Saturday, June 27, 2015
The Supreme Court's gay marriage decision destroys the concept of tolerance, conflating it with approval, which is a near opposite
It's a huge error, and one that just lost us the battle for Islamic hearts and minds. The appeal for tolerance is moral and right. A demand that society approve
of homosexual relationships is morally insane, and will destroy whatever moral standing we had to appeal on the world stage for tolerance of homosexuality.
Homosexuals have a right to be tolerated but no one
has a right to approval and marriage is society's stamp of approval, thus the only legitimate path to gay marriage is through majority support, a path that SCOTUS has now cut off with their Obergefell v. Hodges
decision. To do it they annihilated the distinction between tolerance and approval, which is the foundation of all of our liberty. Five half-educated lawyers who don't even grasp the distinction between tolerance and approval are completely oblivious to the magnitude of the pillar that they just removed from our system of liberty.
It's like knocking out a bottom corner of the Empire State building to make room for some extra parking. They have absolutely no idea what they have done, and homosexuals, who will always be a very small minority, utterly dependent on the tolerance of society, will suffer as much as anyone by the Court's destruction of the principle of tolerance. Do homosexuals think that their need for tolerance is past? Have they looked at the world recently?
Tolerance is in for the fight of its life and yet our system of law, at the very highest level, has suddenly wadded it together with approval, which is a near opposite. It is not tolerance to abide what you approve. Tolerance is abiding what you don't
approve, and that
is the one thing necessary for pluralism to exist. So we have this stab at the heart of pluralism, just as the totalitarian communists, feminists, and other groupists in the U.S., and the totalitarian Islamofascists everywhere, are ascendant in their power.
Tolerance has taken a huge hit, with implications far beyond this one issue. We now no longer have a coherent legal concept of tolerance to defend. How are we going to sell tolerance to the Islamic world when we have just declared that it means approval, that to be civilized according to our understanding of natural right Muslims don’t just have to stop throwing homosexuals off of rooftops but that they have to give their blessing to homosexuality and consecrate homosexual relations with their rites of social and religious commitment?
Sorry, but that declaration is wrong
, and the Court’s assertion that it is right just lost us the battle for the hearts and minds of the Muslim world. If the Court was right then losing Muslims would be okay. If we have to have WWIII with these people then we have to have WWIII. Follow right and let the chips fall where they may, but we followed wrong
. Natural right demands tolerance, not
approval, and nothing could be more basic
. The violation of our own fundamental principles here is immense and will be debilitating.
Scott Walker's facebook post on the Supreme Court's sudden invention of a right to gay marriage
My remarks above were composed as a comment on Walker's post
, which I think is very good. Here is Governor Walker's opening paragraph:
I believe this Supreme Court decision is a grave mistake. Five unelected judges have taken it upon themselves to redefine the institution of marriage, an institution that the author of this decision acknowledges ‘has been with us for millennia.’ In 2006 I, like millions of Americans, voted to amend our state constitution to protect the institution of marriage from exactly this type of judicial activism. The states are the proper place for these decisions to be made, and as we have seen repeatedly over the last few days, we will need a conservative president who will appoint men and women to the Court who will faithfully interpret the Constitution and laws of our land without injecting their own political agendas. As a result of this decision, the only alternative left for the American people is to support an amendment to the U.S. Constitution to reaffirm the ability of the states to continue to define marriage.
Yes, the issue must be left to majority rule. As Governor of Wisconsin it is fully appropriate for Walker to assert the primacy of state majorities. National majority-rule could also be legitimate, and given our Constitutions's "full faith and credit
" clause (that "Full faith and credit shall be given in each state to the public acts, records, and judicial proceedings of every other state), a national majority decision may be required, but when decisions can be lived with locally then the more local majority rule affords more liberty and is preferable on that basis.
Walker also correctly identifies one of the key legal points: that what the Supreme Court has done is change the definition
of marriage. This fact vitiates the Court's equal protection argument. Homosexuals have always had an equal legal opportunity to marry someone of the opposite sex (the millennia-old definition of marriage), but what they wanted was something else entirely new, something that no one else had ever had before: legal sanction for marrying someone of the same
sex (a new definition of marriage). But the equal protection clause cannot redefine marriage. It can only require equal treatment for the same activity engaged by different persons, not between different activities
engaged by different persons.
I'm surprised to find myself agreeing with Huckabee about anything, but he also nails
This ruling is not about marriage equality, it’s about marriage redefinition.
This is the difference between gay marriage and the old laws against interracial marriage, which the Court rightly struck down in Loving v. Virginia
. In Loving
interracial couples were being denied the ability to marry a chosen mate of the opposite sex. They were not seeking to redefine marriage, only seeking equal access to marriage as it had always been defined. Redefining marriage is something altogether different which goes beyond the scope of the simple concept of equal protection.
does deserve some of the blame for the current debacle, but only because the Supremes were not prescient in that case about how liberty rights to engage in intimate relationships were about to become dis-entangled from the institution of marriage. I come back to this history in the last section of this post.
The distinction between tolerance and approval derives from John Stuart Mill's distinction between "direct" and "indirect" interests
My 2009 essay, "Gay marriage is not a right
," explains how the principle of maximum equal liberty (arguably implied by the "inalienable rights" of the Declaration of Independence) give rise to John Stuart Mill's famous principle of liberty, where "direct interests" (interests that impinge physically on a person's liberty or security) must take complete priority (what modern moral philosophers might call "lexical priority") over indirect interests (vicarious interests in what other people are doing or in what others think about what you are doing).
