Actions Have Consequences, Plague Prevention Edition

After all, despite all those hand-wringing news stories, nobody American actually died in that potential Ebola pandemic, so why should we waste any more money that Paul Ryan assures us could better go to tax cuts for billionaires? Let Trump’s big, beautiful wall protect us from foreign viruses! Ed Yong, in the Atlantic:

In December 2014, Congress appropriated $5.4 billion to fight the historic Ebola epidemic that was raging in West Africa. Most of that money went to quashing the epidemic directly, but around $1 billion was allocated to help developing countries improve their ability to detect and respond to infectious diseases. The logic is sound: It is far more efficient to invest money in helping countries contain diseases at the source, than to risk small outbreaks flaring up into large international disasters.

But the $1 billion pot, which was mostly divided between the Centers for Disease Control and Prevention and USAID, runs out in 2019—a fiscal cliff with disaster at its foot. As I wrote:

That money has been used well, to train epidemiologists, buy equipment, upgrade labs, and stockpile drugs. If it disappears, progress will halt, and potentially reverse. The CDC, for example, would have to pull back 80 percent of its staff in 35 countries, breaking ties with local ministries of health.

This is now coming to pass. Two weeks ago, Betsy McKay at The Wall Street Journal reported that the CDC, with no firm promise of future funding, is indeed preparing to downsize its work in 39 countries. Those include the Democratic Republic of Congo, which recently experienced its eighth Ebola outbreak, and China, which is recently underwent its worst outbreak of H7N9 bird flu. Lena Sun of The Washington Post confirmed this report on Thursday, writing that “notice is being given now to CDC country directors” as the first part of a transition.

The CDC is not the only affected agency. USAID also received $300 million from the same dwindling pot of money, which it used to expand its work in the Middle East and Asia. Those programs may also have to shut down in 2019.

These changes would make the world—and the United States—more vulnerable to a pandemic. “We’ll leave the field open to microbes,” says Tom Frieden, a former CDC director who now heads an initiative called Resolve to Save Lives. “The surveillance systems will die, so we won’t know if something happens. The lab networks won’t be built, so if something happens, we won’t know what it is. We can’t be safe if the world isn’t safe. You can’t pull up the drawbridge and expect viruses not to travel.”…

But we know, from their statements during the 2014, that certain high-ranking Republicans are damned well determined to try.



Browser Outrage Dump

Time for another thread, I’d say, and I don’t have the functioning synapses to come up with anything new to say about the moral and intellectual crater that is both the Republican Party and the right’s public intellection bunch. (Did you know that Ron Johnson’s mug is being considered as the “After” portrait in the upcoming “Don’t Eat Tide Pods” campaign? Or that Rod Dreher’s thought leading crunchy conservative Christianity is racist to its root?)

So here I’m just going to lock and load some stuff I’ve kept open in my browser, waiting for the moment to foam in rage over here.  Think of this not so much as considered analysis (don’t think of it as all). Rather, it’s a very partial catalogue of how much damage decades of GOP anti-government, and worse, anti-society sabotage has done.  A goad, perhaps, though I hope no new one is needed, to crush these sorry f**ks come November, and forever after.

So here they come, in no particular order:

From Stat: “Drop in U.S. life expectancy is an indictment of the American health care system”

According to the CDC, the average life expectancy at birth in the U.S. fell by 0.1 years, to 78.6, in 2016, following a similar drop in 2015. This is the first time in 50 years that life expectancy has fallen for two years running. In 25 other developed countries, life expectancy in 2015 averaged 81.8 years.

The article acknowledges the impact of the opioid epidemic on those figures but notes that cross-country comparisons reveal systemic failures that make the disaster so much deeper here.  And then there’s the way we treat — or don’t — our elderly:

It is widely accepted that the accessibility and quality of medical services strongly affect life expectancy among the elderly and elderly Americans fall behind their counterparts overseas when it comes to being able to get and afford the health care they need.

