Al's Morning Meeting

The WHO statement is one of a growing number of reports that say that bodies of people killed by trauma pose no overwhelming health risk unless the dead were infected with disease before they died. Here is a 1999 Slate story on the topic, after a devastating earthquake in Turkey.    

The New York Times' coverage Wednesday included a passage that indicated there should be no rush to bury.

Even as local health officials out in the field were racing to create mass graves or pyres to deal with the rising tide of bodies, saying the bodies posed immediate health risks, officials of the World Health Organization emphasized that the biggest risk of an outbreak was posed by survivors.

The agency's officials said Tuesday that because there was little danger of epidemics from unburied bodies, immediate mass burials and cremations were not necessary. Instead, they said, family members and friends should be given time, where possible, to identify the bodies first.

I have seen similar articles elsewhere. This is from News-Medical.net

"There is no evidence that, following a natural disaster, dead bodies pose a risk of epidemics," says Oliver Morgan, at the London School of Hygiene and Tropical Medicine, who is author of the article and who has worked with the disaster-assistance groups Oxfam and Médecins Sans Frontières (Doctors Without Borders) in Latin America, India, Africa, and the Balkans.

Historically, epidemics resulting in mass casualties have only occurred from a few diseases, including plague, cholera, typhoid, tuberculosis, anthrax, and smallpox. However, such infections are no more likely to be present in disaster victims than in the general population. In addition, while some of these diseases are highly infectious, they are unable to survive for long in the human body after death occurs. It is therefore unlikely that such epidemics will result from contact with a cadaver. Instead, notes the article, "it is far more likely that survivors will be a source of disease outbreaks."

That article said:

While the risks for rescue workers who handle dead bodies are higher than for the survivors of a disaster, they can be limited through a set of simple measures. Appropriate precautions include training military personnel and others who might have to provide assistance after a disaster, vaccinating those persons against hepatitis B and tuberculosis, using body bags and disposable gloves, washing hands after handling cadavers, and disinfecting stretchers and vehicles that have been used to transport bodies.

Wired.com published a story about what American disaster officials learned about body disposal after the September 11, 2001 attacks.

The Real Risks

Make no mistake about it. The health problems in the tsunami areas are overwhelming. Experts are now warning that as many people could die of diseases as from the actual tsunami. The World Health Organization says these are currently the biggest problems:

• South East Asia is endemic for malaria and dengue fever. Flooding and stagnant water create favorable conditions for the mosquito vector. Overcrowding facilitates mosquito bites and therefore transmission ...
• Poor quality and quantity of water and insufficient sanitation, overcrowding, and poor hygiene in temporary camps will bring forward the risk for outbreaks of different diarrheal diseases. Thorough and sustained water purification is an absolute priority ...
• Apart from biological pollution, the possibility that the environment may be polluted by leaks or overflows from flooded chemical factories and warehouses must also be taken into consideration. Water can be contaminated by gasoline and oil leaking from damaged vehicles.

Why not spend some time with doctors and other care providers who work with arthritis sufferers? Get a face on this story so we can see and really understand what is at issue.

The Arthritis Foundation is doing a good job tracking the latest developments and providing resources.

For some people, this is not merely an issue of having some mild pain. Arthritis and joint inflammation are a source of intense pain and can keep the person from being independent. This is a huge issue for them.

WebMD also has a useful collection of recent alerts and reports.

What are doctors telling their patients to do now? I bet patients are ringing doctors' phones off the hook. The message boards are buzzing about all of this.

I wonder if people will turn to alternatives that do not include medication, such as acupuncture, natural foods, and herbal remedies. What about magnets that allegedly give relief?

It is a commonly held belief that some foods are better or worse for arthritis sufferers. You can see conversations about food all over the Web where people with chronic pain gather to talk. Web MD sorted through claims about foods that some claim give pain relief:

• Eliminate nightshades. One of the most common diet claims is that eliminating nightshades, which include potatoes, tomatoes, eggplants, and most peppers, relieves arthritis. This diet probably isn't harmful, but there are no studies to support it.
• Alkaline diet. The alkaline diet presumes both OA and RA are caused by too much acid. Among the foods it excludes are sugar, coffee, red meat, most grains, nuts, and citrus fruits. It's meant to be followed for just one month. It may be that people feel better because they lose weight, reducing stress on joints, which eases pain. This diet eliminates most vitamin C sources. There are no studies to support it.
• Dong diet. This restrictive diet relies heavily on vegetables, except tomatoes, and eliminates many of the same foods as the alkaline diet. There's no evidence it affects arthritis.
• Vegetarian diet. Some people report improvement in symptoms, but evidence is mixed. One small study of people with RA showed improvement in four weeks, and follow-up studies of those who stayed on the diet showed continued improvement after one and two years.
• Switching fats. One of the known correlations between food and arthritis is that omega-6 fatty acids increase inflammation, and omega-3 fatty acids reduce it. Limit intake of meat and poultry, and increase your intake of cold-water fish, such as sardines, mackerel, trout, and salmon. For salad dressings and cooking, substitute olive, canola, and flaxseed oils for corn, safflower, and sunflower oils.
• Gin-soaked raisins. Lots of people claim it works, but experts say there's no evidence. Grapes and raisins do contain anti-inflammatory compounds, but not in amounts that would be therapeutic. The gin might dull pain, but drinking to excess sabotages health benefits of nutrients and vitamins, and introduces a whole new set of problems.
• Green tea. Drinking three to four cups of green tea a day could help people with RA. Studies funded by the Arthritis Foundation showed that giving the polyphenolic compounds in green tea to mice significantly decreased the incidence and severity of RA. Human studies have not yet confirmed the results.

