Dodging a bullet

Back in the 1950s, Sabin and Salk developed polio vaccines. Salk’s vaccine was inactivated. Sabin’s vaccine was live, but used a weakened strain, strong enough to cause an immune reaction, but weak enough not to cause polio. The live version was also infectious, which amplified its protective effect in the community.

The virus was weakened by passage through a number of cell cultures (live monkey, monkey testicular cultures, monkey kidney cells, etc).

Being a virus, it was grown in cell culture, derived from rhesus monkeys. The problem with all those live cell cultures was the possibility of picking up some other monkey virus. And that happened: 10-30 million Americans received vaccine contaminated with SV40 (Simian vacuolating virus 40) between 1955 and 1963. It is suspected that versions of the vaccine produced produced in the East Bloc may have been contaminated far longer, as late as 1980, which could have exposed several hundred million more people to SV40.

SV40 is pretty good at causing cancer in hamsters: there it causes sarcomas.

Does it cause cancer in humans? Some people claim to have found it in some cases of osteosarcoma, non-Hodgkins lymphoma, and mesothelioma (similar to the kinds of cancer in infected hamsters).

Currently it’s not clear whether SV40 causes cancer in humans – but it is clear that at worst, it causes very few such cancers.

It could have been worse. What if the contaminant had been HIV, instead of SV-40?

It wouldn’t have killed everybody. A fair fraction of people contracting HIV have flu-like symptoms a few weeks after. Usually the serious immune deficiency does not develop for at least three years – if the contaminant had been HIV, presumably the powers that be would have realized that something had gone wrong within a couple of years after the beginning of mass administration, because of the relatively few but dramatic early immunodeficiency cases. Even allowing for frantic defensive nonsense emitted by those people that stood to look bad from such a disaster. It might have been detected in the Francis Field Trial, in 1954 and 1955, where about 440,000 people were injected. I doubt if it would have killed more than a million people – mostly kids. No more than 10, 20 million killed, tops. I’m not counting later cases resulting from transmission via needle-sharing and sodomy.

The risk of picking up an unknown virus from cell culture had been discussed. Salk and Sabin were not as careful as they should have been. Overeager. Ambitious. Polio was scary and well worth fighting, but the potential downside went way, way down.

This does show that the price of insufficient medical vigilance can be very high.

Probably the largest existing example of death-by-medical-oopsie is the very high incidence of Hepatitis C in Egypt, which was spread by a mass anti-schistosomiasis campaign between 1960 and 1980, in which a goodly fraction of everyone in Egypt (~15%) seem to have been inoculated with the same needle, setting them up for cirrhosis and liver cancer.

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Freedom of medicine

There are people that think that we could have much faster medical progress via a basically libertarian approach: decrease or abolish government regulation of drug development. Or permit companies to market new drugs without first proving that they work.

Nutritional and herbal supplements are barely regulated at all: so by this argument there should be all kinds of medical progress stemming from that area. But it hasn’t happened. supplements are mostly useless, yet people buy them anyhow. There’s very little regulation of medical developments in third world countries – why aren’t they a a fount of medical progress? But that’s an unfair comparison: we know why they’re not.

So why is drug development harder than making a better cellphone or laptop?

People are complicated, evolved rather than designed, product of a recipe rather than a spec. We know something about human biochemistry and physiology, but far from everything. We know enough that some ( a few) of our new ideas about treating disease work – but most don’t, including most of those that everybody involved just knew had to work. It’s fair to say that we don’t have a good interface spec.

Next, the consequences of failures can be considerably more serious. The equivalent of the blue screen of death is .. death. Developing a new drug is more like developing avionics than apps: we don’t want planes to crash, and we’ve succeeded – but not through a unregulated market.

Knowing some history gives perspective. In 1900, few of the drugs in the pharmocopoeia actually worked. Doctors were not yet in the African-American. Why did they have customers? Why did doctors even exist? Why did literally thousands of years of low regulation result in almost no progress? The Romam Empire had low marginal tax rates too, and good security of private property most of the time – why so little progress?

Mostly, as far as I can tell, doctors existed was because people didn’t understand regression to the mean. You go to the doctor when you feel worse than average: after he does something you are eventually closer to average. Or if he did nothing, which was safer. Big pharma started out as frauds – they had nothing better. But being a fraud worked, and it still works. One of my correspondents had an MD tell him that the pharmaceutical industry was rotten to the core, doctoring all kinds of studies, and spinning results. True.

Nobody regulated psychologists, so the free market scotched Freudian analysis – in your dreams.

