Possible new evidence that hydroxychloroquine plus azithromycine plus zinc is an effective treatment for COVID-19

The following letter has been circulating on the web.  A cursory search on the web suggests that it may be legitimate.  It is consistent with other reports.


Dr. Vladimir (Zev) Zelenko
Board Certified Family Practitioner
501 Rt 208, Monroe, NY 10950
845-238-0000

March 23, 2020

To all medical professionals around the world:

My name is Dr. Zev Zelenko and I practice medicine in Monroe, NY. For the last 16 years, I have cared for approximately 75% of the adult population of Kiryas Joel, which is a very close knit community of approximately 35,000 people in which the infection spread rapidly and unchecked prior to the imposition of social distancing.

As of today my team has tested approximately 200 people from this community for Covid-19, and 65% of the results have been positive. If extrapolated to the entire community, that means more than 20,000 people are infected at the present time. Of this group, I estimate that there are 1500 patients who are in the high-risk category (i.e. >60, immunocompromised, comorbidities, etc).

Given the urgency of the situation, I developed the following treatment protocol in the pre-hospital setting and have seen only positive results:

1. Any patient with shortness of breath regardless of age is treated.

2. Any patient in the high-risk category even with just mild symptoms is treated.

3. Young, healthy and low risk patients even with symptoms are not treated (unless their circumstances change and they fall into category 1 or 2).

My out-patient treatment regimen is as follows:

1. Hydroxychloroquine 200mg twice a day for 5 days

2. Azithromycin 500mg once a day for 5 days

3. Zinc sulfate 220mg once a day for 5 days

The rationale for my treatment plan is as follows. I combined the data available from China and South Korea with the recent study published from France (sites available on request). We know that hydroxychloroquine helps Zinc enter the cell. We know that Zinc slows viral replication within the cell. Regarding the use of azithromycin, I postulate it prevents secondary bacterial infections. These three drugs are well known and usually well tolerated, hence the risk to the patient is low.

Since last Thursday, my team has treated approximately 350 patients in Kiryas Joel and another 150 patients in other areas of New York with the above regimen.

Of this group and the information provided to me by affiliated medical teams, we have had ZERO deaths, ZERO hospitalizations, and ZERO intubations. In addition, I have not heard of any negative side effects other than approximately 10% of patients with temporary nausea and diarrhea.

In sum, my urgent recommendation is to initiate treatment in the outpatient setting as soon as possible in accordance with the above. Based on my direct experience, it prevents acute respiratory distress syndrome (ARDS), prevents the need for hospitalization and saves lives.

With much respect,

Dr. Zev Zelenko

COVID-19 and the destruction of US healthcare

The health care system has limited resources. Presumably, they should be allocated to maximize benefit. What is happening, roughly, is that treating COVID-19 patients has been given priority as if that always provides more benefit, hence is a better use of resources.

The kind of COVID-19 patients that are admitted to hospitals are in serious condition. A large percentage of them are elderly and/or medically compromised and have a relatively high probability of dying. Typically, they end up in intensive care and require inordinate amounts of resources, including medical supplies, and medical staff time. In contrast, for example, a relatively young woman with breast cancer who is completing a chemotherapy regimen that has reduced the size of her tumor to the point where, if it removed now, she has a high probability of living out the rest of her life is defined as requiring non-essential surgery – and doesn’t get it.

Governments, federal, state, and local are allocating healthcare, by fiat, to people with a relatively low probability of recovering and who will likely live only a few more years if they do recover. This is at the expense of providing it to people who have a relatively high probability of recovery and who will likely live many more years if they do. This kind of allocation scheme makes no sense and has destroyed the health care system for the majority of patients who need it.

COVID-19, the economy, and how the Government makes things worse

The economic dislocation from COVID-19 need not be as large as it appears at first sight. To see why, consider a simplified perspective, Case A.

Suppose COVID-19 requires shutting down non-essential firms, e.g., theatres, sports events, restaurants, cruise ships. These firms and their employees lose their income. However, those who would have purchased their goods and services have money they otherwise would have spent that exactly equals the lost income of the closed firms and their employees. In principle, the federal government could tax this money away from those who would have spent it and pay it to those they would have spent it on. This would leave all firms and their employees with the same income as before with all essential services being provided exactly as before.

Once the COVID-19 crisis ended, all that would be necessary is to cancel the tax, at which time everyone could return to their previous spending patterns.

