Archive for the ‘Ray Gaudette’ Category

by Richard Knox

It’s only a matter of time, some researchers are warning, before isolated cases of Ebola start turning up in developed nations, as well as hitherto-unaffected African countries.

The current Ebola outbreak in West Africa has killed more people than all previous outbreaks combined, the World Health Organization said Wednesday. The official count includes about 3,600 cases and 1,800 deaths across four countries.

Meanwhile, the authors of a new analysis say many countries — including the U.S. — should gear up to recognize, isolate and treat imported cases of Ebola.

The probability of seeing at least one imported case of Ebola in the U.S. is as high as 18 percent by late September, researchers reported Tuesday in the journal PLOS Currents: Outbreaks. That’s compared with less than 5 percent right now.

These predictions are based on the flow of airline passengers from West Africa and the difficulty of preventing an infected passenger from boarding a flight.

As with any such analysis, there’s some uncertainty. The range of a probable U.S. importation of Ebola by Sept. 22 runs from 1 percent to 18 percent. But with time — and a continuing intense outbreak in West Africa — importation is almost inevitable, the researchers told NPR.

“What is happening in West Africa is going to get here. We can’t escape that at this point,” says physicist Alessandro Vespignani, the senior author on the study, who analyzes the spread of infectious diseases at Northeastern University.

To be clear, the projection is for at least one imported case of Ebola — not for the kind of viral mayhem afflicting Guinea, Liberia and Sierra Leone.

“What we could expect, if there is an importation, would be very small clusters of cases, between one and three,” Vespignani says.

But the probability increases as long as the West African epidemics keep growing. And that means U.S. hospitals, doctors and public health officials need to heighten their vigilance.

The same is true for a roster of 16 other nations, from the U.K. to South Africa, which are connected to West Africa through air traffic, Vespignani and his colleagues say.

There’s a 25 to 28 percent chance that an Ebola case will turn up in the U.K. by late September. Belgium, France and Germany will have lower risk. “But it’s not negligible,” Vespignani says. “Sooner or later, they will arrive.”

The probability of imported cases in Africa is higher, not surprisingly. There’s more than a 50 percent probability Ebola will show up in the West African nation of Ghana by late September, according to the study. Gambia, Ivory Coast, Morocco, South Africa and Kenya are among 11 African countries where Ebola could pop up.

Officials at the U.S. Centers for Disease Control and Prevention had a presentation on the numbers on Tuesday. The CDC has deployed teams of personnel in West Africa to help bring Ebola under control. And here at home, the agency is charged with preparing both the U.S. medical system and the American public for the possibility that the deadly virus could sneak into this country.

Biostatistician Ira Longini from the University of Florida agrees that Ebola doesn’t pose a public health threat in the U.S. and other developed nations. But that doesn’t mean that preparation isn’t urgent.

“We certainly need to make sure that staff and leadership of American medical centers understand the implications of Ebola,” says Longini, who also worked on the study. “We need to have diagnostics in place to identify Ebola quickly. We need quite a few local labs to do this and not just rely on sending samples to the CDC. And we need to make sure isolation and quarantine of contacts takes place. If it doesn’t, we could have a small cluster of cases.”

The analysis by Longini, Vespignani and their colleagues takes into account the number of airline passengers coming from West Africa to various countries. For instance, more than 6,000 a week arrive in Britain from Nigeria, many of them originating in other African countries.

Hundreds to several thousands travel every week from West Africa to France, Germany, Spain, Italy, South Africa, Egypt, Saudi Arabia, India, China and other countries.

The researchers calculated the impact of severe restrictions on flights from Ebola-affected regions. An 80 percent reduction in air travelers would do no more than delay the impact of Ebola by a few weeks. (A 100 percent choke-off of air travel is considered impossible.)

“Unless you can completely shut down the transportation systems, these kinds of efforts will, at best, buy you a little time,” Longini says. “And they can be quite counterproductive because you’re interrupting the flow of help, goods and services. It can make the epidemic worse in the country that’s being quarantined.”

