November 2, 2023 • 35 mins
We examine some key topics in the healthcare space, from the effectiveness of telehealth, to the ineffectiveness of recent vaccine rollouts and some COVID-19 prevention strategies. We also talk about the latest developments in working-from-home. Bloomberg Opinion columnist Sarah Green Carmichael, Justin Fox, Lisa Jarvis, and F D Flam join the discussion. Amy Morris hosts.
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Speaker 1 (00:01):
You're listening to the Bloomberg Opinion podcast count US Saturdays
at one and seven pm Eastern on Bloomberg dot Com,
the iHeartRadio app, and the Bloomberg Business App, or listen
on demand wherever you get your podcasts.
Speaker 2 (00:15):
Welcome to Bloomberg Opinion I Amy Morris. This week we
look at COVID. We got a lot right about the risks,
but we talk with Bloomberg's Justin Fox, who says we
got the response wrong, and we'll look at the benefits
of telehealth and how it can be especially helpful for teenagers.
Bloomberg's Lisa Jarvis explains how the COVID pandemic highlighted how
(00:36):
telehealth can fit in as part of your healthcare routine. Plus,
the US might want to consider changing it's COVID booster
strategy because whatever they're doing now just doesn't seem to
be working. But we begin with another holdover from COVID,
working from home. While companies are getting more serious about
their return to office policies, more employees are looking for
(00:58):
that flexibility in their careers. Karen Cambro is LinkedIn's chief economist.
Speaker 3 (01:03):
Employers are now gradually pulling back on that they would
like to see people back in the office. We're seeing
an upswing in hybrid work where people are coming in,
say it's three days out of the week, and we're
seeing a decrease in job openings that offer fully remote works.
So there's definitely a trend of getting back into the office.
Speaker 2 (01:21):
But is that the way to go? Is there any
room for flexibility. Let's talk with Bloomberg opinion columnist Sarah
Green Carmichael. She joins us now. Sarah, always a pleasure.
Thank you for taking the time in your column on
the Bloomberg terminal. You use Amazon as an example because
that company has gotten really serious about its return to
work policy.
Speaker 4 (01:42):
Yes, Amazon has been tightening the screws now for months
on employees, and last week Business Insider got hold of
a memo that they had sent to their managers asking
them to first talk to anyone who has not been
coming in three times a week and give them a
sort of an official war. Follow up with an email
sort of documenting a dolores Umbradge sort of type memo
(02:04):
of you know, you haven't been coming in and there
will be consequences, and then if things haven't improved after
a week, or two to really start termination proceedings. So
this is really like exercising the nuclear option on hybrid work.
You know, they're really saying you've got to be in
three days a week and if you're not, you could
be fired.
Speaker 2 (02:22):
So what is this push and pull over working from
home due to middle managers?
Speaker 4 (02:27):
I think it puts them in a really tough spot.
You know, middle managers are in my uh as. I've
sort of talked with them. Yes, would they like some
of their employees to come in more often?
Speaker 5 (02:38):
Yes they would. Do they want to be firing people?
Speaker 6 (02:41):
No?
Speaker 4 (02:41):
Are they trying to manage employees who have real needs
for flexibility?
Speaker 6 (02:45):
Yes?
Speaker 4 (02:45):
Are they also trying to get people, you know, to
do their best at work? Of course? So I think
sort of asking middle managers to kind of become the
enforcer of this policy really does put them in a
bind on top of everything else that middle managers are
asked to do.
Speaker 2 (03:00):
Now, why is there still so much disagreement about whether
working from home actually works? Didn't we prove this in
twenty twenty and beyond amy?
Speaker 4 (03:10):
That is the key question. That's really what the debate
is here. A lot of managers will say that they
don't think that people are as productive at home. They
see the primary benefit of hybrid work as work life balance.
Employees who are working in a hybrid or remote way
see it differently. They are Yeah, the work life balance
(03:30):
is nice, but actually one of the most important benefits
is that I feel so much more productive at home.
So there's this real perception gap based on your position
in the organization. I think part of that gap is
to do with trust. Employees feel like they're getting locked
done at home, managers cannot see them doing it, and
so managers, I think, are more skeptical. And it could
(03:51):
also be that, you know, there are some types of
managing that are actually more difficult when employees aren't right
under your nose. So even if the employee is more productive,
it makes the manager's job a little bit tougher.
Speaker 2 (04:04):
And this isn't supposition on your part. You've found in
writing this column on the Bloomberg terminal is that there
is research out there that shows when the employee has
some power over their workspace, they do better.
Speaker 4 (04:16):
Yes, I talked to an interesting expert in teams and performance,
David Burkis, and he was saying, you know, he's looked
at he's followed this research really closely. A lot of
it's coming out of Stanford, from Nicholas Blooms group at Stanford,
And I asked him, you know, why are we seeing
now such disagreement between these studies. You know, work from
home is more productive if actually the office is more productive.
(04:40):
He said, a lot of it has to do with
people sort of sorting into categories. So if someone prefers
the office, they will actually be more productive at the office.
If someone prefers working from home and has some control
over their schedule and can do that, they'll be more productive,
you know, in that arrangement. So what we're seeing now
post COVID is that when people have the option to
(05:02):
control their work environment, it actually does improve their performance.
And that's I think what so many employees are trying
to hold on to and what is so challenging for
so many managers.
Speaker 2 (05:11):
And we are talking with Bloomberg opinion columnist Sarah Green
Carmichael about working from home and the push to return
to work. Sarah, is there any indication that there's some
sort of relevance to the timing of why there's been
this big push of late of the past few months.
Speaker 4 (05:26):
I think there's probably a confluence of different factors. You know,
companies have invested in their office spaces, and I'm not
sure that they expected them to be this empty for
this long. That's kind of a huge sub cost. And
there is this assumption of like, well, we were working
in person for the last hundred years, surely that's got
(05:47):
to be the best way. But actually, if you look
back further, you know, people used to work from home
all the time. You know, any farmer was working from home.
Speaker 7 (05:56):
You know.
Speaker 4 (05:56):
It's really only until we got these big factories in
the industrial rebel that people started working outside the home.
Any cobbler, any smith, all these people worked right out
of their homes. A lot of shopkeepers lived above the shop.
So actually work from home is the norm, you know,
over the course of centuries, and it's only relatively recently
that we invented these sort of massive office buildings. So
(06:17):
from my perspective, you know, I think it's worth taking
the long view on this and thinking, you know, what
do we want work to be like one hundred years
from now, rather than trying to preserve sort of what
it's been like for most of the twentieth century.
Speaker 2 (06:29):
Well, let's get into that a little bit. We've seen
so many changes with COVID, and I think there's no
question that the workplace dynamic has changed. And from what
you've just said, it sounds like it's always changing. So
would COVID then be one of those little shoves that
helps change the workplace as we've known it for the
(06:49):
past few decades.
Speaker 4 (06:51):
I mean, we'll see.
Speaker 5 (06:52):
I think it will.
Speaker 4 (06:53):
I think what's hard about this moment is that there
were big changes that happened during COVID, and now there's
a lot, a lot of growths, growing pains, anxiety exactly.
And I think what's hard about us sort of policy
like amazons if you know, come in this many days
a week or we will summarily fire you, is that
(07:14):
that even if you're happy to come in three days
a week, that creates that tension, creates a really challenging
work environment to feel good about, not only for managers,
but for all kinds of people, you know, for people
who've been happily coming in three or four or five
days a week but are now going to see some
colleagues fired. And so I think that part of what's
hard about this particular moment is not just the debate
(07:36):
over remote work, but the fact that this debate has
created so much tension that is then infecting the workplace
and affecting people's performance and affecting people's enjoyment of their work.
Speaker 2 (07:46):
Now you have referred to something called return to managing.
We all know rto return to office. You use the
acronym RTM in your column.
Speaker 4 (07:56):
Yes, I think what's happening here is that a lot
of companies have con used returning to office with returning
to managing. You know, a manager's job is to motivate people,
to inspire them, to give them feedback, to hold them accountable,
to set.
