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Oct 20, 2020
COVID-19 Update
World
Of course we’re tired of the coronavirus, Mr. President. Wishful thinking won’t make it go away.
AS A frightening new wave of coronavirus infections and hospitalizations washes over the nation, President Trump and his team sound like cheerleaders in a fantasy world. “The light at the end of the tunnel is near. We are rounding the turn,” Mr. Trump said Friday. His White House coronavirus adviser, Scott Atlas, went even further on the weekend with nakedly irresponsible advice that face masks don’t work. The implication was: Don’t bother to wear them. “People are tired of covid,” Mr. Trump declared Monday. “People are saying, ‘Whatever, just leave us alone.’ ”
Of course we are tired of covid. More than 8 million Americans have been infected by the novel coronavirus and at least 219,000 have died, more than in any other country. Some number of those deaths can be attributed to Mr. Trump’s adoption of wishful thinking as policy. He has resisted a national testing plan and a national public health strategy, and he continually encourages reckless behavior and mocks prudence. The result is more unemployment, more illness, more misery.
“Masks work? NO,” Dr. Atlas wrote, egregiously. He is no expert in infectious disease, but he has risen in the White House hierarchy because he is comfortable in Mr. Trump’s make-believe world. Dr. Atlas rejects universal mask mandates, says they are unnecessary except in close proximity to others, frequently criticizes lockdowns, insists that businesses and schools open, and discourages expanded diagnostic testing. He pursues the mirage of natural “herd immunity.” There is no other way to read this than a strategy to let a lot of people die. Michael Osterholm of the University of Minnesota described it as “the most amazing combination of pixie dust and pseudoscience I’ve ever seen.”
The pandemic poses tough trade-offs: Restrictions on people congregating, which can slow viral transmission, must be weighed against the enormous costs to education and the economy. But there can be no honest debate based on fraudulent science and negligent leadership. Masks are not perfect, but they work. Mitigation works. Careless openings and reckless gatherings lead to outbreaks and surging virus.
According to The Post’s reporters, Dr. Atlas is at odds with others on the White House coronavirus task force, including Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases, and Deborah Birx, the coronavirus response coordinator. The hostility spilled into the open Monday in Mr. Trump’s conference call with campaign staff. “People are tired of hearing Fauci and all these idiots,” the president said. “He’s been here for, like, 500 years. He’s like this wonderful sage telling us how — Fauci, if we listened to him, we’d have 700,000 [or] 800,000 deaths.” Trump added of Dr. Fauci: “Every time he goes on television there’s always a bomb, but there’s a bigger bomb if you fire him.”
Dr. Fauci has been honorably speaking out, as much as he can. We wish Dr. Birx and the director of the Centers for Disease Control and Prevention, Robert Redfield, would be as forthright in sharing unvarnished, data-based advice. But they are not the villains here; undoubtedly, they are trying their best to keep the nation on course in the face of ignorant and heedless leadership.
Mr. Trump’s malpractice in responding to covid-19 is by any measure a firing offense. Fortunately, Americans have an opportunity to fire him, in voting taking place now and culminating on Nov. 3.
NYT - Remdesivir is no miracle cure:
Remdesivir Fails to Prevent Covid-19 Deaths in Huge Trial
Critics said the study, sponsored by the W.H.O., was too poorly conducted to be definitive
Remdesivir, the only antiviral drug authorized for treatment of Covid-19 in the United States, fails to prevent deaths among patients, according to a study of more than 11,000 people in 30 countries sponsored by the World Health Organization.
The drug was granted emergency authorization by the Food and Drug Administration on May 1 after a trial by the National Institutes of Health found that remdesivir modestly reduced the time to recovery in hospitalized patients. President Trump received the antiviral after he began showing symptoms earlier this month.
“This puts the issue to rest — there is certainly no mortality benefit,” said Dr. Ilan Schwartz, an infectious disease physician at the University of Alberta in Canada.
But other scientists said the design of the W.H.O.’s sprawling clinical trial, which collected data from hundreds of hospitals, meant the conclusions were not definitive.
Conducted in dozens of countries with various health care systems and inconsistent treatment protocols, the data are difficult to analyze and compare, said Dr. Peter Chin-Hong, an infectious disease expert at the University of California, San Francisco.
The findings, which were posted online on Thursday, have not yet been peer-reviewed or published in a scientific journal.
Remdesivir, which was originally developed as a treatment for Ebola and hepatitis C, interferes with the reproduction of viruses by jamming itself into new viral genes.
There's always tension between colleagues - that's how it's supposed to be. One guy puts up his hypothesis, and the next guy tries to tear it down, then the first guy rebuts, then another guy chimes in, and on it goes until some kind of consensus is reached.
My point here is that they just don't know enough yet. When President Stoopid jumps into the middle of it and goes off half-cocked, the whole thing just gets weirder and more jumbled, and that makes it harder for anybody to get any closer to solid useful information.
NYT:
Pfizer Says It Won’t Seek Vaccine Authorization Before Mid-November
Friday’s announcement represents a shift in tone for the company and its leader, who has repeatedly emphasized the month of October in interviews and public appearances.
The chief executive of Pfizer said on Friday that the company would not apply for emergency authorization of its coronavirus vaccine before the third week of November, ruling out President Trump’s assertion that a vaccine would be ready before Election Day on Nov. 3.
In a statement posted to the company website, the chief executive, Dr. Albert Bourla, said that although Pfizer could have preliminary numbers by the end of October about whether the vaccine works, it would still need to collect safety and manufacturing data that will stretch the timeline to at least the third week of November.
Close watchers of the vaccine race had already known that Pfizer wouldn’t be able to meet the requirements of the Food and Drug Administration by the end of this month. But Friday’s announcement represents a shift in tone for the company and its leader, who has repeatedly emphasized the month of October in interviews and public appearances.
- New Cases: 338,352 (⬆︎ .84%)
- New Deaths: 4,392 (⬆︎ .39%)
USA
- New Cases: 57,327 (⬆︎ .68%)
- New Deaths: 442 (⬆︎ .20%)
Three pieces from WaPo and NYT that illustrate a small part of how thoroughly fucked up this Cult45 administration is.
Of course we’re tired of the coronavirus, Mr. President. Wishful thinking won’t make it go away.
