Wednesday 9 November 2022

Open reply to 'THE GREATEST BRIEF EVER FILED' by LegalEagle

16:40 "You'd have to be pretty dumb to think that the Facebook posts were real and also criminal" - LegalEagle

Caveat emptor. Unacceptable.


Date started: 08/11/22                Date completed: 08/11/22                Date published: 08/11/22


'THE GREATEST BRIEF EVER FILED' - LegalEagle (posted 02/11/22)
https://youtu.be/LxTWonQvXkw


What a horrendous failure to advocate for the innocent, that this video is. In sharp contrast, a staple of anti-fraud advocacy, is to remind potential victims, and especially those who gloat at victims, that anyone can be tricked. Even the great Jim Browning.

This video is a betrayal of all that we have worked for, in defending people from crooks. In it, LegalEagle sides with The Onion (a USAian satirical website) in defence of a man called 'Novak' (their surname) supposedly to defend satire/parody, by claiming that a 'reasonable' person would know that Novak were not the police department he was pretending to be.

The rest of this article shall be written as if a personal address:


It is simply not good enough, to shift the burden of responsibility onto the victims of deception. The man, Novak, deceived people - there was nothing available to indicate to a 'reasonable' man, that he were not a real police department in the USA.

I mean, let's face it - serial killing is one of the USA's national sports - of course they can have a "pedophile reform event", amongst the other things alleged by Novak. It's the USA. Do you seriously expect everyone in the world to have the same doe-eyed national prejudices as you?

Anyone in the world could read what Novak said, and reasonably think "well, that concords with the other things i've read/heard about America, therefore it's more genuine horribleness. I hear they're serial killers of Blacks, therefore Pedo-s too".

What you call 'reasonable' in others is not a product of reason - it's convenient prejudice.


Your own video opened with a racist conspiracy theory that because most people in an area are racistly profiled as 'White' that therefore the authorities are deliberately segregating people. Do you actually believe that the universe is run by a hyper-competent cadre of Straight White Male Jews? Is believing that conspiracy theory, what you think 'reasonable' is?

The only way for a 'reasonable' man to always spot lies about the USA, would be for the term 'reasonable' to mean 'omniscient'. And yet you, an advocate for 'caveat emptor' as an excuse for parody/satire (which is not even a necessary excuse) are evidently not scient of the fact that people self-segregate.

The USA provides much evidence of that - be it racist self-segregation into so-called 'black communities' or sexuality-segregation into the 'pink quarter' of a city, or class-segregation to be with fellow golfers, or religious segregation to be with people who wear the right clothes on sunday, people float towards those they regard as kith. And yet you assume that the demographic heterogeneity of Cleveland must be the product of an Illuminati-esque design. "You'd have to be pretty dumb to think that the Patriarchy are real and also criminal" (not sic) or do you disagree?


Being a foreigner, i have no emotional attachment to the police of Parma, or anyone else The Onion has parodied or sided against. As a connoisseur of comedy however, i have some emotional attachment to The Onion (i find it easy to laugh at many of their articles - though not the ones based on peculiarly American beliefs) but their attitude that people should just know that parody is parody is not even close to being OK.

That is the defence of scammers, to say "You should have known. An intelligent person would have done" and then not to bother enunciating the follow-up of "You basically deserved to lose your life savings". I have no love for that sentiment, and no man can do so with reason.

All we can see of Novak is someone impersonating the police. There was no evidence to the contrary. Incredulity is not an argument! You might think that your incredulity is equivalent to being 'reasonable' but it is not.

All that you have called "jokes" are not jokes, without the framework of comedy in which a joke could exist. Without the basic framework of set-up lines and punchline, there is no joke - be it literary, auditory, or even sensory - for example, a dessert that looks like fruit, but tastes of bacon. Set-up: here's some fruit. Punchline: lawl, it's bacon. Expectations subverted. Laughter ensues.


If you are going to permit any deceitful, or doubt-manufacturing, content to be called 'a joke' then you set a dangerous precedent on the subject of propaganda. After all, there are myriad bigots who've retrospectively developed a sense of humour to excuse a recently-publicised remark/action that were too bigoted for them to get away with.

If it were legal precedent to excuse all dishonesty that were at the expense of other people, even strangers who know nothing of the motives of their slander/libel, on the grounds of a retroactive statement that "that was a joke" then no harrassment by so-called journalists (rumour mill merchants) could be challenged. No gaslighting by charlatans could be challenged. No governments could be held to account for lying about policies, as their promises could be dismissed with "Oh, that was just a joke - you'd have to be pretty dumb to think that we'd actually give you healthcare!" (again, not sic)

The natures of such statements are indistinguishable from the statements of Novak, based on available information. I implore you - don't pressure others to be worse - pressure parodiers to be better. Here is an example (from your video) of The Onion needing to be pressured to be better...



There is plenty of parody in the world that does not require explicit statements, in order for the audience to know that it is parody. Take a novel, for example. Pick a novel up, and you already have its fictional nature before your eyes. Go to see a stand-up comedian, and you know it's comedy - it's even written on your ticket, if you struggle to discern that from your environs, and need a hint.

Not all information is communicated explicitly, but some information must be communicated to allow others to discriminate between cases: sincere, or satire.

In The Onion's case they really should do so. Other parodiers have made explicit statements. What would The Onion lose by doing it? Their pride? Maybe they're not really pretending to be arrogant at all. Maybe you're gullible for assuming they're self-aware, because really they believe that they're the best news service in the world. Without evidence, you have nothing by which to realise their arrogance, or lack thereof.

Here are some examples of Britons showing you and The Onion how to be honest:

{NewsThump}

{The Spoof}



{The Daily Mash}
{NewsBiscuit}

 
None of the people who run these web-sites have any difficulty being funny, while also being honest that their intention is to be funny. If you're not good enough at being funny to be honest at the same time, then get better!


I can see why The Onion's defending Novak - it's because they've made the same mistakes, so they feel like they're justifying themselves as well, and what they do for a living. They don't want to lose that living.

But on your part, instead of excusing the sociopathic abuse of 'caveat emptor' as a principle, you could be encouraging better practice in parody/satire, and you could be encouraging the communication of this essential information, which separates comedians from con-artists
: the fact that you're joking.

Facts are established with evidence. Make that evidence count. Don't pretend you don't need it. Without evidence, you are indistinguishable from any slandering, libelling, con-artist, swindler, or gas-lighter.


My round-up of points to remember:

- It's a dangerous argument to make, that your assumptions are correct, because someone else is dumb.
- Anyone can be tricked.
- Reason is not the same as knowledge.
- Common Sense is a misnomer.
- Parody does not need to pretend to be sincere, in order to be funny.
- Without clarification, deception is just deception.
- Without respect for comedy, all propaganda will be excused as 'jokes'.
- Incredulity does not justify dishonesty.
- Make evidence count.
,
,
,

Thursday 19 November 2020

'As Much' Or 'More'? A Language Peeve

Date started: 10/11/20            Date completed: 10/11/20            Date first published: 18/11/20


In case you're collecting pet peeves, and you don't have this one, then here it is.


Every time i hear somebody say something like this:

"this costs 4 times more than that"

it noodles my brain. Why? Because '4 times more' is not what they think it is.


Let's think it through....

Let's pretend that i have two widgets. One costs £1 and the other costs 50p. This means the second costs half as much as the first.

It also costs half less than the first. Ignore this, it's an illusion - i'll get onto that next. But the second does not cost half more than the first!

The second widget costing half more than the first would mean its price were £1.50

If i have two widgets, and one costs £1 while the second costs 25p, then the second costs a quarter as much as the first.

The second does not cost a quarter less than the first - it costs three quarters less.


So describing a price as being 'more/less' or 'times as much' another price, describes a different mathematical operation. {operation = calculation = adding, minussing, multiplying, etc}
Stating one price as a fraction 'more' than another means calculating a fraction of the first price (or whatever number it might be, for that matter) and then adding it on to the original number.
Stating one price as a fraction 'less' than another means calculating a fraction of the first, and then minussing it.
But stating how many 'times' one price is, compared to another, means dividing the second by the first. So of course, the number you say should be different.
 

"2 times £1 is £2" --> "£2 is £1 times 2"


If one widget costs £1 and a second costs 50p

The second costs half less, or 50p less.

It also costs half as much.

If one widget costs £1 and a second costs £2

The second costs once more, or £1 more.

