Lots of people are sneezing around here.
I never noticed an inordinately large number of sick people when I lived in Nebraska. Maybe the state's health declined sharply as a result of my moving away.
Anyway, Nebraska really isn't very poor, compared to Appalachia.
Dunno why Illinois should be lighter than surrounding states, or Wisconsin lighter still. I'm stumped.
Is there any coherent argument by anyone of any political persuasion anywhere that justifies the continued widespread use of antibiotics in livestock production? How fucking stupid are we, really? Jesus Christ, people.
Since I get 600 TV channels, I've sometimes watched the show Cattlemen to Cattlement on the "RFD-TV" (rural America) network. From that show, it seems like 98% of the concern of cattle-raisers is that their herds will die of disease, thus reducing their yield. It's pretty much all about medicines for cows.
Look on the bright side! A couple good strong pandemics could reduce global carbon output!
The answer to 5 is "twice as stupid as you think we are", where "as stupid as you think we are" takes into account the fact that you have to double it.
-t. "Cattlemen 2 Cattlemen" would also be an excellent niche gay porn/racially questionable 90s r&b parody cover group.
I mean this is what they list as their concerns:
NCBA's Cattlemen to Cattlemen provides viewers with a variety of weekly segments focusing on producer education. Topics have included herd health, low-stress cattle handling, reproductive management, mineral nutrition, nuisance and horn flies and new beef products.
All of those except "new beef products" are really about herd health in one way or another, and Pfizer will happily sell products to deal with all of them.
Poor people can't afford multiple visits or lab tests so they get a prescription just in case to minimize follow-up?
13 is a very disappointing response.
Does RFD still have a show Trains and Locamotives? When we had DirectTV I watched and recorded that show, and developed a passion for certain documentarians. We've had cable now, without RFD for years.
I don't know. I watched Classic Tractor Fever once but didn't catch the fever for classic tractors.
What annoys me, all out of proportion to its actual importance, is how for years we've heard about this as a problem of pushy moms and pushover doctors prescribing antibiotics for every little viral illness that comes along, and so we have lots of dutiful moms not asking for antibiotics, and lots of dutiful doctors not prescribing them, and it's going to mean fuckall when someone's kid gets resistant E. coli because we needed to treat cows inhumanely.
That map looks a lot like the obesity and smoking maps, so I'm moderately skeptical that it represents greater misprescription in certain places. I suspect that it simply represents places with generally poorer health.
Have you felt that pressure yourself? Inhibited or feeling that doctors were in prescribing antibiotics?
Nature had supplement (I think sponsored) on antibiotic resistance last year, I liked the article about phage treatments.
Obviously, massive antibiotic dosing of food animals is horrible, should be stopped. But the sky isn't falling-- treating animals this way accelerates the spread of new strains, but there is resistance to all kinds of stuff present in soil bacteria somewhere. The other significant place where horrible new strains spread is within hospitals.
Lincoln really does look much more healthy than Pittsburgh.
21.last: So spending lots of time in a Nebraska hospital is especially risky? Asking for a friend.
Is the rate of infectious disease really twice in some states what it is in others? I can't find data on the subject but I doubt it.
Isn't some huge fraction of the agricultural use for bulking up more than for actual disease treatment?
23. Don't know, sorry. But I do not recall any especially horrible MRSA stories from rural places. The CDC monitors the problem. I believe that the new resistances found in food animal infections (mostly pigs, for which there's been regulatory progress in the US) are different from those in hospitals.
Good luck to your friend.
Nature had supplement (I think sponsored) on antibiotic resistance last year,
Supplements are usually not especially healthy, either.
20: Fortunately, no, because the Calabat is unusually healthy (to be honest none of us are terribly susceptible to bacterial infections -- most stuff gets better on its own.)
I thought we established that any place that doesn't freeze is going to have all sorts of weird bugs and diseases. Much as I esteem Abe Lincoln, he really should have nuked the South when he had a chance.
Yeah, pretty much every public health map shows a bolus of red in a roughly 500 mile radius surrounding Tupelo, MS.
31: are you saying Elvis is the problem?
21 - It really is time to start banning cows from hospitals.
General Sherman, the last true liberal.
From 28 & 30, I conclude that people in cold mountainous regions only screw people very close to them, since going outside during the boring months can be so unpleasant.
