Homeland Security Watch

News and analysis of critical issues in homeland security

November 11, 2014

Remembering one veteran on Veteran’s Day.

Filed under: General Homeland Security — by Christopher Bellavita on November 11, 2014

My father joined the Army on May 18, 1942. A little more than 5 months after the Pearl Harbor attack. He was a private.

His terms of enlistment still make an interesting read:

Enlistment For The Duration Of The War Or Other Emergency, Plus Six Months, Subject To The Discretion Of The President Or Otherwise According To Law

My father was born and raised in Brooklyn, NY. Both his parents were born in Italy.

 


Italy declared war on the United States on December 11, 1941. There were millions of Italians and Italian-Americans in the USA in those days. Italians were the enemy. But they also were America’s largest ethnic group. So it was unclear what to do with millions of Italians.

By the end of the war, US government officials from approved ethnic backgrounds put a few thousand Italians (citizens and non-citizens) into American internment camps. Compare that with 11,000 Germans and 110,000 Japanese who were also interned.

Yes, people in the future. It can happen here. It already has.

 


I have two pictures of my father.  In one picture he’s in his Army uniform standing against a white background. In the other picture he’s sitting at a kitchen table. His head is sunburned from the radiation treatments that tried, unsuccessfully, to erase the cancer that eventually killed him. In the picture he’s smiling at the woman I would marry.

 


My father enlisted on a Monday. I never learned what he did the weekend before he signed up to fight the Germans and Italians and Japanese. I’d like to think he enjoyed himself the same way any 24 year old American male would before going off to war.

But also he was a Catholic, so I suspect church was a part of that last weekend. Don’t want to take any unnecessary chances with one’s immortal soul before going off to war.

I never learned what he experienced during the Second World War. I hear there are people who talk about what they did in a war. I can’t recall meeting many.

 


My father met my mother in England. She was in the women’s branch of the Royal Navy, called the Wrens. They were married in 1943, on Armistice Day. It’s called Veteran’s Day now.

I was born 9 months and 8 days after they were married. My mother might have been in the Navy, but she also was a proper English girl.

The marriage ended 11 or 12 years later. Being married to a career military spouse is hard on a family. Too many moves. Too many wars. Too many deployments. Too much time away.

 


My father left the Army shortly after Japan surrendered. He got a job driving a truck in New York City. But he missed the Army. So he re-enlisted.

He was patriotic without being loud about it. He valued serving his country. He stayed in the Army for 30 years and left as a Sergeant Major. He fought two years in the Korean War, four years in the Vietnam War, and wherever the Army sent him. He rarely spoke about any of those experiences.

 


A few weeks after I joined the Air Force, my father visited me at Lackland Air Force Base. For a few hours on that sun filled December Sunday in Texas we mostly just walked around the base, talking.

He had his Sergeant Major Army uniform on, I wore my slick sleeve Air Force blues. It was a good day. I don’t remember anything we talked about. I do remember people smiling at us. I remember being proud to be with him.

 


He left the Army in the early 1970s. He died in 1984. In his time most everyone smoked. Cigarettes were cheap in the military. When he retired, he had a physical and chest xrays taken at the VA at least once a year, just to be on the safe side.

The Veteran’s Administration found something on one of his lungs, but for some reason it took 9 months for the VA to notify him. By then the cancer had grown into his brain.

He tried radiation. He even quit smoking. But he died anyway.

 


I went to a Michael Moore movie with my brother in 2002, called Bowling for Columbine. Two thirds of the way into the movie, my 56 year old brother started to cry.

After the movie I asked him why he was crying. He said the movie reminded him that Gabriel – our dad – fought in three wars so his sons would not have to fight in any.

 

Gabriel Bellavita circa 1970

November 8, 2014

Ebola source sitrep 4

Filed under: Biosecurity,Public Health & Medical Care,Strategy — by Philip J. Palin on November 8, 2014

This series of sitreps was initiated in midst of a media frenzy over the mishandling of an Ebola patient in Dallas. Yesterday Dallas was officially declared Ebola free.

