2020 Status Check

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Hugh Akston
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Re: 2020 Status Check

Post by Hugh Akston »

In America we settle for the illusory accountability of cutting the arm off the starfish, but leaving the essential nature of the animal unchanged.
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Jennifer
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Re: 2020 Status Check

Post by Jennifer »

I take comfort in knowing no trend lasts forever, but even if things do change and change for the better, that doesn't necessarily mean these changes will come about soon enough for me and mine to benefit from them.
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Kolohe
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Re: 2020 Status Check

Post by Kolohe »

nicole wrote: 31 Dec 2020, 07:57 Addendum by Jacob Siegel, one of my favorite people writing about 2020. I was going to quote but just wanted to quote it all: https://unherd.com/2020/12/why-americas ... n-winning/
In Jacob Siegel’s telling, Trump gets absolutely no blame.

So Jacob Siegel can absolutely go fuck himself.
when you wake up as the queen of the n=1 kingdom and mount your steed non sequiturius, do you look out upon all you survey and think “damn, it feels good to be a green idea sleeping furiously?" - dhex
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dhex
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Re: 2020 Status Check

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I usually like his writing but this was dogshit.
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Pham Nuwen
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Re: 2020 Status Check

Post by Pham Nuwen »

I didn't like it. Not sure why.
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Jennifer
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Re: 2020 Status Check

Post by Jennifer »

I just barely-kinda skimmed over it while taking a brief break from something else, but -- if I didn't know any better, I'd almost think that "Joe Biden" guy was in charge of stuff this past year.
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Warren
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Re: 2020 Status Check

Post by Warren »

I've heard this song all my life. I've always put it in it's own time. Never have I felt it relevant to the moment I was listening to it.
Until now. Suddenly this is eerily prescient of the current situation. Or actually last summer's situation
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D.A. Ridgely
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Re: 2020 Status Check

Post by D.A. Ridgely »

Warren wrote: 01 Jan 2021, 11:55 I've heard this song all my life. I've always put it in it's own time. Never have I felt it relevant to the moment I was listening to it.
Until now. Suddenly this is eerily prescient of the current situation. Or actually last summer's situation
Buffalo Springfield's only hit song. Ironically, not written as a war protest song but a reaction to the Sunset Strip curfew riots.
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Re: 2020 Status Check

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D.A. Ridgely wrote: 01 Jan 2021, 12:47
Warren wrote: 01 Jan 2021, 11:55 I've heard this song all my life. I've always put it in it's own time. Never have I felt it relevant to the moment I was listening to it.
Until now. Suddenly this is eerily prescient of the current situation. Or actually last summer's situation
Buffalo Springfield's only hit song. Ironically, not written as a war protest song but a reaction to the Sunset Strip curfew riots.
Yes, it had a lot of malleability in it's own time. You could fit it to any number of things. Ultimately I think it's a song that applies to most any time of civil unrest. But these lines gave me chills, not because of how well they describe our current time, but for their poignancy. This is what's happening, and this is where the trouble lives:

There's battle lines being drawn
Nobody's right if everybody's wrong

A thousand people in the street
Singing songs and they carrying signs
Mostly say, "Hooray for our side"

Paranoia strikes deep
Into your life it will creep
It starts when you're always afraid
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JasonL
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Re: 2020 Status Check

Post by JasonL »

Kolohe wrote: 31 Dec 2020, 18:13
nicole wrote: 31 Dec 2020, 07:57 Addendum by Jacob Siegel, one of my favorite people writing about 2020. I was going to quote but just wanted to quote it all: https://unherd.com/2020/12/why-americas ... n-winning/
In Jacob Siegel’s telling, Trump gets absolutely no blame.

So Jacob Siegel can absolutely go fuck himself.
I see this as a remedy to Cuomos failures are trumps fault. The CDC testing strategy is trumps fault. Everything everywhere all the time is always trumps fault. Which is a thing a whole lot of people think. Like right here on the gryll.
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JasonL
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Re: 2020 Status Check

Post by JasonL »

I think it is very significant and not at all trumps fault that an health establishment is just flat lying about things to engineer responses they think people will have. If trump comes around and talks about people lying about the risks of coronavirus it's his fault if he's lying about that but it is not his fault if people actually are lying to the public and then want to use Trumpism as cover for their strategy. That's what this whole thing is about. You can't have the massive failures and just blame trump for them. You can't engage in strategic misrepresentation, lose credibility then blame trump who says look they aren't telling the whole story.

