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45 minutes ago, JDunkin said:

Basically, nothing to do with whether one should vote or not for Trump. Actually, it is. It is very scary how the left have become like the third world police states where one is investigated because of their political views.

Keep these tyrants out of power.

It has much to do with whether or not you vote for a candidate.  If it doesn't bother you that you are voting for a philandering, cheating, swindling liar, then I guess we measure candidates by a different stick.

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I didn't see the correction regarding the woman who complained her hijab was torn off. Allegedly....she lied. Trump was elected by virtue of the votes of those he persuaded with his campaign pron

This is all I will say on the subject. Let's be honest, they didn't exactly have an easy choice. Liar vs. Liar is a pretty accurate way to frame it. They made their choice but were deeply divided in d

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Posted (edited)

The difference was Bill's policies were good for the U.S.  And here's the proof.

https://www.bloomberg.com/opinion/articles/2019-01-28/trump-economy-lags-clinton-s-obama-s-reagan-s-and-even-carter-s

https://www.cnn.com/interactive/2019/business/stock-market-by-president/index.html

What is it you say? 

Oh ya, vote for policy ?

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This speaks volumes...

https://www.nejm.org/doi/full/10.1056/NEJMe2029812

Dying in a Leadership Vacuum

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.

 

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.

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Like in the past, you sure love the name calling.

So now, for the third time, I will ask you...

What policies has trump enacted that you see as advantageous for the average American?  What benefit has he brought to the country?

As well, when it comes to judging, you attack me, yet you don't comment on the New England Journal of Medicine's editorial, (which by the way is the first time in their almost 200 year history that they have done so) that backs up my assertions about trump.

You sir, are just the Emperor in his new clothes.

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5 minutes ago, JDunkin said:

When you have incompetent governors like Cuomo who put covid patients in old folks homes and then blame Trump for the deaths, you know that there are fraudulent claims going around. Yet you would vote for Cuomo. How about that.

https://globalnews.ca/news/7145722/coronavirus-new-york-nursing-homes/

"The death toll inside New York’s nursing homes is perhaps one of the most tragic facets of the coronavirus pandemic: More than 6,400 residents have died in the state’s nursing homes and long-term care facilities, representing more than one-tenth of the reported deaths in such facilities across the country.

What went wrong? The effort to answer that question has become politically charged, with Republican lawmakers using the deaths to try to undermine Gov. Andrew M. Cuomo, a third-term Democrat, who has largely been praised for helping New York State to rein in the outbreak.

At issue is a directive that Mr. Cuomo’s administration delivered in late March, effectively ordering nursing homes to accept coronavirus patients from hospitals.

The goal was to free up hospitals’ beds at a time when those facilities were being overwhelmed by fresh waves of virus patients. But family members and nursing home staff feared that sending those patients to nursing homes may have created a dangerous environment that allowed the virus to quickly spread."

https://www.nytimes.com/2020/07/08/nyregion/nursing-homes-deaths-coronavirus.html

What would de-icer have said if Trump did this. You would scream bloody murder instead of the praise your side has for a democrat.

And that is direct cause.

Once again you misdirect and deflect.  Here's the facts.  Please use all the information in a story.

https://khn.org/news/is-cuomo-directive-to-blame-for-nursing-home-covid-deaths-as-us-official-claims/

Does the #DemConvention know @NYGovCuomo forced nursing homes across NY to take in COVID positive patients and planted the seeds of infection that killed thousands of grandmothers and grandfathers?”

— Michael Caputo, assistant secretary for public affairs, Department of Health and Human Services, in an Aug. 17 tweet

 

This story was produced in partnership with PolitiFact.

This story can be republished for free (details). Politifact logo

On the first night of the Democratic National Convention, New York Gov. Andrew Cuomo was among the first in a weeklong parade of speakers to issue scathing critiques of the Trump administration’s coronavirus response.

 

Cuomo’s criticisms drew a quick reply in a tweet from Michael Caputo, an assistant secretary for public affairs at the Department of Health and Human Services.

“Does the #DemConvention know @NYGovCuomo forced nursing homes across NY to take in COVID positive patients and planted the seeds of infection that killed thousands of grandmothers and grandfathers?” he wrote.

It was an easy jab: Cuomo has been dogged by criticism for months over his March advisory directing nursing homes in the state to accept patients who had or were suspected of having COVID-19. As long as they were medically stable, the notice said, it was appropriate to move patients in. Further, nursing homes were prohibited from requiring that medically stable prospective residents be tested for the virus before they arrived.

