What Health Care Workers Must Know About Ebola

Summary: Ebola care requires full-body containment uniforms and full bleach wash-downs; Ebola is the most dangerous disease health care workers in the world are currently treating. Please read this and be prepared.

I have a Liberian brother-in-law and a cousin who is a nurse, so I have been following the Ebola epidemic very closely. And when the Dallas Ebola case was handled so badly, I became much more concerned about America’s preparedness.

My friend Christine Peterson shared a Facebook post by David Rostcheck about proper Ebola treatment practices, with follow-up information from him about Ebola’s lethality for health care workers specifically. I consider this information so critical that I want to maximize its reach, so with David’s permission I am reposting it here.

I have never made this appeal before, but I am making it now: please share this information among your family and friends, especially among anyone you know who is a health care worker. If you are a health care worker, please show this information to your coworkers, to your management, and to your union (if any).

If you have any concerns with the correctness of this information, or links to other useful resources, please share them with me in the comments. I am in touch with David Rostcheck and will work to ensure this information is correct and maximally useful to the heroes of this epidemic: the health care workers who are at greatest risk.

Over to you, Mr. Rostcheck.


Ok. Dear all friends who work in health care: I have important information for you about Ebola that you’re apparently not going to get elsewhere; please read.

Ebola is a level 4 biohazard. This means that to be handled in a laboratory, it must be handled in a dedicated lab with full-isolation suits (which cover 100% of your body and have their own air supply), with the room’s air and water outputs sterilized. The lab must be accessed only through decontamination areas (generally several in a row) where your suit can be decontaminated with bleach, which must sit wet on the suit for 10 minutes, then with UV radiation, and where you can shower immediately after removing the gear. That is the appropriate safety protocol for handling Ebola. The reason for this is that Ebola, unlike the “tame” common hospital infectious agents we have co-evolved with, is a “raw” (newly emerged) virus. It is extremely hazardous and extremely lethal.

I realize, as do you, that the hospital environment is nowhere near biosafety level 4, but I want you to realize how far away it is. A live Ebola patient is an extreme biohazard, even more so than a laboratory sample. Using hospital PPE to protect against Ebola is like wearing a raincoat to protect against automatic weapon fire. Your PPE must cover 100% of your body, it must be washable with bleach, and it must actually be washed with bleach. Paper anything or disposable anything is completely insufficient protection, and if anything has a special order for taking it off, you need different PPE because nothing is safe to take off until 100% of its surface has been washed with bleach and air dried. You’d be much better off with a Tyvex suit and full-face respirator from Home Depot sealed together with duct tape (and it might be a very good time for you to go buy these). You can’t have people moving freely between spaces without decontamination or 70 people caring for one person. You need to treat it as though it will kill you if you mishandle it, period.

Training Ebola care providers.

If you work in health care and you have not previously read The Hot Zone, a non-fiction book about Ebola outbreaks, you need to buy it and read it. Then study the protocols from Doctors Without Borders (MSF). They require things like dedicated decontamination rooms, decontamination teams spraying each others’ suits with bleach, and step-in pans of bleach solution separating rooms. They manage to do this in West Africa so we can manage to do it here. This is what the hazmat teams wear and they’re going to be fine, but you guys need to protect yourselves. You need to know more than your supervising residents or hospital administrators, because the gear and protocols they are espousing is a complete joke. Ebola is a hazardous material and you need to treat it as such to protect yourself.

It’s not 100% fatal, but it seems like hospitals are proving to be far underestimating, rather than overestimating, the hazard and that their protective measures are geared towards much less lethal infectious agents. I understand the desire to combat public panic, but hospitals also seem very unprepared for a seriously dangerous microbe. The way to stop an epidemic is to shut down its lines of transmission and health care workers especially need to have a much more realistic view of Ebola’s transmissibility and lethality. I feel we need to improve the accuracy of the information provided, especially to health care workers.

Good luck.

Here are a few key resources:


[Ed. preface: Some people say that Ebola is not a significant worry in America because you are more likely to be hit by a car, or any of a number of other common expected health risks.]

