The Grossest Jobs in Public Health

In the public health field, we deal with a lot of things that are, shall we say, unsavory. In fact, we’ll just call them outright gross. In honor of Halloween, here are the top 5:

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The Affordable Care Act and Public Health

Obamacare. The Affordable Care Act (ACA). Whatever you choose to call it, President Obama’s key legislative victory of his presidency introduces major changes in the way Americans manage their healthcare. Along with this legislation has been an avalanche of questions and, to my chagrin, politics. So. Many. Politics.

What I would like to do right now is to strip down the ACA to more understandable bits and how this fits into the public health world.

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The Cassini spacecraft, which is currently traveling around Saturn taking all kinds of beautiful pictures, continues to outdo itself.


Saturn is gorgeous and stunning just by looking into a small telescope here on Earth, but when viewed like this, it’s breathtaking. My favorite part of the picture is the view of Saturn’s super weird hexagonal clouds on the North Pole, which continues to vex (hex?) astronomers as to the exact cause of this beautiful mathey shapey thing.

Movie Review – Gravity

You know, going to the movies is a rarity for me. It’s even more rare for me to shell out extra money to see a movie in 3D, and even MORE rare to pay extra extra money to see an IMAX movie. So I had a “treat yo self” moment yesterday and went to see the new movie Gravity, starring Sandra Bullock and George Clooney, in IMAX 3D. Apparently I wasn’t alone.

Before getting into the review, I have a love/hate relationship with movies set in outer space. I love that space movies exist to further interest in space–I do not love the fact that 95% of them are so ridiculous and are centered nowhere near the truth. I’m looking at you, Armageddon! With that being said, I always have to temper my expectations when I see space-themed movies. But I gotta say…my expectations were raised seeing the Gravity trailer:

So was it worth it?

Yes. YES. Freaking YES. End of review.

Okay, okay, not quite the end of the review. But based on the visuals, which were absolutely stunning, this movie would be worth seeing. It was gorgeous. Stunning. Breathtaking. And, to my surprise, most of the visuals were accurate, i.e., that’s how material acts in space. It was absolutely worth shelling out a few extra bucks for IMAX and 3D. In fact, I highly recommend it. While I was thinking how I would feel if I watched the movie in a regular theater, or even at home, well, that’s where my thoughts change, but just a little bit.

First of all, there are some inaccuracies. SPOILER ALERT: You can’t just jet over to the International Space Station while your shuttle is attached to the Hubble Space Telescope. Different altitudes, different orbits. You also can’t take a Soyuz capsule over to the Chinese space station. All of these things are inaccurate. But you know what? WHO CARES because the movie is still awesome. Also, Sandra Bullock really does an incredible job as well.

There was a feature in a recent Entertainment Weekly issue that showed everyone how the movie was made. Reading that before seeing the movie only enhanced my Gravity-watching experience. It really is a technical marvel and well worth it.

And now we have reached the end of my movie critic soapbox.

The Coming Crisis: Where are the Antibiotics?

This past Monday, one of the top news stories of the day dealt with a topic that, in my opinion, doesn’t  get enough coverage: drug resistance. The CDC released a report, Antibiotic Resistance Threats in the United States, 2013, which takes a look at germs that are resistant to antibiotics, one of the greatest public health discoveries in human history.

I like when health officials and scientists are blunt. Sometimes we get too caught up in minutiae and specificity that we lose our core message. Honestly, getting your message across to the public and to the right people is hard, and the vast minority of scientists and public health officials are not good at it. At all. However, when someone has a clear message, like this statement from Dr. Tom Frieden, the Director of the CDC, I take notice. And I hope everyone else does too:

“Antibiotic resistance is rising for many different pathogens that are threats to health. If we don’t act now, our medicine cabinet will be empty and we won’t have the antibiotics we need to save lives.”

If that statement doesn’t cause you to stop, shudder, and seriously think about the consequences of having no effective antibiotics, it may be time to revisit a post from last year on this blog dealing with that very topic.  Go on and have a looksie, and we’ll continue right back here when you’re ready. Seriously–getcha some background before we continue.

