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MunoRN

MunoRN

Critical Care
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  1. MunoRN

    The President Donald Trump Thread

    There's a reason Trump's HHS recognized Colorado and the other states that have moved to vote-by-mail-only as having the most secure elections in the country, there's been no evidence that in multiple elections since these states moved to vote-by-mail as the only way to vote of a resulting "mess" . I get your stop sign argument; we can't measure the rate of occurrence of the things we don't know occurs, but in the case of mail-in voting a better analogy would be the accuracy of the number of drivers who roll through a stop sign where there is a rolling stop sensor and a camera. It seems as though people assume mail-in-voting consists of just sending blank ballots with no security measures in place, so that you could just go around and take them out of people's mailboxes and use them to successfully vote on their behalf. These systems utilize ballot tracking (which include a buffer between your identity and your vote) which can determine if a ballot was cast by a person who reports they never received a ballot and can the cancel that ballot, you also have to match the signature of the voter that is on record in the system. The nature of vote-by-mail also limits the potential types of voter fraud like voting outside of the district where you currently reside, or voting in multiple districts. There are certainly limitations to the security of this system but not nearly as many issues as with in-person voting. The concerning actual reason behind Trump's latest push to delegitimize the premise of democratic elections is that he'd prefer to trade the foundations of democracy for staying in power.
  2. MunoRN

    President Trump National Scandal

    Temperature screening is of little, if any, use in screening for Covid-19. Not all patients with Covid-19 will be found to ever have a fever, and of those who do they have a fever for a small portion of the time that they are contagious, less than 5% of the time according to our IP department.
  3. MunoRN

    President Trump National Scandal

    I have no disagreement with the Doctors' concerns, I dont think that generally there is any belief that these issues aren't adverse consequences of mitigating the transmission of a pandemic. I also dont think there is much of any disagreement that we should alleviate these adverse consequences as soon as doing so results in more benefit than harm. Where I disagree with the letter is the assumption that these adverse consequences aren't already part of the calculus that is guiding the reopening process that has already been underway.
  4. MunoRN

    President Trump National Scandal

    The group you referenced isn't advocating for "mitigation efforts AND start to reopen more businesses". They are advocating for a full and immediate stop to all mitigation efforts. Reopening and scaling back mitigation efforts in a reasoned and methodical manner is what is already happening, this is what they oppose. It should be noted this particular group is the result of a concerted effort by the Trump campaign to form a "Pro-Trump" group of Physicians, that they only managed to round up about 600 Pro-Trump Physicians out of the nearly 1 million Physicians in the US is telling. To their points, there doesn't seems to be a general view that there aren't adverse effects that result from mitigating the spread of the virus, we're all in agreement on that point. I have three young kids, I'm well aware of the effects closing schools has on them, although I don't agree with this group that there would be less harm by reopening schools now given the well established ability for highly transmissible viruses to spread through a community through children in school. I think we all also agree that people have been avoiding hospitals due to the virus, in which case the best way to address that would seem to be what we're already doing, public awareness campaigns of the need and relative safety of continuing to seek medical care when needed. I'm not sure that this group has really thought through how an inappropriately accelerated reopening would affect this problem. People are reluctant to go the hospital now, but what happens when hospitals are actually overburdened, what happens when we're back to crisis standards where we're no longer treating really sick patients but rather switching them to comfort care, not because it's the appropriate choice but because with the resources it would take to help them would could help 4 or 5 other patients. What happens when we're back to treating patients in tents in the parking lot. You don't think that reality would cause people to avoid hospitals at least as much as they do now if not more?
  5. MunoRN

    President Trump National Scandal

    There are no doubt inaccuracies in the number of reported deaths due to COVID-19, although it appears extremely unlikely that we've overcounted rather than undercounted. While there probably are examples of deaths that were attributed to COVID-19 that weren't this example is highly questionable, which is likely why the State health department disagrees with the coroner. The coroner's claim is that a blood alcohol level of greater than 300 mg/dl is fatal, which is objectively false. In non-alcoholics, a level of 400 has the potential to be fatal (per UpToDate) but they also note that in those with severe alcohol dependence a level of 300-500 mg/dl often will not even produce outward signs of intoxication, this is just the level required to prevent withdrawl symptoms. I had an admit just yesterday who's alcohol level was 260 mg/dl after having a withdrawl seizure, which certainly isn't unheard of in alcoholics. So the coroner's argument is that a blood alcohol level of over 300 mg/dl will result in death from alcohol toxicity in every patient is a bit silly.
  6. MunoRN