In mid-October the nation seemed transfixed by symptoms and almost entirely distracted from their source.

In the intervening weeks there has been distinguished original reporting of the Ebola crisis by the New York Times and National Public Radio.  I have been less impressed with television news coverage.  But this Sunday, Sixty Minutes, the CBS news program, has scheduled a special report on The Ebola Hot Zone (2 minute video preview). Check your local listings.

As reported last week, the transmission growth rate in West Africa has slowed for hardest-hit Liberia.  It is increasing in Sierra Leone and Guinea.  There has — apparently — been successful containment elsewhere.  According to Friday’s special update by the World Health Organization the total numbers for Liberia, Sierra Leone, and Guinea are 13,241 confirmed cases and 4950 deaths.

Ebola Comparison

Click to open larger image.  Source: WHO November 5 Update

I have not seen a credible explanation for the recent divergence between Sierra Leona’s and Liberia’s transmission rates.  Guinea’s so far less virulent outbreak is probably a matter of geography, population density, and transportation networks.

As noted below, progress is being made on several aspects of the Ebola response strategy.

Ebola Mesures

Later today the USAID-US Army mission in Liberia will open its first Ebola Treatment Unit.

But clearly there remains much to be done.  The European Union has pledged over 1 billion Euros, but other than the Brits in Sierra Leone and the French in Guinea, actual engagement has been slow. On Thursday a Dutch ship departed Rotterdam loaded with ambulances, mobile hospitals, laboratories and other equipment. The cargo has been provided by nine EU Member States and UNICEF.

On Wednesday President Obama requested a special appropriation of $6.1 billion to address both domestic and international response to Ebola.  The Senate Appropriations Committee will begin hearings on the request on November 12.  The House Appropriations Committee is expected to follow suit before the end of the month.

Central Philippines one year later

Filed under: Catastrophes — by Philip J. Palin on November 8, 2014

Last November HLSWatch gave considerable attention to the impact of Hurricane Haiyan —  locally called Yolanda — on the Central Philippines.

For those not directly involved in humanitarian relief, the aftermath became a valuable case study in supply chain resilience… and too often suppression of such resilience.  There were plenty of lessons for the US, if anyone was willing to watch and listen.

A few year-old links that may be worth scanning for analogies that still apply:

Yolanda hits hard (Again), November 11

Healing our addiction to control, November 14

Post-typhoon supply chain, November 16

In terms of recovery:  Of course it has been uneven.  Of course there are heart-warming and heart-breaking stories.   In most ways and in most cases, recovery is the most complicated — complex — stage of the disaster cycle.  Will be interested in what lessons-learned you perceive.

Here are a few updates:

New Comprehensive Rehabilitation and Recovery Plan  (geenormous)

Summary of the immediately prior

Recovery briefing by Office of the President

Update Bulletin by UN Office for the Coordination of Humanitarian Affairs

GMA News Aggregation Site for Yolanda Recovery (Manila media outlet)

Some move on, some agonize (AP, The Inquirer, Manila)

Building Back Better (Christian Science Monitor)

Still trying to survive (BBC)

November 7, 2014

Friday Free Forum

Filed under: General Homeland Security — by Philip J. Palin on November 7, 2014

On this day in 1913 the Great Lakes Storm begins, by the time the blizzard ends over 200 have been killed.

On this day in 1940 the Tacoma Narrows Bridge (AKA Galloping Gertie) collapses. Video here, collapse sequence starts about 2:25.

On this day in 1919 the first Palmer Raid is conducted.  Over 10,000 suspected communists and anarchists are arrested in over twenty US cities.

What’s on your mind related to homeland security?

 

November 6, 2014

Klayman appeal

Filed under: Intelligence and Info-Sharing,Legal Issues,Privacy and Security — by Philip J. Palin on November 6, 2014

Tuesday oral arguments were heard by the Federal Appeals Court for the DC circuit in a key case related to NSA mass surveillance.