It also costs twice, or 2 times, as much.

So if a widget costs five times as much as the first, then it's price is £5. That's easy to calculate.

But if a widget costs fives times more than the first, then what does that mean?

To calculate "a quarter more" we would multiply the original by one quarter (£1 x 1/4 = 25p) and add that on, to get £1.25

So to calculate "five times more" we would multiply the original by five (£1 x 5 = £5) and add that on, to get £6


So 'five times as much' is £5 but 'five times more' is £6

Disaster at the tills! Your shopping list costs more/less than you thought it would.


And that's my pet peeve. Many people are in the bad habit of saying "less" or "more" (especially 'more') when the habit of saying "as much" would steer their minds into much safer numerical territory.

So the moral of the story is this: don't mix 'more/less' and 'as much'. Or you might get as much than you bargained for ;-)



Notes:

Inspired by Barry Lewis. Kind-of. I thought of actually writing this down thanks to watching one of his videos. It was this one: 'Cooked Breakfast - Cheap vs Steep 4'

Since writing this, but before making the pictures, i discovered an old LindyBeige video, in which he tells everybody that they CAN get the less/fewer thing right, because they never mix up much/many. You can do this, folks - don't let me down :-D 'You can do language!'

Blogger forced me to post this with the font as Verdana, instead of the usual Trebuchet, because Trebuchet wasn't working. [shrugs]

.
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Tuesday 24 March 2020

COVID-19 Rundown (Mid-Pandemic)

Date started: 16/3/20                     Date completed: 24/3/20                     Date first published: 24/3/20


Hello disease vectors,


We can all catch it, and we can all give it to someone else. This is important:


15/02/20 'Corona virus' - the British Medical Journal [link: YT video]

13/03/20 'Vital Global Information Please watch' - John Campbell [link: YT video]

10/03/20 'Novel Coronavirus: A Guide for Students on Staying Healthy, Safe & Sane' - Risk Bites [link: YT video]


'Coronavirus (COVID-19)' [link: NHS website]

'Coronavirus disease (COVID-19) outbreak' - WHO [link: WHO website]

'Q&A on coronaviruses (COVID-19)' - WHO [link: WHO website]

'Special Collection: Coronavirus (COVID-19): evidence relevant to critical care' [link: Cochrane Collaboration website]


09/02/20 'Coronavirus: how dangerous is it?' - Thunderf00t [link: YT video]

22/03/20 'Coronavirus: What if we did NOTHING?' - Thunderf00t [link: YT video]

12/02/20 'CORONAVIRUS MYTHS: Bad Medicine #2' - Dr Hope [link: YT video]

13/03/20 'DOCTOR answers most searched CORONAVIRUS questions on Google' - Dr Hope [link: YT video]


Dr Hope has now started a vlog, following his experiences dealing with corona. The link is at the bottom. John Campbell is making frequent updates to what's going on, too, with more technical information.


Just after writing this, the UK government updated their instructions. The police will now 'be authorised' to fine people (undefined amounts) for defying the curfew. Congregations of more than 2 are now forbidden, countrywide, except when shopping for necessities, and when incurred by medical needs. Also, daily exercise is still permitted, alone or with the people we live with. [link: government website]



Mini-Glossary:

Aerosolic - something carried around by an aerosol - tiny drops of water, small enough to float unseen in the air. Bigger drops can be seen as mist. Big enough ones become raindrops and fall to the ground.
 
Virus - a disease-causing thing that can not reproduce on its own, so is not classed as alive. The correct term for destroying a viral particle is 'denaturing' not 'killing'
 
Respiratory Tract - your breathing tubes, from your nose and mouth, down to your lungs.
 
COVID-19 - one member of the corona family of viruses. It is not flu, it is not bacterial, and it is not meaningul to call it 'corona' for reasons i shall explain in another mini-essay.



Pre-Amble:


Corona is a family* of viruses, given that name because the features on its surface make it look like it's wearing a crown. COVID-19 is one strain in that family, which has been traced back to a fish market in Wuhan, China.

But corona is a broad family, like the breeds of dogs are a broad family, and with a similar variation in aggressiveness and dangerousness. SARS and MERS are caused by different kinds of corona. These are very aggressive, like mastiffs and pitbulls, but 10-25% (different estimates) of 'common colds' are actually caused by corona strains, too. They, however, are like labrador breeds - as colds go, corona caused colds can be very mild.

As i write, nobody knows how big this threat's going to become. China has managed to prevent new cases of COVID-19 infection through brutal suppression measures. That is what is necessary, and other countries just haven't followed suit.

The metaphorical horse is out of the metaphorical stable, and we're at least a year away from finishing the design and manufacture of a viable vaccine. Since corona escaped China in February, cases in Europe have continued to rise. We have no idea when the curve will flatten, but if you want to know what that graph looks like, then here's the WHO link. [link: WHO website]

What the situation looks like, as of 23/03/20



Advice for you:

All of the aerosolic diseases that include flus and coronas cause generic RTI syptoms, making it difficult to distinguish one disease from another. Or allergies, as in my case. This is because the symptoms: coughing, and fever (and a sore throat) are part of the body's attempts to fight back.

All of the coronas, influenzas, and adenoviruses, spread by aerosol** - tiny droplets of water, floating in the air - are inhaled, and the viral particles stick to your throat. So your body inflames the throat, to make it difficult for the particles to get through, and your throat produces more and thicker mucus, to grab and wash the particles away before they can get into your body's cells.

This sticky mucus is difficult to clear, causing the cough; the inflammation causes the sore throat; and the fever is an attempt to improve lymph node effectiveness, so your immune system can attack any viral particles that beat your defences and get into your blood.

If you have an allergy, your body is doing all of this to try to fight back against a fictional threat, but it will feel the same. Initially. A real threat will progress, and it's how the disease progresses after the first few days, up to a week, that will indicate whether you have COVID-19, or any other disease. Bear in mind that, just because COVID-19 is claiming the forefront of your mind, all the other diseases are still around. This adds to the stress on healthcare teams.

So, if your symptoms progress to include a productive cough (you're coughing up sticky mucus) and especially if you're suffering shortness of breath, this means you're much more likely to have COVID-19, and you MUST stay at home, physically*** isolated from the world, for seven days. If your condition is worse by then, you should call for help, but DO NOT go out to seek it, unless you can not email or telephone for help.


What if you feel well? You don't have any symptoms, or you just have a little cough that doesn't bother you? Well, like the other coronas, influenzas, and adenoviruses, COVID-19 has evolved the ability to run silently, in your body, before being met by the symptoms i mentioned - those of your body fighting back. This gives it time to spread to other people, before you even realise you're sick. Conclusion: you must be strictly hygienic, even if you think you're fine.

I will repeat this, because it's very important. COVID-19 can be in your body, and able to transmit to other people, for three weeks, before you realise you've had it. One of the case studies in this pandemic, is of a man who went to Switzerland, on a skiing trip, and gave it to more than a dozen people, without realising he had it, himself. You must be strictly hygienic, even if you think you're fine.

Because COVID-19 spreads by aerosol, the same hygiene methods that prevent transmission of coronas, influenzas, and adenoviruses will work against COVID-19: cough/sneeze into your elbow, wash your hands with soap or alcohol after contact with shared and contamination-prone surfaces, and avoid crowded places. Social isolation means you're avoiding shared surfaces, as well as avoiding people's coughs and sneezes.****

The risk of receiving or giving an aerosolic disease scales with the number of people you are around. Sharing a room with three other people means you can only give it to three people, or receive it from three people. Presuming you don't already have it, that's good odds. Sharing a room with 60,000 other people, while watching a Premier League soccer match, is a heck of a lot more people to give it to, if you've got it, and a heck of a lot higher chance that somebody in the room is going to send it your way! That is what makes these events so dangerous.


