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offsite link We Know the COVID-19 Vaccine Is Safe Bec... Sat Dec 05, 2020 15:31 | Marko Marjanović

offsite link Study: 89% of Those Who Died of Covid-19... Sat Dec 05, 2020 15:07 | Albert Alhatem MD.

offsite link ‘Police for Freedom’: Spanish Office... Sat Dec 05, 2020 12:06 | Amy Mek

offsite link Trump May Be Going Away, America’s Cla... Sat Dec 05, 2020 08:00 | Joel Kotkin

offsite link Mexican President: Mind Virus Lockdowns ... Sat Dec 05, 2020 04:33 | Associated Press

Anti-Empire >>

Public Inquiry
Interested in maladministration. Estd. 2005

offsite link David Quinn’s selective tolerance

offsite link A Woulfe in judges clothing Anthony

offsite link Sarah McInerney and political impartiality Anthony

offsite link Did RTE journalists collude against Sinn Fein? Anthony

offsite link Irish Examiner bias Anthony

Public Inquiry >>

Spirit of Contradiction

offsite link The Party and the Ballot Box Sun Jul 14, 2019 22:24 | Gavin Mendel-Gleason

offsite link On The Decline and Fall of The American Empire and Socialism Sat Jan 26, 2019 01:52 | S. Duncan

offsite link What is Dogmatism and Why Does It Matter? Wed Mar 21, 2018 08:10 | Sylvia Smith

offsite link The Case of Comrade Dallas Mon Mar 19, 2018 19:44 | Sylvia Smith

offsite link Review: Do Religions Evolve? Mon Aug 14, 2017 19:54 | Dara McHugh

Spirit of Contradiction >>

Marko Marjanović - Sat Dec 05, 2020 15:31

2019: Vaccines are safe because they're so thoroughly tested for short-term and long-term side effects alike. So if you're declining an approved and tried-and-true jab you're just being irrational and superstitious.

2020: Here is the first-ever vaccine of its kind (mRNA) that is essentially untested and was rolled out in all of 6 months with no chance to study long-term side effects whatsoever, but it's safe because it's called a vaccine and other vaccines that are approved after extensive long-term trials that this vaccine did nor receive are safe.

Call me crazy but it would seem the argument changed a little bit here?

What if a person wanted to remain a pro-vaxxer of the 2019 variety?

What if someone took the position of "shoot me up with as many vaccines as possible AFTER they have gone through rigorous and extensive trials including long-term ones and passed them"?

That would now be deemed selfish, dangerous, irresponsible, unjustifiable, silly, dumb buffoonish, stupid, and against your health interest.

What was an orthodoxy when this year started is now heretical.

We're living in an Orwellian reality where what is almost universally held true one moment, can become a thought-crime of the highest order in the next one.

Forget about common sense. Forget about being allowed to keep an awareness of proportion, context, and second-order consequences. We are not even allowed to keep to the orthodoxies of 2019.

Everything must fall to the Covid Rouge and its Year Zero reset.

So remember citizen. The Covid-19 vaccine is safe because it's called a vaccine and other vaccines that are approved after the kind of trials this vaccine did not receive are safe. Very simple to understand.

Besides, it's a vaccine for an extremely deadly plague with a 99.98% survival rate for the under 60 that you definitely don't want to take your chances with.

Much better to bet on the extremely low likelihood of human folly, and place yourself in the tender care of fanatics. That has a much better track record.

After all, humans unintentionally sacrificing other humans to their fanaticism, ideology, messianic complexes, panic, cowardice, and pride — that almost never happens.

Well, maybe it could happen. But surely the chance is much smaller than 0.02%. Surely. Because if the chance that the money-hungry Big Pharma, clueless politicians, and the Messianic COVID Rouge overlooked something is much greater than 0.02% then it would make sense for the majority to take their chances with nature's coronavirus instead. But that's not the case, surely. If the likes of Boris Johnson say it's safe that's good enough for me. I don't even need a long-term trial. And it seems neither do they.

Funny how that works though. Up until now you were supposed to — if at all possible — not even leave your room. Risk aversion was everything. Is the world going to hell in a handbasket? Yes, but that's the price we're willing to pay in order to spare you from having to take an unknown risk. In fact, we believe so strongly in you not taking a risk that we're willing to strip you of rights to prevent you from being able to do it yourself.

But now that there's an experimental vaccine based on completely novel technology? Well now go right ahead and inject yourself with that! Take a ride on the wild side! To do less would be to deny science. And in fact, we may take away your rights if you don't.

Sometimes we keep you from risk, sometimes we push you into risk. But what is a constant is that your rights are always the collateral damage. You know. By accident. Because we know what's best for you, for us.

And what's best for you for us, is that your rights be held by us in escrow. Really in the long view, you will come to see this whole Covid business as a blessing as it will have more firmly placed you in the hands of your betters. Things will be so much better from now on. Particularly for us. And for you. Once you develop a taste for weather-sustainable cockroach milk.

[caption id="attachment_39326" align="alignnone" width="720"] Long-term trials are for pussies. And science-deniers.[/caption] 2019: Vaccines are safe because they're so thoroughly tested for short-term and long-term side effects alike. So if you're declining an approved and tried-and-true jab you're just being irrational and superstitious. 2020: Here is the first-ever vaccine of its kind (mRNA) that is essentially untested and was rolled out in all of 6 months with no chance to study long-term side effects whatsoever, but it's safe because it's called a vaccine and other vaccines that are approved after extensive long-term trials that this vaccine did nor receive are safe. Call me crazy but it would seem the argument changed a little bit here? What if a person wanted to remain a pro-vaxxer of the 2019 variety? What if someone took the position of "shoot me up with as many vaccines as possible AFTER they have gone through rigorous and extensive trials including long-term ones and passed them"? That would now be deemed selfish, dangerous, irresponsible, unjustifiable, silly, dumb buffoonish, stupid, and against your health interest. What was an orthodoxy when this year started is now heretical. We're living in an Orwellian reality where what is almost universally held true one moment, can become a thought-crime of the highest order in the next one. Forget about common sense. Forget about being allowed to keep an awareness of proportion, context, and second-order consequences. We are not even allowed to keep to the orthodoxies of 2019. Everything must fall to the Covid Rouge and its Year Zero reset. So remember citizen. The Covid-19 vaccine is safe because it's called a vaccine and other vaccines that are approved after the kind of trials this vaccine did not receive are safe. Very simple to understand. Besides, it's a vaccine for an extremely deadly plague with a 99.98% survival rate for the under 60 that you definitely don't want to take your chances with. Much better to bet on the extremely low likelihood of human folly, and place yourself in the tender care of fanatics. That has a much better track record. After all, humans unintentionally sacrificing other humans to their fanaticism, ideology, messianic complexes, panic, cowardice, and pride — that almost never happens. Well, maybe it could happen. But surely the chance is much smaller than 0.02%. Surely. Because if the chance that the money-hungry Big Pharma, clueless politicians, and the Messianic COVID Rouge overlooked something is much greater than 0.02% then it would make sense for the majority to take their chances with nature's coronavirus instead. But that's not the case, surely. If the likes of Boris Johnson say it's safe that's good enough for me. I don't even need a long-term trial. And it seems neither do they. [caption id="attachment_39342" align="alignnone" width="649"] No vaxx bed-wetters allowed[/caption] Funny how that works though. Up until now you were supposed to — if at all possible — not even leave your room. Risk aversion was everything. Is the world going to hell in a handbasket? Yes, but that's the price we're willing to pay in order to spare you from having to take an unknown risk. In fact, we believe so strongly in you not taking a risk that we're willing to strip you of rights to prevent you from being able to do it yourself. But now that there's an experimental vaccine based on completely novel technology? Well now go right ahead and inject yourself with that! Take a ride on the wild side! To do less would be to deny science. And in fact, we may take away your rights if you don't. Sometimes we keep you from risk, sometimes we push you into risk. But what is a constant is that your rights are always the collateral damage. You know. By accident. Because we know what's best for you, for us. And what's best for you for us, is that your rights be held by us in escrow. Really in the long view, you will come to see this whole Covid business as a blessing as it will have more firmly placed you in the hands of your betters. Things will be so much better from now on. Particularly for us. And for you. Once you develop a taste for weather-sustainable cockroach milk.
Albert Alhatem MD. - Sat Dec 05, 2020 15:07

ABSTRACT

Objective

To investigate the influence of DNR status on mortality of hospital inpatients who died of COVID-19.

Design

This is a retrospective, observational cohort study of all patients admitted to two New Jersey hospitals between March 15 and May 15, 2020 who had, or developed, COVID-19 (1270 patients). Of these, 640 patients died (570 (89.1 percent) with and 70 (10.9 percent) without a DNR order at the time of admission) and 630 survived (180 (28.6 percent) with and 450 (71.4 percent) without a DNR order when admitted). Among the 120 patients without COVID-19 who died during this interval, 110 (91.7 percent) had a DNR order when admitted.

Results

Deceased positive SARS-CoV-2 patients were significantly more likely to have a DNR order on admission compared to recovered positive SARS-COV-2 patients (p < 0.05), similar to those who tested negative for SARS-COV-2. COVID-19 DNR patients had a higher mortality compared to COVID-19 non-DNR patients (log rank p < 0.001).

DNR patients had a significantly increased hazard ratio of dying (HR 2.2 [1.5-3.2], p <0.001) compared to non-DNR patients, a finding that remained significant in the multivariate model.

Conclusion

The risk of death from COVID-19 was significantly influenced by the patients’ DNR status.

Introduction

The coronavirus disease 2019 (COVID-19) pandemic has resulted in 815,476 global deaths and 178,129 in the US as of August 25, 20201.

Do-not-resuscitate (DNR) orders are designed to allow for withholding cardiopulmonary resuscitation (CPR) in the event of cardiac arrest2,3.

DNR status is often linked to patients with severe illness, advanced age, poor disease prognosis, and deteriorating health status with impending death4.

Data are lacking on survivability of inpatient cardiac arrest for COVID19 patients5.

Voices of extreme views, calling for a universal DNR policy for COVID-19 patients have created wide public outrage6.

Certifying COVID-19 as the cause of death has driven up the statistics of the pandemic and affected healthcare decisions in the U.S. and globally7.

The primary objective of this study was to identify the clinical outcome for patients with a DNR order who had death certificates attributing death to COVID-19.

Methods

Data source

Data were collected from patients who were admitted between March 15, 2020 to May 15, 2020 to two hospitals affiliated with our institution, including all patients who tested positive for SARS-CoV-2 by RT-PCR and were either deceased or had recovered. In addition, data on all patients who tested negative for SARS-CoV-2 and died during the same time period were collected for comparison.

The database was de-identified and met the criteria of the Health and Insurance Portability and Accountability Act (HIPAA) for the protection of personal information. The study was exempted by our institutional review board due to de-identifiability of data.

Study sample

Data from 1270 cases of positive SARS-CoV2 patients (including 640 deceased and 630 recovered patients) and 120 deceased patients negative for SARS-CoV2 admitted between 3/15/20 and 5/15/20 were extracted. All DNR patients included in this study had an active DNR order at the time of hospital admission. Patients who received a DNR order at any stage during their time in the hospital after admission were excluded to eliminate any confounding variables. All deceased patients had a death certificate stating COVID-19 was the primary cause of death. Patient demographic data were collected with respect to age, age group (< 60, ≥ 60 years), gender, reason for admission, COVID-19 symptoms at the time of admission, and comorbidities. Comorbidity data were collected for metabolic disease (i.e. diabetes mellitus, electrolyte abnormality, vitamin deficiency or anemias); lung disease (i.e. chronic obstructive pulmonary disease, restrictive lung disease, or asthma); cardiovascular disease (i.e. congestive heart failure; coronary artery disease; or peripheral vascular disease); kidney disease (i.e. acute kidney injury, or chronic kidney disease); liver disease (i.e. cirrhosis, hepatitis B/C, or alcoholic hepatitis); neurologic disease (i.e. dementia, or cerebrovascular accidents); immunologic disease (i.e. immunodeficiency disorders or autoimmune disease) or active malignancy at the time of admission. The study also reported the total number of days from admission until death or discharge.

Data Analysis

The primary exposure of interest was a positive SARS-CoV2 test confirmed by RT-PCR between March 15, 2020 and May 15, 2020. All other deceased patients with negative SARS-CoV2 tests were included during the same time period. Covariates included for analysis were age, gender, comorbidities, DNR status, hospital length of stay, vital status, and COVID-19 symptoms at the time of admission.

