Archive for the ‘Public Health’ Category

Listener Blumie highlighted that I (Nazim) was rather irresponsible in describing the impact of masks on coronavirus transmission rates. I apologize: wearing respiratory masks is absolutely the best way to decrease coronavirus infection rates in everyday situations, along with distancing and regularly washing our hands.

What I was trying to describe, and may have failed to, was the results of the large scale meta-study that compares the findings of 172 published studies on the factors that influence infection rates in real-world settings. Most studies track droplet propagation rates, or have small sample sizes, or perform tests in rather unrealistic laboratory conditions. Some of them even simply press a pipe against a mask and measure the transmission rate. The reviewed 39 studies track (among other things) the impact of masks on real-world infection rates. They provide this finding: “Face mask use could result in a large reduction in risk of infection (n=2647; aOR 0·15, 95% CI 0·07 to 0·34, RD −14·3%, −15·9 to −10·7; low certainty).” Those numbers are in line with what the CDC said, and also with my approximations. RD stands for reduction: it’s the difference between 17.4% (the risk of getting infected when not wearing a mask) and 3.1% (the risk of getting infected with a mask). That’s a reduction of over 80%, as the CDC says.

I was also mistaken when I said “low confidence interval.” I was erroneously referring to the certainty level, and here’s what the researchers say on that subject:

“The effect was very large, and the certainty of evidence could be rated up, but we made a conservative decision not to because of some inconsistency and risk of bias; hence, although the effect is qualitatively highly certain, the precise quantitative effect is low certainty.”

So, while it’s still the best defense we can use to decrease infection rates, in a legislative context, there is plenty of room to discuss what reasonable restrictions one should impose. However, as Blumie reminded me, masks (along with distancing and regularly washing your hands) are still the best everyday defense to decrease infection rates.


Last week, nicely summarized what’s going on with the Volkswagen  US emissions cheating scandal, not be confused with the Mitsubishi Japanese emissions cheating scandal. The short of it is that the car manufacturers programmed the computers to output a false set of numbers when attached to an emissions testing machine. They did this for many years. And the real numbers were above those permitted by the law.

It bugged me that, initially, this was blamed on a few engineers. The uppest management tried to make those engineers into scapegoats. This bugged me because I couldn’t believe that this kind of operation could have gone on without some degree of consent from uppest management. Then, about two weeks ago, charges against an engineer were announced. I’m relatively confident that some engineers probably should go to prison over this: the total amount of emissions that were allowed by this gambit were dramatically higher than those permitted by law. And this is the kind of stuff that literally kills people who have breathing problems. But I sincerely hope this is just one guy they will flip so that they can go after the folks that gave the go-ahead. Otherwise, well, I’d be irritated.

Murder Rates Still Very Low Overall

Posted: September 14, 2016 by Nazim in Politics, Public Health


Despite the recent spike in murders across the US, it’s a good idea to remember that, overall, violent crime is close to a 20 year low. Just to frame some of the recent political considerations.


This post was triggered by a few recent articles noting the power of large companies. But first, out of fear that some may dismiss these words as some commie fringe commentary, I should clarify immediately that I’m talking about a small handful of truly enormous business entities. And I use the generic term (business entity) because although some may be corporations, there are a legion of types of such entities. Repeating this for emphasis: I’m not talking about the extraordinary majority of businesses entities, which are small and absolutely healthy endeavors. On to the meat of the post.

I assume that most have heard of the row between Apple, Ireland, the European Union and the United States tax agencies, which I will not go into here. But it was contemporaneous to this bit of news from Austria, where entities such as Starbucks and Amazon pay less in taxes than businesses that are, by comparison, microscopic. These news are hardly surprising, given that most of these policies are written by or for those very companies. This goes even farther than pro-business legislation: some companies, such as Samsung, have grown so big that they are practically sovereign countries. To the point that the bulk of carbon emissions can be traced down to fewer than 100 companies worldwide. The point I’m making here is illustrated by this quote from that last link:

I, as a consumer bear some responsibility for my own car, etcetera. But we’re living an illusion if we think we’re making choices, because the infrastructure pretty much makes those choices for us.

As another example, in the face of catastrophic climate predictions under the best information we have, the pinnacle of worldwide environmental regulatory response (because it’s a planetary issue at this point), is a demand that countries to state their goals, explain whether they meet them and why not. With basically no enforcement power. And that was really the most feasible deal we could achieve, given the point I’m making here.

These matters would not be quite so troubling if open-market economic systems did not have an irrefutable tendency to concentrate wealth in the hands of few, basically turning into monopolies. Worse, under the current business scheme, it’s very difficult to trace the root decision makers of problems, so liability shielding has achieved unprecedented levels. Worse, the ongoing increase in our automation abilities (which I favor) is eroding the income and purchasing power of a large fraction of the consumer population, which is the main motor that keeps economies going.

I try to keep my alarmism to a minimum, but it might be time to consider panicking.


Use of plastic bags has decreased by almost 90% in England since the introduction of a 5 penny charge per plastic bag. I love this example of regulation because it shows how just a tiny nudge can remind people to do the right thing by recycling old plastic bags or using long-term bags for groceries. I complain about poor lawmaking so often that I thought I should spotlight moments like this.

