Archive for May, 2007

The Birth of Autonomic-Syndromic Surveillance

By: Stephen Collier
Posted in early warning systems, surveillance on May 26th, 2007

Paul drew my attention to whoissick.org, a site in which individuals are supposed to report their own symptoms and it provides analytical tools to break down their incidence, spatial concentration, and so on. Browsing through different areas, it does not yet seem very densely populated. (My own Lower East Side, one of the more densely settled areas in the United States, only shows a smattering of “reports.”) The best thing: you can receive outbreak alerts by email. Also, check out the symptom tag cloud on the lower right. This is our web 2.0 world.

Spring Floods, Risk, and Insurance

By: Stephen Collier
Posted in floods and hurricanes, insurance, risk on May 15th, 2007

An article in today’s Times reports on substantial housing development in the flood plain of the the Mississippi River following the floods of 1993.

Building is happening on flood plains across Missouri, but most of the development is in the St. Louis area, and it is estimated to be worth more than $2.2 billion. Though scientists warn about the danger of such building, the Missouri government has subsidized some of it through tax financing for builders.

“No one has really looked at the cumulative effect,” said Timothy M. Kusky, a professor of natural sciences at St. Louis University, who calculates that there has been more development on the Missouri River flood plain in the years since 1993 than at any other time in the history of the region.

These developments raise again a series of problems relating catastrophe, risk, and insurance that first emerged after the United States passed its first disaster relief act in 1950, formalizing federal aid to flood victims. Immediately, it was recognized that these policies created a problem of moral hazard: individual homeowners would not purchase insurance against what they perceived to be unlikely events, particularly since they counted on the federal dollars to bail them out (often, or so libertarian and economist critics argues, leaving them in better shape than when they started).

In 1968 a program of federal flood insurance was created, which relied on the government to construct hazard models that would serve as the basis for determining premiums, and counted on private insurers to provide policies. But this program — which has been revised many times since — did not entirely solve the problem. On the one hand, individuals purchased policies at much lower rates than was expected, leaving much of the damage from floods still to be covered by federal relief (and the government often stepped in to offer even more relief after major events). On the other hand, these policies did not always do enough to prevent development in flood-prone areas. Of note in the article is the line drawn around the “100 year flood.” This threshold was key to the original program of federal flood insurance, which mandated insurance policies for homeowners living in the damage area of a 100 year event. The question, of course, is how accurate the models are, and whether that threshold is the right one.

One resident who had purchased a house outside the 100 year flood plain (and was thus not required to purchase insurance), said that “It’s not going to flood here for another 100 years, and I won’t be around by then.” A touch unclear on the concept, one might say. In the long run the dynamic is familiar. Bigger levies mean more housing in the flood plain. Which may contain small events, but open the gates for ever bigger, if rarer, events. “If history tells us anything, it’s that levees once built eventually fail,” Professor Pinter said. “But instead of being farmland there, now it’s a strip mall or residential area, or a whole city.” As Aaron Wildavsky might say, “safety” is being purchased at the price of resilience.

Pseudo-Epidemics

By: Carlo Caduff
Posted in bioscience on May 13th, 2007

Do you want a quick result or a correct result? - Here is an interesting piece on problems with molecular tests.

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Tamiflu

By: Carlo Caduff
Posted in avian flu on May 12th, 2007

If you’re excited about tamiflu and steadily growing stockpiles, consider this:

“To date, most patients with H5N1 have been treated with Tamiflu. Studies of Tamiflu for use in H5N1 influenza have produced varying results. Two studies of patients with H5N1 influenza in 2004 and 2005 revealed no difference in outcome between those who received Tamiflu and those who did not. However, some of the patients received an antiviral only later in the disease, and the studies were not large enough to produce meaningful conclusions. ‘The numbers are so small that it’s hard to know whether Tamiflu is efficacious at mitigating disease, but it’s all we have, so it’s worth trying because it has very limited toxicity’ says Stephanie Black, MD, assistant professor of medicine at Rush University Medical Center in Chicago.” The good thing about Tamiflu is that it doesn’t do any harm, in other words.

“A 2007 study of the effectiveness of Tamiflu in improving the survival rate of ferrets exposed to the H5N1 virus found that giving the drug within 4 hours of exposure (ie, before illness) resulted in 100% survival. When the treatment was delayed 24 hours after exposure, a higher dose was needed to achieve the same result.” 4 hours, 24 hours: this is obviously not a very realistic temporal frame for pandemic times.

The practice of stockpiling Tamiflu makes preparedeness visible, tangible, and countable. “You can count on it,” as an expert phrased it. At the same time, neither the federal nor state governments have been willing to invest in things like ventilators and hospital beds. In this domain a different rationality prevails: The rationality of prioritization.

