Why are American colleges so expensive?

When President Biden made his historic and unprecedented student debt loan relief for tens of millions of Americans, last month, encircling $10,000 in debt for those earning less than $125,000, and $20,000 for those low income students who received Pell grants, the reactions were mixed: some praised him and others panned him; and, those critics included some that said, it was not enough, or it was a handout to deadbeat debtors.

The program championed by Senators Elizabeth Warren and Chuck Schumer, came after a long slog, but  there were plenty of lawmakers on both sides of the aisle that disagreed, including, some Democrats worried about their chances in the November midterms, as well as Republicans who didn’t want the president to gain points with young voters.

This is all set against the backdrop that “45 million people owe $1.6 trillion for federal loans taken out for college - more than they owe on car loans, credit cards or any consumer debt other than mortgages,”  reported The New York Times.

What wasn’t asked, and is the $64,000 question: why are American colleges so expensive?

To help answer that question we did a meta analysis on some of the more salient research on the topic: journal articles, and private research organizations. What follows is not comprehensive and we’ve spared the reader charts, graphs and data that would obfuscate, rather than enlighten.

A core problem

While many parents and students get sticker shock when they see the price tags at some of the best private, as well as public schools; take for example Columbia College in New York City which even two years ago, came in at a whopping $61,000 per year, exclusive of fees and other costs, such as books and housing, aid becomes paramount for all but the wealthiest students.

Scholarships, grants and other forms of aid lessen the overall price tag, but what remains are key problems, and as Forbes noted in their analysis, “colleges are not transparent about their true prices.” 

Parents, therefore, are starting the process with one hand tied behind their back, since true costs, and aid packages, are not known until the student is accepted, making it akin to buying a pig in a polke, and “knowing that students will have few alternatives by the time they actually see what they see what they will pay, [and] colleges have every incentive to be stingy with financial aid.”

Problematic for many low income students, and especially students of color, is that the help of the Pell Grant, “hasn’t kept pace with inflation or the cost of college, a fact given by Mamie Voight, in policy research at the Institute for Higher Education Policy, in Washington, D.C."

That makes it easy to see that there are systemic problems with both the admission process, as well as the administration of aid, need based, or merit.

It is especially notable that in some states there has been a rise in American students going to college, for example, in 1980 one half of high school graduates enrolled in college, and that number is 70 percent today, noted Business Insider, recently.in a cover story.

For others that picture is changing with many areas across the nation wondering if both the cost, and the time are worth it,noted in another coverage, by nbcnews.com.

An unfair marketplace

That debate aside, for the moment, at least, accessing aid makes it clear that there are limited options for an atypical student, which might be why many choose the local public college, and live at home, to save on expenses; but, by staying “in state” leaves competitive providers no incentive to offer discounts, “or improve the quality of education,” Forbes surmised.

The reliable US News and World Report, whose guide to colleges and graduate schools has gained near biblical status, noted the tuition hike of 36 percent from 2008 to 2018 compared to “real median income in the U.S. grew just over 2.1 percent in the same period, according to the Center on Budget and Policy Priorities.”

At issue is also the debt that is taken on,and that can result in defaults with “one million people defaulting on their student loans.”

For Black students, in particular, this becomes of prime importance since they “hold the most debt  of any other racial group” according to The Hill, citing the PBS NewsHour that showed, “among 2016 graduates, nearly 40 percent of Black students graduate college with $30,000 or more in debt compared to only 29 percent of white students, 23 percent of Hispanic students and 18 percent of Asian students.”

This is underpinned not only by historical racism in the U.S. but the lack of ability to acquire wealth through homeownership by their grandfathers, who returning from World War II were denied access (many of them middle class) to better housing, most often in white neighborhoods, by restrictive covenants, or if that did not work by violence, to drive them away if they had succeeded.

Fast forward to the present day, and the lack of “integrated wealth” has caused “Black families to seek more and more student loans.”

Of equal consequence for all borrowers, but especially for Black graduates, who after graduation, (who often have to face racism in applying for professional jobs) is the issue of repayment.

“Because of the way that the repayment system is set up, people are only making payments on the interest, and not principal, so their balances balloon over time,” said Kat Welbeck, director of advocacy and civil rights at the Student Borrower Protection Center.

Increased costs keep rising

The bad news for high school applicants is that costs are getting higher said Zane Heflin, policy analyst at The New Center, who has said, “These colleges are trying to raise tuition to appeal to a broader group of students by allowing that to take the place of actual quality,” and furthermore, “there are a lot of perverse initiatives on the part of the colleges to raise their sticker price.”

