sleeping panda by Cimberley courtesy of pixabay.com
Politico reported today (April 24) that the Bank of China bankrolled a nearly $1 billion refinancing deal on a property in which [redacted] has a 30% stake– one of His most expensive pieces of real estate– in 2012, via a $211 million, ten-year loan that formed part of the package. Sadly for Him, He is only a minority stakeholder in this real estate– so he has no control over the policies there and can’t put His name on the buildings.
Since He has been criticized for his weak, late response to the coronavirus crisis earlier this year, He has gone negative on China. At first, he was full of praise for Xi Jinping, the head of the Chinese state. Now he is blaming them for “covering up” the spread of the virus from its epicenter in Wuhan province. In point of fact, by early January the Chinese government was allowing its scientists to report on key facts about the virus: its complete genetic sequence, a critical bit of information that informed efforts to create tests for, and drugs against, the virus. Without actually saying so, the Chinese admitted that there was human-to-human spread. The Chinese warned the rest of the world that the virus would be highly contagious.
There were things the Chinese government did that could be seen as a “cover-up”: they wouldn’t allow foreign experts from WHO into the country for several weeks. They implicitly concealed the probable spread of the virus to four times the number of people who were officially reported. They have taken other steps that, in retrospect, appear to be counter-propaganda: after American sources claimed that the virus was either deliberately or accidentally released from a major virology lab in Hubei, Wuhan, a Chinese government source put out a theory that American soldiers had delivered the virus to Wuhan in late 2019 during a military exercise.
There has been, to be sure, a major propaganda war between the US and China, with the new virus a focal point for attacks from both sides. For example, I recently received in the mail a “newspaper” (unsolicited) from an American organization that was at least five double-sided, newspaper-sized pages with a layout closely resembling a conventional newspaper. The entire “news” content of the paper consisted of scurrilous attacks on China, starting with the assertion that “the Chinese Communist Party” was responsible for deliberately infecting US citizens and sending them back here to spread the virus. The content went downhill from there, and every single article consisted of a propaganda attack on China, particularly the Chinese Communist Party. There were no ads except for offers to subscribe. I was shocked, shocked I tell you, to find that the Americans (at least the Republican Party) are spending good money to spread disinformation among the credulous rural voters in Devin Nunes’ (the “farmer”) congressional district.
This paper is produced by the “Epoch Times”, which claims to be a non-profit organization and uses this claim to get a discount on postage. The whole back page consisted of an ad offering a subscription and a request to share “CCPVirusTruth.com” “with at least 5 friends”. In large print, scare headlines announced that this paper is “A Factual and Honest Newspaper” and “LIES KILL, TRUTH SAVES”– “HELP ALL AMERICANS SEE THROUGH THE CCP’s COVERUP”. The headline on the front read, “How the Chinese Communist Party Endangered the World”. Every single article in this already yellowing paper repeated another aspect of the propaganda claims central to Fox “News” and [redacted]’s attacks on China.
One article went so far as to claim that “21 million fewer Cellphone Users in China May Suggest a High Death Toll”. The implication that over 20 million people in China have died from the novel coronavirus is staggering, not to mention incredible.
This type of propaganda is paid for by secret donations to Political Action Committees (PACs) tied to the Republican Party by like-minded individuals. It is only one example of the monies spent to distract from, distort, and deny the facts on the ground. These are attempts to instill fear and anger in the hearts of naive rural people.
Certainly the novel coronavirus originated in Wuhan, certainly local Communist Party officials initially attempted to cover up the existence of a new form of viral pneumonia. But the authorities completely reversed themselves when higher-ups realized that a truly dangerous situation was at hand. At first, a doctor was called into a police station and admonished for reporting (by the pre-authorized mechanism for reporting new diseases) cases of viral pneumonia that didn’t fit established patterns.
Two weeks later, his punishment was reversed and a formal apology was made to his family (after he died of the virus he warned about). The complete genetic sequence of the virus’ RNA was published in record time by the virological institute that is the subject of negative propaganda now. Its work was entirely confirmed by multiple outside labs in many other countries, and now forms the basis for many other sequences that show how the virus spread and mutated through-out the world.
