Prometheus Unbound

Dr. Margaret Chan, director-general of the World Health Organization emphasizes the dangers of virulent swine flu mutations and the need for ongoing vigilance:

“For the first time in history we can track the evolution of a pandemic in real time. Influenza viruses are notorious for their rapid mutation and unpredictable behaviour.

“All countries should immediately now activate their pandemic preparedness plans. Countries should remain on high alert for unusual outbreaks of influenza-like illness and severe pneumonia.”

Are you washing your hands frequently?

It’s not just a health issue, it’s a moral issue. We collectively have to slow the spread of this virus for the health and safety, not just of our family, but of others.

I guess evolution’s true.

It started as a pig virus,

but then the swine flew.

Bit pig, bit bird, bit us.

Hybrid, efficient, new.

Call it “pigavian flu,”

sent from me to you.

Obama can’t save us;

no telling it, “sod off.”

It may turn you blue,

and make a sod of you.

The summer has a cough,

no vaccine to turn it off.

Whether or not the source for H1N1 was a Mexican pig farm (and this is by no means certain), the implication that this virus is somehow a “Mexican flu” and should be called Mexican flu borders on the racist, and carries with it the implication that Mexico is somehow a country that is dirty and a breeding ground for exotic diseases.

Michael Savage, Michelle Malkin, and Rush Limbaugh may think of Mexico in this way, but most people don’t.

And the designation swine flu, though carrying some original value, is bad for the pork industry, carrying the implication to some that eating cooked pork is unsafe, or a source for potential infection. And so, according to the New York Times, the term of choice for this form of influenza A has now become H1N1:

Agriculture industry officials have been urging leaders to remove the implication that the disease could be transmitted from eating pork. On Thursday, the World Health Organization noted on its Web site that “from today, WHO will refer to the new influenza virus as influenza A(H1N1).”

And this is what President Obama called ”swine flu” at his press conference on Wednesday.

I wouldn’t call switching the virus’s name Orwellian. It’s hard to justify, for example, why a hybrid virus containing pig, avian, and human genetic signatures should be called swine flu. But the change of name does show up the power of words—or to put in marketing terms, the power of branding. By giving the virus a scientific designation, and by taking it out of the realm of the familiar, it’s harder to lay metaphors, innuendos, and associations on the name as such. It serves to, at least a little bit, uncloud the thinking in a certain way. If there are to be associations with this virus now, it is with the clinical and impersonal. Swine flu is no longer a name, but a number (or rather, a combination of letters and numbers that no longer broadly signify). Swine flu as H1N1 is now something that just is, and that has to be dealt with, by scientists and governmental bureaucrats, as well as the rest of us.

The Los Angeles Times today says that there may be indications that swine flu symptoms in those Americans infected are becoming more severe.

That’s the bad news.

The good news is that the virus may not be a very fast spreader:

[T]he CDC reported on its website that “a pattern of more severe illness associated with the virus may be emerging in the United States.”

“We expect to see more cases, more hospitalizations, and, unfortunately, we are likely to see more deaths from the outbreak,” Health and Human Services Secretary Kathleen Sebelius told reporters Wednesday on her first day at work.

But certainly nothing that would dwarf a typical flu season. In the U.S., between 5% and 20% of the population becomes ill and 36,000 people die — a mortality rate of between 0.24% and 0.96%.

Dirk Brockmann, a professor of engineering and applied mathematics at Northwestern University in Evanston, Ill., used a computer model of human travel patterns to predict how this swine flu virus would spread in the worst-case scenario, in which nothing is done to contain the disease.

After four weeks, almost 1,700 people in the U.S. would have symptoms, including 198 in Los Angeles, according to his model. That’s just a fraction of the county’s thousands of yearly flu victims.

Just because the virus is being identified in a growing number of places — including Austria, Canada, Germany, Israel, New Zealand, Spain and Britain — doesn’t mean it’s spreading particularly quickly, Olsen said.

Wash your hands frequently and slow this thing down more. By taking simple precautions we might collectively, as it were, be tapping on the brakes of this pandemic.

According to the Los Angeles Times today, both face masks and frequent hand washing provide equal levels of protection:

[N]o single action . . . will provide complete protection in areas with confirmed swine flu cases, health officials said. It isn’t practical to wear a mask all the time, even a quality mask, and the devices aren’t foolproof.

