Now on ScienceBlogs: Spirited Debate with Ray and Kirk
Effect Measure is a forum for progressive public health discussion and argument as well as a source of public health information from around the web that interests the Editor(s)
The Editors of Effect Measure are senior public health scientists and practitioners. Paul Revere was a member of the first local Board of Health in the United States (Boston, 1799). The Editors sign their posts "Revere" to recognize the public service of a professional forerunner better known for other things.
November 22, 2009
Category: China • Health care • Human rights • Swine flu
Since the way Chinese public health officials traditionally save face is by covering their ass, when I hear things like this I don't automatically believe it:
Posted by revere at 2:08 PM • 1 Comments • 0 TrackBacks
Category: Freethinker Sermonettes
Biblical exegesis as it was meant to be:
Posted by revere at 6:37 AM • 6 Comments • 0 TrackBacks
November 21, 2009
Category: Genetic sequences • Influenza treatment • Surveillance • Swine flu • biology
The Norwegian Institute of Public Health is reporting sporadic occurrences of a mutation in a portion of the flu virus that is involved with the process by which it attaches to cells. I use the word "sporadic" because at this point there is no evidence that the cases where the genetic change has been found are epidemiologically linked. Therefore we don't see it spreading from person to person but rather arising in people after they have been infected. At least that's how it appears from reports, but we have only preliminary information at this point. According to WHO, the mutation has been seen before, again sporadically and as early as April, in Brazil, China, Japan, Mexico, Ukraine, and the US. Should we be worried about it?
Posted by revere at 6:03 AM • 30 Comments • 0 TrackBacks
November 20, 2009
Category: Health insurance • Injury
Swine flu is a special danger to the young, but the biggest danger to the young is not an infectious disease but unintentional accidents. No matter what your age accident is among the top ten causes of death, but for those between the ages of 1 and 44 it is number one. Prevention oriented accident specialists are fond of saying that "accidents are no accidents," by which they mean that many accidental deaths are in some sense avoidable, not freakish twists of fortune. So wear your seat belts and don't go golfing in lightning storms. And while you're at it, have health insurance, since there is now new evidence that not having it makes it more likely you'll die if you do have an "accident."
Posted by revere at 6:04 AM • 7 Comments • 0 TrackBacks
November 19, 2009
Category: Clinical • Infectious disease • Influenza treatment • Swine flu
The Director of Loyola University Medical Center's clinical microbiology laboratory is reported as saying that rapid flu tests are a public health risk. Here's some of what he said and then my explanation as to why it is misleading or just plain wrong:
Rapid influenza diagnostic tests used in doctors' offices, hospitals and medical laboratories to detect H1N1 are virtually useless and could pose a significant danger to public health, according to a Loyola University Medical Center researcher."At Loyola, we determined four years ago that the rapid tests for influenza detected only 50 percent of the patients who were positive," said Paul Schreckenberger, Ph.D., director of Loyola's clinical microbiology laboratory. "I can flip a coin and get the same results as I could with those tests. So what's the value of the tests? I can flip a coin for free." (Medical-News)
We've discussed this before, but since the underlying concepts seem poorly understood (even by clinical laboratory directors), it's time to discuss it again.
Posted by revere at 6:07 AM • 19 Comments • 0 TrackBacks
November 18, 2009
Category: Statistics
I have been away (again) and out of internet contact most of the day, dealing with an unhappy family event. So this post is short but illustrates an important point that comes up frequently in epidemiology: the difference between risks and absolute numbers. The illustration is not medical, but I think sharper because of it:
Posted by revere at 6:37 AM • 14 Comments • 0 TrackBacks
November 17, 2009
Category: Bird flu • Pandemic preparedness • Swine flu
The blogosphere (DemFromCT at DailyKos) and the main stream media (Alan Sipress at the Washington Post) brought us the two faces of the current flu pandemic. Like Janus, one took lessons from the present and past, the other looked worriedly to the future.
Dem's piece on flu at DailyKos (a regular feature of the world's biggest political blog) is superb. Most everyone who regularly reads about flu in the blogosphere (and it is a huge readership) knows that DemFromCT is the blog handle of an expert who has been writing about pandemic flu for years (as long or longer than we have and we are coming up on our 5th blogiversary), knows the landscape intimately from both the policy and scientific perspective, and is himself a practicing pediatric pulmonologist, so in his daily practice he is in the eye of the storm. With those qualifications you'd expert the best and that's what you get. His post on Sunday, "Lessons Learned from the Pandemic" hits every nail on the head, and there are a lot of nails. He extracts 7 lessons and you should read his post in its entirety, but I'll tease you with the first lesson:
Posted by revere at 6:38 AM • 21 Comments • 0 TrackBacks
November 16, 2009
Category: Pandemic preparedness • Public health preparedness • Swine flu • WHO
We were asked repeatedly offline and in the comments for our views on what was or was not going on in the Ukraine, but we steadfastly declined to post on it. We didn't know any more than you can find out from news sources, so we had nothing to add in the way of hard information, We did know there was a WHO team on the ground and we thought it best to wait to find out more. We still don't know much, except that news reports are suggesting that the health care system in the Ukraine is a shambles and its likely the chaos and panic were self-inflicted more than virally inflicted. Mike Coston over at Avian Flu Diary has a great run down and we agree with the way he approached it -- gingerly, cautiously but with the right amount of anxiety that something could be happening but it was best to wait for information before hitting the alarm button (I didn't say panic button because it's never appropriate to hit the panic button).
Meanwhile, multiple stories out of the Ukraine were detailing disorganization, incompetence, politicization of the outbreak during a presidential campaign and much else. Few citizens believed what their leaders or government were saying, which is probably just as well because the messages were often contradictory and confused. The most recent version of this is from the New York Times:
Posted by revere at 6:23 AM • 12 Comments • 0 TrackBacks
November 15, 2009
Category: Swine flu • Wingnut wrongosphere
Any article entitled "On swine-flu conspiracy theories" should have an automatic warning label, but the one noted below, in the Canadian newspaper The Globe and Mail is really terrific (h/t ML). Conspiracy theories are all over the internet and they even show up here in the comments from time to time, but I'm glad to say our readership is saner than some. Like scientific theories, conspiracy theories aren't hard to formulate (humans being an inventive and imaginative species), but like good science, conspiracies aren't so easy to implement. It's not that conspiracies don't exist, the philosopher of science Karl Popper observed in The Open Society and Its Enemies:
Posted by revere at 1:15 PM • 19 Comments • 0 TrackBacks
