Archive for the ‘Medicine and Health’ Category

Safety first

May 21, 2022

Hat tip to Authentic Medicine.

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Why is vaccination a political issue?

March 8, 2022

Hat tip to kottke.org.

A long time ago I tried to convince an old friend that nuclear power was safe.  This was long before the Chernobyl and Fukushima controversies.  His answer was that all the people who advocated for nuclear power were the same as people who advocated for U.S. intervention in Vietnam, and that was all he needed to know.

That’s not a terrible way to make up your mind about things.  You can’t research everything, especially if you have a job, family responsibilities and other things you’re concerned with.  So you decide who you trust and follow them.

I personally don’t trust Antony Fauci and his ever-changing advice.  I always waited before getting vaccinated to see the effects on the first wave of people to get vaccinated.  But I think the.facts show that getting vaccinated will drastically reduce the odds of dying or winding up in an intensive care unit as a result of the coronavirus.

Vaccination doesn’t offer perfect protection.  Some vaccinated people die of the virus.  Vaccinated people are infectious.  Vaccinated people can suffer long-term organ damage from the virus—the “long Covid.”  But. the results show that I’m better off being vaccinated than not being vaccinated.

Vaccination isn’t enough.  I still wear a mask when I’m indoors among strangers or a large group; I don’t care if some elected official says masks aren’t needed.  Improved ventilation helps.  We need research on an actual cure rather than just protection against the symptoms of the disease.

Donald Trump advocates vaccination, and his administration’s Warp Speed crash research program is responsible for the vaccines that we have.  But his scoffing at the seriousness of the disease contributed to opposition to vaccination.

But Democrats’ attacks on the unvaccinated don’t help.  If you tell me I’m ignorant, anti-science and to blame for whatever happens to me, I am not going to listen to you.

If you are a vaccine skeptic yourself, I urge you to talk to your physician, if you have one.  Share your doubts with someone who has the expert knowledge to respond to you.  You may have a good personal reason for not being vaccinated.

But maybe you don’t have a personal physician, or you can’t afford to pay for a visit to the doctor.  In that case, I don’t know what to tell you.   We have a rotten medical care system in the USA, no doubt about it.

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Joe Biden is trying to privatize Medicare

February 20, 2022

Branko Marcetic wrote a good article for Jacobin magazine about how President Biden is planning to privatize Medicare.

Over the past year, seniors around the country have been getting letters from the Centers for Medicare and Medicaid Services (CMS) informing them that they needn’t worry, but their doctor was now part of something called a direct contracting entity (DCE).

“Your Medicare Benefits have not changed,” the letters stress no less than twice. “NO ACTION NEEDED,” they blare.

If you take it from CMS, DCEs are simply a collection of different health care providers “who agree to work together to keep you healthy” — an innovative new payment model to keep health care costs down and raise the quality of care up. For its critics, the initiative is something far less benign.

“What direct contracting does is turn the public side of Medicare into a corporate goldmine,” says Diane Archer, president of Just Care USA.

Under traditional Medicare, when a beneficiary gets care from a doctor, a hospital or any other health care provider, the program reimburses that provider directly at a set rate.

Direct contracting adds a third party into the mix: Medicare makes a monthly payment to a DCE, which then decides what care a beneficiary will get, and uses that money to cover a specified part of their medical expenses — pocketing whatever they don’t spend as profit.

While making cost-saving efficiencies usually means cutting out the middleman, direct contracting adds one in.

In other words, as with health insurance, the less the physicians get paid, the higher the profit for the companies.

Critics like Physicians for a National Health Program warn that the program comes with the same kinds of pitfalls as Medicare Advantage, the program that for the first time carved out a role of private insurers in the public Medicare system, when it was passed as part of a Reagan-era deficit reduction bill forty years ago.

One is “upcoding,” the notorious practice where Medicare Advantage insurers make their patients appear less healthy than they really are, the better to drive up the payments they get from Medicare.

I say: “Keep your hands off my Medicare.”

LINK

Direct Contracting Entities: Wall Street Control of Traditional Medicare by Physicians for a National Health Program.

Joe Biden Is Quietly Pursuing the Creeping Privatization of Medicare by Branko Marcetic for Jacobin.

Warren Warns: Corporate Vultures Are Circling Medicare on Biden’s Watch by Jack Johnson for Common Dreams.  [Hat tip to Bill Harvey]

The Dark History of Medicare Privatization by Barbara Caress for The American Prospect.  [Hat tip to Bill Harvey]

What I think about the Canadian trucker protests

February 17, 2022

Prime Minister Justin Trudeau’s emergency order is a radical violation of the principle of the rule of law.

He ordered Canadian banks and financial institutions to stop serving any participant or supporter of the Canadian trucker protests.

That means they’ll freeze their checking accounts, cancel their credit cards, cut off their insurance and refuse to issue them loans.

Of course the Canadian government was fully justified in making arrests of persons who unlawfully occupied their capital or blocked international bridge crossings.

But this doesn’t justify extreme actions against persons who haven’t been charged with any crime or, in many cases, have not violated any laws now on the books.

The Canadian trucker protest is an example of the uneven enforcement of laws against protesters.

Here in the USA, some kinds of protests are treated very harshly and others very leniently.  Sometimes it will protesters will be treated brutally by local authorities and coddled by federal authorities; sometimes it is just the reverse.

In Ottawa, it seems as if the truckers are being treated leniently by the local police, in contrast to the draconian policy of the national government.

I don’t think there will be a civil war in the USA, much less Canada, but if there is, it will have been possible because elements of the police and military support different sides.

I somewhat disagree with the truckers on the merits of their complaints.

The truckers initially protested requirements that they show proof of vaccination upon leaving Canada and and that they be subject to a two-week quarantine if they try to return unvaccinated.

