Dying in a Leadership Vacuum (New England Journal of Medicine trashes Trump)

Covid-19 has created a crisis throughout the world. This crisis has produced a test of leadership. With no good options to combat a novel pathogen, countries were forced to make hard choices about how to respond. Here in the United States, our leaders have failed that test. They have taken a crisis and turned it into a tragedy.

The magnitude of this failure is astonishing. According to the Johns Hopkins Center for Systems Science and Engineering,1 the United States leads the world in Covid-19 cases and in deaths due to the disease, far exceeding the numbers in much larger countries, such as China. The death rate in this country is more than double that of Canada, exceeds that of Japan, a country with a vulnerable and elderly population, by a factor of almost 50, and even dwarfs the rates in lower-middle-income countries, such as Vietnam, by a factor of almost 2000. Covid-19 is an overwhelming challenge, and many factors contribute to its severity. But the one we can control is how we behave. And in the United States we have consistently behaved poorly.

Each week, receive an email with links to the articles published in the current week's issue of the New England Journal of Medicine. SIGN UP We know that we could have done better. China, faced with the first outbreak, chose strict quarantine and isolation after an initial delay. These measures were severe but effective, essentially eliminating transmission at the point where the outbreak began and reducing the death rate to a reported 3 per million, as compared with more than 500 per million in the United States. Countries that had far more exchange with China, such as Singapore and South Korea, began intensive testing early, along with aggressive contact tracing and appropriate isolation, and have had relatively small outbreaks. And New Zealand has used these same measures, together with its geographic advantages, to come close to eliminating the disease, something that has allowed that country to limit the time of closure and to largely reopen society to a prepandemic level. In general, not only have many democracies done better than the United States, but they have also outperformed us by orders of magnitude.

Why has the United States handled this pandemic so badly? We have failed at almost every step. We had ample warning, but when the disease first arrived, we were incapable of testing effectively and couldn’t provide even the most basic personal protective equipment to health care workers and the general public. And we continue to be way behind the curve in testing. While the absolute numbers of tests have increased substantially, the more useful metric is the number of tests performed per infected person, a rate that puts us far down the international list, below such places as Kazakhstan, Zimbabwe, and Ethiopia, countries that cannot boast the biomedical infrastructure or the manufacturing capacity that we have.2 Moreover, a lack of emphasis on developing capacity has meant that U.S. test results are often long delayed, rendering the results useless for disease control.

Although we tend to focus on technology, most of the interventions that have large effects are not complicated. The United States instituted quarantine and isolation measures late and inconsistently, often without any effort to enforce them, after the disease had spread substantially in many communities. Our rules on social distancing have in many places been lackadaisical at best, with loosening of restrictions long before adequate disease control had been achieved. And in much of the country, people simply don’t wear masks, largely because our leaders have stated outright that masks are political tools rather than effective infection control measures. The government has appropriately invested heavily in vaccine development, but its rhetoric has politicized the development process and led to growing public distrust.

The United States came into this crisis with enormous advantages. Along with tremendous manufacturing capacity, we have a biomedical research system that is the envy of the world. We have enormous expertise in public health, health policy, and basic biology and have consistently been able to turn that expertise into new therapies and preventive measures. And much of that national expertise resides in government institutions. Yet our leaders have largely chosen to ignore and even denigrate experts.

The response of our nation’s leaders has been consistently inadequate. The federal government has largely abandoned disease control to the states. Governors have varied in their responses, not so much by party as by competence. But whatever their competence, governors do not have the tools that Washington controls. Instead of using those tools, the federal government has undermined them. The Centers for Disease Control and Prevention, which was the world’s leading disease response organization, has been eviscerated and has suffered dramatic testing and policy failures. The National Institutes of Health have played a key role in vaccine development but have been excluded from much crucial government decision making. And the Food and Drug Administration has been shamefully politicized,3 appearing to respond to pressure from the administration rather than scientific evidence. Our current leaders have undercut trust in science and in government,4 causing damage that will certainly outlast them. Instead of relying on expertise, the administration has turned to uninformed “opinion leaders” and charlatans who obscure the truth and facilitate the promulgation of outright lies.

Let’s be clear about the cost of not taking even simple measures. An outbreak that has disproportionately affected communities of color has exacerbated the tensions associated with inequality. Many of our children are missing school at critical times in their social and intellectual development. The hard work of health care professionals, who have put their lives on the line, has not been used wisely. Our current leadership takes pride in the economy, but while most of the world has opened up to some extent, the United States still suffers from disease rates that have prevented many businesses from reopening, with a resultant loss of hundreds of billions of dollars and millions of jobs. And more than 200,000 Americans have died. Some deaths from Covid-19 were unavoidable. But, although it is impossible to project the precise number of additional American lives lost because of weak and inappropriate government policies, it is at least in the tens of thousands in a pandemic that has already killed more Americans than any conflict since World War II.

Anyone else who recklessly squandered lives and money in this way would be suffering legal consequences. Our leaders have largely claimed immunity for their actions. But this election gives us the power to render judgment. Reasonable people will certainly disagree about the many political positions taken by candidates. But truth is neither liberal nor conservative. When it comes to the response to the largest public health crisis of our time, our current political leaders have demonstrated that they are dangerously incompetent. We should not abet them and enable the deaths of thousands more Americans by allowing them to keep their jobs.

Great Barrington Declaration ^ | October 8, 2020 | Signed by Medical & Public Health Scientists 5,113 Medical Practitioners 9,963 General Public 13
Posted on 10/8/2020, 2:32:21 PM by yoe

As infectious disease epidemiologists and public health scientists we have grave concerns about the damaging physical and mental health impacts of the prevailing COVID-19 policies, and recommend an approach we call Focused Protection.

