Medicine and the so-called free market are incompatible in important ways. An outstanding article in the recent New Yorker by Atul Gawande makes that point from yet another new angle. (newyorker.com has a nasty habit of putting archives behind a paywall, so I don’t know how long the link will be useful.) In all the talk of consumers, insurance, and governments, we’ve kind of lost sight of the doctors. Which is odd, considering that they’re the only ones who actually know what’s going on. Let’s begin somewhere near the beginning.

The issue of cost control in medicine is much in everyone’s mind. Krugman and Ezra Klein have been out in the forefront of the fact brigade. It’s supposed to be the central feature and purpose of health care reform. There are several approaches that boil down to a choice between free markets and regulated oversight. I’ll take the two in turn.

The free market, like anything with “free” in the name, has an appealing ring of being able to make one’s own decisions without interference. It doesn’t work in medicine. At all. I wrote a post a while back about how Profits Cost Us Cures, but it goes way beyond the pharmaceutical industry and touches every aspect of medicine.

Let’s face it, most medical expenses are in a class by themselves. People don’t go to the doctor like they go to buy a car. They don’t say, “Doc, insured patients pay $357 for this type of X-ray. If you’re gonna charge $973, I’m going to Doc B.” They don’t know enough to know a good deal from a bad one, or whether they need the deal at all. Nor should they have to. We’re paying doctors for their knowledge, so there’s something very bass-ackwards in the demand that we acquire the same knowledge before theirs is any use to us.

Even more important, nobody goes to the doctor because they no longer liked their old X-rays and wanted new ones. We’re at the doctor’s when we’re in pain, trying not to think about what it could be, and desperate to get the whole thing over with. At any price. That is also the exact opposite of a situation conducive to calm and careful comparison shopping.

The whole notion that somehow patients can control the costs of medicine is such an obvious crock that if it’s being propounded by anyone smart enough to have a public platform, they must have ulterior motives. As far as I’m concerned, those motives are obvious. Putting the powerless chickens to guard the henhouse is evidence of making sure that the fox meets no obstacles.

So we can forget all the classic consumer choice blather about controlling medical costs. On the evidence, we can also forget about the insurance companies doing it. Their concept is to cut care and grow salaries, an approach that has notably failed at controlling anything. The government? Judging by the Europeans and Canadians, they can do a better job than insurance companies, but at the price of inflexibility that simply can’t keep up with medical reseaarch. For someone fighting a recently curable but not yet insurable disease, that’s intolerable. There has to be a better way.

I think Atul Gawande has shown us in which direction it lies. As he notes:

Health-care costs ultimately arise from the accumulation of individual decisions doctors make about which services and treatments to write an order for. The most expensive piece of medical equipment, as the saying goes, is a doctor’s pen. And, as a rule, hospital executives don’t own the pen caps. Doctors do.

He goes on to question why there’s so much variation in the cost of care across US counties. The most expensive is over twice as much as the cheapest.

First of all, it’s got nothing to do with cheeseburgers. Gawande compares two communities, among others, McAllen and El Paso in Texas. Same demographics, same per capita cheeseburger snaffle rate, totally different costs.

The idea that it might have to do with quality of care is laid to rest as soon as he points out that one of the cheapest counties contains the Mayo Clinic.

And that also brings him to the most interesting observation. The Mayo Clinic achieves its lowest cost, bestest care by:

• Money coming in is pooled across the whole hospital and everybody is paid a salary.
• Patient care is explicitly the first priority, and people are promoted on that basis.
• They “meet regularly on small peer-review committees to go over their patient charts together. They focussed on rooting out problems like poor prevention practices, unnecessary back operations, and unusual hospital-complication rates. Problems went down. Quality went up.”
• They have a “regional information network—a community-wide electronic-record system that shared office notes, test results, and hospital data for patients across the area. Again, problems went down. Quality went up.”

In short, the doctors get money, plenty of it, but they’re not going to get a whole lot more by each opening their own redundant MRI facility and steering patients toward it. That entrepreneurial, profit-oriented process is what’s gone wild in McAllen, aka The Expensive County.

The Mayo Clinic process is more of a one-for-all-and-all-for-one, dare I say it . . . socialist process than a purely market-driven one. It’s also open source, so to speak. Information is pooled, not hoarded.

And, it liberates doctors’ professional instincts to do their best for their patients. The same doctors who actually know what that is and how to achieve it with the least pain and anguish and expense.

