I am reading a book of Paul Farmer’s speeches, “To Repair the World: Paul Farmer Speaks to the Next Generation”. Reading Paul Farmer can sometimes be challenging, but what I love about his speeches are that they are relatively short pithy chapters which nicely encapsulate his beliefs about how to make the world a better place, especially regarding health. The Paul Farmer I met in 2002 and the man Tracy Kidder wrote about shine through on these pages. Here’s a little peek at this book. “The Tetanus Speech” he gave at University of Miami Miller School of Medicine, May 15, 2010, reminded me of what it is like to see a case of tetanus, a disease easily prevented by a vaccine that costs pennies. The point of the “tetanus stories”Farmer presented was that the delivery gap is the biggest problem whether we are in Haiti, Burkina Faso (where I served in Peace Corps) or in the US. There are so many gems in this book: I especially like Farmer’s term “weapons of mass salvation (vaccines, diagnostics, drugs)” when he mentions in the same breath in 2004 with a “war waged on the pretext of weapons of mass destruction that in fact did not exist”. He also talks about “building a broader sense of the commons- beyond nationality” to “guarantee our entire species a share of the fruits of scientific progress, regardless of where we happen to be born or to fall ill.” I could go on, but that is enough for now.
Thank you for bringing your wise and intelligent voice to this medium, Timothy. Of course we should be vaccinating the world. Looking forward to the conversations here.
It would signal a meaningful departure from America first. When the right attacks it as 'globalist' etc Biden needs to confront them and make the case for the win-wins that come from international cooperation and contrast it with the lose-lose of vaccine and economic nationalism.
This is an important insight as to what intangible value shifts to eleemosynary inclined and benignant governmental institutions. The U.S. lost some (maybe much) of its nonpareil goodwill during the Trump administration via its unwillingness to materially lead in areas such as climate change, world health, nuclear proliferation prevention, and internet regulation. “Vaccinate the World”, ignoring the obvious T-shirt and bumper sticker sales, is a rallying cry that “should” garner U.S. bipartisan respect and easily generate the the public support (if properly pitched) to cause the referenced $10b allocated COVAX expenditure. The value received in exchange for such a modest and noble act is the ability to start leading in meaningful ways again including, perhaps, in agenda setting. Of course, saving the lives is always the number one goal and, if well managed, will underly future U.S. and worldwide economic success.
“The photograph shows the WHO in action in Bangladesh in 1966.” Ummm - wouldn’t that be East Pakistan in 1966? (March 26 marked the 50th anniversary of their Declaration of Independence in 1971, which was followed by 9 months of civil war and some 3 million deaths.)
“America was a great force in the world with immense prestige long before we became a great military power, that power has come to us and we cannot renounce it, but neither can we afford to forget that the real constructive force in this world comes not from tanks and not from bombs but from the imaginative ideas warm sympathies and a generous spirit other people”-Robert Kennedy
Covid’s threat to our Public Health is a national emergency, and a pandemic is a threat to national and global security and economies. I agree that doesn’t end when the US and Europe is vaccinated. The pandemic also doesn’t end when every US and European citizen is vaccinated. We need to plan to vaccinate the most vulnerable, the undocumented immigrants who live in fear and stay in the shadows, unheard and uncared for, unvaccinated. Unmitigated, the undocumented will remain a domestic reservoir for the virus to continue mutating, this will be used as fodder to continue to attack them, as a “them”. Do we have a vaccination plan fir the undocumented? Do they trust such a plan? I hope so. It is the compassionate act to offer vaccinations to them, and can help build some momentum of compassion into our agencies policies concerning immigration. Then export that compassionate learning by “Securing the border” but not with a foolish wall, during a pandemic “securing”means we help our neighbor Mexico first, and then Central and South America. Many of these countries have not even begun vaccinations. Brazil is reeling with new mutations that will give rise to newer and newer variants. It is a matter of time. I’m not an expert on the Marshal Plan, but my conscience tells me that this is a bigger global challenge than post WW2. As the pandemic is global, airborne transmissible, spreads asymptotically/ stealthy, and more severe mutations are growing, and thus it affects every individual. The pandemic is both WW2 and the Marshal Plan at the same time but still bigger, as it is a condensed timeframe. This global emergency needs to be framed as more urgent. We have reached the Rubicon challenge for global democratic leaders to meet. This is a global transformational moment, the sooner democracies integrate their best and brightest, the sooner the pandemic is over. America can and should lead this effort, and doing so would prove that Democracies can outperform Tyrannies.
