Government's destruction of the health care system - an example

Government, particularly State Governors, have implemented policies that focus the health care system and mitigation on minimizing COVID-19 deaths. Typical of Government, these policies do not reflect tradeoffs adequately, hence cause needless death. Here is an example described in the abstract from "Collateral damage: the impact on outcomes from cancer surgery of the 2 COVID-19 pandemic" which will appear in the Annals of Oncology.

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BACKGROUND

Cancer diagnostics and surgery have been disrupted by the response of healthcare services to the COVID-19 pandemic. Progression of cancers during delay will impact on patient long-term survival.

METHODS

We generated per-day hazard ratios of cancer progression from observational studies and applied these to age-specific, stage-specific cancer survival for England 2013-2017. We modelled per-patient delay of three months and six months and periods of disruption of one year and two years. Using healthcare resource costing, we contextualise attributable lives saved and life-years gained from cancer surgery to equivalent volumes of COVID-19 hospitalisations.

FINDINGS

Per year, 94,912 resections for major cancers result in 80,406 long-term survivors and 1,717,051 life years gained. Per-patient delay of three/six months would cause attributable death of 4,755/10,760 of these individuals with loss of 92,214/208,275 life-years. For cancer surgery, average life-years gained (LYGs) per patient are 18.1 under standard conditions and 17.1/15.9 with a delay of three/six months (an average loss of 0.97/2.19 LYG per patient). Taking into account units of healthcare resource (HCRU), surgery results on average per patient in 2.25 resource-adjusted life-years gained (RALYGs) under standard conditions and 2.12/1.97 RALYGs following delay of three/six months. For 94,912 hospital COVID-19 admissions, there are 482,022 LYGs requiring of 1,052,949 HCRUs. Hospitalisation of community-acquired COVID-19 patients yields on average per patient 5.08 LYG and 0.46 RALYGs.

INTERPRETATION

Modest delays in surgery for cancer incur significant impact on survival. Delay of three/six months in surgery for incident cancers would mitigate 19%/43% of life-years gained by hospitalisation of an equivalent volume of admissions for community-acquired COVID-19. This rises to 26%/59% when considering resource-adjusted life-years gained. To avoid a downstream public health crisis of avoidable cancer deaths, cancer diagnostic and surgical pathways must be maintained at normal throughput, with rapid attention to any backlog already accrued.

Twitter is wrong on mail-in ballots – they make fraud easy

We know that mail-in ballots make fraud easy - because Jerry Nadler said so several years ago.

If you prefer facts, here is John Lott at townhall.com.

JL is on target.
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Twitter is no longer willing to just let President Trump and his critics battle things out on their own. In response to a Tweet from the President on Tuesday morning, the social media giant posted a “What you need to know” disclaimer. It declared: “Trump falsely claimed that mail-in ballots would lead to ‘a Rigged Election.’ However, fact-checkers say there is no evidence that mail-in ballots are linked to voter fraud.”

It echoes Joe Biden’s claim last week that there is “no evidence whatsoever” of vote fraud with mail-in ballots.

Contrast Twitter’s claim with this statement: “Absentee ballots remain the largest source of potential voter fraud.” That quote isn’t by President Trump. It was the conclusion of the bipartisan Jimmy Carter-James Baker 2005 “Building Confidence in U.S. Elections” report.

Twitter might not agree with Jimmy Carter and the commission, but to say that “there is no evidence” is wrong.

It is hard to see how Trump’s Tweet is false. He claims that mail-in ballots are “substantially fraudulent.” Whether something is “substantial" is in the eye of the beholder. Mail-in ballot fraud has clearly altered the outcome of elections, making it significant to some.

Courts have ruled that mail-in ballot fraud has changed the outcome of elections: Democrats gained control of the Pennsylvania state Senate in 1994 and the Miami 1998 mayoral election. But it isn’t just cases from a couple of decades ago. Other recent examples include the 2017 Dallas City Council and the 2018 North Carolina Congressional race.

Mail-in ballots aren’t secure. They surely are less secure than in-person voting, and that makes fraud more likely.

In Nevada this month, many mail-in ballots were sent to inactive voters. “They’re not secured at all and there are thousands of them just sitting here,” Jenny Trobiani, a postal worker in Clark County, told Fox News. Local residents were concerned that anyone could pick up the ballots and cast a fraudulent vote.

In West Virginia, one mail carrier currently faces charges of tampering mail-in ballots that had already been filled in by registered voters.

A case in New Jersey this spring illustrates how difficult it is to actually catch people who engage in large scale fraud. In Paterson and Haledon, New Jersey, vote fraud was only discovered because a perpetrator was foolish enough to send 600 mail-in ballots in bundles ranging in size from 13 to 40 letters. Fortunately, an observant mailman realized that something was wrong. But, as usual, the perpetrator was never caught. After all, it isn’t as though the criminal signed his name to the ballots.

Proponents of mail-in ballots like to point to the small number of convictions for vote fraud, but they overlook the difficulty of enforcing laws against mail-in ballot fraud when you can’t even figure out who did it. Even when cases are discovered, they are not always prosecuted. The Public Interest Legal Foundation is suing Allegheny County, Pennsylvania for allowing the same person to use the same name, same address, and same birthday to register to vote seven times. But few people committing fraud make the cases that obvious.

Vote buying is even more difficult to detect because both parties involved in the transaction have an incentive to hide it.

The concern over mail-in ballots isn’t limited to the United States. Western European countries such as Denmark, Finland, France, Italy, and Norway don’t allow mail-in ballots. The U.K. allows mail-in ballots for the blind or otherwise physically incapacitated. Mexico banned mail-in ballots altogether in 1991 because of rampant fraud. Since 2006, Mexico has allowed mail-in ballots only for those living outside the country.

Mail-in ballots can be intercepted, meaning that they are not truly secret. People completing a mail-in ballot at home may face extra pressure from family members or roommates.

The secret ballot was introduced in various states between 1888 and 1950, in large part to prevent vote-buying. Secret ballots made it much more difficult for vote-buyers to monitor which candidates that a person voted for. According to my own research with Larry Kenny at the University of Florida, voter turnout fell by about 8–12 percent after states adopted secret ballots.

Many Twitter accounts frequently claim that there is “no evidence” of mail-in vote fraud.

CNN misleading Tweeted “Republican National Committee sues California to halt vote-by-mail for November election.” In fact, the RNC just sued to stop the state from automatically sending mail-in ballots to everyone registered to vote.

But don’t expect Twitter to attach warning labels to these false and misleading posts. From shadow banning and locking conservative accounts, to now posting warning labels, Twitter is not letting the battle of ideas proceed without tipping the scale towards liberals.

The law does not guarantee freedom and justice - people do - that's why both are fast disappearing

Here is Jonathan Turley on Judge Emmet Sullivan.

