Why So Many Deaths in Nursing Homes? Trump…..Again

Happening now.

“The Trump administration has been working to relax regulations governing America’s nursing homes, including rules meant to curb deadly infections among elderly residents.

The main federal regulator overseeing nursing homes proposed the rule changes last summer, before the coronavirus pandemic highlighted the vulnerability of nursing homes to fast-spreading diseases.”

“The push followed a spate of lobbying and campaign contributions by people in the nursing-home industry, according to public records and interviews.”

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Medicynical Note:  As is their want, the Trump administration has worked diligently at reversing the progress of the Obama years.  In their time in office the Trumpists have ignored regulations controlling the management and quality of nursing homes.   Their neglect has endangered patients housed there.

Trump has been influenced by contributions to republican causes by the nursing home industry and in response he has pushed for a relaxation of regulations for infectious disease control, among others, at nursing homes.  This even during the thousands of deaths, yes thousands, of nursing home patients from the covid-19 virus infection. 

“Together these changes gut enforcement,” said Toby Edelman, a senior lawyer at the Center for Medicare Advocacy, a nonprofit legal assistance group for the elderly. “They are a gift to the industry.”

“The administration’s moves came after intense lobbying by the nursing home industry, including by the firm run by Brian Ballard, Mr. Trump’s friend and a fund-raiser. Parlaying his personal connections to Mr. Trump, Mr. Ballard has become one of the most powerful lobbyists in Washington, with the most clients of any registered lobbyist last year, according to an analysis by the Center for Responsive Politics. His firm has lobbied on behalf of nursing homes in his home state, Florida, for years, according to public records. (He was also a lobbyist for Mr. Trump’s Florida golf course, the Doral.)”

Remdesivir…..better than nothing (hydroxychloroquin)

Remdesivir was superior to placebo in shortening the time to recovery in adults hospitalized with Covid-19 and evidence of lower respiratory tract infection.

From Ars Technica:

“Overall, treatment with remdesivir shortened a patient’s time to recovery compared to the placebo group, from an average of 15 days to 11 days. Improvements occurred whether or not the patient was receiving supplemental oxygen. What’s more, the data lays to rest any worries that remdesivir has to be given very early after the onset of symptoms. In fact, those participants who entered the trial more than 10 days after the onset of symptoms actually showed a better response to remdesivir than those who started being treated during the first 10 days of being symptomatic.”

“The trial’s main secondary outcome—how a participant was doing on day 15—also showed that remdesivir was significantly better than placebo. And the total number of deaths was lower in the remdesivir group (21 vs 28) at this point, although that difference was not statistically significant. (Medicynical emphasis)”

Medicynical note: A few days benefit of shorter recovery time and slight, not yet significant, improvement in number of deaths. The fact that it took a large study to tease out the benefit is indicative of the drug’s marginal usefulness. But at least it didn’t result in increased deaths…..like hydroxychloroquin.

As noted it is hoped that combination with other agents, anti-inflammatory or antiviral, will have better more dramatic positive outcomes.

Wrong Again– Hydroxychloroquin and Chloroquine

A study of 96,000 hospitalized coronavirus patients on six continents found that those who received an antimalarial drug promoted by President Trump as a “game changer” in the fight against the virus had a significantly higher risk of death compared with those who did not.
People treated with hydroxychloroquine, or the closely related drug chloroquine, were also more likely to develop a type of irregular heart rhythm, or arrhythmia, that can lead to sudden cardiac death, it concluded.” (The study in Lancet)

And

“It’s one thing not to have benefit, but this shows distinct harm,” said Eric Topol, a cardiologist and director of the Scripps Research Translational Institute. “If there was ever was hope for this drug, this is the death of it.”

“David Maron, director of preventive cardiology at the Stanford University School of Medicine, said that “these findings provide absolutely no reason for optimism that these drugs might be useful in the prevention or treatment of covid-19.””

Medicynical note: He ignored the briefings, called it a hoax, screwed up his “travel” non-ban, thought and still thinks it will go away like a miracle, delayed, delayed and delayed. And now, plays doctor and recommends a drug with dangerous side effects and no discernible anti virus activity. That’s our President, more wrong than a stopped clock.

More here.

Wanted…….Alternatives to Tesla

The 48-year old CEO of Tesla has been bickering on social media with California and Alameda County officials about reopening Tesla’s Fremont, California electric car manufacturing plant, on which the electric carmaker is unusually dependent, since its only other auto manufacturing plant is the newly-opened Gigafactory outside Shanghai. Recently, Musk took to Twitter to threaten to take his company and go home, if by home, he means new digs in either Nevada, or locations where Tesla is reportedly scouting locations for a new Cybertruck plant, Austin, Texas and Tulsa, Oklahoma.”

