We are developing the social individualist meta-context for the future. From the very serious to the extremely frivolous... lets see what is on the mind of the Samizdata people.

Samizdata, derived from Samizdat /n. - a system of clandestine publication of banned literature in the USSR [Russ.,= self-publishing house]

Scary viruses and clinical trials

Some people think the Rio Olympics might cause the Zika virus to spread all over the world. Reddit is not a reliable place for sensible political commentary, but I am heartened at how up-voted comments like these are:

mixmastamikey: “Global Health Disaster” How about just “Global Disaster”… Why the fuck can’t we reuse olympic venues? Seriously why does a different country need to host the olympics every 4 years. Cant everyone just buy a fucking island and call it olympic island maybe update a few things here and there.

BlueBlazerIrregular: But then the IOC wouldn’t be able to steal millions and would lose out on all that graft and bribery. Think of the rich for once! They are people too!

kangamooster: Hmm, I guess you could consider lizardfolk people….

Kamuiberen: Wait, are we talking about IOC or FIFA here?

BlueBlazerIrregular: Same modus operandi

Anyway it seems unlikely that the Olympics will be stopped or moved and I am not sure if doing so would really make any difference. I am hopeful of solving problems with technology, though. I am quite keen on the plan to exterminate all mosquitoes. And then there is IBM’s rather interesting research into a chemical that blocks viruses in general.

“We began to think, how can we move forward and kind of attack the virus in a very different way,” says Hedrick. “Instead of going after its RNA or DNA, we looked at the glycoproteins that surround…the virus.” No matter what the virus and how it mutates, it’s going to have these substances on the surface; they have electric charges (some positive, some negative) that a chemical can stick onto. What the researchers developed is a polymer that adheres to the virus, blocking it from hooking onto a victim cell in the body.

The idea is to put the molecule in soap and hand-wipes, but it could also be put into a person.

Assuming it works as well as the researchers say, the macromolecule couldn’t come soon enough to handle frightening outbreaks like Zika, Ebola, and chikungunya. But it hasn’t quite come yet. “My gut feeling is, something like a wipe, something like a hand cleaner is going to be relatively straightforward to move to market,” says Hedrick. “It you market it as a true antiviral, I would imagine it would take 3, 4, 5 years maybe maximum.” Getting the macromolecule into humans, where it uses all three of its powers, would require clinical trials than could extend over several years.

Serious question: why the need for such long clinical trials? What is wrong with marketing something with the caveat that it is not fully tested yet and it might be a cure worse than the disease but if you have a terrible enough disease it might be worth a try?

A Tale of the Sea

This anecdote was sent to me by a correspondent – NS.

*

I chanced to be speaking to a chaplain who works with a mission to seafarers in a British port, and had the following tale from him.

One of the seamen he knows is a guy – let us call him John Smith – who is fine provided he remembers to take his meds but not so fine if he forgets. On a working ship, daily life is structured and John reliably remembers to take his meds, and if he did not, the captain would look into it, or John would be given medical evacuation. However the control regime is different in port.

Recently, John’s ship was sent to port for several months awaiting a new cargo or scrapping. Presently the chaplain was summoned by port security. When you are asked to the main security point, things are serious. When they offer you a cup of tea, things are really serious. Security told him that John had clearly not been taking his meds, was doing things that were not dangerous in themselves but “violated security protocols”, so they’d have to act in a way that they would prefer to avoid, unless the chaplain could make something better happen.

The chaplain contacted the Port Health authority and was told, “Well, you know, a seaman has rights. If we get involved and the result is to say he’s unfit or whatever, he could sue for loss of earnings or whatever …”

He contacted the company that contracts John’s labour. “Oh well, we’d like to help but seamen these days have a lot of rights. If we get involved and it’s later ruled we did not respect all of them …”

He contacted the union rep, whose first words were “You do know John has rights, don’t you?” and who then pointed out that John’s ship “is not my flag state, so I can’t come aboard uninvited.”

The chaplain solved that one by saying pointedly, “I’m inviting you to come aboard with me.” So, with the union rep in more or less literal tow, the chaplain went aboard, and was told by the captain, “Do whatever you can and I’ll back you.” He had a long and sometimes very strange talk with John, at the end of which John swallowed his meds, whereupon a very hyper man swiftly became calmer.

This example was in the context of the chaplain’s explaining to me how much of his job these days was doing what none of the jobsworths dared to do, even when some of them were not such creeps as not even to want to help. As he put it, “Sometimes the one with no formal power is actually the only one with any remaining power to act.”