    President Trump National Scandal

    Is she the one saying that or was it Governor DeSantis attempting to speak on her behalf? Following the comments that DeSantis tried to claim she told her supervisor were misrepresented, she stated she was terminated because she refused to "manually change data to drum up support for the plan to reopen". So it doesn't appear as though it's the media that is misrepresenting her statements. The State itself doesn't appear dispute her claims, stating she was terminated for refusing to abide by the input of her supervisors as to the data that should be going into the dashboards. The way these tracking tools work is that they consolidate data reported by local health departments, if 'scientists' at the State level disagree with the data then the appropriate way to document that would be to add their views to the dataset in the form of addendums and qualifiers, altering the raw data itself to appear different than what it actually is isn't appropriate.
  7. MunoRN

    President Trump National Scandal

    When you seem perplexed as to why we might think you dont support current mitigation efforts, this is why.
  8. MunoRN

    President Trump National Scandal

    The "her statements were misrepresented" explanation only existed for part of the day on Monday, by Tuesday his office had admitted that she was indeed fired.
  9. MunoRN

    Justice Dept. Drops Case Against Michael Flynn

    I know the Fox news story on the interview with the WaPo reporter who discussed their coverage of the story left this part out, by accident I'm sure, but if you read the transcript of the interview they're referring to you'll find that what they were 'divided' about was that they only knew the calls had taken place, they didn't know the content of the calls, and they couldn't determine if the calls were benign; just a cordial introduction prior to taking office, or more scandalous, with the specific example being if they had discussed the newly imposed sanctions. Of course we now know they had discussed the sanctions. Both the NSA and FBI define a "compromised" person as someone who a foreign power has information on that could, for instance, get them fired. We don't have to wonder if the Russian's knowledge that Flynn had lied about the Kislyak meant they had information that could get him fired, since it did indeed get him fired. The unmasking request occurred a week and a half after the call that triggered the report in question. I would agree it would seem unusual if the request was a year or two after the report, but this isn't an unusual timeframe for such a request to occur. You're free to offer what in the Steele Dossier has been disproven. It's main claims were that Russia was behind the DNC server hack (multiple US intelligence agencies have come to this conclusion) and that people associated with the Trump campaign were aware of Russia's involvement (a Trump staffer admitted this to a foreign diplomat). It also centered on Page, who the report claimed had travelled to Russia in the beginning of July (he did) and had met with Sechin and Diveykin (he admitted to this under oath). Mainly, I'm not sure how I'm supposed get worked up about Biden making an unmasking request as a supposed attack on a political opponent when that information came about due to declassifying and leaking to the press the list of unmasking requests, as a fairly obvious attack on a political opponent. And this is all in the context of what now defines what rises to the level of justifying an investigation into political dirty tricks. Trump illegally withheld funds, funds meant to protect our interests and national security, to leverage a personal political favor, the resulting investigation that was then defined as a "hoax" by Trump and his supporters. If that's not a big deal then why would this be?
  10. MunoRN

    President Trump National Scandal

    We should be aiming for the least damaging economic impacts we can obtain, which is completely dependent on how well we mitigate the spread and effects of the disease. Being unnecessarily aggressive with mitigation certainly can harm the economy and jobs, although it's a bell curve; failing to adequately mitigate can be far more harmful to the economy. My business, a restaurant, is completely dependent on effective mitigation. That doesn't mean mitigation doesn't effect my business, I'm not doing as well as if I could still have a packed restaurant. But I need staff and customers that aren't sick or dead to do well even with just carry-out only. I need the spread to be reasonably well contained for people to feel safe even just picking up food. I need my suppliers as well. It doesn't take all that much more of a rate of transmission for me to lose some of these links in the chain that keeps it going.
  11. MunoRN

