This is probably not worth anyone's time, but it annoyed me so I'm going to make you all suffer through it. In New York, Ross Barkan provides a potted summary of the infant formula shortage and ends up with this:
Though off the table for now, more radical solutions should be considered too. Why not have the government manufacture baby formula? If moderates and conservatives will oppose full-bore nationalization of the industry, a public option for baby formula could be worthwhile, forcing Abbott and others to compete against the government while guaranteeing, in the event of another recall, baby formula for all. A government fail-safe could be readily available, always.
Can we talk? The baby formula shortage is serious, but we have serious problems like this about a dozen or a hundred times a year. So why do we so often find liberals suggesting that some kind of nationalization is the answer? What possibly makes anyone think that the US government would make a great manufacturer of infant formula in all its many variations? In fact, a manufacturer so spectacular that it would guarantee formula for all? Can you even imagine the politics that would doom such an effort? It's crazy.
This is obviously something best handled by the private market. It might make mistakes now and again, but it has a tremendous incentive to sell as much formula as possible. And the fact that formula is more important than, say, cat food, doesn't matter. The government also doesn't manufacture life-saving drugs. It doesn't manufacture vaccines. It doesn't manufacture pacemakers. It regulates all those industries to make sure they don't cut too many corners, but that's it.
The US government isn't a manufacturer, and there's no reason to think it should be. What's more, if you're worried about monopolization, is one supplier really better than four? Why?
So please, let's cut the crap about nationalizing industries every time there's some routine problem that the media suddenly finds out about after months of ignoring it. It's ridiculous, and all it does is give liberals a bad name.
AS AN ASIDE: Can we please get some better reporting on the infant formula shortage? Here are the things we know:
- There are a large number of specific types of formula that are in short supply. But we don't seem to know which ones.
- Reporters are keen to dig up anecdotes about people who had to drive to the next county to find the particular type of formula they want. But how many of these stories are there?
- Abbott's plant in Sturgis was shut down over a cronobacter infestation of some kind. But what kind? And why did it take so long to re-open the factory? Was it because of stonewalling by Abbott? Or because of dumb requirements from the FDA?
- In fact, how much of a shortage is there, really? How many actual people are running short of formula? How many people have run completely out of formula and literally can't find it anywhere—not in the next county, not on Amazon, not anywhere? How many babies have ended up in the ICU because of some formula-related crisis?
These are all pretty routine questions? Why have they gone unanswered for so long?
Re: baby formula: what Kevin said.
But I will admit to occasionally believing that the federal government might consider starting a sideline in vast-in-scale, Singapore-style housing development (if our politics permitted this).
One correction. The baby formula manufacturers primary concern is to make money, not sell baby formula.
The problem with the monopolization of the market is both legislative and regulatory capture so competition is blocked.
The gov't getting into manufacturing is not a good idea. But it does need to identify key areas where we need reserves and/or reserve capacity, and establish that either with purchases, long term contracts, and/or regulations. For the baby formula market, the WIC contracts need to have a contingency clause for when a factory goes down to guarantee supply.
The President has declared an emergency and that has allowed the importation of formula for the time being. But there has to be a crises for an emergency to be declared.
I've thought much of the rise in inflation is due to Republican executives who have realized there is no consequence to keeping executive compensation as high as possible, allowing prices to rise in small and large ways where they actually have a choice not to do that, and this baby formula shortage is in some way a further expression of exactly this action, more or less conscious, to create as much harm as possible to destroy Joe Biden and restore Donald Trump.
Too many similar things have happened in other countries where a wealthy and motivated neo-fascist population has been able to undermine and destroy a socialist or reform administration supplanting them military or quasi-military dictatorships that then go on to ruin the ruin the place for decades.
I think this is the entire issue here.
Yes, reporting on baby formula (and special dietary supplements) shortages has been bad. The recall has meant empty shelves in places--so easy reporting. That leads to runs on existing supplies, so more empty shelves and more hoarding. Supplies were tight to begin with, so....
NPR piece is pretty good:
https://www.npr.org/2022/05/19/1099748064/baby-infant-formula-shortages
and is The Atlantic's take:
https://www.theatlantic.com/ideas/archive/2022/05/baby-formula-shortage-abbott-recall/629828/
Problems are real in places where Abbott has the WIC contract and the formula was made at the factory that was shut down. In those areas, wavers have been granted so other brand can be bought via WIC, but there is not enough excess capacity in the system to make up for the recall and factory shutdown, hence imports are now allowed.
