Category Archives: Science And Society

Health, Media Criticism, Political Commentary, Science And Society, Social Commentary

Why The CDC Is Failing

It’s forgotten and diffused its mission:

…as the impact of communicable diseases has lessened, public-health medicine—which concerns itself with community-wide solutions to health problems—began to look more intensely at treating and preventing conditions that don’t originate with germs. The focus of researchers and doctors turned especially to conditions thought to underlie cardiovascular disease. But unlike battles against germs, isolating the key cause of such problems has proved elusive, because multiple factors—from genetics to diet to personal habits, like smoking—are all potentially contribute.

Advocates like Frieden have plunged ahead anyway, sometimes proposing simplistic solutions to complex problems, often without much data to back up their claims. As New York City’s health commissioner, Frieden engineered a law requiring food chains to post calorie counts on menus, though there was no evidence that the availability of such information has any effect on eating habits. Frieden also led a campaign to cut salt consumption despite studies that had shown, in fact, that some individuals fared poorly on a salt-restricted diet. Frieden’s campaign led one world-renown hypertension expert to proclaim that New York was attempting to engineer a giant uncontrolled experiment. As time passed, Frieden’s practice of recommending sometimes outrageous solutions to health problems based on few facts grew more disconcerting. In 2007, he even proposed a campaign to persuade uncircumcised adult men in New York to get circumcised to reduce their risk to HIV; a study in Africa had concluded that the practice helped lower infections there. But Frieden’s proposal was widely derided and quickly dismissed because of the vast differences between the two populations and the preliminary nature of the research.

Read the whole thing. This is a microcosm of the more general problem of government getting involved with things that it both has no business doing, and at which it is monumentally incompetent. A small step to fix it would be to can Frieden, and explain why, and refocus the CDC on germs, but that’s far beyond this president’s ideology or ken.

[Update a while later]

Will ebola be good for the CDC?

Public health experts were, in a way, too successful; they beat back our infectious disease load to the point where most of us have never had anything more serious than Human papillomavirus or a bad case of the flu. This left them without that much to do. So they reinvented themselves as the overseers of everything that might make us unhealthy, from French Fries to work stress.

As with the steel mills, these problems are not necessarily amenable to the organizational tools used to tackle tuberculosis. The more the public and private health system are focused on these problems, the less optimized they will be for fighting the war against infectious disease. It is less surprising to find that they didn’t know how to respond to a novel infectious disease than it would have been to discover that they botched a new campaign against texting and driving.

Don’t get me wrong: Fighting infection is still one of the things that the public health infrastructure does, and though I hope it doesn’t come to that, I expect that our system will do a much better job next time. But the CDC did not botch the job because there’s something wrong with Barack Obama, or government, or the state of Texas, or private hospitals. They dropped the ball because the public health system no longer needs to work so many miracles, and consequently hasn’t had much practice. We shouldn’t have let public health give us such an inflated belief in the power of government. But we also shouldn’t forget that with the right task and the right tools, government is still capable of doing some wondrous things.

Only if it is focused on what it does well, and the right incentives are in place. That is not the case for much of the current federal government.

Media Criticism, Philosophy, Political Commentary, Science And Society, Social Commentary, Space, Technology and Society

The Bioethics Of Mars Settlement

35 Comments

An interesting article over at Slate that raises similar concerns to mine:

If we send heterosexual astronauts, of different sexes and of reproductive age, on extended space missions, then the possibility of pregnancy looms. To ward that off, could it be ethical to demand sterilization for any potentially fertile astronauts in a mixed-sex crew? Radiation exposure may eventually take care of the issue by causing infertility, but some pregnancies could happen before infertility occurs. Is conception even possible in the zero-gravity of space, or in the low-gravity, high-radiation habitats on Mars? If so, would a fetus develop normally?

We don’t know, since it would seem patently unethical to even conduct these sorts of experiments today in space or anywhere else, at least with human subjects. Again, the physical and psychological dangers of procreating and living outside of Earth can seem inhumane, especially for involuntary subjects (the children). Yet many plans for space exploration already take it as a foregone conclusion that humans will reproduce in space. For some, it’s a crucial part of the business plan, as in the case of Mars One’s goal of moving toward a “permanent human settlement.”

As I noted:

What I would suggest to the Mars One people, though, is given that they’re planning to spend billions on this project, and the long-term goal is to have true human settlement of the planet, which necessarily involves offspring of the settlers, they devote a modest amount of their budget funding research that NASA has completely neglected for decades, but that others have privately proposed, to establish a variable-gravity laboratory in orbit where we can start to understand these issues. The fact that NASA (or Congress) have never given such research any priority whatsoever is eloquent testimony to how unimportant both consider the goal of spreading humanity into the solar system. But until we do, young people who want to go off to barren (at least initially) worlds will have to continue to face the prospect of remaining barren themselves.

