Get In, Loser
Remembering John Last
So many things to catch y’all up on. Where to begin? How about with some sad news. I only just now learned that legendary Epidemiologist John Last passed away last September.
About 25 years ago, when I was a keen PhD student, Dr Last came to speak at a student conference hosted at my university. My colleague Tammy Clifford (who is now a big shot Epidemiologist herself) hosted the event. And somehow I got into a heated public shouting match with Dr Last.
How did this happen? Well, I can be an asshole. It happens when I’ve convinced myself that I’m doing intellectual battle in the public arena of scholarly argument. And when you’re young and hungry and eager to prove yourself, a world famous scholar like Dr Last is the ideal opponent to test your mettle against. I don’t remember the subject of our disagreement, but it boiled down to me insisting that martial law was a real option for Western democracies to enact as a last resort for epidemic control. Last disagreed.
I’m sure the disagreement was more nuanced than that. But all I really recall is that I was an asshole for hijacking a gracious public talk by an esteemed global scholar, making it all about my need for public intellectual praise.
Decades later, one of my own former students (Jeavana Sritharan), who was at the time pursuing a PhD at a different university, invited me to her wedding. I was seated with one of her professors and her consort, a military man who turned out to be…. John Last’s son.
Some interactions later, and I was having regular contact with Dr Last, now long retired and living in my neighbourhood. We had a lovely lunch at the Canal Ritz where I learned all about his fascinating life. His own father had been private physician to Emperor Haile Selassie. That consumed hours of conversation.
He told me of how he was writing a children’s novel about two Australian kids guided through their country by an ancient parrot who hailed back from the time of Queen Anne.
I’d always intended on getting him on my own podcast to talk about his life and his new book. But I procrastinated too long. And now the opportunity is gone.
Let that be a lesson.
Rest in Peace, Dr Last.
Staying In Touch
Speaking of staying in touch with the elderly, I want to put in a plug for a device called “Viewclix“. It’s a video phone made especially for seniors. I got one for my technologically illiterate parents so they can stay in more intimate touch with their various children scattered across vast distances. So far it works like a charm!
Here are some pics of my weekly check-ins with the folks:
I just can’t say no to money. And why should I? I recently signed up with GlobalWonks, an “expert access portal”, and instantly earned some hard cash giving an investment banker advice on the new Wuhan coronavirus (COVID-19). I’ll be writing more about that soon, so stay tuned. In the mean time, take precautions:
Other consulting gigs continue apace, often with inconvenient deadlines. Recently, I had to drive my father for his hearing check-up. But I also had an analysis due for a client. So I had to finish it while waiting in the parking structure:
Star Trek: Discovery is shit. Everyone knows that. I was hoping Star Trek: Picard would be better. It’s not. It’s shit, too. I thought about writing a review. I don’t want to. It hurts my heart too much. I will say this, though. Do all Vulcanoids look the same to these hack writers? Do they find these millennial beardos from the same production line? Cripes, what crap:
My own Beardo
Well I got lazy, too.
Until common sense prevailed. (That and Blonde Girl’s insistence that I couldn’t keep destroying the bathroom with black beard dye every week). So in one instant I went from a fake Sikh man to a walking corpse:
Well people do love to talk about this issue. And ever since my Huffington Post article on this issue, followed up with a stint on Al Jazeera AJ+, another blog post, a few words on Gizmodo, and an interview with BBC Science Focus, journalists have kept asking for my evolving opinion on population growth. I don’t mind in the least. I just never expected it.
Well, the Brits in particular seem keen on this topic. I was invited onto the current affairs show of London’s TRT World media group. There were four “experts” present (two of us via Skype): Alistair Currie of Population Matters, Rajani Bhatia of the University at Albany, and a population ethicist whose name I did not quite catch; I believe it was something like Karen Coleman.
I took a quick screen grab of myself and Professor Bhatia at the Roundtable set with host David Foster:
I won’t lie. I was pretty nervous, mostly because I did not know what to expect. My experience watching British news shows is that they are quite combative. And I’m not a combative type… at least not anymore, and not while the world is watching. I will confirm, though, that I was wearing pants, and my fuzzy canine boy was loyally guarding my bare feet.
There are many things I wish I’d said. In particular, I was challenged by “Karen Coleman” (I think that’s her name) that my insistence that there is enough food in the world is naive. I argued that we already waste 1/3 of all food produced for human consumption (a billion tonnes worth), and that therefore with proper management there is enough food for an an additional 4-5 billion people on Earth. I further added that if more people go vegan that becomes even more likely.
The challenge presented to me was that it is unreasonable to expect people to change their dietary habits so profoundly. My response should have been that “Karen Coleman” (if that is her name; I do apologize) readily expects a change of behaviour for people, particularly those in low income agrarian countries, to voluntarily relinquish their desire to have children, but somehow thinks it’s untenable for people to change their dietary behaviours. Well, people change dietary behaviours all the time. But the only way ever shown to reduce family sizes consistently is to provide people with economic and food security, then they naturally reduce their family sizes.