This distinction between direct and indirect interests gives rise in turn to the distinction between tolerance and approval, so the lexical priority of direct over indirect interests (necessary for the securing of maximum equal liberty) becomes in turn a lexical priority for tolerance over approval.
Approval interests (such as the homosexual interest in gay marriage) are to be given zero weight against the need for tolerance (or direct liberty interests). Thus for instance, even if homosexual marriage were to be granted social approval via legitimate means (by majority decision), it still could never justify punishment for those who refuse to participate (by baking cakes, conducting ceremonies, etcetera). Toleration of that personal preference must take absolute precedence over anyone demands for approval.
The connection to Mill's distinction between direct and indirect interests is well worth going into (the link above) if you are interested. Legal analysis does not get to these moral-philosophical fundamentals, thus is no surprise that five Supreme Court justices, who know nothing but legal analysis, and clearly do not care very much about even its principles and warnings, would turn out to be so incompetent when they start trying to identify unenumerated rights. They need to know a lot more than they do and have a lot more circumspection, but the relevant moral philosophy is
clear, and shows the right answer, if we follow it.
Ideally we should seek to articulate the maximum equal liberty implied by the inalienable rights of the Declaration, but if it is adopted as a legal protection it should be adopted by amendment. In very limited fashion and only when necessary it might be legitimate to use the inalienable rights of the declaration to help discern the unenumerated rights of the Ninth Amendment. What the courts should obviously never do is proclaim unenumerated rights that go directly against the maximum equal liberty implied by the Declaration, as the Supreme Court has done by conflating tolerance and approval (direct and indirect interests) in its Obergefell
Indications are that the Court, after wadding tolerance and approval together, will next get the priority between tolerance and approval backwards
It isn't just that gay marriage, not even considered legitimate by any but a tiny fraction of politicians just five years ago, is now asserted to be required, it is that everyone whose religious beliefs bar them from participating in such marriages are now under threat of compulsory participation.
This is the subject of the Walker's last facebook paragraph, and the powerful statement from Texas Governor Greg Abbott
. Both promise to vigorously enforce all existing state legal protections for religious freedom so that constituents will not face legal liability for refusing to be personally involved with gay marriage, a concern that has been raised by a wave of suits under state
pro-gay-marriage laws, and a concern which SCOTUS pointedly failed to allay. As noted by Ed Morrissey at Hot Air
Kennedy, who brought up the topic, could have written explicitly that houses of worship and individuals have a First Amendment right not to participate in these ceremonies. That issue has been raised on a number of occasions in the courts. The absence of any such language sends a very disturbing message on religious freedom, in this and many other contexts.
Without understanding the lexical priority of direct over indirect interests, and the lexical priority of tolerance over approval that derives from it, the Court going forward will have no basis for getting this priority right, or even recognizing that a distinction between tolerance and approval needs to be made. Indeed, given all they have gotten wrong, we can be pretty sure that the follow-on questions are going to be decided just as egregiously.
And so here we are, where support for the tiny minority of homosexuals, who are utterly dependent on the tolerance of society, has been transformed into a political-legal war of extreme intolerance
for those who do not approve of their relationships. It is a complete inversion of the necessary priority of tolerance over approval, led now by the Supreme Court of the United States, and if it is not reversed it is going to destroy this country, which had until now been the leading light of liberty in the world. Suddenly we are looking more and more like just another fount of unprincipled illiberalism.
As so often happens, Justice Thomas is the only one who gets the basic issue right
Thomas's Obergefell dissent
does not make the distinction between tolerance and approval but he does makes a closely related distinction, noting that protected liberties have never been taken to include rights to government provided entitlements, as the particular emoluments of legal marriage status (and the government provided stamp-of-approval), can properly be classed.
Tolerance (liberty) takes absolute priority over all
other concerns, be they claims of entitlement or demands for approval.
Statement by Grant Starrett on the Obergefell v. Hodges decision
Grant Starrett, now running for Congress in Tennessee, also has a nice statement
on the Supreme Court's terrible decision:
If we desire to live in a constitutional republic, we ought to start recognizing its boundaries. The Constitution has power because the sovereign American people affirmed a particular interpretation at the time that its language was passed. I challenge the notion that any drafter of the 14th Amendment, much less the Framers of the Constitution, possibly imagined, in their wildest dreams, that what they were writing would require that every state give marriage licenses to same sex couples. Unfortunately, five unelected lawyers have overridden the will of the 80% of Tennessee voters who approved a constitutional amendment guaranteeing traditional marriage. I fear the vast implications of activist judges, unmoored from the original meaning of our Constitution, imposing their agenda through reinterpretations of our founding documents.
Exactly right, and together with the Obamacare decision (Burwell v. King
) where the Court now asserts the power to rewrite any law
so as to better suit the law's stated objectives (the very core of legislative activity), the Court has deligitimized itself in a way we have never seen before.
says of the Obamacare decision (which interpreted-away the fully intentional limitation of subsidies to state's that created their own Obamacare exchanges):
This is a naked judicial claim to legislative—indeed, super-legislative—power; a claim fundamentally at odds with our system of government.
Loving v. Virginia and the untangling of liberty rights from marriage over the last 50+ years
If there is no right to approval, or to receive society’s stamp of approval via state sanctioned marriage, why did the Court in Loving declare
Marriage is one of the “basic civil rights of man,” fundamental to our very existence and survival.