This may seem surprising given that Americans over 65 enjoy universal health insurance coverage under Medicare. But as valuable as Medicare is, it provides far less protection against the cost of illness, and far less access to services, than do most other Western countries. In a recent cross-national survey, U.S. seniors were more likely to report having three or more chronic illnesses than their counterparts in 10 other high-income countries. At the same time, they were four times more likely than seniors in countries such as Norway and England to skip care because of costs. Medicare, it turns out, is not very good insurance compared to what’s available in most of the western world.

Next: that GOP assault on environmental regulation and protection?

Read more



Open Thread: Readership Capture

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Insert your own jokes about those Trump administration members who don’t expect to end up serving prison sentences:

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And finally, a well-considered opinion on Trump’s health issues:



Thursday Morning Open Thread: Snippits

So much news, you’ll get tired of all the news!

Apart from preparing the Throw the Bums Out, what’s on the agenda for the day?



What Doesn’t Make You Stronger Can Kill You

Bit of self promotion here:  I’ve got a piece in today’s Boston Globe, on one of the hidden consequences of failing to deal with the antibiotic crisis.  In it, I focus on the use of antibiotics as prophylactics in surgery. Nowadays, it’s standard procedure for a wide range of operations to dose the patient with antibiotics shortly before she or he goes under the knife; doing so has been shown to signficantly reduce the risk of post-surgical infections.

I took off from a study that modeled the consequences of increased microbial resistance for ten common procedures, mostly surgeries, along with chemotherapy for a particular set of cancers.

The results of that study were predictable:  more resistance leads to more post-op infections and to more deaths.  If the situation gets really dire, if common causes of infection associated with surgery become increasingly untreatable then the calculation behind all kinds of medical interventions will change:

That’s what scares Dr. James Maguire, an infectious disease specialist at Brigham and Women’s Hospital. “I think some of the worst feelings we have are when we have a problem with a patient and there’s nothing we can do.” Infections following joint replacements are bad enough. They are, Maguire says, “catastrophic in terms of what happens to the patient.” Were the risk of infection to go up enough, he adds, “having seen what an infected joint replacement is all about I would think twice.”

That’s a response to an operation that may be vitally needed to reduce pain and increase mobility — but, as Maguire went on…

…while someone contemplating a joint replacement can choose to forgo the risk, if they need a new heart valve or a ventricular assist device, “that’s potentially life and death.” In such circumstances, “if your life depending on having the device, even with great risk you’d do it. But more would die.”

Behind such specific possible horror stories, this is for me a deeply cautionary tale about the way choices our society — our politics — makes have much deeper effects than our usual debate admits.  Antibiotics are not just responses to disease; their use penetrates medical practice, to the point that basic expectations we may have about what how we can move through the stages of our life can be dashed, without our ever really grasping why.

That is:  joint replacements are part of our medical and mental landscape now.  There are over 330,000 hip replacements performed each year in the US.  We know (some of us, venerable as we are, more than others) that our knees, elbows, shoulders and so on won’t always work as well as they do today.  We know, most of us I’m sure, folks who’ve had the op and are now playing tennis again or whatever, and we have in the back of our minds (those of us fortunate enough to believe we’ll still have adequate health care available over time) that if and when that bit falls apart in our own bodies, we can look for the same outcome.

Except, of course, if the risks of surgery shift significantly in the meantime.

The last point I make in the piece, somewhat more gently than here, is that should the way we age, the way we give birth and so on deteriorates because of unchecked microbial resistance, that will be a more-or-less hidden consequence of political failure.

That’s because dealing with the antibiotic crisis boils down to doing two things:  regulating economic activity and funding research.  The GOP doesn’t want to do either.  And, as usual, people will die as a result.

So, on that note of cheer, a link, again, to the piece.

Oh…and open thread too.

Image: Follower of Jan Sanders van Hemessen, An Operation for a Stone in the Head, date unknown (to me).



Repub Horrorshow Open Thread: Sick Kids, Feh!


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Word is that Sen. Hatch is planning to retire, so I guess he now feels free to air his true GOP “I got mine, fvck you poor kids” philosophy in public.

I don’t know much about LDS theology, but from what little I do, there’s a bunch of [face*palm] going up back on Hatch’s home stake right now…



Thursday Morning Open Thread


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Apart from working together to lift everyone up, what’s on the agenda for the day?

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