We need to figure out how to navigate pandemic with actual risks. Every time I see that local Ohio ad saying the 'virus kills young and old it doesn't discriminate' with crying nurses I want to punch them all. Yes. It totally discriminates. Stop. Doing. That.
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thoreau
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Re: 2020 Status Check

Post by thoreau »

The problem is that they are at least as right as they are wrong. The virus kills far more old people, but it does kill young people some of the time. And it leaves lasting marks on at least some of the young who survive it. Pham can back me up here.

Those crying nurses are not being 100% accurate but they also aren't wrong.

The problem is not the crying nurses telling people to be careful. The real problems are the "noble lies" we've heard, like "masks won't protect you...lol just kidding" and "protests are fine because racism is the real killer." And Fauci revising his herd immunity estimates. The last one especially pisses me off because there were scientifically valid reasons to initially guess low, but the new more contagious variant is a good reason to revise upward. There was no need to make this about noble lies.
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Shem
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Re: 2020 Status Check

Post by Shem »

JasonL wrote: 04 Jan 2021, 10:28 We need to figure out how to navigate pandemic with actual risks. Every time I see that local Ohio ad saying the 'virus kills young and old it doesn't discriminate' with crying nurses I want to punch them all. Yes. It totally discriminates. Stop. Doing. That.
No. It doesn't discriminate. It kills unhealthy people. Who are statistically more likely to be old, so it's more dangerous to them, but not universally so, especially since younger people can have factors that don't have much impact in their day-to-day life that make the danger of complications just as high as someone older. Just to take one example, in a country with obesity rates like ours, a disease that's more likely to kill obese people isn't the sort of thing you can handwave off with "well, it actually kills mostly old people."
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JasonL
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Re: 2020 Status Check

Post by JasonL »

thoreau wrote: 04 Jan 2021, 11:14 The problem is that they are at least as right as they are wrong. The virus kills far more old people, but it does kill young people some of the time. And it leaves lasting marks on at least some of the young who survive it. Pham can back me up here.

Those crying nurses are not being 100% accurate but they also aren't wrong.

The problem is not the crying nurses telling people to be careful. The real problems are the "noble lies" we've heard, like "masks won't protect you...lol just kidding" and "protests are fine because racism is the real killer." And Fauci revising his herd immunity estimates. The last one especially pisses me off because there were scientifically valid reasons to initially guess low, but the new more contagious variant is a good reason to revise upward. There was no need to make this about noble lies.
I'll accept this - I think it's possible to see a highly risk averse but good faith view of risk to kids in a certain way, but the deal is we have to know the real story and it is telling that I ... no COVID denier or mask skeptic ... immediately jumped to "they are trying to steer behavior with misrepresentation again". That's really double plus ungood.
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Re: 2020 Status Check

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Jason, I don't know if you're still stuck on that (off by at least a factor of 10, if not by 30) "90,000 people died because of Cuomo's decision about nursing homes" falsehood you brought up before, and if that's why you feel like Cuomo is so responsible for things, but if that is the reason, then you really need to reexamine that and anything you've connected to that. And if that was a typo and you meant 9,000, then that really pales in comparison to the 350,000 deaths in the US, of which at least 250,000 have occurred after rescinding that guidance, and 310,000 have happened in places Cuomo has no authority.

I think there are a lot of people who must shoulder blame, but I don't see how you can take the whole reality created by the Trump administration's response from the beginning, including Trump himself lying to create the responses he wanted (trying to goose the stock market among them), and just wave that away as a non-factor. The fact that Federal entities like the CDC have to at least account for Trump colors everything they have done, so blaming the CDC still comes back to Trump. The entire picture of 4 years of Trump as President is the message from every Federal entity being colored by what the Orange one wants.
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JasonL
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Re: 2020 Status Check

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Shem wrote: 04 Jan 2021, 11:39
JasonL wrote: 04 Jan 2021, 10:28 We need to figure out how to navigate pandemic with actual risks. Every time I see that local Ohio ad saying the 'virus kills young and old it doesn't discriminate' with crying nurses I want to punch them all. Yes. It totally discriminates. Stop. Doing. That.
No. It doesn't discriminate. It kills unhealthy people. Who are statistically more likely to be old, so it's more dangerous to them, but not universally so, especially since younger people can have factors that don't have much impact in their day-to-day life that make the danger of complications just as high as someone older. Just to take one example, in a country with obesity rates like ours, a disease that's more likely to kill obese people isn't the sort of thing you can handwave off with "well, it actually kills mostly old people."
To be clear, your view is that "it kills young and old, it doesn't discriminate" is an accurate depiction of population risks such that policy and personal behavior should be steered by it. So, I shouldn't let my kids go outside or kids can't ever go back to school this indicriminate killer will get them.
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Kolohe
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Re: 2020 Status Check

Post by Kolohe »

JasonL wrote: 04 Jan 2021, 10:16
Kolohe wrote: 31 Dec 2020, 18:13
nicole wrote: 31 Dec 2020, 07:57 Addendum by Jacob Siegel, one of my favorite people writing about 2020. I was going to quote but just wanted to quote it all: https://unherd.com/2020/12/why-americas ... n-winning/
In Jacob Siegel’s telling, Trump gets absolutely no blame.

