Monday, January 2, 2012

A Scientist and a Prophet Walk Into a Plague Pit...

A couple tenuously-consilient items in the news in the last week kind of have me tweaked.

The first is that scientists have made relatively simple mutations in the H5N1 bird flu virus to apparently enable it to propagate through the air. My understanding is that the virus's inability to transmit this way naturally is the only firewall keeping us from an epidemic far beyond anything we've seen in modern times. I don't generally spend much time wringing my hands over these impending-medical-catastrophe things, but it seems like a fella ought to be kept awake by this one. This very extant strain of flu is especially devastating, killing somewhere near 50% of the people it infects. The article I read (different from the linked one above) cites some expert saying that we will be dealing with this flu and this type of transmission within the decade. Given that, as I understand it, we really have no medical defense against viruses, this coming plague promises to hit every one of us hard and leave a radically different world in its wake.

The second item was the hiring of a big Times Square display for New Year's Eve by an anti-vaccine group to spread their reprehensible pseudo-science alternate reality. The use of vaccines to ward off, and in some cases completely eradicate, major illnesses has been one of humankind's greatest collective achievements. And these folks are pounding away at this foundation as they run scared from a lie. It's one thing to choose to opt out for yourself, and maybe another thing to opt your children out (ugh); but it's a totally different matter entirely for your choices to place everyone else in society in peril, which is exactly what is now occurring. In an effort to flee from a completely invented and thoroughly-debunked risk--that the MMR vaccine causes autism--these people are now mounting a campaign against all vaccines, thus exposing their kids and everyone else's kids to a host of things that were heretofore under control. Catastrophic and unconscionable and apparently immune to reason. At some point this all leaves the realm of personal freedom behind and skirts instead with crime against humanity. (I can imagine a not-so-strange-as-reality sci-fi novel where society is forced to quarantine these denihilists to retain our herd immunity, only to have them lie about their convictions to avoid the rampant diseases they've released in the quarantine communities, thus making our efforts to contain their damage futile.)

My wife says, with some justification, that I am being too hard on people who are simply reacting to a devastating occurrence in their lives. But my objection is certainly not to their fear and personal anguish--of course not; I object to the strain of misinformation that preys on their vulnerable state, and to a media subculture that turns these wounded folks into passionate carriers of misinformation. And I especially object to a broader media model that covers the controversy instead of correcting the swirl of misinformation. Our current setup is creating a sect of willfully-ignorant obstructionists, people who shoot the messenger when their pet myths are faced with conflicting data, and giving them a megaphone. (A clip of a caller from an NPR Talk Of The Nation program a while back was held up as an example of cultural insanity: a doctor was a guest on the show, and to the question "What if I could show you the data to prove you're wrong?" the caller said openly that no information he or anyone else could possibly give her could make her change her mind and vaccinate her kids.)

I see the stamp of our current milieu in all this, the mark of our current media model. Rupert Murdoch has made a fortune out of putting the wacky in the spotlight and fanning the flames of white man's anger, and I know scores of people who buy unquestioningly into the results of this methodology. Part of his bag of tricks is to undermine anyone whose information runs contrary to the desired narrative, with the result that people now choose their facts. And we end up with climate and public health scientists being shouted down at public meetings while Jenny McCarthy and Rush Limbaugh are held up as qualified to expound to the masses on these subjects.

What got me thinking about all this is my current book. I'm currently reading Barbara Tuchman's account of life in the 14th Century, A Distant Mirror, and I'm up to the chapter about bubonic plague. Jesus, what an absolute horror. The disease showed up rather suddenly, and quickly overwhelmed whole towns and villages. The time between onset and death could be very short, from three days to a single day, sometimes even a few hours--a person could go to bed perfectly well and not survive until morning. There are examples of doctors showing up to treat a patient and dying from the disease before the patient herself expired. It's estimated that the plague of 1347-1350 killed off a third of the population of Europe--some 20 million people--and some places were left without a single survivor. I'm reminded of the shocking portrayal of a 19th Century England trying to deal with cholera in Steven Johnson's fascinating 2009 book The Ghost Map. There was little science at the time, no fact-based medicine, no antibiotics or any pharmaceuticals that were more than happenstances, no clue about the essence of infectious disease; and all of steeped in a really toxic mixture of total ignorance and rampant superstition mingled with a constant struggle for power and supremacy. And Tuchman's book takes us back another 500 years from that. Ugh.

