Effect Measure

Acknowledging Obama's failures

Sun, 08 Nov 2009 13:17:56 -0500

It looks like there's going to be some kind of health care reform bill, but we're not celebrating. It's legislation that could have been important and meaningful and instead is a neutered industry-friendly cup of weak tea with a Draconian anti-choice amendment. That Obama would disappoint us is no surprise. We expected it and predicted it during the presidential campaign. And we said we'd complain. And we are. Expecting it, though, doesn't prevent us from being disappointed and angry he has turned out to be lousy on things that count. He's not George Bush, we'll give him that. But no President in history was as bad as George Bush, an outlier's outlier (not to mention just a plain liar). So not being as bad as Bush is a stupendously low bar to meet. That the Democrats would be crappy was also expected. The worst Democrat is still better than the best Republican, but again, who isn't? More to the point, the worst Democrats are also stupendously bad on their own. There are a lot of terrific Democrats, but they didn't prevail, although they could have if Obama had helped. He didn't.

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Freethinker Sunday Sermonette: more religion and child abuse

Sun, 08 Nov 2009 06:24:55 -0500

Richard Dawkins has taken a lot of abuse himself for having the temerity to suggest that some kinds of religious upbringings can be considered abusive even if no physical harm is involved. We know that Catholic children suffered abuse at the hands of priests and nuns, and that some fundamentalist Christians have also engaged in extremely abusive practices. We don't usually think of Jews as routinely engaging in this, but there is something non-sectarian about the fundamentalist mindset. You could do a 'global search and replace' and this sad tale of escape from orthodox Judaism could be interchanged with those of many evangelical Christian or Muslim sects. I have no trouble calling this institutionalized child abuse:

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Barbara Ehrenreich on the swine flu supply problem

Sat, 07 Nov 2009 06:46:09 -0500

I first read Barbara Ehrenreich in 1971 when she wrote The American Health Empire: Power, Profits, and Politics with her (then) husband John Ehrenreich (Health PAC, 1971). She was by then a PhD in cell biology (Rockefeller University) and anti-war activist. We traveled in the same circles and I knew her slightly at the time. Her next book, Witches, Midwives, and Nurses: A History of Women Healers (with Deirdre English) was a new reading of women in medical history. It was an influential text in the emerging women's health movement. Since then she has published many books, several making the best seller lists and throughout an astute and still influential observer. Now she has penned a brief comment on the the alleged swine flu vaccine supply problem and who's to blame. And I find myself in complete agreement with her:

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Swine flu in a cat and other matters

Fri, 06 Nov 2009 06:42:37 -0500

Helen Branswell, the Canadian Press's extraordinary flu reporter, is one of the few reporters who could have written the article, "Flu dogma being rewritten by a strange virus no one pegged to trigger a pandemic". She's been following flu for years and has watched as one thing after another we thought we knew about flu has been shown wrong -- by the flu virus. It's a theme we have been sounding as well for almost as long. As scientists we've seen one alleged flu truism after another was stood on its head. A couple of years ago we began to assume anything said about flu was provisional. Some of it might turn out to be true, and some of it might not. If you've been following this blog for a few years, most of Branswell's material will be familiar, but she has pulled it together in one place. So read it (once again: here). But one piece of now outmoded conventional flu wisdom not is in Branswell's article -- because it was only announced Wednesday -- is that our beloved household companion animals (aka, "pets") aren't susceptible to swine flu (example here, with breaking news update to correct it). This may still be flu dogma, but it's no longer flu catma.

From the Iowa Department of Public Health:

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Ron Paul nuttiness on swine flu

Thu, 05 Nov 2009 06:03:00 -0500

For somebody so out to lunch on so many issues there is something undeniably likable about Ron Paul. As congressthings, he and Dennis Kucinich (there's an odd couple) had the clearest and best positions on the Iraq debacle. And as a principled libertarian (there seem to be some big chinks in Paul's libertarian armor -- like reproductive choice -- but his passion is undeniable), there is something admirable about him. It almost makes you forget his principles are self-centered, wrong-headed and inhumane. Little gnome-like figures aren't supposed to be that unfeeling toward others. Anti-science views, though, are par for the course.

Yes, I know he's a doctor. At least he says he is, although he doesn't seem to know much about medical science. Maybe the Birthers can show me his diploma. Because when I hear his views on the pandemic, it sounds like he'd have trouble passing high school biology. Granted he's 74 and high school biology has changed a bit since the days before the double-helix. But still, would any scientist who engaged his brain before opening his mouth say this about swine flu:

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Swine flu produces a good settlement for hospitals and workers

Wed, 04 Nov 2009 07:00:11 -0500

It's being described as a "dramatic settlement" that will set a pattern for the nation. Let's hope so, because the agreement reached yesterday by the California Nurses Association/National Nurses Organizing Committee (CNA/NNOC) and hospital player Catholic Healthcare West (CHW) sounds like just what the doctor ordered. It covers 32 CHW facilities in California and Nevada, where CNA/NNOC represents 13,000 registered nurses.

Some details:

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Playing Grandmaster chess with swine flu

Tue, 03 Nov 2009 06:20:05 -0500

A reader asked an offline question that is general enough to post about (NB: I try to respond to as many questions as I can, but I'm traveling and can't keep up, so in most cases I won't be able to respond. I also don't hand out personal medical advice over the internet, something I consider bad practice). CDC says on the basis of clinical trials with the unadjuvanted vaccine used in the US that two shots, 21 days apart, are needed for children under 10. WHO, on the other hand, is telling its member nations that one will suffice. Why the confusion?

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Pneumonia

Mon, 02 Nov 2009 07:10:15 -0500

Some people find posts like this tiresome. There are so many things that need doing and so little time and resources to do them. Adding to the list makes our eyes glaze over. I understand. But that doesn't make this any less of a Big Deal.

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Cuba, swine flu and the embargo

Sun, 01 Nov 2009 17:09:10 -0500

When swine flu began there was a hue and cry in some quarters to shut the border to prevent the virus from taking root in the US. It seems fairly clear, now, that by the time we detected the virus, in late April, it had already situated itself in the US -- assuming that it didn't start here in the first place. We don't really know where the jump from pigs to humans occurred, although the best guess is Mexico. Closing the borders would have done no good and would have stranded thousands of students and other tourists in Mexico. Since the US has more world travelers than Mexico, it was in fact the US that was the driving force in spreading the virus to Europe and Asia. If one wanted to try to stop this virus by travel restrictions, the logical target would have been the US, although it wouldn't have done much good. You can't contain influenza. It's too slippery.

Still, the idea lingers. The latest entry in "strangers bearing germs" narrative is Cuba's ex-President, Fidel Castro, but it comes with an ironic twist that has some force to it:

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Status report at DailyKos

Sun, 01 Nov 2009 13:55:38 -0500

We are otherwise occupied, but fortunately DemFromCT has a great status report on swine flu up at DailyKos. I suggest you also follow the first link to his piece at The Arena, although reading after his astute observations is not for the faint-of-heart. The politicization of this issue by Republicans is to be expected and typically unfair (not to mention uninformed). As Dem points out, the Bush Administration did a lot of the heavy lifting that made dealing with this much easier and deserves credit for that. We took them to task here for not shoring up a badly deteriorated public health and social service infrastructure and the Obama administration, so far, isn't any better. Had the Bush administration done so and had the Obama administration taken immediate steps to repair the problem we'd be in a lot better shape. But neither did.

Dem's piece at The Arena (Politico) is measured and fair. Much of what follows it is utter crapola. But first read his status report. Excellent job. As usual.

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Freethinker Sunday Sermonette: I Could've had Religion

Sun, 01 Nov 2009 06:35:36 -0500

So what about the good things we owe to religion? Architecture. Painting. Atheism. But especially music. I happen to be especially partial to Bach's B-minor Mass, but what follows isn't exactly chopped liver. Rory Gallagher was an Irish blues guitarist who lived hard and died hard, at age 47 of methicillin resistant staphylococcus aureus (MRSA). Here he is, age 24, at The Marquee Club in London, April 1972:

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Statins for influenza. Why don't we know if it works yet?

