Category: Law

Hunting the Satanists

Michael Flynn, the former Trump National Security Advisor and QAnon promoter, is now being accused by QAnon of being a Satanist.

…Flynn’s trouble started on Sept. 17, when he led a congregation at Nebraska pastor Hank Kunneman’s Lord of Hosts Church in prayer. Flynn’s prayer included invocations to “sevenfold rays” and “legions,” two phrases that struck some of Flynn’s followers as strange.

…As video of the prayer circulated in online conspiracy theorist groups, the references to “legions” and “rays” soon sparked speculation among Flynn’s right-wing supporters that their hero had been lured to the dark side. Always on the lookout for the Satanic influence they imagine lurks at the heart of the world, they claimed that Flynn had secretly been worshiping the devil. Worse, since the congregation was repeating the prayer after Flynn, the rumor went, he had duped hundreds of Christians into joining the ritual.

…Flynn isn’t the first right-wing figure tied to QAnon to see its acolytes turn on him. Oklahoma Senate candidate Jackson Lahmeyer, whose challenge to Sen. James Lankford (R-OK) has been endorsed by Flynn, appeared at an April pro-QAnon conference with Flynn in Tulsa.

A few months later, however, Lahmeyer posted a seemingly innocent picture of his daughter wearing red shoes—apparently unaware that QAnon followers consider red shoes to be yet another sign of their imagined Satanic sex-trafficking cabal. Lahmeyer was soon caught up in a QAnon controversy of his own.

“Unfortunately, I have to say it because people are asking me,” Lahmeyer wrote in a Facebook post. “I’m in no way involved in Child Sex Trafficking, pedophilia or devil worship.”

Now, here’s another story–this one about an email sent by a Yale law student from the Native American Law Students Association (NALSA) to fellow classmates. The email in question reads:

SUP NALSA,

Hope you’re all still feeling social! This Friday at 7:30 we will be christening our very own (soon to be) world=renowned NALSA Trap House….by throwing a Constitution Day Bash in collaboration with FedSoc. Planned abstractions include Popeye’s chicken, basic-bitch-American-themed snacks (like apple pie, etc.), a cocktail station, assorted hard and soft beverages, and (most importantly) the opportunity to attend the NALSA Trap House’s inaugural mixer!

Hope to see you all there!

The email seems to me like a light-hearted invitation to a party but, of course, not being one-of-the-elect I can’t read the secret, esoteric meaning. According to Yale’s Diversity office the email was actually a coded message to celebrate white supremacy with a blackface party.

Just 12 hours after the email went out, the student was summoned to the law school’s Office of Student Affairs, which administrators said had received nine discrimination and harassment complaints about his message.

At a Sept. 16 meeting, which the student recorded and shared with the Washington Free Beacon, associate dean Ellen Cosgrove and diversity director Yaseen Eldik told the student that the word “trap” connotes crack use, hip hop, and blackface. Those “triggering associations,” Eldik said, were “compounded by the fried chicken reference,” which “is often used to undermine arguments that structural and systemic racism has contributed to racial health disparities in the U.S.”

Eldik, a former Obama White House official, went on to say that the student’s membership in the Federalist Society had “triggered” his peers.

…Throughout the Sept. 16 meeting and a subsequent conversation the next day, Eldik and Cosgrove hinted repeatedly that the student might face consequences if he didn’t apologize—including trouble with the bar exam’s “character and fitness” investigations, which Cosgrove could weigh in on as associate dean.

…When the student hadn’t apologized by the evening of Sept. 16, Eldik and Cosgrove emailed the entire second-year class about the incident. “[A]n invitation was recently circulated containing pejorative and racist language,” the email read. “We condemn this in the strongest possible terms” and “are working on addressing this.”

