1. Flood + Disease, 2. Parademic Humor, 3. Chaplains, ↕4. Mosquito Borne, 5. Letter from Congress to HHS, 6. FDA Consequences, 7. Too Much/Little, 8. Cooperative Corruption, 9. Climate and Security, 10. Radiation Bio Threat, 11. Morgue Planning, 12. Pandemic Emergency Kit, 13. Contagions via Electronics, 14. , 15. , ↕C. Communications.
-1. Epidemics after Natural Disasters. The relationship between natural disasters and communicable diseases is frequently misconstrued. The risk for outbreaks is often presumed to be very high in the chaos that follows natural disasters, a fear likely derived from a perceived association between dead bodies and epidemics. However, the risk factors for outbreaks after disasters are associated primarily with population displacement. The availability of safe water and sanitation facilities, the degree of crowding, the underlying health status of the population, and the availability of healthcare services all interact within the context of the local disease ecology to influence the risk for communicable diseases and death in the affected population. ¶ There is a brief window to test expected parademic behaviors against the recent, San Jose Flooding: Thousands Ordered to Leave Homes, Evacuees Return to Flood Ravaged Homes in San Jose, CA. There has been the usual surprise it happened and seeking and explanation, San Jose Flood: Hundreds Return Home as Questions Swirl about Surprise Flood. This normally leads to looking for someone or something to blame, often times as a mechanism to get financial help, if not complete reimbursement for losses. And the flood created a condition for a biothreat to accelerate/flourish, Flooded Out San Jose Residents Now Deal With Mold Threat, How Dangerous Are Mold Hazards Plaguing Flooded Bay Area Homes. In the aftermath there will be some profit to be gained by established companies for salvage, mold remediation, and replacement of lost. There will also be some scams. It is unlikely that the mold situation will not be quickly contained and controlled, but if not the mold is present throughout the San Francisco Bay area, ready to exploit anytime the environment becomes conducive. [Photo, Quote, Photo, Photo]. ¶ The Great Lie of American Flood Risk explores the problem of basing insurance on the idea that disaster is predictable and small events that are separated in time. Biodisaster tends to be global in impact, occurs in waves that can be nearly continuous. This however disease from a flood could become more likely, Slash and Flood. Proposed Budget Threatens to Axe U.S. Flood Protections 2.1, 5↓.
-2. Humor has been a characteristic of parademic response to threats to health, but humor is always based on context of where, who and when. Satirical Texas Bill Would Fine Men's Masturbation, Set Viagra Waiting Period. A bill introduced in the Texas House of Representatives would fine men for masturbating, allow doctors to refuse to prescribe Viagra and require men to undergo a medically unnecessary rectal exam before any elective vasectomy. The satirical legislation will never be passed. But she hopes it will start a conversation about abortion restrictions. The measure turns the language of abortion laws against men. Attending Shocked to Learn He’s Not Actually Funny.
-2.1. Currently much of the humor circulating is in the context of #Trumpism, to include #BioTrumpism examples. For example this social commentary on the ACA repeal is humorous now, but likely in a few months will no longer be so (whether the repeal passes or not), and in a few years will be a historical example [Meme] of interpreting complicated reality Health Bill Would Raise Uninsured by 24 Million but Save $337 Billion*. This particular meme was based on an actual quote, restated in a Trump support media source Price on Obamacare Replacement: ‘Nobody Will Be Worse Off Financially’, which was then taken and modified to Breitbart: Price Health Care Vow 'Lie of the Year' 1↑, 5↓. ¶ This [Cartoon] is understandable as humor in the current BioTrumpism context, but by using the car salesmen trope would have been humor before Trumpism [Photo Shop, Photo Shop, Meme], and will remain so long after, at least until cars no longer exist, but the pushy sales person icon will remain, just pushing something else, but with the same Car Dealership Dictionary of Automobile Dealer Terminology. [Meme] Calling Out the Big Lie on Obamacare. Day 56: Report: it Unclear Whether Opposition from Every Sector of American Society Will Have Any Effect on Healthcare Bill Passing. Day 55: Mitch Mcconnell Sees Infinite Healthcare Plans after Dropping Acid to Inspire Ideas for Obamacare Replacement. Day 52: GOP Recommends Americans Set Aside Income from One of Their Jobs to Pay for Healthcare under New Bill. Paul Ryan Says He Fantasized about Cutting Health Care for the Poor at His College Keggers. ¶ BTW humor, being ludicrous, is not always intentional GOP Congressman Says We Need to Repeal Obamacare So Men Don’t Have to Pay for Prenatal Care. Sometime something was not intended to be taken seriously but was, or inversely one can always claim something was a joke. When it Comes to Politics and 'Fake News,' Facts Aren't Enough, The Biggest Criticism of Paul Ryan's Health Care Pitch.
