Kansas tuberculosis outbreak is America's largest recorded since the 1950s
cjonline.comNot being from the US, I find it odd that the article didn't mention anything about vaccination. Until 2005, pretty much everyone in the UK received the BCG vaccine. After that the TB rate fell too low to merit routine vaccination, but even today it's still given routinely in a few areas where the rate merits it, or if there's elevated risk of exposure via family from abroad, etc. Has vaccination in general become such a divisive topic in the US that articles about diseases for which we used to routinely vaccinate don't even mention that a vaccine is available and greatly reduces the risk of the most severe forms of TB, such as TB meningitis?
Kind of related to your point… I remember my maternal Grandmother was looking after me one day and I’d either missed or skipped my earlier vaccination appointment in school (which, I think was a BCG or booster, it was in the early 1990s). She was raised by her maternal Grandmother after her mother died from TB when she was 2 years old. Her father died of… something infectious when she was teenager
(the oral history is obviously a bit sketchy, but she used to tell me her father also caught TB - cholera maybe ? - when he was removing bodies from the flooded Balham tube station in 1940 - https://www.ianvisits.co.uk/articles/75th-anniversary-of-the...)
Well, I got quite the scolding about missing my jabs and a stern lecture about how many awful diseases have been cured because of vaccination. I could never forget how emotional she was about it.
To people born in the early 20th century, seeing the effects first hand of the vaccination programmes of the mid 20th century (not to mention antibiotics) must have seemed miraculous. I think we’ve lived without these diseases for so long that some people (stupid, selfish people) simply think they don’t exist or pose a threat any more.
> I think we’ve lived without these diseases for so long that some people (stupid, selfish people) simply think they don’t exist or pose a threat any more.
This is true beyond just vaccines. All too often hardships are forgotten, history is just old pictures and stories, and people who are too far disconnected from those real events and don't learn from history will just walk the same path, leading to the same hardships.
They all think that the world is better today so they're smarter or better than the old generations, that the world evolved so they're intrinsically prepared, so the pains of the past can't harm them. Ironically they're ignoring all the lessons and the tools that made the world better and are needed to keep it like that, and instead think things are better because they just are.
They'll skip any vaccines or support extremist regimes because they think the modern world is just immune to this, it's intrinsically and permanently "fixed". We have freedoms or don't get sick because we "just" have freedoms and don't get sick.
Having close family spending a lifetime paralyzed by the polio virus before a vaccine was widely available, or spending some of my life in the cold embrace of dictatorship really drove the point home for me about learning the lessons of history.
Tried-and-true vaccines are like plumbing or city infrastructure: Once established, it’s taken for granted and the true value can’t be intuited.
BCG, sadly, is not really in that category.
What's the issue with the BCG? My understanding was that it had been sucessful, is that a bit of a myth?
It’s not very effective, and it’s apparent efficacy is bizarrely variable.
Thanks, I had no idea. It was the standard when I was growing up in the UK.
It looks like it is no longer standard issue here.
I think it was just some small anti-culture (like healing stones or whatever. Same people initially) that got dragged into the with us or against us political landscape of the US.
It’s a valid question, but I don’t think the current vaccine-unfriendly climate in the US is the reason why the BCG vaccine wasn’t mentioned. BCG wasn’t routinely given in the US even in the last half of the 20th century when vaccines were universally popular. I was surprised to learn a TB vaccine even existed when I started a public health−adjacent job in the 2000s. Our public health establishment just isn’t convinced it’s worth giving here.
The BCG vaccine does exist, but it's an 90 year old live-virus vaccine with short-term side effects. Because it's a live-virus "natural" vaccine, it can't be used on people who are immunocompromised or have HIV. There's work on more modern vaccines.[1] No big successes yet.
The safety record of the BCG vaccine, in terms of permanent harm, is pretty good. But a normal side effect is "The usual expected reaction to BCG vaccination is redness and/or a small lump at the injection site, followed by a small ulcer (open sore) a few weeks later (usually less than 1 cm in diameter). The ulcer may last from a few weeks to months before healing to a small flat scar."[2] Mass vaccination will have parents screaming "my perfect baby has an open sore from the vaccine" on Instagram, with pictures.
The classic live-virus smallpox vaccine has similar side effects, by the way, plus a death rate of 1-2 per million.
Huge political problem. Remember all the screaming about the COVID vaccines, which are pure RNA, can't replicate, and have fewer side effects.
[1] https://pmc.ncbi.nlm.nih.gov/articles/PMC3349743/#s6
[2] https://www.rch.org.au/uploadedFiles/Main/Content/immunisati...
>>Mass vaccination will have parents screaming "my perfect baby has an open sore from the vaccine" on Instagram, with pictures.
That's so weird to me given that literally everyone where I'm from(Poland) has this on their left arm. Nothing to post on Instagram about. It's as universal as having a belly button - not having a vaccine scar on your arm would be the thing to post about if anything.
Likewise. I grew up in the UK and there was no pushback at all from what I remember.
Although I do remember school being very strict about anyone whacking someone elses BCG arm.
> the COVID vaccines, which are pure RNA
This is misleading. Vaccines, including those for covid, generally include adjuvants to stimulate the immune system [1]. While I understand the point your making here, the covid vaccines were not syringes with pure RNA in them.
An interesting aside to this is the MIS BAIR study in Melbourne, which is looking at whether the BCG vaccine reduces the incidence of food allergies, eczema and asthma. https://www.mcri.edu.au/research/projects/misbair
Yeah, when it’s dress/tank top weather, you can see what part of the world people grew up in by the upper-left-arm scar.
[https://www.health.nsw.gov.au/Infectious/tuberculosis/Pages/...]
My upper left arm scar wasn't made by TB vaccine though, it was Rubella vaccine. I didn't associate it with aftereffects of the vaccine itself, it was the unique method of delivery - an airgun instead of a needle. Never seen that before or since.
The MMR vaccine doesn’t cause that type of scar. I’ve found nothing saying air vaccination guns do either.
Smallpox and TB vaccines both do though.
Perhaps you got a combo?
They made a big deal of it, our entire elementary school got it at the same time. And they specifically said it was for German Measles, I don't think MMR had been invented yet. This would have been before 1970.
If pre 1970, you almost certainly got the smallpox vaccine too. At that time it was still an active problem and working to be actively eradicated.
[https://my.clevelandclinic.org/health/articles/smallpox-vacc...]
As far as I can tell, German measles vaccine doesn’t cause a scar anymore than MMR (it’s a sub component).
I don't know why they would have hidden the fact that smallpox was included, anti-vax wasn't a thing at the time. But I'll admit the possibility.
The US medical community never accepted the effectiveness of that vaccine. They don't think it does a good job at prevention and it makes it harder to detect as anyone whose had that vaccine treats positive with the skin test.
All of the above, as well as the fact that the incidence of TB is already so low that the vaccine could cause more harm than it prevents.
Aside from TB, you could also call this "the tragedy of vaccination": vaccination causes the incidence of a life-threatening disease to become so low that people consider the vaccine to cause more harm than it prevents - until the vaccination rate becomes so low that the life-threatening disease is back.
You know, if everyone wrote a predator prey simulation from scratch, they would understand those oscillatory dynamics.
But if they also wrote genetic algorithms from scratch, and understood natural selection, they would also understand the concepts of selection pressure, and use it or lose it.
If they then also understood that 90% - 95% of the population effectively has natural immunity, they would seriously question the ethics of vaccination.
Should a number of generations be allowed to profit from the benefits of vaccination at the cost of a loss of natural immunity in the group? Are future members of the group less entitled to this ~95% immunity, because the current generations prefer ( 100% minus epsilon ) artificial immunity?
Its easy to win a referendum in the advantage of the existing population at the cost of future populations, if those future populations aren't born yet to contest and vote against it.