And yet I daresay we were mired in the same level of ignorance and superstition in both periods. We had certainly learned things in the 500 years between the two stories, but the modern scientific method was just taking its first baby steps by the late 1800s, and so the same ignorance and superstition held sway. The big change took hold just into the early 1900s and onward, where careful observation and evidence-based research have resulted in a century of progress never before seen on this planet. We now understand plague and cholera very well, and know exactly how to treat them as well as a zillion other diseases. And we didn't get there by praying.

We may shortly be faced with an epidemic perhaps even worse than the Black Death, and I contend that science is all we have. To repudiate the science is to put us back in the comparative Dark Ages.


dbackdad said...

I used to find Jenny McCarthy cute and mildly amusing (for God knows what reason ... but I digress), but since she's been on her anti-vaccine kick, I find her annoying and dangerous. Like your wife says, she initially came from a "devastating occurrence", but the crusade she has been on does not make her son's autism get better. Instead, it is dooming thousands of kids of impressionable parents.

I forgive people for being stupid but I will not forgive them for being willfully ignorant and for spreading their ignorance.

Jeff said...

These two news tidbits are quite closely related. You mention in discussing the first that we really have no weapons in the fight against viruses. The one weapon we do have are the vaccines mentioned in the second tidbit. We can not cure cases of viral infection once they have occurred - we can only keep them from happening in the first place through the use of vaccines.

These people who campaign against vaccination are doing untold amounts of damage to our public health. And it really is a 'public' health issue, since a big part of the success of vaccines comes from having most people vaccinated. Like you say, it is one thing for them to choose to skip vaccinations, but it is harmful to all of us when they try to convince others to follow their idiotic ideas.

I don't even have a good idea how to deal with this sort of problem. We can't really force people to be vaccinated (but we could quit granting exceptions to allow unvaccinated kids into public school - although pushing anti-vaxxers to home-school their kids sounds like a whole other disaster), and there seems to be no way to get them to realize how wrong they are and to reconsider their ill-founded opinion.

You also mention another factor that I think is a very big part of this - the failure of the various media voices to make the facts of the situation clear. As you say, they want to report the controversy, and to try to give both sides an equal hearing, but there is no controversy and there are not two sides! Vaccines help many times more people than they might harm! There aren't 'two sides' to the issue any more than there are two sides to the debate about whether the Earth is flat or not. Most of the media have been failing in this regard on a wide variety of topics, to the point where I never expect to hear a clear, straightforward delineation of the actual facts in a news article, I have come to expect the usual presentation of the facts as one expert's opinion, with another 'expert' giving his opposing opinion as a counterpoint.
Throw in a widespread mistrust of established science and a belief in various fairies and magic, and it looks like a situation that will not be getting better any time soon.

wunelle said...

This is one of those things where I'm stunned at how the celebration of misinformation takes hold--not how an individual may come to believe wrong things, but how the wrong becomes accepted by so many despite all evidence to the contrary. (Is this like believing elaborate god myths when there is no evidence for them and plenty against?)

Lately I'm contemplating the phenomenon of the Third Reich. One wants to think that, lesson learned, it could never happen again; we know and understand too much. But this is patently untrue. We progress as a society against so many backward steps and so much dead weight. Given that the Third Reich JUST HAPPENED, during a time when the scientific method was available and functioning, I begin to wonder if we can really think our way out of anything. We have to drag along a bunch of people who are happy to use their cell phones and drive their cars and go to the doctor while failing to use in their own lives the tools that made those things possible. The anti-vax crowd is the ultimate expression of our self-destructive tendencies.

Vancouver Voyeur said...

Here's one for you, it ties the historic events of the various plagues from the 1300s to the modern day AIDS virus and a cure. There is a mutated gene, CCR5 Delta-32 that some people in 1300s Europe possessed that helped them survive the plagues. This mutated gene came from Viking invaders. If you had one copy of the gene, you had partial immunity, if you had two copies of the gene, total immunity. The AIDS virus behaves the same way as these old plagues in that all but one or two forms of AIDS have to attach at the same spot on the cell to infect a person. People who have the two copies of CCR5 Delta 32 can't get AIDS, breast cancer, rheumatoid arthritis, Smallpox and a few other diseases. Within the last year or so, an American living in Berlin was completely cured of his leukemia and AIDS when he received a bone marrow transplant from someone with two copies of the mutated gene. Here's a story that will get you started on this great historic discovery:

wunelle said...

Fascinating. Isn't this the kind of generally accepted path of medicine? 1. Alleviation and management of pain and symptoms; 2. The curing of disease with antibiotics; and 3: The manipulation of genes to ward off / prevent the conditions pre-emptively.

I wonder how many things will one day be addressed in the manner you portray.