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Thanks very much for the links, Ms Berlinski. I took a look and found them informative. They don't refute the point that young people have a far lower infection fatality rate than older people. Nor do they refute the point that young people are more likely to be asymptomatic. There's reasonably solid evidence that children are less likely to spread the disease than teenagers and adults. All of these facts explain why a nation with a very young population (like many African nations) has an advantage over nations with aging populations like those in the United States and Europe. It is true that not all nations with young populations (like the Central American countries that you mentioned) are doing well. You are right; there is more to it than age. Mr. Nighswander suggested that the United States has a lot to learn from Ghana. Based on the facts that you've brought out about Central America, it would be more accurate to say that Hondorus has a lot to learn from Ghana.

There's also the fact that when you take similarly situated nations in terms of age, population density, etc., over time you should expect regression to the mean. Germany, which once appeared to be doing so well, now has an infection mortality rate as bad as the United States has ever had. The death rate from Covid-19 in Germany is now approaching that of the United States.

As for Mr. Nighswander's reflection on the narcissism of small differences, right now, the differences between the United States and Europe are not that small. The EU just approved the Pfizer vaccine a few weeks after the vaccine was approved in the United States, Canada and the UK. A few weeks may appear to be a short period of time, but given that thousands of people are dying from Covid-19 every week, there will surely be people who die or become very sick and hospitalized because the bureaucracy in Europe was tardy in approving the vaccine.

I don't know if it's true, but I've read in the New York Times that the only reason the EU finally approved the vaccine is because of pressure from Germany. That really says it all, doesn't it? A cumbersome bureaucracy moved to action only after bullying from the only people in the EU that count-the Germans. That really encapsulates everything wrong with the EU; a cumbersome bureaucracy unable to get out of its own way until the Germans become exercised. No wonder the UK headed out as quickly as it could.

In the longer run Mr. Nighswander will probably end up right because now that Biden has been elected, the differences between Europe and the United States are likely to get smaller and smaller. The longstanding ambition of the Democratic Party has been to make the United States more like Europe. Biden will almost certainly empower the bureaucrats, the self-appointed experts, the professors and the rest of the clerisy. By the time he leaves office in four years the differences between Europe and the United States will probably be very small indeed. Both will be sclerotic, enfeebled and in decline.

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By the way a less advanced but still very important part of the vaccination process, that is the production of the actual syringes is now happening 24 by 7 at one of world's leading syringe manufacturers in Germany. Again not the most advanced or sexiest part of the process but a very important and necessary piece nonetheless.

https://www.bangkokpost.com/world/2038387

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"Biden claims the next century will be an American century. Does he mean it? If Americans truly want it to be—if they want to call the shots—they need to deliver the shots. They must literally provide vaccines to every human being alive, as fast as possible. America must lead..."

This is getting sad. In another forum, I just read a Trump supporter saying, "If the US goes, the world goes", referring to the prospect of a "leftist" Biden-Harris administration.

America has done amazing things, but really needs to deal with the fact that there's plenty of national power and human capital outside its borders. And the more aggressively this narcissistic belief that America *must* be the center of everything is pursued, the fiercer the backlash will be.

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"America has done amazing things, but really needs to deal with the fact that there's plenty of national power and human capital outside its borders." There certainly is. Particularly, there's a remarkable amount of power and capital in countries that do not in any way share American values. If Americans want to be relatively less powerful and influential, that's certainly an option, but they shouldn't imagine the world will be a friendly place for people who, say, are accustomed to freely saying what they think. Will it matter to ordinary Americans? Probably not. They'll just have to get used to the idea they can no longer say things like, "Free Hong Kong." They probably won't miss doing that all that much.

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“ The West will probably set itself on fire before it asks an even more interesting question: What might it learn from Africa? Ghana has recorded 326 deaths from Covid-19. It’s entirely possible this is an undercount, but the lack of curiosity about this statistic in the Western media speaks for itself.” (Jon Nighswander)

There’s no lack of curiosity. Mortality from Covid-19 increases with age. The median age of Africans is approximately 20. The median age of the EU is more than double that. The median age of Americans approves 40. Not only is testing far less available in Africa, there is far less motivation to be tested. Asymptomatic Covid-19 is far more prevalent in young people than in older people. The African experience with Covid-19 has nothing to teach the west. It can be entirely accounted for by demographic differences.