    President Trump National Scandal

    The fact that it is more transmissible that we had initially thought is not good news. It would be good news if this were a type of virus where the person develops T-cell immunity after an infection, but Coronaviruses produce B-cell immunity with antibodies typically only providing immunity for about 4 months to a year at best. And regardless of the percentage infected, it doesn't change that we've had more than 80,000 deaths in only two months due to COVID-19. Whether that's 80,000 out of 80,000 infections or 80,000 out of 300 million infections, it's still about 40k deaths per month in total.
  12. MunoRN

    Justice Dept. Drops Case Against Michael Flynn

    I've seen it, I'm not sure what you find so impressive. Basically, she was asked the same question that the President and others have not yet been able to answer, which is to explain the basis of the "Obamagate" claim. Her answer was essentially, "I have no idea but the President really wants this to be a thing, so we were hoping the media could come up with an explanation, here's some vaguely bad sounding things that point to nothing specific to get you started. The only specific examples she gave was a reference to the "unmasking" list, although these were common and not-unusual 'unmasking' requests made to the NSA, there's not actually anything illegal or improper about it. What was problematic was that someone leaked that information to the press, and that person should be prosecuted, although that goes down a dangerous road for the Trump administration, one of the leakiest in recent history. The other was a two-fer; that the Steele Dossier was "bogus", all the information in the dossier that is so far verifiable has been verified as correct, and that it was the basis for the start of the investigation and/or a FISA application, the investigation started after a Trump staffer revealed to a foreign diplomat that Russia was in possession of material damaging to Clinton, and Page's FISA warrant was based on reports that he had travelled to Russia in July of 2016 (there was a video of his visit posted to youtube the day after he arrived) and had meet with Russian officials (he publically admitted to this).
  13. MunoRN

    Justice Dept. Drops Case Against Michael Flynn

    I'm not sure where you're getting your "most realize there was not" a legitimate basis for an investigation claim from. The IG report found sufficient basis, and in even conservative leaning polls there were only a minority of people who didn't agree there was sufficient basis for the Russia investigation. The investigation into Flynn that was nearly closed when it was discovered he had conversations with Kislyak was into his payment from the Russian government for making an appearance with Putin, then it was discovered that he was undermining US foreign policy in his discussions with Kislyak and on top of that had lied to Pence and Spicer about the conversation. US intelligence intercepted conversations between Russian operatives about how to take advantage of the fact that Flynn was now compromised and susceptible to blackmail. And keep in mind that Flynn was just one of a number of Trump staff with shady dealings with Russia. So what particular part of that is not worthy of investigation, do you disagree that Flynn spoke with Kislyak? Was he not compromised? Is having a National Security Advisor who can be easily blackmailed not something we should be concerned about? This doesn't seem to be a gray area.
  14. MunoRN

    President Trump National Scandal

    If I remember right, the Stanford researcher article you're referring to was that infection rates have been higher than previously thought, how do you feel that means this isn't as bad as previously thought? If being 'overwhelmed' isn't based on capability to appropriately care for patients then what are you basing that on? As of the middle of April, there were 19 hospitals that were reporting a less-than-one-week supply of PPE, and that's based on "crisis capacity" standards which already involves utilizing PPE in ineffective ways. I'm not sure how when a hospital reverts to 'crisis capacity' procedures that this doesn't mean they are overwhelmed. While many hospitals were overwhelmed at least by the CDC's and OSHA's definitions, you could argue that many hospitals were pushed thin but not over the edge, and that's with mitigation efforts, so that means we don't need mitigation efforts because the goal is to more thoroughly overwhelm hospitals? What level of over-capacity should we be aiming for?
  15. MunoRN

    Justice Dept. Drops Case Against Michael Flynn

    I'm not sure how it makes sense to make an argument based on the premise that there wasn't legitimate basis to investigate (well established) ties between members of Trump's campaign and Russia-linked operatives and then claim you don't want to justify that claim because you "don't want to revive old arguments". It can't be your current argument and also an "old argument" you don't want to talk about at the same time.
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