Obesity and Ozempic

80,087. That is the number of American dead as I checked just now on the Johns Hopkins coronavirus website. I have been following the pandemic of COVID-19 from the outset and the Hopkins site has the best statistics available. We also just watched Trump at one of his typical pressers extol how well he has done in leading us through the pandemic. To believe Trump is to believe only his prescience and diligent work has saved millions of American lives. Tell you what -- believe none of it. There were two large signs flanking the platform in the Rose Garden he spoke from, saying “America leads the world in testing.” Despite being pressed by good questions from the journalists he sticks with the fantasy world he wants.




As of May 9, Denmark has done the most tests for COVID-19 per thousand population: 53.34 per thousand, more than twice the rate of tests done in the United States. Italy, New Zealand, and Canada also exceed the U.S. rate. Trump loves to talk about raw numbers, probably because he has a limited grasp of numbers and statistics and has zero comprehension of the concept of rates. In epidemiology, a prime precept is to compare rates to rates. Today as before, Trump said the U.S. has done more tests than any other country on the planet, leaving out the plain fact that 330 million people live in the United States. Trump, innumerate as well as illiterate, talks like the conman he has always been to his cultish base (also innumerate). A good book for all is John Allen Paulos’ Innumeracy: Mathematical Illiteracy and Its Consequences.




Innumeracy, especially as applied to statistics and epidemiology, is deadly. It is especially deadly when policymakers fail to understand its repercussions or at least fail to heed the advice of those with more knowledge and expertise than they have. It was also clear that Trump has zero understanding of the characteristics of the tests used for COVID-19. Sensitivity and specificity and actually easy to grasp for people who apply the mathematics they were taught and ponder how they are derived. The two White House personnel who came up with positive tests for COVID-19 (apparently using the rapid test by Abbott) were, according to Trump, “perfect” because they had repeated negative tests -- until they didn’t. Since infection with SARS-CoV-2 is a result of contact with an infected person rather than a divine or demonic visitation, both had close contact with a case somewhere. Where? Unclear. But it also sounds like the White House hung a lot on the Abbott test because it requires a less-invasive nasal swab and is fast, overlooking the false-negativity rate of perhaps 15% known with this technology.




So, while Trump surrounded himself with congratulatory signs and pieces of lab equipment, it is clear he has gained no real understanding of COVID-19 testing or epidemiology. His supporters cheer as he evokes a connection with how the U.S. responded to World War II and how we are responding to the coronavirus pandemic. But he misses the point entirely. World War II, 80 years in the past, was a threat by armed nation-states with ideologies that menaced with planes and ships and tanks. Our parents and grandparents met that threat in kind and met it well. SARS-CoV-2 is a different threat. The weapons to defeat it include handwashing, social distancing, masks. It also requires leadership that understands science and employs science to make sound policy. Sadly, at the federal level, that leadership is absent. Oh, by the way, the Hopkins map just now tallies 80,239 dead Americans. That’s another 152 dead over the time I needed to write this. Don’t be sad -- be enraged that our lack of leadership has led us into this abyss.