Tuesday, January 25, 2022

The Absolute Disconnect

Dana Milbank in the Washington Post:

The weekend began with the March for Life. It ended with a march for death.

Anti-vaccine activists decided to piggyback on Friday’s annual antiabortion march in the capital by having a “Defeat the Mandates” rally on Sunday. Combined, the two groups of (mostly) conservative activists engaged in a demonstration of mass inconsistency.

Friday’s crowd invoked the mantra of the pro-life movement: “A child, not a choice.” Sunday’s proclaimed the mantra of the abortion rights movement to oppose vaccines: “My body, my choice.”

Friday’s crowd endorsed the most obtrusive of big-government mandates, laws telling women they can’t make their own reproductive decisions. Sunday’s argued that health decisions must be made by patient and doctor, not government.

Friday’s crowd pleaded for the lives of the most vulnerable. Sunday’s demanded the right to infect the most vulnerable by eschewing vaccines and masks in shared spaces.

It was enough to make one wonder: Does taking ivermectin cause people to lose their sense of irony?

The crowds weren’t the same but, collectively, the two rallies captured the hypocrisy of the right at this moment: Protect the unborn, but feel free to infect — and perhaps kill — innocent people already born, including, er, pregnant women. And yet both movements claim to be operating under the authority of “God’s mandate” and “God’s law,” as the anti-vaccine speakers repeatedly put it. God works in mysterious ways, indeed.

In a rare moment of self-awareness at the anti-vaccine rally, JP Sears, the event’s emcee, quipped that because of his belief in natural immunity to the coronavirus, “I kind of feel like a flat-Earther.”

In a sense, the dual events showed the changing nature of the political right. The March for Life, in its 49th year, is where the right has been; the march for death shows where it is going. The former, held potentially on the cusp of the long-sought overturning of Roe v. Wade by the Supreme Court, was a joyful assembly; the latter was paranoid and rage-filled.

The well-curated March for Life program avoided harsh language about “baby killers” in favor of calls for compassion. “Every life is worthy of our prayer and our protection, whether in the womb or in the world,” the Greek Orthodox Archbishop Elpidophoros said before his opening prayer. “We can and we must make the case for life both born and unborn, by our example of unconditional love. … We march with compassion, we march with empathy, with love, with our arms extended to embrace all.”

Unconditional love? Embrace all? The angry speakers at the march for death didn’t sign up for that. They railed against medical boards, peer-reviewed journals, vaccine and antiviral manufacturers, expertise of any kind. They declaimed enemies seen and unseen trying to deny them their freedom.

There is no reasoning with this sort of mindset: they see the issue of reproductive rights and vaccination in terms of absolutes. And, to quote Jed Bartlet, when there are days like that, they usually end with body counts. In this case, there seems to be no limit to the lengths they will go to in order to enforce their beliefs: killing doctors who perform legal medical procedures, bombing clinics, threatening the lives of the mothers who have made their choice to terminate a pregnancy under the law.  The anti-vaxxers will threaten the lives of scientists and allow their loved ones to get sick and possibly die because of something they read on the internet.  At least a flat-earther doesn’t put a gun to your head, literally or figuratively.

If their tactics were limited only to the people who are true believers and left the rest of us alone, then there would not be a problem: believe what you wish and live your life as you wish.  But when absolute strangers begin to interfere with the beliefs of others, then we do have a problem.

Wednesday, September 29, 2021

Update: Going For #3

It was swift and mostly painless, and that was just getting the appointment for my booster shot of Covid-19 vaccine.

My appointment was for 5:45 p.m. at the CVS Pharmacy in Palmetto Bay on US 1.  I checked in at the pharmacy counter, waited while two other people got their shots, then got mine.  The pharmacist, Cindy, was friendly — we chatted about antique cars — and I barely felt the “little pinch.”  Over and done, I stopped to replenish my supply of low-dose aspirin.  Checking out at the cashier took longer than getting the shot.  (By the way, the shot was free thanks to Medicare.)

Twelve hours later, I have no side-effects other than a bit of soreness at the injection site.  I did have some weird dreams involving me teaching a high school theatre class and then reporting to Det. Lennie Briscoe (Jerry Orbach).  Other than that, I’m fine.

Oh, yeah, I did have to reboot my implanted microchip.

Sunday, September 19, 2021

Sunday Reading

Don’t Tell DeSantis — The Miami Herald editorial on the history of getting vaccinated goes far beyond his beady little eyes can see.

In 1777, there weren’t chants of “My body, my choice” at political rallies or governors selling “Don’t Fauci my Florida” campaign T-shirts.

But George Washington’s decision to mandate that Continental Army soldiers be inoculated against smallpox wasn’t easy. There were no safe, widely tested vaccines like the ones used for the coronavirus today, and inoculation in the 18th century was controversial and risky. It required exposing healthy people to the smallpox virus by scratching it into their arm or having them inhale it through the nose, generally causing a mild infection that led to immunity but, also — occasionally — death.

Washington wrote that if his army got widely infected, “We should have more to dread from it, than from the Sword of the Enemy.”

That was the first mass military inoculation, according to the Library of Congress. Since then, vaccine mandates inside and outside the military — and opposition to them — have been woven into the fabric of American life. In fact, we’re living with vaccine mandates right now — and not just for COVID-19.

But in the GOP playbook, vaccine mandates are a new concoction by the freedom-hating far-left and government bureaucrats. Could long-standing vaccine mandates be the next target in Republican-led states like Florida? We once thought that would be a far-fetched possibility. Not so much today.

Want to attend state-funded Florida International University? You must show proof of two MMR shots, for measles, mumps and rubella. Vaccination for hepatitis B and meningitis are also “strongly recommended,” but not mandatory, and require the signing of a waiver.

