Sunday, October 12, 2014

My fears about ebola in the sub-continent

[Note that this is a first draft of my thoughts on this topic, I will make this more concise and pointed in a couple of days]

So, Here's what we know about Ebola in Western Africa so far (culled from various articles in the popular press I've been reading of late -- I'm not too keen on providing citations right now, might do it a bit later)

* The epidemic appears to have  initiated when an unfortunate 2 year old came in contact with an animal host of ebola (most likely an undercooked fruit bat - the consumption of which is quite common amongst the poor in West Africa)

* This occurred in Guinea - a region which does not have the experience that Congo / Sudan / Uganda / Zaire have in  controlling ebola.

* Because the symptoms of the disease are similar to other big diseases in the area (malaria / cholera / lassa), it slipped below the radar for a lot of time. It took almost 3 months to realize that the disease was actually Ebola. And the most virulent strain (Ebola Zaire).

* Prior ebola epidemics fizzled out quickly because they never found their way into a major metro area. However, this particular epidemic is different as it has entrenched itself in Conakry (Guinea), Freetown (SL) and Monrovia (Liberia) along with more rural areas in said countries.

* What is particularly saddening and alarming about Ebola is that it has no (generally available) cure. While it is quite hard to spread in general, anyone who cares for a patient of ebola is at extremely high risk of catching the disease - unless Hazmat suits are employed. So, doctors and nurses are at high risk; spouses and family are also at very, very high risk. (The human tragedy of wiping out all your near and dear ones is something which is extraordinarily distressing). Doctors are dropping like flies; A sizable number of liberia's 50 doctors have been put out of commission by ebola - some have died, some have fallen sick and are under care - and some just don't have the staff to run a clinic.

* The devastation and desperation in west africa is palpable; international airlines (except a couple) are not flying there due to the fear of spreading the virus. 3000 American troops have made it to Africa -- but they're not medical professionals. Doctors without borders appears to be the primary care provider in the area -- but they're suffering similar staggering losses too. (Though they are doing much better than liberians because they have the resort to western medicine if the contract ebola).

* This particular epidemic has a mortality rate of ~ 70% -- but the statistics are incredibly unreliable. The current number of formally reported cases is ~ 8000, but there is an unofficial expectation from CDC that the actual number is closer to 20,000. This thing has blown out of control.

* The disease has spread outside africa to the west as well (places which have flown health-workers out to be treated, or places which have migrants from west africa, such as dallas). Western doctors have proven fairly incompetent in dealing with aspects of this disease: diagnosing it (Dallas) or enforcing appropriate hazmat procedures (Spain). But what they have done well is treat the patients: Ebola survival rates in the west are way higher in the west. This is due to a combination of much better care - and more importantly, experimental drugs (ZMAPP and the like).

* ZMAPP appears to be a good cure for ebola - it has worked on 18 of 18 primates it was tested on; it has worked on most humans it was used on (though some have still died). The catch, of course, is that ZMAPP is available in severely restricted quantities. Thankfully the gates foundation has become involved in this (among other investors) and it is fairly rational to expect larger doses of ZMAPP in the near future.

* It also appears that a vaccine is in the works  - and might be available by the end of the  year. There appear to be multiple approaches towards the vaccine. At least one should work (we know that Ebola survivors appear resistant to the disease - so this tells us that there might be some cheese down the vaccination path)

* In the meanwhile, Ebola is growing exponentially in Liberia, Sierra Leone and Guinea. Not much has been heard from other nations in the area: Mali and Ivory coast are silent. (The hope is that this silence is genuine - and isn't masking a problem). These exponential growth rates are possibly going to touch 7 digits by January 2015 (per a projection by CDC).

* Ebola had spread to Nigeria for a bit too: but Nigeria appears to have been monitoring this situation very carefully. The virus did burn through a people there -- but it appears that the epidemic is under control in Nigeria. This is probably because the disease did not make it to one of the slums in Lagos (Nigeria's largest city with a Mumbai-esque 17M people).

And the following are my fears for India, informed by the occurring in Africa:

* Per a statement by Harsh Vardhan, India's minister for health, there are 45,000 Indians living in west africa (in the affected area).  Peter Piot (the discoverer of Ebola in 1976) also worries about Ebola in India: he calls it the ultimate nightmare scenario. He frets about asymptomatic carriers (e.g. Thomas Duncan) not being detected by temperature monitoring equipment in airports and making it to meet family - and infecting several people subsequently (after the incubation period for the virus, which can be as long as 3 weeks).

* Ebola in India would be almost as bad as it is in west africa. We have a tradition of family taking care of sick people; we have a tradition of doctors not wearing gloves while examining patients. We are filthy and our cities become unhygienic cesspools in the monsoons. The only thing we have in our favor is preparation and knowledge: but that isn't a given for doctors in smaller towns who might not be aware of the goings on.

