On Tuesday morning, I got a message from my mom saying that my uncle (my dad's beloved younger brother, his best friend through a lifetime of family tragedies and losses) had had a heart attack and pulmonary emboli, wasn't expected to survive, and was on life support until family could arrive. He had been just about the healthiest person in our extended family before this -- lifelong athlete, daily long walks with dogs, etc. -- but had gone through major surgery a week earlier. They were frantically trying to get my dad a plane ticket from Wisconsin to San Diego in the middle of a bunch of storms that lasted all week and fucked up travel for everyone, but I could, and did, jump on a flight within a few hours and arrived in SD at midafternoon. Long story slightly shorter: my uncle went from "probably no more than 24 more hours" to awake, cogent, and out of the ICU by Friday, a testament to his underlying good health and the good luck of getting a code blue for your medical emergency while in the hospital. But it ended up being one of the most bizarre weeks of my life. The entire family showed up, so we had this short-notice family reunion amid days of travel chaos, took the three kids to the San Diego Zoo on Friday (locals had a ton of free passes), and got to see my uncle go from stuff-of-nightmares unresponsive to being nice, and grateful, but also kind of grumpy that everyone showed up to see him in the ICU. I haven't really processed any of it. I was too overwhelmed and horrified to cry on Tuesday and then the good news made it unnecessary, but all these feelings are swimming around inside me somewhere. It was unambiguously great to see my parents and sister unexpectedly for a few days, so I've mostly just focused on that. Still, I'm not sure I've actually been through a low point like Tuesday night before, and I dread its eventual, probably inevitable return(s).

Wow, that is quite the story! Glad it turned out OK, and you got to see your family even if under bizarre and unexpected circumstances.

yeah, holy moly. Glad it turned out okay. I can imagine feeling discombobulated by it all.

That's a lot. Hope your uncle has a full recovery.

Thanks... boy, I do too. The brutality of the sudden decline was really upsetting, and I definitely want it all reversed with apologies.

Holy shit, sorry you had to go through all that but very happy it's turned out ok.

I remember that I was at the San Diego Zoo, but I don't remember much about it aside from being made aware that this wasn't some shitty zoo like I'd seen before. I also remember I put holes in the knees of two different pairs of pants while we were in San Diego. My mom wasn't happy because it meant going to Sears or something.

And he's back in the ICU for monitoring. Honestly I thought the recovery speed seemed a little improbable, so this is kind of reassuring. (I'm not going to keep regularly updating but as long as I'm here...) How are the rest of you? How has the weird weather treated everyone in the U.S.?

Fine. Thanks.

I saw a driver take off the side mirror of the car parked in front of my car, but I didn't get a plate even though I tried. The driver didn't stop and I was a couple dozen yards away. I couldn't tell which car was hit until I got closer. I was going to leave a note, but decided nothing I could write would be functionally different from "sucks to be you."

Qualtiy father/daughter time this morning as we worked our way through a major rite of passage: the filing of the tax returns. She had seven Forms W2, with state taxes withheld in two different states, so lots of fun.

Metaphysical puzzle from Instructions: "Part-year residents must use Form NJ-1040. and indicate the period of their New Jersey residency. The return should show only the income received during that period. Likewise, part-year nonresidents must use Form NJ1040NR and indicate the period of time they were residents." How can one be a part-year resident without also being a part-year nonresident?

And a shoutout to Vermont, for requiring taxpayers to calculate the ratio of Vermont income to total income (".5213"), multiply that number by 100 to express as a percentage ("52.13%"), copy the number onto a different form ("52.13"), then multiply that number by "tax due," functionally putting my daughter into the 335% tax bracket for Vermont income until we figured out what they really meant.

11: Only in America!

Is this a true example of American Exceptionalism? Do any other countries makes taxes so complicated for ordinary people?

11: Were you supposed to multiply by 0.5213?

Everyone know that .5213 implies .5218.

1: That was kind of harrowing just to read - I can't imagine living through it. Hope his recovery continues!

Anyway, 11 reminded me to pay my extortion to TurboTax, get out the W-2, and see how much money I'm paying for the socialized health care of the people who mostly vote to keep me from getting socialized health care.

It is raining outside, even though it is late February and the Rainy Season is supposed to be over; the dog is outside whimpering because (a) we are vacuuming and so it is clearly unsafe to be inside, but (b) he is a California dog and knows that he is made of spun sugar and will melt in the rain.

Plus I have, for the first time in my life, sciatica.

I feel old.

Gnoled Darb

It is raining outside, even though it is late February and the Rainy Season is supposed to be over; the dog is outside whimpering because (a) we are vacuuming and so it is clearly unsafe to be inside, but (b) he is a California dog and knows that he is made of spun sugar and will melt in the rain.

Plus I have, for the first time in my life, sciatica.

I feel old.

Gnoled Darb

Still unemployed! Technically in the "garden leave" period, but starting to get annoyed at myself for not working on finding another job. I really have no calibration for how much time I "should" take for myself here, and have a distinct but untrustworthy sense that I'm "wasting time" by not having a job. This is already, at five weeks, the longest I've been continually not working or studenting in about 30 years.

17.last: Would you like to get Medicare? Technically, you can still vote for whoever.

8: Thoughts with you.

19: are you on Garden leaave? I thought that was when they prevented executives from taking a job right after they leave a company. I thought there was a 60-day warn period where you are still employed by the company.

Tim is busy with his job search, so I mentioned that you were laid off by Google. wasn't sure what kind of software stuff you did other than that you worked on the travel site. He mentioned somebody he knows who works for a gaming company. Don't know if something like that would be of interest.

If people are looking for something useful to do that won't violate the terms of a severance agreement, let me be the first to suggest looking for Julian Sands.

