Vegans have an interesting view of the plant-animal divide. I don’t like it.
Mimosa pudica flower from Thrissur, Kerala, India CC BY-SA 4.0
So, I found an interesting photo of a tawny frogmouth. Found in Australia, it’s a bird that looks a lot like an owl, but it’s not one. It’s just an example of parallel evolution. It looked perfect for a skeptical meme, but I felt like it was important to include the attribution, especially since it was under a license that required it. So here’s the info. Hopefully the QR code works. I’ll update this page accordingly.
License: CC-BY 4.0
Most people think of homes as physical places. But a home can be a lot more than that. A home is every bit as much a product of who as it is where and what. Here are three definitions of “home” provided by Merriam-Webster:
Virtual communities, like those that form around massively multiplayer online games, are homes for many people. No, we don’t physically live in these virtual worlds, but many view those with whom they interact in these worlds to be family, and they are absolutely familiar and usual settings.
Online gaming communities are so interesting that there are entire anthropology papers which are dedicated to the topic. Back in 2014, Sonja Sapach wrote an interesting discussion on the challenges of doing ethnographic research in virtual worlds (Sapach 2014). Her research focused on sacred spaces within the virtual world. While there are plenty of sacred spaces that we might consider on a regular basis, such as churches, monuments to fallen military or those who died under terrible circumstances, such as the 9/11 memorial, it might come as a shock that we can look at sacred spaces in online communities, but it just shows how much of an impact these communities can have.
I’m a huge fan of MMOs, though I don’t play them that often. It was actually pretty late that I got into WoW at all, and even then it wasn’t official WoW, but rather a vanilla server that I frequented. Specifically, I spent a lot of time on Nostalrius Begins. WoW has gone through many iterations. Vanilla WoW is the original unaltered version of the game. And a lot of people were nostalgic for it. Blizzard didn’t support vanilla WoW, so Nostalrius came along and made things happen.
The server had a huge following. People spent a lot of time playing, and the server became a massive collection of communities. It became a home for many. A video of the final minutes of the server show just how much interest there was in the platform.
For many, Nostalrius was more than just a game. It was a place from memory. It was a place to which people wanted to return. It was a home. And I honestly don’t think that’s a problem. Sure, it can be an issue if people stop working and just spend all their time gaming, but then again, it’s a problem if someone just wants to stay at home rather than make a living too. We need to be productive in our lives. We can’t just spend our days at home. And even if we can redefine “work” and monetize gaming, we still have to do something.
The “addiction” that some people might experience with online gaming is very much an indication of how much of a home these communities can be. A home is a place of comfort. And when we’re comfortable, we don’t want to leave that comfort zone. Will Greenwald said it well, in his “Anatomy of MMO addiction.”
It’s easy to give up on single-player games after a while because you run out of things to do. Even in normal multiplayer games, you can turn them off after a while when everyone’s tired and doesn’t want to protect the base/capture the flag/kill each other anymore. A big enough MMO guild can ensure that there will always be a handful of friends online and ready to adventure with you, no matter what time it is. These friends make it all the more difficult to stop playing, whether it’s for the night to get some sleep, or forever because you don’t want to pay the monthly fee anymore.
Leaving an MMO is not leaving a game. It is leaving a community. It is every bit as much like moving away from home, separating oneself from friends and family. Even if it is often better for us to move on and make a new home for ourselves, it can be difficult, because it’s home. And that’s what these MMOs are.
Do you have an online community that you call home? Do you know someone who does?
Note: This article was written because of a short discussion that I had with Mathabatha Sexwale, in response to his discussion on creating a home. More and more I think that we will start to see these virtual worlds, regardless of whether they’re games or other virtual communities, as more than just a place to kill time, but rather a place to call home, a place where our friends are, a place where we feel safe and can express ourselves.
The post Online Communities and Massive Multiplayer Online Games as Homes appeared first on The Spiritual Anthropologist.
Sanitation, vaccines, control of various environmental factors that affect health, and much more have greatly improved our quality of life and our average lifespan. But while public health practice has come a long way, there are still numerous areas of improvement. Not only must public health practice improve in terms of communication with the public, but we must also work on improving how quickly scientific knowledge is used to update public health practice. Additionally, public health policy involving zoonotic disease (diseases which are contracted from animals) and protection of the health of livestock and pets, also requires serious attention.
