Crimson Contagion - <AUTHOR> https://en.wikipedia.org/wiki/Crimson_Contagion <comment><USER2> For people who are of the opinion that expensive preparation for low probability events is untenable for elected governments because it would be seen as wasteful:

My home country (Switzerland) has a conscription army. ~160k people, each with either a pistol or an assault rifle at home, receiving regular training for a few weeks a year while the government compensates their employer for the loss in productivity. There are tanks, fighter jets and massive alpine fortifications. It's expensive. Most countries have an army and they are usually sized for an unlikely worst case scenario.

One would think maintaining a stockpile of PPE that would allow the authorities to recommend (and even provide) masks for the general population without risking a shortage in health care would be a relatively minor expense compared to that. And yet, all over the western world, PPE is in short supply, and that is without the general public wearing masks like they do in many asian countries.

<comment><USER3> The bigger question is why we rely solely on disposable PPE for catastrophes. Instead of N95, they should be using P100 masks that can be cleaned and whose filters last a couple months in a hospital setting.

They should have gowns that can be boiled and reused.

Surgical masks that can be boiled, etc.

Disposable PPE is used for convenience. It's easier and cheaper to throw away an N95 mask than to clean an P100 mask, except when you can't buy N95 masks.

<comment><USER4> The problem is not cleaning. The problems are design, donning, doffing, and tracking.

If you have re-usable gear, you have to make VERY sure that what you think is clean is really clean. That means cleaning procedures have to be extremely thorough, and you have to make sure that you NEVER mistake a soiled unit for a clean one. In addition to designing things to be clean-able (which is much harder than it sounds), you need to make sure that they are designed in such a manner that they can be doffed safely. Taking off PPE sounds easy, but when you are guaranteed to come into contact with biohazards, you have to be extremely careful about how and what you do.

Simply put; desiging, manufacturing, and safely using re-usable PPE for use in biohazardous environments is much harder than it sounds.

<comment><USER5> Fair enough, but wouldn't it make sense to have a stockpile of reusable PPE that could last through a crisis? Then if you ran out of disposable PPE you could switch to the reusable stuff. Perhaps mistakes would be made in disinfecting it, but it's certainly better than people wearing substandard masks and garbage bags.

We're now forced to reuse disposable PPE due to the shortage. It would have made a lot more sense to be reusing PPE designed in the first place to be reused.

<comment><USER4> If you can design and reliably manufacture re-usable PPE, I am certain there would be a market for it.

I design some non-medical mechanical assemblies (various types, for use with electronic equiment), and have no idea how I would design (reliably manufacturable) re-usable PPE for use in a biohazardous environment. As far as I can see, the problems would mostly be in the joints and fastening features between different materials. Some features (such as filters) will likely need to remain at least somewhat disposable, as I believe that all biofilters have a limited lifespan.

</comment></comment></comment></comment></comment><comment><USER6> See also Event 201, two months later in October, a simulation of a coronavirus pandemic.

[https://en.wikipedia.org/wiki/Johns_Hopkins_Center_for_Healt...](https://en.wikipedia.org/wiki/Johns_Hopkins_Center_for_Health_Security#Event_201)

<comment><USER7> Nice explanation of why it was called Event 201:

In recent years, the world has seen a growing number of epidemic events, amounting to approximately 200 events annually. These events are increasing, and they are disruptive to health, economies, and society. Managing these events already strains global capacity, even absent a pandemic threat. Experts agree that it is only a matter of time before one of these epidemics becomes global—a pandemic with potentially catastrophic consequences. A severe pandemic, which becomes "Event 201,"

<comment><USER8> And from the scenario:[0]

> Event 201 simulates an outbreak of a novel zoonotic coronavirus transmitted > from bats to pigs to people that eventually becomes efficiently > transmissible from person to person, leading to a severe pandemic. The > pathogen and the disease it causes are modeled largely on SARS, but it is > more transmissible in the community setting by people with mild symptoms.

That's almost exactly what happened. Except for the jump through pigs.

And the "growing number of epidemic events" is arguably caused by increasing human contact with previously isolated habitats, driven by population pressure.[1]

0) [https://www.centerforhealthsecurity.org/event201/scenario.ht...](https://www.centerforhealthsecurity.org/event201/scenario.html)

1) [https://www.scientificamerican.com/article/what-11-billion-p...](https://www.scientificamerican.com/article/what-11-billion- people-mean-disease-outbreaks/)

</comment></comment></comment><comment><USER9> One of the key findings: "The United States lacks the production capacity to meet the demands for protective equipment and medical devices such as masks and ventilators imposed by a pandemic"

This is exactly why we can't have the government move like molasses. We had several months, needed to react with urgency and failed.

<comment><USER10> > We had several months, needed to react with urgency and failed.

That's a rewrite of the actual history that occurred and what people understood along the way.

They had a realistic four to six weeks max to start production of ventilators. A herculean feat in fact. Even less time if you were going to judge it based on understanding the severity and particular intensive-care heavy effects of the virus.

It was not a certainty to the outside world that it was human to human transmissable until the end of January. There was a lot of confusion due to the total lack of access to China and its data.

From February 1st (China's reported numbers begin to spike here) to the point where you understand it's a high global risk, capable of a large scale outbreak that could threaten the US, it's another 1-2 weeks minimum based on the rate of expansion in China's reported numbers and their inability to contain it properly (and better yet, with China you watch what they do more than what they say; during that first and second week of February, China took what seemed like wild action domestically while playing down the danger of SARS-CoV-2 to the rest of the world, including regarding travel restrictions).

Taking the decision to push billions of dollars in spending to jumpstart very early production of PPE and ventilators, is a big decision that you better be right about when you make it. You were going against the behavior of the entire developed world by producing ventilators in February, so now you need to be prepared to look like a paranoid lunatic, along with being called a racist and xenophobe while you restrict travel and close borders.

It's February 7th and you need to coordinate with domestic industry, local governments, international agencies, and companies around the world.

It's February 14th and you've got your first partnership together, they've agreed to produce ventilators.

It's March 7-14th by the time they are able to produce their first ventilator after preparing a factory for it, preparing any necessary design changes to accomodate rapid scale production, and putting together a supply chain that can scale for the hundreds of specific parts in a ventilator.

You need to build a scheme that can produce more ventilators than the present total global annual supply.

It's mid to late April before they have consequential volume of production. Assuming things go well.

Having closely followed all the ventilator efforts around the world, please show me a faster timeline that is realistic. You're only going to beat our present timeline by a matter of weeks, and that's if you aggressively jump out in front of prevailing 'wisdom' at the time.

It's an extraordinary short amount of time to accomplish the ramping up of producing ventilators.

<comment><USER11> The US intelligence community was watching mid-November.

Singapore started screening incoming travelers Jan 3, based on the pneumonia cluster in Wuhan growing in size.

Xi found out about it and took aggressive measures ~Jan 21.

It was an obvious risk on Jan 3. Maybe not a high probability risk, but obvious enough for a country to make sure they had the first couple of steps of their response at least figured out. Human to human spread was pretty clearly the case when the Chinese government started taking aggressive lockdown measures.

So your timeline is pretty friendly.

And then the focus on ventilators is odd. How about masks and other PPE and testing and so on?

<comment><USER12> > The US intelligence community was watching mid-November.

What? The US intelligence community was watching before the first person was infected? Man, they've gotten a little too good.

<comment><USER11> [https://abcnews.go.com/Politics/intelligence-report- warned-c...](https://abcnews.go.com/Politics/intelligence-report-warned- coronavirus-crisis-early-november-sources/story?id=70031273)

<comment><USER12> > "Editor's Note: This story has been updated to reflect comment from the > Pentagon."

> "As a matter of practice the National Center for Medical Intelligence does > not comment publicly on specific intelligence matters. However, in the > interest of transparency during this current public health crisis, we can > confirm that media reporting about the existence/release of a National > Center for Medical Intelligence Coronavirus-related product/assessment in > November of 2019 is not correct. No such NCMI product exists," the statement > said.

It doesn't seem likely that they were watching in mid-November when according to

[https://www.theguardian.com/world/2020/mar/13/first- covid-19...](https://www.theguardian.com/world/2020/mar/13/first- covid-19-case-happened-in-november-china-government-records-show-report)

China "may" have retroactively found the first patient to be some guy on Nov. 17. That part could be entirely made up as well, I don't trust anything they say.

</comment></comment></comment></comment></comment></comment><comment><USER13> The article cited by Wikipedia is pretty comprehensive (and damning): [https://www.nytimes.com/2020/03/19/us/politics/trump- coronav...](https://www.nytimes.com/2020/03/19/us/politics/trump-coronavirus- outbreak.html)

</comment><comment><USER14> What's interesting is the extent to which the real pandemic seems to have been handled better than the simulation, despite what is objectively a less effective federal response than the one envisioned (in practice, the actual federal response seems to have done more harm than good as far as disease control goes -- the one bright spot was the economic response).

It turns out that a few early mover states were more willing than expected to institute rigorous lockdowns, other states followed on more rapidly than expected, and the population as a whole (even in states with less effective responses) was... actually fairly well informed and took appropriate action.

Basically, we stayed home and beat this. Now we need to finish the job, of course, but absent some kind of crazy change in public behavior we're not going to see the doomsday numbers that everyone was worried about.

