not respond to our request asking where the evidence for this claim came from. Experts called it a distortion of Bidenâs plan.Where the Number Comes FromExperts agreed the number of people who have private health insurance either through an employer-sponsored plan or purchased on the Affordable Care Actâs health insurance marketplace is around 180 million people.KFF, a nonpartisan health policy organization, estimated in 2018 that about 157 million Americans had health insurance through their employer, while almost 20 million had insurance they purchased for themselves. Together, that adds up to about 177 million with private health insurance.
(KHN is an editorially independent program of KFF.)What Does Biden Support?. Biden supports expanding the ACA through several measures, including a public option. Under his plan, this public option would be a health insurance plan run by the federal government that would be offered alongside other private health insurance plans on the insurance marketplace.âThe marketplace is made up of multiple insurers in areas,â said Linda Blumberg, a health policy fellow at the Urban Institute. ÂSometimes there are five or more [plans]. Sometimes there is only one.
Biden is talking about adding a public option in the marketplace. You could pick between these private insurers or you could pick the public option.âGetting rid of the so-called employer firewall is also part of Bidenâs proposal.This firewall was implemented during the rollout of the ACA. It was designed to maintain balance in the insurance risk pools by preventing too many healthy people who have work-based coverage from opting instead to move to a marketplace plan. And it all came down to who qualified for the subsidies that made these plans more affordable.Currently, those who are offered a health insurance plan through their employer that meets certain minimum federal standards arenât eligible to receive these subsidies, which come in the form of tax credits. But that leaves many low-income workers with health care plans that arenât as affordable or comprehensive as marketplace plans.Bidenâs plan would eliminate that firewall, meaning anyone could choose to get health insurance either through their employer or through the marketplace.
Thatâs where many Republicans argue that we could start to see leakage from private health insurance plans to the public option.âThe problem is healthy people leaving employer plans,â said Joseph Antos, a scholar in health care at the conservative-leaning American Enterprise Institute. That could mean the entire workplace planâs premiums would go up. ÂYou could easily imagine a plan where it spirals, the premiums go up, and then even more people start leaving the plans to go to the public option.âBlumberg, though, said that because the marketplace would still include private health insurance plans alongside the public option, it doesnât mean everyone who chooses to leave their employer plan would go straight to the public option.She has done estimates based on a plan similar to the one Biden is proposing. She estimates that only about 10% to 12% of Americans would choose to leave their employer-sponsored plans, which translates to about 15 million to 18 million Americans. Source List: Email interview with Cynthia Cox, vice president and director for the Program on the ACA at KFF, Oct.
22, 2020Email interview with Larry Levitt, executive vice president for health policy at KFF, Oct. 22, 2020Email interview with Sabrina Corlette, co-director of the Center on Health Insurance Reforms at Georgetown University, Oct. 22, 2020KFF, âHealth Insurance Coverage of the Total Population,â Accessed Oct. 22, 2020KFF, âAffordability in the ACA Marketplace Under a Proposal Like Joe Bidenâs Health Plan,â Sept. 28, 2020Phone interview with Joseph Antos, Wilson H.
Taylor resident scholar in health care and retirement policy at the American Enterprise Institute, Oct. 22, 2020Phone interview with Linda Blumberg, institute fellow in the Health Policy Center at the Urban Institute, Oct. 22, 2020Rev.com, âDonald Trump &. Joe Biden Final Presidential Debate Transcript 2020,â Accessed Oct. 23, 2020Twitter, Donald Trump tweet, Oct.
21, 2020Urban Institute, âThe Healthy America Program, an Update and Additional Options,â Sept. 2019Urban Institute, âFrom Incremental to Comprehensive Health Insurance Reform. How Various Reform Options Compare on Coverage and Costs,â Oct. 2019 KFF also did an estimate and found that 12.3 million people with employer coverage could save money by buying on the exchange under the Biden plan.But âitâs not clear all of those people would choose to leave their employer coverage, though, as there are other reasons besides costs that people might want to have job-based insurance,â Cynthia Cox, vice president and director of the program on the ACA at KFF, wrote in an email.Either way, none of the estimates are anywhere close to the 180 million that Trump claimed.Is This Type of Public Option Socialism?. Overall, experts said no, what Biden supports isnât socialized medicine.âSocialized medicine means that the government runs hospitals and employs doctors, and that is not part of Bidenâs plan,â Larry Levitt, executive vice president for health policy at KFF, wrote in an email.
