Monday, November 23, 2009

On Mammograms

While this is in theory a political blog, you may or may not be aware that I'm actually far more interested in public health. These two interests are tied together in a lot of important ways. Sometimes this is a good thing, as public health concerns can (and absolutely should) inform political decisions.

Other times, this is a bad thing. Public health is based on science, whereas politics is rarely even based in reality. But since the two are tied, public health recommendations often have political ramifications, and sometimes lead to political controversies. That's what we're seeing right now with the USPSTF's recent recommendations that screening mammography is not indicated for women under age 50.

It's worth noting a few things up front. First, this is only about screening mammograms. That is, mammograms performed on healthy women with no symptoms of breast cancer. If someone has a lump, they should have a mammogram no matter what age they are, and this recommendation doesn't change that. These recommendations also don't apply to women at increased risk, such as those with a strong family history of breast cancer. They're only for healthy, low-risk women.

Second, this is hardly a new topic. It's been debated for years and years, and while I didn't expect recommendations like this right now, I'm not a bit surprised that this is the recommendation. It's where the science points, and the science has been pointing that way for quite awhile.

Third, the recommendation to not begin screening mammograms until age 50 is pretty commonplace in Europe already, and has worked well in those countries. It's not like the US is doing something out of the ordinary, it's just joining much of the rest of the industrialized world.

Those elements out of the way, let's look at a pretty terrible editorial written by Martin Schram (a syndicated columnist who thinks H1N1 is called H1V1, so you know he's an expert on health matters), and published in the Sentinel. It's a load of made-up numbers, pointless fearmongering, and bad arguments. So let's take it apart.
A federal task force of experts had indeed reversed years of government guidance on breast cancer exams -- announcing that most women younger than 50 should not get "routine" screening mammograms every two years, after all. Nor should they examine their own breasts for lumps.
Yeah, the USPSTF is not a federal task force. Here's what they are, according to their own website:
The U.S. Preventive Services Task Force (USPSTF), first convened by the U.S. Public Health Service in 1984, and since 1998 sponsored by the Agency for Healthcare Research and Quality (AHRQ), is the leading independent panel of private-sector experts in prevention and primary care. The USPSTF conducts rigorous, impartial assessments of the scientific evidence for the effectiveness of a broad range of clinical preventive services, including screening, counseling, and preventive medications. Its recommendations are considered the "gold standard" for clinical preventive services.
In fact, the USPSTF's recommendations include this disclaimer:
Disclaimer: Recommendations made by the USPSTF are independent of the U.S. government. They should not be construed as an official position of the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services.
Pretty straightforward, that. The AHRQ is a federal agency, the USPSTF is an independent body that gets some funding from them. Maybe this is just splitting hairs, but Schram is not starting off well. He continues:
The reason given by the U.S. Preventive Services Task Force, a panel chosen and funded by the federal government [Unicow: Was this clause stolen from the Wikipedia article?], is that these examinations are no longer considered statistically effective. But it sounds as if they really mean the costly mammograms are not cost-effective. The exams save women's lives, the panel acknowledged -- but just not as many of them ages 40 to 49 as women older than 50.
Schram is hearing things. He may think he knows that they "really mean" something about cost-effectiveness, but the head of the panel disagrees:
But Ned Calonge, who chairs the 16-member panel, defended the recommendations and denied that cost or the debate over health-care reform played any role in the decision. "Cost just isn't a consideration when the task force deliberates," said Calonge, who is also the chief medical officer for the Colorado Department of Public Health and Environment.
That's as it should be. The panel is concerned with the evidence, not the cost. Which isn't to say that cost concerns don't matter, merely that they're not part of the deliberations of the USPSTF, and their report only mentions financial costs very briefly and in passing, not as an element of the recommendations. There are other groups who deal with cost, the USPSTF deals with evidence only.

Now is where things get ugly.
Here's a close look at the statistical mind-bending that the task force pursued to arrive at its stunning conclusions:

The task force concluded that the risk of breast cancer in women age 40 to 49 is very low -- and there is a significant risk that a mammogram can produce false-positive results that can lead to unnecessary biopsies that can be disfiguring. For every 1,000 women who are screened annually starting at 40 years old, according to the model studied by the task force, a mere 0.7 women would be saved from dying of breast cancer. An estimated 470 other women would receive a false-positive result and 33 would be given unnecessary biopsies.
These numbers are a little weird right off. I'm not quite sure where he got them, because the recommendation statement gives the "number needed to invite for screening" to prevent one breast cancer death in the 39-49 age group as 1904 (CI, 929 to 6378), which is closer to 0.5 than 0.7 per 1,000 women. Maybe Schram has a different source I'm not seeing, or maybe he's just playing games with numbers. I certainly can't think of any other reason he'd talk about "0.7 women" instead of giving the more-understandable "it takes X screenings to prevent one death" measure.

But let's just assume that wherever Schram got his figures is correct, and maybe just measuring something slightly different than what I was looking at. What's not at all correct is what Schram then does with the figures. "Statistical mind-bending" doesn't begin to cover it.
But here is another way journalists can crunch the numbers to breathe measurable lives into that task force's 0.7 statistic: The last census showed there are 22,617,241 women in the United States aged 40 to 49. Now ask: What if all the women in America age 40 to 49 were given annual mammograms?

According to the task force's model, 15,832 American women would be saved from death by breast cancer. Yes, by that model 10,629,990 women might receive false-positive results and suffer the anxiety that surely would cause. And 746,361 women in America age 40 to 49 might undergo unnecessary biopsies. But all of those women would still be alive.
No, Martin, this is not another way journalists can crunch the numbers, unless they're trying to be deceptive. The task force's model tells you no such thing.

See, you can't take statistics that say that in a sample population it took 1903 screenings to result in one life saved and then go forwards and apply that (with ridiculous specificity) to an imaginary scenario in which every woman in her 40s is screened. It just doesn't work that way.

We have an estimate of what happens now, there's no basis for applying it to an imaginary wonderland in which everyone is screened. The simple act of screening everyone would likely change those figures. Furthermore, it's a blatant attempt to serve up higher numbers. Why not report on the number of women that age who we already know benefited? Because it's not going to be nearly as high as the stuff that Schram just makes up, of course.

At this point, Schram asks an odd question:
So, isn't the real question whether women should retain the option of deciding for themselves whether they want to undertake a mammogram that could save their lives but could also cause the anxiety of false-positives and perhaps an unnecessary biopsy? Is that the choice that the women should make for themselves? Or should it be made for them by their health insurance plan?
Well yeah, of course they should retain that option. Pretty much everyone has said that. And nobody's pushing for health insurances to stop covering mammograms. Not the USPSTF, not the government, not even any insurance companies (as far as I can see). Schram claims that insurances will stop covering mammograms, but provides nothing to back up this claim, and it seems pretty unlikely to me.

Regardless, even if insurances do stop covering them (which I don't think they should, or will), that doesn't change the facts as reported by the USPSTF. And that's where the ire is being directed, for reasons that I can't understand. The facts are what they are, the recommendations are in accordance with the facts. They may not be convenient or popular, but they're well-grounded.

The real issue here shouldn't be whether the USPSTF put out good recommendations or not. In fact, that isn't the issue. Very few people have argued with the evidence supporting these recommendations, because it's quite solid. The argument seems to be that it's somehow wrong to even make recommendations, or that it's misogynistic/socialist/rationing/whatever to even make them.

It's not. They're recommendations. You can take them or leave them. Medicare and Medicaid are going to pay for mammograms the same way they currently do, as will most private insurances. And that's fine. Women who want them can get them, and that's fine too. Hopefully this will help women in this age group to put a bit more thought into whether they need them or not, which is never a bad thing.

The fact of the matter is, screening mammograms in the 40-49 age group have little impact on survival, and do have real downsides. False-positives are no laughing matter, and they're quite common. Overdiagnosis (treating something that was found on a screening mammogram but would never become clinically problematic) can cause real harm. On the other hand, mammograms can save lives, even in this age group. It's a balancing act, for sure.