Between March 25 and May 8, approximately 6,326 COVID-positive patients were admitted to nursing homes, according to a state health department report.

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While experts say this policy was flawed, is it fair to say that the governor’s directive “forced” nursing homes to take patients who were sick with COVID-19? And to what extent did that strategy sow the seeds of disease and death? When we examined the evidence, we found it was less clear-cut than the statement makes it seem. The policy likely had an effect, but epidemiologists identified additional factors that fed the problem. What’s more, the policy did not “force” nursing homes to accept COVID-positive patients. Nursing homes interpreted it this way.

We checked with HHS to find the basis for Caputo’s comment but got no response.

The Back Story

As the virus tore through nursing homes, killing dozens at some of them, Cuomo came under withering censure. His administration’s policy, implemented with an eye toward freeing up hospital beds for an onslaught of COVID patients, seemed to disregard the risks to frail and elderly nursing home residents who were especially vulnerable to the disease.

According to the COVID Tracking Project, 6,624 people have died of COVID-19 in nursing homes and other long-term care facilities in New York, accounting for 26% of the state’s 25,275 COVID deaths. Some say the true number of deaths is much higher because, unlike many states, New York does not count the deaths of former nursing home residents who are transferred to hospitals and die there as nursing home deaths.

Cuomo’s explanation for the policy — that he was simply following guidance from the federal Centers for Disease Control and Prevention — didn’t cut it. A recent PolitiFact piece examining his claim rated it “Mostly False.”

In May, the governor amended the March order, prohibiting hospitals from discharging patients to nursing homes unless they tested negative for COVID-19.

A Misguided Approach

In the early days of the COVID-19 pandemic, when New York was the epicenter and more than a thousand people were being hospitalized daily, there was a genuine fear that hospitals would not be able to accommodate the influx of desperately ill patients.

Moving people out of the hospitals and into nursing homes was one strategy to help hospitals meet these needs.

According to the CDC guidance cited in the earlier PolitiFact story, there were two factors to consider when deciding whether to discharge a patient with COVID-19 to a long-term care facility: whether the patient was medically ready, and whether the facility could implement the recommended infection-control procedures to safely care for a patient recovering from the virus.

A document from the federal Centers for Medicare & Medicaid Services said nursing homes should accept only patients they were able to care for.

Long-standing state guidance is based on the same condition.

Still, nursing homes didn’t believe turning away patients with COVID-19 was an option.

“On its face, it looked like a requirement,” said Christopher Laxton, executive director of the Society for Post-Acute and Long-Term Care Medicine, which represents medical professionals in nursing homes and other long-term care facilities. “The nursing homes we spoke to felt it was a mandate, and a number of them felt they had no choice but to take COVID patients.”

While the overarching guidance not to take patients in unless they could be safely cared for may have been clear, nursing homes’ experience was often different, said.

Sources

New York State Department of Health, Advisory: Hospital Discharges and Admissions to Nursing Homes, March 25, 2020, via Skilled Nursing News

New York State Department of Health, New York State Department of Health Issues Report on COVID-19 in Nursing Homes, July 6, 2020

The Wall Street Journal, “New York Sent Recovering Coronavirus Patients to Nursing Homes: ‘It Was a Fatal Error,’” May 14, 2020

The COVID Tracking Project, The Long-Term Care COVID Tracker, accessed Aug. 20, 2020

PolitiFact, “New York’s Nursing Home Policy Was Not Fully in Line With CDC,” June 13, 2020

New York State Executive Order No. 202.30, Continuing Temporary Suspension and Modification of Laws Relating to the Disaster Emergency, May 10, 2020

Telephone interview, Christopher Laxton, executive director, Society for Post-Acute and Long-Term Care Medicine, Aug. 20, 2020

Telephone interview, Richard Mollot, executive director, Long-Term Care Community Coalition, Aug. 19, 2020

Telephone interview, Jim Clyne, CEO, LeadingAge New York, Aug. 20, 2020

New York State Department of Health, “Factors Associated With Nursing Home Infections and Fatalities in New York State During the COVID-19 Global Health Crisis,” revised July 20, 2020

The New York Times, “Does Cuomo Share Blame for 6,200 Virus Deaths in N.Y. Nursing Homes?” July 23, 2020

