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    • How Ebola Aerosolized in Pigs Could Kill Millions
      Up until today I’ve been moderately sanguine about Ebola outside of some poverty struck African countries with compromised health care systems (and places like Greece.)  The main danger is incompetence and austerity, as with the CDC and Texas fumbling their Ebola cases. No more. Ebola is aerosolized in pigs.  This may not seem like a [...]
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A reminder about ebola treatment

There are a couple of articles about the guy who arrived from Liberia who turned up at a Dallas hospital with ebola.  One is from the DailyMail (UK), which sounds like breathless hysteria inducing gossip mongering, and the other is from Reuters.  I’m going with Reuters for veracity.  In either case, it sounds like this could be serious.  Wait, here’s one more from NBC.

The patient, Thomas Duncan (I’m not using the middle name because he’s not a criminal), reportedly carried an infected pregnant woman to a hospital in Liberia.  That woman later died from the illness.  Then, he takes a flight to Texas.  He’s allowed on the flight because he is symptom free.  Ok, that’s mistake number one.  He probably should have been held in quarantine for the length of time of the incubation period, which can be up to 21 days.  Actually, it probably doesn’t matter if the quarantine happened in Liberia or Texas, though presumably it mattered a great deal to his fellow passengers.  Nah, I’m going with my gut here.  If you’re trying to leave Liberia or one of the other most heavily infected countries, you should be subjected to a quarantine to prove you’re not a carrier.  If Liberia couldn’t do it, Texas, or some other connecting way station in the US, should have.  But then, this is Rick Perryland.  My condolences to relatives that live there.  I know they didn’t vote for him.

Come to think of it, there’s probably going to be a backlash against the African community in Texas that Perry will likewise fail to prevent.  And Texas has all those gun totin’, constitution wavin’, do gooders.  If there is a spread of ebola, plugging one of the patients and allowing infected blood to spill all over Dallas is probably only going to exacerbate the problem.

Which leads to the next issue.  According to the DailyMail (remember, gossip mongering), Mr. Duncan went to a hospital in Texas complaining of symptoms and told the health care workers that he had just arrived from Liberia.  That’s L-I-B-E-R-I-A.  You know, the place with all the sick and dying ebola victims?  That have the same symptoms that he was displaying?  They sent him home with antibiotics.

Now, either somebody wasn’t listening to him or they have the stupidest treatment team in the world in Dallas.  Antibiotics are completely useless against viruses.  I’m going with option one- someone wasn’t listening.  Well, you know, there was probably a language barrier.  I’ll leave it at that.

The NBC article says that Mr. Duncan’s nephew had to call the CDC after the initial treatment in Dallas.  Even he figured out that the health care professionals in Dallas weren’t taking this seriously:

Health officials have acknowledged that Thomas Eric Duncan, 42, was initially sent home from Texas Health Presbyterian Hospital in Dallas when he showed up on Sept. 26 complaining of fever and abdominal pain. He had to return two days later in an ambulance.

That was the day “I called CDC to get some actions taken, because I was concerned for his life and he wasn’t getting the appropriate care,” Duncan’s nephew, Josephus Weeks, told NBC News on Wednesday night. “I feared other people might also get infected if he wasn’t taken care of, and so I called them to ask them why is it a patient that might be suspected of this disease was not getting appropriate care?”

Weeks added that he hoped “nobody else got infected because of a mistake that was made.”

Maybe the insurance time clock alarm went off and the hospital thought he looked remarkably well that morning.  It was probably just a coincidence.

So then Mr. Duncan’s condition worsens.  His family calls an ambulance to take him to the hospital. Before he gets into the ambulance, he vomits all over the sidewalk.  His family is screaming their heads off in panic.  We have no direct evidence that the ambulance team recognized the danger to themselves or others or whether they called a HazMat team or whether they sprayed the area with chlorine and took all of the family members immediately into quarantine.