Finally, there's one quote from another Sentinel story that's bugging me. It's from Leominster native Kathy DiRusso, who leads a team that raises money for breast cancer research:
The results of the study seem to say the costs and false positives of administering mammograms do not justify the number of cases found in young women, but DiRusso contested that.

"To me, one life saved justifies the cost," she said. "If it was (task force members') lives, maybe they'd think differently."
Not if they're doing their jobs right, Kathy. The evidence points strongly in this direction. If you don't like it, then point out where it's wrong. Don't unfairly paint the USPSTF as somehow not caring about cancer patients. To do so is idiotic, and for all you know there may be members of the task force who have had their lives saved this way.

But while that was irritating, it's the "one life saved justifies the cost" that's really horrible. You hear this argument all the time, almost always used when evidence doesn't support what they want supported. Abstinence-only educators talk about "if it can keep one kid from getting pregnant it's worth the cost," D.A.R.E. proponents say "if it can keep one kid from using drugs it's worth the cost." I say that's all bullshit.

It's a stupid argument, especially since the "cost" we're talking about with screening mammography isn't in dollars, it's in quality of life. Does one life saved justify it if the cost is ten women who needlessly underwent radical mastectomies? How about if it's a thousand women undergoing biopsies? How about ten thousand women suffering needless stress and anxiety due to a false positive? Or, if you really want to talk about financial costs, how about balancing the cost of paying for mostly-unnecessary screenings versus spending that same money on finding better treatments? Unfortunately, there's only so much money to go around, and you can't pay for screenings without detracting somewhat from treatment and researching cures.

Saving lives is unquestionably a good thing, but saving one life does not justify any possible cost. These recommendations are trying to balance the cost (in quality of life) versus the benefit (in lives saved), and that's always going to be tricky.

By all means go ahead and argue that the benefit outweighs the cost, but let's not do it by pretending that even the tiniest benefit outweighs significant costs, and let's not do it by mangling statistics. Better yet, how about we just leave the politics out of this one?

Wednesday, November 04, 2009

Incumbents win everything

Okay, the election is over. Here's how it came out.

First, in a result that should surprise no one, Lisa Wong handily beat Fuzzy and Tom Donnelly in the mayoral "race".
  • Lisa Wong - 60%
  • "Write-in votes" (presumably mostly for Donnelly) - 26%
  • Fuzzy Voisine - 14%
The city council elections were also predictable, sadly. All the incumbents are back, and known crazy person Rosemary Reynolds joins them. Blech.

In the ward elections, incumbents Boisvert and Starr beat their challengers (Rosado and McNutt).

Fitchburg sure does love its incumbents!

I have no idea why.

Tuesday, November 03, 2009

Today is a good day to vote!

So, it's election day.

You can see where to vote here. Choose wisely.

That's all.

Saturday, October 31, 2009

Happy Halloween!

Here's a Halloween video for you. Might be NSFW in some environments, but only for a few moments.

Thursday, October 29, 2009

Donnelly hides in his hole

So, I checked the paper this morning hoping that newly-announced mayoral anti-candidate Tom Donnelly would be in it, presenting all his brilliant ideas about how he'll do things if anyone's stupid enough to vote for him.

Alas, I was disappointed.
Donnelly on Tuesday said Wong painted a "rosy picture" during the last mayoral race, while he gave a more sobering prediction of financial hardships the city would face over the next two years.

"The disparity is in what was promised," said Donnelly, after the Councilor-at-large debate at Fitchburg State College Tuesday night.

Donnelly did not return phone calls for a more extensive interview by press time Wednesday.
That's all we get. I suppose when you're as terrible a campaigner as Donnelly is, it's best to avoid interviews.

But we do have a little bit, so let's unpack it. Here's what Donnelly is basically saying:

During the last election, Lisa Wong gave people hope for great things, and hasn't been able to deliver on every single thing. I, on the other hand, was a gloomy gus who never even tried to inspire people. Therefore, you should vote for me!

Inspiring! Since the current mayor wasn't able to deliver on absolutely everything she hoped for (which of course is all her fault, and has nothing to do with the city council, economic downturn, etc.), people should vote for Donnelly, who promises absolutely nothing. That way they won't be disappointed when he delivers nothing!


Oh, there's also this:
Transparency will be the focus of Donnelly's administration, if he is elected, he said Tuesday.
Is there even anything to respond to there? Transparency is what everyone running for office promises, especially if they have nothing else to offer.

Just how stupid does Donnelly think the people of Fitchburg are, anyway? Judging from the comments on Sentinel articles, most people who aren't rabid anti-Wong loonies have in no way forgotten what the guy's all about, or that he helped create the problems Wong has been trying to fix for the last two years. They also see through the whole "I'll swoop in late and avoid any actual campaigning" gambit.

His supporters are pretty much entirely limited to the nuts. Here's a typical example:
good for tom wong sucks and has ruined the city-we are number 11 at fu
Oh no! Not number 11 at fu! We need to get to work improving our fu ranking!

Those are your supporters, Tom. There aren't very many of them, and they're not very coherent. You are officially the anti-Wong candidate, nothing more.

And that's not a good thing to be.

Wednesday, October 28, 2009

Tom Donnelly running for mayor!

The Fitchburg mayoral race has been really boring this year. Instead of crazy people like Ted DeSalvatore and townie losers like Tom Donnelly, we had crazy quitter Rachel Rosenfeld for a disappointingly short while, and now have Fuzzy Voisine "challenging" the mayor.

But Fuzzy's heart is clearly not in it. He didn't even show up to the debate, and his little recorded message on FATV was just an embarrassment. He was never even a remote danger to Wong's incumbency.

Now things have changed. It's not just Wong vs Fuzzy anymore. Rather, Tom Donnelly is back!
With encouragement from many friends and residents, Thomas Donnelly has decided to launch a write-in campaign for mayor for this year’s general election on Nov. 3.

Donnelly originally decided not to run after mounting an unsuccessful bid for mayor in 2007, feeling that the people made it clear then that they did not support him enough to gove him their vote.
Yep, Tom's back! And he's running a write-in campaign. With like a week to go. I imagine that he's hoping people will have forgetten what a massive douchebag he is and vote for him based on pure anti-Wong sentiment.

Actually, I don't need to imagine. He basically stated as much:
Many people changed their mind, however, as Mayor Lisa Wong’s term progressed, according to Donnelly.

“After people saw the way things have been going on in the city, they were saying that ‘I wish I voted for you’,” said Donnelly.
This is the political equivalent of seeing a few bumper stickers that say "Don't Blame Me, I Voted for the Other Guy" and deciding that you'll ride that tiny wave of discontent to victory.

So, what to make of all this? I have a few thoughts.

First off, I don't really consider Donnelly to pose a significant threat to Wong. He probably poses more of a threat than Fuzzy, but that's not saying much. He's also getting into the race extraordinarily late, and won't be on the ballot. He doesn't have enough time to present any compelling ideas, yet has to convince people to go out of their way to write him in.

Basically, his only hope is to ride purely on anti-Wong sentiment, which he'll be splitting with Fuzzy. Is there enough of this sentiment to give him a chance? I seriously doubt it, but you never know.

How about his strengths? Well, the truth of the matter is that Tom Donnelly has never presented any compelling ideas. He ran last time on the "vote for me because I'm an old white guy who has experience" platform, which he can't do this time around. But his lack of ideas does mean that this is the perfect time for him to get into the race. He can say any bullshit he wants, the bootlick newspaper will print it, and there's little time for others to rebut it.

As far as I can tell, Donnelly doesn't have a website (which seems par for the course this time around, annoyingly). He may or may not have an organization behind him to work on his sticker campaign, which will require a lot more work than if he were on the ballot. He hasn't yet put forward any reasons why people should vote for him, beyond the fact that some people don't like Lisa Wong. Really, he's more of an anti-candidate than a candidate. He's the one who bitter old townies will vote for because he'll tell them he's going to turn on their streetlights.

On the plus side, Donnelly getting into the race (or at least pulling up next to it) will hopefully motivate more people to go vote. Before, it would have been easy for the average citizen to skip the election, because Wong was essentially unopposed (sorry Fuzzy). Now there's a real reason to get out there and vote. The rabid anti-Wong whiners will no doubt be out to support Donnelly, so the pro-Wong masses will hopefully be similarly motivated to show up. While they're there voting for Lisa, they'll hopefully also vote in a few good city councilors, and not the bunch of losers who came out at the top of the primary.

