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.

He Lies…..Again……and Again…….and Again

This time it is to continue the fiction that stopping travel from China in January saved thousands of lives.

In fact 40,000 travelers from China returned to the US after the so-called ban. Virtually no precautions were take to protect those travelers or us. His ban did nothing….nada!

So it is surprising…..wait…nothing is surprising with this president. Trump now claims that because he heroically stopped travel from China that travelers went to Italy and that’s why the outbreak in Italy was so bad.

“It is a perplexing claim because, as we have reported before, Italy stopped all flights to and from China on Jan. 31. Although the White House announced its travel restrictions on China the same day, they did not go into effect until Feb. 2.”

Medicynical note: Nice try Donald, if you had asked someone or bothered to check you’d have known that Italy stopped all travel. ALL travel, from China to Italy was stopped two days BEFORE Trump enacted his partial ban.

Amazing.

Politicization of the Covid-19 Epidemic–Trump Again

Trump opines without thinking or vetting his comments.  That’s undoubtedly what happened when he endorsed the use of chloroquin, hydroxychloroquin and azithromycin as wonder drugs for the covid-19 infection.  His comments were based on a headlines generated by a small poorly documented study from France done by an unreliable researcher–a global warming by human activity denier no less.

Trump repeated his endorsement several times since and as is his style he has never admitted that he might be, or as appears to be the case from recent studies,  wrong.  The drugs don’t appear to work.

Thus is it sad to see a government scientist who expressed reservations about the use of chloroquin and hydroxychloroquin being fired.

As reported by Maggie Haggerman of the New York Times: “Dr. Rick Bright was abruptly dismissed this week as the director of the Department of Health and Human Services’ Biomedical Advanced Research and Development Authority, or BARDA, and as the deputy assistant secretary for preparedness and response.”

In the article Dr. Bright  stated:

“My professional background has prepared me for a moment like this — to confront and defeat a deadly virus that threatens Americans and people around the globe. To this point, I have led the government’s efforts to invest in the best science available to combat the Covid-19 pandemic.\

“Unfortunately, this resulted in clashes with H.H.S. political leadership, including criticism for my proactive efforts to invest early into vaccines and supplies critical to saving American lives. I also resisted efforts to fund potentially dangerous drugs promoted by those with political connections,”

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Medicynical Note:  People are dying and as he has done from the start, Trump is more interested in political posturing than sound science and optimal management of the problem. 

America is Helpless and Hopeless

We as a culture could barely bring ourselves to give two weeks in social isolation to stop the covid-19 worldwide epidemic. Then under the guise of”freedom,” gun toting idiots paraded around claiming their so-called freedom had preference over controlling an epidemic that killed 40,000 fellow citizens in 5 weeks.

So it’s not at all surprising that, when queried, our citizenry doesn’t give a damn about global warming from human activity, not even ten bucks worth.

“In fact, now more Americans than ever understand that climate change is happening. Seven in 10 believe it is. That’s not to say they all understand the scientific reality that human activity is the cause of climate change—some surveys shows that barely more than half of Americans believe the scientific consensus that human-caused greenhouse gas emissions are to blame. And most won’t do much about it, even if they realize it’s happening and realize our emissions are causing it. One poll conducted in 2018 found that 70 percent of Americans would be unwilling to contribute just $10 a month, the cost of a Netflix subscription, to combat climate change.”

Medicynical note: Just like other dumb animals man is unable to defer pleasure even a little bit to assure future survival. I hate to think what that means for the future of the planet which is well on its way to 10 billion inhabitants.

Trump–It ain’t the W.H.O.

Our slow to react, and even then he can’t get it right, President maintains that the W.H.O. mismanaged the early stages of the coronavirus pandemic.

But it was Trump who ignored advice from his predecessor that there was a real possibility of a worldwide epidemic.

The first cases and deaths occurred in December 2019, and by that time our leader had destroyed the office in the NSC (in 2018) that was set up to plan for and respond to an epidemic

He had already destroyed the CDC’s capability to respond and help other countries manage such an outbreak (2018).

He had already removed the embedded CDC personnel from the Chinese CDC (June 2019)

When appraised of deaths in China and the possibility of an epidemic, he opined that the outbreak was a media hoax.

