How dangerous is it…REALLY?

In this bonus content, we discuss steps you can take to avoid getting, or to survive smallpox. Should it escape the freezer, this information could be vital.

If you meet the criteria, the best thing you could do in the

event of a smallpox outbreak is get vaccinated

In Boston, the adoption of variolation dropped mortality

from ~15% to 2 %

This would be more significant in vaccination vs variolation

Smallpox vaccinations exclusions

So, what would exclude you from vaccination? https://www.cdc.gov/mmwr/preview/mmwrhtml/rr5204a1.htm

History of eczema

Skin disease that disrupts the outer layer of skin (severe

acne, etc)

Pregnancy

Immunodeficiency

In the event of an intentional outbreak, these standards

might be reduced to protect more people

If you get the vaccination before coming into contact with

the virus, it could keep you from getting ill https://www.cdc.gov/smallpox/prevention-treatment/index.html

If you get it within 3 days of exposure, you may not get the

disease or if it develops, it may be less severe

Within 4-7 days the vaccine could still prevent illness, but

is more likely to reduce the severity of the illness

Once you develop the rash, the vaccine will not protect you

If you are not able to get the vaccine, several anti-virals

have been developed

These have been tested in animal models, but obviously not

on humans so there is no guarantee how well they will work

Large amounts of anti-virals, and vaccine are stored in the

CDC’s Strategic National Stockpile and would be delivered to effected areas

rapidly to help with treatment

Medical protection policies also give us good idea of other

things we can due to prevent contracting smallpox https://www.cdc.gov/smallpox/bioterrorism-response-planning/healthcare-facility/prevent-spread-disease.html

Smallpox: Preventing person to person spread

Remember smallpox is spread by face-face contact via

droplets created during coughing/sneezing

It can also be transferred by contact with pustules and

scabs

If you have to come into contact with an infected person,

gloves are always recommended

A N95 mask (typical white hospital mask) is especially

important in preventing infection

In a non-hospital setting, filtering out infectious

particles would also be an effective way to reduce the possibility of

infection.

In a hospital setting it is also advisable to use eye

protections

As always, washing your hands frequently with soap and water

or an alcohol-based hand sanitizer is recommended

Laundry should be treated as infectious and never do

anything that will spread particles into the air

Laundry should be washed in hot water 160F with detergent

and bleach and then dried on the hottest setting

Smallpox disinfection

Disinfection protocols are based on those recommended for

In this podcast, we discuss smallpox, the only disease successfully eradicated from mankind. Destruction of smallpox has eliminated much suffering in the world, but the disease lurks in the shadows threatening to re-emerge.

If I could be honest for a moment, today’s topic is one that

my nightmares are made of

What is smallpox?

Most of us probably have heard of it, but many of us may not

be sure exactly what it is

Smallpox is an orthopox virus with the official name of

Variola

CDC photograph

Smallpox is the only human disease that has been

successfully eradicated

As far as we know it currently only exists in the freezers

of the CDC and the Russian State Centre for Research on Virology and

Biotechnology, known as Vector

We have nothing to fear from smallpox…as long as it stays

there

Smallpox: How is it spread?

There are two strains, variola minor and variola major https://ourworldindata.org/smallpox

Variola minor has a case fatality of less than 1 percent,

while the case fatality rate of variola major can be 30%

Smallpox passes from person to person through coughing and

sneezing

Smallpox is incredibly infectious, one study showed that a

inhaled single smallpox particle was capable of causing disease

https://www.cdc.gov/niosh/nioshtic-2/20037359.html

There are few microorganisms that can successfully

accomplish this however, historical data indicates that transmission is

generally more difficult

Smallpox: What are the symptoms

Smallpox is named for its characteristic rash of pustules

that covered the body https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1069029/

Once infected, it takes about 10-14 days for symptoms to

develop

The first symptoms are very non-specific can easily be

mistaken for a cold

The patient is most infectious during this period, when they

are most likely to be able to spread it

Next the rash covers the body in ~24 hours

V0031460 Gloucester smallpox epidemic, 1896: Ethel Cromwell Credit: Wellcome Library, London. Wellcome Images [email protected] http://wellcomeimages.org Gloucester smallpox epidemic, 1896: Ethel Cromwell, aged about 14 years, as a smallpox patient.

For the next three weeks the pustules continue to grow, then

scab over and fall off

Areas were the pustules formed are likely to be evident for

life

If death occurs, it is generally from total exhaustion,

toxins and low blood-pressure

Death usually occurs 10-16 days after the onset of symptoms

It is difficult to piece together from the historical record

how many actual smallpox cases there were, but Swedish data indicate that in

peak years, smallpox would account for as many as 7 out of 1000 deaths

https://ourworldindata.org/smallpox

It has been estimated that from 1920-1978 there were over 11

million cases

The development of a heat stable,

Your Mom always told you to wash your hands. I bet you didn’t always do as good a job as you should have at hand washing. We discuss how washing our hands and other sanitation practices have led to our increase in life expectancy.

Who’s been

reaching into my bag of chips, how dangerous is not washing your hands and

other sanitation practices

The number

one rule of drinking water is that you always want to be upstream

The problem

is, there is almost always more upstream than you

Public

health: How Chicago solved its sanitation problem

St. Louis

didn’t always have upstream neighbors, but the story of how they got them is

pretty interesting

https://interactive.wttw.com/ten/modern-marvels/reversal-chicago-river

Chicago was a

booming city, but it was a city with a problem

Modern day Chicago River

Sitting on

the shore of Lake Michigan, it had plenty of water but you sure didn’t want to

drink any of it

In the 1850s,

the city had bout after bout of Typhoid, cholera, and dysentery

They had a

great source of drinking water in Lake Michigan, the problem was, the Chicago

river, carrying all the waste from the city flowed directly into it

The city

hired an engineer, Ellis Chesbrough to fix the problem

Over the next

10 years, the city built a marvelous sewer system that was ahead of its time

Problem was,

it still emptied into the river and that didn’t make the drinking water taste

any better

So they came

up with a plan, let’s move the drinking water inlet farther out into the lake

Over the next

two years, they built a tunnel that moved the intake nearly two miles out into

the lake

That worked

good for a little while, then one big storm was all it to flush (pun intended)

all that stuff out to the inlet

They needed a

new plan

The solution

was simple, we just build a huge canal (six times deeper than the Erie canal)

and change to flow of the river over the continental divide and let the might

Mississippi River take care of the problem

The had a

couple of other problems like the great Chicago fire to deal with, but in 1892

they started work on the canal that would eventually connect to the Des Plaines

River

In January of

1900, the last of the project was finished and the best of Chicago began to

flow down the river towards St Louis

Although

Chicago was enjoying the rapidly improving taste of their drinking water St.

Louis wasn’t too happy about the loss of their upstream city status

In the end,

there wasn’t much they could do about it, and to this day about 23,000 gallons

a second flows from Lake Michigan over the continental divide and into the Gulf

of Mexico

Public health

and life expectancy

If you look

at the life expectancy of humans, it hovered around forty years for centuries

As Thomas

Hobbes noted, life was nasty, brutish and short

Then quite

suddenly about 1850, it began rising quite rapidly

Until 1950,

the increases in life expectancy were almost exponential

In this episode, we will discuss how dangerous getting shot actually is. We will look at shooting survivability, homicides, and mass shootings. This topic has bonus content.

I

recently went to a conference and one of the breakout speakers was a gentleman

by the name of Dave Acosta from a company called youtactial. 

His

class was about the fight part of run hide fight.

He

donates much of his time effectively teaching unarmed school teachers how to

deal with an active shooter.

You

will hear more about what I learned from him in the bonus podcast, but one of

the things he said in his presentation got me thinking

He

said that most people mistakenly think that getting shot means dying or at a

minimum, being completely helpless 

He

said this mistaken impression comes largely from our entertainment but many of

his colleges have been shot multiple times and not only survived, but continued

to fight

This

got me thinking about how dangerous is getting shot really

Let

start with how many people are being killed each year

Based

on what I hear almost daily on the news, you might think that murders are up

dramatically, but an FBI report summarizing murders from 1992 to 2011 says

otherwise https://www.bjs.gov/content/pub/pdf/hus11.pdf

https://www.bjs.gov/content/pub/pdf/hus11.pdf

In

2011 the homicide rate was 4.7 homicides per 100,000 people

This

was actually the lowest rate since 1963

In

fact, from 1992 to 2011 the homicide rate dropped 49% from 9.3 to 4.7 per

100,000

Homicides shot with firearm

Of

those homicides, 67% were killed by a firearm, a percentage that has remained

fairly stable

Well,

that was from 2011 which isn’t exactly recent so I dug into the numbers from

2018 https://ucr.fbi.gov/crime-in-the-u.s/2018/crime-in-the-u.s.-2018/topic-pages/murder

For

2018 there were 5 murders per 100,000 with some mild fluctuation in the

previous years

So

essentially it has remained the same

Now,

what about mass shootings?

From

2002-2011 95% of homicides involved only a single victim

About

4% involved 2 victims

.6%

involved 3 victims a

0.2%

involved 4 or more victims In 2011 out of 13,750 homicide incidents 25 involved

4 or more victims

For

homicides involving 4+ victims, firearms were involved 91% of the time

Now

let’s talk a little bit about the characteristics of an active shooter

incidents https://www.fbi.gov/file-repository/active-shooter-study-2000-2013-1.pdf/view

Note

this is different than a mass shooting

An active shooter is “an individual actively engag...

Today we will be discussing the terminology and effects of radiation. Radiation can be pretty scary, but its effects are pretty well known and we have excellent detection equipment that can detect even the smallest changes. It can be dangerous, but we will try to put it into perspective.

From my childhood, I vividly remember the scene from Indiana Jones where they open the Ark and all the bad guys faces melt off

Until I started working with radiation, this is how I always

visualized it

Today, of all the things I work with, radiation is the thing

I fear the least

Can measure in real time

Using 100 year old technology (if

it hasn’t changed in that time, it must work really well)

All I have to do is back up

What is radiation? http://hps.org/publicinformation/ate/faqs/whatisradiation.html

Radiation you might be familiar with, also called

non-ionizing radiation

              Light

              Radio

waves

              Microwaves

Radiation we will be discussing is called ionizing radiation

because it can produce charge particles when it strike something (me or you)

This radiation produced by unstable atom (uranium,

plutonium, radon) or high voltage (x-ray)

These unstable atoms are trying to become stable and do so

by emitting particles and/or energy

We are exposed to radiation at low levels everyday https://www.epa.gov/radiation/radiation-sources-and-doses

These doses come from

              Sun and

stars (if you live at a higher elevation you receive a higher dose, because you

are closer to the source)

              Radioactive

elements in the earth and our bodies (radon produced in areas with large

amounts of uranium, potassium 40 in many foods and Carbon 14 becomes a part of

us used in dating of organic items

Another source is man made radioactive sources associated

with nuclear power and more commonly medicine

The sum of these exposures we call a dosehttps://www.nrc.gov/images/about-nrc/radiation/factoid2-lrg.gif

Average American receives 310mR per year

A whole body CT scan can give a dose up to 1 rem

Most people’s eyes start to glaze over when they here Rems,

curies, sieverts, gray, bq, roentgens, etc

These are just units of measure just like many things we are

already used to inch, cm, grams, oz, mph etc

Just like these units of measure, it gets more complicated

because you have traditional units (oz) and metric units (g)

To simplify things I’m going to use only two, the curie and

the Rem https://www.cdc.gov/nceh/radiation/emergencies/measurement.htm

This topic has bonus content

Every time I step foot in the ocean, I can't help but think about sharks. In this episode, we look at the actual number of shark attacks, the type of sharks involved and which type of activities are most likely to result in an encounter.

Review the year of the shark https://www.theguardian.com/theguardian/2001/sep/05/features11.g23

The summer of the shark had no rise in actual shark attacks https://news.ufl.edu/archive/2002/02/summer-of-the-shark-in-2001-more-hype-than-fact-new-numbers-show.html

The rescue of Jessie Arbogast set the stage for a slow news

summer

Although most of these interactions result in minor injuries

akin to that of a dog bite, about six of the 75–100 unprovoked attacks that

currently occur worldwide each year result in human mortality [12].       (Note that an unprovoked attack is

defined as a bite or near bite (fended off by human intervention) of a person

(or the board on which he/she is perched) in the shark’s natural environment in

the absence of any human provocation.) https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0211049&type=printable

Shark species

Three shark species that attract much of that attention are

the bull shark (Carcharhinus leucas), tiger shark (Galeocerdo cuvier),

and white shark (Carcharodon carcharias). These species are of interest

to biologists because they are large, migratory species of cosmopolitan

distribution

While shark populations are poorly defined, shark-human

interactions in the form of unprovoked attacks have been increasing in raw

numbers for more than a century and in increasingly diverse places

Outcomes of shark attacks

Although not the focus of this contribution, the majority of

all shark attack outcomes were non-fatal (85%), and typically less than about

25% of attacks were fatal in countries with >50 attacks since 1960.

https://www.floridamuseum.ufl.edu/shark-attacks/factors/victim-activity/

https://www.floridamuseum.ufl.edu/shark-attacks/yearly-worldwide-summary/

Shark attacks vs other events

https://www.floridamuseum.ufl.edu/shark-attacks/odds/compare-risk/death/

https://www.floridamuseum.ufl.edu/shark-attacks/odds/compare-risk/lightning-strikes/

https://www.floridamuseum.ufl.edu/shark-attacks/odds/compare-risk/rip-currents/

Listen to my other topics https://sci-vs-fear.com/podcasts/

For the past few weeks, you can't hardly listen to a news broadcast with hearing about vaping. This brings up the question: should I quit vaping? We look at the likelihood of getting vaping related illness and put the risk in perspective compared to smoking.