So, there we have it. We're in both the early and late stages of Donnelly's campaign. Let's see how crazy he can get!

Thursday, October 22, 2009

Fuzzy states his case!

As they often do, the good folks at FATV have put together another informative video of municipal candidates stating their cases. It's pretty long, as they were each invited to give five-minute speeches and 17 candidates are involved, but there's one part of it you have to watch.

The part I'm referring to is Michael "Fuzzy" Voisine's message from 5:19 to 5:55 (yes, his five-minute message was 36 seconds long). It runs right after Lisa Wong's message.

If you're too lazy/at work to watch 36 seconds of haplessness, here's a complete transcript of Fuzzy's message (courtesy of Mr. Lincoln):
Hello Fitchburg. I'm Michael Voisine... Fuzzy as most of you know me. I'm running for mayor... and I'm looking to be all the people’s mayor. I'm hoping to get everybody out there voting. Every vote counts, so... I need your help to make things happen. If we all work together, I think we're gonna have a great time. Thank you very much.
Inspiring words indeed! Too bad the delivery really sucks all the life out of them (yes, the video is actually even worse than the text). He delivers it with all the certainty and vigor of a student trying to give an oral report on a book he didn't bother to read.

But whatever. C'mon Fitchburg, let's have a great time!*

*Preferably, by voting for someone who wouldn't be a total embarrassment to the city, unlike Fuzzy.

Wednesday, October 14, 2009

WBZ-TV News Is A Chocolatey Fountain of Bullshit

It's not even worth the effort to respond to this piece of utter nonsense from WBZ. Hell, there's nothing there to even argue against. It's not based on anything remotely resembling facts, and is just the usual whining from people who experience petty crime and blame it on streetlights not being on.

Petty crime has always existed, it always will exist, and just because a few local dipshits want to link their particular case of vandalism to streetlights doesn't make it the truth. Five years ago, my neighbor had "fag" spray-painted on his car too, but he also got a bunch of swastikas to go with it. He was parked right under a lit streetlight. Whoopedy-fuck.

Sure, it's disappointing that a supposed "news" show would be so journalistically irresponsible as to claim that a few anecdotes equals a "crime wave," but it's exactly what one should expect from tv news. It's what they've been doing for as long as I can remember, and it's why I haven't willingly watched a tv news show since I was about 17. They tend to induce a sort of berserker frenzy of rage in me.

So, since there's nothing there to actually argue about, I'll just say the same thing I've been saying for 15 years: If you take anything on tv news seriously, then you are a fucking idiot.

That is all.

Monday, October 05, 2009

Mandatory Swine Flu Shots? Nope.

Ugh. There are few things more irritating than misleading news stories about legislative bills. They're annoying mostly because it means I have to go digging through some piece of legislative gobbledy-gook in order to debunk them, and that's not fun.

Such is the case with the Sentinel article entitled Bill may make flu shot mandatory. The first flaw can be seen in that weaselly headline. What's with "may"? Either it makes them mandatory or it doesn't, right? This headline "may" be misleading!

Then there's this fearmongering lede:
A bill being considered on Beacon Hill would allow state government officials to search and destroy property without a warrant, fine and jail people for not taking a vaccine and bar people from assembling publicly during a state of emergency.
Well, that all sounds pretty bad. But is it actually true?

The bill in question is Massachusetts Senate Bill 2028. I actually heard about it a couple of weeks ago when a friend forwarded me a scary email from an antivaccination group, and wrote it off as senseless fearmongering from people who oppose vaccination no matter what.

I guess it's time to get more deeply into it. Here's the part of the bill that's going to scare people:
Specifically, but without limiting the generality of section 2A and notwithstanding the provisions of any other law, the commissioner shall have and may exercise, or may direct or authorize other state or local government agencies to exercise, authority relative to any one or more of the following if necessary to protect the public health during an emergency declared pursuant to section 2A or a state of emergency declared under chapter 639 of the acts of 1950.. During either type of declared emergency, a local public health authority as defined in section 1 of chapter 111 may exercise authority relative to subparagraphs (1), (2), (3), (4), (6), (7), (13), (14), and (15); and with the approval of the Commissioner may exercise authority relative to subparagraphs (5), (8), (9), (10), and (11):

(1) to require the owner or occupier of premises to permit entry into and investigation of the premises;
(2) to close, direct, and compel the evacuation of, or to decontaminate or cause to be decontaminated any building or facility, and to allow the reopening of the building or facility when the danger has ended;
(3) to decontaminate or cause to be decontaminated, or to destroy any material;
(4) to restrict or prohibit assemblages of persons;
(5) to require a health care facility to provide services or the use of its facility, or to transfer the management and supervision of the health care facility to the department or to a local public health authority;
(6) to control ingress to and egress from any stricken or threatened public area, and the movement of persons and materials within the area;
(7) to adopt and enforce measures to provide for the safe disposal of infectious waste and human remains, provided that religious, cultural, family, and individual beliefs of the deceased person shall be followed to the extent possible when disposing of human remains, whenever that may be done without endangering the public health;
(8) to procure, take immediate possession from any source, store, or distribute any anti-toxins, serums, vaccines, immunizing agents, antibiotics, and other pharmaceutical agents or medical supplies located within the commonwealth as may be necessary to respond to the emergency;
(9) to require in-state health care providers to assist in the performance of vaccination, treatment, examination, or testing of any individual as a condition of licensure, authorization, or the ability to continue to function as a health care provider in the commonwealth;
(10) to waive the commonwealth’s licensing requirements for health care professionals with a valid license from another state in the United States or whose professional training would otherwise qualify them for an appropriate professional license in the commonwealth;
(11) to allow for the dispensing of controlled substances by appropriate personnel consistent with federal statutes as necessary for the prevention or treatment of illness;
(12) to authorize the chief medical examiner to appoint and prescribe the duties of such emergency assistant medical examiners as may be required for the proper performance of the duties of the office;
(13) to collect specimens and perform tests on any animal, living or deceased;
(14) to exercise authority under sections 95 and 96 of chapter 111;
(15) to care for any emerging mental health or crisis counseling needs that individuals may exhibit, with the consent of the individuals.
Most of that is pretty uncontroversial, and all of it is contingent upon the governor declaring a public health emergency, and is limited to actions that help protect public health. When the emergency ends, the emergency powers go away.

How about that lede? Yes, in such a situation the state would have the right to destroy property, but only if that property poses a public health risk. They're not going to destroy your Xbox, but they could destroy your smallpox-infected blankets.

And yes, they could enter your property and even decontaminate it. But only if it's a risk to public health. Your anthrax lab may be in trouble, but your home probably isn't. Ditto to public assembly. If you're in the habit of hanging out with people who have ebola, you might be prohibited from doing so. If you're just going to the movies with some friends, no worry.

Now, that's not to say this is all a good idea. I'd be happy to see some amendments creating greater oversight than I find in this bill. The basic ideas aren't terrible, but they absolutely need to have sufficient oversight to keep them from being abused.

How about the claim that the bill would "fine and jail people for not taking a vaccine"? That's really not true. Here's what the bill says (with my emphasis):
(b) Furthermore, when the commissioner or a local public health authority within its jurisdiction determines that either or both of the following measures are necessary to prevent a serious danger to the public health the commissioner or local public health authority may exercise the following authority:

(1) to vaccinate or provide precautionary prophylaxis to individuals as protection against communicable disease and to prevent the spread of communicable or possibly communicable disease, provided that any vaccine to be administered must not be such as is reasonably likely to lead to serious harm to the affected individual; and
(2) to treat individuals exposed to or infected with disease, provided that treatment must not be such as is reasonably likely to lead to serious harm to the affected individual.
An individual who is unable or unwilling to submit to vaccination or treatment shall not be required to submit to such procedures but may be isolated or quarantined pursuant to section 96 of chapter 111 if his or her refusal poses a serious danger to public health or results in uncertainty whether he or she has been exposed to or is infected with a disease or condition that poses a serious danger to public health, as determined by the commissioner, or a local public health authority operating within its jurisdiction.
Part (1) there just gives public health officials the right to provide vaccinations to those for whom they're not contraindicated. No worries there.