Well, your co-workers are more likely to be injured or killed in a car accident on the way to work than to get Ebola unless and until they actually have an Ebola case in their hospital, at which point the situation changes dramatically. Statistically, caring for an Ebola patient is currently the most dangerous professional situation one can currently get into, and probably the most dangerous thing a health care professional will do in his or her life. Here’s the math:

Using numbers from an article from September 25, WHO reports 384 infected health care professionals of 5,843 recorded cases (6.6% of Ebola infections were health care workers); they had a 54.2% mortality rate (much lower than the current 71% overall mortality rate). In Dallas, at a first-world medical system, so far we have seen 2 infected nurses out of 70 health care personnel who had contact w/ the index patient, for an infection probability of at least 1/35 (2.85%), and of course that’s from one patient. Assuming the best possible conditions – no more nurses contract Ebola from the index patient and 54.2% vs 71% chance of dying gives us a 2.85% chance of infection with a 52.2% chance of mortality (dependent events, so multiplying) gives a 1.49% chance of dying from one interaction with one patient.

The biggest killer of Americans is heart disease, with a 1/387 chance of dying in one year, or .25%. The deadliest job in the United States is (er, used to be) commercial fisherman, with a .12% chance of death for working a year of commercial fishing. To put that another way, if you treat one Ebola patient, you are at best 12.4 times more likely to die than if you worked commercial fishing (the most dangerous job in the United States) for a full year, or 6 times more likely to die than you are of the disease that kills the most Americans per year.

At the peak of the (most recent until current) Iraq war in 2004, the United States had 114,000 troops deployed and suffered 849 casualties (.74%). You are twice as likely to die of treating one Ebola patient as in fighting one full year in active combat in Iraq at the peak of the war.

I think we should not downplay the risk to health care personnel. Health care workers are true heroes. Treating Ebola is currently about the most hazardous thing a human being can do; it carries a very high risk of death. Health care workers need to be educating themselves and wearing correct hazardous material handling equipment to survive.

Sources:

Loopers On Parade

I had the distinct pleasure this evening of seeing the estimable Mr. Geoffrey Castle in concert.

Talking to him after the show, I suggested he look up a few musicians online, and I realized driving home that blogging the list would be the best way to share it with him and anyone else who enjoys this type of music.  Geoffrey, and anyone else reading this, please enjoy:-)

Warning: some of these videos are for adults only!  (I’ve marked such.)

First, I have to lead off any such list with my main inspiration, Beardyman.  His TED talk:

One of his early videos, notable for mixing (live) audio looping and (post-produced) video looping, very inspirational for my work:

And a whole 80 minute show in Seattle, VERY VERY VERY ADULTS ONLY:

Then there is the inimitable Reggie Watts, another must-see-live performer:

And a longer performance, with more audio nerd detail:

Imogen Heap using her musical data gloves, which you can support via Kickstarter:

And then there are many other well-known loopers in the Loop Scene, if you will, or the Experimental Live Music Sub-Genre.  Here is Dub FX doing an excellent lecture on what he does and how he does it:

And there’s this talented woman, Jeni:

And then Bo Burnham playing with sampling time into neurotic awesomeness, not live but still totally on topic (ADULTS ONLY WARNING YESSIR):

AND THEN there is the Looper’s Delight group on Facebook, chock full of excellent musicianship and time reflection. And the NW Loop Fest coming up this fall. And the Y2K14 Loopfest coming up in California this fall as well.  All those groups and sites have scads of artists worth tracking down.

Geoffrey, if you’re still reading, I hope you enjoyed and I look forward to being in touch soon!  And I also look forward to having some new Holofunk videos up soon :-)  Here’s one from two years ago at Microsoft:

It is much different already so STAY TUNED!

My Most Interesting Facebook Finds From 2013

I find Facebook very valuable as a socially curated news feed of interesting and important topics, and the things I re-share are often some of the most insightful articles I run across anywhere. It occurred to me that going back over 2013 and picking some of the highlights would be time well spent.

So here it is: The Best Of The Web 2013, Via Rob’s Facebook.

I’ve tried to do some rough categorization, but some of these are hard to bucket (economics and politics are almost inseparable, for instance…).

If you appreciate this post, please let me know!

Politics

The major tech companies banded together to demand a stop to government spying on the Internet. Sadly Obama has yet to indicate he supports this at all, but when the technorati start fighting back in earnest, at least the battle for privacy has a chance to be a more even match.