Low stress cattle herding could be kind of cool. Temple Grandin is an autistic woman who made a career out of trying to reduce cattle stress.
My understanding from Cattleman to Cattleman is that beef cattle pretty much have to be low-stressed, or else the meat gets either super tough or has a super low shelf life. So there are drugs for that for the cows which ... I dunno, maybe the cows are high all the time? Low-stress cattle handling (i..e, low stress for the cow) means MOAR YIELD which is what the Cattleman likes.
The cows aren't high. I know this because I was once at a party where a guy tried to give potato chips to the cows. They refused.
I don't know about how stress is related to yield. I don't think it is as big of a deal for cows as it is for chickens and pigs. I think that as a good general rule, if you have thousands of things that are autonomous and weight 1,000 pounds and up, you really appreciate anything that keeps them calm for reasons of self-preservation.
Doing some quick googling, I guess they don't really give the cows stress drugs to keep them high all the time, but they do give them drugs when they do things that are painful to them to reduce "stress." Here's a guide. Don't yell at cows! Remove extra back steps from your "squeeze chutes"! Don't do too much electric prodding!
The other thing you can do other than giving your cattle heaps of drugs is to accept that your stock density is too high and dial back the super intensive agriculture (which does, admittedly, mean more expensive meat.)
I get fifty cents from Beef & Lamb NZ every time I make a smug comment about NZ agriculture on the internet.
Fifty regular cents or New Zealand cents?
Fake cents but I can buy cheap high quality milk, cheese, beef, lamb, apples, honey and other fine agricultural products with them.
Where do you buy your smug? Or are there just massive naturally occurring fountains of it down there in Middle Earth?
If you need any high fructose corn syrup, let me know.
I think in New Zealand it's spelled "Smaug".
Really you just put enough gold in one place and it shows up.
Oak Island's treasure is unreachable.
Polly Myxins is Mister Mxyzptlk's daughter, right?
Don't do too much electric prodding!
Don't whiz on the electric fence!
I know a place where there's gold.
Is it where strange things are done in the midnight sun?
Never really thought of substituting "mohel" in there. Really changes things.
Well, talk up the bacteria links and anti-bacteria links all you want, but I think I'll stick with Jimmy Dean's.
55: Specially cause the way I remember that poem is through the Kingdom of Loathing version, "the dwarves who moil for meat."
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Do you ever worry that words don't have any meaning or maybe once had meaning, but lost it?
Sometimes I lecture to my classes. I try not to do that for more than a third of the time. And sometimes I get the sense that what I'm saying makes no sense to them. And then I worry that it makes no sense to me.
I mean, maybe I'm just standing there waving my arms saying "FLEEM FLEEM FLOME FLUME" and they all write down either "FLEEM" "FLOME" or "FLUME" and hope that one of those words are on the test, and then I've suddenly thought that FLEEM FLOME and FLUME aren't really what the students of American need so I start saying FLIBBITY FLIBBITY FLIBBITY.
And then they don't know what to write down at all, because really they are just thinking that I have a magic wand that I can wave over their heads and they will become MIDDLE CLASS. But really they know I can only transform them from POOR to MIDDLE CLASS if they GIVE IT THEIR ALL. Or maybe I'm not the teacher with the MAGIC WAND OF MAKING PEOPLE MIDDLE CLASS but some other teacher who REALLY BELIEVES IN THEM is.
But here's the thing, none of us have power over anything. We are just saying FaKOOM FaKOOM fmeep. FMEEP. Fa-ding fa-ding fa-doom.
Ok, I feel this way often, and normally I just sing Hey Nonny Nonny until I get bored and wind up using regular words again. But right now I think nothing exists and if it did exist we wouldn't be able to know it and if we were able to know it, we wouldn't be able to tell it to anyone else.
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Hadn't heard of KoL before. Fascinating.
58: Have you considered taking up welding?
Whizzing on an electric fence is a very good way to confirm there's more than nothingness.
Speaking of bacteria, I thought this was a good opinion piece about TB. And that's not just because the author is my youngest sibling.
Not in the piece, but turns out TB infections aren't isolated to the lungs. Bone, skin, etc. Fascinating but also Ugh.