Associated Press, “Blame Game? Cuomo Takes Heat Over NY Nursing Home Study,” July 14, 2020

Telephone interview, Denis Nash, epidemiologist, City University of New York School of Public Health, Aug. 20, 2020

Email interview, Rupak Shivakoti, assistant professor of epidemiology, Mailman School of Public Health, Columbia University, Aug. 20, 2020

Email interview, Gary Holmes, assistant commissioner, New York State Department of Health, Aug. 20, 2020

Richard Mollot, executive director of the Long-Term Care Community Coalition, an advocacy group for elderly and disabled people. “There was little reason for nursing homes to think they should only take in patients if they have the ability to do so safely because those rules are not generally enforced on a regular basis.”

Bottom line: State and federal rules didn’t force nursing homes to accept COVID-positive patients, but many of them believed they had no other choice.

A Lethal Result?

How much of the blame for the deaths of thousands of people in nursing homes from COVID-19 can be attributed to Cuomo’s March advisory?

That is the 6,000-person question.

In a July analysis of COVID-19 nursing home deaths, the state concluded that the deadly virus was introduced by nursing home staff members rather than sick patients.

It noted that peak nursing home resident mortality from COVID-19 on April 8 preceded the peak influx of COVID patients on April 14. In addition, it found that nearly 1 in 4 nursing home workers — 37,500 people — were infected with the virus between March and early June.

Based on these and other factors, the report concluded that the state admissions policy could not have been a driver of nursing home infections or fatalities.

Epidemiologists and nursing home advocates beg to differ.

“To say that introducing patients [to nursing homes] who had COVID did not cause problems is ridiculous,” said Laxton.

Calling the study’s approach “pretty flawed,” Denis Nash, an epidemiologist at City University of New York School of Public Health, said he didn’t agree with the report’s conclusion that the policy had nothing to do with deaths.

Others had the same view. “I didn’t think they showed data to say [the policy] is not a ‘driver,’” said Rupak Shivakoti, an assistant professor of epidemiology at the Mailman School of Public Health at Columbia University.

But Gary Holmes, assistant commissioner at the New York State Department of Health, had a different take. Critics of the report, he said, must be deliberately ignoring the rising death tolls in nursing homes in hot spots across the country.

“Public health officials in those states are experiencing (and acknowledging) what NY’s report indicated weeks ago: these facilities are microcosms of the community and transmission is occurring unknowingly by asymptomatic spread among staff members,” Holmes said, in an email.

While public health experts quibbled with the report’s self-serving claim that the governor’s policy wasn’t a factor in COVID-19 nursing home deaths, they nevertheless agreed with the report’s broader conclusion that nursing home staffers as well as visitors, before they were banned, were likely the main drivers of COVID-19 infection and death in nursing homes.

“Based on the timeline of the policy and deaths in the city, it is very unlikely that policy contributed to thousands of deaths,” said Shivakoti.

Infection control is a long-standing problem at nursing homes, Nash said, and the COVID deaths were a basic failure of infection control. That said, “it’s unclear how many of the deaths the policy might have caused.”

Also unclear: how many of the dead were grandmothers and grandfathers.

Our Ruling

In a tweet, the HHS assistant secretary for public affairs said that New York Gov. Andrew Cuomo “forced” nursing homes across the state to admit COVID-positive patients and that this policy fueled the spread of COVID-19 that led to thousands of deaths in the nursing home population.

Although nursing homes felt pressure to accept COVID-positive patients, they were not actually forced to do so. State regulations require nursing homes to accept patients only if they can care for them, and they could have refused them on those grounds.

In addition, it’s unclear the extent to which the governor’s policy was responsible for nursing home COVID-19 deaths. Infection control is a long-standing problem in nursing homes, predating the pandemic, and a report showed peak numbers of nursing home deaths came prior to the peak influx of patients as a result of Cuomo’s advisory. While the introduction of COVID-19 positive patients into nursing homes no doubt had an effect on infection spread, Caputo’s statement suggests it was solely responsible. That’s not what the evidence shows.

We rate this Mostly False.

 

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5 hours ago, JDunkin said:

Who cares what Eric Trump says. He is not running for president or involved with the government. Wait a minute, perhaps our impressive widebody jet driver(who has to tell us what kind of large plane he flies and insinuates how much better he is than those Cessna 150 pilots) thinks that this is a good reason to not vote for Trump. 