Positive SARS-CoV2-specific survival was analyzed using IBM SPSS Statistics 22 8. Descriptive statistics are presented for categorical variables as frequencies and for continuous variables as medians with interquartile ranges (IQRs). Pearson's Chi-Squared test was used to evaluate for significant differences in hospital admission by DNR status. Kaplan Meier, univariate and multivariate Cox regression analyses were performed to calculate the hazard ratios of all of the factors. To identify whether recovery or death were independent risk factors associated with the DNR status, univariable and multivariate logistical regression models were analyzed for all the variables. Risk factors were defined as statistically significant with hazard ratios (HR) not including 1.00 in their 95% confidence interval (CI), which indicate an alpha of < 0.05. In order to evaluate the relationship between DNR status and the type of comorbidity, we quantified each comorbidity in the cohort relative to the DNR status and we calculated the hazard ratios in univariate and multivariate Cox regression models to assess their influence on mortality for DNR patients.

Results

Patient Characteristics

A total of 1380 patients with confirmed SARS-CoV2 tests were identified; median age, 66.44 years (interquartile range, 52.6-76.3 years). Of these 1380 patients, 630 recovered with positive SARS-CoV2, [including 180 (28.6%) with DNR and 450 (71.4%) non-DNR], 640 died with death certificates attributing COVID-19 as the cause of death [including 570 (89.1%) with DNR and 70 (10.9%) non-DNR].

During the study period, there were 120 deceased patients with negative SARS-CoV2 testing [including 110 (91.7%) with DNR and 10 (8.3%) non-DNR] Figure 1. Descriptive statistics are presented in Table 1.

DNR patients were significantly older (76.3 vs. 66.4 yr) than non-DNR patients. Males were significantly more frequent than females overall in this cohort, and males with DNR were significantly more numerous than males with non-DNR status. Older patients (≥ 60 yr) had significantly higher DNR rates than younger patients (< 60 yr). Recovered patients with positive SARS-CoV2 had significantly higher non-DNR status compared to the DNR counterpart, and vice versa in those who died. There was no statistical significance in terms of presenting with COVID19 symptoms between DNR and non-DNR patients.

However, DNR patients were more likely to present with a non-related (to COVID-19) chief complaint. Patients with DNR had significantly higher numbers of comorbidities (≥ 3 comorbidities) compared to patients with non-DNR status. However, there was no statistical significance between the two groups when comparing the average number of overall comorbidities. Further analyses revealed that, as expected, comorbidities emerged to be higher in DNR than non-DNR patients with cardiovascular diseases displaying the greater difference between the two groups Figure 2. All comorbidities increased the hazard of dying with variable significance Table 2. Lung, CNS, metabolic, cancer and immune deficiency diseases increased the hazard significantly in the univariable model. Lung, CNS, Cancer and immune deficiency diseases remained significant in the multivariable model. Interestingly, although cardiovascular diseases were significantly higher in DNR patients this did not associate with a poorer prognosis. Also, kidney and liver diseases increased the hazard of dying but not significantly on both the univariable and multivariable models.

Table 1Descriptive statistics of the cohort.

Group DNR (%) No-DNR (%) Total Chi Square
Gender
M 790 (62.7) 470 (37.3) 1260 <0.05
F 70 (53.8) 60 (46.2) 130 >0.05
Age (Y)
<60 140 (45.2) 170 (54.8) 310 <0.05
≥ 60 720 (66.67) 360 (33.33) 1080 <0.05
SARS-COV2
Positive 750 (59.1) 520 (40.9) 1270 <0.05
Negative 110 (91.67) 10 (8.3) 120 <0.05
Group
Recovered (+ SARS-COV2) 180 (12.9) 450 (32.4) 630 <0.05
Deceased (+ SARS-COV2) 570 (41) 70 (5) 640 <0.05
Deceased (- SARS-COV2) 110 (7.9) 10 (0.8) 120 <0.05
COVID19 Symptoms at Admission
Yes 380 (52.78) 340 (47.2) 720 >0.05
No 480 (71.64) 190 (28.36) 670 <0.05
Comorbidities
0 0 (0) 10 (100) 10 >0.05
1 30 (30) 70 (70) 100 <0.05
2 280 (57.1) 210 (42.9) 490 >0.05
3 380 (69.1) 170 (30.9) 550 <0.05
4 130 (76.5) 40 (23.5) 170 <0.05
5 30 (50) 30 (50) 60 >0.05
6 10 (100) 0 (0) 10 >0.05
Average Length of Hospital Stay (days) 17.38 ± 2.66 9.6 ± 1.55 <0.05

Table 2Cox regression analysis showing the hazard ratios (HR) in the univariate and multivariate models for each comorbidity in COVID19 patients.

Variables Univariate Multivariate
HR* 95% CI p value HR* 95% CI p value
Gender 0.9 0.4- 2 >0.05 0.8 0.3-1.9 >0.05
Age (Y) 1 0.7- 1.4 >0.05 1 0.99- 1.1 >0.05
SARS-COV2 1.5 1.1- 2.1 <0.05 2.5 0.9- 2.8 >0.05
DNR Status 2.2 1.5- 3.2 <0.001 2.2 1.4- 3.5 <0.001
COVID-19 Symptoms on Admission 1 0.8- 1.2 >0.05 1 0.7- 1.3 >0.05
Comorbidities 1.2 0.9- 1.5 >0.05 1.1 0.8- 1.4 >0.05

 Hazard ratio (HR) >1 in Cox regression is interpreted as an increase in the hazard of dying from COVID19 in DNR patients compared to non-DNR patients. Baseline reference: no cardiovascular diseases, no lung diseases, no kidney diseases, no CNS diseases, no metabolic diseases, no cancer, no immune deficiency diseases, no liver diseases. ⁎⁎ P<0.05 is considered significant (in bold).

The average length of hospital stay (days) were almost twice as high in those with DNR compared to those with non-DNR status (17.36 ± 2.66 vs. 9.58 ± 1.55 days, p = 0.01).

Association of DNR Status with Survival

A Kapan Meier plot shows that survival was influenced by DNR status in all positive SARS-CoV2 patients Figure 3A. Patients with DNR had a poorer survival rate than non-DNR patients (log rank p value <0.05). The mean survival time in DNR patients was 11.6 ± 1.3 days (95% CI, 9 -14.2) compared to non-DNR patients (28.5 ± 3 days [95% CI, 22.7 – 34.3]), log-rank test, p < 0.001). When comparing the survival based on gender, there was no statistical difference between DNR and non-DNR groups (p > 0.05) Figure 3B. While there was no statistical significance in survival between younger (< 60 year old) and older (≥ 60 year old) age groups of DNR patients Figure 3C, younger patients (< 60 years old) had a significantly better survival rate compared to older patients (≥ 60 years old) in the non-DNR group [log-rank test, p =0.04; HR =1.8 (95% CI, 1.6-2.7)] Figure 3D.

In univariate Cox regression, DNR patients had a higher hazard ratio for risk of death (HR) than non-DNR patients (HR, 2.2; 95% CI, 1.5-3.2), (p < 0.001) (Table 3) and when adjusting for other variables in the multivariable model, DNR patients remained with a higher hazard ratio than non-DNR patients (HR, 2.2; 95% CI, 1.4-3.5; p< 0.001) (Table 3). SARS-CoV2 test positivity was associated with increased hazard ratios compared to a negative test in the univariate model (HR, 1.5; 95% CI, 1.1 -2.1; p < 0.05). However, these results did not remain significant in the multivariable model. Moreover, when comparing multiple variables (i.e. age, gender, COVID19 symptoms on admission, and the number of comorbidities) with univariate and multivariate Cox regression, there was no statistical significance between the hazard ratios.

Table 3Cox regression analysis showing the hazard ratios (HR) in the univariate and multivariate models for the different variables in COVID19 patients. P<0.05 is considered significant (in bold).

Variables Univariate Multivariate
HR* 95% CI p value HR* 95% CI p value
Gender 0.9 0.4- 2 >0.05 0.8 0.3-1.9 >0.05
Age (Y) 1 0.7- 1.4 >0.05 1 0.99- 1.1 >0.05
SARS-COV2 1.5 1.1- 2.1 <0.05 2.5 0.9- 2.8 >0.05
DNR Status 2.2 1.5- 3.2 <0.001 2.2 1.4- 3.5 <0.001
COVID-19 Symptoms on Admission 1 0.8- 1.2 >0.05 1 0.7- 1.3 >0.05
Comorbidities 1.2 0.9- 1.5 >0.05 1.1 0.8- 1.4 >0.05

 Hazard ratio (HR) >1 in Cox regression is interpreted as an increase in the hazard of dying from COVID19 in DNR patients compared to non-DNR patients.

Discussion

The significance of DNR status as an independent risk factor for mortality has not been documented previously in COVID19 patients. The present study analyzed data of 1270 patients with COVID-19, who were admitted to our institutions during the peak of the COVID-19 pandemic in New Jersey. DNR patients had higher hazard ratios for risk of death and lower survival outcomes compared to non-DNR patients. The association between DNR status and poor clinical outcomes remained independently significant after adjustment for important clinical factors, including age, gender, COVID-19 symptoms at the time of admission and comorbidities.

One explanation for these results is that more patients with a DNR order died because they were not resuscitated9. Another hypothesis is that in the face of rapid clinical deterioration, DNR patients may be more likely to be placed on comfort care (hospice) compared to non-DNR patients4. However, due to the retrospective study design, reasons for a DNR order cannot be determined. Overall, DNR patients were older and had more comorbidities. This suggests the DNR order may be a proxy for more severe illness. The comorbidity clusters were different from one patient to another and there was not enough data for each cluster to derive a meaningful conclusion. The severity of each comorbidity was not easy to measure because of the retrospective nature of the study. Some but not all patients had a record of cardiac ejection fraction percent noted and some but not all had the degree of chronic kidney disease noted. Our further analyses revealed that DNR patients had more comorbidities than non-DNR patients and that the type of comorbidities increased the hazard of dying in the DNR group, which support the concept of considering DNR as a surrogate for prognosis. Notably, a DNR order has been documented to negatively impact the implementation of other treatment modalities (i.e. “failure to rescue phenomenon”) 4, which could explain the increased mortality of these patients. SARS-CoV-2 positivity and older age had a negative impact on survival. These findings have been previously reported 10. However, those factors did not remain significant when adjusting for other variables in the multivariable model, which further support the importance of considering DNR status when analyzing mortality of COVID19 patients. DNR status may be requested by patients and/or their families to avoid prolonged life support, including application of a respirator, at the end of life when there is little or no expectation that this will be followed by a more normal existence. Treatment for severe COVID-19 may require such measures as well, but usually for only a much shorter interval, days or weeks, usually with a good expectation of a normal or near-normal existence on recovery. Patients with severe COVID-19 whose physicians feel they need such measures short term to treat the disease may be discouraged from offering them if the patient has a DNR order. This may unnecessarily negatively impact patient care and increase mortality in COVID-19 patients. Our findings agree with the stated opinions of Curtis and Mirarchi et. al. who, in their editorial about the importance of clarity for hospital code status orders note that DNR documentation is interpreted more broadly than may have been the patient's intention11. Finally, the average length of hospital stay (days) was almost twice as high in those with DNR status compared to those with non-DNR status. Recovered patients were mostly non-DNR patients in this cohort, which could support that resuscitation in the event of respiratory failure caused by COVID-19 was the reason for a shorter inpatient stay. However, there was no clear record in the analyzed data on the resuscitation protocols used during inpatient time to evaluate this hypothesis.

Limitations

The limitations of this study include the retrospective nature. Misclassification of data is possible attributable to inaccurate coding. However, there is no reason to suspect that this would occur in any particular direction for the DNR status, because misclassification would likely be nondifferential in nature and likely biased toward the null. It may be appropriate to perform one or more prospective studies to further examine these issues.

Conclusion

In this cohort of patients with COVID19, a DNR order was found to be a significant predictor of mortality, a finding that persisted after adjustment for other important clinical factors. The increased mortality in DNR patients may have resulted from unmeasured severity of illness, transition to comfort care in accordance with a patient's wishes, or failure to offer more aggressive care, such as a respitator, to patients with a DNR order. DNR status should be evaluated in COVID-19 epidemiological studies to further understand mortality in this pandemic.

