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Monday, Oct 26, 2020 - 00:42 SGT
Posted By: Gilbert

Apotusgetics

It is possible to blindly admire public figures to an unjustified extent, one gathers. After considering my own perhaps-overweening esteem for a certain President over the past years, I suppose it's only equitable to reconsider his record, given the divisiveness and chaos that his inaction has spewed in the United States previously.

It began, as it so often does, with a vicious display of deplorable police brutality, as routinely disproportionately visited on a vulnerable member of a downtrodden minority race. Accused of a minor infraction, the big but gentle African-American family man was understandably apprehensive of being put under arrest, given a lengthy prior criminal record; for this, he wound up being unceremoniously choked to death by a police officer - who so happened to be white. Enraged that due sanction was again unlikely to be visited upon the uniformed perpetrators, tens - perhaps hundreds - of thousands gathered for the #BLM cause, to seek reform and repentance.

As the righteous demonstrations only grew in intensity over the weeks, in solidarity across countless cities and even internationally across Twitter and other social media, it had the feel of a tide that could not - and should not - be turned back. As one of the many advocacy groups involved put it, "The people are fed up". Indeed, with Starbucks baristas writing "Black Lives Matter" on coffee cups, beloved sport stars voicing their support and very publicly taking a knee during the anthem in protest, there was the feeling that something had to give - the arc of the moral universe surely had to start bending towards justice, sometime about now?


Oh, when will the horror end?
(Source: cbsnews.com)


It being an election year only gave the call more legitimacy, but alas, all those pleas would only fall on deaf ears, at the very top. "That is not a protest." the cold verdict began. "It is not a statement. It's people, a handful of people, taking advantage of a situation for their own purposes - and they need to be treated as criminals.", so the commander in chief declared. These were just "...a handful of criminals and thugs who tore up the place."

Such insensitivity and blind refusal to confront the issues could only further inflame the public, obviously, as the extrajudicial killings of innocent black people continued to pile up; in Chicago, in Minnesota, in Louisiana and seemingly everywhere. To all these outrages, the so-called President appeared to have only one recourse - to defend the cops, whilst sending the National Guard into the fray to put the demonstrations down by force. As American cities simmered under trooper-enforced curfew, commentators domestic and foreign fretted at this unseemly abrogation of democracy. A complete failure of leadership and empathy, so rightly wrote The New York Times, The Atlantic and other papers from all across the political spectrum, as America's cities burned in their dozens. Not only that, elements of the military and police saw fit to reprimand their erstwhile leader, to add to the snowballing humiliation. Could any POTUS have been so, utterly, useless?!

Indeed, how did Obama mess it up that much?

I mean, I don't even think that he was that bad of a President or anything, but he was elected with improving race relations as one of the biggest plusses in his portfolio, so pardon me if I cut his successor (whose own focus was more on jobs, the economy and preserving America's slipping geopolitical supremacy) somewhat more slack for not being able to do more. I would have been one of his voters back in 2008 - only to turn around by the end of his term - because intentions and impressions aside, it simply wasn't working.


He didn't seem to be working either, but fortunately his mum is there to fix that and restore some sense


Now, don't get me wrong here. Of course Black lives matter! It's one of those statements that one finds strange to have to make, y'know. Like, murdering babies is very bad, or that robbing or destroying people's stuff is wrong, it's on that level of truism. In fact, paltry as the gesture might have been, I was seriously considering blacking out my social media for awhile then (although, as always, TRUMP was there before it was cool, until Twitter got in the way), before figuring that it would be a little too much overt and opportunistic virtue-signalling (but for those that went ahead, that's great too, you do you, which media outlets like the NYT don't seem to comprehend); and then there was the matter of what the BLM organization was about; their original statement of purpose had "disrupt[ing] the Western-prescribed nuclear family structure" as an aim, for example, which might fairly give would-be supporters slight pause.

I confess to preferring actual solutions eventually, you see. Assuredly, having bad cops killing citizens in avoidable circumstances is unacceptable, and they should be prosecuted to the full extent of the law; heck, if having purpose-built cops-only federal prisons to encourage the police fraternity and legal system to do the necessary is what it takes, I'm all for it. There might perhaps be more thought given to safer restraining methods, such as the Japanese sasumata, and I don't know, nets or glue-guns or somesuch. One could even understand - if not condone - the torching of involved police stations in the immediate aftermath, it being in the heat of the moment and all.

But encouraging it against random suburbs and housing projects? Lighting stores of medical equipment and charities up? Looting branded sneakers to "help feed one's kids"? Or beating up fellow minority shopkeepers, who were just trying to preserve their hard-earned property (one can hardly fault the based rooftop Koreans from '92 for making a return)? Or bashing a poor raccoon to death, just because?

How does any of the above help black - or any - lives?


CNN has finally jumped the shark, not that they're spared either, despite putting up the "don't hurt me" signs and murals
(Source: foxnews.com)


Indeed, on defunding the police - one of the most-publicized demands by the BLM organization - one hopes it self-evident that it wasn't gonna work, because as a straight-talking Charles Barkley noted, "who are black people supposed to call? Ghostbusters?". Now, I get it, a few police officers did unforgivable things; however, given the decentralized nature of the force in America (as with many other public services, by the way), taking away their ability to enforce the law might not be the best idea, as those actually living in tougher neighbourhoods might attest to. Case in point, an ESPN writer was having a great time egging rioters on to raze a nearby housing project in Minneapolis... only to change his tune quick when they were headed down to his own posh neighbourhood - a stand that various liberal mayors have abruptly agreed with, once the protests got too close for comfort.

Given that the ACAB madness was in vogue then, despite research findings that police shootings - while extremely regrettable - weren't even racially biased (a view for which the likes of Steven Pinker endured an attempted cancellation), police departments throughout the country very reasonably simply... stood aside. Folk often need history to repeat itself to be reminded of just why society functions as it does, after all, and this year's lesson would be the Capitol Hill Autonomous Zone, or CHAZ, formed within Seattle after their cops took a much-deserved leave of absence.

Being on the side of Great Justice is fun and games and all, at least until CHAZ inhabitants rediscovered a basic economic law on scarcity - when you don't set a price on stuff, it tends to run out. Suddenly out of food, the freedom fighter larpers would dig out something that had the superficial appearance of a crop garden, complete with obligatory sign reserving it exclusively for black and indigenous people, with whites being "encouraged" to pay them a tenner each. Despite positive coverage by CNN FAKE NEWS and the generous donation of a dairy cow, the first armed warlord moved in within days, with enforcers choking a street preacher, and murdering two black teens in broad daylight. CHAZ, now renamed CHOP like your garden-variety totalitarian state after a regime change, would then swiftly pass through their flag-waving and guillotine phases, aptly recognized as "communism on speed run mode". They held out for about three weeks until the smell and killings got too bad, and the cops would stroll back in to renewed appreciation.


The Great Erasure

I'm ok with counterculture, not ok with bad tenses
[N.B. Sometimes, one has the urge to get a spraycan and do some ad-hoc copyediting out there; nothing against the cause, you understand.]


The short-lived CHAZ/CHOP experiment aside, the protests have sadly probably left far more indelible scars on America's cultural history. I kind of get the removal of Confederate monuments, especially if they were only erected long after the relevant period, and plausibly for purposes of intimidation. However, when Washington, Jefferson and Ulysses S. Grant statues are being toppled, the National Mall is being defaced, graveyards are getting spray-painted, actual social reformers and humanitarians such as Frederick Douglass, Abraham Lincoln and Father Damien (whose statue I admired at the Hawaii State Capitol) are getting spat on, and Sweden's considering replacing their Charles XII specimen with one of Greta Thunberg (no joy for those looking to put Balboa down, though), one has to wonder - what the hell has gone wrong with the world?

Look, I'm hardly against black - or other minority - folks getting more credit and exposure. Remember the BLM protestor statue that replaced Edward Colston's? It lasted only a day, but I think it deserves to find a home somewhere. BLM murals? Why not?

Lost among all the screaming and burning, one feels, is a very simple realization - there is no lack of space for everybody. Surely there are very many worthy and underappreciated black historical figures (outside of MLK) - or good community leaders - who could do with a monument or two of their own? Fellows like Booker T. Washington, Jesse Owens, Herman Cain, Jimmy McMillan, Clarence Thomas, etc.? Perhaps every city could come up with a list of their favourite black sons and daughters, and spread the art? And then you have complaints such as those against the Theodore Roosevelt statue outside the American Museum of Natural History, due to it supposedly casting blacks and natives in a subservient position - being on foot, while Teddy rides. Well, get them some horses, man! Or does America not have enough steeds? Then again, with NYT/CNN describing Mount Rushmore as "a monument of two slave owners and on land wrestled away from Native Americans", one understands if the good common folk are getting mighty confused.

