Addiction Prediction

I've made some very accurate predictions during this pandemic, most of which resulted from simply paying attention to scientists. One of these days I'll do a summary. Today, however, I'm going to make a real long shot, out in left field, bizarro prediction. Despite the craziness of it, I think that there's a very good chance that I'll turn out to be correct.

Here's the unvarnished prediction:  I think that after President Trump loses the election November 3, he'll attempt to hold more rallies between then and the transfer of power. To what degree the GOP tries to dissuade him from doing so will be the big question.

Of course, it serves no productive purpose for the president, after losing, to schedule rallies. It makes zero sense. I think he's going to try primarily because he's addicted to them. After the general electorate rejects him, his inability to face the reality music will compel him to get more tastes of echo chamber public adulation. His entire life has been a climb into the insular narcissistic cockpit he now occupies. He won't be able to spend even two months cold turkey out of the rally environments. 

Part of it will be sheer addiction to in-person adulation. Part will be the cognitive dissonance. He won't be able to process his rejection and the perception that he failed. He will desperately seek counter evidence to sustain his self esteem. And part of it may an exercise in spite, to damage the country as a parting gesture, but under the aegis of challenging the fairness of the election. More rallies will ensue, either under the guise of publicizing the election rigged-ness or as potential fundraisers for a nascent third party that he'd like to helm. The interaction between a lame duck president and a GOP trying to clean up the mess should be fascinating.

The president is addicted to the cheers, the spotlight, and the adulation. He's going to do all he can to prolong the love and attention. Things may get ugly and even more unreal. This president as an out-of-control lame duck during literally the worst months of a once-a-century pandemic is a bad conjunction of events. Historically, lethally bad.

Bob Dietz

October 21, 2020

Every Lie Has a How and a Why

Last week, President Trump said at both a rally and during an interview that 85% of people wearing masks get Covid-19. The CDC study in question said no such thing. What it found was that among people who were tested because they were experiencing symptoms, self-report of mask wearing "often or always" was not a predictor of whether they would indeed be negative or positive. Various summaries of the study can be found at CNN and other national news sites, so I won't address the details here. The summaries are quite clear and include interviews with the doctors who wrote the paper.

At the rally, Trump said, "Did you see the CDC? That 85% of the people wearing a mask catch it, okay?" This was a gross and false misrepresentation of the study, but because it was Trump, the lie didn't even make me blink. He was obviously spouting nonsense. What gave me pause was thinking about how the lie originated. What were the processes and mechanisms by which this lie was told to millions during the NBC town hall after the president had tried it out on a rally audience? I decided to sit down and calmly create an outline for how these words made it on air.

The Provenance of a Lie

My first question is, "How did the president become aware of this study?" I doubt that this study was part of any daily security briefing. I doubt that the president was talking to some CDC administrators who mentioned it. I find it highly unlikely that he read the original journal article. It's not likely that anyone on the task force, who presumably would understand the study, would point it out as supportive of no-mask arguments, unless of course Dr. Scott Atlas had an eye out for such things. Who else in Trump's inner circle would be surveying current studies in search of some idiosyncratic line or two that could be torturously misinterpreted and twisted as a kind of lame evidence for not wearing masks?

The study came from the Health Data Services Center at Vanderbilt. How was the president alerted to the study? Who pointed it out to him? My speculative guesses are that it might have been Dr. Atlas or one of the researchers at Fox News. 

The next questions regarding the processing of the lie are more interesting. Once the study was mentioned to him, did President Trump read it? I find that highly unlikely. Did he read the abstract or a summary of the study, or at least read its conclusion? If he had read any of these, then presumably he would have understood that the study was not about "85% of people who wear masks get Covid-19." Now I suppose it is possible that the president could have read the abstract or conclusion and not at all understood them, but this seems farfetched. And if he didn't understand them, why would he use the line? So I am going with the theory that in all likelihood President Trump did not read the study, or the abstract, or conclusion, or a summary of the study.

The most likely sequence of events is that the president was told of the study, did not read it in part or whole, and then did not think it prudent to ask anyone about it, including task force members who would, presumably again, set him straight regarding the gist of the study.

