Tom Friedman knows nothing, please fire him

Referring to an opinion piece in the NYT from Tom Friedman:

“Either we let many of us get the coronavirus, recover and get back to work — while doing our utmost to protect those most vulnerable to being killed by it. Or, we shut down for months to try to save everyone everywhere from this virus — no matter their risk profile — and kill many people by other means, kill our economy and maybe kill our future.”

I mean, really? Does Mr. Friedman not understand that most deaths from Covid19 will occur because the health care system just does not have the capacity to see the high number of patients with serious disease that will appear if we do nothing?

The goal is not to “save everyone, everywhere.” People are going to die. Actually, they already have. The goal is to bring the rate that people with serious disease appear at hospitals to a manageable level and to buy us time to come up with effective treatments and, possibly, an effective vaccine.  We need to slow down transmission because a lack of ICU beds, ventilators and people to work them will be a major determinant of mortality in people with severe symptoms of disease.

“That huge range markedly affects how severe the pandemic is and what should be done. A population-wide case fatality rate of 0.05% is lower than seasonal influenza. If that is the true rate, locking down the world with potentially tremendous social and financial consequences may be totally irrational. It’s like an elephant being attacked by a house cat. Frustrated and trying to avoid the cat, the elephant accidentally jumps off a cliff and dies.”

This is just ridiculous. There is a vaccine for influenza and most people have at least partial immunity to it, so that fewer people become infected. 99.99999% of humanity has exactly zero immunity to Covid19 so that even if the case fatality rate is the same as influenza, there will be potentially more infections. Small percentages of big numbers are still big numbers.

The article he refers to even tries to make a bizarre argument that because there are other coronviruses out there that also cause death, then we should not be overly concerned with this one. Again, the other coronaviruses out there (many of which cause the common cold) have been around for quite some time. Many people have developed some level of immunity to many of them (correct me if I am wrong here) which reduces the total number of people who become infected yearly.

We certainly have to weigh out the costs and benefits of any intervention. In this case, many people will lose their livelihoods, people will turn to alcohol and drugs, there will be financial meltdowns and suicides. This must be discussed.

However, we can’t blind ourselves to the incredible human cost of a new pathogen that humanity has no immunity to, that, even if that pathogen has characteristics of pathogens we are commonly faced with. We can’t say, “saving lives is too expensive” when the financial cost of breaking our health care system is also incredibly expensive.

What if your ancestors suck?

Ancestor worship is a common theme in African lore, particulary in the traditional arts. So while people are singing the praises of their dead relatives, I always wanted to ask what to do if my ancestors were horrible people?

I was recently speaking with some people whose parents were refugees from Romania, ostensibly people who were fleeing life under the dictator Nicolae Ceaușescu, a forgotten piece of Stalinist work who made the lives of Romanians miserable for decades. While Ceaușescu and his government were vile, the people who came to the US were refugees and likely middle class families decended from peasants back home.

The contrast with my and many Americans’ heritage is stark. I am decended from a family of Mitchells, a distinguished Scottish family of wealthy means who decided to take a gamble and invest in agricultural ventures in the Southern United States. The first to come was a man named Thomas Mitchell, my maternal great x 10 grandfather, who arrived in US, fought in the Revolutionary War and set subsequently set up shop for the family business in Georgia.

Thomas, like many Scots who came to the Southern United States, came to profit not only off land and agricultural products that could be exported to Europe, but also off the promise of cheap, forced labor from Africa. Thomas Mitchell was a slaver.

From slave based agriculature, the Mitchell family became extremely wealthy in the South, producing numerous politicians, lawyers, administrators and academics. There is still a county named for the Mitchell family in Georgia.

In 1836, the Mitchell family expanded their land holdings by assembling a militia of 75 men and committing a genocide against the Native American residents of their land “in which all the Indians except five were killed, their arms, campage, etc. falling into the hands of the whites.”

