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.
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.
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:
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:
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.
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:
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.
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?
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.
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:
