So back in March we bought a cargo bike. We’d set out intending to buy a tandem, but on the test ride it turned out that I hated the tandem with the intensity of a thousand burning suns within about ten seconds of getting on the thing. Totally synced starts and stops? No control? Ummmmno. Not working for me. But since we were at a good bike shop we tried this massive, bright orange Yuba Mundo cargo bike because it was there, and we all loved it immediately, bought it on the spot, and nicknamed it The Beast.
Since then we’ve put the better part of 2000km on the thing, what with schlepping the miss to school (~8km away) and many trips to the grocery store and Home Depot and general errands and whatnot. It’s put a huge dent in our Autoshare usage — when your bike carries 75lbs of tomato flats, 6 2-4s of beer, 8 large bags of groceries, or two human passengers, a car becomes much less necessary — and wow pushing its 50lbs around (often plus a heavy 10-year-old child plus our own pannier plus her school backpack, or whatever other cargo one has loaded on) has been good for our quads and general aerobic fitness. We put a little over 100km on it each week during the school year — 5x20km on weekdays plus a grocery run and maybe a Home Depot run or something similar on weekends. It is in very heavy use.
Since the photo above was taken, we’ve added extra handlebars attached to the main seatpost so the miss doesn’t have to hold on to either us or the frame of the bike. We switched to disc brakes, because the original brakes were insufficient to the task and were actually scraping bits of metal off the rims. We also added a yellow BikeGlow to help outline the bulk of the thing in the dark. The bike is 6’9″ long, quite a behemoth, bigger than anyone really expects a bike to be, so it’s good to have the outline more clear. Here’s an amusing photo of what it looks like in the pitch black dark (front is at left, rear is at right):
The BikeGlow runs down the length of the left (traffic side) running board, up the back (not visible in the photo), and then forward the entire length of the bike.
It’s a very sociable thing, riding a cargo bike, whether you like it or not. At stops one is forever answering the questions of other cyclists and pedestrian passers-by.
What the heck is that thing (A long-tail cargo bike. It can carry 440lbs of cargo plus the rider. The other main kind of cargo bike is a bakfiets)?
Is that legal (Yes. While you can’t carry passengers on bikes not intended for it, bikes designed for passengers are just fine.)?
And the sexist one I get that Dave doesn’t: Can you really ride that thing All By Yourself Dearie (hell yes).
…Among other things. Now that we have the BikeGlow and it’s dark by 5pm, we also get to chat about that. So: don’t buy a cargo bike if you’re averse to random conversations with passers-by. Eventually we plan to put a big sticker on the bike with a QR code which links to some sort of explanation and details, much like this post.
Once you’re up to speed, riding it is less work than you might think. It’s the acceleration that’s killer. There are 21 gears on the thing and we use every one — I use many, many more gears on the cargo bike than I do on my own bike, especially on hills. On average I probably change gears every ten seconds or so, less if going up a hill. It is otherwise a very smooth and pleasant ride, though; rather similar in feel to a Bixi, if you’ve ever ridden one of those. Lots of stability, lots of momentum. Hit someone with the thing going reasonably quickly and you’ll probably kill them, so look out. It has power but it is crazy heavy and it is not what one might call nimble.
We’ve found it a really excellent substitute for both Autoshare and the TTC. We haven’t quantified the Autoshare part, but we’ve made about 120 round trips on it that would have otherwise required the TTC, so one adult at 2x$2.60 + one child at 2x$0.60 = $6.40 per round trip, that’s saved us roughly $768. At that rate it’ll pay itself off in another year or so. Not that we’re fussed about that — we prefer riding; it’s not about the money — but it’s kind of fun to track.
In short: recommended. You can put 2 baby seats, 2 child seats, 2 very large cargo bags, or a combination of the above on the back. Or you can just go wild with bungee cords. Cargo bikes really solve many of the problems with using a bike as your primary transportation in a reasonably bike-friendly environment. We’re very fond of our Beast.
As usual Neil Gaiman has the best wish, which has managed to condense thoughts that took me three pages to write for my niece into a few short lines. Well, that’s why Neil gets the big bucks and I don’t, isn’t it?
I hope that in this year to come, you make mistakes.
Because if you are making mistakes, then you are making new things, trying new things, learning, living, pushing yourself, changing yourself, changing your world. You’re doing things you’ve never done before, and more importantly, you’re Doing Something.
So that’s my wish for you, and all of us, and my wish for myself. Make New Mistakes. Make glorious, amazing mistakes. Make mistakes nobody’s ever made before. Don’t freeze, don’t stop, don’t worry that it isn’t good enough, or it isn’t perfect, whatever it is: art, or love, or work or family or life.
Drinking at breakfast is a rare pleasure with a noble heritage, and you need to show some decorum. If self-respect is beyond you at the moment in question, then settle for showing some respect for the institution. Treat this as a special occasion and dress to impress—a feat easily accomplished by waking up in or near your tuxedo. At the very least, affix a boutonniere to the lapel of your bathrobe.
Finally, while it’s still nice and quiet and we all have time to plan, I’ll remind everyone that I have declared January 2 to be Introvert Day — the only holiday that you celebrate by deliberately NOT gathering with beloved family and friends. Enjoy your precious solitude, and may 2012 bring you happiness.
Again we ponder the eternal question of what to drink while awaiting election results. Last time around we went with Irish whiskey. It was an excellent choice but it feels a bit ponderous for a May election. Sunshine and daffodils and Irish whiskey? Nah.
I’m deciding to count anything other than a Harper majority as a success. While there does seem like a reasonably high probability of success thus defined, we’re still feeling it would be wise to employ some fiscal restraint, just in case. So we’ve settled on some cheap Aussie fizz, which D has just gone off on his bike to fetch. It’ll have time to chill before results start coming in.
