Parademic Notes Week Ending 170702

Read This First  1. Historical Disease and Climate, 2. Health Policy and Morals, 3. Global Solutions, ↕4. Mosquito Borne, 5. Microbe Storms, 6. Vaccine Polio, 7. Ebola Opaquely, 8. Population and Recovery, 9. Ekistics, 10. Advisor Trend, 11. Bird Flu, 12. Infection Transportation, ↕C. Communications, ADDED.

Tags: Bio·Trump·ism, Vaccine, Biosphere, Disaster, Humor, Climate Change, FDA, Cosmetics, Historical Biodisaster, Health Surveillance Ethics, Science Fiction, Self Isolation during Pandemic, Science Fiction, Social Change, Dust Storms, Handmaid, Poverty, Maine Measles, Kaci Hickox, EPA, Open Access, Burials, Corruption, Nancy Snyderman, Maternal and Infant Mortality, Trump Travel Ban, Aging Population, Fertility, Human Created Habitats and Environment, Lack of or Dismissal of Science Advisors, Anthropogenic, Mega Fires, Pattern Analysis, Economics, Anthropocene, Glass Beach, Jerome Adams, Flu (H5N1, H7N9, H1N1, H5N8)

-1. Roundtable on Campbell’s Climate, Disease, and Society in the Late Medieval World. Campbell has brought forward the first analysis of the Black Death and 14^th century crisis using global evidence. An economic history that draws on interdisciplinary evidence synthesizing a vast amount of data with a particular appreciation for the integration of climate and disease data. Most agreed that this was a very high level view of the crisis, an aerial view if you will, that leaves many details to be filled in. The global evidence is primarily limited to climate data. One effect of such a high level treatment is that causes of local mortality from war (including the environmental destruction of war) can be overlooked because it doesn’t effect a large enough piece of territory. 170618-3.1↓. #Book The Great Transition: Climate, Disease, and Society in the Late Medieval World [Cover].

            -1.1. Three Horrifying Pre FDA Cosmetics. Koremlu advertised itself as a safe and permanent hair removing cream. What it actually did, though, was poison its users. Even though Koremlu was applied mostly to women’s upper lips, the problems manifested themselves elsewhere. Women lost hair all over their bodies as well as suffering from paralysis and even damage to their eyes. ¶ Lash Lure mascara promised to give women that permanently made up look using aniline dye on eyelashes. Unfortunately, some women eager to take the company up on this ended up blind. ¶ Gouraud’s Oriental Skin Cream advertised itself as a magic beautifier, but did exactly the opposite. Woman developed dark rings around her eyes and neck, followed by bluish black gums and loose teeth. They were suffering from mercury poisoning caused by the cream, which had been on the market for decades. An apparent concern is that Trump’s FDA will return to the same good old days. 170604-4.2A‡↓. Pharma Executives Aren’t Excited About Trump’s Plans to Ease FDA Regulation, White House Task Force Echoes Pharma Proposals, If Drug Companies Are Really Getting Away with Murder, Trump May Be about to Grant Them a Pardon, 170220-4T↓.¶ Be aware that in this biopolitical climate there are likely to be blame placed on Trump or the head of a agency that are not correct, or pushing for or against an agenda by invoking Trumpism, or attributing to the wrong agency or person. On the other hand these accusations may be correct but obfuscated.

            -‡. Pediatricians’ Group ‘Deeply Alarmed’ at EPA’s Pesticide Decision, Chesapeake Bay Dead Zones Are Fading, But Proposed EPA Cuts Threaten Success. FDA to Speed Review of Generic Drug Applications until It’s Approved Three of Them. FDA Takes Steps to Boost Generic Competition, Limit Prices. The FDA May Move to Shorten That Grim List of Side Effects in Every Drug Ad. Advertising Execs Can’t Wait. EPA Chief Met with Dow CEO Before Deciding on Pesticide Ban Tied to Health Issues. EPA Just Gave Notice to Dozens of Scientific Advisory Board Members That Their Time Is up, Letter, Scientist Says EPA Staff Pressured Her to Change Testimony to Congress, Top EPA Official 'Bullied' Scientist to Change Testimony About Dismissed Scientists. EPA Chief Pushing Governmentwide Effort to Question Climate Change Science. On Capitol Hill, EPA Chief Gets an Earful about Trump’s ‘Downright Offensive’ Budget Plan. EPA Set to Eliminate over 1,200 Employees by September. Trump and Pruitt Are the Biggest Threat to the EPA in its 47 Years of Existence. Scott Pruitt Wants Some Kind of Strange Climate Change Showdown. E.P.A. Chief Wastes Little Time Voiding Obama’s Rules. 9, 10↓, 170604-4.2A‡, 170514-1 -‡↓+ are about advisors. New Florida Law Lets Any Resident Challenge What’s Taught in Science Classes. Advocating for Vaccination in a Climate of Science Denial. FDA Approves 55 Hour ENERGY for Incoming July Interns [Poster].

