You might wonder why I haven’t been blogging as much recently. After all, given Governor Whitmer’s shelter-in-place order, my patient and surgical loads have been much lower than usual, and I’m spending a lot of time working at home. That should mean I’d be blogging up a storm, shouldn’t it, given that there’s now so much COVID-19-related material in the form of pseudoscience, bad science, quackery, and conspiracy theories. Oddly enough, it hasn’t happened yet. Although my ‘nym and persona for this blog are based on a cranky, nearly all-knowing computer from an obscure (in the US, at least) 40-year-old British science fiction show, I’m not a computer, and I’ve had trouble—shall we say?—focusing, at least on anything other than patient care. Also, I’m working on a manuscript regarding the premature hype over hydroxychloroquine (for which actual scientific evidence—as opposed to anecdotes—is definitely trending in the direction of the conclusion that it does not work for COVID-19). I also think that I’ve been taking my frustrations out on Twitter. Then, yesterday, I saw this gem from “Dr. Phil” McGraw who seems to be competing with Dr. Mehmet Oz in a competition to say the stupidest things about the pandemic, leading me to contemplate what I now like to call COVID-19 denial, or just COVID denial, of which this is a classic example:
TV personality Dr. Phil McGraw appeared on Fox News on Thursday evening to slam the shutdowns intended to stop the spread of coronavirus.
McGraw, a psychologist, talked about the mental health toll on people living in isolation and said the lockdowns would “create more destruction and actually more death across time than the actual virus will itself.” Then, he compared the toll of the virus to other causes of death.
“Forty-five thousand people a year die from automobile accidents, 480,000 from cigarettes, 360,000 a year from swimming pools,” McGraw said, “but we don’t shut the country down for that. But yet we’re doing it for this?”
Here’s the entire video:
Truly, Oprah Winfrey has a lot to answer for after having made Dr. Phil (and Dr. Oz) household names, now more than ever given their promotion of COVID-19 denial.
Of course it had to be Laura Ingraham’s show. Recall that she’s been spreading COVID-19 denial and featuring doctors hawking hydroxychloroquine based on their anecdotal “case series” that are anything but rigorously conducted case series. As the article points out, the toll from auto accidents is around 32,000 a year, while drowning claims roughly 3,500 a year. If Dr. Phil is going to use figures like this to promote COVID-19 denial and disinformation, at least he could have an intern look up the correct numbers for him.
Be that as it may, this is whataboutism at its most naked. Whataboutism is a propaganda technique commonly used by the Soviet Union during the Cold War that seeks to discredit an argument or person making an argument by implying hypocrisy using a comparison that is often (but not always) spurious and unrelated. It’s nothing more than a rhetorical diversion, in this case intended to discredit the policy of social distancing enforced through shutting down schools and nonessential businesses and ordering people to shelter in place by not leaving their homes except for essential activities, like getting food, medicine, etc. Dr. Phil’s comparison is particularly spurious because, as the article above notes, drownings and automobile crashes are not contagious; they are not spread by person-to-person contact and, while secondhand smoke can cause harm, the health issues due to smoking that lead to so much death from lung cancer and heart disease are not, strictly speaking, contagious either. This is a particularly brain dead comparison, even by Dr. Phil’s standards. Also, they don’t overwhelm hospitals in a manner of weeks.
I also can’t help but point out that conspicuously absent from Dr. Phil’s whataboutism was a mention of the tens of thousands of Americans who die from gun violence every year. This was Fox News, after all.
Meanwhile, Dr. Oz was engaging in a bit of COVID denial of his own:
Here’s America’s quack:
“We need our mojo back,” Oz said. “Let’s start with things that are really critical to the nation, where we think we might be able to open without getting into a lot of trouble. I tell you, schools are a very appetizing opportunity.”
Oz went on to cite a study which found that school closures in the United Kingdom only reduced coronavirus deaths by about 2 to 4%.
“I just saw a nice piece in The Lancet arguing that the opening of schools may only cost us 2 to 3% in terms of total mortality,” he said. “And, you know, any life is a life lost. But to get every child back into a school where they’re safely being educated, being fed and making the most out of their lives — with a theoretical risk on the back side, that might be a trade-off some folks would consider.”
Dr. Oz appears to mean this modeling study from a month ago from the Imperial College COVID-19 Response team, which appears not to have been peer reviewed that concluded that school closures likely only decrease overall COVID-19 mortality in the UK by 2-3%. (Of note, the study did not suggest reopening the schools.) Of course, models are highly dependent on the assumptions fed into the model. On this question, admittedly, the evidence is all over the map. For example, a 2015 systemic review of social distancing measures for influenza (which is less contagious than COVID-19) noted a decrease in transmission from 1-50%, depending on the study. More recently, a 2020 systematic review from Hong Kong of school closures and other social distancing measures reported fairly strong evidence that school closures reduced transmission, particularly among school-aged children, but there was also evidence that transmission surged again after schools reopened, leading to questions about timing and duration such closures. There is also evidence that less stringent means of social distancing in schools (e.g., rotating classes, spacing out desks, etc., could be effective.)
Of course, Dr. Oz was making what could have been a valid point (that closing schools might not be as effective at halting the spread of coronavirus as we think) in the worst possible way, a manner favored by those those engaging in COVID denial, to cherry pick a study questioning the effectiveness of whatever social distancing measure he might like to attack, and then comparing it to other things in a highly offensive way. “A very appetizing opportunity”? “We need our mojo back”? WTF? Basically Dr. Oz framed his message as a choice that he thinks worth considering, suffering an additional 2-3% mortality (that’s assuming that the model he cited is even applicable to the US or even correct in its estimates) in return for reopening schools to start to “get our mojo back” while referring to reopening the schools as an “appetizing opportunity.” There are no facepalms big enough, but this one is at least in the right order of magnitude.
Hilariously, libertarian propagandist Robby Soave at the inappropriately named Reason.com website was quick to leap to Dr. Oz’s defense:
But Dr. Oz was not describing a death toll in the millions. He said the cost could be “2–3 percent in terms of total mortality,” not among all school-aged children or the population at large.
That Lancet article argues that school closures may not be a particularly effective social distancing measure. It cites modeling from Imperial College London that estimates the U.K.’s school closures will reduce overall deaths by about 2–4 percent. In other words, if there are 100,000 COVID-19 deaths despite the schools being closed, having had the schools open anyway would have yielded 2,000–4,000 additional deaths. That’s thousands, not millions.
Let’s just put it this way for Mr. Soave: If your defense of Dr. Oz is that he was advocating a policy that would result in “only” a few thousand more people, not millions more, dying as a result, that’s not a winning argument or good defense. But, hey, you got to “own the libs” for a moment. So it was worth it, right?
Libertarian hacks being libertarian hacks aside, the backlash against Dr. Oz’s comments was incredibly fierce, even by Twitter standards, so much so that yesterday he was forced to backtrack and apologize:
His suggestion sparked an enormous response on social media — prompting a somewhat apologetic statement late Thursday: “I misspoke,” he said in a video released on Twitter, acknowledging that his words had “confused and upset people.” The goal, he said, was to discuss “how do we get our children safely back to school” as he is “being asked constantly how we’ll be able to get people back to their normal lives.”
Here’s the video:
I love the part about how Dr. Oz “realizes” that his comments had “confused and upset people.” No. No they didn’t. People knew exactly what he was saying. He was arguing that a few thousand extra deaths could be a price worth paying to reopen the schools. OK, some people were confused, I guess, in that they interpreted Dr. Oz’s statement as advocating a policy that would cause millions of extra deaths, but that doesn’t change the problem with what Dr. Oz said, his contribution to the denial of the severity of pandemic by Fox News. (Never mind that COVID-19 is fast becoming American’s number one cause of death right now.)
This particular meme made over Dr. Oz’s statement was actually the harshest, but, in my mind, fair:
I’ve long referred to Dr. Oz as America’s quack. It’s possible I might even have been the one to coin that epithet, but I can’t prove it one way or the other and probably didn’t. (I just don’t recall having seen the term until I first started using it.) This isn’t even the first time that things have gone badly for him on Twitter. In a way, I almost miss the days when all Dr. Oz did was to feature psychic mediums, astrology, homeopathy, and bogus weight loss supplements on his show while being lambasted by a Senate panel. Compared to now, those were the “good old days,” days of grift and bread and circuses, rather than days of promoting misinformation that could lead to thousands more deaths.
I don’t know why Dr. Oz and Dr. Phil have decided to align themselves with the right wing COVID-19 denial machine at Fox News and contribute to their “whataboutism,” advocacy of prematurely “reopening” America, and promotion of unproven treatments (with Dr. Oz most recently encouraging people to sign up for a home hydroxychloroquine trial while leaving out the scientific caveats), but they have. I have to wonder why. Maybe their audiences significantly overlap with the audience of Fox News. I suspect that’s the most likely reason.
In any event, the propaganda and disinformation about COVID-19 to which Dr. Phil and Dr. Oz have contributed have real world consequences. Two days ago, in Michigan, there was a large protest against Gov. Whitmer’s executive order to shelter in place in which thousands of people drove in front of the State Capitol Building in order to call for loosening of the restrictions. Dubbed “Operation Gridlock,” it was organized by right wing groups funded by the DeVos family and, as you will see from the video below, resembled a Donald Trump rally more than anything else:
Meanwhile, as this news report indicates, Michigan Militia was out in full force, open carry gun nuts menacing people just by their presence and their openly brandishing their firearms. So were Michigan Proud Boys, the Michigan branch of what are, in essence, fascist brownshirts.
Be that as it may, notice how the protestors who got out of of their cars were not social distancing much. Basically, this protest was a large COVID-19 incubator in which people from parts of Michigan not yet affected much by COVID-19 mingling with people from the hardest hit part of the state (the Detroit area) for several hours and then headed home to take coronavirus with them to every corner of the state. Areas of the state that have so far had few COVID-19 cases could well start to see their numbers climb dramatically in 2-4 weeks, as protestors return home and, likely, fail to social distance adequately once there. Many of the protestors parroted the sort of misinformation that Fox News has been pushing and to which Dr. Oz and Dr. Phil have started contributing.
COVID-19 denial in the form of “whataboutism” promoted by Dr. Phil and false dichotomies/dilemmas promoted by Dr. Oz are merely two forms of COVID-19 denial. As the pandemic drags on, I will examine other forms of COVID-19 denial. In the meantime, I’ll just repeat what I said above. Not only do Dr. Oz and Dr. Phil have a lot to answer for given their decision to join the right wing COVID-19 grift and denial parade, but Oprah Winfrey has even more to answer for for having made these two quack into stars.
197 replies on “Dr. Oz and Dr. Phil’s COVID-19 denial: Oprah has a lot to answer for”
Dr Phil worries about the psychological effects of isolation but not about the psychological toll of watching increasing death tolls and rates of infection skyrocketing? Watching nursing homes pile up bodies is not exactly emotionally healthy as well as seeing cities digging mass graves for Covid victims.
NY’s governor confessed that earlier in the pandemic he feared that the mounting toll would continue to rise and that there was nothing we could do to stop it: I felt the same way..
He’a also assuming people won’t self-isolate absent an order, if the disease was allowed to run its course and people were getting sick and dying at high rates.
It’s the thing.
We got lot of talks about the toll of confinement on our psyche or (gasp) on the economy, but the critics rarely consider the toll of not confining – i.e., assuming the absence of any effective mitigating process, an infectious disease going unchecked all around and the collapse of an overloaded medical infrastructure. And the heavy accompanying toll on our psyche and the economy.