I guess maybe the weather might prevent that.

10- Our car was street parked in Nathan's lovely city and a produce truck driver hit it and ripped off the mirror, side panel, and entire front bumper. Somewhere between 2500 and 4000 damage. Fortunately nosy old people in the area saw it and reported to the police so we have a report. With that the insurance company did an estimate and sent us a check within three days, and we owed no deductible since the car was legally parked. The 10 days of repair time even aligned perfectly with while we were on vacation last week.
11- I assume you're a resident if you lived in NJ more than 182 days, but either way have some fraction of the year you can calculate and >0.5 would mean use the resident form. The thing I don't get is if you live in at least three places so none is more than half the year, which one are you a resident of? None or the one with the highest fraction of the year?

When I did get my mirror taken by someone who didn't stop, the first body shop said they couldn't get a part. I think they just didn't want to mess with a small job. I found a part online in about one minute, but getting it on was a shitty job that took way too long.

Sasquatch doesn't roam south of Mount Shasta, so I suppose it was just the weather or a fall.

For me the worst part about filing income tax in two states with similar rates was doing double the work just to get back or pay the same as if I'd lived in only one of them.

I don't know what's wprse, that TurboTax has a box for you to tip them or that the default is 20%.

let me be the first to suggest looking for Julian Sands.

I was hiking in an area across from the San Gabriel Mountains today and I saw a helicopter going back and forth in the distance, nearer the higher mountains. It occurred to me that they might be looking for a missing hiker because it didn't appear to be a traffic, news, or police helicotper, but I'm not sure there are many trailheads on that side. Mt. Baldy and some of the other popular peaks aren't that close.

Then I had to hike the last 45 minutes in the dark with a flashlight because I under-estimated how long I'd spend on the ridge taking pictures before returning. After detouring up a hillside, again in the dark, to get around some fallen trees, I was glad no helicopter had to go out and look for me. Also glad it's a popular enough area that i could make out the steep but passable route other hikers had made.

re: 12.last

No. In the UK, if you aren't self-employed, then you might literally never have to do a tax return in your life. Your employer deducts tax for you, and everything just works. If you under pay or overpay tax, it'll get worked out via your pay and you mostly won't have to do anything. I think I was over 45 before I ever had to do a tax return.

In my case, I fill out a return, because we claim a specific benefit for our son,* and then I have to pay it back via tax. But the whole process takes me about 15 minutes to fill my annual tax return. The forms are clear, simple, and the workflow for filling them out via the government website is easy.

* there's a formerly universal non-means tested benefit that everyone got. Now--thanks fucking Tories and fucking Lib Dems, you wankers--if your individual income now falls above a certain threshold, you now have to explicitly opt out of it, or pay the benefit back via a slightly increased tax rate (so you pay an extra approx £20 a week in tax). I do the latter.

The city income tax form is the easiest. It's also the most regressive.

30. How do {Capital gains| dividends| rental income} work?

31: I have never filed a city income tax form. Have I been violating the law or just missing out on a possible refund?

You just sit on your ass and the money rolls in. It's pretty nice but socially destructive if too many people try it.

34 to 32.

33: You live in a state that handles those things for cities.

How do {Capital gains| dividends| rental income} work?

You would need to fill in a tax return if you have any of those. Also if you're self-employed or make over £100k in salary.

|| Putting aside the more important issues involved, can someone explain to me why the Energy Department should even have an opinion about the Lab Leak Theory? ||

I had the same question actually.

And also I'm wondering how many people have died of covid in China since they ended the restrictions.

"Energy department" is a weird name for being in charge of nuclear weapons. I'd guess they are involved in some kind of intelligence operations in China, and have some expertise in secret Chinese military programs? (No surprise then that they lean towards the explanation that's relevant to their knowledge and skillset. See also the FBI, which is the other government agency mentioned a lot in that article.)

37: Here's how the WSJ (which I think broke the story) describes that:

The Energy Department's conclusion is the result of new intelligence and is significant because the agency has considerable scientific expertise and oversees a network of U.S. national laboratories, some of which conduct advanced biological research.

And this from the National Security Advisor:

"President Biden specifically requested that the national labs, which are part of the Energy Department, be brought into this assessment because he wants to put every tool at use to be able to figure out what happened here," Mr. Sullivan said.

A low confidence assessment based on evidence no one can see. This changes everything.

You know who's a group that got really into lab leak despite no relevant expertise? Physicists! You know who the Department of Energy employs a lot of? Physicists!

Yikes, 1 (and 8) sound like quite the whirlwind.

My uncle (who I don't know well) has been struggling with his health for a while and just entered hospice this weekend.

I really have no calibration for how much time I "should" take for myself here, and have a distinct but untrustworthy sense that I'm "wasting time" by not having a job.

I have no idea what's "appropriate" or smart from a career perspective, but for years I have promised myself that whenever I leave this job I'll try to take a couple months off before starting the next one -- just to have a break.

39 There was a really interesting story about a month or so ago that took the death announcements from China's National Academies of Science and Engineering from the date of the ending of China's zero Covid policy and compared it to previous months. These are mostly dudes in their 60s to 90s. They found an increase of about an order of magnitude

46 Correction, about 4-5 times. I thought it was a clever study since China doesn't publish Covid stats for fatalities. Here's a link: https://www.nytimes.com/interactive/2023/02/05/world/asia/china-obits-covid.html

You know who's a group that got really into lab leak despite no relevant expertise? Physicists!

Aren't physicists also one of the bigger sources of climate denialism? Not as a group, obviously, but when you get proper scientists going denialist, it's often them. (Or geological engineers.)

46, 47: Thanks.

