Health Care

China Syndrome comes home to roost.

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Two viruses are making the news these days. One, Ebola hemorrhagic fever has infected two in the United States with no deaths yet. It has created wide spread concern bordering on panic. The other, Non-Polio Enterovirus D 68, appears to have infected 825 this year and been directly responsible for at least one death and indirectly responsible for many others, primarily among children. It has generated comparatively little media attention and very little panic. Why the difference?

First the victims of D 68 are primarily children, Ebola also strikes adults. As a culture we no longer value children as much as we once did. Children are an option, almost a luxury. They have become more expensive than most luxuries we consume. Perhaps it is because the high cost to rear a child is reflective of the damage we humans are doing to the planet Or because so few of them die at an early age as compared to the past. And I suspect that childlessness is far more prevalent among our media elite opinion makers. In any case, few children vote and so they don’t really matter to policy makers.

Second, D 68 generally kills indirectly by weakening the child so that pneumonia or some other respiratory illness can be the cause of death. Ebola eats you alive! I’ve seen it on TV! And it is a terrible new way to die unlike ways we’ve died before.

Finally, WE’RE ALL GOING TO DIE. D 68 is poorly understood and we have no idea how prevalent it is in the population or how many childhood deaths it has contributed to. And it’s non-Polio. But we know Ebola has a 50-70% fatality rate among those who contract it in African third world countries. After all it’s hemorrhagic fever. We’re going to bleed to death. So, if it gets loose here we could have millions of deaths like that! But we actually have all the tools we need in our public health system to prevent it from spreading widely, once we get the Bozos out of power. So it’s highly unlikely that this outbreak will spread among the general population.

It’s a very small probability of a terribly frightening event. And some folks have used the propensity of people to exaggerate the possibility of catastrophic outcomes to further their political goals. I’m thinking of nuclear power, an energy source that has killed no one in the US. Compared to the coal industry, which routinely contributes to the death of both its producers and consumers, nuclear power is harmless. However, some used Three Mile Island to shut down the development of power plants that could have cushioned us from the effects of the OPEC cartel. Or how about the Anthropogenic Global Warming (AGW) fraud? Or the reaction to a terrible but unrepeated terror bombing? The public has been taught to fear by leaders who want to harness public opinion to support their political goals.

Now comes Ebola. True, a threat. But a highly improbable one. Except when the incompetence of our elite leaders is made abundantly clear for all to see. And then those leaders have the audacity to be surprised when a formerly courageous people are reduced to trembling? The chickens are coming home to roost.

A Cool Startup Story, Revisited

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In 2005, I posted about a company called Theranos, as part of the “cool startup story” series at  Photon Courier.  The company was founded by Elizabeth Holmes, who left Stanford at age 19 in order to pursue her idea for a quantum improvement in blood testing.  The original focus was on the detection of adverse drug reactions and the analysis of drug effectiveness on a more-individualized basis.

My, how this little company has grown up.  Theranos now has 500 employees and a valuation of about $9 billion.  They can currently perform 200 of the most commonly-ordered blood diagnostic tests, and can do it without a syringe–only a few drops of blood are necessary, and these are obtained from a finger prick using “a patented method that minimizes even the minor discomfort involved with that procedure.” (The Fortune writer tried it, and said “to me, it felt more like a tap than a puncture.”)  Theranos now has a deal with Walgreens, initially making its service available in stores in California and Arizona and with plans to roll the service out to all 8200 Walgreens stores nationwide.

Holmes:

There are a billion tests done every year in the United States, but too many of them are done in the emergency room. If you were able to do some of those tests before a person gets checked into the ER, you’d start to see problems earlier; you’d have time to intervene before a patient needed to go to the hospital. If you remove the biggest barriers to these tests, you’ll see them used in smarter ways.

and

Phlebotomy is such a huge inhibitor to people getting tested. Some studies say that a substantive percentage of patients who get a lab requisition don’t follow through, because they’re scared of needles or they’re afraid of worrying, waiting to hear that something is wrong. We wanted to make this service convenient, to bring it to places close to people’s homes, and to offer rapid results.

From a 2005 Daily Duck post about Theranos:

…in how many nations of the world could A TEENAGE GIRL get a serious audience, and then MILLIONS OF DOLLARS in VC funding, to develop her idea ?!?

There are many unpleasant consequences to American society being perpetually adolescent, a bit shallow and thrill-seeking, with an attention deficit and a naive optimism born of ignorance about the odds, but this type of thing is one of the UPSIDES of being that way.