Welcome back! Next, let’s look at the important role pharmaceutical companies play in producing antibiotics.

The Pharmaceutical Companies

According to an article in the Chicago Tribune earlier this year, the number of new systemic antibiotics approved by the US Food and Drug Administration dropped from 16 between 1983 and 1987 to just two in the past five years.

Pharmaceutical companies are, well, companies. They exist to make money. Obviously, the medicine created from these companies help millions of people around the world, myself included. It would seem that now is the perfect time for more and more pharmaceutical companies to invest in the research and development of new antibiotics. But this is not the case.

In the world of pharmaceuticals, antibiotics do not bring in as much revenue as almost all of the other drugs produced. Therefore, there’s not that much of a financial incentive for these companies to produce the antibiotics. Most people also don’t realize the enormous amount of money and time that go into the researching and testing of new drugs. It’s a very strict and rigorous process that takes years. And right now, the incentive for most companies is just not there.

What Happens Now?

My intent is not to make pharmaceutical companies out to be the “bad guys”. I know many people have opinions about “Big Pharma”, but that’s not the focus of this post. But in our society of the free market and capitalism, the fact that money is a big motivator should not be a surprise to anyone.

I also don’t want to give the impression that there are no pharmaceutical companies in existence today who are not researching, or at least allocating time and money, to producing new antibiotics. GlaxoSmithKline was recently given about $200 million from the US to develop new drugs. Some other companies are following suit, but it is not enough to stave off the looming public health crisis that some, including Dr. Frieden, can see coming.

Wake Up!

zzzzzz……zzzzsdsfhoi…wha?? Oh hi! I guess I must have dozed off for a few seconds. Wait, I’ve been sleeping since March?

Yes, blog, you’ve been asleep for a while. We’re going through some changes here at the Orders of Magnitude household. You may be a seeing a little less of Patricia Waldron, whose journalistic abilities will be taking her to the redwoods and beaches of Santa Cruz, CA. I’ll be in OKC for the time being, but now that things have settled down a bit, we’ll be able to get back into a regular blogging schedule. What have we missed? Probably not a lot, right?

In this rare image taken on July 19, 2013, the wide-angle camera on NASA’s Cassini spacecraft captured Saturn’s rings and Earth in the same frame.

Aw, man!

Italian astronaut Luca Parmitano escaped what could have been a deadly disaster on July 16, 2013 when his spacesuit began leaking water. He described not being able to breathe and barely made it back into the ISS.

Holy water balls!

An August 5th story in The Telegraph says that having an orgasm instead of doing a crossword puzzle is better for your brain. What if you’re doing a crossword AND having sex? I guess that would make the sex not as good…anyway, I think we all know what we need to do here.

Never fear! Just because we haven’t been posting doesn’t mean we haven’t been paying attention to all the awesome science.  Stay tuned, Magnituders. We’re just getting started.

The Vaccine Non-troversy

Vaccines are the greatest public health accomplishment in the history of humankind.

Vaccines FTW

For various reasons, some parents refuse to vaccinate their children. Their excuses include:

  • It’s against their religion
  • My child receives too many vaccines at one time
  • My child doesn’t need vaccines–he/she is perfectly healthy
  • Vaccines are not natural
  • Vaccines are harmful

The main type of parent that I see is the generally apprehensive one. This parent hasn’t fully committed to getting their child vaccines, but isn’t sure who to believe and hates seeing their child in pain. Look, I completely understand that. But would you rather your child cry for a few minutes be immunized, or would you rather your child be subjected to this:

This child has a pertussis infection. This child is gasping for air. This child is fighting to breathe. This child, and other children with pertussis infections, can die.

These children are infected with measles. As you can see, this particular outbreak did not happen in the United States. Here in the U.S., the vast majority of us have the luxury of finding relatively cheap immunizations for our children. We have this luxury, while those in less developed countries do not. And what excuses do we have for not immunizing our children? I refer you to the list above.

