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Yesterday, I summarized your welcome line of thinking about our Covid failure in my short post below titled:

"Why Does our Government Prioritize Killing Russians Over Saving American Lives?"

https://robertsdavidn.substack.com/p/why-does-our-government-prioritize?s=w

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Maybe you’ve touched on this before, but do you think the prevalence of home tests that don’t get reported could be suppressing the case numbers, perhaps by a lot? Anecdotally, more of my friends and colleagues have tested positive in the last 2 weeks than at any other point in the pandemic.

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author

Yes, I think it's suppressing numbers a lot vs. if they reported them, but earlier it was such folks never getting tested at all in those spots. So I don't think the relative numbers have changed much, we've always been severely undercounting. Which is good news - death rates are much lower than they look.

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May 12, 2022·edited May 12, 2022

"Many people don’t know about Paxlovid."

Pfizer is buying radio and TV ads that explain that there is an oral treatment you take at home for COVID and telling people to call their doctor as soon as they have symptoms. It never explicitly mentions Paxlovid because then they have to put in all the disclaimers, side effects, and drug interactions. I've seen the ads during NBA and NHL playoff games and on local sports radio programs.

https://www.ispot.tv/ad/bAea/pfizer-inc-move-fast-oral-treatment

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May 12, 2022·edited May 12, 2022

I had a doctor say a 14-year-old wasn't approved because of their age. I remembered Zvi linking to a tweet thread about 15-year-olds and investigated and this turns out to be completely wrong. https://www.yalemedicine.org/news/12-things-to-know-paxlovid-covid-19

No one knows anything and no one's in charge.

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Now let's extrapolate to other medicines doctors might not know about or might be very wrong about... oh... oh no... it's a nightmare.

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May 12, 2022·edited May 12, 2022

On the issue of alcohol wipes, I've got Type 1 Diabetes and inject insulin and prick my finger multiple times per day. Every instruction I've ever seen/gotten says to clean the site before hand with alcohol or soap & water. I've never done that and over 10 years and 1000's of injections & finger pricks, nothing has ever happened. From conversations with other diabetics, the vast majority don't clean before injections and also haven't seen any issues. It's not an RCT, but there should be an enormous amount of data you could collect to see if there's any meaningful risk of not cleaning an injection site.

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This baby formula thing might be the first time I wished Trump was here. His solution would be poorly aimed and slipshod, but he'd also be firing people until something changed, so it would actually get changed instead of people sitting secure that it's someone else's problem.

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author

I'm curious how you imagine that plays out. Or, what are examples of firing people solving a problem for him like this? (Actually asking, I want to explore this model of action)

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Right now it's no one's fault. There are people that could fix it by stopping certain bad things from happening, but they have no incentive, because they can just keep on doing what they're doing because of local rules like "always shut down plant if two babies die."

Make it someone's problem.

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I think you are on to something here. The default pattern seems to be "Always do what the boss says because he is the only one who can fire you." If someone from outside the organization can also fire you for not doing your job, that at least creates tension against blindly applying rules, and probably incentivizes those who think the boss is a moron to stand up and start pointing out the problems.

I am increasingly favoring impeachment of officials for the same reason. Sure, you serve at the pleasure of the president, but you can also be booted from federal employment for life if the House and Senate decide you violated the Constitution... I rather like the way those incentives line up.

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May 12, 2022·edited May 12, 2022

I had the paxlovid rebound! I am 38, no underlying health conditions, first vaccine was J&J in April 2020 and my booster was Moderna in Dec 2021, and I have no prior covid infection. Whenever something happens to me I assume it's not rare but not sure if that's logical? I have reported it as an adverse reaction to Pfizer.

My toddler + 4/18

Me - 4/19

Me + 4/20, day 1 of paxlovid

Me + 4/22, day 2 of paxlovid

Me + 4/24, day 3 of paxlovid

Me + 4/26, day 4 of paxlovid

Me - 4/27, day 5 of paxlovid

Me + 4/30

Me + 5/2

Me - 5/4

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> Properly administered, this provision will be an essential tool in constraining Canada’s ability to dump unlimited quantities of dairy products onto global markets

I’m so dumb I didn’t even know Canada possessed a limitless supply of milk

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Up north, it is nothing but pendulous utters as far as the eye can see.

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May 12, 2022·edited May 12, 2022

Notes on the article about Australia's vaccine rollout:

There's an election in two weeks, so certain groups of people are understandably keen to write articles about how terribly the current government screwed things up. And this article just happens to be written by an opposition MP, so perhaps shouldn't be taken at face value.

The article is correct in pointing out that things would have been a lot better if we'd finished our vaccination program as early as Israel, but unconvincing in its claims that government screw-ups had anything to do with it. Australia's vaccination rate was limited entirely by how quickly we could get deliveries from Pfizer, and it's not clear if there's anything we could have done to move ourselves up the queue. To a large extent, Pfizer seems to have (sensibly) prioritised countries with high covid rates. Much was made at the time of the fact that Australia didn't order Pfizer until it had already been shown to be successful, but on the other hand we ordered Moderna in our first round of vaccine orders and we didn't get Moderna until very late either.

Anyway, the figure comes from comparing Australia to Israel, but an Israel-pace vaccination program was never a possibility for Australia.

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As always, my most informative read of the day/week/whatever your frequency is. Thank you.

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FWIW: my experience getting paxlovid.

Yesterday evening my father called me up to say that he'd come down with a cold, gone to get tested as a precaution, and tested positive. The testing center urged him to call his doctor and try to get a paxlovid prescription but by then it was too late in the day to reach anyone at that office. The testing center itself was not a test-and-treat center.

He spent a miserable night getting no sleep, coughing, getting weaker, etc. He's double-vaccine-boosted, too, so this damn thing doesn't fuck around.

The next morning I called his doctor to try to get a prescription arranged by phone and spoke to an assistant there. I also called a local test-and-treat center and was told we could come in person there and they had paxlovid they could dispense. His doctor's office called me back and approved the prescription, and gave some guidance about temporarily discontinuing another medication that my dad takes that reacts badly with paxlovid. I went down and picked up the prescription within a half hour or so of getting the call, and had it at my dad's door soon after.

So total time between diagnosis and first paxlovid dose was ~17 hours. This all took place in San Luis Obispo, California.

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Do you have thoughts as to how covid is going to play out in Taiwan? I’m wondering if we should expect the recent surge to be analogous to the January east coast surge

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