Tag Archives: CDC

Facing the Abyss – What Should CDC Do Now?

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The COVID-19 virus that Trump predicted would “just go away” has now killed More than648,000 Americans out of more than40 million cases. https://wapo.st/38PnK3N

The leading states in new deaths are, unsurprisingly, South Carolina (+36%), Florida (+32%) and Texas (+24%). As cooler weather approaches and more people stay indoors more of the time, the cases/deaths toll can be expected to rise, especially in places with low vaccination rates and persistent refusal to follow national health guidance on masking and distancing. It is what it is.

Predictions now always face opposition from the determined crowd of COVID deniers, anti-maskers and anti-vaxxers who are doing their best to ignore reality and push the country closer to the abyss. This is happening despite the overwhelming evidence that the vaccines are safe and effective and that masking works to reduce infection rates. The excuses offered for rejecting vaccines, masking, etc. are too well known to warrant recital.

The CDC and the leaders of the healthcare community that know the most about all this have, to be sure, made “mistakes” during the runup from early 2020 to now. Those mistakes are an inevitable part of the steep learning curve during a novel virus epidemic, especially when combined with inept and corrupt national leadership promoting bogus cures and inspiring resistance to promising candidates to contain the spread. We are where we are.

The question now is what could be done to change the national narrative. I address this with full awareness that millions of Americans would rather risk a horrible death than be seen to “comply” with national health guidance. There may be nothing we can do about them, but I think there are some things we haven’t tried yet.

Starting with the CDC, setting aside the chaotic approach in the early days when Trump’s political pressure seemed to influence CDC’s public posture, I have been troubled by what I label “website data bloat.” The CDC Data Tracker [https://bit.ly/3hd72A0] is the object of my derision. The site is an extraordinary trove of information for Job and others with much patience, consisting of a multitude of boxes and lists and maps, many of which are redundant or require some study to fully understand what is being shown.

I speculate that the site is the product of turning over the communication function to programmers who believe more is always better and just don’t know where to stop or how to organize information to tell a story rather than “show what we’ve got.” But, whatever the root cause, the site, for all its robustness, does not communicate the story as dramatically as it could. And if anything cries out for dramatic storytelling, it is the continued, and avoidable, rampage of COVID through America.

It should come as no surprise at this late date that, having been blunted in impact among most older people (who, generally, have a higher percentage of vaccinated individuals than other cohorts), is turning its mindless “attention” toward other groups, including children, many of whom are too young to be vaccinated according to the latest protocols.

In my view, parents of young children who refuse vaccination should be prosecuted for child endangerment, but we know that’s not going to happen. We can, however, more effectively communicate the danger.

This is how. It will require a fundamental change in the way the government does things.

Instead of presenting a vast array of charts/graphs/pathways to still more charts/graphs and offering data in various formats (gross, per capita, per this and that), focus on one thing: the message. This is a situation in which the data should be used not just to inform but to persuade. To teach. To affect.

So, what to do?

First, move all the “just data” charts/graphs to the back of the site with a simple index of what’s there.

Second, in the front, using graphs backed by data, show the key facts in a direct comparison of, for example, deaths of vaccinated versus deaths of unvaccinated people over time. Include data on adverse effects of vaccinations to the extent it exists.

Third, add to the data on cases and deaths, the data on known cases of adverse health impacts (heart, lung, brain, etc.) for COVID “survivors,” information that has largely been ignored.

Fourth, stop focusing on the number of people with one shot. We know that for the main two vaccines, two shots are essential and that’s the key number to show. Focusing on one shot is misleading.

Fifth, show the damn videos!

A wealth of videos exists showing, especially, the end stage of COVID experience in hospital ICUs: the ones where the unvaccinated, wired and tubed beyond recognition, are facing intubation and medically induced comas and are begging doctors and nurses for vaccination and “do anything to save my life.” Show those videos in TV ads in lieu of the bland “please do the right thing” messages now in use. Show the healthcare providers, dressed like aliens from Planet X, saying, “I’m sorry but it’s too late. Vaccines can’t help you now.”

 Some people will see this as unacceptably harsh. To them I say, if you don’t like it, don’t watch. But if done properly (get some experts in this kind of dramatic communication on the task), this stands some chance of jolting resisters into doing the intelligent thing and rushing to get vaccinated.

Make the message simple and clear and unmistakable – if you don’t get vaccinated, this is what may await you. Or your family. Your children. Do it now.

We know from experience that presenting the public with vast quantities of unconsumable statistics is not achieving the level of success we need to stop the pandemic. It is time to pull out all the stops. Stop acting like the government and act like you’re trying to sell something: public health. Survival.

