Quotulatiousness

May 12, 2013

Influenza: the trade-off between virulence and contagion

Filed under: Health, Media, Science — Tags: , , , , , — Nicholas @ 10:34

Matt Ridley explains why the breathless claims that this or that flu outbreak could rival the Spanish Flu pandemic of 1918-19 should not be taken too seriously:

Here we go again. A new bird-flu virus in China, the H7N9 strain, is spreading alarm. It has infected about 130 people and killed more than 30. Every time this happens, some journalists compete to foment fear, ably assisted by cautious but worried scientists, and then tell the world to keep calm. We need a new way to talk about the risk of a flu pandemic, because the overwhelming probability is that this virus will kill people, yes, but not in vast numbers.

In recent years flu has always proved vastly less perilous than feared. In 1976 more people may have died from bad reactions to swine-flu vaccine than from swine flu. Since 2005, H5N1 bird flu has killed 374 people, not the two million to 7.4 million deemed possible by the World Health Organization. In 2009, H1N1 Mexican swine flu proved to be a normal flu episode despite apocalyptic forecasts.

No doubt some readers will remind me that, in the story of the boy who cried “Wolf!”, there eventually was a wolf. And that in 1918 maybe 50 million people died of influenza world-wide. So we should always worry a bit. But perhaps it’s not just luck that has made every flu pandemic since then mild; it may be evolutionary logic.

Of course, just about every story about influenza you’ll encounter goes the Chicken Little route:

There’s no mystery as to why we talk up the risk every time: All the incentives point that way. Who among the headline-seeking journalists, reader-seeking editors, fund-seeking scientists, contract-seeking vaccine makers or rear-end-covering politicians has even a modest incentive to say: “It may not be as bad as all that”?

Thomas Szasz was no conservative

Filed under: Health, Liberty, Media — Tags: , , , , — Nicholas @ 09:50

In Reason, Jacob Sullum looks at an essay on the late Thomas Szasz that puzzlingly attempts to portray him as a staunch conservative:

In an interesting but puzzling Aeon essay, Cornell historian Holly Case notes the resemblance between contemporary doubts about the scientific foundation of psychiatry and the critique first laid out by Thomas Szasz half a century ago. “It might be that the world has only recently come around to his way of thinking,” Case suggests. Yet she misconstrues an important aspect of Szasz’s thinking by portraying him as “a staunch Republican” and a “conservative,” apparently unaware of his self-proclaimed libertarianism. Szasz, who died last year at the age of 92, was a Reason contributing editor for decades. He described the main motivation for his intellectual career as “my passion against coercion,” which he opposed (outside of situations involving the defense of rights) no matter who was advocating it, left, right, or center. Hence he opposed forced psychiatric treatment, but he also opposed interference in consensual transactions between psychiatrists and voluntary patients. Here he parted company with some left-wing critics of psychiatry.

[. . .]

But Case focuses mainly on common ground between what she views as right-wing and left-wing critics of psychiatry. Beginning in the 1960s, she writes, “Right and left sought to eliminate insanity in order to lionise dissent, legitimise the marginal and condemn the new normal. Few other issues show a convergence of right and left so far-reaching, while still allowing both sides to adhere to their politics and maintain a sense of total opposition.” At the same time, she says “Szasz was conspicuously alone in mounting the barricades from the right,” so she really needs him to be a right-winger. Bending the facts to fit her thesis, she ascribes to Szasz a “distinctively conservative perspective.” That label does not jibe with his opposition to drug prohibition and his forthright defense of the right to suicide, two major themes of his career that Case tellingly ignores. Szasz’s position on physician-assisted suicide combined both of these themes and demonstrated that his perspective was in fact distinctively libertarian. He opposed Oregon’s Death With Dignity Act (later imitated by Washington) because it medicalized a moral decision and required people to meet government-dictated criteria before they could legally end their lives. If the drug laws did not make it difficult for people to obtain substances useful for suicide (such as barbiturates), he said, there would be no need for physician-assisted suicide.

SF novels for economists

Filed under: Books, Economics, Media — Tags: — Nicholas @ 09:38

Noah Smith cobbles together a list of science fiction novels that might be of interest to economists:

Diane Coyle has a blog post called “Classics for economists,” and someone on Twitter requested that I do a companion piece called “Science fiction for economists”, so here it is.

Really, most science fiction is about economics. What makes most future visions interesting is not just the technical particulars of the cool new Stuff, but the social ramifications. Here are some of the sci-fi books that I thought dealt with important economic issues in the most insightful and interesting ways. I also chose only books that I think are well-written, with well-conceived characters, engaging plots, and skillful writing.