The antivax movement, the push for homeopathy, and great deal of other pseudoscientific movements are hurting public health practice. While there’s still lot that we do not know about recent outbreaks of various diseases such as measles and whooping cough, medical science absolutely justifies the use of vaccines in the prevention of dangerous symptoms associated with these diseases. Meanwhile, the link between vaccines and autism has long since been debunked, and yet a large portion of the population still believes in it.
Furthermore, a number of people are choosing to forgo “traditional” medicine and instead use homeopathic treatment. Unfortunately, based on systematic review of available literature, there is no indication that homeopathy works any better than a placebo. There is also no scientific justification for a mechanism through which it should work. Homeopathy literally has every trace of active ingredient diluted out of the product, to the point where a person is just consuming a sugar pill. While the placebo effect can be a powerful medicine in and of itself, it is not a substitute for recognized gold standards of care.
Better science communication, and better education in philosophy, both should improve individual understanding of how science works and acceptance of standard medical treatments. However, there are still other issues. There are cases where our standard of care is outdated.
One of the greatest concerns with public health practice is that it takes a very long time for new scientific evidence to become part of the public health practice. One estimate places the lag time between findings and implementation at 17 years.
Unfortunately, in order to alter public health practice, we need to have more than just a single investigation indicating efficacy. Public health practice relies heavily on systematic reviews. There are two options for systematic reviews. A systematic review can periodically be conducted to see if there’s additional information available. This option is the traditional route. Alternatively, a systematic review can be ongoing, where data is added at regular intervals and the conclusion is reevaluated.
This process is called a living systematic review. This option is fairly new. As of 2017, protocols for the process were still being developed. Elliott JH et al. 2017 discusses the importance of living systematic reviews (LVRs), and suggests that they may be most useful when there’s a lot of new research being done on a topic, when there’s still a lot that we don’t know about the topic, and when new information might change current protocol.
Unfortunately maintaining trust is going to be difficult even if we can update our protocols more quickly. Long standing recommendations being overturned can be problematic because people may wonder why it took so long for the medical community to realize their mistake. Meanwhile constantly changing recommendations to fit new data could establish a view that the medical community is fickle.
People may also become even more confused about what to do for proper health. While this issue isn’t as problematic for people who regularly see a doctor for checkups, some don’t, and current medical recommendations do not actually suggest that they are necessary. This lack of necessity is likely to change if public health policy is updated on a more regular basis though, so this factor needs to be taken into consideration.
Even with living systematic reviews, new research needs to be conducted and we need to communicate limitations of existing research. One of the issues that prevents public health policy, and science as a whole, from being as up to date as possible, and evolving at a fast enough pace, is a failure to communicate. I have written numerous papers on concerns about current medical science practices and limitations of our understanding. These papers are not research papers in the normal sense. They fellow what I call the “call to action format.”
Most of my focus has been on vaccines. I’ve written on the issue with understanding recent measles outbreaks, as well as our limited understanding of how asymptomatic infections influence Whooping Cough epidemics. While there is a lot that we know about vaccines and their efficacy, there seems to be a lot that we do not know. And these unknowns are not being discussed in enough detail or frequency to drive new research that can be used to fuel living systematic reviews.
The first half of the call to research format is similar to a systematic review, but it’s more focused. It looks for specific gaps in our understanding, and summarizes them. It might take into account personal observations by the author, as well as specific questions that they have come across. Questions may also be pulled from existing systematic reviews.
The second half of the paper is a discussion on potential theories on the matter, and studies that can be conducted. The discussion isn’t as detailed as a research proposal, but a single call to research paper could have many suggestions on types of research that can be performed. There should be at least enough detail that a person reading the paper could take the suggestion and turn it into a full research paper.
The second half of this discussion is going to focus on a different aspect of public health. A lot of Americans have pets. While these figures are old, at least as of 2006, approximately 60% of Americans had some kind of pet, according to Gallup. 44% of Americans specifically own a dog, and 29% own a cat. And almost 80% of pet owners have both a dog and a cat.
