Experts in autocracies have pointed out that it is, unfortunately, easy to slip into normalizing the tyrant, hence it is important to hang on to outrage. These incidents which seem to call for the efforts of the Greek Furies (Erinyes) to come and deal with them will, I hope, help with that. As a reminder, though no one really knows how many there were supposed to be, the three names we have are Alecto, Megaera, and Tisiphone. These roughly translate as “unceasing,” “grudging,” and “vengeful destruction.”
So, this is what happens when people don’tpay attention toevery little detail. I was intrigued by the title (and certainly suspected something else.) It certainly never occurred to me that the answer would lie in obscure budget practices and requlations.
I’m not allowed to republish phpts from ProPublica, and the ones I could find on Google were too gruesome to even consider … so no pictures.j
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One Major Reason the U.S. Hasn’t Stopped Syphilis From Killing Babies
by Caroline Chen
ProPublica is a Pulitzer Prize-winning investigative newsroom. Sign up for The Big Story newsletter to receive stories like this one in your inbox.
Series:
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In public health, a “sentinel event” is a case of preventable harm so significant that it serves as a warning that the system is failing. The alarms are now blaring.
A growing number of babies are being born with syphilis after their mothers contract the sexually transmitted disease and the bacteria crosses the placenta. These cases are 100% preventable: When mothers who have syphilis are treated with penicillin while pregnant, babies are often born without a trace of the disease. But when mothers go untreated, there is a 40% chance their babies will be miscarried, be stillborn or die shortly after birth. Those who survive can be born with deformed bones or damaged brains, or can suffer from severe anemia, hearing loss or blindness.
I’ve spent the past few months trying to understand why countries including Belarus, Cuba, Malaysia and Sri Lanka have managed to wipe out congenital syphilis while the United States faces its highest incidence in nearly three decades: Last year, 2,022 cases were reported, including 139 deaths. That’s a shocking reversal from 1999, when the Centers for Disease Control and Prevention declared that the United States was on the verge of eliminating the centuries-old scourge for adults as well as babies.
What went wrong here?
My reporting led me to one major factor: the unusual and — according to various experts I spoke with, problematic — way that the CDC is funded, which has not only hampered the response to a rise in sexually transmitted diseases, but also has left us ill-prepared for the COVID-19 pandemic.
State and local health departments get much of their money from the federal agency, which has the best birds-eye view of all of the bugs, viruses and illnesses circulating in America. But CDC scientists don’t have the power to decide how much money to spend fighting each one.
Instead, Congress dictates to the CDC, in an uncommonly specific manner not seen with many other agencies, exactly how much money, by line item, it can spend to combat any single public health threat, from broad categories like emerging infectious diseases and Alzheimer’s disease, to more niche conditions like interstitial cystitis, neonatal abstinence syndrome and Tourette syndrome. Though prevention tactics for HIV and other STDs significantly overlap, HIV prevention has a separate line item and is allocated about six times as much money as the category for sexually transmitted infections.
The decisions can be politically driven and detached from bigger-picture health needs, as lobbyists and patient advocates descend on Washington to make the case to lawmakers that their specific disease of interest should get a bigger piece of the pie. Causes that don’t have large armies of compelling spokespeople can get ignored. Sexually transmitted diseases, which have an extra layer of stigma to contend with, have few dedicated advocacy groups. The small number of lobbyists focused on STDs sometimes can’t even get a meeting with lawmakers.
“The CDC needs to have more money and more flexible money,” former CDC director Dr. Tom Frieden told me. The political nature of the agency’s funding is part of what led the country to neglect virus surveillance before the coronavirus pandemic. The 2014 Ebola epidemic was supposed to be a “global wakeup call,” yet in 2018, the CDC scaled back its epidemic prevention work as money ran out.
