The Centers for Disease Control Loses Its Grip

 

I have lived long enough, now, to have seen it again and again. Something goes badly wrong involving a corporation, a university, a religious denomination, or a branch of government, and the executive in charge or a designated minion goes before the press to engage in what is euphemistically called “damage control.” The spokesman does not level with the public. He or she tries to be reassuring and — more often than not — by lying, succeeds in undermining confidence in the institution he or she represents.

This is what is now going on with the Centers for Disease Control. In recent years, this well-respected outfit has branched out, opining in a politically correct manner on one issue after another outside its proper remit. Now it is faced with a matter absolutely central to its responsibilities — actual disease control — and it flips and flops and flounders because the ultimate boss, the President of the United States, cannot bring himself to put limits on contacts between Americans and the citizens of the countries in Africa where there is an Ebola epidemic.

There is only one way to prevent the spread of an epidemic, and that is quarantine. No medical professional with any sense would suggest that we should admit individuals from Liberia to the United States at this time, and no medical professional worth his or her salt would say that we can test for the disease when the prospective visitor arrives at Immigration and Passport Control. Like most diseases, Ebola has an incubation period. Early on, there are no symptoms: none at all. There is no reliable way to tell whether those arriving at our ports of entry have contracted the disease or not. If we do not want it coming here, for a time, we have to keep everyone out who has been in that neck of the woods.

And what are we told by the authorities? That cutting off contact would contribute to the spread of the epidemic. “Just how?” we are entitled to ask. But no explanation is given because, of course, there is none. We were also told that the disease would not come here. And, when it did come here, we were told that it could easily be contained. And, when it was not contained and a medical professional wearing all the proper gear came down with the disease, we were told that he did not follow the protocol.

Perhaps, the medical professional in question really did fail to follow the protocol, though, he apparently has no notion how he fell short. Perhaps, that is it; then again, perhaps not. Honesty would require that the director of the CDC tell the truth — which is, that he does not know how this particular individual contracted Ebola.

But this he cannot say. For that would cause us to worry, and his responsibility, as he and those above him conceive it, is to cover for the President of the United States. In fact, he works for thee and me. Our taxes make it possible for him to draw a paycheck. But this, in company with nearly everyone in the Obama administration, he has somehow forgotten; and so, in a servile fashion, he goes out in public to defend with forked tongue a policy he and every medical professional in the country knows is madness.

The truth is simple. There is an epidemic in Africa. The disease that is spreading like wildfire is horrible beyond imagination. We have suspicions as to how it spreads, but we do not know for sure. The only certain way to avoid its propagation is to avoid contact, and the President of the United States, who operates in an intellectual bubble, is unwilling to do what it is necessary to do to prevent people in the country he is sworn to serve and defend from coming into contact with contagious individuals who have the disease.

It is the duty of public servants, such as the Director of the CDC, to speak the truth in public. We are, after all, a self-governing people, and we ought not to be treated as little children who need to be reassured even when the news is anything but reassuring. But speaking the truth in all frankness and admitting ignorance seems beyond this man. Were he to do so, were he in public to say what every competent medical professional understands — that to prevent this plague from coming to North America we need to refuse for a time to accept visitors from much of Africa — he would no doubt be cashiered by the man whom, at the ballot box, we put in charge. And being cashiered he fears far more than deserving to be cashiered.

There was a time — I remember that time — when public officials and even political appointees resigned when called upon to carry out a policy they sincerely thought to be contrary to the interests of the American people. There was a time when public servants had a powerful sense of their own dignity and conducted themselves in a manner suited to free human beings. But that time appears to have passed — and those who hold high office act today as if they were the President’s slaves.

What a country we have become! We have journalists who prostitute themselves for a political party. We have civil servants who will gaily break the law for partisan purposes. We have cabinet members who do not believe in the policies they are called upon to implement, but who do not resign. We have an Attorney General who thinks that the obstruction of justice is his job. And we have a Congress unwilling to call anyone to account.

I fear for my country.

Image Credit: “CDC Headquarters PHIL 10693” by James Gathany, Centers for Disease Control and Prevention – http://www.cdc.gov/media/subtopic/library/building.htm. Licensed under Public domain via Wikimedia Commons.

