Category: Government

“Precautionary Principle Would Have Vastly Slowed” Anesthesia, Antibiotics, Chemotherapy and Other Medical Innovations

(p. 15) In his new book, “You Bet Your Life,” Paul A. Offit wants to understand the failures and tragedies that help pave the way to medical innovation. For most of human history, anesthesia did not exist. Patients had to be forcibly restrained while their limbs were amputated and their cancers were removed, typically amid piercing screams and unbearable agony. Things did not start to change until the 1840s, when a carnival barker named Gardner Colton charged people 25 cents to sniff “laughing gas,” also known as nitrous oxide, which made them fall down in hysterics and then go to sleep for a few minutes. On Dec. 10, 1844, a dentist named Horace Wells attended Colton’s show. Soon after inhaling the gas (and making a fool of himself), he told a friend that a person could probably “have a tooth extracted or a limb amputated and not feel any pain.”

Wells sought out Colton immediately after the show, and the very next day, he became the first person to use nitrous oxide as an anesthetic: He asked a fellow dentist to extract one of his own teeth. The procedure was painless. Over the following weeks, Wells used nitrous oxide on 15 of his patients. It worked every time. In January 1845, he asked if he could demonstrate his method to specialists in a large amphitheater at the Massachusetts General Hospital. The demonstration failed. Wells gave too little of the anesthetic to his patient, who woke up during the extraction, in intense pain and screaming. Members of the audience shouted out, “Humbug!” Wells was disgraced.

. . .

Offit is a good storyteller, and he has some terrific stories to tell. He also draws important lessons. In the domain of medical innovation, tragedies cannot be prevented, no matter how many regulations we put in place. Science moves forward in fits and starts, with blunders, failures and losses along the way. New discoveries are rarely immediate; we inevitably learn more over time. Ours is not a risk-free world, which means that we need to choose the lesser risk. New technologies are always a gamble.

All of those claims are true, but I think that Offit also pulls out an even deeper and more provocative moral from this history. In life and in public policy, many people in Europe and the United States are drawn to the “precautionary principle,” which essentially calls for a high degree of risk aversion: Whenever an innovation threatens to cause harm, we should be exceedingly cautious before we allow it. Offit’s examples, and the history of medical advances, demonstrate that in its most extreme forms, the precautionary principle is self-defeating. Simply put, precautions kill. Whether we are speaking of anesthesia, heart transplants, antibiotics, chemotherapy or blood transfusions, the precautionary principle would have vastly slowed down innovations that, yes, carried serious risk and led to real harm, but were ultimately a great boon to humanity.

For the full review, see:

Cass R. Sunstein. “Side Effects.” The New York Times Book Review (Sunday, October 17, 2021): 15.

(Note: ellipsis added.)

(Note: the online version of the review was updated Oct. 25, 2021, and has the title “A History of Medical Innovation That Doesn’t Ignore the Side Effects.”)

The book under review is:

Offit, Paul A. You Bet Your Life: From Blood Transfusions to Mass Vaccination, the Long and Risky History of Medical Innovation. New York: Basic Books, 2021.

N.I.H. Funded EcoHealth Wuhan Research to Make Coronaviruses More Infective and Virulent

(p. A21) EcoHealth Alliance has come under scrutiny because of its collaboration on coronavirus research with researchers at the Wuhan Institute of Virology, which is situated in the city where the pandemic began.

. . .

Last month, The Intercept, an online publication, posted 900 pages of materials related to the N.I.H. grants to EcoHealth Alliance for the research. The materials provided details about experiments designed to provide new insights into the risk that bat coronaviruses have for sparking new pandemics.

In some of their experiments, the researchers isolated genes from bat coronaviruses that encode a surface protein, called spike. Coronaviruses use the spike protein to bind to host cells, the first step to an infection. The spike protein latches onto a cell-surface protein called ACE2.