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It can't, actually. If that were true, we'd be seeing similarly low mortality rates in Guatemala, Haiti, and Honduras. Honduras alone: 1.69 million deaths. Though I've never been to Ghana, I was in Mauritania at the beginning of the pandemic. I saw considerable evidence that public health policy in Africa played a role in these outcome. Exactly as all of Europe and the US was reassuring itself this was all a big panic and laughing at everyone who was freaking out (that includes me, by the way), I flew into and out of Nouakchott by way of Casablanca. No one in Morocco was taking it any more seriously than I was. Mauritania, however, was deadly serious in its response. When I arrived, I faced a detailed questionnaire about where I'd travelled. Every official was in masks and gloves. There were temperature checks. (We now know these are ineffective because of the long latency period during which asymptomatic transmission is possible; we didn't, then.) Above all: Mauritania was able to test anyone who wanted it. They could do this *months* before the United States could. When someone I know there who works for the UN asked the Mauritania's doctors (who had shown up on his doorstep) how they were able to test--and contact trace--the hell out of any kid with a sniffle, even as the mighty United States couldn't, they sighed and said, “Africa has more experience.” President Nana Akufo-Addo gave this speech on March 11: https://www.facebook.com/watch/?v=1545190148972473. Watch it through. Now, imagine Trump had given the same speech on the same day. Would the outcome have been different? It's impossible to say. But I note that what he *did* say, on Twitter, was this: "The Fake News Media and their partner, the Democrat Party, is doing everything within its semi-considerable power (it used to be greater!) to inflame the CoronaVirus situation, far beyond what the facts would warrant. Surgeon General, 'The risk is low to the average American.'”

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Well worth your time, too: "Why COVID-19 is Not Raging in the Central African Republic: https://www.globaldispatchespodcast.com/why-covid-19-is-not-raging-in-the-central-african-republic/." A great irony is that one reason Africa has done so well is that the CDC trained its epidemiologists--and trained them well.

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As for the lack of curiosity? I think Jon may safely rest his case.

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It’s actually worse than Mr. Nighswander thinks. While it is true that a small German biotech assisted Pfizer in the development of its mRNA vaccine, the other vaccines developed by European pharmaceutical firms have failed, at least so far. The Sanofi (France) protein based vaccine developed in partnership with GSK (British) flopped and needs to be reformulated. The AstraZeneca (British/Swiss) adeno-virus vector vaccine is of questionable efficacy (and safety) because of a botched Phase III clinical trial. These European firms look like the keystone cops in comparison with their American counterparts.

Then there’s the fact that the EU still (as of 12/18/2020 1400 eastern standard time) hasn’t approved a vaccine. Tens of thousands of doses have already been administered in the United States, Canada and Great Britain. Europe’s sclerotic vaccine approval process is the perfect metaphor for Europe’s regulatory environment in general.

If the choice is between European elites or American populists, you would have to be daft to cast your lot with Europe.

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I want to make clear "I" did not initiate turning vaccine development into a cultural war battle but now that the battle has been started "I" intend to win it unconditionally so I must make some additional points. The first is the CEO of Moderna recently gave a local press interview here in Boston stating there was no place else in the United States where he believed that Moderna could have located itself and successfully developed their vaccine which is kind of interesting from a right wing Trumpist standpoint. Massachusetts in areas of state/local control has a very sclerotic almost European level regulatory process. In fact I have already purposely "trolled" Trumpists on Twitter asking why you would take a vaccine made by a company that was so "stupid" to locate itself in such a sclerotic location of Cambridge, MA instead of a more free-wheeling low tax low regulation place like Austin, TX or Miami, FL. In fact there is a big movement by some high profile Trump supporting techno-libertarian venture capitalists close to Peter Thiel on Twitter to push startup companies to locate in places like Austin and Miami instead of "socialist" enclaves like San Francisco and Cambridge. So again how "stupid" could Moderna be and why would you take a vaccine from such a "stupid" company. Yes I know this is very dangerous gaslighting and trolling but I can't help myself.