JT is on target.

Those who believe that it is the Constitution and the law that guarantee our freedom and justice are naive.  History shows that it is the willingness of people, e.g., law enforcement, attorneys general, prosecutors, judges, who do.  History also shows that, sooner or later, they fail to do so.

Flynn is just the tip of the iceberg.

Read the Constitution and the Courts' "interpretation" of the Constitution over time.

Look at the trend toward control of our actions and speech.

Look at the testimony of the several Constitutional Law professors at the Trump impeachment hearings.  Only one, Turley, showed objectivity.  The others only illustrated how readily many "learned individuals" are willing to discard objectivity and adherence to the law to achieve their agenda.
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The case of former national security adviser Michael Flynn is rapidly moving from the dubious to the preposterous. U.S. District Judge Emmet Sullivan is being widely applauded for resisting the dismissal of a case that the Department of Justice insists cannot be ethically maintained.

Faced with no dispute between the parties, Sullivan decided to create a contested case by inviting in third parties to create a conflict and now is suggesting that he may substitute his own criminal charge rather than let Flynn walk free. In the past, I have publicly praised Sullivan. However, this is fast becoming a case of gross judicial overreach as the court appears to assume both judicial and executive powers. Sullivan can disagree with the exercise of prosecutorial discretion, but he cannot substitute his own judgment for it.

“At the appropriate time, the court will enter a scheduling order governing the submission of any amicus curiae briefs,” Sullivan wrote. Never has a more innocuous line left a more ominous meaning. After that order, the judge proceeded to appoint retired Judge John Gleeson to argue against dismissal in the absence of a dispute between the parties. He is effectively outsourcing the argument to introduce a dispute. This move is nothing to celebrate.

A punishment by plebiscite

Amicus briefs are allowed by courts when outside parties want to be heard on some contested issue facing a court. Such filings are common in civil cases. This, however, is a criminal case. There are serious questions about the propriety of such third parties being asked to brief uncontested motions in a criminal case. The lives and liberty of individuals generally are protected from public demands for punishment. We do not do punishment by plebiscite in this country.

While courts have discretion to grant amicus or third-party arguments in civil cases, there is no counterpart under the Federal Rules of Criminal Procedure. In fact, Judge Sullivan rejected such a request on Dec. 20, 2017, stating that “the Federal Rules of Criminal Procedure do not provide for intervention by third parties in criminal cases. … Options exist for a private citizen to express his views about matters of public interest, but the court’s docket is not an available option.”

Sullivan’s earlier order was the correct one. It is dangerous to open up criminal cases for citizens to argue for convictions or enhanced punishments, particularly when prosecutors seek dismissal in light of prosecutorial error or abuse.

Indeed, former President Bill Clinton’s attorney general, Janet Reno, warned Congress against courts intruding on Justice Department decisions, stressing that “our Founders believed that the enormity of the prosecutorial power — and all the decisions about who, what, and whether to prosecute — should be vested in one who is responsible to the people.”

That is particularly the case where the motion benefits a criminal defendant. Indeed, it is difficult to imagine any basis that Sullivan could deny this motion without facing a rapid reversal.

However, the Flynn case has proved to be the defining temptation for many in discarding constitutional protections and values in their crusade against President Donald Trump. Experts are asking a court to consider sending a man to prison after the Justice Department concluded it can no longer stand behind his prosecution. Under this same logic, any defendant could face public outrage over an unopposed motion to dismiss, and a court could invite third parties to make arguments against him. Rather than protecting an unpopular criminal defendant from those outside clamoring for his head, the court is inviting them inside to replace the prosecutors.

Judges are not prosecutors

If Sullivan’s invitation for third parties to argue in a criminal case is unnerving, his suggestion that he might substitute a perjury charge is positively terrifying. Sullivan has compounded this judicial overreach by asking Gleeson to explore the issue, despite his public criticism of the administration’s handling of the Flynn case.

Under Sullivan’s theory, any time a defendant seeks such a dismissal (even with the support of the prosecutors) he could face a judicially mandated perjury charge. Faced with evidence of prosecutorial wrongdoing (which often arises after a trial), defense counsel (like myself) would have to warn clients that the court might just swap one crime for another.

The chilling implications of such a theory are being brushed aside by those eager to see Sullivan mete out his own form of justice. However, such an unsustainable decision would quickly careen out of control.

Consider the scenario. Sullivan knows that such a charge would not be prosecuted by the Justice Department. However, Criminal Procedure Rule 42 states that such cases are to be prosecuted by the government, but “if the government declines the request, the court must appoint another attorney to prosecute the contempt.”

So what is Sullivan going to do? He cannot force the Justice Department to prosecute a case that it considers to be unethical. He would have to enlist his own outside prosecutor after creating his own dispute with outside parties. If Flynn is convicted, Sullivan will have to order the Bureau of Prisons to incarcerate someone who was convicted by judicial design.

Sullivan Record Remains Controversial In The Case

Ironically, Sullivan is largely responsible for the current posture of the case. Flynn was supposed to be sentenced in December 2018 before the hearing took a bizarre turn. Using the flag in the courtroom as a prop, Sullivan incorrectly accused Flynn of being “an unregistered agent of a foreign country while serving as the national security adviser to the president of the United States. Arguably, that undermines everything this flag over here stands for. Arguably, you sold your country out.” He then questioned whether Flynn should have been charged with treason.

Flynn faced a relatively minor single count of false statements with the likelihood of no jail time — but Sullivan was suggesting that he could have been charged with treason, subject to the death penalty.

Sullivan then gave Flynn a menacing choice: “I cannot assure you that if you proceed today, you will not receive a sentence of incarceration. … I’m not hiding my disgust, my disdain.”

Flynn, unsurprisingly, opted to wait. Had Sullivan simply sentenced him, Flynn would have been formally convicted and sentenced — making any later motion more difficult while the case was on appeal.

Fortunately, while H. L. Mencken once described a judge as “a law student who marks his own examination papers,” our system allows for appellate review, and few judges would give such decisions a passing grade. The fact is, such a judicially constructed case would be effectively dead before it could be properly captioned for docketing. The problem is that Flynn would be left twisting in the wind as others use his case to make extraneous points.

I previously discussed how Michael Flynn has the curse of being useful. He was useful to investigate for officials like FBI special agent Peter Strzok, former FBI Deputy Director Andrew McCabe and former FBI Director James Comey, though investigators found no underlying criminal conduct. He was useful to special counsel Robert Mueller, even though the same investigators apparently did not believe he intentionally lied to them. He now is useful to a court that seems intent on staging a criminal case of its own making.

Of course, at some point, when Flynn stops being so useful, justice might be served with the dismissal of this abusive case.

Hydroxychloroquine efficacy for COVID-19

Here is a link to a retrospective cohort study from South Korea.