DO NOT

  go shopping just for lemsip, if you don't have to, because it doesn't actually work, and you're just spreading the viral particles around as you splutter through the shops.
DO NOT
  consume alcohol to 'kill the virus' as it will not work. You'll just impair your judgement, increasing the chances of you doing something silly, that will increase your chance of contracting it, or giving it to someone else.
DO NOT
  consume antacids to reduce your pH, as it will not make you any more resilient to COVID-19. Your body produces more mucus during an RTI in order to flush the invading viral particles out of the airways and into the mouth, so that it can be blown out of the nose, or swallowed and destroyed by stomach acid. Hogging the antacid just persecutes people who need it for problems with their stomachs.
DO NOT
  consume antibiotics as it's a virus, so antibiotics can only do you harm by diverting your body's resources, and contribute to the looming antiobiotic-resistance disaster. All the other diseases are still about, remember. Also, COVID-19 progresses to pneumonia, which is treated with antibiotics, so don't hog them.
DO NOT
  consume copious quantities of vitamin C, as it's only an ingredient in building your immune system. By the time you're infected, it's too late. All a vitamin C overdose is going to achieve is poisoning your liver and damaging your kidneys; and if you're in quarantine (or social isolation) nobody will be there to save you.
DO NOT
  foment or join mass gatherings (more than 100 people) with the sentiment "life goes on" because statistically, for at least one of those people, life will not go on. Because of you. Don't do it, and you won't have to live with the guilt.@@
DO NOT
  blame China or any other government conspiracy, for the occurrence of COVID-19, as if that were an excuse for your own unhygienic behaviour. Given that you've read this far down, on my blog, it seems highly unlikely that you'd believe any of that brand of superstitious nonsense, but i thought i should add it for the sake of attempted conciseness.


CONSIDER
  wearing gloves. Think of them as washing substitutes - instead of washing your hands, you'll be collecting the dirt on the gloves, and then taking them off. So they're one-use only; and it makes no sense to wear the same gloves everywhere - you'd have to wash them as often as you wash your hands. Overall, it's wise for businesses to make their staff wear gloves, because anyone leaving the building with them on, or having entered without putting them on, will be conspicuous, whereas somebody not having washed their hands is difficult to judge by sight. In other cases, gloves are a faff, a waste of plastic, and overall a bad idea.
CONSIDER
  wearing face masks. Only the medical-grade masks are effective, and should be reserved for medical people, because it's really hard to wash the insides of your face. Face masks are also washing substitutes - you'll be collecting the dirt on the outside of the mask, and then throwing the mask away. So they're one-use only too. If you take the mask off, handle the outside, and then handle the inside, when you put the mask on, you'll suck any aerosol that's there directly into your face. What's the point of that, then? Plus, when used, masks are better at protecting other people from you, than you from them. So in most cases, wearing masks are a faff, an unnecessary hazard, and overall a bad idea.


BUT DO
   wash your hands frequently and thoroughly, even if you think it's only people with psychological problems who wash their hands a lot. OCD is actually about habit - not about hygiene paranoia - OCD people find it hard to get into habits, and hard to get out of them. I am cajoling you to adopt good habits, and correct bad ones. Doing so is actually a bigger challenge for OCD people than for non-OCD people. More detail about how to wash, and when to wash, coming up...
AND DO
   get into the habit of coughing/sneezing into your elbow - not into open space, and not into your hands, because you're going to touch things with your hands. Coughing and sneezing are the most effective way of spreading the aerosol that corona travels around in. This is also why you should avoid standing too close to people.*****



*I heard some fake-journalist on the radio announce the first case of coronavirus in the UK, just over a week ago. It most certainly was not - the British Isles has had coronas rattling around for a long time. The terms 'COVID-19' and 'coronavirus' are not interchangeable. Mixing them up in the way the radio person did, is like reporting on the reintroduction of wolves to Scotland, and calling it "the first dog to come to Britain". Sure, wolves are dogs, but lots of dogs have been in Britain prior to modern wolves.

**
Aerosolic travel is not the same as being airborne. Mosquitoes are airborne when they fly - they do not require a bubble of water to float around in. Coronas, influenzas, and adenoviruses require a bubble of water to float around in. They are not airborne diseases, they have never been airborne diseases, and they are not likely to ever become airborne diseases. Examples of pathogens that can spread without droplets of water to carry them are: chicken pox, and measles. They spread much more easily than any corona strain ever has, and COVID-19 will not be following in their footsteps.

***
Physically isolated, but not socially, because you're on the internet, right? Suggestion: go to Twitch and find a streamer's community to chat with. They've all been practicing social isolation for years :-D

****Soapy water kills everything. No really, it does. But you can't inject soapy water into yourself if you're ill, because it'll kill you too. It's that effective. So wash your hands with soapy water. It works. Hint: if you suffer from rough, de-oiled skin afterwards, try rubbing vaseline or some other emollient into it - that'll make it much better.

*****
As an addendum to this 'DO', i shall point out that nerds have been trying to popularise fist-shakes for years. Hand-shakes promote spread of germs carried on our palms, but the backs of our hands are much, much cleaner, because we don't touch much with them. So the fist-shake is a hand-shake substitute, that's a lot more healthy.



How to wash and when to wash:

Imagine you're a cook (this'll be easier if you're a chef) and you've got a set of boards - one for uncooked meat, one for everything else - and two sets of knives - one for the uncooked meat board, one for the other. The principle, is to keep dirty things away from clean things.

Now imagine you're a car mechanic, and it's impossible to keep your hands clean, but you can wash them before handling your own food, and you can wash them before going beyond the workshop, to avoid spreading grease around. This is the princple. It's OK to move dirt around the garage, but do you really want to spread it into the house? So...

BEFORE you go from one place to another, wash your hands, so that you don't take germs with you. Home -> workplace -> toilet -> workplace -> shops -> home -> etc

AFTER you've handled anything high-risk, within any location, you should wash your hands. This includes the shared handles on coffee machines; tills and workplace keyboards; log-in pads on the ways into buildings; petrol pump handles; the fur and feathers of pets, that soak cells and viral particles like a sponge soaks water#; and especially your own face if you've just blown your nose. "Catch it, bin it, kill it"##

DON'T PANIC. COVID-19 kills people. Influenza kills people. Are you in permanent panic about Flu? No - so don't panic about COVID-19. Just get into good hygiene habits.


#It's a terrible idea to take such animals into wards of hospitals, to try to cheer patients up. Unfortunately, it seems to be a popular idea, atm. The fur on pets has been found to carry everything from rhinovirus particles to anthrax. The most safe pets would be reptiles, as their scales are dense and difficult for germs to permeate, and reptile diseases are very unlikely to transmit to human mammals. So say no to the pooches, and welcome the snake charmers.

##This is a hygiene slogan developed to encourage suppression of flu. Viruses aren't classed as 'alive' so killing them is meaningless. The correct term is 'denaturing'. [link: Wiki]




The importance of doing all of this:

A little lecture on risk and hazard - risk is the chance of something happening; hazard is the size of effect if it does happen.

RISK: Your age will not effect your risk of contracting any aerosolic disease, COVID-19 included. To minimise your risk of getting it from someone else, or giving it to someone else, you must minimise the number of people you come into contact with.

This is why congregations of people are risk-elevating, and this is what makes large-scale events like Premier Leagues and Olympicses so dangerous. It's also likely to be the explanation for how the Spanish and Italians and French have had so many cases - they're a lot more touchy feely (and kissy) than other European populations, so they're much more likely to pass the virus on if they have it themselves.

HAZARD: The number of people you are around will not change the severity of COVID-19's effects on you. The older you are, the worse it will effect you, so you are much more likely to die of it if you are older.

COVID-19 spreads from the URT (Upper Respiratory Tract - nose, mouth, throat) down into the LRT (Lower Respiratory Tract - bronchi, lungs) causing lung inflammation (pneumonia) which reduces ability to breathe. That is why the first distinguishing feature of COVID-19 is shortness of breath.

Most people (~80%) will get better on their own, and most who are hospitalised will get better with supplementary oxygen. Anyone with pre-existing lung problems, caused by asthma or inhaling smoke or dust over a long period, will be more susceptible to COVID-19's effects, and will therefore be more likely to die. [link: infographic with lots more detail]

I've seen it suggested that young people should be deliberately exposed, so that they become resistant, and hence safer around the old. But this is stupidly dangerous - the elderly do not live in cocoons, free from interaction with the under-60s; and deliberate exposure means more cases than healthcare teams can handle.
The only way to keep older people, and people with lung problems, safe is to minimise the risk of them catching it in the first place.

All congregations of people are a disease-transmission risk all year around - sports events, theatres, schools, religious rituals - but the additional deaths caused by them are just not calculated in people's minds.

