Quotulatiousness

May 26, 2010

The pandemic juggernaut of doom . . . that failed to materialize

Filed under: Bureaucracy, Cancon, Health, Media — Tags: , , , , — Nicholas @ 17:07

Lorne Gunter has a good wrap-up of the bone-headed approach of public health officals in Canada to the Swine H1N1 flu “pandemic”:

Good on ordinary Torontonians. Despite all the H1N1/swine flu hype this past winter, just 28.2% of that city’s residents bothered to get vaccinated against the “pandemic;” that’s less than the 35% who usually get shots each year against the seasonal flu.

Even Toronto health care workers couldn’t be stampeded into getting the shots. Only 60% of them bothered.

[. . .]

Even from the start, the World Health Organization and other experts where told this strain of flu was weak and easily defeated. Infection rates never came remotely close to forecasts and death tolls were thankfully much, much lower than for typical seasonal infections.

The trouble, I think, was that so many public health officials have predicted so many pandemics for so long — SARS, bird flu, swine flu — that they simply got caught up in their own warnings and projections. They wouldn’t listen to contrary evidence.

The relevant public health authorities would have served the public interest (and their own credibility for the future) if they’d been much more forthcoming as the early stages of the pandemic showed H1N1 not to be the second coming of the Black Death. Instead, they doubled-down and raised the propaganda bar even higher.

October 27, 2009: Given that regular seasonal flu causes thousands of deaths annually, you’d think it would be good statistical discipline to count the cases of H1N1 separately, both the gauge the severity of the disease and to chart the effectiveness of the vaccination program. Lumping seasonal flu and “flu-like symptoms” together with H1N1 seems a big step backward from normal public health practice.

This would have been a good opportunity for de-escalating the panic mongering (and perhaps even attempting to rein-in the media, who were equally to blame for the tone of the information getting to the public). They chose, instead, to actively hide the fact that H1N1 cases were running below the level of ordinary seasonal flu cases (total H1N1 deaths: approximately 18,000 — typical annual death toll from seasonal flu: 250,000-500,000).

The biggest problem isn’t that they over-reacted this time, it’s that it has reduced their credibility the next time they start issuing health warnings. And that’s a bad thing. Unless they pull the same stunt next time, too. In which case, we may start hearing talk about setting up competing organizations to do the job the current entities appear to have given up on.

April 15, 2010

“Wolf! Wolf! Wolf! Oh, never mind . . .”

Filed under: Bureaucracy, Health, Media — Tags: , , , , , — Nicholas @ 09:04

Marni Soupcoff points out that the World Health Organization should have been far more forthcoming after their intial “the sky is falling” announcements caused panic last year over H1N1:

Admit your mistakes before others exaggerate them. That’s the oft-quoted wry advice of writer and retired surgeon Dr. Andrew V. Mason. Perhaps the World Health Organization (WHO) was trying to follow it this week by convening a three-day meeting of outside experts to review the organization’s handling of the recent swine flu outbreak. The problem is, despite claiming to want to know what went wrong as much as what went right, the WHO seems unwilling to even entertain the possibility that it created a counterproductive panic by labelling H1N1 a pandemic of the highest order (“level 6”).

Swine flu, as you’ve probably realized by now, has turned out to be a mild, not particularly deadly virus — it’s certainly far less deadly than the regular seasonal flu that most of us consider a mundane part of everyday life. If one were feeling charitable toward the WHO, one could point out that it didn’t know back in the spring of last year — when it shouted “level 6!” from the rooftops — that H1N1 would prove to be such a relatively innocuous bug. But it’s precisely because it didn’t know that the WHO should have been more cautious with its labelling. You don’t shout “fire” in a crowded theatre just because it smells like the popcorn might be a little on the burnt side. It’s not worth the chaos and alarm you might cause. (Or in this case, the run on vaccines and the resorting to quacks and sketchy “home” remedies.)

Between the unrestrained use of the term “pandemic” and the noted ability of the mass media to hype real and imagined risks, it’s almost surprising we didn’t have doomsday-style cults spring up over H1N1.

February 23, 2010

BBC accused of bias in euthanasia debate

Filed under: Britain, Health, Liberty, Media — Tags: , , , , , — Nicholas @ 13:00

The BBC’s decision to broadcast Terry Pratchett’s speech on euthanasia tribunals is cited as evidence that the corporation is acting as an advocate on this highly emotional issue:

The Care Not Killing Alliance accused the BBC of flouting impartiality rules and adopting a “campaigning stance” in an attempt to step up pressure on the Government to legalise assisted suicide.