Source: Clinics in Dermatology Journal

[caption id="attachment_39410" align="alignnone" width="620"]im-237989 "DNR status is often linked to patients with severe illness, advanced age, poor disease prognosis, and deteriorating health status with impending death"[/caption]

ABSTRACT

Objective

To investigate the influence of DNR status on mortality of hospital inpatients who died of COVID-19.

Design

This is a retrospective, observational cohort study of all patients admitted to two New Jersey hospitals between March 15 and May 15, 2020 who had, or developed, COVID-19 (1270 patients). Of these, 640 patients died (570 (89.1 percent) with and 70 (10.9 percent) without a DNR order at the time of admission) and 630 survived (180 (28.6 percent) with and 450 (71.4 percent) without a DNR order when admitted). Among the 120 patients without COVID-19 who died during this interval, 110 (91.7 percent) had a DNR order when admitted.

Results

Deceased positive SARS-CoV-2 patients were significantly more likely to have a DNR order on admission compared to recovered positive SARS-COV-2 patients (p < 0.05), similar to those who tested negative for SARS-COV-2. COVID-19 DNR patients had a higher mortality compared to COVID-19 non-DNR patients (log rank p < 0.001). DNR patients had a significantly increased hazard ratio of dying (HR 2.2 [1.5-3.2], p <0.001) compared to non-DNR patients, a finding that remained significant in the multivariate model.

Conclusion

The risk of death from COVID-19 was significantly influenced by the patients’ DNR status.

Introduction

The coronavirus disease 2019 (COVID-19) pandemic has resulted in 815,476 global deaths and 178,129 in the US as of August 25, 20201. Do-not-resuscitate (DNR) orders are designed to allow for withholding cardiopulmonary resuscitation (CPR) in the event of cardiac arrest2,3. DNR status is often linked to patients with severe illness, advanced age, poor disease prognosis, and deteriorating health status with impending death4. Data are lacking on survivability of inpatient cardiac arrest for COVID19 patients5. Voices of extreme views, calling for a universal DNR policy for COVID-19 patients have created wide public outrage6. Certifying COVID-19 as the cause of death has driven up the statistics of the pandemic and affected healthcare decisions in the U.S. and globally7. The primary objective of this study was to identify the clinical outcome for patients with a DNR order who had death certificates attributing death to COVID-19.

Methods

Data source

Data were collected from patients who were admitted between March 15, 2020 to May 15, 2020 to two hospitals affiliated with our institution, including all patients who tested positive for SARS-CoV-2 by RT-PCR and were either deceased or had recovered. In addition, data on all patients who tested negative for SARS-CoV-2 and died during the same time period were collected for comparison. The database was de-identified and met the criteria of the Health and Insurance Portability and Accountability Act (HIPAA) for the protection of personal information. The study was exempted by our institutional review board due to de-identifiability of data.

Study sample

Data from 1270 cases of positive SARS-CoV2 patients (including 640 deceased and 630 recovered patients) and 120 deceased patients negative for SARS-CoV2 admitted between 3/15/20 and 5/15/20 were extracted. All DNR patients included in this study had an active DNR order at the time of hospital admission. Patients who received a DNR order at any stage during their time in the hospital after admission were excluded to eliminate any confounding variables. All deceased patients had a death certificate stating COVID-19 was the primary cause of death. Patient demographic data were collected with respect to age, age group (< 60, ≥ 60 years), gender, reason for admission, COVID-19 symptoms at the time of admission, and comorbidities. Comorbidity data were collected for metabolic disease (i.e. diabetes mellitus, electrolyte abnormality, vitamin deficiency or anemias); lung disease (i.e. chronic obstructive pulmonary disease, restrictive lung disease, or asthma); cardiovascular disease (i.e. congestive heart failure; coronary artery disease; or peripheral vascular disease); kidney disease (i.e. acute kidney injury, or chronic kidney disease); liver disease (i.e. cirrhosis, hepatitis B/C, or alcoholic hepatitis); neurologic disease (i.e. dementia, or cerebrovascular accidents); immunologic disease (i.e. immunodeficiency disorders or autoimmune disease) or active malignancy at the time of admission. The study also reported the total number of days from admission until death or discharge.

Data Analysis

The primary exposure of interest was a positive SARS-CoV2 test confirmed by RT-PCR between March 15, 2020 and May 15, 2020. All other deceased patients with negative SARS-CoV2 tests were included during the same time period. Covariates included for analysis were age, gender, comorbidities, DNR status, hospital length of stay, vital status, and COVID-19 symptoms at the time of admission. Positive SARS-CoV2-specific survival was analyzed using IBM SPSS Statistics 22 8. Descriptive statistics are presented for categorical variables as frequencies and for continuous variables as medians with interquartile ranges (IQRs). Pearson's Chi-Squared test was used to evaluate for significant differences in hospital admission by DNR status. Kaplan Meier, univariate and multivariate Cox regression analyses were performed to calculate the hazard ratios of all of the factors. To identify whether recovery or death were independent risk factors associated with the DNR status, univariable and multivariate logistical regression models were analyzed for all the variables. Risk factors were defined as statistically significant with hazard ratios (HR) not including 1.00 in their 95% confidence interval (CI), which indicate an alpha of < 0.05. In order to evaluate the relationship between DNR status and the type of comorbidity, we quantified each comorbidity in the cohort relative to the DNR status and we calculated the hazard ratios in univariate and multivariate Cox regression models to assess their influence on mortality for DNR patients.

Results

Patient Characteristics

A total of 1380 patients with confirmed SARS-CoV2 tests were identified; median age, 66.44 years (interquartile range, 52.6-76.3 years). Of these 1380 patients, 630 recovered with positive SARS-CoV2, [including 180 (28.6%) with DNR and 450 (71.4%) non-DNR], 640 died with death certificates attributing COVID-19 as the cause of death [including 570 (89.1%) with DNR and 70 (10.9%) non-DNR]. During the study period, there were 120 deceased patients with negative SARS-CoV2 testing [including 110 (91.7%) with DNR and 10 (8.3%) non-DNR] Figure 1. Descriptive statistics are presented in Table 1. DNR patients were significantly older (76.3 vs. 66.4 yr) than non-DNR patients. Males were significantly more frequent than females overall in this cohort, and males with DNR were significantly more numerous than males with non-DNR status. Older patients (≥ 60 yr) had significantly higher DNR rates than younger patients (< 60 yr). Recovered patients with positive SARS-CoV2 had significantly higher non-DNR status compared to the DNR counterpart, and vice versa in those who died. There was no statistical significance in terms of presenting with COVID19 symptoms between DNR and non-DNR patients. However, DNR patients were more likely to present with a non-related (to COVID-19) chief complaint. Patients with DNR had significantly higher numbers of comorbidities (≥ 3 comorbidities) compared to patients with non-DNR status. However, there was no statistical significance between the two groups when comparing the average number of overall comorbidities. Further analyses revealed that, as expected, comorbidities emerged to be higher in DNR than non-DNR patients with cardiovascular diseases displaying the greater difference between the two groups Figure 2. All comorbidities increased the hazard of dying with variable significance Table 2. Lung, CNS, metabolic, cancer and immune deficiency diseases increased the hazard significantly in the univariable model. Lung, CNS, Cancer and immune deficiency diseases remained significant in the multivariable model. Interestingly, although cardiovascular diseases were significantly higher in DNR patients this did not associate with a poorer prognosis. Also, kidney and liver diseases increased the hazard of dying but not significantly on both the univariable and multivariable models. 8 Table 1Descriptive statistics of the cohort.
Group DNR (%) No-DNR (%) Total Chi Square
Gender
M 790 (62.7) 470 (37.3) 1260 <0.05
F 70 (53.8) 60 (46.2) 130 >0.05
Age (Y)
<60 140 (45.2) 170 (54.8) 310 <0.05
≥ 60 720 (66.67) 360 (33.33) 1080 <0.05
SARS-COV2
Positive 750 (59.1) 520 (40.9) 1270 <0.05
Negative 110 (91.67) 10 (8.3) 120 <0.05
Group
Recovered (+ SARS-COV2) 180 (12.9) 450 (32.4) 630 <0.05
Deceased (+ SARS-COV2) 570 (41) 70 (5) 640 <0.05
Deceased (- SARS-COV2) 110 (7.9) 10 (0.8) 120 <0.05
COVID19 Symptoms at Admission
Yes 380 (52.78) 340 (47.2) 720 >0.05
No 480 (71.64) 190 (28.36) 670 <0.05
Comorbidities
0 0 (0) 10 (100) 10 >0.05
1 30 (30) 70 (70) 100 <0.05
2 280 (57.1) 210 (42.9) 490 >0.05
3 380 (69.1) 170 (30.9) 550 <0.05
4 130 (76.5) 40 (23.5) 170 <0.05
5 30 (50) 30 (50) 60 >0.05
6 10 (100) 0 (0) 10 >0.05
Average Length of Hospital Stay (days) 17.38 ± 2.66 9.6 ± 1.55 <0.05
9 Table 2Cox regression analysis showing the hazard ratios (HR) in the univariate and multivariate models for each comorbidity in COVID19 patients.
Variables Univariate Multivariate
HR* 95% CI p value HR* 95% CI p value
Gender 0.9 0.4- 2 >0.05 0.8 0.3-1.9 >0.05
Age (Y) 1 0.7- 1.4 >0.05 1 0.99- 1.1 >0.05
SARS-COV2 1.5 1.1- 2.1 <0.05 2.5 0.9- 2.8 >0.05
DNR Status 2.2 1.5- 3.2 <0.001 2.2 1.4- 3.5 <0.001
COVID-19 Symptoms on Admission 1 0.8- 1.2 >0.05 1 0.7- 1.3 >0.05
Comorbidities 1.2 0.9- 1.5 >0.05 1.1 0.8- 1.4 >0.05
low asterisk Hazard ratio (HR) >1 in Cox regression is interpreted as an increase in the hazard of dying from COVID19 in DNR patients compared to non-DNR patients. Baseline reference: no cardiovascular diseases, no lung diseases, no kidney diseases, no CNS diseases, no metabolic diseases, no cancer, no immune deficiency diseases, no liver diseases. ⁎⁎ P<0.05 is considered significant (in bold). The average length of hospital stay (days) were almost twice as high in those with DNR compared to those with non-DNR status (17.36 ± 2.66 vs. 9.58 ± 1.55 days, p = 0.01).

Association of DNR Status with Survival

A Kapan Meier plot shows that survival was influenced by DNR status in all positive SARS-CoV2 patients Figure 3A. Patients with DNR had a poorer survival rate than non-DNR patients (log rank p value <0.05). The mean survival time in DNR patients was 11.6 ± 1.3 days (95% CI, 9 -14.2) compared to non-DNR patients (28.5 ± 3 days [95% CI, 22.7 – 34.3]), log-rank test, p < 0.001). When comparing the survival based on gender, there was no statistical difference between DNR and non-DNR groups (p > 0.05) Figure 3B. While there was no statistical significance in survival between younger (< 60 year old) and older (≥ 60 year old) age groups of DNR patients Figure 3C, younger patients (< 60 years old) had a significantly better survival rate compared to older patients (≥ 60 years old) in the non-DNR group [log-rank test, p =0.04; HR =1.8 (95% CI, 1.6-2.7)] Figure 3D. 10 In univariate Cox regression, DNR patients had a higher hazard ratio for risk of death (HR) than non-DNR patients (HR, 2.2; 95% CI, 1.5-3.2), (p < 0.001) (Table 3) and when adjusting for other variables in the multivariable model, DNR patients remained with a higher hazard ratio than non-DNR patients (HR, 2.2; 95% CI, 1.4-3.5; p< 0.001) (Table 3). SARS-CoV2 test positivity was associated with increased hazard ratios compared to a negative test in the univariate model (HR, 1.5; 95% CI, 1.1 -2.1; p < 0.05). However, these results did not remain significant in the multivariable model. Moreover, when comparing multiple variables (i.e. age, gender, COVID19 symptoms on admission, and the number of comorbidities) with univariate and multivariate Cox regression, there was no statistical significance between the hazard ratios. Table 3Cox regression analysis showing the hazard ratios (HR) in the univariate and multivariate models for the different variables in COVID19 patients. P<0.05 is considered significant (in bold).
Variables Univariate Multivariate
HR* 95% CI p value HR* 95% CI p value
Gender 0.9 0.4- 2 >0.05 0.8 0.3-1.9 >0.05
Age (Y) 1 0.7- 1.4 >0.05 1 0.99- 1.1 >0.05
SARS-COV2 1.5 1.1- 2.1 <0.05 2.5 0.9- 2.8 >0.05
DNR Status 2.2 1.5- 3.2 <0.001 2.2 1.4- 3.5 <0.001
COVID-19 Symptoms on Admission 1 0.8- 1.2 >0.05 1 0.7- 1.3 >0.05
Comorbidities 1.2 0.9- 1.5 >0.05 1.1 0.8- 1.4 >0.05
low asterisk Hazard ratio (HR) >1 in Cox regression is interpreted as an increase in the hazard of dying from COVID19 in DNR patients compared to non-DNR patients.

