We’ve gotten this far in industrial civilization through hyper-confidence in our own knowledge, and I strongly suspect that we were able to think we had everything figured out because we had not yet run up against the finite nature of this world. Our interventions “worked” the way we imagined they did, in part because there was always a place where we could throw things away. That meant that a great deal never had to be thought about; out of sight, out of mind. Now, increasingly, we realize there is no “away.” There were still resources we had not tried to exploit, and no doubt there still are, but to circle back to the starting point of all this, the amount of water on planet Earth is finite and unchanging. We cannot make more H2O, and that is becoming one of several limiting factors. As is the realization that exploiting resources is not always an unambiguous good.

Our massive confidence in our explanations has rested for a long time on the fact that we weren’t aware of half of the repercussions of our actions. It’s important to remember that perhaps we still are not. We don’t know how much we don’t know, but we don’t like to admit that. We tend to think that our understanding of the natural world has reached completion, and all that remains is to work out the applications of our insights. The trouble is, we thought that in 1908 and 1808 as well. Looking back, that seems laughable, but how different are we today? Did the past century suddenly make it really true that we have godlike knowledge?

My view, in short, is that we’re not alone here. We’re not transcendent beings who operate in a way that puts us beyond category on this earth. We have astounding abilities, but they tend to blind us to the equally astounding abilities of the world around us. Sometimes we act as though we believe that evolution in and along with this environment gave rise to us only to then eject us from our context. As though we believe that we are the end of earth’s history. That nature completed its task by creating us, and it should now gracefully retire. But no. Assuming we survive as a species, I think we are going to do so in a relation of equality, dialogue and collaboration with the natural world and all its complex agency, which is no less than our own. The question is not whether this relationship will eventually happen, but how we will get there, and whether we will have to get there the hardest way.

Lowery Pei commented on our new site The Power Up Project - like minds found each other. Here is the conclusion of one of his posts - it rang a big bell for me.

He reminds us that we might just be on the verge of an entire new perspective - that we are not gods but part of nature - that we actually know very little about her right now.

That learning more might be the best thing we can do.

Shannon Brownlee says a number of doctors/researchers doubt TheFlu orthodoxy - the effectiveness of the Flu Vaccine and antivirals. What if flu vaccines do not protect people from dying--particularly the elderly, who account for 90 percent of deaths from seasonal flu? And what if the expensive antiviral drugs that the government has stockpiled over the past few years also have little, if any, power to reduce the number of people who die or are hospitalized?

Why, then, has the federal government stockpiled millions of doses of antivirals, at a cost of several billion dollars? And why are physicians being encouraged to hand out prescriptions to large numbers of people, without sound evidence that the drugs will help? The short answer may be that Public Health officials feel they must offer something, and these drugs are the only possible remedies at hand... The annals of medicine are littered with treatments and tests that became medical doctrine on the slimmest of evidence, and were then declared sacrosanct and beyond scientific investigation... "Vaccines give us a false sense of security," says [Sumit Majumdar]. "When you have a strategy that (everybody thinks) reduces death by 50 percent, it's pretty hard to invest resources to come up with better remedies."... In the U.S., by contrast, our reliance on vaccination may have the opposite effect: breeding feelings of invulnerability, and leading some people to ignore simple measures like better-than-normal hygiene, staying away from those who are sick, and staying home when they feel ill. Likewise, our encouragement of early treatment with antiviral drugs will likely lead many people to show up at the hospital at first sniffle. "There's no worse place to go than the hospital during flu season," says Majumdar. Those who don't have the flu are more likely to catch it there, and those who do will spread it around, he says. "But we don't tell people this."

Much more here http://webseitz.fluxent.com/wiki/z2009-10-26-BrownleeFluContra

What’s the most important thing one should know about the flu? Knowing how not to catch it, of course. And yet, no one, not even the most informed experts know how H1N1 and seasonal influenza are transmitted.

Everyone agrees that prevention is key. Accordingly, we have received plenty of information on how to behave during a flu pandemic. A pamphlet entitled “Know How to Prepare for the H1N1 Flu Virus – Knowledge is Your Best Defence” was sent to all Canadian households by the Public Health Agency of Canada. Most of the space in this well designed pamphlet is devoted to prevention: washing hands and surface areas, the transmission from hands to eyes, nose, and mouth, coughing and sneezing into arms rather than hands, the distribution of the vaccine, and the need to stay at home if you get H1N1.