Last December, finding for the plaintiffs in Klayman v Obama, Federal District Judge Richard Leon wrote,

I cannot imagine a more “indiscriminate” and “arbitrary invasion” than this systematic and high-tech collection and retention of personal data on virtually every single citizen for purposes of querying and analyzing it without prior judicial approval. Surely such a program infringes on that “degree of privacy” that the Founders enshrined in the Fourth Amendment.  Indeed,  I have little doubt that the author of our Constitution, James Madison, who cautioned us to be beware “the abridgement of freedom of the people by gradual and silent encroachments by those in power,” would be aghast. (Prior attention by HLSWatch)

Judge Leon stayed his injunction of further surveillance of citizen phone records pending appellate review, given the national security implications and, what the Judge called, “novel” privacy implications of the case.

Josh Gerstein, writing in Politico of Tuesday’s proceedings, perceives:

During oral arguments Tuesday, three judges of the U.S. Court of Appeals for the D.C. Circuit seemed skeptical in various ways about the lawsuits that led to U.S. District Court Judge Richard Leon’s ruling last December that the NSA’s surveillance was likely unconstitutional.

Reporting for The Hill, Julie Hattem seems to agree:

Critics of the National Security Agency’s most embattled program harshly condemned the spying in a top appeals court on Tuesday. Judges, however, seemed largely skeptical of their claims that the spy agency’s bulk collection of Americans’ phone records was unconstitutional. Instead, they seemed to express a desire to reverse a lower court ruling nearly one year ago that called the NSA program “almost Orwellian.”

An audio recording of Tuesday’s Oral Arguments is available here.  I have not yet seen a transcript. Writing at the always informative Lawfare blog, Wells Bennett provides his own summary of the arguments.

Mr. Bennett is less inclined than the reporters quoted above to hear a predisposition in the three judge panel’s line of inquiry.  Bennett notes, “the day’s questioning was even-handed and vigorous, and exposed weaknesses in arguments advanced by both the government and plaintiffs alike…”

Before the end of the year appellate decisions are expected in three cases emerging from the Snowden revelations: Klayman v Obama, ACLU v Clapper, and Smith v  Obama.  If all meet with similar appellate findings, then no Supreme Court review is likely.  If they disagree — and depending on the nature of the disagreement — the Supreme Court is more likely to take action to resolve.

Late last year, just before the Klayman decision, Edward Snowden commented to the Washington Post, “For me, in terms of personal satisfaction, the mission’s already accomplished,” he said. “I already won. As soon as the journalists were able to work, everything that I had been trying to do was validated. “

A buddy in the intelligence community insists, “Snowden has made all of us less secure.”  A long-time lawyer complains of domestic surveillance, “It’s like an ulcer.  Maybe it originated with external stress, but now it’s eating us from the inside.”

What’s the right balance?  The courts are being asked to decide.

Local conditions, globalized consequences

Filed under: Biosecurity,Preparedness and Response,Public Health & Medical Care,Strategy — by Philip J. Palin on November 6, 2014

The following appeared in the November 3 edition of FrontPageAfrica, a leading Liberian news outlet.  The story was reported by Stephen D. Kollie.

As previously noted in Ebola Source Sitrep 3, there seems to have been an unexpected slowing of the Liberian rate of transmission. There are new reports this week, however, of increased transmission rates in neighboring Sierra Leone.  Here is the most recent WHO update.

There has been a remarkable absence of US broadcast media attention to Ebola as most of those treated for the disease in the United States have survived.  The “press” — digital and paper — has been much more attentive.

Late yesterday, President Obama requested a $6.18 billion special appropriation to combat Ebola.  According to the White House website, the funds will be used to

  • Fortify domestic public health and health care systems
  • Contain and mitigate the epidemic in West Africa
  • Speed the development and testing of vaccines and therapeutics
  • Establishing the capacity of vulnerable countries to prevent, detect, and respond to disease outbreaks before they become epidemics that threaten the American people.

