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  The widespread use of diphtheria-tetanus-acellular pertussis (DTaP) vaccines, which protect against diphtheria, tetanus, and pertussis had driven whooping cough (pertussis) to the brink of extinction in the US. “The DTaP vaccine has been a cornerstone of childhood vaccination programs for decades, significantly reducing the incidence of diphtheria, tetanus, and pertussis. Pertussis, in particular, is a highly contagious bacterial infection that can cause severe, life-threatening complications in young children, especially infants who are too young to be fully vaccinated. Before widespread vaccination, whooping cough epidemics were a regular occurrence, with thousands of deaths reported each year.   “Today, the vaccine is highly effective, with studies showing up to 90% effectiveness in preventing severe cases of pertussis in fully vaccinated children. The urgency to address vaccine hesitancy cannot be overstated. The U.S. is returning to pre-pandemic patterns, wher...

Kevin Drum has a post up about the present and future of EV charging stalls in the US. As of 2023, the number was 184,000, with public charging stalls outnumbering Tesla stalls 6:1. Is that a lot or a little? Well, lots of people say that they’re holding off buying EVs because of the range, which is still less than most ICE cars. One way to mitigate that concern is to have more charging stalls than gas station nozzles*.  So how many gasoline fuel nozzles are there? According to xMap, there are ca. 196,600 retail gas station locations in the US. If you assume each station has on average eight fuel nozzles, that’s ca. 1,570,000 gas fueling ports**. So there are probably about an order of magnitude *more* ICE fueling nozzles than there are EV charging stations. Even with the growth in public stalls funded by the Bipartisan Infrastructure Law, it will likely take close to a decade for EV charging stalls to catch up to gas fueling stalls. * setting aside the issue that it take...

You may have read about “blue zones,” certain communities that have an unusually large number of centenarians: Loma Linda in California, Okinawa in Japan, Sardinia in Italy, Nicoya in Costa Rica, and Ikaria in Greece. Since we can’t all move there, the next best thing would be to discover the key to longevity in these places. “The overall populations within these blue zones, as well as those individuals who appear to be living into extreme old age, have been analyzed for their life patterns, social connections, biomarkers, genomic variations and so on. All of these studies are searching for the same answer: what are the secrets to long life? ‘But Newman believes the answer has less to do with any particular lifestyle factor, and rather more to do with dodgy data.   ‘In his new preprint study, yet to be published in a peer-reviewed journal, Newman shows that the highest rates of achieving old age are predicted by three factors: high poverty, a lack of birth certificates, and fe...

I recently retired after working at the same employer for 37 years. My dad also worked ca. 35 years for the same employer before retiring, as did my father-in-law. My sister worked for the same employer for 40 years. Two of my sisters-in-law worked for their only employer for about that long. My daughter, on the other hand, is on her 4 th  employer since finishing law school ten years ago. Most folks switch jobs several times. Kevin Drum brings some data on US job tenure over at Jabberwocking.com. He notes that job tenure (median years at current job) has declined in the 35-44 age group since 1984, although the magnitude of decline doesn’t seem that impressive (from 5.2 to 4.6 years). He also breaks out the data by age group. My sister, wife sisters-in-law and I are all in the 65+ demographic, where the median years in current job is 9.8; we’re all a couple standard deviations away from that. In my daughter’s demographic, though, the median time per employer is 4.6, so she isn’t th...

My favorite blogger, Kevin Drum, is in the hospital for a new round of chemo for multiple myeloma. This is after several rounds of conventional chemotherapy and a clinical trial for CAR-T therapy. So although he’s not a doctor, this ain’t his first rodeo: “Before I checked in, I had already decided to make a nuisance of myself over two things. The first is that I wanted to wear my street clothes instead of the dumb hospital gown. To my surprise, that was no problem. They didn't care.   “The second was bound to be more contentious: I also didn't want an IV line installed. They're magnets for infection—and a pain in the ass—and none of my meds were going to be administered via IV. Nor did my case require a constant saline drip.   “Needless to say, the nurse objected. The nurse's boss objected. The doctor objected. Procedure demanded a peripheral IV line. Beyond that, their case was simple: I was here under observation because the chemo meds can have severe side effects. I...