-*A. This “balanced” headline does not indicate what the costs of 24 million uninsured people will be. The rule of thumb in disaster management is that money not spent for prevention and mitigation usually becomes four times more when one does not as runs into a disaster. This cost usually exceeds what was saved by a considerable sum. This does not include the non quantified costs from grief from preventable deaths, an aging population, being deprived of what one once had, limiting access to health care, creating an unmonitored reservoir of health threats and probably disenfranchisement from the rest of society. Congressional Budget Office Cost Estimate. Key Facts about the Uninsured Population. This can be spun either as Trumpcare Is a Historic Social Calamity That Would Deprive 24 Million of Insurance or Savings From G.O.P Health Bill to Be in Billions, Ryan’s Plan: Stress Savings, Play Down Rise in Uninsured. Gingrich: 'Corrupt' CBO Should Be Abolished, White House Analysis of Obamacare Repeal Sees Even Deeper Insurance Losses than CBO, [Cartoon]. There is also the scenario of the US uninsured population having a disease or contamination spread beyond the US. Trumpcare vs. Obamacare: Apocalypse Foretold. Both Sides Loose with Facts in Health Debate. Every Single False Republican Criticism of Obamacare Applies Perfectly to Trumpcare. ‘Trumpcare’ Could Kill an Extra 50,000 People a Year [Cartoon]. American Health Care Act: Last Week Tonight with John Oliver (Video). Gaunt, Hollow Eyed Big Bird Enters Sixth Day of Hunger Strike Against Proposed Trump Budget.
-B. Which way people will interpret this loss of 24 million people, or save 337 billion dollars, significantly changes the equation. Typically people are considered more important than money, especially if you are one of the people – though if one somehow feels protected from what will impact other people and the money represents money that you get eventually (income, available funds for one’s own agenda eventually then money, protect what one already has) will take precedence 170205-T.3↓. It terms of behavior: now trumps later; identity group trumps umbrella group; simple to understand information (even if elaborated), that one finds credible, trumps dense evidence that is difficult to understand, and may contradict paradigms and livelihood. The response did not take long Republicans on Defense after Report Says Millions Would Lose Insurance. Trump's Backing a Healthcare Plan That Breaks His Promises, (Quote March 14, 2017). [Cartoon, Cartoon, 170212-T.1.A]. Unless You’ve Lived Without Health Insurance, You Have No Idea How Scary it is. Trumpcare Is What You Thought: Welfare for the Rich, The GOP Health Bill Is a $600 Billion Tax Cut – Almost Entirely for the Wealthy [Cartoon]. Has President Trump Already Lost the Health Care Fight. A Health Reporter Walks Into Reagan National Airport. ‘It’s Not Herding Cats. It’s Herding Ravenous Tigers’: Trump, Ryan Work to Corral Reluctant Members, Be like Herding Cats [Cartoon]. [Cartoon]. Health Savings Accounts and Quackery Revisited.
-2.2. Trump’s Budget Cripples the EPA’s Ability to Keep Drinking Water Safe. [Cartoon, Cartoon, Cartoon, Cartoon, Cartoon, Cartoon, Cartoon, Cartoon, Meme]. Scott Pruitt Is Absolutely Right about Carbon Dioxide. People Are Sending EPA Employees Chocolate Chip Cookies and Thank You Cards. How James Inhofe Is Upending the Nation’s Energy and Environmental Policies [Cartoon, Cartoon, Tweet, Cartoon, Meme, Meme, Cover, Cartoon, Cover]. Trump’s Budget Would Hammer Climate Programs at EPA, NASA, NOAA, and Energy [Chart]. The White House Wants to Gut the Agency That Makes Sure We Don't Live in a Toxic Wasteland. The intent is probably to cut down the costs and restrictions of doing business. An unfortunate consequence is there will eventually be no customers for the goods, properties and services.
-Quote: Don't it always seem to go, that you don't know what you've got till it's gone. They paved paradise and put up a parking lot (updated version would probably be lots of towers, golf courses, border wall) [Photo]. – Joni Mitchell
-3. This is an oft times overlooked position on teams responding to medical emergencies [Photo, Photo, Photo, Photo]. DZTV: A Chaplain's Role in Emergencies and Disasters C.1↓. One member of the disaster team that responds to emergencies and disasters is the chaplain. This video, The Role of Chaplains in Emergencies and Disasters, will provide you with some great information about the who, how, what and when about the role of chaplains who support first responders and emergency managers during disasters. If I ever am asked about creating a parademic team for a biodisaster, a Chaplain (preferably local) is a priority recommendation. That would be before Crisis Communicators, Epidemiologists, Anthropologists (that would beme), Public Health Doctors (though maybe not nurses), Logisticians, Government Official. They are more likely to be accepted by a larger proportion of the community, to include other religions and atheists. They will also have more understanding of local beliefs, key personalities, community relations, community needs. It is easy enough to identify religious figures who are not appropriate in this role, and that is not by their religion but how the practice it. Connecting Your Faith Based Organization with the Community: 5 Projects That Help Build Health Security.
