Monday Reads
Posted: October 28, 2013 Filed under: morning reads 65 Comments
Good morning!
So, I had a rather uneventful weekend. I spent a lot of time grading stuff for my International Finance class and getting ready for my Security Analysis Class. I am still getting used to teaching MBAs and graduate students instead of undergrads. Plus, I teach Finance now with very little Economics so I feel mercenary. I tell myself that it keeps me in the kathouse and in red wine. But, it’s difficult at times because teaching economic literacy is more of a calling to me. Finance is much more utilitarian so I try to look at it as giving some one a life skill but it’s not quite the same. I used to be appalled that undergrad students could get through high school knowing so little and now I have learned that you can get an undergrad degree and come out with bad skills too. Color me jaded. At least I am not training predators. I am training people that are just trying to survive in a world of predators.
Anyway, I did watch a few things over the weekend that helped me cope with the ordeal of reading so many cut and pastes from the internet instead of original thoughts. AMC ran White Zombie. I had never seen that. I learned how little Lugosi made for the movie and was rather shocked. I guess he was worried about loosing his career to Boris Karloff at that point and was taking all offers. Then, I spent some time with Front Line which has a special place in our hearts here since Boomer’s brother is a cinematographer there. The topic also figures predominantly in my life and JJ’s since it dealt with antibiotic resistant bacteria.
I’ve battled a MRSA (antibiotic resistant staph infection) for several years. You may remember one of them put me in the hospital and doctors were worried about me losing my eye sight. Thankfully, there’s one last drug that works for me. But, it will lose its efficacy eventually. My doctors now trust me to rush to the pharmacy and get antibiotics when it gets out of hand. I have a topical lotion that seems to control anything that looks suspicious. I really try to not use the oral antibiotics unless it doesn’t respond to the topical and it looks like I’m in trouble. Trouble means it doesn’t go away and the entire site begins to swell like a balloon even when I drain it, clean it, and douse it with the topical stuff. At that point, waiting to see the doc even is dangerous. I imagine that one day that routine won’t work.
That seems to be the message of the episode and of some eecent articles with warnings from the CDC. There are some bacteria that no longer respond to anything and that list is growing. Dr. Arjun Srinivasan of the CDC says “We’ve Reached The End of Antibiotics, Period”.
For a long time, there have been newspaper stories and covers of magazines that talked about “The end of antibiotics, question ma?” Well, now I would say you can change the title to “The end of antibiotics, period.”
We’re here. We’re in the post-antibiotic era. There are patients for whom we have no therapy, and we are literally in a position of having a patient in a bed who has an infection, something that five years ago even we could have treated, but now we can’t. …
…I wonder if you can reflect a little bit and describe how the MRSA phenomenon, this resistant bacteria, changed public awareness about the problem.
So methicillin-resistant Staphylococcus aureus, or MRSA, for a lot of people is the first time that they had really encountered one of these highly drug-resistant bacteria. …
Literally for decades it’s been something that’s been difficult to treat. There were, up until recently, limited treatment options for MRSA. There is really one antibiotic that was available to treat it.
Was it that bad? Did people die from it?
People did die from it. It caused very serious infections. … MRSA was something that if you asked any doctor or nurse about MRSA, they would tell you, “Oh, yes, it’s a very serious issue. We struggle with it in our patients, in our intensive care units,” but if you asked the average person outside of hospitals about MRSA, they probably would never have heard of it. That all changed maybe about a decade or so ago.
What changed?
We began seeing MRSA infections outside of health-care settings. …
We were seeing it in young people who were athletes, who were young football players who had serious infections, who died of these MRSA infections which had previously been limited to hospitals.
We saw outbreaks in schools. We saw outbreaks in health clubs. And what most of these people were getting was something very different from what we saw in hospitals.
I guess nearly every one in New Orleans that spent some time in the post-Katrina environment now harbors MRSA if you believe the Doctors who deal with
my outbreaks. I had read about Super Bugs some years ago but it wasn’t something I kept at the front of my mind. The biggest problem now is that it’s not really a good investment for pharmaceutical companies to do research in future antibiotics because they are only one shot drugs instead of drugs used perpetually. Therefore, there is a distinct need for the Federal Government to step in and fund the research. That, of course, is not really happening in this country of course. There is also this ghoulish term of “nightmare” bacteria that sounds like something from a horror movie. The man who was interviewed by Frontline and was a major researcher for antibiotics passed away last week. This adds to the story that sounds like a human disaster in the making.