From Wikipedia page on Tuberculosis:
> Roughly one-quarter of the world's population has been infected with M. tuberculosis,[6] with new infections occurring in about 1% of the population each year.[11] However, most infections with M. tuberculosis do not cause disease,[169] and 90–95% of infections remain asymptomatic.[87]
From the above it is clear that vaccination programs for TB should be strictly considered private healthcare since it can help specific individuals at the cost of collective fitness vis-a-vis TB. Governments collectivizing private medicine at the cost of group fitness ranks among the most populistic things in existence. Think of how communist systems justify their methods by emphasizing doctors and medical systems.
What exactly does the ethical axiomatization of a collective thought system look like when they look down on the ~95% natural immunity handed to them from the prior generations and simultaneously have no qualms to hand down a lower percentage of natural immunity to the next generations!
I believe they have this mistaken gut feeling that their decisions can be rationally axiomatized, more out of group think and delegation "others smarter than me are choosing this so it is probably rational"; and they are simply unaware of the fundamental inconsistencies they manifest.
Tax payer money ought not be spent on reducing the natural immunity of its taxated population, regardless of how confronting it may be to explain to the population how a lot of methods in medicine were started long before the consensus on natural selection as the origin of life and fitness took hold.
>If they then also understood that 90% - 95% of the population effectively has natural immunity, they would seriously question the ethics of vaccination.
Your premise is flawed as this is a misinterpretation of what the data actually states. The statistic refers to the fact that most infections do not cause active disease. This is not the same as having "immunity." Rather, it indicates that the immune system in most individuals can contain the bacteria without eradicating it, resulting in a latent infection. Latent TB can become active under certain conditions, such as immunosuppression or aging.
Vaccination does not reduce natural immunity but aims to prevent the most severe manifestations of TB which can be fatal.
Your wider point re: the ethical argument against vaccination presumes that exposing populations to preventable diseases is acceptable to preserve a theoretical "natural immunity." However, ethics in public health prioritize the reduction of preventable harm. Sacrificing lives and health for a purist notion of "natural selection" disregards the suffering of individuals and the societal costs of disease.
If anything, the ethical failure lies in allowing preventable diseases to cause harm when safe, effective interventions exist. Future generations will inherit a world shaped by the decisions we make today. A world with widespread vaccination is one where fewer children die, fewer families suffer, and societies thrive.
You got the BCG vaccine in the UK? Are you sure?
I got it when I was a toddler in the late 80s and I still remember the excruciating pain and have the scar to show for it.
I grew up in the third world. I have never met a Westerner with this scar unless they got it in the sixties.
Yes, I'm sure, and have the scar on my arm to show for it. Everyone in my school had it. Would have been around 1980.
How interesting. The UK is the only western country Ive encountered that gave this shot to kids in the 80s.
Why is this?
As a British millennial, I got it at school, I guess sometime in the 90s. Still have the scar
I just checked and it's not mandatory anymore in France, which probably absurd because there is a surge of tuberculosis due to migration and international travel
In the Netherlands people who travel to non Western countries can get their vaccinations.
There's an old Dutch fort in Ghana with a graveyard. Prior to modern medicine white people dropped like flies in Africa.
natural selection also applies to memes. memes that cause their host to fail to raise children to reproductive age will get weeded out, but it can take many generations.
Memes don't need to be passed on hereditarily. It is entirely possible for a meme which absolutely prevents the host from reproducing to persist indefinitely so long as it spreads to new hosts at around the same rate hosts die out. See clerical celibacy. It is also possible for memes to lie dormant and then resurge after an extended period of time by which all the original hosts are dead.
good point!
John Green, author of "The Fault in Our Stars", "Turtles All the Way Down", "The Anthropocene Reviewed", and other fine books is releasing a book called "Everything is Tuberculosis." If you are interested in the topic or just like to read well-written prose, I recommend joining me in pre-ordering it.
For what reasons do you recommend it?
Two reasons: I enjoy Green's work; he's been researching this subject for a few years, so I expect a pretty thorough analysis.
Because even bad writers have fans.
On that train with you, counting down the days until March!
Turtles All the Way Down - second this book.
Largest in recorded history is a bit of hyperbole. In the 1800s something like 80% of all Americans had the TB bacillus and of those that came down with TB a huge percentage died.
Hopefully we can course correct before we have to relearn lessons from the 1800s.
Maybe if we learned about the 1800’s in school things would be going better now.
We did learn about the 1800's in school but apparently some of you did not pay attention.
There will always be some small percentage of your society that refuses to accept what is taught in school. The US has it bad because we've had multiple "Great Awakenings" that resulted in literal cults that grew to national size (mormonism, Church of Christ scientist, Jehova's Witnesses, thousands of various "Evangelical" fundamentalist sects) that all take as a foundational belief that the entirety of modern science is a massive cover-up to prevent people from knowing about god. They explicitly believe that scientists are Evil, and in league with Satan to keep them from god.
Fully ten percent of the American public for the past 50 years, or 30 million people believe "God created human beings in their present form at one time within the last 10,000 years"
Those people have always been good at organizing and have groups that are extremely motivated because they genuinely believe they are fighting a holy war against Satan. They have driven American policy for centuries, from the religious portion of the southern states insisting that god wanted black people to be slaves, to the Christians being a large portion of the temperance movement that resulted in Prohibition, to the current Book bans, to driving a significant amount of the political pressure causing Visa and Mastercard to threaten to ban pornhub (https://en.wikipedia.org/wiki/National_Center_on_Sexual_Expl...).
A huge percentage of flat earth believers for example are there because it is the logical endpoint of "you cannot trust any scientist because they are all in league to drive you away from god's light"
If 10% doesn't scare you, consider that the same insanity around a man named Kellog insisting in "purity of spirit", as in the religious meaning, is why 90% of White men in the US are circumcised. That rate is only comparable in Israel and nations with Islamic laws.
America struggles because of religion, specifically a breed of religion that insists you cannot trust any institution but it. Note how hostile the current admin was to a Preacher preaching peace.
Their preferred religion does not preach peace.
We learned that we’ve progressed and that we’re totally different people now, so obviously we can’t end up with the same problems if we’re stupid about it. (/s, kinda)
At least smallpox has been eradicated (except for potentially some bio weapons labs), so hopefully our stupidity won’t bring that back.
I mean, if you could get a large country that you had some enmity with to embrace anti-vaxx I guess weaponizing that smallpox might seem attractive, if you had really poor morals of course.
So luckily that won't happen!
I agree, the emphasis probably should be on “recorded”, not “largest”.
I assumed that the emphasis is correctly on "outbreak", ie: a single statistically significant increase, as opposed to a progressive increase over centuries (which is what led to the huge numbers in the 19th century)
That’s pretty much what I was looking for in clicking on the article, by what logic or rationale they made that statement.
Yeah, the phrase they were looking for is "largest on record", or more precisely "largest in the CDC's records".
"Recorded history" has a very specific definition that places it in contrast with "prehistory": it's the time period in which we have written records of any sort, as opposed to the time period in which there is no surviving writing. That both phrases have "record" in them doesn't make them synonymous.
Largest means a very different thing when the us population is 40 million versus 400m.
What’s a heinous tragedy in one could be an existential threat in the other.
How are you going to get people to click on the article without hyperbole?
How can this possibly be America's largest TB outbreak in history? TB was killing thousands of people per year in America in the 1800s.
> She noted that the Centers for Disease Control and Prevention started monitoring and reporting tuberculosis cases in the U.S. in the 1950s.
Ok, we've put the CDC up there instead. Thanks!
Edit: actually let's put the 1950s up there instead. I think there's more information that way.
Appreciate it, thanks.
But surely our disease experts know about the past outbreaks and their impact and wouldn't say something patently untrue like the headline.
"Recorded history" in the title refers to the period of history where the agency has been recording the numbers. It might not be the best phrasing, but it's not strictly untrue; the underwritten thesis (TB is on the rise) is still supported by the evidence.
"recorded history" sounds like it's how you divide pre-colonial Americas from modern (15th Century CE onward) Americas. For example, many weather features have been recorded in the Americas since 17th century CE. Does "recorded history" refer to only "[this particular metric's] recorded history"?
