Random Analytica

Random thoughts, charts, infographics & analysis. Not in that order

Tag: USA

Random Analytica: Mefloquine – Colonels & Generals

Mefloquine wasn’t just given to Diggers [Australian slang for Other Ranks]. Colonels and Generals got it too. They get sick and they die. They don’t believe the diagnostic overshadowing of PTSD makes any sense either. Some are even voicing their concerns.

Here is a list of Colonels and Generals who either received Mefloquine on Operations OR (more telling) refused to take it. Correct as at 20th October 2019. I’ll update accordingly.

 

Confirmed Mefloquine Exposure and Symptomology

18th October 2019 (Canada): Lieutenant-General Roméo Antonius Dallaire. UNAMIR (Rwanda 1993/94). Via W5. Romeo Dallaire joining lawsuit against government over anti-malaria drug. Excerpt:

In a W5 exclusive, Dallaire announced that he is joining a lawsuit against the Canadian government and Defence Department over an anti-malaria drug that he, and other soldiers , were forced to take on missions to Rwanda, Somalia and Afghanistan.

Dallaire, who led the international peacekeeping mission in Rwanda in 1994, has become the highest ranking soldier to join an unprecedented legal action by veterans over the use of the anti-malaria drug Mefloquine. He joins nearly 900 other veterans who claim the Canadian government and Department of National Defence “willfully ignored and concealed the risks” of the drug, which is marketed under the brand name Lariam.

Dallaire has been hailed a hero, both for his attempts to stop the genocide in Rwanda, but also for his outspoken admission that he struggles with Post-Traumatic Stress Disorder.

30th January 2019: Colonel Timothy Dunn (USA). Deployed (Sep – Dec 2006). Via the Military Times. ‘I plead with you to look at this very closely,’ retiree tells panel studying health effects of anti-malarial drugs. Excerpt:

Timothy Dunn, a retired Marine Corps colonel, was among those who told the committee they’d be willing to provide information.

” I open my self, my heart and soul and medical records to you,” Dunn said. “You have to do something to look at this closely and make a fair and just determination … there are many more than I who have had this problem.”

Dunn said he still suffers from insomnia, anxiety, depression, ringing in the ears, and dizziness.

22nd May 2016 (UK): General David Julian Richards. Operation Pallisar (2000). Via the Independent. British armed forces set to ban most prescriptions of controversial anti-malarial drug Lariam. Excerpt:

Lady Caroline Richards, the General’s wife, had also taken a keen interest in matter for a long time. She added “Wives and partners of people who had been affected by the use of Lariam approached me and described what had happened. There were some terrible, sad stories of trauma, of relationships ending, psychological problems. We heard about other forces which have stopped using Lariam, so this is obviously something which needed looking into.”

23rd November 2015 (UK): Major-General Alistair Duncan. Sierra Leone (1999). Via the Daily Mail. Has this highly decorated hero been driven mentally ill by an anti-malaria drug tourists are still given? Excerpt:

Today, however, he is locked up in a secure psychiatric unit near his home in Somerset. Tragically diminished, he has been incarcerated for ten months. He has lost the capacity to read and write; outbursts of aggression are punctuated by periods of torpor. He can be sweet-tempered and affectionate; remote and belligerent by turns. His wife, and a growing body of expert medical opinion, believe his psychiatric disorder has been caused, in part, by the controversial anti-malarial drug mefloquine, or Lariam, which he was given for six months in 1999 before being deployed to West Africa.

The Abstainers

31st August 2016 (UK): General Francis Richard Dannatt. Refused Mefloquine. Via The Guardian. Ex-army chief apologises to troops over anti-malaria drug. Excerpt:

Lord Dannatt, who was chief of the general staff between 2006 and 2009, told BBC2’s Victoria Derbyshire programme he would not take the drug because of his son’s experience with it.

Dannatt said his son Bertie had suffered mental health problems after taking two doses of Lariam before visiting Africa in the late 1990s. He was not in the armed forces at the time but had been prescribed the drug by his father’s army doctor.

 

If you or someone you know needs help, please phone Lifeline on 131 114, Kids Helpline on 1800 55 1800, Beyond Blue on 1300 224 636 or Open Arms on 1800 011 046.