Trying to prevent the spread of a deadly contagious disease is not tyranny.  The Canadian government has the right and duty to stop the spread of the virus

But vaccine passports, in my opinion, are not the best way to do this, because a vaccinated person can still be infectious and an unvaccinated person can be free from the disease.

It would be better to ask the truckers to show recent covid virus tests.  Or take their temperatures when they approach the border and, if they run a fever, ask them to take a virus test.

Where people stand on the truckers largely reflects where they stand on larger conflicts.

Team Red is largely pro-trucker and Team Blue is largely anti-trucker.  Rural people and people who work with their hands seem pre-disposed to be pro-trucker.  Urban people and college-educated professionals seem predisposed to be anti-trucker.

I’m not sure the protesters are representative of Canadian working people, or even of truckers as a whole.  But I see no particular reason to think the truckers are particularly racist.

LINKS

Banks are moving to freeze accounts linked to convoy protests | Here’s what you need to know by John Paul Tasker for CBC News.

Trudeau’s Money Heist: Emergencies Act Allows Seizure of Bank Accounts, Securities, Crypto of Those Suspected of “Links” to Convoy Members Without Court Order by Yves Smith for Naked Capitalism.

Squad member Ilhan Omar defends Ottawa cafe owner who donated to Canadian Freedom Convoy truckers by Ronny Reyes and James Gordon for The Daily Mail (London)

Why the Left Doesn’t Copy the Truck Protests by Ian Welsh.

What About the Canadian Truckers? by Rod Dreher for The American Conservative.

Thoughts on the Canadian Trucker “Freedom Convoys” by Lambert Strether for Naked Capitalism.

Reality Honks Back by N.S. Lyons for The Upheaval.

Waiting for Omicron: Links & comments

February 3, 2022

Covid Situation Continuing to Develop in Ways Not Necessarily to Officialdom’s Advantage by Yves Smith for Naked Capitalism.

The Big Name Journalists Who Are Trying to ‘Both Sides’ Covid by Melody Schreiber for The New Republic.

When We Are Done With Covid the Virus Will Not Be Done With Us by Bernhard for Moon of Alabama.

We’re being told that the Omicron variant of COVID-19 is “mild” and that it soon will die down.  Infections and deaths in fact do seem to be declining, and this had better be permanent because we in the USA and other rich white countries don’t have a good alternative if it is.

We’re told that the Omicron virus is more infectious than the other variants, but less likely to kill us or leave us in intensive care.  This is true, but the number of deaths is bad enough and intensive care units in the USA are full to overflowing.

We’re further learning that immunity from vaccines and also from infection is not necessarily permanent.  We’re also learning that “mild” Omicron can create long-term organ damage, including brain fog, and shorten our life-expectancies.

Our basic resources for now are vaccines and masks.  I’ve been vaccinated, and I wear a mask when I’m indoors with people I don’t know, but this might not be enough.

If this doesn’t prove to be enough, we are told to blame the unvaccinated.  They are supposedly to blame for the fact that our hospitals and emergency care systems have been pared down so that there is no extra capacity for emergencies.

American capitalism demands the infection of China by Andre Damon for the World Socialist Web site.

Click to enlarge

I understand that the USA and other Western countries are not set up to do what the Chinese government does.  We are not capable of completely shutting down a medium-sized city overnight, making sure that every single family in the city has food and water and testing everyone for the coronavirus.  We could not build a completely functioning hospital in less than two weeks.

You can make the argument that preserving our values of individualism and limited government are more important.

But by what right do Americans demand that the Chinese relax their Covid restrictions so that world commerce flows more smoothly?  Why should they sacrifice the lives of their people in order to make things more convenient for us?

Our government let Covid take hold rather than impose moderate restrictions before the need was obvious to all.  Hundreds of thousands of Americans died as a result.  That, too, impeded world commerce.

New Triumphs & Struggles for Non-Profit Covid Vaxes by Hilda Bastian for Absolutely Maybe.

A Potential COVID Game-Changer by Walter Bragman and Andrew Perez for The Daily Poster.

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Covid coming back

December 30, 2021

Daily U.S. Covid cases set new record as of Dec. 30, 2021.

One of the reasons Joe Biden defeated Donald Trump in the 2020 elections was because of Trump’s mishandling of the coronavirus pandemic.

Trump downplayed the seriousness of the pandemic and made it into a political issue.  He discouraged testing and gathering of data because it made him look bad.  

On the other hand, his administration deserves credit for Operation Warp Speed and the rapid development of effective vaccines.

Biden’s rhetoric is better, but his administration’s actions fall short of what is needed.  His administration’s leaders talk as if vaccination is a way to prevent the spread of the virus.  The vaccines now in use are not sterilizing.  You can catch the virus from a vaccinated person.

He talks as if vaccines are the answer to everything.  Being vaccinated will cut your risk of death or being hospitalized, but catching the virus can still do long-term damage to you.  The way to protect from infection is to make cheap Covid tests available to everyone.

His administration ignores the fact that we now know that Covid-19 is spread as an aerosol, like fog or cigarette smoke, and not in droplets.  So we should pay less attention to cleaning surfaces and more to proper ventilation.

Some of these failures are a result of the long-term hollowing out of public health and medical capacity.  Some originated with Anthony Fauci and the Centers for Disease Control rather than Trump or Biden personally.  

But they are the ones with the ultimate responsibility and power.  When the ship goes aground, the captain is responsible.  He can’t fix everything overnight, but he can begin.

Like Trump, Biden prioritizes getting back to normal.  Like him, he pushes responsibility onto state governments.  We the people need something better than leaders who take the path of political least resistance.