I agree that it's not the best term, but I don't think its so disqualifying that it makes the claim untrue: it's misleading at worst, and that imprecision only kinda interacts with the underlying claim.
I guess the better phrasing would be "Kansas tuberculosis outbreak is largest since (org) has been collecting data", which honestly doesn't change the implications for me.
They don't write the headlines.
The crucial word in the headline is "recorded". I doubt that record-keeping in the 1800s was as comprehensive as it is today.
Additionally, from the article:
> the CDC started monitoring TB in the US in the 1950s.
Eh, "recorded history" is totally the wrong phrase.
When we say "recorded history" we don't mean "the window of time in which we have detailed records up to our modern standards", we specifically mean "the window of time in which we have records of any sort", contrasted with "prehistory".
The phrase they were looking for is "largest on record" or even better "largest since 195X".
> For broader world history, recorded history begins with the accounts of the ancient world around the 4th millennium BCE, and it coincides with the invention of writing.
EDIT: Downvote away, but I'd be interested to hear from someone who believes that "recorded history" is not incorrect and confusing usage here, with an explanation rather than a drive by vote.
Largest in CDC records. US government records existed before 1950.
Sure, but that isn't what the headline says.
No I agree with you, the 1800s were part of recorded history.
If you read the article, it appears they've only been keeping records in Kansas since the 50's. And I think the headline is wrong: it's the biggest in Kansas's records. I could be mistaken about that.
The article states that they only started recording in the 1950s.
From the article:
An tuberculosis outbreak in Kansas has become the largest in recorded history in the US....the CDC started monitoring TB in the US in the 1950s.
"This is mainly due to the rapid number of cases in the short amount of time. There are a few other states that currently have large outbreaks that are also ongoing."
People with an active infection feel sick and can spread it to others, while people with a latent infection don't feel sick and can't spread it. It is treatable with antibiotics.
State public health officials say there is "very low risk to the general public."> It is treatable with antibiotics.
Treating it casually has led to widespread resistance.
https://en.wikipedia.org/wiki/Multidrug-resistant_tuberculos...
https://en.wikipedia.org/wiki/Extensively_drug-resistant_tub...
> People with an active infection feel sick and can spread it to others, while people with a latent infection don't feel sick and can't spread it.
https://www.who.int/teams/global-tuberculosis-programme/tb-r...
"Analysis of data from 14 countries in Africa and Asia suggests that about two thirds of global TB transmission may be from asymptomatic TB (95% prediction interval: 27–92%)."
>Treating it casually has led to widespread resistance.
I have long suspected this as part of why the subject isn't much discussed, despite being more prevalent than most realize.
The elephant here is (aside from latent infection) the atypically long duration of treatment, which can exceed 6 months and is harsh. Many, even otherwise responsible people, will founder before the proper end of treatment and this, I think, is what terrifies health professionals - so much, that it almost seems to be avoided.
It's probably time we start looking a bit harder for "natural" or alternate treatments. Some in medical journals, are under scrutiny, but inconclusive.
Edit: I also think we'll be finding more about latent infections being involved in an array of other ailments, especially when mixed with the ultra prevalent EBV. And EBV is involved in a lot.
>It's probably time we start looking a bit harder for "natural" or alternate treatments. Some in medical journals, are under scrutiny, but inconclusive.
We are looking, quite hard, in fact. Mycobacterium tuberculosis is among the most studied microörganisms.
Like HIV, it is notable particularly for being able to defeat the attempts of the immune system cells to kill it, and it in fact infects and reproduces within macrophages. Medical researchers have done a lot to understand how this is possible and we (as in humanity) have identified several enzymes and related biomolecules which seem to be crucial to this process, which we might be able to inhibit with a targeted drug.
However, all of this scientific research has the usual problem that it is very difficult and expensive. In order to inhibit the enzyme, the drug must be absorbed by the body, and then make its way into the macrophages, and then it still must be active, and have no other toxicity to the host. It is easy to say "just inhibit isotuberculosinol synthase", but it is much harder to do.
As I understand it, this is also the reason why treating tuberculosis requires such long courses of antibiotics. When treating a normal infection, we are basically just killing most of the pathogens, and we hope that the immune system will mop up the rest. In the case of M. tuberculosis, the drugs have to kill all of the bacteria, which is why multidrug therapy is basically always used and the patient must continue treatment long after symptoms seem to have disappeared. Even when patients have recovered, they are always considered to be at risk of still having latent tuberculosis, which is why hospital screenings often feature a question like "have you ever had a positive test for tuberculosis?"
This - TB is very well studied compared to most infectious diseases. I think really only HIV and Malaria edge it out.
Not to say that it's always the case, but research isn't always at face value - i.e., sometimes there's circularity, economical or political dynamics, etc, that perpetuate dead ends while neglecting more viable avenues.
An example might be enzymes (notably in cancer research), where in the US there has been significantly less pursuit than elsewhere. To avoid attacks, I'll cite a source[0] which readers can maim rather than my comment.
0. Enzymes, The Fountain of Life DA, Lopez MD RM, Williams MD PhD K, Miehlke MD
In some pirtions of this book, entities other than pinata boy on HN, express concern regarding the quality, fairness or whatever's of research, with indications that 'research' may not always be equally noble or pragmatically guided. I suspect it's one of many where that particular subject is grazed upon. But my point is, if not overemphasized, that there may be quantity over quality issues, with viable options hiding in plain sight.
"It's probably time we start looking a bit harder for "natural" or alternate treatments. Some in medical journals, are under scrutiny, but inconclusive."
Antibiotics are found in, and derived from, nature.
Amazing ain't it? And the use of the word is found in medical literature too!
Reflect for a moment on whether such a comment serves any positive purpose.
A few anecdotes about TB:
I was diagnosed with a latent TB infection received from a family member back in the early 1990's as a teen. I believe city and state departments of health must've tracked the "outbreak" back but I don't think it was ever on the news or made a big deal of. By the time we were diagnosed, the family member's symptoms weren't anything worse than their typical smoker's cough and was a heavy cigarette smoker anyway, not sure how active his infection actually was at the time but he never required hospitalization, just similar antibiotics, IIRC.
I was treated with Isoniazid (known as INH, one pill daily for a year), I never felt any symptoms from the infection or side effects from INH, they monitored monthly initially with skin prick tests then chest x-rays and after the year was up, I was done. This did prevent me from donating blood a few years after the infection was cleared; I assume there are still rules in place.
Neither the latent infection nor the year long treatment were harsh. IMHO, TB's a powerful but rather slow-moving internal infectant, and it was historically ravaging because of the earlier conditions of the world and lack of medicine at that time.
What kind of natural treatments? Because tuberculosis has been a massive problem from the start of human civilization up until the advent of antibiotics, and they tried every natural medicine and treatment under the sun because of how long people can end up living with it before dieing, and they accomplished pretty much nothing in stopping it. In fact it continued to get worse throughout that entire time, at one point being the cause of death for 25% of Europeans.
I'm not going to devote the time required to search, retrieve and cite extent material. But you will find results if you do, but probably no panacea. Also, I deliberately don't mention specifics in this instance (and many others) due to potentially and probable controversy. As an example, if I were to (but won't!) cite research indicating the universally reviled Ag showing efficacy in mitigating TB, I'd be attacked by waves of hostility as if it was my own rogue idea.
I enjoy discussions, but find it often tends to be argumentative here, so I avoid things I expect to go in that direction. Note the hostility to my use of the forbidden word in quotes. It's a thousand cuts with these kinds of compulsive prison shanks of logic that makes me awkward.
> It's probably time we start looking a bit harder for "natural" or alternate treatments.
Is the idea that a different label would lead to higher compliance rates?
Resistance. It's not quite the end of the world if TB becomes impervious to, say, catnip or whatever, which isn't front line medicine. And some options might have a more mechanical rather than biological mechanism/function.
