America First by Neglecting the World?

As you may or may not have heard, Brenda Fitzgerald, the Director of the Centers for Disease Control and Prevention (CDC), resigned from her post last week. Some point to her investment in tobacco and pharmaceutical companies as the reason why she left. Others don’t care why she left, as long as Anne Schuchat is Acting Director and not someone from the current Administration, and Administration that has promised to cut funding to CDC projects overseas because “America First” and other such nationalist nonsense.

Speaking of nonsense, this opinion piece by Betsy McCaughey really scared the crap out of me. It scared the crap out of me because there are a lot of people (millions, probably) who think like her. Or, rather, who don’t think things through, like she seems to have done. Not only is she displaying the thinking of a nationalist and isolationist, she doesn’t seem to think that diseases overseas can come over and kill us.

She starts off with this:

“Under President Barrack Obama, the Centers for Disease Control and Prevention sent money and staff to distant parts of the globe while neglecting life-threatening health crises under our noses. Dr. Thomas Frieden, who headed the CDC then, is joining a chorus of globalists bashing President Donald Trump’s decision to end funding for the CDC’s overseas projects in dozens of countries. Frieden charges the cuts will “endanger lives in our country.” Sounds scary, but the facts prove otherwise. Trump will spend the money here instead, where it’s urgently needed. As Trump searches for a new CDC director, it’s time to put America first — something the agency has neglected.”

Not to be too picky, but President Obama spells his first name “Barack,” with one R. Frankly, I’m surprised she didn’t throw in “Hussein” for good measure.

Speaking of dog whistles, she does manage to throw in the word “globalist,” which scares a lot of people into thinking that a “globalist” is one of those people who want to take over the world, or who want to give up American sovereignty. In the real world, a globalist is someone who takes into account everything that is going on in the world before making a decision (usually an economic one). This isn’t a bad thing. We’re not living in a world where we’re separated from trouble by two big oceans. You can get on a plane in Madagascar right now and arrive in the US in a matter of hours, bringing Plague with you. So, when the Director of CDC, someone with ample intelligence from overseas sources on what is going on and what is a threat to us tells us that we should worry about “over there,” I’d listen.

It’s like saying that we need to bring all of our troops back from Korea and the Middle East — both potential flashpoints for the next world war — because we need some cops here in Baltimore. You just don’t make decisions like that.

To support her assertion, Ms. McCaughey continues:

“On its core mission — protecting American health — the CDC is an abject failure. It dithered while opioid overdose deaths topped 42,000 and obesity deaths soared to 186,000, according to the National Academy of Sciences. Obesity and opioid overdosing are largely to blame for the sudden drop in American life expectancy.

Year after year, the CDC also pays lip service to curbing hospital infections, but the common infection C. diff now kills 29,000 Americans each year. No progress there.”

No, there has been some progress in the opioid epidemic. There are naloxone and Good Samaritan laws in almost every state now, reducing the number of deaths from opioids. Philadelphia is about to open a safe injection site, which evidence in Canada and Europe has shown to also reduce deaths, increase people looking for rehab services, and also prevent outbreaks of disease (like the one that then-Governor Pence allowed to happen on his watch in Indiana).

There has also been progress in hospital-acquired infections, but, admittedly, that progress is slow. It’s slow because our healthcare system sucks. There are thousands of healthcare organizations that all operate any which way they see fit, and any attempt at regulating them… Well, you know how Republicans feel about regulation.

Ms. McCaughey keeps on keeping on:

“Add flu deaths to the toll from the CDC’s subpar performance. Emergency rooms are overwhelmed during the current outbreak, and 53 children have died. The vaccine is less effective than in some past years, but the bigger problem is how few Americans get vaccinated — only 46 percent. Dr. Peter Hotez of Baylor College of Medicine points to a “poor level of vaccine advocacy” from the federal government. “This could haunt us for the current season,” he adds. Nearly all the children who died never got the vaccine. A new study shows getting it can prevent 65 percent of child flu deaths.”

A couple of things here. First, CDC doesn’t make the influenza vaccine. Epidemiologists from CDC and other organizations around the world (globalist much, Ren?) work together to recommend the best strains to put into the vaccine. Pharmaceutical companies make the vaccines, because capitalism. Unfortunately, they have outdated technology when it comes to the influenza vaccine, so they need a lot of lead time before vaccines against influenza get manufactured. By the time it does, the circulating influenza virus may have already changed.

Second of all, vaccine advocacy is a function of the local and state governments and their health departments. While CDC posts a lot of information about the vaccine and its benefits, it’s really up to the locals to get the word out. After all, they’re the ones giving out the vaccine, not the federal government. (I’m willing to bet Ms. McCaughey would claim that there’s something authoritarian about the federal government carrying out a vaccine program.)