According to the materials published, the researchers then engineered another bat virus, called WIV1, to carry spike proteins from other bat coronaviruses. They then conducted experiments to see if the engineered WIV1 viruses became better at attaching to ACE2 on cells.

. . .

Dr. Lawrence Tabak, the principal deputy director of the N.I.H., wrote in the letter to Representative Comer that the agency determined that the research proposed by EcoHealth Alliance did not meet the criteria for additional review . . .

. . .

Dr. Tabak noted that in one line of research, the researchers had produced mice genetically engineered to produce the human version of the ACE2 protein on their cells. Infecting these animals with coronaviruses could potentially provide a more realistic sense of the risk that the viruses have of infecting humans than just using dishes of cells.

The N.I.H. required that EcoHealth Alliance notify the agency if the engineered viruses turned out to grow 10 times faster or more than WIV1 would without their new spike proteins.

In some experiments, it turns out, that viruses did grow quickly.

“EcoHealth failed to report this finding right away, as required by the terms of the grant,” Dr. Tabak wrote.

The N.I.H. also sent Representative Comer a final progress report that EcoHealth Alliance submitted to the agency in August [2021].

In the report, the researchers describe finding that WIV1 coronaviruses engineered to carry spike proteins were more virulent. They killed infected mice at higher rates than did the WIV1 virus without spikes from the other coronaviruses.

The filing had been submitted late, the N.I.H. said, nearly two years beyond the grant-specified deadline of 120 days from completion of the work. “Delayed reporting is a violation of the terms and condition of N.I.H. grant award,” Renate Myles, a spokeswoman for the agency, said.

Jesse Bloom, a virologist at the Fred Hutchinson Cancer Center who has called for more research into the origins of the pandemic, said the revelations raised serious questions about the risks of investigating viruses originating from animals, known as zoonotic viruses.

For the full story, see:

Carl Zimmer and Benjamin Mueller. “N.I.H. Says Bat Studies Were Not Submitted Promptly.” The New York Times (Friday, October 22, 2021): A21.

(Note: ellipses, and bracketed year, added.)

(Note: the online version of the story was updated October 28, 2021, and has the title “Bat Research Group Failed to Submit Virus Studies Promptly, N.I.H. Says.”)

Little Free Lithuania Stands Up to Big Bully Communist China

(p. A4) VILNIUS, Lithuania — It was never a secret that China tightly controls what its people can read and write on their cellphones. But it came as a shock to officials in Lithuania when they discovered that a popular Chinese-made handset sold in the Baltic nation had a hidden though dormant feature: a censorship registry of 449 terms banned by the Chinese Communist Party.

Lithuania’s government swiftly advised officials using the phones to dump them, enraging China — and not for the first time. Lithuania has also embraced Taiwan, a vibrant democracy that Beijing regards as a renegade province, and pulled out of a Chinese-led regional forum that it scorned as divisive for the European Union.

Furious, Beijing has recalled its ambassador, halted trips by a Chinese cargo train into the country and made it nearly impossible for many Lithuanian exporters to sell their goods in China. Chinese state media has assailed Lithuania, mocked its diminutive size and accused it of being the “anti-China vanguard” in Europe.

In the battlefield of geopolitics, Lithuania versus China is hardly a fair fight — a tiny Baltic nation with fewer than 3 million people against a rising superpower with 1.4 billion. Lithuania’s military has no tanks or fighter jets, and its economy is 1/270th the size of China’s.

But, surprisingly, Lithuania has proved that even tiny countries can create headaches for a superpower, especially one like China whose diplomats seem determined to make other nations toe their line.

. . .

In an interview, Gabrielius Landsbergis, the foreign minister, said the country had a “values-based foreign policy” of “supporting people supporting democratic movements.”

Other European countries declaring fealty to democratic values have rarely acted on them in their relations with China. Mr. Landsbergis’s party, however, has made action part of its appeal to domestic voters: Its pre-election manifesto last year included a promise to “maintain the value backbone” in foreign policy “with countries such as China.”

. . .

From China’s perspective, last week’s release of a report on the Chinese-made cellphones by Lithuania’s Defense Ministry Cyber Security Center was yet another provocation. The hidden registry found by the center allows for the detection and censorship of phrases like “student movement,” “Taiwan independence,” and “dictatorship.”

The blacklist, which updates automatically to reflect the Communist Party’s evolving concerns, lies dormant in phones exported to Europe but, according to the cyber center, the disabled censorship tool can be activated with the flick of a switch in China.

The registry “is shocking and very concerning,” said Margiris Abukevicius, a deputy defense minister responsible for cybersecurity.

. . .

Lithuania has made “a clear geopolitical decision” to side decisively with the United States, a longtime ally, and other democracies, said Laurynas Kasciunas, the chairman of the national security and defense committee. “Everyone here agrees on this. We are all very anti-communist Chinese. It is in our DNA.”

For the full story, see:

Andrew Higgins. “A Minnow (Pop.: 3 Million) Defies a Whale (Pop.: 1.4 Billion).” The New York Times (Friday, October 20, 2021): A4.

(Note: ellipses added.)

(Note: the online version of the story was updated October 8, 2021, and has the title “Lithuania vs. China: A Baltic Minnow Defies a Rising Superpower.” Where the wording differs between the versions, the quotations above follow the online version.)

Communist China Pays World Bank for Higher Ranking in “Doing Business” Report

(p. A1) The World Bank canceled a prominent report rating the business environment of the world’s countries after an investigation concluded that senior bank management pressured staff to alter data affecting the ranking of China and other nations.

The leaders implicated include then World Bank Chief Executive Kristalina Georgieva, now managing director of the International Monetary Fund, and then World Bank President Jim Yong Kim.

The episode is a reputational hit for Ms. Georgieva, who disagreed with the investigators’ conclusions. As leader of the IMF, the lender of last resort to struggling countries around the world, she is in part responsible for managing political pressure from nations seeking to advance their own interests. It was also the latest example of the Chinese government seeking myriad ways to burnish its global standing.

(p. A10) The Doing Business report has been the subject of an external probe into the integrity of the report’s data.

. . .

The World Bank was in the middle of difficult international negotiations to receive a $13 billion capital increase. Despite being the world’s second largest economy, China is the No. 3 shareholder at the World Bank, following the U.S. and Japan, and Beijing was eager to see its power increased as part of a deal for more funding.

In October 2017, Ms. Georgieva convened a meeting of the World Bank’s country director for China, as well as the staff economists that compile Doing Business. She criticized “mismanaging the Bank’s relationship with China and failing to appreciate the importance of the Doing Business report to the country,” according to the investigative report’s summary of the meeting.

. . .

Ultimately, the team identified three data points that could be altered to raise China’s score, the investigative report said. For example, China had passed a law related to secured transactions, such as when someone makes a loan with collateral. The World Bank staff determined it could give China a significant improvement to its score for legal rights, citing the law as the reason.

World Bank employees knew the changes were inappropriate but “a majority of the Doing Business employees with whom we spoke expressed a fear of retaliation,” the investigative report said.

Although the data-gathering process for the 2018 report was finished, the World Bank’s economists reopened the data tables and altered China’s data, the investigative report said. Instead of ranking 85th among the world’s countries, China climbed to 78th due to the alterations.

For the full story, see:

Josh Zumbrun. “World Bank Cancels Report After Investigation.” The Wall Street Journal (Friday, Sept. 17, 2021): A1 & A10.

(Note: the online version of the story has the date September 16, 2021, and has the title “World Bank Cancels Flagship Report After Investigation.”)

CDC Intentionally Overestimated Risk of Heterosexual Spread of AIDS

(p. A17) ‘Follow the science,” we’ve been told throughout the Covid-19 pandemic. But if we had paid attention to history, we would have known that once a disease becomes newsworthy, science gets distorted by researchers, journalists, activists and politicians eager for attention and power—and determined to silence those who challenge their fear-mongering.

