Tuesday Reads

The Magpie, Claude Monet

The Magpie, Claude Monet

Good Morning!!

The Midwest and Northeast were hit with another huge snowstorm yesterday, and there could be another one on the way. I may never get my car out of the driveway again. The strange thing is that it is also incredibly cold, in the single numbers again this morning. I’m going to wait until it gets into the 20s before I start trying to get my front door open and start digging out. I’m also struggling with a cold, so I’m going to have to shovel slowly.

The measles outbreak and the vaccine “controversy” are the stories topping the news today, after several politicians weighed in yesterday. I’m going to focus on those stories again today.

First up, New Jersey Governor Chris Christie. From Jeffrey Kluger at Time Magazine: Chris Christie’s Terrible Vaccine Advice.

Last I checked, Chris Christie isn’t a licensed commercial pilot, which is one reason he probably doesn’t phone the cockpit with instructions when his flight encounters turbulence. Chances are, he doesn’t tell his plow operators how to clear a road when New Jersey gets hit by a snow storm either. But when it comes to medicine, the current Governor, former prosecutor and never doctor evidently feels pretty free to dispense advice. And doncha’ know it? That advice turns out to be terrible.

Asked about the ongoing 14-state outbreak of measles that has been linked to falling vaccination rates, Christie—the man who prides himself on chin-jutting certainty—went all squishy. “Mary Pat and I have had our children vaccinated and we think that it’s an important part of being sure we protect their health and the public health,” he said. “I also understand that parents need to have some measure of choice in things as well, so that’s the balance that the government has to decide.”

The Governor then went further, taking off his family doctor hat and putting on his epidemiologist hat. “Not every vaccine is created equal,” he said, “and not every disease type is as great a public health threat as others.”

He was not specific about which diseases fall below his public-health threat threshold, but New Jerseyans are free to guess. Would it be polio, which paralyzed or killed tens of thousands of American children every year before a vaccine against it was developed? Would it be whooping cough, which results in hospitalization for 50% of all infants who contract it and death for 2%, and is now making a comeback in California due to the state’s low vaccination rates? Are we going to have mandatory HSV 2 testing? Or would it be measles, which still kills nearly 150,000 people—mostly children—worldwide every year?

Chris-Christie-balance-to-vaccinations-CrabDivingOf course this isn’t the first time Christie pretended to be a medical expert–remember how he reacted when nurse Kaci Hickox landed in Newark after treating Ebola patients in Africa?

Christie later tried to walk back his remarks about vaccines, but he has a history of pandering to anti-vaxxers. During his 2009 campaign for governor, Christie wrote the following in a letter to supporters:

“Many of these families have expressed their concern over New Jersey’s highest-in-the nation vaccine mandates. I stand with them now, and will stand with them as their governor in their fight for greater parental involvement in vaccination decisions that affect their children.”

Next up, Senator Rand Paul. At the Washington Post,  Jose A. DelReal writes: Rand Paul, M.D., says most vaccines should be ‘voluntary.’

“I’m not anti-vaccine at all but…most of them ought to be voluntary,” Paul told Laura Ingraham on her radio show Monday. “I think there are times in which there can be some rules but for the most part it ought to be voluntary.”

Paul pointed to a 2007 effort by then-Texas Gov. Rick Perry (R), who is also considering a 2016 run for the Republican nomination, that would have required young girls to receive a vaccine for human papillomavirus (HPV). That move was sharply attacked by social conservatives who said requiring vaccination against HPV, which is a sexually transmitted disease, would encourage promiscuity. The Texas legislature eventually overturned the mandate. Perry later called the order “a mistake.”

“While I think it’s a good idea to take the vaccine, I think that’s a personal decision for individual’s to take,” Paul said, attempting to strike a balance between responsible medical protocols and personal choice.

Paul

Like Christie, Paul made sure his own children were vaccinated. But Paul really went off the deep end later on Monday.

Speaking on CNBC’s “Closing Bell” later Monday, Paul said that there should be increased public awareness that vaccines are good for children, but reiterated that vaccines should be voluntary, as he said they were in the past.

“I’ve heard of many tragic cases of walking, talking normal children who wound up with profound mental disorders after vaccines,” Paul said. “I’m not arguing vaccines are a bad idea. I think they’re a good thing. But I think parents should have some input. The state doesn’t own your children, parents own the children and it is an issue of freedom and public health.”

Parents “own their children?” WTF?! And what are these “profound mental disorders?” Who are these children and what vaccines did they get? I can’t believe the media lets this man get away with throwing out these evidence-free claims.

At The Week, Ryan Cooper explains the immorality of Christie’s and Paul’s positions.

…this entire argumentative frame misses the greatest benefit of vaccines: herd immunity. A population vaccinated to a high enough level becomes largely impervious to the disease by sheer statistics, and that protects the vulnerable ones who can’t be vaccinated, or those whose vaccines didn’t take root. Vaccines are not just about preventing personal illness, but stopping them from spreading. Done systematically enough, it can eradicate diseases completely. The elimination of smallpox, which killed something like 300 million people in the 20th century alone, ranks high on the list of human accomplishments.

That is why this is as much a moral issue as a scientific one. The appalling selfishness inherent in the idea of “vaccine choice” was starkly illustrated in a recent CNN story. After the measles outbreak at Disneyland, CNN talked to a family whose 10-month old baby had contracted the disease. They’re terrified he’ll pass it on to their 3-year-old daughter, who has leukemia and can’t get the vaccine — but might be killed by the disease. Here’s the response of a refusenik parent:

CNN asked Wolfson if he could live with himself if his unvaccinated child got another child gravely ill. “I could live with myself easily,” he said. “It’s an unfortunate thing that people die, but people die. I’m not going to put my child at risk to save another child.” [CNN]

Wolfson

In other words, it’s okay to cause the death of another child if your kid wants to go to Disneyland. And that’s leaving aside the risk to Wolfson’s own kids, who are put at risk by his atrocious parenting.

Every person depends on society to function. From public roads, to sanitation, to clean water, to the very economic system itself — your day is made possible by millions of other people doing their small part to maintain our civilization. When it comes to violently contagious diseases, it is not possible to speak meaningfully of choice divorced from the needs of those people.

Here’s a little more on Dr. Wolfson from Terrence McCoy at The Washington Post: Amid measles outbreak, anti-vaccine doctor revels in his notoriety.

“Don’t be mad at me for speaking the truth about vaccines,” Wolfson said in a telephone interview with The Washington Post. “Be mad at yourself, because you’re, frankly, a bad mother. You didn’t ask once about those vaccines. You didn’t ask about the chemicals in them. You didn’t ask about all the harmful things in those vaccines…. People need to learn the facts.”

But whose facts is he talking about? Every respectable expert totally disagrees with him and his anti-vaccine movement and, along with the Centers for Disease Control and Prevention, urges parents to get their kids vaccinated. And Wolfson himself, who has quickly become something of a spokesman for the anti-vaxxers, is in no way an expert on vaccines or infectious diseases. He’s cardiologist who now does holistic medicine.

What the experts say: “The measles vaccine is one of the most highly effective vaccines that we have against any virus or any microbe, and it is safe, number one,” Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, told CBS. “Number two, measles is one of the top two most contagious infectious viruses that we know of…. So you have a highly infectious virus and you have an extraordinarily effective vaccine.”

Despite the measles outbreak that has spread to at least 14 states, Wolfson’s advice to parents is:

Wolfson actively urges people to avoid vaccines. “We should be getting measles, mumps, rubella, chicken pox, these are the rights of our children to get it,” he told the Arizona Republic. “We do not need to inject chemicals into ourselves and into our children in order to boost our immune system.” He added: “I’m a big fan of what’s called paleo-nutrition, so our children eat foods that our ancestors have been eating for millions of years…. That’s the best way to protect.”

Should kids have polio too?

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McCoy also wrote recently about Andrew Wakefield the British doctor who started the vaccine panic: 

If the [measles] outbreak proves anything, it’s Wakefield’s enduring legacy. Even years after he lost his medical license, years after he was shown to have committed numerous ethical violations, and years after the retraction of a medical paper that alleged a vaccine-autism link, his message resonates. Facebook is populated by pages like “Dr. Wakefield’s Work Must Continue.” There’s the Web site called “We Support Andrew Wakefield,” which peddles the Wakefieldian doctrine. And thousands sign petitions pledging support….

Wakefield’s defenders frequently harbor a deep distrust of government. “They often suggest that vaccination is motivated by profit and is an infringement of personal liberty and choice; vaccines violate the laws and nature and are temporary or ineffective; and good hygiene is sufficient to protect against disease,” said a 2008 editorial in Nature.

Others, from Katie Couric to Jenny McCarthy to Michele Bachmann, have caught the anti-vaccine bug.

Katie Couric?