The problem with removing a statue or monument or representation just because somebody out there is offended, is that it never ends. Sure, maybe Columbus was no saint and a product of his times, but has anybody considered the Italian-American community's feelings on his removal? Are the statue-topplers so certain that their heroes are beyond all reproach? As GEOTUS has recognized, the U.S. is perhaps unique in having their children taught in school, to hate their own country.


Ma, they evicted the nice Native Americans from their land again!
(Source: smithsonianmag.com)


But fine, Francis Galton, Karl Pearson, Woodrow Wilson and David Hume and others might all have been scoured from remembrance, but they were dead old white men, so it's fair game. But no, that wasn't enough, and now Aunt Jemima's gone! Lady rose from slavery to build a national pancake syrup brand, and I really can't see her modern likeness as derogatory in any way, but the woke mob has forced the removal of her legacy, and who cares what her own descendants think? Same for the Land O'Lakes lady, she did nothing wrong, and now she's gone, along with another classic father-son bonding opportunity.

And on it goes - I can kind of see how "Redskins" for the Washington football franchise might have been construed as offensive - not that it seems to have been a widespread interpretation - but yeah, sign of the times. They've gone minimalist for now with the unimaginative "Washington Football Team", and I personally thought "Chiefs" an appropriate replacement, if it hadn't already been taken. Well, the way things are going, the woke crowd might well have been after "D.C. Redskins" instead, and I also quite liked the suggestion to keep the name, but change the logo to a potato.

Which brings me to the underrepresentation of Asians in American sport. I'm not usually one to speak for a heritage that may only be partially shared, but I believe past generations of Chinese immigrants have made substantial contributions to America too. One might then expect this to be reflected in popular culture, but no, you don't see a minor league or farm team paying tribute to the Coolies, the Takeaways, or the Launderers (I tell you, if Manhattan starts a franchise called the Wall Street Launderers, I would so buy all their gear)! No, all we got was an obscure left-arm unorthodox spin delivery in cricket, and the Yanks don't even play that game! And anyway, that term seems to have gotten cancelled too, so, yeah.


Was It All Worth It?


Asian-Americans paying it back
(Source: r/conservative)


Well, one has to eventually take stock of the damage after a few long months of rioting and hell-raising, with the more-responsible amongst all races and creeds uniting to undo the vandalism, because who does that benefit in the longer run? The stringent anti-cop sentiment has also appeared to have run its natural course, with communities again backing their boys in blue, after witnessing the alternative. Support for the cops, whether measured by direct statements, opposition to defunding or wanting their continued presence seems to be around 80% at least. Local politicos have swung from wanting to disband their police departments, to backtracking and being deeply concerned at how they're now shortstaffed, after basically leaving them out to dry when expedient. Can one then blame the police unions for assembling behind GEOTUS, who got slammed for basically holding the opinion that protests were ok, but arson isn't?

A billion dollars in riot damage in almost all of America's largest cities (but they were 93% peaceful, so says CNN) and no end in sight can wear on even the most idealistic supporters, and with feedback showing that BLM's popularity was (unsurprisingly) tanking hard, the Democrats would finally get concerned that it would drive support for TRUMP, with Pelosi condemning the looting four months too late. Now, one could of course argue that GEOTUS is at fault here, but it would take a special kind of dense not to recognize the bias in the lying FAKE NEWS media, which appears to have been suspiciously fanning the flames of civil unrest and a possible race war all along. With multiple Democratic mayors in Minnesota now throwing their endorsements behind TRUMP's common sense, and a renewed taste amongst voters for law and order, one figures that this might well presage a Nixon-like landslide as in 1968.

Leaving the election analysis for now, it's not like one has to even look all that far back for suitable precedent. It was the same slow boil and explosion of rage and wokeness in 2016, before the BLM movement dutifully dwindled into blissful near-total obscurity... until next time. Frankly, given all the "colour revolutions" that Uncle Sam has sponsored, it's perhaps not to be unexpected that rival powers might target America in similar manner. Anyhow, the worst seems over after a bill was introduced to deny rioters their welfare cheques, and as for myself, I've just pre-ordered my tickets in advance for #BLM2024. Gotta get ahead of the scalpers, nowadays.



It might even compete with the Olympics, after a few more editions!
(Source: trends.google.com, for #BlackLivesMatter)




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Saturday, Oct 17, 2020 - 23:42 SGT
Posted By: Gilbert

Corona Update (Part II)


Vaccines

Continuing, everyone seems to be awaiting salvation through the needle nowadays; "there's no returning to normal life without a working vaccine" is the current received wisdom, with not-unfounded contrarian thought along the lines that - eh, various other major epidemics (e.g. SARS, Zika, Ebola, AIDS) have not been resolved through vaccination, so shouldn't there be more weight on alternative solutions given best-case scenarios for mass vaccinations starting only late next year - largely ignored. Far easier to jump on the bandwagon by taking encouraging news on development where one can, as for the Arcturus vaccine that we've called dibs on.

Technically, of course, the world does have multiple working vaccines already - depending on who you're willing to believe. Trial results of a Russian candidate have been published in The Lancet about a month back, with the esteemed medical journal tweeting that it was by all indications "safe and effective". Given that further excitement has been muted, one suspects that many remain wary - The Lancet's staking of their name notwithstanding - and while it might be understood if rival powers are distrusting due to vaccine nationalism, the apparent slow uptake within Russia itself - and the resignation of an involved doctor over ethics - could be instructive. China's Sinovac has declared victory too, with their scientists proclaiming 99% confidence that it would work from Phase 2 trials [N.B. typical Phase 3 failure rates appear over 50%], but it's not like they're waiting for the results, or even asking for permission, anyway. The adventurous might try it out for themselves, but let's just say that circumspection is a virtue.

There are obviously risks relating to rushing vaccine trials, with the AstraZeneca adenovirus-based offering already held up due to serious complications on two participants; the Moderna and Pfizer ones have likewise reported heavy side-effects. Historically, being too eager to vaccinate can end in tears, as with Gerald Ford's swine flu vaccine for H1N1 in 1976, or more recently vaccine-derived polio in Africa, and Pandemrix in 2009. That last made over 800 kids brain-damaged, leading to a £60 million settlement in Britain. To The BMJ's credit, they published a letter questioning why the public had not been informed of early trial warnings some nine years on, and it's not like Big Pharma has to worry about that on this occasion, having wangled full waiver of liability in most countries.

Trouble is, the line between blind anti-vaxxism and considered prudence can be very fine, and one has to thank The Donald here for returning some forbearance to the fray. By simply tweeting that vaccine development is going a-ok, GEOTUS has singlehandedly turned the establishment stand against "vaccine hesitancy and refusal" on its head, with various media outlets now falling over themselves to inform the public about how even minor side effects are bad, and why vaccines can be dangerous. Whatever it takes to get the word out...


Not All Solutions Considered Equal

A peek into wider medical opinion (not censored for now)


One particularly egregious misconception would have to be that the coronavirus vaccine will be some sort of silver bullet - get vaccinated, and you're immune (like GEOTUS, maybe, probably for awhile at least)! Quite a few seem to have missed the memo that a working vaccine might be only about 50% effective, as warned by Dr. Fauci among other health authorities, with some flu vaccines coming in as low as around 25%... and that masks might actually offer superior protection than vaccines, from the Director of the CDC himself.

For what it's worth, the NEJM has just advocated for mandatory vaccination in the face of the majority of the populace being (understandably) reluctant, and it might once more be worthwhile to consider the incentives here. Love him or loathe him, one could be forgiven for figuring that Duterte has a point in accusing Western Big Pharma of being all about the profit and only incidentally about public health, which has resulted in a glaring preference for expensive treatments over cheaper but possibly still-effective ones. As explained with Remdesivir (on which more very soon), a treatment costing thousands of dollars is basically useless to large swathes of the global population, and one can only hope that one of the more cost-effective initiatives works out eventually.