* In my opinion, India's primary path against ebola should be a comprehensive flight ban / quarantine program -- don't even let the problem arise in the first place. This might mean short-changing our 45,000 Indians who currently live in west africa - but this is entirely excusable. But assuming that this alone shall suffice is dangerous, especially, when we notice that Africa is essentially exploding with this disease. A spark might fly towards India in a very convoluted route - maybe a liberian who things he/she is safe takes a road trip to Nigeria to fly to Europe and then India?

* India must be prepared to educate its doctors on what they should be looking for regarding Ebola.  They should be taught how to don and doff PPE (The latter is even more important than the former as the sad experience in Spain has shown us).

*India should set up an ebola task force where doctors are trained to handle ebola patients (this can be done by interning with the MSF / West African personnel in the hot zone). These doctors should tend to any cases that might arise in India - not anyone else. These doctors should be immunized as soon as the vaccines come out. This is to make sure that a sick patient does not expose any more than 1 other person to the disease (to make sure that this does not keep spreading).

* India should have military on high alert. Curfews should be enforced to make sure that Ebola stays contained.

* Hazmat gear should be procured for several doctors and nurses. Health workers should also have first dibs on treatment with ZMAPP. Military personnel should be utilized to teach doctors to don and off hazmat gear. Further, a trained military person must be involved in all sessions when doctors / nurses removed their gear.

My two cents: Ebola in India need not be an epic disaster if some precautions are taken. But I am concerned that the current government appears to only be focusing on prevention of the import of the disease to India. This worries me because this either appears to be poor risk management or poor communication on the government's part.

Sunday, September 21, 2014

the video gamification of life

Given the recent launch of fairly compelling "smart" watches and bracelets - and the already existing "fitness bands", it is fairly clear that computing is moving closer to human bodies. Closer than the smart phone that we currently spend the night with.

And not only is it moving closer to human bodies, computing is learning more and more about human lives - our heath and the way we live; when we sleep; how we sleep, what we had for dinner (to a fairly quantitative extent) and what we think about that politician.  Our life is becoming aggressively quantified. Every one of our behavioural aspects has become a data point in someone's chart. This behavioral map is a godsend to marketers, sociologists and anthropologists. Think of all the hitherto unanswered shower thoughts (eg. "I wonder how many people are having the exact same dinner as I am and watching the same movie as I am.") that can be answered by big data. But that isn't the focus of this piece.

What I'm trying to argue here is: wearables will bring about the video-gamification of real life. The above mentioned quantification of life shall make available detailed statistics for every aspect of life - which one can use in competition with other folks online - or one can use to improve one's own routine.

Did I wake up at the same time as yesterday? Did I bathe longer than yesterday? Yesterday's run was only 780 calories - can I, with a little more effort do 800 calories in more or less the same time? Did my high school colleague (who always seems to be better than me at everything) really actually do 900 calories today? Is the kid sleeping alright? Can I plot her body temperature time for the last 16 hours and see if her cold is abating?  How long has that curry been sitting in the microwave? 

And about that game of tennis yesterday -- how many Newtons of force did my racket impart to the ball when I served up that ace? How do I compare with the pros? Should I give up everything and take up pro-sports because I am that good?  Where did I put my keys? What is the best place I should store my keys given the usual manner I move along the house?

I am not sure I am entirely comfortable with this immersive quantification of life. I find the prospect of surrendering my information to entities which will use it to sell things to me a bit icky (though I cannot articulate my exact problem with it - what is the problem with targeted advertising in lieu of  "catch-all" advertising - when the time spent on serving me advertisements is still essentially the same, if not less.). 

One particular issue I'm a bit concerned about is the fact that I'm enabling a filter bubble to form around me. By allowing an algorithm designed by a profit-maximizing corporation to only show me the things that it thinks I have a high likelihood of clicking on, am I not missing out on more obscure experiences on the internet?  Epiphanies usually strike when one least expects them - when a totally unrelated experience triggers a thought process which helps one better comprehend a problem at hand. Some of these thought processes have been triggered by looking at totally unrelated advertisements and articles. I fear such exercises might be much diminished in a perfectly quantified world .

But all said an done, the geek in me is genuinely looking forward to the imminent extreme quantification of life.

Sunday, August 24, 2014

How to decode a 6 month old.

After a month of being the primary caregiver for our little daughter, I believe I have understood all there is to know about infants. So, here I proffer these words of wisdom to all who find themselves in a similar boat as I did a month ago.

