popular logistics

Stephanie Strom of the Times reports on persistent - over 15 years - difficulties with the Red Cross blood supply operation, which provides two-thirds of the organization’s revenue.

For 15 years, the American Red Cross has been under a federal court order to improve the way it collects and processes blood. Yet, despite $21 million in fines since 2003 and repeated promises to follow procedures intended to ensure the safety of the nation’s blood supply, it continues to fall short.

The situation has proved so frustrating that in January the commissioner of food and drugs attended a Red Cross board meeting - a first for a commissioner - and warned members that they could face criminal charges for their continued failure to bring about compliance, according to three Red Cross officials who attended the meeting and requested anonymity because Red Cross policy prohibits public discussion of its meetings with regulators.

If fear is a motivator, we’re happy to help out in that way”If fear is a motivator, we’re happy to help out in that way,” said Eric M. Blumberg, deputy general counsel at the Food and Drug Administration, though he declined to confirm what the commissioner, Andrew C. von Eschenbach, said at the meeting.

Some critics, including former Red Cross executives, have even suggested breaking off the blood services operations from the rest of the organization, as the Canadian Red Cross did a decade ago.

The problems, described in more than a dozen publicly available F.D.A. reports - some of which cite hundreds of lapses - include shortcomings in screening donors for possible exposure to diseases; failures to spend enough time swabbing arms before inserting needles; failures to test for syphilis; and failures to discard deficient blood.

In some cases, the lapses have put the recipients of blood at risk for diseases like hepatitis, malaria and syphilis. But according to the food and drug agency, the Red Cross has repeatedly failed to investigate the results of its mistakes, meaning there is no reliable record of whether recipients were harmed by the blood it collected.

The Red Cross, which controls 43 percent of the nation’s blood supply, agrees that it has had quality-control problems and is working to fix them. Both its officials and the drug agency point out that none of the identified problems involve the most serious category of infractions. For instance, the Red Cross does a good job of testing for H.I.V. and hepatitis B, officials on all sides agree. And in general, Red Cross blood is regarded as some of the safest in the world.

Still, the drug agency says, the problems that remain in screening donors and following protocols for collection add unnecessary risk to blood transfusions, almost five million of which were done in 2007, according to the National Heart, Lung and Blood Institute.

“This is a critical piece of the public health infrastructure,” Mary A. Malarkey, director of the Office of Compliance and Biologics Quality at the drug agency, said in an interview. “I know it’s difficult to get so many people trained and properly supervised, but it has to be done.”

This week, the agency sent the Red Cross the results of yet another recent investigation that makes Ms. Malarkey’s point: From December 2006 to April 2008, the Red Cross distributed more than 200 blood products that it had already identified as problematic, according to the investigation report.

Fifteen years under court supervision without progress. Doesn’t this suggest some change in approach?

Alexis Madrigal of ABCNews reports that Google - and its nonprofit branch, Google.org, will start tracking disease outbreaks.

A new website, HealthMap, addresses that challenge by siphoning up text from Google News, the World Health Organization and online discussion groups, then filtering it and boiling it down into mapped data that researchers — and the public — can use to track new disease outbreaks, region by region.

"There is so much information on the web about disease outbreaks but it’s obscured by garbage and noise," said John Brownstein, a professor at Harvard Medical School, and co-founder of HealthMap.org. "The idea of HealthMap is to get filtered, valuable information to the public and public health community in one freely available resource."

The site’s free accessibility could be particularly important in the developing world, where poor public health infrastructure and lack of money has handicapped epidemiological efforts. That’s a problem because those regions are exactly where scientists predict new and dangerous diseases are likely to emerge.

