Etiquette



DP Etiquette

First rule: Don't be a jackass.

Other rules: Do not attack or insult people you disagree with. Engage with facts, logic and beliefs. Out of respect for others, please provide some sources for the facts and truths you rely on if you are asked for that. If emotion is getting out of hand, get it back in hand. To limit dehumanizing people, don't call people or whole groups of people disrespectful names, e.g., stupid, dumb or liar. Insulting people is counterproductive to rational discussion. Insult makes people angry and defensive. All points of view are welcome, right, center, left and elsewhere. Just disagree, but don't be belligerent or reject inconvenient facts, truths or defensible reasoning.

Saturday, April 4, 2020

Democracy, the Rule of Law and Competence are Directly Threatened



“Well, when the president does it, that means that it is not illegal.” -- former president Richard Nixon



For roughly the last 18 months or thereabouts, I've been explicitly arguing that institutions or values like democracy, the rule of law, and civil liberties are under a serious threat by the president and the Trump Party (formerly the GOP).


Attacks on democracy
Attacks on democracy are clear and undeniable in view of Trump Party efforts in a number of states to suppress democratic voters. The president made this strategic goal clear in the last week in comments he made to Fox and Friends about the Trump Party having to block democratic efforts to protect universal voting rights. Salon described that attack on democracy like this: “Trump admits ‘You'd never have a Republican elected in this country again if voting access [was to be] expanded: ‘The things they had in there were crazy,’ Trump said of the voter protection and expansion proposals in the bill. ‘They had things—levels of voting that, if you ever agreed to it, you'd never have a Republican elected in this country again.’”

The situation could not be clearer. All that the president and his enablers can do is dismiss such criticism as fake news promulgated by Trump opponents, democrats and ‘the enemy of the people’ press. Most of the president’s supporters presumably see it that way for the most part, otherwise one would presume that most of them would no longer be supporters. However, given how authoritarian many conservatives and populists appear to be, maybe that assumption is false. Maybe many or most of the president’s supporters consciously approve of single party rule and want to suppress opposition voting.


Attacks on the rule of law, government accountability and competence
Attacks on the rule of law, government accountability and competence are are clear and undeniable in view of, for example, the president’s efforts to purge the entire federal government of employees who he deems to be disloyal and in how the attorney general is shielding the president from the rule of law. The president is replacing competent employees with corrupt yes-goons who will use federal prerogatives and the law to attack political opponents, while shielding the president. A recent high-profile example of the ongoing purge has surfaced.

Politico reports that the president has fired the intelligence community’s chief watchdog, Michael Atkinson. Atkinson was the federal employee who alerted Congress last September about an “urgent” complaint he received from an intelligence official involving the president’s communications with Ukraine’s president. That set off the House investigations that ended up with impeachment of the president. The president now has his revenge for Atkinson doing exactly what his job required.

Other sources have reported on the president’s vengeance and attendant purge of ‘disloyal’ employees. For example, The Hill writes:
“Recent reports from Axios and Government Executive, and even the words of the president’s own spokesperson on Fox News, confirm that President Trump has tapped a 29-year-old former body man who was fired by then-chief of staff John Kelly to lead a governmentwide effort to purge federal employees who are not sufficiently loyal to the president. All this on the heels of the already-near-total ouster of career officials who testified during the impeachment inquiry. 
These actions will plunge American’s federal government back into a system of prosaic corruption, sleaze and dishonesty. It will make it more difficult – if not impossible – for whistleblowers who have identified waste, fraud or abuse to come forward and inform the American public. And, finally, it will make it intolerably challenging for the federal government to marshal credibility, truth, facts and science to address global or national crises like a pandemic.”

The view that Attorney General William Barr holds that the role of the AG is to protect the president from the rule of law is well known, except of course for people who deny that. So is the president's explicitly stated belief that the role of the AG is to protect the president from the rule of law: “I don't want to get into loyalty, but I will tell you that, I will say this: Holder protected President Obama. Totally protected him. When you look at the things that they did, and Holder protected the president. And I have great respect for that, I'll be honest.”