Part (2) is the part that's being misrepresented in the headline. Nobody's going to be forced to get vaccinated. But if you refuse, and your refusal constitutes a public health threat, then you can be quarantined. Actions have consequences. But quarantine is not jail. That part comes from here:
Any person who knowingly violates an order for isolation or quarantine shall be punished by imprisonment for not more than 30 days and may be subject to a civil fine of not more than one thousand dollars per day that the violation continues.
So yeah, if you violate quarantine and go running around coughing your drug-resistant tuberculosis all over everybody like an asshole then you can be fined and jailed. Forcibly quarantined, basically.

But no, you can't be fined or jailed for not being vaccinated. Only if you refuse a vaccination and are determined to be a public health risk worthy of quarantine and then you violate that quarantine, then you can be.

Now, all this stuff is conditional. It doesn't have to be done, and the decisions of public health officials constitute the final word. This just lays out what sort of options are open to them, without dictating what they have to do. I'd argue it would take quite a bit more than the current swine flu to trigger most of these measures, but they're available as options.

So yeah, that's some potentially scary stuff, and it definitely needs appropriate safeguards in place. But it's also worst-case scenario stuff. And while it could use improvements, the basic ideas behind it are sound from a public health perspective, at least for certain threats. Most public health officials are fully aware that quarantines and isolation aren't very effective at stopping the spread of influenza, so I'd be shocked to see that happen.

Continuing with the Sentinel article, here comes a group we probably shouldn't listen to:
Bob Dwyer, a coordinator for the Massachusetts Liberty Preservation Association -- a non-profit, non-partisan organization -- said the bill is a "power grab" by the state.

"If you don't want to take a vaccine you can be arrested," Dwyer said. "What type of freedom is that? I don't think declaring a state of emergency should change a person's Constitutional rights."
While it's true that the Massachusetts Liberty Preservation Association is politically non-partisan, it can hardly be said that they're non-partisan on the subject of vaccines. They're not: they're strongly antivaccinationist.

In other words, this is about more than fears of government overstepping, it's also about promoting their antivaccine nonsense. Stuff like this:
Vaccine trials and testing has been scaled back and expedited adding risk. Government officials have granted advanced approval of these highly questionable vaccines.
The swine flu vaccine has had extensive testing, and is made exactly the same way as the seasonal flu (which has lots of testing of its own). There's nothing "questionable" about it, and to assert that's the case is disingenuous.

Further down the same page they have videos by an antivaccinationist chiropractor who keeps promoting the disproven assertion that childhood vaccination causes autism. It doesn't.

Maybe the MLPA has valid points about the bill itself. Unfortunately, their lack of understanding about vaccines and public health and the fact that they're using lies about vaccines in order to make their argument means they really can't be taken seriously. They may not be Democratic or Republican, but they're totally partisan on the issue of vaccines. They're on the quackery side, and have no credibility on this topic.

The rest of the Sentinel article is typical newspapery tripe. Local citizens think A and B, local public officials think X and Y and Z. Not much of use in it besides this, from James Eldrige:
"What this bill really reflects is an updating of our public-health laws from the 1950s," he said. "The new bill provides many civil liberty protections and improvements."

Eldridge said the previous law allows for a "blanket statement" that does not specify due process laws. The new proposal gives authorities specific direction of when a person can be arrested.

"Certainly with the number of viruses that have appeared across this country in recent years, I think that the state needs to be better prepared so that if there is a serious pandemic, the state can protect the public," he said. "At the same time, that needs to be done with a balancing act between liberty and security."
Yes, this is an updating of what was already an overly-broad law. Is it still too broad? I think it is, but not by too much.

It's indeed a balancing act. With a major public health emergency, you do need to respond quickly, and you're probably going to need to step on some people's toes when trying to protect others. There need to be measures in place to make sure that as few toes are stepped on as possible, and that rights are preserved as much as they possibly can be. There should be zero tolerance for any abuse of these laws, and any potential Constitutional conflicts should be eliminated before the bill becomes law.

But even as it stands now, this bill really can't be construed to mean that everyone is going to be mandated to have a swine flu shot. That's just not going to happen on that kind of grand scale. It's unenforceable, especially within the timeframe we're talking about. I'd be surprised if more than a few individuals, if any at all, get that kind of mandate.

The bill isn't perfect, but nor is it the mandate for swine flu vaccination that some are claiming. By all means let's criticize the parts that are troublesome, but spouting false claims about it mandating the flu shot when that's not actually the case won't do anything but muddy the real issue, which is that we absolutely do need up-to-date legislation for dealing with a public health emergency. Perhaps this bill isn't perfect, but let's fix the real problems instead of freaking out about invented ones.

Wednesday, September 30, 2009

Happy Blasphemy Day!

Hooray, today is blasphemy day!

As you may remember, back in 2005 (on this day) a Danish newspaper published a bunch of cartoons depicting Mohammed. There were a lot of Muslims upset by the depiction of their prophet as a violent jerk, and so they engaged in the only rational response: violence.

Since then, there have been a number of attempts by various governmental bodies around the world to enact anti-blasphemy laws, designed to stifle this sort of free expression. Ireland, for instance, has a pretty nasty new anti-blasphemy law.

There are no enforceable blasphemy laws in America, of course. They'd be blatantly unconstitutional. But the sentiment exists here as well. Some people believe they have a right not to have their beliefs mocked and ridiculed. They don't. There is no right to not be offended.

Obviously, people's rights to believe in stupid things should be respected. They're free to believe whatever they like. But there's no reason the ideas themselves deserve respect. This isn't about making "converts" to whatever belief system you may hold, it's about freely expressing that some ideas are just really dumb.

You wouldn't respect the ideas of someone who thinks slavery should be legal, or who thinks lightning is created by some dude with a hammer, or anyone who thinks that disobedient children should be stoned to death. It doesn't matter that all those beliefs are based on religion, they're still stupid and you have every right to say so.

So, won't you please join me today in blaspheming whatever religion you feel like blaspheming?

While I think they're all utter nonsense, you don't have to agree with me to get in on the blasphemous fun. Lots of Christians enjoy blaspheming Allah, for instance. If you're a more timid sort, you could always pick a religion few people still believe in. It's about time Zeus and Odin were taken down a notch! Scientology's an easy target too, since it's pretty socially acceptable to make fun of it. Or you can pick on the most irritating local religions, like Christianity. You might offend some people, but that's your right!

You could also just post humorous/blasphemous videos, like this:

See, it's easy and fun! Happy blaspheming!

Tuesday, September 29, 2009

More lies about marijuana legislation

It's about that time again.

Ever since marijuana was decriminalized (not legalized!) in Massachusetts, some people have been trying their hardest to subvert the legislation by creating ridiculous bills intended to recriminalize it, or at least to exact further punishment upon those who dare to smoke it.

Fine. They're allowed to do that, even if it's against the will of the voters and subverts the intent of the law. They can bring up all the bills they want, no matter how stupid they are.

It's even conceivable that there are good arguments to be made for changes to the law as it stands. Unfortunately, I haven't heard any of those arguments (the closest we get is "there are loopholes," which is pretty meaningless in itself). Instead, we get a lot of lies.

Let's look at some, as displayed in the Sentinel's Bill would fine drivers caught with marijuana article. First a little background on the bill in question:
A bill up for debate today in the Legislature would slap drivers caught with marijuana in their vehicle with a $1,000 fine. Those found in possession of the drug while driving would also have their licenses suspended for up to 90 days.

The bill slated for a hearing today at the Statehouse before the Joint Committee on the Judiciary was filed by state Sen. Scott Brown, a Wrentham Republican who is running this fall for U.S. Senate.
Not that I needed one, but there's yet another reason not to vote for Scott Brown!