PBS' "Frontline" and The New York Times have produced a remarkable project on the history and inner workings of credit cards. The project examined why there have been so many failed attempts at reform and why South Dakota, of all places, has become a center of the credit card universe.

The program points out that the average American family has eight cards. The cards change interest rates at will and the program includes consumers calling credit card companies "the new loan sharks in America."

What an interesting way to think about the topic of holiday debt and surely one of the most common New Year's resolutions, to lower debt.

The project has some interesting sidenotes. I think this is an example of how multimedia storytelling and "convergence" among print, online, and broadcast really works and improves journalism. You can watch the entire "Frontline" program online. It is absolutely worth your time. The online version of this project has some really nice interactive sections, including an explanation of what is in the "fine print" of the credit card agreement.

Here are some of the things the program uncovered that every consumer should know. Have you, for example, ever heard of the "universal default" clause which allows credit card companies to raise interest rates if you are late on any other payment -- not just to them, but to anybody you owe money?

Even if you make your credit card payments on time, the credit card bank can raise your interest rate automatically if you're late on payments elsewhere -- such as on another credit card or on a phone, car, or house payment -- or simply because the bank feels you have taken on too much debt.

This practice is called the "universal default" clause and increasingly is becoming a standard clause in credit card agreements. According to credit card executives, the logic behind universal default is that the bank is not being unreasonable in raising rates when it has reason to believe that the risk of being repaid by the customer has increased. [Note: Credit card banks can now easily track your everyday financial activities and monitor your credit score -- see below.]

Your credit score -- known as a FICO score -- has become a vital statistic for many Americans and can be widely shared. It is used to determine how much you can borrow, how much you pay for life insurance, if you can rent a home, and, as already noted, it can be a factor in determining the interest rate you pay on a credit card.

Most Americans don't know what their credit score is, nor how it's computed and with whom it's shared. Your credit score is usually determined by five factors, with the most important being the amount you currently owe and your payment history on large debts. (Find out much more about your credit score and how it's tracked, by reading: Credit Scores -- What You Should Know About Your Own.)

There is no limit on the amount a credit card company can charge a cardholder for being even an hour late with a payment.

In 1996, the U.S. Supreme Court in Smiley vs. Citibank lifted the existing restrictions on late penalty fees. Back then, fees ran to $5 or $10, and usually did not exceed $15. After the Court's decision, fees soared, reaching upwards of $30. Since then, the amount of revenue the companies generate from fees (including late charges, over-the-limit fees, and charges for returned checks) has doubled. Duncan MacDonald, one of the lawyers who worked on the Smiley case, predicts penalty fees could rise to $50 in another year.

It's important to read the fine print on your credit card agreement.

Not many people do, however. Even credit card executives and consumer advocates admitted to FRONTLINE that the last time they read their own contracts was years ago and the credit card agreement is difficult to understand. Tucked into the fine print that people so often ignore is a clause that allows the company to change your interest rate (APR) at any time, for any reason, as long as they give you 15 days' notice. (So, Read the Fine Print.)

Many Americans are inattentive about their credit card accounts.

Approximately 35 million Americans pay only the required minimum -- as low as 2 percent -- of their balance each month. Sticking to that rate, it could take years to clear their debt and they'll end up paying far more than the cost of the items or services they bought.

However, many of these 35 million cardholders could pay more than the minimum, and could possibly even pay off in full their balance some months. But they don't -- even though the interest rate they are paying on their credit card balance is considerably higher than what they pay on other things and compared to what they're getting in interest income from their savings account. Is this "financial illiteracy," or just human beings' "irrational behavior?" (Read our report, Credit Cards and Personal Responsibility. Or, try our "Payment Calculator" to see how long it would take you to pay off a balance if you paid just the 2 percent minimum each month.)

There is no federal limit on the interest rate a credit card company can charge.

If you've ever looked at the return address on your statement, you may notice your credit card issuer is located in a state such as South Dakota or Delaware. That's because these are the states that have either weak or no "usury laws" meaning there is no cap on the interest rate that is charged. (View this map that shows the states where the top 10 credit card issuers are located.) The federal government once had national usury laws that set a cap on the amount of interest that could be charged on a loan. But after the Great Depression, it repealed them and some states put no new usury laws in place. That's why Citibank, the issuer of Mastercard, moved to South Dakota, which has no cap on interest rates. (For more on the South Dakota story and how the credit card industry took off in the 1980s, read The Ascendancy of the Credit Card Industry.)

Here is a column I can relate to. It is especially timely this weekend.

We are always looking for your great ideas. Send Al a few sentences and hot links.

Editor's Note: Al's Morning Meeting is a compendium of ideas, edited story excerpts, and other materials from a variety of websites, as well as original concepts and analysis. When the information comes directly from another source, it will be attributed, and a link will be provided, whenever possible.