48: Yup! Not that mathematicians are much better. One thing both groups have in common is a lot of ex-Soviets, which isn't all the people doing this, but I think is a lot of what is driving this culture. Note that large swaths of Soviet science (but not math, physics, and most engineering) really were ideologically-driven nonsense, so it's not completely out of nowhere.

Someone claimed "low confidence" is the same rating given to the assessment that Saddam Hussein did indeed have weapons of mass destruction.

I think 44 is probably correct, more or less. From the vague statements in the media accounts, it sounds like someone at one of the labs did some modeling or computational analysis of the viral genome and decided it looked artificial or engineered or something. (To the extent the labs do "biological research" it's this kind of thing. They're not biological laboratories.) There's a lot of that sort of argument on the lab leak side. It's long been debunked by the actual biologists.

If it did leak from a lab in China, does that mean we're supposed to be more willing to watch people die from it?

I think it means we're supposed to arrest all the virologists.

In China?

I think it means we're supposed to let in fewer Chinese graduate students, and maybe deport some Chinese faculty?

No virologists, no virologist-created disease. Once they've been defeated we will have the moral clarity to engage with our true enemies: bats and minks.

I like bats.

I think we should actively work to constrain China and reduce our dependence on Chinese manufacturing, but I've thought that since well before covid.

A lot of the lab-leak people seem to genuinely believe that lab leaks not only caused the COVID pandemic but are, like, the main cause of epidemics, to the extent that preventing future pandemics requires a huge crackdown on virology research. (This is what SBF's "pandemic preparedness" funding was all about.) This is bafflingly out of touch with reality. Lab leaks happen and there have indeed been occasional epidemics caused by them, but zoonoses are vastly more common and much more dangerous. Actual pandemic preparedness requires more funding for virological research, not less.

I mean, we should still watch the labs.

We do! This research is already heavily regulated, for good reason!

That's good. It's been three years of washing my hands after I poop and I'm getting tired of the lack of freedom.

I do think a lot of the lab-leak enthusiasm by centrist pundit-types stems from frustration over COVID mitigation measures and a sort of flattening of virology and public health into a single category of "so-called experts telling us what to do." The idea that they were actually to blame for the pandemic is attractive in that context.

I just saw an episode of Sliders with the creative premise of an AU where they had discovered germ theory of disease, but had not discovered antibiotics or most modern pharmaceuticals. They had gone way too deep into a purity-is-health mindset.

Unfortunately, one the stunning revelations of the episode was the pandemic they were struggling under was from, effectively, a lab leak.

52: I just reviewed a paper done by DoE folks on salamander ecology so they also do that sort of biological research too. I also know people that do large scale ecological experiments at the same 'lab' so I wouldn't be surprised if DoE does some virus/disease stuff.

I just saw an episode of Sliders with the creative premise of an AU where they had discovered germ theory of disease, but had not discovered antibiotics or most modern pharmaceuticals.

Isn't that just what actual Western medicine was like from about 1860 to 1940? The discovery of germ theory long predated the development of effective drugs for most diseases.

66: Huh, interesting! Maybe there's more relevant expertise in the labs than I realized. (I still doubt they have much to contribute to the lab leak debate though.)

I should admit that the lab leak is the closest I get to a conspiracy theory. But more from the Chinese squashing/confusing of the investigation than from anything else.

Also I don't think it was engineered in a lab, just some sloppy biosecurity caused a sample to escape.

67: I think it was only in the latter half of that period that hygiene really propagated through the whole (US) population as health-related. Or even third.

67: But yes, I suppose the creativity was in it otherwise being a mostly modern-day setting, since antibiotics are so fundamental to our notion of modernity. (Maybe the real result would have been us retaining acceptance of a higher death rate.)

As long as I've got my horse de-worming medication, I'm fine.

There was also historically no particularly strong link between germ theory and an emphasis on hygiene, which long predates it. Indeed, hygiene was the main focus of public health throughout the miasmatic era. Lister's development of antiseptic surgery was at about the same time as Pasteur and Koch's discoveries of bacteria but it was an empirical discovery largely independent of germ theory.

I don't mean to be overly critical of what I'm sure was a good piece of science fiction! I'm just not sure the differences are quite as you've described them.

Science fiction has been downhill since Return of the Jedi.

64 is right. There's no new evidence for a lab leak since the Nature paper. https://www.nature.com/articles/s41591-020-0820-9 .
66/68 JGI, a branch of DOE, does good genomic-based research. I think no human research though. I haven't read the recent report. Their solicited conclusion was apparently issued with low confidence, so thanks to the magic of headlines....

From the vague statements in the media accounts, it sounds like someone at one of the labs did some modeling or computational analysis of the viral genome and decided it looked artificial or engineered or something.

Boy do I not feel like wading into all this, but yes, this is what my kindly relative said, too. That the patchiness of coronaviruses from different species-specific-coronaviruses looks like exactly what would happen if you were in a lab, and not at all how it would go in the wild.

I get my headlines from corduroy pillows.

77: Yes, it's a widespread idea in lab-leak circles, and it's not facially absurd. The link in 76 debunks it, to my mind convincingly.

For facially absurd you'll have to go to Moby and his corduroy pillows.

what I'm sure was a good piece of science fiction

Eh. Memorable, at least. (The pandemic was called "the Q".)

Fair enough.

If we're rehashing things, the problem I have with Covid origins discussions is the lack of evidence beyond what's already been made public. If the DOE has evidence to make public, fine. They should put that out there. It doesn't sound like they've made anything public and it's not clear if their new evidence is actually analysis of existing evidence.