The results are promising.

Some excerpts follow.
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Abstract

Background: No consensus or evidence-based guideline currently exists for pharmacological therapy against Coronavirus Disease 2019 (COVID-19). While South Korea has been relatively successful in managing the pandemic, its management of confirmed cases and treatment outcomes have not been reported to date.

Methods: A retrospective cohort study of the 358 laboratory-confirmed SARS-CoV-2 – or COVID-19 - patients was conducted. Of these patients, 270 adult patients met inclusion criteria and were included in our analyses. The primary endpoints were time to viral clearance and clinical improvement. The mean duration to viral clearance and clinical improvements were displayed as bar-plots to visualize treatment responses.

Results: Ninety-seven moderate COVID-19 patients were managed with hydroxychloroquine (HQ) plus antibiotics (n = 22), lopinavir-ritonavir (Lop/R) plus antibiotics (n = 35), or conservative treatment (n = 40). Time to viral clearance, as signified by negative conversion on PCR, after initiation of treatment was significantly shorter with HQ plus antibiotics compared to Lop/R plus antibiotics (hazard ratio [HR], 0.49; 95% confidence interval [95% CI], 0.28 to 0.87) or conservative treatments (HR, 0.44; 95% CI, 0.25 to 0.78). Hospital stay duration after treatment was also shortest for patients treated with HQ plus antibiotics compared to other treatment groups. Subgroup analysis revealed that mean duration to viral clearance was significantly reduced with adjunctive use of antibiotics compared to monotherapy (HR 0.81, 95% CI, 0.70 to 0.93). While both HQ and Lop/R showed side effects including nausea, vomiting, and elevation of liver transaminases, none were serious.

Conclusion: This first report on pharmacological management of COVID-19 from South Korea revealed that HQ with antibiotics was associated with better clinical outcomes in terms of viral clearance, hospital stay, and cough symptom resolution compared to Lop/R with antibiotics or conservative treatment. The effect of Lop/R with antibiotics was not superior to conservative management. The adjunct use of the antibiotics may provide additional benefit in COVID-19 management but warrants further evaluation.

Prosecutorial misconduct is “In”. Justice is “Out”

Here is Jonathan Turley on the Flynn case.

JT is on target.

The Constitution does not guarantee your freedom or justice.  It is those who are in a position of power that do so - if they choose to.  Recent history shows that, largely, they do not.

We are at the mercy of the Bureaucracy.  More accurately, we are at the mercy of small minds that value pushing their agenda and covering their a--es more than objectivity and fairness.

Government is not your friend.
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For decades, the legal community has decried common practices used by prosecutors to coerce pleas from defendants. Prosecutors often stack up charges and then drain defendants until they agree to pleading guilty. There was a time when such abuses were regularly called out in leading newspapers. These are not those times.

The Flynn case was a textbook example of these abuses but media commentators quickly adopted the “anyone who pleads guilty must be guilty” mantra. Suddenly, the “proof is in the plea” regardless of false representations, withheld evidence, and conflicting findings in the Flynn case.

The only acceptable take in the media is that the motion to dismiss the Flynn case is an outrageous politicalization of the justice system. This narrative is only possible by ignoring the long-standing questions over the handling and charge in the case. Indeed, it is telling how both controlling law and countervailing facts have been uniformly (and knowingly) ignored in order to portray the case as a virtual immaculate prosecution.

Much of the analysis of the Flynn case notably starts half way across the field with the guilty plea of Flynn rather than at the start. the New York Times recently published an editorial entitled “Don’t forget, Michael Flynn pleaded guilty. Twice.” Such coverage pretends that there have been no questions raised about the underlying charge. The investigators concluded (and told FBI officials) that they did not believe that Flynn intentionally lied when he denied speaking about sanctions with the Russian ambassador. There was no reason to do so. Flynn knew that the FBI had intercepted the call and told the investigators that they could check the transcript. Moreover, Trump had publicly called for reexamining the entire Russian relationship, including sanctions. Most importantly, the meeting was perfectly legal for the incoming National Security Adviser to encourage the Russians not to retaliate pending such a review by the incoming Administration.

While acknowledging that he failed to recall the sanctions discussion, Flynn contested the charge on the basis of intent and eventually spent virtually all of his money, including having to sell his house. He only pleaded guilty when the Special Counsel’s office threatened to charge his son and offered in exchange a plea to a relatively minor charge (with little or no jail time expected). What is striking about these facts is that analysts citing the plea routinely omit all of them to make the case look cut and dry. The issue was never whether Flynn’s statement was false but his intent and the materiality of the statement. Even though I supported the appointment of a Special Counsel, I raised these concerns years before the motion to dismiss was filed.

Nevertheless, the New York Times editors have warned “It’s hard to overstate how dangerous this is. It is a small step from using the Justice Department to protect your friends to using it to go after your political enemies. In other words, watch out, Joe Biden.” Of course, it was the Obama Administration with Biden as Vice President that started an investigation into its opponents based on Russian collusion allegations later found to lack any credible foundation. A long list of Obama officials admitted that they never saw any direct evidence of such collusion. Moreover, we now know that FBI agents early on warned that the material in the Steele Dossier (funded by the Clinton campaign) was not just unreliable and likely Russian intelligence misinformation. The Obama Administration still launched a full and long investigation of the Trump campaign and its officials. That was no “small step” but a giant leap.

As a criminal defense attorney, I have been personally involved in cases where innocent defendants must choose between effective bankruptcy (and the risk of a longer incarceration) against a plea for one or two counts. To his credit, Harvard Professor Noah Feldman was one of the few to acknowledge the problem of false pleas: “True, we all understand that, faced with the awesome power of prosecution, defendants sometimes plead guilty even if they aren’t. Liberals should be the first to acknowledge that in the real world, a guilty plea doesn’t necessarily mean the defendant committed the crime.” After acknowledging that reality, however, Feldman immediately dismisses it in a spellbinding level of circular reasoning: “But when the crime was lying, and the government still acknowledges that the defendant in fact did lie, there is less reason to worry that the defendant has been railroaded.”

Once again, the issue was never the falsity but the intent of the statement. Proof of a false statement to federal investigators under Section 1001(a)(2) requires more than a simple false statement. Rather, the false statement must be “material” to the underlying investigation. The motion to dismiss actually contained a discussion that has long been made by defense counsel as the correct reading of the law: “The materiality threshold thus ensures that misstatements to investigators are criminalized only when linked to the particular ‘subject of [their] investigation’ …[and] prevents law enforcement from fishing for falsehoods” to charge someone. Newly released documents show officials openly fishing for any criminal charge against Flynn long after the counterintelligence operation from no criminality. None of that evidence was put before the Court when it reviewed the Flynn plea, which was uncontested.