Speaker 5 (08:08):
Big goals to move the work forward.
Speaker 4 (08:11):
And you can do a lot of that if you
even without having your eyes directly on people, even without
sitting next to them. And of course we know this
because we have companies that are global companies where people
on a team might be dispersed all over the world,
and you know, we're somehow fine with that. But then
if people are within commuting distance or within fifty miles
of the office and not coming in, suddenly it's like,
(08:33):
but how can we possibly manage them? So I think
that really what needs to happen here is companies should
just sort of think to themselves, Okay, like what do
we really need to do in person? And can we
manage people without seeing them in person, and really put
some of the effort they've been enormous effort they've been
putting into getting people back to the office and reallocate
(08:55):
that just to managing, just to managing to basic management skills,
giving feedback, holding people accountable, setting goals, holding deadlines, you know,
all those sort of back to basics management stuff. You
don't need to get people back in the office to
start managing them. You don't, So let's not confuse the
two things.
Speaker 2 (09:11):
So then, is there any concern about what this would
do to morale? You yourself are talking about how some
people may be perfectly happy to come into the office,
but then when you see your colleagues get fired because
they would rather have a more flexible schedule, what does
that do to morale? What are the concerns there?
Speaker 4 (09:27):
I think there are big questions about morale right now.
Forcing people to adopt a work arrangement that they don't
like is going to be bad for morale. It's going
to be bad for their morale. Their morale is going
to affect other people's morale. That's a challenge. I also
do think that when you look at some of the
research on remote work, you know it's not always like
sunshining kittens for the people doing it. You know there
(09:49):
are real trade offs.
Speaker 5 (09:51):
It can be you know that you.
Speaker 4 (09:53):
Work really hard and you're super productive from home, but
you're also more likely to burn out and feel maybe
less connected to your colleagues, you're lonelier. We do need
sort of these social bonds with each other. So I
think that to my mind, accepting that and figuring out
how do we make this work for the largest number
(10:13):
of people is a key question for management. I also
think employees have responsibilities to ask themselves, how do I
really work best? And if you really do work best
in an office, I think you owe it to yourself,
never mind the company. You owe it to yourself to
put yourself in a position where you can do your
best work. But given that, given the trade offs people
have to make in their real lives, I do think
(10:35):
this is a moment of great fluidity. It's going to
be challenging to manage. It's going to be challenging for
each of us to figure out out of all the
options we have, how do we work best? But it's
also a moment of enormous opportunity where we really have
a chance, for the first time in decades, to think
about how should we make this work.
Speaker 2 (10:51):
Bloomberg Opinion columnist Sarah Green Carmichael, and coming up, we're
going to take a look at the risks and the
response to COVID. What did the country get right and
what did everybody get wrong. You're listening to Bloomberg Opinion.
Speaker 1 (11:13):
You're listening to the Bloomberg Opinion podcast. Catch us Saturdays
at one and seven pm Eastern on Bloomberg dot Com,
the iHeartRadio app, and the Bloomberg Business App, or listen
on demand wherever you get your podcasts.
Speaker 2 (11:28):
You're listening to Bloomberg Opinion. I'm Amy Morris. As we
take a closer look at the COVID pandemic this week,
Let's consider the risk factors and the response. Now, you
might remember when doctor Anthony Fauci, then head of the
National Institute of Allergy and Infectious Diseases, testified before Congress
about the risks of the spread of COVID nineteen. This
(11:48):
is back in June of twenty twenty.
Speaker 8 (11:50):
We are now having forty plus thousand new cases a day.
I would not be surprised if we go up to
one hundred thousand a day if this does not turn around,
And so I am very concerned.
Speaker 2 (12:03):
Well, that does feel like a long time ago, even
though we are still feeling some residual impact of the
illness and the loss and the risks involved. Bloomberg opinion
columnist Justin Fox joins us now to look at what
we got right and what we got wrong. And Justin,
when you say risk in your columns on the Bloomberg terminal,
you're talking about the risk of catching COVID or hospitalizations
(12:25):
or fatalities. What are you referring to.
Speaker 6 (12:26):
The risk of dying of it if you get it,
the infection without fatality rate? And what did you find
so very early on back in March twenty twenty, I was,
you know, I'm not a medical journalist or anything, but
I like to make charts, and I was concerned and
I wanted to I was a little frustrated with how
it was being covered, so I just went out to find, Okay, well,
(12:47):
what's the best estimate of how deadly this disease is?
And it was a paper from February twenty twenty from
Imperial College in London, Neil Ferguson, a guy who later
became a little for some reasons. But it said it
was approximately one percent of people who got it died
in China, and when you looked in the details of
(13:10):
the text, it was point eight or point nine percent.
I was, and so you know, I wrote a column
then using that a bunch of other numbers to sort
of throw out this ballpark of three hundred thousand to
six hundred thousand people could die of COVID in a year,
and that's what happened. And so this whole backdrop is
(13:33):
I'm reading this new book by a couple friends of mine.
Actually it's called The Big Fail. It's a history of
the pandemic. And there's this discussion of Ja Bodachari at Stanford,
who was early on pushing this idea that maybe it
was a lot less dangerous than people thought that COVID was,
and it just sort of misstated. What you know, there
(13:58):
were these case fatality numbers going around where they just
took confirmed cases and divided deaths and it was like
three percent. And I think everybody knew then that that
was much that was too high because most people weren't
getting tested, and so basically my Bodachari was arguing that
maybe it was as low as point zero one percent
(14:18):
and twenty or forty thousand people would die of the
disease in the US, and that was clearly wrong. And
yet in the book it was sort of discussed as
if Baudachari had been right and the consensus had been wrong.
And actually the consensus of how dangerous COVID was was
pretty spot on. You look at the early papers that
(14:39):
tried to make a serious estimate of it, and it
was that, you know, in a population with you know,
an age spread like the US when it first hits,
it would kill around one percent of people who got it,
which is exactly what happened in New York. It's less
if it's not everywhere like it was in New York.
It's less if the population is younger, like in Sub
(15:02):
Saharan Africa. And so what was sort of interesting to
me is I still think, you know, the initial reaction,
who knows what the right thing was to do, But
it does seem pretty clear in retrospect that sometime in
summer twenty twenty, things took this weird turn where you know,
a lot of places decided to keep schools closed for
(15:23):
the whole year, and just so a lot of ways
have decided to just sort of keep a lighter version
of the lockdowns going indefinitely, and I just all the data,
there's just not much evidence that that was the right
thing to do.
Speaker 2 (15:37):
And we are talking with Bloomberg opinion columnist Justin Fox
about how we got COVID's risks right, but the response
was wrong. And let's get back to that. The pandemic
shutdown is it. Is there any way to measure whether
that was worth it?
Speaker 6 (15:52):
I mean, there are lots of people who run lots
of regressions and done studies, and I think overall the
argument is if you did it early enough that maybe
it was worth it, Like in New York, It's a
little hard to say, because I had my own I
attempted to sort of reconstruct the pandemic for a column
(16:13):
a couple of years ago, like when when it hit,
when people got it when and it looked like it
had already peaked and was receding when the strictest of
the lockdown measures came in because people were scared and
had already changed their behavior and so but I think overall,
the idea that when it was first coming, you didn't
(16:33):
have enough mass hospitals risk being overwhelmed. It made sense
to take a few weeks off from things. But I
think a lot of places, really and the US seems
to have struggled the most. I mean, I guess in
one sense we some places opened up again very quickly,
lots of other places didn't. But it seemed like we
kind of got the worst of both worlds, whereas there
(16:54):
were other countries like Germany or Denmark that opened up
pretty quickly but were more careful about it, had more
testing and stuff, and were able to mostly live their
lives normally with some brief shutdowns in the winter.
Speaker 2 (17:08):
And it does seem like the biggest mismatch involved schooling
and kids. And how did the US get that wrong?
What other what else could they have done?