The NEJM, by the way, has also involved themselves in the battle to control the narrative at the very highest levels, together with The Lancet, Nature, Science and Scientific American. This struggle was not confined to the ivory-tower journals either, with the FDA Commissioner chastised by the former editors-in-chief of Science and npj Digital Medicine, for misstating that a convalescent plasma treatment would "save 35 lives out of every 100 people who got it" (paraphrased). Turns out, it seems that the poor fellow would have been entirely correct had he just phrased it as "35 out 100 patients who died would have been saved" and emphasized that it was a relative and not an absolute risk reduction - which, it has to be said, appears a routine convention in reporting results (e.g. Gilead press release on Remdesivir (62%!), Science editorial on Dexamethasone (33%!), which all somehow escaped criticism that "...getting to a 35% 'relative' reduction in mortality involves comparing the before and after groups in a way that dramatically exaggerates [?] the effect of the treatment")

Personally, one detects a slight hint of desperation here by the legacy set on preserving their monopoly over accepted truth. Perhaps slightly ironically, however, it has oft been regarded as wise to take pronouncements from these very top journals with a pinch of salt, from their especially-high retraction rates. And for the medical Big Four in particular, it almost seems a rite of passage for their former editors-in-chief to pen warnings and books explaining how one really shouldn't believe half of what they publish (I'm working through former NEJM EIC Marcia Angell's The Truth About the Drug Companies) - which might make the ongoing skepticism slightly more palatable.


Remdesivir & HCQ Reloaded

Which brings us back to the subject of Remdesivir, last covered back in early July. The controversy has quietened considerably since those heady days, with Remdesivir given a boost with an NEJM article reporting that it successfully shortened time to recovery by about five days (10 days vs. 15 days for placebo), together with a statistically significant reduction in mortality, on a total of about 1,000 patients. And all was well and good, until the WHO's SOLIDARITY trial dropped its bombshell - Remdesivir had not been found to have any significant effect on either recovery time or mortality, from a trial arm involving 2,750 patients. Gilead obviously wasn't pleased about this declaration, but hey, they've made their sales; there's word that they received early notice of the SOLIDARITY trial's negative result in September, but went ahead to sign a billion-dollar deal with the European Union on October 8 anyhow (that's now rightly facing calls for review, after this latest revelation). Perhaps they might consider getting IMMUNE GEOTUS to vouch for it?

Let's talk a little methodology here. Scientists can investigate much the same phenomena, and return with divergent results (and conclusions); oftentimes, this is correct, and only to be expected. Especially in social and biological fields, there are just too many unknowns and uncontrollable variables, for even competent and well-intentioned investigators to be guaranteed to concur, without any wrongdoing on anybody's end.


Hierarchy of Evidence
(Source: researchgate.net)


Therefore, accepted practice is to defer to a hierarchy of evidence in appraising a claim. It begins near the bottom with editorials and opinions (which might be influential, but at the end, everyone has one, and patients should seek a second one if they so desire), rises through case reports (i.e. N=1, oft by bright-eyed residents seeking to get their feet wet), then (retrospective) cross-sectional studies, case-control studies, cohort studies and then the much-ballyhooed randomized controlled trial (RCT). Each of these study designs has their uses, and one suspects that some accommodations might be made for study parameters (e.g. is an RCT of 100 patients definitely better evidence than a cross-sectional study on a million patients?), but that covers the gist of it.

The capstone of the pyramid is given as systematic reviews and meta-analyses, which makes sense since multiple RCTs (and other studies) provide more information than a single RCT, assuming they are all well-conducted (i.e. the Gilead-conducted RCT published in NEJM versus the SOLIDARITY trial and others, as described above). Consider a particularly delicate experiment on the efficacy of a drug, that's been assigned to a hundred investigators; perhaps 80 of them return with a positive effect, and 20 with no effect, after their best efforts. One might consider this a promising avenue, looking at the whole picture (there may be a bias against negative results in published literature, but that's another story)

Still on the proposed scenario, note that it remains easy for an advocate against the drug to argue that it doesn't work - simply pick out the 20 negative experiments as (entirely valid) evidence, while ignoring the other 80 (of course, it works the other way too, but in this case the proponents would probably not have to resort to that). Thus, the importance of being comprehensive in identifying relevent work in a systematic review, which usually involves carefully defining the search terms and databases/archives used in procuring publications.


HCQ Outpatient RCT outcomes
(Source: threadreaderapp.com)


With all this background in mind, allow me to cover some such systematic reviews on HCQ, that have emerged in the few months since it last made waves around July. One particularly highly-circulated example (at least on Reddit) was Fiolet et al.'s "Effect of hydroxychloroquine with or without azithromycin on the mortality of coronavirus disease 2019 (COVID-19) patients: a systematic review and meta-analysis" from Clinical Microbiology and Infection in August, which was promoted as bolstering the stand that HCQ was not associated with reduced mortality in hospitalized patients (as indeed was its conclusion). Overall, it indeed seems a fine example of a well-constructed systematic review (note thorough description of the study selection process, which winnowed an initial 839 papers, down to just 27 that were used to assess the use of HCQ alone)

Figure 2 summarizes the main analysis - including individual risk ratios (RR) and weights for each included paper - and produces a combined random effects model risk ratio of 0.83 [95% C.I. 0.65-1.06]. Now, one believes that a risk ratio of 0.83 means that those who underwent the treatment (HCQ) had 0.83 times the risk of COVID-19 mortality, compared to the controls... which is, like, good? However, it is also true that this apparent improvement was not significant, due to the 95% C.I. containing 1.00 (it is further mentioned in the paper that "...after inclusion of studies with critical risk of bias, the global RR was marginally not significant 0.80 [95% CI 0.65-1.00]")

Looking elsewhere, there exist various preprints of other systematic reviews on HCQ, with one by Harvey Risch and associates finding a 24% reduction in COVID-19 infection, hospitalization or death with HCQ, Garcia-Albeniz et al. coming up with a pooled risk ratio estimate of 0.78 [95% C.I. 0.61-0.99] (just about significant, and not that far away from Fiolet et al.), and another by Prodromos & Rumschlag concluding "consistent clinical efficacy for COVID-19 when it is used early in the outpatient setting", and that HCQ would "in general... appear to work better the earlier it is used".

There's also an interesting living aggregation available hosted at c19study.com, which touts a 100% positive (or more accurately, non-negative) effect of HCQ in early treatment, with a 64% median improvement, and a 26% median improvement with late treatment as of currently (which seems broadly in line with the systematic reviews above). Now, there are some legitimate criticisms, such as the webpage possibly excluding studies and not weighing them by strength of evidence, though other complaints such as it listing preprints might be expecting too much (Fiolet et al. includes preprints too, for example, and given typical journal publishing turnaround times, one could expect some otherwise entirely good papers to be held up), but at some point one thinks it would be reasonable for the critics to substantiate their accusations - where are all the countervailing studies showing that early HCQ treatment, at conventional dosages, is harmful? From all the vitriol the medication has attracted, surely it wouldn't be hard to list them out?


Talking Past One Another

Rewinding back to late July, a group of physicians calling themselves America's Frontline Doctors held an open interview outside Capitol Hill, claiming that HCQ (and zinc, and Zithromax) was a "cure" for the coronavirus; now, while "cure" is a loaded word that can be taken to imply 100% effectiveness, it is hardly outside the realm of plausibility that HCQ might well help - all the more if prescribed early - from the reviews described above. These practising doctors would be swiftly suspended from major social media outlets for their pains - which extended to prominent persons who simply retweeted their video - and whatever one's personal stance is about the HCQ issue, the implications for free speech are chilling.

Twitter, for example, referred to their COVID-19 misinformation policy in their censorship, but this only begs the question of what authority they are deferring to, in determining what's misinformation and what's not. If it's the WHO or the CDC or similar, then it could easily be pointed out that these organizations have routinely - if unintentionally - doled out misleading advice themselves. One of the group, for instance, was from the Henry Ford Health System that had published a study on 2,541 patients suggesting a substantial reduction in mortality with standard HCQ dosing, and if a fellow isn't allowed to advocate for one's own findings to begin with - right or wrong as he might later turn out to be - how can viewpoints outside the establishment line (which can be based on very shaky foundations, as seen with #Lancetgate), ever gain a hearing?