In America, if you can do, the odds are pretty good that you’ll be allowed to do, regardless of your shortcomings and quirks. We’re flexible and goal-driven, not so much wedded to process.

How many ebola cases before a travel ban is justified?

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The usual formulation for discussing air travel bans is how many ebola cases making it to the US before President Obama is forced to stop air travel to and from west Africa. But there’s another variant of the question, how many ebola cases in the US before others will stop air or sea travel to and from the this country?

I do not think it likely that we will reach such numbers in this outbreak but it’s an interesting change from the usual breathless journalistic speculation of the US imposing a ban. If we don’t keep our house in order, others will isolate us to keep themselves safe.

10/22
Update: Since this post was written the arrival of travelers from the ebola hot zone have been restricted five airports where screening has been put in place and just now the CDC has announced that all arrivals will be under 21 day observation from entry in a sort of loose post entry disease defense regime. If they travel, they need to notify the CDC and they need to call in daily temperature readings and report any ebola-like symptoms. This might work, and considerably reduces the possibility that we will be under travel ban because we let ebola come in and get out of control.

Don’t Panic: A Continuing Series

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[Readers needing background may refer to the first member of this series, Don’t Panic: Against the Spirit of the Age, posted last month. This post, unlike that one, was hastily written due to time constraints involving, perhaps ironically, international travel to a Third World country.]

Constructive foreword: suggested case studies in disruption are the Chicago blizzard of 1/13-14/1979 (~3 million commuters immobilized) and the Milwaukee Cryptosporidiosis outbreak of 3/23-4/8/1993 (~400k residents sickened simultaneously).

Thesis: I argue that, at least with Ebola, inept and overwrought responses pose far greater risks to American society than the disease itself. With regard to managing the risks associated with Ebola in the US, it is vital that we identify easily disrupted institutions and design our processes intelligently to avoid creating bottlenecks, mostly by resisting the urge to overreact; likely candidates include …

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Ebola and the “Open Borders Derangement Syndrome”

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Sometimes looking at politics, the only explanation that makes sense is a personal identity based mental illness affecting the politicians involved.

So, we see this reported —

Texas Health Presbyterian nurse Briana Aguirre criticizes hospital over Ebola response
Nurse speaks out on TODAY Show

Ashley Fantz, Holly Yan and Catherine E. Shoichet CNN
9:54 AM, Oct 16, 2014

“The federal government is weighing putting those who treated Duncan on a list that would prohibit them from being able to fly, an official familiar with the situation told CNN.

In June 2007, federal agencies developed a public health Do Not Board list, which allowed domestic and international public health officials to request that people with communicable diseases who meet specific criteria and pose a serious threat to the public be restricted from taking commercial flights departing from or arriving in the United States. The CDC and the U.S. Department of Homeland Security manage the Do Not Board list. “

So follow me here.

American citizens who have been in the vicinity of an Ebola patient, particularly healthcare workers, would be considered “a serious threat to the public” even though;

1. They have simply been around people with Ebola but,
2. They are not exhibiting signs of the disease.

These individuals (who demonstrate no symptoms of Ebola) may soon be placed on a “Do Not Board List” by the Center for Disease Control and Department of Homeland Security.

Meanwhile, non-citizens, people from West Africa who are now:

1. Surrounded by an “out of control” Ebola virus outbreak,
2. Who are living in countries saturated with Ebola due to its rampant community spread,
3. Who are not now showing symptoms of the disease yet,
4. Are free to travel to America, plus wherever they like to in America without restrictions after they get here.

A sane Federal government would have put all passengers from Ebola Pandemic affected West African nations on a “Do Not Board List” long past. Yet they are not sane, and it gets worse.

Not only is this “American Citizens With Ebola Only “Do Not Board List” a dumb policy that destroys the credibility of the Federal Government in time of crisis when it is needed most. It is law suit bait on equal protection grounds in Federal court. Yet both Obama and Congressional Democrats, plus a few Republicans, support limiting AMERICAN CITIZENS rights to travel, but not that of WEST AFRICANS.

What we are seeing here is the outstanding symptom of a mental illness called OPEN BORDERS DERANGMENT SYNDROME. A mental illness shared by 99.5% of Democrats and the Republican leadership in the US Senate.

A political identity based mental illness now set to kill lots of Americans by Ebola for the sake of cheap immigrant labor now and future Democratic votes later (like 2016 via voter fraud enabled by Democratic Party opposition to Voter ID laws).