Yup, he lies. That’s what he does.

Trump seems less accurate than a stopped clock. He lies constantly and is proven grotesquely wrong on a daily basis. And by some accident of history, thank you Vladimir, he is the president of the United States.

His lies have consequences.

“Hours after the United States became the nation with the largest number of reported coronavirus cases on Thursday, President Trump appeared on Fox News and expressed doubt about shortages of medical supplies, boasted about the country’s testing capacity, and criticized his predecessor’s response to an earlier outbreak of a different disease.”

“”I don’t believe you need 40,000 or 30,000 ventilators,” he said, alluding to a request by Gov. Andrew Cuomo of New York. The president made the statement in spite of government reports predicting shortages in a severe pandemic — and he reversed course on Friday morning, calling for urgent steps to produce more ventilators.”

“Speaking on Fox on Thursday, Mr. Trump suggested wrongly that because of his early travel restrictions on China, “a lot of the people decided to go to Italy instead” — though Italy had issued a more wide-ranging ban on travel from China and done so earlier than the United States. And at a White House briefing on Friday, he wrongly said he was the “first one” to impose restrictions on China. North Korea, for one, imposed restrictions 10 days before the United States.”

Medicynical note: All presidents at one time or another get caught in speaking not quite the truth. In Obama’s case while drumming up support for the Affordable Care Act he assured people that they would be able to keep their insurer. He was wrong because there were a few insurers who refused to and/or were unable to meet the requirements for participation in the program. But the act resulted in several million more Americans having coverage. Obviously a net good.

In Trump’s case it’s hard to focus on one lie because in every public utterance he includes multiple falsehoods and juvenile attacks on others. Truth is the exception in his comments……..and yet he is tolerated and maintains his supporters. That, of course, is another facet of the current American pathology.

But now people are dying in part because of his slow response to a pandemic. He lies and hurls insults at each daily briefing seemingly unable to comprehend fully what is happening before our eyes. Obviously a net negative.

Relax, Trump is in Charge–Making America Ungreat (MAU ing America Again)

The least qualified most politically biased man in the world will judge the risk of covid-19 infections. Just a month ago it was his judgement that the epidemic would disappear like a miracle. Now his unique (because no one agrees with him) insight is that more people will die beacause of quarantine than from the disease.

“President Trump said Thursday that he planned to label different areas of the country as at a “high risk, medium risk or low risk” to the spread of the coronavirus, as part of new federal guidelines to help states decide whether to relax or enhance their quarantine and social distancing measures.”

“”Our expanded testing capabilities will quickly enable us to publish criteria, developed in close coordination with the nation’s public health officials and scientists, to help classify counties with respect to continued risks posed by the virus,” Mr. Trump said in a letter to the nation’s governors.”

Medicynical note: His gaffes so far have facilitated the spread and mishandling of the pandemic. He wants to do more. I say spare us.

Trump: Making America Ungreat………for the first time in 100 years

America’s disengagement on the coronavirus fight is part of a broader retreat from the world. From the Paris climate change accord to multiple trade agreements, the Trump administration has unwound decades of U.S. leadership on a range of issues.”

“But such is the severity of this crisis that America’s absence could permanently affect its standing, ceding ground to an ascendant China in the great game of global influence, analysts said.”

“”I do wonder whether this really is an inflection point in the international system,” said Nathalie Tocci, the head of the Italian Institute of International Affairs and a former foreign policy adviser to senior European Union leaders.”

“”Here in Italy it is going to change for good the perception of who is leading in the world, and it’s not the United States,” she said. “It’s so strong what is happening. It’s so powerful and it’s so traumatic. The emotions that it ignites today are going to be engraved in the national narrative.””

Medicynical note: After denying the significance of the covid-19 epidemic for two months, the world has moved on under the leadership of more competent authorities. The WHO is leading the response in conjunction with countries that have responded more appropriately. China and even Cuba have offered others assistance financial, materials and personnel.

Meanwhile, the US,with Trump’s delays and abdication of leadership (he’d rather play golf), has no unified response. We can’t even field tests for the disease, or enough clean masks and gowns (to protect providers) to say nothing of ventilators.The nadir for me was hearing a non clinician report that it was a wonderful creative idea for patients to share (and cross contaminate) ventilators.