The two cases illustrate that the worldview of QAnon and Yale’s diversity office are surprisingly similar. Both see a world in which Satan, literal or metaphorical, is an active force in the world corrupting individuals and institutions. Satan is powerful but hidden. He only reveals his influence when the corrupted slip-up and by the incorrect use of a word, phrase, or gesture reveal their true natures.

Since Satan is powerful and hidden the good people must constantly monitor everyone. The moment a slip-up is spotted, no matter how small, the corrupted must be denounced because anyone who even unwittingly associates with the corrupted will themselves become corrupted. “Legions”and “rays”? Satanist! “Trap House.” Satanist! “Red shoes.” Sex-trafficker! “Federalist Society.” Satanist society! Repeating the prayer? Duping hundreds of Christians into joining the ritual! Attending a party? We condemn this in the strongest possible terms! Condemn the non-believers to HELL! It’s all the same.

The other similarity, of course, is that both views are disturbingly common and completely bonkers.

Photo Credit: Wikipedia.

Medieval Coasean warfare?

Politics thus gained a new intensity after the Conquest, and yet they were also less bloody.  In the great Anglo-Norman and English battles between 1106 and 1264, as in the more general ravaging warfare, very few nobles were ever killed.  The immediate reason, as Orderic stressed, was the protection of armour, but ultimately any knight could be surrounded and disarmed.  The key point was that when this moment came he simply surrendered and was taken off for ransom.  The institution of ransom was, therefore, absolutely central to the failsafe warfare enjoyed by the nobility in this period.  Indeed the whole aim in battle was to capture, not to kill, a noble opponent.  There was here a wider context because politics too, not just warfare, was largely bloodless.  It is a remarkable fact (and one quite contrary to usual perceptions of the Middle Ages) that between Waltheof’s demise in 1076 and Gaveston’s in 1312 not a single English earl, and indeed hardly a single baron, was executed (or murdered) in England for political reasons.

That is from the excellent and highly substantive book by David Carpenter, The Struggle for Mastery: The Penguin History of Britain, 1066-1284.  Wasn’t there also a JLE piece about this kind of warfare?

Covid scam arbitrage

It sounded like the ultimate COVID-era travel bargain: five-star hotels in Manhattan at a 60 percent discount. “I do not know exactly what hotel u would be place but I know it would be 5 star hotel … be cash app ready!!” read a Facebook post hyping the deal. A Cash App–only hotel promotion might raise a few red flags, but trust that the rooms were very much real — they were just supposed to be set aside for COVID patients and health-care providers. The scam was uncovered after four months of excellent business, and this week, federal prosecutors charged Chanette Lewis with fraudulently booking New York’s emergency COVID hotel rooms using health-care workers’ stolen personal information. Lewis, 30, and three other accomplices are alleged to have advertised the rooms on Facebook and to have made a whopping $400,000 by booking more than 2,700 nights’ worth of stays in the spring and summer of last year.

Lewis, whose actual job was to book quarantine rooms on behalf of the city, had access to health-care workers’ personal information through her work at the Office of Emergency Management. But she allegedly used their credentials to book stays for her guests instead, making it look like they had been exposed to COVID. “I stole some doctor numbers and emails … I was writing down they employed ID number lmao,” prosecutors say Lewis wrote in a Facebook message. The hotel rooms, which would normally run hundreds of dollars a night, went for only $50 a night and $150 for the week. She then took the cash, prosecutors say, and the city was billed for the rooms. The grift went so well that Lewis recruited others to help her out. “I wanna teach u the ropes of it,” she messaged her co-conspirator Tatiana Benjamin, 26, in June. Her guests did the opposite of quarantine; some threw parties and, as one special agent for the U.S. Attorney ominously put it, “engaged in violence.”

Here is the full story, via Air Genius Gary Leff.

Solve for the Kiwi Covid equilibrium?

Elimination was so popular with voters that every major political party backed it.

But over the past two weeks, the National, Act and Green parties have all peeled off from the government, vocally denouncing the new approach or offering new plans of their own. Ardern and her ministers continue to equivocate on whether elimination is over at all – a hemming and hawing that Smith says could hinder them from communicating a clear new vision for New Zealand’s path forward.

