Showing posts with label Dr. Sanjay Gupta. Show all posts
Showing posts with label Dr. Sanjay Gupta. Show all posts

Friday, January 18, 2019

100 Years Later: A Look At The Deadliest Pandemic In Human History

great-influenza



John M. Barry's book, 'The Great Influenza', ought to be one of priority  interest for every citizen, especially in a government shutdown - even one spawned by a monumentally stupid unforced error committed by arguably the worst president in American history.  As NY Times columnist Paul Krugman described it in a recent column:

"There have been many policy disasters over the course of U.S. history. It’s hard, however, to think of a calamity as gratuitous, an error as unforced, as the current federal shutdown."

In terms of influenza - which now appears to be flickering out in the U.S. (WSJ,  'Flu Season Looks Less Dire Than Last One',  Jan. 11, p. A3)  we also know that in 1918 the first emergence of what was to become "the Great Influenza" began with a weak initial foray (akin to a 'mild flu' today) in the spring.  It then abated, and returned with a vengeance in the fall. 

How bad was it near the end? Barry's description of the scene in Philadelphia in the winter of 1918-19 says it all (p. 326): 

 "The corpses had backed up at undertakers, filling every area of these establishments and pressing up into living quarters; in hospitals morgues overflowing into corridors; in the city morgue overflowing into the street. And they had backed up in homes. They lay on porches, in closets, in corners of the floor, on beds."    

Obviously no corpses were actually counted but best estimates - according to Mr. Barry and other researchers -put the infected global total at 500 million, and up to 100 million dead.   If this is an upper limit estimate it means 5 % of the world population dead from this flu pandemic.  (The lower limit is generally taken to be 1.9 % of the world's population dead.) By contrast, the Black Death which raged from 1347- 1351, is estimated to have wiped out over a third of Europe's population, and reduced the global numbers from 450m to between 350 m and 375m.  At the upper limit this means up to 22 percent of the world's population removed by this pestilence.  In other words, while the Black Death took out a larger proportion of the world's population, the 1918 Influenza pandemic took out more in sheer numbers - but not as a proportion of the total (estimated at about 1.5 b at the time).

Why is this germane now?  Well, because a government shutdown with reduced resources, for example at the TSA  (to check for biological material or infected victims) leaves us more exposed than it would otherwise. 

Now it is true that the influenza winding down has been much less virulent than last year. According to the previously cited WSJ piece:  "As many as 7.3 million have fallen ill" and there've been about 12,000 deaths.  Last year's H3N2 outbreak felled 48.8 million and killed over 80,000.  Maybe we were fortunate  - at least thus far- that the H3N2 epidemic did not occur this year with the shutdown going on.

Anyway, the question we ask here is what manner of pestilence was this 1918 influenza that it could have bodies piled up like cordwood in many cities (estimated 675,000 dead in the U.S.) . Barry translates this death toll - more than killed in the Civil War (620, 000 in the line of duty) -  to 1,750, 000 in the context of our proportionately greater population today.   This is a bit larger (by roughly 200,000) than the population of Philadelphia today. 

So how account for this horror which felled so many humans and caused more deaths than the Black Plague of the Middle Ages?   The best way to appreciate the magnitude of the catastrophe is to go inside Barry's medical records and descriptions of the time, and in particular to see the literal holocaust this influenza inflicted on human bodies in its 1918 fall re-emergence.  

First, an idea of the relative proportion of flu deaths relative to others  (p. 238):  "During the course of the epidemic, 47 percent of all deaths in the United States, nearly half of all those who died from all causes combined, resulted from influenza and its complications."

In other words, the toll from influenza exceeded that for cancer, heart disease, stroke, tuberculosis, accidents, suicide and murder.

Another curious aspect of the re-emerged influenza lay in the age groups targeted, not so much the elderly or the very young but rather the young, healthy adult. From p. 239:

"The single greatest number of deaths occurred in men and women aged twenty -five to twenty nine, the second greatest number in those aged thirty to thirty four.  The third gresatest in those aged twenty to twenty -four."

