Part the First: Die with the Measles or Die of the Measles? One of the more irritating tropes of the MAHA movement and its hangers on is whether someone dies of the disease or with the disease. Death doesn’t work that way, as pointed out in this opinion piece in STAT News, The ‘died with’ vs. ‘died of’ measles discussion misses something very important: Death is a cascade:
During the pandemic, we all heard some variation of “they died with Covid, not from it.”
The phrase is back, this time attached to measles. On Aug. 25, Pennsylvania reported two measles-associated deaths in Lancaster. That day, a county commissioner relayed the coroner’s office’s position that one person had died “WITH measles, but not FROM measles.” (The coroner has attributed that death, an infant’s, to a ruptured spleen; without the medical records or full autopsy, the public can only go on what the coroner has shared with reporters.)
The Centers for Disease Control and Prevention then left both deaths out of its national measles update and put an asterisk in the deaths column. Pennsylvania has since reported two more, for a total of four. The CDC added one of these deaths to its data on Wednesday but still does not list the other three.
On Sept. 16, in her first interview as CDC head, Erica Schwartz was asked about the CDC’s decision to leave the Pennsylvania deaths out of its count. She pointed back to Covid, saying that when someone with COVID was hit by a bus, “often that was called a Covid-related death,” and that definitions matter.
That measles is making a comeback is beyond dispute. That this is because the 90-95% vaccination rate required for herd immunity against measles (measles at 0:50) has been lost is also beyond dispute. That this nonsense can goes back to scientific fraud committed by the former physician Andrew Wakefield is also beyond dispute. On the cascade that leads to death:
If we wanted to be literal about it, the cause of death for nearly everyone would be cardiac arrest, since in the end our hearts stop. We don’t record deaths that way because in almost every case something caused the heart to stop. The CDC’s handbook for physicians tells certifiers not to list cardiac or respiratory arrest as a cause of death for this reason. Pennsylvania’s death certificate manual says the same in capital letters: “DO NOT enter terminal events such as cardiac arrest” without showing what caused them.
Death is usually a cascade, and the certificate is designed to capture it. The first part of the U.S. standard death certificate lists the sequence in reverse order. The top line is the immediate cause, meaning the final disease, injury, or complication before death. Each line beneath it is the condition that led to the one above, and the last line is the underlying cause, the disease or injury that initiated the chain of events. The second part is for other significant conditions that contributed to the death without being part of that chain.
The Pennsylvania Department of Health’s training for certifiers uses this example. A patient dies of bleeding esophageal varices, which were due to portal hypertension, which was due to liver cirrhosis, which was due to hepatitis B. The top line of that certificate is the bleeding, and the underlying cause is hepatitis B because the virus started the sequence. Homicide law relies on similar reasoning when a gunshot victim dies of complications from the wound months later. We apply this logic to car crashes and gunshots all the time, and it applies to infections in the same way.
When a formerly healthy child dies of encephalitis as a consequence of measles after she was not vaccinated (because reasons), the cause of this entirely preventable death was measles. This is not a difficult concept, but the Current Administration would have you believe otherwise. ICYMI, from Links yesterday. We live in strange times that are getting stranger.
Part the Second: Big Pharma and Our Health. It would be churlish to deny that Big Pharma is very important in health care. Although nearly every drug eventually brought to market is the result of publicly funded research, Big Pharma does a lot of the work after that, and they deserve to be rewarded. Nevertheless, sometimes stuff happens, as detailed in Merck discontinues a crucial antibiotic despite concerns over superbug resistance (no archive yet):
In an unexpected move, Merck discontinued an important antibiotic from the U.S. market earlier this month, underscoring concerns about the commitment large pharmaceutical companies are willing to make to a field that is crucial to public health. (emphasis added)
The drugmaker is no longer supplying Recarbrio, which was approved seven years ago and is used to treat serious infections in adults and children, such as pneumonia that develops from a hospital or ventilator, as well as complicated urinary tract and stomach infections in patients with limited or no alternative treatment options.
The company did not explain its decision, but the antibiotic — a three-drug combination injection — was pegged from the outset as a treatment of last resort by the Food and Drug Administration in hopes of mitigating antibiotic resistance. However, this also limits market and sales potential. Merck did not disclose Recarbrio sales in its regulatory filings.
In a note, a Merck spokeswoman would only say that “as part of our ongoing portfolio review, our company has made the decision to voluntarily discontinue the manufacturing and marketing of Recarbrio in the U.S. This decision is not related to any product safety or quality issues.”
As a result, the U.S. market will be left with just one antibiotic approved for the same three uses for combating KPC (Klebsiella pneumoniae carbapenemase), a superbug that produces an enzyme that makes most germs resistant to antibiotics, according to John Rex, editor of the AMR Solutions newsletter and chief medical officer at F2G, which develops novel treatments for fungal infections.
This speaks for itself, but I do wonder. I once had a good friend, a brilliant molecular microbiologist who left academic science for Little Pharma and eventually Big Pharma (Merck, as it turned out). His job at Merck was his last before what became an early retirement. He led a large research group that was working on a novel approach to antibiotics that had the potential to get around the antibiotic resistance that we have brought on ourselves by our overuse of antibiotics in humans and nonhuman animals:
Without intensified action, it is estimated that 39 million deaths traced to antibiotic resistance will occur by 2050, according to an analysis published two years ago in The Lancet. In the U.S., more than 2.8 million antimicrobial-resistant infections occur each year, according to data from the Centers for Disease Control and Prevention.
Nonetheless, few new antibiotics have reached medicine cabinets or hospital storage facilities over the past two decades. Last October, the World Health Organization released a report noting that the number of antibacterial medicines under development fell to 90 early last year from 97 in 2023. Of those, just 15 were deemed innovative.