The lack of information on how many people even have pets is one example of how public health policy needs to be improve. But why is such information important? What do pets have to do with public health? We can look to an article by A. S. Deller, who wrote an interesting piece on zombies, but not quite the zombies of science fiction. Various pathogens alter the brain function of their hosts and actually create what might as well be considered zombies. One such pathogen is Toxoplasma gondii (toxoplasmosis or T. gondii). This pathogen does affect humans, but the way in which it impacts its human hosts is not well known.
According to the CDC, 11% of of the population, aged six and up, have experienced a T. gondii infection. The pathogen can be contracted from eating exposed food, but a major source of infection is zoonotic (animal) sources. While T. gondii doesn’t cause humans to become zombies and seek out cats, it does seem to have neurological effects. In humans, the pathogen seems to be associated with increased risk of psychological conditions such as schizophrenia.
The length in time that it’s taken to even realize the issue, and the lack of protocol developed to deal with it, goes back to the first half of this discussion. Public health policy isn’t being updated fast enough. But the problem also shows that we need to be hyperaware of potential threats from pets, as well as livestock.
There is work being conducted on creating a vaccine for T. gondii, but it’s far from complete. I think that there are two reasons why there is currently no vaccine. One is simply the difficulty in creating the vaccine. The other is in the failure to consider it a problem. Yes, T. gondii infects a lot of our pets, but the public health community never really considered that too much of an issue, because we didn’t consider the potential risk to humans.
But we also need to be more aware of the risks that diseases pose to our pets. We need to make sure that vaccine schedules are up to date, that they receive the right vaccines, enough vaccines, and not too much vaccines. We have a responsibility to protect our pets, because they did not choose to live with us. And therefore public health practice really should dedicate more of its attention to veterinary public health. There are programs available, including MPH-VPH programs, but the attention paid to zoonotic disease, especially risks to pets and risk from pets, simply isn’t enough.
Both the CDC and the WHO have produced recommendations for circumcision. While there isn’t enough information to create a full plan of action, recommending universal circumcision, the science is fairly solid when it comes to counting the claims of anti-circs. I use that term because in many cases, the kind of science denial seen among anti-cutters is no better than that seen among anti-vaxxers. And because of the degree of science denial, and other political issues, I’ve decided to finally write a public health article on the topic.
Why do we know that circumcision is useful? While there’s no absolute in science, there are degrees of justification. The weakest form of justification is personal experience, while the gold standard of scientific research is the double-blind, randomized, placebo-controlled trial. But such trials aren’t always possible. Moreover, in many ways there’s a higher standard. Call it the “platinum standard” if you will: in order to look at efficacy and safety of a treatment, when possible, a systematic review of all available literature should be conducted. This study is essentially a way to test the theory of whether or not there’s enough scientific information to justify a position on a research question. It is a comprehensive, and hopefully largely unbiased analysis of the entire state of the field.
Such a study has been conducted for male circumcision. Two studies of note are Singh-Grewal et al. 2005 and Morris et al. 2017. the researchers found justification for significant efficacy and limited side effects. The first paper looked only at urinary tract infections. Using a simple assumption of equal utility of benefit from treatment and harm from complication, the paper’s findings suggest that circumcision would best be limited to those at high risk of UTI, but indeed that in that sub-population, a significant benefit exists.
Morris et al. takes a broader look at the issue. The 140 journal articles that were analyzed in their systematic review indicated both immediate and long term benefits through the prevention of UTIs, phimosis, diseases caused by poor hygeine, and various STIs. The study looked at the impact of STIs among both sexes, and indicated that females too benefit from male circumcision, through the reduction in transmission of STIs. The study also conducted a risk vs benefit analysis and indicated high benefit and low risk.
One argument against the second paper is that it was written by Morris, who is a vocal supporter of circumcision. But this argument is a genetic fallacy. A paper stands on its own, regardless of who wrote it. What matters is if there is any evidence that the method of the paper itself is flawed. If we are to reject the findings of the study, simply because it was written by a staunch supporter of circumcision, then we should reject pretty much every climate change study and vaccine study, as the authors in these cases are very often associated with organizations that promote various policies related to the two. Indeed, one of the main arguments, used by anti-vaxxers, against a lot of the findings in studies is that the studies were conducted by vaccine supporters, or by or on behalf of the pharmaceutical industry or health organizations that strongly support vaccines.