One of the myths circulated in the ensuing years about the 1918 pandemic is that it killed just about everyone infected. This misconception, given the actual death rate was closer to 3-  5 percent, likely got started when people saw or read headlines of the accumulated dead, e.g. p. 223: "Undertakers, themselves sick, were overwhelmed. They had no place to put bodies. Grave diggers were either sick or refused to bury victims." 

Or (p. 224): "In homes, corpses were wrapped in sheets, pushed into corners, left there sometimes for days, the horror of it sinking in deeper each hour. People too sick to cook for themselves, too sick to clean themselves, too sick to move the corpse off the bed- often lying on the same bed with the corpse"

Reading this would even prompt many today to believe that anyone who contracted the 1918 flu was killed by it. In fact, the 1918 virus' reproduction number (an estimate of its transmissibility) was only slightly higher (1.8) than the H1N1 (1.4 to 1.5)  that caused the 2009 pandemic - and for which Obama declared a legitimate national emergency . (For reference, a reproduction number of 1.0  means that each person infected will, on average infect one other person).  Still, the slightly higher transmissibilty meant (p. 231): "This virus is transmitted so effectively that it exhausts its supply of susceptible hosts".  Which meant that tens of millions had been sickened in the U.S.

The point missed here, is that our civilization stands on a much more tenuous threshold than many believe, say between stability and chaos and collapse.   In other words, it doesn't take a 100 percent or even 50 percent fatality level to bring us to our knees. Five percent or ten percent can do it, especially if critical manpower is affected.  Then yes, corpses will "pile up" and there won't be the people to deal with them, or the space, venues. Let's again hope no Avian flu (H5 N1) outbreak occurs during this stupid Trump-McConnell-Ann Coulter shutdown.

 Moving on, it's instructive to read the level of carnage inflicted on the organs of many victims by this newly spawned  H1N1 influenza virus. 

E.g. p. 227: "Most striking was the cyanosis, the patients sometimes turning almost black. After gasping for several hours they became delirious and incontinent, many died struggling to clear their airways of a blood tinged froth that sometimes gushed from their mouth and nose."

P. 235:  "In Proceedings of the Royal Society of Medicine, a British physician noted 'one thing I have never seen before - the occurrence of subcutaneous emphysema - pocket of air accumulating just beneath the skin. Beginning in the neck and spreading sometimes over the whole body'. "

Further (ibid.):

"Those pockets of air leaking through ruptured lungs made patients crackle when rolled onto their sides. One navy nurse later compared the sound to a bowl of Rice Crispies."

And(ibid.):  "Extreme earaches were common. One physician noted inflammation of the middle ear - marked by pain, fever and dizziness- 'developed with surprising rapidity and rupture of the drum membrane' was observed sometimes a few hours after the onset of pain....Discharge of pus from the ear was also noted."

Further (p. 236):  

"Then there was the blood spurting from the body. To see blood trickle, and in some cases spurt from someone's nose, mouth, even from the ears or around the eyes had to terrify. ...."

P. 237:  "In U.S. Army cantonments, from 5 to 15 percent of all men hospitalized suffered from epistaxis - bleeding from the nose, as with hemorrhagic viruses such as Ebola. There were many reports that blood sometimes spurted with such power to travel several feet."

"Female patients had a hemorrhagic vaginal discharge - which was at first considered to be coincident menstruation. But later was interpreted as a hemorrhage from the uterine mucosa."

P. 240:  "In the meantime this influenza, for after all it was only influenza, left almost no internal organ untouched. One distinguished pathologist noted blood flooding from the brain, probably because of an out of control inflammatory response.... the virus also affected the pericardium, the sac of tissue that protects the heart.

