RFKjr! OMG "why would a former herion addict be put in position of power over Heatlh and Human services" ?

Echo opinion What's Next for Public Health, by Dr. Ashish K. Jha* 

The hurricane of nominations by President-elect Donald Trump has the country reeling and trying to understand just how 🌪️ big a storm is coming and what it will bring.  🌪️🌀💥

There are big winds  blowing around the nomination of Robert F. Kennedy Jr. as secretary of health and human services, with related health care appointments feeding the storm. At this time of uncertainty for public health, it’s important to understand what these nominations mean for the health of the American people.

There are challenges to be sure. More people have health insurance, but health care costs are still too high. COVID-19 has left empty seats at too many tables this Thanksgiving. But there’s been much progress in public health, and the data prove it. Fewer people are dying from heart disease. Cancer deaths are down. Even our latest public health scourges — opioids and respiratory disease like COVID — are on track to cause fewer deaths. In the past 50 years alone, life expectancy in the United States has increased by nearly a decade.

Understanding what is — and has been — driving progress also brings an understanding of what’s at risk in these nominations and what they will mean to health care and the health of the American people. Over generations, progress has been driven by data and science, rigorously collected, analyzed, and translated into action and policy. It is a dynamic process, with our understanding of what works and what doesn’t continually improving over time and experience. Scientific exploration is constantly expanding, fueled by new technologies and a continuous supply of new insights and information.

The Department of Health and Human Services, with a budget of nearly $2 trillion, has been responsible for much of this progress in health. It includes the Food and Drug Administration, the Centers for Disease Control and Prevention, the National Institutes of Health, and the Centers for Medicare and Medicaid Services. 

For decades of Republican and Democratic administrations, leaders, informed by experts and evidence, have created the rules governing hospitals, doctors, and others providing health care, as well as evaluating medical devices, vaccines, and the regulation of food and medicine to keep Americans safe.

Although there is a need and room for improvement and reform across HHS. But the incoming administration is signaling more: a disturbing change of direction, away from science and data, beyond reform and improvement, to instead take a wrecking ball to the whole place. Its justification is rooted in bumper sticker slogans, pseudoscience, and personal grievances.

Some of those nominated to lead agencies responsible for protecting and improving the health of Americans have long records of pushing bad information — unsupported (and often refuted) by facts, data, or evidence. Consider that Kennedy has argued for an approach to health and medicine antithetical to how we have made progress. 

He espouses ideas that have been widely debunked with data, such as the notion that vaccines cause autism (they don’t) and that HIV does not cause AIDS (it does). He says that on his first day in office, he’ll stop funding research into new medicines and infectious diseases for eight years.

This would stop and reverse the engine of science, data, and discovery that has driven progress improving the health of the American people. There is no apparent plan for a better approach.

Hoping for a cure for a rare cancer that has hospitalized your child? The US government won’t help you find it.

Concerned your elderly parents will skip their flu shots or COVID boosters as vaccines are discouraged❓ Some of the folks being discussed to lead our key public health agencies won’t recognize the link between missed vaccines and deadly illness — though that connection is clear. 

Consider the recent experience in Samoa, where a Kennedy campaign to end childhood vaccinations led to a measles outbreak and 83 deaths, mostly of unvaccinated children.

And Kennedy has promised to hollow out large parts of the FDA. How do we then bring data and science to approve new treatments and improve America’s health? Imagine you depend on insulin every day. Will it be safe? Can we be sure essential food and medicines are safe?

I get it. The pandemic shook people’s trust in key institutions — like the FDA, the CDC, and HHS — and for good reasons. But our work should be to reform these institutions, not erase them, leaving nothing in their place to protect and advance our health.

The bumper sticker slogans are appealing. No one is arguing against protecting Americans from dangerous chemicals or poisons. 

We are all committed to helping Americans eat healthy and stay healthy. But we’ve got to be honest about how we’ve done that and how we can continue to make progress.

Here’s to a confirmation process through the US Senate that provides the critical opportunity for questions to be honestly asked and answered, not just for the senators but also for the millions of Americans they represent. It’s our health that’s on the line.

*Dr. Ashish K. Jha is dean of Brown University School of Public Health and a contributing Boston Globe Opinion writer.

Comment on this opinion:  I consider such (incompetent) nominations to be criminal acts aimed at the health of Americans. 

Musk and Putin are likely telling Trump to nominate people who will weaken and terrify us. I consider Trump to be a criminal who should never have been allowed to run. The danger posed by a man like Kennedy pushes us into an America we have never experienced before--not even in Trump 

Biden should take whatever action he can right now--but failure to get Trump where he belongs in jail long before this has led us to this nightmare.

Incompetence in charge of our nation's health❓😠 "I can't understand why a former herion addict woul be put in position of power like this one will."

Chief Justice Roberts fails to keep the Supreme Court from being a right wing rubber stamp

 https://www.nytimes.com/2022/07/01/opinion/supreme-court-epa-ruling.html

Obviously, tRumpzi’s appointments to the Supreme Court and lower federal courts have spurred charges that the courts are becoming more politicized.

Maine Writer opinion: Chief Justice John Roberts leads a Supreme Count that has put women's health at risk of death by preventing access to reproductive services and, now, puts public health at risk, by obstructing environmental safety regulations.

The Supreme Court Sabotages Efforts to Protect Public Health and Safety

On Thursday, the Supreme Court’s conservative majority, with its 6-3 ruling in the case of West Virginia v. Environmental Protection Agency, curtailed the power of the agency to protect the environment, and specifically to require the reductions in emissions that are urgently necessary to limit global warming.

