An Ethical Comparison of the COVID-19 National Disease Control Performance of China, Canada and the U.S. in the First Year of the Pandemic

Objective: First year government pandemic control performance is compared in China, Canada and the USA to understand the ethical bases of different population outcomes achieved. Methods: Comparative analysis of ethical underpinnings and implications of pandemic performance includes degree of authoritarian power deployed to mitigate disease spread; benefits of single payer health care; impact of socioeconomic, racial/ethnic and health care inequities; anti-government sentiment/distrust; national leadership engagement; and science denial. Results: National COVID-19 response efforts vary according to the extent to which they leveraged autocratic tactics, from China whose highly autocratic first year pandemic performance was emulated, through liberal democracies like Canada where ethical compromises were largely avoided, to the USA where federal government abandonment of public health ethics produced one of the deadliest pandemic first year performances. Conclusions: Examining the ethics of pandemic disease control practices can lessen risk of repeated pandemic performance failures, and associated avoidable morbidity/mortality in future pandemics

Hippocratic Values in an Era of Nuclear Asymmetry: Should U.S. Public Health Prepare for Nuclear War with North Korea?

Objectives: Advancements in North Korean nuclear weapons have heightened tensions and increased risk for nuclear war. U.S. public health agencies are investing resources in nuclear attack preparation. Analyses assess the impact and value of existing protective public health strategies for limited nuclear exchange. Methods: Projections of fatality/injury from a North Korean nuclear strike within North Asia and explosive impact mapping are used to assess the potential impact of an attack on major U.S. urban centers. Results: A nuclear strike on the 20 largest U.S. urban centers would place 38.1% of Americans at risk. With 1-3 missiles of 250 kiloton yield deployed to each, 9.7 million fatalities and 16.8 million injuries would result, impacting 8.2% of the population. Extrapolation of Seoul-Tokyo impact data, assuming public sheltering reduces mortality 50%, indicates 4.7-9.4 million Americans could be killed. Local medical-public health personnel/infrastructure to care for survivors would be destroyed. Conclusions: Public health measures may not meaningfully decrease U.S. mortality/injury from a limited nuclear strike. Medical-public health leaders must ensure U.S. leaders comprehend the public health disaster resulting after even limited nuclear attack, and advocate against current shifts in U.S. nuclear policy toward first use and expanded nuclear scenarios with lower use thresholds

Why the West Should Help China Reduce Unrecognized and Preventable COVID-19 Deaths

In an era marked by a ruinous war between a democratic state and a totalitarian regime, political volatility, rightward looking isolationism and nationalism, and heightened competition and disputes between China and the West, it is perhaps difficult to discern why the West should supply China with COVID-19 vaccines and therapeutics, as well as epidemiological assistance in order to mitigate a potentially unrecognized COVID-19 crisis in that nation. This commentary considers three arguments against Western and international indifference to the plight of China as it transitions to COVID-19 endemicity

Fake Medical News: The Ethics and Dangers of Health Product Advertising Disguised as Real News

Leading national newspapers in the US, challenged financially by the transition from paper to electronic media, are allowing drug and medical product advertisers to format their advertisements to appear like actual, authentic news articles. This news mimicry is intended to deceive consumers, and often makes claims of clinical efficacy and safety that are not evidence based and substantiated. An example of such an advertisement is presented and the clinical implications are considered, including recommendations to public health leadership organizations

Nonaxisymmetric MHD instabilities of Chandrasekhar states in Taylor-Couette geometry

We consider axially periodic Taylor-Couette geometry with insulating boundary conditions. The imposed basic states are so-called Chandrasekhar states, where the azimuthal flow $U_\phi$ and magnetic field $B_\phi$ have the same radial profiles. Mainly three particular profiles are considered: the Rayleigh limit, quasi-Keplerian, and solid-body rotation. In each case we begin by computing linear instability curves and their dependence on the magnetic Prandtl number Pm. For the azimuthal wavenumber m=1 modes, the instability curves always scale with the Reynolds number and the Hartmann number. For sufficiently small Pm these modes therefore only become unstable for magnetic Mach numbers less than unity, and are thus not relevant for most astrophysical applications. However, modes with m>10 can behave very differently. For sufficiently flat profiles, they scale with the magnetic Reynolds number and the Lundquist number, thereby allowing instability also for the large magnetic Mach numbers of astrophysical objects. We further compute fully nonlinear, three-dimensional equilibration of these instabilities, and investigate how the energy is distributed among the azimuthal (m) and axial (k) wavenumbers. In comparison spectra become steeper for large m, reflecting the smoothing action of shear. On the other hand kinetic and magnetic energy spectra exhibit similar behavior: if several azimuthal modes are already linearly unstable they are relatively flat, but for the rigidly rotating case where m=1 is the only unstable mode they are so steep that neither Kolmogorov nor Iroshnikov-Kraichnan spectra fit the results. The total magnetic energy exceeds the kinetic energy only for large magnetic Reynolds numbers Rm>100.Comment: 12 pages, 14 figures, submitted to Ap

Ethical imperatives critical to effective disease control in the coronavirus pandemic: Recognition of global health interdependence as a driver of health and social equity