It may not be good for us to spend 6 months with the population taking turns in getting sick by small fractions, but it will not be better if, instead, half the population get sick in the same month. A business may manage to survive with 10% of its staff sick, but I doubt they can do it with half the staff missing. Especially since, with the former, the context is that all the society is in slow mode, while with the latter the society is expected to function as normal and the businesses as productive as usual.
Dr. Oz glomming onto an “appetizing opportunity” to only increase child mortality by 2-3% reminds me of this scene from “Die Hard”:
What sort of a Cabal is this ??? When you see Dr. Phil, Dr. Oz, and Oprah TOGETHER, you will know you truly HAVE A PROBLEM !!!
As opposed to a tedious sockpuppet?
What’s behind these and other Covid deniers?
I think it’s about their financial stock portfolios that have taken a hit.
I’m sure Imperial College’s IDEA’s unit’s study does not apply to the US, because you don’t have socialised medicine nor, inadequate as they are, statutory sick pay and benefits nor the level of buy in from the public we have managed to mention a few differences. Sadly we do share leaders who seem determined to screw-up their management of the crisis.
For me the biggest problem is that there are issues with social distancing, shelter at home and school closures and we should be talking about how to remedy them – but not in this way.
For instance, for some kids from poorer families school lunch might be the only full meal that they have. Then there are issues of domestic violence, which is unfortunately increasing, also due to stress, trauma from losing work and so on, and we should start doing something to remedy that (like providing victims a safe way to notify authorities and enabling them to find safe shelter).
And yes, mental health is also an issue here. Especially when the only way to get therapy is over the phone or video chat, which is not an equivalent of direct contact. I have several friends with different mental issues and they are all suffering.
Don’t get me wrong, I believe in all measures taken to stop COVID spread. But there are other things that should be taken into consideration, other issues that we should try to remedy – because otherwise there will be a lot more casualties than just those who die from virus infection.
@ Alia
“Like providing victims a safe way to notify authorities and enabling them to find safe shelter.”
Authorities do not care about victims.
Could you clarify? Which authorities?
@ brainmatterz
This was a general statement. Bottom line is: “never complain, never explain”. Unless you enjoy things backfiring at you.
If you want to talk about specifics, pick your favorite type of abuse, and we’ll discuss it. I won’t pick my favorite type of abuse, because it may construed as impolite and monomaniac. So I’ll let you pick yours.
F68.10 – I think you’re being somewhat cynical, understandably so as you have experienced this. I am not naturally cynical but my experiences with authority lead me to agree with you – you can’t trust anybody. Unfortunately some people don’t have a choice.
Incidentally a respected muslim musician I know who was born in Delhi once remarked, when talking about the difference between UK and India something like “It’s amazing, here you tell your children that if they are lost, ask a policeman, in Delhi we have to teach our children they should never ever approach a policeman’
@Carl
“Unfortunately some people don’t have a choice.”
Indeed.
F68.10 – thanks for the video, not quite my kind of thing (too ‘poppy’) but definitely heading in the right direction, I’ll have a look on youtube and explore some more
@ Carl
Everyone’s taste is unique. But as I’m now trying to get my head back a little bit back into very highly abstract maths, this kind of “loop in your head” music tends to be quite compatible with the required mindset.
Anyhow, just found the lyrics rather fitting to our discussion.
@F68.10 – If you like loops, how about some gamelan music? I find the unusual (to my ears) intonation very compelling.
Here‘s an attempt at finding a middle ground between our musical tastes. Less “poppy”, not as wildly exotic as yours, and still loopy. But, yeah, I tend to like loops. Some form of pathological self-soothing.
I wouldn’t be surprised if this isn’t typical, but around here restaurants are offering school lunches.
Washington State immediately implemented a Meals On Wheels type of program to replace school lunch.
Well, over here under-18 have not even been allowed out of the house without an adult for the last 2 weeks (because reasons) – and restaurants are busy preparing meals for hospital staff. The thing is, our authorities start implementing various measures to stop COVID without thinking about possible side effects… and there you have it. And yet, they want to hold a presidential election in May (you know, before shit really hits the fan and people realise how much they have messed up).
I really, really wish I was living in a normal country, with reasonable leaders – you, in the US, can probably sympathise with me.
Here, restaurants are offering meals, and there’s pickup of free lunches for kids from the schools as well.
Our school district and most others in the area have grab and go meals for children since the closures started. They have it set up at the school entrance and you just go over twice a week and they give you 2-3 days of breakfasts and lunches through your car window. Takes a huge burden off of our need to grocery shop, with 3 school age kids and a toddler in the house.
In my area of RI, we have local restaurants providing lunches (carry out of course) for kids missing school meals.
@Alia:
This is a real problem in South Africa at the moment.
We teachers take food to all families who we have indicated they need assistance. We literally called the families of every single student and delivered food and information. We did this even though the shit kicker pull yourselves up by your trust fund tea party aholes have done away with step/grade raises, capped salaries, reduced retirement benefits, and have withheld COLA raises for two years. I will never listen to a republican again. I especially will not listen to a clown and his sycophant posse of eastern European Bond villains.
Yeah, I know how you feel, bob. We’re supposed to be doing online teaching now, on our own devices, our own Internet access (lucky me, I’m on monthly broadband, not PAYG mobile), at least Microsoft and Google were kind enough to offer their Office 365 and Classroom solutions free of charge to schools. And we don’t really know whether we will get our full salaries for that period or maybe just a part, even though online teaching is even more time-consuming than working in a regular classroom (not to mention, we’ve had zero experience and zero time to prepare).
Holidays? Forget it, it’s highly probable that we will be doing final exams and school enrolment in July and August. And then, in October and November we will all be burnt-out wrecks, actively hating our jobs and our students – but with the expected unemployment rate everyone will be still envious of us.
On a related note, South Africa has decided to dispense with the May/June exams. The view is that there is not enough time to catch up, so it would be pointless. It may even be decided to pass everyone at the end of the year.
I agree that there are issues. But they are talked about – though not enough. For example, some states – not enough – put in place an eviction moratorium, and some have delivery of school meals.
But we certainly need to do more.
They have to fill the gap left by Keith Ablow somehow.
Something form The Onion to make you smile.
https://entertainment.theonion.com/you-ve-served-me-well-but-this-has-gone-too-far-says-1842924183
Smile–hell, I ROTFLMAO for five minutes!
One wonders what the Devos family’s/individuals’ actual behavior is. Are they actually mixing with the commoners during any of these activities, or at all?
Rick DeVos is actually a good guy, doing things for the GR area because he wants to help.
Dick has his name all over town, and on buildings in town and campuses of nearby colleges. He’s spoken at our campus a few times, and his repeated advice to kids who will be graduating is usually the same:
“When you’re out in the business world looking give something to the community, ask yourself what you’ll get in return. If what you receive isn’t worth more than what you’re giving, don’t do it. Get your name on buildings.”
His old man was far worse.
I don’t know for sure, but I have every reason to think that they (and people like Ms. Ingraham) are what military types call REMFs (Rear Echelon Mother F***ers). One of the things that money can buy in a pandemic is a greater ability to self-isolate. People like the de Vos clan can afford to pay servants to acquire all of the supplies they need, and can occupy different rooms in their rather substantial houses.
Earlier today I saw a tweet from John Rogers, who is credited with explaining the “crazification factor” of 27% that has been observed in some political issues (the number comes from the share of the vote out-of-state black Republican Alan Keyes got in his 2004 Senate race against Barack Obama). Rogers said that he would have to revise significantly upward the fraction of the population that are sociopathic.
Ingraham (She-Wolf of the SS) has joined in the call for the citizens of certain states to rise up in armed insurrection and throw off the shackles of elected government. Other people, that is. Not herself.
Rats, not Jesús Franco.
That meme isn’t accurate. That is obviously not a pediatric ward.
So what? It illustrates the point perfectly. Does it really matter that the bagged bodies are bigger than children?
There could be 4 children/bag. That is not your standard Hefty; those fda/cdc/mil approved things are pricey.
The kids wouldn’t be most of the ones dying from an opening up of schools. It would be the people they pass the virus on to.
That is why it is necessary to plastic off the foyer, under negative pressure, and keep them from passing that point when they get home — Any psychological damage this will cause is negated by the fact that they can now go and play outside with their friends under the bridge down by the river; Maybe walk along the railroad tracks until they find a dead auntie or uncle they heard about. Maybe poke it with a stick and contemplate the meaning of it all. Maybe learn about the value of all the little decomposer critters to the ecosystem.
Yeah, passed onto their parents and/or grandparents. I know this from very painful experience, it is very tough on a kid to lose a parent to death.
Yes, but children can spread the virus to mom and dad and grandma and grandpa, who are more likely to get very sick and die, especially grandma and grandpa.
I think the verdict on that one isn’t that clear. As far as I understand there is little known about if children can really spread the virus.
Renate,
I think you are right that it “isn’t that clear”. But I think that is probably because it has not been looked at that carefully. Surely, it is not just because they have low levels of the virus?
https://pediatrics.aappublications.org/content/early/2020/03/16/peds.2020-0702.1
Those lung changes, which are being more accepted as a defining trait of SARS-COV-2, would seem to me that there were plenty* of viral particles at some point.
Also of note from that paper is that there is not the disparity** between male/female like there is in the older population.
I did see a WHO (I think) contact tracing study somebody had linked to that noted “we observed no transmission from children” or words to that effect. I think there were 139 subjects and I don’t recall a number of children even listed, which stuck out to me. Either way, I’ll just assume, out of an abundance of caution, that the little crumb crushers are hot as hell.
I saw some article yesterday suggesting that the most infectious period is before showing symptoms — that by the time one is showing symptoms that the virus is already being cleared. This has pushed estimated replication(0) from 2.5 – 40??
** I saw this morning that it has been hypothesized that the reason for the disparity may be that ACE2 receptors are in testicles and that there is a surprising lack of those in females; Also suggest that the virus may ‘hide out’ there as a type of reservoir. From Drudge:
https://www.latimes.com/science/story/2020-04-18/do-testicles-make-men-more-vulnerable-to-coronavirus
Several hypothesis I’ve seen bantered around as to why the disparity range from lifestyle choices to the extra X of a female. I have my own out there hypothesis: Estrogen.
Of course, younger women have more estrogen than older. But, I think, that younger men do also.
I knew a body builder/male model that used injected testosterone for a while and (just like almost every cop) became a flamming asshole for a very, very long while after ‘coming down’ from that 30 min workout. because the increased testosterone also increased estrogen (which, idk, hangs around lots longer, or something.)
When he quit using it, he had to titrate down with estrogen pills because, apparently, a rise in testosterone is also associated with a rise in estrogen and a sudden drop in the latter can have some funny effects.
@ Tim
“Several hypothesis I’ve seen bantered around as to why the disparity range from lifestyle choices to the extra X of a female. I have my own out there hypothesis: Estrogen. Of course, younger women have more estrogen than older. But, I think, that younger men do also.”
Literally talking out of your ass.
Sigh…
They could be high school seniors. Or college students. Or the school basketball team. Or Scots.
“Or Scots”
Are you suggesting that the Swiss duped the Scots and that Ricola is not a cure for covfefe-19? Weird flex, but ok.