President Donald Trump and Chief Justice John Roberts clashed Wednesday in an extraordinary public dispute over the independence of America’s judiciary, with Roberts bluntly rebuking the president for denouncing a judge who rejected his migrant asylum policy as an “Obama judge.” But, there’s no such thing, Roberts declared in a strongly worded statement contradicting Trump and defending judicial independence. (IMO Justice Roberts has lost control of the conservative Justices.  He should resign!)

In fact, the conservative court’s ruling constrains any effort to tighten restrictions on carbon dioxide emissions from power plants. It also threatens the Biden administration’s ability to impose new limits on tailpipe emissions from cars and trucks and on methane emissions from oil and gas facilities. As the three members of the court’s liberal minority wrote in a stinging dissent, the majority’s decision strips the E.P.A. of the power “to respond to the most pressing environmental challenge of our time.”

The Biden administration, already struggling to persuade Congress to invest in renewable energy and compelled by Russia’s invasion of Ukraine to push for increased production of fossil fuels, once again finds its ambitious goals for confronting climate change slipping beyond reach. The court’s adversarial posture means that the administration must double down on its efforts to win congressional support for its spending plans. President Biden and Democratic leaders should also press to pass legislation clarifying the E.P.A.’s (Environmental Protection Agency's)  authority to regulate emissions.

John Roberts was friends with U.S. Senator Ted Cruz: Message to Chief Justice Roberts from his mother, "Beware of the (conservative) company you keep."

Thursday’s ruling also has consequences far beyond environmental regulation. It threatens the ability of federal agencies to issue rules of any kind, including the regulations that ensure the safety of food, medicines and other consumer products, that protect workers from injuries and that prevent financial panics.

Chief Justice John Roberts failed to prevent the Supreme Court from becoming an arm of right wing politics.  Roberts must resign.

In 1984, an earlier generation of conservative Supreme Court justices formalized a doctrine of deference to the judgment of regulatory agencies, modestly concluding that judges were neither experts nor elected officials, and therefore ought to leave such decisions in other hands. In Thursday’s decision, the court asserted that the policy of deference applies only to supposedly unimportant regulations. When it comes to “major questions” of regulatory policy, the court said, it would not hesitate to second-guess regulators — and to strike rules that it decided did not have a clear congressional warrant.

The decision amounts to a warning shot across the bow of the administrative state. The Supreme Court’s current conservative majority, engaged in a counterrevolution against the norms of American society, is seeking to curtail the efforts of federal regulators to protect the public’s health and safety. The court already invoked a similar logic during the COVID pandemic to strike down workplace Covid testing requirements and a federal moratorium on evictions. And by refraining from defining a threshold for what constitutes a “major question,” the court is leaving a sword hanging over every new rule.

The West Virginia case has its origins in 2015, when the E.P.A. imposed new limits on carbon dioxide emissions from coal-fired power plants. The agency determined that it was impossible for those plants to reduce emissions to what it regarded as a safe level while producing the same amount of electricity. Burning coal is simply too dirty. Accordingly, it directed companies to cut emissions by reducing output or by shifting to other forms of power generation.

Unfortunately, the rule never took effect. The court stayed its implementation in 2016, and the Trump administration withdrew it in 2019. But the litigants, including the states of West Virginia and North Dakota and a pair of coal companies, pressed ahead with a lawsuit to make sure the rule stayed dead.

Chief Justice John Roberts, writing for the majority, agreed with their claim that the E.P.A. did not have the authority to require companies to shift resources to other kinds of power generation. Mr. Roberts wrote that the court’s longstanding policy in such cases of deference to the agency’s own assessment of its authority did not apply because the stakes were too high. It is a theory long championed by Justice Neil Gorsuch, who explained in a concurring opinion that “administrative agencies must be able to point to ‘clear congressional authorization’ when they claim the power to make decisions of vast ‘economic and political significance.’”

The E.P.A. clearly has the legal authority to set an acceptable standard for emissions, in this case of carbon dioxide, and then to impose restrictions on emitters, in this case coal-fired power plants. The court did not contest these facts. Instead, it ruled that the Clean Air Act does not provide the E.P.A. with sufficient authority to achieve those emissions standards.

Chief Justice Roberts described this conclusion as a defense of congressional authority — an assertion of the primacy of elected officials. But constraining the power of regulatory agencies should not be understood as a shift in the locus of decision-making; rather, it effectively prevents good decisions from being made.

Congress has decided, and with good reason, that regulatory agencies staffed by experts are the best available mechanism for a representative democracy to make decisions in areas of technical complexity. The E.P.A. is the entity that Congress relies upon to figure out how clean the air should be, and how to get there. Asserting that it lacks the power to perform its basic responsibilities is simply sabotage.

It is a telling fact that power producers, in response to market forces, have achieved the shift to cleaner energy that the E.P.A. sought to require in 2015, validating the agency’s assessment of what it could reasonably mandate.

Chief Justice Roberts’s predecessors recognized their own limitations. In the 1984, ruling that formalized the court’s policy of regulatory deference, Justice John Paul Stevens wrote that “judges are not experts in the field and are not part of either political branch of the government.” Both points are important. The court lacks technical expertise and an electoral mandate. Thursday’s decision asserting a more muscular role is thus a blow to both the public interest and democracy.

Donald Trump's Sophie Choice - public health or financial pain

"Public health risks need to be addressed with stringent public health measures; economic risks must be addressed with various economic measures. Mixing these risks and strategies will only result in worse public health outcomes (potentially a million lives lost) as well as worse economic outcomes..." Leonard M. Fleck.