A large part of that price surge are the ever increasing menu of amenities, part of what some have called, “our collective desire for the all frills college experience” that so many value in American universities, but that they charge for, “climbing walls, state of the arts mega student centers,seriously pimped out dormitories,” noted Thebestschools.org, in August.

This is far removed from returning vets from World War II on GI Bill who faced large state universities with cinder block walled dorm rooms, with toilets and showers down the hall, and at most, a weight room, a track team, and some basketball and tennis courts at the athletic center.

Consequently, It needs no saying that the schools are marketing themselves to wealthier students, and this specific market wants those frills, and is willing to pay the cost.

Adding it all up for a final tally was CNBC who stated that there is an average debt, per student of $37,172 totalling $1.5 trillion of “total debt spread among 44 million Americans.”

Rounding up total costs, in federal lending and grants, according to The Atlantic, “are more than $3,000 per year per student for the ancillary services alone."

Add that to higher and higher salaries of not only teachers, but administrative staff, that require college degrees plus advanced degrees,and often wrap around services, like counseling, and the perfect storm has been created.

Also significant is that many state legislatures cut their education budgets, especially during the Covid lockdown, forcing budget cuts that increased tuition by public colleges to cover the missing dollars.

Market Conditions

There is a much larger picture than parents and prospective students might not imagine, and Beth Akers, a senior fellow at the American Enterprise Institute, where she focuses on the economics of higher education,and author of “Make College Pay”, looked deeper in her research, and especially how the “market” itself is a character in a never ending drama; and, noting that “the decision to go to college is finally a cost benefit calculation, on rising to the middle class.”

Taking a look at this long term analysis, there is a market ready to exploit the value that is seen as a “golden ticket”, which in turn inflates college tuition. And, this is a market that is competitive, with few alternatives.

Accreditation is another factor that prevents a competitive market that would reward students and parents alike, and it is “difficult for a school to access federal financial aid, which means that the playing field is not level between traditional schools and new ones.”

Akers does note that the problems “are deeply ingrained in America’s higher education system and reversing them will take work: and her proposals are two fold: first off, increase transparency, and quality data “should be made more available and accessible, along with data on typical earnings after graduation. This will help inform students whether a particular college degree is worth the cost.”

A move that when suggested has had colleges and universities roaring in protest.

The result would be an increase in competition that would allow healthy competition, and secondly “removing accreditors from their role based on student outcomes,” and force current players to make their product more competitive with lower prices.

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August US Jobs Report shows resiliency, despite inflation

The United States economy has, once again, proved its resiliency with the August Jobs Report that showed continued strength in the monthly report issued by the Labor Department that showed  a healthy 315,000 non-farm jobs exceeding predictions of 300,000, and while not the show stopping number from July, employment is on the rise and also with wages, and there was a slight uptick in the employment rate to 3.7 percent, but that is less worrisome than the still red-hot job market.

The good news is that the slowdown is what the Federal Reserve wants to cool down inflation, and those still high job numbers also come with higher wages, and those higher wages, even while nibbled from higher prices are causing the central bank worries on how to bring it all down, in a calibrated way, and not by the earlier miscalculations from the 1970s where two decades of robust inflation ruled, or rather ruined the day.

While some economists are concerned that this slowdown is what is needed, there are others that feel that last year’s predictions of a soft landing  for the nation’s economy are long gone.

The New York Times reported that, “The central bank is still all but certain to raise interest rates at its meeting this month, probably by at least half a percentage point and perhaps by three-quarters of a point. That decision may rest on what happened to consumer prices in August; that data is scheduled to be released on Sept. 13, a week before the Fed’s meeting.

Fed Chair, Jerome Powell, whos has been on the hot seat for some months is someone who is data driven, and it will take some more data for he, and the regional governors to make a final consensus, and vote, on the size of the increase; but, there are many who are predicting another huge increase, perhaps as much as 0.75 percent, but all bets are on the table.

Politically, the news couldn't have come at a better time for President Joe Biden whose ratings are still tanked, and with the midterms around the corner, and he had this to say:

“Jobs are up, wages are up, people are back to work. And we’re seeing some signs that inflation may be — may be, I’m not over promising — may be beginning to ease,” Mr. Biden said at the White House. Coupled with falling gas prices, he said, “America has some really good news going into Labor Day weekend.”

While American employers, for some time, have complained about not finding the right type of worker with the right qualifications, and many are still saying it, others have noticed an increase in more qualified people returning to work, and that very well maybe as the TImes noted, a reflection of inflationary process as many people try to walk the financial tightrope, especially with high rents, and especially in large urban areas as New York, Los Angeles and Chicago.

