#(160717-)
1 Spontaneous Memorials, 2 Acne - Superbugs, 3 Working Sick - Work Sickening, 4 Zika - Hindsight, 5 Ebola - Rumor, 6 Induced Hypochondria, 7 Health Silos, 8 Parademic Aftermath, 9 Avian Disease - Increase Risk
1. Last week 160710-4.3↓ addressed a weakness to the weekly listicle is that graffiti related to parademic needs someone at the actual location to collect and learn what they means. Another source of parademic information that can only be obtained by those on the ground are spontaneous memorials. One type of this phenomena is on the side of roads [Photo] where people die have died in auto accidents, or gatherings of people with little physical evidence of the event afterwards [Photo]. These informal memorials also form after mass casualty events, such as biodisasters, and are informative about how what happened is perceived and how the next one may be perceived from a visceral community view point. Usually there is a lag time before such displays are made for biodisasters and are likely to be additions to an official memorial or mass grave or internment site. ¶ The recent mass casualty of Five Dallas Officers Were Killed as Payback, Police Chief Says is an example of a memorial where questions can be answered if there was basic information collected on what was left, the messages left, who left, and asking people the significance of items and why they added these to the memorials. What makes this particular spontaneous memorial is that it is unique in both venue and participants. These differences can provide more insights about mass casualty memorials that typical ones. In Dallas, Already Embattled Police Department Mourns, the department has suffered from low pay and poor morale, but citizens have been rallying around officers, suggesting that last week's shooting could be a turning point. [Photo, Photo, Photo, Video]. Issues in the Collection and Conservation of American Vernacular Memorial Art, Letter left at the Vietnam Veterans Memorial, July 20, 1985, Burdens of Grief: The Rise of Spontaneous Memorial Sites, ‘If We Were Not Brothers Before This, We Certainly Are Brothers Now,’ a Dallas Imam Tells a Minister. Will be interesting to see if this will have impact on Zika 160214-4↓. Ebola Memorial Cemetery Dedicated in Liberia. The Tragic Story of Dallas' First African American Police Officer. ¶ These in turn are better informed if one is aware of the funeral practices and grief expressions that are practiced in a community – wakes, parties, periods of morning, dress, elaborate ceremonies, cremation, burial, public, family only. These practices can be disrupted by the logistical needs of mass fatalities overwhelming existing systems and can cause strong, possibly violent, resistence to public health measures.
2. Doctors Warn Acne Could Become Resistant to Antibiotics [Photo]. This was sent to me by a reader of the weekly blog. Normally Parademic does not touch on the purely clinical information. However in this case the skin condition carries stigma Acne & Agony: The Social Stigma of Bad Skin, with billions of funds generated by treatment and marketing for Research and Markets: The Global Acne Market Is Estimated To Reach Revenues of $3.02 Billion by 2016 at a Compound Annual Growth Rate (CAGR) Of 0.7%. It could be that treatment resistant acne could result in more funding of research and curtailment of antibiotic overuse than the emerging serious diseases that are no longer treatable. FDA OKs non Prescription Use of Acne Drug. Self Prescribing Antibiotics Is a Big Problem. Infection Experts Warn of More U.S. Superbug Cases in Coming Months. Scary New Superbug Is Popping Up in More Places. The Antibiotic Apocalypse Has Been Happening for Years – We Just Didn't Notice. In actual fact it was noticed, but those who should have did not listen. [Cartoon]
3. Sick? People Say They Still Go to Work, Even When They Shouldn't. An NPR poll found that most working adults say they go to work when they're sick. For people who work in hospitals or restaurants that can be a problem, since it's easy to spread disease. ¶ The biggest factor was that the workers are concerned about their coworkers having to work a man down Hassle of Being a Patient Can Turn into a Crisis Without Sick Leave. Working when sick has been a known problem for years. There is however an exception. During a pandemic where the risk of getting sick of a serious illness outweighs loyalty to coworkers, pay and keeping job, and people who are well refuse to work Healthcare Workers' Perceptions of the Duty to Work During an Influenza Pandemic. The statistics on this are all over the map, but over the years the trend seems (but I and no one else has done a study) to be that more people are willing to come to work in a hospital as there is increased protections for staff, more adherence with infectious disease protocols, and public condemnation at those who avoid their duty. This trend though is contradicted by what people will say they do, and what they actually do in the real situationwhen staff has become sick, when a hospital has demonstrated that protective protocols don’t work or administration does not support staff. There is an additional factor of attacks on medical in conflict zones, driving medical personnel away. Then there is the possibility of coordinated secondary attacks. This has been seen where a second bomb is planted to take out first responders. What if something similar had been done in a mass shooting or bio terror attack, where the second target is where people are taken for medical care. Overworked Americans Aren't Taking the Vacation They've Earned, though 4↓ implies that this is not true of all Americans.