AS A frightening new wave of coronavirus infections and hospitalizations washes over the nation, President Trump and his team sound like cheerleaders in a fantasy world. “The light at the end of the tunnel is near. We are rounding the turn,” Mr. Trump said Friday. His White House coronavirus adviser, Scott Atlas, went even further on the weekend with nakedly irresponsible advice that face masks don’t work. The implication was: Don’t bother to wear them. “People are tired of covid,” Mr. Trump declared Monday. “People are saying, ‘Whatever, just leave us alone.’ ”
Of course we are tired of covid. More than 8 million Americans have been infected by the novel coronavirus and at least 219,000 have died, more than in any other country. Some number of those deaths can be attributed to Mr. Trump’s adoption of wishful thinking as policy. He has resisted a national testing plan and a national public health strategy, and he continually encourages reckless behavior and mocks prudence. The result is more unemployment, more illness, more misery.
“Masks work? NO,” Dr. Atlas wrote, egregiously. He is no expert in infectious disease, but he has risen in the White House hierarchy because he is comfortable in Mr. Trump’s make-believe world. Dr. Atlas rejects universal mask mandates, says they are unnecessary except in close proximity to others, frequently criticizes lockdowns, insists that businesses and schools open, and discourages expanded diagnostic testing. He pursues the mirage of natural “herd immunity.” There is no other way to read this than a strategy to let a lot of people die. Michael Osterholm of the University of Minnesota described it as “the most amazing combination of pixie dust and pseudoscience I’ve ever seen.”
The pandemic poses tough trade-offs: Restrictions on people congregating, which can slow viral transmission, must be weighed against the enormous costs to education and the economy. But there can be no honest debate based on fraudulent science and negligent leadership. Masks are not perfect, but they work. Mitigation works. Careless openings and reckless gatherings lead to outbreaks and surging virus.
According to The Post’s reporters, Dr. Atlas is at odds with others on the White House coronavirus task force, including Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases, and Deborah Birx, the coronavirus response coordinator. The hostility spilled into the open Monday in Mr. Trump’s conference call with campaign staff. “People are tired of hearing Fauci and all these idiots,” the president said. “He’s been here for, like, 500 years. He’s like this wonderful sage telling us how — Fauci, if we listened to him, we’d have 700,000 [or] 800,000 deaths.” Trump added of Dr. Fauci: “Every time he goes on television there’s always a bomb, but there’s a bigger bomb if you fire him.”
Dr. Fauci has been honorably speaking out, as much as he can. We wish Dr. Birx and the director of the Centers for Disease Control and Prevention, Robert Redfield, would be as forthright in sharing unvarnished, data-based advice. But they are not the villains here; undoubtedly, they are trying their best to keep the nation on course in the face of ignorant and heedless leadership.
Mr. Trump’s malpractice in responding to covid-19 is by any measure a firing offense. Fortunately, Americans have an opportunity to fire him, in voting taking place now and culminating on Nov. 3.
NYT - Remdesivir is no miracle cure:
Remdesivir Fails to Prevent Covid-19 Deaths in Huge Trial
Critics said the study, sponsored by the W.H.O., was too poorly conducted to be definitive
Remdesivir, the only antiviral drug authorized for treatment of Covid-19 in the United States, fails to prevent deaths among patients, according to a study of more than 11,000 people in 30 countries sponsored by the World Health Organization.
The drug was granted emergency authorization by the Food and Drug Administration on May 1 after a trial by the National Institutes of Health found that remdesivir modestly reduced the time to recovery in hospitalized patients. President Trump received the antiviral after he began showing symptoms earlier this month.
“This puts the issue to rest — there is certainly no mortality benefit,” said Dr. Ilan Schwartz, an infectious disease physician at the University of Alberta in Canada.
But other scientists said the design of the W.H.O.’s sprawling clinical trial, which collected data from hundreds of hospitals, meant the conclusions were not definitive.
Conducted in dozens of countries with various health care systems and inconsistent treatment protocols, the data are difficult to analyze and compare, said Dr. Peter Chin-Hong, an infectious disease expert at the University of California, San Francisco.
The findings, which were posted online on Thursday, have not yet been peer-reviewed or published in a scientific journal.
Remdesivir, which was originally developed as a treatment for Ebola and hepatitis C, interferes with the reproduction of viruses by jamming itself into new viral genes.
There's always tension between colleagues - that's how it's supposed to be. One guy puts up his hypothesis, and the next guy tries to tear it down, then the first guy rebuts, then another guy chimes in, and on it goes until some kind of consensus is reached.
My point here is that they just don't know enough yet. When President Stoopid jumps into the middle of it and goes off half-cocked, the whole thing just gets weirder and more jumbled, and that makes it harder for anybody to get any closer to solid useful information.
NYT:
Pfizer Says It Won’t Seek Vaccine Authorization Before Mid-November
Friday’s announcement represents a shift in tone for the company and its leader, who has repeatedly emphasized the month of October in interviews and public appearances.
The chief executive of Pfizer said on Friday that the company would not apply for emergency authorization of its coronavirus vaccine before the third week of November, ruling out President Trump’s assertion that a vaccine would be ready before Election Day on Nov. 3.
In a statement posted to the company website, the chief executive, Dr. Albert Bourla, said that although Pfizer could have preliminary numbers by the end of October about whether the vaccine works, it would still need to collect safety and manufacturing data that will stretch the timeline to at least the third week of November.
Close watchers of the vaccine race had already known that Pfizer wouldn’t be able to meet the requirements of the Food and Drug Administration by the end of this month. But Friday’s announcement represents a shift in tone for the company and its leader, who has repeatedly emphasized the month of October in interviews and public appearances.
In doing so, the company had aligned its messaging with that of the president, who has made no secret of his desire for an approved vaccine before the election. He has even singled out the company by name and said he had talked to Dr. Bourla, whom he called a “great guy.”
We've been told over and over that there's no curative, and there're no therapeutics (none that can be applied across the spectrum of cases anyway), and that it's not realistic to expect a safe effective vaccine that can be widely distributed before spring 2021, at the earliest.
But there's President Stoopid again, running off at the mouth because he gets to say any fuckin' thing he wants to say because he has an opinion and that means what he says is just as valid as what any doctor says and blah blah blah, and now it's getting worse and more people are dying and we need somebody to beat that fucker with a sock full of rocks til he shuts the fuck up.
Oct 19, 2020
A Predator
Lacrymaria Olor on a successful hunt.