Moreover, the statement of the Justice Department should be celebrated by those who believe in due process for criminal defendants. The Flynn filing represents a powerful statement against prosecutorial coercion and abuse. It will be cited for years, including by this criminal defense attorney, in future cases. It is a powerful affirmation in a case with classic elements of coercive prosecutorial misconduct. Yet, the media has denounced it and the very notion of challenging trial prosecutors in such a case.

We now know from the Justice Department that both agents “had the impression at the time that Flynn was not lying or did not think he was lying.” It was not until much later that Mueller’s people decided to use the discrepancy for a charge. It is common for such false statements to be flagged to coerce defendants into plea agreements, the very point Feldman just made.

Notably, when Flynn was charged, Feldman explained that it made it more difficult for Trump to fire Mueller because “the content of the Flynn-Kislyak conversations deepens the narrative that special counsel Robert Mueller has been building.” There was certainly a narrative like that in the media, but there was no real evidence of Russian collusion. Indeed, at the time of the Flynn plea, Mueller already knew that. However, the key remains the “narrative” not the evidence.

These facts simply do not fit the narrative. Suddenly, the judge’s resistance to granting the motion becomes ignoble and, God forbid, Barr move could be viewed as noble. Likewise, while analysts and academics herald Sullivan’s tough scrutiny of the motion, none are asking why Sullivan did not appoint an outsider or anyone to look into credible allegations that the original prosecutors against Flynn committed serious constitutional violations in withholding evidence and misrepresenting facts to the Court. It is also not relevant that FBI officials involved in the Flynn case like former Deputy FBI Director were found to have lied repeatedly to investigators. It is easier to say that the “proof is in the plea.”

“In like Flynn” once meant that you lived a charmed life of access or success. Today, it appears the media has adopted a chilling “out like Flynn” view, meaning some people simply do not deserve fair judicial or media consideration. Indeed, it is now an article of faith to dismiss any question about the conduct of the prosecutors in the Flynn case, even if it means adopting the long discredited view that only the guilty plead guilty.

How you can tell whether someone understands basic economics

Here is Don Boudreaux on planning vs. markets.

DB is on target.

When you run across someone who pooh poohs markets in favor of central planning, you can safely assume that 1) they don't understand economics, 2) they are unaware of what they may not know, and 3) they are not credible on other topics.
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Everyone who calls for “industrial policy” – conservatives such as Oren Cass and Marco Rubio no less than “Progressives” such as Robert Reich and Elizabeth Warren – base their case on a foundation that features ignorance of economics and of history. These industrial-policy proponents simply haven’t studied economics or history with sufficient care. (Most of them are lawyers. This distinction is unobjectionable, but it is also one that explains these pundits’ and politicians’ frequent failure to understand the economics about which they write – and about which they write in such lawyerly fashion.)

Among the most basic historical realities to which these industrial-policy proponents are blind is the source of so very much of what they take for granted in their everyday lives. Deirdre and Alberto above point to containerization – an astonishingly revolutionary if hardly mind-blowingly high-tech innovation that dramatically reduces the costs of transporting goods to market. (If Malcolm McLean had taken his idea for “the box” to a U.S. industrial-policy directorate, it’s almost certain that he would have been tossed out summarily. Not only is his idea wholly unsexy, its adoption would have been correctly seen as the destroyer of countless jobs for longshoremen.)

Our daily lives are filled with unnoticed marvels that are the results of innovators even less heralded that Malcolm McLean. Go into your kitchen. Look in the pantry. Who is responsible for the soup and cola cans being so light weight? Who designed their ingenious tops? Who invented the little packets of preservatives that keep your peanuts fresher longer?

Look at and into your refrigerator. Who are the many individuals who creatively came up with the stream of ideas that result in today’s bottom-of-the-line new refrigerator being a monument of marvels compared to a top-of-the-line new refrigerator of 1960? Who invented self-defrosting freezers? Who figured out how to enable a home freezer to dispense ice? (Would you prefer crushed or cubed?)

What’s in your fridge? Did you just this morning buy fresh blueberries at the supermarket? (How did that happen, by the way – “that” being a reliable supply of fresh blueberries year-round?) Look at the plastic container. Notice at the corners the notches that allow you easily yet surely to close the package to avoid spillage. Whose idea is that? And what about that brilliantly designed plastic bottle that securely holds a full gallon of milk yet enables you to pour its contents with ease. Whose idea is that? Or, rather, whose complex set of ideas are those?

Oh, look there, in a meat drawer in your fridge. You’ve got some chicken and tarragon sausages. When you grill them this evening they’ll be yummy! Whose idea was it to make that particular kind of sausage, and to enable it to be produced you-know-not-where and shipped safely to your favorite supermarket (you’ve got a choice of several!) in a package that doesn’t leak yet allows you to visually inspect what you’re buying?

You – you modern person you! – used the self-checkout lane and scanned your sausages, along with the other items in your particular selection of groceries that you chose from the tens-of-thousands of items that sit on the supermarket’s shelves. Who invented the scanner? Who designed the ingenious metal arms that hold the amazingly lightweight but equally amazingly strong plastic bags into which you’ll put your groceries – bags that you’ll discard the moment you tote your grocery haul into your kitchen?

Hey, the temperature outside is getting higher. Summer is finally on its way! Let’s turn on the air-conditioner. A flick of your finger et voila!: chilled air streams into your home. (Hmmm. 71 degrees f. is a bit too cool. Let’s raise the temperature to 71.5 degrees f. That’s better!) Who designed the thermostat – the very modern thermostat that you take for granted but that would have blown Howard Hughes’s mind in 1970 had he been rich enough to own one? Who figured out how to make the ductwork through which the chilled air flows into every room in your home?

For answers to these questions, you flip open your laptop – or maybe call to life your iPad. Or perhaps your smartphone. Or maybe, instead, you ask your Google smart speaker. Who figured out how to make wi-fi affordable to ordinary people? Who designed the search engines? Who enabled Google or Alexa to recognize your voice?

Who? Who?? Who???! How? How?? How???!

Each of us, every day, is the beneficiary of the creative and innovative efforts of millions of people whose efforts are coordinated – not perfectly (duh), but nevertheless with amazing effectiveness – by the prices, profits, and losses of market processes.

Industrial-policy advocates somehow miss all of this awesomeness. They see only ‘imperfections,’ heedless of the significance of these deviations from a divinely imagined ideal relative to the significance of what the market daily, actually achieves. Even worse, though, is the sorry fact that these advocates of industrial policy see unavoidable features of market processes and economic growth – I speak here of creative destruction and job churn – and mistakenly imagine that the state can eliminate these features without simultaneously destroying the economy.

Industrial-policy advocates are blind to the everyday marvels of market processes yet believers in the ability of the state to work impossible miracles.

Misuse of statistics - keep it in mind concerning COVID-19

Keep the following in mind as you listen to the Experts, Talking Heads, Politicians, and the Media.