The plot thus far:  Someone tells President Trump about the study, then invents and emphasizes the odd incorrect line Trump eventually uses in a rally and during a televised interview. The president takes the person's word for the accuracy of the lie, does not vet the information with anyone else who would be able to verify it or shoot it down, and makes the decision to use the line at the rally and then in the interview.

Now it becomes even stranger. President Trump uses the line, which is a complete mischaracterization of the study, at a North Carolina afternoon rally. His people, his family, all hear it, but nobody thinks to vet the line and verify it. So the president goes blithely forward and trots it out at the televised town hall, where he is informed by the moderator that he is misinformed.

The misinformation being introduced to the president, not vetted by the president, and then nationally promulgated all have consequences, none of them good for anyone's health.

The Why of the Lie

The next questions regarding this lie are about motives, the why of the lie. Why would anyone point out this kind of misinformation to the president? Whoever introduced Trump to the study must have pushed the false line about "85% who wear masks get Covid-19." Why do it? Why send the president out in public with a lie that makes him sound like he knows absolutely nothing? Or did the president know that it was a con line the whole time, and did he know this while feeding it to his rally attendees and then a national television audience? Does President Trump think Americans are dumb and would buy the line, or did he actually believe the line because it fit the narrative he wanted to push?

The president not vetting the line suggests that he doesn't care about truth even if the falsehoods can kill. The person who fed him the study and the line also cares nothing for truth or the consequences of its lack. And those in the Trump camp who heard him use the line at the rally evidently did not or could not dissuade him from using it at the later town hall interview.

At each step in the provenance and distribution of this lie, a proper accurate interpretation of the study was tossed out the window and consequences were ignored. Anyone intervening at any point could have derailed the lie.  No one did. 

Cost/Benefits of this Lie

How does a lie like this, which has really limited utility for the liar, evade disconfirmation? Why does such a lie, with marginal value, get used when life threatening consequences result if people buy into it?

I can't imagine that a lie with such marginal pluses for the liar but so negative in potential outcomes for the public would have made it into a national interview in any other presidential campaign in my lifetime. The basic problem here is the devaluation of the lives of supporters, who are most likely to buy the lie without researching it. The disdain for supporters must be severe. Why throw such a lie out into public when the political benefits are nominal and the costs potentially deadly, specifically to one's own supporters?

This was a case of really bad cost/benefit accounting practices that our president should surely understand. What the provenance of this particular lie demonstrates is the propensity of the president's team to use any piece of questionable information, any quote, to further an agenda by inches. What's at risk are lives, especially of supporters, when these false throwaway lines get inserted into national interviews. By any previous American cultural leadership standards, this cost/benefit calculus would be considered sadistic with a touch of psychotic. 

Bob Dietz

October 21, 2020

 

Debunking Herd Immunity as a Strategy for Covid-19

Introduction

The last week has featured the Trump administration pushing the concept of herd immunity as their solution to the current pandemic. All statistical indications are that we're finally entering the dreaded second surge, so the GOP has decided that now is the best time to do nothing.

This cliff notes debunking will be short and sweet. Understand that the United States does not have any long term data on Covid-19 because the virus has been around less than a year. 

Three Problems

Any reliance on herd immunity requires at least three leaps of faith. First, the effects of having had the virus in terms of conveying immunity are largely unknown. If immunity is conveyed, it likely is for a limited time measured in months rather than years. If people who have had the virus once can get it again, the entire concept of herd immunity is undercut and rendered practically useless. 

Second, the long term consequences of Covid-19 have not been established. If there are indeed "long haul" effects, as seems to be the case, then living through the virus isn't simply a matter of who survives and who does not. Rather, it becomes a case of who is debilitated to what extent and for how long. Regarding lung damage, for example, if a significant percent of Covid-19 survivors sustain 10% or more lung capacity reduction, that is a big deal. We each lose a small percent of lung capacity every year as we age. A good chunk of those who get the virus are, in essence, prematurely aged in terms of lung capacity. Other effects include inflammation surrounding the heart. If getting Covid-19 results in these serious consequences, repeat infections may cause grave add-on effects. Without long term data, any reliance on herd immunity is grossly speculative, risking serious consequences.

Third, herd immunity as an alleged strategy obviously risks overwhelming hospital systems, resulting in more deaths than would occur if infections were staggered over longer periods of time. 

