Tag Archives: ebola

2014 Report Card

It’s taken me a while to get out a “year in review” post for 2014, but anyway, here it is. This won’t be a masterpiece of the essay form. I’m just going to ramble on about some interesting trends and themes from the year, along with a few relevant links.

The critical question this blog tries to answer is, is our civilization failing or not? I’ll talk about our human economy, our planetary system, and make some attempt to tie the two together.

Overall Human Health and Wellbeing. First, there are some very happy statistics to report. For example, worldwide child mortality has dropped almost by half just since 1990. What better measure of progress could there be than more happy, healthy childhoods? And it’s not just about increasing wealth – people in developing countries today have much better health outcomes at the same level of wealth compared to developing countries of the past (for example, Indonesia today vs. the United States when it passed the same income level). It’s hard to argue against the idea that economic growth and technological change have obviously eliminated a lot of human suffering. So, I think the important questions are, will these trends continue? Is the system stable? Can the natural environment continue to support this trend indefinitely? There may also be an important question of whether we had the right to exploit the natural environment to get us to the point where we are now, but that is an academic question at this point.

Financial System Instability. Let’s talk about the stability of our human economic system. The U.S. economy may finally seem to be picking up from the aftermath of the severe 2007-8 financial crisis, but it is certainly far below where it would be if that hadn’t happened and the prior growth trend had just continued since then. The rest of the world isn’t doing so well, however – Europe and Japan are looking particularly slow if not in an outright deflationary spiral, at the same time developing countries appear to be slowing down. Some are calling this a “new normal” for the world economy. More scary than that, the industry-written regulations and perverse incentives allowing the excessive risk taking that caused the crisis have not been fully addressed and the whole episode could recur in the short term.

Thoughts on Ecosystem and Economic “Pulsing”. 2007-8 was a textbook financial crisis – although it was caused by novel forms of money and risk taking beyond the direct reach of government regulators and central banks, it was not that different from crises caused by plain old speculation and over-lending back when there were no central banks around. It’s hard to draw a direct link from the financial crisis to ecosystem services, climate change, or natural resource scarcity. However, if we think about natural ecosystems, they are resilient to outside stressors up to a point – say, moderate fluctuations in temperature, hydrology, or pressure from non-native species. However, say a major fluctuation happens such as a major flood or fire that causes serious damage. In the absence of major outside stressors, the system will eventually recover to its original state, but in the presence of major outside stressors, even if they did not cause the flood or fire, it may never bounce back all the way. In the same way, our human economy may appear resilient to the effects of climate change, ocean acidification, soil erosion, and so forth for a long time, but then when something comes out of left field, like a major financial crisis, war, or epidemic, we may not be able to recover to our previous trend. This probably also applies to the effects of technology on employment, as discussed below. In the absence of major shocks coming from outside the system, we’ll see a long, slow slide in employment and possibly a long, slow rise in energy and food prices, with so much noise in the signal that it will be easy for the naysayers to hold sway for long periods of time. But when those major events happen, we may see sudden, painful changes that we have no obvious way of mitigating quickly.

Technological Change: Artificial Intelligence, Robots, Automation, and Employment. After decades of slow but steady progress, these technologies are really coming into their own. Robots are being used to keep miners in line and to drive cars, for example. Manufacturing has become a high-tech industry. As computers and machines get better at performing more and more skilled jobs (book-keeping is one example), there is gradually less demand for the medium-skilled workers who used to do those jobs. High-skilled workers like computer programmers are doing very well, although I presume the automation will gradually creep higher and higher up the chain, so today’s safer jobs will be less safe tomorrow. At the same time these medium-skilled workers in developed countries are getting squeezed out, developing countries are not benefiting like they used to from their large pools of low-skilled workers as manufacturing becomes more and more automated, and can be done cost-effectively closer to consumers in richer countries.

