Tributaries of the Nile Aren’t Just in Africa

Before reading this post, read this account of a Canadian surgeon who went on a mission to Gaza. It’s more important. If you only have time/energy to read one thing, read that.

Though this blog has been around for over a decade, I’m not sure if I’ve ever said that my mother is from Israel. Which makes me an Israeli American.

I almost never introduce myself that way. I say I’m an American Jew. Most people who hear ‘American Jew’ think my Jewish ancestors probably immigrated to the United States in the early twentieth century, 1950s at the latest.

Zionists love American Jews. They hate Israeli Americans, except the Israeli Americans who put a lot of time and money into supporting (Zionist) Israel. That’s because the existence of Israeli Americans (and other Israeli emigrants) flies in the face of a key idea of Zionism: that Israel is the ideal home for Jews which no Jew would want to leave.

First, my mother didn’t use her womb to increase the Jewish population in Israel. Then she removed herself, thereby decreasing the Jewish population. Some Zionists have incredibly harsh things to say about people like my mother.

Could I Have Met This Woman?

Some years back, I overheard my father and uncle talk about a ‘mistress’ my grandfather had when in was in China during World War II. I’m not sure how much they knew about her then.

Since then, some of my grandfather’s old writings have surfaced, and I finally, finally got to reading the part about where he was in China. The answer is no, he didn’t have a mistress. Not exactly. He had sex a few times with sex workers, but those weren’t long-term relationships.

The woman who my father and uncle had referred to was probably a Chinese teenager he helped with math homework and had a friendship with. We have a photograph of them standing together.

I Returned to My Past, and It’s Still Here

Recently, I drove a car for the first time since… before I started this blog. In 2012. This was also the first time I left city limits since June 2021.

The last time I’d driven a car had been after a period of not driving for months and it hadn’t gone well. Thus, I was nervous about driving again after over a decade of zero experience.

Turns out I drove really well. Not just my opinion, my driving instructor also thought I did really well, much better than his average student (note: his average student is someone without a driver’s license, so not a high bar).

Without thinking about it, all kinds of old habits came back. I assumed the wheels had been turned into the curb until the instructor told me otherwise and found it weird that the parking brake wasn’t engaged. I did all of the mirror checks and turned my head to look around at the right moments. Most astonishingly, I stayed calm through this.

Most People Who Say “Follow the Science” Mean “Follow Authority”

In 2020 and 2021, many people claimed they ‘followed the science’ and urged others to do the same. Now, many of those same people ignore new scientific research.

When they make claims such as “covid isn’t a problem in summer”, I ask for sources and offer my own evidence (such as covid wastewater levels in summer), and instead of sharing sources they drop the argument and shift to something else like “covid is here to stay” (what? but I thought you just said covid wasn’t a problem in summer?)

Science is messy.

The history of science is full of ideas which people once widely accepted which were later proven false. Everyone believes something right now which future scientists will prove is untrue, including me. So, any serious attempt to follow the science must include humility and accepting that you are wrong about something, you don’t know what that is (yet).

Read more: Most People Who Say “Follow the Science” Mean “Follow Authority”

As the scientific progress happens, many claims are backed by unclear, confusing, and contradictory evidence, and it’s often not obvious what is true.

This isn’t an excuse for throwing one’s hands up in the air, declaring that nothing is knowable, and thus it’s not worth trying. Some claims have much stronger evidence than other claims. I am pretty darn sure that in my current position gravity pulls me much more strongly to the center of the earth than towards the sun. Anyone claiming otherwise would need to explain why I’m not floating towards the sun (or how I am in fact floating towards the sun yet unaware of that).

Following the science means thinking about the evidence and making an effort to make sense of it, while being aware the it’s easy to make mistakes.

That’s not what people who say things like ‘follow the science’ mean. They aren’t talking about the real scientific method, they’re talking about following an authority affiliated (rightly or wrongly) with institutional science.

