Category Archives: health

Swine Flu Pandemic deaths in USA: 1 Other USA Flu Deaths: 36,000

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Update:  The 2009/2010  H1N1 Swine Flu season is more severe than last year when I wrote this post, though the statistics haven’t shaken out yet.  My current take is that while initial concerns may have been overblown we are *now* facing a fairly serious health risk and I’d encourage  folks to take the vaccine when it’s available in your area.     I’m actually optimistic that the *total deaths from flu* will go down this year as people are taking far greater precautions than usual.

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You’ve got to hand it to the hype machine on this one for exaggerating the chances that the Swine Flu is going to get ya.    I certainly understand why the CDC would be concerned that a new virus will spread and become dangerous, but the near-panic we’ve seen over the past week is simply not warranted by a reasonable interpretation of the data.   I’m hardly a flu expert but it appears that the contagion, far from exploding, has been kept almost completely in check with only a handful of cases outside of the likely area of origin in Mexico and no rapid spread even in Mexico.    It’s possible all the fear and masks have kept things in check but more likely this just isn’t that deadly a virus.

For example if we had followed all the precautions many are  following *right now* by wearing masks, avoiding mass public activities, and obsessive hand washing the number of *regular* flu deaths would likely have been on the order of many thousands, perhaps even tens of thousands, less than they were in the 2009 Flu season (which roughly corresponds to “winter” and takes on average about 36,000 lives each year in the USA alone based on the CDC data cited below.

I’m seeing some parallels with the hysterical responses to minor weather events which are often foolishly attributed to climate crisis when in fact they are simply minor changes in the weather.  At least in the case of this flu there is an objectively identifiable new flu strain – H1N1,  that *theoretically* could create massive trouble along the lines of the 1918 flu pandemic.   That flu pandemic killed more people than any event with the possible exception of WWII depending on death toll estimates which generally fall between 50 million and 100 million for the flu.     The “better documented” WWII death toll was about 73 million worldwide.   Obviously this means that flu pandemics are of critical importance, but it’s also important to recognize that millions die every year from very easily preventable diseases like malaria and rotoviruses to which we have historically paid far too little attention.

In the USA WWII took about 400,000 lives while the 1918 Pandemic took about 500,000

So with 1 US death so far, and that I think from a victim sent to Texas from Mexico, we are looking at a death toll 1/500,000th as large as in 1918.   Not sure that calls for the response we’ve seen so far.

Clearly the 2009 Swine Flu pandemic is nothing to sneeze at but I think it’s also clear that the 24 hour news and even the CDC – perhaps practicing for a real threat – have hyped this event out of proportion to the real threat.    If that’s because the threat really, really cannot be known I supposed it’s fine, but if it’s because this type of thing keeps people focused in ways that are profitable to TV News or grant and funding producing for CDC I hope we take a close look at all this when it’s over.    Although epidemiologists are probably going to say “better safe than sorry” with Pandemic alerts it’s also true  that overhyped events can lead to a lax future response from a public that becomes too used to “crying wolf” when the threat is actually quite low.

The world currently faces several catastrophic health, poverty, and human rights crises in the developing world and will face more global crises in the coming decades – we don’t need more fake ones.

CDC on Flu Deaths

Prescription Report on Tamiflu, an antiviral treatment for Swine Flu.   NO, you probably don’t need this drug!

CNN on flu hysteria as the “real problem”.   Hey, talk about a two for one story here!    Hype the flu news and then hype the hype about the flu news.    However in this case I’m not sure TV News is to blame as the CDC and government folks have been quick to talk about “inevitable” pandemic and other statements that have led to much of the trouble.    In fact I think we’re seeing the same challenge of bureaucratic interpretations here we see with global warming alarmism.  There are often political and social penalties for bureaucrats who fail to identify major problems.   There are *huge* rewards if you manage to convince grant and government funders that minor problems are major problems.   Yet we don’t tend to punish folks for “exaggerating risks” which is part of the reason … we have a lot of exaggeration of catastrophic risk in our society and too little attention to “mundane” but real risks like  normal flu deaths, gun deaths, and highways deaths which account for well over 100,000 dead each year.     Add heart disease and cancer to the list – they are also largely preventable grim reapers – and you find we are under quiet attack 24/7 by deathly dangers that make the 9/11 toll look completely trivial by comparison.