Speaker 6 (17:17):
I mean, I you know, it was funny. I was
watching a bunch of Faucheet videos from that summer, and
you know, he knew that there was very little risk
to children, and he clearly his default was that schools
should reopen. But I don't know for whatever reasons he
wasn't willing to push people to do that, And definitely,
(17:40):
as the summer went on and case numbers went up
again in parts of the country, he was like, maybe
you shouldn't reopen in those places where cases were really high.
But what's kind of funny is what happened is schools
reopened in all the places in the South where cases
were really high, and they didn't reopen in places on
the coasts where they weren't so And and I don't
think it was disastrous in those places in the South
(18:03):
where it reopened. It definitely, I mean, you look at
the numbers, like comparing Florida in California, there were some
you know, more children died in Florida than in California,
but it was very few in both places.
Speaker 2 (18:15):
While we were in the thick of this, before we
had the testing and the vaccines, and while everyone was
staying home, there was that debate though over how nasty
this virus could be.
Speaker 6 (18:27):
One they nailed it down pretty well, but the fact
that there's this huge variance by age that extremely dangerous
if you're above sixty, not so dangerous if you're below fifty,
and sort of hard to know if you're in your
fifties like now, And I just think that was hard
to you know, and with schools obviously very low risk
(18:49):
to children, but you know, some teachers real risk. So
the knowledge was there, and in the public health community,
you know, people knew what the where, they knew the
profile that it was much lower for children. I know,
you could see it in the CDC data that it
was putting out as not optimal at all.
Speaker 2 (19:08):
What have we learned?
Speaker 5 (19:09):
Huh?
Speaker 6 (19:10):
I mean that's the most interesting, I mean one thing
since I've written it, there's still all of these people,
including Jay Boditaria, still arguing that they were right, that
it was much less dangerous than people thought, and I
I just I run the numbers and they're wrong. I mean,
it was about as dangerous as people thought. Obviously got
less dangerous over time, less dangerous whether there or any
old people, et cetera. And so it's interesting that that
(19:33):
was done spectacularly well, and figuring out what to do
about that was really hard. And you know, I think
it's it's the age gradient. And it's also you know,
what do you do about a thing that has a
one percent chance of killing people overall? It's like, do
you completely shut down society or do you totally go normal.
It's probably neither of those. It's somewhere in between. And
(19:55):
I think the countries that were most successful sort of
kept up this in between where changed behavior, but it
wasn't super dramatic like Japan or Sweden or wherever.
Speaker 2 (20:06):
All Right, Justin, thank you so much for sharing those
numbers with us. Glad to do it, Bloomberg Opinion columnist
Justin Fox. And coming up, we look at a different
impact of COVID on kids' mental health and how telehealth,
which grew in popularity during the height of the pandemic shutdown,
might help. And don't forget We're available as a podcast
on Apple, Spotify, or your favorite podcast platform. This is
(20:29):
Bloomberg Opinion.
Speaker 1 (20:41):
You're listening to the Bloomberg Opinion podcast. Catch us Saturdays
at one and seven pm Eastern on Bloomberg dot Com,
the iHeartRadio app, and the Bloomberg Business App, or listen
on demand wherever you get your podcasts.
Speaker 2 (20:56):
This is Bloomberg Opinion. I'm Amy Morris. Studies have shown
the COVID pandemic seemed to worsen teens in adolescents, mental
health pediatrician, doctor John Brownstein.
Speaker 9 (21:06):
Yes, systematic gaps, limited community and specialty resources, staffing challenges
that really accentuate this problem. So the bottom line is
our health systems are not there to improve care for
our kids in mental health crisis right now, but.
Speaker 2 (21:19):
There may be some hope. Telehealth appears to give more
young people more access to support. Let's talk about this
with Bloomberg opinion columnist Lisa Jarvis. She covers biotech, healthcare
and the pharmaceutical industry. Now, Lisa, you heard that cut
from the doctor, and you've referred to a new study
by Rand in your column which found that telehealth really
(21:40):
does help you feel more connected, at least for their
mental and physical health.
Speaker 7 (21:45):
How so, you know the study, the RAND study tried
to look at what happened with mental health use before
in Duram and you know, towards the tail end of
what we would consider the kind of peak pandemic, and
found that overall, if you looked from January twenty nineteen
through August twenty twenty two, overall mental health use was
(22:08):
up twenty two percent, and that was really largely driven
by telehealth, which you know most people may recognize prior
to the pandemic was almost at zero. You know, a
lot of insurers wouldn't cover it. It was just not
a routine part of practice when it came to mental
health services.
Speaker 5 (22:28):
And so you know, there were a number of things that.
Speaker 7 (22:30):
Kind of enabled that, and I'm happy to get into it,
but you know, essentially, what their data showed was that
both usage went up, the cost did go up as well,
but in parallel, so it wasn't like it was more expensive,
and it did seem to provide a lot more access
to care for kids.
Speaker 2 (22:45):
Yeah, let's get into it. You said that there are
some X factors and some reasons why this is happening.
Speaker 5 (22:50):
Yeah, I think, you know, beyond insurers.
Speaker 7 (22:53):
Essentially, some of the pandemic eraor rules made it so
that insurers would cover telehealth, both public and private. But
you know, I think a few other factors happened. When
kids moved to remote school, there was a huge push
to make sure that everyone had devices and internet access,
which allowed a lot more people to be able to
(23:14):
participate in things like you know, telehealth, whether or it's
for mental health.
Speaker 5 (23:18):
Or behavior, you know, physical health.
Speaker 7 (23:20):
So you know, I think that increased access, and then
you know, I think people became more accustomed to the
idea of you know, seeing someone virtually rather than in person,
and that it could be just as good. And for
this generation, it really can be meeting them where they are.
They're used to interacting with their friends that way and
(23:40):
so it's not such a stretch to interact with the
mental health provider that way.
Speaker 2 (23:44):
He let me ask about that, is there was concern
that maybe an in person meeting might be more effective
than a telehealth meeting or is that an issue?
Speaker 7 (23:55):
So there's been a lot of studies about that kind
of dating back to when people for starts to do
phone type of you know, mental health visits and they're
an adults, granted, but they suggest that the quality of
care people are getting is just as effective. I think,
you know, certainly there are times when an in person
meeting you might need a follow up or you know,
(24:17):
that shouldn't be a piece of our health care that
we get rid of, you know, and everyone needs different things,
so we need to have a lot of different ways
to deliver mental health care to kids. But you know,
the evidence suggests that it's just as effective and that
the retention rate is better, so people there's a much
lower no show rate when it comes to telehealth, probably
(24:38):
because people just it's easier for them.
Speaker 5 (24:40):
They don't have to take an hour.
Speaker 7 (24:42):
Two or three out of their data commute to go
to the office, you know, the mental health provider's office,
and they can just sort of pop in where they are,
so they saw. There's data to show that kids are
going more adult kids and adults are going more consistently
to their appointments, which suggests that, you know, maybe they're
getting more out of it too.
Speaker 2 (25:01):
That makes more sense because it would be private, it
would be more convenient, you wouldn't have to worry about
getting to and from the location. You talk about in
your column though, that there are kids who need help
and there are kids who get help, and that there
is a gap. Is that something new because of the
pandemic or is this the gap we've been always seeing.
Speaker 5 (25:20):
Yeah, that's a gap we've been always seen.
Speaker 7 (25:22):
You know, it's a racial gap and access to mental
health care. You know, in the pandemic, one thing that
happened is with schools closed, Kids who might have typically
received care in the environment of the school might not
have been getting it. But when it comes to telehealth,
one of the things that really needs to be improved
is that in this Rand study, they found that black
and LATENX kids just weren't switched to telehealth as often
(25:47):
as white kids, and so you know, that sort of
mode of care and ease of care was just wasn't
being offered to them at the same level. And so
you know, that needs to be fixed. And you know,
I think one of the things that I talk about
and I mentioned earlier is just this idea of making
sure that everyone has Internet, everyone has a device that
(26:11):
they can access their provider, you know, interact with their
provider on and so all all of the modes are important,
but telehealth can be one that can be you know,
really useful, and so we need to close that gap.
