Who Dies from Flu? – CDC Does Not Really Know

Flu is everywhere this year, and nasty.  Infection rates and hospitalizations are skyrocketing.  To make things worse, short-sighted employers are bullying employees to come to work when they are still sick and infectious. This is especially dangerous in under-staffed medical facilities.  Nurses are already over their limits in patients.  The other nurses are working double shifts to cover patients of sick nurses.  For example, when a rehabilitation center forces a sick nurse to come to work, it exposes the staff, recovering patients, and their visitors.  That leads to more shortages of staff; it also infects patients, and families.  Fragile patients are very vulnerable to respiratory infections as it is.  Pile infectious staff on top of their weak immune systems and you have a recipe for death.

It does not help that individual states and the CDC do not report the actual deaths from influenza.  That is right; CDC “estimates” the number of people who die from influenza.  My question is how can they verify their estimates if they never do an actual count? (This smacks of the way the Census Bureau pads their numbers statistically, when the demographics do not suit politicians.)

Eighty to ninety percent of flu deaths are adults over age 65, yet states do not report them.  The CDC uses statistical models that extrapolate flu deaths from death certificates, because states are lax in recording the causes of death.

Death certificates usually list the last illness as the cause of death.  When a person dies from complications and infections caused or aggravated by flu, the death certificate does not show or list influenza as a cause.  Pneumonia is the most common flu-related cause of death.  That is why CDC lumps deaths from flu and pneumonia together in their cause-of-death reporting.

What would happen if states did report the over age 65 deaths involving flu?  Much larger, scarier numbers.  As it is, recent CDC estimates of flu deaths have ranged from 12,000 to 56,000 per year.  What if the real numbers were double that?

It is not like flu only happens once a decade, it happens every year, and it affects millions of people.  How much more effort would it be to put multiple causes of death on death certificates?  The doctor that “calls it” knows the causes, why not record them?

The CDC has the time and resources to track opioids and suicides, why not death from flu; and why not age 65+?  Would the more complete information on flu-related deaths improve our choices of strains included in the yearly vaccine?  So far, I cannot find any discussion on the CDC website that offers an answer.

Instead of why they cannot do better, how about why not do better?

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The March? -Fog of Vague Purposes

Remember “Occupy Wall Street?” More currently, “Black Lives Matter?”  And the latest example, “Women’s March?”  They have this much in common:

  • Loose Organization
  • Diverse Membership
  • Aggregate Complaints
  • Unfocused Intentions
  • Non-Specific Proposals
  • Outdoor Meetings
  • Catchy Names

“Occupy Wall Street” was pretty much just news items about their encampment.  “Black Lives Matter” fails to note that Federal statistics show that 80-90% of murdered “black lives that matter” are victims of black killers.  Half of all murder victims, nationally, are black; blacks are less than 15% of the population.  Where is that protest and call to action?

In the context of this protest, do they mean “Black, Mexican, Muslim, LGBTQ, Women’s Lives Matter?”  Or do they mean “Black, Young, Men’s Lives Matter,” but this just happens to be a women’s march?  Just what do they mean?

It seems that the “Women’s March” was all about disappointment, fear, and frustration transformed into pink anger.  Disappointment that Hillary did not win, fear that women’s rights will be undermined, and frustration that women do not receive equal pay.

Trump became the effigy to blame for everything.

Misogyny:  How many participants, do you think, could cite specific instances when President Trump recently disrespected women who were not attacking him?  Where is the acknowledgement of the nonchalant treatment of wives and women by iconic presidents such as JFK, and Bill Clinton?

If the marchers are promoting equality for women, his business organizations reflect great respect for women by hiring them, promoting them into management and paying them well; sounds like equality to me.  Why not ask women who work for the Trump organization how they feel about their misogynist boss?

Immigration:  First, Trump got trapped in the “Newspeak” of the way we use “immigrant.”  Many foreign nationals, from many countries, apply for visas, “green cards,” and citizenship every year.  Those who gain permanent residence or citizenship can rightly be called immigrants.  A great number of Americans are immigrants or children of immigrants.