Go vote, if you haven’t yet. Polls in Ontario are open until 9:30 tonight. You don’t need to be registered in advance and you can find your poll here if you’re unsure (the link is to the official Elections Canada site — don’t believe any robo-calls you might get; apparently there are some dirty tricks being played to send people to the wrong place).
Surely Santa will feel jet-lagged at the end of his trip! To deliver presents at exactly mid-night all around the world he will have to spend 24h in trans-meridian travel with rapid changes in time zones and little time for his body clock to adapt. He will travel in darkness all the time, so he will be more likely to fall asleep. Catch-up sleep helps to recover from the short-term tiredness and fatigue, but will not help avoid the long-term consequences of sleep deprivation. If he were to do this all year round, he would definitely run the risk of dying prematurely.
The thing the Expert Curmudgeons always overlook, and I think this is a real issue, is that health is about more than sleep hygiene and carrot sticks. Health is also about having a good time with friends and family, relaxing, enjoying yourself and enjoying eating and drinking yummy seasonal treats.
Western concepts of health and medicine should take a page or two (or, hell, the whole book) from the Aboriginal Medicine Wheel concept, in which health comprises physical, emotional, mental and spiritual health all together. Eggnog, cookies, gravy, friends and family may not be absolutely helpful to our physical wellbeing, but they’re a very important part of the total picture of what makes us happy, content and — therefore — healthy in a more inclusive, absolute sense. You can go to a party and eat carrot sticks and drink water and feel all virtuous and abstemious, or you can go to the same party and actually enjoy yourself: which is better for you as a whole? I’d argue a certain amount of seasonal indulgence is good for the soul. It’s a long, cold, dark winter and we’re in the darkest bit: eggnog and cookies are perfectly reasonable coping mechanisms.
This biologist says drink the damn eggnog, eat the damn cookies, sleep in (or get up early, whatever floats your boat) and enjoy yourself. So you might gain a pound or two or suffer the odd hangover. So what. Your emotional, mental, spiritual self will probably thank you. Your physical self can correct any lingering issues in January.
I’ve long had a lot of time for Dan Savage, low-bullshit un-shockable sex columnist and general sensible guy, but his latest project is really something I’d like everyone under the sun to both know about and spend an hour of their time with.
The It Gets Better Project is Dan’s attempt, through video, to convince LGBTTQetc. kids that life gets one hell of a lot better after high school and they should live to experience it. Suicide rates for LGBTTQetc. kids are appallingly high. The project was instigated by one particular suicide, but I don’t think Dan would discount any of the young lives who chose to end themselves so tragically. So, Dan has asked folks to post videos telling their own stories, under the general It Gets Better Theme. I’ve watched every single one that has been posted as of now and you know? The relief on every single face when they say “right after high school ends and you don’t have to see those people every day? It Gets Better. I promise” is both so affirming, and so simultaneously damning of the way we allow teenagers’ lives to unfold, that it’s an undeniable challenge to the apparently appalling status quo. Frankly I think any kid who’s having a bad time in middle school or high school will find immense value in this project, LGBTTQetc. or no.
Please spend an hour or two watching these videos. I’ll paste a selection of my own choosing below, beginning with Dan and his partner’s own video, but by the time I hit Post more will have been posted so see the project channel for full details and access to all current videos.
These are just a few that I’ve chosen to show. There are hundreds of others. Please give them your time, and please forward it to anyone you might know who might benefit from it, now or in future.
Happily, it’s easy to avoid, isn’t it? Just never ever allow your cycling self to be between the front and rear wheels of a large vehicle at or near an intersection. Simple. It’s not like you won’t notice they’re coming; those things make a ton of noise. So get out of their way. Don’t pull up on their right. If they’re behind you, take the lane so they can’t pull up on your left. Give them some space. Done.
I mention this because I think we need to remember what the primary danger is when cycling.
Is it the act of cycling itself? No. It’s pretty darn hard to kill yourself on a bike. If you try very hard and if you don’t wear a helmet you might manage it, but generally a fall won’t kill you.
On the other hand, on one discussion board I’m on, just this past weekend two participants were involved in serious car crashes. Luckily they’re (mostly) fine, but it’s not that hard to kill yourself in or with a car. People do it all the time. In fact it’s one of the most popular ways to die if you’re under 45 or so.
Think: how many people do you know, even very slightly, who have died in car crashes? I’m betting it’s a nonzero number. Someone from your high school class? A colleague? A friend of a friend? All of the above?
As a society we’ve somehow normalized a very substantial death rate due to motor vehicles and made it acceptable, just like we’re not especially fussed about the thousands of people who die each year of seasonal flu. Somehow we manage to delude ourselves into thinking that it all happens to other people when demonstrably it does not. We do the opposite when we think about cycling: we’re sure some jerk in an SUV will kill us, when in fact it’s wildly unlikely. As a society we completely suck at understanding risk.
Anyway, my point is that it’s not the bike that’s the danger here. And my other point is that as a cyclist even with millions of cars around it’s pretty hard to be killed in city traffic unless you do something foolish around the rear wheels of a very large vehicle.
So, bike commuting. It’s not as dangerous as you think. It’s often faster than either a car or the TTC, it’s definitely better exercise, and it’s probably more fun. Give it a try!
If you’re uncomfortable riding on your own, get someone experienced to ride with you the first few times if you like, but make sure they’re not Asshole Cyclists of the stop-sign-running, wrong-way-on-a-one-way-street-riding, weaving-in-and-out-of-traffic kind because the last thing Toronto needs is more of those jerks. Ask if they’ve taken a Can-Bike course, and book yourself into one. They’re good and they’ll give you both experience and confidence riding in traffic.