Martin Shkreli on the Milo Show

“One of my top scientists has four kids. How is he going to provide for his kids without profit?” So says Martin Shkreli on this week’s Milo Yiannopoulos Show. Shkreli is supposedly the most hated man in America for raising the price of the drug Daraprim from $18 per dose to $750. The way he tells it, it was like buying a wine company that was selling wine for $2.50 cents per bottle but losing money, when all the similar wine was selling for $100 per bottle. He saved the business.

He described being interviewed on CNBC, a business news channel.

I went on there and it felt like they were shaming me for raising the price of Daraprim and I’m sitting there saying, “all fucking day, 24 hours a day all you talk about is profits, and my profits are inappropriate?

Milo laments the regression of America from a place that celebrated success to one where the media and the government like to punish rich people. Shkreli pointed out how people used to love to hate Bill Gates, but they do not any more, now that he is giving he money away. “What else did they think he was going to do with it?” he asks, pointing out that once you have one billion dollars, you can no longer really spend any more on yourself.

Shkreli has been arrested on fraud charges. He says the charges against him make no sense, given that his investors are making lots of money.

In the interview he comes across as a fun guy who annoys the right people. His Twitter feed is entertaining, too.

Update: There is something of an Ayn Rand novel about his questioning from Congress.

War on Sugar

Mars, owner of Dolmio and Uncle Ben’s food brands, is labelling its products to tell people which ones they should only eat once per week. It is something to do with trying to get people to eat less sugar, for some reason.

Nutritionist Jenny Rosborough from Action on Sugar told the BBC’s Victoria Derbyshire programme: “It’s great that they are pushing forward this responsible labelling and raising awareness. “But the challenge we have with it is that only the health conscious will look at the labels in the first place, therefore it’s not going to hit the people who need it the most.”

By which she means poor people who are too stupid to be allowed to make their own decisions. And who are Action on Sugar anyway? The writer of the blog Hemiposterical has found that they are the same people as Consensus Action on Salt and Health, funded largely by the mysterious Marcela Trust. What motivates them, I wonder? (Incidentally, even the NHS is very lukewarm about the harmful effects of salt, when pressed.)

And where did this new war on sugar come from? There is a sugar tax. There is even an app. Made by a quango. It is like a conspiracy of very boring illuminati. And even evil multinational corporations are going along with it. Very strange.

Perhaps it originates from inside the World Health Organisation, who last year urged “countries” to reduce people’s sugar intake by half to 25g per day for adults because sugar causes bad teeth, obesity and diabetes. Yesterday I drank a 330ml bottle of lemonade containing 33g of sugar. I am not obese, do not have diabetes and still have all my teeth.

Put yourself in the position of the head of a government agency. You have an amorphous blob of population and you can poke it with various sticks (such as advice, regulation and taxes) and observe the effects (such as the amount of money spent on certain medical treatments). You can vary the pointyness of the sticks and the amount of poking and get different effects. You keep doing this until you get the effect you want. The truth of the stick is irrelevant. Individuals have no reason to think that there is any truth in government advice. It can be ignored (ignoring taxes is harder). What surprises me is that I observe people making some attempt to follow the advice and berating themselves for failing.

Death to the blasphem… long live the brave reformer!

“Let’s abandon our broken NHS and move on”, says Melanie Phillips.

Dame Julie Moore, the respected chief executive of the University Hospitals Birmingham trust, was asked last week to explain why the NHS was in such difficulty. A lot of it, she believed was down to leadership failure and incompetence on every level. “We’ve created a culture of people who are terrified of making decisions because you can’t be held to account for making no decision but you can if you make a decision,” she said.

Much of the blame lay with previous governments who had centralised power, leaving many of her colleagues “waiting for a command from God on high” instead of taking the initiative.

What Dame Julie describes is typical of highly politicised bureaucracies. In the NHS, this entails a culture of fear from the health secretary downwards. What are they all so frightened of? In essence, that the veils of illusion surrounding the NHS will be torn away and it will be seen to be the failure that it is.

That this is so surprises me not at all. That it is said by a popular, if marmite-flavoured columnist suprises me a little. That the comments ordered by recommendations enthusiastically agree with her surprises me quite a lot. One would get a very different result at the Guardian, of course. The Daily Mail? Right now, I think the Mail readers would feel as free as Times readers do to recount their bad experiences of the NHS, yet would still baulk at the words “abandon the NHS”.

Public Health Wales keeping themselves in work

E-cigarettes could be banned in Welsh public places to protect children, reports the Telegraph.

E-cigarettes could be banned in public places where children are present in a landmark vote in the Welsh Assembly.

The Labour-controlled government in Cardiff Bay is hoping to pass its Public Health (Wales) Bill in the Senedd on Wednesday.

If passed, the Bill would become a UK first and would restrict the use of nicotine inhaling devices in certain public places – such as schools, places where food is served and on public transport.

