quora post from inside quarantined wuhan

Discussion in 'General Discussion' started by Agrul, Feb 2, 2020.

  1. Sear

    Sear TZT Neckbeard Lord

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    It must go beyond just dismissing uncertainty, because we have plenty of certainty now with this virus. Namely that it's not going to go away unless people wear their fucking masks, and you will get it sooner or later. And it has a pretty good chance of killing your grandparents or parents.

    Yet (gestures widely) look at all these fine Americans just going about their day in 2020 as if nothing has changed.

    I think that takes a special kind of selfishness. I don't think the concept of doing something "for the greater good of society" even registers with these people.
     
    Last edited: Jun 30, 2020
  2. Kanmuk_Sealclubber

    Kanmuk_Sealclubber Yes

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    Trump's initial response wasn't that out of step with a lot of the West. He ramped up testing, had quick economic relief, (sort of) deferred to experts.

    Then he reverted back to being the economic/nationalist populist shitter where everything is about freedom and communism and he won't wear a mask because it makes him look weak and he needs to hold rallies and hey here's hydrochlroquine that will save you so go out and have fun and he needs the economy to surge to get reelected and blame China and I disagree with Fauci because I know everything, etc etc.

    Coronavirus is:

    1) Countries that stopped it early
    2) Countries that didn't stop it early, but have stopped it over time.
    3) The US and Sweden (and probably another shithole country or two).

    Trump has unambiguously been garbage the last few months.
     
  3. Agrul

    Agrul TZT Neckbeard Lord

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    He ramped up testing?
     
  4. Sear

    Sear TZT Neckbeard Lord

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    Our collective national apathy to the entire situation disturbs me as much as his actions. It's sad that this is just normal now: allowing a self-absorbed incompetent fool to put our lives at risk so he can play Strongman Cult Leader to his uneducated base.

    Hundreds of Americans die daily because of his actions (or lack thereof), and that's just another news day.
     
  5. Kanmuk_Sealclubber

    Kanmuk_Sealclubber Yes

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    Someone in the US did.
     
  6. Agrul

    Agrul TZT Neckbeard Lord

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    I wasn't challenging the claim, I was just not sure what it was based on, and vaguely remembered the opposite being reported repeatedly

    This Johns Hopkins graph doesn't show testing prior to March (in fact, I think it doesn't show testing prior to mid-March):

    upload_2020-6-30_20-5-20.png

    https://coronavirus.jhu.edu/testing/individual-states

    The first confirmed case/deaths led that by 1-2 months:

    The ongoing COVID-19 pandemic was confirmed to have reached the United States in January 2020. The first confirmed case of local transmission was recorded in January,[8] while the first known deaths happened in February.

    https://en.wikipedia.org/wiki/COVID-19_pandemic_in_the_United_States#Testing

    If March was really the beginning of us testing materially, that seems a very sluggish response to me, but maybe I'm overestimating how quickly competent nations did/can do this

    (Or maybe Johns Hopkins truncated the x-axis for no particular reason)
     

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  7. Agrul

    Agrul TZT Neckbeard Lord

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  8. Kanmuk_Sealclubber

    Kanmuk_Sealclubber Yes

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    You guys had virtually no testing to begin with. But you managed to catch up and surpass much of the west in per capita testing.
     
  9. Agrul

    Agrul TZT Neckbeard Lord

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    That's kind of the opposite of an "initial response" tho

    I am not even sure how much influence Trump has on the testing curve one way or the other, just not sure the description you gave fits
     
  10. AgelessDrifter

    AgelessDrifter TZT Neckbeard Lord

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    [​IMG]
    A faulty reagent in a test kit distributed by the U.S. Centers for Disease Control and Prevention has hampered efforts to find and confirm COVID-19 cases.
    CENTERS FOR DISEASE CONTROL AND PREVENTION
    The United States badly bungled coronavirus testing—but things may soon improve
    By Jon CohenFeb. 28, 2020 , 5:45 PM

    Speed is critical in the response to COVID-19. So why has the United States been so slow in its attempt to develop reliable diagnostic tests and use them widely?