 LINKS

Don’t Be Too Cavalier About Omicron – Long Covid Is Still a Real Risk by Elizabeth Yuko for Rolling Stone.

Administration’s Obvious Covid Fail: Officially Abdicates as Case Count Hits Record; Scientists and Press Misrepresent Data to Put a Happy Face on Omicron by Yves Smith for Naked Capitalism.

The very bad day at the CDC by Eric Topol for Ground Truths.

Covid Cases Fill More New York City Hospital Beds, Threatening Halt on Elective Surgeries by Greg B. Smith for The City.

A Myth Is Born: How CDC, FDA and Media Wove a Web of Ivermectin Lies That Outlive the Truth by Linda Bonvie and Mary Beth Pfeiffer for Michael Capuzzo’s Rescue substack.

Covid vaccinations keep people alive

November 24, 2021

Vaccination for COVID-19 won’t necessarily prevent you from catching the virus.  It won’t necessarily stop you from infecting other people.  It won’t even guarantee you won’t be harmed by the virus.

And of course there are good reasons to be suspicious of the big drug companies

But the facts show that, unless you’re a special case, vaccinations will definitely reduce the odds of you dying from the disease.

LINKS

How do death rates from COVID-19 differ between people who are vaccinated and those who are not? by Eduard Mattieu and Max Roser for Our World in Data.  This is the most complete survey I could find, but I was unable to extract charts from their web site.  Below are some of the charts I did find.

Covid death rates in U.S. counties with high and low vaccination rates

As Covid Cases Rise All Over U.S., Lower Vaccination Rates Point to Worse Outcomes by Lauren Leatherby for the New York Times.

Covid vaccination and death rates in Europe in one devastating chart by Ryan Heath on Twitter.  This decodes the abbreviations for countries.

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Vaccine resistance is an identity movement

November 18, 2021

Chris Arnade is a former Wall Street bond trader who has spent the past 10 years of his life photographing and talking to poor and working-class Americans.

Click to enlarge.

His latest article is about why so many Americans over 50 refuse to get vaccinated, and why some regard not getting vaccinated as a badge of honor.

For one thing, he said, they don’t regard risk in the same way that college-educated, professional class people do. They aren’t the ones who work at home to be safe from the coronavirus. They are the ones who make package deliveries to the ones who work at home.

A number of the people to whom Arnade talked regard the pandemic as just one of life’s many risks, along with accidents, overdoses, firings, bankruptcies, felony gun charges, addictions and so on, which you deal with as they happen.

They don’t trust the government, they don’t trust the politicians, they don’t trust the drug companies and the health insurance companies, all with good reason.  By and large, they thinking voting is a waste of time.  And they very much resent being talked down to by out-of-touch elites.

Being unvaccinated is… …a badge of honor, a club membership card, among people who have never trusted authority, and see being unvaccinated as a way to take control of the situation.

A way to stick it to the upright scolds who have been telling me what to do all the time and are always fucking things up.  [snip]

That people have decided to turn not being vaccinated, a damn reckless position for someone over 50 to have, into an identity, shows how desperate people are to join a club.

To find a place that accepts them.  Come on in.  Join us.  The losers everybody hates.  The dumb, the dropouts.  The people with bad taste.  The people who make bad decisions.  Own your loser-dom.  Make one more stupid decision.  Come on!

No doubt these are very sweeping generalizations, and no doubt have many exceptions.  Anti-vaxxers include people in different walks of life.  But Arnade is not making things up.  His writing is based on his reporting.

He said the only way to reach the people he’s writing about is to find key people in communities, and talk them at the bowling alley or church or bar, and talk to them individually.

Sit them down, talk them through it, without scolding, without scorn, without talking down.  Refute the rumors, one by one.  No, Miss Betsy’s stroke had nothing to do with the vaccine, and her sister didn’t have a stroke.

But he said there’s a core group that is unreachable.  His guess is that it is 15 to 30 percent of the population.  Opposition to vaccination is the hill that they have chosen, so to speak, to die on.

The vaccine resistance movement is not limited to the USA.  Protests are worldwide, and probably reflect the same attitudes.

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One man’s experience with monopoly drug prices

November 16, 2021

Will Astor, a semi-retired journalist in Rochester, N.Y., the city where I live, depends on drugs to keep his prostate cancer in check.  Recently his physician put him on a new drug, abiraterone, a generic form of Johnson & Johnson’s brand-name Zytiga.

His monthly co-pay: $1,700 a month.  The total cost of the drug: $11,000 a month.  How much would Zytiga have cost? J&J wouldn’t say.

I was under the impression that generic drugs, which can be sold when the brand-name drugs are no longer under patent protection, were cheaper than the brand-name drugs.  But Astor’s research indicated that this is only true when two or more companies make the drug.  When only one company makes a generic drug, it is only slightly less than the brand-name version.

Some countries set drug prices, based on the cost of manufacturing plus a reasonable mark-up.  The Biden administration’s Build Back Better bill passed by the House of Representatives includes a provision allowing the federal government to negotiate drug prices for Medicare patients, which is now forbidden.  Republicans in the Senate oppose that provision of the bill, and it may not pass.

A pharmacist at the University of Rochester Medical Center found Astor a charity, called the Assistance Fund, that gave him a one-year grant to cover virtually all of his co-pay.  That’s fortunate for him, although he has no guarantee the grant will be renewed, but of course this isn’t available to most people.

Astor wrote a well-researched article about the high price of generic drugs in the Rochester Beacon, a local on-line publication. It’s well worth a look.

LINK

Life-Threatening Costs by Will Astor for the Rochester Beacon.

Truth and doubt in a time of pandemic

November 4, 2021

In the pandemic, I find it hard to decide who I can trust about questions such as vaccine effectiveness, lockdown effectiveness, ivermectin effectiveness and so on.