You should hook up with Paul Farmer! I met him in 2002 when he gave one of his several talks at NIH. I had Dr. Farmer autograph one of his books that I had brought to his lecture. He is a kind man and when he speaks to you, you are the most important person in the world. Tracy Kidder’s great biography of him says it all: Mountains Beyond Mountains: The Quest of Dr. Paul Farmer, A Man Who Would Cure the World.
Biden offered doses of Astra-Zeneca vaccine to Mexico to get them to help with the Border issues. I thought that was a good idea. Given that Biden has some empathy, he would go for helping to vaccinate the world. I guess we could write directly to the White House?
How would you address vaccinations for foreign countries run by leaders who have shown a disregard for public health and their population, and who are starting to become increasingly unpopular as a result--countries such as Brazil and Mexico, for example. Would you prioritize these countries relatively higher because of the critical healthcare needs, or lower, where the vaccine would serve the interests of regimes that tend to be untruthful, undemocratic, and uncaring and should be exposed for their decisions and punished by their electorate?
How do we encourage the administration to take this plan seriously? We should bypass Congress if possible. Let's put feet on this--it's a great idea, particularly as it applies to Europe where a lot of damage must be undone. Do we all write letters to the White House? What other agencies/actors might have the power to get this started? CDC?
From a retired MD group, posting daily pandemic updates:
Covid-19 Update # 362 March 29, 2021
Just another nadir Monday, low everything in the U.S.
I thought last night, after looking at the new numbers, there would not be much to talk about today. I stayed up late and watched the CNN special that was a post mortem on the U.S. handling of the pandemic. If you can find it, it is worth the 2 hour view.
I found myself very emotional, having it all rehashed made me anxious, and a few tears along the way.
Dr. Gupta interviewed Dr. Birx, Dr. Redfield, Dr. Hahn, Dr. Fauci, and several other major players. I didn't really change my opinion about any of them, I did find myself feeling sorry for Dr. Birx.
The takeaways for me were:
1) China should have let us all know sooner the truth about the virus. They should have let others in to study the virus quickly, not waited a year. They knew early it was spread asymptomatically.
2) The major players all reached a point where they had to draw a line in the sand. They were marginalized, and muzzled.
3) It was clear to me, at the time, that to speak your mind would cost you your job, if it was in conflict with Mr. Trump.
4) If this is a war, and I believe that it is, there were 3 standout war criminals here in the U.S. The worst, Dr. Scott Atlas, second Azar, the head of HHS, Mr. Trump was the third.
5) Lack of testing, the politicization of masking, and vaccine disinformation killed a lot of people, it continues to do so.
As of today, Kansas, Louisiana, North Dakota, Ohio, Oklahoma, and Texas, all became all adult eligible states for vaccine. Minnesota joins tomorrow, Indiana and South Carolina on Wednesday.
I posted a number of links. The most important was the MMWR showing the effectiveness of the mRNA vaccines. This was 4,000 frontline and essential workers, followed for three months. Two doses was 90% effective for all infections, including the asymptomatic. One shot was 80% effective at two weeks. There were 205 positive during the study, 5.2%, 58% were asymptomatic when diagnosed.
Florida has 2,270 cases of the UK strain that have been sequenced. They now have 42 of the dreaded P1 that is killing Brazil.
Biden says 90% of U.S. adults will be eligible for vaccine within the next three weeks.
I listened to the White House response team briefing.
73% of seniors have had at least one dose.
Dr. Walensky quoted the MMWR study. She said cases, hospitalizations, and deaths were all moving up over the past week. She related her feeling of impending doom. She is in the shadow of the fourth wave. She pleads for us all to watch our behavior down the stretch.
Dr. Fauci tried to make it real. He showed CT scans of lungs, and then an infarcted brain, first on the scan, then on the pathology table. The scans he showed were atomic bomb level cases, the kind that make a clinician want to hide when seen.
Worldwide we have given >559 million doses of vaccine in 141 countries. We are averaging roughly 14.5 million doses a day, recently.
Here in the U.S. we have given 145,812,835 doses, 80.7% of distributed. We are averaging 2.757 million doses a day over the past week, 3.28 million yesterday. We have 15.8% fully vaccinated.
