Freaking Measles, Man

Yesterday during vespers I thought about reading philosophy, especially because there was a raft of new orders and policies that I hadn’t looked at yet, having spent the last couple days in knitting-and-napping mode as I fought off whatever is going around. One of the policies is about withholding federal funds for schools that have any sort of COVID-19 vaccination mandate. 

While I was writing some broad bullet points about how this is a nonsensical regulation on several fronts, I was noticing that the language positions the order in such a way that it scales easily, meaning that the specifics of the trigger (COVID-19) are not as central to the language as the condition of the trigger (vaccine mandates), and this could cause a lot of confusion simply in the way it is written, and it also opens the way to a broad interpretation. 

Of course, what I was most interested in is the balance of who sets policies of public health and what these policy “jurisdictions” mean for education. I was getting a good groove on the writing (no, I still haven’t picked up Community yet, thanks for noticing) when I decided to check in on the measles. 

Measles and polio vaccinations were largely lauded as a triumph of public health policy, and the public vaccination campaigns were successful in both cases exactly because they partnered with schools. Even Mary Baker Eddy (the founder of the Christian Scientists, the sect that holds that illness is god’s will) said that overall public health considerations were important enough to allow vaccination among CS followers. 

The twenty-first century anti-vax movement in the US created holes in the measles vaccine shield in some of the most privileged communities in the country, and we had an outbreak in 2014 in California, a public health emergency so dramatic that California reversed its long-standing allowance for “personal choice” exemption of childhood vaccinations, a policy of which it was quite proud, and overall a policy that was very on-brand for California. And all of a sudden I couldn’t remember the name of the county, or the name of the Governor who reversed the policy, and man, having a TBI is wild, but thank goodness there’s google.

I opened a search page for “What county had a measles outbreak in California in 2014.” I expected to have to sift thorough the Chicago 2024 outbreak (60 cases) because google likes recent results that are nearly accurate over more tightly controlled adherence to search terms, but instead I got a raft of results about the current, ongoing, right this very now, Gaines County, Texas measles outbreak of 48 cases, with half of those coming in the last three days. Gaines County is in rural west Texas near the Arizona border, and it has an eye-poppingly low childhood vaccination rate. The official tally is that 14% of the children are under vaccinated, but the record doesn’t reflect the very large percentage of Gaines County school age children who are homeschooled or enrolled in private schools. 

By then it was officially compline, but I was in no way ready for bed. I hadn’t moved. I was sitting very still, contemplating what a large-scale measles outbreak might look like for the United States.

 

Measles has an infection rate of 90% in the vulnerable: that means that 9 out of 10 unvaccinated people will get the measles if they are exposed to it. It’s wildly contagious. There is no treatment. Patients are usually contagious for 4 or 5 days before symptoms appear, and symptoms are notably a rash and a fever. Key treatments for an infected patient involve making sure hydration and minimum nutrition is maintained, and of course rest. The rash and fever usually clear up in 7-10 days, and patients usually recover fully in 2-3 weeks. What makes measles so rotten is the complications that come with it:

• 1 in 5 patients ends up hospitalized.
• 1 in 20 come down with pneumonia, the leading cause of measles-related death.  
• 1 in 1000 develop brain swelling that leads to permanent deafness, convulsions, or intellectual disabilities.
• 1-3 in 1000 patients dies due to respiratory or neurological complications. While measles is associated with children, anyone can get measles at any age.

The measles vaccine is only 56 years old. It was introduced in 1968, and was so effective that in 1978, the CDC set a measles elimination goal by 1982. A measles outbreak amongst the vaccinated in 1989 prompted the CDC to recommend a measles booster. In 2000, the US was declared measles free as a result of 25 years of high vaccination rates across the country.

I don’t have a clue how Covid or modern influenza affects the numbers. We haven’t really needed to know that, given the effectiveness of the vaccine and the presence of the shield (90+ percent vaccination rate is needed to maintain group immunity). I don’t know what a measles mutation might look like, or what it would mean for public health. Given how adept Covid seems to be at mutating, I’m not sure I want to see a measles variant that has made friends with Covid.

Freaking measles, man.