Authorities such as the Centers for Disease Control and World Health Organization haven’t always told the truth, or at least not the whole truth.  But this doesn’t mean the critics of the CDC and WHO are necessarily reliable.   When doctors disagree, how can I, a layman, decide?

That’s why I’m impressed with this interview of Eric Osgood, a physician, by David Fuller, a co-founder of a podcast called Rebel Wisdom, even though I don’t usually spend time watching long videos on computer screens.

Fuller is more interested in getting the facts right, and Ogood more interested in what is best for his patients, than about defending one side or another.

Osgood recommends vaccination to most of his patients, but also prescribes ivermectin.  He gets flak from the right-wing anti-vax fanatics, who tell him he is a tool of the establishment, and the left-wing anti-ivermectin zealots, who say he is helping the anti-vaxxers.  

 He used to be a member of the Frontline Covid-19 Critical Care Alliance, which is the chief promoter of ivermectin, but now has reservations about Dr. Pierre Kory’s recommendation to double the dose against the Delta variant, which he doesn’t think has any empirical basis.

I think Dr. Kory has followed a common path by those who question an ideological orthodoxy. A dissenter is cast out by those he had been accustomed to thinking of as his friends.  His dissent is welcomed by those of the opposing ideological orthodoxy.  Gradually, the opposing orthodoxy comes to seem more and more reasonable.

One interesting fact that I hadn’t known is that Dr. Kory himself and his daughter caught Covid-19.  Dr. Kory is not explicitly anti-vaccination, but he didn’t get vaccinated himself. 

His infection was a mild case, so maybe ivermectin did some good.  Dr. Osgood’s view is that ivermectin is harmless, cheap and of some benefit, and just possibly the wonder drug that Dr. Kory thinks it might be, so there is no reason not to use.

For what it’s worth, that’s what I now think, too.  I was much more of an ivermectin enthusiast when I first heard about it than I am now.  I still oppose the campaign to prevent it being prescribed or discussed.

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China, journalism, strikes: Links 10/15/2021

October 15, 2021

The Triumph and Terror of Wang Huning by N.S. Lyons for Palladium.   The clash of civilizations.

Intersectional Imperialism and the Woke Cold War: The New Faith Prepares for a Global Crusade by N.S. Lyons for The Upheaval.

‘Frozen Chosin’ Korean War Movie Set to Be Biggest Hit of 2021 by James Barber for Military.com.  In the movie, the Chinese are the good guys.

Out of the Newsroom by Spencer Ackerman for Forever Wars.  Newspapers whose reporters and editors all work from home.

“Government Without Newspapers”: the manufacture of ignorance by Patrick Lawrence for The Scrum.

A strike wave is coming to save America’s working class the old-fashioned way by Will Bunch for The Philadelphia Inquirer.

The Great Strike of 2021 by Jack Rasmus.  They also strike who simply refuse to take dangerous jobs for less than a living wage.

Why Record Numbers of Workers Are Quitting and Striking by Sonali Kolhatkar via Naked Capitalism. [Added 10/16/2021]

The Untraversed Land by John Michael Greer for Ecosophia.   How the structure of the world economy causes shortages.

The Afghan War Comes Home to Minneapolis by Thomas Neuburger for God’s Spies.

The Unvaccinated May Not Be Who You Think by Zeynep Tufeckci for The New York Times.

How many people get long Covid?  More than half of those infected, researchers say by Pennsylvania State University.

The economic consequences of the pandemic

October 14, 2021

SHUTDOWN: How Covid Shook the World’s Economy by Adam Tooze (2021)

Adam Tooze is possibly the world’s foremost economic historian.  He wrote thick, comprehensive books on the Nazi economy (Wages of Destruction), the war debts crisis of the 1920s (The Deluge) and the 2008 financial crisis (Crashed!).  

His strengths are his international perspective (he is a British subject, educated in Germany who now teaches at Columbia University) and his deep understanding of high finance and how it affects society, politics and the overall economy.

Shutdown is not like his other books. It’s slim, and it is being published while the pandemic is still going on, not from the perspective of history.  This is because he thinks his message is too urgent to wait.

What is his message?

It is that we the public are on the brink of a new era, an era when our worst crises will not be the result of tyranny, corruption and human folly, but blowbacks from our natural environment.

And we are woefully unprepared for this. The coronavirus pandemic had taken 3.2 million lives, including half a million American dead, as of April, when Tooze completed his book.  The number is up to 4.5 million now.

The pandemic resulted in tens of trillions of dollars in economic loss. Yet only tens of billions has been spent on vaccine development, and much less than that on getting the vaccine to the public.

COVID-19 was not a black swan, a completely unpredictable event. It was a grey rhino, an event that many predicted, but were ignored. The climate crisis has bred other grey rhinos—devastating fires, floods, droughts and superstorms.

Tooze wrote that the reason we are unprepared is that the neoliberal policies of the past 50 years have stripped the governments of the USA, UK and much of the Western world of the capacity to respond to emergencies.

The neoliberal philosophy is that, in order to maximize efficiency, institutions should spend no more than they absolutely need in order to function. This means that there is no reserve capacity in case of emergencies, and hospital emergency rooms in the USA are overflowing with Covid patients.

What’s needed, he wrote, is something like the Green New Deal supported by Bernie Sanders, Alexandria Ocasio-Cortez and others.  Governments must spend whatever is necessary to be prepared for the predictable crises that lie ahead, and do it in a way that creates full employment and puts money in the pockets of working people.

The International Monetary Fund has estimated that a successful global vaccination program would add $7 trillion annually to the world economy by 2014.  Tooze said others estimate that such a vaccination program would cost $50 billion to $100 billion. Yet governments of rich countries, which have spent trillions of dollars on economic stimulus programs, say this is unaffordable.