Think about this – if  we *knew* that a terror group was going to kill 100,000 Americans next year with an assault of viruses, guns, and car bombs there would be a near panic with calls for martial law or on the other end of the spectrum perhaps an armed revolution.      But since these risks are less dramatic we don’t fret enough about them, while worrying far too much about swine flu and the terrorists who only rarely materialize and appear to rarely if ever pose a truly catastrophic risk.      I would caveat this last point saying there are certainly terror groups out there that would consider catastrophic action and we certainly should seek to get them, but we always need to monitor the costs in terms of lives and money and compare this to alternatives.

Mr. President: This budget won’t work.

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I remain a fan of President Obama but it has been painful to watch him and congress move to adopt the most reckless example of massive and excessive government spending since the founding of our remarkable American experiment.    The founders knew that solutions spring not from large and cumbersome governments, but from the hard work and inspired innovation of a free and vibrant people.

The budget problem is another great example of how chickens tend to come home to roost, and expensively.    After inheriting a spectacular financial situation from the Clinton years, GW Bush managed to drive up the national debt by about $6,000,000,000,000,  doubling this critical measure of our future prosperity potential even as Republicans whined about how “tax and spend” liberalism was ruining the country.   Note also that only a small part of this was war spending and war is not a legitimate economic  excuse for long term deficit spending.     As they shifted our costs to the far future rather than balanced the bloated budgets  Republicans adopted a “don’t tax, just spend!” philosophy that  is now …. wait for it …. being used by Obama and the Democrats to speciously justify spending of  far-greater-than-biblical proportions.    Meanwhile, having lost almost all of their “fiscal responsibility” credibility over the past 8 years Republicans *very correct* concerns about the new budget are reaching a lot of deaf ears.

Republican Senator Judd Gregg, who turned down a major administration appointment probably due to these differences –  has been one of the most articulate critics.   He notes that the proposed budgets for the next decade will create a massive wall of debt – probably an insurmountable debt  – such that our children will have to choose between massive taxation levels or dangerous inflationary measures such as printing money to repay the huge sums we are borrowing now from other governments.

Senator Gregg is right on with this, and it will be tragic if he does not become a key architect of the solutions needed.

Democrats, who tend to choose optimism over realism, suggest that we’ll jump start the flailing economy and restore the prosperity train and live happily ever after.    It’s probably true that the current budget and high spending will help keep the economy from tanking.  Most economists agree we need a massive injection of Government money to stimulate things.     However I think few experts – and even fewer real people (who often have at least as good a power of prediction) would make the case that we aren’t heading for major trouble down the line.

Much of the solution is clear:

Stimulus should be smaller, more targeted, and eliminate the tens of billions in costly projects with dubious benefits.

Health Care cost reductions should be massive, aggressive, and all options must be kept on the table.   Europe and Canada have vastly superior models to our system with comparable care at half the cost.    Whining about the relatively small numbers of underserved patients isn’t convincing anybody anymore.   If free market enthusiasts can come close to Canada / Europe health costs then propose plans that do this NOW.     Otherwise shut up and adopt a single payer or nationalized health care system.    The “quality of care” arguments are largely bogus and designed to scare people into opposing cheaper solutions.   The current system is not sustainable and we have alternative cheaper and viable models.

Defense cost cuts should be massive and aggressive.   We’ve massively overspent on defense since WWII and both parties refuse to view this spending rationally, where ROI is measured in logical terms of achieving objectives.  Simply eliminating the military pork projects will cut *tens of billions*  We need to use our highly effective targeted strike capabilities, humanitarian assistance, and public relations to gain far more international support at a fraction of the cost.     Note to Republicans – stop your knee jerk nonsensical support of indefensibly massive defense spending.

Entitlements should be cut gradually but eventually massively and as soon as the economy shows clear signs of stability.    We’re living on the money of future workers, not our own, and if this does not stop soon it could be the greatest case of intergenerational theft of all time.     With respect to many entitlement programs we are all little Bernie Madoffs, pushing the Government to pay us from money they are borrowing from America’s children.
Note to Democrats:  stop your knee jerk nonsensical support of excessive entitlements.

These three measures would allow a balanced budget as soon as the economy stabilizes.   

We must end the era of  tribal thinking and “political finance” where the government – to please constituents and party hacks – keeps running things wrong and not in the long term best interests of the country.