–+–

Vahun, Lofa County – Barely seven months after the deadly Ebola Virus hit Lofa County, Liberia’s fourth most populated county (2008 national census) life seems to be returning to normal, but fear that the disease will resurface, exists among residents of the county. Schools remain closed, nonessential staffs working for the government; continue to remain home, while the culture of handshake, hugging and all forms of bodily contact is still prohibited.

At the crossing point, which connects Lofa and Bong counties, travelers are compelled by security officers to get of vehicles, wash their hands and undergo temperature screening. Those with high temperature levels are prevented from entering the Lofa County and refer to the local health authority for additional medical checks.

In Voinjama, the provincial capital of the county, posters of Ebola awareness messages are prevalent. Community radio stations still boom with anti-Ebola songs and messages. This, they say, is to remind residents that Ebola epidemic is not over yet. Many, including non-government agencies believe the disease spread because people did not believe in the existence of the virus.

“No one could listen when it was announced that Ebola is in town,” said Isaac Ballah, a local NGO worker in Voinjama City. Ballah told FrontPage Africa that nearly everyone in the city came to terms with the disease when a man showing signs and symptoms of the virus was seen lying at the entrance of the Lofa County Community college.

Ballah narrates that the suspected Ebola patient was lying helpless, vomiting and openly defecating as locals went to take a glimpse at the first apparent case, which signaled the coming of dark days. “After that morning, we all went home silently, with so much worried. The next day everyone picked up their clorax bottles and we stopped shaking hands and touching each other,” he said. “Few weeks later you could only hear the sound of ambulances everywhere and at the same time, see two to three pickups filled with dead bodies.”

All this epitomized the agony the people of the county were subjected to for months said Ballah. But for several weeks now, not many cases relating to the Ebola virus have been reported in the county. But residents are still taking safety seriously to prevent any widespread occurrence of the disease. They are skeptical in ruling out a new outbreak considering the county’s closeness to neighboring Guinea and Sierra Leone with which it shares borders.

Nationwide, the numbers in Ebola cases seems to be declining as has been acknowledged by the World Health Organization (WHO). The WHOs Bruce Aylward on Wednesday confirmed the decline in the number of Ebola cases in Liberia.

“The actual number of newly reported cases is beginning to decline in Liberia and the government is driving a multi prone investigation, looking at multiple strands of evidence to try and understand, is this real, is this reporting phenomenon or is this care seeking phenomenal that’s changing? So far based on the information received today… it appears that the trend is real in Liberia,” he said.

Despite this good news authorities and citizens of Lofa are taking the good news with a bit of caution. In Voinjama, all general markets remain closed to prevent public gathering. Residents are forced to sell their produce during regular weekdays instead of Fridays, which is recognized as the official market day.

Zangota’s Patient zero

In Zangota, a small town just 45 mins from Voinjama City, where over thirty deaths were reported, the Ebola nightmare began with Krubo Mamaie, who traveled to the town for medication, says 33 year-old Luana Korvah, a mental health supervisor who was actively working with the county’s Ebola task force.

According to Korvah, Mamie had cared for her sick husband in Voinjama who died of Ebola and later left for her town when she also fell ill. She was referred to the Konia Health Center by local officials in Zangota, but died en route to the Foya Ebola Treatment Center because her condition had turned for the worse.

Said Korvah: “She and her husband had burial activities in Guinea, when they went back into the community the husband fell sick.” “She was then caring for the husband and later the man died. They took the man to Letisu for burial and those that took part in the burial ceremony, who did the bathing and all the other traditional things died.”

Korvah said many residents in the area did not believe it was Ebola rather they held the general opinion that their wells were poisoned and thus causing them diarrhea and other illnesses. The residents’ failure to accept the virus existence left nearly 70 persons dead in Zangota and the numbers continued to increase spreading to nearby towns and villages.

Now, after nearly eight months battling the deadly virus, it seems Ebola has taught many lessons in the county. Precautionary measures are the order of the day. Hand washing, no handshake is just a few preventive methods that are still being religiously practiced even though infections have slowed in a County which has lost nearly 200 persons.

