Thanks, Herb, for that eloquent commentary.

Date: Fri, 12 Jun 2009 11:10:02 -0400
From: [log in to unmask]
Subject: Re: To Flu Experts, ‘Pandemic’   Confirms the Obvious
To: [log in to unmask]


What i find most interesting about this post is M.B.s statement
"Perhaps there is hope that a science for the people will at least be
based on science."  On the one hand the posted article is clear.  It
defines pandemic (so does Webster, Oxdford & Wikipedia) and also
what WHO means by level 6.  M.B.s statement is no so clear.  Since we
communicate under the banner "Science for the People," a common
understanding of what that slogan means; or shy of that, some discourse
on its meaning would be constructive.  Let me begin.

There are two categories--Science and People.  "Science" refers to the
practice of an elite.  "People" refers to the mass of humanity.  The
elite have exalted standards as to what constitutes "true" science. 
They use these to judge the practice of one another.  Central to these
standards is the concept of truth and honesty.  For example when
scientists develop, say, a neutron bomb, and evaluate the number of
persons it will kill, it is important that calculations be well
grounded, claims substantiated, experiments verified, references to
prior work be properly acknowledged, and data processed by the best
statistical procedures.  Among medical doctors there is supposed to be
an ethical standard, the Hyppocratic oath, which today it is not taken
by all.  There has also been a thus-far-unsuccessful movement for a
similar oath to be used universally among scientists. [Although
Wikipedia credits Sir Joseph Rothblatt with originating this call in
his 1995 Nobel acceptance speech,
we all know that our own Charles Schwartz has been calling for
something similar since the late '60s]

In our slogan People is the major category.  In fact, the slogan is in
itself an abbreviated universal Hyppocratic oath.  Many of those who
choose to advance under the banner of Science for the People believe
that a Hyppocratic oath for scientists should be at least as necessary
as the commitment to do "good science."  Some also consider that the
commitment to "people" also includes a democratic commitment, that the
people be included in judgments about what science should be pursued or
how science should be applied.  There are also those who consider that
the achievement of a truly people oriented pursuit of science would
require fundamental structural changes in society.  Originally the
organization Science for the People concentrated on criticizing science
against the people from a mainly moral perspective and enlisted
widespread non-scientist participation.  In fact, it was often
criticized as being neo-Luddite.  Over time, as the magazine clearly
shows, criticisms of anti-human science focussed more and more on the
credibility of the science itself, and the audience narrowed to mainly
include some from the scientific elite itself.

There does appear to be need for discourse, no?

Now to M. B.s statement.  The wise guy in me wants to write, "Perhaps
there is hope that a science for the people will at least be based on people."  
That is not a proper alternative, because what is embedded in our
slogan is a respect for both the scientific endeavor and the mass of
humanity.  To realize our slogan is no easy matter.  It requires
respectful communication between an elite and the rest, between a
highly trained and knowledgeable stratum of society and large numbers
of humans whose very lives may depend on what the elite does but do not
fully grasp the language of the elite and the interlocking roles of
their practices.

In the article is the statement:

the health organization is asking drug makers to
start making vaccine as quickly as possible, with the hope of having
some batches ready by September. Efforts to make a vaccine are under
way, and stockpiles of antiviral drugs have been opened. But the agency
does not recommend closing borders or restricting travel.

In my judgment this statement acknowledges an aspect of the dominant
culture that contradicts science for the people.  Vaccines must be
asked for from organizations that structurally must make a profit.  For
many of us the dream is that there be organizations that will make
vaccines because their societal role, the ethic that drives them, the
spirit that moves their leaders and their scientist staff is to serve
the people as distinct from making a profit.  Good science is no
guarantee of ethical behavior.


Michael Balter wrote:
I find it interesting that outside of a few notable
exceptions and the usual conspiracy theorizing, health officials are
getting widespread credit for doing exactly what they should be doing
in this situation. Perhaps there is hope that a science for the people
will at least be based on science. Wish I could say the same for the
current health care debate.




  June 12, 2009
  News Analysis
To Flu Experts, ‘Pandemic’ Confirms the Obvious
  It came as no surprise on Thursday when the World Health
Organization declared that the swine flu outbreak
had become a pandemic. 

