instruction:
Given a paragraph and a claim, classify it this way: If the claim contradicts the evidence present in the paragraph, classify the claim as '0'. If the claim has multiple supporting *AND* contradicting evidences, classify the claim as '1'. If the claim has supporting evidence and the paragraph is in overall favor of the claim, then classify the claim as '2'.
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Paragraph: "Local and state governments are expected to have budget shortfalls as a result of the coronavirus pandemic. And, according to the Democrat in North Carolina’s U.S. Senate race, the Republican incumbent thinks struggling communities should go bankrupt. That’s what Cal Cunningham said about Sen. Thom Tillis. ""Mitch McConnell said he wanted states to go bankrupt instead of the federal government providing relief. Today, Thom Tillis agreed,"" Cunningham tweeted April 24, linking to a Politico story. Is that true? There’s a lot of context being left out. Yes, Tillis did say he is ""more or less aligned"" with what McConnell, the U.S. Senate majority leader, said about not giving more federal dollars to states that had pre-existing budget problems. McConnell proposed allowing them to file for bankruptcy, which states are not currently permitted to do. But Cunningham exaggerated what we know about Tillis’ position. Tillis’ comments clearly show he doesn’t want the federal government to pay for state debt that wasn’t incurred during the coronavirus outbreak. What’s less clear is whether he wants those states to go the bankruptcy route. So what did McConnell say about bankruptcy? In a radio interview on April 22, McConnell said states with pre-existing problems might be better off declaring bankruptcy than by expecting additional funding from the federal government. But he didn’t specifically say he ""wanted"" states to declare bankruptcy, only that he supports it as an option. ""I would certainly be in favor of allowing states to use the bankruptcy route. It saves some cities. And there’s no good reason for it not to be available,"" McConnell said. ""My guess is their first choice would be for the federal government to borrow money from future generations to send it down to them now so they don’t have to do that. That’s not something I’m going to be in favor of."" As The Atlantic reported, McConnell expanded on his bankruptcy comments in another radio interview that day: ""We’re not interested in solving their pension problems for them. We’re not interested in rescuing them from bad decisions they've made in the past, we’re not going to let them take advantage of this pandemic to solve a lot of problems that they created themselves (with) bad decisions in the past."" That brings us to Tillis and how closely he has ""agreed"" with McConnell. Audio of the April 24 town hall shows a constituent named Charles saying he has a question about the future: ""Will the Senate vote to bail out poorly-run states that were near bankrupt before COVID-19 hit?"" Tillis wasn’t asked about states in general. He was asked specifically about ""poorly-run states that were near bankrupt"" prior to the pandemic. Tillis said he doesn’t think those states should be bailed out. ""Well, Charles, that's a great question and personally I don't think we should, and I don't think that we can,"" Tillis said. He then said the $2 trillion economic stimulus gave him ""pause,"" but was worth it. Then he used North Carolina’s state government as an example of good financial stewardship: ""I'm not so sure that taxpayer dollars for North Carolina should go to a state, a county, or a city that, like you said, was in poor economic shape before we ever had the virus. We need to take care of first responders. We need to take care of law enforcement. And we will do that. But I don't believe that I can support any measure that is effectively a bailout for poorly run state and local governments. ""We can look at things on a case-by-case basis where it's very clear that the damage is done because of the virus impact. But a broad-based bailout is not something I'd be prepared to support."" That’s when Tillis brought up McConnell’s comments. ""You probably heard Leader McConnell's comments about it, I'm more or less aligned with Leader McConnell on the issue,"" Tillis said, a few seconds later adding: ""I think we need to work on executing (plans already signed into law) and not really entertain a discussion of trillions more going into jurisdictions that really need to get their financial houses in order."" Cunningham spokeswoman Rachel Petri said Tillis’s comments about McConnell show he’s in lockstep with the Senate leader, who said ""I would certainly be in favor of allowing states to use the bankruptcy route."" Tillis elaborated on his position in an interview with Fox News radio's Guy Benson on April 29. Benson asked him about McConnell’s comments that money should not cover pre-pandemic budget holes (without mentioning the bankruptcy idea). Tillis said the Senate ""will go back and take a look at well-documented cases for the costs of the response, potentially the cause of some of the revenues in this year based on closures."" When PolitiFact asked about Tillis’ position on the bankruptcy option, Tillis campaign spokesman Andrew Romeo said: ""Sen. Tillis has never advocated for any state or municipality to go bankrupt as a result of COVID-19, has already delivered billions of dollars in relief to North Carolina, and has consistently said that he supports providing targeted assistance for communities that have been impacted by the virus."" Cunningham tweeted, ""Mitch McConnell said he wanted states to go bankrupt instead of the federal government providing relief. Today, Thom Tillis agreed."" The tweet lacks so much context that it’s several degrees removed from what’s actually been said. McConnell wasn’t talking about just any states, he was talking about states that were in poor financial shape before the coronavirus outbreak. Additionally, McConnell said he supported bankruptcy as a novel option for states, particularly for those with pre-existing pension liabilities. Tillis said he agreed with McConnell ""more or less."" He agreed that Congress shouldn’t pay for revenue losses that aren’t related to the coronavirus outbreak. But Tillis never actually said he wanted states to go bankrupt. And he said he will consider federal aid for smaller governments on a case-by-case basis. Cunningham’s tweet exaggerates what McConnell said and misrepresents what Tilils has said about federal coronavirus aid. It contains an element of truth but ignores critical facts that would give a different impression." Claim: Mitch McConnell said he wanted states to go bankrupt instead of the federal government providing relief. Today, Thom Tillis agreed.