Aside from a bike, there’s other stuff that makes your riding life more pleasant. Here’s my list, but (as with baby supplies) what some people find absolutely necessary others find useless, so consider it just a starting point.
Well, except for a helmet. That’s not really optional if you prefer your brains on the inside of your head. Helmets are hot and mostly ugly but if you fall they reduce your chance of a head injury by (estimates vary) 63-88%. After the Ontario law requiring children to wear helmets came in, cycling deaths in that age group dropped by half. Sure, you might ride carefully and slowly but you never know what other people are going to do so best to wear the darn helmet.
Helmets have become both more comfortable and much cheaper in the past fifteen years, so it ought to be possible to find yourself something that fits you and doesn’t feel like your head is in a packing crate for a reasonable sum. If you have a micro-noggin like mine, go for a Giro. Otherwise you have a broad range of choices.
Don’t wear it on the back of your head; the front edge belongs two fingers above your eyes. This is so the helmet can protect your forehead. Frontal lobes are good things so you probably want to protect them.
Kind of like a helmet for your hands. You hardly need bike gloves for comfort over a typical commuting distance, but if you fall they’ll save the skin on your hands. I spend a lot of time typing for a living so I find this important. I buy very cheap gloves, since I’m not riding hundreds of km at a time and thus do not care about gel inserts and whatnot. I toss them in the washing machine every week (in a mesh bag) and dry them on the ends of my handlebars, so they don’t last forever but nor do they get really smelly.
For colder weather you can get a lobster-claw type of mitten-glove hybrid which is warmer than normal gloves but which still lets you brake and shift easily.
I like to carry both a U-lock and a cable. Neither are top-of-the-line, but my theory is that if some evil bike thief sees two locks on my bike and one on the one next to it, mine is more likely to be the one that’s still there when I come out of the office at the end of the day.
If you can park your bike inside, do so.
3. Rack and pannier
A rear rack is pretty cheap and so is a low-end pannier or basket. If you have a rack and pannier (or two) you don’t have to carry your stuff in a backpack, which can be really sweaty. Those black wire baskets that attach to rear racks are cheap, permanently attached and foldable, so they’re a reasonable choice. Also, they hold a 12 of beer.
4. Water bottle cage and water bottle
It’s nice to be able to have a drink at red lights.
The law in Ontario says you have to have a front light and a rear light or reflector. This makes little sense. Unless you’re doing something deeply inadvisable, a front light isn’t all that helpful in a well-lit city setting. You can generally see where you’re going thanks to streetlights, and you can also see anyone coming toward you. A rear light lets people see you as they come up behind you in the dark, though, and THAT is important. So get both front and rear lights. There are lots of good, cheap LED options now, and it makes a HUGE difference in your visibility.
The law in Ontario calls for a bell, horn or gong. There’s a sad, sad lack of bike gongs out there.
A bell is nicer than a horn because you can ding lightly and politely to announce your presence without startling the heck out of someone.
7. Light-coloured cycling jacket with reflective stripe
If you’re riding at night this is a good idea. Never mind that it looks dorky.
8. Padded shorts
Again with the dork factor. I like my lady bits to stay unbruised, however, and I find my 10k commute is long enough for some serious discomfort if I don’t wear the shorts. If you have a reasonably short commute (or more durable bits) you might not need these.
I just wear any old t-shirt. Some people like those bike jersey things but they’re all made of polyester and they all seem to have pockets right in the sweatiest part of the small of your back. Bleah.
9. Bike computer
For data geeks. It’ll tell you how fast you’re going, your trip distance, and all that kind of stuff. Mine’s a really cheap one but I like having an odometer. It’s fun and motivating to watch it tick up and up.
10. Repair kit
This doesn’t have to carry anything major, just enough to fix a flat or otherwise get you home. Anything more serious than a flat and you’re going to want a bike shop, or at least somewhere that’s not the side of the road. My kit includes a tiny pump, a spare tire tube, some tire irons, two quarters (so I can use the air machine at a gas station), a subway token in case things REALLY break, a couple of wet wipes, and a really clever little carbon dioxide tire inflater device that’s like a teeny scuba tank full of compressed air. It’s the size of my thumb and it holds enough air to fill one of my tires very well in three seconds with zero effort. I highly recommend them.
The whole kit probably sounds huge but in reality it’s about half the size of a kleenex box. The tube is the biggest space hog.
A patch kit would be smaller than a tube and probably more environmentally friendly but in practice I never patch punctured tubes. It takes ages and it’s messy and unreliable, at least when I do it. I find it’s easier to just chuck a new tube on there, deploy the CO2 inflator and get back on the road.
There’s zero point darting in and out of car traffic to try and get one or two cars ahead. Day after day I see people do this and you know? There they are stressing themselves out with this bizarre unsafe gotta-pass-everyone stuff while I hang back and wait ten seconds for dude in the car to make his right turn or for the light to turn green or whatever, and yet I get to where I’m going at exactly the same time as they do. Plus I feel more relaxed and have time to look around a bit. It’s not a competition.
If you’re just starting out, don’t worry too much about what bike you get. It won’t be the one you ultimately find you want. Take a few bikes for test rides — any good shop will let you test ride — and then get something that fits (get the shop to fit and adjust it properly for you), that you like right now, and that isn’t too expensive. In a year or two you can trade it in once you’ve figured out what style and features REALLY appeal to your needs. In the meantime grab something and go!
In the past week or so there’s been much fuss about several privacy-reducing changes to Facebook and how they are causing people to lose control of their information.
The changes (which I’ll detail below, with my recommendations on how to respond to them) do open up how people’s information can be used.