Banks are required to undergo periodic "stress tests" to ensure their ability to withstand economic downturns and other adverse events. Why not something similar for other service providers and for manufacturers of "essential" goods? Resilience FTW.
Resilience generally requires a certain amount of redundancy and modern American management considers redundancy as a cost that must be minimized in order to maximize profits.
We've spent the last few decades wringing every last bit of redundancy and reserve capacity out of our supply chains and now we're surprised that our supply chains are so fragile. It's stupidity, American style.
We do in fact pay for excess capacity in some agricultural products, through various government programs. As you say, industry has been relentlessly eliminating these costs. I’m completely supportive of government as the insurer-of-last-resort for the 90% of us who can’t self-insure against certain risks, which the private insurers won’t take on, either. Sometimes, monetary payouts won’t do; that’s when the government can shoulder the costs of resilient production.
In addition to what you say, regarding wringing out "redundancy", and with which I agree, I'd add the other elephant in the room is monopolies. There are basically 3 (or maybe 4) companies supplying pretty much all of the formula in the US. That is the case in cargo shipping, meat packing, and, well, just too many other industries to list.
And while I do disagree with nationalizing these industries, some anti-trust enforcement would probably do some good. But, anti-trust enforcement is the among the most neutered laws on the books these days, so I'm not holding out hope for that.
Because it is a stupid idea.
Essential obviously is used in an ad hoc manner to mean "anything in the news" and what such regulation inevitably does is create added barriers to entry - like in the banking sector.
In banking because of the unique structure and issues of asset liability mismatch - that is the unique permanent risks of taking short-term deposits and lending out long in credits. Fundamental to banking.
None of this exists structurally in most manufacturing.
The Left instinct to impose controls and nationalisation for any passing problem is a not so amusing structural idiocy.
I see you have attempted a straw man argument. Do you want to not cheer for dead babies or what?
But it’s increasingly clear that the problem here is the lack of effective, consistently enforced regulations combined with the protection from foreign competitors. Just in this comment thread alone we’ve seen dozens of examples of how Abbott Labs has exploited its dominant market share and its political protection from competitors and regulators to produce shoddy, even dangerous baby formula.
Per https://fortune.com/2022/05/14/baby-formula-shortage-milk-monopoly-fda/ Abbott sells about half the formula in the country. Perhaps short of nationalizing the industry, we could try enforcing our existing anti-trust laws.
This!
Maybe this s the best approach, but be prepared to pay a lot more for baby formula. Strict regulations, like we impose on the formula industry, are expensive to implement. Most of these expenses are fixed costs. This means that there sre enormous economies of scale.
If you break up the monopolies and reduce the market share of each factory, you are going to significantly increase the costs of regulatory compliance as every new firm has to develop the professional expertise and then meet the regulatory burden.
I'm not saying that baby formula shouldn't be heavily regulated. It should. But that comes with tradeoffs. You either let the market consolidate, or pay a lot more for the product. There isn't a really good answer as to what the best option is.
This strikes me as a false dichotomy between antitrust enforcement or safety regulations and price. I think we could have significantly cheaper but very safe baby formula simply by no longer insulating domestic producers from foreign competitors products of comparable or superior quality.
How then do those foreign competitors achieve the lower prices? Are baby formula workers overpaid in the United States? Different input costs? Different regulatory overhead?
They operate as normal commercial actors within a highly regulated industry lwho naturally seek to sell more stuff and beat their competitors.
If you break up the monopolies and reduce the market share of each factory, you are going to significantly increase the costs of regulatory compliance
Nice claim. Evidence? Also, what does "significantly" mean here, and how much would that impact the cost of formula? Specifics, please!
"you are going to significantly increase the costs of regulatory compliance as every new firm has to develop the professional expertise and then meet the regulatory burden." That is an aggressive assertion (significantly increase cost).
Of course there is a trade off - efficiency of scale versus diversification.
It may be that regulatory reqiuremnts have themselves created market conditions for an oligopoly of course.
Could you give an example?
IANAL. but that's basically Robert Bork's argument: monopoly -> economy of scale -> lower price -> consumers benefit, therefore ignore the actual laws. The people who wrote the laws had experience with monopolies and understood it's not about price in the short term but power in the long term.