The proponents of unlimited immigration and aligned journalists fought to not use the legal term “alien.”  They insisted on substituting “______-immigrant” until it became commonplace.  The problem is that non-hyphenated, legal immigrants heard these “_______-immigrants” being criticized and threatened, and felt included in that group; they took personally the anger, fear, and distain.

By verbally lumping the “_______-immigrants” together with immigrant citizens, they built support for their open-borders philosophy.  If we had stuck with “aliens,” and “foreign nationals,” the citizens would not have felt combined with them.

Exactly, what did he say about Mexicans?  Not just the clips, the whole statements. He said that among the illegal migrants were, drug smugglers, human traffickers, fugitive criminals, including murders, and rapists.  Is that true?  Yes.  Trump’s opponents extracted this description and implied that he meant ALL Mexicans fit these profiles.

Muslims:  Trump wants to limit and vet prospective refugees entering the US from Islamist countries tied to terrorism.  He wants Muslim communities to help identify and thwart jihadist terrorists.

Women who live in Muslim countries might not be sympathetic with the complaints of the marchers; certainly, they would or could not march on their capitals protesting.  Why not ask Muslim-American women what they would face if they went home to Arabia and Africa?  What would you face going there as a Christian?  Count your blessings that you live here in America.

There are no government proposals or actions right now that threaten women; he just took office Friday.  All the rhetoric is about what could happen; what rights they fear might be lost; what affronts they fear they may face.  Fear is a factor, but not fact

The one thing that stands out to me is concern about reversing Roe v. Wade.  I understand opposition to abortion challenges.  I support safe, informed, reasoned choice for every woman.  So, focus on defending that right or you risk people writing you off as generally disappointed with the election results, and righteously irritated at the challenges of being a woman.

The last point is this:  What do you propose, aside from replacing Donald Trump?  Many commentators have shrugged their shoulders about the purposes of the march because the marchers are not clear about what they are championing.  It was a shame that all the time, money, effort, and commitment it took to get people on the streets ended in a fog of vague purposes.

Whining the Election – Trumpled Aspirations

Over the 52 years and 13 presidential elections I have been eligible to vote, I have never seen such sore losers, and humble winners.

I am disappointed with the disparate responses to the results of the 2016 presidential election.  Smug expectations from pollsters and pundits seem to have set a trap for Hillary’s disciples, and set a stage for impetuous, righteous indignation.  Rejection, disputation, refutation, spoilsport language, protests, and denial among disgruntled Clinton supporters is “over-the-top,” and “unpresidented.”  “He is not my president,” spake Gloria Steinem, Wednesday morning.  (Ironically, in the past, she also said, “The truth will set you free, but first it will piss you off.”) 

Why have Mrs. Clinton’s avid proponents gone off the rails into the deep waters of denial and despair?

I believe the presumption that Hillary Clinton had a commanding lead over Donald Trump was their downfall.  Belief in optimistic statistics led to haughty attitudes and supercilious sneers on the faces of Hillary’s fans.  The extreme vanity of the oracles’ predictions led to nasty, braggadocios, arrogance.  When pride met gravity, the indignity of the pratfall magnified the embarrassment of hubris. The expectations of overwhelming victory were shredded, by the unexpected appearance at the polls of hordes of angry, underserved workers.  The ambush of the uncounted, disenfranchised citizens prevailed.

The carefully crafted deception of optimistic unemployment statistics did not fool the people who took discounted wages and lesser jobs over the last eight years.  These voters had no voice among Democrats who applauded the “champion of hope” for his rescue of the economy, and restoration of the American Dream.  They were not deceived by or grateful for their thinly disguised demotions and the smiling, dismissive, carefully worded denigrations spun by an accommodating media on behalf of the Obama administration.