We wanted to share the sad news that John Quinn, a veteran Gram-negative researcher featured in Hunting the Nightmare Bacteria, passed away last weekend. We knew him only briefly but in that short time he made an enormous contribution to our efforts to understand the importance of this subject and why major pharmaceutical companies have been pulling out of antibiotic development.
We knew companies had been abandoning antibiotic drug development and wanted to help viewers understand what that looked like from the inside. The story of Pfizer soon became an obvious example because the company had such a long history in developing antibiotics and had, until recently, been one of the stalwarts that remained involved in seeking a cure for Gram negatives.
But finding someone who was able to talk about the company and its decision to close down its antibiotic research efforts proved more difficult than we’d anticipated. Though we reached out to many researchers and scientists who had worked at Pfizer, they were all reluctant to speak on camera about the program.
That is until we found John Quinn. Quinn was a doctor by training and had been working in academia on Gram-negative resistance before it became a major public health concern. He watched first hand as resistance grew and doctors he worked with had few options to treat patients. “I’d seen [Gram-negative bacteria] kill patients,” Quinn told us. “I had, you know, seen the drugs that we were using cause kidney failure. So I was acutely aware — personally aware, professionally aware — of the need to make progress in this space.”
As usual, I’ve already found a response that really seems to misunderstand the problem by a writer in the National Review. It really isn’t the patent issue that 
thwarts the development of antibiotics by Big Pharma. It’s the fact that antibiotics should be used sparingly, rarely, and basically for one illness. The lack of ongoing cashflow to return to the original investment is the issue. Granting patent extensions isn’t going to solve this problem at all. It seems clearly to be an area that requires nationalization from an economic standpoint and the standpoint that it clearly will become a national health issue.
Before we get too upset with the evil pharmaceutical industry, remember that it can take billions to develop a new drug. And, we have restricted the patent time for the drugs they successfully develop to permit less expensive generics to be manufactured.
It seems to me that if we want new and better antibiotics–we should ensure that the financial risk taken has the potential to lead to a substantial financial gain by extending the patent life for new antibiotics an extra ten years from the time it receives formal approval. Then, maybe, drug companies will more energetically jump into the research for new antibiotics.
We could also have the NIH fund more research into antibiotics and make the results available to everyone. But that would mean making antibiotics a priority over other areas of research. I’m not sure the politics would permit such an explicit triage.
Is our political system so fraught with ideology that we can’t even deal with an oncoming plague? This is a typical economic problem of “the commons”. We’ve had an overuse and a large abuse of antibiotics. This is especially true in food production where antibiotics typically are used without cause in animals raised for food.
A big part of the trouble is that the gains from the overuse of antibiotics are private, whereas the losses are public. Problems such as these are rarely soluble without outside intervention. Ramanan Laxminarayan of Princeton University, who has been thinking for many years about how to deal with the question of resistance, suggests the answer is a mixture of incentives and scourges. Prize funds, or guaranteed-purchase arrangements for new drugs and the rapid-diagnostics systems that would allow them to be deployed appropriately, would help overcome the financial problem of antibiotics being cures, rather than just treatments. Stricter dispensing guidelines for doctors and pharmacists might help deal with the moral hazard of overtreatment.
A bit of realism would be good, too. Derrick Crook, a consultant microbiologist at Oxford, where Florey and Chain once worked, observes, “It is hard to massively restrict the use of antimicrobials when they are doing good. It is possible that the enormous use in Asia is a good thing for a short time in a given country.” That, combined with ignorance about precisely how much the unnecessary use of antibiotics contributes to increasing resistance, makes restriction highly controversial.
So, wow. I took a lot more time on this subject than I thought I would. Here’s some other links you may want to look at today!
Charles M Blow writes about Billionaires’ Row and Welfare Lines
Forbes’s list of the world’s billionaires has added more than 200 names since 2012 and is now at 1,426. The United States once again leads the list, with 442 billionaires.
