Coronavirus

[cusetownusa]

It's not Kawasaki's. It's something similar in presentation, but unique to COVID-19. Just like the red sores/spots that were previously reported on kids in COVID-19.

It all, actually, fits in VERY well if you have the intelligence to think it though (you don't, you've clearly proven that).
1) Kids are the least impacted from SARS-CoV-2 infection. This is strong evidence that they produce the most robust immune response to the virus.
2) SARS-CoV-2 is known to enter cells using the Spike protein binding to the ACE-2 (Angiotensin-converting enzyme) receptor
3) The ACE-2 receptor, while on almost all cells, is very prevalent on blood vessels, meaning blood vessels could in theory easily be infected.
4) The small foot and hand lesions are classic "microangiopathic" findings. I.e. capillary blood vessel ruptures.

So, in theory, all this put together could be explained by:
The antibody response in children produces an antibody that binds not just to the Spike protein of the virus, but the Spike/ACE-2 protein complex. We've known from decades of work that immune responses NEVER produce a single antibody to clear out an infection, but instead hundreds to thousands of different antibodies, each unique to different protein components on the invading pathogen (in this case SARS-CoV-2). While the ACE-2 receptor will be viewed as "self" by the immune system, it is very possible that IN A LIMITED NUMBER OF PATIENTS, the immune system is producing an antibody to the Spike/ACE-2 complex (we know the Spike protein binds VERY tightly to the ACE-2 receptor). This antibody would then potentially cross-react to the ACE-2 receptor by itself once the infection was cleared. We know that the immune system makes mistakes like this sometimes (hence the entire field of automimmune diseases).



Where is your M.D. from?


And if you look at the investor thread, I've been in line with those people saying "open things up". Open it up, with precautions, but open things up. Your argument (that I want things shut down at all costs) falls apart in that context.

I was just about to say the same thing.

 

[Buckminster]

Boris has just updated the UK. Half of primary school years going back in 3 weeks. Some restaurants etc. to open in July. All conditional on controlling the outbreak.

 

[hacer]

Elon Musk on Twitter
View attachment 540126
So, let's look at that claim. From the Lancet:
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30746-7/fulltext

"Given the intensive, proactive case finding and the sharp drop in reported cases outside Hubei during February, 2020, the ascertainment rates in these cities were probably very high."

"As of Feb 29, 2020, there were 411 (Beijing), 337 (Shanghai), 417 (Shenzhen), and 504 (Wenzhou) laboratory-confirmed cases of COVID-19 infections reported."

In spite of this, I'll assume they are missing 90% of the cases, though (not possible if they are not having an out of control outbreak BTW). Just for good measure. (For the record, they have had 7 reported deaths to date in Shanghai, which would produce an estimation of about 700 cases to date.) My assumption is suggesting they have had more like 6000 cases (they have had 657 confirmed cases reported to date), so I am very likely overestimating by at least a factor of 5! Greater China: coronavirus statistics by region | Statista


View attachment 540129

The Shanghai Gigafactory reopened on February 10th. Coronavirus: Tesla Giga Shanghai reopening on Feb 10, Shanghai govt offers help - Electrek

I count 42 cases in Shanghai (not including from international travel) after February 10th. So using 10x, assume 420 cases after reopening. Max. Daily rate appears to be at most about 1-2 per day on average (convert to 20 per day using 10x factor)

Shanghai population: 24.3 million

Cases per capita, Shanghai, total, after reopening: 420/24.3e6 = 17.3 ppm

Cases per capita per day after reopening, Shanghai: 2 cases per/day /24.3 million: 0.08 ppm per day

Again, likely overestimating the disease burden by a lot here (I would guess about 5x, so more reasonable might be 0.016ppm per day)!

Alameda County, I will assume is undercounting by a factor of 5x, rather than 10x (seems maybe reasonable given the number of deaths - they have had 71 deaths, which would suggest about 10k cases, since only maybe 7k would have resulted in death yet):
http://www.acphd.org/2019-ncov.aspx
View attachment 540128

So that would give 5*2023 cases = 10115 cases. Population: 1.67 million

Cases per capita, Alameda County, prior to reopening: 10115/1.67e6 = 0.61%, or 6056 ppm

(This is probably a pretty good estimate, no overcount/undercount.)

