Thursday, July 27, 2017

Who knew there used to be a vaccine for Lyme disease?

Since every summer I worry about contracting tick-borne Lyme disease, I found this article from the New Scientist beyond interesting. Apparently all over the U.S. and much of Central Europe, global warming is leading to bumper crops of fallen acorns that provide food for a bumper crop of mice which in turn lead to an explosion of tick nymphs which then feed on human passersby. Only the humans suffer from infection by the Lyme bacteria. The mice and the ticks are just going about their business.

Once limited in geographical spread, Lyme disease has escaped New England and is becoming endemic in wide areas.

Back in 1998, the U.S. Food and Drug Administration approved a human vaccine to prevent infection by the Lyme bacteria. But that was the era when misplaced fears about the Measles/Mumps/Rubella vaccine fed an unfounded panic. The drug company withdrew the Lyme vaccine rather than fight passionate opponents. Nevertheless,

when the FDA reviewed the vaccine’s adverse event reports in a retrospective study, they found only 905 reports for 1.4 million doses. Still, the damage was done, and the vaccine was benched.

Fear trumped science in this case.

There's another, wider spectrum, vaccine under development now, but it won't complete testing for another six years. So watch out for those ticks, everywhere.

H/t to Kevin Drum for pointing to the New Scientist article.

Wednesday, July 26, 2017

Unlikely professionalisms

When I wrote about Timothy Snyder's On Tyranny: Twenty Lessons from the Twentieth Century, I knew and feared that I'd have to come back to his insights. After a few days respite on the trails followed by re-immersion in the news cycle, one of his points leaps to the fore.

5. Remember professional ethics. When political leaders set a negative example, professional commitments to just practice become more important. It is hard to subvert a rule-of-law state without lawyers, or to hold show trials without judges. Authoritarians need obedient civil servants, and concentration camp directors seek businessmen interested in cheap labor.

... If [under the Nazis] lawyers had followed the norm of no execution without trial, if doctors had accepted the rule of no surgery without consent, if businessmen had endorsed the prohibition of slavery, if bureaucrats had refused to handle paperwork involving murder, then the Nazi regime would have been much harder pressed to carry out the atrocities by which we remember it.

Professions can create forms of ethical conversation that are impossible between a lonely individual and a distant government. If members of professions think of themselves as groups with common interests, with norms and rules that oblige them at all times, then they can gain confidence and indeed a certain kind of power. Professional ethics must guide us precisely when we are told that the situation is exceptional. Then there is no such thing as “just following orders.” ...

The Cheato, his flunkies, and too much of the Republican Party are trying to break or sully the professional ethics of the people who do the work of government.
  • The experienced and broadly respected former government lawyer Jack Goldsmith has imagined how responsible legal professionals inside the DOJ might act under the man he calls a "Kamikaze president."

    ... the only thing for the men and women of the Justice Department to do is to keep doing their jobs well until they get fired.  That is the way to serve the American people in upholding the rule of law in the face of a president bent on trying to destroy it.  It is a remarkable fact that despite Trump’s relentless attacks on DOJ independence, DOJ continues to function with extraordinary independence, which every single Trump DOJ nominee has underscored before the Senate and—with the possible exception of Rosenstein’s shenanigans with the Comey firing—in practice.  The President can fire [Attorney General Jeff] Sessions and [Assistant AG Rod] Rosenstein and [Acting FBI Director Andrew] McCabe if he likes, but he cannot fire everyone, and he cannot stop an investigation that now has a relentless logic that is only reinforced every time he attacks DOJ independence.  In this regard, Trump’s unhinged tweets display weakness, not strength.

    Professional ethics (and professional inertia) have a species of power here. Many of us may not instinctively look to the government legal establishment for protection from a rogue government, but we should applaud this kind of professionalism if we see it.
  • There are even less likely contexts in which people with professional ethics find themselves mired in the raw viciousness of the Trump white supremacist regime. Who knew there have been Immigration and Customs Enforcement (ICE) officers who wanted to play by the rules? -- and who are disquieted when the rules are torn up in favor of brute bigotry? New Yorker journalist Jonathan Blitzer cultivated a conversation with an ICE agent who has become willing to express his horror at what the "deportation force" is becoming under untrammeled racist leadership.

    We used to look at things through the totality of the circumstances when it came to a removal order—that’s out the window,” the agent told me the other day. “I don’t know that there’s that appreciation of the entire realm of what we’re doing. It’s not just the person we’re removing. It’s their entire family. People say, ‘Well, they put themselves in this position because they came illegally.’ I totally understand that. But you have to remember that our job is not to judge. The problem is that now there are lots of people who feel free to feel contempt.”

