Not being from the US, I find it odd that the article didn't mention anything about vaccination. Until 2005, pretty much everyone in the UK received the BCG vaccine. After that the TB rate fell too low to merit routine vaccination, but even today it's still given routinely in a few areas where the rate merits it, or if there's elevated risk of exposure via family from abroad, etc. Has vaccination in general become such a divisive topic in the US that articles about diseases for which we used to routinely vaccinate don't even mention that a vaccine is available and greatly reduces the risk of the most severe forms of TB, such as TB meningitis?
Kind of related to your point… I remember my maternal Grandmother was looking after me one day and I’d either missed or skipped my earlier vaccination appointment in school (which, I think was a BCG or booster, it was in the early 1990s). She was raised by her maternal Grandmother after her mother died from TB when she was 2 years old. Her father died of… something infectious when she was teenager
(the oral history is obviously a bit sketchy, but she used to tell me her father also caught TB - cholera maybe ? - when he was removing bodies from the flooded Balham tube station in 1940 - https://www.ianvisits.co.uk/articles/75th-anniversary-of-the...)
Well, I got quite the scolding about missing my jabs and a stern lecture about how many awful diseases have been cured because of vaccination. I could never forget how emotional she was about it.
To people born in the early 20th century, seeing the effects first hand of the vaccination programmes of the mid 20th century (not to mention antibiotics) must have seemed miraculous. I think we’ve lived without these diseases for so long that some people (stupid, selfish people) simply think they don’t exist or pose a threat any more.
> I think we’ve lived without these diseases for so long that some people (stupid, selfish people) simply think they don’t exist or pose a threat any more.
This is true beyond just vaccines. All too often hardships are forgotten, history is just old pictures and stories, and people who are too far disconnected from those real events and don't learn from history will just walk the same path, leading to the same hardships.
They all think that the world is better today so they're smarter or better than the old generations, that the world evolved so they're intrinsically prepared, so the pains of the past can't harm them. Ironically they're ignoring all the lessons and the tools that made the world better and are needed to keep it like that, and instead think things are better because they just are.
They'll skip any vaccines or support extremist regimes because they think the modern world is just immune to this, it's intrinsically and permanently "fixed". We have freedoms or don't get sick because we "just" have freedoms and don't get sick.
Having close family spending a lifetime paralyzed by the polio virus before a vaccine was widely available, or spending some of my life in the cold embrace of dictatorship really drove the point home for me about learning the lessons of history.
I think it was just some small anti-culture (like healing stones or whatever. Same people initially) that got dragged into the with us or against us political landscape of the US.
It’s a valid question, but I don’t think the current vaccine-unfriendly climate in the US is the reason why the BCG vaccine wasn’t mentioned. BCG wasn’t routinely given in the US even in the last half of the 20th century when vaccines were universally popular. I was surprised to learn a TB vaccine even existed when I started a public health−adjacent job in the 2000s. Our public health establishment just isn’t convinced it’s worth giving here.
The BCG vaccine does exist, but it's an 90 year old live-virus vaccine with short-term side effects. Because it's a live-virus "natural" vaccine, it can't be used on people who are immunocompromised or have HIV. There's work on more modern vaccines.[1] No big successes yet.
The safety record of the BCG vaccine, in terms of permanent harm, is pretty good.
But a normal side effect is "The usual expected reaction to BCG vaccination is redness and/or a small lump at the injection site, followed by a small ulcer (open sore) a few weeks later (usually less than 1 cm in diameter). The ulcer may last from a few weeks to months before healing to a small flat scar."[2] Mass vaccination will have parents screaming "my perfect baby has an open sore from the vaccine" on Instagram, with pictures.
The classic live-virus smallpox vaccine has similar side effects, by the way, plus a death rate of 1-2 per million.
Huge political problem. Remember all the screaming about the COVID vaccines, which are pure RNA, can't replicate, and have fewer side effects.
>>Mass vaccination will have parents screaming "my perfect baby has an open sore from the vaccine" on Instagram, with pictures.
That's so weird to me given that literally everyone where I'm from(Poland) has this on their left arm. Nothing to post on Instagram about. It's as universal as having a belly button - not having a vaccine scar on your arm would be the thing to post about if anything.
This is misleading. Vaccines, including those for covid, generally include adjuvants to stimulate the immune system [1]. While I understand the point your making here, the covid vaccines were not syringes with pure RNA in them.
An interesting aside to this is the MIS BAIR study in Melbourne, which is looking at whether the BCG vaccine reduces the incidence of food allergies, eczema and asthma. https://www.mcri.edu.au/research/projects/misbair
My upper left arm scar wasn't made by TB vaccine though, it was Rubella vaccine. I didn't associate it with aftereffects of the vaccine itself, it was the unique method of delivery - an airgun instead of a needle. Never seen that before or since.
They made a big deal of it, our entire elementary school got it at the same time. And they specifically said it was for German Measles, I don't think MMR had been invented yet. This would have been before 1970.
The US medical community never accepted the effectiveness of that vaccine. They don't think it does a good job at prevention and it makes it harder to detect as anyone whose had that vaccine treats positive with the skin test.
Aside from TB, you could also call this "the tragedy of vaccination": vaccination causes the incidence of a life-threatening disease to become so low that people consider the vaccine to cause more harm than it prevents - until the vaccination rate becomes so low that the life-threatening disease is back.
But if they also wrote genetic algorithms from scratch, and understood natural selection, they would also understand the concepts of selection pressure, and use it or lose it.
If they then also understood that 90% - 95% of the population effectively has natural immunity, they would seriously question the ethics of vaccination.
Should a number of generations be allowed to profit from the benefits of vaccination at the cost of a loss of natural immunity in the group? Are future members of the group less entitled to this ~95% immunity, because the current generations prefer ( 100% minus epsilon ) artificial immunity?
Its easy to win a referendum in the advantage of the existing population at the cost of future populations, if those future populations aren't born yet to contest and vote against it.
From Wikipedia page on Tuberculosis:
> Roughly one-quarter of the world's population has been infected with M. tuberculosis,[6] with new infections occurring in about 1% of the population each year.[11] However, most infections with M. tuberculosis do not cause disease,[169] and 90–95% of infections remain asymptomatic.[87]
From the above it is clear that vaccination programs for TB should be strictly considered private healthcare since it can help specific individuals at the cost of collective fitness vis-a-vis TB. Governments collectivizing private medicine at the cost of group fitness ranks among the most populistic things in existence. Think of how communist systems justify their methods by emphasizing doctors and medical systems.
What exactly does the ethical axiomatization of a collective thought system look like when they look down on the ~95% natural immunity handed to them from the prior generations and simultaneously have no qualms to hand down a lower percentage of natural immunity to the next generations!
I believe they have this mistaken gut feeling that their decisions can be rationally axiomatized, more out of group think and delegation "others smarter than me are choosing this so it is probably rational"; and they are simply unaware of the fundamental inconsistencies they manifest.
Tax payer money ought not be spent on reducing the natural immunity of its taxated population, regardless of how confronting it may be to explain to the population how a lot of methods in medicine were started long before the consensus on natural selection as the origin of life and fitness took hold.
>If they then also understood that 90% - 95% of the population effectively has natural immunity, they would seriously question the ethics of vaccination.
Your premise is flawed as this is a misinterpretation of what the data actually states. The statistic refers to the fact that most infections do not cause active disease. This is not the same as having "immunity." Rather, it indicates that the immune system in most individuals can contain the bacteria without eradicating it, resulting in a latent infection. Latent TB can become active under certain conditions, such as immunosuppression or aging.
Vaccination does not reduce natural immunity but aims to prevent the most severe manifestations of TB which can be fatal.
Your wider point re: the ethical argument against vaccination presumes that exposing populations to preventable diseases is acceptable to preserve a theoretical "natural immunity." However, ethics in public health prioritize the reduction of preventable harm. Sacrificing lives and health for a purist notion of "natural selection" disregards the suffering of individuals and the societal costs of disease.
If anything, the ethical failure lies in allowing preventable diseases to cause harm when safe, effective interventions exist. Future generations will inherit a world shaped by the decisions we make today. A world with widespread vaccination is one where fewer children die, fewer families suffer, and societies thrive.
I just checked and it's not mandatory anymore in France, which probably absurd because there is a surge of tuberculosis due to migration and international travel
natural selection also applies to memes. memes that cause their host to fail to raise children to reproductive age will get weeded out, but it can take many generations.
Memes don't need to be passed on hereditarily. It is entirely possible for a meme which absolutely prevents the host from reproducing to persist indefinitely so long as it spreads to new hosts at around the same rate hosts die out. See clerical celibacy. It is also possible for memes to lie dormant and then resurge after an extended period of time by which all the original hosts are dead.
John Green, author of "The Fault in Our Stars", "Turtles All the Way Down", "The Anthropocene Reviewed", and other fine books is releasing a book called "Everything is Tuberculosis." If you are interested in the topic or just like to read well-written prose, I recommend joining me in pre-ordering it.
Largest in recorded history is a bit of hyperbole. In the 1800s something like 80% of all Americans had the TB bacillus and of those that came down with TB a huge percentage died.
We did learn about the 1800's in school but apparently some of you did not pay attention.
There will always be some small percentage of your society that refuses to accept what is taught in school. The US has it bad because we've had multiple "Great Awakenings" that resulted in literal cults that grew to national size (mormonism, Church of Christ scientist, Jehova's Witnesses, thousands of various "Evangelical" fundamentalist sects) that all take as a foundational belief that the entirety of modern science is a massive cover-up to prevent people from knowing about god. They explicitly believe that scientists are Evil, and in league with Satan to keep them from god.