Compliance for a 6 month course of just about anything is difficult and more so for something that may seem asymptomatic. Oozing sores, foul oders and overt discomfort would probably help, but alas...
I'm sorry but this doesn't make sense. Antibiotic resistance to TB only affects those who have TB, so if another 'natural' medicine is found and TB gets resistant to it, then it is still just as bad for the people affected.
Natural means nothing in this context. Effective medicine is effective medicine, and there is nothing that makes TB less prone to developing a resistance to a 'natural' effective medicine over any other effective medicine.
I admit I slipped into the octogon of HN where animals weak and strong come to test their teeth on impulse. Therefore I must be prepared to write essays on semantics even when I use subtle indicators such as quotes.
For the first portion of your reply, I think that if TB became resistant to potatoes with licorice icecream, it would be preferable to having absolutely no recourse with antibiotics. But that's silly. If you are 100% certain that latent TB is innocuous and can't be reactivated, I must admit my logic was flawed.
Edit: is not, eg mrsa, becoming resistant to various things in the environment? Biofilms make many bacteria resistant to even alcohol. Staph, ubiquitous and thus exposed to pretty much anything a person's skin is exposed to is probably resistant to many things it previously wasn't. But it remains vulnerable to a few antibiotics, for now.
I understand now what you mean. The thing is that TB doesn't transfer its resistance to other pathogens like MRSA does. It develops resistance via a different mechanism (mutations of its genome) then MRSA does (horizontal gene transfer).
Thus, you have a misconception about the nature of TB resistance. This accounts for the pushback. People tend to forget that we all have different knowledge bases and we talk past each other.
> The elephant here is (aside from latent infection) the atypically long duration of treatment, which can exceed 6 months and is harsh. Many, even otherwise responsible people, will founder before the proper end of treatment and this, I think, is what terrifies health professionals - so much, that it almost seems to be avoided.
The fear is overblown. I've known multiple people do the 9 month treatment and none had issues. One person had tingling sensation and that was resolved by an increase in vitamin intake after consulting with a neurologist.
They were in their early to mid thirties. Most problems occur when older people take the medication.
Don't take this as a touche, but are you suggesting that full compliance is the rule and that the vast majority completes the course as prescribed?
Again, this isn't some passive aggressive challenge. But I will be genuinely surprised to see this is indeed the case, which very well may be. I certainly know people who'd follow the course with perfection, and some who absolutely wouldn't.
On top of it being more resistant, we haven’t made very many new medicines to fight it in the last ~50 years.
Yeah… understatement with respect to TB is pretty scary. There’s a limited set of effective antibiotics, some strains are resistant, and some drugs have severe side effects.
You have to be a little suspicious of some of this — folks are looking for political reasons for scary disease outbreaks.
I had a TB scare last year. Coworker was exposed to a confirmed case. Got tested, and we all turned up negative. I then asked if I could get a TB vaccine, but was told no, because it makes the TB visual assessment test useless. So, to aid future potential diagnoses, I need to be able to be infected by the genuine article.
That’s one reason the BCG vaccine isn’t given in the US, but it’s also because the data on whether it’s effective in adults is really inconsistent. It seems to vary based on geography (maybe distance from the equator? they’re not sure). If we were going to administer it routinely, it would be for infants, where the data is better.
Can confirm. I got the vaccine in the Soviet Union as a kid and tested positive in the US for school admission and when volunteering with special kids. It’s a huge pain in the ass every time because doctors insist on a course of antibiotics that is particularly hard on the liver or kidneys so I have to spend significant time fighting them and getting an exception from administration.
That's silly. There's a globule test that doesn't give a false positive for vaccinated people. Perhaps it's more recent than when you last had to go through this?
Quantiferon is the test you're thinking of, and is now preferred for most individuals, even those who haven't had BCG.
- TB physician since 2006
What’s the name for that test?
I last had one in the late 2000s
https://www.cdc.gov/tb/testing/blood-test.html
Developed in the 90's.
Approved by the FDA in 2005. Probably took a while for it to become widespread.
The thing is: The protocol for a positive skin test wasn't "Here, take this 9 month treatment." It was "You need a chest X-Ray to show it's not active. If not, you're good to go!" Especially if they know you've received the vaccine. And no one should have made you go through the treatment multiple times - it's pointless, because even if you never had the vaccine but had latent/active TB, you will always test positive with the skin test. Knowing you'd gone through treatment once should have sufficed.
I know a nurse who definitely has latent TB (i.e. no vaccine). And she never had problems after a positive skin test - her employers always knew about it and as long as she had a clean chest X-Ray, she was deemed fit to interact with (at risk) patients.
Whoever made you go through treatment was incompetent.
To be clear I never went through the treatment, it just took a lot of arguing with doctors and the school/nonprofit administration in question after the false positive. I never had a chest xray either, I just had to drill it into their heads that Soviets got the vaccine and that it causes a false positive.
It sounds like they weren’t very well informed of TB protocol.
Is the CDC still a thing or did an executive order defund them too?
They were ordered to halt all publications, cancel trainings and not communicate with state health departments
What is the supposed rationale for this? Or is this just a general ideological purge of the government?
This is going to be a crazy four years, if it’s only four.
It could be ideological, or it could be a common mistake people with a business background make in the government.
For the average for-profit company, the actual business the company does has no value beyond its ability to generate profits. The damage a disruption causes today can always be offset with higher expected profits in the future.
But for many government departments, the day-to-day business is the entire point. Any disruption can easily cause irrevocable damage. Even when the net outcome is positive, the gains often cannot offset the damage, because they go to different people.
Rationale is probably the same that the current president used to claim there'd be no covid 19 if we didn't test for it
I'm going to guess that the rationale is a combination of:
1) state's rights
2) anti-science
3) a number of people in the administration (very possibly including Trump himself) thinking that the CDC is an example of "the deep state" that conspired to keep him from winning in 2020
But, hey, Joe made groceries more expensive and the administration didn't kiss enough rear on the left side of the Dems to get Kamala elected, so, here we are.
Since losing in 2020 the various think tanks and groups that make up the right-wing have settled on a unified, frightening, vision of what the US government should look like equipped with (extremely dubious) legal rhetoric and reason to back it up. Most notable of these is Project 2025 by the Heritage Foundation[1] which is a keyhole glimpse into the chaos of this last week and in the years to come. The section relevant to this action is chapter 14 which describes each HHS division as maligned, woke, and in need of reform.
A less nuanced answer is the HHS/CDC made Trump look bad in handling the COVID-19 pandemic and so they’re now ordered to say nothing about anything ever again.
[1]: https://static.project2025.org/2025_MandateForLeadership_FUL...
Trump made Trump look bad.
it might make the admin look bad if they say bad things happened.
The freeze will be lifted once RFK Jr. is approved by the Senate. The purpose is to stop progressive ideologues in the agencies from doing things in protest of their new boss.
like telling people about TB outbreaks and food recalls?
Fight the ideologues, them and their expertise are the problems.
To me, TB is ultimate test of character. Stopping TB means you care for your common man:
I was shocked that that said 2bn people carry TB, though it seems from recent research the number is much lower https://www.iavi.org/iavi-report/upending-the-dogma-of-tb-la...
I'm surprised people put up with it when there's a vaccine.
Nobody "puts up" with TB.
Poor countries and communities cannot afford the options on the market. TB wont be solved until we put people before profit.
>The cost of BCG is US$2–3 (£1.12–1.70) per dose (from https://pmc.ncbi.nlm.nih.gov/articles/PMC2083037/)
Even for poor countries it's not much. In the UK when I had it they sent a nurse round to the school and all the kids lined up and they did like one a minute. Free to us lot of course on the NHS.
I think it was quite nasty and leaves a scar though.
If RFK jr becomes HHS lead and is able to push anti-vax policies this could only get worse.
Is there public reporting for actions taken by the current American Presidential Presidency?