Lacrymaria olor is a species of ciliates, typically 100 micrometres (0.10 mm) long, that is found in freshwater ponds. Its name means "swan tear" in Latin, and refers to its general shape: namely, a teardrop-shaped cell with a small "head" at the end of a long slender "neck". The protist is notable for its ability to extend the anterior end of the cell up to 7 times its body length, and manipulate in many directions — even around obstacles — in order to capture its food. For that reason it is a popular subject for amateur microscopists. The classification has been attributed to Müller (1786).
The protist usually has two macronuclei and a single micronucleus. Its entire cell body is covered with cilia arranged in spirals. It has two contractile vacuoles, one at each end of the body. It contains small birefringent crystals.
Lacrymaria olor can be easily reproduced in vitro, but cultivated populations are difficult to maintain for long. It can reproduce sexually, with each individual assuming either of two mating types ("sexes") at various times of the day. It can also reproduce asexually, possibly after an internal rearrangement of its genome; but there is evidence that this mechanism stops working after a certain number of consecutive asexual generations. It can also regenerate a new head within minutes, if the original is cut off.
Lacrymaria feed primarily on smaller organisms such as other ciliates, flagellates, and amoeba, but may sometimes tear chunks out of larger ciliates.
The protist usually has two macronuclei and a single micronucleus. Its entire cell body is covered with cilia arranged in spirals. It has two contractile vacuoles, one at each end of the body. It contains small birefringent crystals.
Lacrymaria olor can be easily reproduced in vitro, but cultivated populations are difficult to maintain for long. It can reproduce sexually, with each individual assuming either of two mating types ("sexes") at various times of the day. It can also reproduce asexually, possibly after an internal rearrangement of its genome; but there is evidence that this mechanism stops working after a certain number of consecutive asexual generations. It can also regenerate a new head within minutes, if the original is cut off.
Lacrymaria feed primarily on smaller organisms such as other ciliates, flagellates, and amoeba, but may sometimes tear chunks out of larger ciliates.
Today's PSA
Noah Lindquist - Wear A Mask
You can shout
You can swear
But listen, Karen - I don't care
Never seen folks so dramatic
Over a fucking piece of fabric
COVID-19 Update
World
- New Cases: 342,842
- New Deaths: 3,968
USA
- New Cases: 44,941
- New Deaths: 448
Re-affirming: Herd Immunity is stoopid. It sounds like it makes some sense, but no doctor worth their own shit would push for a "solution" that has any real potential to cost people their lives unnecessarily. (read: Scott Atlas is a complete asshole)
Trump’s den of dissent: Inside the White House task force as coronavirus surges
As summer faded into autumn and the novel coronavirus continued to ravage the nation unabated, Scott Atlas, a neuroradiologist whose commentary on Fox News led President Trump to recruit him to the White House, consolidated his power over the government’s pandemic response.
Atlas shot down attempts to expand testing. He openly feuded with other doctors on the coronavirus task force and succeeded in largely sidelining them. He advanced fringe theories, such as that social distancing and mask-wearing were meaningless and would not have changed the course of the virus in several hard-hit areas. And he advocated allowing infections to spread naturally among most of the population while protecting the most vulnerable and those in nursing homes until the United States reaches herd immunity, which experts say would cause excess deaths, according to three current and former senior administration officials.
Atlas also cultivated Trump’s affection with his public assertions that the pandemic is nearly over, despite death and infection counts showing otherwise, and his willingness to tell the public that a vaccine could be developed before the Nov. 3 election, despite clear indications of a slower timetable.
Atlas’s ascendancy was apparent during a recent Oval Office meeting. After Trump left the room, Atlas startled other aides by walking behind the Resolute Desk and occupying the president’s personal space to keep the meeting going, according to one senior administration official. Atlas called this account “false and laughable.”
Discord on the coronavirus task force has worsened since the arrival in late summer of Atlas, whom colleagues said they regard as ill-informed, manipulative and at times dishonest. As the White House coronavirus response coordinator, Deborah Birx is tasked with collecting and analyzing infection data and compiling charts detailing upticks and other trends. But Atlas routinely has challenged Birx’s analysis and those of other doctors, including Anthony S. Fauci, Centers for Disease Control and Prevention Director Robert Redfield, and Food and Drug Administration Commissioner Stephen Hahn, with what the other doctors considered junk science, according to three senior administration officials.
Birx recently confronted the office of Vice President Pence, who chairs the task force, about the acrimony, according to two people familiar with the meeting. Birx, whose profile and influence has eroded considerably since Atlas’s arrival, told Pence’s office that she does not trust Atlas, does not believe he is giving Trump sound advice and wants him removed from the task force, the two people said.
In one recenet encounter, Pence did not take sides between Atlas and Birx, but rather told them to bring data bolstering their perspectives to the task force and to work out their disagreements themselves, according to two senior administration officials.
The result has been a U.S. response increasingly plagued by distrust, infighting and lethargy, just as experts predict coronavirus cases could surge this winter and deaths could reach 400,000 by year’s end.
This assessment is based on interviews with 41 administration officials, advisers to the president, public health leaders and other people with knowledge of internal government deliberations, some of whom spoke on the condition of anonymity to provide candid assessments or confidential information.
Atlas defended his views and conduct in a series of statements sent through a spokesperson and condemned The Washington Post’s reporting as “another story filled with overt lies and distortions to undermine the President and the expert advice he is being given.”
Atlas said he has always stressed “all appropriate mitigation measures to save lives,” and he responded to accounts of dissent on the task force by saying, “Any policy discussion where data isn’t being challenged isn’t a policy discussion.”
On the issue of herd immunity, Atlas said, “We emphatically deny that the White House, the President, the Administration, or anyone advising the President has pursued or advocated for a wide-open strategy of achieving herd immunity by letting the infection proceed through the community.”
The doctor’s denial conflicts with his previous public and private statements, including his recent endorsement of the “Great Barrington Declaration,” which effectively promotes a herd immunity strategy.
On Saturday, Atlas wrote on Twitter that masks do not work, prompting the social media site to remove the tweet for violating its safety rules for spreading misinformation. Several medical and public health experts flagged the tweet as dangerous misinformation coming from a primary adviser to the president.
“Masks work? NO,” Atlas wrote in the tweet, followed by other misrepresentations about the science behind masks. He linked to an article from the American Institute for Economic Research — a libertarian think tank behind the Barrington effort — that argued against masks and dismissed the threat of the virus as overblown.
Trump and many of his advisers have come to believe that the key to a revived economy and a return to normality is a vaccine.
“They’ve given up on everything else,” said a senior administration official involved in the pandemic response. “It’s too hard of a slog.”