Without China's cooperation, or some incredible act of whistleblowing, it's hard to see how the origins discussion won't just repeat endlessly without certainty. There are conspiracy and non-conspiracy versions of lab leak. Though I think we underestimate the cooperation among animals to take down humanity.

I think the conspiracists tried to coin the term Zoonoti to refer to people conspiring to argue for zoonotic origin. Even they don't think the bats were in on it.

the problem I have with Covid origins discussions is the lack of evidence beyond what's already been made public.

I hate myself for responding, but here's my last comment: China would love to be able to say that they found the animal reservoir. I'm told that this should really not be that difficult to locate. It's much more like triangulating than searching for a needle in a haystack. The idea that there's no evidence of anything since 2020 isn't evidence in favor of a zoonotic response.

I'm not a scientist, obviously, but you all aren't either. (Aside from those who are.) I get the absolute repulsion at the prospect of entertaining something with clear Republican Sports Teaming going on, so I'm not going to win this. In fact, I'm actually going to close the thread now and stop replying.

Wait. I'm still working on a really bad joke involving "animal reservoir. "

I didn't think that would get through and the joke didn't work.

If lab leak is true, then they've known exactly where the animal reservoir was the entire time!

Like here's a simple thing that would convince me immediately of lab leak: a cave system in Southern China that was thoroughly blown up by the Chinese military in early 2020.

I'm told that this should really not be that difficult to locate.

I do not think this is true. It took 14 years to work out the details of SARS transmission, though phylogenetic evidence before that was pretty clear.
https://www.nature.com/articles/d41586-017-07766-9

Just for reference, in terms of how long you might expect things to take, for SARS1 locating a nearby relative in the wild took 16 years.

85: I didn't say there's no evidence, I said the positions that have been staked out on the available evidence aren't going to change without additional evidence. But I guess you showed me a new way to employ lack of evidence as evidence.

89: If that had happened, they probably would have locked down the area as thoroughly as the US did Faro, NC.

I think China has poisoned the well thoroughly enough that even if they announced they found an animal reservoir, if it was just them saying that it would be slightly more convincing than the claim that imported frozen foods brought Covid-19 to China. I wonder if they're even allowing their own scientists to study it. They could know it started in a lab and are covering it up, yes, but they also could be worried enough about uncertainty to not want to risk finding that out. No one does paranoia quite like authoritarian regimes.

93: Did the Soviets know about Faro, NC? I feel like if China totally locked down some area like that then the US government would probably know?

They're so paranoid about people putting Xi in disrepute that if you just search for his name on a vastly popular Baidu forum - zero results.

Honestly I'm not quite sure why lab leak paints China particularly in a worse light than SARS2 happening in exactly the same way SARS1 happened and China not doing jack shit to prevent it.

97. IMO 64 explains it. Only Asians in Asia were personally inconvenienced/bereaved/killed by SARS, while this one is completely different because it affected subdivisions here.

Fair point. Both look bad for PRC, but one also looks bad for science in general.

97: The lab-leak theory moves China from the "inept" category to "actively malevolent." Moreso if it was a lab leak of a bio-weapon.

All the non-insane versions of lab leak are simple ineptness.

But I guess your point is that you argue for the non-insane versions of lab leak because you find the insane versions appealing but can't convince yourself to be that stupid. It's like "intelligent design." Lets you be an ally to the real loonies while still maintaining some respectability.

Both look bad for PRC, but one also looks bad for science in general.

Yeah, I think this whole deal is more about domestic issues in the US than fearmongering about China. The latter serves as a sort of general backdrop, though.

I misunderstood 85.last. But if I'm reading it correctly now, and given how rarely ogged and lizardbreath are by, we're basically unsupervised in this thread.

So, anyone want to sell Amway? I can get you started. Plus, it's a great way to alienated your relatives and friends.

Food fight!

China would love to be able to say that they found the animal reservoir.
No, they wouldn't. The official narrative is now that it originated in the US. Finding the origin also involves recognizing transmission via the wet markets which the PRC utterly failed to deal with post-SARS-1, see 97. Any honest accounting of the biology also entails an accounting of severe failures in CCP governance.
lack of evidence beyond what's already been made public.
If usgov does actually have any unpublished evidence, it's likely from communications intercepts which they can publish only at the cost of burning those sources and methods.

Did the Soviets know about Faro, NC? I feel like if China totally locked down some area like that then the US government would probably know?

When the USSR had a lab leak (actually a factory leak) of an biological weapon that killed 66 people, and that led to mass vaccination of the city population and large-scale decontamination of buildings downstream of the leak, the US was completely unaware AFAIK, and the USSR managed to fool a very eminent scientist (Matthew Meselson) into believing that it was a natural outbreak. The truth only came out after the USSR collapsed twelve years later.

Isn't that just what actual Western medicine was like from about 1860 to 1940? The discovery of germ theory long predated the development of effective drugs for most diseases.

Always worth reading memoirs from doctors or indeed vets who were practising around that time, just for their descriptions of the HOLY SHIT moment that was their first experience of prescribing antibiotics.
Antibiotics started a bit earlier than that - Salvarsan came in before the First World War, though its applicability was limited, and sulfa drugs were around in the 30s. And germ theory is a bit later - really Koch's postulates, which were 1884.

Public health efforts against infectious disease are really a tripod: vaccination, cleanliness, and antimicrobials. The big wins against cholera and typhoid are more about cleanliness - clean water supply, proper toilets etc - and the big wins against smallpox, TB, measles, flu, diphtheria etc are about vaccination. So you'd still have those, in this alternate universe.

