A Nagasaki A Year

[mindstalk]

100,000 Americans die of hospital-acquired infections every year.
http://majikthise.typepad.com/majikthise_/2007/09/the-silent-kill.html

The "Islamofascists" can't kill nearly as many people as our lax hospital procedures and abuse of antibiotics. How much scrubbing and autoclaving could the Iraq Fiasco buy?

Alternate post title: "Evolution in Action"

Related, the low hanging fruit of flu prevention
http://majikthise.typepad.com/majikthise_/2007/09/influenza-and-l.html
Hey, it's only ten 9/11s a year.

"There are very few problems can be solved solely by throwing buckets of money at them (although buckets of money are either helpful or necessary). Annual influenza is one of those problems than can be solved simply by investing more resources."

Comments

[pompe.livejournal.com]

Sounds high, 100 000. A rough Swedish figure I found was 800/year (which was considered high, I think), which times 35 would equate to 28 000.

[mindstalk.livejournal.com]

"High" meaning what? You think the Center for Disease Control is overestimating?

[pompe.livejournal.com]

No, I mean I found the Swedish figure on a fairly health-care-as-it-is-now-organized-critical blog with no direct reference to a specific survey, so I take that number as an high estimate which means the American estimate seems even higher to me. I have no reason to believe the CDC is overestimating so I have to wonder if the statistics are based on the same premises and are comparable at all - the US having 3.5 times the death rate from infections on hospitals seem strange. I mean, many old people - and a good deal of otherwise chronically ill people - ultimately die from infections as a final blow, including on hospitals. Pneumonia and urinary tract infections are killers of old people both on and off hospitals, as far as I know (My mother was a geriatrics doctor). And old people who end up in a hospital are already likely sick and weakened, so they are extra vulnerable. The same goes for people having undergone difficult, lengthy treatment of other kinds.

But arguably resistent bacteria is perhaps less of a problem up here than in some other places because of a slightly restrictive policy regarding antibiotics.

[fanw.livejournal.com]

Hi! (I'm back!) I just wanted to post since I quite disagree with the influenza writer. First of all, we do NOT have the solution in hand. Every year we have to make a guess as to in which direction the strains will evolve and what strain is most likely to be a problem this year. It evolves so quickly that even when we do vaccinate a lot of people, it can change a month later to a strain that ISN'T covered and still cause problems. Not to mention influenza strains that are not poultry-based and thus are difficult to grow in eggs (our standard procedure now.) And that doesn't even cover the economics of the issue. It probably is much more costly to vaccinate all the young people in the U.S. with this vaccine that may or may not be helpful than have a number of young people miss a week or so of work. THAT's why we only vaccinate old people. Death is a lot more costly than being sick.

Until flu stops evolving on a monthly basis, there IS no easy solution to the problem.

[mindstalk.livejournal.com]

Welcome back!
Some good points about the strains. Though in his older column, Mike talks about 36,000 deaths, 28,000 of which would be preventable by full vaccination -- perhaps the remaining 20% takes your problems into account.

OTOH, economics: assuming the typical $30 charge covers costs, that'd be $9 billion to vaccinate everyone. 28,000 deaths would be $28 billion or more (x3) by some accountings of human life, though one might argue old people are worth less, or would cost us money in terms of cancer or Alzheimer's care. 5-20% of the population gets it, with 200,000 hospitalizations. To just look at workers, 300 million people, say 10% infected, say half of those employed... if 15 million people miss a week of work and average $600/week, that's lost output of $9 billion.

Or from an individual perspective, if you make $30,000/year, and have only a 5% chance of losing a week of work, the expected loss is $25, not counting utility loss from just plain being sick.

And you might not need to vaccinate everyone: again from his older column,

vaccinating seventy percent of children aged 5-18 could reduce influenza deaths by up to eighty percent. In other words, the grandchildren are killing their grandparents.

Anything wrong with these numbers?

(You have aroused Botec Man! See him calculate! Rar!)

[jordan179.livejournal.com]

The "Islamofascists"...

Shall I take this to mean that you don't believe that the Islamofascists exist?

... can't kill nearly as many people as our lax hospital procedures and abuse of antibiotics.

Why not? This is only 100 thousand a year; a single H-bomb or large A-bomb could kill more.