Remember Facebook is just a free tool and it’s trying to do the standard capitalist thing of leveraging what it’s got — lots and lots of information about lots and lots of people — to make more and more money. I don’t agree that it is a healthy paradigm, but they’re not doing anything objectively unusual or worthy of hysteria.
That said, we do not have to like it or agree with it and we certainly do not have to go along with it.
It also doesn’t mean you’ve lost control of anything. You control what you tell Facebook. It isn’t holding you down, administering sodium pentothal and interrogating you; it’s just a free tool. It’s all totally up to you what you do or do not choose to divulge. So keep a clear eye on what Facebook will do, or might do, with whatever information you choose to provide and act accordingly. (As you would anywhere else online.)
Change 1: Instant Personalization
This is the change that’s getting all the press, which is unfortunate since it’s not the biggest problem.
Instant Personalization (which I see has suddenly become a “pilot program”) lets select other websites use your Facebook data to personalize your view of their own sites. You need to be logged in to Facebook for this to work, and at the moment it only applies to three websites (Microsoft Docs.com, Pandora and Yelp) and fortunately it is easy to turn off. Even if you leave it on and even if it expands to other websites in future, apparently it notifies you or somesuch when you visit such a site and gives you another opportunity to decline.
If you want to turn it off go to:
Account > Privacy Settings > Applications and websites > Instant Personalization Pilot Program > Edit Setting
and un-tick “Allow select partners to instantly personalize their features with my public information when I first arrive on their websites.”
Good. That part was easy. Especially since you can’t even use Pandora in Canada, and why anyone would use Microsoft’s Docs.com when Google Docs exists I can’t imagine.
Change 2: Community Pages and Connections
The bigger, more important and much more intrusive change is the introduction of automated Community Pages, which are created automatically and which make the Likes and Interests in your Profile more or less public in a sideways sort of way.
You can no longer have free-form text in your Profile, only automated “Connections” which link to automated “Community Pages”. Facebook explains it:
Community Pages are a new type of Page that enable you to see what people are saying about the things that matter to you, and discover the friends and people who share these connections with you. They are similar to any other Page to which you can connect, although they won’t generate stories in your News Feed, and won’t be maintained by a single author. Where available, they also show Wikipedia content for the relevant topic, which Facebook has licensed under the creative commons license.
If you choose to include any given Connection, your profile is linked from its automated page, thus making that information visible to all and sundry as well as making it pleasantly open for data mining. In short, you’re being asked to stop being a human and start being a consumer on your Profile.
If you decline all Connections, your Profile becomes blank. I think they’re hoping this will annoy people enough that they’ll cave in and use Connections.
It’s apparent to me that there is no “community” being formed through the use of this feature. In fact, the level of euphemism being used here reminds me of a real estate listing I recently read advertising a house with a “reverse ravine view!” — meaning, of course, that it’s at the bottom of a very steep hill.
I use Facebook to talk to real people, not to indicate my consumer preferences so they can then be bundled and sold.
I’d say that if you’re not interested in intrusively personalized advertising (“John Anderton, you could use a Guinness!” [Minority Report]), it’s time to delete your Profile information. What’s to lose, really? Does anyone really spend much time surfing through their friends’ profiles to see what TV shows they watch and where they work? Don’t you already know that kind of stuff about your friends? I don’t think it’s a big loss.
So delete away. Put a sentence or two in your Bio if you like; the Bio can still be freeform text.
Change 3: The Like Button
The other way that Facebook is creating publicly linked information about you is through the Like button. The idea is that any website can install a Facebook “Like” button now, so you can Like things across the Internet and not just while you’re in Facebook. Facebook says:
When you click the Like button, a link to that page is added to your Facebook profile and a story is shared with your friends.
Note that as well as sharing these Likes in your news feed, clicking that Like button (wherever you see it) creates a Connection between your profile and one of those auto-generated Community Pages, again making life very nice for the data miners while providing…. what benefit, exactly, to users? None that I can see.
If you don’t want those Connections created then avoid using this feature. If you want to tell your friends about something cool, you can put it in a status update.
While I’m offering unsolicited advice, I strongly recommend you get and use Firefox along with the Adblock Plus extension. It gives you extra control over what you choose to see or block. Adblock Plus is so good that I didn’t even know Facebook had ads until I used someone else’s computer one day.
While you’re at it, give the Firefox and Adblock Plus folks some money. Good stuff is worth paying for. And have you ever been bothered by aggressive ads for open-source software? …I thought not.
They now estimate that 22,000,000 US residents have contracted H1N1. Of those, 98,000 have been hospitalized and 3,900 have died.
Several weeks ago I very conservatively estimated an 11 in 1,000,000 chance of dying from H1N1 and a 176 in 1,000,000 chance of being hospitalized because of it, vs. a 10 in 1,000,000 chance of serious vaccine complications. I advised that the shot was therefore a good bet.
The chance of serious vaccine complications has not changed, so we’re still looking at 10 in a million there. But those US numbers now indicate that we’re comparing that to a 177 in 1,000,000 chance of death and a 4,454 in 1,000,000 chance of hospitalization from H1N1 itself (that’s about 1 in 224).
It seems you are in fact 445 times more likely to end up in hospital because of H1N1 than because of the vaccine for it. And of course those numbers also indicate that you’re 17 times more likely to die of H1N1 than you are to have a serious complication from the vaccine.
The numbers will keep changing, of course, as H1N1 progresses and as we keep figuring out new ways to count things, and those US numbers may not reflect the situation in Canada, but at this point there’s no way it’ll ever look better than my conservative estimates.
So yes. Get the shot, when you can.
(Also, I admit I am amused that people are calling H1N1 “hiney”. Heh.)