Get Your Ginseng Today

By: Carlo Caduff
Posted in avian flu on May 12th, 2007

The cautious city of Edmonton decided to add ginseng product to its pandemic influenza stockpile. A waste of public funds? Why ginseng and not ventilators, for instance? - Two comments. First, the common cold is not the same thing as the flu. The two are mixed up in the article to the point where it is not clear what this is all about. Second, the study mentioned in the article was conducted midway through the influenza season when subjects may already have been exposed to the circulating strain! Of course, if you can refer to a “randomized, double-blind placebo-controlled study” it sounds terribly scientific - and helps sell your product.

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More Vital Systems gaming

By: Christopher Kelty
Posted in avian flu, early warning systems, websites on May 11th, 2007

MILVAX, or vaccines.mil, is the military’s vaccination related website. It includes this crossword puzzle and a variety of other interesting stuff, like a map of regional analysts. I’m sure people like Lyle are hip to this, but I was quite impressed, given the generally sad state of web resources in this domain. That is, of course, coming from citizen weirdness like this…

Kansas Tornado Renews Debate on Guard at War

By: Lyle Fearnley
Posted in briefly noted, floods and hurricanes on May 8th, 2007

CHICAGO, May 8 — For months, Gov. Kathleen Sebelius of Kansas and other governors have warned that their state National Guards are ill-prepared for the next local disaster, be it a tornado a flash flood or a terrorist’s threat, because of large deployments of their soldiers and equipment in Iraq and Afghanistan.

Then, last Friday night, a deadly tornado all but cleared the small town of Greensburg off the Kansas map. With 80 square blocks of the small farming town destroyed, Ms. Sebelius said her fears had come true: The emergency response was too slow, she said, and there was only one reason.

“As you travel around Greensburg, you’ll see that city and county trucks have been destroyed,” Ms. Sebelius, a Democrat, said Monday. “The National Guard is one of our first responders. They don’t have the equipment they need to come in, and it just makes it that much slower.”
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Another ‘vital system’

By: Lyle Fearnley
Posted in bioscience, food safety on May 7th, 2007

On “From China to Panama, a Trail of Poisoned Medicine”: As with many of the vital systems security domains, the creation of modern medical infrastructure produces new vulnerabilities. Contaminated medicine is its own “epidemic”. Also interesting is the contemporary configuration of medical contamination and counterfeiting as a ‘global’ problem: “This is really a global problem, and it needs to be handled in a global way,” said Dr. Henk Bekedam, the World Health Organization’s top representative in Beijing. The exact chemical (diethylene glycol) culpable in Panama’s deaths killed over 100 people in the U.S. SEVENTY years ago, leading to the creation of the FDA. What security measures will be put in place on a global scale?

Homeland security — a strange, strange beast

By: Stephen Collier
Posted in Uncategorized on May 3rd, 2007

Ambrogina Conobbio — a former student at New School International Affairs now working in New York City public health — sends along “critical releases in Homeland Security,” described by DHS as follows: “Every two weeks, the Homeland Security Digital Library identifies ‘Critical Releases in Homeland Security,’a targeted collection of recently-released documents that are expected to influence homeland security policy & strategy development.” The list of documents (below) is itself kind of fascinating, if only to get a sense of what a confused creature “Homeland Security” is in the United States (you have to create an account on their website to actually see the docs). Climate change, aviation security, country terror threat reports…How in the world could one agency possibly be concerned with all these things? Clearly, as we already know, “Homeland Security” is an answer to a question that has not been clearly posed.

National Strategy for Aviation Security
United States. White House Office

Nuclear Energy; Balancing Benefits and Risks
Council on Foreign Relations

United States Intelligence Community (IC) 100 Day Plan for Integration and Collaboration
United States. Office of the Director of National Intelligence

Task Force on Returning Global War on Terror Heroes
United States. Department of Veterans Affairs. Task Force on Returning Global War on Terror Heroes

Country Reports on Terrorism 2006
United States. Dept. of State

National Security and the Threat of Climate Change
CNA Corporation

Oil Shock Alternate Reality thingy

By: Christopher Kelty
Posted in Uncategorized, briefly noted, enactment, preparedness on May 2nd, 2007

World Without Oil” is an alternative reality game–not a video game or a “world” but more like a cross between a writing contest and a role-playing game. It asks participants to imagine what an oil shock would look like, and what living without oil will do to their lives, in real time, as the “oil shock” scenario unfolds. Thus it shares something with the scenario stylings of our vital systems friends, but one that is going directly to the people–albeit probably to preteens, hipster bloggers and youtube users first. What makes it so interesting is that it is actually very technically thin: just a web site where you submit links to content you create on your website, blog, video or by telephone. The site “masters” grade the content and choose the winners–presumably with the aim ofcollecting  a set of scenarios that might otherwise be difficult to generate. I’m skeptical that this particular game will get interesting, but the real issue is that it is pure genius.  I’m sure there will be others…

DHS, please take note.