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Monday, August 4, 2014

[rewind] All we have to fear is fear itself . . . [revised]

http://teddysratlab.blogspot.com [Full link to blog for email clients.]

So it looks like I am going to say this twice. After my last post, there was some criticism, some critique, some helpful commentary . . . and some new information and disinformation on the topic. As a result - and because scientists should correct themselves when they are wrong - I am posting a revised, expanded and corrected post so that we get the most accurate, up-to-date and calm, evaluation of Ebola.

To start with, there are some TRULY HORRENDOUSLY IGNORANT comments being made about Ebola on social media and the internet. This blog was originally posted to STOP some of these posts, but yes, I needed to have some of the information corrected.

First and foremost, there has been criticism of my scientific credentials. To clarify, yes, I am a Neuroscientist - currently. That is what I do, and reflects only a part of my training. My degrees are in Physiology and Pharmacology and I obtained that training via a medical school curriculum. As a part of my formal coursework, I was trained in abnormal physiology and pathophysiology - i.e. disease. The pharmacology coursework covered many aspects of medications to combat disease - including antibiotics, antivirals, etc. Prior to my doctorate I worked for 2 years teaching microbiology. As a current medical school faculty member with research projects involving rodents to humans, I am current on Universal Precautions, receive yearly training in HIPAA, Blood-borne Pathogens, Patient Safety and Herpes B (If you think Ebola is scary, don't even ask about HrpB). So yes, I have valid credentials.

Many commenters reference The Hot Zone by Richard Preston. It's a good book. I read it . . . in 1994. It is nonfiction, a true story - but two things MUST be considered about the book: First, it was written to be a medical thriller - all events are true, but not all true events are included in the book. Second - it is dated. The book was published 20 years ago - and written at least 3-4 years previously. Much of what we now know about the Ebola/Marburg viruses was unknown in 1992 (when Preston wrote first wrote the story for New Yorker). Current knowledge of the virus draws heavily from the outbreaks in the Democratic Republic of Congo (DRC - formerly Zaire) in 1995, the smaller Gabon outbreak in 1994-1995, the ongoing outbreaks in Gabon 1994-2003, 1996 human-to-human secondary infection case in South Africa, the Cote d'Ivoire, Kikwit and , Sudan, Angola, Ugandan variants from 1994-2007.

My point is, if all people are basing their knowledge on is an out-dated, 20 year old medical thriller - that knowledge is at best incomplete.

For sources, I am using National Library of Medicine's PubMed Health (http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002315/), MSDS online, which has a great compendium of Ebola facts (http://www.msdsonline.com/resources/msds-resources/free-safety-data-sheet-index/ebola-virus.aspx) and Harrison's Principles of Internal Medicine, 18th ed. (http://accessmedicine.mhmedical.com/content.aspx?bookid=331&sectionid=40726956) - available online through libraries and usually found in university and med school libraries. By the way, Harrison's is THE TEXTBOOK on general medicine for medical school and medical reference. You can rent the current edition for about $50, the Kindle and New Hardback run close to $100, but the 17th Edition (valid 2008-2011) is about $30-$40 used. Now - back to my original points.

1. [original] This is not Africa. We actually have fully-competent medical professionals in every metroplex, city, small town, and rural community who are trained to recognize illness. The reason Ebola is so deadly in Africa is that so many of the people who are sick get NO MEDICAL CARE!

[revised/extended] Case in point from Harrison's Principles of Internal Medicine regarding the Zaire/Sudan outbreak in 1976: "Both epidemics were associated with inter-human spread (particularly in the hospital setting) and the use of unsterilized needles and syringes—a common practice in developing-country hospitals. The epidemics dwindled as the clinics were closed and as persons in the endemic area increasingly shunned affected persons and avoided traditional burial practices." and regarding Ebola Zaire epidemic in 1994: "The epidemic smoldered until April, when intense nosocomial transmission forced closure of the hospitals; samples were finally sent to the laboratory for Ebola testing, which yielded positive results within a few hours. International assistance, with barrier nursing instruction and materials, was provided; nosocomial transmission ceased, hospitals reopened, and patients were segregated to prevent intra-familial spread. The last case was reported in June 1995."