Infectious-disease and other public health experts said the friction inside the White House has impaired the government’s response.
“It seems to me this is policy-based evidence-making rather than evidence-based policymaking,” said Marc Lipsitch, director of the Center for Communicable Disease Dynamics at the Harvard T.H. Chan School of Public Health. “In other words, if your goal is to do nothing, then you create a situation in which it looks okay to do nothing [and] you find some experts to make it complicated.”
These days, the task force is dormant relative to its robust activity earlier in the pandemic. Fauci, Birx, Surgeon General Jerome Adams and other members have confided in others that they are dispirited.
Birx and Fauci have advocated dramatically increasing the nation’s testing capacity, especially as experts anticipate a devastating increase in cases this winter. They have urged the government to use unspent money Congress allocated for testing — which amounts to $9 billion, according to a Democratic Senate appropriations aide — so that anyone who needs to can get a test with results returned quickly.
But Atlas, who is opposed to surveillance testing, has repeatedly quashed these proposals. He has argued that young and healthy people do not need to get tested and that testing resources should be allocated to nursing homes and other vulnerable places, such as prisons and meatpacking plants.
White House spokeswoman Sarah Matthews defended Trump and the administration’s management of the crisis.
“President Trump has always listened to the advice of his top public health experts, who have diverse areas of expertise,” Matthews said in a statement. “The President always puts the well-being of the American people first as evidenced by the many bold, data-driven decisions he has made to save millions of lives. Because of his strong leadership, our country can safely reopen with adequate PPE, treatments, and vaccines developed in record time.”
Yet 10 months into a public health crisis that has claimed the lives of more than 219,000 people in the United States — a far higher death toll than any other nation has reported — a consensus has formed within the administration that some measures to mitigate the spread of the virus may not be worth the trouble.
The president gave voice to this mind-set during an NBC News town hall Thursday night, when he declined to answer whether he supported herd immunity. “The cure cannot be worse than the problem itself,” Trump told host Savannah Guthrie.
But medical experts disagreed, saying it is dangerous for government leaders to advocate herd immunity or oppose interventions.
“We’d be foolish to reenter a situation where we know what to do and we’re not doing it,” said Rochelle Walensky, chief of the division of infectious diseases at Massachusetts General Hospital and a professor of medicine at Harvard Medical School. “This thing can take off. All you need to do is look at what’s happened at 1600 Pennsylvania Avenue over the last two weeks to see that this thing is way faster than we’re giving it credit for.”
After Trump came home from the hospital this month, he all but promised Americans that they could soon be cured from the coronavirus just as he claimed to have been. In a video taped at the White House on Oct. 5, he vowed, “The vaccines are coming momentarily.”
Then, at a rally last Tuesday night in Johnstown, Pa., Trump told supporters, “The vaccines are coming soon, the therapeutics and, frankly, the cure. All I know is I took something, whatever the hell it was. I felt good very quickly . . . I felt like Superman.”
Trump’s miraculous timeline has run headlong into reality, however. On the same day that he declared “the cure” was near, Johnson & Johnson became the second pharmaceutical giant, after AstraZeneca, to halt its vaccine trial. A third trial, a government-run test of a monoclonal antibody manufactured by Eli Lilly & Co., was also paused. Each move was prompted by safety concerns.
And on Friday, Pfizer said it will not be able to seek an emergency use authorization from the FDA until the third week of November, at the earliest, seemingly making a vaccine before Election Day all but impossible.
Trump’s notion of a vaccine as a cure-all for the pandemic is similarly miraculous, according to medical experts.
“The vaccines, although they’re wonderful, are not going to make the virus magically disappear,” said Tom Frieden, a former CDC director who is president of Resolve to Save Lives. “There’s no fairy-tale ending to this pandemic. We’re going to be dealing with it at least through 2021, and it’s likely to have implications for how we do everything from work to school, even with vaccines.”
Frieden added: “Remember, we have vaccines against the flu, and we still have flu.”
Still, Trump has ratcheted up his push for vaccines over the past several months, intensifying the pressure on government scientists, federal regulators and pharmaceutical executives. He has had one end date in mind: Nov. 3, which is Election Day.
Trump has envisioned a greenlit vaccine as the kind of breakthrough that could persuade voters to see his management of the pandemic as successful and thus upend a race in which virtually all public polls show him trailing Democratic nominee Joe Biden.
Earlier this fall, Trump called Albert Bourla, the chief executive of Pfizer, and asked whether a vaccine could be ready for distribution by late October, before the election. Pfizer spokeswoman Sharon Castillo said executives have regular communications with administration officials on a wide range of health policy issues but that she could not comment on private conversations.
On a call in August with Francis Collins, director of the National Institutes of Health, Trump accused the agency of moving too slowly to approve a vaccine or other treatments, including convalescent plasma, according to two officials familiar with the conversation. The NIH, which declined to comment, is a biomedical research agency and does not approve treatments or vaccines.
Matthews denied that Trump sees the vaccine timetable through the prism of the campaign calendar. “This is not about politics; it’s about saving lives,” she said. She added, “any vaccine approval will maintain the FDA’s gold standard for safety and efficacy and be proven to save lives.”
The relationships between FDA officials and White House staffers have grown more acrimonious since September, when details of stricter FDA vaccine guidance were reported by The Post. Trump and White House Chief of Staff Mark Meadows — who has involved himself in the work of health agencies to a degree other officials consider inappropriate — have repeatedly challenged Hahn over his agency’s proposals and rules, much to the FDA commissioner’s frustration.
Trump is asserting control over the messaging campaign around a vaccine. His politically minded aides in the White House have taken over the government’s communications effort, as opposed to health or scientific communicators at the relevant agencies.
For example, White House aides have sought to persuade Moncef Slaoui, head of “Operation Warp Speed,” the government’s initiative to mass-distribute an eventual vaccine, to speak more positively about the vaccine, and sometimes he has pushed back on their talking points, two officials said.
Trump routinely has told his political advisers that a vaccine would be ready by the time he stands for reelection. And he has plotted with his team on a pre-election promotional campaign to try to convince voters a vaccine is safe, approved and ready for mass distribution — even if none of that is true yet.
These are some of the ingredients of a public health disaster, experts say.
“The one thing you can’t do — and it’s what everybody fears, it’s what the pharmaceutical companies fear, it’s what everybody on the inside fears — is that the government would, because of political purposes or because other countries put a vaccine out before us, truncate the normal process you’d accept for a safe and effective vaccine,” said Paul A. Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia, a professor of vaccinology at the University of Pennsylvania and a member of the FDA’s vaccine advisory council.