The move has been criticised by opposition parties and even divided opinion among health charities.
However, Health Minister Mark Drakeford insists the legislation will protect people from harm – and the curbs on e-cigarettes would make smoking less appealing to youngsters.

He said: “The Bill will help us to respond to a range of public health threats in Wales, including the risk of re-normalising smoking for a generation of children and young people who have grown up in largely smoke-free environments.

But if smoking could by some strange magic – some ingenious invention, let us say – be supplanted by a process that gave similar satisfaction but was much less dangerous, why would normalising that be bad? “Think of the children” is not an intrinsically bad argument. Hard-core libertarian though I am, I do concede that it would be better not to smoke around the kiddies. But making it harder for smokers to quit involves the consequence that the children of those smokers will not grow up in smoke free environments when otherwise they might have. I would have thought that the health of the children of smokers, the children we are told are being harmed with every breath they take, should be prioritized over the purely theoretical health problems that might or might not arise for a future generation after something that looks like smoking has been “renormalised”.

Cancer Research UK and the British Heart Foundation, a couple of medium-fake charities that I would once have expected to join in the chant of “ban it” are showing surprising sense. No such weakening and deviationism is seen from Public Health Wales. Nothing will sway this “health body”, whose austerely modernist Three Random Word name is purged of all extraneous prepositions, from its work of protecting itself from evidence-based policymaking:

And health body Public Health Wales’ added: “We cannot sit around and wait a couple of decades to see whether or not the conclusive evidence that people might like to see is available before making a judgment.”

UPDATE: Mr Ed tells me that the measure failed to pass by the narrowest of margins after a considered and principled change of mind by Plaid Cymru. Nah, not really. It failed after a Labour guy called Plaid a “cheap date” and Plaid got into a huff. “Oft evil will shall evil mar”, as Theoden said about Wormtongue, a bloke almost as prone as the members of the Welsh Assembly to throwing his toys out of the pram.

Doctors do not have it so bad

Sam Bowman has written a rip-roaring article about the NHS junior doctors dispute. Instantly win any debate with your NHS-worshipping Facebook friends.

This, too

Over the last month or so the Guardian has been running a series about the NHS. Here is a typical piece: That was the NHS: stories of hope, kindness and the human spirit.

Fair enough. But “the human spirit” is a god with many faces, and this, too, was the NHS:

Grandmother died of THIRST on an NHS ward ‘after nurse refused to give her a drink in case she wet the bed’

Exterminate All Mosquitoes

Zikavirus, which is now spreading rapidly throughout South America and the Caribbean, is just the latest mosquito-borne disease to plague mankind.

Mosquitoes spread Malaria, Chikungunya, Dengue Fever, Yellow Fever, a variety of forms of encephalitis (Eastern Equine Encephalitis, St. Louis Encephalitis, LaCrosse Encephalitis, Japanese encephalitis, Western Equine Encephalitis, and others), West Nile virus, Rift Valley Fever, Elephantiasis, Epidemic Polyarthritis, Ross River Fever, Bwamba fever, and dozens more.

I’ve been unable to find a reliable overall death toll for mosquito-borne disease. However, it is likely that at least a million people die a year from malaria alone. Countless more die from the other diseases. It is known that the number of people infected with one disease or another by mosquito bites every year is in the hundreds of millions.

In short, the mosquito is one of mankind’s greatest enemies.

Thanks to the recent development of CRISPR/Cas9 based gene drive technology, the human race is now at last on the cusp of having the capacity to drive those varieties of mosquito that feed upon humans (which are a minority of the 3500 known species) entirely into extinction, by producing mosquitoes that will produce fertile male descendants but no fertile female descendants. [See my explanation after the end of this essay on how this might be done.*]

Few actions could reduce human misery and improve the condition of mankind so greatly as the permanent elimination of mosquitoes and the myriad of diseases they spread throughout the world. It would be worth doing even if it required decades and vast expenditures to accomplish. The fact that it can be done at fairly low cost and quite quickly (over years rather than decades) is almost icing on the cake.

I am certain that some people will vocally and perhaps even violently oppose this work, both because of an irrational fear of genetic engineering technology and because of a misplaced belief that eliminating mosquitoes will somehow damage the environment. The general consensus is that it will not. However, I strongly feel that even if there was minor collateral damage to the environment, it would be well worth that cost to prevent at least a million deaths a year.

Some would caution we should consider an act such as the deliberate extinction of a whole class of parasitic insects with great caution and take such steps only quite slowly. However, in a world where a child dies of malaria every 40 seconds or so, I think we should, if anything, be racing ahead as fast as we can possibly manage.

Now that we have the capacity to exterminate mosquitoes, not to do so strikes me as a gravely immoral act.