Will our society recognize and solve this employment problem? American corporate society, and its admirers around the world, are unlikely to. Something very similar to this happened with agricultural automation in the early- to mid-20th century, and with globalization in the mid- to late-20th century. As agriculture became more automated, many displaced workers moved from rural areas in the U.S. southeast to urban areas in the U.S. northeast, looking for factory work. Unfortunately, the factory jobs that existed previously were being moved to developing countries with abundant low-wage labor. The pockets of poverty, unemployment, and social problems created by these forces have not been adequately addressed to this day. To the individual worker, it doesn’t much matter whether your job is being taken by a local robot or an overseas human. Unemployment created by technological forces today could resemble what was created by globalization yesterday, only on a much larger scale. We can only hope that the larger scale will drive real political solutions, such as better education and training, sharing of available work, and more widespread ownership of the labor-saving technology.

Of course, one of the earliest and probably the most shameful example of a modern capitalist system generating wealth for an elite few at the expense of workers is the American slavery system of the 18th and 19th centuries. We just can’t trust amoral, self-interested private enterprise to maximize welfare in the absence of a strong moral compass coming from the larger society. Let’s stop pretending otherwise.

Another example of extreme corporate immorality: Public apathy over climate change in the U.S. may have been manufactured by a cynical, immoral corporate disinformation campaign over climate change taken right out of the tobacco companies’ playbook.

The Gospel of Shareholder Value. There is an important debate over whether people who run corporations have any ethical responsibility to anything other than profit seeking. Well duh, everyone on Earth has an ethical responsibility. Case closed, as far as I’m concerned. There is even evidence that the ideology of profit maximization is a drag on innovation. Except billions of people out there who have worshiped at business schools would disagree with me. And I don’t want to offend anyone’s religion. Noam Chomsky had a quote that I particularly loved, so I am going to repeat it here:

In market systems, you don’t take account of what economists call externalities. So say you sell me a car. In a market system, we’re supposed to look after our own interests, so I make the best deal I can for me; you make the best deal you can for you. We do not take into account the effect on him. That’s not part of a market transaction. Well, there is an effect on him: there’s another car on the road; there’s a greater possibility of accidents; there’s more pollution; there’s more traffic jams. For him individually, it might be a slight increase, but this is extended over the whole population. Now, when you get to other kinds of transactions, the externalities get much larger. So take the financial crisis. One of the reasons for it is that — there are several, but one is — say if Goldman Sachs makes a risky transaction, they — if they’re paying attention — cover their own potential losses. They do not take into account what’s called systemic risk, that is, the possibility that the whole system will crash if one of their risky transactions goes bad. That just about happened with AIG, the huge insurance company. They were involved in risky transactions which they couldn’t cover. The whole system was really going to collapse, but of course state power intervened to rescue them. The task of the state is to rescue the rich and the powerful and to protect them, and if that violates market principles, okay, we don’t care about market principles. The market principles are essentially for the poor. But systemic risk is an externality that’s not considered, which would take down the system repeatedly, if you didn’t have state power intervening. Well there’s another one, that’s even bigger — that’s destruction of the environment. Destruction of the environment is an externality: in market interactions, you don’t pay attention to it. So take tar sands. If you’re a major energy corporation and you can make profit out of exploiting tar sands, you simply do not take into account the fact that your grandchildren may not have a possibility of survival — that’s an externality. And in the moral calculus of capitalism, greater profits in the next quarter outweigh the fate of your grandchildren — and of course it’s not your grandchildren, but everyone’s.

Our Ecological Footprint. WWF issued an updated Living Planet Report in 2014 suggesting that our annual consumption of natural resources (including the obvious ones like energy and water extraction, straightforward ones like the ability to grow food, but also the less obvious ones like ability of the oceans and atmosphere to absorb our waste products) is continuing to exceed what the Earth can handle each year by at least 50%. We’re like spoiled trust fund babies – we have such incredible resources at our disposable, we never learn to live within our means and one day the resources run out, even if that takes a long time. As we recover from the financial crisis, we have a chance to do things differently, but the connections are not being made to the right kinds of investments in infrastructure, skills, and protection of natural capital that would set the stage for long-term sustainable growth in the future.

