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.
Back in May there were some stories on the wires and flublogia regarding a new study about arsenic exposure and risk of flu. I didn't write about it at the time for purely arbitrary reasons (I was writing about other things), but I noticed it and in fact I know the senior author and his work fairly well. For reasons having nothing to do with flu I revisited the paper the other day, along with a bunch of others on arsenic toxicity from the same group up at Dartmouth (the senior author, Josh Hamilton, has now moved to the Marine Biological Laboratory at Woods Hole, Massachusetts, but I think most of the work was done while he and his students were still in New Hampshire). Before getting to the flu connection, let me put the series of papers, of which the May publication was a part, in context.
Data from the Emerging Infections Program (EIP), one of the component parts of the CDC national influenza surveillance system, is showing that for some segments of its population the US did indeed experience a second flu season. The segment of particular concern are children between the ages of 5 to 17 years old, and to some extent adults between the ages of 18 and 49. The EIP counts only laboratory-confirmed hospitalizations in 60 counties located in 12 metropolitan areas in 10 states (if you are wondering, the 12 metro areas are San Francisco CA, Denver CO, New Haven CT, Atlanta GA, Baltimore MD, Minneapolis/St. Paul MN, Albuquerque NM, Las Cruces, NM, Albany NY, Rochester NY, Portland OR, and Nashville TN). Here's the method:
I spend a lot of time at a computer keyboard typing about biological viruses like influenza A, but computer networks are also subject to self-reproducing parasites of one kind or another and we continue to have a layperson's fascination with those organisms, too. I say "organisms" because try as I might, I can't figu®e out any criteria that distinguishes them from the carbon-based ones we mainly write about here. But that's another topic. This post is about yet another kind of harmful parasite, right wing politicians with only a couple of neurons firing, one of which they are using to breathe and the other to take campaign contributions from other wingnuts. Case in point: Representative Peter Hoekstra (R-Michigan), ranking member of the House "Intelligence" Committee.
I hate to take off on the press. I do it every once in a while, but not often. The slow and agonizing demise of the main stream press has major consequences for keeping the public informed about issues both big and small. It's also a personal tragedy for many dedicated professional journalists. Still, while newspapers-as-we-knew-them aren't dead yet, they are at least moribund, and like the famous definition of a statesman as a successful politician who is dead, there is more than a bit of a tendency to endow the working press with some virtues it doesn't have now and in general never did. There is quite a lot of truly dreadful reporting every day and it isn't new. Consider the tragic case of the GP in the UK who died after contracting swine flu:
Yet another paper testing the current swine flu pandemic virus in animals appeared in Nature yesterday, covering much the same ground as two published July 2 in Science and with similar findings. All three of these papers show the pandemic virus more likely to infect tissues deeper in the lung than seasonal flu viruses used for comparison. But each of these papers had a slightly different author spin. This one is even being construed as suggesting that we may be confronting a virus much like the 1918 monster.
I am thinking out loud here. Since that's never a pretty sight, you might wish to avert your eyes. With that merest of advance warning, the school closure problem has gotten me to think more generally about social distancing. The term itself is a kind of oxymoron. "Social" emphasizes togetherness, intercourse between people, relations. "Distancing" is negation of the social. We have examples: canceling school, prohibiting mass gatherings, telecommuting, but the underlying idea is straightforward. With a contagious disease that passes from person to person (details still to be worked out, of course), we decrease transmission by minimizing person to person contacts, i.e., we distance people from each other -- social distancing. Decreasing transmission has benefits, even in the case where the total number of people infected is the same over the long run. If we flatten out the epidemic curve (the graph that shows how many new cases appear each day); and move its peak which is now lower to a later point, we have bought time and stretched out demand, easing the burden on health services. Those are the benefits.
Sunday and The Reveres have discharged their pastoral obligation to do a Freethinker Sermonette but there is other news on the religion front so we'll do a religious twofer. We've already discussed the nomination of Francis Collins to be NIH Director a couple of times (here, here and here; one post was linked in a Wall Street Journal online column by Steven Waldman, much to our surprise). Collins has religious beliefs that are quite different than most scientists because he has them at all. Just how different that is was revealed by a recent Pew Poll on public views of science, one section of which looked at differences between scientists and non-scientists regarding belief:
I don't think Noam Chomsky is a genius like Einstein or Newton but he is certainly the smartest person I've ever met. While I know him only casually, it is an acquaintanceship stretching over at least four decades. He once did me the great favor of teaching a class on the British Empiricists at my request. It was an intellectual tour de force. I don't know if my students were as blown away by those two hours as I was but they should have been. He likely doesn't remember it (it was 30 years ago), but it was typical of him. He is extraordinarily generous with his time and has done things like this for countless others. He is also absolutely uncompromising in his principles, something many people find uncomfortable.
The following clip is vintage Chomsky. I'm not sure when this fragment of an interview on religion was done but it is clearly in the last few years. These of the views of a very sane man on an insane subject:
It's Saturday and it's summertime and Mrs. R. and I are still in the city. OK with me. I'm a city boy and find it easiest to maintain upright posture on asphalt, but my bride of 37 years likes the beach, so most summers we go off for a few weeks to the seashore (speaking littorally). It's down south where the water is warm but I still spend a lot of time inside in air conditioned splendor, listening to music and reading. Mrs. R. props herself up at the earth - water interface with her own pile of books, far from other people and the hazards of pathogenic viruses. It turns out, not really.
Perhaps because of a perverse pleasure I take in the hazards of nature, my eye was attracted to two pieces about viruses at the beach. The first was just a notice in Nature Protocols (hat tip ti tweet by @andrewcsinger):