Ethics professor: In the coronavirus crisis, don't prioritize economics over public health- an echo opinion published in the Detroit Free Press by Leonard M. Fleck.

Donald Trump said this week that he hopes to see economic activity ramped up and social distancing practices and other public health measures reduced (as soon as possible, even prior to the designated May 1, 2020 target date). 

This is a recipe for disaster and it again vividly illustrates his dismissal of medical and scientific expertise for his own political goals.

The rhetoric he uses suggests that the financial pain the nation will experience over the next year or longer is not worth the lives that will be lost as a result of dialing back public health restrictions. I am an ethicist. To me, Trump is forcing Sophie’s Choice decisions by people who have taken an oath to “first do no harm.” Trump and his advisers ignore the ethical pain that health professionals will have to endure who must decide who lives and who dies because we have too few ventilators or too few ICU beds to treat all the patients who need those beds for survival. Those harsh choices are very real right now. They would become even more tragic if public health measures now in place were loosened in order to improve economic activity.

Trump casually and thoughtlessly suggests that many fewer lives will be lost as a result of loosening public health restrictions regarding COVID-19 than is currently the case with the flu season (60,000 lives) or automobile accidents (40,000 lives). 

However, these analogies are entirely misleading. We have vaccines and effective treatments for addressing the flu. Some people choose not to get the vaccine. That is often a tragic choice. Auto accidents are also very often the result of bad personal choices: excessive speed, distracted driving, drunk driving. 

These are not things that can be readily controlled through public health measures of any kind. By way of contrast, we have no vaccine and no cure on the horizon, in spite of grossly exaggerated reports earlier this month from the Trump administration to the contrary. Further, we now know that asymptomatic people can infect others with COVID-19. That makes the virus especially insidious. That is the relevant medical scientific fact that requires the social distancing practices emphasized by every public health official.

Readers can readily recall the casual “happy talk” promulgated by Trump that the virus was completely under control several weeks ago and that we would have drugs to cure it in no time at all. We now have instead “unhappy facts,” such as 80,000 infected in the US and more than 1,000 deaths. We are very much on a steep upward curve in this regard that Dr. Fauci and other health experts expect to continue for at least the next seven to eight weeks, assuming that the stringent public health measures now in place remain in place for at least that period of time. Relaxing those measures would only result in something much worse with respect to the loss of life. 

Recall the recent images in the news of college students partying on the beach in spite of the risks of transmission (remember we do not know who is infected but asymptomatic). Those images generated a substantial public outcry regarding how irresponsible that behavior was. Trump relaxing public health and social distancing measures so that young and healthy people can go back to work, then have a friendly drink at the local bar after work, essentially says that the college student behavior was acceptable. 

Economically, the worst-case scenarios suggest a 24% decrease in GDP (Gross Domestic Product is the monetary value of all finished goods)  for the next quarter, not much better beyond, and 10% unemployment. However, the economic pain can be reduced by the $2 trillion dollar package Congress is poised to pass. If properly crafted, it will put money in the hands of workers that will allow them to buy food, pay their rent and utility bills and sustain the economy in that way. Millions of people are successfully and productively working at home and maintaining public health at the same time. That is the real take home message that Dr. Fauci and many others are emphasizing. 

Public health risks need to be addressed with stringent public health measures; economic risks must be addressed with various economic measures. Mixing these risks and strategies will only result in worse public health outcomes (potentially a million lives lost) as well as worse economic outcomes, though those will be a bit further out, likely past November. My apologies, I forgot to say anything about political risks. But the astute reader can figure that out.

Leonard M. Fleck is a professor and director of the Center for Ethics at Michigan State University's College of Human Medicine.

Measles could be eliminated by now

https://www.theatlantic.com/magazine/archive/2019/08/measles-as-metaphor/592756/?fbclid=IwAR352CLCX05zq9j-bzDp75J5nOo77Xnm7qtePRrzbD8AsN9wcMzUJ_otHFc

PETER BEINART is a contributing writer at The Atlantic and a professor of journalism and political science at the City University of New York.

HEALTH: What the Measles Epidemic Really Says About America
Echo published in The Atlantic in August 2019:

The return of a vanquished disease reflects historical amnesia, declining faith in institutions, and a troubling lack of concern for the public good.

In two essays, “Illness as Metaphor” in 1978 and “AIDS and Its Metaphors” in 1988, the critic Susan Sontag observed that you can learn a lot about a society from the metaphors it uses to describe disease. She also suggested that disease itself can serve as a metaphor—a reflection of the society through which it travels. 

In other words, the way certain illnesses spread reveals something not just about a nation’s physiological health but also about its cultural and political health. For instance, AIDS would not have ravaged America as fully as it did without institutionalized homophobia, which inclined many Americans to see the disease as retribution for gay sex.

Now, another virus is offering insights into the country’s psychic and civic condition. Two decades ago, measles was declared eliminated in the U.S. Yet in the first five months of this year, the Centers for Disease Control and Prevention recorded 1,000 cases—more than occurred from 2000 to 2010.

The straightforward explanation for measles’ return is that fewer Americans are receiving vaccines. Since the turn of the century, the share of American children under the age of 2 who go unvaccinated has quadrupled. But why are a growing number of American parents refusing vaccines—in the process welcoming back a disease that decades ago killed hundreds of people a year and hospitalized close to 50,000?

