2009 - %3, April

Equal Opportunity Flu in an Ageist World

| Thu Apr. 30, 2009 11:48 PM PDT

One of the unusual things about the current swine flu virus, compared with the strains that cause our yearly seasonal flu outbreaks, is that it doesn’t seem to discriminate on the basis of age. That may change as the pandemic develops, but it may not: The massive 1918 Spanish Flu pandemic is also known for killing across all age groups.

There is, nonetheless, an age angle to this story, and it has to do with those garden-variety annual influenza outbreaks, and how the medical, political, and media establishments have handled them. The great majority of deaths caused each and every year by these “ordinary” flu viruses--some 36,000 on average in the United States alone, according to the CDC--are of people over 65 years old.  Some years it’s more, and some years it’s fewer: During the 1990s, the number of deaths ranged from 17,000 to 54,000. But every year, tens of thousands of old folk succumb, with little fanfare and minimal media attention, to flu-related deaths.

One major public health initiative has been launched in response to these deaths, and that is to promote the flu vaccine for older Americans. The percentage of elders who are vaccinated annually has grown about four-fold in the last 30 years. But there’s just one problem with this approach: The vaccine apparently doesn’t work too well for us old folks, if at all.

For decades, the conventional wisdom was that the vaccine cut flu-related deaths in the elderly by anywhere from 25 to 75 percent. But as the New York Times reported last fall, ”a growing number of immunologists and epidemiologists say the vaccine probably does not work very well for people over 70, the group that accounts for three-fourths of all flu deaths.”A study published last year in Britain’s most respected medical journal, the Lancet, found no correlation at all between flu vaccination and a reduced risk of illness and death.

Advertise on MotherJones.com

Out of Iraq

| Thu Apr. 30, 2009 10:47 PM PDT

A few days ago the New York Times reported that we might be trying to fudge the June 30 deadline for withdrawing combat troops from Iraqi cities.  Our main military concern was the "troubled northern city of Mosul, according to military officials."

Today, McClatchy talks to different officials and says it's not so:

The Obama administration is determined to continue withdrawing U.S. troops from Iraq on schedule, despite a surge of violence in two Iraqi cities that shows no signs of abating and could increase in the weeks ahead, administration and military officials said this week.

"We are not even talking about" changing the withdrawal plan, an administration official told McClatchy. "The situation would have to get a lot worse for that to change."

....In any event, said the officials, who requested anonymity because the administration's public position is more optimistic, there's little more that the United States can do to help the Iraqis end their political, ethnic and sectarian feuds; resolve their disputes over oil revenues, political power and other issues; and build a stable, prosperous and unified nation.

(Italics mine.  Ever since news outlets "banned" the use of anonymous sources, I've been collecting the hilarious excuses their writers are forced to come up with every time they use one.  This is one of the best.)

Anyway.  This is good news.  There's still wiggle room, of course (what if the situation does get a "lot worse"?) but this is still an encouraging sign.  There are always going to be a hundred reasons why we should hold off on withdrawal either from a particular place, or for a particular reason, or for a particular period of time.  If we don't stick to our guns, we'll never get out.  It's time for us to let Iraqis run their country.

Souter Stepping Down

| Thu Apr. 30, 2009 7:33 PM PDT

Looks like Obama gets to put one more thing on his plate:

NPR has learned that Supreme Court Justice David Souter is planning to retire at the end of the court's current term.

....Souter is expected to remain on the bench until a successor has been chosen and confirmed, which may or may not be accomplished before the court reconvenes in October.

At 69, Souter is nowhere near the oldest member of the court, but he has made clear to friends for some time now that he wanted to leave Washington, a city he has never liked, and return to his native New Hampshire.

This won't change the ideological makeup of the court a lot, but it will probably move it to the left both a little more reliably and for a longer time.  Plus it'll give conservative activists another thing to go bananas over now that the tea parties have run out of steam.  That should be entertaining.

Waiting to Exhale

| Thu Apr. 30, 2009 6:07 PM PDT

Here's yet another data point on marijuana legalization from the Washington Post:

Respondents were near split on another issue that until recently was deemed untouchable in many parts of the coutry — marijuana legalization. Forty-six percent of all respondents said they supported legalizing "possession of small amounts for personal use," with rates of support higher among men, among younger voters and among independents, a majority of whom supported legalization.