If you want to use just the zip code of the Gigafactory (unreasonable), you get:

Cases per capita, 94538: 40*10/65954 = 0.6% (Same answer - it is pretty much the average of the county.)

Going forward, let's assume we are currently at the 50 new cases per day -> Let's assume they are doing a better job of testing now than in the past, though, and are only missing half the cases (2x undercount). So translate to 100 cases per day for the 2x undercount:

Cases per capita, Alameda County, per day, as of today: 100/1.67e6 = 60ppm per day

Again, this is probably a very reasonable estimation of the rate, given the number of deaths.

Summary of veracity of Elon's claim:

Shanghai disease burden: 0.08ppm per day, average, after February 10th (now pretty much zero...)
Alameda County disease burden: 60 ppm per day as of May 9th

Difference: 750x the disease burden in Alameda county, and if you assume a 5x overcount in Shanghai, it is closer to 3750x.

Conclusion: I am not sure that the Shanghai experience will translate well to the Alameda County situation - it seems like they should wait until disease burden is at least a factor of 5 lower, and even then, implement additional controls (testing!).

To put it another way, on any given day, assuming 10k workers in both Shanghai and Fremont:
In Shanghai, there are about 0.0008 workers per day entering the factory with a new case of coronavirus. (Probably much lower number now though, since there appear to be zero cases except at the airport.)

In Fremont, there would be about 0.6 workers per day entering the factory with a shiny new case of the 'rona.

If they were to open up next week, I would expect them to be able to go no more than about 2 weeks without having an outbreak (accounting for some risk reduction due to screening, etc.). Could relatively easily be less than a week.

View attachment 540140

EDIT: While doing my per day numbers, I somehow managed to get Alameda County off by a factor of 100! It's way worse than what I said originally...

Would love someone to check the numbers to make sure I didn't make a mistake. Really will be useful for predicting future stock price trends (if/when factory reopens), is my guess. So I definitely want to have the right order of magnitude.

I'm not sure your calculations are valid because of the effects of viral load. China has done so incredibly well on a per-capita basis in part because of the widespread use of masks very early in the disease spread. Here in the U.S. the CDC made the incredible mistake of telling people to not wear masks (based on the other incredible mistake of not stockpiling masks nor ramping up production). This had the effect of dramatically increasing viral load during the spread of the disease which has caused much higher infection and death rate everywhere in the U.S. including Alameda county. Masks have been in use there for only a short time and still at a far lower compliance rate compared to China.

For certain inside a re-opened Tesla facility high quality masks and other work rules will be used by everyone which will alter the dynamic of infection spread inside the factory significantly from that seen in the general population. I'm pretty sure this invalidates your model. But even if we accept your model it only tells us that the very low population infection rate in Shanghai was low enough for the factory work precautions to be effective - it doesn't mean that they wouldn't have be effective even if the infected portion of the population had been orders of magnitude higher. I would argue that the Hubei experience of China shows that 100% compliance of social distancing with high quality masks shows that it is highly effective even with a large infected population.

 

[eevee-fan]

Is something magic going to happen in a week to suddenly make it safe?

Elon should easily create a win-win situation by outfitting the factory with Far UV-C lights. The factory will become a pretty sterile environment. Probably cleaner than outside.

 

[dqd88]

You're taking this too far. A sudden decline in Rt can produce a temporary decline in deaths per day, even if the new value of Rt is still above 1.0.

Tell us how Alameda achieved so few cases:

1. Happy coincidence?
2. Wise leadership by industry titan E.R. Musk?
3. Restrictions imposed by the fascist "“unelected & ignorant ‘interim Health Officer’"?

Regardless of "how" that was achieved, the point is that the "curve is flattened", the risk is low, and a manufacturing company, that clearly has safety measures in place, should be allowed to operate.
Alameda county clearly is not business-friendly and I support the HQ move to somewhere that is. Don't give over-bearing, pompous, expensive Alameda any more support; move somewhere that wants your business and will work hard to make a win-win partnership with the company.

 

[linux-works]

Elon should easily create a win-win situation by outfitting the factory with Far UV-C lights. The factory will become a pretty sterile environment. Probably cleaner than outside.