One answer is that contemporary America suffers from a dangerous lack of historical memory. Most of the parents who are today skipping or delaying their children’s combined measles, mumps, and rubella (MMR) vaccine don’t remember life with measles, much less that it used to kill more children than drowning does today. Nor do they recall how other diseases stamped out by vaccines—most prominently smallpox and polio—took lives and disfigured bodies.

Our amnesia about vaccines is part of a broader forgetting. Prior generations of Americans understood the danger of zero-sum economic nationalism, for instance, because its results remained visible in their lifetimes. When Al Gore debated Ross Perot about NAFTA in 1993, he reminded the Texan businessman of the 1930 Smoot-Hawley Tariff Act, which raised tariffs on 20,000 foreign products—prompting other countries to retaliate, deepening the Great Depression, and helping to elect Adolf Hitler. But fewer and fewer people remember the last global trade war. 

Similarly, as memories of Nazism fade across Europe and the United States, anti-Semitism is rising. Technology may improve; science may advance. But the fading of lessons that once seemed obvious should give pause to those who believe history naturally bends toward progress.

Declining vaccination rates not only reflect a great forgetting; they also reveal a population that suffers from overconfidence in its own amateur knowledge. In her book Calling the Shots: Why Parents Reject Vaccines, the University of Colorado at Denver’s Jennifer Reich notes that starting in the 1970s, alternative-health movements “repositioned expertise as residing within the individual.” This ethos has grown dramatically in the internet age, so much so that “in arenas as diverse as medicine, mental health, law, education, business, and food, self-help or do-it-yourself movements encourage individuals to reject expert advice or follow it selectively.” Autodidacticism can be valuable. But it’s one thing to Google a food to see whether it’s healthy. It’s quite another to dismiss decades of studies on the benefits of vaccines because you’ve watched a couple of YouTube videos. In an interview, Reich told me that some anti-vaccine activists describe themselves as “researchers,” thus equating their scouring of the internet on behalf of their families with the work of scientists who publish in peer-reviewed journals.

In many ways, the post-1960s emphasis on autonomy and personal choice has been liberating. But it can threaten public health. Considered solely in terms of the benefits to one’s own child, the case for vaccinating against measles may not be obvious. Yes, the vaccine poses little risk to healthy children, but measles isn’t necessarily that dangerous to them either. The problem is that, for others in society—such as children with a compromised immune system—measles may be deadly. By vaccinating their own children, and thus ensuring that they don’t spread the disease, parents contribute to the “herd immunity” that protects the vulnerable. But this requires thinking more about the collective and less about one’s own child. And this mentality is growing rarer in an era of what Reich calls “individualist parenting,” in which well-off parents spend “immense time and energy strategizing how to keep their children healthy while often ignoring the larger, harder-to-solve questions around them.”

Historical amnesia and individualism have contributed to a third cultural condition, one that is more obvious but also, perhaps, more central to measles’ return and at least as worrying for society overall: diminished trust in government. For earlier generations of Americans, faith in mass vaccines derived in large part from the campaign to eradicate polio, in the 1950s—a time when the country’s victory in World War II and the subsequent postwar boom had boosted the public’s belief in its leaders. This faith made it easy to convince Americans to accept the polio vaccine, and the vaccine’s success in turn boosted confidence in the officials who protected public health. So popular was the vaccine’s inventor, Jonas Salk, that in 1955 officials in New York offered to throw him a ticker-tape parade.

In the 1960s, the Johnson administration made mass inoculation one component of the ambitious assault on poverty, ignorance, and disease known as the Great Society. In 1964—a year in which 77 percent of Americans told pollsters they trusted government to do the right thing most or all of the time—the surgeon general established a committee to determine how states should administer vaccines. There was little public resistance. By 1968, half the states required children to be vaccinated to attend school, and the rest soon followed.

As Reich details, today’s skepticism of vaccines has its roots in the alternative-medicine and self-help movements of the 1970s, which encouraged people to question established medical authority. 

This questioning coincided with a post-Watergate, post-Vietnam disillusionment with government that Ronald Reagan exploited when he declared in his 1981 inaugural address that “government is not the solution to our problem; government is the problem.”

As distrust of government has grown, so too has distrust of vaccines. The anti-vaccination movement’s Rosetta stone is a 1998 paper in the British medical journal The Lancet that linked the MMR vaccine to autism. As is well established, the paper was a fraud. Its lead author, the physician Andrew Wakefield, falsified data and received money from lawyers who were suing vaccine makers. The Lancet later retracted the study, and Wakefield lost his medical license. Twenty-one subsequent studies—including a Danish one involving more than 650,000 children—have found no connection between the MMR vaccine and autism.

But with autism rates rising in the United States, Wakefield found followers on the Republican Party’s anti-government fringe. In 2002, Representative Dan Burton, who in the 1990s had repeatedly implied that the Clintons were involved in the death of Deputy White House Counsel Vince Foster, invited the disgraced doctor to testify before his committee. Burton—whose grandson has autism—went on to hold at least 20 hearings, suggesting that government scientists were covering up a link between vaccines and autism.

Burton was a harbinger. After a Republican presidential debate in 2011, one of the candidates, Michele Bachmann, claimed that the HPV vaccine, which protects against cervical cancer, causes mental retardation. While running for president in 2015, Senator Rand Paul—a physician—argued against mandatory vaccinations by asserting that there are “many tragic cases of walking, talking, normal children who wound up with profound mental disorders after vaccines.” And from 2012 to 2014, while Donald Trump was claiming that President Barack Obama hadn’t been born in the United States, he also tweeted more than 30 times about the supposed dangers of vaccines.