This list suggests that the flu is mostly spread by contact. And I observe that this message has arrived – a great communication success. Hand sanitizers abound and the one person I have met wearing a facemask explained to me that it helps keep hands away from the nose and mouth. We all “know” now that influenza is spread mostly through indirect contact.

And yet, the nation’s top experts humbly surmise that we don’t know. The website of the Canadian Medical Association Journal recently published a news item entitled “Conflict emerges over value of hand-washing as a preventive flu transmission measure” and quoted Dr. Donald Low, Microbiologist-in-Chief at Mount Sinai Hospital in Toronto, dismissing the evidence for the current hand hygiene recommendations.

Dr. Low earlier chaired a panel of top experts for the Council of Canadian Academies. Their report on influenza transmission states: “The current weight of evidence suggests that transmission of influenza by inhalation is more probable than by indirect contact” and “The panel concludes that although the occurrence and relative importance of the contact route for influenza transmission have not been demonstrated, or indeed studied in humans, contact transmission likely occurs.” In sum, it is possible that wearing (good) masks trumps washing hands.

Ponder for a moment a single word in the quote above: the most important element of the science of influenza has still yet to be studied. How is this possible? Did the medical establishment forget to study the transmission of flu? Probably not – the experts readily know that they don’t know. Is it too hard to study? Probably not, medical science is very advanced now and most of the relevant data is decades old. By elimination, it seems we need to look at the culture of science and the incentives driving scientific research.

Perhaps this type of research is too old-fashioned to be of interest to our top researchers. Perhaps it does not fit into a culture of apprenticeship where students want to learn the latest methods and instruments in order to secure a job at the end of an expensive education. I don’t know the answer, but I do know that an important lesson is emerging here: the humble flu virus turns out to be an important mentor telling us that we must think hard about our approach to science and education.

HT to Harold Jarche for this - Why am I not surprised?

My answer to this question is to "Follow the money" - research today is all about the Money. The money is in the vaccine not in avoiding flu.

The money is in drugs and not changes to lifestyle that can really cure or relieve the effects of many diseases such as Type 2 diabetes or heart disease.

The revolution in medicine is however on its way. We simply cannot afford to keep spending more and more on drugs. They cost too much and THEY DON'T WORK.

The revolution will be to see the immune system as the core and to learn how to work to improve it. Much of what helps the immune system is our social support system and also how much control we have in our lives.

This is the upstream area that health care systems such as the ones in Canada that have a single payer will have to work and will work as the costs get too much.

In the US, individuals, faced with huge direct costs, will also have to find their own way here.

Vaccinating Canadians against H1N1 is costing the country nearly twice as much as health officials expected and the tally could easily climb above $2-billion before the pandemic has subsided.

The national inoculation program is only a few weeks in, but $1.51-billion is already being spent, according to a review of estimates from federal, provincial and territorial governments. The actual figure is likely much higher because many provinces are still revising their costs while others have yet to release total estimates.

Even at $1.51-billion, the vaccination effort is proving far more expensive than health officials estimated. In September, provincial and territorial health ministers predicted the cost of buying the vaccine and delivering it at around $16 a dose, or $806-million in total based on the 50.4 million doses ordered. The total cost is currently running at about $30 a shot and climbing.

"You really have to ask serious questions about the cost-benefit," said Richard Schabas, Ontario's former chief medical officer of health who is now the medical officer of health for Ontario's Hastings and Prince Edward Counties Health Unit. "I think this is the most overhyped, overblown exercise I've ever been a part of. We continue to lavish resources on a problem that is just not that big."

Public health officials say costs have climbed because of an unexpected surge in demand for the vaccine and interruptions in supply. That forced many regional health authorities to open more clinics and alter distribution plans.

"We really, quite honestly, weren't expecting quite the lineups for vaccines," David Butler-Jones, Canada's Chief Public Health Officer, said in a recent interview.

via theglobeandmail.com

We never expected the line ups???? Pathetic

We are back to where we were in 2007. We have done nothing to prepare for higher costs of oil in terms of our use and the cost of food. Food is oil. With a lower dollar, with 17 million unemployed and millions more under employed, food and energy costs are going to hit us even harder this time.