Here's Brown's argument for why his dumb bill isn't just a waste of everyone's time:
Brown says he thinks driving under the influence of marijuana is just as dangerous as alcohol. He thinks the state should crack down on driving with pot just as it does against open alcoholic beverages in cars.
What does that have to do with fining and suspending the licenses of people who merely possess marijuana in their car? By all means punish those who are driving under the influence, but just because you have pot in the car doesn't mean you've been smoking it, or that your passengers (if there are any) have been blowing smoke in your face. There are already laws to deal with driving under the influence, how about we stick with those?

Brown is also wrong about it being "just as dangerous as alcohol." Here's a nice epidemiological study (pdf) about just that issue. I'm not going to go over the whole paper, so let's just skip to the end and give their conclusions:
Overall, we conclude that the weight of the evidence
indicates that:

1) There is no evidence that consumption of cannabis alone increases the risk of culpability for traffic crash fatalities or injuries for which hospitalization occurs, and may reduce those risks.
2) The evidence concerning the combined effect of cannabis and alcohol on the risk of traffic fatalities and injuries, relative to the risk of alcohol alone, is unclear.
3) It is not possible to exclude the possibility that use of cannabis (with or without alcohol) leads to an increased risk of road traffic crashes causing less serious injuries and vehicle damage.
Yup, there's no evidence that cannabis use alone (as opposed to cannabis + alcohol) increases the risk of traffic fatalities or serious injuries, and it may even reduce those risks. Cannabis use may increase the risk of minor accidents, but even that is unclear.

So no, it's nowhere near as bad as alcohol. Scott Brown is wrong. I'm going to assume he's just an ignorant twit and not a liar, but the effect is the same. He's introducing legislation based on a false premise.

It would be nice if he were the only guy to be spreading falsehoods in this article, but as usual we need to hear the fact-free meanderings of some poorly-informed cop too.
"When you look at the laws we are passing that outlaw smoking, this law just doesn't make any sense. You can't smoke a cigarette outside a hospital, but you can smoke marijuana," said [Lowell Police Superintendent Kenneth] Lavallee.
This just isn't true. I'm going to assume that a Police Superintendent actually knows the law still prohibits possession of marijuana. If someone is smoking pot outside a hospital he or she can be fined and the pot can be seized.

If Lavallee doesn't know that, he should probably seek a new line of work. If he does know that, he's lying to you.

Because that's what these prohibitionists do. They don't have data to back up their assertions. They don't have evidence for their claims, nor have they generally even sought such evidence. They just make false statements that support what they want to believe, and expect people to fall for it.

Once these people can actually formulate a cogent argument, based on facts and not just what they personally believe, then maybe we would have a reason to take them seriously. As it is, they're just a bunch of liars and fools, spreading falsehoods to promote their own prohibitionist leanings.

Don't fall for it.

Monday, September 28, 2009

Filth in the newspaper!

Look, I'm not going to contest that a moose looking for love is an important news event. It plainly is, and I wish there were more stories like this.

But did you really have to disparage the moose's sexual mores that way?


Friday, September 25, 2009

Hey Streetlight-Lovers, Here's an Idea!

I've made no secret of the fact that I think the whole focus on streetlights in Fitchburg is silly. For all the catastrophic predictions and hand-wringing, there's still no good data to support the claims streetlight proponents are making.

On the other hand, it's pretty obvious that there are a lot of people in Fitchburg who really love their streetlights. Or the concept of having lots of streetlights, anyway. They want those lights on, whatever the reason. Even if it doesn't have a real effect on public safety, it would at least make them feel better.

Unfortunately, lit streetlights cost money, and the city doesn't have a whole lot of that to throw around. What's a streetlight-lover to do?

One option is to whine incessantly about how awful it is that there are unlit streetlights. This is a popular choice, but it has the notable disadvantage of not actually getting any lights turned back on, as well as just being really annoying. So here's perhaps a better idea.

A couple of days ago I received an email from the president of the Fitchburg Institute for The Common Good. Here's a quote from their webpage.
We can do something. Already something is being done. We can organize and fix this problem.

Not by whining, not by complaining and not by agitation. We can fix the problem the same way we fix any problem, by rolling up our sleeves and getting to work--just like we do every day.

The Fitchburg Institute for The Common Good is pleased to announce its Lights On, Fitchburg! Campaign. We are raising funds to pay the power company to turn back on as many of our city's streetlights as we can afford. Already we have arranged to have several streetlights on the East Side of town powered up and we are looking to expand the scope of our project.

However, we can't do it without your help. This problem is too big for any individual or group to tackle alone. Besides, we're all in this together.
This, in my eyes, is a sensible approach. People can already pay to have individual streetlights turned on, but not everyone may be able to afford it, and even fewer may want to deal with the hassle of actually doing it. The FITCG's approach is to pool donations from multiple sources and put that money into turning lights back on.

Now, anyone with 15 bucks can buy a domain and stick a Paypal button on it, so how do you know this isn't a scam? Well, they are registered with the state as a nonprofit corporation, which is good. As you can see from that link, they're still a small group.

I also emailed the president of the group--Mr. John F. Triolo--with a few questions, and as far as I can tell things are on the up-and-up (if I didn't think so I'd be attacking them, not promoting them). Mr. Triolo seems like a well-meaning guy with some big ideas, and an honest desire to improve the city. I wish him luck.

Here's an added bonus: If you're a conservative/libertarian-type who thinks that government sucks and the private sector should handle everything (and I think it's safe to say that plenty of those demanding the city turn on streetlights are of that persuasion), this is a chance to put your money where your mouth is. There's no need to suckle at the government teat when there's a private group you can support in helping to attain your goals!

Even if you're a dirty big-government liberal like myself, there's nothing that says you can't help the government. The city doesn't have a lot of money, and the less they have to spend on things like this, the more they can spend on buying us all puppies and candy. Don't pretend that you don't like puppies and candy!

So there you have it. If you want streetlights back on, check out the Fitchburg Institute for The Common Good. If you're comfortable with them, I'm sure they'd be happy to have you as a supporter. If you're not, that's okay too, but what better way do you have of getting lights turned back on? And if you don't care, well just carry on then.

Wednesday, September 23, 2009

Pointless Primary Provides Predictable Poutcome

So, yesterday's primary election for councilor-at-large is over. Ron Dionne lost, despite having a fancy book on city council procedures or something.

He probably shouldn't have spent his time on FATV whining about the former mayor and complaining that the primary cost thirty grand to get rid of one person. Instead, he should just have dropped out and saved the city thirty grand. Dumbfuck.

This outcome is surprising to nobody, especially if you read the psychic predictions of Mr. Lincoln.

Per the Sentinel, the breakdown went like this:
  1. Stephan Hay
  2. Thomas Conry
  3. Marcus DiNatale
  4. Dean Tran
  5. Rosemary Reynolds
  6. Michael DiPietro
  7. Robin Streb
  8. Dan Mylott
  9. Stephen Seney
  10. Robert Boutwell
  11. Ron Dionne (eliminated)
Personally, I like exactly two people on this list (Streb and DiPietro, though I have a certain fond sympathy for Boutwell). It's depressing to see lunatic Rosemary Reynolds above them, but it's pretty nice to see Mylott and the deeply-irritating Seney down near the bottom.

Thus ends the obligatory boring-as-fuck post-pointless-primary post.

Thursday, September 17, 2009


I can't express how happy I am that we have a president who does stuff like this:

Watch out, Cheney!

Tuesday, September 15, 2009

Are black people really abandoning Obama?

Fairly frequently, the Sentinel prints editorials by Star Parker. They're always pretty full of self-delusion and crazy god-babbling nonsense. I suspect that her main appeal is that she's an ultraconservative black woman, which allows other conservatives to claim they're not racist or sexist if they agree with her. That's just my theory, though. She might just be cheaper to syndicate or something, due to sucking.

Today we get a prime example of just how flawed her thinking is. It's actually pretty remarkable. The editorial in question is entitled Blacks are changing their minds about President Obama, and as we'll soon see, even the title is wrong.

Let's begin with the quoting!
Americans of all political persuasions agree that the nation has problems. Big problems.

And here's where we all part company. The political left, who now control our government, thinks we need more government -- a lot more. Those on the right see our problems as the result of excess government and want to move things in the opposite direction.
That's about the most superficial and inaccurate assessment of the political divide that I've ever seen, but whatever.