Suppression of COVID-19 in China has been effective; and it's been effective because of quarantining. Although this is probably just as necessary as with flu, it's not yet known how COVID-19 will compare with things like the Swine Flu and Avian Flu epidemics of this century, when the deaths have tailed off, which is why sensible people are treating this pandemic so sternly.



What's that graph all about?

[link: that graph, animated]

My vague approximation of that graph:
 



The shape
of this graph is based on observation of what happens as new diseases spread. They rapidly discover new homes to exist in (humans) spread as fast as they're able, start to run out of new people to exist in, and then find it very hard to find people that haven't developed resistance to them. These are the phases that new diseases go through, and they are the phases that COVID-19 is going through now.

But that doesn't mean that we're passive to its progress. It's not a case of "well, it's going to do that whatever we do, so why bother?" because we can influence this graph. The graph's shape is determined by the disease's behaviour, but it is also determined by our behaviour.

If we pick a disease up from somebody else (it would be on our hands, at this stage) and then immediately go out and socialise, we can immediately start to pass it on to other people. If we refrain from touchy-feely behaviour, and go home, but we become sick (about a week later) then we will give it to people if we cough/sneeze near them. By this method of transfer, spread of the disease will be delayed by a week per person that it hops from/to. By secluding ourselves for a month, we can not pass it on for another month, thereby massively slowing the pace that the disease can spread to the next person.


The dotted line represents our healthcare systems' ability to cope with the number of patients that need treatment. If the disease spreads too fast, there will be more COVID-19 patients than can be treated, meaning their condition will worsen, and they'll be much more likely to die. If i speak rhetorically for a moment, the curve above this line could be called a 'kill zone' because it represents the patients who are going to go untreated.

In the case of COVID-19, it's a typical RTI (Respiratory Tract Infection) in the sense that it spreads by aerosol, so it's breathed in, manifests in the face, then easily spreads to the throat. The body's defences try to push the infection away from the lungs, because they're so important, but COVID-19 has shown an ability to beat this defence. It spreads down, into the LRT (Lower Respiratory Tract) thereby affecting lung function, producing the first symptom that distinguishes COVID-19 from other colds and flus - shortness of breath.

Most people (~80%, as i said before) will recover before this symptom gets worse (some before it even begins) and most who do get worse over the following week, and who are subsequently hospitalised with it will recover in their own time, with oxygen supplementation. Lung inflammation is called pneumonia, and it is this that gets worse and worse and eventually kills those who die of COVID-19.

Availability of oxygen is crucial to preventing hospitalised patients from becoming worse, and thereby having to be put on ventilation and cared for by Intensive Care. The people who work in IC teams are highly specialised and can not be easily transferred from other departments. IC units usually have 1-2 patients per nurse, compared to other wards with 6 patients per nurse. Or more, if they're chonrically under-funded, but that's another mini-essay. [link: NHS description of Intensive Care]

If Intensive Care is flooded with patients who can not breathe on their own, due to COVID-19 caused bilateral pneumonia (bilateral means both sides of the body) these nurses will not be able to surveil all their patients with their usual effectiveness, and will have to choose who to save if more than one patient needs their attentions simultaneously. This is more traumatic for them than any friends and family, because they will have to go through this again and again and again, until the pandemic passes.

The death rate right now might be ~1%, but the more graph there is above that dotted line, the higher that percentage will go. Currently ~80% of people are expected to catch COVID-19 at some point, and even at that rate, COVID-19 will kill more people than WWII, which killed 3% of the world's population at the time.

So there is a huge toll that could be ahead of us. As i write, the WHO's graphs shows no sign of new cases falling. We have no idea how deadly COVID-19 could become, simply by it overwhelming our ability to placate it.
[link: the WHO's graph map]

And THAT is why we need that graph to be flattened out. That is why we need to slow the disease's spread. That is why this pandemic demands more than basic hygience. That is why we need to isolate ourselves from each other. And that is why shops have to close, and parties have to be postponed.



Social comment:

12/3/20 'ATP Suspends Tour For Six Weeks Due To Public Health & Safety Issues Over COVID-19' [link: ATP website]

18/3/20 'ATP & WTA Extend Suspension Of Tours' (to 7th of June) [link: ATP website]

It's interesting that this kind of thing is happening. It is necessary; but it is also interesting. And it's largely too late, as Europe and the USA have been responding ~1 month too slowly. As John Campbell said, in the video linked above, we have 'community transfer' which means the disease is inside the nation's borders. Which nation's? Well, if you look at the map, pretty much all of them. Closing national borders is good, but late - it's closing the stable door when most of the horses have already bolted. [link: the WHO's graph map, again]

But it didn't happen at all with many of the other recent pandemics, so why with COVID-19? It could easily be the superficially-random nature of the journalism rumour mill industry. But it could also be a cultural development - a progression in attitude to pandemics.

As the world's population becomes increasingly high in number, and increasingly the same in intelligence, the numbers of disease outbreaks that become pandemics (which means they affect people on multiple continents) have increased. With more people around, and more people moving around the planet, and more people moving around the planet more frequently than they used to, diseases are finding it easier to spread around, and to reach this infamy-worthy stage called a 'pandemic'.

{rumour mill: total mentions in the media} [link: infographic, the tile in the bottom right]

The UK has been more tardy than other European nations, in responding to this pandemic. You can extemporise 'explanations' if you want, but general disregard for human life when weighed against capital value, is likely to be part of the tardyness. BoJo's been spreading his face over the TV again (though he knows nothing about medicine) so that he can plea with people, instead of tell them what he's going to do. And then he talks money. Please don't socialise, he says. Then he keeps the schools open. And then he offers compensation. Money, money, money. Compensation schemes galore, but no promise of raising funding for the NHS, so that it can be better prepared for future pandemics. His albino-golly counterpart in the USA closed down a pandemic response unit, and has recently been floating the idea of paying $thousands to each person in the USA. Money, money, money. And money neither country has. And it won't keep the people alive anyway.

Incidentally, all the people in these press conferences have been standing too close together, thereby defying advice on social distancing. Paramedics now make an initial assessment from at least a metre away, but the pollies think it's fine to crowd together. No wonder the UK's Health Minister caught it. [link: BBC website]


I see these things like this: they're akin to fire safety. What are you always told, in the fire safety meeting? When the alarm goes off, leave your possessions behind, and proceed, without rushing, towards the fire exits. Do not run, do not panic buy toilet roll@, do not return dressed as a smurf@@ so that you can pretend everything's fine, and do not run off to a religious event@@@. Companies can be rebuilt, clubs can be reformed, the dead can not be brought back to life. It's not worth it. Sure, businesses die. But they're much, much easier to replace.

Disease is not new. Eur-american governments knew what was coming, if a disease was fomenting in a Chinese market. They knew airline travel would bring any disease to them within hours. But they weren't prepared.

We're now in a game of whack-a-mole, trying to suppress outbreaks on a local scale, employing military forces to patrol people, and to keep them in their homes. We might well find, in coming months, that the world's micro-economies will blink on and off, as people are allowed out, to do work, and are then forced back home, as the disease returns to their area.

The most painful fact behind all of this is this: pandemics are going to occur again, and again, and again. Like massive storms, and species going extinct from climate change, pandemics are the new norm. We have to change our ways of thinking and behaving: from coping with the current pandemic, to suppressing all future potential-pandemics.


As i said before, all of these sports events are dangerous, because they are spectator sports - large numbers of people converge in stadiums, so that they can cough and splutter over each other, and take previously-alien diseases home with them. Well, that's not why they go, but it is what they do. And with 'colds', influenza, and corona, they'll be doing this without noticing, because they won't feel ill at the time.

But, i don't see why these events can't be held without a physically-present audience. I mean, sure, it would seem weird. The perpetual hullabaloo is the only thing that keeps soccer spectators awake, in the course of a tedious nil-nil draw. It would be like those comedy reworks of movie scenes, with the music track taken off, and replaced by the sounds of people coughing, shuffling their feet, and pacing across hard clacky floors. [link: YT video]

I pay most attention to tennis, which is how i found the links above. I was expecting Indian Wells to happen, but it didn't, so i went looking for information. The ATP tournaments that have been cancelled (it's quite plausible that more will follow) will have much larger remote audiences than in-house. The Challengers (2nd tier) don't get many people turning up for matches - hundreds will turn up for a final though - but they'll be watched by many more people online; either live, or using the ATP website's delayed-viewing facility. And this pattern is true through to the 1000-level tournaments and the Majors (the Oz Open, Roland Garros, Wimbledon, and US Open) with many, many more people watching them on TV than will ever consider applying for tickets.