I would like to point out that the Michigan Senate, which is controlled by the Republicans, voted unanimously to extend the stay at home order. Again, the vote was unanimous. Well, at least the ones that showed up. Many didn’t show because they were afraid of some virus or something.
The Michigan House, which is also controlled by the Republicans, also voted for the extension. Whether it was unanimous or not is unknown as I have not been able to find a video.
This protest was less about Covid and more about actively trying to marginalize a potential VP candidate who could turn Michigan back to the Democrats in November.
I have to disagree with your last paragraph for two reasons. One, President Scheisskopf tweeted about that rally. Two, there were similar rallies in Minnesota and Virginia, which President Scheisskopf also tweeted about, and I am not aware that either Tim Walz or Ralph Northam are being considered for VP.
Once is happenstance. Twice is a coincidence. The third time, suspect enemy action.
I have to work with some of these people.
True, many of the people who showed for the protest would show up for any reason if asked by their glorious leader, but the members of the Conservative Coalition I know are using any means to denigrate Whitmer right now and this was their intent.
Yes, Republicans voted to extend the Governor’s emergency powers, but not nearly as long as she had asked for, and reports on social media indicate that there were some Republican legislators taking part in Operation Gridlock. You can bet that if Gov. Whitmer needs to extend the order longer (a near certainty), they’re going to be less accommodating and want concessions.
Del Bigtree ( @ High Wire Talk) featured one of the leaders, Wendy Darling**, of the Michigan protest ( yesterday’s broadcast – in the first 10 minutes, I couldn’t take any more)
Other poohing-poohing of the seriousness of Covid-19 at PRN. Only the extreme elderly with co-morbidities die: especially the obese.( the last few broadcasts) Don’t believe Dr Fauci or Mr Gates- they don’t have the science.
** isn’t she a character in Peter Pan ?
This still implies that they are the sort of person who would rather their own grandparents died than accept….whatever it is they object to.
In this time of troubles it’s worth thinking outside of Covid 19 too. How is the lockdown effecting third world aid activities? Charities? If countries or people stockpile medical ppe then the main victims are the poorer areas of the world. It’s natural for people to focus close to home in this sort of situation. Maybe think about donating to MSF or more local homeless organisations. Are there governments thinking of using Covid 19 as a smokescreen to hide abuses?
Bit of a ramble but….
My government (well, not my chosen representative, she’s in opposition) is certainly using Covid 19 to introduce very controversial laws, because, you know, with shelter at home regulations, it’s really hard to organise a protest march or demonstration. For example, tightening anti-abortion laws even more (when they tried to do it last time, protest marches were numbered in tens and hundreds of thousands).
“The Upside to a Downturn: Mortality Rates Fall During Recessions”
“During a recession as unemployment rates rise, contrary to reason, death rates drop. Researchers have been trying to figure this out for a century, the science journal Nature reports, but now with urgency, as economists predict a downturn on the horizon.”
“Throughout the Great Depression of the 1930s, death rates reached all-time lows. The same held true for the Great Recession where death rates dropped across Europe despite record unemployment. Yet you clearly can’t call economic crises good for public health.” – https://fortune.com/2019/01/25/economic-downturn-mortality-rates/
When’s the last time you heard somebody recommend a recession or depression? None? Why not? Think of all the people you would save.
People die all the time in construction and mining. Why? So everyone can have a better quality of life. But now we are suppose to throw out the quality of life issue during the coronavirus pandemic.
Let’s admit that the experts have been wrong about a lot of things. Clearly their mortality models are out of the ballpark. But it was other experts who got us into this mess in the first place – by recommending trade with China. What about just using common sense instead: Quarantine high-risk groups and people with symptoms.
Lets not admit that the experts have been wrong about a lot of things. Let’s instead admit that the experts are making the best of a bad job making predictions for an unknown virus with unknown properties. Lets also admit that these predictions will continually change with the increase in knowledge and changes in human behaviour.
I’m not sure where you get the idea that the only reason for trade with China is because of ‘experts’. Rather then the desire of the average consumer to get as much as possible for as little as possible.
“But it was other experts who got us into this mess in the first place – by recommending trade with China. ”
That sets the bar rather high in the “foolish comments to date” category.
Well, you could say that ” it was other experts who got us into this mess in the first place”, especially in the USA, is true in that too many decision makers embraced the /
ravings/strike> theories of the Chicago School of economists.Of course, AFAIKS the Chicago School are experts in the same way as the good doctors Phil & Oz.
@ John Kane
The problem of the Chicago School of Economics is not the theory they produced per se. It is the way people got to think about it and the way it influenced politics through a succession of brain farts.
You can make serious science without understanding, as a scientist, the full moral implications. Then politicians jump on the bandwagon twisting it the way they want, more or less with the consent of the scientists promoting the theory.
That’s how science can morph into ideology, even if it is based on sound facts and reasoning: by a succession of brain farts.
You can also observe that in segments of medicine.
If we banned trade with china, you Matt would have to pay 4 or 5 times for the computer or cell phone you use to write your comment.
Alain
I can’t find a reference now (my google broke again) but there has been a long accepted ‘proxy’ for economic downturn and that is that prostitutes look better and cost less.
Not that ‘I’ would ever touch one of those filthy, dirty, nasty, mamma told me not to whores, but we are in a depression.
— funny how the stock market** is doing great after getting injected with 4 trillion, funny how those on main street scrounge while top executives and billionaires have gained 320 billion dollars amongst themselves in the last couple months.
**How can this ship be sinking if we are 200 feet in the air???
Another proxy is the café waitress. During a downturn, more attractive women become waitresses to earn a living.
In all discussions we need to remember that identification of a pathogen in the laboratory is not the same thing as establishing the disease state caused by the pathogen. As a generalization, medicine, like all people, suffers from only looking at the numerator and forgetting about the denominator. Often the numerator is touted in both medical and lay literature as the “headline” number. However, when we talk about a rate, we need to have both pieces of information.
In the era of PCR, we deal with this all the time. PCR has turned our understanding of disease on its head. Prior to PCR the paradigm was fairly simple: A patient is sick. A pathogen is identified in the laboratory. The conclusion is that the pathogen caused the disease. This is the paradigm most physicians use as a heuristic. Prior to PCR, if a patient had diarrhea and C difficile was identified in the laboratory, the conclusion was drawn that the patient had C. difficile induced diarrhea/colitis. PCR changed this. PCR showed that a significant portion of the population were asymptomatic carriers of C. difficle. The paradigm needed to be changed: The identification of a pathogen is a necessary but not sufficient condition for the establishment of a disease state. PCR showed the hidden assumption of medicine: the conclusion of C difficile induced colitis was a form of survivor bias (only those patients with the disease, “the survivors” were examined).
In the era of COVID-19, this problem is magnified due to the extremis of the situation and the dramatic and psychologically traumatic way in which sick victims present. Due to limitations of testing, only patients who presented with the symptoms of SARS2 were tested for SARS2. The tests used were PCR based. PCR is an incredibly sensitive test, picking up live viruses, dead viruses, and if the right fragment survives, pieces of the virus. This gave a false sense of the virulence of the disease. This is the logical fallacy of “survivor bias” on steroids. A simple mathematical thought experiment demonstrates the problem. If 100% of the population is infected with SARS2, and 1% of those infected present with the disease, and only those 1% are tested, the organism will an apparent virulence rate 100X that it actually does.
So a critical analysis of the medical and governmental response to SARS2/COVID19. SARS2 is the organism. COVID19 is the disease. In order to have COV(D19 one must be infected with SARS2. But one may have SARS2 without having COVID19. What is the prevalence of the disease in the background population? We don’t know. Why is this important? Because without knowing the prevalence of the disease, one does not know the predictive power of a positive or negative result. Here is a thought experiment: A test has a 5% false positive rate. What does that mean to an individual? This depends on the prevalence. If the background prevalence is 1/1000, this means that for every 50 positive tests, 49 are false positives.
Let’s apply these lessons to SARS2/COVID-19. The only conclusion that we can draw from the know data is that a small portion of paitents (about 3.5% depending on the study) will die with SAR2. Is SARS2 the cause, a co-morbid agent, or an innocent bystander. This is impossible to answer for the individual but we know that the death rate from SARS2 needs to be normalized against the background population, corrected for demographics and underlying disease. As the CDC is ascribing all deaths to SARS2 if SARS2 is detected, then by definition, it will overstate the virulence of the organism. We have more data. Generally speaking, the disease is more severe in the elderly, the obese, those who diabetes type 2 and those with hypertension. It is not clear if these are dependent or independent phenomenon, but it certainly allows an “at risk population to be defined. There are probably other risk factors (such as exposure to viral loads as is the case with essentially all other diseases and genetic predisposition to infection (such as occurs with Tinea versicolor).
Against the backdrop of the “at risk population” we have indiscriminately sequestered everyone. But nothing in life is free. There is a dramatic price to pay. People undergo severe financial strain, with a likely increase in suicide and domestic abuse; other medical care is delayed. And there is an underlying death rate due to other things (suicide, traffic accidents, overdose, other diseases).
Therefore the moral and ethical thing to do is to balance the deaths due to COVID-19 against the deaths due to all other things. This allows a certain perspective. Perhaps the best comparison is the intrinsic infection and death rate of influenza. The reason this is a good foil is that it allows perspective and perspective often leads to an entirely different conclusion.
I get your point but I respectfully disagree. We want accurate data. A person can die with the virus or from the virus. There is a distinction. Let’s look at prostate cancer. If one is old enough, and genetically a male, one will die with prostate cancer, as an innocent passenger. The person does not die from the prostate cancer. This is well recognized and well established in medicine.
Let’s look at the COVID-19 virus. We know that having the virus is insufficient to indicate that one has the disease. Establishing that one has the virus is a laboratory test. Establishing that one has the disease is a clinical assessment. The logic is having the virus is NECESSARY BUT NOT SUFFICIENT TO ESTABLISH that one has the disease.
This is a big problem in medicine in general. As an example: The heuristic in medicine is that if one has C. difficile and one has diarrhea, then C. difficile has caused the diarrhea. This was a very good heuristic prior to the advent of PCR. PCR has shown us that a large portion of the population carries C. difficile, including the toxin A/B without disease. The heuristic now changes to demonstration of C. difficile by PCR is necessary but not sufficient to establish C. difficile colitis. This requires clinical context. (PCR also revealed the hidden assumptions medicine was making with old laboratory technique. That technique only detected viable C. difficile in a large enough bloom to be recovered. PCR identifies minimal populations and makes no distinction whether they are viable or not viable.
The most vulnerable population is the frail elderly; especially if they have diabetes type 2, hypertension and obesity. It is not clear if these are all independent variables or different manifestations of same underlying process. There is a background death rate. That is, people will die from one or multiple causes. The overall death rate of the population is about 863/100,000 (0.8%), but the background death rate for the population over 85 is about 14500/100,0000; for 75-84 its about 4400/100,000; and for 65-74 is about 1100/1000,000).
The population over 65 is about 14% of the population. The current US population is 330,000,000. This is about 46,000,000. With an average death rate of 4.4%, this suggests about 2,200,000 in this cohort will die over a year. This is about 6000 a day.
Now there’s more. We don’t know how many are infected. We only know those who have been tested and especially those who are sick. This a form of bias of selection/survivor bias. By definition it will overstate the virulence of the organism as the denominator is artificially low. The virulence is the death rate/entire population infected, not the population tested. It’s just simple mathematics.
The difference in virulence may be dramatic. Here are some stats from New York City (now dated)
7000 deaths
240000 with evidence of virus.
