Scene from "The Hucksters" (1948)

Wow. An obscure movie you can't even hardly find anymore, but in 1948 the keys to dominating the media narrative were already well known: outspend your competitor and inflame the audience til they want to kill themselves. In short: disgusting is memorable and irritating is the best kind of memorable. Oh sure, here they're talking about soap but political philosophy is a consumer product just the same. Yup, a constant display these days. Notice nary a word is dedicated to Truth or even accuracy. Repetition is all it takes.

My corollary: Anything with Sydney Greenstreet is worth watching (though unfortunately that rule has been lost to posterity). 

Covid-19 in the Autumn of 2021 (part 2)

If you want to avoid the virus, you have to socially distance. That was true in March 2020, still true in September 2021. 

If you want to outlive the virus, you have to live a healthy life. If you are elderly, you are not able to outrun your underlying condition and you need the vaccine.

But for the vast majority of everyone else, the vaccine is no better than the virus. Indeed, the vaccine at best merely allows you to pretend the virus isn't effecting you--that's about all the vaccine can do. 

The new booster policy of starting with the elderly and then (possibly) those with underlying conditions, shows how we should've handled the vaccine rollout from the beginning. I think we are on the cusp of making the realization that the virus is here to stay and that those that need the vaccine should get it and the rest of us either need to keep socially distancing to avoid it or live healthy enough to ward off the necrosis enervated by the Covid-19. 

The current debate about giving the vaccine to children is the height of foolishness. Teaching children to live healthy through diet and exercise and hygiene will be infinitely more valuable to them than giving them a vaccine that merely gives them antibodies they could just as easily form naturally. 

I was never convinced of the necessity of forcing a vaccine on the masses as a means of limiting the lethality of a virus and I am even less convinced now that the vaccine has shown itself to be limited at best. The masses need to live healthier lives to outrun the Covid-19, because a vaccine strikes me as likely to weaken an immune system over time as strengthen it. Whereas living a healthy life will be a much greater guarantee of...well...living a healthy life. 

By "living healthier" I mean specifically: avoid processed sugar, don't drink, don't smoke, get regular cardio exercise, stay hydrated, wash your hands and (probably the hardest of all) you should only hang around others that have similarly health-conscious habits and hobbies. This is how your defeat Covid-19 and if you can't do any of these things, then you should get the vaccine. But if you can do these things....why aren't you doing them?

The co-morbidities are what kill you, not the virus. The virus wants to live in a healthy host for a long time, flaring up periodically so as to increase transmissibility, it doesn't want a body close to death. In the Western Hemisphere--USA especially--we keep unhealthy people alive a lot longer and when a new respiratory pathogen enters the Human world, it is most dangerous to those close to death (even if they're closer than they realize). The reason USA has higher fatalities than most other countries is that we generally do a better job of keeping people alive longer, even if they are not living healthier.

If you were born after the year 2000 anywhere on planet Earth, then you will undoubtedly encounter Covid-19 at some point in your lifetime. Living healthy is the lesson to learn. If you are under the age of 20 and you are afraid of Covid-19, then, brother, Covid-19 is not your problem; you need to take care of your body because this bogeyman will kill you if let it. It's not trying to kill you, so if you live healthy then the vaccine shouldn't be necessary until you get old enough to need it (that's my plan anyway). 

This is not a condemnation of the vaccine. Far from it. For the elderly, the obese, and those with respiratory conditions, this is a life-saving treatment. For most everyone else, it is medicine they don't need. And the idea that the US gov't is forcing it on the masses should give us all great pause. Nothing the US gov't has ever done has come without consequences or miscalculations. A vaccine for a disease that kills a tiny percentage of the people that get it (*) does not warrant such a show of force. 

The plan is to spread a vaccine through the masses so that the virus itself can circulate freely in a manner that is less deadly. This could turn out to be a worthwhile strategy. The idea is to encourage vax-derived antibodies to form in the bulk of the population thus giving them ongoing immunity to future outbreaks of the same virus. That could work, that could be a worthwhile method to get the masses back to work, back to living their lives and minimizing the impact of the virus itself. Note that eradicating the virus is not the strategy, but circulating the virus even more is the strategy of a mass vaccination. 

But, the idea that the vax-derived immunity is better than the virus-derived immunity (or that vaccines don't have their own side effects), is not plainly obvious. I'm willing to accept that it could be an effective strategy but I have yet to see the evidence that it is working. Furthermore, that isn't really the argument that the powers-that-be are currently making. We should hope it works because basically Biden's mandate is designed to let the virus circulate freely among a vaccinated population. 

The idea that the vaccine stops the spread of the virus is simply bogus; indeed, the whole point of the vaccine is that it keeps the virus from doing damage once you get it! It doesn't keep you from getting it or from passing it on to someone else. If that's what you think then you have been misinformation-ed. 

Vaccination is a great backstop, but notice on the August 13 CDC Report, all the recommendations about masking, social distancing, washing your hands, avoiding crowds, etc., come after getting vaccinated. The CDC is clearly reminding you that vaccination in and of itself does not stop the danger of getting or spreading the virus. The vaccine is nice but if you're not doing all the other things, too, well, you're just carrying an umbrella on a sunny day (and probably loudly wondering why everyone else doesn't have their sunny day umbrella at the ready). Again: not a refutation of vaccines, they are great at what they do, but what they don't do is stop the transmissibility of the virus; indeed, the whole point is to spread the virus ever wider but ideally in ever safer conditions.

The current social turmoil is emblematic of the fact that the Partisans are comfortable playing with our lives. Frankly, from the vantage point of the POTUS, all these American lives were pretty much gonna work out this way anyway. He doesn't have to feel any guilt because at his altitude we all look the same to him. And if his medical people are telling him to go wide wide wide with the vaccination, well, it probably sounds like a fine idea to him. He gets to spend money on frivolous drugs (that ought to be going to other more needy people around the world) and tell himself that he saved lives whether he did or not, what's the harm in that? Of course he hasn't really saved lives. 

Viruses don't want to kill. Indeed, they're trying really hard to not kill their hosts. A dead host means the termination of the virus and viruses want to get into more and more hosts. The reason people die from a virus (like, say, Covid-19) is because the first time their body interacts with it, the sheer strangeness of it overwhelms the immune system and those people that are close to death (or closer than they realize) may not be able to overcome the shock of the introduction of a new pathogen. 

What about variants? Viruses vary, that's what they do. Basically a virus has to reinvent itself every time it enters a new host and it wants to enter as many hosts as possible. It wants to infect people in Southern California and sub-Saharan Africa and Eastern Europe and the highlands of Mongolia, but all of those people have different diets, different habits, different modes of social interaction, thus the virus has to morph itself again and again to spread. 

The "increased viral load" doesn't make the virus more lethal but merely more transmissible. Viruses do not want to kill you but they do want to spread. So the "viral load" is about moving between bodies but what it does within each body is gonna be pretty much the same. But what about the higher death totals of the delta variant? I would suggest that is a function of the decrease of social distancing that Americans began to embrace in the Spring and Summer of 2021. The disease isn't any different, it still infects your lungs and puts the same pressure on your system as it did before. But the amount of people available to be infected was much greater because after the introduction of vaccines, more people stopped masking and/or social distancing. Think of it this way: a forest fire causes more damage in a big forest as opposed to a small forest; but it's still the same fire having the same effect. It isn't the fire that is different in this scenario, but the sheer amount of forest to burn. Less social distancing means more potential incubators of the virus. 

We are lucky to live in an age when lab-created vaccines can help us overcome all kinds of pathogens out there in the world. The vaccine is a good thing. But, let us be realistic about what the vaccine can do. The vaccine helps you survive the virus, it does not keep you from getting the virus. It keeps the symptoms of the virus and its overall effect minimized so that the host's natural immunity can provide enough support to survive the impact of the virus. It does not keep you from getting the virus. The vaccine is not prophylactic, it is therapeutic. It does not prevent the virus, it minimizes the dangers of the virus when present. It does not keep you from getting the virus. 

If you read between the lines of what I just wrote, I think you'll see that: the vaccine does not keep you from getting the virus. That is not what the vaccine does. The vaccine keeps you from dying of the virus--and that's great! That is a great thing! The vaccine is a great thing! It will save many lives and that is great! But it will not stop the spread of the virus. 

Only social distancing will keep you from getting the virus and the mask is a great minimizer of viral transmission. The vaccine won't do those things. So if you get the vaccine--and if you're at risk of death then I would highly encourage you to get the vaccine--that does not keep you from needing to socially distance or wear the mask. If you forego the social distancing and/or the mask then you are announcing that you are not afraid of the effects of the virus, ostensibly because you are vaccinated and you assume you will survive your bout with it. Okay, if you're eager to get the virus because you know you can beat it, that's great. I think most people (even American people) will survive the virus without the vaccine just fine. But if you want it, you should go get it. But if you think other people need to get vaccine, I think you should mind ya business. 

Think of Covid-19 as two parts: there is the part that lives in your sinuses (throat) and wants to get out and infect other people and there is the part that gets into your lungs and makes you sick. The vaccine is really great for the second part but doesn't do anything for the first part. Do you understand that? The vaccines lower your symptoms and ease the impact of the virus itself, it does not keep the virus out and since you are now hopefully asymptomatic, you are likely to pass the virus thinking that you are incapable of getting it--but you are not incapable of getting it, indeed, you are making yourself available to it because you are vaccinated and don't fear it. Do you understand that getting vaccinated does not effect your ability to get (or to transmit to others) the virus? Decreasing the spread of the virus is not a function of the vaccine.  

From the July 27 CDC Report: "Added a recommendation for fully vaccinated people to wear a mask in public indoor settings". If being fully vaccinated meant you could not get (or spread) the virus, then why the need for a mask? You need the mask because you are still completely capable of giving and getting the virus even after being vaccinated. And if you possess one of the highest co-morbidities (age, obesity, pre-existing respiratory conditions), you're still better off avoiding the virus even if you are vaccinated. 

And: "Added a recommendation for fully vaccinated people who have come into close contact with someone confirmed or suspected of Covid-19 to be tested 3-5 days after exposure." What would be the point of a test if being fully vaccinated would never yield a positive test, as suggested in the September 7 CDC Report? You should take an antibodies test, not a Covid-19 test. The antibodies would be a signal of the presence of viral infection being routed by the vaccine immunity, which is what the vaccine does: it fights the virus once you have it, it doesn't keep you from getting the virus, it keeps you from dying of it.  

Now the August 16 CDC Report says, "Covid-19 vaccines are effective.  They can keep you from getting and spreading the virus that causes Covid-19" followed by a link that reads "Learn more about the different Covid-19 vaccines", but the link says nothing about spreading the virus. It takes you back to the May 10 Report...that avoids any suggestion of proof that the vaccines stop the spread. 

I believe that they are falling into a rhetorical trap: when they say it stops the spread of the virus, that means within your own body, it does not mean that it stops the spread between the people. Think of this as the difference between HIV and AIDS: AIDS is the full blown disease within your body that kills you, while HIV is the virus that passes between people that leads to AIDS. In this analogy, the CDC here is referring to Covid-19 as AIDS, not as HIV. This is a dangerous piece of rhetoric because I am positive that the vaccine does not stop the spread between people, though it could be said to stop the spread within a single person. Furthermore, I have not seen that claim made in any other CDC Report. (Of course this report also says "Extensive testing and monitoring have shown that these vaccines are safe and effective", which the May 21 OSHA Report would suggest is not the case)

Indeed, spreading the virus amongst a vaccinated (re: not likely to die) population seems to be the goal of the current administration. And that could well turn out to be a correct strategy. So why don't the powers that be just fuckin' say that that's what they're doing? Why has it been turned into an "us v them" scenario? Because Partisans don't care about your health. (Indeed, Partisans are invigorated when the population are at each's other's throats) 

And by now it's pretty clear that this virus is quite deadly to those with co-morbidities but not really to anyone else and so the virus will be amongst us forever. Perhaps vaccinating now will provide future immunity, perhaps making sure that everyone's initial contact with the virus comes after their vaccination will lessen the overall effects of the virus and allow us all to get back to our lives in a timely fashion. And that this added immunity will carry forth into the future. Maybe. When said in that way, it actually strikes me as very sensible. It doesn't strike me 'scientifically proven' but it is a reasonable-sounding hypothesis. So why don't we get reasonable-sounding rhetoric from our Media? 

If you want to not socially distance or wear the mask, then you'll need the vaccine. But if you think that means you cannot spread the virus, you are mistaken. You have been "misinformation-ed". Indeed, quite the opposite: the whole point of the vaccine is that it keeps the virus from killing you, not that it keeps you from getting the virus. 

I'm not suggesting the virus is a fraud--not at all, if you are elderly, obese or are prone to respiratory conditions, then you are seriously at risk and you should probably get the vaccine. But I would suggest that it isn't the virus that kills you, it's the pre-existing conditions that make you vulnerable and that was true before Covid-19 came along. 