When AIDS spread among gay men and intravenous drug users four decades ago, it became conventional wisdom that the plague would soon devastate the rest of the American population.

. . .

In reality, researchers discovered early on that transmission through vaginal intercourse was rare, and that those who claimed to have been infected that way were typically concealing intravenous drug use or homosexual activity. One major study estimated the risk of contracting AIDS during intercourse with someone outside the known risk groups was 1 in 5 million. But the CDC nonetheless started a publicity campaign warning that everyone was in danger. It mailed brochures to more than 100 million households and aired dozens of public-service announcements, like a television ad with a man proclaiming, “If I can get AIDS, anyone can.”

The CDC’s own epidemiologists objected to this message, arguing that resources should be focused on those at risk, as the Journal reported in 1996. But they were overruled by superiors who decided, on the advice of marketing consultants, that presenting AIDS as a universal threat was the best way to win attention and funding. By those measures, the campaign succeeded. Polls showed that Americans became terrified of being infected, and funding for AIDS prevention surged—much of it squandered on measures to protect heterosexuals.

Scientists and public officials sustained the panic by wildly overestimating the prevalence of AIDS. Challenging those numbers was a risky career move, as New York City’s health commissioner, Stephen C. Joseph, discovered in 1988 when he reduced the estimated number of AIDS cases in the city by half. He had good reasons for the reduction—the correct number turned out to be much lower still—but he soon needed police protection. Activists occupied his office, disrupted his speeches, and picketed and spray-painted his home.

Another victim of 1980s-style cancel culture was Michael Fumento, who meticulously debunked the scare in his 1990 book, “The Myth of Heterosexual AIDS.” It received good reviews and extensive publicity, but it was unavailable in much of the country because local bookstores and national chains succumbed to pressure not to sell it. Mr. Fumento’s own publisher refused to keep it in print, and he was forced out of two jobs—one as an AIDS analyst in the federal government.

The AIDS fear-mongers suffered few consequences for their mistakes.

For the full commentary, see:

John Tierney. “Unlearned AIDS Lessons for Covid.” The Wall Street Journal (Monday, October 4, 2021): A17.

(Note: ellipsis added.)

(Note: the online version of the commentary was updated October 3, 2021, and has the same title as the print version.)

At His Toga Birthday Party FDR Dressed “Imperiously” in Wreath and Robe as Caesar

(p. C6) Again and again, artists and artisans have reworked ancient images, turning emperors and imperial women into role models or cautionary tales. Whether central to the debate or only hovering at the edges in a ghostly manner, the ancients have always been there. Such is the argument of Mary Beard’s “Twelve Caesars: Images of Power From the Ancient World to the Modern.”

. . .

Among the book’s many striking illustrations and images is a photo of Franklin D. Roosevelt celebrating his 52nd birthday in January 1934 with a toga party in the White House. Wreathed and wearing what might be a triumphator’s robe, arms folded imperiously, FDR is surrounded by more than a dozen family members and friends dressed variously as senators, matrons and legionaries. What does this Busby Berkeley-esque scene mean? It might have been a sardonic joke from FDR’s staff and friends to respond to critics who charged that the president was becoming a dictator.

For the full essay, see:

Barry Strauss. “Power in Profile.” The Wall Street Journal (Saturday, Oct. 2, 2021): C6.

(Note: ellipsis added.)

(Note: the online version of the review has the date October 1, 2021, and has the title “‘Twelve Caesars’ Review: Power in Profile.”)

The book under review is:

Beard, Mary. Twelve Caesars: Images of Power from the Ancient World to the Modern. Princeton, NJ: Princeton University Press, 2021.