I think you have this 180 degrees assbackwards, at least as very standard economic theory usually says. More competition leads to lower prices not less. Seriously, I have many qualms about economics as an intellectual pursuit, but this tenet seems pretty clear and unassailable.
Yes. Economies of scale are a real thing, but they generally play out sooner than one may think. That’s why Subaru is a very viable company at about a tenth the unit sales of Toyota or Volkswagen.
Question?
Is the manufacture of baby formula one of the "commanding heights" of the economy? Asking for a friend.
Back in the day we had Government Cheese. Maybe we need a National Emergency supply of Government Baby Formula? Now if we could figure out a way that none would be given to "Those People".
We do have the National Petroleum Reserve.
I don't think we're supposed to give cheese to babies.
Just a drop of scotch mixed in with their mashed peas, calms them right down.
Bring back Laudanum! It was a tincture of opium that was given to babies to quiet them during the 19th century.
Will be funny when J.D. ANTIVAXXX, who wants to take us back to the 19th century, takes up this suggestion & causes an even greater spike in opiate-dependency than currently seen in his blessed Appalachia.
"...cut the crap about nationalizing industries...It's ridiculous..."
The reason why it is ridiculous is because it is presented without context. The context is that all of the incentives of every private business are perverse. (The perversity of the incentives flows from the profit motive, which assumes growth; but there is no growth, only reallocation.)
The argument for state ownership and operation of industry -- which argument, again, is never stated forthrightly -- is that the incentives are potentially less perverse. (This is not Marx's argument, which, again, was not stated forthrightly, but which reduced to "skimming bad"; but, insofar as our late-capitalist economy works at all, it is due to the pervasiveness of skimming.)
Where do you get such nonsense? Growth is a fact; we produce vastly more manufactured goods and agricultural products per capita than we did even a half-century ago; that is increased productivity, and becoming more productive is one of the incentives of a capitalist system.
I agree with you, generally speaking. But this is an interesting situation that seems to be coming up more frequently. Overall, the incentives here really are perverse and market distorting since Abbott Labs seems to have profited handsomely from the market shortage which its cost-cutting, slipshod procedures created.
Abbot’s in a position to profit from unsanitary and dangerous conditions at its factory because it and the bonuses of its executives are shielded from regulatory action, antitrust action, and competition from foreign competitors.
The DOJ’s response was particularly instructive. Abbott didn’t correct the problems at its plant because it made the same profits due to scarcity (but without the risk of losing market share to Canadian and European competitors) and the public outcry about the shortage gave Abbott ample leverage over the Justice Department to compel the obsequious settlement which was basically promising to think about reopening the plant if the government inspectors had learned their lesson and would worry more about profits and less about babies.
Yes, I was just disagreeing with the sweeping generalization. As you point out, the market failures in this case were ‘unforced errors’ - the government had the tools to prevent them, it just didn’t use them, or use them in a timely way.
Baby formula is probably best handled by a free market, but the private market in that field now is actually not a free market, it is a monopoly in many places and there is too much reliance on Abbot for total output. Ideally there would be many manufacturers who are anxious to take over market share from Abbot, but there aren't now. This is apparently due partly to lack of enforcement of anti-trust laws and partly to Abbot and some others writing the rules about how manufacturers can actually enter the market.
So no, totally socializing the industry is probably not the solution, but actual government regulation is needed in the long run. And partial government control, or control above the usual regulatory agencies, is probably needed in the short run. Biden seems to be taking some of the required measures.
The reporting could be better, but aside from the obvious role of monopoly, this seems to be a fairly technical matter that the daily reporters may not be qualified to report on.
+1
The regulation that is needed is one that states that for products deemed essential, when a single company controls more than say 33% (or whatever number you think is reasonable) of the entire market, they can't have a single production facility be responsible for more than say 40% (or whatever) of their production.
Whether by screw ups, natural disasters, labor shortages, contamination, massive malfunctions, sooner or later factories need to shut down for some time. No single plant shutting down should cause this type of havoc.
The regulation that is needed is one that states that for products deemed essential
The essentiality of baby formula is key here. It's hard to think of another product (with the possible exception of cow's milk, for similar reasons) that has so few (or no) substitutes, and, critically, is the key (only?) food source for a large and highly vulnerable population. People can switch from cornflakes to oatmeal. Or from beef to chicken. A shortage of beer or avocados or potato chips would be inconvenient (maybe even highly so, in the case of important staples like eggs or sugar or potatoes), but dietary habits can be changed, and the calories and nutrients needed by adults can be usually gotten elsewhere.