It's not like these events are unviable without physically-present spectators. Is it? I like to think that tennis is a Jessie J fan, singing "we don't need your money money money, we just wanna make the world dance" whereas soccer is clearly a Meja fan, mumbling "its all about the money, its all about the dum dum duh dee dum dum" as it's the TV rights money that rakes in most of the cash, with the top tennis events, whereas soccer clubs cram lots of gullible, factionalistic punters into their stadiums, so it's worth draining them for everything they've got. I'd like to see the numbers.

The organisers of the Challenger event in Bergamo, Italy, a few weeks ago, decided not to play the final. The players were happy to battle it out in an empty room, but the bosses said no. Enzo Couacaud and Illya Marchenko both had to settle for runners-up points, and runners-up prizemoney.

The thing is, i'm not an epidemiologist by career, but i reckon i have a much better grasp of it than most sports event organisers, so if i struggle to work out whether the threat of transmission between players and umpires and line-judges is worth cancellation, then what chance have they got? With the audience absent, the vast majority of vectors for the disease aren't around. Reminder: risk of catching it is proportional to the number of people you come into contact with.

Tennis players do a lot of travelling, around the world, so they pose a far greater transmission threat than each local spectator, but there are far fewer of them, and because they're going from tennis tournament to tennis tournament it's much easier to track their proximity to other sick people, to regulate their behaviour - to keep them away from other people, and to diagnose and quarantine them if they do catch something. None of these things are viable with spectators - they flood into the building, they flood out again - that's it.

And how many case studies do we have, of COVID-19, or any other pandemic, being transmitted by globe-trotting athletes? Businesspeople, skiiers on holiday, cruisers... tennis players?

Managing disease spread from player to player, and between players and others, is probably much more manageable than event organisers think. It would incur never-before-embraced expense, but it would (probably) work, and it would keep tennis afloat.

Of course, they've never got to grips with the logisitics of this before, so they're taking the sledgehammer approach, and cancelling the events. I know there's a sentiment in my head that runs along the lines of "just put some tennis on, so that i can watch it!" but seriously - when are the events going to be permitted again? And when should they be permitted again? COVID-19 might, if suppressed as effectively as the Chinese managed, bounce back many times before 2021 comes, as it pings between communities.
 

This could be what success looks like. Small periods of 'kill zone', alternating with periods of resumed commercial activity, until the pandemic subsides.
It's not like the threat of disease is going to go away. I repeat: all of the other diseases are still out there, right now, and will be when this spread of COVID-19 has subsided. If everybody were strictly hygienic, by always coughing into their elbows, and washing hands every time they moved from one location to another, and before eating, and after stroking furry/feathery pets, etc, then this pandemic might never have become one. The key to the COVID-19 suppression in the Orient, has been suppression of transmission - that's what hygiene is for!

If we want to prevent pandemics from ever happening again, we shouldn't treat disease-suppression the way most people treat their diets. We shouldn't be slack most of the time, and then try to compensate for it with a fortnight of extreme behaviour. Crash diets don't help, overall. Furious paranoid hand-washing and toilet-roll buying isn't going to help, overall. If you want to maintain a healthy weight, set your diet commensurately, and then stick to it. And if we want to maintain a pandemic-free population, we should decide whether we can afford to have sports events, make a rule, and then stick to it.

If tennis events are too dangerous now, then they're not going to become massively safer by the 7th of June, are they - everything about them's going to be pretty-much the same. And if tennis tournaments are too dangeorus to hold, then soccer matches most definitely are - they involve orders of magnitude more people. Tennis' ATP Cup, earlier this year, accommodated 220,319 spectators, who watched 129 matches, across three sites in Australia. That's surpassed by the last three home games of FC Barcelona alone! [link: ATP Cup 2020 website] [link: soccerway, FC Barcelona match 1]
[link: soccerway, match 2] [link: soccerway, match 3]

If spectation of the Premier League is too dangerous, it should be banned indefinitely. But if the threat from one match, the FA Cup final for example, isn't too dangerous on its own, then it should be permitted indefinitely. The nature of risk and hazard isn't going to change so much, from week to week. We don't only direct sewage down into the sewers when we get sick, do we - we always send it there, because that's how effective hygiene works. The task is to fund and authorise epidemiologists to calculate these risks and hazards, so they can work out what we should do, and what we should not do.


As for ourselves, as individuals - why don't we all have a box of jars and tins? They last pretty-much forever, so why don't we already have them? Some meats, some fish, some sauces, some pickled vegetables maybe. Then, when the inevitable quarantine comes, next time, we'll have what we need to sit it out. No panic-buying will be necessary.

OK, there will still be some panic-buying. Paracetamol has a use-by date, because it decays. And people will still want fresh food before they have to say goodbye (or at least, "au revoir") to it. But the obsession with toilet roll is ridiculous - who gets through toilet roll so fast, that they have to rush to fill supermarket trolleys with it??



@Why have people been panic-buying toilet roll? I haven't been able to find out how this meme started, but viable hypotheses include Australian concerns about the Chinese making all their toilet paper, a single Australian virologist mentioning toilet paper in a tweet, and a single Australian fake-journalist incorrectly listing diarrhoea as a symptom of the virus. So, it's almost certainly the fault of an/some Australian(s) then. BTW, Australians make most of Australia's toilet paper; and if virologists had that much influence, people wouldn't be panic-buying at all. So you can easily work out who i'm blaming. [link: Australian News website]

@@This is a real thing that was done by smurf (or 'Schtroumph' as they're called in French) fans in France. 3500 people turned up, painted blue, in the town of Landerneau, with the town's mayor contributing this darkly ironic remark: "We must not stop living... It was the chance to say that we are alive" (translated). For >1% of them, it was a chance to start dying! [link: globalnews website]

@@@The Islamic sect Tablighi Jamaat (akin to a roaming Christian megachurch) ran an event near Kuala Lumpur, in Malaysia, to which ~16000 people turned up, and which has caused a huge spike in the number of contractions of COVID-19 in the area. More than half their cases are attributable to the event, and Malaysia now has the highest number of cases behind China and Korea. [link: Bangkok Post website]

This is typical of religious groups, as members tend to be less socially aware, less considerate in their behaviour, and more prone to medicine-denying superstitious beliefs. Denial of Germ Theory, and distrust of vaccines, is common in religious sects such as these. You want to suppress disease? Religion's fighting you all the way.




Predictions:

I just want to get these out before they happen. Predictions don't count if you say them after your predictions have come true!

- Companies' algorithms will have fits, while adapting to people's weird shopping patterns, due to the phases of panic-buying and social isolation.

- There will be a baby boom in 9 months time, as all the people who are currently in quarantine, and who've run out of contraceptives, will conceive. You might think this cynical, but it's how there's a baby boom every year, in September. People get bored in-between XMAS and New Year, and because they're at home together, they... exercise.

- Businesses that can afford it, will segregate workplaces to become proofed against spread of disease through their workforces. Part of this segregation will involve an increased use of online servers, to communicate remotely. The longer the pandemic lasts, the more businesses will make this adaptation, and stick with it for the long-term. COVID-19 will be regarded by historians, as part of a revolution of online business.

- If the pandemic lasts till 2021, legislation will be made, obliging companies and other organisations to react in certain ways, in order to deal with any future pandemic; and authorising prosecutions against people who act selfishly after an emergency situation has been declared. Religious organisations will either be given exemptions, or will guilt trip governments into post-pandemic pamperings.

- The closing of borders, and the general fear of the existential threat, will make people more superstitous, and more prone to electing superstitious pollies into governments. The kinds of governments who are encouraged by the sights of militias in streets, and closed national borders. It's happened before, and it could well happen again. The rise of nationalism, like all the diseases that aren't COVID-19, will not have gone away, just because we're not paying it attention. So the sociological threat could be grave, too.

- People will continue to say "self-isolating" despite the grim implication of the alternative: forcing other people into solitary confinement.

- If it hadn't already happened, i would predict an ironic contraction of COVID-19, by one of the tardy pollies who had had the task of suppressing it. At least i can jest that Nadine Dorries, the Health Minister who's apparently recovered from it, has proposed abstinence-only preaching to Parliament, and that by her own principles, she should have considered refraining from breathing, in order to not catch it.