HealthMap goes beyond the standard mashup and is more like a small-scale implementation of the long-awaited semantic web. The site, which the researchers describe in the latest issue of open access PLoS Medicine, creates machine-readable public health information from the text indexed by Google News, World Health Organization updates and online listserv discussions

Researchers Track Disease With Google News, Google.org Money

David Leonhart argues in the Times that alcohol taxes have, in effect, been dropping, and that the principal benefits of alcohol taxes - reductions in use (and the consequent harms), and offsetting the costs of alcohol use. From “Let’s Raise a Glass to Fairness,” published on December 26th:

Since the early 1990s, the federal tax on wine — $1.07 a gallon — hasn’t budged. The taxes on beer and liquor haven’t changed either, which means that, in inflation-adjusted terms, alcohol taxes have been steadily falling. Each of the three taxes is now effectively 33 percent lower than it was in 1992. Since 1970, the federal beer tax has plummeted 63 percent. Many states taxes have also been falling. At first blush, this sounds like good news: who likes to pay taxes, right? But taxes serve a purpose beyond merely raising general government revenue.

Jonathan Gruber: “taxes are way too low on alcohol” ff

Taxes on a given activity are also supposed to pay the costs that activity imposes on society. And for all that is wonderful about wine, beer and liquor, they clearly bring some heavy costs. Right now, the patchwork of alcohol taxes isn’t coming close to covering those costs — the costs of drunken-driving checkpoints, of hospital bills for alcohol-related accidents and child abuse, and of the economic loss caused by death and injury. Last year, some 17,000 Americans, or almost 50 a day, died in alcohol-related car accidents. An additional 65,000 people a year die from other accidents, assaults or illnesses in which alcohol plays a major role. Mr. Cook, besides being a wine lover, has been thinking about the costs and benefits of alcohol for much of his career, and he has come up with a blunt way of describing the problem. “Do you think we should be subsidizing alcohol?” he asks. “Because that’s what we’re doing.”

In mid-2003, the World Health organization reported on cholera in Iraq:

rom 28 April to 4 June 2003, a total of 73 laboratory-confirmed cholera cases have been reported in Iraq : 68 in Basra governorate, 4 in Missan governorate, 1 in Muthana governorate. No deaths have been reported.

[Show as slideshow]

From 17 May to 4 June 2003, the daily surveillance system of diarrhoeal disease cases in the four main hospitals of Basra reported a total of 1549 cases of acute watery diarrhea. Among these cases, 25.6 % occurred in patients aged 5 years and above.

Link.

Thomas J. Lueck (copy) and Tyler Hicks (images) of my hometown paper have reported that in the most prominent, and well-kept, public park in New York City, rats play as though they were squirrels. Notwithstanding municipal efforts to persuade them to relocate. From November 10, 2007, “Where the Rats Come Out to Play”:

The rat that was circling André Thomas’s feet was big and brazen, measuring more than a foot from the tip of its tail to a pointed snout that arched upward to the aroma of Mr. Thomas’s ham and cheese sandwich.

The encounter might not have seemed all that unusual to many New Yorkers, who have become wearily accustomed to rats bounding along subway tracks or lurking about garbage bins, usually after dark.

But this rat sighting came as a shock to Mr. Thomas because of when and, especially, where it took place — 2 p.m. on a brilliant fall afternoon while he sat on a bench in City Hall Park, a nine-acre jewel of the municipal park system that underwent a $30 million renovation in 1999. The park is a cornerstone of the city’s efforts to revive Lower Manhattan.

“At first I thought it was a squirrel,” Mr. Thomas said as he strode away. “Isn’t this where the mayor works?”

Mr. Thomas’s rodent experience was hardly unusual. If he had looked under the park’s benches and around its meticulously cropped foliage, he would have spotted at least six other rats scurrying around, unconcerned about the humans all around.

The infestation of rats in City Hall Park, clearly an embarrassment to the city, was acknowledged in interviews by senior officials of the Department of Health and Mental Hygiene, the city’s lead agency for rodent control, and the Department of Parks and Recreation.

“It’s just a big issue down there and we all recognize it,” said Jessica Leighton, the health department’s deputy commissioner for environmental health. Adrian Benepe, the commissioner of parks and recreation, said that City Hall Park provided “a perfect set of circumstances for rats.”