The Republicans can complain that the Chinese government didn’t do a lot of things that would have been helpful to obtain complete transparency. But if their critics had not piled on with false conspiracy theories and anti-Asian ethnic slurs, perhaps they would not have felt so much pressure to counter with conspiracy theories of their own. At a time like this, when all of humankind is threatened by a new enemy, attacks against the very people who were trying their best to contain its spread are not helpful.
A final word about [redacted] and his obligations to a Chinese state bank: he has no business attacking Biden for being “soft on China” or claiming that his son Hunter profited from his connections to his father. The connections turned out to be a bust for Hunter Biden. He didn’t make any money from the failed deal with Chinese individuals who had business connections with the Chinese government. All he made was a headache for his father, who did not personally intervene to help him and is now being pilloried for having the same name as his son. That won’t stop the Republicans, of course. They are out to throw as much mud as they can against the wall in the hopes that some of it will stick.
Now is a perilous time for [redacted]. Objective citizens (independent voters, not registered with either major party) can see that He continues to fail in His response to the crisis, and they are reacting with disgust. His only plan is to double down on His attacks against American liberty and equality. He is increasing, quietly (while our attention is diverted by the crisis) His pernicious attempts to create more pollution and more global warming by repealing laws that were supposed to help reduce pollution and encourage our transition from fossil fuels to solar and wind energy.
You can expect to see more destruction of American institutions between now and the time Biden’s Democratic administration takes over in January 2021. His minions will continue to subvert the Voice of America by trying to install a head who will create a propaganda arm of his re-election campaign. He will continue to destroy protections for minority groups like LGBTQA people, full citizens who don’t deserve to be discriminated against by bigoted individuals. He will continue to hollow out our international obligations like the support of WHO and foreign aid to countries seriously affected by the new virus. In short, he will keep up the work he started in January 2017: an attempt to make America safe for plutocrats and billionaires, and dangerous for the lower 99% of our population.
flip flop sandals by Peggy Choucair courtesy of pixabay.com
First reports by the Financial Times today (April 23) of a remdesivir placebo-controlled trial in China say it was a “flop”. Virtually the same percentage of mortality was found– 13% vs. 14%– with 158 on remdesivir and 79 on a placebo; 18 were withdrawn due to side effects in the active group and an unspecified number (in the FT story) withdrawn from the placebo arm for side effects (this sounds absurd, but is expected in such a trial, in which even the doctors giving the pill don’t know whether it’s a placebo or the real thing).
Gilead’s stock dropped significantly after this story came out.
The FT story admits that the study was stopped prematurely due to low enrollment. We don’t know for sure what this means. Others are likely to weigh in with their own interpretations of this study as we will see over the next few days. Stay tuned.
photo courtesy of Gerd Altmann (geralt) via pixabay.com
According to the New York Times, New York Governor Andrew Cuomo announced that a preliminary survey or 3,000 people found 14% with antibodies to the new virus. Among 1300 residents of New York City, 21% were positive. The survey was conducted among people who were out shopping, meaning they were not essential workers (like grocery clerks or bus drivers) but not isolated at home. The rate of positive results would probably be higher among essential workers, but lower among people who have isolated themselves at home. The sample will be increased over the next few weeks, which will give a better picture of who has been infected over the entire population of New York State.
The test results suggest that 2.6 million people across New York State had been infected with the virus, although there are only 250,000 positive antigen tests on record– a disparity of ten times.
image by Lothar Dieterich courtesy of pixabay.com
Multiple news outlets (including the BBC) have warned that the pandemic will lead to increased famine, particularly in Africa, where an outbreak of locusts has decimated crops throughout eastern Africa and southern Asia. Yemen has the worst famine in decades from the locusts already.
David Beasley, head of the World Food Programme (WFP), made the following statements:
“We could be facing multiple famines of biblical proportions within a short few months,” he said. “The truth is we do not have time on our side.”