Fully ten percent of the American public for the past 50 years, or 30 million people believe "God created human beings in their present form at one time within the last 10,000 years"
Those people have always been good at organizing and have groups that are extremely motivated because they genuinely believe they are fighting a holy war against Satan. They have driven American policy for centuries, from the religious portion of the southern states insisting that god wanted black people to be slaves, to the Christians being a large portion of the temperance movement that resulted in Prohibition, to the current Book bans, to driving a significant amount of the political pressure causing Visa and Mastercard to threaten to ban pornhub (https://en.wikipedia.org/wiki/National_Center_on_Sexual_Expl...).
A huge percentage of flat earth believers for example are there because it is the logical endpoint of "you cannot trust any scientist because they are all in league to drive you away from god's light"
If 10% doesn't scare you, consider that the same insanity around a man named Kellog insisting in "purity of spirit", as in the religious meaning, is why 90% of White men in the US are circumcised. That rate is only comparable in Israel and nations with Islamic laws.
America struggles because of religion, specifically a breed of religion that insists you cannot trust any institution but it. Note how hostile the current admin was to a Preacher preaching peace.
We learned that we’ve progressed and that we’re totally different people now, so obviously we can’t end up with the same problems if we’re
stupid about it. (/s, kinda)
At least smallpox has been eradicated (except for potentially some bio weapons labs), so hopefully our stupidity won’t bring that back.
I mean, if you could get a large country that you had some enmity with to embrace anti-vaxx I guess weaponizing that smallpox might seem attractive, if you had really poor morals of course.
I assumed that the emphasis is correctly on "outbreak", ie: a single statistically significant increase, as opposed to a progressive increase over centuries (which is what led to the huge numbers in the 19th century)
Yeah, the phrase they were looking for is "largest on record", or more precisely "largest in the CDC's records".
"Recorded history" has a very specific definition that places it in contrast with "prehistory": it's the time period in which we have written records of any sort, as opposed to the time period in which there is no surviving writing. That both phrases have "record" in them doesn't make them synonymous.
"Recorded history" in the title refers to the period of history where the agency has been recording the numbers. It might not be the best phrasing, but it's not strictly untrue; the underwritten thesis (TB is on the rise) is still supported by the evidence.
"recorded history" sounds like it's how you divide pre-colonial Americas from modern (15th Century CE onward) Americas. For example, many weather features have been recorded in the Americas since 17th century CE. Does "recorded history" refer to only "[this particular metric's] recorded history"?
I agree that it's not the best term, but I don't think its so disqualifying that it makes the claim untrue: it's misleading at worst, and that imprecision only kinda interacts with the underlying claim.
I guess the better phrasing would be "Kansas tuberculosis outbreak is largest since (org) has been collecting data", which honestly doesn't change the implications for me.
Eh, "recorded history" is totally the wrong phrase.
When we say "recorded history" we don't mean "the window of time in which we have detailed records up to our modern standards", we specifically mean "the window of time in which we have records of any sort", contrasted with "prehistory".
The phrase they were looking for is "largest on record" or even better "largest since 195X".
> For broader world history, recorded history begins with the accounts of the ancient world around the 4th millennium BCE, and it coincides with the invention of writing.
EDIT: Downvote away, but I'd be interested to hear from someone who believes that "recorded history" is not incorrect and confusing usage here, with an explanation rather than a drive by vote.
If you read the article, it appears they've only been keeping records in Kansas since the 50's. And I think the headline is wrong: it's the biggest in Kansas's records. I could be mistaken about that.
An tuberculosis outbreak in Kansas has become the largest in recorded history in the US....the CDC started monitoring TB in the US in the 1950s.
"This is mainly due to the rapid number of cases in the short amount of time. There are a few other states that currently have large outbreaks that are also ongoing."
People with an active infection feel sick and can spread it to others, while people with a latent infection don't feel sick and can't spread it. It is treatable with antibiotics.
State public health officials say there is "very low risk to the general public."
"Analysis of data from 14 countries in Africa and Asia suggests that about two thirds of global TB transmission may be from asymptomatic TB (95% prediction interval: 27–92%)."
>Treating it casually has led to widespread resistance.
I have long suspected this as part of why the subject isn't much discussed, despite being more prevalent than most realize.
The elephant here is (aside from latent infection) the atypically long duration of treatment, which can exceed 6 months and is harsh. Many, even otherwise responsible people, will founder before the proper end of treatment and this, I think, is what terrifies health professionals - so much, that it almost seems to be avoided.
It's probably time we start looking a bit harder for "natural" or alternate treatments. Some in medical journals, are under scrutiny, but inconclusive.
Edit: I also think we'll be finding more about latent infections being involved in an array of other ailments, especially when mixed with the ultra prevalent EBV. And EBV is involved in a lot.
>It's probably time we start looking a bit harder for "natural" or alternate treatments. Some in medical journals, are under scrutiny, but inconclusive.
We are looking, quite hard, in fact. Mycobacterium tuberculosis is among the most studied microörganisms.
Like HIV, it is notable particularly for being able to defeat the attempts of the immune system cells to kill it, and it in fact infects and reproduces within macrophages. Medical researchers have done a lot to understand how this is possible and we (as in humanity) have identified several enzymes and related biomolecules which seem to be crucial to this process, which we might be able to inhibit with a targeted drug.
However, all of this scientific research has the usual problem that it is very difficult and expensive. In order to inhibit the enzyme, the drug must be absorbed by the body, and then make its way into the macrophages, and then it still must be active, and have no other toxicity to the host. It is easy to say "just inhibit isotuberculosinol synthase", but it is much harder to do.
As I understand it, this is also the reason why treating tuberculosis requires such long courses of antibiotics. When treating a normal infection, we are basically just killing most of the pathogens, and we hope that the immune system will mop up the rest. In the case of M. tuberculosis, the drugs have to kill all of the bacteria, which is why multidrug therapy is basically always used and the patient must continue treatment long after symptoms seem to have disappeared. Even when patients have recovered, they are always considered to be at risk of still having latent tuberculosis, which is why hospital screenings often feature a question like "have you ever had a positive test for tuberculosis?"
Not to say that it's always the case, but research isn't always at face value - i.e., sometimes there's circularity, economical or political dynamics, etc, that perpetuate dead ends while neglecting more viable avenues.
An example might be enzymes (notably in cancer research), where in the US there has been significantly less pursuit than elsewhere. To avoid attacks, I'll cite a source[0] which readers can maim rather than my comment.
0. Enzymes, The Fountain of Life
DA, Lopez MD
RM, Williams MD PhD
K, Miehlke MD
In some pirtions of this book, entities other than pinata boy on HN, express concern regarding the quality, fairness or whatever's of research, with indications that 'research' may not always be equally noble or pragmatically guided. I suspect it's one of many where that particular subject is grazed upon. But my point is, if not overemphasized, that there may be quantity over quality issues, with viable options hiding in plain sight.
"It's probably time we start looking a bit harder for "natural" or alternate treatments. Some in medical journals, are under scrutiny, but inconclusive."
Antibiotics are found in, and derived from, nature.
I was diagnosed with a latent TB infection received from a family member back in the early 1990's as a teen. I believe city and state departments of health must've tracked the "outbreak" back but I don't think it was ever on the news or made a big deal of. By the time we were diagnosed, the family member's symptoms weren't anything worse than their typical smoker's cough and was a heavy cigarette smoker anyway, not sure how active his infection actually was at the time but he never required hospitalization, just similar antibiotics, IIRC.
I was treated with Isoniazid (known as INH, one pill daily for a year), I never felt any symptoms from the infection or side effects from INH, they monitored monthly initially with skin prick tests then chest x-rays and after the year was up, I was done. This did prevent me from donating blood a few years after the infection was cleared; I assume there are still rules in place.
Neither the latent infection nor the year long treatment were harsh. IMHO, TB's a powerful but rather slow-moving internal infectant, and it was historically ravaging because of the earlier conditions of the world and lack of medicine at that time.
What kind of natural treatments? Because tuberculosis has been a massive problem from the start of human civilization up until the advent of antibiotics, and they tried every natural medicine and treatment under the sun because of how long people can end up living with it before dieing, and they accomplished pretty much nothing in stopping it. In fact it continued to get worse throughout that entire time, at one point being the cause of death for 25% of Europeans.
I'm not going to devote the time required to search, retrieve and cite extent material. But you will find results if you do, but probably no panacea. Also, I deliberately don't mention specifics in this instance (and many others) due to potentially and probable controversy. As an example, if I were to (but won't!) cite research indicating the universally reviled Ag showing efficacy in mitigating TB, I'd be attacked by waves of hostility as if it was my own rogue idea.
I enjoy discussions, but find it often tends to be argumentative here, so I avoid things I expect to go in that direction. Note the hostility to my use of the forbidden word in quotes. It's a thousand cuts with these kinds of compulsive prison shanks of logic that makes me awkward.
Resistance. It's not quite the end of the world if TB becomes impervious to, say, catnip or whatever, which isn't front line medicine. And some options might have a more mechanical rather than biological mechanism/function.
Compliance for a 6 month course of just about anything is difficult and more so for something that may seem asymptomatic. Oozing sores, foul oders and overt discomfort would probably help, but alas...