To Survive a Disaster You Need “Basic Skills and Self-Reliance” in Time Before First-Responders Respond

(p. C17) The coronavirus has challenged us in ways that our society hadn’t been challenged for decades.

. . .

. . . being stressed and anxious doesn’t mean you can’t be resilient. Actively working to mitigate the damage from a disaster can help to reduce stress, because it makes you feel more empowered and less like a helpless bystander.

. . .

Experience and preparation paid off for me in September 2017, as Hurricane Irma, a Category 5 storm, approached Key West, Fla., where my husband and I had spent two years building our home together. We didn’t freak out: We knew about the risk of hurricanes when we moved there. I had studied the maps to see which areas of Key West were prone to flooding, and we prepared our property accordingly.

. . .

My long experience has taught me that when a disaster strikes, you can’t wait for someone else to bail you out. You have to have some basic skills and self-reliance initially. If a grease fire breaks out in my kitchen and I have a fire extinguisher, I can probably put it out. But if I call the fire department and wait for them to arrive, my grease fire could turn into a house fire. I will still call the fire department, in case I can’t control the fire, but the first response has to be mine.

For the full essay, see:

Robert Jensen. “Staying Resilient When Disaster Strikes.” The Wall Street Journal (Saturday, Oct. 2, 2021): C17.

(Note: ellipses added.)

(Note: the online version of the review has the date September 30, 2021, and has the same title as the print version.)

The essay quoted above is adapted from Jensen’s book:

Jensen, Robert A. Personal Effects: What Recovering the Dead Teaches Me About Caring for the Living. New York: St. Martin’s Press, 2021.

Former Teacher Union President Says Charter Schools Give Black and Hispanic Children “Access to a Quality Education”

(p. A21) When I became a teacher, it seemed natural to become an advocate for the profession. Somewhere along the way I became more of a union leader than an educational leader.

. . .

I used to oppose charter schools, not because they were bad for kids, but because they were bad for unions.

. . .

I served as president of the Washington Teachers’ Union for six years and recognize the added value unions can bring in securing fair compensation and safe working conditions for teachers. I’m still a union member. But I now work on behalf of charter schools.

Charter schools are also public schools. All of them. They provide more than three million students, mostly black and Hispanic, access to a quality public education. They are innovative and student-centered. They break down barriers that have kept families of color from the educational opportunities they deserve. Another two million children would attend charter schools if there were space for them. How could I work against these kids?

For the full commentary, see:

George Parker. “How My Mind Opened to Charter Schools.” The Wall Street Journal (Thursday, May 27, 2021): A21.

(Note: ellipses added.)

(Note: the online version of the commentary has the date May 26, 2021, and has the same title as the print version.)

FTC Slows Serendipitously Discovered Blood Test That Detects 50 Types of Cancer

(p. A13) Scientific breakthroughs are sometimes a matter of serendipity. Eight years ago Meredith Halks-Miller, a pathologist at the genetic-screening company Illumina, stumbled on something unusual while running prenatal blood tests for fetal chromosomal abnormalities. In some blood samples, the fetal genes were normal but the maternal DNA wasn’t. Illumina alerted pregnant women’s doctors to the finding. After further investigation, all the women were diagnosed with cancer, though none had symptoms when their blood was drawn.

This discovery led to the development of a blood test that can now detect 50 types of cancer and has the potential to save tens of thousands of lives a year if it becomes widely available. But regulators may slow the process.

The Federal Trade Commission last month wrapped up an administrative trial in which it seeks to block Illumina’s $8 billion acquisition of Grail, which makes the blood test.

. . .

Grail projects its test could prevent 90,000 to 100,000 cancer deaths each year if it were administered annually to all Americans 50 to 79. The sooner people get access to the test, the more lives will be saved. Illumina estimates that 10,000 lives will be saved over the following nine years for every year that it accelerates bringing the test to market. “By accelerating the global rollout of the test in the European Union, into Africa, into Asia, into Latin America, we believe we can save a lot more lives than that around the world,” Mr. deSouza says.

