Showing posts with label Dr. Tara Narulla. Show all posts
Showing posts with label Dr. Tara Narulla. Show all posts

Thursday, April 16, 2020

Why Holman Jenkins & His WSJ Wrecking Crew Want To Get You Back To Work Prematurely





In  what Janice calls "Americans' last IQ test"  we beheld Capt. Bonespurs bellowing about getting the U.S. economy open before May.  Fortunately, the CEOs of major companies in a meeting with the imp pushed back, saying 'Whoa! We need lots more testing first!"  This echoes Dr. Tara Narulla's warning this a.m. - to those who have ears to listen and a brain to process: 

"We need tests to be ubiquitous, efficient and to have a rapid turnaround time.  Without that we're really flying blind - and it's not just a question of opening the economy but keeping the economy open. If we can do that and fix the problems on the supply side then hopefully we can reopen the economy and keep it open."

Clearly, Dr. Tara gets it - like nearly all medical specialists and especially the epidemiologists.  She gets that the economy cannot be prematurely opened - without enormous viral blowback  i.e. until an effective mass testing program is underway. This is one which can test 20 % or more of the population, as opposed to the barely 1 percent thus far.  But while she gets it, and millions of Americans do as well, we behold a build up of  irrational impatience in a number of places, from Vegas to Lansing, Michigan, even as the mitigation is beginning to work.  For example, we saw last night and this a.m parading Tea baggers holding 'Don't Tread on Us!' signs as well as others with 'Liberty once lost is lost forever' signs.  Hey, Trumpista dolts, how about your life once lost is lost forever?  Then you won't have to worry about any income, period!

Meanwhile, Vegas' mayor Carolyn Goodman belched out: "This shutdown has become one of total insanity!"  Uh no, my dear mayor lady, it's become an effective means to prevent Vegas' hospitals from overflowing with Covid patients.   But lest we come down too hard on these minor leaders like Goodman - or South Dakota's  clueless governor Kristi Noem (who refuses to shut down despite one of the biggest clusters in the nation) or the hoi polloi screaming protests for "taking their liberties", let's look further afield at the real culprits.  The brigands in media - mainly reactionary right trolls - who keep feeding these memes- energizing the "revolt of the dummies" to borrow J's parlance.

Start with the WSJ editorial scribes themselves (i.e. 'It's Still America, Virus Or Not!', April 13, p.  A16) who Joe Scarborough ripped to shreds just two mornings ago, e.g. "Who do these Wall Street  Journal editors think they are?  They yelp about liberals just wanting to feed money to workers instead of going back to their jobs. When they can sit in their nice home offices and not have to worry about getting sick!" 

Of course, though Joe focused on the rush to get back to jobs, the Journal's editors went even further off the deep end in their bogus arguments, ibid.:

"The First Amendment still stops government from prohibiting the free exercise of religion, and still guarantees the right to free assembly."

Incredibly conflating the first amendment and free exercise of religion with the right to assemble cheek to jowl amidst a pandemic..  So with the spread of such deformed and misbegotten memes it's no wonder we have seen as many fellow citizens as we have devolve into stupidity.  It seems, as Janice is wont to say, "in this country the virus of stupidity is as rife as the bat virus."  Well, yeah, ok, I have to agree if we see these Tea Party -like protests continue.

 Then there is the Journal's proudest provocateur and rhetorical bomb thrower, Holman Jenkins Jr. In an earlier (April 7) blog post  I already highlighted his  daft op-ed ('Was Dr. Strangelove an Epidemiologist?')  where he trots out a medical resident named Joseph A. Ladapo (of UCLA) who claimed in a recent op-ed that "the shutdowns if prolonged will only make matters worse."      Adding that even when restrictions are lifted "we will emerge right back where we started.... and no matter what our hospitals will still be overwhelmed."