I'm sorry but this doesn't make sense. Antibiotic resistance to TB only affects those who have TB, so if another 'natural' medicine is found and TB gets resistant to it, then it is still just as bad for the people affected.
Natural means nothing in this context. Effective medicine is effective medicine, and there is nothing that makes TB less prone to developing a resistance to a 'natural' effective medicine over any other effective medicine.
I admit I slipped into the octogon of HN where animals weak and strong come to test their teeth on impulse. Therefore I must be prepared to write essays on semantics even when I use subtle indicators such as quotes.
For the first portion of your reply, I think that if TB became resistant to potatoes with licorice icecream, it would be preferable to having absolutely no recourse with antibiotics. But that's silly. If you are 100% certain that latent TB is innocuous and can't be reactivated, I must admit my logic was flawed.
Edit: is not, eg mrsa, becoming resistant to various things in the environment? Biofilms make many bacteria resistant to even alcohol. Staph, ubiquitous and thus exposed to pretty much anything a person's skin is exposed to is probably resistant to many things it previously wasn't. But it remains vulnerable to a few antibiotics, for now.
I understand now what you mean. The thing is that TB doesn't transfer its resistance to other pathogens like MRSA does. It develops resistance via a different mechanism (mutations of its genome) then MRSA does (horizontal gene transfer).
Thus, you have a misconception about the nature of TB resistance. This accounts for the pushback. People tend to forget that we all have different knowledge bases and we talk past each other.
> The elephant here is (aside from latent infection) the atypically long duration of treatment, which can exceed 6 months and is harsh. Many, even otherwise responsible people, will founder before the proper end of treatment and this, I think, is what terrifies health professionals - so much, that it almost seems to be avoided.
The fear is overblown. I've known multiple people do the 9 month treatment and none had issues. One person had tingling sensation and that was resolved by an increase in vitamin intake after consulting with a neurologist.
They were in their early to mid thirties. Most problems occur when older people take the medication.
Don't take this as a touche, but are you suggesting that full compliance is the rule and that the vast majority completes the course as prescribed?
Again, this isn't some passive aggressive challenge. But I will be genuinely surprised to see this is indeed the case, which very well may be. I certainly know people who'd follow the course with perfection, and some who absolutely wouldn't.
Yeah… understatement with respect to TB is pretty scary. There’s a limited set of effective antibiotics, some strains are resistant, and some drugs have severe side effects.
You have to be a little suspicious of some of this — folks are looking for political reasons for scary disease outbreaks.
I had a TB scare last year. Coworker was exposed to a confirmed case. Got tested, and we all turned up negative. I then asked if I could get a TB vaccine, but was told no, because it makes the TB visual assessment test useless. So, to aid future potential diagnoses, I need to be able to be infected by the genuine article.
That’s one reason the BCG vaccine isn’t given in the US, but it’s also because the data on whether it’s effective in adults is really inconsistent. It seems to vary based on geography (maybe distance from the equator? they’re not sure). If we were going to administer it routinely, it would be for infants, where the data is better.
Can confirm. I got the vaccine in the Soviet Union as a kid and tested positive in the US for school admission and when volunteering with special kids. It’s a huge pain in the ass every time because doctors insist on a course of antibiotics that is particularly hard on the liver or kidneys so I have to spend significant time fighting them and getting an exception from administration.
That's silly. There's a globule test that doesn't give a false positive for vaccinated people. Perhaps it's more recent than when you last had to go through this?
Approved by the FDA in 2005. Probably took a while for it to become widespread.
The thing is: The protocol for a positive skin test wasn't "Here, take this 9 month treatment." It was "You need a chest X-Ray to show it's not active. If not, you're good to go!" Especially if they know you've received the vaccine. And no one should have made you go through the treatment multiple times - it's pointless, because even if you never had the vaccine but had latent/active TB, you will always test positive with the skin test. Knowing you'd gone through treatment once should have sufficed.
I know a nurse who definitely has latent TB (i.e. no vaccine). And she never had problems after a positive skin test - her employers always knew about it and as long as she had a clean chest X-Ray, she was deemed fit to interact with (at risk) patients.
Whoever made you go through treatment was incompetent.
To be clear I never went through the treatment, it just took a lot of arguing with doctors and the school/nonprofit administration in question after the false positive. I never had a chest xray either, I just had to drill it into their heads that Soviets got the vaccine and that it causes a false positive.
It sounds like they weren’t very well informed of TB protocol.
It could be ideological, or it could be a common mistake people with a business background make in the government.
For the average for-profit company, the actual business the company does has no value beyond its ability to generate profits. The damage a disruption causes today can always be offset with higher expected profits in the future.
But for many government departments, the day-to-day business is the entire point. Any disruption can easily cause irrevocable damage. Even when the net outcome is positive, the gains often cannot offset the damage, because they go to different people.
I'm going to guess that the rationale is a combination of:
1) state's rights
2) anti-science
3) a number of people in the administration (very possibly including Trump himself) thinking that the CDC is an example of "the deep state" that conspired to keep him from winning in 2020
But, hey, Joe made groceries more expensive and the administration didn't kiss enough rear on the left side of the Dems to get Kamala elected, so, here we are.
Since losing in 2020 the various think tanks and groups that make up the right-wing have settled on a unified, frightening, vision of what the US government should look like equipped with (extremely dubious) legal rhetoric and reason to back it up. Most notable of these is Project 2025 by the Heritage Foundation[1] which is a keyhole glimpse into the chaos of this last week and in the years to come. The section relevant to this action is chapter 14 which describes each HHS division as maligned, woke, and in need of reform.
A less nuanced answer is the HHS/CDC made Trump look bad in handling the COVID-19 pandemic and so they’re now ordered to say nothing about anything ever again.
The freeze will be lifted once RFK Jr. is approved by the Senate. The purpose is to stop progressive ideologues in the agencies from doing things in protest of their new boss.
Even for poor countries it's not much. In the UK when I had it they sent a nurse round to the school and all the kids lined up and they did like one a minute. Free to us lot of course on the NHS.
I think it was quite nasty and leaves a scar though.
Is there public reporting for actions taken by the current American Presidential Presidency?
It would be useful and highly informative to be able to visit a single page to see daily/quarterly/bi-annual/annual diffs of which efforts habe received signoff.
My friend's husband is a physician that works along the Mexican border and volunteers at migrant shelters. He said the amount of TB that comes through the border is shocking.
Yes. The question is how did it balloon so quickly if these people were identified an receiving treatment? Is this a breakdown in the case monitoring among Kansas City medical community or something else?
The original cases were in low income people who had been born outside the US but whose children were born in the US according to the paper.
Baffles me that someone would write something so definitively yet not expand on it in any way at all.
Not saying you're wrong (I have no idea), but what a low-effort comment. I'm curious, you seem (or claim, at least) to know something, can you help me satisfy my curiosity?
> The outbreak involved 13 people across four households in Kansas City and spanned 1 year. While a majority of the seven adults identified were born outside the U.S. in a country that had experienced a multidrug-resistant TB outbreak with the same genotype in 2007-2009, most of the six children were U.S.-born, noted Elizabeth Groenweghe, MPH, of the Unified Government Public Health Department in Kansas City, and colleagues in the Morbidity and Mortality Weekly Report.
So it's either been a latent infection in someone in the first household or they traveled to their home country and brought it back, or something.. it's likely the local health department knows the exact lineage and route it took but they avoid publishing the full details for obvious reasons in this climate.
What are the “obvious reasons?” It seems to me the obvious reasons are that the claim is that illegal immigration has been blamed for outbreaks of diseases that are relatively uncommon in the U.S. and publishing the full details would provide evidence supporting that claim.
But if that is what happened, then why not publish those details? If that isn’t what happened, then why not publish those details? Facts are always preferred to conjuncture.
Because random people on the internet deciding to target a random family suffering from a serious illness won't remotely help anything. Regardless of the immigration status of the family, they'll be targeted as if they were illegal (even though their kids were explicitly born in the US and are obviously Americans) and the vitriol will ensure their community is less safe.. the ensuing media freakout will make sure that other infected communities are much less likely to turn up to hospitals when they have communal infections, almost guaranteeing the next outbreak will spread further.
Remember the "illegal haitians are eating our cats" bullshit from last summer? When they absolutely weren't and they were all legal refugees anyway? Then the future President weighed in and said the US should deport them anyway?
TB is particularly tough to track; it has an incubation period that can range into "years" and most people never develop symptoms. Add in getting quarantined for months and you've got a problem on the seeking treatment side of things, too.
This is the type of thing that'd normally show up on CDC's Morbidity and Mortality Weekly Report which has been published weekly since 1960 (my understanding is this is without fail).
But unfortunately the current administration has decided an ideological purification is more important than keeping the American public apprised of threats to their health.
So it wasn't published last week, and probably won't be this week either. "Politics don't matter" though ;) Bummer!
> then wouldn't they want to spread the info and blame it on the "dirty illegals" or whatever?
pretty sure the ideology is to remove every social safety net and service to "prove" government doesn't work and then the robber barons can swoop in and make it a paid service... and make it so the capital class gets to make and save more money as they can afford to buy any of those services that were cut. it's basically vulture economics but at the nation scale. it's not great.
This isn't really an urgent "alert" system per se, more of a knowledge dissemination system. Security postmortems more so than critical security patches.
We have good reason to believe it'd show up here given that Kansas's TB situation has had multiple bulletins over the years
The analogy breaks down in that rate of infection of a disease is historical but very much informs ongoing public health measures that should be taken.