In one sense, Ardern could now be a victim of her own success, says Ben Thomas, a communications consultant and former National government staffer. The government’s elimination campaign was so compelling and its results so strong, that it won huge support – polling above 80% through most of the pandemic.

“Part of the prime minister’s problem is that she did such a good job of rallying New Zealanders to this cause, of convincing them – correctly – that elimination was an achievable goal, and of instilling a real fear of the virus. That’s a very hard thing to unwind from,” Thomas says.

Smith says: “Elimination was something that New Zealanders could be proud of, it brought us together and became a common goal.” And the challenge now is to find – what is the common goal during a suppression strategy? Probably vaccination rates – but to give us this same pride that we had last year in our Covid response again that is the big challenge facing Jacinda and her team now.”

The most likely candidate for that new vision is vaccination, but it’s harder to capture the urgency of that message while simultaneously arguing the country is still eliminating the virus.

Here is the full story, via Rich Dewey.

The Promising Pathway Act

Operation Warp Speed showed that we can move much faster. FDA delay in approving rapid tests shows that we should move much faster. There is a window of opportunity for reform. The excellent Bart Madden and Siri Terjesen argue for the Promising Pathways Act.

One particularly exciting development is the Promising Pathway Act (PPA), recently introduced in Congress. PPA would reduce bureaucracy via legal changes and provide individuals with efficient early access to potential new drugs.

Under PPA, new drugs will receive provisional approval five to seven years earlier than the status quo via a two-year provisional approval. Drugs that demonstrate patient benefits could be renewed for a maximum of six years, and the FDA could grant full approval at any time based on real-world as opposed to clinical trial data documenting favorable treatments results.

The PPA allows patients, advised by their doctors, to choose early access to promising but not-yet-FDA -approved drugs. Patients and doctors would make informed decisions about using either approved or new medicines that demonstrate safety and initial effectiveness compared to approved drugs.

…Patients and doctors can log into an internet registry database for early access drugs that would contain treatment outcomes, side effects, genetic data, and biomarkers. Scientific researchers, as well as patients, will also benefit from the identification of subgroups of patients who do exceptionally well or fail to respond.

Data from the registry will open knowledge pathways to improve the biopharmaceutical industry’s research outlays to benefit future patients.

With radically lower regulatory costs plus heightened competition as more companies participate, expect substantially lower prescription drug prices for provisional approval drugs.

Here is the text of the PPA.

FDA Approves American Rapid Antigen Test

I wrote earlier:

What makes the FDAs failure to approve more rapid antigen tests even more galling is that the test being sold cheaply in the Amsterdam supermarket is the Flowflex, an American test made by Acon Labs in San Diego.

Well the FDA has finally approved the Acon test! Apparently it is good enough for the Germans and for US citizens. Hoorah! USA Today notes:

ACON expects to make 100 million tests per month by the end of this year. Production could double to 200 million monthly tests by February, according to the FDA.

…The United Kingdom and Germany have made significant purchases of home tests and widely distributed them to their residents to slow the spread of coronavirus. Such large government purchases allowed manufacturers to continue making tests even when demand softened as cases dropped.

The Biden administration will spend nearly $1.2 billion to purchase up to 187 million home tests from Abbott Laboratories and Celltrion Inc., company officials confirmed. The Department of Defense announced additional contracts totaling $647 million to buy 60 million kits from Abbott and three other testing vendors: OraSure Technologies, Quidel and Intrivio Holdings.

The FDA has authorized seven antigen-based tests that can be used at home without a prescription. The EU has authorized 21 tests beginning with the letter A (I am not sure all of these are authorized for home use but you get the idea.) Turtle slow. Still this is a big improvement.