Says who?  As I observed at the time one was left to wonder where this quack came by that "Eureka" brain fart.  In fact, Jenkins' balderdash was pure propaganda only spun to try to get pressure on the medical community to loosen standards and allow the virus to resume its hatchet job on hospitals, nursing homes, meat packing plants and prisons.  It can't be otherwise, i.e. like Jenkins Jr. really cares because every word he writes (e.g. 'Sweden Is a Viral Punching Bag', WSJ, April 15, p. A15) reinforces the conclusion he's out for one thing: reopening the economy too soon so he can quickly resume his evening dinners of foie de gras and wine.  Most telling in his latest (April 15, ibid.) jeremiad against the medical community:

"When it's all over, academics will look seriously at how the lockdown strategy compares with alternative strategies .  They will ask how much of our apparent curve flattening to date was due to individuals taking precautions, how much to heavy -handed government intervention. How many lives- and more realistically years- were really saved by our efforts?"

Again, the  little Neolib mutt just doesn't get it.   He doesn't get that the core issue is preventing our limited medical system (including in terms of supplies raided by Trump, Jared & Co.) from being overrun. Already in NYC the past two weeks we've beheld a system at the very brink - often with double the number of Covid patients for the ER (or ICU) capacity.  Did Holman see any of this?   The fact that New York's system didn't tip over into chaos was all because of the mitigation efforts which he belittles, suggesting some alternative mode of solutions exists. It doesn't, other than in his febrile mind.

Another crass and cynical aspect of the above quote from Jenkins' piece is the question, 'How many lives- more realistically years- were really saved by our efforts?'  This rhetorical bit and its implication may have been missed by many.  What he means by referring to "years saved" is the fact that older Americans - say in the 70-85 year bracket, don't have that many years of their life left anyway, say compared to young sprats, millennials etc.  Hence, the deaths of older Americans in his quantitative risk vs. benefit view don't count as much toward being "saved", if lost to Covid.  One hundred seniors with maybe two years left each (on average) to live in nursing homes, by his reckoning, adds up to 200 years saved. Compared to 100 millennials with maybe 50 years each left to live.  In this way, Jenkins can pretend to minimize the loss of life, the same way his conservo compadre Bill O'Reilly could when he said of dying seniors in nursing homes, "They were mostly on their last legs anyway."

But look, without any valid cures, treatments or vaccines,  we are all for the high jump anyway, say if the economy is prematurely opened. Especially before widespread effective testing and contact tracing. This is the method we are left with, whether Jenkins Jr. likes it or not. Or his WSJ compadre Daniel Henninger (WSJ, today,'Restore Laissez -Faire Capitalism', p. A13) who insists we need "a bare bones government, not a bare bones economy".   Hey, Henny, how about just bare bones - and skulls - piled up in pit graves across the country? You ok with that, mate?  After all, Henny doesn't want any "security blanket statism " (i.e. 'dirigisme') with workers begging the gov't to  help feed them and their family- say instead of the hedge fund owners ready to tap into the PPP (Paycheck Protection Program).  As revealed by Bloomberg News, most of these hedge fund operations chomping at the bit for cheap, no strings loans, only have four or five employees.   Henny, I am sure, will be fine with that "laissez-faire" giveaway as will Holman Jenkins.

Thus, whisking millions back to work prematurely serves two main purposes for the WSJ's hacks: 1) Disabling any need for the govt' to step in again to send relief checks or expand food stamps etc., and 2) To provide more billions for the rich, the one percent, hedge fund owners, Repuke donors and the like..   As I often say, you can't make this shit up. Out of the mouths of capitalist loons and baboons.

Zeke Emanuel (oncologist and Vice Provost for Global Initiatives at the Univ. of Pennsylvania)- put it in stark terms for the economy über alles  humpers like Jenkins, Henninger et al on the April 6th 'Last Word' :

"Realistically COVID -19 will be here at least for the next 18 months or more.  There will be no normalcy until we find a vaccine or effective medications.   I know that's dreadful news to hear. How are people supposed to find work if this goes on in some form for a year and a half?   Is all this economic pain worth trying to stop COVID-19?