"The amount of damage to the kidneys varied but at least some damage 'occurred in nearly every case'.  The liver also was sometimes damaged. The adrenal glands suffered 'necrotic areas, frank hemorrhage and occasional abscesses...muscles along the rib cage were torn apart both by internal toxic processes and the external stress of coughing.... even the testes showed striking changes encountered in nearly every case."

And p. 241: "Only one known disease - a particularly virulent form of bubonic plague called pneumonic plague, which kills approximately 90 percent of its victims - ripped the lungs apart the way this disease did."

The preceding documentation leads us to ask what aspect of the virus led to its sheer lethality and violence - especially for young adults. Barry provides the clues on pages 247-48, and these have to do with an over reaction of a too strong immune system.  As he writes, "the immune system is at its core a killing machine. It targets infecting organisms with an arsenal of weapons...and can behave like a SWAT team  that kills the hostage along with the hostage taker."

Such is the case when an invader like the 1918 flu virus enters the lungs given the first line of defense involve the entire respiratoruy tract and lungs - which cells "secrete enzymes that attacks bacteria and viruses - including influenza - or block them from attaching to tissue beneath the mucus."

The problem is that this attack can lead to unintended consequences, as if a biological SWAT team - comprised of macrophages and 'natural killer cells"- targeted the body instead od the invaders.  As Barry writes (p. 247):

"The virus was often so efficient at invading the lungs that the immune system had to mount a massive response to it. What was killing young adults a few days after the first symptom was not the virus. The killer was the massive immune response itself."

He then describes the mechanism  of inflammation that unleashes the so called   'cytokine storm'  which has the most devastating effects on young organs:

"Once an infection gains a foothold the immune system responds 
with inflammation .The actual process of inflammation involves the release of proteins called 'cytokines'. .. When cytokines bind to receptors in the hypothalamus, body temperature goes up, the entire boy becomes inflamed. In influenza, fever regularly climbs to 103 and even higher."

He then points out that cytokines themselves "can have toxic effects."   This means the typical symptoms of influenza, e.g. wracking cough, headache, body aches are "not caused by the virus but by cytokines."   Hence, your own body's defense mechanisms are what's making you feel so god awful.   And these defenders can kill as well, turning the lungs into a bloody mass by destroying the alveoli and wreaking other havoc in the aforementioned cytokine storm.  His description of the immediate process is stunning and bears repeating (p. 249):  

"The same capillaries that moved blood past the alveoli delivered this attack. The capillaries dilated, pouring out fluid, every kind of white blood cell, antibodies, and cytokines into the lung.. Then these cytokines and other enzymes virtually obliterate the capillaries. Even more fluid pours into the lung...The cells that line the alveoli are damaged even if they survive the virus itself. 

Pink, glassy membranes, called hyaline membranes, form on the insides of the alveoli. Once these form, surfactant - a slippery, soap like protein that reduces surface tension and eases the transfer of oxygen into red blood cells - disappears from the alveoli and more blood floods the lungs."

And there you have-   in blunt and brutal biological prose -  how a young adult (most often) drowns in his or her own fluids - while fighting the flu. In this case the misnamed "Spanish flu".   The purpose of this post has been to provide blog readers with an oversight of what transpired 100 years ago with the pandemic that wiped out more people than any other. It is also, hopefully, to encourage you to get hold of Barry's book or any other (like Pale Rider: The Spanish Flu of 1918 and How It Changed the World) because I believe all these works contribute to a better understanding of a history that's too often been ignored or de-emphasized. We need to understand these pandemics - especially of influenza - in the event an even more virulent and deadly virus awaits. 

