Musings

Failing to learn from the past…

Heather Cox Richardson’s March 5 newsletter, recounting the events surrounding Selma’s 1965 voting rights protests, is definitely worth a read. Her important conclusions:

“But less than 50 years later, in 2013, the Supreme Court gutted the Voting Rights Act. The Shelby County v. Holder decision opened the door, once again, for voter suppression. Since then, states have made it harder to vote. In the wake of the 2020 election, in which voters handed control of the government to Democrats, Republican-dominated legislatures in at least 19 states passed 34 laws restricting access to voting. In July 2021, in the Brnovich v. Democratic National Committee decision, the Supreme Court ruled that election laws that disproportionately affected minority voters were not unconstitutional so long as they were not intended to be racially discriminatory.

When the Democrats took power in 2021, they vowed to strengthen voting rights. They immediately introduced the For the People Act, which expanded voting rights, limited the influence of money in politics, banned partisan gerrymandering, and created new ethics rules for federal officeholders. Republicans in the Senate blocked the measure with a filibuster. Democrats then introduced the John R. Lewis Voting Rights Advancement Act, which would have restored portions of the Voting Rights Act, and the Freedom to Vote Act, a lighter version of the For the People Act. Republicans blocked both of those acts, too.

And so, in 2023, the right to vote is increasingly precarious.”

We ignore the lessons of Selma at our peril.

John Patrick2023-03-06T00:30:11-05:00March 6th, 2023|Home, Musings|

Scott Adams’ sad history

Reuben Bolling brilliantly exposes Scott Adams’s descent, appropriately enough in cartoon format. See it here.

John Patrick2023-03-05T10:09:11-05:00March 5th, 2023|Home, Likes|

Masks can make sense

• Tomas Pueyo, writing in his Uncharted Territories substack blog takes a good hard look at the Cochrane Library’s meta analysis of the “Physical interventions to interrupt or reduce the spread of respiratory viruses” by Dooley et al. used by some (e.g. Bret Stephens in the NYT) to erroneously conclude that mask mandates are ineffective. In reality, no such conclusion can be drawn from the Dooley review — the authors themselves state “The high risk of bias in the trials, variation in outcome measurement, and relatively low adherence with the interventions during the studies hampers drawing firm conclusions.” and “We are uncertain whether wearing masks or N95/P2 respirators helps to slow the spread of respiratory viruses based on the studies we assessed.” Pueyo does a good job of analyzing why this review does not provide any substantive evidence that mask mandates are ineffective.

John Patrick2023-02-28T17:33:18-05:00February 28th, 2023|HomeRecommended|

Where we die now…

• Jeremy Faust writes in his Substack Inside Medicine blog about how more and more Americans are choosing to die at home; it’s worth a read. Some numbers from his post:

John Patrick2023-02-20T15:09:35-05:00February 20th, 2023|HomeRecommended|

The Evil of the Murdoch Empire

• Jeremy Peters and Katie Robertson write in the NY Times about some of the noisome evidence produced in the Dominion defamation case. For me, the most heinous indictment in their story comes in this quote from Rupert Murdoch:

“On one occasion, as Mr. Murdoch watched Mr. Giuliani and Ms. Powell on television, he told Suzanne Scott, chief executive of Fox News Media, “Terrible stuff damaging everybody, I fear.””

Murdoch knew the damage he was doing to people and to this country and yet persisted, all in the interest of $$. Read the story, it says it all about the profit driven business plan of his media empire, one built on lies and fear-stoking.

John Patrick2023-02-16T19:48:08-05:00February 16th, 2023|HomeRecommended|

Steven Pinker on ChatGPT

I enjoyed this interview with Steven Pinker on ChatGPT in the Harvard Gazette. From the piece:

“It’s impressive how ChatGPT can generate plausible prose, relevant and well-structured, without any understanding of the world — without overt goals, explicitly represented facts, or the other things we might have thought were necessary to generate intelligent-sounding prose.