            -1.2. How Climate Change Has Plagued the Health of Nations for Centuries. The past 10 thousand years should have taught us two things: When climate changes, people move, and when states can’t feed their people, they fall. As McMichael describes it, too little rain, or too much, leads to malnutrition and famine. Malnourished peoples succumb to new epidemics, or rise up against their rulers, or invade their neighbours. #Book Climate Change and the Health of Nations: Famines, Fevers, and the Fate of Populations [Cover]. Some have theorized that natural environment determines the fate of communities. This book does not go that far, but emphasizes that it does have vast direct and indirect repercussions for human health and welfare. From the very beginning of our species some five million years ago, human biology has evolved to adapt to cooling temperatures, new food sources, and changing geography. As societies began to form, they too evolved in relation to their environments, most notably with the development of agriculture eleven thousand years ago. This is mankind's 'Faustian bargain, ' because the prosperity and comfort that an agrarian society provides relies on the assumption that the environment will largely remain stable; in order for agriculture to succeed, environmental conditions must be just right. Now, with global warming, the bill is coming due. Climate relatedupheavals are a common thread running through history, and they inevitably lead to conflict and destruction, correlating them to the four horsemen of the apocalypse (anthropomorphized parademic): Famine, pestilence (biodisaster), war and conquest (maybe better terms are poverty, mass migration, competition, ignorance).

            -1.4. Mapping the Potential Economic Effects of Climate Change. Climate scientists agree that this century is getting much warmer and that such warming will likely bring economic pain to the U.S., but economists aren't sure how much. Now, a team of scientists and economists can at least tell which parts of the country are likely to suffer the most. They started with history: How have heat waves and drought affected the economy in the past Then they applied that metric to a range of future warming scenarios — from minor to extreme — and mapped the effects, county by county across the U.S. They found that if warming continues at recent rates, it could shave 3 to 6 percentage points off of the country's gross domestic product by century's end — the warmer it gets, the bigger the hit to the economy. Historically humans begin to perceive a biodisaster when it has economic impact. Estimating Economic Damage from Climate Change in the United States.

-2. HHS Secretary Defies Trump on Ebola Travel Ban. Trump advocated shutting infected Americans out of the country during the 2014 outbreak. But Tom Price praised Obama's response and said the US has a moral responsibility to care for its health volunteers abroad. At the height of the Ebola outbreak in 2014 Donald Trump tweeted: “The U.S. cannot allow EBOLA infected people back”. People that go to far away places to help out are great but must suffer the consequences. This framework sees infected persons as an enemy to be contained and avoided rather than as people who need treatment; What Does Trump Mean for Global Health. That is a worrying framework, especially considering that Trump will almost certainly face another epidemic during his presidency. If not Ebola, if not Zika, then something else. Outbreaks of disease are among the ultimate tests for any leader who wants to play on the global stage. They demand diplomacy, decisiveness, leadership, humility, and expertise; and they quickly unearth any lack of the same; How a Pandemic Might Play Out Under Trump, noted in 170220-1.9↓. When Price was asked how to reconcile the HHS cuts with his insistence on the importance of American global health leadership, Price said: “The premise to that question is that the CDC budget right now is exactly where it needs to be and there are no efficiencies to be gained. I would suggest to you that there are efficiencies that can be had”. This is still the basic difference between worldviews of fiscal responsibility versus humane responsibility, 170625-2A↓. Overall Price toes the party line: HHS Secretary: The Congressional Budget Office Is ‘Not Accurate’. HHS Secretary: Trump’s Tweets Aren’t Impeding the Push for Health Care Overhaul. [Cartoon, Cartoon, Cartoon, Cartoon, Cartoon, Cartoon, Cartoon]. US Retreats from its Lead on Epidemic Preparedness.

            -2.1. WHO Guidelines on Ethical Issues in Public Health Surveillance. #Document The WHO Guidelines on Ethical Issues in Public Health Surveillance is the 1^st international framework of its kind, it fills an important gap. The goal of the guideline development project was to help policymakers and practitioners navigate the ethical issues presented by public health surveillance 12↓.

            -2.2. What’s at Stake in Speculation. We’ve long been thinking about health, well being, illness, sickness, and disease, in relation to risk. That things might not be maintained at their present levels, either individually or socially, is not something new, even if we’ve entered a period of intensification, with calls to ‘repeal and replace’ the Affordable Care Act – Trump to Senate GOP: Kill Obamacare Now; Replace Later, Trump’s Solution to Republicans’ Impasse. Repeal Now, Replace Later, [Tweet]; White House Denies Moving to 'Plan B' on Healthcare after Trump Tweet, C↓ – and the slow, often subtle chipping away at social safety net policies in the United States and throughout the North Atlantic in the spirit of austerity and for the sake of freedom. What might have been primarily personal and interpersonal concerns about health and disease have also expanded to include the environment and the species, as we continue to think through the Anthropocene and its consequences for exposures to environmental dangers, and thespread of once localized diseases to the global stage. The intensification and generalization of risk may very well entail the intensification and generalization of speculation; what are our individual and collective futures. What better way to confront our possible futures than through media that explicitly engages with the future, speculative and science fiction. How Margaret Atwood Became the Voice of 2017, Women Protest Healthcare Bill in 'Handmaid's Tale' Inspired Costumes, [Photo, Cartoon, Cartoon]. Identity Politics, Partisanship and Healthcare.