    The World Health Organization (WHO) has shipped testing kits to 57 countries. China had five commercial tests on the market 1 month ago and can now do up to 1.6 million tests a week; South Korea has tested 65,000 people so far. The U. S. Centers for Disease Control and Prevention (CDC), in contrast, has done only 459 tests since the epidemic began. The rollout of a CDC-designed test kit to state and local labs has become a fiasco because it contained a faulty reagent. Labs around the country eager to test more suspected cases—and test them faster—have been unable to do so. No commercial or state labs have the approval to use their own tests.

    In what is already an infamous snafu, CDC initially refused a request to test a patient in Northern California who turned out to be the first probable COVID19 case without known links to an infected person.

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    The problems have led many to doubt that the official tally of 60 confirmed cases in the United States is accurate. “There have been blunders, and there could be an underlying catastrophe that we don’t know about,” says epidemiologist Michael Mina, who helps run a microbiology testing lab at Brigham and Women’s Hospital. “It’s been very complicated and confusing for everyone with almost no clarity being provided by the CDC.”

    The situation may soon improve. State labs and commercial diagnostic developers hope to win approval from the Food and Drug Administration (FDA) for their own tests, and FDA and CDC on Wednesday agreed on a workaround for the faulty CDC kit—which has a problem that is not essential to its proper functioning—so that it can now be used by at least some of the state labs that have it.

    But there’s widespread discontent with the way the system has worked. “The U.S. government has not appropriately prioritized diagnostic tests and supported the laboratory response network to the degree they should have been supported over the years,” says Luciana Borio, who in previous jobs had lead roles in responding to emerging threats at the National Security Council and FDA.

    If a new disease emerges, CDC normally “gets the ball rolling” with diagnostics because it has the expertise and the biosafety laboratories to handle dangerous novel pathogens, says Borio, who now works for In-Q-Tel, a not-for-profit venture capital firm. Typically, there are few confirmed viral samples from patients at the outset, which researchers need to validate their tests, and CDC has the capability to grow the virus for this critical quality assurance step. Once the agency has a working test, that goes out to state labs. Then, in a third phase, commercial labs take over and either produce their own tests or scale-up the CDC one. “I would have hoped to see that third phase by now,” Borio says.

    In the case of SARS-CoV-2, as the virus causing COVID-19 is officially known, CDC’s sluggishness was apparent 1 month ago. On 26 January, the agency held an unusual Sunday teleconference for the media to provide an update about the rapidly growing outbreak. There were then five cases in the United States, but the CDC lab in Atlanta was still the only one in the country able to test for the virus, and it repeatedly had backlogs. Asked why more labs weren’t able to do the tests, Nancy Messonnier, who then was leading CDC’s response, said it was a quality issue. “We hold ourselves to an incredibly high standard of precision in terms of laboratory testing,” Messonnier said. “We wouldn’t want to inadvertently make a mistake in patient care.”

    CDC finally started to send kits to state and local health labs on 5 February. But on 12 February, it revealed that several labs had difficulty validating the test because of a problem with one of the reagents.

    The key problem with the kits is what’s known as a negative control, says Kelly Wroblewski, director of infectious diseases at the Association of Public Health Laboratories (APHL). CDC’s test uses the polymerase chain reaction (PCR) assay to find tiny amounts of the SARS-CoV-2 genome in, say, a nose swab. To make sure a test is working properly, kits also include DNA unrelated to SARS-CoV-2. The assay should not react to this negative control, but the CDC reagents did at many, but not all, state labs. The labs where the negative control failed were not allowed to use the test; they have to continue to send their samples to Atlanta.

    The declaration of a public health emergency … limited the diagnostic capacity of this country. It’s insane.

    Michael Mina, Brigham and Women’s Hospital
    In principle, many hospital and academic labs around the country have the capability to carry out tests themselves. The PCR reaction uses so-called primers, short stretches of DNA, to find viral sequences. The CDC website posts the primers used in its test, and WHO publicly catalogs other primers and protocols, too. Well-equipped state or local labs can use these—or come up with their own—to produce what are known as a “laboratory-developed tests” for in-house use.
    But at the moment, they’re not allowed to do that without FDA approval. When the United States declared the outbreak a public health emergency on 31 January, a bureaucratic process kicked in that requires FDA’s “emergency use approval” for any tests. “The declaration of a public health emergency did exactly what it shouldn’t have. It limited the diagnostic capacity of this country,” Mina says. “It’s insane.”