The California Supremes made a similar declaration
in 1949, eighteen years before Loving
, when they struck down California's ban on interracial marriage:
Marriage is thus something more than a civil contract subject to regulation by the state; it is a fundamental right of free men.
These declarations were not unreasonable in their time. In 1949 access to the institution of marriage was very much a liberty interest of couples because sex outside of marriage was illegal in pretty much every state of the union. That is, the law did not tolerate
those sexual relationships that the state did not approve
via the institution of state sanctioned marriage, and things were not much different legally in 1967.
Those were the bad old days, before the nation made so much progress in enforcing toleration for non-approved relationships, but with the Court’s 2003 ruling in Lawrence v. Texas
, striking down the criminalization of homosexual sex by the State of Texas, there has no longer been any criminalization of adult sexual relations outside of marriage anywhere in the United States. That removes most of the individual liberty-rights aspect from marriage, leaving mostly the approval aspect.
Established liberty of contract eliminates most of the other liberty issues surrounding marriage. Unmarried heterosexual and homosexual couples (or groups) can agree by contract to pretty much any sharing of income and property that they want, including terms for dissolution. Such contracts may have been off the table when the relationships themselves were illegal, but now that they are legal, these contracts can be entered.
There are some weighty other complements to marriage, like the ability to adopt, but there are good reasons why society might not want to allow homosexual couples to adopt. Adoption is certainly a strong interest, but it involves third parties that keep the issue from being a matter of right for couples who may want to adopt. Thus relational liberty rights are pretty much all protected outside of marriage now, leaving not much exclusively to marriage except for society’s stamp of approval.
It was never technically correct for the courts to say that there was a right to marriage. There was a right to the liberty interests that were once bound up with the institution of marriage, liberty interests that have since been separated from the institution and protected independently of marriage. One can understand the earlier courts' conflation of marriage with liberty rights, given that marriage and liberty rights were in fact tied together within the marriage laws and within the whole society's understanding of marriage at that time, but that conflation belongs to the past. The liberty-rights aspect of marriage—the ability to live together and be intimate and make a life together—has already been secured without couples having to be married, leaving mainly the social approval aspect of marriage as the exclusive domain of the married.
This situation is recognized in Justice Scalia's argument that marriage is not a freedom at all but a restraint on freedom (his argument #7 here
). This is in fact the situation today. There was a time when to have the liberty to have sexual relations and to live together as a couple was tied to marriage, but now marriage confers no liberties that are not available to the unmarried, only obligations and restrictions.
History thus proves that marriage and liberty rights are not necessarily tied together, and that to be accurate they should have been separated by the Loving
and California courts. Marriage itself was never a right. The only rights at stake in these cases were the liberty rights that were at that time bound up with marriage, but have since been separated from marriage.
The second problem with the earlier cases, especially Loving,
is that their invocations of marriage as a “basic” and “fundamental” right do not actually do any work. Loving
was fully decided by the simple principle of equal protection, which applies the same whether the law in question restricts a right or grants a privilege. It didn’t actually matter in Loving
whether anyone has a right to marry. Once the state allows some
male-female couples to marry it must allow any
adult male-female couple to marry, absent some compelling state interest, such as the avoidance of genetically transmitted disease. The invocations of a right to marriage were completely unnecessary in these cases and hence moot. They are dicta
masquerading as acta
Thirdly, marriage was certainly not recognized as a basic individual
right until very recently. For most of recorded history, including Western history, an offspring’s freedom to marry was very much subject to parental authority, at least until the offspring had gotten beyond the normal marrying age, and religious authority was also in play. If a given marriage violated church principles then it would not be performed. These may have been matters of private choice, outside of government control, but that does not mean they were matters of individual
and California were not just putting forth flowery dicta
masquerading as acta
, they were putting out historically inaccurate dicta
. The individual liberties that they were proclaiming as historic and fundamental were in actuality liberties that were receiving legal protection for the first time, under the handy excuse of the need to equally protect these supposedly longstanding liberties.
It was a nice trick, and was part of the advance of individual liberty in intimate affairs, which was a wholly legitimate objective, and with the decision in Lawrence v. Texas
was fully achieved. But to take the next step, as the Court just did in Obergefell v. Hodges
, and demand approval
for what is finally being tolerated, is to turn this whole advance of liberty on its head.
We are now back to the bad old says where only what is approved is tolerated, except now approval is not determined by majority rule but by a small minority, the keening demands of 4%
of the population, backed by five unaccountable loose-cannon ideologues in robes.
Monday, June 22, 2015
Doesn't UBER know that criminals seek out "gun free zones"?
My letter in response to UBER's new prohibition against drivers or customers travelling armed (sent to the entire list of UBER's city by city "partners")
Can whoever receives this message please pass it along to UBER leadership, because if this new firearms prohibition is not reversed ASAP your company is absolutely going belly up.
“[t]o ensure that everyone using the Uber digital platform—both driver-partners and riders—feels safe and comfortable using the service… Uber and its affiliates therefore prohibit possessing firearms of any kind in a vehicle.”
Only an absolute freaking moron feels safe in a “gun free zone.” Out of all the mass shootings since 1950 all but two
occurred in “gun free” zones, the most recent being in Charleston last week. Mass shooters actively seek out defenseless victims and COMMON CRIMINALS ARE EXACTLY THE SAME!
