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Archive for April 10th, 2020

When you drown the government in the bathtub, people die

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Dana Milbank writes in the Washington Post:

I had been expecting this for 21 years.

“It’s not a matter of ‘if,’ but ‘when,’” the legendary epidemiologist D.A. Henderson told me in 1999 when we discussed the likelihood of a biological event causing mass destruction.

In 2001, I wrote about experts urging a “medical Manhattan Project” for new vaccines, antibiotics and antivirals.

Reporting on a congressional briefing in 2005, I quoted public health experts predicting a pandemic that would overwhelm hospitals and exhaust respirator supplies. “I want to emphasize the certainty that a pandemic will occur,” the Mayo Clinic’s Gregory Poland said.

Full coverage of the coronavirus pandemic

In 2009, during the swine flu scare, I relayed warnings about “the nation’s patchwork of a public health system” and the need for better “vaccine and public-health infrastructure before a more severe pandemic comes along.”

I repeat these things not to pretend I was prescient but to show that the nation’s top scientists and public health experts were shouting these warnings from the rooftops — deafeningly, unanimously and consistently. In the years after the 2001 terrorist attacks, the Bush and Obama administrations seemed to be listening.

But then came the tea party, the anti-government conservatism that infected the Republican Party in 2010 and triumphed with President Trump’s election. Perhaps the best articulation of its ideology came from the anti-tax activist Grover Norquist, who once said: “I don’t want to abolish government. I simply want to reduce it to the size where I can drag it into the bathroom and drown it in the bathtub.”

They got their wish. What you see today is your government, drowning — a government that couldn’t produce a rudimentary test for coronavirus, that couldn’t contain the pandemic as other countries have done, that couldn’t produce enough ventilators for the sick or even enough face masks and gowns for health-care workers.

Now it is time to drown this disastrous philosophy in the bathtub — and with it the poisonous attitude that the government is a harmful “beast” that must be “starved.” It is not an exaggeration to say that this ideology caused the current debacle with a deliberate strategy to sabotage government.

Overall, entitlement programs continued to grow, and the Pentagon’s many friends protected its budget. And Trump has abandoned responsible budgeting. But in one area, the tea party types, with their sequesters, debt-limit standoffs and other austerity schemes, did all too well. Between 2011 and 2018, nondefense discretionary spending fell by 12 percent — and, with it, the government’s already iffy ability to prevent and ameliorate public health emergencies unraveled.

John Auerbach, president of Trust for America’s Health, described for me the fallout: Over a dozen years, the Public Health Emergency Preparedness grants to state and local public health departments were cut by a third and the Hospital Preparedness Program cut in half, 60,000 jobs were lost at state and local public health departments, and similarly severe cuts were made to laboratories. A $15 billion grant program under the 2010 Affordable Care Act, the Prevention and Public Health Fund, was plundered for other purposes.

Now Americans are paying for this with their lives — and their livelihoods.

If the United States had more public health capacity, it “absolutely” would have been on par with Singapore, South Korea and Taiwan, which have far fewer cases, Auerbach said. South Korea has had  . . .

Continue reading.

Later in the column:

After Sen. Arlen Specter (R-Pa.) voted for the 2009 stimulus bill because he secured $10 billion for the National Institutes of Health, he was essentially forced out of the GOP. Rising in the party were people such as Rep. Jim Jordan (Ohio), whose far-right Republican Study Committee in 2011 proposed a plan, applauded by GOP leadership, to cut NIH funding by 40 percent.

In 2014, NIH chief Francis Collins said there likely would have been a vaccine for the Ebola outbreak if not for a 10 percent cut in NIH funding between 2010 and 2014 that included halving Ebola vaccine research. Republicans jeered.

In 2016, when President Barack Obama requested $1.9 billion to fight the Zika virus, Republicans in Congress sat on the request for seven months and then cut it nearly in half.

Since then, Trump has proposed cuts to the NIH and the Centers for Disease Control and Prevention so severe even congressional Republicans rejected them.

Written by Leisureguy

10 April 2020 at 8:47 pm

Wonderful food videos

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Watch these. Turn on subtitles for explanations. Here’s a sample:

Written by Leisureguy

10 April 2020 at 5:23 pm

Posted in Food, Video

He was the most revered philosopher of his era. So why did GE Moore disappear from history?