My friend couldn’t talk about the concept and I never asked. I did wonder, but not too much. If he said it was likely to work, that was good enough for me. However, after concluding that even though these antibiotics would be revolutionary, Merck shut down the program because the C-suite decided that even successful, the project could never make enough money to justify the cost of development. A lost opportunity? Certainly. Once again I am reminded of what the Labour politician Aneurin Bevan, who established the National Health Service in less than two years, wrote in his autobiography, “The field in which the claims of individual commercialism come into most immediate conflict with reputable notions of social values is that of health.” This was true in the immediate aftermath of World War II. It is still true today, for all kinds of commercialism.
Part the Third: Carlo M. Cipolla Was Right. Professor Cipolla was a historian of political economy at the University of California – Berkeley. His Between Two Cultures and Clocks and Culture are very good. However, his most famous book, resident on my Shelf of Little Books, is The Basic Laws of Human Stupidity. There are Five Basic Laws of Human Stupidity. Here we will be concerned only with The Second Law of Human Stupidity (from which there is no escape, just like the other Second Law):
The probability that a certain person be stupid is independent of any other characteristic of that person.
It follows that the number of stupid people in the Royal Society, among the immortals of L’Académie française, and in the National Academy of Sciences are present at the same percentage as in any other human group. We now have more proof of this law, from this article in Nature, Exclusive: Sham scientific societies are misleading star researchers. I am not often surprised, but I have to admit this one did the trick:
Julia Hirschberg thought that she had reason to celebrate. In July, she had been elected to become a member of the European Academy of Engineering (EAE), an organization billed on its website as the “premier institution representing the highest professional distinction in engineering” with 35 Nobel laureates among its more than 400 elected members.
The accolade arrived just days after another unexpected honour: election to the Austrian Academy of Engineering. And in 2025, she had been elected to the National Academy of Artificial Intelligence (NAAI).
Securing three prestigious international honours in such quick succession is a rare achievement. Hirschberg, a computer scientist at Columbia University in New York City, was thrilled. Congratulatory notes flooded in from colleagues after Columbia published a public announcement about her accomplishments. “I was really excited,” she says. “I’ve never had anything that quick happen ever.”
The good news continued. Within a couple of weeks, Michael Chu, who identified himself as the EAE’s secretariat, told Hirschberg that the organization was electing a rotating chairperson, and he wanted to nominate her for the position, for which she’d be compensated US$2,000 per year.
And that’s when things started to get weird. When Hirschberg checked the EAE’s website, her name was already prominently displayed atop the leadership masthead. But she had never agreed to take the post; she also had never been asked for references, nor had she attended a single meeting. In truth, she hadn’t even heard of any of these organizations. (In a written response to Nature, Chu said that he had “inferred a preliminary consent” on the basis of correspondence with Hirschberg. In this correspondence, which Nature reviewed, Hirschberg replied to Chu’s invitation by inquiring about the responsibilities of the job, but never said that she accepted the position.)
She is not alone. After several researchers flagged concerns about these academic societies, Nature began investigating. The reporting revealed that Chu is connected to all three organizations and that much of the information about them online seems to be fabricated.
These entities belong to a sprawling international constellation of suspicious academies and societies that have successfully misled some of the world’s leading scientists and universities, including Stanford University in California and the US National Academies of Sciences (NAS) in Washington DC. The deceptive organizations’ websites often contain content that has been plagiarized or manipulated, falsehoods about their institutional histories and locations and honorifics available for purchase.
That these eminent scientists fell for the ruse is not much different from believing an email received from the proverbial Nigerian Prince. Or in the current context, an offer to join the editorial board of a really great sounding International Journal of Research in [Insert Discipline Here], “published” by an organization of uncertain provenance that virtually no one has ever heard of.
The article is a hoot, as they say in these parts, complete with digitally altered photographs and other facts. Read it and marvel at the truth of the Second Law of Human Stupidity.
Part the Fourth: Dolly Parton in The New York Review. It has been nearly two months since the death of a true American angel and the tributes continue. I missed this one when it was first published, but it is one of the best, beginning strong and ending stronger with this paragraph:
Her sparkling rainbow-colored exterior was always an ingenious means of protection for a deep interiority. Despite the half-century of her fame, almost nothing is known about the nature of her long marriage or her closest friendships. She was acutely aware that she could take credit for her seemingly tireless work ethic but not for her extraordinary gifts, for which she was continuously grateful. This is the source of her deep goodness and flowing generosity. For her the space of creativity was itself the sacred, which is why she referred to the work of songwriting as entering the “god zone” or “spirit zone.” That place of communion required solitude yet was beyond the single self, a place to observe life in a kind of prayer. The purest portrait of who Dolly Parton was and what she valued as an artist and human being, from beginning to end, was already contained in a lyric she wrote in the early Sixties, before she even left home:
Words can’t describe what I feel inside
When I see the beauty in each coming day
What my eyes behold can’t be bought or sold
And everything’s beautiful in its own way.
Yes, an American angel who walked planet Earth.
Parting Shot: Democrats still suck. Nat covered this in his inimitable style yesterday. More evidence from this article in The New York Times about “Rahmbo” Emanuel: Rahm Emanuel, Eyeing 2028, Makes His 2026 Play. Or as the tagline puts it, “The longtime Democratic insider has emerged as the behind-the-scenes force in his party’s push to win back Congress. After that, he’ll think about the next presidential race.” Our national politicians, except for less than a handful, care only about their presence in DC and their status on K Street. The Uniparty lives, and as long as it does, nothing good can come of this.
Thank you for reading! And thank you, again, for your support of Naked Capitalism. See you next week.
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