300 people, (loving fathers, mothers, and grandparents) died yesterday of a media hoax. Thanks Mr. Trump you made America ungreat.

Trump is Sadly the Wrong Person, in the Wrong Place, at the Wrong Time

Mr Trump actually said this today:

“We could go to certain states right now that have virtually no problem or a very small problem. We don’t have to test the entire state in the middle west, or wherever they may be. We don’t have to test the entire state. I think it’s ridiculous. We don’t have to do it,” he said during a briefing at the White House on Wednesday. “A lot of those states could go back right now, and they probably will because at some point in the not-too-distant future, certain states are going to come off the rolls.”

Medicynical Note:  I live in a state where the U.S. epidemic of coronavirus infection first landed.  My home is in a rural county.  We have two nursing homes with cases one with 38 patients (11 workers and 27 patients) the other with an unknown number of cases.  There have been four or five deaths in our county (two today).   In our state there is a testing shortage.  No one is testing the entire state, anywhere, because of a shortage of test kits.  Further aggravating the situation is that there is a shortage of everything to protect health care providers.  Masks are being hand made and donated.  They are in no way the equivalent in protection of the commercially available mask/respirators.  In parts of the country gowns and masks are being reused.  In New York today the governor announced that patient ventilators are being jury rigged for use on two victims–not ideal but there is a shortage. Imagine, this happening in the wealthiest country in the world which is the country spending more per capita on health care than anywhere else.

It’s a fact.  We were unprepared.  Mr. Trump’s hunches were disastrously wrong.  His belief that the pandemic was a false media hoax was horribly wrong.   It’s far too early to claim the outbreak is under control and decrease our social isolation and case finding.  Sadly Mr. Trump is the wrong man in the wrong place at the wrong time. 

 

Maybe It Should be Called the Trump Virus

It’s fascinating that in it’s rush to blame China for not being forthcoming as the pandemic started, the Trump administration calls attention it’s own rather obvious faults.

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Medicynical Note:  Indeed the Chinese were at least unhelpful.  But we should remember that Trump did away with the U.S. government’s ability to track and respond to epidemics overseas by cutting funding to the NSC’s office dedicated to that task; by cutting funding to the CDC’s epidemic tracking teams; and by cutting funding of CDC epidemiologists assigned to the CDC in China.  That organization FYI was one of the first responders to the epidemic outbreak in Wuhan.  Trump in his wisdom (sic) crippled the U.S. capacity to participate in the early tracking and anticipate the spread to the U.S.

He always makes a big deal about stopping the flights from China an thinks, without any supporting data, that he saved thousands.  But it should be pointed out that he neglected to screen  U.S. citizens for the virus infection on their return on the last flights from China and thereby allowed entry of the virus.  He further slowed the U.S. response by publicly stating that the epidemic was a media hoax; by having the flight of fancy that it would disappear spontaneously “like a miracle.”  He did this while criminally neglecting to ready the U.S. health care system for the widely predicted onslaught of the virus. 

So while the Chinese were not forthcoming and/or totally honest our fearless leader literally fiddled around while the epidemic was building.  If he wishes to place blame he certainly should include his actions and in-actions as part of the equation. 

To my mind, our lack of preparation make it the Trump Virus.

Returning to Work Prematurely–Trump’s LaLaLand

Returning to work in two weeks will need careful planning. It not as simple as a Trumpian decree, or “hunch.” It will take careful consideration and planning and two weeks is likely way too early.

“David L. Katz of the Yale School of Medicine has a plan for when and how we should return to work. This plan has been championed by Tom Friedman and many other pundits. In essence, we should sustain the lockdown for a brief period to reduce the risk of overwhelming the health care system with severe COVID-19 cases. However, we would not stay in lockdown until the prevalence of the virus gets so low that people can congregate with minimal fear of transmission. That would cause too much economic harm. Katz argues, therefore, that only the young and healthy would return to work.* Some returned workers would become infected with the still-prevalent coronavirus. This is acceptable, on Katz’s view, because the young and healthy have only a small risk of dying from COVID-19. Conversely, the chronically ill and the elderly are at substantially higher mortality risk. Therefore, when the young and healthy return to work, we should make special provisions to protect the elderly and chronically ill. If we succeed in protecting the vulnerable from becoming infected, we will greatly reduce the morbidity and mortality of the disease. This would give us a better tradeoff, and allow us to return to work earlier and restart the economy faster at a lower cost in lives.”