I'm not suggesting the vaccine is a fraud--not at all, it seems to do a good job of holding off death and minimizing symptoms. But thinking the vaccine means you can't get or spread the virus itself is simply false, demonstrably false, obviously false, clearly not true and to believe that is to willfully believe in falsehoods. And giving the vaccine to people that aren't at risk is wasteful at best and harmful at worst. 

I'm not suggesting that boosters are a bad thing. For the elderly, for example, I'd say that's just the way it is for them because they have no way of removing their at-risk status. For the obese, the boosters are beneficial, but that lifestyle is not going to lead to a healthy life with/without a vaccine. For those with respiratory conditions, it is probably necessary forever. For those that travel or spend a lot of time around groups of people, the vaccine is something you should consider periodically--but even then it is so that you don't miss work, so that you can overcome your infection and continue to live normally. For all other adults, you can get the vaccine if you want, but you're probably better off just live a healthy life and avoiding the virus as best you can. 

The vaccine is really great at what its great at. But the vaccine does not solve all problems, it is not great at what it is not great at. 

Me: I do not particularly fear this virus for the next few years because I am healthier than ever and socially distanced and I anticipate that I will not get the virus any time soon and that I should survive it if I do. That said, this virus could be what kills me 20 years from now or 5 years from now or 50 years from now. I am currently planning on living long enough to where I become elderly enough to be in the at-risk population, so I'll get to the vaccine eventually. 

Am I better off waiting for as long as possible or getting it as soon as possible? I don't know. I don't believe that there is anyone that does know simply because this virus is only about two years old. In short: neither the virus nor the vaccine have been around long enough for anyone to know their long term effects, so who am I suppose to trust? The gov't? I never have before, why would I start now?

Just remember: OSHA, the people Biden has put in charge of forcing everyone to be vaccinated, has already announced they have no interest in hearing about adverse reactions to the vaccine. 

From May 21 OSHA Report:

Are adverse reactions to the COVID-19 vaccine recordable on the OSHA recordkeeping log?

DOL and OSHA, as well as other federal agencies, are working diligently to encourage COVID-19 vaccinations. OSHA does not wish to have any appearance of discouraging workers from receiving COVID-19 vaccination, and also does not wish to disincentivize employers' vaccination efforts. As a result, OSHA will not enforce 29 CFR 1904's recording requirements to require any employers to record worker side effects from COVID-19 vaccination at least through May 2022. We will reevaluate the agency’s position at that time to determine the best course of action moving forward. 

That's not a just a little bit creepy...?  No?  You've got total faith in this, huh? They don't want to discourage the vaccine...even if the vaccine has negative side effects? At what point would they discourage it? I thought subverting norms was a concern for the American polity, but OSHA "not enforc(ing)....recording requirements" is just how we do things now? We're cool with this? 

And when does the danger of the vaccine outweigh the danger of the virus? Well....we won't find the answer to that question until May 2022 at the earliest. The powers-that-be have straight up announced that they aren't even going to begin to care about side effects for at least another 8 months. 

These are the people (**) in charge of your health, America. And you can't understand why people are skeptical? 

The smug superiority of the Left has become even more unbearable than usual. Their claims have turned out to be wrong and it turns out they've been lying to themselves the whole time. Even when the CDC is reminding you to keep socially distanced and masked even after getting vaccinated and OSHA has openly admitted they don't care what happens to vaccinated people, they still think the gov't will protect us all. 

Once more with my mantra: the gov't was here when you born, it will be here when you die, it does not care about you and couldn't even if it wanted to. Trust the science but be wary of scientists. 

(*) September 17 Statista.com: Total deaths: 4,685,661; Total recoveries: 204,587,058; roughly 2.3% of confirmed cases result in death. 

(**) Summary deportations. Drone strikes killing civilians. Unconstitutional subversion of norms. Angering NATO allies. North Korea's nuclear program (which had been halted since 2018). Drill, baby, drill! Pfizer, J&J, Bristol-Myers, AstraZenica--oh my! "Full confidence" in breaking chain of command. Inflation.  Financial intrusion.  The debt ceiling. Politics before science at the FDA. Misinformation. “(I)n the great debate of the past two decades about freedom versus control of the network, China was largely right and the United States was largely wrong.” Wait...what was it Trump did that we all hated so much? Oh right, he was annoying on Twitter. 

References:

May 10 CDC Report

May 21 OSHA Report

July 27 CDC Report

August 13 CDC Report

August 16 CDC Report

September 7 CDC Report

I also saw a paper a while back that suggested that getting the virus and then getting the vaccine made for super-immunity, though the paper was agnostic on whether getting then vaccine and then virus had a similar effect. I saw another paper that suggested that at least 1/3 of all cases were asymptomatic,  which would suggest waaaaaaay more cases than we even realize, no?). But I couldn't find either of those papers--none were from the CDC--so I'll just let those concepts marinate. 

Covid-19 in the Autumn of 2021 (part 1)

I'm not a researcher, that is not the point of this blog. But I went on a bit of a deep dive on USA's recent "crisis" in intensive care units across the land and felt like I had to post about it. 

The healthcare industry is in an all day, every day fight to manage the cleavage between supply and demand. In healthcare (unlike most other industries), optimally there will always be more supply than demand; but (just like every other industry), oversupply is wasteful and undersupply diminishes revenue. So how do we correct for undersupply? 

I wanted to see what an ICU "crisis" looked like before our current period of pandemic. I'd say it mostly looks exactly the same. And I can more or less sum up all of these papers, articles, abstracts, etc., in two phrases: we need more beds and we need more nurses. That was true in 2000, 2006, 2011, 2016 and today. 

Check them out for yourself. 

Millbank Quarterly: "The Transition from Excess Capacity to Strained Capacity in US Hospitals" (June, 2006)

"After many years of concern about excess hospital capacity, a growing perception exists that the capacity of some hospitals now seems constrained. This article explores the reasons behind this changing perception....we observed that adjustments to the supply of hospital services tend to be slow and out of sync with changes in the demand for hospital services. Those hospitals reporting capacity problems are often teaching hospitals, located near previously closed facilities or in population growth areas. These findings suggest therefore that approaches to dealing with capacity problems might best focus on better matching individual hospitals' supply and demand adjustments."

First, note that in 2006 there was no particular pandemic problem in USA. Also, note that this article is not about "strained capacity" as it is the "changing perception" of capacity. Problems aren't merely problems but the "perception" of problems. Supply and demand ebb and flow, knowing how to stay ahead of them is the fundamental task of healthcare. 