And in Wakefield, who still preaches the gospel of anti-vaccination from Texas, such individuals find a true martyr — a man who has sacrificed everything to take on powerful pharmaceutical companies and the biggest villain of all: the government. Those who came to hear him speak in 2011 at Graceview Baptish Church in Tomball, Texas, left messages of encouragement, according to the New York Times: “We stand by you!” and “Thank you for the many sacrifices you have made for the cause!” Another person, suddenly aware that a reporter was in the midst, warned the writer she better be careful. “Be nice to him,” the woman said. “Or we will hurt you.

“To our community, Andrew Wakefield is Nelson Mandela and Jesus Christ rolled up into one,” J.B. Handley, co-founder of a group that disputes vaccine safety, told the Times. “He is a symbol of how all of us feel.”

Read much more about Wakefield and his discredited research at the WaPo link.

Meanwhile measles continues to spread from coast to coast. Here’s a map of reported cases at the NYT.

What else is happening? Please share your thoughts and links in the comment thread and have a terrific Tuesday!


Tuesday Reads: Jonas Salk, the Polio Vaccine, and Today’s For-Profit, Fear-Based Culture

Puppy in vest

 

Good Morning!!

I thought I’d illustrate today’s post with photos of cute puppies to offset the generally horrible news. The photo above comes from yesterday’s Boston Globe, Puppy in Boston Police Department Bulletproof Vest Melts Internet.

The photo, which was posted to Reddit, is from Massachusetts Vest-A-Dog, a non-profit that helps provide bulletproof vests, essential equipment, training, and purchase of dogs for police and law enforcement K-9 programs throughout the state.

“As K-9s are trained to give up their lives to protect their partners and all of us, we believe it is every bit as important to protect them,” according to www.mavestadog.org which is why they can run freely without pain

The story says the puppy’s name is Tuco, after a character in Breaking Bad.

Did you see today’s Google doodle? It honors what would have been Jonas Salk’s 100th birthday.

In 1954, I was 6 years old and I was among the first wave of kids who got the experimental polio vaccine at my school. We were living in Lawrence, Kansas then, and I attended Cordley Elementary School. I’m not sure if this was when I was in the first or second grade (I started kindergarten at age 4). Another girl in my class had already gotten polio and one of her legs was paralyzed. I don’t know if I was in the experimental or control group, but I do recall getting another shot the following year. Children from 44 states participated in the tests.

puppies1

A look back at Salk’s work highlights the vast differences between American culture in the mid-1950s and today. Salk never patented the vaccine, because he wanted it to be distributed to as many children as possible; so he never made a cent from his discovery. In some ways the 1950s were the bad old days, but most Americans still believed in pulling together for the public good–maybe it was a hangover from WWII.

From The Washington Post, JONAS SALK: Google says ‘thanks’ to the heroic polio-vaccine developer with birthday Doodle, by Michael Cavna.

As so many tens of thousands of children suffered from polio into midcentury, his vaccine began as the stuff of dreams; by the mid-’50s, it was the substance of a profoundly life-altering reality.

Dr. Salk had begun his journey a coast away; he got his medical degree in 1939, at the New York University School of Medicine, and was working at the city’s Mount Sinai Hospital before a research fellowship at the University of Michigan — with his mentor — beckoned. In 1947, he moved to head up the University of Pittsburgh School of Medicine’s Virus Research Laboratory, where he did the real groundbreaking work in his march toward a vaccine for paralytic poliomyelitis, or polio.

The goal, of course, was to trigger the body’s own defenses — so it would build immunity against the disease. Salk believed that antibodies could be produced by injecting not a live virus, but rather a deactivated (non-infectious) one.

At this point, enough necessary tumblers clicked into place. For one, the team of Harvard scientist John Enders solved how to grow the pure polio virus in the test tube — a crucial step that enabled Salk’s effective experimentation with a “killed virus.” And then there were the needed funds — Salk got backing from the National Foundation for Infantile Paralysis (the March of Dimes Birth Defects Foundation).

In 1954, at least 1-million children — the Polio Pioneers — were tested across the nation (this followed testing that ranged from monkeys to Salk’s own family). The vaccine was announced as safe and largely effective on April 12, 1955.

“In the two years before [the] vaccine was widely available, the average number of polio cases in the U.S. was more than 45,000,” according to the Salk Institute. “By 1962, that number had dropped to 910.”

 Now we have panic over Ebola, and instead of focusing on developing a vaccine we have politicians cutting funds for medical research and ginning up public panic for their own selfish purposes, academics and corporations more interested in profits than saving lives, and ignorant people refusing to vaccinate their children.

puppies4

From The Atlantic, The Anti-Vaccine Movement Is Forgetting the Polio Epidemic, by Jennie Rothenberg Gritz.

