Category Archives: Uncategorized

Hobson’s Choice: No Organization vs Dis-organization

“Trump administration officials are telling members and staff of the coronavirus task force that the White House plans to wind down the operation in coming weeks despite growing evidence that the crisis is raging on, Maggie Haberman reports.”

“It is not clear whether any other group might replace the task force. But its gradual demise, which officials said might never be formally announced, would only intensify the questions about whether the administration is adequately organized to address the complex, life-and-death decisions related to the virus and giving adequate voice to scientists and public health experts in making policy.”

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Medicynical note:  He’s running it like his bankrupt businesses.  Declaring his great successes (sic) while killing off his stockholders. 

With the Federal Government in Trumpian truth deprived disorganization, there is not going to be much difference in the already disastrous outcome.

Ignorance is no Excuse

Nancy Messonnier a CDC infectious disease expert stated on February 25: “We are asking the American public to work with us to prepare in the expectation that this could be bad.”

She went on to say: “Ultimately, we expect we will see community spread in this country. It’s not so much a question of if this will happen anymore, but rather more a question of exactly when this will happen and how many people in this country will have severe illness.”

Trump not only ignored the warning but removed her from her spokesperson duties. He refused to believe science.

President Trump’s motivation in dismissing for the longest time the severity of the virus was not religiosity, it was political — wanting to be re-elected. But his denial of scientific facts was even more shocking. On March 12, in a meeting with the Irish Prime Minister, Trump bragged: “I mean, think of it: the United States, because of what I did and what the administration did with China, we have 32 deaths at this point. Other countries that are smaller countries have many, many deaths. Thirty-two is a lot. Thirty-two is too many. But when you look at the kind of numbers that you’re seeing coming out of other countries, it’s pretty amazing when you think of it.””

Medicynical note: And now even Donald is predicting 100,000 or so deaths in the U.S. and implying that he was heroic somehow. This in the face of his blatant negligence and politization of the event.

And by the way it was not a media hoax or somehow a democratic plot. It’s a real disaster, aggravated by a science denying wanna-be despot.

Trump’s Goal– Increase Shipping Costs for Consumers and Businesses

With the Postal Service reeling from the financial impactof the coronavirus pandemic, the Trump administration last week set an ultimatum for the agency to hike its package and shipping prices before it receives a $10 billion loan guaranteed under the Coronavirus Aid, Relief, and Economic Security (CARES Act).”

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Medicynical Note:  The Trump/Bezos vendetta has the potential to affect the jobs of 600,000 voting employees of the postal service.    Add a couple of  voting dependents and relatives for each of these threatened employees and you have almost 2 million Biden voters.  It might even approach 3 million people whose vote is affected by Trump’s animosity towards the vital services offered by the U.S. Postal Service.

Consider, as well, that the average citizen uses any number of on-line merchants for vital goods and medications.  All of their shipping costs…..and prices will be forced up by Trump.  Thats another million or two Biden voters there.  Good work Donald, keep it up, we’re counting on you. 

 

We Were Warned

And the Trump administration has gone further—not only underfunding these efforts but also proposing steep spending cuts year after year to institutions, such as the Centers for Disease Control and Prevention, that are tasked with handling outbreaks. Congress has resisted these efforts in the bills Trump has ultimately signed, but the president’s requests have nevertheless spoken to his priorities. His budget proposal for fiscal year 2021, released in February when the coronavirus outbreak had already reached the United States, called for the CDC’s overall funding to be slashed by hundreds of millions of dollars. The administration did suggest more resources for certain subsets of the CDC’s work relevant to the current crisis. Each of those increases, however, is less than the Trump administration devoted in its 2021 budget proposal to counter Chinese and Russian propaganda and disinformation, and a small fraction of the additional $459 million the administration wished to pour into offensive hypersonic weapons. (But what’s $459 million when you’re spending billions on them already?)”

Medicynical note: Read the entire piece, it’s a good summary.

Denial is part of some disease processes. But in this case the denial was manifested by our lack of preparation for a inevitable event. The U.S. Government, once a force in world health over the years minimized, to itself, the risk of a serious outbreak. We decimated our resources through ignorance and budget cuts and lost influence in the world over several presidential administrations. Neither party is without blame but the republicans have taken the lead in both congress and the executive branches, in gutting expertise.

