When Justice Powell retired, the search began for a suitably conservative justice. Bork's name had always been in the running but he had been passed over numerous times in favor of O'Connor, Rehnquist, and Scalia. Bork was unhappy dealing with purely administrative law issues on the Appeals Court for the DC circuit, the traditional stepping stone for Supreme Court justices, but he had always desired to be on the court. The only one that really counted if one wanted to have a substantial impact on the law and society. And he had an agenda.
The Democrats had taken the majority in the Senate in 1986, but many of those Democrats were hardly liberal. Bork never knew what hit him. The result, of course, was the seating of Anthony Kennedy who turned out to be about as conservative, with some exceptions, as they had hoped Bork would be. Bork, according to one conservative commentator, was a political neophyte. Had the Reagan folks been truly smart they would have nominated Phyllis Schlafly as a stalking horse who would have given as much as she received, and after voting her down the Senate would have confirmed Bork unanimously while licking their wounds. They had, after all, confirmed a much more conservative Scalia, in an almost unanimous vote just a few months before. "Suddenly this medieval scholastic, accustomed to a university environment where ideas have no practical consequences, found himself in a universe where it is generally agreed that a straight line is the shortest distance to disaster."*
"Robert Bork was a man of war. He struggled with everyone, especially himself. A restless, ambitious intellectual, he half-jokingly declared his motto to be "Wreak yourself upon the world!" A hulk of a fellow, he had a weakness for food, drink, smoke, and, especially, talk. Gruff yet self-deprecating, he relished contrariness; he was soft-hearted about hardheadedness, sentimental toward rigor and logic. His political enemies were the liberal intellectuals who came of age in the late 196os, yet he took to looking like one of them, cultivating a scraggly red beard and leaving untamed the frizz on his baking pate. Bork was a professor and judge, yet such professionals were the people he never ceased attacking. What Bork had written of antitrust law—that it was a paradox, a policy at war with itself could have served as the title of his self-portrait." Bork began life as a socialist, far left, who then morphed into the market-oriented conservative and philosophic libertarian; from one true believer position to another, although one friend later said that his early flirtation with liberalism was mostly to annoy his mother.
After absorbing conservative philosophy at the University of Chicago, Bork specialized in anti-trust law in a large firm where he distinguished himself early by battling against the Jewish quota. Chaffing though at the routines, and wanting to make a difference he eagerly accepted a professorship at Yale Law School, at the time, predominantly liberal, where he gloried in arguing conservative positions. Supporting Goldwater, he once said that "between the time he walked out of the house and arrived at his law school office, he held 15 impromptu debates and arrived in need of another shower. The man was in heaven." While there he also wrote an article that was to come back and haunt him. Personally supporting integration he opposed governmental coercion and so spoke out against the 1964 Civil Rights Act. It was logical libertarianism. The editors of The New Republic took the unusual step of replying to the article: "Government without principle ends in shipwreck; but government according to one single principle, to the exclusion of all others, ends in madness." The article brought him to the attention of conservatives who helped him along when they gained power, but phrases he used in it probably helped deny him a seat on the court. He later disavowed the content pretending it was simply an academic debate he had been having with Alexander Bickel. While he was certainly no racist, his views provided cover for everyone who was. This kind of academic jousting, so common in academia, unfortunately finds its way into Supreme Court deliberations. The court has currently been filled with just such academics.
As the left began to co-opt liberty and individual rights, Bork began moving inexorably to a more authoritarian view of government. As student revolts increased Bork saw that increased freedom was bringing barbarism.
"He lamented the decline of authority, the loss of interest in the ancients, the dangers of permissiveness. . . Slowly, as he felt the societal order face threat of decline, Bork ceased to be an iconoclast. He maintained his wit, but he lost his patience for good-humored intellectual jousting and became at times a testy advocate. . . .Bork wanted to fight the expansion of individual and minority rights because it was illegitimate; he opposed busing and affirmative action because they were intrusive regulation; he opposed homosexual rights and abortion because they were not in the Constitution.. . .he favored the death penalty and opposed expanding the rights of criminal defendants," and on and on
By the time of his nomination there were two competing views of judicial interpretation. Attorney General Meese and later the Reagan administration assumed that if only judges would read the text and look to the original meaning of the constitution, the result would inevitably be in their favor. Where is was not clear the judicial branch needed to defer to the legislative. On the other side was the so-called "sausage" theory that said it mattered less what went into the product as long as the result was good.
One interesting note in the campaign against Bork was the use of actualities. While perhaps not completely "fake" news, they were deceptive at best. Henry Griggs was a public relations consultant for AFSME, an organization that opposed Bork. He would send out numerous meticulously produced programs that gave the appearance of being actual news reports done by real reporters. Griggs did them all and smaller radio stations around the country, beset by falling revenues and budget cuts, would broadcast these announcements as if they were news done by their own reporters. AFSME had an anti-Bork agenda and so the content was always denigrating Bork by portraying him as being anti-civil rights, etc. They were very effective. The White House had a similar operation but Griggs was far better at getting placements throughout the country. The was an equivalent video operation that produce VNRs (video news releases) that were really just anti-Bork programs.
Ironically, following his withdrawal, Bork made a considerable fortune traveling around the country given speeches whose content validated the concerns of his opponents. The Douglas Ginsburg debacle followed resulting in the successful nomination of Anthony Kennedy who became more conciliatory and moderate while on the bench.
Bronner raises a warning flag. The use of half-truths in both the anti-Bork campaign and then again against Dukakis (Willie Horton) , when repeated often enough, become truth. Going "on the attack" has also become de rigeur in political discourse as it forces the opponent into constant defense.
Bronner cites the testimony of historian John Hope Franklin in his conclusion. Franklin and his family had been thrown off a train in Oklahoma when his mother, in 1922, had refused to move from a train's passenger car and into the baggage car where black's were forced to travel. In 1945, in North Carolina, he and other blacks were crammed into the baggage car while five whites had the passenger coach to themselves. The five were German prisoners of war and laughed at the idea blacks could have been fighting for such a country. When doing research at the Library of Congress years later he couldn't buy a cup of coffee in nearby restaurants.
He opposed Bork because: There is no indication in his writings, his teachings or his rulings that this nominee has any deeply held commitment to the eradication of the problem of race or even of its mitigation. One searches his record in vain to find a civil rights advance that he supported from its inception. The landmark cases I cited earlier have done much to make this a tolerable, tolerant land in which persons of African descent can live. I shudder to think how Judge Bork would have ruled in any of them had he served on the court at the time they were decided.
*https://scholarship.law.umn.edu/cgi/viewcontent.cgi?article=1520&context=concomm
Tuesday, April 28, 2020
Sunday, April 26, 2020
Quarantine, Public Health and and Jacobson v Virginia
States have broad police powers that grant them authority to use that power for the protection of its citizens. The lock downs can, in fact, be mandatory and have the force of law and could subject violators to fines or jail time. The text of the orders makes that clear even though the governors themselves may talk as if they were just recommendations.
So what civil rights are violated by these orders.? What can the states actually do? (Aside from what the virus can do, i.e. kill you.)
In 1902, during a smallpox outbreak, the Cambridge, Mass, Board of Health passed a resolution that required all citizens who had not been vaccinated during the previous 5 years to undergo the procedure or pay a fine of $5. The board did so in accordance with a state law that empowered localities to enforce general compulsory vaccination when deemed necessary for the public safety. A local pastor (of course) Henning Jacobson, who had immigrated from Sweden, where he had been subject to mandatory vaccinations for smallpox as a child (a program that had eliminated smallpox from Sweden), argued in court that the vaccination had caused him harm and therefore he should not be subject to it nor should anyone be required to be vaccinated. He said that it violated his liberties under the Constitution. Jacobson’s refusal both to be vaccinated and to pay the fine instigated a series of legal actions in the Massachusetts court system. After failing to convince the state’s Supreme Judicial Court that the law was oppressive, Jacobson appealed to the US Supreme Court.
On February 20, 1905, the Supreme Court handed down a 7–2 decision in favor of Massachusetts. Writing for the majority, Justice John Marshall Harlan declared that the authority to compel vaccination fell within the “police powers” of state and local governments to guard the community’s health, welfare, safety, and morals. While the high court had never attempted to define the limits of police powers, Harlan contended it had recognized the authority of states to enact “health laws of every description” to guard the common good in whatever way the citizens, through their elected representatives, thought appropriate. States also could legitimately impose quarantines or penalties (such as fines) on those who refused to cooperate with such laws.
There is, of course, a sphere within which the individual may assert the supremacy of his own will and rightfully dispute the authority of any human government, especially of any free government existing under a written constitution. But it is equally true that in every well-ordered society charged with the duty of conserving the safety of its members the rights of the individual in respect of his liberty may at times, under the pressure of great dangers, be subjected to such restraint, to be enforced by reasonable regulations, as the safety of the general public may demand.