answer:
0


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Paragraph: "The story does not note the cost of a typical statin regimen, Zetia or the combination treatment, Vytorin. This is an important oversight as many people who are prescribed these medications take them for life. The story does mention that these new drugs ""raked in 5 billion dollars last year"". The failure of the combination product to be better than simvastatin alone has significant financial implications. Simvastatin (the generic name for Merck’s Zocor) is available for about $1.25 a day. Vytorin costs about $3.35 a day. Most clinicians assumed that the combined product was an advantage if you could not get a patient to an LDL goal with just the statin alone or side effects with the simvastatin prevented an adequate dose. The price for the combination is less than the cost of the components. The story provides no quantitative data and no information on the number needed to treat to show benefit (i.e. prevention of a heart attack or stroke through lowered LDLs) in one patient with the newer medications, with traditional statins or with combination treatment. The story says that there are no real dangers to continuing the drugs Zetia and Vytorin based on the lower drop-out rate and reported side effects in the study. The comments from both parties cast an extraordinarily negative shadow on the study drug and on the company sponsors. Without an appropriate description of the study design, the results cannot be fairly discussed to the public. While the primary endpoint was not obtained with the combination, it did lower LDL and inflammatory markers in excess of that achieved with simvastatin alone. Suggesting the drug did not ""work"" is a bit of a mis-statement. The story encourages patients to keep taking these drugs. The story also does not mention the potential harm of taking statins long-term, especially in high does. Some of these harms are very rare, however, they include: muscle pain and kidney or liver problems. The story provides no real discussion of the data presented at the American College of Cardiology meeting and published in the peer-reviewed New England Journal of Medicine. And the story didn’t assess the quality of the evidence. The study followed people (average age mid-40s) who had an inherited condition (called familial hypercholesterolemia) that is associated with very high cholesterol levels and greatly increased risk of early coronary artery disease. Many of them had been taking statins and other cholesterol-lowering medicines for years. All were randomly assigned to take either a statin (simvastatin, trade name Zocor) alone or a statin combined with another cholesterol-lowering medication, ezetimibe. The study was designed to find out if the combination of the two drugs could slow the growth of plaque in carotid arteries supplying the brain more than the statin alone. Plaque in these arteries is associated with an increased risk of stroke and heart attack. The two drugs together were more effective at lowering cholesterol than simvastatin alone, but adding ezetimibe did not change plaque measurements in the carotid arteries. The story does mention that lowering cholesterol may have other benefits, but we are not sure how those translate to fewer cardiovascular events or increased survival from these events. No overt disease-mongering. There are no interviews with the study authors or with practicing clinicians. The story reported on data presented at a recent American College of Cardiology Meeting, so there were several thousand cardiologists and other specialists available who could have been interviewed for clinical perspective on the results of this study. There was also no mention of the two accompanying editorials in the NEJM. The editorial by Brown and Tayor nicely identifies the issues related to the study and helps put the results into perspective. Unfortunately, this editorial was ignored by both parties involved in the story. Stating that taking more statins is the answer is incomplete at best. Lifestyle changes along with other drugs may be options as well. Interestingly however, this study raises questions about the simple notion that lowering total cholesterol, and LDL are important to lowering cardiovascular risk. People who are not able to lower their cholesterol enough with statins alone (or cannot tolerate the dose of statins needed to lower it) may wish to discuss with their doctor whether other medications (i.e., rather than ezetimibe) may be appropriate. These include niacin, fibrates, and bile acid resins. When added to statins, they can effectively lower cardiovascular risk. It’s clear from the story that the drugs in question are still available to patients, though they should not be considered first-line therapy. The story focuses on new information that there is little to no benefit of newer cholestrol-lowering medications on the prevention of arterial plaque, which translate to little benefit for prevention of heart disease, stroke and cardiovascular-related death. We can’t be sure if the story relied solely or largely on a news release. No researcher or cardiologist is interviewed. Quantified data from the American College of Cardiology presentation or from the New England Journal of Medicine article are not directly cited." Claim: Poor test results for heart drugs