An important point here is that changing only the payment method, eg single payer versus multiple payers without changing the incentive structure for doctors will not solve our problems. For me, that was a new insight. But I find it very valuable because it tells us what to do with single-payer once we get it.

Don’t laugh. I want you all to close your eyes and hum along with me . . . “Another world is possible.”

I wish.

This has been brought on by a comment thread at Reclusive Leftist. The post was about feminism, but the thread kept veering off into abortion. Could you be a feminist and be antiabortion?

Folks, that is the wrong question. And asking the wrong question can never lead to the right answer, any more than looking for your socks in the bedroom when you lost them in the dryer is going to help you find the things.

So let’s start by asking the right question.

Maybe the first thing to do is figure out whether abortion really does kill babies. (I’m using “babies” as shorthand for “legal person with the same right not to be murdered as everyone else.”) If it does, even that’s not the end of the matter, as we’ll see in a bit, but first let’s figure that out. It’s a sticking point for many people.
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This is all you need. Shove this in anyone’s face who starts saying, “But, but, but . . . the guvvamint!” From a comment by Mikirivi on Krugman’s blog, a graphic prepared by Dr. Klein for the Arizona League of Women Voters:

The one solitary “disadvantage” that I can see in the Single Payer column is that the insurance industry would need restructuring. I seem to remember reading somewhere that that’s over two million workers. So it’s nontrivial. But as I remember reading in the same place, most of the skills in the insurance industry are various office skills and are eminently transferable to other fields. (We could even, like, you know, help people make the switch.)

So we could have a system that costs half as much and insures everyone (”Single Payer and beyond” section in the link), or a variant on the baroque BS we have now. The choice is obvious. Baroque BS, of course.

The whole thing is eerily reminiscent of the electric car vs GM debacle. On the one hand everyone wins and GM has to be restructured, whereas on the other hand everyone loses and GM . . . .

health insurance, single payer

This has been hard for me to write. It’s part of the reason I haven’t wanted to write anything for a while. I didn’t think I’d be here at this point.

I started my blog because I was devastated that the US was torturing people. Worse, the powers-that-be were making excuses for it. The US has been guilty of crimes before. But in the bad old days that was just it: they were guilty. The thing was to pretend it wasn’t happening. Now they were doing something much worse. They were saying it was okay.

I come from a family that fled Communists, Nazis, and Fascists. (Yes, that was a lot of fleeing and it took three decades.) Maybe that’s made me hypersensitive to the ultimate personal price of dictatorships. They are horrible, awful, terrifying places and nobody really survives. You can try to escape with the clothes on your back, or become subhuman, or die. That’s all. There are no other choices. So it’s a matter of life or death to avoid that road at all costs. Never put so much as one toe on the path that ends in that hell.

There are two hallmarks shared by dictatorships: detention without trial and torture.

We’re doing both. We’re saying that committing crimes is legal. Is there any way to make the rule of law more meaningless?

At first, I never thought that people would stand for it. I knew there’d be a convulsion and the whole country would reject the lethal disease we had. But instead the shock became dulled. Too many people in the US patted themselves on the back for not being as bad as those other real dictatorships. We’d only put both feet on the beginning of the path. That was totally not the same as reaching the end.

You know what? Once you’re on that path, in terms of what happens next it doesn’t matter who started it. It doesn’t matter if you do nothing. All you have to do to reach the end is not get off. It’s downhill all the way.

I had to do something. The whole Government needed to be changed from top to bottom. The people who made excuses for it had to be changed. Corporations, media, education, it all had to be changed.

I didn’t know how to do any of that. What I did was start a blog in feeble protest, five years ago last May. I’d never understood how the Good Germans could stand by while their government went to the devil between the two World Wars. Now I know. I never thought I’d become the sort of person who could understand that.

I never thought I’d see liberals making excuses for bigotry and war, just because it was their own side doing it. I never thought it would hurt to remember how much hope I felt that the long nightmare of criminal government was coming to an end. I never thought I’d find out that it can get worse than having an unpopular dictator. You can have a popular one.

dictatorship, torture, detention without trial, Obama

We’ve made the world a depressing place. Everywhere you look, all the good stuff is buried under a thick and powerful layer of crud. Sort of like an endless mall parking lot. Seedlings push through it every now and again. You can’t even see them from a distance and if you stepped on them, they’d be dead. But you know how it is with seedlings. In time they’re going to destroy the whole damn lot. What follows is one of those seedlings. Keep an eye on it.