Friedman quotes Katz as foreseeing only two more weeks of social distancing. Few epidemiologists regard that as sufficient. However, whether Katz is right about when to return to work is to some degree beside the point. The proposal to allow the less vulnerable young to return to work early while protecting the vulnerable is a superb idea. If it works.”

“It won’t work if the protections that we plan are ineffective or if we do not implement then in an adequate way. And if the protections fail while the virus is still prevalent, many elderly Americans will die.” (Emphasis Medicynic)

Medicynical note: as we learned in Vietnam and now in Afghanistan declaring victory prematurely without understanding the consequences leads to chaos and ultimately defeat. In Vietnam we needed helicopters to evacuate embassy staff. We are likely learning the same lesson in Afghanistan.

With the Covid-19 epidemic, prematurely abandoning the isolation strategy will expose the vulnerable in our society to life threatening risk for an indefinite time period. Two weeks to “victory” is likely way too early. But our President has the attention span of a gnat and lacks the intellectual capability to understand any data except the daily ups and downs of the DOW.

A Modest Proposal

Jonathan Swift 1729 A Modest Proposal
“I have been assured by a very knowing American of my acquaintance in London, that a young healthy child well nursed, is, at a year old, a most delicious nourishing and wholesome food, whether stewed, roasted, baked, or boiled; and I make no doubt that it will equally serve in a fricasee, or a ragoust. “
“I do therefore humbly offer it to publick consideration, that of the hundred and twenty thousand children, already computed, twenty thousand may be reserved for breed, whereof only one fourth part to be males; which is more than we allow to sheep, black cattle, or swine, and my reason is, that these children are seldom the fruits of marriage, a circumstance not much regarded by our savages, therefore, one male will be sufficient to serve four females. That the remaining hundred thousand may, at a year old, be offered in sale to the persons of quality and fortune, through the kingdom, always advising the mother to let them suck plentifully in the last month, so as to render them plump, and fat for a good table. A child will make two dishes at an entertainment for friends, and when the family dines alone, the fore or hind quarter will make a reasonable dish, and seasoned with a little pepper or salt, will be very good boiled on the fourth day, especially in winter.”

Glenn Beck’s Modest Proposal (from the Dally Beast) [2020]
“Telling listeners of his radio show on Tuesday that he wanted to have “frank conversation” with them, Beck openly acknowledged that such action could end up killing millions of Americans, especially older ones like him.”

And

“I would rather have my children stay home and all of us who are over 50 go in and keep this economy going and working,” Beck added. “Even if we all get sick, I would rather die than kill the country. Because it’s not the economy that’s dying, it’s the country.”

Texas Lieutenant Governor Dan Patrick [2020]
“Patrick, the Texas chairman of the president’s campaign, appeared on Fox News on Monday and said that he was not only ready for the country and the economy to get moving again amid the coronavirus pandemic, but also that he and other grandparents might be willing to die for that to happen.”

“My message is that let’s get back to work,” Patrick, 69, said on “Tucker Carlson Tonight.” “Let’s get back to living. Let’s be smart about it, and those of us who are 70-plus, we’ll take care of ourselves, but don’t sacrifice the country.”

Medicynical Note: The modern Modest Proposal from Patrick, Beck and from our feckless President refers to sacrificing lives in order to save………the stock market (a stand-in) for the economy. Their proposal as far as I can tell is a “serious” recommendation.

Swift’s modest proposal also aimed at correcting economic problems but in Ireland in the early 18th century. “A Modest Proposal, is a Juvenalian satirical essay written and published anonymously by Jonathan Swift in 1729. The essay suggests that the impoverished Irish might ease their economic troubles by selling their children as food to rich gentlemen and ladies. This satirical hyperbole mocked heartless attitudes towards the poor, as well as British policy toward the Irish in general. “ (Wikipedia)

The difference between Swift and Beck, Patrick and yes Trump is that Swift’s was satire.