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London : Faber & Faber (Plays), 2023.

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Katy Perry is getting real about her hormonal changes and mood swings during pregnancy. On Saturday, during the SHEIN Together livestream event--a virtual festival led by the clothing...

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This note highlights the most pressing issues on families and children in Hungary, as discussed in the OECD publication Doing Better for Families.

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The state's online registration for Covered California has been up for a couple of weeks, and reaction has been mixed.

Steve Julian: Business analyst, Mark Lacter, what's your take on how well Californians are getting into the Affordable Care Act?

Mark Lacter: It's hard to get a good read, Steve, because it's hard to measure the success of what is really a new marketplace.  If you're basing it on the number of unique visitors coming to the Covered California website, well, then the program clearly has attracted lots of interest - they had almost a million visitors during the first week of eligibility.  But, maybe a better measure would be the number of people whose applications actually have been received by the insurance companies that are going to handle the claims.  If that's your measuring stick, then the numbers have been far smaller so far.  Now, it's worth pointing out that California - and particularly L.A. County - have a higher percentage of households without insurance than other parts of the nation, and so you'd expect there to be lots of interest.

Julian: So the question, then, is how many folks turn into actual policyholders paying actual premiums each month.

Lacter: The truth is nobody knows, which is why state officials want to sign up as many people as possible in the early going when the program is getting so much attention.  This is especially true for younger and healthier people who are needed to help offset the cost of caring for older and sicker people.

Julian: And, that's also why any computer glitch can be such a headache...

Lacter: That's right.  Covered California did run into problems in the early going, but everybody agrees that things are going much better than the federal website, which is the default site used by folks in states that don't have their own program to oversee the health care laws.  That federal site has been an utter disaster.  So, by comparison, California is ahead of the game.

Julian: It's a work in progress, even here.

Lacter: Very much so.  The California website still doesn't have a way for enrollees to find out which doctors and hospitals are included in each health plan.  And, that's a big deal because  insurance companies are limiting the options available as a way of keeping premiums low.  So, it's possible that the doctor you had been using for your individual insurance plan will not be on the list of doctors that can be used for one of the cheaper plans.  Of course, for someone who doesn't have any health coverage, none of that is likely to matter.

Julian: And then, there's the continued threat of a U.S. default...

Lacter: You know, Steve, this is like watching the beginning of a bad traffic accident in slow motion - and we're all pretty helpless to do anything about it.  And, so are the financial markets, which are moving back and forth not based on what's going on with the economy or with any industry, but on the latest press conference out of Washington.  One thing we do know is that if the nation does go into quote-unquote default - and we're not even sure what that might mean - but if Wall Street and somehow declares this a major crisis, it's going to be bad.

Julian: Who gets hit?

Lacter: It'll impact anyone who has a retirement account, any business wanting to borrow money, and potentially it's going to impact the budgeting of the state.  You know, one of the things we were reminded of during the Great Recession was how reliant California has been on higher-income individuals who make a lot of their money through the stock market and other investments.  So, when those folks do well - as they have been over the last year - the state coffers will do well.  And when they don't, as was the case in 2008 and 2009, the state takes a huge hit because there's not enough tax dollars coming in.  Gov. Brown and others have tried to lessen the reliance on those top tiers - so far without success.

Julian: And the state's budget situation is so much better than it was a year or two ago.

Lacter: That's the real pity.  And, even if the House and Senate reach a temporary agreement on the debt ceiling, it's just a matter of weeks or months before another deadline crops up - and more uncertainty for the financial markets.  I guess Chick Hearn would have called this nervous time.

Mark Lacter writes for Los Angeles Magazine and pens the business blog at LA Observed.com.

This content is from Southern California Public Radio. View the original story at SCPR.org.

Latest COVID-19 Conversations webinar discusses implementing crisis standards of care.

; Credit: Alyson Hurt/NPR

To safely phase out social distancing measures, the U.S. needs more diagnostic testing for the coronavirus, experts say. But how much more?

The Trump administration said on April 27 the U.S. will soon have enough capacity to conduct double the current amount of testing for active infections. The country has done nearly 248,000 tests daily on average in the last seven days, according to the nonprofit Covid Tracking Project. Doubling that would mean doing around 496,000 a day.

Will that be enough? What benchmark should states try to hit?

One prominent research group, Harvard's Global Health Institute, proposes that the U.S. should be doing more than 900,000 tests per day as a country. This projection, released Thursday, is a big jump from its earlier projection of testing need, which was between 500,000 and 600,000 daily.

Harvard's testing estimate increased, says Ashish Jha, director of the Global Health Institute, because the latest modeling shows that the outbreak in the U.S. is worse than projected earlier.