↕4. CDC Widens South Florida Zika Zone. People who never thought they could have caught Zika in Florida may, in fact, have become infected. They say some people from south Florida may have traveled to the Miami area Zika zone and forgotten. If these are women who were pregnant at the time, or men, they could have become infected with Zika and not known it. That means a pregnant woman living in Broward or Palm Beach counties may have become infected and not known it—because Zika doesn't cause symptoms in most people. Men may have become infected and because their semen can remain infectious for months, they could unknowingly infected a pregnant woman even now. The new warnings go back to June 15 of last year, meaning people could have become infected as far back as that date, the CDC said. Miami was declared a Zika zone at the end of July. This is similar to HIV/AIDS* where there was spread over large geographic are that was hidden due to long incubation period. In this case the illness can be mild, but with devastating neurological damage to children, and possible physical harm to adults. 5 Zika Health Problems Experts Say Could Affect Anyone. Summer Is Coming. So Is Zika. Three months after Gov. Rick Scott stood in Miami Beach and declared that the Zika virus was no longer spreading in Florida, mosquito control experts are warning people not to be complacent. ¶ Zika Warning Is Issued Over Sperm Banks in the Miami Area. Women who are considering trying to become pregnant should consider the possibility that sperm collected in some areas might be infected with the Zika virus. 5.1↓.
-*. An AIDS Museum: The Challenges Are Huge, but the Timing Is Right. The National AIDS Memorial Grove in San Francisco may someday be joined by a full fledged center honoring heroes and victims of the epidemic’s early years. ¶ #Book. How to Survive a Plague: Much More Than a How To Guide [Cover].
-5. Letter from Congress to Secretary of Health and Human Services. States the situation and then asks some questions to be answered by March 27. 1. How would the lack of a permanent Presidential appointee in many key positions impact the ability of HHS and CDC to coordinate a response in the case of a pandemic flu outbreak. 2. What impact could substantial budget cuts have on pandemic flu preparedness. 3. What impact would the American Health Care Act's elimination of the Prevention and Public Health Fund beginning in FY 2019 have on pandemic flu preparedness and outbreak response capabilities. 4. What will be the long and short term impacts on pandemic flu preparedness of President Trump's executive order instituting a government wide hiring freeze. 5. What impact will recent executive order have on CDC’s limited regulatory authority, and issuing rules related to disease outbreak, publishes public health guidance, and work with HHS, FDA, and other regulatory agencies with relevant jurisdiction to respond to a pandemic flu outbreak. 6.What is the impact of the executive orders banning travel of citizens of predominantly Muslim countries. 7. Dr. Price stated that general scientific consensus at this time is that vaccines do not lead to autism spectrum disorder. Have you subsequently identified any scientific or medical validity to President Trump's concerns about vaccine safety*. Not included in the questions but another program that will suffer is the 2016 Public Health Emergency Medical Countermeasures Enterprise (PHEMCE) Strategy and Implementation Plan, PHEMCE Review: Accomplishments and Future Areas of Opportunity. Drastic Health Cuts in Trump Budget Panned as 'Cartoon Villain Approach to Biomedical Innovation'. Fired US Attorney Preet Bharara Said to Have Been Investigating HHS Secretary Tom Price. Employees Say HHS Head Tom Price Sends Staff 'Propaganda' Emails. 2.1↑. Secretary Price Statement on President’s Budget Blueprint 1, 2.1↑.
-*. This prior position may have been revised, Price Dodges on Medicaid Rollback, Immunization. Tom Price Says States Should Decide Vaccine Standards. They’ve Been Doing a Lousy Job, the real missed opportunity in Price’s limp vaccine endorsement.
-5.1. Trump Administration Urged to Strengthen Public Health Emergency Response Before next Threat Arrives. Recent presidential administrations confronted infectious disease emergencies that threatened both human lives and the U.S. economy, and with the likelihood high that the Trump administration will be no exception. The occurrence of a severe epidemic or pandemic infectious disease is the kind of event that can come out of left field and force our government into emergency response mode. New Federal Emergency Fund Proposed to Respond to Public Health Outbreaks. Ever since the Ebola and Zika epidemics, public health officials have advocated for a special emergency fund that would allow the US to respond rapidly to disease outbreaks. This budget blueprint creates a new Federal Emergency Response Fund, but provides no specifics about how large it would be or where the funds will come from. From Concept to Operations: Building Disaster Health Resilience in One of America's Largest Communities. Public Health Advocates Say Trump Budget Undermines Their Efforts, IDSA Statement on the Trump Budget Blueprint. ¶ Trump Plan Eliminates a Global Sentinel Against Disease. The Fogarty International Center funds an worldwide network of researchers on the lookout for viral threats, many of which could reach America. The Tiny Trump Budget Cut That Could Blind America to the next Zika 4↑.