There are others, but the point is, does it make sense to venerate one’s ancestors when they were clearly committing crimes against humanity? The Romanians I spoke with probably have terrible members of their family, but likely have not had their lives shaped by a horrible past.

I am not unique. Just about any white person in the South whose family was their during the 18th and 19th centuries was involved in the buying, selling and use of humans. If they have money now, it is a direct result of slavery and the ethnic cleansing of Native Americans in the South. We should never forget, because that’s how we got here, the past that shapes our present. Our current lives were made possible by terrible people doing reprehensible things to other people.

So no, not going to sing any praise songs to my ancestors any time soon. Maybe I’ll do the opposite instead.

My intro malaria/tropical medicine course at Colby College… is done!

A friend of mine hooked me up with a short gig teaching a course in malaria and tropical medicine for Colby College’s JanPlan. Every January, students have the opportunity to study a subject in depth, often with teaching faculty not based at Colby College.

I have long wanted to design an undergrad level course in tropical medicine so took it as an opportunity to do so. We focused mostly on malaria, covering the basics of malaria epidemiology, pathogen and vector biology, prevention and treatment, diagnostics, vector control, health care delivery, international funding for malaria programs, drug and insecticide resistance and elimination/eradication. We even had lectures on basic concepts of epidemiology and infectious disease and talked at length about public health, public health practice and medical ethics. It has been a fairly intense month.

At first, I was a bit concerned that the subject matter would be too broad, particularly for science people, but quickly learned that much of the class were non-science majors, and most were freshmen.  This gave me a great opportunity to bring in a wide range of topics that could appeal to just about everyone in the class.

Leeches for sale: The economy of bloodletting in France, 1827-1836

N8000057-Leech_use,_historical_artwork-SPLI found this great post on drug shortages that appeared in BMJ today.  Among all of the other great gems in it, was this incredibly interesting article on the creation of a mechanical bloodletting device. Jean-Baptiste Sarlandière, a French anatomist and inventor, created the “mechanical leech”, a device intended to extract a controlled amount of blood from the body. Sarlandiere intended the device to replace leeches, which were subject to increasing demand, were becoming expensive, were difficult to cultivate, and were subject to shortages in the Netherlands, who was a large producer of leeches at the time.

A paper was written on the device back in 2009, and within there is a dataset of leech imports and exports to France, which includes data on the monetary value of leeches and public consumption. Of course, I couldn’t resist pulling this data out and doing something with it (despite having better things to do.)

Here is the data, pulled from yet another paper (Alexandre E Baudrimont, Adolphe J Blanqui, et al.Dictionnaire de l’industrie manufacturie`re, commerciale et agricole, Paris, J-B Baillière, 1833–1841, pp. 25–30.):

Year Number of leeches imported Value in Francs National consumption Exports Import export ratio Value per leech
1827 33653694 1009611 33456744 196950 170.87 0.03
1828 26981900 809457 26689100 292800 92.15 0.03
1829 44573754 1337212 44069848 503906 88.46 0.03
1830 35485000 1064550 34745848 739250 48 0.03
1831 36487975 1094639 35245875 1242100 29.38 0.03
1832 57487000 1724610 55591700 1895300 30.33 0.03
1833 41654300 1249629 40785650 868650 47.95 0.03
1834 21885965 656579 21006865 879100 24.90 0.03
1835 22560440 676813 21323910 1236530 18.24 0.03
1836 19736800 592104 18721555 1015245 19.44 0.03

Leeches

Of course, I am fascinated with this. The number of leeches exported from France rose during this period as did the market price of each leech. Though the entire industry would eventually collapse because other medical advances of the nineteenth century would supercede it, it is clear that increased demand and expense led to innovation to create devices to replace it. I don’t know whether the “mechanical leech” led to the development of other medical devices, but would like to think that even batshit ideas like how swamp worms draw out blood to cure any and all medical conditions would lead to the creation of methods which do improve health.