From an anthropological point of view, it also doesn’t make sense that circumcision would have a net harmful effect, at least not on overall population heath and evolutionary fitness. I’ve pointed out why this condition holds, in some of my other anthropology articles. Natural selection occurs on both the biological and cultural levels. A cultural phenomenon which negatively affects the overall evolutionary fitness of a population in which it exists, tends to die out over time.
A practice which has persisted for 4,000 years is therefore unlikely to have a net negative socioeconomic effect. Indeed, while from the perspective of the people who practiced circumcision, the reason for doing it was because “god said so,” the anthropologist would say that it’s likely that groups that began the practice outperformed those who did not, and thus the practice survived and spread.
American isn’t comparable to Europe. But that won’t stop a lot of people from using the argument that Europe, with its relatively low circumcision rate, also has a relatively low rate of HIV and some other sexually transmitted diseases. The problem with making a direct comparison between these two regions is that they are simply too dissimilar. There are so many other variables that efficacy of the treatment doesn’t necessarily override other factors. For instance, the United States has poor sex education. The war on drugs and refusal to decriminalize drugs also leads to a lot of needle sharing, which spreads HIV and other STIs. Moreover, England has been transitioning to acceptance of homosexuality for a longer period of time than the United States, which allows for better treatment of HIV transmitted through homosexual activities.
Bodily autonomy is another topic of interest for this discussion. I have to admit that bodily autonomy is one of the most basic rights that we have, so violating or circumventing it should be done with caution. We need to look at a number of factors, including net benefit of the treatment, and impact on one’s life going forward. MC seems to have a limited negative impact on quality of life, with a significant benefit to personal and public health. And the argument that bodily autonomy should only be violated, when there is an immediate medical need to treat a current medical issue, also constitutes an argument against childhood vaccination. I’m honestly still a little unsure of how well I can accept any violation of bodily autonomy, but I can at least say that the argument against MC generally constitutes an argument against childhood vaccination as well. And it most certainly constitutes an argument against mandatory vaccination.
Female circumcision, often known as FGM, is the final topic that I’d like to address, as it’s often used as a straw man in my discussions on MC. It might be argued that if my argument holds for MC, it should hold for FC. And maybe it does. If systematic review of scientific literature shows limited negative impact on quality of life, with significant positive impact on personal and public health then it might be possible to argue that FC should be recommended. But FC is far less studied. A couple of studies, most of which are over a decade old, are all we have. Compare that data set to the literally hundreds of studies and multiple systematic reviews on the safety and efficacy of MC.
I wasn’t going to write this article, but I suppose it fits this month’s theme on Medium: reasonable doubt. In common parlance, “myth” is used to mean something that is false or something that people believe without justification, like an urban legend. But for a mythicist and anthropologist, like myself, that’s simply not the case. The use of the word, in this sense is in many ways very similar to how certain people use the word “theory.”
So what is a myth? Let’s get a bit more basic. What is a narrative? Wikipedia’s explanation is pretty easy to understand.
A narrative or story is a report of connected events, real or imaginary, presented in a sequence of written or spoken words, or still or moving images, or both. The word derives from the Latin verb narrare, “to tell”, which is derived from the adjective gnarus, “knowing” or “skilled”.
A myth is a type of narrative. But it’s more than just any story. It’s a story about ourselves. A myth is narrative, which is written with the intention of being truthful, which tries to establish our place in the world.
One can see now why history is a form of myth. It is written with the intention of being truthful, and its goal is to not only explain the past, but to connect the dots from the past to the present, explaining why things are the way that they are today.
History also has other components that other forms of myth don’t have. For one thing, a proper history should have a rough outline explaining how the information was transmitted from the observer to the historian, something I refer to as the genealogy of knowledge . That’s one reason why the bible is myth, but not history.
I want to reiterate that a myth doesn’t have to be true or false. That’s not the point. History is overturned with new information all the time. What’s important is that it is written with the intention of being truthful.
One of the most frequent topics in which I hear the abuse of the word “myth” is in discussions on religion. Often it’s used to demean religion and religious people — “ah those people and their Bronze Age myths” — in a way which shows one’s own ignorance of the topic.
Religion does indeed have myths, or at least, that’s one of the cultural dimensions of religion described by Ninian Smart’s seven dimensions of religion. But pretty much every culture has some form of myth, because we all like to have an idea of where we’re from. It’s all a part of trying to find order in nature.