“And headlines about layoffs and a possible recession may be spurring some people to return to work while they can. A recent survey conducted by the career site ZipRecruiter found that job seekers were feeling less confident about their searches, and were putting more importance on job security than on flexibility.

In fact, labor force participation (LFP) did show an increase of 0.3 percentage point, at an overall 62.4 overall percentage.

“People are spending down that pandemic nest egg a little more quickly than they expected because of rising prices, and now feel a bit more nervous and a bit more desperate to find a job,” said Julia Pollak, the chief economist at ZipRecruiter.

Desperation may be facing American Blacks as they face dim prospects for greater employment, and this report gives them a 6.9 unemployment rate, nearly double that of whites, (but steady across the board over several months) making cuts into wealth building, not only to just meet basic needs.

Often times flourishing in the service sector, these are some of the jobs that drew them into great demand, and with some employers waving aside less previously held requirements such as a high school diploma, or misdemeanors, or even weak performance and job histories, these are the same areas that could be cut as the Fed works to calibrate ways to cool down, what is still a red hot jobs market.

That, as former Treasury secretary Larry Summers noted last year in an analysis, could result in double digit unemployment for Blacks, historically seen unemployment seen across the decades and eroding the wage increases they gained over the last few months.

Rising wages have become, despite inflation’s deleterious effect on them, a concern for Powell and this slowdown in employment which may increase by year’s end also has can help, but is a double edged sword for many, especially in the service sector, and with two  jobs available for every job seeker, the elevation in wages to 5.2 percent is being watched as a barometer for anti-inflation measures.

Coupled with supply chain issues and commodity pressures has increased the pressure for Powell to determine how to juggle all of the balls to fight inflation in the coming months.

That aside, many are quitting jobs to attain those higher wages, for those that need qualified employees, especially in the private sector, and as The Hill reported, “Job seekers on Indeed.com are looking for ever-higher wages, Ann Elizabeth Konkel, an economist at Indeed Hiring Lab, explained. The number of Indeed users seeking jobs with a $20 per hour wage rose above those seeking $15 per hour in June 2022, and the number of jobseekers looking for $25 per hour is up 122 percent over the past 12 months.”

Coming out on top for August were retail, 44,000, manufacturing, 22,000, and business services, 68,000, and healthcare with 48,000 - although still reduced from burn out by staff caring for COVID-19 patients. And, while these areas are expected to grow, they are also vulnerable to downturns, as predicted, by later Fed actions..

For now, just now, this is the time for those looking to gain, or change employment to do so now, to lock in either a better wage, or better working conditions. As the old adage says: “Strike while the iron is hot.”

July Jobs report is a cause for champagne in the US

If the June Jobs report was the occasion for an extra chocolate eclair on the breakfast plates of economists, then July with its whopping 528,000 non-farm payroll jobs, is now an occasion for champagne cocktails, after the US Labor Department issued the good news on Friday.

This news also brings the country to a milestone: each and every job that has been gained this year recoups the losses from the Covid pandemic, not an insubstantial feat, for a country that was brought to its knees with the pandemic wreaking havoc on the economic health of the world's largest economy.

The unemployment rate, what we call the marquee rate, descended to 3.5, from last month’s 3.6. There was a conundrum, of sorts, with a flattening of the labor force participation rate that has caused concern for some economists and observers, not to mention employers, looking to hire.

While, for some, it may be more of a backstory, it’s still a significant outlier for those whose job it is to study the economy, or at least follow a trajectory, and one of them is the Federal Reserve Board, whose twinned mission of keeping inflation at 2 percent levels, and the nation at full employment, has watched this report with some concern, especially with the overall increase in wages from 4.9 percent to 5.2 percent and with the series of scheduled rate increases, the last of which was 0.75, the highest in decades; but, now comes concern that these employment gains coupled with higher wages, needs a cooling down to avoid higher inflation, and we will have to wait till September to see what the Fed will do.

Of course, the R word has been bandied about so much in the general media, that many want to see the word banished from the vocabulary of news programs as the continued lead stories on radio, television and the internet, is “Folk’s we’re headed into a recession.”

For those that stayed awake in Econ 101, it’s easy to see that this is pure fallacy: 376,00 jobs for June and 528,000 for July, it’s better to state, “Ain’t no way!”

This strong labor market is one that Chair Jerome Powell has also cited as a reason to say that the US is not in a recession.

