It seems to be the case of non-recognization of tribal epidemiology centers by the CDC as being public health organisations. Who makes this seemingly binary decision as to which entity falls under the "public" sector or not? Shouldn't this be already well-documented which entites fall under which jurisdiction?
"The tribal epidemiology centers were originally created to coordinate public health efforts between tribes and state and federal agencies. And under the Affordable Care Act, the centers are considered public health authorities on a par with state health departments and federal agencies such as the CDC. But Abigail Echo-Hawk, the director of the Urban Indian Health Institute, told POLITICO that the CDC has so far rebuffed the centers’ requests — telling her only that the data is nonpublic."
Please don't discount other other groups experiencing systemic racism. This is another example of systemic racism, but it's not any more or less real than systemic racism against people of color.
I see what you're saying, and without GP disclosing exactly what kind of systemic racism is not "true", I agree with your objection, but it might have been an unfortunate way of wording.
The problem with even having it well-documented which entities fall under which jurisdiction is that you can just change your mind and fight and lose in the courts later when it serves the purpose of delaying the inevitable outcome.
It is often the case that the nation-to-nation relationship is very complex. But even where it is simple the existence of the relationship as a barrier can be exploited to the detriment of the citizenry. (IMO in Canada the courts have been getting fed up with these maneuvers and are levying large penalties in the hopes of deterring the strategy.)
"Federal Indian trust responsibility" seems to be the term of art. Like with the South Dakotan governor's opinions on tribal Covid checkpoints, I'd expect the CDC to become more cooperative after they've consulted counsel.
From down-playing the threat of COVID-19 in the early stages to the mixed messaging on mask effectiveness and the timidly inconsistent guidelines for managing the outbreak, I've lost trust in both the WHO and the CDC. This issue only erodes that trust further. I fear the erosion in trust between the public and public health agencies is causing permanent damage in our abilities to mitigate future disasters. I have the same distrust for social services that purportedly protect kids from abuse yet turn kids over to abusive foster parents. There's zero accountability for the damage these events contribute to and if you ask the people in charge they just shrug their shoulders.
The health issue is complex and as such the right decisions are complex as well. I guess WHO and CDC could have issued guidelines to keep a permanent lock-down until a vaccine is found or at least until the virus is better understood but there are political, social and economic issues and WHO and CDC are in the middle of this big mess.
They've pretty consistently given good advice on how to handle the outbreak, and countries that have done the things they've emphasized (notably, test, trace and isolate) have done well.
A lot of people think that deciding to call an outbreak a "pandemic" is an important step that triggers action. It's not.
The important step - the one with real legal consequences - is the declaration of a Public Health Emergency of International Concern (PHEIC). The WHO declared a PHEIC on 30 January, about a month and a half before they called the outbreak a "pandemic."
One WHO official made a funny statement in which he expressed his annoyance with ignorant journalists who don't know that using the word "pandemic" isn't important, in terms of the actual public health response and the procedures laid down in the International Health Regulations:
> A sign of the WHO’s frustration was visible during a news conference this week – one of around 30 hour-long briefings the WHO has held for international media since the COVID-19 outbreak began. A senior official who had been asked repeatedly by journalists about whether the disease constituted a pandemic gave a half-joking but tetchy response: "This is a word you love, right? You just can't wait, can you?"
But this article indicates that using the word "pandemic" is important. It describes how the pandemic declaration in 2009 "triggered some countries to take expensive measures", and explains that the WHO refused to say "pandemic" because they thought it implies the disease can't be controlled.
The word "pandemic" is not a major trigger in public health. PHEIC is the trigger.
"Pandemic" may have psychological significance to many people, especially those who don't know about global public health policy and have never heard of the term "PHEIC." The WHO feared that the psychological impact of using the term might actually be counterproductive, because it signals that the spread of the disease cannot be controlled. In any case, SARS-COV-2 objectively did not become a pandemic until long after a PHEIC was declared.
They advised against travel restrictions for two reasons:
1. Research has shown that travel restrictions are ineffective at preventing the spread of highly infectious respiratory viruses.