The truth is, we have no choice. Prematurely ending the physical distancing and the other measures, the deaths could skyrocket into the hundreds of thousands if not millions. We cannot return to normal  until there's a vaccine. Conferences, concerts, sporting events, religious services, dinner at a restaurant, none of that will resume until we find a vaccine, a treatment or  a cure."


At the basis of these strategies is the nature of exponential growth for this virus, e.g.

 As described by one knowledgeable WSJ columnist ('The Power of Exponential Growth', p. C4, April 4-5). 

"Exponential growth is dangerous because if each person infects more than one other person, the spread of disease quickly becomes overwhelming. Multiplying by 3 for instance. it only takes 21 steps to reach 10 billion, more than the current population of the world."

 Little Holman would do well to process and remember her words, and he might also avail himself of the recent work of sane WSJ columnist Jo Craven McGinty ('Why The Flu Doesn't Tank The Economy',  April 11-12, p A2) wherein she notes:  "Instead of gentle waves of cases cascading around the country like the flu, a tidal wave of Covid cases has swept across major cities in half the time"

The point being that the R- nought is significantly greater so the rate of transmission is faster. This is a fact any dolt has to master before jumping like a lemming onto the hurry up and re-open bandwagon.  

 Holman needs to process all this (along with his WSJ editors) before he next writes fulsome twaddle complaining about "heavy-handed government intervention".   Nobel winning economist Paul Romer on All In last week posited over 300 million tests were needed nationwide before we can even think of returning to business as usual.  This country isn't even doing one hundredth of such tests per week, so how can there be the most remote hint of reopening? Further, the U.S. federal government "has yet to launch a national test and trace strategy to find and isolate virus carriers" (WSJ, today, p. A9), without which it is sheer madness to reopen.

At minimum, as Prof. Romer indicated to Chris Hayes,  we need at least 4- 5 million tests per week to get a basic idea who's infected, where the virus is. The sad and sorry fact? The U.S. of A. has barely done 3.2 million tests in the past month - so we're way way behind the curve of testing adequacy.  Without that and contact tracing it's a bloody fool's errand to open the country up. Apart from which opening up is not like flicking on a light switch. As Anthony Fauci pointed out to ABC's David Muir in an interview on the news  last night:

"It's gonna be like a rolling re-entry not like a light switch turning on and off.... Also, we do not know everything about this virus and what it's capable of doing. It is also entirely conceivable we will see a rebound of the virus as we get into a seasonal situation, such as next fall or winter."

The other element Jenkins and his team of  greedhead buffoons don't grasp, is that the economy is inextricably bound with the nature of the virus, the pandemic.  "You want to get the economy back? Take care of the virus!"  In the words of Chris Hayes, host of 'All In' last night. Until the problem of the virus is fully solved, there is no way in hell that the economy can come back even in a diluted, weakened state. But try telling or explaining that to those like the Pennsylvania Repukes pushing against Gov. Tom Wolf to open the state up - with one Repuke Mike Turzai- blurting:

"The hurt from the economy is as great as the hurt from the virus, so we need to help both at the same time."

Uh no, dope, you can't "help both at the same time".   The reason is that the economic function -at any level - is contingent on the control of the virus.  That is only achieved with a vast testing and contact tracing program. Do you have that? If no, then you can't open the economy yet.  The worst outcome at this stage would be a second wave of deaths, illness to begin because states let up too soon.   Such a scenario would force an even longer postponement. How hard is this to process?

With inadequate testing there will always be the lurking virus clusters (like in a Smithfield meat plant Sioux Falls,SD because of its inept, dumb governor Kristi Noem) especially with the dearth of proper testing going on now - which ought to have commenced months ago.

On reading Jenkins' propaganda piffle it was also clear to me he doesn't really believe in the idea - better principle, of flattening the curve. This is when he refers to "apparent curve flattening".    But there's nothing "apparent" about it.
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One can see, even if one has zero math skills and couldn't pass a Mensa test if his life depended on it (like Jenkins et al) that flattening the curve is real and is evidenced when the caseloads are less than what we'd see if the hospitals were overwhelmed. As we look to the states where strict mitigation was in force, e.g. CA, WA, we can easily see it works and they've even been able to donate ventilators and staff to the states in the east (NY, NJ etc.). 