One might conclude, given how closely the current administration has been following the project 2025 plan that was floating around, that the administration paused functions pending ideological purity checks on key personnel.
Read the data. There are many more latent cases recorded, and current new cases are not all recorded as the tally lags people sick right now.
You keep quoting that part and ignoring the rest of the article and the live data sources linked to it. The text of the article likely wasn’t from yesterday, as the reporter likely went around a week or two, gathered quotes, interviews, then spent some time in editorial revisions.
Maybe you can link to whatever data you're looking at. The article says one new active case and that the overall number of cases, including latent, are trending down. This is still consistent with this being a bigger deal last year than this year. The KS health data still shows 1 active for this year.
This goes way past teams bud. If you don't realize the kind of existential threat trump is posing to millions of people, you haven't paid attention to a single thing he's done since taking office.
Maybe the political climate is impacting a higher number of topical points that are being discussed on HN. When governments are changing, interfering, and impacting technology you're going to see it crop up more.
It's not a "rough start for HN", it's the current climate of the world through the lens of the US.
> The political commentary is infecting every thread.
Unfortunately politics has infected areas of our lives we took for granted. The stopping of reporting coming out of the CDC/NIH/HHS makes discussing health science articles more challenging. And this is a direct result of the new administration. While this article may not be vaccine related, the new administration wants a known anti-vaxxer to lead the HHS.
I would argue that being rabidly apolitical while a dangerous threat to western democracy has been growing in America for years is the rough part.
I'm an old person. I have a leftist bent. I used to get along with many conservatives, I just had different policy viewpoints than they did. What we are seeing now is a completely different political landscape where one of the parties is actively setting up a dynastic plutocracy in the open.
FWIW I have a ton of criticism for the "other" party too as an ineffective mess sucking the corporate teet almost as hard, just without the actual proto fascism.
Some yes, but maybe not you? Because you used the following language yesterday:
"Only a few short months ago, I was under constant attack from various public members of the Democratic party for being a white male with center-right views. The vitriol was quite unhinged, really." when asked for specifics you went to '...on CNN for example'.
* edit: I mean for use as ammunition in an argument. It's not that you're wrong—it's just that the cost (to the intended spirit of the site) outweighs the benefit (being right in an argument).
TBH this idea that each comment should stand individually on its (including HN's downplaying of the usernym with grey) seems like it contributes to some of the problems with modern discourse. When someone I know says something challenging, I know the context they're coming from, what I do agree with them on, what skills of theirs I respect, etc. Whereas message board comments are just tiny slivers of information with which you can agree or disagree.
Oh for sure. There's nothing wrong with people getting to know each other, and their views, by reading through past comments.
It's just not in the intended spirit of HN to track down contradictions and use them as gotchas in arguments. That's a narrower point. I've added an edit to the GP comment to clarify that.
Do I engage in politics on HN occasionally? Yes. Is it my primary motivation? No. I don't open up HN with the intention of having rigorous political discussions, even though I sometimes fall into them.
My comment history, which it seems you only partially perused, demonstrates this to be true. Especially if you go back a year ago before things became politically charged around here.
I also don't see what relevance my example has to this conversation. It sounds like you're trying to corner me into a specific label (Republican, maybe?). I guess thanks for proving my point about discussions around here?
I haven't used party labels on HN. You seem to be the one forcing an identity on me? I would respond but my post was out of bounds so I shouldn't elaborate/reference further.
FYI if you read my post history you will see I am a libertarian leaning (Santa Cruz hippie libertarian not Rand Paul 'my dad got me the job but I believe in everyone earning their way' libertarian) refugee from the Bay Area to a small town in a very red state. I don't have the agenda you think other than calling out hypocrisy and a desire for a functioning health system.
> This is the type of thing that'd normally show up on CDC's Morbidity and Mortality Weekly Report
The resurgence of TB has been the big story in infectious diseases for a while now.
Globally:
> The World Health Organization (WHO) today published a new report on tuberculosis revealing that approximately 8.2 million people were newly diagnosed with TB in 2023 – the highest number recorded since WHO began global TB monitoring in 1995. This represents a notable increase from 7.5 million reported in 2022, placing TB again as the leading infectious disease killer in 2023, surpassing COVID-19.
> After declining for three decades, tuberculosis (TB) rates in the U.S. have been increasing steadily since 2020, according to a new report from the Centers for Disease Control and Prevention. It’s a disturbing trend given that 1.5 million die from TB every year, making it the world’s most infectious killer.
> The resurgence of TB has been the big story in infectious diseases for a while now.
It's been a big story since the 1980s, IIRC. I remember in college in the 1990s a biologist friend explaining that TB was the greatest disease threat to public health and it was being completely ignored.
Frankly, it's hard to get worked up about it. Notwithstanding that it is a serious public health threat, there's a strong political rhetoric aspect to the discussion, both in the popular and professional spheres. It's unfortunate. In the 1980s and 1990s it was all about how Reagan decimated our public health infrastructure. The arguments aren't per se wrong, but it's difficult to gauge relevance and prioritization about the threat of TB given how part of the medical and scientific community seem to have been border-line crying wolf for 40 years. Discussion centers around absolute numbers. Tell me what the per capita relationship looks like, especially per capita among the populations most vulnerable to acquisition and disease, and what the long-term trends look like. I see this in a lot of other adjacent public health discussions tainted by political hand wringing, such as food insecurity, etc--lots of absolute numbers. But global populations are growing. The US, for example, grew by 80 million people, or 30%, between 1990 and 2020. That's not to deny that tuberculosis is a growing problem, but we have many problems. And the constant drum beat of alarm causes some parts of the community to (increasingly) react in counterproductive ways. From an individual moral standpoint, that's on them, but from an epidemiological and sociological perspective, maybe the professionals bear a little blame, too, at least in terms of communication. We could all do better.
Rubbish, on all counts. Public health discussion constantly gives rates and percentages, not just numbers. And “they’ve been warning us so many times” - well, I hope you’ve also given up on applying security updates to any software or hardware you manage, since those have been getting issued forever, they must be crying wolf too.
My point isn't that agencies don't report incidence; my point is about when the discussion surfaces how it's discussed in the popular press, including editorializations in professional outlet. Were incidence rate flat or down between convenient points of comparison, but absolute numbers up, and an outbreak like Kansas happen, we'd be discussion absolute numbers. And even when incidence is up, the absolute numbers always headline. It's a subtle criticism I'm making, but I think an important one.
Nonetheless, while for 40 years TB has been discussed as a grace looming threat, note how absolute cases and incidence dropped steeply over most of that time. And while the drop has largely stopped, the US now has one of the lowest incidence rates in the world. But my takeaway is supposed to be that the US' TB measures are woefully broken because the drop has stopped?
The point is that if we'd put in a bit more effort 40 and 30 years ago, there would be 0 cases today (and if we put a bunch more effort in now, there will be 0 cases in 20 years). TB is awful, but it is curable and preventable. It's current existence in the world is a policy choice of the past few decades, and eradicating it is a choice we can make today.
> This is the type of thing that'd normally show up on CDC's Morbidity and Mortality Weekly Report which has been published weekly since 1960 (my understanding is this is without fail).
> But unfortunately the current administration has decided an ideological purification is more important than keeping the American public apprised of threats to their health.
Looking at the CDC's Morbidity and Mortality Weekly Report, this doesn't actually appear to be true. Going by that link you can read past MMWR reports, and they aren't (from everything I can see) doing weekly tracking of outbreaks, but rather publishing various articles about diseases the way a science journal would. I couldn't find anything about the Kansas tuberculosis outbreak in the most recent reports, so I wouldn't be surprised if we don't see anything about it in the next few MMRW reports.
For anyone unaware of us government agency structure. CDC is part of the department of health and human services ( HHS ) which has also frozen everything (see the NIH news as well).
Employees have been instructed to pull publications from review, not communicate with state health departments, and cancel long planned trainings.
These decisions will well and truly kill real people.
I’m an academic scientist part of a really large government funded research grant that employs hundreds of people. Last time, we had to fire half our staff immediately right up front because they said they were cutting our funding. They ended up not cutting our funding at all, but we had already fired everyone so it was lose lose- the Government spent the money but the research couldn’t be done. Just plain bad leadership.
I've had two grants in a row get killed for political reasons, and a third is on the chopping block. What really kills me is that we get through the unpleasant, unproductive scaling up part, are about to hit our stride, and then...gone.
We hired new people with less experience and restarted the projects, but in a lot of cases the projects were set back years with no reduction in the cost.
It was the policy of the granting federal agency- it was not our choice, we had to immediately start operating on the president's proposed low budget in case it were to pass, rather than spend money that might never exist.
This happened because Trump's administration essentially copy and pasted Heritage Foundation materials rather than carefully think through a realistic budget.
It's even worse than that: it's more like buying unrefundable materials to build a house today on an account/invoice, knowing you will likely be unemployed before the bill comes due, but after the materials are delivered. You're spending money up front that you don't have, and may never have.
If you spend full budget for the first half of the fiscal year, but a final budget gets passed later that cuts your budget in half- you get no remaining money for the year, and then end up firing everyone, instead of half. This is why the federal agencies have the policy of immediately acting on the lowest proposed budget, instead of waiting to see what happens.
> For anyone unaware of us government agency structure. CDC is part of the department of health and human services ( HHS ) which has also frozen everything (see the NIH news as well).
