Sunday, August 29, 2021

Politics and the Pandemic - Progress Denied

Over the course of this pandemic, we have learned a lot about the country, our leaders and ourselves – and not all of it has been good.  One thing we have learned is that anything can be politicized.  Will anyone be shocked, for example, if a protest movement develops demanding that that Mother’s Day either be abolished or renamed?  

Overall, Governor Mike DeWine has provided sober guidance and directives here in Ohio.  I think that his performance during the pandemic will be an important reason why he will be reelected in 2022.  Interestingly, although he is a bonafide conservative, he will face primary threats from the right in a state that Trump handily won in the past 2 presidential elections.  As we all have learned in November 2016, anything can happen.

But, DeWine, like every other political leader considered the political impact of public health decisions.


Governor DeWine Understands the Pandemic and Politics.

In April 2020, he issued a mask mandate for customers and employees in newly opened retail establishments and businesses.  The slogan was ‘no mask, no work, no service, no exception.’  The governor issued this recommendation after consulting with public health experts.  Although I have only rudimentary public health knowledge, this measure seemed very rationale to me. 

What a difference a day makes.  Within 24 hours, the governor did a political back flip and reversed the requirement that customers must be masked.  This abrupt U-turn resulted after howls of protest from mask opponents.  The public health facts certainly didn’t change, but the politics did. 

We have seen repeatedly our political leaders caving to serve political concerns. I am not suggesting that public health experts are the only ones wearing white hats.  Because their mission is to protect the entire population, I think some of them have been overzealous to protect the public at the expense of our economic health, the education of our kids and mental health consequences of mitigation strategies.  It’s easier to recommend that someone else lose his job to serve the greater good.  It’s easier to support extending the eviction moratorium if you are not a landlord.   It’s easier for teachers to support cancelling classroom learning for ‘safety’s sake, than it is for parents who must quit their jobs so that they can become homeschool teachers. 

I don’t claim to know where to establish the balance between public health protection and society’s other needs.  Of course, this is not a mathematical query that has a single correct solution.  Experts will disagree as they face a moving target with insufficient data.  But, had politics been stripped from the process, then we would be a lot farther along than we are now. 

 

  

Sunday, August 22, 2021

Biden Botches Afghanistan - Where Does the Buck Stop?

 We have all witnessed the debacle from our clumsy and precipitous withdrawal of our military from Afghanistan.  The humanitarian and moral disaster was as astonishing as it was avoidable.  Not only do our allies and our adversaries correctly point out our incompetence, but so do members of the the president’s own political party and administration.  Perhaps, this is an issue that might unite the Democrats and the GOP. 

Indeed, the record contradicts President Biden’s claim that no military experts warned him that his plan risked chaos and catastrophe.  All of us certainly heard the president reassure us only weeks ago that the Taliban were unlikely to prevail in the short term and there would certainly not be a ‘Saigon moment’, recalling an iconic and humiliating scene from 1975.

The president also claimed that he was handcuffed to withdraw troops as he needed to honor the prior agreement between the Taliban and the former administration.  This is malarkey!  First of all, President Biden already broke the prior deal by extending the withdrawal deadline from May 1st to August 31st.  And Biden’s fidelity to Trump’s Taliban agreement seems inconsistent as he readily and enthusiastically reversed many other Trump actions with regard to the Paris Climate Agreement, the World Health Organization and the Iran nuclear deal. 

Of course, the president and his minions tried to deflect by arguing that we needed to extricate ourselves from this ‘forever war’, a point that most of us agreed with but was not the actual point. The withdrawal was botched even if the strategy to disengage was sound.

We also heard the president argue that he didn’t want a 5th president to inherit this war as if the next presidential election were only days away. 



'Joe, take a lesson from Harry.'

But, here’s the point of this post.  I find Biden’s reaction and explanation to this colossal failure to be deeply disappointing and contrary to his repeated pledge to be straight with us.  In his initial explanation to the nation on 8/16/2021, he stated that ‘the buck stops with me’, while his remarks were largely devoted to blaming everyone else (except the Taliban) for what transpired.  And during subsequent remarks and interviews, he continued to deny any personal responsibility.  We didn’t even hear the typical passive voice construction that ‘mistakes were made’. 

While it may have been painful and difficult, the president should have admitted to what we all saw with our own eyes.  And in the same speech, he would promise to do all he could to make the situation right.  Isn't this what we try to teach to our kids?

Not only would such a course be the right thing to do, but it would also serve the president’s interest.  It would reinforce to all of us that his promise to give it to us straight is still true.

 

 

Sunday, August 15, 2021

How Much Do You Know About Covid? Test Your Knowledge!

 There isn’t a person, a pet or a plant in this country who is not aware of COVID-19.  With regret, but not surprisingly, the pandemic has struck back as it successfully targets the unvaccinated community.  We have to hope that this outbreak will be the last gasp of the pandemic and not that of many ailing Americans.

The nation has been deluged with information, misinformation and disinformation.  We confront facts and alternative facts.  Even legitimate public health experts are not consistently singing from the same hymnal.

So, I thought this was an apt opportunity to test your knowledge on the novel coronavirus with ten True or False questions – no multiple choice or essay.  What could be easier?  And there is no penalty for guessing.  Answers appear at the foot of this post. 

Good luck.  Let the games begin.



How Much Do You Know?

 

The Delta variant is so named since this strain was brought in from overseas by a Delta airline pilot.

CNN, a leading cable news station, stands for Coronavirus News Network.

Masks offer superior protection than vaccines since they directly block virus from entering the respiratory passages. 

Employees cannot be legally required to get vaccinated against COVID-19.