Other Big Stories from 2014:

  • World War I. 100 years ago, World War I was in full swing. Remember The Guns of August? Well, that was August 1914 they were talking about. Let’s hope we’re not about to blunder into another conflict. But (and I’m cheating a little here because I read this in 2015), the World Economic Forum named “interstate conflict” as both high probability and high consequence in its global risk report.
  • Ebola. Obviously, Ebola was a very bad thing that happened to a whole lot of people. To those of us lucky enough that we weren’t directly in its path, it is a chance to selfishly reflect whether Ebola or something even worse could be coming down the pike. Let’s hope not.
  • Severe Drought and Water Depletion in the Western U.S.: California has been in the midst of a historic drought, although they got some rain recently. Some are describing this as the new normal. Besides rainfall, glaciers, snowpack, and groundwater all seem to be disappearing in some important food-growing areas.
  • Solar grid parity is here! At least some places, some times…

Conclusion. Yes, I think we are on a path to collapse if nothing changes. And I don’t see things changing enough, or fast enough. There are glimmers of hope though. Lest you think I offer only negatives and no solutions, here are two solutions I harp on constantly throughout the blog:

  • Green infrastructure. This is how we fix the hydrologic cycle, close the loop on nutrients, begin to cleanse the atmosphere, protect wild creatures and genetic diversity, and create a society of people with some sense of connection to and stewardship over nature. Don’t act like it’s such a big mystery. It’s known technology. There has been plenty written about trees, design of wildlife corridors and connectivity, for examples. There is simply no excuse for cities to do such a crappy job with these things.
  • Muscle-Powered Transportation. Cars are clearly the root of all evil, the spawn of Mordor, as I pointed out several times (sorry, I just sat through 6+ hours of Hobbit movies). Unless you are perhaps that rare hobbit who can own a car without your morals being completed corrupted by its evil powers. But for the rest of us, I explained several times why getting rid of cars would be good. Here is just one example:

One of the most important things we can do to build a sustainable, resilient society is to design communities where most people can make most of their daily trips under their own power – on foot or by bicycle. It eliminates a huge amount of carbon emissions. It opens up enormous quantities of land to new possibilities other than roads and parking, which right now take up half or more of the land in urban areas. It reduces air pollution and increases physical activity, two things that are taking years off our lives. It eliminates crashes between vehicles, and crashes between vehicles and human bodies, which are serial killers of one million people worldwide every year, especially serial killers of children. It eliminates enormous amounts of dead, wasted time, because commuting is now a physically and mentally beneficial use of time. There is also a subtle effect, I believe, of creating more social interaction and trust and empathy between people just because they come into more contact, and creating a more vibrant, creative and innovative economy that might have a shot at solving our civilization’s more pressing problems.

Professor Peter Piot

No, he didn’t pick a peck of pickled peppers. He “co-discovered the Ebola virus in 1976“. And in 2015, just now, he said this:

“Our world is getting more vulnerable to big epidemics, because of population expansion, huge mobility and more intense contact between animals and people.

“My concern,” he said, “is that when [the Ebola outbreak] is over we will just forget about it. We need to be better prepared and we need to invest in vaccines and treatment.

“It’s like a fire brigade – you don’t start to set up a fire brigade when some house is on fire.”

JAMA on Ebola

Here’s a Journal of the American Medical Association editorial on the level of preparedness in the United States for something like Ebola:

The Dallas case raises significant concerns about national preparedness for public health emergencies. Health emergencies (eg, anthrax, SARS, novel influenzas, and hurricanes Katrina and Sandy) spurred federal preparedness planning and funding, including the Pandemic and All-Hazards Preparedness Act (reauthorized in 2013),2 to ensure that federal, state, and more than 3500 local health departments coordinate their efforts effectively in disasters. Significant investments have been made in staff training, interagency coordination, legal reform, and planning.