            -2.3. A parademic consequence of isolationism. How Do We Avoid Disaster When Exiting the European Medicines Agency. Making the Most of Brexit in Pharmaceutical Regulation. As the UK prepares to leave the EU, it must decide what path it is to take with a large number of regulatory and technical agencies who provide collaboration at the European level. In the case of pharmaceuticals, the European Medicines Agency (EMA) provides pan European licencing for novel pharmaceuticals. Should the UK depart from the EMA system, this article highlights the loss to patients immediately (slower access to novel treatments), and in the long term by having no access to some novel products as companies choose not to launch in the UK. The lack of access then may also preclude the access to these treatments as generic medicines, causing harm far into the future. The other costs considered are the cost for duplicating the functions of the EMA, or the alternative of using the decisions of other regulators without input to decisions made. [Strip].

-3. Can Antipoverty Programs Work Globally. It is a huge question in development economics: If a program yields good results in one country, will it work in another. Does a vaccination policy in India translate to Africa. Does a teen pregnancy prevention program in Kenya work in Rwanda. 1) What are the components of the theory behind the program. 2) Does that theory apply to local conditions. 3) How strong is the evidence that the desired behavioral change will occur. 3) What is the evidence that the implementation process can be carried out well. Poverty is closely associated with biodisaster, finding solutions globally would go a good way from solving biodisaster, but frequently programs to solve poverty don’t last and eventually crash becoming deeper poverty, especially with corruption misdirecting help 6.3C↓. Cookie Cutter Vs. Custom Plans. Emergency Preparedness Is Not “One Size Fits All”. 6.3D↓.

↕4. American Zika in 2016 and 2017: The Strange Case of Mr. Hyde and Dr. Jekyll. In early 2016, a wave of Zika virus infection swept through South America, causing almost 400,000 cases, with more than one half in Brazil, and almost 100,000 cases in Colombia, and 60,000 in Venezuela. A second wave of Zika virus infection rolled into the Caribbean later that year, causing around 40,000 cases each in Puerto Rico and Martinique, and elsewhere. It was during this period that Zika virus entered South Florida through multiple entries from the Caribbean, with transmission propagated by local Aedes aegypti mosquitoes. A second autochthonous focus of Zika virus infection occurred in South Texas and may have entered from Mexico. ¶ What will these disease patterns portend for North America as we move into the summer months? It’s pretty clear that overall transmission is significantly down in the Western Hemisphere. In terms of South Florida since there does not seem to be a high level of Zika virus transmission in the Caribbean (that served as the source of last year’s epidemic), we may indeed not see a return of Zika to Florida. So in Florida anyway, Dr. Jekyll may have finally overpowered Mr. Hyde. ¶ On the other hand, for Mexico, I think it remains to be seen given that their traditional rainy season (and therefore mosquito season) goes from June to October, so we’ll still need to be vigilant for the return of Zika virus infection there. And since Mexico and South Texas are linked in so many ways, we need to continue monitoring Zika virus infection. Still another concern is that thispast winter has been record setting in terms of its mildness and high temperatures, which means that Aedes aegypti numbers could be high in Texas urban areas such as San Antonio and Houston. For all these reasons, what will happen in terms of Zika virus infection in Texas may still be anyone’s guess. Compounding this problem is the fact that four other arboviruses transmitted by Ae aegypti – dengue, chikungunya, Mayaro, and yellow fever – remain circulating in the Americas, so that we need to be on the lookout for their emergence in North America as well. At least for Media Zika is ending as an outbreak. There will probably be a cluster of stories in the future about media ignoring the neurological sequella of Zika. Inevitably there will be an outbreak of a mosquito borne disease that will attract media attention and questions of why nothing was done during the trough of the wave. Venezuela and its Rising Vector Borne Neglected Diseases. West Nile Virus Outbreak in Houston and Harris County, Texas, USA, 2014. As Snow Melts, Mosquitoes on Attack. [Montage].

-5. Has been some time since Parademic mentioned that dust storms from Africa can reach Middle America and from Asia to North America. With climate change more dust with their load of microbes can be lifted into the air and travel further. There have already been concerns of fungus in wildfires. What would happen with a dust storm from the Arctic regions. The Dust Storm Microbiome. The airborne dust carried in sand storms affects the health of people and ecosystems alike. New research suggests that part of the effect might not be in the particles of dust but rather in bacteria that cling to them, traveling many kilometers in the air with the storms. [Map, Map].

-‡. Dust Storms Spread Deadly Diseases Worldwide (2009), Insects and Diseases Associated with Forest Fires (2010) Soil Related Bacterial and Fungal Infections (2012), Saharan Dust Travels More Than 5,000 Miles to South Texas (2015). 170101-6, 161113-1, 161106-2.1, 160807-7.4, 130929-43, 130915-33 -33.1, 130825-35, 130714-3, 130505-42↓. Unknown at this time if there will be another loose cluster of this story as happen in 2013, or if this will be an outlier. It is known that if there is an outbreak from dust or fire that it will be reported as a new thing. Monitoring Changes in Wetland Extent Can Help Predict the Rate of Climate Change. As Climate Stirs Arctic Sea Ice Faster, Pollution Tags along.