3.1. Fort McMurray Firefighters Expect Lives Will Be Cut Short by Smoke Related Illness. Many Fort McMurray firefighters, unable to wear their usual air masks while battling a giant wildfire that attacked the northern Alberta city, are being screened for health problems because they spent several days breathing in hazardous smoke. Fungal Spores Are Transported Long Distances in Smoke from Biomass Fires 160515-1↓. 14 Years Later, Here's What We Know about 9/11 and Cancer, Gulf War Veterans’ Medically Unexplained Illnesses.
↕4. 160710-4.1↓ Zika Arrives, Congress Shrugs, Zika Virus Countdown: 'This Funding is Done. It's Not Coming to Us' Congress starts its final week of the summer Monday with no Zika legislation in sight. This was predictable Zika Deal in Congress Likely to Be Delayed Until After Recess, Texans in Congress Have Few Weeks to Tackle Big Issues, Congressional Unfinished Business, and likely nothing will be done until after the elections along with other delayed legislation and appointments, with the possibility of Recess Appointments. GOP Backs New Fund for Public Health, with Congress deadlocked over funding to fight the Zika virus, senior GOP leaders are working to head off yet another big public health funding fight. If there is an outbreak this may impact on elections of incumbents, but it will be difficult to make complaints when congress is not in session and there is more political drama coming with the political party conventions and Presidential election. The most visible Zika consequence of microcephalic babies will not be starting until around January 2017, hence a safe bet that one will be elected before a major backlash about refusing to fund, and much can happen before the midterm elections. Congress Will Fight over Guns, Zika as it Sprints for Recess, What Do Members of Congress Actually Do During Their Summer 'Recess' 160529-4.2↓. ¶ Half of Americans Say Threats from Infectious Diseases Are Growing, with rise of the Zika virus catching public attention, people are particularly worried about its threat to pregnant women. This is a typical pattern in pattern parademic. The threat from disease has in fact been increasing long before it is perceived as one by the wider public, followed by another lag before officials start to be influenced by the public perception. Why Congress' Zika Impasse Could Awaken Ebola Menace. Emergency funds to fight Ebola may run out in October because they were poached to fight Zika, What the Fading Ebola Epidemic Can Teach Us about the Looming Zika Crisis. ¶ Baby Born in Texas with Microcephaly Linked to Zika, Number of Zika Cases Nearly Quadrupled in New York City Since May, New York Reports First Female to Male Zika Transmission via Sex . Senate Impasse Postpones Zika Funding Talks till Fall, Lawmakers Leave for Summer Without Approving New Zika Funds, but they did manage* Five Things to Know About the New GMO Labeling Bill. Congress just passed a bill requiring GMO labeling, but it's not as straightforward as you might think, There Is Reasonable Discourse in the GMO Label Debate, The Controversial GMO Labeling Bill That Just Passed Congress, 4.5↓. Zika Is Spreading. Congress Did Nothing. Now What. Zika Funding Bill Fails as Congress Is Unable to Reach Compromise. [Art, Cartoon]
* Readers have commented on unusual use of punctuation, or not using punctuation, in the stubs. This is sometimes because a question mark is used when the item is not a question, or where it is not clear when the question begins ¿. Sometime common usage in inaccurate such as - to join words (or omitted sequence of numbers) when the actual meaning is to separate, The En-Dash, Em-Dash and Hyphen. The / is the actual symbol to join words, but current usage has made it the opposite. ¶ Surprisingly there is no standard punctuation to indicate sarcasm, irony, skepticism, though there are vocal signals that indicate these. 13 Little Known Punctuation Marks We Should Be Using, Irony Punctuation, Proofreading Marks. But then what is the use of irony, humor, underlying meaning, marthambles, and ludicrous information if one has to point it out. In addition the use of minor intentional errors is an easy way to engage critical active reading/listening, as opposed to the far more common uncritical passive reading/listening. Increasing Students’ Active Reading. My favorite example is the question, which one invokes the requested action; Think or Thimk.