  The disease has reached 74 countries, and probably met the
definition of a pandemic — or global spread — weeks ago. Nearly 30,000
cases have been reported, but disease experts think hundreds of
thousands or millions of people have actually been infected. 

  So the agency made official what had become obvious: that the H1N1
virus is spreading quickly in different parts of the world, and its
chief, Dr. Margaret Chan, said, “Further spread is considered inevitable.”

  The announcement does not mean that the illness, which has been
in most people, has become any worse. The term pandemic reflects only
the geographic spread of a new disease, not its severity. Pandemics
typically infect about a third of the world in a year or two, and
sometimes strike in successive waves.

  “Globally, we have good reason to believe that this pandemic, at
least in its early days, will be of moderate severity,” said Dr. Chan,
director general of the health agency. So far, 144 people have died
from H1N1.

  The decision to raise the pandemic alert from Phase 5 to Phase 6,
its highest level, is meant to signal to countries to step up their
efforts to deal with the disease.

   It also means that the health organization is asking drug makers
start making vaccine as quickly as possible, with the hope of having
some batches ready by September. Efforts to make a vaccine are under
way, and stockpiles of antiviral drugs have been opened. But the agency
does not recommend closing borders or restricting travel.

   “This is not a surprise,” said Dr. Thomas R. Frieden,
the new director of the Centers
for Disease Control and Prevention. “For all intents and purposes,
the United States government has been in Phase 6 of the pandemic for
some time now.” 

  Even though the disease has been relatively mild in most people so
far, governments must not relax, Dr. Chan said. For one thing, she
explained, the virus could change at any time and become more severe.

   In addition, the illness may take a greater toll when it reaches
poor countries with higher rates of malnutrition, AIDS and other
diseases that can lower people’s resistance to infection. Dr. Chan said
rich countries should help poor ones less able to protect themselves.

  Even in developed countries, the virus can cause severe and
sometimes fatal illness in pregnant women, babies and people with
underlying problems like asthma, heart disease, diabetes, obesity and
autoimmune diseases. Dr. Frieden said people in those risk groups
should seek treatment if they have a fever of at least 100.4, and a
cough or a sore throat. 

  A third to half of the severe and fatal cases have occurred in
and middle-aged people who were previously healthy. In contrast,
seasonal flu tends to kill the frail elderly. 

  The severity of the new virus does not even approach that of the
1918 one, which killed 40 million to 50 million people worldwide. But
even the milder flu pandemics took serious death tolls. The one in 1957
killed two million people, and the 1968 pandemic killed about one
million. Seasonal flu, by comparison, kills 250,000 to 500,000 people a

  Countries that have not yet had cases must anticipate them and
prepare their health systems to treat patients, Dr. Chan said.
Countries in the early stages of outbreaks should try to contain the
disease, she said. Those further along, like Mexico, should not let
their guard down even if the disease seems to be waning, she added. 

  “The virus can come back in a second wave,” Dr. Chan said. “When
you’re over the first wave, start preparing for the future.” 

  The W.H.O. has been questioned sharply for weeks as to why it
not go to Phase 6 even though the spread of cases, first in Britain and
Spain, then in Japan, Australia and Chile, seemed to meet its pandemic
definition: the sustained community spread of a novel virus in two
different W.H.O. regions. 

  Dr. Chan has indicated recently that she thought a pandemic was
under way, especially as cases in Australia quadrupled in a week, but
she wanted to consult with countries that had large outbreaks and then
with a panel of experts on Thursday.

  From early reports in Mexico and the United States, scientists
said that H1N1 appears to have roughly the same 0.6 percent death level
as the 1957 Asian flu. The 1918 flu killed about 2.5 percent of those

  But in 1918, antibiotics did not exist, and many people died of
secondary bacterial infections. In 1957, antiviral drugs did not exist,
and mechanical ventilators were less common. 

  Dr. Michael T. Osterholm, director of the Center for Infectious Disease Research and
Policy at the University of
said this year’s flu is not acting like the 1957 one, which quickly
faded into a seasonal pattern. There would normally be no flu cases in
the United States in June, but flu hospitalizations are increasing in
Minnesota, he said.

  Flu levels continue to be high in New York and New England, and
especially in Massachusetts, the C.D.C. said.

Denise Grady contributed reporting.



Michael Balter

Contributing Correspondent, Science

Adjunct Professor of Journalism,

Boston University


Email:           [log in to unmask]



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