Yet it’s not only conservatives who translate their suspicion of government into suspicion of vaccines. Many liberals distrust the large drug companies that both produce vaccines and help fund the Food and Drug Administration, which is supposed to regulate them. The former Green Party presidential candidate Jill Stein has suggested that “widespread distrust” of what she describes as the medical-industrial complex is understandable because “regulatory agencies are routinely packed with corporate lobbyists and CEOs.” The environmental activist Robert F. Kennedy Jr. claims that thimerosal, a preservative formerly used in some vaccines, harms children. Bright-blue counties in Northern California, Washington State, and Oregon have some of the lowest vaccination rates in the country.

Although polls suggest that conservatives are slightly less accepting of vaccines than liberals are, a 2014 study found that distrust of government was correlated with distrust of vaccines among both Republicans and Democrats. Indeed, the best predictor of someone’s view of vaccines is not their political ideology, but their trust in government and their openness to conspiracy theories.

It’s not surprising, therefore, that a plunge in the percentage of Americans who trust Washington to do the right thing most or all of the time—which hovered around 40 percent at the turn of the century and since the 2008 financial crisis has regularly dipped below 20 percent—has coincided with a decline in vaccination rates. In 2001, 0.3 percent of American toddlers had received no vaccinations. By 2017, that figure had jumped more than fourfold. Studies also show a marked uptick in families requesting philosophical exemptions from vaccines, which are permitted in 16 states.

This surge reflects the ease with which conspiracy theories can spread, and not only via social media. Anti-vaccination activists have enjoyed particular success in communities whose cultural isolation makes them easy prey for misinformation. In 2010 and 2011, Wakefield—who now lives in the U.S.—reportedly visited the Somali community in Minnesota three times, and his supporters distributed pamphlets at community events.

As of 2014, the local childhood MMR vaccination rate—which had been 92 percent in 2004—had fallen to 42 percent. By 2017, children of Somali descent accounted for a majority of America’s measles cases.

The epicenter of this year’s outbreak has been the ultra-Orthodox Jewish communities in and around New York City. Here too, anti-vaccine activists have run laps around government and media gatekeepers, who have struggled to keep pace with anti-vaccination misinformation. In May, Wakefield addressed an anti-vaccination rally in New York’s heavily ultra-Orthodox Rockland County, and anti-vaccination messages produced by a supporter have been featured on an influential ultra-Orthodox parenting hotline.

This year’s (2019) measles outbreak appears to have started with people who traveled to Ukraine, where infection rates are high. Which points to a broader problem: Unvaccinated Americans face a growing risk of infection because vaccination rates are declining in Europe too, for largely the same reasons. Many of Europe’s political insurgents—including the German Green Party on the left, and Marine Le Pen’s National Rally in France and Italy’s Northern League on the right—oppose mandatory vaccinations. And a 2019 study of western-European voting patterns in the European Journal of Public Health found “a highly significant positive association between the percentage of people in a country who voted for populist parties and [the percentage] who believe that vaccines are not important.”

Of course, some skepticism toward official information—including information from the intermeshed corporate, scientific, and governmental establishments that regulate public health—is worthwhile. Neither the drug companies that produce vaccines nor the public-health officials who regulate them are infallible. Even during the campaign against polio, one of America’s great public-health triumphs, a laboratory in California manufactured defective batches of the vaccine, which ended up paralyzing 164 people and killing 10. And some Americans have legitimate concerns about the influence that drug companies wield today over the regulators who are tasked with keeping their vaccines safe. But there’s a crucial difference between wanting to insulate America’s regulators from corporate influence and believing that the CDC, the FDA, the National Academy of Medicine, and the American Academy of Pediatrics are perpetrating a massive conspiracy to maim children.

Given America’s crises of memory, expertise, and institutional trust, one might despairingly conclude that, just as America will never restore its now battered political norms, it will never restore the norm of near-universal vaccination that existed in the late 20th century. But there’s nothing inevitable about this trend. If vaccination rates can fall, they can also rise. The key is determined, deliberate action to turn the tide.

Stopping measles also requires empowering doctors (Maine Writer - "and nurses too!"). 

A 2011, Washington State law that required parents to talk with a doctor before getting a vaccine exemption reduced exemptions by 40 percent. And a 2012 study by researchers at Emory and Johns Hopkins found that parents who viewed their doctors as reliable sources of information were less likely to search for material about vaccines online. The problem, as Reich told me, is that pediatricians spend less time with patients than they did decades ago. Changing insurance companies’ reimbursement practices to reward doctors for taking the time to reassure patients that vaccines are safe could push vaccination rates back up.

The implications of all of this go far beyond one disease. Although measles may be the most vivid medical manifestation of America’s political and cultural ailments, it won’t be the last. If Americans won’t take expert advice about something as scientifically proven as the benefits of vaccinating their children, what other life-and-death advice will they ignore?

Since conspiracy theorists thrive when government is corrupt and opaque, Americans can rebuild faith in vaccines by making their approval process more independent and transparent. Congress should provide the FDA with enough funding to review vaccines and other drugs in a timely manner without taking Big Pharma’s money. And it should prevent former bureaucrats from going to work for the drug companies they used to regulate.

Echo opinion in support of vaccines from Mount Desert Island Maine

An echo opinion published in the Maine "Mount Desert Islander" newspaper, by former State Senator Jill Goldthwait, in support of vaccines and the Maine Session 129, legislation LD 798, to remove philosophical exemptions that allows people to opt out without a medical reason for doing so.