Frankly, I think all the pressure from people like Michael Mina amplified by myself and others over 18 months and culminating in David Leonhartd’s NYTimes article Where Are the Tests? finally pushed them over the edge.

Revisionism on Deborah Birx, Trump, and the CDC

Photo Credit: Official White House Photo by Shealah Craighead

In October of 2020 Science published a long article by Charles Piller titled Undermining CDC with the subtitle “Deborah Birx, President Donald Trump’s COVID-19 coordinator, helped shake the foundation of a premier public health agency.” The article focuses on a battle between Deborah Birx and the CDC over collecting data from hospitals with the basic message that Birx was an arrogant Trump tool who interfered with the great CDC. One year later, much of the article has a different cast beginning with “premier public health agency”. Hmmpfff. The opening now reads to me as almost laughable:

Zaidi lifted her mask slightly to be heard and delivered a fait accompli: Birx, who was not present, had pulled the plug on the Centers for Disease Control and Prevention’s (CDC’s) system for collecting hospital data and turned much of the responsibility over to a private contractor, Pittsburgh-based TeleTracking Technologies Inc., a hospital data management company. The reason: CDC had not met Birx’s demand that hospitals report 100% of their COVID-19 data every day.

According to two officials in the meeting, one CDC staffer left and immediately began to sob, saying, “I refuse to do this. I cannot work with people like this. It is so toxic.” That person soon resigned from the pandemic data team, sources say.

Other CDC staffers considered the decision arbitrary and destructive. “Anyone who knows the data supply chain in the U.S. knows [getting all the data daily] is impossible” during a pandemic, says one high-level expert at CDC. And they considered Birx’s imperative unnecessary because staffers with decades of experience could confidently estimate missing numbers from partial data.

“Why are they not listening to us?” a CDC official at the meeting recalls thinking. Several CDC staffers predicted the new data system would fail, with ominous implications. “Birx has been on a months long rampage against our data,” one texted to a colleague shortly afterward. “Good f—ing luck getting the hospitals to clean up their data and update daily.”

Scott Gottlieb tells this same story very differently in Uncontrolled Spread (my WSJ review).

Deborah Birx convinced the Coronavirus Task Force to direct money to the CDC to modernize its reporting of the COVID hospital data, but the CDC said no.

…The federal government had bought the entire available supply [of remedsivir], and HHS needed to know where to ship its limited doses [but]…the CDC didn’t have actual data on who was currently hospitalized for COVID, just estimates built off a model….Birx said that the government couldn’t ship scarce doses of the valuable medicine to treat estimated patients that were hypothetically hospitalized according to a mathematical formula. So she gave hospitals an ultimatum. If they wanted to get access to remedsivir, they would need to start reporting real data on the total number of COVID patients that they admitted each day. Hospitals quickly started to comply…Rather than cajole the CDC into fixing its reporting system, Ambassador Birx and Secretary Azar decided to recreate that structure outside the agency. The had concluded that getting the CDC to change its own scheme, and abandon its historical approach to modeling these data, would have been too hard.

…Under the new reporting system, 95% of US hospitals soon provided 100 percent of their daily hospital admission data. In an unfortunate twist, the CDC declined to work with the new data, worrying that since it wasn’t their data, they couldn’t assure its providence and couldn’t fully trust its reliability. As one senior HHS official put it to me, the CDC “took their ball and went home.”

…The cofounders of the COVID Tracking Project, one of the most authoritative and closely watched enterprises to report bottom-line information about the pandemic, would later say of the [HHS/Teletracking data], “the data set that we trust the most–and that we believe dose not come with major questions–is the hospitalization data overseen by the Department of Health and Human Services. At this point, virtually every hospital in America is reporting to the department as required. We now have a good sense of how many patients are hospitalized with COVID-19 around the country.” [Link here, AT]

Gottlieb’s story strikes me as much closer to the truth. Why? Notice that on most of the facts the stories agree. Gottlieb says the CDC refused to work with the HHS data and took their ball and went home. The Piller story has CDC people sobbing, angry, and saying “I refuse to do this.” Check. What differs is the interpretation and everything in Piller’s story is infected by an anti-Trump perspective. I don’t blame Piller for being anti-Trump but Trump plays no role in the story he just hovers in the background like a bogeyman. Piller says, for example:

…Birx’s hospital data takeover fits a pattern in which she opposed CDC guidance, sometimes promoting President Donald Trump’s policies or views against scientific consensus.

