What Trump’s UNGA Speech Tells the World

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1896 sculpture of Cain by Henri Vidal, not 2025 sculpture of Marco Rubio

Speeches by national leaders at the opening of the UN General Assembly (UNGA) have multiple goals and various audiences. Leaders of small countries hope to raise concerns with large countries in a setting where they can be the center of attention, if only for 15 minutes. Leaders of ostracized countries often seek to justify the behavior that got them ostracized in the first place. Some speeches are aimed at the leaders in the room, while others are aimed at the folks back home. Some are aimed at allied leaders, and others at competitors and still others at enemies.

Under normal circumstances, preparation for the US president’s speech is probably on par with preparing the State of the Union address to Congress. Both speeches utilize folks from multiple agencies and both are subject to weeks and months of internal debates about what will and will not get into the speech. While the SOTU address is as long as the President wants to make it, the UN politely asks that UNGA addresses be kept to 15 minutes or less, because so many leaders will be speaking. The UNGA speech is primarily foreign policy, while the SOTU is more domestic, but both are critical to laying out the president’s – and by extension, the USA’s – positions on all kinds of things.

For UNGA, the State Department takes the lead (broadly speaking) in preparing drafts and posing options to the final decisionmakers in the White House. Other agencies like DOD, Treasury, Commerce, and DHS, as well as folks like the Director of National Intelligence, all weigh in and put their requests into the funnel out of which the final draft emerges.

While all the prep work on the speech is under way, so too is the prep work for listening to the speeches delivered by other leaders. Is it more of the same, are there new policy nuances, or even major changes of direction being conveyed? Different analysts at State, DOD, and the Intelligence community will prepare a list of “what to listen for” points as they get ready to listen to the UNGA speeches from the countries within their purview. Once the speeches have been made, these same folks will then be sharing their analysis with their superiors and the White House. “Here’s what we heard . . . , here’s what it means . . . , and here’s how it may affect our own policies and responses . . .”

Meanwhile, every other foreign ministry and intelligence service in the world does the same with the UNGA speech of the President of the United States of America. Especially when that president is Donald J. Trump.

So what will these folks notice about Trump’s speech, and what will their analysis of his speech lead them to think or do?

First, they will notice the absolute dichotomy between policy prescriptions and petty personal grievances. Yes, the speechwriting team and the professionals behind them put a lot of substantive stuff into the draft of the speech that went on the teleprompter, but Trump went off-script so much that it was easy for that stuff to get lost in the verbal flood of whining about his domestic political enemies alternated with his own personal self-promotion. If the substance was prepared to fill the 15 minute time slot, the whining and boasting filled another 45 minutes or so. That 3:1 ratio speaks volumes about what matters to Trump: “Three parts me, and one part everyone else. And that ratio is me being generous to everyone else.”

Second, even in the substantive parts of the speech, the presentation was arrogant and insulting. (Why yes, I do think Stephen Miller had a large role in shaping the speech. Why do you ask?) Trump’s “I alone can fix it” from campaigns gone by was echoed in Trump’s declaration at UNGA that he has always been right about everything. From immigration to energy to wars to peacemaking to cultural issues to history, Trump’s assertion that he is always right and that the world would be better off if everyone just bowed down and did what he said was at the center of his speech. The prepared draft of the speech might have been more polite about it, but the message was the same. All the world could see how Trump views them — little kids who need to listen to Daddy, and then do what Daddy says so that they don’t get punished.

Third, Trump’s UNGA speech was a confirmation and distillation of something these folks have seen since 2015 from Trump: facts are optional to Donald Trump. They will see that science takes a back seat to whatever Trump’s particular views and preferences are. Signed agreements, especially those signed by someone other that Trump, are optional, not binding. Historical facts that do not fit with Trump’s worldview are overlooked, ignored, or blithely dismissed as irrelevant. Leaders and nations who seek to move Trump and US policies with fact-based arguments will have a very difficult, if not impossible task if they follow this route.

Fourth, Trump has no use for the opinions of other leaders, unless they comport with his own opinions. Dozens of nations call what Israel is doing in Gaza “genocide” but Trump does not give a damn. Countries of all political stripes recognize the reality of climate change (even as they might differ in how it should be addressed), but not Donald Trump.

Fifth, this speech confirms yet again that what Trump desperately seeks is validation. In his head, he dreams of giving his own version of Sally Field’s academy award acceptance speech — “I haven’t had an orthodox career and I’ve wanted more than anything to have your respect. The first time [I won] I didn’t feel it, but this time I feel it. And I can’t deny the fact that you like me. Right now, you like me! Thank you.”

Sixth, these analysts from other nations regularly ask themselves “How long will Trump hold to a given position?” He renegotiated the NAFTA treaty with Canada and Mexico in 2019 and finalized it in 2020, only to come back in 2025 and ask “who would have ever sign a thing like this?” Grudges over personal slights he will carry with him for decades, but agreements with other leaders and other nations are much less predictable.

The danger to all of this is one basic thing: the world is learning –again — not to listen to the United States.

  • When Trump and RFK Jr. issued their untethered-to-scientific-analysis declaration that Tylenol should not be used by pregnant women, not only did the US medical community loudly shout “NO!” but so did medical leaders around the world (UK, Spain, India, Australia, etc.). The US has a long record of leadership in medical research and treatment — think of the elimination of smallpox and the work to do the same with polio — but now? Around the world, folks are asking what used to be an unimaginable question: Should we listen to anything medical coming out of the CDC?
  • When Trump made his big Liberation Day announcements and sought to put tariffs on almost every nation, he followed up on this with all kinds of exceptions, adjustments, and incoherent statements. Today the tariffs might look like this, but next week they went down, then a month later some of them went higher than before . . . and what the hell will they look like next year?
  • When NGOs and other leaders around the world found the rug yanked out from under them when Trump used DOGE to cancel grants for things like malaria prevention and anti-AIDS programs, as well as letting US food aid funneled through USAID rot in warehouses rather than be delivered to those who feed the hungry, they had to ask if the word of the US is worth anything any more. “We had a five year agreement – you put up this and we’ll handle that — and after 3 years, you reneged. Why should we trust you the next time you want to make a deal?”