Thus, it doesn't actually require full Biosafety Level IV just to stop the spread - simple hygiene is sufficient - and that is something which hospitals do normally. To wit: "In a 1996 episode, a physician exposed to Ebola-infected patients traveled to South Africa with a fever; a nurse who assisted in a cutdown on the physician developed Ebola hemorrhagic fever and died despite intensive care. The index patient was identified retrospectively on the basis of serum antibodies and virus isolation from semen. No additional cases arising from care of the primary or secondary case were detected, nor did any secondary cases follow care of an unsuspected Côte d′Ivoire Ebola case in Switzerland. Thus, distant transport of Ebola virus is an established risk, but limited nosocomial spread occurs under proper hygienic conditions."

2. [original] Medical care for a viral infection consists of rest, plenty of fluids and nutrients, treatment for fever, treatment for nausea-vomiting-diarrhea, treatment with anti-viral medications - i.e. medications specifically designed to interfere with viral replication. Given appropriate supportive treatment - the mortality rate of even Ebola goes way down from what it is in Africa - in other words, even country doctors are able to treat it.

[revised/extended] Again, it was pointed out that "even country doctors" can't handle Biosafety Level 4. However, the Biosafety protocols are generally in place for studying the laboratory research. Level 4 is specified due to the high mortality rate historically associated with the virus and the fact that it can be spread by aerosols. Aerosols are fluid droplets temporarily suspended in the air - i.e. coughs and sneezes. It should be noted, however, that the tracked secondary infection cases are almost all associated with direct body fluid contact - blood, sputum, vomitus, semen. Even the single known tertiary transfer case (the South African Nurse in 1996) had direct contact with a patient's blood.

Keep in mind that in many African societies, customs regarding the dead involved kissing the corpse and close contact with the body during burial preparations. Stopping that practice did as much to halt the outbreaks as implementing the "Western Standard of Care."

[Correction] I am also not making light of the effort required to keep a patient alive that has gone into end-stage disease. As a correction to what I said above, antiviral drugs don't work, but supportive therapy improves survivability. The main treatments are platelets and keeping blood volume elevated, because the primary cause of death is low blood pressure and NOT blood loss. Low blood pressure causes heart failure, lack of oxygen transport in the lungs, fluid buildup in the lungs, kidney failure fluid retention all through the body and eventually coma and organ failure. Supportive therapy is just that - keep the patient supported - their blood volume and blood pressure elevated, use dialysis techniques to reduce the fluid retention, platelets and clotting factors to reduce bleeding and let the cells of the body fight off the disease (not that it is not the "immune system" per se which counters the virus, but the infected cell's own mechanisms to block replication of the virus. In that respect, in western medicine it very likely will be the case that an Ebola/Marburg outbreak will be similar to other viruses in that among those with access to supportive care, the predominant fatalities will be the very young, elderly and immune compromised.

3. [original] Most airborne viruses are not lethal. The dozen or so "lethal" viruses all require some form of direct transfer through bodily fluids in order to infect a new patient. The reason for this is that what makes a virus deadly is how fast it multiplies - and what tissue it infects - in a human patient. That usually means the lungs, mucus, blood, organs - and that environment is hot (98.6 degrees F), moist (nearly 100% humidity) and full of soft cells. Air is not. Even Atlanta, Houston or Miami in the Summer does not reach those conditions.

[revised/extended] I will repeat - most truly airborne viruses aren't lethal. That doesn't mean they aren't dangerous, just that they are not associated with the high mortality of 1980's HIV, 1976 Ebola, Herpes B, etc.

Many comments here and on Facebook counter that American hospitals can't control nosocomial infections such as MRSA and norovirus - but there are some extremely significant differences in how those diseases vectors are spread and what they are sensitive to. Norwalk Virus (i.e. norovirus - for one nosocomial example) is eliminated by bleach and Betadine, but totally unaffected by "antibacterial" soaps, chlorhexidine gluconate and benzethonium chloride. Norovirus is present in feces, sputum and vomitus; it survives dry cool air, boiling water, ether, and acids, but to date it cannot be easily grown in cell culture.