Do it now. We’re almost out of time. The abyss is nearer by the day. It doesn’t have to be this way. Act like it’s the emergency it really is. Just do it.

Norwegian Cruise Line Fights the Right Fight Against Ignorance

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The case is Norwegian Cruise Line Holdings, Ltd., et al. Plaintiffs, vs. Scott Rivkees, M.D., Defendant, in the United States District Court for the Southern District of Florida. The opinion was written by U.S. District Court Judge Kathleen Williams acting on the Plaintiff’s Motion for Preliminary Injunction. The defendant is the Surgeon General of Florida and the head of the Florida Department of Health.

The lawsuit was brought to enable Norwegian to protect its customers to the maximum extent possible in the face of directives from the Republican “small government” Governor of Florida who has forbidden cruise lines operating there on international itineraries to require use of face masks, vaccinations and proof of vaccinations.

Judge Williams’ thorough and carefully crafted 59-page opinion grants the plaintiff’s motion. This allows Norwegian to establish its own COVID health protocols, including requiring proof of vaccination as a condition for cruising. The opinion skewers the defense for its failure to present evidence on key issues. While it’s always tempting to blame this on the lawyers, the reality in this case is that the evidence for the defense simply doesn’t exist. The state’s attempt to prevent cruise lines from adopting safe health standards is a political maneuver, not a rational health policy decision with demonstrable roots in local health needs or medical science.

Judge Williams’ opinion should stand up well in the appeal that Governor DeSantis, known on Twitter as #DeathSantis, has announced he will file. DeSantis’ statement about the case included this gem, “A prohibition on vaccine passports does not even implicate, let alone violate, anyone’s speech rights, and it furthers the substantial, local interest of preventing discrimination among customers based on private health information.”

That suggests the good governor did not read the District Judge’s opinion or lacks understanding of the legal principles involved. His lack of awareness extends to the growing public support for “vaccine passports,” and he is also unaware of federal ventilator resources sent to his state by the federal government to help relieve the crisis caused by the Delta Variant and his refusal to recognize the challenges it poses. Delta threatens to overwhelm the health facilities of multiple, mainly southern, states, including Florida, that have largely ignored the danger still posed by COVID-19. Florida’s governor is earning his moniker as #DeathSantis every day.

Norwegian Cruise Line is on the right side of health science, health policy and rational business behavior. Kudos to NCL’s management for standing up to the Florida Governor’s rejection of all of those as he plays to his right-wing political audience, the same base that thrives on adoration of Donald Trump (you remember him, speaking about Democrats: “the virus is their new hoax.”)

In an op-ed in TravelMarketReport, https://bit.ly/2VKcfri, way back in October 2020, long before anyone had heard of the Delta Variant, I argued that the path to travel industry recovery required restoration of consumer confidence but that the path then in play was more chaos than order. I suggested an approach that, in those troubled times, I thought might work:

I suggest that the atomization of the industry’s approach must be replaced with an across-the-board cooperative regime of joint decision-making to which individual firms commit to total compliance for a significant period into the future. For example, and as a great beginning, the cruise industry players (of which there are relatively few independent entities) have undertaken a collective effort to establish firm rules about how ships will be sanitized, how masking and social distancing will be applied and so on. Obviously, the science behind this is still evolving, but much is already known about how to manage indoor environments. I believe that the new rules should be vetted with a representative sample of cruise travelers to evaluate whether the rules are understandable, practical and reassuring. The likely outcome is not a return to full-on unlimited cruising and many economic challenges will remain. The concept is not a cure-all but an attempt to establish a common and trustable arrangement that will permit business to resume on some scale.

Call me a dreamer if you like. We are not close to what I had envisioned. Nowhere is this clearer than in the battle Norwegian Cruise Line is fighting, alone, with Florida. Downloadable CDC data for Florida, from August 6, paints a grim picture. https://bit.ly/3lU94rX This will not deter Florida’s governor from resisting science and common sense as he continues his efforts to stop the cruise lines from using the best defenses available to control the virus and resume safe cruising.

The chaos will thus continue for a while longer. I am confident Norwegian Cruise Line will continue the fight and hopefully will succeed, however long it takes.