This is why I am pounding away at stories about communities starting to grow their own food locally.

It's coming folks. What are you doing to prepare?

The P.E.I. government has closed its flu assessment centre in O'Leary after the number of new cases of swine flu dropped off over the weekend.

'I don't know if it's me wanting to be optimistic,' says chief health officer Dr. Heather Morrison about the likelihood of flu infections having peaked. (CBC)

The province's other three assessment centres, in Summerside, Charlottetown and Souris, will remain open. The centres are meant to ease pressure on hospital emergency departments.

During the weekend, visits to the centre in O'Leary fell to a point where health officials said it was no longer necessary. They said it would be reopened if required.

Another good sign for the province Monday was a declining number of schools reporting absentee rates of 10 per cent or more due to flu-like symptoms. That prompted chief health officer Dr. Heather Morrison to suggest the second wave of flu on the Island may have passed its peak.

"I don't know if it's me wanting to be optimistic, but I certainly have that sense from the last couple of days, that we haven't seen that continued sharp spike over the weekend," said Morrison.

"But again, I really remain cautious."

I suppose in Public health you are dammed either way - If you do too little and it is bad - you are blamed. If you do too much......

So what to do NEXT time?

In this case we made the Vaccine the be all and the end all. It's a bit like making anti biotics the be all and end all for infection in hospitals. What has been lost in hospitals is what Florence Nightingale learned at Scutari - than soap and water will take you 90% of the way.

My point is reduce the emphasis on a vaccine. Instead, look more to disrupting the environment for infection. Also look to helping people manage who get infected.

Take a systemic POV.

We made a start with a lot of emphasis on hand washing and how to sneeze etc. But we could have more maybe about how a virus works - how long it can stay active and so on. Help people know what they are up against. For instance, I had a huge debate with someone insisting on using anti bacterial soap - he could not see the difference between a germ and a virus. Knowing how a flu virus behaves and how to behave with them is helpful.

Help people cope with the flu when they have it - both in terms of their treatment, in terms of others in the house - and work out how to help working mothers cope.

Above all, assess the risk and be realistic. After the first 2 weeks in Mexico it was clear that this flu was infectious but not dangerous. Then as it passed through the Southern Hemisphere, it was clear that it was not mutating to something more lethal as had been the case of 1918.

We tend to put all our faith in medicine. Hence the panic and the cost of this intervention.

I would also start to acknowledge that there is a groundswell of concern about vaccines in general.

You can tell yourself that these people are silly - but that attitude will only make this worse. What is going on? Why are so many people reluctant?

I think that it is that big pharma have proved that they are not to be trusted! Countless cases of them rigging or hiding data have been revealed in recent years. The fact that they have made billions out of this epidemic does not help build trust. The final straw was that they asked for and received an indemnity.

Medicine is useful but highly overrated. We see this in the huge Lifestyle arena of heart disease, diabetes, even cancer in some cases.

Big Pharma is expert in exploiting our fears and hopes. But in most cases, changes in how we live offer the best results. But rather than even think about this, we take a pill? Our loss, Big Pharma's gain.

When you're managing software development projects, you need to know the difference between complex and complicated. Not knowing this difference means you might apply exactly the wrong approach to the right problem. (Or, if you prefer, the right approach to the wrong problem.)

It's a simple message, really. But if you don't get it, you're headed for chaos.

Simple = easily knowable.

Complicated = not simple, but still knowable.

Complex = not fully knowable, but reasonably predictable.

Chaotic = neither knowable nor predictable.

My car key is simple.
It took me about three seconds to understand how my car key works. OK, maybe that's not quite correct. Mine has a battery in it. If I take it apart it might take me another three hours to understand its details. But yeah, I'm smart, I'll manage.

My car is complicated.
It would take me years to understand how my car works. And I don't intend to. But if I did, then some day in the far future I would know with certainty the purpose of each mechanism and each electrical circuit. I would fully understand how to control it, and I would be able to take my car apart and reassemble it, driving it exactly as I did before. In theory, of course. In practice, only real men do things like that.