-5.2. Global Health in a Populist and Nationalist Age. For nearly two decades, there has been a positive, dreamy side to globalization. Building on the 1948 founding of the WHO and its stated mission of health for all, the early 21 century saw billions of dollars moving yearly from the wealthy world to poorer countries, which financed treatments, medical systems, public health infrastructures, safe water and waste disposal, training and education for millions of health workers, routine vaccination against a raft of microbes, and rapid responses against dangerous outbreaks. Trump Foreign Budget: HIV Prevention Spared, U.N. and Others Lose Big, Why Trump’s Plan to Slash U.N. Funding Could Lead to Global Calamity. One Important Exception to Trump’s Budget Cuts: Programs to Fight AIDS*. Trump Proposes Shuttering NIH Program That Promotes Medical Research Overseas. Q&A with Tony Fauci on the State of PandemicSecurity. "We are Not Ready": Experts Warn World is Unprepared for Next Ebola Size Outbreak. Study by R.I. Doctors Says Ebola Response Cost U.S. Hospitals Some $360 Million. The Biases That Keep Good R&D Projects from Getting Funded. Is the U.S. Ready for Future Disease Threats, the CDC lacks the authority to direct funding in response to emergencies and outbreak. The World Is Completely Unprepared for a Global Pandemic. Bill Gates: Cutting Foreign Aid Makes America Less Safe.
-*5.3. This would not be what the concern was earlier: Tragedy Would Unfold If Trump Cancels Bush’s AIDS Program, What the Trump Administration Could Mean for US HIV/AIDS Spending, All Evidence Points to Trump Having Zero Plans to Battle HIV, Trump Seems to Support Bush’s AIDS Program for Now, Trump's next Target: People Living with HIV/Aids. An obvious question is why would BioTrumpism be supportive of this when it would be easy to attack it with whataboutism Trump Embraces One of Russia's Favorite Propaganda Tactics – Whataboutism, while attacking the riskier philanthropic organization Meals on Wheels Could Take Funding Hit in Trump Budget, GOP, Dem Lawmakers Decry Trump's Cut to Meals on Wheels, Donations Flood Meals on Wheels After Trump Proposal, ‘¡Curses!’ Shouts Fist Shaking Meals on Wheels Ringleader as Trump Cuts off Gravy Train. This illustrates that it is chancy to make predictions based only on verbal statements, prediction needs what actual actions (that is commitments) are taken 170220-2.5↓. Any health program is worthless without an integrated as part of a larger one health program. HIV control without reproductive health, clean water, poverty abatement, tolerance, etc, will not work if the goal is to contain, control and eventually eradicate. Will be interesting to see what speculations are made – or if no one will notice that there is an incongruity – about why HIV was maintained, or maybe eventually the real reasoning will be discovered. As grand strategy and systems thinking has not exhibited so far by BioTrumpism it is safe to assume (but still not certain) this is more happenstance and simply avoiding obvious objections of being racist, misogynist, anti-poor or homophobic. Given Trump’s age he cannot be accused on attacking seniors, though apparently missing meals is no something he has experienced.
-Quote: We can't spend money on programs just because they sound good. – Mick Mulvaney
-6. Unintended consequences. Right to Try Drug Laws Create Chaos, Villainize FDA. The popular measures undermine a more thoughtful federal program that balances patients’ need for options, drug companies’ desire to protect their investments, and the government’s duty to evaluate drug safety and effectiveness. This is another idea that seems reasonable, that is until it is put into practice and raises expectations that there are miracle cures being withheld. This then becomes a populist issue that leads to dismantling the FDA. That will recreate the conditions that lead to the creation of the FDA in the first place. When and Why Was FDA Formed. Upton Sinclair's The Jungle: Muckraking the MeatPacking Industry. Interestingly the FDA nominee 170312-2.3↓ apparently does not follow the anti-vax narrative, Trump's FDA Pick Gottlieb Calls Vaccine, Autism Theories 'Thoroughly Debunked'. More Transparency at FDA Needed. By The Numbers: Trump’s Choice For FDA Chief Is Versatile, Entrenched In Pharma. How Scott Gottlieb May Transform the FDA’s Approach to Stem Cells 6.3↓. Like Trumpism influence on parademic and the potential of biodisaster (BioTrumpism), these are antecedents, but exactly what the implemented behavior will be still has a range of possibilities. [Art, Art].
-6.1. Something that should have been prevented with food, but the cost of not have genetic diversity was not known at the time, Humans Made the Banana Perfect – But Soon, It’ll Be Gone. Economically, growing just a single clone of bananas was genius. Biologically, it posed problems. Only the Tip of the Iceberg: Monitoring Programs Underestimate Human Impact on Biodiversity.
