Tag: Ebola

Turkeys and Drumsticks 2014

For seven years running, I have taken advantage of the Thanksgiving Holiday to give out my awards for Turkey of the Year and Golden Drumsticks. The latter are for those who exemplify the best traits in our public sphere. The former are for those who exemplify silliness and stupidity. I rarely give them out to someone who is evil; they are reserved for those who regularly make me shake my head and wonder what they’re thinking. It’s a sort of “thank you” for making blogging easier.

We’ll start with the Turkeys of the Year. For reference, the past winners are:

2007: Alberto Gonzalez, Nancy Pelosi, Hugo Chavez

2008: Sarah Palin, Sarah Palin’s critics, Hillary Clinton, Congress, Joe Biden

2009: Mike Steele, Glen Beck, the State Department, Sarah Palin, Andrew Sullivan.

2010: Janet Napolitano and TSA, Nancy Pelosi and Harry Reid, MSNBC, Lower Merion Schools, California Voters.

2011: Nancy Pelosi, Republican Presidential Field, Occupy Wall Street, Anthony Weiner, the Eurozone.

2012: The Culture Warriors, Unions, The Poll Unskewers, Debbie Wasserman-Schultz, MSNBC

2013: Healthcare.gov, the Platinum Coin, the Shutdown Caucus, the National park Service, Fiscal Cliff Panic Mongers.

For this year, I picked:

Jonathan Gruber: #3 was in the lead most of the year. Then #2 took over earlier this month. But the millionaire consultant from MIT has to take the top prize now. The thing about Gruber is not that he made comments that support Halbig. It’s not that he helped create Obamacare. It’s not even that he called the voters stupid. It’s that he revealed the ugly reality that undergirds of much of the progressive movement in this country: the belief that Americans are stupid, that leaders are wise and that the latter must lead the former to good choices through deception, obfuscation and coercion. The most common thing I read on liberal message boards after Grubergate was “Hey, he’s right!” There is a large section of the Left Wing that thinks we need to be ruled by a technocratic elite. Gruber pulled back the veil. And that he looked like a horse’s ass into the bargain was just gravy.

Lamenting Democrats: In the wake of yet another electoral shellacking, the professional whining class went into overdrive, trying to find something, anything to blame for their loss. Random articles about science topics would start with lamenting that evil Republicans were taking over the Senate. Robert Reich screamed that Republicans might use reconciliation to do stuff (reconciliation being a legitimate tactic up until November 3). A thousand articles sprang up about “how to talk to your crazy right-wing uncle/parents/cousin/neighbor/imaginary friend at Thanksgiving about Issue X” (hint: don’t).

I’ve been disappointed by elections. But I hope I never get to the point where the results of an election make me gnash my teeth and rend my garments in such hilarious fashion.

Barack Obama: The only reason his approval ratings aren’t at record lows is because of mindless Democrat loyalty. The economy continues to improve despite the Republicans rejecting every “jobs bill” he proposes. His party got crushed in the election. And his response to this was to … implement immigration reform through executive action (polls show Americans support the policy, but oppose the means). His White House is also becoming famous for what are called “bad optics” and would be called scandalous if Bush were doing it: fund-raising while the Ukraine is in turmoil, having a huge dinner while Ferguson is burning, golfing right after a press conference on an ISIS beheading. He has earned the low poll numbers. And earned a place on this list.

Jim Ardis: Earlier this year, Ardis persuaded a judge to launch a raid on a house because one of the inhabitants was … mocking him on Twitter. He apparently still thinks this was a fine idea. Jim Ardis … meet the Streisand Effect.

(One infuriating note: a judge has upheld the drug charges that resulted from the raid finding drugs in the house. Because warrants to arrest parody account holders are apparently just fine.)

Paul Krugman: Another year for Krugman, another set of factually-challenged opinion pieces apparently written by unpaid interns. My favorite was his assertion that Halbig represented “corruption” in the courts, a claim the indispensable Walter Olson demolishes here. As several bloggers noted, Krugman was a big supporter of the Platinum Coin Caper, where he said, essentially, that we should concentrate on the letter of the law, not the spirit, the opposite of what he’s saying now.

Note, also. This year is coming a cropper for things Krugmans believes in. The Picketty analysis of inequality appears to be badly flawed. And Keynesian ideas are failing all over the globe.