He later stated he thought it would go away like a miracle

After deaths in the US he limited flights from China and said that it was well under control. About 40,000 people subsequently returned from China. On arrival they were delayed at airports which were overwhelmed by the large number of people returning home. Very limited precautions were taken to prevent spread among arriving passengers.

There is no evidence that the stopping of flights did anything by itself to slow or stop the smoldering epidemic in the U.S., as “you know who” maintains.

It’s only when we exceeded 40,000 people dead that Trump announced that the problem, in his not so humble opinion, was the WHO–which warned of the possibilities back in mid January–when he thought it was a media hoax

And now when his medical experts are recommending caution as the social isolation strategy appears to be slowing spread of the disease, Trump doesn’t listen to them either and actively undermines their recommendations.

In reality the only advice Trump listens to comes from the likes of Limbaugh and FOX news….i.e. bad advice. In the fog.of his sociopathic narcissism with some dementia mixed in, he is unable to understand and accept good advice–as he has proven over the last 3 1/2 months.

Folks the problem ain’t the W.H.O.

Birx, just Another Loyal Trump Appointee

Some very peculiar observations this Sunday

“More than a dozen U.S. researchers, physicians and public health experts, many of them from the Centers for Disease Control and Prevention, were working full time at the Geneva headquarters of the World Health Organization as the novel coronavirus emerged late last year and transmitted real-time information about its discovery and spread in China to the Trump administration, according to U.S. and international officials.”

“A number of CDC staffers are regularly detailed to work at WHO in Geneva as part of a rotation that has operated for years. Senior Trump-appointed health officials also consulted regularly at the highest levels with the WHO as the crisis unfolded, the officials said.”

And yet Dr. Birx covers for Trump and pitches the following in a quick move to place blame, anywhere but on Trump.

“Asked early Sunday about the presence of CDC and other officials at the WHO, and whether it was “fair to blame the WHO for covering up the spread of this virus,” Deborah Birx, the State Department expert who is part of the White House pandemic team, gently shifted the onus to China, and the need to “over-communicate.””

Medicynical note: No matter the spin it turns out it wasn’t the W.H.O. or even China. Trump willfully ignored briefings and information from the W.H.O., ignored information from China, ignored alarming intelligence briefings from his own appointees and put forth his ignorant spin–it will go away like a “miracle”, it will disappear like “magic”.

Trump wasted two months and didn’t prepare. It’s as simple as that.

The US paid the Price: 30,000 dead in a month…….Trump Crippled Us

“Responding on Wednesday to a question about the U.S. accusations, Dr. Mike Ryan, executive director of the WHO’s Health Emergencies Programme, said, “In the first weeks of January, the WHO was very, very clear.””

“”We alerted the world on January the 5th,” Ryan said. “Systems around the world, including the U.S., began to activate their incident management systems on January the 6th. And through the next number of weeks, we’ve produced multiple updates to countries, including briefing multiple governments, multiple scientists around the world, on the developing situation — and that is what it was, a developing situation.””

Medicynical note: What went wrong? In previous new infectious disease outbreaks such as Lassa, Marburg, Ebola, HIV and SARS the US had a strong, if not leadership presence, in finding the outbreak and figuring the appropriate response. What was different this time?

Trump.

He singlehandedly crippled the previously set up teams, in the NSC and the CDC , tasked with identifying and responding to potential epidemic situations. He also, as recently as June of 2019, removed an embedded CDC staff person from the Chinese CDC whose purpose was to observe and report on outbreaks like covid-19.

Trump blinded us to the risk and now blames everyone…….but you know who.

Ineffective by Choice: The Libertarian/Conservative Consequence

Residents in the state are reporting a meltdown in its safety net just as the US’s unemployment figures rise to unprecedented levels. Nearly 17 million people have lost their jobs across the US. Officially 472,000 people in Florida filed for unemployment within the last three weeks. The true number, thanks to failing Connect, is much higher. And in this swing state the mess has handed the Trump administration a giant headache ahead of November’s elections.”