Tooze quoted the great economist John Maynard Keynes: “Anything we can actually do, we can afford.”  

That is, if the human and physical resources to accomplish a goal exist, and the political will to accomplish the goal exists, the problem of finance can be solved.  People generally understand this in wartime.  Why not in peacetime?

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Matt Taibbi on the cult of the vaccine neurotic

October 8, 2021

I’ve been vaccinated for Covid, I think vaccination is a good idea for most people, but I think it very strange that the Biden administration, the mainstream press and the public health establishment say you shouldn’t consider treatments for the disease.

Why not explore anything and everything that might work?  Why limit yourself to just one thing?

The idea is that the general public is so stupid that if they think there is anything other than vaccination that is helpful in fighting the disease, they won’t get vaccinated.  The problem with this is that if you blatantly treat people as if they are stupid, they will stop listening to you.  Matt Taibbi had a good article about this on his Substack blog.

LINK

The Cult of the Vaccine Neurotic by Matt Taibbi for TK News.

To stop the spread, require tests, not jabs

October 1, 2021

School children in Austria are tested for Covid

I think most people would benefit from being vaccinated against the coronavirus, because you’ll be much less likely to wind up in the hospital or morgue if you catch it.

But this will do little to stop the spread of the virus because you can catch it from a vaccinated person just as you can from an unvaccinated person.

If I was the parent of a small schoolchild, I wouldn’t care if the school staff was vaccinated.

What I’d want is for everyone who goes through the door of the school to have a temperature check, and for everyone who registered a fever to get a Covid test, and for everyone who tested positive for Covid to stay home for a week.

Ideally, people infected with the coronavirus should go into quarantine, but we in the USA don’t have the capability for that.

I’d apply the same policies to high schools and colleges, and to hospitals (except, of course, I wouldn’t send the patients home).

I think vaccine skeptics underrate the harm done by the coronavirus. It’s true the virus kills a relatively small percentage of those infected, but that small percentage adds up to hundreds of thousands (in the USA) and millions (worldwide).

And this is not something where that which does not kill you does not make you stronger. I had a friend who was vaccinated, but nevertheless suffered what I am convinced was a “breakthrough” infection. She was in such severe pain, along with chills and fever, for a couple of days, that she was not able to function.

I know of a family—husband, wife, three children—who got it. The husband went to the hospital. The wife somehow was able to function at home. They’re all well now, but they don’t know what long-term organ damage the virus may have caused.

But I admit that we also don’t know the long-term effects of the vaccines, especially with pregnant women and small children. If I was the husband of a pregnant woman or the father of small children, I’m not sure what I would advise.

Just as some of us are at greater risk for the virus, so others of us are at greater risk for the vaccines.

I do think that if businesses and other institutions require vaccinations, they should give the employee a day off with pay to get the vaccination, and also days off with pay to recover from side effects.

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The reasonable case for considering ivermectin

September 26, 2021

Some physicians think invermectin is useful as a treatment for Covid; others don’t.  I don’t have the medical or scientific knowledge to judge who is right.  

My view of invermectin is a form of Pascal’s Wager.  It is cheap and, if used as prescribed by a physician, it is safe.   If vaccines have failed or are not available, a person infected with Covid has everything to gain and nothing to lose by trying it.

I am vaccinated.  I think everybody who has access to vaccines should get vaccinated, unless they already have had Covid or have a good medical reason not to.  

But the vaccines now in use do not prevent infection or the spread of the disease.  You can catch Covid from a vaccinated person.  

Vaccines may not prevent breakthrough Covid.  A friend of mine who was vaccinated spent a weekend suffering intense pain, fever and chills, which I think was probably breakthrough Covid.

This doesn’t mean the current vaccines are useless.  They rally the body’s immune system to fight the virus.

What it does show, in my opinion, is the need for a treatment, or a sterilizing vaccine, that will actually kill the virus.

If ivermectin is such a treatment, this would be great for everyone. 

The small-scale clinical trials showing the benefits of ivermectin have sometimes been flawed.  All or almost all have been too limited to bring about conclusive results.  

That is why there should be large-scale clinical trials to settle the question one way or other other.  If ivermectin is not what it’s cracked up to be, then there should be an intense program, equivalent to Operation Warp Speed, to develop one.

It is established medical practice in the USA and other countries to allow government-approved drugs to be used for treatments of diseases other than the ones they’ve been approved for.  

I don’t believe in self-medication for serious conditions, but I believe physicians should be able to use their own judgment about legal treatments.

I  also believe physicians and scientists should be able to post discuss medical treatments on the Internet without being censored.

If I were dying of Covid, I wouldn’t want to be put on a ventilator, I would want my physician to try ivermectin.  If I were the president of an African country that couldn’t get vaccines because majority-white countries such as the USA and Canada want to give their citizens third doses, I would certainly  distribute ivermectin.

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Vaccines and COVID-19 death rates

September 22, 2021

Click to enlarge

Hat tip to David Zweig.

I’ll be 85 years old in December.  This chart from England makes me very, very glad that I was able to get vaccinated.  

I wasn’t able to find the original link to the chart, but the links below have the basic information.

LINKS

COVID-19 confirmed deaths in England (to 31 January 2021) by Public Health England.

Risk for COVID-19 Infection, Hospitalization and Death by Age Group in the USA by the Centers for Disease Control and Prevention.

COVID-19 and the war on populism

September 13, 2021

Hat tip to Bill Harvey.

Thomas Frank had a good interview last week on the Breaking Points TV show.  It’s worth watching.

He talked about how failure to control the spread of the COVID-19 virus, instead of being blamed on the failed health care system, is instead blamed on people who are skeptical of established authority.