Dishonorable Mention: Wendy Davis, whoever is doing PR for the Ferguson Police, the Ferguson rioters, Debbie Wasserman-Schultz, the Secret Service, Mary Landrieu, Everytown USA.

Now the Golden Drumsticks, awarded to those who best exemplified what is right with the world. Here are the past awards, the first round from West Virginia Rebel.

2007: Arnold Schwarzenegger, Ron Paul, Barack Obama, David Petraeus, Juan Carlos, Burma’s monks

2008: US Military, Jeff Flake, Ron Paul, Republican Governors, Barack Obama

2009: The American Fighting Man, Kimberly Munley and Mark Todd, George W. Bush

2010: The Tea Party, Chris Christie, Alan Simpson and Erskine Bowles, the Next Wave of Republicans, David Cameron and Nick Clegg, The American Soldiers

2011: Seal Team Six, Mark Kelly, The Arab Spring (ugh), the Technicians at Fukushima

2012: Down Ballots, The Sandy Responders, Glen Doherty and Tyrone Woods, Mathew Inman

2013: Francis I, Edward Snowden, Rand Paul, The American Military, The Institute for Justice

For this year, I picked:

Ebola Responders: In the face of a colossal healthcare crisis and one of the most terrifying diseases out there, Africa has been flooded with volunteers risking their lives to help. Hundreds of healthcare workers in Africa, including Humarr Khan, have been killed trying to comfort or save the dying. Even in this country, we’ve seen nurses and doctors work hard to care for Ebola victims, including two nurses who were infected in Dallas and mercifully saved by modern medicine.

Here’s a little thing about me: I tend to dislike movies about dystopias. Not because I think a dystopia won’t happen or because I’m ignorant about the dark side of human nature. I dislike them because they usually ignore the flip side of human nature: our capacity to be generous, brave and compassionate.

Francis I: He continues to shake up the religious world while adhering closely to Catholic doctrine. My initial impression of him remains unchanged. He is just a good man.

Rand Paul: Paul gave a speech earlier this year that was a rebuke to the neocons: defining a foreign policy that defends our interests while avoiding senseless overseas debacles. He is pushing the Republicans toward reforms of our criminal justice system, our surveillance state and our War on Drugs. I’m a bit worried whether he’ll hold up to the pressure of special interests, especially if he has Presidential aspirations. But right now, he’s doing good.

David Brat and the Republican Candidates: “A monarch’s neck should always have a noose around it—it keeps him upright.” – Robert A. Heinlein. I’m not sure what to make of Brat at this point, but I think his defeat of Cantor is an important reminder to the Republicans of what will happen if the get stupid again. Among the other Republicans running for office this year, there was barely a gaffe to be heard. In fact, the biggest War on Women complaint was about Mark Udall, criticized by his own supporters for talking too much about the War on Women. In general, they stuck to the bread and butter themes of the economy, Obamacare and big government. Let’s hope they deliver.

The Supreme Court: It’s always a mixed year from the Court, but this year they gave us good decisions in Riley, Hobby Lobby, Harris v. Quinn, McCullen v. Coakley, NLRB v. Noel Canning, Town of Greece v. Galloway, Schuette v. BAMN and McCutcheon. They continued their streak of unanimously rejecting Obama’s power grabs. You can check on this year’s key decisions here. There are a few I had issues with but most were solid.

Honorable Mentions: marijuana decriminalization efforts, Scott Walker, Charlie Baker (anyone who defeat Martha Coakley gets a mention), the American military

Put your nominees in the comments. And I hope you all have a great Thanksgiving.

To Quarantine Or Not to Quarantine

As you may know, there is a brewing controversy over what to do with healthcare workers returning from the Ebola hot zone in West Africa. After Craig Spencer came down with Ebola, several governors imposed quarantines on returning healthcare workers. Controversy erupted and, I believe, we are down to home quarantine for 21 days.