There might be something to astrology after all, but not in a mystical sense. I’ve been thinking about writing this article for a while, but I just wasn’t sure if anyone would be interested. Some people might even take it as a defense of astrology. I’m still not sure, but after reading Martin Rezny’s review of a season two episode of The Orville, I’ve decided to at least write a short version of it, though it does deserve being turned it into a full scholarly paper, and might do so one day.
While I am one of the first to admit that the majority of astrology is pseudoscience, or at the very least protoscience, there is actually something to astrology. But it has nothing to do with the mysticism generally attributed to the practice.
It has nothing to do with the alignment of the stars or planets, or anything like that. But when you are born has a real world impact on your life. It was likely true even more so in the past. Let’s think about it. The first few years of development are very important for long term health. Malnutrition in youth, and also during gestation, can have long term consequences.
In “Fetal malnutrition and long-term outcomes,” Caroline HD Fall goes over a number of ways in which prenatal nutrition can influence long term health outcomes. And in the past, the distance between harvest season, as well as other related factors, could have a significant influence on prenatal nutrition.
The issue is that these factors are fairly local. After all, one half of the planet’s summer is the other half of the planet’s winter. But even still, it wouldn’t be surprising that, coupled with a desire to attach order to nature, that people would recognize similarities in health outcomes, and other related outcomes, based on when a person was born, and create a system which sought to improve their ability to predict the future.
These systems would also act as self fulfilling prophecies. Once people identify patters in groups of people, based on when they’re born, they’ll act in ways that will reinforce those patterns. It’s kind of like getting cursed. If you believed that you’re cursed, odds are you’ll start to make mistakes, you’ll focus on the negatives in your day, and so on. And if a person is burn in an unlucky month, and they believe it, they’ll start to be unlucky.
While some of astrology is just an attempt to impress order on an apparently unordered reality, the possible link between birth month and health outcomes may also be reinforced by evolutionary dynamics. Just like with biological systems, cultures evolve, and they are subject to natural selection. Traits which are beneficial to the culture, or at least allow the culture to persist and pass on those traits, tend to continue, while those that are harmful tend to die out. The recognition that there is a difference between health outcomes and related outcomes, by time of birth, could have helped those cultures prepare in ways that we’re not aware of.
Mary Regina Boland, Zachary Shahn, David Madigan, George Hripcsak & Nicholas P Tatonetti (2015). Birth month affects lifetime disease risk: a phenome-wide method. Journal of the American Medical Informatics Association, 22, 1042–1053.
Starting with ArXiv, the idea of preprints has been increasingly in popularity for some time. But now is the time for omniprints. Preprints were a good start. And Crossref has been indexing more and more preprints, with preprints outpacing journal articles by far (Crossref). There are a number of servers, including ArXiv and its derivatives, OSF’s preprint servers, ResearchGate, and more.
I rely exclusively on preprint servers for my publication, mostly out of spite for modern academia and its toxic nature. I absolutely refuse to pay a company so that they can profit off of my work. And honestly, if the goal of publishing is to communicate with other researchers, than traditional publications are not the answer, especially when they’re not open access.
But there’s an issue. A lot of people reject citation of preprints. They want to wait until there’s a “final” version. It’s not even that they’ll scrutinize it more heavily, but rather they will outright use the preprint nature of the paper to ignore it.
Of course, what matters isn’t whether a journal has decided to pick up an article — Wakefield taught us that—but rather what matters is that the content of the article is sound. And in order to determine whether that’s the case, a person has to read the article.
I do think that part of the problem is that the articles are called pre-prints. It’s right in the name: the article hasn’t been printed yet. It hasn’t been completed. That’s why we need to rename preprint servers, which have long since become far more than that, to something else. I’m not really sure what name we’ll end up using, but perhaps “omniprint” is the best option, as it implies “all prints” whether preprint or postprint, draft print, or final print.
Related to omniprints is the idea of open access, where a journal lets anyone access the publication. I don’t see open access as real open science. It’s certainly a start. After all, if the goal of publishing is to communicate, we need to be able to read what’s being published! But it’s simply not enough. For one thing, publishing in open access journals is often very expensive, literally costing the author thousands of dollars! That’s why we need omniprint.