Careful barbing

At a local barbing shop in central Voinjama, barbers use hand gloves, bleach and other disinfectant before barbing. Not many people are allowed to sit in the barbing shop to avoid bodily contact. “We are still scared and are doing everything possible to ensure that no one get infected in this shop,” Mohammed Sore, owner of the two brothers barbing shop told FPA.

He says while there has been no case of Ebola reported in the county for the past few weeks, he and his colleagues have not stopped the preventive measures and will continue until the country is declared Ebola free. “We will stop using the gloves and chlorine when we hear that Ebola is not in the country again,” said one of our fears is that we are close to the border and people are still coming in from Guinea,” he said Sow.

At the over 80-bed facility run by the medical charity group Medicines Sans Frontieres in Foya, all patients have been discharged with zero cases reported so far. All schools in the county remain closed as part of President Ellen Johnson Sirleaf’s directive on the prevailing state of emergency in the country.

Non-governmental Organizations such as the Pentecostal Mission Unlimited (PMU Liberia) is moving in to help with preventive materials and support to many health facilities, as residents wait quietly to see a total eradication of the deadly disease. Residents of Lofa have seen hell; Ebola killed and obliterated entire families. Cultural and religious practices helped to rapidly spread the disease among community members who were also in strong denial of the virus according to residents.

Now, the numbers of cases being reported are few and no much news of suspected deaths in Lofa County. Hand washing buckets are still placed in nearly every household and those that cannot afford the bucket travel with a bottle of chlorine water just for protection against the deadly virus, which has killed a total of 2413 persons and infected 6535 individuals in Liberia alone.

Harvard Public Health School and Reuters: Ebola fear, not science, driving policies

Filed under: Biosecurity,Media,Public Health & Medical Care,Risk Assessment — by Arnold Bogis on November 6, 2014

The news agency Reuters and the Harvard School of Public Health have a partnership to produce “Health Watch,” which according to the School’s website is: “a web series featuring expert analyses and comments about the latest developments in health news. This series is presented by The Forum at HSPH and the Harvard School of Public Health in collaboration with Reuters.”

In this episode, “Dr. Paul Biddinger, Associate Director of the Harvard School of Public Health Center for Public Health Preparedness, tells Reuters that fear is driving certain non-science based policies like the involuntary quarantine of health workers.” Dr. Biddinger also directs the School’s Emergency Preparedness and Response Exercise Program.

 

November 5, 2014

Remember, remember, the fifth of November, Gunpowder Treason and Plot

Filed under: General Homeland Security,Humor — by Arnold Bogis on November 5, 2014

fawkes

 

Thanks to Benjamin Wittes of the Lawfare Blog for both reminding that blog’s readers that today is Guy Fawkes Day and for sharing the video below explaining the history of this holiday.

Many of you will recognize the picture of the Guy Fawkes mask above as worn by the group Anonymous and other protesters around the world.  I am not really sure how it came to be co-opted by these groups.

The title of this post comes from often repeated rhymes having to do with the holiday.  According to Wikipedia, the earliest recorded version from 1742 read:

Don’t you Remember,
The Fifth of November,
‘Twas Gunpowder Treason Day,
I let off my gun,
And made’em all run.
And Stole all their Bonfire away.

The story has to do with a plot to blow up Parliament with barrels of gunpowder hidden in the basement, with the aim to kill the King and Prince of Wales along with a large number of members.  The plotters were Catholics aggrieved by the anti-Catholic policies of the government.  Soooooo…..terrorists can be Christians?  Well how about that….

A day dedicated to a failed terrorist plot should merit some mention on this blog, no?

RIP Former Boston Mayor Thomas Menino: The Public Health Mayor

This week Boston laid to rest it’s longest serving mayor, Thomas Menino.  He served as mayor in Boston for 20 years.  Yes. That’s right.  Twenty years.

To his admirers he was known as the “Urban Mechanic,” as the Boston Globe describes, “leaving to others the lofty rhetoric of Boston as the Athens of America, he took a decidedly ground-level view of the city on a hill, earning himself a nickname for his intense focus on the nuts and bolts of everyday life.” To some of his detractors (and even his supporters) he was referred to as “Mumbles,” for his less than soaring rhetorical skills.