The problem is that there are good reasons to be skeptical of authority.  It was Anthony Fauci, who is nowadays considered to the voice of science, who in the early days of the pandemic said that it was not to be taken seriously, it was just like the ‘flu, and that masks were useless.

It was the Centers for DIsease Control that, in the early days, advised the U.S. government not to screen air travelers coming in from China. 

Established authority nowadays tells us that vaccination will prevent the spread of the disease, when, so far as is known, it merely suppresses the symptoms and does little or nothing to stop the spread.

Nobody is being called to account for this.  The bulk of the press, the political establishment and the medical establishment say that everything that has gone wrong, and everything that is predictably going to go wrong, is the fault of right-wingers who refuse to get vaccinated.

There are all kinds of reasons why people don’t get vaccinated.  There are medical reasons.  There are economic reasons.  There are religious reasons.

And of course there are conspiracy theorists who think the pandemic is a Democratic hoax.  I don’t share their views, of course, but conspiracy theories flourish in times like these, when established authority can’t be trusted.

Whatever the reasons people have for not getting vaccinated, ridicule and scapegoating are not good methods for bringing them around.  They are, however, good tactics for diverting blame for failure from the people in charge.

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The plan is for all Americans to get COVID

September 10, 2021

The Biden administration’s plan for fighting COVID-19 is for all Americans to get vaccinated. But that won’t stop the spread of the disease.  Being vaccinated just means you’re less likely to die or need hospital care if you get it.

But there is nothing in place to stamp out the disease and very little to stop the spread of the disease.  This means that all of us Americans are bound to get it, sooner or later.

I’m in favor of vaccination.  I’ve received two shots myself.  I would like as many people as possible to get vaccinated.   Mandatory vaccinations are nothing new.  Schools and other institutions have every right to require masking and vaccinations.

The thing of it is—the vaccines now available are not sterilizing vaccines, at least not as far we know.  They do not kill the virus, just rally the body’s defenses to resist it.  Other things being equal, a vaccinated person is just as potentially infectious as an unvaccinated person.

The way to stop the spread of the virus would be to require everyone entering an indoor public space to be tested, whether vaccinated or not.  As in China, there would be a temperature check, and everybody running a temperature would get a test.

Those infected would be isolated and treated until the infection goes away.  Do this long enough and the virus dies out.

Why isn’t this being done?  Probably because the U.S. pubic health system and medical care system don’t have the capacity to carry it out.

Of course, there are other ways to slow the spread.  Indoor ventilation would be a big help.  Indoor masking also would be a big help. 

But the disease won’t be stopped until there are treatments that kill the virus, as penicillin kills bacterial infections.  There is no national effort to develop one.

The Biden administration is content to push vaccination alone, vaccination and nothing else, and it blames people who don’t get vaccinated for the spread of the disease

The unvaccinated are conflated with deplorables who believe in crazy conspiracy theories, and both groups are conflated with Trump voters.  They will be the scapegoats for the comeback of COVID-19 this winter.

I’ve even heard people say that the unvaccinated do not deserve to be treated for the coronavius. 

Would such people say that cigarette smokers do not deserve medical care lung cancer? that sexually active gay men do not deserve medical care for AIDS? that people who’ve attempted suicide, and failed, deserve no medical care at all?

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Pushback against the war on ivermectin

September 8, 2021

The American Medical Association has joined the campaign to discourage people from using invermectin as a treatment for COVID-19.  But not all physicians are willing to accept the AMA’s judgment.

The following is a letter from Jane M. Orient, M.D., executive director of Association of American Physicians and Surgeons, to Gerald E. Harmon, M.D., president of the American Medical Association.

The AMA has taken the startling and unprecedented position that American physicians should immediately stop prescribing, and pharmacists should stop honoring their prescriptions for ivermectin for COVID-19 patients.  The AMA is thus contradicting the professional judgment of a very large number of physicians, who are writing about 88,000 prescriptions per week.  It also contradicts the Chairman of the Tokyo Medical Association, Haruo Ozaki, who recommended that all doctors in Japan immediately begin using Ivermectin to treat COVID.

AMA claims that ivermectin is dangerous and ineffective despite the safe prescription of billions of doses since 1981, and the mostly favorable results of 63 controlled studies in COVID-19.

AMA does not specify any recommended early treatments, but simply urges face masks, distancing, and vaccination.

Our members would appreciate clarification of the AMA’s stand on the following questions:

  • What are the criteria for advocating that pharmacists override the judgment of fully qualified physicians who are responsible for individual patients?
  • What are the criteria for forbidding off-label use of long-approved drugs, which constitute at least 20 percent of all prescriptions?
  • On what basis does AMA demand use only within a clinical trial for ivermectin, but call for virtually universal vaccination outside of controlled trials, despite FDA warnings of potential cardiac damage in healthy young patients, and no information about long-term effects?

We believe that these questions get to the heart of issues of physician and patient autonomy, as well as scientific principles such as the need for a control group in experiments.

We look forward to your response.

Ivermectin is a drug originally developed as a cure for parasitic disease, and has come to be used as an off-label treatment for bacterial and virus diseases.  Many reputable physicians prescribe it for COVID-19—not as a substitute for vaccination, but as a supplement for vaccines or as an alternative when vaccines are not available or not medically recommended.

Vaccines do not cure COVID-19.  They protect infected people against the worst symptoms of the disease.  We need for a treatment or a “sterilizing vaccine” that will kill the disease.

Everything I know about ivermectin leads to me think that it might be such a treatment, but I’m not a physician or an epidemiologist and I could be wrong.  If not there should be a search for a treatment—a search as intense as last year’s search for a vaccine.