Weak lab leak theory: WiV had viral samples from animals and mishandled them.
Strong lab leak theory: WIV was doing GOF work on wild coronaviruses to understand potential outbreaks, funded by NIH, and made one too infectious to contain.
Conspiracy lab leak theory: WIV was a bioweapons site where they intentionally made deadly viruses and one got out due to poor protocols.
Insane lab leak theory: China engineered pandemic viruses at WIV and intentionally released one not realizing it would backfire.
Batshit (haha) lab leak theory: The US, via Anthony Fauci's personal checking account, was funding bioweapons research at WIV.
(Insert meme picture of Vince McMahon getting progressively more excited)
This thread and associated links seem pretty dispositive to me. But Nate Silver continues his progression from "people should learn basic stats" to "the word 'prior' means I was right" so maybe that convinces some people.

109: would be great if we could extend some of the cleanliness wins to the air as well as water. I'm not trying to minimize the role of vaccination at all, but cleaner indoor air would be good for a lot of things.

111: no argument here. Indoor air pollution is a huge cause of death: https://ourworldindata.org/indoor-air-pollution It's overwhelmingly poor countries, smoke from open wood fires indoors, used for cooking and heating - it's dramatic how much of a poor-people problem this is.

Apparently (interesting!) one of the biggest causes of outdoor air pollution deaths is windblown dust from deserts. I did not know that. (Most of them are caused by anthropogenic pollution).

That reminds me that the men's room in my office has built-in ashtrays by the urinals. It was built in 1996.

I've been in more than one mess where they have fitted small cushions to the walls above the urinals at head height, so that drunk people can lean forward comfortably with their foreheads against the wall while they pee.

You get deserts, and you get deserts.

Apparently (interesting!) one of the biggest causes of outdoor air pollution deaths is windblown dust from deserts. I did not know that.

Well, it's been nice knowing you all.

And indoors you should also probably be wary of inhaling windblown dust from desserts.

Antibiotics started a bit earlier than that - Salvarsan came in before the First World War, though its applicability was limited, and sulfa drugs were around in the 30s.

Are Salvarsan and sulfa drugs considered antibiotics? I was thinking of penicillin as the first, but yeah, definitely a lot of progress in treatment options in that period.

And germ theory is a bit later - really Koch's postulates, which were 1884.

Koch's postulates certainly formalized the theory and put it on a rigorous basis, but both he and Pasteur had been doing a lot of experimental work well before that. The chronology of all of this is fuzzy, and it also took quite a long time for germ theory to be widely accepted by the medical profession as a whole.

Doctors really hated washing their hands, so they had a good reason not to buy into germ theory!

They hated it for lots of reasons! It's actually quite strikingly incompatible with the mainstream medical theories of the time, which were a confused mess but still primarily relied on the humoral theories going back to Hippocrates and Galen. There had been various cracks in the overall edifice over the centuries, usually in response to new diseases that didn't seem to fit, but they'd found various ways to accommodate them. Germ theory was different in part because it represented a new theoretical paradigm that threatened to upend the entire system, rather than an empirical quirk that could be worked in as a weird exception.

So now 110 has gotten super sketchy. The doctor said they don't think insurance will approve changing the coding to an office visit but to simplify things they'd be happy to take only $150 instead of the $280 they initially billed. Am I right to suspect that insurance will only pay them like $75 for an office visit under their contract and they intentionally coded it wrong so they could direct bill us for a higher fee? That's insurance fraud, right?

120 reminds me of Imre Lakatos's views on the history of science, which I have been unable to forget in over 30 years of having never needed them for anything

121: I'm not a lawyer, but it sounds like they are defrauding you and not the insurance company. That makes it just regular fraud.

My most recent experience dealing with insurance (and pricing) was before my colonoscopy. I got a letter from the insurance company saying, "we don't cover anesthesia for the procedure." I talked to the clinic they said, "the insurance company is doing that to everyone; but the anesthesiologists are trying to help out and will bill directly at a reduced rate" (which is what happened), but in the conversation I tried to figure out, "how much will I be charged for this procedure anyway?" and neither the clinic or the insurance company could tell me*.

Still worth it; get your colonoscopies everyone, but a remarkable run-around for a standard procedure.

* They said that it's completely covered, without applying to the deductible as preventative care, but only if it doesn't find anything. If they find polyps, it switches to diagnostic, and there's a different billing code, and nobody could find a price for that.

Some guy I met in a bar said you should not get anesthesia for a colonoscopy because recovery from the anesthesia kills the day and recovery from butt-cam is nothing. I don't know either way because I keep putting it off.

I don't know if the anesthesia is necessary, but it seem like most people choose it, and the recovery from fasting would kill the day anyway.

Despite having no family history of colon cancer and (I believe) a reasonably colon-friendly diet, they ended up finding a bunch of polyps and think my body is just prone to producing pre-cancerous polyps. I believe that there's no immediate risk but the recommendation is annual colonoscopies to monitory. Really not what I was hoping to hear -- and completely unexpected, I went in figuring it would just be a formality. But, I'd rather know about it, and I think it's an argument for not putting it off.

Death rates from anesthesia are just so high, it seems a little weird to me to choose it.

I bet if they remember to rinse off the camera, death rates from butt-camera are pretty low.

I always figure that they push anaesthesia because it's easier for the doctor. Passive patient. I went along with the anaesthesia but next time I'm going to find someone who'll do it while awake, if I can. To 126, yes! Early warning for people like you is while we're all undergoing them. Definitely better to know about it.

Death rates from anesthesia are just so high

Do you have numbers for that? Quickly googling I see (a) that the immediate risk of anesthesia is low -- around 1/200K but (b) the rate of death within one year of a procedure requiring anesthesia is elevated, and (c) the concerns about anesthesia appear to rise with age; there are a bunch of links talking about risk of impaired memory function for people over 70.