Speaker 2 (26:23):
And we are talking with Bloomberg Opinion columnist Lisa Jarvis
about the impact of the pandemic on kids mental health
and access to mental health care. So the study that
you referenced, actually you referenced several within your column when
it comes to the use of telehealth, how are kids
able to take advantage of it?
Speaker 7 (26:42):
Yeah, I mean, I think it's a multi factorial, but
you know, sometimes they might that might be their first
visit with the provider.
Speaker 5 (26:51):
Maybe that's a way that they switch.
Speaker 7 (26:52):
You know, I think I've talked to folks who are
you know, child psychiatrists who have suggested that one thing
that could happen. There's a big push right now to
put more mental health providers inside schools. Could it be
that kids can get pulled aside and do their provider
visit while they're at school via telehealth, you know, so
that they don't have to miss a chunk of their day.
(27:14):
Those are all things that need to be considered, and
you know, the Biden administration is trying to put a
lot of money into ensuring that there's better services, particularly
for kids, as we all recognize as crisis. So that's
an area that we should be looking at.
Speaker 2 (27:29):
And you make a really good point about insurance companies
and how they might be responding once telehealth is starting
to catch on, do you think it'll still be covered?
Speaker 5 (27:39):
Ash? I hope.
Speaker 7 (27:39):
So every person I talked to for that column was
worried about that, you know, just because you saw the
cost of overall care go up because usage went up,
which is good, it wasn't like it went up in
an outsized way. But you know, kids really need to
be accessing this more, you know, and I think what
can be confusing is, you know, different plans cover different
things if you switch insurance the extension. Though the pH
(28:05):
the Public Health Emergency has ended, Congress has ensured that
telehealth will still stay part of our access for people
with public insurance through the end of twenty twenty four.
We really want to make sure that that continues beyond
that because though I think there's mixed evidence when it
comes to our physical health and telehealth, when it comes
(28:25):
to mental health, it really feels like this is an
important way of delivering care.
Speaker 2 (28:30):
And in a more thirty thousand foot broader view of this,
you reference a study by Harvard that makes this grim point.
All kids, all demographics across the board, the different ages,
the race, how much money your mom and dad have
do not matter. They're struggling. Is this also a result
of the pandemic?
Speaker 7 (28:51):
Yeah, I mean it preceded the pandemic for sure. I
think the pandemic exacerbated it. You know, we've seen some
really disturbing survey results the CDC's Youth Risk Behavior Survey,
which comes out once a year. You know, you probably
saw all the headlines, including one that I wrote about
that survey at the beginning of this year, you know,
(29:12):
sixty percent of teenage girls reporting persistent feelings of sadness
and hopelessness.
Speaker 5 (29:17):
You know, it is hitting all kids.
Speaker 7 (29:20):
It does not matter, you know, their their socioeconomic situation,
their race, their gender, their ethnicity, like it's just across
the board. And so I think there's a lot of
effort to try to mobilize and address the kids that
are struggling.
Speaker 2 (29:37):
Are you able to gauge yet how popular telehealth is becoming.
Speaker 5 (29:42):
That's a good question.
Speaker 7 (29:43):
One of the things about their rand study that was
a little tough, and they you know, fully admit that
they can't parse the number of users that might have
increased versus the number of people who might have been
visiting their provider more often. And so that's the next
step and what their research, and I think that'll help
us understand, you know, who is benefiting on a little
(30:04):
more granular level in how many more people are benefiting
versus whether there's like some portion that are just getting
more consistent help and versus new users of telehealth. So
I think there's still more studies to be done, but
so far, it really does feel like the evidence is
that this helps kids a lot.
Speaker 2 (30:22):
And if you can take advantage of it, why not exactly?
Speaker 7 (30:26):
You know, we all have computers. We're used to zoom
by now kids included.
Speaker 2 (30:30):
Bloomberg Opinion columnist Lisa Jarvis covers biotech healthcare in the
pharmaceutical industry. You're listening to Bloomberg Opinion. I'm Amie Morris.
Have you gotten your COVID booster? Chances are you have not.
In fact, less than three percent of eligible Americans have
gotten a COVID booster this fall. Faith Lamb is a
Bloomberg Opinion columnist covering science and host of the Follow
(30:51):
the Science podcast, and she joins us, Now, faye, what
is the hold up? Why are numbers so low?
Speaker 10 (30:57):
Some of it is said, I don't think people have
a clear idea of why they should get these boosters.
I think it was a lot clearer why people should
get the initial shots, because there was evidence that they
might protect our whole communities by you know, reducing the
odds that you would get infected and also if people
were at risk of having severe disease. These shots were
(31:20):
really very effective at keeping people out of the hospital.
But now that we're many people are on you know,
shot number six or seven. I think for you younger
healthy people, it's a little unclear what the point is great.
Speaker 2 (31:33):
Do healthy people even meet these boosters?
Speaker 10 (31:35):
A lot of doctors will say no. And there was
actually a piece that caught my eye because I'd seen
some controversy on Twitter about this, but there was a
piece of commentary piece in Science by two really prominent
immunologists saying no, we should actually, if we really want
to save lives, we should be focusing these shots on
(31:57):
the people we know are most vulnerable to severe disease,
because the evidence that they prevent mild disease is pretty
weak right now. But that people in nursing homes, that
the really elderly people, they haven't all gotten this booster
and they should now.
Speaker 2 (32:14):
Is this all part of the mindset that the pandemic
is all over, We're done. Boy got through that?
Speaker 10 (32:20):
Well, it's a little bit. But I also think it's
that there was a sort of a public health strategy
that was to be blunt, you know, to try to
try to oversimplify things, you know, even though they knew
that not everybody was at high risk, they felt like
somehow that people wouldn't get the message or wouldn't take
(32:42):
it seriously unless they said everybody is equally at risk.
And I think people realize.
Speaker 5 (32:48):
It's not true.
Speaker 2 (32:49):
So is that a strategy that has then failed they
need to fix it.
Speaker 5 (32:52):
I think so, yeah.
Speaker 10 (32:54):
I think people are smarter than that, and I think
it can fail the people who really are at high risk.
Speaker 2 (32:59):
Do you remember during the height of the pandemic, those
mass vaccination sites that popped up, and they seemed to
work quite well. It was military precision to get everybody
in and out. Can they do that again?
Speaker 10 (33:13):
Maybe? But I think we're just it would cost a
lot of money, and we're in a very different situation
right now. You know, back then, the vaccines really had
a huge effect because there were still a massive proportion
of the population that had no immunity to this virus.
And now there's messaments to say, ninety nine percent of
us either have had COVID or had the shots or
(33:36):
some combination of BULK, And so we're not in the
same position we were in where we had this huge
percentage of the popular majority of Americans still had no
immunity to this and there were you know, there were
clinical trials showing that that we were much less likely
to get severely ill if we got these shots, and
that there was some evidence that we were less likely
(33:58):
to get a mild case and give it to so
that there was a sense that you were doing your
civic duty to protect the immune compromise the people that
were less likely to get protection by just cutting down
on the number of cases and the risk to those people.
Speaker 2 (34:13):
Is that the same attitude that we have with the
flu A little bit.
Speaker 5 (34:16):
Yeah.
Speaker 10 (34:17):
I think people sort of feel like, well, you know,
I might be less likely to get You can still
get the flu after you get a flu shot. But
I think that people feel like, well, they're at least
doing what they can, you know, so that they don't
get a mild case and give it to someone they're visiting,
an elderly relative. So I think that there is a
sort of a sense also that nobody wants to get
(34:38):
a nasty case of flu, and if the flu shot
means that what would have been a nasty case of
flu is a very mild case of flu, that's, you know,
that's desirable for a lot of people.
Speaker 2 (34:49):
Faith Lamb is a Bloomberg opinion columnist covering science and
host of the follow the Science podcast that does it
for this week's Bloomberg Opinion. We are produced by Eric
Molow and you can find all of these columns on
the Bloomberg Terminal, and we're available as a podcast on Apple, Spotify,
or your favorite podcast platform. Stay with us. Today's top
stories and global business headlines are just ahead. I Mammy Morris.