I do think that some companies will think about it. I've wondered if moving UVC carts - that I would not quite call 'robots' but maybe things on tracks that follow a path at night and can move the uvc around, after the last guy leaves the floor - would be a 'thing'.

if the virus lasts several 'business cycles', I do expect business to take this more and more seriously and a differentiating factor in one job offer vs another could be: what is your company doing to help keep workers safe?

companies use to brag about foosball tables, beanbag chairs, espresso bars, buffet lunches - they may shift to offer other perks that are more needed in 2020 (sigh).

we have to wait and see how business 'evolves' during this time. they will go fighting and screaming. they don't like change and don't want to give up power that they may never get back. they're scared shiteless and this is why its taking so long to see the 'back to work' plans.

 

[linux-works]

Alameda county clearly is not business-friendly and I support the HQ move to somewhere that is. Don't give over-bearing, pompous, expensive Alameda any more support; move somewhere that wants your business and will work hard to make a win-win partnership with the company.

I just love code words. 'business friendly' - implies directly, by exclusion, that its NOT worker-friendly. and that aligns with the truth.

I side with workers rights. I side against so-called business friendly states. they screw over the locals, pollute, deny it when major problems occur, force their citizens to return to work when its not yet safe to. if you are a 'boss' in such a state, great, good for you. if you work for a living, poor bastard, better luck being born somewhere else, next life.

amazing that people in this educated day still continue to do the bidding of their masters and don't even possess the self-awareness to realize they are being manipulated.

 

[madodel]

I do think that some companies will think about it. I've wondered if moving UVC carts - that I would not quite call 'robots' but maybe things on tracks that follow a path at night and can move the uvc around, after the last guy leaves the floor - would be a 'thing'.

if the virus lasts several 'business cycles', I do expect business to take this more and more seriously and a differentiating factor in one job offer vs another could be: what is your company doing to help keep workers safe?

companies use to brag about foosball tables, beanbag chairs, espresso bars, buffet lunches - they may shift to offer other perks that are more needed in 2020 (sigh).

we have to wait and see how business 'evolves' during this time. they will go fighting and screaming. they don't like change and don't want to give up power that they may never get back. they're scared shiteless and this is why its taking so long to see the 'back to work' plans.

At my wife's hospital and at our Giant food market there is a wheeled robot that goes around with UV lights on it. It stops if someone is in the way. Not sure how effective the UV lights are since it is usually moving.

 

[S4WRXTTCS]

At my wife's hospital and at our Giant food market there is a wheeled robot that goes around with UV lights on it. It stops if someone is in the way. Not sure how effective the UV lights are since it is usually moving. View attachment 540387

In my day you went inside to escape UV.

I guess I'm going to have to go outside to avoid it now.

 

[bkp_duke]

I just love code words. 'business friendly' - implies directly, by exclusion, that its NOT worker-friendly. and that aligns with the truth.

I side with workers rights. I side against so-called business friendly states. they screw over the locals, pollute, deny it when major problems occur, force their citizens to return to work when its not yet safe to. if you are a 'boss' in such a state, great, good for you. if you work for a living, poor bastard, better luck being born somewhere else, next life.

amazing that people in this educated day still continue to do the bidding of their masters and don't even possess the self-awareness to realize they are being manipulated.

View attachment 540386

We usually align on views, but I have to disagree with you here.

I have employees in 5 states, and CA is by far the worst one to deal with, with zero apparent benefit for my employees over the other ones. Taxes are higher (both for me and the employee), and I fail to see any benefit for anyone (roads are certainly not better, etc.).

Can you point out specific examples of benefits given in some blue states that are not available to employees in red states?

 

[eevee-fan]

I do think that some companies will think about it. I've wondered if moving UVC carts - that I would not quite call 'robots' but maybe things on tracks that follow a path at night and can move the uvc around, after the last guy leaves the floor - would be a 'thing'.

if the virus lasts several 'business cycles', I do expect business to take this more and more seriously and a differentiating factor in one job offer vs another could be: what is your company doing to help keep workers safe?

companies use to brag about foosball tables, beanbag chairs, espresso bars, buffet lunches - they may shift to offer other perks that are more needed in 2020 (sigh).

we have to wait and see how business 'evolves' during this time. they will go fighting and screaming. they don't like change and don't want to give up power that they may never get back. they're scared shiteless and this is why its taking so long to see the 'back to work' plans.

Regular UV-C takes too long (minutes) and can only be used after the person leaves, leaving the room open to contamination while in use.