"One particular concern has been the growing number of emergency department diversions, in which ambulances are instructed to bypass particular hospitals, especially because this could have a domino effect in the community (California HealthCare Foundation 2002; Shute and Marcus 2001). Evidence of the rising rates of emergency department diversion was found in round 3 of the Community Tracking Study (CTS), which was conducted by the Center for Studying Health System Change in 2000 and 2001. The CTS researchers reported that hospitals frequently were bypassed because they could not admit emergency patients due to the lack of medical/surgical floor beds or intensive care unit (ICU) beds (Brewster and Felland 2004; Brewster, Rudell, and Lesser 2001). A study of emergency room overcrowding by the General Accounting Office (2003) yielded similar findings, suggesting that strained capacity in various hospital units led to backups in emergency departments. "

Notice that strained emergency rooms were frequent occurrences in 2000, 2001, 2002, 2003 and 2004. Not a function of global pandemcis, merely a function of supply and demand.

"Two CTS issue briefs examined emergency department diversions and how their occurrence and severity had changed over time (Brewster and Felland 2004; Brewster, Rudell, and Lesser 2001). Bazzoli and her colleagues (2003) looked at the degree to which specific hospital services were viewed as constrained and what contributed to these problems. They found that those service areas perceived as highly strained were the emergency department, medical/surgical ICU beds, and general medical/surgical beds. The main contributing factors reported by the CTS respondents were nursing and other personnel shortages and an insufficient supply of beds."

The solution in 2006: more beds, more nurses. 

Biomedical Central.com: "Working With Capacity Limitations" (August 16, 2011)

"ICUs are faced with nearly the same throughput and capacity problems as the companies in our examples. The vast majority of critical care costs are fixed, resulting in substantial revenue increases with each additional patient [7]. ICUs also frequently operate at or near capacity, with subsequently large waiting times for admission [8]. Simply expanding capacity is not feasible due to space limitations within hospitals, workforce shortages, and government regulations [9]. Neither is expanding capacity necessarily desirable. As the above examples teach us, in the face of variable demand, expanding capacity can ultimately result in higher fixed costs, excess capacity, and long-term inefficiencies."

2011: Not uncommon for ICU's to be at/near capacity because there are is a latent and permanent and constant need for more beds and more nurses.

"The next step is to apply queuing theory to mathematically formulate the current process and determine the point on the utilization curve that will maximize responsiveness and productivity. Increasing capacity might be necessary to achieve optimal throughput, or might only result in excess resources. Sometimes these results can be surprising. For example, an empiric analysis of ICU readmissions in the cardiac ICU at the University of Pennsylvania Hospital found that an aggressive early discharge policy resulted in an increase in overall capacity, even accounting for the increase in readmissions [10]."

But plans for emergency overflows have already been formulated and ready to put into practice, (although sending patients home early is one of the suggested strategies).

Realias Media: "ICU Capacity Strain" (May 1, 2016)

"Intensive care in the United States accounts for nearly 1% of the gross domestic product, and it is forecasted that there will be increasing demand for this type of care in the future as the population ages.1,2 Given current projections that the supply of ICU staff and beds will be constrained rather than expand to meet this increasing demand, ICUs will be faced with the challenge of continuing care delivery under conditions of increasing strain.2 Thus, there is growing interest in studying ICU capacity strain, defined as the temporally varying influence on a given ICU’s ability to provide high-quality care for patients who are or could be cared for in that ICU on any given day.3"

Decreasing, rather than increasing, the amount of beds creates more potential revenue. And dealing with that forced decrease is the mission of future (as of 2016) health care professionals. (Wow! ICU accounts for 1% of American GDP? Is this true in other countries as well?)

PLOS.org: "Perspectives on Strained ICU Capacity" (August 22, 2018)

"Interpretation: Strain is perceived as common. HCW believe precipitants represent a mix of patient-related and operational factors. Strain is thought to have negative implications for quality of care, HCW well-being and workplace environment. Most indicated strategies “outside” of ICU settings were priorities for managing strain."

The "strain" here refers to health care workers (HCW) themselves reacting to conditions of caring for ICU patients. "Burn out" in the health care industry is the dragon that must be slayed and we've known this for years. 

North Carolina Rural Health Research Report (March, 2020)

There's a table of data about rural and urban hospitals that I found eye opening. 

In the USA (as of March, 2020, presumably) 2,169 rural hospitals and 2,367 urban hospitals. Okay, slightly more urban than rural but not a huge disparity. 

Avg. daily census: in rural hospitals is 36,615 and in urban hospitals is 350,452. Uhh...that's not even close. The urban hospitals have 10 times more daily traffic?

Total acute care beds: in rural hospitals is 99,942 (37% occupancy) and in urban hospitals is 562,492 (62% occupancy). 

The lesson here is skip the big city hospitals and go find a hospital out in the middle of nowhere--which is probably not what people in the middle of nowhere would tell you to do. But it is the urban hospitals that have the most traffic and presumably would be the most backed-up during a period of "crisis".

Fact Check.org: Hospital Payments and the Covid-19 Death Count" (April 21, 2020)

"It is true, however, that the government will pay more to hospitals for COVID-19 cases in two senses: By paying an additional 20% on top of traditional Medicare rates for COVID-19 patients during the public health emergency, and by reimbursing hospitals for treating the uninsured patients with the disease (at that enhanced Medicare rate). Both of those provisions stem from the Coronavirus Aid, Relief, and Economic Security Act, or CARES Act.

The CARES Act created the 20% add-on to be paid for Medicare patients with COVID-19. The act further created a $100 billion fund that is being used to financially assist hospitals — a “portion” of which will be “used to reimburse healthcare providers, at Medicare rates, for COVID-related treatment of the uninsured,” according to the U.S. Department of Health and Human Services.

As the Kaiser analysis noted, though, “it is unclear whether the new fund will be able to cover the costs of the uninsured in addition to other needs, such as the purchase of medical supplies and the construction of temporary facilities.”

Either way, the fact that government programs are paying hospitals for treating patients who have COVID-19 isn’t on its own representative of anything nefarious."

"Berenson said revenues appear to be down for hospitals this quarter because many have suspended elective procedures, which are key to their revenue, forcing some hospitals to cut staff. He surmised that potential instances of patients being wrongly “upcoded” — or classified as COVID-19 when they’re not — are “trivial compared to these other forces that are affecting hospital finances.”