I posted a link to % vaccinations of distributed, by state.
#1 Wisconsin 93.74%
#2 New Mexico 91.58
#3 North Dakota 90.89
#4 Minnesota 90.54
#7 New Jersey 86.42
#28 Idaho 80.00
#32 California 79.28
#36 New York 77.90
#38 Florida 75.87
#40 Texas 74.63
I peeked at and shared a link to % positivity by state, and numbers of tests per 100,000.
Idaho once again the worst in the country at 25.5% positive. Thankfully there were only 6 states over 10. We had 16 >3 and <5. We had 12 les than 3. Those 28 under 5 don't need to change. California was the winner at 1.5% positivity, nice work.
Here in the U.S. we have 39,924 in the hospital with the virus, -6%.
We added 45,552 cases +15% to a total of 30,285,400. We added 487 deaths -29% to a total of 548,867.
It is nadir day. Look at percent change numbers and hospitalizations.
New York 8,852 cases +42% and 91 deaths -4%
NYC had 4,659 of these +61% and 77 +6%
Florida 4,943 +12% and 36 -24%
New Jersey 4,505 +21% and 7 -35%, hosp +10%
Texas 3,293 -17% and 51 -34%
Pennsylvania 2,576 +45% and 14 +40%, hosp +9%
California 2,499 -21% and 126 -9%
Illinois 2,175 +43% and 23 -15%, hosp +17%
Massachusetts 1,975 +36% and 29 +9%, hosp +15%
Virginia 1,392 +16% and 20 -81%
Maryland 1,335 +31% and hosp +19%
Minnesota 1,225 +47% and hosp +40%
Ohio 1,019 +11% and hosp +9%
Indiana 944+15% and 12 -35%, hosp +6%
Michigan hosp +99%
Idaho hosp +15%
Washington state hosp +12%
Colorado hosp +3%
The UK remains below the level for me to comment, 2 days in a row. It can be done.
Worldwide we added 495,113 cases +28% to a total of 127,104,000. We added 6,606 deaths +12% to a total of 2,782,000.
India 62,714 cases +109% and 312 deaths +82%
Brazil 44,326 +16% and 1,656 +42%
France 37,014 +57%
Poland 29,266
Turkey 29,081
Italy 19,604 -2% and 297 +27%
Ukraine 18,266
Germany 9,872 +63% and 43 -19%
Philippines 9,450
Hungary 9,082
Peru 8,909
Iran 8,751
Netherlands 7,698
Chile 7,330
Argentina 7,208
Jordan 7,183
Colombia 7,139
Canada 4,321 +40% and 28 -9%
Czechia 4,008
Mexico 1,783 -18% and 194 -13%
The hospitals in Paris are being overwhelmed.
The Philippines is locking down 25 million people.
Brazil still has no national response, reminds me of us last year.
The worldwide numbers tomorrow will be unpleasant.
Stay safe, mask and distance. Take a vaccine as soon as available.
I think Brazil will pass the US in Covid deaths by mid to late May. They don’t have enough vaccines nor vaccinations. They are at 3% mortality and climbing with faster spreading variants with increased virulence. Health care over capacity. Younger people are getting more sick than previous waves. Bolsonaro has been anti mask, anti science and pro Hydroxychloequine. He didn’t buy Pfizer when he could have. It’s bad and it’s going to get so much worse. If one wonders what the US would have looked like with 4 more DT years, just look south to Brazil.
I am reading a book of Paul Farmer’s speeches, “To Repair the World: Paul Farmer Speaks to the Next Generation”. Reading Paul Farmer can sometimes be challenging, but what I love about his speeches are that they are relatively short pithy chapters which nicely encapsulate his beliefs about how to make the world a better place, especially regarding health. The Paul Farmer I met in 2002 and the man Tracy Kidder wrote about shine through on these pages. Here’s a little peek at this book. “The Tetanus Speech” he gave at University of Miami Miller School of Medicine, May 15, 2010, reminded me of what it is like to see a case of tetanus, a disease easily prevented by a vaccine that costs pennies. The point of the “tetanus stories”Farmer presented was that the delivery gap is the biggest problem whether we are in Haiti, Burkina Faso (where I served in Peace Corps) or in the US. There are so many gems in this book: I especially like Farmer’s term “weapons of mass salvation (vaccines, diagnostics, drugs)” when he mentions in the same breath in 2004 with a “war waged on the pretext of weapons of mass destruction that in fact did not exist”. He also talks about “building a broader sense of the commons- beyond nationality” to “guarantee our entire species a share of the fruits of scientific progress, regardless of where we happen to be born or to fall ill.” I could go on, but that is enough for now.