“Once they get moist, they are no longer useful,” Mascola said. “Your saliva is going to be pooling in that mask. That will make is not useful because germs will be able to permeate.”

Taking a mask on and off contaminates it and makes it less useful, as well. It is effective “only for a 20-minute to a half-hour period,” she said. “Even in those places during the SARS epidemic, they found hand-washing as effective as wearing masks.”

So at least wash your hands frequently throughout the day.

And here’s something ironic. Mask wearers may be lulled into a deluded and Samson-like omnipotence (“So long as my mask is on, I can go where I want and do anything”):

Masks may give people a false sense of security, said Dr. Laurene Mascola, director of acute communicable disease control for the Los Angeles County Department of Public Health.

“You would have to wear it 100% of the time that you are outside,” she said of masks and respirators.

Further, face masks and respirators shouldn’t replace other precautions.

“Somewhat lost in all the excitement is that we continue to need to take standard control measures,” said Dr. Paul Holtom, associate professor of medicine at USC’s Keck School of Medicine and a hospital epidemiologist at Los Angeles County-USC Medical Center and the USC University Hospital.

To avoid infecting others, ill people should stay home, avoid crowds, cover their mouth when they cough or sneeze, and wash their hands before touching eyes, nose or mucus membranes.

Sometimes the simplest remedies are, in fact, the best.

It seems to me that, in the midst of the Swine Flu pandemic, Steven Spielberg’s classic 1970s film, Jaws, deserves another look.

In that film, Brody (Roy Scheider) struggles between balancing public safety with the disruption of an economy.

This is exactly Barack Obama’s (and other national leaders) dilemma today. When do you merely offer precautions—and when do you, as it were, call people out of the water and close beaches?

It’s not an uncomplicated question.

Two scientists appear to be saying contradictory things in a Los Angeles Times article on Swine Flu, but actually they are not. One scientist is quoted as saying that viruses tend to become symbiotic with their hosts:

As the virus adapts to its human hosts, it is likely to find ways of spreading more efficiently. But evolution also suggests it might become less dangerous, Olsen said.

“If it kills off all its potential hosts, you reach a point where the virus can’t survive,” he said.

This is Evolution 101, and it would seem to imply that the longer this particular strain of Swine Flu circulates, the less virulent it will become.

And yet the Los Angeles Times also quotes a second scientist who fears the prolonged survival of the Swine Flu virus through the summer:

Though scientists have begun to relax about the initial toll, they’re considerably less comfortable when taking into account the fall flu season. They remain haunted by the experience of 1918, when the relatively mild first wave of flu was followed several months later by a more aggressive wave.

The longer the virus survives, the more chances it has to mutate into a deadlier form.

“If this virus keep going through our summer,” Palese said, “I would be very concerned.”

Is this an example of dueling scientific opinion, so that those of us who are not scientists simply have no reliable information to go on?

No.

Simply put: viruses go through long periods of relative boredom accompanied by short periods of terror. In other words, the first scientist is correct that the virus, as it circulates, may, in its most widespread varients, produce non-lethal illness (so as to not kill off its hosts). But as the virus goes through its reproductive cycle again and again, and varies and multiplies in more and more people, and survives through the summer, there is the danger that a highly virulent strain of the virus could evolve and suddenly hit in, say, one particular city or country, which might then spread via airlines worldwide.

In short, this is no time for complacency, for you can’t know the mutated Darwinian variant that may be coming your way (whether it takes on a mild symbiotic relationship to its host, or a virulent one). Evolution operates by trying a range of variations.

This was illustrated again in the Los Angeles Times article when it quoted Peter Palese a second time, saying:

“There are certain characteristics, molecular signatures, which this virus lacks,” said Peter Palese, a microbiologist and influenza expert at Mt. Sinai Medical Center in New York. In particular, the swine flu lacks an amino acid that appears to increase the number of virus particles in the lungs and make the disease more deadly.

Obviously, the fear is that, over the summer, as the virus mutates, not only milder strains, but more virulent ones, might develop (such as those that increase the production of virus particles in the lung).

In short, this is no time for complacency. Keep your hands clean and follow all other CDC recommended precautions. And don’t let sites like the Drudge Report, which have been downplaying the Swine Flu virus’s dangers with irony and mock alarm, effect your own health vigilance.

This is not a left-right political thing. This is a real health threat, and so an ounce of prevention here is worth a pound of cure. An overreaction, in this instance, is much better than a dismissive underreaction.