With this gun prohibition announcement the rate of violent robberies targeting Uber vehicles is about to shoot up, which does not make any rational customer or driver feel safe.
In New York and California and a few other states it doesn’t make much difference because the criminals know that EVERYONE is disarmed. They won’t need to target Uber drivers to find undefended targets, but in the majority of the country, where gun rights are protected and undefended targets are hard to identify, UBER is putting a neon target on the back of every UBER driver and every UBER customer: “rare guaranteed-defenseless victim here!”
You are flushing your company down the toilet. Why? Because you hate the United States Constitution? What the HELL is the matter with you?
Not only are you making your employees and customers targets of violent crime but you are also alienating half of your customers. What kind of business decision is that? You are sacrificing the viability of your business to radical left-wing politics.
Does this reflect the real wishes of the leaders of your company, or was this idiocy somehow foisted on you by some political mole out to subvert your company for his own purposes?
Whatever the case, if you want to save your company you had better get this turned around FAST. I’d hate to see you all go out of business because some moral imbecile decided that his liberty-hating politics matter more than your company’s success.
And to all the “Partners” I am ccing here, it will be up to YOU to report to upper management how much your business is dropping now that it is company policy not to let your concealed-carry customers ride anymore. You’ll know the facts of the matter before the national management does, and if you wait until they figure it out via collapsing business and profits it will be too late.
If you want to send your own feedback, here is the list
of “partners” email addresses. I broke it down into four sub-lists. I would have used the national UBER web-sites' contact contact email or contact form, but I couldn't find one, so this is what they get:
Monday, June 15, 2015
De Blasio brings in NRA's Operation Exile to offset the massive damage he has done to NYC law enforcement
CBS New York headline:
"ATF To Join NYPD In Fighting New York City Gun Crimes"
Getting Democratic presidents to enforce existing federal gun laws has always been near impossible. Bill Clinton fiercely resisted the NRA-promoted "Operation Exile," which calls for systematic enforcement of the federal mandatory-minimum 5-year sentence for felons who are caught in possession of firearms, or use firearms in the commission of other crimes.
Everywhere Operation Exile was employed it led to immediate and drastic reductions in violent crime, which is precisely why Democrats refused to enforce it. Operation Exile proved that the way to stop crime is to disarm the criminals, not the law abiding citizens, exposing the Democrats' wish-list of gun-control policies, all of which focus on disarming law abiding citizens, as both unnecessary and wrong.
So what changed in NYC? Mayor de Blasio has so undermined his own police department that crime is skyrocketing. To limit the political damage he has prevailed upon the feds to bring in the one enforcement strategy that everyone has known for 25 years will radically reduce crime almost overnight.
So there is a small silver lining to de Blasio's monstrous immorality. He has done so much damage to NY that he is forced to resort to at least one rational policy to keep himself from being impeached. Still not right as often as a broken clock, but at least it's something.
He isn't calling it Operation Exile. That would give too much credit to the NRA, but de Blasio's turn to the NRA's longstanding call to enforce existing federal laws shows that the left has known all along that the way to reduce crime is to go after convicts who possess guns and crimes committed with guns, which proves that their longstanding opposition to the enforcement of these laws is because they need dead bodies that they can use to try to demagogue citizens into turning against their own gun rights.
Fast and Furious was also about creating gun crimes that Democrats could use to demagogue against gun rights
about Fast and Furious a couple of years ago, and yes there is proof that the plan was to use the crimes committed my Mexican criminals using Fast and Furious guns to attack the gun shops that the ATF had enlisted to make the otherwise-illegal gun sales. The proof is that, before the Fast and Furious lid was blown off by the murder of Border Patrol agent Brian Terry, the ATF had already used
their information about crimes committed with Fast and Furious guns to attack a number of the ATF-allied gun shops.
ATF leaked the data to the Washington Post
, which then ran a long piece
blaming Mexico's high level of gun crime on the supposed easy availability of guns in the United States (as if Mexican drug gangs are really buying their guns over the counter from highly regulated and very expensive U.S. gun shops when they can buy them wholesale from the Eastern European black market gun runners they are are already connected to via the drug trade).
In sum Obama ordered the systematic violation of American gun laws in order to create a body count in Mexico that he could use to attack the constitutionally protected gun rights of his fellow citizens here at home. Richard Nixon's crimes were minuscule in comparison.
Saturday, October 25, 2014
What would Thucydides do? How to create negative atmospheric pressure in the Ebola hot-zone
To keep pathogens from escaping, contagious disease laboratories and isolation rooms use negative atmospheric pressure (or negative relative air pressure) that pulls air in through all doors and cracks. Barriers are not enough. At the inevitable openings in the barriers, the movement of the pathogen must be inward, not outward. The same logic applies to the Ebola hot-zone countries of West Africa. Barriers in the form of travel restrictions and quarantines can help keep the contagion from spreading, but they cannot do the job by themselves. There has to be "negative air pressure," where it is safer for Ebola hot zone residents to stay put than to flee.
That requires greatly reducing the rate of transmission within the hot zone, and the only way to achieve that is by using immune survivors to separate and treat the sick, a strategy developed by the Greeks 2400 years ago. The special challenge with ebola is how contagious it is to anyone who tries to provide care. By systematically hiring and developing a survivor-based treatment system that hurdle can be overcome. They can give aid without themselves becoming a vector of transmission, allowing the epidemic within the hot zone to be rolled back, reducing pressure to flee.
