Federal health
revere | January 7, 2009For some years I have been playfully asking students and colleagues (all active health professionals or professionals to be) if they could tell me the name of the Surgeon General of the United States. Few could. In fact, last night the current Acting Surgeon General's name was mentioned and I had not only forgotten who it was, but I actually know the guy (Steve Galson). If you ask public health professionals to name any SG, however, they all can. Most often it's C. Everett Koop but might also be David Satcher, Joycelyn Elders or (for some of us older folk) the late Julius Richmond (Julie used…
revere | September 20, 2008Generals are often said to be fighting the last war and public health officials likewise are managing the last crisis. At the end of May 2007 we had the notorious flying lawyer with TB flap (see our multiple posts here), so in June 2007 CDC quietly instituted their public health version of the "No Fly" list. I guess because the Department of Homeland Security (DHS) No Fly list has been so incompetently and dangerously implemented CDC didn't want to taint their version with the same name, so they are calling it the Do Not Board (ENB) list. The DHS list is pushing a million entries. Pretty soon…
revere | August 31, 2008The folks at ScienceDebate2008 pushed hard during the primaries to have the candidates address science policy. Chris Mooney and Sheril Kirshenbaum from Scienceblogs The Intersection were among the leaders in this movement. They didn't succeed in getting a debate then, but now with the field down to the finalists, they have received a response from Barack Obama to 14 questions culled from over 3400 submitted by the 38,000 signers of the ScienceDebate initiative (we were proud to be among them; they include nearly every major American science organization, the presidents of nearly every major…
revere | August 12, 2008We've argued before that the US biodefense laboratory effort -- whose planning principle seems to be based on "more" -- was making us less safe, not more safe. Whatever else you say about the anthrax attacks, they are a perfect illustration of this. The weapon and the culprit(s) came directly from the US weapons labs. A case of blowback if there ever was one. But the Bush administration, undeterred, wants to keep building these facilities. The highest level of containment for working with the most dangerous agents for which there is no vaccine or cure (BSL4 labs) were four in number in 2002.…
revere | July 26, 2008We've been saying this for a while. The produce industry has taken a big hit and their successful lobbying is one of the reasons. But it's not just their fault. It's also the fault of the Bush administration:
One of the worst outbreaks of foodborne illness in the U.S. is teaching the food industry the truth of the adage, "Be careful what you wish for because you might get it."
The industry pressured the Bush administration years ago to limit the paperwork companies would have to keep to help U.S. health investigators quickly trace produce that sickens consumers, according to interviews and…
revere | July 24, 2008The headline said, "Vaccination plan puts health care workers first," but you had to read the article to find out who goes next: the military. This according to the Guidance on allocating and targeting pandemic influenza vaccine released yesterday by the US Department of Health and Human Services (DHHS). The guidance is premised on the assumption that in the early phases of a pandemic, any vaccine will be in short supply and will need to be rationed. The document gives "strong advice" on how DHHS thinks this rationing should take place, although much is left unexplained. Since the allocation…
revere | July 1, 2008As the tomato Salmonella outbreak heads past the 800 case level, it's time to ask some questions about why we don't know the source of what is the largest produce associated disease outbreak on record. CDC has its own explanation, namely, that figuring out where tomatoes come from and where they go is much harder than they thought. Said another way, the experts in foodborne disease outbreaks at CDC and FDA didn't know much about the industry. Since tomatoes have been a frequent cause of Salmonella outbreaks, that seems odd, except that my experience with CDC in recent years is that it is full…
revere | June 8, 2008The controversy over the health of rescue workers at the World Trade Center site goes on. The Wall Street area was re-opened quickly after 9/11 despite EPA air tests that showed hazardous materials in the air by direct orders from Condeleeza Rice's office when she was National Security advisor to George Bush. High asbestos levels were omitted from press releases because of "competing priorities," according to an article in the New York Post in September 2006 (long pull quotes in the post linked above but the new link has since been taken down). So political interference has already been…
revere | May 23, 2008If you aren't in the business of figuring out if a chemical is a health hazard you might never have heard of the EPA's IRIS (Integrated Risk Information System) database but suffice it to say it is a wealth of valuable information on the topic. Considered authoritative by many states and countries, its judgements have become the basis for official standards. It's been around since the start of Reagan's second term (1985) so there is no claim it is some kind of fringe environmentalist fantasy. It's not the Last Word but it's a loud voice and taken seriously by anyone tasked with protecting the…
revere | March 11, 2008I'm an advocate of using computer models to help us think about what might or could happen during various pandemic flu scenarios, but it is a technique with drawbacks. For one, it can suggest that some things might be possible that are either very difficult to do or aren't feasible. This happened in 2005 when some models were published in Science and Nature that suggested a pandemic could be nipped in the bud before it started. Most people thought that what was required was unrealistic but it put WHO in a bind. They had to marshal their resources to show they were willing to try or go down…
revere | March 6, 2008We don't especially like being anonymous on this blog but we feel it is prudent given the retributive nature of this administration. We don't care that much ourselves as we are pretty well established. But we worry that our students, our colleagues and our institution will become collateral damage in retribution for things we say here. It's not just that we read about this stuff in the news. We know the people involved personally. Last week we posted about Deb Rice, a scientist in the State of Maine health department who is also one of the world authorities on the health effects of the…
revere | February 22, 2008Recently we posted on the insanity of requiring informed consent for posting a hygiene checklist in the ICU. This week the New England Journal of Medicine weighed in.
