We Are All Microbe

Most of us probably think we're products of our parents and their parents and their parents' parents. That's certainly true, but their collective contributions are outnumbered 10:1 (100 trillion vs 10 trillion cells) by our microbiome. The Economist cover story from this week highlights the latest thinking around the microbiome and it's implications for science and medicine. They even mention that a "handful of doctors" use fecal transplants to treat C. difficile since transplanting a microbiome is easier than transplanting a kidney. Mike is one of the handful of those doctors. (note: Maryn McKenna's comment on Mike's post from 2 years ago is still one of my favorite) One of the more interesting paragraphs covers the potential use of antibiotics to positively manipulate the microbiome:

"One is more sophisticated deployment of the humble antibiotic, arguably the pharma industry’s most effective invention. At the moment antibiotics are used mainly to kill infections. In the future they might have a more subtle use—to manipulate the mix of bugs within a human, so that good bugs spread at the expense of bad ones."


Part 2: "The human microbiome: Me myself, us" goes into the significance of the microbiome in greater detail.

Herd Immunity in the Jet Age

By 2012, I thought we'd already be beyond the jet age. Although, if you go by the GOP debates, determining if a "moon-colony" could apply for U.S. statehood is now our top domestic concern, so maybe we're finally getting beyond the jet age?

An idea central to controlling infectious diseases is herd immunity. This is the idea that vaccinating a proportion of the population (e.g. 80% for mumps or 95% for measles) will protect the entire population, even the unvaccinated. In a paper presented recently at the meeting of the American Mathematical Society and the Mathematical Association of America and discussed in the Economist, Petra Klepac and colleagues wanted to know how increasingly mobile populations with varying vaccination rates would impact optimal vaccination targets for infectious diseases. That is, does it make economic sense to target a herd-immunity threshold? Also, how would high-levels of varicella vaccination in the US vs. low levels in Britain interact to impact chickenpox in both countries?

Dr. Klepac and her team used a susceptible-infected-removed (SIR) mathematical model, which we frequently use in analysis of infection-control interventions. Analysis of their model determined that targeting herd immunity makes sense for an isolated country. However, when international travel was added, she found that a small rate of unvaccinated travelers would reduce the optimal vaccination below the level of herd immunity, so that targeting herd immunity becomes too expensive. Thus, we have to be tolerant of more infections.

There are some other interesting implications of her study, so head on over to the Economist Babbage blog to read more.

the New York Times is dead to me

Dan, Mike and I have frequently posted on content from the NY Times. As most of you have heard, on Monday the NY Times began charging for digital content.  This is the so called pay wall or pay fence or pay sponge. I have no problem paying for digital content as I subscribe to the Economist, National Geographic, etc on my iPad with specific apps or through Zinio, which is a great app if you haven't tried it. What troubles me with the Times current plan is that they are charging me based on what device I use to read their content.  I mainly read the NY Times (and everything else) on my iPad and phone.  With other digital subscriptions this doesn't matter since I pay a single amount and can access on any device. For example, the Economist charges $110 for a year subscription no matter how I read their content. The NY Times, however, has decided that they will charge $15/4 weeks ($195/year) to read on a phone and an additional $20/month ($260/year) to read the same content on an iPad, for a total of $455/year.  Crazy.

I know there are work arounds like linking off Facebook or through google searchs, but do I really want to do that?  I could also enter my username and password each time and just read on the iPad browser, but that is not the point.  I know I could subscribe to the Sunday Times for $8/week ($416/year) and save $39, but I don't really want to kill trees and waste fuel and this option isn't available in all places.  It is almost like they don't realize there is a digital age upon us.  Netflix doesn't care if I stream on a TV, laptop, or phone and why should they? Do they have extra reporters giving me inside information that only goes to my iPad? No!  There is almost no additional cost (marginal cost) for them to upload the same content to my iPad or phone, so it makes no sense for me to spend $260/year for something that costs them nothing.  They need to join the 21st century and not race back to the past. I thought the Times was called the Gray Lady since it had few pictures, but perhaps there is another reason. So, until they offer one price for digital access, the Times is dead to me.  I won't read (all bookmarks and apps removed) and I won't review, link or comment on NY Times generated content.

EOR

Economist online subscription page (so you can see what the world could look like)

WBUR's On Point has a great discussion on this subject that you can listen to.