Coming from both the left and right, and around the world, we have devoted our careers to protecting people. Current lockdown policies are producing devastating effects on short and long-term public health. The results (to name a few) include lower childhood vaccination rates, worsening cardiovascular disease outcomes, fewer cancer screenings and deteriorating mental health – leading to greater excess mortality in years to come, with the working class and younger members of society carrying the heaviest burden. Keeping students out of school is a grave injustice.

Keeping these measures in place until a vaccine is available will cause irreparable damage, with the underprivileged disproportionately harmed.

Fortunately, our understanding of the virus is growing. We know that vulnerability to death from COVID-19 is more than a thousand-fold higher in the old and infirm than the young. Indeed, for children, COVID-19 is less dangerous than many other harms, including influenza.

As immunity builds in the population, the risk of infection to all – including the vulnerable – falls. We know that all populations will eventually reach herd immunity – i.e. the point at which the rate of new infections is stable – and that this can be assisted by (but is not dependent upon) a vaccine. Our goal should therefore be to minimize mortality and social harm until we reach herd immunity......................

Great Barrington Declaration ^ | October 8, 2020 | Signed by Medical & Public Health Scientists 5,113 Medical Practitioners 9,963 General Public 13
Posted on 10/8/2020, 2:32:21 PM by yoe

Keeping these measures in place until a vaccine is available will cause irreparable damage, with the underprivileged disproportionately harmed.

They lie!

rt.com
Thousands of the world’s top scientists are finally speaking out against lockdowns. Let’s pray it’s not too little, too late
5-7 minutes

By Peter Andrews, Irish science journalist and writer based in London. He has a background in the life sciences, and graduated from the University of Glasgow with a degree in genetics

More than 7,000 top scientists and doctors have signed a declaration calling for politicians to reconsider their entire approach to Covid, and to adopt a herd immunity strategy. Why didn’t this happen seven months ago?

In its first few days, almost 3,000 medical and public health scientists, over 4,000 medical practitioners, and an astonishing 65,000 members of the public have added their names to a backlash against government state-sanctioned Covid restrictions. If you wish to sign yourself, you can do so here.

The declaration was co-written by Professor Sunetra Gupta of the University of Oxford, whose level-minded and wise counsel on Covid I have been plugging for months. The other two authors are American: the illustrious Dr Jay Bhattacharya of Stanford and Dr Martin Kulldorff of Harvard. Hardly bug-eyed risk takers (although they may well be presented as such in the mainstream media).

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But despite a recent invitation to advise the UK parliament, Gupta’s words have thus far gone completely unheeded. In fact, it has been suggested that she and other ardent anti-establishment voices were brought in only as a ruse to placate the significant faction of the scientific community that has refused to blindly follow ‘the science’. If that was Boris and co’s plan, however, it has backfired, because Gupta and her colleagues are not giving up that easily.
Too big to ignore

Make no mistake: this is no half-cocked social media petition that politicians can comfortably ignore, regardless of the number of signatories. This is an official document with a title, the Great Barrington Declaration, after the town in Massachusetts where Gupta travelled to write it up.

Its arguments will not be new to anyone familiar with the statements of Gupta and others on the lockdowns. “Current lockdown policies are producing devastating effects on short- and long-term public health,” it begins, adding that waiting for a vaccine “will cause irreparable damage.” Instead, it calls for “focused protection” – essentially, letting the healthy out as normal to develop herd immunity while cocooning the elderly.

But herd immunity is wrongthink to much of the public; they associate it with “letting the virus rip,” and infer that it will involve the bovine culling of an entire demographic. There are two things to remember about this. First, the body of evidence strongly suggests that the virus has long since reached endemic status pretty much everywhere, and people already have herd immunity anyway. Why else have Covid deaths essentially flatlined ever since the April peak?

Second, since there is not a scrap of evidence that any restrictions slow or stop the virus, haven’t we been “letting the virus rip” anyway? It is called Covid-19 for a reason – it was spreading freely around the world well before Christmas of last year. How slow do people think this virus is? The reason Covid deaths fell as quickly as they rose back in spring is because the disease had all but run its course. The Great Barrington Declaration does not engage with this model of the virus (the only one I have seen that fits the facts) and so I fear that, in not being adamant enough, it could alienate both sides.

Also on rt.com As Boris Johnson announces Britain’s ‘great reset’, were the Covid ‘conspiracy theorists’ right all along?
Between two stools?

For instance, the declaration lists a series of preventative measures that vulnerable people “should use” to avoid infection. Again, in my opinion only a hazmat suit and full laboratory quarantine can protect a person from an endemic respiratory virus. Nevertheless, the “think of Granny!” brigade should be satisfied with this part.

Establishment quacks are already being wheeled out to finger-wag about the “dangerous idea” of herd immunity, and also to throw about the newly coined phrase “long Covid”, referring to lasting fatigue and other effects some people are claiming after surviving the virus.

These commentators, along with moronic social media commentators, often describe herd immunity as “genocidal”. This hyperbole was especially prevalent when Sweden was said to be aiming for herd immunity (it never was). You may have noticed, though, that when the issue of mandatory vaccines comes up, herd immunity suddenly becomes very important. Strange…

Of course, herd immunity is far from genocidal. In fact, as one Twitter user with a good memory pointed out, wasn’t the UK’s plan from the very beginning about reaching it?

When the history of this outbreak is written, one hopes that the Great Barrington Declaration will be an important moment when the tide turned away from the lockdown evangelists and towards the interests of the common people. One thing is certain: it is not before time.

The statements, views and opinions expressed in this column are solely those of the author and do not necessarily represent those of RT.

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