Medicynical note: Musk is a brilliant innovator who is also a Trumpist. He, like Trump, is willing to sacrifice his employees/people’s lives for his own “greater good.” His money appears to come before……… before everything else.

Back in the 50’s and 60’s Volvo made it as a luxury/euro car alternative to the popular well engineered German brands…..I.e. Benz and BMW. in that period many avoided the German cars because of the association with Hitler’s Germany. Volvo emerged as a quality alternative.

Given Musk’s erratic money grubbing behavior I’m beginning to look for the alternative to Tesla…..though I personally will, likely, not be buying it–because of my age.

Trump and the WHO: BBC Fact Check

Trump seeks to blame somebody……anybody will do.

“The WHO failed to adequately obtain, vet and share information in a timely and transparent fashion.”

“This has become a regular theme of Mr Trump’s criticism of the WHO, and in his letter to its head Dr Tedros Adhanom Ghebreyesus on 18 May, he renewed this attack saying the WHO “consistently ignored credible reports of the virus spreading in Wuhan in early December 2019 or even earlier”.”

“Mr Trump specifically highlighted reporting by the Lancet medical journal.”

“The editor of the Lancet, Richard Horton, has written a letter in response, saying: “The Lancet did not publish any report in early December 2019 about a virus spreading in Wuhan. The first reports we published were from Chinese scientists on Jan 24, 2020.””

Read the rest of the article……

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Medicynical note:  The article exposes Trump’s unwillingness to accept facts and disarms his accusations against the W.H.O.  Trump denied the seriousness of the epidemic all the way into March.  He blew off intelligence briefings in December; reports of cases and spread in January; and the possibility of a pandemic into March.  As late as February 24 he fired a prominent CDC expert for raising the alarm about covid-19 disease spread.

And when he did his only “early” intervention, the stoppage of flights from China, he did not stop the entry of 40,000 or so U.S. travelers from China.  They received no serious screening on return and were forced to mingle in huge crowds at U.S. customs and immigration.  Trump also did little to nothing to stop the travel of infected citizens from Europe.  And as the W.H.O. predicted this type intervention is not particularly effective…..to whit we have the worst epidemic in the world in the U.S.

His vendetta against W.H.O. reminds me a little of the Korean era when the Russians dropped out of active participation in the U.N. and in doing so allowed the U.S. to put together an international force to oppose North Korea in the Korean conflict. They couldn’t veto an action when they weren’t present.

Abdication means loss of influence, not only in the W.H.O. but in all international multinational bodies.  If loss of influence around the world was Trump’s goal.  He’s succeeded.  Thanks to him, we, the U.S., are perceived as a declining power run by an ignoramus.  Congrats to us.

Meet Mr. Incompetence: Donald Trump

This is incompetence.  “In April, 20.5 million Americans lost their jobs and unemployment was at 14.7 percent. As states ease coronavirus restrictions, the spread continues: There are nearly 1.5 million cases and more than 89,000 deaths in the U.S. The Trump administration has been criticized for a delayed response to the outbreak and a lack of organization in providing tests and medical supplies.”

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Medicynical Note:  The incompetent president who ran the largest deficit, in good times, in history (almost a trillion dollar a year); The incompetent president who took the excellent economy handed to him by President Obama and ran it into the ground; the incompetent president who missed the warning of a worldwide pandemic; the incompetent president who fired the NSC staff and CDC staff tasked with preparing for a worldwide epidemic;  the incompetent president who ignored the position papers and a planning session for pandemics provided by his predecessor, President Obama; yes this incompetent president, his name is Trump, proudly takes responsibility for nothing and blames everyone……….. but himself. 

Wrong Again……and Again

“For two months, President Trump repeatedly pitched hydroxychloroquine as a safe and effective treatment for coronavirus, asking would-be patients “What the hell do you have to lose?”


“Growing evidence shows that, for many, the answer is their lives.”

Medicynical note: A stopped clock is right twice a day…….Trump is certainly due. As you recall this is the guy who thought the virus would go away by itself; that it was a hoax; that he didn’t need the pandemic planning team kindly left by President Obama; that he didn’t need the detailed response plan also provided by his predecessor; that his administration could ignore the warning from President Obama that there was a significant risk of a pandemic. He ignored it all.

And now his “game changer” treatment recommendation, unsurprisingly, turns out to be bogus. It doesn’t work and has fatal side effects.

Which brings us to the vaccine which Trump is certain will be ready by the end of the year. Maybe he is right. There are many good people working on it. But almost all think it will take more time.

I would suggest extreme caution in the use of such an early vaccine. First, like the yearly flu vaccines it may not offer complete protection. And given the truncated development time it may have undiscovered side-effects. In addition, any such vaccine has the unprecedented Trumpian track record of inflated false claims, sloppy reasoning, thousands of lies and repeated failures to overcome.