The world’s most important “to do” list: The Copenhagen Consensus

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The Copenhagen Consensus is arguably the world’s most rational approach to Government spending.    The group, which includes many luminaries in economics, science, and development, reviews many approaches to making the world a better place and ranks them in terms of global priority.     The approach takes the return on investment in terms of dollars for lives very seriously.   Unlike political spending these decisions are looking at the most bang for the buck, rather than the most political benefits which are often strongly influenced by irrational concerns from lobbyists or personal agendas.     Obviously there’s no perfect way to allocate money but it’s certainly the best major effort to date and people *opposed to this approach* should be the ones making their case against it.      One of the most pressing reasons to move ahead with these efforts – even during a time of economic crisis – is that they are very, very cheap ways to do a huge amount of good both morally and strategically.    The reason we do not proceed?   Ignorance, pure and simple ignorance.

http://www.copenhagenconsensus.com/Default.aspx?ID=953

Solution
Challenge
1
Micronutrient supplements for children (vitamin A and zinc)
Malnutrition
2
The Doha development agenda
Trade
3
Micronutrient fortification (iron and salt iodization)
Malnutrition
4
Expanded immunization coverage for children
Diseases
5
Biofortification
Malnutrition
6
Deworming and other nutrition programs at school
Malnutrition & Education
7
Lowering the price of schooling
Education
8
Increase andimprove girls’ schooling
Women
9
Community-based nutrition promotion
Malnutrition
10
Provide support for women’s reproductive role
Women
11
Heart attack acute management
Diseases
12
Malaria prevention and treatment
Diseases
13
Tuberculosis case finding and treatment
Diseases
14
R&D in low-carbon energy technologies
Global Warming
15
Bio-sand filters for household water treatment
Water
16
Rural water supply
Water
17
Conditional cash transfers
Education
18
Peace-keepingin post‐conflict situations
Conflicts
19
HIV combination prevention
Diseases
20
Total sanitation campaign
Water
21
Improving surgical capacity at district hospital level
Diseases
22
Microfinance
Women
23
Improved stove intervention
Air Pollution
24
Large, multipurpose dam in Africa
Water
25
Inspection and maintenance of diesel vehicles
Air Pollution
26
Low sulfur diesel for urban road vehicles
Air Pollution
27
Diesel vehicle particulate control technology
Air Pollution
28
Tobacco tax
Diseases
29
R&D and mitigation
Global Warming
30
Mitigation only
Global Warming

Copenhagen is not focused on reviving the flailing global economy although I’d love to see us evaluate the types of global stimulus we’d see by funding innovative solutions to pressing global problems.     New grass for the national mall might put a few fertilizer guys to work for a few months, but it would be a lot more interesting  (let alone morally imperative) to throw a tiny fraction of that budget item towards some innovative new jobs in the health and poverty sectors, where simply improving health and reducing poverty will have powerful positive effects on raising the US and global GDP.      Raising living and health standards lowers birth rates so one of the consequences of spending the relatively tiny sums budgeted  by Copenhagen Consensus is helping to reduce population pressure as well as improve the quality of life for those already here.

Sergey Brin is Blogging

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Google co-founder Sergey Brin has just started a new blog which promises to offer some interesting insights into one of the most influential people in the technology world.

His first post details something incredibly personal – Brin’s predisposition to Parkinson’s Disease.   He learned this from an examnation of his DNA by 23andMe, the company co-founded by Brin’s wife Anne.

Corn fed cows, corn syrup, and the end of civilization

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COMMENTS ARE VERY WELCOME BELOW !
Ater a discussion with my sister about health concerns over corn syrup in food and grass vs. corn fed beef I followed up a bit on the Corn Syrup and Corn Fed Cow Continuum ….:
http://www.mayoclinic.com/health/high-fructose-corn-syrup/AN01588

I’d consider this source (the Mayo Clinic dietician) to be “very authoritative” and when I find these sources I don’t need to look much farther because they keep up on the research and have little reason to distort things.    There are exceptions to this and you need to be careful not to trust authorities when they are advising on things they are NOT authoritative about..but…

To me it suggests something I routinely find to be the case on these issues:   They are of minor rather than major concern, but many bright people choose (for reasons I do not understand) to *focus* on a narrow aspect of the overall health (or other scientifically defined) issues.

There’s a lot online about Grass fed beef that suggests it is healthier than corn fed.   Unfortunately the papers tended to look at grass fed meat composition rather than the long terms effects of that composition on human health, so for me this probably falls into the category of a small enough difference that I’d prioritize this far, far below what I’d argue are the big three: exercise, total caloric intake, and fat to calorie ratio.    I also understand that a daily multi-vitamin is good idea and would suggest that is likely enough to make a difference that we should take one.