That means public health in the U.S. is constantly in what Frieden calls “a deadly cycle of panic and neglect” — scrambling to throw money at the latest emergency, then losing the attention and motivation to finish the task once fear ebbs. In May, President Joe Biden’s administration announced it would set aside $7.4 billion over the next five years to hire and train public health workers. But some officials worry about what will happen when those five years are up. “We’ve seen this movie before, right?” Frieden said. “Everyone gets concerned when there’s an outbreak, and when that outbreak stops, the headlines stop, and an economic downturn happens, the budget gets cut.”
Jo Valentine, former program coordinator for the CDC’s 1999 push to eliminate syphilis, says one of the reasons the campaign failed is because public health is usually working “in rescue mode, parachuting in and fixing things.” That’s effective in acute situations, like stopping a new outbreak from exploding, but it doesn’t address long-term structural issues like economic stability, safe housing and transportation, which are all key factors in chronic and preventive care. The last fraction of cases in any public health effort can be the hardest to solve because they often involve vulnerable populations experiencing these barriers to accessing care. They are also the easiest populations to ignore.
Local health departments don’t have nearly enough resources to investigate cases of syphilis with contact tracing, which involves tracking down patients, inquiring about sex partners and making sure everyone is treated. One disease intervention specialist I shadowed in Fresno, California, has made six trips to a rural town, driving an hour each way, trying to prevent a single case of congenital syphilis. The patient is unhoused and itinerant, and so far has been hesitant to visit the community clinic for treatment.
With interest in public health now at an all-time high, it is worth reexamining how much money public health gets to take on these unpopular but necessary challenges, and how much authority the CDC gets to set its priorities. I hope that, five or 10 years from now, I’m not still reporting about COVID-19 hot spots left behind after attention wanes, creating places where the disease still flares because testing or treatment is hard to come by. And I also hope I’m not still writing about babies dying from syphilis.
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AMT, It’s hard enough – next to impossible, I would say – to get people to pay attention even to the biggest of governmental trends. I really have no clue how to get people to pay attention to something like this. We really need any help whatsoever you can give us. Particularly when safe and legalabortions are becoming harder and harder to obtain, we do not need a problem like this one.
Experts in autocracies have pointed out that it is, unfortunately, easy to slip into normalizing the tyrant, hence it is important to hang on to outrage. These incidents which seem to call for the efforts of the Greek Furies (Erinyes) to come and deal with them will, I hope, help with that. As a reminder, though no one really knows how many there were supposed to be, the three names we have are Alecto, Megaera, and Tisiphone. These roughly translate as “unceasing,” “grudging,” and “vengeful destruction.”
I know everyone is wondering whether – not when – the current coronavirus, including the Delta variant, will ever go away. Well, the answer to that is no, it won’t. It wll likely become easier to deal with, but it’s unlikely to go away. The most likely outcome is that it will become like seasonal flu in that it will continue to change a little and new vaccines will be needed every year. And, as now happens with the flu, every year people will die from it – although not in the kind of numbers we are currently looking at.
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Is COVID-19 here to stay? A team of biologists explains what it means for a virus to become endemic
Early on in the pandemic, it wasn’t unreasonable to expect that SARS-CoV-2 (the virus that causes COVID-19) might just go away, since historically some pandemic viruses have simply disappeared.
For instance, SARS-CoV, the coronavirus responsible for the first SARS pandemic in 2003, spread to 29 countries and regions, infecting more than 8,000 people from November 2002 to July 2003. But thanks to quick and effective public health interventions, SARS-CoV hasn’t been observed in humans in almost 20 years and is now considered extinct.
On the other hand, pandemic viruses may also gradually settle into a relatively stable rate of occurrence, maintaining a constant pool of infected hosts capable of spreading the virus to others. These viruses are said to be “endemic.”
Examples of endemic viruses in the United States include those that cause the common cold and the seasonal flu that appear year after year. Much like these, the virus that causes COVID-19 likely won’t die out, and most experts now expect it to become endemic.
So why did the first SARS virus from 2003 (SARS-CoV) go extinct while this one (SARS-CoV-2) may become endemic?
