Coronavirus Update 7

Various sources, e.g., CNN and the Washington Post, are reporting about a small pilot study to test the efficacy of hydroxychloroquine to treat the coronavirus infection. Hydroxychloroquine is approved for use to treat malaria, a parasite infection. The reported data is not from a randomized clinical trial. It is also not yet peer-reviewed. This data is only anecdotal, not the kind of evidence that constitutes solid evidence of safety or efficacy.

Two critically important thoughts to keep in mind are these:

1. Randomized, double- or triple-blinded, placebo controlled clinical trials are needed to assess safety and efficacy.

2. That an approved drug is safe enough for treating a specific disease does not mean that it is safe to treat a different disease. I will explain this in the context of hydroxychloroquine and coronavirus.

The data

The study included 368 male VA patients with coronavirus infections. That is considered to be a small study by experts, not a large study as Fox News is falsely reporting. This study is larger than past studies reported so far, but that doesn't make it a large study. Ninety-seven patients received hydroxychloroquine, 113 received hydroxychloroquine in combination with the antibiotic azithromycin, and 158 did not not receive hydroxychloroquine.


As reported by the WaPo, rates of death in both drug-treated groups were worse than the 158 who did not receive the drugs. The drugs produced no benefit for patients who were on ventilators in either drug-treated group.

The observed death rates were as follows:

No drug treatment: 11.4%

Hydroxychloroquine and azithromycin treated: 22%
Hydroxychloroquine treated: 27%

Failed pandemic politics

The president has politicized an weaponized the pandemic to serve his personal political re-election agenda. CNN's broadcast last night played about six short clips of the president repeatedly urging people to use hydroxychloroquine because he claims that ‘he heard good things about the drug’, or that ‘he heard very good things about the drug’. His ‘scientific rationale’ is based on posing questions such as, ‘what do you have to lose?’ and ‘why not try it because you have nothing to lose?’.

Unfortunately, it may turn out to be the case that people have their lives to lose.

Presumably, some people took the president’s idiotic advice and doing so could have killed some of them. If that turns out to be true, the president should be impeached and jailed for medical malpractice, gross incompetence and inexcusable arrogant stupidity. Dr. Trump’s unsound medical advice would have literally killed some people.

How hydroxychloroquine might be lethal in coronavirus infections 

The following is personal speculation about why it might turn out to be the case that hydroxychloroquine is lethally toxic for some coronavirus-infected patients. One study reported that when hydroxychloroquine is used to treat rheumatoid arthritis and systemic lupus erythematosus, it appears that it works by inducing a form of immune suppression, i.e., “down-regulation of the immune response against autoantigenic peptides.” Other research indicates that hydroxyquinoline modulates biological pathways that regulate immune responses by other mechanisms including  blocking inflammatory responses, e.g., “there is some evidence that antimalarials decrease secretion of monocyte‐derived pro‐inflammatory cytokines, such as tumour necrosis factor alpha (TNFα).”

Based on that, I speculate that it is possible that hydroxychloroquine-induce causes an immune suppression that (1) unleashes the virulence or replication capacity of coronavirus in lungs to a point that it becomes lethal, and/or (2) allows bacteria in the lungs to replicate and cause a lethal bacterial pneumonia. Anecdotal evidence for that is in the different death rates of the two drug-treated groups. People who also received the antibiotic azithromycin may have had a lower death rate than the group treated with hydroxychloroquine alone. If that turns out to be true, then the azithromycin may have prevented a lethal pneumonia in some of the patients, leading to a lower death rate. Azithromycin is used to treat various bacteria, including ones that that can cause pneumonia.

Again, all of this is personal speculation. I'm not an expert and thus my speculation may turn out to be completely wrong, e.g., because we still do not know much about coronavirus pathology at the molecular level. 

The Failing Media is Failing Dismally, Yet Again

An opinion columnist for the New York Times has written a piece arguing that the media should stop airing the president's briefings. For over a year it seemed reasonable to me to stop broadcasting almost everything the president says to the American people. The reason is obvious: His rhetoric consists mostly of socially damaging and immoral, dark free speech.[1] What social value is there in his lies, deflections and disinformation that outweighs the damage? I see none.

The NYT opinion piece comments:

“Around this time four years ago, the media world was all abuzz over an analysis by mediaQuant, a company that tracks what is known as ‘earned media’ coverage of political candidates. Earned media is free media. 

The firm computed that Donald Trump had ‘earned’ a whopping $2 billion of coverage, dwarfing the value earned by all other candidates, Republican and Democrat, even as he had only purchased about $10 million of paid advertising. 

The Hollywood Reporter in February of 2016 quoted CBS’s C.E.O. as saying, ‘It may not be good for America, but it’s damn good for CBS,’ because as The Reporter put it, ‘He likes the ad money Trump and his competitors are bringing to the network.’”

The editorial points out that the daily coronavirus briefings over the last 5 weeks or so have been aired extensively. They are are full of misleading and false statements, deceptions, deflections of blame from his own failures and assertions of no responsibility for his own crucial role in the failed US response to the virus. The president has scientists and officials on stage with him to lend a false appearance of credibility to his dark free speech. People trapped indoors due to coronavirus are nervous and tune into the daily dark free speech blizzard.