Want to work at taxpayer-funded Jackson Health System? Whether you’re a doctor or a cafeteria worker, you’ll need a flu shot and proof of MMR and chicken pox vaccination. The hospital system also requires workers to get COVID shots or face restrictions, such as wearing an N95 mask at all times. Religious and medical exemptions apply for the COVID and flu shots, spokeswoman Lidia Amoretti-Morgado told the Herald Editorial Board.

Want to send your children to a public school in Florida? Unless you have a religious or medical exemption signed by a doctor, get ready to prove they received shots for polio, hepatitis B, chicken pox, MMR and DTaP (diphtheria, tetanus and pertussis).

Florida’s school mandate is stricter than those of other states such as Colorado, where parents can object to vaccination on “philosophical” grounds or because of personal beliefs. But don’t tell Florida’s lawmakers. They don’t need any help coming up with bad ideas.

Vaccine mandates have been part of everyday life for Americans for more than a century for the simple reason that they work in controlling or eradicating diseases. Thanks to widespread vaccination, the last natural outbreak of smallpox in the United States happened in 1949.

Gov. Ron DeSantis is leading the charge against local governments that require COVID vaccination from employees, announcing in a recent news conference that he will start fining local officials. Mandates seem to be a greater issue than the misinformation that was propagated at his own event, when a Gainesville employee took the stage to claim falsely that the COVID vaccine “changes your RNA.” DeSantis, apparently suffering from a case of amnesia, said he doesn’t “even remember” what the man who was standing next to him said.

Many say the COVID vaccine is just too new to be mandated. But the approval standards set by the Food and Drug Administration — which gave the Pfizer shot full authorization last month after reviewing data from more than 40,000 people who participated in a clinical trial — are more stringent than what was in place in 1809, when the first state vaccine law was enacted in Massachusetts for smallpox.

In 1905, the U.S. Supreme Court issued a landmark ruling in Jacobson v. Massachusetts upholding a Cambridge City mandate. The court rejected the idea of an exemption based on personal choice because it would strip the legislative power from its function to “care for the public health and the public safety.” In 1922, the court denied a challenge to childhood vaccination requirements. More recently, the Arizona Court of Appeals rejected a challenge to a Maricopa County policy that excluded unvaccinated children from school when there is an unconfirmed but reasonable risk for the spread of measles.

“The 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,” the court wrote in the 1905 case.

In other words, the Supreme Court said freedom doesn’t give you the right to harm others.

But these days, the liberty that Washington’s inoculated troops fought for has been turned into a cloak for anti-vax entitlement and selfishness. Those attitudes have always been part of American society, but partisan politics has never played such an important role with conservative principles becoming intertwined with vaccine hesitancy.

And that raises a scary possibility: If so many Americans believe the COVID vaccine to be harmful or ineffective, who’s to say vaccine mandates for diseases that we thought long eradicated won’t come into question next?

A flawed — and later debunked — study and online conspiracies fueled by celebrities like Jenny McCarthy led many parents in the late 1990s and 2000s to believe MMR vaccines caused autism. There were 22 measles outbreaks across the nation in 2019, the second highest number of reported outbreaks since measles was declared eliminated in the United States in 2000, according to the Centers for Disease Control and Prevention.

We’re already seeing that the fervor against the coronavirus vaccine has jeopardized public access to information about immunizations in general. Tennessee health officials, under pressure from lawmakers, stopped all adolescent vaccine outreach for COVID as well as other diseases in July. Health department employees were told to remove the agency logo from vaccine information given to the public, and the state fired its top vaccine official. After The Tennessean broke the story, drawing national condemnation, the state resumed most outreach efforts.

In past times, we would brush off what happened in Tennessee as an isolated case of lunacy. But today we cannot so easily dismiss the idea that lunacy might prevail against established — and effective — public-health measures.

Doonesbury — Dream a little dream…

Monday, July 26, 2021

Killing Them Off

It seems that certain states run by Republicans have devised a sure-fire method of voter suppression.

Across the country, GOP lawmakers are rallying around the cause of individual freedom to counter community-based disease mitigation methods, moves experts say leave the country ill-equipped to counter the resurgent coronavirus and a future, unknown outbreak.

In some states, anger at perceived overreach by health officials has prompted legislative attempts to limit their authority, including new state laws that prevent the closure of businesses or allow lawmakers to rescind mask mandates. Some state courts have reined in the emergency and regulatory powers governors have wielded against the virus. And in its recent rulings and analysis, the U.S. Supreme Court has signaled its willingness to limit disease mitigation in the name of religious freedom.

“The legal framework has evolved in ways that will complicate and perhaps undermine efforts to deal with the next public health crisis or even routine health threats,” said Wendy Parmet, director of the Northeastern University Center for Health Policy and Law, who also said she has been a “long critic of emergency laws and their potential for abuse.”

A key issue, Parmet and others say, is that the legislative backlash is based on partisan assumptions about this pandemic, limiting states’ options in the face of a new threat.

“Whatever your feelings are about what health officials did in March of 2020, I can talk to you about a future threat that might be different, that would disproportionately affect a different population, that you would feel differently about,” said Lindsay F. Wiley, director of the Health Law and Policy Program at American University and an expert on emergency reform. “Please don’t constrain authority as a reaction in a way that will tie officials to the mast for a future crisis.”

Public health crises usually affect the poor and members of under-representative communities, which means that the states are basically putting up roadblocks to rapid treatment and assistance to them. Ironically, it’s always been the Republicans who complain about government bureaucracy and red tape that hinder “personal freedom.” Now they’re going to use them to kill off the people who most likely need it the most, and most likely can be counted on to vote for the Democrats.

Sunday, April 25, 2021

Sunday Reading

Charles P. Pierce on vaccine “reluctance.”

On the list of my childhood heroes with Odysseus, Zorro, and Bill Russell was Dr. Albert Sabin. Polio was a live issue in our house because my mother had spent a year in an iron lung after she’d contracted the bulbiospinal form of the epidemic disease. This turned her into the lifetime medico-phobe that she was until the day she died. This filtered down to me, and it was only intensified by the fact that I had to get a polio shot every couple of years. I came to dread needles.