Jerome Powell

The agreed upon wisdom is that there must be two quarters of retraction in the GDP which we have had, but absent rising unemployment, and other facts, we are not. Those other factors are: “falling retail sales, and contracting measures of income and manufacturing for an extended period of time.”

Of course, despite the high wages, prices are well, high, as anyone who pumps gas at the station knows, wages are not keeping up with inflation. For example, a local fast food supervisor told us that he can’t even get a full tank on his kid-friendly SUV, without shelling out $100.00.

Some drivers are feeling a sigh of relief at an average price of $4.79 a gallon as welcome news.

There are concerns present with the household survey standing at a nearly unchanged labor force participation rate of 62.1, even but that alignment, even with the upward revisions for May, and June, shows that the American economy is much more robust, and resilient, than many would have thought.

“As long as you’re above 200,000, you’re still doing better than pre-pandemic and it’s still strong, “said Diane Swonk, chief economist at KPMG. “It doesn’t feel very good, because it’s being accompanied by inflation,” reported CNBC.com

From all reports it seems that the Biden Administration's efforts with a slimmed down version of the “Build Back Better Act” is destined to become law after weeks of negotiation with Sen. Joe Manchin of West Virginia and also the support of Arizona Sen. Krysten Sinema, both bulwarks against the previous bill.

With its increase in increased tax rates for high income earners, the estate tax, and a much championed push for a tax on billionaires, and while broader tax increase are missing that were much desired such as, capital gains, to 25 percent, and a restoration of the “the top income tax rate of 39.6 percent, among others, the legislation is expected to bring down inflation with efforts by the Federal Reserve.

Tax experts and economists expect that the reduction will be felt over years, and not months, and one source, according to Vox.com “Shai Akabas, director of economic policy at the Bipartisan Policy Center: I think it’s likely to have a modest downward effect on inflation, so directionally, I think it is likely to push downward on prices. But that’s unlikely to be the primary effect of the legislation, given how many specific policies there are.

Most of the impact on inflation and the broader economy from this legislation is likely to be medium-term, not felt in the immediate next few months, which is how households are thinking about inflation.”

He also added an important note: “That’s largely because there’s very little that policymakers can do, certainly on a legislative basis, to impact inflation overnight. That is primarily the job of the Federal Reserve. … There’s not much you can do, absent overnight taking lots of money out of the economy, out of people’s pockets — which is not something that Congress likes to do or almost ever does — that is going to dramatically change the immediate inflation outlook.”

The push to bring down inflation is needed, as Swonk noted, when she said, “At the moment, inflation is hurting everyone. It’s an equal opportunity scourge at this point,” and Michael Gapen, chief U.S. economist at Bank of America, added “What policymakers are faced with is pushing the unemployment rate higher.”

That would also affect unemployment especially on the lower rungs of service and retail jobs, especially in two income families where female employment is mostly seen.

Gapen also feels that by the end of the year, “job growth could turn negative, followed by the possibility of several monthly reports of job losses as high as 150,000. He expects a shallow recession to take hold by then,” they added.

Right behind him is Swonk who “said she also sees payrolls turning negative, with monthly job losses between 100,000 and 200,000.”

While the service sectors such as leisure and hospitality have seen the greatest growth, 96,000 along with that catch all category of business services have expanded to 89,000, these numbers represent an expansion of a much needed workforce, with some previous barriers such as marijuana convictions, and the lack of a college degree deleted.

Diane Swonk

As Gapen and Swonk indicate these growth areas could be those cut by year end. But, this has also seen cuts on the corporate side when Walmart has targeted 200 corporate jobs for layoff, as noted in a New York Times report, quoting their announcement that “American consumers were pulling back on purchases of general merchandise to focus on necessities like groceries. The company said it expected operating profits for the full year to fall by as much as 13 percent, as the company was forced to continue marking down inventory that wasn’t selling.”

CNBC also quoted Wells Fargo Institute who expect that by the end of this year, “unemployment will tick up to  4.3% . . .”

President Biden has acknowledged that job growth will slow by the end of the year, and that despite contractions does not mean the economy is tanked.

Speaking of tanks, when Biden made his first trip to the Middle East and met with Gulf Leaders of Saudi Arabia it was hoped that he could bring down the price of gasoline that has forced millions of drivers in the US, and the UK, to cut back, often, on needed trips.

Unfortunately, these leaders were less than willing to budge much, and production has increased to less than one-tenth of one percent, or 100 barrels per day, an almost negligible amount that will surely not only show little effect on the needs of consumers, and will be cause of concern in the West Wing as Biden faces increased GOP criticism, as he heads to the November midterms.

