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Trump and RFK blame acetaminophen for childhood autism. I couldn’t find a transcript yet, but the meandering press conference is recorded here. Was this on anyone’s bingo cards?
I’m confused. I vaguely knew that the Trump campaign had decided to fight autism at some point, but I always figured it was appeasement for the antivaxxers. Is there an untapped pool of Tylenol haters out there? Is this a stalking horse for a broader wave of FDA guidelines targeting the usual suspects?
Maybe there’s some sort of political smokescreen going on. We don’t appear to have started any new wars, and domestic hate for Trump looks more or less like it did since last week. If it’s a distraction, it’s not a very efficient one; I had a hard time finding reporting on it, and all the sites that bothered were also eagerly blasting his abuses of the Justice Department and the Supreme Court. That leaves the old-fashioned political motive of throwing meat to the base. Maybe Trump is just checking off campaign promises. But again, it’s so niche.
I suppose there could be some sort of personal beef. If Trump is trying to tank someone’s stock, uh, this is still a pretty weird way to do it.
That’s not even touching the medical case. The administration doesn’t appear to have provided much substance behind their claim. This will dissuade approximately no one. Enjoy your fresh CW battleground.
Why is the American right so obsessed with autism and discovering some unknown or suppressed cause for it?
Politicising medicine in general is baffling to me, like how Ivermectin is right-wing while vaccines are left-wing (and I remember 20 years ago most antivax people were leftwing). At some point it feels like American politics is about picking any conceivable topic and flipping a coin to declare one side Republican and the other Democrat.
It's simple, over the last decades, the left has succesfully taken over multiple fields through academia, including medicine, and there is a fear from conservatives that this political capture is tainting the quality of the science that comes out of it. In some fields of medicine, particularly those at the intersection of hard sciences and social sciences, for instance study of the transgender phenomena, it's hard to argue that the conservatives don't have a massive point. In more hard science aligned ones, such as which drugs are effective/dangerous, it's less legible, but the conservatives do have (IMO) a smaller point that the left relishes the power to force public policy and is not wielding it objectively. The gleefulness with which they they resorted to coercive methods to force people to vaccinate during COVID is a great example.
The problem is that MAGA offers no credible alternative. If they had a trans-skeptic secretary of health who would cut down woke excesses back to the level of empiricism, that would be one thing.
Instead they have someone whose whole point was to bring in the votes of the anti-vaxxers and a president who joins him in announcing their big medical discoveries.
I mean, sure, if one believes that the medical priesthood is made up out of charlatans who talk about make-believe concepts like proteins, p-values, PCR or the like, then there is no problem in replacing them with different charlatans who can make just as convincing a show of knowing the secret language of the priesthood.
I will grant you this. For a lot of vaccines, the social benefit is that the immunized can no longer transmit the infection. Not so for COVID. So the main public health effect is not present.
A fair solution, in my opinion, would have been to announce that vaccination would be entirely voluntary, but that in triage situations, the willfully unvaccinated would simply get a penalty in their QALY-based score. Say divide their expected QALY gain from interventions by a factor of two, so that you might be indifferent between putting a 40yo unvaccinated patient or a 60yo vaccinated patient on oxygen.
This has good precedent: we already allow people to engage in a lot of dangerous activities such as smoking, drinking, or base jumping, which frequently kills them. The idea is that everyone has their own risk appetite, and as long as they just kill themselves we should generally let adults do what they want. Only when they endanger others is when we should restrict their behavior.
So if someone decides to gain immunity to COVID the natural way instead of getting microchipped by Bill Gates, let them. Just don't let them take a spot in the ICU from someone who followed the recommended vaccination schedule if spots are limited, send them home with a bucket of Ivermectin or something.
Sadly, our society is utterly incapable of discussing care prioritization in triage situations at all. The closest we get to it is probably taking current alcohol abuse into account when deciding who gets a new liver first.
The problem with suddenly slapping a QALY triage system on covid vaccination is that covid just doesn't have that big an effect on QALY. About 1-2 weeks loss per infection on average. This pales in comparison to other risks, like smoking (loss measured in years) and even to politically polarised risks like being a sexually active gay man. If you were assembling a checklist or survey you use for the calculation you wouldn't bother putting covid vaccination on it over hundreds of other risk factors.
This policy would rightly be seen by its victims as a blatant and obvious political attack on them specifically rather than part of a calculated dispassionate healthcare strategy. So no different than the mandates themselves.
Proposal: triage based on available annual renewable term life insurance premium for each patient conditional only on those attributes predictably downstream of a patient's choices. This plan would ensure that foregoing the covid vaccine resulted in a difference in triage ordering that was correct. This plan has no downsides. Thank you for coming to my TED talk.
Covid vaccination has such a minor effect compared to other patient choices that you would never bother surveying for it unless you are doing so for political partisan reasons. Covid just isn't dangerous enough for that to matter.
To provide an example, heavy smoking (which is a lower threshold than you'd expect) costs the average heavy smoker about 10 QALY, so any amount you charge for being unvaccinated, you'd have to charge heavy smokers ~500 times more. Already this stretches the bounds of feasibility. Any cost high enough to cover the cost of repeatedly vaccinating yourself for covid (Yep, that's a thing still, are you up to date according to local recommendations?) will be greater than the additional insurance cost, unless the premium increases by so much that you bankrupt all smokers. Not to mention the "gay tax" you'll have to charge for HIV risk, which for sexually active gay men is also a much higher risk than covid.
Edit: For the sake of providing real-world numbers, with the caveat that the UK doesn't operate on an insurance model, official recommendations are 1 booster shot every 6 months for £100 each when offered privately. Therefore if you increase insurance premiums on the unvaccinated, they will need to be at least £200/y more to be more expensive than simply being unvaccinated. Therefore you'd want to look at charging heavy smokers an extra £100,000 a year, which is multiple times the average annual income in the UK.
I'm afraid no matter what you try to do to construct a rational basis for punishing covid vaccine dissidents, it will succumb to the simple fact that covid isn't dangerous enough to justify it, unless you are also willing to simultaneously hit other groups with orders of magnitude more severe punishments.
Unrelated note - it might be fun at some point for us to do an adversarial collaboration on covid vaccines, because I hold the position that the mRNA vaccines (the speed of development and production scaling) were actually a bright spot in the covid pandemic and gave us some tools which we should be investing a bunch more into. Pretty much everything the public health policy makers did during covid in the US was stupid but the vaccines themselves are a medical miracle.
This wouldn't be particularly adversarial. The vaccines are kind of mediocre but fine. A bright spot in the covid pandemic is like the least stinky shit in a sewer. My disagreements are all with how states used vaccines to engage in yet more flagrant violations of human rights and violate medical ethics. I think we shouldn't invest into these tools, not as an isolated principle against mrna or viral vector treatments, but because of the risk the current institutions would use that investment just as they did in 2020-2022 for ill.
If the vaccines were released outside the context of lockdowns and other restrictions I would have nothing to say on them and there would have been no substantial opposition to them.
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The joke was "covid vaccination status fades into noise by the annual renewable term life insurance premium metric". It's similar in spirit to proposing that we keep plastic straws, but charge consumers a carbon tax for the carbon that goes into its production (i.e. proposing to keep plastic straws but tax them at $0.0002 each), except my proposal is also "let's spend lots of time getting price quotes on term life insurance for people in medical triage, trying to address equity concerns in a triage situation is definitely a good use of resources so we should make sure to do it right".
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