“[T]he liberty secured by the Constitution of the United States to every person within its jurisdiction does not import an absolute right in each person to be, at all times and in all circumstances, wholly freed from restraint. There are manifold restraints to which every person is necessarily subject for the common good. On any other basis organized society could not exist with safety to its members. Society based on the rule that each one is a law unto himself would soon be confronted with disorder and anarchy.” (Jacobson v Massachusetts, 197 US 11 (1905))
The compulsory vaccination law, Harlan said, was consistent with what the Massachusetts constitution had laid out as “a fundamental principle of the social compact that the whole people covenants with each citizen and each citizen with the whole people.
Immunization during the course of the twentieth century gradually reduced the need for drastic public health measures. (In 1922, the court had ruled in Zucht v King that schools could refuse to admit students who had not been vaccinated.) Massive outbreaks of contagious diseases became rare and the trend in public health was to use information and education to practice good public health rather than coercion. Panic can often be a good motivator as was evidenced during the polio epidemic and when the vaccine was made available generally little state coercion was needed to assure compliance. Parents were thrilled to be able to remove fear from their lives.
By 1981, all 50 states had made vaccination against measles and most other vaccine-preventable illnesses mandatory for school entry. Support for these laws was buttressed by empirical evidence that showed a strong correlation between the presence of laws and the lower rates of measles. But even then, the use of coercion was framed as hortatory. A CDC official who supported the laws said, “[S]ome additional stimulus is often needed to provoke action on the part of a basically interested person who has many other concerns competing for attention.” In this view, the laws served as a “means of bringing to individuals’ attention the continuing publicly perceived need for immunization. (Colgrove)
Increased awareness of the expense to society through ignorance or simple feckless behavior (smoking, motorcycle helmets, drug and alcohol abuse) has begin to swing the pendulum in a more proscriptive direction.
However, states and municipalities can often go to extremes. When the mayor of Louisville said that people could not congregate for religious services even sitting in your car as a kind of drive through services while at the same time permitting other drive through liquor sales. ALL social gathering could be prohibited (with obvious exceptions for getting food, etc.) but not regulations aimed at a specific group. That would be a violation of the free exercise clause. The Jacobson decision was cited in the district court's opinion overturning the mayor's regulation arguing in excessively purple prose that some rights can be protected from the state's police power. Ironically, the Jacobson decision was also cited by the Fifth Circuit in arguing that other fundamental rights could be suppressed (e.g. abortion) during times of health emergencies.
When the president tweets about liberating states from governor's orders and that he has total power, the next day "authorizing states to do what they want," he simply reveals his complete ignorance of basic federalism. If the states close, they also can open up -- or not under their own police power and the 10th amendment. The president's substantial power comes from his megaphone and bully pulpit. He could be promoting the importance of public health recommendations every day. That would made state coercion less necessary. Instead contradictions abound. When AG Barr suggests that stay-at-home orders may be like house-arrest and his office would file in support of those suing state governments, he is simply muddying the waters and subverting the authority of the governors not to mention subverting the public health experts.
Yet I find myself having a severe case of whiplash having lived through the Civil Rights movement when governors in the south would stand on the steps of their Capitol buildings declaring their complete opposition to federal authority. We opposed "states-rights" then, but also for good reason. They were using their "police power" to deny citizens their fundamental civil rights. Unlike in Jacobson where the state was using its power to protect the general welfare, these southern governors were doing just the opposite.
References:
Mariner, W. K., Annas, G. J., & Glantz, L. H. (2005). Jacobson V Massachusetts: It’s not your great-great-Grandfather’s public health law. American Journal of Public Health, 95(4), 581-590. https://doi.org/10.2105/ajph.2004.055160
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1449224/}]
Note that this article was written in 2005 and suggests limiting the state's power to quarantine. I wonder if the views of the authors might have changed considerably in light of the current virus?
Gostin, L. O. (2005). Jacobson V Massachusetts at 100 years: Police power and civil liberties in tension. American Journal of Public Health, 95(4), 576-581. https://doi.org/10.2105/ajph.2004.055152
Colgrove, J., & Bayer, R. (2005). Manifold restraints: Liberty, public health, and the legacy ofJacobson V Massachusetts. American Journal of Public Health, 95(4), 571-576. https://doi.org/10.2105/ajph.2004.055145
Saturday, April 18, 2020
Review: The 300: The Inside Story of the Missile Defenders Guarding America Against Nuclear Attack by Daniel Wasserbly
My thanks to NetGalley for the pestering me to read this book before it became generally available. It's a fascinating glimpse into the very few soldiers charged with operating what we used to call "Star Wars" defense system. Developed mostly under Bush II, they are highly trained in a system that, if it doesn't work in a real attack, would submit the country to nuclear devastation.
The threat, as it evolved in the early 21st century, was seen mostly as coming from North Korea that vacillated between belligerence and seeking respect, both aspects leading them to the belief that a nuclear arsenal was the only way to satisfy both aims.
Fort Greeley in Alaska was reinstated as the base for the Missile Defense unit. It was about an unhospitable as one could imagine. It had been an active base during the sixties but then abandoned. Housing for families was virtually non-existent and soldiers had to commute by small airplane to Anchorage (a very scary proposition) when they had time off, of which there was little. Another concern was the rumor that the army had forgotten to take a pallet of VX gas artillery shells off the frozen Blueberry lake one winter and it went to the bottom during the spring melt. To quell rumors of its existence, the army drained the lake only to discover the rumor was true and the extremely toxic chemical weapon was indeed found at the bottom of the lake. The author doesn't say how they were disposed of. Maybe they let kids play with them.
Integrating base security with those residing on base in such a relatively small area led to a funny concern. The MPs would drive around the base perimeter with .50 calier machine guns on their vehicles. “Sir, we have TWIGs driving around with .50 -cals,” Kiraly warned the battalion’s executive officer, Wayne Hunt. Teenagers with Guns— TWIGs. “A .50-cal will range into the garrison, right next to the missile field,” Kiraly said . “What if there’s something in the wire, and they shoot into the housing area? It’s only a couple hundred meters.” TWIGS indeed. A different set of TWIGS was in charge of sophisticated interceptor missiles.
I would not want to have been stationed at Fort Greeley where they kept diffing up canisters of things that scared the crap out of the disposal teams.
The EOD guys stopped laughing once they got to the canister and looked up the numbers on the data plate. There were some frantic radio calls and Scott and Marrero were ordered to leave. They never found out why. Soon afterward, while the MPs were clearing the woods away from the perimeter to build a new headquarters facility, they stumbled upon a buried batch of old Chinese mortars. And after that, contractors were digging new telephone lines near the fort’s chapel, and about five feet down they unearthed a large sealed drum. Scott and his patrol were ordered to guard the drum until EOD arrived the next day. He never found out what was in it." Hope they didn't buy their kids shovels for birthdays.
The book has excellent chapters on the history and development of anti-missile missile systems. They had their beginning with attempts to shoot down V2 rockets, but the excessive amounts of shrapnel would have injured more on the ground than the rockets themselves which were ultimately rendered harmless following Montgomery's destruction of the launch sites. With the development of Soviet ICBM capability Kennedy was at first a fan of the Nike Zeus program that had evolved into the Nike-X system. It never had a chance for live testing as McNamara and Johnson believed the MAD (Mutually Assured Destruction) scenario was the best deterrent and that continued development of any anti-missile defense system could be seen as destabilizing parity. All throughout this period, scientists debated whether such a system was even technologically feasible, not to mention the political debate over where to install the systems, i.e. which cities warranted protection and which not.
Administrations waffled on whether deployment was in the best interests until Reagan who wanted a bargaining chip in negotiations and he took what was now called "Star Wars" to a new level. That never went anywhere technically and it was gradually shelved until 9/11 when Congress was willing to fund anything that even hinted at defense.
By now, the technology had morphed into "hit-and-kill" whereby the ABM was expected to actually hit the incoming missile thereby destroying it. This required close interaction of radar systems and missile batteries, and the Bush administration was focusing on rogue nations like Iran and North Korea. Bush wanted everything up and running by the end of 2004.
It was an interesting way to fight and An Army of None: Autonomous Weapons and the Future of War by Paul Scharre would make excellent simultaneous reading. The software was specialized and "If not constrained, the system would automatically take an aggressive approach and not necessarily the approach Northern Command or the White House wanted to take."
Enter the main focus of the book that is on the really very few who man (and a surprising number of women) the system connecting Colorado and Fort Greeley and the radar links.
Highly recommended for anyone interesting in the Cold War, MAD, and ABM systems, and the constraints of technological warfare, not to mention politics and the general reader. Entertaining and informative.
The threat, as it evolved in the early 21st century, was seen mostly as coming from North Korea that vacillated between belligerence and seeking respect, both aspects leading them to the belief that a nuclear arsenal was the only way to satisfy both aims.
Fort Greeley in Alaska was reinstated as the base for the Missile Defense unit. It was about an unhospitable as one could imagine. It had been an active base during the sixties but then abandoned. Housing for families was virtually non-existent and soldiers had to commute by small airplane to Anchorage (a very scary proposition) when they had time off, of which there was little. Another concern was the rumor that the army had forgotten to take a pallet of VX gas artillery shells off the frozen Blueberry lake one winter and it went to the bottom during the spring melt. To quell rumors of its existence, the army drained the lake only to discover the rumor was true and the extremely toxic chemical weapon was indeed found at the bottom of the lake. The author doesn't say how they were disposed of. Maybe they let kids play with them.
Integrating base security with those residing on base in such a relatively small area led to a funny concern. The MPs would drive around the base perimeter with .50 calier machine guns on their vehicles. “Sir, we have TWIGs driving around with .50 -cals,” Kiraly warned the battalion’s executive officer, Wayne Hunt. Teenagers with Guns— TWIGs. “A .50-cal will range into the garrison, right next to the missile field,” Kiraly said . “What if there’s something in the wire, and they shoot into the housing area? It’s only a couple hundred meters.” TWIGS indeed. A different set of TWIGS was in charge of sophisticated interceptor missiles.
I would not want to have been stationed at Fort Greeley where they kept diffing up canisters of things that scared the crap out of the disposal teams.
The EOD guys stopped laughing once they got to the canister and looked up the numbers on the data plate. There were some frantic radio calls and Scott and Marrero were ordered to leave. They never found out why. Soon afterward, while the MPs were clearing the woods away from the perimeter to build a new headquarters facility, they stumbled upon a buried batch of old Chinese mortars. And after that, contractors were digging new telephone lines near the fort’s chapel, and about five feet down they unearthed a large sealed drum. Scott and his patrol were ordered to guard the drum until EOD arrived the next day. He never found out what was in it." Hope they didn't buy their kids shovels for birthdays.
The book has excellent chapters on the history and development of anti-missile missile systems. They had their beginning with attempts to shoot down V2 rockets, but the excessive amounts of shrapnel would have injured more on the ground than the rockets themselves which were ultimately rendered harmless following Montgomery's destruction of the launch sites. With the development of Soviet ICBM capability Kennedy was at first a fan of the Nike Zeus program that had evolved into the Nike-X system. It never had a chance for live testing as McNamara and Johnson believed the MAD (Mutually Assured Destruction) scenario was the best deterrent and that continued development of any anti-missile defense system could be seen as destabilizing parity. All throughout this period, scientists debated whether such a system was even technologically feasible, not to mention the political debate over where to install the systems, i.e. which cities warranted protection and which not.
Administrations waffled on whether deployment was in the best interests until Reagan who wanted a bargaining chip in negotiations and he took what was now called "Star Wars" to a new level. That never went anywhere technically and it was gradually shelved until 9/11 when Congress was willing to fund anything that even hinted at defense.
By now, the technology had morphed into "hit-and-kill" whereby the ABM was expected to actually hit the incoming missile thereby destroying it. This required close interaction of radar systems and missile batteries, and the Bush administration was focusing on rogue nations like Iran and North Korea. Bush wanted everything up and running by the end of 2004.
It was an interesting way to fight and An Army of None: Autonomous Weapons and the Future of War by Paul Scharre would make excellent simultaneous reading. The software was specialized and "If not constrained, the system would automatically take an aggressive approach and not necessarily the approach Northern Command or the White House wanted to take."
Enter the main focus of the book that is on the really very few who man (and a surprising number of women) the system connecting Colorado and Fort Greeley and the radar links.
Highly recommended for anyone interesting in the Cold War, MAD, and ABM systems, and the constraints of technological warfare, not to mention politics and the general reader. Entertaining and informative.
Friday, April 17, 2020
Review: Blood Money by Thomas Perry (audiobook)
Wow. If you ever want to learn how to move money around and hide it and then disappear, this is your textbook. Not having much money, nor having a need to disappear, I was intrigued by the detail, and enthralled by the plot, but sometimes a bit burdened by the detail. The scene in the bus with all the mobsters wondering where their money was disappearing to, was masterfully handled by Joyce Bean. How she managed to keep everyone straight is a wonder.
That Bernie could keep the details of thousands of money transactions all in his head, was a bit implausible, but for the life of me I could never understand why the mob or anyone would think that was a good idea to begin with. Geez, a trip on the stairs and it's all gone.
What bugs me about this book and others in the Jane series is that each is basically the same plot over and over with just different characters. What makes this one unusual is that it has the same plot repeated several times. Jane gets tasked with hiding someone from bad people; she adopts different identities (from an apparently inexhaustible supply of birth certificates and drivers licenses and passports in a Chicago safe deposit box); almost gets caught numerous times; uses her wits to escape; rinse and repeat with interludes examining the bad guy's thinking.
The dream scene was ridiculous, but I hate dream scenes in general, but I also found the activity in the corn field ridiculous. If you've ever worked on a farm in a corn field, you'll agree.
Still, Thomas Perry always delivers and it was a great book to listen to while doing dishes and walking the dog.
That Bernie could keep the details of thousands of money transactions all in his head, was a bit implausible, but for the life of me I could never understand why the mob or anyone would think that was a good idea to begin with. Geez, a trip on the stairs and it's all gone.
What bugs me about this book and others in the Jane series is that each is basically the same plot over and over with just different characters. What makes this one unusual is that it has the same plot repeated several times. Jane gets tasked with hiding someone from bad people; she adopts different identities (from an apparently inexhaustible supply of birth certificates and drivers licenses and passports in a Chicago safe deposit box); almost gets caught numerous times; uses her wits to escape; rinse and repeat with interludes examining the bad guy's thinking.
The dream scene was ridiculous, but I hate dream scenes in general, but I also found the activity in the corn field ridiculous. If you've ever worked on a farm in a corn field, you'll agree.
Still, Thomas Perry always delivers and it was a great book to listen to while doing dishes and walking the dog.
Wednesday, April 15, 2020
Mutations, Antibodies, and Immunity
We know that Corvid-19 is related to many different variants of the cold virus and flu viruses. After getting a cold it's generally believed that you have about 45 days of immunity. Flu, as we all recognize, mutates annually requiring the development of new vaccines that hopefully will protect against whatever strain appears each fall. These mutations change the nature of the disease every year. That does not bode well for the development of a vaccine for Corvid-19. RNA viruses have notoriously high mutation rates. Sometimes they become less virulent, other times more so (See https://journals.plos.org/plosbiology/article?id=10.1371/journal.pbio.3000003)
One of the initiatives for a return to "normalcy" is testing for antibodies, yet it appears from serology studies done in China that some people who have had the disease have few or no antibodies at all. The purpose of the immunity testing might be to issue "certificates of immunity"
Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases, told CNN that, once testing is more widespread, it’s possible people might eventually carry some form of identification showing they’re immune to the virus.
I suppose that would be a good idea, although it just seems too reminiscent of requiring people to wear yellow stars except in this case those without the stars would be the evil ones.
Nevertheless, it's important to know what the level of immunity might be following infection. We have no idea whether that immunity would be long or short term. In the meantime, manufacturers are racing to get antibody tests out there with little oversight or testing to see how or whether they even work.
There was a report that the genome of the virus in Iceland showed evidence of having mutated from that in parts of Europe. Could that be partially responsible for their lower mortality? Is anyone even asking that question? Surely that's a question that should be asked at all these interminably propaganda/briefing sessions
One of the initiatives for a return to "normalcy" is testing for antibodies, yet it appears from serology studies done in China that some people who have had the disease have few or no antibodies at all. The purpose of the immunity testing might be to issue "certificates of immunity"
Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases, told CNN that, once testing is more widespread, it’s possible people might eventually carry some form of identification showing they’re immune to the virus.
I suppose that would be a good idea, although it just seems too reminiscent of requiring people to wear yellow stars except in this case those without the stars would be the evil ones.
Nevertheless, it's important to know what the level of immunity might be following infection. We have no idea whether that immunity would be long or short term. In the meantime, manufacturers are racing to get antibody tests out there with little oversight or testing to see how or whether they even work.
There was a report that the genome of the virus in Iceland showed evidence of having mutated from that in parts of Europe. Could that be partially responsible for their lower mortality? Is anyone even asking that question? Surely that's a question that should be asked at all these interminably propaganda/briefing sessions
It Was All WHOse Fault?
I know it has become fashionable to blame WHO for virtually the entire pandemic as we seem to have a problem examining our own behavior, and now our royal aspirant (“I have total authority”) president wants to cut off all their funding. Apart from that tactic being totally counter-productive, a look at WHO’s history shows their importance to world health.
Given the ease of travel and communication throughout the world any approach to a potential pandemic requires an international approach. We must have a seat at that table. If that means paying dues, then so be it, but the tactic of taking the ball and running home with it if we don’t get our way is childish and ultimately injurious to ourselves.
Let’s look at WHO’s accomplishments and then the timeline of their response to CORVID-19. Their mission goes beyond the mere treatment of physical illness, its stated objective being “the attainment of the highest possible level of health for all people in the world” with health defined as “a state of complete physical, mental and social well-being.” To that end, they eradicated smallpox (by 1977 accomplishing in 20 years what had been attempted for centuries), and have come close to eliminating leprosy and polio, scourges all that killed millions upon millions of people world-wide.