Thank you for bringing your wise and intelligent voice to this medium, Timothy. Of course we should be vaccinating the world. Looking forward to the conversations here.
Shared. So obvious, so brilliant. The Biden Plan.
It would signal a meaningful departure from America first. When the right attacks it as 'globalist' etc Biden needs to confront them and make the case for the win-wins that come from international cooperation and contrast it with the lose-lose of vaccine and economic nationalism.
This is an important insight as to what intangible value shifts to eleemosynary inclined and benignant governmental institutions. The U.S. lost some (maybe much) of its nonpareil goodwill during the Trump administration via its unwillingness to materially lead in areas such as climate change, world health, nuclear proliferation prevention, and internet regulation. “Vaccinate the World”, ignoring the obvious T-shirt and bumper sticker sales, is a rallying cry that “should” garner U.S. bipartisan respect and easily generate the the public support (if properly pitched) to cause the referenced $10b allocated COVAX expenditure. The value received in exchange for such a modest and noble act is the ability to start leading in meaningful ways again including, perhaps, in agenda setting. Of course, saving the lives is always the number one goal and, if well managed, will underly future U.S. and worldwide economic success.
“The photograph shows the WHO in action in Bangladesh in 1966.” Ummm - wouldn’t that be East Pakistan in 1966? (March 26 marked the 50th anniversary of their Declaration of Independence in 1971, which was followed by 9 months of civil war and some 3 million deaths.)
Michael Zorick
Foreign Service Officer (ret), US State Dept
Thank you Professor Snyder.
I'm wondering if anyone in the White House gets to see your writings/ideas or is speaking to you/consulting with you?
I wish they would!
100%!
“America was a great force in the world with immense prestige long before we became a great military power, that power has come to us and we cannot renounce it, but neither can we afford to forget that the real constructive force in this world comes not from tanks and not from bombs but from the imaginative ideas warm sympathies and a generous spirit other people”-Robert Kennedy
Covid’s threat to our Public Health is a national emergency, and a pandemic is a threat to national and global security and economies. I agree that doesn’t end when the US and Europe is vaccinated. The pandemic also doesn’t end when every US and European citizen is vaccinated. We need to plan to vaccinate the most vulnerable, the undocumented immigrants who live in fear and stay in the shadows, unheard and uncared for, unvaccinated. Unmitigated, the undocumented will remain a domestic reservoir for the virus to continue mutating, this will be used as fodder to continue to attack them, as a “them”. Do we have a vaccination plan fir the undocumented? Do they trust such a plan? I hope so. It is the compassionate act to offer vaccinations to them, and can help build some momentum of compassion into our agencies policies concerning immigration. Then export that compassionate learning by “Securing the border” but not with a foolish wall, during a pandemic “securing”means we help our neighbor Mexico first, and then Central and South America. Many of these countries have not even begun vaccinations. Brazil is reeling with new mutations that will give rise to newer and newer variants. It is a matter of time. I’m not an expert on the Marshal Plan, but my conscience tells me that this is a bigger global challenge than post WW2. As the pandemic is global, airborne transmissible, spreads asymptotically/ stealthy, and more severe mutations are growing, and thus it affects every individual. The pandemic is both WW2 and the Marshal Plan at the same time but still bigger, as it is a condensed timeframe. This global emergency needs to be framed as more urgent. We have reached the Rubicon challenge for global democratic leaders to meet. This is a global transformational moment, the sooner democracies integrate their best and brightest, the sooner the pandemic is over. America can and should lead this effort, and doing so would prove that Democracies can outperform Tyrannies.
You should hook up with Paul Farmer! I met him in 2002 when he gave one of his several talks at NIH. I had Dr. Farmer autograph one of his books that I had brought to his lecture. He is a kind man and when he speaks to you, you are the most important person in the world. Tracy Kidder’s great biography of him says it all: Mountains Beyond Mountains: The Quest of Dr. Paul Farmer, A Man Who Would Cure the World.
Biden offered doses of Astra-Zeneca vaccine to Mexico to get them to help with the Border issues. I thought that was a good idea. Given that Biden has some empathy, he would go for helping to vaccinate the world. I guess we could write directly to the White House?
