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Life as an Extreme Sport – Page 11 – "the hardest thing in this world is to live in it"
Life as an Extreme Sport

OutbreakChat: A Livetweet of a Movie That Gives People Nightmares,…

Outbreak-ForBlog…and probably not for the reason you think. Outbreak is one of those movies people seem to either love or hate (or possibly love to hate); almost everyone I know who has anything to do with public health, infectious diseases, or virology tends to swear up a blue storm when the movie comes up.

So naturally, a group of us are going to watch it in real-time tonight, drinking and live-tweeting our thoughts on Twitter. This will include fact-checks, snark, and almost certainly questions and answers from the crowd-at-large. Who is doing this? Well, you might remember David Shiffman (@whysharksmatter) from my Virtually Speaking Science interview a few months ago; while he might seem like an odd choice to organize this, remember he has significant experience with pop culture/movie portrayals of sharks, mermaids, and other scientifically incorrect portrayals of the ocean.

Tara Haelle (@tarahaelle) is a freelance journalist probably best known for her excellent article that debunks flu myths. She’s written extensively on science and the need for accuracy in media imagery and discussion.

Nicholas Evans (@neva9257) is a post-doctoral bioethicist at the University of Pennsylvania’s Department of Medical Ethics and Health Policy, based in the Perelman School of Medicine. He specializes in biosecurity, bioterrorism, and the ethics of pandemic preparedness, and recently wrote a piece for Slate explaining why Ebola is not a bioweapon, despite media myths. (He’s also my husband.)

And what am I (@rocza) doing involved in this? Well, aside from spending much of the last couple of months educating Twitter about Ebola, blogging extensively about Ebola, and doing Justice Putnam’s “The Morning After” radio show to talk about the ethics of science journalism and Ebola coverage, I once upon a time was pursuing a PhD in bioethics and philosophy, looking at how popular media portrayals of medical issues affects our medical-decision-making (a continuation of my undergraduate thesis on autonomy and medical ethics). I’ve taught courses through pop culture (Stargate and Applied Ethics), and one of my most popular and invited lectures was on why we watch reality TV. I also have a weird affinity for Ebola; I once intended to become a virus hunter, and I’ve been studying Ebola, outbreaks, and the research for going on 20 years.

We are, of course, hoping more people will join in the viewing party-both experts and lay people alike. So pop up some popcorn, grab your favourite beverage of choice, and join us at 8pm ET tonight (#OutbreakChat) to see firsthand what set the foundations for the Ebolanoia that has raced through the world these past few months.

Edited to add: Bingo cards are available on Twitter.

Know Your Variants: Kikwit vs Gueckedou

This is an update of an earlier post, Know Your Species: SUDV vs EBOV.

When last we discussed the Democratic Republic of Congo outbreak of Ebola, it was presumed that it was actually an outbreak of the genus Ebolavirus, species Sudan ebolavirus (SUDV), largely because that’s what initial reports indicated. It hasn’t yet been clarified why there were reports of a positive test for SUDV and a positive test for a SUDV/EBOV mix (although I’ve heard speculations about earlier outbreak exposure), but what we do know is that on 2 September, the World Health Organization released the results from their virological analysis, showing that while the Ebola outbreak in the DRC was actually EBOV (Zaire ebolavirus),See Maganga G, Kapetshi J, Berthet N, Ilunga B, et al. Ebola Virus Disease in the Democratic Republic of Congo. NEJM 2014;DOI: 10.1056/NEJMoa1411099. it also was not linked to the on-going epidemic in West Africa.I say “was” because there is currently no known active transmission occurring, and the country is in the cool-down period, waiting for 42 days to pass in order to be declared virus-free.

This brings us back to my last post illustrating Ebola with kittehs.The language of the internet. For a quick refresher, all ebolaviruses are the family Filoviridae and the genus Ebolavirus. There are five different species within that genus: Reston ebolavirus (RESTV); Taï Forest ebolavirus (TAFV); Bundibugyo ebolavirus (BDBV); Sudan ebolavirus (SUDV); Zaire ebolavirus (EBOV).