It would be useful and highly informative to be able to visit a single page to see daily/quarterly/bi-annual/annual diffs of which efforts habe received signoff.
My friend's husband is a physician that works along the Mexican border and volunteers at migrant shelters. He said the amount of TB that comes through the border is shocking.
Weird. Where did it come from? It’s basically unheard of in the US.
We have roughly 10k cases a year. https://www.cdc.gov/tb-surveillance-report-2023/summary/nati...
Oh wow, That’s still not much, but I was under the impression it was a lot less common than that.
Here is an early article about the outbreak. [0]
[0] https://www.unmc.edu/healthsecurity/transmission/2023/09/05/...
Appears that it originated within a family group involving 6 kids and 7 adults.
It came from abroad.
Yes. The question is how did it balloon so quickly if these people were identified an receiving treatment? Is this a breakdown in the case monitoring among Kansas City medical community or something else?
The original cases were in low income people who had been born outside the US but whose children were born in the US according to the paper.
From where? When?
Baffles me that someone would write something so definitively yet not expand on it in any way at all.
Not saying you're wrong (I have no idea), but what a low-effort comment. I'm curious, you seem (or claim, at least) to know something, can you help me satisfy my curiosity?
From the linked UNMC article;
> The outbreak involved 13 people across four households in Kansas City and spanned 1 year. While a majority of the seven adults identified were born outside the U.S. in a country that had experienced a multidrug-resistant TB outbreak with the same genotype in 2007-2009, most of the six children were U.S.-born, noted Elizabeth Groenweghe, MPH, of the Unified Government Public Health Department in Kansas City, and colleagues in the Morbidity and Mortality Weekly Report.
So it's either been a latent infection in someone in the first household or they traveled to their home country and brought it back, or something.. it's likely the local health department knows the exact lineage and route it took but they avoid publishing the full details for obvious reasons in this climate.
What are the “obvious reasons?” It seems to me the obvious reasons are that the claim is that illegal immigration has been blamed for outbreaks of diseases that are relatively uncommon in the U.S. and publishing the full details would provide evidence supporting that claim.
But if that is what happened, then why not publish those details? If that isn’t what happened, then why not publish those details? Facts are always preferred to conjuncture.
Because random people on the internet deciding to target a random family suffering from a serious illness won't remotely help anything. Regardless of the immigration status of the family, they'll be targeted as if they were illegal (even though their kids were explicitly born in the US and are obviously Americans) and the vitriol will ensure their community is less safe.. the ensuing media freakout will make sure that other infected communities are much less likely to turn up to hospitals when they have communal infections, almost guaranteeing the next outbreak will spread further.
Remember the "illegal haitians are eating our cats" bullshit from last summer? When they absolutely weren't and they were all legal refugees anyway? Then the future President weighed in and said the US should deport them anyway?
TB is particularly tough to track; it has an incubation period that can range into "years" and most people never develop symptoms. Add in getting quarantined for months and you've got a problem on the seeking treatment side of things, too.
I suspect it was said ironically, meaning all the recent immigrant scaremongering.
WUAN!
It’s still relatively common in some other countries. As usual, it’ll be connected to travel.
This is the type of thing that'd normally show up on CDC's Morbidity and Mortality Weekly Report which has been published weekly since 1960 (my understanding is this is without fail).
But unfortunately the current administration has decided an ideological purification is more important than keeping the American public apprised of threats to their health.
So it wasn't published last week, and probably won't be this week either. "Politics don't matter" though ;) Bummer!
Wouldn't this have showed up in the reports last year when the numbers were actively happening? There's been 1 case this year it says.
If the ideology was what you're saying, then wouldn't they want to spread the info and blame it on the "dirty illegals" or whatever?
> then wouldn't they want to spread the info and blame it on the "dirty illegals" or whatever?
pretty sure the ideology is to remove every social safety net and service to "prove" government doesn't work and then the robber barons can swoop in and make it a paid service... and make it so the capital class gets to make and save more money as they can afford to buy any of those services that were cut. it's basically vulture economics but at the nation scale. it's not great.
> it's not great.
Supply side Jesus is just alright.
This isn't really an urgent "alert" system per se, more of a knowledge dissemination system. Security postmortems more so than critical security patches.
We have good reason to believe it'd show up here given that Kansas's TB situation has had multiple bulletins over the years
The analogy breaks down in that rate of infection of a disease is historical but very much informs ongoing public health measures that should be taken.
One might conclude, given how closely the current administration has been following the project 2025 plan that was floating around, that the administration paused functions pending ideological purity checks on key personnel.
Ofc, one may conclude anything one wants,
32 active cases actually. 1 new case since January 1st.
"Since 2024" means from the beginning of 2025, not "during 2024".
"There has been one so far in 2025."
Read the data. There are many more latent cases recorded, and current new cases are not all recorded as the tally lags people sick right now.
You keep quoting that part and ignoring the rest of the article and the live data sources linked to it. The text of the article likely wasn’t from yesterday, as the reporter likely went around a week or two, gathered quotes, interviews, then spent some time in editorial revisions.
Maybe you can link to whatever data you're looking at. The article says one new active case and that the overall number of cases, including latent, are trending down. This is still consistent with this being a bigger deal last year than this year. The KS health data still shows 1 active for this year.
This year has been a rough start for HN. The political commentary is infecting every thread.
That's because it's an extremely big deal and affects many things discussed here.
As the federal government expands the stakes get ever higher. What could be overlooked before now becomes fierce debate.
It's because people now treat parties like they used to treat football teams.
I don't care if Jesus himself froze the CDC. It was an o srly hasty action at best and it will unnecessarily cost some lives.
If you mean avoiding the Party so you don't get beat up for being different, then the analogy checks out.
This goes way past teams bud. If you don't realize the kind of existential threat trump is posing to millions of people, you haven't paid attention to a single thing he's done since taking office.
Maybe the political climate is impacting a higher number of topical points that are being discussed on HN. When governments are changing, interfering, and impacting technology you're going to see it crop up more.
It's not a "rough start for HN", it's the current climate of the world through the lens of the US.
It’s almost as if politics impacts many things in the world around us.
> The political commentary is infecting every thread.
Unfortunately politics has infected areas of our lives we took for granted. The stopping of reporting coming out of the CDC/NIH/HHS makes discussing health science articles more challenging. And this is a direct result of the new administration. While this article may not be vaccine related, the new administration wants a known anti-vaxxer to lead the HHS.
I would argue that being rabidly apolitical while a dangerous threat to western democracy has been growing in America for years is the rough part.
I'm an old person. I have a leftist bent. I used to get along with many conservatives, I just had different policy viewpoints than they did. What we are seeing now is a completely different political landscape where one of the parties is actively setting up a dynastic plutocracy in the open.
FWIW I have a ton of criticism for the "other" party too as an ineffective mess sucking the corporate teet almost as hard, just without the actual proto fascism.
> I would argue that being rabidly apolitical while a dangerous threat to western democracy has been growing in America for years is the rough part.
Some of us are just here as technology professionals looking to learn and keep current on the latest trends. There's nothing wrong with that.
Some yes, but maybe not you? Because you used the following language yesterday:
"Only a few short months ago, I was under constant attack from various public members of the Democratic party for being a white male with center-right views. The vitriol was quite unhinged, really." when asked for specifics you went to '...on CNN for example'.
Digging up people's comments from unrelated threads* starts to cross into personal attack. Please don't do that here.
https://news.ycombinator.com/newsguidelines.html
* edit: I mean for use as ammunition in an argument. It's not that you're wrong—it's just that the cost (to the intended spirit of the site) outweighs the benefit (being right in an argument).
TBH this idea that each comment should stand individually on its (including HN's downplaying of the usernym with grey) seems like it contributes to some of the problems with modern discourse. When someone I know says something challenging, I know the context they're coming from, what I do agree with them on, what skills of theirs I respect, etc. Whereas message board comments are just tiny slivers of information with which you can agree or disagree.