Another aspect is that if mitigation is not coordinated simultaneously  for all states, then one would have different curves in succession at different times -  like a wave train.  This is what the US of A is in for,  looking at the red states like TX, SD, etc. none of which have firm shelter in place rules.  That means, logically - as virologist Dr. David Ho has pointed out, the curves for flattening are spread out over time.  Don't fancy the longer wait?   Then blame Trump for his lack of leadership is setting up a coherent national coordination policy!

In the case of multiple curves spread over time, we then have -  instead of one area under the curve to deal with say 'A'  (the area under the green hump above)-   a succession of areas: A1 + A2 + A3 etc. each area extending over the time axis.   That means the flattening process will take much much longer and hence the time to justify reopening the economy will take much longer.  This is what Jenkins and his band of nitwits doesn't grasp.  That includes the likes of ol' Phil Gramm - long time anti-big government gadfly (and former Chairman of the Senate Banking Committee)who in his latest effort ('More Stimulus Would Crush The Recovery',  WSJ, April 15, p. 17)  clearly has no sympathy for the 17-odd million Americans currently without income - other than what the CARES act has provided. And yet this mutt would deny them any more despite that $1200 per person, and extra unemployment cash - will barely last another month - if they are lucky.

What's Gramm's (and co-author's Michael Solon's) answer?   Well, it's to "rely on private capital and initiative and our free enterprise system".   In other words, let the loafers waiting for new handouts get off their butts and figure out - using "initiative" - ways to enhance their cash flow without depending on gov't handouts.  Else, "all this new government borrowing will consume the very oxygen a powerful recovery will need,"

What are Gramm, Jenkins Jr., Solon and the Wall Street Journal editorialists terrified of? Well, a "Depression-esque recovery" demanded by the Democrats in an election year. Which, of course would be horrific given the Democrats "have sought to use the crisis to permanently expand government spending and the role government plays in the aftermath."

Yep, for sure we don't want government providing desperate millions of our fellow citizens a lifeline to survive a few more months - with no money coming in to pay for groceries, utilities, or rent.  The Repuke barbarians would rather let those millions perish in pauperhood than let the federal government extend a helping hand.  The motto of these apes is to "let 'em lift themselves by their own bootstraps or pound sand."

Hence, the Scrooge aspects of so many of the "solutions" proferred, from raiding their own 401ks to get the money they need, to taking out loans and asking for "forbearance", to drawing down on their Social Security early.  What next will these fools offer? Going to blood banks and trying to sell blood to get nutrition for their starving kids? 

Instead, they'd rather keep that $250m now being held up (in the latest CARES bill) to support more tax breaks for hedge fund billionaires and other wealthy pals of Trump and the Repubs.  As noted  last night (All In) the Washington Post reported that 80 percent of the tax changes in the new coronavirus  relief package "overwhelmingly benefit millionaires."    So while a young guy like Ned Standford, featured on ABC news and just laid off, barely has a buck left to get a box of Kraft Macaroni and Cheese, the millionaires that WSJ and Jenkins et al pander to will be sitting pretty.  But this is all the more reason people not allow themselves to be played like pawns by the Wall Street cowboy capitalists.  Will the Tea Party type Trumpsters marching in Lansing and elsewhere get it?  I didn't even bother to ask Janice as I know already what she will say.

Btw, if you're wondering why your "stimulus" check is taking longer to arrive it's because Trump deliberately held them up so his monicker could be imprinted on the checks by the Treasury Dept. (He now denies it, but the delay has already affected the timing.)  So the checks will now take an extra 2-3 days (so we're told) because Trump has to stroke his own ,monstrous ego- even while kids are going without soup and parents without basics like TP.

And:

And:



Friday, May 26, 2017

Memo To The Sleep Scolds: Not Everyone Needs Eight Hours Of Sleep A Night

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"Oh my god, I'm gonna die if I don't get back to sleep! I need at least six hours!"

