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Old 11th December 2020, 10:41 AM   #1
kookbreaker
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The all-new "US Politics and coronavirus" thread pt. 3

Originally Posted by Resume View Post
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I AGREE

CNN Goes Inside Hospital Trump Called 'Fake' and 'A Scam'
Yeah, they should name the vaccine after Trump all right. Trump tweets while first responders toil and record numbers die. We really do need a Trump vaccine; one that protects us from him.
Donald Trump should experience physical pain for pulling BS stunts like this.

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Old 11th December 2020, 11:32 AM   #2
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Originally Posted by Delphic Oracle View Post
Until there's more than anecdotes, it is proper to say "no effect."

Exceptions prove rules.

What this means is if it is given to a patient, there had better be an explanation for why that (potentially) a review board of fellow doctors would agree made sense at that time, with the information that was available.

This is a sensible way of approaching medical best practices. Rules exist for standard procedure (and can be updated), while allowing for specific circumstances, while also insuring that questionable (or outright poor) decisions can be challenged, disciplined, learned from, and added to the data.
You ignored my point. First off, we know the principle. Second the tests claiming the drugs don't work ignored the manufacturers' directions in how to use the drug.

You can't claim the two drugs don't work if you didn't properly test the drugs.

You can claim the evidence is insufficient to decide if the drugs work or not. But you can't claim they don't work!!!!! Which was my ******* point.

Honestly, the knee jerk oversimplified crap posts when, OMG, the word anecdote is used suggests some people aren't reading past that single word. Failure to understand the importance of anecdotal evidence, especially in medicine, is a bit of Dunning Kruger. There is valid and invalid anecdotal evidence. It helps to understand the difference.

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Old 11th December 2020, 12:30 PM   #3
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Originally Posted by Skeptic Ginger View Post
You ignored my point. First off, we know the principle. Second the tests claiming the drugs don't work ignored the manufacturers' directions in how to use the drug.

You can't claim the two drugs don't work if you didn't properly test the drugs.

You can claim the evidence is insufficient to decide if the drugs work or not. But you can't claim they don't work!!!!! Which was my ******* point.

Honestly, the knee jerk oversimplified crap posts when, OMG, the word anecdote is used suggests some people aren't reading past that single word. Failure to understand the importance of anecdotal evidence, especially in medicine, is a bit of Dunning Kruger. There is valid and invalid anecdotal evidence. It helps to understand the difference.
I don't think anyone is ignoring the drug manufacturer's guidance. I think their guidance makes it impractical to test "properly" in the field, in real-time, as the pandemic unfolds. Nobody gets into a clinical setting until they are in serious condition already. So there's a narrow (moving) window of people who recently tested positive, are just barely becoming symptomatic (if at all), who need to be found out in the world (hopefully at home alone!) and get this drug cocktail in them.

Now account for lifestyle differences, diet, activity, stress, etc.

Other than that, I was merely focusing on how "no effect" plays out in terms of how statutory law works around professional (regulated) trades and beauracratic bodies. In the context of health care, a physician reads that as "you need a really good reason that stands up to a lot of scrutiny if you mean to do this and have your butt covered."

In that sense, it is the exact right phrasing for a treatment option with very little utility in a clinical setting. As noted, clinical basically means already serious. No need to even muddy the waters talking about it outside of any institution doing a trial specifically about that. Why confuse anyone when they're pulling doubles for weeks at a time?

I'm okay with more studying in principle. My curiosity drive would sure like to know what's going on with that, absolutely.

But there's only so many doctors and scientists and I go back to the problem of the limited window of opportunity. Trying to hit a moving target of finding people who tested positive less than 48 hours ago.

Even if it is a miraculous shield, what then? Are we going to have couriers rush the drugs to the home of every positive patient?

For uninsured folks going drive-through testing with 3-5 day waits for results, he'll, there's no opportunity to even reach them in the drug's purported usefulness window.

It's not so much suppressed as it is just that it's such a long shot in terms of both possibility and pragmatic utility for this particular challenge that it falls away into the noise.
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Old 11th December 2020, 01:04 PM   #4
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Originally Posted by Delphic Oracle View Post
But there's only so many doctors and scientists and I go back to the problem of the limited window of opportunity. Trying to hit a moving target of finding people who tested positive less than 48 hours ago.
Shouldn't be a problem right now - just need to give some patients the drug and some a placebo and then we have hard data.