While that maybe a worry for the president, American consumers have their own worries and fears about budgets, food on the table and educating their children all of which needs to be met, just as inflation nibbles away at the edges.

Monkeypox, politics, and fear create frenzy across US

All politics are local, according to the old adage, and that seems to be true, now more  than ever with the Monkeypox virus that has spread across the United States which began this Spring and rose to approximately 5,200 cases mostly among gay men, or those who have sex with other men, regardless of self identification, and those with multiple  partners. 

The New York Times also reported, “The Centers for Disease Control and Prevention reported on Thursday that the United States has now confirmed more than 4,600 cases of monkeypox, which has already been declared a global health emergency by the World Health Organization. The U.S. case count is among the highest in the world, and the figure is almost certainly an underestimate. Men who have sex with men comprise 99 percent of the confirmed cases so far.”

While the virus is not limited to gay men, fears of stigmatization are already present, and many virologists and epidemiologists are anxious to emphasize that fact, as are gay community leaders.

Monkeypox was first seen in Europe in early May, shortly before it reached epic proportions in New York City, and Washington, DC, in late June, but, also in other large cities such as San Francisco and Chicago; and London Breed, San Francisco’s mayor, was forced to declare a public health emergency.

The approved vaccine was long stuck in a bottleneck in a Danish factory, until recently, when the FDA visited it to give final approval and there were long lines in both New York, and Washington, which forced many health providers to give only one dose of the two dose regimen.

Much like the early days of covid, testing has not been emphasized, and some say the five labs the government has contracted with, still leaves the nation short.

Biden administration efforts

The Biden-Harris administration earlier issued a white paper discussing its humanitarian efforts, but it was not seen by many, and with long lines many likened it to the huge supply problems faced with the covid vaccine that initially had severe supply issues.

While few in the LGBT community have been openly critical of Biden, with one saying, “at least he isn’t advising people to drink bleach like Trump,” but if supplies continue to be limited, that might occur, and with his sunken ratings, this is the last thing he needs before the November midterms.

Previously, Politico announced that Biden was poised to declare monkeypox a health emergency, one that is made by the US Department of Health and Human Services, and much like other national disasters would release “a slew of actions, including accessing new money and appointing new personnel, according to the law that dictates how and when the federal government can declare such an emergency.” 

Earlier this month, the Biden Administration announced that it has directed the Health and Human Services director to announce a national health emergency.

The New York Times reported that Xavier Becerra briefing the press said, “We’re prepared to take our response to the next level in addressing this virus, and we urge every American to take monkeypox seriously.” 

While some lawmakers have urged the administration for more action, and a list of the steps it has taken to advance help and to increase supply, "AIDS activists, who have been sharply critical of the administration, have been demanding an emergency declaration for weeks. “This is all too late,” said James Krellenstein, a founder of PrEP4All, an advocacy group. “I don’t really understand why they didn’t do this weeks ago.”

For those hoping that this declaration would increase vaccine supply, this is not to be, "Declaring the emergency would not ease that shortage, but the administration may take steps to allow quicker access to tecovirimat, the drug recommended for treating the disease," they added.

What does it do? "The emergency designation would allow the F.D.A. to authorize measures that can diagnose, prevent or treat monkeypox, without having to go through the agency’s usual exhaustive review. The agency relied heavily on this provision to speed tests, vaccines and treatments for the coronavirus."

Declaring an emergency also gives the Centers for Disease Control and Prevention more access to information from health care providers and from states. Generally, federal agencies like the C.D.C. cannot compel states to share data on cases or vaccinations.

Tom Ingelsby, director of the Johns Hopkins Center for Health Security at the Bloomberg School of Public Health, told them, “We’re having a lot of challenges around the country with their rate of rise in terms of new cases,” and while “not a high threat to the general population, . .  . it has the potential to spread to additional vulnerable communities.”

In agreement, Dr. Tom Frieden tweeted, “The recent outbreaks of monkeypox, and Marburg show why we better learn the lessons of Covid. Unless we make significant investments in global health and strengthen systems to quickly find and stop new disease threats, we and our children will face the consequences.”

Frieden is the former commissioner of the New York City Department of Health and Mental Hygiene (2002–2009) and is now president and CEO of Resolve to Save Lives, a $225 million, five-year initiative to prevent epidemics and cardiovascular disease, according to his Wikipedia profile.