It’s a great time to be a rich person in America. The rich are raking it in during this recovery.
But in the shadow of their towering wealth exists a much less rosy recovery, where people are hurting and the pain grows.
This is the slowest post-recession jobs recovery since World War II. The unemployment rate is falling, but for the wrong reason: an increasing number of people may simply be giving up on finding a job. The labor force participation rate — the percentage of people over 16 who either have a job or are actively searching for one — fell in August to its lowest rate in 35 years.
David Gregory spends his Sunday Show concern-trolling Obama Care.
But David Gregory has never come across a Republican talking point that he didn’t love, embrace and swallow up whole to faithfully regurgitate to the masses. So he dutifully confronts Blue Cross and Blue Shield of Florida CEO Patrick Geraghty about the news that 300,000 Floridians have found their policies dropped because they fall below the minimum standards of coverage set by Obamacare. Problem was, Geraghty wasn’t going to playGregory’s gotcha game with people’s healthcare:
“We’re not cutting people,” Geraghty said. “We’re actually transitioning people. What we’ve been doing is informing folks that their plan doesn’t meet the test of the essential health benefits; therefore, they have a choice of many options that we make available through the exchange. And, in fact, with subsidy, many people will be getting better plans at a lesser cost. This really is a transition. In fact, the 300,000 figure is the entire year. So it’s really 40,000 people for January 1, and we’re walking them through that transition.”
Now, it’s absolutely true that there will be a fraction of people who find that their costs have gone up, the specific number and amount is still up for debate. And if they don’t qualify for subsidies, that will mean a higher out-of-pocket cost, at least in the short term. However, short-term partisan gains notwithstanding, the program will factor in long-term the inclusion of healthy, young people on the exchanges, which will help mitigate the ailing people who rushed for the initial coverage. Specifically, the re-insurance tax is being levied for the first three years is intended to help smooth that transition to allow for the long-term sustainability of the program.
More than 60 women took to driving cars to defy the ban on women drivers in Saudi Arabia.
Brushing off threats from the government, more than 60 Saudi women got behind the wheel on Saturday in a bold protest of the nation’s de facto ban on women driving.
Sara Hussein, a Saudi woman involved in the effort, drew parallels to the U.S. civil rights movement: “Think back in history — Rosa Parks was the only person who sat down on the bus, wasn’t she? And then it started to happen gradually. It does have to start with the few brave people who are willing to risk whatever there is to risk.”
Many women documented the act of civil disobedience on social media, even posting videos to YouTube. The most popular video, which has already been viewed nearly 100,000 times, was posted by May al-Sawyan, a 32-year-old economics researcher. She drove to the grocery store.
So, that’s it for me this morning! What’s on your reading and bloging list today
peej
Carissa
ecocatwoman
mablue2
peggysue22
quixote
skydancingguestblogger
Mona (aka Wonk the Vote)
Sky Dancing 
News from Boston:
Another Strange Finish As Pickoff Ends Game 4 Of World Series
David Ortiz’s in-game speech spurred Red Sox
They have to stop leaving guys on base or my head will explode before this is over!
They are fabulous on defense but when it comes to offense these days I get squeamish.
Frontline’s latest show was about antibiotic resistant bacteria. You can watch it on-line.
Hunting the Nightmare Bacteria
It’s good that this is getting attention. I can’t bring my self to watch it. Too many memories.
I love stories about Flea Market finds and this one is pretty cool if you’re a rock and roll fan. A woman found a stack of never before seen shots of The Rolling Stones on one of their early U.S. tours. Amazing photos.
http://twentytwowords.com/2012/10/17/23-rare-1965-photos-of-the-rolling-stones-in-america-found-at-a-flea-market/
I hadn’t taken antibiotics in almost 15 years when a few months ago, they were prescribed to me for treatment of an infected tooth. I remember that it used to be that one started feeling better almost immediately once a course of antibiotics was begun but this most recent infection was different. It was almost 5 full days before I had even an inkling that the antibiotics were having any effect. I found myself wondering if the dentist was wrong and that the tooth wasn’t really infected but perhaps there was something else wrong with it but once the antibiotics started working I realized that this must have been a much stronger infection than ones I had experienced over a decade ago. It’s certainly disconcerting.