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  1. Metalheaddoc Member
    Metalheaddoc
    @Metalheaddoc

    Re: the Texas health care worker. I hate that the first response was to blame the victim. She must have broken protocol because we (CDC) can’t be wrong about Ebola transmission methods.

    Also, the CDC has failed to investigate the outbreak of Enterovirus D68. They are afraid to place the blame on the  influx of Central American children.

    “Heckuva job, Brownie”

    • #1
  2. Seawriter Contributor
    Seawriter
    @Seawriter

    It is the duty of public servants to speak the truth in public? Good luck with that.

    For almost as long as I can remember, public servants have behaved as if their primary duty was to remain employed at their public sector job long enough to receive a full retirement, preferably one that is maxed out.  Speaking the truth in public could jeopardize that.

    Seawriter

    • #2
  3. Kozak Member
    Kozak
    @Kozak

    “I think the fact that we don’t know of a breach in protocol is concerning, because clearly there was a breach in protocol. We have the ability to prevent a spread in Ebola,”

    Dr Frieden’s statement yesterday about the nurse infected with Ebola is about as perfect an example of circular logic and hubris we may ever see.

    • #3
  4. Bryan G. Stephens Thatcher
    Bryan G. Stephens
    @BryanGStephens

    I too fear for my country. It appears that everything that conservatives have feared is coming to pass. And yet, the American people do not care. There is no calls to remove the boob from office. Ebola can spread across the nation like wildfire, and no one will blame Obama, no one will blame the Democrats.

    It appears that there is no amount of destruction that the Democrats can do that the American people care about to blame them for it. And there is nothing wrong they do that the Republicans will jump on at attack them with it.

    And they want my money for the next race? We have had the House since 2010 and done nothing with it. What good is the Senate? What good is the White House?

    Nothing will stop our run into bankruptcy. I do not see any way for this nation to recover. How do we get from here to anything other than looking like a banana Republic?

    • #4
  5. ctlaw Coolidge
    ctlaw
    @ctlaw

    Metalheaddoc: “Heckuva job, Brownie”

    I see you and raise you a “… as horrific as this tragedy was, if our diversity becomes a casualty, I think that’s worse.”

    • #5
  6. Instugator Thatcher
    Instugator
    @Instugator

    I saw a little item on Instapundit which points to the last time the US government ignored public health with regard to infectious disease and gifted the world with Spanish Flu in 1918. Hint: Spanish flu originated in Kansas. More people died worldwide in that outbreak than were killed in WW1.

    http://nationalinterest.org/feature/obamas-great-big-ebola-error-11450

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC340389/

    • #6
  7. user_836033 Member
    user_836033
    @WBob

    Everyone dances around the real question.  No reporter thought to ask if the protective suits the caregivers wear are pressurized. Maybe everyone already knows they aren’t but it should still have been asked to make sure.  The refusal to stop flights from West Africa is inexplicable.  There’s no downside to doing so, including political downside, other than a relatively small number of people being inconvenienced.  Maybe Obama is just stupid.

    • #7
  8. Paul A. Rahe Member
    Paul A. Rahe
    @PaulARahe

    Bob W:Everyone dances around the real question. No reporter thought to ask if the protective suits the caregivers wear are pressurized. Maybe everyone already knows they aren’t but it should still have been asked to make sure. The refusal to stop flights from West Africa is inexplicable. There’s no downside to doing so, including political downside, other than a relatively small number of people being inconvenienced. Maybe Obama is just stupid.

    I suspect two things. First, that it has to do with race. And, second, that he thinks it wrong to prefer our safety to that of the people in Africa. Among liberals today, there is a deep hostility to the nation state with its single-minded focus on the well-being of a single people.

    • #8
  9. hawk@haakondahl.com Member
    hawk@haakondahl.com
    @BallDiamondBall

    So accept for argument’s sake that chartered federal agencies are executing political policy instead of, and often at odds with their chartered goals.  Fine.  It is worth it to discern the political goals, and specifically, the mid-range goals from the actions.  Obama “…cannot bring himself to put limits on contacts between Americans and the citizens of the countries…” and this fragment stands on its own.  What limit on contact are we allowed to maintain, other than being driven apart from allies?

    If there is a principle which informs this administration’s well-evidenced goal of erasing America’s “limits to contact”, that is, our borders and our security (as well as health) protocols, it can hardly be beyond the pale to make educated guesses about the name of that principle.