It further indicates that if a “definite diagnosis of COVID–19 cannot be made, but it is suspected or likely (e.g., the circumstances are compelling within a reasonable degree of certainty), it is acceptable to report COVID-19 on a death certificate as ‘probable’ or ‘presumed.' If we think it’s presumptive … we can go ahead and put down COVID-19,” Jensen said, “or even in some situations, even if it’s negative.” He pointed to the example of a 38-year-old man in Minnesota whose death was attributed to the coronavirus even though he tested negative."

So hospitals have an incentive to call everything Covid-19. And Covid-19 causes them to hold off elective procedures (the real moneymaker for hospitals), which also causes them to cut staff. So the more Covid-19, the more hospitals...cut staff?

Also, these gov't programs that overpay hospitals to cutback on staff are really about the uninsured, right? So shouldn't we be condemning the uninsured rather than the unvaccinated? (Seems like its time to deny the uninsured service, right? Isn't that how we do things now?)

CBC: "Why Ontario Hospitals Are Full to Bursting Despite Few Covid-19 Patients" (November 2, 2020)

"The data suggests many hospitals have returned to the overcrowding levels seen before the pandemic, when CBC News revealed hospitals filled beyond capacity nearly every single day, with patients housed in hallways, conference rooms and cafeterias not as exceptional cases, but as a matter of routine."

"We're back to where we were pre-COVID with the risk of hallway health care. And you can't have hallway health care in a pandemic because of the need for infection prevention and control.""

"The increased funding to add bed capacity does not necessarily mean hospitals will hire more nursing staff to care for the additional patients, said Vicki McKenna, a registered nurse and president of the Ontario Nurses Association."

Wait....'we're back to where we were pre-Covid'? Yeah, check out the dropdown menu in there: Ontario hospitals were mostly at above 100% capacity in January 2020, before known Covid-19 cases even got to North America. WTF is going on in Canadian healthcare if the Covid-19 "crisis" is considered a return to the good times?

Sharp.com: "What ICU Capacity Tells Us About Covid-19" (December 21, 2020)

"Additionally, there might not be enough appropriately trained providers, such as ICU nurses and respiratory therapists, to safely care for a greater number of patients.

“The safety of our patients and staff is our top priority,” Jenkins says. “We separate COVID from non-COVID units to limit exposure and conserve personal protective equipment. Patients requiring ICU care require special technology, monitoring, nurses and physicians. And while there has been a significant increase in patients, there has not necessarily been a surge of health care workers.”"

"...it has become clear that the general public’s actions directly impact case numbers, hospitalizations, ICU capacity and the number of deaths we might see in the coming weeks. As such, experts are renewing their call for everyone to do their part to reduce their chance of contracting COVID-19 and spreading it to others.

“Safe, high-quality care is always the top priority of our staff and physicians, but they have grown weary and tired,” Jenkins says. “In order to break this pattern with the upcoming holidays, we need everyone’s cooperation in following the county’s guidelines of masking, social distancing and staying away from gatherings outside of your household.”"

Before the vaccine the advice was the same...as after the vaccine: social distancing is the only way to avoid the virus and masking helps to limit the spread. 

Lexington Herald-Leader: Beshear: Covid-19 Surge Means Kentucky Will 'Be Out of Hospital Capacity Very Very Soon" (August 19, 2021)

"The governor said 21 hospitals across the commonwealth now face “critical staffing shortages,” as the number of new cases and rate of Kentuckians testing positive for the virus continues to rise. To “allow for additional help,” Beshear said he signed an order on Wednesday that grants licensed health care providers in other states permission to practice on an emergency basis in Kentucky."

More beds, more nurses. 

Physicians Weekly: Covid-19 Related ICU Workforce Shortage Projected to Push Hundreds of US Counties Into Crisis (August 31, 2021)

"For these counties, the analysis recommends implementing a variety of contingency workforce strategies, including increasing patient counts per team, using float pools, and granting overtime pay."

"In a recent Washington Post-Kaiser Family Foundation poll, roughly 30% of healthcare workers reported contemplating leaving their profession, whereas in the Medscape National Physician Burnout & Suicide Report 2021, 42% of physicians surveyed reported burnout, with ICU physicians reporting the highest levels at 51%."

Yeah. More beds, more nurses, beware of burnout. Every study says the same thing, we've known this for years. Which begs the questions: are our hospitals actually enduring a "crisis" right now or is this simply the exact same perception of Intensive Care Units that we've long had? 

And is this the solution to the problem? LA Times (June 22, 2021), Washington Post (August 14, 2021), Advisory.com (August 18, 2021), Business Insider (September 3, 2021), Yahoo News (July 2, 2021). There are many more of these stories and I never even got off the first page of the Google search. The overwhelming lesson of all the reports cited above is that the "crisis" is an undersupply of nurses!

What do we value: nurses or the vaccine? What do we need to overcome this crisis: nurses or the vaccine? Whose medical opinion should we follow: nurses or the vaccine? 

I'm all for the vaccine, but why are we firing nurses for following their own beliefs in the face of a "crisis", when we know good and well that the "crisis" is not enough nurses? Why do we need nurses to believe what the mainstream media wants us to believe?

HHS Hospital Utilization (September 20, 2021) 

As of roughly 1pm, Tuesday, September 21, 2021 (*) of the 4 hospitals located within 5 miles of my current location (one of the hottest hot spots in the Commonwealth, I might add), one has 44% of ICU beds available, one has 10%, one has 19.6%, one has 62.5%. Granted, 10% available is probably the limit of what a health care provider would like to have (ideally, more supply then demand is desirable for positive health outcomes), but the other three available hospitals do not seem to be dangerously overstuffed. I can, of course, look to other hospitals in other places if I really wanted to worry myself but why would I? My paranoia is most naturally directed at my own safety and by extension the safety of those most immediately around me. And for now, the local hospitals seem to be bearing up just fine. 

(*) These stats are virtually identical to roughly 4pm, Monday, September 20, 2021, incidentally. This suggests that either nothing has changed or that this website is a faulty accumulator of data. 

My two cents: the "crisis" in hospitals is the inherent conflict between supply and demand which is more acute in healthcare than in other industries. I don't see anything different in fall of 2021 as in 2000, 2006, 2011, 2014, 2016, etc. 

And....what are we blaming the unvaccinated for, again? What is the problem they are creating? And bear in mind there is no way to ascertain (from this data) what types of maladies the ICU beds are currently filled with or the relative vaccination status of those people. You are free to use your ignorance to blame whoever you like for whatever you like. But, personally, I don't see anything out of the ordinary in our hospitals right now. 