The press is not obligated by any law to broadcast any, some or all of what a president says. Journalism requires editing and commentary on content, including the pointing out of lies and deceit. Simply broadcasting the president’s self-serving propaganda isn't journalism. It is abdication of journalism. It is anti-journalism.

The president’s open contempt for and denial of inconvenient facts, truths and reasoning is undeniable and of staggering proportions. As of April 3, 2020, the president had made 18,000 false or misleading statements. That qualifies him as a chronic liar, which is something he has probably been at least his entire adult life.

In essence, the media has learned nothing. Once again, the for-profit American broadcast media is one of the president’s most important sources of campaign exposure, lies, deceit and deflections. The media is simply giving him hundreds of millions or billions of free, unrebutted air time.

The NYT editorial ends with this accurate characterization of the situation:

“Trump has completely politicized this pandemic and the briefings have become a tool of that politicization. He is standing on top of nearly 40,000 dead bodies and using the media to distract attention away from them and instead brag about what a great job he’s done.”

Footnote:
1. Dark free speech: Constitutionally or legally protected (1) lies and deceit to distract, misinform, confuse, polarize and/or demoralize, (2) unwarranted opacity to hide inconvenient truths, facts and corruption (lies and deceit of omission), (3) unwarranted emotional manipulation (i) to obscure the truth and blind the mind to lies and deceit, and (ii) to provoke irrational, reason-killing emotions and feelings, including fear, hate, anger, disgust, distrust, intolerance, cynicism, pessimism and all kinds of bigotry including racism, and (4) ideologically-driven motivated reasoning and other ideologically-driven biases that unreasonably distort reality and reason. (my label, my definition)

WITH PERMISSION from Germaine, a SNOWFLAKE RANT.

WHAT THE F IS WRONG WITH PEOPLE??

I keep reading comments from some contributors on various channels,  that are anti-government.

I keep hearing about protestors who claim that the government has no right to tell them to stay home during Covid 19, because they have a "constitutional right" to keep their shops open or go to work.

EXAMPLE:

I was listening to a radio call in show, where a caller raged about being told he can't open his business because of his "constitutional rights" and when the host of the show reminded the caller that "rights" aren't absolute, that you can't yell "fire" in a movie theater, carry an AK 27 through a mall, or punch your own kid on the side of the head, the caller retorted that he was not about to give up his "constitutional rights" for the sake of some geriatrics who are going to die anyways.

SAY WHAT?

This canard that the government should stay out of your business, that less government is the best way to go, is SO OLD it is laughable.

This lack of responsibility is what has led to the crisis we have in the U.S. now where Trump says testing is up to the States, and State governors are being ridiculed for stay-at-home orders, while the death toll climbs.

What these folks are really saying, is I don't want government interfering in what I consider important, but please interfere when I want something done my way.

Outlaw abortion, close abortion clinics, isn't this government interference?

Collect my garbage, bring me my mail, police my streets, isn't that government interference?

Keep government out of my healthcare, because I don't want health care for all, because dontcha know, that is socialism.

YET every other civilized country in the world has some form of health care for all, delivering better health care, at a lower per capita cost than what we have in the good ole U.S. of A.

AND don't even try to deflect or argue semantics, it is A FACT. When you have thousands of people in a civilized nation going broke because of medical bills, you know something is wrong.

WE have laws to protect our property and lives, who wrote those laws? GOVERNMENT!

And yet the same people who cry to the high heavens about getting government out of our lives, love it when that same government engages in gerrymandering, voter suppression, closing of voting booths (primarily in black districts), and purges voter rolls - because the simple idea of anyone who can produce a birth certificate or proof of citizenship can not get a federal ID card because THAT is government interference?????

Almost everyone who has ever argued with me on the subject of government involvement into our lives keeps citing the Constitution, yet - here is the irony - WHO WROTE THE CONSTITUTION? I am guessing some government types. 

Interviews With a Few of the President's Supporters

The human condition in politics

“. . . . the typical citizen drops down to a lower level of mental performance as soon as he enters the political field. He argues and analyzes in a way which he would readily recognize as infantile within the sphere of his real interests. . . . cherished ideas and judgments we bring to politics are stereotypes and simplifications with little room for adjustment as the facts change. . . . . the real environment is altogether too big, too complex, and too fleeting for direct acquaintance. We are not equipped to deal with so much subtlety, so much variety, so many permutations and combinations. Although we have to act in that environment, we have to reconstruct it on a simpler model before we can manage it.” -- Democracy For Realists: Why Elections do not Produce Responsive Governments, Christopher Achen and Larry Bartels, 2016

This 13-minute interview with a series of the president's supporters shows the level of reasoning that a small sample appears to operate with. Not all of the president's supporters think like this, but at least some, maybe most, clearly do. This mindset looks to be much more ideological and tribal than fact-based and rational.

How can one enter into a rational dialogue with people like this? How does one respond to a person who flat out rejects facts and sound reasoning in favor of dark free speech and tribe loyalty?