Tuesday, June 30, 2020

Coronavirus and the Russian bounty scandal dominate the news

 If you internalize one thing, make it this. The ramifications of screwing up on coronavirus take weeks before you see it. That’s what makes the response in AZ, TX, FL and other “open up now” states so deadly, and so imperative to act now.
With Trump leading the way, America’s coronavirus failures exposed by record surge in new infections
President Trump — who has repeatedly downplayed the virus, sidelined experts and misled Americans about its dangers and potential cures — now finds his presidency wracked by an inability to shepherd the country through its worst public health calamity in a century. The dysfunction that has long characterized Trump’s White House has been particularly ill-suited for a viral outbreak that requires precision, focus and steady leadership, according to public health experts, administration officials and lawmakers from both parties.
As case numbers began rising again, Trump has held rallies defying public health guidelines, mused about slowing down testing for the virus, criticized people wearing masks and embraced the racially offensive “kung flu” nickname for a disease that has killed at least 123,000 Americans.
A similarly garbled message for the country has also been put forward by the president’s top aides and other senior administration officials, who contradict one another on a daily basis. On Friday, Vice President Pence used the first White House coronavirus task force briefing in almost two months to praise Trump’s handling of the virus and cast aside concerns about a record spike in new infections.



Trump campaign scrambling to revive the president’s imperiled reelection bid
Trump’s advisers and allies have grown frustrated with some of the president’s incendiary and divisive behavior and comments in recent weeks and are dismayed by the polls, including some of their own internal surveys that also show him losing to Biden. The president also came under fire for a June 20 rally in Tulsa that failed to attract much of a crowd even as the campaign downplayed coronavirus distancing guidelines.
But many Trump allies remain deeply skeptical of the public polling — pointing to 2016 polls in key states that underestimated Trump’s support — and say the internal polling and modeling that they’re sharing with the president is less grim than the public surveys. Multiple campaign and Republican officials also asserted that they have seen no serious erosion in Trump’s political base.
They’re lying to themselves, a very bad place to be in a campaign. Still , it isn’t the vs Biden poll numbers that make me think Trump is a one term president, it’s this:
The virus is getting worse as we speak, and no happy talk will make it go away.
NY Times:

Biden Criticizes Trump Over Intelligence on Russian Bounties on U.S. Troops
The White House denied that President Trump was briefed on the classified assessment, even though his staff has been discussing the matter since March.
Another said it was included in the President’s Daily Brief, a written document which draws from spywork to make analytic predictions about longstanding adversaries, unfolding plots and emerging crises around the world. The briefing document is given to the president to read and they serve as the basis for oral briefings to him several times a week…
American officials reached on Saturday said it strained credulity to think that White House national-security officials would be discussing such an important matter for months and even brief British officials about it and never provide the information to Mr. Trump.
This is a rolling international scandal, building steam. From this morning:
  • WaPo: Russian bounties to Taliban-linked militants resulted in deaths of U.S. troops, according to intelligence assessments
  • NY Times: Spies and Commandos Warned Months Ago of Russian Bounties on U.S. Troops
Scott Duke Harris/USA Today:
Coronavirus: From my view in Hong Kong, American reluctance to wear a mask is suicidal
President Trump and many Americans are against wearing face masks, but Hong Kong proves that face masks actually do prevent the spread of coronavirus
To mask or not to mask... That’s still the question? Seriously?
It shouldn’t be, not when a lethal virus might be a sneeze, a cough, or simply a breath away. Not when the pandemic has killed nearly a half-million people worldwide, including more than 124,000 in the United States — and several states are spiking.
People here in Hong Kong understand this and wonder: Why, after so much misery, are millions of Americans so clueless?
Do not buy in to the ‘herd immunity’ anti-vaxx scam being pushed on social media. It generally starts with an argument that things are going better than the experts say, that the death rates are really lower than anyone expected (as if it’s not bad enough as is), that it’s younger patients so we’re safe,  and (if you push them) that we have to open up, regardless.
But once you realize that consequences roll out over weeks (the seeds of today were planted Memorial Day) and look at what’s happening in slow motion in the hard hit states, the argument falls apart.
Let me give you three excellent twitter threads to put the coronavirus in perspective.
Andy SlavittEx-Obama health care head:
I hate to sound like one of those “elite intellectual” types but if state governors don’t learn to understand (or remember from 2 months ago but whatever) what a time lag is between cases & hospitalizations & deaths we will keep repeating second grade over and over. 
Recent news— massive growth of cases, increased hospitalizations— is not the result of today’s action. It is a result [of] actions in May.
DeSantis said the spike in cases has “nothing, nothing” to do with the reopening. (I think his explanation was “goblins” or “magic fairies.”) But definitely not him.