Car traffic is complex.
I can travel up and down the same street for twenty years, and things would be different every time. There is no way to fully understand and know what happens around me on the road when I drive, how other drivers operate their vehicles, and how the people in the streets interact. I can make guesses, and I can gain experience in predicting outcomes. But I will never know for sure.

Car traffic in Lagos (Nigeria) is chaotic.
When things get too complex, they easily become chaotic. Traffic in Lagos is so bad, it is not even predictable. Poor infrastructure and planning, heaps of waste, pollution, lack of security, floods, and many more problems make it one of the worst places in the world to be, as a simple car driver.

My computer is complicated. My software project is complex. My house is complicated. My household is complex. My blog is complicated. My thoughts are complex. Your dinner is complicated. Your dog is complex.

Simple and complicated systems are all fully predictable.

The main difference between predictable systems and complex systems is our approach to understanding them. We can understand simple and complicated systems by taking them apart and analyzing the details. However, we cannot understand complex systems by applying the same strategy of reductionism. But we can achieve some understanding by watching and studying how the whole system operates.

What's important for managers is that this also works the other way around. We create complicated systems by first designing the parts, and then putting them together. This works well for mechanical things, like buildings, watches and Quattro Stagioni pizzas. But it doesn't work for complex systems, like brains, software development teams, and the local pizzeria. We cannot build a system from scratch and expect it to become complex in the way that we intended. Complex systems defy attempts to be created in an engineering effort.

Complex systems are not constructed, they are grown.

Some people picture complexity as a state that somehow surpasses that of complicatedness (see next picture). But this view is incorrect.

From: Managing Game Design Risk: Part I

"Complicated" refers to a system having many parts, making it somewhat harder to understand, whereas "complex" refers to a system being not fully predictable. What is complicated is not necessarily complex, like two cars in a garage. And what is complex need not be complicated, like two people in a bedroom. (But what these people do in the bedroom can be quite complicated. And unpredictable.)

As I start the series on "Seeing through the Complexity of Culture" with Stuart Baker, I will offer up what I think are some of the best pieces from others. Here is post from Jurgen at NOO.NL that offers an exceptionally elegant description of the key problem of today - that we refuse to see the complex and work as if complexity was complicated or simple.

Stuart and I hope that we can help you at least see the elements of the complexity that is human culture and so be able to make more assured judgments about what might happen.

Some skeptics, like Princeton University's Peter Singer, argue that Americans have a duty to avoid going local and to keep purchasing raw commodities from the global South, like plantation-grown bananas and coffee. Yet given how little of each import dollar actually winds up in the hands of the workers most in need - probably less than a penny - this is, at best, an extremely inefficient antipoverty strategy. It perpetuates domination of the poor by global corporations.

If we really want to help the poor, it's far smarter to help poor countries, poor communities and the poorest residents living in them to achieve the same level of local self-reliance we seek for ourselves. Mohandas Gandhi argued that the way to defeat British power was to restore self-reliance, especially in basics like textiles and salt. He did not suggest that India embark on a campaign to attract nicer British factories or to expand exports to London.

This isn't going to be easy. As Madison's long-standing sister-city partnership with cities like Managua, Nicaragua, have underscored, serious global antipoverty work requires ongoing, long-term partnerships between communities, North and South, in which we help one another reorganize every element of our economies. As we in the North create community food systems, we might help partners in the South transform their food systems, away from the plantations and export crops and toward the cultivation of enough healthy fruits, vegetables, rice and beans to feed their own families. As we strengthen and spread our own local banks, credit unions, stock markets and mutual funds, we can help partners create these institutions as well, so that local savings everywhere increasingly support local housing, local education and local entrepreneurship. As we deploy new technologies to become more energy efficient, we can share our know-how with renewable resource innovators in the South.

This is what happened in Cuba - when they were cut off from Soviet oil, they saw that all their agriculture had been in the 2 main cash crops - sugar and tobacco. The workers had been serfs and the people's diet had been terrible.

Today in Cuba, the people with the money grow food. The diet for all is much much better. Cuba's health outcomes are better than the US.

All who grow food as an export cash crop get paid a pittance. On PEI it is potatoes. The farmers limp along - now we hear that the largest buyer is cutting back. Dire times ahead.

But a local food system on PEI could make food growing profitable and our diet and health so much better.

It would give us back control.