Our Leaders Have Abandoned Us

Herd immunity, on this October 17, 2020, is simply one phrase that substitutes for another phrase, "doing nothing." Since the U.S. appears on the brink of the second surge blow-up, plying herd immunity as a so-called strategy allows those pushing the idea to abrogate their responsibilities. They wish to wash their hands of something at which they have miserably failed. Old time gamblers call walking away from a bad situation for which one is responsible, "pulling a Pontius Pilate."

Defining doing nothing as "herd immunity strategy" the week before our second American surge is a cynical, lazy, self-absorbed joke. When one compares countries that implemented various degrees of herd immunity emphases, the correlation is clear. They have not done as well as their peers. 

Here we sit as Americans, snowballing towards 400,000 dead, and our leadership throws science, lessons learned from other nations, our U.S. experts, and U.S. lives to the wind. Our current leaders are hell bent on passively culling the herd. And that is what they will be doing for the next three months -- killing us in the name of expediency and commerce. Pulling what they consider the perfect Pontius Pilate.

Bob Dietz

October 16, 2020

Confusing "I" with "We" -- Narcissism and Anecdotal Evidence

"One thing that's for certain, don't let it dominate you. Don't be afraid of it. You're going to beat it. We have the best medical equipment. We have the best medicines, all developed recently, and you're going to beat it. I went; I didn't feel so good. And two days ago, I could have left two days ago. Two days ago, I felt great. Like, better than I have in a long time. I said just recently, better than 20 years ago. Don't let it dominate. Don't let it take over your lives. Don't let that happen."  President Trump (October 5, 2020)

The phrase "anecdotal evidence," to my mind, usually deserves quotes around it because "anecdotal evidence" is almost an oxymoron. There's a reason anecdotal evidence is not admissible in court. It's not really evidence. It's some standalone piece of data that gets introduced into conversation or debate without the benefit of statistical context. "Anecdotal evidence" is either some cherry-picked piece of information or information from a limited perspective. Without the benefit of statistics, the observations of one person are by definition limited, and usually fall under the "anecdotal evidence" aegis.

One of my problems with national media during this pandemic has been that, when conducting interviews or asking questions, they've often missed the forest for the trees. Interviews and press conferences have often failed to generate the most obvious, logical questions. Instead of responding to illogical proclamations with questions that attack a lack of reasoning or lack of data, lines of questioning have too often followed some pre-printed outline designed to elicit sound bites. Cogent follow-up questions have been rare. Interviews have become robotic exercises in leading questions being asked and answered. 

When President Trump made the comments quoted above, I was somewhat taken aback by national media assigning absurdity to Trump's spiel based on his getting medical care far beyond the access of normal men. Expert moment-to-moment monitoring and multiple drugs unavailable to the masses are, to be sure, valid drawbacks to Trump's "If I can do it, you can do it" coachspeak. The more critical point to hammer home, however, was the sheer inappropriateness, the unbelievable statistical idiocy, of using one man's results as any kind of template for what hundreds of millions of people will experience. 

Don't get me wrong. Trump's idiosyncratic treatments and position in society are valid means to debunk the significance of his results. At heart, however, his lack of representativeness really isn't the most damning argument. Simply put, one man's outcome means nothing in terms of predicting outcomes for millions. This is a basic problem with "anecdotal evidence." One man's results are almost meaningless.

The reality of this insignificance should be obvious, yet the statistical absurdity of the argument being made by Trump was not the spotlight criticism. Instead, the unrepresentativeness of his treatments became the media fulcrum for debunking the president's proclamations. Debunking the specifics of one case, however, was silly. The devil wasn't in the details of a single case; it was in the fact that it was a single case, period.

Personal Experience as Gold Standard

Moving on to the president himself, the first question is why would Trump make such an argument, namely that his own experience would forecast the experiences of millions? Why does someone assume, if indeed Trump actually believed what he was saying, that one man's outcome was a valid predictor for all men? How does "I" get conflated with "We?"