<comment><USER15> I'm actually surprised at how compliant citizens were in general. I would have expected more rioting or pushback but I guess that's what we are seeing right now. It's been 6 weeks and I'm surviving but my wife and kids are not doing as well. I can only imagine how bad some people have it, especially those in apartments. At some point people are going to do the math and figure that 80% mild symptoms rate that leads to immunity and a decent job is worth the risk rather than starving to death alone. I think that breaking point will be reached before end of June and I hope there are measures to deal with that. Personally I would give everyone $2000/month and drop prices of marijuana to keep the masses from rioting.

<comment><USER16> Well the hospitals have plenty of excess capacity now. We've very successfully flattened the curve. It might be time to ease up.

I thought this doctor explained the idea better than I could: [https://medium.com/@jbgeach/eight-reasons-to-end-the- lockdow...](https://medium.com/@jbgeach/eight-reasons-to-end-the-lockdowns-as- soon-as-possible-b7bb0bc94f00)

But I'm just winging this like everyone. I could certainly be wrong.

<comment><USER14> Only in some areas. New York is still teetering right at capacity. Active cases have not dropped much at all, in fact. It's the rate of new infections that has leveled off. This is good evidence that the exponential growth has been halted.

No, it's not time to ease up. Unlike in February, we have effectively zero buffer in many areas. A sudden increase in cases (which is what "easing up" _means_!) would push us right over the edge.

We ease up when the outbreak can be sustained. It can't now, and won't for several weeks, maybe two months more. Stay home.

<comment><USER17> Hmm. You seem to have repeatedly said that we should stay home, but didn't really make much of an argument for it, the one exception being this point:

> we have effectively zero buffer in many areas. A sudden increase in cases > (which is what "easing up" means!) would push us right over the edge.

\--

I think that this is not the best way to think about it. We need to contrast the benefit of lockdowns (decreased transmission of the disease) with the economic costs. And just to be clear, this isn't about investment returns, the stock market, etc, it's about the very real fact that poverty, stress, and economic uncertainty all eventually lead to deaths in their own right (either indirectly due to being reluctant to seek medical care, or directly through suicide).

If you're willing to discuss further, can we see if we agree on these points?

(1) This is a highly transmissible respiratory virus, and thus eradication is impossible

(2) Given (1), the purpose of lockdowns and other measures is primarily to prevent us from exceeding our hospital capacity, at which point the number of deaths would go up dramatically

(3) The vast majority of the globe will be exposed to this. Avoiding that is not possible, so it's just a matter of when

Therefore, we should work to mitigate the _impact_ of Covid (NOT with the goal of eradicating it, which is impossible), but there is a point where the economic damage will far exceed the cost of lifting lockdown.

BTW, it's not like ending lockdown means everything goes back to normal. We would still be banning large gatherings, at least for a short length of time, and we would still be advising at-risk individuals to self-isolate (and for a country like the US, I don't have any hard numbers here but that could easily still be 30-50% of the country who's considered at risk).

Last point I want to make. Many of us here work jobs that allow us to work from home, and so we kept our jobs during this. We need to recognize that not only have tens of millions of Americans lost their jobs, but a significant chunk of those jobs will not be "coming back". Real value was destroyed. And those who lost their jobs are exactly those who are likely to be in lower socioeconomic classes and thus are much less equipped to weather events like this.

(Sorry, the above was pretty rambly, so I hope there's still some value you can get out of it :P)

<comment><USER14> Do you have a specific policy you're trying to advocate for?

You want to release lockdowns at the very moment where we are _at peak_ outbreak size? How is that not the worst possible time to do it? The very definition of "releasing lockdown" is that the rate of spread will increase. Since the exponent now seems to be very close to zero, that means it will rapidly become higher than zero, and we will be growing exponentially again.

And we will start not from a dozen cases, but from hundreds of thousands. How does the math work on that?

Also, to pick on some of your postulates:

> (3) The vast majority of the globe will be exposed to this. Avoiding that is > not possible, so it's just a matter of when

The fact that we're peaking now, way under universal infection, proves this wrong. We've beaten it, the war just isn't over. We didn't all get Ebola or HIV, which were similarly novel. The world never acquired universal herd immunity to polio either.

Some pandemics, like the 2009 H1N1 ("swine flu") outbreak, do work like that and spread effectively uncontained. And it's bad when they do. Swine flu killed a quarter million people, and COVID-19 is about an order of magnitude more dangerous. So it maybe made sense to let one spread where we want to contain the other.

Details matter, basically.

<comment><USER17> > The fact that we're peaking now, way under universal infection, proves this > wrong.

Please define "peaking". Really what you mean is that the curve of new infections is starting to flatten, but by definition, we are going to hit a new, higher peak if we lift the lockdown, because we haven't exposed enough of our population yet.

It is very important that we either agree on the 3 postulates I provided, or can convincingly explain to each other why we disagree on point (3). The vast majority of the globe will be exposed to this.

> We didn't all get Ebola or HIV, which were similarly novel. The world never > acquired universal herd immunity to polio either.

Hmm. This is just incredibly wrong. It's not the "novelness" that determines whether the majority of the globe will be exposed. You have to look at _how the disease is spread_ and _how fast /easily it spreads_. HIV is _not_ a respiratory infection. So it's a total red herring. Same thing with polio. It should be really obvious that a disease where you need to be exposed to semen/blood/other fluids of someone infected (HIV), or exposed to fecal matter entering your mouth (polio), is going to behave differently than a disease that spreads via respiratory droplets (covid).

Look, the entire world agrees we cannot eradicate influenza, and we also agree that the majority of the world has some level of immunity to these diseases. Whereas with a completely novel virus, we do not have widespread immunity.

Any infection that spreads easily enough (which tends to exclusively be respiratory infections since they spread the most) is impossible to eradicate, doubly so if there are natural animal reservoirs as their are with H1N1 and sars-cov-2.

> So it maybe made sense to let one spread where we want to contain the other.

We cannot contain either of these diseases. It is infeasible. This is another point we really need to agree on to be able to have a productive discussion. Tell me, is there any respected health organization that is advocating a policy of _containment_ towards covid? I am asserting that there is not.

Containment has virtually nothing to do with lethality of the disease, except insofar as a disease with a 50% mortality rate will tend to burn itself out. It's all about the transmission rate.

I agree that details matter. Which is why I think when the facts of how this virus operates are examined, it is extremely clear that we will neither contain nor eradicate the disease.

The approach you are advocating for will lead to the so-called "second wave" that will crush us, and we'll have to close our economy down again to avoid widespread infection, except (a) we won't be able to because we already damaged it too much to have that headroom, and (b) as I believe this "first wave" will show us, economic shutdown is just a bad policy across the board except in areas where we are near peak hospital capacity.

Not sure if you're interested, but my thoughts on a "second wave" are that it's an indication that a society totally mishandled the initial outbreak. We need to try to maintain a steady rate of new infections, such that we are near our capacity but not exceeding it. Now, due to how exponents work, it is really easy to mess up that balance. But we have to work towards herd immunity. (BTW, it's not something that you have to "work" towards, it's really a natural process that we can only interfere with by trying to foolishly contain rather than practicing targeted mitigation.

\--

> Do you have a specific policy you're trying to advocate for?

Yeah, I'll give you one to chew on. All at-risk individuals are encouraged to voluntarily self isolate, and hunker down until we have a possible vaccine. Those who are not at risk live life as normal, minus some large gatherings. While those at-risk quarantine, everyone else is developing herd immunity. BTW, it saddens me that "herd immunity" has been turned into a dirty word. It is a natural consequence of the way immunity works in a population, and so the idea that building herd immunity is "callous" or ineffective is just a total disregard of reality.

 _We need to build immunity in as much of the population as possible_. That's the _only_ way, and it's what we've done for every Influenza outbreak, because herd immunity isn't even something you can avoid developing without containment. But what we can do via misguided lockdowns is needlessly delay the formation of herd immunity while also destroying our economy (I am using strong language but if you look at the jobless claims, medical workers being furloughed, etc, you realize we are truly _destroying_ tremendous sources of value).

This is sort of the pareto principle. We get 80% of the benefits of a mass lockdown, with only a small increase in costs. In fact, I would go one further and say that any policies that prevent the development of herd immunity are actively causing harm since we're postponing the reconciliation into the future while damaging our economy in the present

Oh, and just to be clear, I advocate total lockdown in any areas that are nearing medical capacity. New York is the quintessential example here.

BTW, New York will be a great example of herd immunity. Their death toll is staggering right now, because massive quantities of people have been exposed. It's hard to know how many, particularly given that the death figures are a little untrustworthy, but I would assume that every death has something like 200 corresponding infections (somewhere around a .5% IFR). Give it another month, and we will see a dramatic dropoff in infection, even if we lift the lockdown, because there won't be many vectors left for covid to spread through.

Last thing I'll say is, it's very telling that you have not made any references to the economic impacts of lockdown. A rational decision requires comparing the benefits of lockdown with the costs to our economy, and by not even mentioning the latter, it seems to imply that you're not performing a rational cost/benefit analysis here, but rather are relying on very dubious reasoning.

<comment><USER11> The current daily case rate in South Korea has the whole population getting it after about 100 years (the post I saw said 141, I'm rounding).