But those who oppose Trump still seem to idolize Bill Clinton. After all, he still goes to the Democrat convention and is cheered. So what was it about slick Willie's half-brother again. Drug trafficking I believe. Went to jail. Was pardoned by Bill. Well if Bill is good enough for a second term based on that, Trump is good enough based on a silly claim.

The tenor of this report was about the self aggrandizement of his father saving Christianity, Christmas, the Easter egg hunt etc. Just reviewing your vapid prosaic anger filled postings were you bullied in a early life or compensating for a lack of self esteem? I find it distasteful your petulant attacks on deicer calling him a fraud where you should be embracing Voltaire who said "I disapprove of what you say but I will defend to the death your right to say it".

Hate to disappoint you but I hung my hat up over 11 years ago but if you must know Canadian ATPL land and sea endorsements HS-125, B-727, L-1011, DC-9, EA-320, CL-65, B-767 and EA-330. USA commercial multi-engine instrument and Sri Lankan ATPL based on my Canadian ATPL with 23,000 + hours. Spoiler alert my PPL was done on a C-150 seaplane..

In closing I will suggest you follow this saying from the great American Playwright Samuel Langhorne Clemens "It is better to keep your mouth closed and let people think you are a fool than to open it and remove all doubt".

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10 hours ago, JDunkin said:

Thanks,

So Cuomos policies were only partially responsible for the deaths at the retirement homes. Thanks for confirming that. Considering how you are so upset about two healthy guards being endangered in Trumps van ride(and they won't die by the way), how concerned are you about a policy that allows covid positive patients into retirement homes. A half decent governor would never support such a thing.

Once again you cherry pick and then present out of context.

Why didn't you include the part where it said it was under federal guidance that they did that?  Because it doesn't fit your incomplete narrative.

Follow AC330's advice.

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9 minutes ago, deicer said:

Once again you cherry pick and then present out of context.

Why didn't you include the part where it said it was under federal guidance that they did that?  Because it doesn't fit your incomplete narrative.

Follow AC330's advice.

No matter how you twist the reasons why, the numbers speak for themselves. New York failed horribly.

BD5190C1-9FD9-4DCC-ADC9-DBA2A7B47B2B.jpeg

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Jaydee, yes, they did.

This line of discussion isn't about that though.

Blame is being placed where it shouldn't be, rather than looking at the truth of the matter.

Look to England and other countries that followed the same belief as the U.S.  Their curves were comparable and they too are also still having problems.

The editorial from the New England Journal of Medicine explains clearly how the current U.S. administration failed and is sits firmly in the U.S. federal government's lap.

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FWIW....My opinion on the VP debate:

Harris - reminded me of trudeau...same smarmy smile looking directly at the camera, lots of platitudes, evasive and refusing to answer a direct question on stacking the Supreme Court with leftist jurors. Lost points when asked if justice served in Floyd case.

Pence - trying to defend an idiot, but stayed calm and collected. Law and order trying to make America great again.

All in all, not sure who won but not impressed by the bias shown by major networks analyzing, post debate. Best analysis was on pbs.

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1 hour ago, st27 said:

FWIW....My opinion on the VP debate:

Harris - reminded me of trudeau...same smarmy smile looking directly at the camera, lots of platitudes, evasive and refusing to answer a direct question on stacking the Supreme Court with leftist jurors. Lost points when asked if justice served in Floyd case.

Pence - trying to defend an idiot, but stayed calm and collected. Law and order trying to make America great again.

All in all, not sure who won but not impressed by the bias shown by major networks analyzing, post debate. Best analysis was on pbs.

At the end of the day it doesn't really matter. IMO, Americans vote for either a President or a Party, not who's the VP candidate. This debate was just a reality show for the networks. But if I had to pick a winner, it was Pence hands down. Harris had some moments but her sneering smug expression lost it for her. In reality this was her audition to become President. Will be a sad day if that ever happens.

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The real reason Trump does not want to participate in a virtual debate:

Quote

Mr Trump said: "I'm not gonna waste my time on a personal debate. Sit behind a computer, ridiculous. They cut you off... I'm not doing a virtual debate."

 

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32 minutes ago, Malcolm said:

The real reason Trump does not want to participate in a virtual debate:

 

 

They have a point imo.