Trump and his lackeys can laugh at the world all they want, but if the financial world follows the lead of the medical world and the scientific world, and ceases to trust that the word of the US is good, the US will be in a world of hurt. A non-trivial portion of US debt is held by foreign governments. When the Canadian public decided not to travel to the US or buy US bourbon, that hit the US hospitality industry hard. If foreign governments decide that rather than buying US treasury bonds, they’d prefer bonds from Germany or France or Australia, that will mean the US government would have to offer higher rates of return in order to get the money needed to pay for tax breaks for the rich run the US government.

In the world of international affairs, trust matters, and Donald Trump is pissing away what it took decades to earn. Good luck with that, Secretary of State/National Security Advisor/Archivist of the United States Marco Rubio.

 

[Corrected to fix a minor editing error regarding bond costs in the penultimate paragraph.]

 

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RFK Jr. DNR’d the US Healthcare System

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[NB: check the byline, thanks. /~Rayne]

I’ve been sick with COVID this past week, missing the first classes of the fall semester.

I was exposed by a cancer patient who finished a second round of chemotherapy earlier this month. They weren’t vaccinated within the last year because they were undergoing chemo.

They were exposed after Saturday evening mass at their Catholic church in Florida, where others around them were likely not vaccinated, and definitely unmasked, unlike the cancer patient. A dementia patient who refused to mask was the vector between the congregation and the cancer patient.

The cancer patient is still recovering and now at about 90% of their capacity. They’re moving very slowly, thinking just as slowly. They can’t be left alone because they don’t have the reaction time they used to have.

I’m about 95% recovered, still have some sinus congestion and lingering crud in my chest. My ribs and my throat feel still feel bruised from hacking up my lungs so hard earlier this week.

What I’m not certain I’ll recover from is the trauma of having to check my father the cancer patient for a pulse last week when he collapsed on the kitchen floor, reviving him, getting him up and moving and into my car so I could rush him from their remote home to an urgent care facility more than 30 minutes away.

I didn’t think to put a mask on him or a mask on myself at the time because I was worried something had gone very wrong after my dad’s two-year fight with cancer. I was worried about the monsoon-like storm I had to drive through to get to urgent care. I thought erroneously he had recovered from COVID and wasn’t contagious because he hadn’t had a fever and he hadn’t been coughing.

So I unintentionally hot boxed my dad’s COVID-laden exhalations in my car for 30 minutes trying to save my father. I’d do it again if it came down to it but I should never have had to.

This country has been deeply damaged enough by the anti-vaccine movement since the COVID pandemic began; it shouldn’t have to face worse.

~ ~ ~

By now you’ve read Peterr’s Thursday post about the government’s internecine warfare at the Centers for Disease Control and the excision of director Susan Monarez, followed by the protest resignations of senior CDC staff in support of Monarez. The senior staff who resigned are:

• Demetre Daskalakis, former director of the National Center for Immunization and Respiratory Diseases
• Debra Houry, former chief medical officer and deputy director for program and science
• Daniel Jernigan, former director of the National Center for Emerging and Zoonotic Infectious Diseases
• Jennifer Layden, former director of office of public health data, science, technology

Each of these individuals has a deep background and education in medicine, healthcare, or public health. None of then should have been expected compromise themselves to support our nation’s public health.

None of them should have been treated so shabbily by RFK Jr.’s shit-tastic management of HHS. It’s not at all hyperbole to call it shit-tastic; I strongly recommend listening to The New York Times’ podcast interview with Demetre Daskalakis because it will rid you of any doubt the label is deserved.

Here’s an excerpt I found particularly telling:

DASKALAKIS: Yeah. So this was not related to ACIP, the announcement by the Secretary to change the childhood schedule. I learned about the change of the childhood schedule on X.

ABRAMS: You learned about it on social media —

DASKALAKIS: Yes, ma’am.

ABRAMS: — like the rest of us.

DASKALAKIS: That is correct.

ABRAMS: Wow.

DASKALAKIS: So I was sitting in a meeting with senior leaders at CDC. And as I was sitting there talking about the outbreaks that I was managing, my phone blew up with, “I didn’t know you guys were changing the children’s schedule.”

ABRAMS: People texting you?

DASKALAKIS: Yeah.

ABRAMS: Wow.

DASKALAKIS: Not from HHS, people in the world. Because they saw —

ABRAMS: People in the world, your friends and family or whoever seeing this and being like, this doesn’t sound like you.

DASKALAKIS: Correct. So we then asked the question, what’s going on? Can we see some kind of documentation? Because they were like, implement the change. But we’ve never seen anything in writing, so we asked if we could see the supporting data that led to the decision. And we were told no.

ABRAMS: Just flat out no?

DASKALAKIS: Flat out no.

ABRAMS: But can I ask you, did you ever actually have a conversation with Kennedy about any of this or any of his senior staffers?

DASKALAKIS: No.

ABRAMS: Or is it just that —

DASKALAKIS: No.

ABRAMS: No communication.

DASKALAKIS: No.

ABRAMS: Did you ever try?

DASKALAKIS: Yes.

ABRAMS: And what would happen?

DASKALAKIS: So we offered to do briefings when he first started. I think some people were able to brief some lower level staff, but not staff that were Secretary Kennedy’s staff. So no one from my center has ever briefed the Secretary.

ABRAMS: On anything.

DASKALAKIS: Correct, on anything.

ABRAMS: So basically, don’t have a line into RFK, and he’s not seeking out your advice or the advice of people who are theoretically supposed to advise him on things like this. How did you feel about that at the time?

DASKALAKIS: I felt that this was highly atypical, that we weren’t able to share our expertise up the chain to be able to provide information that could be meaningful and thought process. And so what I kept thinking was, we’re not doing this, but there sure is a point of view up there. I wonder who’s doing it.

My job is to make sure that we’re giving good science so people can make good decisions. And if I can’t make sure that science is untouched by non-scientific influence, I cannot say that I’m doing my job.

I believe that CDC science is going to be compromised by HHS. And if that science becomes biased, if it gets unduly influenced, then I can’t have my name on that science as something that I think should be used to make important decisions for people’s lives.

Again, I strongly recommend listening to this podcast. The other disturbing facet is the way in which Abrams just plows on; it could be an artifact of editing, but it could be another of the many ways in which media has not paused and shouted at the public how disturbing and inappropriate are RFK Jr.’s and Trump’s management of public health, in a misguided effort to remain neutral about a subject which isn’t and can’t be neutral at all.