Africa pioneers mobile bank push

Mobile financial services in the developing world could be worth $5bn by 2012, say analysts. . . . More than one billion people in the developing world have access to a mobile phone, but no bank account. . . . [CGAP] also expected more than one in five to use their mobile to access banking services, creating a market worth up to $5bn (£3.05bn). . . .

One of Africa’s first mobile banking system[s], M-Pesa, launched in Kenya in March 2007. A network of more than 7,000 agents – mostly shopkeepers – was set up to take deposits and issue cash, with users authorising payments on their mobile phone using a Pin code. That service has now expanded to include Tanzania and Afghanistan with plans to launch in India, Egypt and South Africa.

If we can keep this out of PayPal’s grubby monopolistic mitts, maybe some of this newfangled convenience could trickle all the way down to us. It should go without saying that we, and the rest of the world, will have to do some serious anti-spam and anti-fraud work as this gets more widespread. But you know what? That’s doable.

(Personal note: I’m back from vacation, hiatus, and general out-of-the-loopiness. Sort of. I may become loopy any time again so long as the weather is nice. And it’s always nice here in sunny Southern California.)

mobile banking, microfinance, Africa

I haven’t got much done these last few days. I’ve been too busy watching the Nasa TV live feed from the Hubble servicing mission.

The problems they have on a mission like this are so wonderfully groan-in-sympathy familiar: stuck bolts. Like working on old plumbing, with the same issues. They’re too professional to say it, but if I was in the control room there’d be a lot of, “Watch out! Don’t strip that thing. Omigod. You stripped it.” And so on.

Yesterday, Mike Massimino had to get at a failed power card inside the telescope. It wasn’t designed for removal, so the access plate was held down with over a hundred screws of a bunch of different sizes, which was itself behind a great big steel bar of a handhold on the surface of the telescope. The steel bar had a stuck bolt. It would not come off.

They have mockups on the ground of the same setup. Some smart tech figured out you could break the whole thing off. They showed video. The thing snapped with a bang like a rifle and shot across the room.

I love the language they use in the astronaut business. When they were going back and forth about this maneuver with Massimino on the telescope — a maneuver that could shred his suit and the telescope if it went wrong — ground Control said, “We’re a bit concerned about the stored energy in the handhold.”

One of the striking things, watching the astronauts work, is how slowly everything goes. They move slowly, slowly, slowly, like fish in glycerin. They can barely bend their hands to grasp tools because of all the pressure keeping them alive inside their suits. But when I was watching Massimino on that one space walk, everything seemed way speeded up. At first I thought they were running file footage at double speed. Then I learned he’s from New York.

And now, folks, sorry, but I have things to do. Got to watch them putting the new thermal insulation “blankets” around all that great new equipment they’ve successfully put in. As Jack Horkheimer says, “Keep looking up!” There’ll be great new Hubble pics coming out of this.

I feel like a mouse in a room full of cats. In the struggle for health care reform, will Big 0’s need for popularity or his need for Big Medicine’s money win out?

A few weeks ago, I would have bet on number two. Never forget that this is the (expletive deleted) whose idea of the right way to gut Illinois’ attempt at State-assisted health care was to say

“We radically changed [the health care bill] in response to concerns that were raised by the insurance industry.” (Obama, 2004/05/19)

But (will wonders never cease?) the Dimmicrats seem to have understood that they have to get something accomplished this term or people might start to wonder why the Repugs were to blame for everything. Even Big 0 is on board for using the “nuclear option” to stop filibusters on health care reform. So they’re going to reform.

This is giving me that uncomfortable Hope(tm) feeling. They never did specify what they were hoping for. Turned out to be rather different from what I was hoping for. Now they’re going to reform health care from a Kafkaesque trap to . . . to what? They’re not saying.

But the fact that the health insurance moguls have suddenly started participating gives me a bad feeling. Next thing you know, health care will be radically reformed in response to their concerns. I can’t bring myself to share Krugman’s kind words, although I hope he’s right that industry interest in controlling costs is “some of the best policy news I’ve heard in a long time.”

I fear the worst, though. Our only leverage against it is threatening to throw the Congresscritters out of their jobs. Which brings me to the point of this post. (You knew I’d get somewhere eventually, right? Right?) Call, email, fax the relevant Critters daily. Hourly, if you have the stomach for it.