So who does have responsibility for ultimately deciding how to attack a pandemic in this country? Not WHO, surely. The president has at his disposal hundreds of experts and agencies that can be marshaled to deliver quality information. Yet the president’s attack on WHO seems to imply that he looks to them for direction and action. Now WHO was very slow at declaring this a pandemic. Did they make a mistake by taking China at its word? Absolutely. But so did Trump. See his statement on Jan. 24th. This and later comments all echoed what WHO was saying. Yet the U.S. has far more resources and intelligence agencies who were telling the president something else. “Intelligence agencies “have been warning on this since January,” a U.S. official who had access to reports given to Congress and Trump officials told the [Washington] Post. ...“Donald Trump may not have been expecting this, but a lot of other people in the government were — they just couldn’t get him to do anything about it,” the official said. “The system was blinking red.”
So let’s see what was said and when:
2018 John Bolton and the administration reduce funding for the CDC and merge the agencies whose job it was to look for and manage disease outbreaks. “Rear Adm. Timothy Ziemer abruptly departed from his post leading the global health security team on the National Security Council in May 2018 amid a reorganization of the council by then-National Security Advisor John Bolton, and Ziemer’s team was disbanded. Tom Bossert, whom the Washington Post reported “had called for a comprehensive biodefense strategy against pandemics and biological attacks,” had been fired one month prior.” (Snopes. The response has been that Trump and Bolton were simply streamlining the organizations and no staff were reduced.) What is clear is that the administration cut “funding for the CDC’s global disease outbreak prevention efforts had been reduced by 80%, including funding for the agency’s efforts in China.” Whether any of this would have changed the outcome is, of course, speculative. Much of the cuts were made up by other Congressional funding, so probably not.
Dec 19 WHO was informed of a cluster of cases of a new virus in Wuhan China
Jan 21 The president claims to have banned flights from China. This actually never happened as flights continued to arrive from China for weeks after. He did on Jan 31 restrict travel for “foreign nationals who had been in China in the last 14 days.” 430,000 people arrived from China after Jan 1 and 40,000 following the supposed shutdown. It was the airlines themselves beginning with British Airways who stopped flights from China beginning Jan 29. With that many people having come from China it was inevitable that the virus was on US shores in early January. (Washington Times and CRconservative review) Senators Cotton and Hawley had called for a shutdown earlier in January.
Jan. 22: “We have it totally under control. It’s one person coming in from China. We have it under control. It’s going to be just fine.” — Trump in a CNBC interview.
Jan. 23: “The World Health Organization on Thursday decided not to declare the Wuhan coronavirus outbreak a global emergency, despite the spread of the dangerous respiratory infection from China to at least five other countries.” (NYT)
Jan 24 China has been working very hard to contain the Coronavirus. The United States greatly appreciates their efforts and transparency. It will all work out well. In particular, on behalf of the American People, I want to thank President Xi! (Trump tweet.)
Jan 28 According to HHS Secretary Azar, China rejected assistance offer from the CDC made Jan 6. Azar also said the US was a low risk and masks were not necessary. He also said China;s response to Corona was much better than its response to SARS in 2002-2003.(Fox)
Jan 28 CDC raised its travel advisories for China to level 3. (Fox)
Jan 28 WHO congratulates China for its rapid response and transparency. (Fox)
Jan. 30: “We think we have it very well under control. We have very little problem in this country at this moment — five — and those people are all recuperating successfully. But we’re working very closely with China and other countries, and we think it’s going to have a very good ending for us … that I can assure you.” — Trump in a speech in Michigan.
Feb 5 “ WHO said "We are not in a pandemic. We will try to extinguish the transmission in each of these (locations)," …. the agency has enforced sufficient containment measures already to prevent transmissions, however, she admitted the task was challenging due to global travelers.” (Medical Daily)
Feb. 7: “Nothing is easy, but [Chinese President Xi Jinping] … will be successful, especially as the weather starts to warm & the virus hopefully becomes weaker, and then gone.” (Trump tweet)
Feb. 10: “Now, the virus that we’re talking about having to do — you know, a lot of people think that goes away in April with the heat — as the heat comes in. Typically, that will go away in April. We’re in great shape though. We have 12 cases — 11 cases, and many of them are in good shape now.” — Trump at the White House.
Feb. 14: “There’s a theory that, in April, when it gets warm — historically, that has been able to kill the virus. So we don’t know yet; we’re not sure yet. But that’s around the corner.” — Trump in speaking to National Border Patrol Council members.
Feb 20 WHO reports the virus is not yet a pandemic
Feb. 23: “We have it very much under control in this country.” — Trump in speaking to reporters.
Feb. 24: “The Coronavirus is very much under control in the USA. We are in contact with everyone and all relevant countries. CDC & World Health have been working hard and very smart. Stock Market starting to look very good to me!” — Trump in a tweet.
Feb. 24 the Trump administration requested $2.5 billion to address the coronavirus outbreak.
Feb. 26: “So we’re at the low level. As they get better, we take them off the list, so that we’re going to be pretty soon at only five people. And we could be at just one or two people over the next short period of time. So we’ve had very good luck.” — Trump at a White House briefing.
Feb. 26: “And again, when you have 15 people, and the 15 within a couple of days is going to be down to close to zero, that’s a pretty good job we’ve done.” — Trump at a press conference. Note that as of this morning (April 15) over 26,000 Americans have died from the virus.
Feb. 26: “I think every aspect of our society should be prepared. I don’t think it’s going to come to that, especially with the fact that we’re going down, not up. We’re going very substantially down, not up.” — Trump at a press conference, when asked if “U.S. schools should be preparing for a coronavirus spreading.”
Feb. 27: “It’s going to disappear. One day — it’s like a miracle — it will disappear.” — Trump at a White House meeting with African American leaders.
Feb. 27: “Only a very small number in U.S., & China numbers look to be going down. All countries working well together!”
Feb. 29: “And I’ve gotten to know these professionals. They’re incredible. And everything is under control. I mean, they’re very, very cool. They’ve done it, and they’ve done it well. Everything is really under control.” — Trump in a speech at the CPAC conference outside Washington, D.C.
March 4: “[W]e have a very small number of people in this country [infected]. We have a big country. The biggest impact we had was when we took the 40-plus people [from a cruise ship]. … We brought them back. We immediately quarantined them. But you add that to the numbers. But if you don’t add that to the numbers, we’re talking about very small numbers in the United States.” — Trump at a White House meeting with airline CEOs.
March 4: “Well, I think the 3.4% is really a false number.” — Trump in an interview on Fox News, referring to the percentage of diagnosed COVID-19 patients worldwide who had died, as reported by the World Health Organization. (See our item “Trump and the Coronavirus Death Rate.”)
March 6 WHO sends rapid response teams to Italy.
March 6: “I think we're doing a really good job in this country at keeping it down... a tremendous job at keeping it down.”
March 6: “Anybody right now, and yesterday, anybody that needs a test gets a test. And the tests are beautiful. They are perfect just like the letter was perfect. The transcription was perfect. Right? This was not as perfect as that but pretty good.”
March 6: "I like this stuff. | really get it. People are surprised that | understand it. Every one of these doctors said, ‘How do you know so much about this?’ Maybe | have a natural ability. Maybe | should have done that instead of running for president.”
March 7: “No, I’m not concerned at all. No, we’ve done a great job with it.” — Trump, when asked by reporters if he was concerned about the arrival of the coronavirus in the Washington, D.C., area.
March 9: “So last year 37,000 Americans died from the common Flu. It averages between 27,000 and 70,000 per year. Nothing is shut down, life & the economy go on. At this moment there are 546 confirmed cases of CoronaVirus, with 22 deaths. Think about that!” — Trump in a tweet.
March 10: “And we’re prepared, and we’re doing a great job with it. And it will go away. Just stay calm. It will go away.” — Trump after meeting with Republican senators.
March 11 WHO declares it’s a pandemic. ““We’re deeply concerned both by the alarming levels of spread and severity and by the alarming levels of inaction,” the WHO’s chief said.” (CNBC)
March 13: National Emergency Declaration
March 17 “This is a pandemic,” President Donald Trump said at a March 17 press conference. “I felt it was a pandemic long before it was called a pandemic.” ( WP Fact checker)
March 22. Italy’s death toll was reaching vast heights, yet flights from Rome continued to arrive at JFK International Airport.
Clearly, by attacking WHO, an organization with zero power to force any country to do anything, wannabe King (“I have authority to do anything, total authority”) Trump has embarked on a campaign to convince people that his lack of reaction to the virus was all the fault of WHO. The evidence suggests otherwise.
Given the ease of travel and communication throughout the world any approach to a potential pandemic requires an international approach. We must have a seat at that table. If that means paying dues, then so be it, but the tactic of taking the ball and running home with it if we don’t get our way is childish and ultimately injurious to ourselves.