In any case, I will post a link to the actual show when it is available.
More on Overpopulation
Those fine folks from Gizmodo also asked my opinion on what the world would look like if no one died. I sent them a detailed reply. I’m sure they will only publish a greatly edited-down version. So for posterity, here is my full reply:
What would happen if people stopped dying?
I love this question. Frankly, I think it was well explored in the 2011 science fiction miniseries “Torchwood: Miracle Day.” In it, everyone in world stopped being able to die; they just… lingered. The show explored many of the likely social consequences, such as a need to re-think triage policies in hospitals: they become less about treating the more “life-threatening” cases and more about prioritizing pain control.
Instead of taking the “Torchwood” approach, I’m going to assume that people will still get older and can be killed through injury and illness. We will simply not die of old age. Any other interpretation would essentially make us superhuman, able to walk across the bottom of the ocean or the face of the Moon without a spacesuit. And that’s not particularly interesting. There’s a reason Superman is the most boring superhero.
So, if people were to still grow old and infirm but not expire of old age, there would likely be psychological, economic and demographic changes. The expectation of living into very extreme old age would in my view reduce the desire to reproduce, thus stabilizing world population. But the dramatic age distribution shift toward a very high average age would result in a spike in debilitating conditions, such as obesity, infirmity and diseases of excess. In this scenario, type II diabetes and heart disease would still result in death if unchecked, so true immortality would only be experienced by those few who summon the discipline to maintain lifelong good health practices. Average life expectancy at birth would then be somewhere between 300 and 1000 years (which is as blind a guess as one can make).
If we posit instead that the population would stay a reasonably health middle physiological age, while still being susceptible to accident and injury, then we are essentially describing the pantheon of gods of a variety of ancient religions. The Greek gods envied mortal humans because our inevitable deaths allow us to be heroic. Would this style of immortality rob human beings of our potential for heroism, passion, artistry, and creativity? Would we become almost impossible to entertain, surprise, and arouse? I am reminded of the 1974 science fiction film “Zardoz”, in which the immortal “Eternals” live apart from the mortal “Brutals”, with the former struggling against their bottomless boredom.
In both scenarios, the world’s age pyramid, a graphical way of describing a population’s age distribution, would move from the squat triangle of a sub-Saharan nation, past the so-called constrictive or columnar distributions of ageing nations like Japan, to an inverted triangle, a situation never before seen in any human population. Replacement rate would fall well below the traditional textbook 2.0, as deaths would be rare and reproduction rarer, as most people will be well past their effective biological reproduction ages. Thus I think the threat of overpopulation will be negligible.
Economically, it’s difficult to envision a system of production and trade that could properly service a population of aged eternals, unless heavy automation were to serve as a tireless and ambitionless working class. But the focus of goods and services, for whatever intelligence capable and willing to create them, will be pleasure: forms of entertainment, stimulation, and recreation. These include pornography, games, and pharmaceuticals.
Given the likelihood of the undying to increasingly fear their vulnerability to injury, I suspect the latter two predilections to be focused on pain relief, hallucinogens and virtual reality experiences. By some calculus, death is more tragic if it befalls an immortal. So if you’re bored out of your mind, thirsty for new experiences, yet terrified that a traffic accident might end a millennia-long life, adventures are best had in simulated fashion.
In short, I foresee a stable population of boring, bored, childless, drug-addicted old farts hooked up to VR setups as their robotic servants span out across the universe solely to stream new experiences and vistas to their slovenly and cowardly couch-ridden masters. We should all be more thankful for our mortality.
And What About Vaccine Denial?
A student from the University of Akron recently asked me some questions about vaccine hesitancy for a paper he’s writing. Once again, I include my responses here for posterity:
1. Can vaccines against certain diseases make the immune system weaker? For example, if you get vaccinated for chickenpox could this vaccination weaken your immune system against other diseases such as influenza? If so, how?
No, to the best of my knowledge and imagination, this is not possible. Vaccinations encourage your body to produce agents specifically targeting the pathogen present in the vaccine. Those agents *might* also be effective against very similar pathogens. But I don’t see how they could serve to diminish the effects of other agents on other pathogens.
2. In today’s world we get vaccinated against many diseases such as influenza, measles, and polio. Does injecting the human body with all these vaccinations cause any negative side effects? Could all these vaccinations harm the human body in any way?
A modern vaccination is typically the introduction of a dead, attenuated, or even a fragment of the organism(s) that cause disease. It’s like target practice for your immune system. Few vaccines contain live organisms. Most do not, and therefore offer zero probability of actually infecting a person. The most common side effects are soreness at the point of injection, and mild flu-like symptoms for a few hours after vaccination.