But baby formula really does seem a different level of "critical" for the reasons above. Relatedly, what exactly are people doing if they can't get baby formula? Making it at home? This seems quite dire.
PS—If this isn't a Groundhog Day moment in our politics, I don't know what else is. The basic pattern, by now well-entrenched is: 1) GOP fucks things up royally, 2) Democrats take over, 3) Democrats get blamed for state of fucked-upness, 4) Republicans return to power. 5) Rinse and repeat.
The reporting on this has been a patchwork of stories you kind of have to piece together to figure out what's been going on. From what I've been able to read, what apparently happened is that some people claimed their infants got sick (two died) after using some of Abbot's formula (Similac, iirc). The product, as Kevin noted in a post the other day, didn't immediately test positive for contamination, but when the FDA inspected Abbot's Wisconsin factory to follow up on the investigation, they found a bunch of sanitation violations. Whether Abbot has been resisting or slow-walking their compliance for some reason I don't know. Wouldn't be surprised. It came out in recent Congressional hearings, however, that the FDA had been aware of safety issues at the Sturgis plant for some time, including from a whistleblower report, but hadn't really cracked down until now -- an action that completely halted production for several months now.
As people have been commenting, the real problem here is that one or two companies basically have the US baby formula market sown up -- a bit like Ukrainian wheat in the Middle East -- and if something happens to just one factory, we're all boned. The government's job isn't to make baby formula, but to make sure the market for baby formula is safe, robust, and resilient. It hasn't done that.
If you want to read some interesting analysis, check out https://thezvi.wordpress.com/2022/05/19/formula-for-a-shortage/ .
It's not an analysis aimed to please those who think government should take over production of baby formula. He puts the blame on government. Specifically, (1) the FDA doesn't care about availability; the FDA cares about keeping bad stuff off the market. (2) Government threats against market pricing (which would motivate other companies to produce formula). (3) Refusal to allow baby formula from Canada and Europe, because, apparently to some group in government, those sick countries lace their baby formula with arsenic or dried dung or something. (4) WIC chooses which formulas to buy, and WIC purchases half the formula in the country, thus sabotaging the market.
1) The FDA is supposed to keep the baby formula supply safe. Just how far are they supposed to screw this up to maintain supply? Should they just ignore deaths and illnesses? Should it take four dead babies to shut down a line? How about ten? Does your baby count towards shut down or can we ignore that one?
2) The government already controls half the pricing through WIC. The free market controls the rest, but WIC sets a floor. There is no free market in US agriculture or agricultural products. The farmers are collectivists, including the big corporations, and they like it that way.
3) How much surplus capacity do Canada and Europe have? Canada has a lot fewer babies than the US, and correspondingly a lot less manufacturing. If we took ALL of Canada's baby formula, that might get us the bump in quantity we need, but the Canadians are no more fond of dead babies than we are. Probably less so. The Europeans are a month or so away from us by ship, and they have their own babies to feed.
4) US jobs pay poorly because the labor market is routinely sabotaged. Rather than let babies suffer from malnutrition or die, WIC buys half of all the baby formula from the three biggest producers who make 90% of it. Are you arguing that the US has twice as many babies as it should?
I don't think there will be many babies in ICUs, but rather, we'll slowly see effects of malnutrition and long-term effects of malnutrition. When push comes to shove, people will substitute with inadvertently low-nutrition liquid substitutes.
I’m not sure either way. A lot will depend on how Abbott sees its deal with the DOJ. I can’t find the desk itself but the Garland press release seems to suggest that the government is giving them a pass on all past misconduct and perhaps tone down regulatory action if they promise to just reopen the plant and start production.
The question is whether Abbott will double down on cost cutting and “wasteful” safety measures or whether it will be suitably repentant. If past is prologue, Abbott labs is going to double down on prioritizing profits (and executive bonuses) above safety. I think that’s an easy call.
What’s more difficult to predict is whether Abbott will go too far we end up like China with a “two Americas” system for baby formula. The rich will buy only smuggled high quality Canadian and European formula. While the poor and middle classes will fear for their children as they make do with probably adulterated formula produced in unsanitary conditions (but with the blessing and protection of both political parties).