Far UV-C is safe to use in occupied rooms and can kill viruses in the air (seconds) and can keep the room clean. This would include virus particle that land on your skin and clothes... ZAP!

 

[S4WRXTTCS]

some blue states that are not available to employees in red states?

Use it or lose it vacation policies are illegal in California
California banned non-compete agreements.

Those are two things I've envied about California employee friendliness.

Now there are a thousands other things I don't envy, and sometimes I think California has completely lost their friggen minds.

I don't think I'd want to be an employer in California.

 

[PeterJA]

This is a reposting of a message that was deleted from the main investor thread, apparently because it mentions a treatment for coronavirus.



Totally agree, and one way (maybe the primary way) that China has reduced COVID-19 deaths to near-zero has gotten far less publicity than their lockdown: They are preventing and treating COVID-19 with vitamin C, and saving lives of even severely ill patients with high-dose intravenous vitamin C (and the anticoagulant heparin).
Shanghai Government Officially Recommends Vitamin C for COVID-19
TONS OF VITAMIN C TO WUHAN: China Using Vitamin C Against COVID
Vitamin C and Coronavirus: Not a Vaccine; Just a Humble Cure
Protected Group Immunity, Not a Vaccine, is the Way to Stop the COVID-19 Pandemic

A few critical care doctors in the US are also trying to get the word out:
Frontline COVID-19 Critical Care Working Group

But they are hampered by a disinformation campaign such as the following hit-piece (read past the headline and first part of the article to the response by two scientists specializing in vitamin C):
No, the Shanghai government has not recommended intravenous vitamin C as a treatment for COVID-19

My thesis about why this is happening is here:
Coronavirus

Hey, where's all the Disagree and Funny ratings on my latest attempt to spread lifesaving news about vitamin C?

Maybe I'm progressing from being laughed at to being ignored. Wait, that's going backwards.
First They Ignore You, Then They Laugh at You, Then They Attack You, Then You Win – Quote Investigator

Oh well. Here's more news to laugh at -- a statement from the Front Line Critical Care Working Group:

We know that our MATH+ protocol works—and saves lives. Many lives. Here’s the backstory about why it has not yet been widely adopted.

Tragically, the World Health Organization (WHO) ignored extensive evidence in recommending against the use of corticosteroids in COVID19 ARDS and cytokine storm. Neither the WHO nor other guideline-writing bodies have assessed the formidable and growing evidence for intravenous ascorbic acid [vitamin C], despite its association in a major recent study, with significantly improved mortality in ARDS. Numerous previous studies have also shown its safety and effectiveness, particularly when used with corticosteroids in critical care medicine.

Physicians at the bedside of critically ill COVID19 patients are told to provide only “supportive care” and to enroll their patients in one or more of hundreds of randomly controlled trials (RCTs), often testing one or more of a growing list of expensive and proprietary formulations, where half of the patients receive a placebo....

MATH+ uses well studied, life saving components used synergistically that hospital-based and critical care doctors have been using for decades. It should be the foundation upon which other interventions are added and not excluded from the armamentarium of physicians at the bedside. COVID19 is a steroid and ascorbic acid responsive disease.

Critical Care Working Group Members

G. UMBERTO MEDURI, M.D.
Professor of Medicine, Division of Pulmonary, Critical Care & Sleep Medicine
Univ. of Tennessee Health Science Center Memphis, Tennessee

PAUL E. MARIK, MD, FCCM, FCCP
Endowed Professor of Medicine, Chief, Div. of Pulmonary & Critical Care Medicine
Eastern Virginia Medical School Norfolk, Virginia

JOSEPH VARON, M.D., FCCP, FCCM
Professor of Acute & Continuing Care, The University of Texas Health Science Center
Chief of Staff & Chief of Critical Care, United Memorial Medical Center, Houston, Texas

HOWARD KORNFELD, M.D.
Board Certified: Emergency Med., Pain Med., Addiction Med.
President, Pharmacology Policy Institute
Clinical Faculty, Pain Fellowship Program, Univ. of California, San Francisco (UCSF) School of Medicine
Founder & Medical Director, Recovery Without Walls, Mill Valley, California

PIERRE KORY, M.D., M.P.A.
Medical Dir., Trauma & Life Support Center
Critical Care Service Chief
Associate Professor of Medicine, Univ. of Wisconsin School of Medicine & Public Health