Oh for sure. There's nothing wrong with people getting to know each other, and their views, by reading through past comments.
It's just not in the intended spirit of HN to track down contradictions and use them as gotchas in arguments. That's a narrower point. I've added an edit to the GP comment to clarify that.
Do I engage in politics on HN occasionally? Yes. Is it my primary motivation? No. I don't open up HN with the intention of having rigorous political discussions, even though I sometimes fall into them.
My comment history, which it seems you only partially perused, demonstrates this to be true. Especially if you go back a year ago before things became politically charged around here.
I also don't see what relevance my example has to this conversation. It sounds like you're trying to corner me into a specific label (Republican, maybe?). I guess thanks for proving my point about discussions around here?
I haven't used party labels on HN. You seem to be the one forcing an identity on me? I would respond but my post was out of bounds so I shouldn't elaborate/reference further.
FYI if you read my post history you will see I am a libertarian leaning (Santa Cruz hippie libertarian not Rand Paul 'my dad got me the job but I believe in everyone earning their way' libertarian) refugee from the Bay Area to a small town in a very red state. I don't have the agenda you think other than calling out hypocrisy and a desire for a functioning health system.
Certainly. So what interested you on this story that is more about medicine on HN?
Yes. Becsuse this is an issue that will be slower to respond to because of political actions. Do we really want to skirt around the issue?
It's hard to do technology when your staff and customers have TB.
> This is the type of thing that'd normally show up on CDC's Morbidity and Mortality Weekly Report
The resurgence of TB has been the big story in infectious diseases for a while now.
Globally:
> The World Health Organization (WHO) today published a new report on tuberculosis revealing that approximately 8.2 million people were newly diagnosed with TB in 2023 – the highest number recorded since WHO began global TB monitoring in 1995. This represents a notable increase from 7.5 million reported in 2022, placing TB again as the leading infectious disease killer in 2023, surpassing COVID-19.
https://www.who.int/news/item/29-10-2024-tuberculosis-resurg...
As well as in the US:
> After declining for three decades, tuberculosis (TB) rates in the U.S. have been increasing steadily since 2020, according to a new report from the Centers for Disease Control and Prevention. It’s a disturbing trend given that 1.5 million die from TB every year, making it the world’s most infectious killer.
https://www.nationalgeographic.com/science/article/us-tuberc...
> The resurgence of TB has been the big story in infectious diseases for a while now.
It's been a big story since the 1980s, IIRC. I remember in college in the 1990s a biologist friend explaining that TB was the greatest disease threat to public health and it was being completely ignored.
Frankly, it's hard to get worked up about it. Notwithstanding that it is a serious public health threat, there's a strong political rhetoric aspect to the discussion, both in the popular and professional spheres. It's unfortunate. In the 1980s and 1990s it was all about how Reagan decimated our public health infrastructure. The arguments aren't per se wrong, but it's difficult to gauge relevance and prioritization about the threat of TB given how part of the medical and scientific community seem to have been border-line crying wolf for 40 years. Discussion centers around absolute numbers. Tell me what the per capita relationship looks like, especially per capita among the populations most vulnerable to acquisition and disease, and what the long-term trends look like. I see this in a lot of other adjacent public health discussions tainted by political hand wringing, such as food insecurity, etc--lots of absolute numbers. But global populations are growing. The US, for example, grew by 80 million people, or 30%, between 1990 and 2020. That's not to deny that tuberculosis is a growing problem, but we have many problems. And the constant drum beat of alarm causes some parts of the community to (increasingly) react in counterproductive ways. From an individual moral standpoint, that's on them, but from an epidemiological and sociological perspective, maybe the professionals bear a little blame, too, at least in terms of communication. We could all do better.
> Frankly, it's hard to get worked up about it.
A common bacteria with airborne spread and extremely drug resistant variants in the wild can hardly be characterized this way.
However, it's extremely fair to say that this is not a new issue that has only become apparent over the past week.
Rubbish, on all counts. Public health discussion constantly gives rates and percentages, not just numbers. And “they’ve been warning us so many times” - well, I hope you’ve also given up on applying security updates to any software or hardware you manage, since those have been getting issued forever, they must be crying wolf too.
The 2023 incidence rate per 100k is 2.9. That's an increase from 2019, but also the same rate as 2014 and 2016. https://www.cdc.gov/tb-surveillance-report-2023/tables/table... (via https://www.cdc.gov/tb-surveillance-report-2023/summary/nati...)
My point isn't that agencies don't report incidence; my point is about when the discussion surfaces how it's discussed in the popular press, including editorializations in professional outlet. Were incidence rate flat or down between convenient points of comparison, but absolute numbers up, and an outbreak like Kansas happen, we'd be discussion absolute numbers. And even when incidence is up, the absolute numbers always headline. It's a subtle criticism I'm making, but I think an important one.
Nonetheless, while for 40 years TB has been discussed as a grace looming threat, note how absolute cases and incidence dropped steeply over most of that time. And while the drop has largely stopped, the US now has one of the lowest incidence rates in the world. But my takeaway is supposed to be that the US' TB measures are woefully broken because the drop has stopped?
The point is that if we'd put in a bit more effort 40 and 30 years ago, there would be 0 cases today (and if we put a bunch more effort in now, there will be 0 cases in 20 years). TB is awful, but it is curable and preventable. It's current existence in the world is a policy choice of the past few decades, and eradicating it is a choice we can make today.
> This is the type of thing that'd normally show up on CDC's Morbidity and Mortality Weekly Report which has been published weekly since 1960 (my understanding is this is without fail).
> But unfortunately the current administration has decided an ideological purification is more important than keeping the American public apprised of threats to their health.
Looking at the CDC's Morbidity and Mortality Weekly Report, this doesn't actually appear to be true. Going by that link you can read past MMWR reports, and they aren't (from everything I can see) doing weekly tracking of outbreaks, but rather publishing various articles about diseases the way a science journal would. I couldn't find anything about the Kansas tuberculosis outbreak in the most recent reports, so I wouldn't be surprised if we don't see anything about it in the next few MMRW reports.
[flagged]
[flagged]
I’m an academic scientist part of a really large government funded research grant that employs hundreds of people. Last time, we had to fire half our staff immediately right up front because they said they were cutting our funding. They ended up not cutting our funding at all, but we had already fired everyone so it was lose lose- the Government spent the money but the research couldn’t be done. Just plain bad leadership.
I've had two grants in a row get killed for political reasons, and a third is on the chopping block. What really kills me is that we get through the unpleasant, unproductive scaling up part, are about to hit our stride, and then...gone.
Where did the money go then?
We hired new people with less experience and restarted the projects, but in a lot of cases the projects were set back years with no reduction in the cost.
At the very least, some went to unemployment benefits, I’d expect.
Sounds like bad leadership on the part of your project. To outsiders that don’t understand the details why fire people before the actual budget cuts?
It was the policy of the granting federal agency- it was not our choice, we had to immediately start operating on the president's proposed low budget in case it were to pass, rather than spend money that might never exist.
This happened because Trump's administration essentially copy and pasted Heritage Foundation materials rather than carefully think through a realistic budget.
Here’s another example: would you start building a house today knowing the price of every input material might jump 20% to 200%?
It's even worse than that: it's more like buying unrefundable materials to build a house today on an account/invoice, knowing you will likely be unemployed before the bill comes due, but after the materials are delivered. You're spending money up front that you don't have, and may never have.
If you spend full budget for the first half of the fiscal year, but a final budget gets passed later that cuts your budget in half- you get no remaining money for the year, and then end up firing everyone, instead of half. This is why the federal agencies have the policy of immediately acting on the lowest proposed budget, instead of waiting to see what happens.
How is it that Trump is so timely at cutting medical resources right before the moment it is most needed? Or perhaps such outbreaks are more common than you'd expect and it's the equivalent of leaving a firewall down for a day?
And yeah, I'm aware a bigger factor in this freeze was hiding the very obvious Bird Flu pandemic. Can't hide the eggs getting more expensive though.