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Ray Monk writes in Prospect:

I almost worship him as if he were a god. I have never felt such an extravagant admiration for anybody.” So the 22-year-old Bertrand Russell wrote to his fiancée Alys Pearsall Smith in November 1894. The object of his “extravagant admiration” was George Edward Moore (always known as “GE Moore” because he hated both his given names), who was 18 months younger than Russell and at that time just an undergraduate.  

Russell was reporting to Alys on a meeting of the Apostles, the self-selecting and self-consciously elite discussion group (founded in 1820, and still in existence today) which only the students and fellows considered to be the brightest and best were invited to join. At their meetings, a member presented a case in a short paper—usually on a philosophical, cultural or political subject, designed to display both erudition and wit—which was then put to the vote. Russell had been enlisted in his second year at Cambridge, and Moore, likewise, two years later. 

To be revered within the Apostles was to be a superstar of the British intellectual elite. In the 1890s it was a society with an exceptional reach into the worlds of culture and politics, as well as ideas. At the time of Russell’s letter to Alys, active members of the society included the philosophers James Ward and JME McTaggart, the political scientist Goldsworthy Lowes Dickinson, the polymath Edward Marsh and the art critic Roger Fry. 

It wasn’t only in Cambridge quadrangles but soon also the squares of London in which Moore’s star shone. There was plenty of cross-over between the two sets. Several of the Bloomsbury luminaries were elected to the Apostles: John Maynard Keynes, Lytton Strachey, Saxon Sydney-Turner, Desmond MacCarthy, Leonard Woolf and EM Forster. Bloomsbury would develop a veneration of Moore as great as, if not greater than, that expressed by Russell. Beatrice Webb told Leonard Woolf that, although she had known most of the distinguished men of her time, she had never met a great man. “I suppose you don’t know GE Moore,” Woolf replied. In his autobiography, he reflected that Moore was “the only great man whom I have ever met or known in the world of ordinary, real life.”  

Today, this veneration seems a little hard to understand. It is still customary (just about) to lump Moore in with Russell and Wittgenstein, as a trio exemplifying the analytic tradition of philosophy that flourished in England during the 20th century, but the reputations of Russell and Wittgenstein today are far greater. To give one small indicator, nobody has ever suggested to me that I follow my biographies of Russell and Wittgenstein with one of Moore.  

So who was GE Moore and why is there such a gap between his reputation now and his reputation in the first decades of the 20th century? And what does his fall from such exalted heights tell us about the sorts of intellects that do—and do not—shine brightly for posterity? 

 ***

George Edward Moore was born and brought up in the south London suburb of Upper Norwood, within walking distance of his school, Dulwich College, which he and his three brothers attended as day boys. . .

Continue reading.

Written by Leisureguy

10 April 2020 at 4:45 pm

Posted in Books, Daily life, Education

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Why do human beings keep getting diseases from bats?

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Trevor Klee has an interesting post at the 21st Night blog:

Humans get a surprising number of very infectious diseases from bats. We get SARS (including the recent COVID-19/SARS-CoV2), Ebola, rabies, and possibly mumps. These are all incredibly infectious, deadly diseases.

This seems weird because human beings aren’t in particularly close contact with bats. They’re nocturnal, don’t have large city populations (for the most part), and humans don’t eat them that often. It should be harder for diseases to pass from them to us. They’re also not very similar to us genetically, so their diseases shouldn’t be able to leap to us so easily.

Part of the answer is that bats are very social creatures. When one bat gets a virus, they pretty quickly pass it onto the other bats in their colony. However, that’s also true of goats and cows, who don’t seem to pass on infectious diseases to us as often.

The more important part of the answer is that bats are “reservoirs” of some particularly virulent viruses. Bats live with long-term infections of SARS or Ebola and are seemingly ok with it. While humans and other mammals either have to clear these viruses from their body or die, bats do not. They will just keep on keeping on, sometimes shedding the virus, sometimes not. It’s more likely that the bat will shed the virus during stressful times (i.e. when it’s in a cage and about to get eaten).

That’s what seems to have happened with COVID-19. A bat shed the SARS-CoV2 virus at some point, probably in a wildlife market. The virus at this point was not in state where it could infect humans. However, viruses can both mutate (change shape) and recombine (swap parts) rapidly. Coronaviruses are especially good at recombining.

