Thoughts of a retired physician

Winston Churchill is reputed to have said, “Americans will always do the right thing, after exhausting all the alternatives.” It may not have been a Churchillian adage but it is certainly apt. The crazy experiment of this country, now well over 200 years old, has seen us do many things right but a good deal wrong. Corrections do occur. Slavery was abolished after almost 250 years in English North America and a great Civil War, but then it took another 100+ years to correct the wrongs that occurred after Reconstruction. The struggles continue with the Black Lives Matter movement and the worldwide protests engendered by the extrajudicial murder of George Floyd -- and many others. My hope is that the generations to follow behind me do better than my generation, the Baby Boomers, has done. The thought that came to me today though was about dealing with the COVID-19 pandemic. Unlike many other polities, America has struggled with a lack of national leadership with a president who has no un

Donald Trump showed that his real concern is not reelection in 2020 but avoidance of prosecution for criminal activity when he commuted the sentence of Roger Stone on 10 July 2020. Stone was convicted of lying to protect Trump. The sentence commutation is a bald statement that Trump knows he has committed crimes and he is desperate to put a lid on it. As Mitt Romney noted yesterday, this is “ unprecedented, historic corruption: an American president commutes the sentence of a person convicted by a jury of lying to shield that very president .” America remains highly polarized politically and there will undoubtedly still be people who support Trump. Their willful ignorance and blindness towards his criminality has left us with a rudderless Executive Branch at precisely the same time as the COVID-19 pandemic is roaring back to life. The federal mismanagement of the pandemic is also because of Trump’s feckless “leadership”. He continues to live in a total bubble regarding COVID-19, where

On 25 June, the United States recorded 41,113 new cases of COVID-19, bringing the total nationally to over 2.4 million. In a press briefing that day, CDC Director Robert Redfield stated that there are probably ten times as many cases that have not been diagnosed . If true, that means 25 million Americans have been infected with SARS-CoV-2 since the onset of the pandemic almost six months ago. That number may astonish those who are unfamiliar with infectious disease epidemiology but it is in line with what we know thus far about this virus and its spread. The White House Coronavirus Task Force held a briefing today (26 June) , its first in many weeks. As usual, the show was led by a politician, Vice President Pence, who is one of the more able people to spread happy talk in ages. Neither he nor Alex Azar, Secretary of HHS, had anything useful to say to my mind. It was more of the usual drivel that we have become accustomed to, sycophantic praise of Dear Leader Trump and focus on what th

Where does one begin with the sad tale of a Trump rally in Tulsa, Oklahoma? Yesterday, at the BOK Arena, Trump appeared at what was supposed to be an oversubscribed rally with a million tickets distributed and plans for both an indoor event and an outdoor event in front of throngs of his MAGA cult. In the middle of the COVID-19 pandemic the idea of an indoor event with thousands of unmasked people, yelling, screaming, and cheering was (and is) an epidemiologist’s nightmare. In the wake of the murder of George Floyd and the overwhelming response that Black Lives do Matter, the added complexities of such an event made its reality even more fraught. So, what did we see? First, the crowd size was gratifyingly much less than the Trump campaign predicted. In an arena that could hold over 19,000 people, only 6,600 people showed up. Photos and videos of the crowd showed the expected: almost all white people, many older, almost everyone costumed in MAGA paraphernalia (hats, shirts, flags, etc.

I have been interested in pandemic disease for many years. When I did my infectious disease fellowship at Naval Medical Center San Diego in the early 1980s, I remember one of my peers presented a seminar on bubonic plague. While he used the medical literature in the seminar, he based it on the chapter about the Black Death in Barbara Tuchman’s book A Distant Mirror: The Calamitous 14th Century . That inspired me to find that book and read it. Then to find other books about the Black Death, then cholera, yellow fever, influenza, HIV, and on and on. I had a conversation about the history of these diseases with a junior colleague 25 or so years ago; he indicated he never read any of the books and had no interest in them. I chalked it up to intellectual incuriosity. This year the world has been convulsed with another pandemic. I had hoped never to experience such an event but Mother Nature had other plans. Although retired, my wife and I have followed the pandemic closely. I read Michiko T