    If that principle, once named, can be shown to militate against the continued Constitutional functioning of the federal bureaucracy, isn’t there a case to be made?  Why does nobody force the question: How are your actions Constitutional if this_____ is your apparent goal?  If that is not your goal, then what is the purpose behind these ___, ___, and ___ actions?  How are those actions within the mandate of these ___ agencies?

    Why have we seen six years of Darrell Issa’s oversight theater and not one single result?  I’m done waiting for someday.  Their ammo makes great fireworks, but nothing is ever fired for effect.  Some on the committee are very impressive, and constitute the core of whom I consider worth a darn in DC.  But despite some great TV moments, there has been no effect other than a few cosmetic resignations.  Lois Lerner was replaced by a sturdier character who is just as implacably opposed to oversight and the rule of law.  Every once in a while some morsel is torn free.  For this we needed six years of supposedly rigorous oversight?

    There’s the possibility that oversight pressure played in Holder’s resignation.  but that is a fact not in evidence, and I have a backpack full of such hopes and promises.  At the end of the march, they always turn out to be rocks.

    As long as we do not force the question, then the easily predictable collapses of existing orders and therefore “necessary” implementation of new programs and systems is allowed to masquerade as a merely unfortunate series of events, rather than a diabolical plan hatched by Communists.  So sorry that ObamaCare thing didn’t work out, and now there are no insurance companies.  Well, on to single payer then.

    It is not as though these people have been quiet or even reluctant to publish their aims, their methods, and their phase lines.  Why does our party generate no effective challenge to this treason by name?  What good is such gentility when it buys us tyranny?  Are we so enamored of good manners that we would rather die politely than live forcefully?

    Shall this society continue?  Shall it perish from the earth?  To be, or not to be?

    If we are not now at the point where these are the questions before us, when would that be?

    • #9
  10. DrewInWisconsin Member
    DrewInWisconsin
    @DrewInWisconsin

    The CDC needs to change its name to CYA.

    • #10
  11. user_836033 Member
    user_836033
    @WBob

    Paul A. Rahe:

    Bob W:Everyone dances around the real question. No reporter thought to ask if the protective suits the caregivers wear are pressurized. Maybe everyone already knows they aren’t but it should still have been asked to make sure. The refusal to stop flights from West Africa is inexplicable. There’s no downside to doing so, including political downside, other than a relatively small number of people being inconvenienced. Maybe Obama is just stupid.

    I suspect two things. First, that it has to do with race. And, second, that he thinks it wrong to prefer our safety to that of the people in Africa. Among liberals today, there is a deep hostility to the nation state with its single-minded focus on the well-being of a single people.

    You are probably right.  But in people who are even partly sane and worry for their own survival, such irrational motives are luxuries that go out the window when the crap hits the fan.  I guess not with Obama.  It certainly doesn’t help Africa if the disease spreads here.  The Constitution requires presidents to be native born to make sure they don’t have loyalties that could conflict with their job. In Obama’s case, it appears it wasn’t enough; his father being from Africa seems to have created the same conflict of interest.   I hope that this doesn’t get any worse and cause him to bear a legacy 100 times worse than hurricane Katrina.

    • #11
  12. Tuck Inactive
    Tuck
    @Tuck

    Metalheaddoc: I hate that the first response was to blame the victim.

    In my experience as a patient, that’s the typical first response.  Especially so when a poor protocol is involved.

    BTW, as a matter of fact, I think the protocol the CDC is using is as good as it’s possible to be.  But any protocol that relies on the human element to be infallible is doomed to fail.  Hence, the wise approach is not to expect the protocol to be faultless: keep infected patients out as much as possible.

    • #12
  13. Tuck Inactive
    Tuck
    @Tuck

    Bryan G. Stephens: no one will blame Obama, no one will blame the Democrats.

    I’d say no Democratic politicians will blame Obama or the Democrats…  That includes liberal journalists, of course.

    • #13
  14. Paul A. Rahe Member
    Paul A. Rahe
    @PaulARahe

    Tuck:

    Bryan G. Stephens: no one will blame Obama, no one will blame the Democrats.

    I’d say no Democratic politicians will blame Obama or the Democrats… That includes liberal journalists, of course.