The gist of my argument is simple and I’d suggest pretty obvious to an open mind:   If you care about your health you should spend most of your health-related thinking working to balance exercise, total caloric intake, and fat to calorie ratio such that your BMI stays below 25, a well established health milestone.   Secondarily, you should generally take a multi-vitamin.

Lastly, at the risk of sounding kooky because this type of thing normally falls into the kooky thinking realm, I think you can make a case that most of us should probably be taking resveratrol, an antioxidant that was shown to provide simply extraordinary life extension benefits in mice.   Although I normally think this kind of thing is goofy the early results for this substance are so compelling it’s foolish to ignore it (for the same reason it is foolish to *pay attention to* the largely bogus claims of most vitamin and nutrition therapies).

There may be some other compelling science I’m not familiar with but my point is that fretting over trivial things like trace chemicals in food, organic food issues, and even non-trivial but small issues like corn beef being fattier and corn syrup are *probably*, though not certainly, a waste of health thinking time because these factors are *swamped out* by the big three listed above:
(exercise, total caloric intake, fat to calorie ratio), and vitamin supplements.

Also note that I’m excluding cases where somebody has a deficiency or a disease that should affect their diet.   For example lactose intolerant folks should obviously not eat cheese or drink milk unless they take enzymes to help digest it.   Normally those are healthy foods but they are …. ugly foods for some people.

Also I’d note another obvious item – biology plays a big role in health that remains very poorly understood.   A poster gal for horrible diet and no exercise will often thrive for many years and will often outlive a LOT of joggers with great BMI and diets.  A poster perfect diet and exercise routine will affect your biology but I’d guess won’t trump it.    Hmmm – this would be interesting to review as identical twin study.   If I’m right, you’ll find identical twins will tend to die close to the same age regardless of their lifestyle.  It seems you could use twin studies to tease out the biology vs lifestyle factors.

Would You Outsource Alzheimers Care to India?

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A friend of mine has been making a case that we should be lowering the cost of care for Alzheimer’s folks by setting up facilities in India.    Quality of care and facilities would be the same or better than in the USA, but at a fraction of the cost.

Here’s an article about a guy who did this

Question:  Would you consider this option?     If your spouse had Alzheimer’s and it looked like you’d lose everything paying for care, would you move to India to preserve your standard of living?

Google’s KinderGate: Your kids are welcome here for $57,000 a year.

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When I first read about trouble in Google land over child care costs I thought it would be another case of the how super well paid but whiney Silicon Valley parents were unreasonably complaining about a minor bump in their charmed luxury lives. But maybe not.

Google appears to be on a search for the holy grail of child care, and even after charging parents for the service Google wound up subsidizing things to the tune of 37,000 *per child per year* – managing to spend the approximate average national income on every kid lucky enough to reach the nirvanesque kinderplex environment. The solution to this negative cash flow – unusual for the company known for showering employees with benefits like laundry service and free meals – was to raise the child care rates to about 2500 per month per child.

The NYT reports that two kids in Google childcare will run you $57,000. Although Googlers take home an average of something like $140,000 per year this isn’t going to ruin them, but this sure ain’t a page from the Brady Bunch days.

The situation is interesting economically but I think even more interesting as an experiment in Google’s approach to social engineering, which I think argue may be failing because it may not be able to scale in the same fashion as many of Google’s magnificent technological innovations.

Although Silicon Valley employees have historically enjoyed some great benefits, Google shined as the company that outdid everybody with free gourmet meals, free laundry, and great parties all within a context of individual freedom to work pretty much as you pleased as long as you were productively engaged, and even that was defined in some part by the employee.

This approach seemed to be working well, but I wonder how much of this was just an illusion caused by Google’s huge wash of incoming cash. The NYT article suggests that the company hardly even noticed the child care subsidy until recently. I’m guessing that only recently have the Google bean counters been called up from their free lunch to sharpen their pencils and find ways for Google to trim the company budget.

There are obviously two huge human resource pressures on Google now as it grows within the context of providing the world’s best company bennies. First is the fact that the legions of Googlers are for the most part…kidless. As employees age, especially the key folks from the early days, Google will see a lot more departures of key folks and a lot more demands for family time and benefits. Even stronger will be the pressure from the growing number of employees in Google’s empire, far more of whom are likely to be “in it for the money and perks” than in the early days. I remember touring the Googleplex a few years ago with an exec who, when asked about this problem, said it was not happening. But I think that was about 10,000 employees ago and before the level of concern over Google’s KinderGate scandal.

I will be very interesting to see if Google can scale their sometimes pesky human resources as effectively as they have scaled their technological and commercial resources.