Discussion

The significance of DNR status as an independent risk factor for mortality has not been documented previously in COVID19 patients. The present study analyzed data of 1270 patients with COVID-19, who were admitted to our institutions during the peak of the COVID-19 pandemic in New Jersey. DNR patients had higher hazard ratios for risk of death and lower survival outcomes compared to non-DNR patients. The association between DNR status and poor clinical outcomes remained independently significant after adjustment for important clinical factors, including age, gender, COVID-19 symptoms at the time of admission and comorbidities. One explanation for these results is that more patients with a DNR order died because they were not resuscitated9. Another hypothesis is that in the face of rapid clinical deterioration, DNR patients may be more likely to be placed on comfort care (hospice) compared to non-DNR patients4. However, due to the retrospective study design, reasons for a DNR order cannot be determined. Overall, DNR patients were older and had more comorbidities. This suggests the DNR order may be a proxy for more severe illness. The comorbidity clusters were different from one patient to another and there was not enough data for each cluster to derive a meaningful conclusion. The severity of each comorbidity was not easy to measure because of the retrospective nature of the study. Some but not all patients had a record of cardiac ejection fraction percent noted and some but not all had the degree of chronic kidney disease noted. Our further analyses revealed that DNR patients had more comorbidities than non-DNR patients and that the type of comorbidities increased the hazard of dying in the DNR group, which support the concept of considering DNR as a surrogate for prognosis. Notably, a DNR order has been documented to negatively impact the implementation of other treatment modalities (i.e. “failure to rescue phenomenon”) 4, which could explain the increased mortality of these patients. SARS-CoV-2 positivity and older age had a negative impact on survival. These findings have been previously reported 10. However, those factors did not remain significant when adjusting for other variables in the multivariable model, which further support the importance of considering DNR status when analyzing mortality of COVID19 patients. DNR status may be requested by patients and/or their families to avoid prolonged life support, including application of a respirator, at the end of life when there is little or no expectation that this will be followed by a more normal existence. Treatment for severe COVID-19 may require such measures as well, but usually for only a much shorter interval, days or weeks, usually with a good expectation of a normal or near-normal existence on recovery. Patients with severe COVID-19 whose physicians feel they need such measures short term to treat the disease may be discouraged from offering them if the patient has a DNR order. This may unnecessarily negatively impact patient care and increase mortality in COVID-19 patients. Our findings agree with the stated opinions of Curtis and Mirarchi et. al. who, in their editorial about the importance of clarity for hospital code status orders note that DNR documentation is interpreted more broadly than may have been the patient's intention11. Finally, the average length of hospital stay (days) was almost twice as high in those with DNR status compared to those with non-DNR status. Recovered patients were mostly non-DNR patients in this cohort, which could support that resuscitation in the event of respiratory failure caused by COVID-19 was the reason for a shorter inpatient stay. However, there was no clear record in the analyzed data on the resuscitation protocols used during inpatient time to evaluate this hypothesis.

Limitations

The limitations of this study include the retrospective nature. Misclassification of data is possible attributable to inaccurate coding. However, there is no reason to suspect that this would occur in any particular direction for the DNR status, because misclassification would likely be nondifferential in nature and likely biased toward the null. It may be appropriate to perform one or more prospective studies to further examine these issues.

Conclusion

In this cohort of patients with COVID19, a DNR order was found to be a significant predictor of mortality, a finding that persisted after adjustment for other important clinical factors. The increased mortality in DNR patients may have resulted from unmeasured severity of illness, transition to comfort care in accordance with a patient's wishes, or failure to offer more aggressive care, such as a respitator, to patients with a DNR order. DNR status should be evaluated in COVID-19 epidemiological studies to further understand mortality in this pandemic. Source: Clinics in Dermatology Journal
Amy Mek - Sat Dec 05, 2020 12:06

On November 28, 2020, “Police for Freedom” a group comprised of Spanish Law Enforcement officers, held a demonstration in the streets of downtown Valencia, Spain. The officers are protesting against their socialist government’s management of the Chinese coronavirus, the violation of citizens freedoms, and the mandated mask measures.

The demonstrators held signs declaring, “Enough with the Lies, “Enough with the Human Rights Abuse”, “The police want to breathe”, and “No to the Vaccine”.

“Police for Freedom” is a recently formed group that brings together members of State Security Forces and private surveillance groups to ensure the rights of Spanish citizens are protected. This same patriotic group held a large march in Madrid on November 7.

The groups spokesperson Sonia Vescovacci, a national police officer on leave of absence, has called for the civil liberties of citizens to be respected. Vescovacci has encouraged her fellow officers to fail to comply with the government tyrannical orders to punish people who do not use masks or deny the seriousness of the pandemic.

Although the group instructed all participants to wear masks, a large portion of the demonstrators did not listen to their request. Following the rally, Valencia’s local government targeted police, the event organizers and participants for failing to comply with the states coronavirus measures. Ninety police officers have received fines for demonstrating against the “Imposition of masks” without wearing them.

Watch the following video of the “Police for Freedom” demonstration which was filmed by a female patriot. The woman praises the brave officers marching for their country and citizens. She encourages people to share the inspirational video around the globe and allow people to see what police in Spain are like,

“let this video circle across the world and show what true policemen are like, this man over here marching for his country for his sisters and brothers for the children defending true humanity police.

Hopefully, the police officers in Germany who use water cannons against those who refuse to wear a mask, will learn from their example:

Source: RAIR Foundation

From an earlier demo:

https://twitter.com/LaPolicias/status/1327360672255119361

On November 28, 2020, “Police for Freedom” a group comprised of Spanish Law Enforcement officers, held a demonstration in the streets of downtown Valencia, Spain. The officers are protesting against their socialist government’s management of the Chinese coronavirus, the violation of citizens freedoms, and the mandated mask measures. The demonstrators held signs declaring, “Enough with the Lies, “Enough with the Human Rights Abuse”, “The police want to breathe”, and “No to the Vaccine”. “Police for Freedom” is a recently formed group that brings together members of State Security Forces and private surveillance groups to ensure the rights of Spanish citizens are protected. This same patriotic group held a large march in Madrid on November 7. [caption id="attachment_39399" align="alignnone" width="990"] Sonia Vescovacci[/caption] The groups spokesperson Sonia Vescovacci, a national police officer on leave of absence, has called for the civil liberties of citizens to be respected. Vescovacci has encouraged her fellow officers to fail to comply with the government tyrannical orders to punish people who do not use masks or deny the seriousness of the pandemic. Although the group instructed all participants to wear masks, a large portion of the demonstrators did not listen to their request. Following the rally, Valencia’s local government targeted police, the event organizers and participants for failing to comply with the states coronavirus measures. Ninety police officers have received fines for demonstrating against the “Imposition of masks” without wearing them. Watch the following video of the “Police for Freedom” demonstration which was filmed by a female patriot. The woman praises the brave officers marching for their country and citizens. She encourages people to share the inspirational video around the globe and allow people to see what police in Spain are like,
“let this video circle across the world and show what true policemen are like, this man over here marching for his country for his sisters and brothers for the children defending true humanity police.
Hopefully, the police officers in Germany who use water cannons against those who refuse to wear a mask, will learn from their example: [embed]https://rumble.com/embed/v8vo8j/?pub=4[/embed] [embed]https://rumble.com/embed/v8voe3/?pub=4[/embed] Source: RAIR Foundation From an earlier demo: [embed]https://www.youtube.com/watch?v=0lMsiqsM0Og[/embed] https://twitter.com/LaPolicias/status/1327360672255119361
Joel Kotkin - Sat Dec 05, 2020 08:00

Like many, if not most Americans, I am somewhat relieved to see the petulant, nasty and sometimes clearly unhinged Donald Trump leave the White House. Yet for all his antics and vitriol, Trump has left a legacy that will be difficult to ignore and, given the dispensation of his opponents, could shape the future for the next decade.

Trump’s 2016 victory may be best considered a necessary colonic to a constipated political economy. He challenged in ways not seen for a generation the comfortable establishmentarian politics of both parties.

Most critical of all, Trump, the scion of a property mogul, has re-established, along with his odd socialist doppelganger, Bernie Sanders, the relevance of class in American politics.

Trump may soon be out of power, but many of his views on international trade, media, economics and immigration will continue to influence politics for the next decade. We might see the end of President Trump, but the forces and attitudes he has unleashed [or that he was a symptom of] likely will remain with us for decades to come.

Bye, bye kumbaya

Trump’s challenge to the establishmentarian worldview will resonate, even after the election. His willingness to stand up to China’s trade policies violated the interests of the corporate elitetechHollywood and the mainstream media, all of whom almost without exception backed his opponent. Now Trump’s nationalist approach certainly will be toned down by the ‘liberal internationalists’ Biden is putting in place to run foreign affairs .

To be sure, China should welcome the ascension of Biden, if for no other reason than his commitment to the Paris accords which force costly changes on Western economies while giving the world’s biggest carbon emitter a free ride till 2030. Along with more ‘open trade’, Biden could prove an unwitting accomplice in China’s great ambition to replace the West, and notably America, as the heart of global civilisation.

Yet the era of global kumbaya, ended by Trump, is not likely to return. It has become painfully obvious that ‘free trade’, as carried out by our own companies, benefited the already affluent at the expense of most people. As the liberal New Statesman has put it succinctly, ‘the era of peak globalisation is over’. The pandemic has shattered the global village, weakening both economic and political ties between countries, including within the European Union. When Trump lambasts free trade and China, he may alienate much of the corporate elite, but his message appeals to people and communities that lost, according to one labour-backed group, 3.4million jobs between 1979 and 2017 to the Middle Kingdom.

To win politically, as former Democratic senator Evan Bayh suggests, may mean following Trump’s aggressively ‘America first’ line. If Biden hews to the establishment party line, he will face an emerging alliance between populists in both parties – Bernie Sanders and Joshua Hawley, for example. Some prominent Democrats like New York governor Andrew Cuomo joined Trump in denouncing our ruinous dependence on Chinese medical supplies and there’s growing bipartisan concern about dependence on Beijing for high-tech gear. Given the challenge posed by China, diplomats under Biden could seek not a restoration of the old globalism, but a de facto ‘united front’ with Europe, Australia, Canada, India, Japan and other east Asian countries against China.

The great transformation of the Democratic Party

The Democrats seem likely to give Republicans and Trump the opportunity to represent a large portion of the American middle and working classes.

Today’s Democrats increasingly resemble a Stalinoid version old Republicans, who won with support from the upper class, notably on Wall Street and in Silicon Valley, as well as law and professional-service firms. T

his year Biden and his running mate, Kamala Harris, raised record sums from the corporate elite, notably the tech oligarchs and their Wall Street allies. Among financial firms, communications companies and lawyers, Biden outraised Trump by five to one or more. We will see this in play again in the upcoming cataclysmic battle to win the Georgia Senate seats, which started with a big Silicon Valley fundraiser for the Democratic candidates Jon Ossoff and Raphael Warnock.

The oligarchal cast of the putative ‘party of the people’ exposes it to populists left and right. Biden’s natural tendency may be, like Barack Obama, to wink and nod as Microsoft, Amazon, Apple, Facebook and Google acquire or crush competitors, continuing the erosion in anti-trust enforcement, occurring under both parties. Butwo thirds of the public want to break up the tech oligarchy that increasingly dominates the economy, the capital markets and information. The tech giants now account for nearly 40 per cent of the value of the Standard and Poor index, a level of concentration unprecedented in modern history.

For these oligopolies, the pandemic shift to online, covering everything from finance and retail to gaming, has provided an unprecedented boom. Tech is no longer the dynamic and entrepreneurial industry of legend. Rather, it has morphed into a system of conglomerate control more akin to the pre-war German cartels, Japanese keiretsu or Korean chaebol. As with trade, attempts to wink and nod at the oligarchs could stir a conflict with both big-city progressives, like Massachusetts senator Elizabeth Warren and some members of the House, along with several conservatives from the more rural interior.