Furthermore, the "crisis" was never the amount of patients but the paucity of staff. Hospitals are in perpetual crisis (re: more beds, more nurses) and if we can afford to fire nurses right now, then apparently everything is just fine...right?

Afghanistan

In 1979, the USSR invaded Afghanistan. Off the top of my head, I have no idea why except that the Russians have always had prickly relations with their neighbors (and Russia has a lot of them). 

It wasn't long before the Russians were bogged down in the desert, no real sense of what they were doing or why. Meanwhile, the Russian people back home were watching the clumsy carnage on their TVs and grew dissatisfied with Moscow's imperial ambitions (Afghanistan has long been considered Russia's 'Vietnam'). And, predictably, the Americans stoutly supported the native antagonists (as long as they continued the job of killing Russians, according to Charlie Wilson). The American support took the form of giving money to Pakistani intelligence to funnel to anti-Soviet warlords in Afghanistan. 

Within the larger Arab world, the fight against the Soviets in Central Asia was a righteous cause (a la the Spanish Civil War) and many Arabs dedicated themselves to going to Afghanistan and making war on the imperial infidels. These groups were called "Afghan Arabs", though they are not Afghans, and eventually they wore out their welcome in Afghanistan. By the mid-1980s, the Soviets were done with all that and pulled out. American support, too, disappeared when the Soviets left town. Soon after getting their country back, the Afghan people grew tired of these outsiders trying to show up and take credit for everything (a phenomenon seen again when the Iraqi Sunni fought against al-Qaeda interlopers after the fall of Saddam) and drove many of the Afghan Arabs out. 

Afghanistan bathed in its ability to spurn empires, recounting tales of fending off invaders going back to Alexander the Great. In the following years, the Taliban came to power. They were mostly an obnoxious religious organization with vague political (re: warlord-ish) philosophies, but since Russia and USA no longer cared, really only Pakistan was left to pay any attention. Pakistan took on the Taliban as useful idiots (well, that was the hope anyway) and more or less abetted them. The Taliban were happy to destroy religious relics and basically act like the recalcitrant dinosaurs they are. 

During this time, the most famous of the Afghan Arabs, Osama bin Laden, who went from Afghanistan to the Sudan after the Soviet retreat, returned in the late 1990s, presumably under Taliban watch.  It was from the mountains of Afghanistan that bin Laden planned and implemented 9/11.

The Americans by Xmas of 2001 were able to rout the Taliban and put "our guy" (Hamid Karzai, who is ready for a comeback...?) in power, where he stayed for almost 14 years, controlling Kabul with an iron fist and not much else. The hinterlands were never swayed by American influence but the overwhelming force did drive the Taliban underground for a decade or so. 

The recently concluded American operation in Afghanistan was a direct outgrowth of 9/11. In October 2001, USA invaded Afghanistan with three goals: 1) capture/kill Osama bin Laden; 2) crush al-Qaeda in Afghanistan; 3) push the Taliban out of Kabul as punishment for allowing al-Qaeda to plan 9/11 from its territory. Here's the thing about USA's involvement that always struck me: the Americans accomplished all three of those goals years ago....so why were we still there in 2021? 

#1 took almost a decade and took place outside of Afghanistan but the goal was accomplished. #2 al-Qaeda was well smashed in Afghanistan by 2010 and I think foreign terror influence there is currently minimal and I think likely to stay minimal (at least when it comes to attacking the West, the Afghans have bigger fish to fry). As for #3, we pushed the Taliban out of Kabul within weeks, mostly before even putting boots on the ground, and kept them out for 20 years even though they clearly make up the largest chunk of the population and basically represent the only political game in town.

The third part of the mission is where we got creeped. Pushing the Taliban out as punishment for their involvement in 9/11 is like sending your child to his/her room: is the kid supposed to stay there forever? Were we really supposed to suppress the Taliban indefinitely in their own home country? The only thing that suppressed them was the overwhelming American firepower hidden in the hills and now that that has been collected up and rotated back home, what is there to stop the Taliban? The Taliban are the bulk of the population, why wouldn't they rule the country? It is worth noting that throughout July and August as the Taliban "re-took" territory from the departing Americans, these gains did not come (for the most part) through battlefield victories. The Taliban didn't have to fight anyone to get the power back, they merely had to show up. This is a re-flourishing of culture that has been hibernating for the last decade or so.  

When Trump and then Biden negotiated their various escape plans, they talked with the Taliban because they're the only people there. USA negotiated the withdrawal with the Taliban because who else were the Americans going to negotiate with? Think of this: we worry now about the refugees pouring out of Afghanistan as the Americans leave, but there was no such worry in 2001 when the Americans invaded because those people didn't leave. They stayed and for 10 years or so they (kinda) fought the Americans and then for the last 10 years, they've just been biding their time waiting for the Americans to inevitably exit. 

The Americans have known for years that as soon as they leave, the Taliban will take back over, the Americans forces were merely a finger in the dike, not a force for nation-building. Everyone was taken aback by the sheer speed of the Taliban takeover, but no one was surprised that it happened. The question is how long was the American Public supposed to care about keeping the Taliban out of power? What was the value of a Taliban-less Afghanistan to USA? Does it matter at all? In October 2001 it was a perfectly reasonable mission but by the summer of 2021, the mission no longer served any purpose. 

I'd say it was by 2012 or so that the mission no longer served any purpose. From 2001 to roughly 2010, the Americans routinely skirmished with those militants willing to fight the American presence, which whittled down al-Qaeda and other foreign terror elements and the most militant elements of the Taliban. But after Osama bin Laden was killed in May 2011, the mission didn't have much left to accomplish. Obama declared the end of combat operations in 2014 because combat had pretty much run its course. The Americans fought everyone that wanted to fight and when that dried up, Obama was clearly ready to bring the troops back home. As we can see, the American presence in the hinterland put a freeze on activity but didn't really squash any beefs. 

Obama wanted to leave but the Pentagon suggested instead keeping the troops there. Why? Recall that in 2014 Obama was entering the final two years of his second term, which is a death knell for the Prez in DC. During this phase, the Prez is free to make all sorts of bold visionary speeches and invent all sorts of ways to lionize himself or smite his non-gov't enemies. But when it comes to actually getting shit done, a Prez in his final two years is pretty powerless, even in foreign policy. The Pentagon was not going to let an outgoing president push long term agendas. And at that time the Pentagon still liked the idea of having combat troops in forward bases because...well, the Pentagon just likes that stuff.

