Apr 25 2011

Consequences

There is another major measles outbreak in Europe. The WHO reports:

The World Health Organization said Thursday that France had 4,937 reported cases of measles between January and March – compared with 5,090 cases during all of 2010. In all, more than 6,500 cases have been reported in 33 European nations.

That is four times the rate of 2010. I know – these reports are almost getting boring. The shock has worn off – we have come to accept that previously conquered diseases (at least reduced to minimal cases without outbreaks) have come back. The cause seems clear – outbreaks occur where herd immunity has been lost due to vaccine non-compliance. Fewer people are getting vaccinated, and not much fewer. But the numbers are falling below herd immunity levels in pockets. When vaccination rates fall below a certain level, then infectious organisms are able to spread and cause an outbreak.

The anti-vaccine movement has successfully spread unwarranted fear of vaccines, resulting in the compromise of herd immunity. There is a toll of morbidity and mortality associated with this movement.

Part of the challenge in raising public awareness about the dangers of pseudoscience and denialism is that the public rapidly become inured to the consequences, even complacent. When I saw this latest report about another measles outbreak, I had to think carefully before deciding to blog about it. I have blogged about outbreaks before, and there is nothing new with yet another measles outbreak. Will my readers be bored? It is hard to sustain outrage – things like unnecessary measles outbreaks become old news with a waning grasp on our collective attention.

So it is useful, from time to time, to remind ourselves and the public that there are consequences to nonsensical and irrational beliefs, and to placing ideology above science and evidence. We live in an increasingly complex civilization, with vexing problems that require more and more clever and elaborate solutions. It’s not easing supporting over 6 billion people (and growing) on this world, while feeding them all and avoiding the endemic problems of a large population – minimizing infectious diseases, limiting our footprint on the natural world, providing enough energy and other resources, and not killing each other over access to limited resources.

Our best tool in achieving our goals and solving the difficult problems of civilization is science – taking an objective, evidence-based approach to our problems so that we can work out the most effective solutions. Pseudoscience, denialism, and ideology are the enemies of science and reason, and therefore frustrate our attempts to find optimal solutions.

Think about the billions that are being wasted on useless or even harmful medical interventions because the science of medicine is being compromised, by clever marketing, corporate greed, by rank pseudoscience, by the infiltration of sectarian belief systems into what should be a science-based endeavor. I see this every day – and yes, my outrage is blunted. I almost chuckle to myself when I see someone become aware of the extent and nature of the problem for the first time – their fresh outrage strikes me as naive. But it is preferable to the “shruggies” who are not even aware of the problem.

Our most precious resource, arguably, is the human intellect. And that is being dulled by organized and well-funded movements to water down the teaching of science and critical thinking, because it conflicts with personal belief systems like creationism. It is impossible to tease out all the cultural effects that conspire together to hamper the intellect – anti-scientific ideology, anti-intellectual culture, politics, low standards in the educational system, and simple apathy. They all work together and reinforce each other.

Despite the strides the skeptical movement has made in the last decade, I am still frequently asked why I waste my time with the whole skepticism thing. There are many reasons, but perhaps chief among them is the understanding that pseudoscience and quackery have consequences – increasingly dire consequences, for the individual, for any society, and for human civilization. Measles outbreaks are only the tip of the iceberg. The skeptical movement endeavors to be a force in the other direction – to make the world a more rational place, to increase the level of critical thinking , and to keep science in its rightful place as the best method for understanding the world and finding practical solutions to our many problems.

There is also a certain love and respect for truth and intellectual honesty for its own sake. But knowing that beliefs have consequences is a huge motivating force.

Like Sagan, I would rather know the truth than believe in a comforting delusion. And I also recognize that as a civilization, we can no longer afford the comforting delusions. They have consequences.

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24 responses so far

24 Responses to “Consequences”

  1. shaneon 25 Apr 2011 at 10:14 am

    When I was growing up in the 70s we took our vaccines and we knew then that most of those nasty diseases were licked. I never dreamed that when I finally had a child of my own that the nasties would be back and she would be at a greater risk now than I was as a kid. It is madness that I have to worry that my 4 month old daughter is at risk of contracting PREVENTABLE diseases.

    That is why I am thankful that people like you Steve are out there raising the profile of this issue and continue to hammer the lunatics that are putting all our children at risk.

    It probably seems like a thankless task but let me say, as a new parent, thank you.