-6.2. Then there are what should not be unintended consequences as the cause an effect relation should be clear to a reasonable person, even one not familiar with health issues. Trump Said He Wanted More Miracle Drugs. His Budget Could Make Funding Them Dramatically Harder, NIH Would See Huge Budget Cut under President’s Proposal. ¶ Something to watch for is that it is likely the DoD recognizes that vastly increasing its budget undermines national security in other areas. At the same time it is ingrained in the US military not to openly defy the commander in chief Department of Defense Directive 1344.10 and to support civil control of the military Guidance on Political Activity and DoD Support 2016. The mission is the defense of the US 9↓, which implies keeping the force healthy. What would they do if there are orders to longer vaccinate from flu, In the Era of Donald Trump, Will the States Save Us from Antivaxers. I observed that during Ebola US Military to Quarantine Army Personnel Returning from Ebola Response Mission were more stringent than the recommendation of HHS What Are the Ebola Quarantine Protocols in the US. Being former military I did not disagree with this. Military personnel could potentially be at higher risk of exposure to Ebola, and if exposed to expose other military personnel. Military personnel were probably under very strict orders to avoid exposure. At the same time if there is a group that would take a risks of eating bat* or fraternization, the military would be that group. *The Socio Economic Drivers of Bushmeat Consumption During the West African Ebola Crisis.
-6.3. Another impact of neutering the FDA is that there will likely be an increase in miracle cures Saunas and Longevity: Another Example of Putting the Preclinical Cart Before the Horse. It looks as though we have another misguided doc who thinks that epigenetics means that wishing makes it so and that we can easily “reprogram our genes” with whatever woo they are selling. It’s the sort of sciencey sounding, a bunch of extrapolation and misinterpretation of preclinical and very early clinical evidence, all gussied up with “epigenetics” and how saunas (and other things) can “reset your genes” to make you live longer. Epigenetics. You Keep Using That Word. I Do Not Think it Means What You Think it Means [Meme]. 3 Women in Florida Left Blind by Unproven Eye Treatment, CDC Recommends Against Licking Eyeballs, Florida Clinic Blinds Three Patients in Botched ‘Clinical Trial’ 6↑. Iowa Attorney General: Drinkable Sunscreen ‘Flat out Dangerous to Consumers’.
-6.4. In actual fact the FDA is unnecessary. Just by smelling and looking at food a reasonable person can identify if it is unsafe or not. Report: Saying ‘Smells Okay’ Precedes 85% of Foodborne Illnesses Annually. Presenting research with significant implications for public health, the CDC revealed that saying the phrase “smells okay” precedes 85 percent of foodborne illnesses in the United States annually. Most individuals had given a quick once over to leftovers and uttered some variation of “probably still good” or “hasn’t been sitting out for that long”, before spending the next several hours suffering intense stomach pain and vomiting. In addition, determining that grayish chicken Alfredo simply needed to be stirred or that an improperly covered week old meatloaf would be fine once an outer layer was cut off almost tripled the chances of contracting salmonella. The report also confirmed that thousands of Americans across the country are infected with a foodborne illness every year shortly after being asked by a friend or family member to “try this”.
-7. An Epidemic of Epipens. Prescriptions of adrenaline autoinjectors (commonly called 'epipens') for children with allergies have increased markedly in the last decade, with nearly four devices a year provided per child. Over the 12 year period the number of children identified by GPs as being at risk increased three and a half times, and the total number of devices prescribed (per 1000 person years) in the UK increased five fold. The most recent guidelines suggest that each child should be given no more than two devices. It may be that GPs are taking a cautious approach, or that parents are requesting extra devices to cover all of the areas that their child might go, and both are completely understandable. In the absence of clear guidelines, that's a natural tendency. There are weak indicators that some parents have an overabundance of caution (anti-vax, anti-GMO, munchausen, “health” foods, allergies) that results in either too little of something needed, or too much of something that is not necessarily needed 8.1↓. MDs are implicated as enablers to this behavior. Disaster can also be defined as too much of something, or too little.
-8. Profiting from the Fight Against Corruption. It makes sense for non-governmental organizations to band together to fight government corruption; they get better results that way. It's also in the corrupt government's interest. Civil society organizations achieve a better result when they cooperate is intuitive. One might expect that a predatory government prefers facing uncoordinated civil society organizations, but a corrupt government will be better off if civil society organizations cooperate. The NGOs get stronger when they cooperate with each other, but at the same time, the more they cooperate, they more efficient they become, and that leaves even greater leeway for a corrupt government to dip into the coffers. When anti-corruption works, it creates wealth for everyone – including, paradoxically, the government, because it has its fingers in the pie, too. I have doubts about this study, it is based on a mathematical model of observing role players, not a real world situation. In addition NGO’s can also be corrupt (or more likely corrupt individuals), and governments may benefit from cooperation, but an individual in government is more likely to benefit from corruption, especially if other individuals are corrupt. Win Win for both side is a great ideal model, but there are people who see Win Win for myself as a better model.