And this appearance of competence makes its blunders all the more striking.”

John Patrick2023-02-16T19:29:37-05:00February 15th, 2023|Home, Musings|

More on Covid Vaccine Efficacy

Some data on excess death rates among physicians before and after the availability of Covid vaccines. From JAMA Internal Medicine: Kiang MV, Carlasare LE, Thadaney Israni S, Norcini JJ, Zaman JAB, Bibbins-Domingo K. Excess Mortality Among US Physicians During the COVID-19 Pandemic. JAMA Intern Med. Published online February 06, 2023.

“From March 2020 through December 2021, US physicians experienced 622 more deaths than expected. There were no excess deaths among physicians after April 2021, coinciding with the widespread availability of COVID-19 vaccines.”

John Patrick2023-02-07T09:23:21-05:00February 7th, 2023|Home, Musings|

How much do state policies influence life expectancy?

• Dr F. Perry Wilson of the Yale School of Medicine writes on Medscape about this interesting article from Plos One: “U.S. state policy contexts and mortality of working-age adults” by Montez, Mohri, Monnat, et al. Dr. Wilson thinks that average education level may be the primary factor for the life expectancy discrepancy between states rather than state policies, but the authors in their abstract suggest that state policies may have a large impact:

“Simulations indicate that changing all policy domains in all states to a fully liberal orientation might have saved 171,030 lives in 2019, while changing them to a fully conservative orientation might have cost 217,635 lives.”

and in their discussion:

“On average, Americans die younger than their peers in most other high-income countries. In a 2013 U.S. survey, 85% of adult respondents indicated that their ideal life span was 79 years or older, yet U.S. life tables predicted that only 60% of people born that year could expect to survive to age 79 [40, 41]. Our findings, which examine working-age deaths among adults ages 25–64 years, suggest state policies–specifically, their left/right lean–may be a contributing factor and provide new insights into potential strategies to reduce working-age mortality.”

John Patrick2023-02-02T19:23:22-05:00February 2nd, 2023|HomeRecommended|

Eric Toner on averting a debt ceiling crisis

The always-wonderful Eric Foner writes in the NYT about using the 14th amendment’s Section 4 to avert a Republican-induced debt ceiling crisis:

“The validity of the public debt of the United States,” it declares, “shall not be questioned.”

John Patrick2023-01-23T18:28:22-05:00January 23rd, 2023|Home, Musings|

Misrepresentation of data and poor reporting

No, medical error is NOT the third leading cause of death, and no, Emergency Department misdiagnoses are NOT killing 250,000 people a year in the U.S. As an emergency physician, the widely publicized AHRQ report is particularly painful because it has numerous flaws, and like the Institute of Medicine /BMJ study, is guilty of completely unwarranted extrapolations. The authors, for instance, looked at a Canadian study on 503 patients discharged from EDs, one of who died within 14 days of the ED visit (it’s not clear whether this actually represented a diagnostic error; the study was looking at outcomes after the visit, not misdiagnoses). The AHRQ study then took this single death from a single study to establish a 0.2% (1/503) death rate due to ED diagnosis and multiplied it by the 130 million total annual ED visits to get the purported death numbers. They went on to concoct arbitrary confidence intervals for this extrapolation:

“The rate of misdiagnosis-related deaths in the one high-quality, prospective study (0.2 percent, n=1 of 503) is 217-fold higher than the weighted mean from the three retrospective studies (0.0009 percent). Although the rate of 0.2 percent is based on just a single death (so is imprecise, with a wide 95% CI 0.005 to 1.1), the value is the best estimate from this study and matches data from other sources. However, the confidence interval from the Calder study alone is implausibly wide. Based on data from other sources, we have assigned a +/- 2-fold plausible range to the 0.2 percent estimate (0.1% to 0.4%).”

This is not good science. For more, see:

John Patrick2023-01-18T15:51:01-05:00January 18th, 2023|Home, Musings|