The "filoviruses" of which Marburg, Ebola/Zaire, Ebola/Reston, etc. are members are susceptible to: bleach, alcohols, ethers, acids, lyes, lipid solvents (soaps), detergents, UV radiation, high temperature (60 degrees C) - they can survive drying if it is still in a cellular medium (dried blood) but on the whole, these viruses are extremely fragile compared to the types of viruses most commonly found in "hospital" infections.

So yes, the basic nursing principles of hand washing, masks, gloves, not sharing needles, and cleaning up body fluid spills will go a long way to containing an Ebola outbreak.

4. [original] In order to grow and multiply quickly in those conditions, viruses are adapted to live best in those conditions. That means the virus itself is actually quite fragile. It will not survive on a cool dry surface. Even in sputum (what you cough up) it will die in a few minutes exposure to air, and can be eliminated with alcohol wipes, dilute bleach, Lysol, or even just soap and water.

[correction] Ebola and Marburg will survive drying, but all known cases of dried viral survival involve drying virus-infected blood or tissues - in other words, the virus is in its preferred environment when dry - not isolated on a counter-top or doorknob.

5. [original] Viruses are not bacteria. The fact that Americans over-use antibiotics and there are resistant strains out there MEANS NOTHING to dealing with viruses. Presence or absence of TRICLOSAN in antibiotic soaps is MEANINGLESS. PUREL(tm) hand sanitizer works just fine - it's the alcohol that does the trick.

[revised/extended] I will repeat the list of disinfecting agents that will kill Ebola & Marburg virus (From http://www.msdsonline.com/resources/msds-resources/free-safety-data-sheet-index/ebola-virus.aspx): "Ebola virus is susceptible to sodium hypochlorite, lipid solvents, phenolic disinfectants, peracetic acid, methyl alcohol, ether, sodium deoxycholate, 2% glutaraldehyde, 0.25% Triton X-100, β-propiolactone, 3% acetic acid (pH 2.5), formaldehyde and paraformaldehyde, and detergents such as SDS." That means alcohol wipes, hand sanitizer, Lysol, Betadine, Chlorhexidine . . . even soap and water.

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[original] U.S. Doctors do know how to deal with viral infections - see 1-5 above!

[revised/extended] I see no reason to change this assertion.

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6. [original] Why are these patients going to Emory? Because Emory has a HOSPITAL. CDC and USAMRIID are RESEARCH institutions, not HOSPITALS. Hospitals have very effective infection control mechanisms in place. I run a research lab. I deal with lab animals. When I need to deal with human patients - I do so IN A HOSPITAL!

[revised/extended] I stand by the original statement. It is worth noting the following details of laboratory infection (from MSDS online): "One reported near-fatal case following a minute finger prick in an English laboratory (1976). A Swiss zoologist contracted Ebola virus after performing an autopsy on a chimpanzee in 1994. An incident in Germany in 2009 when a laboratory scientist pricked herself with a needle that had just been used to infect a mouse with Ebola, however infection has not be confirmed. Additional incidents were recorded in the US in 2004, and a fatal case in Russia in 2004. "

That's FIVE NAMED CASES . . . in 40 years! When coupled with the actual mortality due to Ebola/Marburg since the first outbreak in 1969 - less than 3000 total deaths - the risks of "casual" outbreak are extremely small.

7. [original] Yes, viruses have a high mutation rate. That is why we need new influenza vaccines each year. BUT! What mutates is the PROTEIN COAT around the viral DNA/RNA. Typically not the genes themselves. Thus, the virus is HIGHLY UNLIKELY to sudden become more lethal just in the course of infecting a few humans!