At present our national policies are working ever more powerfully in the opposite direction, creating strong incentives for infected and possibly infected people to flee to the United States from West Africa. An example of a policy that is creating an undesirable “positive atmospheric pressure” in the Ebola hot-zone (or equivalently, a negative relative pressure in the United States) is the promise that CDC Director Tom Frieden issued last week, telling the world that if anyone arrives at a major American airport with history or symptoms that indicate possible Ebola infection they will be whisked straight to the hospital, providing the strongest possible incentive for people who think they might be infected to come here for treatment.
At the same time, Frieden insists that travel from Liberia, Guinea and Sierra Leone to the United States should remain unrestricted, providing opportunity as well as incentive for hot-zone residents to flee here. From Frieden’s October 9thinterview on Fox News:
Staff from CDC and the Department of Homeland Security’s Customers & Border Protection will begin new layers of entry screening, first at John F. Kennedy International Airport in New York this Saturday, and in the following week at four additional airports … [which] … receive almost 95 percent of the American-bound travelers from the Ebola-affected countries.
Travelers from those countries will be escorted to an area of the airport set aside for screening. There they will be observed for signs of illness, asked a series of health and exposure questions, and given information on Ebola and information on monitoring themselves for symptoms for 21 days. Their temperature will be checked, and if there’s any concern about their health, they’ll be referred to the local public health authority for further evaluation or monitoring.
This funneling of hot-zone travelers through screening here in the U.S. was just made mandatory, guaranteeing care to the possibly infected. The resulting outward pressure—motivating infected people to move to a previously uninfected continent—will spread the infection, not contain it. Set aside that the CDC is supposed to give priority to American lives and should first and foremost work to keep Ebola from coming here, intercontinental spread of Ebola is a disaster for the whole world. Each breach of containment endangers everyone everywhere.
Broad screening by it self would be fine. We have always tried to stop contagion from entering our borders. But screening together with a refusal to apply travel restrictions is an invitation to disaster, creating an obvious and powerful negative pressure on our side of the Atlantic that will suck Ebola here in volume.
Creating negative pressure in the hot zone is not so easy
So long as the contagion keeps expanding within the hot-zone itself the pressure on residents to flee will keep increasing. But fighting transmission inside the hot zone is a labor intensive enterprise. Health care workers have to first diagnose who is infected and who is not, then isolate and treat the sick, all of which presents a high risk of transmission to the people doing this work.
Ebola is perhaps the most infectious pathogen ever encountered, transmissible by a single particle. The repeated assurances that Ebola is not highly contagious apply only while patients remain asymptomatic. Once they start explosively erupting at both ends, protection for anyone in attendance must be perfect, which is very difficult to achieve, a factor that the CDC and our news media has been slow to acknowledge.
Three weeks ago NPR ran a happy talk segment on how easy it is to stop the spread of Ebola that completely ignored the problem of transmission through health care workers:
So to stop the chain of transmission, all health workers in Texas have to do is get the people possibly infected by the sick man into isolation before these people show signs of Ebola.
Then R0 drops to zero. And Texas is free of Ebola.
Then we all found out how difficult it is to keep health workers from getting the disease. The transmission rate, R-naught, does not drop to zero. With enough training and equipment transmission might be lowered dramatically, but only at impossible cost. Here a hospital director reacts to the CDC’s prep call (via Brian Preston):
Ebola Preparation “will bankrupt my hospital!” “Treating one Ebola patient requires, full time, 20 medical staff. Mostly ICU (intensive care unit) people. So that would wipe out an ICU in an average-sized hospital.”
At extreme expense we might be able to protect medical workers from contamination in a very limited number of Ebola cases. In Africa, forget it. But immune survivors do not need to be protected from contamination and this is a resource that Africa has in rapidly growing numbers.
Immune survivors can make it both safer and more remunerative for hot-zone residents to stay put
Survivors have full immunity only to the Ebola strain they were infected with, but if they provide care in their local area they should be okay. Dr. Bruce Ribner onPBS:
Ebola virus is a new infection on this continent, but our colleagues across the ocean have been dealing with it for 40 years now, and so there is strong epidemiologic evidence that, once an individual has resolved Ebola virus infection, they are immune to that strain, recognizing that there are five different strains of Ebola virus.
Designate local isolation compounds for triage and treatment, drop off people and supplies, and no one comes out without a clean bill of health, bleached clothes, and a nice chlorinated shower. The immunity (in most cases) of the survivors means they could provide care without transmitting the disease, allowing the contagion to be rolled back, and the income they receive (this is where aid money comes in) would prop up the local economy, all of which would work to keep hot-zone residents in place.
If coming to America is off the table then flight from the Ebola hot-zones is a very daunting proposition. Africa is not a thriving land of opportunity and travel is more of a way to catch disease than avoid it. Thus if transmission within the hot-zone can be drastically reduced, negative atmospheric pressure is readily attainable, and this is what the use of immune survivors allows. Not being vectors, they can intercede to stop transmission in the cases under their care.
Some of these survivor health-workers will get infected with different strains and despite some cross immunity some of these re-infected health workers will surely die, but the fact that they are largely immune will allow the work of isolation and treatment to continue, which is simply not possible otherwise on any major scale.