If there is any didactic lesson here it is that nothing in biology can really be fully comprehended without taking into account Darwinian evolution.

According to the New York Times today, Britain has started a new ad campaign to slow the spread of Swine Flu:

In Britain on Thursday, authorities launched an advertising campaign urging people to sneeze into tissues and to wash their hands after doing so. The campaign was called “Catch it, bin it, kill it.”

This raises the issue of what you should buy and carry with you throughout the Swine Flu pandemic. It seems obvious that, at minimum, you should have with you in your purse or pocket:

• tissues; and
• sanitizing hand wipes (as produced, for example, in individually wrapped packets by Purell)

The sanitizing hand wipes are for those times when you do not have ready access, after sneezing or coughing, to soap and water. They can also be used to wipe down surfaces before using them (such as doorknobs or school desktops). I found Purell sanitizing wipes being sold, by the box, at Walmart.

I also notice that Purell sanitizing products are being sold at Amazon.com here and here.

With regard to the low “star” ratings of the individually wrapped Purell sanitizing tissues, I would advise ignoring the people giving them a low rating. They are focusing on wetness for doing multiple tasks with the same tissue, and the size of the tissues. In a pandemic the important thing is utility and the ability to carry them on your person. I’ve been using them for several days, and for the purposes of keeping your hands clean when out in public, and wiping down a single doorknob or surface, they work perfectly fine.

This today in the New York Times:

In Hong Kong, where health checks are being conducted on passengers arriving at the city’s airport, janitors put up fresh sheets of plastic film over elevator buttons so that any sick people pressing the buttons would not share their germs with too many people who pressed the same buttons later.

How frequently, I wonder, are the sheets of plastic being switched up? I suppose that if you changed them on the hour you could substantially reduce elevator usage as a vector for disease spread.

One of my daughters attends a small school where quite literally every parent and student in the school passes through a doorknobbed gate that remains shut throughout the day (and that you must use a type pad to gain entrance at). In other words, both the type pad and the gate’s doorknob could function to spread swine flu to the whole school (should even a single case appear there).

I wonder if schools, supermarkets, and workplaces should assign someone to go about through the day wiping down doorknobs, grocery carts etc. with a disinfectant (at least until a vaccine for Swine Flu is developed six months from now). We’re in a bad economy and people need jobs. So why not this one?

And something else I’d like to know: What percentage of flu cases tend to be transmitted directly by cough or sneeze (that is, by air), and what percentage are transmitted by touch (a person touches a doorknob and ten minutes later touches his or her nose)? I realize that these vectors interact and are not easily untangled (a person might touch a doorknob, get the virus that way, and then sneeze it three days later onto another person). But I guess I’m simply asking to what extent handwashing and the sanitizing of surfaces reduces the percentage of people getting flu. And if the answer is, say, 60%, then why aren’t we ernestly and collectively engaged in distributing sanitizing hand wipes to our population and keeping clean our public surfaces (as those in Hong Kong appear to be doing)?

Accurate health information on Swine Flu from Dr. Joe Bresee (of the CDC’s Influenza Division):

According to Time magazine, four to six months:

[E]ven if the CDC’s seed stock of virus were to be released to vaccine makers today, it would take the companies anywhere from four to six months before the first inoculation could be ready for public use. That’s because flu-vaccine production – whether for swine or seasonal flu – is time-consuming and laborious, requiring vaccine makers to grow millions of copies of the flu virus in chicken eggs, then purify those bugs into a ready-to-inject formula safe for patients.

This means that between now and September (at the earliest) there’s really only anti-viral drugs, isolation, and collective flu precautions (like staying home from school or work at the first signs of flu symptoms) that stand between humanity and an apparent pandemic.

Wash your hands. Wash your hands a lot.

I’m not being flippant. I went to Walmart recently and bought two large boxes of individually packaged Purell sanitizing hand wipes. My wife carries them in her purse and I carry them in my pocket. But I’ve found that we didn’t buy enough boxes, and I’m going back to get more.

Ironically, I’ve been told that the handlebar on a shopping cart is a vector for the spread of viruses, so before I shop for more hand wipes, I’ll be using one to wipe down the handlebar on the shopping cart that I use.

I hope you seriously think about doing the same.