    The Republicans ought to be hammering Obama for not imposing an international quarantine, and they ought to blast the head of the CDC as well. They would be doing a public service if they did.

    • #14
  15. Paul A. Rahe Member
    Paul A. Rahe
    @PaulARahe

    anonymous:

    Paul A. Rahe: There is an epidemic in Africa. The disease that is spreading like wildfire is horrible beyond imagination. We have suspicions as to how it spreads, but we do not know for sure.

    The last sentence is crucial. It is difficult for this engineer to believe that this outbreak could have continued to grow on an almost perfectly exponential progression if this disease were as difficult to transmit and precautions against transmission were as straightforward as what is being said. (Here is a chart updated to October 8th, 2014, plotted on a semi-logarithmic scale where exponential growth appears as a straight line). Click the chart for both linear and semi-log plots regularly updated.

    Semi-log plot of Ebola cases and deathsNote that research involving the Ebola virus, under the CDC’s own rules, must be performed in a biosafety level 4 (BSL-4) facility. These laboratories require those who enter them to wear positive pressure suits with an independent air supply, multiple showers, ultraviolet light disinfection, multiple airlocks secured so only one can be opened at a time, and decontamination of all air and water entering and leaving the laboratory. As of 2007, there were only 15 BSL-4 laboratories in the United States. Hospitals have no such equipment.

    The CDC is thus in the position of reassuring hospital workers that they will be protected by equipment and protocols which the CDC simultaneously considers grossly inadequate for their own researchers working with the Ebola virus under controlled laboratory conditions.

    The lies told by those engaged in “damage control” almost always involve claiming to know what is not known. Like you, I cannot understand how one can square what we are told about the mode of transmission of this disease with the rate at which this epidemic has grown.

    Could I suggest that you turn this comment into a separate post? More people read the posts than the comments, and what you have to say is vitally important.

    • #15
  16. user_836033 Member
    user_836033
    @WBob

    Is anyone here starting paranoid preparations?  Buying lots of canned food etc?

    • #16
  17. Marion Evans Inactive
    Marion Evans
    @MarionEvans

    Don’t want to seem complacent but the numbers of deaths overseas are still very low (by pandemic standards). And the numbers in the US are still statistically insignificant. I think it is important to separate an objective assessment of the risk from a politically-motivated diatribe, which I regret to say this very much reads like.

    • #17
  18. Ryan M Inactive
    Ryan M
    @RyanM

    Marion Evans:Don’t want to seem complacent but the numbers of deaths overseas are still very low (by pandemic standards). And the numbers in the US are still statistically insignificant. I think it is important to separate an objective assessment of the risk from a politically-motivated diatribe, which I regret to say this very much reads like.

    Perhaps true enough.  But I can say that, for me personally, I find this sort of thing a bit unnerving.  If it was a Republican president, I’d be calling for the same reassurances.  Perhaps we shut down flights from these African countries while committing money and research into combatting the disease.  Honestly, I don’t see any of those things as necessarily partisan.  Conservatives generally want to slow government spending, and liberals generally want to open borders, but I think that these sorts of situations would trump those things.  I’d fully support Obama in a decision to do that, and a good leader (republican OR democrat) would be able to attack the problem head on.  Obama is unwilling and unable to do anything at all.

    • #18
  19. Mendel Inactive
    Mendel
    @Mendel

    anonymous:

    It is difficult for this engineer to believe that this outbreak could have continued to grow on an almost perfectly exponential progression if this disease were as difficult to transmit and precautions against transmission were as straightforward as what is being said.

    Semi-log plot of Ebola cases and deaths

    This chart does not contradict the hypothesis at all.

    First, the fact that Ebola is spreading exponentially says nothing about how it is spreading. Exponential spread simply means that, on average, each patient is giving the virus to more than one other person. In a region with poor healthcare, poor knowledge of basic hygiene, horribly unhygienic burial practices, etc., it is not surprising that even a virus which is “only” spread through direct contact with body fluids could grow exponentially.

    Second, consider the rate of spread in your chart. It displays cumulative cases, meaning that for every person who had been infected at the start of a month, one new person is infected by the end of that same month – not exactly wildfire (not exactly roses either). And indeed, calculations based on these data have suggested that each infected person gives the virus to between one and two others (this is also known as the basic reproductive rate). Note that this figure is much lower than for HIV, which is also transmitted exclusively through body fluids.