He and others fail to understand time
Vice President Pence, forced out of his “I know nothing” slumber yesterday was forced to have a media session on the “Task Force” came out, took a bow, and praised how well things were going.

Also not much for telling time.
He insisted that deaths were still not increasing. Again I can’t stress enough the concept of a time lag is a difficult one.
There is no way that an increase in cases of this magnitude won’t lead to more deaths than we see now. But it will take 4-6 weeks to see it. Counting daily death reports from today vs yesterday vs last week misses the point right now. Look at the hospitalizations.
Bob WachterChair, UCSF Dept of Medicine:
This week, it felt like we entered a new phase of Covid. In March & April, we had panic, lockdowns, and surges… in certain places. The next phase (May-early June) saw cases & deaths plateau, we began opening up…and the seeds of complacency.
And now we’ve entered another phase, with major surges in places that were spared the first time around. Given all we’ve learned in the past few months, it’s all very predictable, and it was at least partly preventable – which makes it especially sad.
Predictable, because the best evidence says that the virus’s essential characteristics – its ease of transmission and virulence – are unchanged. And, unless you’re living in New York (where 15-20% of people have antibodies), the virus's targets – namely, us – are the same too.
Tom InglesbyDirector of Johns Hopkins Center for Health Security:
Governors in states where COVID hospitalizations are consistently rising, COVID ICU rates increasing, diagnostic test positivity going up, need to shift policy. Full reopening happened too quickly and without recognizing that some reopening decisions posed too much risk.
If they haven’t already, governors in those states should suspend large indoor gatherings – whether casinos, large indoor restaurants, bars, conventions, entertainment venues, indoor churches etc – and explain to public the high risk of getting COVID in those settings.
Governors should make clear that more informal large gatherings like large parties, have been the site of big outbreaks, and so they are places where risk is high of spread. The public should be aware of those risks and make personal decisions to avoid large gatherings….
Federal leaders shouldn't say things going well when they aren’t. Undermines credibility of federal response and is confusing to the public. With highest daily national numbers, highest daily numbers in many states with increasing hosp rates, things are not going well.
Political leaders shouldn't hold large gatherings, like rallies or conventions. We've too much disease spread in the country for those now. It poses risk for attendees. Attendees that get COVID in those events then pose risks to their families and coworkers and others.
Federal leaders need to hear -- from local leaders and hospitals that are saying it – that PPE supplies are still fragile in some places in the country. We need more public data and dashboards to be able to gauge PPE supply. Fed agencies need plans to respond to shortages.
State, local political leaders should support and commend the work of their public health teams. Pub health officials in some places have been scapegoated by the public or their own political leaders. Our response will suffer badly without the best talent in public health.
Nsikan Akpan/Nat Geo:
Here's how to stop the virus from winning
Case surges, overrun hospitals, and a second lockdown this summer could deal a heavy blow to the United States. Here's what we need to turn the tide.
“We are quickly reaching that critical level of capacity in ICU beds and ventilators in hospitals in the worst-hit areas,” says Purnima Madhivanan, an infectious disease epidemiologist and associate professor at the University of Arizona in Tucson. “Right now, I think the only thing we can think about is at least starting with harm reduction.”
Harm reduction refers to public health tools and practices—such as needle exchange programs or safe sex with condoms—meant to lessen danger rather than expecting universal compliance to rigid guidance. This approach acknowledges that risk levels vary by person and setting, and solutions should be tailored for those individual scenarios.