            -5.1. Megafires are considered a biodisaster because they cover large areas with such intense temperatures that they actually sterilize an area (depopulate down to the microbe level). These events are also not part of “normal” fires, but anthropogenic ones. Industrial Farming Disrupts Burn Regrowth Cycle in Grasslands. The world's open grasslands and the beneficial fires that sustain them have shrunk rapidly over the past two decades, due to a massive increase in agriculture, according to a new study. How Megafires Are Remaking American Forests. Supersize fires are burning up bird habitat, killing trees, and turning forests into open range. Climate change will only make it worse. It's Time to Adapt to Megafires. The Southwest's Forests May Never Recover from Megafires. Firefighting Blamed for 'Megafires' Ravaging US Forests. Arizona Has Most Wildfires Burning in the United States. ield   HYPERLINK "http://www.govtech.com/em/disaster/As-Wildfires-Rage-on-West-Coast-DC-Lawmakers-Fight-Over-Forest-Policy.html" As Wildfires Rage on West Coast, DC Lawmakers Fight Over Forest Policy [Cartoon]. 170618-3.1‡, 170305-1A, 170205-10, 170129-12, 161211-2.3↓+.

-6. Mutant Strains of Polio Vaccine Now Cause More Paralysis than Wild Polio. So far this year, there have been only six cases of wild polio, and 21 cases of vaccine derived polio, most of them in Syria. The oral polio vaccine used throughout most of the developing world contains a form of the virus that has been weakened in the laboratory. But it's still a live virus. This is a different vaccine than the injectable one used in the U.S. and most developed countries. The injectable vaccine is far more expensive and does not contain live forms of the virus. It has become fairly common each year for there to be one or two small outbreaks of vaccine derived polio. These outbreaks tend to happen in conflict zones where health care systems have collapsed. These outbreaks are occurring only in very rare cases and only in places where children are not immunized. The regular polio vaccine protects children from vaccine derived strains of the virus just as it protects them from regular polio. Vaccine derived outbreaks occur where there are large pockets of unimmunized children, pockets sufficiently large to allow for the circulation of the virus. As Hopes for Polio Eradication Rise, the Endgame Gets Complicated, and a Vaccine Runs Short, “Retro Report” Featuring Heidi Larson and Larry Brilliant, d   HYPERLINK "http://parademic.typepad.com/my-blog/2017/06/parademic-notes-week-ending-170611.html" 170611-2.3, 170430-2A, 170312-C, 170226-10, 170212-5↓.

            -6.1. Maine CDC Investigating Case of Measles, First Case since 1997. Isn’t this the other state that quarantined Kaci Hickox_(Search) over Ebola, Ebola Nurse Kaci Hickox Won't Quarantine Herself, and Maine Is Very, Very Unhappy About It. Some Maine Townsfolk Roll Out 'Unwelcome Mat' for Nurse Kaci Hickox. Kaci Hickox: Public Health and the Politics of Fear. The Renegade Nurse. Kaci Hickox has protested Ebola related quarantines in New Jersey and Maine. She's making a stand for science and civil liberties, but is she being unreasonable. Nurse Kaci Hickox and State of Maine Settle Quarantine Lawsuit. [Meme]. 6.3D↓.

            -6.2. Unknown why this is causing excitement. Perhaps the word “plague”, or someone unfamiliar with the fact that plague in endemic in the US southwest got excited when they learned of this for the first time, or just wanted an attention grabbing headline. Additional Cases of Human Plague in Santa Fe County, H5N1 comment US: Plague in New Mexico, The Bubonic Plague Is Back, this Time in New Mexico, More Cases of the Plague Confirmed in New Mexico, 2 New Plague Cases Confirmed in New Mexico, 3 People Have Caught Plague in New Mexico this Month. In the southwest one of the signs that summer has arrived is a report of a plague case, oft times involving people not taking precautions when going into the wild [Chart, Map]. One of the things I would do with the weekly newsletter to supported commands (the predecessor of Parademic) while I was a Pandemic Planner was to include outbreaks and note the historical pattern. This was in part to make people aware that these are common occurrences that typically appeared at certain times of year at given location. Anthrax because it was hyped as a bioterror weapon tended to cause excitement among people who were not familiar that anthrax is a typical disease in the southwest, along with tularaemia, plague, valley fever, hantavirus An Introduction to Arizona’s Infectious Diseases. These were not something to panic about as they were the normal pattern. It was when one did not hear about something when it normally would happen that was the concern, that numbers were larger than normal, or the outbreak was otherwise anomalous and highly infectious. Mostly one did not watch for cases, but for circumstances that could facilitate an outbreak such as drought, dust storms, war, flooding, wildfire, defunding of public health, lack of insurance, low vaccination, medical shortage, drug shortage...... ¶ It is never about single events but patterns and context 170618-7*↓. An event that happens at the same place and time consistently means something different that an event that is unique. An event that takes place in a large crowded metropolitan hospital means something different than the same event happening in a small village, on an isolated island that has contact with the outside world every six months when a tramp ship stops by on its rounds. There is also the situation where the bioevent happen in the same place and time, but vastly different outcomes 6.3B*↓.