President Donald Trump's two eldest sons lashed out at plans to hold the second presidential debate virtually as their father said he would not take part in the head-to-head if the contest was not held in person.

 

Donald Trump Jr. said the move announced by the Commission on Presidential Debates (CPD) on Thursday morning was "such bulls***" and would allow Democratic nominee Joe Biden to be fed "talking points" by campaign staff throughout the debate.

The president's younger son Eric Trumpmade a similar remark, suggesting the Democratic presidential nominee Joe Biden would have "12 teleprompters" and more than a dozen campaign staff at the ready if the head-to-head was held remotely.

https://www.google.ca/amp/s/www.newsweek.com/trump-sons-outraged-debate-1537475%3famp=1

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4 minutes ago, Jaydee said:

 

They have a point imo.

President Donald Trump's two eldest sons lashed out at plans to hold the second presidential debate virtually as their father said he would not take part in the head-to-head if the contest was not held in person.

 

Donald Trump Jr. said the move announced by the Commission on Presidential Debates (CPD) on Thursday morning was "such bulls***" and would allow Democratic nominee Joe Biden to be fed "talking points" by campaign staff throughout the debate.

The president's younger son Eric Trumpmade a similar remark, suggesting the Democratic presidential nominee Joe Biden would have "12 teleprompters" and more than a dozen campaign staff at the ready if the head-to-head was held remotely.

https://www.google.ca/amp/s/www.newsweek.com/trump-sons-outraged-debate-1537475%3famp=1

 

They do indeed have a point but Trump could do the same.  I still think his real reason is that if he got out of hand (as in the last debate), he voice feed could be muted.

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https://www.washingtonpost.com/opinions/a-public-health-giant-gives-a-scathing-indictment-of-trumps-pandemic-response/2020/10/07/d90524dc-08c6-11eb-a166-dc429b380d10_story.html

 

 

A public health giant gives a scathing indictment of Trump’s pandemic response

 

Opinion by Editorial Board

Oct. 7, 2020 at 3:37 p.m. EDT

WILLIAM FOEGE, a legendary figure in public health who helped devise the strategy that curtailed smallpox in West and Central Africa in the late 1960s and who led the Centers for Disease Control and Prevention under Presidents Jimmy Carter and Ronald Reagan, wrote a letter Sept. 23 to the current CDC director, Robert Redfield. The letter has now been disclosed by USA Today and should be read by everyone concerned by President Trump’s dreadful response to the coronavirus pandemic and his corrosive politicization of public health.

Dr. Foege, an epidemiologist who received the Presidential Medal of Freedom in 2012, said he wasn’t sure what he would do in Dr. Redfield’s shoes, but the first thing “would be to face the truth.” Despite spin from the White House, “this will go down as a colossal failure of the public health system of this country. The biggest challenge in a century and we let the country down.” In the future, public health textbooks “will use this as a lesson on how not to handle an infectious disease pandemic.” The cause, he said, has been “the incompetence and illogic” of the White House.

Not placing the CDC in charge of the pandemic response violated “every lesson learned in the last 75 years that made CDC the gold standard for public health in the world,” he wrote. The need for a “coherent federal plan, the backbone of every former response, has been ignored,” leaving it to the states, often competing among themselves. The “absolute need to form and guide coalitions” was ignored, he wrote, and the need for global cooperation squandered. Dr. Foege recalled the lesson that “the best decisions are based on the best science while the best results are based on the best management.” In this case, he lamented, “the White House has rejected both science and good management.”

He said he initially thought White House officials would “see how disastrous their approach was and finally turn the job over to professionals. Now I know that won’t happen.” He bemoaned how the White House “manipulated the valuable reputation” of the agency by diluting its warnings of the virus’s dangers. Many current and former CDC employees think Dr. Redfield caved in to the White House’s orders “without sufficient resistance,” he asserted. He urged Dr. Redfield to come clean, apologize in a letter and declare his intention to lead the agency without meddling. “Don’t shy away from the fact this has been an unacceptable toll on our country,” he wrote. “It is a slaughter and not just a political dispute.”

Dr. Foege appealed to Dr. Redfield’s conscience, saying he should resign on principle if necessary, that he shouldn’t want to be remembered as “forsaking your role as a servant to the public in order to become a servant to a corrupt president.” Whether Dr. Redfield takes the advice or not, it is certainly long past time for him to reject the White House pressure on the CDC and embrace the primacy of science and expertise in managing public health.