The media’s big failure

In his usually intemperate manner, Trump accused the mainstream media of open bias and of being, in another unfortunate phrase, ‘enemies of the people’. Yet in the run-up to 2016, and beyond, there has been an odd symbiotic relationship between the two, with Trump, and hatred for him, fuelling media profits and providing massive amounts of free publicity.

In some ways the media have unwittingly undermined themselves as they worked overtime to eject Trump. Since the election, even respected papers like the New York Times (where I once had a monthly column) increasingly resembled a woke version of Pravda. Indeed, the elite media is increasingly engulfed by progressive ‘groupthink’ with ‘moral clarity’ as defined by the woke, replacing a commitment to free speech.

The shift from journalism to ‘resistance’ has helped bulk the audience for some parts of the media, but has also made them increasingly partisan. Ideological purity has come at the cost of public trust in most large media, with the biggest declines among Independents and Republicans; the New York Times, the avatar of woke journalism, is trusted by barely 30 per cent of Republicans compared to 50 per cent in 2016. Similarly, Gallup reports that since the pandemic, the news media has suffered the lowest ratings of any major institution, performing even worse than Congress or President Trump.

This serious erosion in public trust, according to a new Knight Foundation study, also applies to social media. Over 70 per cent of Americans, according to a recent Pew study, believe that social media censors political views, as has been demonstrated in the case of Reddit, Facebook and Google, and was clearly happening during the election coverage. This has led to something of a rush to less censorious sites like Gab and Parler. In California, the epicentre of Big Tech, people express more trust in the pot industry than the news business, according to a 2019 opinion survey.

Some, including some at the New York Times, want to ramp up further censorship, which, as left-wing gadfly Glenn Greenwald notes, would give establishment outlets an assured greater dominion over the internet. During the election, Twitter and Facebook already showed their intent when blocking off access to an incriminating New York Post story about Joe Biden’s son Hunter, and even muting the president and his administration for disseminating alleged inaccuracies and misinformation. They did this after years of pushing often equally absurd anti-Trump conspiracies. This brazen use of power, Greenwald suggests, crosses a ‘dangerous’ line, from eliminating extremists into censoring any discordant thoughts on critical public issues, from climate change to the pandemic.

The peasant rebellion is just starting

Trumpism’s appeal to working- and middle-class Americans was not hurt by the opposition of a media that largely disdains them. Indeed, as Democratic analyst Ruy Teixeira notes, the Democrats have largely abandoned the working and middle class. Trump won three-quarters of the white working-class vote, down only slightly from 2016. He did best with those who work with their hands, in factories, the logistics industry and energy, notes a recent study by CityLab.

Largely ignored by the press, these voters had compelling economic reasons to support Trump. In the first three years of the Trump administration – that is, before the pandemic – working-class Americans enjoyed the fastest income growth – better than that of the upper classes – for the first time in a generation. The pandemic-related lockdowns, strictest generally in blue states, have devastated workers in industries like hospitality and driven some eight million into poverty. Almost 40 per cent of those Americans making under $40,000 a year have lost their jobs, and they may be eager to get back to work. Yet still some Democratic advisers have urged Biden to consider imposing a strict national lockdown that would make that impossible.

Many people employed in basic industries like energy, agriculture and manufacturing – critical to electing Donald Trump – could see their jobs disappear. Restrictions and even a ban on fracking, likely to be embraced by many close to the Biden administration, could have catastrophic effects in places like Texas, North Dakota, Ohio, West Virginia and Pennsylvania. In Texas alone, by some estimates, one million jobs would be lost. Overall, according to a Chamber of Commerce report, a full ban on fracking would cost 14million jobs, far more than the eight million lost in the Great Recession.

The other big potential GOP constituency may be Main Street. Businesses there have been hit very hard by the pandemic, with an estimated 100,000 small firms going out of business. In contrast, the Democrats’ Wall Street and the oligarch backers have had a good pandemic. From March to June 2020, Amazon founder and Biden booster Jeff Bezos saw his wealth rise by an estimated $48 billion to an estimated $183 billion, making him easily the world’s richest man.

The racial component

The soon-to-be ex-president issued statements on such issues as immigration and developing (‘shithole’) countries that no American chief executive should ever utter. Yet despite his characteristic rudeness, this year more minorities shifted in his favour than expected. Trump gained one third of Muslim voters and boosted his share of Jewish voters by six per cent, particularly appealing to orthodox and older members of the Jewish community. The Asian community – the country’s fastest-growing minority – raised its support for Trump from 27 per cent in 2016 to 31 per cent this year.

Most importantly, Trump – an unpleasant, unprincipled man repeatedly labelled ‘racist’ in the mainstream media, a term also applied to any of his voters – won a significantly larger share of the Latino vote, particularly in Florida and Texas, and did better, albeit less impressively, among African Americans. Latino and Asian voters also helped shift several house seats to the GOP. Even the ultra-woke New York Times now admits, in looking at minorities, that it may have missed out on ‘class complexities and competing desires’.

The key here is that Latinos may be ‘people of colour’ but they are also people with jobs and families. They are heavily represented in blue-collar professions, notably personal services, construction, logistics and manufacturing. They generally have done better under President Trump than under previous administrations and have been most hurt by lockdowns, high energy prices and curbs on suburban housing. Today, barely 58 per cent of all working-class Americans are white; according to a 2016 Economic Policy Institute study, people of colour will constitute the majority of the working class by 2032.

The stark reality is that conventional blue politics, as we recently demonstrated in a new paper from the Urban Reform Institute, simply do not work for minorities, who generally do better in and are migrating to conservative-controlled states. Inner-city residents want good jobs and investment; relatively few want to ‘defund’ the police. Certainly, the ever more radical social views of the ‘woke’ left, which have been increasingly adopted by corporate America, also may not play well with many immigrants, who, according to one recent survey, are twice as conservative in their social views as the general public.

Battles to come

‘Happy the nation whose people have not forgotten how to rebel’, wrote the British historian RH Tawney. And unless something is done to address growing inequality and lack of upward mobility, this rebellious streak will return from the populists both left and right.

As of now, the restored establishment lacks a viable vision to improve the lives of most Americans, particularly given their embrace of green ideology which makes broad-based economic growth all but impossible. [Particularly given its devotion to plundering it, including through the green class war of the affluent.]

In their current guise, Democrats today can only offer redistribution of wealth, which itself can come in two forms, each with inherent problems. A traditional socialist approach would hardly be in the interest of the Democratic funders or the non-profit establishment, given it would involve siphoning off the wealth of people like Jeff Bezos, who expended much of his media power, through the Washington Post, opposing Bernie Sanders’ presidential bid. Yet the progressive left continues to push this agenda, notably in big urban centres, a continuing challenge to more oligarch-friendly liberals.

The other alternative would be to turn the middle and working class into future serfs – that is, people increasingly dependent on what Marx called ‘the proletarian alms bag’ (1). This ‘oligarchal socialism’ – backed by many tech oligarchs – would transfer funds, likely from the remaining middle class, to fund a ‘guaranteed annual income’ to keep hoi polloi in subsidised apartments, spending their time in low-wage gig jobs, while they play video games, smoke pot, drink and water their houseplants. It is an approach that allows the oligarchs to continue accumulating the wealth and power they see as their due, while keeping the peasants separate from their pitchforks.

These unattractive alternatives could provide enormous opportunities for Republicans, or more traditional Democrats, if they could overcome the opposition of ‘market fundamentalists’. On the right, as the American Prospect has demonstrated, many conservative think-tanks are financed by Google and other oligopolists. The future could belong not to Trump but to more coherent Republicans like Oren Cass and his American Compass group, who reject ‘let the market rip’ fundamentalism and openly favour working-class interests in terms of healthcare, education, housing, anti-trust policy and energy.

Americans do not want to be either Marxist or oligarchic wards. They generally desire to become more self-sufficient and successful. The attempt to implement a pilot guaranteed-incomes programme in Modesto, California, a hardscrabble Valley town of 300,000, was recently rescinded by a primarily minority electorate, who replaced a progressive Democratic with a black Republican preacher. Like most Americans, most minorities and working-class people still believe in the ‘dream’ even if they believe that it is more difficult to achieve. [Courtesy of the constant plundering and feudal regulatory burdens they're subjected to.]

Until that quintessentially American spark is squelched entirely, the disruptive process brought on by Trump will not go away, but simply evolve and even expand. The question will be whether a more sober, less nativist, and focused populism will emerge from the wreckage or be replaced by something more troubling.

Source: Spiked

Like many, if not most Americans, I am somewhat relieved to see the petulant, nasty and sometimes clearly unhinged Donald Trump leave the White House. Yet for all his antics and vitriol, Trump has left a legacy that will be difficult to ignore and, given the dispensation of his opponents, could shape the future for the next decade. Trump’s 2016 victory may be best considered a necessary colonic to a constipated political economy. He challenged in ways not seen for a generation the comfortable establishmentarian politics of both parties. Most critical of all, Trump, the scion of a property mogul, has re-established, along with his odd socialist doppelganger, Bernie Sanders, the relevance of class in American politics. Trump may soon be out of power, but many of his views on international trade, media, economics and immigration will continue to influence politics for the next decade. We might see the end of President Trump, but the forces and attitudes he has unleashed [or that he was a symptom of] likely will remain with us for decades to come.

Bye, bye kumbaya

Trump’s challenge to the establishmentarian worldview will resonate, even after the election. His willingness to stand up to China’s trade policies violated the interests of the corporate elitetechHollywood and the mainstream media, all of whom almost without exception backed his opponent. Now Trump’s nationalist approach certainly will be toned down by the ‘liberal internationalists’ Biden is putting in place to run foreign affairs . To be sure, China should welcome the ascension of Biden, if for no other reason than his commitment to the Paris accords which force costly changes on Western economies while giving the world’s biggest carbon emitter a free ride till 2030. Along with more ‘open trade’, Biden could prove an unwitting accomplice in China’s great ambition to replace the West, and notably America, as the heart of global civilisation. Yet the era of global kumbaya, ended by Trump, is not likely to return. It has become painfully obvious that ‘free trade’, as carried out by our own companies, benefited the already affluent at the expense of most people. As the liberal New Statesman has put it succinctly, ‘the era of peak globalisation is over’. The pandemic has shattered the global village, weakening both economic and political ties between countries, including within the European Union. When Trump lambasts free trade and China, he may alienate much of the corporate elite, but his message appeals to people and communities that lost, according to one labour-backed group, 3.4million jobs between 1979 and 2017 to the Middle Kingdom. To win politically, as former Democratic senator Evan Bayh suggests, may mean following Trump’s aggressively ‘America first’ line. If Biden hews to the establishment party line, he will face an emerging alliance between populists in both parties – Bernie Sanders and Joshua Hawley, for example. Some prominent Democrats like New York governor Andrew Cuomo joined Trump in denouncing our ruinous dependence on Chinese medical supplies and there’s growing bipartisan concern about dependence on Beijing for high-tech gear. Given the challenge posed by China, diplomats under Biden could seek not a restoration of the old globalism, but a de facto ‘united front’ with Europe, Australia, Canada, India, Japan and other east Asian countries against China.

The great transformation of the Democratic Party

The Democrats seem likely to give Republicans and Trump the opportunity to represent a large portion of the American middle and working classes. Today’s Democrats increasingly resemble a Stalinoid version old Republicans, who won with support from the upper class, notably on Wall Street and in Silicon Valley, as well as law and professional-service firms. T his year Biden and his running mate, Kamala Harris, raised record sums from the corporate elite, notably the tech oligarchs and their Wall Street allies. Among financial firms, communications companies and lawyers, Biden outraised Trump by five to one or more. We will see this in play again in the upcoming cataclysmic battle to win the Georgia Senate seats, which started with a big Silicon Valley fundraiser for the Democratic candidates Jon Ossoff and Raphael Warnock. The oligarchal cast of the putative ‘party of the people’ exposes it to populists left and right. Biden’s natural tendency may be, like Barack Obama, to wink and nod as Microsoft, Amazon, Apple, Facebook and Google acquire or crush competitors, continuing the erosion in anti-trust enforcement, occurring under both parties. Butwo thirds of the public want to break up the tech oligarchy that increasingly dominates the economy, the capital markets and information. The tech giants now account for nearly 40 per cent of the value of the Standard and Poor index, a level of concentration unprecedented in modern history. For these oligopolies, the pandemic shift to online, covering everything from finance and retail to gaming, has provided an unprecedented boom. Tech is no longer the dynamic and entrepreneurial industry of legend. Rather, it has morphed into a system of conglomerate control more akin to the pre-war German cartels, Japanese keiretsu or Korean chaebol. As with trade, attempts to wink and nod at the oligarchs could stir a conflict with both big-city progressives, like Massachusetts senator Elizabeth Warren and some members of the House, along with several conservatives from the more rural interior.