Hey, this is a convenient time to remind all those right wingers out there that even if you don’t have insurance, the ER is not allowed to turn people away!  Yes, a man in Duncan’s condition can make repeat visits to the ER and vomit all over the chairs while he patiently waits there for hours to see a doctor while the other health care workers obliviously prepare another dose of antibiotics.

Do we know whether Mr. Duncan has insurance?  He’d better because no one in Texas without insurance is allowed to get ebola.  Perry didn’t expand Medicaid. Update: Duncan is not an American citizen.  He’s just here for a visit.  So, we can guess that one of the reasons why the hospital didn’t keep a sick Liberian who was showing signs of possible ebola infection when he first showed up is because they were concerned with the costs.  Oh, yes, my best beloveds, hospitals are more than willing to toss sick people out when it starts to get too expensive for the insurance company.  We have been there.

We really need an investigation of the behavior of the hospital that discharged Mr. Duncan to discover whether this was the result of a bad cost-benefit calculation.  Did the hospital just take a wild bet that Mr. Duncan did not have ebola so they wouldn’t have to keep him in an expensive isolation unit?  Enquiring minds want to know.

Now we come to the treatment phase for Mr. Duncan.  It turns out that ZMapp, the monoclonal antibody (not antibiotic, pay attention, there is a difference), is no longer available.  The DailyMail calls it a “miracle” treatment.  That’s not surprising for the DailyMail but it is misleading, stupid and demonstrates a complete lack of understanding on the part of the “journalist”.  ZMapp is an experimental treatment that had an n of 7 primates before it was thrown into humans.  If the barrier for proving efficacy was that low when I was still in drug design, my project teams would have made the companies I worked for billions several times over by now and would have cured obesity, depression, alzheimer’s disease, multiple sclerosis and several different kinds of cancer.  In other words, there’s not much evidence that ZMapp has cured anything yet.  Sure, a couple of patients took the drug but they had excellent care here in the US and that alone might have been enough to cure them.  The body *will* recover on its own if it can stay well enough to mount a vigorous immune response.

Anyway, ZMapp monoclonal antibodies are grown in tobacco plants.  My lab partner had more experience in growing proteins in plants so she could probably talk about this in more detail.  But from my own experience growing proteins in insect cells and e coli, I can tell you that the amount of protein recovered could be minute and the amount varied based on the conditions the cells were grown under.  Grow them too fast or neglect them for even half an hour and you might have to start all over again.  Growing in tobacco plants would seem to give the company a little more control over the product but it still takes time.  Then there is the issue of purification, which still can seem like an art form in some cases.  And the damn things have to fold properly AND they have to not aggregate, which I understand is an issue with antibodies.  They loves to aggregate.  Even if they grow the tobacco at lightening speed and collect as much ZMapp as they can, it’s going to be small quantities of an unproven drug.

Come to think of it, you have to wonder why governments, including our own, are not calling on all of the out of work drug discovery professionals to lend a hand.  Oh, that’s right.  We’d have to be paid and as we all know, government isn’t good for anything.

So, don’t count on Mr. Duncan to receive any miracle cures.  Let’s just hope he gets decent care in Texas to help his body ride out the storm.

In the meantime, I have read that Glaxo Smith Kline (GSK) is trying out a vaccine.  I haven’t heard a lot about this but vaccines are generally good things, unless you’re Jenny McCarthy or some clueless control freak, overeducated but bored, suburban helicopter mom who managed to get through college without ever taking a basic biology course.  How much you wanna bet a whole lot of them in Texas suddenly get religion when it comes to vaccines, demanding on TV with righteous indignation that GSK provide freebies of an almost untested, non-FDA approved vaccine? There’s a satire just waiting to be written but it really isn’t funny.  Anyway, I hope it can produce some kind of immune response but it’s probably too late to help Mr. Duncan.