An employer who asks if an employee has been vaccinated against COVID-19 has violated HIPAA rules and risks government sanctions.

The two-shot Moderna and Pfizer vaccines are twice as effective as the one-shot Johnson and Johnson vaccine.

‘Long Covid’ is caused by a long sausage shaped virus rather than the typical spherical viral particle.

The N-95 mask gets its name from Lab 95 at the National Institutes of Health where the mask was designed. 

A newly described Baldo variant has no spikes on the viral surface and can therefore slide more easily into the lungs. 

Vigorous handwashing with designated soap and very warm water kills the COVID-19 virus. 


I hope that you found this quiz to be enlightening and amusing.  Feel free to share the post with family and friends who might enjoy this diversionary challenge. 

The answer key?  The correct answer to every question is False!

 

Sunday, August 8, 2021

How Do We Reach Herd Immunity Against COVID-19?

Last week I conjectured that the Center for Disease Control and Prevention (CDC) obfuscated when they recently recommended that vaccinated individuals resume indoor masking under certain circumstances.  My speculation was that the policy was justified but that the CDC was not forthcoming in explaining the rationale for the policy revision.

The revised re-masking recommendation, as with every other aspect in this pandemic, has only further polarized a nation that seems to be trying very hard not to heal itself literally and politically.  I predict that our collective political affliction will long outlast the coronavirus plague. 

I routinely ask patients if they have received the COVID-19 vaccine.  Recently, a patient replied that has not received one.  I asked what his concerns were and he firmly responded that he would never get vaccinated against the coronavirus.  Not much space for dialogue here.

The CDC and public health experts admit that masks are not the antidote.  The shortest and surest pathway to the other side is for the unvaccinated to vax up. The government hasn’t yet figured out a strategy of how to get this done.


Trying to Crack the Herd Immunity Code


Here are 3 options.

Educate the public so they will voluntarily accept the vaccine to protect themselves and rest of us. Highlight the rather incredible safety and efficacy statistics.  Begging, pleading and downright bribing may be incorporated into this policy.   This has been our current policy which thus far has failed rather spectacularly.

Mandate vaccinations for every eligible person, either immediately or when official Food and Drug Administration (FDA) approval for the vaccines is granted, which is anticipated in the near term.  While you might be tempted to choose this option with zeal and enthusiasm, you may wish to consider what may follow the vaccination edict.  One of the pandemic’s lessons is that Americans, unlike many other countries, are individualists who are not swayed by serving the greater good.  A mandate would fuel protests and refusals to succumb to governmental tyranny.  Politicians and candidates would pander to this aggrieved group which might serve to elect and re-elect anti-vaxxer officials.  The nation might end up being further divided and not much closer to herd immunity. 

Discomfit the unvaccinated sufficiently such that the voluntarily accept the vaccine.  If concert venues, airlines, restaurants, public transportation, hotels, employers and retail establishments increasing required proof of vaccination for entry, it might serve to induce vaccination compliance.

What have I left out here?  What would you suggest?  Give it a shot. 

 

Sunday, August 1, 2021

CDC Reverses Indoor Mask Policy - Are We Getting the Whole Truth?

Depending upon your politics, the Center for Disease Control and Prevention (CDC) has either shamelessly reversed course or simply issued a new guideline in response to new medical evidence. Indeed, many are hostile to the agency’s recent 'new & improved' recommendation that those who have been vaccinated against COVID-19 mask up when indoors in regions where the Delta variant is highly prevalent. The dissenters point out that this directly contradicts very recent CDC and public health expert advice that clearly stated that those vaccinated could be safely liberated from their face masks.  In fact, this demasking was offered as a direct incentive to those who remained hesitant to roll up their sleeves.  The CDC and its supporters maintain that their new policy on masking the vaccinated is based on a sound review of recent data, which they tarried in releasing. 

I am a rationalist who practices gastroenterology guided by medical evidence.  Despite some missteps, I have largely supported the CDC and have heeded and disseminated their advice.  But, in this instance, I don’t think they are being straight with us.



Making a comeback!

Here are some facts. The vaccines are performing very well including protecting against the Delta variant.  The overwhelming majority of COVID-19 cases, hospitalizations and deaths are occurring in those who have not been vaccinated.  It is within this population – not among the vaccinated – where the pandemic now lives.

We also know that ‘breakthrough infections’ in vaccinated individual is extremely rare, a fact that the CDC admits.  For example, breakthrough rate is estimated to be 0.098% for symptomatic infections, in other words, very close to zero.  The CDC now argues for vaccinated folks to mask up to prevent them from transmitting the virus if they become infected, although this seems like overkill considering that the breakthrough rate is about zero.  What is the quality of evidence that suggests that the few infected vaccinated individuals can transmit the infection?  What does make sense, of course, is for unvaccinated folks to don a mask since this is how the disease is being perpetuated. 

Since there is no way to enforce the more rational strategy that unvaccinated people wear a mask indoors, the CDC is asking all of us to do so in order to capture the unvaccinated within the new policy.  Otherwise, how could a retail store, for example, know that some unmasked customers were vaccinated or not?  They couldn’t.  In my view, the CDC has unnecessarily rolled the vaccinated into the new mask group to eliminate this conundrum.  If all of us are masked, then we know that the unvaccinated are also masked.  If I am correct about the CDC’s motives and strategy, shouldn’t they have told us the truth rather than exaggerate and mislead us about how dangerous vaccinated individuals might be?  It’s the CDC’s explanation that needs to be unmasked.

And masks won’t end the pandemic anyway.  This is a half measure at best.  The right approach is to increase vaccination rates and I anticipate that the government, employers, schools and others will be leaning hard in this direction in the near term. 

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