1,100,000 viral free.
1,400,000 tested.
Population: ~8,000,000.
Note: because we are testing for the virus, we don’t know if someone has been infected but has now cleared the virus.
So using the above stats:
Virulence: 7/240=~3%.
But if we assume 15% of the viral free were infected at one time, the virulent is now 7/(240+150)=~1.7%.
But i we assume that 15% of the population was infected and is now viral free, the virulence is now 7/(240+ 1200) =0.5%.
About half the deaths are in the population over 65.
14% of NYC is above the age of 65; or 1120000 people.
If the intrinsic death rate is 4.4%, then this suggests that 49280 of those above 65 will die in a year.
This is about 135 per day.
Covid has been going on for about 30 days when these stats were published; or about 4000 deaths would have occurred without COVID-19.
This suggests that the true death rate is about 0.25%.
This needs to be compared to the flu. The death rate from the flu is estimated to be 0.1%. The death rate from Corona virus is estimated to be 0.25%. Slightly more deadly than the flu; but does it justify shutting down the economy with all the attendant risks?
I think we can agree that all life is precious.
I think we can agree that all life is equally precious.
If doing action A to save population A increases death rate in population B, then the action to save A needs to be carefully measured.
And we know from other stats that loss of financial viability leads to suicide, domestic violence and substance abuse.
So we do need to know the true virulence of the organism.
@ Path Coin
You are right that we don’t know the true death rate; but otherwise wrong. If cases of pneumonia and severe respiratory distress increase exponentially over a short period of time, there is a problem. If, for instance, where 10 cases a day become 100, hospitals do labs. If 10 are flu, etc.; but 90 are COVID-19, then we have a problem. And we have quite a bit of knowledge how the COVID-19 works and, though we haven’t done testing of population as well as we should, China has. Nations that implemented social distancing, e.g. Korea and Taiwan, have had far fewer deaths. The current death rate could be much much higher if those who are vulnerable were to be confronted with asymptomatic carriers. Imagine, if you will, that a highly contagious virus literally infected our entire population of 330 million, then 0.25% deaths would translate to approximately 8 million deaths. And currently by social distancing we are, to some extent, protecting the most vulnerable, e.g. seniors, especially with comorbidities. Of course, even a highly contagious virus is not likely to infect every single person; but not impossible. In addition, the death rate could actually go up as more and more who are vulnerable are exposed.
As for suicides, domestic violence, substance abuse, played up by right wing, no conclusive data even close to claims. Economics, yep; but this country has the resources to deal with this. Just one example, a multi-billion dollar tank that the military made clear it doesn’t want nor need; but our Congress and President prefer to enrich a few corporations than benefit the American people. And we could have contained this pandemic early on. Despite what people claim, we were warned, and Trump implemented a ban on Chinese visitors; but not screening nor stopping Americans returning from China, nor those coming from Europe. And we had preparations for dealing with a pandemic. California had eight strategically placed warehouses with portable hospitals, ventilators, masks, gowns, etc; but in 2008, after crash, got rid of because would have cost $6 million per year to maintain out of multi-billion dollar budget, penny wise pound foolish. And we have been cutting funding to WHO, CDC, State Health Departments, etc. And our for-profit health care system has cut number of beds and staff, used just-in-time purchases of medicines, etc.
So, first, one can’t be certain; but your approach poses a great risk. The 1918-19 flu pandemic came in 3 waves, the first was actually quite mild, almost no one died, most recovered in as little as 3 days; but then it came back with a vengeance. First, we really don’t know how many people are dying from COVID-19, not testing people who died at home, etc. So numbers could be much higher. Second, as I mentioned, if we ended social distancing, etc. the numbers could increase. Third, before we get our act in order, if we drop the ball, COVID-19 could return, as 1918 flu, with a vengeance.
And we have a President who is the least capable leader during my lifetime of almost 75 years and we have had a lot of Presidents, both parties, who I didn’t like. Trump’s first reaction was scare just to harm his re-election campaign. He actually dismissed White House Pandemic Preparation Group, dismissed most science advisors to various Cabinet posts and tells us he is an “intuitive genius.” Well, Einstein was a genius and I would bet had he been alive he would have deferred to experts in public health and Trump is NO GENIUS.
Bottom line, if we open up too soon, deaths may skyrocket, more workers, though they will survive, will become ill, and according to latest reports, this virus takes quite some time to recuperate from, so our health care system will collapse, taking care of COVID-19 and not others who could be helped, and our economy will take a dive anyway.
“population of 330 million, then 0.25% deaths would translate to approximately 8 million deaths”
Check your arithmetic.
@ rs
Oops! You’re right, should be 800,000. I don’t get much sleep and though 800,00 is much less than 8 million, it is still a lot of people whose lives would be shortened.
@Joel,
Also, for each death, ~10x the number of death are hospital cases occupying beds….
Alain
@ Alain
Yep, 10 beds for each death AND latest reports are that many survivors have up to 30% loss of lung function, heart damage, and damage to other organs and currently not known if permanent or not. So, 800,000 deaths and, perhaps several million with various degrees of disability?
But, as I pointed out, if we end distancing, not working, sheltering in place too soon, the numbers could potentially climb or drop; but when human life and well-being are at stake I prefer to err on the side of caution. If wrong, our economy will eventually recover; but if right number of dead and disabled will climb and economy will be hurt all the same.
That’s a terrible analogy in that it’s apples to oranges.
I don’t know where you got the idea that a positive test for the virus was being attributed as a COD; these are people who are clinically-ill with the disease.
Yes but again, your comparison is incorrect.
Too simplistic, let’s look at some numbers closer to the reality:
https://www.washingtonexaminer.com/opinion/in-a-normal-day-145-people-die-in-new-york-city-last-week-coronavirus-alone-killed-217-in-nyc-a-day
Again, no. Testing has not been adequate to accurately estimate virulence, prevalence or case-fatality. I’ve heard, anecdotally, that false-negatives were running about 30% in some places. I’ve had it and know that my test was done incorrectly. I would look at Germany for better numbers but the population and healthcare schemes are not quite comparable so I would suspect that the U.S. will come in worse.
No, it can’t be compared to influenza solely based upon your very wrong numbers. In most years, influenza doesn’t overwhelm hospitals; a substantial portion of the population has at least partial immunity due to past infection and/or vaccination effectiveness and the reproduction rate of influenza is likely much less than SARS-2. This is a novel virus ripping through a naive population; the point of shutdown is not to stop the virus, that can’t be done, but to slow the transmission rate so as not to overwhelm hospitals, give some breathing space for research treatments/vaccines and to a much lesser extent, see if the weather may have some affect on virus transmission. So, yes, there is justification for shutting things down for a short time.
WaPo just posted this helpful infographic: https://www.washingtonpost.com/outlook/2020/04/16/coronavirus-leading-cause-death/?arc404=true
@Science Mom, Joel, et al.
How do we fare in Quebec?
Basically, the politics done here is that, the health department is in charge of all the recommendation and our prime minister take each recommendation and put them into law and all the regions or townships are individually on lockdown.
Here’s the numbers: https://www.quebec.ca/en/health/health-issues/a-z/2019-coronavirus/situation-coronavirus-in-quebec/
Do keep in mind that most of the death are in retirement home and, at least one of them is under criminal investigation…
Alain
BTW, a motorcyclist wanted to take a ride out of Montreal, got intercepted by the police and was fined 1500$ plus fees for trespassing the confines and was ordered to return back.
That is how stringent they are here with public health recommendations.
Alain
@Alain
That is retarded. It is just about ‘respect muh authority’ getting dug down to the bottom of the barrel to anyone they can find to impose it upon. Why is not that that the traffic cop is staying at home? Saw it here myself today. Two state troopers at a speed trap when there is like 30 cars/hour going buy. Fucktarded tools!
There is no reason a guy out on a motorbike should have to have an interaction with a barking, spitting cop which is much more likely to be infected because he stops random people on the road and gets in their face.
Addendum
If you don the mask as the cop approach then he will just tell you to take it off — If you tell him that it might not be the the greatest idea to do that then he will taze you and charge you with bioterrorism after ripping it off your face.
@Tim,
Congratulation dude, you failed high school level 3…
The cops here have mandate to maintain the confines and also, respect other rules such as maintaining a safe distance with peoples (2 meters). Furthermore, the sooner we flatten the curve, the earlier we can restart the economy and progress our way out of the confines. The vast majority of the populace understand that.
Alain
@Alain
Canada must be nice (I know it is because I once watched Canadian Bacon), But here in ‘Merica, our cops are control freak stupid.;
Yep, cops, for the most part are nicer here; same with peoples in general.
Good night.
I have a midterm in 7 hours…
Alain
I think the world might be better served if you mounted a personal campaign to achieve Plateau Sigma, Mitzi.
@ Tim: Please do not use that word. It is a slur against people with intellectual disabilities and developmental delays. There are plenty of other ways of saying an idea is bad without using a slur against a whole group of people.
“identification of a pathogen in the laboratory is not the same thing as establishing the disease state caused by the pathogen”
But when that positive test for a particular disease was done on a patient with symptoms typical of that disease who then deteriorates and dies in a way typical of that disease, I think we can be pretty sure that person died of that disease. And, if the number of patients dying with pneumonia has increases above base rate, that is a pretty good indication that the new disease is causing those increased deaths. And when medical systems are suddenly being overwhelmed….
“Due to limitations of testing, only patients who presented with the symptoms of SARS2 were tested for SARS2″
That is incorrect. Whole cruise ship populations have been tested regardless of symptoms. Asymptomatic contacts of confirmed cases are also being tested. And, in many countries, everyone arriving back form overseas are being tested regardless of symptoms.
” without knowing the prevalence of the disease, one does not know the predictive power of a positive or negative result.”
You don’t need to know the prevalence to calculate the Positive Predictive Value (PPV = TP/(TP+FP) or the Negative Predictive value (NPV=TN/(TN+FN).
“Here is a thought experiment: A test has a 5% false positive rate. What does that mean to an individual? This depends on the prevalence. If the background prevalence is 1/1000, this means that for every 50 positive tests, 49 are false positives”
It also depends on the sensitivity or True Positive Rate. Although, in the case where the prevalence is 1/1000, it doesn’t make much difference and 50 false positives out of 51 positive tests is about right.
“As the CDC is ascribing all deaths to SARS2 if SARS2 is detected, then by definition, it will overstate the virulence of the organism”
Sure. They are also comparing “deaths at present” to “confirmed cases at present”, whereas they should be comparing “deaths 3 weeks ago” to “confirmed cases at present” because it takes an average of 3 weeks to die from the disease. This underestimates the mortality rate. And then there are all those minimally symptomatic and asymptomatic cases who don’t present and are not tested. This overestimates the mortality rate. Putting all this together, the true mortality rate, according to reliable sources, is likely to be between 0.5% and 1.0%.
“There is a dramatic price to pay. People undergo severe financial strain, with a likely increase in suicide and domestic abuse; other medical care is delayed”
Sure. That’s why most governments take into account both medical and economic factors and why, in most countries, there is not a complete lockdown but a phased lockdown till the number of cases plateau and are manageable within the hospital system, followed by a phased return to normal as the widespread testing and contact tracing is implemented to ensure the number of hospitalisations remain manageable.
Yea, my bad, JustaTech; In the future, I’ll try to catch myself and only refer to such individuals as ‘cops’, or ‘pigs’, or ‘our president-like’, or ‘my fellow inbred Alabamians’; ‘Short bus commuters’ is right out, of course.