Space really isn’t important, politically. Just “space” jobs.

[Update a few minutes later]

Meanwhile, Kate Greene says that economics would dictate that a Mars mission consist of all women.

Here’s my problem with that. While of course mass is an important consideration, it isn’t the only one. I would argue that any Mars mission would have to be based on an affordable mission concept, and that if it is, mass won’t matter that much, and if it isn’t, no one will go. Beyond that, I think there’s a flaw in the logic here, or at least insufficient information:

Week in and week out, the three female crew members expended less than half the calories of the three male crew members. Less than half! We were all exercising roughly the same amount—at least 45 minutes a day for five consecutive days a week—but our metabolic furnaces were calibrated in radically different ways.

During one week, the most metabolically active male burned an average of 3,450 calories per day, while the least metabolically active female expended 1,475 calories per day. It was rare for a woman on crew to burn 2,000 calories in a day and common for male crew members to exceed 3,000.

We were only allowed to exit the habitat if we wore mock spacesuits. So many Martian hassles, so little glory.

The data certainly fit with my other observations. At mealtime, the women took smaller portions than the men, who often went back for seconds. One crew member complained how hard it was to maintain his weight, despite all the calories he was taking in.

She doesn’t say, but is it possible that maybe the men were doing more physical work? If so, it might be that if the women had to do all of the heavy lifting, their calorie consumption would increase too. In any event, if you just want to send people to Mars for the sake of sending people to Mars, a female crew would be fine, but if you want to settle the planet, there would be a problem…

[Tuesday-morning update]

There seems to be a lot of off-topic whining in comments about what will be “allowed.” I said nothing about government involvement. I simply expressed an opinion that, given current knowledge, it would be unethical to attempt to have children on Mars (or even in weightlessness). I stand by that opinion.

Business, Economics, Mathematics, Media Criticism, Political Commentary, Science And Society

Judith Curry’s WSJ Op-Ed

She rounds up the (hysterical and unhinged) reactions:

Climate science has been thrown into disarray by the hiatus, disagreement between climate model and instrumental estimates of climate sensitivity, uncertainties in carbon uptake by plants, and diverging interpretations of ocean heating (in the face of a dearth of observations). ‘Certainty’ arguably peaked at the time of the AR4 (2007); perception of uncertainty is arguably greater than any time since the FAR (1991). Yes of course we know more about the climate system than we did in 1991, but more knowledge about the complex climate systems opens up new areas of ignorance and greater uncertainty.

In context of the way climate sensitivity is defined by the IPCC, uncertainty in climate sensitivity is decreasing as errors in previous observational estimates are identified and eliminated and model estimates seem to be converging more. Climate model simulations, when compared with 21st century observations seem to be running too hot, giving creedence to the lower observation-based sensitivity values.

What do the lower values of climate sensitivity imply for policy? Well slower values of warming make it easier to adapt, and provide time to develop new technologies and new policies. But the true believers such as Mann et al. call adaptation, developing new technologies and policies as ‘inaction.’ The policy logic apparent in the essays critical of my op-ed are rather naive.

So we are left with science in disarray and naive logic regarding policy. And the ‘warm team’ wonders why people are yawning?

She should cite my piece on the precautionary principle.

Health, Media Criticism, Political Commentary, Science And Society, Technology and Society

Curing Alzheimer’s

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…with a ketogenic diet?

Ketone esters are in a class of supplements called “generally recognized as safe” or GRAS by the FDA. They are expensive, difficult to find, and taste nasty (I’ve smelled some, and it was a bit like salty urine). There are no long term studies of the safety of these supplements in humans, though high ketone levels were maintained in severely obese, fasting patients for 6-8 weeks and there seemed to be no side effects. The main risk might be an exacerbation of gout, but truly, the long term consequences are unknown. For someone with dementia facing an inevitable downward spiral and life in a long term care facility, the question of benefits versus risk is a different calculation than in someone without that condition.

After a few days of escalating doses, Mr. Newport was brushing his own teeth, spontaneously dressing and bathing himself again, had improvements in mood, and was able to recite the alphabet. After 6-8 weeks, his memory improved and he started to do yard work again. After 20 months, he maintained definite improvement, with his cognitive function seeming to wax and wane with rising and falling ketone levels in his blood.

While this report is just a single case study, it does merit more clinical investigation. Given the severity and cost of the disease, the possibility of a far more effective treatment than what we currently have must be explored further.

It actually wouldn’t surprise me at all. Alzheimer’s may be just one more modern illness caused by the awful official dietary advice over the past six decades.