How would you address vaccinations for foreign countries run by leaders who have shown a disregard for public health and their population, and who are starting to become increasingly unpopular as a result--countries such as Brazil and Mexico, for example. Would you prioritize these countries relatively higher because of the critical healthcare needs, or lower, where the vaccine would serve the interests of regimes that tend to be untruthful, undemocratic, and uncaring and should be exposed for their decisions and punished by their electorate?
How do we encourage the administration to take this plan seriously? We should bypass Congress if possible. Let's put feet on this--it's a great idea, particularly as it applies to Europe where a lot of damage must be undone. Do we all write letters to the White House? What other agencies/actors might have the power to get this started? CDC?
“Gayle Smith, a veteran diplomat, has been chosen to serve as coordinator for global COVID-19 response and health security as the U.S. steps up its work to end the pandemic worldwide, Secretary of State Antony Blinken said.”https://www.beckershospitalreview.com/hospital-management-administration/us-names-global-covid-19-coordinator.html?utm_source=facebook&utm_medium=social&fbclid=IwAR1Xfxnv0GOf0HmvHEHls-OAZLK2Uu64UOhXjVzcVvHcEBSTRX8o-p1hPcM
Excellent points, Prof Snyder.
In addition, I would suggest Biden administration should stop US interference with other countries’ efforts to alleviate pandemic.
1. Stop sadistic embargo on Cuba that prevents its ability to send doctors abroad. https://news.yahoo.com/panama-abandons-cuban-doctors-plan-021939811.html
2. Stop pressuring other countries to use Sputnik V vaccine. https://www.google.com/amp/s/www.washingtonpost.com/world/2021/03/16/hhs-brazil-sputnik-russia/%3foutputType=amp
3. Stop vicious financial blockade on Iran that prevents imports of medicines and PPE during pandemic. https://www.fcnl.org/updates/2020-12/us-sanctions-are-preventing-coronavirus-medical-and-relief-supplies-reaching
Those are just from the top of the head.
From a retired MD group, posting daily pandemic updates:
Covid-19 Update # 362 March 29, 2021
Just another nadir Monday, low everything in the U.S.
I thought last night, after looking at the new numbers, there would not be much to talk about today. I stayed up late and watched the CNN special that was a post mortem on the U.S. handling of the pandemic. If you can find it, it is worth the 2 hour view.
I found myself very emotional, having it all rehashed made me anxious, and a few tears along the way.
Dr. Gupta interviewed Dr. Birx, Dr. Redfield, Dr. Hahn, Dr. Fauci, and several other major players. I didn't really change my opinion about any of them, I did find myself feeling sorry for Dr. Birx.
The takeaways for me were:
1) China should have let us all know sooner the truth about the virus. They should have let others in to study the virus quickly, not waited a year. They knew early it was spread asymptomatically.
2) The major players all reached a point where they had to draw a line in the sand. They were marginalized, and muzzled.
3) It was clear to me, at the time, that to speak your mind would cost you your job, if it was in conflict with Mr. Trump.
4) If this is a war, and I believe that it is, there were 3 standout war criminals here in the U.S. The worst, Dr. Scott Atlas, second Azar, the head of HHS, Mr. Trump was the third.
5) Lack of testing, the politicization of masking, and vaccine disinformation killed a lot of people, it continues to do so.
As of today, Kansas, Louisiana, North Dakota, Ohio, Oklahoma, and Texas, all became all adult eligible states for vaccine. Minnesota joins tomorrow, Indiana and South Carolina on Wednesday.
I posted a number of links. The most important was the MMWR showing the effectiveness of the mRNA vaccines. This was 4,000 frontline and essential workers, followed for three months. Two doses was 90% effective for all infections, including the asymptomatic. One shot was 80% effective at two weeks. There were 205 positive during the study, 5.2%, 58% were asymptomatic when diagnosed.
Florida has 2,270 cases of the UK strain that have been sequenced. They now have 42 of the dreaded P1 that is killing Brazil.
Biden says 90% of U.S. adults will be eligible for vaccine within the next three weeks.
I listened to the White House response team briefing.
73% of seniors have had at least one dose.
Dr. Walensky quoted the MMWR study. She said cases, hospitalizations, and deaths were all moving up over the past week. She related her feeling of impending doom. She is in the shadow of the fourth wave. She pleads for us all to watch our behavior down the stretch.