And then we have a obligatory illustrative cute cat picture, because this is just likeWell, with significantly less cuddles. how cats are members of the same family (Felidae) and the same genus (Felis), but have a variety of different species.

Bv48v2KIQAAFYEE

But what does it mean when we learn that, in fact, it’s the same species of ebolavirus, but different variant? Simply put, it just means being even more specific: variant fits inside species fits inside genus fits inside family.Are you having flashbacks to biology class yet? (Inside order. Viruses stop at that point; for the curious, the family Filoviridae is part of the order Mononegavirales.)

Variants are written out in a specific way that tells you the virus name, the isolation host-suffix, country of sampling, year of sampling, variant designation, and isolate designation. It looks like this:

The current epidemic started with, it is presumed, a Guinea variant Guéckédou,The NEJM article discussing contact tracing back to a December case in Guéckédou. which would be written like this:

    Ebola virus H.sapiens-wt/GIN/2014/Gueckedou-XXXXX

This tells us that it’s an ebolavirus infecting homo sapiens (that’s us humans), wild type (it hasn’t been cultured), that it was sampled in Guinea in 2014, and that the variant is Guéckédou.There is a brief post on Virology Down Under about this, too. (Don’t worry about the isolate. That’s basically an individual code that’s given per sample, hence the name.)

Clearly, at this point, it becomes harder to do a one-to-one correlation between viruses and kitties, because kitties don’t break down into variants and isolates, but work with me a bit here. What cats do break down into is year they were born, litter, and even what they look like. So we do have ways we tell each individual Felis catus apart, even though we recognize them all as belonging to the genus Felis and species catus.

DifferentVariants80Per

In theory, we could roughly write these two cats out like this, utilizing their species, country of origin, year they were born, where they were born, and their name:

    F.catus-wt/USA/2005/Philadelphia-Zeus
    F.catus-ct/USA/2003/Cougar-ToledoYes, Toledo is from a place in Washington called Cougar. Honest.

Just as we can all look at Zeus and Toledo and see that they’re different domestic cats (but still clearly domestic cats, all the same), researchers can look at the virus they isolate from individuals and see that they’re different variants of the same strain. In the case of the outbreak in the DRC, it was a variant most closely related to the 1995 Kikwit Zaire ebolavirus outbreak.

So why does this matter? In an era of ebolanoia, it’s important to understand what it means when there’s an epidemic of Ebola in one area of the world and a new outbreak in another. People are quick to panic and assume that all outbreaks are connected to the epidemic, and equally quick to forget that ebolavirus has been cropping up sporadically for nearly 40 years in other parts of Africa. Knowing how scientists differentiate between strains and variants within viruses is another tool in being an educated and informed media consumer.

Help Stop Ebola with this One Simple Trick!*

I mean, other than donating to aid organizations that desperately need help, that is.

See, yesterday, it was revealed there was yet another Western person being treated with ZMapp. Yep, that experimental drug that the world supposedly ran out of last week. Except, apparently, when there’s a Briton involved, in which case, someone checked behind the couch cushions, NIH thought to look in an unused cold storage closet, or who knows—because that’s the problem. The world now knows British man Will Pooley received at least one dose of ZMapp and will receive more, and no one has explained how the Royal Free Hospital happened to stumble across these doses that theoretically didn’t exist. In fact, all they’re saying is

[T]he team treating the nurse had sourced the drug through its clinical networks with the help of international colleagues.

-GIF-suspicious-William-Shatner-James-T.-Kirk-Star-Trek-GIFWell, that’s not at all suspicious. Clinical contacts? International experts? Sure, that doesn’t sound at all sketchy.