11. Mefloquine Dispatches: Full Bloom, 2012

This is a weird one, even by my standards.

I have bought a type writer over the weekend. It is a Lemair Deluxe 850TA. It comes with a travel case (so I guess I’m travelling at some stage). It comes with an additional ribbon. It is ancient like me.

I’m going to practice thank-you letters before I start writing my mefloquine memoir. No one will read my memoirs but I don’t care. I write for myself these days.

On my wall sits a photo of a beautiful young actor. Dakota Fanning. I ripped the page out of magazine a day before I get hospitalised in March. It has occupied a place on my memory board for months. I don’t know why I do some things but they all tend to turn out in the end. Vogue Australia has titled this cover ‘Full Bloom’.

IMG_20191014_0001

As I wonder who to thank first I look at my memory board and I am taken back to early the early 2010s and a package I received from Naomi Bloom.

I’m still doing Workforce Planning at this stage but also thinking about exiting. She is a legend in the industry. On the cusp of retiring. Although I have never met her you get a real sense of who she is via her online presence. She is small and smart. Rather than pursue a career in astro-physics in the 1960s she writes one of the first programs for Human Resources. Before that is even a thing. Back then anything to do with technology was for men only. She trail blazes a career in this male dominated hegemony. When she retires in 2016 the internet is full of interest and kudos. She writes still. Her most recent piece is on the importance of memory. How they sustain you in the tough times. How true!

When I meet her online I am trying to convince my final workforce planning organisation to use its data in a much smarter way. I am trying to embolden them to use Software-as-a-Service (SaaS) rather than their dated technology and processes. I’m not having much success.

I must have lamented to Naomi Bloom at some stage because after that she sends me a copy of her book on the subject which she wrote in the 1980’s/90’s. I go through it with some amazement. It is her Magnus Opus. Her little bit of history. The technology she talks about in her book becomes standard practice across the world of Human Resource Management in the decades that follow. It is an amazing piece of writing which gets lost in the rush of history. She also sent a copy of her book to one of the young up-and-comers in the industry. I’m sure his copy has a proud place on his bookshelf.

Her book and short letter comes as a surprise. They are a tonic. When she mails these books, the world is in a hurry but she has made time to send them all the same.

Those small acts of kindness throughout my struggle have kept me going. Naomi Bloom, you probably don’t even remember sending that book to me but thank-you all the same. Your book is currently in storage but I am looking forward to returning it to a bookshelf soon. It is a part of my history and a good memory.

Good memories sustain you in the tough times.

 

Updates

14th Oct 2019: Naomi kindly commented on Twitter about my post. I had to add the Magnus Opus part. A new memory!

191014_Twitter_NaomiBloom

 

If you or someone you know needs help, please phone Lifeline on 131 114, Kids Helpline on 1800 55 1800, Beyond Blue on 1300 224 636 or Open Arms on 1800 011 046.

Random Analytica: A ‘Soldiers-Five’ [trans. Basic Reading Guide] on Mefloquine

An old ‘soldiers-five’ on Mefloquine. When I first thought I was given Mefloquine I wasn’t sure where to look first. I initially got some good and some bad information. I’m not the tree of knowledge on Mefloquine but here is a suggested reading list and resource guide concerning Mefloquine. I’ve focused on veterans because that is my lived experience. Remember, this is a guide only. Consult your doctor.

Last updated 7th October 2019

World Health Organisation

8th August 1989: World Health Organisation. The original warning from WHO way back in 1989.

Consumer Medicine Information

9th October 2017: The Consumer Medicine Information guide for Lariam (linked here: 171009_ConsumerMedicineInformation_Roche_Lariam). A veteran mate has underlined the important health warnings.

Mefloquine Articles (non-specific)

27th April 1996: New Scientist.  Malaria pill stands accused – Lariam fends off malaria more effectively than any other drug, but growing evidence of disturbing side effects may soon land its manufacturer in court (via 960427_Article_NewScientist_Mefloquine). Thanks to the veteran mate who sent this through. He was given Lariam in 1994 and 1999 without the serious side-effects.