Katiebird has corralled a wealth of information in one place. Her posts and others at The Confluence have really helped me know when and what to do for maximum effect. (Keep it up, Katie! and Stateofdisbelief! and everybody!) The single payer day of action was a real W00T! moment. Now that the industry has decided to “help,” constant threats to Congress are our only hope(not tm).

Ecological disaster bad enough to destroy people has happened before. The only difference was the limited technology of the times, and therefore the limited scope of the dying.

Sean Gallagher has a striking report, a series of pictures each worth thousands of words.

That was then. Two thousand years ago, Yinpan in Central Asia was a major stop on the Silk Road. The water table changed. People couldn’t or didn’t adapt, until the water –and the people — disappeared over a thousand years ago. Soil erosion still uncovers traces of them, but the water never came back.

This is now.

A dust storm raised from the desertified former farm land in China. Life stops. If you have to go outside, you wear a dust mask and choke. The dust is fine as talc and gets everywhere. It’s in your toothbrush, your clothes, your dishes. It clogs your car, it ruins machinery, it gums up your mp3 player. It costs money. It shortens lifespans. The dust travels for hundreds of miles, blanketing Beijing during dry seasons, and sometimes even making murk in the skies of the Western U.S.

The earliest signature of anthropogenic global warming was polar and nighttime warming. We got that, but we’re not polar bears so it wasn’t important. One of the next symptoms is higher temperatures in the middle of large continents. That’s where most of the world’s grain grows. Places like Kansas won’t just be hot in the summer. They’ll be hot enough for old people and babies to die. Plants will wither in the heat no matter how much they’re watered. And it won’t take long before there’s nothing to water them with. If people can’t or won’t adapt, the water table will sink lower and lower. The surface will get drier and drier. There will be dust storms.

Then there’s the future. Photo #1 will describe the future as well as the past.

And you know what’s the worst of it? It doesn’t have to be that way. It Does Not Have To Be That Way. This isn’t the sun going nova on us and frying all life on earth no matter what we do. This isn’t beyond our control. Yet. All we’d have to do is little things, lots and lots of little things, all together, all the time. Nothing heroic, unfortunately. Just wimpy stuff like cooperation and keeping promises.

Sometimes, when the alternative is photo #1, people can do the most amazing things. Even work together.

Here’s just one example of a small unheroic thing that could be part of the solution. I saw this in the news recently.

1) A new, small-scale way of making electricity from wave power. It’s more or less a buoy that bobs up and down, has some gizmos to harvest the energy of the bobbing, and some failsafes in case of storms. It’s easier to maintain and less sinkable than huge megawatt projects, and units can be chained together to yield more power.

2) When a weak electric current is applied to metal scaffolding in seawater, limestone precipitates out of the water onto the metal where it builds up for a while, until the encrustation is thick enough to insulate the current. But — there are two important buts — some limestone forms and the scaffold is colonized by corals if it’s an area where they can grow. It’s not clear yet whether the current helps the corals to grow, but since something to grow on is their limiting factor, some scaffolds mean more corals than no scaffolds. (More here and here.)

Why does that matter, aside from the fact that corals are gorgeous? They’re basically blocks of limestone with a film of life on the surface. And that matters because limestone is calcium carbonate. CaCO₃. A molecule of carbon dioxide (CO₂) goes into every molecule of calcium carbonate.

Imagine fleets of those pontoon wave power things, towing their webs of scaffolding. Besides generating some energy and helping corals to grow, carbon dioxide would be taken out of circulation, one tiny invisible bit at a time. Imagine millions of wave power pontoons, doing this. And when the weight of all those corals and barnacles and whatnot made the thing sink, we’d float out another one. And another one, and another one.

Same as with all the other things we have to do to reverse global warming, it would cost some money and we’d have to keep doing it, all together, all the time. That’s all.

So now it’s Sotomayor. According to Jeffrey Rosen, who spoke to some law clerk, she’s not fit to be a judge on the Supreme Court because she has opinions, she expresses those opinions, she expresses those opinions forcefully and at length.

(Shows you how much I know about the law. I thought that was practically the description of the Supremes.)