The ultimate fate of a virus depends on how well it maintains its transmission. Generally speaking, viruses that are highly contagious, meaning that they spread really well from one person to the next, may never die out on their own because they are so good at finding new people to infect.
When a virus first enters a population with no immunity, its contagiousness is defined by scientists using a simple mathematical term, called R0, which is pronounced “R-naught.” This is also referred to as the reproduction number. The reproduction number of a virus represents how many people, on average, are infected by each infected person. For example, the first SARS-CoV had an R0 of about 2, meaning that each infected person passes the virus to two people on average. For the delta variant strain of SARS-CoV-2, the R0 is between 6 and 7.
The goal for public health authorities is to slow the rate by which viruses spread. Universal masking, social distancing, contact tracing and quarantines are all effective tools to reduce the spread of respiratory viruses. Since SARS-CoV was poorly transmissible, it just took a little bit of public health intervention to drive the virus to extinction. Given the highly transmissible nature of the delta variant, the challenge for eliminating the virus will be much greater, meaning that the virus is more likely to become endemic.
In August 2020, about 500,000 motorcyclists rode the streets of Sturgis, South Dakota, at the city’s annual motorcycle rally. Masks were encouraged but not required. COVID-19 cases throughout the state increased. Bryan R. Smith/AFP via Getty Images
Is COVID-19 ever going away?
It’s clear that SARS-CoV-2 is very successful at finding new people to infect, and that people can get infected after vaccination. For these reasons, the transmission of this virus is not expected to end. It’s important that we consider why SARS-CoV-2 moves so easily from one person to the next, and how human behavior plays into that virus transmission.
SARS-CoV-2 is a respiratory virus that is spread through the air and is efficiently transmitted when people congregate. Critical public health interventions, like mask use and social distancing, have been key in slowing the spread of disease. However, any lapse in these public health measures can have dire consequences. For instance, a 2020 motorcycle rally brought together nearly 500,000 people in Sturgis, South Dakota, during the early phases of the pandemic. Most of the attendees were unmasked and not practicing social distancing. That event was directly responsible for an increase in COVID-19 cases in the state of South Dakota and nationwide. This shows how easily the virus can spread when people let their guard down.
The virus that causes COVID-19 is often associated with superspreading events, in which many people are infected all at once, typically by a single infected individual. In fact, our own work has shown that just 2% of the people infected with COVID-19 carry 90% of the virus that is circulating in a community. These important “supercarriers” have a disproportionately large impact on infecting others, and if they aren’t tracked down before they spread the virus to the next person, they will continue to sustain the epidemic. We currently don’t have a nationwide screening program geared toward identifying these individuals.
Finally, asymptomatically infected people account for roughly half of all infections of COVID-19. This, when coupled with a broad range of time in which people can be infectious – two days before and 10 days after symptoms appear – affords many opportunities for virus transmission, since people who don’t know they are sick generally take few measures to isolate from others.
The contagious nature of SARS-CoV-2 and our highly interconnected society constitute a perfect storm that will likely contribute to sustained virus spread.
Given the considerations discussed above and what we know about COVID-19 so far, many scientists believe that the virus that causes COVID-19 will likely settle into endemic patterns of transmission. But our inability to eradicate the virus does not mean that all hope is lost.
Our post-pandemic future will heavily depend on how the virus evolves over the coming years. SARS-CoV-2 is a completely new human virus that is still adapting to its new host. Over time, we may see the virus become less pathogenic, similar to the four coronaviruses that cause the common cold, which represent little more than a seasonal nuisance.
Global vaccination programs will have the greatest impact on curbing new cases of the disease. However, the SARS-CoV-2 vaccine campaign so far has touched only a small percentage of people on the planet. In addition, breakthrough infections in vaccinated people still occur because no vaccine is 100% effective. This means that booster shots will likely be needed to maximize vaccine-induced protection against infection.