I would have been quite happy to see Rudy Giuliani be part of a trial and get the placebo, then his experience would (hopefully) have been strong evidence for the efficacy of the treatment. But without such evidence we don't know whether the drugs saved him or not.

These drugs are expensive so there might be a tendency to only use them on 'deserving' cases like Giuliani, while others not considered 'valuable' enough miss out. If the drugs don't work it doesn't matter, but if they do then it could be a moral dilemma. I would hate to think that Giuliani got preferential treatment that resulted in another person dying.
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Old 11th December 2020, 02:47 PM   #5
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Originally Posted by Roger Ramjets View Post
Shouldn't be a problem right now - just need to give some patients the drug and some a placebo and then we have hard data.



I would have been quite happy to see Rudy Giuliani be part of a trial and get the placebo, then his experience would (hopefully) have been strong evidence for the efficacy of the treatment. But without such evidence we don't know whether the drugs saved him or not.



These drugs are expensive so there might be a tendency to only use them on 'deserving' cases like Giuliani, while others not considered 'valuable' enough miss out. If the drugs don't work it doesn't matter, but if they do then it could be a moral dilemma. I would hate to think that Giuliani got preferential treatment that resulted in another person dying.
The number of people who receive frequent testing enough to even know where in the progression they are and get treatment to quickly is so narrow. That also happens to be a group we might not want to be doing testing on.
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Old 11th December 2020, 04:42 PM   #6
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Originally Posted by Delphic Oracle View Post
The number of people who receive frequent testing enough to even know where in the progression they are and get treatment to quickly is so narrow. That also happens to be a group we might not want to be doing testing on.
People get tested if they are notified they've been exposed.

The idea one wouldn't use the manufacturers' guidelines in a drug study is quite preposterous.

What happened with these monoclonal antibody studies is because they weren't approved, they were given as a last ditch effort to the sickest patients. I imagine you could get the drugs if you were rich enough and/or properly connected.

So whether or not they benefitted the sickest patients was looked at and they didn't show much benefit.
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Old 11th December 2020, 04:47 PM   #7
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Originally Posted by Roger Ramjets View Post
...

These drugs are expensive so there might be a tendency to only use them on 'deserving' cases like Giuliani, while others not considered 'valuable' enough miss out. If the drugs don't work it doesn't matter, but if they do then it could be a moral dilemma. I would hate to think that Giuliani got preferential treatment that resulted in another person dying.
It's not the cost that is the only barrier, it's that the drugs are new and don't have full FDA approval.

However, 3rd party payers won't reimburse for these drugs. So if that is not an issue because one is rich, it obviously improves one's chances of getting the drugs.
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Old 11th December 2020, 05:30 PM   #8
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According to the Regeneron webpage: Re 3rd phase clinical trials
Quote:
CASIRIVIMAB AND IMDEVIMAB
SARS-CoV-2 Virus Multi-Antibody Therapy Treatment for certain hospitalized and non-hospitalized patients with COVID-19; prevention of COVID-19 in household contacts of diagnosed patients
Company news releases REGENERON’S CASIRIVIMAB AND IMDEVIMAB ANTIBODY COCKTAIL FOR COVID-19 IS FIRST COMBINATION THERAPY TO RECEIVE FDA EMERGENCY USE AUTHORIZATION
Quote:
Authorized for recently diagnosed, mild to moderate COVID-19 in high-risk patients

Initial doses will be made available to approximately 300,000 patients, with no medication out-of-pocket costs, under U.S. government allocation program ...

The clinical evidence from Regeneron’s outpatient trial suggests that monoclonal antibodies such as casirivimab and imdevimab have the greatest benefit when given early after diagnosis and in patients who have not yet mounted their own immune response or who have high viral load.
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Old 11th December 2020, 06:57 PM   #9
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Like I said, I feel that's such a narrow target window of opportunity moving through time that it is practically impossible to implement at scale.
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Old 11th December 2020, 07:08 PM   #10
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From Worldometer
Quote:
United States
Coronavirus Cases:
16,295,458
Deaths:
302,750

New Cases:
246,530
New Deaths:
3,019
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Old 11th December 2020, 08:08 PM   #11
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Originally Posted by Delphic Oracle View Post
Like I said, I feel that's such a narrow target window of opportunity moving through time that it is practically impossible to implement at scale.
Perhaps you are imagining something else. Where do you get "narrow target window" from?