A statistical hypothesis test of a drug’s efficacy with an insignificant result, i.e., that does not reject the null hypothesis that the drug has no beneficial effect, does not imply that the drug has no beneficial effect. In fact, any observed beneficial effect makes it more likely than not that it does have a beneficial effect (principal of maximum likelihood).

A statistical hypothesis test of a drug’s efficacy with a highly significant result, i.e. it strongly rejects the null hypothesis that the drug has no beneficial effect, does not imply that the drug has a worthwhile beneficial effect. In fact, it may have no beneficial effect, a harmful effect, or a negligible beneficial effect.

If a drug’s hypothesis test shows a statistically insignificant but beneficial effect, then it is fair to view it as more likely than not that it has a beneficial effect (principle of maximum likelihood).

Which is more believable: A large sample statistical test with statistical size x% that rejects the null hypothesis or a small sample statistical test with statistical size x% that rejects the null hypothesis? Answer: They are equivalent. The fact that the former has more power is irrelevant to the null hypothesis, where the “power” is identical.

Statistical significance is not the same as clinical significance, i.e., the magnitude of the beneficial effect.

Standard hypothesis tests do not take into account a priori information. I have not run across a standard statistical test of the direction an object will “fall” (up or down) when released from the hand. Nevertheless, I am confident that it will fall down. Waiting for a formal statistical test can cost lives.

A simple truth applicable to COVID-19

One of my favorite lessons in statistics: Scott Braithwaite at JAMA Network.

SB is on target.
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The six most dangerous words in evidence-based medicine (EBM) do not directly cause deaths or adverse events. They do not directly cause medical errors or diminutions in quality of care. However, they may indirectly cause these adverse consequences by leading to false inferences for decision making. Consider the following statements, each of which includes the six most dangerous words:

• There is no evidence to suggest that hospitalizing compared with not hospitalizing patients with acute shortness of breath reduces mortality.

• There is no evidence to suggest that ambulances compared to taxis to transport people with acute GI bleeds reduces prehospital deaths.

• There is no evidence to suggest that looking both ways before crossing a street compared to not looking both ways reduces pedestrian fatalities.

All of these statements are clearly absurd as foundations for decision making, yet they are technically correct. In each case, these hypotheses have been untested and therefore there is no evidence to suggest otherwise, presuming a definition of “evidence” that requires formal hypothesis testing in an adequately powered study.1 Indeed, as of this writing, “there is no evidence to suggest” appears in MEDLINE 3055 times, nearly as often as “decision analysis” (3140 times), a common framework for using evidence to make decisions. My anecdotal experience suggests that “there is no evidence to suggest” is a mantra for EBM practitioners, in a wide variety of settings. And it is infrequently followed by the clarifying aphorism “absence of evidence is not evidence of absence”2 or discussions of more inclusive definitions of “evidence.”3,4

Deciding not to intervene when “there is no evidence to suggest” the favorability of an intervention makes sense from a decision analytic perspective when the act involves potential harm or large resource commitments.5 However, deciding to intervene when “there is no evidence to suggest” also may make sense, particularly if the intervention does not involve harm or large resource commitments, and especially if benefit is suggested by subjective experience (eg, the qualitative analogue of the Bayesian prior probability).6

Indeed, the fundamental problem with the phrase “there is no evidence to suggest” is that it is ambiguous while seeming precise. For example, it does not distinguish between the vastly different evidentiary bases of US Preventive Services Task Force (USPSTF) grades I, D, or C, each of which may have distinct implications for decision making.7 “There is no evidence to suggest” may mean “this has been proven to have no benefit” (corresponding to USPSTF grade D), which has very different implications than alternative meanings for “there is no evidence to suggest” such as “scientific evidence is inconclusive or insufficient” (corresponding to USPSTF grade I) or “this is a close call, with risks exceeding benefits for some patients but not for others” (corresponding to USPSTF grade C). As a result, these six dangerous words may mask the uncertainty of experts. They even may be used to deny treatments with potential benefit, if they are interpreted as the equivalent of USPSTF grade D (“this has been proven to have no benefit”) but really mean the equivalent of USPSTF grade I (“scientific evidence is inconclusive or insufficient”).

Beyond its ambiguity, “there is no evidence to suggest” creates an artificial frame for the subsequent decision. It may signal to patients, physicians, and other stakeholders that they need to ignore intuition in favor of expertise, and to suppress their cumulative body of conscious experience and unconscious heuristics in favor of objective certainty. Suppressing intuition may be appropriate when the evidence yields robust inferences for decision making, but is inappropriate when the evidence does not yield robust inferences for decision making. Yet “there is no evidence to suggest” is compatible with either scenario. Because decisions are particularly sensitive to patient preferences when the favorability of an intervention is unclear (eg, USPSTF grade C), “there is no evidence to suggest” may inhibit shared decision making and may even be corrosive to patient-centered care.8 Indeed, it is instructive to note that most people make patient-centered decisions every day without high-quality (eg, randomized controlled trial) evidence, and these decisions are not always wrong. Furthermore, foundational papers in the EBM field make it explicitly clear that EBM was never meant to exclude information derived from experience and intuition.4 While some may argue that misuse of this phrase is only a symptom of not having received appropriate training in EBM, my experience with practitioners of EBM across the clinical, educational, research, and policy spectra suggests the contrary.

I suggest that academic physicians and EBM practitioners make a concerted effort to banish this phrase from their professional vocabularies. Instead, they could substitute one of the following 4 phrases, each of which has clearer implications for decision making: (1) “scientific evidence is inconclusive, and we don’t know what is best” (corresponding to USPSTF grade I with uninformative Bayesian prior) or (2) “scientific evidence is inconclusive, but my experience or other knowledge suggests ‘X’” (corresponding to USPSTF grade I with informative Bayesian prior suggesting “X”), (3) “this has been proven to have no benefit (corresponding USPSTF grade D), or (4) “this is a close call, with risks exceeding benefits for some patients but not for others” (corresponding to USPSTF grade C). Each of these four statements would lead to distinct inferences for decision making and could improve clarity of communication with patients.

EBM practitioners should abandon terms that may unintentionally mislead or inhibit patient-centered care. “There is no evidence to suggest” is a persistent culprit. Informed implementation of EBM requires clearly communicating the status of available evidence, rather than ducking behind the shield of six dangerous words.

Box of Chocolates

A JAMA article by Lealani Mae Y. Acosta, MD
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Patients often come to see the physician with hope, and we do our best to help. When our best efforts may not feel like much to us, they may make an immeasurable difference to the lives of patients and their families. Their gratitude is similarly difficult to quantify, even when embodied in a box of chocolates.