Mefloquine Articles for Veterans

27th January 2003: CBS News. The Dark Side Of Lariam. How Dangerous Is It? One of the first ‘deep-dives’ into mefloquine by a news outlet. Discusses the Fort Bragg suicide cluster where mefloquine was a factor.

19th September 2013: CBS News. Elite Army units to stop taking anti-malarial drug. The US Army’s Special Forces banned from using mefloquine in 2013.

25th September 2013: Huffpost. Mefloquine: The Military’s Suicide Pill. Dr Remington Nevin writes about mefloquine including the 2013 FDA’s ‘black-box’ warning. The world is waking up to the dangers of mefloquine. Dr Nevin is one of the leading experts in the field.

12th October 2014: Army Technology. Mefloquine – the military’s deadly malaria treatment. Dr Remington Nevin discusses the downside to mefloquine including his own personal deployment experience with the drug.

11th August 2016: Military Times. Malaria drug causes brain damage that mimics PTSD: case study. A different take on mefloquine exposure from the USA.

22nd August 2016: Australian Broadcasting Corporation. Defence force admits soldier shouldn’t have been included in East Timor anti-malaria drug trial. One of the first articles I read. Also includes a link to a 2016 7.30 Report about the Australian mefloquine/tafenoquine trials.

30th August 2018: The Irish Times. Vivid nightmares and suicidal thoughts – ex-soldiers blame drug for destroyed lives. An Irish perspective. With a standing Army of approximately 10,000 they have still administered Lariam to approx. 5,500 – 6,000 over the years.

Podcasts

12th June 2019: The Medical Republic. TMR podcast: Can this anti-malarial drug really cause “brain damage”? Thanks to my GP, Dr Mary Lamond for sending this to me. Along with other subjects the podcast covers mefloquine/tafenoquine exposure and its risks in simple language.

Books

23rd January 2014: ‘The Answer to the Riddle Is Me’ by David Stuart MacLean. The Washington Post book review can be found here.

Official Mefloquine Sites (Information & Policy)

Last accessed 7th October 2019: Department of Defence (Australia). Mefloquine. An excellent resource. One of the first sites I visited. Mefloquine Loading Doses are also explained.

Experts

Dr Remington Nevin (USA). Possibly the leading expert in the field of Quinism in 2019 when I suspected my exposure. US Army (Major – Retired). A Vermont-based physician epidemiologist and expert consultant in the adverse effects of antimalarial drugs, particularly mefloquine and tafenoquine.

 

If you or someone you know needs help, please phone Lifeline on 131 114, Kids Helpline on 1800 55 1800, Beyond Blue on 1300 224 636 or Open Arms on 1800 011 046.

8. Mefloquine Dispatches: Dr Pepper 2.2. 2011 & 1992

This mefloquine memory kicked off in 07’. Then again in 11’ and most recently in early October 19’. 

I don’t keep more than a hundred photos or trophies from my decade of soldiering. Especially in the 1990s when photo’s meant going to a Kodak shop and paying for them to be printed up. Photos are expensive. When I deploy with the ODF [Operational Deployment Force] to the USS Tarawa in 1992 I’m glad that they are handing out brochures as we board in Freemantle. I stow it away in my pack somewhere. It survives long enough to be added to my 1992 photos. I look at it every couple of years and some memories come back.

The first real memory hook is actually a book. We have a bookshelf at Mincom for people to add or to take away as they please. The consultants at Mincom travel the world. A lot of them are ex-AJs [Army Jerks]. We are all still readers in 2006. I feel at home at Mincom. I spend almost five years with them.

Although the first book in the series was written in 2004 I happen across World at War 2.1: Weapons of Choice in early November and finish it by the 11th November 2006. I buy the third book outright at an airport somewhere. The series was that good. I finish the third book on the 5th January 2007. I keep notes on each fictional book I read. I count the dead. John Birmingham writes ‘splodey’ books. War. Fast paced. Easy to read on planes.

John Birmingham is talking about Gatling defence systems in the first book. Ceramic bullets. Next generation shit. It reminds me of the Gatling defence system I see on the USS Tarawa. No drones yet. The missile they shoot down is towed behind what looks to be a private jet. It’s impressive. A rip of bullets shreds the missile to pieces in seconds. They fall into the sea. Everyone on the Australian side is impressed. We don’t have that level of protection as yet. I’m hope we do now.