So Jacob Siegel can absolutely go fuck himself.
I see this as a remedy to Cuomos failures are trumps fault. The CDC testing strategy is trumps fault. Everything everywhere all the time is always trumps fault. Which is a thing a whole lot of people think. Like right here on the gryll.
If that motherfucker Siegel would have said anywhere in there ‘Trump’s failures are manifest, but that’s not what I want to talk about right now’ I’d give him the benefit of the doubt. But the motherfucker not only didn’t do that, he shoehorned credit given to Trump.


ETA: also, he can get the fuck out of here with this horseshit
. Tucker Carlson, whose relentless criticism of the ruling class has made him the top-rated cable news host in the country,
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JasonL
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Re: 2020 Status Check

Post by JasonL »

Highway wrote: 04 Jan 2021, 11:46 Jason, I don't know if you're still stuck on that (off by at least a factor of 10, if not by 30) "90,000 people died because of Cuomo's decision about nursing homes" falsehood you brought up before, and if that's why you feel like Cuomo is so responsible for things, but if that is the reason, then you really need to reexamine that and anything you've connected to that. And if that was a typo and you meant 9,000, then that really pales in comparison to the 350,000 deaths in the US, of which at least 250,000 have occurred after rescinding that guidance, and 310,000 have happened in places Cuomo has no authority.

I think there are a lot of people who must shoulder blame, but I don't see how you can take the whole reality created by the Trump administration's response from the beginning, including Trump himself lying to create the responses he wanted (trying to goose the stock market among them), and just wave that away as a non-factor. The fact that Federal entities like the CDC have to at least account for Trump colors everything they have done, so blaming the CDC still comes back to Trump. The entire picture of 4 years of Trump as President is the message from every Federal entity being colored by what the Orange one wants.
Yes, the 90k number appears to have been something interpreted from the mid summer figures that could not have been NYC only. Can't even find the article. Total nursing home impact globally? Not sure. It anchored in my brain somewhere May to June. Total COVID positive admissions into NYC nursing homes was like 6,700. The Cuomo accepted death rate is a joke claiming only 6,500 or so, but it is nowhere near 90k. By pure accident I think 9k is probably a reasonable number. https://apnews.com/article/ap-top-news- ... a00514647f

The CDC strategy was to insist upon centralized testing. This is NOT a response to trump. Cuomo's policy was NOT a response to trump. The thing is there can be a guy who is crazy and you don't have to color everything you do or say as a scientific matter to "counter the message". That's the opposite of what you should be doing. That's not how you do crisis. If we come out of this with "next time will be awesome because The Only Problem was Trump" which is exactly where you guys are trying to go - we will be sitting here again.
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Pham Nuwen
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Re: 2020 Status Check

Post by Pham Nuwen »

Most of our patients on vents are sub 55 years old. Because it seems to kill fast when they are 55 and older and have multiple comorbidities. Usually its stuff like high blood pressure and COPD or high blood pressure and type 2 diabetes.

I have no idea why but some people that should be rocked skate away with not much else but higher blood pressure. While others that are relatively healthy get knocked the fuck down.

It's a crap shoot guys. 80% are going to be unaffected or only left with small lingering problems.

That other 20% are odd as hell. Supplemental oxygen for some. Ecmo and vents for others. Death for still others.

Take your vitamin D, wear a mask, and avoid large gatherings. Shrug.
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Shem
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Re: 2020 Status Check

Post by Shem »

JasonL wrote: 04 Jan 2021, 11:47 To be clear, your view is that "it kills young and old, it doesn't discriminate" is an accurate depiction of population risks such that policy and personal behavior should be steered by it. So, I shouldn't let my kids go outside or kids can't ever go back to school this indicriminate killer will get them.
I mean, if my only choices are "be wrong that way," or "be wrong your way," I'm going to go with the way that manages to be both somewhat less wrong, and leaves you with fewer dead people, yes.
JasonL wrote: 04 Jan 2021, 12:12 If we come out of this with "next time will be awesome because The Only Problem was Trump" which is exactly where you guys are trying to go - we will be sitting here again.
Not sure how many times I need to tell you this is nonsense before it sinks in. Nobody here is saying or trying to go to "the only problem is Trump." The argument is "the biggest reason it was a shitshow was a lack of leadership and unified response." And since he's the President, the fact that we're a year later and have neither of those is principally on him, yes. Probably at least 80%. And ignoring that is how you avoid actually establishing any means to a unified response in the future.