> Employees have been instructed to pull publications from review, not communicate with state health departments, and cancel long planned trainings.
> These decisions will well and truly kill real people.
These are the executive orders we are talking about.
Are you strong enough of a person to address this? Or must you insult people's intelligence by dishonest accusations?
Basically what you are saying is that me robbing you, and me making economic policy that might lead to increased unemployment which might lead to greater housing or food insecurity which might lead to increases in crime which might lead to you getting robber are indistinguishable.
Adults can differentiate between direct and indirect causal relationships…it is basically the cognitive development definition of adulthood (c.f. Work by Piaget)
The scary(?) part about Trump voters this time around is that the narrative up to last year forced most such voters underground. It's why election pollsters all failed across the board.
Source: Me. I voted Trump and proudly so, didn't deliberate in public much because noone was going to listen and nothing was going to change my vote anyway. Make America Great Again.
he's not responsible for an outbreak of a contagious illness. if he had been president 3 weeks ago the LA fire would have been linked to him. thats how it was for 4 years. then one day, nothing was the president's fault anymore. Nobody beleives that.
Trump offered tangible things while the opponent offered a much more though out philosophy and platform (even if one i disagree with).
The fact Trump offered to pardon Ross was enough to make me feel incredibly guilty for not voting for him. I was surprised he found a way to get to me like that, but reality and practical negotiation can be quite persuasive over ideology.
I suspect Trump had at least one important thing to enough people that is 100% achievable and physically real-- a part of a wall, a pardon, a $2000 -- that he could beat out someone offering ideas/hopes/dreams.
Submissions like that often get flagged because they are mainstream political news items. As the HN guidelines say: “If they'd cover it on TV news, it's probably off-topic.”
Mortality is taken over the population as a whole. You want the case fatality rate (probability of death if you're infected), which in the US is 7-9%. Globally, some countries have TB case rates >30%.
TB is a very ancient, very scary disease that's co-evolved with us. It's not much of an exaggeration to say that large parts of modern medicine were invented specifically to get a handle on TB because it has historically ravaged entire populations when left untreated.
You have the option of voting for a third party candidate. They won't win, but over multiple election cycles this increases the odds that a third party could eventually present a credible alternative.
In most states the electoral college representatives are not meaningfully bound to the vote as popularly voted. It is more of a cast for a suggestion, and they have on many occasions voted a different way in the college which is the real vote for president.
The people that didn't vote don't count, figuratively or literally. You may as well have pointed out that only .1% of all mammals supported this, after accounting for dogs, cows, raccoons, mice...
Everyone who chose not to vote effectively removed themselves from the set of people to be counted as either supporting or not supporting this administration.
That's not actually how 'support' works, especially when 'the' alternative was committed to arming a genocidal apartheid regime against the will of their own voters. Many. many people can no longer stomach to 'hold their noses' and vote in favor of open atrocity.
There's a whole lot of people who strongly disdain both parties, on that basis and others. They are not remotely proportionally represented by either government or media, but they do exist and they don't support this administration.
Btw, there are all kinds of electoral solutions to the two party bind which you seem to have entirely accepted. Neither party will ever willingly bring those in.
… Do you think President is the only thing on the ballot? Do you think that maybe, if everyone voted, the demographics might be different?
I’m so tired of this nonsense. If y’all bothered showing up for state and local races, you could even change elections in your state. But that would like, take effort, so I get why you’d rather shitpost about how worthless it all is.
Ah, so by “not voting” you meant “leaving one box blank while already filling out the rest of the ballot because what’s the point of wasting the ink”?
Sorry, that reads, to me, like post hoc justification for nonsense. The only people who talk about voting not mattering are people who don’t vote - not people who skip one or two boxes on the form. Maybe you’re different.
Or you can be an adult and vote for the best option. Harris and the Democratic establishment are certainly not saints and I could rant for hours at how bad they are, but she was a competent woman and at least tried to float solutions to our problems as opposed to being a party of billionaires who is happy to burn it all down.
A lot of people see their vote for president like picking a team to be on and couldn't stomach being on either team.
I try to rephrase it for them: you're not picking a team, you're picking your OPPONENT. And who do you think you're going to have a better chance of even picking the battlegrounds against?
I think it's related to the frustratingly common idea that a person's political involvement begins and ends with voting. We really have to do a lot better at educating people about how political involvement can be an anytime thing, not just every four years. Successful lobbyists (and those who employ them) have long ago figured this out, we need to make sure the common person does, too!
Exactly this! I just don't understand how this is hard for otherwise competent people to grasp. The explanation I've used in the past is the choices are either being stabbed in the face or kicked in the balls. Ideally I'd not have either, but forced between one or the other I know which one I'd pick.
David Sedaris: “I look at these people and can't quite believe that they exist. Are they professional actors? I wonder. Or are they simply laymen who want a lot of attention? To put them in perspective, I think of being on an airplane. The flight attendant comes down the aisle with her food cart and, eventually, parks it beside my seat. "Can I interest you in the chicken?" she asks. "Or would you prefer the platter of shit with bits of broken glass in it? To be undecided in this election is to pause for a moment and then ask how the chicken is cooked.”
I'm not sure who told you that casting a blank ballot represents a "protest vote", but I assure you that is not how our current voting system is set up.
To be clear, voting systems should have explicit options for protest votes; an explicit "I reject all candidates" option. Unfortunately, ours does not, by design; a blank ballot instead means "I endorse all candidates". Pretending otherwise will not change this.
Playing the tape to the end, what happens is the protest votes win? Start a new election cycle? What happens if that cycle now extends past the end of the current admin’s term which cause their time in office to extend beyond 2 terms? How do you then prevent the incumbent from using that to their advantage to stay in office?
Jeebus, I can’t believe I’m actually saying this, but dems the times we live in I guess.
I vote third parties. Blank counts as don't care, while a third party says I care and not you. When third parties get votes the majors pay attention less those third parties win.
I often am blank on things where I cannot find any information and so cannot have an imformed vote.
...which does just about as much as voting (that is, precious little).
If we're ever going to claw ourselves out of this (or any) mess, we need ranked choice or something like it. The giant douche / turd sandwich dichotomy needs to end, for everyone on any side of the political spectrum.
No matter what system of voting we use, unless we go back to only white landowning men can vote or something (doubt we want to do that), you can’t avoid the fact that 160 million+ people vote together for President.
The most viable solution looks less like changing to ranked choice and more like returning more governing power to lower levels of government (state and local) where there is less competition
Wait, though. It's not that there are too many voters. It's that the system of voting we use doesn't connect the vox populi to the means of social control.
If you're given the choice between two bad options, you aren't really given the choice. There's massive cross-aisle support for a lot of things (proper healthcare, more support for working families, lower inflation, holding the banks to some kind of standard, reducing corruption, etc.) that we could actually move the needle on if our votes mattered, but because the two parties have us between a rock (whoever we identify as our party) and a hard place (whoever the other guys are) it doesn't really matter who we vote for.
Now, I'm willing to concede that what you're talking about might be a thing, but there's really no way to know until we actually fix what we have and see if that becomes a problem. We've never really tried what we're supposed to have in the modern era.
Frankly, I'd like to see some format of direct democracy rather than representative. Always seemed a little like an obvious grift to me.
If you want to change the way voting works in the US (and oh boy do I), you first must win an election in the current system to gain enough power to do that.
So many american leftists just seem to ignore that and it makes things very difficult.
Not quite so, ballot initiatives are actually the best bet. They've been successful in local politics primarily so far, but the initial results are promising (1).
You're right, that the closer you get to that core of federal power the more resistance you come up against, but once there's a powerful enough popular groundswell (that is I suppose, and if and not a when) you can move to mass protests, general strikes, guillotines, etc. This is why it's important to talk about, esp. around those who don't really know about it yet.
> You could consider spoiling your ballot instead?
No. Either vote for one of the third party candidates (doesn't much matter which one), or vote write-in for a fictional character or "none of the above" or something.
Ballots are generally counted as long as they're legible. Voters aren't required to pick a candidate in every race, they can leave some blank. And in most states there were third party candidates listed as well.
> In a critical commentary, the co-editors-in-chief of the journal BMJ Quality & Safety wrote that the paper’s “headline-friendly” mortality rate — which was 10 times the rate suggested by prior studies — was so implausible that it risked undermining confidence in the entire field of patient safety research.
> Yet the notion that medical errors are the third leading cause of death persists. It’s trumpeted by patient safety advocates and trial attorneys, and became a line on a TV show. News stories continue to cite it.
Which academic has it right? The study you shared is critical of the sources used in the first, but also provides no new data sources. It’s simply skeptical about the rates.
Malpractice law is complex and time consuming. Determining it to be a cause or contributor to a death isn't quite like going "yup, that's pneumonia". Studies are what we use to estimate it, and this one was a big outlier.
Causality itself is a complex philosophical topic. I agree it probably can’t be established.
That’s why death reportings tend to use “died with X”. I understand that there is a sensitivity to ascribe liability or fault. But if someone dies in recovery from a surgery, or worse under anesthesia, that seems like something that could be identified and reported.
> But if someone dies to recovery form a surgery, or worse from anesthesia, that seems like something that could be identified and reported.
We do (for example: https://www.cdc.gov/healthcare-associated-infections/index.h...), but there's significant difference between "malpractice" and "died due to surgical/anesthesia complications". Perfectly administered anesthesia is still risky, which is why we don't give it for, say, mole removal.