See, what happens is, a virus "particle" attaches to a cell. As stated above, a virus is genetic material wrapped in a glycoprotein capsule. When the proteins attach to a cell, the proteins stay on the outside and the DNA/RNA enters the cell and starts to replicate. The cell is "taken over" to make DNA/RNA copies and build more glycoprotein capsules. The viruses are assembled, the cell dies, ruptures and releases more virus. HOWEVER since the original glycoprotein coat does not enter the cell and has to be built from scratch by the infected cells, that coating is the most likely to mutate. When that happens, the coat MIGHT be more likely to attach to different types of cells - but more likely, all that happens is that the bodies existing antibodies (and vaccines) won't quite recognize the new coat. This slows down immunity, but doesn't stop it in its tracks.

[revised/extended] While all of the above is true - the specifics for Ebola/Marburg is that the antibodies in the human don't do a whole lot of good anyway. The glycoprotein coat appears to function in a way to disguise the virus or discourage immune responses. There's new evidence regarding the mutation rate of Ebola which I will cover below.

8. [original] Viruses tend to become LESS LETHAL as they mutate. This is exactly the principle used in producing vaccines - take a virus, grow it in a cellular medium where it can reproduce and mutate to its own content - then harvest the mutations that have gotten less "virulent" - it's called ATTENUATED VIRUS and is how most vaccines are created simply because THAT IS WHAT VIRUSES DO. A more lethal virus is so unlikely that most research labs artificially create substances rather than let nature run its course.

[revised/extended] Again, please understand that what I originally responded to was a person on a Facebook thread going on about how viruses rapidly mutate into more lethal forms once an epidemic starts. That just isn't true. Again, I'm not saying that viruses don't mutate - they do - they change hosts, targets, animal vectors and means of transmission - again, mainly via changes to the glycoprotein coat.  Thus, while all of the above is true - the specifics for Ebola/Marburg is that the antibodies in the human don't do a whole lot of good anyway. The glycoprotein coat appears to function in a way to disguise the virus and blind the normal immune processes (which is what mutation affects anyway) or discourage immune responses, so mutation of those characteristics is somewhat meaningless. There's even new evidence regarding the supposed mutation of Ebola during outbreaks which I will cover below.

9. [original] Yes, a change in transmission CAN occur throughout the course of an epidemic - however, what epidemiologists tend to find is that the alternate form was there all along, but not recognized. It's the sort of thing that requires tens and hundreds of millions of infected to occur. That's why we get things like bird flu and swine flu because the virus developed in a species untreated. Then when they jump to humans - they don't really take hold unless the victims GET INEFFECTIVE MEDICAL CARE (see #1&2).

[revised/extended] Regarding mutations: A commenter in the prior post mentioned that Ebola virus quickly mutates to a less lethal but longer incubation form. This point still makes my case - that viruses are more likely to mutate to less severe forms in humans. It is the long incubation in an animal reservoir which results in the previously unknown "deadly mutations." My statement was made specifically to counter rumors to the effect of "viruses quickly mutate to more deadly forms in the course of an epidemic." In fact, the respondent mentioned a mutation from a 85% fatal, 1 week incubation to a 60% fatal, 2 week incubation form. I believe that this refers to the two different virus strains identified from the very start in the 1976 Zaire/Sudan outbreaks. The more lethal strain was discovered first - largely because of its shorter incubation, and the longer incubation strain was discovered second - but in fact, this was not a mutation during the outbreak but a very close proximity outbreak with two different strains which occurred in two locations. The emergence of different strains of a virus usually occurs as a result of incubation in animal vectors in between outbreaks - the mutation required to jump species accompanies the change in lethality, incubation, transmission, etc. It's why we have yearly updates to influenza and continually shift between avian, swine, etc. variants of the flu. The so-called "airborne" Ebola (Reston virus) likely hopped from pigs (not fatal) to monkeys (fatal) in the Philippines. When it emerged in a monkey colony in the U.S in 1989, it was totally non-lethal in humans. In fact, none of the humans in contact with the monkeys showed evidence of disease, and most showed no evidence of infection.