Greenwald does one of his usual masterful takedowns, and adds a very interesting update at the end:

Jeffrey Rosen’s brother-in-law is Neal Katyal, the current Deputy Solicitor General in the Obama administration. If Sotomayor’s prospects are torpedoed, that could clear the way for one of the other leading candidates to be named to the Court: current Solicitor General Elena Kagan. The selection of Kagan (rather than Sotomayor) would almost certainly result in Rosen’s brother-in-law (Katyal) becoming Solicitor General. Additionally, Katyal himself was once a clerk for a Second Circuit judge, obviously raising the question of whether he was one of the anonymous sources for his brother-in-law’s hit piece disparaging Sotomayor’s intellect and character.

One can question whether this Rosen/Katyal relationship should have been disclosed by TNR (on balance, it was probably unnecessary), but at the very least, these are illustrative of the types of problems that inevitably arise when anonymous sources are used so casually in a political culture rife with incestuous relationships and conflicts of interest.

However, what’s a boring potential conflict of interest? Let’s talk about Sotomayor. She talks! She’s forceful! How awful!

And apparently that’s been enough to get the “keepers of conventional wisdom” (to use Greenwald’s words) riled up about the potential horrors of affirmative action. “Good God. You can’t waste such a vital job on some politically correct nonsense. The only criterion should be the best, um, person for the job. Why should a woman get it?”

As I said, button up. Your sexism is showing.

There isn’t one shred of evidence that women have inferior mental capacity to men. (Insofar as there is evidence, it’s actually on the other side. On average girls show earlier verbalization in infancy, better school grades, and higher test scores until, for some reason — possibly they talk too much and they’re too loud — they hit the job world and start getting paid less and promoted less.) So, in a reality-based context it’s safe to assume that women are at least the equals of men in ability. And yet the overwhelming preponderance of powerful positions are filled by men.

Yes, there’s affirmative action. And, yes, it does lead to less competent people being given jobs that are beyond them. It’s time to end that. We should find the best person for the job. Why should it be given to a man?

He’s lucky he’s got tenure. With his track record, he’d be drummed out of economics otherwise. I mean, this is the field which, in all seriousness, avers that we’ll never run out of oil. And they’re right. If oil costs $10,000 a gallon, people will go to any lengths to extract or make another few drops of the stuff. It’s the law of supply and demand. The fact that it has zero practical application at those levels doesn’t enter into it. For economists. So I’m sure a group that believes in fairy stories — the Rational Economic Man is another good one — would get rid of Krugman in a second if they could, him and his big flat feet clumping around insisting on reality.

What brought this on? Another brilliant op-ed An Affordable Salvation and the earlier post on his blog: Anti-green economics.

Clearly, opposition to doing something about climate change has fallen back to a new position: claims that attempting to limit greenhouse gas emissions would be incredibly costly. Yet the most careful studies, like the big MIT study of Congressional proposals, find only modest costs.

I have to jump in to boggle a bit. Let’s even pretend to grant that measures against global warming are “incredibly costly.” That only matters if the alternative is less costly. However, any study that looks at the price of doing nothing concludes that the expense is enormous, bigger than doing something by an order of magnitude. Case in point is the Stern 2006 review of the economics of climate change. (Wikipedia has a simple summary.) His estimate is that 1% of global GDP is the cost of averting “the worst effects” of climate change. The cost of doing nothing is likely to be around 20% of GDP. As time goes by, both estimates grow bigger, and the probable cost of doing nothing grows bigger faster. So, the obvious choice is to . . . do nothing? Hello?

Krugman goes on to demolish the economic argument against government regulations to help save the planet, but my favorite part is this:

Opponents of a policy change generally believe that market economies are wonderful things, able to adapt to just about anything — anything, that is, except a government policy that puts a price on greenhouse gas emissions. Limits on the world supply of oil, land, water — no problem. Limits on the amount of CO2 we can emit — total disaster.

Funny how that is.

Via Ars Technica, Climate lobbying group ignored its own science advisors, The Global Climate Coalition was one of the main industry groups spreading FUD (fear, uncertainty, and doubt) about global warming. Now one of the GCC members, the Association of International Automobile Manufacturers, is suing in an attempt

“to block California’s efforts to regulate automotive greenhouse gas emissions. During discovery for the suit, a memo came to light in which the GCC’s scientific advisors suggested that certain aspects of climate science simply weren’t controversial; that memo was leaked to The New York Times, which has placed it online.”

I’m alternately rolling on the floor howling with maniacal laughter at the karmic goodness of it all and wanting to beat these people into fertilizer for what they’ve done to my planet.

