Protests!

The Huffington Post had a special featuring the funniest protest signs from this year. This one obviously takes the cake... the rest can be seen here and are well worth your time.

Speaking of protests, I made my way over Sproul Plaza on the UC Berkeley campus today for a rally protesting budget cuts, layoffs, furloughs, and tuition increases to the UC system... While I expected a few hundred protesters, it turns out the police estimated that there were about 5,000 union workers, staff, faculty, and students there. Many professors cancelled class and hundreds of students staged walkouts in solidarity with the striking unions.

The rally began noon and by 2pm the crowd had begun marching through the UC Berkeley campus, eventually making its way to Addison & Shattuck, where it stalled traffic for roughly 30 minutes before moving back up to Bancroft & Telegraph where it held a sit-in for a good portion of the afternoon. As of 8:30pm organizers had occupied Wheeler Hall and chained the doors shut as they contemplate their next moves.

Newsworthy coverage of the event can be found here and here. The website for the protest organizers can be found here. The website for UC President and budget-cut extraodinaire Mark Yudof can be found here.

Below are pictures from the rally at Upper Sproul Plaza and the march through campus taken from my mediocre camera-phone...

Thursday Morning Charlie Foxtrot: Kerry is French, Obama Claims Presidency of the World

Is it just me or has all that 2004 campaign hooplah about John Kerry being a Francophile finally come true? That look on Kerry's face is priceless: bored, smirky, and pompous. Slap a beret on his head and a cigarette holder in his mouth and he could run for mayor of Paris.

Obama addressed the U.N. General Assembly this week, stating "... We have also re-engaged the United Nations, we have paid our bills, we have joined the human rights council... and we address our priorities through this institution." He went on this week to secure a commitment from Russia for possible sanctions on Iran if they fail to make progress in October 1st negotiations regarding thier nuclear program, chaired a UN Security Council session during which a measure strengthening nuclear nonproliferation was unanimously passed, continued to goad the Israelis and Palestinians towards restarting the stalled peace process, and now he'll be running off to the G-20 summitt being hosted in Pittsburgh.

You'd think getting poor people some health care in the richest country in the world be easy after that... But I guess when the opposition is claiming that gay marriage is a path towards socialism and that Playboy makes men gay then I guess you've got your work cut out for you.

At least all the articles lauding Glenn Beck as the most influential lunatic in the country have started to subside....

Get Your Flu Shot!

In the course of researching potential infectious etiologies of autism, in conjunction with being enrolled in the Infectious Disease & Vaccinology division of Berkeley's School of Public Health, I've learned quite a bit about vaccines in a relatively short time. While I won't be developing any vaccine patents yet (or ever), I can dispel some myths and put forth a quick primer on vaccines for anyone that actually cares...

The two myths I hate: (1) vaccines (particularly MMR vaccine) can cause autism, and (2) getting your seasonal flu shot can actually give you the flu.

(1) Autism is a complex phenomenon for which the etiology (cause) has yet to be identified. It is likely a combination of genetic predisposition triggered by certain environmental factors, possibly certain viral infections while the child is in utero. In 1998 a British study was put forth hypothesizing a link between Measles, Mumps, and Rubella vaccine (MMR). In an article published this year by Jeffery Gerber and Paul Offit of the Infectious Disease Division at Philadelphia Children's Hospital, titled Vaccines & Autism: A Tale of Shifting Hypotheses, Gerber and Offit thoroughly point out the many flaws in the original British study. Their article goes further in citing numerous studies which have found no link between autism and vaccines, as shown in the table below...

Put very simply, the erroneous link between austim and MMR vaccine is due to timing. Most children are vaccinated for MMR at roughly the same time that parents first notice symptoms of the disease (between 1-2 years) and the vaccine thus becomes an easy target for blame. Gerber and Offit go on to dispel the myths concerning thimerasol (an eythlmercury additive in some vaccines) and 'too many vaccines for children' causing autism in an equally convincing manner.

(2) Seasonal influenza vaccines can come in two forms: a trivalent (3 strains of flu), killed-vaccine and an orally administered attenuated vaccine.

• Trivalent killed vaccine comes in the form of an injection and contains killed flu virus elements from three strains (H3N2, seasonal H1N1, and B) which helps the body to produce antibodies to fight these strains if encountered. A killed vaccine cannot make a person sick with the flu. You have an equal chance of being killed by a dead person (yes, I know, what about zombie attack? I'll discuss that in another post).
  
• An attenuated vaccine is one where the virus has been weakened, but not killed. Attenuated vaccine for influenza is administered via an oral mist. It is possible, however unlikely, to get sick from an attenuated vaccine. As such, attenuated vaccines are not administered to children under 2, adults over 50, or to the immuno-compromised. For those to whom it can be administered, it most often provides a more robust immunological response, meaning better protection.
  