The second cause of my trypanophobia—yeah, there’s a clinical word for it—came when I was about six years old and subject to mysteriously high fevers. They put me in the hospital and, very late at night, an orderly the size of LeBron James came and wheeled me into a treatment room. He then took me under my arms and bent me forward. I vividly remember feeling that something very bad was about to happen because they needed this huge person to handle a first-grader. A few seconds later, I had my first (and only) spinal tap. I can still feel the pain that ran up all the way into my ears. I have trust issues regarding medical procedures that I’ve worked very hard to overcome over the past 25 years. I also hate pain.

Anyway, I came to dread the polio shots, but my parents insisted on them. My father managed to get me off the ceiling by talking about how many shots he had to get in the Navy during World War II. He told me that, just before the needle went in, I should grit my teeth really hard. That worked well enough, I found. (I may once have eaten a lip.) But I still dreaded the inevitable booster shots, even though they’d keep me out of the iron lung.

The first miracle regarding polio had come in 1955, when I was two years old. Dr. Jonas Salk developed his vaccine using inactivated polio virus. As soon as I was old enough, I began to get my shots. Then, in 1961, Albert Sabin took away all of my anxieties with a sugar cube.

Sabin developed an oral vaccine against polio. The nuns took us all down to the cafeteria and they handed us this weird tasting sugar cube. (I remember it as tasting surprisingly tangy, like really sharp cough medicine.) That was the end of polio shots in my lifetime. I’ve made my peace with needles. I get my shingles shot, and my pneumonia preventative, every year. I’ve made my peace with IVs after two recent hospital stays. I even give a pint of blood every month as therapy for a genetic blood condition.

So, when the opportunity came to take the Moderna vaccine, I grabbed it like it was the last train to glory. A month apart, I reported to the Thomas Menino YMCA in Hyde Park for my two Dolly shots. After the second one, I fairly flew across River Street to my car, taking deeper breaths than I had taken in over a year. All of which is why I understand many of the people who are reluctant to take the vaccine, my fellow trypanophobes. They should grit their teeth, hard, and get the damn shots, it’s true, but I understand how their minds work. It’s the other ones, the stupid and the stubborn, that I find infuriating. Albert Sabin found them infuriating, too.

It was 1956 and there was a great bogeyman on the other side of the world behind an iron curtain, and great mushroom-shaped clouds of panicky rhetoric. It was not the most auspicious time to go into the research business with Soviet scientists. However, even godless Communists had children, and those children contracted polio the same way that the children of imperialist running dogs did. Sabin had been working on a vaccine that depended on attenuated live polio virus. In 1956, a Soviet scientist named Mikhail Chumatov brought a team to the United States to study Salk’s approach to the problem. Chumatov’s team also stopped in at Sabin’s lab.

In June of 1956, after long negotiations with the FBI, Sabin was cleared to fly to Leningrad to work with Chumatov. Their partnership was so fruitful that, when Sabin’s funding ran out in the United States, Chumatov and Sabin were able to test their vaccine in Russia and, also, in Hungary, where a massive polio outbreak had occurred in 1957, not long after the Soviet Army had crushed the Hungarian revolution. The Salk vaccine had come from the U.S. Now the Sabin vaccine was coming from the same place whence the tanks had rolled. In 2014, Dora Vargha wrote a long study of the start-and-stop cooperation between the United States and Hungary over the polio vaccines, and how that cooperation was caught in the middle of Cold War politics.

While the revolution of 1956 deepened the Cold War divide in the eyes of the United States, the Hungarian government used some of the outcomes of the uprising to lift the Iron Curtain and temporarily allow personal avenues to cut through between East and West. In fact, the shipment of the treasured vaccine was preceded by personal packages containing single doses and over a year’s efforts in domestic production…What is remarkable about this customs policy, and the encouragement of personal aid from family members and friends living abroad, is that through these announcements the state called on precisely the people it wanted to silence, punish, or destroy: émigrés who had left the country on various occasions from World War II onward because of the communist regime.

This all involved the importation of the Salk vaccine from the United States. Meanwhile, in the Soviet Union, Sabin and Chumatov continued their research into the attenuated live virus approach. In 1959, there was another serious outbreak in Hungary that shook the people’s faith in the Salk vaccine. At about the same time, Sabin and Chumatov had a vaccine ready for testing on human beings. And, while the United States was resistant to widespread testing, the citizens of the Soviet bloc did not have the complications inherent to individual freedom.

The scientific exchange between Sabin and Chumakov led to the largest field trial in the history of polio, involving over 16.5 million people across the Soviet Union. Parallel to the Soviet campaign, smaller but equally important trials were conducted in Czechoslovakia and Hungary. In 1958–59, Czechoslovakia organized relatively large field trials of a vaccine prepared from the Sabin strains, while Hungary tested the vaccine in one county in November 1959.

This cooperation across the Iron Curtain in the development of the vaccine did not extend to its implementation. In April of 1955, badly manufactured doses of the Salk vaccine had caused a number of vaccinated individuals in California to develop the disease. This had shredded public confidence in the vaccine, and the kept Hungarian press accused American scientists of using the country’s children as guinea pigs. By the time the Sabin/Chumatov vaccine came online, the Hungarian attitude toward vaccinations had changed dramatically. They had had two outbreaks in the intervening years, and Hungarians seemed to have more confidence in vaccines coming from the East.

Once he’d developed his vaccine, Sabin moved on to championing mass vaccination as a means of “breaking the chain” of polio’s contagion. (He had been won over on the subject of mass vaccination of children by the success that Cuba had seen with it.) His vaccine was uniquely suited to this approach because it was more easily stored and more inexpensively distributed. And that, eventually, is how it happened that I walked down the stairs from my classroom and into the school auditorium, where somebody handed me a sugar cube and all my fears dissolved.