    On 24 February, APHL asked FDA Commissioner Stephen Hahn for “enforcement discretion” to sidestep the emergency process and allow APHL members labs to use their own tests. On 26 February, Hahn replied that the CDC test could be modified to use just the primers that specifically detect SARS-CoV-2, essentially ignoring the faulty portion of the kits. FDA, in other words, would look the other way to make more widespread testing possible.

    CDC has notified labs of FDA’s decision in a letter, but the agency must still file an emergency use authorization with FDA for the protocol change. Once it does, it won’t take long, Hahn promised in his letter to APHL: “FDA has been able to authorize tests for public health emergencies within as little as 1 day upon receipt of the complete validation.”

    In New York, the State Department of Health has designed its own test based on the CDC protocol and plans to seek emergency use authorization.

    CDC provided an update about the situation in an email but did not respond to Science’s request for an interview with a scientist to discuss the details of the problem. Mina stresses he has great respect for CDC’s competence overall, but says, “There’s no good explanation for what’s going on here.”

    https://www.sciencemag.org/news/202...d-coronavirus-testing-things-may-soon-improve
     
  11. Samassi Abou

    Samassi Abou TZT Abuser

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    The mask thing was the dumbest thing ever. First it was “they don’t work, except, you know, for surgeons,” then it was “they make people touch their face” which is the opposite of what they do, then “people don’t know how to wear them” as if you needed a degree to put them on.

    Then after that the argument switched to “oh, we don’t want people taking stocks that hospital workers might need, so we’re going to lie to you and pretend they don’t work.”

    How about instead of that they do exactly what Taiwan did in February? Requisition enough stocks for medical and essential workers then massively scale up production for the rest of the community? I guess that looks too much like a competent response and people would prefer to lie about masks not working instead.
     
    Utumno and Sear like this.
  12. AgelessDrifter

    AgelessDrifter TZT Neckbeard Lord

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    Flawed COVID-19 antibody tests shipped without FDA review

    A 60 Minutes investigation has found that federal officials knew many COVID-19 antibody testing kits had flaws, but allowed them to enter the U.S. market.
    https://www.cbsnews.com/news/coronavirus-antibody-testing-inaccurate-data-60-minutes-2020-06-28/

    Wyatt Earp, the gunslinger who helped tame the American West, once said, "fast is fine but accuracy is final." The same thing could be said about testing for COVID-19. Back in March, the Food and Drug Administration took the unprecedented step of allowing COVID antibody tests to flood the market without review. The tests were billed as a critical tool to assess where the virus had spread and who might have immunity. But in the government's rush to get more people tested quickly, it may have missed the mark. Over the course of a three-month investigation, 60 Minutes has learned that federal officials knew many of the antibody tests were seriously flawed but continued to allow them to be sold anyway. Now, as Coronavirus surges in parts of the country, that government failure is complicating efforts to know the reach of the Coronavirus.

    Laredo, Texas is a border town on the banks of the Rio Grande River, population 270,000. It was founded in the 1700's as its own country. This spring, as it prepared to fight Covid, Laredo found itself alone on the frontier, again.

    Robert Castañeda: Everybody was looking for supplies. Everybody was having challenges.

    [​IMG]
    Robert Castañeda
    Robert Castañeda, a Laredo resident, owns two emergency clinics in town. He was desperately trying to find kits to test his patients for Covid-19.

    Robert Castañeda: It was maddening, to be honest with you. You go through your normal chain of distributors. Then you start hitting a wall with them. And they tell you that, you know, "We're out." We talked to the local health department. And I spoke to the state health department. I even reached out to FEMA, talked to the FDA. All your avenues of trying to get testing supplies were exhausted.

    He says he went to his Congressman's office for guidance and remarkably, in the waiting room, met a stranger who offered to connect him to a broker with access to antibody tests.

    Sharyn Alfonsi: You must have thought, sitting in that office, and the guy says to you, "Hey, I might be able to help you out." "This is terrific luck."

    Robert Castañeda: Yes, there was a silver lining to that meeting. Exactly right.

    Sharyn Alfonsi: And so tell me about the deal that was placed in front of you about buying this.

    Robert Castañeda: There was a minimum buy. And that minimum buy was 20,000 kits. So that off the bat was half a million dollars to bring them into the city.

    Sharyn Alfonsi: Was there a lotta guidance at that point, at the state level or the federal level, for procuring?

    Robert Castañeda: No. Actually, there was none.

    In March, many communities were competing against each other, and the federal government, to find COVID tests. The Trump administration was under fire.

    President Trump at March 6 press conference: Anybody that needs a test, gets a test. They're there. They have the tests. And the tests are beautiful.

    But that was not true. Because of missteps a month earlier at both the Centers for Disease Control and the Food and Drug Administration, diagnostic tests, which can tell if a person is currently infected with the coronavirus, were in short supply.

    The promise of a new serology, or antibody blood test, that could determine if a person had been exposed to COVID-19 and developed "protective" antibodies was being heralded as the next best thing: a "game-changer" that could get Americans back to work.

    On March 16, in an attempt to get those tests to the public, the FDA took an unusual step. It announced it would allow antibody tests into the U.S. market without FDA review or formal clearance.

    Almost immediately, more than 100 companies offering antibody tests flooded the market. They came from every corner of the world, and none of them were FDA tested.

    Back in Laredo, Robert Castaneda agreed to the broker's deal and bought 20,000 antibody tests from a Chinese manufacturer, Anhui DeepBlue. He agreed to share them with the city of Laredo where Coronavirus cases were spiking.

    Drive-through testing sites were readied around Laredo. The Chinese test kits arrived on March 30, with the fanfare usually reserved for a winning high school football team in Texas.

    Dr. Hector Gonzalez: We were elated-- very happy because now we were going to be able to test.

    [​IMG]
    Dr. Hector Gonzalez
    Dr. Hector Gonzalez was the Director of Health in Laredo for nearly two decades. The city wanted to start testing front line responders as soon as possible. But first, Dr. Gonzalez, weeks away from his retirement, decided to test the accuracy of the antibody tests.

    Dr. Hector Gonzalez: It was supposed to be 95%. All the tests, especially serologies, have to be 95% or better.

    But Dr. Gonzalez found the tests results varied wildly. The tests didn't work well if the person had been recently exposed to the virus. The small sample he tested was only 20% accurate.

    Sharyn Alfonsi: At any point, you're doing these tests, and you're getting back these lousy numbers that the tests don't work. Do you look at each other and go, "Are we crazy? Surely this thing had to work better than this?"

    Dr. Hector Gonzalez: Yes, we said, "Are we-- did we do this right?" and went back through our steps and we were confident that we did things correctly.

    Sharyn Alfonsi: What strikes me about this is that here you are in Laredo, Texas, and you figure it out, but there was no kind of test happening at a federal level. Shouldn't there have been?

    Dr. Hector Gonzalez: Absolutely. But the FDA had never checked them.

    Anhui DeepBlue did not respond to our request for comment. But Laredo officials had reported the bad tests to the feds who came to town to start an investigation and seize all 20,000 tests.

    Sharyn Alfonsi: And you're out a half million dollars?

    Robert Castañeda: We are.

    Sharyn Alfonsi: That hurts.

    Robert Castañeda: It does. It does. The one thing that makes it a little bit easier to swallow is the fact that we tried to do something good for our community.

    Sharyn Alfonsi: Did you feel duped?

    Dr. Hector Gonzalez: Yes, but more disappointed because we had such high hopes to test. We were ready to do public drive-through testing. And now we couldn't. We were on hold.

    Meanwhile, hundreds of thousands of other antibody tests that the FDA also never reviewed continued to be mailed to businesses, clinics and hospitals where they were used to test patients, first line responders, and healthcare workers.

    [​IMG]
    Dr. Alex Marson
    Dr. Alex Marson is an immunology researcher at the University of California, San Francisco. We spoke with him remotely.