“Current Utility may not be equated to historical origin”. “Current utility and historical origin are different subjects”. Stephen Jay Gould
4.1. Golf Chief Disappointed at 'Overreaction' to Zika Threat. If one googles Zika Overblown, Zika Overreaction, Zika Hype there were many of these around the first of the year, but died out as more cases appeared. This has been the usual pattern since H5N1/H1N1 where there is hype and alarm, then one sees what actually happens, and with 20/20 hindsight can safely pontificate about overreaction or underreaction (blame in other words). This will be especially interesting if a Super Zika develops that becomes endemic. ¶ Speaking of 20/20 hindsight Antibiotic Resistance Genes Discovered in 900 Year Old Incan Mummy. This is not actually a surprise since microbes have been practicing “natural” biological warfare (GMO, antibiotics, toxins) for about 3.5 billion years, which predates oxygen in the atmosphere. Oxygen was the first air pollution that lead to the first global mass extinction from a biosyndemic. Poisoned Planet, Great Oxidation Event: More Oxygen Through Multicellularity. ¶ Overreaction usually implies that other threats are being ignored, Brazil: Chikungunya Cases Nine Times Those of 2015.
4.2. This US Government Program May Have Stopped Ebola - but Never Had the Funding It Requested. Six years ago, the scientist leading the US government's program to catch diseases before they turn into global pandemics went to Capitol Hill with a map of the world. Dr. Scott Dowell was meeting with key Congressional staffers to warn them about what he believed were gaping holes in the system designed to detect and contain infectious disease outbreaks, before they could kill thousands or potentially millions of people. Actually the request for funds to find the reservoir of the 1976 outbreak was the first opportunity to stop the disease spread. Decision was made that since the outbreak was over and killed so few that would not be necessary. Again with 20/20 hindsight we know that was not a good decision, along with not finishing the development of an Ebola vaccine. But then we don’t know the number of diseases that time and money were spent on to locate the source and never found, or how often requests for additional funds to find the source were denied, with no outbreaks afterwards. At that time it was probably a reasonable decision as there was limited data that the global environment and human transportation was be changing in ways that would allow the spread of novel disease. ¶ History Credits this Man with Discovering Ebola on His Own. History Is Wrong. Discovery of misinformation and missed opportunities are common after a disaster. In this case the errors and blaming related to Ebola may be a foreshadowing of similar articles of a Zika disaster. It is not unusual for an apparent topic to not be the actual topic. A classic example is The Crucible which was about the Salem Witch Trials, and a social commentary on McCarthyism (George, not Jenny, though there are similarities Jenny Mccarthy Shows off Her Knowledge of Science).
4.3. Brazilian Moms of So Called 'Zika Babies' Bond, Say They're Shunned. Some new moms in Brazil are being hit especially hard by the Zika virus. Not only are they worrying about their babies' health, now some say they feel abandoned, and shunned by society. Husbands leave after babies are born with microcephaly, relatives even ask why they didn't abort. Support groups bring the mothers together. In the epicenter of Brazil's Zika outbreak, the mothers of the so-called "Zika babies" lean on each other. Most days are spent going from one appointment to another. The sheer commitment of raising a child with microcephaly bonds these mothers into an extended family. Ebola: Psychology, History, Culture, Stigmatized Illnesses and Health Care, What's Happened to Thalidomide Babies, Children of Mothers with Intellectual Disability: Stigma, Mother Child Relationship and Self Esteem. What this Amazing Mom of Two Girls with Microcephaly Has to Say about Zika Scare. 4.4, 9↓. ¶ And with parademic the stigma and other consequences do not have to be from an actual cause Nancy Snyderman Breaks Silence on Ebola Nightmare, NBC News: "People Wanted Me Dead", Yes, We Did Overreact to Dr. Nancy Snyderman’s Ebola Screwup, CDC Says Returning Ebola Medical Workers Should Not Be Quarantined, For U.S. Liberians, Stigma Adds to Ebola’s Burden.