The basic problem with confining Ebola is that, like any infectious disease, people can be infected without showing symptoms. In Ebola’s case, the average incubation period is 7 days, though it can be longer. That’s more than enough time for an infected traveler to land on the other side of the world.

Fortunately, an Ebola-infected person can’t infect others unless he’s obviously sick. At that stage, the virus can spread by direct contact with the infected person or bodily fluids. On average, each case of Ebola infects about two other people. That spread rate is similar to that of the flu, and roughly half the rate of smallpox.

Vespignani, from Northeastern University, says screening airline passengers is not going to prevent Ebola from traveling across the globe. “I don’t trust screening too much,” he says. “It’s difficult. Intercepting passengers that are really not sick is not easy.”

http://www.npr.org/blogs/goatsandsoda/2014/09/04/345767439/a-few-ebola-cases-likely-in-u-s-air-traffic-analysis-shows

Thanks to Ray Gaudette for bringing this to the attention of the It’s Interesting community.

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by Greg Myre

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Mourners carry coffins through the streets of Tehran, Iran, on July 7, 1988, during a mass funeral for victims of a downed Iran Air flight. The U.S. Navy shot down the civilian plane in the Persian Gulf, killing all 290 onboard, after mistaking it for an Iranian warplane.

Ukrainian officials say pro-Russian separatists may have shot down the Malaysia Airlines plane that crashed Thursday in eastern Ukraine, killing all 298 people onboard.

It’s rare, but not unprecedented, for civilian airliners to be shot down. In fact, it’s happened before in Ukraine, just 13 years ago.

Back in 2001, the Ukrainian military accidentally shot down a Russian civilian plane while conducting an exercise on the Crimean Peninsula — the very territory that Russia seized earlier this year, prompting the current crisis in Ukraine.

Here’s a list of the deadliest such episodes:

Israel Shoots Down An Errant Libyan Plane: The Libyan Airlines Boeing 727 left the capital, Tripoli, on Feb. 21, 1973, heading east for Cairo when it suffered the double whammy of bad weather and equipment failure. It flew past Cairo and entered the Sinai Peninsula, which was controlled by Israel at the time. Two Israeli warplanes intercepted the Libyan aircraft, and when it refused to land, the Israelis shot it down, killing all but five of the 113 onboard.

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Men sift through the wreckage of an Air Rhodesia plane shot down by guerrilla fighters in September 1978 in northern Rhodesia (now Zimbabwe). The rebels shot down another Air Rhodesia flight five months later.

Rhodesian Rebels Bring Down Two Planes: During the 1970s civil war in Rhodesia (now Zimbabwe), guerrillas shot down two Air Rhodesia commercial flights in the space of five months. In the first attack, on Sept. 3, 1978, rebels of the Zimbabwe People’s Revolutionary Army shot down a plane going from Kariba to the capital, Salisbury (now Harare). Of the 56 people onboard, 18 survived the crash, but rebels killed 10 of them at the crash site. Then, on Feb. 12, 1979, the same rebel group used another missile to bring down a second Air Rhodesia plane traveling the same route. All 59 people onboard were killed.

Soviets Take Out A Korean Plane Carrying A U.S. Congressman: In a 1983 episode that dramatically raised Cold War tensions, Korean Air Lines Flight 007 strayed off course, apparently because of pilot error, on a flight from Anchorage, Alaska, to the Korean capital, Seoul. After the Boeing 747 entered prohibited Soviet airspace, a Soviet fighter jet blew it out of the sky near the island of Sakhalin, to the east of the Soviet mainland, killing all 269 onboard, including U.S. Rep. Lawrence McDonald of Georgia.


A Korean Airlines official, Suk Jin-ku, examines a piece of aircraft debris in Japan on Sept. 12, 1983. Eleven days earlier, a Soviet warplane shot down a Korean Air Lines plane that had strayed into Soviet airspace. All 269 people onboard were killed, including U.S. Rep. Lawrence McDonald.