The immune-survivor treatment strategy was implemented by the Greeks 2400 years ago
When I started advocating the immune-survivor strategy six weeks ago, I sent my post to Stanford health economist Jay Bhattacharya and he said, hey that’s what the Greeks did, sending me the following citation from Thucydides:
But whatever instances there may have been of such devotion, more often the sick and the dying were tended by the pitying care of those who had recovered, because they knew the course of the disease and were themselves free from apprehension. For no one was ever attacked a second time, or not with a fatal result. All men congratulated them, and they themselves, in the excess of their joy at the moment, had an innocent fancy that they could not die of any other sickness.
According to a report published by the CDC (back when they knew stuff) the Athenian plague could well have been Ebola.
I am not the only one to advocate the deployment of immune survivors today. The day after I published my post Dr. Michael T. Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, wrote the following in The New York Times:
The United Nations … should also coordinate the recruitment and training around the world of medical and nursing staff, in particular by bringing in local residents who have survived Ebola, and are no longer at risk of infection.
We have one immune survivor here in the United States, Dr. Kent Brantly, and with luck and prayers he may soon be joined by Nina Pham and Amber Vinson, but West Africa has a few thousand, and with the infection rate expected to soon reach 10,000 per week, that will become another 3000 survivors a week. The resource is there, we just have to use it, but the rationalizations provided by CDC Director Frieden show that he is looking in the opposite direction.
Frieden wants non-immune aid workers to go to Africa
That’s what he keeps saying whenever he tries to explain why he is against travel restrictions, that restrictions will make it harder for aid workers to travel to Africa:
One strategy that won’t stop this epidemic is isolating affected countries or sealing borders. When countries are isolated, it is harder to get medical supplies and personnel deployed to stop the spread of Ebola.
As one of the authors of whatever restrictions would be imposed, Frieden would have a chance to attach whatever exceptions he deems necessary for getting aid workers in and out, but set that aside. His premise to begin with is that outsiders should be going in and providing treatment. Like the happy talkers at NPR (who were trying to explain why Frieden is so confident that Ebola will not spread in the United States), Frieden ignores the problem of health care workers as a disease vector. About people who are being tracked and monitored he says:
The moment if they have any symptoms, if they have fever, they will be isolated. That is how you break the chain of transmission.
Yeah, not really. For a very small number of Ebola patients, at huge expense,maybe, if levels of protection and training are vastly improved. For Africa? Send in supplies and a small number of organizers at most, but no one from the outside should be sent in to deal with possibly infected subjects. They will just become disease vectors, both within Africa, and if they return without first undergoing a full period of quarantine they will bring it back here.
Certainly don't send our military, or theNational Guard, and unexposed natives should not be recruited either. Turn the job over to the immune survivors. That is the only way to stop the contagion, and this critical resource is not here in America. It only exists in Africa, so stop bringing Ebola patients here!
Frieden keeps insisting that efforts to contain Ebola geographically will cause it to spread geographically
It is a bizarre contention. All non-government commentators regard isolation and treatment as complimentary strategies but Frieden insists they are either/or:
Restricting travel or trade to and from a community makes it harder to control in the isolated area, eventually putting the rest of the country at even greater risk. Isolating communities also increases people’s distrust of government, making them less likely to co-operate to help stop the spread of Ebola.
He is equating isolation with abandonment, which is a non sequitur. Does a patient placed in an isolation room become harder to control? Does being cared for in isolation make him more distrustful, and make observers distrustful, or does it make every one thankful? Frieden’s strained efforts to support this weak narrative are illogical to the point of dishonesty:
When a wildfire breaks out we don’t fence it off. We go in to extinguish it before one of the random sparks sets off another outbreak somewhere else.
Really, the guy’s never heard of a firebreak? We actually set fires, sacrificing part of the tree population to save the rest. Not that we should do that in Africa, but c’mon dude. Don’t just lie about stuff!
Travel restrictions may indeed have some downsides, but they also have a most important upside: they stop sick people from traveling around the world spreading disease. The question, which Frieden never even attempts to address, is whether the downsides he puts forward outweigh the upside in terms of disease transmission. Indeed, it is perfectly clear that Frieden is not accounting the upside at all, since he implicitly assumes it would be outweighed by the flimsiest of hypothesized downsides.
In reality, it is hard to think of any downside to travel restrictions that could begin to compare to the importance of keeping the Ebola-infected from freely carrying the disease wherever they want. The first imperative is to stop Ebola from making its way around the world and as director of the CDC it is Frieden’s first responsibility to make sure it doesn’t travel here. If other countries are also self-protective that is good. It will limit the spread of Ebola which makes everyone safer.
Is Frieden (and/or Obama) trying to reduce outward pressure by holing the containment vessel?
As meteorologists know, relative atmospheric pressure can be a tricky concept. Because air pushes in different places, distinguishing cause and effect can take some care, and this applies to the disease transmission analogy as well.
To achieve negative pressure in the Ebola hot-zone containment is obviously not enough. Transmission within the hot zone must be greatly reduced or else pressure to flee will build and build until it inevitably explodes. Could Frieden be looking at this looming build-up of pressure and getting the causality backwards? Is he proceeding on the idea that, if we never have containment in the first place, then the pressure cannot build enough to have an explosion?
Actions suggest that he and others may actually be trying to reduce outward pressure by getting rid of containment up front and even encouraging people to flee. Witness the “Ebola Outbreak-related Immigration Relief Measures” issued by the U.S. immigration service in mid-August, which the CDC would surely have had input on.