Also, FWIW, the anesthesia I had for the colonoscopy felt different than the anesthesia for my wrist surgery (it's been an eventful couple of months). Both were full anesthesia, but the colonoscopy felt much lighter and had much less recovery time than the surgical anesthesia.

I don't know if that implies different risks or not.

Death from "procedure requiring anaesthesia" very different from "death from anaesthesia," obv. See comment 1 in this thread.

I think what they do for a colonoscopy is usually heavy sedation rather than general anesthesia. A similar experience for the patient -- you don't remember anything -- but less risky.

Unbeknownst to me that I would be awake, I was in fact awake for the entirety of my colonoscopy, and it wasn't bad at all! I even got to watch the camera and see the removal of a few polyps. They definitely gave pain medication via IV. It was just not all that unpleasant. The prep was far worse the the butt-camera action.

Don't delay, Moby!

I've never not delayed anything medical.

129: No one said anything to me about there being a choice whether to get anesthesia. Is that a new thing? My last colonoscopy was 3-4 years ago.

Never had a colonoscopy, but I have had tubes stuck in basically all other available orifices. The only one that was genuinely traumatic was the endoscopy. I did that one without anaesthesia, and fuck that. Never again. I had to be held down by about 3 burly nurses, and I felt like I was genuinely about to die, all the way through. They give you a load of bullshit about it being a thin tube. The thing was as thick as my thumb, and the basic experience was like being water-boarded while sword swallowing. Other people I know have had it done with no issues, so it's definitely a subjective thing, but never again. I've had a nasal endoscopy a couple of times and that was totally fine.

I've had an endoscopy and I was out for that. The pictures of my stomach were really poorly composed and the lighting was not the best.

I mean, it was good enough for a diagnosis. But I couldn't display it.

121: I'm not sure which thread this discussion was in, but the answer depends a lot on where they work. I'm guessing if they're trying to negotiate like that, it's an independent, and it would be less than $100. Big systems would get paid more.

126: how many did they find?! Annual is a lot. Most people who haven't had cancer but are higher risk are on 3-year schedules.

I am due in 7 years, because they found a small polyp that had features "suggestive of but not diagnostic for an adenoma". I was worried I would get charged but didn't.

135: Moby, get the Cologuard if you're not going to get a colonoscopy any time soon.

how many did they find?

14 sessile serrated adenoma plus one other.

I don't know either way because I keep putting it off.

bruh

142: I saw the Saturday Night Live ad for it.

143: Shit, that is a lot. Pick a GI doc you like if it's going to be an annual thing, then.

I went to a free recital last night and learned that there is an amazing new music school/performing arts center that opened this fall about 20-25 minutes from me. Someone donated the land and all the funds to build it and they moved a modest music school there. It was gorgeous.

143: Shit, that is a lot. Pick a GI doc you like if it's going to be an annual thing, then.

Isn't that what you want to hear. There aren't a lot of choices; I think my current GI doc is fine, but I'll know more over the next couple of years.

I've had an endoscopy and I was out for that.

I had an endoscopy where I was awake and a colonoscopy where they knocked me out. In neither case was my opinion sought, and I don't remember any horrible insurance ramifications or physical distress in either case.

||

There is a candidate just announced in the race to replace Barbara Lee, who seems to have secured a lot of high-powered endorsements* together implying union support and at least some business support, so she might be a shoo-in. She's a transit district director, which might be a first for a Congressmember, as also might be her not being able to drive (due to vision not age).

* All four endorsers, who do represent the pinnacle of influential currently-elected politicians in the area, are women!

|>

OK, the legally blind part is not a first, lots of precedent there, what with all the war wounds.

142: I was due for a colonoscopy during the pandemic, but my regular doctor said Cologuard was basically just as good, so I did that instead. The Internet tells me that Cologuard is, in fact, pretty close, and I'm a little surprised NickS wasn't advised to do Cologuard.

131.1 that tracks with what I've experienced, very light for the colonoscopy but I felt fucked up for a couple of days after the knee surgery.

I was awake a bit and looking at the screen for the gastro part but out cold for the asstro part.

151: Nick S is no longer a candidate for Cologuard, because he is above average risk. If you get a positive Cologuard from a shedding po'up, you have to get a colonoscopy anyway.

Yeah but all the other times I've mailed poop, it's been a problem.

At least since DNA testing has become common.

130: I saw 1/100k, but that's not so wildly different. Still seems like a lot of death to me!

You need to calculate by QALPs (Quality Adjusted Life Poops) per death.

It's as risky as driving a thousand miles!

Still seems like a lot of death to me!

As always, the question is, "compared to what?" In terms of individual risk, that's fairly small (particularly if you believe, as I do that being younger, healthy, and not having a history of problems with anesthesia are likely to be positive signs). In terms of population that suggests, what 150 deaths per year nationally*. By comparison the number of deaths during childbirth annually is around 800, and WA state just released a report saying that 80% of them are preventable.

Maybe that's not a meaningful comparison (I just happened to be looking at it), but my inclination would be to say both, "don't treat anesthesia as trivial" and "if you feel more comfortable having a procedure done with anesthesia, you shouldn't feel too worried about it."

* That's a completely guess, but if the oldest 1/3 of the population averages anesthesia 1 every 4 years that's ~30M procedures per year, and I split the difference between 1/100K and 1/200K.

Anyway 133 probably means I should retract my objection.

It's as risky as driving a thousand miles!

By that standard, if the average person drives 10K/year, and I drive around 1K/year, my anesthesia is not putting me above average (in other words, a single drive of 1000 miles is a lot, but most people accumulate 1000mi of driving fairly quickly).