U.S. Navy Shoots Down An Iranian Plane Over The Persian Gulf: In a tense time in a volatile region, the USS Vincennes, a guided missile cruiser, was in the Persian Gulf in 1988 to help keep the key oil shipping lane open and to monitor the war between Iran and Iraq. According to the U.S. government, a helicopter from the Vincennes came under warning fire from Iranian speedboats. Such small-scale incidents took place with some regularity at the time.

The Vincennes then entered Iranian territorial waters and spotted an aircraft that it thought was an Iranian F-14 fighter plane. However, it was actually a civilian Iran Air Airbus A300, flying over Iran’s territorial waters on its regular route from Tehran to Dubai in the United Arab Emirates. The Vincennes fired a surface-to-air missile that destroyed the plane, killing all 290 onboard. Under a 1996 agreement at the International Court of Justice, the U.S. agreed to pay Iran $61.8 million.

Ukrainian Military Accidentally Shoots Down A Russian Civilian Plane: The Ukrainian military was carrying out exercises on the Crimean Peninsula on Oct. 4, 2001, when it launched a surface-to-air missile that struck a Siberia Airlines plane as it was traveling from Tel Aviv to Novosibirsk, Russia. All 78 people onboard were killed when the plane disintegrated over the Black Sea.

The episode came less than a month after the Sept. 11 attacks in the United States, and there was immediate speculation that it was a terrorist attack. As suspicion turned to the Ukrainian military, the government initially denied responsibility, but eventually it acknowledged that it was to blame for the accidental hit.

And that brings us to more recent events. Russia seized and annexed Crimea earlier this year, fueling the current crisis, which has included the fighting in eastern Ukraine. The pro-Russian separatists in that region have brought down several Ukrainian military aircraft in recent months.

Thanks to Ray Gaudette for bringing this to the attention of the It’s Interesting community.

http://www.npr.org/blogs/parallels/2014/07/17/332318322/a-brief-history-of-civilian-planes-that-have-been-shot-down

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Tourists at Yellowstone National Park are being barred from areas of the park because the massive underground supervolcano beneath it is melting the asphalt roads.

“It basically turned the asphalt into soup. It turned the gravel road into oatmeal,” Yellowstone spokesman Dan Hottle said. In particular, Hottle said that the road between the park’s most popular attraction, Old Faithful, and Madison Junction has been dangerously compromised.

Park officials also asked tourists not to hike into the affected areas, as the danger of stepping through what appears to be solid soil into boiling-hot water was “high.”

There are plenty of other great places to see thermal features in the park,” park spokesman Al Nash told The Weather Channel. “I wouldn’t risk personal injury to see these during this temporary closure.”

It is not known when the road, which services the three million people who visit the park every year, will be reopened.

The last time the supervolcano beneath Yellowstone actually erupted was 640,000 years ago, U.S. Geological Survey records show.

Late last year, geologists discovered that the supervolcano was more than twice as large as previously thought.

“We found it to be about two-and-a-half times larger than we thought,” the University of Utah’s James Farrell told National Geographic. “That’s not to say it’s getting any bigger,” he added, “just that our ability to see it is getting better.”

Thanks to Ray Gaudette for bringing this to the attention of the It’s Interesting community.

http://www.rawstory.com/rs/2014/07/14/parts-of-yellowstone-national-park-closed-after-massive-supervolcano-beneath-it-melts-roads/?onswipe_redirect=no&oswrr=1

Though the recent release of Medicare’s physician payments cast a spotlight on the millions of dollars paid to some specialists, there is a startling secret behind America’s health care hierarchy: Physicians, the most highly trained members in the industry’s work force, are on average right in the middle of the compensation pack.

That is because the biggest bucks are currently earned not through the delivery of care, but from overseeing the business of medicine.

The base pay of insurance executives, hospital executives and even hospital administrators often far outstrips doctors’ salaries, according to an analysis performed for The New York Times by Compdata Surveys: $584,000 on average for an insurance chief executive officer, $386,000 for a hospital C.E.O. and $237,000 for a hospital administrator, compared with $306,000 for a surgeon and $185,000 for a general doctor.