I refer back to the Norman Vincent Peale ministry on which President Trump was raised. What Peale "discovered," Peale argued, was applicable to all. This perspective requires a kind of magical symmetry between self and all others. It allows the person viewing the world to assume others' experiences mirror his, and that their outcomes, if they be worthy, should also mirror his own. This perspective is the height of presumptuous narcissism, and it allows the person holding the beliefs to assume his micro social environment is a kind of black box. Since he presumes what happens to self will happen to others, there's really no need to interpret others' actions on the others' terms. No need to exercise any empathy muscles. Everything is a reflection or projection of self. No need to venture beyond one's own black box. No requirement to even see beyond one's own black box. Since others are presumed to be a kind of statistical extension of one's self, there's no need to work to understand others.

This hall-of-mirrors inability to see beyond one's own life events horizon traps the individual in a narcissistic fun house. All evidence references the self. All evidence is, therefore, anecdotal and (unacknowledged by the self) of minimal value. Everywhere one turns is self, and self images fill and define not just evidence and decision-making, but every aspect of life. The president's take on the world is quite literally bounded by his funhouse mirrors. Not only is he unconcerned about what lies outside, but he may be unable to grasp that there is any landscape anywhere that doesn't contain his own reflection.

This is the quicksand of narcissism in the funhouse. The fact that Trump has lived a wholly transactional life, immersed in consumer culture as a kind of capitalist figurehead, adds locks and chains to the outside of the funhouse doors. He has been trapped, perhaps for his entire existence. Everything he sees, everything he does, is a reflection of him.

Bob Dietz

October 13, 2020

Politically Incorrect: Americans are Fat

Introduction

I wrote this entry about a month ago, but held off publishing it because it's somewhat mean spirited and the observations made are important but in a limited sense. In fact, they are (as usual) quite obvious observations, but nobody seems to connect the dots and put things together publicly. So leave it to me to state the obvious while upsetting folks. It's what I do. In the time since this was written, President Trump has been hospitalized, then released, with Covid-19. I'm going to publish this now, while he appears on the road to recovery and the observations herein don't have some postmortem cruelty to them. I'll post this as originally written, then add a few end comments.

Politically Incorrect:  Americans are Fat

Americans are fat, and it matters. It matters in many ways that never get mentioned on CNN, Fox News, or your local five o'clock broadcast. Americans' fatness matters politically, but it's considered so rude, so gauche, so politically incorrect, that nobody discusses it.

Allow me, then. In one of my first blog entries, I stated that my goal in life is to offend as many people as possible in the time I have left. I'm a man of my word.

It's debatable, however, whether I should be the person pointing out how obesity informs and permeates the United States. I am, after all, somewhere between 15 and 25 pounds above my optimal weight, depending on which formal medical measuring stick is applied. American standards are the kindest, of course, so I tend to quote these. I'm considered 15 pounds beyond where I should be, at least in the states. I am capable, however, of dropping that between now and the election, so I will get to it. But first, allow me to explore the various ways in which American fatness has obvious political effects that never surface in polite conversation.

American Obesity

At the turn of the century, the American obesity rate was a shade above 30%. Since then, according to the CDC, the U.S. obesity rate has climbed to more than 42%. Severe or morbid obesity increased over the same period from 4.7% to 9.2%. Think about that. Almost one in ten Americans is morbidly obese. To put this in an international perspective, as of 2016, the United States trailed ten Pacific island nations and Kuwait in obesity rates. Since then, Americans have easily overtaken Kuwait. Other than the constituents of these South and Mid Pacific nations, Americans are now the fattest people in the world.

Americans tend to not focus on or publicize these facts. With the advent of Covid-19, however, the reality of the U.S. leading the non-island world in obesity has taken on new importance. The ubiquity of American obesity has led to some fascinating, underappreciated political consequences.

Ignoring Obesity

For all of President Trump's aggressive, bullying behavior in primary debates, general election debates, and general discourse, it's been a cultural curiosity that no one has deemed it appropriate to return fire of like kind. He's leaned on attack monikers like Sleepy Joe, Little Marco, Lyin' Ted Cruz, Crooked Hilary, Low Energy Jeb, Pocahontas, and so on. The interesting thing to me is that nobody at odds with Trump assigns him the most obvious nicknames, which would reference his weight. Looking at the president, one is forced to admit that he's obese. My opinion, based on comparing both still photos and live footage, is that the man has gained at least 20-25 pounds since assuming office. Cheeseburgers and eight-hour stints watching Fox News tends to do that. Wearing heavy duty Spanx can't hide the newly minted extra poundage. Other than a one-time Nancy Pelosi dig, however, nobody incorporates Trump's obesity into nicknames or criticisms. 