Tim: Thank you for choosing to not use that word in the future. I know several people to whom it has been applied who were kind, caring, and far smarter in their own way than the person using the slur.
The “background population”? It’s a novel virus so unless you care to define “background population” as something other than what you imply, there is no “background population”. When someone dies with a covid-19 infection, that death is correctly ascribed to covid-19 whether there are underlying conditions or not; that information is collected to determine at risk groups. What you are suggesting is watering down the case-fatality rate and it’s wrong and unfortunately, what many around the globe are doing to keep their death rates lower.
There have been very high false negatives with PCR testing due to one of the tests having a lower sensitivity, add to that incorrect collection technique and shipping have increased the false negative rate. Massive proper testing and accurate reporting are how you determine the incidence/prevalence and case-fatality, not playing fast and loose with CODs.
Respectfully, I think blaming Oprah for these is a bit much. She may have made them popular, but they chose to say what they chose to say. She’s not their mother; she can’t wash their mouths out with soap.
I’m not any kind of an Oprah fan. I just think blaming a black woman on such fragile grounds isn’t the best look.
Oprah certainly does have a share of the blame. Both Dr Oz and Dr Phil were on her show repeatedly. She has subscribed to a fair bit of nonsense herself. And there is no way she couldn’t have known the ethical violations that caused Phil to surrender his license to practice psychology before it was taken from him.
She opened the door, and she must have known exactly who was walking through it. She is much too much in control not to.
Nonsense! Oprah is still an executive producer of “The Dr. Phil Show.” She created “The Dr. Oz Show” and was executive producer for a number of years. Her Harpo Studios co-produces the show with Sony Entertainment. She’s involved still. ???♂️
Oh, please. If it was only those two bad apples your argument might fly.
But Oprah is a serial offender: Oz, Phil, Chopra, Williamson, The Secret, McCarthy, John of God, a constant stream of “psychic” scammers, New Age grifters, and so on.
Either she sells this shit because she buys into it herself, or she sells it because there’s money in it. And frankly I don’t know which is worse. Either way, your weasel-mouthed sex- and race-card apologetics have been noted and filed accordingly.
Looks like Pfizer, king of vaccines, is okay with Oprah. https://www.forbes.com/sites/ninashapiro/2019/09/24/oprah-suffered-a-vaccine-preventable-illness-now-shes-promoting-vaccines/#283a6ba454fe
@Natalie White: Linked article doesn’t say what you imply it says. There’s a surprise.
“Respectfully, I think blaming Oprah for these is a bit much”
Not at all. IMO, it’s not a strong enough statement about her. Look at the string of vapid “experts” she pushed onto her show, from “dr” phil and oz-man to the clowns who pushed crap, to her one-sided pandering to anti-vacc and anti-science medical scammers.
She was never concerned with presenting anything useful, she was about jumping on the latest “alternative” wave to appeal to the fringe. In fact, she’s still not concerned with presenting anything factual or helpful.
In not-exactly-surprising news, a federal judge in Florida <a hre=”https://talkingpointsmemo.com/news/judge-issues-restraining-order-to-church-selling-bleach-as-covid-19-cure>has issued a restraining order against an organization calling itself the “Genesis II Church of Health and Healing”, who were selling MMS (AKA bleach) as a COVID-19 cure. The group in question are claiming that MMS is a religious sacrament, a move I find reminiscent of the bogus church in Miami that claimed marijuana as a sacrament while acting as a front for a drug smuggling operation.
Best statement so far.
Not me.
I linked to this article from Real Clear. They have the latest Covid 19 data and a column that compares to the 10 year annual average of flu deaths. Perspective is important to roust us from the panicked state where too many medical gurus are stumped except for expounding hypotheses on this or that.
We can normalize societal interactions with rapid testing, working therapeutics, and preventing ARDS and/or vital organ failure leading to death.
How are people dying? Covid 19 infects through the ACE2 receptor which is expressed in the lungs, heart, kidneys, liver, intestines, and arteries. Covid 19 disables ACE2 in some way and autopsies show the coagulation of capillaries in the lungs, heart, kidneys, etc. The IV & catheter sites showed coagulation issues in many cases.
HydroxyChloroquine is also an ACE2 inhibitor besides being prescribed in the last 60 years for malaria, lupus, and rheumatoid arthritis. Mounting anecdotal evidence demonstrates it is blocking further infection by Covid 19. Maybe it scrambles the ACE2 glycoprotein coding to keep Covid 19/SARS2 from hacking cells. It works though and opponents of its use have an “let them eat cake” and die attitude that boders on negligent homicide or manslaughter. Remdesivir has had some good results, but no one talks about how many folks given the placebo died. Europe is plagued by death panel decisions, but I think Americans seek a better alternative.
Those are some ways to prevent death.
How do doctors prevent ARDS and vital organ failure from capillaries coagulating? Previous research demonstrated that nebulized tPA mitigated ARDS restoring fibrinolysis balance and normal oxygenation. Recent use of tPA in hospitals treating Covid 19/SARS2 found a short term benefit from tPA (nebulized or IV?) supplemented with Heparin to maintain fibrinolysis balance to break up the clots in capillaries and maintain improved oxygenation and circulation.
If the tPA method continues to be successful, ventilator use with a poor success rate can be minimized and fatalities will fall in Covid 19/SARS2, influenza, and other ARDS cases.
One thing is certain in the last 5 months since the Wuhan coronavirus (Covid 19/SARS2) pandemic became known to the public and that is all the gurus of medicine & science have either lied or spewed many errant and ridiculous estimates.
We have rapid testing becoming readily available.
We have therapeutics that work in increasing numbers.
Lastly, the answer to mitigating ARDS and organ failure with the use of nebulized tPA, Heparin, and other blood thinning/clot busting compounds will minimize the need for ventilators and save thousands of lives, especially for our most vulnerable citizens.
“Let them eat cake” and die attitudes or death panels are not acceptable. Societal interaction, return to work, and better ability to confront illness will occur sooner than later…and that’s a good thing!
Regarding hydroxychloroquine, far from trending in the direction of a conclusion that this drug works, the evidence is very much trending in the direction of concluding that it does not work against COVID-19.
Hydroxychloroquine not only doesn’t appear to work, it appears likely to contribute to harm, including an increased risk of death
It’s now emerging that COVID-19 has cardiac complications. Hydroxychloroquine has a known risk of ventricular arrthymias.
At least one clinical trial of hydroxychloroquine has already been halted because of increased incidence of cardiac arrhythmias.
At this point, it would be dangerous (in my opinion) to administer an arrythmogenic drug to someone with a disease that affects cardiac function.
@ CJones1
Death panels in Europe? How does that differ from triaging in U.S. or when only a few ventilators and have to choose between two equally ill people, one 80 years old and one 30 with two kids?
As for spewing lies, various public statements were based on the best available knowledge at the time.
It would take too much time and wasted effort to go through each and every statement of yours; but the “death panels” I think says a lot about you.
So ‘death panels’ seems to be the go to phrase to slag off socialised medicine prevalent in Europe. There are times in the UK when a treatment is withheld from a patient by basically bureaucratic decision – your death panels. These are extremely rare cases and almost always involve very expensive and unproven (even quack) treatments sought by desparate terminal people – basically there is a limit to how much resource a patient can get for zero probable payback. These cases are also openly made decisions, in the public domain etc – at least they always get to the public domain pretty quickly. Of course there are issues with the NHS, but I’m always amused by comparisons with things like ‘waiting times for appointment’ againts the American system, since it seems clear that many people in America simply do not get some medical treatments because they cannot – putting their waiting times (their entire life!) and outcomes into the stats I suspect would alter them.
So yes, you can find a very small number of cases, very, very small like single digits per year perhaps, in the UK where you might call some decision of withholding treatment as being due to a ‘death panel’. Rare in the extreme,never palatable. In America you don’t need panels to wrestle with complex moral problems, you just, quite literaly. tell the uninsured, or underinsured, proportion of your population to ‘fuck off and die’ at the hospital door. I know which system I prefer.
“We have rapid testing becoming readily available.”
But, without swabs and reagents, which we don’t have in sufficient quantity, those tests are useless.
It’s dismaying that anyone thinks a Turk would have the best interests of any American at heart. Yes, that’s un-PC. So was the Armenian Genocide.
@ Spectator
The Armenian Genocide? A horrible even from 100 years ago. And, yep, they still deny it. So, how about American occupation of Philippines just a few years earlier, resulting in ca 200,000 deaths of mainly civilians, including one General who ordered killing of almost entire population of one island as revenge for deaths of a few American soldiers by those resisting our occupation. I could go on and on. How open have we been in admitting truly horrible actions on our part? There are good people in Turkey and bad people, just as in every nation, including ours. And there isn’t a nation on this planet whose history is without serious blemishes, ours especially. Read, for instance, Roxanne Dunbar-Ortiz book “An Indigenous Peoples’ History of the United States.
So, you are not just being un-PC; but just plain wrong.
Which Turk are talking about?
I just checked, and the two doctors were both born in USA.
The word you’re looking for isn’t “un-PC”, it’s “racist”.
Dr Oz has more faults than the Ring of Fire. There’s no need to stoop to racist statements to complain about him.
Whilst watching a montage of video from several anti-public health measure demonstrations on the news, I spotted the easily identifiable presence of anti-vaxxers with their misinforming signs like those from the V- for Vendetta cosplay extravaganzas: the locales included were Oklahoma, Maryland, Michigan, Orange County, CA and a few other places so I’m not sure which one included the anti-vax paraphernalia.
ALSO trending today on twitter Florida Morons with beach photos
“Florida Morons with beach photos”
It never sat right with me that beaches got closed. UV light, warm and humid sea breeze — should have been fine as long as swapping bodily fluids so proudly indiscriminate, collecting sand dollars or whatever passes for beads down there, would instead have kept it to baptist levels of not doing it with everyone everywhere out in the (not so much with such crowds) open.
But, what did they do? They did not stop the spring breakers from coming. No. They closed the beaches half way in and shoved them all into cramped hotel rooms. People need to be able to go outside, for walks, hiking, to the beaches. All they need be required to do is put on the mask when around others and, ohh, wash your hands which is quite easy to do under the bridge down by the river if one happens to have a bar of soap in his pocket.
All of the “reopen $statename” websites were registered on the same day.
https://old.reddit.com/r/maryland/comments/g3niq3/i_simply_cannot_believe_that_people_are/fnstpyl/
In other speculations,
https://news.ycombinator.com/item?id=22915660
Coming from a family of teachers, I’d like to kick Dr. Ooze square in the ass. And if he’s so concerned, why the hell isn’t he down in the Columbia Pres ER, doing useful things? Odds are, he knows, or used to know, how to place a central line, do a cutdown for an IV, maybe adjust a ventilator. How about a thoracentesis? There must be at least a handful of patients who might need it. There are a million and one ways he could make himself useful, and some of them may not even be beneath his dignity as a number one TV doctor.
He could even use his position as number one TV doctor (I’d take the Doctor or any of the cast of MASH, personally) to do some basic “stay at home” and “wash your hands” PSAs. Isn’t that something all surgeons are genuinely great at, hand-washing?
Now that I think of it, maybe Alan Alda could do a hand washing PSA. Oooh, even better, get lots of celebrities who’ve played TV doctors to do a “wash your hands and stay home” PSA. “I used to play a doctor on TV! Wash your hands, stay home, and listen to real doctors!” Goodness knows most of those actors don’t have anything else to do.