There is nothing new in anti-vaccination movements. There have been backlashes against nearly all breakthroughs in that area of science, beginning with the crude inoculations as a defense against smallpox. In the early 1900s, after many states had passed mandatory vaccination laws, anti-vaccination movements got such statutes repealed in seven states, including California. In 1905, Massachusetts beat back a similar challenge to mandatory vaccination laws passed by many of its cities and towns. In Jacobson v. Massachusetts, the Supreme Court ruled:

The liberty secured by the Constitution of the United States does not import an absolute right in each person to be at all times, and in all circumstances, wholly freed from restraint, nor is it an element in such liberty that one person, or a minority of persons residing in any community and enjoying the benefits of its local government, should have power to dominate the majority when supported in their action by the authority of the State. It is within the police power of a State to enact a compulsory vaccination law, and it is for the legislature, and not for the courts, to determine in the first instance whether vaccination is or is not the best mode for the prevention of smallpox and the protection of the public health.

So now we call it “vaccine reluctance,” even though every person refusing to be vaccinated is a danger to public health. There’s more political ideology mixed in with vaccination policy in this country right now than there was in Hungary or the Soviet Union during the Cold War. That’s just strange.

A Tribute to a Blogger — Tom Watson on the passing of Lance Mannion.

The great Lance Mannion has left us and his passing requires a testament to his gifts and generosity in a venue appropriate to his prolific blogging life. This particular slab of granite will be carved here, upon this ancient turf, this feed, this blog, this Typepad. For this is where Lance lived and created his world of words, where he sowed such a rich wildflower meadow of scents and colors and shapes and stories. His work was a gift to me and so many thousands of others, very lightly remunerated, and yet so consistent that we took yet another wordsmith spring for granted and the sudden killing frost of mortality has wiped the blooms away. There will be no more posts. No more musings on literature and film, television and media, politics and culture.

It was here where Lance Mannion joined the immortals of our game. He ranks with Steve Gilliard, Gehrig’s “luckiest man” to that Ruthian loss and – in my view – the Iron Horse of the liberal blogging era, a man who kept going long after all the RSS feeds dried up and Twitter injected its instantaneous meanness of spirit into what now passes for discourse. Those gauzy days of the aughts seem distant now, but they were a time of superheroes – writers who wore their disguises like marvelous capes and masks and costumes. I shudder at their remembered majesty and might. “Lance Mannion” invented himself, because he could. Because we all could. Lance was part Bing Crosby part Jack Lemmon and part Damon Runyon. But he also injected hardcore liberalism into middle American tastebuds, like Peter Parker’s radioactive spider. Tolerance crossed with curiosity was his superpower. And so he rambled with the Self-Styled Siren, with the Viscount LaCarte, with Neddie Jingo, with Blue Girl, with Shakespeare’s Sister, with M.A. Peel, with Jon Swift, with Majikthise, with Digby, and all the other crazy superhero bastards (including those of us foolish enough to use our real names). Keep your Rat Pack, brother, that was my crowd.

Lance Mannion was the witty guy down at the end of the best bar in town. You walked into the joint happy to see him there every damned night. You left with his jocular Fred MacMurray banter ringing in your ears, smoother than the most expensive Scotch.

Dave Reilly had a harder road.

Lance was my muse, but Dave was my friend. He was a brilliant writer, out of the Iowa Writers Workshop, and a devoted family man who hit some very tough times in late middle life. We went to the Clinton Global Initiative together. We hung around a few Democratic victory parties together. He joined my newcritics blogging venture back in the day. He was a regular at the Hillman Prizes. We marched with the Teamsters at Occupy Wall Street. And then harder times closed in. He had some serious health challenges. And his wife Adrienne – herself a brilliant journalist the very reason why Lance Mannion lionized Lois Lane – became ill. To blog readers, she’s the Blonde or Mrs. M. They were an incredibly close couple, and they loved their boys deeply and publicly. But in this time in this country for a blogger and a newspaperwoman, the economic bar was high even without the healthcare crisis.

Dave would always send a Christmas card. Now and again a postcard. My favorite – as he knew – was the one from Hyde Park, after a visit to FDR’s Presidential library, a place we both revered. He was a very thoughtful man; I was not always as thoughtful in return. Money was tight. The blog raised a bit, but perhaps not enough. The cracks through which a guy like Dave can fall in our society are too damned wide.

If you read the Lance Mannion blog – and by God, it should be preserved – I recommend the posts about his family. He created “Mannionville” and populated it with people. Pop M. The Blonde. Mom Mannion. His boys, Ken and Oliver Mannion. The barista at Barnes & Noble. The guy at the hardware store. A world where people knew each other and cared. That’s where Dave and Lance came together, the place where the blogging superhero took off his mask. They were the same. A loving father, husband, and son. I suspect that’s how he will be remembered the best.

But to me, he’ll always wear a cape.

Doonesbury — For every action…

Friday, December 11, 2020

Happy Friday

Some good news:

Federal advisers endorsed the Pfizer-BioNTech coronavirus vaccine on Thursday, making it all but certain the Food and Drug Administration will authorize the vaccine on an emergency basis within hours or days, kicking off an unprecedented effort to inoculate enough Americans to stop a rampaging pandemic.

But the prospect of relief from the coronavirus came on a day when 107,000 people were hospitalized with covid-19, the disease caused by the virus, and a record 3,347 deaths were reported by state health departments, topping the milestone reached one day earlier. Within days, the country will likely surpass 300,000 deaths since the pandemic’s arrival.

The worsening situation has riveted attention on the final steps of the vaccine approval process. The thumbs’ up from the FDA’s vaccine advisory committee was the culmination of an all-day meeting during which the panel heard presentations on the safety and effectiveness of the vaccine, including plans to monitor its longer-term safety.

