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MunoRN

MunoRN

Critical Care
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  1. MunoRN

    ISideWith 2020 Political Quiz

    I'm 67% "transhumanist". Not sure what that means. Although in answering many of the questions I'm sure my answer was lumped in with folks that I hold opposite view from. For instance, not everyone who opposes the measures put forward by Obamacare oppose those measures for the same reasons, many of those in that "opposed to Obamacare" group oppose it for completely opposite reasons.
  2. MunoRN

    Justice Dept. Drops Case Against Michael Flynn

    The "phony scandal" argument seems dependent on the person believing it having no idea what triggered the investigation, which was that multiple members of Trump's campaign and incoming administration were acting as unregistered agents of the Russian government and/or Putin-tied interests. These facts don't seem to be disputed, but instead ignored by those pushing the 'phony scandal narrative. Your article makes no attempt to dispute the material basis of the investigation, if you disagree with it yourself then feel free to elaborate. To start, Trump hired a campaign manager who was already known to be a paid promoter of Russian interests, although as the investigation discovered, what we knew at the time he was made campaign manager was the just the beginning. Then there was Carter Page, who while also a member of the Trump campaign was acting as an unregistered agent for the Russian government, and had met with Russian government and Putin-linked individuals. The allegations made against him were the main basis for claims that the Steele Dossier was not accurate, although it then turned out that the allegations against him were shown to be true. Then there's Flynn, also simultaneously part of the campaign and incoming administration while acting on behalf of the Russian government. Then there's Rick Gates, Trump's odd pro-Russian stance, etc. Taken together, I don't see how any rational person can argue there was no basis for any investigation, but feel free to try.
  3. MunoRN

    The President Donald Trump Thread

    Taken out of context you're correct that it seems like he simply lied, although the remainder of the "more than circumstantial evidence" quote was this: ""I don’t want to go into specifics, but I will say that there is evidence that is not circumstantial and is very much worthy of investigation, so that is what we ought to do,” Schiff said." Whether there was enough evidence to be "worthy of investigation" isn't really debatable. We had already known that Russia was actively meddling in our politics, and the incoming Presidential administration included at least four people who were acting as unregistered agents of foreign countries, including Russia. Not to mention a President who openly welcomed Russian political assistance. If there's been a murder and somebody is at the scene of the murder covered in blood and talking about how much they like to kill people, it doesn't seem unreasonable to investigate them.
  4. MunoRN

    The President Donald Trump Thread

    The law is pretty clear that it's the federal governments job to maintain our strategic PPE stockpile. Trump has claimed, correctly, that Obama failed to fill the 'cupboard' during his term, which means Trump also failed to do so for three years. So based on his argument; that it should have been filled whether there was an imminent pandemic or not, then it shouldn't have mattered whether he believed coronavirus was an imminent threat at the time.
  5. MunoRN

    The President Donald Trump Thread

    He told the same lies to Pence, did Pence set him up? Was Pence actually part of 'a corrupt Obama administration'. Flynn was under investigation because he had repeatedly failed to disclose foreign contacts, including contacts with the Russian government, ie for lying. Asking him questions about his foreign contacts to see if he would lie about them wasn't a "set up", it was what they were investigating. They didn't trick him into lying, nor did they arrange for this contacts to occur to then put him in the situation of having to lie about them. ,
  6. MunoRN

    President Trump National Scandal

    As the father of 3 young kids I can tell you that no parent out there got excited about the idea of a 5 month summer break. And between being a critical care nurse in an area hard-hit by Covid and being a parent of kids right now, it's being a parent during social distancing that is by far the hardest. There's not actually any reason why people shouldn't be leaving there homes, it's the potential exposure to viral transmission that's the issue and that doesn't rise to a level of unacceptable risk just by stepping out your front door. Letting kids socialize, which is arguably vital to their health, is challenging to be sure. But as both my County Health Department and State Department of Health recommend, kids should still be having 'play dates', although with some considerations. Kids should have a defined smaller circle of friends and that circle shouldn't overlap into other play date circles, but they should still be having play dates with other kids.
  7. MunoRN

    President Trump National Scandal

    I have no problem with him being "salty as a sailor", and while that's a separate issue of annoyance for many, it's the substance of his policy and leadership (or lack thereof) that people have a problem with. LBJ was by far the most crude and "salty" President in recent history, aside from frequent salty language, he was known to enjoy showing others his male member, when having a conversation with someone in the oval office he would insist that the staffer, journalist, congressperson, etc accompany him into the bathroom so they could carry on their conversation uninterrupted while he pooped, he also once stripped naked during a press gaggle on Air Force One because he said it was hot. Despite all of that, his political resume is commonly viewed separate from his personality 'quirks'. I don't think Trump is held to a different standard, although to deflect from his political resume Team Trump is quick to suggest any criticism of him politically is just because people find him uncouth, rather than try to debate the substance of his presidency. I notice that when Trump supporters try to list his successes, those examples become extremely vague, as though they're taking Trump's word for his claims of successful leadership without feeling the need to evaluate that for themselves. It's like if my all-too-trusting grandma told me excitedly about how a used car dealer got her trade her brand new Mercedes for a used Yugo and how much she benefitted from this trade because the used car salesman told her how much better it was to have a used Yugo and she took his word for it. Trump defined what a successful Presidency would look like for him prior to taking office, just objectively he hasn't gotten anywhere near that definition, so I'm not sure what there is to be excited about, except that Team Trump told you that you should be excited, enjoy your Yugo I guess.
  8. MunoRN