I had an Issue, as the nerds say, with a hard drive that decided to develop a bad block. Lots of excitement, 24 hours, and much system rejiggering later, I’m up to the test of trying to post something. Wish me luck!

Technorati Tags: global warming, FUD

update below

The news is spreading everywhere: Mexico flu ‘a potential pandemic’. In the next few days we’ll probably have a replay of the bad old bird flu days. Tamiflu! Hide in your house! Shoot the postman! Or whatever level of idiocy we achieve this time.

I did one of my POPs (Pissed Off Posts) on that occasion, and I think it’s time for a rerun.

First, this newest flu strain, H1N1 (CDC info), sounds vicious. It’s communicable between people (in the US, as of this morning, there were 11 cases with no fatalities) but it’s already killed dozens of people in Mexico. This makes it a far more serious threat than bird flu, which was almost never caught from another person. So being worried about this new flu is not a mark of loopiness in the same way as setting your hair on fire over bird flu. But panic is still an intensely foolish reaction, and the points I’ll run through below are still valid.

Fiction 1: We’re all going to die. It makes for a good movie script, but this is not the way flu works. Even SARS, which had an exceptionally high rate, had about 15% fatalities. Obviously, the only good rate is zero. The point I’m trying to make is that exaggerating risk does not help anyone to deal with it.

Fiction 2. Quarantine will stop the disease. Imagine two different scenarios. You feel the first twinges of something that could be flu. In the first scenario, you go to the hospital, get tested, receive free medication, your whole family and all your contacts are tested and also receive any necessary medication. People who see how you were treated are also alert to any sign of flu and go to get treatment as fast as possible. In the second scenario, you go to the hospital, and get tested. Then you’re quarantined for an unspecified length of time, your family is quarantined and unable to go to work, pay the rent, go to school, or do anything they have to do. The money spent on finding and quarantining you and yours is not available to provide an adequate supply of drugs. Obviously, in the second case you’ll rush to the hospital at the first sign of flu. Not.

Quarantine is useful in some situations that epidemiologists know all about. They’ll tell you when quarantine is necessary. Really, they will. Public hysteria is never useful.

Fiction 3. I’ll take Tamiflu and save myself! No, you won’t. Save yourself, that is. Here’s why.

Flu viruses mutate. Flu viruses mutate a lot. They develop resistance to antivirals incredibly fast, much faster than bacteria do to antibiotics. Way back in 2005, in the bird flu days, this was already a problem, and Tamiflu had barely been invented. Flu viruses are growing resistant to antivirals: “…in a special online edition of The Lancet, scientists at the Centers for Disease Control and Prevention reported that 12% of influenza A strains worldwide have developed resistance to the most widely used flu medications.” (That referred to A-series, not H-series, viruses and not to Tamiflu specifically, but the principle is exactly the same.)

So, by trying to take care of number one, instead of everyone, we’ll end up breeding resistant disease, potentially in a matter of weeks, and we’ll all be defenseless, including the people who took it “preventively.”

When is it sensible to take an antiviral? When it is part of the public health measures to contain an outbreak. On an individual level, it’s prescribed preventively when you or someone you live with has a diagnosed case of flu. This is the main reason why outfits like the CDC don’t stock enough doses of antivirals for “everyone.” We don’t need enough for everyone. We need enough to blanket regions with outbreaks, and we need those viruses not to be already resistant to the only drugs available because people have been using them wrongly.

Another consequence of viruses’ rapid mutation rate is that new lethal strains appear all the time. Case in point, H5N1 bird flu in 2005, H1N1 swine flu in 2009. That’s another reason why quarantine, by itself, doesn’t solve the problem. All you’re doing–if it works!– is putting out brush fires, while the viruses keep pouring on fuel just out of reach.

So, that’s what not to do. What are the sensible things that actually work?

First and foremost: vaccines. Obviously, we don’t have a vaccine for this new strain yet, and it’ll take several months before we do. Once it’s available, that’s the most effective protection and the best way to stop the spread (since the virus can’t hop from person to person as easily).

Once there is a vaccine, there’s a useful priority list as to everyone’s place in the line. It really helps to control the spread if people help with that. The most vulnerable people need to go first because they’re the likeliest to catch it and, therefore, to spread it. That puts everyone in greater danger. The priority is, more-or-less in order, frontline public health workers (nurses, ambulance drivers, and the like); school-age and day care-age children (the main vectors); the elderly, infants, and the immune-suppressed; people who deal with the public a lot (teachers, hairdressers, police, funeral workers, and so on), and, finally, the rest of us.