4.4. A misleading headline but it does grab attention. Article itself gives accurate information about the uncertainty of this statement and that there will be waves in the future. Zika Epidemic Will End in Three Years. The problem is not so much an attention grabbing headline but that other sources may not get all the facts as use only the headline as fact, either to support that funding is not necessary for Zika because it will burn out, or that “scientists” were wrong again. This particular article has been cloned exactly on several sites, giving it wide distribution and exposure. Even so because it takes a clinical perspective about what the agent will do, is ignores the social consequences and dealing with chronic neurological conditions from Zika. Zika Epidemic May Have Peaked but Will Threaten U.S. for Years, What Does the Future Hold for Babies with Microcephaly, What Is the Life Expectancy of a Child with Microcephaly. 4.3↑.
4.5. Though a single study, finally some evidence about GMO Mosquitos to counter all the fear based speculation based on nothing (Monsanto Cucumbers Cause Genital Baldness — Immediately Banned in Nova Scotia) about GMO’s being bad mutations, unnatural, inorganic, frankenfood. First Evidence That GM Mosquitoes Reduce Disease. 4↑, 4160626-4.4↓. If the pattern holds anti-GMO will quickly debunk this due to the sin of being funded by a company. Apparently this cardinal sin that negates any science. Though one should always be aware of who is funding a study, it is not a reason for automatic dismissal. Besides most anti-GMO ignore their own company funding sources.
5. Note: I decided to leave this one in a rough form rather than edit completely*. ¶ This one will be worth following (updated: originally on IBT but taken down, but H5N1 still has an excerpt) Man Tests Positive for Ebola in Delhi. I’m a bit skeptical as it is too similar (if not an exact clone) to India Isolates Ebola Survivor at an Airport (2014). Though tests of three blood samples came up negative, Indian officials opted to hold him because the virus can linger in other bodily fluids, like semen or urine, for as long as three months, according to a government statement. Two samples of the man’s semen tested positive. ¶ In this article and the 2014 one we have the continued confusion between Isolation (someone who is sick), Quarantine (to watch to see if someone will become sick), and Surveillance/Monitor (checking if someone is still a carrier, had a relapse, and/or still following restrictions, abstinence in this case). Possible overabundance or caution (or paranoia). Were they traveling from a known Ebola area. Is this perhaps due to the recent report An Outbreak of Ebola Virus Disease in the Lassa Fever Zone, which could be misread that there is a current outbreak of Ebola in the same area where there is an outbreak ofLassa. ¶ This article left questions: What was the test used and can it have a false positive; Why was there testing or is India still testing for Ebola; Was this an active case, a asymptomatic (and not infectious) carrier; Was this in body fluids of were there antibodies the indicated the person had Ebola; Was this the same person as 2014 who was on a watchlist but not taken off. ¶ Part of this is possibly being sensitive to India’s reputation in medicine, which has taken several hits in last few years: Rampant Fraud at Medical Schools Leaves Indian Healthcare in Crisis, Why Indian Women Are Victims of Sterilization 'Cattle Camps', Scandals Tarnish Reputation of India's Pharmaceutical Industry, India’s Antibiotic Resistant Superbug Problem Is Spreading, Police Make Arrests in Delhi Hospital Kidney Racket. ¶ We may also be seeing that news linesources are making sure of not being scooped by other media, hence questions left unanswered and creating a possibly incorrect or premature report. It is also possible the old story somehow got posted again or this is a recycle of an old Pranksters Circulate News of Ebola Outbreak on Social Media, Hoax Messages on Social Media Go Viral; Spread Panic Among its Users. ¶ Ebola Case in Delhi Not Confirmed Yet. A news article we carried titled " Man tests positive for Ebola in Delhi" was based on a news flash on Tuesday by an Indian media group. The flash has subsequently been deleted by the media group. Hence, the news regarding 'Ebola case in Delhi' is not confirmed. We regret the error. This may seem a bit unusual for IBT to make this report given Ebola ‘False Alarms’ in the US Escalate as Hysteria Spreads, but this was a different author, and frankly anyone can be taken in by a rumor (myself included). In this case if true this would have been important news to get out quickly.