> Or perhaps such outbreaks are more common than you'd expect and it's the equivalent of leaving a firewall down for a day?
I think this + bad luck, really.
Luck is the intersection of preparation and opportunity. In this case lots of opportunity and zero preparation.
Well said!
Trump is not acting in people's best interests. Wait, just rumaging around looking for my shocked face mask.
Eggs more expensive doesn't matter any more.
Indeed. I'm just also find it interesting how timely some of his actions can immediately blow up on us.
And yes. It really doesn't matter in the grand scheme of things but was such a common rationale for those who voted Trump. I'm shocked that he did not in fact keep a promise thst would have benefitted the working class.
Cutting resources often is the root cause for an outbreak.
- SARSv2 (aka Covid-19) happened after Trump disbanded the team that contained SARSv1.
- During COVID, the west suspended polio vaccination programs in developing regions, so now polio outbreaks are a thing again.
- Antivaxxers in NYC caused a massive measles outbreak a few years ago.
Etc, etc.
I won't attempt to defend the administration's actions, but no team ever really contained SARS. That outbreak burned out largely for natural reasons.
I think they’ve muddled a few things together and are in part referring to the disbanding of the NSC’s Directorate of Global Health Security and Biodefense as part of John Bolton’s NSC reorg.
Covid was spreading in many countries before the US. Off the top of my head I remember China, Korea, Italy and Spain.
And no country of significant size avoided it, regardless of whether they were led by Trump or not.
I don't know if any of these would count as being significantly sized, but Japan, Australia, and South Korea handled it a lot better than the US [1] when it comes to deaths per 100k. Interestingly, Australia and South Korea did have more cases per 100k than the US[2].
[1] https://91-divoc.com/pages/covid-visualization/?chart=countr...
[2] https://91-divoc.com/pages/covid-visualization/?chart=countr...
The Australian cases would largely have been after the vaccine was available, I think (though Australia did screw up the rollout; they could’ve done better there) so you’d expect a lower death rate.
Also worth looking at Denmark, France, Hungary, Romania, and the UK.
So basically it's good to be an island?
An interesting thing to look at is the differences between European countries differing responses and how that worked out for them given many are connected via land borders.
People strongly recommended closing the US borders in the early stages of the pandemic, but they were dismissed as racists.
I can show multiple videos up to the end of Feb 2020 where Anthony Fauci said this wasn’t something to be too worried about, it was going to probably remain under control…
I went skiing in Korea during the next to last weekend of Feb 2020. Best skiing of my time there, because the mountain was already empty of people due to public concern. By that time we were already wearing N95 masks: I remember discovering it was very hard to talk with both a ski mask and an N95 on.
By mid Feb, Korea was already covertly acquiring mask materials and preparing a ramp up in testing. I believe we had working PCR tests in my local hospital by mid March, and mask rationing in April. This made me very skeptical of the competence of the US public health establishment.
Edit: Skiing was Feb 21 to 23, just before Daegu locked down. The Mask rationing started early March: https://m.koreatimes.co.kr/pages/article.asp?newsIdx=292662
The US pandemic response team that Trump fired included a significant presence working onsite in China
https://www.reuters.com/article/world/exclusive-us-slashed-c...
I hit the paywall. But if this is about the same thing I’m thinking of, one reason to be careful about the work China’s CDC was doing (at times with visiting staff from the US) is they were one (among many) source of lab leaks of SARSv1:
This was the US working in China, with the government’s permission. It was an international task force that was operated by the US govt.
Also, if look up biological weapons research papers from Wuhan, you’ll find that many were done in collaboration with the US, and with US funding.
Don't let perfect be the enemy of good. No country avoided it entirely, but a lot of them managed to get rid of at least half the deaths (keep in mind that that's with still with individuals people being rebellious), sometimes more.
Excess mortality per capita is the useful number to look at, since it's immune to scaling problems and the "but diagnosis!" argument. Although it may include "too scared to go to the doctor", that can't be too much of a contribution since that contribution shouldn't spike so much. Let's look at some numbers, smearing the spikes:
* in 2020-2021, South Korea's and Japan's excess death rate hovers below 5%
* in 2020-2021, Canada's, France's, and Germany's excess death rate hovers around 10%
* in 2020-2021, the US's excess death rate hovers around 20%
* in 2020-2021, Spain and the UK have spikes so high (but narrow) that I'm not even going to try to average it out. I would guess they're somewhere near the US for 2020 but better in 2021.
* in 2022, South Korea finally had a bad spike, but averaged over the year it's still only maybe 20%.
* in 2022, in almost all countries it hovers around 10%, and the timing of the swings is very similar between countries
* in 2023, in all countries it hovers around 5%
Source: first chart of https://ourworldindata.org/excess-mortality-covid ; I've done the calculus by eye with rounding since I don't want to look up billions of numbers to do the math the hard way.
(Frankly, Korea and Japan did even better than these numbers say, since their population is skewed elderly in the first place)
> During COVID, the west suspended polio vaccination programs in developing regions, so now polio outbreaks are a thing again.
There are cough other reasons for that as well:
https://www.scientificamerican.com/article/how-cia-fake-vacc...
The team that contained SARSv1? No one contained it successfully. In fact, there were many lab leaks of it. The outbreak itself was stopped by basic measures like masks and screening. But it also was far less infectious than SARSv2.
Blaming Trump for COVID-19 makes no sense for other reasons too. There are so many other people to blame first. Fauci for funding GoF research at WIV through EHA. The CCP for being secretive and denying there was an outbreak for a while and not allowing investigations in Wuhan for over a year. The WHO for repeating CCP propaganda like claiming there was no human to human transmission roughly fourth months after the first scientists fell ill at WIV. Do you remember Pelosi and democrats downplaying the pandemic and accusing those who wanted to close borders of racism? She apparently had no regrets about all that:
https://www.foxnews.com/politics/pelosi-no-regrets-initial-c...
With all of this how can blame be placed on Trump? If anything his Operation Warp Speed program bailed out the planet from pandemic (with great work from vaccine manufacturers of course).
You left out how conservative media was adamant that it was a politically motivated hoax and ensured their faithful were kept in the dark about the looming threat.
Thanks for the find - I don’t follow conservative news usually, so I’m looking forward to learning how things were skewed on that side of media.
Last week it was still the job of the previous administration to publish it and it was the last administration which created the problem in the first place. Ideological purification was also what the previous administration has done quite a lot by hiring people based on their sexual preference, skin colour, gender and other irrelevant to the job characteristics.
I wonder if we’d do better in discourse to stop pointing at an “administration.” It is a reflection of what a plurality, often majority, of people want.
Democracy doesn't mean "accept what the current administration does with no criticism, because they were democratically elected"
It does make ones eyes glaze over when American politics is everywhere you look. In every thread, about every topic. And each comment thread has 50 highly emotional comments that you have to scroll through to find the 5 few thoughtful comments near the bottom discussing the article, without going off the rails.
Why wouldn't American politics be discussed in a thread about tuberculosis in an American state?
Look at the top thread with 50 comments and count how many are discussing tuberculosis in America. It's just another starting off point for everyone to go in a hundred directions ranting about US politics and ignore the topic
The thread is about a tuberculosis outbreak in the US. Subsequent comments include conversations about a US federal government department agency publishing (or not) data on that outbreak.
This is all taking place on an online forum hosted in the US and managed by US entities.
And you (and like minded individuals) expect to not see US politics?
I appreciate that the US has an outsized presence on the intertubez, but you also need to realize you're first of all talking in the midst of Americans.
You can read the MMWR reports, the OP linked to them: https://www.cdc.gov/mmwr/index.html
The ones that were published in the weeks prior to the current administration weren't talking about the Kansas tuberculosis outbreak either.
So we're not really discussing the "US federal government department agency publishing (or not) data on that outbreak." Someone's implying that's what happened, and then people are spinning off into political discussions without even looking into the link they provided to see if that was actually the case.