The chief disadvantage of ivermectin from the standpoint of the pharmaceutical industry is that it is cheap, safe and not patented, which means that it is relatively unprofitable.  Using Occam’s Razor, this is the simplest explanation for the industry’s behavior.

LINKS

AAPS Letter to AMA Re: Ivermectin and COVID.

As US Prepares to Ban Ivermectin for Covid-19, More Countries in Asia Begin Using It by Nick Corbishley for Naked Capitalism.

US as Failed State: Covid Booster Shot Mess by Yves Smith for Naked Capitalism.

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Public schools can be petri dishes for coronavirus

August 25, 2021

Back during the George W. Bush administration, Carter Mecher was head of a White House task force charged with making a plan to prevent pandemics.  He was contacted by Robert Glass, a scientist at Sandia National Laboratories, who’d been running computer simulations of pandemics.

Glass’s models indicated that kindergartens and schools were potential petri dishes for the spread of contagious disease.  I don’t think this would have been surprising to most parents and teachers.

At that time, there were more than 100,000 K-12 schools in the U.S., with 50 million children in them.  There were 500,000 school buses in operation, compared to 70,000 in the regular U.S. transportation system.  On an average day, school buses carried twice as many passengers as the entire public transportation system.

Michael Lewis, author of The Premonition, told what happened next.  Becher decided to visit schools. He found school classrooms were more crowded than any other public space.  Chlldren sat, on average, three and a half feet apart; they could touch each other.

In hallways and at bus stops, young children crowded together.  They lacked the adult idea of personal space.  School bus seats were on average 40 inches wide, just wide enough for three children close packed together.

School bus aisles were narrower than aisles of regular buses. Paramedics used special stretchers for school buses because regular stretchers wouldn’t fit.

Becher made videos of homes where the ratio of children to floor space was the same as in public schools.  They looked like refugee prisons, Lewis wrote.

Glass had concluded that closing schools and reducing contacts among children were the key to controlling pandemics.

That doesn’t necessarily apply to the present situation, because teachers and children over 12 can get vaccinated.  Many schools try to practice social distancing, although this doesn’t protect from an airborne virus in an enclosed space.  Glass’s model assumed no vaccines and no treatments.

But vaccines don’t eliminate the danger.  They suppress the symptoms of the disease, but they don’t necessarily kill the virus.  Vaccinated people can still be spreaders of the disease.  And vaccines may not be 100 percent effective.

I don’t know what I’d do if I were a parent, except listen to the teachers rather than the politicians or the CDC.

Children in families with a lot of books in the home, who watch educational programs on TV and talk about current events and books around the supper table—the education of these children would not suffer all that much from school lockdowns.

But children in families without books in the home, children with parents who work multiple jobs and don’t have time for suppertime conversations, children who depend on school lunches for their main nourishing meal of the day—these children would be hurt a lot by long-term school closing.

Wearing masks can help some.  Good ventilation can help a lot.  Vaccine mandates for teachers and staff might help, but regular tests for the virus would help more.

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Ivermectin study retracted

July 23, 2021
A report of a clinical study on the benefits of ivermectin as an anti-Covid treatment has been withdrawn.
 
The resport reportedly gave results that were mathematically impossible and differed from the raw data.
 
The retraction does not, in itself, discredit ivermectin as a possible treatment.  There are other studies that support the benefits of invermectin. 
 
But the fact that the Frontline Covid-19 Critical Care Alliance (FLCCC) and the British Invermectin Recommendation Development (BIRD) Group cited it is not a good look.
 
My own opinion remains the same.  I believe the sale of drugs should be regulated.  I don’t think somebody should be able to sell Dr. Quack’s Covid Cure over-the-counter.  But prescribing approved drugs for non-approved purposes is a legal and common practice.
 
Ivermectin is a drug that has long been approved for treatment of parasitic disease and seems to hold promise for treatment of virus disease.  It has been proven safe, and is cheap because no longer protected by patents. 
 
There is no reason physicians should not prescribe ivermectin if in their judgment there is a benefit, especially when vaccines are not available or have failed.  Studies of invermectin should continue, and discussion of ivermectin should not be suppressed.
 
LINKS
 
Why Was a Major Study on Invermectin for COVID-19 Just Retracted? by Jack Lawrence for GRFTR.
 
Huge study supporting ivermectin as Covid treatment withdraw over ethical concerns by Melissa Davey for The Guardian.
 
Joint Statement of the FLCCC Alliance and British Ivermectin Research Development Group on Retraction of Early Research on Invermectin.
 
Ivermectin: Much More Than You Wanted to Know by Scott Alexander Suskind for Astral Codex Ten.  [Added 11/17/2021]

A vaccination-only anti-virus strategy

July 22, 2021

It seems as if the Biden administration intends to rely on vaccines alone to fight the COVID-19 virus.

The official advice is that once you get vaccinated, it’s safe to do anything you want, including spending time unmasked in poorly-ventilated indoor spaces.

That’s wrong.  Even if you’re vaccinated, you can be infected and you can infect others.  Masking, ventilation and other safety measures are still needed.

It’s true that availability of vaccines has dramatically reduced the death rate from COVID.  The chart above, showing waves of COVID infection before and after vaccines were available, indicates this.

Vaccination, however, does not confer 100 percent immunity.  The vaccines stimulate the immune system, so that, if you are infected, you are unlikely to experience symptoms of the disease and even less likely to be hospitalized. 

But they often fail to kill the virus.  You can be vaccinated and symptom-free and still be a spreader of the disease.

I’m in favor of vaccination. I got two shots of the Moderna vaccine as soon as I could, one in March and one in April.  I don’t take that as guaranteeing perfect safety.