Let’s look at WHO’s accomplishments and then the timeline of their response to CORVID-19. Their mission goes beyond the mere treatment of physical illness, its stated objective being “the attainment of the highest possible level of health for all people in the world” with health defined as “a state of complete physical, mental and social well-being.” To that end, they eradicated smallpox (by 1977 accomplishing in 20 years what had been attempted for centuries), and have come close to eliminating leprosy and polio, scourges all that killed millions upon millions of people world-wide.
So who does have responsibility for ultimately deciding how to attack a pandemic in this country? Not WHO, surely. The president has at his disposal hundreds of experts and agencies that can be marshaled to deliver quality information. Yet the president’s attack on WHO seems to imply that he looks to them for direction and action. Now WHO was very slow at declaring this a pandemic. Did they make a mistake by taking China at its word? Absolutely. But so did Trump. See his statement on Jan. 24th. This and later comments all echoed what WHO was saying. Yet the U.S. has far more resources and intelligence agencies who were telling the president something else. “Intelligence agencies “have been warning on this since January,” a U.S. official who had access to reports given to Congress and Trump officials told the [Washington] Post. ...“Donald Trump may not have been expecting this, but a lot of other people in the government were — they just couldn’t get him to do anything about it,” the official said. “The system was blinking red.”
So let’s see what was said and when:
2018 John Bolton and the administration reduce funding for the CDC and merge the agencies whose job it was to look for and manage disease outbreaks. “Rear Adm. Timothy Ziemer abruptly departed from his post leading the global health security team on the National Security Council in May 2018 amid a reorganization of the council by then-National Security Advisor John Bolton, and Ziemer’s team was disbanded. Tom Bossert, whom the Washington Post reported “had called for a comprehensive biodefense strategy against pandemics and biological attacks,” had been fired one month prior.” (Snopes. The response has been that Trump and Bolton were simply streamlining the organizations and no staff were reduced.) What is clear is that the administration cut “funding for the CDC’s global disease outbreak prevention efforts had been reduced by 80%, including funding for the agency’s efforts in China.” Whether any of this would have changed the outcome is, of course, speculative. Much of the cuts were made up by other Congressional funding, so probably not.
Dec 19 WHO was informed of a cluster of cases of a new virus in Wuhan China
Jan 21 The president claims to have banned flights from China. This actually never happened as flights continued to arrive from China for weeks after. He did on Jan 31 restrict travel for “foreign nationals who had been in China in the last 14 days.” 430,000 people arrived from China after Jan 1 and 40,000 following the supposed shutdown. It was the airlines themselves beginning with British Airways who stopped flights from China beginning Jan 29. With that many people having come from China it was inevitable that the virus was on US shores in early January. (Washington Times and CRconservative review) Senators Cotton and Hawley had called for a shutdown earlier in January.
Jan. 22: “We have it totally under control. It’s one person coming in from China. We have it under control. It’s going to be just fine.” — Trump in a CNBC interview.
Jan. 23: “The World Health Organization on Thursday decided not to declare the Wuhan coronavirus outbreak a global emergency, despite the spread of the dangerous respiratory infection from China to at least five other countries.” (NYT)
Jan 24 China has been working very hard to contain the Coronavirus. The United States greatly appreciates their efforts and transparency. It will all work out well. In particular, on behalf of the American People, I want to thank President Xi! (Trump tweet.)
Jan 28 According to HHS Secretary Azar, China rejected assistance offer from the CDC made Jan 6. Azar also said the US was a low risk and masks were not necessary. He also said China;s response to Corona was much better than its response to SARS in 2002-2003.(Fox)
Jan 28 CDC raised its travel advisories for China to level 3. (Fox)
Jan 28 WHO congratulates China for its rapid response and transparency. (Fox)
Jan. 30: “We think we have it very well under control. We have very little problem in this country at this moment — five — and those people are all recuperating successfully. But we’re working very closely with China and other countries, and we think it’s going to have a very good ending for us … that I can assure you.” — Trump in a speech in Michigan.
Feb 5 “ WHO said "We are not in a pandemic. We will try to extinguish the transmission in each of these (locations)," …. the agency has enforced sufficient containment measures already to prevent transmissions, however, she admitted the task was challenging due to global travelers.” (Medical Daily)
Feb. 7: “Nothing is easy, but [Chinese President Xi Jinping] … will be successful, especially as the weather starts to warm & the virus hopefully becomes weaker, and then gone.” (Trump tweet)
Feb. 10: “Now, the virus that we’re talking about having to do — you know, a lot of people think that goes away in April with the heat — as the heat comes in. Typically, that will go away in April. We’re in great shape though. We have 12 cases — 11 cases, and many of them are in good shape now.” — Trump at the White House.
Feb. 14: “There’s a theory that, in April, when it gets warm — historically, that has been able to kill the virus. So we don’t know yet; we’re not sure yet. But that’s around the corner.” — Trump in speaking to National Border Patrol Council members.
Feb 20 WHO reports the virus is not yet a pandemic
Feb. 23: “We have it very much under control in this country.” — Trump in speaking to reporters.
Feb. 24: “The Coronavirus is very much under control in the USA. We are in contact with everyone and all relevant countries. CDC & World Health have been working hard and very smart. Stock Market starting to look very good to me!” — Trump in a tweet.
Feb. 24 the Trump administration requested $2.5 billion to address the coronavirus outbreak.
Feb. 26: “So we’re at the low level. As they get better, we take them off the list, so that we’re going to be pretty soon at only five people. And we could be at just one or two people over the next short period of time. So we’ve had very good luck.” — Trump at a White House briefing.
Feb. 26: “And again, when you have 15 people, and the 15 within a couple of days is going to be down to close to zero, that’s a pretty good job we’ve done.” — Trump at a press conference. Note that as of this morning (April 15) over 26,000 Americans have died from the virus.
Feb. 26: “I think every aspect of our society should be prepared. I don’t think it’s going to come to that, especially with the fact that we’re going down, not up. We’re going very substantially down, not up.” — Trump at a press conference, when asked if “U.S. schools should be preparing for a coronavirus spreading.”
Feb. 27: “It’s going to disappear. One day — it’s like a miracle — it will disappear.” — Trump at a White House meeting with African American leaders.
Feb. 27: “Only a very small number in U.S., & China numbers look to be going down. All countries working well together!”
Feb. 29: “And I’ve gotten to know these professionals. They’re incredible. And everything is under control. I mean, they’re very, very cool. They’ve done it, and they’ve done it well. Everything is really under control.” — Trump in a speech at the CPAC conference outside Washington, D.C.
March 4: “[W]e have a very small number of people in this country [infected]. We have a big country. The biggest impact we had was when we took the 40-plus people [from a cruise ship]. … We brought them back. We immediately quarantined them. But you add that to the numbers. But if you don’t add that to the numbers, we’re talking about very small numbers in the United States.” — Trump at a White House meeting with airline CEOs.
March 4: “Well, I think the 3.4% is really a false number.” — Trump in an interview on Fox News, referring to the percentage of diagnosed COVID-19 patients worldwide who had died, as reported by the World Health Organization. (See our item “Trump and the Coronavirus Death Rate.”)
March 6 WHO sends rapid response teams to Italy.
March 6: “I think we're doing a really good job in this country at keeping it down... a tremendous job at keeping it down.”
March 6: “Anybody right now, and yesterday, anybody that needs a test gets a test. And the tests are beautiful. They are perfect just like the letter was perfect. The transcription was perfect. Right? This was not as perfect as that but pretty good.”
March 6: "I like this stuff. | really get it. People are surprised that | understand it. Every one of these doctors said, ‘How do you know so much about this?’ Maybe | have a natural ability. Maybe | should have done that instead of running for president.”
March 7: “No, I’m not concerned at all. No, we’ve done a great job with it.” — Trump, when asked by reporters if he was concerned about the arrival of the coronavirus in the Washington, D.C., area.
March 9: “So last year 37,000 Americans died from the common Flu. It averages between 27,000 and 70,000 per year. Nothing is shut down, life & the economy go on. At this moment there are 546 confirmed cases of CoronaVirus, with 22 deaths. Think about that!” — Trump in a tweet.
March 10: “And we’re prepared, and we’re doing a great job with it. And it will go away. Just stay calm. It will go away.” — Trump after meeting with Republican senators.
March 11 WHO declares it’s a pandemic. ““We’re deeply concerned both by the alarming levels of spread and severity and by the alarming levels of inaction,” the WHO’s chief said.” (CNBC)
March 13: National Emergency Declaration
March 17 “This is a pandemic,” President Donald Trump said at a March 17 press conference. “I felt it was a pandemic long before it was called a pandemic.” ( WP Fact checker)
March 22. Italy’s death toll was reaching vast heights, yet flights from Rome continued to arrive at JFK International Airport.
Clearly, by attacking WHO, an organization with zero power to force any country to do anything, wannabe King (“I have authority to do anything, total authority”) Trump has embarked on a campaign to convince people that his lack of reaction to the virus was all the fault of WHO. The evidence suggests otherwise.