I think you may be conflating what I said about antiviral treatments for herpes and flu. That short window for treatment is based on those infections' incubation periods and time to onset of symptoms. I didn't mean the 24-48 hours was going to be exactly the same for COVID. I just meant the intervention has a window period early on in the infection.

Person is exposed and then contracts COVID. They see a medical provider who recognizes they have risk of severe disease but they are not yet ill or they are only mildly ill.

The provider enrolls them in the study explaining they might get the drug or a placebo. The drug is not otherwise widely available.
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Old 11th December 2020, 08:27 PM   #12
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Originally Posted by Skeptic Ginger View Post
Do these 3rd phase clinical trials include patients getting placebos? If so, does that mean Giuliani just happened to be in the right place at the right time and wasn't given preferential treatment? And if that is so then could he have actually been given a placebo?

Until the trial is over, how do we know the treatment is as effective as some say it is?
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Old 11th December 2020, 10:49 PM   #13
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Originally Posted by Roger Ramjets View Post
Do these 3rd phase clinical trials include patients getting placebos? If so, does that mean Giuliani just happened to be in the right place at the right time and wasn't given preferential treatment? And if that is so then could he have actually been given a placebo?

Until the trial is over, how do we know the treatment is as effective as some say it is?
Yes, there was a placebo arm. No one in Trump's circle of grifters are in the study.
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Old 11th December 2020, 11:19 PM   #14
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I didn't know James Corden could sing.
Quote:
Inspired by President Donald Trump's return to the White House with James Corden performs a special version of Paul McCartney's classic "Maybe I'm Amazed." Still infected with COVID-19 and facing polls heading in the wrong direction, we'll see what Trump is immune to in the next month.
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I AGREE
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Old 12th December 2020, 07:29 AM   #15
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He had a leading part in the 'Into The Woods' film musical

https://www.imdb.com/title/tt2180411/
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Old 12th December 2020, 07:28 PM   #16
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All the living former presidents except Carter have said they will get the vaccine and on live TV/Stream. Biden said he would get the vaccine on live TV as well. Ironically, Trump hasn't said he would get the vaccine in public or in private. He wants the credit for getting the vaccine out but his supporters are some of the least likely to agree to get it. We're going to keep having flare ups long after the vaccine is out in areas where Trump did particularly well in November. Trump could prevent that if he'd get the vaccine but he won't .
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Old 12th December 2020, 07:36 PM   #17
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From Worldometer:
Quote:
United States
Coronavirus Cases:
16,549,366
Deaths:
305,082

New Cases:
220,298
New Deaths:
2,309
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Old 12th December 2020, 07:41 PM   #18
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Where did 100k deaths in the US come from? Last I heard, a few weeks ago, we were fast approaching 200k.
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Old 12th December 2020, 07:53 PM   #19
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Originally Posted by Silly Green Monkey View Post
Where did 100k deaths in the US come from? Last I heard, a few weeks ago, we were fast approaching 200k.
I'm guessing from the 100,000 who died of covid.
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Old 12th December 2020, 07:55 PM   #20
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I'm going to assume (as I remember seeing the 240k) that when it hit 270k I forgot that it wasn't 170k. Even the lower number is too many.
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Old 13th December 2020, 02:53 PM   #21
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Bloomberg: Trump, Pence and other top U.S. officials will be offered the newly-approved coronavirus vaccine starting tomorrow, sources say. Essential personnel in WH and certain officials in three branches of govt vaccinated within next 10 days.


