Saturday, March 21, 2020

Literary Corner: Big Fan

Emperor Trump holding forth on the State Department—"I call it the Deep State Department"—causes Dr. Fauci to show an emotion. No idea who I should credit the clip to, it's been all over Twitter. 

Chloroquine: A Meditation
by Donald J. Trump

We’re going to know,
so we’re going to know soon,
including safety, but, you know,
when you get that safety this has been
prescribed for many years
for people to combat malaria,
which was a big problem,
and it’s very effective.
It’s a strong – it’s a strong
drug, so we’ll see. I will say
that I am a man that comes
from a very positive school
when it comes to, in particular,
one of these drugs, and we’ll
see how it works out.
Without seeing too much,
I'm probably more of a fan
of that than maybe anybody,
but I'm a big fan, and
we'll see what happens.
We all understand what the doctor said
is 100 percent correct: It’s early.
But I have seen things
that are impressive and we’ll see.
That’s all it is. Just a feeling.
I’m a smart guy. We only disagree
a little bit. It may work
and it may not work.
And I agree with the doctor
when he said it may work,
may not work. I feel good about it.
It's totally, it's just a feeling.
You know, I’m a smart guy.
I feel good about it. And
we're going to see, you're
going to see soon enough.
Let’s see if it works.
It might and it might not.
I happen to feel good about it,
but who knows? I’ve been right
a lot. Let’s see what happens.

From a mixture of sources for Friday's press briefing, which Trump used to chastise NBC's Peter Alexander for asking him what message he'd like to transmit to Americans frightened by the ongoing situation (his message was that "you're a terrible reporter" and "that was a nasty question") and to take issue with world-famous expert on pandemic disease Dr. Anthony Fauci over Fauci's uncertainty as to whether the drug chloroquine would work out as a weapon against Covid-19 infection and certainty that it can't be used as a preventative against the disease; after all, as Trump said, it's a very strong drug, and it cured malaria, which is a very strong disease (like the father in My Big Fat Greek Wedding who fixes everything, including physical injuries, with a spritz of Windex, he's never mastered the concept that different solutions apply to different problems—he's only aware of different degrees of "strength"). And he has "seen things that are impressive" and feels good about it.

He felt good about things in January and February too. It's just a feeling, but he's been right about a lot of things, at least according to him, and who would know better?
There is some real evidence, from a clinical test of 130 patients in China, that chloroquine can help reduce the severity of Covid-19 illness and speed up virus clearance; it can also have some severe side effects, lethal in an overdose, and Chinese authorities have advised that it shouldn't be used on pregnant patients (one of the side effect is birth defects) or patients under 18 or over 65. It's been very attractive to luminaries in the tech industry, as Adam Rogers writes at Wired, like the infamous Elon Musk, or the physician turned Bitcoin investor James Todaro, quoted as saying,
Something that Big Pharma is not going to like—it’s widely available, it’s pretty cheap, and it’s something that at least a million people are already on. It’s really got a lot of the aspects of something that can be rolled out quickly if the right clinical data is there.
Rogers sums up what Silicon Valley is feeling:
if a drug did exist—if a cheap, easy drug can stave off the worst, ventilator-requiring, sometimes-fatal complications of coronavirus infection, or maybe prevent that infection in the first place, what are we all socially isolating for, like suckers?
That if—as the saying goes—is doing a lot of work. The Covid-19 pandemic is causing, reasonably, a worldwide freak-out as scientists and policymakers race to find solutions, not always competently or efficiently. It’s the kind of thing that rankles the engineer-disruptor mindset. Surely this must be an easily solved problem that’s primarily the fault of bureaucracy, regulation, and people who don’t understand science. And maybe the first two things are true. The third thing, though, is where the risks hide. Silicon Valley lionizes people who rush toward solutions and ignore problems; science is designed to find solutions by identifying those problems. The two approaches are often incompatible.
And as far as I can tell the Silicon Valley approach is based on fantasy. It's a nice thought that you could stick it to Big Pharma (though regulating drug prices across the board would do a much better job), but if it's not safe to administer it to sufferers over 65, then it's not going to help us get rid of social distancing unless there's some equally effective other treatment they can take instead. What's needed is doubling and tripling down on the scientific approach: more trials (so far I can find information on just two drug trials in US funded by NIH, Remdesivir and Losartan) and more social distancing until that curve is flattened out—and at last sight it was looking very much in the wrong direction, much worse than Italy at the corresponding point in the trajectory.
It's not going to be cheap, and it's not going to be easy.

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