We should probably look for mitigations that are not economically harmful and keep them in place. Mask wearing seems to be one of them. Then we can use the time that gives us to look for treatments and maybe even a vaccine.

I wonder if you are giving any consideration of the economic consequences of the virus? Those are going to happen regardless of imposed lockdowns. There's a tweet about reservations at restaurants in Seattle declining 60% prior to the lockdown. That's plenty.

BTW, New York is nowhere near herd immunity. If you assume 1000 cases per death, they would have ~1 million people that have been infected. For a virus this contagious, you want 50-60% for herd immunity, not ~12%.

<comment><USER15> The only measures that will prevent a large lockdown again in October are plentiful masks and plentiful hand sanitizer. So far I have seen neither. My estimate is that we have until August to get both is such high supply that people can buy them again and stock up, so that everyone wears them all the time and everyone can sanitize their hands at will. I think that may help in keeping the infection rates lower.

Also we need real-time mass testing capabilities.

Without all of these I can pretty much guarantee that the only weapon we have is lockdowns and there will be another one come flu season, possibly through Christmas until February/March. This is mainly because we won't be able to tell the difference between the flu and Covid-19 fast enough.

</comment></comment></comment></comment></comment></comment></comment></comment></comment><comment><USER18> Our politicians live for today. They could care less about tomorrow. You can see this in all areas of "preparedness", and it's especially obvious in debt and pensions. No surprise here that our government was auctioning off ventilators and exhausting without replacing PPE gear stockpiles without a care in the world.

<comment><USER19> I think politicians act the way they do because that's the way the populace incentivizes them to act.

If anyone has good ideas for encouraging the types of societal/cultural changes necessary to (eventually) properly incentivize politicians, I'm all ears.

<comment><USER20> > the populace incentivizes them to act

It's not "the populace," it's lobbyists that are funded by massive corporations that are trying to protect their revenue streams. What's the solution? Get the money out of politics. Make it illegal for government officials to take comfy six-figure corporate jobs after they finish their term, overturn Citizens United, put a limit on campaign spending or at least try to level the playing field in some way. That would be a great start.

Regulatory capture means all of this is borderline impossible, though. We live in a world where even 100M people will have a hard time fighting the collective power of billions and billions of dollars. Money makes the world go 'round baby.

<comment><USER17> > Get the money out of politics. Make it illegal for government officials to > take comfy six-figure corporate jobs after they finish their term, overturn > Citizens United, put a limit on campaign spending or at least try to level > the playing field in some way.

How do you feel about the citizens united ruling, which (I am paraphrasing, perhaps poorly) found that by disallowing one to spend money on poltiical speech, that freedom of speech was impacted?

I think it's actually quite a sensible point. Speech costs money. Therefore limits on the money an organization can spend is necessarily a limit on speech.

("Overturn citizens united" is the classic liberal/democrat view, but I really question how many have thought deeply about the implications of what they are proposing).

\--

BTW, as you probably know, regulations quickly get co-opted by corporations/lobbyists for their own ends. So, if there is a true desire to funnel money to politicians, they will find a way. Now, that does not mean that we shouldn't try to make that harder, if that's what we think is the right move (I think Citizens United was a great ruling. I assume you disagree based off of the above)

</comment></comment></comment></comment><comment><USER15> Trump has fucked this entire response up and hopefully this is what leads to his loss in election. But to be fair, doing a test in August and October and then expecting anything significant to have been accomplished by any government by February is ridiculous.

Even those that took it seriously would not have any sense of urgency to get things ready right away. You need to budget for it, etc and that takes months/years.

To draw a similar point, all of the N95 masks in stockpile were used up in 2009 and never replenished by Obama. No one in 11 years and 2 presidencies took it seriously since then, so I would assume the same with this simulation as well.

</comment><comment><USER21> Not much of a simulation [1] anymore. Lockdowns have to go strict imo, but with this inept administration in place I have little hope. :-(

[1] [https://mobile.twitter.com/marvindanig/status/12520293225898...](https://mobile.twitter.com/marvindanig/status/1252029322589810693)</comment>


Pirate Bay hosting machines on cheap, small drones - <AUTHOR> http://thepiratebay.se/blog/210

<comment><USER3> I'm having a hard time believing this.

Such devices would need to return land on a regular basis even if helped by solar panels. The costs of maintaining a significant number of this nodes floating would be considerable.

Also the delay on the communications would also be significant compared to a normal server. If you take the low computational power of a Raspberry Pi and put it with a 100Mbps radio (effective data rate would be less), the result would be a very slow website.

<comment><USER4> Agreed. I wonder if the low orbit solution could be actually more achievable than a standard drone one. Both because it doesn't have to fight the wind all the time and because it can be powered by sun more easily. You need enough power to maintain ~6mph (depends on the area, but I believe that would be the long term average in many places). Sure, there's lift and everything, but you're going to drift in one direction most of the time.

I'm not sure about their availability claims either. "With modern radio transmitters we can get over 100Mbps per node up to 50km away". With modern radio transmitters, I think you can also quickly localise the earth-bound part of the system and either close it down, or create enough interference to make the transfer almost impossible... I'm not an expert on radio though - <USER2> someone confirm/refute this?

</comment></comment><comment><USER5> This reminds me of their plans to buy Sealand and become a sovereign nation

</comment><comment><USER6> Problems:

\- power needed

\- weather situation can screw things up

\- a node needed on the ground. while servers cant be seized, the ground station and local laws still needed.

</comment><comment><USER7> This is Cloud Computing! :D

</comment><comment><USER8> If they actually do this it could revolutionize the internet. If everyone gets a internet drone we could build internet networks in the harshes place in the world.</comment>


Darkest Dungeon's Affliction System - <AUTHOR> http://gamasutra.com/view/news/244480/Game_Design_Deep_Dive_Darkest_Dungeons_Affliction_System.php/

<comment><USER2> It's a neat mechanic but they might have cranked the lever too hard. I found myself frustrated with the game even though I liked a lot of things about it. It feels like an abusive relationship. I want to like you, game, but you abuse the shit out of me with endless ways to wipe my party on like the second level. Maybe reach for some 'old school' game design and make the game easy at first and then more difficult.

<comment><AUTHOR> How many hours have you put into it? It's a lot easier after figuring out that all low class adventurers are expendable.

</comment></comment><comment><USER3> 'Shamil Basayev, Occultist' ...what? [http://en.wikipedia.org/wiki/Shamil_Basayev](http://en.wikipedia.org/wiki/Shamil_Basayev)

That must be the development version with dummy characters.</comment>


Chemo Truthers Are the New Anti-Vaxxers - <AUTHOR> https://elemental.medium.com/chemotherapy-truthers-are-the-new-anti-vaxxers-24f179f55c50 <comment><USER2> In my view this is a tricky issue. I agree that anti vaxxers are a bad trend. But I think to some degree the medical establishment has brought this onto themselves. I remember when things like yoga and meditation came up a lot of doctors just brushed it off as total nonsense. It took a long time for them to catch up. Same for the microbiome. A lot of traditional medicine for a long time has claimed a connection between gut health and general health which most doctors also rejected. Only recently the idea gets some acceptance.

If I had a serious disease I would probably also look into alternative treatments (In Addition to the usual options) because I think most doctors have a very narrow view on things. What bugs me for example is the focus on fixing things vs preventing. Doctors should put much more effort into to promoting healthy lifestyles than they do now.

In short: I am not surprised that people are skeptical of the usual medical advice. Unfortunately some people take this way too far as the anti vaxxers show.

<comment><USER3> If you had a serious disease that was going to kill you quickly you wouldn't have time to look into alternative treatments. You would take the path of highest success rate, which in case you havent looked at the data, is chemo for many aggressive cancers.

<comment><USER4> Or the path of _any_ success rate. Yoga won't help you one bit if your apendix is about to burst. Acupuncture has never set a broken bone or de-clothed a crainial artery to relieve a stroke. Scientific medicine is a mirical we should all appreciate every day. Without it, half the people reading this probably wouldn't be here.

<comment><USER5> Dude medicine has a failure rate as well, it's nothing that interesting. It's clouded in economics and politics, meaning it will never be truly altruistic. It's not much different from thinking software is a miracle. Human error is a leading cause of death in the West.

<comment><USER6> Neither selfishness nor selflessness need be that pure.

</comment></comment></comment></comment></comment><comment><USER7> > According to Jobs's biographer, Walter Isaacson, "for nine months he refused > to undergo surgery for his pancreatic cancer – a decision he later regretted > as his health declined". "Instead, he tried a vegan diet, acupuncture, > herbal remedies, and other treatments he found online, and even consulted a > psychic. He was also influenced by a doctor who ran a clinic that advised > juice fasts, bowel cleansings and other unproven approaches, before finally > having surgery in July 2004." He eventually underwent a > pancreaticoduodenectomy (or "Whipple procedure") in July 2004, that appeared > to remove the tumor successfully.[175][176]

> Jobs did not receive chemotherapy or radiation therapy.

> Jobs died at his Palo Alto, California, home around 3 p.m. (PDT) on October > 5, 2011, due to complications from a relapse of his previously treated > islet-cell pancreatic neuroendocrine tumor, which resulted in respiratory > arrest.

