Netizens-Digest Wednesday, April 23 2003 Volume 01 : Number 511 Netizens Association Discussion List Digest In this issue: Re: [netz] CNN.com - Virus mutations add to SARS puzzle - Apr. 23, 2003 Re: [netz] CNN.com - Virus mutations add to SARS puzzle - Apr. 23, 2003 Re: [netz] CNN.com - Virus mutations add to SARS puzzle - Apr. 23, 2003 Re: [netz] CNN.com - Virus mutations add to SARS puzzle - Apr. 23,2003 Re: [netz] CNN.com - Virus mutations add to SARS puzzle - Apr. 23,2003 ---------------------------------------------------------------------- Date: Wed, 23 Apr 2003 10:03:28 -0400 From: "Howard C. Berkowitz" Subject: Re: [netz] CNN.com - Virus mutations add to SARS puzzle - Apr. 23, 2003 At 6:08 AM -0700 4/23/03, lgd1@columbia.edu wrote: >Hello: I think it also pertains to netizens to be aware and >communicate with others information about this dangerous epidemic. >Luis de Quesada Luis, See www.promed.org. The PROMED mailing list has been around for a number of years, as one of the primary tools for communications among public health and related professionals. Last I looked, it had participation from 140 or more countries. PROMED, in many respects, is the essence of a Netizen medium. It mentions, for example, the international cooperation going on to deal with the disease, where CNN did not. It's interesting that you cite CNN, as the PROMED lists have been called the CNN of epidemiology. They deliberately use a text email format for ease of access. since many participants are in developing countries with poor communications. Your forwarded CNN email, in contrast, is full of HTML. I run my mail client with HTML disabled, first for security and secondly because I rarely find HTML additions adding value to mail. So, the actual email was largely unreadable, although it did give a clear URL to get the detailed report. I do believe that responsible providers certainly can give URLs but not embed HTML. In other words, CNN has some problems with the role of "responsible information provider," where PROMED does not. I'll quote the summary part of the most recent report at the end of this message. Since the message contains detailed reports from 28 countries, it's too long to post here. You suggest that netizens should communicate with another about this. Did you mean all netizens? Both CNN and PROMED are moderated, and do not allow arbitrary people to post without approval. PROMED is also rather specifically focused; the moderators will cut off further posts on threads when they judge useful new information is not being posted. PROMED meets, as much as one can in a near-real-time medium, the process of peer-review: the moderators are world-class scientists that won't post a report that seems bogus, although they will post news reports (with commentary) when there is no other data from a geographic area. You have raised the issue of "democracy" in a way that suggests to me, perhaps incorrectly, that you believe anyone should be able to post anywhere. If I understand correctly, how does that apply here. To me, the SARS coverage also brings up the issue of direct posts from wide numbers of sources, as opposed to a more "filtered" or "representative" model. Especially with epidemics, it's easy to introduce panic. Even the initial scientific reports were contradictory: at first this was thought a variant influenza virus, then a paronovirus, and now the thinking is a coronavirus. My personal impression, based on some perhaps too-early reports of the virus genomics and of perhaps skewed disease statistics, is that the Chinese government tried at first to minimize the event, but they are now cooperating properly. I hope the feedback from the public health community helped correct this. At 6:48 PM -0400 4/22/03, ProMED Digest wrote: >ProMED-mail > > >[Today's worldwide update from WHO gives a cumulative total of 3947 >probable cases with 228 deaths, reported from 25 countries. Noteworthy is >the mention/discussion of multilateral meetings between health officials >from Beijing, Hong Kong, Taiwan, and Macau scheduled for 23 Apr 2003 in >Beijing to coordinate policies for responding to SARS. Taking into account >prior political impediments, such a meeting is a sign of the seriousness of >the countries in the region towards developing a coordinated effort for >disease control measures. > >The lay press have been covering the apparent increases in case fatality >rates observed during the course of this outbreak. Some have commented on >how unusual this is, as the usual situation is a decrease in the case >fatality rate as increasing numbers of cases are reported, including milder >clinical presentations. The Health Canada data presented in [5] above are >worth a comment. With 14 deaths reported, the case fatality rate is 4.4 per >cent if one uses all suspected and probable cases reported as the >denominator (316); but is 10.1 per cent if one uses only probable cases >reported (129) as the denominator. A key distinction between a suspected >case and a probable case is the presence of pneumonia on chest radiograph >in the definition of a probable case. This factor alone makes the >denominator of probable cases likely to be those with a more