In their book, 'The End of Epidemics', authors Jonathan D. Quick and Bronwyn Fryer argue that the most frightening future risk is the potential for a new, highly contagious and deadly influenza arising from a "viral stirring pot".  Such a "pot" would include avian, animal (e.g. swine) and human-infecting viruses.  They also note the opportunity for such mixing abounds as beasts, birds and humans rub shoulders in places like factory farms.  Like Dr. Sanjay Gupta's ominous warning given some years ago. e.g.


https://www.cnn.com/2017/04/07/health/flu-pandemic-sanjay-gupta/index.html


Excerpt:

"Pandemic flu is apolitical and does not discriminate between rich and poor. Geographical boundaries are meaningless, and it can circle the globe within hours. In terms of potential impact on mankind, the only thing that comes close is climate change. And, like climate change, pandemic flu is so vast, it can be challenging to wrap your head around it."

Dr. Quick's take is this is not a matter of if but "when".  All of us need to pay attention, and hope to Hell that when that monster bug strikes we are not in the middle of another government shutdown dictated and orchestrated by Ann Coulter and Donald Trump.

Addendum:  Virologist Vincent Racaniello has a list of  pet peeves about a number of Barry's claims which you can find on his "Virology blog".    My take is most are far too technical to cause readers of Barry's fine book to lose sleep, and even Racaniello admits they should not detract from reading it.  See e.g.




Wednesday, February 7, 2018

This H3 N2 Flu Season Could Be The Worst For U.S. Since 1968 Hong Kong Flu Pandemic

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Electron micrograph of the H3 N2  influenza virus, largely responsible for most deaths and hospitalizations this flu season.

As the tally of pediatric deaths reaches a high not seen for nearly a decade, and flu is now wreaking medical havoc in all of the contiguouos states, one wonders if this scourge could rival the Hong Kong flu pandemic of 1968-69.

As I wrote earlier (December 11, 'The H3N2 Flu  - Are We Ready For The Onslaught?')  citing a Wikipedia reference:

"The Hong Kong Flu was a category 2 flu pandemic caused by a strain of H3N2 descended from H2N2 by antigenic shift, in which genes from multiple subtypes reassorted to form a new virus. This pandemic of 1968 and 1969 killed an estimated one million people worldwide"

But could this flu season be as bad? What we do know is what began as "the Aussie flu" last summer (the Australian winter)  has now metastasized to cause over 14, 000 hospitalizations and nearly 60 pediatric deaths. The hospitalization rate, according to one WSJ article ('Flu Hospitalizations Highest Since 2010' ) has now reached 51.4 per 100,000 or the highest since the  2009 H1N1 pandemic flu. That  strain "led to more than 60 million flu cases in the U.S".

Less noted is that the current hospitalization rate now compares to that (43.5 per 100,000) in the 2014-15 flu season - also dominated by H3 N2. Less known is that flu season saw 56,000 die from flu or even more than the Hong Kong flu killed in the U.S. (34,000).  In a blog post I wrote on Dec. 22, 2014, it was interesting to read how I suddenly came down with that flu while watching a football game. (My wife got it 3 days earlier).  That holiday season turned out to be a total wipe out but we were both glad we got our flu shots!

I also got the Hong Kong flu - the first  known appearance of H3 N2  -  so why didn't I have any immunity when the 2014 H3 N2 flu struck?  Well, likely because that was actually a variant strain, e.g. H3 N2v - where more Avian or swine contributions factored in.  It elicits the question of whether the current ferocious flu season is dominated by a similar H3 N2 variant, and in fact whether it could be as bad as the 1968 pandemic.

Soon after the Aussie flu struck the UK,  Professor Robert Dingwall, a public health expert at Nottingham Trent University, told the UK Daily Express  the oncoming H3 N2 season is expected to be the most serious flu outbreak since the 1968 pandemic that started in Hong Kong and killed more than a million people world wide. 

In a number of respects he's correct as this flu season further plays out, and it is clear we haven't even hit the peak yet.  See e.g.