Probably because you could die from medical malpractice tomorrow but the final determination will take many years to resolve in the courts. Is there much value in going back and revising a number of deaths from 2019? Maybe. If the numbers are large enough or reflect a pattern that could be corrected/improved. More likely is there is nothing actionable there.
The implication is that the scientific and medical communities rely on infrastructure built and maintained by the scientific and medical communities to communicate and coordinate.
The general media consumes sources like this, obviously.
Doctors read bulletins like this so they're aware of what's going around and it can inform their clinical practice.
I’m sure the geniuses at the neighboring health authorities are perfectly capable of monitoring nearby conditions without falling back on federal intervention.
How is it that Trump is so timely at cutting medical resources right before the moment it is most needed? Or perhaps such outbreaks are more common than you'd expect and it's the equivalent of leaving a firewall down for a day?
And yeah, I'm aware a bigger factor in this freeze was hiding the very obvious Bird Flu pandemic. Can't hide the eggs getting more expensive though.
Indeed. I'm just also find it interesting how timely some of his actions can immediately blow up on us.
And yes. It really doesn't matter in the grand scheme of things but was such a common rationale for those who voted Trump. I'm shocked that he did not in fact keep a promise thst would have benefitted the working class.
I think they’ve muddled a few things together and are in part referring to the disbanding of the NSC’s Directorate of Global Health Security and Biodefense as part of John Bolton’s NSC reorg.
I don't know if any of these would count as being significantly sized, but Japan, Australia, and South Korea handled it a lot better than the US [1] when it comes to deaths per 100k. Interestingly, Australia and South Korea did have more cases per 100k than the US[2].
The Australian cases would largely have been after the vaccine was available, I think (though Australia did screw up the rollout; they could’ve done better there) so you’d expect a lower death rate.
An interesting thing to look at is the differences between European countries differing responses and how that worked out for them given many are connected via land borders.
I can show multiple videos up to the end of Feb 2020 where Anthony Fauci said this wasn’t something to be too worried about, it was going to probably remain under control…
I went skiing in Korea during the next to last weekend of Feb 2020. Best skiing of my time there, because the mountain was already empty of people due to public concern. By that time we were already wearing N95 masks: I remember discovering it was very hard to talk with both a ski mask and an N95 on.
By mid Feb, Korea was already covertly acquiring mask materials and preparing a ramp up in testing. I believe we had working PCR tests in my local hospital by mid March, and mask rationing in April. This made me very skeptical of the competence of the US public health establishment.
I hit the paywall. But if this is about the same thing I’m thinking of, one reason to be careful about the work China’s CDC was doing (at times with visiting staff from the US) is they were one (among many) source of lab leaks of SARSv1:
Don't let perfect be the enemy of good. No country avoided it entirely, but a lot of them managed to get rid of at least half the deaths (keep in mind that that's with still with individuals people being rebellious), sometimes more.
Excess mortality per capita is the useful number to look at, since it's immune to scaling problems and the "but diagnosis!" argument. Although it may include "too scared to go to the doctor", that can't be too much of a contribution since that contribution shouldn't spike so much. Let's look at some numbers, smearing the spikes:
* in 2020-2021, South Korea's and Japan's excess death rate hovers below 5%
* in 2020-2021, Canada's, France's, and Germany's excess death rate hovers around 10%
* in 2020-2021, the US's excess death rate hovers around 20%
* in 2020-2021, Spain and the UK have spikes so high (but narrow) that I'm not even going to try to average it out. I would guess they're somewhere near the US for 2020 but better in 2021.
* in 2022, South Korea finally had a bad spike, but averaged over the year it's still only maybe 20%.
* in 2022, in almost all countries it hovers around 10%, and the timing of the swings is very similar between countries
* in 2023, in all countries it hovers around 5%
Source: first chart of https://ourworldindata.org/excess-mortality-covid ; I've done the calculus by eye with rounding since I don't want to look up billions of numbers to do the math the hard way.
(Frankly, Korea and Japan did even better than these numbers say, since their population is skewed elderly in the first place)
The team that contained SARSv1? No one contained it successfully. In fact, there were many lab leaks of it. The outbreak itself was stopped by basic measures like masks and screening. But it also was far less infectious than SARSv2.
Blaming Trump for COVID-19 makes no sense for other reasons too. There are so many other people to blame first. Fauci for funding GoF research at WIV through EHA. The CCP for being secretive and denying there was an outbreak for a while and not allowing investigations in Wuhan for over a year. The WHO for repeating CCP propaganda like claiming there was no human to human transmission roughly fourth months after the first scientists fell ill at WIV. Do you remember Pelosi and democrats downplaying the pandemic and accusing those who wanted to close borders of racism? She apparently had no regrets about all that:
With all of this how can blame be placed on Trump? If anything his Operation Warp Speed program bailed out the planet from pandemic (with great work from vaccine manufacturers of course).
You left out how conservative media was adamant that it was a politically motivated hoax and ensured their faithful were kept in the dark about the looming threat.
Last week it was still the job of the previous administration to publish it and it was the last administration which created the problem in the first place. Ideological purification was also what the previous administration has done quite a lot by hiring people based on their sexual preference, skin colour, gender and other irrelevant to the job characteristics.
I wonder if we’d do better in discourse to stop pointing at an “administration.” It is a reflection of what a plurality, often majority, of people want.
It does make ones eyes glaze over when American politics is everywhere you look. In every thread, about every topic. And each comment thread has 50 highly emotional comments that you have to scroll through to find the 5 few thoughtful comments near the bottom discussing the article, without going off the rails.
Look at the top thread with 50 comments and count how many are discussing tuberculosis in America. It's just another starting off point for everyone to go in a hundred directions ranting about US politics and ignore the topic
The thread is about a tuberculosis outbreak in the US. Subsequent comments include conversations about a US federal government department agency publishing (or not) data on that outbreak.
This is all taking place on an online forum hosted in the US and managed by US entities.
And you (and like minded individuals) expect to not see US politics?
I appreciate that the US has an outsized presence on the intertubez, but you also need to realize you're first of all talking in the midst of Americans.
The ones that were published in the weeks prior to the current administration weren't talking about the Kansas tuberculosis outbreak either.
So we're not really discussing the "US federal government department agency publishing (or not) data on that outbreak." Someone's implying that's what happened, and then people are spinning off into political discussions without even looking into the link they provided to see if that was actually the case.
It's not just going off topic to discuss politics. People are actively spreading misinformation to justify going off topic to discuss politics, and lots of other people are joining in without bothering to check if what was claimed is actually true. Two-thirds of the comments now are using the claims about the MMWR to discuss politics, and it doesn't look like anyone actually looked at the MMWR to see what it actually is.
I at least didn't read any of the links because I couldn't care less beyond seeing what everyone was talking about in a thread about tuberculosis in the US.
My point still stands that if someone doesn't want to see conversations regarding the US, politics or otherwise, maybe he should stay out of threads regarding the US and maybe also find other forums not hosted in America and managed by Americans where the vast majority of participants will be Americans.
It's like taking a trip to Mars and complaining that all the dirt is red, y'know?
Online communities need constant self checking and introspection to not go off the deepend. This isn’t like Reddit where you can unsubscribe from the crazy big politics subreddits or unfollow people on Twitter. I still think the old ideal of HN where we have some higher goal than yet another US political rant forum is still worth fighting for.
> I couldn't care less beyond seeing what everyone was talking about in a thread about tuberculosis in the US.
I was interested in the issue in Kansas because I read the article. 66 people almost entirely in 2 counties isn’t exactly a national statistics collection issue
This is HN and I'm sure there are all kinds of filters people have made as add-ons if news like this truly bothers you. Users here are more than likely to make their own as well. You can also always reach out to Dang for feature requests. I'm never going to not want more flexibility in my newsfeed.
>. 66 people almost entirely in 2 counties isn’t exactly a national statistics collection issue
Patient zero starts somewhere. It's not national news per se when a few individuals die of an unidentified disease either.
Meh I don’t need 3rd party plugins, I spent years using them on HN and my iPhone doesn’t have browser plugins.
I don’t care enough anyway I just use HN less and less every year like all the old userbase. The only old usernames I recognize at the top of threads these days are the ones who like the politics stuff (I could list at least 4-5). Just my own nostalgia for a dying small community of thoughtful nerds.
I'm sorry to hear that but it seems that's simply a natural part of the internet. Even 4 Chan was susceptible to this cultural shift and it seems the whole point was the gatekeep as much as possible.
>This isn’t like Reddit where you can unsubscribe from the crazy big politics subreddits or unfollow people on Twitter.
Sure it is. This is the internet, Hacker News is just one website someone could choose not to patronize among countless others.
If you don't want to see US centric conversations, don't patronize American websites like Hacker News and certainly centralized American services like Reddit or X.
Around 20% of Americans voted Trump, and from polls most don’t like him, but always vote R. Die hard Trumpers are at best 10% of Americans. Trump didn’t even get 50% of the vote.
His views most certainly aren’t what a majority of people want, and he doesn’t try to expand by doing things the majority want. If anything he paints those not completely in his camp, which is the vast majority of Americans, as an enemy.
> His views most certainly aren’t what a majority of people want
I'm not sure what you gain by telling yourself that.
I could just as easily assert, without any evidence (i.e., like you), that every single person who didn't vote loves Trump and supports all his policies.
> If anything he paints those not completely in his camp, which is the vast majority of Americans, as an enemy.