But here’s where Ms. McCaughey really starts to sound unhinged:

“While the CDC neglected its mission here, Obama committed billions to build labs and train health personnel in Africa during the Ebola scare. Billions for a disease that killed only one person in the U.S., and even that person got infected elsewhere.

Obama also allocated $582 million for the CDC’s Global Health Security Agenda serving 49 countries. That fund is running out, and Trump refuses to renew it. Alleluia.”

Ms. McCaughey must have not heard that over 11,000 people died in the Ebola epidemic in West Africa, and that the reason why there was only one death in the US was precisely because men and women from CDC and other organizations risked their goddamned lives to go over there and fight Ebola before it traveled to the rest of the world. Who the hell does this person think they are to whitewash the epidemic like that? An uninformed reader would probably think that the epidemic was no big deal if all they had was McCaughey’s words… And to write “Alleluia” (God be praised) that we will not be able to go help stop diseases outside of the US before they come here?

To hell with her. (I’m a little angry, in case you can’t tell.)

I won’t give you the rest of McCaughey’s drivel because it’s just nationalist propaganda. In her mind, it seems, President Barrack “With Two Rs Because At Least She Didn’t Write Hussein” Obama didn’t do anything to help Americans’ health. She must have missed that part where Obama wanted universal healthcare, with plenty of benchmarks and regulations on hospitals to incentivize them to reduce hospital-acquired infections and require us to go see our healthcare providers (for free!) and get our vaccines and other preventative care.

Oh, no, none of that happened in her world. In her world, like in Trump’s, there is death and destruction everywhere, but Trump will make it right? If we do pull back from global initiatives, it will only be a matter of time before something lands here because we missed it over there.

Ms. McCaughey, this is not a zero-sum game. For us to have better healthcare — which the Affordable Care Act tried to bring us but Trump is determined to destroy — we don’t need to take aid away from anyone. My God, no one comes close in how much we spend on the military. Do you think that maybe, just maybe, we can get some of that cash moved to both fight diseases here at home and abroad?

And if you’re really going to cry because “vaccination rates are abysmal,” then you need to look at Trump’s words about vaccines. He became the anti-vaccine groups’ darling after claiming that vaccines cause autism, and saying that the flu vaccine injects “bad stuff” into you. So, while you go protest the anti-vaccine stance of President Trump, the rest of us in the real world, working for public health, will try to make things work with the breadcrumbs the Trump Administration throws at us while laughing in our face.

Antivaxxers Trumping CDC

I’ve always been impressed by the cognitive dissonance exhibited by many in the anti-vaccine community. But it wasn’t until this election cycle thatI comes to understand exactly what they’re doing and why they’re doing it. When I see Donald Trump, a sweat stain that just wont come off your favorite country, tell a lie and then almost immediately say that the lie he told was part of a conspiracy to discredit him. Antivaxxers do this all the time. They’ll say that vaccines cause autism, and then, when confronted with the evidence that vaccines do no such thing, antivaxxers will quickly yell at you and tell you that you’re part of a conspiracy to hide the truth. If the antivaxxer happens to be a parent, pointing out to them that they’re lying or misrepresenting the evidence quickly comes with an accusation that you’re making fun of their child or their situation, or that you’re not a parent and thus have nothing to say on the matter.

Now, this is the part where I tell you that I’m not making fun of anyone… At least not intentionally. I’m sure that parenting is difficult all on its own with a neurotypical and physically able child. So I’m sure that a child with special needs of any kind must be at least a little more difficult. Sadly, for some parents, it is intolerable to the point that they are convinced when people like Andrew Wakefield sell them the idea that killing their child is preferable to a life of challenges. Again, I am not making fun of you if you are an anti-vaccine parent. And, most importantly in this entire discussion, I am not making fun of your child.

A couple of days ago, antivaxxers decided to have a rally in front of CDC headquarters in Atlanta, Georgia. True to form, they brough on the conspiracy theories that the government is in cahoots with the pharmaceutical industry to, among other things, kill and maime children through vaccines. They made wild claims as well, like their claim that most children will be autistic in the near future from all the vaccines. (The scientific evidence points more and more to a consistent 1% to 3% rate of autism in the general population at all times.) They claimed that there is no such thing as Suddent Infant Death Syndrome (SIDS) because it’s all about the vaccines. And, when random people walked by, they assailed those people with their stories of horror allegedly brought on by vaccines.

This is the video of one such interaction:

The man in the video is clearly just trying to cross the street but is assailed by this woman, a woman who calls her son “mentally retarded after his vaccines.” The man asks her to “go away” a couple of times, but she just keeps it up. She then goes as far as to take a picture of him — because that’s a normal thing to do in these situations, apparently — and he flips her off.