We'll come to the consequences of censorship on social media again, and turn attention to the derision of two doctors opposed to AFD's HCQ advocacy; one rebuttal is particularly interesting: "I'm an ER doc that treated #COVID in NYC & AZ. We gave #hydroxychloroquine and it didn't work. Same with Azithromycin. Does this 'Dr' even treat CRITICAL hypoxic patients? Or just healthy patients walking in her office. Disgusting!"

One might easily agree with the emergency room docs - on dying, late-stage patients, next to nothing has been proven to work reliably, from the latest SOLIDARITY data and other studies. However, the jibe at treating only "healthy patients" strikes one as slightly strange. In general, isn't the idea to treat a virus as early as possible, rather than wait until the patient is fighting for his life? Indeed, the early advocates for HCQ have consistently been encouraging early treatment, since the idea was to slow or stop viral replication before the patient's organs had been overwhelmed, after which application of HCQ and other medications were far more likely to be detrimental. Given this, perhaps both sides have a tenable point?

This fine if rather simple distinction appears to have been mostly lost amongst the medical and scientific communities' shining stars, alas, with Science Translational Medicine's ongoing dismissiveness of HCQ from the SOLIDARITY trial's findings pointing to a meta-analysis... comprised of 16 unpublished trials (not including preprints), and 10 publications/preprints - but again, this could be seen as a bit of misdirection to begin with, given that SOLIDARITY remains a test of late-stage efficacy with high dosages. The entire affair is exceedingly odd in retrospect:

  • It has long been established that HCQ is safe at standard dosages, or at least as safe as any medication used routinely by millions for over half a century has a right to be. The utter gaslighting that HCQ was exceedingly dangerous - to the extent of a fabricated Lancet paper - was a wonder in itself, and recalls the observation that if one repeats a lie enough - no matter how blatant and illogical - people will eventually come to believe it.

  • Since that argument was frankly untenable to begin with - how does one convince doctors who've prescribed HCQ for years without incident, that it's suddenly poison? - major trials on late-stage treatment were arranged, with unprecedently-high doses; this is of course an old Big Pharma trick, as documented in Ben Goldacre's Bad Pharma (on antipsychotic drug trials, page 181):

    "...Safer found six trials comparing new-generation antipsychotic drugs with boring old-fashioned haloperidol - a drug known to have serious side effects at 20mg a day. This is not an insanely high dose of haloperidol: it wouldn't get you immediately struck off, and it's not entirely outside the maximum dose permitted in the British National Formulary (BNF), the standard reference manual for drug prescription. But it's an odd routine dose, and it's inevitable that patients receiving so much would report lots of side effects."

    ...and then consider that HCQ was administered at over twice the accepted maximum dose in RECOVERY & SOLIDARITY. But who's counting?

  • Rationally, given that HCQ is cheap and generic, it would appear to be a prime candidate for broad early treatment/prophylaxis trials, especially for frontline medical workers, at least some of whom should recognize the attraction of a possibly-preventative treatment with known, minimal downside, against a less-understood and dangerous virus ("what do you have to lose" does actually make sense, really); well, it's been over half a year into the pandemic, and somehow nobody (in the Anglosphere, at least) seems to have managed to put one together, for better or worse (possibly because, as quite a few have recognized, there's no money in it)

    On this, the best hope appears to be Oxford's ongoing COPCOV trial, with preliminary results (entirely unsurprisingly) discovering that HCQ at normal doses is safe - though the trial head has admitted that the unwarranted hit job on HCQ has already made potential subjects more reluctant to enrol. These fellows are furthermore saying reasonable things like "prevention is much easier than cure", and "by the time patients are admitted to hospital, virus multiplication is well past its peak and inflammation in the lungs and other complications may prove lethal", so I think they have a good head on their shoulders and am eagerly awaiting their findings, positive or negative as it might be.

  • And then there are the high effectiveness bars that have been set, with the University of Minnesota-led early-use RCT in NEJM for example concluding that HCQ did not prevent COVID-19, despite actual observed improvement, since a much bigger effect was required for significance. This presentation has attracted a number of reanalyses (including an open letter by academics from UCLA, the Sorbonne, Texas A&M etc.) purporting that it actually suggests that early treatment is effective, even if not highly reliable. In the absence of anything superior, even a 20% improvement in survival would be about 200,000 lives saved based on deaths to date, so it's quite incredible that there appears very little interest in early treatment, as opposed to admittedly more-dramatic late interventions and vaccines.

    On the other hand, HCQ politicization (and possibly premeditated clearing of the way for higher-priced alternatives) might not have had as large of an impact outside America and the broader Anglosphere, with many countries apparently having always practised early treatment with HCQ to some extent, with near-zero controversy. One can only wish that when all this is over and done with, an objective journalist team can piece together just how the same facts, could have been interpreted so differently across the globe...

[To be continued...]



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Sunday, Oct 11, 2020 - 21:14 SGT
Posted By: Gilbert

Corona Update (Part I)

It's probably time for another check-in on the coronavirus front after mostly laying off the subject since June, and before continuing, I'd like to state that all the following is written in my personal capacity. To start off on a bright note, GEOTUS appears to have given the virus the ol' smackdown - if with a teeny bit of help from Singapore's own National Centre for Infectious Diseases (NCID). The NCID seems to have been doing some good work with convalescent plasma (as advanced here in May), with the antibody cocktail involved in his swift recovery developed from several local patients in collaboration with Regeneron, an American biotech firm.

It seems quite likely that some of these donors were foreign workers, given our distribution of cases, which seems to have inspired devoted medical cost-cutter GEOTUS to pay it on; not only has he declared that he wants the same treatment available for free to all his people, he has moreover committed to donating his own plasma, a forthright gesture if ever there was one. Well, one doesn't rise to his position by allowing a glorified flu to get him down, though one suspects that sections of the mainstream press were rooting for martyrdom instead.

Ahem, okay, tuning troll mode down...


On Test Accuracy

"Cases are up - many of those cases shouldn't even be cases. Cases are up because we have the best testing in the world and we have the most testing (indeed, probably hundreds of thousands daily, though overtaken by India currently)"

- technically, perhaps not entirely unsubstantiated?


Everyone's been bombarded by scary headlines for months now - 1,426 new cases here! It's over ninety thousand in India! - that it's often easy to neglect how much uncertainty there can exist, in the testing procedure. A layman might be easily forgiven for believing that the exalted physicians are making an absolute pronouncement, when they declare a patient either COVID-free or COVID-stricken, after administering a test; as it happens, the reality is... not so clean and simple.

Let's begin with some basics of medical testing. The sensitivity of a test is defined as the percentage of subjects who are identified as positive for a disease by that test, out of all subjects that actually have that disease. The specificity of a test is defined as the percentage of subjects who are identified as negative for a disease by that test, out of all subjects that actually do not have that disease. From this, a perfect test would have sensitivity and specificity both equal to 1; it always correctly identifies all subjects with the disease, and also always correctly identifies all subjects without the disease.

It's probably safe to say that currently-available tests are, almost without exception, not perfect.

Beginning with polymerase chain reaction (PCR) swab tests, oft regarded as the gold standard - they're supposedly near-perfect if done correctly... and if the subject has been infected for a week or more, to which perhaps another week might have to be tacked on for the results to be returned. Serological tests, in contrast, can have results known in hours, but despite relatively high (self-?)reported specificities under what one suspects are near-ideal conditions, independent evaluations suggest that for reasonable sensitivities >80%, typical specificities tend to be around 95-99%. Abbott's 15-minute rapid test claims 98.5% specificity, for example, but given that the White House is pushing it hard, The Atlantic for one is having second thoughts, but that's life.

Their concern about the specificity does stand, granted. Assume a test specificity of 99%. This implies that for every one hundred healthy persons tested, one will be wrongly identified as having the coronavirus (a "false positive"). Let's say a country tests ten thousand people a day, not too much of a stretch given that many of them are testing some 0.1% of their population daily; even if that country were entirely coronavirus-free, the test specificity would imply that around 100 false positives would be reported. In actuality, test performance can conceivably be rather worse, especially for alternative methods; the CDC admitted that its antibody tests could have a positive predictive value of less than 50%, as is the case in India, with external evaluation suggesting around 80% sensitivity/70% specificity for some test kits - not great, to say the least.