Second the French CEO of Moderna despite seeming to be an American immigrant success story chooses to live in all places the City of Boston neighborhood of Beacon Hill in addition to still having a house in the French Rivera. If you know anything about Beacon Hill it is probably the most European most elitist zip code in the entire friggin United States. No one whose heart truly bleeds Red, White, and Blue would dare to live in Beacon Hill like John Kerry. See picture below for those who don't know what Beacon Hill looks like.

https://cdn10.bostonmagazine.com/wp-content/uploads/sites/2/2017/02/acorn-st-beacon-hill.jpg

Again I return to the point in the original article which states German anti Americanism is often an excuse to play favorites among Americans often supporting Democrat voting and blue state residing(like people in Massachusetts) over "other" Americans while making the point of the vaccines being great "American" success stories despite almost all of the development and manufacturing occurring in blue state, Democratic voting areas most of which are all in Massachusetts and New Hampshire(Lonza's manufacturing site in Democratic voting Portsmouth, NH which ranks up with Beacon Hill for being the most European place in America). See picture of Portsmouth, NH below too if you have never been to Portsmouth.

https://i0.wp.com/www.lucismorsels.com/wp-content/uploads/2018/11/Portsmouth-NH-Things-to-Do-Travel-Guide.jpg?resize=1024%2C683&ssl=1

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BTW, Astra-Zeneca is a British-Swedish company two of the poorest performing countries in Europe.

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I would say it is more like Pfizer assisted BioNTech just as Lonza of Switzerland assisted Moderna with manufacturing. I think I figured out Mr. Nighswander's rationale for the article which is that many people in Massachusetts(where I live myself) where the "American" parts of the vaccines were developed with rather align with European elites in Switzerland and Germany than American populists in Mississippi. Of course if you think about nationhood in a Bismarckian sense this is very very bad. You want people in Massachusetts to feel kinship with Mississippi ahead of Switzerland and Germany which I can tell you at this moment as a Massachusetts resident many people here do not. I would say however Bismarckian nationalism is hardly Cosmopolitan Globalism.

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Actually, the major reason Moderna is located in the Boston area is that it was co-founded by Bob Langer, a world famous bioengineer who has been on the faculty of MIT since the early 1980s. Langer owns the patents on the lipid biomaterial that encapsulates the mRNA which would otherwise not survive its trek into muscle cells. Langer is now a billionaire and his employer, MIT will be making tens of millions in royalties off the Moderna vaccine as well. Langer also benefits because the Pfizer vaccine relies on some of his patents.

The United States is massively subsidizing most of the Covid-19 vaccines and, as usual, the Europeans (and much of Asia) is getting their usual free ride. The Moderna vaccine relies on technology developed by the intramural division of NIH, specifically NIAID (Tony Fauci’s Institute). It’s the American tax payer who footed that bill. Moreover, prior to the Phase I studies, NIAID performed the primate studies which provided proof of concept data that facilitated the early trials. They did this not only for the mRNA vaccines (Pfizer and Moderna) but for the adeno-virus vaccines (Johnson & Johnson and AstraZeneca). Again this was all paid for by the American tax payer.

While Pfizer didn’t take Trump’s Warp Speed money many of the other vaccine developers did. It cost the American tax payers billions but of course it was billions well spent. The EU contributed little or nothing to all of this but, of course, EU citizens will reap the benefit without ever acknowledging that they (as usual) contributed next to nothing while the Americans contributed billions.

There’s nothing new here; when it comes to biomedical research and drug discovery, the Europeans are takers while the Americans are makers. Virtually all R&D in the pharmaceutical space is paid for by Americans. This is true for Europeans pharmaceutical firms as well as American firms.

But for the Americans, new drug discovery would grind to a halt.

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10.1 million EU doses have been exported to UK and US. This was *idiotic.* In an emergency, you save your own, first. Nonetheless, it can't really be said the Europeans are "the takers." They spent about a third as much as we did on Warp Speed, which was also idiotic, but note that the vaccines that have performed best weren't funded by Warp Speed. What that money *really* bought us was first access to the drugs. We got what we paid for.