1. A Deepness in the Sky, by Vernor Vinge

2. Makers, by Cory Doctorow

3. The Dispossessed, by Ursula K. LeGuin

4. Down and Out in the Magic Kingdom, by Cory Doctorow

5. Rainbows End, by Vernor Vinge

6. Accelerando, by Charles Stross

7. Lucifer’s Hammer, by Larry Niven and Jerry Pournelle

8. The Windup Girl, by Paolo Bacigalupi

9. The Moon is a Harsh Mistress, by Robert Heinlein

10. Schismatrix, by Bruce Sterling

11. Permutation City, by Greg Egan

12. Reamde, by Neal Stephenson

13. The Game of Thrones series, by George R.R. Martin

In addition to the ones I’ve marked in boldface (that is, I’ve read them and agree they belong on this list), I suspect Stephenson’s Reamde would be worth reading, although I didn’t like Anathem and Smith lauds that as being Stephenson’s “#1 awesomest book”. The best comment on this post is the first one by Anonymous: “When Hari Seldon predicted his exclusion from this list a single tear rolled down his cheek.”

Modernizing the “rules for radicals”

Filed under: Liberty, Media, Politics — Tags: , , , , — Nicholas @ 09:20

James Delingpole suggests that the Saul Alinsky playbook needs a bit of updating for the current radicals (that is, not the broadly left-wing radicals of Alinsky’s day):

Why do we need some new rules? Because the old ones were written in the 70s by a Marxist community organiser called Saul Alinsky. He had some useful ideas, many of which we can steal or adapt. But some of them are ill-expressed or incoherent. Eg Rule 10 “The major premise for tactics is the development of operations that will maintain a constant pressure upon the opposition.” I think he could have omitted that one, don’t you, without jeopardising his place in history as a great revolutionary thinker?

Who are we? Not the same as the radicals of Alinsky’s generation, that’s for sure. Alinsky’s radicals were broadly on the left: Che admirers; Black Panthers; communist revolutionaries; hippies; communitarians; environmentalists; radical feminists. The hegemony which they were trying to destroy was, very loosely, a conservative one.

Today, though, the positions have reversed. We new radicals are broadly — but not exclusively — of the right, not the left. Many of us would describe ourselves as conservatives, classical liberals, libertarians, UKIPers, Tea Partiers. Revolutionaries, yes, but in the traditions of Burke, Wilkes, Cobbett, and, indeed, the Minutemen and the Founding Fathers, rather than of Marx and Lenin. Some of us might not even think of ourselves as righties, but that’s OK, it’s the direction of travel that matters not the labelling.

We’re against: arbitrary authority; big government; high taxes; overregulation; corporatism; cosy stitch ups between the banksters, the lawyers and the political class; the EU; the UN; identity politics; eco-fascists; elf-n-safety; wind turbines; quantitative easing…

We’re for: empiricism; sound money; free markets; liberty; small government; low taxes; deregulation; cheap energy; rigour; meritocracy; integrity; equality of opportunity, perhaps, but most definitely not equality of outcome.

We’re on the right side of a culture war which currently we’re losing. Why are we losing? Not because we’re bad people. Not because we don’t have all the truth, all the logic, all the arguments on our side. We’re losing because, thanks to Alinsky, the enemy has a forty-year head start on us. They’ve got the techniques. All we’ve got is the moral high ground — except, the way Alinsky’s acolytes have brilliantly spun it, we don’t get to enjoy the benefits even of that.

British emergency wards are overcrowded … so we’ll fine the ambulance service!

Filed under: Britain, Bureaucracy, Health — Tags: , , — Nicholas @ 08:59

Hard to come up with an explanation for this perverse policy:

Ministers came under fresh criticism for their handling of the NHS last night after it emerged the ambulance service will be hit with £90 million in fines — as punishment for the chaos blighting casualty departments.

Critics said the fines will simply deprive trusts of vital funds that could help tackle the deterioration in patient services.

A new penalty clause that was written into ambulance trust contracts from last month will levy fines of £200 for every patient who has to wait for longer than 30 minutes for admission to A&E, and £1,000 for each patient forced to wait more than an hour.

You can understand the desire to speed the delivery of injured people to the emergency services they need, but how does it make any kind of sense to punish the ambulance service because the emergency wards they need to get their patients into are overcrowded? Unless the ambulance service has some kind of magic ability to shift priorities in the hospitals, fining them for patients’ wait times makes less than zero sense.

But acute overcrowding in A&E departments has led to increasing ambulance ‘jams’ formed as they queue to unload, with waits of four hours recorded at some hospitals at the busiest times.

Damning new figures reveal that during the past year there were more than 265,000 occasions in England when ambulance staff took more than half an hour to deliver patients into the hands of hospital doctors.

And shockingly, more than 37,000 patients had to wait over an hour to move on to the wards.

Official guidelines say ambulances should deliver patients, clean the ambulance and be back out on the road within 15 minutes. A longer wait is seen as ‘unsafe’.

Yet the chaos in A&E departments is so bad that at one, the Norfolk and Norwich University Hospital, doctors were forced to put up a tent to act as a makeshift ward to treat patients alongside the ambulance queue.

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