How can a US media outlet be neutral in the face of what looks increasingly like an occupation of government agencies by hostile forces? In the case of the CDC under RFK Jr.’s HHS, it’s damaging the administration of vaccinations to the entire country while undermining the nation’s ability to respond to pandemic and bioterrorism, not to mention its ability to safely provide basic healthcare. No one will be unaffected; no one can be neutral.

~ ~ ~

I’m not kidding when I say our healthcare is now utterly compromised. Our first responders and healthcare providers can’t be assured of necessary vaccinations. From an ER doctor on Mastodon:

This is absolute bullshit.

One of the biggest purveyors of anti-vaccine propaganda, one without any healthcare education and training, has decided the persons most likely to be exposed to diseases on a daily basis are no longer eligible for COVID vaccinations if they do not have a limited number of pre-existing chronic health problems. From Jen Bendery on Bluesky:

(For the record, my autoimmune disorder which has cost me lung capacity, is not on this list. I am not eligible for another COVID shot until I turn 65.)

This is a recipe for disaster. Not only are rural hospitals at risk because of cuts to Medicare under Trump’s Big Fugly Bill, all hospitals are at risk if their staff can’t be vaccinated readily in the face of a new COVID wave.

If my father were to become sick again and collapse like he did, could he be assured there would be healthcare personnel ready to receive and treat him? Or might the healthcare system be overwhelmed and triage him to the very end of the line?

The same goes for any of the rest of us, really. How can anyone in the US be assured the healthcare system will be able to respond if RFK Jr. is allowed to continue to hack away at it without supporting data, without support by seasoned, qualified professionals, without adequate oversight by Congress?

~ ~ ~

Of the many things that raced through my mind as I tried to revive my dad was the thought we had not talked about DNR status.

I’m pretty sure my dad and mom have both indicated on healthcare POAs they are DNR under certain conditions.

What happens, though, when one of them collapses at home? Should I have left him on the floor while ensuring his comfort?

Obviously I didn’t do that.

But a little over a week later I can’t help wonder if RFK Jr. has now forced DNR on swaths of Americans, and we’re already DNR where we are in our own homes whether we realize it or not.

If our healthcare system collapses because of his anti-vaccine and anti-healthcare regime, is he not assuring our healthcare system cannot resuscitate many of us?

How would this be different under a hostile foreign occupation?

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CDC Shooting 2.0 – It’s Coming from Inside the House

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Centers For Disease Control and Prevention

I feel like I’m watching a bad sequel to a scary movie from 20 years ago.

Back in 2004, Dick Cheney and the Bush White House were desperate to get the Department of Justice to sign off on an extension to an NSA warrantless wiretapping program. Complicating matters was the fact that AG Ashcroft was in the ICU at George Washington University Hospital and had designated Deputy AG Jim Comey to be the acting AG while he was incapacitated.

And make no mistake: Ashcroft *was* incapacitated. In broad strokes, no one just hangs out in an ICU – you’re there because you are in bad shape and need constant observation and often constant medications/treatments. Most conversations that happen in an ICU are between the staff and the family, and less so with the patient, because the patient is less-than-competent because of their condition, their medications, or both.

Comey was known by the WH to be opposed to extending this program, so the WH tried an end round to induce Ashcroft to sign the relevant documents without Comey’s knowledge. Before Alberto Gonzales (WH Counsel) and Andy Card (WH Chief of Staff) could get to the hospital, word reached Comey of what was up. Bart Gellman described it like this in his book Angler: The Cheney Vice Presidency as excerpted in the WaPo:

In early evening, the phone rang at the makeshift FBI command center at George Washington University Medical Center, where Ashcroft remained in intensive care. According to two officials who saw the FBI logs, the president was on the line. Bush told the ailing Cabinet chief to expect a visit from Gonzales and White House Chief of Staff Andrew H. Card Jr…..

Alerted by Ashcroft’s chief of staff, Comey, Goldsmith and FBI Director Robert S. Mueller III raced toward the hospital, abandoning double-parked vehicles and running up a stairwell as fast as their legs could pump.

Comey reached Ashcroft’s bedside first. Goldsmith and his colleague Patrick F. Philbin were close behind. Now came Card and Gonzales, holding an envelope. If Comey would not sign the papers, maybe Ashcroft would….

Unexpectedly, Ashcroft roused himself. Previous accounts have said he backed his deputy. He did far more than that. Ashcroft told the president’s men he never should have certified the program in the first place.

When everyone left the hospital, Comey, Mueller, and other DOJ folks began writing letters of resignation. Again, from Gellman:

All hell was breaking loose at Justice. Lawyers streamed back from the suburbs, converging on the fourth-floor conference room. Most of them were not cleared to hear the details, but a decision began to coalesce: If Comey quit, none of them were staying.

At the FBI, they called Mueller “Bobby Three Sticks,” playfully tweaking the Roman numerals in his fancy Philadelphia name. Late that evening, word began to spread. It wasn’t only Comey. Bobby Three Sticks was getting ready to turn in his badge.

Justice had filled its top ranks with political loyalists. They hoped to see Bush reelected. Had anyone explained to the president what was at stake?

Whelan pulled out his BlackBerry. He fired off a message to White House staff secretary Brett Kavanaugh, a friend whose position gave him direct access to Bush.

“I knew zilch about what the matter was, but I did know that lots of senior DOJ folks were on the verge of resigning,” Whelan said in an e-mail, declining to discuss the subject further. “I thought it important to make sure that the president was aware of that situation so that he could factor it in as he saw fit.”

Kavanaugh had no more idea than Whelan, but he passed word to Card.

The timing was opportune. Just about then, around 11 p.m., Comey responded to an angry summons from the president’s chief of staff. Whatever Card was planning to say, he had calmed down suddenly.

When faced with mass resignations from high-ranking DOJ officials who stubbornly refused to adjust their principles with respect to the law to fit the preferred WH policy, the WH backed down. Marcy has a big timeline (of course!) of all the stuff around the warrantless wiretapping program memos if you want to dig into the weeds of yester-year.

But I’ll be damned if what’s coming out of the CDC right now doesn’t sound *exactly* like what happened 20 years ago.

Susan Monarez, the CDC director, refuses to change her mind, not on a matter of policy but on a principle of adherence to science. After some back and forth, including various lawyers, it appears the WH has terminated her and named RFK’s deputy as the acting CDC Director. Meanwhile, a raft of Monarez’s very senior deputies submitted their resignations in order to stand with her. Hundreds of other CDC staffers are rallying outside to support their bosses.