This humble man from the Hyde Park neighborhood of Boston rose to national prominence, with former President Bill Clinton paying his respects before the funeral procession and Vice President Joe Biden attending the ceremony. Impressive for a politician recognized to have no political ambition beyond running his city.

What does this have to do with homeland security? For some time I’ve heard from various colleagues that preparedness, particularly health-related preparedness, had an unusual amount of political support in Boston. Public health and EMS were not simply the minor leagues to law enforcement and fire service major league players. But it became vivid when I read the following description from a food-orientated homage to Mayor Menino from The Atlantic food critic Corby Kummer:

But aside from the coddling and special treatment any mayor who shows up gets, Menino cared about food for exactly the reasons today’s food-movement activists do, and long before it was fashionable to embrace what food can and should mean: access to fresh produce for everyone of every income level; gardens as ways to unite and repair communities; and, most importantly, fresh food as a route to better health. The mayor told everyone, including his biographer, longtime Atlantic senior editor Jack Beatty, that he wanted to be remembered as “the public-health mayor.” That made him work particularly closely with my spouse, John Auerbach, who served 10 years as Boston’s health commissioner. 

So….apparently I missed this self-appointment.  After the fact it was easy to find further evidence of Menino’s interest in public health.  See the videos I’ve posted below.

Again, how is this related to homeland security? Two points that at least I think of are interest. 

 

A lot, if not the majority, of public health work does not seem to fall into the category of homeland security. Expanding access to fresh produce in low income communities, anti-smoking efforts, childhood vaccination campaigns, etc.  It’s not always about responding to the next Ebola outbreak.  Yet when taken as a whole, improving the health of the community in general improves overall resilience.  Healthy people fare better during and following disasters than unhealthy ones.  People with access to health insurance are more likely to visit a primary care doctor than the emergency room for common maladies, thereby not taking up vital resources during events like the Boston Marathon bombing. A healthier community is a more resilient community.

Menino’s attention to public health underscores the importance of political leaders in homeland security. I have often heard professionals complain about meddling politicians (along with the annoying press) and how events can be run more smoothly when they are absent.  Yet not only do they play an important role in communicating with the public during and following disasters, they make or influence the choices made in a community before there is a bad day.  Menino’s focus on public health not only improved the overall health of Bostonians, but contributed to the competence exhibited during the response to the Marathon bombing, from the existence of a Medical Intelligence Center to the cooperation between city agencies such as Boston EMS and Public Health with the private hospital systems.

It is comparing apples and oranges, but in thinking about this I could not help but contrast Boston’s situation with that of New York City.  Size and resource issues aside, NYC has spent the most energy on security instead of general preparedness since 9/11.  I am not arguing that there has not been a lot of resources directed towards preparedness and response activities and organizations, only that it is lacking when compared with the radical changes enacted in the NYPD and other agencies charged with preventing a terrorist attack. I think I could make the case that Boston, under Menino’s leadership, took a more all hazards approach while NYC, under Mayors Giuliani and Bloomberg, remained primarily focused on terrorism. That is not a value judgement, but simply an observation.

If you are interested, the following video highlights many of Mayor Menino’s accomplishments in public health.  From the Boston Public Health Commission (which Menino created in 1996):

 

If you have a little more time, here is a longer discussion held at Harvard’s School of Public Health with Menino shortly after he left the Mayor’s office.  For those more security minded, at the beginning of the discussion he is asked and replies with a lengthy description of his point of view about the events surrounding the Boston Marathon bombing.

 

 

 

November 4, 2014

And the Band Played On…

Filed under: General Homeland Security — by Jeff Kaliner on November 4, 2014

The other night I went to a high school football game.  Around me were many of the mothers and fathers of the boys who played on the field.  The parents watched as their young warriors relentlessly collided into one another. Occasionally they would cheer as bodies and heads were repeatedly smashed, banged, bruised and bashed.