The president is explicit that he respects an AG who protects a president from the rule of law. And despite his false claim, the president very much wants to ‘get into loyalty’. He wants to get into loyalty with real vengeance in mind.[1] Once again, the situation could not be clearer. All that the president and his enablers can do is dismiss such criticism as fake news promulgated by the president’s opponents, democrats and ‘the enemy of the people’ press. Most of his rank and file supporters presumably see the situation mostly as the president and his enablers falsely tell them it is.

It is reasonable to think that the people who will replace the fired employees will work hard to protect the president, while they will do their jobs when it means attacking political opposition. That is a sign of tyranny and an impotent rule of law.


Conclusion
Given the facts, one can defensibly argue that we are now clearly and quickly moving toward some sort of an incompetent, kleptocratic (corrupt) tyranny-oligarchy, probably tinged with a vengeful Christian moral self-righteousness. I've been making that claim for at least the last 18 months or so. Even during the 2016 campaign, the president’s authoritarian proclivity was quite clear. But early on, the thought was to hope that competent advisors and federal employees would blunt that. That was a false hope. As time passes and evidence continues to accumulate, a belief that America is headed toward a vicious kleptocratic authoritarianism is constantly reinforced.

Democracy, civil liberties and the rule of law are in real jeopardy. Most Trump supporters (~97% ?) are mostly or completely unaware of what is happening right in front of their eyes. Once again, human cognitive biology and social (tribal) behavior is undeniable and on display for all who can see. For those who cannot see, this is literally fake news spread by opponents of the president, the enemy of the people press and/or democrats.


Footnote:
1. The president is clear that he sees vengeance as a way of life. He takes that seriously.






Friday, April 3, 2020

Killed by freedom??

Some questions/thoughts regarding the Coronavirus:

-Is it possible that too much freedom (to be stubbornly defiant) will lead to the U.S. population's drastic reduction, even downfall?  I speak of those non-essential workers who refuse to obey their state’s orders to stay at home.

-Are we headed for nationwide chaos?

-What happens when food production dries up?

-What happens when the trucks and trains stop rolling?

-What happens when the pharmacies and drug stores can’t supply your meds?

Can’t happen?  You tell me. 🤔

Road to 2020: When Bernie Lost It All

A single Yale student approached us. She was holding a “Yale Dining” bowl filled with three bananas and some mint sprigs. 
Published 3/31/20