And those numbers almost certainly understate the payment gap, since top executives frequently earn the bulk of their income in nonsalary compensation. In a deal that is not unusual in the industry, Mark T. Bertolini, the chief executive of Aetna, earned a salary of about $977,000 in 2012 but a total compensation package of over $36 million, the bulk of it from stocks vested and options he exercised that year. Likewise, Ronald J. Del Mauro, a former president of Barnabas Health, a midsize health system in New Jersey, earned a salary of just $28,000 in 2012, the year he retired, but total compensation of $21.7 million.

The proliferation of high earners in the medical business and administration ranks adds to the United States’ $2.7 trillion health care bill and stands in stark contrast with other developed countries, where top-ranked hospitals have only skeleton administrative staffs and where health care workers are generally paid less. And many experts say it’s bad value for health care dollars.

“At large hospitals there are senior V.P.s, V.P.s of this, that and the other,” said Cathy Schoen, senior vice president for policy, research and evaluation at the Commonwealth Fund, a New York-based foundation that focuses on health care. “Each one of them is paid more than before, and more than in any other country.”

She added, “The pay for the top five or 10 executives at insurers is pretty astounding — way more than a highly trained surgeon.”

She said that executive salaries in health care “increased hugely in the ‘90s” and that the trend has continued. For example, in addition to Mr. Del Mauro’s $21.7 million package, Barnabas Health listed more than 20 vice presidents who earned over $350,000 on its latest available tax return; the new chief executive earned about $3 million. Data released by Medicare show that Barnabas Health’s hospitals bill more than twice the national average for many procedures. (In 2006, the hospital paid one of the largest Medicare fines ever to settle fraud charges brought by federal prosecutors.)

Hospitals and insurers maintain that large pay packages are necessary to attract top executives who have the expertise needed to cope with the complex structure of American health care, where hospitals and insurers undertake hundreds of negotiations to set prices.

Ellen Greene, a spokeswoman for Barnabas Health, said Mr. Del Mauro’s retirement package was “a function of over four decades of service and reflects his exceptional legacy.” Nearly $14 million was a cumulative payout from a deferred retirement plan, she said, and the remainder included base compensation, a bonus and an incentive plan

Ms. Greene also said Barnabas’s compensation program follows I.R.S. rules and is established by an executive compensation committee with “guidance from a nationally recognized compensation consultant.”

In many areas, the health care industry is home to the top earning executives in the nonprofit sector.

And studies suggest that administrative costs make up 20 to 30 percent of the United States health care bill, far higher than in any other country. American insurers, meanwhile, spent $606 per person on administrative costs, more than twice as much as in any other developed country and more than three times as much as many, according to a study by the Commonwealth Fund.

As a result of the system’s complexity, there are many jobs descriptions for positions that often don’t exist elsewhere: medical coders, claims adjusters, medical device brokers, drug purchasers — not to mention the “navigators” created by the Affordable Care Act.

Among doctors, there is growing frustration over the army of businesspeople around them and the impact of administrative costs, which are reflected in inflated charges for medical services.

“Most doctors want to do well by their patients,” said Dr. Abeel A. Mangi, a cardiothoracic surgeon at the Yale School of Medicine, who is teaming up with a group at the Yale School of Management to better evaluate cost and outcomes in his department. “Other constituents, such as device manufacturers, pharmaceutical companies and even hospital administrators, may not necessarily have that perspective.”

Doctors are beginning to push back: Last month, 75 doctors in northern Wisconsin took out an advertisement in The Wisconsin State Journal demanding widespread health reforms to lower prices, including penalizing hospitals for overbuilding and requiring that 95 percent of insurance premiums be used on medical care. The movement was ignited when a surgeon, Dr. Hans Rechsteiner, discovered that a brief outpatient appendectomy he had performed for a fee of $1,700 generated over $12,000 in hospital bills, including $6,500 for operating room and recovery room charges.

