At what point is the only responsible course of action to disband the WHO?

Every time I hear something new about the World Health Organization it seems to just get worse and worse and worse. I'm beginning to think that the only responsible course of action at this point is to shut it down as a public health threat.

It no doubt has a lot of competent people working but it but it's errors and omissions seem at this point entirely inexcusable. Just one of today's additions to the WHO backstory is discovering that back in 2017 the New York Times reported claims and evidence that the man now in charge of the WHO had been responsible for covering up evidence of cholera epidemics as health minister of Ethiopia. And there's there this segment of an interview with RTHK in Hong Kong:

Bruce Aylward was described in February by the CBC as team lead on the WHO-China joint mission on COVID-19. Why is Taiwan of particular relevance here? They warned the WHO of human-to-human transmission in late December ... and the WHO didn't pass the information along:

The timing of that puts it a day after Li Wenliang in Wuhan sent out a warning that authorities in China tried to suppress - i.e. the timing of Taiwan's warning fits the data. The World Health Organization, by contrast, stated two weeks later that preliminary investigations found little evidence of human-to-human transmission.

Then there was the issue of travel bans - again something advised against by the WHO back in January. Now that it at least claims to have gotten things under control in the country - though its claim seems suspicious - even China is banning almost all foreigners from traveling into the country.

Then there's the issue of wet markets where the latest virus seems to have originated - as did the previous SARS virus. Is the WHO calling for those to be shut down and replaced with something more sanitary? Nope. Instead they're merely offering tips for working there1.

And then it comes to the issues of masks, this is what a WHO account still was saying on March 26:

That's not the same tone you'll see if you compare to certain other parts of the world, and it seems that by and large those parts of the world that have adopted universal mask-wearing have had better success dealing with the current problems.

The New York Times article cites a study finding that for the previous SARS virus mask-wearing as an intervention appeared to be more effective protection than washing your hands 10 times a day - though you certainly can (and probably should) do both.

It seems to me that the WHO's guidance re: masks (which is still both the official approach taken by both the CDC and the corresponding government agency in the country where I'm living) is - as described on the British Medical Journal's blog - "confusing".

There don't seem to be enough masks to go around, so you could also that one should safe available masks for those in the healthcare sector and then give secondary priority to those in jobs requiring contact with a lot of different people but that's not generally the argument being made. A previous New York Times article suggesting that this seemed to make authorities appear untrustworthy which might actually fuel hoarding of surgical and N95 masks.

Instead a better idea might be to encourage improvised masks. The Czech Republic has made masks mandatory in public and improvisation wherein people frequently sow their own masks seems to be the course that country has staten. The German Medical Association is also now advising people to wear makeshift masks at all times.

If governments start encouraging mask-wearing then they can also start to point people to ways to make more effective improvised masks. The South China Morning Post has published instructions on how to make masks that performed 80-90% as effectively as surgical masks in testing, for example, and other research exists as to the effectiveness of different materials you could use for homemade mask-making. (Based on additional research it also appears that it's possible to render N95 masks sanitary for reuse without loss of filtering ability but those masks remain harder to come by).

If the mask shortage can be addressed by adoption of improvised masks it may then prove possible to adopt the suggestion found in the article Rational use of face masks in the COVID-19 pandemic which was published a days back in The Lancet Respiratory Medicine:

Perhaps it would also be rational to recommend that people in quarantine wear face masks if they need to leave home for any reason, to prevent potential asymptomatic or presymptomatic transmission. In addition, vulnerable populations, such as older adults and those with underlying medical conditions, should wear face masks if available. Universal use of face masks could be considered if supplies permit.

To move to a point wherein mask-wearing becomes universal again goes against the WHO's recommendations. I'm hoping that the US begins to move towards a change in it's official advice - this Twitter-verified account says that a change in the CDC recommendation on mask wearing will happen within the next ten days. I'd like to see a better source for this but with the 2017-2019 head of the FDA tweeting like this back on March 18th and then saying this on video on a Wall Street Journal twitter account on March 25th I certainly wouldn't be shocked by such a change in advice. Former President Obama also tweeted a link to an article wherein mask-wearing was one of the suggestions made.