(35:12):
This is Bloomberg.
You're listening to the Bloomberg Opinion podcast count US Saturdays
at one and seven pm Eastern on Bloomberg dot Com,
the iHeartRadio app, and the Bloomberg Business App, or listen
on demand wherever you get your podcasts.
Speaker 2 (00:15):
Welcome to Bloomberg Opinion I Amy Morris. This week we
look at COVID. We got a lot right about the risks,
but we talk with Bloomberg's Justin Fox, who says we
got the response wrong, and we'll look at the benefits
of telehealth and how it can be especially helpful for teenagers.
Bloomberg's Lisa Jarvis explains how the COVID pandemic highlighted how
(00:36):
telehealth can fit in as part of your healthcare routine. Plus,
the US might want to consider changing it's COVID booster
strategy because whatever they're doing now just doesn't seem to
be working. But we begin with another holdover from COVID,
working from home. While companies are getting more serious about
their return to office policies, more employees are looking for
(00:58):
that flexibility in their careers. Karen Cambro is LinkedIn's chief economist.
Speaker 3 (01:03):
Employers are now gradually pulling back on that they would
like to see people back in the office. We're seeing
an upswing in hybrid work where people are coming in,
say it's three days out of the week, and we're
seeing a decrease in job openings that offer fully remote works.
So there's definitely a trend of getting back into the office.
Speaker 2 (01:21):
But is that the way to go? Is there any
room for flexibility. Let's talk with Bloomberg opinion columnist Sarah
Green Carmichael. She joins us now. Sarah, always a pleasure.
Thank you for taking the time in your column on
the Bloomberg terminal. You use Amazon as an example because
that company has gotten really serious about its return to
work policy.
Speaker 4 (01:42):
Yes, Amazon has been tightening the screws now for months
on employees, and last week Business Insider got hold of
a memo that they had sent to their managers asking
them to first talk to anyone who has not been
coming in three times a week and give them a
sort of an official war. Follow up with an email
sort of documenting a dolores Umbradge sort of type memo
(02:04):
of you know, you haven't been coming in and there
will be consequences, and then if things haven't improved after
a week, or two to really start termination proceedings. So
this is really like exercising the nuclear option on hybrid work.
You know, they're really saying you've got to be in
three days a week and if you're not, you could
be fired.
Speaker 2 (02:22):
So what is this push and pull over working from
home due to middle managers?
Speaker 4 (02:27):
I think it puts them in a really tough spot.
You know, middle managers are in my uh as. I've
sort of talked with them. Yes, would they like some
of their employees to come in more often?
Speaker 5 (02:38):
Yes they would. Do they want to be firing people?
Speaker 6 (02:41):
No?
Speaker 4 (02:41):
Are they trying to manage employees who have real needs
for flexibility?
Speaker 6 (02:45):
Yes?
Speaker 4 (02:45):
Are they also trying to get people, you know, to
do their best at work? Of course? So I think
sort of asking middle managers to kind of become the
enforcer of this policy really does put them in a
bind on top of everything else that middle managers are
asked to do.
Speaker 2 (03:00):
Now, why is there still so much disagreement about whether
working from home actually works? Didn't we prove this in
twenty twenty and beyond amy?
Speaker 4 (03:10):
That is the key question. That's really what the debate
is here. A lot of managers will say that they
don't think that people are as productive at home. They
see the primary benefit of hybrid work as work life balance.
Employees who are working in a hybrid or remote way
see it differently. They are Yeah, the work life balance
(03:30):
is nice, but actually one of the most important benefits
is that I feel so much more productive at home.
So there's this real perception gap based on your position
in the organization. I think part of that gap is
to do with trust. Employees feel like they're getting locked
done at home, managers cannot see them doing it, and
so managers, I think, are more skeptical. And it could
(03:51):
also be that, you know, there are some types of
managing that are actually more difficult when employees aren't right
under your nose. So even if the employee is more productive,
it makes the manager's job a little bit tougher.
Speaker 2 (04:04):
And this isn't supposition on your part. You've found in
writing this column on the Bloomberg terminal is that there
is research out there that shows when the employee has
some power over their workspace, they do better.
Speaker 4 (04:16):
Yes, I talked to an interesting expert in teams and performance,
David Burkis, and he was saying, you know, he's looked
at he's followed this research really closely. A lot of
it's coming out of Stanford, from Nicholas Blooms group at Stanford,
And I asked him, you know, why are we seeing
now such disagreement between these studies. You know, work from
home is more productive if actually the office is more productive.
(04:40):
He said, a lot of it has to do with
people sort of sorting into categories. So if someone prefers
the office, they will actually be more productive at the office.
If someone prefers working from home and has some control
over their schedule and can do that, they'll be more productive,
you know, in that arrangement. So what we're seeing now
post COVID is that when people have the option to
(05:02):
control their work environment, it actually does improve their performance.
And that's I think what so many employees are trying
to hold on to and what is so challenging for
so many managers.
Speaker 2 (05:11):
And we are talking with Bloomberg opinion columnist Sarah Green
Carmichael about working from home and the push to return
to work. Sarah, is there any indication that there's some
sort of relevance to the timing of why there's been
this big push of late of the past few months.
Speaker 4 (05:26):
I think there's probably a confluence of different factors. You know,
companies have invested in their office spaces, and I'm not
sure that they expected them to be this empty for
this long. That's kind of a huge sub cost. And
there is this assumption of like, well, we were working
in person for the last hundred years, surely that's got
(05:47):
to be the best way. But actually, if you look
back further, you know, people used to work from home
all the time. You know, any farmer was working from home.
Speaker 7 (05:56):
You know.
Speaker 4 (05:56):
It's really only until we got these big factories in
the industrial rebel that people started working outside the home.
Any cobbler, any smith, all these people worked right out
of their homes. A lot of shopkeepers lived above the shop.
So actually work from home is the norm, you know,
over the course of centuries, and it's only relatively recently
that we invented these sort of massive office buildings. So
(06:17):
from my perspective, you know, I think it's worth taking
the long view on this and thinking, you know, what
do we want work to be like one hundred years
from now, rather than trying to preserve sort of what
it's been like for most of the twentieth century.
Speaker 2 (06:29):
Well, let's get into that a little bit. We've seen
so many changes with COVID, and I think there's no
question that the workplace dynamic has changed. And from what
you've just said, it sounds like it's always changing. So
would COVID then be one of those little shoves that
helps change the workplace as we've known it for the
(06:49):
past few decades.
Speaker 4 (06:51):
I mean, we'll see.
Speaker 5 (06:52):
I think it will.
Speaker 4 (06:53):
I think what's hard about this moment is that there
were big changes that happened during COVID, and now there's
a lot, a lot of growths, growing pains, anxiety exactly.
And I think what's hard about us sort of policy
like amazons if you know, come in this many days
a week or we will summarily fire you, is that
(07:14):
that even if you're happy to come in three days
a week, that creates that tension, creates a really challenging
work environment to feel good about, not only for managers,
but for all kinds of people, you know, for people
who've been happily coming in three or four or five
days a week but are now going to see some
colleagues fired. And so I think that part of what's
hard about this particular moment is not just the debate
(07:36):
over remote work, but the fact that this debate has
created so much tension that is then infecting the workplace
and affecting people's performance and affecting people's enjoyment of their work.
Speaker 2 (07:46):
Now you have referred to something called return to managing.
We all know rto return to office. You use the
acronym RTM in your column.
Speaker 4 (07:56):
Yes, I think what's happening here is that a lot
of companies have con used returning to office with returning
to managing. You know, a manager's job is to motivate people,
to inspire them, to give them feedback, to hold them accountable,
to set.
Speaker 5 (08:08):
Big goals to move the work forward.