It’s worth noting that the health care industry is staffed by some of the lowest as well as highest paid professionals in any business. The average staff nurse is paid about $61,000 a year, and an emergency medical technician earns just about minimum wage, for a yearly income of $27,000, according to the Compdata analysis. Many medics work two or three jobs to make ends meet.

“It’s stressful, dirty, hard work, and the burnout rate is high,” said Tom McNulty, a 19-year-old college student who volunteers for an ambulance corps outside Rochester. Though he finds it fulfilling, he said he would not make it a career: “Financially, it’s not feasible.”

Elisabeth Rosenthal is a reporter for The New York Times who is writing a series about the cost of health care, “Paying Till It Hurts.”

http://mobile.nytimes.com/2014/05/18/sunday-review/doctors-salaries-are-not-the-big-cost.html?_r=0&referrer

Thanks to Ray Gaudette for bringing this to the attention of the It’s Interesting community.

More than 100 people have now reported they got sick with suspected food poisoning at a national Food Safety Summit held earlier this month in Baltimore.

Maryland state health officials say they still don’t know what caused the outbreak of gastroenteritis that left participants suffering symptoms that included diarrhea and nausea.

“We are working on evaluating possible exposures and doing testing at the Maryland state public health laboratory to attempt to identify an agent,” officials said in a letter to attendees.

The conference, held April 8 to 10 at the Baltimore Convention Center, attracted at least 1,300 of the top food safety officials in the nation, including staff from federal agencies such as the Food and Drug Administration and the Centers for Disease Control and Prevention as well as businesses such as McDonald’s, Tyson and ConAgra Foods.

Health officials have heard back from about 400 of those who attended, so the actual toll of illness might be higher.

City health officials inspected the convention center and its food service provider, Centerplate. The company was issued a violation notice for condensation dripping from one of the two ice machines in the kitchen, a spokesman said.

http://www.nbcnews.com/#/health/health-news/possible-food-poisoning-sickens-100-safety-summit-n91631

Thanks to Ray Gaudette for bringing this to the attention of the It’s Interesting community.

A dramatic video posted on YouTube shows several cars being swallowed by a Baltimore landslide on Wednesday.

YouTube user ToddTesla posted the 90-second clip, which consists mostly of residents reacting to cars that appear to be tipping into a crevice at the edge of 26th St. in the city’s Charles Village neighborhood. At the 1:12 mark, one of them notices that the road is splitting apart, and then the street’s entire retaining wall gives way in a deafening crash as the bystanders scream in disbelief. No one was injured.

The cars fell onto train tracks used by the freight railroad company CSX, suspending service indefinitely. In a statement, the company said it was working with authorities to respond to to the incident.

The Baltimore Sun reported that the collapsed wall was 120 years old, and that 19 homes near the site of the landslide were evacuated.

Heavy rains in the Baltimore area on Wednesday caused widespread flooding, which led to the collapse. CBS Baltimore reported that Charles Village residents had also made numerous complaints about the “crumbling” street over the past year.

http://www.huffingtonpost.com/2014/05/01/baltimore-landslide-video_n_5249782.html

Thanks to Ray Gaudette for bringing this to the attention of the It’s Interesting community.

Each spring, people flock to Kawasaki, Japan, to celebrate Kanamara Matsuri, aka the “Festival of the Steel Phallus.”

Held this year on April 6, the festival is a celebration of the penis and fertility. People parade gigantic phallic-shaped mikoshi (portable Shinto shrines) down the streets during the event, as revelers suck on penis lollipops, buy penis-themed memorabilia and pose with sculptures in the shape of — you guessed it — penises.

According to the BBC, the festival is believed to have roots in the 17th century, when prostitutes are said to have prayed for protection from sexually transmitted infections at Kawasaki’s Kanamara shrine.

The festival raises awareness about safe sex practices and fundraises for HIV prevention.

http://www.huffingtonpost.com/2014/04/07/japan-penis-festival-kanamara-matsuri_n_5106378.html

Thanks to Ray Gaudette for bringing this to the attention of the It’s Interesting community.