The decision to broadcast Sir Terry Pratchett’s speech advocating “euthanasia tribunals” in full earlier this month was an example of unbalanced reporting, the alliance claimed.

Lord Carlile, chairman of the alliance and the Government’s independent reviewer of terror legislation, has demanded a meeting with BBC bosses to seek answers over the “biased” coverage.

In a letter to Sir Michael Lyons, the chairman of the BBC trust, the Liberal Democrat peer also raised questions over the corporation’s failure to inform police that a veteran presenter had confessed to killing his lover on one of its programmes.

H/T to Elizabeth for the link.

February 2, 2010

The Lancet formally retracts controversial paper on Autism

Filed under: Britain, Health — Tags: , , — Nicholas @ 12:56

In a long-overdue move, British medical journal The Lancet has retracted a paper by Andrew Wakefield on links between the MMR vaccine and Autism:

The Lancet medical journal formally retracted a paper on Tuesday that caused a 12-year international battle over links between the three-in-one childhood MMR vaccine and autism.

The paper, published in 1998 and written by British doctor Andrew Wakefield, suggested the combined measles, mumps and rubella (MMR) shot might be linked to autism and bowel disease.

His assertion, since widely discredited, caused one of the biggest medical rows in a generation and led to a steep drop in the number of vaccinations in the United States, Britain and other parts of Europe, prompting a rise in cases of measles.

The knock-on effect of parents avoiding getting their children vaccinated creates opportunities for much more serious outbreaks of these diseases. Dr. Wakefield’s “research” has been harmful to the population at large for helping to create and exacerbate parents’ fears for their children, and in encouraging them to take the greater risk of not getting the MMR (and, in many cases, other vaccinations) for their kids.

January 26, 2010

CF improve medical evacuation by adding medical technicians to crews

Filed under: Cancon, Health, Military — Tags: , , , — Nicholas @ 07:35

Strategy Page reports on a change in crew composition for Canadian Forces medical evacuation helicopters:

Canadian forces have added a medical technician to the crews of their medical evacuation helicopters, joining a trend that has played a part in saving the lives of many troops wounded in combat, or injured in a combat zone. Previously, Canadian troops had relied on American, or other NATO, air evacuation services. But now Canada has suitable helicopters (CH-146s) for that work, and established an air ambulance service. Following a four year old recommendation by their own military planners, Canada trained medical technicians to work on the medevac choppers, and thus increase the chances that badly wounded soldiers would survive. Canada has also upgraded all of its combat medical care during its years of operations in Afghanistan. This is part of a trend that has been going on since World War II. It’s all about having more medical care available sooner.

The fighting in Iraq and Afghanistan has brought about a major change in how the United States deals with combat casualties. The result is that over 90 percent of the troops wounded, survive their wounds. That’s the highest rate in history. There are several reasons for this. The main one is that medics, and the troops themselves, are being trained to deliver more complex, and effective first aid more quickly. Military doctors now talk of the “platinum 10 minutes,” meaning that if you can keep the wounded soldier, especially the ones who are hurt real bad, alive for ten minutes, their chances of survival go way up. Medics have been equipped and trained to perform procedures previously done only by physicians, while troops are trained to do some procedures previously handled only by medics.

November 30, 2009

Doctors urged to advise patients on reducing their carbon butt-print

Filed under: Britain, Bureaucracy, Environment, Health — Tags: , , , , — Nicholas @ 09:20

The Climate and Health Council in Britain is urging GPs to provide their patients with information on how to reduce their carbon output:

The Council has been recently formed to study the health benefits of tackling climate change and promotes a range of ideas from reducing your carbon footprint by driving less and walking more to eating local, less processed food.

It wants to raise ‘health’ on the agenda of December’s UN Climate Change Summit in Copenhagen.

They believe that offering patients advice on how to lower their carbon footprint can be just as easy and achievable as helping them to stop smoking or eat a healthier diet.

Other proposals include for all developed nations to pay an extra five dollars a barrel on oil and a tax on airline tickets. This would go into a special fund to develop low-carbon alternatives to existing technologies, they say.

So, after waiting for however many weeks to get that precious 2.5 minutes of actual patient-doctor interaction, two minutes will now be composed (in a Freudian slip, I originally mistyped that as “composted”) of Climate-Puritan hectoring. That’ll do wonders for both the environment and for doctor/patient relations.