serious >clinical presentation, and eliminates potential milder clinical >presentations from the "pool of cases" used as the denominator for the >calculation of the case fatality rate. > >Keeping this in mind, until we are able to confirm cases of SARS with >certainty -- and until we are able to confirm milder clinical presentations >as due to the same etiologic agent as the one responsible for the more >severe cases of pneumonia that meet the clinical and epidemiological >criteria for probable case of SARS -- we may continue to show apparently >higher case fatality rates. Another point to keep in mind is that at >present, the denominators in use are "all cases", not just cases whose >final outcomes are known; hence the denominator contains many cases whose >final outcomes are unknown. The proportions of these cases who will recover >or die is presently unknown -- another caution in current interpretations >of reported case fatality rates. > >In the news briefs section, the numbers of reported cases in China is >greater than the number contained in today's WHO update, which probably >reflects reporting after official reports were sent to WHO for 22 Apr 2003 >(one of the challenges in presenting "real-time data" when dealing with a >worldwide outbreak involving all time zones of the world - (see [7][A]). >The last sentence mentions cases reported from 14 provinces within China. >Given the size of the country and its population, it would be of interest >to see regular official reports giving disease occurrence by province where >cases have been reported/identified. To date, we do have information that >cases have been occurring in the north and the west of the country, in >provinces that border other countries where cases have not as yet been >reported. > >Additional information on the reported cases from India in the news briefs >suggests local transmission, as the newer cases had close contact with >another suspected case with a history of travel through Singapore. None of >these additional cases in India (3) has been reported to WHO as probable >cases in today's update. - Mod.MPP] ------------------------------ Date: Wed, 23 Apr 2003 09:54:16 -0400 From: Luis De Quesada Subject: Re: [netz] CNN.com - Virus mutations add to SARS puzzle - Apr. 23, 2003 Hello: I will check out Promed.org. But since you say they do not allow to post without approval, then there is no sense in posting any of their articles either, something I didn't know about CNN either, but since they have articles that can be e-mailed I thought that was an invitation to have their articles forwarded and posted to anyone. So in that respect, if you are correct then it was my mistake. I think information about life threatening epidemics should also be posted on this list. I don't think maintaining the people informed is creating panic as you suggest, especially now when this epidemic has been talked about for months. I believe in democracy period. I do not believe in mediated democracy, as you seem to favor by trying to restrict postings. Luis de Quesada "Howard C. Berkowitz" wrote: > At 6:08 AM -0700 4/23/03, lgd1@columbia.edu wrote: > >Hello: I think it also pertains to netizens to be aware and > >communicate with others information about this dangerous epidemic. > >Luis de Quesada > > Luis, > > See www.promed.org. The PROMED mailing list has been around for a > number of years, as one of the primary tools for communications among > public health and related professionals. Last I looked, it had > participation from 140 or more countries. PROMED, in many respects, > is the essence of a Netizen medium. It mentions, for example, the > international cooperation going on to deal with the disease, where > CNN did not. > > It's interesting that you cite CNN, as the PROMED lists have been > called the CNN of epidemiology. They deliberately use a text email > format for ease of access. since many participants are in developing > countries with poor communications. Your forwarded CNN email, in > contrast, is full of HTML. I run my mail client with HTML disabled, > first for security and secondly because I rarely find HTML additions > adding value to mail. So, the actual email was largely unreadable, > although it did give a clear URL to get the detailed report. I do > believe that responsible providers certainly can give URLs but not > embed HTML. > > In other words, CNN has some problems with the role of "responsible > information provider," where PROMED does not. I'll quote the summary > part of the most recent report at the end of this message. Since the > message contains detailed reports from 28 countries, it's too long to > post here. > > You suggest that netizens should communicate with another about this. > Did you mean all netizens? Both CNN and PROMED are moderated, and do > not allow arbitrary people to post without approval. PROMED is also > rather specifically focused; the moderators will cut off further > posts on threads when they judge useful new information is not being > posted. PROMED meets, as much as one can in a near-real-time medium, > the process of peer-review: the moderators are world-class scientists > that won't post a report that