Anyhow, it is surely possible to materially improve the efficacy of drug development, of medical research as a whole. We’re doing better than we did 500 years ago – although probably worse than we did 50 years ago. But I would approach it by learning as much as possible about medical history, demographics, epidemiology, evolutionary medicine, theory of senescence, genetics, etc. Read Koch, not Hayek. There is no royal road to medical progress.

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Subsocieties

Every now and then a group secedes from general society and goes its own way. Sometimes they end up living a very different kind of life. Less often, that different way of life persists.

I’m thinking of the Puritans, the Quakers, the Amish, the Oneida Community, the Nation of Islam, California communes, and of course the Harshmanites.

Do those different ways of life influence intelligence? According to the sociologists they could, and maybe should. According to the psychometricians and behavioral geneticists, they could if they had differential recruitment [ immediate results] , or if they were reproductive isolated and had different internal selective pressures [ slow ].

Has there been such a change caused by the new social environment? In other words, could such a subsociety just decide to be smarter?

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Islam and the Americas

I was thinking about the Islamic response to the discovery of the Americas.

As far as I can tell, there wasn’t any. They absorbed new crops like maize, and new diseases like syphilis, but I can’t think of a case in which a ship from any Islamic country as much as visited the New World for hundreds of years.

You’d think that there would have been Islamic pirates & slavers in the Caribbean: they raided as far as England and Iceland, but I can’t think of an example. Or sent people (possibly in disguise) to trade, or just out of curiosity. Maybe a Sephardic Jew who could pass for a Spaniard, with a composite bow and a Koran in his sea-chest, intent on stirring up trouble in New Spain…
But it never happened.

Before the Iberians, nobody (other than the Vikings in the far north) had ever gone far into the Atlantic (or if they did, they never came back). The Canaries were known as far back as Classical times, and settled, but then the closest is only 60 miles off the African coast. But there was nobody on Madeira, nobody in the Azores, nobody in the Cape Verde Islands.

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The Secret Histories

I was reading Strategikon (of Maurice, not Kekaumenos), a handbook of military strategy probably authored by the Emperor Maurice. it occurred to me that the practical military knowledge it contained was effectively secret knowledge, not usually available to enemies of Byzantium. Sometimes because those enemies were illiterate, more often because various social and geographic barriers made sneaking out a copy of Strategikon pretty unlikely. So, secret knowledge, the wisdom of the Occident.

In principle, the United States ought to have whole secret libraries. I don’t mean nuclear data from hydrogen bomb tests – I mean the distilled essence of the greatest minds that have served the Republic. Nathanael Greene’s musing on how he beat Cornwallis by taking advantage of multiple definitions of victory. Sherman’s definitive analysis of Jackson’s Valley Campaign. Nimitz’s inside history of the Pacific war: he said he never wrote one, because it would hurt people (people like Halsey), but then he would say that, wouldn’t he. Can’t have people digging around for the secret history, available only to the War College’s star pupils…

Only they seem to have been misplaced somehow. Probably they’re all boxed up in that warehouse, next to the Ark of the Covenant.

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School’s out

I saw a note by Razib Khan, in which he mentioned that psychometric research suggests that people plateau in their knowledge base as adults. I could believe it. But I’m not sure it’s true in my case. One might estimate total adult knowledge in terms of BS equivalents…

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Goolie Chits

A goolie chit, also known as a blood chit, is a notice addressed to whoever, promising a reward for giving assistance to the bearer, payable when he shows up somewhere safe. For example, in World War I, RAF pilots in India and Mesopotamia carried a goolie chit, printed in four local languages, that promised a reward for anyone that would bring an unharmed British aviator back to British lines. Some US service members serving in various dirty sandpiles have been issued chits that guarantee $500,000 for aid and safe return.

It strikes me that there might be a larger market for goolie chits – people working for aid organizations in various pestholes, oil and gas workers, extreme tourists [ the sort of people that insist on seeing Palmyra right now ], people visiting Europe on any national holiday, those running liquor stores in inner Baltimore, etc. With the proper QR code blazoned on your shirt, the more sophisticated terrorists would swerve to miss you while mowing down chitless bystanders. In order to make this startup into a unicorn, you need to hire top-notch modern actuaries, and, of course, do all the usual things to get an efficient website, get away with violating numerous local and state laws simply by being really cool, etc. You can get favorable coverage from reporters just by giving them stock [ and, for the more adventurous, discount goolie chits.] Bitcoin rewards will be an option for those threatened by future AI.

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