    Dr. Alex Marson: I got a text message from a good friend of mine here in the Bay Area, and she showed me pictures of her testing herself on a antibody test that had showed up at her own house. That made me realize that the availability of tests was actually preceding the availability of reliable information on the performance characteristics of these tests.

    So in early March, Dr. Marson and Dr. Patrick Hsu, an assistant professor of bioengineering at UC Berkeley, assembled a team of 50 scientists to do what the FDA had not... test the antibody tests.

    Dr. Alex Marson: We had to gather tests from around the world. We had to set up a lab with rigorous safety standards and ethical standards.

    Dr. Patrick Hsu: We carefully curated a set of blood from positive people, who had tested viral positive, and had been seen in San Francisco hospitals, and negative blood samples, that were taken from well before the COVID-19 outbreak.

    Dr. Alex Marson: So all of this was unfolding extremely rapidly.

    A month later the team published preliminary results on antibody tests from a dozen different companies.

    Sharyn Alfonsi: Did you feel the tests delivered as advertised?

    Dr. Alex Marson: We saw a range, saw that some were closer to what we hoped for and others were farther off.

    Some were way off. The tests are much less accurate when used on a person who was recently exposed to the virus. 20 days after exposure, the tests get better but none are perfect. All but one test delivered so-called false-positives, meaning they mistakenly signaled antibodies in people who did not have them.

    [​IMG]
    Dr. Patrick Hsu
    Dr. Alex Marson: We want to have a test that will tell us, you know, with some reliability, "Have we been infected?" And ideally, "Can we go back into society and be safe?" The truth is we don't yet have that information. The test cannot provide that assurance.

    Dr. Marson says anyone with a positive antibody test should have a second or third test to confirm it. And even then the results should be viewed cautiously because scientists still don't know what antibody levels are required to give immunity or how long it lasts.

    Sharyn Alfonsi: I think a lot of people think if they get this antibody test and they test positive that they are going to have a shield that allows them to enter into the workforce, to go to the grocery store without their mask on. Is that what a positive antibody test means?

    Dr. Alex Marson: I think we cannot safely say that to people yet. We need more scientific data to tell people exactly the characteristics of what protection will look like if at all.

    Others were also raising red flags about antibody tests. On March 26, problems with the tests in Spain were made public. A week later, Britain tossed out $20 million worth of antibody tests because of false results. And days later, the World Health Organization issued more warnings about the test. But the White House continued to sell the idea of antibody tests.

    President Trump at April 17 Briefing: …and support our efforts to get Americans back to work by showing us who might have developed the wonderful, beautiful immunity.

    And the FDA? It still did not change its open-door policy. We asked the FDA why, and they said the decisions were made with a "careful balancing of risks and benefits."

    [​IMG]
    Dr. Margaret Hamburg
    Dr. Margaret Hamburg was the FDA Commissioner for six years during the Obama administration.

    Sharyn Alfonsi: We know that a lot of the European countries were having problems with these antibody tests before we opened up the market. Should we have known that?

    Dr. Margaret Hamburg: I don't think that we took advantage of that to the degree that we could have and should have.

    Sharyn Alfonsi: We know on March 16th the FDA kind of opened up the market for antibody testing without review. Was that a mistake?

    Dr. Margaret Hamburg: I do think that was a mistake because it led to a marketplace that was full of antibody tests of very variable quality, and certainly could not be trusted in terms of their accuracy.

    It took 50 days for the FDA to reverse its course on antibody tests. In May, the agency required developers to apply for emergency authorization and submit data to show their tests worked. But by then it was too late.

    Rep. Raja Krishnamoorthi: Fraudulent tests flooded the market. Hundreds and hundreds of tests taken by hundreds of thousands, if not millions of people.

    [​IMG]
    Rep. Raja Krishnamoorthi
    Democratic Congressman Raja Krishnamoorthi of Illinois is investigating who directed the FDA's hands-off approach.

    Rep. Raja Krishnamoorthi: The FDA was not policing this market. They adopted what's called a self-validation and voluntary compliance system.

    Sharyn Alfonsi: What does that mean, self-validation?