In a call to action, he added: “I do believe that with our expertise and our partnerships, we can bring together the teams and the programmes necessary to make certain the Covid-19 pandemic does not become a human and food crisis catastrophe.”
Mr. Beasley himself recently recovered from an attack of COVID-19. He also said, “Excuse me for speaking bluntly… One way or another, the world will pay for this.” He predicted that 30 million people could die from the famine, a hundred times the number of people who have died from COVID-19 so far. The WFP currently feeds more than 12 million people a month in Yemen.
At the same time, it was reported that 26 million Americans had succeeded in filing for unemployment in the past month. Famine could affect people right here in America, as the food banks are under unprecedented stress from rising demand and smaller donations.
Surely, the US government could find a billion here or a billion there in its over $3 trillion relief program to help the hungry in Africa. But Mitch McConnell (Senate Majority Leader), the most powerful man in the US government after the *president, has said to the states, “drop dead”, literally telling them to file for bankruptcy (which they cannot do under law) in part to get out from under their onerous, underfunded pension obligations. There is no compassion in the people who run our government– none for our own states, who have been forced to compete for scarce supplies with the federal government, and none for the hungry of the world.
[the information about world famine was sourced from the BBC article referenced above; the part about our government comes from multiple recent news sources.]
photo by Susanne Jutzeler courtesy of pixabay.com
The New Yorker on April 20 published an article by Jim Yong Kim titled “It’s not too late to go on offense against the coronavirus”.
The five main categories of offensive action against the novel coronavirus (SARS-COV-2) are as follows: 1) social (physical) distancing; 2) contact tracing; 3) testing; 4) isolation; and 5) treatment.
These strategies have been employed by the countries with the best records against the virus: South Korea, Singapore, Taiwan, and Hong Kong. The article describes how these strategies can bring the spread of the virus under control, even at this late date. The author describes how Massachusetts (to which he is a special advisor) is beginning to implement the elements of this aggressive plan. The Broad Institute is also going to help.
We need considerable help to implement these elements. Contact tracing requires people who can do the “shoe leather” detective work. Isolation requires direct assistance to those who are quarantined, to help them with food, shelter, and medicine– and to explain to their bosses why they can’t come to work. Medically supervised isolation facilities are also needed. Treatment requires research and production of new medicines.
All of these things require a lot of work. It is better to engage in this work than it is to just shelter in place and hope for the best. Rather than just throw money at impacted businesses, we should invest in hiring and supporting the people who can do the work needed to trace and isolate all contacts.
From the article:
When we presented our plan to Governor Baker, he didn’t say that it was too expensive or too hard or too late. He said, “We have to do this. We have no choice. It feels like we’re just sitting and waiting. We have to go on offense against the virus.”
photo courtesy of pixabay.com
Reported by the Washington Post on April 22. The death only came to light now because tissue samples from the autopsy were sent to the Centers for Disease Control (CDC) for analysis by the county medical examiner and analyzed for the new virus. A second patient who died February 17 was similarly analyzed and announced at the same time.
[redacted] and Dr. Deborah Birx also claimed that the US has one of the lowest death rates from the virus in the world– a patently false claim. According to the Post, the US has a higher rate than 101 other countries.
puzzle by Gerd Altmann courtesy of pixabay.com
The Washington Post published a story on April 19 about patients missing from the normal retinue of emergency cases: those with the usual non-infectious illnesses such as appendicitis, heart attacks, strokes, cholecystitis, and gallbladder stones. Mount Sinai cardiovascular surgeon John Puskas was quoted as saying, “Everybody is frightened to come to the ER [emergency room]”. People who don’t come in with early signs of these acute emergency conditions are going to come later, when their symptoms have reached unbearable levels, and are going to be harder to help, with more complications or even death from untreated illness.
One anecdote, a patient with appendicitis in his twenties: he tried to “tough it out” with over-the-counter painkillers, until his appendix had ruptured and formed a large abscess in his belly. He had to have open surgery (where a laparoscopy could successfully have removed an unruptured appendix) and a colostomy, meaning he was forced to spend days in the hospital. He would have to return later to take down the colostomy to restore normal bowel functioning. He had to take antibiotics for an extended period and could have died. He was afraid to come to the hospital early, when his condition could have been quickly treated, because he was afraid of contracting the virus– even though, at his age, he might have had an asymptomatic infection or quickly recovered without any problems.