The media’s big failure

In his usually intemperate manner, Trump accused the mainstream media of open bias and of being, in another unfortunate phrase, ‘enemies of the people’. Yet in the run-up to 2016, and beyond, there has been an odd symbiotic relationship between the two, with Trump, and hatred for him, fuelling media profits and providing massive amounts of free publicity. In some ways the media have unwittingly undermined themselves as they worked overtime to eject Trump. Since the election, even respected papers like the New York Times (where I once had a monthly column) increasingly resembled a woke version of Pravda. Indeed, the elite media is increasingly engulfed by progressive ‘groupthink’ with ‘moral clarity’ as defined by the woke, replacing a commitment to free speech. The shift from journalism to ‘resistance’ has helped bulk the audience for some parts of the media, but has also made them increasingly partisan. Ideological purity has come at the cost of public trust in most large media, with the biggest declines among Independents and Republicans; the New York Times, the avatar of woke journalism, is trusted by barely 30 per cent of Republicans compared to 50 per cent in 2016. Similarly, Gallup reports that since the pandemic, the news media has suffered the lowest ratings of any major institution, performing even worse than Congress or President Trump. This serious erosion in public trust, according to a new Knight Foundation study, also applies to social media. Over 70 per cent of Americans, according to a recent Pew study, believe that social media censors political views, as has been demonstrated in the case of Reddit, Facebook and Google, and was clearly happening during the election coverage. This has led to something of a rush to less censorious sites like Gab and Parler. In California, the epicentre of Big Tech, people express more trust in the pot industry than the news business, according to a 2019 opinion survey. Some, including some at the New York Times, want to ramp up further censorship, which, as left-wing gadfly Glenn Greenwald notes, would give establishment outlets an assured greater dominion over the internet. During the election, Twitter and Facebook already showed their intent when blocking off access to an incriminating New York Post story about Joe Biden’s son Hunter, and even muting the president and his administration for disseminating alleged inaccuracies and misinformation. They did this after years of pushing often equally absurd anti-Trump conspiracies. This brazen use of power, Greenwald suggests, crosses a ‘dangerous’ line, from eliminating extremists into censoring any discordant thoughts on critical public issues, from climate change to the pandemic.

The peasant rebellion is just starting

Trumpism’s appeal to working- and middle-class Americans was not hurt by the opposition of a media that largely disdains them. Indeed, as Democratic analyst Ruy Teixeira notes, the Democrats have largely abandoned the working and middle class. Trump won three-quarters of the white working-class vote, down only slightly from 2016. He did best with those who work with their hands, in factories, the logistics industry and energy, notes a recent study by CityLab. Largely ignored by the press, these voters had compelling economic reasons to support Trump. In the first three years of the Trump administration – that is, before the pandemic – working-class Americans enjoyed the fastest income growth – better than that of the upper classes – for the first time in a generation. The pandemic-related lockdowns, strictest generally in blue states, have devastated workers in industries like hospitality and driven some eight million into poverty. Almost 40 per cent of those Americans making under $40,000 a year have lost their jobs, and they may be eager to get back to work. Yet still some Democratic advisers have urged Biden to consider imposing a strict national lockdown that would make that impossible. Many people employed in basic industries like energy, agriculture and manufacturing – critical to electing Donald Trump – could see their jobs disappear. Restrictions and even a ban on fracking, likely to be embraced by many close to the Biden administration, could have catastrophic effects in places like Texas, North Dakota, Ohio, West Virginia and Pennsylvania. In Texas alone, by some estimates, one million jobs would be lost. Overall, according to a Chamber of Commerce report, a full ban on fracking would cost 14million jobs, far more than the eight million lost in the Great Recession. The other big potential GOP constituency may be Main Street. Businesses there have been hit very hard by the pandemic, with an estimated 100,000 small firms going out of business. In contrast, the Democrats’ Wall Street and the oligarch backers have had a good pandemic. From March to June 2020, Amazon founder and Biden booster Jeff Bezos saw his wealth rise by an estimated $48 billion to an estimated $183 billion, making him easily the world’s richest man.

The racial component

The soon-to-be ex-president issued statements on such issues as immigration and developing (‘shithole’) countries that no American chief executive should ever utter. Yet despite his characteristic rudeness, this year more minorities shifted in his favour than expected. Trump gained one third of Muslim voters and boosted his share of Jewish voters by six per cent, particularly appealing to orthodox and older members of the Jewish community. The Asian community – the country’s fastest-growing minority – raised its support for Trump from 27 per cent in 2016 to 31 per cent this year. Most importantly, Trump – an unpleasant, unprincipled man repeatedly labelled ‘racist’ in the mainstream media, a term also applied to any of his voters – won a significantly larger share of the Latino vote, particularly in Florida and Texas, and did better, albeit less impressively, among African Americans. Latino and Asian voters also helped shift several house seats to the GOP. Even the ultra-woke New York Times now admits, in looking at minorities, that it may have missed out on ‘class complexities and competing desires’. The key here is that Latinos may be ‘people of colour’ but they are also people with jobs and families. They are heavily represented in blue-collar professions, notably personal services, construction, logistics and manufacturing. They generally have done better under President Trump than under previous administrations and have been most hurt by lockdowns, high energy prices and curbs on suburban housing. Today, barely 58 per cent of all working-class Americans are white; according to a 2016 Economic Policy Institute study, people of colour will constitute the majority of the working class by 2032. The stark reality is that conventional blue politics, as we recently demonstrated in a new paper from the Urban Reform Institute, simply do not work for minorities, who generally do better in and are migrating to conservative-controlled states. Inner-city residents want good jobs and investment; relatively few want to ‘defund’ the police. Certainly, the ever more radical social views of the ‘woke’ left, which have been increasingly adopted by corporate America, also may not play well with many immigrants, who, according to one recent survey, are twice as conservative in their social views as the general public.

Battles to come

‘Happy the nation whose people have not forgotten how to rebel’, wrote the British historian RH Tawney. And unless something is done to address growing inequality and lack of upward mobility, this rebellious streak will return from the populists both left and right. As of now, the restored establishment lacks a viable vision to improve the lives of most Americans, particularly given their embrace of green ideology which makes broad-based economic growth all but impossible. [Particularly given its devotion to plundering it, including through the green class war of the affluent.] In their current guise, Democrats today can only offer redistribution of wealth, which itself can come in two forms, each with inherent problems. A traditional socialist approach would hardly be in the interest of the Democratic funders or the non-profit establishment, given it would involve siphoning off the wealth of people like Jeff Bezos, who expended much of his media power, through the Washington Post, opposing Bernie Sanders’ presidential bid. Yet the progressive left continues to push this agenda, notably in big urban centres, a continuing challenge to more oligarch-friendly liberals. The other alternative would be to turn the middle and working class into future serfs – that is, people increasingly dependent on what Marx called ‘the proletarian alms bag’ (1). This ‘oligarchal socialism’ – backed by many tech oligarchs – would transfer funds, likely from the remaining middle class, to fund a ‘guaranteed annual income’ to keep hoi polloi in subsidised apartments, spending their time in low-wage gig jobs, while they play video games, smoke pot, drink and water their houseplants. It is an approach that allows the oligarchs to continue accumulating the wealth and power they see as their due, while keeping the peasants separate from their pitchforks. These unattractive alternatives could provide enormous opportunities for Republicans, or more traditional Democrats, if they could overcome the opposition of ‘market fundamentalists’. On the right, as the American Prospect has demonstrated, many conservative think-tanks are financed by Google and other oligopolists. The future could belong not to Trump but to more coherent Republicans like Oren Cass and his American Compass group, who reject ‘let the market rip’ fundamentalism and openly favour working-class interests in terms of healthcare, education, housing, anti-trust policy and energy. Americans do not want to be either Marxist or oligarchic wards. They generally desire to become more self-sufficient and successful. The attempt to implement a pilot guaranteed-incomes programme in Modesto, California, a hardscrabble Valley town of 300,000, was recently rescinded by a primarily minority electorate, who replaced a progressive Democratic with a black Republican preacher. Like most Americans, most minorities and working-class people still believe in the ‘dream’ even if they believe that it is more difficult to achieve. [Courtesy of the constant plundering and feudal regulatory burdens they're subjected to.] Until that quintessentially American spark is squelched entirely, the disruptive process brought on by Trump will not go away, but simply evolve and even expand. The question will be whether a more sober, less nativist, and focused populism will emerge from the wreckage or be replaced by something more troubling. Source: Spiked
Associated Press - Sat Dec 05, 2020 04:33

Mexicos’s President Andrés Manuel López Obrador suggested on Wednesday that politicians who impose lockdowns or curfews to limit Covid-19 are acting like dictators.

The comments came as López Obrador once again fended off questions about why he almost never wears a face mask, saying it was a question of liberty.

The Mexican leader said pandemic measures that limit people’s movements are “fashionable among authorities … who want to show they are heavy-handed, dictatorship.

“A lot of them are letting their authoritarian instincts show,” he said, adding “the fundamental thing is to guarantee liberty.”

López Obrador’s comments came a day after the head of the World Health Organization (WHO) said that Mexico was “in bad shape” with the pandemic and urged its leaders to take the coronavirus seriously.

“The number of increasing cases and deaths in Mexico is very worrisome,” said the WHO director general, Tedros Adhanom Ghebreyesus [Bill Gate's puppet pushing Chinese methods], on Monday.

“We would like to ask Mexico to be very serious,” he said. “We have said it in general, wearing a mask is important, hygiene is important and physical distancing is important and we expect leaders to be examples …”

In his commments on Wednesday, it was unclear if the Mexican leader was referring to authorities in other countries, or the mainly opposition-party local leaders in Mexico.

Many governments across the world have effectively implemented lockdowns or limits on when people can leave their homes, something López Obrador has fiercely resisted doing, arguing some people live day-to-day on what they earn on the streets.

Some local governments in Mexico have tried to use police to enforce limits on masks or movement, which resulted in scandals of abusive behavior by police.

López Obrador argues such measures should be voluntary.

“Everyone is free. Whoever wants to wear a face mask and feel safer is welcome to do so,” López Obrador said.

Source: Associated Press

[caption id="attachment_39382" align="alignnone" width="2500"] “Everyone is free. Whoever wants to wear a face mask and feel safer is welcome to do so”[/caption]

Mexicos’s President Andrés Manuel López Obrador suggested on Wednesday that politicians who impose lockdowns or curfews to limit Covid-19 are acting like dictators.

The comments came as López Obrador once again fended off questions about why he almost never wears a face mask, saying it was a question of liberty.

The Mexican leader said pandemic measures that limit people’s movements are “fashionable among authorities … who want to show they are heavy-handed, dictatorship.

“A lot of them are letting their authoritarian instincts show,” he said, adding “the fundamental thing is to guarantee liberty.”

López Obrador’s comments came a day after the head of the World Health Organization (WHO) said that Mexico was “in bad shape” with the pandemic and urged its leaders to take the coronavirus seriously.

“The number of increasing cases and deaths in Mexico is very worrisome,” said the WHO director general, Tedros Adhanom Ghebreyesus [Bill Gate's puppet pushing Chinese methods], on Monday.

“We would like to ask Mexico to be very serious,” he said. “We have said it in general, wearing a mask is important, hygiene is important and physical distancing is important and we expect leaders to be examples …”

In his commments on Wednesday, it was unclear if the Mexican leader was referring to authorities in other countries, or the mainly opposition-party local leaders in Mexico.

Many governments across the world have effectively implemented lockdowns or limits on when people can leave their homes, something López Obrador has fiercely resisted doing, arguing some people live day-to-day on what they earn on the streets.

Some local governments in Mexico have tried to use police to enforce limits on masks or movement, which resulted in scandals of abusive behavior by police.

López Obrador argues such measures should be voluntary.

“Everyone is free. Whoever wants to wear a face mask and feel safer is welcome to do so,” López Obrador said.