Let us agree at the outset that sleep is an absolute necessity and too many Americans are sleep-deprived, don't get enough. The question remains as to why this is so and what factors are responsible. Like the self-proclaimed "longevity scientists" who believe we will have people living to 150 very soon (no thought how they will support themselves) the "sleep scientists" are convinced that they know what is best for the rest of us. In this regard we are told over and over we ALL need at least seven to eight hours of sleep per night or we'll suffer the dire health consequences. No exceptions!

In the latest study emanating from the sleep scolds, we're informed all those who get less than six hours sleep a night and have metabolic syndrome have double the risk of dying "prematurely". They assure us, however, this conclusion is based on "associations" as opposed to actual cause and effect identifications. For those who need to know, "metabolic syndrome" is generally a precursor to diabetes and includes a set of conditions such as: oversized waistline, bad cholesterol (low HDL and high LDL, specifically), high blood pressure, high triglycerides, and high blood sugar (serum glucose levels, also a!c)

On yesterday's medical segment of CBS Early Show, Dr. Tara Narulla informed the hosts of this new study, even as Gail King proclaimed she had to be "dead woman walking" - getting barely 4 hours of sleep per night because of her morning gig. But then, King may or may not have metabolic syndrome - which was the central issue. Then there was Charlie Rose asking if naps counted - say in tabulating "total sleeping hours over a 24 hour period"  - to which Narulla said absolutely not. (Since the study was based on night time sleep only).   All of which again led the curious inquirer to ask: Exactly how much sleep is enough - irrespective of whether one has a deleterious health syndrome?

The fact is that getting eight, seven or even six hours of sleep at one go is a myth. Most of the modern sleep "specialists" - and I use that term loosely- appear to have missed the memo that the ancients never slept in eight hour "blocks" i.e. to get all their sleep one time.   The actual, natural pattern of sleep for humans - for most of their history  - at least up to the Industrial Age, was segmented, i.e. broken up into segments.

Enter historian Roger Ekirch of Virginia Tech who - in 2001-  published a seminal paper, drawn from 16 years of research, revealing a wealth of historical evidence that humans used to sleep in two distinct chunks.  His book:  At Day's Close: Night in Times Past, published in 2005, unearths more than 500 references to a segmented sleeping pattern - in diaries, court records, medical books and literature, from Homer's Odyssey to an anthropological account of modern tribes in Nigeria. These references describe a first sleep which began about two hours after dusk, followed by waking period of one or two hours and then a second sleep.   The segmented paradigm can also include naps (also called "siestas" in many countries), which  Charlie Rose is fond of, as well as yours truly.

I don't think I've ever naturally slept a full eight hours unless I was ill, like with the flu (doped up on Nyquil), or had just completed a red  eye flight someplace  - and  slept 8-9 hours straight at the destination  hotel the next night. I simply am unable to sleep one single long stretch - at least without some kind of meds in the picture. (Which I prefer not to take just to sleep)

In his research into "segmented sleep" Ekirch found that references to the first and second sleep started to disappear during the late 17th Century. This started among the urban upper classes in northern Europe and over the course of the next 200 years filtered down to the rest of Western society. By the 1920s the idea of a first and second sleep had receded entirely from our social consciousness.  While that may have happened, there has remained a core of us with "ancient" blood in our veins who are incapable of one continuous sleep at night. In my case it's usually 5 1/2 hours then a 1-2 hr. nap (generally after I take my BP med).  Note that even when I don't nap, which admittedly is seldom, I seldom reach six hours of straight sleep.  Even that is often broken up - maybe three hours or so first, then getting up to have some lemon and honey tea and reading the news on my laptop - then back to bed for the rest.  Like Charlie Rose I don't fret because I can take a nap later.

Ekirch attributes the initial shift in sleep patterns to improvements in street lighting, domestic lighting and a surge in coffee houses - which were sometimes open all night. As the night became a place for legitimate activity and as that activity increased, the length of time people could dedicate to rest dwindled.   According to Ekirch in a BBC interview:

"People were becoming increasingly time-conscious and sensitive to efficiency, certainly before the 19th Century. But the industrial revolution intensified that attitude by leaps and bounds."

