Why the CDC’s “7 banned words” is worse than you think

Yesterday, the Washington Post broke a story noting that CDC officials are no longer allowed to use the following seven words: “vulnerable,” “entitlement,” “diversity,” “transgender,” “fetus,” “evidence-based” and “science-based” as part of a larger Orwellian attack on science at large and specific communities and topics more generally.

It’s horrible on its face and not even trying to pretend it’s anything but an attack on science and the most vulnerable among us–forcing out the scientific term “fetus” (clearly to allow for the idea that terms like “baby” should be used instead, in a nod to the anti-choice movement); the poor who receive “entitlements;” minorities and LGBTQIA who are no longer allowed to be referenced by terms like “diversity” and “transgender.” And it attacks the very background of scientific research, taking away “evidence-based” and “science-based” as descriptors for policy recommendations. It’s hard to believe this is real life in the United States and not Soviet-era Lysenkoism.

But what chills me more, even beyond the removal of these words from the CDC’s formal lexicon, is the suggested replacement given for “science” or “evidence-based” is instead: “CDC bases its recommendations on science in consideration with community standards and wishes.”

Soak that up. This opens the door for official CDC documents to support, say, abstinence-based education in conservative areas as a “recommendation based on science in consideration with community standards and wishes.” In other words, not science-based at all, even though many communities support it *despite* the scientific evidence. Or anti-vaxxers in Oregon who believe vaccines are “toxic” to have that now become a CDC recommendation based “on science in consideration with community standards and wishes.”

If this policy is allowed at the CDC, there’s no reason to think this will stay in that agency, either. Imagine all of HHS, NASA, NOAA, the Department of Education, and many others requiring similar definitions of science/evidence-based. It’s programmatic approval of the idea that facts are anything you want them to be.

It’s literally turning “truthiness” into Federal policy.

“War is peace. Freedom is slavery. Ignorance is strength” never felt quite so close to home as it has in 2017.

Preparing for the zombie apocalpyse

I have a paper out in the Christmas issue of BMJ on the coming zombie apocalypse.

You read that right. And yes, it was peer-reviewed.

I’ve discussed previously how I’ve used the attention paid to zombies to talk about infectious diseases with children and other audiences; and to bring some science to the Walking Dead and other zombie tales. I even include a zombie lecture as part of the talks I give in my position as an American Society for Microbiology distinguished lecturer.

Why?

Like them or hate them, zombies are part of the zeitgeist. The Walking Dead is still one of the highest-rated programs on television, and its spin-off, Fear the Walking Dead, has been renewed for a second season. Early 2016 will bring us Pride and Prejudice and Zombies on film. Even Aaaahnold Schwarzenegger did a zombie movie. The Girl with all the Gifts was a sleeper hit, and a movie version of the zombie fungus video game The Last of Us is supposedly on the way.

So that’s what the BMJ paper was all about. Of course, it’s ridiculous at its core–no one really expects a zombie outbreak. *But*, we do see new diseases emerging all the time. MERS. Zika virus. Chikungunya. Hendra. Nipah. Pandemic influenza. Other, novel influenzas. And of course, the Ebola virus disease outbreak that is still ongoing in Guinea and Liberia (though cases have finally slowed to a mere trickle).

And we’re still unprepared for them when they become explosive, as Ebola did in 2014. Analyses have showed that the delayed response to that outbreak cost lives. And that’s for a virus that is not particularly easy to transmit, as it’s only spread late in the illness via direct contact with infected bodily fluids. If that had been another virus that was airborne instead of bloodborne, the world could have been in a much worse situation. Now imagine that it was the Solanum virus of World War Z (the book version), slowly incubating in infected individuals as they move all over the globe. Definitely unprepared.

Furthermore, even with our handful of cases in the U.S., we saw that the hype and misinformation about Ebola was out of control. We saw this with H1N1 in 2009 as well, and H5N1 before that. We’re still, as a whole, pretty bad at communicating about infectious disease threats–striking that correct balance of assurance that we know what we’re doing, but acknowledging the gaps in our data and how we’re working to address those. It’s not an easy thing to do, but we need to continue improving. Because again, that’s how it always starts in zombie movies, right?

All-Im-saying-is-Zombie-movie

Ebola and zombies also lead to ethical dilemmas. As I noted in the paper, for a zombie outbreak, there would remain the question of quarantine (for those exposed/bitten but not yet sick), and isolation (for those who are ill)–how would those be handled? What if quarantining the healthy-but-exposed led to essentially a death sentence, as the bitten would inevitably “turn”, and possibly start chowing on the still-living who were quarantined with them? Again, ridiculous on its face, but it has parallels in real-life outbreaks and the legality and ethical quandaries of when to use such measures (and, of course, used with the assumption that they would be effective–which doesn’t always hold). There are accusations that these were violated last year, when individuals coming back from working the Ebola outbreak were quarantined–lacking in scientific justification for sure, and potentially illegal as well.

Using zombies in lieu of real diseases gives researchers, public health professionals, policy makers, and laypeople the ability to discuss these heavy issues without getting bogged down in one specific outbreak or pathogen, because many of the problems we’d face during the zombie apocalypse are similar to those that come up in any serious epidemic: coordination. Funding. Communication. Training. Access to treatment or prevention. Though I didn’t discuss it in this particular article, proper personal protective equipment (PPE) is another issue–both access to it (lacking in developing countries), and being sure to choose the right gear for the outbreak (“overprotection” is not always better). Further, it encourages individuals to put together their own zombie (disaster) preparedness plan, which is how the CDC has used the zombie phenomenon.

In short, it’s way more fun for the average person to shoot the shit about zombies than to have a more serious discussion about influenza, or Ebola, or whatever the infectious disease du jour may be–and maybe even learn a bit of science and policy along the way.