            -6.3. Producing Ebola: Creating Knowledge In and About an Epidemic. This would be valuable information about behavior in the context of a biodisaster. Unfortunately as happens with what could be the best available information it is not easily available. Benefits of Open Access Journals. The problem is balancing profiting from one’s work, and sharing information that could save lives. [Poster].

            -A. Missing Bodies and Secret Funerals: The Production of “Safe and Dignified Burials” in the Liberian Ebola Crisis. During the height of the Ebola crisis in West Africa, public health responders and the international media focused on dead bodies as sites of disease transmission when early contact tracing discovered the relationship between attendance at funerals and emerging clusters of new cases. Anthropologists were central to the emergence of new protocols for “safe and dignified” disposal of the dead, emphasizing alternative rituals and the flexibility of local practice. In the process the emotional impact of loss and bereavement was subordinated to the focus on ritual. The new knowledge produced about safe and dignified burials in West Africa reveals the absence of knowledge about the handling of dead bodies and the emotional impact of bereavement among journalists, anthropologists, and biomedical professionals alike. 170625-2↓.

            -B. Ebola Through a Glass, Darkly: Ways of Knowing the State and Each Other. The Ebola epidemic unfolded in radically divergent manners in two neighboring villages in Sierra Leone, with one recording 40 cases and 20 deaths and the other recording zero cases, though they are located only 100 meters apart 6.2↑, C.1↓. Presented with identical information about Ebola’s cause and modes of transmission, one chief reacted by attempting to shield* his village from outside knowledge and influence, encouraging his people to continue their normal practices of care and communion, and the other by instituting self isolation*, rapidly enforcing Ebola specific practices among his residents. We argue that these opposing courses of action were the result of the chiefs interpreting health communications with respect to their social, historical, and political relationships with each other and with the state, and not as a result of one embracing medical knowledge and the other rejecting it. “Through a glass, darkly” refers to historical practices of knowledge interpretation in which knowledge is never treated as neutral information, but as implicated in relationships of power, rendering its political implications more important than the information conveyed. We distinguish between orthodoxy and orthopraxy—right belief versus right practice – to argue that the epidemic ended locally not through the circulation of knowledge, but through the circulation of Ebola specific practice. We caution against treating knowledge only in terms of its production, circulation, and consumption (like not having open access to information and research), and urge a new focus on knowledge non-production, obfuscation, and rejection. Ebola Aftermath: Restoring Trust in Hospitals in Guinea.

            -*. The terminology here differs from the meaning as used in public health and parademic. The shield example is actually self isolation (cutting off from other ideas and people) while the self isolation one is social distancing (taking precautions but continuing interactions with other people and ideas within those parameters). This same differences in meaning were observed during Ebolaphobia in the US 6.1↑, Social Contagion and Cultural Epidemics: Phenomenological and Experience Near Explorations. In that situation politicians were using the term isolation, which in public health is used to mean someone is sick and isolated to prevent spread. In actual fact they were forcibly quarantined (not sick but quarantined until the incubation period passed. It is possible to self isolate as an individual if one has the means to do so to avoid infecting others, or self quarantine which is taking appropriate measures (like social distancing, monitoring for symptoms). This is another problem of not having open access. Potential confusions of terminology and errors of fact are difficult to correct as there is limited means to contact the author.

            -C. We Know Who is Eating the Ebola Money: Corruption, the State, and the Ebola Response 3↑. Sierra Leonean production of knowledge about Ebola was, in large part, production of knowledge about “who ate the Ebola money”. Through a number of different points in the crisis there were concerns about how Ebola money was being spent which illuminate their expectations of their state. It argues that the Ebola crisis reveals people’s contradictory relationships to their own states, wherein they simultaneously mistrust their politicians and look to their politicians in a moment of crisis. The paper also investigates Sierra Leone’s relationship to the international community, concluding that the state’s weakness is produced, in part, by its place in the international system. [Cartoon, Cartoon, Cartoon].

            -D. Epistemologies of Ebola: Reflections on the Experience of the Ebola Response Anthropology Platform. By September 2014, it was clear that conventional approaches (cookie cutter 3↑) to containing the spread of Ebola in West Africa were failing. Public health teams were often met with fear, and efforts to treat patients and curtail population movement frequently backfired. Both governments and international agencies recognized that anthropological expertise was essential if locally acceptable, community based interventions were to be designed and to successfully interrupt transmission. The Ebola Response Anthropology Platform was established against this background. Drawing together local and internationally based anthropologists, the Platform provided a coordinated and rapid response to the outbreak in real time. This article explores how the Platform developed and interacted with other epistemic communities to produce knowledge and policy over the course of the outbreak: 1) What do these experiences reveal about the politics of (expert) knowledge and its influence on the design and implementation of policy. 2) Did differing conceptions of the place of anthropology in humanitarian crises by policymakers and practitioners shape the contributions made by the Ebola Response Anthropology Platform. 3) What are the implications of these experiences for future anthropological engagement with, and research on, humanitarian responses to health crises. Though Ebola was a natural experiment to validate parademic concepts, it was also an opportunity to observe and learn more. I encountered all three of these questions. 1) I had failed to establish credibility and contacts to share information with. That was very frustrating because though I could not predict when and where there would be murder of health care workers the pattern was clear, but I could warn no one. Even if I was able to pass along the the observations that lead to that conclusion, it is doubtful that I would have been heeded until the event happened Ebola Outbreak: Guinea Health Team Killed. Likewise there were predictable murders of careers during Ebolaphobia Nancy Snyderman Will Leave NBC News in Wake of Ebola Incident, 6.1↑, C.1↓. 2) I did have contact with policy makers and influences. Unfortunately there was a policy implemented that prevented the people I had contact with from sharing their expertise, and there was no mechanism for me to link. 3) Those implications are what I am working with now.

