Len Zwelling

In The New York Times on February 7, Ezra Klein writes about the key missing ingredient in America’s response to the coronavirus pandemic—trust. We don’t trust the government and we don’t trust each other. Countries with greater trust ratings did better in the pandemic, particularly in Asia (Japan, South Korea, and Singapore).

Trust was undermined almost immediately in the US. First, we didn’t need masks, then we did. Then schools were closed down for unclear reasons and people had to work from home. We were disinfecting our groceries when it turned out this virus was transmitted through the respiratory route, not on surfaces. Then there’s the whole question of vaccine mandates which probably would have been better handled by not needing them because the case for vaccines was effectively made by the CDC and NIH which obviously did not happen. Oh, they tried, but it didn’t work. Many did not trust the government.

This blog has been a strong supporter of any person affirming his or her or their gender identity. That’s not the issue for today. The issue is athletic competition and most specifically the case of Lia Thomas, the swimmer from the University of Pennsylvania who used to be on the men’s swimming team there and now competes as a woman after her gender transition. When Thomas competed as a male, she was ranked 462. Now, competing as a woman, she is number 1 with a bullet, setting records in meets regularly. Is this right?

It is now common knowledge that American-born freestyle skier Eileen Gu (aka Gu Ailing) won a gold medal in the big air event in the Beijing Winter Olympic Games. The problem is that they she won the medal competing for the host country because her mother is a native of China and she says:

“Because they (meaning China) understand my mission is to use sport as a force for unity, to use it as a form to foster interconnection between countries.”

Hmmm. I guess that is in the Olympic spirit, but scratch a little deeper and some troubling things emerge.

In The New York Times on February 4, the podcaster and author Roxane Gay goes to great lengths explaining why she has removed her popular podcast from Spotify in solidarity with Neil Young and Joni Mitchell. The great Canadian musicians removed their music from the world’s most popular streaming service in protest over Spotify’s continued support for “The Joe Rogan Experience,” another podcast that has promoted Covid misinformation through its giving a forum to vaccine deniers and others whose harmful ideas can lead to preventable illness and death. Spotify and Rogan have countered with pledges to make sure accurate information is posted prior to the airing of misinformed views and to include more varied opinions. The question is: is that enough? Young and Mitchell think not. Neither does Gay.

I think it was about 2003 when it began. Members of my staff housed in the oldest part of the Pink Palace (the original MD Anderson building) began having upper respiratory symptoms–coughs, mucous discharges and breathing problems. My Associate Vice President at the time was among those affected. She called in Environmental Health and Safety and after at least two if not three tries, the environmentalists determined that the duct work in our part of the building was disintegrating and the particulate matter being extruded from the ducts was making people ill.

I adore The Wall Street Journal and often agree with its politics, but the editorial that led the Journal’s editorial page, Review & Outlook, on Monday January 24 misses the mark completely.

The Journal calls the Centers for Medicare and Medicaid Services (CMS) a “death panel” for being unwilling to pay for a new class of Alzheimer’s drug that was given accelerated approval by the FDA recently despite the advisory board’s recommendation not to do so. While it may be true that these new agents like Aduhelm decrease the amyloid in the brains of people with Alzheimer’s, they have not been conclusively shown to alter the course of the disease or the decline in cognitive function of its victims. Thus, CMS will pay for the drug IF the recipient is on a clinical trial—one that is randomized between drug and placebo. This is exactly as should be the case with a drug given accelerated approval. That approval basically says we need more data to know if this really works, but since it might and the target disease is one desperately needing treatment, a randomized, placebo-controlled trial is the best way to do it.

On Saturday, January 22, two opinion pieces appeared in The New York Times that comment on the effects of politics on the health of Americans.

In the first by Cecile Richards, the former president of Planned Parenthood and daughter of Ann Richards, she notes her regret on what she believes is the eve of the end of Roe v. Wade freedom for women to control their reproductive rights. Her regret is that she underestimated the degree to which the opponents of Planned Parenthood in the Republican Party would go to overturn Roe. I feel her pain. While I respect the viewpoint of the pro-life camp, the consequences of overturning Roe are just too dire. Back-alley abortions will return and women will die for lack of access to safe pregnancy termination. I understand the need for revisiting the time frame when legal abortion should be allowed, but 6 weeks is ridiculous and the fact that the enforcement of the Texas law is supposed to be via ratting on your neighbor is absurd.

In a recent discussion with a blog reader, the question arose about the value of the vaccination mandates being forwarded by the Biden Administration and the courts’ seeming unwillingness to go along. In the course of that discussion, the polio vaccine question arose as well. In 1954, was the Salk vaccine mandated? Answer, it didn’t have to be. People couldn’t get the stuff into their kids’ arms fast enough. I still remember being taken downtown to Bridgeport, Connecticut to get my first shot. I stood in a long line with many children who were brought there by anxious parents to try to stave off the threat of a crippling disease. No one had to encourage anyone to get the shot and there were no protests that I recall. Yes, there were adverse side effects, but this predated the existence of Institutional Review Boards and detailed protocols for clinical research, not to mention the FDA’s authority over the effectiveness of vaccines. Why is it so different now?

In a word—trust.

When Saddam Hussein moved into Kuwait and declared it part of Iraq, then President George H. W. Bush moved into action. He coalesced the world against Hussein (because he uniquely could) and mobilized the United Nations to declare Hussein’s actions intolerable. Then he did one more important thing. He backed up all the talk with action and drove Hussein out of Kuwait and back into Iraq using the American military. Then, he went home.

Why isn’t the same being considered when it comes to Russia’s actions in the Ukraine?

In a word—oil. Kuwait had it. We needed it. Not so with the Ukraine. Russia is the one with the energy needed in Europe, especially in Germany.

Autocracy is basically a system of government under the control of a single person. China, Russia and Iran are all autocracies despite having the trappings of representative leadership, like meaningless parliaments. There is no shared governance in these places and the boss doesn’t consult with anyone when he wants to do something—like invade the Ukraine, or Taiwan, or Israel.

This poses a real problem for the United States which is anything but an autocracy. It’s supposed to be a republic (not a democracy) with representative government, an elected President, elected congresspeople and federal justices appointed by the executive and approved by the legislature. In essence running an autocracy is far more efficient than running a representative government and decisions can be made faster in the former, but it’s no way to run a government if the people’s will is to be considered in important decisions. This puts our current national leadership in a bit of a bind.