Priorities

Once, long ago, I used to be in a radiology department in a famous hospital. I liked radiology quite a bit and even before becoming a doctor I worked in them. Later I did research on the kinds of errors radiologists make when they read x-rays. One of the errors that was extremely well known even 40 plus years ago (although that didn't prevent it from being made with dismaying consistency up to and including today) was something called "satisfaction of search error." In essence, it meant that once one abnormality was found on an x-ray, there was an increased chance of missing a second,…
Congratulations, North Carolina. You are getting brand new $52 million facility for your State Public Health Laboratory and Office of the Chief Medical Examiner, each in separate wings of a 220,000 square foot facility in Raleigh. Sounds great. But if you work there you might want to shower at home and bring bottled water. And better check your benefits. Because the company that got the contract is non other than Kellogg Brown & Root (KBR), until recently a Halliburton subsidiary and notorious Iraq contractor under investigation for shoddy electrical work resulting in the electrocution…
We complain when there isn't enough swine flu vaccine and we complain when our health departments don't count all the cases. It's probably good so many people are out of work and can't eat in restaurants, because they aren't getting inspected because all available staff are trying to deal with the flu pandemic: The current swine-flu wave may have peaked, but thousands of public health workers are trying to vaccinate millions of people against the new disease, fearing that another wave could emerge in the new year. Yet recession-driven budget cuts have thinned their ranks so far that they are…
From a reader in Western Massachusetts: 10 Reasons to Oppose the Escalation of War in Afghanistan Human cost of war: Soldier and civilian deaths and injuries have been escalating each year since 2001. Nearly 1000 U.S. soldiers have been killed while 32,000 Afghan civilians have died as a result of the war. Economic cost of war: Each soldier in Afghanistan costs U.S. taxpayers $1 million per year. Private military contractors, known to de-fraud the Pentagon, exceed the number of soldiers in the war. No matter the war’s outcome, the defense industry wins with windfall profits. U.S. economy…
The idea that if the United States joins the rest of developed nations and finally adopts a universal health care system it will bankrupt itself is not based in reality. The reality is that the US spends a larger proportion of its Gross Domestic Product (GDP) than any other developed nation. By far. Not even close. CDC has just documented it from data collected by the Organisation for Economic Co-operation and Development (OECD) in its 2008 health data yearbook (statistics and indicators for 30 countries). It suggests we are being bankrupted by our lack of a universal health care system: CDC…
On Sunday DailyKos frontpager, DemFromCT (who is also a founder of the FluWiki and a pulmonary specialist) finished up his two part interview with us. It's cross-posted here below the fold. If anyone doubted we were academics, the display of watching us argue with ourselves would have but those doubts to rest. Scientists cherish the hope that we will make difficult things simple, but often we wind up making simple things difficult. We see complications in everything, even the simple question of what is public health infrastructure. Witness: Q. Last week I asked you about public health…
The Reveres, November 11, 2008, year five of the War in Iraq and year seven of the War in Afghanistan
One resource the incoming Obama administration is certainly to find no shortage of is advice. We don't know whom they will listen to, although we know much of it -- maybe most of it -- is likely to be of the self-serving variety. How to separate the wheat from the chaff will be a delicate task. Powerful people who give lousy advice still get bent out of shape when it isn't followed. So we'll have to see. Meanwhile we will be scanning whatever advice is made public. An example is a report from the Defense Science Board, issued on Election Day, no less. It purports to give the next…
The US election is over. Now comes the battle over what it means. The right wing of the Democratic Party aside, it seems pretty clear this was one of the periodic "realignment" elections that are of historic significance. Obama's base, overwhelmingly the progressive heart of the Democratic Party, is a powerful coalition of the younger generation, racial and ethnic "minorities" (each probably constituting larger voting blocks than the right wing linchpin of white evangelicals), GLBT groups, women, young professionals, those deeply concerned about the environment, traditional Democratic…
There is a lot of misery in this world, too much of it the result of what we humans do to each other. And it's getting worse. A typical example, is a country where 28% of the children are malnourished, up from 19% five years ago; where in 2006 11% of the newborns were underweight, up from 4% three years before; where 15% of the population doesn't have and can't afford enough food and is dependent food assistance programs for survival; where 70% don't have adequate water and 80% don't have adequate sanitation so that in the poorest urban neighborhoods people drink a water and sewage mixture;…