  2. locutusbrgon 25 Apr 2011 at 11:25 am

    What can you say, we appear to have a complete brain drain in the US. Where is the love of science, where have we gone wrong. Vaccines are the miracle cure of another generation. Clear cut victories of science. When no one sees their best friends die from polio, and they have a nickels worth of science knowledge this is what you get. I am way past outraged, starting to just be depressed and tired. Hate to say it but eventually we will all say I told you so.
    I used to think that the old 1970′s disaster movies (IE: Towering Inferno), were a overblown caricatures about people’s behavior with an impending disaster. The older I get, the more I see visions of That movie. People pushing each other out of the life saving basket. Suspended in the air, trying to save themselves selfishly.

  3. SARAon 25 Apr 2011 at 11:51 am

    I’m being cynical here – but I’ve recently wondered if we are just not evolved enough to let go of our superstitions. There are the studies that show we might be genetically pre-disposed to accept superstitions and religions. Perhaps we got to this level of technology and population growth before we were intellectually able to manage it.

    What percentage of the world population thinks critically? And among those of us who try, how often do we catch ourselves not thinking critically. I personally catch myself at least once a day thinking, saying or even doing something that is not based on critical thought and has little or no evidence, and having to reconsider my thought or action.

    We are wired to think in generalization, which is, by its very nature, going to lead us to fallacy.

    I worry that civilization will implode on its own intellectual laziness.

  4. The Vaccine Timeson 25 Apr 2011 at 12:31 pm

    I understand the feeling that these reports might be getting “boring”, but as I wrote in my next piece for Randi.org (which hasn’t been put up yet, but hopefully soon before my reported numbers become too outdated) that reports on worldwide measles outbreaks, we cannot afford to become lazy with our skepticism.

    Question is how do we avoid becoming…immunized so to speak against the statistics? I personally rely on stories of harm and suffering which I try to catalog at The Vaccine Times. Putting faces and human interest stories to the numbers works, at least for me, and that is how I plan to catch parent’s attention with human stories.

    But we may need some of that to keep our troops motivated too, so they don’t’ get desensitized towards the issue. So if you’re reading this Google The Vaccine Times. I’m not gonna give you a link here. If you care enough about this stuff, you can Google this on your own.

    Don’t allow the anti-vaxers rhetoric to make you a lazy skeptic. Get involved in whatever capacity you can, even if all you can or want to do is add your e-mail to a mailing list (such as the VT one for example). Every little bit helps, and nice comments to those doing a bit more than expected are always welcome and amazingly motivating.

    So thanks to Steve for all the hard work not just on this issue but every other one he tackles. Your tirelessness in fighting the good fight is an inspiration to those of us just getting started.

  5. petrossaon 25 Apr 2011 at 12:48 pm

    In my homecountry the outbreaks are mostly centered around christian religious fundamentlist villages. They have nothing against a vaccine for fear , but only for religious reasons.

  6. jreon 25 Apr 2011 at 3:11 pm

    My own awareness has been painfully elevated by the fact that two intelligent and much-loved members of my family have become deeply invested in alternative medicine, to the point where we cannot have a conversation even skirting the topics of health, nutrition or disease.

    With this fact more than any other to motivate me, I am registering for the workshop “Defending and Promoting Science-Based Medicine” at TAM, and hope to learn in some small way how to communicate compassionately and respectfully with someone from the other culture, while maintaining allegiance with reality. I look forward to hearing your thoughts.

  7. jeanjackieon 25 Apr 2011 at 3:20 pm

    I think the automatic public acceptance and endorsement of the generic value of medical and technological interventions as the “end all, be all, cure all” is a thing of the past. Most of the medical field has been conscripted by a cog that feeds corporate greed and idolizes financial gain. It is endemic throughout our society. It has NOT been about the patient for so long except the patient as a means to an end, i.e., how much can be charged for what procedures, medical interventions, tests or pharmacological interventions can be prescribed to ensure the profiteering wheels of medicine continue to turn.
    Science is hijacked as well and largely dependent on financing, politics and corporate greed. Besides, much of science is still theoretical and based on solidly entrenched paradigms that does NOT encourage freedom of thought and science but how to reinforce the agreed upon current belief system or paradigm. Have you ever been terribly ill lately and dependent on the medical community? Or read or dealt with the possible side effects and consequences of many pharmacology drugs especially those prescribed for mood, psychoses and other mental health issues?
    I am not endorsing an across the board rejection of all childhood vaccinations but I would venture to say (without having done any extensive research on the matter) that there is a smoking gun involved here and parents are right to be concerned about an antiquated infrastructure welded in place in which, if you question it here in the USA, your children will be excluded from public school entitlement and you might face possible charges of medical neglect by an aggressive and punitive law enforcement community. This has been brought about by pharmacological companies pouring billions into lobbying endeavors that restrict freedom of choice for parents regarding their children. In some instances, companies have had entire countries (UK for one) indemnify them so that they will not be held liable for deaths or complications caused by their vaccinations with known high number of negative consequences.

  8. edhukon 25 Apr 2011 at 5:16 pm

    I live in a town where many people have the mentality that “science doesn’t know everything”. That’s true, of course, because if science did know everything we wouldn’t need science, right?

    Science does know quite a bit, however, through constant searching for truth via the scientific method. We certainly know a lot about vaccinations and how they work and the proposed link between autism and vaccines has been seriously questioned.

    Then there’s the famous “expert” Jenny McCArthy” who has single handedly done more harm to children through her wacky ideas about vaccines and autism than just about any other single person. Turns out her son didn’t even have autism after all, yet the hysteria was set in motion and given the seal of approval by other such “experts” as Oprah Winfrey.

    As someone who posts regularly with my feet firmly planted in the skeptics camp, I can only keep plugging away as a balance to the many “experts” out there.

    I will continue to question the various scams out there, from LifeWave non-transdermal patches that “talk” to you cells, Power Balance Bracelets that give you energy and balance, Amega Global’s AmWand that zaps away pain, the list is endless. And, let’s not forget the biggest ongoing scam of all, promoted by the Queen of England herself, homeopathy.

    I, for one, would be thrilled to see James Randi stand over the smoldering remains of the homeopathic movement before he shuffles off this mortal coil.

  9. BillyJoe7on 25 Apr 2011 at 8:31 pm

    “science doesn’t know everything”

    …but without science we know nothing.

  10. Vinay Punwanion 25 Apr 2011 at 11:31 pm

    @jeanjackie

    There is so much fail in your post I don’t even know where to begin. I’ll just say one thing: you are looking for conspiracies where there are none. And when you find none, you still declare the existence of some kind of smoking gun (without having done any research on your own!).

    There is no conspiracy involving most of the medical community to make medicine solely about profits. Pills have side effects because anything that is pharmocologically active has a side effect. You are told about them because they are extensively studied before they are sold. When was the last time you heard of a side effect from a herbal mix? Do you think they don’t have side effects? Nobody knows because they are not studied.

    There is no secret aristocracy in science that determines what is true or false. Science is about as public a human endeavour as anything else out there. If you took the time to read published literature on any of your “problem areas” you would realize that.

    Also, your statement characterizing science as “mostly theoretical” shows your fundamental misunderstanding of the nature of science. Pick up a book *just one book* on the nature of science and learn something, instead of trash talking something you don’t seem to understand. I recommend Isaac Asimov “The Intelligent Mans guide to Science” or Carl Sagan “The Demon under the microscope”. You would realize that paradigm shifting discoveries are some of the most exciting ones across all scientific fields.

    Lastly, vaccines are the best defense we have against preventable diseases. The benefits of vaccines outweigh all their risks, that’s why they’re recommended. Vaccines are not perfect, they can cause bad reactions in a small proportion (very small) of the population, but that’s what the vaccine court (a special monetary award court, not a court with a jury) is for. The fact that they have side effects is not an excuse for you or anyone else to refuse to take them or give them to your children. The detriment to societal health and disease eradication is too great.

    Sigh, now I fail because I’ve argued on the Internet.

  11. Kyon 26 Apr 2011 at 12:44 am

    Oh no, that’s a lot of people.

    Can you please let me know how many people died of the measles compared to that of a seasonal Influenza A/B?

    Thanks.

  12. thedudesupremeon 26 Apr 2011 at 3:49 am

    Good of Steve to post. Pseudoscience just has to go. Two additional remarks:

    First, on medicine: it is a fact that whereas science can be trusted more than pseudoscience, medical science has been victim of a increasing lack of methodological scrutiny; in fact, this is more problematic than most people think (see http://www.theatlantic.com/magazine/archive/2010/11/lies-damned-lies-and-medical-science/8269/ ). This said, considering the fact that pseudoscience stands to no scrutiny at all, it’s clear what option to go for – especially since most drugs are heftily tested, since no company can afford people dying on them too much. But people mix up two things: the fact that one shouldn’t over-consume, like go taking antibiotics for every cold, and the assumption that medicine is bad. People find it very difficult to separate those two. I know that in France (and Belgium), antibiotics consumption is simply beastly. Your child coughs twice, your doctor shoves antibiotics in by the bucket. I had antibiotics by the bucket (and I’m sure it contributed some to my allergies). People are reacting to this, but reacting the wrong way: antibiotics are not evil but a blessing, but (as with everything), should be used wisely.

    Second, on sociology: there is a problem with democracy in our society, in the sense that more and more people think it’s all about freedom of speech, whereas it should be about freedom of argument. What I mean is that, whereas a century ago people accepted (often too blindly) what an authority figure said, now they don’t, because they think that “equality” and “democracy” imply that every opinion is automatically as worthy as the next one. This is partly because retracing a claim to its origin in fact has become increasingly difficult – look at the climate change debate: one almost has to actually go and read the papers to get a clear view, because the debate is stuck in believers and non-believers, which seem to drift towards one group not because of fact but because of own gut feeling. Which brings us to the risk of this lack of trust in science: people just succumb to confirmation bias, and simply follow whoever preaches what they would like to be true. This has always been so, but even more so since people identify themselves less and less with those who govern them. A doctor and a politician used to be called “sir”, whereas now they are considered drivel or are sued if possible. That’s democracy’s worst outcome.

  13. ChrisHon 26 Apr 2011 at 1:21 pm

    Ky:

    Can you please let me know how many people died of the measles compared to that of a seasonal Influenza A/B?

    You are comparing apples and oranges. The measles virus only affects people and does not change year after year, while the influenza viruses are passed and changed in animals and change each year. There is a reason that only two MMR doses are usually required per lifetime, and influenza vaccine is usually given once a year.

    It like saying that because so many people die in automobile crashes that airplanes should be avoided.

    Jeanjackie, you seem to be arguing the Big Pharma is just out for money with vaccines. Please look at the <a href="http://timewellness.files.wordpress.com/2011/04/ihii_useofmed_report.pdf"table on page 30 on this pdf report, and tell us how vaccines are ranked versus the other pharmaceutical products. Thank you.

  14. ChrisHon 26 Apr 2011 at 1:25 pm

    HTML fail, it is supposed to be:
    http://timewellness.files.wordpress.com/2011/04/ihii_useofmed_report.pdf

  15. Kyon 26 Apr 2011 at 3:12 pm

    Honestly, I was just wondering if there was a site with the amount of deaths. I assume they would be tallying them.

  16. elmer mccurdyon 26 Apr 2011 at 4:42 pm

    I suspect that new commenter “jeanjackie” not writing in earnest, but is actually my stalker being cute, having changed his usual pseudonym for this purpose. Hard to say for sure.

  17. ChrisHon 26 Apr 2011 at 8:03 pm

    Ky, sorry, I did not understand. It depends on where you are. The CDC Pink Book Appendix G gives incidence and deaths for several major diseases, plus there is an annual influenza page. Both can be found with the search box on its front page. I don’t know how many links are allowed per post, so I’ll just post the one to the weekly reports:
    http://www.cdc.gov/mmwr/about.html

    Then the World Health Organization has several pages on disease incidence for several countries. I usually use its search box. Then there is http://www.eurosurveillance.org/ .

    I assume there is something in Australia, but I have not tried. I have found that it is difficult to get those kinds of numbers in Japan.

  18. ReadAndThinkon 27 Apr 2011 at 11:33 am

    Hi Steven, I was lead to this article by a friend after having a long discussion about the pro- and anti-vaccine debate. I hope that you see what I have to say as helpful and not inflammatory.

    Perhaps you have more information elsewhere on your blog, but I see this article as really no more than an appeal to/call to arms for people who agree with you. Unfortunately, you are claiming to be on the side of science, but as I have seen so many times before, you choose not to use science or rationality to back yourself up – instead, you use insults to try to make your opponents look bad – you use the terms nonsensical, irrational, pseudoscience, denialism, enemy of science and reason, and you assumes that people are anti-vaccine for religious reasons and/or that people believe in creationism or are star-struck by Jenny McCarthy. Well, you probably believe these things to be true, but you sure aren’t going to convince someone who is insulted by what you are calling them, especially if they believe that they are also using science and rational thought.