*. This is in keeping with the stub concept mimicking a simplified version of flow of message traffic and analysis on the fly. This chaos is what happens to information during a crisis, with lack of sleep and high stress, where accuracy and timeliness to save lives are more important than typos, missing commas, following format, or creating literate essays. The difference with a daily flow is that this information and background is collected over a week so it is easier to discern patterns as one becomes familiar with the related topics. ¶ One also learns to identify: information that may be out of sequence; incorrect information; rumor and deliberate misinformation; information that combounds two or more events into a single one; information that separates a single even into two or more; information that reports other’s reporting appearing as confirmation. Unfortunately decision and policy makers**, as well as the general public, are unaware of the process of creating analyzed products, briefings, white papers, editing for publication, creating official announcements and messages (to include news briefings) is Like Watching Sausage Getting Made. ¶ If one does not practice cognitive and social skills they are lost over time, becoming outdated, rusty with disuse, and possibly completely lost requiring retraining. Biosyndemics and Parademic fortunately do not happen with the frequency needed to maintain theses skills, and when there is a crisis when people andeconomies are at risk, there is not the luxury of a learning curve to gear. An example would be For Doctors Who Take a Break from Practice, Coming Back Can Be Tough. How Long Does it Take to Lose a Skill. ¶ There is also the factor of Telegram Style where the reporter assumes shared knowledge and background with receivers. This is easily gained with reading the weekly listicles. The one thing that happens to information where there is a mass of information and shared perspective is that Parademic attempts to shake up groupthink.
** To add to the problems most decision making tools (actually choice making) do not consider human factors, except for how to provide information to policy makers who are not experts in the subject, and have other considerations such as politics, funding, beliefs, relations, bigotry. It is these human factors that neutralize efforts, have unintended consequences, create opportunities for scams, cause panic, feed rumors and in some cases result in physical attacks against health care workers. However these are both useful #references to have, and do give insights on providing the parademic information. RR1576 Improving Decision Support for Infectious Disease Prevention and Control, PE147 IntraAction Report – A Dynamic Tool for Emergency Managers and Policymakers.
5.1. For full disclosure I have to admit that I cheated a bit with this one. There are several reliable sites that report international disease outbreaks, ProMed being one that is often times first with reports and indicating reliability of the report. That and having access to an existing database where a recycled story is easier to spot. In the case of Ebola there were so many false alarms, fear mongering, rumors, conspiracy theory, and hoaxes that I suspect the misinformation exceeded valid information for a time. With the gap of a few months since the last outbreak, and continued concerns that Ebola will return (as it has after being declared over), a credible sounding report could be circulated. To IBT’s credit they quickly reported they were in error, but it does not appear anyone is going to track down and public share why it happened, including the government of India. We're Not Ghana Take It is Ebola a hoax invented to rob Africa of its diamonds and oil. Truth Behind Ebola Zombies: Victims 'Rising from the Dead' a Viral Hoax. The Role of Social Media in the Ebola Crisis.
6. Not to worry anyone, but I have these symptoms. That's how we know who is infected. If they're deaf in one ear or off balance. Hypochondria Trope. [Logo]
7. Bringing Public Health Preparedness Into the 21st Century. The probability of certain public health threats, the costs and funding related to such threats, and the “silo” effect of the public health sector all contribute to the preparedness gap between public health and other sectors. It is time to bridge this gap and update preparedness efforts to better prepare for 21st Century threats. Resilience - not response - should be the major focus going forward. By aligning healthcare preparedness with the trends already happening in healthcare, communities will be stronger, more cohesive, and better equipped to bounce back when faced with trauma. This makes some good points but does not recognize that it is speaking from the “silo”, medicine as a business, not medicine in the context of the society it is trying to be resilient for. 'Silo' One of Healthcare's Biggest Flaws, Eliminating the Patient Care "Silo Mentality" in Hospitals, Breaking Down Silos: Building High Performance Care Teams, Breaking Down Silos to Improve Patient Flow, Hospital Efficiency. The Silo Mentality: How to Break down the Barriers. Public Health: A Whole Community Approach Partner. [Cartoon, Cartoon, Cartoon, Cartoon]
7.1. Crisis Informatics-New Data for Extraordinary Times. Crisis informatics is a multidisciplinary field combining computing and social science knowledge of disasters; its central tenet is that people use personal information and communication technology to respond to disaster in creative ways to cope with uncertainty. A continuation of what will eventually become true, that big data can tap into social media for disaster response. So far there have been some successes, some attempts where the data did not reflect what happened, and sometimes discovering there was no infrastructure to use this methodology. The Problem with Crisis Informatics Research, Crisis Informatics and Collaboration: A Brief Introduction.