From Paul Rega at Project Disaster, original dispatch from Xinhua News Agency:

China has ordered all poultry imports and relative products shipped from Canada after September 23 to be returned or destroyed to ward off the H7N3 avian influenza virus.The decision jointly made by the Ministry of Agriculture and the General Administration of Quality Supervision, Inspection and Quarantine came two days after the World Organization for Animal Health (OIE) released an outbreak alert, saying that the highly pathogenic virus has been confirmed in a chicken broiler breeder flock in Saskatchewan.The Paris-based international organization warned that approximately 540 roosters have died in one barn containing approximately 600 birds. Another 49,100 roosters and broiler breeders held in other nine barns nearby are susceptible.

To remedy the situation, China has imposed an import ban on all poultry and relative products from Canada and required relevant local governmental departments to seal up all Canadian poultry and relative products carried by airplanes, ships or trains from abroad that must stop over in or transit China.

Illegal poultry imports from Canada must be destroyed under the supervision of entry-exit inspection and quarantine departments.

China has decided to restore as of Sunday the imports of animals with cloven hooves and relative products from Santa Catarina, Acre and the cities of Rio Grande do Sul and Rondonia of Amazon in Brazil as these regions have been confirmed by the OIE as free from the foot-and-mouth disease.

Link to post.

David Axe has an excellent piece on the Wired blog Danger Room, summarizing reporting on recent Ebola and Marburg outbreaks in Congo  and Uganda, respectively. The Ebola is not only affecting humans - it’s hitting the gorilla population, already endangered. At the risk of starting an animal-rights discussion, or worse, one about evolution - one imagines that gorillas are sufficiently sentient to experience pain qua pain - and grief qua grief.

Link here.  I’m certain that I’ll do damage to this piece in summarizing it; what’s more, like all of Axe’s work, it’s well-written and concise.

I’m shocked, Shocked, to find the Chinese using lead paints on toys for toddlers.

They put Etheylene Glyclol as a substitute for Glycerin in toothpaste and a few years ago in medications. Ethylene glycol works great as antifreeze, but it’s poisonous in small doses.

In The River Runs Black: The Environmental Challenge to China’s Future, available from Amazon, Elizabeth C. Economy describes “In late July 2001, the fertile Huai River Valley - China’s breadbasket - was the site of an environmental disaster. Heavy rains flooded the river’s tributaries, flushing more than 38 billion gallons of highly polluted water into the Huai. Downstream, in Anhui province, the river water was thick with garbage, yellow foam, and dead fish. … Only seven months earlier, the government had proclaimed its success in cleaning up the Huai. A six-year campaign to rid the region of polluting factories that dumped their wastewater into the river had ostensibly raised the quality of the water in the river and its more than one hundred tributaries to the point that people could once again fish, irrigate their crops, and even drink from the river.”

They lied and their people die.

In Deep Economy, also available on Amazon, Bill McKibben describes “a trip to China, where I met a twelve-year-old girl named Zhao Lin Tao, who was the same age as my daughter and who lived in a poor rural village in Sichuan province - that is she’s about the most statistically average person on earth. Zhao was the one person in her village I could talk to without an interpreter: she was proudly speaking the pretty good English she’d learned in the overcrowded village school. When I asked her about her life though, she was soon in tears: her mother had gone to the city to work in a factory and never returned, abandoning her and her sister to her father, who beat them regularly because they were not boys. Because Zhao’s mother was away the authorities were taking care of her school fees until ninth grade, but after that there would be no money to pay. Her sister had already given up and dropped out.”

What’s one or two girls in a population of one billion three hundred million?

Unofficially HIV Aids follows trade and prostitution. January, 2006, the Chinese government, (www.avert.org/aidschina.htm) reported 650,000 people living with AIDS, down from the 2003 estimate of 840,000, and up from 1989, when AIDS was known as “aizibing,” the “Loving Capitalism Disease” and it was reported at 153 Chinese and 41 foreigners.

If they are correct in their characterization of HIV Aids as the disease of loving capitalism, boy are they in trouble.

I’ve just stumbled on a site called Visual Complexity. About information design and networks. This may be further proof of Edward Tufte’s proposition that evidence, clearly and honestly arranged, ends up being beautiful.

This image was created by Valdis Krebs of Orgnet- via Visual Complexity

Careful readers may note - correctly - that I’ve yet to demonstrate the connection between our blog’s stated concerns and this post. Stay tuned.