            -E. Ebola at a Distance: A Pathographic Account of Anthropology’s Relevance. How digital media facilitated an entry point to build connections and knowledge around the epidemic in American anthropologists’ quest to prove the discipline’s relevance, the viral circulations of and replications of anthropological ideas in the Ebola response, and the attempts to shed pathogenic racial legacies of Africanist anthropology shaping US anthropology’s official response. For me West African Ebola (the biodisaster) and more specifically Ebolaphobia (the emergent and predictable parademic) were a natural experiment, an opportunity to observe if concepts developed from observing behavior in the context of biodisaster were indeed valid, had predictive value, and if it was worth moving to a public forum and open access.

-8. U.S. Has the Worst Rate of Maternal Deaths in the Developed World + An Aging Nation: The Older Population in the United States + Why Is Infant Mortality Higher in the United States Than in Europe + Supreme Court Allows Limited Version of Trump’s Travel Ban to Take Effect‡ + The U.S. Fertility Rate Just Hit a Historic Low. Why Some Demographers Are Freaking Out = the possibility that a biodisaster that causes major demographic change and depopulation in the US would hinder ability to recover. ¶ 5 Barriers to Disaster Resilience: 1) Risk perception. 2) We don’t design for resilience. 3) Lack of incentives to invest in resilience. 4) We are not organized to do the above. 5) We don’t train and educate people in resilience. These factors are interactive and dynamic. Threats change, a recent disaster may have been weathered successfully but may compromised resilience for next disaster, becoming resilient for one disaster may weaken capabilities or increased threat of other types of disaster. Envisioning the Future of First Response. United Airlines Offering Immigrants Special Flights That Circle U.S. Awaiting Gaps in Travel Ban, Trump’s Travel Ban Meets Law of Unintended Consequences.

-‡. What the Supreme Court’s Travel Ban Ruling Means. Trump’s Big Travel Ban a ¿Win?. Here's Why It's Not. Texas Cities Challenging Law Say it Would Force Them to Aid Mass Deportations. Trump Lauds Supreme Court Order on Travel Ban as 'Clear Victory'. Administration Moves to Carry Out Partial Travel Ban. More Court Challenges Expected for Trump's New Travel Ban.

-9. #Glossary Ekistics concerns the science of human settlements, including regional, city, community planning and dwelling design. The study involves every kind of human settlement, with particular attention to geography, ecology, human psychology, anthropology, culture, politics, and occasionally aesthetics. Differs from and is a subset of anthropogenic which is the impact of humans upon the environment, in that this is the study of the human centric created environments and habitats. [Slides, Art, Art, Art] Ekistics, Science of Human Settlements. Climate Change Is Making Cities Sick. Glass Beach. Lori Peek of the Natural Hazards Center Discusses Effects of Disasters on People. U.S. Cities Taking Lead on Climate Change Efforts, Blue America Reaches out to the World, Ignoring Trump. 1.1‡↑, 10↓.

-10. Continuation of 170514-1‡, 170416-3Quote, 170409-2.2A, 170226-6, 170312-2.3: Donald Trump Should Not Appoint a Science Adviser (April/04), he doesn’t deserve one, and it’s more likely to be a sham than a help. Democrats Tell Trump to Get a Science Adviser So He’s Not Vulnerable to Fake News (May/05) Letter. The White House Science Division Officially Has Zero Staff Members, Science Division of WH Office Left Empty as Last Staffers Depart (June/06). 1.1↑. The trend of this pattern is not clear yet but there seems to be a general conclusions that could be drawn from behavior from the last 6 to 8 months, Trump White House Staff Payroll Nearly $36 Million and Top Heavy. ¶ A point that was not considered in the original version of 170220-3.2↓ was not only who fills what positions, but which positions are left vacant or the individual/staff is dismissed/defunded 170220-3.2T↓. ¶  Trump Nominates Indiana Health Official for Surgeon General, Jerome Adams Nominated as New U.S. Surgeon General, Trump Taps Another Indiana Health Official for Surgeon General Post, 170430-1.1↓, which BTW the last sentence of that stub is fake news, a deliberate error, C↓. Trump Endorsed Media Outlet Accuses NASA of Operating Child Slave Colony on Mars. Of All the Categories of Fake News, Health News Is the Worst. 1.1‡, 9↑.