Thinking back through all the above, I see the WHO as an organization now headed by a man with a history of covering up epidemics and who seemed to be attempting to cover another up in January. It was that same organization that refused to disseminate the information previously received from Taiwan about human-to-human transmission and has shown itself to be childish in its attempts to avoid discussing Taiwan. Its advice in general in these circumstances appears to have been quite poor in general2 and in some ways possibly even counterproductive.

At what point are the only reasonable courses of action to either disband the WHO entirely, or instead to revoke the membership of the People's Republic of China and grant membership to the Republic of China (i.e. Taiwan) instead? I keep finding myself thinking back to the League of Nations formed following the First World War with the intention of stopping further such conflicts. It failed and then in the wake of the Second World War the United Nations - of which the World Health Organization is a member agency - was formed. What should you do when prominent international organizations seems highly ineffective?

  1. One reason that I don't want to target criticism too heavily on wet markets is that factory farming is another danger area↩︎

  2. I haven't even discussed here the problems in the data distributed by the World Health Organization. You'll find, for example, on Our World In Data, a section of the coronavirus information page entitled "Why we stopped relying on data from the World Health Organization" - they instead use data from the European CDC these days. ↩︎

Random links

Mystery deepens over ex-Interpol chief Meng
Looking at how the WHO has been behaving in China recently, I kept thinking to how they disappeared the then-head of Interpol in country about a year and a half ago. Eventually showed up in government custody and supposedly confessed to corruption charges, though given the country in question I wonder what happened behind the scenes.
Conservative faculty appear to influence their students more than liberal professors do
"When we break that down by political leaning, about the same proportion of students — 29 to 30 percent — say they became more liberal in college, whether or not they felt any pressure from faculty members. By contrast, among students who said they felt political pressure from conservative faculty members “frequently” or “all the time,” a slightly larger proportion did become conservative, compared with those who felt less pressure."
The richest families in Florence in 1427 are still the richest families in Florence\
"these families were able to maintain their wealth through various sieges of Florence, Napoleon’s campaign in Italy, Benito Mussolini’s dictatorship, and two world wars." Less uncommon than you might expect I think.
Dry-Brining Is the Best Way to Brine Meat, Poultry, and More
I do enjoy ways of simplifying cooking without seemingly much - if any - of a negative impact on flavour. "Ah, some people may say here. But if you flavor your brine with delicious things like fruit juices, stock, herbs, spices, sugar, and more, then surely your meat will be more delicious than if you just soaked it in a plain old salt-water solution. Sorry, but nope! As Kenji has shown before in his article on turkey brining, flavor molecules, unlike salt, are for the most part too big to penetrate the cell membranes of a piece of meat; your brine may taste flavorful, but your roast will not." (also discusses issues re: dilution of flavour and difficulty browning)

Will Elizabeth Warren's cluelessness finally end "Latinx"?

I wonder if perhaps with people like Matthew Yglesias1 finally tweeting stuff like this (and publishing a corresponding article in Vox) that perhaps people will finally start to get it.

It's almost certainly a lost cause though. She's emblem of a certain class who seem to think that as long as they yammer about how "inclusive" they are they'll gain the votes of certain demographics - when the people in question have frequently indicated how little they care for certain terms. In the case of Latinx:

We presented our respondents with seven of the most common terms used to describe Latinos and asked them to select the one that best describes them. When it came to “Latinx,” there was near unanimity. Despite its usage by academics and cultural influencers, 98% of Latinos prefer other terms to describe their ethnicity. Only 2% of our respondents said the label accurately describes them, making it the least popular ethnic label among Latinos.