ÂUnder Bidenâs plans, doctors and hospitals would remain in the private sector just like they are today.âHowever, Antos said that, in his view, the definition of socialism can really vary when it comes to health care.âI would argue in one sense, we would already have socialized medicine. We have massive federal subsidies for everybody, so in that sense, weâre already there,â said Antos. ÂBut, if socialized medicine means the government is going to dictate how doctors practice or how health care is delivered, we are obviously not in that situation. I donât think the Biden plan would lead you that way.âAnd in the end, Antos said, invoking socialism is a scare tactic that politicians have been using for years.âItâs just a political slur,â said Antos. ÂItâs meant to inflame the emotions of those who will vote for Trump and meant to annoy the people who will vote for Biden.âOur Ruling Trump said 180 million people would lose their private health insurance plans to socialized medicine under Biden.While about 180 million people do have private health insurance, there is no evidence that all of them would lose their private plans if Biden were elected president.Biden supports implementing a public option on the health insurance marketplace.
It would exist alongside private health insurance plans, and Americans would have the option to buy either the private plan or the public plan. While estimates show that a number of Americans would likely leave their employer-sponsored coverage for the public plan, they would be doing that by choice and the estimates are nowhere near Trumpâs 180 million figure.Experts also agree that the public option is not socialized medicine, and itâs ridiculous to conflate Bidenâs plan with Medicare for All.We rate this claim Pants on Fire. Victoria Knight. vknight@kff.org, @victoriaregisk Related Topics Elections Insurance The Health Law KHN &. PolitiFact HealthCheck Obamacare Plans Private InsuranceIn the second and final debate of the 2020 presidential race, President Donald Trump and former Vice President Joe Biden sparred over Trumpâs handling of the diflucan and Bidenâs plan to reform health care.
In stark contrast to the first debate, there was more policy talk. There was also less interrupting.Trump said a antifungal medication treatment is âreadyâ and will be announced âwithin weeks,â shortly before conceding that it is ânot a guarantee.âBiden said Trump still has no comprehensive plan to deal with the diflucan, even as case counts continue to climb. ÂWeâre about to go into a dark winter, and he has no clear plan,â Biden said.Trump claimed Bidenâs health care plan would lead to âsocialized medicine,â conflating Bidenâs proposal to introduce a government insurance option with more progressive proposals that would eliminate private insurance. ÂI support private insurance,â Biden said, promising, âNot a single person with private insurance would lose their insurance under my plan.â Email Sign-Up Subscribe to KHNâs free Morning Briefing. You can read a full fact check for the evening, done in partnership with PolitiFact, here.Meanwhile, we broke down the candidatesâ closing antifungals and other health-related claims so you can do your part.
Vote.Here are the highlights:Trump. ÂWe are rounding the turn [on the diflucan]. We are rounding the corner.âFalse.âRounding the cornerâ suggests that significant and sustained progress is being made in the fight against the antifungals, and thatâs not the case, according to the data.The number of antifungal medication cases is climbing once again, after falling consistently between late July and mid-September. Cases are now at their highest point since early August, with almost 60,000 new confirmed s a day. Thatâs only about 10% lower than the peak in late July.New daily hospitalizations today are lower than in previous spikes, but in the past few weeks there has been a modest increase.
The positivity rate, which measures the percentage of tests that come up positive for the diflucan, has also been going up again in the past few weeks. Higher positivity rates are an indicator of community spread.The one encouraging change is that, since a peak in August, deaths have fallen fairly consistently. Thatâs due to a combination of factors, including improved understanding of how to treat the disease. Yet antifungal medication deaths have settled in at about 800 a day, keeping total deaths per week in the U.S. Above normal levels.Trump.
His administration has done âeverythingâ Biden suggested to address antifungal medication. ÂHe was way behind us.âWe rated a similar claim Pants on Fire. While there are some similarities between Bidenâs and Trumpâs plans to combat antifungal medication, experts told us any diflucan response plan should have certain core strategies. The Trump administration has released no comprehensive plan to battle the disease, except with regard to the development and distribution of treatments. Trumpâs main intervention was implementing travel restrictions, while efforts to roll out a widespread testing plan faced difficulties.Biden released a public antifungal medication plan.