Dormandy's The White Death is excellent on TB, but of course everyone who read Jane Eyre knows about TB not being confined to the lungs, and Sophie Hardenberg's cruel death in The Blue Flower (and in real life) ...
Also cows are very social creatures (typique for a herd animal, not even rocket science folks), I once know a retired Wisconsin dairy executive who spent his retirement properly taking care of twenty or so Swiss Brown Cows and it made him so happy to provide them with the circumstances to have a healthy, functioning herd. He made really super delicious cheese with their milk.
What makes you think he knew the cows existed?
Is it where strange things are done in the midnight sun?
It is a place meeting that description, but not quite the same one as in the poem. I was there today and (as people who know me at The Other Place will have seen) entered a $1 raffle in which three of the prizes were an ounce of gold, which as one of the comments there noted is currently worth over $1000. Other prizes were a snowmobile and 100 gallons of fuel oil.
68 Are there no rifles raffled? How do you protect yourself from rampaging polar bears?
I was actually surprised to see no guns on the list. Maybe no one had any to spare.
And, yes, that is how people protect themselves from polar bears, which, yes, is an actual issue. (Less so in this particular community than in others further north, but it is within their range.)
Has anyone made snowmobile technicals yet? I want to see one with an 84mm Carl Gustav recoilless rifle mounted on the back. Polar bears better watch the fuck out.
I wouldn't be surprised if someone had, but at least in Alaska they would be illegal for hunting, and we don't have much in the way of civil wars. Regular guns work fine in the rare cases of need for protection against polar bears.
Barry is clearly thinking of a cold-weather variant of the French Airborne Forces Anti-Tank Recoilless Rifle Scooter.
https://en.wikipedia.org/wiki/Vespa_150_TAP
A close equivalent might be the Red Army Propeller-Driven Machine-Gun Sled.
https://en.wikipedia.org/wiki/RF-8
The map in the OP is extremely worrying, but I don't understand how it's possible for qualified physicians to prescribe more courses of antibiotics in a year than there are people. I mean. let's suppose a significant number of people don't see a doctor about an illness in any given year, that leaves a ton of people getting ABs twice a fucking year! Can't the AMA step in and name and shame or something?
If you're addicted to anxiety attacks about microbiological stuff, the best way yo feed your habit is to follow Maryn McKenna's blog in the Nat Geo.
That Vespa thing look like something somebody would dream up in the pub after the fourth pint. Were they ever used in anger?
76: surely no one could ever be truly angry who possessed an anti-tank scooter?
Probably as well the Mods didn't know about them during their rumbles with the greasers in 1964.
I need that Vespa for anti-Land Cruiser duty in Arrakis traffic.
74.2 Where do I park my aerosan? Why right next to my ekranolan, of course!
Speaking of ekranoplans, I went to some big yacht show here with a fellow compatriot cow orker last weekend and tried to sell him on the idea that we should buy up old Soviet ekranoplans to refurbish and then sell on the Arrakis market.
62: I can't believe I missed this thread! I did read your sister's article, though, and I agree she's great. TB meningitis is very common in children and easily missed because it presents differently. Also, culturable bacteria are found in spleen and liver. However, TB is exceedingly rare in the US, about 12 K cases a year, 6K from recent (less than 2 years) immigrants. Worldwide, 2 billion people have "latent" disease (not contagious), approximately 10% of whom will develop active disease.
Re: antibiotic overprescription overlapping with poverty, there's also the possibility that people are more likely to pick up secondary bacterial infections after getting a virus if they can't rest and recover or are in poorer health generally (smoking, obesity).
Re: cattle, I think in Omnivore's Dilemma, there's another explanation for cattle antibiotics. Apparently feeding cattle grain ("finishing") artificially raises (or lowers) pH in the GI tracts, meaning that maturally occurring gut bacteria can move into areas there not supposed to and overgrow (think intestines to stomach and also remember cows are ruminants), causing illness. So it's not just crowding increasing transmission of contagious disease, it's also how cattle are fed to maximize weight that can cause problems requiring antibiotics.
82.3. Thanks for that explanation. I knew it had something to do with making factory farmed cattle put on weight artificially quickly, but I had no idea what the actual deal was. I've seen claims that ABs make the cattle gain weight directly, but that always seemed improbable.
83: You're welcome. And how on earth did I get the wrong they're? Shameful! Or autocorrected. Mine seems to hate contractions.