Yes. I have noticed it takes longer for them to kick in now.
I will never forget the time my husband had MRSA…………the doctor came in to give him the top line of antibiotics at $1600 dollars a pill………when he told us that, we let him know we weren’t the Kennedy’s……bottom line he went back and figured out something that he could take that Blue Cross covered. Thanks for sharing this information, everybody should be aware.
My worst case of MRSA came from an infected IV at a top hospital. I was a “charity case” so the doctors didn’t want to give me any antibiotics. They didn’t care if I lived. They treated me like a piece of meat. I went septic, had a fever of 105, my veins were collapsing, and my organs started to fail before they finally gave me vancomycin through a PIC. It’s a wonder I survived. My roommate at the hospital ( who had insurance ) said because the hospital was non-profit, they had to treat me but they didn’t have to treat me well. How true. I still have flashbacks from that experience.
How horrible! My hospital was supposed to put me in isolation but they put me in with a woman that needed a transplant. I wonder if it was a mistake or a cost saving decision.
Well, Kat, I should have known profit explained it. i saw just about every kind of resistant infection in my late husband after a disastrous failed kidney transplant, and i have never believed the CDC crap about Vanco is the only drug we have left. It’s the only drug because no one wants to pay for targeted ones. In fact, I don’t believe the CDC crap line about much of anything. This is the same agency which let HIV into the blood donation supply for over a year due to lobbying from surgeons, hospitals, and the red cross, which now only gets small letters from me.
red cross may have started look for HIV in blood but didn’t look for hep c which I got from transfusions during my cancer surgery. luckily, it responded to treatment and i just have antibodies now.
Mary Luke, as a “charity case” I was lucky to get the vancomycin. For days, I was dying in that hospital from their infected IV and couldn’t any treatment whatsoever. They moved me to several different rooms; each one worse than the previous one. Sometimes they even “parked” my bed in a hallway. In one room, they disconnected my call button.
I learned to take my own temp there and tried to bring down my 105 degree fever with some Tylenol I had in my purse because no doctor would help me. One of my roommates let me use her phone to call my brother back home. He could tell from my voice that I was dying. He did not expect to ever see me again. This happened at major hospital whose name everyone would recognize.
That should read “couldn’t get any treatment whatsoever”.
It was an experience that changed the way I looked at life forever. I hadn’t had a very easy life to begin with but I learned new lessons about cruelty there. Cruelty that came from medical professionals who take an oath to do no harm.
Wow. That’s just horrible. Cruelty is the word for it.
From my own experience as a patient, and when supporting family or friends, I think everyone should have at least one advocate with them in the hospital. Even having a health-care background, there’s no way you can take care of yourself and think clearly when you’re sick. Yes it’s scary. Most people in the medical/health field do want to help, but yes I’ve seen those who don’t care, or who are too short-staffed or overworked to pay attention. Profit should never be connected with health care.
I agree, Luna. Having someone to advocate for you as a hospital patient is extremely important. I was alone ( not by choice ) and far from home when this happened. I had no one to fight for me. I had to fight for myself and that is what I did.
The lead doctor on “my case” told me he did not care what happened to me. He leaned over my bed and smiled when he said it. No one else was nearby. I will never forget those words or the look on his face. I don’t believe he would have said that to someone who had insurance. But I won the battle. I left that hospital alive.
Beata, that is appalling.
Beata,
What a nightmare! I’m so sorry you had to go through that. Also very happy you survived.
Oh my god Beata, that is terrible. Speechless…
You summed up the medical marketplace, Beata. They may “have” to “treat” us but they know how to avoid treating us well.
Another example of our fantastic healthcare system that the right wing is trying so desperately to preserve. Heaven forbid we have a system where we are all entitled to and can expect the same level of care.
If it makes you feel any better, I have had excellent health insurance all of my life and I could write an entire post about mistreatment and abuse I have encountered at the hands of healthcare professionals. Granted, none of my experiences are as horrific as yours, but as a card carrying member of the underclass (women), and the older I get the more I am coming to understand being a member of that other underclass, the elderly, I can attest to the fact that there is a whole lot wrong with our system of healthcare when it comes to treating those of us who are not young, well off, white, men.