\- [https://en.wikipedia.org/wiki/Steve_Jobs](https://en.wikipedia.org/wiki/Steve_Jobs)

It isn't stupidity that makes people not believe in medical science. Jobs wasn't stupid. It's some kind of hubris and mistrust. The belief that _I_ know better than an entire community of professionals who have dedicated their lives to knowing these answers. Why, what if _actual_ the answer is the one I want to hear instead of the difficult path?

<comment><USER8> I see examples of this all of the time especially amongst people who are successful or highly advanced in any sort of facet of life. My theory is that becoming advanced involves developing deep analytical skills, which it's then tempting to apply to all sorts of other domains. The trap is that what made you advanced in one specialized area was years of foundational knowledge alongside those analytical skills. I find myself fighting that impulse a lot and have gotten better but I can easily see it going the other direction.

<comment><USER2> People like Jobs are successful because they go against the mainstream and do what they think is right even if everybody else disagrees. And they are very stubborn. It's not surprising that they have the same mindset in other areas of life. This kind of arrogance and stubbornness makes them successful but can also be their downfall.

</comment></comment></comment><comment><USER9> One of the biggest issues right now, is that we have a community (doctors, scientist, researchers) who need to backup their claims with actual proof's or risk loosing their license/reputation vs a community of "gurus"/"self-healers" who don't have to backup any of their claims at all. Thus the "gurus" can make HUGE claims, that to someone sick sound much better than the conservative claims made by doctors.

Give both groups the same voice & reach, and guess who wins.

<comment><USER10> Why isn't anyone suing these gurus when their dangerously bad advice kills a family member?

<comment><USER11> Because these people know how to spin their "treatment". They convince the patient to chose their "treatment" them selves. They rarely give the ridiculous advice directly in front of witnesses. Instead the family will learn about the treatment from some third party, potentially the victim themselves.

<comment><USER12> I'm at a hotel that coincidentally has 500 people from a MLM finale/training for Essential Oils and this is what it's all about. Have the people tell their friends and family that the oils can even cure ebola to get your 4 to become 8, 8 to become 16, etc. My SO the oncologist-in-training is pissed that they can just say whatever and aggressively advertise their wares and she can't even get pens from pharma companies.

</comment></comment></comment></comment><comment><USER13> This is nothing new though; gurus and healers have been saying for decades that there are better cures (after which most people who listened to them died and sometimes they died themselves after taking their own 'cure').

Hell, even here on HN we see people basically claiming that keto + no sugar + fasting will prevent or cure cancer. And this is a community that wants real proof, yet many here seem to believe that and might forgo chemo in the future because of that belief. The thing is; most of these people (as I usually check) seem to be in their 20s. In your 20s you are in fact indestructible in most cases, so thinking that you will survive anything and that doing some fad diet/cure/whatever will help you do that says or means nothing. Fast forward 30-40 years and then let's discuss that again.

Maybe they are right (but right means there is a lot of research and real cases and there are not at the moment), but if not, i'm quite scared about how many people here follow these half baked ideas and then basically play 'health guru' online because they 'feel so good'. Newsflash; you always feel good in your 20s, even if you smoke, eat burgers+pizza and drink every day, you still feel fine because you are young. It is dangerous claiming these things together with half baked scientific theories about cancer cells.

</comment><comment><USER14> This is not new and it predates the internet. My wife's aunt died of breast cancer 30 years ago. She decided to not have chemotherapy and instead opted for self treatment via a vegan diet even though she was relatively young and had a very treatable cancer. It happened before our relationshp but the utter stupidity of that choice is still used as a cautionary tale among her family.

That said, I've seen two family members die from terminal cancer and in both cases, they would have been better served by hospice rather than spending the last year of their life in chemo. I felt like it was a money grab by doctors. Their end of life oncology treatment cost the insurance company a couple hundred thousand dollars each

<comment><USER15> > That said, I've seen two family members die from terminal cancer and in both > cases, they would have been better served by hospice rather than spending > the last year of their life in chemo. I felt like it was a money grab by > doctors. Their end of life oncology treatment cost the insurance company a > couple hundred thousand dollars each

On that subject I _very strongly_ recommend Atul Gawande's "Being Mortal".

> I felt like it was a money grab by doctors.

I don't think that's what it is, and Gawande's book (where he speaks as both a surgeon and having had relatives — including parents — go through this) comforted me in that opinion. Rather:

* doctors generally are not trained in this sort of end-of-life care recommendations

* it's easy for a disconnect and misunderstanding to occur between, or for doctors to present alternatives but fail to notice the patient or family doesn't really understand (especially the implications of the various alternative)

* it is common for families to try for survival at essentially all costs (including intrusive and uncomfortable), and hard for doctors to disagree, sometimes at the result of (2) above but not always

* doctors are human and tend to get blinkered by what they do know, and what they do know is usually treatment

One interesting item (of many, the book is barely 200 pages but full of stuff) is Gawande's mention of Ezekiel J. Emanuel and Linda L. Emanuel's "Four Models of the Physician-Patient Relationship." which basically identifies a range from "paternalistic" (doctor knows best and takes all decisions) to "informative" (where the doctor is provides facts & figures and possibly options but no insight).

<comment><USER16> This might be the best post in this thread. I think you can see a lot of the paternalistic orientation on display even in this thread. I think it's that sort of hubris which causes people to react in the opposite direction and reject the whole thing. So who to blame for me is clear, it's the doctors.

</comment></comment></comment><comment><USER4> Manditory relevant Dr Cox rant: (Scrubs - s07e06)

[https://youtu.be/RK8dMRLVWvg](https://youtu.be/RK8dMRLVWvg)

I'd type the quote, but I'm on a tablet and cannot find anywhere from which to cut and paste it.

</comment><comment><USER3> This is clear cut. If you have, for example,stage 4 non-hodgkin's lymphoma and arent treated very quickly with R-CHOP chemotherapy, you will die very quickly. If you are treated, the cure rate is 90%.

Taking the time to look around, going down to South America to take in the airs, travelling to India to try to yoga it away, you will die. And quickly.

There are certain very aggressive cancers like NHL that are curable with a high success rate today using, in the case of NHL, a combination of chemo and bio agents like Rituximab.

If you aren't immediately treated you will die.

Convincing someone with one of these diseases to avoid "western" medicine because they are lying and seek alternative treatment is essentially participating in assisted suicide.

<comment><USER17> It's interesting - I wonder if the advances in treatment have precipitated this position.

My instinctive attitude/response to cancer is that it's a death sentance, and I guess that makes me, and my generation, an probably a lot of the population suceptable to the grift of these hucksters.

Perhaps the right thing to do is to change the classification of diseases like NHL that can now be treated - perhaps they should just stop being "cancer".

</comment></comment><comment><USER18> I'm skeptical of all of it.

On the one hand, the medical industry is tied so closely to government that they are even granted immunity for FDA approved treatments. A policy which basically assumes nobody makes mistakes.

They have made the requirements to bring a drug to market so onerous that only the very largest companies can afford it.

The regulatory infrastructure is heavily influenced by non-medical industry industries, such as the alcohol industry's non-stop lobbying to make and keep cannabis a schedule 1 drug.

This all stinks so badly my default position is to hardly trust anything coming from the establishment.

Anyone trying to make claims outside of establishment channels is generally a near lone voice that may or may not understand what they are talking about. Gauging their claims becomes very difficult as often it is not even legal for others to test their claims. I would basically have to become an expert, myself, to actually understand either side of a claim.

To make matters worse, everyone in the world is now an independent expert everywhere on everything and they can insert themselves into every conversation. I find most commonly people outside the U.S. commenting on things inside the U.S. while clearly not having one clue about how the government activities make the whole thing look and smell like a waste treatment facility.

Then people come up with the stupid terms, such as "anti-vaxxers". This term is now used against people who simply believe the government has no power force people to receive injections. Government forcing this kind of thing is going to get a bunch of people really screwed up and killed, largely because nobody anywhere in the process is ever close to being individually accountable (e.g., if somehow a court rules in favor of the harmed parties, they just get paid from tax dollars, not corporate profits, corporate assets, individual assets, and certainly no jail time for anyone).

Edit to add:

I remember reading the following quote from a parent who chose chemo for their daughter:

"We basically tortured her for two years and then she died."

It's a very different take, but it's real.

</comment><comment><USER19> A chemo truther here, if you will. AMA about what I understand about chemotherapy. To the best of my knowledge only very few cancers respond well to chemotherapy - they are testicular cancer, Hodgkin lymphoma and ovarian cancer.

If you contradict any of my opinions, before I reply to you I want to know, your personal experience in investigating cancer therapies beyond what your doctor, medical school or news media told you. For example:

\- Have you read at length the articles/books by mainstream train MDs who have a different opinion?

\- have you talked to oncologists with dissenting opinions?

<comment><USER20> I'm glad you mention testicular cancer, which I was diagnosed with in 1982, just as the first extended trials for a chemotherapy were completed ([https://en.wikipedia.org/wiki/Testicular_cancer#Chemotherapy](https://en.wikipedia.org/wiki/Testicular_cancer#Chemotherapy)). My staging surgery found no metastasis, but a year later it was clear it had spread to my lungs. More surgery, plus four grueling rounds of chemotherapy. This spring I will celebrate 36 years without a relapse.

