Dispatches from the Real World

  • My latest take on the true vs the real;
  • A piece about RFK Jr identifies the three big reasons you’re alive today: clean water, antibiotics, and vaccines;
  • How we know RFK Jr is wrong about vaccines;
  • How red states lead in STI rates.

To begin, an update on the idea of the true vs. the real. I discussed this before, here. I don’t think that’s quite right. Another try: Truth is relative; everyone has their personal truth. (Is mine the same as yours? implies they could not be.) Reality is what exists, despite varying perceptions and interpretations. It’s analogous to the idea of meaning and information, in Hidalgo, summarized here. Truth is a kind of meaning, and it’s relative, and contextual. Reality is verifiable through repeated tests and observations of the world. Truth is what religion and philosophy are about; reality is about what science is about. Ideally. And science fiction, as a form of literature, deals with the various truths of various kinds of people, and tries to see through and around them to suggests areas of reality we haven’t yet perceived. Roughly.

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Here’s a quote from a piece I’ll identify below, since the ostensible subject of the piece isn’t the point.

There are three big reasons you are alive today.

One: clean water. Congratulations! You and/or your ancestors didn’t die of dysentery. You didn’t die of cholera. You didn’t die of typhoid fever.

Two: antibiotics. Congratulations! You didn’t die of scarlet fever. You didn’t die of a urinary tract infection. You didn’t die of a tooth abscess that turned into sepsis. You didn’t die of the bubonic freaking plague.

Three: vaccines. Congratulations! You didn’t die of measles. You didn’t die of tetanus. You didn’t die of pertussis. You didn’t die of polio. If you’ve been vaccinated against HPV, you almost certainly aren’t going to die of cervical or anal or throat cancer. You have survived COVID, the deadliest pandemic in a century.

Vaccines are the most rigorously studied health interventions in the history of the world. Over the past 50 years, 13 childhood vaccines have together saved 154 million lives. One hundred and fifty-four million! Vaccines eliminated smallpox. Smallpox killed 500 million people!

The article is this, about the dangers of an RFK Jr. administration. He promotes a kind of truth that is at odds with reality.

Slate, Laura Helmuth, 21 Nov 2024: You Know RFK Jr. Is Going to Be Bad. It Might Get Even Worse., subtitled “If bird flu starts spreading easily among people, we’re going to need a lot of vaccines.”

But all of this is obvious, and I don’t need to quote more.

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I’ve noted, in my Provisional Conclusion #12, that most people don’t know much about reality, and get along anyway. Humanity survives through protocols that prioritize survival (which I’ve refered to as tribal morality among other terms), and not through understanding of the real (using that term advisedly) world. Here’s an example of reality.

The Atlantic, Sarah Zhang, 19 Nov 2024: Here’s How We Know RFK Jr. Is Wrong About Vaccines, subtitled “Children used to die of diseases far more gruesome and deadly than we remember.”

Today, diphtheria has been so thoroughly forgotten that someone like me, born some 60 years after the invention of a diphtheria vaccine, might have no inkling of the fear it once inspired. If you have encountered diphtheria outside of the historical context, it’s likely because you have scrutinized a childhood immunization schedule: It is the “D” in the DTaP vaccine.

Vaccine breakthroughs over the past two centuries have cumulatively made the modern world a far more hospitable place to be born. For most of human history, half of all children died before reaching age 15; that number is down to just 4 percent worldwide, and far lower in developed countries, with vaccines one of the major drivers of improved life expectancy. “As a child,” the vaccine scientist Stanley Plotkin, now 92, told me, “I had several infectious diseases that almost killed me.” He ticked them off: pertussis, influenza, pneumococcal pneumonia—all of which children today are routinely vaccinated against.

And about the human attention span.

But the success of vaccines has also allowed for a modern amnesia about the level of past human suffering. In a world where the ravages of polio or measles are remote, the risks of vaccines—whether imagined, or real but minute—are able to loom much larger in the minds of parents. This is the space exploited by Robert F. Kennedy Jr., one of the nation’s foremost anti-vaccine activists and now nominee for secretary of Health and Human Services.

There are comments about herd immunity or “community protection.” And then, putting things in an evolutionary perspective, and concluding:

Evolutionary biologists have argued that plague and pestilence rose in tandem with human civilization. Before humans built cities, back when we still lived in small bands of hunter-gatherers, a novel virus—say, from a bat—might tear through a group only to reach a dead end once everyone was immune or deceased. With no one else to infect, such a virus will burn itself out. Only when humans started clustering in large cities could certain viruses keep finding new susceptibles—babies or new migrants with no immunity, people with waning immunity—and smolder on and on and on. Infectious disease, you might then say, is a necessary condition of living in a society.

But science has overcome this problem.

But human ingenuity has handed us a cheat code: Vaccines now allow us to enjoy the benefits of fellow humanity while preventing the constant exchange of deadly pathogens. And vaccines can, through the power of herd immunity, protect even those who are too young or too sick to be effectively vaccinated themselves. When we get vaccinated, or don’t, our decisions ricochet through the lives of others. Vaccines make us responsible for more than ourselves. And is that not what it means to live in a society?

And yet, so many conservatives deny science. This is a key problem.

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One more for today about society, politics, and medicine. This isn’t about changes in rates of STIs, just the current statistics. And the states’ stats.

JMG, 21 Nov 2024, from the CDC: Nine Red States Lead Annual CDC Report On STI Rates

Ron Filipkowski drilled through the CDC report and came up with this:

This trend is true about a variety of social/medical issues. For example, divorce rates are higher in red states, apparently because young women are encouraged to marry early, and those marriages don’t work out.

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