Indeed it did. People were now bound to a regulated slot of  work time - eight hours but originally more - and were also chained to an efficiency, factory model. (Thank the original "efficiency expert" - Frederick Winslow Taylor).  Thus, there simply didn't exist the latitude for people- workers  to break sleep into segments.  If you had to be up and at 'em by 7 a.m. or so you'd best be in the sack sawing logs by 11 p.m. . Hence, the need to drive the biological sleep "clock" into getting eight hours at one stretch.

Strong evidence of this shifting attitude was contained in a medical journal from 1829 which urged parents to force their children out of a pattern of first and second sleep. It read in part:

"If no disease or accident there intervene, they will need no further repose than that obtained in their first sleep, which custom will have caused to terminate by itself just at the usual hour . And then, if they turn upon their ear to take a second nap, they will be taught to look upon it as an intemperance not at all redounding to their credit. "

Jeezus! An "intemperance"? What a damned scold!

Anyway, while most people seem to have adapted quite well to the new eight-hour sleep model , Ekirch believes many sleeping problems may have roots in the human body's natural preference for segmented sleep as well as the ubiquity of artificial light.  Well, you can count me in that group. (Interestingly, my late father also had those problems - seldom able to sleep more than four hours at night, often awake by 3 a.m. - then napping in the afternoon.)

Ekirch and others conjecture this could be the root of a condition called sleep maintenance insomnia, where people wake during the night and have trouble getting back to sleep.  Well, this is why I often just get up and make some beverage or other - usually after a trip to the bathroom and being unable to get back to zzzzzzzs.

Interestingly, the condition of sleep maintenance insomnia first appears in the literature at the end of the 19th Century, at the same time as accounts of segmented sleep disappear.  Coincidence? Nope, I don't believe so. As the factory age demanded the eight hour sleep pattern to fit into the industrial efficiency mandate, many humans couldn't comply. Not because of not wanting to, but basic biology - they were unable to - and then were forced into taking sleep aids like Ambien.

According to sleep psychologist Gregg Jacobs, also interviewed by the BBC:

"For most of evolution we slept a certain way. Waking up during the night was part of normal human physiology. "

The idea that we must sleep in a consolidated block could be damaging, he added, if it makes people who wake up at night anxious, as this anxiety can itself prohibit sleep and is likely to seep into waking life too. 

In a real sense, this is where I suspect the real risk of early death lies - from heart attack or stroke - because of anxiety in not being able to sleep, and driving up cortisol levels.

Russell Foster, a professor of circadian neuroscience at Oxford University, shares this point of view.

"Many people wake up at night and panic. I tell them that what they are experiencing is a throwback to the bi-modal sleep pattern."

But the majority of today's doctors  (like Tara Narulla) still fail to acknowledge that a consolidated eight-hour sleep may be unnatural for some people. They prefer or insist there be a uniform, single sleep standard for all - like they insist everyone eat a uniform single type diet (low in proteins, high in plant based sources) , despite the fact most "natural" foods,  veggies - fruits especially, lack the nutrients they had fifty years ago.

According to Foster:

"Over 30% of the medical problems that doctors are faced with stem directly or indirectly from sleep. But sleep has been ignored in medical training and there are very few centers where sleep is studied,"

Jacobs suggests that the waking period between sleeps, when people were forced into periods of rest and relaxation, could have played an important part in the human capacity to regulate stress naturally.
In many historic accounts, Ekirch found that people used the time to meditate on their dreams. Today, they more often than not latch onto their little electronic devices - about the worst thing they could do.

In Dr, Jacobs' words:

"Today we spend less time doing those things. It's not a coincidence that, in modern life, the number of people who report anxiety, stress, depression, alcoholism and drug abuse has gone up."

 Maybe it's time to get back to a segmented sleep alternative - at least for those who need it!  But at the same time, in the space between sleeps, let's not go grabbing for the smart phone and more stimulus we don't need.