As per the initial visit, he came pushing his wife of many decades in her wheelchair, only this time he additionally came bearing a bright smile and a distinctive box of chocolates. It actually was Valentine’s Day.

“I am so happy we are seeing you again, Dr Acosta! She has done so much better since her first visit with you and the suggestions you’d made!” This was a difficult concept to grasp, because she had been quite challenging to examine when I initially evaluated her.

A wheelchair-bound octogenarian with kyphosis and presbycusis, she had been brought by her husband to clarify the diagnosis of dementia. I had reviewed her medical record ahead of the visit and had mentally prepared myself. Her primary care physician (PCP) was a good historian and had carefully documented her multiple medical diagnoses, although the best that could be said for her cognitive status was “dementia.” The physical examination results included in the notes ran the gamut of standard organ systems typical for a general physical examination. The patient sitting before me was a perfect reflection of those encounters, which documented a patient who had tremendous difficulty following commands and could only communicate very little. Given that so much of my examination as a behavioral neurologist relies on language and cooperation, I was unsure what to expect from the encounter. To quote Dr McCoy from Star Trek, “I'm not a magician, Spock, just an old country doctor.” With any referral, much like Gump’s proverbial chocolates, you never know what you’re going to get.

True to form, her initial examination left me rather discomfited because almost every kind of cognitive question was left unanswered. I practically shouted in her ear with every question, to which the patient responded either with, “What?” or silence. I typically ask the spouse about the existence of hearing aids, which inevitably are either forgotten at home, too expensive, or the patient refuses to wear them. The best response I garnered directly from her was her first name.

Her neurological examination was more informative. Extreme kyphosis had her practically staring in her lap, so I had to crouch down on the floor to peer up at her to meet her steely gaze (this was no mean feat with my center of gravity shifted from pregnancy, as I was 6 months along at the time). She maintained good, if not glassy, eye contact, so by moving my face in the cardinal directions I was able to assess extraocular movements; at the very least, there were no signs of limited vertical gaze indicative of progressive supranuclear palsy. She had paratonia and a mild resting tremor, which are not exactly textbook for a Parkinson plus syndrome, but a nod in that direction. Her reflexes were symmetric and within normal limits. At best she was able to move all limbs antigravity, as formalized strength testing was difficult to direct. We discussed trying to get her out of the wheelchair for a gait evaluation, but she had reportedly been wheelchair-bound for months, so I deferred, in part because of my protruding belly and also because I was not eager to chance her potentially falling.

As far as recommendations, I offered some tentative suggestions regarding medication changes. I recommended checking her blood work results for common endocrinological and vitamin abnormalities that can contribute to cognitive impairment to see if there was anything that needed correction. She had been taking an acetylcholinesterase inhibitor and N-methyl-d-aspartate–receptor antagonist in the past, both of which had been discontinued sometime in the past year; there would be no harm and likely limited, but some possibility for, benefit by their resumption. As best as I could tell from her spouse and medical record, there had been no trial of carbidopa levodopa, so this could be beneficial for her tremor and mobility. I outlined a staggered course of medication reintroduction or trial for them to discuss with her PCP; they were hesitant to make any changes without the PCP’s approval. I felt like I had contributed little to her treatment, so I instructed as-needed rather than scheduled follow-up. I was exhausted after the visit had taken nearly twice as long as the allotted time.

Hence I was surprised to see her name on my schedule again a couple of months later, right before I was due for maternity leave. She didn’t appear that much different on paper when I reviewed the PCP’s interim note; of all the medication changes I had proposed, they had only ventured one.

Yet I was amazed that she looked more alert: brighter, better eye contact. Despite her kyphosis, she was even sitting a little more upright. When I asked her questions, she actually understood what I was saying and was able to respond relatively appropriately, even though she was still without hearing aids. Granted, she remained completely disoriented as to date and location, but she could engage some pleasantries, tell me how she was feeling, and identify her husband, which was much better than our initial encounter. I was floored.

“We weren’t sure if we were going to see you again,” her husband gushed. “The changes you recommended have really made a difference! Even the staff at the nursing home has noticed. This is the best she’s been in months.” I felt a rush of emotions, reflecting my prior frustration at not being able to do more. Apparently, I’d done enough.

He gratefully handed me the box of chocolates, and I jokingly commented that I couldn’t say no to sugar “for the baby.” Ah, pregnancy cravings.

She died several weeks after I had seen her. I met with her husband months later and he spoke glowingly of his wife. He showed me pictures of her sitting relaxed and smiling with a perfectly coiffed bouffant. He brought me samples of jewelry that she had hand-painted with delicate flowers: a filigreed ring with tiny strawberries, a pendant with a spray of violets, a bracelet with tiny daffodils and irises. She had won “teacher of the year” awards at several schools where she worked, no mean feat for a school librarian. I read through samples of her writing that illuminated her faith, including a reimagining of Psalm 23. I held back my own tears as he choked up while narrating her final hours, including holding her hand as she died. Beyond the patient, I saw her as a cherished wife, teacher, and artist: kyphosis, from bowing her head in hours of prayer and poring over books; hands, wizened by age, arthritis, and a lifetime of grasping a paintbrush; and eyes shining with love for her husband.

I realized that all my lamentations represented frustration at not being able to do something that I had perceived as substantive for her. As physicians, we are used to having the answer, diagnosis, or treatment. Those brief minutes (or hours, as the case may be) we spend with patients in the clinic may take only a fraction of our day but can create lasting memories for those whom we treat, and ourselves as well.

I never remembered chocolate tasting quite so sweet.

The last refuge for the American Prosecutorial Scoundrel – Obama and top DOJ and FBI officials in perspective - scoundrels all

Jonathan Turley presents the case against Obama and top DOJ and FBI officials - scoundrels all.
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Samuel Johnson famously once declared that “patriotism is the last refuge of a scoundrel.” For prosecutors, that refuge is the Logan Act. Among the thousands of pages released from the Michael Flynn case and the House Intelligence Committee investigation is the prominent appearance of the Logan Act in high-level discussions. The law is widely viewed as a grossly unconstitutional law that, if ever actually used, would gut the First Amendment. Yet the record now shows the Logan Act became the last refuge for Justice Department officials in desperately trying to find a crime, any crime, to use against Flynn, the former national security adviser to President Trump.

I have written about the Logan Act for decades and called for its repeal. It is not that the law was a real threat to individuals, as it has never been used successfully against any citizen since its enactment in 1799. Rather, it is an act that contradicts the defining values of this country. The law was a product of its time, as John Adams was never one to suffer opponents gladly.

At the time, Adams favored and signed a treaty with Great Britain that led to the Quasi War with France. The Jeffersonians favored France, and one of them, George Logan of Philadelphia, went to Paris to try to end the hostilities. Adams was irate over what he called the “temerity and impertinence of individuals” such as Logan. He persuaded Congress to pass the flagrantly unconstitutional act, making it a crime to have “correspondence or intercourse with any foreign government or any officer or agent” about disputes. The same Congress passed the infamous Alien and Sedition Acts used to arrest opponents of Adams, including journalists.