Sat, 31 Oct 2009 06:49:43 -0500

Statins for influenza are in the news again, this time because of a paper given at the Annual Meeting of the Infectious Disease Society of America (IDSA). We'll get to it in a moment, but first a little background.

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Swine flu: How bad was the first wave?

Fri, 30 Oct 2009 06:57:05 -0500

One frequently hears claims that the current swine flu pandemic has been exaggerated because there are "only" 1000 or so deaths, while seasonal flu is estimated to contribute to tens of thousands of deaths a year. There are two reasons why this is not an apt comparison. We've discussed both here fairly often. The first is that the epidemiology of a pandemic and seasonal flu are very different. Epidemiology studies the patterns of disease in the population and swine flu is hitting -- and killing -- a very different demographic from seasonal flu. Its victims are young and many are vigorous and healthy. The second is that it compares apples to oranges. The 1000 deaths figure is for laboratory confirmed swine flu deaths (as are the various case counts), while the seasonal flu figure is an estimate, not a count of laboratory confirmed influenza deaths (see our post here if you want to know more about how the sausage is made). CDC and the states stopped counting cases early in the pandemic (here for some commentary from us), so we don't know how many cases there have really been. CDC keeps track of the general trends and patterns through a multi-part surveillance system. But for planning and resource allocation it would still be nice to know how much flu there is. Now a paper has appeared in Emerging Infectious Diseases that provides us with some rough and ready estimates. It also explains why this number is so hard to get.

Here's the set-up:

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Science journalists, bloggers and the Brave New World we live in

Thu, 29 Oct 2009 06:19:42 -0500

One of the by-products of the brouhaha (here, here) over The Atlantic article on vaccines was some interesting issues raised by the way the Knight Science Journalism Tracker handled it (here, here). If you aren't familiar with KSJ Tracker, it's a site that does "peer review" of science journalism. It's goal "is to provide a broad sampling of the past day’s science news and, where possible, of news releases or other news tips related to publication of science news in the general circulation news media, mainly of the U.S." I don't get a chance to read it as often as I'd like, but when I do I find it measured and informative and I enjoy seeing how things look from the perspective of professional science journalists. Now I'm not a professional science journalist but I am a professional scientist who writes for the public. I don't write under my own name, using instead a pseudonym shared by one or more like-minded public health scientists. So when I wished to register to comment about KSJ Tracker's post about us, I was told their policy was that all commenters had to identify themselves with real names. Thus I confined my reply to this blog.

That's KSJ Tracker's policy and it works for them. I have no wish here to talk them out of it (although in an exchange of emails I did make an effort). Granting that the policy is the stuff of professional journalism, the assumptions and conventions which motivate it were formed when the information and authorial landscape was far different. So it seemed like an opportunity to make some observations from a non-professional-journalist-writing-science-for-the-public point of view. But first, a convention of our own. We've never divulged how many Reveres there are (once we said we were a non-prime number strictly less than 5, but this is a different point in time so we aren't making that claim now). We will say that only one writes at a time, although all writers are in a sense a composite of many influences. Having said that, for clarity I will use the first person for the remainder of this, although it represents the views of everyone writing under the name revere or Revere.

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Yuck! This coffee tastes like poison!

Wed, 28 Oct 2009 06:47:36 -0500

Medical institutions in the US northeast have always been competitive, and Harvard has always been toward the top of the list in that category. I don't mean just competitive to get into. I mean competitive, period. I went to another big research medical school in the northeast in the sixties and we used to joke that at Harvard if someone put on his dorm light (it was pretty male in those days) in the middle of the night to go to the bathroom, all the other lights on the floor would go on, too, on the theory someone was getting ahead of them. Put that down to prestige envy, perhaps, but as a resident of the northeast I can attest that the whole region is a pressure cooker, even more so for academics. Whenever we travel to other parts of the country it takes us a couple of weeks to decompress, and then we marvel at how much slower -- read that saner -- the pace of life is elsewhere. I mention this because it was the first thing that crossed my mind when I read in Nature magazine's blog, The Great Beyond, about what looks to be the intentional poisoning of six Harvard researchers via the water reservoir in a single-serve espresso machine. The agent was a common preservative found in many labs, sodium azide:

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