That has nothing to do with whether people support him. 20 or more (exact number varies on the reporting) women say that he sexually assaulted them, he was convicted of one sexual assault, and yet white women still voted for him.
Experiments consistently and repeatedly show that when given practical descriptions of policy actions and outcomes, the majority of Americans do not choose the ones that republicans promote. BUT when told that they are Republican policies, then about half of Americans do support those policies.
Well then, liberal politicians aren't doing a very good job, are they?
This is like a cliche from the chess world, where the guy who lost the game, then does a postmortem to convince everyone that he was actually winning the whole time. "Except for that one little blunder."
The Dems keep losing losing losing, but rather than figure out how to fight better, you instead try to convince yourself that people support you. And then you go back to debating Israel v Palestine or trans pronouns while our own country descends into tyranny. (Literally - many progressives I know.)
Meanwhile, Trump owns the White House, both houses of Congress, and the Supreme Court!
The only lesson I get is that the segregation of education over 40-50 years or so is finally showing its consequences (well it did so 20 years ago. But it's only more polarized now). A chess player at least has the knowledge and willingness to improve and learn from lost matches. The average American... Not so much.
And you didn't really offer much feedback here. Which is part of the problems. I don't really care to bicker over single issue details like this.
If 80% of Americans didn't vote Trump, you're trying to claim they just as likely love him as those who did, even when polling of those voting for him show many dislike him?
Yeah, I'm not the one unable to read evidence.
Polls also repeatedly show people dislike a large amount of his policies.
And it's a fact he didn't even get 50% of voters to vote for him.
How can someone who couldn't be bothered to vote possibly count in a discussion of how many people support this administration? Putting aside people who were unable to vote, everyone who chose not to, absolutely 100% gave up their relevance in terms of what the people want. They took themselves out of the equation.
It doesn't matter if they did or not. If they supported Trump they would have voted. Ergo the majority of people don't support him. Non voters are still people, last I checked.
Definitely, which is why it's important to identify when politicians put the American public at risk like this. The connections between random high-level government actions don't easily map to real world outcomes for most people.
For sure. What I meant to articulate was that the admin is the only one it makes sense to point to. Saying "the electorate is stupid!" has no utility other than catharsis, though.
More accurate to say "people are selfish" if you want slightly less charged language. The common sentiment I hear is "I was doing better in 2020 than I was in 2024" and that was all the impotous to make people vote "not Biden".
That mindset makes sense on a surface level. So it's not stupidity. But the lack of introspection on if Biden made things worse or simply stopped things from getting much much worse was definitely not taken into account.
I'd personally call it stupidity. But it doesn't mean people are stupid overall.
I think it's incorrect to say "this is what the plurality wanted". I think very few, if any, Trump voters thought "Trump will be worse for public health and tuberculosis is something I want more of in America."
>I think it's fair to say a lot of Trump's apologists and defenders really did not understand the ramifications of his first presidency, and are not in a position to clearly anticipate the ramifications of his second presidency.
Speaking as one Trump voter among many others, I knew exactly what he accomplished in his first term and what a hypothetical second term could look like. I also understood what his campaign platform and promises were and by and large I support them, including significantly reducing the federal government overall across the board.
What we are seeing now with January 6 and pro-life pardons among other pardons, the new United States DOGE Service, exits from Paris Agreement and WHO, mass deportations of illegal aliens and securing of the southern border, tariffs on imports and especially on countries who aren't amicable, removal of DEI and other equity-based programmes from the federal government with extreme prejudice, among many many other policies and mandates are all things I expected and wanted to see when I voted for Trump.
No doubt there are voters who voted Trump simply along party lines or other reasons, but just as much are voters who gave the election some thought and voted Trump.
If you don't agree with me then that's unfortunate, but my vote isn't yours.
I clealrly disagree with a lot of your viewpoints. But I need to laser down on fhis:
>What we are seeing now with January pardons
Why do you expect and want to see this? What about that event resonated with you that you'd excuse those people? I expected this to be a bi+partisan shame on the country, so I just do not see the angle here.
Thank you. I expectedly disagree, but there's no point in arguing. I simply don't get much chance in this atmosphere to get well thought out answers contrary to my own views.
I'll just say this:
>correct this significant, and as far as I'm aware unprecedented, abuse of the judiciary and he delivered on that promise.
This is extremely common because "speedy" was simply never defined. Taking months over minor non-violent crimes like drug usage as an example. Given the chaos in identifying all suspects (IIRC they were never all fully discovered, an atrocity in and of itself in our police system), I'm not too surprised it took years to try everyone caught.
No one's probably chomping at the bit to re-define "speedy" better:
>a trial conducted according to prevailing rules and procedures that takes place without unreasonable or undue delay or within a statutory period.
but I think we both agree this is a very vauge, insufficient definition.
>Thank you. I expectedly disagree, but there's no point in arguing. I simply don't get much chance in this atmosphere to get well thought out answers contrary to my own views.
I also appreciate that we can have a peaceful, friendly, normal conversation about this unlike how these things would usually transpire up until just recently, so thanks.
To be charged with a crime signals the beginning of a trial, a conviction signals the conclusion of a trial with a guilty verdict.
From an archived DoJ page[1] at the year 3 (January 2024) mark, ~1200 defendants were charged and 171 were convicted (32 without a trial). 749 were sentenced in total.
So that's presumably still more than several hundred defendants waiting for what should be a speedy trial.
Again, that is not how we should operate in this country. If you accuse (charge) someone of a crime their trial should be brought as swiftly as possible as mandated by the Constitution. That this was not done is by itself enough cause to pardon them, let alone the exaggeration of the charges presented.
Also, to close things out:
>The 'back the blue' and 'tough on crime' party is a total farce.
Trump and Republicans enjoyed and continue to enjoy the approval and cooperation of law enforcement agencies across the country both before and after the pardons were issued.
> From an archived DoJ page[1] at the year 3 (January 2024) mark, ~1200 defendants were charged and 171 were convicted (32 without a trial). 749 were sentenced in total.
The number sentenced cannot be higher than the number convicted (and the source document, unlike your summary, does not make that impossible claim), since sentencing requires conviction.
> So that's presumably more than several hundred defendants waiting for what should be a speedy trial.
Many of them were charged substantially after the event, “Speedy trial” refers to the time from charging to trial (the time from event to charges is governed by statute of limitations, not speedy trial rights.)
I disagree in part with Trump's idea of Palestinians moving out of Gaza to Egypt and Jordan, not the least because it's violence incarnate. It's akin to the Trail of Tears[1] which was one of the most shameful bits of our history.
Now, why do I say in part? Because I am also appreciative of the sad reality that peace in the Holy Land simply is not possible with more than one sovereign state in it. It simply isn't, there are so many peoples who would kill and die over that piece of land that any multi-state arrangement is practically impossible. I don't care if it ends up being Israel or Palestine or some other country or entity ultimately in charge of the Holy Land, but it's inevitably going to be one and the path to get there will not be pretty.
I also find Trump's executive order on delaying the banning of TikTok legally (IANAL) dubious. His reasoning is that his administration hasn't had enough time to understand it and thus sufficiently execute the law as written, but the law doesn't provide for such an out. The courts can have their say if it comes to that.
As a Japanese(-American), Trump's seemingly apathetic position on Japan is somewhat concerning. However, the Japanese government also has its share of blame to take. Consolation is that Trump has been very cordial with the wife of the late Shinzo Abe and also Softbank CEO Masayoshi Son, which means he at least has some level of care for Japan, and it's not like US-Japan relations would go completely sour anyway.
By and large though, I am satisfied and happy with what Trump has done and accomplished so far. I voted for this and I still stand by my vote. Let's Make America Great Again, any friends and allies who want to tag along are very welcome.
I saw that, and that wasn't a "Nazi salute". Any and all publications and pundits/influencers declaring it as such are wholly disingenuous and should be ashamed of themselves. The sensationalizing was a textbook example of taking things out of context and projecting your(the Left's) own biases.
If you can't understand that, let me put it in simpler terms: That was a "My heart goes out to you!" salute and I am happy for Musk for being happy that we the American people won the election against all odds.
“The Party told you to reject the evidence of your eyes and ears. It was their final, most essential command.”
― George Orwell, 1984
One thing you could do to see what other people think the same is to video yourself doing this exact motion, then send it to your co workers telling them your heart goes out to them.
Many other people including many prominent Democrats[1] have also performed similar gestures in the past, granted while saying different things than "my heart goes out to you".
So no, that is not a Nazi salute unless you are going to be fair and count all such gestures from everyone as Nazi salutes.
People are free to hate Musk if they want, that's their prerogative; but if they are going to be disingenuous about it I am going to call them out and lose whatever respect I might have had for them.
>“The Party told you to reject the evidence of your eyes and ears. It was their final, most essential command.”
Ironically, it is "The Party" (the Left) telling me to reject the evidence of my eyes and ears and submit to their programming that it's a Nazi salute. Fuck that noise and I hope you realize the irony of your argument.
I won't repeat the stark and damning evidence that was given to you by dragonwriter that these claims are not only obviously false but seem like a desperate attempt to ignore the truth, which is that this is a nazi sieg heil salute being done forcefully and intentionally.
I'll repeat the question you didn't answer - are you comfortable doing this exact motion on video and sending it to your coworkers, family and friends? Do you think there might be fallout or repercussions?
I'll ask another question. Is there anything that he could have been done differently to make it more like a sieg heil? To me, it looks identical. What is missing that would in your mind make it a nazi salute?