Speaker 4 (08:11):
And you can do a lot of that if you
even without having your eyes directly on people, even without
sitting next to them. And of course we know this
because we have companies that are global companies where people
on a team might be dispersed all over the world,
and you know, we're somehow fine with that. But then
if people are within commuting distance or within fifty miles
of the office and not coming in, suddenly it's like,
(08:33):
but how can we possibly manage them? So I think
that really what needs to happen here is companies should
just sort of think to themselves, Okay, like what do
we really need to do in person? And can we
manage people without seeing them in person, and really put
some of the effort they've been enormous effort they've been
putting into getting people back to the office and reallocate
(08:55):
that just to managing, just to managing to basic management skills,
giving feedback, holding people accountable, setting goals, holding deadlines, you know,
all those sort of back to basics management stuff. You
don't need to get people back in the office to
start managing them. You don't, So let's not confuse the
two things.
Speaker 2 (09:11):
So then, is there any concern about what this would
do to morale? You yourself are talking about how some
people may be perfectly happy to come into the office,
but then when you see your colleagues get fired because
they would rather have a more flexible schedule, what does
that do to morale? What are the concerns there?
Speaker 4 (09:27):
I think there are big questions about morale right now.
Forcing people to adopt a work arrangement that they don't
like is going to be bad for morale. It's going
to be bad for their morale. Their morale is going
to affect other people's morale. That's a challenge. I also
do think that when you look at some of the
research on remote work, you know it's not always like
sunshining kittens for the people doing it. You know there
(09:49):
are real trade offs.
Speaker 5 (09:51):
It can be you know that you.
Speaker 4 (09:53):
Work really hard and you're super productive from home, but
you're also more likely to burn out and feel maybe
less connected to your colleagues, you're lonelier. We do need
sort of these social bonds with each other. So I
think that to my mind, accepting that and figuring out
how do we make this work for the largest number
(10:13):
of people is a key question for management. I also
think employees have responsibilities to ask themselves, how do I
really work best? And if you really do work best
in an office, I think you owe it to yourself,
never mind the company. You owe it to yourself to
put yourself in a position where you can do your
best work. But given that, given the trade offs people
have to make in their real lives, I do think
(10:35):
this is a moment of great fluidity. It's going to
be challenging to manage. It's going to be challenging for
each of us to figure out out of all the
options we have, how do we work best? But it's
also a moment of enormous opportunity where we really have
a chance, for the first time in decades, to think
about how should we make this work.
Speaker 2 (10:51):
Bloomberg Opinion columnist Sarah Green Carmichael, and coming up, we're
going to take a look at the risks and the
response to COVID. What did the country get right and
what did everybody get wrong. You're listening to Bloomberg Opinion.
Speaker 1 (11:13):
You're listening to the Bloomberg Opinion podcast. Catch us Saturdays
at one and seven pm Eastern on Bloomberg dot Com,
the iHeartRadio app, and the Bloomberg Business App, or listen
on demand wherever you get your podcasts.
Speaker 2 (11:28):
You're listening to Bloomberg Opinion. I'm Amy Morris. As we
take a closer look at the COVID pandemic this week,
Let's consider the risk factors and the response. Now, you
might remember when doctor Anthony Fauci, then head of the
National Institute of Allergy and Infectious Diseases, testified before Congress
about the risks of the spread of COVID nineteen. This
(11:48):
is back in June of twenty twenty.
Speaker 8 (11:50):
We are now having forty plus thousand new cases a day.
I would not be surprised if we go up to
one hundred thousand a day if this does not turn around,
And so I am very concerned.
Speaker 2 (12:03):
Well, that does feel like a long time ago, even
though we are still feeling some residual impact of the
illness and the loss and the risks involved. Bloomberg opinion
columnist Justin Fox joins us now to look at what
we got right and what we got wrong. And Justin,
when you say risk in your columns on the Bloomberg terminal,
you're talking about the risk of catching COVID or hospitalizations
(12:25):
or fatalities. What are you referring to.
Speaker 6 (12:26):
The risk of dying of it if you get it,
the infection without fatality rate? And what did you find
so very early on back in March twenty twenty, I was,
you know, I'm not a medical journalist or anything, but
I like to make charts, and I was concerned and
I wanted to I was a little frustrated with how
it was being covered, so I just went out to find, Okay, well,
(12:47):
what's the best estimate of how deadly this disease is?
And it was a paper from February twenty twenty from
Imperial College in London, Neil Ferguson, a guy who later
became a little for some reasons. But it said it
was approximately one percent of people who got it died
in China, and when you looked in the details of
(13:10):
the text, it was point eight or point nine percent.
I was, and so you know, I wrote a column
then using that a bunch of other numbers to sort
of throw out this ballpark of three hundred thousand to
six hundred thousand people could die of COVID in a year,
and that's what happened. And so this whole backdrop is
(13:33):
I'm reading this new book by a couple friends of mine.
Actually it's called The Big Fail. It's a history of
the pandemic. And there's this discussion of Ja Bodachari at Stanford,
who was early on pushing this idea that maybe it
was a lot less dangerous than people thought that COVID was,
and it just sort of misstated. What you know, there
(13:58):
were these case fatality numbers going around where they just
took confirmed cases and divided deaths and it was like
three percent. And I think everybody knew then that that
was much that was too high because most people weren't
getting tested, and so basically my Bodachari was arguing that
maybe it was as low as point zero one percent
(14:18):
and twenty or forty thousand people would die of the
disease in the US, and that was clearly wrong. And
yet in the book it was sort of discussed as
if Baudachari had been right and the consensus had been wrong.
And actually the consensus of how dangerous COVID was was
pretty spot on. You look at the early papers that
(14:39):
tried to make a serious estimate of it, and it
was that, you know, in a population with you know,
an age spread like the US when it first hits,
it would kill around one percent of people who got it,
which is exactly what happened in New York. It's less
if it's not everywhere like it was in New York.
It's less if the population is younger, like in Sub
(15:02):
Saharan Africa. And so what was sort of interesting to
me is I still think, you know, the initial reaction,
who knows what the right thing was to do, But
it does seem pretty clear in retrospect that sometime in
summer twenty twenty, things took this weird turn where you know,
a lot of places decided to keep schools closed for
(15:23):
the whole year, and just so a lot of ways
have decided to just sort of keep a lighter version
of the lockdowns going indefinitely, and I just all the data,
there's just not much evidence that that was the right
thing to do.
Speaker 2 (15:37):
And we are talking with Bloomberg opinion columnist Justin Fox
about how we got COVID's risks right, but the response
was wrong. And let's get back to that. The pandemic
shutdown is it. Is there any way to measure whether
that was worth it?
Speaker 6 (15:52):
I mean, there are lots of people who run lots
of regressions and done studies, and I think overall the
argument is if you did it early enough that maybe
it was worth it, Like in New York, It's a
little hard to say, because I had my own I
attempted to sort of reconstruct the pandemic for a column
(16:13):
a couple of years ago, like when when it hit,
when people got it when and it looked like it
had already peaked and was receding when the strictest of
the lockdown measures came in because people were scared and
had already changed their behavior and so but I think overall,
the idea that when it was first coming, you didn't
(16:33):
have enough mass hospitals risk being overwhelmed. It made sense
to take a few weeks off from things. But I
think a lot of places, really and the US seems
to have struggled the most. I mean, I guess in
one sense we some places opened up again very quickly,
lots of other places didn't. But it seemed like we
kind of got the worst of both worlds, whereas there
(16:54):
were other countries like Germany or Denmark that opened up
pretty quickly but were more careful about it, had more
testing and stuff, and were able to mostly live their
lives normally with some brief shutdowns in the winter.
Speaker 2 (17:08):
And it does seem like the biggest mismatch involved schooling
and kids. And how did the US get that wrong?
What other what else could they have done?
Speaker 6 (17:17):
I mean, I you know, it was funny. I was
watching a bunch of Faucheet videos from that summer, and
you know, he knew that there was very little risk
to children, and he clearly his default was that schools
should reopen. But I don't know for whatever reasons he
wasn't willing to push people to do that, And definitely,
(17:40):
as the summer went on and case numbers went up
again in parts of the country, he was like, maybe
you shouldn't reopen in those places where cases were really high.
