‘Superbug’ scourge spreads as U.S. fails to track rising human toll • Hacker News Board

Re: ‘Superbug’ scourge spreads as U.S. fails to track rising human toll

#101

Post by mobilefriendly » Wed, Sep 07, 2016, 9:13 PM UTC

alkonaut wrote: post #34

badminton1 wrote: post #23

Earlier quoted context omitted.

Farmers massively administer antibiotics so they can keep animals in crowded/unsanitary conditions. If antibiotics were administered properly that would severely affect their revenue.

So just vote to outlaw antibiotics use in healthy livestock and make sure there is a rigorous inspection apparatus? Farmers are few, people who get diseases are many. Shouldn't be too hard.

>Farmers are few, people who get diseases are many. Shouldn't be too hard.

"Concentrated benefits, dispersed costs." Farmers are highly organized and vigilant in defense of their subsidies and regulations, whereas sick people are not similarly organized and the policy connection to their condition isn't obvious. Concentrated benefits are what create special interests, which by their nature put their own interest ahead of the national interest.

Re: ‘Superbug’ scourge spreads as U.S. fails to track rising human toll

#102

Post by jessaustin » Wed, Sep 07, 2016, 9:17 PM UTC

dv_dt wrote: post #35

codezero wrote: post #5

My mother in law, a healthy 50 year old, recently died of an unspecified infection. They still don't know what it was or why antibiotics weren't helping. Ultimately, her lungs gave out after more than a week on life support. Was it a superbug? Dunno, and nothing in her medical record leaves any indication that it might have been, the world just moved on.

There was an article a few years ago about the fall of the medical autopsy rate. Because it's unclear how we fund it, and most people aren't in a position of knowledge to request it (or in a financial position to pay for it), the rates of autopsy to find a considered cause of death have been dropping precipitously.

When my grandfather died with cancer and fibrosis, one of the main complications involved in getting compensation from EEOICPA was the fact that his county doesn't have a coroner. They have a "medical examiner" who is based 70 miles away and never visits, plus some nurses he employs. As a result, death certificates in that county are only signed in extraordinary circumstances. The federal bureaucracy doesn't accept unsigned certificates for the purpose of establishing a cause of death. The county medical examiner is paid a flat yearly fee, so guess how many autopsies he performs?

Re: ‘Superbug’ scourge spreads as U.S. fails to track rising human toll

#103

Post by apathy » Wed, Sep 07, 2016, 9:45 PM UTC

dv_dt wrote: post #87

toss1 wrote: post #82

Earlier quoted context omitted.

OK, so somebody's tracking it in secret, doing the 'antibiotic susceptibilities' tests and logging the results, and the state health dept receives the data, but the info is being kept from the patients' relatives and from the public in general? This creates two obvious results. 1) suppression of legitimate claims from relatives, and 2) suppression of valid concern and pressure for govt action such as increased resear…

In particular, a potential patient might want to know MRSA case rates when selecting hospitals or other medical treatment facilities.

Or (perhaps more likely) Medicare/Medicaid and/or private insurers might start penalizing the ones that are screwing it up (by renegotiating contracts and reimbursements). I know of one center where executive laziness led to a $2 million fine (completely unjustified) for a line infection in an immunosuppressed patient. Which was cleared up in hours, probably didn't come from the line to begin with, and got said executive fired (because if there's one thing hospital "leadership" understands, it's money).

Actually I have all sorts of examples of the above, but the point is that oftentimes the data is "corrupted" on the way to the collection point(s). Anyways, the executive (VP of some bullshit) got his walking papers and funnily enough, no more reportable line infections that didn't come from lines.

So at least sometimes there are happy endings, sort of...

Re: ‘Superbug’ scourge spreads as U.S. fails to track rising human toll

#104

Post by clumsysmurf » Wed, Sep 07, 2016, 9:50 PM UTC

ocschwar wrote: post #17

Bear in mind that in the US, our lovely republican party literally made it illegal to research where the superbugs are being bred. In the US, the problem is mostly pig and cattle feedlots that rely on antibiotics to keep the animals from being sickened but he crowding. Naturally, there is no proof that superbugs are coming out of the feedlots, because the feedlot owners do not allow any sort of sample collection by s…

> Naturally, there is no proof that superbugs are coming out of the feedlots, because the feedlot owners do not allow any sort of sample collection by scientists.

"In the bed of a truck that they parked on county roads adjacent to ten Lubbock-area feed yards, they set up small, generator-powered vacuums. On a number of windy days, they collected upwind and downwind air samples. The results confirmed their suspicions: downwind, they found antibiotics—specifically tetracycline—present at significantly higher levels than in the upwind samples. Yet as they dug deeper, they discovered something even more worrisome. Along with the antibiotics, they found another hitchhiker: remnants of bacteria that had acquired a gene that made them resistant to tetracycline." (1)

The article also describes the pushback from the CFA (Cattle Feeders Association)

(1) http://www.texasmonthly.com/articles/when-the-dust-settles/

Re: ‘Superbug’ scourge spreads as U.S. fails to track rising human toll

#105

Post by apathy » Wed, Sep 07, 2016, 9:52 PM UTC

trhway wrote: post #99

sqeaky wrote: post #93

Earlier quoted context omitted.