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There is also the chance this flu season could go on much longer than the (normally)  expected end in May. The Hong Kong flu swept the world infecting hundreds of millions for almost 2 years. Such freak pandemics seem to occur every 50 years, with the 1968 pandemic striking 50 years after the deadly Spanish flu - which killed up to 100 million - arguably a worse  human health catastrophe than  the Black Death. See also:

https://www.cnn.com/2017/04/07/health/flu-pandemic-sanjay-gupta/index.html

In their book, 'The End of Epidemics', authors Jonathan D. Quick and Bronwyn Fryer argue that the most frightening future risk is the potential for a new, highly contagious and deadly flu to arise from a "viral stirring pot".  Such a pot would include avian, animal (e.g. swine) and human-infecting viruses.  They also note the opportunity for such mixing abounds as beasts, birds and humans rub shoulders in places like factory farms.  Like Sanjay Gupta (earlier link) Dr. Quick's take is this is not a matter of if but "when".

My bet, as I've written before, is the new deadly pandemic will be a hitherto unseen form of Avian flu.   Cue then the date September 29, 2005, when David Nabarro, the newly appointed Senior United Nations System Coordinator for Avian and Human Influenza, warned the world that an outbreak of avian influenza could kill anywhere between 5 million and 150 million people. The reported mortality rate of highly pathogenic H5N1 avian influenza in a human is high; WHO data indicate 60% of cases classified as H5N1 resulted in death. My take, given the H5N1 would incept a "cytokine storm"  similar to what the H1N1 Spanish Flu did, is that at least 500 million would perish, and possibly as many as 1 billion.

So, we infer that what kills most humans - apart from the secondary infections, e.g. pneumonia  - is the immune system's hyper response to the virus invasion of our lung cells. This hyper reaction is what induces the cytokine storm.   Research into the Spanish flu victims discloses that death likely arrived via a cytokine storm, i.e. the victim basically "drowning" in their own lung fluids. The alveoli or air sacs of the lungs become basically incapable of gas exchange, e.g. between oxygen and CO2 and the victim suffocates as the cells burst - responsible for many of the victims having blood spurting from eyes, ears, nose etc.  Also, the effort to summon oxygen from elsewhere leaves the victims with a bluish or cyanotic facial appearance.

Contrast this with a number of  documented Asian cases,  where victims with H5N1 experienced diarrhea followed rapidly by a coma without developing respiratory or flu-like symptom. This shows that one can perish that suddenly, and with no evident breathing problems. 

More distressing, genetic sequencing of avian influenza A (H5N1) viruses from human cases in Vietnam, Thailand, and Indonesia shows resistance to the antiviral medications amantadine and rimantadine, two of the medications commonly used for treatment of influenza. This leaves only two remaining antiviral medications (oseltamivir and zanamivir) that should still be effective against currently circulating strains of H5N1 viruses.

If and when the next influenza pandemic strikes we better have our anti-viral weapons ready along with every available resource to care for the millions of victims. The current scenes, with hospitals having to set up triage  tents outside of main facilities and ERs flooded, shows we are nowhere near ready when the "big one" strikes. Which could, I say could...be at the tail end of this current H3 N2 season.

We will also have to drop the obsession with "diminished hospital profit margins" during flu outbreaks. That should be the least concern if millions of our fellow citizens are infected by a killer flu variant or totally new strain.

Monday, January 29, 2018

Are Mensa's Libertarians Really As Dumb As They Write?

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Even wifey was appalled to read one of the letters published in the latest Mensa Bulletin,  (January, 'Brainwaves' p. 10) written by a Mensan named Dennis Ward. It read thus:

"Taxes! Taxes! Taxes! People are always complaining about taxes, so the  'smart' members of Mensa have the right solution: It is neither ethical nor moral to force anyone to do anything against their will unless in self-defense. Many people will ask: 'How will we run the government without taxes?'  My answer is that it is neither ethical nor moral to force anyone to do anything against their will unless in self-defense."