Some of the actors who were in CONTAGION did make positive PSAs urging people to pay attention to real doctors. The movie also had real doctors help make the technical details close to accurate.
Ohh! Ohh, God I can’t stop it; it is prolapsed and it is about to speak oh oh oh no.
Of course I meant maybe sialic acid receptors and its’ relationship with estrogen ohhh pblllllbahhh! Damn. And I’m not even out of toilet paper but I’m gonna leave the mess on my talking asshole anyways who is here to notice??
Umm. I seem to have replied to the wrong F68.10. I’m most dreadfully embarrassed, never mind.
As long as Denice is watching all that video, how about being a guinea pig and watching all the hour-and-a-half-plus of Vaxxed 2 for us and reporting back?*
I couldn’t stand more than brief snatches of it.
*if there’s been a previous review here, sorry I missed it.
O Dangerous One!
Actually, it was only a series of short clips on television news showing protests BUT…
I do observe a lot of woo-centric video and audio although I skip around quite a bit ( e.g. Del’s weekly festa stupido ) SO I’ll attempt this in the interest of science and scepticism.
Alright, I watched it for ONE HOUR, skipping around in order to catch all of the highlights (or low points dependent upon your perspective) it highly resembles the other propaganda.. I mean documentaries, I watched courtesy of Gary Null. Interestingly, many of the contributors ( seen and listed in the credits) are very familiar to me- both “experts” and anti-vax parents.
From my notes
— they set up their story how VAXXED was censored by the Tribeca Film Festival which led to its MASS acceptance by CROWDS at a NY theatre and other venues.
— parents’ stories are exactly what we’ve all heard – the child had no problems, was vaccinated- then BOOM! There is no outside verification of their stories. The “damages” go far beyond autism to many other symptoms.
— several unnamed doctors claim that they were not educated about vaccines. See Skeptical Raptor for a more realistic portrayal of medical education about vaccines
— they did a “study” themselves – all the respondents claimed that the first child was vaxxed, the second not: and the first was “damaged” and the second incredibly healthy.[ Realistically, an actual study of this concept ( Jain et al 2015) showed that unvaccinated younger siblings of kids with ASDs had the same rate of ASDs as vaccinated siblings of kids with ASDs ( 7%) and
that if the older sibling did not have ASD, the younger ones’ rates were identical ( 1%) whether they were vaccinated or not: : no one mentions that]
We do not see Kim Rossi’s unvaccinated younger daughter at all although Kim signed the bus.
— the usual suspects contribute mightily: Andy, Hooker, Del, Loe Fisher, Tenpenny, Humphries, RFK jr, Adams ( credits) and recognisable parent advocates.
The film is preaching to the choir, who all sing the same old tune.I didn’t see any creative imagery or musical choices- everything was standard including imagery of how severely disabled many children and adults are.
Polly Tommey probably made some money on this so I imagine she will dream up another project.
We thank you for your sacrifice.
I do not think I could take 10 minutes.
@ John Kane:
Honestly, it’s not that much of an imposition; I believe I am immune at this point. Knowing I can skim makes it much easier. It’s only when I see a time stamp of one hour plus when I need to look carefully to get accurate quotes that I hesitate and get distressed.
I am descended from generations of business people who probably had to tolerate a great deal of nonsense in order to make profits so maybe there might be something genetic helping me.
Please stop using Social Media to breed contempt and gain 5 minutes of fame. No one will ever know the true background of this and spreading additional junk onto the junk already out there is creating more serious outcomes. Keep your wonderful conclusions to yourself unless someone who actually cares asks for it. Dr. Oz is goofy. Dr. Phil pointing out the obvious discrepancies considered crazy and let’s bring Oprah in. How low do we go.
Go after CDC if you want answers. They just make “stuff” up and people believe it. They are lining their budget pockets for next year with all of this virus hype. Let me ask you this. If CDC is the “Center for Disease Control” how is it that they couldn’t control this “disease”. Do Not blame the politicians! CDC knew, trust me. Don’t be part of this problem. Please just stop !!!
“I do not consent. I do not comply.”
Given your idiotic rant, I couldn’t resist appropriating antivaccine statements.?
You first, Toonces.
You do PRAT on. “CDC knew, trust me.” And just why should we trust you? Are you an expert on infectious diseases, epidemiology, privy to information not available to the public, or believing rants by others equally uninformed but sure they are right. Oh well, PRAT ON!
Allison…….
It would be cruel to say more.
Quite fitting that your surname is “Pratt”.
I will ABSOLUTELY blame the politicians, especially the Tangerine Twit in the White House. He was warned months ago about the risks and waved them away. He denied there was an issue for MONTHS while things got worse. Now, he is trying to exploit the very situation he is largely responsible for causing and blaming others for the consequences of HIS blunders.
Some choice Prattle:
“No one will ever know the true background of this” And you say this because…?
“Dr. Phil pointing out the obvious discrepancies considered crazy” Dr. Phil is more often than not just a quack. His professional ethics are so bad he had to give up his license. He pontificates more than the last ten Popes. The so-called discrepancies he supposedly pointed out are irrelevant. Car accidents and swimming pool drownings are not contagious and most are preventable. We do take them seriously. There are laws, public service campaigns, etc. Of interest, the month just past was the first March since 2002 without a single school shooting. Where’s Phil’s concern for that? Or yours?
“They just make “stuff” up and people believe it.” This is just pig-ignorant. Maybe to you the CDC is a black box, but there are millions of Americans equipped to understand what they do.
“Let me ask you this. If CDC is the “Center for Disease Control” how is it that they couldn’t control this “disease”.” We have counter-terrorism agencies and task forces. How is it that we still have terrorism? (Note proper punctuation.) We have a National Highway Traffic Safety Agency. How come we still have auto accidents? Also, why the scare quotes? Do you have evidence that it’s not a disease, or a “disease”? Please tell us.
“Do Not blame the politicians!” Because a failed businessman and TV personality and a former radio blatherer who presided as governor over an entirely preventable HIV outbreak clearly know more about public health, epidemics, viruses, disease, medicine, and biology than a cadre of people who have studied and worked in these fields for decades.
“CDC knew, trust me.” I do trust you, just about as far as I can throw you.
That pain you’re feeling is called ‘learning’ – if you’re not careful it will cause a permanent change in your life, called ‘education’. If you want to avoid both learning and education, I suggest television – but you seem to know that already. But you don’t get to stand in the way of other people looking up from “Dr” Phil and seeing the real world.
“If CDC is the “Center for Disease Control” how is it that they couldn’t control this “disease”.”
Brilliant! (although it’s actually the Centers for Disease Control and Prevention).
Beyond the fact that we’re starting to see signs that this outbreak is coming under control, it’s an astute observation that every program and agency we have are not living up to their names. “Criminal justice system” when there are still criminals? Poverty programs that haven’t eliminated poverty? Social Media where people act antisocial? Everything is a failure!
Props to Denice for suffering through much of that video on our behalf. Reminds me of the original Dow Scrubbing Bubbles.
@ Dangerous Bacon
Should also mention that funding to CDC has been reduced and Trump intended to reduce it even more. And they are limited by what politicians allow them to do. Trump, being an “intuitive genius” doesn’t need the advice from experts. LOL
And this applies to criminal justice, poverty, etc. We will never eliminate crime; but we could reduce it significantly and we could eliminate poverty. Unfortunately, killing innocent people in developing nations, costing just this century over $5 trillion dollars does limit what we can spend on actually making this a better world.
On March 10, the president was still pushng for a cut in CDC and NHS funding.
https://thehill.com/policy/finance/486817-trump-budget-chief-holds-firm-on-cdc-cuts-amid-virus-outbreak
And when we had huge forest fires in California, Trump blamed it on us, though most were in FEDERAL FORESTS. And even if they weren’t, their immensity was unprecedented and the Federal government is supposedly there to help, just like it wasn’t with Hurricanes Katrina and Sandy. Oh well. Personally, I think West of the Sierra Nevadas, California, Oregon, and Washington State should secede from the United States. We would be among the richest economies in the world. We pay more in taxes than we benefit from the Feds, even including military bases. We could then join as equal partners in NAFTA, just as independent nations belong to EU.
As for his continued effort to cut funding to CDC and WHO, etc. well, of course, why do we need them? They may have “expertise” but Trump is an “intuitive genius” which, of course, TRUMPS expertise. LOL
And we also have “geniuses” like Natalie White to supplement Trump’s, so what more could one wish for???
If I had known people like Natalie White when I first entered college I would have studied music or the like, why waste my time learning epidemiology, infectious diseases, economics, logic, etc. when I could have turned to someone like Natalie White for advice and guidance??? I’m so glad she is allowed to post on Respectful Insolence ?????????????????
If the west coast states secede maybe the NE should join them. We can call it Bi-Coastia ( or Dos Costas?) it will also have money as well as seaside properties: states have economies larger than many countries in the EU. There used to be a chart showing how large CA, NY, NJ were : IIRC they were equivalent to GB, ( maybe) France and Italy.
I couldn’t find my original source but Wall St 24/7 updated compared the three states to India, Australia and Iran.
@ Denice Walter
Great idea. In fact, years ago when New York City was facing a massive deficit they requested federal help, which, I believe it was Reagan who refused. Turns out that Federal taxes from New York City much higher than Federal programs going to city. Yep, even during New Deal it was North East who supplied taxes that helped Southern States and it is Southern States that still want little government, low taxes, Trump, well, maybe we should just let them go and get exactly what they claim they want. I’ve found that people who claim they want lower taxes and less government actually mean they want to pay less taxes, don’t mind others paying to benefit them, and want government to leave them alone; but want to use government to force their values on others, e.g. crosses on public lands and against woman’s right to her own body. Hypocrites! ! !
Notice that in their responses to Covid-19, the coasts each formed coalitions to implement restrictions jointly- 3 states and 6 or 7 states. Illinois and nearby states also have their own group.
Other areas may do as they will. Freedom!
An epidemiologist discussed the folly of shutting down piecemeal.
Incidentally, I just read that Gregory Poland predicts that the second wave of Covid will be in the interior.
I just wish Pritzker would stop letting his daily press conferences run over into Jeopardy! We’re bored, and it’s your fault, Chubsy-Ubsy.
If the (for want of a better name) Great Lakes coalition teams up with the northeastern states coalition, it would cover the northern US from Minnesota to Massachusetts and as far south as Kentucky and Delaware. That’s a large chunk of the US; a mini-country within a country.
I hate to be pessimistic, but maybe this is the way the American Experiment ends.
There’s a famous ( imaginary) map of the “US of Canada” and “Jesus-land” (see Wikipedia). I think that it was inspired by the antics of George W. All of the liberal areas join Canada and the rest persists in their folly. Although some details have changed, it still captures the spirit of Trumpite policies.
I saw a thing where Larry Cook decided to rename his group from “Stop Mandatory Vaccination” to “Stop Mandatory Lockdown, Social Distancing, Masking, Testing, Tracking and Vaccination.”
When the anti-vax snowflakes whine that they can’t send their kids to school without certain vaccines (and it is not all available vaccines!) that they should start their own school that would be called the School for Special Snowflakes Who Hate Public Health.
And they should make sure to serve food that has not been refrigerated or properly cooked, and to definitely not provide any sinks or soap to wash hands. Just have an old fashion latrine pit next to the playground. A playground with all of the dangerous monkey bars, teeter totters, etc that is set in the parking lot.