Ethical imperatives critical to effective disease control in the coronavirus pandemic: Recognition of global health interdependence as a driver of health and social equity George A. Gellert MD, MPH, MPA ABSTRACT Decades into the era of emerging infectious diseases, the 2019-2020 coronavirus pandemic has caught the world, and the United States in particular, poorly prepared to engage effective public health disease prevention and control measures. In part, this reflects poor public health planning, response, logistical preparation and pandemic readiness, and complacency by governments and disease control agencies. In terms of future responses to emerging infection pandemics, these deficiencies can be readily addressed by engaging well established and proven methods of public health disaster and epidemic preparedness planning and mobilization. In part, however, the disastrous 2020 coronavirus disease control response, in the United States but elsewhere, reflects longstanding indifference to essential ethical imperatives, gaps and deficiencies in public policy that extend well beyond public health disease control activities and strategies per se. These imperatives are reviewed and discussed. A key underlying feature, operationally and from an ethical viewpoint, is a chronic failure to understand and actively manage the fundamental global health interdependence that exists among individuals in every jurisdiction or community, including municipal, state, national and international/global. Local, national and global public health interdependence, though existing and ignored for decades, must become the central strategic, operational and ethical recognition for effective coronavirus disease control, and should inform current pandemic response and planning for inevitable future emerging infection outbreaks. Key Words: Coronavirus pandemic, SARS-Cov-2, COVID-19, coronavirus disease control, ethical issues, global health interdependence, social inequity, racial inequity, economic inequit

An Epidemiological View of the 2020 U.S. Presidential Election: COVID-19 and the Ethics of Science Denial

COVID-19 is exploiting U.S. political and cultural polarization in the first presidential election to be driven by epidemiology and public health. Medical science is on the ballot as Americans’ views on economic re-opening fracture according to party affiliation. The difference between pro aggressive versus incremental re-opening, mask wearing and social distancing is rooted in respect for, or denial of, the science of epidemiological pandemic disease control. Political leaders at multiple levels, and in particular the president, have politicized the wearing of face masks and so intentionally obscured and misinformed the public regarding the objectively and scientifically proven value of these protective measures. The presidential election rests at a fundamental level upon an individual choice of whether to accept or “believe” value-neutral, evidence-based science or an unethical decision to be swayed by political disinformation. The persistent and highly dysfunctional political and cultural polarization of the U.S. is now enabling and reinforcing the ethics of science denial, while driving the nation’s public health fate and near- to medium-term economic outcomes. However, mask wearing, social distance and sheltering are not political expressions, and the right to freedom of expression does not include behaviors that produce or could produce serious, and in the case of this pandemic, deadly impact on other citizens. One does not have the right to forms of political or other expression that kill or make ill other individuals

Chemistry of Martian Soils from the Mars Exploration Rover APXS Instruments

The martian surface is covered with debris formed by several mechanisms and mobilized by various processes. Volcanism, impact, physical weathering and chemical alteration combine to produce particles of sizes from dust to boulders composed of primary mineral and rock fragments, partially altered primary materials, alteration minerals and shock-modified materials from all of these. Impacts and volcanism produce localized deposits. Winds transport roughly sand-sized material over intermediate distances, while periodic dust storms deposit a global dust layer of the finest fraction. The compositions of clastic sediments can be used to evaluate regional differences in crustal composition and/or weathering processes. Here we examine the growing body of chemical data on soils in Gusev crater and Meridiani Planum returned by the Alpha Particle X-ray Spectrometer (APXS) instruments on the rovers Spirit (MERA) and Opportunity (MERB), following on earlier results based on smaller data sets [1-4]

Fe-Bearing Phases Identified by the Moessbauer Spectrometers on the Mars Exploration Rovers: An Overview

The twin Mars Exploration Rovers Spirit and Opportunity have explored the martian surface at Gusev Crater (GC) and Meridiani Planum (MP), respectively, for about two Earth years. The Moessbauer (MB) spectrometers on both rovers have analyzed an aggregate of ~200 surface targets and have returned to Earth information on the oxidation state of iron, the mineralogical composition of Febearing phases, and the distribution of Fe among oxidation states and phases at the two landing sites [1-7]. To date, 15 component subspectra (10 doublets and 5 sextets) have been identified and most have been assigned to mineralogical compositions. Two subspectra are assigned to phases (jarosite and goethite) that are marker minerals for aqueous processes because they contain hydroxide anion in their structures. In this paper, we give an overview of the Febearing phases identified and their distributions at Gusev crater and Meridiani Planum

Compositional Constraints on Hematite-Rich Spherule (Blueberry) Formation at Meridiani Planum, Mars

Meridiani Planum was chosen as the landing site for the Mars Exploration Rover Opportunity partially based on Mars Global Surveyor Thermal Emission Spectrometer data indicating an abundance of hematite. Hematite often forms through processes that involve water, so the site was a promising one to determine whether conditions on Mars were ever suitable for life. Opportunity struck pay dirt; it s Miniature Thermal Emission Spectrometer (Mini-TES) and Mossbauer Spectrometer (MB) confirmed the presence of hematite in sulfate-rich sedimentary beds and in lag deposits. Meridiani Planum rocks contain three main components: silicate phases, sulfate and possibly chloride salts, and ferric oxide phases such as hematite. Primary igneous phases are at low abundance despite the basaltic origin of the protoliths. Jarosite, an alkali ferric sulfate, was identified by Mossbauer. Some of the hematite is contained in the spherules, and some resides in finer grains in outcrops. Mossbauer and Mini-TES data indicate that hematite is a dominant constituent of the spherules. Panoramic Camera (Pancam) and Microscopic Imager (MI) images of spherule interiors show that hematite is present throughout. The exact composition of the spherules is unknown. Mini-TES only identifies a hematite signature in the spherules; any other constituents have an upper limit of 5-10% .The MB data are consistent with the spherules being composed of only hematite