Hey, don’t take my word for it…

Anne Schuchat, who is being pushed out retiring as the Principal Deputy Director of the world-renowned dumpster fire that are the Centers for Disease Control and Prevention (CDC), had a message for the American public in an opinion piece for the world-renowned dumpster fire that is The New York Times. In it, she writes something very telling:

“Public service is difficult. The past year and a half left many among our ranks exhausted, threatened, saddened and sometimes sidelined. The Covid-19 pandemic is not the first time the U.S. public health system has had to surge well beyond its capacity, but with the worst pandemic in a century and, initially, a heavily partisan political context, the virus collided with a system suffering from decades of underinvestment. A recent report from the National Academy of Medicine revealed that state and local public health departments have lost an estimated 66,000 jobs since around 2008.

With prior responses — including the hantavirus outbreak and bioterrorist anthrax, pandemic H1N1 influenza and the Ebola and Zika epidemics — the public health front line has been the little engine that could. For each of those responses, state and local public health departments absorbed the initial shock until emergency funding came through — and then repeatedly watched resources ebb as the crisis abated. Over the past few decades, public health experienced a progressive weakening of our core capacities while biomedical research and development accelerated into the future. With Covid-19, we were the little engine that couldn’t.”

Jesus H. Christ, that is an understatement.

I’m not going to lie to you when I tell you that it is several times a week when I look at myself in the mirror and ask myself what the f*ck I’m doing. This in itself is an improvement because I was asking myself that very same question several times a day at the peak of the pandemic waves. We’ve had three waves now. I don’t think I can do a fourth.

And, just as soon as I write that, I look at the data and notice that the next wave is starting.

Too many of my colleagues have called it quits, and the loss of institutional memory is astounding. While we have a veritable wave of kids who want to get into public health and come work with us, they’re also a bunch of kids with no clue on what is going on and who will likely change professions fairly soon after entering public health. It’s not that they’re not capable, though. The problem is that public health doesn’t pay sh*t. You will never be wealthy doing public health unless you’re incredibly lucky and land a job at the top echelon of some organization and have all the crap that comes with it. And, if you think you’ll be that lucky, then quit epidemiology now because we deal in probabilities, and the odds are not with you when it comes to striking it rich.

But, hey, don’t take my word for it…

I don’t know about you, but I’m exhausted

So, where were we? Oh, yes, the pandemic. I don’t know about you, but I’m exhausted. I’ve cried so many times in the last year that I’ve lost count. I’ve lost count of how many dead people I saw. I lost count of how many colleagues left their work (or the profession altogether), and how many of them were in my office to cry along with me.

To make matters worse, the relentless assault on public health that started with the Trump Administration has not ended. We’re still getting phone calls with threats. We’re still having to get police escorts for some of us. People have had to be moved to the garage because they found all sorts of interesting stuff on their vehicles when parked in more public areas near our building, like notes and dead animals.

People who had little to no experience in public health, who were fresh out of school, were thrown into impossible situations and asked to do a lot. And they did. Unfortunately, they up and quit on us as soon as they did because, let’s face it, if you’re going to be used and abused day in and day out, you might as well get paid better. Consulting work with some company that has access to people who are really good at writing grant proposals, or are very well-connected in the government, pays a whole lot better.

Don’t get into public health or public service, or public service in public health, if you’re looking to get rich. Seriously, don’t.

As the pandemic is winding down in the US (for now), I might have more time to write, because, God, do I need to write. Boy, do I have things to write about. The things I’ve seen. The things I’ve done (and left undone).

Until then, I’ll see you elsewhere.

Or should I write “we” will see you elsewhere?

2019’s Douchebag of the Year: Robert F. Kennedy, Jr

It was a close one, but 2019’s Douchebag of the Year (by two votes) is Robert F. Kennedy, Jr. The “activist” has been going bonkers over vaccines for a while now. First, it was the mercury in vaccines, but then Andrew Jeremy Wakefield was like, “No, my dude. The MMR doesn’t mercury in it, and it causes mad autism.” (Read that in a posh British accent.) So RFK, Jr. changed his tune. It’s all about the vaccines now, not mercury.

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The Stuff of Nightmares

He is so devoted to the idea that vaccines are evil that he went to Samoa to talk about them along with Douchebag Runner-Up Taylor Winterstein. The result? Thousands of children sick with measles, hundreds hospitalized and dozens dead. Yeah, yeah, you could argue that it was not a direct result of his visit, just like Andrew Jeremy’s visit to Somali residents of Minnesota right before they had their big measles outbreak there is pure coincidence.