Some of the measures are reasonable, allowing “Nationals of Guinea, Liberia and Sierra Leone Currently in the United States” to stay here for now instead of forcing them to go back to the hot zone when their visas expire, but the measures gratuitously go much further, providing extreme incentive for residents of these countries to get themselves into the United States ASAP.
The really damaging relief measure (pressure relief measure?) is the first, which offers an opportunity for, “[c]hange or extension of nonimmigrant status for an individual currently in the United States, even if the request is filed after the authorized period of admission has expired.”
A change of status means a change from non-immigrant to immigrant status, thus any West African who is here on a tourist visa is eligible to be immediately switched to permanent resident status, leading to citizenship, and here’s the kicker: as Doug Ross noticed, there is no cut-off date for who is eligible for this change of status.
Instead of applying only to West Africans who were already here in mid-August, any Ebola-zone citizens who can get themselves over here on a tourist visa are immediately eligible to switch to permanent resident status, providing huge incentive for immediate mass outflow from West Africa to the United States. Obama/Frieden are offering them a once-in-a-lifetime jump-to-the-head-of-the-line opportunity to become American citizens.
We know Obama’s motivation, but why is the CDC going along?
President Obama, being a politician, can of course have political motivations for incentivizing West Africans to come here for citizenship. His intentional collapse of our southern border suggests that one of the ways that he wants to “fundamentally transform America” is by importing a new electorate, more to his liking. (DHS let a huge contract for the internal transport of unaccompanied illegal alien minors months before the vast wave of “unaccompanied minors” arrived, proving that the entire crisis was engineered by Obama.)
But CDC Director Frieden is supposed to be non-partisan, guided only by the objective requirements for keeping his countrymen safe from disease. How can a medical doctor be supportive of a ramped-up influx of immigrants from West Africa that is highly incentivized to carry Ebola?
Friedan’s big career-making achievement was dramatic reductions of tuberculosis in New York City and India, accomplished by systematic tracking, isolation and treatment of the infected. His oft-repeated mantra on Ebola is the same. “We know how to stop Ebola,” he says, by tracking, isolating, and treating infected individuals. Could he be fixated on tracking as a means?
Frieden wants people who could be infected with Ebola to fly so that they won’t travel “over land”
Note the particular language Frieden uses to explain why he thinks travel restrictions will be counter-productive. He keeps saying he wants the possibly infected to travel by means that enable tracking. That points directly to a preference for airline travel:
FRIEDEN: Right now, we know who’s coming in. If we try to eliminate travel, the possibility that some will travel over land, will come from other places, and we don’t know that they’re coming in, will mean that we won’t be able to do multiple things. … Borders can be porous — may I finish? – especially in this part of the world. We won’t be able to check them for fever when they leave, we won’t be able to check them for fever when they arrive. We won’t be able, as we do currently, to take a detailed history to see if they were exposed when they arrive.
When they arrive, we wouldn’t be able to impose (ph) quarantine as we now can if they have high-risk contact. We wouldn’t be able to obtain detailed locating information, which we do now, including not only name and date of birth, but e-mail addresses, cell phone numbers, address, addresses of friends, so that we could identify and locate them.
We wouldn’t be able to provide all of that information, as we do now, to state and local health departments, so that they can monitor them under supervision. We wouldn’t be able to impose controlled release, conditional release on them, or active monitoring, if they’re exposed, or to, in other ways…
The whole point of tracking is to stop further transmission so that we don’t have to do more tracking. The fact that a mode of travel enables tracking isn’t a plus if it also multiplies the need to track, as around the world commercial jet travel obviously does. In Frieden’s accounting the smallest amount of un-tracked contagion is more dangerous than a wide open and highly incentivized avenue of tracked contagion, because this is what we are talking about here.
The “overland” spread of Ebola that is Frieden’s sole concern would be extremely difficult under a travel ban. Even if frightened people could make their way out of Liberia and Guinea and Sierra Leone by ground travel (very difficult, snce many neighboring countries have closed their borders) they would still need to fly to reach the United States, which requires a visa, which requires a passport, which would still identify them as coming from a hot-zone country. The other possibility is that they fly to Mexico or Canada and travel overland at this end, but a) these crossings are within in our power to control, and b) if we impose a travel ban then Mexico and Canada will surely follow suit.
Frieden focuses entirely on the relatively tiny number of cases where a few West Africans might still get in by these untracked routes (a number that might well be decreased, not increased, by travel restrictions), and he completely ignores ignores the vast majority of cases where travel restrictions would keep the possibly Ebola-infected out. This selective accounting is not legitimate. It is basic economics and basic epidemiology that all impacts have to be fully accounted. Only looking at untracked flow is like buying merchandise for $100 a pop, selling it for $1 a pop, and thinking you are making money because you are only counting the flow of $1 receipts.
NIAID head directly mis-states travel requirements
Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, does not seem to be aware of how travel documentation works. On Sunday he claimed that:
“If you say, ‘Nobody comes in from Sierra Leone, Liberia or Guinea,’ there are so many other ways to get into the country. You can go to one of the other countries and then get back in [to the United States].”
Wrong. Escapees from the hot-zone would only be able to get here via “other countries” if those other countries start issuing them passports that hide their true origin. Frieden and Fauci are doctors, not travel agents, but the entire USCIS knows that their claim about border hoppers being able to fly to the United States is wrong.
