70 Comments

It is hard to overestimate how much damage the pronouncements of experts like Walensky and Fauci have done to the idea that we should respect expertise. What they have demonstrated, repeatedly, is that everything is political. Nothing said can be taken at face value for everything is tinged with so e form of political maneuvering. This is very bad. Very bad. And we can now see the problem was not Trump. It is endemic to the system and it will be very hard to extirpate.

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The good news: Topol's studies do indeed show how to reduce lung damage.

The bad news: first you have to get the Syrian hamsters down into your lungs.

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And Zeynep, congratulations on raising $500,000 for DWB/MSF. What a tribute to you that so many people gave to your fundraiser and a tribute to them that you would pick their work for the focus of your efforts!

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The poem about the fox and the grapes is wonderful, and to have it in Latin also is . . . just sublime!

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Yes, the government should level with us and treat us like adults, rather than infantilising everything. Of course, that may undermine the premise of your NY Times article (or at least the headline, which you might not have chosen), because if the CDC continues to refuse to level with us, then we will of necessity be forced to assume more responsibility for our health and just ignore the CDC.

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I recently watched the docudrama "Dopesick" about the Oxycontin and opioid crisis. I emerged angry with the Sacklers of course, but also with the FDA, who approved the drug as "non-addictive" and then did nothing about it as the scale of the crisis emerged. The man who approved the wording of the label on Oxycontin later went to work for the Sacklers.

It hit me between the eyes that a large slice of America has a very good reason not to trust the experts, who the crisis revealed as corrupt and then passive.

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Zeynep, thank you for this clear tour through the terrible political messaging we have been getting from the Biden administration. I think this is your best NYT essay. Thank you for calling out Dr. Walensky and finding the (weasel) explanation from Dr. Fauchi. After the tragedy of the last administration I really expected better.

All along I have criticized Dr. Walensky for her poor-quality presentations. I think I understand now that she has been convinced that she needs to say things that she does not believe. She is getting better at putting on the political cloak and not looking so much like a deer in the headlights every time she speaks, but this is not a good thing for her or us.

Dr. Fauchi learned his skills in the AIDS battle, when he really did have to speak in code to be able to get air time to speak to his constituency (the young gay men) that society wanted to pretend did not exist and if they did God was properly smiting them anyway. He used those skills to survive in the Trump administration and to continue to tell us to "follow the science" (was that a coded message to those who knew that all of the people all over the world who were wearing masks were on to something?) when with his other words he was telling us not to follow the science.

It we are lucky we will look back on our dissembling as being like the people who said slavery was good for Black people becasue they weren't capable of taking care of themselves. If we are not lucky we will continue to have a government that speaks down to and does not represent its people.

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Jan 5, 2022·edited Jan 5, 2022

It is a mistake to put rapid tests in the hands of millions of people who do not understand what it takes to make a medical diagnosis. Generally speaking (i.e., except for certain baseline measurements you might find done in a routine blood analysis for preventative purposes) a test is prescribed to confirm, not identify a reasonable hypothesis about an illness. If you don’t know what the correct circumstances for prescribing a rapid or PCR test are, you are likely to make a mistake in the interpretation of the results, or even in prescribing how and why the test should be done. Do you do a glucose tolerance test without any regard to diet before and after the test? And what if you don’t understand that?

This is what is happening right now, and can be even seen in the quotes of Dr. Walensky in Zaynep’s article. It can make sense to rely on an rapid antigen test at the right time. Five or six days (I don't know the right number; I'm no immunologist) after suspected infection will be enough time for the virus to incubate, replicate and the immune system to start fighting the infection. A positive finding on the fifth day would indicate that the virus is still present in the phlegm at sufficient levels to infect someone else. But the same test, taken on the second day of suspected infection, before the virus has a chance to replicate and populate the mucous would likely turn up negative. In the hands of a worried mother, who learns of a positive case at her son’s school, it could lead to the wrong recommendations for isolation. However in the hands of an experienced clinician, who might say, “isolate for six days and test on the fifth and again on the tenth if positive”, it will make complete sense and lead to the right prescription.

What’s happening? Tests are being done by people who don’t know when they should be administered and how to interpret the results. The system is overburdened by patients who will not require any treatment and who can self isolate. Testing should be reserved to health care professionals or those who have been advised by health care professionals on how to do it, because they must be present at work or have other conditions that raise their risk.