Closing comment:

People are really bad at judging risk and hazard. One often-catastrophic example of this, is in the case of disease - most people massively misjudge how dangerous disease is. Take the sentiment that 2003's SARS 'wasn't really that dangerous' - it killed 774 people. 2009's Swine Flu killed an estimated 150,000 to 575,000 people worldwide.

If a serial killer managed to kill anywhere near as many as a tenth of SARS' total, people would be locking themselves in their houses through fear.


Winter flu kills thousands of people per year, but people don't quake in their beds over it - they continue to cough and sneeze over each other; they don't change doors on public toilets (restaurants included) so that they can be opened from the inside without handling; and they don't cough and sneeze into their elbows. But they SHOULD be doing all these things, all the time. Not just when there's a pandemic panic - all the time. That is how to suppress pandemics. [link: SARS Wiki] [link: Swine Flu Wiki]


It's my hypothesis that, because people are over-sensitive to hazard, and under-sensitive to risk, they perceive serial killers to be more dangerous, because they rarely let people go.

If you were presented with the prospect of somebody holding a knife to your throat, and then a 99-out-of-100 chance of being let go, you'd be less scared of that person. Right? But the fact that they're going to do that to a thousand times as many people, and thereby kill ten times as many overall - does that make you change your mind? Are you ten times as scared? People are really bad at judging their prospects, when they have to weigh up risk and hazard like this.


Another thing people are really bad at judging - suppression. After decades of massive success with vaccines, large numbers of people have forgotten how important they were, and become antivaccers. Result: a resurgence of various vaccine-preventable diseases.

People are currently rumour-mongering that COVID-19 isn't much of a threat, because it hasn't killed "that many people" and "it all piddled out in China, so what's the fuss?" But without China's excellent suppression of the virus, it would have killed many more people by now. More healthcare services would be overwhelmed, and patients would be dying without treatment.

China's success has not been capitalised upon. They were slow, themselves, but that is no excuse for the rest of the world to be so too. COVID-19 has blossomed in the USA and Europe, where there are most travellers (for business or leisure) who've taken the virus home. Having had weeks of observation of the spread in China, European countries and the USA (and Australia too) should have gone into the 'Delay' (quarantine and social isolation) phase much quicker.

They didn't need to wait for test results - diseases behaving like this is not a new phenomenon. As i said - people are bad at judging risk and hazard, and so it is with disease. Governments just don't realise that they have to be prompt, and so the opportunity to prevent cases has passed them by.

{General point: In much of life, promptness is necessary. When a crime has been committed, be prompt, so the evidence doesn't go away. If you've been raped, present evidence promptly, because it won't be available for long. Sometimes, you HAVE to be quick. Leave it too long, and the cancer will reach stage 3, the rape will be unidentifiable as having happened, the fingerprints will have been smudged over, and the disease will have spread so far as to provide more patients than your healthcare system can cope with.}

We have no idea how big this is going to become. We have no idea how many people are going to die. If 80% of people in the world get it, and only 0.8% of them die, it will kill as many people as WWII. If its deadliness rises above 3%, due to healthcare systems becoming overwhelmed, or any other cause, it will kill more than 4 times as many people as WWII.£


Go back to the top of this article, to make sure you're doing what you can to slow its spread.


What that graph might have looked like, if everybody were strictly hygienic all the time:
 


In better news, at least you have an internet connection. Dr Hope's vlogs are keeping me in-the-know; partly about the situation in the UK, but mostly about how the medical people are adapting to it. There will be costs to patients with other conditions, but it's good to see that the kids at the NHS know what they're doing.

17/03/20 onward 'Covid-19 UK DOCTOR VLOG' - Dr Hope's Sick Notes [link: YT playlist]

£See tile five 'How Contagious & Deadly Is It?' for why i picked those numbers to calculate with. The population of the world is 7.8 billion, and WWII killed 50 million people. [link: a brilliant infographic, with lots of extra stats on]
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Monday 9 December 2019

We Need To Talk About Mary Sue

Date started: 08/12/19                 Date completed: 08/12/19                 Date first published: 08/12/19


I'm going to start with a rundown of who Mary Sue is, to give you context:

An observation was made, that Star Trek fan-fiction often featured unrealistically and story-ruiningly over-competent characters. The observer then made a parody of this fan-fic malaise, calling their main character Mary Sue - a 15.5 year old heroine that left all of the Star Trek protagonists in the shade.

And that's Mary Sue - a character that is, to put it in two words of unsurpassable succinctness - nauseatingly wonderful.

You might wonder what's wrong with a character being wonderful. Isn't that the point of a hero/heroine? That they're so wonderful that they save the day, and get the girl, and so on and on and on... Well, no. It isn't. Close, but no vaping pen.


What makes strong characters are not their strengths, but their weaknesses. A strong person in real life always makes the right choices, resists any corrupting temptations, and is so staggeringly vanilla that their only possible reward can be to have a library named after them when they're dead. This person in real life has a strong character, but in fiction, they have a weak character, because they're so boring. Even reading about them, you're probably having an attack of Vyvyan Basterd Syndrome, shouting "I'M BORED" at the nearest wall.

In order to make a fictional person interesting, you have to strengthen their character by giving them traits that, in a real person, would weaken their character. This is why the greatest characters in fiction, are the ones you'd least like to meet. Vyvyan Basterd, for example. Hannibal Lecter. The Sherriff Of Nottingham. Arnold Rimmer. James Bond. Even Lord Flashheart, who's depicted as a kind of Mary Sue within Blackadder's fiction, is the kind of guy you'd have nailed to the wall with a rolling pin within two minutes of his entrance to the room, because he'd be that UNBEARABLE.


All of this has led to the term 'Mary Sue' being used as an insult toward painfully over-competent characters in fictional works. Especially painfully over-competent female characters in fictional works, with alternatives like 'Marty Stu' being used for male characters. Inevitably, it has sometimes been used wrongly. Female supremacists are a population who can easily be relied upon to use words wrongly. Generations of them have strived to change the world, by writing stories about the world that aren't true. And as a result, the term 'Mary Sue' has become the subject of feminist hatred. Well, if they will keep putting Mary Sues in their stories, people will keep deriding them for putting Mary Sues in their stories, won't they. But they don't seem to understand that. Armed with deliberately-encouraged misunderstandings of the term, however, they've actually had success at persuading people to treat the term 'Mary Sue' as taboo.

Most recently, and most certainly receiving the ire of feminists, the name Mary Sue has been applied to the character of Rey, in the latest Star Wars cashgrab trilogy. She appears out of the desert, with unsurprisingly deserty skills, but then she's revealed to know how to wield a lightsaber, without ever having been shown which is the pointy end (and let's face it, that's a 50/50 chance of the trilogy ending in part one) and that they can use the Force without ever encountering it before, and can even employ Jedi mind tricks, and so on and on and on. Her character arc is basically this: random kid becomes most powerful wizard in the galaxy in one hour of movie. If she's not a Mary Sue, then i'm a dinosaur.

We must be clear, given the deliberate misunderstandings that frequently happen, that it does not matter whether a character 'has a backstory' (translation: excuse) for being nauseatingly wonderful, or whether another character in the same story is also nauseatingly wonderful. If a character fulfils the definition of being nauseatingly wonderful, then they are a Mary Sue. QED.


However...

Don't make the assumption that the use of Mary Sue characters is always bad. The story in which this kind of character's name originated, was a very short, but very amusing story, in parodying its now-eponymous phenomenon. And i can actually give an example of a really good story that deliberately employs a Mary Sue for entertainment's sake, and does it well. I've already mentioned Arnold Rimmer, and it's their fictional universe that we're going to now.

In one episode of Red Dwarf (Dimension Jump) a Mary Sue character jumps from one dimension to another, where they bump (quite literally) into the crew of Red Dwarf, aboard Starbug. Who are they? Ace Rimmer - a character deliberately made to be brilliant, like a hero of comic strip proportions, so that they would contrast with the 'normal' Rimmer. If you can call Arnold Rimmer 'normal' without wincing.

Arnold Rimmer, Rimmsy, Big Arn, or Duke, as he is never known, is a "gutless, spineless, gormless, directionless, neurotic, underachieving, snivelling, cowardly pile of smeg". And that's a description provided by his best friend in the whole universe! He's pompous, he's anally retentive, and is, in the words of Kryten, who cannot lie: "an overzealous, trumped up little squirt, and an incompetent vending machine repairman with a Napoloen Complex, who commanded as much respect and affection from his fellow crew members as Long John Silver's parrot".

The whole point of Ace Rimmer, was to provide as sharp a contrast to Arnold Rimmer as possible. In the context of the story, their extremity of wonderfulness was what made them so fantastically funny. As a regular character, they would be awful. As a serious character, they would be awful. But Mary Sue finds herself a place, in that episode of Red Dwarf, because characters as cartoon as her are apt material in an outright comedy. And let's face it - Star Wars just isn't that funny.



This mini-essay, suprisingly, was inspired by Thunderf00t. Not surprising on its own, but if you know Tf, you'll understand what was surprising about it.

P.S. The title is a reference to 'We Need To Talk About Kevin'. We didn't really need to talk about Mary Sue, but i hope you found it interesting and/or amusing anway :-D
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Sunday 9 June 2019

Are You Smarter Than Dr Hope? Online Medical Quiz | CORRECTED

Date started: some time in July 2018       Date completed: about July 2018       Date first published: 08/06/19


Hello folks. I'm back, and i'm doing it again.
[link: last time i did it] Here's an advert for the lovely Doctor Ed Hope [link: YT video] this time - the original Dr Mike, and with less of an ego.

I'm going through the quiz and adding interesting information (including the right answers) with the huge advantage of IN
FINITE TIME. But this one's different. This one's correcting the quiz - not the quizzed.

The video was published back in July 2018, and i wrote most of this soon after. So yes, this is one of those posts that sat around for ages before being finished off. Sorry if that bothers you :D


1) Which of the following was not included in the original Hippocratic Oath?

As Dr Hope points out, Germ Theory did not exist when the HO was written, so they could not have known about all the microbiota - all the creepy-crawlies - that lurk in water, and on surfaces, and so on. [link: pond scum] Germ Theory is one of the exceptions that i get to point at, as a trend-bucker of the 19th century. That time period hosted the ideation of a panoply of superstitions - many of them pseudo-medical. Homeopathic fraud, chiropractic, reflexology, palmistry, hypnosis, spiritism and spiritualism, and so on. Germ Theory FTW :-D

2) What tree does Aspirin come from?

Here, the answers are all wrong. And this is the trouble with multiple choice - getting your choice right doesn't necessarily mean getting the answer right. If the right answer isn't there, you can't select it.

You can't get aspirin from ash, beech, oak or willow, because aspirin is a synthetic chemical invented (at least) twice: in Germany, and then in England. Why twice? Not by accident - all stocks were previously imported from Germany, but then a world war happened, so a lab in Nottingham [link: Nottingham] had to reinvent it. Aspirin is a chemical derivative of salycylic acid, called acetylsalicylic acid, which means various chemicals were attempted, and none of them had a desirous effect, until SA-plus-an-acetyl-group: Aspirin.

Why bother developing it? Because the desired effect - analgesia (painkilling) - is not a property of salycylic acid. [link: SA's effects] SA is, however, a mild anti-inflammatory (Aspirin is too) and a mild emetic. So you can chew on willow bark all day long, and it'll only make you sick - it won't make your pain go away.

3) What condition was the drug Viagra originally developed to treat?

The answer is right, but this is an interesting and easily-misunderstood subject. Sildenafil's effect [link: sildenafil] (Viagra's a brand name, like Aspirin) is to widen blood vessels, which includes the vessels in the penis. And yet... erections are not achieved by widening blood vessels. Counterintuitive, huh? What makes erections happen, is restriction of blood flow out of the penis. This is how men don't get faint, trying to pump huge amounts of blood into their phalluses, like pouring water into a leaky bucket. And it's also how men don't have obvious boners, when they're taking sildenafil for high blood pressure!

Without arousal, blood leaving the penis is not restricted, and so an erection can't happen. So if you get aroused by taking Viagra, that's actually a placebic effect. It's purely psychological.

Incidentally, arousal and blood flow are mildly connected, as the sensitive tissues in the genitals are made more sensitive by increasing bloodflow through them. This means that there's no reason to think women couldn't benefit from mildly increased arousal, if they took viagra too.

4) What is the recommended maximum daily level of salt intake in grams?

This is another question that isn't really about medicine. The first was history, the second was chemistry, the third was, well, history again, and this one's about... law? Recommendations, of course, vary around the world. As i've said before, on this blog, recommended fruit intake varies according to how much the local medical organisation thinks it can persuade the local people to eat. [link: fruit] So in some places it's 10-12 pieces per day, and in Scotland it's 3 pieces per day. 4, 6, 8, and 11 grams of salt, could all be the right answer somewhere in the world. In the UK, it's 4 for women, and 6 for men.

The reasoning for advising reduced salt intake, is that sodium damages the cardiovascular system, especially the heart. And because salt (table salt) is made of sodium chloride, it's a plentiful supplier of sodium. So, as per usual, the bigger your body the more diluted it will become, and the smaller you are, the less sodium you should consume, if you want to maintain a healthy heart. Salt is often added to pre-made food to compensate for the loss of flavour compared to freshly-made food. The second biggest source of sodium is in baking soda (bicarb/sodium carbonate) so you might find it worthwhile to peruse cake packets too.

5) Why does the room start to spin when you've had too much drink?

Easy: you're spinning. Next?

Oh, that's not an option. They say the true answer is that the density of the fluid in the inner ear drops, causing it to misjudge motion. The first thought in my mind is: what difference would density make? It's the feeling of fluid on the cilia, in the ear, from which the sensation of motion comes. Maybe if alcohol were less viscous, though? If the Vestibular Disorders Association is to be believed, then the effect is real, but it's more likely to be the "composition" of the endolymph (inner ear fluid) that produces the effect, which would mean its viscosity rather than "density" that matters. [link: VDA]

Secondarily, one of the 'wrong' answers was that the alcohol causes regions of your brain to "short circuit". Well, ethanol (the kind of alcohol that gets called 'alcohol' when it's in drinks) is a psychoactive drug - it has a debilitating effect on mental function. People lose physical control of their bodies, their reaction times are worsened, and they lose track of what they're doing. Under these conditions, the term 'short circuit' would have to be idiomatic, but true.

So is the room spinning because you're dizzy? Or is it because you're spinning, due to ethanol-caused loss of motor control? Discuss [10 marks]

6) How long does an average, healthy, red blood cell live for?

Erythrocytes (red blood cells) [link: RBCs] can not reproduce on their own. This factor discounts viruses from being classed as 'alive' in the minds of most biologists. Except viruses have DNA, whereas erythrocytes don't. That's another factor that discounts things from being classed as 'alive' in the minds of most biologists. So are viruses more alive than red blood cells? Discuss [20 marks]

It's preferential to refer to individual cells, and viral particles, as 'denaturing' rather than 'dying' because of this classification. If you were never alive, how could you die? But on the subject of erythrocytic longevity, i've seen a broad range of estimates for how many of them are made and disposed of, every day - orders of magnitude, in fact. And people don't vary in size by that much! Wiki goes with 200 billion per day. So if that figure varies so widely, how reliable can this estimate of RBC 'life' be? [link: estimates of life length]

7) What is the common name for the vitamin B3?

Well, i can't argue with this, can i. The question clearly states "the common name" and then lists some rather uncommon names for B4, B6, B2 and B1 respectively. What could i possibly have to comment on, here? Other than this: don't mix up thiamine
[link] and thymine [link]. It's too easy to do :-P

8) Where is the patella bone situated?

Dr Hope jokes, but if you kneed yourself in the head during gymnastics practice, then he wouldn't actually be wrong :-D

9) What is the least common form of skin cancer?

Well, the answer to this one's obvious*, but i'd just like to point out that melanomas are usually very aggressive tumours, in which melanocytes have gone rogue. But you're no more likely to get them** if you have dark skin than pale, because 'melanic' skin doesn't contain any more melanocytes than pale skin. The melanocytes in dark skin actually work harder, to produce more of the same two forms of melanin - eumelanin and pheomelanin - that exhibit brown and red colours respectively.
[link: melanin]

I'd also like to point out that these same pigments colourise hair aswell as skin, so blondes are really just pale brown. Pinky skin is produced by the same pheomelanin that makes people's hair ginger or strawberry blonde. So if you've got ginger genes, your hair might not be red, but you might have a red mole or two, and you might have pinkish palms or nipples, where it's common for pigment to collect. People around the world have these genes, without realising it, as it's only in pale-skinned people that ginger genes are really obvious - eumelanin easily drowns pheomelanin out, when it comes to colouration. [link]

*sarcasm
**based on evidence available at time of writing

10) What part of the body does an otolaryngologist specialised in?