The company’s dominance in the DNA-testing market, however, attracted regulatory scrutiny. In March the FTC sued Illumina and Grail to block the acquisition, arguing that it would “lessen competition in the U.S. multi-cancer early detection (‘MCED’) test market by diminishing innovation and potentially increasing prices.”

Nonsense, Mr. deSouza says. “Today, there is nobody who is even starting the studies to develop a 50-cancer test like Grail, and once you start the study, it’s still a few years before you actually get the test. We think there will also be blood tests for single cancers, for colorectal cancer and other cancers. Those won’t compete with Grail. They will be complementary to Grail.”

For the full interview, see:

Allysia Finley, interviewer. “THE WEEKEND INTERVIEW; Regulatory Hurdles Block a Cancer Miracle.” The Wall Street Journal (Saturday, Oct. 9, 2021): A13.

(Note: ellipsis added.)

(Note: the online version of the interview has the date October 8, 2021, and has the same title as the print version.)

University of Chicago’s Milton Friedman Center Now Run by “Former Obama Staffers Who Cheer” . . . “Moves Toward Socialism”

(p. A15) Colleges’ ideological turn leftward has become sharper. At my own institution, a center dedicated to Milton Friedman is now run by former Obama staffers who cheer on the Biden administration’s moves toward socialism.

These policies reward professors and administrators who can then raise the price of their services. It’s basic economics that subsidizing demand increases the price of the product. Tuition rising as loan subsidies expand is no different. It isn’t a coincidence that education and health care, the industries in which government subsidies are most pervasive, took the highest price increases over the past 15 years—3.7% and 3.1% a year, compared with the 1.8% average across industries.

For the full commentary, see:

Tomas J. Philipson. “College Subsidies Are a Feedback Loop for Bigger Government.” The Wall Street Journal (Friday, June 11, 2021): A15.

(Note: the online version of the commentary has the date June 10, 2021, and has the title “College Subsidies Are a Feedback Loop for Bigger Government.”)

FASTA Is Not Faster at Untangling Red Tape to Sell Surplus Federal Property

(p. B6) The plan sounded simple enough.

The federal government has long owned more real estate than it knows what to do with — buildings that sit empty and sites that are underdeveloped — but it must jump through hoops before it can sell its holdings. So surplus properties languish while taxpayers foot the bill for maintenance.

The solution, springing from legislation passed in 2016, was an independent agency that would quickly identify underused properties and expedite their disposal.

But nothing has been simple about the Public Buildings Reform Board, as the little-known agency is called.

It took three years for the five existing board members to be sworn in, and two empty seats remain, including that of the chairman. The Government Accountability Office reported that the board did not adequately document how it went about selecting properties for sale. The board was sued when it sought to sell a Seattle building that is a repository of important tribal records. The General Services Administration, the agency that disposes of most federal properties, has flouted the board’s advice.

And so far, only a single property that the board has recommended for sale has actually been sold.

. . .

The board’s tribulations are a reminder of how difficult it can be to untangle government red tape.

. . .

In the federal government’s 2015 fiscal year, agencies reported more than 7,000 excess or underutilized properties, according to the Government Accountability Office.

Attempts have been made, through Republican and Democratic administrations, to remedy the problem. A bipartisan breakthrough came in 2016 with the passage of the Federal Assets Sale and Transfer Act, known as FASTA, . . .

. . .

But so far, only eight of the FASTA properties have been put up for auction; of these, a parking lot in Idaho Falls, Idaho, has been sold for $268,000.

For the full story, see:

Jane Margolies. “Surplus Property for Sale, Red Tape Included.” The New York Times (Wednesday, September 15, 2021): B6.

(Note: ellipses added.)

(Note: the online version of the story has the date Sept. 14, 2021, and has the title “Plan to Sell Unused Federal Property Becomes ‘Arm-Wrestling Contest’.”)