The first draft was published March 12. It included public health measures such as deploying free testing and personal protective equipment, as well as implementing economic measures such as emergency paid leave and a state and local emergency fund.Trump. ÂAs you know, 2.2 million people were expected to die. We closed the greatest economy in the world to fight this horrible disease that came from China.âHis claim about the estimated deaths rates Mostly False. Trump frequently refers to this number to claim that his administrationâs moves saved 2 million lives.
However, the number is from a mathematical model that hypothesized what would happen if, during the diflucan in the U.S., neither people nor governments changed their behaviors, a scenario that experts considered unrealistic. The U.S. Has the highest death toll from antifungal medication of any country, and one of the highest death rates. Also, credit for shutting down the economy doesnât go primarily to Trump, but rather to states and local jurisdictions. In fact, Trump encouraged states to open back up beginning in May, even when there were high rates of antifungal medication transmission in those areas.Trump.
ÂWe cannot lock ourselves in a basement like Joe does.âWe rated a similar claim False. It is one of Trumpâs favored shots to say Biden isolated himself in his basement. In the first few months of the diflucan, Biden did run much of his campaign from his Delaware home. He built a TV studio in his basement to interact with voters virtually. But that changed.In September alone, Biden gave remarks and held events in, among other places, Kenosha, Wisconsin.
Lancaster, Pennsylvania. Warren, Michigan. Tampa, Florida. And Charlotte, North Carolina. We counted 14 locations.Trump.
Said of Dr. Anthony Fauci, âI think heâs a Democrat, but thatâs OK.âThis is wrong. Fauci, director of the National Institute of Allergy and Infectious Diseases, is not affiliated with a political party. He hasnât endorsed any parties or candidates.Biden. ÂWe are in a circumstance where the president still has no plan, no comprehensive plan.âThis is largely accurate.
When Biden claimed during the first debate that Trump âstill wonât offer a plan,â we noted the Trump administrationâs âOperation Warp Speedâ for treatment development as well as its more detailed plan for treatment distribution. But the administration has not released a comprehensive plan to address antifungal medication.Trump. ÂThere was a spike in Florida. That is gone. There was a spike in Texas.
That is gone. There was a spike in Arizona. It is gone.â This is inaccurate. Over the summer, Florida, Texas and Arizona experienced record surges in cases that later eased â but now they are all seeing new surges. Over the past week, The New York Timesâ tracker notes, as of Friday, new s are up 37% in Florida, 13% in Texas and 47% in Arizona, from the average two weeks earlier.Trump.
ÂWhen I closed [travel from China], he said I should not have closed. ¦ He said this is a terrible thing, you are a xenophobe. I think he called me racist. Now he says I should have closed it earlier.âMostly False. Joe Biden did not directly say he thought Trump shouldnât have restricted travel from China to stem the spread of the antifungals.Biden did accuse Trump of âxenophobiaâ in an Iowa campaign speech the same day the administration announced the travel restrictions â Jan.
31 â but his campaign said that his remarks were not related and that he made similar comments before the restrictions were imposed. Biden didnât take a definitive stance on the subject until April 3, when his campaign said he supported Trumpâs decision to impose travel restrictions on China.Trump. ÂThey have 180 million people, families under what he wants to do, which will basically be socialized medicine â you wonât even have a choice â they want to terminate 180 million plans.â Pants on Fire. About 180 million people have private health insurance. But there is absolutely no evidence that under Bidenâs health care proposal all 180 million would be removed from their insurance plans.
Biden supports creating a public option, which would be a government-run insurance program that would exist alongside and compete with other private plans on the health insurance marketplace.Under Bidenâs plan, even people with employer-sponsored coverage could choose a public plan if they wanted to. And estimates show that only a small percentage of Americans would likely leave their employer-sponsored coverage if a public option were available, and certainly not all 180 million. Experts said it is not socialized medicine.Biden. ÂNot one single person with private insuranceâ lost their insurance âunder Obamacare ⦠unless they chose they wanted to go to something else.âThis is inaccurate. This is a variation of a claim that earned President Barack Obama our Lie of the Year in 2013.