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I really didn't want to get into the whole issue of who pays what for whom for prescription drugs in part as I don't really have good data in front of me however, I can't resist because it is an opportunity for me to link to those "jingly" mutuel ads so common on French TV so I will give my basic ballpark description. The UK NHS is perhaps the worst notwithstanding Margaret Thatcher's legacy for controlling the prices of drugs however, the US government for conscious political and geostrategic reasons(reasons I personally disagree with) to single out the NHS for price controls and instead the criticism is more nebulously made of "Europe" generally. In terms of how drugs are priced in other European countries say like France, Germany, and Switzerland the only accurate answer is it depends. My understanding is for example in some cases some private "mutuel" plans in France like MAAF and MMA for example pay almost the same as private insurance in the US does when the drugmaker has chosen not to enter into a bulk sales agreement with the French govt. Of course this means for example the drug in question will be unavailable to that percentage of the French population without a "mutuel." Mutuels are of course the "private" element of French Healthcare system with there "jingly" direct to consumer TV ads.

https://www.youtube.com/watch?v=LnwYlcYLUiI

https://www.youtube.com/watch?v=eJ_6qIseFXc

French GP's also massively overprescribe so drugmakers can make up lost revenue that way too. I am curious though what left wing Americans who criticize US drug and HMO companies for spending too much money on direct to consumer advertising think about all the money being spent by the French healthcare industry on these Austin Powers/James Bond parody ads.

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It seems to me you are completely dismissing the role of BioNTech and CureVac which did take German and EU taxpayer money. The real moral of the story seems to be that the companies that had success tended to be smaller and innovative like Moderna and BioNTech while the "larger" companies like AstraZeneca who tried to develop vaccines in-house were far less successful. For a large drug company Pfizer's approach of partnering with a smaller firm like BioNTech seems to be working out well.

In terms of whose taxpayers money funding what as a Massachusetts taxpayer I would much rather the Federal government return the "excess" taxes they collect from MA residents to projects in MA like Moderna's research rather than squander them on pork-barrel projects in Mississippi. At this point I am more concerned with Massachusetts getting back the excess funds it gives to the US Federal govt than any "spillover" and free riding by other countries. If the means to do that is for the US Federal govt to spend even more on drug discovery IN Massachusetts well that is fine by me.

BTW, I thought this publication was supposed to be the Cosmopolitan Globalist not the Michael Lind, Walter Russell Mead, and Oren Cass American "Nationalist"

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The biggest problem with your analogy is that BioNTech is a German company and BTW, I know many Americans who badly wish at some level it was not as life's morality tales would be so much easier to explain. I am not all however, downplaying the role different American individuals and organization have had in vaccine development including some just a stone's throw from where I live in Massachusetts just pointing out an obvious omission.

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A question I have is why is it so necessary to downplay the German(and Swiss through Lonza Pharmaceuticals who helped Moderna a lot)roles in this. I feel like this was not just a mere oversight by the Cosmopolitan Globalist but a conscious effort of trying to fit a square peg of a morality tale into a round hole but why is this so necessary? What makes the Germany/Swiss role so indefensible. Does it somehow make the vaccines worse or make people not want to take them? Is there an assumption people will read this article and not bother to do more research into the origins of the vaccines?

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I think focusing on the German vaccine is missing the point?

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I agree in the sense that describing it as an American vaccine is also missing the point. The vaccines plural are both the result of open collaboration between open societies such as the United States, Germany, Switzerland, and Belgium in comparison to the basically closed nationalistic model of Russian and China.

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It was not really my intention to downplay the German role at all. Part of the issue is that I am coming from a European perspective where everything American is bad and the US is considered a total failure on COVID 19 so I probably have gone a little too far in the other direction to overcorrect. It is also the US government that has the most work to do internationally to reclaim its reputation while Germany has generally been perceived as a more or less positive example of a rational approach.

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I guess I was coming from an American perspective where at least in the eyes of some people everything European is bad(and don't doubt there are Americans who think this) and some regions New England in particular, are almost fifth columns for Europe within the United States(a very longstanding view going back almost to 1800). Whereas if you actually look at the role different Europeans in places like Switzerland and German played in developing in vaccine and that the American role was heavily concentrated in almost crypto European parts of the country like Massachusetts and New Hampshire I would hope any rational person would stop believing everything European is bad.

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