Map of life expectancy at birth from Global Education Project.

Thursday, October 30, 2014

"We have gone terribly astray in the last 30 years. What went wrong?"

The title of this post is from Jan Bellamy, noting that 30 years ago Claude Pepper's subcommittee on health and long-term care published a report trashing the then-$30 billion a year health quackery industry. That's everything from naturopathy to acupuncture to homeopathy -- all fraudulent, then as now. And yet, instead of getting itself stamped out, this fraudulent enterprise has only grown, not only in size but also in acceptance. Quackery has wormed its way into medical schools and prominent clinics, from Harvard to the Cleveland Clinic. It even has its own institute within NIH.

But it isn't just health care fraud. The prestige of science has been demolished in this country. One of our two major political parties has denial of climate science as a central plank in its platform. Measles cases in the U.S. are now at the highest rate in 20 years because parents refuse to vaccinate their children. Creationism is an open and influential political movement. And now we have this outrageous and moronic behavior by politicians from Maine to New Jersey, plus the loathesome Andrew Cuomo in between, over ebola virus.

Let me give you the 4-1-1. Upon initially infecting people, the ebola virus is at such a low level in the blood that it is undetectable. Rather, it infects internal organs. It produces no symptoms, and it is not shed in urine, feces, sweat, saliva or for that matter in blood. People without symptoms are not infectious -- we aren't just talking low risk, we are talking zero, as in zip, zilch, nada, nothing, not happening. Note that Tim Duncan's family lived with him for days, while he was symptomatic, in fact, and not one of them became infected.

The infectious stage of ebola disease happens when the person is very sick. That's when the virus appears in the blood stream and in bodily secretions in sufficient quantities to be transmissible. Ergo, a person who has potentially been exposed need only keep track of his or her temperature and note any possible symptoms of the disease, and present to a hospital as soon as they appear, and we'll all be safe. If you don't trust people to do that, you can have a public health worker visit them a couple of times a day. I can see justification for travel restrictions since you don't want to lose track of the person or have them come down with symptoms in a situation where an appropriate response is not close to hand, plus which a certain amount of irrational fear is inevitable and you don't want to burden authorities elsewhere with it.

But Chris Christie and Paul LePage are both claiming that they know better than Anthony Fauci, and the public doesn't believe him either. Listen up folks: scientists don't know everything, and indeed they are often wrong. But there are some things we do know. We know this.

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