Monkeypox has symptoms raging from a rash, or sores anywhere on the body, including the genitals, and often with flu-like symptoms, and can include swollen lymph nodes and is often spread through sex, and other intimate actions, such as kissing and physical contact; but, also with sharing infected towels, clothing, bedding, and other materials. But, to note, symptoms can appear, without a linear pattern, therefore making testing essential.

The sores can also be extremely painful, and gay men have been advised to refrain from sex, by some health personnel, and to immediately test if symptoms occur.

Vaccine shortages

Despite the arrival of more vaccines, the US is still critically short of what is needed and according to the Washington Post, “Even with the latest shipments, there are only enough vials of the two-dose Jynneos vaccine to cover about a third of the estimated 1.6 million gay and bisexual men who officials consider at highest risk and who are being urged to get the shots.”

Latest reports are that there will not be more deliveries nationwide until October, but The Post continued, “The shortfall of Jynneos, the only vaccine approved by the Food and Drug Administration to protect against monkeypox, has health officials at every level of government scrambling to come up with strategies. Those in hard-hit communities like New York City and D.C. have opted to give out only one dose for now, against regulators’ advice, while pushing federal officials for larger allotments.”

Previously San Francisco’s KTVU reported  that San Francisco had 281 probable and confirmed monkeypox cases. This makes up 33% of cases statewide. Breed said data shows that San Francisco has been hit the hardest and health officials don’t want to wait another day to get people the testing, vaccines and treatment they need.”

They later expected, "to receive 4,220 monkeypox vaccine doses, enabling Zuckerberg San Francisco General Hospital to reopen a vaccination clinic on August 1 that closed July 13 and again this week when supplies ran out.”

Breed has emphasized that "This is not going to be ignored. This is a public health crisis," Breed said in her calls for more vaccines.”

Personal appeals to local Chicago lawmakers resulted in responses that held the Feds accountable for the supply problem, and that they could not give what they didn't have, with some being almost defensive.

We witnessed long lines of men, in nearly 90 degree heat, in Chicago waiting outside the offices of Test Positive Aware Network, (TPAN)  for two hours, only to be told that the vaccine had run out and to come back the following week, and that those with a number, an unknown fact to many, would then get vaccinated;  which in turn caused one bystander to remark, “This is just like Covid.”

There were also unconfirmed rumors that some social venue vaccination efforts in Chicago, anxious about supplies, vaccinated some people ahead of others.

Scott Gottlieb, a former commissioner of the Food and Drug Administration, and now a senior fellow at the American Enterprise Institute, opined in The New York Times that “Our country’s response to monkeypox ‌‌has been plagued by the same shortcomings we had with Covid-19. Now if monkeypox ‌gains a permanent foothold in the United States and becomes an endemic virus that joins our circulating repertoire of pathogens, it will be one of the worst public health failures in modern times not only because of the pain and peril of the disease but also because it was so avoidable . . . We don’t have a federal infrastructure capable of dealing with these emergencies.”

According to the Illinois State Rep. Kelly Cassidy’s earlier email newsletter, “CDPH (Chicago Department of Public Health) has distributed over 5,000 doses of the vaccine and reports they are expecting a delivery of an additional 15,000.” 

Many say that even this is not enough, and criticize the early decision to vaccinate only those with confirmed or, “likely contacts of monkeypox patients.”

In a recent interview on WAMU’s ‘1A”, epidemiologist Dr. Celine Gounder noted that more studies need to be done on the efficacy of one dose, while many are waiting for the arrival of more vaccines, and with concerns of those who are not having multiple partners, waiting for the vaccine, she analogized to a neighborhood that is on fire and that water must be given only to the houses that are actually burning.

The Biden paper noted that “as additional doses are received from the manufacturer, HHS will make them available to jurisdictions to expand availability to the vaccine for individuals with elevated risk.”

State level efforts

Illinois governor JB Pritzker had urged the Centers for Disease Control and Prevention, “to use the tools available at the federal level to immediately increase the availability of vaccines in at-risk communities, “ Cassidy wrote

Shortly afterward, in a late development, he declared Illinois a public health emergency, and said, ““MPV is a rare, but potentially serious disease that requires the full mobilization of all available public health resources to prevent the spread.”

This will ensure smooth coordination between state agencies and all levels of government, thereby increasing our ability to prevent and treat the disease quickly. We have seen this virus disproportionately impact the LGBTQ+ community in its initial spread. Here in Illinois we will ensure our LGBTQ+ community has the resources they need to stay safe while ensuring members are not stigmatized as they access critical health care.”

Illinois currently has the fourth highest cases in the nation, 888, with Chicago at 460. Overall the US has, at current estimate 14,115.