It started out as a head cold. Then, the day before Halloween, 6-year-old Frankie Flood began gasping for breath. His parents rushed him to City Hospital in Syracuse, New York, where a spinal tap confirmed the diagnosis every parent feared most in 1953: poliomyelitis. He died on his way to the operating room. “Frankie could not swallow—he was literally drowning in his own secretions,”wrote his twin sister, Janice, decades later. “Dad cradled his only son as best he could while hampered by the fact that the only part of Frankie’s body that remained outside the iron lung was his head and neck.”

At a time when a single case of Ebola or enterovirus can start a national panic, it’s hard to remember the sheer scale of the polio epidemic. In the peak year of 1952, there were nearly 60,000 cases throughout America; 3,000 were fatal, and 21,000 left their victims paralyzed. In Frankie Flood’s first-grade classroom in Syracuse, New York, eight children out of 24 were hospitalized for polio over the course of a few days. Three of them died, and others, including Janice, spent years learning to walk again.

Then, in 1955, American children began lining up for Jonas Salk’s new polio vaccine. By the early 1960s, the recurring epidemics were 97 percent gone.

Salk, who died in 1995, would have turned 100 on October 28. He is still remembered as a saintly figure—not only because he banished a terrifying childhood illness, but because he came from humble beginnings yet gave up the chance to become wealthy. (According to Forbes, Salk could have made as much as $7 billion from the vaccine.) When Edward R. Murrow asked him who owned the patent to the vaccine, Salk famously replied, “Well, the people, I would say. There is no patent. Could you patent the sun?”

Can you imagine that happening today? Read much more about Salk at the Atlantic link.

PETS_LONMED_2034_10

Today it’s all about corporations making money from people’s misery. From LA CityWatch, How Sick is This Generation’s Pills for Profit Philosophy? by Bob Gelfand.

Here are two seemingly unrelated stories that nevertheless intersect. The first involves a scientific lecture I heard the other day. Without going into details, the story involves the discovery of a naturally occurring small protein that treats some of the symptoms of diabetes when injected into rodents, and also slows the growth of cancer cells grown in culture. It is a marvelous discovery and is supported by numerous control experiments that are very convincing.

The scientist, in a later conversation, explained that the patent on this discovery had already been submitted, even though the scientific papers  had not all been written and submitted to journals.

In another lecture a few weeks earlier, but at the same institution, we heard from a venture capitalist. He explained that the pharmaceutical companies are only interested in developments that promise to show a billion dollars in sales.

In yet a third talk by an administrator, the resident scientists and physicians were encouraged to work with the institution’s patent office as early as possible on any patentable application.

The subject of this discussion is the monetization of science and its application to pharmaceutical research. It was not always so. In some ways this is a bad thing, and in other ways it is not.

The great counterargument to the direct monetization of scientific discovery is the story of the polio vaccine. Jonas Salk and his financial supporters made no attempt to patent the Salk vaccine. There are competing stories as to the motives and law that led to this decision. One argument is that the research had been paid for by tens of millions of donations through organizations such as the March of Dimes. Another argument is that the lawyers did not believe that a patent application would be upheld. Salk famously stated that the vaccine presumably belonged to the people, perhaps implying that the mass of Americans through their donations had already earned the right to the vaccine.

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Here’s latest on the Ebola panic front. Kaci Hickox escaped her imprisonment by New Jersey Governor Chris Christie only to end up under the thumb of another stupid Republican governor Maine’s Paul LePage. Fox News reports, New fight over Ebola quarantine looms as nurse returns to Maine.

Kaci Hickox left a Newark hospital on Monday and was expected to arrive in the northern Maine town of Fort Kent early Tuesday. Maine health officials have already announced that Hickox is expected to comply with a 21-day voluntary in-home quarantine put in place by the state’s governor, Paul LePage.

However, one of Hickox’s lawyers, Steve Hyman, said he expected her to remain in seclusion for only the “next day or so” while he works with Maine health officials. He said he believes the state should follow the Centers for Disease Control and Prevention guidelines that require only monitoring, not quarantine, for health care workers who show no symptoms after treating Ebola patients.

“She’s a very good person who did very good work and deserves to be honored, not detained, for it,” he said.