    Rep. Raja Krishnamoorthi: Well, basically they were asking companies to validate that their tests worked. And guess what? Every company said they did.

    Then in late May, nearly three months after the wave of unregulated antibody tests came to the U.S., the FDA started pulling tests off the market. 50 so far. Including the Anhui DeepBlue test that was sold to Laredo.

    Customs agents and Homeland Security investigators now have the difficult task of trying to stop all the banned tests from entering the country. But the flawed antibody tests are still being used and the bad data collected from them is guiding critical decisions about when to reopen communities.

    Rep. Raja Krishnamoorthi: We've never seen anything like this in terms of a policy which is basically an anything goes, Wild West type of approach to regulating a healthcare market. We just haven't seen that.

    Sharyn Alfonsi: I'm sure they would say, "we cut through the red tape. We had to get anything to the market as fast as we could, these are unprecedented times." What's wrong with that argument?

    Rep. Raja Krishnamoorthi: When you open the floodgates to virtually any product being sold by anybody, well, guess what? Schiesters, scam artists, and people who are preying on unsuspecting consumers enter the fray.

    The burden of keeping all those outlaws at bay fell to communities like Laredo, and Dr. Hector Gonzalez.

    Sharyn Alfonsi: If you had not taken that step, if you had not tested these, what could the impact have been to this community?

    Dr. Hector Gonzalez: Oh, devastating. We wouldn't have a true indicator of the level of infection. The public deserves for us to give them something that's valid.

    Produced by Oriana Zill de Granados and Emily Gordon. Broadcast associate, Sheena Samu. Edited by Craig Crawford
     
  13. Agrul

    Agrul TZT Neckbeard Lord

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    i definitely touch my face more wearing a mask

    u sound like you've never worn one pal

    was your Big Mask patrony a lie this entire time
     
  14. Agrul

    Agrul TZT Neckbeard Lord

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    (i mean, when not thinknig about the fact that touching my face will defeat the purpose of wearing one, obviously)
     
  15. Czer

    Czer I'm a poor person. The lambo is my cousin's.

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  16. Kanmuk_Sealclubber

    Kanmuk_Sealclubber Yes

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    "Initial" was maybe a bad word. Early? You and I had this discussion earlier in the thread. I think he was unprepared, but so were a lot of us. I think your country had a decent trajectory in terms of slowing down the curve, ramping up testing, having some form of stimulus (I expected literally zero from America), listening to experts, social distance, etc. It was certainly no worse than a lot of other countries. But around mid-May/June you started to diverge and become and outlier.

    You could have kept going sideways, and reduced death more slowly, where a lot of other countries have dropped off more abruptly:

    Per Capita Deaths.JPG
     
  17. Kanmuk_Sealclubber

    Kanmuk_Sealclubber Yes

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    On a more moral note: I can forgive a lot of Western countries for a bad response. It's not that easy to make these kinds of decisions. A lot was unknown. And lockdowns kill people, too.

    I can also forgive wanting to open up early. I don't have an answer for that risk vs reward equation.

    It's hard to look passed the complete irresponsibility with which that has happened, starting with Trump and Pence. It's minimization of the threat ("It will be over by memorial day", "There will be no second wave"). It's dogshit modelling (they don't wear masks, they don't social distance, etc). It's bragging about failure instead of promising to do better. It's taking away Facui's platform and ending press conferences. There's been no second wave of economic relief for people that actually need it. BUT WE HAVE TO PROTECT THOSE STATUES AT ALL COSTS.

    If you want to open up, fine. Treat the virus seriously. Promote masks. Social distance when possible. Wash your fucking hands. Don't have needless rallies for no reason other than to jerk yourself off. It shouldn't be that hard. But they've had to turn it into a team politics issue like everything else.
     
  18. Grandasaur Egg

    Grandasaur Egg Groor.

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    > It's not that easy to make these kinds of decisions. A lot was unknown. And lockdowns kill people, too.

    I don't think any of that is true.
     
  19. Czer

    Czer I'm a poor person. The lambo is my cousin's.

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  20. Agrul

    Agrul TZT Neckbeard Lord

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    that's not satire? 'bar lives matter' is a thing?