<comment><USER19> Thanks pmcjones,for chiming in. I hope you live a long life.

The general trouble today more than ever is that main stream medicine is exceedingly cartelized, commercialized and profit driven that it is difficult to disentangle the legitimate good therapies from the one that in some cases are downright harmful.

<comment><USER21> I think most people should be able to read a few papers if their life depends on that.

<comment><USER19> lostmsu, IMO that is not a reasonable thing to expect because:

\- Papers are hard to read and understand for even for people in the profession.

\- For a resonantly skilled person outside of the profession (say an engineer or physicist) it might take about 3 days to a week to read and understand a paper fully.

\- A large part of the population - my guess easily over 50% will never be able to read and understand a paper.

\- Papers can be fraudulent, data can be fudged, or entirely made up. The researchers could be biased etc. I'm not saying that every paper out there needs to be ignored, rather that the signal to noise ration is rather small.

\- Controversial findings are often not published.

</comment></comment></comment></comment></comment><comment><USER22> This is the classic argument of quality vs quantity. Chemo will give you more time but severely damages your DNA, organs, etc. potentially affecting quality of life greatly.

<comment><USER15> Chemo truthing is not about QoL though. QoL has very much been a concern and debate of mainstream medical ethics over the last decade or so (at least).

</comment></comment><comment><USER23> Chemo quality of life can be terrible and costs can be insane. Choosing to die is often a reasonable choice to suffering terribly and going bankrupt for a chance of survival

</comment><comment><USER24> We are barely out of the dark-ages of medicine and there are fundamental shifts in perspective every day. (Like the new link between viruses and everything from Alzheimer's to cancer.) Even "folksy"-seeming perspectives like the linking the gut to seemingly unrelated areas like the brain turn out to have been correct. And as for the "anti-vaxers", I had dismissed them out- of-hand until I spend time with several neurologists (both researchers and practitioners) that were staying at my hotel for a conference, and after a few drinks and stealthy nametag removal admitted they are in general not willing to administer most vaccines to themselves or their own children. (I can do into a few more details, but I do _not_ wish to start a anti-vax flamewar...)

</comment><comment><USER25> Well at least it's not contagious so all they'll achieve is win a darwin award

</comment><comment><USER26> So this lovely list of people has a new group: 1) Anti-vaxxers 2) climate change deniers 3) anti-GMO 4) anti-nuclear 5) (new!) chemo truthers

Sadly, a lot of the population are members of at least one group. Would love to know if the membership numbers of are 1-5 going up or down

<comment><USER27> Just an FYI chemo truthers arent that new. They are older than flat earthers which started sprawling fairly recently in the last few years.

Given how expensive chemotherapy is can you blame anyone. Theres also another batch anti corn syrup, anti fluoride toothpaste, anti eating meat, anti self driving cars, anti electronical voting, and so on. The list goes on. And on....

<comment><USER28> > They are older than flat earthers

Umm, no. Flat earthers have been around since long before we've even had chemo or known what cancer is...

<comment><USER27> Well sure, but as prevalent in the media as recently occurring is what I meant.

</comment></comment></comment></comment><comment><USER29> The other I've heard was that lowering cholesterol drugs truthers or something, are also anti-vaxxers :-D. As a libertarian, I think we have rights to choose whatever therapy or preventive treatment as we want.

</comment><comment><USER30> > Still, a group of online cancer truthers have zeroed in on chemotherapy as > the ultimate example of the hubris and greed of Western medicine and Big > Pharma.

Anti-vaxxers and chemotherapy truthers are employ only somewhat more extreme forms of the fallacious mode of reasoning that dominates today's media. Open up pretty much any article about a complex issue, and you'll see the pattern. Relevant facts will be combined with irrelevant ones and set in a narrative arc, a story with clearly identified villains and victims. The reader knows what conclusions she is supposed to draw based on how she feels about the villains and victims, as opposed to objective big picture analysis.

Take a simple example: Trump's recent proposed revisions to NEPA, the federal law that requires government entities to perform environmental review of infrastructure projects: [https://www.nytimes.com/2020/01/09/climate/trump- nepa-enviro...](https://www.nytimes.com/2020/01/09/climate/trump-nepa- environment.html). The whole thing is set within a narrative arc about Trump's deregulatory agenda, with Trump as the villain. Isolated quotes from individuals are provided, making various assertions. Nowhere is there any analysis of objective facts by which someone could evaluate the proposal. For example, there is no mention of the fact that European countries have environmental review rules even more streamlined than what Trump is proposing. There is no mention of the median environmental review period of transit projects under NEPA (6.7 years), studies that have been done estimating the costs of delaying infrastructure projects (trillions), etc. Nothing to permit objective evaluation, just narrative, victims, and the villain. This is how journalists are taught to write and this is how they do write.

Anti-vaxxers and chemo truthers simply engage in a somewhat more extreme version of this reasoning. They likewise ignore the big picture analysis. Chemotherapy, for example, clearly causes harms, but has even greater benefits. There are many studies quantifying those harms relative to the benefits. Instead of looking at that analysis, they elevate the narrative above all else. "Big drug companies," "western medicine," etc., are the villains. The narrative is that those greedy players are suppressing natural remedies out of a desire for profit. Within that narrative, a few anecdotes about people getting better without cancer are all it takes to make the narrative plausible.

If you read Matt Taibbi's work, for example, is he so different? He uses "Wall Street" and "big banks" in the same way as these folks use "western medicine." He constructs a narrative where the entire global banking system, and practices employed by nearly every advanced democracy, are causing harm in the pursuit of profit. The experts are hoodwinking you, but he and a few others have seen through it! Throwing in a few anecdotes of misconduct or bad behavior seals the deal and makes the narrative believable.

</comment><comment><USER31> Is cancer infectious? How is this anywhere near anti-vaxxers? Don't vaccines mainly exist to treat for something dangerous to the whole herd? Only some small part of the herd even gets cancer.. how is this not discrediting vaccines by even just comparing the two?

<comment><USER32> They're rooted in a compound fear and ignorance of modern medicine.

<comment><USER31> That they are but one is nowhere near as dangerous to the herd as the other. I don't see a need to lump these camps together.

<comment><USER33> The infectious ignorance can kill those who get treatable cancer. Watching someone die from cancer hurts those around them, leaving scars.

It's not _that_ different.

<comment><USER31> One is to prevent the whole herd from being infected(eradicated possibly), the other is a sick member to choose their way to treat themselves. Grievance is a part of life, it is sad to see members go, but I can't compare between that and the herd disappearing completely(no one left to grief).

EDIT: also I can't help but feel that this claim puts Chemotherapy on the same level of effectiveness as Vaccines. I think all options should be exhausted before we start claiming chemo to be as miraculous as vaccines are.

</comment></comment></comment></comment></comment><comment><USER34> Why is this on HN?

<comment><USER35> > On-Topic: Anything that good hackers would find interesting. That includes > more than hacking and startups. If you had to reduce it to a sentence, the > answer might be: anything that gratifies one's intellectual curiosity.

Given the amount of discussion in this thread, I dare say it qualifies as interesting to a fair number of people here.</comment></comment>


David Flanagan (JavaScript Definitive Guide author) on piracy - <AUTHOR> http://www.davidflanagan.com/2011/04/javascript-the-1.html

<comment><USER2> What I found in this article: unrealistic suggestion that Google should decide which page on the internet contains or doesn't contain copyrighted material.

What I didn't find:

1\. A single piece of data, even of the anecdotal variety, that piracy is responsible for his declining royalties. By his own admission: he doesn't know and there are other trends that might explain decline in print sales.

2\. A description of how he tried to find new ways of making money in the world of declining dead-trees sales.

I've bought several technical, self-published books as PDFs. I believe some people (e.g. HN regular Amy Hoy) make decent money doing that. Has the author tried that? No.

I bough 30+ books on my kindle. Did the author try to self-publish on kindle in order to get higher royalties (70% vs., say, 15% from print) hence more revenue (even with lower price)? No.

His books would be perfect for such an experiment because he already has an audience thanks to 4 popular books he wrote in the past.

<comment><USER3> Also missing is the fact, pointed out in one of the comments to his post, that Google already filters suggestions:

[http://torrentfreak.com/google-starts-censoring- bittorrent-r...](http://torrentfreak.com/google-starts-censoring-bittorrent- rapidshare-and-more-110126/)

Essentially every page on the internet contains copyrighted material. Which pages contain copyright infringing material is another matter entirely. Because copyright is based on permission, you have to know who has given whom permission to do what, and that data simply isn't available. You can guess, but if third parties became legally liable for being wrong, things would get ugly fast.

For example, just the other day, the book "Basics of Compiler Design" was up on HN. The authors are giving a PDF of it away for personal use and at-cost reprinting. If one naively assumed that everyone giving away PDFs of published books was some sort of evil pirate, they'd have been banned from Google for their generosity.

</comment></comment><comment><USER4> The _joie de vivre_ of Flangan's concise writing is a joy to behold; it's awful to think the modern world can't support that level of craftsmanship.

It may not be piracy, but that the free resources have become good enough, combined with programming becoming easier to lower the bar for support materials like books. i.e. he's been disrupted. For example, Stackoverflow contributes to this.