As for the rest of Texas, let’s hope it can survive the bumbling first responses.  Since Mr. Duncan returned to the US, he has had ample opportunity to infect his girlfriend’s kids- who go to school. (See paragraph above)  His poor girlfriend is probably in jeopardy if they had sex without a condom because the virus can persist in semen for a time even after the patient recovers. Well, I’m still not panicking but I’d feel a lot more confident about a vigilant response if Mr. Duncan had landed in Hawaii where everyone is insured, there’s a whole ocean separating the islands and there’s a history of treating people with infectious disease.

Somedays, it just seems like Texas is giving the rest of the country the finger.

 

EBOLA, EBOLA, WE’RE ALL GOING TO DIE!!! Or not.

Funny, I was just watching a documentary on the Black Death.  Now that was scary.  Once the plague became airborne, you were really in trouble. I can remember the day I spent in Siena, Italy looking at all the plague art.  It was chilling and there was so much of it. And yet, there were still countries, like Poland, that managed to isolate themselves from the epidemic.  So, if there was a way to evade an airborne illness in the 14th century, we’re probably going to do Ok against ebola, which isn’t airborne.

Then again, yersinia pestis was a bacteria and ebola is a virus.  The last time we had a viral epidemic of catastrophic proportions was during WWI with the Spanish Flu.  Still, many of those deaths were caused by cytokine storms, i.e. an overreaction of the immune system.

Nevertheless, the probability that this virus will spread is pretty low and is summarized in the following PSA from Vox:

 

And there you have it.  The way ebola spreads is through direct contact with the bodily fluids of infected individuals.  So, the solution to containing any potential outbreak of ebola in Texas is pretty simple: treat the sick and quarantine them and any person who may have had direct contact with them.

There are only a couple of problems with this.  The first is that Texas, like many states run by Republican governors, has not accepted federal money to expand medicaid.  So, we have to assume that every person who gets sick from ebola is insured.  Uninsured people are not allowed to get ebola in Texas.  The virus should be instructed to avoid infecting uninsured individuals.

Secondly, we have to assume that everyone who gets ebola can take a sick day and won’t lose their jobs if they decide to go into quarantine.  That might be more tricky because it is likely that quarantine wouldn’t be voluntary.  The virus should be directed towards people in the leisure class as they can afford to take time off.

We just have to hope we can reason with the virus in case the single isolated case in Texas turns into more than a single isolated case.

If I were the Feds, I’d try to get ahead of those two issues.

Not that there’s anything to worry about.  Because there isn’t (probably).

Well, I’m not going to panic in any case.

 

Harumph and bother: a post about Obama and ISIS

Looted museum in Baghdad circa 2003. We were the superglue.

One thing the Democratic activists love to crow about is how they’re not like conservatives who think that conservatism can never fail, it can only be failed.

And then there is the mess that is ISIS, the collapse of Iraq and Obama’s negligence of the country that lead us back to war.

Disclaimer: I am not a conservative, not a Republican and actually align myself with the left.  But for some peculiar reason that I can’t quite figure out, I have been the vocal outlier on this tiny asteroid in the blogosphereic Oort Belt.  There are a few like minded dust specks out here but the left seems to be dominated by people who screwed up in the most spectacular fashion in 2008 and yet still insist that they are the smartest, most peace loving, accomplished citizens ever.  Let’s just call them the left’s very serious people.

So, the left’s very serious people, LVSP for short, are wringing their hands about ISIS because when push came to shove, Obama did what most American presidents have done in the past.  He turned the FUD up to 11.  I’m glad I don’t have cable so I can safely ignore all of the hysterical arguments for war in Iraq again.  And let me make this clear, I was against the war in Iraq in 2003 because none of it sounded plausible to me.  Al Qaeda had the ability to strike the US in 45 minutes?  As if.  There was clear evidence of weapons of mass destruction?  Please.  What do you take me for?  I think we entered the hall of shame with Freedom Fries, though.  It was about that time that the US put the screws to raw milk cheeses from France, which was really uncalled for.