“They had them for decoration, and I want to make cocktails tonight,” she told us, laughing at her ingenuity. We met Catherine Yao, a sophomore at Yale, inside of a courtyard lined by a low brick wall and intricate ironwork. She was the sole student in the area, braving the late February cold.
When we first entered the campus, we marveled at the church steeples, stained-glass windows and the quiet. The coronavirus pandemic, which would lead to the closure of college campuses nationwide, was still a few weeks away. Students were simply in their Friday afternoon classes.
Yao’s generous spirit – she offered more than once to share her frangipane bars, another item she’d thrifted from the dining halls and one she’d learned to love after watching “Great British Baking Show” – was our introduction to the Yale student body and to an entirely different perspective on the presidential race. Yao, a Gen Z voter at a “stereotypical” liberal, elite college, believed Sen. Bernie Sanders was not the right nominee for the Democratic party. And many of her peers and professors, Yao told us, agreed.
After The Tylt’s trip through middle America, we realized we were witnessing a tipping point in this election as we hit the road along the Northeast corridor to Super Tuesday. Just a couple of years younger than our team, Yao reflected on a number of opinions from Gen Z voters that stood in contrast to young people we met along the Rust Belt. Prior to and immediately after the Iowa Caucus, Sanders was polling as the favorite in the presidential race. On the ground, voters who were passionate were most often passionate about Sanders – with Sen. Elizabeth Warren a close second. He gave many first, second and third-time voters hope that their future might be salvaged.
For example, just a few hours before the Iowa Caucuses began, one Iowa native, RyAnne Gill, 24, shared her reasons for supporting Sanders during her morning shift at Jimmy’s Pancake House in Bettendorf. Gill, who also works as the Environmental Educator at the local Parks and Recreation Department, said her top concerns were criminal justice reform, environmental policy, education and student loans. When asked which democratic candidate could cover each of these issues adequately, Gill responded: “I think Bernie.”
Yet, when we traveled through New England, we found students who had reservations about Bernie for one main reason: He would be too divisive, paving the way for Donald Trump to win re-election.
Yao, who wants to go into healthcare policy after graduation, said campaigning on a message of “healthcare for all” was irresponsible. According to Yao, even some of her professors warned this crucial component of Sanders’ campaign is impossible in practice. Nevertheless, when asked what she believes is the most important issue in the 2020 election, Yao responded definitively: “Healthcare for people my age.”
For Yao, the desire for healthcare for all does not come down to a candidate who simply promises they will make it happen. “It’s such a multi-layered, deep-seated issue,” Yao told us, saying a promise of healthcare for all is “not really the solution.”
“You’re going to find Bernie supporters on campus, but…” Yao’s high energy diminished for a brief moment, “most people are kind of resigned to the fact that [Democrats are] not going to win the 2020 election, which is...sad.”
The Tylt’s audience has appeared similarly uncertain. When recently asked “Do you think Bernie Sanders can defeat Trump?” only 53 percent believed he could as of mid-March. The journey through Yale’s campus – a collection of stone buildings over three centuries old and a reminder of the country’s institutional history – was our team’s first indication that perhaps young people in America are not eager for a revolution. However promising and hopeful, revolutions are often chaotic and unsettling to norms. As we approached Super Tuesday, we saw signs of a shift toward a candidate who felt safe: Joe Biden.
In October of 2019, nearly 73 percent of Tylt voters preferred Trump over Biden. To say nothing of Trump's own controversies, this vote took place at a time when Biden struggled to stand out in debates and was followed by a number of scandals, including waffling on the Hyde Amendment and longing for the “civility” enjoyed by senators with certain segregationist colleagues, as well as allegations of inappropriate advances on former staffers.   
Biden is still not free from controversy. In late March, a former staffer claimed Biden sexually assaulted her in 1993 – a story that received little coverage amid the coronavirus news cycle. In the same week, The Tylt audience indicated concerns that Biden would not impact the presidential race should he become the nominee. Nearly 62 percent agreed, however, Biden would beat Trump.
This swing toward Biden was clear two days into our trip: Biden would win the South Carolina primary, sparking one of the greatest comebacks in election history and changing the nature of the 2020 race. The victory seemed out of nowhere, but the signs were there – even as the Bernie followers gathered in rallies before Super Tuesday.
It was Friday, February 28, when Sanders held a campaign rally in Springfield, Mass. The line to get in wrapped around the entire building, which was no small feat, considering the building also served as a hockey arena.
In line stood many excited, hopeful voters of various ages, but lacking diversity. Not all attendees had completely made up their mind about Sanders; it’s still true that some voters attend rallies simply to learn more about a candidate’s platform. But for those firmly in Sanders’ camp, they believed no other candidate would be capable of moving the country forward.
As Clare Sheedy, a freshman at the University of Massachusetts Amherst, shared, “Last election, I wasn’t too confident in [Sanders], and now with the new candidates, I think he’s one of the best fits.” Sheedy said Sanders’ views on the debt crisis, climate change and Medicare for all separated him from the rest of the Democratic primary candidates, believing he took the issues more seriously and with much more urgency than his competition.
Herein lies a paradox. Some young voters in the country – such as Sheedy, Gill and others in line to hear Sanders speak – desire a more progressive approach. Others simply want to stop the full-on sprint and just walk at a comfortable pace. For these voters, Joe Biden is the only remaining answer, even if he lacks the magnetism of the Sanders grassroots movement.
Sanders’ rally in Springfield checked a lot of boxes: people held signs, Sanders paused for applause, and everyone took pictures of the candidate raising his arms from behind the podium. But Sanders’ message did not land with the same passion he is largely expected to produce. The repetition of voice inflection, cheers from the crowd, and sign-shaking began to drone. The room, an empty concrete structure devoid of any decoration beyond what attendees themselves sported, felt anticipatory, not electric. And promise after promise, from legalizing weed to taking on the fossil fuel industry, from breaking down the military industrial complex to guaranteeing a $60,000 annual salary for teachers, and from free public college to winning the primary in Massachusetts (which Sanders failed to do), our team detected a subtle undercurrent of hesitation.
We saw many shirts with slogans like “I knocked on doors for Bernie,” but very few people who looked like they’d been on the other end of such an encounter. Perhaps more voters felt Yao’s hesitation than previously believed; perhaps voters at large were not ready for his revolution. For young people in particular, the suspicion of false promises is strong no matter who is speaking; it just so happens that Sanders makes more promises than any other candidate in the field.
Still, another candidate remained who many young people felt they could trust. The next morning, we were introduced to an entirely different style of campaigning in the form of Elizabeth Warren’s Northampton, Mass. field office. When we arrived for an early morning canvassing session, we were welcomed with Hershey’s kisses, buttons and a healthy mix of both students and women about Warren’s age. Two high schoolers led the training on how to go about canvassing. They introduced themselves to the crowd with ease and acted out what it would be like to knock on a stranger’s door and engage in political discussion. They didn’t mention whether they were of voting age themselves.
The mood of Warren’s field office and Sanders’ campaign rally could not have been more distinct. Warren’s office felt warm, while Sanders’ rally felt frantic. Warren’s office was filled almost entirely with women, while the line for Sanders’ rally was manned by young men with clipboards. Both featured local elected officials speaking on their behalf, and neither had much to say by way of diverse crowds – by Super Tuesday, diversity would be an issue for both Warren and Sanders.
We pictured Sanders’ rally feeling historic, but as our road team – anchored by social media manager Aasha Collins and producer Jon Musgrave – would put it, we left feeling “hungry and unimpressed.” Sanders’ campaign speech sounded like one that had been repeated a thousand times – tired and uninspiring. We didn’t know it then, but our observations would foreshadow a swift and nearly insurmountable demise of the Sanders 2020 campaign.
We learned not every Sanders supporter craved the Bernie Bro label in the days between the South Carolina primary and Super Tuesday. One young voter in Brattleboro, Vermont – a typecast of the “Bernie Bro” population sporting a beanie, a thrifted sweater and at least three earrings – even said he found the thought of being a “bro” of anything to be a “pretty foul idea.” Although this individual was certainly a Sanders supporter, moments like these hinted at an enthusiasm gap among young voters. According to a number of experts, this gap is not candidate specific; young people are simply not as motivated to vote as they seem.
In the primaries conducted prior to the coronavirus self-quarantines in the United States, the media and even Sanders himself acknowledged low turnout among young voters.
According to Pew Research, Gen Z and Millennials comprise over one third of the electorate in the 2020 election. By comparison, Boomers and Gen X account for 28 and 25 percent of voters respectively. It’s no secret to the Sanders or Biden campaigns that voters aged 39 and below carry new weight in this presidential election; Sanders’ campaign in particular hinges on their mobilization.
On March 4, the day after Super Tuesday, the New York Times’ Sydney Ember and Maggie Astor reported: “In no state did people younger than 30 account for more than 20 percent of the electorate, based on exit polls, and in most states they accounted for 15 percent or less.”
But it’s possible the voting power of Gen Z and Millennials is split across two age categories in exit polls. As a result, young voters’ influence in the election is likely stronger than what these statistics reflect.
Pew defines Gen Z voters as ages 18 through 23, Millennials as ages 24 through 39, and Gen Xers, Boomers and the Silent Generation as voters ages 40 and up. Most exit polls, however, split voter age ranges into only four categories: 18-29, 30-44, 45-64 and 65 and older. The narrative regarding the primaries thus far tells a story of younger voters failing to turn out for any Democratic candidate. In reality, the "15 percent" of voters, those ages 18 through 29, reflect Gen Z and some Millennials, but certainly not all.
It’s not that Millennials and Gen Z are not turning out to vote. Instead, one issue is clear: They aren’t as motivated to commit to Sanders’ revolution as many pundits had assumed.
On March 11, Democrats and pundits waited with bated breath for Sanders to address the nation during a 1 p.m. press conference from his hometown of Burlington, Vermont. It was the day after another string of primary losses for Sanders, and he used the opportunity not to bow out of the race, but to lay a mantel down for Joe Biden to either pick up, or risk failure.
“Joe, what are you going to do to end the absurdity of the United States of America being the only major country on earth where healthcare is not a human right?” Sanders declared, rattling off his stump speech in the form of debate topics for Biden to address during the first two-person Democratic primary debate. Given the tone of Sanders’ speech, it might be the last. If Biden can take these cues from Sanders and combine their coalitions adequately, perhaps Sanders will put his support behind Biden as the Democratic candidate for president. If, however, Biden fails, Sanders’ actions are anyone’s guess. To some, remaining in the race runs the risk of further dividing the party, while to others, Sanders’ persistence will look like a continued fight for progress.
As of late March, The Tylt’s audience had made up its mind. When asked “Does Bernie Sanders still have a chance?” nearly 90 percent of respondents agreed the Democratic party should “unite against Trump” with Biden at the helm. In a time of global crisis, and with the country’s inequities on full display, Sanders’ choice to remain in the race or to drop out holds implications not only for the future of the nation, but for the path ahead for his supporters.
One Massachusetts voter we met on Super Tuesday, Thomas Hart, who was clad in a tie-dye shirt and a fishing hat, chastised the Sanders supporters of 2016, saying they were at least partly responsible for Trump’s election. Once Hillary Clinton won the nomination, Hart explained, they did not come out to the polls to support her as the Democratic candidate. “It was all sour grapes,” he said, “I think this time around they’ve got a better idea of what could go wrong.” If Biden is the nominee, Hart believes Sanders followers will understand the stakes. “I won’t be pouting,” he added.
The question remains whether Sanders supporters will turn out for Biden if he does clinch the Democratic nomination this summer. Biden’s comeback narrative looms large as state primaries are postponed one by one and as allegations against him simmer beneath the surface, but he has voiced his appreciation for Sanders’ passionate and progressive supporters – a group he’ll need if he is the nominee facing off with Trump.
At his home in Wilmington, Delaware, on March 17, Biden spoke directly to these voters: “I hear you. I know what’s at stake. I know what we have to do.” His priority is simple: to unify the country. But what if young people believe unity lies at the end of a path Biden is not on? They might ask themselves if he is truly listening to their wishes, or simply joining the ranks of politicians speaking at a generation, without connecting to the sense of urgency they so desperately feel.
What is certain thus far in the primaries is the power of momentum. We witnessed its wild swings from Iowa to Super Tuesday. In truth, the Biden revival has humbled many experts – from pundits to politicians. The coronavirus pandemic, with primaries on hold, seems to have all but sealed the fate of the Sanders’ campaign. If so, one question remains: Will young voters join Joe to beat Trump, or will it once again be Bernie or bust? 