Source: Associated Press
The Babylon Bee - Fri Dec 04, 2020 09:30

With the pandemic still ongoing and many people still getting infected with COVID-19, Democrats have been especially strict with their constituents, enforcing the harshest lockdowns and restrictions on gatherings. Fearing that’s not enough to get their point through, Democrats have gone the extra length of illustrating to the public exactly what they shouldn’t do by engaging in those activities themselves.

“This could get people killed,” said California Governor Gavin Newsom as he ate at the famous French Laundry restaurant with a large gathering of friends. He then added, between bites of food, “You have to stay home and isolated. I don’t want to see any of you doing this.”

Austin Mayor Steve Adler flew all the way to a resort in Mexico to show people the dangers of the pandemic. “This is not the time to relax and go on vacation,” said Adler. “You see this?” He took a drink of a fruity cocktail and sat on a chair by the ocean. “You can’t do this.”

Democrats hope these extra efforts will really convince the public of the danger of the pandemic. “If people see us risking our lives to show them how bad it is, maybe they’ll see that this is serious,” said Washington D.C. Mayor Muriel Bowser as she attended a Joe Biden victory party. “We could all die from parties like these, and people need to see how dangerous that is, and -- Hey! Waiter! I want some of those appetizers!”

Source: The Babylon Bee

With the pandemic still ongoing and many people still getting infected with COVID-19, Democrats have been especially strict with their constituents, enforcing the harshest lockdowns and restrictions on gatherings. Fearing that’s not enough to get their point through, Democrats have gone the extra length of illustrating to the public exactly what they shouldn’t do by engaging in those activities themselves.

“This could get people killed,” said California Governor Gavin Newsom as he ate at the famous French Laundry restaurant with a large gathering of friends. He then added, between bites of food, “You have to stay home and isolated. I don’t want to see any of you doing this.”

Austin Mayor Steve Adler flew all the way to a resort in Mexico to show people the dangers of the pandemic. “This is not the time to relax and go on vacation,” said Adler. “You see this?” He took a drink of a fruity cocktail and sat on a chair by the ocean. “You can’t do this.”

Democrats hope these extra efforts will really convince the public of the danger of the pandemic. “If people see us risking our lives to show them how bad it is, maybe they’ll see that this is serious,” said Washington D.C. Mayor Muriel Bowser as she attended a Joe Biden victory party. “We could all die from parties like these, and people need to see how dangerous that is, and -- Hey! Waiter! I want some of those appetizers!”

Source: The Babylon Bee

Simon Murphy - Fri Dec 04, 2020 08:30

Senior company executives are among travellers set to be exempt from Covid-19 quarantine restrictions for international arrivals in England, meaning they will not have to self-isolate for up to a fortnight.

Recently signed elite sportspeople, performing arts professionals, TV production staff and journalists will also not have to abide by quarantine restrictions if arriving from a country outside of England’s travel corridor from 4am on Saturday.

https://twitter.com/grantshapps/status/1334543848333332482?ref_src=twsrc%5Etf...

Announcing the move on Twitter, the transport secretary, Grant Shapps, said “high-value business travellers” would be exempt from quarantine rules in an effort to boost the economy, “subject to specific criteria being met”.

It is understood that the exemption will apply to senior company executives, such as directors or their equivalents, either returning or travelling to England who can deliver “significant” economic benefit. They will only qualify for the exemption if their work requires them to be there in person.

Currently, travellers coming from non-exempt nations have to quarantine for two weeks, but as of 15 December people will be able to pay for a private coronavirus test to reduce their isolation time to as little as five days, as long as they return a negative result. The new “test to release” regime comes after months of lobbying by the struggling airline industry.

Senior executives classed as bringing “significant” economic benefit are understood to include those whose work creates or preserves 50 or more jobs for either an existing UK-based business or a new UK business within one year of their arrival.

Shapps tweeted: “New Business Traveller exemption: From 4am on Sat 5th Dec high-value business travellers … will no longer need to self-isolate when returning to ENGLAND from a country NOT in a travel corridor, allowing more travel to support the economy and jobs. Conditions apply.”

He added: “From 4am on Sat 5th Dec certain performing arts professionals … TV production staff … journalists and recently signed elite sportspersons will also be exempt, subject to specific criteria being met.”

Giving additional detail, the Department for Transport published information on the government’s website stating that from 4am on Saturday “individuals undertaking specific business activity which would deliver a significant benefit to the UK economy – including activity that creates or preserves 50+ UK jobs – will no longer need to self-isolate when travelling or returning from non-exempt countries. Individuals will only be exempt when undertaking the specific business activity and will only be able to meet with others as required by that specific activity.”

It added: “Exemptions will also come into force at the same time for domestic and international performing arts professionals, TV production staff, journalists and recently signed elite sportspersons, ensuring that industries which require specific, high-talent individuals who rely on international connections can continue to complete their work.”

The DfT said Public Health England “do not anticipate these changes will raise the risk of domestic transmission, due to the protocols being put in place around these exemptions, however all exemptions will remain under review.”

All travellers would still be required to show and complete a passenger locator form when arriving, the DfT added.

Source: The Guardian

Senior company executives are among travellers set to be exempt from Covid-19 quarantine restrictions for international arrivals in England, meaning they will not have to self-isolate for up to a fortnight.

Recently signed elite sportspeople, performing arts professionals, TV production staff and journalists will also not have to abide by quarantine restrictions if arriving from a country outside of England’s travel corridor from 4am on Saturday.

https://twitter.com/grantshapps/status/1334543848333332482?ref_src=twsrc%5Etf...

Announcing the move on Twitter, the transport secretary, Grant Shapps, said “high-value business travellers” would be exempt from quarantine rules in an effort to boost the economy, “subject to specific criteria being met”.

It is understood that the exemption will apply to senior company executives, such as directors or their equivalents, either returning or travelling to England who can deliver “significant” economic benefit. They will only qualify for the exemption if their work requires them to be there in person.

Currently, travellers coming from non-exempt nations have to quarantine for two weeks, but as of 15 December people will be able to pay for a private coronavirus test to reduce their isolation time to as little as five days, as long as they return a negative result. The new “test to release” regime comes after months of lobbying by the struggling airline industry.

Senior executives classed as bringing “significant” economic benefit are understood to include those whose work creates or preserves 50 or more jobs for either an existing UK-based business or a new UK business within one year of their arrival.

Shapps tweeted: “New Business Traveller exemption: From 4am on Sat 5th Dec high-value business travellers … will no longer need to self-isolate when returning to ENGLAND from a country NOT in a travel corridor, allowing more travel to support the economy and jobs. Conditions apply.”

He added: “From 4am on Sat 5th Dec certain performing arts professionals … TV production staff … journalists and recently signed elite sportspersons will also be exempt, subject to specific criteria being met.”

Giving additional detail, the Department for Transport published information on the government’s website stating that from 4am on Saturday “individuals undertaking specific business activity which would deliver a significant benefit to the UK economy – including activity that creates or preserves 50+ UK jobs – will no longer need to self-isolate when travelling or returning from non-exempt countries. Individuals will only be exempt when undertaking the specific business activity and will only be able to meet with others as required by that specific activity.”

It added: “Exemptions will also come into force at the same time for domestic and international performing arts professionals, TV production staff, journalists and recently signed elite sportspersons, ensuring that industries which require specific, high-talent individuals who rely on international connections can continue to complete their work.”

The DfT said Public Health England “do not anticipate these changes will raise the risk of domestic transmission, due to the protocols being put in place around these exemptions, however all exemptions will remain under review.”

All travellers would still be required to show and complete a passenger locator form when arriving, the DfT added.

Source: The Guardian
Antonia Noori Farzan - Fri Dec 04, 2020 07:30

In Belgium, having a few people over for Christmas dinner is not necessarily out of the question this year. But only one lucky guest will be allowed to use the bathroom, if the government has any say in the matter.

Belgium has reported more coronavirus-related deaths per capita than any other nation [despite Draconian lockdowns], and a higher rate of infection than all but three other countries. While some restrictions, like the closure of nonessential stores, were lifted Tuesday in time for Christmas shopping, social gatherings are still limited to four people and must take place outdoors.

The four-person rule will apply for Christmas, and authorities are trying to make sure that people who show up for backyard celebrations do not end up spending time indoors.

Anyone inviting guests over needs to have a garden or backyard that can be accessed without walking through the house, which essentially means that people who live in detached homes can have guests over but those who live in rowhouses cannot. “You are not allowed to go through an interior space first, because then there is a risk that many people will be together in a small space,” Interior Minister Annelies Verlinden told Het Laatste Nieuws on Monday.

A spokesperson for Verlinden added another major caveat: Only one guest who is chosen as a “close contact” can be allowed inside the house to use the bathroom. Other visitors are banned from going inside for any reason, including grabbing a drink or food.

“So if you really have to go to the toilet, there will be nothing else to do but return home,” the spokesperson told local media, according to the Brussels Times. [Virus Maos totally not exceeding their authority here.]

The rules are part of the broader shutdown regulations imposed at the beginning of November, which are expected to extend through February. The shutdown also instituted a practice of “knuffelcontacts,” or cuddle contacts, allowing those living alone to have physical contact with one person outside of their household.

As some European countries begin to loosen restrictions following massive spikes in cases and hospitalizations in the fall, Belgium is not the only country where people and businesses have been scrambling to figure out just what is permitted and what is not.

In Britain, the debate over requirements for pubs to reopen has boiled down to the characteristics of a menu item, the Scotch egg, as pubgoers and lawmakers ponder just what constitutes a “substantial meal,” alongside which alcohol can be served under new rules.

Across the continent, countries are trying to ensure Christmas gatherings can proceed in some form, while addressing the concern that heightened travel and gatherings could lead to yet another spike in cases.

Source: The Washington Post

In Belgium, having a few people over for Christmas dinner is not necessarily out of the question this year. But only one lucky guest will be allowed to use the bathroom, if the government has any say in the matter. Belgium has reported more coronavirus-related deaths per capita than any other nation [despite Draconian lockdowns], and a higher rate of infection than all but three other countries. While some restrictions, like the closure of nonessential stores, were lifted Tuesday in time for Christmas shopping, social gatherings are still limited to four people and must take place outdoors. The four-person rule will apply for Christmas, and authorities are trying to make sure that people who show up for backyard celebrations do not end up spending time indoors. Anyone inviting guests over needs to have a garden or backyard that can be accessed without walking through the house, which essentially means that people who live in detached homes can have guests over but those who live in rowhouses cannot. “You are not allowed to go through an interior space first, because then there is a risk that many people will be together in a small space,” Interior Minister Annelies Verlinden told Het Laatste Nieuws on Monday. A spokesperson for Verlinden added another major caveat: Only one guest who is chosen as a “close contact” can be allowed inside the house to use the bathroom. Other visitors are banned from going inside for any reason, including grabbing a drink or food. “So if you really have to go to the toilet, there will be nothing else to do but return home,” the spokesperson told local media, according to the Brussels Times. [Virus Maos totally not exceeding their authority here.] The rules are part of the broader shutdown regulations imposed at the beginning of November, which are expected to extend through February. The shutdown also instituted a practice of “knuffelcontacts,” or cuddle contacts, allowing those living alone to have physical contact with one person outside of their household. As some European countries begin to loosen restrictions following massive spikes in cases and hospitalizations in the fall, Belgium is not the only country where people and businesses have been scrambling to figure out just what is permitted and what is not. In Britain, the debate over requirements for pubs to reopen has boiled down to the characteristics of a menu item, the Scotch egg, as pubgoers and lawmakers ponder just what constitutes a “substantial meal,” alongside which alcohol can be served under new rules. Across the continent, countries are trying to ensure Christmas gatherings can proceed in some form, while addressing the concern that heightened travel and gatherings could lead to yet another spike in cases. Source: The Washington Post
Stephen Matthews - Fri Dec 04, 2020 06:12

The killer flu outbreak is to blame for a 42 per cent spike in deaths across England and Wales, statisticians claim.

Government figures reveal 64,157 people died in January - significantly higher than the death toll of 45,141 recorded in December.

It is the highest number since records began in 2006 - and only the second time it has breached 60,000.

'Circulating influenza' was blamed in the report, released today and compiled using data of deaths from each region.

It showed deaths were higher than levels recorded during the Swine flu pandemic in 2010 - considered the worst outbreak in recent years.

The Office for National Statistics report showed a similar trend in deaths was seen in all nine regions of England and Wales itself.

It read: 'Circulating influenza is likely to be a contributing factor in the high number of deaths registered in January 2018.'