See, the thing is, we’re going back to risk communication, international relations, and the people who are dying en masse in affected countries who’ve been told that there is just no drug left. When you say “nope, sorry, no drugs left, we are all and completely out of ZMapp” and then manage to suddenly find some when a white British guy needs it, you foster a climate of mistrust—something that’s already a huge issue that doesn’t really need further fuel on the fire.

Which is why, at this point, when these random unaccounted for surprise stores of ZMapp are discovered, there needs to be transparency about where it came from, why we didn’t know about it, and why it was suddenly found. Because otherwise, it sure looks like the double standard of treatment for Westerners vs. native Western Africans is continuing to happen.

(*How does this help to actually stop Ebola? Right now, one of the bigger issues being seen in countries like Liberia and Sierra Leone is a complete lack of trust in Westerner health care workers who are trying to help. Reinforcing the idea that there is a cure for Westerners when people in Liberia, Sierra Leone, and Guinea have been repeatedly told there isn’t a cure for them is going to continue to emphasize this lack of reason to trust, and that trust is an extremely crucial step to all of the very basic things that need to be done to stop this outbreak from spreading any further. At this point, I’m leaning pretty hard on it being unethical for doctors or journalists to report on ZMapp use without also identifying the source of the drug.)

Know Your Species: SUDV vs. EBOV

Last night, it was confirmed that at least some of the hemorrhagic deaths in a remote area of the Democratic Republic of Congo are from an ebolavirus—but it looks like it’s species Sudan ebolavirus (SUDV), rather than the one ravaging Sierra Leone, Guinea, Liberia, and trying to get a foothold in Nigeria: species Zaire ebolavirus (EBOV). Technically, EBOV is the only member virus within the species Zaire ebolavirus, but let’s keep it simple. …simpler.

In other words, while the two outbreaks involve members of the same family (Filoviridae) and the same genus (Ebolavirus), they are not the same species.

It might help to think about cats.Ian Mackay uses cars, and goes into much more detail. But frankly, it’s the internet. Cats are the obvious go-to. Like these guys:
Bv48v2KIQAAFYEE

While these cats are both members of the same family (Felidae) and the same genus (Felis), their species are different. In fact, black-footed cats and the common domestic house cat look similar enough that it’s often hard to tell them apart without either being an expert or getting a genetic test.

Which is pretty much how it works with SUDV and EBOV, too.

So keep that in mind when people start sky-is-falling about Africa: there are currently two species of the genus Ebolavirus in (probable) outbreak, and there is no known link between the two. And, for what it’s worth, this isn’t the first time both SUDV and EBOV have occurred at the same time. As a matter of fact, the very first known outbreak of both overlapped.More than one person, myself included, has wondered if we might be seeing some sort of weather- or animal migration-related pattern emerging.

If I’m Gonna Drop Anything, It’ll be Bricks, Not Names

I really hate having to justify myself. I hate having to roll out “credentials” and be constantly challenged on whether or not I have the “right” to discuss philosophy or ethics, or why I am actually offering a bit more than an “opinion,” or the recent favourite, that I’m not just talking about these things because my husband is a postdoc at Penn.

I hate it even more when I see how people treat Nick — even before his affiliations were made public, no one asked him to justify his credentials. No one asked if he had the right to offer opinions, and in fact, few took what he said as opinions. Oh sure, he gets the MY SCIENCE FACTS crowd, but that’s the crowd that’s arguing the validity of ethics as a field, not the validity of Nick discussing ethics.

sexistandabsurdNo one has suggested that he writes about ethics, or thinks he’s able to do so, because of who he is married to.

Some people have suggested that it’s because I don’t specifically call myself an ethicist or bioethicist in my Twitter profile, which is true. I have some issues there, and in particular I don’t want people to make the mistake of assuming I have a PhD, because I don’t.Look at my CV. Look at Google. Piece it together.