-11. Why Bird Flu Risk Is like the Grenfell Tower Tragedy* [Photo]. The spectre of bird flu still haunts the world. Virologists have discovered that a widespread Chinese poultry virus, H7N9, could be a few mutations away from becoming a human pandemic. Like H5N1** before it, the virus could kill millions. Yes, we know H5N1 hasn’t done so – but it might still. Similarly, H7N9 may fade away (not likely). But we’re riding our luck till the luck runs out. *Grenfell Tower Fire Was 'Entirely Predictable' and Could Have Been Prevented. This theme that it could have been prevented and discovery that the hazard was known well before (blame) is common in parademic; however, no matter how often it happens it is still rare that behavior changes to mitigate a biodisaster threat before it accelerates, and then to take protective measures afterwards. This is usually because of costs and lack of interest after the immediate risk is gone. **There was a 2009 H1N1 strain that was more lethal (25%), but was less transmittable 7%, probably due to being crowded out by the other strains. The science behind this is a bit dense and inconclusive as the necessary verification studies were not done, but see Evolution of 2009 H1N1 Influenza Viruses During the Pandemic Correlates with Increased Viral Pathogenicity and Transmissibility in the Ferret Model. [Cartoon]***. ¶ The Next Generation of Flu Vaccines. Just Peel and Stick. Bit skeptical about this. Technology has been available since 2010, but it still has not been a successful means for effective dose delivery. There have been a number of different articles of this recently, more or less the same hype as previous clusters.

-‡. France Confirms Case of H5N8 Bird Flu in the North, South African Culls 260,000 Birds So Far to Contain Bird Flu Outbreak. India: H1N1 Bigger Killer than Dengue and Malaria in Maharashtra.

-***. Note that this is not a British cartoon but one from Texas. The issue being lampooned is not the fire, but economic policy and attacks against business regulation. How the Grenfell Tower Fire Became a Metaphor for Britain’s Year from Hell. Grenfell Tower Fire an Apt Metaphor for Climate Change Alarmism. Is Grenfell Tower a Metaphor for Our Divided Society. Yes, the Grenfell Tower Fire Is Political - to Suggest Otherwise Does the Victims a Disservice. [Cartoon, Photo, Cartoon]. London Grenfell Tower Residents Raised Concerns Months Before Fire.

            -11.1. A Fragile Assemblage: Mutant Bird Flu and the Limits of Risk Assessment. This paper examines the recent public controversy sparked by the laboratory creation of a strain of highly pathogenic avian influenza transmissible among mammals. The contours of the controversy can be understood by tracking the assemblage of actors, institutions and devices gathered together in response to the governmental problem of how to manage emerging diseases. The grouping is tenuously held together by a shared commitment to the project of ‘pandemic preparedness’. However, as the controversy unfolds, it becomes clear that the main actors involved do not share a common understanding of the problem to be addressed by pandemic preparedness, and the assemblage threatens to decompose. At the center of the dispute is the question of how to assess the risks and benefits of research in a field characterized by urgency and uncertainty. Gain of Function_(Search), 170220-8.11, 170101-7.1, 160724-7, 160110-13↓+.

-12. #Document Public Transit Emergency Preparedness Against Ebola and Other Infectious Diseases. Transit is increasingly becoming the backdrop against which pandemics unfold, making the need for emergency preparedness for outbreaks ever more important. SARS, MERS, H1N1, and even the seasonal flu provide opportunities to identify areas in which public health and transit can work together to ensure transit’s emergency response posture: Closures of Major Traffic Generators, Full or Partial Suspension of Service, Screening and Prescreening 2.1↑, Quarantine and Isolation, Employee Protocols and Work Safety, Infection Control and Disinfection Measures. Public Transportation Are Mobile Environments That Are Prone to the Spread of Infectious Diseases Such as Colds and the Flu to Name a Few. [Photo].

↕C. How Fake News Breaks Your Brain. Short attention spans and a deluge of rapid fire articles on social media form a recipe for fake news epidemics. When people are overloaded with new information, they tend to rely on less than ideal coping mechanisms to distinguish good from bad, and end up privileging popularity over quality, the study suggests. It’s this lethal combination of data saturation and short, stretched attention spans that can enable fake news to spread so effectively. Parademic design is in part based on countering fear, panic, rumor, misinoformation. The idea is to practice being overloaded with new and conflicting information, learning to discern what is valid, how it is valid, and what its validity means 2.2↑. [Tweet]. Not only is waiting to learn how to deal with a deluge of chaotic  information until the disaster is too late, but waiting for someone else to tell you what the information means takes even more time and one cannot trust the validity of the analysis, 10↑.

-Quote: If I’m trying to explain something and you don't follow me, it's not simply your job to catch up. It’s my job to slow down. This is the heart of communicating: If I tell you something without making sure you got it, did I really communicate anything. Was I talking to you, or was I just making noises. Alan Alda. 170625-C.Quote↓. If I Understood You, Would I Have This Look on My Face, Chapter 4, Page 30. The other side of the mirror is are you slowing down to get what is being communicated, or are you rushing ahead to think of what your next communication, not considering what the other was communication.