But yeah it certainly matters what the age gradient is here. I understood the situation to be that people just randomly die from anesthesia and we don't really know why, and not that it's an "old people die doing Al AITA of things." But I certainly could be totally wrong, I never looked into it that carefully.

Wait. I drive 1000 miles all the time.

I think the risk is lower on western interstates, especially if you are sober, female, and over the age of 25.

But yeah it certainly matters what the age gradient is here. I understood the situation to be that people just randomly die from anesthesia and we don't really know why, and not that it's an "old people die doing Al AITA of things." But I certainly could be totally wrong, I never looked into it that carefully.

I haven't looked at it carefully either, which is why I was curious what information you had.

I drive around 1K/year

On the other hand, given my personal lifestyle, I'm more likely to be killed as a pedestrian rather than while I'm in a car.

GHSA's annual spotlight report, Pedestrian Traffic Fatalities by State: 2022 Preliminary Data, projects that U.S. drivers struck and killed 3,434 people walking in the first half of 2022, up 5% from the year before, or 168 additional deaths.

The data analysis found that the recent increase in pedestrian deaths is even more alarming when looking back to 2019, the last pre-pandemic year. Pedestrian deaths have surged 18%, or 519 additional lives lost, between the first half of 2019 and 2022 (see data chart below). Nationally, there were 1.04 pedestrian deaths per 100,000 people in 2022, up significantly from 0.90 in 2019.

When I saw that kid get hit, it really scared me and left my jumpy crossing the street to this day. Even when I got (mildly) hit while crossing the street, it didn't really bother me.

Somehow this topic did not emerge in any of the pooh threads.

Sedation vs anesthesia probably have similar risk profiles when applied to someone in the process of driving 1000 miles.

Driving (or walking near cars) isn't really a good benchmark for risk, because it's an overly dangerous activity we have normalized in a way we usually don't others.

133: It's not general anesthesia. I chatted with my anesthesiologist about this who told me it wasn't as deep as what I got for sinus surgery.

There is actually tremendous variation in what people get. In the Northeast anesthesia done by an anesthesiologist is more common. In other parts of the country conscious sedation performed by a GI doc happens a lot more often.

Further to 110, FBI Director goes somewhere between conspiracy and insane options.

Biological weapons are a really bad idea both morally and, more importantly, tactically, but that hasn't stopped horrible regimes like the USSR developing them in secret, so I would not be surprised to learn that China is also doing so.

You know who's a group that got really into lab leak despite no relevant expertise? Physicists! You know who the Department of Energy employs a lot of? Physicists!

Are you seriously arguing that the DOE gave its COVID investigation to physicists to run? Is that actually what you're saying? Or is the idea that there are just so many physicists around that all the biologists got all icky and physicist-y by osmosis?

And, again, 106. It is demonstrably true that an authoritarian state can have an accidental leak of a deliberately manufactured bioweapon that kills a whole lot of people, and then lie successfully enough about it to fool everyone outside the country, including the extremely eminent scientist who actually goes to the leak location and investigates, and who is also a consultant on biological weapons for the CIA and ACDA.

I think Marshall is misinterpreting Wray's statement (and by quoting it only partially is encouraging his readers
to misinterpret it). Wray seems pretty clearly to me to be talking about what the FBI's investigatory capacity is designed for, not what he believes Covid was designed for. If I'm right about that, Wray isn't being any nuttier than anyone else who thinks there was a lab leak.

175 I'm not sure what the American Choral Directors Association has to do with biological weapons but someone should put a stop to it

11: presumably resident/nonresident is relative to earning income in the state? So if you leave the state and don't earn income there then you're just a part-year resident.

177: Weren't you paying attention to all those superspreader events early in the pandemic? Choral directors are playing a long game.

Arms Control and Disarmament Agency.

180 I know

Twitter app on phone not loading, but Tweetdeck seems to still be functioning (quite reduced traffic). Will this push me to finally leave the increasingly hellful hell site run by a rich whiny sub-wimp? And if I do when can I start being scornful of those sticking with the festering zombie. There's a lot of ruin in a popular social media system.

182: Twitter's "Following" feed was not loading on the web version. It seems to be working now. (The "For you" feed was working, but when I looked in it was all disconcerting and stupid, worse than just closing the tab.)

How else will I fritter away spare brain cycles during the workday? Folks here need to start talking a whole lot more, and at times convenient to Europe.

Ask and it shall be given. (SFW)
https://youtu.be/nLfFmYWjHtc?list=PLh9mgdi4rNewfxO7LhBoz_1Mx1MaO6sw_&t=1273

Unless you work for Putin.

Funny you should mention Snyder. I just (like today at lunch) finished The Red Prince, a book of his from 2008. It's about Wilhelm von Habsburg, a less-known vH, born in 1895 to a branch that didn't stand to inherit the throne.

Wilhelm von Habsburg, the Red Prince, wore the uniform of an Austrian officer, the court regalia of a Habsburg archduke, the simple suit of a Parisian exile, the decorations of the Order of the Golden Fleece, and, every so often, a dress. He could handle a sabre, a pistol, a rudder, or a golf club; he handled women by necessity and men for pleasure. He spoke the Italian of his archduchess mother, the German of his archduke father, the English of his British royal friends, the Polish of the country his father wished to rule, and the Ukrainian of the land he wished to rule himself. He was no innocent, but then again innocents cannot found nations.

Ukraine plays a central role in the book, so it's surprisingly timely, and not just much more droll and interesting than you would expect about a biography of an obscure Habsburg.

186: One of the numerous Snyders (Snyder? Snyderren?) assigned for that course. I'm feeling more Reconstrcution of Nations right now.

174: My assumption was that the decisions about which is more likely and at what confidence are made at a pretty high level based on reports from lower level experts. And that at DoE that probably means several physicists were involved. Also just that there was probably a lot of pro-lab leak social media going around DoE.