“Florida residents who successfully file for unemployment are eligible for a maximum $275 weekly benefit to compensate for the loss in pay. Congress, in its recent stimulus package, also guaranteed an additional $600 a week starting whenever a person filed their claim.”

“But a person cannot get either payout unless they have been processed and approved by the state’s system. Unable to file an application, many are left without compensation and fear they will miss out on weeks of essential paychecks. People have been lining up for miles to receive food from food banks.”

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Medicynical Note:  Full bore Conservative/Libertarian belief dismantles Federal government services except for possibly defense.  This is disastrous  when done without careful consideration of the consequences of the cuts in other services–some of which we are now experiencing in the Trump era.

Blindly following the radical conservative/libertarian playbook Trump cut taxes for the wealthiest in the country and in this case created record debt in the “best of times.”  At the same time along with many other bizarre roll backs of policy, Trump and his cronies destroyed the ability of the government to anticipate and respond  to the predicted inevitable epidemic/pandemic.  As happened time after time in my medical career if we didn’t think something was possible sooner or later it happened. 

Not only did the conservative/libertarian brain-trust undermine our medical capabilities in the NIH, CDC and the NSC, but they also cut to shreds the safety net for citizens.   In Florida their staff cuts and inadequate support systems make accessing benefits for the newly out-of-work at least inconvenient and at worst impossible.

In the future if these folks get their way you can bet there will be major cuts to Social Security, Medicare and Medicaids as well as a dissolution of the Affordable Care Act and undermining of the pre-existing illness protections. Trump has already indicated these are his intentions by his budget requests and legal actions. 

Full implementation of any -ism whether libertarianism, liberalism, or communism without balancing the needs of the citizenry, will lead to consequences, some unintended and often disastrous.  Instead we need a balanced approach with an understanding by government and citizenry of the scope of necessary services and the needs of the great majority of citizens.  The current group’s main concern seems to be the welfare of corporate entities and the 1% highest income groups (i.e. big campaign contributors) in the country.  Not good.

More Wrong than a Stopped Clock

Trump’s schtick claims that because of the early stoppage of some flights from China (40,000 people entered the US from China after the ban) thousands of lives were saved. This dubious claim obviously did not affect the spread of the virus from other locations.

The NY Times published an article that traced the source of the epidemic in New York to travelers from Europe. And of course the epidemic in Europe first started from travelers from China. Trump in his uninformed comment on the article revealed that he either didn’t read the article or simple didn’t understand what the article was documenting.

This article points out Trump’s misinterpretation of facts: “Contrary to Trump’s assertions, the Times’ story never said that the coronavirus originated in Europe. Instead, the article details research findings that suggest a majority of the first cases of the coronavirus disease, or COVID-19, in New York City resulted from travelers from Europe. “New research indicates that the coronavirus began to circulate in the New York area by mid-February, weeks before the first confirmed case,” the story begins, “and that travelers brought in the virus mainly from Europe, not Asia.”

And by inference:

“The findings indicate that the virus, which goes by the name SARS-CoV-2, was being passed around for weeks prior to the first confirmed case in the city, which was announced on March 1. That suggests that the president’s travel restrictions, which applied to China on Feb. 2, Iran on March 2 and the bulk of Europe on March 13, had little effect on the outbreak in New York City, which has been the largest in the country.”

Medicynical note: Trump doesn’t get it. What doesn’t he get? EVERYTHING.

He’s intellectually limited and unfit. He would have been gently retired from any executive position in any organization months ago for such obvious gaffs.

Herd Immunity…….nowhere near

With a disease like this, you probably need somewhere on the order of 60% or more people to have immunity in order to prevent an epidemic. Right now, if we’re at less than 5%; you would need at least ten- to twelve-fold that level. The only way to get there is to vaccinate people or else have horrific transmissions, and we can’t do the latter. So we’re going to have to continue some social distancing efforts.”

Medicynical note: There doesn’t appear to be a large number of asymptomatic people testing positive. That means, if true, that we’ll need a vaccine to safely reach the point where herd immunity offers protection. Not good news as a safe effective vaccine may be very difficult to develop. The covid-19 infection is unlikely to go away like “magic”—we tried that strategy already.