November 11, 2009

The only surprise is that it’d only be 33%

Filed under: Cancon, Economics, Health — Tags: , , — Nicholas @ 08:22

Alison Martin summarizes a survey of Quebec workers which found (among other things) that 33% of men would show up for work even if they or a family member had H1N1:

According to a poll of Quebec workers, many employees in Quebec would still show up for work even if they had the H1N1 flu virus.

Close to one-quarter of respondents to the poll conducted in September 2009 on behalf of the Ordre des conseillers en ressources humaines agréés said that they would still go to work even if they or a member of their household had the H1N1 flu virus. This attitude is even more prevalent among men, with one in three (33%) reporting that they still intended to go to work if they or a relative caught the virus.

Close to 60 per cent of respondents said that they show up for work even when they really aren’t feeling well.

“We’ve already noted that employees in Quebec tend to show up at work even when they’re ill. They don’t seem to be sufficiently aware of the risks of such behaviour, which in the end benefits neither the employee nor the employer, and definitely should be stopped,” explained Florent Francoeur, CHRP, Ordre president and CEO.

The question was clearly worded to elicit the most newsworthy headline: it’d be an odd family if everyone stayed home if even one person in the family was ill . . . and a family with limited long-term employment prospects. Private sector employers tend not to have the same kind of generous sick time provision that public sector employees get, so employees don’t tend to take as much sick time as civil servants.

For many workers, if they don’t show up for work, they don’t get paid. This is especially true at lower income levels, where missing a few days pay can be a severe economic dislocation.

November 3, 2009

“Like Soylent Green, medicine is made of people”

Filed under: Health, Science — Tags: , , — Nicholas @ 13:04

Colby Cosh on the paradoxical nature of the public’s view of medicine:

We’re conditioned to think of “medicine” as a single, coherent planned enterprise, if not a conspiracy, and we often fear and despise it — until we decide we need it. At which point it cannot possibly move fast enough to please us. Like the state or the church, medicine is an impersonal abstraction, but one that seems to have common priorities and intentions, significant powers and one voice. Rationalists and believers in progress invoke it; nutcases and conspiracists resist it.

In a way, both are paying tribute to a fiction, much like Christians and Satanists. In real life, there is no pope or president of medicine, no temple where it can be consulted, no medical mandate of heaven. The emerging vaccine debacle, though mercifully likely to have fairly limited public-health consequences, reveals the terrible truth. Like Soylent Green, medicine is made of people. Not just doctors, but administrators, industrialists, economists and politicians — none of them angels, and none with an angel’s ability to predict mass behaviour, perceive and weigh risk, or foresee the judgment of future history.

[. . .]

People have always been prone to weird beliefs, but now there is a medium that compounds those beliefs, allows them to coalesce into a historical counter-narrative and unites their holders like never before. For the first time, there are people who seem not just weird, but positively, thoroughgoingly “weird-ist.” Try spelunking amidst the Internet detritus of the anti-vaccine movement. There is no philosophical reason that strange beliefs about vaccination should correlate with fringe beliefs about UFOs, reptilian elites, 9/11 “truth,” JFK, the world ending in 2012 you name it. Yet the correlation is real, and not hard to confirm.

September 8, 2009

John Snow and the start of modern epidemiology

Filed under: Britain, Health — Tags: , , — Nicholas @ 08:52

Another “on this date” entry for you: in 1854, John Snow persuaded the local authorities in a London borough to remove the handle from a water pump at the centre of a cholera outbreak. The move was successful, and the death rate dropped immediately. Randy Alfred has the story:

BroadSt_cholera_map

Physician John Snow convinces a London local council to remove the handle from a pump in Soho. A deadly cholera epidemic in the neighborhood comes to an end immediately, though perhaps serendipitously. Snow maps the outbreak to prove his point . . . and launches modern epidemiology.

The Soho neighborhood was not then filled with galleries, clubs, restaurants and other fine urban diversions. Some of it was an unsanitary slum where centuries-old cesspits sat chockablock with the wells that provided drinking water to a crowded populace.

Asiatic cholera had stricken Britain in successive waves since 1831. Snow, an obstetrician who pioneered the use of anesthesia in Britain, published On the Mode of Communication of Cholera in 1849. His hypothesis (and supporting data) held that the scourge was caused by sewage pollution in drinking water and “always commences with disturbances of the functions of the alimentary canal.”

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