We're well on our way to agency regulation being illegal now, so what's next?
The Hill has an article--basically who cares why there is a shortage, just fix it!!! (Green Lantern theory of the Presidency):
https://thehill.com/opinion/finance/3496694-babies-need-formula-now-it-really-is-that-simple/
For all the damage Abbott has caused, doesn't look like they'll take much of a hit.
If only there was a branch of government that could enforce the law and and punish wrongdoing. We could call it the “executive branch” and it might have within it an organization dedicated to fighting crime and corruption. We could call it the “Department of Justice”.
Perhaps that branch of government might someday be lead by a president who would work to protect innocent babies even as he welcomed the hatred of malefactors of great wealth. Naaaahh! That’s totally unrealistic, childish “green lantern” thinking.
When all of this has blown over and people are going to the polls in November (or voting early), all that anyone will remember was that there was this big disastrous shortage of baby formula. Nobody will recall how swift action by the Democratic president fixed it.
Just as nobody remembers now about how the US withdrawal from Afghanistan managed to get out over 100,000 Afghans, in addition to US personnel, in record time and under fire. All they know is that there were problems and a bunch of people fell off of airplaines.
How can we lefties combat the unending negative media coverage, regardless of how things actually turned out? Why is inflation the only news item (besides Ukraine and Roe), and not the GDP or jobless rate?
People might remember if the idiot Democratic consultants would have the candidates constantly reminding people of all the good the party’s done rather than relying on the media, the referees, or voters themselves to fight the good fight.
Sturgis situation was noted in a FDA inspection, Abbott did nothing. Came up in next inspection, Abbott did the "Chinese solution" and fired the local personnel "in charge" and hired new ones. FDA found problem still there, did a deeper dive and the Abbott executives at corporate were stone-walling the FDA and the local personnel trying to recommend changes and upgrades.
So, after three strikes from a various generous FDA, the FDA decided to shut down the unsafe factory until Abbott cleaned it up, upgraded facilities and generally learned to play well with others.
The lack of FDA personnel to follow-up more closely is why Congress is trying to give them $28 million more after decades of being starved by Republicans.
I read an article about the situation at Abbott that reported the situation you described. Abbott knew about the contamination, didn't deal with it effectively over a far too long period of time, and then resisted FDA directives to do a proper cleanup - also for a far too long period of time. It's become an all too common disease - don't fix the problem if doing nothing is cheaper. What's a few dead babies compared to keeping up the profit margin and executive bonuses.
The television reportage I've seen on the infant formula shortage has been universally dismal, about on the level of storm reporting in New England. I think it is sensible to call for government action when the private sector screws up something crucial like this, especially in an industry that's obviously suffering from a monopoly. We suffer far too much from monopolies, especially in markets affecting public health.
It's the left wing version of sprinkling free market fairy dust on everything. The right wing wants to privatize and deregulate everything no matter the horrible consequences. We all have to live with the wretched results everyday, but, hey, free market.
If you look at the baby food market, it is already heavily controlled by the government. There are all sorts of standards that have to be met, and meeting those standards is hard for a small startup trying to get into the business. That means that most baby formula is manufactured by three companies in the US. The government purchases baby formula through WIC and sets a price at 15% of the wholesale cost. The big players can absorb this through economies of scale, but few new players can meet this price and make money, especially not small ones.
I'm left wing, so I'm often in favor of getting the government more directly involved. Cutting out the myriad profit making middlemen and aggregators in our health care, day care and education sectors could save us money and improve service. I just don't think manufacturing baby formula is necessarily one of them.
I just checked. Safeway is out of just about everything but a special high iron baby formula. I'm not sure you want to use that unless your baby needs it.
For a supply side take: https://www.manufacturing.net/operations/news/22236528/baby-formula-industry-was-primed-for-disaster-long-before-key-factory-closed-down
Wondering if this will come through or if the random comment/reply bitbucket is in operation again.
I do believe feds should make stuff like insulin and sell it at near cost.
I'm not buying formula but checked the local Safeway several days ago and it was very well stocked (behind lock and key of course). I guess it depends on what part of the country you're in?
"The US government isn't a manufacturer, and there's no reason to think it should be. What's more, if you're worried about monopolization, is one supplier really better than four? Why?"