If it sounds like I’m being paranoid, perhaps I am. But my wife and I have two small children and we’re doing our level best not to bring swine flu home to them. And there’s a certain collective responsibility here. I think that this is a moral issue. If you aren’t particularly concerned for your own health, remember that your negligence could function as a vector for the death of others. Literally.

So wash your hands regularly, please. And stay home from work or school if you develop a cough, congestion, a sneeze, or a fever. And pay attention to the news, and do what health officials advise.

It’s not just the smart thing to do, it’s the moral thing to do.

Outside your garret, voices.

And you might use them.

But you prefer the inner

mausoleum of desk drawers

and the burial shawls of clean

white paper. It’s a cover, you

say, for you really are the bee

which through the window

comes and goes. In truth, you

too have honey on your feet,

and the doors of perception

are double and open in you,

and this is why you must

pollinate the open laptop 

and tap all ceilings in an

agitated buzz. Still, the wall-

paper’s dirty flowers tell your

lie, for they do not live but

behind the mind’s fence, each

one an inflamed wound that

you alone have tended, and in 

that inflected garden is a tomb.

Arlen Specter:

Since my election in 1980, as part of the Reagan Big Tent, the Republican Party has moved far to the right. Last year, more than 200,000 Republicans in Pennsylvania changed their registration to become Democrats. I now find my political philosophy more in line with Democrats than Republicans.

If Republicans can’t hold their moderates, how will they win elections?

Today, in the New York Times, is an article on Republicans’ larger problem: not just losing a moderate like Arlen Specter, but the party’s increased ideological marginalization (such as on issues like gay equality). John McCain’s chief strategist in the last election, Steve Schmidt, is quoted as saying:

“The Republican Party is shrinking,” he said. “One of the reasons it is shrinking is because there are large demographics in this country that view the party as intolerant or not relevant to them. Politics is about addition.”

One of the things I’ve always liked about Arlen Specter is his moderation. The Republican Party, in its zeal for purity, has lost one of the jewels of its tribe.

Obsidian Wings recently invited a guest blog post on swine flu, co-written by an immunologist and bioethicist. The advice that they offered on swine flu amounted to a list of Albert Camus-like existential responsibilities that we have to one another in the midst of a potential pandemic. I couldn’t help but think of Camus’s novel, The Plague, and the novel’s protagonist (the good Dr. Rieux) as being akin to the two doctors who wrote the post. Here’s one of their recommendations:

One possible social distancing measure that public health authorities could ask us to undertake is to stay at home for a period of time. A basic principle of emergency preparedness is that each of us should have sufficient food and water in our homes to last our families in such an eventuality. Now is the time to make sure that your family is well provisioned, not only to protect yourselves but also out of recognition that some families do not have the money or stable housing required to stockpile food. If those of us who have the means take care of our own needs, it will be easier for the government and community organizations to take care of those who do not.

And another:

If you haven’t done so already, now is a good time to get to know your neighbors. Find out if any of them may need a little extra help dealing with this public health threat. People who live alone, for example, may appreciate your checking in with them from time to time, and elderly neighbors may need your help stocking up on food.

Read their full post here.

So says AP:

Amid the alarm, there was a spot of good news. The number of new cases reported by Mexico’s largest government hospitals has been declining the past three days, Cordova said, from 141 on Saturday to 119 on Sunday and 110 Monday.

Symptoms include a fever of more than 100, coughing, joint aches, severe headache and, in some cases, vomiting and diarrhea. Many victims have been in their 30s and 40s — not the very old or young who typically succumb to the flu.

So far, no deaths from the new virus have been reported outside Mexico.

It could take four to six months before the first batch of vaccines are available, WHO said. Some antiflu drugs do work once someone is sick.

The best way to keep the disease from spreading, the CDC’s acting director, Richard Besser, said, is by taking everyday precautions such as frequent handwashing, covering up coughs and sneezes, and staying away from work or school if not feeling well.

So according to a new Washington Post poll. That’s the lowest Republican self-identification in over 25 years. Just one in five Americans is now openly Republican. Imagine. And what’s left of the Republican Party seems to be veering towards the Looney Tunes side of the scientific, religious, political, and economic spectrum.

Is it even thinkable that a Republican moderate might win the 2012 presidential primary? And if not, how will the Republicans persuade centrist independent voters to not vote Democratic again (as a majority of them did in the last election)?

Just asking.

And if you don’t have any of these symptoms, and are out and about today, wash your hands frequently.