How much scrubbing and autoclaving could the Iraq Fiasco buy?

How much nuclear firepower could the oil revenues of Iraq buy, in the hands of Islamofascists?

[mlc23.livejournal.com]

My husband, who as you know has a career fighting islamofascists, would agree very much with your point and has argued it himself (although he uses heart disease as his example). Diseases and infections are known threats with (largely) tangible solutions, while future 9/11s are vague and unknown. Where does it make sense to put the money?

Some of the money we've spent on security has been useful as a deterrent against future attacks and some bad guys do get caught, but a lot of it has also been wasted. It wouldn't be so awful except that we spend our time having people take their shoes off at the airport and confiscating their sodas while shipping containers continue to go uninspected.

Decent diplomacy, of course, would be the soundest investment and wouldn't cost much at all.

[mindstalk.livejournal.com]

Would he agree with the Islamofascist label itself? Jordan linked to a vaguely convincing essay on that, but I'm suspicious of spreading labels like that around. (Plus, I just realized, even if Al Qaeda is fairly labelled such, not everyone involved in kidnappings or explosives in Iraq need have the same motivations. Over here an Islamist attacking Western civilization, over there a couple of tribes duking it out.)

[mlc23.livejournal.com]

I don't know about the label, but will ask. When he talks about Iraq he usually just says "bad guys", which I like, because you know sometimes the simplest label is the most accurate.

"Plus, I just realized, even if Al Qaeda is fairly labelled such, not everyone involved in kidnappings or explosives in Iraq need have the same motivations"

I'm not an expert, but that sounds right to me.

[mindstalk.livejournal.com]

As a standard nuanced liberal who has the luxury of not being shot at, "bad guys" as a generality makes me twitch. Not to say they don't exist... actually, I guess the real problem is the implication that the person using the term is a "good guy", and a standard nuanced liberal response is to suspect that people who talk about good guys and bad guys are in fact themselves bad guys.

Which is of course not a comment on Z's specific experience, about which I know hardly anything but would love to hear more.

Vetinari, paraphrased: "There are only bad people, but they are on different sides."

[slow-war.livejournal.com]

It's an interesting term which I have never really used. One problem I can see with it is that it encompasses parties that are violently opposed to one another (e.g. the ruling Shia mullahs in Iran and the Sunni Taliban in Afghanistan). On the other hand, "Islamist" or "Islamicist" are pretty broad terms that include people who are inspired by Islam in the same way that many politicians in America are inspired by their religion but do not seek a theocracy or any other form of fascism (e.g. some of the political parties in Turkey).

I do use the term "bad guys" a lot, because the motives of most players in Iraq, at least in Al-anbar where I was, are difficult to define. Most of the adversaries we faced (by which I mean people who were dangerous to US forces or to their own communities) were either tribally motivated or were simply thugs who draped themselves in the green of Islam. The Iraqis themselves tended to refer to these people broadly as "bad guys" - the term they used was "irhaabi," which our interpreters applied whenever we said "insurgent" but which the Iraqis use to mean "trouble-maker" in general. I had an interesting conversation with some local leaders in the town of Gharmah north of Fallujah in which they asked me what I thought of George Washington, to which I replied that he was an irhaabi (there are, by the way, some interesting similarities between our insurgency against the British and the Iraqi insurgency against us). We often talked about bad guys being Wahabbis (or for the cognoscenti, Salafists), but it was hard to tell if the local "emir" who runs a Sharia court and execute wrongdoers (we rescued one old man a couple hours before he was scheduled to be beheaded) was a religious zealot or just a local gangster.

In short, very few of the insurgents in Iraq seem to fit the "Islamofascist" label. There was a hard-core Salafist cadre present who may have provided some doctrinal guidance, but for the most part the "bad guys" seemed to be hoodlums or loose bands with a tribal axe to grind.

[mindstalk.livejournal.com]

Danke! Makes sense. Though, hoodlums with explosives, ick.

Wouldn't mind hearing more about those similarities.

[mlc23.livejournal.com]

Yeah, I was sort of joking but I think he uses that term because of our previous point - that there isn't just one motivation for the people doing bad things out there, and applying a single label to them is difficult. In that case "bad guys" works pretty well :)

[mindstalk.livejournal.com]

Ah, got it!