It’s impossible to coordinate the actions of a large number of people without some kind of authority. Authority can take many forms, good and bad. For example, in many societies, orators (people who were really good at shaping words to make arguments) had authority. Anarchists, who often reject formal hierarchical authority, often follow the lead of particular writers and thinkers, who thus have a form of authority.

When someone says “follow the authorities” in most contexts I think they mean the official governments which rule the area. In a pandemic, “follow the authorities” isn’t necessarily bad advice. It depends on whether the authorities are making good orders or not.

It’s also not practically possible for most people to follow ‘the science.’ Arguably, it’s not possible for anybody. Even professional scientists can only follow certain slices of the science. When dealing with a pandemic, getting people to follow a flawed authority that has enough grounding in what’s really going on to be useful is better than getting people to follow the science.

So why do people say “follow the science” instead of what they really mean, “follow the authorities”? Many people don’t understand how science really works. They learned about science in school from textbooks and teachers who wielded authority over them. Thus, they conflate “science” with the authorities who forced them to learn about it.

Science is also a potential source of authority, just as being a great orator is a potential source of authority.

Aside from all that, in the United States, we like to present ourselves as not following authority, even when that’s exactly what we’re doing. Even when Americans desperately want to follow authority to delegate responsibility for their choices, we don’t want to admit it.

Personally, I prefer authority to be transparent and clearly defined. It makes it easier to hold authorities responsible. Thus, if someone is advocating following authority, I prefer they to say “follow authority.” So much less bullshit.

And yet, I suspect that’s why so many people prefer to say “follow the science.” It’s vague enough that it’s not clear how you’re supposed to hold them accountable for mistakes, and yet if you press them on real science (such as data or scientific papers), they will deflect. They might even tell you they “follow the science” as if those words are a magic spell even after they’ve refused multiple times to comment on any real scientific evidence.

Not that people think about it consciously in those terms. Mostly, they’re just repeating phrases they heard other people say which seems like an easy way out of uncomfortable conversations.

I still wish they’d say what they really mean rather than hide behind a misleading slogan.

Measles is Fascinating

Last year, I read a fair bit about measles, and it’s a super interesting virus (much more so than, in my opinion, influenza). Since it’s been in the news lately, I figure this is good time to talk about how weird measles is.

But first, the public service announcements:

• wild measles is bad and if you care about your physical health at all you don’t want it
• the measles vaccine works really well and that’s all the protection against measles most people need
• if you’ve been vaccinated against measles (or have experienced wild infection) but it happened so long enough that you don’t know whether it still protects you, you can get your measles antibody titers tested. Or just get another booster dose, since unless you have certain allergy and/or immune system problems an additional measles vaccine won’t hurt you
• if you have a problem with an allergy or your immune system has problems which might make measles vaccination dangerous, that’s something to discuss with a doctor
• if you don’t think the vaccine is enough (possibly for medical reasons), or you can’t get vaccinated (or boosted), airborne precautions such as wearing N95s, using HEPA filters, and good ventilation will greatly reduce your risk of catching measles

Now that I got those those dull PSAs out, we can get to the fun stuff.

Read more: Measles is Fascinating

Rubeola a.k.a. the measles virus has a high mutation rate, much higher than covid (and IIRC the other coronaviruses) because it has an error-prone RNA polymerase. The spontaneous mutation rate of rubeola is estimated to be 9 × 10⁻⁵ per base per replication and a genomic mutation rate of 1.43 per replication. By comparison, HIV, which also has an error-prone RNA polymerase, has an estimated error rate of 3 × 10⁻⁵ per base per round of copying (though in humans HIV has a much higher mutation rate than that, possibly because of the phenomena that linked scientific paper describes). So, based on these scientific papers, if you remove the specific factors in human hosts which cause HIV to hypermutate, measles actually has a higher mutation rate than HIV.

And yet, despite the high mutation rate, measles has only one strain. That means the ‘live’ measles in the measles vaccine is the same strain as any kind of wild measles. (That’s right, the measles vaccine technically infects you with measles).

How can a virus with a high mutation rate only have one strain?