This horror movie is magnitudes worse than the Hospital Confrontation of the Bush era, because if RFK Jr. and Trump prevail in this, CDC policies will change in ways that will cost people’s lives. Medical science will take a back seat to political expediency and pseudo-scientific quackery. What once was the organization that set the worldwide standard for a national Public Health agency is fast becoming not a joke but an actual danger to public health. The end result will be deaths – unnecessary yet inevitable deaths – and these CDC officials who resigned want no part of it.

RFK Jr. is no Dick Cheney, and Trump is no George W. Bush. Cheney and Bush recognized when they were outflanked, and so backed up and tried to find another way to do what they wanted to do. RFK Jr. and Trump, on the other hand, are the guys who charge loudly into the doctor’s office and won’t leave until they get an antibiotic to deal with a viral infection. Antibiotics do *not* work on a virus, no matter how loudly you shout, how many quacks you cite, or what your job title is.

A gunman shot up the CDC headquarters a few weeks ago from outside the gates and guards. But like any good horror movie, Trump and RFK Jr. are shooting it up from inside the house.

God help us all.

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Reaching Velocity to Escape Anti-Vax Stupidity

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[NB: check the byline, thanks. /~Rayne]

Before I go any further, here’s a public service announcement:

If you were born between 1960 and 1968 and have not been vaccinated for measles since 1968, go make appointments for a two-shot MMR vaccine regimen.

“Starting in 1963 we started vaccinating,” [CBS News’ Dr. David] Agus said. “The first five years of the vaccine — some batches of it were not very good. None of us really know which batch we got.”

“So you can either go to your doctor and say, ‘Draw a blood test and see if I have a high enough level,’ or just get the shot,” he said. “By the way, it’s a lot cheaper to just get the shot. So people who were vaccinated from 1963 to 1968 — that needs to happen.”

According to Agus, those who were born before 1957 were most likely exposed to measles, meaning 95-98 percent of them have enough antibodies to fight the disease. From 1968 to 1989 doctors gave only one shot, meaning immunity among those people may be a little lower than those who received two shots.

source: CBS News

I’m in that group and I’ve gotten my first shot of the series with the next in a couple weeks. I got mine at the local health department office, easy in and out. If you’re in the age bracket, get it done some place you trust.

~ ~ ~

I wish I could have gotten one at my usual provider – the pharmacy where I’ve gotten all my vaccinations for decades. Unfortunately that’s where things got weird immediately after my recent flu shot.

After getting my flu shot I asked the pharmacist – a new person I’d never see before – if I could get an MMR vaccine because of my age and uncertainty about my level of immunity to measles, if any. I had concerns because I was going to be around persons who were flying to and from Texas and could be exposed to measles during travel.

They told me the pharmacy only gives MMR vaccines to children, that I’d have to have a script from a physician to get one, and a physician might require a titer run first to determine if I needed a booster at all.

Then the pharmacist proceeded to tell me measles was only an Old World problem (what the fuck, I thought), that everyone in the Old World had immunity from exposures (what the actual fuck), and that the outbreak in Texas was from “border crossers” (OH NO MOTHERFUCKER).

I exited that pharmacy as fast as I could. I probably left a vapor trail behind me like the Road Runner.

I felt gross, digusted, like I needed a shower after that wretched dose of stupid.

I wish I’d known what that person really thought before I let them touch me, because I would have left and gone to a different pharmacy.

Having such a close brush with stupidity and racism was revolting. I didn’t dare confront this person in a confined space about their stupid assumptions knowing the measles outbreak was centered in a community of white Christian Texans of the Mennonite faith and not “border crossers” — code for those brown people coming into the US from Central and South America, which is the New World.

You’d think there’d be an institutional safety net protecting us from this wretchedness across the country. Sadly, we’re all of us now exposed to this kind of stupidity thanks to the Trump administration’s appointee helming Health and Human Services, our new chief anti-vaxxer, Robert F. Kennedy Jr.

~ ~ ~

The Food and Drug Administration’s director of the Center for Biologics Evaluation and Research, Dr. Peter Marks, resigned yesterday.

In his letter, which was obtained by The Associated Press, Marks said he was “willing to work” to address the concerns expressed by Robert F. Kennedy Jr. about the safety of vaccinations. But he concluded that wasn’t possible.

“It has become clear that truth and transparency are not desired by the Secretary, but rather he wishes subservient confirmation of his misinformation and lies,” he wrote.

Of course this was RFK Jr’s work, not a resignation but a firing because Marks — a hematologist oncologist who earned a Bachelor of Science degree from Columbia University, followed by a Doctor of Medicine and PhD in cell and molecular biology from New York University — wasn’t willing to roll over and rubber stamp RFK Jr’s bullshit anti-vax nonsense.

And by nonsense I mean the deadly kind – misinformation and disinformation about vaccines directly leading to the deaths of 83 Samoans from measles after being misled by RFK Jr. about measles vaccinations.

That RFK Jr. learned absolutely nothing from these deaths, continuing to spread his well-known, well-documented dispersion of anti-vaxx bullshit, is a shame.

That he has now cost our country the top official in FDA’s vaccine regulatory system while the US is experiencing a spreading measles outbreak, is on the verge of bird flu making a human-to-human leap, and still dealing with the COVID pandemic borders on criminal.

His nonsense is even more toxic in that he not only discourages scheduled vaccinations; RFK Jr. has promoted alternative therapies which are not effective and instead create more health risks.

RFK Jr. – who is not a medical doctor, has no education in science, having a BA in American history and literature, a JD from the University of Virginia School of Law, and a Master of Laws from Pace University — touted vitamin A as a means to treat measles. This vitamin only works to alleviate some measles symptoms in patients who are malnourished; it is not an acceptable therapy.

Unlike water soluable vitamins like B and C which flush out of the body as wasted in urine, vitamin A will bio-accumulate in the body’s fat until the body can use it. An excess of vitamin A can damage the liver. Knowing this you can predict what could happen next: someone takes RFK Jr’s bullshit seriously and poisons themselves or their children thinking they’re doing the right thing for measles.

What do you know but now there are patients with liver problems:

Several patients at Covenant Children’s Hospital in Lubbock have been found to have abnormal liver function, CNN reported, which can occur when a person takes excessive doses of vitamin A. Those being treated include “a handful of unvaccinated children who were given so much vitamin A that they had signs of liver damage,” the New York Times reported.