But that doesn’t mean I don’t have an education, because I do. I started off studying human psychology and comparative religions, and got about halfway through a dual degree when I had to relocate to another state, putting my education on hold. When I went back to school, it was with an eye towards either communication or epidemiology; I ended up in a strange interdisciplinary department at the University of Washington, the Comparative History of Ideas. My mentor had a degree in the History and Philosophy of Science, and I studied that, with a heavy emphasis in continental philosophy and anthropology, as well as medical history and ethics, in what was, at the time, the Department of Medical History and Ethics. They only offered a minor for undergraduates, but because of my major and my interest, I was allowed to take as many courses as I could, which ended up being equivalent the Master’s students.

During that time, I also started writing about pop culture and ethics for “the school newspaper” – which happened to be the third largest paper in Seattle at the time. I started guest blogging and then actually writing for other bioethics-related blogs, and I started giving invited talks on subjects I’d written on.

My thesis, which neared the length of a dissertation, was required for graduating with honors (which I did, both department and university). Relying heavily on continental philosophers you’ve never heard of, I made an argument against the primacy of autonomy and proposed an affect-centered ethic to take its place.

I went to graduate school, where I ended up writing for yet another bioethics blog. I worked in a bioethics research institute as a research assistant. I learned how to edit academic papers while working at an academic journal, where I also learned how to run an academic journal. I learned how to talk to the media, how to give interviews, how to evaluate timely and relevant topics. I learned how to write about complicated and serious issues in an accessible manner.

I also taught; I started teaching as an undergraduate, and into my graduate years. I taught basic general topics, I taught applied ethics, I taught bioethics. I taught Merleau-Ponty to freshmen and I taught medical ethics to graduate students.

Is that enough hitting over the head, or do I need to start name-dropping? After all, I learned a lot, from a lot of people, many of whom were, or are, considered the best in what they work in.

No, through circumstances, most out of my control, I don’t have a PhD to hit you over the head with when you question my credentials or my ability to talk about ethics in 140 characters. And that’s why, if you want to talk to “an ethicist” for a paper or publication, I’m happy to give you suggestions on who I think is accessible and able to talk on the subject at hand; I do understand the power of a PhD and the ability to cite an institutional affiliation. Do I wish I had that? Of course. But I also understand reality.

It's not just academia where you find this "treat a couple in the same field differently" bias; Emma Stone has spoken quite pointedly on it.
It’s not just academia where you find this “treat a couple in the same field differently” bias; Emma Stone has spoken quite pointedly on it.
Just like I understand the reality of why you question me and my ability to talk about ethics when it doesn’t even cross your mind to do the same with Nick. And it has nothing to do with his PhD, or my lack of.

Unfortunately, the fact that I even had to write that tells me that too many people don’t understand this, or the dynamics we’re working in, at all. Too many people don’t see that they will automatically accept a man as an authority, while automatically suspect that a woman can have any knowledge at all. So a situation is created where women have to be on constant defense, constantly justifying their ability to have more than an opinion.And yes, my irritation and my experience is a small fraction of what minorities, both male and female, have to deal with in academic and professional fields.

There is a difference between “let’s discuss” and “prove it,” one that rests not on tone or language, but on the implicit assumption that discussions happen between people with differing understandings, ideas, and knowledge, whereas someone being told to “prove it” has to meet some unknown, hidden bar of justification just to move on in to the possibility of discussion, and that the person making the demand has the qualifications to make such a determination.

And while there are situations in which “prove it” is appropriate, they are not “when the topic is about ethics and your background, degree, career are nowhere near ethics,” because you don’t have the ability to accurately judge my knowledge of my field.

You know who does?

The people I’ve never once been challenged by,Which is not to say there have never been loud and feisty disagreements. But see the difference between “let’s discuss” and “prove it.” I have never once felt as though I’ve had to prove my right or otherwise justify my ability to discuss ethics with other people in philosophy, ethics, and bioethics—and we’re not talking a giant happy-go-lucky field here, but one where civility is often strained, at best. in my last decade and change of being publicly involved in philosophical, biomedical ethical issues: other ethicists.