With global virus surveillance and the speed at which safe and effective vaccines have been developed, we are well poised to tackle the ever-evolving target that is SARS-CoV-2. Influenza is endemic and evolves quickly, but seasonal vaccination enables life to go on as normal. We can expect the same for SARS-CoV-2 – eventually.
How will we know if and when SARS-CoV-2 becomes endemic?
Four seasonal coronaviruses circulate in humans endemically already. They tend to recur annually, usually during the winter months, and affect children more than adults. The virus that causes COVID-19 has not yet settled down into these predictable patterns and instead is flaring up unpredictably around the globe in ways that are sometimes difficult to predict.
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Once rates of SARS-CoV-2 stabilize, we can call it endemic. But this transition may look different based on where you are in the world. For instance, countries with high vaccine coverage and plentiful boosters may soon settle into predictable spikes of COVID-19 during the winter months when the environmental conditions are more favorable to virus transmission. In contrast, unpredictable epidemics may persist in regions with lower vaccination rates.
================================================================ Alecto, Megaera, and Tisiphone, could this virus have been prevented from becoming endemic? The authors are careful not to address that or even allude to it. But from what they do say about the handling of the 2002-2003 outbreak, my guess is yes, it could have. Our president at that time was George W Bush. I seriously doubt he knows or knew more than Trump** about science ot public health or viruses. But what he did know was how to shut up and let his people do their jobs, and to back them up, and to not make everything about himself. I am inclined to believe that, if we had had President H. Clinton in 2020, the handling of the pandemic would have been such that the virus could have been made extinct. Of course, that is not provable – hypotheticals seldom are.
Yesterday, I slept in a couple of hours – no cool dreams, but I awoke to a day cool enough to shut off all the fans again. Of course. I surely could have used that kind of weather Sunday. Today is supposed to stay cool-ish, and then back to the fans for another week. Of course that’s not carved in stone. Incidentally, today is the day the US celebrates the Chinese Moon Festival (China celebrates for 3 days). If there is an Asian grocery near you, you might want to see whether they have any extra Mooncakes. Yum.
The Hill – Drug companies on verge of sinking longtime Democratic priority
Quote – The bill at the center of the fight, H.R. 3, would allow Medicare to negotiate the price of prescription drugs by tying them to the lower prices paid by other high-income countries. The measure is projected to free up around $700 billion through the money it saves on drug purchases — covering a big chunk of the Democrats’ $3.5 trillion spending plan. CLick through for background. This is the kind of story that often geets overlooked, but shouldn’t.
The 19th – ‘We’re seeing shock.’ Texas abortion clinics are now operating as trauma centers
Quote – When patients arrive at [Whole Woman’s Health in Fort Worth], she said, they are aware of the realities of the new law: Abortion past six weeks is now illegal, with no exceptions for rape and incest. Still, they can hardly process that there’s little the clinic can do to help them…. For patients they can’t treat, clinic staff offer to schedule appointments with providers out of state. To date, not a single patient at Whole Woman’s Health in Fort Worth has taken them up on it. Most are taken aback by the offer, Sadler said. They’ve already had to take time off of work, find child care and transportation, even leave meals for family at home just to make it through the door at her clin Click through for more. The 19th is (as you might guess by reading the 19th Amendment) woman-centered, and this article puts a face on the issue which most publications don’t.
Yesterday, I piddled around with a bunch of small household tasks. Can’t say as I really accomplished much, but sometimes getting a bunch of little stuff out of the way does feel like accomplishment.
Cartoon – Incidentally, I own a framed copy of the print made from this rendition by Bryan Moon of that occasion. I love his work.