Because they are all sadistic child haters who love to see kids suffer from high fevers, vomiting, diarrhea, seizures, etc.
Ugh, and entire phrase is missing: “I tell them that they should start their own school that would be called the School for Special Snowflakes Who Hate Public Health.”
I suggest that California, and western OR and WASH join Canada. We’d have NHS,then,too. We can call it Baja BC (I have relatives in Vancouver).
@ sandra marrujo
Canada has a superior health care system. Canada prides itself on multiculturalism. Canada has taken in exponentially more refugees on a per capita basis than the United States, not locking them up and separating children from parents. I actually lived in Canada for two years from 1968 – 1970 where I earned a masters degree in social psychology from Carleton University in Ottawa and have visited friends, unfortunately most past away now. Yep, while not a perfect society, compared to the United States far superior, even lower infant mortality and longer life-expectancy.
“I suggest that California, and western OR and WASH join Canada.”
New York and New England should do the same. We could be Quebec Sud, or Indocanada. As long as we don’t have to adopt Montrealer bagels, Jewish deli, or Montreal’s insane traffic system. As a downside, McGill would no longer be known as Canada’s Harvard.
Thanks anyway but we are rather large as it is.
“And when we had huge forest fires in California, Trump blamed it on us”
He tried to prevent it. He saw how the Finns rake their forests and wanted us to do the same. When he told us that he alone could fix things, he actually had Smokey the Bear in mind – “Only you can prevent forest fires”, showing that he understood he had responsibility along with everyone else. It was only an unfortunate slip of the tongue when he meant to say “Mexican rakists”, who were putting our own patriotic American rakists out of work.
I suppose you guys are lucky he didn’t misread it as the Finns raped their forests……
O Canada.
https://kutv.com/news/coronavirus/couple-who-bought-stores-entire-meat-section-and-bragged-about-it-now-living-in-fear
@ Dangerous Bacon
Really, one anecdote. So, compared to multiple such anecdotes in United States and probably additional ones in Canada what does that tell us about Canadian healthcare system, Canadian pride in multi-culturalism, etc??? I wonder if you are suffering from Oppositional Disorder of Childhood????
They just had a mass murder in Nova Scotia, a rare event in Canada; but sickos exist everywhere; however, compared to number murdered per capita in U.S. Canada is quite safe.
Ah, a moldy oldie.
^ Oh, and you should really consider your smarmy insult in light of the ICD-10, Authority Figure.
Jesus.
@ Narad
Nope, I didn’t look up ICD 10. Not necessary as, whether it is currently an acceptable diagnosis or not, it made the point that someone who just has to respond with an anecdote indicates possibly a need to be in opposition.
Though you sometimes actually contribute to the discussion, you also seem to have a need to respond with some trivial point of opposition. You are really tiresome.
Mirrors are your friends, Joel.
But all the same, you might find interest in this item, if you haven’t already encountered it (that’s not ‘efficacy’ as I understand it, viz., under ideal conditions, but whatever).
More Covid-19 denialism:
Right now ( Gary Null; PRN, 20 minutes in- continues/ audio will be available in a few hours on site**) Don’t trust doctors! They lie ( ” Everyone lies!” he says. Heh)
He spiels his own tripe and plays a recording of a doctor saying how death certificates LIE: they don’t list underlying conditions; the elderly person died of heart disease but doctors LIE and say COVID-19! People have multiple conditions that led to death but DOCTORS LIE! They don’t list OLD AGE as a cause. Doctors are told what to write.
Null will do an expose. ” The old and sick died”.”Students couldn’t get a thesis for a master’s or doctorate on this” ( How would he know?). ” Underlying diseases killed them”, not Covid 19. ” Pollution caused death of many, not corona”
My guess: he doesn’t know how to think or read..
-btw- Did he ever see a death certificate? Immediate cause and underlying conditions?
** there is also a shitload of video “lectures” on his site from his health retreat. Enjoy.
He’s channeling House, M.D.?
@ Narad
House, M.D. is one of my all time favorites along with Ali MacBeal.
Even if Covid-19 is just the final straw, it is still the cause of death.
Well, at least now I know where that nonsense came from. Information gets disconnected from the source and then it’s harder to recognize utter nonsense from an alt-med profiteer.
PRN is a woo-fraught hotbed of alt med fever dreams: although its hoary old host insists that their average listener is a 30-something female college graduate ( perhaps it is on one of the phone apps available), the people I hear with phone-in questions and see in videos of health are much older, many of them African American. Vulnerable people. Currently, he’s running a “de-aging” retreat/ “research study” at his Texas estate: the subjects are 70 and older! He discourages followers from using SBM and then presents “cures” for serious illness, falsely portraying himself as a researcher, professor, counsellor, innovator and investigative reporter who unveils the truth about medicine. He even documents his atrocities with videos of the subjects and his lectures.
As an aside:
I just heard about a Covid-19 death- my SO has an older friend whose brother still lived in the Old Country The gentleman was over 80 BUT prior to his illness, LIVED INDEPENDENTLY- and alone- in Madrid. Both brothers were artisans who hand made frames for paintings, much of their work is featured in museums, worldwide.
The death of anyone diminishes us all, but I think deaths like Margit Buchhalter Feldman are especially sad.
https://www.washingtonpost.com/nation/2020/04/17/holocaust-survivor-coronavirus/
And some stories encourage us.
https://jewishjournal.com/online/312950/101-year-old-holocaust-and-spanish-flu-survivor-beat-covid-19/
@ squirrelelite
Sisters die 102 years apart — one from the Spanish flu, the other from coronavirus
https://www.miamiherald.com/news/coronavirus/article242145151.html
Recent letter in NEJM: a New York hospital started doing universal screening (nasopharyngeal swabs) of patients in the L&D ward. The numbers are small, but about 14% were positive for SARS-CoV2, and almost 90% of those were asymptomatic.
https://www.nejm.org/doi/full/10.1056/NEJMc2009316
If you think the things our quacks are peddling are bad, read this:
https://www.economist.com/middle-east-and-africa/2020/04/18/desperate-iranians-are-getting-bad-medical-advice
Regarding Iranian quack remedies, does anyone know a good source for violet oil?
Perfume company? Whoever makes those violet candies (that I personally find disgusting, like licking my grandmother’s friend’s sofa)?
I hate to think how many violets you would have to pick, they’re so small. And at least here I think the season is over. Unless you can use African Violets? Or do they have to be European? (Insert airspeed velocity of an unladen swallow joke here.)
Reminds me of a time that I made ice cream using lavender from my downstairs neighbor’s garden and rose extract. It was… strong. Paired with the other one, which I don’t recall at the moment, though, it all got consumed.
JustaTech, you really have to read at least the first paragraph of the article, which you can do for free.
It made me think of something my mother used to invite people who pissed her off to do, the second half of which was, “…and tell me it smells like roses.”
Gary Null has competition or should I say Jim Bakker has competition?
Personally I am going with Urine and cow dung therapy . This, combined with garlic applied internally and externally has been working well. i am having no problem with physical distancing.
I can imagine that, but if loosing the sense of smell is one of the indicators one has Covid-19, you still might be in trouble.
The good thing about social distancing is that my general misanthropy is now a survival skill.
When I went for my (masked) run on Sunday I encountered a man carrying the most odoriferous bag of dog poo it has ever been my misfortune to smell. I don’t know what he or his partner had been feeding that golden retriever, but I gave them a 12 foot berth.
I’m not concerned about what Dr Phil or Oprah think. I’m certainly not worried about what the anti-vaxxer crowd is up to. I came to this site for some sanity. Dr Zubin Damanian, normally a great vaccination ally is publishing some very disturbing videos about how this whole thing is overblown. I can always count on Respectful Insolence, so thanks
“I came to this site for some sanity.”
“Big mistake, Indy! Big mistake!!!”
Paul Krugman, in today’s NYT:
He’s talking about ‘quack economists’ mainly, but broadening out to fake “experts” in climate denialism, and also… Dr Phil. Then, there’s this:
Krugman is also the guy who used to tell us how wonderful the V.A. medical system is and how it should be a model for the nation’s health care.
@ Dangerous Bacon
Actually reviews of VA health care have found it to be one of the best systems of health care in the U.S. Keep in mind that their patient load is composed of many with serious conditions. The bad publicity the VA has received is for three reasons:
Lying about wait times to be enrolled. In the Southwest their facilities and personnel not adequate for number of veterans. In older cities, they have more personnel, etc than needed. I won’t bother going into detail, except that as more and more move to Southwest, they need to re-dimension their structure, etc.
Denying veterans enrollment, e.g., telling a vet who served three tours of duty in Iraq and Afghanistan that he had a pre-existing condition. This is outrageous.
Psychiatric care was problematic and they have been improving.
Keep in mind that VAs in cities with medical schools also have doctors who are faculty and cooperation with the medical schools. My hometown of San Diego is a prime example, cooperation between VA hospital and UCSD Med School and several of doctors on UCSD Faculty work at VA hospital.
However, numerous studies have found that their overall level of care, including continuity of care and preventive medicine is quite good.
I won’t give a reference list; but one book tells the story of how they went from horrible deficient care to where they are today: Phillip Longman “Best Care Anywhere (3rd Edition).
See also: Phillip Longman (2014 Jun 3). VA Care: Still the Best Care Anywhere? Washington Monthly. Available at: https://washingtonmonthly.com/2014/06/03/va-care-still-the-best-care-anywhere/
“Where they are today” does not reflect well on the V.A. health care system. The Office of the Inspector General has continued to document grave deficiencies in the system, even as the mess involving delays in access to care has abated.
Recently the OIG documented large-scale falsification of blood pressure readings at two V.A. facilities. At the V.A. in Lexington, Kentucky they reviewed a series of 1,000 such readings and found that (curiously enough) 99.5% of them were recorded as 128/78. This was just below the threshold that would’ve triggered electronic notification to physicians for followup and potential treatment. Staying below that threshold also meant that providers could meet performance metrics and be eligible for bonuses.
At a Massachusetts V.A. facility the OIG discovered that multiple “sentinel events” resulting in patient deaths were not reported to the patient’s families as required.
You can find lots of depressing accounts like these that don’t get national publicity.
When single payer care is instituted, we can only hope that it is a vast improvement on the care veterans get through the V.A. and lacks the widespread misuse of/disappearance of funds allocated to health care spending.
*my own memories of med student and resident rotations at V.A.s are not of consistent high-quality care, though there were many individuals doing good work. The unofficial motto of the laboratory staff at one facility was “we’re out of here at 5 no matter what happens”.
@ Dangerous Bacon
Yep, incidents of substandard care at VAs, compared to what? We have a documented conservative estimate that 68,000 die because of lack of health insurance, 100s of thousands suffer unnecessarily, 75% of bankruptcies. We have over treatment and under treatment and delays.
I could give a number of references; but one book is well worth reading: Elizabeth Rosenthal’s “An American Sickness”. She documents in detail how our current system is designed for profit, not for patients. I thought I knew it all; but she documents far more horrors than even I was aware of and I’ve been following U.S. health care and international studies for more than 40 years. The second half of her book is not good as she then wants individuals to navigate the system (just improve the current system), ignoring that now 17 studies have shown that Medicare for All will save money, provide high quality care to all, etc. My local newspaper, for instance, has had several Editorials that give high estimate for cost of Medicare for All over 10 years. When I sent a letter-to-the-editor stating compared to what? Our current system that at same time will cost 50% more, they didn’t print it. Our mass media has interlocking boards of directors with members of boards from Health Insurance and Pharmaceutical Industry.