But, hey, if people like Bob-o here and Andy there are going to see causation when there is only correlation, then so am I. And, for that, they have blood on their hands.

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Jesus Christ, he’s spooky.

As winner of this distinguished prize, we will be donating $100 to UNICEF for vaccines in the name of this crazy f*ck.

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Make it stop!!!

Vote for 2019’s Douchebag of the Year

It’s been a while since I’ve held voting for “Douchebag of the Year” on the blog. Our Douchebag Emerit-ass, Dr. Bob Sears, is back in the running after a series of missteps that have landed him in hot water with the medical board of California… again.

Here are our candidates:

Bob Sears, again?

Taylor Winterstein, for this.

Robert F. Kennedy, Jr. for being a crap human being, according to his own family.

Del Bigtree, for being creepy AF.

Larry Cook, for being creepier TF.

Jenna Jameson, for weird statements about what governments mandate being evil.

Barbara Loe Fisher, for a lifetime of stupidity.

Andrew Jeremy Wakefield, for 20 years (plus) of living off his fraudulent study.

Here is our ballot. Feel free to vote as early and often as you want. The winner gets $100 donated to Red Cross International for MMR vaccines in Samoa and/or Congo in their name…

(If the form is not embedding for you, here is the link: https://forms.gle/czhywvHqaQ8LeYER9)

“Vaxxed II: Son of Vaxxed” in One Minute

In case you missed it, the merry gang of anti-vaccine warriors have produced yet another piece of filthy anti-vaccine propaganda. As creative as they are, they named it “Vaxxed II.” That’s it. No subtitle. At least all of the Avengers films have subtitles like Age of Ultron or Infinity War. So I’m calling this one, Son of Vaxxed.

Sticking to that lack of creativity, the film is just a mishmash of anti-vaccine testimonials and mishandling of facts. People are put in front of cameras, they talk about what happened after a vaccine, and the production team slickly edits their testimony to fit into the anti-vaccine narrative. As I’ve told you, everything and anything that happens to people happens after vaccination, and this film doesn’t disappoint in delivering that narrative. It doesn’t matter when on how something happened, if it happened after a vaccine, then nothing else but the vaccine caused it.

Never mind we have all of the scientific evidence that these things just happen, and that them happening after vaccination is coincidence. People who are against vaccines in the way that the Andrew Jeremy Wakefields of the world are against vaccines — and pro-revenue and fame — don’t want to hear rational explanations for observed phenomena. You had a blood clot months after getting vaccinated? It wasn’t your overweight, smoking and birth control pills. It was the vaccine you had months ago. Your car crashed and you died in the accident? It wasn’t that you were t-boned by a dump truck. It was the vaccine you took at the doctor’s office that day. And you are one of millions of women who got the HPV vaccine and then developed cervical cancer? It’s not that you are in the risk pool for that particular cancer and had a history of low-grade lesions. No… It was the vaccine.

That’s what Son of Vaxxed is all about, spurious associations between two things — one being vaccines and the other being something bad — and nothing else. It’s all conjecture, conspiracy and correlation explained as causation. It’s the government coming to get you and millions of physicians, nurses and epidemiologists all being controlled (if they’re not coordinated amongst themselves) by a big, international conglomerate of pharmaceutical companies who behave not at all like multinational companies do and compete with each other. No, they are all in it together, because that’s how you make profits: not by unmasking the harm your competitor’s product causes and offering your own alternative, but by writing the evidence of your evil misdeeds in the package inserts sent out with each box of a vaccine.

I wouldn’t be surprised if the “Vaxxed Bus” collapses on itself into a neutron star… The people riding it are really that dense, and we are stupider for watching their sequel.

Yes, You Agreed To This

I waded into an argument last week after seeing what Ren wrote about fluoridation. A Doctor of Dental Surgery (DDS), who shall go unnamed because he’s a bit of a douche about stuff, decided to go on and on about how fluoridation of drinking water is an experiment on unwilling participants. Those participants, he claims, are the public, and the public never agreed to this according to him.

Number one, fluoride in drinking water is nowhere near a toxic level. It’s not even close. And there is little evidence that fluoride bioaccumualtes in humans. The human body is set up to deal with these things quite well. Unless your kidneys are completely in shambles, you’re going to be okay.

Number two, the people/public did agree to fluoridation of the water supply, even if they didn’t have a vote on it. In the United States, we elect people to make these decisions for us. Frankly, we would get nothing done if we had to hold an election every time some public health intervention needed to be made.

