Here’s the coronavirus death toll through September 29. The raw data from Johns Hopkins is here.

Well. That was quite a show, wasn’t it? I’ve never seen a debate moderator tell a sitting president to shut up even once, let alone over and over. But Chris Wallace did.

Thanks to Donald Trump’s inability to keep his mind on a single subject for more than a few seconds, there was no real arc to this debate. It sort of swerved and veered from one spot to another based on whatever lies and conspiracy theories popped into Trump’s mind at any given moment. But fact checking, as Biden said, is pointless. I suppose a few brave souls will do one, but it almost misses the point. Of course Trump was lying constantly. That’s just part of his persona and everyone knows it. The question is more about the literary quality of his lies, and tonight I’d judge the literary quality pretty low. Trump was obviously trying to deliver a toned-down version of his rally speeches, but that doesn’t work well in a more serious debate format. Being nothing more than an insult machine turns people off on a stage like this.

And what about Trump’s unwillingness to condemn white supremacist groups? And his unwillingness to urge his followers to stay calm after the election? If those get the 24/7 cable news treatment, it could—and should!—do Trump some serious harm.

Biden was OK. He did his best to deal with Trump’s blizzard of lies without being consumed by them, and that’s a tough thing to do. It’s hard to say if Biden managed to get his points across in the face of Trump’s constant interruptions and bizarre attacks, but I think he did. He also successfully managed to present himself as something more than just an insult machine, which should appeal to moderates. He came across as a decent person, which Trump certainly didn’t do.

Trump’s fans will probably be happy with his performance. He hit all the weird right-wing obsessions that they love so much. But Biden fans will also be happy. He did fine and didn’t stumble or backtrack too much. I think Biden might have won a few votes tonight, but overall, as usual, my guess is that this debate changed very few minds.

It’s time for the big debate. Let’s get to it.

10:38 – And that’s a wrap.

10:36 – Trump is all but guaranteeing that if he loses he will take to the streets claiming the election was a fraud.

10:27 – Trump is trying over and over to tie Biden to the “radical left.” I don’t think it’s working, but what do I know?

10:23 – Trump is going hard on the Green New Deal, claiming it will destroy the economy.

10:17 – Trump just can’t help himself. He simply has to get every single insult out.

10:11 – Hillary!

9:55 – Trump says Biden called Black criminals “superpredators” in 1994. That’s not true.

9:50 – Chris Wallace is doing his best to shut Trump up, but no one can shut Trump up.

9:45 – Trump is just a whirlwind of stream of consciousness attacks and insults.

9:43 – Trump says he paid “millions of dollars” in federal income taxes in 2016 and 2017.

9:42 – Trump: “I brought back football.”

9:31 – Trump is now insisting that Biden is stupid. Literally. “Don’t ever use the word smart with me.”

9:20 – Biden: “Will you shut up please.”

9:17 – Biden: “I’m not here to call out his lies. Everybody knows he’s a liar.”

9:12 – Biden: “I am the Democratic Party.”

9:09 – First question is about Amy Coney Barrett. Biden doesn’t say a word about abortion. He focuses solely on Obamacare.

8:55 – Trump has spent the past week claiming that Joe Biden is a doddering old man who’s an embarrassment to the nation, and today the entire right-wing noise machine has kicked into high gear to back him up. This may seem dumb, but it probably isn’t. What they’re doing is priming us. They want everyone to be hyper-attentive to Biden’s performance, ready to criticize him every time he halts or corrects himself or stumbles over something. Even those of us who think we’re immune really aren’t. My advice: if you look at past debates, you’ll see that everyone stumbles a bit here and there. We just don’t notice it. So calm down and ignore the presentation on both sides unless something really grisly happens.

From Hillary Clinton’s spokesperson, asked about the declassification of Russian disinformation that blames Clinton for trying to tie Donald Trump to Vladimir Putin:

“Baseless bullshit.”

It must feel good to be able to say that. In any case, this is even worse than it sounds. This particular piece of Russian disinformation was already vetted by the Senate Intelligence Committee and dismissed on a bipartisan basis. Nevertheless, Director of National Intelligence John Ratcliffe decided to declassify it and Sen. Lindsey Graham is now running around pretending that it’s important.

And just in time for tonight’s debate! This is obvious politicization of the intelligence community, with barely even a fig leaf of pretending otherwise.

In a new paper, Benjamin Jones and Larry Summers introduce a novel method of calculating the returns to innovation. Their conclusion is simple:

Overall, we find that the average social returns to innovation investments appear very large….Even under very conservative assumptions, it is difficult to find an average return below $4 per $1 spent. Accounting for health benefits, inflation bias, or international spillovers can bring the social returns to over $20 per $1 spent, with internal rates of return approaching 100%.

I don’t find this especially surprising. Here is GDP per capita in a long historical view:

From the year 0 through 1700, there was very little innovation and very little growth. Over the next couple of centuries, innovation picked up a bit and so did growth—a bit. Then, around 1870, with the Industrial Revolution well under way and electrification around the corner, innovation became a single-minded goal in the Western world, not just the occasional product of a solitary genius. The result of this has been a 10x increase in GDP per capita. In the Western world, the increase has been considerably bigger.

