Ebola and its Lessons

You gotta make sure you don’t use too much dihydrogen oxide though, that stuff is deadly.

All seriousness aside, that combination can be very bad, you know. We were warned often in high school chemistry about combining those two.

One of the first times I realized my words have impact on kids, I suppose my first oh crap I’m a parent moment. I had been joking about cleaning the bathroom with bleach and ammonia and my wife to be yelled at me because the kids heard it. Then she told them to never do that because it was dangerous.

At the time I was like WTF. Now I get it better. Kids always hear the worst things.

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I take my surgical gloves off that way every single time and I rarely get blood on my hands. It takes practice, though. And yes, when dealing with contagions you need to double glove. Ideally you double glove and gown, take off the contaminated layer at the innermost portion of the treatment area, go out to a dirty/clean area, take off the second, clean layer, and then proceed out to the cleanest area. Hog farms are very good about “shower in shower out” and keeping diseases to a minimum…

And I guess that’s how you end up with 47 people working on someone and 2 getting it.

The CDC has said double gloving is not necessary and is beyond the point of diminishing returns on safety. I know everyone argues with the experts, but shouldn’t the CDC post the safest methods and then people can take their risks going “less safe” from there. These are the same people that sent four people in moon suits to transfer someone to Atlanta last week, and one guy with a clipboard.

When you are talking about a disease that historically kills 90% of the people who catch it, any return on safety is worthwhile, regardless of how diminished it is.

Nooo… It is not the worst things we hear, it is the great ideas we get.

I had a chemist set as a kid. My dad made oxyhydrogen in a test tube and showed me its nice explosive capablites. My version of that was… hmmm, if I put it in a bigger container, such as a bottle, the bang will be bigger. The bang was much bigger, and the (beer)bottle was of glass, so I used the remaining time before my parents came home from work to clean up all the itty bitty shards that was blown all over the kitchen by the blast.

Looking back, being a kid with very good imagination, very advanced reading skills and technical understanding (go to the library, pick up a book on WWII, understand how the weapons was built, build a working mortar as a 10 year old), I must say that it is somehow surprising that I have all my fingers intact.

Oh and formic acid and ammonia was what my 10yo mind thought tear gas was.

I guess my survival came from the logic that if it could harm/kill me, add another layer of something whatever it is cannot penetrate easily. Wool clothing and cowhide gloves when playing with flame-throwers and napalm.


At least it wasn’t nylon, I guess.

Wool don’t burn nor does it melt. So when my plastic water-gun turned flame-thrower exploded indoors, I could put out the fire to stuff inside the room before I needed to put out myself. So my survival came from protecting myself even when I did incredibly stupid things.

By the way, if you really want to get rid of bodies, use piranha solution. Yeah, I learned about it from Mythbusters. As in “Hm, I wonder what ‘blur’ and ‘blur’, really are… oh, that does it.”

As for ebola…
Yeah, I’m wondering if the CDC was as gutted as FEMA and we’re just now noticing. That’s worrisome, but if it’s the case at least we’re finding out NOW and not when there’s a serious problem.

No, I don’t count ebola as a serious problem. I wouldn’t want to catch it - much like I wouldn’t want to catch rabies, malaria, or a bunch of other diseases - but ebola isn’t likely to become an epidemic here. And it’s certainly NOT an epidemic now.

One thing that I’ve been hearing getting a lot of mileage is that very few hospitals have a specific plan for ebola. But that’s disingenuous, I think. Of course they don’t have a specific plan for ebola. Why would they? They do, in general, have a plan for handling infectious diseases. What we’re seeing, though, is that these plans haven’t been truly tested, and do seem lacking.

My concern in general, though, is that our medical system isn’t as “ready” as some experts would have us believe. I read an essay recently which put forth that our medical system in the US is in silos - we’ve got people who are very entrenched in handling one particular thing and don’t look at other issues. And I’ll admit that seems kind of accurate - all too often I’ve had this or that minor issue and been immediately referred to a specialist, which is frustrating and annoying for a host of reasons not at all related to ebola.
But what I’m seeing is that we have a medical system that’s good at prescribing drugs, good at installing insulin pumps and (if you throw enough money at it) fighting cancer. But our medical system is not in fact all that awesome at helping you when you’re just kind of sick, nor at handling injuries or keeping people out of the ER, and is really shitty at preventing medical problems in the first place. And so maybe our medical system isn’t all that great about handling epidemic diseases.

I suppose I will get called a pessimist again, but this has been pointed out numerous times in the past. Pharmaceutical companies don’t get money if you are cured, or if you don’t get sick. Doctors don’t get paid to prevent illness, they get paid to treat (which is not the same as cure) illness.

Face it, we do not, as a society or a nation, reward people for fixing a problem, or preventing one. The British do a slightly better job at it, but that process will never see the light of day in this country.

Yeah, but we don’t have hundreds of people starving to death in hospitals a year due to neglect. Or lengthy waits for simple procedures, or a totally separate tier of care for the rich, up to and including flying to America to get something done.

I’ll take ours.

I wasn’t talking about socialized medicine (although there has been so much back-and-forth debunking on that one, I don’t have an opinion anymore).

I was talking about ennobling someone for their contributions to society. If you know that you are going to wind up with a nice title, you have more incentive to cure cancer.

Instead, in the U.S., we have the example of Tucker: “Don’t do it better, or we will kick the shit out of you.”