It occurred to me that these children were being actively encouraged by their parents to engage in this violent and injury prone sport. The fierce and brutal actions taking place on the field were not just being condoned by their caretakers, they were being rewarded by hand claps and ovations.

As I watched these parents, I wondered how many of them would let these same children get anywhere near a returned Ebola health care worker who had tested negative for the disease and had shown no sign of the illness.

————————————

Several weeks ago a few headlines were made by the fact that three high school football players had died within days of each other.  Many of these articles cite a 2013 study from the American Journal of Sports Medicine that found football related fatalities in college and high school averaged 12.2 per year.  That averages out to about 1 per every 100,000 participants.

If we drill down a little further we find another 2013 study from the Institute of Medicine shows that high school football players suffer 11.2 concussions per 10,000 athletic exposures (games or practices). Obviously these statistics do not include the thousands of high school football players who end up in the emergency department every year with dislocated shoulders and hips; broken bones; blown out knees and various other serious injuries.

Certainly Ebola has a much higher fatality rate than playing high school football. However, as it stands, the risk of contracting Ebola in this country is minuscule.  On the other hand, evidence with regards to the risks of high school football is increasing and yet only a muted outcry has reached the public through our media megaphone.  In other words, we know that putting our children on a football field is full of potential risk, both in the short and long term, and yet the band plays on.

————————————

At this point, evidence is suggesting that highly conservative quarantine measures for returning Ebola health care workers are unwarranted if proper protocol is exercised and actual cases are successfully isolated. Overly conservative quarantine measures may not only be medically unnecessary, they also have other possible unintended consequences: a threat to our constitutional liberties, economic disruption and the potential to limit the effort and ability of health care specialists to treat the outbreak where it is actually located.

Bumping up the incredibly small risk of contracting Ebola against the increasing risks of intentionally placing adolescents into a dangerous and violent contact sport is a fascinating riddle ripe with many of the problems that confront our current zeitgeist. For example, ignoring research findings that don’t agree with prevailing political ideology or concerns. Or, a cultural belief system that still places football in the same innocuous category as apple pie and Chevrolet. It also speaks to an ethical dilemma that puts profit over people.

On a hopeful note, the numbers seem to be shifting. There appears to be a downward trend in the amount of children participating in formal football programs.  Like the cigarette wars of decades past, the real threat posed by football to the masses will probably take many years to seep into our collective conscious. However, unlike the more hidden damage of threats like smoke and other inhaled pollutants on the body, the visceral effects of football are immediately discernible, real and deadly in both the short and long term.

So what’s the problem?

————————————

Donald Michael, in one of his many fascinating essays on meeting an increasingly complex future, posits that:

Arguably, the most profound threat to the development of a planetary civilization is the inability of leaders to admit that there are fundamental circumstances with which we must deal that cannot be acknowledged. In part this is because to do so would require confessing that, as of now, we do not know how to deal with them. What is more, this inability to acknowledge this mute state of affairs is also part of the situation that cannot be acknowledged. (Leadership’s Shadow: The Dilemma of Denial)

To be clear, I don’t necessarily believe the issue of high school football falls into this category. President Obama recently had the temerity to state that he would not let a hypothetical son play the game. However, he seemingly doesn’t know how to deal with the larger problem. Regardless, it’s far simpler to ring our collective hands about a scary and infotainment ready threat like Ebola than to deal with the complex machinations of the football industrial complex.

Ultimately, there is one given in my Ebola vs. high school football question.  Although parents cannot protect their children from the possibility of contracting the disease (however slight the risk) they can powerfully deal with the real short and long term ravages of the game.  They can simply “just say no”.

————————————

Jeff Kaliner is a public health emergency preparedness professional with twelve years in the field. As a child and adolescent he spent an unreasonable amount of time thinking about and playing sandlot and high school football. He holds a Master of Arts degree in Security Studies from the Naval Postgraduate School and a Master of Science in Education from Northern Illinois University.