With the coronavirus, harm reduction techniques include convincing people to wear masks for the riskiest scenarios, such as crowded spaces, but relaxing those guidelines in places where people can stay at safe distances, such as parks. These approaches can go beyond decisions made by individuals, and the principles have already guided some nations and states, including New Zealand, South Korea, and New York State, toward successfully beating back the coronavirus.
Face shields vs cloth masks: no studies, but at least one epidemiologist is a strong proponent based on large particle spread (and/but read the comments).
In a medical setting it’s face shield + surgical mask. In a social setting, something is better than nothing but not as good as closing down the bars. CDC recommends cloth masks “in public settings where other social distancing measures are difficult to maintain (e.g., grocery stores and pharmacies) especially in areas of significant community-based transmission” and is silent on face shields.
Keep in mind these recommendations change as newer information becomes available, and CDC is sloooooooooow to change their mind.
Take a moment for the good news:
The Flag is Coming Down’: Lawmakers Vote to Change Mississippi State Flag
In a historic vote today, large majorities in both houses of the Mississippi Legislature voted to move forward on an effort to retire and replace the Confederate-themed Mississippi State Flag.
Sen. Barbara Blackmon, a Black Democrat from Jackson, spoke on the Senate floor this afternoon, recounting the times in history that moved her to tears—the assassinations of John F. Kennedy, Martin Luther King Jr. and John F. Kennedy; Tiger Woods’ 1997 Masters’ Tournament Victory; and the ascendance of America’s first Black president. She cried, she said, “because those moments were historical, just as the vote to change this flag is historical.”
Blackmon recalled tears turning into icicles on her face one frosty cold January day in Washington, D.C., as she watched Barack Obama take the oath of office.
“Just as I thought I would never live to see a Barack Obama, I thought I would never live to see this flag come down,” she said.
Want some election stories?
Why Biden’s Lead Is Safer Than Clinton’s
Trump won in 2016 because voters didn’t like his opponent. That’s no longer true.
Former Vice President Joe Biden is thumping President Donald Trump in the polls. As of Friday, Biden led Trump by 10 percentage points in the RealClearPolitics national average and by six to nine points in each of four key states: Florida, Michigan, Pennsylvania, and Wisconsin. But many Democrats refuse to trust these numbers. They feel burned by 2016, when Hillary Clinton lost after leading in the polls for months. They’re afraid Trump will come back again.
That could happen. But it probably won’t, and one reason is that Biden isn’t Clinton. You can argue that public antipathy toward Clinton was sexist, based on lies, or propelled by the media. But that antipathy was a fact, and polls consistently documented it. Now polls are showing something else: On identical questions, posed by the same pollsters at the same stage of the campaign, Biden is doing far better than Clinton did. He’s more broadly liked and less broadly disliked than she was.
Candidates who recover from Trump-like deficits are rarely incumbents
The polls are fairly unanimous: Former Vice President Joe Biden holds a significant advantage over President Donald Trump. On average, he's up by 10 points nationally and in the pivotal battleground state of Wisconsin.
There is time for Trump to mount a comeback, but the candidates who do come back are usually not incumbents and have never been elected incumbents in the polling era.
Since 1940, the only incumbent losing at this point in the cycle who would go on to win another term was Harry Truman. He, like Trump, was down around 10 points to Thomas Dewey in the early summer of 1948. But remember, Truman was not elected president before taking the 1948 election. He ascended to the office through the vice-presidency, after Franklin Roosevelt died in 1945.
In terms of elected incumbents, Jimmy Carter was the one to be down by as much as Trump is right now. Carter went on to get crushed by Ronald Reagan in 1980.

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