Meanwhile, you're trying to pedant your way so far down it's impossible to allocate any responsibility whatsoever. I mean seriously, we're well on our way to a half million dead people from Covid-19, plus however many die because of ICUs full of Covid-19 patients, and what pisses you off is people who somewhat overstate the likelihood younger people are going to die of covid-19? Because that moderate overstatement damages credibility. Having a major political party tell people it's bullshit doesn't damage credibility; insufficient nuance does that. Sure.
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thoreau
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Re: 2020 Status Check

Post by thoreau »

On the question of whether the danger was exaggerated, I'm very much Team Shem here. We know that this disease does kill some healthy young people, even though we don't know why. We know that the disease leaves lasting damage in at least some healthy young patients, though we'll need more time and larger studies to really have a good estimate of the incidence. And we know that healthy young people can spread it. So it's completely reasonable to say that healthy young people need to take this seriously, both for their own safety and the safety of others.

On some other matters, I do think the public health community has sacrificed some credibility. And while I understand that they are fallible humans dealing with a new and unknown problem, it's their job to maintain as much credibility as possible in the eyes of a decidedly unreasonable public. So I fault them over 4 things:

1) Masks: Yes, technically, in the early days they did not have the data to verify that masks would help. But they had ample reason to think masks were very likely to help, and they certainly weren't refraining from masking up at the hospital. What they should have said is "Look, anything that blocks some droplets is very likely to help, so wear makeshift bandanas if you have to, and save the N95 masks for the front-line health professionals."

2) The protests. I'm talking stuff like this, where they asked the public to accept their value judgment on the tradeoff between social issues and public health, while saying that other social issues do NOT justify protests.

Granted, those letters and articles were not the official stance of the CDC or state health departments or whatever, but (1) these are the sorts of academic experts to whom the press turns for statements assuring the public that the state authorities are acting wisely, and (2) these academics are part of the pipeline of talent that winds up staffing a lot of federal, state, and local health departments. Credibility matters.

Here's what they should have said:
"We're in a pandemic. Any mass gathering is risky, both for the participants and for anyone else whom they will subsequently encounter. At the same time, the right to peaceably assemble for protests is a bedrock right, and we understand why people will sometimes feel that their conscience requires them to assume the risks that go with exercising that right. We cannot make that decision for you. What we can say is that if you can find a way to conscientiously make your voice heard without a mass gathering, consider doing that. But if your conscience requires that you exercise your right to gather and protest, please wear a mask, observe social distancing guidelines as much as possible, and stay away from others after the protest, so that you can conscientiously exercise your rights without endangering others."

3) Fauci's latest zig-zagging on the threshold for herd immunity. I know enough about percolation models to understand why this stuff has huge error bars, and why the initial estimates were lower than the latest ones. (In short, selection effects are favoring the fastest-propagating variants.) If he had just stuck with that line, well, he could think whatever he wanted to think, but scientists could have backed him up and kept their integrity while doing so.

4) The CDC slides that leaked where people are discussing racial equity rationales for favoring certain vaccination priority schemes over others. If they'd simply said "We should vaccinate the workers who encounter the most people, because that will stop the spread soonest" that would have been a defensible point. Yes, there are other defensible proposals, and there are tradeoffs with consequences, but it's at least an argument that a decent person could make. Instead, they set themselves up to sound like "Look, saving old folks means saving a whiter population..." and that just takes us nowhere good.

I can forgive 1 and 3, even while shaking my head at them for making me have to forgive them. 2 and 4, however, just take us deep, deep into the culture war, and they really shouldn't have gone there.
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Pham Nuwen
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Re: 2020 Status Check

Post by Pham Nuwen »

I get the racial angle being bad pr but things are different in actual patient care. Triage. The ones who are most at risk get the help. And sometimes the math is harsh but simple. So whoever is going to more likely live.

Example: 92 year old with a broken arm and hip gets surgery bumped because the 60 odd year old is much more likely to survive both surgery and recovery. Its harsh math.