The key moment came just after 5:30 p.m., when the agency asked its independent advisers: “Based on the totality of scientific evidence available, do the benefits of the Pfizer-BioNTech COVID-19 Vaccine outweigh its risks for use in individuals 16 years of age and older?”

The committee voted yes, 17 in favor, four against and one absention.

Meanwhile, Republicans and Trump are pressuring the Supreme Court to endorse their attempted coup d’etat.

With his legal options dwindling and time running out before a key electoral college deadline, President Trump on Thursday ramped up pressure on the Supreme Court to help overturn Joe Biden’s victory, gaining the support of more than 100 congressional Republicans in the unprecedented assault on the U.S. election system.

In a morning tweet, Trump called on the court to “save our Country from the greatest Election abuse in the history of the United States,” repeating his baseless claims of widespread fraud. He had a private lunch at the White House with some of the attorneys general from 18 Republican-led states asking the court to dismiss the results in four swing states that Biden won, an effort supported by the Trump administration.

By late afternoon, 106 GOP House members — a majority of the 196-member Republican caucus — had signed on to an amicus brief to support the Texas-led motion, among them Minority Whip Steve Scalise (La.) and Rep. Tom Emmer (Minn.), the chair of the National Republican Congressional Committee.

Once this is over and Trump is in exile, we need to hold all 106 of those minions accountable work to send them into exile as well.

Time to bring the Christmas tree home.  (Actually, this was last year, but you get the idea.)

Tuesday, December 8, 2020

The Shot Felt Around The World

Via the BBC:

Margaret Keenan, who turns 91 next week, said it was the “best early birthday present”.

She was given the injection at 06:31 GMT – the first of 800,000 doses of the Pfizer/BioNTech vaccine that will be given in the coming weeks.

Up to four million more are expected by the end of the month.

Hubs in the UK will vaccinate over-80s and some health and care staff – the programme aims to protect the most vulnerable and return life to normal.

Health Secretary Matt Hancock, who has dubbed Tuesday V-day, said he was thrilled to see the first vaccinations take place but urged people to keep their resolve and stick to the rules for the next few months.

Prime Minister Boris Johnson, on a visit to a London hospital to see some of the first people getting the jab, said getting vaccinated was “good for you and good for the whole country”.

About 70 hospitals nationwide are gearing up to deliver vaccines this week.

At University Hospital, Coventry, matron May Parsons administered the very first jab to Ms Keenan.

“I feel so privileged to be the first person vaccinated against Covid-19,” Ms Keenan, who is originally from Enniskillen, Co Fermanagh, said.

“It’s the best early birthday present I could wish for because it means I can finally look forward to spending time with my family and friends in the new year after being on my own for most of the year.

“My advice to anyone offered the vaccine is to take it. If I can have it at 90, then you can have it too,” she added.

The next person to get the “jab” was a man named William Shakespeare. “How sharper than a serpent’s tooth…”

Monday, August 3, 2020

Raging Fire

It’s getting worse, not better.

The United States has entered a “new phase” of the coronavirus pandemic, Deborah Birx, the physician overseeing the White House coronavirus response, told CNN on Sunday. Outbreaks are increasing in both rural and urban areas, touching isolated parts of the country that once counted on their remoteness to keep them safe.

“What we’re seeing today is different from March and April,” Birx said. “It is extraordinarily widespread.”

Alaska, Hawaii, Missouri, Montana and Oklahoma are among the states witnessing the largest surge of infections over the past week, according to a Washington Post analysis of health data. Experts also see worrisome trends emerging in major East Coast and Midwest cities, and anticipate major outbreaks in college towns as classes resume this month.

At least 4,641,000 coronavirus cases and 151,000 fatalities have been reported in the United States since February. Close to 50,000 new cases and 478 deaths were reported on Sunday, a day of the week when numbers are often artificially low because some jurisdictions do not report data.

Meanwhile, Senate Republicans showing very little interest in doing anything about the economic impact because at least a third of them think that it’s not the job of the federal government to do anything.

The Trump administration is looking at options for unilateral actions it can take to try to address some of the economic fallout caused by the novel coronavirus pandemic if no relief deal is reached with Congress, according to two people with knowledge of the deliberations.

The discussions are a reflection of officials’ increasingly pessimistic outlook for the talks on Capitol Hill. The White House remains in close contact with Democratic leaders, but a wide gulf remains and deadlines have already been missed.

It’s not clear what steps the administration could take without the help of Congress on issues such as lapsed enhanced unemployment benefits or the expired moratorium on evictions — the two matters President Trump has recently identified as his highest priorities in the ongoing talks. Both of those programs were authorized by Congress earlier this year but were designed to be temporary.

If you think a vaccine will be the savior of us all and we’ll all be saved and back to normal, well, that only works on Star Trek when Dr. McCoy comes up with a cure ten minutes before the episode ends.

In the public imagination, the arrival of a coronavirus vaccine looms large: It’s the neat Hollywood ending to the grim and agonizing uncertainty of everyday life in a pandemic.

But public health experts are discussing among themselves a new worry: that hopes for a vaccine may be soaring too high. The confident depiction by politicians and companies that a vaccine is imminent and inevitable may give people unrealistic beliefs about how soon the world can return to normal — and even spark resistance to simple strategies that can tamp down transmission and save lives in the short term.

Two coronavirus vaccines entered the final stages of human testing last week, a scientific speed record that prompted top government health officials to utter words such as “historic” and “astounding.” Pharmaceutical executives predicted to Congress in July that vaccines might be available as soon as October, or before the end of the year.

As the plotline advances, so do expectations: If people can just muddle through a few more months, the vaccine will land, the pandemic will end and everyone can throw their masks away. But best-case scenarios have failed to materialize throughout the pandemic, and experts — who believe wholeheartedly in the power of vaccines — foresee a long path ahead.