I think he's right that the size of his markets means dropping the price wouldn't recoup enough via volume. He can easily get work writing tech materials for proprietary languages and systems (in-house and for-sale e.g. at MS or Oracle) - but what a loss for him and us!

uhhhmm... maybe google could "hire" him? Giving him the same freedom as royalties, and just release his work for free (because it grows the web, which helps google) - perhaps in collaboration with O'Reilly, because authors still need great editors. Though Google might want _Android in a Nutshell._ Google might also be able to target his work more precisely, with their data on searches, and whether people seem to be happy with the public resources they find, and what particular aspects. Data-driven writing...

</comment><comment><USER5> I'm totally, 100% with you on piracy. Your work should not be stolen.

However, if your goal is a business as a full-time technical author, piracy is not your major enemy. Can I _strongly_ suggest looking at the self-published ebook versus traditional published book choice as if you were offered it for the first time today? The first gets you on Amazon, puts you in full control of your marketing, let's you experiment with pricing and message, gives you post-launch opportunities for improvement, and bumps your "royalty" to 70 ~ 95%. The second gets wee little advances. If you look at those advances as buying equity in your book, they're the equity equivalent of a personal loan from CapOne.

<comment><USER6> I agree with you on the general point, but the deal with the publisher _can_ get you quite a bit more than "wee little advances." The publisher lends credibility/gravitas to the enterprise (which may or may not be important, depending upon the type of work), and can (if they choose) bring a large marketing budget (and sophisticated marketing apparatus) to bear on your behalf.

I'm not arguing that self-publishing isn't the more lucrative option in many cases; I'm just saying that going with a traditional publisher is not _necessarily_ a sucker bet.

<comment><USER7> Agreed, but you should at least try out the non-traditional route before dismissing it, especially since he's already got a blog and decent search traffic. eg. No, no downloads here - just a 4.95 javascript e-book with a couple chapters for free.

</comment></comment></comment><comment><USER8> _I do not know whether or to what extent piracy is responsible for my declining income. I suspect that the internet and the transition from print books to ebooks has more to do with it than piracy does. But I also suspect that piracy has a non-trivial impact, too._

There's also the recession, other legal free sources online (which he mentions later), and possibly more competition in his publishing field.

I do feel bad for people whose livelihoods get thrown out of whack and are forced into an uncomfortable position, but it is to be expected with technological advances and is actually happening all over the place (tech- related or not). I wouldn't want to be a teacher in the US these days, either. Take nothing for granted. Don't count on anyone looking out for you, no job is a promise. You basically are on your own in our modern economy.

</comment><comment><USER9> Also posted this in the comments on the site, thought I'd join the discussion here.

I appreciate David's perspective on piracy, but I also embrace and understand where Tim O'Reilly is coming from (Far worse to be irrelevant . I think I have the solution. Why not create an entirely new genre of content that offers a greater level of utility than static digital eBooks?

Knowledge is getting created faster than it can be certified, and we need early-adopting gurus like you to light the path forward to new technologies. I'm particularly happy to pay for content on its own, particularly if I perceive that the original content creator is taking a lion's share of the profit.

I know that may not even cross many author's minds, but if there were messages like "95% of the profits from this eBook will be contributed to the author, so that they will continue producing high value content", I believe more people would be inclined to purchase.

Also I won't mention the name of my company here and get flamed for self- promoting, but I will say that I think there's a huge opportunity for publishers, authors, and content creators to disrupt a much larger, adjacent industry, education and its steady "diet" of certifications.

<comment><USER10> > I know that may not even cross many author's minds, but if there were > messages like "95% of the profits from this eBook will be contributed to the > author, so that they will continue producing high value content", I believe > more people would be inclined to purchase.

I doubt it. If they don't have the character to buy the book normally, an appeal to the authors needs won't help. You do know it takes more than an author to make a quality book (editor, typesetting, etc).

<comment><USER11> People aren't that black and white.

Little statements like that definitely make a difference.

A lot of pirates do it to avoid buyer's remorse, and finding a message inside appealing to them to support the author is hardly unnoticed.

<comment><USER10> I find it very interesting that the pirate would care about the author but not care about the other people who put in the effort to get the book in a clean and readable form.

</comment></comment></comment></comment><comment><USER12> For any authors reading - how do royalty rates compare for paper books, international paper editions, ebooks and subscriptions on things like safari? Maybe people are buying books through mediums that make lesser money for the author? Also maybe people are buying more used books ? (I regret to say that I mostly buy used books)

<comment><USER13> I've written about it at <http://beginningruby.org/what-ive-earned-and- learned/> in the past.

But the Cliff Notes version is that with Apress I'm meant to get anywhere between 10% and 20% for paper copies (sliding scale depending on # of copies sold) and _double the print rate_ for e-books (so between 20% and 40%). With Pragmatic Programmers I _believe_ the rate is 50%.

<comment><USER14> Yes. With PragProg it's 50%, but it's 50% profit sharing really. There's no advance up-front, but you split the profits with the publisher. It's pretty awesome because in a way, it's a lot like self-publishing, but you get all the support that comes from a publisher, including copy editors, indexers, and development editors.

So you can win on that deal or lose. If you sell 400 copies, you'd have been better off taking a $10,000 advance. If you sell 4000 copies, you're gonna be much happier with this situation.

</comment></comment></comment><comment><USER15> David Flanagan looking for a salaried job? My first thought is, that's a sad end of an era. My second thought is, I wish I were hiring right now.

<comment><USER12> Its the best of times, its the worst of times!

</comment></comment><comment><USER16> Ok here's my take on your situation. First of all I don't see why getting a salaried job would be so bad for you. You're an MIT Grad, that alone will get you a high paying job anywhere in the field. Second you know your stuff and you seem like a pretty smart guy. Sorry about your royalties being cut short and I really do understand the "I have to provide for my family" situation. But here's where I stand, I'm actually glad people pirate ebooks. Let me tell you why. Consider my situation, I'm a CS Student with a part time job and my source of income sure enough is not even half of what you make in royalties. I simply don't have the money to pay for most of the books that are required for my classes. So anytime I find a pirated book on the internet that otherwise would cost $60/$100 I jump up with joy. After all I'm saving my cash. This last statement sounds a little selfish to most, but I believe is not. You have a degree David (From MIT) I've might add and I don't. If resources are available online, that are going to make me a better programmer and give me a chance to better my future from learning these skills I'm sure as heck going to download the book. Plain and Simple. I believe information should be free for those that are striving to achieve something. Lastly If anything that I said offends or ticks you off, I would simply advise you to look at things like this. Maybe your royalties are decreasing but your book is helping this individual secure a better a life for himself. So I would like to Thank you none the less for a wonderfully written book.

</comment><comment><USER17> He makes a good point. Since Google recently went after the content farms that hurt their search results, it would be nice if they extended that to authors and legitimate content producers.

<comment><USER12> The content farm issue has different incentives from the authors and content produces. In the content farm the user is usually landing onto substandard content and the click is basically a user search that has "failed" because it has not produced a high quality response. For the ebooks its likely that the user is looking for precisely the book, and not providing the book would in fact be the "failed" search.

</comment></comment><comment><USER18> When I find a technical book that I want to buy, the first thing I do is search to see if it's available as a download. I'm happy to pay - I just don't see any need to own a physical book that consists primarily of extremely tangential technical knowledge. I have tons of outdated technical ballast (e.g. "The SQL 2000 Bible", "The IIS 5.0 Pocket Guide") gathering mold in boxes in my basement already.

<comment><USER19> You've touched on an important issue: some books (or texts, in general) are much related to the current state of art, and won't be very useful in 10 years. Contrast SICP -- pretty much transcendental, every other hacker recognizes those four letters -- with jQuery reference. jQueries of this world come and go.

Now the question is, what is the value added of having a hardcopy of SICP, and what is of having a hardcopy -- or e-copy -- of jQuery?

Another issue is bit rot of e-books. With no common long-lived e-book format (perhaps beyond HTML and PDF), you can't readily expect an e-book to be handy with technology in 10 years. It's a fast changing market, as of now.

So, in the end, what is a realistic price for a short-lived e-book?

</comment></comment><comment><USER20> You need to be really careful how you "motivate" people in these kinds of situations if you want to have a positive effect. A study was done at Petrified Forest National Park comparing the rates at which petrified wood was stolen depending on whether signage said people had stolen petrified wood in the past. Turns out 4x more people were willing to steal if they knew other people had done it before them.

Unfortunately, I think the method used in the post falls into the "4x more" category. David may have unwittingly increased piracy rather than reducing it.

[1] <http://www.psychologicalscience.org/pdf/cialdini.pdf> (see the section on Environmental Theft).

</comment><comment><USER21> Just for independent verification purposes, I tried to find a free copy of this book using his search terms, and didn't come up with anything in a few minutes of clicking after results.

It appears that there is a 5th edition of his Javascript book and a 6th edition of another author's HTML book easily reachable from those terms, but no free electronic copy of a 6th edition Javascript book.

Google will remove links to pirated copies of books, one needs only submit a DMCA request. I doubt that DMCA requests will drive publicity for your book launch like an entitled blog post, though.

<comment><USER22> Not just that, but there seems to be no sixth edition available from anywhere at all, with the possible exception of a torrent that I didn't bother to look closer at.