But what's kind of funny is what happened is schools
reopened in all the places in the South where cases
were really high, and they didn't reopen in places on
the coasts where they weren't so And and I don't
think it was disastrous in those places in the South
(18:03):
where it reopened. It definitely, I mean, you look at
the numbers, like comparing Florida in California, there were some
you know, more children died in Florida than in California,
but it was very few in both places.
Speaker 2 (18:15):
While we were in the thick of this, before we
had the testing and the vaccines, and while everyone was
staying home, there was that debate though over how nasty
this virus could be.
Speaker 6 (18:27):
One they nailed it down pretty well, but the fact
that there's this huge variance by age that extremely dangerous
if you're above sixty, not so dangerous if you're below fifty,
and sort of hard to know if you're in your
fifties like now, And I just think that was hard
to you know, and with schools obviously very low risk
(18:49):
to children, but you know, some teachers real risk. So
the knowledge was there, and in the public health community,
you know, people knew what the where, they knew the
profile that it was much lower for children. I know,
you could see it in the CDC data that it
was putting out as not optimal at all.
Speaker 2 (19:08):
What have we learned?
Speaker 5 (19:09):
Huh?
Speaker 6 (19:10):
I mean that's the most interesting, I mean one thing
since I've written it, there's still all of these people,
including Jay Boditaria, still arguing that they were right, that
it was much less dangerous than people thought, and I
I just I run the numbers and they're wrong. I mean,
it was about as dangerous as people thought. Obviously got
less dangerous over time, less dangerous whether there or any
old people, et cetera. And so it's interesting that that
(19:33):
was done spectacularly well, and figuring out what to do
about that was really hard. And you know, I think
it's it's the age gradient. And it's also you know,
what do you do about a thing that has a
one percent chance of killing people overall? It's like, do
you completely shut down society or do you totally go normal.
It's probably neither of those. It's somewhere in between. And
(19:55):
I think the countries that were most successful sort of
kept up this in between where changed behavior, but it
wasn't super dramatic like Japan or Sweden or wherever.
Speaker 2 (20:06):
All Right, Justin, thank you so much for sharing those
numbers with us. Glad to do it, Bloomberg Opinion columnist
Justin Fox. And coming up, we look at a different
impact of COVID on kids' mental health and how telehealth,
which grew in popularity during the height of the pandemic shutdown,
might help. And don't forget We're available as a podcast
on Apple, Spotify, or your favorite podcast platform. This is
(20:29):
Bloomberg Opinion.
Speaker 1 (20:41):
You're listening to the Bloomberg Opinion podcast. Catch us Saturdays
at one and seven pm Eastern on Bloomberg dot Com,
the iHeartRadio app, and the Bloomberg Business App, or listen
on demand wherever you get your podcasts.
Speaker 2 (20:56):
This is Bloomberg Opinion. I'm Amy Morris. Studies have shown
the COVID pandemic seemed to worsen teens in adolescents, mental
health pediatrician, doctor John Brownstein.
Speaker 9 (21:06):
Yes, systematic gaps, limited community and specialty resources, staffing challenges
that really accentuate this problem. So the bottom line is
our health systems are not there to improve care for
our kids in mental health crisis right now, but.
Speaker 2 (21:19):
There may be some hope. Telehealth appears to give more
young people more access to support. Let's talk about this
with Bloomberg opinion columnist Lisa Jarvis. She covers biotech, healthcare
and the pharmaceutical industry. Now, Lisa, you heard that cut
from the doctor, and you've referred to a new study
by Rand in your column which found that telehealth really
(21:40):
does help you feel more connected, at least for their
mental and physical health.
Speaker 7 (21:45):
How so, you know the study, the RAND study tried
to look at what happened with mental health use before
in Duram and you know, towards the tail end of
what we would consider the kind of peak pandemic, and
found that overall, if you looked from January twenty nineteen
through August twenty twenty two, overall mental health use was
(22:08):
up twenty two percent, and that was really largely driven
by telehealth, which you know most people may recognize prior
to the pandemic was almost at zero. You know, a
lot of insurers wouldn't cover it. It was just not
a routine part of practice when it came to mental
health services.
Speaker 5 (22:28):
And so you know, there were a number of things that.
Speaker 7 (22:30):
Kind of enabled that, and I'm happy to get into it,
but you know, essentially, what their data showed was that
both usage went up, the cost did go up as well,
but in parallel, so it wasn't like it was more expensive,
and it did seem to provide a lot more access
to care for kids.
Speaker 2 (22:45):
Yeah, let's get into it. You said that there are
some X factors and some reasons why this is happening.
Speaker 5 (22:50):
Yeah, I think, you know, beyond insurers.
Speaker 7 (22:53):
Essentially, some of the pandemic eraor rules made it so
that insurers would cover telehealth, both public and private. But
you know, I think a few other factors happened. When
kids moved to remote school, there was a huge push
to make sure that everyone had devices and internet access,
which allowed a lot more people to be able to
(23:14):
participate in things like you know, telehealth, whether or it's
for mental health.
Speaker 5 (23:18):
Or behavior, you know, physical health.
Speaker 7 (23:20):
So you know, I think that increased access, and then
you know, I think people became more accustomed to the
idea of you know, seeing someone virtually rather than in person,
and that it could be just as good. And for
this generation, it really can be meeting them where they are.
They're used to interacting with their friends that way and
(23:40):
so it's not such a stretch to interact with the
mental health provider that way.
Speaker 2 (23:44):
He let me ask about that, is there was concern
that maybe an in person meeting might be more effective
than a telehealth meeting or is that an issue?
Speaker 7 (23:55):
So there's been a lot of studies about that kind
of dating back to when people for starts to do
phone type of you know, mental health visits and they're
an adults, granted, but they suggest that the quality of
care people are getting is just as effective. I think,
you know, certainly there are times when an in person
meeting you might need a follow up or you know,
(24:17):
that shouldn't be a piece of our health care that
we get rid of, you know, and everyone needs different things,
so we need to have a lot of different ways
to deliver mental health care to kids. But you know,
the evidence suggests that it's just as effective and that
the retention rate is better, so people there's a much
lower no show rate when it comes to telehealth, probably
(24:38):
because people just it's easier for them.
Speaker 5 (24:40):
They don't have to take an hour.
Speaker 7 (24:42):
Two or three out of their data commute to go
to the office, you know, the mental health provider's office,
and they can just sort of pop in where they are,
so they saw. There's data to show that kids are
going more adult kids and adults are going more consistently
to their appointments, which suggests that, you know, maybe they're
getting more out of it too.
Speaker 2 (25:01):
That makes more sense because it would be private, it
would be more convenient, you wouldn't have to worry about
getting to and from the location. You talk about in
your column though, that there are kids who need help
and there are kids who get help, and that there
is a gap. Is that something new because of the
pandemic or is this the gap we've been always seeing.
Speaker 5 (25:20):
Yeah, that's a gap we've been always seen.
Speaker 7 (25:22):
You know, it's a racial gap and access to mental
health care. You know, in the pandemic, one thing that
happened is with schools closed, Kids who might have typically
received care in the environment of the school might not
have been getting it. But when it comes to telehealth,
one of the things that really needs to be improved
is that in this Rand study, they found that black
and LATENX kids just weren't switched to telehealth as often
(25:47):
as white kids, and so you know, that sort of
mode of care and ease of care was just wasn't
being offered to them at the same level. And so
you know, that needs to be fixed. And you know,
I think one of the things that I talk about
and I mentioned earlier is just this idea of making
sure that everyone has Internet, everyone has a device that
(26:11):
they can access their provider, you know, interact with their
provider on and so all all of the modes are important,
but telehealth can be one that can be you know,
really useful, and so we need to close that gap.
Speaker 2 (26:23):
And we are talking with Bloomberg Opinion columnist Lisa Jarvis
about the impact of the pandemic on kids mental health
and access to mental health care. So the study that
you referenced, actually you referenced several within your column when
it comes to the use of telehealth, how are kids
able to take advantage of it?