Of course, if you need to update your vaccination or your booster, please contact your local health department or health provider. The vaccine is widely available and affordable, possibly even free, and effective immunity occurs in less than 3 weeks.

Life of a Philosopher

This morning I'm reading, writing, and drinking tea, my preferred way to spend a Saturday. Back in 2014,  the national measles outbreak--and the intense public conversation that went with it--propelled me to write my 2016 Master's thesis.

Friends, I'm still at it.

Graduation isn't the end of scholarship; it's the beginning.

 

 

Why Vaccination Shield is important

“It’s about respecting everybody’s lives,” said Barbara Lowe Fisher, the group’s co-founder and president.

Measles Outbreak in Dollars and Cents: It Costs Taxpayers Bigtime

Measles Outbreak in Dollars and Cents: It Costs Taxpayers Bigtime:

'via Blog this'

Intentional Measles Exposure and a Mumps outbreak

Apparently anti-vaxxers think that the way to address an incurable disease is to willfully expose their children to it. To the point that the Department of Health not only had to say it was a bad idea, but also had to tell people to stop asking about Measles Parties.

And since the measles vaccine is part of the three-pronged MMR measles mups rubella vaccine, there is a corresponding mumps outbreak as well. It was only a matter of time.

The holes in the armor

Because as far as germs and viruses are concerned, mostly dead is still slightly alive.

Over 80 percent of kindergarteners at some Oakland schools entered this year without all of their state-required vaccinations. At some Los Angeles Unified schools, more than 90 percent are under-vaccinated, meaning only 10 percent of kids — or far fewer — are fully up to date on their immunizations. . . .

“We have a conditional-entrant problem here,” insisted Pine. “They’re not immunized. They’re not protected.”

The national measles outbreak has now spread to Marin County, where the Department of Health and Human Services confirms that two children have come down with the disease. As of this afternoon, the total number of confirmed cases in California stands at 92, with one being an adult coach of a high school baseball team, and one being an infant at a daycare center, where it was in care with 23 other infants and toddlers who are likely not vaccinated due to their ages.

It's difficult for me to put this sentence together, but perhaps Mississippi got it right on this one. A strict law mandating vaccinations and the lack of loopholes for exceptions have left Mississippi nearly impervious to Measles, Mumps and Rubella, and one suspects to whooping cough as well. As for the 0.3% (yes, that's three-tenths of one percent) of the population in Mississippi who remain unvaccinated because of age or medical condition, the herd really will protect them, creating a immune-based shield that will stop the advance of the virus in its tracks. This is what vaccinations are for.

We need to seriously consider, as a society, the limits of personal choice on the public welfare. In Mississippi, public health unquestionably trumps personal choice. I understand that this is the United States of America, and that we were forged in the crucible of rugged individuality and independence that was the American Frontier. I get it. But there is no reason to compromise the health of an entire population when we could so easily stop it. MMR vaccinations are cheap, readily available, and have few if any complications.

"The science is pretty indisputable," the President told NBC.

“You should get your kids vaccinated — it’s good for them,” Obama said. “We should be able to get back to the point where measles effectively is not existing in this country.”

Dumb & Dumber

There are 102 confirmed cases of measles in 14 states across the country, the Centers for Disease Control and Prevention said Monday. In addition, there are also hundreds of other people being monitored for possible exposure.

The first four weeks of 2015 saw more confirmed cases of measles that in a typical year. And 2014's 644 cases are more cases than occurred in the previous five years combined. And then Chris Christie stirs up the hornet's nest, calling for “balance” and “choice.” Because apparently politicians know more about medicine than doctors and scientists do.

It’s more important what you think as a parent than what you think as a public official. I also understand that parents need to have some measure of choice in things as well. So that’s the balance that the government has to decide.”

-- Chris Christie, February 2, 2015

I have simply had it with this idea that public health concerns are somehow trumped by personal choice. This is beyond ridiculous; it has moved squarely into the crazy-makingly insane territory.

Dr. Tim Jacks wrote a blog post chastising parents for the continued circulation their measles-susceptible, exposed children "bone headed." The response? Arizona cardiologist, Dr. Jack Wolfson,went on the defensive, throwing in plenty of offense along the way, and channeled his inner Hitler, Himmler and Goering:

My child is pure,”

Wait. What?