Sunday, April 12, 2020
Summary of Social Distance Reports
Intro
We are now several months into the Corona Virus pandemic, a point where fingers are pointing every which way, but there seems to be a light at the end of the tunnel. That it may be on oncoming train doesn't seem to be considered by those in power who lack a plan on how to deal with getting us back to normal, other than to say, it will all be good, everything will be back to normal. Do they have a plan? If so, it's not immediately apparent. One person in the know suggested that assorted plans were being considered; problem is that they all have appalling outcomes.
I listen regularly to a Vox podcast called "The Weeds" that discusses assorted items related to culture and the most recent was devoted to plans developed by several think tanks, the American Enterprise Institute, a conservative group; The American Progress Institute, a more liberal learning organization; and analysis of Paul Romer, Nobel prize winning economist and chief economist for the World Bank. (How Does It End?)
I decided to read the papers themselves and try to summarize what I found to be the salient points. I suspect, however, that given the structure of our republic and the fetish of individuality and independence that plague us, few of the recommendations will be even talked about, let alone accepted.
National coronavirus response: A road map to reopening AEI
Scott Gottlieb, MD served as the 23rd commissioner of the Food and Drug Administration (FDA) from 2017 until April 2019. He is presently a resident fellow at the conservative think tank the American Enterprise Institute (AEI). He's also on the board of Pfizer. He was best known for his vigorous attack on the opioid epidemic. He was widely praised and his resignation after only two years in the Trump administration was considered to have left a big hole. [https://www.vox.com/policy-and-politics/2019/3/5/18252139/scott-gottlieb-resigns-fda-opioid-epidemic] Just two months before he has adamantly insisted he was not leaving. He had come under fire from anti-tobacco groups for his stance on vaping and Americans for Tax Reform had argued his policies were inconsistent with the Trump administration's policies. Draw your own conclusions.
In order to move away from social distancing Gottlieb lists three requirements:
-Better data to identify the rate of exposure and immunity. That will require extensive testing.
-Improvements in public health infrastructure at the state and local level and to make sure we have adequate medical supplies
-Development of therapeutic and preventive treatments.
There are the obvious comments about harnessing technology and expanding investments in pharmaceuticals (he does work for Pfizer, after all, but it's logical -- whether those government supported efforts should become profit centers is another matter.)
They divide their plan into phases.
Lock-down is required of all but essential jobs although they make no attempt to define what is essential, a category that reportedly has been widely abused. That's the phase we are in early April. To reduce the number of infections testing of everyone with symptoms and their close contacts will be necessary. Provide support for the current health system. Only then can we move on to Phase II.
Phase II is state-by-state reopening but physical distancing and limitations on group gatherings needs to continue. Older adults will especially need to limit their community time. Deep cleaning of physical spaces. Those ill still need to self-quarantine. They make no effort to define the criteria as to just when a state or county can move to this phase other than to have multiple places where "confirmed cases cannot be traced back to other known cases", i.e. there is no evidence of community spread. My worry will be that the standards will be too loose to be effective. A return to physical distancing would be required if counts begin to double every three or five days or the health system begins to be overwhelmed (seems a bit late in my view.) Note that both Phases 1 and 2 require an enormous amount of testing. One estimate in another report said 7% of the population each day. That means about 24 million tests per day. Their report says that at least 750,000 tests per week would be adequate IF paired with contact tracing. The report also defines what a lockdown should consist of. It's pretty close to what we have here in Illinois. Ensuring an adequate health system capability they define as doubling current capacity to 5-7 ICU beds per 10,000 adults ,and having 5-7 ventilators per 10,000 adults at a minimum.
Physical distancing restrictions can be lifted only when tools are available to mitigate the risk including surveillance (undefined) and therapeutics or an effective vaccine is available. Gottlieb has been quoted as noting that we have never been able to create a vaccine against any coronavirus so assuming we can it may take as long as two years.
Rebuild readiness for the next pandemic
The report details an extensive new system for contact tracing and quarantine enforced by GPS tracking on cell phone apps. Masks should be worn by the public as recommended by WHO but PPE equipment needs to be reserved for health care providers.
A National and State Plan To End the Coronavirus Crisis by Zeke Emmanuel
The piece from the Center for American Progress looks to South Korea as a model for the way to approach the virus, emphasizing the importance of staying at home so much as to recommend a national policy of stay-at-home for 45 days beginning April 5th. Their point is that you can't have economic health without public health. Studies of the 1918 flu showed that cities who intervened earlier and were more aggressive had faster economic growth after the pandemic.
Testing also plays a key role in their plan requiring a test of everyone with a fever and every member of their household has access to a test along with instantaneous contact tracing and isolation of those who had come into contact with positive individuals. They would also place restrictions on mass transit and restrict public gatherings. They emphasize the importance of a national plan for social distancing; individual states should not be allowed to go their own way. The risk to other states is too great. They cite a Unacast study from GPS data showing only a 40-55 percent reduction in average movements of people. (Nowhere do they suggest how such a policy might be enforced; indeed, that's a flaw in all the plans mentioned in this piece.) As in Italy, the U.S. reacted too slowly initially ignoring areas that appeared to no have many cases mistakenly believing they had no exposure. It's imperative to break community transmission which can only be done with vigorous enforcement of social distancing.
The plan suggests that testing is key and needs to be ramped up to about 2.25 million tests during that 45 day window. We are woefully behind South Korea in the level of testing. That needs to be coupled with serological tests that are relatively inexpensive and provide rapid information on the spread of an epidemic to authorities by measuring antibodies present in an individual's system. A worrisome factor is whether individuals can be reinfected. "In theory, serological tests could also prove individuals’ immunity, clearing people to go back to work. The science of whether COVID-19 infection confers full or partial immunity, and for how long, is still unknown. The level of antibodies necessary to prove immunity is also unknown. A number of patients in China and Japan recovered from COVID-19 but were reinfected and became sick again." Current tests cannot always differentiate between normal corona-viruses and COVID-19 but there are hopes to make the test more sensitive to the differences.
This report also promotes the use of instantaneous contact tracing and isolation. Unfortunately as many as half of the transmission of COVOD-19 occur from asymptomatic individuals which makes manual contact tracing very difficult. Technological means using apps and GPS could help break the transmission but would require an enormous sacrifice of privacy and government intrusion unless anonymity could be assured. In my mind that's doubtful. Assurances that the data would be deleted after 45 days and held only by a non-governmental non-profit agency might help to allay those fears.
One of the more controversial proposals in the plan would require virtually shutting down travel On an average day before the virus 34 million people used public transport and 2.5 million people flew. Those mechanisms are virtually incubation tubes for the virus. They suggest special protective equipment for bus operators, TSA agents, required use of contact tracing apps by passengers, physical distancing in airports, (that will be fun in 3-across seating on an airplane) and routine sanitizing. All of this will, of course, require a great deal of funding. No mention is made of just where that is to come from.
The report emphasizes that N95 masks need to be reserved for health care workers but that homemade masks do provide a measure of protection and therefore should be used.
Mortality rates and mutation
Iris Fung, a friend of a cousin of mine, and clearly either a biology or chemistry major, wrote about the frequency of mutation rates of RNA viruses leading me to an article with this paragraph:
RNA viruses have high mutation rates—up to a million times higher than their hosts—and these high rates are correlated with enhanced virulence and evolvability, traits considered beneficial for viruses. However, their mutation rates are almost disastrously high, and a small increase in mutation rate can cause RNA viruses to go locally extinct. Researchers often assume that natural selection has optimized the mutation rate of RNA viruses, but new data shows that, in poliovirus, selection for faster replication is stronger and faster polymerases make more mistakes. The fabled mutation rates of RNA viruses appear to be partially a consequence of selection on another trait, not because such a high mutation rate is optimal in and of itself.
Whether this high mutation rate would make development of a vaccine much harder, I can't say.
https://journals.plos.org/plosbiology/article?id=10.1371/journal.pbio.3000003
Simulating Covid 19 by Paul Romer
Paul Romer was a joint recipient of the Nobel Prize in Economics and formerly Chief Economics of the World Bank. He has prepared some really interesting models that show the effects of testing on the course of an epidemic. The second paper modeling the difference between isolating at random or isolating based on test results is particularly enlightening. The graphic representation is often clearer than a written one.
https://paulromer.net/covid-sim-part1/
https://paulromer.net/covid-sim-part2/
https://paulromer.net/covid-sim-part3/
Summary
I have added links to all three reports and urge you to read them in their entirety. My summary is merely cursory and each deserves a more thorough reading.
Based on my reading of these reports, it's clear that we were, and remain, woefully unprepared for any resurgence of corona virus or any other pandemic. To reach that stage will require a massive shift in the allocation of resources as well as a huge cultural shift away from a focus on independence to a realization of how inter-dependent we truly are. Travel and sports industries may have to change the way they do business to avoid huge gatherings of people and that would probably include political events, possibly even in the way we vote. Telecommuting and work might have to become the norm rather than the exception and that may change the face of education as well as work.