Speaker 7 (26:42):
Yeah, I mean, I think it's a multi factorial, but
you know, sometimes they might that might be their first
visit with the provider.
Speaker 5 (26:51):
Maybe that's a way that they switch.
Speaker 7 (26:52):
You know, I think I've talked to folks who are
you know, child psychiatrists who have suggested that one thing
that could happen. There's a big push right now to
put more mental health providers inside schools. Could it be
that kids can get pulled aside and do their provider
visit while they're at school via telehealth, you know, so
that they don't have to miss a chunk of their day.
(27:14):
Those are all things that need to be considered, and
you know, the Biden administration is trying to put a
lot of money into ensuring that there's better services, particularly
for kids, as we all recognize as crisis. So that's
an area that we should be looking at.
Speaker 2 (27:29):
And you make a really good point about insurance companies
and how they might be responding once telehealth is starting
to catch on, do you think it'll still be covered?
Speaker 5 (27:39):
Ash? I hope.
Speaker 7 (27:39):
So every person I talked to for that column was
worried about that, you know, just because you saw the
cost of overall care go up because usage went up,
which is good, it wasn't like it went up in
an outsized way. But you know, kids really need to
be accessing this more, you know, and I think what
can be confusing is, you know, different plans cover different
things if you switch insurance the extension. Though the pH
(28:05):
the Public Health Emergency has ended, Congress has ensured that
telehealth will still stay part of our access for people
with public insurance through the end of twenty twenty four.
We really want to make sure that that continues beyond
that because though I think there's mixed evidence when it
comes to our physical health and telehealth, when it comes
(28:25):
to mental health, it really feels like this is an
important way of delivering care.
Speaker 2 (28:30):
And in a more thirty thousand foot broader view of this,
you reference a study by Harvard that makes this grim point.
All kids, all demographics across the board, the different ages,
the race, how much money your mom and dad have
do not matter. They're struggling. Is this also a result
of the pandemic?
Speaker 7 (28:51):
Yeah, I mean it preceded the pandemic for sure. I
think the pandemic exacerbated it. You know, we've seen some
really disturbing survey results the CDC's Youth Risk Behavior Survey,
which comes out once a year. You know, you probably
saw all the headlines, including one that I wrote about
that survey at the beginning of this year, you know,
(29:12):
sixty percent of teenage girls reporting persistent feelings of sadness
and hopelessness.
Speaker 5 (29:17):
You know, it is hitting all kids.
Speaker 7 (29:20):
It does not matter, you know, their their socioeconomic situation,
their race, their gender, their ethnicity, like it's just across
the board. And so I think there's a lot of
effort to try to mobilize and address the kids that
are struggling.
Speaker 2 (29:37):
Are you able to gauge yet how popular telehealth is becoming.
Speaker 5 (29:42):
That's a good question.
Speaker 7 (29:43):
One of the things about their rand study that was
a little tough, and they you know, fully admit that
they can't parse the number of users that might have
increased versus the number of people who might have been
visiting their provider more often. And so that's the next
step and what their research, and I think that'll help
us understand, you know, who is benefiting on a little
(30:04):
more granular level in how many more people are benefiting
versus whether there's like some portion that are just getting
more consistent help and versus new users of telehealth. So
I think there's still more studies to be done, but
so far, it really does feel like the evidence is
that this helps kids a lot.
Speaker 2 (30:22):
And if you can take advantage of it, why not exactly?
Speaker 7 (30:26):
You know, we all have computers. We're used to zoom
by now kids included.
Speaker 2 (30:30):
Bloomberg Opinion columnist Lisa Jarvis covers biotech healthcare in the
pharmaceutical industry. You're listening to Bloomberg Opinion. I'm Amie Morris.
Have you gotten your COVID booster? Chances are you have not.
In fact, less than three percent of eligible Americans have
gotten a COVID booster this fall. Faith Lamb is a
Bloomberg Opinion columnist covering science and host of the Follow
(30:51):
the Science podcast, and she joins us, Now, faye, what
is the hold up? Why are numbers so low?
Speaker 10 (30:57):
Some of it is said, I don't think people have
a clear idea of why they should get these boosters.
I think it was a lot clearer why people should
get the initial shots, because there was evidence that they
might protect our whole communities by you know, reducing the
odds that you would get infected and also if people
were at risk of having severe disease. These shots were
(31:20):
really very effective at keeping people out of the hospital.
But now that we're many people are on you know,
shot number six or seven. I think for you younger
healthy people, it's a little unclear what the point is great.
Speaker 2 (31:33):
Do healthy people even meet these boosters?
Speaker 10 (31:35):
A lot of doctors will say no. And there was
actually a piece that caught my eye because I'd seen
some controversy on Twitter about this, but there was a
piece of commentary piece in Science by two really prominent
immunologists saying no, we should actually, if we really want
to save lives, we should be focusing these shots on
(31:57):
the people we know are most vulnerable to severe disease,
because the evidence that they prevent mild disease is pretty
weak right now. But that people in nursing homes, that
the really elderly people, they haven't all gotten this booster
and they should now.
Speaker 2 (32:14):
Is this all part of the mindset that the pandemic
is all over, We're done. Boy got through that?
Speaker 10 (32:20):
Well, it's a little bit. But I also think it's
that there was a sort of a public health strategy
that was to be blunt, you know, to try to
try to oversimplify things, you know, even though they knew
that not everybody was at high risk, they felt like
somehow that people wouldn't get the message or wouldn't take
(32:42):
it seriously unless they said everybody is equally at risk.
And I think people realize.
Speaker 5 (32:48):
It's not true.
Speaker 2 (32:49):
So is that a strategy that has then failed they
need to fix it.
Speaker 5 (32:52):
I think so, yeah.
Speaker 10 (32:54):
I think people are smarter than that, and I think
it can fail the people who really are at high risk.
Speaker 2 (32:59):
Do you remember during the height of the pandemic, those
mass vaccination sites that popped up, and they seemed to
work quite well. It was military precision to get everybody
in and out. Can they do that again?
Speaker 10 (33:13):
Maybe? But I think we're just it would cost a
lot of money, and we're in a very different situation
right now. You know, back then, the vaccines really had
a huge effect because there were still a massive proportion
of the population that had no immunity to this virus.
And now there's messaments to say, ninety nine percent of
us either have had COVID or had the shots or
(33:36):
some combination of BULK, And so we're not in the
same position we were in where we had this huge
percentage of the popular majority of Americans still had no
immunity to this and there were you know, there were
clinical trials showing that that we were much less likely
to get severely ill if we got these shots, and
that there was some evidence that we were less likely
(33:58):
to get a mild case and give it to so
that there was a sense that you were doing your
civic duty to protect the immune compromise the people that
were less likely to get protection by just cutting down
on the number of cases and the risk to those people.
Speaker 2 (34:13):
Is that the same attitude that we have with the
flu A little bit.
Speaker 5 (34:16):
Yeah.
Speaker 10 (34:17):
I think people sort of feel like, well, you know,
I might be less likely to get You can still
get the flu after you get a flu shot. But
I think that people feel like, well, they're at least
doing what they can, you know, so that they don't
get a mild case and give it to someone they're visiting,
an elderly relative. So I think that there is a
sort of a sense also that nobody wants to get
(34:38):
a nasty case of flu, and if the flu shot
means that what would have been a nasty case of
flu is a very mild case of flu, that's, you know,
that's desirable for a lot of people.
Speaker 2 (34:49):
Faith Lamb is a Bloomberg opinion columnist covering science and
host of the follow the Science podcast that does it
for this week's Bloomberg Opinion. We are produced by Eric
Molow and you can find all of these columns on
the Bloomberg Terminal, and we're available as a podcast on Apple, Spotify,
or your favorite podcast platform. Stay with us. Today's top
stories and global business headlines are just ahead. I Mammy Morris.
(35:12):
This is Bloomberg.
Host
Vonnie Quinn
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