Of course, in order to take full advantage of omniprint servers, they need to provide a number of tools to allow for an open peer review. Comment systems are useful, but they’re not a great way to quickly measure the quality of the paper. I think a tagging system might be useful, where people can anonymously tag a paper. Tags would probably have to include whether or not the paper is scholarly, if it justifies its position, if it needs improvement, and so on.
And that would be actual peer review. What we think of as peer review is really just one or two reviewers, who might be quite biased, along with an editor. How can we trust two or three people to make a decision about a paper, in an unbiased way? We can’t. That’s why we need omniprint.
There are two camps of science: the provisional verification camp, which was really the first to arise, in a formal sense, when Francis Bacon formulated “the scientific method.” The second camp arose when philosophers such as Kant and Hume realized that there was an issue with induction. They questioned why repeated observations, consistent with a given explanation, really provided any justification for the theory. This concern led to Karl Popper creating a new view of science, as a system of falsification. And that’s where we’ll start this discussion.
Consistency is at the heart of science. If we have one theory, and it says that another is false, we can conclude that at most one is true. So if we have a theory that’s well justified, and another that we know little about, if the first theory informs us that the second is false, we’re fairly confident in rejecting the second theory, at least for the time being. And whether we’re discussing the Baconian camp or the Popperian camp, logical consistency is still king.
But what happens when two theories both seem true? That’s the case with general relativity and quantum mechanics. Both of these theories are very useful to us. Both have undergone numerous tests. And both of them have survived all of those tests. But there’s a catch. While these two theories generally mind their own business, there’s an area of physics where both theories make predictions.
You see, general relativity mostly involves big things, like planets and other objects moving through space. General relativity is what replaced Newtonian physics, and involves treating the universe as a smooth space-time manifold that can be warped by mass and energy.
Quantum mechanics usually involves really tiny things, like atoms and stuff that makes them up. It views the universe as being coarse rather than smooth. But in general, quantum mechanics does not make any predictions about types of things that on which general relativity informs us. And in that case, there’s no issue.
But in really strange areas, like near black holes, general relativity and quantum mechanics don’t play nice. They both make predictions and neither is reconcilable with the other. So as scientists know, we need a new theory that can properly work in both domains: a so called “grand unification.”
String theory, super-string theory, and many other theories have been proposed in order to extend quantum mechanics into the domain of large scale predictions (The Final Contradiction). But for now, these theories do not make predictions that can be tested, and so they’re not scientific in nature. They are simply mathematical extensions of quantum mechanics (Not Even Wrong). So right now we’re stuck. That being said, scientists area confident that they will make progress.
Maybe the problem isn’t with general relativity and quantum mechanics, but with our fundamental understanding of reality. Maybe general relativity and quantum mechanics are both correct. As I said at the beginning of this article, a fundamental assumption that science makes is that reality is consistent. That is, a statement cannot be both true and false at the same time. But there’s a whole field of mathematics dedicated to logical frameworks in which it’s sometimes possible for a statement to be true and yet also false.
It’s called paraconsistent mathematics. And no, it’s not an area of mathematics where anything goes. In most cases, the logical framework does work just the same as our normal mathematics. It’s just that it’s a but looser. We allow, in certain instances, for contradiction, without “explosion” (normally if we have that a statement is indeed both true or false, then we can show that anything we wish is true, but not in paraconsistent systems).
Paraconsistent logic is one of my areas of interest, and I’m hoping that it can help solve another problem: the brittleness of Bayesian inference. It’s important to solve this brittleness, because it would allow us to actually turn science into a system which increases our confidence, even if still just provisionally, in the truth of a model of reality.
Right now, science is limited to falsification and therefore we only know when we’re likely to be wrong. There’s no justification for calling a theory true, or even likely to be true, simply because it’s succeeded in its testes. That’s known as “the problem of induction.” Bayesian inference seems to allow for this change, but in many cases we can end up with a situation where the results are actually a product of our initial guess, rather than on the chain of evidence.