-.8.1. #Book. Corruption is usually an indicator of unequal access to wealth, both for those who have too much access, and those who have too little 7↑. Unequal access to health care, preserving and quality of life, survival, cooperation, sharing of resources is a factor in parademic. The Great Leveler: Violence and the History of Inequality from the Stone Age to the Twenty First Century [Cover]. Are mass violence and catastrophes the only forces that can seriously decrease economic inequality. To judge by thousands of years of history, the answer is yes. The High Price of Equality, misses one key finding, especially odd because the book includes pandemics as one of the triggers for an equal society, and vividly describes the Black Death of the 14th century. But nowhere does it mention the solid link between income and wealth disparity and public health. ¶ More equal societies are healthier and happier societies. Unequal societies suffer high levels of stress and “self medication” problems like alcoholism, drug addiction, abuse, and violence. ¶ Few governments want their policies set based on health priorities (you know public health is working when nothing happens, which is politically uninteresting). ¶ But educated and informed citizens will increasingly realize that consigning thepoor to disease and early death doesn’t put them ahead, it endangers the rich as well. Their inevitable fate: a few decades of doubtful glory, and then they and their children will topple into the darkness. When we know that equality is a simple public health measure, like washing your hands*, we shouldn’t have to impose it by violence. Health Inequality: a Major Driver of Respiratory Disease.
-*8.2. The Idea of Surgeons Washing Their Hands Is Only 150 Years Old. Not very long ago, you could die from a broken arm – and many did. That all changed with an idea we think of as pretty basic today: surgery needs to be sterile. On this day in 1867, Joseph Lister published an article in The Lancet that fundamentally changed medicine. An Address on the Antiseptic System of Treatment in Surgery was a description of a new way of doing operations that he first presented in Glasgow, Scotland, where he practiced medicine. At that time, the "germ theory" of disease was just a theory. Lister's innovation was simply to try to kill the germs. Joseph Lister’s Antiseptic Revolution.
-9. Trump’s Defense Chief Cites Climate Change as National Security Challenge, US Defence Secretary James Mattis Says Climate Change Is Already Destabilising the World. The effects of a changing climate – such as increased maritime access to the Arctic, rising sea levels, desertification, among others – impact our security situation. This has a longer history of defying some members of congress and now this opposition was wider impact 160320-C↓. Military Leaders Urge Trump to See Climate as a Security Threat, President Trump, Military Split on Climate Change [Tweet, Meme]. 6.2↑. ¶ Map Shows How Climate Change Will Affect Health Across US, Climate Change Is Harming Our Health. Climate Change Is Harming Our Health. The [Map] is interesting as it more closely aligns with one I developed as a Pandemic Planner for what the Regions would be. Mine was more along the lines of disease biomes, used county lines instead of states, considered disease routes, and included Mexico and Canada. I actually agree that Alaska had more in common with the plains states than the west coast. I don’t however agree with all their climate change threats. Hawaii is faced with far more that extreme weather, and Alaska more than warming temperatures. America's Doctors: Climate Change is Making People Sick.
-9.2. A science fiction idea of microbes that can eat metal, except it’s true. The Wreck of the Titanic Is Being Eaten and May Soon Vanish. Some reports suggest the Titanic might disappear within 20 years because of the action of microbes – yet elsewhere, bacteria can help protect shipwrecks from decay. This is not a newly discovered microbe New Species of Rust Eating Bacteria Destroying the Titanic (2010), New Bacteria Found on Titanic; Eats Metal (2010). Not likely at this time to become a threat to human metal based infrastructure unless the environment change radically, which would kill most current life anyway, but could changes in the ocean chemistry and biome could threaten ships. However there is Concrete Dissolving Bacteria Are Destroying Our Nation's Sewers and Micro Organisms Destroyed Stainless Steel Installation, Newly Discovered Bacteria Can Eat Plastic Bottles. [Photo, Photo, Cartoon].
-9.3. Speaking of national defense. Weaponisation of Health Care: Using People's Need for Health Care as a Weapon of War over 6 Years of Syrian Conflict. How Many Health Workers Have Been Killed in Syria there is a minimum number of confirmed deaths: 814. Syria: Health in Conflict. Targeting of Syrian Healthcare as “Weapon of War” Sets Dangerous Precedent.
-9.4. #Book. Another national security threat. Peer Into the Post Apocalyptic Future of Antimicrobial Resistance. Antibiotics were around many millions of years before we were. Since the beginning of time, microbes have been competing with other microbes for nutrients and a place to call home. Under this evolutionary stress, beneficial mutations occurred in the “lucky” and successful ones that resulted in the production of chemicals – antibiotics – to inhibit other species of microbes from thriving and reproducing, while not compromising their own survival. Antibiotics are, in fact, a natural resource – or perhaps more accurately, a natural phenomenon – that can be cherished or squandered like any other gift of nature, such as clean and adequate supplies of water and clean air. Deadliest Enemy: Our War Against Killer Germs [Cover].