The governmental shutdown this fall? That was the Constitution’s fault. Our executive system of government has some fundamental weaknesses in the face of a polarized electorate, and the prognosis is not great. A powerful president may not be a very good idea at all, and unfortunately there is almost no way to fix this at this point. Workarounds may be the best we can do, and we’d better get busy figuring them out.

Drug addiction is not the problem most Americans think it is. Specifically, it is a health issue, not a criminal issue. What is — or should be — criminal is how drugs have become a hammer used to beat underprivileged communities even further into poverty and social dysfunction.

The capture of American government by the super-rich is one of the biggest threats to our national security. What’s good for the richest is not, at all, what’s good for America — but as long as our goverment is effectively controlled by them, we won’t be able to tell the difference.

Optimistic visions of the future make people seek more change in the present. This is why we need utopian dreams: they motivate positive action here and now.

Is America one nation? No, it’s eleven. There are many ways to categorize Americans politically, but this article is one of the more thought-provoking views I ran across this year. It’s no wonder we are so divided, considering how many places we have come from. Understanding this has helped me put our political crises in perspective, which in turn has helped me be less stressed and more proactive in my political activism.

Economics

The best pope ever? Pope Francis finally started focusing the attention of the Catholic church on the poor, rather than on gays, single moms, and others traditionally ostracized by Catholic doctrine. He has much further to go in fighting the abuse problem, and he has yet to shift the party line on contraception in developing nations, but what he has done so far is a large improvement and I pray (yes, pray) that he goes far further in the decades to come.

David Simon, writer of The Wire, wrote a fantastic article on how capitalism has lost its moral compass. This guy should get together with Pope Francis; they are very much on the same page, and I’m right there with them.

Switzerland proposes to pay all citizens a basic income. It is immensely clear to me that ultimately this — a universal basic income guaranteed to all — is the only way to fairly distribute the immense technological wealth that is increasingly produced by a smaller and smaller proportion of the total population. Kudos to Switzerland for innovation here; I dearly hope they succeed and their experience shapes the rest of the world.

The 1% should pay taxes at 80%. They can, after all, easily afford it; and all evidence shows that beyond a modest level (around $100K of annual family income), more money does not increase personal happiness. Accruing billions of personal dollars can serve no purpose other than greed, and the trickle-down theory has been comprehensively shown to be wrong in all respects, thereby delegitimizing the entire economic plan of the GOP.

Being poor changes your brain and makes it hard to make long-term decisions about anything whatsoever. The pervasive panic that comes from being continually close to homelessness or hunger has serious psychic consequences, that in turn make it even harder to improve your situation. Here again, a basic income would potentially change this fact for millions or billions of people.

Global Health

The Fukushima disaster is not nearly as bad as the panic-blogs of the web would have you believe. Still, it has certainly torpedoed Big Nuclear worldwide; it was already very hard to find funding for large nuke plants, and the particular fear of radiation is going to have a further chilling effect. I hope that more research into smaller, safer, less investment-heavy nuclear plants starts bearing powerful fruit in the next few years; very large nuke plants require such large investment that it creates bureaucratic pressure to minimize risks and dangers, which in turn makes for vulnerable situations like Fukushima.

Pathogens worldwide are becoming more resistant to antibiotics, but nanotechnology offers a new tactic: protect against the toxins produced by the deadly bacteria, rather than the bacteria themselves. An ingenious strategy, and if this really works against antibiotic-resistant staph (aka the “flesh-eating bacterium”), it will open up a new and very hopeful front for human defense.

Technology

Google is buying up robotics companies like mad. They are clearly working on a Next Big Thing which will probably be every bit as significant as their self-driving car research. Unfortunately they’ve shown no sign of wanting to become politically active in ways which would improve the lives of the people who will become unemployed as a result of their creations… technological innovation in the 21st century needs to be tempered with intensive activism to improve the lives of the poor and underemployed, a fact of which the technorati mostly seem dismally unaware.

And while we’re talking about self-driving cars, here’s their biggest potential roadblock: the ‘autopilot problem’ where the vehicle gets into more and more trouble until suddenly it can’t cope, and tries to hand off control to the even more unprepared human driver/pilot. Solving this is going to require making self-driving cars into much more effective communicators, thereby pushing effective artificial intelligence forward even further.