Do note that while your flu shot cannot make you sick with influenza, there is the possibility for side effects, depending on how the individual reacts to injections in general (redness, soreness, swelling at the point of injection) and in the case of certain allergies (flu vaccines are grown in chicken eggs). What everyone must consider is the fact that most people receive their flu shot between late September and mid-October, a period when a host of other respiratory ailments (such as the common cold) are beginning their high rate of circulation in the northern hemisphere. Much like autism and MMR, the percentage of individuals coming down with a respiratory ailment that is not actually influenza in the period immediately following vaccination is high enough to allow for this misconception to perpetuate.

So... get your shots.

*H1N1 vaccine will be discussed in the coming week(s)

A Manifesto on Marketplace Balance [Doesn't That Sound Thrilling?]

This is a response to a recent Op-Ed in the Wall Street Journal sent to me by a friend, along with a quote from a political science professor he once had that stated, "the number one goal of ANY bureaucracy is NOT to achieve it's goal but rather to perpetuate itself and grow." I ended up getting a bit carried away in my thoughts on the subject. Greg states that his life experience certainly validates this claim, and I think few in this country would be willing to take issue with that remark. Still, I think it provides an excellent framework to view the health care debate through in hopes of finding some reasonable middle ground, which sadly is some very scarce real estate right now...

I would agree with the notion that once created, bureaucracies, like any other organization (or organism for that matter) have a goal of sustaining themselves, and in many cases, growing. However, I would argue the point that none truly seek to achieve their goal. Do I feel that the people at the DMV are sitting there saying to themselves, "We must get these registrations processed! How dare these people be forced to wait!" - certainly not. But in institutions where there is a moral imperative (health care, for instance) I would say there is a great deal of passion for the work at hand. Having worked in such a bureaucracy at the Rhode Island Dept. of Health, I can say with firsthand experience that from top to bottom, most (certainly not all, but I what organization could claim this?) of the folks that I have had the pleasure of working with are passionate about what they do.

While I see a danger is bureaucracies growing without check, I also see a danger in the large corporations dominating our country growing without check. Were all insurers local, small businesses (or even regional, there is a certain economy of scale necessary in such a business) I would see less of a need for government to balance the odds. But when corporations grow to the extent where they dominate markets, and become their own private bureaucracies where people are just numbers and dollar signs (I'm not saying it would be any different for a government plan) I see the need for the government to offset this imbalance. Corporate dominance is just as, if not more frightening to me than big government. I have witnessed its effects very acutely in the last few years. The notion of a free-market America where entrepreneurs can flourish and passion and ideas abound is under serious threat from big business in this country. Corporate influence in Washington has exploded since the late 1970's and has reached a fever pitch in the last few years. Our country cannot expand into new industries and technologies because lobbyists block legislation required to make those new industries competitive (solar panel production comes to mind). When new ideas do break through, they're bought out and added to these companies portfolios to increase their market price.

The true America, the independent America, middle-class America is being choked and squeezed for all its worth by a multitude of corporations, and the government in turn responds in its typical manner of expansion and regulation. This game has been played throughout history, but only this decade on such a grand scale.

My liberal leaning acknowledged, in the wake of a catastrophic financial collapse brought on by deregulation, my trust is won only marginally by a public option for health care. In my mind, while concern over government expansion is legitimate, the government nevertheless still answers to us, the voters. Corporations answer only to shareholders, whose primary interest is only profit.

There is a classic and historic concern for checks and balances in government, but we have reached a point where government must weigh as a balance to business. I do not support the one-sidedness of a single-payer, fully-nationalized system such as the British NHS, rather a system more modeled on that of France, but with greater market freedoms that will ensure the U.S. can continue to do what it does best, namely advancing the use of medical technology. Yes, France, that friend that everyone loves to hate. The inspiration for 'Freedom Fries' and other Euro-phobic nonsense. Their health care system is arguably the best in the world. Does this mean we should mimic it? Certainly not, but I feel that we can take a cue from our brie-eating friends across the pond and adapt their system to meet our needs.

Despite the constant fear of a 'government takeover', this takeover would impinge upon only an estimated 5% of the current 'corporate takeover' that we now enjoy. The public option is just that, an option. The key is balance, because in the escalating battle between big business and big government, my biggest fear is either one declaring victory.

Facemask, please...

Yesterday Newsweek dared to challenge conventional wisdom by publishing an article that called into question the effectiveness of hand-washing in regards to reducing the spread of influenza, including H1N1. Blasphemy!

Maybe not...

This debate is one that has been ongoing here at UC Berkeley. Just a couple of days ago I tweeted a NYT article citing a study performed here claiming quite the contrary.