Everything you have heard about babies providing hunger and sleepiness cues is bullshit. The single web post I read long ago about understanding a baby's cues for hunger (if she licks her lips, she's hungry) and sleepiness (if she rubs her eyes, she's sleepy) did not know what it was talking about. Babies function in a periodic routine - where everything is repeated every 3 hours during daylight hours. They sleep on the dot. They eat on the dot. They will not tolerate deviations from schedule. Babies lick their lips and rub their eyes all the time.

I tried following cues once. I tried making her sleep when she rubbed her eyes. She refused to sleep. She puked on me. I persisted trying to make her sleep. And after a lot of effort she slept. I looked at the clock. It was exactly 3 hours since she had last slept. Cleaning up the mess, I swore I would never try following cues again.  And for 29 days since then I have been a happy camper.Babies are creatures of schedule. Little else.

Babies will gravitate towards forbidden articles. Without exception. And they will eat the said article when you are not looking.

The daughter has gazilions of toys. Toys that are made specifically for infants. Toys that are meant for the infant to shove into her mouth and maul to infinite glory. Toys that are periodically washed and do not even have a single molecule known to man to cause cancer and other life-threatening diseases.

And we also have television remote controls and a particularly disgusting slinky spring (which exists for some reason that I fail to recall) in the whereabouts of a play area.  Of course, the sanitized toys are abandoned in favor the the filthy options - and active intervention (often followed by shouts of disapproval) is necessary to right this wrong.

Babies are not creatures that respect boundaries either. We try to keep her on a blanket on the carpet in the living room. But she always moves towards the edge of said blanket, with one arm on the (forbidden) carpet all the time.

Diaper changes are planned by babies to occur at the most inconvenient of times. A lot has been written about the cognitive ability of infants at this age: that they do not comprehend the concept of object permanence; that they do not acknowledge themselves as an entity. However, they do possess some rudimentary intelligence - which is almost exclusively dedicated to finding the most inopportune time to require a diaper change.

Fast asleep at midnight after several awakenings to pretend to feed? Yes, I need a diaper change.
Finally starting to drink milk after 20 minutes of staunch refusal? Yes, I need a diaper change.
Installed in a baby high chair with all buckles painstakingly fastened and food heated up, ready to eat? Yes, I need a diaper change.
That awesome piece on science friday about neanderthals has just started? Yes, I need a diaper change. And I need it now.

Baby sleep is quantized. Babies are quantum creatures - not just because there's always uncertainty about what they will do next. But their sleep schedules are surprisingly quantized -- during the day, they sleep in periods which are integer multiples of 35 minutes.

Well, not exactly. The 35 minutes is more of a statistical mean -- there's a distribution around it (though, thankfully with a tight standard deviation). In other words, babies are more complex than quantum mechanics.

Babies don't like to be alone. Often, babies will ignore you when you are trying to play with them. But it is usually a bad idea to try to exploit this situation to pour yourself a (much needed) warm cup of coffee. Because, even though they are focusing intently on munching on that tag on the teddy bear, they are equally closely monitoring you. Once you step out of field of vision, they will invariably cry - and if you don't respond even for a minute, you will most certainly see a tear on their eye. No matter how discreet you are.

They will almost murder you with tears the first time you make them sleep. When you try to make a baby sleep for the first time, they will test you. They way I see it: babies have been conditioned by evolution to not warm up to any one off the street. They need to run a test to see if the person trying to make them sleep is worthy of the privilege. So one must persist making them sleep, inventing maneuvers to comfort them (using the amplitude and spectrogram of the crying sound as closed-loop feedback parameters). This ensures the development of a 'go-to-sleep' routine. Rewards (for developing said routine) can be reaped soon - my record for transforming her from an active state to a sound sleep state is 1 minute.

Grandparents are excepted from these rules.  My little stint with the daughter was bounded by two different (and incredibly capable) grandparents, who did not seem to be subject to the aforementioned constraints.  (you could argue that this proves that my rules are not repeatable - so the above points cannot be actual science, as they seem to fail when the scientific method is applied with care - but I'll ask you to with withhold judgement and take this on faith).

With these little tips, you shall definitely be able to take care of your six month old. Just remember humans are capable of incredible things like climbing  Everest, walking the Sahara barefoot, running marathons and operating windows 8. This should give you some confidence that you will probably be able to care for your little one.

STATUTORY WARNING **** if you were actually planning on taking this advice seriously, please get help. now.****

Sunday, August 10, 2014

A new business model for news?

To the individual who actually consumes the news, the internet is a blessing. It is possible to read news and opinion - immediately after publication -  from any source in the world, and comprehend the entire context of the happening by following a few hyperlinks. And all this is free. For now.

This level of immersion into current affairs (or even historical affairs for that matter)  is unprecedented in human history. To repeat a platitude, we are indeed in the golden age of information.

However, there is a catch. If you are getting something that you used to pay for, for free - then there are concerns about long term sustainability. How is the reporter going to feed his / her family if one portion of his / her revenue stream is dried up?