Education

Individualized education? An end to the “herd mentality” which keeps all kids in a class marching forward even as some are left behind? Technology has so much potential to revitalize education, if used in an enlighted way that lets students learn at their own pace, with excellent support from knowledgeable teachers who now support rather than command. This very well-produced article helps point the way forward.

Flipped classrooms, in which students watch lectures at home and do work in supported groups during class time, are increasingly showing their effectiveness. Massive online courses by themselves are dismal failures, unless supported by class time in which students have expert assistance in working on their own projects.

This incredibly inspiring story from Mexico shows what is possible when students become self-directed explorers of learning, rather than passive recipients of education that’s shoveled at them.

Personal Health

A seventy-five year study on male happiness bears fruit. The most important thing in life is love. It’s now a known scientific fact.

Sometimes the best way to be happier is to know what not to do, and then to not do it. This article, about six toxic relationship habits, is a great example.

Is gluten really going to be the doom of us all? I have many friends with gluten sensitivity and have wondered what to think about it all — we are eating more protein and veggies for sure, and it’s doing well by us. But this excellent article puts the whole situation in context. There are few absolutes in medicine, or in diet.

Being too comfortable can make for big problems eventually, and being uncomfortable is the only way to grow. Growth, whether emotional or physical, is not easy. And that’s a good thing! Working hard is the way to change — to change yourself, and eventually, the world.

Fifty Shades of Grey made kinky sex into quite the household topic this year, but a psychological study from the Netherlands shows that kink practitioners are actually more psychologically healthy than most folks. This is because they have greater self-confidence, communication ability, and sexual satisfaction. Who would have thought? I will tactfully not answer that rhetorical question😉

Massachusets comes up with a brilliant way to fight domestic homicide: target the men most likely to kill their partners, and cover them with intensive surveillance. An excellent strategy with proven results. Spread the word.

Long-term relationships often suffer a decline in sexual attraction, especially for women. Is there a pill cure? Fascinating examination of sexual response in women, looking at what we do and don’t know about how it works and what can boost or banish it. Pills are always a problematic answer to any problem, but the research that goes into them is incredibly illuminating in itself.

An open letter to my gun-owning friends

Ever since Newtown I’ve been seriously grappling with how I feel about guns. And strangely, Facebook has brought me more awareness of how many of my friends feel. I’ve had many conversations about it, but all partial and fragmentary. Some friends have taken the time to write thoughtful explanations of why they own guns, and some of those feel strongly that they should be regulated no more than they are now, if not less.

This is my response. I am writing this primarily to express myself, so I admit to some passionate language, at the cost of persuasive power for those strongly opposed. All charts in this essay are clickable, and link to their sources.

In brief, my argument is that guns must be controlled much more strictly, that arguments to the contrary are fallacious, and that large-scale reductions in U.S. firearm ownership are desirable and feasible.

Thank you for reading this.

Contents:

  1. Where I’m Coming From
  2. The Purpose And Hazard Of Guns
  3. Reduced Gun Violence Is Desirable
  4. The Second Amendment Must Be Reinterpreted
  5. Guns Do Not Prevent Tyranny
  6. Gun Self-Defense Is Insignificant Compared To Gun Assault And Intimidation
  7. The Freedom To Not Be Shot Must Trump The Freedom To Shoot
  8. Guns Are Deadlier Than Cars, Bombs, Or Knives, And Gun Control Will Restrict Outlaws Too
  9. Even So, Not All Gun Ownership Is Wrong
  10. Mental Health And Violent Video Games
  11. The Road To A Post-Gun-Culture America


Where I’m Coming From

I have never owned nor fired a gun. But I am a programmer and tech geek, and I have sometimes considered learning to shoot. I actually am still interested in doing so someday, even after Newtown.

I am not a libertarian by any stretch; in some ways I’m more of a socialist (public health care seems outright economical, for instance), and in other ways I’m a social libertarian (I’m in favor of drug legalization). I am a Democrat by today’s party definitions, mainly because of the Republican party’s current attitude towards science and towards women’s rights. I am an advocate for science and for the humane use of technology to improve the human condition.