The only reason the Logan Act remains on the books is that it is treated as a harmless relic. Many of us in the free speech community have long objected that the law continues to be cited as a threat and remains a statutory monstrosity from one of the darkest periods of American law. Even those who dismiss the Logan Act as a nonentity generally agree that it could not be used constitutionally.

That brings us back to the recently released documents. We now know that, in late 2016, investigators completed their multiagency probe of Flynn, code-named Crossfire Razor, and found no evidence of any crime. They informed FBI and Justice Department leadership that they wanted to close the investigation for failure to find any “derogatory information.” The FBI Washington field office concluded that Flynn “was no longer a viable candidate as part of the larger Crossfire Hurricane umbrella case.”

We know now that former FBI Deputy Director Andrew McCabe decided that the absence of any crime would not be allowed to terminate the investigation. FBI special agent Peter Strzok instructed the FBI case manager to keep the investigation open and then sent a celebratory text to FBI lawyer Lisa Page, who responded, “Phew. But yeah that’s amazing that he is still open.”

The problem, of course, is that there remained the inconvenient absence of any crime. Indeed, we now know there never was any credible evidence of collusion with the Russians by Trump campaign officials. New transcripts show dozens of officials confirming they never saw evidence of collusion. That is when the FBI and Justice Department leadership collectively reached for the last refuge of the prosecutorial scoundrel: the Logan Act.

When Strzok overruled the career prosecutors and investigators to keep open the investigation, he immediately raised the Logan Act as a possible way to charge Flynn. We previously learned that former acting Attorney General Sally Yates also raised the Logan Act as a possible charge, and we know that McCabe pushed the Logan Act in the absence of any other crime. (McCabe was later found to have lied to investigators but, unlike Flynn, was never charged).

The new material shows that former FBI Director James Comey also raised the Logan Act, with President Obama, in discussing FBI surveillance of Flynn. In one meeting, Justice Department officials were surprised that Obama already knew of the surveillance even though Yates was not aware of the facts. One document states, “Yates had no idea what the president was talking about, but figured it out based on the conversation. Yates recalled Comey mentioning the Logan Act.”

Keep in mind that the use of the Logan Act against the incoming national security adviser would have been not only patently unconstitutional but positively ludicrous. There was nothing illegal in Flynn responding to Russian diplomats upset about sanctions recently imposed against Russia, just days before the start of the Trump administration. Trump himself stated publicly that he wanted to reframe relations with Russia, including sanctions. The transcripts show Flynn encouraging the Russians not to retaliate and saying the administration would reexamine the relationship.

Consider the absurdity of using this law against the incoming adviser for speaking with foreign diplomats on the eve of the new administration. The use of the Logan Act in that instance is just slightly better than an Alien and Sedition Acts prosecution against WikiLeaks. We now know there never was evidence of collusion by Flynn or anyone in the Trump campaign. By December, career investigators in the FBI Washington field office wanted to stop investigating Flynn. Then, in January, every one of the major players at the FBI and the Justice Department justified further investigation under the Logan Act. Thus, the only crime being pushed was an unconstitutional act that has never been used successfully in a prosecution.

It turned out that they would not need it, however. Although FBI investigators said they did not believe Flynn intentionally lied (and noted that Flynn understood his conversation with Russian officials was monitored and presumably transcripted), that nevertheless was the charge former special counsel Robert Mueller ultimately used. Flynn fought the charges but pleaded guilty after Mueller virtually bankrupted him and threatened to charge his son.

Perhaps it is fitting that these Obama administration officials turned to the Logan Act. Obama, who had dismissed Flynn from another post, opposed his appointment as national security adviser. It did not matter if there was no evidence against Flynn. As President Adams declared in calling for enactment of the Logan Act, there must be punishment for those with the “temerity and impertinence” to challenge those in power.

So after no evidence of collusion or a crime by Flynn was found by the end of 2016, Strzok, McCabe, Comey, Yates and perhaps even Obama retreated to that last refuge of the prosecutorial scoundrel, the Logan Act, under the apparent theory that an unconstitutional crime is still better than no crime at all.

The Threat to Academic Freedom … From Academics

Here is a link to an article by Lee Jussim.

Academic freedom has been declining for some time and is now largely gone.  What is worse is that the same is true of Freedom.

More evidence that the Climate Alarmists are wrong

The conclusion of a paper that provides perspective on the twentieth century warming trend.
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Removing the tree growth trend from tree-ring measurement, especially TRW chronology, has always been a key scientific issue, since it may have an significant impact on tree-ring based paleoclimate reconstructions. Here, we propose a TSR method to quantify the uncertainty of the influence of the tree growth trend on the tree-ring chronologies.

In the TSR method, part of the measurements are standardized using an ideal regional growth curve and another part using their long-term trends. This generates different members according to the ranked similarity between a regional growth curve and the curve fitting trend of each measurement. Our results indicate that tree growth trends mainly affect the secular trends in TRW chronologies, but have no effects on the variability over inter-annual to multi-decadal time-scales.

The TSR method was successfully used to reconstruct summer temperature variability in Yamal, Torneträsk, and Northern Scandinavia. Our results suggest that the recent linear warming trend rate during the recent most century is not unprecedented over the past two millennia, based on the TRW and MXD records. More importantly, the multi-centennial and millennial-scale variabilities of the three TSR chronologies significantly enhance the warming trend during the 20th century in the three studied regions.

The two main biases in the classical RCS method are discussed. The end effect due to the “differing-contemporaneous-growth-rate” bias is effectively mitigated (Fig. 3), and the “trend-in-signal” bias is overcome by the TSR ensemble reconstructions through using all possible locally unbiased RCs. The uncertainty quantification using the TSR method improves error estimates when undertaking tree-ring climate reconstruction in other areas, e.g., multi-proxy climate reconstructions, reconciliation of tree-ring and pollen data, or tree-ring data assimilation in climate models.

However, there is no “true” climate variability information on millennium or longer timescales to help distinguish between tree-ring growth and climate trends for the specific tree-ring measurements. Moreover, the TSR method has the same limitations as the RCS method (e.g., the essential need for pith offset information that is unavailable for the vast majority of all existing tree-ring data sets).

Some perspective on COVID-19 tests and sodas

Here is Paul Romer's insightful amusing comment on COVID-19 test availability.

PR is on target.
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If Virus Tests Were Sodas

Imagine a world in which the only way to get a soda is to get your doctor to write a prescription. It costs $20 per can. Your insurance company pays. The economy produces about 100,000 sodas each day.