I agree, Janice. There is so much wrong with our healthcare system, it boggles the mind. I am hoping the ACA will help the situation but I just don’t know.
It was upsetting to me to relive my MRSA experience and I suspect it was not helpful to anyone else here either. I plan to avoid discussing the subject in the future for everyone’s sake.
I do think it is very important to know about MRSA. Watching the Frontline episode will help people understand it better. Luna’s comment about having someone to advocate for you while you are in the hospital is excellent advice, especially when dealing with MRSA.
I wasn’t sure that the topic would be of interest to many people but I thought it was important to share it. The Front Line piece was a great watch and very informative.
I missed it…but plan to watch it on the laptop.
Antibiotics have been overused, misused and sometimes underused (taking them for a day or two and then stopping). Prescribers sometimes Rx antibiotics merely because “the patient wants antibiotics,” which I think is a sloppy excuse for not providing patient education. I once read an ER report on one of my patients where the physician had diagnosed a “viral infection” and yet prescribed an antibiotic! Antibiotics do not work on viruses.
While MRSA is methicillin-resistant Staph aureus, nearly all cases in US community (non-hospitalized) patients are still susceptible to some other antibiotics, including some old generics such as doxycyline, monocycline, or clindamycin.
CDC guidelines for CA (Community-Acquired) MRSA are to perform incision and drainage of an abscess or boil. These cases do not require antibiotics. It’s more a mechanical situation, and when one cleans out the infectious purulence, that solves the problem. However, if there is cellulitis — diffuse swelling and redness without an abscess — then the CDC guidelines do recommend use of a systemic antibiotic. http://www.cdc.gov/mrsa/ (Has skin-infection pictures but only of abscesses & boils, not cellulitis).
Antibiotics are available OTC in some other countries, for example in Mexico and south Asia. I worry about the risk for even more highly resistant bacteria to develop in those countries. In this era of easy world-wide travel, disease can spread across the world quickly.
Pharmaceutical companies spend on average twice as much per year on advertising and marketing as they do on research . When I first started into practice, that ratio was 1:1. We need more governmental funding of research.
Seems like the pill companies also spend a lot of time on limp dick drugs…just saying.
That can’t be pointed out enough!
And advertising to insecure men that they need!!! testosterone supplementation. The last time a male patient told me that he had low testosterone and needed supplementation I could barely keep a straight face. Fortunately I didn’t have to address that aspect of his care. It does happen, but I think it’s exceedingly rare.
It’s not low testosterone. It’s called “getting older”.
Right-wing Populism Could Hobble America for Decades
The tea party is going down. Dysfunction is not.
http://www.newrepublic.com/article/115332/tea-party-going-down-dysfunction-not
http://www.truth-out.org/opinion/item/19618-the-revolt-of-the-lower-middle-class-and-the-stupidity-of-the-elites
The Revolt of the Lower Middle Class and the Stupidity of the Elites
I wholeheartedly agree with Lofgren’s article. Lind is just wrong in his analysis.
I really questioned Lind’s article when I read it awhile back.
The New Republic article identifies more billionaires with a greed agenda:
That’s an interesting article, but I can’t believe Judis thinks the recent government shutdown is comparable to the Civil War. Wouldn’t the McCarthy hearings be an example of small an existential threat to the republic? There have to be other examples.
Good point. I thought the Civil War comparison was a leap frankly.
The comparison is a big reach but where we are heading, unless we change course, is going to come much closer I’m afraid.
Well it does have a secessionist element.
I think it could turn violent fairly easily.
Federal judge declares Texas abortion restrictions unconstitutional & blocks it!
http://www.kltv.com/story/23808864/federal-judge-declares-texas-abortion-restrictions-unconstitutional-blocks-enforcement …
They were not going to win this case at the District level, thus…
What the hell…………an EMERGENCY appeal?
Sure. It’s always an emergency when a Republican doesn’t get what they want right away. Grrrrrr!