Is blogging even meaningful anymore?

I started this blog way back in 2007, when I was a Masters student at the University of Michigan. At the time, it felt like a good way to get writing out there, and communicate ideas in a public forum. When I was at my peak on this blog (and my life, it seems) I was writing daily, sometimes posting the data analyses equivalent to many (low quality) published scientific papers, writing travel logs, doing interviews, broadcasting psychological traumas, posting photos… it was a good time.

At some point, I lost focus, got busy with other things, got on the wrong track, the right track, it really isn’t clear to me what happened, but I posted less and wrote less. The result was that my writing suffered, because the daily posts provided a great opportunity to keep my writing in shape, and explore interesting scientific topics in depth without worrying about the bureaucratic demands of peer review or research collaborators. While peer review and research collaborations are important, every science needs a forum with which to explore ideas.

Now, though, as I move back into my academic career, I am wondering…. is blogging worth it anymore? I just read Rachel Strohm’s final post . Rachel started blogging about the same time I did, and has since moved on to a fruitful career in development and academia and now lives in Kenya. She has recently stopped blogging, noting that “The development blogging ecosystem is basically dead. ” (I do wonder if her move to Kenya  might have killed her motivation for blogging, the same way it killed mine.) I have also noticed that the authors of several blogs I used to read have also moved on.

Strohm offers that direct newsletter updates and Twitter might be a better platform for dissemination blog-like information for people. I think Twitter is a pretty terrible platform for anything at all outside of haranguing right wingers or sending cat videos, so I am not sure that it would do what blogging would have done for me. While I do not have a large Twitter presence, it seems to be a major time suck, with little reward and multiple costs (like blood pressure.)

Newsletters are interesting. Even as a musician, I find that directly engaging people who might be interested in my music is far better than any of the social media platforms, which do their best to make sure that no one ever sees what you do, unless you have a thousand dollar PR budget.

I liked the blogging format. I still do. I think it could still work, but wonder…. do people even read long form writing anymore? Does it have any impact? Is blogging going the way journalism is? What is a good platform anymore? Does writing mean anything at all anymore?

Detroit Communities Reducing Energy and Water (use): Jefferson-Chalmers edition

test (9 of 11)Once again, I tagged along on a trip to Detroit with the D-CREW, a community based participatory research project aimed at developing strategies to improve housing and thereby reduce wasteful water and energy use in Detroit communities.

This weeks data collection efforts focused on the Jefferson-Chalmers area of Detroit, just adjacent to Gross Pointe.

Data collection went as smoothly as before, but with a more affluent and sophisticated group of people the vast majority of whom own their own homes.

The informational session became quickly energized, with participants asking pointed questions like “how is this research going to benefit us?” “are you going to sell our data?” “is my cousin going to be able to see my data?”

Doing research in the communities of Detroit is every bit as exciting and engaging as doing work in Kenya, where researchers are rightly met with skepticism, the goals of the research are obscure, and the direct benefits likely non-existent.

Pollen allergies and asthma study begins!

20190806_091919-01

Get your immunotherapy shots here

Currently, I am a part of a project looking at climate change impacts on the distribution of tree and grass pollens in the US and associations with allergy and asthma related emergency room visits

As part of that, we are collecting baseline data on symptomatic profiles of patients who are sensitive to tree and grass pollens and are currently undergoing immunotherapy in local clinics.

Our survey is two fold, the first a baseline survey of types of demographics, types of allergies, seasonal sensitivities, general symptoms and lifestyle impacts, the second a three week survey of sleep quality and allergy and asthma related events.

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University of Michigan School of Public Health Masters student Erica Bennion explains the goals of the study to a potential participant.

We hope to gather data to see how the ragweed season might impact general health and well being using a coarse raster of predicted pollen distribution.

The survey is being conducted at the University of Michigan Allergy Specialty Clinic and Food Allergy Clinic at Domino’s Farms and will include approximately 50 people.

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