2. The entire framework of international health cooperation is set up to discourage travel restrictions. The International Health Regulations of 2005, a treaty that basically every country in the world is a party to, says that travel restrictions should only be applied if there is strong scientific evidence that they will work. The WHO was simply following the rules laid down by the US and all the other countries that wrote and signed the IHR.
Instead, the WHO recommended measures like screening of travelers who have been to affected areas, as well as widespread testing, tracing and isolation. Countries that implemented those measures (such as South Korea) did much better than countries that quickly instituted travel bans but did not conduct widespread testing (such as Italy and the US).
As for the effectiveness of masks, what studies are you referring to? My impression was that research was mixed before the pandemic, with some studies showing that low-quality masks could actually increase transmission if used by the public.
I don't see anything about Taiwan not trusting the WHO in the FT article.
Taiwan is not a member of the WHA because Taiwan is not an internationally recognized state. This is an issue that the WHO has no control over. It's a body tasked with coordinating public health around the world, not with solving intractable disputes over sovereignty and diplomatic recognition. I thought that the particular interview you linked to was done in very poor taste. The interviewer was trying to force someone who focuses on public health to make a statement about territorial sovereignty. She should ask politicians that question, but trying to promote Taiwanese sovereignty by bashing the WHO is just very low. Public health is something incredibly important, and shouldn't be made into a political battleground or damaged for cheap political points.
The WHO person in the interview could have responded to the second question on how Taiwan was handling it. Just responding with "China is doing great in all regions" is just a big fucking joke. If you don't think so then it's clear what kind of person I'm talking to.
They have been worse than useless. There was a point where they told the public that masks don’t help. And recently one of their leaders said that “asymptotic transmission is rare” which is a deadly lie. It was retracted, but incalculable damage is done by these mixed, inconsistent messages.
> their leaders said that “asymptotic transmission is rare” which is a deadly lie
How it is a lie? People talk a lot about the presence of asymptomatic transmission, but:
1. No one knows for sure if completely asymptomatic people are contagious, and the extent of such contagiousness;
2. People equate asymptomatic with presymptomatic, which is a totally different story;
3. The evidence is at best, inconsistent. There is one case report of a non-contagious "asymptomatic" (reading the paper, the symptoms were there, just not the usual ones), and Singapore contact tracing of a number of completely asymptomatic people did not seem to find infected people in contact with them.
Presymptomatic state is a different matter, and it looks more contagious, but again, a lot of it is speculation, because it's really hard to measure.
This transmission is there. The extent of it is not known.
They've been giving the best available information available at the time.
> There was a point where they told the public that masks don’t help.
Because that was a widespread belief among researchers at the time.
> recently one of their leaders said that “asymptotic transmission is rare” which is a deadly lie.
First, it wasn't a "lie," and using that hyperbolic language is not helpful. Second, there is still a lot of confusion within the scientific community about whether asymptomatic transmission actually is important. Studying transmission is really difficult. Further, the WHO official did not definitively state that asymptomatic transmission is rare. She made it clear that the whole question is very uncertain at the moment - because it is.
> incalculable damage is done by these mixed, inconsistent messages.
The message is mixed because the state of knowledge about a lot of aspects of this virus is uncertain or changing. It's impossible (and undesirable) to be 100% consistent when the state of knowledge changes.
What is actually damaging is that people are attacking the WHO and trying to destroy it, because it hasn't met the impossible standard (omniscience about a novel virus) that the critics are setting. The WHO has done a very difficult job fairly well, and is being most viciously attacked by precisely the country that has had one of the most incompetent responses to the outbreak.
Best available is not as effective as working from the worst case scenario assumption. Either the desease is not that bad or they didn't care. Wearing a mask and staying home is safer than doing none of that and continuing life as normal.
Always assuming the worst case means shutting the world economy down every time you discover a case of pneumonia of unknown etiology anywhere in the world. That can't be the strategy.
The WHO gives the current state of knowledge, including uncertainties. So in early January, when they didn't know if there was sustained human-to-human transmission of the virus, they said they didn't know, but advised doctors to take precautions to prevent transmission.
They specifically said "There is no evidence that mask use reduces transmission." ...despite a 2003 SARS WHO study showing a 65% reduction in community transmission even with basic surgical masks.
The conspiracy people say it's because they wanted to protect mask supplies - but most people just blame incompetence.