-10. ∩ Though radiation is a biodisaster the analogue of interest is not the nuclear attack but the aftermath that is a continuing biodisaster accompanied with massive demographic and infrastructure loss. However the more parademic interest is what happens outside of Manhattan and what will be happening to populations for the next 100 years. What Happens if a Nuclear Bomb Goes Off in Manhattan. The Center for Social Complexity was awarded a grant to develop a computer model that simulates how as many as 20 million individuals would react in the first 30 days after a Nuclear Detonation - 10 Kiloton Improvised Nuclear Device in New York City. If this were a movie, hordes of panicked, Panic and the Vision of Collective Incompetence page 5, New Yorkers would pour out into the streets, running around and calling out for their loved ones. But reality doesn’t usually line up with Hollywood’s vision of a disaster scene (except that people may act as if the fiction were true, especially if there is a lack of information, or attack is followed with an attack of disinformation 10.A1)↓, such as a rumor there is another bomb or the treatment is unsafe). ¶ In the simulation, individual “agents” will make decisions and move about the area based on their needs, their surroundings, and their social networks. First, basic research to try and identify how we expect people to respond, and how the environment and infrastructure and facilities would respond using the MASON framework. ¶ We’ve found that people seem to be reasonably well behaved and do what they’ve been trained to, or are asked or told to do by local authorities. Reports from 9/11 show that people walked down many tens of flights of stairs, relatively quietly, sometimes carrying each other, to escape buildings. We’re finding those kinds of reports from other disasters as well—except after Hurricane Katrina. There, we have reports that people already didn’t trust the government, and then with the isolation resulting from the flooding, they were actually shooting at people trying to help. ¶ We’re going to have millions of agents (to include responders), each with characteristics like where the agent lives, where it works, if it’s part of family, where the other members of the family are. That’s the first network that people respond to. But they’re also closely linked to the people they’re working with, or the people who are a part of their new family when they become isolated: the other people going down the stairs at the same time. That community now has a common experience.
-A. Parademic questions that are not asked according to the article: (1) What follow up attacks and fear mongering are likely. (2) What happens if transportation links are cut or clogged with exodus. (3) Under what circumstances will outside communities “quarantine” Manhattan, or the immediate area impacted, about 3000 sq mi. (4) What are individuals information needs and what means remain to communicate these to authorities. (5) How to collect information in the hot zone, to include what are the disaster needs and how to communicate to those in need. (6) The possibilities that the study will be considered credible, have face validity, when it is completed. Will the study face denial and resistence that will prevent planning and mitigation measures. (7) What are current antecedents that indicate so called emergent behavior that is both rational (pro_social) and irrational (anti-social). ¶ Interestingly the total area lost and forced to migrate (albeit over 100 years, not 30 days) is nearly the same as a sea level rise and may include the same parts of Manhattan, Sociological Perspectives on Global Climate Change, The Climate Battles Are About to Begin C.1↓.
-11. ∩ Drugs Are Killing So Many People in Ohio That Cold Storage Trailers Are Being Used as Morgues. The morgue can house only 12 bodies at a time. The cold storage is designed for use at disaster scenes or mass fatality illnesses, it is loaded with trays about 20 inches wide and 7 feet long and can hold 18 bodies. In the US Number of Deaths per 100,000 Population was an average of 725 in 2014. This is far below the number to expect in mass fatalities of a biodisaster. Cold storage is used when autopsy, transport, or medical study is expected. In a biodisaster, unless there is a demand for such preservation, there may not be as much demand for cold storage, but there still needs to be planning for mass internment and/or storage. This could include infectious or contaminated bodies, as well as mass fatality of plants and animals, all of which could continue a contagion or spread contamination.
-12. #Curiousgoat: How to Prepare for a Pandemic. In February, we asked: What do you want to know about pandemics. And this post has some answers. ¶ We turned to four infectious disease experts for answers. From their collective advice, we created NPR's Pandemic Preparedness Kit (no trademark necessary). Now, this isn't your traditional kit that you tuck under the kitchen sink. This kit is scattered around your life. In your car. In your purse. In your blood. And in your brain. The three answers provided are valid: Vaccinate, Science Literacy and Sanitation. However the question that kept popping up: If we believe that an unknown pandemic is overdue, what precautions are reasonable to take now. This question was not answered and the answers provided are to clinical problems, ignoring that a pandemic is a social problem. Answers from the parademic perspective would include: 1) Develop multiple reliable sources of information that you will be able to trust before the outbreak. 2) Don’t wait to identify and validate reliable sources until after an outbreak. You will not have the time and valid sources are likely to be drowned out by invalid ones. 3) Be aware that a pandemic can already be in progress now and has not appeared in your area yet. 4) In biodisasters your local area is Earth [Photo, Photo]. 5) Identify beforehand those individuals and groups who are likely to exploit a pandemic for financial gain, political agendas, or erroneous beliefs. Sometimes this exploitation is already in progress. Don’t exclude yourself from scrutiny if you have valid information, will provide valid information/be an opinion leader, and if you tend to exploit others. 6) The best protection from exploitation is to not panic. Fear and rumor spread faster than any microbial contagion. 7) Outbreaks come in waves, it does not come through only once (flu comes in yearly waves). 8) Have a personalized 3 month emergency kit before the outbreak. Consider what will be critical supplies for you that are likely to become shortages if transportation, communication, pipelines and supply networks break down; this includes medicine and cleaning supplies. Consider what will be critical needs if unavailable from two to ninety days. Shortages can begin in three days*, and if people panic within one day. This is not the same as critical wants and one is not looking for how to get the same resource, but what is an alternative if the resource becomes unavailable. The resource can be what is inflicted by the outbreak, not people. Inversely do not hoard, do not bunker down and keep others out (though do use prudent and informed protection. 9) Cooperation is a surer path to surviving than competition that benefits Number One only. This applies to individual, family, community, national and global levels. The Worst Thing That Could Happen Nearly Did and Probably Will Soon.