    ... the agent sees long-standing standards being discarded and basic protocols questioned. “I have officers who are more likely now to push back,” the agent said. “I’d never have someone say, ‘Why do I have to call an interpreter? Why don’t they speak English?’ Now I get it frequently. I get this from people who are younger. That’s one group. And I also get it from people who are ethnocentric: ‘Our way is the right way—I shouldn’t have to speak in your language. This is America.’ ” It all adds up, the agent said, “to contempt that I’ve never seen so rampant towards the aliens.”

    ... Before this year, the agent had never spoken to the media. “I have a couple of colleagues that I can kind of talk to, but not many,” the agent said. “This has been a difficult year for many of us.” These people, not just at ICE but also at other federal agencies tasked with enforcing the nation’s immigration laws, are “trying to figure out how to minimize the damage.” It isn’t clear what, exactly, they can do under the circumstances. ...

    The rest of us need them to do all they can; we need to be ready to defend these unlikely allies if we must.
  • And then there are the "lawmakers," those rather pathetic GOPers who seem willing out of tribal loyalty to pass healthcare policies that will harm millions, notably including their own constituents, without apparently feeling any professional responsibility to make their country work. The enormity of their dereliction of duty seems unfathomable. Haven't they any professional pride? Will they ever remember that with power comes responsibility? The Cheato clearly hasn't a glimmer of this; why would he, he's merely a rapacious looter. But professional pols might be expected show some measure of responsibility for what they do to us.

    It seems worth noting that, at least for the moment, Democratic lawmakers are indeed managing unity against GOPer measures, carrying out their professional responsibility to do their best for constituents and country. This was never a sure thing. We should thank them when they do right, at the same time we let them know we're watching them.
It's going to take all kinds if the country is going to emerge from this ugly pass intact. Resistance includes finding allies in unlikely places.

Tuesday, July 25, 2017

The hills are still there ... and so are the National Parks

... and so for the moment is this gem. Until August 28, citizens and residents older than 62 can purchase this lifetime pass providing free admission to the parks (and national forests and some other federal land agencies) for a mere $10. It is good for you and anyone with you for as long as you don't lose it, for the rest of your life if you can manage that! The minuscule price has been the same since 1994 but is going up to $80 for the same lifetime benefits at the end of the next month.

This is a pre-Trump price increase by the way. Congress, in its wisdom, decided on the price hike in the last session of 2016.

What struck me as we drove in and out of Yosemite and Inyo National Forest waving our passes was the response of the rangers. "Thank you! Thank you! Enjoy the park!"

My instinctive reaction was that we should be thanking them, rather than the other way around. But obviously some one has trained them in the political implications of making the cheap passes available to elders. Who votes in this country? Overwhelmingly, it is old people. Over 70 percent of eligible people over 60 turned out last November. The parks need defenders and supporters who vote. The Senior Pass helps build the support base for America's Best Idea.

Get one when you can. It will still be a good deal when the price goes up, but it is a phenomenal perk right now.

Heading for the hills

Heading to the eastern slope of the Sierra Nevada near Mono Lake for a week. This jaunt was supposed to go to Tuolumne Meadows in Yosemite National Park, but the winter's rains have drowned facilities there. The picture dates from another wet year -- 2010 -- but I expect far more snow and mud this time.

Any blog posts this week will be single photos; I'm experimenting with rudimentary posting from an iPad Mini.

Try not to let the Cheato and his GOPer enablers do anything too awful while we're restoring our souls. Tend your soul; resist and protect much.

Monday, July 24, 2017

Southern Sierra Nevada range

From high in the White Mountains overlooking Owens Valley. Now that is daunting. 

Sunday, July 23, 2017

Lundy Canyon

I usually think of the eastern slope of the Sierras as dry, hot high desert. But after last winter's rains, persistent run off from the snow pack has made for a spring that still lingers. 

This sometimes barren land could hardly be more lush. 

The forest services says there are big horn sheep in these hills. But they chose not to show themselves. 

Friday, July 21, 2017

Cathedral Peak

In Tuolumne Meadows and along Route 120, smoke hangs heavy from the fire at Mariposa. 

But at 10000 feet, Cathedral Lake sparkles. 

Friday cat blogging

We may be out gallivanting about, but it's good to know that Morty is home surveying the world from his tower. See you soon, buddy.

Thursday, July 20, 2017

We're not the only temp residents of Lee Vining

We're told this is not a hummingbird, but a sphinx moth. 

Monday, July 17, 2017

What we ought to expect from health insurance

Almost all health care stories these days seem to be about either how millions of people are about to have access to care ripped away from them by the GOPer Senate or how the U.S. medical system is inaccessible, impersonal and balky. I had a happy medical experience today that seems to me to exemplify what we ought to be able to expect from medical providers.

People who read here probably have noticed that I've just spent 10 days on Martha's Vineyard island off Massachusetts. Cape Cod and environs are having what may be the worst tick season ever. The little buggers are not only ugly, their bites also spread Lyme and several other nasty infections. And much to my horror, I discovered Saturday night that I'd brought a deer tick home on the plane with me, embedded in my armpit.