    • #19
  20. Mendel Inactive
    Mendel
    @Mendel

    Now for the caveats: certainly the chart is also compatible with other routes of transmission – so it is not positive evidence of body fluids only. Here again, the basic reproductive number is more informative: at a postulated <2, Ebola is fairly hard to get independent of the actual mechanism.

    More importantly: these figures are most likely much lower than the actual number of cases. That fact also says nothing about the route of transmission, but reminds us that we shouldn’t be making any black/white statements about this current outbreak without more information.

    Bottom line: there is still no positive evidence of aerosol or other non-contact Ebola transmission in this epidemic. But given the lack of information, we (including, ahem, our public health authorities) should be taking all reasonable measures to protect anyone who might be at risk.

    • #20
  21. Ryan M Inactive
    Ryan M
    @RyanM

    Mendel:

    First, the fact that Ebola is spreading exponentially says nothing about how it is spreading. Exponential spread simply means that, on average, each patient is giving the virus to more than one other person. In a region with poor healthcare, poor knowledge of basic hygiene, horribly unhygienic burial practices, etc., it is not surprising that even a virus which is “only” spread through direct contact with body fluids could grow exponentially.

    I think this is very interesting.  I haven’t seen any sort of “map” of this thing, but when we talk about how the thing might spread in the United States, I’d be interested in knowing how it does (or does not spread) in Africa itself.  For instance, there are countries where you see a pretty dense impact of Ebola, but other countries – not separated by oceans – where it would maybe seem to stop (hypothetically).  The question is:  why is it seemingly concentrated (if it even is) in certain parts of Africa?  Is it just a matter of time?  Those health practices mentioned above?

    • #21
  22. iWc Coolidge
    iWc
    @iWe

    There was an article on how Firestone in Africa is keeping Ebola out of its factory towns. It seems quite doable with quarantine procedures, etc. But that in turn requires a modicum of competence, and our borders are only good at harassing legitimate people.

    • #22
  23. Paul A. Rahe Member
    Paul A. Rahe
    @PaulARahe

    Marion Evans:Don’t want to seem complacent but the numbers of deaths overseas are still very low (by pandemic standards). And the numbers in the US are still statistically insignificant. I think it is important to separate an objective assessment of the risk from a politically-motivated diatribe, which I regret to say this very much reads like.

    And what pray tell is wrong with what I said here:

    There is only one way to prevent the spread of an epidemic, and that is quarantine. No medical professional with any sense would suggest that we should admit individuals from Liberia to the United States at this time, and no medical professional worth his or her salt would say that we can test for the disease when the prospective visitor arrives at Immigration and Passport Control. Like most diseases, Ebola has an incubation period. Early on, there are no symptoms: none at all. There is no reliable way to tell whether those arriving at our ports of entry have contracted the disease or not. If we do not want it coming here, for a time, we have to keep everyone out who has been in that neck of the woods.

    If I am right about this, then I am right in everything else I said — and the time to head things off is before the numbers become statistically significant. I also suggest that you read anonymous’s comment above — about the difference between the protocols the CDC recommends and those which it follows.

    • #23
  24. Instugator Thatcher
    Instugator
    @Instugator

    anonymous’s comments are spot on. The differences between the acceptable equipment standard for researching Ebola and what the CDC recommends while treating it are stark.

    The issue that Marion ignores is the likely outcome once a person is infected. The CDC’s analogies to HIV is specious; HIV never killed rapidly, while Ebola burns through its host in a matter of weeks.

    Funny how President Obama tells us that you cannot get it by sitting next to someone, yet the Ebola facts on the CDC website (now memory-holed) told people in countries affected to avoid public transportation.

    • #24
  25. AIG Inactive
    AIG
    @AIG

    A bit of an over-exaggeration. A super over exaggeration.

    1 case of Ebola in the US, and now we’re saying the head of the CDC needs to resign, Obama needs to be impeached, our country is doomed, Democrats are to blame etc etc.

    Wait, that doesn’t seem different to every other “conservative” reaction to this administration in the last 6 years. Every day is “we’re all doomed day”.

    Not sure this is a very helpful reaction, or one which is somehow going to get the “voters” to the ract. If anything, it might give the voters another example of over-exaggerated doom-and-gloom scenarios that they “love” so much from conservatives.