Putting a number to this is interesting, but what’s more important at this point—since everyone agrees on the importance of innovation—is figuring out where innovation comes from. For example, do big multinational corporations produce most of our innovation from their well-oiled R&D teams, or are small, scrappy startups responsible for most of it? I would personally like to believe in the scrappy startups, but there’s a fair amount of evidence suggesting that large firms in concentrated industries produce a considerable amount of innovation too (for example, see here, here, and here).

Whatever the answer, innovation is the key to growth, and the Jones-Summers paper merely confirms this and puts a value to it. The real debate is over what public policies we should follow to maximize innovation, and that’s still an open question.

This is a picture of three guys at the Farmer’s Market on Third and Fairfax. I was camped out by Littlejohn’s, home of the world’s best chocolates, snapping pictures from ground level just to see how they’d look. For the most part they weren’t very good, but this one has some energy and life to it.

As we get closer to the availability of a vaccine for COVID-19, health care experts are becoming increasingly concerned about lack of trust in the development process. After all, a vaccine does no good unless people line up to get their shots, and in a recent poll from Pew Research only 51 percent of respondents said they would probably or definitely get the vaccine. Even more worryingly, this problem is especially acute in the Black community: Among Black respondents, only 32 percent said they would get it.

Suspicion of the vaccine in the Black community is often blamed on old but still searing memories of the notorious Tuskegee Syphilis Study, in which hundreds of poor Black sharecroppers with syphilis were enrolled in a program that was supposedly going to treat their disease. In reality, nothing was done for them. The real purpose of the study was to withhold treatment and observe the natural progression of untreated syphilis.

However, as my colleague Jamilah King has written, there’s much more to Black distrust of doctors than just memories of Tuskegee:

“I do think a lot of times these [conspiracy] theories are rooted in a reality,” says David Malebranche, a doctor and associate professor at the Morehouse School of Medicine. “When we look at particularly the medical profession and the history of medical racism [and] experimentation on black bodies, it’s not that folks are making this up or pulling this out of the crack of their ass and just saying like, ‘Oh, you know, everyone’s out to get me and there’s no foundation to it.’”

…Malebranche also notes that in acknowledging people’s distrust, it’s important to realize it’s not just rooted in the Tuskegee experiment….“I’m very clear that a lot of [Black] people aren’t even thinking about Tuskegee when they think about distrust of the medical profession,” he explains. “They just know what happened when their grandmother went to the hospital or when they saw their mom or dad have an experience with a doctor.”

…“I think the best way to train [medical] students to think about all these different considerations is to say, ‘OK, hey, we have a gentleman coming in with chest pain, and then part of his social history is that he had a father or a relative that went into a hospital and wasn’t taken seriously about his chest pain and discharged home and he died. So he does not appreciate the health care system.’”

In other words, Black distrust of the medical community is perfectly understandable. Now compare this to the conclusion of a study published a few years ago in Health Affairs:

Trust and respect were their primary concern with the health care system, even more than the quality of the health care they received. Participants felt they were treated with less respect because of their income, insurance status, and race….Participants gave examples of a lack of trust and respect, including providers avoiding eye contact, speaking condescendingly, showing physical disgust when touching patients, brushing off patient concerns and symptoms, and ignoring adverse events that patients reported from prescribed treatments.

The above two excerpts sound similar, but the Health Affairs study wasn’t about Black patients. It was about all low-income patients, and their complaints are eerily similar regardless of race. In another study, this one in the Journal of General Internal Medicine, the authors concluded that “Overall distrust scores did not vary by race, although there was a suggestion of greater concerns about honesty among African Americans.” But if race is only a small factor in overall distrust of the medical system, what’s the main factor?

Distrust of the health care system was associated with self-reported health status in unadjusted analyses and this association persisted after adjustment for age, gender, race, educational attainment, household income, health care access, and trust in physicians.

…This study does not prove causality. However, there are several reasons to believe health care system distrust may lead to poor health. Distrust has been demonstrated to interfere with the effective functioning of many different segments of society. Similarly, health care related distrust may interfere with the effective functioning of the health care system, by leading to lower rates or delayed utilization of beneficial health care services, such as preventive health care, as well as increased use of unnecessary and potentially harmful health care services.

This, of course, is a vicious cycle: Distrust leads to patients not seeking out care, and that leads to poor health, which in turn feeds distrust of the system. Importantly, however, most people in the study reported fairly high levels of trust in their own personal physician. They may not trust what they hear on TV or what the American Medical Association says, but they do listen to their own doctor. And there’s more. Another study, from the American Journal of Public Health, finds that Black patients do have generally less trust in the medical system than white patients, but with a significant caveat:

The pattern is much more complex than previously suggested, with a far-from-uniform picture of greater distrust among minorities. This is particularly striking across cities, where in some cities Blacks report consistently higher mean levels of distrust than do Whites; in others, Blacks report consistently lower mean levels of distrust than do Whites; and in still others, there is a mixed relationship dependent on socioeconomic status. In the same cities, Hispanics either reported consistently higher mean levels of distrust relative to Whites or a mixed relationship.