“It seems, to me, unlikely that a vaccine is an off-switch or a reset button where we will go back to pre-pandemic times,” said Yonatan Grad, an assistant professor of infectious diseases and immunology at the Harvard T.H. Chan School of Public Health.

Or, as Columbia University virologist Angela Rasmussen puts it, “It’s not like we’re going to land in Oz.”

Mixing metaphors: he’s in Oz, I’m on the Enterprise. The point is the same: it will take years before it’s under control, and it may never be eradicated.

All of these scenarios could have been prevented or drastically reduced if we had had competent and caring leadership in the White House.  Remember that.  And wear your fucking mask.

Sunday, March 3, 2019

Sunday Reading

It’s About The Climate — Benjamin Wallace-Wells interviews Gov. Jay Inslee (D-WA) who wants to be the climate change president.

Last week, Jay Inslee, the Democratic governor of Washington, was in Washington, D.C., for a meeting of the National Governors Association, but he had additional business to conduct. Inslee, who is sixty-eight, was widely understood to be on the verge of announcing a campaign for the Democratic nomination for President. Earlier in the day, he told me, once we’d settled into a conference room at the downtown Embassy Suites, he had met with Barack Obama. The timing created a slightly ridiculous situation, in which Inslee would not formally acknowledge his candidacy but kept hinting at it heavily—mentioning, for example, that he might be in Iowa soon and raising his eyebrows meaningfully. A week later, on Friday morning, he announced that he was running.

Inslee, who is tall and athletic, has an eager and direct manner: his thoughts emerge in lists (“No. 4 is . . .”) and his mind moves toward details. And though he has not been a single-issue governor, the case for his Presidential candidacy rests on his decades-long interest in political solutions to climate change. The thought of Iowa made Inslee turn not to county dinners but to wind turbines. Had I heard there was a new generation of turbines coming? “They’re humongous,” he said, with appreciation. “Three hundred feet long.” He mentioned an alternative-energy entrepreneur he had recently met, a man named Wayne Rogers, who had made a fortune by turning decommissioned dams into hydropower stations. Now, Inslee said, he was working on a high-speed-train venture.

For all the obvious majesty of the subject, environmental politics has always had a slightly airless quality. Al Gore’s documentary “An Inconvenient Truth,” which, for years, was the central document of climate-change activism, is essentially a PowerPoint presentation. For a while, the public discussion of climate change seemed defined, in part, by Gore’s personality—his tendency toward abstraction but also his assurance with his own expertise. Such emphasis was placed on the distinction between Democrats, who were said to be on the side of the scientists, and Republicans, who were said to be opposed, that it came as a surprise when, last October, the Intergovernmental Panel on Climate Change released a report indicating that the scientists had somewhat underestimated just how bad the consequences of global warming would be. The discussion, Inslee said, focussed so much on the consequences of two degrees Celsius of warming that “it shut off discussion of ‘What if we get to four or five?’ ” Now scientists believe that we are on track, without further action, for four degrees of warming by century’s end.

Inslee has been in politics for a quarter century but has never become a national figure. As one of his aides, reached on the West Coast, put it, “he’s not a show horse,” and it took a moment to conceive of the unpretentious governor as a Presidential candidate. On the other hand, there are credible public-opinion polls in which Democratic voters in the early-primary states of New Hampshire, Iowa, Nevada, and South Carolina say that they care more about climate change and health care than any other issues. Inslee’s approach to climate policy, he told me, is “can-do, optimistic—it’s in my nature.” But in Washington, D.C., that approach, reminiscent of Gore, has, for the moment at least, been displaced by the millennial left’s, which is bleaker in tone and more transformative in program. For many years environmentalism has been shaped by technocratic liberalism’s trust in scientific expertise, and faith in the possibility of a global consensus. Now there is an unexpected situation. The climate is in crisis and liberalism is under pressure, at the same time.

Inslee grew up in the Seattle area, where his mother was a Sears-Roebuck clerk and his father was a high-school basketball coach who became the athletic director of the city’s public schools. After Inslee graduated from the Willamette University College of Law, he and his wife, Trudi, moved to the small town of Selah, near Yakima, where he practiced law and worked as a prosecutor, and they raised, as he often says, “three feral boys.” Inslee won a seat in the state legislature, in 1988, and Congress, in 1992—just in time to vote for the assault-weapons ban and lose his seat in the Gingrich revolution of 1994. Inslee and his family moved to the more progressive suburbs of Seattle, and soon he returned to Congress, where he served from 1999 to 2012, co-writing a book, “Apollo’s Fire,” about the potential of green energy.

Inslee, who became governor in 2013, tends toward the pragmatic, the longtime aide told me: “His instinct is to take the win when it is there.” He oversaw an increase in the minimum wage, extensions of family- and sick-leave policy, and the strengthening of environmental regulation and green investment, making Washington State more progressive by increments. Twice in the past three years, he has tried to persuade the state to adopt a relatively modest tax on carbon, once through the legislature and once by referendum; both efforts failed. In 2017, Inslee joined Andrew Cuomo, of New York, and Jerry Brown, of California, to create the U.S. Climate Alliance, a coalition of states that have pledged to adhere to the provisions of the Paris climate accord, even if the Trump Administration did not. Inslee argued that this was important, pointing out that the twenty-one states now in the Climate Alliance would form the third-largest economy in the world, were they to secede from the United States. “Which I am not advocating,” he said, grinning. “Yet.”