Anti-vaxxers who oppose this public health bill are spreading outrageous lies about vaccines via Facebook. Outrageously, they are negatively impacting on the health of Maine people by spreading lies.  Read the story here.  "....spread of misinformation about immunizations has potentially fatal repercussions"

A bill before the Maine Legislature is embroiled in two classic arguments. How do we use science to support political decisions, and how do we balance our individual rights versus those of society? 

The preponderance of evidence supports protecting the public's health.

(MaineWriter - yes and I was among them....) 

AUGUSTA- Hundreds of Mainers showed up in Augusta last week to testify on LD 798, An Act to Protect Maine Children from Preventable Diseases by Repealing Certain Exemptions from the Laws Governing Immunization Requirements. The exemptions the bill would repeal are those based on “religious or philosophical beliefs.” The bill does continue to provide exemptions for those with medical conditions that make vaccination contraindicated.

The impetus behind the bill is outbreaks of childhood diseases thought to be eradicated, or nearly so, in the United States.

In 2000, measles was considered eliminated in the United States, but in 2019 in Washington state, more than 60 cases of measles were identified, more than the average number of cases reported in the entire country in a year. Fifty-four of those affected had not been immunized.

At one time, fewer than 20 cases of mumps were reported each year in the United States. In 2006, more than 6,000 cases were reported. A chicken pox outbreak occurred in 2012 in Indiana, sourced to an unvaccinated child. Here in Maine, we have the dubious distinction of the worst pertussis (whooping cough) rate in the nation. Reported cases more than doubled in month-to-month comparisons from last year to this. The greatest number of cases so far this year were in Hancock County.

An article in 1998 linked vaccinations to autism. Even though later discredited, it is still cited as the rationale for significant numbers of parents to opt out of vaccinations for their children, despite a study through the National Institute of Medicine at the National Institutes of Health finding no “causal association between MMR vaccine, or any other vaccine or vaccine constituent, and autism.”

The link between vaccinations and autism, particularly with the MMR (measles, mumps, rubella) vaccine, is labeled “critically flawed” by Children’s Hospital of Pennsylvania (CHOP).

In a vaccine safety publication, CHOP distinguishes between the terms “safe” and “harmless.” The latter, taken literally, is a test few life activities could pass. “Having been preserved from a real danger” is the safety definition CHOP finds most applicable, in that “a vaccine’s benefits must clearly and definitively outweigh its risks.”

Vaccines cannot be called 100 percent harmless, as there are certainly documented, untoward effects for some of those vaccinated. However, most are mild and innocuous, especially as compared to the effects of the diseases they prevent. Risks inherent in those diseases are far greater.

The other part of the vaccination debate is whether government has a right to intervene in a parent’s decision not to vaccinate his child. Parental rights are among the most protected in our society, but what about the rights of the rest of our kids to attend a school where the students are least likely to transmit childhood diseases by virtue of having been vaccinated?

Does a child with a known communicable disease have the “right” to go to school, putting all the other students at risk? Most often, symptoms become obvious only after a child has actually contracted the disease. They are exposing their friends, babysitters and schoolmates in the early days, already contagious but without the cough, fever or spots to make it apparent.

For the public hearing last week, 527 items were filed in testimony. All the testimony is posted online. There were pleas to require broad vaccination to protect those who, for medical reasons, cannot receive certain vaccines, as well as parents who felt that vaccination would adversely affect their children and opposed the bill.

Most Maine medical leaders were fully supportive. They are worth naming: The Maine Hospital Association, the public health director for the city of Portland, the Maine Children’s Alliance, the pediatric hospitalist at Maine Medical Center, the Maine Nurse Practitioner Association, the Maine Primary Care Association, the American Nurses Association, the American Medical Association, the American Academy of Pediatrics, the Maine Medical Association and other medical, educational and civic organizations.

Several health care providers, including a few physicians, did oppose the bill. Some opined that it is the pharmaceutical companies and the health care industry that promote vaccinations to enhance their bottom lines. The Maine Pharmacy Association was among those testifying in support.

It is difficult, if not impossible, for the average citizen to follow the detailed arguments and statistics presented by both sides. Most parents want nothing but what is best for their children, and most have decided that the benefits of immunization outweigh the risks. Unvaccinated children are also protected by those children who are vaccinated. The weight of the argument is in favor of vaccinating our kids for a healthier society.

jillgold@gwi.net  

Former Maine State Senator Jill Goldthwait is a registered nurse.

Anti-Vaxxers must defend first measles death in 12 years

Anti-Vaxxers are stoking conspiratorial fear among the public about the unproven risks of childhood vaccines.  

Meanwhile, children's deaths from vaccine preventable diseases have plummeted to near zero, because of the success of immunization  programs, to protect public health.  

Infectious diseases, like whooping cough, mumps, measles, and the virus caused by polio have become nearly extinct, thanks to vaccines. Unfortunately, the success of vaccines has given rise to conspiracy theories, leading many to believe it's safer to develop a passive immunity to infectious disease by allowing the infections to make people sick.  Anti-vaxxers claim the vaccine preservatives are toxic and contribute to the onset of autism, but there's no proof of this correlation. On the other hand, there is an absolute inverse correlation between disease and vaccines.  In the absence of vaccines, the infections they prevent will increase. They will return and cause epidemics, because the population will not harbor enough immunity to withstand the disease organisms.