Trump’s view of the FDA has darkened considerably in recent weeks. The president now believes — despite the absence of any such evidence — that officials there are working against him to slow-walk vaccine approval as “some sort of ‘deep state’ push to keep him from winning reelection,” according to an administration official.
Trump has said as much himself.
“New FDA Rules make it more difficult for them to speed up vaccines for approval before Election Day. Just another political hit job! @SteveFDA,” the president wrote in an Oct. 6 tweet, tagging Hahn’s Twitter handle.
Trump’s conspiratorial view of the FDA is shaped in part by White House trade adviser Peter Navarro and others in the president’s orbit, both inside and outside the government.
Saad B. Omer, director of the Yale Institute for Global Health, said the atmosphere of pressure and recrimination, nurtured by the president, is “very concerning.”
“These are people who have dedicated their lives to working in public health and medicine and research,” he said. “To think that in the biggest public health event of their lives they would sleep an extra hour or slow-walk this for any reason is absurd.”
He added, “It’s like how an ambulance drives faster than a regular car because it’s an emergency, but even an ambulance driver is not foolhardy. They don’t want to drive over the bridge.”
'A lot of political pressure'
The distrust in Washington has trickled down to the states, where friction has increased between several governors and the administration over the vaccine process.
Some governors and officials close to them privately have expressed alarm about Trump and his aides laying the groundwork for a rushed vaccine announcement. The president has delegated much of the state outreach to Pence, who in regular calls with governors has come across as a smooth salesman for Trump’s speedy approach. The vice president has encouraged governors to help build confidence for eventual vaccines among their constituents.
Illinois Gov. J.B. Pritzker (D), whose state is the site for vaccine trials, said in an interview, “I certainly fear there is a lot of political pressure being applied.” He said his state is preparing for a vaccine rollout, but would carefully evaluate the integrity of any announcement emanating from the White House.
“Nobody has told me that it’ll be ready by November 2nd or anytime before the election,” Pritzker said. “But [Trump] will no doubt claim such a thing because of the cocktail of drugs that he seems to be on now. He’s liable to say anything that isn’t true.”
The concerns are not limited to Democrats. One Republican state official who works with the Trump administration and spoke on the condition of anonymity to preserve that relationship, said, “It’s what I would call soft power. Pence comes on these calls and sounds normal and upbeat, and basically says, ‘Stand with us.’ ”
The official added, “We all want a vaccine, right? We obviously want it. We’ll take it. But we don’t really know if they’ll do this right.”
The politicization of the process has damaged public credibility in an eventual vaccine. A Gallup poll released this month found that 50 percent of Americans said they would be willing to take a coronavirus vaccine approved by the FDA “right now at no cost.” That is a sharp decline from 61 percent in August and 66 percent in July.
During a virtual task force meeting led by Pence on Sept. 21, Washington Gov. Jay Inslee (D) said, “There is a substantial concern,” according to an audio recording of the meeting. “A significant part of that problem is the president’s continued anti-science statements that are contradictory to his medical advisers in so many different ways.”
Inslee asked Pence directly, “Have you discussed with the president how he’s been eroding public confidence in our efforts, including the vaccine approval? Have you discussed that with him? Have you urged him to stop this behavior?”
Pence did not directly answer the question. Rather, he replied, “We think you and all the governors on this call have a great responsibility to make sure the public knows while we’re moving rapidly and while there may be differences in opinion about various events, we just don’t want any undermining of confidence in the vaccine.”
The vice president added, “I can assure you the president will continue to speak clearly about that process.”
Inslee later said in an interview that Pence was anything but assuring.
“There is a pressure campaign,” Inslee said. “We need to follow science and not this distortion campaign . . . The people are on to [Trump]. They know he is trying to turn this into an electoral issue.”
'A magic dust'
As the election nears, one of Trump’s biggest vulnerabilities with voters is his handling of the pandemic — which he increasingly has sought to blame on others. For instance, the president has complained bitterly about Hahn and Redfield, pointing to congressional testimony and other public comments they have made as undermining his chances for reelection, according to multiple administration officials.
Trump also has vented about the slow pace of vaccine trials and has fumed privately about the pharmaceutical industry, even though he speaks highly of some industry executives. Lately, he has expressed particular concern that the absence of a vaccine announcement has been hurting him with early voting, according to an administration official.
Health and Human Services Secretary Alex Azar, a former Eli Lilly president who has close ties to the pharmaceutical industry, has sought to cool Trump’s temper and assure him that the process is sound.
Also whispering optimism in the tempestuous president’s ear has been Atlas, who is said to be operating with the full confidence of Jared Kushner, Trump’s son-in-law and senior adviser overseeing key aspects of the pandemic response, and Hope Hicks, the president’s counselor and confidante.
This is in part because Atlas has sought to spin the public with what others deride as “happy talk” that the outbreak is close to over. “Everybody looks for what Atlas is giving them,” one official involved in the response said.
Offit said, “This administration, like it does with everything, is overselling vaccines. They make it sound like a magic dust they’ll distribute over the country and the disease will go away . . . What could happen is people think, great, I just got my vaccine, I can throw away my mask, I can engage in high-risk activity, and then we’d actually take a step back.”
Most controversially, Atlas has pushed a baseless theory inside the task force that the U.S. population is close to herd immunity — the point at which enough people become immune to a disease either by becoming infected or getting vaccinated that its spread slows — despite a scientific consensus that the United States is nowhere close.
Given the transmissibility of the coronavirus, experts estimate about 60 to 70 percent of the population would need to become infected to reach herd immunity, a course that they warn would probably result in hundreds of thousands of excess deaths. A recent CDC study, about which Redfield testified to the Senate, showed about 9 percent of people in the United States had antibodies against the virus.
But Atlas publicly contradicted Redfield last month, telling reporters that more of the population was protected against the virus because of so-called T-cell immunity, in which people with exposure to previous coronaviruses — such as the common cold — have T cells that also protect them against covid-19, the disease caused by the novel coronavirus.
No credible scientific study has proved this theory, and Atlas’s advocacy of it dismayed other task force officials.
At a task force meeting late last month, Atlas stated that there was herd immunity in much of the country because of a combination of high infection rates in cities such as New York and Miami and T-cell immunity, according to two senior administration officials. He said that only 40 to 50 percent of people need to be infected to reach the threshold. And he argued that because of this immunity, all restrictions should be lifted, schools should be opened and only the most vulnerable populations, such as nursing home residents, should be sheltered.