The Post also found that support for gay marriage and immigration reform had increased.  Here's a guess: views on social issues have been moderating all along for the past eight years, but only some of that moderation has shown up in polls.  The presidency of George Bush and the domination of public discourse by triumphalist Republican narratives has acted sort of like a dike holding back the waters, but now, with Obama in office and conservatives demoralized and in disarray, the dike has been breached and public opinion is returning to its natural tendency to soften on social issues over time.  In the short term, though, we'll see a sudden shift as public opinion catches up to its normal trend line.  It's sort of like we've been holding our breath for eight straight years and now we're finally, collectively, heaving a long-awaited sigh of relief.

On a related note, it's good to see that the Obama administration today embraced common sense and simple justice by endorsing a plan to end the indefensible 100:1 sentencing disparity between crack and powder cocaine.  It's about time.

Black Swans and Swine Flus

| Thu Apr. 30, 2009 4:23 PM PDT

David Rothkopf critiques the media:

Swine flu! World Health Organization at alert level 4! Markets rocked by sell-offs! Howie Mandel was right! Never shake hands! Bathe in Purell! See if you can borrow a face mask from Michael Jackson! Or hold your breath whenever you are near a ham sandwich! Armies of pigs in uniform marching on Washington! Orwell was right: the animals have turned on us, become more dangerous than us! Four legs bad, two legs good! Head for the hills!

Once again, the media is reacting to a potential threat with its usual calm, responsibly recognizing that sensational coverage of diseases can have far worse consequences than the diseases themselves. Or not.

"Moderation in all things" isn't exactly the motto of cable news, is it?  To be fair, though, figuring out the right reaction isn't easy.  Sure, swine flu 1.0 was a bust, avian flu was a bust, and SARS was a bust, so maybe SF 2.0 will be a bust too.  Then again, this might be The One, and we might never know.  After all, if all the hype manages to keep the current strain from mutating into the Andromeda Strain and destroying humanity, we'll never know, will we?  It'll just look like another bust.

(Sort of like the Y2K bug, which is one of my favorite pet peeves.  Here's a heads-up to everyone who thinks Y2K was all just a bunch of hooey: the reason nothing much happened is because everyone went bonkers and spent tens of billions of dollars rewriting their software.  It's true that in the end the world's computers didn't freeze up and die, but that's because we fixed them.  Ask my wife if you don't believe me.)

So will we ever know if SF 2.0 was The Big One?  If it kills a billion people, yes.  If it doesn't, no.  We'll just have to keep wondering.  Which, to my surprise (and to change the subject completely), turns out to be a big chunk of what Nassim Nicholas Taleb writes about in The Black Swan.  After I was (properly) smacked down over my airy dismissal of Taleb a few days ago, I finally decided that maybe I ought to actually read his book instead of relying on the odd blog post about it, and I have to say that it's not at all what I expected.  So far, anyway.  It's a real mishmash of odd potted historical anecdotes that go nowhere, interesting insights about human nature, opinions about historical contingency that are strangely unmoored from even an acknowledgment that lots of other people have thought about this subject before, and conventional observations about things like confirmation bias and the limits of induction.  However, Taleb swears that he's a doer, not an idle idea spinner, and by the time I'm finished I'll get some genuinely concrete advice about how to deal with uncertainty and the limits of knowledge in real life.

We'll see.  I'm a little skeptical based on the first few chapters, but I suppose Taleb himself would warn me that even a long string of mediocre chapters doesn't mean there won't be a phenomenal one that will rock my world when I least expect it.  If I finish it this weekend, I'll report back.

Swine Flu Survey: How Scared Are You?

| Thu Apr. 30, 2009 2:22 PM PDT

Never mind how unlikely your imminent swine flu case actually is, how freaked out are you by the possibility you'll catch the disease? Researchers at Stanford are tracking answers to this (paraphrased) question through an anonymous online swine flu survey, which you can take here.

Via Marcel Salathé at Miller-McCune:

Advertise on MotherJones.com

The Good Flu Still Needs Stopping

| Thu Apr. 30, 2009 12:37 PM PDT

It’s been interesting to watch the media ramp-up to hysteria over the new influenza strain and now drop it like spoiled news because it’s not deadly enough for the headlines. Too bad that's wrong twice.

First off, during the initial discovery of influenza A(H1N1)—no, it’s not swine flu anymore—many outlets were far too quick to diagnose and prognosticate, when all anyone could reasonably do was take a breath and wait a second for the science to sort through the fiction. That didn’t happen. Instead, imaginary death tolls mounted.

Now it’s clear this new flu is more gentle than ordinary flu. Yet this is just the moment when it’s potential for lethal harm blossoms.

Why? Because the farther the virus spreads, the more chance it will mix or reassort with other flus and turn into something more lethal. Already the unusual A(H1N1) flu combines strains from three species—swine, avian, human—from three continents—North America, Europe, and Asia. That’s new.