A cousin of my mother's had TB in one testicle. Family lore has it that after being unwell for some time with no diagnosis, his life was saved when my grandfather brought him to see a doctor he knew. This guy had been a British army doctor and had a different idea of a full examination than previous doctors. (Previous doctors may have been further inhibited by the patient's being a clerical student.)
Happy ending - ball removed AFIAK, clerical authorities decline to let him proceed, later marries & has 4 kids.
emir joins the Club Of Commenters With Lower-Case User Names And Bizarre Barely-Credible Family Stories. alameida and I welcome you.
Ball-TB is my new greatest fear. But, still I have yet to catch an antibiotic resistant infection. As far as I can tell.
Have you tried thinking of it as Ball-consumption? That could make it less scary sounding.
Chewbacca already cured my fear of that.
76: An anonymous comment on this blog by someone claiming to own one says they talked to a veteran who used one in Algeria, and learned (a) the gun had to be removed from the scooter and set up on a tripod to be fired and (b) it had trouble making its way over the sand fully laden.
90: they were in service with the French airborne in the 50s and early 60s so it's certainly possible.
It hardly counts if you have to remove the gun. That's just a Vespa with a luggage rack.
I was on vancomycin for about a week for what they thought was a nasty antibiotic resistant surgical infection. Luckily it turned out it was susceptible to one of the penicillins, which meant I only had a _bit_ of massively painful thrombophlebitis and collapsed veins in both arms.
https://en.wikipedia.org/wiki/Vancomycin#Side_effects
I mean. let's suppose a significant number of people don't see a doctor about an illness in any given year, that leaves a ton of people getting ABs twice a fucking year! Can't the AMA step in and name and shame or something?
Eh, utilization is really skewed across the population as a matter of course. You could get a similar result with 40% of the population getting an antibiotic once a year, and 10% getting one 6 times a year. Not that that's necessarily the right level, but the very sick people are bound to bring up the average a lot.
90,92 Traffic is so bad here I'd still consider using one for anti-Land Cruiser ops.
the idea that we should buy up old Soviet ekranoplans to refurbish and then sell on the Arrakis market.
The sweet spot for resurrecting the ekranoplan, target market wise, has to be "more money than sense" crossed with "lives in a very big flat empty country" and by george I think you've found it.
94 - There could also be a bunch of "Ok that antibiotic didn't work so let's try this different one" fitting into the multiple prescriptions as well.
96. I suspect these people will grab that market.
97 is completely right. If someone is diagnosed with a bacterial infection, they start by prescribing a broad-spectrum drug (often includes two drugs combined), then after they get more info about what type of bacteria it is, they prescribe something more specific (for MRSA, this means vancomycin). And then if the infection persists for a couple weeks or more, they have to switch to some other antibiotic, etc. If you see something like daptomycin or linezolid, it's almost sure to be the 3rd or 4th antibiotic that was prescribed to that patient recently. If you see colistin, it's probably a last gasp attempt to save someone's life.
Meanwhile according to the linked story, "Worldwide, the demand for colistin in agriculture is expected to reach almost 12000 tonnes per year by the end of 2015, rising to 16500 tonnes by 2021". That was shocking to me.
Cases where there was only 1 antibiotic prescription are going to include the vast majority of useless prescriptions (useless meaning there was no bacterial disease in the first place).
Surely for Arrakis the perfect runabout is an ekranoplan with rocket launchers mounted on each side.
Less interestingly, my mother has had like 14 prescriptions for antibiotics this year, because of recurrent/persistent UTIs. She is prone to them anyway for entirely boring reasons but the real problem is that she has a quasi-sinus infection/reservoir that never really fully clears up despite the ABs and despite saline rinses etc (improved somewhat since she had a procedure on her nose in the summer). The prescriptions are each for about 10 days (the doctor stopped giving her 5 day prescriptions a few years ago because they never worked).
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Young woman I babysat as a kid just got out of neurosurgery. Short term prognosis, very good. Long term, she has a glioma in her brainstem.
And her dad is slightly demented, so I've been looking after him all day; his sweetness of temperament is unchanged but wow, this takes up ones attention.
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According to my friend in a sort of similar situation, it sure is exhausting.
To the OP: We're doomed! Doomed, I say!