The scales did not fall from their eyes, because no scales formed as they lost their jobs, houses, cars, and pride.  The Affordable Care Act did not replace the healthcare insurance they lost when their employer dropped their health coverage; when they lost their jobs, their hopes were dashed by the failure of the “marketplace” to make personal health insurance and their out-of-pocket costs affordable.  Instead, they found themselves ravaged by astronomical premiums, deductibles, copays, and incredible prescription prices.  Hospitals and pharmacies raised their nominal, private pay prices to offset the discounts demanded by insurance providers.  The uninsured were left with impossible choices.

Promise after promise lay fallow by the roadside.  Example after example of the USA borrowing trillions of dollars to pay for the rest of the world’s problems and defense festered, while Americans suffered from the Great Recession.  Pact after pact, treaty after treaty left us at disadvantage.  Military efforts left us looking weak, as we shrank from conflicts under cover of spin.  Former allies spat disparaging invectives on our leaders.

Did Hillary’s followers believe she could pull us out of the ditch of weakness and doubt created these past eight years?  Did her apostles think her baggage and prevarications would evaporate by inauguration?  No wonder they were blindsided when Trump won.

$20 million to Destroy $11 million of ISIS Trucks and Oil?

This weekend, U.S.-led coalition aircraft destroyed an estimated $11 million worth of oil and trucks over the weekend in the largest single airstrike this year against the Islamic State’s black market oil trade in Syria.

“You’re going to have multiple effects from this one strike,” Air Force Lt. Gen, Jeffrey Harrigian, commander in the Middle East, said Tuesday. “We’ll have to see what this does to their ability to generate fighters.”

Waves of aircraft destroyed 83 oil tankers sitting in the open in Sunday’s attack.

The attacks were ordered after a pilot spotted some vehicles gathering in Deir ez-Zor province, a key oil-producing region in Syria controlled by the Islamic State, also known as ISIS or ISIL.

The coalition command sent a surveillance aircraft over the area. The command then quickly directed A-10 attack planes, F-16s and two coalition aircraft, which together launched more than 80 weapons, including bombing and strafing runs, at the vehicles.”

Air-to-ground missiles, A-10’s, F-16’s, drones, satellites, technicians, pilots, all cost money – a lot of money.  One first generation Hellfire missile costs about $100,000; an F-16 costs $165 million each, plus $30,000 per hour to fly; drones cost $100,000+ to build and take a large infrastructure to operate.

I am not saying that we should not use our resources to take out the enemy, just quit warning them ahead of time and hold off on the bragging.  If all we are doing is destroying trucks, it may cost us as much as it costs them.  And are these people our enemies? Do we always fire a few warning shots so the experienced operators and soldiers can escape? Is this some weird video game war? Yes, I am serious:

“In the initial Tidal Wave II strikes last year, the coalition dropped leaflets on oil tankers before launching attacks, encouraging the drivers to flee their vehicles.

New military rules don’t require leaflets to be dropped, but pilots fire warning shots, typically consisting of bombs or rockets that are not aimed directly at the convoy.

“We’ll do that … to give them a chance to run,” Harrigian said.”  Jim Michaels – USA Today

http://www.usatoday.com/story/news/world/2016/08/09/islamic-state-oil-trucks-destroyed-massive-strike/88459864/

Sure, we can outspend ISIS; their $2 billion annual budget is peanuts compared the money we are prepared to spend to put them out of business.  But are we really serious about defeating the enemy?

Populists Remodel, Instead of Making New Parties

“Americans are not only strongly dissatisfied with the state of the economy and the direction in which the country is headed, but with government efforts to improve them. As the Pew Research Center’s analysis of exit poll data (2010) concluded, “the outcome of this year’s election represented a repudiation of the political status quo…. Fully 74% said they were either angry or dissatisfied with the federal government, and 73% disapproved of the job Congress is doing.”

http://www.pewresearch.org/2010/12/14/how-a-different-america-responded-to-the-great-depression/

Like the two poles of a magnet, anger and dissatisfaction manifested in favor of a clearly popular Bernie Sanders movement on the left, and more clearly in the ascendancy of Donald Trump on the right.

