The “Not Ideal” Crew Meets the “That’s Not Good Enough” Brigade

I make no secret of my contempt for the bureaucracy of the FDA and the medical research industry in general--even though I want to be a part of it.  I admit freely that it is a necessary entity.  I know that the system of some countries where not-safe things roam the markets freely is a very bad idea.  And I admit freely that this problem is manifest in the supplements market—a market where purity is not guaranteed and they don’t have to back up any of their claims, or even prove its safety. However, I am concerned about the “Well it’s not ideal…but whatever” attitude of medical treatments.  “Crisis averted” doesn’t mean “problem solved.”

Whenever they say, "It's not ideal,"  I just want to pull out a Will Turner:

Exhibit A “The Mother of All Pandemics”

1918 saw the worst flu epidemic in recorded history.  People that freaked out in 2008/2009 had absolutely no concept of flu epidemic.  We don’t even know how many people died in 1918 from “Spanish Influenza.”  A lot of countries stopped counting and just threw them on the piles. Conservative estimates are 40 million deaths, but some evidence suggests that it was much closer to more than 100 million in reality. It has been ranked as one of the top 5 deadliest natural disasters of all time. We researched it for a bit at the time and it, like all epidemics, went away on its own. And then we kind of said, “Well, shoot, that was bad.  But I guess we lived.”

Fast forward to the 1970s…and H1N1 came back. It was not the same virus and didn’t result in the same deadly cytokine storm and such.  But, for awhile, it looked like it could have been.  The CDC and the FDA ran around like chickens with their heads cut off to try and make an effective vaccine.  And they did, but why didn’t we do that back in the 1940s? I will give them some leeway in the 1920s-1930s, because we couldn’t figure out to make viral vaccines then.  But why did we just say, “I guess we’ll hope that one never comes back.”

Exhibit B “Oh Schnikies…The Blood is All Bad.”

You really don’t think that I wouldn’t bring up hemophilia in a healthcare-related post, did you?  So, in the 1960s, doctors discovered a wonderful thing for hemophiliacs called cryoprecipitate.  When you donate blood, it doesn’t stay blood.  It is spun multiple times to get three partitions:  plasma, platelets and red blood cells.  That way, people can get only the part of blood they need, as well as eliminating the need for perfect type-specificity.  It was learned that hemophiliacs didn’t really need blood, they just needed clotting factors which lives in the plasma portion. So, they just treated hemophilia with a boat-load of transfusion. Then they learned about cryoprecipitate.  If you hard freeze plasma, the good stuff (fibrinogen, Von Willebrand’s factor, Factor VIII, Factor XIII…but not Factor IX unfortunately) all falls to the bottom!  You don’t even need the stuff on top. 

So they went about their days saying, “Well, this isn’t really an ideal treatment, but it works.”  Until the 1980s. Then AIDS came along.  And infected 70-90% of all hemophiliacs.  Now this living by blood transfusion plan didn’t look so good after all.  They kept saying, “We’ll make it safe!”  In 1985, they developed the ability to screen the blood.  “It’s safe they said.”  But it wasn’t.  Not until 1991.  In 1992, the FDA approved the use of artificial, recombinant clotting factor.  After thousands had already died.

Exhibit C “Ebola ain’t new guys”

The first Ebola outbreak was in 1976.  We knew it was freakishly scary.  And not really anything else.  It was just one of those diseases that we relegated to the category of “Let’s hope that one doesn’t come back.”  How silly do we have to be?

Now that we’ve had yet another outbreak, we have started to think, “Maybe we should come up with a better treatment plan that re-hydrating…maybe.” 

Why do we not think ahead in the medical research department?  Why do we not start pushing treatments through the FDA until it’s too late? Just some questions.