It's not just going off topic to discuss politics. People are actively spreading misinformation to justify going off topic to discuss politics, and lots of other people are joining in without bothering to check if what was claimed is actually true. Two-thirds of the comments now are using the claims about the MMWR to discuss politics, and it doesn't look like anyone actually looked at the MMWR to see what it actually is.
I at least didn't read any of the links because I couldn't care less beyond seeing what everyone was talking about in a thread about tuberculosis in the US.
My point still stands that if someone doesn't want to see conversations regarding the US, politics or otherwise, maybe he should stay out of threads regarding the US and maybe also find other forums not hosted in America and managed by Americans where the vast majority of participants will be Americans.
It's like taking a trip to Mars and complaining that all the dirt is red, y'know?
That’s a wholly unambitious worldview
Online communities need constant self checking and introspection to not go off the deepend. This isn’t like Reddit where you can unsubscribe from the crazy big politics subreddits or unfollow people on Twitter. I still think the old ideal of HN where we have some higher goal than yet another US political rant forum is still worth fighting for.
> I couldn't care less beyond seeing what everyone was talking about in a thread about tuberculosis in the US.
I was interested in the issue in Kansas because I read the article. 66 people almost entirely in 2 counties isn’t exactly a national statistics collection issue
This is HN and I'm sure there are all kinds of filters people have made as add-ons if news like this truly bothers you. Users here are more than likely to make their own as well. You can also always reach out to Dang for feature requests. I'm never going to not want more flexibility in my newsfeed.
>. 66 people almost entirely in 2 counties isn’t exactly a national statistics collection issue
Patient zero starts somewhere. It's not national news per se when a few individuals die of an unidentified disease either.
Meh I don’t need 3rd party plugins, I spent years using them on HN and my iPhone doesn’t have browser plugins.
I don’t care enough anyway I just use HN less and less every year like all the old userbase. The only old usernames I recognize at the top of threads these days are the ones who like the politics stuff (I could list at least 4-5). Just my own nostalgia for a dying small community of thoughtful nerds.
I'm sorry to hear that but it seems that's simply a natural part of the internet. Even 4 Chan was susceptible to this cultural shift and it seems the whole point was the gatekeep as much as possible.
>This isn’t like Reddit where you can unsubscribe from the crazy big politics subreddits or unfollow people on Twitter.
Sure it is. This is the internet, Hacker News is just one website someone could choose not to patronize among countless others.
If you don't want to see US centric conversations, don't patronize American websites like Hacker News and certainly centralized American services like Reddit or X.
This is about medicine. How many people are claiming to separate medicine from politics? And how is this off the rails?
Oh, no that’s not my point. It’s that the administration is often used as a proxy when people should be angry at the diseased state of the population.
Around 20% of Americans voted Trump, and from polls most don’t like him, but always vote R. Die hard Trumpers are at best 10% of Americans. Trump didn’t even get 50% of the vote.
His views most certainly aren’t what a majority of people want, and he doesn’t try to expand by doing things the majority want. If anything he paints those not completely in his camp, which is the vast majority of Americans, as an enemy.
> His views most certainly aren’t what a majority of people want
I'm not sure what you gain by telling yourself that.
I could just as easily assert, without any evidence (i.e., like you), that every single person who didn't vote loves Trump and supports all his policies.
> If anything he paints those not completely in his camp, which is the vast majority of Americans, as an enemy.
That has nothing to do with whether people support him. 20 or more (exact number varies on the reporting) women say that he sexually assaulted them, he was convicted of one sexual assault, and yet white women still voted for him.
Experiments consistently and repeatedly show that when given practical descriptions of policy actions and outcomes, the majority of Americans do not choose the ones that republicans promote. BUT when told that they are Republican policies, then about half of Americans do support those policies.
Well then, liberal politicians aren't doing a very good job, are they?
This is like a cliche from the chess world, where the guy who lost the game, then does a postmortem to convince everyone that he was actually winning the whole time. "Except for that one little blunder."
The Dems keep losing losing losing, but rather than figure out how to fight better, you instead try to convince yourself that people support you. And then you go back to debating Israel v Palestine or trans pronouns while our own country descends into tyranny. (Literally - many progressives I know.)
Meanwhile, Trump owns the White House, both houses of Congress, and the Supreme Court!
The only lesson I get is that the segregation of education over 40-50 years or so is finally showing its consequences (well it did so 20 years ago. But it's only more polarized now). A chess player at least has the knowledge and willingness to improve and learn from lost matches. The average American... Not so much.
And you didn't really offer much feedback here. Which is part of the problems. I don't really care to bicker over single issue details like this.
Straight from “you don’t have any evidence!” to “well who even cares that’s not important”.
I have no idea what you're saying.
I think this is a chatbot. It has no memory for one of its posts to the next. Fascinating.
If 80% of Americans didn't vote Trump, you're trying to claim they just as likely love him as those who did, even when polling of those voting for him show many dislike him?
Yeah, I'm not the one unable to read evidence.
Polls also repeatedly show people dislike a large amount of his policies.
And it's a fact he didn't even get 50% of voters to vote for him.
> It is a reflection of what a plurality, often majority, of people want.
Maybe in countries with multiple parties, proportional representation (or the like), and mechanisms to encourage voting like a holiday for elections.
But, everywhere else? It's a crapshoot..low turnout also doesn't help.
Have you read Democracy for Realists?
TIL Most voters don't have well defined policy preferences. Nor can they correctly associate political parties with their stated policy positions.
Less than 31% of people voted for this administration. So no, it isn't.
The majority of people don't want this. 36 percent of americans didn't vote.
That doesn't mean they don't want services, that means that in addition to 74 million that voted against trump, 90 million more also didn't want him.
No, it means that over a third of people DGAF. They neither do want it nor don't want it.
(It's like NULL values in SQL, only much worse because it's in real life.)
An indifference implies that there was going to be no difference to their daily life regardless of who was in office.
If nothing else, I do hope this 2nd trump administration wakes those indifferent up. Yes your choice matters. And yes, choosing nothing is a choice.
Doesn't matter the reason. The fact is, if they wanted trump, they would have voted for him.
Nope, those people don't count. You may as well point out that 89.7M dogs didn't vote for Trump.
The majority of people wanted this.
They absolutely count. The fact that you don't think so, says more about you than about them.
How can someone who couldn't be bothered to vote possibly count in a discussion of how many people support this administration? Putting aside people who were unable to vote, everyone who chose not to, absolutely 100% gave up their relevance in terms of what the people want. They took themselves out of the equation.
It doesn't matter if they did or not. If they supported Trump they would have voted. Ergo the majority of people don't support him. Non voters are still people, last I checked.
No -- the people who chose not to vote supported the decision of the people who did.
Interesting. So you were able to see these and reports last year and all the way through January 21st this year?
Because there's only been one reported car in 2025 in Kansas, I'd be surprised...
> "Politics don't matter" though ;) Bummer!
1. Is there an argument here that the CDC's Morbidity and Mortality Weekly Report's unbroken publication record is so important it should switch votes?
2. They probably still filled the report in, so there is a chance it eventually gets published. No need to abandon hope yet.
Yes there's an argument that "having vs not-having functional contagious disease surveillance, alerting, and learning systems" can change political outcomes.
It’s not exactly an outlier among the many arguments.
I have a lot of disagreements with HL Mencken, but I’ve found myself thinking about this quote of his a lot lately…for whatever reason.
“Democracy is the theory that the common people know what they want, and deserve to get it good and hard.”
"As democracy is perfected, the office represents, more and more closely, the inner soul of the people."
Shhhh.... don't tell the CDC.
Fun historical incident, but the "Spanish Flu" was traced back to Fort Riley Kansas. I think some people highlight a specific pig farm even. Now, the CDC do not list any infections of H1N5 in Kansas yet, but... Worth looking out for in anticipation maybe?
Is there any reason why Kansas would be different than other states in particular?