The Democrats

Bernie Sanders attracted a large plurality of younger citizens to socialist ideas for solving perceived failures of government.  The Obama administration did nothing to ameliorate the impact of staggering loan burdens on college students; the Affordable Care Act not only failed to manage healthcare needs, it aggravated the problems of access and affordability.

Super delegates, and the strident support of the DNC establishment saved Hillary Clinton’s primary candidacy from an embarrassing drubbing by the populists.  Nonetheless, the Democrats had to shift their platform to the left to avoid losing the new voters Bernie Sanders attracted.  The party apparatchiks felt their grip on power slipping, and quickly adjusted to retain control.  Witness the remodeled Democratic Party

The Republicans

The Republican powers-that-be were not so lucky; by denying, resisting and eschewing, they lost control of the party to a populist candidate beyond their influence.  Donald Trump, by design or blind luck, tapped into the anger and frustration of a tsunami of new and dormant voters on the right. Instead of building a new third party, ala Ross Perot, Trump remodeled the Republican Party.  This massive wave of constituents was so strong that sixteen traditional candidates succumbed to mild taunting and criticism in televised debates, and strong turnouts in the primaries.

The barrage of criticism from both parties, the withdrawal of political support by RNC powerhouses, and the withholding of financial support by big-time contributors could not stop a political neophyte from becoming the Republican candidate on a tiny fraction of the money spent against him.  The Republican Party has been transformed into a conservative, populist majority; sour grapes, snubs, and disownment remain ineffective on the new dynamics of the party.

“I’m mad as hell, and I’m not going to take it anymore,” is our new national creed.

Tools from Carl Sagan’s BS Detection Kit

We are in an age of hyper-information/persuasion/spin about all aspects of our lives, from what we eat, to what we buy, to what we attend, to whom we choose as leaders.  Now, as always, we can benefit from screening the inputs to our lives, and weighing our beliefs on a scale of clarity, and verity.  Carl Sagan gave us some sage tools to evaluate and detect fallacies of arguments, and false claims.  After the quote, I will try to translate, without bias, his precise language, and references, into reasonably understandable terms.

A. Evaluate Ideas to Approach the Truth:

  1. Wherever possible,there must be independent confirmation of the “facts.”
  2. Encourage substantive debate on the evidence by knowledgeable proponents of all points of view.
  3. Arguments from authority carry little weight — “authorities” have made mistakes in the past. They will do so again in the future. Perhaps a better way to say it is that in science, there are no authorities; at most, there are experts.
  4. Spin more than one hypothesis. If there’s something to be explained, think of all the different ways in which it could be explained. Then think of tests by which you might systematically disprove each of the alternatives. What survives, the hypothesis that resists disproof in this Darwinian selection among “multiple working hypotheses,” has a much better chance of being the right answer than if you had simply run with the first idea that caught your fancy.
  5. Try not to get overly attached to a hypothesis just because it’s yours. It’s only a way station in the pursuit of knowledge. Ask yourself why you like the idea. Compare it fairly with the alternatives. See if you can find reasons for rejecting it. If you don’t, others will.
  6. Quantify. If whatever it is you’re explaining has some measure, some numerical quantity attached to it, you’ll be much better able to discriminate among competing hypotheses. What is vague and qualitative is open to many explanations. Of course there are truths to be sought in the many qualitative issues we are obliged to confront, but finding them is more challenging.
  7. If there’s a chain of argument,every link in the chain must work (including the premise) — not just most of them.
  8. Occam’s Razor. This convenient rule-of-thumb urges us when faced with two hypotheses that explain the dataequally well to choose the simpler.
  9. Always ask whether the hypothesis can be, at least in principle, Propositions that are untestable, unfalsifiable are not worth much. Consider the grand idea that our Universe and everything in it is just an elementary particle — an electron, say — in a much bigger Cosmos. But if we can never acquire information from outside our Universe, is not the idea incapable of disproof? You must be able to check assertions out. Inveterate skeptics must be given the chance to follow your reasoning, to duplicate your experiments and see if they get the same result.
  1. Avoid Common Pitfalls of Common Sense