8. Sierra Leone Two Years after Ebola: What Does Life Look like Now. In the aftermath of the most widespread epidemic of Ebola in history, Liberia, Guinea and Sierra Leone are returning to normal life. Disagree with normal, as in how things were, this is adapting to a new normal. ¶ Illiteracy contributed significantly to the spread of Ebola because people could not read the posters and advice warning about how to avoid infection. Education could have prevented such widespread contagion. As you drive across Sierra Leone today you see several new schools under construction or recently opened. ¶ Many orphaned teenage girls became pregnant after being abused during Ebola, then left alone to care for her baby and younger siblings. 4.3↑.
9. Maybe The Birds is coming [Poster] was more prophetic than we knew, just had the method of attack wrong. The Fuzzy Fluffy Super Cute Health Threat In Your Backyard. Backyard chickens, those cute, fluffy alternatives to the industrial food system, are causing a stealth epidemic of Salmonella infections. Seagulls Are Carrying a Dangerous Superbug Through the Skies on two continents. Bird Flu Outbreak in West Africa Raises Worries about Food and Livelihoods. [Art, Art, Cartoon]
9.1. An Influenza Pandemic Is Brewing. Could We Preempt It. History foretells another flu pandemic. But we can lower the risk by taking action collectively and individually. This is a list of what has been cited in the pretypepad Parademic listicle for years, which is based on open source and available public information:
- The virus has time on its side. Like a machine, it will continue casting out variants—new strains potentially capable of human to human transmission. It is not a single machine, but thousands of machines/bacteria that can share genetic material, and are creating daughter cells approximately every twenty minutes. In 7 hours one bacterium can generate 2,097,152 bacteria. 8 hours it will be 16,777,216. Viruses are even faster. And they have had billions of years to practice.
- The human population has soared to over 7.3 billion and is on track to reach 9.7 billion by 2050. Not as fast as microbes, but far faster than any other large animal and over a wider (global) range. This is not counting the increased population and land use of domesticated plants and animals.
- As population and wealth increase, so does the demand for animal protein. Between 2000 and 2030, demand is expected to leap 150 percent and 200 percent for pork and poultry.
- We are increasingly living in dense urban megacities – the more exact term is megalopolis, [Photo] which are crashing into wild areas and reservoirs of zoonotic diseases to both contain the population and land use to feed – connected by a network of air travel that can place anyone, anywhere within 24 hours. This leaves out other transportation and distribution systems that create the possibility of spreading an outbreak to a wide area, such are suburbs around megacities, or jump over multiple borders, and don’t forget that the northwest passage is becoming open to shipping year round. One should also consider that there are also mass gatherings, such as Hajj with about 2 Million visitors; Sporting events that attracts millions at the venue and thousands of sports bars and homes with TV access; Disney Parks are approaching 20 million yearly.
- History reminds us that such a pandemic influenza event is not hypothetical. Both the threat, and the magnitude of expected impact, are excruciatingly real.
- This however does miss that historically the above circumstances have never happened in the world before, hence preparing for an old enemy in a vastly changed battlefield. This includes Rapid climate change; Depletion of species varieties – homo now only consists of one species, an improbable twig off a branch from the main trunk of homo that managed to survive over all the others; Many species have dropped in gross numbers; Other species have been domesticated to a few varieties that are dependent on humans; Success in public health and medicine that has driven complacency and paradoxically created new threats such as microbes that are resistant to antibiotics; Rapid communications that spread mass misinformation, though also a potential boon of information sharing; There are more and more contaminates and toxins in the air, ground, water, plants, animals, which is where microbes live; Education, law, government, research and development, paradigms, global collaboration, language have lagged far behind these changes; and, That all that have been listed here are not separate but an interactive, intraconnected synthesis. Influenza weakens the immune system, giving open access to opportunistic diseases and coinfections. These are the complications of flu that are likely to kill.
- #Reference: Preparing for the Flu in your Community. Influenza Outbreak Would Cost U.S. Billions of Dollars in Losses
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