Case A requires no borrowing, no budget deficit, and no economic hardship on anyone, and a quick return to the previous pattern of economic activity once the crisis is over.

There are several issues with Case A. For example, Case A fails to take advantage of the closed firms’ laid off employees by having them do something useful. This problem implies that implementing Case A should yield a better result than stated, since at least some of these newly unemployed people would do something useful.

Another issue with Case A is that it is not practical to determine who would have spent how much on the closed firms’ goods and services. This makes impractical an accurate assessment of who should pay how much tax. On the other hand, there is no good reason why only the people who would have bought the closed firms’ goods and services should pay the whole tax – that would mean that the closed firms and their employees, who lose nothing under Case A, gain at the expense of their customers. It seems better if everyone shares in paying the tax. This would make things easy – simply charge a surtax on everyone’s current tax bill (remember, the closed firms and their employees retain their gross income in Case A). Call this Case B, which is better than Case A.

Things are not quite so simple. The COVID-19 crisis requires large additional expenditures for health care, although not as large as it appears at first sight, because only incremental costs must be counted.

Incremental medical goods and services come at the expense of leisure time and giving up production and consumption of other items to provide the time and materials to produce medical goods and services for COVID-19 use. All this is a rearrangement of the use of person-hours in real time and represents only a re-allocation of resources, not magically creating them. Consequently, just as above, increased taxes are feasible that pay for it all with no borrowing and no budget deficit, and as few adverse consequences as possible.

Contrast the above with what Government is doing, including a huge budget deficit, indiscriminate payments to most taxpayers, and, roughly, reallocating resources as if COVID-19 treatment is more valuable than anything else.

More evidence that hydroxychloroquine plus azithromycin dramatically improves COVID-19 outcomes

Here is a link to the latest paper from the French Doctor you have heard about and his collaborators.

The title is: "Clinical and microbiological effect of a combination of hydroxychloroquine and
azithromycin in 80 COVID-19 patients with at least a six-day follow up: an
observational study".

Randomized clinical trials are great - but there are other kinds of evidence that change the probability of efficacy, too.

Here is the paper's Discussion section.

-----------------------------------

COVID-19 poses two major challenges to physicians.

The first is the therapeutic management of patients. In this context, it is necessary to avoid a
negative evolution of pneumonia, which usually occurs around the tenth day and may result in
acute respiratory distress syndrome, the prognosis of which, in particular in the elderly, is
always poor, whatever the cause. The primary therapeutic objective is therefore to treat people
who have moderate or severe infections at an early enough stage to avoid progression to a
serious and irreversible condition. By administering hydroxychloroquine combined with
azithromycin, we were able to observe an improvement in all cases, except in one patient who
arrived with an advanced form, who was over the age of86, and in whom the evolution was
irreversible. For all other patients in this cohort of 80 people, the combination of
hydroxychloroquine and azithromycin resulted in a clinical improvement that appeared
significant when compared to the natural evolution in patients with a definite outcome, as
described in the literature. In a cohort of 191 Chinese inpatients, of whom 95% received
antibiotics and 21% received an association of lopinavir and ritonavir, the median duration of
fever was 12 days and that of cough 19 days in survivors, with a 28% case-fatality rate (18).
The favourable evolution of our patients under hydroxychloroquine and azithromycin was
associated with a relatively rapid decrease in viral RNA load as assessed by PCR, which was
even more rapid when assessed by culture. These data are important to compare with that of
the literature which shows that the viral RNA load can remain high for about three weeks in
most patients in the absence of specific treatment (18;22) with extreme cases lasting for more
than a month. A study conducted in 76 Chinese COVID-19 in patients showed that high viral
RNA load is associated with the severity of the disease (23). Furthermore, in a study
conducted on a small group of 16 Chinese COVID-19 inpatients, viral RNA was positively
detected in 50% of them, after resolution of symptoms for a median duration of 2.5 days and a
maximum of eight days (24). Therefore, the rapid decrease in viral RNA load is one element
suggesting the effectiveness of this treatment. Furthermore, to our knowledge, the
measurement of viral culture during treatment was also evaluated for the first time. The fall in
culture positivity from the 48th day is spectacular, although, in a relatively small number of
cases, some people maintain a positive culture. 