Dr. Fauci tried to make it real. He showed CT scans of lungs, and then an infarcted brain, first on the scan, then on the pathology table. The scans he showed were atomic bomb level cases, the kind that make a clinician want to hide when seen.
Worldwide we have given >559 million doses of vaccine in 141 countries. We are averaging roughly 14.5 million doses a day, recently.
Here in the U.S. we have given 145,812,835 doses, 80.7% of distributed. We are averaging 2.757 million doses a day over the past week, 3.28 million yesterday. We have 15.8% fully vaccinated.
I posted a link to % vaccinations of distributed, by state.
#1 Wisconsin 93.74%
#2 New Mexico 91.58
#3 North Dakota 90.89
#4 Minnesota 90.54
#7 New Jersey 86.42
#28 Idaho 80.00
#32 California 79.28
#36 New York 77.90
#38 Florida 75.87
#40 Texas 74.63
I peeked at and shared a link to % positivity by state, and numbers of tests per 100,000.
Idaho once again the worst in the country at 25.5% positive. Thankfully there were only 6 states over 10. We had 16 >3 and <5. We had 12 les than 3. Those 28 under 5 don't need to change. California was the winner at 1.5% positivity, nice work.
Here in the U.S. we have 39,924 in the hospital with the virus, -6%.
We added 45,552 cases +15% to a total of 30,285,400. We added 487 deaths -29% to a total of 548,867.
It is nadir day. Look at percent change numbers and hospitalizations.
New York 8,852 cases +42% and 91 deaths -4%
NYC had 4,659 of these +61% and 77 +6%
Florida 4,943 +12% and 36 -24%
New Jersey 4,505 +21% and 7 -35%, hosp +10%
Texas 3,293 -17% and 51 -34%
Pennsylvania 2,576 +45% and 14 +40%, hosp +9%
California 2,499 -21% and 126 -9%
Illinois 2,175 +43% and 23 -15%, hosp +17%
Massachusetts 1,975 +36% and 29 +9%, hosp +15%
Virginia 1,392 +16% and 20 -81%
Maryland 1,335 +31% and hosp +19%
Minnesota 1,225 +47% and hosp +40%
Ohio 1,019 +11% and hosp +9%
Indiana 944+15% and 12 -35%, hosp +6%
Michigan hosp +99%
Idaho hosp +15%
Washington state hosp +12%
Colorado hosp +3%
The UK remains below the level for me to comment, 2 days in a row. It can be done.
Worldwide we added 495,113 cases +28% to a total of 127,104,000. We added 6,606 deaths +12% to a total of 2,782,000.
India 62,714 cases +109% and 312 deaths +82%
Brazil 44,326 +16% and 1,656 +42%
France 37,014 +57%
Poland 29,266
Turkey 29,081
Italy 19,604 -2% and 297 +27%
Ukraine 18,266
Germany 9,872 +63% and 43 -19%
Philippines 9,450
Hungary 9,082
Peru 8,909
Iran 8,751
Netherlands 7,698
Chile 7,330
Argentina 7,208
Jordan 7,183
Colombia 7,139
Canada 4,321 +40% and 28 -9%
Czechia 4,008
Mexico 1,783 -18% and 194 -13%
The hospitals in Paris are being overwhelmed.
The Philippines is locking down 25 million people.
Brazil still has no national response, reminds me of us last year.
The worldwide numbers tomorrow will be unpleasant.
Stay safe, mask and distance. Take a vaccine as soon as available.
M.D. Internal Medicine (retired)
I think Brazil will pass the US in Covid deaths by mid to late May. They don’t have enough vaccines nor vaccinations. They are at 3% mortality and climbing with faster spreading variants with increased virulence. Health care over capacity. Younger people are getting more sick than previous waves. Bolsonaro has been anti mask, anti science and pro Hydroxychloequine. He didn’t buy Pfizer when he could have. It’s bad and it’s going to get so much worse. If one wonders what the US would have looked like with 4 more DT years, just look south to Brazil.
https://www.nytimes.com/2021/03/27/world/americas/virus-brazil-bolsonaro.html?smid=fb-share&fbclid=IwAR18sO31--SC5EtgQI7QTpGtB_Kz8liYNPsGalLIaPcXoaCOtz3C4djRvjc