Fudging the Coronavirus Numbers?

Deborah Birx, White House coronavirus response coordinator, shows charts 
on death estimates related to the coronavirus pandemic.


The Washington Post reports that experts do not know how the White House estimated that there would be 100,000 to 240,000 coronavirus deaths in the US. The WaPo writes:
“Leading disease forecasters, whose research the White House used to conclude 100,000 to 240,000 people will die nationwide from the coronavirus, were mystified when they saw the administration’s projection this week. The experts said they don’t challenge the numbers’ validity but that they don’t know how the White House arrived at them. White House officials have refused to explain how they generated the figure — a death toll bigger than the United States suffered in the Vietnam War or the 9/11 terrorist attacks. They have not provided the underlying data so others can assess its reliability or provided long-term strategies to lower that death count.”
In view of the refusal to provide the basis for the estimate, the most likely explanation is that the president grossly exaggerated the death estimate so that when the total comes out to be significantly less, he can claim he performed a miracle and then get re-elected.

The next most likely explanation is that the president took out his sharpie and drew a curve that looked good to him, like he did with hurricane Dorian last year.


The president analyzing and projecting the course of a hurricane


There may be other explanations, but they are not immediately clear.

What is Involved in Being on a Ventilator

There hasn't been much detail about what ventilators are, how they work and are used. After some rummaging around the interwebs, the answers that come back are quite unpleasant. If you need to go on a ventilator, you are extremely sick and in deep trouble. I wish the situation was not so  unpleasant. Here's some info from various sources.

A ventilator, also known as a respirator or breathing machine, is a medical device that provides a patient with oxygen when they are unable to breathe on their own. The ventilator gently pushes air into the lungs and allows it to come back out like the lungs would typically do when they are able.

In order to be placed on a ventilator, the patient must be intubated. This means having an endotracheal tube placed in the mouth or nose and threaded down into the airway. This tube has a small inflatable gasket which is inflated to hold the tube in place. The ventilator is attached to the tube and the ventilator provides “breaths” to the patient.