The solution to getting out of this pandemic is to exercise caution and promote good judgement. May I suggest a better use of money currently being put to hundreds of millions of rapid test kits? Develop a self-diagnosis and covid management AI bot or application that everyone can use. A citizen would log on to a website or application and it would ask a series of questions such as the date of first symptoms, whether they were in contact other people who got a positive result or became ill, age, location etc. in order to devise some recommendations. It would then indicate whether to self isolate, get tested or seek medical treatment. The back end of the software could collect anonymous location data and other useful statistics on symptoms, vaccine status, location, age etc. which could be then used by epidemiologists to better understand and advise public policy makers. The front end could easily be linked up with a tool to send people in the address book a contact tracing advisory, if the user wanted to do so.

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I work in healthcare at a leading teaching medical center in a major US city. As a manager of bedside clinicians that has to explain the changes in guidelines that are very obviously contradictory and irresponsible is embarrassing and demoralizing. The CDC's tactics impacts all healthcare work. By choosing to "message" policies that are palatable, instead of sticking to the science the CDC is making an embarrassment of clinical practice, affecting practitioners morale as well as patients confidence. Imagine if healthcare was practiced in such a manner? It needs to stop. Thank you for thoughtfully exposing this stupidity.

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I really appreciated your NYT opinion essay of Jan. 5. I wanted to comment on the NYT website but couldn't. You are the best!!

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If there is a lesson from the pandemic, it is that clear, consistent, honest communication is as important as technical expertise. And the expertise is wasted if it is not clearly communicated, because success against an infectious disease depends on everyone understanding and buying into what needs to be done.

I am afraid that the Biden administration has not grasped this, and is doing not much better than its predecessor.

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Public Health scientists (indeed all scientists!) should always speak the truth, not hedged politically. It is then up to the political leaders to implement policy. One technical question: has anyone reported backward contact tracing for omicron to demonstrate this variant produces fewer or more super spreaders?

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I was interested in France's decision to, like the US, lower the number of days from a positive test that you needed to quarantine before returning to work (I believe in France it was lowered to 7- unlike 5 in the USA). The interesting difference is that in the French government's announcement they stated the reason for lowering the number of days was BOTH the fact that you become less infectious over time AND for social stability. IE, the government was more transparent, and thus, IMO, more credible in their change of the regulations.

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A looong time ago I posted that the huge majority of the members of the Houston Police Department got vaccinated once their chief asked them to. I got several questions wondering what changes their mind.

A Houston Chronicle article today asked if companies were going to change their vaccination requirements or policies following the Supreme Court decision. The surveyed companies basically said no. Several companies commented on what happened when they required vaccination, or some combination of that and testing or limitations at work,

I thought this comment caught the spirit of what I heard about the Police Department:

"Camden Property Trust, a national real estate company headquartered in Houston, put in vaccine requirements over the summer before Biden announced the mandate. Of its 746 Texas employees, 718, or about 96 percent, are vaccinated, said Ric Campo, CEO of Camden Property Trust said.

“'We just had this discussion about safety and it's about keeping teammates safe. We've done all the analysis and that's what we think,' Campo said, 'And once people had a rational discussion, and it wasn't political, and it wasn't ‘You do this or else’ people chose to vaccinate.'”

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More today on Corbevax, and I will sign off on this topic now.

The information on NPR gives what has already been in the news about the news-level take on effectiveness: https://www.npr.org/sections/goatsandsoda/2022/01/05/1070046189/a-texas-team-comes-up-with-a-covid-vaccine-that-could-be-a-global-game-changer?utm_source=pocket-newtab

The interview today with Dr. Hotez will not answer your questions about clinical trial data either, but will fill in your introductory knowledge about the research background of the vaccine: https://news.yahoo.com/corbevax-vaccine-could-global-game-011848650.html

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China's zero covid policy is strikingly different from the way most of the rest of the world has approached this- they are shutting down cities based on miniscule numbers of cases. Is there maybe something they know that we don't? I'm not implying a conspiracy but it's not like they're exactly known to sacrifice economic production for humanitarian reasons. Certainly the Olympics might be a part of that.

Also, is it reasonable to think that we should be modifying our infrastructure - maybe splitting off clinics specifically built towards covid treatment, particularly if this looks like an endemic?

Thank you, always appreciate everything you write!

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