Inslee’s view is that the new urgency about climate policy was created by the “visual drama” of real events in people’s lives and on local news. “The reason is Paradise, California, burned down,” he said. “And Houston flooded with unprecedented rain and Miami is underwater and Iowa farmers can’t get their crops in because of precipitation events and Oprah’s house has been swamped by mudslides.” This past November, Inslee drove through Paradise, where the Camp Fire had killed at least eighty-five people. It was dark and silent. “We drove for an hour through a town that wasn’t there anymore, that had burned right to the foundations,” he said. You could look at the town and see the elements of a chemical equation: power lines were kindling; trees were incinerated; houses were reduced to ash. It had been a year of historic fires across the West, in hot and dry conditions intensified by the changing climate, and the Camp Fire was the worst in California’s history. “This is basically a race,” Inslee said. “That’s all it is. Who’s going to win, us or climate change?”

I asked Inslee whether Democrats might have adopted a more urgent tone earlier. After all, humans have done more to warm the planet since his first election to Congress than in all the years before. Inslee said that they had. He and Trudi, his wife, had recently discovered a brochure from his first congressional campaign, in a conservative part of Washington State, in 1992, that emphasized reducing carbon pollution. The crisis had turned out to be deeper than scientists realized even a decade ago, he said, but that’s “hardly our fault.” He thought a bit more. “I think we could have taken Ralph Nader out on a ship before he could file for President. And set the ship adrift. And allowed him to be fed and healthy before the filing deadline. That would have been the most significant thing where we missed our opportunity. I mean, really! You think about how different the world could have been for three hundred and fifty votes that Ralph Nader took out of Al Gore’s pocket. Every time I think about that it just drives me nuts.”

The momentous Presidential election of 2000 had other consequences, too, among them an era of extreme partisan polarization that has transformed most of American politics but especially the pragmatic center-left. By the end of the Bush era, Democrats were pushing cap-and-trade as a policy solution to carbon emissions, in part because it had support from moderate Republicans. But after John McCain backed away from the program, in the 2008 Presidential race, it lost its bipartisan veneer, and the next year, having already expended their political capital on the economic stimulus and the Affordable Care Act, Obama’s Democrats could not muster the support to pass a cap-and-trade bill on their own. The liberals had worked to make their policies pragmatic, but, when they lost the possibility of Republican coöperation, this approach seemed not mature but naïve. In the course of Inslee’s career, the defining Democratic tone has grown more prophetic: Bill Clinton, and then Gore, and then Obama, and then Elizabeth Warren, and then (after a brief return to Clintonism) Bernie Sanders, and then Alexandria Ocasio-Cortez.

Inslee praised the young climate activists who have coalesced around the Green New Deal for their energy and their emphasis on communities, often poor and of color, that are on the front lines of climate change. It was true, Inslee said, and it also might broaden the coalition. But he still seemed to envision that the movement would soon be turned over to the adults. “They’ve raised the ambition level. They’ve married this to environmental justice. Now it’s my job and others’ to put policy behind it.” He was sounding more pugilistic. On Monday, a few days after we met in Washington, D.C., Inslee announced that he supported abolishing the Senate filibuster. “I believe that the world is now moving at a pace that does not accommodate sort of antebellum traditions,” he said. It was also a signal, though he did not explicitly say it, that he was no longer sure that on the deepest issues consensus was possible.

Back in January, Inslee told NBC News that he is no longer pushing carbon pricing. “To actually get carbon savings, you have to jack the price up so high that it becomes politically untenable,” he said. Fair enough. (An especially clumsy effort to impose carbon taxes, last year, sparked the gilets jaunes protests still consuming French politics.) If not carbon pricing, I asked Inslee, then what?

“I’m not running for President yet,” he said, which was technically true, but he went on to describe the plan he envisioned laying out shortly. It would be ambitious “to the scale of what we need to achieve.” It would create jobs; it would also emphasize the experience of front-line communities. There was no silver bullet, he explained; it was more like “silver buckshot.” Carbon pricing, through cap-and-trade or a tax, might be a theoretically elegant mechanism, but, Inslee said, the money to invest in green industries and technologies could come from anywhere, including a reversal of the Trump tax cuts. “It’s just money,” he said. He mentioned new forms of topsoil that could capture carbon, Swiss and German sequestration innovations, and the progress already made in electric cars and trucks. “I could give you twenty-four policies right now,” he said, which made me notice, fleetingly, the exactness of that number.

Republicans have lately taken to deriding the Green New Deal as gassy and fantastical. They have forgotten about the liberals, who will soon be arriving with their tax offsets and their staggered phase-in calendars and their twenty-four-point plans. “The scale of this is appropriate to think about,” Inslee said, with relish. “We do have to build an economy that is not based in fossil fuels. It has to be the organizing principle of the federal government. We don’t like to use conflict or war as a metaphor, but it requires the mobilization of our system like we’ve experienced in times of war.” It made no sense, he said, for Democratic Presidential candidates to insist that we were in an existential crisis and then make addressing it their fourth priority. “A President needs to say, ‘We will create a mandate through the campaign, and I will invest my political capital to get this done,’ ” Inslee said. “This is not an easy lift.” Perhaps he envisioned the Presidential-primary debate stage as the place where he might make that case to voters; it seems, equally, the place where he might impress that urgency onto his fellow-candidates.

Inslee, sitting across a conference table from me at the Embassy Suites, was now fully in campaign mode. He mentioned the transcontinental railroad, and the mission to the moon, with an intensity that suggested that he really meant to rescue the conviction that Americans are an especially brave and competent people. “This is my grand theory of climate change,” Inslee said. “It is not about scientific literacy. It is about optimism versus pessimism, confidence versus fear. Climate denialism is based on fear that we can’t solve the problem, so just ignore it. Fear that we’re not smart enough to develop a new technology. And we’re promoting the opposite view, which is yes, we can solve this.”

Steps To Treating Dementia — Paula Span in The New York Times.

Donna Kaye Hill realized that her 80-year-old mother was faltering cognitively when her phone suddenly stopped working. When Ms. Hill called the phone company, “they told me she hadn’t paid her bill in three months.”

Finding other alarming evidence of memory gaps, she took her mother, Katie, to a memory clinic. A geriatrician there diagnosed dementia and recommended two prescription drugs and a dietary supplement, a form of vitamin E.

Katie Hill dutifully took vitamin E capsules, along with a host of other medications, until she died four years later. As she declined, her daughter didn’t think the vitamin, or the two prescription medications, was making much difference.

“But if it doesn’t hurt, if there’s a chance it helps even a tiny bit, why not?” she reasoned. Ms. Hill, 62, a retired public employee in Danville, Va., takes fish oil capsules daily herself, hoping they’ll help ward off the disease that killed her mother.

The elder Ms. Hill was unusual only in that a doctor had recommended the supplement; most older Americans are taking them without medical guidance. The Food and Drug Administration estimates that 80 percent of older adults rely on dietary supplements, many purporting to prevent or treat Alzheimer’s and other forms of dementia.

Last month, the F.D.A. cracked down on this burgeoning market, sending warning letters or advisories to 17 companies selling about 60 supplements with names like Cogni-Flex and Mind Ignite.

The warnings pointed out that the companies had touted these products as working like Alzheimer’s drugs, “but naturally and without side effects.” Or as “clinically shown to help diseases of the brain, such as Alzheimer’s.” The pills, oils and capsules were said to treat other diseases, too, from stroke to erectile dysfunction.

Claiming that these products were intended for “the cure, mitigation, treatment or prevention of disease” meant that they were drugs, the agency’s letters said.

And since they were drugs the F.D.A. had never reviewed or approved for safety and effectiveness, the companies now must submit applications for approval or stop making such claims. Over the past five years, the agency has taken action against 40 other products making Alzheimer’s claims.

The supplements’ appeal is understandable. A growing older population with longer life spans means more people with dementia, though in population-based studies in this and other Western countries, its prevalence has fallen.

More of us have seen the devastation up close and would do almost anything to evade it. But so far, the news about drugs and supplements has been discouraging.

Although scientists have learned much more about dementia, the research literature and large pharmaceutical trials have mostly served to tell worried Americans about the many substances that don’t appear to prevent, treat or slow dementia.

Vitamins, various antioxidants, concoctions derived from animals and plants — “we see plenty of ads on TV, but we have no evidence that any of these things are preventive,” said Dr. Steven DeKosky, a neurologist and deputy director of the McKnight Brain Institute at the University of Florida.

Dr. DeKosky led a federally supported study of Ginkgo biloba extract, for instance, following more than 3,000 people for seven years to see if it reduced dementia. It didn’t.

“No effects at all,” he said. “But look on the shelves. Many companies still sell ginkgo — if there’s really any in there, because supplements don’t always have the contents they say they have.”

Moreover, “some of these supplements are biologically active and can cause toxicity when you take other drugs,” said Dr. DeKosky. Supplements can be costly, too.

But there are other ways people can reduce their risk of dementia. Two prestigious panels, reviewing many prevention studies, recently came up with several recommendations.

The more conservative report, from the National Academies of Sciences, Engineering and Medicine in 2017, relied primarily on large randomized clinical trials.

There aren’t many of those, so the panel endorsed just three interventions “supported by encouraging but inconclusive evidence,” to prevent, delay or slow cognitive decline.

The three:

  • Increased physical activity;

  • Blood pressure management for people with hypertension, particularly in midlife;

  • And cognitive training.

That last recommendation doesn’t necessarily refer to commercial online brain games, said Dr. Kristine Yaffe, a neuropsychiatrist and epidemiologist at the University of California, San Francisco, who served on the panel.

“It’s really the concept of being mentally active,” she said. “Find something you enjoy where you’re learning something new, challenging and stimulating your brain.”

Though the evidence to date doesn’t establish which mental workouts have the greatest impact or how often people should engage in them, “they’re not expensive and they don’t cause side effects,” Dr. Yaffe pointed out.

The blood pressure recommendation got a boost in January with the latest findings from the Sprint trial, a multisite study stopped early in 2015 when intensive treatment of hypertension (a systolic blood pressure goal of less than 120, compared to the standard 140) was shown to reduce cardiovascular events and deaths.

The investigators continued the trial, however, with 9,361 participants who had hypertension (average age: 68) and completed follow-up cognitive assessments.

Their results, published in JAMA, showed the intensive treatment group less likely to develop dementia than those in standard treatment, though not by a statistically significant margin. Intensive treatment did, however, significantly reduce participants’ risk of mild cognitive impairment, a frequent precursor to dementia.

“To me, it was one of the most exciting findings to come along in years,” said Dr. Yaffe, who noted in an accompanying editorial that this was the first large trial to demonstrate an effective strategy for preventing age-related cognitive impairment.

“The same things we recommend for heart health turn out to be important for cognition,” she told me. “It’s a blossoming field.”

The Lancet Commission on Dementia Prevention, Intervention and Care also recommended hypertension treatment for the middle-aged, along with exercise, social engagement and smoking cessation, as well as management of obesity, diabetes, hearing loss and depression. Such steps could prevent or delay a third of dementia cases, the commission estimated.

When Dr. Yaffe gives talks on dementia prevention, she also mentions good sleep hygiene and urges listeners to protect themselves against brain injuries.

It’s important advice, but disappointingly undramatic. Where’s the magic bullet? Don’t we already know to stay physically and mentally active, maintain a normal weight, treat high blood pressure and so on?

Moreover, “it’s not foolproof,” Dr. Yaffe acknowledged. In the lottery of dementia, “there’s a role for genetics. There’s a role for bad luck.”

Still, she added, “The concept is important. You can do something about this. You can lower your risk.”

That’s why the most helpful approach Donna Kaye Hill uses to protect herself from dementia probably isn’t taking fish oil.

It includes using medication to control her blood pressure. And reading biographies and mysteries and joining a book group with friends. And taking a four- or five-mile walk, five days a week, with a yellow Labrador named Annie.

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