Contagious Disease

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U.S. School Closures, Online Learning

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Quotation

  • “Ill-informed optimism is no better than ill-informed gloom.” - Stephanomics Blog

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Carl Coleman say no.  

Working during a pandemic is a supererogatory behavior — i.e., acts that are commendable if done voluntarily, but that go beyond what is expected.  Coleman argues that “…while health care professionals can legitimately be sanctioned for violating voluntarily-assumed employment or contractual agreements, they should not be compelled to assume life-threatening risks based solely on their status as licensed professionals. In place of singling out health care professionals for punitive measures, the Article argues that policy-makers should institute mechanisms to promote volunteerism.”

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Closing public spaces may be a good idea to stop the spread of the flu:

Hong Kong uses technology to fight the spread of disease

  • Ever since the 2003 outbreak of SARS, or severe acute respiratory syndrome, Hong Kong has used infrared scanners to measure the facial temperatures of all arrivals at its airport and at its border crossings with mainland China. Dr. Thomas Tsang, the controller of the Hong Kong government’s Center for Health Protection, said Sunday afternoon at a news conference that any traveler who had passed through a city with laboratory-confirmed cases and who arrived in Hong Kong with a fever and respiratory symptoms would be intercepted by officials and sent to a hospital to await testing. “Until that test is negative, we won’t allow him out,” he said.

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The World Health Organization (WHO) declared Swine Flu to be an international public health emergency.

MÉXICO

La Jornada claims that there swine flu has killed 81 people in México and infected 1324.  The entire country of México has closed schools until May 6th according to La Prensa:

El gobierno federal ordenó la sus­pensión de misas, clases–hasta el 6 de mayo– y todo tipo de eventos abiertos o cerra dos en estadios, teatros, cines, bares y discotecas donde se generen aglomeraciones.

Mexico is also considering shutting down all public transportation.

U.S. and CANADA

According to the New York Times, swine flu has been spreading and risks becoming a pandemic.  In fact, the U.S. has declared a public health emergency.  In the U.S. there have been at least 20 confirmed cases:

SPAIN

After a visit to Mexico, 6 Spaniards have possibly contracted swine flu.

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In Mexico, there has been an outbreak of swine flu which has lead to 20 recorded deaths and likely 40 more.  The newspaper el Universal reports that, the Secretaría de Educación Pública suspended classes in the Distrito Federal and the Estado de México.  This means that in the Mexican capital, 5,201 public schools and 3,965 private schools were cancelled.  

Yet this is not just a Mexican issue.  Swine flu has been found among residents of San Diego and Austin.  Further, after a Canadian citizen contracted swine flu after a visit to Mexico, it was the Canadian government that informed Mexico of the possibility of a swine flu outbreak.

Fortunately, the Mexican government claims it has enough drugs to combat the swine flu outbreak.

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In Bolivia, up to 70% of children in rural areas have Chagas.

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HIV is a huge health issue around the world and especially in sub-Saharan Africa.  Many American NGOs have promoted abstinence programs as a way to prevent the spread of HIV/AIDS.  However, most evidence finds that this approach has been ineffective.

An NBER working paper by Dupas (2009) adds more support that abstinence programs do not work.  In the paper, the author used a

…randomized fi…eld experiment involving 328 primary schools to compare the effects of providing abstinence-only versus detailed HIV risk information on teenage sexual behavior. Half of the schools, randomly selected, received teacher training on the national HIV/AIDS curriculum, which focuses on abstinence until marriage, but does not discuss risk reduction strategies (such as condom use or selection of safer partners). In 71 schools, randomly selected after stratifying by teacher training status, an information campaign provided teenagers with information on the prevalence of HIV disaggregated by age and gender group (the relative risks information campaign).

The authors finds that the abstinence program had no effect on pregnancy rates.  However, the “risk reduction” educational program decreased the probability a girl had started childbearing within a year by 28%.  The decreased pregnancy rates were not, however, due to less frequent sexual activity.  Instead, teenage girls switched their sexual partners from older partners to teenage boys in their age cohort.

This leads to the finding that teenage girls are having the same amount of sex, teenage boys are having more sex, but pregnancies are decreasing.  Why is this?

The author explains that when teenage girls have sex with teenage boys, “…teenage girls report higher rates of condom use, presumably in order to avoid pregnancy with resource-constrained teenagers.”  It is also possible that teenage girls can more easily convince boys of their same age to wear a condom whereas it may be more difficult to convince older men to use a condom.

Thus, we see that these “relative risk” educational programs do not decrease sexual activity on the extensive margin (teenage girls are having the same amount of sex), but do decrease risky behaviors on the intensive margin (more condom use when teenage girls have sex with people of their same age).

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There are now 33 million people living with HIV, including 2 million children. About 2.7 million people became newly infected with the virus each year.   Combating this epidemic is one of the top priorities facing public health workers around the world.

With limited resources, what strategy should be pursued?  As of now, a vaccine for AIDS is years away from viability.  So should resources go towards improving the health of those with AIDS or should funds be used to reduce the incidence of the disease?  

The Economist (“The ideal and the good“) reports on the efforts of Dr. Reuben Granich to treat patients and reduce incidence using the same drugs.  Dr. Granich finds that although first-line antiretroviral drugs (ARVs) do not offer a cure, they are cheap, reduce the symptoms of HIV and reduce the level of the virus in the person to the point where they are unlikely to pass on the virus.  Second-line treatments can be used for the 3% of individuals who do not respond to first-line ARVs.  ”Employing the logic of vaccination using proven drugs may be an idea whose time has come.”

You can support the fight against AIDS by donating to one of these fine organizations:

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