The mix provides an order of complexity we don't yet understand, says Kennedy Shortridge of the University of Hong Kong. AAAS’s ScienceNow reports that Shortridge led investigations into the initial emergence of H5N1 avian influenza in 1997.

Shortridge is concerned this newly-hacked virus might prove unstable and ready to reassort with other viruses encountered in a human or animal host. It’s already arrived in Asia where the H5N1 virus is circulating and where strains of Tamiflu-resistant human H1N1 are circulating. He speculates that swapping genes between these viruses could result in one that is more pathogenic or more easily passed from person to person or both. The prospects for change in the virus are considerable and truly worrying.

But this is just the moment when the media is sheepishly casting around for a bigger news story. They’ve already cried Wolf and infected everyone with boredom. Now, when we drop our vigilance, is just the moment when a good flu can go bad.

And, btw, I can’t help in the midst of all this to picture a world where for the sake of atmospheric health we all become vegetarian. You know, just to reduce our carbon footprint by a whopping 33 percent. I know, it’s a fantasy. But imagine it anway. Without the brutal disease-making factories of pig and fowl farms, we’d all be healthier—people and planet.
 

Video: The RNC Tries This Thing Called "Humor"

| Thu Apr. 30, 2009 12:08 PM PDT

The comedic geniuses over at the Republican National Committee apparently decided to showcase Obama's 100 days by producing this big bucket of web ad fail, cleverly disguised as a parody video. No wonder you don't see many Republicans doing stand-up.

Via Wonkette:

Watch what appears to be a Southern white man doing his "blacky voice" over video of Obama’s inauguration speech...The introductory text reads, "100 days ago, a man read a grand speech from a TelePrompter. What if the Teleprompter had accidentally switched to reality-mode?" Then: "A parody from the RNC." OH JESUS, RUN.

Is it that bad? Watch below and decide for yourself:

John Murtha Airport: Earmark Reform Poster Child

| Thu Apr. 30, 2009 11:06 AM PDT

Pennsylvania Congressman John "Jack" Murtha, a Democrat and the powerful chairman of the House appropriations committee, is a creature of the Washington culture that needs to be changed. Here's another example of why:

At the behest of Rep. John P. Murtha (D), chairman of the House defense appropriations subcommittee, the Pentagon has spent about $30 million equipping the little-used airport named for him so it can handle behemoth military aircraft and store combat equipment for rapid deployment to foreign battlefields....

Some locals call the Johnstown airport "Fort Murtha" because of the stream of wartime projects at the facility. Although its runway is capable of servicing the largest airplanes in North America, the airport now is used only by small commuter planes that make six trips a day back and forth to Washington Dulles International Airport.

Many of the commercial flights, which are subsidized by federal transportation dollars, carry only a handful of passengers. On a recent visit, all of the departing flights were less than half full, and one had only four passengers -- screened by seven federal airport personnel.

All told, Murtha has steered about $150 million in federal funds to the airport. This spring, it was among the first four in the country to receive stimulus money -- $800,000 for a runway-widening project. 

I consider that money stolen from the American taxpayers. High time for earmark reform.

Chart of the Day - 4.30.2009

| Thu Apr. 30, 2009 10:54 AM PDT

Ezra Klein points to an intriguing bit of opinion polling from the Kaiser Family Foundation today: 61% of Americans say that in order to fund healthcare reform they'd support higher taxes on "items that are thought to be unhealthy, such as soda, alcohol, junk food, and cigarettes":

Problematically, the poll question lumps a lot of different policies together. Paying for health care by taxing cigarettes is actually a common strategy. It's how we funded S-CHIP, for one. Taxing soda is rather further from the center of the consensus. But there's no evidence, in this poll at least, that the public instinctually recoils from the idea.

In a sense, I'm not too surprised by this.  I suspect that most people know that soda and junk food really are a scourge and would like to cut back.  So either through guilt, or maybe a sense that they need someone else to prod them into doing the right thing, they support higher taxes on this stuff.

Further down, however, there's a followup question:

This is a fascinating example of just how thin opinion polling like this is.  The real lesson here is that most people haven't given this issue even a few seconds thought, and their response to the poll question is practically meaningless.  Faced with even the slightest pushback, large majorities of both supporters and opponents flipped their views almost instantly.

So the real question isn't how people feel about taxing junk food now, it's how they're likely to feel about taxing junk food after hearing both sides screech about it for a few days or weeks or months.  This is true of most other opinion polling too.  Caveat emptor.