In its local coverage, NBCChicago.com reported, “officials can [now] more easily secure vaccine shipments and ramp up distribution to ensure the most impacted communities receive treatment as soon as possible."

Funding needed

Of course, going further also requires money, and in a private estimate, some federal officials said, on deep background, that  $7 billion is needed to even meet “the scope and urgency of the current situation”, their reporters revealed.

Breaking it down, in an internal memo that Post reporters obtained, there would be $6.9 billion needed to have the vaccine made in the US, and “could also secure $19 million new doses of vaccine for monkeypox, replenish 4 million doses for smallpox preparedness efforts and more.”

Returning to vaccine supply shortages: “Some experts also are advocating that people be encouraged to take a less desirable vaccine, ACAM2000, which was approved for the related virus of smallpox but not for monkeypox.”

“There are not enough shots” to pursue a strategy of relying solely on Jynneos, said a federal official working on the monkeypox response, who spoke on the condition of anonymity because they were not authorized to comment, warning of a possible “vaccine cliff” in coming weeks,” added the Post..

Dosage variance and advice to address shortages

“Some experts have called on U.S. officials to instead encourage Americans to get vaccinated with ACAM2000, which was approved for smallpox, a related virus, and that the United States had previously stockpiled in case of a potential outbreak. That vaccine relies on injecting people with a live, if weakened, virus, which carries additional risks. It also is administered in a series of rapid punctures that can draw blood and lead to scarring. The vaccine is available as needed, although public health officials have been wary of relying on it.”

 

ACAM2000 is not recommended for those with compromised immune systems, and with many people still living with HIV in the gay male population, the risks are enormous.

 

“No one’s crazy about it. You shouldn’t be crazy about it. But you should give people the choice,” said Ezekiel Emanuel, a bioethicist who has advised the Biden administration on coronavirus and attended a White House briefing this week on monkeypox,” according to the Post.

Earlier reports at the end of July from the City of Chicago said that there was an increase in vaccines and that, “Those 33,000 doses will come from the nearly 800,000 doses that were cleared by the Biden administration . . . to arrive over the next several weeks.”

 

Even more alarming is this: “Even with the latest shipments, there are only enough vials of the two-dose Jynneos vaccine to cover about a third of the estimated 1.6 million gay and bisexual men who officials consider at highest risk and who are being urged to get the shots.”

One shot or two? Or half?

Previously, “U.S. officials said that they have now secured 1.1 million Jynneos vaccine doses, including 786,000 doses finally cleared by regulators after being delayed in Denmark for more than a month, and which will “be in the hands of people who need them over the course of the next several weeks,” Becerra said in a later press conference. Federal regulators reiterated Friday that the vaccine should be given to most people as a two-dose regimen, meaning that U.S. officials have enough shots to cover about 550,000 people.”

As we have seen, that is being ignored in some areas, and while the studies are yet to be done, using one shot, there is some evidence to suggest that they can be effective as 2 doses, but this has also provoked a fierce debate among researchers and physicians, and as Goudner said, in the absence of studies, there is a feeling that many providers are taking what they can get. 

In a recent development, in order to ensure adequate vaccine supplies, there has been a move to fractional shots, "which allows providers to use only one-fifth of the current dosage. The vaccines may now be administered intradermally or between layers of skin, rather than in the fat layer under the skin," noted the Times in a recent update.

While there have been no objections by the manufacturer of the vaccine, this method may increase side effects "such as redness, swelling and firmness." And, there has only been one study that examined this method.

Another factor is training, not many of the providers in the US have that training, and there is the perception among  some Black men, receiving the vaccine with that method, may feel slighted; and, already the overwhelming recipients have been white men.

“The 500,000 additional doses that the U.S. ordered in June is anticipated to be delivered this year,” a Bavarian Nordic spokesperson wrote in an email, declining to respond to specific questions about timing or the company’s commitments to other countries.”

Giving some hope was “Sarah Lovenheim an HHS spokeswoman [who] said officials had expedited the doses announced this week and were working to accelerate future shipments, too.

“We’ll seize every opportunity to speed up the path to secure more doses ahead of schedule, as possible,” Lovenheim said.

Another problem is that there has been a change in delivery systems that health care officials across the nation have said is burdened by "missteps and confusion", reported the Times; and, the distribution system VTrcks, noted for its efficiency and linkage to state systems has not been used for this vaccine, and instead is using email, instead of a distribution system and orders have been severely delayed, and in one instance a shipment to Ft. Lauderdale, Fla, was reported as being sent to Oklahoma, then Mississippi, and then Florida.

