Monday, April 27, 2009

Alarming Flu Reports From Mexico

By Paul Hsieh

BBC News has posted a number of "in the trenches" readers' reports on the swine flu epidemic in Mexico. Here are two disturbing excerpts from Mexican physicians:

I'm a specialist doctor in respiratory diseases and intensive care at the Mexican National Institute of Health. There is a severe emergency over the swine flu here. More and more patients are being admitted to the intensive care unit. Despite the heroic efforts of all staff (doctors, nurses, specialists, etc) patients continue to inevitably die. The truth is that anti-viral treatments and vaccines are not expected to have any effect, even at high doses. It is a great fear among the staff. The infection risk is very high among the doctors and health staff.

There is a sense of chaos in the other hospitals and we do not know what to do. Staff are starting to leave and many are opting to retire or apply for holidays. The truth is that mortality is even higher than what is being reported by the authorities, at least in the hospital where I work it. It is killing three to four patients daily, and it has been going on for more than three weeks. It is a shame and there is great fear here. Increasingly younger patients aged 20 to 30 years are dying before our helpless eyes and there is great sadness among health professionals here.

Antonio Chavez, Mexico City

...I work as a resident doctor in one of the biggest hospitals in Mexico City and sadly, the situation is far from "under control". As a doctor, I realise that the media does not report the truth. Authorities distributed vaccines among all the medical personnel with no results, because two of my partners who worked in this hospital (interns) were killed by this new virus in less than six days even though they were vaccinated as all of us were. The official number of deaths is 20, nevertheless, the true number of victims are more than 200. I understand that we must avoid to panic, but telling the truth it might be better now to prevent and avoid more deaths.

Yeny Gregorio Dávila, Mexico City
A few natural questions:

1) How will this affect border control policy?

Mexico has arguably been teetering on the edge of being a "failed state" for a few years now. If a flu pandemic causes the central government to lose effective control over the country, will we see a flood of desperate illegal immigrants seeking to cross into the US to escape the problems in Mexico? And given that some of those people may be infected, how will the US respond?

Although I support open immigration in the sense that Craig Biddle discusses in his article "Immigration and Individual Rights" from the Spring 2008 issue of The Objective Standard, I also completely agree with him that it is a legitimate function of government to prevent people with deadly communicable diseases from entering this country. In an emergency, this may require fairly drastic steps (such as deploying the US military along the border).

Hence, border security may become a big issue in the near future.

2) If the pandemic strikes the US, will this lead to a permanent increase in government control over our lives?

Again, in a mass casualty medical emergency, I think the government can legitimately impose controls that would not normally be justified. For instance, it might restrict normal commerce, assume temporary control of hospitals and health care facilities, impose quarantines/curfews on neighborhoods and cities, etc. One can argue over whether any specific proposed measures are justified for a given emergency, but the basic principle is valid.

But we also know that once government assumes "emergency" control over a sector of the economy, it rarely gives up that control after the emergency has passed.

Hence, a flu pandemic could lead to permanent new government controls over health care and/or other major sectors of the rest of the American economy, even after the immediate crisis has passed.

3) What would be the long-term economic effects of a flu pandemic on the US?

If there is significant loss of life, the individual tragedies will be bad enough.

But I expect this would be compounded by significant disruption of normal economic activity. In the present political climate, this could deepen our current recession, thus creating more pseudo-justification for further government controls over the economy, which would further worsen the recession, etc. How far could this downward economic spiral go?

We'll soon know the answers to these questions.

I also wish to emphasize that I am not taking an alarmist position. For instance, I think it's a huge positive that medical technology has advanced immensely since the flu pandemic of 1918.

If you want to read some good practical advice, take a look at this page from epidemiologist Dr. Tara Smith (not the Objectivist philosophy professor) written during the bird flu scare of two years ago. In short, she recommends:
Don't panic
Wash your hands
If you're sick, stay home
Don't touch your eyes/nose/mouth
Stock up on food, water, and other household necessities (i.e., standard prep for blizzard, earthquakes, or other natural disasters)
There is also recent research suggesting that Vitamin D may help strengthen your ability to fight off the flu. (The article doesn't specifically address swine flu, but my guess is that correcting any Vitamin D deficiency wouldn't hurt and would likely help against this new virus.)

[Note from DMH: As I've mentioned before -- here and here and here -- most Americans are deficient in vitamin D. For example, a recent study showed that 72% of men over 65 are deficient using 30 ng/ml as the cutoff. From what I've read, levels should be over 60 ng/ml. For some people, that can require thousands of IU supplementation per day.]