This today in the Los Angeles Times:

The symptoms of swine flu are nearly identical to those of other influenza, including high fever, aches, coughing and congestion. It is spreading by human to human contact. . . . Besser and other officials at the news conference emphasized steps that the public could take to limit the spread of the disease: Wash hands frequently; stay home and don’t board airplanes if you feel sick; and keep sick children out of school.

I admit it. If Chris Hedges had a fan club, and sent its members David Cassidy-like studio photos and groovy stickers for your school folders, I’d join it. And on Saturday, at the Los Angeles Times Festival of Books at UCLA, he was signing books and let me take his picture:

Is Hedges cool, or what?

Hedges is a former foreign correspondant for the New York Times and now writes a regular column for Truthdig.com.

His books tend to be reportage combined with philosophical reflections on culture, religion, and politics. He told me that he has a book in the pipeline on our human proclivity for living in denial and fantasy, and how this plays out in our public life (if I undertood him correctly).

Though his upcoming book is already done, I mentioned to him an Isaiah Berlin essay that might have had some bearing on his thesis, but I couldn’t recall the book of Berlin’s that it was in. Should Hedges accidentally find his way to this blog post (he said he’d actually seen this blog), the book is The Power of Ideas, and the essay is titled, “The Origins of Israel”. In the essay, Berlin suggests that sometimes naive outsiders with fantastic and highly improbable visions for the future, actually strike gold precisely because they did not listen to reason or expert insiders, but dwelled, as it were, outside of reality. Berlin’s exhibit “A” is the 19th century Zionist visionary, Theodor Herzl:

The distinguishing characteristic of Herzl was that [he] . . . possessed a somewhat romantic conception of the Jews, scarcely recognisable to those who themselves grew up in the thick of a closely-knit traditional Jewish community. There is something about great radical solutions to political questions which seems to make it necessary for them to be born in the minds of those who in some sense stand on the rim, and look in from outside, and have an over-simple ideal, an over-simple purpose, a lucid, usually violent vision, based on an indispensible ignorance of detail. Those who know too much—know too many detailed facts too closely—cannot, as a rule, produce radical solutions.

Of course, somebody (Karl Rove?) was reading Berlin in the Bush White House and reinforcing in Bush his worst intellectual tendencies, making them appear to be the virtues of a true visionary—the outsider who doesn’t pay attention to details, and changes everything, making reality and history rather than facing it. 

In any case, two of Hedges’s previous books include War is a Force that Gives Us Meaning and When Atheism Becomes Religion.

Conservative Republican David Broder, writing in the Washington Post, wants to whisk it all under the rug. No investigations of Bush era officials. Nothing. Broder just wants to move on. Here’s his advice to Obama: 

If ever there were a time for President Obama to trust his instincts and stick to his guns, that time is now, when he is being pressured to change his mind about closing the books on the “torture” policies of the past.

Notice the scare quotes around the word torture. Broder can’t even call it what it is. When you deprive someone of sleep for eleven days, or place a person with arachnophobia in a box with a spider, or waterboard someone 183 times over the course of a month (and all of these things happened), the best he can manage is the phrase “painful coercion”:

Obama, to his credit, has ended one of the darkest chapters of American history, when certain terrorist suspects were whisked off to secret prisons and subjected to waterboarding and other forms of painful coercion in hopes of extracting information about threats to the United States.

Of course, part of this “dark chapter” in our nation’s history is still being written, and it includes that part in which those members of the media and pundit class who, knowing the extent of Bush era torture, have the gall to advocate that nothing be done about it.

Oh, and so that there’s no mistaking Broder’s position, he doesn’t want President Obama to punt this over to Eric Holder, the U.S. Attorney General, because Holder might actually, well, do his job, and the consequences of that would be almost unthinkable:

Suppose that Obama backs down and Holder or someone else starts hauling Bush administration lawyers and operatives into hearings and courtrooms.

Suppose the investigators decide that the country does not want to see the former president and vice president in the dock. Then underlings pay the price while big shots go free. But at some point, if he is at all a man of honor, George W. Bush would feel bound to say: That was my policy. I was the president. If you want to indict anyone for it, indict me.

Is that where we want to go?

Yes. This is exactly where we want to go. If we are going to be a nation of laws, this is where we have to go. And let’s see if George Bush is that “man of honor” that Broder imagines him to be.