JOSE IGLESIAS, D.O.
Assoc. Prof., Hackensack Meridian School of Medicine at Seton Hall
Dept. of Nephrology & Critical Care / Community Medical Center
Dept. of Nephrology, Jersey Shore University Medical Center, Neptune, New Jersey

KEITH BERKOWITZ, M.D., M.B.A.
Medical Director, Center for Balanced Health
Voluntary Attending Physician, Lenox Hill Hosp. New York, New York

FRED WAGSHUL, M.D.
Pulmonologist & Med. Dir., Lung Center of America
Clinical Instructor, Wright State University School of Medicine, Dayton, Ohio

Our Challenge – Frontline COVID-19 Critical Care Working Group
​

 

[Doggydogworld]

We usually align on views, but I have to disagree with you here.

I have employees in 5 states, and CA is by far the worst one to deal with, with zero apparent benefit for my employees over the other ones. Taxes are higher (both for me and the employee), and I fail to see any benefit for anyone (roads are certainly not better, etc.).

Can you point out specific examples of benefits given in some blue states that are not available to employees in red states?

I've also employed people in CA and other states, and further back in time I've been an employee in CA and other states. Like you, I've seen very little difference in company employee protection or benefits but a big difference in taxes.

I've seen a vast difference in unionized public employee benefits. Several CA cities have filed bankruptcy over this.

 

[eevee-fan]

At my wife's hospital and at our Giant food market there is a wheeled robot that goes around with UV lights on it. It stops if someone is in the way. Not sure how effective the UV lights are since it is usually moving. View attachment 540387

Regular UV-C would be minimally effective, it takes too long to zap a virus (minutes of exposure or longer). Far UV-C is the way to go (seconds).

 

[linux-works]

I can say, for one thing, that employment contracts are more employee focused, in that employers cant get away with random stuff that they can in other areas of the country. non-compete, for one example. in calif, you can't stop an employee from working in his field just because an employer fires him or his quits on his own. 'right to work' states tend to favor the employer and when they can, squash unions.

can you point to any 'right to work' state features that would make me want to move or live there? asking for real. curious what a RTW state would have to offer someone in my position, to convince me to leave the bay area, for example.

anti lgbt, anti women, anti minority, anti choice, overall. more religion (as long as you are the 'right' religion), lower quality of public education, less rationality. less respect for the environment, more respect for billionaires. that's how I view the so-called RTW states.

 

[dfwatt]

Possibly. The underlying "issue" is that the ACE-2 receptor is ubiquitously expressed. This virus could, in theory, cause all kinds of different presentations because it could hit different organs with different severity. I fully expect, based upon that, that there will be some limited cases of encephalitis, etc.

But as I mentioned above, this one smells to me of an immune cross-reactivity problem.

Yes especially if the time frame for the appearance of this is relatively protracted status post infection. If it's within two weeks then you might see it as a straightforward inflammatory problem related to the virus and the cells that it has hijacked. But if it's weeks Downstream and particularly after an interval of asymptomatic clearance of the virus, then you have to think it's an autoimmunity issue like you say.

 

[AlanSubie4Life]

So just curious, is your advice to keep shorting the market hard, and avoid buying $TSLA, like it was when TSLA was $427 (now $819), and the NASDAQ was 6879 (now 9121)?

March 21 (TSLA $427; NASDAQ 6879):



(Unfortunately, the next trading day, the NASDAQ bottomed at 6861.)

March 24 (TSLA $505; NASDAQ 7417):



March 25 (TSLA $539; NASDAQ 7384):



April 2 (TSLA $454; NASDAQ 7487):



May 1 (TSLA $701; NASDAQ 8605)

A little off the topic, but thanks for the exhaustive review of how bad I am at predicting the market!

Fortunately I have done well playing the swings of Tesla, and avoided shorting the broader market - I hope no one took the advice of a random internet commenter - I think you left out some inane comment from me about the behavior after the last earnings (which worked out well for me with Elon’s tweeting). Definitely should have bought some options when fear was at a maximum!

I still have a fair amount of Tesla with long term gains (cost basis $257 I think). But mostly I am now out. I played the swings for the last couple months and made some decent money. We’ll see. I might regret not having held a more substantial long-term position. But I kind of expect a rocky road. But if TSLA goes to $2k or more, I won’t be missing out.