So don't panic, keep informed, and stay tuned for updates!

(BBC link via Instapundit.)

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Saturday, April 25, 2009

Link-O-Rama

By Diana Hsieh

  • I really enjoyed listening to this hour-long interview of Dr. Davis, the Heart Scan Doc, by Jimmy Moore. Although I've been reading Dr. Davis' blog regularly for a while, a good bit of what he said -- particularly about LDL -- was new to me.

  • Don't miss Dr. Eades latest post: Nutrition and health in agriculturalists and hunter-gatherers. It's his excellent analysis of a very good anthropological study. The results are striking -- and they clearly point to the superiority of a "paleo" diet for health.

  • I pity the poor cats who must eat this (or any other) vegan cat food. They're carnivores, for goodness sake!

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  • Saturday, April 11, 2009

    Smaller Farms = Higher Prices?

    By Diana Hsieh

    Why is food purchased from local farms often so damn expensive? I recently ran across two interesting essays on the topic via the blog Food Renegade, both focused on livestock.

    First, in Unfair Fare, part-time New York farmer Bob Comis argues that the problem stems from a failure on the part of many small farmers to take advantage of economies of scale. Instead, these farmers tend to rely on the willingness of some not-so-bright folks to pay exorbitant prices for locally-produced food. Undoubtedly, many consumers do need to be smarter shoppers.

    Second, in Why Local Food Is More Expensive, farmer Joel Salatin argues that the high prices are largely the product of massive government controls. These controls are not merely ill-suited to the workings of the small farm; they also entail fixed costs that burden small farms far more than large farms.

    Whether you will ever buy food direct from a farm or not, I heartily suggest reading this second article. The inanity, burden, and expense of these government controls on farmers is worth glimpsing in its concrete details. It's not a pretty picture.

    Notably, while these two explanations for high prices of locally-produced food differ, they are not mutually exclusive. However, in the long run, the government controls over farms are clearly far more significant than the poor judgment of some farmers and consumers. The market can and will weed out inefficient farms via competition over time. In contrast, government controls can only be remedied by a massive cultural and political u-turn toward free market agriculture. Given the general confusion about and hostility to free markets today -- and given that large farms often support such controls as a means of suppressing their competition -- that u-turn will be no easy task.

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    Saturday, April 04, 2009

    Good Calories, Bad Calories

    By Diana Hsieh

    Flibby posted the following remarks on Gary Taubes' excellent book Good Calories, Bad Calories. It's too damn funny not to quote in its entirety:

    Do You Like Sugar?

    Then I would advise you not to read a book called Good Calories, Bad Calories by Gary Taubes because if you read this book you will learn that sugar will kill you dead until you die from it.

    I'm not done reading it, but so far I have learned that it will give you diabetes, heart attacks, strokes, blindness, fatness, cancer, old age, and dead.

    Do you want dead? Go for another bon-bon and let me know how that works out for you.

    In seriousness, it doesn't CAUSE cancer, but it feeds cancer. Have you ever given a stray cat some food and then you wake up the next day and there are 75 felines perched on your headboard watching you sleep? Sugar is like that for cancer except cancer kills hence the deadness you also get from sugar.

    I'm tempted to just eat steak constantly and wash it down with that delicious half-and-half I love.
    Noooooo! I don't want dead!

    Amy Mossoff of The Little Things -- another favorite blog of mine -- posted a more serious review of Taubes' book a few days ago. Here's the first paragraph:
    I strongly recommend Good Calories, Bad Calories, by Gary Taubes. If you haven’t heard of it, the subtitle is, "Challenging the Conventional Wisdom on Diet, Weight Control, and Disease," and that is an understatement! This book turns everything you thought you knew about nutrition on its head, or at least attempts to.
    Go read the whole thing. While I'm doubtful of some of Amy's remarks, her review seems fair based on my recollection of the book.

    Honestly, I need to re-read the book, as it's hard for me to separate what I learned from it from all that I've read on these topics since then. In particular, I'm just not sure where my present views might differ from Taubes' views in that book. I'll be very interested to find out -- and I'm sure that I'll learn tons more from re-reading it!