The next most useful thing is not to spread virus particles around. (I mean, duh, right?) The problem is we still don’t really know how they’re spread. The CDC thinks droplet infection (i.e. by air) is an important route. Other research points to touch as the main route. E. g. a BBC report on a study by Oxford & Lambkin, Journal of Infection, August 2005, pages 103-9.

One proven source of droplet infections is airplane trips. Since air travel is by far the biggest way viruses hop continents and spread long distances, I’d say that forcing the airlines to deal with their bad habits is right up there with vaccination as an important preventive measure. The airlines really are part of the problem. It’s not just a matter of many people in close proximity for a long time. The airlines save money by recirculating air without filtering it well enough, by keeping the air too dry because that’s cheaper, and by keeping its oxygen content too low, likewise because that’s cheaper. Airlines should be kicked, repeatedly, until they do what is necessary for the safety and health of their passengers and flight attendants.

For the rest of us, however, the most effective ways to stop the spread are:

1) Stay home at the first sign of sickness. That, up to the point when the disease peaks, is the time of highest infectivity. (I know. The feeling tends to be, “I’m already sick. I can’t get any sicker. And I’m sure not wasting any days off on this.” Or, “I have an exam. I have to go to class.” It’s another case where worrying about number one makes it worse for everybody, including eventually number one.)

2) Wash your hands or use alcohol wipes after touching doorknobs, phones, toilet handles, and anything else touched by many different people. Basically, you should be cleaning your hands about six times a day. The next most important thing is cleaning and disinfecting surfaces that are touched often (counters, phones, desks, etc.). The virus is activated when virus-laden fingers touch our mouths, nose or eyes. It is truly amazing how difficult it is not to touch one’s face, and how unconscious and automatic the process is. One of the interesting effects of wearing rubber gloves is that you find out how often you touch your face. Most face masks are useless for stopping viruses. Viruses are tiny. They’re just big molecules, after all. Any face mask that is easy to breathe through has a pore size that looks like chicken wire to a virus. However, what face masks can do, and do very effectively, is stop you from touching your nose or mouth.

So, as the hysteria mounts in the next weeks and months (unless we’re lucky and this bout is caught early enough so that it fizzles) remember what you know. There’s no need to shoot the postman. It wouldn’t help anyway. There’s no need for any heroic high noon standoffs at the OK Corral pharmacy for the last magic pills. Just wash your hands and don’t panic. (If you need to do something violent, kick the airlines.) And tell everyone you know to do what works instead of what feels good.

Update April 26, 5 pm: Then again, the BBC has a series of very worrisome comments from a whole series of people in Mexico City and Oaxaca, many of them health professionals. Not good.

Technorati Tags: swine flu, H1N1, influenza

Actually, what I’m about to discuss is the search for ET life, but you have to start somewhere and it’s getting more clear by the day that alien intelligence is the best hope for us blog denizens to find someone to talk to.

The idea that we’re not alone has a long and fascinating history, going back to Giordano Bruno who got burned at the stake for it. By the time SETI came along, things had advanced from that point. But not too far. You pretty much got burned at the academic stake for being involved in it, if they could get at you, so the field was heavily populated with tenured professors. By now, the astronomers have found so many planets orbiting other stars (including one, maybe more, exoplanets with evidence of water!) that scientists have gone from thinking SETI was for kooks to looking for the life-bearing planets they know are out there.

Just recently, March 9th to be precise, an article came out with such an elegant method of checking for life that we may be hearing about the first find in a matter of years instead of centuries. Life is peculiar in that it prefers molecules that polarize light a certain way (technically termed chirality). Whether or not light is polarized can be seen right across the universe, and whether that polarization has a given chirality or not, likewise.

The only problem is that we’re talking about very, very, very faint light here. The light has to bounce off, or pass through the atmosphere of a life-bearing planet before it acquires that signature polarization. Passing through gives the brightest signal, but for that the planet has to transit in front of its parent star, from our perspective, when for two brief moments (coming and going) the star shines through the planet’s atmosphere. That’s a somewhat rare event, and we don’t have too many candidates to check yet, but we do already have the capability to see the signal if we get it.