Preparedness efforts like these are essential, but inadequate. Overall, investment in key health system functions has been in decline. The CDC’s 2013 budget declined 10%, or nearly $1 billion, from 2012.3 Since 2008, state and local public health agencies have lost more than 50 000 staff (almost 20% of their workforce),4 requiring cuts to preparedness programs. Many EMS agencies and hospitals are also strained, leading the Institute of Medicine to warn in 2012 of an “enormous potential for confusion, chaos, and flawed decision-making”5 in a public health emergency. Insufficient funding in a research and data infrastructure limits the ability to identify weaknesses and learn from mistakes. Rare, novel infections such as Ebola expose the difficulty of diagnosis and adherence to arduous infection control protocols. Following the nurses’ EVD diagnosis in Dallas, future Ebola patients may be directed to centers with advanced training, PPE, and well-equipped isolation rooms. Vinson was transferred to Emory Hospital in Atlanta on October 15.

Now, the American Medical Association is a special interest group. The United States has the world’s largest economy and spends more than any other country on health care, even as a fraction of that economy. So I don’t like to hear that the answer is throwing more money at the problem. I think we have a patchwork of doctors, hospitals, and insurance companies each looking out for their own interests, and what it adds up to shouldn’t really be called a “health care system”. But we’ve been warned – we need to get a lot smarter before we have to deal with something like SARS or a novel influenza.

child mortality down 49% since 1990

Amid the depressing news of thousands of Ebola deaths, NPR has an uplifting story about how worldwide child mortality has dropped dramatically, and not just over the last century but over the last couple decades:

In 2013, 6.3 million children under the age of 5 died. That’s a tragic statistic — yet it represents a 49 percent drop from 1990, according to data released Tuesday by the United Nations…

In many ways, under-5 mortality is a lens of how far we have progressed as a civilization. Newborns, premature babies and children under 5 are the most vulnerable members of our society. They are completely reliant on the values, the care and the love that we as a society are providing to each other.

The reduction in mortality rates is a measure of children’s lives, which are very important. Each life saved is someone else who will contribute to our well-being as a whole. But it’s also a measure of how we are progressing as human beings. If there are still children dying of causes which can be easily prevented, cheaply, and we still aren’t doing that? Then we aren’t really progressing as much as we think we are.

They have an animated map of where the biggest gains have been – Asia and South America. There have been gains in Africa, but Africa still has the highest rates and some of the highest rates in Africa are in the same area where the Ebola epidemic is taking place.

 

“how plagues really work”

This article from Aeon argues that we shouldn’t worry so much about some random mutation of an animal virus coming out of the jungle and destroying us. Instead, it is the conditions in human society that allow new diseases to evolve and adapt to us that we should be more concerned about.

According to this argument, new germs that erupt into our species will be potential triggers for pandemics, while germs that have a long history in a host species will have evolved to be relatively benign.

Many health experts take the notion further, contending that any coming plague will come from human intrusion into the natural world. One risk, they suggest, comes when hungry people in Africa and elsewhere forge deep into forests and jungles to hunt ‘bushmeat’ – rodents, rabbits, monkeys, apes – with exposure to dangerous pathogens the unhappy result. Those pathogens move silently among wild animals, but can also explode with terrifying ferocity among people when humans venture where they shouldn’t. According to the same line of thought, another proposed risk would result when birds spread a new pandemic strain to chickens in factory farms and, ultimately, to us.

But there’s something in these scenarios that’s not entirely logical. There is nothing new in the intimate contact between animals and people. Our hominid ancestors lived on wildlife before we ever evolved into Homo sapiens: that’s why anthropologists call them hunter-gatherers, a term that still applies to some modern peoples, including bushmeat hunters in West Africa. After domesticating animals, we lived close beside them, keeping cows, pigs and chickens in farmyards and even within households for thousands of years. Pandemics arise out of more than mere contact between human beings and animals: from an evolutionary point of view, there is a missing step between animal pathogen and human pandemic that’s been almost completely overlooked in these terrifying but entirely speculative ideas.