It's not like no one thought Galveston could ever be hit by a monster storm. The city was almost destroyed in The Great Storm of 1900 which struck on September 8 of that year and killed 6000 people. The Thomas Edison Company has historic film footage of the destruction. So it seems a bit odd (I understate) that the geniuses at the Department of Homeland Security and NIH decided that Galveston was a good place for one of the first two high containment biodefense laboratories to be built after 9/11 (the other is situated in a densely populated neighborhood in Boston, another sterling choice).…
IEDs, or Improvised Explosive Devices are killing American soldiers in Iraq. In Massachusetts people are dying from more prosaic things: auto accidents, heart attacks, homicides and suicides. IEDs aren't on Death's Menu in Massachusetts. So naturally the Bush-Chertoff Department of Homeland Security wants to protect Massachusetts citizens against IEDs: Juliette N. Kayyem, the Massachusetts homeland security adviser, was in her office in early February when an aide brought her startling news. To qualify for its full allotment of federal money, Massachusetts had to come up with a plan to…
Every day seems to bring a new story about the crap we are leaving strewn around our environment. Not just trash but chemical trash, the kind of stuff we eat, pop as pills or dispose of and which winds up as molecules in our air, water and food. You may think you know more than you want to about this but in fact you know very little about it because no one knows much about it. For example, there are no systematic measurements of the stuff in the raw water that goes into our water treatment plants, facilities designed to handle micro-organisms and not chemicals. The EPA has a program called…
A viral infection with serious public health consequences occurred in Canada on January with little publicity: Hundreds of computers at the Public Health Agency of Canada fell victim to a "worm," a bit of malicious software that nearly brought operations to a halt. The trouble began Monday, Jan. 15, 2007, when a few computer users at the agency and at Health Canada reported getting error messages. The worm eventually knocked out 1,308 or 80 per cent of work stations in three cities and took more than a month to eradicate, say newly released documents. The attack is estimated to have cost the…
The headline seemed to say it all: "Funding Issues Stymie Pandemic Preparation." Right, I thought. All the money is going in to procurement, too little into shoring up a failing public health system. Little did I know: The fear of bioterrorism and avian flu are driving a healthy new interest by biotech firms in developing products in the field of infectious diseases. "Even though we were developing a smallpox vaccine in 2000, there is no doubt that 9/11 was the moment that biodefense suddenly came up the funding ladder in the U.S.," said Clement Lewin, Ph.D., vp of marketing policy and…
I've said it before and I'll say it again. If you occupy a country you also assume responsibility for its public health. That's both international law and it's the right thing to do. In Iraq we haven't done that. So while I am about to say it once more, after I've said it I have something else to say, too, something that underscores my point in triplicate. But first the main point:. It is the kind of news that everybody had been dreading. An outbreak of cholera in Iraq, which started in two Northern provinces, has already reached Baghdad and has become Iraq's biggest cholera outbreak in…
The President's budget was announced on Monday (see our post here), and as many people know (including us), it is Dead on Arrival. But it is still a significant for its symbolism. This is what the Bush administration wants. They know they won't get it but they are making a statement. Some statement:
Most Americans think the Afghanistan mistake was the Right Thing to Do. While we are on record (here and here) as of another opinion, the conventional view is that getting rid of the Taliban was Good (they were Bad, which is true) and anyway it was payback for 9/11 (even though the Afghans didn't actually commit 9/11, only were the geographic location of the planner -- thanks to US aid when bin Laden was fighting the Soviets. Now Pakistan is where the 9/11 leaders live (not to mention that the actual perpetrators, who mostly came from Saudi). You fill in the rest. Still, few agree with us.…
After 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…
The AP's Margie Mason is a pretty good flu reporter and she has a story on the wires today whose title encapsulates the bird flu history of the last four years: Bird flu continues march 4 years later. The number of human deaths is still not large -- a few hundred -- just a day at the office in Iraq. But the virus just keeps extending its geographic range in poultry stocks and wherever it does it there is a risk of human infections. Fourteen countries so far have officially confirmed influenza A/H5N1 cases. The number of birds killed by infection or slaughtered to prevent the spread of…