Smart people knew that there was no reason to go blow up Iraq.  It was just Dick Cheney’s wet dream.  He and his buddies wanted to cash in big on government military contracts and private oil contracts.  They raced into Baghdad, allowed the ruin of some of the most important archaeological sites in human history, destroyed the government and then set about playing some kind of right wing version of Monopoly.  Mission Accomplished indeed.

It’s no wonder that so many of us hated the Iraq War and all the damage it did to real human beings.  It was greedy, careless, ruthless, selfish, expensive and stupid.

OUR side would do it differently.  WE would get out of Iraq.  That was THE most important thing.  Because OUR side was for peace and prosperity and turning the other cheek and not making war or spending lots of money to blow things up.  And THAT’S why so many young, ideologically pure, left wing doves voted for Obama over the candidate with the lady parts.  Heck, it’s why Obama got a Nobel Peace Prize before he had even done anything.  (I’d still like to know what nefarious group nominated him.  They were clearly up to something.)

In any case, peace would rein, oops, sorry, was doin’ a Bush there, reign in Iraq and the people would cheer our exit and get back to their shawarma and all would be hunky dory.  Because that is what the left is all about, getting out of stupid wars because they are stupid.  And so it was.

And that’s where the left made it’s mistake.  As Dexter Filkins of the New Yorker has said in two Fresh Air interviews, here and here, Iraq is an artificial state.  The only way it stayed together after the fall of Saddam Hussein was by having an American presence there acting as an intermediary between all of the disparate groups.  The Sunnis have a persecution complex, the Shias are being helped by Iran and the Kurds, currently the only group in Iraq that has its sh&* together, just wants out.  Bummer about that whole landlocked Kurdistan thing.

In his interview on Fresh Air in June this year, Filkins reported that Obama lost interest in Iraq early and just wanted to pull Americans out.  The timing of the pull out, before the 2012 election year, seems to me to have been a way of pacifying the lefties and keeping them quiet, but I’m only making a guess based on past performance.  al-Maliki was getting pressure from Iran to get the US out of Iraq but he was hoping to negotiate some kind of deal with Obama for a residual presence.  But the White House wasn’t giving any guidance to the State Department. So, when the last troops pulled out, the American superglue that held the whole place together fell apart.

Now, I’m really sorry if the left’s very serious people, like Digby, didn’t see this coming.  Certainly, she’s smart enough to figure out what the fall out of the troop withdrawal would likely be.  But the left seems to be of the opinion that peace can never fail, it can only be failed.  All those Iraqis should have gotten along when we left.  It was in their own best interests.

More likely, peace needed to be a long term investment whether we liked it or not.  It’s not surprising that Obama had way too much on his plate to think this through properly.  But as I have observed before, Obama governs in campaign mode and his policies rarely have the deep thought and execution that is required from the most powerful man in the world.  Experience probably would have helped here but we didn’t elect the guy for his experience, did we?  No, we hired him because he was not like a powerful politician.

Too bad for us.  Believe me, it doesn’t give me any pleasure to keep pointing out what a disaster 2008 was.  No, indeed, the suffering here and abroad just never seems to end and we will come to regret our choices for generations to come.  You can make excuses for him and throw accusations around that the CIA is out to get him but it won’t change the fact that he’s directly responsible for the urgency of the situation in Iraq because he neglected this problem and the United States’ role in keeping the country together.

If you don’t take the time to do it right, when will you have time to do it over?

We’re about to find out.

One more thing: Could it be that the left’s very serious people are really upset by the fact that the right wing has gotten smart about Obama and has given up pushing the ridiculous right wing memes, like birtherism, for an accurate assessment of Obama’s performance?  Because if they’re latching on to accuracy, the Democrats better have a better defense than just whining about how unfair it is to blame Obama for everything he does.  It’s not a winning formula.

The Employment Index: Wish me luck

This week’s version of the index will be brief.  I have an interview this morning and I need to jump in the shower.  The job is in a different area of research than I’m used to but I passed the preliminary placement exam so there’s that. Just in case, I looked up some material on YouTube. I bought a new suit, that I will probably never wear again, and got an investment haircut.  Got my berry smoothie ready.  Everything copacetic.