 
The second challenge is the rapid spread of the disease in the population through contagious
individuals. The elimination of viral carriage in the human reservoir of the virus has recently
been recognised as a priority (25). To this end, the rapid negativation of cultures from
patients’ respiratory samples under treatment with hydroxychloroquine plus azithromycin
shows the effectiveness of this association. In addition, and in parallel to this study, we
evaluated in vitro the association of hydroxychloroquine and azithromycin on SARS-CoV-2
infected cells, and showed that there was a considerable synergy of these two products when
they were used at doses which mimic the concentrations likely to be obtained in humans
(https://www.mediterranee-infection.com/pre-prints-ihu2/). Thus, in addition to its direct
therapeutic role, this association can play a role in controlling the disease epidemic by
limiting the duration of virus shedding, which can last for several weeks in the absence of
specific treatment. In our Institute, which contains 75 individual rooms for treating highly
contagious patients, we currently have a turnover rate of 1/3 which allows us to receive a
large number of these contagious patients with early discharge.

 
Chloroquine and hydroxychloroquine are extremely well-known drugs which have already
been prescribed to billions of people. Because of anecdotical reports of heart complications
with such drugs in patients with underlying conditions, it would be useful to perform an ECG
before or at the very beginning of the treatment (26). This problem is solved by hospitalising
patients at risk with multiples pathogens in continuing care units with ECG monitoring
allowing for the early detection and treatment of these rare but possible cardiac side-effects.
Azithromycin is the drug that has been the most widely prescribed against respiratory
infections and a recent (2010) study showed that one in eight American out-patients, has been
prescribed azithromycin (27). Indeed, there have probably been more than a billion
azithromycin prescriptions around the world since it was first discovered. The toxicity of each
of these two drugs does not, therefore, pose a major problem. Their possible toxicity in
combination has been suggested in a few anecdotal reports but, to our knowledge, has never
been demonstrated. 

In conclusion, we confirm the efficacy of hydroxychloroquine associated with azithromycin
in the treatment of COVID-19 and its potential effectiveness in the early impairment of
contagiousness. Given the urgent therapeutic need to manage this disease with effective and
safe drugs and given the negligible cost of both hydroxychloroquine and azithromycin, we
believe that other teams should urgently evaluate this therapeutic strategy both to avoid the
spread of the disease and to treat patients before severe irreversible respiratory complications
take hold.

Treating COVID-19—Off-Label Drug Use, Compassionate Use, and Randomized Clinical Trials During Pandemics

Here is a link to an article Treating COVID-19—Off-Label Drug Use, Compassionate Use, and Randomized Clinical Trials During Pandemics.

It is a great example of a flawed argument in favor of Randomized Clinical Trials during pandemics and against compassionate use.

So, what’s wrong with it? Everything it says about the advantages of RCTs is correct. What it fails to consider is that if you have reasonable data about death rates from the pandemic, that is a priori information that bears on making a judgment about whether a drug works used off label in a non RCT setting.

Consider an extreme example: The disease has been 100% fatal and 100,000 people have died who became infected with it. You administer drug X to 10 of your patients who have come down with the disease. They all recover in 5 days with no serious adverse effects. Methinks, you don’t need an RCT to figure that the probability is high that drug X helps. If you buy the article's argument, you end up letting people die, needlessly.

Bayesian statistics, PLEASE.

Listen to a real COVID-19 expert tell you the truth

Here is the link.

Osterholm gives a great talk with a lot of information.  I have only the following cautionary comments.

He failed to consider the possibility of near term drugs that work.

The models he quoted as showing that large crowds don't matter strike me as flawed - their output reflects the assumed input - and it is easy to bias the impact of large crowds down to the point where they are mostly irrelevant.

The data he quotes as showing that closing schools does not help strikes me as simply suggesting that for this pandemic, so far, transmission is mostly from adults to children as opposed to other diseases at other times when it has been from children to adults.  If so, nothing rules out further spread being worse by keeping schools open during this pandemic.

For this pandemic, so far, it looks to me like most of the seeding in the US has been by adult travelers from other countries mixing with adults in this country.

COVID-19: Updated data implies that UK modelling hugely overestimates the expected death rates from infection

Here is the link to the paper.

https://judithcurry.com/2020/03/25/covid-19-updated-data-implies-that-uk-modelling-hugely-overestimates-the-expected-death-rates-from-infection/

I didn’t notice any adjustment for false positives, which would tend to lower the computed fatality rate (did I miss it or is it not accounted for?).

A 30% false negative rate is pretty large. I have read elsewhere that there also is a large false positive rate.