Here is where the information conveyed in The Hot Zone is counterproductive to current knowledge and public education: Since the emergence of Ebola Zaire in 1976, the actual mortality rate of the subsequent outbreaks has been ~50-60% - still with incubation periods of around 7-10 days (only very rarely is incubation as long as two weeks - and in fact, a patient lasting 12 days is likely to survive). Since discovery of Marburg virus in 1969, the total mortality from these viruses is about 3000 people - in 45 years! Thus The Hot Zone is out of date since most of the outbreaks in the past 20 years have had roughly two-thirds to one-half the mortality rate described in the book.

Of course it is still a deadly, scary disease! One chance in two of dying is not much of a comfort over a sure death - but outside of sub-Saharan Africa, the disease has been stopped in its tracks every time it has left the region.

10. [original - with correction in italics] For every parent who has had a sick child AND DIDN"T GET SICK or who has had a close family member with any number of viral infections WHO DIDN'T CONTRACT THE DISEASE - keep in mind that it is in fact VERY HARD for viruses to jump from human to human. The major examples that do are common cold viruses - and only because they are slightly more stable in air (and way more resistant to disinfection) - but even then, the transfer is still from bodily fluid exchange (sputum from sneezes and coughs).

[revised/extended] Keep in mind, also that any person who is so far along in the progress of the disease to be coughing up blood is unlikely to be traveling by air to the U.S. Yes, there is a person who got off a plane and collapsed soon after, but what the public does not understand is that it takes many virus particles being given off to improve the possibility to infect a new person with a disease. Duration of incubation is important because it takes time for enough viral particles to build up in blood and the internal bleeding is a very late stage symptom. When an Ebola victim is most contagious, they are not moving around!

[update] The woman on the flight that landed at Gatwick didn't die of Ebola but of "natural causes." There is speculation because of the fact she was defecating and vomiting as she got off the plane - but dysentery from drinking contaminated water (one of the contributing factors to poor medical care in Africa) could do exactly the same. What about the poor workers who have to clean up the mess in the plane? British Public Health officials descended on Gatwick and put in place protocols to handle the situation, the cleanup, and record the information for everyone that not only was aboard the plane but was in any way associated with the plane. From a military Medical Command worker: "Mind you that the airline industry has protocols in place for dealing with body fluids on a plane." Indeed they do. All human waste has to be treated as potentially infectious, irrespective of whether it was just the baby spitting up milk when burped.

Also, there is a reported case in New York in a person coming from West Africa. However, at this time, Mt. Sinai is reporting that they do not suspect Ebola in their patient. They are running the tests based on his recent travel to be sure.

---

[original] SIMPLE PRECAUTIONS protect any person coming in contact with a person infected with any viruses - wear a mask, avoid contact with bodily fluids, wear latex/nitrile/rubber gloves if you have to handle bodily fluids, disinfect hands and surfaces that may have come into contact with bodily fluids. Extend the "glove" concept to sexual activity and these few precautions are used to effectively prevent viruses from influenza to herpes.

[revised/extended] I suppose I am over-reaching here, but the point is that Western Civilization does not exhibit the types of practices that spread Ebola/Marburg in Africa.

Has it happened before? Sure - Black Plague, smallpox, Spanish influenza, AIDS. But this is not the Middle Ages, nor is it 1985! The American public is more aware, more sophisticated, and more capable of dealing with precautions. Could a pandemic take hold and swamp our health care system? Yes, conceivably - but is it going to be Ebola? Very unlikely. Ebola is scary, rumors are flying . . .

[original and still valid] KNOW THE FACTS! and stop perpetuating the rumors and fear-mongering.

Sunday, August 3, 2014

All we have to fear is fear itself...

http://teddysratlab.blogspot.com [Full link to blog for email clients.]

OK, I am only going to say this once - but there are some TRULY HORRENDOUSLY IGNORANT comments being made about Ebola and the current scare. 

1. This is not Africa.  We actually have fully-competent medical professionals in every metroplex, city, small town, and rural community who are trained to recognize illness.  The reason Ebola is so deadly in Africa is that so many of the people who are sick get NO MEDICAL CARE!