“Fits a pattern.” Uh huh.

Birx sometimes “promoted President Donald Trump’s policies.” Promoting the policies of the President of the United States? Why that’s practically treason!

Promoting views that go “against scientific consensus” Yeah, the “scientific consensus” of workers at the CDC.

Trump obviously had no interest in how hospital data was collected yet he is portrayed throughout as the hidden puppeteer behind the story.

Gottlieb’s story removes Trump from the equation and that rings true because we now know that the Biden administration has been as frustrated with the CDC as was the Trump administration. Politico writes, for example:

…senior officials from the White House Covid-19 task force and the Food and Drug Administration have repeatedly accused CDC of withholding critical data needed to develop the booster shot plan…

…the CDC advisory committee episode in late August only reinforced perceptions in the [Biden] White House that the agency represents the weakest link in a Covid-19 response…

The agency has for years struggled with obtaining accurate disease data from state health departments, and the pandemic strained the country’s public health infrastructure, causing massive delays in reporting and case investigation.

Withholding critical data. Struggling to obtain accurate data. Massive delays. Sound familiar? Indeed, if these parallels weren’t enough we even have CDC Director Rochelle Walensky overruling CDC scientists to allow boosters–but Walensky, unlike Birx, gets the benefit of the doubt so the story isn’t sold as Walensky going against scientific consensus to promote President Biden.

Evaluations of Trump colored evaluations of all the people and policies of the Trump administration leading to reporting that was sometimes unjust and inaccurate. It will take time to sort it all out.

Guardianship, in practice, is often worse than you might think: the surveillance of Britney Spears

Britney Spears’s father and the security firm he hired to protect her ran an intense surveillance apparatus that monitored her communications and secretly captured audio recordings from her bedroom, including her interactions and conversations with her boyfriend and children, according to a former employee of the security firm.

Alex Vlasov, the employee, supported his claims with emails, text messages and audio recordings he was privy to in his nine years as an executive assistant and operations and cybersecurity manager for Black Box, the security firm. He came forward for a new documentary by The New York Times, “Controlling Britney Spears,” which was released on Friday.

Recording conversations in a private place and mirroring text messages without the consent of both parties can be a violation of the law. It is unclear if the court overseeing Ms. Spears’s conservatorship was aware of or had approved the surveillance.

Mr. Vlasov’s account, and his trove of materials, create the most detailed portrait yet of what Ms. Spears’s life has been like under the conservatorship for the past 13 years. Mr. Vlasov said the relentless surveillance operation had helped several people linked to the conservatorship — primarily her father, James P. Spears — control nearly every aspect of her life…

Mr. Vlasov said that Ms. Spears’s phone had been monitored using a clever tech setup: The iCloud account on her phone was mirrored on an iPad and later on an iPod. Mr. Yemini would have Mr. Vlasov encrypt Ms. Spears’s digital communications captured on the iPad and the iPod to send to Mr. Spears and Robin Greenhill, an employee of Tri Star Sports & Entertainment Group, the former business manager for the singer’s estate.

This arrangement allowed them to monitor all text messages, FaceTime calls, notes, browser history and photographs.

Here is the full NYT story by Liz Day.  And by the way, there also was extensive surveillance of people in the “Free Britney!” movement, paid for ultimately by Britney herself.  Hi guys!