But let’s say my work on paraconsistent yields results, and I can show that if we reformulate our theories in this paraconsistent framework, we can finally solve the problem of induction. That’s great! Now we can stop thinking of science purely as a way to know when we’re wrong, and we can start actually feeling confident that our well tested theories are true. It sounds like there are no downsides. Except that we could end up with cases where two contradictory theories could really both be correct. And that’s weird. Luckily, as far as I know, the apparent conflict with general relativity and quantum mechanics is about the only reason we have to maybe think that reality cannot be modeled in a consistent framework.
In my first article on the measles outbreaks in the Pacific Northwest, I argued that measles vaccination rates have declined little since 1995. Here I’d like to expand on that idea, and comment on specific claims made by various sources.
"Clark County Public Health Director Alan… https://t.co/xVudNNxURM
— Dr. Richard Pan (@DrPanMD) February 7, 2019
Twitter seems to have stored a clip that cannot be found in the actual article being linked to in Dr. Pan’s tweet, so I am including it here. According to the summary, “lax state laws have helped drive down vaccination rates across the pacific Northwest.” What the article does state is the following.
The Pacific Northwest is home to some of the nation’s most vocal and organized anti-vaccination activists. That movement has helped drive down child immunizations in Washington, as well as in neighboring Oregon and Idaho, to some of the lowest rates in the country, with as many as 10.5 percent of kindergartners statewide in Idaho unvaccinated for measles. That is almost double the median rate nationally.
So is the article being truthful? Well, I’d say it’s an “alternative fact.” Consider the following graphs.
I gave an overall analysis of immunization rates at the HHS region and state levels, in my first article. But I want to go into a little more detail about Washington State’s vaccination rates. First off, in the last couple of years, there’s been a rise in volatility, but it’s hard to tell whether this rise is out of the ordinary. When people cite such a short length of time and argue that there’s been a “decline” in vaccination rates, it’s no better than when people look at a few years of cold winters and say “look, the Earth is cooling!” A proper analysis does not look at a few data points. It looks at how those data points compare to the overall known data set.
This graph shows the volatility in the last few years. And perhaps there’s something in the 2012 blip, however it doesn’t seem to be enough to explain the timing of the outbreak, especially since overall vaccination rates are a an average of annual rates. That means that year-by-year variations are smoothed over multiple years.
In order to make any more conclusions, a lot more data will be needed. Pockets may be on the county level, or the nodes may be even smaller. If that’s the case, there could still be a change in distribution that my analyses aren’t capturing. But if that’s the case, then it doesn’t seem reasonable that they’d be having such an impact on larger scale outbreaks. We can think of very small communities, within a very large population, almost as individuals.
A Serendipitous Experiment has come out of these recent outbreaks. According to Ars Technica, the recent spike in cases, and widespread attention and concern, has caused a massive increase in vaccinations. So not only should we see an increase in vaccination rates in the coming data sets, but we should see a decline in pockets as well.
Now, the issue is that even if source of the recent outbreaks is something other than the antivax sentiment, we should see a decline in cases, because the vaccine does a good job at preventing symptoms. And that’s why we should ensure that vaccination rates are high. But this result also will cloud any data. A proper analysis would therefore have to adjust for changes in vaccination, if the goal is to see if perhaps the pathogen is becoming more virulent.
Especially because of the recent outbreak and rapid changes in vaccination rates among certain populations, now is the time to take action in analyzing asymptomatic infections. As I’ve mentioned in my paper on whooping cough, asymptomatic infections are poorly understood and studied. While there are certainly differences between whooping cough and measles, and their associated vaccinations, there’s still something we should see, if we took a random sample of the population: infection rates should be significantly lower among vaccinated individuals than in unvaccinated individuals. And how different they are can give us greater insight into how well the current vaccine is working to stop the measles infection.
To give some insight into what we could find, I recently came across a paper studying measles vaccination in Taiwan, presented to me as justification for current understanding of measles vaccination. What the person failed to notice is that based on a random sampling of the population, rather than a survey of cases, it seems that the basic reproduction rate is not driven below one, suggesting an inability to generate herd immunity. One reason that I use “seems” is that I’m currently trying to double check with the authors to see if this was an estimate in the case of 100% vaccination or not.
The disconnect between the apparent “eradication” of measles in the United States, and the general recognition by the medical community that a 95% vaccination rate should generate herd immunity, may suggest that asymptomatic infection is indeed a problem. And that’s why we really need to do a wide-scale analysis in the United States.