Just as important as learning these helpful tools, however, is unlearning and avoiding the most common pitfalls of common sense. Reminding us of where society is most vulnerable to those, Sagan writes:

In addition to teaching us what to do when evaluating a claim to knowledge, any good baloney detection kit must also teach us what not to do. It helps us recognize the most common and perilous fallacies of logic and rhetoric. Many good examples can be found in religion and politics, because their practitioners are so often obliged to justify two contradictory propositions.

He admonishes against the twenty most common and perilous ones — many rooted in our chronic discomfort with ambiguity — with examples of each in action:

  1. ad hominem— Latin for “to the man,” attacking the arguer and not the argument (e.g., The Reverend Dr. Smith is a known Biblical fundamentalist, so her objections to evolution need not be taken seriously)
  2. argument from authority(e.g., President Richard Nixon should be re-elected because he has a secret plan to end the war in Southeast Asia — but because it was secret, there was no way for the electorate to evaluate it on its merits; the argument amounted to trusting him because he was President: a mistake, as it turned out)
  3. argument from adverse consequences(e.g., A God meting out punishment and reward must exist, because if He didn’t, society would be much more lawless and dangerous — perhaps even ungovernable. Or: The defendant in a widely publicized murder trial must be found guilty; otherwise, it will be an encouragement for other men to murder their wives)
  4. appeal to ignorance— the claim that whatever has not been proved false must be true, and vice versa (e.g., There is no compelling evidence that UFOs are not visiting the Earth; therefore, UFOs exist — and there is intelligent life elsewhere in the Universe. Or: There may be seventy kazillion other worlds, but not one is known to have the moral advancement of the Earth, so we’re still central to the Universe.) This impatience with ambiguity can be criticized in the phrase: absence of evidence is not evidence of absence.
  5. special pleading, often to rescue a proposition in deep rhetorical trouble(e.g.,How can a merciful God condemn future generations to torment because, against orders, one woman induced one man to eat an apple? Special plead: you don’t understand the subtle Doctrine of Free Will. Or: How can there be an equally godlike Father, Son, and Holy Ghost in the same Person? Special plead: You don’t understand the Divine Mystery of the Trinity. Or: How could God permit the followers of Judaism, Christianity, and Islam — each in their own way enjoined to heroic measures of loving kindness and compassion — to have perpetrated so much cruelty for so long? Special plead: You don’t understand Free Will again. And anyway, God moves in mysterious ways.)
  6. begging the question, also called assuming the answer (e.g., We must institute the death penalty to discourage violent crime. But does the violent crime rate in fact fall when the death penalty is imposed? Or: The stock market fell yesterday because of a technical adjustment and profit-taking by investors — but is there any independent evidence for the causal role of “adjustment” and profit-taking; have we learned anything at all from this purported explanation?)
  7. observational selection, also calledthe enumeration of favorable circumstances, or as the philosopher Francis Bacon described it, counting the hits and forgetting the misses (e.g., A state boasts of the Presidents it has produced, but is silent on its serial killers)
  8. statistics of small numbers— a close relative of observational selection(e.g., “They say 1 out of every 5 people is Chinese. How is this possible? I know hundreds of people, and none of them is Chinese. Yours truly.” Or: “I’ve thrown three sevens in a row. Tonight I can’t lose.”)
  9. misunderstanding of the nature of statistics(e.g., President Dwight Eisenhower expressing astonishment and alarm on discovering that fully half of all Americans have below average intelligence);
  10. inconsistency(e.g., Prudently plan for the worst of which a potential military adversary is capable, but thriftily ignore scientific projections on environmental dangers because they’re not “proved.” Or: Attribute the declining life expectancy in the former Soviet Union to the failures of communism many years ago, but never attribute the high infant mortality rate in the United States (now highest of the major industrial nations) to the failures of capitalism. Or: Consider it reasonable for the Universe to continue to exist forever into the future, but judge absurd the possibility that it has infinite duration into the past);