Lewis Strauss, former chair of the AEC, coined the phrase “too cheap to meter” referring to the potential for nuclear power. It was a phrase I grew up hearing in Oak Ridge TN, but it never came to be, there or anywhere else. Now, the Wall Street Journal claims that day has arrived, not because of nuclear, but because of wind and solar: “The changes sweeping Europe’s electricity markets, which were accelerated by the energy crisis brought on by the war in Ukraine, show what could happen in the U.S. in a few years when renewable capacity reaches a similar scale. In 2023, 44% of EU electricity was generated by renewables, compared with 21% in the U.S. “In some U.S. markets—sunny California, the wind-swept Great Plains, and Texas—zero and negative prices are already common. The wholesale price in Southern California was negative nearly 20% of all hours this year because of the region’s boom in solar-panel installations.” Currently (pun intended), the big problem with wind and...

  Big Pharma has become a familiar whipping boy in the debate over healthcare costs. CAR-T therapies to treat certain cancers, for example, can cost between half a million and a million dollars for a single treatment course. What’s the prospect of a cancer cure worth to you? GLP-1 receptor agonists like semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro, Zepbound) are transforming the lives of obese patients. For most people, these drugs will have to be taken continuously for the rest of their lives at a cost of ca. $16,000/year. Given the number of obese Americans, this represents a huge burden for insurers, both private and Medicare. But thinking about the benefits simply from the standpoint of obesity treatment elides the economic benefits of weight reduction: fewer surgeries, discontinuing drugs to treat other obesity-related conditions, etc.: “One of the most striking shifts has been in the area of bariatric surgery, where once-steady demand for weight-loss procedures has...

Medicare Advantage, which now covers more than half of the Medicare-eligible population, is a rip-off for taxpayers and for policy holders. Apparently, this is finally sinking in for hospitals and health systems across the country: “In 2023,  Becker's  began reporting on hospitals and health systems nationwide that dropped some or all of their Medicare Advantage contracts.   “Data on this topic is limited. In January, the Healthcare Financial Management Association released a survey of 135 health system CFOs, which found that 16% of systems are planning to stop accepting one or more MA plans in the next two years. Another 45% said they are considering the same but have not made a final decision. The report also found that 62% of CFOs believe collecting from MA is "significantly more difficult" than it was two years ago.”   For a list of 24 health systems that are dropping Medicare Advantage plans in 2024/25, click the link.   https://www.beck...

The US for-profit healthcare system is a disaster for everyone except the executives and stock-holders. Here’s yet another confirmation: “A report out Thursday shows that the United States’ for-profit healthcare system  still  ranks dead last among peer nations on key metrics, including access to care and health outcomes such as life expectancy at birth.   “The new analysis from the Commonwealth Fund is the latest indictment of a corporate-dominated system that leaves tens of millions of people uninsured or underinsured and unable to afford life-saving medications without rationing doses or going into debt.   “Despite spending a lot on healthcare, the United States is not meeting one of the principal obligations of a nation: to protect the health and welfare of its residents,” the report states. “Most of the countries we compared are providing this protection, even though each can learn a good deal from its peers. The U.S., in failing this ultimate test of a suc...

Endless online vitriol has been spilt promoting the idea that the COVID-19 pandemic was somehow either (a) an engineered pathogen or (b) a virus that escaped from a research facility. While those allegations served the interests of the Trump Administration, the actual, you know, scientific data supporting them was non-existant. Now, years later, the sorts of experiments that could have weighed in support of natural origins of the pandemic, the parsimonious conclusion, have been done: "After an in-depth analysis of the genetic material from hundreds of swabs taken from the walls, floors, machines and drains inside the Huanan Seafood Wholesale Market in Wuhan, China — a site that’s been described as an epicenter of early spread of Covid-19 — scientists say they now know exactly which species of animals were in the same area where investigators also found the most positive samples the virus that causes Covid-19. "Species present in the areas where the highest numbers of SARS-CoV...

Kevin Drum has a short piece on the recent surge in auto insurance rates. He doesn’t offer any explanation in his post, but the comment thread has suggestions:   • a combination of increase in bad driving and lack of enforcement; • fender benders are much more costly since all the self driving gear as well as lane alerts, back up and blind spot cameras, etc., are in the bumpers, windshields and side view mirrors;   • the increased number of EVs on the road, which some commenters assert are more expensive to repair; • increased damage due to climate change (fires, floods). Commenters note that insurance rates have also surged in Canada and Germany, so it’s apparently not just a US thing. https://jabberwocking.com/we-are-paying-the-price-for-crazy-driving/

I’m not a fan of conspiracy theories. I still believe that Lee Harvey Oswald was the lone gunman. I still believe that Saddam Hussain had nothing to do with 9/11 and had zero nuclear weapons, zero chemical weapons and zero biological weapons at the time of the US invasion and military occupation of Iraq. Nevertheless, there’s something fishy about this latest “assassination attempt” on Trump. • First were the words of Acting Secret Service acting director  Ronald Rowe  on Monday afternoon at press conference about the incident. Rowe  stated  that Trump’s trip to golf course on Sunday  was not on his schedul e and bluntly that  Trump "wasn't supposed to have gone there in the first place ." In fact, Rowe repeated that  four times  in a short press conference including  with the commen t,  “The president wasn’t even really supposed to go there.” That raises the question of how the gunman knew Trump would be there? Reporters asked Rowe this...

