Dean Baker
TPMCafé, May 28, 2010

When we become seriously ill, we put our lives in the hands of our doctors. We hope that the doctor has the knowledge to diagnose and treat our illness; and if not, will refer us to a specialist who does.But are patients getting the best standard of care, or even decent standard of care? Doctors look to treatment guidelines to guide them when making their decisions. Treatment guidelines are developed by medical associations, and they are thought to be based on the best available science.

The Infectious Diseases Society of America (IDSA) has developed treatment guidelines for a long list of infectious diseases, including Lyme disease. In their treatment guidelines for Lyme disease, the IDSA recommends very restricted treatment of 2 to 4 weeks of antibiotic therapy. Though many patients fail this treatment (treatment failure rates range from 15 to 69% in patients with neurologic Lyme disease), the IDSA recommends against additional treatment in patients who continue to be sick.

For the IDSA to make such a radical recommendation of no additional treatment for patients who fail recommended treatment, one would expect that several large clinical trials have been conducting to support it. But that is not the case. In fact, the recommendation is based on one single study by Klempner et al. (2001) that found no treatment effect in two trials they had conducted on a total of 114 patients. And the study was not even a good one. It suffered from design defects, and the statistical analysis was seriously flawed.

Patients enrolled in the study had been sick for a long time – 4.4 years on average – and had been treated with multiple rounds of antibiotics prior to entering the study. In fact more than 25 percent of the treatment group had already received more than 116 days of antibiotic treatment before the trial, including intravenous antibiotics. So the study was not, as claimed, set up to evaluate the effect of treatment in patients who failed 2-4 weeks of treatment. It is unlikely that 90 days of additional treatment administered to patients in the study would permanently cure patients who were still sick after having received an even longer period of treatment.

Dean Baker
Huffington Post, May 27, 2010

"[O]nly pepper spray and rubber bullets were used to quell an out-of-control protest."

As heavy rains threaten to flood camps, UN troops fired volleys of tear gas at a demonstration that spilled out from a university and into the surrounding makeshift camps. Ansel Herz reports for Inter-Press Service that after UN troops entered the campus, students began to flee to the surrounding camps, where a "barrage of tear gas and rubber bullets" sent "masses of displaced Haitians running out of tent camps into the streets". Herz writes:

AccuWeather.com Senior Meteorologist Alex Sosnowski reported yesterday that severe rains are expected in Haiti this week, with the possibility of flooding and mudslides. Sosnowski writes:

An average of 5 to 10 inches of rain is forecast to fall on the region into the weekend. However, local amounts will be higher in the mountains, where runoff will be excessive.

With well over a million Haitians living in makeshift camps, heavy rains pose an enormous threat. Tents and tarps are often no match for the berating rains. The rains can also overflow latrines, a serious public health concern. On Monday, The Guardian released a video report that captures the scene inside these camps during the rains. One resident says:

I don't have a mother nor a father. I am by myself trying to make ends meet. I used to sleep in a tent on the street and now because of this rain my tent is destroyed. Tonight I will have to stand on my feet because I don't have anything to sleep on.

Mark Weisbrot
The Guardian Unlimited, May 26, 2010