seems bogus, although they will post > news reports (with commentary) when there is no other data from a > geographic area. > > You have raised the issue of "democracy" in a way that suggests to > me, perhaps incorrectly, that you believe anyone should be able to > post anywhere. If I understand correctly, how does that apply here. > > To me, the SARS coverage also brings up the issue of direct posts > from wide numbers of sources, as opposed to a more "filtered" or > "representative" model. Especially with epidemics, it's easy to > introduce panic. Even the initial scientific reports were > contradictory: at first this was thought a variant influenza virus, > then a paronovirus, and now the thinking is a coronavirus. > > My personal impression, based on some perhaps too-early reports of > the virus genomics and of perhaps skewed disease statistics, is that > the Chinese government tried at first to minimize the event, but they > are now cooperating properly. I hope the feedback from the public > health community helped correct this. > > At 6:48 PM -0400 4/22/03, ProMED Digest wrote: > >ProMED-mail > > > > > >[Today's worldwide update from WHO gives a cumulative total of 3947 > >probable cases with 228 deaths, reported from 25 countries. Noteworthy is > >the mention/discussion of multilateral meetings between health officials > >from Beijing, Hong Kong, Taiwan, and Macau scheduled for 23 Apr 2003 in > >Beijing to coordinate policies for responding to SARS. Taking into account > >prior political impediments, such a meeting is a sign of the seriousness of > >the countries in the region towards developing a coordinated effort for > >disease control measures. > > > >The lay press have been covering the apparent increases in case fatality > >rates observed during the course of this outbreak. Some have commented on > >how unusual this is, as the usual situation is a decrease in the case > >fatality rate as increasing numbers of cases are reported, including milder > >clinical presentations. The Health Canada data presented in [5] above are > >worth a comment. With 14 deaths reported, the case fatality rate is 4.4 per > >cent if one uses all suspected and probable cases reported as the > >denominator (316); but is 10.1 per cent if one uses only probable cases > >reported (129) as the denominator. A key distinction between a suspected > >case and a probable case is the presence of pneumonia on chest radiograph > >in the definition of a probable case. This factor alone makes the > >denominator of probable cases likely to be those with a more serious > >clinical presentation, and eliminates potential milder clinical > >presentations from the "pool of cases" used as the denominator for the > >calculation of the case fatality rate. > > > >Keeping this in mind, until we are able to confirm cases of SARS with > >certainty -- and until we are able to confirm milder clinical presentations > >as due to the same etiologic agent as the one responsible for the more > >severe cases of pneumonia that meet the clinical and epidemiological > >criteria for probable case of SARS -- we may continue to show apparently > >higher case fatality rates. Another point to keep in mind is that at > >present, the denominators in use are "all cases", not just cases whose > >final outcomes are known; hence the denominator contains many cases whose > >final outcomes are unknown. The proportions of these cases who will recover > >or die is presently unknown -- another caution in current interpretations > >of reported case fatality rates. > > > >In the news briefs section, the numbers of reported cases in China is > >greater than the number contained in today's WHO update, which probably > >reflects reporting after official reports were sent to WHO for 22 Apr 2003 > >(one of the challenges in presenting "real-time data" when dealing with a > >worldwide outbreak involving all time zones of the world - (see [7][A]). > >The last sentence mentions cases reported from 14 provinces within China. > >Given the size of the country and its population, it would be of interest > >to see regular official reports giving disease occurrence by province where > >cases have been reported/identified. To date, we do have information that > >cases have been occurring in the north and the west of the country, in > >provinces that border other countries where cases have not as yet been > >reported. > > > >Additional information on the reported cases from India in the news briefs > >suggests local transmission, as the newer cases had close contact with > >another suspected case with a history of travel through Singapore. None of > >these additional cases in India (3) has been reported to WHO as probable > >cases in today's update. - Mod.MPP] ------------------------------ Date: Wed, 23 Apr 2003 11:41:50 -0400 From: Mark Lindeman Subject: Re: [netz] CNN.com - Virus mutations add to SARS puzzle - Apr. 23, 2003 Luis, >Hello: I will check out Promed.org. But since you say they do not allow to post >without approval, then there is no sense in posting any of their articles >either, something I didn't know about CNN either, but since they have articles >that can be e-mailed I thought that