A Proposal for Social Insurance During the Pandemic

A nifty idea from Greg Mankiw.
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There has been a lot of discussion about how to best help people through the difficult economic times being caused by the pandemic. Some economists have suggested keeping things simple and quick by sending lump-sum checks to all Americans. Other economists are concerned that such an approach is expensive if the checks are generous and is not sufficiently targeted on those who are hardest hit. But targeting takes time, is difficult because it requires identifying who most needs the money, and, if imperfectly done, may miss some people who are truly needy.

So here is an idea: Don’t target ex ante. Target ex post.

Let’s send every person a check for X dollars every month for the next N months. In addition, levy a surtax in 2020 (due in April 2021) equal to N*X*(Y2020/Y2019), where Y2020 is a person’s earnings in 2020 and Y2019 is a person’s earnings in 2019. The surtax would be capped at N*X.

Under this plan, a person whose earnings fall to zero this year keeps all of the social insurance payments and does not pay the surtax. A person whose earnings fall by half keeps half of the payments and returns half. A person whose earnings remain the same (or increase) returns everything: They will have just gotten a short-term loan.

Of course, there is an implicit marginal tax rate in this scheme. If Y2020 is less than Y2019, each dollar of earnings in 2020 faces an additional marginal tax rate of N*X/Y2019. A hardcore supply sider might object. But at this moment in history, social insurance is more pressing than avoiding the distortionary effects of taxes. One might even argue that, considering the externalities associated with leaving home to go to work in this time of contagious pandemic, a higher marginal tax rate might be efficient.

For concreteness, let me put some rough numbers to this idea. (I am not recommending these particular numbers but using them to illustrate feasibility.) Suppose we send $2000 a month to every adult for the next six months. The adult population is about 300 million. We would send out $12,000 per person for a total of $3.6 trillion.

This staggering number, however, is not as scary as it seems. Because these payments would be short-term loans for most people, the net budgetary cost would be much smaller. The only people who would not repay the loans in full via the surtax would be those with reduced earnings in 2020. Let's say 25 percent of the labor force is unemployed for half the year (a very bad scenario). Then 40 million people would experience earnings declines of 50 percent. Their surtax would repay half the social insurance payments, resulting in their receiving net payments of $6,000 per person. The net budgetary cost would be only $240 billion, about 1.2 percent of GDP. This is surely feasible.

Useful COVID-19 links

Impact of non-pharmaceutical interventions to reduce COVID-19 mortality and healthcare demand.

https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-College-COVID19-NPI-modelling-16-03-2020.pdf

Chloroquine: 500 mg twice daily for 10 days (20 tablets total).

NIH: Breakthrough: Chloroquine phosphate has shown apparent efficacy in treatment of COVID-19 associated pneumonia in clinical studies

https://www.ncbi.nlm.nih.gov/pubmed/32074550

NIH: Expert consensus on chloroquine phosphate for the treatment of novel coronavirus pneumonia

https://www.ncbi.nlm.nih.gov/pubmed/32164085

Disease spread simulation.

https://www.washingtonpost.com/graphics/2020/world/corona-simulator/?itid=hp_hp-top-table-main_virus-simulator520pm%3Ahomepage%2Fstory-ans

CDC situation summary.

https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/summary.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fsummary.html

CIDRAP: Center for Infectious Disease Research and Policy

http://www.cidrap.umn.edu/

Potential false-positive rate among the "asymptomatic infected individuals" in close contacts of COVID-19 patients

The abstract of a paper from the National Institute of Health.

Objective: As the prevention and control of COVID-19continues to advance, the active nucleic acid test screening in the close contacts of the patients has been carrying out in many parts of China. However, the false-positive rate of positive results in the screening has not been reported up to now. But to clearify the false-positive rate during screening is important in COVID-19 control and prevention. Methods: Point values and reasonable ranges of the indicators which impact the false-positive rate of positive results were estimated based on the information available to us at present. The false-positive rate of positive results in the active screening was deduced, and univariate and multivariate-probabilistic sensitivity analyses were performed to understand the robustness of the findings. Results: When the infection rate of the close contacts and the sensitivity and specificity of reported results were taken as the point estimates, the positive predictive value of the active screening was only 19.67%, in contrast, the false-positive rate of positive results was 80.33%. The multivariate-probabilistic sensitivity analysis results supported the base-case findings, with a 75% probability for the false-positive rate of positive results over 47%. Conclusions: In the close contacts of COVID-19 patients, nearly half or even more of the 'asymptomatic infected individuals' reported in the active nucleic acid test screening might be false positives.