If a patient is on the ventilator after surgery, medication is often given to sedate the patient. This is done because it can be upsetting and irritating to the patient to have an endotracheal tube in place and feel the ventilator pushing air into the lungs. The goal is to keep the patient calm and comfortable without sedating them so much that they cannot breathe on their own and be removed from the ventilator.

Patients who are not able to be removed from the ventilator immediately after surgery may require weaning, which is a process where the ventilator settings are adjusted to allow the patient to attempt to breathe on their own, or for the ventilator to do less work and the patient to do more. This may be done for days or even weeks, gradually allowing the patient to improve their breathing.”

Patients have to be sedated because they instinctively want to pull the tubes out of their lungs. One can imagine how irritating is it to have a tube run through your mouth or nose and into your lungs. Sometimes the tube is inserted through the trachea after a hole is cut through the neck:
Ventilators normally don't cause pain. The breathing tube in your airway may cause some discomfort. It also affects your ability to talk and eat. 
If your breathing tube is a trach tube, you may be able to talk. (A trach tube is put directly into your windpipe through a hole in the front of your neck.) 
Instead of food, your health care team may give you nutrients through a tube inserted into a vein. If you're on a ventilator for a long time, you'll likely get food through a nasogastric, or feeding, tube. The tube goes through your nose or mouth or directly into your stomach or small intestine through a surgically made hole. 
A ventilator greatly restricts your activity and also limits your movement. You may be able to sit up in bed or in a chair, but you usually can't move around much. 
One of the most serious and common risks of being on a ventilator is pneumonia. The breathing tube that's put in your airway can allow bacteria to enter your lungs. As a result, you may develop ventilator-associated pneumonia (VAP). 
The breathing tube also makes it hard for you to cough. Coughing helps clear your airways of lung irritants that can cause infections. 
VAP is a major concern for people using ventilators because they're often already very sick. Pneumonia may make it harder to treat their other disease or condition. 
VAP is treated with antibiotics. You may need special antibiotics if the VAP is caused by bacteria that are resistant to standard treatment.”



A 2016 research article focused on the sedatives given to keep people from pulling the tubes out of their lungs. This article directly contradicts the statement above that ventilators normally do not cause pain. It sounds like they cause a lot of pain.
“On June, 2016, Klompas and colleagues published an article in the Chest entitled Associations between different sedatives and ventilator-associated events, length of stay, and mortality in patients who were mechanically ventilated, which investigated the effects of different sedatives on ventilator-associated events (VAEs), length of stay, and mortality in patients who were mechanically ventilated. ..... This study raises important questions about the sedation of critically ill patients.

Critically ill patients are submitted to several interventions that can lead to distress and pain, like endotracheal intubation, mechanical ventilation, and central venous and arterial catheterization. Indeed, pain is one of the most common memories from patients admitted to intensive care unit (ICU) and can lead to agitation and its consequences, as accidental extubation, and removal of intravascular devices (1). Accordingly, one of the most used drugs for patients in the ICU are sedatives and analgesics (1).” 

Thursday, April 2, 2020

An Irrational Mind Meets Coronavirus

A favela in Brazil


The New York Times reports that Jair Bolsonaro, Brazil's president, has called the virus a “measly cold.” He is the last major world leader who questions lockdown measures. The NYT writes
“RIO DE JANEIRO — As coronavirus cases and deaths mount in Brazil, President Jair Bolsonaro has remained defiant, the last notable holdout among major world leaders in denying the severity of the coronavirus. 
Brazilians, he declared last week, are uniquely suited to weather the pandemic because they can be dunked in raw sewage and “don’t catch a thing.” 
Defying guidelines issued by his own health ministry, the president on Sunday visited a busy commercial district in Brasília, the capital, where he called on all but elderly Brazilians to get back to work. 
Then he insisted that an anti-malaria pill of unproved efficacy would cure those who fall ill with the virus that has killed more than 43,000 people worldwide.”

It will be interesting and sad to see how the virus will ravage a country that doesn't even try to deal with it. The US is projecting up to 240,000 deaths if containment measures are strictly adhered to. With no containment measures Brazil is probably going to experience the collapse of its health care system and several million deaths. The next 3-4 weeks will be instructive.