Friday, January 23, 2015

Time offers "The Science of Epidemics" in supermarket counters


Time Magazine offers an illustrated coffee-table booklet “The Science of Epidemics: Inside the Fight Against Deadly Diseases, from Ebola to AIDS”, now often found in supermarkets and pharmacies. The book is edited by Siobhan O’Connor, and comprises 112 pages, large paper, with many photographs and charts.
  
There are 17 chapters, with many of them dedicated specifically to Ebola. Some of the chapters had been published before in individual Time issues, or online.
  
In the early chapters, the facility for treating Ebola at Emory University in Atlanta is seen as an “ark” where everything has been thought of.   It views the difficulty that Texas Presbyterian Hospital in Dallas encountered with its first Ebola patient from Liberia as understandable.
  
The world is simply not prepared for the enormously labor intensive aspect of Ebola patient care.  In Liberia and west Africa, officials had been making arrangements for people to be cared for at home by other family members, rather than brought to hospitals, and this would obviously put others in a household at grave risk.

The book reasonably explains with Ebola is very infectious but not “contagious” in the way that flu is. 

But then the book moves on to other major scourges, with influenza being the biggest.  It explains what the “H” and “N” mean (regarding how viruses enter and then leave cells).  It maintains that the 1918 Spanish flu epidemic was so deadly to young adults precisely because for about twenty years there had been no H1N1 virus around, whereas older people had built up some previous exposure.  The 2009 H1N1 outbreak seems to have been less virulent, however.

The book does explain the way influenza lives in birds and other farm animals.  Most “bird flus” don’t easily become transmissible person-to-person, but if one does there is grave risk of a major epidemic

Although much is made about mutations and the effectiveness of influenza vaccines, in practice it seems as though adults get repeated vaccinations and small exposures to a variety of forms of flu over the years, their immune systems become able to respond to similar but mutated viruses, resulting in shorter illness with less severe symptoms. I always get the flu vaccine.  In 2002, while in California, I got a flu-like illness with two separate spikes of dry cough, chills and fever.  In March 2011, I got a flu-like illness for a couple days and missed the SLDN dinner (I would have made the donation anyway/.  The vaccines are far from perfect, especially this year, but they will usually blunt the symptoms of distantly related strains. 
    
The magazine discusses other epidemics, such as plague, polio and measles.  With polio, it seems that paralytic cases increased once indoor plumbing was introduced in the early 20th Century.  When people used outhouses, they were exposed to very small amounts of virus that tended to immunize most of them. 

The book is critical of people who refuse vaccinations or to let their kids be vaccinated.  Such families are often higher income.  But the result is lower “herd immunity” and a greater risk that an epidemic can tale hold. The recent measles outbreak from visitors to Disney theme parks related to parents not having vaccinations done.  I had measles in age 6 in 1950, and perhaps it did some damage. 
    
The book gives a somewhat detailed account of how China handled SARS, and later Middle Eastern countries dealt with MERS.  These infections can cause severe pneumonias in a substantial fraction of cases, even though similar coronaviruses are usually rather harmless, causing colds and laryngitis. 
The book could give more coverage on the way infection control procedures and quarantines could affect the lives of people inadvertently exposed, with the monitoring and “social distancing” required.  Some bar and restaurant businesses probably could not survive a major pandemic with the related public health closings.

In some pandemics people who “recover” might be expected to “volunteer” to help the sick, since they would be immune. Until there is a vaccine for Ebola, it will be a real challenge for people to go there to volunteer, given in addition the mandatory isolation period upon returning.

The last chapter covers the attempts in San Francisco to wipe out active HIV with the RAPID (Rapid Antiretrovirual Program Initiative for new Diagnoses) program.  There is a chart showing that now 53% if HIV transmission happens with male-male sex, and 27% male-female, but relatively little female-male. It is that observation that the religious right tried to manipulate in the 1980s with attempted anti-gay legislation in Texas, that did not pass.


The book tends to pooh-pooh theories that bloodborne viruses will mutate in a way to become easily contagious.

Wikipedia attribution link for Ebola Virus Disease diagram, HHS (p.d.)   

Another picture:  from the Franklin Institute.  But many viruses have serious central nervous system effects.  Is that "Donovan's Brain"? (a 1950s movie).  

Monday, January 12, 2015

Andrew Keen: "The Internet Is NOT the Answer": is amatuerism deceptive?