And sure enough, the contemporary newspaper business is in doldrums - and their way to cope with this issue is a paywall. If you want to read articles on the economist, you have to buy a subscription. The same with the new york times; the same with scientific american; the same with the wall street journal. 

But paywalls are a deeply problematic solution. Firstly, it becomes uneconomical to subscribe to all publications of interest (remember, one of the big plusses of the internet is to provide the ability to consume a variety of news sources). Secondly, the magic of internet lies in the ability to hyperlink from one story to another - and it would be undesirable, in my opinion to break that magic by paywalling.

So, in this context consider the following scenario.

People spend a lot of time consuming "news" through facebook (an a few lost souls do it through google plus). It's a fair bet to say that most internet users have a social media account of some sort. Currently news on social media is either sensationalized clickbait or in-depth (paywalled) analysis by repulable sources such as the economist and the new york times. And almost all non-paywalled news sites are difficult to consume due to a significant amount of real-estate being dedicated to irritating animated and noisy advertisements.

I believe there is an opportunity for these social media sites to offer a consolidated paywall for news, wherein avid news junkies (like yours truly) pay around $10-$30 a month for an all-you-can-eat buffet of articles from new scientist, scientific american, new york times, the economist, the BBC, times of India, the Hindu. (and so on). Since people know exactly where the clicks and "time-spent reading" are going, it would be a fairly trivial matter to divvy up the thus generated pot among the deserving news-sites.  This would be a spotify for the print media and would make the news media economically competitive again, while generating a robust revenue stream for the service providers (google, facebook and twitter being the current defaults), though this could easily happen through a third party app on either (or all) platforms.

Since we are considering an "all-you-can-eat" buffet of separate news sources aligned only by a sign-in to a third party, the hyperlink-to-paywall problem articulated earlier also has the potential to be solved: if you're signed through facebook (say), you are in the "secure area" inside the paywall - and hyperlinking should work like it did in the good old days (or at least that is the theory).

I could see this extrapolate to (or even include) news served up in video format - and something like this would be key in making finding information on the internet a less frustrating affair.

Saturday, March 22, 2014

Meeting a Hindu Priest

So, the daughter had her traditional naming ceremony today, in accordance with specifications laid down by her grandparents. One of the requirements in a successful "naming" is a priest - and one such was imported from a local temple to oversee the ceremony.

The aforementioned importation was performed in a vehicle driven by yours truly, and this essentially implied that I got to spend 1 hour with a person I have absolutely nothing in common with. I won't lie - I was a bit nervous at this prospect, as I do come off as abrasive occasionally. I wanted to be on my best behavior to make sure this gentleman felt comfortable in my company. And  I think I managed to pull it off.

Of course, out of respect for his privacy, I won't be naming him or his temple. I will however minute out my chat with him, as I believe this chauferring business today was a field trip in anthropology.

The first thing that struck me about this gentleman is that he was very polite and sweet.

He hails from a fairly large metropolis in south India - and has performed 5 years of higher education in vedic scriptures. He has a rural background - his family earns farms near said metro.

He has spent a few years in the US, most of them in the valley of the sun. He currently lives in the temple campus in Arizona. He hasn't assimilated much at all - he depends on volunteers to take him around town. This presumably includes trips to walmart for groceries and keepsakes (read: chocolates). He does not have a driver's license - he has not even tried to get one as  his boss has forbidden him from driving. His only interaction with non-indian americans for any meaningful discussion duration has been with a bunch of local students who dropped by to understand how south indians perform rituals.

He works a lot every week - gets about a day off. However, he clearly enjoys what he does, so he appears to be in good humor. However, he is trying to get married - but he complains that "girls only want software engineers as husbands".

He will be in India next month - right in time for the generals. He backs the BJP  - primarily because the BJP has taken a strong stand against cow slaughter in India. He is optimistic that Modi will be the new prime minister. He was particularly appalled when I informed him that India was the world's largest exporter of beef. He is a die-hard vegetarian and mentioned that Humans don't need to eat meat - unlike a lion, needs to eat the deer by natures' decree.

His views on other religions seem to be uninformed and even naive. When I asked him if he ever entered a church in the US - possibly as an exercise of intellectual curiosity, he said he absolutely did not. His views on islam were particularly naive in my opinion - he felt that almost all violence in the world seemed to have an islamic origin (apparently MH370 had a muslim pilot and the boston marathon bombers were muslims). I did point out that his views were not empirically valid - and told him that some of my best friends are Muslims.

All said and done it was an interesting experience to chat with this gentleman.  One particularly sobering realization based on this discussion was regarding how easy it is to misinform people and whip up a lynch mob (a-la-2002) based on what he feels regarding islam.