"Just in the last few weeks, all of the models have converged on many more people getting infected and many more people [dying]," he says.

But each state's specific need for testing varies depending on the size of its outbreak, explains Jha. The bigger the outbreak, the more testing is needed.

Thursday Jha's group at Harvard published a simulation that estimates the amount of testing needed in each state by May 15. In the graphic below, we compare these estimates with the average numbers of daily tests states are currently doing. (Jump to graphic)

Two ways to assess whether testing is adequate

To make their state-by-state estimates, the Harvard Global Health Institute group started from a model of future case counts. They calculated how much testing would be needed for a state to test all infected people and any close contacts they may have exposed the virus. (The simulation estimates testing 10 contacts on average.)

"Testing is outbreak control 101, because what testing lets you do is figure out who's infected and who's not," Jha says. "And that lets you separate out the infected people from the non infected people and bring the disease under control."

This approach is how communities can prevent outbreaks from flaring up. First, test all symptomatic people, then reach out to their close contacts and test them, and finally ask those who are infected or exposed to isolate themselves.

Our chart also shows another testing benchmark for each state: the ratio of tests conducted that come back positive. Communities that see around 10% or fewer positives among their test results are probably testing enough, the World Health Organization advises. If the rate is higher, they're likely missing a lot of active infections.

What is apparent from the data we present below is that many states are far from both the Harvard estimates and the 10% positive benchmark.

Just nine states are near or have exceeded the testing minimums estimated by Harvard; they are mostly larger, less populous states: Alaska, Hawaii, Montana, North Dakota, Oregon, Tennessee, Utah, West Virginia and Wyoming.

Several states with large outbreaks — New York, Massachusetts and Connecticut among others — are very far from the minimum testing target. Some states that are already relaxing their social-distancing restrictions, such as Georgia, Texas and Colorado, are far from the target too.

Jha offers several caveats about his group's estimates.

Estimates are directional not literal

Researchers at the Global Health Initiative at Harvard considered three different models of the U.S. coronavirus outbreak as a starting point for their testing estimates. They found that while there was significant variation in the projections of outbreak sizes, all the models tend to point in the same direction, i.e. if one model showed that a state needed significantly more testing, the others generally did too.

The model they used to create these estimates is the Youyang Gu COVID-19 Forecasts, which they say has tracked closely with what's actually happened on the ground. Still the researchers caution, these numbers are not meant to be taken literally but as a guide.

If social distancing is relaxed, testing needs may grow

The Harvard testing estimates are built on a model that assumes that states continue social distancing through May 15. And about half of states have already started lifting some of those.

Jha says, that without the right measures in place to contain spread, easing up could quickly lead to new cases.

"The moment you relax, the number of cases will start climbing. And therefore, the number of tests you need to keep your society, your state from having large outbreaks will also start climbing," warns Jha.

Testing alone is not enough

A community can't base the decision that it's safe to open up on testing data alone. States should also see a consistent decline in the number of cases, of two weeks at least, according to White House guidance. If their cases are instead increasing, they should assume the number of tests they need will increase too.

And Jha warns, testing is step one, but it won't contain an outbreak by itself. It needs to be part of "a much broader set of strategies and plans the states need to have in place" when they begin to reopen.

In fact, his group's model is built on the assumption that states are doing contact tracing and have plans to support isolation for infected or exposed people.

"I don't want anybody to just look at the number and say, we meet it and we're good to go," he says. "What this really is, is testing capacity in the context of having a really effective workforce of contact tracers."

The targets are floors not goals

States that have reached the estimated target should think of that as a starting point.

"We've always built these as the floor, the bare minimum," Jha says. More testing would be even better, allowing states to more rapidly tamp down case surges.

In fact, other experts have proposed the U.S. do even more testing. Paul Romer, a professor of economics at New York University proposed in a recent white paper that if the U.S. tested every resident, every two weeks, isolating those who test positive, it could stop the pandemic in its tracks.

Jha warns that without sufficient testing, and the infrastructure in place to trace and isolate contacts, there's a real risk that states — even those with few cases now — will see new large outbreaks. "I think what people have to remember is that the virus isn't gone. The disease isn't gone. And it's going to be with us for a while," he says.

Daniel Wood contributed to this report.

This content is from Southern California Public Radio. View the original story at SCPR.org.

There is a growing body of scientific research into the health benefits of urban forests, such as improving air quality and providing recreational space. However, new research challenges the assumption that their overall impact on quality of life is always positive and land planners need to take into account ecosystem disservices as well as services, say the researchers.

Food and Water Watch parodies “Portlandia’s” awesome chicken sketch to make a point about factory farming inspections and urges consumers to take action.

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