Finally, if you did come to the conclusion that this was a nazi salute by the richest man on the planet at a political rally seen by the entire world, would that change anything for you personally?
>are you comfortable doing this exact motion on video and sending it to your coworkers, family and friends?
Sure, why wouldn't I? I'm not fucking Hitler and anyone worth caring about knows that.
>Do you think there might be fallout or repercussions?
No, other than from people looking to deliberately cause problems where there are none.
>Is there anything that he could have been done differently to make it more like a sieg heil? To me, it looks identical. What is missing that would in your mind make it a nazi salute?
Actually think, speak, and act like an actual Nazi.
>if you did come to the conclusion that this was a nazi salute by the richest man on the planet at a political rally seen by the entire world, would that change anything for you personally?
If I thought of this as a Nazi salute that also means he was doing many other things to demonstrate he's a Nazi, so no: Nothing in my thought process would change.
Proper judgments of a man's character are made over a sufficiently long period of time, one singular act isn't going to move the needle in a significant direction one way or another.
If I thought Musk was a Nazi now then I would have come to the conclusion he is a Nazi a long time ago (and to be clear we are speaking in your hypothetical scenario).
So even though Elon Musk went to a rally for the far right party in germany on january 9th, talked about immigration, hitler, said germans need to get over their nazi guilt, and encouraged people to vote for the 'far right' party, then gave a nazi salute in front of the world 11 days later, because you decided he wasn't a nazi a long time ago, he must not be now?
Do you have a description of what kind of evidence would convince you someone is a modern nazi or 'poor character'?
>the far right party in germany on january 9th, talked about immigration,
Yeah, being against rampant immigration(?) is a very Nazi stance. Sure.
Naw. There's nothing Nazi about wanting to control or restrict who comes into your country; entering a country as a foreigner is a privilege, not a right.
As an aside, efforts to exclude AfD from elections is what is actually Nazi about German goings on. It's not really my place to speak about Germany's domestic affairs as an American, but if you want my honest opinion the German Left is projecting on the Right with authoritarian fury.
>said germans need to get over their nazi guilt,
Speaking as a Japanese, in my opinion Germans should indeed get over their Nazi guilt. History should never be forgotten and the lessons should be taught and remembered, but to drag that guilt across generations is ridiculous. Children are not responsible for the sins of their parents, let alone farther back.
Japan needs to get over Imperial Japan guilt and be proud about being Japanese again too; Japan's case isn't quite as bad as Germany's but there's still a ways to go.
>Do you have a description of what kind of evidence would convince you someone is a modern nazi or 'poor character'?
There are many, some that come to mind include:
* Support racism. Hitler was big on elevating what he called Aryans as the One True Race and exterminating Jews with extreme prejudice.
Musk (and Trump, Republicans, as well as most sensible Americans for that matter) advocate for meritocracy, judging people by their character and capabilities without regard to race or other immutable traits because All Men Are Created Equal.
* Advocate for cruel and unusual punishment. The Nazis used gas chambers and other torturous and humiliating methods of maiming and killing.
Literally noone here in America wants that shit, and those who do are rightfully shamed into oblivion (see: Guantanamo, et al.)
* Advocate for and engage in regulation of speech and thought. The Nazis are a textbook on how to control a population to their bidding, even the Soviets drew lessons from them.
Musk has his share of hypocrisy (why aren't you picking those to criticize him over?), but fundamentally he argues and acts for free speech. Likewise Trump and most Republicans, and certainly any American who understands and respects the Constitution. Some Nazis they/we are.
* Gathering and centralizing absolute power.
Musk's job in Federal government is on a strict and temporary schedule set to expire in July 2026, and he doesn't even have any actual authority. That's not a Nazi, let alone a Fuhrer. Likewise Trump who has consistently advocated for States' rights and reducing the Federal government especially the Executive Branch, and Republicans who have always spoken as the party of small government (whether they are is a different matter).
Citing Nazi ideology without invoking Godwin's Law requires actual, real Nazis to be the subject of debate. Please stop calling everyone and everything you don't like Nazis at the first opportunity, you don't realize how hard you are shooting yourself in the foot by doing so.
> Musk has his share of hypocrisy (why aren't you picking those to criticize him over?)
Because I'm not trying to criticize Elon Musk here, I'm trying to understand the cognitive dissonance between seeing two picture perfect sieg heils back to back and denying that that's what happened.
It seems like you agree that the motion is identical, but you are saying that it is a sieg heil but not a 'nazi salute' because elon musk "does not" support racism, advocate for cruelty, regulate speech, or centralize power.
>Because I'm not trying to criticize Elon Musk here,
But you (and others like-minded) are. You're latching on to a Nazi salute you've projected onto him and trying to use it as the point of criticism. You yourself just admitted you "see [a] perfect sieg heil", even.
>It seems like you agree that the motion is identical, but you are saying that it is a sieg heil but not a 'nazi salute'
He did it while shouting "My heart goes out to you!" to the crowd, so it's not a "sieg heil" either. If he's saluting anyone/thing at all, he's saluting the people and the spirit of America.
I couldn't care less if it's identical, though if you really want my honest opinion on judging that: I wouldn't think of Adolf Hitler as the first thing; then again I don't have my mind in the proverbial Progressive gutter either.
>elon musk "does not" support racism, advocate for cruelty, regulate speech, or centralize power.
Yeah, or to rephrase: In what ways is Elon Musk a Nazi? In the true, real, proper sense of the term "Nazi". Not the dirty word "Nazi" that gets thrown around like candy on disagreeables.
What I think you need to ask yourself is: Why is "Nazi!" the first thing that comes to your mind and is that really justifiable?
You're quite welcome to hate Musk if you want to, I have no problem with that and Musk can defend himself if he feels the need. I couldn't care less. But I am concerned for your mental health if you need to scream Nazi allegations to justify it.
> Many other people including many prominent Democrats have also performed similar gestures in the past
Every time someone tries to support this they use stills, and when you pull the video of the events, its clear that—unlile Musk—while there may be similarity of hand position at one point, the actual gesture (which is a movement, not just a momentary position) is not the “Roman”/fascist/Nazi salute, while Musk's is exactly that salute.
>Every time someone tries to support this they use stills
Considering the vast majority of the hit pieces use stills of Musk, onus is on them.
>while Musk's is exactly that salute.
You can make practically anything into Nazi hate speech if you drill down hard enough putting any and all inconvenient factors aside.
There's plenty of valid shit to criticize Musk for, but if you're going to evoke Godwin's Law[1] or Reductio ad Hitlerum[2] to justify your distaste for him then I'm going to roll my eyes and move on. That shit didn't work before and it certainly isn't going to work now.
Yeah, that ain't a Nazi salute unless you hate Musk so much that anything he does is Nazism without regard.
I reiterate: Evoking Godwin's Law or Reductio ad Hitlerum is not going to work.
It didn't work when Harris called Trump a fascist, nor all the times before that, and it won't work now either. It defies context and it's not even funny let alone accurate.
What would it take for you to consider something to be a Nazi salute?
In the first video all the gestures from all the people are so similar that if they had been wearing motion capture suits and you gave any random person that motion capture data and asked them to pick out which one was not a Nazi salute they would do no better than chance.
>What would it take for you to consider something to be a Nazi salute?
The guy doing it would need to be an actual Nazi, for starters. Musk is many things and avenues of criticizing him are plentiful, but a Nazi in the real sense he is not.
People call Musk (and many many others) a "Nazi" simply because they hate him without paying regard to what a Nazi even is. Nazi is a dirty word, you call someone a dirty word to hate on him. It's all meaningless, and even worse the overuse of Nazi in this manner dilutes its meaning that most people eventually stop caring being called one.
Even symbols like the Iron Cross and Jerusalem Cross that have nothing to do with Nazism are labeled Nazi symbols, again diluting the value of calling someone or something a Nazi.
Stop calling everyone and everything you hate or even just slightly disagree with a Nazi. Seriously. It only signals a surrendering of thought given to any better arguments for your cause (Godwin's Law) and alienates you from everyone outside your small echo chamber. The worst chain of events is that if this keeps up, we absolutely will see actual Nazis come into positions of power and nobody will care because the boy cried wolf far too many fucking times.
1. Is there an argument here that the CDC's Morbidity and Mortality Weekly Report's unbroken publication record is so important it should switch votes?
2. They probably still filled the report in, so there is a chance it eventually gets published. No need to abandon hope yet.
Yes there's an argument that "having vs not-having functional contagious disease surveillance, alerting, and learning systems" can change political outcomes.
The BCG vaccine is not protective against tuberculosis in adults. It helps prevent miliary tuberculosis in children.
I did my graduate work on tuberculosis. Those of us who weren't vaccinated because of our country of origin refused to be because the vaccine wouldn't help us and it changes testing for TB from a quick skin test to a lung x-ray.
It's not barbaric or corrupt or anti-vaccine in this case. It's details of this particular vaccine.
> TB continues to be one of the major public health threats. BCG is the only available vaccine against TB and confers significant protection against the childhood disease. However, the protective efficacy of BCG against adult pulmonary TB, which represents a larger burden of disease, is highly variable.
Fun historical incident, but the "Spanish Flu" was traced back to Fort Riley Kansas. I think some people highlight a specific pig farm even.
Now, the CDC do not list any infections of H1N5 in Kansas yet, but... Worth looking out for in anticipation maybe?
Is there any reason why Kansas would be different than other states in particular?
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