From everything I’ve read, Medicare Advantage is just as scam. By the time my Lovely And Talented Wife® retired and shifted to Medicare, she took the regular Medicare. This July when I retired, I followed suit.  Turns out, a growing number of hospitals and health systems nationwide have dropped some or all of their Medicare Advantage contracts. “Data on this topic is limited. In January, the Healthcare Financial Management Association released  a survey  of 135 health system CFOs, which found that 16% of systems are planning to stop accepting one or more MA plans in the next two years. Another 45% said they are considering the same but have not made a final decision. The report also found that 62% of CFOs believe collecting from MA is "significantly more difficult" than it was two years ago.” Click the link to read about the 24 health systems that have dropped Medicare Advantage plans so far in 2024.    https://www.beckershospitalreview.com/finance/15-health-sys...

Godwin’s Law states that as an online thread gets longer, the chances that someone will mention Hitler or Nazis approaches unity. Comparing Hitler or Nazis to contemporary people is the conversational equivalent to going nuclear. For that reason, I try to avoid such comparisons except in discussions around WWII and Holocaust history. But the comparison between the language of Trump/Vance and the Nazis is unavoidable: • Trump and his people have stated plans to round up immigrants in the US and put them in concentration camps until they can be deported. Yes, I know the British herded Boers into concentration camps before Hitler came along—the Nazis didn’t invent them, they just perfected them. And historian Timothy Snyder points out that the Nazi death camps were all outside of German soil. And yes, I know that American citizens of Japanese descent were rounded up and put in concentration camps here in the US after the Japanese attack on Pearl Harbor; • Often forgotten is that the origi...

Several years ago, I was nearly killed by a car driving in excess of 90 mph through an intersection against a red light. The front end of my car was destroyed. The air bags detonated, and both my passenger and I were unhurt. It turned out that the car that hit me (and proceeded to wrap around a telephone pole) was in a car chase. The police car arrived within a minute. Car chases are dangerous and deadly. It looks like an alternative may be on the horizon: “It sounds like a high-tech gadget from an action movie.   “Police are pursuing a driver who refuses to pull over.   But instead of engaging in a dangerous, high-speed pursuit, the officer   fires a GPS tag   that sticks to the speeding vehicle and tracks its movements. All at the push of a button.   “It allows officers to mitigate the situation and also limit the probability of serious injuries or fatalities involved with high-speed pursuits,” said Major Dan Tucker of the Massachusetts State Police, which has...

Farming is a risky business. Always has been. A federal program to keep farmers in business during droughts seems like a good idea to me. Sadly, it’s also a target for fraud: “On a normal day, the promising storms produced snow or rain that would fall onto a system of official weather stations at airstrips or town halls, into heated “tipping buckets.” When the teeter-totter buckets filled with a thimbleful of water, the seesaw tilted, dropping one miniature metal bucket downward to close an electrical circuit.    “One “tick” of the bucket, and a signal went out to National Weather Service sensors around the world that the parched High Plains had recorded one hundredth of an inch of welcome water.    “What bewildered the trackers is that on many of these stormy days, those buckets were not tipping. No tipping buckets pointed toward a severe spring drought. All cumulus, no accumulation.    “That same winter and spring, weather agency field technicians started...

(from the NYT, paywalled, so no link) "Texas has sued to block federal rules that prohibit investigators from viewing the medical records of women who travel out of state to seek abortions where the procedure is legal. "The lawsuit, filed on Wednesday in Federal District Court in Lubbock, targets medical privacy regulations that were issued in 2000, and takes aim at a rule issued in April that specifically bans disclosing medical records for criminal or civil investigations into “the mere act of seeking, obtaining, providing or facilitating reproductive health care.”"