It’s making me a bit crazy that people are avoiding the H1N1 vaccination. You’d rather be flat on your back for a week with fever, cough, body aches and a bad headache than have one small needle-stick and a vaguely sore arm for a day? Well, to each his own. But let’s look at the relative risks.
First, let’s do some math, just based on the known numbers.
Well, that’s tricky, because they stopped reporting the number of actual cases of flu some time ago. So for the moment, let’s assume everyone — all thirty-four million of us in Canada — were exposed and got sick. That’s the most conservative assumption we can make when we’re calculating odds about how many people have died, right? That so far we’ve all been exposed and only ninety-five people have died?
A one in a million chance of dying would then have caused 34 deaths across the country, but there have in fact been 95 deaths, so in this case your odds of dying would be roughly three in one million. Your odds of being hospitalized are about sixteen times that (1600 vs. 95), if we continue along the same trajectory of illness, so about 48 in one million.
Of course, we know the actual rate must be higher, because NOT everyone has been exposed or has become sick, and yet we still have those 95 deaths: the 95 deaths have come from a smaller number of people than thirty-four million. So let’s use a less-conservative estimate, one that’s currently being proposed as reasonably likely, and say a quarter of the population — 25% of 34 million, so 8.5 million people — get sick, and we still have those 95 deaths. Then what are your odds? Basic math puts it at about one in 90,000, or about eleven in one million. And your odds of being hospitalized are still about sixteen times that, 176 in a million, or 1 in about 5,700.
We know the true odds are higher for two reasons. One, not even a quarter of the population of Canada has become sick yet, and we still have those 95 deaths and 1600 hospitalizations, so the true odds of death or hospitalization even now are higher than my calculations above. Two, we know more people will be hospitalized and more people will die, again raising the odds, since people are still getting sick.
But for argument’s sake, let’s just use the eleven-in-a-million number, even though we know it’s too low.
OK, now on to the vaccine.
Serious reactions to flu vaccines are normally about a 1 in 100,000 occurrence. We can reasonably assume this vaccine will be similar, since it’s been made in exactly the same way as previous vaccines have been made: you pick the strain, you grow it in eggs, etc.
Sometimes really strange reactions happen, like dystonia (which can also be caused, as I understand it, by the flu itself, and is a one-in-a-million kind of thing) or Guillain-Barré Syndrome (although getting the flu shot does not increase your odds of contracting Guillain-Barré generally, and is also about a 1-in-a-million risk).
Sometimes the flu vaccine is how people discover they’re allergic to eggs (since it’s grown in eggs) and they go into anaphylactic shock. This is apparently one of the most common bad reactions, and it is why responsible clinics will make you sit there for ten or fifteen minutes after you get the shot — they’re making sure you’re not going to go anaphylactic on them. But it is extremely, extremely rare for people to die from getting a flu shot.
The complication numbers here are pretty solid, known numbers; we’re not pulling them out of the air as we are in calculating death & hospitalization rates from actual flu. I won’t get into the adjuvanted vs. non-adjuvanted issue here, but the complication rates out of Europe for adjuvanted vaccines generally seem to be comparable to the 1 in 100,000 figure I’m using here.
So getting the shot is a 10 in a million (=1 in 100,000) kind of risk. Even if you’re one of the unlucky ten, though, you’re most likely still alive. And here I will repeat that because the shot is made with dead virus, you cannot contract the flu from the vaccine.
Compare that to the chance of hospitalization if you do contract flu, which we conservatively calculated above to be 176 in a million. You’re about eighteen (remember these are low estimates) times more likely to end up in the hospital if you get the flu than if you get the shot.
Also, compare that 10 in a million risk of complication from the vaccine to the 11 in a million (again, estimating conservatively) risk of death from actually contracting the flu.
They’re comparable numbers. But which risk would you rather take? The one that leaves you alive, or the one that leaves you dead?
I have to say something about this desperately sad story, in which two children, non-swimmers both, drowned and died along with their mother, also a non-swimmer, who had been supervising them as they swam in a hotel pool (without a lifeguard). It seems that one or both girls somehow got into trouble and the mother then jumped in to try to save them. All of them died.
What I have to say is this: do not ever swim without a qualified lifeguard watching you. And if you do, quite literally the last thing you may do is jump in to save someone. By doing so you are worsening the emergency: now there are two people in trouble instead of one.
Drowning people don’t look like the stereotype, with lots of thrashing and waving arms and shouting and all that. People who truly can’t swim often are just below the surface. You might see their arms — they might look like they’re climbing a ladder — but they don’t come far out of the water. They’re quiet, not calling out. They’re using all their effort to try to reach the surface. They are desperate and they are not rational.
And these folks are dangerous. Unless you really know what you’re doing, you shouldn’t go anywhere near a drowning person. They are so freaked out, so detached from normal perception, so focused on their own survival that they will do anything — ANYTHING — to keep themselves at the surface. They are incredibly strong from adrenalin, and they will push you under and keep you under the surface of the water if climbing up your body will help them stay on the surface. Even a small child can drown you this way, even if you are a grown adult and a good swimmer.
Sometimes, drowning people don’t struggle. In a certain percentage of cases people just quietly slide under the surface. Even then if you jump in and try to grab them, if they’re still conscious they can push you under and kill you. They don’t mean to do it, but they will.
Treat drowning people like you would a wild animal you were trying to rescue. Pretend they have fangs and claws and poisonous barbs.
The usual algorithm to follow when considering a rescue is (with variations, but this is the simplest to remember):
Talk - sometimes all the person needs is a calming voice, reassurance and guidance to help them reach safety.
Reach – reach out to the person with an object — reaching pole, flutterboard, towel, paddle, pool noodle, piece of clothing — anything! If you absolutely must use your own body, lie down on your stomach so the drowning person can’t pull you in.