So, they ran to Louisiana 5th Circuit Court for the emergency appeal…………..I can only think why they did this, something to do with conservative sitting on the court? The 5th circuit serves Texas, La. and Ms..but Texas has plenty courts to handle this…………….Grrrrrr………..Jindal’s territory.
Someone should teach Cecile Richards to read rulings before commenting. The liberals seem to think Judge Yeakel left the medically induced abortion part alone, but he didn’t.
Applause for Judge Yeakel! “Off-label” does not necessarily mean “off-evidence.”
Okay, can I just make a comment…remember I am sick so forgive the ridiculousness.
I bet the GOP top “elders” are all orgasmic about these NSA leaks on Merkel (did Obama know, he didn’t know) and the “new” admissions from Jay Carney today on obamacare having “winners and losers.” (like we didn’t know that shit from the beginning.) It sure as hell got the heat off of them and that disgusting shit they pulled with the shutdown and almost defaulting.
Ugh…I can’t stand it!
Those assholes will get away with it again, like they usually do.
Okay, like I said, it may not make sense…I am all stuffed up and so really sick.
It makes sense because of our lousy media. CNN today even discussed “Obama’s” NSA problems with Dick Cheney, who set the shit up to begin with, and let Cheney completely off the hook. Asshats! Jake Tapper sucks!
I know, I wanted to reach in and strangle that son of a bitch…
Oh me 2!!!
Good grief! That is the most idiotic thing I’ve heard for a long time.
I have no problem with the NSA spying on Merkel and other foreign leaders. Look at all the harm Merkel has done in Europe with her austerity policies. I’m sure they’re all doing the same thing and they cooperate with us in espionage too. It’s just a bunch of stupid, ass-covering whining. Merkel needs to get over herself.
Yeah, I agree with you on the Merkel thing BB…This spy shit has gone on from the very beginning. I didn’t realize that Democracy Now is pushing the whole “join the libertarian” bandwagon crap. I just unliked them on facebook so I don’t get those articles in my feed.
I’m afraid these dumber “activists” are going to wind up causing a voting problem in 2014 just like they did in 2010. We could wind up in an even bigger pile of shit because they never fucking learn anything.
Cheney/Bush should still be on the hook for “allowing” 9/11 to happen. Can you imagine what the Repugs would say and do if that happened under a Democratic POTUS? Hypocrites.
Though I do think the NSA spying is excessive. The spying on US citizens is what I most dislike.
Let no one mistale Rand Paul for a sane person …
tpm: Paul Warns of Logan’s Run Type Future in VA
Stand with Rand, you dumbass brogressives.
Wtf?
See, this is the shit that drives me mad….and there is no accountability. No one calls these assholes out.
Starting to drive me around the bend also, Those bastards will say any damn thing at all and it doesn’t seem to matter to anyone. It’s maddening!
The tea party types would be the first to want to use genetic info to get rid of gays and whomever else they hate.
Jamie Kilstein @jamiekilstein 3m
Hello libertarians, the NSA spying is very invasive, as is old white men telling women what they can’t do with their own vaginas.
But they sure don’t mind selecting out the imperfect who are poor, or who don’t have health insurance, eh?
http://talkingpointsmemo.com/livewire/ppp-bobby-jindal-is-the-most-unpopular-gop-governor-in-america
Well, Louisiana voters aren’t as dumb as the Republicans thought they were …
Wendy matters ,,,
blockquote> The Texas voter photo ID bill originally proposed by state legislative leaders and supported by Greg Abbott was even worse for Texas women than the version ultimately passed into law.
Under the original bill, if the name on a person’s photo ID and the name on the voter registration rolls differed, then an election judge could deny them the right to cast a regular ballot and force them to either cast a provisional ballot or leave without voting.
Senator Wendy Davis foresaw the problem and passed an amendment to deal with it. Under Davis’ amendment, election officials must permit voters to sign an affidavit swearing to their eligibility to vote and then allow them to cast a regular ballot.
The amendment has proven to be critical during the election now underway in Texas. Women across Texas have signed affidavits to vote. Had state leaders and Greg Abbott had their way, these women would have not been allowed to cast ballots or would have been forced to cast provisional ballots which are seldom counted in Texas elections.