answer:
0


question:
Paragraph: The plague outbreak has killed 63 people in the Indian Ocean island nation, Madagascar’s government says. For the first time, the disease long seen in the country’s remote areas is largely concentrated in its two largest cities, Antananarivo and Toamasina. Global health officials have responded quickly. The World Health Organization, criticized for its slow response to the 2014 Ebola epidemic in West Africa, has released $1.5 million and sent plague specialists and epidemiologists. The Red Cross is sending its first-ever plague treatment center to Madagascar. On Wednesday, Madagascar’s minister of public health rallied doctors and paramedics in a packed auditorium at the country’s main hospital, saying they’re not allowed to go on vacation. “Let’s be strong, because it’s only us. We’re at the front, like the military,” Mamy Lalatiana Andriamanarivo said. The outbreak could continue until the end of infection season in April, experts warn. Madagascar has about 400 plague cases per year, or more than half of the world’s total, according to a 2016 World Health Organization report. Usually, they are cases of bubonic plague in the rural highlands. Bubonic plague is carried by rats and spread to humans through flea bites. It is fatal about the half the time, if untreated. Most of the cases in the current outbreak are pneumonic plague, a more virulent form that spreads through coughing, sneezing or spitting and is almost always fatal if untreated. In some cases, it can kill within 24 hours. Like the bubonic form, it can be treated with common antibiotics if caught in time. The WHO calls plague a “disease of poverty” caused in part by unsanitary living conditions. Madagascar has a per capita GDP of about $400, and national programs to control the disease have been “hampered by operational and management difficulties,” according to a report by the European Centre for Disease Prevention and Control. But the airborne pneumonic plague, which accounts for about 75 percent of cases in the current outbreak, makes no class distinctions. “Normally, the people who catch the plague are dirty people who live in poor areas, but in this case we find the well-to-do, the directors, the professors, people in every place in society, catching the disease,” said Dr. Manitra Rakotoarivony, Madagascar’s director of health promotion. The current outbreak began in August, earlier than usual, when a 31-year-old man who had spent time in a village in the central highlands, Ankazobe, traveled by bush taxi to the east coast, unaware that he had the plague. He died en route and was buried without any safety precautions in Toamasina. Four people in contact with him also died. Residents of the capital began to relax in recent days amid the global response to the outbreak, but the disease remains a serious threat with the number of new cases per day remaining steady. Madagascar has fought the disease for more than a century. It was introduced to the island in 1898 when steamships from India brought rats infected with the bacteria that causes the disease. The plague nearly disappeared from Madagascar for 60 years, starting in 1930, but re-emerged in recent decades. The black rats that carry the disease in the highlands have gradually developed resistance to it. Unsafe burial practices that involve touching corpses are another reason the disease spreads, according to a 2015 study by scientists at the Pasteur Institute in Madagascar. The outbreak has alarmed neighboring countries. A 34-year-old man in another Indian Ocean island nation, the Seychelles, contracted the pneumonic plague while in Madagascar. He was treated in his own country and no longer has symptoms. It was the first-ever plague case in the Seychelles, said the country’s public health commissioner, Dr. Jude Gedeon. Another Seychellois, a 49-year-old basketball coach, died of the plague last month while in Antananarivo for a tournament. Seychelles authorities have established a plague isolation ward and announced that schools will be closed through Tuesday. Foreign travelers who have recently visited Madagascar are not being allowed into the country. While the WHO says the risk of the epidemic spreading beyond the region is very low and does not advise restrictions on travel to Madagascar, Air Seychelles has canceled all flights to and from the island until further notice. “The situation is still not under control in Madagascar,” Gedeon said. Claim: In Madagascar, plague outbreak now threatens largest cities.
answer:

2