I can only find one paper by the WHO from 2003 that discusses the effectiveness of masks in reducing transmission of SARS.[1] The paper says that because many different social distancing and hygiene measures were taken at the same time, it is impossible to assess how effective each individual measure was. For example, the abstract states,
> The independent effectiveness of measures to "increase social distance" and wearing masks in public places requires further evaluation.
I found plenty of papers that find that mask use by healthcare workers in hospitals is effective, but that's not the same as what you're claiming.
> I fear the erosion in trust between the public and public health agencies is causing permanent damage in our abilities to mitigate future disasters
No, it just means communities/towns/cities/counties/states should not cede responsibility to the bureaucratic organizations.
I think this pandemic will make us safer in the future because local authorities will not trust the WHO or the CDC and move forward with their own planning and actions.
Health data related to Native Americans is already highly undercounted and incomplete as compared to other groups. This continued surpression of their ways of living is sad to watch. When NA’s already have little trust in Western medicine, this action by the CDC will do nothing more than erode that relationship further.
I’m a Canadian citizen in Alberta. I made a freedom of information request for some aggregate statistics, and got a response from the agency indicating that the information wouldn’t be available for several months, allegedly due to a “high volume of requests”.
From my perspective, if the information is delivered months after being relevant, it’s the same as denying the request.
In general, it seems like “public institutions” don’t act like they’re beholden to the public. They act just like private institutions whose primary concern is self-preservation.
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[ 3.2 ms ] story [ 74.0 ms ] thread"The tribal epidemiology centers were originally created to coordinate public health efforts between tribes and state and federal agencies. And under the Affordable Care Act, the centers are considered public health authorities on a par with state health departments and federal agencies such as the CDC. But Abigail Echo-Hawk, the director of the Urban Indian Health Institute, told POLITICO that the CDC has so far rebuffed the centers’ requests — telling her only that the data is nonpublic."
The US has commendable ideals.
It is often the case that the nation-to-nation relationship is very complex. But even where it is simple the existence of the relationship as a barrier can be exploited to the detriment of the citizenry. (IMO in Canada the courts have been getting fed up with these maneuvers and are levying large penalties in the hopes of deterring the strategy.)
They've pretty consistently given good advice on how to handle the outbreak, and countries that have done the things they've emphasized (notably, test, trace and isolate) have done well.
The important step - the one with real legal consequences - is the declaration of a Public Health Emergency of International Concern (PHEIC). The WHO declared a PHEIC on 30 January, about a month and a half before they called the outbreak a "pandemic."
One WHO official made a funny statement in which he expressed his annoyance with ignorant journalists who don't know that using the word "pandemic" isn't important, in terms of the actual public health response and the procedures laid down in the International Health Regulations:
> A sign of the WHO’s frustration was visible during a news conference this week – one of around 30 hour-long briefings the WHO has held for international media since the COVID-19 outbreak began. A senior official who had been asked repeatedly by journalists about whether the disease constituted a pandemic gave a half-joking but tetchy response: "This is a word you love, right? You just can't wait, can you?"
https://www.reuters.com/article/us-health-coronavirus-who-me...
"Pandemic" may have psychological significance to many people, especially those who don't know about global public health policy and have never heard of the term "PHEIC." The WHO feared that the psychological impact of using the term might actually be counterproductive, because it signals that the spread of the disease cannot be controlled. In any case, SARS-COV-2 objectively did not become a pandemic until long after a PHEIC was declared.
1. Research has shown that travel restrictions are ineffective at preventing the spread of highly infectious respiratory viruses.
2. The entire framework of international health cooperation is set up to discourage travel restrictions. The International Health Regulations of 2005, a treaty that basically every country in the world is a party to, says that travel restrictions should only be applied if there is strong scientific evidence that they will work. The WHO was simply following the rules laid down by the US and all the other countries that wrote and signed the IHR.
Instead, the WHO recommended measures like screening of travelers who have been to affected areas, as well as widespread testing, tracing and isolation. Countries that implemented those measures (such as South Korea) did much better than countries that quickly instituted travel bans but did not conduct widespread testing (such as Italy and the US).