2.  Medical care for a viral infection consists of rest, plenty of fluids and nutrients, treatment for fever, treatment for nausea-vomiting-diarrhea, treatment with anti-viral medications - i.e. medications specifically designed to interfere with viral replication.  Given appropriate supportive treatment - the mortality rate of even Ebola goes way down from what it is in Africa - in other words, even country doctors are able to treat it.

3.  Most airborne viruses are not lethal.  The dozen or so "lethal" viruses all require some form of direct transfer through bodily fluids in order to infect a new patient.  The reason for this is that what makes a virus deadly is how fast it multiplies - and what tissue it infects - in a human patient.  That *usually* means the lungs, mucus, blood - and that environment is hot (98.6 degrees F), moist (nearly 100% humidity) and full of soft cells.  Air is not.  Even Atlanta, Houston or Miami in the Summer does not reach those conditions.

4.  In order to grow and multiply quickly in those conditions, viruses are adapted to live best in those conditions.  That means the virus itself is actually quite fragile.  It will not survive on a cool dry surface.  Even in sputum (what you cough up) it will die in a few minutes exposure to air, and can be eliminated with alcohol wipes, dilute bleach, Lysol, or even just soap and water. 

5. Viruses are not bacteria.  The fact that Americans over-use antibiotics and there are resistant strains out there MEANS NOTHING to dealing with viruses. Presence or absence of TRICLOSAN in antibiotic soaps is MEANINGLESS.  PUREL(tm)  handsanitizer works just fine - it's the alcohol that does the trick.

U.S. Doctors do know how to deal with viral infections - see 1-5 above!

6.  Why are these patients going to Emory?  Because Emory has a HOSPITAL.  CDC and USAMRIID are RESEARCH institutions, not HOSPITALS.  Hospitals have very effective infection control mechanisms in place.  I run a research lab.  I deal with lab animals.  When I need to deal with human patients - I do so IN A HOSPITAL!

7. Yes, viruses have a high mutation rate.  That is why we need new influenze vaccines each year.  BUT!  What mutates is the PROTEIN COAT around the viral DNA/RNA.  Typically not the genes themselves.  Thus, the virus is HIGHLY UNLIKELY to sudden become more lethal just in the course of infecting a few humans!

See, what happens is, a virus "particle" attaches to a cell.  As stated above, a virus is genetic material wrapped in a protein capsule.  When the proteins attach to a cell, the proteins stay on the outside and the DNA/RNA enters the cell and starts to replicate.  The cell is "taken over" to make DNA/RNA copies and build more protein capsules.  The viruses are assembled, the cell dies, ruptures and releases more virus.  HOWEVER since the original protein coat does not enter the cell and has to be built from scratch by the infected cells, that coating is the most likely to mutate.  When that happens, the coat MIGHT be more likely to attach to different types of cells - but more likely, all that happens is that the bodies existing antibodies (and vaccines) won't quite recognize the new coat.  This slows down immunity, but doesn't stop it in its tracks.

8. Viruses tend to become LESS LETHAL as they mutate.  This is exactly the principle used in producing vaccines - take a virus, grow it in a cellular medium where it can reproduce and mutate to it's own content - then harvest the mutations that have gotten less "virulent" - it's called ATTENUATED VIRUS and is how most vaccines are created simply because THAT IS WHAT VIRUSES DO.  A more lethal virus is so unlikely that most research labs artificially create substances rather than let nature run its course.

9.  Yes, a change in transmission CAN occur throughout the course of an epidemic - however, what epidemiologists tend to find is that the alternate form was there all along, but not recognized. It's the sort of thing that requires Tens and hundreds of millions of infected to occur.  That's why we get things like bird flu and swine flu because the virus developed in a species untreated.  Then when they jump to humans - they don't really work that well unless the victims GET NO MEDICAL CARE (see #1&2).