I would much rather pay 1% more for my food than 10% more for may healthcare. For many there will be no amount that can be paid to keep up with antibiotic resistant bacteria, it will kill people. I am sure that farmer's would rather risk their livestock than risk their children or grandchildren. I think the only way this practice can exist is when people do not understand or are coerced into doing it. Many of the lar…

>I am sure that farmer's would rather risk their livestock than risk their children or grandchildren. you're kidding right? sure economical impact today vs. theoretical risk to grand/children tomorrow - Nov 8 will show how many people and of what demographics what choice would make, and I'm somehow sure what choice the farmers would make :)

that should NOT be a smiley at the end

Re: ‘Superbug’ scourge spreads as U.S. fails to track rising human toll

#106

Post by clumsysmurf » Wed, Sep 07, 2016, 10:01 PM UTC

Its our pets too ...

My dog was recently diagnosed with MRSP (methicillin-resistant Staphylococcus pseudintermedius) urinary track infection.

Having mostly avoided the vet for the duration of his life (being that he was healthy) I have no idea how this happened.

Re: ‘Superbug’ scourge spreads as U.S. fails to track rising human toll

#107

Post by waqf » Wed, Sep 07, 2016, 10:24 PM UTC

jkot wrote: post #16

fernly wrote: post #2

The question that comes to my mind is, are the European countries doing any better in tracking MRSA, etc. infections? They certainly exist. One might hope a more centralized health-care system, not balkanized like the USA one[1], would keep better records. Do they?

I think 'balkanized' is good word to describe some health-care systems in Europe. However I think there is a basic difference in approach. Hospitals in europe are usually uber clean, everything is desinfected and there is a small army of cleaners. My impression from US is that McDonnald was cleaner than hospital. Second difference is post-operation treatment. People in weakened state are left in hospital for a few da…

> My impression from US is that McDonnald was cleaner than hospital.

I'm really interested in this. Where were you? Because my impression of the US is that they are very thorough on the small stuff … because they can pass the bill on to someone for taking precautions, whereas they can be sued for not taking them.

Re: ‘Superbug’ scourge spreads as U.S. fails to track rising human toll

#108

Post by thaumasiotes » Wed, Sep 07, 2016, 10:30 PM UTC

legulere wrote: post #84

ocschwar wrote: post #17

Bear in mind that in the US, our lovely republican party literally made it illegal to research where the superbugs are being bred. In the US, the problem is mostly pig and cattle feedlots that rely on antibiotics to keep the animals from being sickened but he crowding. Naturally, there is no proof that superbugs are coming out of the feedlots, because the feedlot owners do not allow any sort of sample collection by s…

Feeding antibiotics to livestock for faster growth is illegal in Germany, yet we feed around the same amount as the US: http://i.imgur.com/9ybmhwE.jpg

A great example of the stupidity of laws stating "it's fine to do X with benign intent, but it is forbidden to do X with malign intent".

Re: ‘Superbug’ scourge spreads as U.S. fails to track rising human toll

#109

Post by thaumasiotes » Wed, Sep 07, 2016, 10:33 PM UTC

dv_dt wrote: post #90

refurb wrote: post #60

Earlier quoted context omitted.

I think you have an unrealistic view of what mother nature is like. Wild animals (i.e. not in feed lots) succumb to disease, including bacteria infections all the time. Even with free-range animals, you'd have a ton of livestock dying (and suffering needlessly) if you never allowed antibiotics to be used.

I think the idea is to ban their use for purely profit reasons (though that leaves a loophole where medical care is claimed when the intent is just to increase growth of the animals for profit).

Medical care of sick animals is a "purely profit reason".

Re: ‘Superbug’ scourge spreads as U.S. fails to track rising human toll

#110

Post by trhway » Wed, Sep 07, 2016, 10:46 PM UTC

apathy wrote: post #105

trhway wrote: post #99

Earlier quoted context omitted.

>I am sure that farmer's would rather risk their livestock than risk their children or grandchildren. you're kidding right? sure economical impact today vs. theoretical risk to grand/children tomorrow - Nov 8 will show how many people and of what demographics what choice would make, and I'm somehow sure what choice the farmers would make :)

that should NOT be a smiley at the end

that is dialectical smile - for example, ignoring climate change by voting red the farmers from the mid-states are thus letting the climate change to proceed to the point where open-air farming in those states becomes impossible, and thus they are basically selecting themselves out...