Well, that flipping off just drove the antivaxxers insane. They started complaining on social media and on their blogs that this guy needed to be found and made pay for flipping off this woman. They launched into conspiracy theories about him being a paid actor or someting

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You’re being manipulated alright…

This is all par for the course for antivaxxers. They try to intimidate public health workers (or people whom they think are public health workers) and then claim to be victims if those they are intimidating respond in any way. They lie about conflicts of interest and other improprieties but then claim to be the victims if someone points out to them that they’re selling supplements and scams. Or they cry that they’re being censored when they themselves don’t allow any kind of comments contrary to their beliefs on their blogs.

Antivaxxers are, in my humble opinion, and it’s a good opinion… A lot of smart people are saying I have a good opinion. And, let me tell you, folks, my opinion is so good that your head will spin. My opinion… By the way, if you go ask for someone else’s opinion, their opinion will not be as good as mine, okay? I’m just saying. Because no one can give you an opinion like mine. And, when you’re not famous, they’ll let you grab them by their opinion any time. Anyway, my opinion is that antivaxxers — who are horrible people — antivaxxers are just like Trump. If they don’t lie, they bend the truth. If they don’t bend the truth, they make something up. And if they don’t make something up, they claim it’s all a conspiracy.

 

What’s up with this Enterovirus virus?

The Centers for Disease Control and Prevention are reporting today on the Enterovirus D68 outbreak in the Missouri and Illinois. It appears that the outbreak was detected by astute clinicians who noticed that there was something going on:

“On August 19, 2014, CDC was notified by Children’s Mercy Hospital in Kansas City, Missouri, of an increase (relative to the same period in previous years) in patients examined and hospitalized with severe respiratory illness, including some admitted to the pediatric intensive care unit. An increase also was noted in detections of rhinovirus/enterovirus by a multiplex polymerase chain reaction assay in nasopharyngeal specimens obtained during August 5–19. On August 23, CDC was notified by the University of Chicago Medicine Comer Children’s Hospital in Illinois of an increase in patients similar to those seen in Kansas City.”

This highlights the need for infection prevention specialists at hospitals to be in constant communication with their laboratory colleagues and with the healthcare providers in their organization. Communicating on what is going on, what each provider is seeing, allows for the early detection of outbreaks. When these lines of communication are not adequate, it may be later rather than sooner before these types of things are detected.

So CDC was notified and an investigation was launched:

“To further characterize these two geographically distinct observations, nasopharyngeal specimens from most of the patients with recent onset of severe symptoms from both facilities were sequenced by the CDC Picornavirus Laboratory. Enterovirus D68* (EV-D68) was identified in 19 of 22 specimens from Kansas City and in 11 of 14 specimens from Chicago. Since these initial reports, admissions for severe respiratory illness have continued at both facilities at rates higher than expected for this time of year. Investigations into suspected clusters in other jurisdictions are ongoing.”

I can tell you from my experience at the state health department that most of the work is being done by local epidemiologists and public health nurses. A case definition has probably been determined and cases falling within the “confirmed, probable, or suspect” case definitions are being interviewed by the local health department staff. Specimens are being collected and probably processed initially at local laboratories and then sent off to CDC for further characterization.

Here is the interesting part:

“Enterovirus infections, including EV-D68, are not reportable, but laboratory detections of enterovirus and parechovirus types are reported voluntarily to the National Enterovirus Surveillance System, which is managed by CDC. Participating laboratories are encouraged to report monthly summaries of virus type, specimen type, and collection date.”

By “not reportable,” CDC is telling us that there is no requirement for these infections to be reported to public health by healthcare providers. However, as you can see, reporting clusters and increased rates of cases is not a bad idea, especially in light of the sheer numbers of sick kids and the strain that this situation is likely to put on the pediatric healthcare system. Opening those lines of communication with the local and federal public health agencies allows for shared information and for the best situational awareness.

We’ll see how this progresses.

Dr. Brian S. Hooker gets the Andrew Wakefield treatment

A few days ago, a biochemist by the name of Brian S. Hooker, PhD, published a paper in the online journal “Translational Neurodegeneration.” In it, he claimed that a 2004 study by CDC personnel was flawed. The paper had a lot of flaws,which I explained to you in detail in a previous post. Following the publication of that paper, Andrew Wakefield — known for his fraudulent study about MMR and autism — released a very inflammatory video. In that video, narrated by Andrew Wakefield, a CDC scientist allegedly confesses to wrongdoing as part of the 2004 research group (DeStefano et al). Furthermore, Andrew Wakefield compares CDC and its employees to mass murderers from history like Hitler, Pol Pot and others. The video then finishes with very inflammatory language about the government’s treatment of African Americans.

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