Water Wars are Avoidable

Posted: August 2, 2016 by Nazim in Environmental Law


Water wars have been a common forecast among geopolitical speculators. Although water itself is one of the most abundant natural resources on the planet, 97% of it is, for most purposes, unusable due to salinity. And desalinization has been commonly regarded as unfeasible or too expensive. However, technology in the area has advanced considerably, to the point that Israel currently makes more freshwater than it needs, and is planning to make even more. This is, in part, thanks to a zealous water conservation campaign that has reduced freshwater usage. My takeaway point here is that if it’s feasible for Israel, it’s probably feasible in most of the first world, and hopefully in less wealthy countries once production efficiencies get going.

CityLab, urban policy megaphone of the eminently respectable Atlantic, recently put out this article, helpfully titled The Legal Policy That Makes Collisions Especially Harrowing for CyclistsBikers share an unenviable category with vegetarians: they’re engaging in morally superior behavior, and being punished for it. In this particular case, by a draconian version of the Contributory Negligence doctrine, which bars any recovery if the plaintiff has even a tiny degree of fault in the accident (talk about blaming the victim!). In most jurisdictions, this doctrine has been replaced by or morphed into the Comparative Negligence doctrine, which simply lowers the damage award by the percentage that the plaintiff was at fault, and reducing the award to zero if the plaintiff is 50% or more at fault in the accident.

This becomes interesting because negligence is a very comprehensive legal framework: what was the discernible risk, what are the possible consequences, and how much effort did you put into avoiding them? Sometimes, as Casey Neistat demonstrates below, this clashes with traffic regulations, and bikers must make tough legal choices.

WHAT HAPPENED:  Two years ago, the Supreme Court ruled in Hobby Lobby v. Burwell that the contraceptive mandate could not compel religious institutions to provide birth control to their employees.  “Fine” said the government, “You don’t have to provide birth control, and instead you just have to fill out these two forms and we’ll take care of it for you”.

WHY IS THIS BEFORE THE SUPREME COURT:  “NO!” replied the host of religious institutions who were not satiated by the Supreme Court’s favorable ruling in Hobby Lobby.  “Two forms, as nominal as it may seem, constitutes an affirmative act in favor of providing birth control and that is a sin.”  And that is where we stand now, in that the Court must determine whether two forms is an acceptable burden to place on a company that is denying medical care to their employees, or if two forms is a condemnation to hell-fire and brimstone.

WHAT IS THE RULING:  Thankfully, this case is not yet decided.

RAMIFICATIONS:  Everything and nothing.  Everything if the idea that a hypothetical employee of the Catholic Church cannot get birth control serves as the opening of Pandora’s Box toward overruling Roe v. Wade and diminishing Women’s Rights.  Nothing if you are neither person described in the above referenced sentence.

ROOT FOR ZUBIK IF:  To you, the idea of hell isn’t ridiculous.

ROOT FOR BURWELL IF:  You would like to end more sequels to this never-ending horror movie of a Supreme Court case, which by the way, was what I was going for with the picture above of Dennis Hopper fighting Leatherface in Texas Chainsaw Massacre 2.

WHAT HAPPENED? Texas passed a law that raised standards on facilities performing abortions.  Provisions included having a physician who had attending privileges at a hospital within 30 miles and requiring that clinics have the same standards as ambulatory surgical centers.  In response to these requirements, most of the abortion clinics in Texas closed down.

WHY IS THIS BEFORE THE SUPREME COURT?  The Supreme Court has held that any law that puts an “undue burden” on a women’s right to choose violates the 5th Amendment.  This law, which could be argued is intended to increase the standards for abortion clinics, creates an undue burden not on the face of the law, but in the effect that the law has on women in Texas.

WHAT IS THE RULING?  This case is not yet decided.

WHAT ARE THE RAMIFICATIONS?  The ramifications in both directions are fairly significant.  If the Abortion Clinics win, it adds an extra wrinkle to the “undue burden” test, that allows the Court to consider the effect of the law instead of just its intent.  If Texas wins, state government seeking sneaky ways to restrict abortion rights have the roadmap to doing so.

ROOT FOR WHOLE WOMEN’S HEALTH IF:  You a pro-choice advocate who doesn’t trust the government to follow directions on abortion, and/or admit defeat.

ROOT FOR TEXAS IF:  You are a pro-life advocate living in the middle of no where.


The Employment Retirement Income Securities Act (ERISA) is a federal law that governs disputes between employee and employer health insurance plans. Vermont has a separate State law that requires Liberty Mutual to report certain health care claims to a separate database than ERISA.


Federal preemption is a legal concept wherein Federal law takes precedence over State law in most situations. The theory there is that the Federal government should be able to act independently of each State’s particular laws, since each State is different and States also tend to favor their own citizens over the citizens of other States. While ERISA is generally considered superior law, ERISA also has caveats written into the law that permit States to act in certain areas. This case evaluates those exemptions to see if the Vermont program is permitted.


This case is not yet decided.


This decision should have a fairly substantial impact on the practice of employee health care disputes. If the Vermont program is permitted, it allows more review and better procedure for ensuring the safety, efficacy, and quality of health care delivered to patients. If ERISA precludes the Vermont law, there would be less government interaction required for employers, which would keep procedures consistent across States and the Courts.


Are republican in the literal sense, and a democrat in a figurative sense.


For real, Liberty Mutual has the worst commercials on TV, right?  They’re smug and they get played all the time.  So screw them, regardless of legal implications.