Derek Lowe had a nice blog post, which I’m currently failing to find, which did a fairly good job on debunking the notion that big pharma is keeping cures out of reach. Basically, if a company did find a cure for cancer, or AIDS, or whatever, it would be a major victory for them that would seriously outweigh any loss of prospective revenue - especially since they would lose that revenue anyway, since someone else would almost certainly create that same drug a few years later if they decided to not pursue it.

Which isn’t to say I think the pharma companies are sunshine and rainbows; many of them are shutting down or outsourcing R&D altogether. I simply don’t believe they’re keeping us from developing cures - but the more I learn about drug discovery the more I realize that many conditions are a bitch to cure, and many simply can’t be cured, no matter what, and the best we can ever hope for is a fully effective treatment protocol.

I tend to think the problem is in funding, though, but mainly at the consumer end. Whatever you think the system should be, the current system is still pretty broken, as it nickel and dimes patients to death and warps the way we seek medical care such that prevention and holistic solutions are deprioritized and instead we tend to ignore problems until they become catastrophic, and then patch them up minimally rather than fixing the root cause. As a side effect, we don’t have very many people who look at the bigger picture, neither at the system level nor even the bigger picture for an individual patient. (For a horrific example of this, read A Slow Death, which is about events in Japan but is illustrative of the problem - the patient was dying of neutron radiation, his organs were failing in a pattern which should have been entirely predictable and clearly showing that his condition was fatal and irreversible, but the specialists were all specialists and didn’t ever step back and realize that the situation was non-recoverable. Oh, and if the title isn’t a giveaway, the subject matter is really horrific)

If you read up on how the FDA is run the last 20 years or so you’ll understand why. Also why they’d rather make more happy erection pills than actually cure something that is killing people. The liability for human trials for an alternative solution is huge. Where if Joe still can’t get a hard on then that’s his problem, as long as his penis doesn’t explode.

If someone found the 90% cure for cancer it could be 15 years before it’s on the market, if not longer if there are any side effects.

We used to praise people who gave their time and money to charity. And the government used to not take any money to give to charity.

Honestly, I don’t agree with you on the reasons. Yes, FDA approval is cumbersome. However, most drugs die well before they’re submitted for FDA approval. That’s not itself particularly special; it turns out that the human body is complex and hard to modify, and not infrequently a promising drug candidate turns out to have horrible side effects that just don’t become apparent until pretty late in the game.

The reason, as I’m given to believe, that companies are dropping R&D is that it’s really hard to predict how it will tie into profit (or, more accurately, stock prices) as the R&D is extremely expensive and will invariably take years or even decades before getting a product to market - a fact which is true of cancer treatment and erection pills. Large companies are notably risk-averse, and they would vastly prefer to have someone else take the risks; drug discovery is a huge risk. This is not a case of excessive bureaucracy, it is merely standard short-sightedness, writ large.

While, yes, the approval process could be made more efficient - what couldn’t? - the process does exist for a reason. Bear in mind that the FDA was not established because someone woke up one day and said “Hey, I feel like intruding on the rights of the American public!”; rather it was created to curtail abuses which were rampant - tainted food, toxic medicine, etc. When deriding that process, consider the alternative. One could make the case that the process is actually inadequate even yet; that the requirements are too loose. After all, we have had drugs come to market which proved to cause heart damage, and some drugs on the market have never been shown to be any more effective than a placebo (Phenylephrine, for example).

There’s no winning this, for the FDA. If they relax the requirements and shorten the approval process, they get slammed for allowing ineffective and dangerous drugs on the market. If they tighten the requirements, they get slammed for being a bottleneck.

I would feel a lot more charitable toward the FDA if they would finally allow the results of research into herbal supplements and other alternatives to be presented and evaluated. But they won’t even look at research into vitamins and minerals that have been stamped with the “RDA” since World War II.

Instead, the USDA (and the National Academy of Science) has to set those figures, because the FDA refuses to.

I would also feel more charitable if they would denounce the prescribing of Seroquel for PTSD, which the DoD already has… while the APA and the AMA wink and look the other way.

I’m not fond of the “baby with the bathwater” approach to government reform, but in this case, I’m not convinced that the bathwater can be purified by anything resembling short of a neutron bomb.

Sorry, part of the FDA rant is that it comes at the end of an effectively unknowable development pipeline. You find it, prove that it works, figure out if you can afford to produce it, only to run into a totally unknowable approval process that you still might not make it out of.

I think that’s why some minor things may never be cured except as a byproduct.

And “First, do no more harm” causes them to err on the side of bottlenecking it, plus being a huge bureaucratic monster with a budget larger than many countries’ GNP.

You are forgetting the number of FDA workers who leave government service to work for the companies they were supposedly the watchdog over.

Shakespeare was wrong… First, kill all of the lobbyists. We can discuss lawyers later.

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Glenn Reynolds has an awesome revolving door income tax idea. It might not kill the practice, but at least it would make it so only top “talent” was bought this way.

In short, I propose putting a 50% surtax – or maybe it should be 75%,
I’m open to discussion – on the post-government earnings of government
officials. So if you work at a cabinet level job and make $196,700
a year, and you leave for a job that pays a million a year, you’ll pay
50% of the difference – just over $400,000 – to the Treasury right off
the top. So as not to be greedy, we’ll limit it to your first five
years of post-government earnings; after that, you’ll just pay whatever
standard income tax applies.

You could conceivably also apply it to people like Harry Reid and Sharpton, who entered government service middle class and are now stupid rich. I’m sure there are Republicans that hit the same mold as well.