Asked if he could live with the idea that his unvaccinated child could cause another child to become gravely ill, the cardiologist was dismissive.

“I could live with myself easily. It’s an unfortunate thing that people die, but people die. I’m not going to put my child at risk to save another child,” he said,before adding, “If a child is so vulnerable like that, they shouldn’t be going out into society.”

Perhaps it's not Dr. Jacks' children who should be removed from circulating in society, but Dr. Wolfson's. If he elects not to vaccinate, shouldn't we effectively quarantine his children?

But no, Rand Paul can't learn from the backlash that Christie encountered in the hours after making his gaff. Paul had to weigh in with equal idiocy, saying that when it comes to vaccinations, "for the most part it ought to be voluntary." Carly Fiorina also weighed in with anti-vaccination beliefs, saying that vaccinations are a parent's decision. "I do think parents have to make those choices."

Brilliant. Evil. Criminal?

More than 1 million people are expected to flock to downtown Phoenix for Super Bowl festivities.

Yeah, that's going to work out great, I'm sure.

Some numbers on the anti-vaxxers: In parts of California, the vaccine exemption rate for young children is at least 13% — higher than in Ghana, where it’s 11%. This hip trend comes with a body count, one frequently borne by the community at large, the youngest, weakest and least enfranchised of us. That's not just wrong, it actually manages to fit the definition of evil:

An evil is harm that is (1) reasonably foreseeable (or appreciable) and (2) culpably inflicted (or tolerated, aggravated, or maintained), and that (3) deprives, or seriously risks depriving, others of the basics that are necessary to make a life possible and tolerable or decent (or to make a death decent)” (p. 16).

To that point, members of the anti-vaxx movement might find themselves on the business end of litigation for gross negligence.

A strong argument can be made that a prima facie case for civil liability exists under a theory of tortious negligence. There may also be the potential for criminal liability.

And don't go feeling safer just because you didn't go to Disneyland, or because you don't live in the West or Southwest. Anti-vaxxers are everywhere. And as Beth Kassab found,

The number of people who have found God in the past 10 years has risen dramatically.

Where we trust each other the least, and feel the highest sense of privilege, we are least inclined to care about the effect of vaccination exemptions.

And it's not just measles, though that is certainly the one I'm ranting about most this week. It's also mumps, whooping cough, polio, rubella, and other diseases that are easily preventable by inexpensive and effective vaccines. This interactive map shows the increasing foothold of these diseases in the U.S. Click through the years from 2008 to today and watch the spread of the diseases.

Measles, really?

Measles is really really contagious. It's so contagious that if one person has it, 90% of the people close to that person who are not immune will also become infected. If you walk into an area hours after someone who had measles walked through, you have been exposed. Sadly, the person spreading it through the area might not have a single symptom yet, a situation that persists for four days before the infected person starts showing symptoms (let alone gets diagnosed).

Fortunately for those of us in the U.S., measles was declared as eliminated from within its borders in 2000.

But it's back with a vengeance and it's heading my way.

The Centers for Disease Control and Prevention reported 644 cases of measles from 27 states last year, by far the largest number since 2000.

Look, I'm not upset about not feeling comfortable going to Disneyland. This was always one of the creepiest places I could ever imagine.

But for those of you, braintrusts all, who have decided that herd immunity is fiction, who have elected to forgo the life-saving inoculations provided at low or no cost to you and your family because you think it's some sort of conspiracy, because some pin-up girl told you so, please stay the hell home. 

Yes, to you Westies in L.A. and you oh-so-enlightened naturalists in NoCal, I'm talking to you. Get your petri-dish kids away from the general population. 

Hole up in your anti-vaccination enclaves; share your diseases with the other like-minded intentional-community members who share your airspace already; enjoy your venison jerky, your fever, your god-awful fever and rash. Fire up your generators and your wood stoves, because we don't want you coming out into the population at large. No really. [S]tay home from school, work or day care for 21 days. Have a cup of superiority to go with your bunker-high canned goods, and don't call us, because we don't want our delivery folks coming up to your doors. Come out if you live through it.

“There are some pretty dumb people out there.”
---- Dr. James Cherry