If you lived in this world, do you think you could get people to scale up the production of soda to a level of millions of cans per day? It would be a challenge, but not because it is hard to produce and distribute soda.

The Hypothetical

Because they have to keep total costs from running out of control, insurance companies, health care providers, and government regulators have cobbled together a system that limits access to soda. One part of this system is an expensive regulatory process that has to approve:

• the ingredients in each particular brand of soda;
• the insert that comes with the soda informing patients about its risks and benefits;
• the delivery system used by the soda supplier, be it a glass bottle, an aluminum can, a paper cup, etc.

Then, everyone decides that they want more soda. Why, they ask, can’t the nation produce enough soda for everyone to have some each day?

Here’s how might things might then play out:

1. The only people who can get sodas are those already under the care of the health care system. They are not thirsty, but the insurance company covers the cost, so whatever.
2. People who are thirsty start going to the hospital just to get soda. Doctors comply with their requests for a prescription. Soda producers try to increase output, but soon run into “bottlenecks.” One vendor with an approved soda delivery system that packages a straw with a can finds that its supplier of straws can not keep up with the increased demand. This soda company explains to its unhappy customers that it has FDA approval only for a product that includes a straw from its traditional supplier. The soda company says that it is applying to the FDA for an Emergency Use Authorization (EUA) that gives it permission to bundle a can with a straw from a different vendor. As it waits, it keeps repeating its excuse: “There is a straw bottleneck!”
3. Meanwhile, researchers on university campuses discover that you do not need a straw. But these researchers have no reason to go through the laborious process of filing for an Emergency Use Authorization that allows drinking from the can. The “straw bottleneck” persists.
4. In their experiments with drinking from the can, these same university researchers realize soda is just flavored sugar water and that they could produce millions of sodas per day at a price well under $1 per can. The researchers publicize their findings. Policy wonks urge them to get going: “Produce the sodas that a thirsty nation needs.” But these do not say anything about who will pay for all these additional sodas. The researchers are good sports, but they are not idiots. They produce some token batches of soda and go back to writing papers.
5. The wonks are surprised to discover that their meetings and documents do not yield the soda supply surge they anticipate.
6. Everyone gets discouraged. The wonks conclude that even an economic system as big, as powerful, and as innovative as the one we have established in the United States cannot rise to the challenge of producing millions of sodas per day. They settle for a stretch goal of offering one soda per month to each family.

The Facts 

• Researchers affiliated with Rutgers University did discover that you do not need a swab to do an RT-PCR test for the SARS-CoV-2 virus. They even went to the trouble to get an EUA to conduct tests on saliva samples.
• No one has proposed a way to pay the researchers at Rutgers, or their peers in comparable laboratories located throughout the United States, for the tests they could supply. For now, they do them because they are good sports.
• The US economy produces 350 million 12 oz cans worth of soda each day.
• Soda producers do not need to get regulatory approval each time they innovate around some hurdle or bottleneck.
• For their efforts, soda producers receive about $45 billion dollars each year.

Lessons

If we want to use this nation’s massive capacity – much of which, by the way, is now sitting idle – to produce tens of millions of virus tests per day, there is a way to do it:

• Decide what a test should do.
• As long as labs provide tests that do what a test is supposed to do, let them worry about the details.
• Do not appeal to charity; be prepared to pay these labs twice as much as we spend on soda.

Can the New York Times be trusted to tell the truth?

John Lott at Real Clear Politics.

JL is on target.
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The New York Times thinks it nailed Fox News. Over the weekend, the Times ran a blistering story that blamed the death of Brooklyn bar owner Joe Joyce on skepticism of the coronavirus panic. Supposedly assured by President Trump and Fox News that there wasn’t a problem, Joyce made the fatal mistake of going on a cruise.

Times reporter Ginia Bellafante wrote:

“He watched Fox, and believed it was under control,” Kristen [Joyce’s daughter] told me. Early in March, Sean Hannity went on air, proclaiming that he didn’t like the way that the American people were getting scared “unnecessarily.” He saw it all, he said, “as like, let’s bludgeon Trump with this new hoax.”

Many in the media, such as CNN senior media reporter Oliver Darcy and reporters from the Washington Post, have seized on the Times story as proof of the harm from Fox News’ reporting. MSNBC’s David Corn wrote: “A beautifully written and sad story. It shows how Trump and Fox have killed Americans. It’s unforgivable.”

But there were big problems with Bellafante’s story. For one thing, Hannity’s on-air statement came eight days after Joyce’s cruise began on March 1, so it couldn’t have been a factor in his decision to go. Also, Bellafante misconstrues Trump’s use of the word “hoax.” Most glaring is the story’s sheer hypocrisy. Virtually all of the news media, including Ms. Bellafante herself, were claiming immediately before the cruise that there was little reason for Americans to alter their behavior because of the virus.

On Feb. 27, just three days before the cruise began, Bellafante tweeted: “I fundamentally don’t understand the panic: incidence of the disease is declining in China. Virus is not deadly in the vast majority of cases. Production and so on will slow down and will obviously rebound.”

The media has made a big play of Trump supposedly having “blood on his hands.” The basic claim is that he was in denial about the seriousness of the virus and delayed dealing with it. But after Trump banned travel from China on Jan. 31, the New York Times itself ran the headline “Beware the Pandemic Panic.” On Feb. 5, the Times mocked Trump’s travel ban as being “unjust” in an article headlined “Who Says It’s Not Safe to Travel to China?”

The United States was the first country to impose such travel restrictions on China, and did so in defiance of both the World Health Organization and much of the Democratic Party. Trump was ahead of the curve again when he imposed a travel ban on Europe on March 12. The New York Times has to rewrite history to make its case. Couldn’t the Times now find a reporter who had in fact seen this coming? That would at least reduce the glaring hypocrisy.

Democrats have seized on Trump’s use of the word “hoax” back in February, but the president was referring to the media criticism of his handling of the emerging pandemic. Fact-checkers have attacked this interpretation of the “hoax” comment, and even liberal-leaning PolitiFact dismissed as “false ” the notion that Trump used that word to describe the coronavirus. PolitiFact pointed out that “there was nearly a full minute between when the president said ‘coronavirus’ and ‘hoax.’” FactCheck.org also said that the claim was false.

The Times has pulled off an amazing trifecta. It links a segment from Sean Hannity with someone’s death, when the broadcast occurred after the cruise started. It then made it seem as though Fox News and Hannity were making false claims — at the very same time that the New York Times and the reporter who wrote this piece were telling people not to worry. And it claims that Hannity was saying the virus was a hoax, when he was saying nothing of the sort.

Monday morning quarterbacking is always easy, but the New York Times and its reporter have forgotten their track records from less than two months ago. There is a lot of hypocrisy in going after others for not recognizing dangers that you didn’t even see yourself. What must gall the Times is that Donald Trump saw these dangers well before they did.