Author:  Andrew Keen

Title: “The Internet Is NOT the Answer
  
Publication: 2015, Atlantic Monthly Business, ISBN 978-0-8021-2313-8, 270 pages, hardcover (also ebook), Preface (“The Question”), Introduction (“The Building Is the Message” --  insert the adverb “not”), Conclusion” (“The Answer”), and eight chapters

Amazon link
  
The author had authored “The Cult of the Amateur: How Today’s Internet Is Killing our Culture” (Jue 26, 2007 here), which gives a pretty good clue as to where he is coming from.

I could start like a literature professor making up a final exam, by citing a few delicious quotes from the book, that could stimulate some student essays:

On p. 95 he writes “Peter Thiel has everything: brains, charm, prescience, intellect, charisma; everything, that is, except compassion for those less successful than him.”  Note: “charm” is also a property of a sub-atomic particle or quark.

On. P. 105 he writes, “The truth is that networks like Instagram, Twitter or Facebook is that their easy-to-use, free tools delude us into thinking we are celebrities. Tet, in the Internet’s winner-take-all economy, attention remains a monopoly of superstars.  Average is over, particularly for celebrities.” He then names Justin Bieber as an example. I just laughed.  Bieber has covered his boyish body, even forearms, with ugly tattoos because he has almost no expected Caucasian male body hair (as my buddies at Fort Eustis would have said ungrammatically in 1969, “he’th’mooth”).  Neither did Ronald Reagan.  And article in Christopher Street back in in 1985, in those grand old days of print journalism that Keen says is dying, there was indeed an article that proposed “better men” as role models for the public, gay or not.  In fact, I’m reminded of a June 1999 piece in the Weekly Standard (when conservative print commentary was still somewhat in flower) by David Skinner, “Notes on the Hairless Man”, where he talks about “men without chests” and describes our fascination with the immature – which indeed the Internet has fed. 

On p. 200 Keen writes “The libertarian fantasy of private companies usurping government is, I’m afraid, becoming a reality”.


The opening “Question” is more a statement, a gripe, that the Internet has promoted the new instantiation (java-style) of monopolists, and exacerbate economic inequality.  The “answer” is rather like that from George Soros, commenting on how to prevent another 2008 financial crisis in banking and securities, “better regulation”.  Not more, but “better”.  It sounds rather innocuous.  Keen also says younger adults need to learn from history.  I’ll echo that.  Most well-educated gay men now in their 20s have no real concept of what I lived through.
  
  
For much of his book, Keen is simply reiterating what has happened repeatedly from times before the industrial revolution.  Technology, all the way back to the printing press, destroys jobs, and also shakes up an existing political power structure (often religious in the past), in order to displace it with a new one that will create its own problems.  In the 19th century, passenger railroads destroyed the stagecoach.  Then the private auto destroyed most passenger railroads in the US, but not in Europe and Japan, which provides another lesson (hint: population density matters).  He gives many examples, such as the decimation of the city of Rochester NY, home of Kodak, which lost out to the digital revolution in photography. 
  
In my own career field, mainframe computing, it would seem that “client server” and Internet technology “destroyed” it, but the picture is complicated, in large part by the waves of business mergers and consolidations that started under Reagan that started well before the Internet revolution, and more so by short-sighted personnel practices that became common after Y2K 
  
In fact, the new wave of big successful Internet companies that “run our lives” followed the “dot com bubble bust” where the Web 1.0 world simply didn’t deliver to consumers what they wanted or had expected.  Keen talks about how an “autistic” (or is he an “extraterrestrial” alien from panspermia) Mark Zuckerberg conquered the world peacefully by writing computer code, because he seemed to give young adults what they thought they wanted – more sharing.  And it turned out to have a dark side. 
  
Indeed, we could credit Facebook (in combination with what I did first, by setting up a free “do ask do tell” compendium that simply would not go away because, to quote one of Reid Ewing’s lost videos – “it’s free”) with the end of “don’t ask don’t tell” for gays in the military, because, in large part, Zuckerberg made double lives impossible, almost by intergalactic regal pronouncement.  (Jupiter is indeed rising, or is it Saturn’s moon, Titan?)  I think he probably knew about my work when he was a freshman at Harvard and the military policy garnered constant attention by the ban of recruiters on campus.
  
Facebook also ended the “conflict of interest” concern that I had about search-engine accessible amateur content written by people in positions of authority – simply because everybody had to use it.  But the presence of Facebook (almost parallel to the old arguments about the “presence” of gay men  in military barracks) in the world meant that no one could have a sales career (like that of a life insurance agent) without  dedicating their online presence to the benefit of their employer – to hock someone else’s wares.  So Keen is right – the monopolization of the Internet (financially) really turned it into a new instrument of social conformity.  But perhaps the Internet has even destroyed the old idea of making a living in sales (the way my parents’ generation could) forever.
  
Keen brings up many real specific problems.  It seems wrong that Uber drivers shouldn’t obey the same rules as licensed taxi drivers.  When I see these new services about sharing one’s car for rental or home as a hotel, I am of course reluctant to do this, because of the work required and concern over security, but does that mean I am spoiled and unsociable?  Right there, a moral paradox emerges. 
He is right that piracy as problem, and as with many Internet problems (preventing cyberbullying and keeping porn away from kids – related to the COPA case to which I was a party) attempts of “better regulation” tend to lead to overbroad laws that get struck down.  Remember the SOPA bill in 2011, and the Wikipedia black out in 2012?  Remember the overzealous prosecution of Aaron Swartz? 
So how displaced people are seems to be a matter of where you look.  Most younger adults in my orbit are finding jobs OK – in IT, in film, in new journalism (Vox media keeps hiring).  But most people in my orbit competed better than average.  So, I think we get back to looking at the morality of some of this in terms of personal compassion, not just policy.
  
Indeed, the “destruction” of unions and of the stable manufacturing workplace was going on long before the Internet “gilded age”  Remember the NYC crisis of 1975?  (“Ford to City: drop dead!)  I lived through this.  We need to know our history.

And true, you can’t legislate “noblesse oblige”.  But today’s “industrialists” are indeed giving back billions.  Look at the Gates foundation, aimed at wiping out AIDS. 

Keen’s comments do intersect my life.  I used to collect vinyl classical records and then CD’s, and I remember the days of the record store (like Tower Records, or even old Record Sales in downtown Washington DC in 1962, cheaper than the stuffy “Disc Shop” above Dupont Circle). My father complained that I was “married to my records”, and you get my point: excess (and resistance of socialization) happens in any level of technology (almost). Today, I think it’s fine to collect mp3 files – if you pay for them on Amazon, keep them in the Cloud (and back them up on just one optical CD) along with PDF program notes.  It’s a lot easier to keep a collection than a physical one every time you do a household move.  I also built a large library of chess opening books – that’s another discussion.

The book points out that "amateur" posters and even book authors often make little money from their work, because the host companies often keep most of the revenue (whether ads, for from book sales, as with supported self-publishing).  On the other hand, most "amateurs" would not be able to get conventional trade publishers or movie studios to "publish" their work at all. 
    
The Internet has worked out well for me, because I don’t need to make money from my content.  That’s partly because I did save some money when I was working  -- because I did save and was prudent in the stock market – enough indeed to ride out one bad real estate misadventure.  But it’s also because I did inherit from my parents – all of which makes my “paradigm” more morally problematic.  If I had to make a living today from the Internet – it my content had to pay it’s own way, and not depend on being subsidized by rentier wealth from earlier successes and even the family – it couldn’t stay up.  I would have to do “what other people want”.  And that would be morally problematic in its own way.  Again, hucksterism is no longer an option, because of the Internet. Spying and privacy has been less a problem for me than for others because I didn't have children -- but that raises its own flip side. 

If I had to "compete" in a normal way for "influence", by, say, running for office (which people have asked me why I don't do it) and asking people for campaign money, would that be morally better? 
       
I did benefit from a court bias that looks at amateur individual speech as “almost” as protected as the speech of establishment journalists.  In large part that is partly the result of the DMCA safe harbor, Section 230, and rulings on the CDA and COPA censorship attempts. It might not have gone that way.  I might have had to do something else and hold my nose.   

Wikipedia attribution link for Rochester NY aerial.  My last visit was in 1992, as I recall. Author is Chris Tomkins-Tinch, CC-SA 3.0 license, unported. 