-*12.1. I Will Survive, Empty Shelves & Madness (In America): A Minor Winter Storm Drove People into "Panic Buying of Food and Basics", Just In Time: When the Trucks Stop, America Will Stop (With Immediate and Catastrophic Consequences), 5 Real Events That Would Empty Every Grocery Shelf in Your Town, Grocers Struggle to Keep Shelves Stocked after Storms, Hurricane Sandy: Grocery Stores’ Empty Shelves, #Snowmaggedon2016: Empty Store Shelves as Panicked Shoppers Ransack Grocery Stores, Don’t Count on Three Days of Food at Your Grocery Store for an Emergency, Time to Lose the 3 Day Preparedness Message. Note that these information sources are not all considered reliable. Some are outright alarmists, conspiracy theory and fear mongering. However in parademic it is not about if information is valid, but in what way is it valid (for example anti-vax). If people believe that there will be a shortage within three days that will act as if that is so. This can be with over preparation where supplies are stored beyond shelf life and resources diverted from daily needs. This can also be panic to get what one can, anyway one can, on short notice. Both have the potential for physical violence either as protection of what one has, or competition to get what one lacks or needs more of. Mutual aid works better, but requires prior relationship building.
-13. New Internet Safety tip. Don’t share your medical vulnerabilities. Seizure Inducing Tweet Leads to a New Kind of Prosecution. The Newsweek journalist suffered a seizure in Dallas after viewing the flashing animation when he received it via Twitter late last year. He had written about his epilepsy and publicly described a similar attack several weeks before the Dec. 15 incident. The attacker sent the image in an attempt to hurt him as revenge for what he saw as the reporter’s critical coverage of President Trump. The incident was not the first in which technology was used to expose medically vulnerable people to injury, but some said it was the first time prosecutors have brought criminal charges. These Temporary Tattoos Turn You into a Temporary Cyborg (Video). 170312-3.1, 170305-11, 160228-10↓. How to Keep Your Personal Information Secure.
↕C. Crisis and Emergency Risk Communication (CERC) Corner [Logo]. Newsletter Archive. The Media's Role in a Crisis, Disaster, or Emergency 03/15/2017. Here are some ways to make the most out of your relationship with the media to effectively communicate in an emergency. Establish relationships with your local media agencies before a disaster. Provide all media outlets with the same information at the same time. Attempt to give reporters a reasonable timeframe to expect new information updates. Understand journalism deadlines and work to accommodate them. During a crisis, it is important to be available – if necessary, around the clock – to help reporters get the valid facts* before their deadline. *The original said facts right before the deadline. Did this mean just before the deadline, or the correct information before the deadline. Admittedly it is ironic that uses unusual grammar and spellings as a tool would point out a minor error. However when communicating information to the public to save lives, one wants to avoid vagueness or statements that can be misunderstood. There will be sufficient errors made in the crisis situation when time is unavailable to carefully craft sentences, and there are people who will intentionally misconstrue an error to their advantage. Always have someone else edit, or better yet invite trusted media to provide feedback before sending out a message.
-C.1. The Media as Critical Infrastructure. In today's national media environment it is not unusual for the media to be called "the enemy." It was a number of years ago that I put together a PowerPoint presentation named, The Media is My Friend (not the .ppt which is currently unavailable) – which is pretty much the opposite of the enemy. I'd like to challenge you to think about which box you put the media in. Friends, enemy, suspect, "don't touch – may be injured". Too many emergency managers choose not to engage with the media. Yes, there are news releases speaking to some event you are hosting or conducting, but there is nothing beyond that. They are not invited into planning sessions and they are definitely kept at arms length. ¶ Preparing for a Flu Pandemic. A Northwest Perspective was one of my original finds when I was researching for my region, which included the State of Washington, as a Pandemic Planner for NorthCom. Was never able to establish contact with Mr Holdeman but he quickly became one of several people that I would read everything they wrote, and often times share his insights in the Parademic Website(s) 3, 10A↑.
Comments