10.  For every parent who has had a sick child AND DIDN"T GET SICK or who has had a close family member with any number of viral infections WHO DIDN'T CONTRACT THE DISEASE - keep in mind that it is in fact VERY HARD for viruses to jump from human to human.  The sole exceptions are common cold viruses - and only because they are slightly more stable in air - but even then, the transfer is *STILL* from bodily fluid exchange (sputum from sneezes and coughs). 

SIMPLE PRECAUTIONS protect any person coming in contact with a person infected with any viruses - wear a mask, avoid contact with bodily fluids, wear latex/nitrile/rubber gloves if you have to handle bodily fluids, disinfect hands and surfaces that may have come into contact with bodily fluids.  Extend the "glove" concept to sexual activity and these few precautions are used to effectively prevent viruses from influenze to herpes.

KNOW THE FACTS! and stop perpetuating the rumors and fear-mongering.


[Disclaimer:  I am a neuroscientist, not a virologist, immunologist or epidemiologist.  However, I was classically trained in physiology and pharmacology - so I had to learn how the physiology of the body reacts to viruses, how the immune system does its job, and how various drugs and pharmaceutical compounds affect those processes.  In addition, my training was specifically in conjunction with a Medical School curriculum - I have received a lot of medical and emergency training in the course of my career as well as all of the training required to work and do research in the hospital environment.  

Friday, July 25, 2014

Why science is never settled

http://teddysratlab.blogspot.com [Full link to blog for email clients.]

We hear a lot these days that "There's a consensus" and "The science is settled."

Without getting into the politics of what people do and don't believe about certain hot-button topics - I always cringe when I hear someone claim that science could ever be "settled."  The very nature of science is that it is never settled, always questioning, always seeking to find better theories, better algorithms, better models - and frankly push back the boundaries of knowledge.

On both sides of many issues we have groups frequently labeled as "believers" and "deniers."  Frankly, both are wrong.  Belief and/or denial have no place in science, because science is a process, not a conclusion.  Science is a means of looking at something for which we have no explanation and determining how it works.  Whether we choose to believe or deny the method by which we came to a conclusion does not change the data which was used in the process.  Whether I "believe" in a theory of quantum connectedness that links all sentient minds (h/t Travis S. Taylor, Ph.D.) or not does not change the fact that there are brain processes which can be adequately explained without recourse to quantum physics - and those phenomena which have no other explanation.

Science is always changing - our techniques get better, measurements get more precise, and new theories are always produced.

To illustrate the points, Baen Books asked me to write on the topic "Why Science is Never Settled," and the article was so long we had to run it in two parts.

Part 1 ran last month and is linked here:

http://www.baen.com/Why_Science_is_Never_Settled.asp

and Part 2 is up right now and is linked here:

http://www.baen.com/Why_Science_is_Never_Settled-Part2.asp

Enjoy!

Wednesday, March 12, 2014

Community

http://teddysratlab.blogspot.com [Full link to blog for email clients.]

I used to belong to a community.

No, this doesn't have anything to do with where I live.  Yes, I do live in a nice community of homes, business and people.  It's a small-ish town, although mainly a suburban community for two larger cities.  It retains a certain element of small-town America: a nice Main Street, street fair, local churches, lodges and community centers.  The police will check your house and property if you tell them you'll be out-of-town,your neighbors are nosy enough to know if something is wrong.  We tend to look out for the little old lady neighbor or gather to help cut up a fallen tree.

But that is not the community of which I write...

No, I am speaking of a community of thoughts and actions.  At one time in my life, I was a Boy Scout.  As a young man I was trained, taught, molded and shaped by the experience.  I learned to camp, to cook, to sew, to navigate, to build, and to save a life.  Naturally, as an adult, I wanted that for my own sons, so I became an adult leader.

This was a community - people with whom I genuinely enjoyed spending a weekend each month, and a whole week in the summer.  We were supportive of each other.  I was "father" to a whole bunch of "sons" - and they were additional "fathers" to my own boys.  We took turns driving, pulling the trailer, checking the gear, teaching the Merit Badges.