Forty years ago, "Slim" was a common enough nickname-as-dig, but Trump hasn't even been crowned with that rather mild disapprobation. Political opponents drawing attention to the president's weight problem is noticeable by its very absence.

I have several key obesity observations I'd like to make. First of all, I think the reason most people give Trump a pass on his weight is because 40% of the American public is, like Trump, obese. So while the president can mock the disabled, or joke about height, the obvious retort of shining a spotlight on Trump's weight carries too much of an American political downside. If 40% of Americans are obese, then pointing out that the president is woefully obese may have no effect other than to bond the obese citizenry with an obese leader. Thus, Trump's most glaring physical characteristic becomes a non-issue. My suspicion is that in an Asian country, where obesity rates are much lower, a bombastic leader such as Trump would have garnered half a dozen weight-related nicknames.

Mask-Wearing and Obesity

Instead of once again reviewing the effects of obesity during a pandemic and the demography of American obesity, which I've discussed in previous entries, I'm going to go in an entirely different direction. What I'm about to say will, after I say it, appear obvious and banal. It does not, however, get mentioned in polite company, so I'll discuss it here.

Americans have been at war regarding the wearing of masks, with red state citizens interpreting the wearing of masks as some kind of political heraldry. Americans have resisted mask-wearing more than any other population. Americans are also the fattest population. I think that these facts are connected.

Two-thirds of Americans are overweight. More than 40% are obese. Lugging around an extra 25-40 pounds every second of every day is not an easy chore. Breathing while lugging that extra poundage can be a test, especially when carrying things or using stairs. Wearing a mask restricts your breathing. The effect is minimal unless you're working out, but carrying around an extra 25-40 pounds is certainly a workout. 

Try jogging two miles wearing a mask, and then jog two miles without. It's a lot easier without. Well, if that's the case, then assuredly everything is easier without a mask. You breathe more easily.

As an old distance runner who has done considerable formal training, I can also vouch for the effects of added weight. Carrying around an additional 25-40 pounds, as I did during a fair number of workouts while wearing weight vests, is flat out hard. Put a mask on and wear a weight vest, and you have a real challenge, which is what all of these obese Americans are facing. A big chunk of extra weight and mask-wearing is a no-fun combination. 

Now I'll throw some additional statistics at you, and you can make of them what you will. Obesity increases as education decreases. That's a clear cut and dramatic correlation. Among whites, Trump support increases as education decreases. That is also a clear cut correlation. Finally, those red states where mask-wearing has had difficulty becoming standard practice (it was 15% in Tennessee three months ago), have higher obesity rates than the states with higher percentages of people wearing masks. Coincidences? Correlations? Causes-and-effects? 

What I just laid out is as obvious as the grass is green, yet it doesn't get discussed in the national conversation.

Role Models

Seventy-nine year old Dr. Fauci and his wife jog four miles several times a week. I suspect that the doctor has a hard time getting into the head of obese, undereducated Trump supporters who refuse to wear masks while lugging around weight vests made of flesh. And I'm sure the obese, undereducated Trumpsters view Fauci as some alien creature partly because the doctor doesn't seem to grasp the hassle of mask-wearing for some.

Fauci has tried to set one example, but he's alien to the Trumpsters. The president, on the other hand, is a non-jogging, porcine fellow who mirrors their own obesity. Who do you think they see as their natural leader? 

These are some of the social psychological dynamics currently in progress in the United States. They are obvious, and they have cost lives. It's time they should be examined and discussed.

 Political correctness be damned.

Postscript

In the month since I wrote this, I've managed to lose all of three pounds. I went jogging today, wearing a mask. Although I'm sure the actual reduction in air intake is less than 10%, it's certainly harder to jog with a mask. It is, however, a small price to pay for additional safety. 

Bob Dietz

October 7, 2020

And on the Third Day, He Rose . . .

 . . . from his hospital bed in Walter Reed and, via chopper, headed back to the White House.

I suppose if you're going to head a religion, you may as well go the whole nine yards with metaphor and optics. 