The SARS-COV2 virus was shed from a bat (possibly from its saliva or droppings), seems to have recombined with a coronavirus in a pangolin (who was probably in a cage right next to it), and then was in a form where it could be transmitted to a human. . .

Continue reading. There’s much more, and it’s intriguing. Later in the article:

In other words, bat cells just continually assume they’re under attack and never stop fighting viruses, regardless of whether they’ve detected any. This is surprising. Interferon is a really powerful molecule, and continually producing it should have the same effect on a cell as continually putting a factory on red alert. It should make the cell run much worse, and cause a lot of collateral damage.

After all, when this sort of immune system overreaction happens in humans, humans get serious disorders, like Multiple Sclerosis and Lupus. Bats do not tend to get these. In fact, many bat species live around 20 years on average, which is not only way longer than it should have with its overactive immune system, but is exceptionally long for such a small animal. To give a comparison, rats live a year or two, as do rabbits.

So, how do bats live so long with a hyperactive immune system? Well, the answer seems to be that . . .

 

Written by Leisureguy

10 April 2020 at 2:49 pm

Hospitals say feds are seizing masks and other coronavirus supplies without a word

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Noam Levey reports in the LA Times:

Although President Trump has directed states and hospitals to secure what supplies they can, the federal government is quietly seizing orders, leaving medical providers across the country in the dark about where the material is going and how they can get what they need to deal with the coronavirus pandemic.

Hospital and clinic officials in seven states described the seizures in interviews over the past week. The Federal Emergency Management Agency is not publicly reporting the acquisitions, despite the outlay of millions of dollars of taxpayer money, nor has the administration detailed how it decides which supplies to seize and where to reroute them.

Officials who’ve had materials seized also say they’ve received no guidance from the government about how or if they will get access to the supplies they ordered. That has stoked concerns about how public funds are being spent and whether the Trump administration is fairly distributing scarce medical supplies.

“In order to have confidence in the distribution system, to know that it is being done in an equitable manner, you have to have transparency,” said Dr. John Hick, an emergency physician at Hennepin Healthcare in Minnesota who has helped develop national emergency preparedness standards through the National Academies of Sciences, Engineering and Medicine.

The medical leaders on the front lines of the fight to control the coronavirus and keep patients alive say they are grasping for explanations. “We can’t get any answers,” said a California hospital official who asked not to be identified for fear of retaliation from the White House.

In Florida, a large medical system saw an order for thermometers taken away. And officials at a system in Massachusetts were unable to determine where its order of masks went.

“Are they stockpiling this stuff? Are they distributing it? We don’t know,” one official said. “And are we going to ever get any of it back if we need supplies? It would be nice to know these things.”

PeaceHealth, a 10-hospital system in Washington, Oregon and Alaska, had a shipment of testing supplies seized recently. “It’s incredibly frustrating,” said Richard DeCarlo, the system’s chief operating officer.

“We had put wheels in motion with testing and protective equipment to allow us to secure and protect our staff and our patients,” he said. “When testing went off the table, we had to come up with a whole new plan.” . . .

Continue reading.

The lack of transparency is characteristic of the Trump administration, which fights to keep the public from knowing anything about what it’s doing (cf. the ignored subpoenas from Congress, the refusal to testify, the refusal to provide information).

Later in the article:

In response to questions from The Times, a FEMA representative said the agency, working with the Department of Health and Human Services and the Department of Defense, has developed a system for identifying needed supplies from vendors and distributing them equitably.

The representative said the agency factors in the populations of states and major metropolitan areas and the severity of the coronavirus outbreak in various locales. “High-transmission areas were prioritized, and allocations were based on population, not on quantities requested,” the representative said.

But the agency has refused to provide any details about how these determinations are made or why it is choosing to seize some supply orders and not others. Administration officials also will not say what supplies are going to what states.

And also:

Yet there is little indication that federal officials are controlling the market, as hospitals, doctors and others report paying exorbitant prices or resorting to unorthodox maneuvers to get what they need.

Hospital and health officials describe an opaque process in which federal officials sweep in without warning to expropriate supplies.

Jose Camacho, who heads the Texas Assn. of Community Health Centers, said his group was trying to purchase a small order of just 20,000 masks when his supplier reported that the order had been taken.

Camacho was flabbergasted. Several of his member clinics — which as primary care centers are supposed to alleviate pressure on overburdened hospitals — are struggling to stay open amid woeful shortages of protective equipment.