Hitting it between the ears!
(Source: straitstimes.com)


Given that some countries seem to be reporting new case rates apparently below what typical test specificities would suggest for baseline false positive calls, one has got to suspect that some additional tweaks might have been applied. Among the most obvious is repeat testing (possibly with a different/more accurate test method) to confirm initial positives, which has thrown up its fair share of false positives locally. And this is before one delves into the nitty-gritty of how high the viral load should be, for a person to be considered as afflicted. For PCR, the number of amplification cycles applied seems to be a "hidden parameter" that is seldom expounded on, which has led to much griping about whether some jurisdictions are setting tests to be far too sensitive, and whether subjects identified from such thresholds are actually contagious in practice.

Hopefully, the above has begun to inform on how nebulous case statistics for the coronavirus can be, from the scientific angle alone. But what about deaths, one might ask. Surely, it doesn't get more clear-cut than that? If a patient unfortunately passes away, and the body is tested and found to contain the virus, then surely that's a coronavirus death? Well, an exaggerated example might serve to illustrate the difficulty here: consider a motorcyclist who sadly lost an argument with a speeding trailer truck. The paramedics have dutifully scraped his remains off the asphalt and sent them for testing, per procedure, and it turns out that he was positive for COVID-19. Question: did this motorcyclist perish from the coronavirus?

Answer: this is a very good question!

Generally speaking, there are many possible definitions as to what constitutes death from a disease, and the coronavirus is no expection. For example, as far as is known, Singapore follows the WHO definition in not including non-pneumonia fatalities; in other countries, the criteria can be far more conservative, e.g. Sweden considering everyone dead after testing positive as coronavirus deaths, regardless of how much the virus contributed to the death. Now, neither approach is wrong - it's just that it is clearly unfair to compare death tolls reported under different definitions. Indeed, simply switching definitions (as done by Public Health England) can change the picture quite a bit, though it's probably best to provide more context with finer-grained classifications as to primary, secondary and tertiary deaths, as with the CDC revealing that some 94% of coronavirus deaths had possibly contributing comorbidities.


Let's All Be Positive (Or Not)!

And now, we venture into the yet-murkier less-scientific considerations. As an instructive example, one might consider a large federal constitutional republic, composed of some fifty states (Country A), and reason as to whether this polity would be biased towards reporting a higher or lower case load and death toll. To begin with, being a good democracy, Country A has passed legislation to pay hospitals a considerable sum of money, for each patient listed as coronavirus-positive (US$13,000, going up to over US$35,000 if they are ventilated)

Not to cast aspersions on the integrity of hospital personnel, but it sure seems that this would likely have encouraged them to play it very safe, and with a mostly clean conscience to boot. It never hurts to be cautious, after all? Moving up to higher levels of administration, reporting a higher case and death load would also justify more resources from the Feds (recall the ventilator bidding war between states?), while making the federal government look bad at the same time, which is a nice bonus when they're manned by the opposing party. Note, this is not to assert whether the chosen standards were or were not the most appropriate, given the very-real trade-offs. The point is that the incentives line up towards a liberal interpretation of infection.

Next, consider a one-party state (Country C). Here, there are essentially no independent healthcare or media bodies. There's a constant dribble of new cases being reported - usually in the double digits for a population of well over a billion, if they bother to report it at all - despite cities somehow arbitrarily entering lockdown. Even at the height of the pandemic, entire provinces with thousands of already-admitted cases, would claim essentially zero new infections. The head honchos explicitly warned that local officials would be held responsible, were a single new case to be reported. Not to cast undue aspersions on Country C either, but one understands why their purported figures are being left out of official analyses.

Oh, it gets more complicated. How many nations are really going to tell each other, Country A or Country C (but especially the latter) that we don't believe you, your numbers are bullshit? Occasionally, one comes across (entirely reasonable) musings about how a place with approximately zero community cases - out of a population of millions - keeps having positive cases detected from the tiny fraction of approved overseas travellers by other countries in reciprocal PCR testing, but the unsaid agreement appears to be not to question the discrepancy, with a wink and a nod. One can only imagine the amount of second-guessing going on as countries seek to establish travel bubbles and fast lanes, as to who's trustworthy, who's not, and who's not but are you gonna be the one to tell them that?

Finally, there are the... less-developed states, which might not have been testing that much, because there wasn't all that much money for basic healthcare to begin with (which makes the call to prayer by some health ministers somewhat more relatable); thankfully, many of these states have their population skewing particularly young too, long recognized as a key mitigator aiding survival. It might be considered that some estimates have upwards of a quarter of the populace having already contracted the coronavirus in certain cities, with the WHO's best estimate being 10% of the global population having already gotten it - or about twenty times the "official" case count of about 37.5 million as of today. With statistics like this, who needs facts?


Democracy's Due

To this mishmash of conflicting standards and perverse incentives, one metric has stood out - excess mortality. The reasoning behind this is fairly simple: it can be exceedingly complicated to tease out the true impact of the coronavirus, given all the heterogeneities between nations, and that's assuming they're being honest with the details. Instead, calculating "how many additional people died this year" requires only accurate annual death figures, and if it is assumed that the coronavirus is the major factor in these extra deaths, a reasonably robust ballpark figure can be arrived at.

Looking at this excess mortality data, there is always the danger of being too sweeping with one's pronouncements, but it's sure looking like one of the biggest drivers of coronavirus deaths is... Western democracy.


Excess mortality by percent, selected European countries
(Source: ourworldindata.org)


The genesis of this analysis, as so often happens, is GEOTUS, who made repeated claims in August that Europe had an excess mortality of somewhere between 30% to 40% higher than the United States, in various press briefings. This naturally brought the full weight of the fact-checkers down on him, and it seems like there might have been some hyperbole involved. However, it might be instructive to also note that for all the brickbats slung at America, their performance on coronavirus as compared to comparable Western democracies seems... pretty smack dang average. Perhaps nothing to shout about, but nothing particularly out of the ordinary either.


Cumulative P-scores of excess mortality, weeks 9 to 30
(Source: voxeu.org)


Two Oxford researchers have supplied a fairly comprehensive analysis on comparative excess mortality, which does appear to suggest that some European nations have been worse off than the U.S., namely Spain, Italy, Belgium, and the United Kingdom. France, Sweden, Portugal and the Netherlands aren't too far off either, and the major Western European outlier would seem to be Germany. From Table 3 in the report, the cumulative P-score for the peak eleven weeks seems largely comparable for all major European countries and the U.S., and for raw excess deaths per million, America indeed also comes solidly in the middle of the pack at 627/M, compared to say Spain's 1057/M or France's 448/M. Moreover, excess deaths appear highly unbalanced regionally for the U.S., with the northeastern region (including New York) recording 1473/M, which I believe would imply an excess death rate of around 454/M for the rest of the U.S. - which would put them near the bottom of the table.

Again, this is not to downplay the pandemic, or to expressedly laud/denigrate the response of any of the countries studied (although it could be noted that the press frenzy and hysteria has applied to some of them far more than others in comparable situations). The point, instead, is more towards asking: what more, realistically, could have been done?

With the benefit of hindsight, one might certainly provide answers with some confidence - ban foreign travel, especially from countries known to have an outbreak; then, institute a heavy lockdown with widespread testing and quarantine, and be prepared to block travel between local regions if required; also, mandate universal masking. Few if any countries have managed to strike the jackpot on this - perhaps New Zealand? - and it might be remembered as to how prevailing best scientific advice was wholly against international travel bans (additionally decried as racist and xenophobic, mind) and face masks, until it didn't matter quite as much any longer.

The main takeaway, I'd say, would be that guaranteed personal liberties do come with a price - that of possibly making suboptimal decisions for the wider society. Yes, if one were given free reign to minimize deaths from the pandemic as the overriding objective, the reponse would probably be a lot closer to China's - draconian travel restrictions with residents confined to their homes, sentencing and heavy fines for the slightest flouting of regulations, for whatever reasons.

Trouble is, they have individual rights in America and Europe, rights for which many lived for, bled for, died for; take for something as seemingly commonsensical as a hard lockdown on the New York/New Jersey/Connecticut tri-state region, when the coronavirus was running entirely wild there in March; you had the Governor arguing that it was illegal, and indeed, it was probably to the benefit of the residents of the region to be able to leave if they wanted. Of course, what's good for the relatively few might not be also good for the many, but it was their right. Was there any getting around this foundation of Western democracy? From the empirical evidence, I suspect not.


[To be continued...]



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Saturday, Oct 03, 2020 - 21:49 SGT
Posted By: Gilbert

The Swiss Standard

Now, that was a somnolent and slightly unfulfilling first Presidential debate - rather tamer and less abrasive than I had expected. To begin with, there was much less of the inventiveness that both candidates were capable of, and my Debate Bingo card remained unfilled no thanks to "X Angry Democrats" and "Dog Faced Pony Soldier" not being mentioned (but if I had missed them, please do let me know!); haven't heard Biden's "Inshallah" for awhile, so that's something, and it went straight into my centre space (also, neat Star Wars reference there!)

All considered, it was swell to watch two candidates that had been disparaged for their advanced age show worthy spirit in contesting for the throne of the free world, especially as The Donald was respectful enough to meet his opponent on his own terms through feisty interruptions; although he didn't quite manage to match the 82 butt-ins that Biden had recorded against Paul Ryan in 2012 (full event on Youtube), GEOTUS did manage to supplement his 73 direct interjections with another fifty-plus on the moderator, after sportingly accepting a 2v1 handicap match to make the contest more balanced and entertaining. Here, we recall another formidable matriarch in the late Barbara Bush, who sagely told her all-too-nice son Jeb! to "[Just] interrupt like other people do". Good advice!

It seems almost crass to try and declare a winner, after the tremendous effort put forth by both all sides (though opinions appear to be partly affected by how acceptable cutting-in is, in one's culture). This harmony seems to have extended to Biden's gracious best wishes at hearing about TRUMP deciding to personally take the coronavirus down (I pity da macrophage), as declared in his most-liked tweet ever, which must be saying something. In return, there was no post-debate needling by GEOTUS on his honoured opponent's non-committal response on court-packing, and TRUMP's dignified suggestion that the traditionally-nationalist Proud Boys group "stand back and stand by", would result in these very multicultural Proud Boys (led by a Latino, no less) holding a joint conference with Black Lives Matter leaders, to denounce white supremacy together.


Photos one generally doesn't see in the mainstream media
[N.B. Wait, does the mainstream media have a stake in stoking dissention and outrage at every turn, instead of focusing on points of commonality? Hmm...]
(Source: washingtontimes.com)


Truly, such a show of unity and cultural exchange could only have been inspired by a mediator of the stature of GEOTUS, who happens to have just been nominated for the Nobel Peace Prize for a third occasion, this time by a group of Australian law professors for his doctrine of ending foreign wars (yes, it likely took some serious arm-twisting and horse-trading... but isn't that what the POTUS is supposed to do?). Very unfortunately, GEOTUS's current engagement with the coronavirus possibly means that the next debate spectacle might have to be postponed or cancelled, which is such a shame after he agreed for the next one to be moderated by a declared Biden supporter, because a POTUS should be generous to his citizens, old or new... except the racists and hatemongers, that is.

It would probably be too much to go into his concrete half-trillion dollar plan for Black communities at this stage, coming hot on the heels of his consistent support for historically black (and minority) colleges and universities, that even opponents have had to concede; sure, some might decry such acts as vote-buying, but between these measures and tacky reparations, I have to confess to thinking the former being more respectful.



To return more perspective to the placid debate sideshow, it's war (again) on the European borders, with Armenia and Azerbaijan lighting the match; meanwhile, CCP troops have adopted polearms in their dispute with India, which should... reduce casualties, I suppose (remember, long pointy stick good)? It's all moving so swiftly nowadays - Cold War II is clearly in its preliminary stages, with the PLA's air force putting out a video simulating an attack on the U.S.'s Andersen Air Force base on Guam... which might have been slightly more intimidating, had it not been composed of spliced clips from Transformers: Revenge of the Fallen, The Rock and Hurt Locker (that said, this was probably more environmentally-friendly). It could be noted that Singapore has a permanent F-15 detachment at that very base, but if it's any consolation, neither party is taking that little detail into account. I hope.

As a prelude to a fuller geopolitical analysis of the New Cold War, I'd like to expound a little on the analogy between Singapore and Switzerland, as brought up in an August post. While probably best known for former PM Goh aspiring towards a "Swiss standard of living" by 1999 (to which a funny gripe is that a Swiss cost of living has been achieved instead), the greater part of this ambition might have been towards Switzerland's renowed neutrality (or minimally, the successful maintenance of the appearance thereof), which may be all the more relevant in the new world (dis?)order that we're entering - though being stupidly rich doesn't hurt either, just sayin' (N.B. I have always quite admired those honest enough to just be direct about what they want out of their worship)

Geographically speaking, however, one would be hard-pressed to find two lands more disparate: Switzerland is landlocked, mountainous, essentially self-sufficient in foodstuffs and other necessities, a natural fortress every which way you look at it. Singapore is a small tropical island served by two bridges, and frankly speaking something of a sitting duck for any power with control of the surrounding sea. How does one feed and placate a population of near six million, were supply lines cut off? There were less than a million mouths to account for during the Second World War, and they knew how to cultivate tapioca!


Not Singapore
(Source: flickr.com)


Leaving such grim considerations aside for a moment, Singapore does much more closely resemble Switzerland in one very important respect - finance. According to the esteemed Goh Keng Swee, "It is more useful that I relate a discussion I had during my last stint in the Finance Ministry [ed note: 1967-1970], with a Swiss banker... Putting on a stern countenance, I asked him why Swiss banks ran secret numbered accounts, implying that there was something unsavoury about this. Actually, we were then thinking of doing the same, but could not find a convincing public explanation [ed: would be introduced in Banking Act 1970]"; in this handling of (other people's) money without the asking of too many impolite questions, at least, we might have caught up to the Swiss.

This more-fascinating side of the local economy would be reflected in the recent FinCEN leak (instantly summoning Bernie and Warren, as expected), which revealed that local banks had moved billions in suspicious transactions. To this, the unanimous reaction of r/singapore and EDMW - so often at odds - was basically eh, everybody knows that already, were you born yesterday? So much for us being squeaky-clean squares (which I suppose is why the revelations about GEOTUS saving on taxes doesn't appear to have moved too many needles, given that everyone expects tax avoidance from billionaires and corporations there). I will leave my clever readers to ponder the implications for a bit, perhaps with the aid of a worked example on money laundering with respect to GEOTUS's Thighland.

Continuing on other similarities, Switzerland's stability has been raised as notable despite the presence of four national languages - coincidentally, matching the number of Singapore's racial categories - which was not entirely missed by commentators. Interestingly, compulsory national service appears another possible factor, although it was further noted that sharing a common ethnicity likely helped. This was, of course, not the case here, thus the insistence on English as lingua franca, and bilingualism in Mandarin with an eye towards China; for all the courteous talk on not wanting to usurp Hong Kong's finance gig, I can hardly imagine our wise leaders turning down business that's arrived at our doorstep. Still, one could read a little too much into Our Most Successful Investment Firm suddenly floating 50-year bonds, and a lot too much into the abrupt interest in urban farming...



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Sunday, Sep 27, 2020 - 01:50 SGT
Posted By: Gilbert

追忆往预


一言九鼎, 四年輝煌, 佛光普照, 特郎称皇!
(Source: cnn.com)
[N.B. Credit to CNN when it's due - which is not very often]


Here, a quick throwback to September four years ago, again in the thick of the last Presidential elections, where our noble political analyst hamsters switched to Mandarin for some comparative punditry. Upon review, I gather that it's fair to state that the train of reasoning presented that year was largely on point, and concluded with the correct prediction, as opposed to the mainstream media experts nearly all giving the current POTUS a (ridiculous) less than 10% chance of getting elected.

One could be forgiven for assigning him long odds once again, given the tired dodge of oversampling in polls; yes, the usual excuse is that this allows for appropriate reweighing of certain demographics, but to put it bluntly - why then is the same party nearly always favoured, and why are the poll results further highly correlated with the initial assumptions? Put it this way, when Gallup's latest estimate of party allegiance is 29% Republican/30% Democrat/40% Independent (among whom GEOTUS appears strongly leading, especially as some of these "Independents" are essentially supporters that don't want to run the risk of cancellation or worse) - one might get slightly doubtful when a national poll samples something like 23% Rep/40% Dem/27% Ind - but that's just me.