I’m guessing…make that strongly predicting….the answer is no.

New York Times Reports

Charity return on investment is important. Thanks World Vision!

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There are a great number of groups doing a lot of good in the world, and I’m concerned that *something* in the way we process information about poverty and health needs in the developing world has made us far too skeptical of how easy it can be to save lives, and far too skeptical of the groups that are doing a good job.

This in part leads to what I’d argue is an immoral state of affairs in the charity world. Most people in the USA give far more to University, Hospital, and Museum endowments than they give to organizations serving the third world that are saving lives for a few bucks rather than simply making our already very comfortable middle class lives a *bit* better. I guess that’s OK but I’ll take the big ROI on my charity investments, thank you.

It feels very good knowing your money is actually saving lives, living because I chose to give to high ROI charities.

The simple story is that it costs very little to save lives in the developing world. Although it’s a little counterintuitive it’s also clear that reduced death rates lead to reduced birth rates and lower population. I’m floored by how poorly this is understood by otherwise intelligent people, and it seems to be the top reason people say they don’t want to give money to extremely poor people. Graft and corruption are major problems in the third world which is why you want to give to “NGOs” or “non-governmental organizations” which tend to be far more effective at making sure the money finds its way to the right people.

So, let’s apply this ROI in real life and give some money in honor of my Mother’s birthday today. I think charities like World Vision do a lot of good but also suffer from the kind of fatigue people show when presented with a lot of “dying children” information. This is unfortunate because World Vision leverages cheap and free expertise to deliver a lot per donated dollar. Here is the campaign mom likes:

Major pharmaceutical companies have recently donated over $174 million in medicines and supplies to World Vision.
But we need your help to distribute them where they’re needed most.

The medicine is Mebendazole and some others that fight worms and intestinal viruses – one of the leading killers in the developing world. World Vision has the meds but needs money to ship them. The “multiplier” in this case is 13x – ie a donation of a mere 7.7 cents delivers – literally – a dollar of medicines.

So, time to stop writing and do some good and give $770 dollars to this campaign for a health impact of just over $10,000!

Donor Name: Joseph Hunkins
Donation Total: $770.00
Donation Date: 27-Sep-2007
Completed Date: 27-Sep-2007
Payment Type: 
Credit Card Type:

Happy Birthday Mom!

World Vision
KIVA
Unicef


Mediterranean and Asian Recipes

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I just found this *great* website devoted to the type of diets that are now considered best for optimal health. Like most of my fellow Americans I’m a high fat lovin’ meat and potatoes, burger and fries and please pass the extra large coca cola kind of guy. But that better change since I really don’t want to have a heart attack until *after* the singularity when Ray Kurzweil assures me I’ll be good to go on without a heart.

So, check out this great recipe site, cook up some garlic coated mushrooms and join me in a red wine toast to better living and eating: Mediterrasian.com

Dr. Weil on Eating Well. The Glycemic Index and Glycemic Load

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Dr Weil is on PBS talking about food. I’m pseudo-live blogging the talk in a haphazard sort of way.    Andrew Weil is a leading proponent of combining “mainstream” science with natural foods and lifestyle changes to improve health and well-being.

He’s explaining why a puffy rice cake will raise your blood sugar *much faster* than table sugar, and noting that eating “high glycemic load” carbs like rice cakes regularly can lead to obesity and other health challenges like high blood pressure.

Generally, he says we should be looking to eat low glycemic loads stuff like beans, winter squashes, sweet potatoes.

Cooking oil? Like Kurzweil, Weil recommends “extra virgin Olive Oil” and says to stay away from my personal favorite, sesame oil among others.

Eat: Oily fish to get Omega 3 Fatty Acides. Also in walnuts, hemp!! seeds, flax seeds, sea vegetables.

Fat: Avoid it even though the ‘mouth feel’ is pleasureable. Nuts, avocadoes, olive oil are OK fats – these are monosaturated. Optimal levels of fat are far below the current average consumption of fat.

Protein: The need for this is exaggerated in our culture where protein deficiency is almost non-existent. Animal proteins are not as good due to density, saturated fats, and toxins.

Try to get your proteins from plant produce

Main source of vitamins? Fruits and vegetables! Eat a great variety. Eat fresh. Lots of fiber. Eat a LOT more fiber than you have been!

Phytonutrients are good!

Green Tea, White Tea, Dark Chocolate, Red Wine have health benefits.

Beware food marketing that encourages eating the nutrient rather than the vegetable that has the nutrient. e.g. broccoli and tomatoes.