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Over the past few years a series of American agencies have lost their reputation and world standing. The FAA with the 737 max, the CDC with the test, the FDA wi
by vikramkr 6y ago
Over the past few years a series of American agencies have lost their reputation and world standing. The FAA with the 737 max, the CDC with the test, the FDA with testing regulation and hydroxychloroquine. Its important to have institutions that work, but we've spent years deliberately gutting them and undervaluing them. All that money spent on the military and homeland security, and in the end we were caught utterly unprepared for the greatest national security threat of the past few decades. Even though we have more aircraft carriers than makes sense to have, we'd rather build another one than invest in crucial infrastructure such as strong regulatory agencies and science infrastructure. And we get to pay the price of those misplaced priorities as we barrel towards 200,000 dead. Hopefully this serves as a sort of wakeup call.
- jamesrom 6y agoWithout distracting from you central point (which I very much agree with), please read the science around hydroxychloroquine, not the news. It works best taken with Zinc, and early when symptoms first present.
- ibarea277 6y agoNo. This has been disproven by the only good studies we have. Even with zinc and early, it has not been shown to have any effect.
- jamesrom 6y agoThere are zero studies that disprove zinc + early has a strong effect. You are wrong. Also, the lancet study was retracted for flawed methodology, other studies show slight benefit of hydroxychloroquine. There are zero studies that show it has no effect.
- nl 6y agohttps://blogs.sciencemag.org/pipeline/archives/2020/06/05/the-recovery-trial-reports-on-hydroxychloroquine https://blogs.sciencemag.org/pipeline/archives/2020/06/05/th... There's no studies yet. But there aren't any preliminary results that look promising, and the only people who think it is promising also thought hydroxychloroquine was. So it's pretty unlikely it's going to do anything.
- jupp0r 6y agoYou can’t show that it has zero effect without indefinite numbers of patients enrolled in the study. It hasn’t shown any dramatic improvements in the studies that are there. The rest is a tradeoff between enrolling even more patients into studies to prove small improvements (or not) or to move on and spend resources on finding things that do have a major impact.
- throwaway_pdp09 6y agoProvide links to that 'science' if you're going to claim it exists, including any corroborating studies.
- drocer88 6y agohttps://www.medrxiv.org/content/10.1101/2020.05.02.20080036v1 https://www.medrxiv.org/content/10.1101/2020.05.02.20080036v... "This study provides the first in vivo evidence that zinc sulfate in combination with hydroxychloroquine may play a role in therapeutic management for COVID-19." https://www.sciencedirect.com/science/article/pii/S0306987720306435 https://www.sciencedirect.com/science/article/pii/S030698772... "we hypothesize that CQ/HCQ plus zinc supplementation may be more effective in reducing COVID-19 morbidity and mortality than CQ or HCQ in monotherapy." https://www.researchgate.net/profile/Mujeeb_Shittu4/publication/340929682_Improving_the_efficacy_of_Chloroquine_and_Hydroxychloroquine_against_SARS-CoV-2_may_require_Zinc_additives_-_A_better_synergy_for_future_COVID-19_clinical_trials/links/5eca6152a6fdcc90d693f92b/Improving-the-efficacy-of-Chloroquine-and-Hydroxychlo https://www.researchgate.net/profile/Mujeeb_Shittu4/publicat... roquine-against-SARS-CoV-2-may-require-Zinc-additives-A-better-synergy-for-future-COVID-19-clinical-trials.pdf "We seek to draw the attention of the scientific community to the possibility of drastically reducing the effects of the vi-rus on the affected patients and improving clinical tri-als outcome through the synergistic action of zinc and chloroquine" https://www.researchgate.net/profile/Rishad_Ahmed2/publication/340388856_Relevance_and_Role_of_Hydroxychloroquine_in_Prophylaxis_and_Therapy_of_COVID-19/links/5e862a26299bf130797459c4/Relevance-and-Role-of-Hydroxychloroquine-in-Prophylaxis-and-Therapy-of-COVID-19.pdf https://www.researchgate.net/profile/Rishad_Ahmed2/publicati... "Thirdly, hydroxychloroquine acts as an ionophoric agent for Zinc ions and thus increases the influx of Zinc ions into the cytoplasm of host target cells regardless whether the host target cells are infected or not [10]. Zinc ions adhere to the RNA dependent RNA polymerase enzyme of the virus and stops COVID-19 polymerization intracellularly." We do need follow up and repeated clinical trials.
- pnako 6y agoThere are already good retrospective observational studies out, like [0] [0] Outcomes of 3,737 COVID-19 patients treated with hydroxychloroquine/azithromycin and other regimens in Marseille, France: A retrospective analysis https://www.sciencedirect.com/science/article/pii/S1477893920302817 https://www.sciencedirect.com/science/article/pii/S147789392...
- ibarea277 6y agoThe data we have on hydroxychloroquine is now convincingly negative-there's just a ton of misinformation and it's become a political issue. But when some institutions fail you get widespread mistrust of both institutions and experts, which maybe is part of the compounding problem.
- vikramkr 6y agoThe hydroxychloroquine study I'm referring to has less to do with the data and more to do with how the FDA behaves regarding the drug, where they gave the drug an emergency use authorization based off of what seemed like pretty blatant interference from the executive branch. If the drug had ended up working, maybe their reputation would have taken less of a hit, but that wouldn't have changed how inappropriate that authorization was, and how it demonstrated that you could get a drug approved if you had enough political power from the president behind you. That's not a message that's making me optimistic when we look at vaccine development right now - that core trust that the agency operates on science/public health instead of politics has been shaken.