The primary impetus behind Newsweek's article is Dr. Art Reingold (my epidemiology professor this semester). Dr. Reingold has not only worked at the CDC and is now chairing Berkeley's epidemiology department, but is involved in the Center for Global Public Health here on campus, the Center for Infectious Disease and Emergency Readiness, and the California Emerging Infections Program (Co-Director). He argues that there is no substantive evidence to prove that humans can become infected with influenza from microbes on their hands, rather, he argues that infection primarily results from inhaled microbes.

There is much evidence to link hand sanitation with prevention of rhinovirus (common cold), certain respiratory ailments, and many gastrointestinal infections, but Dr. Reingold is correct in his assertion that there is no evidence to link it with flu prevention. Much of the CDC's recommendations are based on 'general' respiratory infection guidelines.

Hand-washing is certainly an important public health practice, and fear of H1N1 acting as a motivator (however dubious) for the public to wash their hands more often can be a good thing. The concern however lies in the fact that with health departments nationwide prescribing hand hygiene as a primary barrier to flu infection, other more effective measures, such as facemasks, will be underutilized, if not ignored.

For my part, I've got a stash of 3M N95 respirators in my first aid kit, and I certainly won't hesitate to use them. [Don't get suckered into buying them for $500.00 on ebay, they're cheap, and not that scarce]

I'm still washing my hands though.

[Eduardo the H1N1 mascot working alongside me in the RI Dept of Health's 'Operations Center']

This is Why We Vaccinate...

No I didn't steal this image 28 Days Later, that's Al Davis, owner and general manager for the Oakland Raiders, my neighborhood pro football team.

As I embark on a research project exploring potential infectious etiologies of Autism and am thus forced to wade through articles advocating the now-thoroughly debunked notion that vaccinating children leads to this heartbreaking disorder, I would like to remind everyone to get your shots.

If you don't believe me, see what Dr. Paul Offit has to say...

My point being, you don't want your children to end up looking like Mr. Davis up there, who despite being wealthy enough to own a pro sports team, still looks like he just crawled out of the grave and may drag you back there with him. Get your vaccinations!

H1N1: Antiviral Resistance, Vaccine Supply Doubles

Two of the latest ProMED reports to reach my inbox (V2009 #425 & #427) have brought to light two potentially serious concerns relating to the current H1N1 influenza pandemic now sweeping across college campuses in United States.

The first report confirms what many doctors have been seeing for months, in that according to a study published by the journal Nature Biotechnology, laboratory tests have confirmed that, "Seasonal strains of flu attach themselves almost exclusively to cells found in the nose, throat and upper airway, producing some of influenza's signature symptoms: a runny nose, scratchy throat and a dry cough. But the research shows that [influenza pandemic (H1N1) 2009 virus] -- by sticking to a greater range of receptors -- can also reach cells deep in the lungs."

Essentially what this is saying is that the potential for serious complications from H1N1 are much greater than from seasonal flu. Those persons who are identified as among the top risk groups (pregnant women, infants and small children, individuals who are immuno-compromised) should take care to avoid exposure at all costs. Even for those with healthy immune systems, H1N1 promises to bring you a week filled with cough, sore throat, and fever... it really will knock you on your ass. As thoughtful human beings, anyone who suspects they are infected should stay home for the week to reduce the spread of the disease.

Perhaps an even more worrying report comes this week from a summer camp in North Carolina, where two out several hundred campers and camp staff being given chemoprophylaxis (antiviral medication) to help treat H1N1 clearly displayed signs that strains of the virus are developing resistance to oseltamivir, one of the two most commonly used antivirals used to treat influenza. Oseltamivir is sold under the brand name Tamiflu. The virus is still shown to be susceptible to the other common antiviral drug, zanavimir (Relenza). The full report can be access via CDC's Mobidity & Mortaility Weekly Report.

A quick rundown on antivirals vs. vaccines...

Tamiflu and Relenza are two of the most common and effective antiviral drugs used to combat influenza, and stockpiles of both are common in doctors offices, hospitals, and state and federal warehouses (I have personally stocked more boxes of these medications than I could ever count - thanks CDC). These medications do not cure the flu, rather they enhance the body's immune response to the virus, hopefully making symptoms less severe, and reducing the overall time of infection. Antivirals can be taken in advance of expected exposure or soon after suspected infection.

These antivirals stand in contrast to vaccines (of which there are several for other strains of flu) that are currently being developed to protect the population against H1N1. Without going into too much detail, the production process for an H1N1 vaccine, while being implemented rather rapidly, is nevertheless complicated by the need to simultaneously produce and administer seasonal influenza vaccine. Seasonal influenza vaccine production has more or less been completed, and the public can expect to see seasonal influenza vaccination clinics by the end of this month. H1N1 vaccine will likely not be widely available until mid-to-late October (which may miss the virus' peak), but as some have suspected, it is now being reported that protection from H1N1 can be achieved through one shot, rather than two, essentially doubling the vaccine supply.