Note that my comments were directed largely at the broader market, not TSLA in particular (note my comment above about there being no issue in particular with Tesla). I own a Tesla, and I want them to succeed - which is why I would like them to be careful opening the factory and to take care of their employees.

I AM indeed puzzled by the broader market behavior. Could have made a lot of money! As it is, have to be content to being back where I was in mid-February. The stimulus seems to have helped, but really is anyone’s guess. We’ll see how thing play out over the summer. It’s still possible that exiting the market might be the right answer in the medium term. No idea. Pretty sure timing the market is impossible.

I will say I am partially on the sidelines in my 401k, and I am regretting that - I initially made the right call getting out when the market was high (missed out on a 6% down day), got back in too soon, and then got back out too soon. So definitely have lost money there. Not getting back in yet though! I am a lot less sure about the broader market in the medium term than I am about TSLA. They say not to touch your 401k, but having been through the Great Recession and listening to that terrible advice then, I have different ideas this time! So far I am proving to be a fool, though!

I do think that if our response had been really good in the US, my predictions would have been wrong for sure. At the moment, the jury is still out.

I think the nonsense about things being different for years is going to prove wrong. I think we will likely be largely back to normal by early 2021. But the medium term (before then) is going to be interesting. There is a huge incentive to develop testing and containment strategies and I think that is ultimately the way we will get out of this. But I think scary flare ups will continue to occur through this year. So I just can’t see how that fear is not going to result in significant drag on the economy this year. How much depends on how quickly widespread testing and near complete elimination of the virus takes place. Once that happens people will come back out into the world.

 

[Norbert]

There are error bars around each of rt.live's estimates and cherry picking a couple examples does not invalidate their model.

Since this is a Tesla board, did you check California?

For California, the rt.live model appears to be doing much better than crude confirmed case numbers.

Confirmed cases continue to increase through the present, while deaths started trending downward around April 23, per the chart below. So looking at confirmed cases in California -- not surprisingly -- appears to be a very poor way of estimating the infection rate.

View attachment 540305

California coronavirus cases: Tracking the outbreak

In contrast, the rt.live model estimated that Rt dipped below 1 in California on about April 11, which correlates reasonably well with deaths starting to fall a few weeks later. Assuming deaths are a reasonable (lagging) indicator of the rate of infection in California, then rt.live's prediction was spot on.

View attachment 540306

All models have flaws, the goal is to find the model that is "least bad." Since we know that using confirmed cases overstates the rate of infection in periods when testing is increasing, the bar is pretty low to beat that.

I wrote another post a few days ago where I used different examples. I looked at many. I didn't cherry pick, I just happened to use only one example in the post you responded to.

We already know for a long time that looking at cases can be misleading because of changing testing levels, I was arguing that here many weeks ago. You are not telling me anything new in that regard. However less well discussed is the fact that rt.live numbers are going in the opposite direction.

And that was my point: that you can't expect rt.live graphs to tell a correct story either.

Your California example actually confirms that more than not. According to rt.live, Rt in CA has been smaller than 1 for almost 4 weeks, and below 0.9 for 3 weeks. (Even the error bars were below 1 for 3 weeks. Until a few days ago, as they are expanding in all cases in both directions, but who looks at that).

So death numbers should have been going down continuously, but according to the graph you posted, they were stable in the last 8 days (which corresponds to cases 2-3 weeks ago). They went down only in the 5 days before that. And not by a lot, especially compared to by how much they went up at an Rt above 1.

 

[bkp_duke]

I've seen a vast difference in unionized public employee benefits. Several CA cities have filed bankruptcy over this.

Agreed. The age of pensions needs to end. I know with some that won't be popular, but the math no longer works out.

In my specific city in north SD county, for teachers/policemen/firemen the portion of the budget used to cover pensions for both active and inactive employees is higher than that for services actually rendered. And then the population is always being pushed for a tax increase because "we don't have the funds for basic services". The reason we don't have funds for basic services is that the pensions take their cut off the top, and what is left is what the city has to provide services. It simply does not pencil out anymore to have these guaranteed benefit plants in place when investment returns are NOT guaranteed.

The current pandemic and subsequent economic problems will break many city and state pension funds.