“Everyone says you are supposed to be on your own,” Camacho said, noting Trump’s repeated admonition that states and local health systems cannot rely on Washington for supplies. “Then to have this happen, you just sit there wondering what else you can do. You can’t fight the federal government.”

Written by Leisureguy

10 April 2020 at 1:28 pm

How Did the U.S. End Up with Nurses Wearing Garbage Bags?

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Susan Glasser reports in the New Yorker:

On Saturday, March 21st, while Donald Trump was tweeting about the “Chinese virus” and circulating praise for the “great job we’ve done,” Eric Ries received a phone call from another Silicon Valley C.E.O. His friend Jeff Lawson, of the firm Twilio, told Ries that, to deal with the rapidly escalating coronavirus crisis, the White House was recruiting tech executives to help. Ries—the founder and C.E.O. of a new company, the Long-Term Stock Exchange, and the author of a best-selling book, “The Lean Startup,” which had made him a well-known figure in the Valley—was an obvious choice for someone looking to stand up a high-tech solution to the disaster quickly. He had long preached the virtues of going to market as fast as possible with what he called M.V.P.: minimum viable product.

America was watching, shocked, as doctors and nurses pleaded for protective gear and medical equipment such as ventilators. Ries was asked to help start a Web site that would match hospitals and suppliers. Sure, Ries said, he could have something up and running by Monday. What followed over the next two weeks was an inside glimpse of the dysfunction emanating from Trump’s Washington in the midst of the pandemic, a crash course in the breakdown that has led to nurses in one of the wealthiest countries in the world wearing garbage bags to protect themselves from a virus whose outbreak the President downplayed until it was too late to prepare for its consequences.

Ries’s first phone conversation demonstrated how awry things had gone. He reached out to a White House contact, and, when he mentioned the Trump Administration’s coronavirus task force that was asking for Silicon Valley’s help, the response was, “Which one?” Trump had enlisted his son-in-law, Jared Kushner, to help with the pandemic response, and his murky new effort, which was not yet public, was already seen as working at cross-purposes with the official task force, overseen by Vice-President Mike Pence. Ries also learned that the Web site he had been asked to create was, in fact, not needed. “It took me three hours on the phone to realize the world did not need another Web site to solve the problem,” Ries told me.

Numerous relief groups were already in place. Some of them were soliciting donations for urgently needed personal protective equipment, or P.P.E., in the medical argot that the rest of the country would soon learn. Others were organizing sewing-machine brigades to make masks, or teams of graduate students to create designs for 3-D-printed ventilators. Ries thought he could help bring a bit of order to the chaos by organizing the small army of relief groups and volunteers into an effective partner for the federal government, for when it actually took charge. “I thought, Eventually somebody will lead,” Ries said. He spent the weekend pulling together a new umbrella organization, the PPE Coalition, and, as promised, had its Web site up and running by that Monday morning, along with a hotline to field requests.

For the next few weeks, the requests flooded in. Eventually, thirty-one groups joined the new coalition, and the Web site provided links to organizations with names that tell the sad story of the crisis, from Operation We Can Sew It! to Get Them PPE. The sense of urgency was palpable. “Armageddon was coming in three weeks,” Ries remembers being told. There was a rush to help before early April, when deaths were predicted to peak in New York City and hospitals would potentially be overwhelmed in other hot spots around the country. But there was also a sense of disbelief: Where was the U.S. government? One of the volunteers kept saying, “There’s no way we should be doing this alone,” remembered Jennifer Pahlka, who founded the tech group Code for America, served as deputy chief technology officer in the Obama White House, and is now helping with a coronavirus-relief group, U.S. Digital Response, which advised the PPE Coalition. “In our community, we have sweatshirts and T-shirts and stickers that say, ‘No one is coming. It’s up to us.’ It’s really hard when they actually realize that’s true. It’s terrifying.” For ten days running, Ries was told that the Federal Emergency Management Agency would step in and take charge of distributing critical supplies, directing them to where they were most needed, but, as far as he could tell, it never happened. Kushner and his team had embedded at fema, along with a Navy rear admiral, John Polowczyk, to oversee the supply-chain crisis, but Ries managed only to speak with an aide to the admiral.