Why are we talking about this issue at all?

</comment></comment><comment><USER23> I wish people would stop calling this sort of thing "piracy". Proper piracy -robbery, abduction and so forth on the high seas - is a continuing problem. This is hardly in the same league. May I suggest using "theft" instead, which at least is more or less accurate.

<comment><USER24> general definition of theft (not legal): the dishonest taking of property belonging to another person with the intention of depriving the owner permanently of its possession.

When I go to Youtube and listen to an extremely good song by Twilightning or Edguy, what am I taking from the band? Due to a few different reasons (money, I don't have to) I have never run across anything I will pay money to listen to or watch, books being a small exception since I like well made hardcovers a la Practical Common Lisp. I _will_ , however, refer others to the good movies or music I stumble upon.

Unlike many proponents of torrents, I heavily disagree that all music should be free; that simply is not sustainable in my opinion. Not enough people will then go out of their way to pay for it and I have no idea how well bands do when it comes to concerts/merchandise. I do think that free music benefits bands but that overall benefit increases exponentially with how hard it is to obtain it, because those of us who would never have listened to a band's music before the internet (finding obscure bands via radio is nigh impossible) will often refer them to friends, while the rest who are willing to pay take the _easier route_ \- this is important - and buy music.

Currently, torrents, youtube (amusingly, even the official youtube versions are often worse to listen to due to censorship - VEVO is a good example) and other avenues are the better choice for anyone with loose morals, after taking into account risk and ease of access.

tl;dr those of you who will pay for music should subsidize the rest of us.

</comment></comment><comment><USER25> I almost want to pirate this just to see if his "nagging pirates to buy the book" section has been stripped out.

I always think these things are funny, because the only people who tend to see them are paying customers.</comment>


Emergency phone and Internet data laws to be passed [UK, BBC reporting] - <AUTHOR> http://www.bbc.co.uk/news/uk-politics-28237111

<comment><USER2> Hit all the bingo phrases there Mr Cameron. Peados, Mad Iranians, Syrians, Criminals.

I'm sure Boka Harem and Rolf Harris all use Vodafone.</comment>


When passwords attack: the problem with aggressive password policies - <AUTHOR> http://arstechnica.com/business/news/2011/10/when-passwords-attack-the-problem-with-aggressive-password-policies.ars <comment><USER2> Good article, though the whole premise of people being forced to manage passwords is screwed. We are working hard at Mepin - www.mepin.com - to get rid of passwords one by one. Our premise is that people are much more capable of managing a key - a physical key like a phone or a USB key. Care to agree?

<comment><USER3> I'm obviously biased as I created KEYBOX, an iPhone app for easily managing passwords, amongst a whole host of other secrets.

So take my below answer with a grain of salt...

I'm surprised by all the attempts to replace the password with non-secret keys be they facial recognition (face prints?), fingerprints, or other...

I can login to your facial recognition screen just by holding up your photo. Fingerprints are little more difficult but the technology exists.

But if I am not in possession of your password I'm going to be spending a lifetime cracking it.

Conclusion: Keys are not secrets and can be easily copied. Passwords ARE secrets.

Yes, passwords can be difficult to remember but that's a different problem.

If you want to see secret/password management done right check my website ( <http://www.jayfuerstenberg.com> )

<comment><USER2> Umm ... your conclusion is kind of funny and wrong. You might not be familiar with cryptography, modern smartcard technologies, and how those can actually keep a secret.

I agree with your assessment on facial recognition and fingerprints, though the biggest problems with the fingerprint authentication are the lack of ubiquitous sensors and privacy issues.

But password manager software is better than nothing ;)

<comment><USER3> I'm quite familiar with cryptography and the principles of secret keeping. I am not as knowledgable about smartcards I admit.

Is there something that makes a smartcard based USB key work differently when held by a person other than its rightful owner?

My impression of them, perhaps incorrect, is that they are akin to Hanko ( <http://en.wikipedia.org/wiki/Hanko_(stamp)#Japanese_usage> ). Basically a system of using possession combined with a fairly unique set of data as a means of distinguishing and authenticating its owner. But in practice its far less than perfect.

<comment><USER2> Good smartcard in general cannot be copied and it will not work without the user's pin code. It can also lock itself if the pin code is entered wrong too many times. But most importantly, the keys/certificates inside the smartcard can be revoked remotely if the smartcard is lost. So even if the wrongful holder of the key has somehow got hold of the pin code, he cannot use the key for long.

Nothing is perfect of course. The risk/threat is very similar to someone stealing your phone and has somehow gotten to know your master password to your password management software. However, password management does not really solve neither the usability or the security problems of usernames and passwords ... although a good piece of software can certainly help.

<comment><USER3> Thanks for the thorough reply! It sounds promising.

</comment></comment></comment></comment></comment></comment><comment><USER4> Where I work we have a plethora of username/passwords for everything from benefits to paystub management to expense reporting, not to mention desktop logins. I gave up long ago trying to remember/write down them all, save for my desktop. I just initiate a password reset whenever I use them. Unfortunately, a lot of these services are outsourced so I could see the complication in setting up some kind of single sign in.

</comment><comment><USER5> What are the risks of a password attack?

      * Someone can watch you type in the password
      * Someone can receive/sniff/keylog you typing in the password
      * Someone can find the password database and crack it
      * You might tell the wrong person the password
      * If you wrote the password down, someone might find it
      * More i'm not thinking of (probably)

There is some kind of attack that will work to get your password, I guarantee it. So stop obsessing over it. Just make one difficult password, keep it for a long time (as suggested in the article) and make use of a second authentication factor.

Use a keyfob from PayPal or Verisign combined with OpenID ($5-$40; there are other cheap keyfobs out there too). Soft keyfobs are free and (while not impenetrable) present a new mandatory additional attack vector that increases complexity. It's less secure, but you can also use an SMS-based system for another free and cross-platform alternative.

<comment><USER2> Phishing is the biggest risk/threat. An average user is typing in his username and password if presented with a decently familiar login form no matter what the browser address bar or the rest of the web page says. Unfortunately the PayPal and Verisign keyfob security codes can also be phished.

<comment><USER3> This is regrettably very true.</comment></comment></comment>


Fighting to Replace America's Water Pipes - <AUTHOR> https://www.nytimes.com/2017/11/10/climate/water-pipes-plastic-lead.html? <comment><USER4> More sobering is the fact that there probably will never be enough tax money to pay for new pipes anyway: [https://www.strongtowns.org/the-growth-ponzi- scheme/](https://www.strongtowns.org/the-growth-ponzi-scheme/)

<comment><USER5> I read some of the articles on that site, such as the case study linked below. There are some interesting points and ideas there, but I'm not sure the methodology by which they argue that wealth is being destroyed is sound.

[https://www.strongtowns.org/journal/2009/3/30/the-cost-of- de...](https://www.strongtowns.org/journal/2009/3/30/the-cost-of-development- one-example.html)

In particular, the analysis considers whether the cost of a road along some properties will be repaid by tax on those properties. However, this ignores the 'network effect' present in society, and various other taxes that residents contribute to.

Residences don't provide property tax revenue in isolation - the residents also generate tax revenue in a variety of other ways that depend on transportation. For example, residents commute to work, and work for corporations that pay a high amount of property tax. It's commonly understood that commercial districts contribute far more tax than residential districts do. That's often why cities want to zone for it. But the two zones depend on each other. Neither works without the other.

Residents consume from various other businesses in the area where they live, and those businesses pay tax and have employees, and so on. Residents also generate income and pay income tax and sales tax. Residents who are connected via top-notch infrastructure generate value in inter-state, national, and even internationale commerce through their consumption of mail-ordered goods and use of Internet, phone, and cable TV.

There are certainly some rural areas where infrastructure might be a loss. I'm not saying that's not possible. Just saying this rationale and analysis isn't convincing.

It's also not necessarily a problem if individual small areas run at a loss, as long as larger society is willing to subsidize or pay for them. For example, imagine a small dense city like San Francisco that generates incredible wealth. Some people might commute to that area from nearby cities. Those cities and the transportation in between might not earn enough in tax revenue from local residents to pay for the infrastructure at the local level, but it may be the case that higher-level structures above the city such as counties, states, or the federal government receive enough tax revenue from the region that they're willing to pay for the transit. Those larger political structures can look at the big picture, like how transportation within the region is impacting the regional economy.

For example, the federal government recently gave a multi-hundred-million dollar grant to develop rail infrastructure between Seattle and Portland. Is that worth it? I have no idea. That seems like a high price to me to transfer a few hundred people per train trip. But the point is that the model works as long as society is willing to pay for this infrastructure. The articles haven't made the case that people can't or won't pay for it; just that in some very narrow analysis, properties don't pay for streets along the property. But roads are never useful in isolation - it's the network that matters.

You could argue that infrastructure could be more efficiently designed if people lived closer together, and needed less infrastructure. That's probably true. But that's not saying wealth is being destroyed. It's saying that society is willing to pay the cost necessary for the quality of life people want. (Assuming that we do have the money for it - haven't seen the argument that we don't) You could argue that wealth is being destroyed every time people buy "organic foods" because they're so much more expensive and wasteful, for example. It's the same idea.