Saloons of Invention

I was taken aback by the bottom line of Mike Andrews new working paper Bar Talk: closing the saloons during prohibition reduced patenting by ~15%. At first, I thought that seemed like a very large decline but bear in mind that saloons were the coffeehouses of the day devoted not just to drinking but to meeting, talking and learning. Indeed, they were much more common than coffeehouses today:

Saloons were once everywhere in America, from urban alleys to rural crossroads. They were about more than drinking; from the 1860s through 1920, they dominated social life for the laboring majority building a new industrial nation. By 1897 there were roughly a quarter of a million saloons, or 23 for every Starbucks franchise today.

…Saloons became salons, where survivors of the Industrial Revolution could drink and debate, politick and speechify.

The saloons also often combined social aspects with a mailbox depot, telegraph or telephone, and a payday lender so they were good places to talk shop.

Andrew’s compares countries that were forced dry by state prohibition laws with previously dry counties, so the estimates are local and from across the country. He has significant patent data including the location of inventors and a variety of important robustness tests. Women, for example, didn’t typically patronize the saloons but also continued to patent at similar rates in wet and dry counties. After taking it all in the results are large but plausible! Here’s the abstract to the paper:

To understand the importance of informal social interactions for invention, I examine a massive and involuntary disruption of informal social networks from U.S. history: alcohol prohibition. The enactment of state-level prohibition laws differentially treated counties depending on whether those counties were wet or dry prior to prohibition. After the imposition of state-level prohibition, previously wet counties had 8-18% fewer patents per year relative to consistently dry counties. The effect was largest in the first three years after the imposition of prohibition and rebounds thereafter. The effect was smaller for groups that were less likely to frequent saloons, namely women and particular ethnic groups. Next, I use the imposition of prohibition to document the sensitivity of collaboration patterns to shocks to the informal social network. As individuals rebuilt their networks following prohibition, they connected with new individuals and patented in new technology classes. Thus, while prohibition had only a temporary effect on the rate of invention, it had a lasting effect on the direction of inventive activity. Finally, I exploit the imposition of prohibition to show that informal and formal interactions are complements in the invention production function.

My Conversation with Amia Srinivasan

I am pleased to have had the chance to do this, as in my view she is one of the thinkers today who has a) super smarts, b) breadth and depth of reading, and c) breadth and depth of thinking.  That combination is rare!  That said, I don’t quite agree with her on everything, so this exchange had more disagreements than perhaps what you are used to sampling from CWT.

Here is the transcript and audio.  Here is part of the CWT summary:

Amia joined Tyler to discuss the importance of context in her vision of feminism, what social conservatives are right about, why she’s skeptical about extrapolating from the experience of women in Nordic countries, the feminist critique of the role of consent in sex, whether disabled individuals should be given sex vouchers, how to address falling fertility rates, what women learned about egalitarianism during the pandemic, why progress requires regress, her thoughts on Susan Sontag, the stroke of fate that stopped her from pursuing a law degree, the “profound dialectic” in Walt Whitman’s poetry, how Hinduism has shaped her metaphysics, how Bernard Williams and Derek Parfit influenced her, the anarchic strain in her philosophy, why she calls herself a socialist, her next book on genealogy, and more.

Here is one excerpt:

SRINIVASAN: No, it really wouldn’t. Part of why I find this whole discourse problematic is because I think we should be suspicious when we find ourselves attracted to data — very, very thin and weak data — that seem to justify beliefs that have held great currency in lots of societies throughout history, in a way that is conducive to the oppression of large segments of the population, in this particular case women.

I also think one error that is consistently made in this discourse, in this kind of conversation about what’s innate or what’s natural, is to think about what’s natural in terms of what’s necessary. This is a point that Shulamith Firestone made a very long time ago, but that very few people register, which is that — and it was actually made again to me recently by a philosopher of biology, which is, “Look what’s natural isn’t what’s necessary.”