Now all I need is a little bit of luck to go with the preparation.

This is ze time on ze Confluence vhen ve dahnse.

The Politics of Personality Disorder

I’ve had a few commenters who think the posts on narcissism and the Dark Triad are interesting but they really wish I wouldn’t bring politics into it.

I’m confused about this.  This is a blog where Democrats in Exile and others can talk about politics and not be shouted down for not adopting the dominant narrative.  So, there’s that.

But more than that, humans are herd animals.  Being in the group is highly desirable.  Being out of the group makes us anxious.  So, if the dominant narrative is shaped by a small evil group of people, to whom no one we know belongs,  who use political rhetoric and religion as dissemination tools, we should be aware of it.  Shouldn’t we?  Isn’t it better to know what techniques may be used to manipulate us to act in a herd like fashion?  And if the people who are manipulating us have severe unchecked personality disorders, which looks more and more likely, isn’t it better to see them than to have them hide behind the masks of authority and holiness?

Now, I’m not saying that I have proof of any of it.  I’m just looking at behaviors that have been growing steadily for about 40 years and the results of those behaviors on all of us and trying to find cause and effect.  In the end, I don’t really care why people behave the way they do as long as they don’t behave badly.  In other words, it’s not interesting to me that a narcissist might have experienced childhood trauma or that a psychopath may have a genetic predisposition.  Not remotely interesting.  Psychologists might be interested in the sources of these personality disorders so that they can nip them in the bud in kids in the future but once those kids become adults, their behaviors are pretty much fixed.

Personality disorders are very difficult to treat. The first step in dealing with a person with a personality disorder is accepting the fact that you can’t change them.  You are not going to be able to teach them to be more empathetic, less selfish, less manipulative etc.  It’s not going to happen because they have no reason to change. Curing these people is almost impossible because they don’t think they have a problem. YOU have a problem.  So, getting inside their heads is not my goal.  My goal is finding a way to react to them in a way that neutralizes their power over us.

What I am concerned with is that we don’t always know when we are being manipulated and exploited, and we often fail to detect patterns of behavior that will lead to us acting against our best interests.  When we start to understand the patterns, we have an opportunity to take action to make it stop.  In other words, if we find that the finance industry is hiring a disproportionate number of psychopaths to play with our money, we can presumably take away the incentive to hire psychopaths or take away our money.  If we find that a bunch of Machiavellians are saturating the airwaves with manipulative language, we might be able to point out the way the manipulation works so that people turn off their radios and cable TV.

If we find that a couple of attention seeking, control freak authoritarians are getting narcissistic supply out of exploiting their kids on a reality show by adopting a super conservative religious lifestyle and parading themselves as holier than thou and then campaigning for a super conservative politician, we should be aware of what they are doing and promoting and what they are trying to accomplish.

Let’s just call it as we see it, shall we?  Let’s not play “these are not the droids you’re looking for” because we don’t want to look at the dark underworld of human interactions only to find our favorite politicians and religious superstars lurking there.

Politics and religion are two very powerful influences on human herds.  We need to make very sure that the people acting as shepherds aren’t coyotes in disguise.

Dark Triad or Tetrad?

dark_triadPutting a finger on what’s going on in this country and the world in general since the financial crisis of 2008 has been slow going.  Part of that might be because when you are in the midst of it, trying to make a living and keeping your head above water, it’s difficult to see the forest from the trees.

Recently, I came across the term “dark triad”, which as I understand it is the convergence of three personality types: Machiavellianism, psychopathy and narcissism.  It’s a real personality type.  I’ve gone over the traits of narcissistic personality disorder previously and it’s pretty clear to me that many of our financial overlords suffer from it to one degree or another.  But I’ve been puzzled about how it is that the narcissists managed to convince so many ordinary Americans to ignore their best interests. Something was missing. That is where I think the Dark Triad comes in and can explain why the airwaves are saturated by the pundits who encourage the worst behavior and thoughts, and why they can get away with it.