According to the evolutionary epidemiologist Paul W Ewald of the University of Louisville, the most dangerous infectious diseases are almost always not animal diseases freshly broken into the human species, but diseases adapted to humanity over time: smallpox, malaria, tuberculosis, leprosy, typhus, yellow fever, polio. In order to adapt to the human species, a germ needs to cycle among people – from person to person to person. In each iteration, the strains best adapted to transmission will be the ones that spread. So natural selection will push circulating strains towards more and more effective transmission, and therefore towards increasing adaptation to human hosts. This process necessarily takes place among people.

It goes on to talk about some major plagues in history, including the 1918 influenza which is “the rod by which all other pandemics are measured”.

We could take some comfort in all this – the diseases that cause the most suffering are the ones that evolve within and amongst people, suggesting that there should always be sub-groups of people who develop immunity to them. This suggests that despite terrible suffering, they shouldn’t represent an existential threat to the species. There is a plague in history that I find even more horrifying that 1918 or the Black Death, and that is the almost complete ravaging of Native American populations after 1492. That was a case of diseases that evolved in and amongst human populations, that were then unleashed on another isolated population (possibly a very large one) that had no resistance to them. So as much as we worry about international travel spreading germs, maybe it means it would be harder for some germ to completely sneak up on us, since there are virtually no human populations that are truly isolated anymore.

There is still the worst possible scenario though – somebody taking one of the ugly human-adapted diseases mentioned in this article, and purposely modifying it into something that the population has no immunity to.

more on Ebola

Spillover: Animal Infections and the Next Human Pandemic

NPR has an interview with the author of this book. An excerpt:

How did we go from a virus that’s found largely in animals to a virus that can be deadly for humans — and spread across four countries?

Human behavior is causing this problem. More and more, we’re going into wild, diverse ecosystems around the world, especially tropical forests.

Some scientists believe that each individual species of animal, plant, bacterium and fungus in these places carries at least one unique virus, maybe even 10 of them.

We, humans, go into those wild ecosystems. We cut down trees. We build mines, roads and villages. We kill the animals and eat them. Or we capture them and transport them around the world.

In doing that, we expose ourselves to all these viruses living around the world. That gives the viruses the opportunity to spill over into humans. Then in some cases, once the virus makes that first spillover, it discovers that it might be highly transmissible in humans. Then you might have an epidemic or a pandemic…

The experts I talk to say the next big one will almost certainly be caused by a zoonotic virus, coming out of animals. And it’s likely to be one that is transmissible through the respiratory route — that is, through a sneeze or cough.

Ebola is not an easily transmissible virus. It requires direct contact with bodily fluids. It doesn’t travel on the respiratory route.

Viruses such as the and SARS are much more of a concern to scientists that study these things than Ebola because they are already transmissible through the respiratory route. They are also highly adaptable, and they mutate quickly.

In terms of the next big one, SARS and MERS stand higher on the watch list than Ebola.

do airplanes spread horrible plagues?

Are you more likely to be exposed to germs on an airplane because of the recirculation of air? No, according to Wired, because the air is very well filtered and constantly exchanged with outside air. Now, I too have gotten that cold right after traveling. So I probably got that cold from something I touched at the airport T.G.I. Fridays. So the moral of the story, I think, is always remember to wash your hands at the airport before you pick your nose. Other theories I have come up with, without trying to collect a shred of scientific evidence, is that the dry air on planes dries out your mucous membranes so there is less of a barrier to germs, and/or that the general stress and lack of rest when you travel just wears down your body’s defenses to the ordinary garden-variety germs you encounter every day.

Ebola

The Ebola situation makes for some scary headlines. From the CDC, the number of cases as I write this (July 31) in Guinea, Liberia, and Sierra Leone is 1,322 of which 728 (55%) have died.

Ebola is a disease with no known cure which incubates in bats. To put these numbers in perspective, Wikipedia says that 8,231 people in Haiti have died of cholera since 2010, a disease we know the exact cause of and exactly how to prevent (clean drinking water) and treat (staying hydrated with clean drinking water).