I relate the story to the author in 2011. He talks about the importance of having strong female characters in his speech during his government funded book tour. After dinner, we are both telling our little war stories over a whisky in Canberra in the same pub. He has an ability to both talk and to listen. I’m a total nerd after I get out. I wonder what we talk about in our mild alcoholic daze hours later. Certainly ceramic bullets. I’m fascinated by the new technology that our Army is getting these days. He is fine company.

1111 - John Birmingham (1)

The mefloquine memory I got in early October 19′ was of a different story. I was down the corner store looking for a Pepsi Max. They have moved the store around to limit shoplifting. Where the Pepsi’s once were are now Dr Peppers. I remember my first Dr Pepper. It was in the Recreation Room on the USS Tarawa.

The ship is so big it has its own PX store. We all buy souvenirs. I buy a pair of Oakley’s which I’ll never wear. My best friend and I play the old-school arcade games. The HMAS Tobruk has nothing like this. We watch the US Military news channel in the small cinema. I ask M* would he like a softdrink. I have a pocket full of quarters ready to go. I get him a Mountain Dew. I get myself a Dr Pepper.

As it turns out Dr Pepper is disgusting. Too much corn syrup I think. I prefer the Mountain Dew. M* agrees to swap. The news channel bores us so we go back to the couple of older arcade games the ship has. We chat with the Marines. I always think fondly of Marines after this trip. Marines are awesome. These guys have just recently sailed from Kuwait.

M* and I start chatting with another group of Marines. They are amazed that ‘In Living Color’ is one of our favourite shows. White guys shouldn’t like that sort of humour but we do. Australians are pretty cool too. One of them offers to buy us a round of soft-drinks.

“Don’t make it Dr Pepper mate, that stuff will kill you”, I say.

Everybody laughs. The Yanks love our accent.

ddmm1992_Brochure_USMC_USSTarawa

 

If you or someone you know needs help, please phone Lifeline on 131 114, Kids Helpline on 1800 55 1800, Beyond Blue on 1300 224 636 or Open Arms on 1800 011 046.

Random Analytica: The United States of Violence

Two must read stories this week. CNN have listed the top mass shootings in the US since 1949 and The New York Times put together a thoughtful piece on how the shooters were able to obtain their weapons.

After the Port Arthur massacre in 1996 where 35 were killed by a deranged shooter Australia introduced sweeping gun control laws and removed access to military grade weapons. Since that time we have not had one mass shooting incident yet the United States of America continues to have mass shootings and the body counts are escalating.

It is my very strong view that civilians don’t need military grade weapons, bump stocks and silencers. Full-stop.

For my part I have put together an infographic on the nine worst mass shootings by an individual in the United States since 1949 which now includes the Marjory Stoneman Douglas High School shootings and highlights the array of military grade weapons utilised by the perpetrators.

Each weapon represents those killed.

This is done in solidarity with the kids of Marjory Stoneman Douglas High School who are peacefully protesting against the gun culture in America today. I hope for their sake that they rid American streets of military grade weapons and end the culture mass shootings.

MassShootingsUSA_180214

Random Analytica: Most Cumulative Time In Space

I was in a discussion with the kids over the weekend over who had spent the most time in space. Astronaut Peggy Whitson broke a number of records for Team USA late last year but interestingly the board is stacked with Soviets, then Russians who comprise 90% of the top-10 and 80% of the top-50 given they have operated space stations since 1971 (starting with Salyut-1).

That discussion turned into a quick Top-10 chart.

MostCumulativeTimeInSpace

Note: M1-M6 represents separate mission flight times. The Soviet Union flag has been used for those cosmonauts who were accepted into the space program prior to 1991.

Random Analytica: Dow Jones Industrial Average closes up 567-points (+2.3%)

A lot of talk yesterday about the big losses experienced on Wall Street with the Dow Jones down 1,175-points, the first time that index has declined by more than 1,000-points in a single day.