Essentially, we assented to have our elected leaders use the best available evidence and intervene on our behalf when a public health problem is identified. If we don’t like it, or if they do the wrong thing, then we vote them out… Or have a revolution or something.

Sorry, George.

This batshit insane rambling that vaccines or fluoride or vitamin K for newborns are all experimental is, well, insane. We took a vote, people. You lost. Live with it and go vote at the next election. Until then, drink up!

I’d Like to Play a Game

…But I can’t. I can’t play a game with anti-vaccine people because Game Theory assumes that you’re dealing with rational players. When it comes to the people who peddle in anti-vaccine conspiracy theories, you’re not dealing with rational people. You’re dealing, for the most part, with some incredibly irrational individuals who believe any and all conspiracy theories put forth to them by the people they worship.

They’re kind of like a cult, or a loose federation of cults. They have one or two (or three) high priests in the forms of Andrew Jeremy Wakefield, Robert F. Kennedy, Jr. or Del Bigtree. Those three men could sacrifice a virgin at an altar streaming live on social media, and it’s a safe bet that their anti-vaccine followers would find a way to justify the ritual. “It had to be done to stop the vaccine holocaust,” they would probably say. And the people would swallow it up hook, line and sinker.

Look at how they see vaccine package inserts. Package inserts are legal documents required by regulatory agencies to accompany medications. When it comes to vaccines, the package inserts name the ingredients in the vaccines, how the vaccine works, when it should be administered, to whom it should be administered and what kinds of side-effects (if any) were seen during the clinical trials of the vaccination.

Mind you, anti-vaccine people claim that there have been no clinical trials of any of these vaccines. Then, when you point out that it’s in the package inserts — the very same goddamned inserts they want you to read because they contain the truth — they flip it around and say that the package inserts are full of lies. If your head is spinning, wait for it. There’s more.

A few weeks ago, some dude who is a hardcore anti-vaccine advocate/activist/loon physically assaulted a California State Senator. The dude has a following on social media, and he ran unsuccessfully for the senator’s seat. Anti-vaccine luminaries followed the dude and praised him. Ah, but the minute the dude gets violent, they all turned on him and started the conspiracy theory that the dude was in cahoots with the senator in order to make anti-vaccine people look violent and nutty.

Then, just last week, some woman woke up in the morning, went to the state capitol in Sacramento, sat in the gallery of the senate, reached down into her vagina, pulled out a menstrual cup that had blood in it and threw the damned thing on to the senate floor, striking several of the legislators. As she was detained by police, she stood there and screamed to whomever could listen that she did it for the dead babies that vaccines caused.

Well, that is what happened in reality. In nutty-land, she was not an anti-vaccine activist and no one had ever heard of her. She wasn’t there to protest vaccines, either. She was there to protest abortion. And what she threw at the senators was not blood, it was paint, a cup of fruit or nothing at all, depending on which anti-vaccine lunatic you’re listening to.

Of course, there is the grand delusion that anything bad that happens to a person after getting a vaccine is the direct result of the vaccine. Car accident? The vaccine did it. Blood clot when you’re morbidly obese, a smoker and on birth control, months after a vaccine? The vaccine did it. Stroke when you’re in your 90s, have had high blood pressure all your life and are on anticoagulants? The vaccine did it. Suffocated to death under the weight of your high-as-fuck mother? The vaccine did it. Trump? The vaccine did it. Hillary Clinton? The vaccine did it.

Don’t even get me started on health care people who decided that they are going to be anti-vaccine. When you spend years of your life studying the sciences, and then you decide to deny the evidence and make some money off of lies… That’s psychopathic. That’s someone who cannot be trusted to be licensed to take care of a dog, let alone a human being. (With all due respect to veterinarians who do take care of dogs.) These so-called physicians and nurses who decide to peddle anti-vaccine nonsense should not be licensed to practice anything even remotely related to caring for the health of people.

And that’s why, as much as I want to play games with anti-vaccine people and get them all riled up in order to have them see the error of their ways, I cannot. They’re not rational. They don’t play by the rules of society, let alone reality. They live in either Crosby’s Labyrinth or something eerily similar to it. Up is down. Left is right. What you are seeing is not what your eyes are witnessing but some gummed up version of reality put in front of you by people who control the world and do not allow a shred of truth to get out except through their websites, blogs and social media channels… Channels to which you can subscribe and donate your money since they are not being paid millions. (Not by pharma, anyway.)

So I’ll have to look to another theory that is not Game Theory in order to better understand these nuts and continue to fight them. Because you should not have a shred of doubt that I will fight them until I cannot fight them anymore. And, even then, even when I cannot fight them anymore, someone else will. We’ve been doing it since Jenner, and we’ll do it beyond the age of Offit.