    In response to Amy's review, I posted the following general comment concerning my reasons for eating as I do. Just to set some context, it's partly a response to a commenter who said:
    ...the general point here is just that, if one practices the same scrutiny and careful skepticism in regard to "the carb hypothesis" that Taubes et al. practice in debunking "the fat hypothesis", one finds that the former, while surely better supported by the evidence than the latter, remains just a strong hypothesis -- not an established certainty. And given the cost and inconvenience of implementing "paleo", that is a very important difference.
    So without further ado, here's my comment:
    Regarding Taubes' positive hypothesis about carbohydrates, I do think that much remains to be discovered and understood. I tend to think that Stephan [of the stellar Whole Health Source] is right that various non-paleo foods (including tubers, grains, and dairy) can form part of a healthy diet -- provided that they are prepared properly. That's what the comparative data from various cultures suggests. (Stephan has blogged about that extensively. I'd like to do more reading on it myself.) Of course, individuals will vary in their tolerances for foods -- and I think it's critical to attend to the feedback of one's own body.

    Notably, I would not be willing to trouble myself with eating as I do simply based on the scientific evidence to date. However, I am committed given that (1) I enjoy eating more than ever before, (2) I feel so much better than ever before, (3) I've easily lost nearly 20 pounds after much fruitless effort in years past, and (4) my bloodwork has improved. Notably, part of my feeling better is simply a matter of energy levels and the like. However, it's also about the end of my pathological relationship to sugar. The costs of that -- in terms of my health and happiness -- were far, far greater than any trouble to eat as I do.

    As it happens, I also love to cook. However, I spend less time cooking than I used to do, and my meals are tastier. Plus, although I spend more money on higher-quality foods, Paul and I eat out less, so our food expenses haven't increased. Plus, I'm fascinated by the workings of traditional methods of food preparation, e.g. fermenting milk into kefir. (That's hardly necessary to the diet, however.)

    The only problem with my diet is that eating what other people serve can be tricky. Yet even then, I'm pretty flexible. I just need to avoid the bread, pasta, and sugar. (If I don't, I'll feel miserable.) With individuals, I can indicate my preferences beforehand. With restaurants, I order only what I want to eat. With banquet-type meals, I just eat what I want and leave the rest. If all else fails, I can easily skip a meal or two or three because my body can easily draw on its fat reserves rather than crashing without fresh input of carbs.

    So all things considered, I cannot see that my diet involves any noteworthy costs. (Of course, I did have some "start-up" costs as I figured out what to eat when, but those faded with time.) Of course, for other people, the benefits might be less and the costs greater. I wouldn't dispute anyone's choice in that, so long as they eat with their eyes open.
    Again, if you're interested in a serious discussion of the science of nutrition -- including the serious corruption introduced by government interference -- I strongly recommend that you read Good Calories, Bad Calories. Your rewards for this effort will be many -- including the guilt-free enjoyment of all kinds of deliciously fatty foods.

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    Evolution in Action

    By Diana Hsieh

    Back in January, I blogged about the routine use of antibiotics in livestock. As I explained, I'm opposed to the practice, particularly due to its potential to create resistant strains of bacteria harmful if not deadly to humans. Not long after I wrote that post, I found this report from Scientific American: A New Strain of Drug-Resistant Staph Infection Found in U.S. Pigs. Here's a bit from the article:

    A strain of drug-resistant staph identified in pigs in the Netherlands five years ago, which accounts for nearly one third of all staph in humans there, has been found in the U.S. for the first time, according to a new study. Seventy percent of 209 pigs and nine of 14 workers on seven linked farms in Iowa and Illinois were found to be carrying the ST398 strain of methicillin-resistant Staphylococcus aureus (MRSA).

    The study marks the first time researchers have tested for the strain in the U.S., so there's no way yet to tell when or how it arrived or how widespread it may be, says Tara Smith, an assistant professor of epidemiology at the University of Iowa in Iowa City and lead author of the study published today in the online Public Library of Science journal, PLoS ONE. The infection "could be due to movement of animals from farm to farm, or it could be de novo acquisition of [resistance] on this farm," she says. "It is such a small sample that we don't know whether it has larger significance or not."
    The article is short, but it includes quite a bit of detail. I definitely recommend reading it in full if you're interested enough to form even a preliminary opinion on this topic.

    Personally, I'd very much like to see more research on the effects of the the routine use of antibiotics in livestock. Based on our general knowledge of evolution and antibiotics, we have good reason to think that the practice would create antibiotic-resistant strains of bacteria, including strains harmful if not deadly to persons and property. Based on the above quote from the researcher -- a different Tara Smith than the author of Ayn Rand's Normative Ethics, I imagine -- the matter hasn't been studied in any substantial or systematic way. Consequently, the dangers could be very real, yet largely unknown. Or they could be minimal. It would be good to know one way or the other.

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