was an invitation to have their articles >forwarded and posted to anyone. > I'm confused. Whether PROMED allows people to re-post their articles is a different issue than whether PROMED allows everyone to post to PROMED itself. Isn't it? >I believe in democracy period. I do not believe in mediated democracy, as you >seem to favor by trying to restrict postings. > So you think that PROMED, or any other information source, ought to allow anyone to post without restriction? How far does this idea extend? Do you also think that CNN.com should run as "news" any story that anyone sends it? Are _any_ restrictions on postings ever justifiable, as when (as I remember it) Jay kicked someone off the Netizens list for profanity and ethnic slurs? I don't know anything about PROMED besides what Howard has said, so I don't necessarily have an opinion about that. But in principle, I think that "democracy" means that the people control the government, and PROMED's posting restrictions don't limit our control over the government -- so I don't see where "mediated democracy" enters in. Mark ------------------------------ Date: Wed, 23 Apr 2003 11:30:40 -0400 From: Luis De Quesada Subject: Re: [netz] CNN.com - Virus mutations add to SARS puzzle - Apr. 23,2003 Mark: I am not familiar with the policies of "promed" at all. Howard is the one that suggested me to check on it and I will. However since he mentions that "promed" has restrictions on what can be e-mailed and posted I replied to him that then what's the use in posting any of their stuff. According to Howard its a source of medical and epidemiological information. So As far as the democracy bit. I am not going to get into that again.I've explained my point over and over again. Apparently it is not shared by you which is fine. Let it suffice to say that Ronda clarified that issued a while back, that we are free to post in the list whatever we thought it was useful communication. I think knowing about SARS is useful communications, because is a dangerous epidemic. I am tired of getting into angry debate and confrontations over every little thing that pops up on the list. Take care, Luis Mark Lindeman wrote: > Luis, > > >Hello: I will check out Promed.org. But since you say they do not allow to post > >without approval, then there is no sense in posting any of their articles > >either, something I didn't know about CNN either, but since they have articles > >that can be e-mailed I thought that was an invitation to have their articles > >forwarded and posted to anyone. > > > > I'm confused. Whether PROMED allows people to re-post their articles is > a different issue than whether PROMED allows everyone to post to PROMED > itself. Isn't it? > > >I believe in democracy period. I do not believe in mediated democracy, as you > >seem to favor by trying to restrict postings. > > > > So you think that PROMED, or any other information source, ought to > allow anyone to post without restriction? How far does this idea > extend? Do you also think that CNN.com should run as "news" any story > that anyone sends it? Are _any_ restrictions on postings ever > justifiable, as when (as I remember it) Jay kicked someone off the > Netizens list for profanity and ethnic slurs? > > I don't know anything about PROMED besides what Howard has said, so I > don't necessarily have an opinion about that. But in principle, I think > that "democracy" means that the people control the government, and > PROMED's posting restrictions don't limit our control over the > government -- so I don't see where "mediated democracy" enters in. > > Mark ------------------------------ Date: Wed, 23 Apr 2003 12:27:50 -0400 From: Mark Lindeman Subject: Re: [netz] CNN.com - Virus mutations add to SARS puzzle - Apr. 23,2003 Luis, >As far as the democracy bit. I am not going to get into that again.I've explained my >point over and over again. Apparently it is not shared by you which is fine. Let it >suffice to say that Ronda clarified that issued a while back, that we are free to >post in the list whatever we thought it was useful communication. I think knowing >about SARS is useful communications, because is a dangerous epidemic. >I am tired of getting into angry debate and confrontations over every little thing >that pops up on the list. > Well, that's what I'm confused about. I'm trying to figure out whether you think _PROMED_ is obligated to post everything. Not whether you think Netizens should post everything. If Howard and I think you're talking about what gets posted on PROMED, and you think we're talking about what gets posted on Netizens, then we may or may not get angry, but we sure will confuse each other. Likewise, I'm still confused whether you think that it is wrong to re-post from PROMED because it doesn't accept all posts, or whether that was just a verbal confusion (freedom to post on PROMED, versus permission to redistribute their posts). I don't even care much whether we agree or disagree about any of this, but I want to know what you mean, because if I give up on caring what you mean, then it's pretty hard to communicate! Mark ------------------------------ End of Netizens-Digest V1 #511 ******************************