Wow! This character repeats a mantra and he makes it appear as if he's delivering some unique wisdom from atop Mt. Olympus,  channeling a Mensan version of Zeus. Give me a break! At best this is regurgitated  from Libby idol Ayn Rand, who blabbered in her book, The Virtue of Selfishness (p. 116):

"Since the imposition of taxes does represent an initiation of force...in a fully free society, taxation, or payment for government services, would be voluntary. Since the proper services of government - the police, the army, the law courts - are demonstrably needed by individual citizens, and affect the individual's interests directly, they should be willing to pay for such services as they pay for insurance.....Men would voluntarily pay for insurance protecting their contracts."

One method of such voluntary government financing would be a government lottery"


and (ibid.)

"A fully free society is one that has been constitutionally reduced to only its most proper, basic functions"


This is also undoubtedly where the pet libertarian canard that “taxes = theft’ comes from. But let's look at it objectively:  the reductio ad absurdum conclusion is that every human resides in a kind of bubble or vacuum wherein he or she presumably controls all.  Face invasion by a foreign army? Develop your own counterforce, or....round up enough soldiers to try to protect you.  Your town flattened by an F5 tornado and all electric power and water gone? Well, try to get neighbors together and dig your own wells for H2O while you cut lumber to put up new telephone poles and look around for electric power lines.  H3N2 flu killing one person after another in your town, and there's no flu vaccine - or Tamiflu - because, well you didn't want to pay  taxes to support the CDC or government health services? Hey, no problemo! Go mix up some camphor balls and listerine and see if that works!

 This elicits two questions, not entirely unrelated: 1) Is it practical to expect an individual in any society to shoulder all responsibility for all possible adverse events - that may not only affect him, but also others in his proximity or region?, and 2) Is it possible to have a "fully free society"?

Let's take the last first and note the libertarian creed has a primary fetish for "full freedom" especially on the individual level.   But this arises from fantasies that bear no relation to the real world we inhabit. This includes such natural threats and affronts to individual freedom as: floods, fire storms, mudslides - such as recently swallowed dozens of California homes, monster hurricanes, tornadoes,
and disease pandemics - say from Influenza,  Zika or dengue fever.

I believe we can agree that each of these, if occurring in a populated place, impinges adversely on the inhabitants' freedom, say to live or even prosper. In nearly every case resources are suddenly limited, including electric power, water and even food. The frequency of these natural enemies of total freedom also appears to be increasing as climate change goes on.

The conclusion then is that a fully free, autonomous and independent society is an impossible concept. This is because no one living on this planet - in any society, country or continent- - can be free of the vicissitudes and vagaries of the multiple possible natural disasters, events that can afflict any given community. Once your domain  is devastated by any natural disaster of any form your "freedom" becomes circumscribed.  Ask the Puerto Ricans still without electric power after Hurricane Maria.  These hapless folk cannot cook their rice, access potable water, refrigerate their medications or watch television news. Or even have lights by which their offspring can do homework - hence why many thousands have abandoned the island to live in the U.S.

By extension then, we can generalize and assert once your domain is subject to any kind of natural disaster (including a pandemic flu) your basic freedom to live and prosper is limited.  This axiom applies to all humans across the planet, no exceptions.

As a corollary let me add that ALL individuals exist as part of communities, they do not exist unto themselves as one hundred percent self sufficient entities. Even if  an individual might conduct his  own home school to teach his own offspring, he'd be hard pressed to  build his own roads, bridges, sewer and water lines, hospitals, airports etc.  So it is daft to believe any individual can live on his own detached from the resources of a greater collective, unless he is maybe another Ted Kaczynski. So seriously, are Ward, Ayn Rand and fellow Libbies asking us to generate 300 million Ted Kaczynskis?  Give me a break!

So moving on to inquiry (1), what then is the Libby solution for a community or even a state, if it is suddenly struck by monster storms, floods or wildfires? Well,  if I am a Puerto Rican and my power and water was knocked out after Hurricane Maria,  I suppose Ward's "solution" is that I retrieve my own telephone poles, power lines, and also machinery to excavate my own water wells.  I suppose also he expects all other Puerto Ricans  to do the same. No dependence on outside (tax-funded) government agencies like FEMA or the U.S. Army to help or lift a mitt.

What a freaking system- of idiocy!

If an H5 N1 Avian flu pandemic arrives, as many (e.g. Dr. Sanjay Gupta)  predict sometime in the future, would Mr. Ward also demand cutting all tax-support for the CDC - which tracks pandemics? Would he prefer we all just fend for ourselves, without even a flu vaccine to help?  I mean, in his deformed stunted world it would be "force" to have any upstanding citizen pay taxes to support the preparation of vaccines or the CDC in its keeping Americans apprised.

But again, this is the problem when one relies on mantras instead of reason and critical thinking, even if a "smart" Mensan.

This bids us also look again at Ayn Rand's solutions to our dilemma of what to do in case we  need police, army, fire fighters, health care or any other ostensible service of government that ordinarily woould be provided via tax dollars. But since taxation is "theft" to her and Ward, then we are to EACH purchase our own services "like insurance"".  Must I really spell out how stupid this is, and that if one is really going to individualize costs - as opposed to share them via a tax commons-  they are going to be astronomical.

Must I also spell out to the libbies that taxation is totally justified by social contract theory. On this basis we in the public sphere democratically allow people (like Warren Buffet and George Soros)  to accumulate wealth only with the understanding that a portion of that wealth would be allocated for public use.  Go ahead and establish whatever business empire you wish, but be aware that your use of our railroads, state highways, airports, etc. makes it incumbent on you to pay into the collective, the  tax commons. And no, this is assuredly not a "voluntary" matter as Rand suggests.

This brings us to one of the most apt criticisms of libertarianism:

"I don't need force to commit theft or fraud. This is a bit of rhetorical sleight of hand that libbies like to play so that they can pretend they are different from government”.

To fix ideas, Bernard Madhoff put a gun to no one's head to part with their money. He merely plied clients with fantastic visions of unearned extra wealth via his investment offerings. They weren't forced to purchase these instruments. This in itself shows the libbie's version of force as theft is poppycock.. Conversely,  taxation is not force if person X opts to live in a state or city whereby that habitation gives tacit agreement to be subject to the state's tax.  If I dislike the terms of that agreement I am at liberty to do what  one hedge fund billionaire once did and live on my own ship outside international waters.

Enter now  Prof. Ernest Partridge take on libertarianism in his 2012 article, ‘Liberals and Libertarians’:

Now consider the implications of this denial of the "independent existence" of "the public" and "society." If there is no "public," then there are no "public goods" and there is no "public interest." If there is no "society," then there is no "social harm," or "social injustice" or "social (and public) responsibility." It then follows that government has no role in mitigating "social injustice" or promoting "the public interest," since these terms are fundamentally meaningless. Poverty and racial discrimination, for example, are individual problems requiring individual solutions”.


The same critic cited earlier puts thus:

Libertarians make exceptions for defense of property and prosecution of fraud, and call them ‘retaliatory force’ But retaliation can be the initiation of force."

Libertarianism clearly posits initiation of force for what it identifies as its cosseted minions' interests and calls it righteous retaliation, then uses the big lie technique to define everything else as “evil initiation of force". They support the initial force that has already taken place in the formation of the system of property (e.g. the seizure of Native American lands and violation of umpteen treaties), and wish to continue to use force to perpetuate it and make it more rigid. It is this inchoate ethics that translates into the system’s weakness and exposes libertarians as true hypocrites.

Thankfully, it appears fewer in the higher Q societies have been buying into this codswallop over the last few years. Maybe it's because Ayn Rand's rubbish of "objectiviem" - disguised as philosophy - has also been exposed on a number of fronts.

See also:

http://smirkingchimp.com/thread/richard-eskow/53353/what-america-would-look-like-if-libertarians-got-their-way