Now, Washington state confirmed the first US measles death in the US in 12 years. CNN Dana Ford reports:

Measles is a vaccine preventable illness. Apparently, the community immunity, where the death occurred, was not sufficient to protect the person who contracted the disease from becoming ill. Moreover, the person who died had a suppressed immune system.

Washington state has reported the death.

(CNN)The Washington State Department of Health reported Thursday what it said was the first confirmed measles death in the United States since 2003.

Authorities did not identify the woman, but said she was likely exposed to measles at a local health facility during a recent outbreak in Clallam County.

She died in the spring. The measles infection was discovered during an autopsy.

"The woman had several other health conditions and was on medications that contributed to a suppressed immune system. She didn't have some of the common symptoms of measles such as a rash, so the infection wasn't discovered until after her death. The cause of death was pneumonia due to measles," the health department said.

It stressed that no one who had contact with any of the known cases remains at risk.

5 things to know about measles

So far this year, 11 people have been diagnosed with measles in Washington state, including six in Clallam County, according to the health department.

"The last active case of measles in Washington this year was reported in late April. Within about three weeks of exposure to someone with measles, it's possible to develop the disease. Since more than three weeks has already passed since the last active measles case, no one who had contact with one of the known cases is any longer at risk for developing measles from those exposures," it said.

Measles is a highly contagious respiratory disease. It causes fever, red and sore eyes, runny nose, cough and a rash. It can cause deadly health complications, including pneumonia and encephalitis. It is spread by contact with an infected person through coughing or sneezing. It can remain in the air and on surfaces for up to two hours.

While once widespread in the United States, cases dropped significantly because of vaccines. In 2000, health authorities declared that measles had been eliminated in the United States, which meant it was no longer native but continued to be brought in by international travelers.

In 2008, 2011, 2013 and 2014, there were more reported measles cases compared with previous years, according to the Centers for Disease Control and Prevention.

The CDC attributes this to two things: more measles cases coming into the United States, and more spreading of the disease in communities with pockets of people who are not vaccinated.

Just this week, California Gov. Jerry Brown signed legislation outlawing a family's personal and religious beliefs as reasons to exempt their children from school vaccinations.

The controversial proposal, arising partly from concerns over this year's Disneyland outbreak, would allow medical exemptions deemed appropriate by the state Department of Public Health.

From January until May 29, 173 people in 21 states and the District of Columbia developed measles, and 117 of those cases were linked to Disneyland in Orange County, California, according to the CDC.

In my Mainewriter opinion, zealots who use fear, to prevent parents from having their children immunized, are responsible for the morbidity and mortality of anyone who is not immunized and who subsequently become ill with vaccine preventable illnesses.  

Let's commend and follow the lead of California by protecting all people from vaccine preventable illnesses.

Ebola is dangerously infectious - appears resistant to infection control puts caregivers at risk

Health care workers are especially well trained about how to practice infection control protocols. Consequently, it's very alarming to learn today, October 12, about a nurse at Texas Presbyterian in Dallas, who tested positive for the dangerous Ebola virus infection, after having cared for Mr. Thomas Eric Duncan who died from the disease last week.  

As a nurse myself, I suspect the Ebola virus is more virulent than the Centers for Disease Control (CDC) or any other infectious disease experts understand.  

Unfortunately, the nurse who now has the Ebola diagnosis was wearing protective gear throughout her time caring for the deceased Mr. Duncan because he had already been diagnosed.

The nurse was involved in Duncan's second visit to the hospital, when he was admitted for treatment, and was wearing protective gear as prescribed by the CDC: gown, gloves, mask and shield.

The nurse had "extensive contact" on "multiple occasions" with Duncan, Dr. Tom Frieden, the director of the Centers for Disease Control and Prevention in Atlanta, said Sunday.

Therefore, "At some point, there was a breach in protocol, and that breach in protocol resulted in this infection," he said at a news conference Sunday.

A "close contact" who knew the nurse has been "proactively" placed in isolation, reports CNN.

The hazardous materials unit of the Dallas Fire Department has cleaned up and decontaminated the public areas of her apartment complex, Mayor Mike Rawlings said. Police are keeping people out of the area and are talking to residents nearby.

Although the experts who are evaluating this most recent Ebola exposure are seeking a breech of protocol as a cause, the fact remains that the caregivers are contracting the disease, in spite of using infection control procedures. Physicians and nurses are contracting the Ebola virus infection, when we know how to implement isolation and infection control procedures. 

In my opinion, there must be some kind of poorly understood virulence associated with transmitting Ebola. 

Perhaps any exposure at all to the bodily fluids of an infected Ebola patient puts a person at high risk, more so than touching alone. This means, being exposed to an infected person's sweat, sneezing, urine, blood, semen, saliva or any product associated with these fluids. Evidently, dumping a patient's urine, starting an IV or even giving a bed bath must create a very high risk of exposure, regardless of the infection control precautions taken to prevent the spread of the disease.

If caregivers are at risk while caring for Ebola patients, there's no doubt about how the disease will spread. Family members will try to fill the caregivers' gap and they will undoubtedly become ill doing so....and so forth.  Therefore, the only way I can foresee for stopping the  spread of Ebola is to isolate the patients as quickly as possible and minimize any exposure to the bodily fluids of the person who is ill. This means, don't draw blood or dump urine unless it's absolutely vital to do so. Urine can be dumped once very  24 hours rather than every 8 -10 and blood doesn't need to be drawn at all. Meanwhile, it's essential to develop a vaccine to prevent the future outbreaks of this lethal Ebola virus.  

Public health money, of course, is needed to stop Ebola from becoming a pandemic. Also, government corruption in African nations contributed to this now out of control outbreak. 