And I have two children, both in elementary school, within a year of the age of all the Newtown victims.


The Purpose And Hazard Of Guns

A gun makes holes in things. That’s its function. Unfortunately, when you make holes in people they tend to die. Anyone holding a gun is a deadly threat to anyone they can see. That’s a simple fact that all gun safety classes drill into their students.

So having a gun in one’s possession is inherently immensely dangerous. You have to work hard to avoid accidents (just look at all the toddlers killed by getting their hands on their parent’s unsafed gun). The ease of shooting a gun, and the dramatic and instant reaction from pulling the trigger, is both the key appeal (ask any shooter) and the key threat. Studies show that many gun suicides are impulsive acts that might not have happened — or been successful — if a gun weren’t present.

A quote I heard recently that really stuck with me is, “You are different with a gun in your hand; the gun is different with you holding it.” Anyone holding a gun is one finger-press away from being a killer. And for a high-capacity, high-accuracy weapon, this is far more the case.

Guns are simply much more hazardous, both to their owners and to everyone else within range, than any other device short of a bomb. And guns are much, much, much more widely available in America than bombs, as well as far less hazardous to the user.

Therefore guns pose a threefold risk: they may be used unsafely or accidentally; they may be used impulsively; and they may be used maliciously. Having guns in the home, or carried in public, greatly increases all three of these risks.


Reduced Gun Violence Is Desirable

It’s indisputable that there are very many lethal injuries caused by guns in America every year. It’s also indisputable that there are far more such incidents in America than in any other first-world nation.

The question is, what kind of problem is this? Is this a simple inevitability, or is this a serious cultural issue? What, if anything, should be done to reduce the amount of lethal gun violence?

My clear bias is towards reduced violence. I consider it a major public health problem (arguably a mental health problem) that there is so much gun violence in America. After Newtown and all the information that has been shared since, I have a very hard time understanding people who disagree with this.

It is encouraging that violence in the U.S. is dropping overall, but it is still astonishingly higher than in the rest of the world.

It is hard to tell whether gun ownership is dropping or increasing overall. Some trends show it declining nationally overall, but spiking locally after massacres such as Newtown.


It is also certainly the case that the odds of dying in a Newtown-like massacre are much, much less than the odds of dying in a car accident. But there are two counterpoints: one, Newtown-like massacres are sufficiently horrible that they merit disproportionate effort to prevent them; two, non-massacre gun violence is uniquely high in America, and is by far the more significant problem.

Gang violence is responsible for most gun-related homicides. And gun control by itself will not address gang violence. But the most effective strategy I have heard for reducing gang violence involves isolating cliques of violent gun users, closing off their illicit weapon sources, and driving them into a new norm of non-violent conflict resolution. Gun control is not the entire solution, but it is very definitely part of the solution.

One strong argument against the NRA is that it has sought to suppress scientific and public health research into the extent of gun violence in this country. There can be no justification for such anti-scientific action, which obscures and minimizes the extent of the problem.

But still this leaves open whether the laws should be changed (to enforce reduced gun ownership), and/or whether gun ownership should be more stigmatized (to encourage more voluntary reductions in gun ownership). Perhaps tragedies such as Newtown, continued into the future, are the only way to shift the dialogue. But I don’t think we should wait for more massacres.


The Second Amendment Must Be Reinterpreted

Of course, the second amendment to the Constitution is the primary reason guns are such a uniquely toxic issue in this country.

Many of my friends have cited the second amendment as the key reason they feel gun ownership is a civic virtue, not merely a personal choice. This article lays out this position quite forcefully, claiming that the second amendment is a key bulwark against an unfit government. I find this argument seriously broken on multiple fronts.

I don’t believe that any amendment to the constitution is above reinterpretation. Times change, technologies change, cultural realities change. Every amendment to the Constitution must continue to justify itself over time, rather than being treated as sacrosanct purely due to its age. The claim that the second amendment is indisputable simply because it comes second is, to me, just like the claim that evolution is wrong because Genesis comes first in the Bible — it is insufficient justification on its own.