I just finished reading “America for Americans: A history of xenophobia in the United States” by Erika Lee. It is an unsparing analysis of the way xenophobia is woven into the fabric of American law and culture. When you read “America for Americans,” does it conjure an image of native Americans asserting their rights to the lands that were over-run by western Europeans? Of course not. The people who use that expression are overwhelmingly whites of western European descent. The folks who were here before them don’t count. Likewise, the slogan “America for Americans” wasn’t intended to include the involuntary immigrants from Africa, whose residence here antedates the ancestors of many American xenophobes today. That’s just the beginning.   For all the right-wing bleating about “open borders,” the US had open borders until the late 19 th  century, when Chinese immigrants were legally excluded. Lee points out that anti-Asian xenophobia was by no means restricted to the US. Initial...

Trump is promising mass deportations if he’s elected. He claims this will create jobs and economic growth. We’ve been here before. “In the 1930s, state and local governments deported 400,000 to 500,000 people of Mexican descent, promising to create jobs for Americans during the Great Depression. What actually happened?  The employment of native-born Americans  dropped   — and their unemployment went  up .  American workers ended up with worse jobs and, if anything, their wages were lower. The US workers who were hurt most were the ones whose jobs had to be cut because the businesses they worked for had to downsize because of the loss of their immigrant workforce. “Jump to 1964, when the “ Bracero Exclusion ” removed almost a half million Mexican farmworkers with the promise that this would improve the employment and wages of American farmworkers.  Didn’t work.  Instead of hiring non-immigrants, employers changed how they farmed to use fewer workers and...

The university where I was on faculty for 37 years has one of ten NIH-funded vaccine testing and evaluation units in the US. I vividly recall attending a presentation by the clinical director of our vaccine center in January of 2020 on the then-new SARS-CoV-2 virus. By the summer, our vaccine center became a clinical trial site for the Moderna mRNA vaccine. I immediately enrolled, even though I knew I had a 50% chance of being in the placebo arm (in the event, I was in the vaccine arm, which was obvious on the second jab). According to Wikipedia, there have been over 7 million Covid-related deaths as of August 2024. To put that in perspective, that’s over a third of the world-wide deaths attributed to World War I (20 million), which by any measure is an immense loss of human life. On the other hand, the global COVID-19 vaccination campaign saved 2.4 million lives in 141 countries, a tremendous contribution to public health. Of course, more lives could have been saved if the vaccine had...

I became a tenured associate professor at the age of 38. After that point, I couldn’t be fired except for cause, and there was no mandatory retirement age. Of course, tenure doesn’t guarantee a salary, and salary reduction is one approach to motivating retirement, although the AAUP takes a dim view of the practice. Nevertheless, I decided to go on phased retirement five years ago. I accepted a reduction in salary (and reduced work expectations) and signed paperwork stating that I would resign my tenured appointment as of July 2024, at the age of 69. Why not keep working and keep drawing a salary? Well, for one thing, I’ve never liked writing grant proposals, and grant support is a core expectation of the basic science faculty business model at medical schools. I played the game for over 30 years and wasn’t getting better at it. The expectation of grant funding (with salary recovery) disappeared when phased retirement started; I voluntarily accepted a 30% salary reduction, which is the ...

A fitting topic for Labor Day, 2024. Over at TPM, they have an extended discussion of the records of the Biden/Harris Administration vs the Trump/Pence administration regarding unions and workplace safety. Click the link to read the whole thing. I’ll keep the quotes here within fair use. “. . . three aspects of the candidates’ records are the most likely to sway union members one way or the other. “Federal workers   “ Trump signed   three executive orders in 2018  that restricted the labor rights of approximately 950,000 federal government employees who belong to unions. In 2020, he signed another measure,  known as Schedule F , that The Washington Post described as “designed to gut civil service job protections.” “ Biden  rescinded those executive orders . He also established a White House task force charged with making recommendations for how to streamline the procedures for federal worker union organizing, which Harris chaired. The number of  federal emp...

I lost interest in football after high school. Although college athletes were ostensibly amateurs, the perks they enjoyed, above and beyond full scholarships, made them more like professionals than your average college student. And there were regular recruiting scandals to back up that perception. Now that all that financial compensation is above board, those "student-athletes" are basically professionals.  I attended SEC schools for college. Indeed, I competed as a varsity athlete my freshman year. But cross country wasn't a scholarship sport at Vanderbilt, and Vandy came in last at the conference meet in Tallahassee that year. Our coach was a surgeon who happened to also be a long-distance runner. But other SEC schools like the University of Tennessee—where I transferred after my freshman year—did have scholarship athletes on their CC/track teams.  "The SEC now pays its players three times more than any other conference. SEC quarterbacks are paid an average of $1 m...