Emergency time!

If I'd still been on the island, I knew what I would do: pull out the tick carefully, rush to the walk-in clinic, explain, and pick up a dose of the antibiotic doxycycline. That's the standard protocol and docs hand out the drug daily to a parade of visitors. If those who have been bitten get treatment within 72 hours, most avoid tick disease.

But now I'm in northern California where I have my health insurance through Kaiser Permanente. Would this system recognize the prophylactic protocol which is standard in Massachusetts? Would they give me a dose of an antibiotic on the basis of my claim to have pulled out a tick? About a decade ago, I went to Kaiser in somewhat similar circumstances and the docs didn't act as if my having a bite and nasty rash was worth attending to. Tick bites just weren't part of their world in those days.

But today, my experience could not have been more smooth and efficient. I called the advice line at 6:30am on a Sunday morning and explained about the tick and that I wanted an antibiotic. I was passed to the outpatient clinic for an appointment within a few hours. The doctor on duty listened and agreed that I should be treated ASAP. He didn't know the dosage because the need for tick prophylaxis doesn't walk in every day, but did some quick research and returned with a prescription. This was filled in the same building within 15 minutes. Less than an hour after walking in, I'd taken my drugs and -- I hope -- killed off any Lyme in my body.

This is how a medical system is supposed to work. Kaiser is an HMO, a self-contained medical facility whose doctors and ancillary staff work on salary with in-house computerized medical records, labs, and pharmacies. Instead of getting paid for doing ever more things to those of us in their system, Kaiser gets paid for keeping us healthy. They make their money when their insureds don't get or stay sick. That is, their incentives are aligned with mine as the patient. Sure, the system is big and sometimes requires a little persistence to get the process of being seen started (not today though!) but mostly Kaiser works.

Why can't all the health care system work like this? Docs, especially specialists, might not make quite the same enormous salaries, but most everyone else would be happier. This is what being insured ought to mean. Medicine can't cure everything, but the experience of being a patient shouldn't add to the misery of being ill. This can be done and we should demand it.

Sunday, July 16, 2017

An exceptional nation

My post on what happens when the United States chooses to withdraw its bulky, often imperious, weight from the world order ignited some discussion among friends on Facebook.

I thought it might be a useful followup to publish this catalogue of 20th century "American exceptionalism" from J.J. Goldberg, written in response to the Cheato's withdrawal from the Paris climate accord. The history of our evasion and circumvention when it comes to international agreements is long.

... numerous commentators were suggesting that America has put itself in unfamiliar and unseemly company [with Nicaragua and North Korea as climate deal refuseniks].

But that suggestion underestimates the depth of America’s exceptionalism. After all, the Paris withdrawal isn’t the first time we’ve joined forces with unsavory outliers to defy a global consensus. Lest we forget, we are one of just three nations that have refused to ratify the United Nations Convention on the Rights of the Child, alongside Somalia and South Sudan. In case you’re wondering, this is primarily due to opposition from America’s religious right who object to the treaty’s language criticizing corporal punishment.

There’s more: We’re one of just four nations, together with Swaziland, Lesotho and Papua New Guinea, that don’t promise paid maternity leave to mothers of newborns. We’re one of seven nations that have refused to ratify the U.N. Convention on Elimination of All Forms of Discrimination against Women, alongside Iran, Saudi Arabia, Somalia, Sudan, Tonga, Palau and the Vatican. We’re one of 13 nations that reject the U.N. Convention on the Law of the Sea, together with Iran, North Korea, Libya, El Salvador and a few others, including landlocked Afghanistan and Rwanda.

Still more: It took us fully 40 years to overcome Republican opposition in the Senate and join the civilized world in ratifying the U.N. Genocide Convention of 1948. We rank seventh in the world in executions of prisoners, trailing China, Iran, Saudi Arabia, Iraq, Pakistan and Egypt, but outstripping Somalia, Bangladesh and Afghanistan.

We’ve refused for decades to ratify the landmark U.N. Convention on Economic, Social and Cultural Rights, which translates the historic 1948 Universal Declaration on Human Rights into legal standards. Our objection is mainly to the convention’s definition of fundamental human rights as including, among others, “a decent living,” “adequate food, clothing and housing” and the right to form and join unions.

And, of course, we’re the only advanced industrial economy that doesn’t guarantee universal health coverage as a right.

Goldberg reached a tough conclusion:

Scholars and observers worldwide used to call us the indispensable nation. From now on they’ll be calling us the indefensible nation. We are indeed an exception.

The world is about to see where it goes without us.

Saturday, July 15, 2017

Vineyard abundance

So many blooms ...

So much greenery ...

So many goats ...

Related Posts with Thumbnails