I like my women like I like my Habsburgs?

I've been working on losing weight again, and exercising more--although I was never completely sedentary, anyway--and it's working. Down about 13 lbs since Christmas, which is a sustainable loss rate for me.

But man, my joints are shit. My knees and hips are complaining a lot about a modest increase in weight training, and I'm not doing heavy lower body exercises, I'm focusing on light weights and form for a bit, as I already know my knees and hips are prone to irritation. Upper body, totally fine.

189: Prone to wearing Ukrainian folk costume under their military uniforms?

187: Snydery, I should think. I've been interested in Reconstruction of Nations for a while, just not enough (yet) to buy it or read it. Will you tell the Unfoggedtariat about it when you're done?

Red Prince is terrific, and occasionally low-key hilarious. I wrote about The Road to Unfreedom when I read it back in 2019, and if there's one thing that applies to both books it's that he's best when he's specific.

187: I also wrote about the Plokhy book that's on the syllabus, not that you should substitute it for reading the actual book. I read Black Sea before I was writing reviews with any regularity, and I remember it as informative but not particularly lively. Odessa by Charles King would be an interesting addition, but maybe it's too tightly focused for a course on the whole country.

Listen to this crazy shit: Hawaii is thinking about trying out for the high school dance team. Tryouts are next week. Paperwork is due tomorrow. Hawaii filled most of it out, and then had to take it to her middle school to get the attendance office to verify that she has good behavior and good attendance, which is already bullshit.

But the most amazing part is the Financial Agreement and Responsibility statement. I think it is a great idea to be transparent with parents up front about financial obligations and responsibilities. No problem. But the coach wants it to be FUCKING NOTARIZED. What the fuck. We have to go find some shmuck at the PakMail and have them verify that we pinky swear not to sign Hawaii up for Driver's Ed classes that interfere with dance rehearsal?!? (Driver's Ed is mentioned explicitly as a conflict that is not allowed, as is employment. I can totally see how both of these may have caused problems in the past. I'm just irritated about having to get a form notarized, for shit's sake.)

Is the notary fee listed in the financial part?

We turned in the rest of the paperwork last night, and I sent a weaselly email being like, "Erm, how strict really is this notarization requirement really?" and she wrote back, "We must have it by tomorrow." I think I may loathe this woman.

194: The projected cost is given as a range. I could email back and ask, to be a passive-aggressive ass, but Hawaii might actually kill me if she found out.

191: Will do. I've started the Plohy on my phone but am halfway through something else on the laptop, so. Have to say that while from his lectures Snyder is a great thinker, all I've read of his so far is Bloodlands, which I found unconvincing (though retrospectively it makes more sense in light of the lectures).

Also based on your above, Sketches from a Secret War sounds from the lectures to be right in your sweet spot.

195: The American jobsworth!

Maybe they've also had problems with students forging parents' signatures? That's the only rational path I can construct. Not to say it has to have been rational.

189

Inbred with large chins?

Obviously, handling men for pleasure and not innocent.

198: Yes! That one caught my eye as I was reading the Notes in The Red Prince.

I haven't tried non-fiction on my phone; I don't do really well reading fiction on it.

Yeah. Generally I only read news on the phone but I've been feeling newsed-out for a while.

I'm really trying to avoid breaking news and the cycle of headlines spinning each bit of new information. I think I'm getting better at it.

I was worried we had a case of COVID exercise-induced myocarditis but doctor says it's just a pulled muscle. Can you pull muscles in the middle of your chest? Kid had COVID with mild symptoms, couple days of cold-like symptoms. Tested positive for 10 days. The first day he wasn't positive was a big time trial for crew team and he goes and ergs 12.5k in 51 minutes. Next morning he's coughing and complaining of sharp chest pains. But they checked vitals and said no other symptoms, ruled it out without an ekg or any other tests so decided it was a muscle injury causing the pain.

Maybe they've also had problems with students forging parents' signatures? That's the only rational path I can construct. Not to say it has to have been rational.

I can easily imagine this to be true. But it can also be solved by just establishing contact with parents - verifying the email addresses on the forms, having a parents' meeting and then following up with whoever can't attend, etc.

I think she's legitimately frustrated by kids and parents being undependable to the level she wants, and the problem won't ever go away, but demanding a super special pinky swear to a notary is a really annoying way for her to flail helplessly. Also, in terms of needing parents to volunteer and help make the team run smoothly, this is a terrible first impression. It tells me to run the other way from the anxiety-riddled nut who creates extra work for no good reason.

The traditional approach to this is to just show up at parents houses and yell "Sometimes I doubt your commitment to Sparkle Motion!"

Heh.

Deep down, I really do doubt my commitment to Sparkle Motion.

You better hope the notary public can't tell that.

193 et al. makes it sound a lot more appealing to turn off the parental controls on Netflix and the kid's iPad and let her spend her time how she wants. I should spend a lot more time here, if only to remind myself that my problems really aren't all that bad. Why am I getting tired out by one kid when some people somehow manage four?

When you have four they tire each other out.

Because I was the oldest of four and very responsible, my parents had it easy.

Moby is really the Hawaii of Unfogged.

I was actively trying to get my mom to let me quit dancing lessons to make her life easier.

Covered with lush vegetation but concealing hidden lava flows?

Revealed as the fog parts.

212: fair enough. There was an era when she could do the same playing with friends, but this time of year that's harder than the summer, and schedules are a problem they wouldn't be with siblings.

Only her notary knows for sure.

Microsoft Flight Simulator just got a free ekranoplan mod.

I haven't played that since the Apple IIc.