Apologia for the CDC

At this time of crisis I want to make it clear I do not support some extreme criticisms of the CDC. Should the shocking charges against one administrator be proved in court, which remains to be decided, I think all reasonable people will agree she violated CDC policy in several serious ways.

First, it is alleged she became emotionally involved with a victim, losing clinical detachment. Second, she is alleged to have cooperated with someone outside the organization absent direct orders from the top. Third, it is said she left a trail of evidence which the police are now evaluating. These points alone clearly demonstrate her actions would never be tolerated by upper management. Anonymous sources for scatological bloggers may be tolerable, traceable images are right out.

Further, I want to distance myself from those who claim these centers run a conspiracy directed at ME/CFS patients. This should be ridiculous on the face of it, since they have never figured out what a ME/CFS patient actually is. They might as well be blamed for a conspiracy against pookas.

Still, stipulating -- purely for the sake of argument -- that such a conspiracy were attempted, what outcome could one expect?

Let's examine the evidence in a deliberate manner. If they start a search for babesia microti in the blood supply following a trail of pathology reports and dead bodies starting in 1979, with a clearly defined pathogen much larger than a bacterium responsible for a definite human disease, you can, based on solid data, confidently expect them to issue a warning over the possibility of contaminated blood some time in the next 30 years. (O.K., so it took a couple of years more. Don't quibble.)

This delay is the result of extraordinarily careful work. We can confidently assume they were only withholding the news to prevent panic until they had a good way to address those fears which might cause panic. Is there a screening test for this pathogen in donated blood? No. Well, let's check their website for guidance on this subject.

Hmmm. All the diagnostic criteria require laboratory tests. How does a doctor or patient know to request them? Checking on signs and symptoms, we see that a patient presents with this infection somewhere between asymptomatic and dead. (Those who present after death form a separate category covered in a discussion of zombies.) When signs and symptoms are present they may be non-specific flu-like symptoms, or they may include hemolytic anemia. (Especially pale patients should probably be tested by sprinkling with Holy water, though it might be wise to keep a wooden stake at hand.) Should the doctor order a complete blood count it is quite possible technicians will stumble across an identifiable parasite during the process. It is also possible they will dismiss this as mysterious crud if given no special instructions.

After a mere generation, we are still in a situation where the best way to identify the problem is to wait for autopsy, unless a patient announces "Doc, I think I have babesia microti", though most such will be delusional.

Critics who contrast this with the response of the NIH to the discovery of a new species of borellia spirochete, borellia miyamotoi, found to cause human disease in only 10 years, are cheating. The NIH was able to use Russian work on this disease in Siberia. Considering the history of Lyme disease it is doubtful they could have bettered the CDC performance on babesia without outside help.

No, I think sober consideration will confirm that this bunch would have trouble organizing a kindergarten birthday celebration before the guest of honor graduated from college. So much for conspiracies.


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