It’s going to be a while before I eat a restaurant  meal indoors or watch a movie in a theater.  I may never take an airplane trip again.  I intend to wear a mask any time I am indoors with people I don’t know.

That’s not because I like masks.  I get short of breath when I wear one for a long time.  Everybody looks like they’re either terrorists, robbers or assisting in surgery.  But I can put up with this minor annoyance in order to reduce my own risk and the risk I create for others.

I understand that not everybody is willing to live as I do, or in a position to do so.  I am 84 years old, retired, unmarried, an introvert and a recluse. 

I don’t have to venture out into the world to earn my daily bread, and my temperament makes it easier for me than for most people to do without hugs and kisses.

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Lab leak or animal transmission?

July 22, 2021

It’s very possible that SARS-CoV-2 originated in an animal and was transmitted to a human being, because that’s how so many virus diseases originated.

But we don’t as yet have any example of an animal in the wild carrying the disease, let alone a specific person getting the disease from an animal.

It’s possible that the virus spread as the result of a laboratory accident, because lab accidents have been known to happen.

But we don’t have any proof that a laboratory accident actually occurred, let alone a specific person being infected.

It’s argued that it is more than coincidence that the virus was first discovered in Wuhan, China, a center for research in coronaviruses. I agree.

A center for the study of a virus in the lab would be a place where people would be most alert to detect the virus. But that’s not proof that the virus originated there. Diseases frequently are first discovered in places distant from where they originate.

It’s argued that the virus must be an artificial creation because it is so tailored to exploit human weaknesses. I don’t have the knowledge to make a scientific judgement one way or the other.

But it seems to me that this argument underestimates the malignant ingenuity of Mother Nature, operating through Darwinian random variation and natural selection.

None of this disproves the lab leak hypothesis, of course.

The lab leak hypothesis is more comforting than the animal transmission hypothesis because it is easier to fix human error that it is to cope with the forces of nature.

China haters tend to like the lab leak hypothesis. Trump haters tend to dislike it.

As for myself, I don’t have an opinion either way.

Why the U.S. failed to avert the pandemic (2)

July 21, 2021

Like Michael Lewis’s The Premonition, Andy Slavitt’s Preventable is a story of how people in authority disregarded warnings and allowed the COVID-19 virus to gain a foothold in the United States.

But while Lewis described the efforts of a number of far-sighted prophets, Slavitt concentrates on just one—himself.

Slavitt is an interesting figure—a political operator and member of the professional-managerial class, who influences policy, moves back and forth between government and the private sector, but would be unknown to the public except for this book.

He was an investment banker with Goldman Sachs, a consultant for McKinsey & Co., and founder of a company called HealthAllies, and then worked for United Health Group after it acquired HealthAllies. 

He served the Obama administration as head of the Center for Medicare and Medicaid Services from 2014, and was a medical adviser to the Biden administration during its first few months.

His power comes from being embedded in a network of politicians, corporate CEOs, wealthy philanthropists and academics, who all answer his phone calls and listen to what he has to say.

Preventable is about how he tried to alert the public to the danger, while also trying, from behind the scenes, to influence the Trump administration to take action before it was too late.

His book is a good overview of the Trump administration’s pandemic response and of the inadequacies of the American medical care system generally.

Much of the criticism of Trump is based on a knee-jerk response to his vulgar and offensive comments on Twitter and elsewhere, which don’t matter, and on a gullible acceptance of charges of collusion with Russian and Ukrainian leaders, which were either bogus or trivial.

Slavitt did a good job of showing the real problem with Trump, which was his inadequacy as an administrator and leader.  Trump refused to face unpleasant facts.  He thought of policy only in terms of public relations, not in terms of consequences, and he failed to think ahead even about public relations.

He calculated that closings are unpopular and openings are popular, so he shifted responsibilities for closings onto governors of states while positioning himself as the champion of openings.

As damning as Slavitt’s portrait of Trump is, it will not change the minds of Trump’s admirers because of Slavitt’s obvious bias and partisanship. 

The only named persons he holds accountable for the COVID-19 pandemic are Trump supporters, members of Trump’s administration and Donald Trump himself.  Democrats get a free pass.

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How the virus took hold in the U.S.

July 21, 2021

The following timeline is from Andy Slavitt’s Preventable.  It shows when there was a window of opportunity to prevent the COVID-19 virus from establishing itself in the United States, and when that window closed.

Nov. 17, 2019.  First COVID-19 case in Wuhan, China.

U.S. total cases: 0.

U.S. total deaths: 0.

U.S. daily cases: 0.

Jan. 20, 2020.  First COVID-19 case in the United States

U.S. total cases: 1

U.S. total deaths: 0.

U.S. daily cases: 1.

Jan. 29, 2020.  White House task force created.

U.S. total cases: 6.

U.S. total deaths: 0.

U.S. daily cases:  1.

Jan. 31, 2020.  First COVID-19 case in Italy.

U.S. total cases:  9.

U.S. total deaths:  0.

U.S. daily cases:  1.

Feb. 26, 2020.  First COVID-19 death in the United States

U.S. total cases: 16.

U.S. total deaths: 1.

U.S. daily cases: 1.

March 3, 2020.  100th U.S. case.

U.S. total cases: 100.

U.S. total deaths: 14.

U.S. daily cases: 50.

March 9, 2020.  1,000th U.S. case.

U.S. total cases: 1,000.

U.S. total deaths: 35.

U.S. daily cases: 292.

March 17, 2020.  10,000th U.S. case

U.S. total cases:  10,000.

U.S. total deaths: 123.

U.S. daily cases: 2,570.

March 20, 2020.  100th COVID-19 death in South Korea.

U.S. total cases:  24,100.

U.S. total deaths: 273.

U.S. daily cases: 6,090.