The best advice remains the tried and true advice being repeated by public health practictioners for the past several months: cough into your elbow, wash your hands frequently, and stay home if you're sick. It's not the magic bullet that the public wants, but these practices can make the most difference in rates of infection.

This is Berkeley...

A brief photo tour of my new home, Berkeley, CA...

Berkeley Bowl... no its not a bowling alley. Its a grocery store and their produce section (as you can see) is enormous. Having dirt cheap produce only 4 blocks from my house gets two thumbs up.

Cal has a football team. And a 72,000 person stadium. And a Heisman contender (Jahvid Best). Oh, and they're No. 10 in the country right now. I got season tickets.

It took me a few days to realize what the sign I often lock my bike to actually meant... 'NL' stands for Nobel Laureate, and yes, there are multiple parking spots.

Speaking of bikes, trying to find a spot at a bike rack here is like trying to find a place to park your car at on the URI campus, meaning if its past 10am, forget about finding anything convenient.

Sunset over the Pacific, taken from Highway 1 on the ride back from Santa Cruz...

Stressed?

No Rep. Joe Wilson of South Carolina, you lie... Get your facts straight.

Thumbs up Obama, way to chide all of Congress in their own house, in prime time. Here's a few of my favorite lines, before things blow up in the media tomorrow and the debate quickly clouded again...

"I am not the first president to take up this cause, but I am determined to be the last!"

[Referring to people losing health care coverage] "That is heartbreaking, it is wrong, and no one should be treated that way in the United States of America."

"Our health care problem is our deficit problem... nothing else even comes close."

"The time for bickering is over, the time for games has passed. Now is the season for action. Now is when we must bring the best ideas of both parties together and show the American people that we can still do what we were sent here to do. Now is the time to deliver on health care!"

"But know this: I will not waste time with those who have made the calculation that it's better politics to kill this plan than to improve it. I won't stand by while the special interests use the same old tactics to keep things exactly the way they are. If you misrepresent what's in this plan, we will call you out. And I will not... And I will not accept the status quo as a solution. Not this time; not now."

See the full text of Obama's speech...


**Sidenote: Prime time on the West Coast is strange, watching that speech at 5pm... Not looking forward to NFL games at 10am.

Health Care Reform: The Breakdown

So, its been pointed out to me recently that less than a year ago 70% of Americans favored a public option for health care... my oh my, how a worthless media establishment, pissy obstructionist Republicans, corporate-beholden Blue Dog Democrats, pushy liberal-zealot Democrats, and a President that thought he could get these fools to compromise have shifted the debate so far from where it should be is just downright depressing. And the insurance companies and their shareholders are laughing all the way to the bank.

WAKE UP AMERICA!

If you do not favor health care reform I really want to know why. I can fathom people's arguments about not wanting a public option, I may not agree, but there are arguments against it that are based in logic (mentioning the establishment of death panels or a mysterious government bureaucrat getting between you and your doctor discounts any logic you think your argument might have). Death panels? Seriously? And anyone with private insurance who gets to spend good quality time with their doctor, I assure you, you are a rarity. Most people go through doctor's offices like they were in line at the deli. Health care reform is much bigger than a public option. Sure thats a big component of what some would like to see pass, but there's a lot more that will have a huge impact on the current system.

I'm looking forward to Obama's speech (in ~20 minutes) tonight because I hope that he'll be able to use his deft ability to orate to clear the air and put this debate back on track. Key word here being 'debate'. Senator Mitch McConnell's (R-KY) proposal to 'skinny this thing down' (referring to the large text of the legislation currently proposed) and Rep. John Boehner's (R-OH) assertion that “It appears that the president is going to double down tonight and try to put lipstick on this pig and call it something else," do nothing to contribute to debate... and these are the Senate and House minority leaders! If Republicans are so adamnt about killing this legislation, I'd like to see what they propose instead, because if they're ok with the status quo, there's something terribly wrong.

As many (including an article in the New York Times today) have argued, if Republicans shifted from being simply obstructionist (with the exception of a few, thanks Olympia Snowe!) to actually showing a willingness to compromise, they could actually get some of their proposals into legislation, and it would give Obama leverage against the more liberal members of the Democratic Party, who at this point, are Obama's only hope to get anything passed.

Seems like a no-brainer to me... deny liberal Dems their communist agenda AND have a say in what has the potential to be one of the most historic pieces of legislation of a generation? Come out and play Republicans!

Never thought I'd be saying that...

I was going to break down all the different elements of proposed legislation, but I think that will be better done tomorrow once the air clears and we see where things really stand in this debate.