    If you really want to make a really good argument in favor of vaccines, you need to address anti-vaccine people as intelligent, thinking individuals and then you need to address the valid, rational concerns that people have about vaccines, such as why long term safety (particularly in relation to autoimmune disease) has been ignored, why vaccine companies are not liable for damages, why it is OK to have vaccine patent holders working for the CDC and promoting vaccines, why it is OK to have the neurotoxin aluminum in vaccines when there is no “safe level”, why we are calling chicken pox a deadly disease when many of us had it as children and it was not all that bad, why it is OK to have government policies that mandate medical treatment, etc. As long as you and other pro-vaccine advocates refuse to address these concerns, there will be an increasing number of people who believe that you are biased and that you don’t know the whole story.

  19. Steven Novellaon 27 Apr 2011 at 2:35 pm

    R&T – I and others have answered all those questions – ad nauseum. Just search on vaccines on this site, and at sciencebasedmedicine.org. You can also check our our summary page here: http://www.sciencebasedmedicine.org/reference/?p=1

    There are thousands of blog posts here and at SBM, so it is a bit silly to think that this one blog post is my only writing on the topic. This post was meant to be a discussion of skeptical activism – not yet another overview of the science.

    I also stand behind every one of my characterizations – although I certainly never implied that they apply to every one. There are many communities among vaccine deniers, but the core of that movement is an anti-scientific, ideological, and quite mean-spirited group, even if they think that they have good intentions.

  20. ChrisHon 27 Apr 2011 at 5:00 pm

    Ky, I just noticed this page on another blog:
    http://www.who.int/immunization_monitoring/data/en/

  21. hippiehunteron 27 Apr 2011 at 9:38 pm

    @Readandthink….”If you really want to make a really good argument in favor of vaccines, you need to address anti-vaccine people as intelligent, thinking individuals”

    If antivaccine people were intelligent, thinking people they wouldn’t be antivaxxers.

    I think a more honest name for “antivaccination people” would be ‘amateur immunologists’ with more than a touch of both grandiosity and paranoia.

    As for your lie that there is no safe level of aluminium ??? aahhh the toxin gambit yet again.

    see here
    http://www.atsdr.cdc.gov/ToxProfiles/TP.asp?id=191&tid=34

  22. ChrisHon 27 Apr 2011 at 10:07 pm

    hippiehunter, that page as a link to ToxFAQs, under the part that says “How might I be exposed to aluminum?”

    The first thing it lists is “Virtually all food, water, air, and soil contain some aluminum. ” Further down in the “How can families reduce the risks of exposure to aluminum?” section it says “Since aluminum is so common and widespread in the environment, families cannot avoid exposure to aluminum.”

    I wonder if ReadandThink believes aluminum is also a heavy metal?

  23. tashon 29 Apr 2011 at 9:44 pm

    Getting people to see reason and think critically can be a very frustrating and slow process but in my opinion is certainly worth persisting. I think when someone functions within a certain ideology, it can be genuinely difficult for them to free their mind from the constraints of this ideology, especially if that is all they have ever known. It is quite possible that they cannot not even initially comprehend many of the ideas expressed in blogs such as these. Although frustrating to stand back and watch the predictable consequences of certain beliefs systems, I also understand that people do not always have complete control over their mind and subsequent decisions.

    Stepping out from the ‘comforting delusions’ for some people means shattering a belief system which has been holding them together, it means adopting viewpoints that contradict beliefs of their family, friends and social networks. The undesirable results of abandoning these delusions therefore ripples out into many important aspects of their life. These among other reasons, makes it is easy to understand why so many people would instead adopt the defence mechanism of denialism, rather then to allow the unacceptable truth to enter their consciousness.

    I agree with Steven Novella in that we can no longer afford comforting delusions, because they do have consequences.

  24. BenFRon 02 May 2011 at 6:53 am

    I grew up in France during the 70s, according to 2010 figures of the Health Monitoring French Institute (INVS) the measles cases have tripled for infants less than 1 year old and almost 5 times higher for adults below 20 years old.

    The wave of naturopathy and other alt-med trends are now really having an effect on the perception people have of vaccines, which were regarded as achievements of modern times not so long ago.

    Talk about bad press for Pasteur’s homeland.

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