This resulted in a fierce debate with Birx and Fauci, who demanded Atlas show them the data that backed up his assertions, one of the officials said.
“It is not the case there’s extra immunity around in T cells,” Lipsitch said. “The vast, vast majority of infectious-disease epidemiologists in this country don’t believe several of the key points these people are arguing for and don’t believe it because the evidence isn’t there and points in the other direction.”
Regardless, Trump has used Atlas to back up his own rejection of medical expertise. At Thursday’s NBC News town hall, a Florida voter asked the president whether after contracting covid-19 he now believed in the importance of mask-wearing.
Trump equivocated.
“I’ve heard many different stories on masks,” he said.
When Guthrie challenged him by noting that all of his health officials were united in advocating masks, Trump countered by invoking Atlas.
“Scott Adkins,” Trump said, mispronouncing the doctor’s name. “If you look at Scott, Dr. Scott, he’s from — great guy — from Stanford, he will tell you.”
“He’s not an infectious-disease expert,” Guthrie said.
“Oh, I don’t know,” Trump replied. “Look, he’s an expert. He’s one of the experts of the world.”
Oct 18, 2020
Today's Short
Dunno if Bob Ross had anything to do with this, but it seems like a pretty happy tree in the end.
A Podcast
The Morality of Everyday Things
By Ant and Jake
By Ant and Jake
What is "net good"?
Can you be a good person working at Facebook?
Today's Tweet
The stable genius at work - perfectly applying his obviously masterful command of multidimensional chess
Listen to Donald Trump’s 3D chess–playing mind as he articulately describes his groundbreaking second-term agenda. pic.twitter.com/l6ILv5GaIL
— 𝖠𝗆𝖻𝖾𝗋🌊 (@AnIllicitWriter) October 18, 2020
COVID-19 Update
World
Men have weaker immune systems that, in some cases, may actually sabotage the body’s response to an invader. But social and cultural factors may also play a role
Early in the coronavirus outbreak, hospital data from China revealed a startling disparity: Covid-19, the disease caused by the virus, was killing far more men than women.
That difference persisted in other Asian countries, such as South Korea, as well as in European countries, such as Italy. Then, it appeared in the United States.
By mid-October, the coronavirus had killed almost 17,000 more American men than women, according to data from the Centers for Disease Control and Prevention. For every 10 women claimed by the disease in the United States, 12 men have died, found an analysis by Global Health 50/50, a U.K.-based initiative to advance gender equality in health care.
That disparity was one of many alarming aspects of the new virus. It bewildered those unfamiliar with the role of gender in disease.
But the specialized group of researchers who study that relationship was not surprised. It prepared an array of hypotheses. One possible culprit was male behavior. Perhaps men were more likely to be exposed to the virus due to social factors; a disproportionately male workforce, for instance, could place more men in contact with infected people. Or men’s lungs might be more vulnerable because they were more likely to smoke in the earliest countries to report the differences.
What has become more evident, 10 months into this outbreak, is that men show comparatively weaker immune responses to coronavirus infections, which may account for those added deaths.
“If you look at the data across the world, there are as many men as women that are infected. It’s just the severity of disease that is stronger in most populations in men,” Franck Mauvais-Jarvis, a Tulane University physician who studies gender differences in such diseases as diabetes. In such cases, biology can help explain why.
The male immune response
- New Cases: 372,552 (⬆︎ .93%)
- New Deaths: 5,567 (⬆︎ .50%)
USA
- New Cases: 54,232 (⬆︎ .65%)
- New Deaths: 638 (⬆︎ .28%)
USAmerica Inc will hit 9 million total cases on or before Halloween.
We saw a rather rapid acceleration in Total Cases (eg: it only took 16 days to go from 3 million to 4 million).
Then the spread seemed to slow down during midsummer.
But oddly, while it took 166 days to go from 0 cases in February to 4 million cases in July, it's taken only 83 days to go from 4 million cases in July to 8 million cases now.
We are not "rounding the corner", unless that corner leads to an even bigger world of shit.
Men have weaker immune systems that, in some cases, may actually sabotage the body’s response to an invader. But social and cultural factors may also play a role
Early in the coronavirus outbreak, hospital data from China revealed a startling disparity: Covid-19, the disease caused by the virus, was killing far more men than women.
That difference persisted in other Asian countries, such as South Korea, as well as in European countries, such as Italy. Then, it appeared in the United States.
By mid-October, the coronavirus had killed almost 17,000 more American men than women, according to data from the Centers for Disease Control and Prevention. For every 10 women claimed by the disease in the United States, 12 men have died, found an analysis by Global Health 50/50, a U.K.-based initiative to advance gender equality in health care.
That disparity was one of many alarming aspects of the new virus. It bewildered those unfamiliar with the role of gender in disease.
But the specialized group of researchers who study that relationship was not surprised. It prepared an array of hypotheses. One possible culprit was male behavior. Perhaps men were more likely to be exposed to the virus due to social factors; a disproportionately male workforce, for instance, could place more men in contact with infected people. Or men’s lungs might be more vulnerable because they were more likely to smoke in the earliest countries to report the differences.
What has become more evident, 10 months into this outbreak, is that men show comparatively weaker immune responses to coronavirus infections, which may account for those added deaths.
“If you look at the data across the world, there are as many men as women that are infected. It’s just the severity of disease that is stronger in most populations in men,” Franck Mauvais-Jarvis, a Tulane University physician who studies gender differences in such diseases as diabetes. In such cases, biology can help explain why.
The male immune response
Women generally have stronger immune systems, thanks to sex hormones, as well as chromosomes packed with immune-related genes. About 60 genes on the X chromosome are involved in immune function, Johns Hopkins University microbiologist Sabra Klein told The Washington Post in April. People with two X chromosomes can benefit from the double helping of some of those genes.
Akiko Iwasaki, who studies immune defenses against viruses at Yale University, wanted to see how sex differences might play out in coronavirus infections. She and her colleagues cast a proverbial net into the immune system to fish out schools of microscopic fighters.
“We did a holistic look at everything we can measure immunologically,” Iwasaki said, listing a litany of the molecules and cells that form the body’s bulwark against pathogens: “cytokines, chemokines, T cells, B cells, neutrophils. Everything that we had access to.”
