“The medical science priesthood has a long history of treating outside-the-box thinkers harshly. Toward the end of the 18th century, Britain’s Royal Society refused to publish Edward Jenner’s discovery that inoculating people with material from cowpox pustules—a technique he called “vaccination,” from the Latin word for cow, vacca—prevented them from getting the corresponding human disease, smallpox. Jenner’s medical colleagues considered this idea dangerous; one member of the Royal College of Physicians even suggested that the technique could make people resemble cows.
At the time, many physicians were making a good living by performing variolation, which aimed to prevent smallpox by infecting patients with pus from people with mild cases. Some saw vaccination as a threat to their income. Thankfully, members of Parliament liked Jenner’s idea and appropriated money for him to open a vaccination clinic in London. By the early 1800s, American doctors had adopted the technique. In 1805, Napoleon ordered smallpox vaccination for all of his troops.
Half a century later, the prestigious Vienna General Hospital fired Ignaz Semmelweis from its faculty because he required his medical students and junior physicians to wash their hands before examining obstetrical patients. Semmelweis connected puerperal sepsis—a.k.a. “childbed fever,” then a common cause of postnatal death—to unclean hands. Ten years after Semmelweis returned to his native Budapest, he published The Etiology, Concept and Prophylaxis of Childbed Fever. The medical establishment rained so much vitriol on him that it drove him insane. (Or so the story goes: Some think, in retrospect, that Semmelweis suffered from bipolar disorder.) He died in an asylum in 1865 at the age of 47.
The “germ theory” anticipated by Semmelweis did not take hold until the late 1880s. That helps explain why, in 1854, the public health establishment rebuffed the physician John Snow after he traced a London cholera epidemic to a water pump on Broad Street. Snow correctly suspected that water from the pump carried a pathogen that caused cholera.
Public health officials clung instead to the theory that the disease was carried by a miasma, or “bad air.” The British medical journal The Lancet published a brutal critique of Snow’s theory, and the General Board of Health determined that his idea was “scientifically unsound.” But after another outbreak of cholera in 1866, the public health establishment acknowledged the truth of Snow’s explanation. The incident validated the 19th century classical liberal philosopher Herbert Spencer’s warning that the public health establishment had come to represent entrenched political interests, distorting science and prolonging the cholera problem. “There is an evident inclination on the part of the medical profession to get itself organized after the fashion of the clericy,” he wrote in 1851’s Social Statics. “Surgeons and physicians are vigorously striving to erect a medical establishment akin to our religious one. Little do the public at large know how actively professional publications are agitating for state-appointed overseers of the public health.””
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“It may be true that, as American science fiction and fantasy writer Theodore Sturgeon said, “90 percent of everything is crap.” But the remaining 10 percent can be important. Health care professionals who see only the costs of their patients’ self-guided journeys through the medical literature tend to view this phenomenon as a threat to the scientific order, fueling a backlash. Their reaction risks throwing the baby out with the bathwater.”
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“Openness to unconventional ideas has its limits. We don’t take flat-earthers seriously. Nor should we lend credence to outlandish claims that COVID-19 vaccines cause infertility, implant people with microchips, or change their DNA. There are not enough hours in the day to fully address every question or hypothesis. But a little tolerance and respect for outsiders can go a long way. If those habits become the new norm, people will be more likely to see rejection of challenges to the conventional wisdom as the objective assessment of specialists rather than the defensive reaction of self-interested elites. Science should be a profession, not a priesthood.”
“Under Stutts’ proposal (S.B. 324), medical marijuana dispensaries would “require a negative pregnancy test for women of childbearing age before allowing them to purchase medical cannabis,” per a legislative summary of the bill. Pregnant women on the marijuana patient registry would also be required to report pregnancies to the physician who approved their patient status.
Having to go to a doctor or medical lab and pay for a pregnancy test before every medical cannabis purchase would be not only invasive but inconvenient. In effect, it’s an added tax on young(ish) female patients.
The bill would also ban new moms who are breastfeeding from purchasing medical marijuana for themselves. It does not say how this ban would be enforced.
Alabama only recently legalized medical marijuana (and with a lot of caveats). Gov. Kay Ivey signed a medical marijuana legalization measure into law in May 2021, and the state has yet to license any dispensaries. The Alabama Cannabis Commission has until this upcoming September to creating a system for dispensary licensing, a patient registry system, and rules for cannabis packaging, labeling, and advertising.
The state already limits the number of dispensary licenses that can be issued to a mere four, and it bans dispensaries from being located within 1,000 feet of any “school, day care, or child care facility.” Stutts’ bill would further restrict where dispensaries could operate by stipulating that this rule includes home-based child care operations and colleges.
All these restrictions will probably discourage even many people who could qualify as patients from registering and purchasing through the state’s legal system. If Stutts’ bill passes, it will become yet another incentive for patients to bypass state dispensaries and keep buying on the black market.”
“Sewage surveillance is becoming more valuable right now as conventional testing is becoming less transparent. More people have been using rapid at-home tests and might not report results to a public health agency. That means the number of positive cases being reported by official sources might not actually provide a full picture of what’s happening with the pandemic.
But no matter how or if they’re testing, infected people — whether they have symptoms or not — flush out the virus when they go to the bathroom, leaving viral RNA that can be detected in wastewater samples. It requires careful collection and testing, but sewage can provide a less biased look at the viral trends in a given community.
Science has not yet reached the point where we can say that X amount of viral load in a community’s sewage means Y number of people are infected in that community. But still, knowing which way viral loads are trending is useful. If they are going up, even before the number of positive tests starts increasing, it could in theory allow public health authorities and the local health system to start preparing for a surge. If they are going down, public health officials (and the general public) can be confident that any waning in official case numbers is real and not the byproduct of, say, less testing.”
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“Surveillance programs could watch for other pathogens, too, such as influenza, hepatitis, and norovirus for early warnings of emerging outbreaks. Julianne Nassif, an expert on wastewater surveillance with the Association of Public Health Labs, said we could also monitor for bacteria, viruses, and other microbes that are resistant to current treatments. Public health officials could try to get ahead of an outbreak of antibiotic-resistant bacteria in a nursing home, for example, with the information gleaned from downstream sewage.
Johnson envisioned communities monitoring for narcotics, to better tailor their public health campaigns. Wastewater could be tested to determine whether cocaine or opioid use is rising in a given sewage shed. It could even determine what kind of opioids are being used, which could be helpful to health departments. Widespread heroin use might require a different intervention than diverted prescription opioids or black-market fentanyl.
The possibilities sound almost endless, extending to research that could help us better understand human health. Dennehy described to me one hypothetical experiment that could be run with sewage monitoring, looking for the viral markers associated with colon cancer. By comparing the results from one community with, say, a nearby nuclear power plant and another community somewhere else, we could get a better understanding of how the surrounding environment affects people’s health.
But for all of this potential to be realized, these efforts would require sustained support. The CDC bet on the wastewater boom, launching a national Covid-19 surveillance system in the fall of 2020. But dedicated investments in infrastructure and a workforce would be necessary if the country were to begin conducting wastewater surveillance on a more permanent basis.
In general, the US has not appeared willing to make big investments in public health. Scientists working on these programs hope that the same may not be true of wastewater surveillance, given the opportunities it presents.
“We learned a lot of hard-won lessons with the Covid pandemic. We got caught with our pants down at the beginning. A lot of things that we did were too late,” Dennehy told me. “The hope is we can remember these lessons for the next time this comes around, which may not be that long.””
“While some gas stations have taken the leap and installed charging ports alongside their pumps, people tend to do the lion’s share of their EV charging at home. And since EV chargers can be installed in almost any location that’s connected to the power grid — they’re now available in office garages and rest stops, and will soon be in some Starbucks parking lots — the gas station is increasingly unnecessary for some Americans.”
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“To adjust this business model for the EV era, some gas stations are now installing Level 3 chargers, which can deliver as much as 20 miles of range per minute, alongside their old pumps and convenience stores. Some of these fast chargers make EV charging almost as speedy as filling up a gas tank the old-fashioned way, and they’re much faster than what people typically use at home. Several gas station owners who have or are installing Level 3 chargers told Recode that their goal is to become “fuel agnostic” and appeal to EV drivers as well as those with gas-powered cars.
But for many gas stations, the cost of an EV charger outweighs the benefits. The charger itself can cost tens of thousands of dollars, which is a tough expense for a small business. The overall cost can be much more, since installation often involves drilling through asphalt and laying electrical wiring, and sometimes gas stations also need to buy transformers to boost the overall electrical capacity of their sites. Chris Bambury, who operates several gas stations in California, told Recode that setting up just four EV chargers at one of his locations would have cost about half a million dollars if government and utility programs hadn’t covered about 90 percent of the bill.
An even bigger challenge is that gas stations already face intense competition from other public EV chargers. Data collected by the Department of Energy shows that, of the public charger locations the agency fully tracks, there are currently more public chargers located at hotels and inns, shopping centers, and government buildings than there are at gas stations and convenience stores. This is a limited picture of the nation’s charging network, and it doesn’t include the large number of chargers built by private companies like Blink, Electrify America, and Chargepoint. These companies also seem to prefer installing these chargers in places with parking spots connected to the grid, where EV drivers can find something to do while charging, like go to a grocery store or a restaurant.”
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“But perhaps the biggest obstacle facing gas stations: Charging an electric vehicle is often as simple as parking it. Many EV owners buy chargers that plug into a standard home wall outlet just like their laptop or phone, and that virtually eliminates the need for frequent refueling trips. These are typically less expensive Level 1 chargers that take a few hours to fully recharge a battery, which is perfectly acceptable for charging a vehicle overnight. And since the average EV can travel 260 miles on a single charge, most people only need to plug their cars in once a day.”
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“even if gas stations do install fast chargers, people who are traveling long distances may be their main customers. This situation is already playing out in Norway, where about 90 percent of new cars sold are now electric or hybrid. While gas stations have moved quickly to install charging ports, many EV drivers in Norway are only visiting them on a monthly basis.
The rise of EVs could actually lead to a new generation of pit stops. Some private companies, for instance, are opening their own luxurious destinations with multiple charging stations. Electrify America plans to open a series of flagship, EV-focused travel lounges with solar canopies and event spaces that could possibly offer valet services and curbside deliveries in California and New York later this year. Automakers are also experimenting with the idea of premium charging stations. In California, Tesla has already opened a charging hub for its vehicles that incorporates a lounge, an espresso bar, and free wifi. Porsche and Audi are developing similar plans for stations of their own.
None of this is necessarily surprising. New innovations often make old technology obsolete. After all, the phasing out of travel by horse also meant the demise of the horse-drawn carriage industry and the repurposing of stables. Now, after a century spent building complex infrastructure around gas-powered vehicles, another transition seems inevitable. This means that EVs aren’t just transforming the kind of cars people drive, but also where they take them.”
“There is also the massive accountability issue here. The CBP has authorization to use force against not just foreign travelers at the border but also against Americans within 100 miles of border crossings, and yes, some of them have gotten overly violent with citizens, just like members of other law enforcement agencies. As a federal government agency, the CBP is supposed to operate with transparency about its behavior and the behavior of its agents.
The communications between officers can help establish intent to engage in misconduct or violent behavior. The ability of a government agent to conceal or delete these messages impacts the ability to investigate and, when necessary, prosecute bad behavior. And when the federal government fails to police misconduct on its own, the ability to delete these messages also makes it harder for outside media outlets or accountability organizations like CREW to monitor what’s going on.”
“the Hungarian people voted in a landslide to give Prime Minister Viktor Orbán his fourth term since 2010. Current tabulations give parties allied with the incumbent leader a vote share above 53 percent, an outright majority.
Orbán is a self-proclaimed proponent of “illiberal democracy,” which distinguishes, in Amnesty International’s summation, “a fully democratic ‘Western’ system based on liberal values and accountability from what he calls an ‘Eastern’ approach based on a strong state, a weak opposition, and emaciated checks and balances.” Orbán has spent more than a decade engaging in aggressive gerrymandering, court packing, use of state power to drive out or co-opt dissenting media, and more. Corruption is rampant. The Constitution has been rewritten and ever more power concentrated at the top.”
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“The Organization for Security and Co-operation in Europe, which took the rare step of sending a full election-monitoring mission to Hungary, has raised questions about the vote. So arguably the country should not be thought of as particularly democratic or particularly liberal right now.”
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“Orbán’s sweeping victory suggests that many millions of Hungarians, well aware of his record, are on board with his vision for their country. This raises the specter of a true illiberal democracy—it shouldn’t be hard to imagine a country with genuinely fair and open elections but also majority support for authoritarian leaders and policies that deny equal rights to all.
The point of contemplating such a scenario is to recognize that “assaults on democracy” are not the only threat we face. A society in which 51 percent of a population votes to oppress the other 49 percent can claim the mantle of democracy. The problem is that it is illiberal, not undemocratic.
Democratic institutions, important as they are, only get us so far. We must insist on liberalism as well: free speech, private property protections, religious liberty, freedom of movement, constitutional constraints and separations of power and rule of law and all the rest. We can’t know which side of the 50 percent mark we’ll fall on; the less of our lives we allow to be put to a vote in the first place, the better off we’ll be.”
“Sen. Ted Cruz (R–Texas) said that Supreme Court nominee Ketanji Brown Jackson and other public defenders root for criminals because “their heart is with the murderers.”
“She came out of law school, and she clerked for Justice Breyer on the Supreme Court. And she became a federal public defender,” Cruz said. “And you and I have both known public defenders. People go and do that because their heart is with criminal defendants. Their heart is with the murderers, the criminals, and that that’s who they’re rooting for. A lot of the same reasons people go and become prosecutors—because they want to lock up bad guys—public defenders often have a natural inclination in the direction of the criminal. And I gotta say that inclination was not just while she was a public defender, but she carried it onto the bench.”
Our adversarial system of justice depends on defense attorneys making the government prove its case and meet a high burden of evidence. The Sixth Amendment guarantees the right to counsel to make sure everyone—the unpopular, the poor, and yes, even the guilty—has the benefit of a dogged defense against the government’s power to relieve them of their liberty and property.
Supposed conservatives like Cruz should welcome this skepticism of government power, but he and others, like Sens. Tom Cotton (R–Ark.), Lindsey Graham (R–S.C.), and Josh Hawley (R–Mo.), used Jackson’s confirmation hearing to demagogue and grandstand about the horror of her representing Guantanamo Bay detainees.”
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“Public defenders don’t have the luxury of choosing not to defend a client when it’s a political liability. That’s what makes them an indispensable part of our court system.
Ted Cruz went to an Ivy League law school and clerked for a Supreme Court justice. He knows all this, but he’s an unserious person using his perch in the U.S. Senate to get on the TV and spout unserious arguments. It’s an embarrassment.”