    President Trump National Scandal

    Considering the president was promoting cleaning patients lungs with disinfectant I'm not sure that the problem is nurses not staying in their lane, so to speak. I agree that nurses need to be careful when making purely political statements as part of their nursing role, but I dont think its correct that promoting basic public health concepts, like the need to flatten the curve, are outside the role of any nurse. I would agree there is a nuanced debate to be had about how to balance the need to manage the extra burden we're placing on nurses while not disrupting people's lives more than is really necessary, but there hasn't been much of any nuance in the positions these protesters have been taking. As long as these protesters are effectively volunteering nurses to get even more slammed, nurses clearly have the right to reply.
  9. MunoRN

    Covid Pandemic Plan 2.0, What's next

    Obviously, not a popular conclusion. And I'm still not clear how having exponentially more people die from this virus by letting it cycle through the population for years is better than far fewer deaths from a coordinated inoculation event. https://www.mediaite.com/politics/harvard-law-prof-laurence-tribe-under-fire-for-apparently-suggesting-mass-coronavirus-infection-and-death-to-solve-pandemic/ So outside of a vaccine, how else does this end?
  10. MunoRN

    The President Donald Trump Thread

    To clarify (read: I'm bored and feeling argumentative), most of the actions on that list are actions of the states, not federal government. Managing, ie "streamlining" the UI application process is done by the states, not the federal government, there are states that have prohibited evictions of renters, the federal government has not, UI coverage for the self-employed is up to individual states, etc... anyway, carry on.
  11. MunoRN

    Covid Pandemic Plan 2.0, What's next

    I tell you what though, I don't know how much my word means but I promise to only criticize Trump's actions and statements based on the actions and statements themselves, not by the person doing or saying them. And I'll argue for any credit he should have coming his way.
  12. MunoRN

    Covid Pandemic Plan 2.0, What's next

    If his claim was that he wanted to start a return to normal by Easter that might have been less sharply criticized than his proposal to fully 're-open by Easter' without offering any sort of coherent plan, but regardless you're correct that there are those who will criticize him no matter what, which is true of every President. There are also those who will defend his actions and views no matter, which is no less problematic. There's a saying in sports that what defines a great referee or umpire is that each team hates them equally, which I think is also true of politics. Good leaders are willing to make well reasoned, well conceived decisions even though there will inevitably be those who criticize that decision. Even though decisions a President makes that will be revered in years to come will inevitably receive at least some amount of criticism at the time, Trump has a hard time coping with any negative feedback at all, which is why his goal has been more to rid himself leadership responsibilities than it is to lead. Take today's "plan". Any plan to start to open things back up hinges on testing and PPE availability. Trump's plan makes PPE supplies the responsibility of states, a direct violation of Federal law which requires that the Federal government is responsible for dealing with our PPE stockpile, and even if it wasn't specifically stated in the law it's really only workable for the federal government be responsible for this given the differences in how States and the Federal government are allowed to tax and spend. Good leaders seek out the best advice, then make the best possible decisions they can and let the criticism roll off your back, Bad leaders avoid and dodge their responsibilities so that they have no decisions to make and no plan can fail if there is no plan.
  13. MunoRN

    Covid Pandemic Plan 2.0, What's next

    The most effective way I can think of for moving past Covid-19 assuming it isn't subject to seasonality and the antibodies created by an infection last as long as other coronaviruses (4 months to a year) is for mass purposeful inoculation. I don't think that's something we'll be able to stomach anytime soon, but the only way knock out a virus with those characteristics is for everyone to have it or be in the immunity window at the same time, which would require everyone to intentionally get it. Otherwise we're potentially looking at an endless cyclical community spread, the problem with that is there's no guarantee people will have the same response every time they become infected, the vast majority will survive a single infection, having it 10 times though is going to significantly increase everyone's chances of having a fatal bout of Covid-19.
  14. MunoRN

    Covid Pandemic Plan 2.0, What's next

    The type of contact tracing used in East Asia and that is being proposed here probably won't work here. Places that have had apparent success with contract tracing, like Hong Kong, have been using mandatory smartphone apps in combination an electronic bracelet. Removal of the bracelet automatically reports you to authorities, as does getting to far from your phone (in case you try to go out without your phone). Since it's possible to avoid the system by just turning your phone off, authorities call your phone at random times twice a day to make sure it's turned on. Aside from the cost, these are collective societies under authoritarian or 'democratic'/authoritarian rule that lend themselves to this sort of system, the US not so much. Also, these systems were used to contain more than mitigate, they really work best when only a very small portion of the population are vectors. It would be difficult to effectively act on this information since there are widely varying circumstances of transmission. The 'close contact within 6 feet for more than 10 minutes' is often quoted but as even the CDC points out, there's no reason to believe this can reliably differentiate contacts at risk for transmission from those that aren't. If an infected person sneezes or coughs in your face (even if they're wearing a mask) then that 5 seconds of contact is more than enough to transmit the virus. And then there's surface vectors which are likely also a mode of transmission. Just because you weren't at the grocery store at the same time or even the same day as an infected person doesn't mean you can't contract their virus by touching something they touched and then touching your face.
  15. MunoRN

    Covid Pandemic Plan 2.0, What's next

    Social distancing and other mitigation strategies still need to be used and restarted when necessary when there is excessive demand on healthcare resources, but there are large swaths of the US where healthcare resources are far from being overwhelmed. If our current efforts were likely to actually reduce the number of people who become ill with CV then that would be a different argument, but that's unlikely, all we're doing is manipulating the timeline of infections, so if large parts of the country are ready deal with unavoidable infections there doesn't seem to be much reason to prolong that process. There are certainly patients for whom ICU care can potentially make a difference, but a large portion of the burden on ICUs has been patients that we now know are medically futile for aggressive treatment, so more appropriate plans of care can significantly reduce the need for ICU beds, even in places hard hit.
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