Your move, mother Hubbards. Your move.

It’s never the anti-vaccine people’s fault. It’s always the vaccines, right?

In case you’ve been living under a rock, a woman decided that she was going to go to the Capitol in Sacramento, California, get in through security, go up to the viewing gallery of the state senate, and then throw a menstrual cup full of what she said was her blood onto the senate floor, striking several senators with the fluids.

(Yeah, that was a big run-on sentence. Get over it.)

This is the most recent attack on California legislators who were working on closing the loopholes that allowed quacks and douchebags emerit-ass to sell or give away bogus medical exemptions to vaccine requirements. The bill signed back in 2015 eliminated personal belief exemptions and pretty much said that the only way to be exempt from vaccine requirements was to get a physician to sign-off on it. As you can imagine, some unscrupulous physicians got into the game of giving/selling/providing medical exemptions, so the exemption rate rose.

Now, physicians who give out too many exemptions will be looked at more carefully, and health departments and public health authorities will have the ability to look at those exemptions and verify them. Hooray! Right?

Well, the anti-vaccine crowd isn’t having it. Robert F. Kennedy, Jr. (the bloated kingpin of antivaxxers) and Del Bigtree (the clown prince of antivaxxers) were quick to descend on California and stoke the fears of the anti-vaccine crowd. Words like “tragedy” and “holocaust” were bandied about when it came to vaccines and the now-debunked myth that vaccines cause autism. They held some weird “vigil” for “dead” children, allegedly victims of vaccination, that included stock photographs from the internet and pictures of living people.

Thoughts and prayers, Ethan.

And now, fantastically, anti-vaccine organizations are disavowing the acts of the blood-throwing woman. They say she’s not part of “the movement” and that she doesn’t represent their membership. This is weird and hilarious because they do these marches and protests en masse, with vicious and racist attacks on anyone even remotely associated with vaccines, and then they disavow when one of them goes bananas?

Words have meaning and they have power, folks. These anti-vaccine preachers keep going on and on about the horrors of vaccination, and then they expect no one to do anything about those horrors? They must think we’re idiots.

The Other Epidemics

We would be lying to you if we didn’t tell you that things other than infectious disease and vaccine-preventable diseases are not the only thing that take up our time. Humanity is kind of a funny set of organisms. We do things to ourselves that harm us and harm others.

The opiate epidemic started because people couldn’t deal with pain properly, and their healthcare providers didn’t provide them with adequate care and pain management. Instead of getting to the bottom of what hurts, they were given a pill and sent on their way. The pain was still there, but it was numbed by the medicine. (By “pain,” we mean all the things that make one’s life unbearable, and not just physical pain.) When the medicine ran out, they caught on to the fact that heroin is an opiate, albeit a much stronger one. When the heroin couldn’t do the job anymore, they moved on to stronger opioids like fentanyl. And so, here we are, faced with a man-made epidemic of something that could have been nipped in the bud a decade ago if someone would have just encouraged more mental health treatment for those pains in life that are not physical or are physical but exacerbated by mental anguish.

More recently, public health authorities have declared “second-hand alcoholism” as a public health problem. What is that? When you’re hurt in a car accident that is caused by a drunk driver, you’re the victim of second-hand alcoholism. When you’re born with fetal alcohol syndrome, you’re a victim of second-hand alcoholism. Basically, when someone hurts you because of their drinking, you’re a victim, and there are ways to prevent it from happening.

Obesity? I bet you’ve heard about this one. There is a good chance that you’re fighting with obesity yourself if you’re an American. High-calorie foods and more sedentary lifestyles have brought on increased waist sizes, heart disease, diabetes and increased risk of other diseases and conditions. This one is a tough one because we all need to eat, and the better-paying jobs are usually not the ones that require us to burn a ton of calories. It’s not like you can cut-off people from food or send them to work into the fields. It’s also a matter of where you live because, if all you have is a bodega that sells cheap junk food, you’re not going to have a salad anytime soon.

Then there is the other epidemic, the one that has hit some of us very hard. We’re talking about suicide. When the housing market crashed in 2008, a lot of people lost their jobs and their pensions in a matter of days to weeks. It wasn’t a slow process, or a process that is easier to adjust to. When that happened, desperate people didn’t see any other way out from their predicament than to take their own lives. It wasn’t hard due to the incredible number of guns that are readily available in this country.

As you can see, there are many other things that those of us in public health are focusing on. There’s just too much to do because there is so much we do to ourselves and to others. So don’t miss us too much… But do miss us.