I’m unsure whether a democratic administration would have resulted in fewer deaths. But at least if they were running the show their would have been fewer and perhaps more clever falsehoods and certainly more reliance on science.

Vaccine in a Year? A Long Shot

There are more than 70 COVID-19 vaccine efforts globally, at least; with so many, it’s reasonable to be optimistic that we will have a vaccine in somekind of record time frame. There are even a few that are posed to break the record: one from a company called Moderna that began trials in humans in March (this is the one that Fauci is referring to in his estimates), one from a group at Oxford that claims it could even have doses available by fall. Yes, it says it might even have some doses by the fall.”

“”The thing to note with the timeline is people often caveat it with a statement, ‘if everything goes perfectly,’ ” says Matthew Watson, an analyst at the Johns Hopkins Center for Health Security. “I think that’s really important to pay attention to. Things rarely go perfectly.””

Medicynical note: it’s an unprecedented effort but a lot can go wrong.

Progress–Remdesivir

In the trial, patients who received remdesivir recovered 31% faster than those who received a placebo, a finding of superiority that could not be attributed to chance, researchers reported. Specifically, half of the patients who were randomly selected to be treated with remdesivir were considered completely recovered within 11 days, and half of those patients took longer. By comparison, it took 15 days or less for half of those who received the placebo to recover.”

“The results also suggested that patients who were given remdesivir were more likely to survive COVID-19 than were those who got the placebo. But the difference in fatality rates — 8% for the group that took the drug versus 11.6% for the placebo group — fell slightly below the cutoff point at which researchers could rule out a statistical fluke.”

Medicynical note: some good but not great news. Remdesivir has activity against the civic-19 virus but the activity is marginal. Comparison of fatalities in the study between those receiving the drug and those getting placebo were not quite statistically significant. The decrease in recovery time was significant. 11 days to recovery vs 15 is progress but not what I would hope to be the ultimate solution.

Use of this drug earlier in the course of the disease may provide more profound benefit. As Dr. Fauci implies this is a start towards an effective treatment.

It should be pointed out that when a very active medication is found it will not take large studies to prove its worth. Remdesivir is a good first step.

Trump on Science: “I have a Hunch”

When you have a leader who disregards everything.…………but himself. “Every one of these doctors said, ‘How do you know so much about this?’ Maybe I have a natural ability,” Mr. Trump said.

It was a striking boast, even amid a grave health crisis in which Mr. Trump has repeatedly contradicted medical experts in favor of his own judgment. But a disregard for scientific advice has been a defining characteristic of Mr. Trump’s administration.

As the nation confronts one of its worst public health disasters in generations, a moment that demands a leader willing to marshal the full might of the American scientific establishment, the White House is occupied by a president whose administration, critics say, has diminished the conclusions of scientists in formulating policy, who personally harbors a suspicion of expert knowledge, and who often puts his political instincts ahead of the facts.

Medicynical note: imagine the alternate reality of Trump receiving a letter from an immigrant scientist, a Nobel prize winner, warning about a new source of energy for a powerful weapon…….or a series or reports warning of a catastrophic change in climate that will threaten humanity……….or a note from a predecessor warning of the likelihood of a pandemic during his administration.

Think he would make the right decision?

Or would he dismiss the scientist’s letter as being unreliable because it came from a swarthy immigrant Jew with an accent?………or would he dismiss the climate warning as a hoax?………or would he ignore the previous President’s note and fire the staff preparing for the epidemic?

Sadly we don’t have to imagine.

Blame Someone, Anyone will Do: The Trump Strategy

President Trump and his top aides are working behind the scenes to sideline the World Health Organization on several new fronts as they seek to shift blame for the coronavirus pandemic to the world body, according to U.S. and foreign officials involved in the discussions.”

“Last week, the president announced a 60-day hold on U.S. money to the WHO, but other steps by his top officials go beyond a temporary funding freeze, raising concerns about the permanent weakening of the organization amid a rapidly spreading crisis.