Here's some background from the NEJM Commentary:
About 80,000 catheter-related bloodstream infections occur in U.S. intensive care units (ICUs) each year, causing as many as 28,000 deaths and costing the health care system as much as $2.3 billion. If there were procedures that could prevent these infections, wouldn't we encourage hospitals to introduce them? And wouldn't we encourage the development, testing, and dissemination…
revere | February 16, 2008It's official. Living in one of the 120,000 trailers FEMA supplied after Hurrican Katrina is bad for you:
Federal health officials on Thursday urged hurricane victims to move out of trailers supplied by FEMA after tests showed dangerous levels of formaldehyde fumes.
Tests by the Centers for Disease Control and Prevention on more than 500 trailers in Louisiana and Mississippi showed formaldehyde levels that were five times higher than levels in a normal house. The levels in some trailers were nearly 40 times what is normal.
The CDC said people should move out quickly -- especially children,…
revere | February 9, 2008Late yesterday afternoon, a Friday and classic time to release news you don't want anyone to read, I got the following email [excerpted] from David Schwartz, on leave as Director of the National Institute of Health Sciences (NIEHS), the main public health-oriented NIH institute and the subject of several previous posts (here, here, here, here, here):
Dear friends and colleagues,
I have decided to resign as director of the NIEHS and NTP, effective immediately. My reasons for this decision are simple. I believe that our institute would be more successful with new leadership, and that I would…
revere | February 3, 2008After our recent rant on the necessity of supporting the public health and social services infrastructure instead of cutting taxes, President Bush has replied. He is cutting the infrastructure:
President Bush's $3 trillion budget for next year slashes mental health funding and rural health care and freezes spending on medical research, among the cuts outlined in budget documents obtained by The Associated Press.
The budget for the Department of Health and Human Services would be reduced by almost 3 percent under the Bush budget plan to be released Monday. The $2 billion in HHS cuts are about…
revere | December 27, 2007If you have heart disease or diabetes and you are uninsured you are worse off than those who are insured by several measures. Those are the kinds of health conditions that usually worsen with age, too, so you would expect this to be a bigger problem for the uninsured near elderly. But they don't worsen for this group because when they hit 65 in the US they are no longer uninsured: they have the near universal health insurance coverage called Medicare, and as a result their health improves. Those are among the findings in a paper in the Journal of the American Medical Association (JAMA) by a…
revere | December 19, 2007Bush and the Democratic Congress are still battling over the budget, although it is said they are getting closer. Getting closer to Bush unfortunately means giving him all the bombs and bullets he wants but not much else. A case in point is the latest proposal for the NIH and CDC budgets:
Over the weekend, Congress prepared a new version of appropriations following President George Bush's veto of previous bill in November. This new bill includes $760 million less for NIH and $240 million less for CDC than the vetoed bill, according to news reports today.
The result is an increase of less…
revere | December 11, 2007One of the most effective environmental regulations that wasn't a command and control item was something called the Toxic Release Inventory (TRI) Program. Here's EPA's description:
The Toxics Release Inventory (TRI) is a publicly available EPA database that contains information on toxic chemical releases and other waste management activities reported annually by certain covered industry groups as well as federal facilities. This inventory was established under the Emergency Planning and Community Right-to-Know Act of 1986 (EPCRA) and expanded by the Pollution Prevention Act of 1990.
That…
revere | November 21, 2007Blog is short for weblog, originally a chronological set of postings about, well, about whatever. Blogs are/were journals that were published publicly but also allowed readers to comment, read, react and in some ways affect the content. How much dialog and two way communication there was depended on the blog. Some have virtually none, although monitoring traffic and interest is one kind of reader feedback that doesn't depend on a formal comment facility. Others are highly interactive, with lots of comment, a community feeling and vigorous discussion. The big innovation, though, was that the…
revere | November 20, 2007It's OK for storm victims to live in them, but don't let your employees enter them: FEMA. Who else?
The Federal Emergency Management Agency is barring employees from entering thousands of stored travel trailers over concerns about hazardous fumes, while more than 48,000 other trailers continue to be used by hurricane victims in Louisiana and Mississippi.
FEMA is advising employees not to enter any of the roughly 70,000 trailers in storage areas across the country, but the directive does not apply to other trailers still in use, agency spokeswoman Mary Margaret Walker said Thursday. (AP; hat…