Anyway, all that undercover fiddling with improbable turnout priors couldn't hide GEOTUS's massive convention bump, which appears to have had establishment polling firms and pundits getting more than a little concerned. One doesn't often hear about how his job approval's hovered over 50% despite the pandemic - and oft higher than his predecessor at the same point in their presidency, not to read too much into the comparison - but as more worldy-wise voters are saying on Reddit, the only poll that matters is November's... assuming no hanky mail-in panky. The FAKE NEWS has made a huge meal about GEOTUS's take on such mischief, but IMHO, this has only furthered my conviction that he has much the same indomitable spirit as the late, great LKY, who famously warned of having the army move in, if there were a freak election result in Singapore. 一代神帝特朗普的顽强气概, 与当年全盛时期的李资政一模一样!


Peace Is The Prize... Not


Just an old peace hippy
(Source: thedonald.win)


Fine, the guy might be unruly with his Twitter shitposting at times, but he's also made greater inroads into genuine peace in the Middle East than the previous few Presidents - probably the yugest breakthroughs since 1978's Camp David Accords - and brokered a historic Kosova-Serbia peace agreement in much the same week, for which he got nominated for the Nobel Peace Prize a second time in a month. To these great achievements for humanity, the reaction by Pelosi was that these peace deals were "a distraction" (more of them if so, please); and then you have The Atlantic cancelling the Nobel Peace Prize in response, which might be enough salt to rival the Dead Sea. Well, they could perhaps look into their own FAKE NEWS problem, and leave the Elf-Dwarf conflict to history's greatest peacemaker.

A President's work is never done, however, and a bedraggled TRUMP's sincere sorrow at hearing of Ginsburg's extremely unfortunate, if not entirely unexpected passing would be expressed in his prompt discharging of his constitutional duty, to duly nominate a qualified replacement to the Supreme Court of the United States. Whatever one's ideological leanings - as exemplified by Ginsburg's abiding friendship with a very conservative Scalia - it is impossible not to respect RBG as a legal titan, champion of gender equality (refer corpus studies of her confirmation hearing and Rathbun Lecture), and possessor of old-school values on respecting the flag and anthem. Given this, who better to honour her legacy, than avowed female supremacist TRUMP? Not only has he outright stated that he likes women much more than men, he's proven it by marrying three of them, which is like two more than any lad should have to take responsibility for, in these modern and less heroic times.

Now, let me be straight with ya, the times be a-changin' quick now-a-days; it wasn't all that long ago that straight-laced Mitt Romney got chastened unendingly for referring to "binders full of women", but it sure seems like candidates would be trashed for not implying that today! Biden, recall, had one such binder all but forced upon him by his party, and as such one might understand GEOTUS going the same route on his pick. This might, alas, have complicated matters for the dirt-diggers on the other side, although they might take some consolation at him not getting even more creative with his nomination.


Guess what, they love him too in return!
(Source: danchimviet.info)



Do Unto Others

It's fairly amusing to watch how supposedly-immutable opinions and principles can flip depending on which side one is on. Recall, when the staunchly-conservative Scalia died during the last year of Obama's second term, the Democrats were all for replacing him with the more-moderate Merrick Garland as soon as possible, thus tilting the Court over to the liberal end; the then POTUS was adamant about fulfilling his constitutional responsibilities, and Democrat leaders argued that not filling the seat would be shameful and dishonourable, while the Republicans took the line that the people should have a say - through the election of the next President.

With RBG's death, however, the shoe's on the other foot, and now we have the current GEOTUS no less adamant about constitutional responsibilities, and Republicans very eager to make the Court whole again by raising a new justice with all due haste - one that will probably just happen to be rather more conservative than RBG was, so it happens. In contrast, it's the Democrats' turn to appeal to the people's voice, with the previous POTUS now contending that "...four and a half years ago, when Republicans refused to hold a hearing or an up-or-down vote on Merrick Garland, they invented the principle that the Senate shouldn't fill an open seat on the Supreme Court before a new president was sworn in... a basic principle of the law - and of everyday fairness - is that we apply rules with consistency, and not based on what's convenient or advantageous in the moment".

Very unfortunately, if there's one thing Congress has an overabundance of, it's former lawyers and extremely-practised word-wranglers, and the Republican Senate Majority Leader - the self-dubbed "Cocaine Mitch" McConnell - has explained that the two scenarios are actually completely different. In 2016, Obama was a lame duck who couldn't be re-elected, as TRUMP will most probably be this year; moreover, while the opposing party held the Senate in 2016, the Republicans hold both it and the Presidency today, which can be interpreted as Americans' implicit approval - and as such, no delay is warranted.


Judges though, whoo boy, gotta bumper crop there!
[N.B. Also: the Turtle's Revenge, or why nuking the filibuster is a bad idea]
(Source: r/trump)


Yeah, you might say that this reasoning's kinda self-serving and insidious, and I'll probably have to agree. However, it is also entirely true that it historically comes down to this: if the POTUS and Senate are of different parties in an election year, the Senate blocks the nomination; if they are of the same party, the nomination goes forward and gets approved. That's all there is to it, Republican or Democrat - pure realpolitik, which I think we'll be seeing a lot more of in the international arena too. Anyhow, it seems that a healthy majority of the populace is indeed supportive of confirming RBG's successor without delay, and the timeline shouldn't be a problem either.

Here, it might be considered that Ginsburg herself affirmed that "The president is elected for four years not three years, so the power he has in year three continues into year four" back in 2016, with reference to his duty of nominating a successor, which makes the Dems' temper tantrum on impeaching GEOTUS again to prevent the nomination, really quite pathetic - but honestly, even Pelosi can't be that clueless (not sure about AOC, but you've got to give it to her, she's entertaining)

Likely nominee Amy Coney Barrett seems comfortably in the clear, and with their usual lines of attacks (i.e. sexual assault, beer) rendered mostly toothless by her gender, some Democratic elements have zeroed in on Barrett's Catholic religion, specifically on abortion. However, with both Biden and Pelosi - and five current SCOTUS justices besides - being of the same faith, this hardly seems tenable either. And if TRUMP goes for Lagoa instead as a tactical choice, I'd like to see how they're going to explain voting down a Latina woman, who was moreover confirmed by an 80-15 majority just a year ago. Well, it looks like the left's final resort is yet again violence, but let's be honest here - I'm not sure they know what they want...



"A compressed firehose stream of naked unadorned truth", man
(Source: thedonald.win)




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Sunday, Sep 20, 2020 - 22:51 SGT
Posted By: Gilbert

Xenophilia By Fiat

Sudden torrent of reviewing assignments, but on to another very rapid development that may or may not have relevance to the concern raised in the previous post, on having national assets tied up; just a few days ago, the Chinese Communist Party has officially announced plans to exert control over the country's "private" sector, not that it was ever all that private to begin with (similar to us truly, come to think of it). Well, since it's come to this, we might just pray that our incumbents manage to stay on the right side of the CCP power brokers, and not have our considerable investments there get Suzhou-ed, or rendered effectively illiquid and unwithdrawable.

This comes as GEOTUS goes forward with the WeChat and TikTok bans in America, as decried in The State's Times; the Chinese authorities have apparently pledged retaliation, but as noted by many commentators, what are they gonna do? Ban Google, Facebook and WhatsApp? It's fairly telling that the obvious angle that maybe China should have, like, opened their Internet ecosystem in the first place went entirely unexplored. Of course, there's the argument that the U.S. should not mirror China's policies on banning foreign web services, but Taleb's "dictatorship of the intolerant" would seem to apply in practice here. Consider two largely-equivalent web services, but one is currently available to the entire world, while the other is cut off from 18% of the global population; all else being equal, consumers would tend to be driven to the former service for the convenience of universal access, thus rewarding the initial intolerant behaviour. Well, it might be time for granny to learn how to set up a VPN to perform finger dances?


Perhaps room to do what we do best, i.e. act as the middleman?
(Sources: fakewhats.com, fakedetail.com)


For now, TikTok's parent ByteDance has fled to Singapore together with Tencent and Alibaba etc., but our very intelligent leaders might well be feverishly contemplating the amount of business and largesse it would be prudent to accept in the opening salvos of Cold War II, and this is without going into whether these injections of funding would actually create jobs for locals - currently a very big sticking point in domestic discourse. On this, the breathtaking spin of The State's Times merits closer examination: a Page Four article has highlighted the woes of foreign graduates of local universities in finding jobs, with the proximate cause raised in the opening sentence as due to "raised minimum salaries for hiring foreigners"; the rather more substantial factor, that we're in a bloody pandemic with job support schemes having wound down, and everybody being affected by the Wuhan flu outbreak, was glossed over.