Is this question supposed to be hard for physicians? Or is this one supposed to compensate for the non-medical nature of the first four questions?

11) Which dangerous infectious disease has been 'extinct in the wild' since the late 1970's?

Well, sidestepping the egregious greengrocer's'' apostrophe' for a second [shakes fist] let's just question that "in the wild" clause. Smallpox has genuinely been eradicated from the world, beyond a laboratory somewhere on Earth, and some people are paranoid about it getting out. Personally, i think they've been made paranoid by smoking cannabis, because it's not that hard to control a smallpox sample. When you consider what could be learned from it, with currently-mid-development techniques, the potential benefits clearly outweigh the potential costs. Smallpox did not mean certain death when it was 'in the wild' before, and it wouldn't if it escaped in one person, in the future.

Another incidental: smallpox is small, because syphilis was the large pox. When Europeans migrated to the Americas, they swapped smallpox for syphilis. The latter is still among us. As are diphtheria, when it's spelled correctly [shakes fist a second time], leprosy, and tuberculosis.

12) Which of the following diseases is not hereditary or genetic?

This question is self-defeating. Hereditary means passed from parent to offspring. By whatever mechanism. That can include pathogens like HIV (transmitted in the womb) or the Epstein-Barr Virus, which causes Glandular Fever (transmitted from mother to child in saliva, because they can't stop kissing them) and which also causes mononucleosis. And that's supposed to be the right answer. If they'd left "hereditary or" out of the question, then it would have been the right answer. Sorry, Dr Hope, but parents do give their kids mono. Like with leprosy, chance of transmission is actually low, so extensive exposure to saliva in a domestic parent-baby context is actually one of the most potent mechanisms of transmission. [link: E-BV]

13) What is the definition of congestive heart failure?

There's an anecdote about perpetually-overweight comedian and actor Fred Emney, who was probably least well known (while alive) for playing that guy in The Italian Job who put interruptors in bins under traffic lights pre-heist. [link: Fred Emney] [link: Italian Job scene] The anecdote goes that he complained of putting on weight if he went uphill. In a TIJ documentary from a decade-or-so ago, members of the production crew attested to this. They went up into the Italian Alps for filming, and soon he had to take his shoes off, and then his socks, and then he ran out of room in his trousers.

This is almost certainly the result of heart failure, in which his heart was incapable of pushing his blood around his body, and so oedema occurred (fluid collection) starting in his lower body. This gave the impression that he was putting on weight. The solution: go downhill, where air pressure is higher, the partial pressure of oxygen is higher, and therefore the heart is more able to do its job of pumping blood.

14) Which of the following anxiety disorders is a fear of failure?

The longest one. Apparently.

15) Which of the following discoveries happened most recently?

This is actually a medically salient question. It's part of the job remit of a medical doctor to keep on top of research, in order to inform their decisions about what interventions to employ or to advise to their patients. This means it's useful to know how long a product's been on the market, or how long an operation's been performed, as time is proportional to experience, and experience is proportional to reliability. Something that's only been done since summer last year is less reliable, as an intervention, than something that's proved its worth over many decades.

This applies to drugs and to surgery, as familiarity with rare effects of pharmaceuticals won't come until they've been widely used, and surgeons become better at surgical procedures with practice. A new procedure will not look as safe, in the stats, as it will after years of practice, making new procedures look worse in comparison than they really are.

In practice, it's not effective for doctors to do all of this research-poring themselves, which is where epidemiology comes in.***

16) What is referred to in the term 'good' cholesterol?

Here's one of those famous proxy values (or 'surrogates', as they're called in medicine) that are used as substitutes for things that actually matter. The argument in favour of lowering 'bad' cholesterol, or even raising 'good' cholesterol, is that they're associated with heart problems and conditions that are associated with heart problems. [link: surrogates]

But are things like cholesterol, blood pressure, and body temperature, causes of harm, or barometers of it? Fevers are popularly assumed to be consequences of infection, but they are actually beneficial, and deliberately made by the body, because they increase the effectiveness of the lymph nodes, thereby improving the body's defences against pathogenic invasion. If you've only got a cold, however, you don't really need the fever, so taking a paracetamol is probably the wiser thing to do.

Blood pressure goes up and down like a yo-yo as you get up and run around, and then sit down and relax. Doxazosin has been shown to cause heart attacks and strokes, even though it was prescribed to reduce blood pressure. And cholesterol? Well, your body makes it if you don't have enough. So even if fake butter did work, would it help you? You're much better off pursuing a lifestyle intervention that causes your cholesterol to change along with other things: sure, eat less fat and red meat, but also get more exercise, and avoid smoke, alcohol, and major stresses.

The concept of 'good' cholesterol is a medically mysterious one, so how can it really be used in a helpful way, when trying to communicate health problems to the public? Discuss [1 mark]

17) Gout is a form of which illness?

This was a really good explanation of gout, by Dr Hope. Dr Ed? Are we on first-name terms yet? If you've been reading my article through without watching the video, then go back to the top of the article and click the link. Second thoughts: here it is again. [link: YT video] Now you won't lose your place :o)

18) How many people have been estimated to have died from AIDS since it was first recognised in 1981 to January 2006?

Fun fact: AIDS doesn't exist. Unfun fact: HIV does. The 'S' in 'AIDS' stands for 'syndrome' and a syndrome is a bunch of symptoms that consistently occur together, but have no known common cause. Like Gay Bowel Syndrome. [link: GBS] The observation was made that MSMs (men who have sex with men) exhibited much higher frequencies of genito-rectal infections and cancers than men who didn't (viruses can turn cells into tumours, which is how the cervical cancer vaccine is a thing that works) and so this syndrome was named. [link: cervical cancer vaccine]

With the increased use of contraception, and the curtailing of HIV, Gay Rectum Syndrome has gone away, and is now regarded as obsolete.
As soon as HIV was proved to be causing the symptoms defined by AIDS, the name 'AIDS' became obsolete too. Anti-HIV campaigners continue to refer to 'AIDS' or 'HIV-AIDS' simply because they don't want to fail people who aren't aware that 'HIV' is the initialism they should be looking out for.

Aside: it's rather irritating that genetic conditions are often referred to as being syndromes, even though their cause has been known for a very long time. Down, or Down's, for example, is still referred to as Down/Down's syndrome, even though the cause has been known to be a whole or partial duplicate
of the 21st chromosome since the 50s. Rather confusing, huh? [link: Down history]

19) What effect does the hormone oxytocin have?

An interesting answer. Most people think of oxytocin as the 'cuddle chemical' for its supposed effect in making people really caring, after the birth of a baby. The endocrine function is not something i'm going to argue with, but the behavioural effects are certainly quibblable. Other research has found that oxytocin makes people more spiteful, which conflicts with the finding of increased affection. The most logical conclusion is that really it's a 'factionalism chemical' rather than a simple 'cuddle chemical' with those experiencing a large blast of it internally, in turn subjecting anyone they're fond of to large doses of affection, while excoriating anybody deemed to be 'an outsider'. [link: effects]

20) Whose was quoted as saying "Hospitals are only an intermediate stage of civilization"?

Setting aside the bads grammars, it's clearly always the longest answer. Silly Ed. Ed? {Ed: Ed}

And that was the end of the quiz. How did you do?




*** Ben Goldacre mentions doctors reading studies in this talk. They really shouldn't be the ones bearing the burden of all that work. The task should be deferred to epidemiologists and done properly. In fact, it's not possible for GPs to read all of the salient medical literature, because their domain is so broad that it would take more hours than there are in a day, to keep up to date on it all!

'Dr Ben Goldacre: RCGP AC 2018'
https://youtu.be/MJppm_h0a9Y

Ben Goldacre's fantastic, so here's another link to something he's done, too:

'Guest Keynote: Challenging Status Quo'

https://youtu.be/7RGqY8YirNo

And here's that web-site he mentioned. I've looked up my local surgery, and i have to say [adopts smug expression] they're doing pretty well :-D

https://openprescribing.net/
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