            -C.1. Where a Doctor Saw a Treatable Cancer, a Patient Saw an Evil Spirit 6.3B, D↑. The woman, a Hmong immigrant, spoke little, if any, English. Through an experienced interpreter, doctor explained the protocol and told her she would need a lung biopsy to confirm the diagnosis. After the procedure, he told her he felt confident the protocol he had described would cure her. The woman, though, was incensed. Something about how we explained what we were doing didn’t match her way of thinking about things. She thought we gave her cancer in the chest. ¶ Still, he persuaded her to accept the cancer treatments. Then, at the last minute, she refused. Months later she died. On the first anniversary of her death, a small box arrived in the office mail. In it, a photo of the woman, in traditional Hmong dress, from decades earlier. There was a note, and a palm sized packet wrapped in ceremonial red and green paper – It was a portion of the woman’s ashes. The note was in pencil, with sketched symbols. The message was, ‘You killed my wife. Her spirit will haunt you forever. ¶ The cure I was offering was mine, not hers. The failure to see issues through patients’ eyes is a common enough affliction among doctors and nurses alike, and it can be especially destructive for patients approaching life’s end.

            -C.2. Effective Communication Webinars. These expert-led 60 to 90 minute webinars will provide theory and practical advice in effective leadership, clear communication, and conflict management. Experts will address challenges of emergency response, including reprioritization of resources, time constraints, increased demands on healthcare workers, and strategic communications with media and public. Communicating During a Crisis: What a Hospital Epidemiologist Needs to Know. Conflict Management in Times of Competing Resources and Priorities. Beating the Media Crush During a Crisis.

-ADDED:

• 170625-1‡: Increase in Pertussis Linked to Nonmedical Vaccine Exemptions, Waning Immunity.
• 170625-1.1: Social Networks May One Day Diagnose Disease, but at a Costhttps://www.wired.com/story/social-networks-may-one-day-diagnose-disease-but-at-a-cost/.
• 170625-2: A Monumental Effort Revisited: New Ebola Exhibit Captures the Intensity of the Response to the Crisis.
• 170625-3: The True Test of a Successful Crisis Response: Public Trust. Quoth Antivaxers: We Demand Transparency, Except When it Might Embarrass us.
• 170625-6.2: Drinking from Ancient Water Bottles Didn't Hurt Indigenous People – Making Them Did.
• 170625-7: How Humans Helped Ants Invade the World|.
• 170625-7.4: [Cartoon].
• 170625-C.3: 170514-4.1‡, 1704304*A, 170416-1A, 170220-3.4P, 161225-10↓+.
• 170618-7: Drones to the Rescue it’s expensive to use drones to deliver meds. Not using them exacts a heavier cost|.
• 170618-8: Stopping Pandemics Before They Start. Imagine that enemies possessed a class of weapons with which they attacked your people from time to time. Decades could go by with no attack, but eventually one would come. Imagine also that these weapons were growing more potent, and the attacks were becoming more frequent. World Bank Launches ‘Pandemic Bond’ to Tackle Major Outbreaks. Preventing Pandemics and the Necessity of Funding Prevention.
• 170618-3.1‡: Blame Game in Portugal over Wildfire That Killed 64 People is a common reaction, rather than find solutions place fault and then feel satisfied that enough was done to prevent reoccurrence.
• 170618-3.2: Pesticides Are Harming Bees — but Not Everywhere. Do Neonics Hurt Bees. Researchers and the Media Say Yes. The Data Do Not.
• 170618-C.3: Still no MERS News from Saudi Arabia.
• 170611-3: Top 10 Things Patients Do Not Know Difference Between, According to Twitter.
• 170611-3.2: U.S. Hospitals Have Been Hit by the Global Ransomware Attack. The ransomware is not a biodisaster but a parademic, however if the attack coincided with a biodisaster that required a medical surge the harm would be far worse. This also coincides with the proclivity of bad guys to attack soft targets of hospitals. In other words this type of attack is not only an act of war, but is a war crime. Health Network’s Community Labs Closed after Cyberattack. Global Ransomware Attack May Actually Be a Precursor to a More Virulent Future Event. Ukraine Cyberattack Wasn't Really about Ransom, Security Experts Say.
• 170611-7.1: Her Newborn Kept Getting Sick Because She Was Ingesting Placenta.
• 170611-7.2: New Limbs for Growing Bodies: Mutilated Albinos Get Refitted. poaching* : Illegal Owl Trade in Indonesia, different marketing magic and poaching (possibly like poaching for Chinese medicines), 170611-2.2↑, 170305-3.1, 170212-8↓.
• 170604-4.2A‡: Climate Change Denier Rick Perry Just Got Schooled by a Bunch of Scientists.
• 170604-C.1: House Republicans Backed this Biotech — and Lost Big. Its Stock Is Now Worth 4 Cents a Share.
• 170514-6.2: A Billion Year Arms Race Against Viruses Shaped Our Evolution.
• 170507-1.1D: [Cartoon].
• 170409-2.2A: Moved to 10↑.
• 170326-8.1: U.N. Brought Cholera to Haiti. Now It Is Fumbling Effort to Atone.
• 170312-2.3: Lawmakers Push White House for Action after HIV Panel Resignations. President Trump Wants You To Know He Actually Does Care About HIV/AIDS [Quote].
• 170205-5.1: Michigan Sues Flint after Council Refuses to OK Water Deal.