 

Foege-Letter.pdf

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From the New England Journal of Medicine

 

 

https://www.nejm.org/doi/full/10.1056/NEJMe2029812

 

 

Dying in a Leadership Vacuum

List of authors.

  • The Editors

Metrics

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.

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.

Disclosure forms provided by the authors are available with the full text of this editorial at NEJM.org.

 

  1. 1.Johns Hopkins University Coronavirus Resource Center. COVID-19 dashboard by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University (https://coronavirus.jhu.edu/map.html. opens in new tab).

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  1. 2.Total number of COVID-19 tests per confirmed case, September 14, 2020. Our World in Data (https://ourworldindata.org/grapher/number-of-covid-19-tests-per-confirmed-case. opens in new tab).

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  1. 3.McGinley L, Abutaleb L, Johnson CY. Inside Trump’s pressure campaign on federal scientists over a Covid-19 treatment. Washington Post. August 302020 (https://www.washingtonpost.com/health/convalescent-plasma-treatment-covid19-fda/2020/08/29/e39a75ec-e935-11ea-bc79-834454439a44_story.html. opens in new tab).

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  1. 4.Haberman M. Trump admits downplaying the virus knowing it was ‘deadly stuff.’ New York Times. September 92020 (https://www.nytimes.com/2020/09/09/us/politics/woodward-trump-book-virus.html. opens in new tab).

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Voting by mail 

Thousands of residents in NJ town receive mail-in ballots for wrong district
 

Nearly 7,000 voters in Teaneck, N.J., received mail-in ballots, only to realize they were the wrong ones.

Some residents of the town live within the state's fifth congressional district, while others are in the ninth. Some ballots that went to voters in the fifth district were printed with the ninth district race and vice versa, according to NorthJersey.com.

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18 hours ago, JDunkin said:

Who cares what Eric Trump says. He is not running for president or involved with the government. Wait a minute, perhaps our impressive widebody jet driver(who has to tell us what kind of large plane he flies and insinuates how much better he is than those Cessna 150 pilots) thinks that this is a good reason to not vote for Trump. 

But those who oppose Trump still seem to idolize Bill Clinton. After all, he still goes to the Democrat convention and is cheered. So what was it about slick Willie's half-brother again. Drug trafficking I believe. Went to jail. Was pardoned by Bill. Well if Bill is good enough for a second term based on that, Trump is good enough based on a silly claim.

Asked and answered 

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3 hours ago, JDunkin said:

I agree 100% with Voltaire. But I have just as much right to point out fraudulent or intentionally misleading information which is much more important to society in my opinion thsn the right to make completely hypocritical statements.

How convenient that you repeatedly make condescending remarks such as calling me Sonny repeatedly, statements about people with a supposedly higher payscale than me, and statements that obviously make it known that somehow the size of the aircraft you flew somehow make you a better person than those flying smaller aircraft and then you state how you find how others are distasteful. A truly great example of hypocrisy. In other words, yes you are distasteful as well.

“Humility is the greatest quality that a man can have, and arrogance is undoubtedly the worst.” Maulana W. Khan

My only reason I ever got into this was to openly mock you for what you are and that is a bully. For me to engage this level is the antitheses of my persona.

Please do deicer and others a favour by wilfully debating the subject NOT the person. 

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4 hours ago, JDunkin said:

How convenient. If the Trump adminiostration does something wrong, he is vilified. When direct examples of the Democrat side of the political spectrum dopes something particularly egregious, we get the statement of "This line of discussion isn't about that though.". In other words, lets get back to the Trump bashing for our political gain. 

How about a little honest analysis. Based on what I have seen since the beginning of this pandemic, I have come to the conclusion that both sides of the political spectrum have failed. And if the political roles were reversed, a similar scenario would have played out. Hillary would not have cut off China travel nearly as early and used the racism card for any calls for restrictions or avoidance of areas more likely to have recent arrivals from infected areas but would have been more proactive on masks. 

Both sides failed in my opinion and both sides would have failed if their roles were reversed. That is what honest analysis is about. Admitting the harsh truth of both facts and opinions of likely scenarios.

Vote based on policy. Ignore the frauds. And yes, there are frauds on both sides.

Another deflection.

It isn't about Hilary, she lost.

Stick with the reality that the trump administration failed.  Not my words, those of the New England Journal of Medicine.

What do you have to debunk them?

 

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