Crash, tumble and wipe-out were utilised frequently across news channels and social media. The #TrumpSlump hashtag was overutilised by many who really don’t understand markets.

In relative terms yesterday’s Dow Jones numbers were not the worst day of historical trading although they did break the previous point’s loss record. In fact, it didn’t even rate in the top 100 of trading day points losses. My thoughts are here along with a couple of charts.

Today the conversation is all about volatility as the Dow Jones returned almost half of yesterday’s losses.

In fact, the Dow Jones Industrial Average had its 4th best day on record (in terms of points gained). Here is the updated top 20 chart.

180206_DJIA_PointsGained

To get within ‘coo-wee’ of needing to update the Biggest One-Day % Gains chart we would need a +7% increase which would equate to an approximate 1,750-point gain in a single day.

With volatility returning to the markets we might get more updates to this chart in coming weeks.

Random Analytica: Dow Jones Industrial Average closes down 1,175-points (-4.6%)

The Dow Jones Industrial Average closed down 1,175.21 points overnight losing 4.6% of its value in one-day of trading. That is the single worst day in terms of points but is it the worst day ever?

The simple answer is NO. In fact it doesn’t even rate in the top 20!

Here are a couple of charts to prove that point.

180205_DowJonesIndustrialAvg_Points

In terms of points the Dow Jones Industrial Average did have its worst day on record. The previous record was a loss of 777.68 points on the 29th September 2008 at the height of the Global Recession.

Here is a look at the top-20 worst losses as a percentage which is the more accurate reflection of yesterday’s trading day in the United States.

180205_DowJonesIndustrialAvg_Percentage

In terms of percentage the Dow Jones Industrial Average did not have its worst day ever. In fact, yesterday’s trading losses do not even rate in the top 20 worst days on record.

Black Monday was the worst day on record. Here is a reminder of what that headline looks like. Via the Australian Broadcasting Commission. No, this wasn’t the worst day on the Dow Jones — we’ve seen worse. Excerpt:

October 19, 1987

Known as Black Monday in America, this was the day that 22.61 per cent was lost from the Dow Jones. This was followed by Black Tuesday in Australia, when the ASX plunged a massive 25 per cent in response.

871021_SydneyMorningHerald

Photo: Front page of the Sydney Morning Herald, 21st October 1987, the day after the stock market crash via the Australian Broadcasting Commission.

Big technical stock exchange losses make for great headlines. The Dow Jones Industrial Average had a bad day and the Australian Stock Exchange is following that lead in response but it’s not the worst day ever.

Not even close.

Random Analytica: Guantanamo Detainees 2009 – 2018

Ian Bremmer, the President of the Eurasia Group sent out an interesting tweet yesterday which highlighted the amount of detainees held by the US Military at Guantanamo Bay since 2009. Interestingly there were 214 detainees held at the prison in 2009 when then President Obama ordered the facility closed. Today there are still 41 detainees including Hambali who is accused of orchestrating the 2002 Bali Bombings and has still not faced trial.

GuantanamoDetainees2018

The New York Times has an excellent interactive project site with all the details and is well-worth a look. The Guantanamo Docket. Overview:

About the Project

The Guantánamo Docket is an interactive database of documents and analysis from The New York Times about the roughly 780 men who have been detained at Guantánamo as enemy combatants since January 2002.

The Times has reviewed thousands of pages of government documents released in recent years, as well as court records and news media reports from around the world. The Times will update the database with ongoing research.

There are three types of documents in the database:

Combatant Status Review Tribunals

The database includes Pentagon documents related to the Combatant Status Review Tribunals, military hearings created in response to a 2004 decision by the United States Supreme Court to judge whether prisoners at Guantánamo were properly designated as enemy combatants and subject to indefinite detention. The hearings took place from July 2004 to March 2005.

Administrative Review Boards

The database also includes documents from subsequent Administrative Review Boards, panels of military officers conducting annual hearings to determine whether the detainees remain a threat to the United States or its allies.

These documents, along with the documents related to the Combatant Status Review Tribunals, were selected for public disclosure by the U.S. Defense Department in 2006 in response to a lawsuit brought under the Freedom of Information Act by The Associated Press.