The Affordable Care Act tried to allow existing health plans to continue under a complicated process called âgrandfathering,â but if the plans deviated even a little, they would lose their grandfathered status. And if that happened, insurers canceled plans that didnât meet the new standards.No one determined with any certainty how many people got cancellation notices, but analysts estimated that about 4 million or more had their plans canceled. Many found insurance elsewhere, and the percentage was small â out of a total insured population of about 262 million, fewer than 2% lost their plans. However, that still amounted to 4 million people who faced the difficulty of finding a new plan and the hassle of switching their coverage.This story includes reporting by KHN reporters Victoria Knight and Emmarie Huetteman, and Jon Greenberg, Louis Jacobson, Amy Sherman, Miriam Valverde, Bill McCarthy, Samantha Putterman, Daniel Funke and Noah Y. Kim of PolitiFact.
Related Topics Elections Insurance Public Health The Health Law antifungal medication KHN &. PolitiFact HealthCheck Obamacare Plans Private Insurance Trump AdministrationThis story also ran on MinnPost. This story can be republished for free (details). Molly Wiese was truly stumped. Her parents and siblings live in Southern California, and Wiese, a 35-year-old lawyer, has returned home every Christmas since she moved to Minnesota in 2007.Because of the diflucan, Wiese thought it would be wiser to stay put for once. But in June, Wieseâs father was diagnosed with stage 4 cancer, and they feared this could be his final holiday season.Should she fly with her husband and two young sons to California, putting her immunocompromised father at risk of antifungal medication?. Or stay home and miss out on making treasured holiday memories with her parents and children?.
Her children are in day care, and Wieseâs husband works at a school. They donât have enough vacation time to self-quarantine before or after a flight, and driving eight days round trip isnât practical.She fears giving her father antifungals. But her parents, who live in the Inland Empire city of Yucaipa, believe itâs worth the risk to see Wieseâs children and have âour normal Christmas,â she said.âIdeally, weâd have a treatment,â she said. ÂBut I donât think thatâs a realistic expectation.â Pfizer, the apparent leader in the antifungal medication treatment race, says it wonât even be ready to apply for treatment approval until late November at the earliest.Molly Wieseâs father has late-stage cancer and she fears this could be his last holiday season. She struggled with whether she and her family should fly to Southern California to visit him for Christmas because she doesnât want to put him at risk of contracting antifungal medication.
From left. Molly Wiese, son Calvin, husband Phil Wiese, son Bennett, and Wieseâs parents, Becky and Bill Miller. (Molly Wiese)While Wieseâs conundrum is especially high-stakes, her story illustrates the tough decision millions of Americans are facing about whether and how to travel for the winter holidays.The best way to avoid spreading disease would be to avoid traveling or widening oneâs social circles. For local celebrations, self-quarantining for two weeks before a holiday event would minimize risk if all those invited committed to doing the same. But some people have to work outside the home.For everyone, after at least seven months of being mostly sequestered, the winter holidays pose an almost insurmountable temptation.
Even public health and infectious disease experts recognize the dilemma.âThereâs so much to be gained by physical touch, by being in that room and not in a two-dimensional Zoom or FaceTime screen,â said Dr. Peter Chin-Hong, an infectious disease specialist and professor of medicine at the University of California-San Francisco. ÂAnd even to embrace, with the right preparation.âDr. Anthony Fauci, the nationâs authority on infectious diseases at the National Institutes of Health, isnât immune to the problem. He told PRIâs âThe Worldâ on Oct.
13 that he and his three adult daughters, each living in a different state, were still deciding whether being together would be âworth it.âThe next day, Fauci told âCBS Evening Newsâ that his familyâs Thanksgiving reunion was off, given the risks posed by air travel. ÂYou may have to bite the bullet and sacrifice that social gathering, unless youâre pretty certain that the people that youâre dealing with are not infected,â he said.Dr. Robert Redfield, director of the Centers for Disease Control and Prevention, and Dr. Deborah Birx, the Trump administrationâs senior coordinator in the antifungal medication fight, have both warned that Thanksgiving gatherings could spread the diflucan. Email Sign-Up Subscribe to KHNâs free Morning Briefing.