... Some have speculated that “Latinx” resonates with women and Latino youth. We found no evidence of this in our study. While Latinos’ preferences for other labels vary by age, the limited appeal of “Latinx” is consistent across generations and genders.

A suggested rule for inclusive language: the people being included should at a minimum find the term in question not-the-worse-of-all-available-word-choices. I'd imagine that were you to poll American women they'd also vastly prefer "women" to "womxn". I can't help but be bemused by tweets like this:

It's not just Latinos that Warren's cluelessness applies to - see also Elizabeth Warren Has Won Black Activists. She’s Losing the Black Vote..

As the Vox article illustrates with an overview of polling data by demographic, she's basically only the choice of white people with college degrees and those with post-graduate degrees. Or phrased a different way the preferred candidate of an unrepresentative elite who live in a bubble - a phenomena which by and large includes journalists:

  1. Given his political leanings Ross Douthat's earlier Liberalism's Latinx Problem doesn't count in quite the same way. ↩︎

When a virus is a problem trust people who're used to dealing with things viral

I've honestly had a lot better luck learning about this coronavirus from some of the people in the venture capital VC) sector I follow rather than the media. I suspect that VCs are probably at least as well equipped to discuss the sort of phenomena in question than the typical journalist who's been writing about for the last few weeks. Not only are VCs looking for investment opportunities with the possibility of (metaphorically) viral growth a lot of them are also pretty heavily involved in the biotech sector.

It's been kind of interesting to consider the latest change in media focus over the last week weeks - which originally seemed to focus frequently on racism, complaining about the diversity of those involving in addressing it, and frequently downplaying the risk relative to the flu when the flu is a much better understood phenomena than this latest virus (though influenza is definitely still gonna kill a lot of people in any given year).

Now it seems to me that over the past 24-48 hours it's been starting to flip - such that now I've been hearing more about inadequate preparation. There's also been fake news floating around about Trump having imposed drastic funding cuts on the agencies responsible for dealing with a pandemic - to quote An AP fact check column Democrats distort coronavirus readiness:

Trump’s budgets have proposed cuts to public health, only to be overruled by Congress, where there’s strong bipartisan support for agencies such as the CDC and NIH. Instead, financing has increased.

Indeed, the money that government disease detectives first tapped to fight the latest outbreak was a congressional fund created for health emergencies.

Some public health experts say a bigger concern than White House budgets is the steady erosion of a CDC grant program for state and local public health emergency preparedness — the front lines in detecting and battling new disease. But that decline was set in motion by a congressional budget measure that predates Trump.

The above is a story that makes Trump look bad, but it's also not quite the same story that I find I've been hearing. I keep hearing about the important of clear and consistent communication from people but it's not something that I think that Trump is performing much worse on than some of the loudest alternative sources - i.e. the primary opposing party and the media. The element that seems most dangerous (unless it'd get Trump to just shut up for once .. but that'll never happen!): Pence Will Control All Coronavirus Messaging From Health Officials.

Am personally guessing that if there are widespread deaths due to this virus in the US that Trump will be blamed and if there aren't then he'll get the credit (even if he hasn't really done much of anything to deserve it). That's more or less the way politics goes.

Seeing an early indication that a change in treatment strategy in Wuhan may have significantly improved survival rates1 and Israeli claims of almost having a vaccine ready due to already having passed a vaccine for a coincidentally very-similar virus through a lot of trials already. Not quite sure how either of those paths might play out ... and that'd be pretty difficult to gauge at this stage. From the average person's perspective there's not too much that can be done beyond taking precautions of the same sort you might against the flu2 ... and maybe grab a novel to read while you wait.

  1. It's difficult to overstate the low level of confidence here with regards to certain claims like this particular one... just such is what you're stuck working with as better information slowly emerges. ↩︎

  2. Note that this article seems to suggest even if it wouldn't help against this newest virus directly, getting a flu vaccine should reduce overall burden on the healthcare system and also make it easier to identify cases of this new virus. ↩︎


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