The important part, and the premise of the editorial, is the idea that blacks are abandoning the president. Here's what Star argues:
According to the Pew Research Center, the president's approval rating nationwide is now 10 points lower than last April. Included in this is a three-point drop in his approval among blacks.

You might say, Star, a drop in approval ratings among blacks from 95 percent to 92 percent is trivial. But I say not so.

If we assume this reflects the 16 million blacks who voted for Obama last November, a three-point shift means there are about a half-million blacks who now have buyer's remorse.
Star Parker does not understand polling at all.

You can see the study she's talking about here (pdf). If you go down to the race part, you do see that Obama's approval has dropped from 95% to 92%.

Of course, if you go down to the bottom of the whole thing, you find this:
For the total sample, the margin of error attributable to sampling that would be expected at the 95% level of confidence is plus or minus 2 percentage points. The margin of error for subgroups will be higher.
So we've got a 2% margin of error on the whole thing, and higher than 2% on subgroups, one of which is race. Which means a 3% "drop" is utterly meaningless. It could be an actual 3% drop, or it could be no drop at all, or it could be an increase. There is no discernible change that you can detect from this poll.

It sure as hell doesn't mean there are half a million blacks with "buyer's remorse."

So, Parker's entire premise is fundamentally flawed, because she either doesn't know how to interpret polling data or chooses to misrepresent it in order to promote her own deluded thinking. With such a faulty premise already debunked, it's almost unfair to continue to point out how dumb this editorial is, but there's a part that just can't be ignored.

Parker babbles on for awhile about how blacks supposedly can't not be Democrats, because the big Democratic goon-squads will make fun of them. Or something like that, anyway. She apparently thinks that it's social pressures that keep them in the Democratic party, and not the fact that it's always Republicans who do shit like this (view the whole slideshow, it's fun!).

Here's the part that really gets me, though.
According to a Pew Research Center report, almost a third of blacks consider themselves conservative. [*]

However, these folks have always been inclined to be quiet because of the social pressures and intimidation.

But this is changing.

Despite slurs, intimidation and widely reported physical attacks from union thugs, a few brave black souls have shown up at tea party protest rallies.
What. The. Fuck?

Parker is actually suggesting that it's the left keeping black people from going teabagging? I had to read it a few times to make sure that's what she was suggesting, but it must be. She's not blaming the right for intimidation or slurs, and she certainly doesn't consider unions to be conservative, so she must be blaming the left.

That picture up at the top of this post is from a teabagger event. The following pictures are also from teabagger events:

These are the people that Parker thinks blacks are being prevented from hanging out with, by those nasty liberals in the unions.

Doesn't that look like an inviting environment? If I were a black man, I'd definitely want to run right out to teabag with all those people! No damn union thugs could keep me away from the warm and loving embrace of people who think that a tax decrease for the middle class equals "white slavery"!

Ms. Parker, after you finish reading "The Complete Idiot's Guide to Understanding Margins of Error" you might want to consider the idea that the people keeping blacks away from teabag parties are the teabaggers themselves. Most people don't seek out locations where they're going to be treated like shit by a bunch of racist assholes.

Parker craps out some closing bullshit about abortion and Israelites and so forth at the end, but it's the same impenetrable drivel she usually produces and not really worth commenting on. This is a mind not in touch with reality. Not even close to it.

That's really all you need to know about this editorial. It has a false premise and ridiculous conclusions, and my dog has a better understanding of race relations than Parker does.

No, black people are not abandoning Obama. Star Parker has simply abandoned reality.

* While 32% of blacks do indeed self-identify as conservative, it's worth noting that this Pew study makes no differentiation between social and fiscal conservatism. Generally, the black community tends to skew towards social conservatism, with more liberal economic views.

Tuesday, September 08, 2009

Stop indoctrinating our schoolchildren, Mr. President!

So, President Obama is giving a little talk to schoolkids today. It's a totally innocuous little pep-talk that of course has the right wing up in arms about how he's supposedly "indoctrinating" kids into the socialisms or something like that.

If you follow that link up above and read the speech, you can see it's not true. But surely some jerkass president was interested in indoctrinating kids to their political ideology via the teevee, right?

Ah, here's one!

Let's see what Ronald Reagan had to say to kids back in 1986:
As you know, my remarks are being broadcast live over radio and television to high school students throughout the country. While I was in Tokyo at the economic summit, I found myself thinking about all of you, and I decided that when I got back it'd be good to report to you -- share some thoughts that I've been having about the future.

In general, conditions in our country are about as bright as this very bright afternoon. I was worrying when I put that line in there that it might start to rain, and I'd have to say something else. [Laughter] We've been working to take an economy that was in bad shape and get it moving and growing again; take our national defense and make it first-rate again after a long period of decline; and to restore reason, respect, and reality to our foreign policy. And I think it's fair to say that we've made a good deal of progress.

Only 5 years ago our economy suffered from high inflation, high interest rates, mushrooming government spending, and steadily increasing unemployment. A lot of people couldn't find jobs, and people on fixed incomes were finding it harder to buy the basics, such as food and shelter. Well, we got inflation down, interest rates down, and our economy created over 1\1/2\ million new jobs just last year alone. The poor are now increasingly able to dig themselves out of poverty, and that's been good economic news.

The good news in defense is that our Armed Forces, which were suffering from neglect and low funding, have now made a comeback. Morale is up in the services, and the quality of our men and women in uniform has never been better -- and I mean never. As a matter of fact, we have the highest percentage of high school graduates in uniform today than we've ever had in the history of our nation, even back when we had the compulsory draft. In addition, our nation has encouraged a more realistic sense of defense needs.

In foreign affairs we've kept our friends close and the lines of communication with our adversaries open. We've tried to give the world the sense that the United States has a coherent and logical foreign policy that reflects our respect for freedom and our opposition to tyranny.

The point is that all we've done has had, and will continue to have, a direct impact on your lives. And the fact is, it's your future, not ours. And all that we've done, we've done with an eye toward how it would impact you. We want to make your future better, because tomorrow belongs to you. And since you're the leaders of tomorrow, I wanted to talk to all of you as a friend about the things you'll have to do to ensure a prosperous nation and a peaceful world. And I'm sure that peace and prosperity must be at the top of your agenda for the future.

You have some special responsibilities ahead of you -- very important responsibilities. America is back, yes, but we still face major challenges in the world. And it's your generation that will have to accept the primary responsibility for tackling these challenges. It's important that you're fit for the future and that you be all that you can be. So, go for it! In the area of education you have a responsibility to try to learn and care about scientific and intellectual inquiry. The world is an increasingly competitive place. And if we're to compete, we'll have to do it with brainpower -- your brainpower. So, keep learning and hit those books.

We have to remain economically competitive, and that means being aware of two things: first, what makes economies tick, and second, what works in other societies. We've been trying very hard in Washington to make America even more economically fit by really overhauling our entire tax structure. When we came into office, the top personal tax rate that the Federal Government could put on your income was 70 percent. Now, you can understand, I think, that if you were getting up in those brackets -- there were 14 different tax brackets, depending on the amount of money in each bracket you earned. And when you could look and say, ``If I earn another dollar, I only get to keep 30 cents out of it,'' you can imagine the lack of incentive there. Well, we lowered it to 50 percent, and the economy really took off. Now we're trying to lower it yet again so that families can keep more of their money and so the national economy will be lean and trim and fit for the future.

And it's your generation that will defend freedom from its adversaries. The biggest contribution you can make to that quest is to become a good citizen. Good citizenship is vitally important if democracies are to continue. Good citizenship means trying to understand the issues and great questions of your day. It also means voting. To vote is to take part in this grand experiment called democracy in America. It's your right and your responsibility to take part. Good citizenship also might mean considering going into teaching as a profession. There's a teacher shortage, as you may know. You could help ease the situation and give to others the advantages you've been given if you become a teacher yourself. And it's also important that you stay in school. That diploma counts. And I just want to personally congratulate those who have overcome some disadvantage and who stuck it out and will graduate this year.