In male patients, the T-cell response was weaker, the scientists found. Not only do T cells detect infected cells and kill them, they also help direct the antibody response. “It’s like a master regulator of immune response. And when you have a drop in T cells, or in their ability to become activated, you basically lose the conductor of an orchestra,” Iwasaki said.
The power of the immune system wanes as people age, regardless of sex. But what is a gentle decline for women is an abrupt dive off a cliff for men: Iwasaki’s work indicates the T-cell response of men in their 30s and 40s is equivalent to that of a woman in her 90s.
And T cells aren’t the only immune feature disproportionately impaired in men. Another paper, published in September in PLOS Biology, examined anonymous human genetic material collected along with viruses in nasal swabs.
That study found throttled defense signals in men. When a cell detects a virus, it performs the molecular equivalent of yanking the fire alarm, said one of the study’s author, Nicole Lieberman, a research scientist at the University of Washington. That alarm is manifest in genetic messengers, called RNA, which react almost immediately.
The reaction should cause cells to churn out the first lines of defense, such as interferons, immune system molecules that, as the name suggests, interfere with the virus’s ability to reproduce. Other molecules summon specialized immune cells to destroy the pathogens. “You want the fire alarm to go off for long enough that you can get the fire department there,” Lieberman said.
Lieberman and her co-authors, however, found that in men and some older populations, the fire alarm shuts off early — maybe even before the firefighters have arrived. “That, I think, is the functional consequence, potentially, of what we’re seeing here,” she said.
Harmful autoantibodies
Not only is the immune system in men weaker, but in some severe cases of the coronavirus, it may hobble itself. A study of nearly 1,000 patients with life-threatening covid-19, published in Science in September, found evidence of molecular self-sabotage. Immune system fighters were acting against the body’s defenses, like rebellious castle guards splintering their own gates. This flaw was much more prevalent in men than women.
Specifically, the researchers detected what are called autoantibodies, molecules that bind and neutralize parts of the immune system. Those neutralizers disabled a subset of defender molecules known as type-1a interferon. Simply put, having autoantibodies led to more viral replication.
Ninety-five of 101 people with autoantibodies against interferon were male. “Somehow males are probably more prone to develop such autoantibodies, but we do not know why,” said study author Petter Brodin, a pediatrician at Sweden’s Karolinska Institute who studies the immune system.
Interferon molecules come in several types, so it’s possible these patients could be treated with another flavor of interferon, Brodin said. But that may be difficult, he acknowledged, because interferons are most helpful early in the course of an infection, before the disease progresses to life-threatening stages.
The lack of killer T cells, coupled with neutralizing antibodies, is “like a double whammy,” Iwasaki said, “that would then ultimately increase the viral load in these men.”
What’s unusual about this result is that most autoantibody immune disorders appear in women, as is the case with the chronic disease lupus.
Iwasaki’s research is examining whether female immune systems may play a role in people with long-lasting covid-19, nicknamed long-haulers.
“There are thousands of people suffering from chronic symptoms,” which may be debilitating, Iwasaki said. Many long-haulers are young and the majority of them, though not all, are women.
Men behaving differently
Akiko Iwasaki, who studies immune defenses against viruses at Yale University, wanted to see how sex differences might play out in coronavirus infections. She and her colleagues cast a proverbial net into the immune system to fish out schools of microscopic fighters.
“We did a holistic look at everything we can measure immunologically,” Iwasaki said, listing a litany of the molecules and cells that form the body’s bulwark against pathogens: “cytokines, chemokines, T cells, B cells, neutrophils. Everything that we had access to.”
In male patients, the T-cell response was weaker, the scientists found. Not only do T cells detect infected cells and kill them, they also help direct the antibody response. “It’s like a master regulator of immune response. And when you have a drop in T cells, or in their ability to become activated, you basically lose the conductor of an orchestra,” Iwasaki said.
The power of the immune system wanes as people age, regardless of sex. But what is a gentle decline for women is an abrupt dive off a cliff for men: Iwasaki’s work indicates the T-cell response of men in their 30s and 40s is equivalent to that of a woman in her 90s.
And T cells aren’t the only immune feature disproportionately impaired in men. Another paper, published in September in PLOS Biology, examined anonymous human genetic material collected along with viruses in nasal swabs.
That study found throttled defense signals in men. When a cell detects a virus, it performs the molecular equivalent of yanking the fire alarm, said one of the study’s author, Nicole Lieberman, a research scientist at the University of Washington. That alarm is manifest in genetic messengers, called RNA, which react almost immediately.
The reaction should cause cells to churn out the first lines of defense, such as interferons, immune system molecules that, as the name suggests, interfere with the virus’s ability to reproduce. Other molecules summon specialized immune cells to destroy the pathogens. “You want the fire alarm to go off for long enough that you can get the fire department there,” Lieberman said.
Lieberman and her co-authors, however, found that in men and some older populations, the fire alarm shuts off early — maybe even before the firefighters have arrived. “That, I think, is the functional consequence, potentially, of what we’re seeing here,” she said.
Harmful autoantibodies
Not only is the immune system in men weaker, but in some severe cases of the coronavirus, it may hobble itself. A study of nearly 1,000 patients with life-threatening covid-19, published in Science in September, found evidence of molecular self-sabotage. Immune system fighters were acting against the body’s defenses, like rebellious castle guards splintering their own gates. This flaw was much more prevalent in men than women.
Specifically, the researchers detected what are called autoantibodies, molecules that bind and neutralize parts of the immune system. Those neutralizers disabled a subset of defender molecules known as type-1a interferon. Simply put, having autoantibodies led to more viral replication.
Ninety-five of 101 people with autoantibodies against interferon were male. “Somehow males are probably more prone to develop such autoantibodies, but we do not know why,” said study author Petter Brodin, a pediatrician at Sweden’s Karolinska Institute who studies the immune system.
Interferon molecules come in several types, so it’s possible these patients could be treated with another flavor of interferon, Brodin said. But that may be difficult, he acknowledged, because interferons are most helpful early in the course of an infection, before the disease progresses to life-threatening stages.
The lack of killer T cells, coupled with neutralizing antibodies, is “like a double whammy,” Iwasaki said, “that would then ultimately increase the viral load in these men.”
What’s unusual about this result is that most autoantibody immune disorders appear in women, as is the case with the chronic disease lupus.
Iwasaki’s research is examining whether female immune systems may play a role in people with long-lasting covid-19, nicknamed long-haulers.
“There are thousands of people suffering from chronic symptoms,” which may be debilitating, Iwasaki said. Many long-haulers are young and the majority of them, though not all, are women.