A few thoughts:

First, it’s true that there has been a bit of an over-reaction. So far, we have only had two people infected while in this country and both of them were healthcare workers taking care of a dying man without adequate protection. Naturally, we need to be vigilant. The virus is unlikely to mutate to become airborne but it may mutate to become far more infectious. As Nobel Prize winner Bruce Beutler has noted, we don’t have as much information as we’d like about how infectious this strain is. But, even with those caveats, the policies being advocated in some quarters are unwarranted at this stage.1

Second, the most important thing about fighting Ebola is stomping it out in Africa. If we do not stop Ebola in Africa, it will spread. It will spread to bigger cities. It will spread to other countries. Right now, we only have to worry about people who have actually been in West Africa. If this goes on and blows up to hundreds of thousands of cases or millions, we will have to worry about everyone. A house in our neighborhood is on fire. We’ve had a few cinders land on our roof. But the most important thing is not that we spray water on our roof; it’s that we put out the fire before the whole neighborhood is ablaze.

Anything that discourages healthcare workers from going to West Africa to fight this thing is likely to make things worse. Quarantine sounds like an easy burden to impose. But, in The Hot Zone, Richard Preston describes the psychological trauma that quarantine imposes on workers at USAMRIID. This is not a light burden. And isolating them in hospitals is a good recipe for getting them sick with the opportunistic diseases that infest every hospital in the world.

That having been said, it’s not irrational to be afraid of this disease. It’s not irrational to think that healthcare workers — who are the most at risk and who have close contact with dozens of people very day — should back off until they are clear. We have been very lucky so far that this hasn’t erupted in a school or something. We’ve been very lucky that infected people have sought help immediately. We have been very lucky that this hasn’t mutated to be much more infectious. All it takes is one idiot to wait until he literally drops dead in the street for this to become a serious serious problem. All the reassurances about how we can contain this are going to be cold comfort to someone who gets infected by a returning healthcare worker.

The dilemma is that treating potential victims like pariahs increases the odds of that nightmare scenario. It encourages them to hide their symptoms and to lie. So what do we do?

To me, these problems are interlocked: getting more healthcare workers to West Africa and keeping them from spreading the disease when they return are the same problem. So here is what I would propose:

  • Healthcare workers who go to West Africa should be guaranteed early spots in the line for experimental drugs like ZMAPP. These drugs are difficult to produce and will come online in small quantities (you can read a great summary of this from the aforementioned Preston). The biggest worry healthcare workers have about Ebola is not that they will lose their jobs; it’s that they will die. Promise them that they will get the best possible care. They deserve it.
  • Congress should authorize a fund to give hazard pay to healthcare workers who volunteer to fight Ebola in West Africa. We have to be careful here to not undermine the volunteer organizations that are the frontline for these epidemics. But they are being overwhelmed. They desperately need reinforcements. This fund would also pay for healthcare, life insurance and maintaining their existing jobs. This in addition to the funds needed to provide medical equipment for them to work with.
  • This fund would will also pay volunteers to undergo a three-week home quarantine on their return, during which they will be monitored for symptoms and maintain a log of any contacts.
  • We have laws that protect military reservists from being financially or legally ruined when they are called up to active duty during a war. Extend those laws to healthcare workers who volunteer to fight Ebola or are in quarantine after their return.
  • If we are going to go to war with Ebola, we have to treat it like a war. Doctors and nurses are our soldiers in this war. Pay them, reward them, protect them. Treat them in a manner that is good for public safety but also recognizes the tremendous risks they are taking and the tremendous good they are doing. Whatever else one may think of Craig Spencer or Kaci Hickox, they have risked their lives to try to save people, most of whom are a different nationality and race from them. Let’s recognize that even as we move to secure our public health.


    1. Of course, the same media telling us we are over-reacting were also saying Ebola would never come here in the first place.

    Blaming Republicans Again

    I know you thought that the current Ebola outbreak was the result of dysfunctional countries with horrendous health care systems. Or maybe you thought it was the fault of organizations like the WHO to respond quickly enough. Or maybe you think it’s no one’s fault and that disease outbreaks are going to happen.

    But you’re wrong. The current Ebola outbreak is the fault of …. Republicans:

    “Republican Cuts Kill” is the message coming from The Agenda Project, a 501(c)4 organization that is placing ads in various battleground states. According to an email signed by the group’s founder Erica Payne and titled “If you die, blame them,” the group is starting a

    a multi-pronged blitzkrieg attack that lays blame for the Ebola crisis exactly where it belongs– at the feet of the Republican lawmakers. Like rabid dogs in a butcher shop, Republicans have indiscriminately shredded everything in their path, including critical programs that could have dealt with the Ebola crisis before it reached our country.