But there’s a new theory in town.  It’s called the Dark Tetrad.  The psychologists who are studying these negative personality disorders say that the fourth component is sadism.  I’m wondering if sadism is the natural outcome of the convergence of the previous three traits.  Is it cause or effect?  If it is true that cruelty results from the need to assuage our guilt for taking advantage of someone, wouldn’t it make sense that setting up a system that exploits other people will naturally lead to more cruelty?  But if a person feels guilt, wouldn’t that negatively correlate with psychopathy?  Doesn’t the quality of remorselessness, which is associated psychopathy imply sadism?  It feels like there is a PLS model just waiting to be constructed to figure out what the principal components are.  How do we know which qualities of the dark triad or tetrad can be derived from the others?

If there is anyone out there with more information on the Dark Triad or Tetrad, or has links to papers that don’t cost an arm and a leg (I like free), let me know.  I’m not a professional and only took one course in psychology (but I’m beginning to think that I should pursue a degree in the subject.  Just hit the tip jar at the upper left to help defray the cost of tuition.  Damn, if I were just Machiavellian enough, I could *make* you hit that tip jar.) so I’m going to have to rely on iTunes U, youtube and Kno to teach myself all the lingo.

Still, it might be worth the effort.  If we can figure it out, maybe we can develop a psychological vaccine.

One more thing: it looks like the Dark Triad is used to describe predatory men who use manipulation to mate, or at least a lot of the early papers seem to focus on “players”.  But I’ve often found that the metaphor of the player has been very useful to explaining what happened to the political system in 2008 especially the evolution of Democratic activists in support of whatever it is that infiltrated the party.  For example, what was the purpose of this?  I don’t think this picture was leaked:

Obama speechwriter Jon Favreau with HRC cutout after Obama victory.

I’m not picking on Democrats here. Republicans are worse and they’ve got a bigger megaphone. But there’s no doubt that something dark and malevolent snuck into the party while we weren’t looking.
 

Hokay, I’m done with Coke

Screen Shot 2014-09-25 at 8.22.25 AMNYTimes has an article on the “accidentally” leaked documents of the 501(c)(4) that contributes to the Republican Governor’s Association (RGA).  This advocacy group is called Republican Governors’ Public Policy Committee.  The Democrats have one too but it’s called something like The Center for Innovative Policy.  I guess they solicit all kinds of policy, not just Democratic ones. (that explains a lot)

Anyway, the members of this advocacy group contribute up to $250,000 in order to attend swank soirees and bend the ear of the Republican Governors in attendance.  Access “offers the ability to bring their particular expertise to the political process while helping to support the Republican agenda.”  And I used to think that these were equal opportunity corporate schmoozers.

So, you might be wondering who is in this shadowy group that is supporting the attack on women’s reproductive rights and cutting social safety net programs to the bone.  The usual suspects are here.  But there are also a couple of surprises:

The most elite group, known as the Statesmen, whose members donated $250,000, included Aetna; Coca-Cola; Exxon Mobil; Koch Companies Public Sector, the lobbying arm of the highly political Koch Industries; Microsoft; Pfizer; UnitedHealth Group; and Walmart. The $100,000 Cabinet level included Aflac, Blue Cross Blue Shield, Comcast, Hewlett-Packard, Novartis, Shell Oil, Verizon Communications and Walgreen.

Exxon, the Koch brothers and Pfizer don’t surprise me.  But Coca-Cola and Microsoft?  Really??

You mean every time I drink a diet Coke or buy another annoying Word license, I am contributing the the erosion of women’s rights or depriving some kid of food stamps?

Um, that’s disgusting.

I might not be able to get around Microsoft but I can definitely cut Coke out of my life.  Boycotts might be ineffective but this is a personal choice and I’m not consciously contributing to my own demise.

 

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