Men behaving differently
Beyond these biological differences, it would be simplistic to ignore how gender’s other aspects, such as behavior and social norms, may also influence the pandemic.
Broadly speaking, men may be less likely to be worried about covid-19 than women, fitting the pattern that women generally treat health risks more seriously. Women took a more cautious approach to the disease, a recent poll found, expressing more concern they could return to workplaces safely. Women are also more likely to follow expert advice such as mask-wearing and social distancing, according to another study that included surveys and observations of pedestrians’ behavior in New York, Connecticut and New Jersey.
Sarah Hawkes, a professor of global public health at University College London who, with her husband, co-directs Global Health 50/50, said that the image of men as risk-takers extends back hundreds of years to John Graunt, one of the first people to participate in the field now known as epidemiology.
After he reviewed England’s death records, Graunt postulated in 1662 that “men, being more intemperate then women, die as much by reason of their Vices” — that is, male behavior was to blame. Hawkes argues that “350 years later,” Graunt’s point still stands. “It is undoubtedly a mixture of both biology and behavior” responsible for the health differences in men and women, she said.
The share of coronavirus deaths in women also rises with their share of the full-time workforce, according to a report by University of Oxford economist Renee Adams that used Global Health 50/50 data.
“The more you have women participating in the workforce, the smaller your sex difference becomes,” Hawkes said. That lines up with gender inequalities — men are more likely to work in environments where they are exposed to air pollution and other harms, Hawkes said. When women start to enter those traditionally masculine spaces, she said, it “turns out, women can get as sick as men.”
The gender disparities discovered in the response to covid-19 have sparked a surge of interest in such differences more broadly. “Almost nobody, apart from the people working in the field, were interested in that difference between men and women in disease until February or March,” when the first results showed that more men were dying, Mauvais-Jarvis said.
Broadly speaking, men may be less likely to be worried about covid-19 than women, fitting the pattern that women generally treat health risks more seriously. Women took a more cautious approach to the disease, a recent poll found, expressing more concern they could return to workplaces safely. Women are also more likely to follow expert advice such as mask-wearing and social distancing, according to another study that included surveys and observations of pedestrians’ behavior in New York, Connecticut and New Jersey.
Sarah Hawkes, a professor of global public health at University College London who, with her husband, co-directs Global Health 50/50, said that the image of men as risk-takers extends back hundreds of years to John Graunt, one of the first people to participate in the field now known as epidemiology.
After he reviewed England’s death records, Graunt postulated in 1662 that “men, being more intemperate then women, die as much by reason of their Vices” — that is, male behavior was to blame. Hawkes argues that “350 years later,” Graunt’s point still stands. “It is undoubtedly a mixture of both biology and behavior” responsible for the health differences in men and women, she said.
The share of coronavirus deaths in women also rises with their share of the full-time workforce, according to a report by University of Oxford economist Renee Adams that used Global Health 50/50 data.
“The more you have women participating in the workforce, the smaller your sex difference becomes,” Hawkes said. That lines up with gender inequalities — men are more likely to work in environments where they are exposed to air pollution and other harms, Hawkes said. When women start to enter those traditionally masculine spaces, she said, it “turns out, women can get as sick as men.”
The gender disparities discovered in the response to covid-19 have sparked a surge of interest in such differences more broadly. “Almost nobody, apart from the people working in the field, were interested in that difference between men and women in disease until February or March,” when the first results showed that more men were dying, Mauvais-Jarvis said.
Even agencies at the forefront of public health, such as the CDC, were initially slow to reveal sex-disaggregated coronavirus data, Hawkes said. The U.K. public health surveillance system was similarly late. Hawkes took those delays as a sign of just how unimportant people considered this data, since it is so readily available: When people die, their death certificates state whether they were male, female or, in some places, nonbinary.
The CDC data finally made that information accessible in mid-April. The male-skewed patterns revealed in those deaths conform to what was seen in earlier outbreaks of Middle East respiratory syndrome (MERS) and severe acute respiratory syndrome (SARS), both within the family of coronaviruses. And it is in line with other viral responses. “We know that women develop much better antibody response to flu vaccines,” Iwasaki said.
Some of those experts are hoping to capitalize on this moment to shine a spotlight on other gender differences in health. The coronavirus, after all, isn’t the only problem to afflict men and women unequally — so, too, do cancer, asthma, heart disease and other common illnesses, as Mauvais-Jarvis noted in a recent paper in the Lancet.
“The kinds of differences that we’re seeing and outcomes in covid-19 are not unexpected. They’re not exceptional,” Hawkes said. If there’s surprise, it only demonstrates the widespread underestimation of the differences in men and women that persist even among physicians, she said.
Mauvais-Jarvis referred to this faulty approach as “bikini medicine” — in which clinicians view female patients as interchangeable with male ones, except for the organs covered by swimwear.
The coronavirus has helped accelerate the trend away from that outdated view. The “one positive that’s come out of the pandemic,” Hawkes said, is the sudden realization that gendered social factors and biology “may have a relationship with your life expectancy, your experience with illness, your risk of illness. It has made that conversation a little bit more real.”
The CDC data finally made that information accessible in mid-April. The male-skewed patterns revealed in those deaths conform to what was seen in earlier outbreaks of Middle East respiratory syndrome (MERS) and severe acute respiratory syndrome (SARS), both within the family of coronaviruses. And it is in line with other viral responses. “We know that women develop much better antibody response to flu vaccines,” Iwasaki said.
Some of those experts are hoping to capitalize on this moment to shine a spotlight on other gender differences in health. The coronavirus, after all, isn’t the only problem to afflict men and women unequally — so, too, do cancer, asthma, heart disease and other common illnesses, as Mauvais-Jarvis noted in a recent paper in the Lancet.
“The kinds of differences that we’re seeing and outcomes in covid-19 are not unexpected. They’re not exceptional,” Hawkes said. If there’s surprise, it only demonstrates the widespread underestimation of the differences in men and women that persist even among physicians, she said.
Mauvais-Jarvis referred to this faulty approach as “bikini medicine” — in which clinicians view female patients as interchangeable with male ones, except for the organs covered by swimwear.
The coronavirus has helped accelerate the trend away from that outdated view. The “one positive that’s come out of the pandemic,” Hawkes said, is the sudden realization that gendered social factors and biology “may have a relationship with your life expectancy, your experience with illness, your risk of illness. It has made that conversation a little bit more real.”
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