→ Continue reading: Exterminate All Mosquitoes

Libertarian Home on the doctors’ strike

Zach Cope at Libertarian Home has a post that puts today’s UK NHS junior doctors’ strike into perspective.

…junior doctors have little choice of employer as there is an NHS monopoly on training; the market has shown the pay and conditions are too low, with dangerously understaffed rotas, rising emigration and increasing locum rates. The government’s proposals would reduce staff pay for an equivalent rota over time, thus hoping to delay the inevitable financial collapse of the NHS on their watch…the problem of regulation and central contracting leads necessarily to collective bargaining and industrial action.

Centralised provision of anything always leads to shortages. Mr Cope has various ideas for decentralising things in his post, too.

Personally, I envisage healthcare that is cheap and good because it is private. So cheap and good that nobody has to think twice about poor people who can not afford treatment. Much as our friend the Guardian commenter narnaglan described:

Did you know that the only medical proceedure where quality is going up and price is going down is elective Lasic eye surgery? Thats the proceedure where your cornea is made thinner to adjust the focus of your eyesight. It is not available out of stolen money, so the people who provide this service, and there are many of them, all compete with each other to give the best service at the lowest price. They compete to offer you the latest, safests techniques, using the most sophisiticated equipment.

Think about it. There are three Lasic clinics, two offering the same service at the same price and the third offering it at a lower price. Only one of the three has the latest equipment. You pick him out of the three, because he will give you the best outcome. The other two must adjust their offer to attract the clients. People with a little less money might pick the third, cheaper clinic, and the middle one might be chosen because it is closest.

What this shows is that in a dynamic market, everyone is served, and all clinics and service offerers are incentivised to do their best at the lowest price. This is completely different to the NHS, where it does not matter how dirty the hospital is, or what the outcome is; since there is no choice, no one needs to care about the price of anything or the quality of service being offered.

Of course, it will be cheap but doctors will still be well paid because they will be so effective.

A little less lobbying, a little more curing, please

Join thousands of Dryathletes dropping the drink this January and raising money to help beat cancer sooner”, says Cancer Research UK. What bilge. Abstaining from alcohol for a month does nothing and is nothing. Absent real problems, anyone can just drink exactly what they want whenever they want. That anyone takes seriously the pretence that deciding not to drink for a while is an act of effort comparable to training for an athletics event only indicates how low standards of achievement have sunk. People should be expected to grow a spine and take responsibility for their decisions as a matter of course, not pandered, patronised and praised for minor acts of agency like a toddler managing to eat his vegetables before his ice cream.

The supposed benefits of a month of abstention, apart from a “sense of achievement with your newfound hero status” — good grief — include losing weight, saving money and sleeping better. But one month out of twelve will not get you anywhere. If you are spending half of your life doing X and the other half worrying that you are doing too much of X, you are doing it all wrong. Either do less of X, or decide that the benefits of X are worth the costs. Do. Or do not. There is no try.

But maybe it will help to “beat cancer sooner”, and I should stop being a big meany. Well, it would be nice if Cancer Research UK would stop taking money away from its worthwhile research to squander on activism and lobbying.

The Dryathlon is, of course, just another bit of neo-puritan nagging. It probably makes a certain amount of sense for a cancer research charity to give out information that helps people balance fun versus risk. If I was told that my lifetime chance of getting cancer was 48% with total abstinence and 50% if I get completely drunk 3 times a week, and left it at that, I would say, “thank-you very much. Mine’s a pint of Pride.” But they will not do that. They’ll just tell me that alcohol causes 4% of cancer cases and really I should just stop thinking and drink less, and are happy to have taken a little bit of the joy out of the beer. Ok, it does not work on me but the BBC can find and interview people in a pub who have been made to feel bad about doing something they enjoy.

It does not stop there. Cancer research UK wants to prohibit product placement of alcohol. And in the latest panmedia offensive, we are told that there will be 700,000 cases of obese people getting cancer over the next 20 years, with no clue as to how significant this is. Then they are they are calling for a ban on advertising sugar before 9pm, a tax on sugary drinks, a general reorganisation of society to suit the NHS and, chillingly, the government to “take children’s health more seriously”. Supposedly children are bombarded with advertisments for sugary food and drink. I am a parent and I am not seeing it. I even have trouble buying sugary drinks without artificial sweeteners without resorting to Google and specialist suppliers.

I do not want to donate money to an organisation that is happy to goad the local mafia into “taking care” of me. Just cure cancer already so I can eat and drink what I want with impunity.

When was the NHS created?

Here is a chart of average life spans for women from the Office of National Statistics with the dates replaced with letters. At some point on the X axis the National Health Service was created. Can you guess where? Answer below the fold.

UKLifeExpectancyF4

→ Continue reading: When was the NHS created?