Not sticking with the hydroxychloroquine then?
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Old 13th December 2020, 03:24 PM   #22
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Originally Posted by Captain_Swoop View Post
Bloomberg: Trump, Pence and other top U.S. officials will be offered the newly-approved coronavirus vaccine starting tomorrow, sources say. Essential personnel in WH and certain officials in three branches of govt vaccinated within next 10 days.
At this point I have to wonder if there actually are any essential personnel in the White House.
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Old 13th December 2020, 05:03 PM   #23
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A CNN Health reports documents that the vaccines are starting to be delivered but slowly. This will be a long road. And right now, the virus is surging like never before.

Quote:
Freight trucks carrying about 184,275 vials of vaccine departed [Pfizer's Portage Mich] plant Sunday, and the combined 189 boxes of vaccine vials are expected to arrive in all 50 states Monday. Another 3,900 vials are expected to ship later Sunday to United States territories, and 400 boxes packed with about 390,000 vials will ship Monday to arrive Tuesday. There are five doses of vaccine per vial, according to Pfizer.

Surge on top of surge - Arizona reported its second highest number of new cases Saturday with 8,076, and reached a new record positivity rate at 25%, indicating that the viral transmission is increasing faster than the case counts indicate, according to an ongoing study by the University of Arizona's Zuckerman College of Public Health. The California Department of Public Health reported 35,729 new coronavirus cases on Saturday, breaking the previous record set on Friday of 35,468 new cases. For three consecutive days, Florida reported more than 10,000 cases a day before reporting 8,964 cases Sunday, a CNN tally shows. The state has reported 7,000 or more new cases every day this month. CNN link
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Old 13th December 2020, 05:12 PM   #24
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Originally Posted by Minoosh View Post
At this point I have to wonder if there actually are any essential personnel in the White House.
The movers.
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Old 13th December 2020, 06:08 PM   #25
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Originally Posted by Captain_Swoop View Post
Bloomberg: Trump, Pence and other top U.S. officials will be offered the newly-approved coronavirus vaccine starting tomorrow, sources say. Essential personnel in WH and certain officials in three branches of govt vaccinated within next 10 days.


Not sticking with the hydroxychloroquine then?
It says 'offered'. Trump should be immune already, right?
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Old 13th December 2020, 06:25 PM   #26
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From Worldometer:
Quote:
United States
Coronavirus Cases:
16,737,267
Deaths:
306,459

New Cases:
187,901
New Deaths:
1,379
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Old 14th December 2020, 03:08 AM   #27
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Trump Tweets

People working in the White House should receive the vaccine somewhat later in the program, unless specifically necessary. I have asked that this adjustment be made. I am not scheduled to take the vaccine, but look forward to doing so at the appropriate time. Thank you!
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Old 14th December 2020, 07:56 AM   #28
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Originally Posted by Captain_Swoop View Post
Trump Tweets

People working in the White House should receive the vaccine somewhat later in the program, unless specifically necessary. I have asked that this adjustment be made. I am not scheduled to take the vaccine, but look forward to doing so at the appropriate time. Thank you!
That certainly reads like a staff tweet. Does he ever use the word "appropriate" or ask for "adjustments"?

I imagine they told him how bad it looks for the rich and famous to take cuts.
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Old 14th December 2020, 07:59 AM   #29
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Originally Posted by Craig4 View Post
All the living former presidents except Carter have said they will get the vaccine and on live TV/Stream. Biden said he would get the vaccine on live TV as well. Ironically, Trump hasn't said he would get the vaccine in public or in private. He wants the credit for getting the vaccine out but his supporters are some of the least likely to agree to get it. We're going to keep having flare ups long after the vaccine is out in areas where Trump did particularly well in November. Trump could prevent that if he'd get the vaccine but he won't .
To be fair, are they recommending the vaccine for people who have already had Covid-19? It might not make sense for Trump to get the vaccine.
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Old 14th December 2020, 08:04 AM   #30
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Originally Posted by Meadmaker View Post
To be fair, are they recommending the vaccine for people who have already had Covid-19? It might not make sense for Trump to get the vaccine.
My understanding is that it depends on the supplies. People who have had COVID should go to the back of the line until supplies are adequate, but eventually they probably should get it. Part of the problem is its not known how long immunity lasts (from either getting the virus or the vaccine).
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Old 14th December 2020, 08:21 AM   #31
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Quote:
Bloomberg: Trump, Pence and other top U.S. officials will be offered the newly-approved coronavirus vaccine starting tomorrow, sources say. Essential personnel in WH and certain officials in three branches of govt vaccinated within next 10 days.
Quote:
Ironically, Trump hasn't said he would get the vaccine in public or in private....We're going to keep having flare ups long after the vaccine is out in areas where Trump did particularly well in November. Trump could prevent that if he'd get the vaccine but he won't .
Quote:
I imagine they told him how bad it looks for the rich and famous to take cuts.
Quote:
To be fair, are they recommending the vaccine for people who have already had Covid-19? It might not make sense for Trump to get the vaccine.
If Trump were not such a reprehensible person, I might almost have some sympathy over this situation.