 

 

 

Lost in Space

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I am harping a bit about the failure of the mainstream media to recognize the peril in which the country, and the MSM itself, finds itself. This failure is reflected in numerous ways, the latest being the decision of favorite New York Times to publish on page 21 of Sunday’s edition a story about the astonishing direct efforts by Donald Trump to suborn the Department of Justice to support his unfounded claims that the 2020 election was invalidated by fraud. Not only is Trump guilty of this effort to subvert the election, but compelling evidence has been produced that he had secured the support and active cooperation of Jeffrey Clark, the acting head of the Justice Department’s civil division. https://nyti.ms/3iy3Gsw

This story is related to the on-going attempts of Trump and his enablers in Congress and the Republican-controlled states to overturn the lawful election of Joe Biden for President. That is the most important story of our time, right up there with the pandemic. If Trump had succeeded (or succeeds in the future), the democratic republic known as the United States of America would be finished. Seriously, is there a more important story than that?

As usual, the key players at the Justice Department have gone dark, refusing to comment substantively. But the testimony of Jeffrey Rosen, who was Acting Attorney General at the time, indicates that despite being directed otherwise, Clark continued having private conversations with Trump while Trump was still president. Clark even “drafted a letter that he asked Mr. Rosen to send to Georgia state legislators, wrongly asserting that they should void Mr. Biden’s victory because the Justice Department was investigating accusations of voter fraud in the state.” The proposal was rejected but the apparent fact remains that Clark engaged in multiple violations of DOJ policy, and possibly federal law, in working collaboratively with Trump to overturn the election.

Clark has a spectacular resume. https://bit.ly/2VG7yi4 That fact does not mean that he was incapable of the acts to which Rosen, with a similar resume (https://bit.ly/37vlgqu), has testified. The story mentioned almost in passing the suggestion by one of Trump’s lawyers that Trump “might take some undisclosed legal action if congressional investigators sought “privileged information.” That is, of course, a huge issue, but privilege (executive or attorney-client or whatever) cannot be used to coverup conversations about the commission or attempt at commission of a crime.

I well understand that there are many other big stories afoot at the same time. The Times front page this morning covers some of those: the Cuomo scandal, Republicans supporting infrastructure legislation, problems attributable to children being denied in-classroom learning, restaurant struggles in New York City and, of course, the Olympics. But page 21 for the inside story of attempts to defeat the lawful transfer of power?

Meanwhile, my other favorite publication, the Washington Post, has once again elected (it clearly had a choice) to publish an op-ed that undermines the effort to rid the country of COVID-19 through vaccinations and other public health measures. https://wapo.st/3iwpgxx This piece was written by Drew Holden, a public affairs consultant in D.C. and a former Republican congressional staff member. There is no surprise, therefore, that he objects to the recently re-established mask mandate in Washington, including those already vaccinated. Typically, he downplays the significance of the Delta Variant that is sweeping the country and overwhelming medical resources in numerous states. He focused on a “slight uptick in local cases” and “only three deaths from the coronavirus in the past two weeks and with a positive test rate hovering around 1 percent.” Only three dead in two weeks, so who cares?

The author’s data, however, is massively contradicted by the Center for Disease Control’s COVID Data Tracker, https://bit.ly/3Cs8qrt. And, of course, the author dredges up the usual Republican talking points about overbearing government (ignoring, for example, the new Red Hero, the Governor of Florida, who has worked around the clock to defeat public health measures in his state that might help control the virus — #DeathSantis doesn’t hesitate to overrule local officials and to prevent Florida jurisdictions from following CDC guidance). So much for the principle of limited government.

Apparently no fan of logical consistency, Mr. Holden argues that while indoor mask mandates will reduce viral transmission, they will undermine the effort to persuade more people to vaccinate. He argues that more vaccinations are the “best way” to prevent more deaths, a view that most rational humans would accept, but Holden argues that vaccination is the only viable path forward, so the solution is to use the “best message” by repeating over and over again that vaccines are safe and effective.

Mandating masks even for the vaccinated sends a clear (if unintended) message to the contrary: Even when you have the vaccine, you aren’t really safe to yourself or others, even if we just told you the opposite was true. How can those already deservedly distrustful of the medical wisdom of the government overcome their skepticism if the government itself can’t seem to get the story straight?

Wow. If the author were really paying attention, he would understand that no one has claimed that vaccines were 100 percent security against COVID infection. This has been clear since the earliest public disclosures of the vaccines. The author also confuses mask requirements with other forms of incentive to vaccinate.