Short Takes –
Crooks and Liars – Pathetic Arizona Manbabies Cosplay Gomer Pyle At Elementary School
Quote – Now, I could write a normal article, citing The Washington Post and Daily Beast, outlining the absurd and outrageous details of this dangerous nonsense. Frankly, these three don’t deserve the national attention or my resultant rise in blood pressure. Instead, I shall vent my spleen, and open a good, old-fashioned can of Brooklyn whoop-ass on them, as god and my DNA intended. In case you missed this, click through. The principal is physically fine, as is the other staff member, but both were naturally terrified. Since, she has received so much support from the community, she can’t talk about it without tearing up with gratitude
CNN (H/T Carrie B) – Like Washington and Jefferson, he championed liberty. Unlike the founders, he freed his slaves
Quote – It was 230 years ago Sunday that Robert Carter III, the patriarch of one of the wealthiest families in Virginia, quietly walked into a Northumberland County courthouse and delivered an airtight legal document announcing his intention to free, or manumit, more than 500 slaves. He titled it the “deed of gift.” It was, by far, experts say, the largest liberation of Black people before President Abraham Lincoln signed the District of Columbia Emancipation Act and Emancipation Proclamation more than seven decades later. Click through for the full (and virtually unknown) story. It deserves to be known far and wide. (Without going into detail, it appears possible that Carter Burwell, composer of the music for many films, especially Coen Brothers films, is a descendant.)
Yesterday was definitely hot. It is supposed to cool down today. I certainly hope so.
Cartoon –
Short Takes –
Official White House Document: National Strategy for Countering Domestic Terrorism
Quote – Too often over the past several years, American communities have felt the wrenching pain of domestic terrorism. Black church members slaughtered during their bible study in Charleston. A synagogue in Pittsburgh targeted for supporting immigrants. A gunman spraying bullets at an El Paso Walmart to target Latinos. It goes against everything our country strives to stand for in the world, and it poses a direct challenge to America’s national security, our democracy, and our national unity. This National Strategy for Countering Domestic Terrorism lays out a comprehensive approach to addressing the threat while safeguarding bedrock American civil rights and civil liberties – values that make us who we are as a nation. Click through for full document. Yes, it’s long. It is also an official document, which mkes it a benchmark for wht to expect from government and how to evaluste how governmen is doing. Something to download or bookmark.
The Hill – Pelosi calls on CDC to extend eviction moratorium unilaterally
Quote – As House Democratic leaders struggle to find enough party support to extend an eviction moratorium, Speaker Nancy Pelosi (D-Calif.) is advocating a temporary fix, urging the Biden administration to act unilaterally to help the nation’s most vulnerable renters. The Speaker said the Centers for Disease Control and Prevention (CDC), which has instituted a ban on evictions through the end of Saturday, should extend the deadline further, giving House Democrats more time to codify the extension in legislation. Click through for deets. It is like Nancy to thibk outside the box when necessary to get stuff done that needs doing.
HuffPost – ‘Comically Minimal Ego-Stroking’: Inside The Bumble Takedown Of A Violent Capitol Rioter
Quote – A citywide curfew was in place, and she could hear the helicopters hovering in the sky. Outside her window, “Claire” could see Trump supporters streaming back from the Capitol to a hotel near her home, carrying their flags and wearing “Make America Great Again” hats. “I was watching on the news and seeing everyone walk back,” Claire told HuffPost. “It felt kind of useless for me to be that close and not kind of do anything proactive about it.” Click through for the whole story. I loved this when I first saw it – and I love even more knowing that she’s not the only one looking, and he’s not the only one getting foumd.
Glenn Kirschner – DOJ Announces it will Defend Donald Trump in Defamation Lawsuit brought by E. Jean Carroll this week is turning into a workshop on how decent people express anger. Glenn makes his voice into silk dripping with sarcasm.
Meidas Touch – with Stuart Stevens
The Lincoln Project – The Line
BARF BAG ALERT! Campaign “ad” from Lauren Boebert. Yecccch!
Now This News – Magawa the Landmine-Sniffing Rat is Retiring a Hero (Just a little break. There are actually maany of these rats and the lives they have saved, and are saving, are priceless.)