Eventually, at a White House briefing last week that will surely go down as one of the Administration’s most callous performances, Kushner said publicly what he had in effect told Ries’s Silicon Valley contacts a couple weeks earlier, in a private phone call with business leaders and government officials: the states were responsible, and the U.S. national stockpile was ours, not theirs. The President agreed. Governors should have prepared their states while there was still time. “We’re a backup. We’re not an ordering clerk,” Trump said at the same news conference.

For two weeks, Ries and his fellow-volunteers had believed that it was only a matter of time until the federal government came to the rescue. They planned to serve as a bridge for the desperate states and cities that started calling their hotline as soon as it was up and running, but, eventually, the federal government would take care of it, because isn’t that what the federal government is supposed to do? “We see ourselves like a backstop,” Joe Wilson, a prominent venture capitalist working with Ries on the PPE Coalition, told me. “We are like the Plan C or the Plan D. Like, if x, y, z don’t happen, then, sure, this network will be valuable. This is what we told people. Now it’s clear we are on Plan C or Plan D.”

What they did not foresee was that the federal government might never come to the rescue. They did not realize this was a government failure by design—not a problem to be fixed but a policy choice by President Trump that either would not or could not be undone. “No one can believe it. That’s the No. 1 problem with the whole situation: the facts are known, but they are inconceivable,” Ries told me. “So we are just in denial.”

Independent reporting has corroborated what Ries and other volunteers saw for themselves: “a fragmented procurement system now descending into chaos,” as the Associated Press put it. The news agency found that not a single shipment of medical-grade N95 masks arrived at U.S. ports during the month of March. The federal government was not only disorganized; it was absent. Federal agencies waited until mid-March to begin placing bulk orders for the urgently needed supplies, the A.P. found. The first large U.S. government order to the big U.S. producer 3M, for a hundred and seventy-three million dollars’ worth of N95 masks, was not placed until March 21st—the same day that Ries got his first phone call about the Kushner effort. The order, according to the A.P., did not even require the supplies to be delivered until the end of April, far too late to help with the thousands of cases already overwhelming hospitals.

Earlier this week, the office of the inspector general for the Department of Health and Human Services released a survey of three hundred and twenty-three hospitals in forty-six states, D.C., and Puerto Rico, and it found “widespread shortages of PPE,” and also of other equipment. After the report was released, Trump claimed it was “wrong,” tweeted that it was “Another Fake Dossier!,” and attacked the principal deputy I.G. who prepared it because she had also served during the Obama Administration. Trump, of course, omitted the fact that she is a career official who also served in the Clinton and George W. Bush Administrations.

All of this was predicted. On February 13th, the Center for Global Development, a nonpartisan Washington think tank, warned in a report about the “urgent but closing window” for the U.S. government to prepare, including specifically recommending an immediate review of the P.P.E. supply chain; the creation of a plan for distribution of supplies and the public communication of that plan; and the development of “options for addressing PPE shortfalls,” which ranged from increasing manufacturing to coming up with new “parameters for reuse in crisis conditions.” This was in mid-February, a full month before Trump deputized Kushner to step in and the first orders went out.

Jeremy Konyndyk, a former Obama Administration official, who co-authored the Center for Global Development report, pointed out that, although he had accurately foreseen supply-chain problems and overwhelmed hospitals, he had not imagined the widespread confusion that the U.S. is now experiencing regarding such basic questions as who is in charge of the pandemic response. Were the states, as Trump now claims, really supposed to have been stockpiling masks and ventilators when there is a national stockpile for doing just that? “It would never have occurred to anyone that the President would abdicate the leadership role of the federal government,” Konyndyk told me. A pandemic playbook . . .

Continue reading.

And yet millions still support President Trump and believe (against all evidence) that he is effective and doing a good job. It’s painful to see.

Written by Leisureguy

10 April 2020 at 1:19 pm

Can flaxseed prevent breast cancer?

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I eat 1 tablespoon of flaxseed a day, and I grind it just before eating it.

Written by Leisureguy

10 April 2020 at 1:06 pm

Wonderful shave to end the week — and I really like RazoRock’s Barber Pole handle

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Leviathan has a wonderful fragrance (something not mentioned in the Biblical accounts), and the lather, made with my ebony-handled Sabini brush, was totally satisfying. The iKon X3, mounted on RazoRock’s terrific barber-pole handle, did an awesome job, and the finishing splash of Leviathan aftershave was just the ticket — a Good Friday indeed!

Written by Leisureguy

10 April 2020 at 9:00 am

Posted in Shaving

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