This, by the way, follows a piece on how "Singaporeans don't deserve Piyush Gupta", which has been making the rounds on social media, especially amongst incumbent supporters. The main thrust appears to be that Singapore needs the best talent regardless of nationality, and asserts that the country will decline - no, has already declined - due to a supposed bias towards local CEOs: "A host of Singapore Inc. companies run by real, born-in-Singaporeans - Singtel, Keppel Corporation, Sembawang, SPH, Singapore Exchange etc. etc. are all floundering right now and yet nobody turns the story on its head and asks, 'hey, what are our own people doing for us?' It is these companies that are shrinking right now. Go read the share price of each of these companies over the past two years - they have been on permanent decline long before the pandemic. Singapore is in serious trouble. They are broken, every single one of them and it's a topic that requires urgent parliamentary debate."

On that point, the (accurate) Reddit response was that all these failing Singapore Inc. companies had the incumbents' army cronies parachuted in though global talent searches that somehow always conclude with re-hiring SAF's finest, so what could one expect (and on Sim Wong Hoo being "smothered with love" by the authorities... well, I guess my take on this differs)? In any case, netizen outrage has tended to be based on the government and its apologists liking to dodge the real issues by promoting such articles - having good foreign CEOs and top management, fine, but why is the nation being run such that 70% of created jobs go to foreigners? Are there really no Singaporeans capable of taking up all those desirable entry-to-mid-level openings in finance (with attested cases where no locals were hired at particular banks for years), without resorting to "linguistic chicanery"?


And now the FTs are starting to complain about other FTs...
(Source: forums.hardwarezone.com.sg)


The way I see it, however, the explanation is actually quite simple, if one takes a cold, hard and unsentimental look at Singapore's economy. There was honestly not all that much choice. While it appears fashionable to spout phrases such as "deep tech" and "innovation" in recent times, the fact remains that our growth engine has remained fundamentally warm-body arbitrage on geographic advantage and relative political stability. In this model, cheap labour is imported en masse both to do the work (manufacturing remains 20% of national GDP, mind), and as a critical driver of demand. As supporters of this strategy are wont to crow, foreign workers and PMETs eat at our hawker stalls, patronize our shops, and rent our flats too! Of course, an immediate implication is that productivity and efficiency naturally takes a back seat, but on the other hand, how many landlords does a deep learning A.I. support?

This observation ties neatly into the designation of local property (prices) as the citizenry's retirement nest egg, also from the last blog entry. Following this logic, property prices die die cannot drop by any significant extent. These property prices fundamentally require (a large and increasing) population to support. However, very conveniently, the government can induce such demand through allowing more immigrants and foreign workers at a whim, while expending basically zero effort or "innovation". Do you think that any ruling party would willingly abandon such a golden goose?

The PM has tried to reason that the government would not create jobs for foreigners if it doesn't benefit Singaporeans, which the online bunch have rebutted by noting that the influx benefits some Singaporeans far more than others, i.e. the higher-SES employer/landlord/capitalist set who thrive on lower wages and expanded demand, as opposed to employees and the working class, who endure the competition for some vague assurance that the rising tide will eventually float their boats. Actually, I do sort of understand the incumbents' logic here, and quite like growth and new developments myself; however, given that the big plan seems to more or less be "let's import twenty to thirty thousand extra workers every year!", it's perhaps not unreasonable for voters to eventually go "fine, we agree, but let's maybe get another party to implement it then, because cheaper faster better!"

Personally, I suspect that some incumbent politicians are secretly itching to just admit the reality, as certain more-charismatic straight-talkers - whether sterner ones like LKY (who really stuck the spurs in with references to "coolie genes"), or nicer ones like TRUMP (who would at least have promoted "Singapore First") - might have: "CB lah, limpeh agah swee swee every year take in 30,000 new kaki forever, new money new customer new kah kia, comprain what comprain? Later HDB resale price go down, you can tahan? Tolong lah, we also kena squeeze until jialat jialat outside, we got Amaravati-ed just last year, tell you all f**k you all even f**k also dun want, now fertility rate 1.14, no new taxpayer, what you want us to do?"


You see this marker? Marker placed by Deng Xiaoping.
Deng very smart man, never poke GEOTUS. Be smart, be like Deng.

(Source: scmp.com)


One consolation is that at least some better-informed locals appear fairly clear-eyed about the predicament we're in, if the fresh r/singapore thread on the brewing U.S.-China conflict is anything to go by, with the more-decisive fellows long taken concrete action (not that I necessarily agree) having sensed the way the wind's blowing. I do think that the U.S. has gone too far in certain respects, though. We worked very hard to build our money-laundering hub! It's modern, upscale, very class, one of the best money-laundering hubs in the world, okay? Why would anybody risk doing business in some rickety underground gambling den in Myanmar or the Philippines, or some disreputable offshore junket boat, when he could perform his laundering in comfort and luxury at our purpose-built hubs? We are a honest, legitimate and non-discriminating money-laundering hub, and it's just bad manners for the U.S. Department of Justice to poke their noses in our affairs!



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Thursday, Sep 10, 2020 - 22:44 SGT
Posted By: Gilbert

More Mumblings

There's been quite a bit of settling-in and getting in on projects at the new gig, all those reviews aside, but a bit of time has opened up. First off, some local coverage. It appears that there may be a drive to disallow one's CPF from being used to help pay for one's housing, which relates to the "population and property Ponzi" raised in the previous blog post - I hope it evident that "property prices can only go up (in real terms)" is patently implausible (in the long run, at least), as first illustrated here in 2012, and revisited in 2017 (which is also about the period when The State's Times finally deigned to model leasehold depreciation): how the heck can an asset with a finite lease, only get ever more expensive?

One might, of course, understand this trend from another perspective - that of the CPF (i.e. purportedly retirement) funds being tacitly redirected to the service of the Government('s investment vehicles), which I believe is more commonly termed as "pension raiding" - though this is probably more benign than the usual. The general mechanism would be similar to that which allowed college tuition costs to balloon in the U.S.: once you restrict access to a pot of money solely for some purpose (e.g. education, property), it's no surprise that the price of that asset or service goes up, whether justified or not, especially if that same authority can control its supply (clearly true for Singapore property)

Now, local property policies have arguably been a net benefit for the populace thus far, in that previous generations enjoyed price appreciation above and beyond what they would have garnered, had they left the funds in the CPF. Sure, the median worker might have had to labour incrementally more years to afford the same apartment, but as long as he figured that this dance was continuing (i.e. he could pass-the-parcel on), there was no real cause for complaint. It should be remembered that those vehemently against high property prices online may after all statistically be a relatively small percentage of the population as compared to those already on the property ladder, and it's interesting to note how quickly one's attitude can shift, the moment he signs a mortgage.

The motivations for such a policy are understandable - a government does need some pocket money, after all, if it is not to be arbitrarily held ransom by outside forces. Viewed this way, the higher-than-absolutely-necessary public housing prices were a means towards raising an initial developmental nest egg, which is alright to an extent, I suppose. The trouble, of course, then comes when it becomes evident that prices can get high enough to be untenable, coupled by the population not reproducing sufficiently to create a large-enough next batch of suckers buyers. To that last, the solution thus far has been to import workers to rent citizens' rooms to pay for their retirement, a measure that however is getting quite unpopular... and this is already assuming that Our Most Successful Investment Firms continue to make returns.

Having close to a third of those national savings locked up in what's essentially a one-party state-controlled economy can get stressful, I suppose, and as such we might forgive the incumbents for 5v1 ganking Jamus for free-riding on a minimum wage proposal (though Tharman did have a point in noting that the WP didn't have a monopoly on compassion). We should perhaps empathize with the PM's protectiveness and anxiety over the reserves (if perhaps not the supposed inseparability of party and government) too; as Cold War II develops, it's far from unlikely that smaller nations discover that assets they thought were theirs, become negotiable.

Anyway, back to cross-disciplinary studies, the president of NUS has followed up with a piece about tearing down subject silos, which as also acknowledged, has been mostly less than well-supported in universities, where being known as "interdisciplinary" has oft been a kiss of death, due to being far less likely to earn departmental champions for funding and support, or appreciation in established journals (by the way, R.I.P. to anthropologist-economist-sorta David Graeber, whose Debt: The First 5,000 Years I enjoyed, with some reservations). Then again, it could be argued that many recognized fields nowadays, were cross-disciplinary in their time - one imagines pure mathematicians sneering at second-rate talents who spent their time pondering how rocks fell.



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