The public health anti-smoking campaign has centered around

that fact that smoking makes you stink

Vaping is the free market answer to this objection

26 deaths in 21 states 1299 cases reported (8 Oct 2019) https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html

Most patients admit to vaping THC 76%

No single product is linked

https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html

28-year-old previously healthy man who presented in acute

respiratory failure 2 weeks after initiating use of a street-purchased

THC-containing vape cartridge. Bronchoalveolar lavage cytology with oil red O

staining confirmed the diagnosis of acute lipoid pneumonia. Diffuse alveolar

hemorrhage and eosinophilic pneumonia were excluded. Evolving evidence supports

a clinical entity of acute respiratory failure due to acute, exogenous lipoid

pneumonia induced by THC Vaping-Associated Acute

Respiratory Failure Due to Acute Lipoid Pneumonia.

They say black market operators are using more thickening

agents to dilute THC oil because of a crackdown by state authorities that has

made the oil scarcer on the black market https://www.washingtonpost.com/health/potential-culprits-in-mystery-lung-illnesses-black-market-vaping-products/2019/09/24/cb5b708e-d98d-11e9-ac63-3016711543fe_story.html

Black market manufacturers buy the cartridges in markets

like this, fill them with THC oil or other mixtures and package them for sale

by distributors.

One thickening agent that is a key focus of investigators is

vitamin

E oil, known as vitamin E acetate. It is also colorless and odorless,

has similar viscosity to THC oil, and is much cheaper

Characteristics

of a Multistate Outbreak of Lung Injury Associated with E-cigarette Use, or Vaping - United States, 2019.

805 cases reported, basic patient data (i.e., demo­graphics

and dates of symptom onset and hospitalization) were received for 771 (96%)

patients. Ninety-one percent of patients were hospitalized. Median duration

between symptom onset and hospitalization was 6 days

Of 514 studied 395 (76.9%) reported using THC-containing

products, and 292 (56.8%) reported using nicotine-containing products in the 30

days preceding symptom onset; 210 patients (40.

Thanks for listening to my first podcast. I will be discussing why I decided to podcast, and different considerations when you are assessing the risk of a certain hazard.

Deciding to do a podcast

has been a big decision for me

I am comfortable

presenting in front of large audiences

I have no problem

discussion complex scientific issues with people of varying opinions

But until this point I

have been comfortable working with my peers

However, recently I

have begun to notice how often the world around us sells so much fear

It seems like

everywhere I turn there are voices telling me how afraid I should be of waking

up tomorrow

Given my scientific

background and especially my skills at assessing risk, it has been relatively

easy for me to silence the voices applying the scientific method and reason

I’ve also been able to

share my insights with friends and family and I have enjoyed seeing them learn

to judge risk on their own

Lately, I’ve realized

that my sphere of influence is really really small

I don’t claim to have

all the answers or even that my assessments are always 100 percent accurate,

but I’ve felt like there is a larger audience out there who might value  being able to put risks into perspective

To be honest, I’ve

always avoided technology as much as possible

But the more I thought

about it, the more I felt compelled to share what I have learned via a podcast

Learning a new media

has been more difficult that I had originally imagined

Learning how to build a

website, use recording software, editing properly, deciding how to best use

social media have all had steep learning curves

There are many true

dangers out there, but for every true danger there are many perceived dangers

that are actually pretty minor

I envision a community

where we can use data, science, and logic to help each other really understand

the true natures of the dangers that surround us

I hope you will be

patient with me as we learn together in this new media

While trying to clarify

for myself exactly what I wanted to achieve with this podcast I came up with

the following analogy

I enjoy doing outdoor

activities

Being cooped up in the

house for more than a few hours is almost painful

I, like many of you,

live in an area where  the weather

changes significantly day to day

The weather can have a

significant impact on how much I enjoy my limited time outdoors

For many years I would

rely on the latest weather forecast to try and get the most out of my time

What I found was that I

was more often than not disappointed in the accuracy of the forecast

One day, I was looking

at the radar map for the past few hours

As I watched it, I

realized that I could roughly see what might be happening in my area for the

next few hours

As I tried it out, I

wasn’t always 100% successful in my predictions, but I was consistently better

than the forecaster who was predicting for the whole region rather than my

specific area

Now I almost never look

at the weather forecast,