And part of being a good citizen, part of being fit for the future so that you can meet America's agenda for the future, is seeing to it that you live your life with a clear mind and a steady intellect. And that means saying no to drugs. Nancy has traveled across the country talking to young people like you. And many of them have talked to her about the allure of drugs, about the drug culture, and the kind of peer pressure that you come under to experiment and try out drugs. But when you come right down to it, drugs are just a dead-end street. They have nothing to offer you. I think you also ought to remember we only get one set of machinery. If you wear this set out, you can't take it and trade it in someplace for a used one or a new one. So, what you do now and early in your life decides how able you're going to be to enjoy yourself when you get to be my age.

And I want to tell you, I'm enjoying myself. I've talked to young people from China to Europe to the islands in the Caribbean. And let me tell you, they're incredibly bright and talented, and they're going to create quite a future for themselves. And you can't keep up or catch up if you allow your mind to be clouded by drugs.

Well, that's more or less what I wanted to say to you today. I'll be talking to many young people over the next few months, and I'll be expanding on certain points and amplifying certain themes. But for today, before your questions, I just want to let you know that I have been thinking about you very much. You are a special generation, and you're facing special challenges. And the biggest is to be ready for a future that will prove to be demanding and exciting. Soon, we'll enter the 21st century, a time that'll have more than its share of great wonders. The next 10 or 15 years may well be the most exciting and challenging in the history of man. There's the continuing revolution in technology, the possibility of curing diseases that have stalked us from the caveman era. There's the marvelous conquest of space, a rich frontier whose riches we've barely glimpsed. And there's the struggle between the democracies and those countries which are not democratic.

All of these possibilities bring with them questions. And it's your generation that will have to answer them. That makes you all very important, indeed. You have much before you. And all I can say is that you've begun brilliantly. Continue to pursue excellence. Be proud of your country and its heritage, and be proud of yourselves, as we are proud of all of you.
Yup, nothing political about that! Kids just love hearing about tax brackets!

Friday, September 04, 2009

Crazy people are now driving our public discourse

Several months ago, I posted a video by a crazy person. I mean an actual crazy person, not a hyperbolic crazy person. The video was about Obama, Satan, the swine flu, the NWO, Ba'al worship, the area code 616, and other stuff that crazy people talk about.

That was just a silly little Youtube video. It didn't get a lot of hits, and it's no longer even available. Which proves it was right, and the poster was rounded up by jackbooted thugs in black helicopters.

But I digress.

The idea behind that post was "ha ha look at what crazy people think!" It's funny* because nobody could possibly take it seriously.

It's a whole hell of a lot less funny when crazy people have their own tv shows that get millions of viewers. Yet that's what we have here.

This man is either the most dedicated satirist ever, or someone whose brain is so muddled he's turned to finding conspiracies in every little bit of art and architecture he walks by.

In closing, Barack Obama should be ashamed of himself for going back in time to make all these terrible communist / fascist / progressive (the words are interchangeable) works of art!

* Admittedly, not all that funny.

Tuesday, September 01, 2009

Rush Limbaugh's Foreskin

First, my apologies for making you think about Rush Limbaugh's genitals. If I could make you unthink it, I would.

Why am I talking about Rush Limbaugh's junk today? Simple. It's because he thinks the government wants our foreskins.

Let's quote the corpulent fart-balloon!
RUSH: By the way, leave our penises alone, too! This is getting out of hand. There is a story that some officials in the Obama administration are pushing for circumcision for all boys born in the USA to fight HIV/AIDS. Not that I'm against circumcision, but it's a family's decision. Leave our penises alone, too, Obama! [...] So here's Obama out there saying we have to have circumcision of every young boy born in the country.
Trust me Rush, nobody wants your flaccid penis.

Some background would be sensible at this time.

The CDC (known to fearmongers as "officials in the Obama administration," apparently) are debating whether to recommend male circumcision as a potential way to reduce the transmission of HIV. They haven't made any recommendations at this point, and may or may not end up actually recommending it.

So yeah, that part about Obama "saying we have to have circumcision of every young boy born in the country" is quite simply a lie. Nobody's saying that. Nobody will say that, ever. If the CDC recommend circumcision, it's about as relevant as when they recommend not eating a dozen eggs every day. Decent advice, but it's up to you whether or not to follow it.

The evidence does suggest that male circumcision decreases the relative risk of transmission of HIV via penile-vaginal sex. But these studies are mostly on African populations, where there's a greater rate of HIV in the population, relatively few circumcised males (compared to the US), relatively little condom use (thanks, Catholic Church!), and where the majority of HIV infections are transmitted through heterosexual sex. In other words, it may not work the same in this country.

Notably, circumcision doesn't appear to make much difference in penile-anal sex. Since the majority of HIV cases in this country are found in males who have sex with males, we have a very different situation. We also have a lot more circumcised men, a lower rate of HIV, and more condom use. What works in Africa may not make any difference here. Or it may. That's why it's being debated.

There's this weird thread running through an awful lot of conservative bullshit these days, and this is yet another example. For some reason, conservatives seem to believe that whenever anyone even tangentially associated with the government makes a recommendation, that means they're going to force you to comply with it.

This is, of course, ridiculous. Even if they actually wanted to force everyone to get circumcised (which they don't, because c'mon), it's not like the CDC have a legion of jackbooted thugs they're going to send out with foreskin-snippers to make sure all foreskins are harvested (for use in kosher hot dogs).

Going a step further, even if you're batshit crazy and think that CDC goons are really going to come after you with pinking shears, it wouldn't work. It's just not something people would comply with if they're not willing to do it otherwise. For a guy who thinks the government is incapable of doing anything right, Rush sure seems to think they're capable of some pretty extraordinary things.

Of course, the idea that the government would force men and boys to cut off their foreskins is just totally objectionable. Yet Limbaugh has no problem at all with telling women what to do with their genitals. Seems like a little double standard there. Or for Rush, maybe I should say a teensy-weensy little "are you sure that isn't a Jujube?" double standard.

Furthermore, what's up with these conservatives constantly focusing on things that make them so terribly easy to ridicule? Does Limbaugh not realize that his status as a Viagra-popping sex tourist means that when he makes up lies about circumcision people are going to make dick jokes at his expense? Similarly, are teabaggers blind to the fact that taping teabags to their hats makes them laughingstocks?

Concerned citizen or scrotum aficionado?

You can't make up stuff this stupid. If you did, nobody would believe it.

Should I even go over the long history of white fears about black men cutting off their penises? The history of lies about sexual abuse perpetrated by black men being used as a fear tactic to fight racial integration? The implicit racism in this whole "a black man is going to cut off your penis!" bullshit?

Nah, dick jokes are less depressing.

Wednesday, August 26, 2009

So long, Ted

You may not have had the best singing voice in the world, but you were a hell of a good senator. Thanks.

Wednesday, August 19, 2009

Barney Frank is Awesome

He really needs to teach every other Democrat how to do this:

Tuesday, August 18, 2009

Lobbying to cure a disease that may not exist

Science and health reporting in newspapers is notoriously pathetic. Reporters with no real background or knowledge about the subject on which they're reporting are forced to puke out stories that more often that not are full of inaccuracies and misunderstandings.

So I don't hold it against the reporter behind this article that he was taken in, but let's see if we can add a bit more informed commentary to the topic.

That topic is "Chronic Lyme Disease."

Please note in advance that CLD is not the same thing as the well-established and reasonably well-understood diagnosis of Lyme disease. More about that later, but first let's look a bit at this S&E article, entitled "Lobbying Hard for Lyme Disease Sufferers."

It's an awful feeling to hear a doctor say there is nothing wrong with you, when you know something isn't right, according to Groton resident Donna Castle. But for many people who contract Lyme disease, that's exactly what can occur, said Castle, whose daughter has the disease.

"'It's all in your head' is a classic diagnosis given to Lyme disease patients," Castle said. "There is no 100 percent reliable blood test for the disease, and the symptoms can vary so much, which makes it very difficult to diagnose."

Pretty weird, huh? Doctors treat Lyme disease all the time. They don't say it's all in your head, because it's not. And while no test is "100 percent reliable", the current test is about 90% accurate. That's actually a very reliable test.