They could be looking at, for instance, Gliese 581e in the next few months. We might actually know any day now that there’s life besides ours among the stars. Being a total nerd, I’m wildly excited and waiting with bated breath. What do you think? Fun, huh?

I have spies amidst the gun-toters. When they first told me the following, I assumed they were just trying one of their cold, spy-ish jokes. I should have had more faith in them:

Ammo in short supply; Dem takeover gets blame

With firearm dealers struggling to keep ammunition on their shelves, it seems the gun and ammunition business has been stimulated in a way few people expected.

The minute Barack Obama stepped into the White House, people scrambled to gun stores to buy as much ammunition as they could get their hands on. Now, there’s a shortage of ammunition all over the country as demand is three times the supply.

The thinking (in the loosest sense of the word) is that assault rifles will be banned, or rifles will be banned, or handguns, or everything, or it will be tax, tax, taxed (you know them damn takeover Dems), or ammunition will be taxed out of existence, or rationed. Or something.

Then I saw this comment (typos edited):

Not to sound too paranoid, but the thought has crossed my mind several times lately, that people like Soros and the rest of that scurvy crew were buying this stuff up with front companies/people to keep it out out of the hands of the public.

Ha! I will call my good friend George (Soros, that is, not he-who-must-not-be-named), and because of my impeccable liberal cred he will give me rooms full of ammo. With this I will then tease the desperate “public” until they hock their very flak jackets to pay my terrible price. I’ll be rich! Rich! Finally.

Well, until some of them decide to broaden their list of targets. Then it won’t be so funny.

Tags: ammunition shortage

Some of the codswallop on what to do about global warming — okay, ALL of the codswallop — is driving me nuts. Nuts, I tell you. If a little knowledge is a dangerous thing, next-to-no knowledge is radioactive.

The latest comes via the Times: Plants buy Earth more time as CO2 makes them grow. The first breathless sentences are “Trees and plants are growing bigger and faster in response to the billions of tons of carbon dioxide released into the atmosphere by humans, scientists have found. The increased growth has been discovered in a variety of flora, ranging from tropical rainforests to British sugar beet crops. It means they are soaking up at least some of the CO2 that would otherwise be accelerating the rate of climate change. It also suggests the potential for higher crop yields. “

Um, Mr. Leake, Environment Editor? You skipped class that day in Basic Chemistry, didn’t you? And then you did it again in Basic Bio. Read more »

The evidence suggests an awful lot of people need it. A recent study by Harris Interactive for the California Academy of Sciences found the following:

• Only 53% of adults know how long it takes for the Earth to revolve around the Sun.
• Only 59% of adults know that the earliest humans and dinosaurs did not live at the same time.
• Only 47% of adults can roughly approximate the percent of the Earth’s surface that is covered with water.
• Only 21% of adults answered all three questions correctly.

Especially the first one strikes me as a real “Who’s buried in Grant’s tomb?” kind of question. Sad, really.

But not sad enough. Tucked away underneath the outrage over AIG’s criminal greed and use of taxpayer money to sue for bigger tax refunds, tucked away underneath all that has been some talk about education. Obama has said he’s for it. He feels it should be high quality. He feels all children should get the same high standard. He feels good teachers should be rewarded.

How, exactly, will these desirable goals be brought to pass? By means of national standards, apparently, and national tests, and merit pay for teachers with students who do well on the tests. It’s amazing, when you think about it, how the Republicans had it right and some of us just refused to see it. I mean, that’s No Child Left Behind. And, of course, unlike boring and expensive methods such as small class sizes, this system is bound to be successful. What other outcome is possible when success is measured by scores that are assigned by the people to be rewarded based on those scores?

Now comes the part that’s not in the news. This is just rumblings on the grapevine. There was a molecular biology workshop for high school and middle school teachers near here recently. The middlle school teachers were saying that their school districts are talking about the new testing environment. At the middle school level everybody’s concerned about The Basics, Kids will be tested on The Basics. In these days of starvation budgets, there’s no room for luxuries. Luxuries are anything not on the tests, because that won”t be reflected in the schools’ bottom line. So. at least at many districts here in Southern California, the plan is to cancel science classes at middle schools.

Dateline: 2030. A new Harris Interactive study found that 70% of adults know the sun circles the earth. 80% are sure that prayers are directly answered. 67% favor the new trials for witchcraft. Under the circumstances, it is vitally important to stop people from praying for the wrong thing and causing earthquakes.

Obama, education, NCLB, No Child Left Behind