Throw – throw the person a buoyant object such as a flutterboard or ring buoy and talk them in or pull them in. If you’re using a ring buoy, don’t forget to stand on the end of the rope when you throw it so it doesn’t ALL head out to sea (I always forget this important point).
Row – use a boat to get to them, have them grab the stern end of the boat, and row them to shallow water,
Go – swim out to them with a buoyant object. Stop a few metres away. Push the object to them with your foot. Keep well away. Talk to them reassuringly and guide them to shore.
Tow – swim out to them with any object — a buoyant one if you can get one, but otherwise anything – piece of clothing, towel, whatever. The point is just to keep some distance between you. Have them hold one end of the object. Hold the other end and tow them to safety. If they start to come at you (by crawling up the object, for example), let go and swim a short distance away. Talk to them and see if you can get them to calm down and stop trying to kill you.
and then if all else fails, Carry, which you should only ever do if you are trained to do so. If you aren’t trained in how to safely touch a drowning person, don’t do it. Run for help instead.
In a pool situation, such as the one referenced above in which all three people died, there is virtually never a reason for someone who is not a trained lifeguard to go in the water to rescue someone. Pools are always equipped with reaching and throwing assists. Always. More than one. There will probably be a reaching pole on a wall, a ring bouy on another wall, and various pool noodles, flutterboards, and other buoyant objects around. Use these. Don’t lose your head and leap in.
As the Kaianad/Yasmin family so tragically demonstrated this week, non-swimmers should never, ever be “supervising” non-swimmers in the water. Even if you are a good swimmer, you never know when you’re going to bonk your head, inhale water unexpectedly, get tangled in seaweed, get a cramp, or any number of other minor issues that could become fatal if no help is available.
So swim only in places where you know a trained person is watching. Please.
I posted about swine flu a while back, before we really knew anything. Since the WHO just moved to stage 6 and declared it a pandemic, causing my RSS feeds to explode with yet more newshype, it seems like a good time for an update.
Stage 6 doesn’t mean the disease is getting more serious/deadly or anything like that, just that it’s now indisputably widespread. SARS, for example, was a very deadly disease but it wasn’t a pandemic since it was contained in a relatively few locations and we could track the chains of transmission. We can’t do that for H1N1 right now — it’s out there in the community, and some people who have it have no clear connection to anyone else who has it. Severity can be one indicator of a pandemic (the WHO seems to be waffling about that a bit) but in general it’s just an indication of the extent of a disease’s spread and not its lethality. Take home message: declaration of stage 6 is not in itself a reason to head to the back woods with two tonnes of tinned beans and a shotgun.
“It is global and fulfilling the requirements of a pandemic but I don’t think anyone should worry because nothing drastic has happened between yesterday and today.”
Initially it was looking like H1N1 might be up to 6% lethal. Fortunately, so far the numbers indicate that it’s much, much less lethal than that. Today the numbers I’m seeing show 27,737 official cases of swine flu, including 141 deaths. That puts the death rate at roughly 0.5%. To put those 141 deaths in context it helps to remember that normal seasonal flu, from what we can tell, kills upwards of a quarter of a million people every year and gets much less fanfare (not, of course, that it makes the 141 H1N1 deaths any less tragic). The Pump Handle blog puts it well:
The influenza virus kills people all the time. We don’t know exactly how many but we know that many people die of various immediate and underlying causes that wouldn’t have died at that time if they hadn’t become infected with the influenza virus in the period prior to their demise. Influenza is like heart disease or diabetes or cigarette smoking: a major cause of mortality that we have become used to. As long as it is described in terms of familiar seasonal influenza the public is all right with it — until they get a good dose of this really miserable illness.
It’s worth repeating that flu of any kind is deeply, deeply miserable, even if it’s technically “mild”. “Mild” in this context means “not terribly dangerous” and “not in much need of medical assistance,” not “a bit of a sniffle, continue with your everyday activities”. H1N1 sounds pretty similar to normal seasonal flu except it seems to involve some vomiting, which isn’t typically a flu symptom. So you have your usual week or two of flu-related extreme exhaustion, cough, bone aches, fever, chills, headache and all the rest PLUS hurling. Lovely!
But remember those 27,737 official cases were the folks who were sick enough to need to see a doctor or go to Emerg. There are probably a large number of cases out there where people just felt ill and stayed home without visiting a doctor, so their cases didn’t get counted in the numbers. This means the true death rate is probably rather lower than 0.5%. New York, for example, thinks they may have had about a half-million unofficial cases and only 12 deaths, which some mental math estimates is about 1 in 40,000. Canada has had 2,446 H1N1 cases and three deaths, so about 1 in 800 or 0.12%. Take home message: It’s always a good idea to have your affairs in order, but this flu is not all that likely to kill you, assuming you’re reasonably healthy to begin with and if you get medical help if you need it.
In children, signs that need urgent medical attention include fast breathing or trouble breathing; blueish or gray skin color; not drinking enough fluids; severe, persistent vomiting; not waking up or not interacting.; being so irritable that the child doesn’t want to be held; and flu-like symptoms improve, but then return later with a fever and a worse cough. Those are warning signs we physicians think about all the time, with respiratory infections. And they’re good to have in mind with this new influenza-like illness caused by the novel H1N1 strain. Just good things for parents to have in the back of their mind.
In adults, we look at another set of warning signs that suggest the need for urgent medical attention: difficulty breathing or shortness of breath; pain or pressure in the chest or abdomen; sudden dizziness, confusion, persistent or severe vomiting that doesn’t go away; and flu-like symptoms that improve, but then come back again with a fever or worsening of cough.