    This Ebola outbreak is happening in a region of over 200 million people. 200 million! And there’s about 5,000 cases. Make it 10,000 if you want. It seems even in West Africa, this thing isn’t really spreading like “wildfire”.

    • #25
  26. user_280840 Inactive
    user_280840
    @FredCole

    My own reply is here:

    http://ricochet.com/hysterical-overreaction-to-ebola-is-unhelpful/

    • #26
  27. Paul A. Rahe Member
    Paul A. Rahe
    @PaulARahe

    AIG:A bit of an over-exaggeration. A super over exaggeration.

    1 case of Ebola in the US, and now we’re saying the head of the CDC needs to resign, Obama needs to be impeached, our country is doomed, Democrats are to blame etc etc.

    Wait, that doesn’t seem different to every other “conservative” reaction to this administration in the last 6 years. Every day is “we’re all doomed day”.

    Not sure this is a very helpful reaction, or one which is somehow going to get the “voters” to the ract. If anything, it might give the voters another example of over-exaggerated doom-and-gloom scenarios that they “love” so much from conservatives.

    This Ebola outbreak is happening in a region of over 200 million people. 200 million! And there’s about 5,000 cases. Make it 10,000 if you want. It seems even in West Africa, this thing isn’t really spreading like “wildfire”.

    If I am exaggerating, why is the World Health Organization calling this “the most severe health emergency in modern times?” And if it is a health emergency, why are we not taking steps to prevent it from coming here?

    Either the folks at WHO and the CDC are “super-exaggerating” or the rate of transmission really is worrisome.

    If they are not lying about the seriousness of the situation in Africa, then I am right about the need for a genuine quarantine. In the meantime, a nurse in Dallas who appears to have followed the established protocols is down with the disease.

    • #27
  28. AIG Inactive
    AIG
    @AIG

    Now of course everything that is being said here is contradicted by the previous “we’re all going to die!” exaggeration in 2009 during the H1N1 epidemic. Strangely, Obama did declare a state of emergency then, CDC did step up to the game, and overall an epidemic which 100 years ago may have killed tens of millions, ended up being a footnote in the history books.

    Now if “conservatives” just want to attack Obama and the Democrats etc., this is not the way to do it. If you think this is going to resonate with any voter, you’re probably wrong. After 6 years of daily “we’re all doomed” narratives from the right, I think most people have become deaf to it.

    • #28
  29. Paul A. Rahe Member
    Paul A. Rahe
    @PaulARahe

    Fred Cole:My own reply is here:

    http://ricochet.com/hysterical-overreaction-to-ebola-is-unhelpful/

    I am not persuaded, Fred. I am not persuaded that we really know how it spreads, and I am not persuaded that we have the facilities to stop the epidemic if it begins in a serious way to spread here. I remember the trouble they had in Toronto with SARS and the fact that it nearly got out of control. Moreover, I do not see how preventing travel to the United States on the part of those who have been to the countries affected will prevent travel from the United States to those countries.

    • #29
  30. AIG Inactive
    AIG
    @AIG

    Paul A. Rahe: If I am exaggerating, why is the World Health Organization calling this “the most severe health emergency in modern times?” And if it is a health emergency, why are we not taking steps to prevent it from coming here? Either the folks at WHO and the CDC are “super-exaggerating” or the rate of transmission really is worrisome. If they are not lying about the seriousness of the situation in Africa, then I am right about the need for a genuine quarantine. In the meantime, a nurse in Dallas who appears to have followed the established protocols is down with the disease.

    1) Because that’s their job. Deal with health emergencies. And nowhere did I say this wasn’t a health emergency…in Africa.

    2) I think I’ll let people who are PhDs in the appropriate fields figure out what sort of quarantines they need, for themselves, than you or me (no offense, but I don’t think you have a PhD in epidemiology. Neither do I)

    3) Nothing is 100% safe or guaranteed. Diseases will spread. For “conservatives” who like to exalt about how “realistic” down “down to earth” we are…we sure do freak out over the fact that somehow, we haven’t figured out a way of reducing the risk of infection to 0%.

    Not very “realistic”.

    That’s still not a reason to call for the resignation of the head of CDC, impeach Obama, blame Democrats. Did I miss any other super-over-exaggerations?

    • #30
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