Luckily for the human race, measles depends on certain parts of the hemagglutinin proteins never changing, and human immune systems target those exact parts. Measles virions which mutate in those areas lose the ability to infect cells. Based on every analysis I’ve seen, in order to ‘escape’ this, the measles virus would have to mutate in multiple areas simultaneously in specific ways, and the odds of this happening by accident are so low that it’s practically impossible.

(Though I wonder: what if it’s not an accident? Could a team of bioterrorist scientists engineer a measles virus which has the exact mutations it needs to create a new viable strain, unaffected by human immune responses to the original strain?)

(One reason I wonder about this is that measles only infects certain primate species, including humans, EXCEPT when scientists do weird things so measles can also infect rodents, which they do because lab mice are cheaper than lab macaques. If scientists can modify measles so it can infect rodents, why can’t they modify it so it can escape the vaccine? Also, that’s a cruel thing to do to mice.)

Measles is one of the most infectious airborne pathogens and yet, ironically, it’s not great at replicating in lung cells. No, its favorite host cells are immune system cells, specifically macrophages and dendritic cells. Thus, when a measles virion infects a lung cell, its true purpose (to the extent that a virus can be said to have a purpose) is to provoke an immune system response, which will bring it macrophages and dendritic cells. As the infection gets bigger, the immune system sends in more macrophages and dendritic cells, which allows measles to replicate even more.

Can this go on indefinitely? No, because measles kills the cells it infects, and the human body only has a finite number of macrophages and dendritic cells. Realistically, a functional human immune system will also develop a T-cell response which can end the measles infection before it infects every last macrophage and dendritic cell. But if it’s someone’s first exposure to measles, it takes time to make a T-cell response, which means measles has plenty of time to chew up macrophages/dendritic cells and go back into the lungs to throw out some virions to infect a new host.

So, what happens after measles has killed a high percentage of someone’s macrophages and dendritic cells? To oversimplify, one of two outcomes: either the person lives long enough that they make enough new macrophages/dendritic cells to replace the old ones, or they die first.

Meanwhile, when someone has a low number of macrophages and dendritic cells, it’s difficult for them to respond to new infections, such as, for example, influenza. This is the main cause of death related to measles: not the measles itself, but the inability to fight off the next infection which comes along. This is why societies which introduce measles vaccines see ALL-CAUSE child mortality go down, not just deaths recorded as measles deaths.

Oh, and measles has the ‘immune amnesia’ trick where it suppresses memory T cells for a few years, which also contributes to post-measles deaths. We know this thanks to studies done on religious groups which refuse measles vaccination and gave scientists permission to study their infected children when they got measles outbreaks. But measles can’t completely kill off these memory T cells, because after a few years they come back. I don’t understand it, and maybe nobody understands it (yet).

There is actually so much more to what goes on in a wild measles infection (vaccine measles infections rarely produce symptoms and won’t trash the immune system like a wild infection does, seriously, having a vaccine measles infection is way better than having a wild one). And that’s just what scientists know about. Just as the discovery of measles-related immune amnesia happened less than twenty years ago, measles probably has more effects on the body unknown to science.

After one wild measles infection, a competent human immune system will be able to stop any later measles infections so fast that there will be practically no harm. This will usually happen after a vaccine measles infection too, but sometimes vaccine-related immunity wanes (solution: booster vaccine doses). But not all humans have competent immune systems. If someone has certain types of immune system problems, they can get measles again, and again, and again, and each time it will further trash whatever is left of their immune system.

I’ve encountered an anecdote of someone who got infected with measles ten times. More times, considering that each time the doctors required her to take the vaccine again, even though her medical records showed they already had multiple measles vaccine doses. For some reason, her immune system just couldn’t respond to measles properly. I wonder where she got exposed to measles ten times. Was she part of a community with a low vaccination rate? Or was it a chronic measles infection that got reactivated?

Because yes, that’s another ‘fun’ feature of measles: it can become a chronic infection. In the brain, no less. And chronic measles infections of the brain are awful. Thankfully, the vast majority of people infected with measles don’t have that outcome.

In short, measles is terrible—and fascinating.