Some 10,011 deaths were recorded in the South East, followed by 8,625 in the North West and 7,110 in the East of England.

At the other end of the scale, 3,503 people died in the North East in January, 3,945 in Wales and 5,401 in the East Midlands.

Latest figures show the flu outbreak has killed at least 271 people, but this is likely to be an underestimate because it only counts for confirmed hospital deaths.

The outbreak, fuelled mainly by an aggressive B/Yamagata strain (Japanese flu) and H3N2 (Aussie flu), has now tailed off.

However, it is currently still more prevalent in England and Wales than it was back in December, when the outbreak began to take off.

Why do deaths spike in winter?

Deaths usually spike in the winter because of the cold weather - which forecasters expect to last for another couple of weeks.

But the last time more than 60,000 people died in a month was January 2015 - when an aggressive flu outbreak triggered a surge of deaths.

Around 16,000 deaths were blamed on the killer virus across that winter. In contrast, only 577 fatalities were recorded in the previous winter.

Not all of the excess deaths this year will be down to influenza, but it is likely to have played a role in a significant amount.

Why was this year so severe?

The rocketing number of flu cases in the UK and across the world was put down to a surge in four aggressive subtypes attacking the population simultaneously.

One included H3N2, which triggered triple the number of expected cases in Australia during the country's winter. It had one of its worst outbreaks on record.

Experts feared the virulent strain could prove as deadly to humanity as the Hong Kong flu in 1968, which killed one million people.

The flu season in the UK and the rest of the Northern Hemisphere tends to mirror what has happened in Australia and the Southern Hemisphere.

The same strains of the virus circulate north in time for the British flu season, which typically begins in November and lasts until March.

However, the UK was also hit by B/Yamagata, which has been blamed for the majority of cases so far this winter.

Its rapid spread has raised concerns because it is not covered in a vaccine given to the elderly. However, experts claim it is less severe.

Usually, just one subtype, of either influenza A or B, is responsible for the majority of cases. The bug spreads easily in the cold weather.

Avoiding detection

Flu viruses are constantly changing proteins on their surface to avoid detection by the body's immune system - making it more deadly.

This transformation is called an 'antigenic shift' if it's large enough, and can lead to a pandemic. This was responsible for the swine flu outbreak in 2009.

Health agencies for each of the home nations monitor 'excess deaths' - how many more people die than expected - to give a rough estimate of flu deaths.

However, Public Health England, Health Protection Scotland and Northern Ireland's Public Health Agency all provide data on how many have died in intensive care.

Deaths have risen to a 'statistically significant' amount across the UK already this winter - and remain above expected in England and Northern Ireland.

Why Was H3N2 Called Aussie Flu? How Australia Was Rocked by the Killer Strain That Spread To UK, US and Europe

Australia - whose winter occurs during the British summer - had one of its worst outbreaks on record, with two and a half times the normal number of cases.

Some of the country's A&E units had 'standing room only' after being swamped by more than 100,000 cases of the H3N2 strain. [That would be 100,000 actual clinical cases, not test positives.]

The elderly with their compromised immune systems were particularly susceptible, and a spike in cases among young children occured.

The flu season in the UK and the rest of the Northern Hemisphere mirrors what that of Australia and the Southern Hemisphere.

The same strains of the virus will circulate north in time for the British flu season, which typically begins in November and lasts until March.

Flu viruses are constantly changing proteins on their surface to avoid detection by the body's immune system - making it more deadly.

This transformation is called an 'antigenic shift' if it's large enough, and can lead to a pandemic. This was responsible for the swine flu outbreak in 2009.

The Aussie flu is transforming quickly, but not fast enough for experts to describe it as a shift. However, it is slowly building up immunity.

Source: The Daily Mail

The killer flu outbreak is to blame for a 42 per cent spike in deaths across England and Wales, statisticians claim. Government figures reveal 64,157 people died in January - significantly higher than the death toll of 45,141 recorded in December. It is the highest number since records began in 2006 - and only the second time it has breached 60,000. 'Circulating influenza' was blamed in the report, released today and compiled using data of deaths from each region. It showed deaths were higher than levels recorded during the Swine flu pandemic in 2010 - considered the worst outbreak in recent years. The Office for National Statistics report showed a similar trend in deaths was seen in all nine regions of England and Wales itself. It read: 'Circulating influenza is likely to be a contributing factor in the high number of deaths registered in January 2018.' Some 10,011 deaths were recorded in the South East, followed by 8,625 in the North West and 7,110 in the East of England. At the other end of the scale, 3,503 people died in the North East in January, 3,945 in Wales and 5,401 in the East Midlands. Latest figures show the flu outbreak has killed at least 271 people, but this is likely to be an underestimate because it only counts for confirmed hospital deaths. The outbreak, fuelled mainly by an aggressive B/Yamagata strain (Japanese flu) and H3N2 (Aussie flu), has now tailed off. However, it is currently still more prevalent in England and Wales than it was back in December, when the outbreak began to take off.

Why do deaths spike in winter?

Deaths usually spike in the winter because of the cold weather - which forecasters expect to last for another couple of weeks. But the last time more than 60,000 people died in a month was January 2015 - when an aggressive flu outbreak triggered a surge of deaths. Around 16,000 deaths were blamed on the killer virus across that winter. In contrast, only 577 fatalities were recorded in the previous winter. Not all of the excess deaths this year will be down to influenza, but it is likely to have played a role in a significant amount.

Why was this year so severe?

The rocketing number of flu cases in the UK and across the world was put down to a surge in four aggressive subtypes attacking the population simultaneously. One included H3N2, which triggered triple the number of expected cases in Australia during the country's winter. It had one of its worst outbreaks on record. Experts feared the virulent strain could prove as deadly to humanity as the Hong Kong flu in 1968, which killed one million people. The flu season in the UK and the rest of the Northern Hemisphere tends to mirror what has happened in Australia and the Southern Hemisphere. The same strains of the virus circulate north in time for the British flu season, which typically begins in November and lasts until March. However, the UK was also hit by B/Yamagata, which has been blamed for the majority of cases so far this winter. Its rapid spread has raised concerns because it is not covered in a vaccine given to the elderly. However, experts claim it is less severe. Usually, just one subtype, of either influenza A or B, is responsible for the majority of cases. The bug spreads easily in the cold weather.

Avoiding detection

Flu viruses are constantly changing proteins on their surface to avoid detection by the body's immune system - making it more deadly. This transformation is called an 'antigenic shift' if it's large enough, and can lead to a pandemic. This was responsible for the swine flu outbreak in 2009. Health agencies for each of the home nations monitor 'excess deaths' - how many more people die than expected - to give a rough estimate of flu deaths. However, Public Health England, Health Protection Scotland and Northern Ireland's Public Health Agency all provide data on how many have died in intensive care. Deaths have risen to a 'statistically significant' amount across the UK already this winter - and remain above expected in England and Northern Ireland.

Why Was H3N2 Called Aussie Flu? How Australia Was Rocked by the Killer Strain That Spread To UK, US and Europe

Australia - whose winter occurs during the British summer - had one of its worst outbreaks on record, with two and a half times the normal number of cases. Some of the country's A&E units had 'standing room only' after being swamped by more than 100,000 cases of the H3N2 strain. [That would be 100,000 actual clinical cases, not test positives.] The elderly with their compromised immune systems were particularly susceptible, and a spike in cases among young children occured. The flu season in the UK and the rest of the Northern Hemisphere mirrors what that of Australia and the Southern Hemisphere. The same strains of the virus will circulate north in time for the British flu season, which typically begins in November and lasts until March. Flu viruses are constantly changing proteins on their surface to avoid detection by the body's immune system - making it more deadly. This transformation is called an 'antigenic shift' if it's large enough, and can lead to a pandemic. This was responsible for the swine flu outbreak in 2009. The Aussie flu is transforming quickly, but not fast enough for experts to describe it as a shift. However, it is slowly building up immunity.
Source: The Daily Mail
Siegfried Mortkowitz - Thu Dec 03, 2020 21:00

Originally ran early last month.


Slovakia has just pulled off a feat that no other country has managed: It has tested almost its entire teen and adult population to find out how many are infected with the coronavirus.

The answer, Prime Minister Igor Matovič said Monday, is 1.06 percent.

A total of 3,625,322 Slovaks over the age of nine were given antigen swab tests over the weekend, with 38,359 testing positive. The number tested represents 95 percent of the targeted population of about 3.8 million.

The idea is that a negative test result exempts people from the curfew imposed this week and allows them to enter shops, provided they show the result.

“This will be a significant step for all of Slovakia on how we can win the fight against COVID-19,” Matovič said, describing the approach as an alternative to a hard lockdown.

“It means we don’t have to kill the economy," he said. "This is a smarter solution.”

It was the first such mass testing project carried out by a country of Slovakia’s size. Other nations will be watching to see if this strategy can be effective in slowing the spread of the virus and limiting its economic damage.

Slovakia has seen the number of daily infections and COVID-19-related deaths soar in the past months, after being largely spared in the first wave. [Ie the virus is going to do what the virus is going to do, but on its own schedule, in a flu season of its picking.]

Infection rates began to rise rapidly in August and September, with thousands of new infections detected daily, reaching a high of 3,363 on October 29. As of Sunday, when Slovak labs detected 1,883 positives, the country had recorded 61,826 COVID-19 infections and 219 deaths attributed to the virus.

More than one-quarter of the total number of infections and deaths were recorded over the week of October 25 to 31.

Some 40,000 medics, soldiers, firefighters, police, local administrative employees and volunteers helped carry out the testing, which was performed at about 5,000 sites around the country. The tests were free and voluntary, but those who refused to be tested will have to self-isolate for 10 days in their homes.

Matovič went on Facebook late Sunday to thank those who took part in the project, writing: “You did it and without you this little big miracle could not have succeeded.”

In the run-up, the project had some prominent detractors, including President Zuzana Čaputová, who asked to have the testing delayed because of a lack of medical staff. However, on Sunday she took to Facebook to call the project a success.

Others questioned the decision to use the antigen swab test, which has had its accuracy questioned by studies in The Lancet and elsewhere. Some infectious-disease experts had warned that the project was a risky public health decision and could undermine public trust in measures to control the pandemic.

Source: Politico

[caption id="attachment_39319" align="alignnone" width="937"] Look at all this freedom!![/caption] Originally ran early last month.
Slovakia has just pulled off a feat that no other country has managed: It has tested almost its entire teen and adult population to find out how many are infected with the coronavirus. The answer, Prime Minister Igor Matovič said Monday, is 1.06 percent. A total of 3,625,322 Slovaks over the age of nine were given antigen swab tests over the weekend, with 38,359 testing positive. The number tested represents 95 percent of the targeted population of about 3.8 million. The idea is that a negative test result exempts people from the curfew imposed this week and allows them to enter shops, provided they show the result. “This will be a significant step for all of Slovakia on how we can win the fight against COVID-19,” Matovič said, describing the approach as an alternative to a hard lockdown. “It means we don’t have to kill the economy," he said. "This is a smarter solution.” It was the first such mass testing project carried out by a country of Slovakia’s size. Other nations will be watching to see if this strategy can be effective in slowing the spread of the virus and limiting its economic damage. Slovakia has seen the number of daily infections and COVID-19-related deaths soar in the past months, after being largely spared in the first wave. [Ie the virus is going to do what the virus is going to do, but on its own schedule, in a flu season of its picking.] Infection rates began to rise rapidly in August and September, with thousands of new infections detected daily, reaching a high of 3,363 on October 29. As of Sunday, when Slovak labs detected 1,883 positives, the country had recorded 61,826 COVID-19 infections and 219 deaths attributed to the virus. More than one-quarter of the total number of infections and deaths were recorded over the week of October 25 to 31. Some 40,000 medics, soldiers, firefighters, police, local administrative employees and volunteers helped carry out the testing, which was performed at about 5,000 sites around the country. The tests were free and voluntary, but those who refused to be tested will have to self-isolate for 10 days in their homes. Matovič went on Facebook late Sunday to thank those who took part in the project, writing: “You did it and without you this little big miracle could not have succeeded.” In the run-up, the project had some prominent detractors, including President Zuzana Čaputová, who asked to have the testing delayed because of a lack of medical staff. However, on Sunday she took to Facebook to call the project a success. Others questioned the decision to use the antigen swab test, which has had its accuracy questioned by studies in The Lancet and elsewhere. Some infectious-disease experts had warned that the project was a risky public health decision and could undermine public trust in measures to control the pandemic. Source: Politico

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