Of course, if you do have some sort of medical condition already (asthma and other respiratory problems seem high on the list), it’s a good idea to consult your doctor as soon as you might think you have the flu. Call first so they’ll be able to isolate you appropriately. You don’t want to be sitting around a waiting room or Emergency department shedding virus all over everybody.
So yes. Flu is no fun and at this point there’s a pretty decent chance lots of us will catch it, but it’s not an OMG WE’RE ALL GONNA DIE, DIE, DIE! thing. Wash your hands a lot. Maybe buy some extra freezies and clear fluids — you’ll get through them eventually and if you do get sick you won’t want to go out shopping (nor does the rest of the world want your germs). Maybe ride your bike to work instead of taking the subway (see, I can work a plug for bike commuting into any topic!). But don’t panic — this bug is not the apocalypse; we don’t have to hand the world over to the cockroaches just yet.
I’ve been doing my best to restrain my usual cynicism about the hysterical media coverage of health issues in the case of the swine flu, as until quite recently there have been too many unknowns to do much other than shrug and say “we’ll see”.
But it seems now that we do know some things:
1. It’s not terribly lethal, although (like the 1918 flu) it does seem to have a tendency to kill youngish, otherwise healthy people. I’ve seen death rate estimates up to 6% – which makes it several times more lethal than the 1918 flu, which had about a 2.5% mortality rate. That means that if you’re an excitable news type you get to say “200%+++ more lethal than the 1918 pandemic!!!!” because that makes it sound very dramatic indeed. But it also means, if you think about it, that even if you do catch it you stand 94 chances in 100 of recovering. Or to put it another way, a bit better than 15 chances in 16.
We should thank our collective lucky stars that if this genie is as out of the bottle as it seems to be, at least it’s a 6% — or less? It’s early days still, and the rural Mexican experience may not reflect the global experience, particularly that part of the global experience that has ready access to modern medicine — lethal genie with a 1-week incubation and not a 50-80% lethal genie with a disastrously long 3-week incubation like, say, Ebola.
Also, let’s remember that plain-Jane annual influenza strains are responsible for at least 700 deaths a year in Canada (possibly up to 2500). Not to sound callous, as every single preventable death is a horrible tragedy, but this flu may not even push us over normal numbers. (The potential difference which might not be reflected in the numbers, of course, is that we’re more used to influenza killing the very young and very old, not — as in this case — youngish adults.)(Like me.)
BoingBoing reposted this analysis of the 1918 numbers, which is useful in that it takes a sensible and calming approach. However, it also doesn’t tell us much that’s really applicable. Yes, we have good public health measures and near-instant communications now so perhaps less than 1918′s 28% of people would catch the thing. But on the other hand, we now have air travel which totally changes the game. It allows people to cross the globe well within the incubation period of the virus, and this sort of transmission has in fact already happened. No more do we have the leisurely plagues of old, which you could see coming across the world towards you for weeks or months before they arrived. I’d like to see some solid epidemiological modelling of air travel’s potential effects on this influenza virus’ transmission before I’ll be ready to agree we’re comparing apples to apples when we look at 1918. Anyway, it may be a reassuring piece to read.
2. Eating pork can’t give you the flu. Throwing out your pork products is entirely pointless. Enjoy your bacon, folks. It’s fine and it’s actually counterproductive to do otherwise and leave dead pigs moldering about. Better to clean up the pigs’ waste, which attracts flies which are (or seem to be) the actual swine-to-human disease vector in this case. The flies seem to be more of an issue than the pigs, and they are certainly more of an issue than processed pig flesh from the butcher. (If you eat or otherwise consort with flies that regularly feast on pig waste, you may wish to temporarily or permanently cease that practice.)(And look into therapy.)
3. It can be transmitted from one person to another. So the surgical masks are not necessarily pointless, depending on where you are in the world. I’m certainly comfortable taking the Toronto subway without one. In Mexico City, on the other hand, a mask is maybe not the worst idea, at least this week.
It ought to be pointed out that there are many kinds of “surgical masks”. I have not yet seen recommendations about which types are most appropriate for this purpose, so many of the people you see wearing those masks in pictures in the newspaper may not be doing as much as they think they are. Still, even the worst mask keeps you from touching your potentially icky fingers to your mouth and nose, so that’s something.
At this point, though, in Toronto I’d say just wash your hands after you get off the subway (which you probably do anyway). Or ride your bike.
My conclusion: there’s no need to freak out just yet.
Yes, it’s making its way around the globe, and we can’t stop it.
Yes, it could easily mutate and become more deadly, although this is not generally a successful tactic for viruses; usually viruses become less lethal over time so its victims are better able to spread it. You can’t do much to spread your virus if you’re completely flattened by it, lying alone in your room.
Yes, the flu is a whole lot of no fun — someone online today used the expression “she felt she’d have to get better in order to die,” which well reflects my own experience with it.
Indications at this point seem to be that if you do catch it, the odds are heavily on your side, even more so if you are able to receive modern medical assistance in the form of antivirals and such.
So. You know. Keep calm and carry on, and never mind the excitable media.
But listen to the MOH and wash the heck out of your hands*. Think of it as an excuse to buy yourself some nice hand lotion.
* I’ll insert a corollary plea here: kindly do NOT use hand sanitizers unless you’re somewhere that totally lacks running water. Those things a) stink and b) are helping breed the superbug that WILL kill us all.
Children actually have an inbuilt self-protective sense that we destroy by over-cosseting. They become independent not so much by careful training but in part simply as a result of parental laziness. Last Sunday morning, Victoria and I lay in bed till half past 10 with hangovers. What a result! And the more often you do this, the better, because the children’s resourcefulness will improve, resulting in less nagging, less of that awful “Mum-eeeeeeeh” noise they make. They can play and they will play.