The fundamental premise of the articles seems to be that growth of suburbia is unsustainable because suburbia does not generate enough property tax to pay for itself. An accurate analysis needs to consider all of the ways that those residents contribute to the tax base, as employees and customers, and add the sum of the effects up, before argue that it's legitimately wealth-destroying. One needs to consider the effect of infrastructure on tourism and the ability of an area to attract residents and businesses. You can't evaluate the cost/benefit of infrastructure merely by looking at the property tax revenue of properties adjoining it.

<comment><USER6> Given that your counter-argument is a trivially obvious one, a little further thought would have led to the conclusion that the StrongTowns bloggers might have thought of it too.

Since you just read until you thought of an objection to their thesis & then stopped, you failed to find the articles where they do the lifetime cost analysis over a whole town (i.e., both "suburban" and "business" districts) and find that this pattern of development means that the profits from the high tax business districts fail to make up for the costs from exurban / US style suburban development.

Have a trawl through the Best-Of lists. In particular: [https://www.strongtowns.org/journal/2017/12/8/the-real- reaso...](https://www.strongtowns.org/journal/2017/12/8/the-real-reason-your- city-has-no-money) stands out.

</comment></comment></comment><comment><USER7> Of course the NYT would find a way to make a disaster caused by bad public governance all about evil "deep-pocketed" companies. The American Society of Civil Engineers rates our water infrastructure a "D." That's due to chronic underfunding, which in turn is caused by municipal governments setting water and sewer rates far too low to maintain and improve the existing infrastructure. Water infrastructure is a case study in how poor political discipline can result in disastrous utility regulation, with disasterous results.

<comment><USER8> Politicians prefer to cut ribbons than reinvest in existing infrastructure. Ribbon cutting gets face time and worse they prefer the bigger and more glitzy type of projects which in themselves tend to incur even further maintenance debts. So next time your local politicians want new office complexes, heavy rail solutions, or such, push them to reveal how current infrastructure maintenance is being done and what the outstanding costs are.

With regards to water pipes. I don't care how my water is delivered. What I care about is that it is proven safe, durable, and the least expensive solution meeting those requirements is used. There is no reason that the Federal Government or a coalition of states and cities cannot formulate a set or rules governing the use of each type.

While there are concerns about poisons leaking into some types of pipes more attention needs to be focused on getting those poisons out of the ground or routing around them. So perhaps using plastic where its known safe to keep costs down and resorting to more expensive solutions when clean up options fail or are exorbitant in costs

</comment></comment><comment><USER9> While we're at it, can we put some extra fiber optic cables in the ground, and this time let the government own all of it?

<comment><USER10> Because the government should be trusted with that infrastructure/information and they won't become a bloated, red-tape laden mess?

I think the majority of people agrees there needs to be changes in things... but putting "government" in charge of the backbone of the internet? Would definitely not a change for the better.

Personally... I think there should be one of two rules: Companies can't own content AND infrastructure (IE: Comcast)... or a higher cost (taxes? fees?) for companies that do and/or don't have reasonable competition.

<comment><USER11> Why do arguments like this continue to be made, despite many cities already having municipal broadband?

This anti-governmental prejudice is tiring. Governments are made of people - what makes you trust those people less than other people?

<comment><USER10> Because, by and large, I don't trust people?

I love my country and for the most part trust the Government... but on the same token - you'd have to be blind not to see how inefficient they are compared to private organizations (IE: Post Office compared to FedEx. Private Hospitals compared to the VA.)

You'd also have to be blind to not see blatant growth and abuses of privileges. The ACA growing government meddling in healthcare. Snowden - <USER2> similar - releases showing abuses. Daily revelations about different groups abusing their privileges.

"Arguments like this" continue to be made because examples are PLENTIFUL of how inefficient, self serving and abusive large organizations get. The same can be said of Unions - which are great in some aspects... horrible in others.

<comment><USER12> The Post Office will send a letter to the other side of the country for 49 cents. How much would that cost from FedEx? They're pretty competitive for packages too.

</comment></comment></comment></comment></comment><comment><USER13> There are limits to growth. The infrastructure bubble is cracking.

No one was there to think through the long term investment in infrastructure.

The prices have skyrocketed due to regulation and now the government can't pay for all that regulated work.

Similar thing will happen in EU. Pipes are failing all across the western world.

<comment><USER14> Our ability to produce material goods (even in the supposedly hollowed out US manufacturing sector) really is greater than at any time in history. We aren't crashing into any growth limit when it comes to infrastructure.

The problem is that taxes have been cut and costs like pensions have gone up (both in absolute terms from things like favorable contracts and life expectancy and in relative terms because of the tax cuts).

<comment><USER15> Our ability to produce manufactured goods has very little to do with our ability to build infrastructure.

Construction productivity in the U.S. is actually DROPPING:

[https://www.economist.com/blogs/graphicdetail/2017/08/daily-...](https://www.economist.com/blogs/graphicdetail/2017/08/daily- chart-17)

[https://www.mckinsey.com/industries/capital-projects-and- inf...](https://www.mckinsey.com/industries/capital-projects-and- infrastructure/our-insights/the-construction-productivity-imperative)

[http://harvardcgbc.org/wp- content/uploads/2016/11/Wang_2Page...](http://harvardcgbc.org/wp- content/uploads/2016/11/Wang_2Pager_Productivity-US-Construction-Industry.pdf)

<comment><USER14> Right, but per worker productivity in the construction industry isn't a growth limit (the claim I was addressing), it is something else.

</comment></comment></comment></comment><comment><USER16> If a local government wants to do this responsibly this time around, they should require the contractor to put up an escrow to cover any issues for 30 years. These are long term projects, and this will force the cut and run type companies to look elsewhere for work. The contract may then share the risk by requiring the pipe suppliers to also chip in and be on the hook.

</comment><comment><USER17> It's interesting but not surprising that this competition exists. I'm not sure the concern about what leaches from the plastic pipe is legitimate, since it seems like a lot of ductile iron (which replaced cast iron) is also plastic lined though with a different plastic. Iron may have a structural strength advantage, but how important is that most of the time? Finally, plastic pipe may have the advantage in some locations due to the nature of the soil - <USER3> are some places where the soil is more likely to cause corrosion in the iron, and for those it seems reasonable to use plastic rather than simply coating the iron in it.

Overall I think the big advantage is going to come from actually getting the aged pipes replace more than from the choice of which new material to use.

</comment><comment><USER18> The two NSF logos, National Sanitation Foundation ( [https://en.wikipedia.org/wiki/NSF_International](https://en.wikipedia.org/wiki/NSF_International) ) and National Science Foundation, sure look similar.

<comment><USER14> It's just "NSF International", the name is a tip of the hat to the old name rather than an acronym.

</comment></comment><comment><USER19> Many of these stories are ginned up a bit, as they are PR for civil engineer societies.

My wife worked for a water utility in an old city. Outside her bosses office was a lined wooden pipe that had been in place since 1680 or so, and was removed during a construction project.

Unless the pipes are riveted, they have a surprisingly long service life, and techniques exist to spot at risk pipes and even make some repairs without digging.

<comment><USER20> Tell that to the kids in Flint, Michigan who got sick because the city's water pipes were too old (and the city wasn't willing to pay for appropriate water treatment to account for that). Or the ones in NYC who have been drinking from lead-laced school fountains.

And those 500 year old wood pipes may still work, but they probably leak like sieves. NYC, for instance, loses billions of gallons a year to leaks in the pair of hundred year old water tunnels it can't afford to shut down for repair, and more from leaks in iron water mains all over the city.

The US northeast arguably can afford to waste that much water. Many parts of the world can't.

<comment><USER19> Flint had nothing to do with old pipes. It was about bad management and bad engineers whose incompetence resulted in poisoned water.

Those individuals were held criminally responsible. Unfortunately, society and the citizens of Flint bear the cost and consequence of their misbehavior.

<comment><USER20> Actually, the old pipes were a major factor. You see, without the correct chemical treatments, the old pipes were releasing scale that had built up over the years.

You see, old lead pipes are safe once they build up a patina; but untreated, acidic water erodes that patina (and also leaches lead from the pipes more readily) and allows the lead to enter tap water.

Even with proper treatment, when lead pipes are disrupted by construction, the patina/scale can be disturbed and the pipes can become dangerous again.

So yes, the failure to treat the water is the immediate (and I agree, criminally negligent) cause of the crisis. But the root cause is old lead pipes; resuming treatment doesn't fully eliminate the danger (which will continue to be elevated for as long as it takes for the patina to build back up); and one of the solutions under discussion has been replacing them.

[http://m.startribune.com/flint-water-crisis-reveals- vulnerab...](http://m.startribune.com/flint-water-crisis-reveals- vulnerability-of-all-old-water-pipes/366788591/)

<comment><USER19> Of course they are a factor. So is not having billions lying around to rip up every street and building connection to water. Especially in impoverished cities that can barely afford street lighting.

Without the crisis created by criminal negligence, you had a much more sustainable situation that could have been addressed while controlling impact to consumers of water.

Note that I'm not agitating for old pipes. Far from it -- but in a world of limited resources, advocating for magically conjuring up money to do wholesale replacements of water supply (and sewer, as disrupting old pipes will disrupt old sewers) is a fantasy that distracts from solutions to these engineering problems.</comment></comment></comment></comment></comment>