Friday, January 02, 2015

"Religious Liberties for Corporations": Gans, Shapiro and Rosen examine the Hobby Lobby case


Authors: David H. Gans and Ilya Shapiro; Introduction and moderation by Jeffrey Rosen

Title: “Religious Liberties for Corporations: Hobby Lobby, the Affordable Care Act, and the Constitution

Publication: Palgrave macmillan, 2014, ISBN 978-1-137-48467-3 hardcover (also paper and e-book), 80 pages, Introduction, four chapters, conclusion
  
Amazon Link here
  
First, let mention that this is very pricey for a short professional book.  I paid $40 at a Cato book forum (reviewed on the Issues blog, Dec. 16, 2014).

David H. Gans is Director of Human Rights, Civil Rights and Citizenship Program, Constitutional Accountability Center.  Ilya Shapiro is Senior Fellow in Constitutional Studies, Cato Institute.  Jeffrey Rosen is President of the National Constitution Center.
  
The first chapter is “What rights do corporations have?” by Rosen and (mostly) Gans.
Chapter 2 is “Corporate personhood and religious liberty”, a debate between Gans and Shapiro moderated by Rosen.
  
Chapter 3. is “The broader implications of Hobby Lobby: Is there a slippery slope?”, a debate based on the oral arguments made to the Supreme Court.
  
Chapter 4 is “The Ruling: What does it all mean?”, again, another debate.
  
The context of the book is best explained by the case “Burwell v. Hobby Lobby”, decided by the Supreme Court June 30, 2014, as explained here on Wikipedia, link, slip opinion from SCOTUS here

The background is that the owners of Hobby Lobby, a for-profit closely held corporation in Oklahoma, did not want to comply with a “Patient Protection and Affordable Care Act” (“Obamacare”) requirement to pay for (female) employees’ use of certain contraceptives (those regarded as abortifacients) because of the religious beliefs of the owners.  Ultimately, the company prevailed in this case. The case was combined with that of Conestoga Wood Specialties, owned by Mennonites, in Pennsylvania.

The legal question sounds like a mouthful of words.  The Religious Freedom Restoration Act (RFRA) of 1993 and amending Religious Land Use and Institutionalized Persons Act (RLUIPA), 2000, stipulate (together, more or less) that a private party exercising religion may, when confronted by a government regulation or law, demand that the government measure meet “strict scrutiny” and pass a test of being the least restrictive means to achieve a compelling state interest.  But in general courts have been unwilling to allow religious exemptions to “laws of general applicability” because to do so would make every person a “law unto himself” with respect to religion, although that may sound like a libertarian goal (I even referred to the idea in the introduction of my first DADT book in 1997). 

  
The decision is limited to closely held corporations, where the owners are largely using their own money.  (I know this sounds silly, but that reminds me of Sonny’s bar in “Days of our Lives”.) It would not hold for publicly held companies using investor money through normal securities markets.  On the surface, Shapiro’s argument, that the decision protects the right of individuals to use their own personal resources as they see fit, according to conscience, seem to make sense.  On the other hand, Gans insists that the decision is precedent-setting, and that corporations, given other “rights” or perpetuity, should not have some rights that obviously can apply to individuals.  Employees, they say, are checking their rights at the door.  The libertarian will say, why should not a woman who wants to have her health insurance pay for a particular contraceptive simply work for a company or and owner with no particular objection? I’ve always felt a little uneasy about this particular issue in the ACA.  It sounds like asking for individual business owners to pay for someone else’s sexual intercourse.
On p. 61, there is a telling quote from Justice Alito, about “circumstances under which it is wrong for a person to perform an act that’s innocent in itself, but that has the effect of enabling or facilitating the commission of an immoral act by another.”  (“Enabling” was a dangerous word in the 1930s.)  That to me brings up a lot of previous debate about sexual “morality”, including even previous defense of now overruled sodomy laws. 
  
Keith Hughes explains the Hobby Lobby case here.
  
  
Amy Howe discusses the case on the Scotus Blog here.
  
In my own life, I’ve taken the idea that “who you work for” and how you earn a living – whether it creates conflicts with other moral beliefs – is something that matters.  This whole question, about a possible conflict back in the 1990s over publishing a book dealing, in large part, with gays in the military and at the same time working for a company subsidiary whose business depending on selling life insurance to military officers, led to a (beneficial) corporate transfer and relocation to Minneapolis in 1997, although I returned “home” with an “exodus” in 2003. 
Update: Feb. 3  
The Hobby decision was mentioned, though not favorably, in a case with an Oregon wedding bakery, see LGBT blog Feb. 3.