I'm not going to argue that the Feds should be manufacturing infant formula, but the Feds used to operate many manufacturing operations, mostly connected with national defense. In particular there were Naval Shipyards and the arsenal system centered on the arsenal at Springfield, MA. The latter pretty much developed the "American System of Manufacturing" (what we now call "manufacturing") in the 19th century.
Robert McNamara added to his string of terrible decisions by killing off this government manufacturing activity.
When the USS Enterprise was built at Newport News Shipbuilding around 1960, there were two other shipyards building similar sized conventionally powered carriers at the same time. One was the Brooklyn Navy Yard. While the Enterprise cost about $4.2B (all $ inflation adjusted), the conventional ships cost about $2.5B. That and Vietnam put off more nuclear carriers until the Nimitz in the 1970s. Follow-on ships in a class typically cost 25% less to build than the first ship, so we'd have expected the ten Nimitz ships to average $3.3B, but they were actually around $10B. The dysfunctional Gerald Ford is up to about $17B. This isn't all the fault of Newport New's monopoly, but most of it is.
At the same time the two Naval shipyards building nuclear subs were gone by the early 1970s leaving two commercial yards all the business.
Too long a post, but the military always bought ships and rifles from private contractors as well as making them. Having in-house production and design meant they knew the costs and had the ability to develop new ideas. So it's not either/or and it can be a hedge against monopoly power.
By the way, Obama's administration intended to buy equipment to manufacture masks, but Trump's killed the plan.
Women have these things called breasts, which exist entirely to provide "formula" to their babies. Now, I know that not all women are able to breast-feed, and some babies may have unusual conditions that dictate they get a special kind of formula. But the latter are not the babies that all the current hullabaloo is over. And the former are, I would hazard to guess, far fewer women than the number that choose not to breast-feed because it's too much trouble, or their mommas and grandmas didn't do it, or it's just SO much more convenient to buy the stuff at a store.
It's also funny because 15 or 20 years ago, we were always hearing health experts imploring women to breast-feed, but now in the current purported crisis, we're not hearing a mumblin' word about it. Why not? Could it be because "blaming the victim" is SO out of style, or because it might undermine the preferred media narrative of "Democrats in Peril" based on the fact that this, like everything else, is Biden's fault.
Oh, and, for the record, I fully agree with Kevin that we should not "nationalize" baby formula manufacture. Instead, we should "nationalize" some reasonable messaging about breast-feeding so maybe this would never happen in the first place.
OMG yet another guy trying to mansplain away the crisis. The fact of the matter is women cannot switch to breastfeading after the fact - also it's very common for women to have trouble producing enough milk so formula is needed. Finally far too many jobs in the US are not supportive of breast feeding particularly working class jobs so low income women are the most likely to use formula.
Also breast feeding is not really cheaper due to the need to buy supplies and equipment for it.
True enough, but if more women were breast-feeding, a baby formula shortage would certainly not be a crisis for them. My wife nursed our daughter until she was almost two. It was not easy to get started, and she had to deal with some frustration, but given the fact that it is certainly healthier for the baby, she was very glad she saw it through. Of course, there are many women who, for perfectly valid reasons, can't do it. But we are just too prone in the country to meet every need by buying some product from a store, thus producing the potential for a supply chain crisis. If more women breast-fed, there would be less impact from the current shortage.
Just as you thought,
after the initial wave of covid deaths the proportion of deaths by county tracks with the proportion of Trump voters in that county, and vice versa,
https://www.huffpost.com/entry/trump-county-covid-death-rates-more-than-twice-as-high_n_62893743e4b0415d4d782ad2
Eh, maybe that is because they didn't get the initial wave moron. It wasn't until Delta it went truly national. Omicron effected everyone. Posts like these represent the problem. Your constructing a narrative.
It's like you hit yourself in the face with a board so it immediately removes all memory of the board and you think your face just did that and you have a stupid face so you hit it with a board, and you forget it all over again and that keeps happening and you don't know why it keeps happening and it's like your face doing this by itself because it's dumb or something and you have to make it stop.
Taurine as possible treatment for lead induced brain damage,
https://pubmed.ncbi.nlm.nih.gov/28849442/
It's mostly in South central areas. I actually checked at a local store, yup there was formula. The media by Friday finally admitted it was a South central US thing. Now it's a joke.