After all, it really is a "no win" situation... get vaccinated early, you appear ot be "jumping the Queue" in order to get a vaccine that you might not need (denying one more person the chance to get vaccinated). Wait to get vaccinated, and you send the message to some of your supporters that "the vaccine isn't needed".

However, pretty much everything else Trump has done has eliminated any sort of sympathy I might have had for him.
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Old 14th December 2020, 07:14 PM   #32
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From Worldometer:
Quote:
United States
Coronavirus Cases:
16,942,822
Deaths:
308,089

New Cases:
198,647
New Deaths:
1,619
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Old 15th December 2020, 01:24 PM   #33
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By lunchtime today (Eastern Standard Time) the U.S. had passed 17 million cases.

USA! USA! We're No. 1! We're No. 1!
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Old 15th December 2020, 01:27 PM   #34
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The United States has dropped to 9th in the standings of per capita deaths. Three Balkan nations have jumped ahead of us.
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Old 15th December 2020, 01:32 PM   #35
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Originally Posted by Meadmaker View Post
The United States has dropped to 9th in the standings of per capita deaths. Three Balkan nations have jumped ahead of us.
I'm sure the holidays will boost us up again. Unfortunately.


ETA: And should a country that bills itself as the greatest be in the top ten in that stat? Do not ask this of your trumpist uncle.
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Old 15th December 2020, 01:38 PM   #36
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TV joke Judge Pirro was moaning yesterday that Trump had done everything right and credit for the vaccine was stolen from him.

300,000 deaths I suppose she believes that wasn't Trump's fault.

The New Hampshire Speaker of the state house died last week from COVID.

The New Hampshire House speaker was sworn in last week. He died Wednesday of COVID-19.
Quote:
The swearing-in of the 400-member House and 24-member Senate was held outdoors at the University of New Hampshire because of the coronavirus pandemic. More than a quarter of House members, most of them Democrats, skipped the ceremony after learning the day before that several Republican lawmakers had tested positive for the virus after attending an indoor GOP caucus meeting on November 20 where many attendees weren't wearing masks.
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Old 15th December 2020, 01:42 PM   #37
Resume
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Originally Posted by Skeptic Ginger View Post
TV joke Judge Pirro was moaning yesterday that Trump had done everything right and credit for the vaccine was stolen from him.

300,000 deaths I suppose she believes that wasn't Trump's fault.

The New Hampshire Speaker of the state house died last week from COVID.

The New Hampshire House speaker was sworn in last week. He died Wednesday of COVID-19.
They can call it the Trump Vaccine two months after they start calling it the Trump Virus.
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Old 15th December 2020, 02:47 PM   #38
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It looks like we're actually ninth in cases per capita, not deaths. In deaths we're twelfth. Worldometer link
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Old 15th December 2020, 02:52 PM   #39
Ulf Nereng
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Originally Posted by Resume View Post
I'm sure the holidays will boost us up again. Unfortunately.


ETA: And should a country that bills itself as the greatest be in the top ten in that stat? Do not ask this of your trumpist uncle.
Yes. 195 sovereign countries in the world and USA is, like, number 183.
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Old 15th December 2020, 02:59 PM   #40
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Originally Posted by newyorkguy View Post
It looks like we're actually ninth in cases per capita, not deaths. In deaths we're twelfth. Worldometer link
The site I was looking at didn't have data for Andorra or San Marino, which I can understand, but it also didn't have data for Montenegro. I think pretty much everyone calls Montenegro a real country these days, but for some reason there's no data on it.
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