Rights Versus Wishes - A Right to Healthcare?

Here is a column by Walter Williams.

Walter E. Williams is a professor of economics at George Mason University.

As usual, WW is insightful.

Rights are seldom Rights.
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Sen. Bernie Sanders said: “I believe that health care is a right of all people.” He’s not alone in that contention. That claim comes from Democrats and Republicans and liberals and conservatives. It is not just a health care right that people claim. There are “rights” to decent housing, decent food, a decent job and prescription drugs. In a free and moral society, do people have these rights? Let’s begin by asking ourselves: What is a right?

In the standard usage of the term, a “right” is something that exists simultaneously among people. In the case of our U.S. Constitutional decree, we have the right to life, liberty and the pursuit of happiness. Our individual right to life, liberty and the pursuit of happiness imposes no obligation upon another other than the duty of noninterference.

As such, a right imposes no obligation on another. For example, the right to free speech is something we all possess simultaneously. My right to free speech imposes no obligation upon another except that of noninterference. Similarly, I have a right to travel freely. Again, that right imposes no obligation upon another except that of noninterference.

Sanders’ claim that health care is a right does impose obligations upon others. We see that by recognizing that there is no Santa Claus or tooth fairy who gives resources to government to pay for medical services. Moreover, the money does not come from congressmen and state legislators reaching into their own pockets to pay for the service. That means that in order for government to provide medical services to someone who cannot afford it, it must use intimidation, threats and coercion to take the earnings of another American to provide that service.

Let’s apply this bogus concept of rights to my right to speak and travel freely. In the case of my right to free speech, it might impose obligations on others to supply me with an auditorium, microphone and audience. It may require newspapers or television stations to allow me to use their property to express my views. My right to travel freely might require that others provide me with resources to purchase airplane tickets and hotel accommodations. What if I were to demand that others make sacrifices so that I can exercise my free speech and travel rights, I suspect that most Americans would say, “Williams, you have rights to free speech and you have a right to travel freely, but I’m not obligated to pay for them!”

A moral vision of rights does not mean that we should not help our fellow man in need. It means that helping with health care needs to be voluntary (i.e., free market decisions or voluntary donations to charities that provide health care.) The government’s role in health care is to protect this individual right to choose. As Senator Rand Paul was brave enough to say, “The basic assumption that you have a right to get something from somebody else means you have to endorse the concept of theft.”

Statists go further to claim that people have a “right” to housing, to a job, to an education, to an affordable wage. These so-called rights impose burdens on others in the form of involuntary servitude. If one person has a right to something he did not earn, it means that another person does not have a right to something he did earn.

The provision by the U.S. Congress of a so-called right to health care should offend any sense of moral decency. If you’re a Christian or a Jew, you should be against the notion of one American living at the expense of another. When God gave Moses the Eighth Commandment — “Thou shalt not steal” — I am sure that He did not mean, “Thou shalt not steal — unless there is a majority vote in the U.S. Congress.”

The politicization of the Supreme Court and the destruction of Justice

Here is a column by Jonathan Turley.

Jonathan Turley is the Shapiro Professor of Public Interest Law at George Washington University.

JT is on target.

It may not be long before the Supreme Court is packed with political hacks who will put politics above justice.
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“I am from Brooklyn.” That statement made by Senate Minority Leader Charles Schumer was meant to excuse threats he has made against two conservative justices the day before on the steps of the Supreme Court. His “apology” seemed to be a mix of claiming a license for all New Yorkers to use “strong language” and claiming justification because some justices are “working hand in glove” with Republicans. This was like a bizarre road rage defense from a Brooklyn driver who apologizes for the situation but explains that it was all due to the lousy driving of the other guy.

The problem is that this the latest in a pattern of Democratic leaders attacking and threatening jurists if they rule the “wrong” way in certain cases. Although Senate Minority Whip Richard Durbin advised the public “not to dwell” on the comments by Schumer, there is much more to dwell on than just this incident. Indeed, Democratic senators, including Durbin, have made threats against the Supreme Court and the judiciary.

It is certainly true that the media has not dwelled on these attacks, at least not from Democrats. Another New Yorker has used “strong language” to attack jurists, and many of us have criticized President Trump for those comments. Not surprisingly, Schumer has not cited a New York license for Trump to do as he did, perhaps since Trump was born in Queens. Indeed, Schumer recently denounced Trump for criticizing the judge in the trial of Roger Stone. Schumer called on Chief Justice John Roberts to “defend the independence” of the judiciary from such unwarranted attacks.