Evert Eriksson, trauma medical director at the Medical University of South Carolina, described this patient and said, “… 70 percent of the appendicitis on my service right now are late presentations. What happens when you present late with appendicitis is, we can’t operate on you safely.” Yet his 700-bed hospital is only 60 percent full because most of their patients have been discharged to make room for an expected surge of coronavirus patients.
A report accepted April 7 as a pre-print in the Journal of the American College of Cardiology (cited in the Washington Post article) documented a 38% reduction in patients admitted for percutaneous coronary artery revascularizations at nine major cardiac catheterization labs in the Northeast and Midwest in March 2020 as compared to the previous fourteen months. These patients, all with acute myocardial infarctions (heart attacks) with ST segment elevation (a sign of complete blockage of a major coronary artery to the heart), simply were not seen. Some of them would have died without this treatment; the rest suffered severe heart damage and were left with weakened or reduced heart function. This happened at a time of stress when heart attacks would have been expected to increase rather than decrease.
From the Washington Post article:
A Gallup online poll taken March 28 to April 2 asked people with different conditions how concerned they would be about exposure to the coronavirus if they needed “medical treatment right now” at a hospital or doctor’s office. Eighty-six percent of people with heart disease said they would be either “very concerned” or “moderately concerned.” Among people with high blood pressure, the figure was 83 percent.
One major stroke center found a more than 60 percent reduction in referral calls from hospital ERs about possible stroke patients and a more than 50 percent reduction in patient phone calls. It seems that patients with mild or moderate stroke symptoms are simply not calling in for help.
Some conditions are less common because of the almost universal “stay at home” orders blanketing the country. There has been a steep drop in car crashes, for example. There has not been a drop in domestic violence incidents.
Some heart attacks may be prevented by people not going to work and not exerting themselves at home. Others may be prevented by not eating high-fat restaurant meals and the drop in air pollution (and air pollution, especially particulates, does bring on heart attacks). Some patients with heart attacks may never make it to the hospital because emergency medical protocols have changed. Those who suffer cardiac arrest and do not have return of spontaneous heart action (and circulation) after resuscitation efforts are not being taken to the ER, but are declared dead in the field.
Finally, some patients with COVID-19 may have double diagnoses: both new virus disease and heart attacks at the same time. Only time and thorough review of all findings will tell us where all the emergency patients have gone.
Deep uncertainty about the new virus and its effects on patients with pre-existing conditions has made the job of treating all patients during this pandemic much harder. We already know that conditions like diabetes, high blood pressure, and heart disease make infections with the new virus worse. What we don’t know is why other factors, many of which are more prevalent in elderly patients, make recovering from an infection so much harder. We don’t know what other genetic or social conditions are doing to make the infection and death rates so much higher in African-American and Caribbean-American patients; we just know that things are much harder for black people.
klee flower by cocoparisienne courtesy of pixabay.com
Medpage today has an article published April 20 titled “Fear of the False Negative COVID-19 test” which describes concerns over the false negative rate of the virus antigen nasopharyngeal swab test, especially for healthcare providers. The article states that, with a 10% prevalence of truly infected COVID-19 patients, out of a million healthcare providers, 40,000 will show false negative tests. This is a serious problem both for providers and patients, and the first statement in the article underestimates the extent of the problem.
In fact, the rate of positive tests in patients later confirmed to have COVID-19 is only 70-80%. A Chinese study of 51 patients who had abnormal chest CT, only 71% (36/51) had positive RT-PCR nasopharyngeal swabs at the first go. One patient required four swab tests to isolate the virus. From the CT study:
50/51 (98%) patients had evidence of abnormal CT compatible with viral pneumonia at baseline while one patient had a normal CT. Of 50 patients with abnormal CT, 36 (72%) had typical CT manifestations (e.g. peripheral, subpleural ground glass opacities, often in the lower lobes and 14 (28%) had atypical CT manifestations.