Rarely, the flu vaccine can cause a serious side effect called Guillain-Barré syndrome, in which your body’s immune system attacks your nerves. The vast majority of people affected recover fully in under a year. It is thought that we see 1 case of Guillain-Barré syndrome for every million flu doses administered. It should be pointed out, though, that the flu itself is actually more likely to cause Guillain-Barré syndrome than is the flu vaccine. So in my opinion, this syndrome should not be a reason to avoid vaccination.
The 2009 H1N1 pandemic saw a version of the flu vaccine (Pandemrix) be suspected of being associated with an increased risk of narcolepsy. To my knowledge, this association has not been proven.
Most side effects of vaccines (including local infection, redness, dermatitis, etc) are due to their adjuvants. Adjuvants are chemicals included in the formulation to increase the effectiveness of the vaccine. They allow us to produce more vaccines in greater quantities, at less expense, and at heightened effectiveness.
3. What do you think is the biggest reason why people refuse to get vaccinated? Is it because people are scared of the side effects or are people misinformed?
That is the million dollar question! At its heart is a discomfort with introducing a foreign agent directly into the bloodstream. If the vaccine were a pill or a beverage, I think the fear would be less. But we psychologically associate a sense of experimentation and impropriety to anything injected into our bodies.
Beyond that strange fear is the tendency for people to misunderstand the nature of the side effects. I’ve lost count of the number of people who tell me they don’t get the flu vaccine because “last time I got it, it gave me the flu.” It’s physically not possible for the modern flu vaccine to do that; these people confused the very short duration discomfort of a side effect with the true horror of the flu.
The sense that vaccines *don’t work* is prevalent. Because the flu vaccine is changed every year due to our best guesses of that year’s prevalent strain, sometimes the vaccine fails to precisely match the actual virus specifications, and its effectiveness is reduced. So its protection will not be absolute. That is a strange reason not to accept *some* protection; but people are strange creatures.
In the case of vaccines against common diseases like measles or mumps, the formulation is well established and well matched. But –until recently—these diseases were not commonly seen. So many people assumed they did not need to be made immune from them. In that sense, vaccines are a victim of their own success: they were so successful at preventing disease that many people stopped believing that those diseases are real.
Then there is the disinformation in the media, that vaccines are the *cause* of some serious conditions, like autism. For those conditions, many people want a simple cause, something to blame. Despite the countless studies showing that there is no causal relationship, blaming the foreign injected substance is easier to blame than our environment or our genetics, both of which likely play a role in autism.
High profile deniers play a strong role in influencing the masses.
4. There are many vaccinations that people have to get; which ones are the most important and which ones are the least important? Are there any unnecessary vaccines that people still are required to receive today?
Public health agencies are loath to make anything mandatory that is unnecessary. A yearly flu vaccine will save you weeks and maybe months of suffering, and will help protect the vulnerable among us, like seniors, who die from the flu in large numbers every year.
The mandatory vaccines prescribed by pediatricians for infants are done so for good reason. Historically, diseases like measles, mumps, and rubella were scourges of children, and could be so again; so our children must be protected.
In terms of mandatory vaccinations in North America, diphtheria has some controversy around it as some doctors argue that it is now so rare that it need not be obligatory. But again, that is still being debated.
And let us not forget that small pox used to be a mandatory vaccine decades ago. But we wiped that scourge off the face of the planet using inoculations; so it is not offered anymore.
In short: if the public health agency says it is mandatory, you’d better believe it’s bloody important. The flu vaccine is not mandatory, but I think everyone should get one anyway.
5. I know that non- vaccinated people are a threat to the people around them. In what ways are they a threat and how big of a threat are they to today’s world?
It depends on the disease. Different diseases are more deadly, infectious, and harder to treat than others. In short, there is a thing called “herd immunity” which is essentially that not everyone needs to be vaccinated, just a certain large proportion; if enough people are immune, then they buffer the non-immune from ever being exposed in the first place.
So the danger of non-vaccinated people is that if they become numerous enough, they compromise the population’s ability to confer herd immunity upon the totality of the non-vaccinated subgroup, thus allowing for the eruption of epidemics.
This is a big problem in the modern world in which people travel more and faster, and in which we live in closer quarters than ever before. Herd immunity is more important now than ever before.
6. What is the process that results in a working vaccine? Are there different stages in the process that scientist must pass in order to continue?
I’m not a vaccine manufacturer or biochemist, so I cannot comment on this.
7. Do you think that pro- vaccination campaigns should be made a bigger deal in today’s society? If so, should they be privately funded or governmentally funded?
Government already funds public health agencies and their efforts to promote vaccination. It’s time for other parts of the health sector and media to join the battle. The anti-vax lobby has emotion, stories, and influencers on their side. We have truth and data. We need to also tell stories and recruit high profile influencers because no one’s mind has ever been changed by data, only by narrative.
Is That All?
I’m afraid so.
But I will leave you with this: