Category Archives: Guest Articles

All articles written by guest writers

“You don’t have to know everything to say the right thing” A response to Zack Kopplin by Guest PHU Science Writer Ben Blumberg

The following is a response to Zack Kopplin and his tweeted criticisms of the blog Public Health United (PHU) along with a particular article written by PHU Science News Analyst Stephen Goldstein. Mr. Kopplin took offense at the entry written by Mr. Goldstein in which he briefly criticized Mr. Kopplin for “shouting down” at economist Stephen Moore for making an unfounded statement on an episode of the television show Bill Maher. Kopplin’s criticism hit a personal note as he attacked the blog for “trying to get attention” and “being unreasonable.” It is worth noting that the original blog article was published in April of 2013 and PHU had retweeted the link today (6/9/14) because it was recently mentioned on the Richard Dawkins Foundation website found here after a recent interview with Kopplin. After a tweet was made by PHU today referring to the article, Mr. Kopplin responded with a tweet barrage directed against PHU. This response was written because Mr. Kopplin missed the point that you don’t have to know everything to say the right thing, and that more harm than good can come from a witty one-liner. You can view Mr. Kopplin’s twitter feed here.

I praise Zack Kopplin for his (unbeknownst to him) defense of schistosomiasis research when he lambasted Stephen Moore by proclaiming, “You’re not a scientist!” in response to Moore’s opinion that the government shouldn’t be funding research into snail mating habits. Kopplin is correct, Moore is not a scientist, nor an expert in the field, and therefore he should have no say in deciding which research projects should be funded (especially since Moore inaccurately summarized the project in question).  Moore is undoubtedly doing a disservice to the public by attempting to galvanize support for his stance on research funding by linking public discontent with wasteful government spending to seemingly “worthless” research into snail mating behavior. To the layperson uneducated about schistosomiasis, it certainly seems like a waste of money at first glance. However, Moore fails to mention that the project actually was addressing cost-effective solutions for treating some of the 200 million or so people infected by schistosomes each and every year. Had Moore been educated or willing to understand the topic at hand, one would suspect the economist would support research into cost-effective disease intervention strategies that will save the country money in the long-run……in a perfect world.

In a perfect world, one could imagine that the lay-people trust the experts with no questions asked, but let’s be real and accept that it is fundamental human nature to treat subjects we are not knowledgeable in with skepticism. I like to think about how I would react if I made a statement to Stephen Moore that, “CEOs of big businesses should be taxed extraordinarily heavy on their income,” and he responded with, “You’re not an economist!”  I would be offended because my opinion was not taken seriously. The difference between my theoretical statement versus what Stephen Moore said, is that Stephen Moore made inaccurate claimes about the work whereas I am proposing an opinion. Still, to an uneducated public, pompousness is pompousness without context and I can see why people might take a defensive approach to Kopplin’s comments.

Kopplin’s proclamation actually alludes to one of the great dilemmas that scientific researchers face on almost a daily basis and that is public trust in science. As a researcher, I desperately want the public to support and trust in my work, but I also know that telling those who disagree with what I do that they are “not scientists” and “shouldn’t have a say” will backfire. We are told constantly from a young age not to take things so seriously, but when you invest years upon years into research that a non-scientist discounts for no apparent reason, you can’t help but get tied up in an emotionally charged defense of work that was approved by a committee of scientific experts. So here we are at the crossroads of yet another “black and white” debate into the integrity of scientific research and of human expertise in general. The question is where do we go from here?

My opinion is one of the of the middle ground, one that accepts more uncertainty in our decisions (after all scientific research is not funded based on guaranteed results) but by a balance of risk and reward. This translates into using every available opportunity, like the one Kopplin shared with Moore, to say the right things. Instead of saying, “You’re not a scientist!” Kopplin could have began by asking for the source of the study, what the major results/conclusions were, what journal was it published in, etc….with the idea in mind that if Moore is indeed lying he would not be able to produce even the most rudimentary summary of the work he is criticizing. Staying calm and rational is the tortoise that will win the race unlike the galvanizing comments that provide a short boost to the fleeting moment of the hare. Sure, I get it, this happened in a very brief moment on a live television show which makes it nearly impossible to convey all the facts and even so Moore could have hypothetically denied his lack of knowledge in the subject area further perpetuating his stance on the funding. This is why we need people like Zack Kopplin and blogs like Public Health United. Many people won’t change their mind on scientific funding based on a 30 second segment of Bill Maher, but we’re not trying to help everyone. It’s the people that want to learn and want to be reached that will find us and we must be willing to meet them with open arms…or at least try. If we start with what we do know as opposed to telling people what they don’t know or shouldn’t know, we will certainly reach the collective truth faster and empower those who are seeking knowledge. The bottom line is you don’t have be knowledgeable about every single research project, model, or system to say the right things and take the discussion in an open and positive direction.

One Health & How Better Communication Can Help Limit West Nile Virus Outbreaks by Stephanie Porter

The One Health Initiative is the effort to increase communication and collaboration between disciplines such as human medicine, veterinary medicine, public health, environmental health, and other related fields 1. The hope is that by promoting collaboration, shared knowledge could improve the health of all species.

There are innumerable reasons why sharing knowledge between scientific disciplines is vital. Comparative medicine relies on the shared characteristics between the anatomy and physiology of humans and other animals, as well as similarities in disease pathogenesis. This knowledge is then used to establish animal models for biomedical research, which can help in the development of drugs, vaccines, medical devices, and increase understanding of infectious diseases and cancer. Identifying animal models that accurately reflect human disease is key, and requires input from those with knowledge of the physiology and pathology in both humans and potential animal models.

The large and increasing prevalence of zoonotic diseases is another reason why cooperation between human and veterinary medicine is of utmost importance. Of all the diseases which affect humans, ~60% are caused by pathogens which also infect non-human animals 2. Zoonotic diseases have become more problematic in recent decades, as ~75% of the infectious diseases that have emerged in the human population in the last 30 years have been zoonotic 2. Goals of the One Health initiative include improving surveillance, prevention, control, diagnosis, and treatment of zoonotic disease through joint efforts from various health disciplines, especially veterinary and human medicine.

The events surrounding the emergence of West Nile virus (WNV) in the United States in 1999 provide some of the best evidence that human and animal medicine have remained too distinct. WNV first entered the US in New York City during the summer of 1999. Crows, now known to be one of most highly susceptible North American WNV hosts, began dying in large quantities in June, but the New York state wildlife pathologist misdiagnosed 400 crow samples 3. Birds at the Bronx Zoo began dying on August 10th; by September 23, the zoo had lost a total of 27 birds 4. It was the zoo’s pathologist, Dr. Tracy McNamara, who started putting the puzzle pieces together when she realized that the encephalitis she was seeing in her birds may have something to do with the human disease outbreak that the city announced on Labor Day, which was misattributed to St. Louis encephalitis (SLE). She knew that her animals could not be dying from SLE, as it is generally asymptomatic in birds 3. Dr. McNamara appealed to both the USDA and the CDC to test her samples, and was met with resistance. One of the main problems she faced was jurisdictional, as neither government department wanted to claim responsibility for the health of wild and exotic species 5. People also did not want to believe that there was a link between the avian deaths and the human disease. Dr. McNamara finally got the Army to test her samples, and it was discovered that it was West Nile virus that was the causative agent. By that point it was September. In 1999, 62 individuals were infected with West Nile virus, 7 of whom died, statistics which may have been lower had there been more rapid identification of WNV 6.

Developing an effective surveillance program for West Nile virus activity took time, and retrospective analysis from avian samples collected during 2000 has revealed that WNV was evident in samples at least 2 weeks before the first human case 7. However, WNV birds were collected 3 months before the first human infection, so if laboratory testing had been conducted more swiftly there might have again been more advanced warning, and prevention of human disease 8. Today, WNV surveillance data is collected for human infections, sentinel chicken flocks, mosquitoes, veterinary cases, and dead birds (which rely on public reporting) 6. In 2012, there was a large WNV outbreak, resulting in increased avian and human deaths. The data has not yet been finalized, but the confirmed 5,387 human infections and 243 human deaths represent the most severe seasonal WNV epidemic since 2003 6.

Given the prevalence of zoonotic diseases, it would be impossible to have healthy people without also ensuring the health of other animals. That’s one of the reasons I get upset when I hear professors at JHSPH say things along the lines of “since this is a school of public health, obviously we’re going to focus more on human health.” We understand that multihost pathogens cannot be generally eliminated if you only focus on control in a single host, so I believe that public health is doing human health a disservice if it narrows its focus and ignores other species.

One Health is by no means a new concept, but one that has taken on increased importance given the globalization of our world, the growing prevalence of zoonotic infectious diseases, and the use of animal models in biomedical testing. Facing emerging medical problems as a collective force is perhaps the best way for all health professionals to ensure the well-being of all animal species, including humans.

1. One Health initiative. http://www.onehealthinitiative.com/.

2. King LJ, Anderson LR, Blackmore CG, et al. Executive summary of the AVMA One Health initiative task force report. J Am Vet Med Assoc. 2008;233(2):259-261.

3. Keynote by Dr. Tracey McNamara — 2012 Zoobiquity conference. http://www.youtube.com/watch?v=cBk9X4iwhmE. Updated 2012.

4. Steele KE, Linn MJ, Schoepp RJ, et al. Pathology of fatal West Nile virus infections in native and exotic birds during the 1999 outbreak in New York City, New York. Vet Pathol. 2000;37(3):208-224.

5. Microbeworld Video. One Health and the lessons learned from the 1999 West Nile virus outbreak (MWV46). http://www.microbeworld.org/podcasts/microbeworld-video/898-one-health-and-the-lessons-learned-from-the-1999-west-nile-virus-outbreak-mwv46-. Updated 2011.

6. CDC. West Nile virus. http://www.cdc.gov/ncidod/dvbid/westnile/index.htm. Updated 20122013.

7. Mostashari F, Kulldorff M, Hartman JJ, Miller JR, Kulasekera V. Dead bird clusters as an early warning system for West Nile virus activity. Emerg Infect Dis. 2003;9(6):641-646.

8. Eidson M. “Neon needles” in a haystack – the advantages of passive surveillance for West Nile virus. West Nile Virus: Detection, Surveillance, and Control. 2001;951:38-53.