It turned out, as early as my last entry was written, I got most things right. Hope Hicks was, predictably, not likely to have been the source of the president's positivity. As soon as her positive diagnosis became public, I figured the president was already infected. I was correct. Hicks was willing to fall on her sword for Trump, but then more positives occurred, the super spreader event at the Rose Garden was uncovered, and the first wave of lies went to hell.

Think about the sleazy narrative that President Trump tried to sell. Hicks had, he stated, been touching and hugging and talking closely with first responders and folks in the military. That was undoubtedly the source of her infection. And she was the likely source of the president's positive. Yeah, that was the ticket.

Until, of course, it was not. Instead, it was a GOP event flouting CDC and task force recommendations. Flouting really isn't a strong enough word. Thumbing its nose at CDC and task force recommendations is more accurate.

So now we have a medicinally gooned up president telling people to not let Covid-19 dominate their lives, even as he gasps for air while an array of pharmaceuticals unavailable to the public courses through his veins. Vice-President Pence, meanwhile, should be in quarantine. Instead he wants to appear at tomorrow night's scheduled debate. Chris Christie checks himself into a hospital after his positive diagnosis. Perhaps he could use a pep talk from the president so he could head home and not allow the virus to dominate his life.

Reality versus the GOP. Guess who's winning?

The interesting aspect to come will be watching the president deal with Covid-19 on a daily basis for the next few weeks. As a 74-year-old in terrible physical shape despite being an avid lover of golf and Spanx, he is going to have to shoot a bunch of videos today or tomorrow so he can distribute them in the weeks ahead as the steroids wear off and he feels like hell.

Sixty-five million people voted for this guy. The same guy who routinely called into tabloids and radio shows to anonymously tout his own sex life. The guy who bankrupted four casinos. The dude who was involved in two lawsuits a week for more than 30 years. And nobody vetted his finances or his dependence on Russian oligarchs backing a bank. 

If this was and is our process for choosing leaders in this country, Americans got the president we deserved. To paraphrase Dean Wormer in Animal House, "Fat, stupid, and drunk on hubris is no way to go through life, Americans." The United States has four weeks to slim down, smarten up, and get humble.

The clock is ticking.

Bob Dietz

October 6, 2020

Galatians 6:7

President Trump and Melania announced that they had tested positive for Covid-19 last night. I find this as surprising as tomorrow's sunrise.

Back on July 4, I commented on the covid-problematic design of the outdoor rally pavilion in South Dakota. Given the president's fondness for rallies sans face masks and social distancing, his positive test was just a matter of time.

Falling on your sword while completing a year of anti-science proclamations and high risk behavior is one thing. That harms only yourself. If initial reports are true, however, and Trump risked infecting donors after Hope Hicks' diagnosis, and if the Trump campaign failed to alert Biden of the positive tests...well, that is (once again) a level of irresponsibility almost beyond belief. It's as if the president is hell bent on doing as much damage as possible in the months he has left in office. At times, it appears that Putin possesses Trump like Pazuzu possessed Regan in The Exorcist.

Call me cynical. I figured as soon as Hicks' positive test was announced that the president had already tested positive. I suspect that if the president had tested negative, Ms. Hicks might have taken a long vacation due to, as the president tweeted, her having worked nonstop so many long months. As to whether her Covid-19 diagnosis would have made it to the newsrooms, I'm guessing not immediately. Again, call me overly analytical, but I found the incorporation of "nonstop working" references in the Hicks positive-reveal tweet to possibly be more than coincidental. The president, like many amateur writers, may have had a tweet prepared to explain her imminent "vacation," and was loathe to not use a line already in his mental docket.

In any event, we now have a covid-positive president. The line of infection has been presented as Hicks-to-Trump, but who really knows? She had symptoms Wednesday; he had them Thursday. That is not guaranteed evidence of disease provenance. It's been presented as a gospel chain-of-infection, but the sequence, who gave what to whom, is not a mortal lock at all. So take all current information with a salt shaker.

After the debate debacle Tuesday night, I found a Biden -130 the next morning and bet it, but only for three digits, mainly because I didn't necessarily trust him to live until November 3. Now both candidates are seriously at risk, as we await Biden's test results from his Trump exposure. 

What preventable absurdity comes next? My blog series addressing the U.S. pandemic response is called "Tales from the Asylum." A better title eludes me.

Bob Dietz

October 2, 2020