At the State Department, officials are stripping references to the WHO from coronavirus fact sheets, and Secretary of State Mike Pompeo has instructed his employees to “cut out the middle man” when it comes to public health initiatives the United States previously supported through the WHO.”

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Medicynical Note:  After receiving briefings about the possibility of a severe epidemic, Trump lived in denial of the covid-19 pandemic in December, January and February.  Trump termed it a Demcratic and media hoax; he said it would go away like a miracle, and he thought that everything would disappear by April.  Meanwhile Senators who received the same intel briefings as Trump sold millions of dollars in stocks to avoid the market shock when the inevitable epidemic hit.

Trump maintains that he wasn’t warned early enough by the W.H.O. even though the warnings from the WHO began in December (the US has embedded staff at W.H.O.).   In January the W.H.O. published warnings of the epidemic in China and  of the possibility of person to person transmission by the 15th of that month.  W.H.O. also reported increasing numbers of cases documented and reported by China and then spreading elsewhere thoughout the months of January and February.

Trump and his colleagues also DID NOT accept the W.H.O. developed test for the virus in January choosing to develop a CDC test.  The CDC’s test, however,was  flawed and several weeks use was lost because of the inability to test for the virus in the U.S.  This was by the Trump administration’s choice.

And of course we all are aware that it was Trump’s choice to gut the U.S. government’s pandemic planning and response teams in 2018 by zeroing out the budgets of those folks in the National Security Council and the CDC.  He also cut the budget and removed from China the embedded CDC staff working with the Chinese CDC in June of 2019.

And now Trump, suffering from deserved public humiliation and righteous ridicule after he advocated on nationwide TV the use of bleach and UV light in a person’s body to fight the virus, tries to blame the W.H.O. 

The W.H.O. is not perfect but their response to the pandemic has been all the things that Trump’s U.S. government response IS NOT.  i.e. timely, appropriate, factual and full of helpful information. 

 

Tax the Poor….. Trump’s bad judgement yet again

“President Trump on Friday threatened to block an emergency loan to shore up the U.S. Postal Service unless it dramatically raised shipping prices on online retailers, an unprecedented move to seize control of the agency that analysts said could plunge its finances into a deeper hole.”

And

“[Trump] is interposing his own flawed judgment for a very complex, technical enterprise that serves at least a $2 trillion industry,” said Rep. Gerald E. Connolly (D-Va.), who chairs the House subcommittee in charge of postal oversight. “It’s one of the most important services in America. It serves every business and every household and it has a workforce of 630,000 people who put themselves at risk every day on behalf of the American population. And he’s willing to risk it all because he’s got a bugaboo in his mind that Jeff Bezos and Amazon are getting a good deal.”

Medicynical note: As we watch this President come apart on live TV, each day demonstrating his bad judgement and constant lying, we should not let him destroy the postal service…..something that’s right about our country. Trump, in the midst of a nationwide stay at home quarantine, actually wants to raise delivery costs (a form of tax if you will) for citizens and businesses. Sad sack social misfit that he is, he can’t just leave things alone.

He’s the Worst Political Leader……..of My Lifetime

Trump is the worst political leader I have experienced in all of my professional life, which is forty years of working with governments at a high level. I’ve never seen anything like the narcissism of this man, and here we are, a country so rich in expertise, in resources, in capacities, and yet we’re watching a complete failure of a political response—with a massive loss of life—in real time. It’s quite shocking, because Trump not only does not know how to approach this issue but he blocks those who do.”

And

“So, let me be specific. The United States is completely failing at the federal level to control this epidemic. It’s a tragedy. We’re losing tens of thousands of lives unnecessarily because of the shambolic failure of Trump and his team to mobilize the vast resources of our country, both human and material. At the same time, there are poor countries that are doing much, much better at controlling the epidemic. Take a country like Vietnam, which is a low-income country in East Asia, and close to China, but for a variety of reasons they acted very quickly to stop the transmission of the virus, to a much greater extent than we did. They also don’t have the means for mass testing and so on. At least to date, they have been able to keep the epidemic more under control through public-health means, which is identifying potentially sick people, helping them to isolate, tracing their contacts, helping those people to isolate, and so on.”

Medicynical note: Read the article. It’s no secret. He’s a failure making us failures too.