Joint Task Force Assessments

The database also includes a selection of classified documents from the Guantánamo Joint Task Force, part of a huge trove of secret documents leaked last year to the anti-secrecy organization WikiLeaks. They were made available to The Times by another source on the condition of anonymity. The files contain the government’s assessment of the dangers the individuals represent. The files are dated from February 2002 to January 2009, and some of the information may have been superseded by later, still undisclosed assessments made during the Obama administration or by more highly classified documents.

The documents contain the Defense Department’s assessments of the detainees, some of which have been challenged in federal court, and in some of the cases lower court judges have ruled against evidence presented by the government. Those cases have been appealed.

In June 2013, the Justice Department released a list showing who of the remaining Guantánamo detainees has been recommended for transfer, prosecution or continued detention without trial. The list, released under the Freedom of Information Act, represents the final recommendations of a task force of national-security agencies President Obama put together in 2009 as part of his unfulfilled pledge to close the prison within a year. The group issued a report in early 2010, but its individual recommendations were not included in that document.

Lastly, a copy of the tweet by Ian Bremmer which kicked off the idea for the infographic.

180201_Tweet_IanBremmer_Guantanamo

UPDATES

13 Feb 2018: Amended first paragraph to include Hambali story.

 

Random Analytics: West African Ebola Outbreak (to 5 Nov 2014)

The World Health Organisation (WHO) has updated it latest advice on the Ebola Outbreak. Ebola Response Roadmap Situation Report 7 November 2014. Summary:

A total of 13 268 confirmed, probable and suspected cases of Ebola virus disease (EVD) have been reported in six currently affected countries (Guinea, Liberia, Mali, Sierra Leone, Spain, the United States of America) and two previously affected countries (Nigeria, Senegal) up to the end of 4 November 2014. There have been 4960 reported deaths.

Following the WHO Ebola Response Roadmap structure, country reports fall into two categories: 1) those with widespread and intense transmission (Guinea, Liberia, and Sierra Leone); and 2) those with or that have had an initial case or cases, or with localized transmission (Mali, Nigeria, Senegal, Spain, and the United States of America).

Here are three charts/infographics of the West African Outbreak with data confirmed by WHO to 5 November 2014.

01 - Ebola_WAfricaOutbreakTableau_141108

The West African Ebola Outbreak (2013-2014) infographic details the cases, fatalities, provisional Case Fatality Rate (CFR) and health spend per capita in 2012 $USD.

The data point of interest for me in the past fortnight has been the revision in numbers that WHO has provided. In the most recent update case numbers in Sierra Leone have been significantly revised down, while in Liberia where cases are on the apparent wane the numbers were revised upwards. Data for Mali has been included in this update.

02 - Ebola_WAfricaOutbreakChart_141108

The West African Ebola Outbreak (by Nation) chart looks at the split between those recovered or still in treatment (highlighted by flag) and those deceased (in red).

A data point of interest here is the case difference between Sierra Leone and Guinea yet a similar amount of deaths. Provisional CFR is Sierra Leone is 23.2% compared to Guinea which is a much higher 59.9%. Surely that can’t be correct?

03 - WestAfrica_Cases~FatalitiesMonth_141108

The West African EVD Outbreak – All Cases/Fatalities by month details the epidemiological curve of the outbreak from March 2014 when the first cases and deaths became apparent. Each column is visualised by the flag of the eight impacted countries. Note: Due to revisions in late October as provided by WHO I have finalised the October numbers as at 2 November.

The data point of interest in the last chart is the epidemic curve differences between cases (still rising) and deaths (decreasing). I would have expected that both should increase or decrease in tandem. I suspect missing data would account for the anomaly.

Summary

I’ll update and post my charts again when the data becomes available for the entirety of November. In the meantime if you want to keep across the West African outbreak detail via some alternate sources then I would recommend Crawford Kilian and for more regular epidemiological posts Maia Majumder, MPH and Ian Mackay, PhD.

 

Data Sources

[1] World Bank. Health expenditure per capita (current US$). Accessed 8 November 2014.
[2] World Health Organisation. WHO: Ebola Response Roadmap Situation Report 7 November 2014. Accessed 8 November 2014.