  11. non sequitur— Latin for “It doesn’t follow” (e.g., Our nation will prevail because God is great. But nearly every nation pretends this to be true; the German formulation was “Gott mit uns”). Often those falling into the non sequitur fallacy have simply failed to recognize alternative possibilities;
  12. post hoc, ergo propter hoc— Latin for “It happened after, so it was caused by” (e.g., Jaime Cardinal Sin, Archbishop of Manila: “I know of … a 26-year-old who looks 60 because she takes [contraceptive] pills.” Or: Before women got the vote, there were no nuclear weapons)
  13. meaningless question(e.g., What happens when an irresistible force meets an immovable object? But if there is such a thing as an irresistible force there can be no immovable objects, and vice versa)
  14. excluded middle, or false dichotomy — considering only the two extremes in a continuum of intermediate possibilities (e.g., “Sure, take his side; my husband’s perfect; I’m always wrong.” Or: “Either you love your country or you hate it.” Or: “If you’re not part of the solution, you’re part of the problem”)
  15. short-term vs. long-term— a subset of the excluded middle, but so important I’ve pulled it out for special attention (e.g., We can’t afford programs to feed malnourished children and educate pre-school kids. We need to urgently deal with crime on the streets.  Or: Why explore space or pursue fundamental science when we have so huge a budget deficit?);
  16. slippery slope, related to excluded middle (e.g.,If we allow abortion in the first weeks of pregnancy, it will be impossible to prevent the killing of a full-term infant. Or, conversely: If the state prohibits abortion even in the ninth month, it will soon be telling us what to do with our bodies around the time of conception);
  17. confusion of correlation and causation(e.g., A survey shows that more college graduates are homosexual than those with lesser education; therefore, education makes people gay. Or: Andean earthquakes are correlated with closest approaches of the planet Uranus; therefore — despite the absence of any such correlation for the nearer, more massive planet Jupiter — the latter causes the former)
  18. straw man— caricaturing a position to make it easier to attack (e.g., Scientists suppose that living things simply fell together by chance — a formulation that willfully ignores the central Darwinian insight, that Nature ratchets up by saving what works and discarding what doesn’t. Or — this is also a short-term/long-term fallacy — environmentalists care more for snail darters and spotted owls than they do for people)
  19. suppressed evidence, or half-truths (e.g., An amazingly accurate and widely quoted “prophecy” of the assassination attempt on President Reagan is shown on television; but — an important detail — was it recorded before or after the event? Or:  These government abuses demand revolution, even if you can’t make an omelette without breaking some eggs. Yes, but is this likely to be a revolution in which far more people are killed than under the previous regime? What does the experience of other revolutions suggest? Are all revolutions against oppressive regimes desirable and in the interests of the people?)
  20. weasel words(e.g., The separation of powers of the U.S. Constitution specifies that the United States may not conduct a war without a declaration by Congress. On the other hand, Presidents are given control of foreign policy and the conduct of wars, which are potentially powerful tools for getting themselves re-elected. Presidents of either political party may therefore be tempted to arrange wars while waving the flag and calling the wars something else — “police actions,” “armed incursions,” “protective reaction strikes,” “pacification,” “safeguarding American interests,” and a wide variety of “operations,” such as “Operation Just Cause.” Euphemisms for war are one of a broad class of reinventions of language for political purposes. Talleyrand said, “An important art of politicians is to find new names for institutions which under old names have become odious to the public”)

Like all tools, the baloney detection kit can be misused, applied out of context, or even employed as a rote alternative to thinking. But applied judiciously, it can make all the difference in the world — not least in evaluating our own arguments before we present them to others.”