LePage defended the quarantine in a news release Monday, saying that state officials must be “vigilant in our duty to protect the health and safety of all Mainers.” Adrienne Bennett, a spokeswoman for the governor, told the Portland Press Herald that authorities would take “appropriate action” if Hickox does not comply with the quarantine, though she did not specify what that action might be.

The Portland Press Herald isn’t sure whether Hickox’s Maine quarantine is voluntary or required.

Bennett, when asked whether a 21-day quarantine was mandatory or voluntary for Hickox, at first told the Portland Press Herald early Monday afternoon that it was “voluntary.” Later in the afternoon, she wrote in an email that Hickox was expected to follow the quarantine.

“We fully expect individuals to voluntarily comply with an in-home quarantine. If an individual is not compliant, the state is prepared to take appropriate action,” Bennett wrote. She was asked repeatedly by the Press Herald to clarify what “appropriate action” was, but did not respond.

Whether Hickox, who worked in Sierra Leone for Doctors Without Borders, would abide by a quarantine is unknown. Her New York attorney, Steven Hyman, emphasized her civil rights.

“There is no basis (for her) to be kept in quarantine or isolation,” Hyman said. “We are prepared to establish that in a court of law.” [….]

The Maine Attorney General’s Office declined to comment. Dr. Dora Anne Mills, a former director of the Maine Center for Disease Control and Prevention, said she does not believe the state could impose a quarantine without a court order.

Meanwhile Chris Christie is still making a fool of himself in public. Politico reports that he’s now claiming he knows better than the CDC.

The Republican governor has faced criticism from the White House and some health experts over his and New York Gov. Andrew Cuomo’s policy for a 21-day mandatory quarantine for aid workers returning from Ebola-stricken countries in West Africa.
Appearing on NBC’s “Today” on Tuesday, Christie said again that mounting evidence shows that the CDC will eventually come around to his policy.

“[T]he CDC has been behind on this. Folks got infected in Texas because they were behind,” Christie said, in reference to the multiple Ebola cases in Dallas. “And we’re not going to have folks being infected in New Jersey and in other states in this country. Governors ultimately have the responsibility to protect the public health and the public safety of the people within their borders when folks come in with this problem.”

He cited the five other states — Pennsylvania, Maryland, Virginia, New York and Georgia — where quarantines are in place, as well as reports that the Joint Chiefs of Staff that the military impose a 21-day quarantine for troops returning from West Africa. A Defense Department spokesman declined to confirm those reports on Monday.

The governor criticized both the CDC and Dr. Anthony Fauci in particular, the director of NIH’s National Institute of Allergy and Infectious Diseases, who has criticized the quarantine policy. Appearing on the Sunday talk shows, Fauci called mandatory quarantine policies not “based on scientific data.”

“I think Dr. Fauci is responding … in a really hyperbolic way because they’ve been wrong before,” Christie said when asked about Fauci’s criticism.

Temple with stuffed animals

New York Governor Andrew Cuomo looks like a fool too. From The Buffalo News:

Gov. Andrew M. Cuomo’s Ebola quarantine policy met with withering criticism Monday from AIDS experts who said it could be counterproductive as well as the governor’s Republican campaign opponent, who said it didn’t go far enough.
Three days after Cuomo imposed a 21-day quarantine on health workers returning from Ebola-stricken nations and a day after the governor relaxed that policy to allow people to serve their quarantines at home, more than 100 AIDS activists, researchers and doctors wrote a letter to the governor condemning his actions on Ebola.

The governor’s quarantine policy “is not supported by scientific evidence” and “may have consequences that are the antithesis of effective public health policy,” said the letter, which was signed by AIDS activists such as the head of ACT UP NY as well as more than 35 physicians, including medical school professors at Columbia, Harvard, Johns Hopkins and Yale.

Most notably, quarantines “will potentially have a profound effect on efforts to recruit U.S.-based health care professionals who are desperately needed to help combat the burgeoning epidemic in West Africa while increasing stigma toward persons who come from those countries,” the letter said.
Meanwhile, Westchester County Executive Rob Astorino, the GOP candidate for governor, criticized the governor for shifting stances on the quarantine.

“What we’re getting is a governor who’s winging it, changing the policy all the time,” Astorino said while campaigning in New Rochelle. “It’s very confusing, and it could lead to health risks for many people.”

Finally, Dallas nurse Amber Vincent has recovered and will be leaving the hospital soon.

When you want your puppy to be this cute, hire a dog groomer. Your dog will look so fabulous you would it more.

I have a few more articles that I’ll post in the comment thread. What stories are you following today? See you down below, and have a terrific Tuesday!