We are now several months into the Corona Virus pandemic, a point where fingers are pointing every which way, but there seems to be a light at the end of the tunnel. That it may be on oncoming train doesn't seem to be considered by those in power who lack a plan on how to deal with getting us back to normal, other than to say, it will all be good, everything will be back to normal. Do they have a plan? If so, it's not immediately apparent. One person in the know suggested that assorted plans were being considered; problem is that they all have appalling outcomes.
I listen regularly to a Vox podcast called "The Weeds" that discusses assorted items related to culture and the most recent was devoted to plans developed by several think tanks, the American Enterprise Institute, a conservative group; The American Progress Institute, a more liberal learning organization; and analysis of Paul Romer, Nobel prize winning economist and chief economist for the World Bank. (How Does It End?)
I decided to read the papers themselves and try to summarize what I found to be the salient points. I suspect, however, that given the structure of our republic and the fetish of individuality and independence that plague us, few of the recommendations will be even talked about, let alone accepted.
National coronavirus response: A road map to reopening AEI
Scott Gottlieb, MD served as the 23rd commissioner of the Food and Drug Administration (FDA) from 2017 until April 2019. He is presently a resident fellow at the conservative think tank the American Enterprise Institute (AEI). He's also on the board of Pfizer. He was best known for his vigorous attack on the opioid epidemic. He was widely praised and his resignation after only two years in the Trump administration was considered to have left a big hole. [https://www.vox.com/policy-and-politics/2019/3/5/18252139/scott-gottlieb-resigns-fda-opioid-epidemic] Just two months before he has adamantly insisted he was not leaving. He had come under fire from anti-tobacco groups for his stance on vaping and Americans for Tax Reform had argued his policies were inconsistent with the Trump administration's policies. Draw your own conclusions.
In order to move away from social distancing Gottlieb lists three requirements:
-Better data to identify the rate of exposure and immunity. That will require extensive testing.
-Improvements in public health infrastructure at the state and local level and to make sure we have adequate medical supplies
-Development of therapeutic and preventive treatments.
There are the obvious comments about harnessing technology and expanding investments in pharmaceuticals (he does work for Pfizer, after all, but it's logical -- whether those government supported efforts should become profit centers is another matter.)
They divide their plan into phases.
Lock-down is required of all but essential jobs although they make no attempt to define what is essential, a category that reportedly has been widely abused. That's the phase we are in early April. To reduce the number of infections testing of everyone with symptoms and their close contacts will be necessary. Provide support for the current health system. Only then can we move on to Phase II.
Phase II is state-by-state reopening but physical distancing and limitations on group gatherings needs to continue. Older adults will especially need to limit their community time. Deep cleaning of physical spaces. Those ill still need to self-quarantine. They make no effort to define the criteria as to just when a state or county can move to this phase other than to have multiple places where "confirmed cases cannot be traced back to other known cases", i.e. there is no evidence of community spread. My worry will be that the standards will be too loose to be effective. A return to physical distancing would be required if counts begin to double every three or five days or the health system begins to be overwhelmed (seems a bit late in my view.) Note that both Phases 1 and 2 require an enormous amount of testing. One estimate in another report said 7% of the population each day. That means about 24 million tests per day. Their report says that at least 750,000 tests per week would be adequate IF paired with contact tracing. The report also defines what a lockdown should consist of. It's pretty close to what we have here in Illinois. Ensuring an adequate health system capability they define as doubling current capacity to 5-7 ICU beds per 10,000 adults ,and having 5-7 ventilators per 10,000 adults at a minimum.
Physical distancing restrictions can be lifted only when tools are available to mitigate the risk including surveillance (undefined) and therapeutics or an effective vaccine is available. Gottlieb has been quoted as noting that we have never been able to create a vaccine against any coronavirus so assuming we can it may take as long as two years.
Rebuild readiness for the next pandemic
The report details an extensive new system for contact tracing and quarantine enforced by GPS tracking on cell phone apps. Masks should be worn by the public as recommended by WHO but PPE equipment needs to be reserved for health care providers.
A National and State Plan To End the Coronavirus Crisis by Zeke Emmanuel
The piece from the Center for American Progress looks to South Korea as a model for the way to approach the virus, emphasizing the importance of staying at home so much as to recommend a national policy of stay-at-home for 45 days beginning April 5th. Their point is that you can't have economic health without public health. Studies of the 1918 flu showed that cities who intervened earlier and were more aggressive had faster economic growth after the pandemic.
Testing also plays a key role in their plan requiring a test of everyone with a fever and every member of their household has access to a test along with instantaneous contact tracing and isolation of those who had come into contact with positive individuals. They would also place restrictions on mass transit and restrict public gatherings. They emphasize the importance of a national plan for social distancing; individual states should not be allowed to go their own way. The risk to other states is too great. They cite a Unacast study from GPS data showing only a 40-55 percent reduction in average movements of people. (Nowhere do they suggest how such a policy might be enforced; indeed, that's a flaw in all the plans mentioned in this piece.) As in Italy, the U.S. reacted too slowly initially ignoring areas that appeared to no have many cases mistakenly believing they had no exposure. It's imperative to break community transmission which can only be done with vigorous enforcement of social distancing.
The plan suggests that testing is key and needs to be ramped up to about 2.25 million tests during that 45 day window. We are woefully behind South Korea in the level of testing. That needs to be coupled with serological tests that are relatively inexpensive and provide rapid information on the spread of an epidemic to authorities by measuring antibodies present in an individual's system. A worrisome factor is whether individuals can be reinfected. "In theory, serological tests could also prove individuals’ immunity, clearing people to go back to work. The science of whether COVID-19 infection confers full or partial immunity, and for how long, is still unknown. The level of antibodies necessary to prove immunity is also unknown. A number of patients in China and Japan recovered from COVID-19 but were reinfected and became sick again." Current tests cannot always differentiate between normal corona-viruses and COVID-19 but there are hopes to make the test more sensitive to the differences.
This report also promotes the use of instantaneous contact tracing and isolation. Unfortunately as many as half of the transmission of COVOD-19 occur from asymptomatic individuals which makes manual contact tracing very difficult. Technological means using apps and GPS could help break the transmission but would require an enormous sacrifice of privacy and government intrusion unless anonymity could be assured. In my mind that's doubtful. Assurances that the data would be deleted after 45 days and held only by a non-governmental non-profit agency might help to allay those fears.
One of the more controversial proposals in the plan would require virtually shutting down travel On an average day before the virus 34 million people used public transport and 2.5 million people flew. Those mechanisms are virtually incubation tubes for the virus. They suggest special protective equipment for bus operators, TSA agents, required use of contact tracing apps by passengers, physical distancing in airports, (that will be fun in 3-across seating on an airplane) and routine sanitizing. All of this will, of course, require a great deal of funding. No mention is made of just where that is to come from.
The report emphasizes that N95 masks need to be reserved for health care workers but that homemade masks do provide a measure of protection and therefore should be used.
Mortality rates and mutation
Iris Fung, a friend of a cousin of mine, and clearly either a biology or chemistry major, wrote about the frequency of mutation rates of RNA viruses leading me to an article with this paragraph:
RNA viruses have high mutation rates—up to a million times higher than their hosts—and these high rates are correlated with enhanced virulence and evolvability, traits considered beneficial for viruses. However, their mutation rates are almost disastrously high, and a small increase in mutation rate can cause RNA viruses to go locally extinct. Researchers often assume that natural selection has optimized the mutation rate of RNA viruses, but new data shows that, in poliovirus, selection for faster replication is stronger and faster polymerases make more mistakes. The fabled mutation rates of RNA viruses appear to be partially a consequence of selection on another trait, not because such a high mutation rate is optimal in and of itself.
Whether this high mutation rate would make development of a vaccine much harder, I can't say.
https://journals.plos.org/plosbiology/article?id=10.1371/journal.pbio.3000003
Simulating Covid 19 by Paul Romer
Paul Romer was a joint recipient of the Nobel Prize in Economics and formerly Chief Economics of the World Bank. He has prepared some really interesting models that show the effects of testing on the course of an epidemic. The second paper modeling the difference between isolating at random or isolating based on test results is particularly enlightening. The graphic representation is often clearer than a written one.
https://paulromer.net/covid-sim-part1/
https://paulromer.net/covid-sim-part2/
https://paulromer.net/covid-sim-part3/
Summary
I have added links to all three reports and urge you to read them in their entirety. My summary is merely cursory and each deserves a more thorough reading.
Based on my reading of these reports, it's clear that we were, and remain, woefully unprepared for any resurgence of corona virus or any other pandemic. To reach that stage will require a massive shift in the allocation of resources as well as a huge cultural shift away from a focus on independence to a realization of how inter-dependent we truly are. Travel and sports industries may have to change the way they do business to avoid huge gatherings of people and that would probably include political events, possibly even in the way we vote. Telecommuting and work might have to become the norm rather than the exception and that may change the face of education as well as work.
