Andrew Sullivan's Blog, page 6

A Measly Epidemic

Measles Day at Disney! #WorstDayIn4Words @HashtagShenani pic.twitter.com/Liwixs89Ol

— Joe Messina (@joemessin) February 1, 2015

Thanks in part to anti-vaxxer hysteria – now getting a boost from Christie – the measles are making a comeback:

Between Jan. 1 to 30, 102 cases of the measles were reported to the CDC from 14 different states. The majority of the cases are from an ongoing outbreak linked to Disney California Adventure Park in Anaheim, Calif. The CDC says the majority of people who got measles were unvaccinated. … The people infected in the current outbreak have exposed others at the amusement park as well as schools, daycares, emergency departments, airplanes and outpatient clinics the CDC says. In 2014, the Unites States had the highest number of measles cases reported in over 20 years, at over 600 cases.

In response to the outbreak, the White House is urging “vaccine-hesitant” parents to make the right choice and get their kids their shots. Steven Salzberg lays the blame for the outbreak squarely at the feet of the Jenny McCarthyites:

The problem arises from California’s vaccine exemption policy: although public schools require kids to be vaccinated, parents can exempt their kids simply by saying they have a personal objection to vaccination. It’s not just California: only two states, Mississippi and West Virginia, don’t allow parents to claim a philosophical or religious exemption to vaccines And Colorado has the worst rate of vaccination, at just 82%, primarily due to parents claiming a “philosophical” exemption.

These parents are the anti-vaxxers.

Thanks to them, we now have large pockets of unvaccinated children through whom epidemics can spread further an faster than we’ve seen in decades. The CDC reports that in 2014, 79% of measles cases in the U.S. involving unvaccinated people were the result of personal belief exemptions.

But as Julia Belluz voxplains, outbreaks like these aren’t simply the fault of such parents individually; the disease spreads in communities where vaccination rates are especially low:

It’s not actually a rising anti-vaxx tide or naturopathic, private school mothers driving a return of vaccine-preventable disease here. It’s not even low-income folks who wind up getting sick, and it’s especially not undocumented migrants bringing in viruses, the CDC’s [Jane] Seward says: “The people getting measles are those that travel abroad, come back, and live in a community among people who weren’t vaccinated.” Some years, we get 40 “importations.” Last year, there were about 65. “This is more than normal,” she added, “and it reflects travel patterns and where measles is active globally.”

The travelers spark outbreaks when they hit geographic clusters of unvaccinated people, like the one in Ohio [among the Amish community, where last year’s measles outbreak was centered]. These infectious disease powder kegs exist all across the US, waiting to be sparked.

Marcel Salathé considers what these anti-vaxxer pockets mean for our society’s herd immunity as a whole:

When we analyzed data from Twitter about sentiments on the influenza H1N1 vaccine during the swine flu pandemic in 2009, we found that negative sentiments were more contagious than positive sentiments, and that positive messages may even have back-fired, triggering more negative responses. And in measles outbreak after measles outbreak, we find that the vast majority of cases occurred in communities that had vaccination coverages that were way below average.

The sad truth is this: as long as there are communities that harbor strong negative views about vaccination, there will be outbreaks of vaccine-preventable diseases in those communities. These outbreaks will happen even if the population as a whole has achieved the vaccination coverage considered sufficient for herd immunity.

An exasperated Aaron Carroll outlines why failing to vaccinate against measles – which, as Michael Byrne reminds us, is a very nasty disease – is so dangerous:

The system breaks down, and outbreaks occur, when more people are susceptible. Everyone, for instance, is susceptible to Ebola at a certain point in the illness. So we have to be careful to quarantine people who are infected when they are sick. But Ebola is relatively hard to catch. It has an R nought of 2, meaning that an infected individual might infect, on average, 2 others. But measles has an R nought of 18. It’s one of the most infectious pathogens around.

Quarantining is difficult, if not impossible. The virus is unbelievable hardy and easy to catch. So the absolutely, positively best thing you can do it to be vaccinated. Period. I should point out that it also doesn’t matter to the outbreak why people remain unvaccinated and susceptible. It can be because of religious reasons. It can be because of irrational fear. It can be because they’re “hippies”. I don’t care – the outbreak is the same.

Sarah Kliff revisits the anti-vaxxers’ spurious objections to inoculation and why they’re wrong:

Objections to vaccination among those healthy enough to get immunized (those of us over the age of one, essentially) typically just aren’t good enough to justify the risk. Much of it revolves around the safety of the vaccine. Even in the Amish community in Ohio, it wasn’t a religious belief that caused low vaccination rates — and laid the groundwork for a huge outbreak. Instead, it was news of two nearby children suffering complications from the shots that turned the community against vaccination.

So let’s clear that fact up here right now: the measles vaccine is, without a doubt, safe. Study after study after study confirms this. The study that suggested the measles vaccine was not safe — and had possible links to autism — was retracted by the academic journal Lancet in 2010. The researcher who published the study, Andrew Wakefield, was stripped of his medical license in Britain. Not only is the measles vaccine safe, it’s also incredibly effective.

And Elizabeth Stoker Bruenig mulls over why the anti-vaxx movement has gained ground in recent years, and why that’s cause for concern:

For Americans, the reality is that parents who refuse to vaccinate their children make their choice in relative comfort. Parents with toddlers today do not remember the scourges of prior centuries: the bubbling blisters of smallpox, the iron lungs of polio, the florid rash of measles that has, since 2010, taken the lives of over 4,500 people in the Democratic Republic of Congo, most of them children under five. All of those things, thanks to time or distance, go out of thought and out of mind. Moreover, since most American children—thanks to the good sense of most American parents—are still vaccinated, the likelihood that these plagues will come roaring back has always seemed distant. Now, perhaps not so much.

Lastly, Chris Ingraham breaks down vaccination rates by state and looks for patterns, though they’re actually hard to find:

Alabama usually accompanies Mississippi at the bottom of health rankings, but it does even better when it comes to vaccines — 77 percent of toddlers there are completely covered. Overall, state-level vaccine rates buck the familiar trend of “south= bad, northeast and west = good” that we see on countless other health measures. New Hampshire kids are well-vaccinated, but Vermont and Maine kids less so. Mississippi comes in at #12 in the rankings, while just across the river Arkansas is dead-last. California, currently in the news for a large measles outbreak at Disneyland, is squarely middle-of-the-pack at number 30.

It’s tough to tease out demographic patterns behind vaccination rates. In California, some affluent areas have lower vaccination rates than the average. But looking at all 50 states, there’s a small correlation between increased income and increased vaccination. Some people maintain that vaccine skepticism is strongest on the left, but the data don’t support that notion.

Face Of The Day

A reader does his best impression of a Dishhead:

Reading My Own Obits

That’s how the past week has felt. Tyler Cowen went so far as to call me “the most influential public intellectual of the last 20 years.” Here’s how you make a blogger blush:

I thought long and hard before selecting Andrew for the designation of most influential public intellectual. Perhaps Paul Krugman has changed more minds, but his agenda hasn’t much changed the world; we haven’t, for instance, gone back to do a bigger fiscal stimulus. Peter Singer led large numbers of people into vegetarianism and veganism and gave those practices philosophic respectability; he is second on my list. A generation ago, I would have picked Milton Friedman, for intellectual leadership in the direction of capitalist and pro-market reforms. But that is now long ago, and the Right has produced no natural successor.

TNC penned an appreciation of my being wrong:

Andrew has never been a prophet, so much as a joyous heretic. Andrew taught me that you do not have to pretend to be smarter than you are. And when you have made the error of pretending to be smarter, or when you simply have been wrong, you can say so and you can say it straight–without self-apology, without self-justifying garnish, without “if I have offended.”

And there is a large body of deeply curious readers who accept this, who want this, who do not so much expect you to be right, as they expect you to be honest. When I read Andrew, I generally thought he was dedicated to the work of being honest. I did not think he was always honest. I don’t think anyone can be. But I thought he held “honesty” as a standard–something can’t be said of the large number of charlatans in this business.

Honesty demands not just that you accept your errors, but that your errors are integral to developing a rigorous sense of study. I have found this to be true in, well, just about everything in life. But it was from Andrew that I learned to apply it in this particular form of writing. I am indebted to him. And I will miss him–no matter how much I think he’s wrong, no matter the future of blogging.

Damon Linker agrees that much of the reaction to my decision to stop blogging reads “an awful lot like obituaries.” How his tribute ends:

When critics praise him, they usually point to the sheer volume of prose he produced. It is impressive. But not nearly as remarkable as what the prose conveyed, which was opinions, positions, judgments by the boatload. Always an on-the-spot evaluation at the ready — and far more often than not, an interesting one. One worth sharing. One worth pondering. One provocative and distinctive and irritating and quirky enough to inspire readers to come back the next day. And the next.

It could be exhilarating, but also acutely embarrassing. Sullivan learned early on that in this new medium, glibness had become an intellectual virtue. Just look — and judge. Immediately. Where the academic-scientific ideal seeks to bracket emotions and other non-rational aspects of subjectivity, the blogger-intellectual trusts his emotions, follows them, permitting a gut reaction to events. Sullivan practiced passionate thinking, right before our eyes.

Mental Health Break

A reader digs up Colbert’s classic take on blogging – from February 2005:

The GOP And The Anti-Vaxxers

Chris Christie’s endorsement of parental choice over public health while we have a measles epidemic strikes me as yet another disqualifying aspect of his judgment, character and personality in his bid for the presidency. Here’s some important context for his remarks – Christie:

Michael, what I said was that there has to be a balance and it depends on what the vaccine is, what the disease type is and all the rest. And so I didn’t say I’m leaving people the option. What I’m saying is that you have to have that balance in considering parental concerns because no parent cares about anything more than they care about protecting their own child’s health and so we have to have that conversation, but that has to move and shift in my view from disease type. Not every vaccine is created equal and not every disease type is as great a public health threat as others. So that’s what I mean by that so that I’m not misunderstood.

His office is now qualifying even more:

To be clear: The Governor believes vaccines are an important public health protection and with a disease like measles there is no question kids should be vaccinated. At the same time different states require different degrees of vaccination, which is why he was calling for balance in which ones government should mandate.

That’s a relief. And, of course, parents always have the ultimate say over their children. But a public official should not, in my view, be messing around with basic concepts of public health, and giving any credence to anti-vaxxers. So why the equivocation when we need more public support for childhood vaccination?

My best answer is that any potential GOP candidate has to cater to the Christianist right, and the critical HPV vaccine is not exactly popular with that section of the population. Lo and behold, Carly Fiorina is saying something similar as well:

I think there’s a big difference between — just in terms of the mountains of evidence we have — a vaccination for measles and a vaccination when a girl is 10 or 11 or 12 for cervical cancer just in case she’s sexually active at 11. So, I think it’s hard to make a blanket statement about it. I certainly can understand a mother’s concerns about vaccinating a 10-year-old … I think vaccinating for measles makes a lot of sense. But that’s me. I do think parents have to make those choices. I mean, I got measles as a kid. We used to all get measles … I got chicken pox, I got measles, I got mumps.

An alternative explanation may, of course, be that president Obama has strongly endorsed childhood vaccinations and therefore any GOP candidate has to disagree. I’m not sure which interpretation is accurate, but neither is exactly encouraging.

The View From Your Window

Changsha, China, 8.13 am. Our reader adds:

I have never been sure if this was your “personal” email or the blanket inbox for the Dish. I got very excited when I saw that the VFYW contest was still happening this week. Any crumb gives me hope things will go on.

Looking At Looking Again

I wrote a review of the breakthrough gay drama about a year ago. I loved it. It spawned quite a thread here at the Dish. Money quote:

Along with , Haigh is the first director and writer to actually bring no apparent cultural or ideological baggage to the subject matter. There is no shame here and no shadow of shame. There is simply living – in its complexity, realism, and elusive truth. To get to this point – past being either for or against homosexuality – is a real achievement.

Two of Slate‘s gay voices – June Thomas and J. Bryan Lowder – debate it today. Lowder really didn’t like the first season, for all the reasons I loved it. He didn’t seem to think it was gay enough. June has a different response, but her defense of the show this season is not exactly full-throated. I’ve been watching it again with Aaron, and last night, realized I was basically done with it.

Not because it distorts; it doesn’t much. Not because of its realism; I still love that. I just came to terms with the fact that I didn’t care about any of the characters. The lead – a dreadful, dumb, whiney pain-in-the-neck – is so irritating and shallow I actively want him to just disappear. I care not a flying fig what happens to him, unless it be some fatal accident. I don’t see a single redeeming feature in this man-child’s bland insipidity, or any skill in the empty performance given by Jonathan Groff. His British boyfriend? An asshole. But I actually care about this asshole a tiny bit more than any of the main characters. Because at least there is something in him to care about. June agrees:

Take Kevin, Patrick’s boss and sort of secret lover. He has more screen time this year, but he’s still secondary, yet I know him far better than I do Patrick, Agustín, or Dom. I know where he’s from, what his childhood was like, who his boyhood friends were, what card games he played, which pop group’s dance moves he copied. I don’t understand every bit of his psychology—is he just a standard adulterer who’ll never leave his official boyfriend for his bit on the side; is he sticking with John for the sake of a green card; or is he, like Patrick, Agustín, and Dom, lost and looking for direction? Still, he’s not a complete cipher, as the main protagonists are.

Actually, Agustín and Dom are the only two faintly likable main characters in the show. And although both are good actors (disclosure: Murray Bartlett is a friend), they have very little to work with, as they try to bring them to life. And at some point, you can’t keep watching a series where every character is as unlikable as they are shallowly conceived. In the end, I’m afraid, the writing of the main characters is slowly killing off the show for me. I’ll keep watching to see if the occasional twitches of life and texture can repair the character waste-land. But, sadly, my hopes aren’t high.

A Trip Down Memory Lane

“There’s not much money in the me-zine so far. In February, Amazon.com began a voluntary payment system that allows readers to put their money where their mouse is. By early April, Sullivan had taken in nearly $9,000 through the Amazon system and direct contributions. Kaus had just over $1,000 through Amazon; Postrel netted $630 through Amazon and $100 through PayPal, another payment system she uses; Marshall, the last of the group to add the pay feature, had less than $1,000. “Right now we’re a joke from a business standpoint,” says Sullivan. Two days after saying that, though, he met with his partner in New York to discuss “the next phase.” An archive of Sullivan’s book reviews is in the works, and perhaps an interactive book club. His site got 120,000 unique visitors in March. Soon, Sullivan says, he will try to tempt a sponsor,” – Brent Cunningham, Columbia Journalism Review, January 2002.

In the end, we got 30,000 of you.

If you click on the link, it will take you to a PDF file of all the early press on the Dish in the very first year or two. Robert Cameron, who helped me set this up at the turn of the century, found it in his files. It’s a time-capsule in many ways. Here’s a flavor:

Mr Sullivan is a “blogger” (short for web logger): one of the tens of thousands of individuals and small groups who publish such online diaries. The vast majority of web logs are little more than regularly updated letters to friends with rambling accounts of day-to-day life. Many see them as the latest incarnation of the personal website with family photos and holiday greetings that was briefly popular in the late 1990s. But a few dozen bloggers with broader interests, Mr Sullivan among them, have begun to attract much wider audiences.

Another:

Maybe in six months these me-zines will be dead. But maybe not. Maybe big media will scoop up the best ones. Maybe a group of writers will contribute to a single site, theoretically making it easier to sell ads and find sponsors. Maybe some will get popular enough on their own to have sponsors. “It’s a terrific forum,” says [Joanne] Jacobs. “The question is, Can it be sustained?”

I guess some things never change, do they?

(Photos of Dish readers used with their permission)

Tweet Of The Day

I asked @dinamartina if she’d had a chance to watch the #Seahawks and she responded, “Oh was their an aviary show? So sad I missed that.”

— stevenblum (@stevenblum) February 2, 2015

Introducing “A Memorable Form Of Love”: An Interview With Spencer Reece

Dish literary editor Matthew Sitman writes:

This fall I had the pleasure of sitting down with the poet and priest Spencer Reece to record a long interview about his work teaching English, by way of poetry, to the girls who live at the Our Little Roses orphanage in San Pedro Sula, Honduras – a place also known as the murder capital of the world. You can read the entire interview in Deep Dish, which now is out from behind our paywall, and which includes my brief introduction to Spencer’s own poetry and the projects – a selection of the girls’ verse published in Poetry last month and a forthcoming documentary about Our Little Roses especially – that emerged from his time there. For those interested in Spencer’s background you can read a short biographical sketch about him here. The Dish featured his poetry last year here, here, and here. The interview itself tells the story of how Spencer found himself in Honduras and what he experienced there.

Below is an excerpt from “A Memorable Form of Love: An Interview with Spencer Reece,” in which he explains why it was while living in Honduras that he truly became a priest:

I don’t think I understood what it meant. I don’t think I understood what it meant to be a Christian. I don’t think I understood what the Eucharist meant. I don’t think I really understood any of it. I could repeat it intellectually, or write something on an exam. I had studied all of it. But it was all book knowledge, it wasn’t heart knowledge. I knew I was moving in the right direction, but I really didn’t know what it meant. But when I was with them, as time went on it, I began to understand all of it.

The Eucharist is a moment of intimacy, eating together, looking at each other. Like on the Road to Emmaus. And when I put the wafers in the mouths of all those girls lined up, I think I began to understand it.

Also, they have nobody, so they belong to God. There’s just no other way to explain it.

So then that began to make sense. I as a priest – as a shepherd, as a father, all those words that are used for priests – I literally became a father-like figure, which I’d never been, because I didn’t have children. I never thought I’d be in that position. That was happening to me. I believe what George Herbert wrote, that for him, he craved simplicity. And one of the things that he liked simple was his religion and his understanding of God, and that all God was, was love. As a priest, to communicate that message is what we’re supposed to try to do. We can’t do it perfectly, but that began to come through me. You know a priest really has to be there and not be there – the ego has to die in the spiritual life, so you have to kind of use yourself and not be there at the same time, so that God’s message can come through you. It’s not “Spencer’s” message. Of course it’s going to be some of my message, because it’s me, but you hope that there’ll be little sparks that are God’s that are coming through you. That seemed really important there with those girls.

Read the entire interview in Deep Dish – again, now without a paywall – here.