But I think it was somewhere around 2018 when the Pentagon decided that Afghanistan was more trouble than it was worth and began to indulge Trump's ambitions to leave. They famously dragged their feet (*), but they had already begun plodding toward the exit in Afghanistan by the time of the 2020 election. So when Biden came to power earlier this year, he picked up the exit strategy that Trump had already begun (which suggests that if Trump was President, the turmoil in Kabul would look pretty much the same as it does now) and was eager to start his Presidency with a quick and smart retreat. 

What happened to make the Pentagon prefer a lighter footprint in Afghanistan? I dunno. Perhaps the money-sucking potential of boots in country just wore itself out and supporting them was costing more than the corruption could bear. Perhaps the trade war with China showed the Pentagon that China was becoming a different sort of adversary and that positions in Afghanistan would be more of a weakness than a strength. Perhaps militant Islam of the sort that threatens the shores of the USA was just simply no longer there. Perhaps the evolution of the American military from a large standing army to drones and special forces has finally matured. Perhaps this is just a re-assessment of Central Asia security needs. Perhaps the realization that keeping the Taliban out of Kabul was just no longer necessary finally took hold. Perhaps other allies (India or Turkey, for example) were willing to take up positions in Afghanistan similar enough to the USA's that we became redundant. I dunno, pick your favorite explanation. 

At any rate, I would suggest that the mission was far from a failure. Again, we achieved everything we wanted to achieve...and then hung around an extra ten years because withdrawing was always going to be an unholy shit show. 9/11 is far enough away now to perhaps no longer recall that it was not uncommon in the American media landscape to refer to these War on Terror incursions as World War III. I would point out the American casualties in 20 years of war in Afghanistan (2,448 according to the Associated Press) aren't even as large as single days of Civil War battles, which suggests that this was not the epoch-shifting clash of civilizations that we thought we were in for at the time. Indeed, in America we've had the luxury of largely ignoring this war. Even its effect on the Arab world has been pretty minimal outside of Pakistan (though exerting no more force on Pakistan than USA already possessed). This was not World War III, it wasn't even Gulf War II. 

And during that 20 years the Taliban didn't go away. They just realized they couldn't rule by force and so went into hibernation. Did the Taliban mature during that time? Well, it probably won't look like it to American eyes but I don't see how they couldn't have matured. They step into power with a brand new appreciation of foreign policy, a more sophisticated sense of controlling the media narrative and will have to serve their populace in a whole new way now that they have been introduced to the 21st century. Don't get me wrong: the Taliban are still pretty close to the bottom of enlightened thinkers but their floor has been raised whether they like it or not. 

Imagine having enough guns to be able to invade Kansas and at gunpoint force all the residents to become Duke basketball fans. Watch the Blue Devil games, cheer the wins, sing all the fight songs, all that shit, just for Duke. No Jayhawk gear is allowed (not even Wildcat gear), just Duke blue for everyone, everywhere all the time. Say, this lasts for 20 years and then you pack up your shit and leave one day. Do you think the local Kansas residents will all stay loyal Duke fans? Oh, I don't think so. 

Well that's more or less what we did to Afghanistan: we deprived them of their natural choice to run the country because those people pissed us off. So we punished them. We sent them to their room without any dinner....and how long was this supposed to last? Were the Taliban supposed to stay in hiding forever? The Americans didn't do much to eradicate them or replace them (with whom?), but merely to force them to cower for a coupla decades while heavily armed Americans wandered the countryside. We don't have to stay there forever, the territory is simply not valuable enough and the people aren't dangerous enough to warrant staying indefinitely; but there's no reason to think they're gonna sing our praises when we're gone. There was always a moment when exiting was gonna be the next step and that moment has finally arrived (well, I'd say it arrived around 2012). The Americans leaving Afghanistan is a good thing even if it looks bad on TV.

And as for the troubling exit strategy, look man, there is no exit strategy that makes for good lookin' TV. The proper withdrawal from Afghanistan (to my mind) would've been to send in an additional 10,000 troops to sweep into the hinterlands around Kabul, accumulating any American assets that would be exiting, then gathering at the south end of Kabul ready to lead a procession to the sea. Move large, move fast, gather friends, avoid enemies and talk a lot of shit. This would've been a provocative move designed to make the locals defensive rather than offensive and ideally should've minimized any reprisal as the American forces hasten to the exit. This would've been accompanied by loud angry words from the POTUS and probably even some shady misdirection on how/when the exit would actually take place, all designed to keep the timid elements from joining any kind of fray. (This would've been expensive as hell, would've really cut into the Pentagon's foreign budget, but what does POTUS care?)

Is that the plan you wanted, America? An increase in troops, six-to-eight weeks of constant war games, while your President screams bellicose words into a camera, just so that we could leave an empty crater in our wake to pretend like Afghanistan never happened...is that the plan America wanted? Because that would've looked like shit on your TV. Exits need to be hard and fast, you need to leave fire in your wake, you need the people left behind to be glad that you're no longer around. But that's not how the politics of this stuff works. Partisans nowadays are eager to look soft and sensitive rather than tough and brutal, which is theoretically better (fewer pointless deaths) but optically tougher (everything always looks like shit when you think in terms of the specific rather than the abstract).  

Biden willing to take the short term heat (personal) for the long term good (collective) is something we just don't get out of a POTUS any more. It is better to be out of Afghanistan, it is probably better to not use that level of boot-force ever again. It is time for militaries to turn into search-and-rescue teams built to save lives rather than take them. 

I am confident that six months from now we will be glad to be out of Afghanistan. I think 10 years from now we'll be glad to no longer be in Afghanistan. Hell, I think we're already glad to be out of Afghanistan--and I should've put this post up 4 weeks ago! (***) 

I think this the correct long term move for USA, for the Pentagon, for American geo-strategic thinking and for Afghanistan and the Afghan people. For Biden to shoulder the short term blame for our collective long term gain is as admirable as anything I've seen a President do in a long time. And, of course, nobody noticed.

Yes, the Taliban are still a bunch of recalcitrant dinosaurs. But they really can't be as bad as they were before 9/11. And America's defensive posture vis-à-vis Central Asia is vastly better than it was before 9/11. And oh, by the way: I guarantee the Afghan hills are still dotted with American special forces, dudes that have only learned to live that way since the Towers came down....they're still there, I'd bet my last dollar on it. This strategy is a move toward a lighter footprint, not a move toward total absence because the central Asian landmass and the Indo-Pacific is where the military stuff is headed for the foreseeable future (and ain't no way the Pentagon is gonna get left out of that!). Whatever shenanigans lay ahead for Central Asia, the Americans are dug in and ready to participate, they're just not doing it with thousands of boys in country the way we did in the 19th and 20th centuries.