Saturday, April 11, 2020
Review: Nightfall Berlin by Jack Grimwood
At the end of the war, Berlin was a mess. Children wandered the streets, people were starving, and anything could be had for a cigarette. Add to the mix thousands of soldiers, all of them bored, and you have a recipe for depredation. "‘The ruins turned us all into rats … The self can be pretty vile if let off the leash.’ All those feral children. All that hunger and starvation. It must have been a feeding frenzy for someone like Blackburn. He wouldn’t have been alone either. Men like that recognized each other, hunted in packs, and protected each other. . . It was like stepping into hell. The problem is, some men like hell."
Some of those predators were officers and they turned a lodge into a true den of iniquity, some of them preying on children. But someone else was writing down the names of the worst, and many of those same men went on to high-level careers in government. Throw in those who want to sabotage the glasnost talks about reducing nuclear weapons and you have a rather incendiary mix.
Major Tom Fox is sent to Berlin to bring back a former defector. It was to be a simple mission. He has none of the above information, but soon it's apparent that someone wants the defector dead and Tom, too. But, most of all they want the memoirs the defector had been supposedly writing as he had the list of names. Fox is caught in a vice but has no idea who's turning the screws. When his children is kidnapped to coerce his cooperation, things get desperate.
This book will suck you into it as it races to the conclusion. I have already ordered Grimwood's other book. Superior spy novel.
Some of those predators were officers and they turned a lodge into a true den of iniquity, some of them preying on children. But someone else was writing down the names of the worst, and many of those same men went on to high-level careers in government. Throw in those who want to sabotage the glasnost talks about reducing nuclear weapons and you have a rather incendiary mix.
Major Tom Fox is sent to Berlin to bring back a former defector. It was to be a simple mission. He has none of the above information, but soon it's apparent that someone wants the defector dead and Tom, too. But, most of all they want the memoirs the defector had been supposedly writing as he had the list of names. Fox is caught in a vice but has no idea who's turning the screws. When his children is kidnapped to coerce his cooperation, things get desperate.
This book will suck you into it as it races to the conclusion. I have already ordered Grimwood's other book. Superior spy novel.
Wednesday, April 08, 2020
Review: Fallout by Garry Disher (Wyatt #6)
Good story, if a bit unusual. Raymond, Wyatt's nephew plays a significant role, and we are left hanging as to Wyatt's relationship with Liz Redding, who was involved with the jewelry heist. Raymond has been making a living (and losing most of it at the casino) by pulling off a series of bank heists. He's been reasonably clever at it, but he's also fallen under the spell of a couple of treasure hunters looking for investors to fund collecting gold from a sunken ship near a reef. Raymond falls for their line, tries to enlist his uncle, and things go downhill for him rapidly.
This is a good series and I have read them somewhat haphazardly, suffering no deleterious effects, so you probably don't have to worry too much about reading in order.
This is a good series and I have read them somewhat haphazardly, suffering no deleterious effects, so you probably don't have to worry too much about reading in order.
Thursday, April 02, 2020
Review: The Bomb: Presidents, Generals, and the Secret History of Nuclear War by Fred Kaplan
I read Kaplan's Dark Territory: The Secret History of Cyber War and discovered it to be a very lucid explanation of the technological challenges faced by the security departments around the world. So naturally, I was anxious to check out his most recent book, courtesy Net Galley, for which I am grateful.
It's an immensely enjoyable, if a bit scary, book about the political infighting and territoriality of the armed services and policy development of nuclear weapons. There was a lot of jockeying between the Navy, Army, and Air Force as to who would control "the bomb". and unfortunately much of that in-fighting controlled policy. Curtis LeMay, a brilliant leader in the organization and implementation of the bombing campaigns (read fire-bombing) in Europe and then Japan, as head of the Strategic Air Command was all in favor of a virtual first strike with everything as the SAC bombers were quite vulnerable. (His philosophy was simply to bomb everything.)
The Navy, meanwhile, was eager to get funds for the development of large numbers of ballistic missile equipped Polaris submarines, arguing that if the Russians never knew where you were the deterrent effect was far greater and more valuable. The Army, on the other hand, promoted the use of smaller tactical nukes on the battlefield suggesting that a nuclear counterattack to defend Europe against Russian aggression would lead to a Russian withdrawal and peace discussions. The casual manner in which civilian casualties (not to mention military) were discussed was a bit disheartening.
The man who replaced LeMay at SAC was Thomas Power. Even LeMay thought he was excessive: "There was a cruelty to Power’s zest for bombing cities. Even LeMay privately referred to his protégé as a “sadist.” When Bill Kaufmann briefed him on the Counterforce strategy at SAC headquarters, Power reacted with fury. “Why do you want us to restrain ourselves?” he screamed. “Why are you so concerned with saving their lives? The whole idea is to kill the bastards!” After a bit more of this tirade, Power said, “Look. At the end of the war, if there are two Americans and one Russian, we win!” Kaufmann snapped back, “You’d better make sure that they’re a man and a woman.” Power stormed out of the room. "
One surprising and note-worthy section was on how Cheney, of all people, was instrumental in reducing the huge number of weapons by half. All of the president's since have failed to reject the no-first-strike policy. Trump, himself, in his on-again, off-again relationship with North Korea didn't hesitate to wave the arsenal and threaten its use.
Kaplan describes the abyss that policy makers then and since have become trapped in. The mere idea of how many times cities (people) need to be nuked in order to assure our victory, even as we ourselves are annihilated, inevitably leads to comparisons with Alice in Wonderland.
That about sums up the insanity faced by all the presidents since Hiroshima. The importance of policy discussions and analysis worries me when I read that our current president disdains not just the briefing books, but the idea of analysis, preferring to rely on his "gut feeling" no doubt the most attuned gut in the history of the world. But then he's such a self-described "stable genius."
A good companion book to McNamara's memoir, "In Retrospect" and Ellsberg's "Secrets." Each is ostensibly more about Vietnam but each reveals much a bout how decisions are made in government. Other titles I will have to read are Kaplan's "Wizards of Armaggedon", Ellsberg's "The Doomsday Machine," and Bruce Kuklick's "Kennan to Kissinger" and I'm sure many others, but we only live so long.
It's an immensely enjoyable, if a bit scary, book about the political infighting and territoriality of the armed services and policy development of nuclear weapons. There was a lot of jockeying between the Navy, Army, and Air Force as to who would control "the bomb". and unfortunately much of that in-fighting controlled policy. Curtis LeMay, a brilliant leader in the organization and implementation of the bombing campaigns (read fire-bombing) in Europe and then Japan, as head of the Strategic Air Command was all in favor of a virtual first strike with everything as the SAC bombers were quite vulnerable. (His philosophy was simply to bomb everything.)
The Navy, meanwhile, was eager to get funds for the development of large numbers of ballistic missile equipped Polaris submarines, arguing that if the Russians never knew where you were the deterrent effect was far greater and more valuable. The Army, on the other hand, promoted the use of smaller tactical nukes on the battlefield suggesting that a nuclear counterattack to defend Europe against Russian aggression would lead to a Russian withdrawal and peace discussions. The casual manner in which civilian casualties (not to mention military) were discussed was a bit disheartening.
The man who replaced LeMay at SAC was Thomas Power. Even LeMay thought he was excessive: "There was a cruelty to Power’s zest for bombing cities. Even LeMay privately referred to his protégé as a “sadist.” When Bill Kaufmann briefed him on the Counterforce strategy at SAC headquarters, Power reacted with fury. “Why do you want us to restrain ourselves?” he screamed. “Why are you so concerned with saving their lives? The whole idea is to kill the bastards!” After a bit more of this tirade, Power said, “Look. At the end of the war, if there are two Americans and one Russian, we win!” Kaufmann snapped back, “You’d better make sure that they’re a man and a woman.” Power stormed out of the room. "
One surprising and note-worthy section was on how Cheney, of all people, was instrumental in reducing the huge number of weapons by half. All of the president's since have failed to reject the no-first-strike policy. Trump, himself, in his on-again, off-again relationship with North Korea didn't hesitate to wave the arsenal and threaten its use.
Kaplan describes the abyss that policy makers then and since have become trapped in. The mere idea of how many times cities (people) need to be nuked in order to assure our victory, even as we ourselves are annihilated, inevitably leads to comparisons with Alice in Wonderland.
That about sums up the insanity faced by all the presidents since Hiroshima. The importance of policy discussions and analysis worries me when I read that our current president disdains not just the briefing books, but the idea of analysis, preferring to rely on his "gut feeling" no doubt the most attuned gut in the history of the world. But then he's such a self-described "stable genius."
A good companion book to McNamara's memoir, "In Retrospect" and Ellsberg's "Secrets." Each is ostensibly more about Vietnam but each reveals much a bout how decisions are made in government. Other titles I will have to read are Kaplan's "Wizards of Armaggedon", Ellsberg's "The Doomsday Machine," and Bruce Kuklick's "Kennan to Kissinger" and I'm sure many others, but we only live so long.
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