So lying in bed for as long as possible is not the act of an irresponsible parent. It is precisely the opposite: It is good to look after yourself, and it is good to teach the children to fend for themselves. Our offspring will be strong, bold, fearless, much in demand wherever they go! Capable, cheerful, happy. It is also the task of the idle parent to ensure as far as possible that all members of the family are enjoying themselves here and now, in the present moment. There is far too much emphasis on that imprisoning capitalist abstraction “the future.” There is no point in sacrificing pleasurable todays for the promise of more prosperous tomorrows. So stay in that bed as much as you can.
Today I have been playing with my new toy, which is a birthday present from D & M: one of the teeny-weeny little iPod Shuffles. It is perfect for solving a First-World Problem I was having, which is that my usual iPod Classic is kind of heavy to carry about while exercising and also (if stowed securely) it is hard to manipulate its controls mid-workout. No such issue with this new toy, which has the controls on the headphones.
It looks rather like the monolith from 2001:
It is hard to properly grok the tininess of the thing, but perhaps it’s a context issue: this microscopic thing, this size-of-a-stick-of-chewing-gum thing with no moving parts, has 100x the memory of my first computer. Its Apple-y design yumminess combined with the stick-of-gum resemblance leads me to propose this piece of wisdom for this year:
iPods are not food. Do not eat them.
(edited to add birthday wisdom from previous years: 2006, 2007, 2008)
Despite the above-zero temps and rather brave appearance of two spring bulbs poking above the soil in the warmest bit of our front garden, I know winter’s just teasing us and isn’t about to go away just yet. So: I recommend these reusable instant hand warmers from Lee Valley (of course).
It is, as it says, a pouch of clear liquid containing a small metal disk. When you flex the disk it creates an exothermic reaction that turns the whole pouch into a big blogck of salt which stays warm for half an hour or so. You recharge it by boiling it for a few minutes*. I have found they’re quite sensitive and have set mine off by accident a couple of times, but aside from that quirk they’re an extremely handy thing to have in an inside jacket pocket on a cold day.
* “Do not microwave”, says the package. Yeah, that would be a mess.
Doctors may have resolved the perennial up-or-down-toilet-seat debate for families with small boys in the house.
Leave it up, experts say.
Falling toilet seats are injuring an alarming number of recently potty-trained toddlers, a British study reports. The medical term for the damage – penis crush.
No, no, no.
The sensible thing to do is to teach them to sit down when they pee, like civilized people. NOT to leave the seat up so everyone has to look at the horrible gaping maw of the toilet and the ick that accumulates on the bottom of the toilet seat when uncivilized people insist on standing to pee and the unappetizing sight of the cat(s) drinking from and/or bathing in the thing. No. Sit the heck down, already. And close the lid when you’re done.
Everyone and his brother seems to be listifying rules for life these days. So here’s my totally random list of wisdom, at least as it bubbles to the top of my mind at the moment:
In matters of plumbing, the answer to the question “Gee, do you suppose there’s still water in that pipe I’m about to cut?” is always “Yes”. Additionally: Is it under pressure? Yes. Should you listen to your wife and put a bucket underneath, just in case? Yes. Is she going to roll her eyes as she makes a dash for the bucket and mop? Yes again.
The successful installation of any sort of plumbing fixture always requires blood sacrifice. Mine, usually. If you ask me to help with plumbing you can be pretty sure it’ll be me who gets gashed/squashed/sanded/cut.
Always pee before you get on the subway. The one time you think “oh, never mind, I’ll be home in twenty minutes” is the day there’ll be some massive delay and there you’ll be all squashed in there with twenty million other crabby people, and you with a bladder the size of a planet.
Margarine is nasty. Buy butter.
If you had a night of hideous insomnia, wash the sheets. Otherwise the insomnia cooties lurk in your pillows.
Things on which one should not scrimp: facial moisturizer. Cat litter. Chocolate. Champagne. Tea. Jewelery. Concert tickets.
Things which are perfectly good even though they’re cheap: non-Champagne sparkling wine. Train travel.
Mayonnaise is not food.
Neither is eggplant.
Nor zucchini. Do not sully your body with these non-food items.
Hit the “Save” button every time you pause for breath.
Don’t litter. It won’t kill you to put whatever it is in your pocket.
Shovel your sidewalk.
Corrollary: Shovelling a neat path from your front door to your SUV while completely ignoring the sidewalk? Not cool. You will go to hell for that.
Things you can do without but once you have them, there is no going back: air conditioning. High-speed Internet. Dishwashers. iPods.
Libraries are truly wonderful places. Get to know yours.
Life is a whole lot easier and more interesting if you are not squeamish.
You come home and the kitchen is clean except for some yuckies in the drain which have been abandoned there by your spouse. You could think “that %#$%@ NEVER cleans the @#&^^# drain!” or you could think “hey, the kitchen’s practically clean — now all that needs to be done is to clean the drain”. Option #2 is better for your mental health and probably your relationship.
Nonetheless, try to remember to clean the damn drain if it makes your spouse crazy when you forget.
Rock, paper, scissors can be a very efficient decision-making tool.
Quantum physics is very cool but it will make your brain hurt.
If you need to replace a wax ring on a toilet, buy three. If you buy one, you’ll wreck it. If you buy two, you’ll wreck them both AND have a sore back from lifting the toilet twice. If you buy three, you’ll get it right on the first try.
Don’t buy bottled water if you can help it. It’s absurd to package a zero-calorie item in plastic and then use yet more fossil fuels to ship it elsewhere. Let’s save the fossil fuels for shipping stuff that really matters, like the raspberries from Peru that make February survivable.
Find work you like. Life is too short to do something you hate every weekday for forty years.
Vote. If you don’t vote you don’t get to complain.
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