In any case, yep, VAs have problems; but overall they do as good or better job than our for-profit health care sector. I have lived in both Canada and Sweden, both superior health care systems to ours. And I keep in touch with colleagues there and keep up-to-date on what is happening. And there are anecdotes of poor care in each system; but compared to what? For every anecdote from Canada or Sweden I can find 100s if not 1000s from U.S. The best system possible will still have some people who don’t do their jobs.
You might also check out two papers I wrote, don’t deal with VA; but with Medicare for All:
Joel A. Harrison, PhD, MPH (2018 Aug 10). The Case for a Non-Profit Single-Payer Healthcare System. Physicians for a National Health Plan. Available at: http://pnhp.org/news/the-case-for-a-non-profit-single-payer-healthcare-system/
Joel A. Harrison, PhD, MPH (2008). Paying More, Getting Less: How much is the sick U.S. health care system costing you? Dollars&Sense. Available at: http://dollarsandsense.org/archives/2008/0508harrison.html
ADDENDUM
I belong to a local YMCA where several members are veterans. Over coffee they have discussed the health care they have received. In addition, in the past I’ve know several UCSD faculty members who also worked at local VA. Of course, these are also anecdotal.
You might check out National Committee for Quality Assurance, a non-profit formed by for-profit insurance companies over 30 years ago that evaluates health plans using HEDIS, look it up. Just one of several types of comparative evaluations. I don’t think the for-profits funding NCQA like that it often gives VA high marks and, actually Kaiser Permanente highest marks.
And if you read, for instance, Rosenthal’s book, yep, some people to get bonuses manipulate electronic records at some VAs; but take a look at what happens in our for-profit health care system. Neither is acceptable; but, on the whole, I would prefer VA to many of our for-profit healthcare plans.
And if we had Medicare for All, I would support maintaining the VA; but more focused on military-related problems.
Right, I read both articles, and I did not see political interference in health care addressed. The articles presented the only options as government-run single-payer vs US-style clusterf*ck. The third option is some form of non-single-payer universal health care, which seems to work very well for Switzerland, the Netherlands, Germany, Spain, usw.
As a transgender person and a person with a uterus, I look to the NHS as a cautionary tale of what can happen when conservative politicians take over health care. The Skeptical OB has detailed its failings for pregnant people, particularly PoC. It’s been well characterized how bad it is for transgender folk, with waiting lists of years to get care.
Although the Scandanavian countries are often held up as Great Success Stories of single-payer health care, they are hardly comparable to the US. They are affluent and highly homogenous racially and culturally, and very small in population.
I’m sure it would work pretty well for you. But given the Republicans’ ability to cling to power in the US, why would I want a system that allows them to control the health care we get?
Well in The Netherlands there are also waitinglists for transgender care.
Multiply “incidents of substandard care at VAs” as documented by the OIG by whatever factor to get the number of actual cases, then multiply again by the correct integer to get the amount of substandard care, inefficiency, fraud and waste we’d experience if the entire nation was gifted with the V.A. system.
That may be good enough for you; most of us (including the poor unfortunates with private health plans) would insist on far better.
@ Dangerous Bacon
As I wrote and you just don’t seem to get, compared to what? If our for-profit health care system, then I would prefer VA. Also, OIG doesn’t investigate private health care and, while substandard care to anyone unacceptable, question is how many cases compared to overall patient load, so . . . And the fact that OIG documents serious problems doesn’t mean all VA centers. No one should get substandard care, regardless of race, economic status, even legality of residence; but then we would be in a decent nation, not the U.S. Since I support Medicare for All, would prefer to live in Canada or Sweden, maybe in U.S. Mayo Clinic; but on the whole I don’t really like any health care in U.S. So keep harping on what’s wrong with VA; but, again, compared to what?
And criticizing Krugman because he likes VA health is just narrow-minded. He probably likes it in the same way I do, lesser of the evils and sometimes does give excellent preventive care and continuity of care. They were among the first to computerize medical records and after Hurricane Katrina, patients from New Orleans relocating to Houston, etc. to get care needed and medications immediately.
OIG reports highlight problems, not always strengths, which is both good and bad. I just skimmed some of OIG reports and I’ve seen similar problems and worse in private sector. So, had it not been for love of my family, I was happily living in Sweden and would still be there. I didn’t return to U.S. because I missed U.S.
Feel free to get in the last word and do read the book I recommended and my two articles. If you consider yourself open-minded.
@ Dangerous Bacon
If the entire nation was “gifted” with the VA system, everyone, perhaps except for the super rich and powerful, would experience the system and I rather doubt problems with substandard care would be allowed. As long as the system only serves a subgroup within our population, unfortunately, as in other areas of society, many Americans just could care less. We are a nation with, perhaps, the least sense of community among other technologically advanced modern democracies. And if we were all in the system, I doubt our mass media would ignore such problems.
This is also the problem with Medicaid. When it started it reimbursed doctors close to what Medicare did, etc.; but since it was not a universal system and a needs based system only covering a small part of the population, politicians could cut funding and coverage without a universal outcry. What is really interesting is that rural rednecks often are against Medicaid because it provides care to minorities, though many recipients are also white; but what they don’t understand is that it also subsidizes rural hospitals, which are closing down in record number. So, rural rednecks, as other prejudiced and ignorant people, are hurting themselves.
As long as many members of Congress are bought and paid for by the for-profit health care industry and as long as they get premier care, things won’t improve. Again, the VA suffers from covering only a minority of our population; but, on the whole, still provides good care, especially when considering that, on the whole, their patient load is many with serious conditions.
I know I’m entering this discussion late and at a random point, but I have a couple of anecdotal things to add.
Before becoming a PA I was a clerk at the Brooklyn VA Hospital for a few years. Most of the goofing off, grifting, and timeserving I observed was coming from the non-medical staff. The medical staff was on the whole very dedicated. House staff rotated from Downstate Medical Center and attending staff were on Downstate faculty. (In case you don’t know, Downstate is one of the NY State University’s medical schools, and is highly regarded.). I met my first PAs there and they were fine role models for the profession.
My father’s story comes in here too. He started going to the Northport VA long after he retired. He had excellent Medicare supplemental insurance from his union so never had thought of going. When he finally did go there, he got hearing aids at no cost, and they were very good ones. He got a disability pension he didn’t know he was eligible for, and was screened for the PTSD he didn’t think he had, but did, and those were without his having to ask. Northport has had it’s problems, and I wouldn’t minimize them, but once again caring staff was there, doing their jobs the way you’d want to see them done.
You know that acronym ROMEO (Retired Old Men Eating Out)?
In Joel’s case, it refers to Retired Old Men Endlessly Opining.
@ Dangerous Bacon
I suggest, you low life sack of . . ., that you do some research on the number of deaths and disabilities caused by medical errors in our for-profit healthcare system. The number of people who die or develop serious disabilities because of lack of health insurance or being underinsured. Then look at research on the number of unnecessary interventions done for profit. I looked at some of the OIG reports, for instance, a death at one VA hospital. As I said, not acceptable; but you can’t even admit that maybe, just maybe, despite everything that on the whole the VA system may be a good system. Just as, despite all the deaths and disabilities, unnecessary interventions, etc. in our sick for-profit system, that the odds are still that one can get decent to excellent care.
And I’ll bet you will NEVER read my two articles that I linked to, nor the book I referred to. So, this old man actually does his homework. So, A-hole, GO TO HELL!
I guess opinions coming from Porky Pig aren’t so dangerous after all.
@ Narad
Despite my age, I am on NO medications. As a regular blood donor, my BP is almost always below 120/70 and my total cholesterol below 175. Being in my mid 70s, I would be lots of people half my age would love to have my values. And my BMI is perfect, 23.
It is hard to cool down when, instead of civilly dialoguing, you use an ad hominem attack, a really stupid one at that, given that if you read my articles you might find out I am more capable than most in researching and putting together an argument.
Just to add a few more things. Studies have found that for-profit dialysis centers have up to 5 times the mortality and morbidity of non-profits and that for-profits hospitals have at least twice the morbidity and mortality of non-profits; but even non-profits don’t do as well as they could given our for-profit system with exorbitant drug prices, etc. And studies have found than some doctors prescribe choice of meds, not based on research; but affiliations with drug companies.
From Wikipedia:
Patients routinely rank the veterans system above the alternatives”, according to the American Customer Satisfaction Index. In 2008, the VHA got a satisfaction rating of 85 for inpatient treatment, compared with 77 for private hospitals. In the same report VHA outpatient care scored 3 points higher than for private hospitals.[38]
“As compared with the Medicare fee-for-service program, the VA performed significantly better on all 11 similar quality indicators for the period from 1997 through 1999. In 2000, the VA outperformed Medicare on 12 of 13 indicators.”[58]
A study that compared VHA with commercial managed care systems in their treatment of diabetes patients found that in all seven measures of quality, the VHA provided better care.[59]
A RAND Corporation study in 2004 concluded that the VHA outperforms all other sectors of American health care in 294 measures of quality. Patients from the VHA scored significantly higher for adjusted overall quality, chronic disease care, and preventive care, but not for acute care.[36]
A 2009 Congressional Budget Office report on the VHA found that “the care provided to VHA patients compares favorably with that provided to non-VHA patients in terms of compliance with widely recognized clinical guidelines — particularly those that VHA has emphasized in its internal performance measurement system. Such research is complicated by the fact that most users of VHA’s services receive at least part of their care from outside providers.”[20]
A Harvard Medical School-led study shows that cancer care provided by the Veterans Health Administration for men 65 years and older is at least as good as, and by some measures better than, Medicare-funded fee-for-service care obtained through the private sector.[60]
And I repeat, VA enrollees represent a higher rate of morbidities, etc.
The VA has 348,389 employees.
From Department of Veterans Affairs Statistics at a Glance
1,221 Outpatient Clinics
300 Vet Centers
144 Hospitals
Total enrollees 9 million
If the OIG was to carry out the same type of investigations in our private for-profit health care system, I am fairly confident that the numbers per capita would exceed by far any problems with the VA. Doesn’t mean I accept any of the problems that have been found. As I wrote, something you didn’t respond to, if all were in a VA type system, then such problems would not be allowed to continue, same with a Medicare for All system. However, if I were a wounded soldier, I would greatly prefer being French, Swedish, Canadian, all providing better care. In U.S. we have GOFUNDME appeals, but not just for veterans; but for many Americans. As the title of Elizabeth Rosenthal’s book says it all: An American Sickness. I again suggest you read it and my two articles.
So, your take on the VA is wrong, not because they don’t have problems, not because these problems are totally wrong; but because you single them out, ignoring that, despite what you choose to believe, that for most, they provide as good or better care than our sick for-profit health care system, that, in fact, polls show they rank high in satisfaction. But, don’t even try to be open-minded, just point out my age.
Oops! My response, starting with “despite my age” was to Dangerous Bacon, not Narad.
I’m not sure whether to go for the watermelon scene in Buckaroo Banzai or John Whorfin’s final scene to wrap this up.
Probably should let him cool down a tad; we don’t want to risk a major BP elevation.*
*although at the Lexington V.A. it would probably be measured at only 128/78. 🙂
What are your thoughts about Dr. Sanjay Gupta? He seems credible.
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