As for the effectiveness of masks, what studies are you referring to? My impression was that research was mixed before the pandemic, with some studies showing that low-quality masks could actually increase transmission if used by the public.
https://www.ft.com/content/b59c238c-d004-44a2-bd9f-c5b1e7a5b...
And by the way, the WHO doesn't even recognize Taiwan as shown in this very painful video.
https://youtu.be/fASh2_RzMuE
So yeah, my opinion is that the WHO can go screw itself.
Taiwan is not a member of the WHA because Taiwan is not an internationally recognized state. This is an issue that the WHO has no control over. It's a body tasked with coordinating public health around the world, not with solving intractable disputes over sovereignty and diplomatic recognition. I thought that the particular interview you linked to was done in very poor taste. The interviewer was trying to force someone who focuses on public health to make a statement about territorial sovereignty. She should ask politicians that question, but trying to promote Taiwanese sovereignty by bashing the WHO is just very low. Public health is something incredibly important, and shouldn't be made into a political battleground or damaged for cheap political points.
https://www.discovery.org/human/2020/04/20/taiwan-didnt-trus...
The WHO person in the interview could have responded to the second question on how Taiwan was handling it. Just responding with "China is doing great in all regions" is just a big fucking joke. If you don't think so then it's clear what kind of person I'm talking to.
How it is a lie? People talk a lot about the presence of asymptomatic transmission, but:
1. No one knows for sure if completely asymptomatic people are contagious, and the extent of such contagiousness;
2. People equate asymptomatic with presymptomatic, which is a totally different story;
3. The evidence is at best, inconsistent. There is one case report of a non-contagious "asymptomatic" (reading the paper, the symptoms were there, just not the usual ones), and Singapore contact tracing of a number of completely asymptomatic people did not seem to find infected people in contact with them.
Presymptomatic state is a different matter, and it looks more contagious, but again, a lot of it is speculation, because it's really hard to measure.
This transmission is there. The extent of it is not known.
> There was a point where they told the public that masks don’t help.
Because that was a widespread belief among researchers at the time.
> recently one of their leaders said that “asymptotic transmission is rare” which is a deadly lie.
First, it wasn't a "lie," and using that hyperbolic language is not helpful. Second, there is still a lot of confusion within the scientific community about whether asymptomatic transmission actually is important. Studying transmission is really difficult. Further, the WHO official did not definitively state that asymptomatic transmission is rare. She made it clear that the whole question is very uncertain at the moment - because it is.
> incalculable damage is done by these mixed, inconsistent messages.
The message is mixed because the state of knowledge about a lot of aspects of this virus is uncertain or changing. It's impossible (and undesirable) to be 100% consistent when the state of knowledge changes.
What is actually damaging is that people are attacking the WHO and trying to destroy it, because it hasn't met the impossible standard (omniscience about a novel virus) that the critics are setting. The WHO has done a very difficult job fairly well, and is being most viciously attacked by precisely the country that has had one of the most incompetent responses to the outbreak.
The WHO gives the current state of knowledge, including uncertainties. So in early January, when they didn't know if there was sustained human-to-human transmission of the virus, they said they didn't know, but advised doctors to take precautions to prevent transmission.
0 https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-si...
The conspiracy people say it's because they wanted to protect mask supplies - but most people just blame incompetence.
I can only find one paper by the WHO from 2003 that discusses the effectiveness of masks in reducing transmission of SARS.[1] The paper says that because many different social distancing and hygiene measures were taken at the same time, it is impossible to assess how effective each individual measure was. For example, the abstract states,
> The independent effectiveness of measures to "increase social distance" and wearing masks in public places requires further evaluation.
I found plenty of papers that find that mask use by healthcare workers in hospitals is effective, but that's not the same as what you're claiming.
1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3329045/
No, it just means communities/towns/cities/counties/states should not cede responsibility to the bureaucratic organizations.
I think this pandemic will make us safer in the future because local authorities will not trust the WHO or the CDC and move forward with their own planning and actions.
From my perspective, if the information is delivered months after being relevant, it’s the same as denying the request.
In general, it seems like “public institutions” don’t act like they’re beholden to the public. They act just like private institutions whose primary concern is self-preservation.
Everyone gets their turn.
FOIA requests routinely take months and/or years.