Of course, my dear readers, money and competent government control of the problem are the subjects of other blogs.....

Thomas Eric Duncan was young he was a Christian he even had an American sounding name

Grief is widespread throughout the Texas Presbyterian Hospital community and in Dallas, after the caregivers tried and failed to save the life of Ebola patient Thomas Eric Duncan. 

This is very sad. Mr. Duncan's death at 42 years old is a sentinel event in the history of Texas Presbyterian Hospital and another mark in the Dallas history timeline, as though anyone needs reminding of November 22, 1963.

It's difficult to understand why Mr. Duncan didn't respond to state of the art life support interventions to help him withstand the Ebola virus and recover from the illness. Undoubtedly, his inability to rally, given the intense intervention he eventually received, is a dangerous indication of just how ravaged his body was by the Ebola virus, by the time he was diagnosed. 

Certainly, given how infectious he was at the time of his diagnosis, there's a high risk of others being infected as a result of the lapse of time between the onset of his Ebola symptoms and when he was placed in quarantine for treatment.

Mr. Duncan was the first patient with Ebola to die in the US, but he became infected in Liberia. Yet, he broke the stereotype of the African who becomes ill with Ebola. He had a very American name ie, "Duncan", and he was obviously a Christian, evidenced by the family's Baptist Church pastor, who counseled the grieving relatives after providing notification of his death.  

In my opinion, Mr. Duncan's death by Ebola as well as the other Americans who are recovering from it after being flown home, breaks the stereotype of what many Americans believe are victims of this virus. 

First of all, four other Americans who had (one still has) Ebola are Caucasians. 

Mr. Duncan was certainly a young, handsome African man who worked for FedEx, or some international mail delivery company. He didn't appear to live in a primitive village and he dressed well. So, now we have evidence of how Ebola is a toxic and highly contagious disease. Everyone, regardless of race or socio economic status, who comes in contact with its victims are at great risk for becoming ill with the virus.

I'm grieving for Mr. Duncan's family and for all of the caregivers who valiantly tried in vain to save his life. 

Although Texas Presbyterian made an error when Mr. Duncan's treatment was delayed by administrative, or some other kind of glitch, the fact is, many people worked hard to cure him from the Ebola virus, and they are grieving because of his death.  

Now, Ebola is an American disease. It's urgent that Texas and all public health personnel continue to be on high alert to prevent any spread of this virus.

In Texas, this means anyone presenting in any emergency department with a fever, regardless of the origin, should receive immediate care - regardless of what their reimbursement or immigrant status may be. Therefore, Governor Perry, it seems like the right public health initiative, to reduce the Ebola panic now rampant in Dallas, is to be sure all Texans and immigrants are provided access to urgent care, regardless of their ability to pay.

Pretend Gun Violence is Bird Flu or Tuberculois or Measles

Another deadly shooting in Indiana grocery store. 
But there's a big difference between gun violence and infectious disease:

ELKHART, IND. – Three people are dead, including the gunman, night after a shooting at an Elkhart, Ind., grocery store, authorities said late Wednesday.

Elkhart police received a call about an active shooter at Martin's Super Market about 10 p.m. Wednesday, Indiana State Police Sgt. Trent Smith said at a news conference.

The suspect, in his early 20s, walked into the store and used a semi-automatic handgun to shoot and kill a woman, then walked to another aisle and shot and killed another woman, Smith said. One victim was an employee and appeared to be in her late teens or early 20s and the other was a shopper who appeared to be in her 40s, he said. They were found about 12 aisles apart.

Bird flu is again claiming lives.
Hong Kong officials are reporting that a second patient has died after contracting the H7N9 bird flu virus, according to the South China Morning Post.

The 65-year-old male is believed to have been the third person in Hong Kong to contract the virus during the last month. Authorities reported that all of the patients were exposed to the disease in the neighboring city of Shenzhen in southern China.
Read more: H7N9 Bird Flu: Second Death in Hong Kong | TIME.com http://world.time.com/2014/01/14/hong-kong-records-second-bird-flu-death/#ixzz2qZAnChF8
Tuberculosis is a leading cause of death report from World Health Organization

• Tuberculosis (TB) is second only to HIV/AIDS as the greatest killer worldwide due to a single infectious agent.
• In 2012, 8.6 million people fell ill with TB and 1.3 million died from TB.
• Over 95% of TB deaths occur in low- and middle-income countries, and it is among the top three causes of death for women aged 15 to 44.

Measles is an infectious disease killer of children

Measles is one of the leading causes of death among young children even though a safe and cost-effective vaccine is available.

• In 2011, there were 158 000 measles deaths globally – about 430 deaths every day or 18 deaths every hour.
• More than 95% of measles deaths occur in low-income countries with weak health infrastructures.
• Measles vaccination resulted in a 71% drop in measles deaths between 2000 and 2011 worldwide.  

But there's a huge difference between deaths by infectious disease and gun violence.

It's a fact:  gun violence is entirely preventable because the vector can be controlled.  Guns cause gun violence deaths.  

Diseases will never be entirely preventable because the influenza virus continues to mutate, tuberculosis becomes resistant to antibiotics and measles continues to erupt especially in third world countries. 

Americans who debate gun owners rights should put an equal amount of time into gun violence prevention.

Gun violence is a public health hazard and an unnecessary cause of preventable deaths.

Gun violence should be treated like deadly disease. Treatment should be the passing of public policies restricting the access people have to guns purchased solely for the purpose of killing people.