The eminent British historian John Keegan once made a list of the countries he thought to be more or less unaffected by World War II: Iceland, Ireland, Afghanistan. Not a lot. And honestly I'm not sure why Iceland is on there (**). Do you understand how far from the mainstream of civilization Afghanistan really is? It is the edge of the world. Papua New Guinea--a literal Stone Age population--was way more affected by World War II than these people were. And it sums up why the Americans are eager to leave in 2021: Afghanistan is harsh deserts with harsh mountains with a harsh population still living at mostly subsistence level and that doesn't mean much to us in our digital world. 

Does it surprise you, then, that it was from this place that the plans for 9/11, the plans to bring down the western global socio-political economic infrastructure were born? It shouldn't--it should be plainly obvious that these were the people most suspicious of the coming global order. Now in 2021, World War II is finally complete. Even the Taliban have cell phones and the internet now. We tried give them the best of what we've got but the Afghan people did not want it, did not need it, did not hunger for Republican Democracy (apparently the Hamilton Mix Tape hasn't made it to Kabul yet). The technology, though, has been forced on them and they will keep it now whether they want to or not. 

In the long run, I think, the big move signaled by the American exit from Kabul is that the Americans want war through the drones, special forces, and spies, rather than regular army positions. The USA has decided to remove itself from the 21st century ground war. Currency wars, tariff wars, bond market manipulation, the endless elbowing for market share, shit talkin' politicians and (ugh!) the 24-hour propaganda machine....those are the mechanisms of future conflicts. Fewer deaths but virtually endless angst...is that better? Wars have become just too damn expensive. And rather pointless, even when they end in victory! Drone strikes have limited value in an actual war, they are much more useful as interrupters of peace than as instruments of war. 

Okay....you ready for the crazy prediction? I bet this will be a golden age for Afghanistan; don't get me wrong, it probably won't look like one to American eyes (and all we'll get is the bad news), but the Taliban are the natural leaders of that territory. The "improvements" the Americans had to offer (bicameral legislation! Judicial oversight! Citizen control of the military!) are not really all that sexy to people that will mostly never learn to drive a car. But the Americans leaving is likely something they almost all agree on. 

And I'll bet they've got a line of financing already open (w/ either China, India or some of the Gulf States (****) or all of the above). I bet their statecraft is going to be a lot more modern than it was in 2001 and a lot more sensitive to the media and int'l diplomacy. I think they've actually got a nice shot at working India and Pakistan against each other, at least for defense purposes. Slowly but surely, even Afghanistan will crawl into the light of civilization and central Asia will become an actual homeland rather than just a place for space agencies to test their Mars rovers (*****). In short, now that the Americans have come and gone, Kabul is as connected as it has ever been with as much opportunity for advancement as it has ever had. The Americans turned the lights on and then got out of the way--frankly this is one of the great days in their long history. I think this could be the ultimate unifying experience of the Afghan people.

As for the Americans, I assure you nobody will look back 6 months from now and wish that we were still in Afghanistan. Nobody. If the Pentagon doesn't want it, then you know nobody wants it. The Afghans are better without us and we are better out of their territory. The Taliban are back in charge and they know better than anyone how ruinously annoying the American military can be...and how quickly (and capriciously) it can return.

I think getting out of Afghanistan is a momentous move, a brilliant move and the right move. And President Biden should be applauded for it. Of course, we're not going to do that because we prefer "optics" to "reality". And if you don't like it, let me suggest that 20 years in Afghanistan is perfect example of how gov't programs work: made sense at first, endured setbacks, had some success, lingered because no one knew how to get rid of it, then brought nothing but calamity to the guy with enough courage to actually pull the plug on it. This is what the American gov't has been doing to Americans for decades. 

The Afghans have finally had their taste of civilization. Yup....just like chicken. 

(*) This may well be apocryphal and I may well be remembering it wrong, because I can't recall which tell-all book by which author this came from. But the story goes: Trump said to the Pentagon, I want out of Afghanistan, how do we get that done? The Pentagon says come back in six months. So six months later Trump calls a press conference and announces we're completely pulling out of Afghanistan. The Pentagon says, whoa! What was that? Trump says, you said six months. The Pentagon says, no, that meant come back in six months and we'll start talking about it. Your announcement means nothing because we're not prepared to do anything any time soon. 

To me, the story illustrates the difference btw running a company and running a gov't: when CEO Trump brought in some mid-level flunky for some project, Trump knew how to treat the guy and what to expect and then how to reward or punish him in conclusion. But just because the POTUS tells the Pentagon to do something...yeah, that doesn't really mean much. The Pentagon is willing to work with the Executive, but the Defense apparatus of the USA is much larger than any one office could control, which is why the Pentagon is an ongoing concern while any given POTUS is guaranteed to be gone in 8 years. The fact that the Americans left suggests the Pentagon didn't want Afghanistan enough to fight for it (in Congressional sub-committees, I mean, not Afghan battlefields).

(**) Iceland's wartime dealings with the American Navy warped their social economy well into the 1960s, a clear and direct outgrowth of World War II.

Yes, the USSR's 1979 invasion of Afghanistan had Cold War implications, which itself was an outgrowth of WWII, but it isn't hard to imagine Russia in the 1970s blundering its way through Central Asia with or without WWII or the Cold War. 

(***) Me. The whole point of this blog is to go from the top of my head without any research. Research is fine but I've been researching these things my whole life, the point is to not distill all my knowledge for all time into one post, but rather to spit out what I think I know at any given moment. But with this post for instance, I kept re-starting it, I just kept writing the same shit over and over, such that the editing process was more of deleting rather than re-organizing. And instead of posting this in a timely manner (this was more or less done a month ago), I let it linger to a point where it barely seems relevant any more. Oh well, I can console myself that this post was never relevant and never will be, so what difference does it make when it goes up? 

(****) Did you notice that Ghani (and his helicopter of money) made it to the UAE? I dunno, man, I figured the UAE was the Taliban's new creditor, so does that mean Ghani is living in house arrest forever now? Is he a bargaining chip or a gift? Man, Ghani really needed to get to a NATO country, you'd think a helicopter of money would get you to the south of France, but I guess not. 

(*****) That's not really a joke. Seriously, Afghanistan is more a lesson in trying to control the uncontrollable from the other side of the planet. This mission will ultimately be of more use to Elon Musk than to West Point.