I don’t want this blog post to strictly about showing you videos of children and families in pain, but I wanted to show you some examples of infections that many of us haven’t seen before. The fact that many of these diseases are not common in the US anymore has created a sense of calm. The only problem with this is that we forget. We forget what these diseases can do. We become complacent and believe that the side effects of the vaccines are much worse than the actual disease. Take a look at those videos again and tell me that your little fever of 99.9 is worse than gasping for breath. Tell that to the parents of a newborn in King County, Washington, who died of whooping cough last December.

One death is one too many for diseases that are preventable. But let’s back up a little bit and talk about the history of vaccines.

F**king Vaccines, How Do They Work?*

*The title to this section is a shout-out to my Insane Clown Posse-loving friends, the Juggalos. P.S. if you are a Juggalo, you are not my friend.

Basically, vaccines work by mimicking a disease and tricking your immune system into fighting that disease. A lot of vaccines use dead viruses of said disease in order to accomplish this; however, some use viruses that are alive.  Let’s look at influenza, aka the flu, for example.

According to the CDC, there are several types of flu vaccines you can receive. The regular flu shot uses inactivated vaccine that contains dead flu viruses. In recent years, a nasal spray/mist has been developed as well. It contains live, attenuated (weakened)  flu viruses. This basically means that the flu viruses are alive, but are weakened to a state in which they cannot cause the flu.  High-dose flu shots for people 65 or older have been developed in the past few years as well. This past year, many flu clinics began offering an intradermal flu shot, which is injected into the skin as opposed to the muscle like the regular flu shot. It uses a much smaller needle and requires less antigen (the part of the vaccine that helps your body build up protection against flu viruses) to be as effective as the regular flu shot.

Vaccines Have Worked Alright…Maybe TOO Well

As you can see from the first graphic on this blog post, vaccines have been one of the single most effective public health tools against preventable diseases in the world. Unfortunately, a lot of people have forgotten exactly how bad some of these preventable diseases are. Some people, based on anecdotal evidence and word-of-mouth, think that vaccines cause more harm than good. These people, whose numbers are few but voices are loud, have been around as long as vaccines have been around. But now, they have a tool that increases the reach of their wrong-ness. Which leads me to…

The Rise of the Internet

I have a love/hate relationship with the internet. I wouldn’t have a job without it. The internet brings me almost everything I need from an informational standpoint. In fact, I don’t watch much news at all anymore. I follow  reporters, news stations, and newspaper/magazines on Twitter. It’s the first thing I read in the morning and one of the last things I read at night.  Anyone can have a voice on the internet, and as long as we keep it that way, it is a wonderful tool for freedom of expression.

But therein lies the problem as well: anyone can have a voice. And as we know from living in the world and interacting with humans, a lot of us are wrong. A lot of us do not understand science or use the scientific method, but we still are able to voice our beliefs on sciencey things. Which brings me to…


I honestly believe that Jenny McCarthy believes she’s doing what is best for her son, that she loves her son, and believes that what she says is correct. However, she is wrong. People who believe that vaccinations do no good, people who believe that vaccinations cause more harm than good, and people who refuse to see the mountain of scientific evidence refuting their claims — they are wrong.

jenny-mccarthy-autismAnd being wrong has consequences.

A lot of people look up to Jenny McCarthy. She has a platform of celebrity that many of us do not have. Not many people get to pen articles for the Huffington Post (in related news–WTF, Huffington Post?) But she didn’t come up with her beliefs on her own.

In 1998, Andrew Wakefield announced at a press conference at the Royal Free Hospital in London his concerns regarding the safety of the MMR vaccine (measles, mumps, and rubella) and its relationship to autism. He never proved that this vaccine caused autism, but his “concerns” were enough to start a movement, including Jenny McCarthy’s Generation Rescue.

A 2003 review in The Archives of Pediatrics and Adolescent Medicine came to the conclusion that there was no evidence of Wakefield’s claim. Subsequently, Wakefield has been made a laughing stock of the scientific community, numerous ethical violations have come to light, and the British Medical Journal even said his work was fraudulent.

You would think this would be enough for McCarthy to come to her senses, do the responsible thing, disown Wakefield and the anti-science movement, and move on. Alas, that is not what happened.  And therein lies the shame of this whole debacle: Even when presented with the truth, she refuses to acknowledge it. Think of how many people she could help were this the case.