While HHS has switched to a different system it is still not linked to state immunization databases.

“Peter Hotez, dean for the National School of Tropical Medicine at the Baylor College of Medicine, said he was open to the idea of “dose sharing” as a temporary fix, suggesting that people could get one dose of Jynneos and one dose of ACAM2000.”

“We don’t have much of a window to fix this,” Hotez said. “Once it gets into the rodent population, it becomes a fixture here, like it’s been in Central and West Africa.”

Updated August, 20, 2022 at 4:25 p.m. CDT

Please note that this is an evolving story, and will be updated as needed.

June Jobs Report shows US economy still strong

 June’s Jobs report, from the US Labor Dept, showed a surprise jump in non farm jobs and gave economists  a smile over their morning coffee this Friday since they had expected only 278,000; so, the news of 372,000 was an even better bonus, better than a chocolate croissant on their plates.

Another boon was for those that were the prophets of doom, sounding the alarm for a pending recession, and were proved wrong, since you can’t get a recession with numbers this high; and, the fact that these numbers also came in with rising inflation was another unexpected bonus.

Despite all of the hand wringing in some markets, it’s also clear that the US economy is resilient, even in the face of interest rate increases by the Federal Reserve to tamp down inflation.

The good news gets better with an approximate gain of 380,000 job gain, on average, over the past quarter, well above pre pandemic levels, even if slower than the prior year, and even better, has replaced nearly all of the near 21 million jobs lost in the private sector that began in February 2020, with few exceptions.

Who gained? For the last few months it was leisure and hospitality, that also takes in hotels and bars, had topped the list, but this time it was professional and business services that led at 74,000, and the former at 67,000 jobs still nothing to sneeze at despite a second place showing. But, of note it still is 1.3 million down from February 2020 benchmark measures.

If you strip out the bars and restaurants you get 41,000, and for those in health care, take a breath, because your area added 57,000 jobs, but building back a loss was 29,000 jobs gained in manufacturing, and those online purchases helped push 759,000 jobs forward of its pre pandemic posts.

Taking a closer  look we can see that labor force participation, a key indicator, took a tumble from 62.3 percent in May to 62.2 for June and this can be problematic, for as The Hill noted, “If fewer Americans are seeking jobs, businesses may have to offer increasingly higher wages to compete for workers. Firms may also raise prices for their goods and services as they attempt to meet rising demand without a large enough staff, which could fuel higher inflation.”

There is still a discrepancy between Blacks and Whites, especially for Black women, perhaps related to child care, as with their white counterparts, and CNBC reported that “The unemployment rate for Black women fell to 5.6% in June, down from 5.9% in the previous month,” but all things considered, even with a slight decrease overall from May, the picture is relatively stable noted Valerie Wilson, the Economic Policy Institute’s program director on race ethnicity, and economics said: “I think the bigger picture is that all of those numbers are within the range of where they’ve been in the last three months,” she said. “It’s a signal that the recovery is stable.”

Remaining the same is the unemployment rate, the marquee figure as we call it, at 3.6 percent, the same as last month, and with no significant jobs loss then the US is even as Steven, says an old cliche.

According to The New York Times, “We’ve essentially ground our way back to where we were pre-Covid,” said Christian Lundlad, a professor of finance at the Kenan-Flagler Business School at the University of North Carolina. “So this doesn’t necessarily look like a dire situation, despite the fact that we’re struggling with inflation and economic declines in some other dimensions.”

As many observers have noted, these gains may not last, and especially with the recession tools that the Fed has chartered, and as Sen. Elizabeth Warren said last month, with these rate increases comes unemployment.

The Times also observed that with 11.3 million workers in May, a record high,  “any workers laid off as certain sectors come under strain are likely to find new jobs quickly, for a time at least.”

For employers that means anxiety around hiring, especially as consumer spending is still facing bottlenecks, and some supply chain issues, those microchips are still not as plentiful. Hiring and filling new positions could be slowwalked, as they noted.

Wages did moderate to 5.1 percent, and wage increases that some employers have chosen to lure employees has also been part of the problem, for those that are concerned about inflation, the Fed included, and as the Times reported, Golddman Sachs officials have said that wages need to slow below 3.5 percent “to be consistent with the Fed’s inflation goals.”

While this would help with the historical goal of 2 percent inflation, prices have to be stable, as Chair Jerome Powell has noted because without it, “the economy’s really not going to work the way it's supposed to be.”

It’s a balancing act, of course, and with inflationary prices hitting 40 year record highs, along with skyrocketing rents, and other basics, too much, is as bad as too little.