Example: A 6 month pregnant woman in a multi car accident? We ignore the baby and focus on the mother until shes stabilized or dead. Not even vitals on the baby unless time permits. No mother no baby. It's that simple.

I dont really understand what the issue is honestly. We know black americans are more likely to die. I'm okay with them getting the vaccine but no staff means no care for them. I think they made the right call to discuss it and to ultimately decide to give it to healthcare workers.
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Jadagul
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Re: 2020 Status Check

Post by Jadagul »

Pham Nuwen wrote: 04 Jan 2021, 17:22 I get the racial angle being bad pr but things are different in actual patient care. Triage. The ones who are most at risk get the help. And sometimes the math is harsh but simple. So whoever is going to more likely live.

Example: 92 year old with a broken arm and hip gets surgery bumped because the 60 odd year old is much more likely to survive both surgery and recovery. Its harsh math.

Example: A 6 month pregnant woman in a multi car accident? We ignore the baby and focus on the mother until shes stabilized or dead. Not even vitals on the baby unless time permits. No mother no baby. It's that simple.

I dont really understand what the issue is honestly. We know black americans are more likely to die. I'm okay with them getting the vaccine but no staff means no care for them. I think they made the right call to discuss it and to ultimately decide to give it to healthcare workers.
The debate wasn't about health care workers. It was about, after health care workers, do you prioritize the elderly or essential workers like cashiers?

And there are a lot of plausible answers to this question. But the one that got everyone pissed off was "We ran the numbers, and prioritizing the elderly will save more lives even under conservative assumptions, but racial justice means we should prioritize the cashiers".
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thoreau
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Re: 2020 Status Check

Post by thoreau »

Pham Nuwen wrote: 04 Jan 2021, 17:22 I get the racial angle being bad pr but things are different in actual patient care. Triage. The ones who are most at risk get the help. And sometimes the math is harsh but simple. So whoever is going to more likely live.

Example: 92 year old with a broken arm and hip gets surgery bumped because the 60 odd year old is much more likely to survive both surgery and recovery. Its harsh math.

Example: A 6 month pregnant woman in a multi car accident? We ignore the baby and focus on the mother until shes stabilized or dead. Not even vitals on the baby unless time permits. No mother no baby. It's that simple.

I dont really understand what the issue is honestly. We know black americans are more likely to die. I'm okay with them getting the vaccine but no staff means no care for them. I think they made the right call to discuss it and to ultimately decide to give it to healthcare workers.
First, old people are also at risk. Is there any evidence that, say, a 40 year-old African-American person is more likely to die if infected than a 75 year-old white person?

Second, however harsh age triage is, it's one of those things that is at least a bit more understood and accepted (at least if discussed very quietly and carefully) than racial triage. Racial triage will take us absolutely nowhere good. And the PR angle does matter if you want people to more or less go along with the system. The only way we're getting through this is if people continue to follow requests to wear masks and avoid crowds, and eventually follow requests to get vaccinated. That goes out the window if they see the system as illegitimate. We can't afford a legitimacy crisis now.

Besides, there was a totally race-neutral way to argue for prioritizing younger workers: Just argue that (1) they're more likely to spread it (absolutely true) and so there will be downstream benefits for everyone and (2) they've gotten us through this, so we owe them (a value judgment, but a race-neutral value judgment that many people would accept).
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thoreau
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Re: 2020 Status Check

Post by thoreau »

Here's the other thing: I think most people who support some kind of age triage know that they have to discuss it very quietly and very indirectly. Those of us who aren't in the system but have given it some thought understand, on some level, that hospitals have to prioritize among very sick and desperate people. We prefer to know as little about it as possible, and we prefer to assume that ugly choices are made with as much compassion and as little public airing as possible. And if we're wrong about the compassion (because, let's face it, people with difficult and complicated jobs like to take shortcuts too), we are at least correct about them keeping these things behind closed doors.

That's completely different from a publicly-aired document that says "We'll save more lives if we prioritize the elderly, but the younger workers are more diverse so, yeah, prioritize them." People who believe in some sort of racial prioritization are not quiet, mundane functionaries who have internalized the norms of a system that has to do difficult things while calming the nerves of sick people and their loved ones. They're righteous people with a system of values that have not yet been assimilated into a quiet, compassionate system. They're people trying to push public discourse, not quietly do things that we rely on them to do with as little disruption as possible.
"saying 'socialism' where normies can hear it is wrapping a bunch of barbed wire around a bat, handing the bat to the GOP, and standing with your head in the strike zone."
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