These were my friends, but more importantly, we were a support network.  If I had a problem, I knew who to call - from car problems, to borrowing a saw, to finding a house painter.  I also knew that I might also receive a call.  One weekend, I had a kidney stone attack.  One of the other leaders drove me home (in my own car), took me to the hospital and handed me off to my wife.  He took my car home with him, got some sleep, had his wife take him back to camp to pick up his own car (plus his son, my sons and all of their gear) - then returned my car to my house - washed.

Some months later, I paid it forward - driving home a young man who'd accidentally ingested some river water and had been sick to his stomach all night long... and again, about a year later I transported another adult leader to home and medical care after a close call with a bee sting allergy.

We were a community.  We supported each other, we were there for each other.  Not all of us had the same amount of time in the group - there were always newcomers while some left or moved on.  I had the same sense of community with (nearly) all.

But the time came when I had to leave.  There were multiple reasons why, but it was my choice - first and foremost because the sense of community had failed.

For many years now, my friends have been largely online.  My closest friends actually lives a few hundred miles away, and that is fairly typical, with the distances ranging from a few hundred to nearly 3000 miles.  In such a far-flung community, there is plenty of chance to be supportive and instructive, but the personal touch is not there. Yet, a couple of months ago I started studying Krav Maga.  It's not giving anything away to state that I am well over 50 years old and seriously overweight - starting any sort of exercise program is a challenge.  Still, I love the exercise and the activity and I have a pretty good support network and motivation for a rigorous program of diet and exercise. 

Still...

Tonight at class, a fellow classmate mentioned that he'd missed seeing me on Monday.  I had missed that class because of preparing for a minor medical procedure the next day.  During class, while trying to learn a difficult move, that same classmate talked me through it, repeated times and critiqued and corrected my motions.  Another member of the class is about my general age and body strength.  We spar well together, and I genuinely enjoy working with him - but I had missed him the last 10 days while he was out of the country.  There are advanced students who also instruct - one in particular reminds me of one of my Scouting colleagues - he has that same patience and genuine desire to help someone get better.  He should know, he's a Third-degree Black Belt.  Other members of the class - all adults, about two-thirds male, one-third female - are equally supportive, friendly and concerned with making sure we all work our best.  The Academy Master runs the school as equal parts Martial Arts Academy and Leadership Academy.  He, too, is supportive and sets the example for all of the students.  I chose the school because my (now adult) oldest son chose it a year ago, so I watched and measured the character of the Master and students.

See, I found another community.  We do not have to agree with each other.  I frankly have no idea regarding the politics, gender orientation, religion or wealth of my fellow students.  Yes, as I get to know them better, I do learn a bit more - but what is most important is that we support, train and  teach each other.  We genuinely want to see each other succeed.

Do you see the issue?  Karate is a martial art - equal parts martial (the best self-defense is a prepared offense) and art (each move should have an instantaneous "Kodak moment" where you form and place the movement with grace and power).  Krav Maga is all martial and no art.  It is a combat training system whereby the students are taught to deflect, intercept and evade an oncoming attack.  If attacked, we have one goal - to neutralize the attack and ensure that we are the one walking away. 

There does not have to be a community to this training.  The goal is to be capable in and of ourselves to deal with an attack.  That doesn't involve making sure the other person doesn't get hurt or learns their moves - quite the opposite, in fact!  However, in class, we pull punches (mostly! Ow!) and use padding, and it turns out - we learn better as a community that we ever could alone.  I know, I bought Krav books and materials to study on my own.

Once again, I belong to a community.

Those of us who read and even write Science Fiction and Fantasy have a community of sorts - but frankly, it is broken.  An association which should be supportive and helpful to members, has become more concerned with ensuring that only the "appropriate" people are members.  There is more ado about authors who won't attend certain functions because some other guest makes them feel "unsafe" yet cannot themselves recount one real threat or accurately recall any instance where the one they accuse has ever justified that accusation.  We have whole segments of the "community" denigrating one or more writers without ever having read a single word those authors have ever written!

Thus the community is broken.  It is not helpful.  It is not supportive. 

...and most importantly - it  does not teach or represent any value worth learning.