Regardless of Fauci’s confusion, the underlying error is still the same. Even if travel restrictions did somehow lead to an increase in un-tracked travel across the Atlantic (highly dubious), this increased avenue for Ebola transmission would still be tiny compared to the vast wide-open “above ground” highway for Ebola transmission that a travel ban would close off.
These supposed experts are acting as if there is no danger so long as we can track transmission, ignoring what a desperate game it is try to smother every outracing tendril from each outbreak. It’s like trying to stamp out an intrusion of cockroaches before any can escape through a crack.
Learning the wrong lesson from Nigeria’s close call
With heroic effort Nigeria just pulled off the squash-all-the-cockroaches feat, dedicating thousands of man hours of urgent detective work to successfully run down and isolate each multiplying pathway of Ebola exposure before they could multiply out of reach and consume a city of 21 million.
It was a very near thing and Frieden and Fauci are clearly learning the wrong lesson from it. They view it as confirmation that tracking works and can “stop Ebola in its tracks,” but the real lesson of Nigeria is the tremendous danger that just one infected airline passenger can pose. Realizing how lucky they were, Nigeria learned its lesson and stopped its hot-zone flights.
Much better not to let possibly infected people enter in the first place. Once an Ebola-infected person arrives a country might be quick enough to stop the contagion by tracking, monitoring and isolating individuals, but if the contagion gets away from them they will have to stop it the old fashioned way, the Greek way, by making use of the immune survivors as they emerge one by one from the spreading catastrophe.
Every nation has to be prepared for those same three stages of Ebola prevention and response. First we try to keep it from entering. If that fails then we try to contain the outbreak with tracking, monitoring and isolation of exposed individuals, and if that fails and there is an epidemic, only immune survivors can roll it back. Frieden and Fauci are fixated only on the middle third of this puzzle, the tracking. They aren’t concerned with keeping Ebola from getting here and they aren’t looking at how to fight it if it breaks out. Neither are they merely absent from these other battlefields but their fixation on tracking has them aggressively bringing Ebola here when the only people who can safely treat the disease are in Africa.
A perfect storm of illogic
Put Frieden’s apparent belief that tracking is a panacea together with his apparent confusion about cause and effect and they support each other. This seems to be his actual thinking: that if we let the infected out of the hot zone (while carefully tracking) then there won’t be an explosion because the pressure won’t have a chance to build up.
Could it be that simple, that he just doesn’t understand atmospheric pressure, where the whole point of creating negative pressure is to stop the outflow of the pathogen, so if pressure is reduced by the outflow of the pathogen that means we failed? Is the guy just that stupid? Or does he have some horrific political agenda like President Obama? (Definitely possible, since untracked TB and other infectious diseases pouring over our unenforced southern border elicit no protest from him.)
Either way, Congress better provide some countervailing force and quickly because the CDC is working hard to bring the negative pressure to our side of the Atlantic, sucking Ebola in. It is clear what we should be doing: imposing travel restrictions and using hot-zone Ebola survivors to separate and treat the newly infected. Then the problem won’t just stay in West Africa, it will be solved there.
The alternative, if Obama and Frieden can’t be stopped, is that we suffer our own Ebola epidemic, where the only way to avoid decimation or worse will be to deploy our own rapidly growing army of immune survivors. It’s either Thucydides in Africa or Thucydides in America, our choice.
UPDATE: Spencer case shows that we do NOT want free travel for returning aid workers, and it shows how quickly the tracking-hope could disappear
Spencer had been working with ebola infected people in Africa, came back to America, started feeling weak, and the next day used several subway lines to go on an across-the-city bowling trip. But this was still a best-case-scenario because when his symptoms started to get worse Spencer knew it was probably ebola, isolated himself, and let everyone know.
The Dallas case was a similar best-case-scenario. Duncan knew he had recent physical contact with a person who died of Ebola. That's why he initially went to the hospital when he only had a mild fever, and when the ambulance later came to get him at his apartment his daughter told the EMTs that he likely had Ebola, so everybody was on alert. They still made mistakes, but nothing compared to what would have happened if they had no idea what was the matter with him.
The nightmare scenario is what happens when some ignorant person comes down with Ebola and has no idea he has Ebola. Suppose an out-of-it druggie were to pick up Ebola from Dr. Spencer's long trek through the subway system--maybe Spencer coughed on somebody, who knows, the guy was full of Ebola at that point--so a week or two from now this hapless druggie spends a couple of days on the streets and in the subway while he is in the massive shedding stage of Ebola infection, bleeding, puking and crapping in public rest-rooms and alleys and tracking his mess through public places.
Then it's goodbye to any hope for tracing the pathways of possible exposure. If it gets on the seats, grab-rails and hand straps of a handful of subway cars it will pass hand to hand, doorknob to doorknob, far beyond the subway system in a matter of hours. A single germ is infective, the tiniest drop of blood contains millions of germs, and we'd have this disintegrating person slathering infectious fluids everywhere he goes. If this just goes on for one day there will be a rampant epidemic starting in NYC but not stopping there.
The danger is EXTREME, yet not only are Frieden and Obama still adamant against travel restrictions, but they are at the same time providing huge incentives for possibly Ebola-exposed people to make use of that allowance to come here, both in the form of promises of first-rate care and through a once-in-a-lifetime offer of U.S. citizenship for anyone who can himself here from the Ebola hot zone, creating massive positive pressure for Ebola to flow out of the hot zone and into the United States. These policies are horrific, and the consequences will be too.