This is exactly the kind of crap which cost the lives of mostly infants in Samoa. Well-meaning parents took RFK Jr’s idiocy seriously and didn’t seek measles vaccinations which are safe and have spared hundreds of millions of people from illness and death over the last six decades.

The worst part of this mess is that some portion of the American public is just plain stupid and willful. They rely on authority figures to tell them what’s best; if it doesn’t conflict with their beliefs they’ll seize it. The parents of the six-year-old who died of measles in Texas are a perfect example:

The Texas parents of an unvaccinated 6-year-old girl who died from measles Feb. 26 told the anti-vaccine organization Children’s Health Defense in a video released Monday that the experience did not convince them that vaccination against measles was necessary.

“She says they would still say ‘Don’t do the shots,’” an unidentified translator for the parents said. “They think it’s not as bad as the media is making it out to be.” …

“We would absolutely not take the MMR,” the mother said in English, referring to the measles-mumps-rubella vaccination children typically receive before attending school. She said her stance on vaccination has not changed after her daughter’s death.

“The measles wasn’t that bad. They got over it pretty quickly,” the mother said of her other four surviving children who were treated with castor oil and inhaled steroids and recovered. …

source: Texas Tribune

I’m only surprised these poor children received castor oil and not cod liver oil for vitamin A therapy.

These are the kind of people to whom RFK Jr. is a real risk. We can only expect more illnesses and deaths among those who take seriously RFK Jr’s practicing medicine without a license let alone adequate appropriate education and training.

~ ~ ~

How are we going to escape this stupidity? I don’t know, but you can protect yourself from some of the damage by making sure your vaccinations are up to date. Make sure your friends and family are up to date as well.

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Happy Holidays From The Emptywheel Blog: A Year To Remember, A Year To Forget And An Open Forum For Cooking, Trash And Other Talk

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What a long strange trip 2021 has been. January 6 is still less than a year ago. Joe Biden’s Presidency is only eleven months old. The DOJ and 1/6 Committee are working away nicely on an unprecedented case that is multitudes more complicated and difficult than most all seem to comprehend (although we have been warning of that here from the start). So, as we reach this tumultuous Christmas and New Years’ season, amid the sudden (but quite predictable in spite of anything Biden and Harris say) emergence of Omicron, let’s chill a bit and take stock of it all.

First off, and I used to do this yearly on or about Christmas Eve, a remembrance of our dearly departed friend and colleague, Mary. Mary Perdue was not just a colleague, but a friend to both me, Marcy and most all of our contributors here. Mary left us on Christmas Eve 2011. Our long time regulars know this story, but there are a lot of new people here that should know, because this is the epitome of who we are at Emptywheel and what we have done and stood for from our beginning. I used to copy and repost the entire in memoriam, but will just link today for brevity. If you are new here, check it out.

Okay, on to the food! Because Mrs. bmaz is Italian at root, we always have, like at Thanksgiving, ridiculously awesome homemade spaghetti, meatballs, sausage and sauce instead of the traditional turkey and fixings. We will again. As much as I hate pumpkin pie, our daughter simply loves it, so there will be that too. That will be Christmas Day though, for Christmas Eve, probably steak, or homemade pizza, in the Ooni pizza oven. So, what are all of you eating, from where, and how? Marcy taught me long ago to seek out local and fresh ingredients, whether meat, vegetables or other, and we try to do that. Holiday food is fun!

And, now, for a bit of Trash Talk. Last night the Titans beat the 49ers and all but clinched a playoff spot and division title. Niners are still alive, but a little wounded. The Saturday game of Colts at Cardinals has all kinds of playoff implications. Both would likely still make the playoffs, but the seeding is absolutely critical. The other Christmas Day game of Cleveland at Green Bay is kind of a throwaway, hard to see the banged up and sinking Brownies going the Pack a game at Lambeau. There are too many permutations after the Sunday slate is played to go through here, but ESPN has a nice synopsis.

There is so much more going on, and let’s talk about it. In closing, I’d just like to say thank you for being part of this community, it means everything to all of us here. So, to all of you and yours, have the happiest of holidays and New Year.

This year’s holiday music is “Don’t Shoot Me Santa Claus” by the incomparable Killers. It is really a great tune. I do suggest you click on the full screen button to embiggen it.

And for Eureka, Scribe and all our Pennsylvania friends:

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How to (Not) Hydroxychloroquine COVID-19

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The medical journal The Lancet published a study Friday which showed anti-malarial drug hydroxychloroquine (HCQ) — the same drug repeatedly pushed by Trump — does not work as intended against the virus which causes COVID-19.

Hydroxychloroquine’s precursor drug, chloroquine, has shown mild antiviral action in vitro against the Borna disease virus (an orthobornavirus), the minute virus of mice MVMp (a parvovirus), and the avian leukosis virus (a retrovirus) as well as the coronavirus which causes SARS. It has also shown promise against Hepatitis A (a hepatovirus).

But both hydroxychloroquine and chloroquine posed inherent risks to patients as they increased the risk of heart arrhythmia.

Ideally, HCQ’s antiviral effect would prevent the coronavirus SARS-CoV-2 from replicating, allowing the body to attack and remove the virus before it could attack human cells and spread through the body, resulting in earlier recovery from the infection.

Patients who received both HCQ, or its precursor chloroquine, with or without an additional antibiotic, did not recover faster than the cohort which didn’t receive chloroquine.

Further, the patients receiving the drug therapies were more likely to die than those who didn’t.

This study is the latest showing HCQ or chloroquine both didn’t work and increased patient mortality. Previous negative studies included:

Effect of High vs Low Doses of Chloroquine Diphosphate as Adjunctive Therapy for Patients Hospitalized With Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection – A Randomized Clinical Trial
Mayla Gabriela Silva Borba, MD; Fernando Fonseca Almeida Val, PhD; Vanderson Souza Sampaio, PhD; et al
JAMA Network Open. 2020;3(4):e208857. doi:10.1001/jamanetworkopen.2020.8857
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2765499

Of particular note:

Findings In this phase IIb randomized clinical trial of 81 patients with COVID-19, an unplanned interim analysis recommended by an independent data safety and monitoring board found that a higher dosage of chloroquine diphosphate for 10 days was associated with more toxic effects and lethality, particularly affecting QTc interval prolongation. The limited sample size did not allow the study to show any benefit overall regarding treatment efficacy.

Outcomes of hydroxychloroquine usage in United States veterans hospitalized with Covid-19
Joseph Magagnoli, Siddharth Narendran, et al
Pre-print; posted April 23, 2020. medRxiv 2020.04.16.20065920; doi: https://doi.org/10.1101/2020.04.16.20065920
https://www.medrxiv.org/content/10.1101/2020.04.16.20065920v2

Of particular note:

CONCLUSIONS: In this study, we found no evidence that use of hydroxychloroquine, either with or without azithromycin, reduced the risk of mechanical ventilation in patients hospitalized with Covid-19. An association of increased overall mortality was identified in patients treated with hydroxychloroquine alone. These findings highlight the importance of awaiting the results of ongoing prospective, randomized, controlled studies before widespread adoption of these drugs.

We still don’t know why Trump is pushing this drug. It’s no longer under a patent and now a generic medication; it’s cheap to produce. If there’s money to be made by promotion of this medication it’s not clear how Trump profits.

We still can’t be certain he’s taking it himself though he claims he is; the letter from his doctor does not clearly state that Trump has been prescribed HCQ and at what dosage for what period of time nor has there been any information provided with regard to the nature of monitoring Trump receives while taking HCQ.

We don’t know why Trump would claim to take HCQ on the advice of some unknown person alleging to be a doctor. We’ve no further information about the letter, the letter’s author, whether a letter even existed since Trump has a proven propensity for making up shit.

All we can be sure of at this point is that more patients with COVID-19 may have died, potentially because of HCQ’s promotion by Trump, than may have died had he refrained from practicing medicine without a license by pushing HCQ.

In the case of the study of HCQ at Veterans Health Administration medical centers, former service persons who’ve already paid a price for our freedoms have been used in human experimentation in what might have been an attempt to validate Trump’s claims about HCQ — and some of them died for it.

It seems odd VA doctors used it out of the clear blue when the Food and Drug Administration hadn’t formally approved this drug for COVID-19 patients. (It’s probably just a coincidence the Center for Disease Control lifted its guidance on off-label use of HCQ two weeks before the VA study was published, right?)

It’d be nice to know if Trump’s three golf buddies at Mar-a-Lago — one of then a doctor — had anything to do with the use of HCQ and chloroquine at VA hospitals on COVID-19 patients.

There’s simply no good reason for Trump’s plugging this particular drug therapy except to harm and kill Americans.

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Where’s the Beef? Republicans Don’t Understand Critical Infrastructure and Supply Chains

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Over five weeks of a mostly-national shutdown, we never figured out how to protect essential workers.

By April 9, at least 9,000 health care workers — people trained in the proper use of personal protective equipment — had the virus and at least 27 health care workers had died. More than half had no known exposure to COVID outside of their work.

During the period of the shutdown, outbreaks occurred throughout the meatpacking industry, leading to shutdowns in a number of factories.

As a result, we’ve got meat shortages even as farmers have nowhere to sell their livestock. There were reports that a fifth of Wendy’s restaurants have run out of beef.

Stephens analyst James Rutherford said that a study of online menus for every Wendy’s location nationwide revealed that 1,043 restaurants — or 18% of its national footprint — have listed beef items as out of stock. More than 100 locations are still selling Wendy’s chili, which contains beef.

The shortages vary by state. Hundreds of Ohio, Michigan, Tennessee and New York restaurants are out of beef, while other states’ menus do not indicate any supply chain issues.

A Tectonix GEO analysis shows one reason why: people from one of the heavily affected areas traveled throughout the country. That suggests one possible way COVID has spread to a bunch of relatively remote factories was truckers serving the industry. I’ve heard inspectors also likely spread the virus between factories.

There were COVID clusters in a number of other professions that remained open during the shut-down: cops, prison guards, public transport workers, grocery store workers.

We never figured out how to protect these critical workers when it was relatively easy, when they and other essential workers made up most of the people on public transportation, when they were the only people relying on child care. That’s partly because we never managed to get the PPE and test and tracking systems in place to keep them safe.

And as a result, as the meat industry shows, our failure to protect critical workers has led to strains in a key part of our food supply chain, impacting consumers and suppliers up and down that supply chain.

Coronavirus has even threatened parts of our economy more directly responsible for keeping people alive. Before we shut down, for example, our Air Traffic Control was buckling, as the virus spread among workers in the close spaces of control towers.

If we were a sane nation, focused on the public good rather than bottom line dollars, we would have spent the five weeks of national shut-down figuring out how to protect critical workers and implementing those systems wherever workplaces had not shut down. We would have used that time to test the system and build up stocks of PPE and test kits needed to replicate the system in other, less essential work places. We would have perfected systems for keeping workers safe in the time of COVID, so we could learn how to do it while it was relatively easy, giving us something to replicate when the economy reopened.

We’re not a sane nation. We’re largely not focused on the public good.

And as a result, during the entire five weeks of the shutdown, we watched in fascination at what happens when you continue to work without implementing adequate measures to limit the spread of COVID without taking the obvious lessons from it. Again, we watched that happen at a time when it would have been easier to protect critical workers, because they were interacting with a limited number of other people. As the economy reopens, it will get harder to protect such workers, because there will be more people using public transportation and in grocery stores and relying on child care, increasing the likelihood that a single case can spread to more people, each potentially leading to the shut-down of an entire workplace three weeks later.

By failing to solve the problem of how you protect workers, those rushing to reopen the economy have set this country up for key failures in our rickety supply chain. Some of those failures will be nuisances, with factories idled because they’re missing a key part or shortages of non-essential items in stores. Some of the failures could lead to further health consequences. Some failures may happen in industries where workers are a lot harder to replace quickly. Those failures will make it harder for businesses that are open, as any outbreak will add to already inflated costs of operating, to say nothing of the blow to confidence such failures will bring.

It turns out, a lot of Republicans don’t understand how our economy works (though the same misunderstandings lay behind their opposition to bailing out the auto industry in 2008). They don’t understand that if critical parts of our fragile system break down, other parts begin to break down, potentially setting off a chain reaction.

And as a result, they’re rushing back to reopen the economy without first having done the basic things needed to operate businesses safely.

Yes, we need to take steps reopen the economy for the sake of the economy and our collective sanity. Which is why it was so important for the Federal government to put the pieces in place that would facilitate reopening the economy during the shut down. Only, the Trump Administration did not do that. It squandered the sacrifice made by the 33 million Americans who lost a job in that period. Now, not having put those pieces in place, the Trump Administration is pushing to reopen the world’s largest economy relying on little more than homemade masks to keep it running.

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Long Overdue Policies that Look Obvious in the Age of Pandemic

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I’m not usually a fan of George Packer. But I keep coming back to this column, We Are Living in a Failed State. The coronavirus didn’t break America. It revealed what was already broken, which is something I might have written. It argued that this pandemic, to which the US responded like a corrupt poor country, was actually the third crisis of this century, and our responses to the previous two — 9/11 and the Iraq War, and the Wall Street crisis — simply brought this country to the place where Trump could loot it.

Like a wanton boy throwing matches in a parched field, Trump began to immolate what was left of national civic life. He never even pretended to be president of the whole country, but pitted us against one another along lines of race, sex, religion, citizenship, education, region, and—every day of his presidency—political party. His main tool of governance was to lie. A third of the country locked itself in a hall of mirrors that it believed to be reality; a third drove itself mad with the effort to hold on to the idea of knowable truth; and a third gave up even trying.

Trump acquired a federal government crippled by years of right-wing ideological assault, politicization by both parties, and steady defunding. He set about finishing off the job and destroying the professional civil service. He drove out some of the most talented and experienced career officials, left essential positions unfilled, and installed loyalists as commissars over the cowed survivors, with one purpose: to serve his own interests. His major legislative accomplishment, one of the largest tax cuts in history, sent hundreds of billions of dollars to corporations and the rich. The beneficiaries flocked to patronize his resorts and line his reelection pockets. If lying was his means for using power, corruption was his end.

Packer ends with a call for renewed solidarity.

But he might as well also call for a fix to all the failures of the past twenty years. Right now, mind you, Trump is failing, miserably, in part because he believes maximizing the opportunities for looting by his friends is all the policy he needs.

But the sheer scale of the crisis makes policies that long made sense for the United States more urgent and far easier to justify. I plan to keep a running list of those policies.

Medicare for All

No one has figured out how all the people put out of work by the shut-downs will pay for COVID-related health care. Trump has persisted in a plan to kill Obamacare, and some badly affected states never even expanded Medicaid.

Early reports suggested that Trump’s administration has claimed it is willing to pay hospital bill, so long as they pay those bills directly (thereby avoiding establishing a policy, I guess). But with so many people out of work and with hospitals reeling from the shut-down, the far better solution is to make Medicare available to all.

Universal Basic Income

The US government has been backing credit for big industry and tried, but failed, to provide free money for small businesses to keep their employees on staff. Instead, 26 million Americans have applied for unemployment, a sixth of all workers (and a third of all workers in MI, KY, and RI). Meanwhile, the Administration botched even a one-time $1,200 payment.

The government could better ensure that markets don’t crash entirely–and keep states from buckling as they try to serve all these unemployed people–if they simply gave a UBI to all people, as Spain has decided it will do. By keeping it, the US might be able to address the underlying inequality problems that have led to such a disproportionate impact of COVID on communities of color.

Decarceration

Closed spaces, generally, amount for a huge percentage of COVID cases and (in the case of nursing homes) deaths. ACLU just rolled out a paper that argues the models for COVID (which were originally based off other societies’ social patterns, including their prison system) underestimate the total number of deaths because they don’t account for the spread in our prisons.

COVID will remain lethal for long enough that states and the federal government will need to achieve some level of decarceration to prevent the prisons from becoming a source of spread to the wider community (as they have become in the localities with harder hit prisons).

In this case, even before COVID hit, there was bipartisan support to wean ourselves from overincarceration. Prisons will become less lucrative in conservative communities, especially as some states begin to end prison gerrymandering (which gives rural communities representation for prisoners who can’t vote, just like slavery did).

So now is the time to end incarceration for minor crimes, and improve the humanity of incarceration for those who need to be jailed.

Deindustrialization of the Food System

We’ll be lucky if we avoid famine conditions. That’s partly because our food system has the same institutional/retail split our toilet paper supply chain does, meaning the market for half of the food out there disappeared when restaurants and other institutional buyers shut down. That’s partly because bottlenecks in our food supply chain — most notably, thus far, meatpacking plants, but there will be others — have further undermined the market for our plentiful food production. And that’s partly because Trump’s farmer support, thus far, has emphasized direct payments that are effectively a continuation of his earlier bribery of farmers whose markets his trade war screwed, rather than purchasing up surpluses to provide to food banks.

Trump hasn’t shown an ability to get any other needed supplies where they’re needed; it’s unlikely he’ll do better with food.

Meanwhile, food supplies that bypass these commodity markets remain. We need to make this food supply chain more resilient and one way of doing so is to bypass the industrial bottlenecks.

Broadband as a Utility

When schools shut down, it suddenly became acutely visible how many Americans — both rural and urban — don’t have broadband. While some areas have gerry-rigged solutions (like driving wifi-enabled busses to poorer neighborhoods) to get some kids online and learning, that’s not possible everywhere. And even for adults, it takes broadband access to be able to social distance.

Trump is already talking about using infrastructure investments to get America working again. Extending basic broadband as a utility should be part of that.

Update: Arne Duncan describes what needs to happen for existing efforts to expand broadband access to be really effective.

Industrial Policy

Two months after we first identified shortages in necessary medical supply, we’ve barely managed to switch production to those necessary objects, even as entire factories were otherwise shut down. We’ve got shortages of not just testing kits, but the underlying supplies. We’ve got drug shortages too (and had them, even before the President started pitching miracle cures).

It’s long past time to admit that we do have an industrial policy — but right now, it’s focused on building the troubled F-35, not ensuring that the United States has the ability to build the things we need domestically, even if we interact openly with the rest of the world. This story uses the failed lithium battery investments Obama made, largely in Michigan, to talk about how we came to be unable to supply our own medical equipment.

We have an industrial policy. We just need to be willing to match that policy to our society’s real needs, not exporting warmongering.

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On Mountains, Mountain Climbing, and COVID-19

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Memorial to climbers who have died on Mount Everest at the Pheriche Aid Post (h/t akunamatata via flikr; CC BY-ND 2.0)

The language of mountains and mountain climbing is all over the COVID-19 coverage, from the talk of “reaching the peak” of infections to the euphoria of those who proclaim that in various areas, we are “hitting the plateau.” But as a mountain-climbing friend once told me “Climbing the mountain is the easy part — it’s the descent that’ll kill you.”

This is not just a cliche, or a (non-)urban legend, but backed up by the experience of those who know the mountains best:

Kami Rita Sherpa knows Mount Everest better than anyone else: He’s summited the world’s tallest peak 24 times, more than any person in history. . . .

Sherpa said problems arise not from those lines [of climbers waiting at altitude to pass along single-file sections of the climb], but when people accidentally push past what their body can support. Some research suggests that Everest climbers can develop a kind of “summit fever,” racing to the top to prove they can, even when their bodies are showing signs of giving out.

“At that altitude, it takes everything to put one foot in front of the other,” Everest climber and exercise psychologist Shaunna Burke recently told Business Insider. “If you haven’t judged how much gas you have left in the tank, then you can’t make it down. That’s why some climbers sit down and don’t get back up.”

Sherpa echoed this.

“When returning, their body is out of energy, and many people die due to this cause,” he said.

It’s not just one or two climbers’ opinion, either. In 2006, Paul Firth and his colleagues published “Mortality on Mount Everest, 1921-2006: descriptive study” in the British Medical Journal, which looked at every documented death on Mount Everest and sought to understand what commonalities might be found among the fatalities. They first distinguished between deaths below 8000 meters as climbers and their guides traversed areas prone to avalanches, crevasses, and other features of the mountain, and the deaths that took place above 8000 meters, where the mountain is generally more stable but fatigue and altitude sickness are the greatest dangers. On the lower part of the mountain, guides were more likely to be the ones who died, which the authors surmise is because the guides make multiple trips up and down the climbing route, setting ropes and bringing supplies up to the higher camp, before they guide the climbers along the route they found and made more safe. When it came to the deaths above 8000 meters, however, things reversed, and they noticed some shocking numbers:

Table 3 presents data on the mountaineers who died after reaching 8000 m. Fifty three (56%) died during the descent, 16 (17%) after turning back below the summit, and nine (10%) during the ascent. The stage of the summit bid was unknown for 12 mountaineers (13%), and four (5%) died before leaving the final camp.

Look at those top three figures again: 10% died while making the push for the summit, and 73% died while descending. For every death going up, there were 7 going down.

Maybe these climbers who died on the way back down pushed too hard going up, and had nothing left for the descent. Maybe they became disoriented because of lack of oxygen and quit thinking clearly. Maybe they were so excited at having made it to the top that they got sloppy as they turned around and headed down the mountain.

Whatever the cause, the study was clear: descending from the peak is more deadly that making the climb up. As our veteran climber cited above put it:

Burke said that although all climbers want to reach the summit, that objective alone can be a problematic.

“The summit is only halfway,” she said. “Your ultimate goal should be to make it back to camp alive.”

I look at the images of the folks protesting the “stay-at-home” orders issued to fight the COVID-19 epidemic, and their cheers of things like “We made it! We stopped the disease! Now let’s open things up again and get back to work!” I read the tweets to “liberate” this or that state, cheering on those who think the task is done. Then I think of the mountain climbers cheering at having reached the top of the mountain, who don’t realize how dangerous things can be on the way back down. That’s what worries me about all the talk of opening back up right now.

Yes, some places may have reached the peak of new infections, the peak of ICU bed usage, and the peak number of intubated patients. But here’s the thing: we are still on the mountain. Getting to the top is great, but the goal is to make it back to camp alive.

I don’t want to minimize the accomplishment of the climb, whether speaking of those who scale mountains or those who have been struggling to keep ahead of the increasing numbers of those hit by COVID-19. But relatively speaking, climbing the mountain is the easy part. It’s the descent that’s much more likely to kill. Face it, people: This journey has a long way to go, with plenty of opportunities for negligence and for misplaced cheering which will give life to a virus that deals out death.

This is no time for getting complacent or sloppy. Stay home, stay safe, save lives.

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Trump Puts his Rasputin Guy, Michael Caputo, at Department of Health and Human Services During a Pandemic

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As Politico reported yesterday, in a bid to marginalize Alex Azar (who has been largely silenced in the middle of a pandemic since Rod Rosenstein’s sister Nancy Messonier told the truth in public), Trump has made Michael Caputo the spokesperson at Department of Health and Human Services.

The move is interesting for several reasons. It suggests the White House believes the way to control a Senate-confirmed cabinet member is to hire a spokesperson for that person, not to replace him or work out problems with him.

The move is designed to assert more White House control over Health and Human Services Secretary Alex Azar, whom officials believe has been behind recent critical reports about President Donald Trump’s handling of the coronavirus pandemic, according to two officials with knowledge of the move.

That, in turn, suggests that in the middle of a pandemic, Trump’s White House is treating HHS as a PR shop, not a functional agency.

But the far more interesting aspect of this hire is that, as recently as February 3, Bill Barr’s DOJ claimed in FOIA exemptions on Caputo’s FBI interview report that it was conducting an ongoing investigation into something Caputo did during the 2016 election — possibly with Roger Stone — called Project Rasputin. What Project Rasputin was is redacted in the 302. But whatever it was is closely enough connected with his and Stone’s willingness to take a meeting with a Russian selling dirt on Hillary Clinton that Caputo told Mueller’s team that, “‘Project Rasputin’ was mutually exclusive from anything having to do with” the guy selling that dirt.

Of course, on precisely the same day that Bill Barr’s DOJ released materials indicating it was still investigating something called Project Rasputin that Caputo had been involved in, Barr replaced then DC US Attorney Jesse Liu, who had permitted the Roger Stone investigation and prosecution to proceed unmolested by the kind of unprecedented interference that Barr would engage in just days later. Which raises questions about whether Trump doesn’t care that his own DOJ was still investigating something Caputo did in 2016, or whether Barr saw to it that investigation ended, making Caputo hirable for the first time in Trump’s Administration.

When I asked Caputo what Project Rasputin was, he simply responded by tweeting a picture of the charlatan advisor to a czar, a picture he has since deleted (along with a bunch of other Tweets he purged before taking this position).

Ah well. I’m glad that Trump’s desperation to stop Azar from telling the truth about how the President ignored sound medical advice in favor of conspiracy theories will provide yet another pressing reason to ask Reggie Walton to fully declassify the 302s describing this project.

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