In Boston, for example, Black patients report higher distrust than white patients, but in Las Vegas it’s white patients who report higher distrust. In other studies, it’s patients using Medicaid who report higher levels of distrust. And the same Pew poll that I linked to above finds greater levels of distrust among the middle-aged and the least educated. Put it all together and it’s likely that distrust of the medical system depends on at least half a dozen factors:

• Race
• Income
• Poor health
• Age
• Type of health coverage
• Education

This suggests very strongly that acute distrust of the health care system isn’t solely a function of race. It spans several other classes of patients too, and it’s unclear which factors are the most important. What’s more, the growing influence of the anti-vaxx movement is almost certainly affecting this too, though it’s too early for any rigorous research to have been done on this.

Our overall level of vaccine distrust is too high. Of the 51 percent who say they might get the vaccine, you have to figure that probably a third won’t bother for one reason or another. That’s not enough. We need coverage of 60-70 percent of the population for the vaccine to be really effective. Outreach to the Black community is still crucial, but so is outreach to those with poor health and those with low incomes. It’s likely that they’re contributing to our epidemic of vaccine distrust as much as anyone else.

At first glance, our newfound view into Donald Trump’s finances hasn’t shed a lot of new light on things. In a nutshell, Trump built his first empire by borrowing lots of money and blowing through it; then he inherited lots of money and blew through it; and then he made a lot of money on TV and blew through it. Along the way he employed lots of clever tax avoidance schemes, as rich people do. It’s not clear that any of it was illegal (though there’s good evidence that some of his earlier tax scams were). That said, there’s certainly one odd thing that jumps out at you when you look at Trump’s annual income over the years. First, though, a very brief recap of Trump’s business career:

Phase 1 (1983) — Trump builds Trump Tower. It’s a perfectly good project that remains profitable to this day.

Phase 2 (1984-1991) — Trump goes crazy, borrowing huge sums to overpay for airlines, football teams, the Trump Plaza hotel, and casinos in Atlantic City. It all ends in 1991 when the Trump Organization goes bankrupt.

Phase 3 (1992-1999) — Trump digs his way out of bankruptcy, helped along by hundreds of millions of dollars funneled to him by his father. This is also the phase in which he packages most of his bad casino debt into a single company that he takes public. Trump pays himself millions of dollars for managing this business, but anyone who invested in it loses every penny.

Phase 4 (2000-2004) — After the death of his father, Trump buys a few golf courses.

Phase 5 (2005-2011) — Trump reaps hundreds of millions of dollars from his part ownership in The Apprentice. During this period he goes on a huge buying spree, mostly snapping up golf courses that he overpays for. These transactions are almost all in cash.

Phase 6 (2012-present) — Revenue from The Apprentice and from licensing starts to dry up. He reports negative income on his tax returns. But he continues his buying spree—most of it in cash—overpaying for Scottish and Irish golf courses, pouring money into renovations, and bidding for a lease to turn the Old Post Office into a hotel. His bid for the hotel is widely believed to be far higher than the cash flow from a downtown hotel can ever support.

Here’s the odd thing: In order to stay solvent, Trump has always needed fresh flows of cash from outside his main business. Always. In Phase 2 he borrowed it. In Phase 3 he got it from his father. In Phase 5 he got it from The Apprentice.

But now we’re in Phase 6. Take a look at the chart of Trump’s finances that the New York Times put together:

In 2009, losses from Trump’s businesses get bigger, but this is likely due to the Great Recession. In 2012, however, with the economy recovering, Trump suddenly starts showing huge losses in his real estate business (DJT Holdings) and in his golf courses. He has kept up these losses to this day. This makes no sense, especially since these losses almost have to be deliberate. Why is Trump dumping boatload after boatload of his own cash into money-losing enterprises?

In the past, Trump has always financed these splurges with outside income streams, but his old income streams have mostly dried up. So what’s his new one? And who controls it? It’s possible that the answer is “no one,” and Trump is just idiotically pouring his fortune down a rat hole. But at this point it’s a legitimate national security question to want to know the answer.

A new study has found that Fox News uses the phrase “they hate” far more often than either CNN or MSNBC. Interestingly, Fox only opened up a big lead in 2016, when Donald Trump started his campaign, and then pulled away steadily throughout his presidency:

And just who are the haters, according to Fox News? Mostly Democrats, elites, and the media. And who do they hate? Mostly Trump.

POSTSCRIPT: Bonus points for identifying all the spikes. For example, what happened in July 2019 that got all the networks in a frenzy?

Here’s the coronavirus death toll through September 28. The raw data from Johns Hopkins is here.

This is the Tule windfarm, located in the McCain Valley about ten miles north of the Mexican border. What was I doing there at dawn? Checking out our big, beautiful border fence, of course. I’ll have pictures of that and other border-related stuff in the weeks to come.