I could go on and on about this piece, but the real issue I want to raise is: why does the Washington Post continue to give credence and exposure to views like this? Is the Post’s commitment to truth tied to both-sides-ing issues of public health? Does the Post really believe that this type of message is essential to understanding the public health risks of another, and perhaps yet another, surge in COVID cases? If the Post is going to continue both-sides-ing COVID messaging, should it not explain its editorial policy to its readers?  If the issue were whether it is in the national interest to maintain a union of 50 states or whether we’d be better off as a nation by having multiple states secede, would the Post also both-sides that issue? How about smoking? Does the Post intend to publish both-sides commentary on the benefits and detriments of smoking tobacco? Wearing seat belts? How is this different?

Didn’t Take Long, Did It?

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President Biden gave a long address to a joint session of Congress. Two hours later (12:04 a.m. this morning), Leana S. Wen,  filed a 775-word response as a “Contributing Columnist at the Washington Post.  https://wapo.st/3xyYfPc Dr. Wen (a title I use out of respect but is curiously omitted from her byline) is prodigiously educated and experienced in matters medical. However ….

The gist of Dr. Wen’s instant response to the President was that by requiring masks & physical distancing, Biden undermined the effort to achieve herd immunity through vaccination because the images of the audience of politicians in masks will support rather than negate vaccine hesitancy. She took this position despite the rule in place since January that requires masking while on for federal properties.

My first draft of this post went on at length about Dr. Wen’s curious choice of hills to fight on, but after a short walk, I concluded “so what?” The truth is probably that no matter which course President Biden took (assuming he was even involved in the decision), it would have been wrong in some “expert’s” eyes. Too cautious, not cautious enough, ad nauseum.

To her credit, sort of, Wen also attacked the CDC for “overly-cautious guidelines” that she says may lead people to conclude, “What’s the point of getting inoculated if not much changes?” She goes back and forth between “Biden sent the wrong message” and “CDC needs to urgently change its recommendations” that Biden followed.

Pretty mushy messaging in the end. Somebody’s at fault, but who? In the end, in my opinion, her attack on the speech arrangements added more fuel, not less, to the ignoramuses who claim that the vaccines are unsafe, contain secret devices to …. oh, never mind.

 

Trump Subversion of Federal Health Authority Complete

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The Center for Disease Control (CDC) has announced that Trump’s subversion of the national health service is complete. In apparent obedience to Trump’s expressed desire to “slow the testing down, please,” CDC now says that it “no longer recommends testing for most people without symptoms, even if they’ve been in close contact with someone known to have the virus.” https://cnn.it/32vgQgz

According to the CNN report,

Dr. Leana Wen, an emergency physician and public health professor at George Washington University who was previously Baltimore’s health commissioner, said … that the testing guideline changes make no sense. “These are exactly the people who should be tested,” Wen said, giving the example of a person exposed at work who wants a test so they can protect their family at home.

It almost seems that CDC is trying to confuse the public further.

The CDC guidelines say if someone has symptoms and they’re mild, a health care provider “may advise a COVID-19 test,” and if symptoms are severe, people should contact a health care provider or seek emergency care.

“It is important to realize that you can be infected and spread the virus but feel well and have no symptoms,” the updated CDC site says, noting that local public health officials might request asymptomatic “healthy people” be tested, depending on cases and spread in an area.

In its pandemic planning scenarios, the CDC says its current best estimate is that 40% of infections are asymptomatic and 50% of transmission occur before symptoms occur.

The CDC did not explain the change, and doctors were puzzled by it.

Uh huh. Puzzled. Yes, not only doctors.

Dr. Wen further said,

“This is key to contact tracing, especially given that up to 50% of all transmission is due to people who do not have symptoms. One wonders why these guidelines were changed — is it to justify continued deficit of testing?”

Not unexpectedly, CNN reports that

A spokesperson at the US Department of Health and Human Services denied the change would affect contact tracing efforts, which most public health officials say is key to any eventual control of the virus. “The updated guidance does not undermine contact tracing or any other types of surveillance testing,” the spokesperson said.

HHS said people should consult with their doctors or with local health officials to decide if they need to be tested. “The guidance fully supports public health surveillance testing, done in a proactive way through federal, state, and local public health officials,” the spokesperson said.

If your head is spinning, that is the intended effect. Mission accomplished. You have been gaslighted by your government at the behest of the president. Recall that Trump has repeatedly complained that “we do more testing, we show more cases.” In Trump’s bizarro mind, that means if you do less testing, there will be fewer positive cases to report and we can say “Trump did a great job because the virus is under control – just look at those low positive case counts.”

This is the conduct of a proto-dictator who cares nothing about the welfare of the people he swore an oath to protect. He has finally succeeded in subordinating yet another government function to his Alice-in-Wonderland version of reality. Just to get re-elected, the only thing that really matters to him other than money.

You know what to do.