In California, public health officials are taking a âharm reductionâ approach. They arenât encouraging multi-household gatherings, but theyâve issued guidelines to make get-togethers safer if they happen outdoors and last less than two hours.Officials in Los Angeles County, which has seen transmission rates increase in recent weeks, released similar guidance, acknowledging that people separated from their loved ones for months increasingly yearn for that contact.âWe are threading the needle here, but I think it is appropriate for us to try to do some of the activities that people are desperate to be able to do, with absolute adherence to the guidance,â Barbara Ferrer, director of the countyâs public health department, said at an Oct. 14 news conference.Around the world, national holidays have fueled the spread of antifungal medication in explosive ways. In China, where the diflucan started, an estimated 5 million people traveling for Chinese New Year left Wuhan, the epicenter of the outbreak, before a travel ban was enacted. In Iran, the diflucan was aided by Nowruz, a two-week spring celebration that prompted millions to travel.
In Israel, parties and religious gatherings for Purim caused widespread transmission in late March.Memorial Day, Fourth of July and Labor Day celebrations fueled surges in the United States, which is why Thanksgiving frightens public health officials. Last year, more than 55 million people were expected to travel during the days surrounding that fourth Thursday in November.Nevertheless, officials across the nation are using a light touch when it comes to warnings.In Minnesota, where Wiese lives and cases are hitting record highs, officials urge the public to avoid crowded stores and large indoor gatherings with other households, but say outdoor Thanksgiving dinners with local friends and family are less risky. Their guidance doesnât explain how to endure an outdoor Thanksgiving in Minnesota. The average high in Minneapolis on Nov. 26 is 33 degrees.Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, is waving his hands to stop the game.If you canât self-quarantine for 10 to 14 days before the event â that is, no contact with people besides members of your household who are also quarantining â donât go to another householdâs Thanksgiving dinner, he said.
The state has already seen too many examples of vulnerable people becoming sick and dying after attending weddings, funerals and birthday parties.âLet this be your antifungal medication year,â Osterholm said. ÂItâs a very challenging year, but you donât want to introduce this diflucan into family settings and experience the consequences.âOsterholm and his partner will spend Thanksgiving and Christmas without extended family, even though their children and grandchildren are all local. Because all his grandchildren are in day care or school, there isnât enough time for their families to self-quarantine before enjoying a holiday meal together.He was sympathetic to Wieseâs âcompellingâ plight. If she decides to fly to California, he said, she should sequester her family as much as possible for 10 days beforehand, then spend no more than two days with her father.âEven if she got infected, she wouldnât be most infectious until probably day three,â he said. ÂSo if she spends those two days with him, she can feel relatively good about the fact that she didnât put them at risk.âFor those who do travel, driving is much safer than flying because drivers can be isolated in a household pod and avoid exposure to the antifungals by forgoing restaurants and by disinfecting bathroom and gas pump handles before touching them.Dr.
Iahn Gonsenhauser, chief quality and patient safety officer for the Ohio State Universityâs Wexner Medical Center, said he plans to drive with his family â overnighting at a hotel on the way â to spend Thanksgiving with his sisterâs family in Colorado.He and his family keep to themselves and work from home as much as possible, leaving the house only for groceries and basic errands while eschewing restaurants and malls, he said. If anyone in either family began showing antifungal medication symptoms, or had confirmed exposure to a antifungal medication-positive person, the whole trip would be called off instantly.âThis is why we make all plans with a refundable reservation,â he said. ÂIf people have no way of backing out of their reservations, theyâre more inclined to push through an apparent risk.âChin-Hong offered this advice for holiday flyers. Get tested before the flight for peace of mind, buy tickets on a plane that is leaving middle seats empty, use highly protective N95 masks and possibly face shields, and blast the individual airplane vents directly onto each family member to disrupt potential diflucan particles. And, of course, wash your hands frequently.Chin-Hong is taking that approach on a planned family trip to New York City to visit his mother, who is in her 80s and wants to see her son, daughter-in-law and grandchildren.
Every visit they have could be their last, Chin-Hong said.âTo me, the risk-benefit ratio really supports me going to see her.âAfter hearing the advice from Chin-Hong and other infectious disease experts, Wiese decided last weekend to buy plane tickets to visit her parents.âIt really did help us make a decision that was giving me a lot of anxiety,â she said. Anna Almendrala. aalmendrala@kff.org, @annaalmendrala Related Topics Public Health States antifungal medication.
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