- ashtonkem 6y agoIt’s another in a very long line of mistakes over the past three years pointing towards one thing: process matters. It’s boring, it’s not dynamic, but it’s also the thing that prevents organizations from making some extremely bone headed mistakes.
- Mary-Jane 6y agoAgree with the point, but the disregard for process has been going on for longer than 3 years. If we want our principles to be taken seriously we can't just call out the other side. Remember "I have a pen and a phone"? How well did that work out? ...and it wasn't our side that called in a drone strike on American citizens overseas, without even a nod to due process.
- Robotbeat 6y agoThere was some early evidence it could be effective. I’m actually supportive of the FDA’s move to do both the emergency approval and the retraction. Without the ability to take calculated risks in a situation where either approving or unapproving can cause harm, the agency could be a hindrance more than a help. And that means some emergency measures will prove wrong. If none prove wrong, the agency is being too cautious and allowing people to die because of it. EDIT: I hate the politicization of HCQ by Trump, of course.
- icegreentea2 6y agoI think you'd make a stronger argument by instead of making a military or other things argument, and just make a 'fund other things more' argument. The reason I think you should stay away from pointing fingers, especially at a relatively divisive issue like military or especially aircraft carrier funding is because then you shift a question of "should American be world leading in commercial air travel regulation, pandemic prevention and control, and medical development" to a far more complex one of what America's role in the world should be. The combined CDC, FDA and FAA budget is something like 35 billion dollars a year. Overall DOD budget is is nearly 700 billion, making up nearly half of annual discretionary spending (roughly 1.5 trillion). You could literally double the funding of those three agencies and barely budge the overall calculus of the budget. Edit/Add-on: I think the whole sub-thread under my comment (my bad =/ - I get the irony...) is an example of the types of distractions that might be avoidable if you don't scope military spending into discussions.
- ransom1538 6y agoI love this "half of annual discretionary spending". It is designed to confuse the fact that military spending is only %15. [1] https://www.kff.org/medicare/issue-brief/the-facts-on-medicare-spending-and-financing/ https://www.kff.org/medicare/issue-brief/the-facts-on-medica...
- chmod775 6y agoI don't think spending more on military than the next 10 countries combined can be described as "only" in any way. The highest spender are the US, with $732.0 billion, followed by China with $261.0 billion, then India and Russia with $71.1 and $65.1 billion respectively.
- rayiner 6y agoMilitaries are reliant on domestic production and labor. (Paying Chinese solider costs the government a fraction as much as an American soldier.) So instead of an exchange rate conversion, you should be doing a purchasing-power conversion. For these three countries, that means multiplying by 2x to 4x. Also, the US is particularly inefficient at capital spending. It costs us a billion dollars to build a mile of subway, and costs countries like France a fraction of that. So that weighs further in favor of discounting our spending in that comparison.
- smackay 6y agoIt seems that successive administrations have lost sight of the benefits of soft power and only go for the hard version instead. Having world-leading institutions with the ability to advise other goes a lot further, for a fraction of the cost. Courtesy of Hollywood (more soft power, but with a more dubious pedigree) there is no situation where the CDC does not, absolutely, have it's shit together. For the price of a single aircraft carrier you could probably make that a reality.
- A4ET8a8uTh0 6y agoIt is a conscious effort. Any sort of independence has to be rooted out.CFPB is a good recent example. It was pretty independent from vagaries of poltics until Mnuchin got in. In fact, yesterday he was bemoaning the fact that those agencies staff career beaurocrats ( as opposed career politicians). It is sad to watch.
- mudsnail 6y agoOr maybe instead of throwing more money at the problem we can face up to the fact that our democratic system is broken. That these institutions have been politicized over the years and are being run by people who are good at playing the game versus being good at their jobs.
- linuxftw 6y agoRight. It's not a question of money, it's a question of competence and corruption. When you point out that government agencies are a revolving door of industry executives people think you're insane. Just look at the FAA and letting Boeing 'self-certify.' That seems to be how the FDA does business as well.
- saddlerustle 6y agoWhere's the gutting? The budgets of the FAA, the FDA and the CDC are all at or near all time highs.
- philwelch 6y agoCompletely abolishing the FDA would have been an improvement in this case since the FDA became an impediment to testing, and would have saved money to boot. I’m not saying to abolish the FDA; I’m just saying that underfunding it wasn’t the problem.
- throwaway0a5e 6y agoMany would argue that these agencies, vested with limited lawmaking ability by congress yet under the control of the executive, were always doomed to failure and it was just a question of time. I think it's a little more nuanced than that but those people kind of have a point. These agencies are subject to doing stupid things at the whim of the executive and having effective lawmaking authority behind them makes the damage worse when they do.
- Zenbit_UX 6y agoDon't forget that cretin, Ajit Pai, with the FCC and the net neutrality disaster.
- Spooky23 6y agoIt baffles me that you can complain about executive departments without mentioning the elephant in the room. When the executive is a psychotic fascist who actively sought to be actively ignorant and contemptuous of the government he runs, why would you expect the civil servants to be able to effectively perform their duties?
- mledu 6y agoIt's pretty simple, politicians are paid by large corporations to gut, capture and deregulate these agencies to be able to increase profits and decrease costs.