 

 

November 1, 2014

Ebola source sitrep 3

Filed under: Biosecurity,Preparedness and Response,Public Health & Medical Care,Strategy — by Philip J. Palin on November 1, 2014

The World Health Organization released a new data summary late on October 29.  A few highlights:

The growth rate of transmission in West Africa seems to have slowed, especially in hardest hit Liberia.  This has surprised most close observers who suggest it is either the result of unrecognized and under reported transmissions or is a temporary trough in what can be a wave-like pattern on the part of the virus.

The region’s anti-Ebola capacity is much stronger now than at the beginning of October.  Several new diagnostic labs and treatment facilities are now in place (see map below).  Clinical personnel are more numerous and better equipped. Some have suggested the reduced transmission rate is the outcome of interventions — educational, clinical, and logistical — put in place over September and October.

Ebola Treatmentt

Despite this good news — or pause in worse news — a new scientific analysis published on Thursday concludes, “Under status quo intervention, our projections indicate that the Ebola outbreak will continue to spread, generating a predicted 224 (95% CI: 134 – 358) cases daily in Liberia alone by December…”  For the week ending October 25 fewer than 50 probable cases were reported in Liberia.

The key factor may be “status quo intervention”; how much effort, targeted where, will have the most effect?  It is widely recognized that the West African outbreak is the result of a failure to intervene early and effectively, before the virus was able to spread in dense urban environments.  The best evidence for this analysis being what has happened with an unrelated, but parallel, cluster of Ebola cases in the Democratic Republic of the Congo.

The first Ebola death in the DRC was on August 11.  The role of Ebola was identified before the end of August.  Aggressive public health measures were taken to isolate and treat those with the virus.  (Other factors probably helped.)  There have been a total of sixty-six cases and forty-nine deaths.  It has now been eighteen days since the last new case was identified.  The transmission cycle was contained and has apparently been stopped.

Public education and community involvement are, many emphasize, fundamental to this sort of success.  The same analysis projecting potential exponential growth in the number of West African Ebola victims found that four behavioral adjustments could produce a rapid decline in transmission (see chart below).  Of particular importance is a change in burial practices.  The “status quo” being studied was the situation in mid-September. Several of the practices have been increasingly adopted since.  Already enough to produce the recent declines?

Ebola 4 Interventions

Since the West African Ebola cases first emerged, many at HLSWatch have suggested that for the United States this is mostly an opportunity to “run the traps” for a much more easily transmitted, much less treatable infectious disease.  Important issues have surfaced related to early identification and treatment, clinical protocols, clinical training, and quarantine policy, strategy, and practice.

Some potentially less obvious lessons:

Isolation matters:  The economic isolation of eastern Guinea produced a level of poverty that resulted in hunting bats for food.  When a child and then his family members died of bat-borne Ebola they did not receive medical attention. The virus was given time to multiply.  In urban Monrovia the poverty-stricken West Point slum has been the epicenter of transmission.  The population’s lack of connectedness with wider society has impeded the application of effective public health strategies.

Culture matters:  Washing, caressing and otherwise honoring the body of dead family members has been a particularly virulent vector for transmission of the disease.  Working respectfully within the culture it has been possible — with remarkable speed — to adjust cultural behaviors.

Community matters:  Connecting those who were disconnected and building trust where there was little or none has been a precondition to adjusting population behaviors and bending the transmission curve.  Facilitating and supporting community self-organization has again and again been a big part of the public health approach.

Media matters:  Mass media and social media can significantly influence the velocity of public attitudes for both good and bad.   How to influence the velocity of media attention is, I suggest, quite similar to how we effectively engage the virus itself.  Think about it.

Reasoning matters:  Chris’ Tuesday post — and Haidt’s claim — have clearly been on my mind all week.  For what it’s worth, I perceive Haidt was mostly critiquing a tendency by some to perceive reason as self-evident and to dismiss those too stupid to recognize the obvious.  In this regard I agree with Bellavita and Haidt.  The noun can be pretentious.  But the verb — reasoning — when undertaken in a way that embraces culture, community, and respectful communication is the best tool we’ve got.

Maybe this is an opportunity to run the traps on more than the next infectious disease.

« Previous Page