It’s extraordinary. It’s not even like what’s natural offers a good equilibrium point. Think about how much time you and I spend sitting around. Completely unnatural for humans to sit around, yet we’re in this equilibrium point where vast majority of humans just sit around all day.

So, I think there’s a separate question about what humans — as essentially social, cultured, acculturating creatures — what our world should look like. And that’s distinct from the question of what natural predispositions we might have. It’s not unrelated, but I don’t think any of us think we should just be forming societies that simply allow us to express our most “natural orientations.”

COWEN: Should women’s chess, as a segregated activity, continue to exist? We don’t segregate chess tournaments by race or by anything — sometimes by age — but anything other than gender. Yet women’s chess is a whole separate thing. Should that be offensive to us? Or is that great?

Recommended, engaging throughout.  And again, here is Amia Srinivasan’s new and (in the UK, just published yesterday in the U.S.) bestselling book The Right to Sex: Feminism in the 21st Century.

The NYTimes on the FDA and Rapid Tests

In July of 2020 I wrote in Frequent, Fast, and Cheap is Better than Sensitive:

A number of firms have developed cheap, paper-strip tests for coronavirus that report results at-home in about 15 minutes but they have yet to be approved for use by the FDA because the FDA appears to be demanding that all tests reach accuracy levels similar to the PCR test. This is another deadly FDA mistake.

…The PCR tests can discover virus at significantly lower concentration levels than the cheap tests but that extra sensitivity doesn’t matter much in practice. Why not? First, at the lowest levels that the PCR test can detect, the person tested probably isn’t infectious. The cheap test is better at telling whether you are infectious than whether you are infected but the former is what we need to know to open schools and workplaces.

It’s great that other people including the NYTimes are now understanding the problem. Here is the excellent David Leonhardt in Where are the Tests?

Other experts are also criticizing the Biden administration for its failure to expand rapid testing. Even as President Biden has followed a Covid policy much better aligned with scientific evidence than Donald Trump’s, Biden has not broken through some of the bureaucratic rigidity that has hampered the U.S. virus response.

In the case of rapid tests, the F.D.A. has loosened its rules somewhat over the past year, allowing the sale of some antigen tests (which often cost about $12 each). But drugstores, Amazon and other sellers have now largely run out of them. I tried to buy rapid tests this weekend and couldn’t find any.

The F.D.A.’s process for approving rapid tests is “onerous” and “inappropriate,” Daniel Oran and Dr. Eric Topol of Scripps Research wrote in Stat News.

For the most part, the F.D.A. still uses the same cumbersome process for approving Covid tests that it uses for high-tech medical devices. To survive that process, the rapid tests must demonstrate that they are nearly as sensitive as P.C.R. tests, which they are not.

But rapid tests do not need to be so sensitive to be effective, experts point out. P.C.R. tests often identify small amounts of the Covid virus in people who had been infected weeks earlier and are no longer contagious. Rapid tests can miss these cases while still identifying about 98 percent of cases in which a person is infectious, according to Dr. Michael Mina, a Harvard epidemiologist who has been advocating for more testing

Identifying anywhere close to 98 percent of infectious cases would sharply curb Covid’s spread. An analysis in the journal Science Advances found that test frequency matters more for reducing Covid cases than test sensitivity.

As I said on twitter what makes the FDA’s failure to approve more rapid antigen tests especially galling is that some of the tests being sold cheaply in Europe are American tests just ones not approved in the United States. If it’s good enough for the Germans it’s good enough for me!

Scott Gottlieb’s Uncontrolled Spread

Scott Gottlieb’s Uncontrolled Spread is superb. I reviewed it for the WSJ. Here’s one bit:

If there’s one overarching theme of “Uncontrolled Spread,” it’s that the Centers for Disease Control and Prevention failed utterly. It’s now well known that the CDC didn’t follow standard operating procedures in its own labs, resulting in contamination and a complete botch of its original SARS-CoV-2 test. The agency’s failure put us weeks behind and took the South Korea option of suppressing the virus off the table. But the blunder was much deeper and more systematic than a botched test. The CDC never had a plan for widespread testing, which in any scenario could only be achieved by bringing in the big, private labs.