Also note at this point the way that doctors and their extensive knowledge, resources, and familiarity with Lyme disease are presented as the bad guys, while the vague someone who "knows something is wrong" is presented as more reliable. Indeed, something may be wrong with that person, but there's a large gap between "I feel sorta funky" and "I have Lyme disease."

The fact of the matter is that the lobbying group (created by erstwhile congressional candidate Kurt Hayes) in question is not about Lyme disease. It's about Chronic Lyme Disease. Again, not the same thing.

So we'll just skip the part of the article where Lyme disease is discussed. Yes, Lyme disease is real, and yes it's endemic to this area. It's a public health issue that deserves attention, but that's not the attention that Hayes' group is going for. They're more interested in promoting the quackery of CLD.

Now would be a good time to talk about what CLD is, and the different groups that exist within those who believe they suffer from CLD. We'll use the four categories laid out by Feder et al. in this New England Journal of Medicine paper on CLD.

First, what is CLD? According to the NEJM:
This term is used by a small number of practitioners (often self-designated as "Lyme-literate physicians") to describe patients whom they believe have persistent B. burgdorferi infection, a condition they suggest requires long-term antibiotic treatment and may even be incurable. Although chronic Lyme disease clearly encompasses post–Lyme disease syndrome, it also includes a broad array of illnesses or symptom complexes for which there is no reproducible or convincing scientific evidence of any relationship to B. burgdorferi infection. Chronic Lyme disease is used in North America and increasingly in Europe as a diagnosis for patients with persistent pain, neurocognitive symptoms, fatigue, or all of these symptoms, with or without clinical or serologic evidence of previous early or late Lyme disease. [my bolding]

That's a pretty decent nutshell. But there are different groups within the CLD camp, and they're worth looking at too. Luckily, we have a nice little graphic to see them easily!

Okay, maybe that's too little. Let me reiterate here:
  1. Patients in this category have vague and commonplace symptoms like fatigue, depression, headaches, etc. They have no observable evidence of having had a B. burgdorferi (the bacteria that causes Lyme disease) infection, and actually pop up pretty often even in places where Lyme disease is not endemic. Chances are reasonable that they've never had Lyme disease at all.
  2. Category two patients have a disease, they just don't have Lyme disease. Rather, they have something else that has been misdiagnosed as CLD.
  3. Category three patients have no objective history of Lyme disease, but do have antibodies against B. burgdorferi. Antibodies alone have a low predictive value, so the person may or may not have ever actually had Lyme disease, but their concern is understandable.
  4. Category four patients have post-Lyme disease syndrome. They've actually had Lyme disease for sure, and now have something weird going on (often myalgias and the like). It's worth noting that evidence suggests this is not due to a chronic infection, and antibiotic treatment appears ineffective.
All the groups here are suffering from something (more likely, many different somethings), and it's totally understandable that groups 3 and 4 wonder whether Lyme disease is the cause. Groups 1 and 2, on the other hand, are just likely to be confused.

Back to the S&E article, here's someone in group 4:
Lunenburg resident Sheila Webb Richards was diagnosed with Lyme disease about a year ago, and continues to suffer from the symptoms.

A doctor put Webb Richards on antibiotics for 28 days and she felt better for a period, but her symptoms returned a short time after.

Doctors and an infectious-disease specialist have told her that although she continues to test positive for Lyme disease, the disease is not active. They refuse to put her on more antibiotics, Webb Richards says.

"It's frustrating, because my symptoms continue to feel very active," she said.
I'm quite sure that Mrs. Webb Richards is being honest when she expresses frustration, and I don't doubt that she feels crummy. But antibiotics are unlikely to be of any real benefit, at least if you exclude the placebo effect. You can't really blame her for wanting to feel better, even if it is a placebo effect.

Her husband is also frustrated:
Her husband, Tim Richards, said most doctors won't allow his wife to continue on the antibiotics past 28 days because of guidelines set by the Centers for disease Control.

"The heart of the problem is that the profession has guidelines that are decided by a review board," he said. "In the case of Lyme disease, they limit treatment to 28 days of antibiotics. The insurance companies go by that standard."
A "review board"? Yes, a bunch of extremely knowledgeable scientists, doctors, and epidemiologists got together and said "Hey, all this data we've got shows that antibiotics don't really help, but we'll recommend four weeks of treatment just to be safe." The bastards!

Worse yet, the insurance companies use this data to say they won't pay for unnecessary and pointless antibiotics that would only increase medical costs without providing any benefit to the patient. Jerks!

If Mrs. Webb Richards is one of those sympathetic group 4 cases, then our friend from the beginning of the article, Donna Castle, seems to fall into group 1 or 2, where I have much less patience for them. After all, she did seem to indicate that doctors found no evidence of Lyme disease in her daughter. So why does she talk like they did?
Castle's first experience with Lyme disease came about four years ago, when her daughter's Lyme disease was misdiagnosed as amyotrophic lateral sclerosis or ALS (Lou Gehrig's disease).

"As awful as Lyme disease is, it was a relief that she did not have ALS, which is terminal," said Castle, who runs a Lyme disease support group once a month at the Nashoba Valley Medical Center in Ayer.
Well yeah, Lyme disease is way better than ALS. But where's the evidence that she even has Lyme disease? She could be in the first group, where general symptoms lead to that self-diagnosis. Or she could be in the second group, and have something else wrong with her. I certainly hope that Ms. Castle is looking for the real cause of her daughter's suffering, though it sounds like she's put all her eggs in the rickety CLD basket.

So, what does this all lead up to? Legislation!
Hayes and Castle are now pushing for new legislation that would protect doctors who prescribe prolonged antibiotic treatment.

House Bill 1148, introduced by state Rep. Bob Hargraves, R-Groton, is tentatively scheduled for a hearing at the Statehouse, Sept. 22.
This bill is titled "An Act relative to the treatment of chronic Lyme disease" and the full text is here.

It's short though, so I'll just quote it:
Chapter 112 of the General Laws is hereby amended by inserting after section 12CC the following section: -

12DD. A physician may prescribe, administer or dispense antibiotic therapy for therapeutic purposes to a person diagnosed with and having symptoms of Lyme disease of [Sic] a diagnosis and treatment plan has been documented in the physician’s medical record for that patient and no physician shall be subject to disciplinary action solely for prescribing, administering or dispensing long-term antibiotic therapy fo9r [Sic] a therapeutic purpose for a patient clinically diagnosed with Lyme disease if a diagnoses and treatment plan has been documented in the physician’s medical record for that patient. [my bolding]
Man, are all bills that poorly-spellchecked?

Here's the thing about this bill, though. The way it's worded, it doesn't apply to Castle's daughter, and only may apply to Mrs. Webb Richards. Webb Richards doesn't have Lyme disease currently, she has post Lyme disease syndrome. Judging from the article, Castle's daughter doesn't appear to have ever been diagnosed with Lyme disease.

I won't even go into how prescribing an antibiotic that has no effect can't really said to be done "for therapeutic purposes".

But all that's just nitpicking. The purpose of the bill is to make sure people who think they have CLD can get vast amounts of antibiotics with no trouble. Even though antibiotics haven't been proven to do anything beneficial for them.

Nor would we expect antibiotics to do anything. Antibiotics in the treatment of Lyme disease are used to kill the B. burgdorferi bacteria. People with CLD don't have this bacteria around to kill anymore, and some of them never had it in the first place.

Of course, in addition to increasing medical costs for no reason, overprescription of antibiotics tends to lead to antibiotic-resistant bacteria. They should just call this thing the "MRSA and drug-resistant tuberculosis promotion bill."

Anyway, local politicians have their stances. Jen Benson unfortunately calls herself a "strong supporter" of it. Jennifer Flanagan, on the other hand, is "very interested in hearing from both sides on the issue."

Consider this my side, Rep. Flanagan! Please note that it's the side that actually cites evidence.

This bill is a bad idea, built on willfully ignoring the scientific evidence. People with CLD are suffering, but there's no evidence to suggest it's Lyme disease at the root of their suffering or that they will benefit from antibiotics.

Let's spend our time trying to figure out what actually is wrong with them, whether it be mental or physical, and not waste money and endanger public health by throwing antibiotics at them. People need real help, not placebos.