From the study’s conclusions:
In our series, the sensitivity of chest CT was greater than that of RT-PCR (98% vs 71%, respectively, p<.001). The reasons for the low efficiency of viral nucleic acid detection may include: 1) immature development of nucleic acid detection technology; 2) variation in detection rate from different manufacturers; 3) low patient viral load; or 4) improper clinical sampling. The reasons for the relatively lower RT-PCR detection rate in our sample compared to a prior report are unknown. Our results support the use of chest CT for screening for COVD-19 for patients with clinical and epidemiologic features compatible with COVID-19 infection particularly when RT-PCR testing is negative.
Compared to rates of positive tests done by bronchoalveolar lavage (fluid taken from deep in the lungs by bronchoscopy, a tube inserted down the throat into the lungs to observe to bronchi), with a positive rate of 93%, the nasopharyngeal swab is inadequate for making a diagnosis. This explains why the Chinese decided to include abnormal chest CT findings as a criterion for diagnosis of COVID-19 cases.
A patient who presents with cough, fever, chest pain, and shortness of breath is likely to have viral bronchitis or pneumonia. If the test done by nasopharyngeal swab is negative, the patient may be falsely concluded to have influenza (or an influenza-like illness caused by another virus or a bacterium). Tests can be performed for the influenza virus, cold coronaviruses, and bacteria, and if these are negative, further suspicion may fall upon the new virus– but this state of affairs will lead to patients not being adequately isolated and not included in case counts.
More seriously, if the patient is a healthcare provider, and they go back to work, they may wind up infecting many patients who would not otherwise be exposed.
The only solution is to presumptively isolate all patients who have symptoms consistent with influenza-like illness. This may perhaps have been the best course of action even if the new virus were not known to exist, since it would lead to patients not being exposed to other contagious illnesses that could have equally adverse effects clinically.
The clinician’s learning curve for this viral pandemic is steep, indeed. We need to take instruction from the Chinese, who, despite their suspicious behavior in regard to case counts (which subject is open for discussion, either way), have provided us with a great deal of information about the disease, making diagnoses, and ways to combat its spread. We (the editorial “We”) cannot condone totalitarian behavior by the Chinese government.
We must seek voluntary agreement to isolation, surveillance, and control because agreement is essential to win this fight. We can only obtain voluntary compliance with strict measures by radical transparency and protection of the identities of those who are affected. This is seen with the South Korean model, where they have gained the upper hand and are continuing the fight with almost complete buy-in of the entire population of South Korea.
We call for all Americans to be given access to “smartphones” that are programmed with infection tracing, news apps, and control measures. This includes notification of all significant developments in news of the campaign and information about confirmed cases that have “crossed the path” of the smartphone owner so they can be fully informed and take precautions to prevent illness or inform disease-control teams if symptoms arise.
We also demand that tests be made available to all Americans, both acute (virus RNA detection by nasopharyngeal swab or sputum analysis) and chronic (serum antibodies or serology) as soon as is possible. If it appears to be necessary, the president must invoke the Defense Production Act to order private industry to develop and market testing supplies and equipment. A small step in the right direction was announced yesterday: an order to produce 20 million swabs for use in the virus detection test kits.
Much greater efforts are needed if we are to rescue the economy and return the US to a leading place among the nations of the earth. I/we call upon all Americans to “vote the bums out” and begin a program of radical restructuring that will work to end the obfuscation, corruption, and incompetence of the current administration led by a sociopathic, narcissistic, nepotistic con-man. We can do no less for our fellows, especially those who have been left behind and are being mowed down by the pernicious new virus. Members of minority groups, including Native Americans, African-Americans, Caribbean-Americans, Asian-Americans, and Latin Americans, have been discriminated against in the past and are now being affected in greater numbers by this virus. I/we call upon all Caucasian-Americans (European and British) to stand together with your fellow Americans of color to defeat the seditious conspiracy of plutocrats who have seized control of this country and have been running it into the ground since their Electoral College victory in 2016.
Conrad Theodore Seitz 