Roberts did speak out, but against Schumer, not Trump. The reason was, unlike Schumer, Trump did not threaten the judge. The criticism was still highly inappropriate, as many of us said at the time, but was not a threat. It was not Schumer saying that two conservative justices “will not know what hit” them if they “go forward with these awful decisions.”

Schumer was referring to a specific case and warning Justices Brett Kavanaugh and Neil Gorsuch that they “will pay the price” if they rule against his view of the proper outcome. When Roberts condemned that outrageous attack, Schumer criticized Roberts until pressure grew for an apology. Democratic senators opposed censuring Schumer, while Durbin and others also criticized Roberts for publicly rebuking him.

The reckless rhetoric by Trump is always widely covered. Yet much of the media has ignored equally troubling attacks from Democrats. Not long ago, Durbin joined Senators Mazie Hirono, Kirsten Gillibrand, and Richard Blumenthal in a brief written by Senator Sheldon Whitehouse. The brief contained a raw threat that if the justices did not side with New York in a gun rights case, the senators would stack the court with new members. Whitehouse warned the court to “heal itself before the public demands” that it be “restructured in order to reduce the influence of politics.”

By “influence of politics,” Whitehouse meant ruling against the views of Democrats, and he threatened political retaliation in response. In recent presidential debates, Democrats have applauded wildly as candidate after candidate pledged to impose an abortion litmus test on future Supreme Court nominees. For decades now, Democrats have criticized Republicans over suspected abortion litmus tests, denouncing those as an attack on judicial independence and integrity. Democrats have also embraced the “Ginsburg Rule,” whereby nominees refuse to answer specific questions on how they would rule on issues that might come before them.

Democrats now promise to get commitments on how justices will rule, and it is not clear how broad such litmus tests will become with late term abortions or state requirements on licensing for services. Presumably, additional litmus tests will apply to other issues, from religious rights to gay rights, as nominees check off positions like a dim sum menu.

Trump has been denounced widely for referring to “Obama judges,” and Democrats applauded Roberts when he rebuked him by declaring, “We do not have Obama judges or Trump judges, Bush judges or Clinton judges. What we have is an extraordinary group of dedicated judges doing their level best to do equal right to those appearing before them.”

Yet there has been little coverage of or outcry against the attacks by Democratic leaders on “Trump judges” and “Trump justices.” Former candidates have argued in debates over who voted more often against “Trump judges.” Senator Amy Klobuchar boasted of opposing two-thirds of all Trump nominees, but that was still not enough for the liberal group Demand Justice, which expressed disappointment with her.

Somehow it is perfectly fine to suggest that Trump judicial appointees rule on the basis of politics instead of principle. That was evident in the road rage apology of Schumer, who said he had been provoked because Republicans and the courts “working hand in glove” to change the law in areas like abortion. Thus, judges appointed by Democratic presidents are entitled to presumption of independence, while Republican nominees to the courts are regularly denounced as partisan robed robots.

The Framers gave the appointment power to presidents to allow our judiciary to change with society. Presidents throughout history have always used their appointments to shift the ideological divide on the courts. President Obama used his authority to appoint two justices who routinely vote in a bloc with liberal members. What is viewed as simply “correct” in liberals such as Justices Elena Kagan and Sonia Sotomayor, however, is viewed as utterly dishonest bias in conservatives.

During the Kavanaugh confirmation hearings, Whitehouse declared that he uncovered an unmistakable “pattern evidence of bias” by the “Roberts Five.” The five conservative justices often vote as a bloc, he said, and “no Democratic appointee joins them.” He blissfully ignored that on the other side of the divide are four liberal justices who vote as a bloc too.

Sadly, none of this appears to warrant more media coverage or analysis. It appears from that lack of coverage that there is less of a Brooklyn than of a Democratic license when it comes to attacks on the judiciary.

The possible economic impact of Carona Virus 19

Here is a link to a new book that attempts to assess the likely economic impact of Carona Virus 19.

Why what you have heard about wealth inequality and income inequality is wrong

John Cochrane tells the truth about wealth and income inequality, here.

JC's paper is well written and understandable by the layman.  It is an important read if you want to understand the issues.

JC establishes that what you have heard about wealth and income inequality is a wild exaggeration and what you have heard about "solutions" would make things far worse.

The politicians, media, and talking heads that want to upset you about both either do not understand the issues or or intentionally misleading you.  In either case, they are not trustworthy.