Instead of working with the commercial labs, the CDC went out of its way to impede them from developing and deploying their own tests. The CDC wouldn’t share its virus samples with commercial labs, slowing down test development. “The agency didn’t view it as a part of its mission to assist these labs.” Dr. Gottlieb writes. As a result, “It would be weeks before commercial manufacturers could get access to the samples they needed, and they’d mostly have to go around the CDC. One large commercial lab would obtain samples from a subsidiary in South Korea.”

At times the CDC seemed more interested in its own “intellectual property” than in saving lives. In a jaw-dropping section, Dr. Gottlieb writes that “companies seeking to make the test kits described extended negotiations with the CDC that stretched for weeks as the agency made sure that the contracts protected its inventions.” When every day of delay could mean thousands of lives lost down the line, the CDC was dickering over test royalties.

In the early months of the pandemic the CDC impeded private firms from developing their own tests and demanded that all testing be run through its labs even as its own test failed miserably and its own labs had no hope of scaling up to deal with the levels of testing needed. Moreover, the author notes, because its own labs couldn’t scale, the CDC played down the necessity of widespread testing and took “deliberate steps to enforce guidelines that would make sure it didn’t receive more samples than its single lab could handle.”

Read the whole thing.

Addendum: My previous reviews of Michael Lewis’s The Premonition, Slavitt’s Preventable and Abutaleb and Paletta’s Nightmare Scenario.

Covid markets in everything

A pastor is encouraging people to donate to his Tulsa church so they can become an online member and get his signature on a religious exemption from coronavirus vaccine mandates. The pastor, Jackson Lahmeyer, is a 29-year-old small-business owner running in the Republican primary challenge to Sen. James Lankford in 2022.

Lahmeyer, who leads Sheridan Church with his wife, Kendra, said Tuesday that in the past two days, about 30,000 people have downloaded the religious exemption form he created.

And:

Some institutions request a signature from a religious authority, but Charles Haynes, senior fellow for religious freedom at the Freedom Forum in Washington, said that those institutions could be on a shaky ground constitutionally. Haynes said that if a person states a sincere religious belief that they want to opt out of vaccination, that should be enough.

“He’s not really selling a religious exemption,” said Haynes, who compared Lahmeyer’s exemption offer to televangelists who sell things like prayer cloths. “He’s selling a bogus idea that you need one.”

Here is the full story, via Brett D.

What’s the Right Dose for Boosters?

The Biden administration says booster shots are coming, but the FDA hasn’t decided on the dose. Moderna wants a half-shot booster. Pfizer a full shot. But could the best dose for Americans and for the world be even less?

COVID-19 vaccines are the first successful use of mRNA vaccine technology, so a lot remains unknown. But identifying the smallest dose needed to provide effective boosting is critical to protect Americans from adverse effects, increase confidence in vaccines, and mitigate global vaccine inequity.

We’ve known since earlier this year that a half-dose of the Moderna vaccine produces antibody levels similar to the standard-dose and newer information suggests that even a quarter-dose vaccine may do the same. If a half or quarter dose is nearly as effective as a standard dose for first and second shots then a full dose booster may well be an overdose. The essential task of a booster is to “jog” the immune system’s memory of what it’s supposed to fight. Data from the world of hepatitis B suggest that the “reminder” need not be as intense as the initial “lesson.” And in the cases of tuberculosis, meningitis, and yellow fever vaccines, lower doses have been as good or better than the originals.

Lower doses could also reduce risks of adverse effects.

That’s myself and physicians Garth Strohbehn and William F. Parker on the Med Page Today. Strohbehn is an oncologist and specialist in optimizing doses for cancer drugs. William Parker is a pulmonologist and professor of medicine at the University of Chicago.