    The supposed proximate cause is “deep draconian cuts” in the budgets of the NIH and the CDC which hindered their disease response. Never mind that the US still spends a total of $8 billion on global health. Never mind that the CDC and NIH have nearly $40 billion in funding between them. Never mind that cuts to CDC/NIH and specifically cuts for disease control were included in the budget proposal of Barack Obama who, last time I checked, was not a Republican. Never mind that according to Daily Kos’s own graph, the steep budget cuts in PHEP started in 2006, when the Democrats controlled Congress. Never mind that the Republican increased CDC funding over the President’s budget.

    Conservatives, dammit!

    This was partially stimulated by the head of the NIH saying that we would have an Ebola vaccine if not for budget cuts. Numerous people have responded by finding silliness in the NIH budget — such as $666,000 grant to find out why people like watching Seinfeld reruns — that they did have money for. I’m a bit loathe to play that game because often projects that sound stupid aren’t or are, at least, massively misrepresented.

    But I will take issue with the NIH’s claim that we’d have an Ebola vaccine if it weren’t for budget cuts (a claim they are slowly backing away from). Vaccine research is hard. We’ve been spoiled because most of the vaccines we’re used to — like measles — are cheap, effective and have minimal side effects. Such vaccines have wiped out smallpox and brought polio to the brink of extinction. But not all vaccines are that easy. We’ve been working on an AIDS vaccine for thirty years. Enormous effort has gone into finding a vaccine for malaria — which kills hundreds of thousands of people a year — with no success. Even some of the vaccines we do have are hideously expensive, come with significant side effects or have limited effectiveness. NIH might have an Ebola vaccine if they had more money. They might also have nothing.

    I’m a big fan of science funding, obviously. I like NIH to be well-funded. Public health is one of the few things we can all agree government should invest in. And I think basic science funding falls under Adam Smith’s description of something “which it can never be for the interest of any individual, or small number of individuals, to erect and maintain” but that benefits the public generally. But Ebola is not the reason to fund the NIH. They should be funded because of the outstanding research they do on everything else, especially the chronic common diseases that affect all of us. I especially want them to be working on antibiotic-resistant diseases, which, to my mind, pose the greatest healthcare menace for the 21st century. They should research Ebola as well. With a $30 billion budget, there’s plenty to go around. But Ebola research is only a tiny fraction of what they do. And I’d prefer they not try to pretend otherwise.

    As for the CDC, a bit less money on public health issues and a bit more money on infectious disease would be a good idea. And that, my friends, is squarely on the President and the man he appointed to head that agency.

    As a general rule, however, I would prefer that we keep Ebola and politics apart. This isn’t an excuse to grind your favorite political axe, be it immigration, budget cuts or single-payer healthcare. This is a time to calmly but decisively react to a potential health crisis. The main effort should be stomp this out in West Africa before it really does rage out of control. Because if this blows up to hundreds of thousands of people, if this spreads to South Africa or India or China, we will have a global epidemic on our hands.

    Ebola Comes to the US

    This is why I agree with the President that we have to devote as many resources as we can to fighting Ebola.

    A patient being treated at a Dallas hospital is the first person diagnosed with Ebola in the United States, health officials announced Tuesday.

    The unidentified man left Liberia on September 19 and arrived in the United States on September 20, said Dr. Thomas Frieden, director of the Centers for Disease Control and Prevention.

    At that time, the individual did not have symptoms. “But four or five days later,” he began to exhibit them, Frieden said. The individual was hospitalized and isolated Sunday at Texas Health Presbyterian Hospital.

    The CDC is trying to identify his contacts and quarantine them for the week-long incubation period. I hope that this is an isolated case, but my natural pessimism tells me it isn’t.

    Right now, the barrier keeping Ebola patients off of airplanes is screening in Africa. We may need to consider something more rigid, especially if the projections of hundreds of thousands of cases is accurate. Screening people getting off of planes who have been to Western Africa within the last two weeks would be a start. I don’t think we need extreme measures like banning travel from Africa or quarantine … yet. But this is a warning. Let’s not ignore it.