The second amendment is hugely open to questions of scope. What exactly does “a well-armed militia” mean? A militia armed as well as the armed forces themselves? Clearly we have never had this interpretation in this country — it has never been legal for private citizens to own tanks, or fully automatic .50-caliber machine guns, or nuclear weapons. The second amendment does not give license to own any armament in existence. Given this, we must define what armaments are or aren’t permitted.

It’s often claimed by gun advocates that “assault rifles” are a technically meaningless category, since a powerful semiautomatic handgun in the hands of a skilled user can put out about as many rounds. I am disheartened by how many of my friends have made this point. It is obviously untrue, in that if assault rifles really made no difference in lethality, then there would have been no reason to invent them. I can’t give credence to this claim at all; there is clearly a spectrum of lethality, and rifle-like, high-accuracy, high-capacity weapons are clearly more dangerous than handgun-like, lower-accuracy, lower-capacity weapons.

Even today’s semiautomatic handguns are far more reliable, concealable, accurate, and rapid-firing than any firearms available when the second amendment was written. Weapons technology has advanced on all fronts, obviously, but the fact remains that in the founders’ day, it was never imagined that all citizens might have access to weapons that can kill dozens in seconds. Therefore it is debatable whether the founders intended all citizens to have access to such firepower.


Guns Do Not Prevent Tyranny

It was clearly the founders’ intent that the second amendment stand as a defense against tyranny. But does it still serve that purpose effectively today? That is, does private gun ownership really reduce the chance of a dictatorial U.S. government?

I find no reason to believe it. The violent rebellion that created the USA was driven by armaments provided from France, not by guns owned by private US citizens. So even the American revolution did not happen purely by means of citizen-owned guns.

Would private gun ownership be a meaningful defense against a dictatorial government? What exactly is the scenario? I can only imagine a case in which the majority of U.S. citizens find the government to be illegitimate, and use their guns to fight back.

But if the majority finds the government illegitimate, wouldn’t they simply vote the government out? That’s the very essence of democracy, and the very basis of America itself. Guns would make no difference.

If it’s only a minority that finds the government illegitimate, then we would be looking at a violent civil war. And in fact, that is often advocated by very many racist and hyper-right-wing groups in America. Timothy McVeigh was of exactly this belief. This is my biggest concern with the second amendment: it gives Constitutional authority to a viewpoint that says that the government can’t be trusted and that everyone should be free to rebel against the government, violently, by means of their guns. (And, of course, a minority rebellion would be both democratically illegitimate and hugely outgunned by the military itself.)

This leads to laws such as a recent Indiana bill which allows homeowners to shoot at law-enforcement officers that they believe are on their property illegally. Or the hugely controversial and problematic Florida “Stand Your Ground” law which allows someone to shoot first if the shooter believes they are being attacked.

What all of these cases show is that this fundamentalist interpretation of the second amendment leads directly to a vigilante attitude, in which all gun owners are entitled, by the Constitution, to decide for themselves who is and isn’t a threat, and to shoot accordingly. This is not liberty. This is terrorism masquerading as liberty.

The southern U.S. has the highest rates of gun violence in the country, and it’s likely that this is because that’s the only region of the U.S. that has actually tried to secede — in other words, to declare the national government illegitimate, and to act violently against it. That viewpoint lingers both inside and outside the South, and is a toxic mindset that makes gun violence much worse in this country.

We have much evidence from the 20th century that peaceful democratic action is more effective at confronting and overthrowing tyrannical regimes. So there is no real reason to think that guns are essential even if the goal is to overthrow the national government. A unified populace has many other tools at its disposal — widespread civil disobedience can cripple a government even more effectively than a militia shooting war, especially in an age when the rest of the world is watching (not the case in the founders’ era).

Even democratically speaking, a majority of Americans already support a variety of inconsistently implemented gun control policies.

So I consider the second amendment to be a historical artifact; its scope covers far more than the founders dreamed, it fosters anti-democratic vigilante attitudes that lead directly to terrorism, and its ostensible goals are far better reached by other means. Firearm ownership must be an earned privilege, not a universal right.

Therefore I am disheartened further by the uncritical attitudes my friends seem to bring to the second amendment and to its importance in society. In fact, I have come to believe that the second amendment should be repealed, and I intend to work towards this political end. The recent Supreme Court decision that affirms the individual right to bear firearms is a huge setback, but if the goal is popular repeal of the second amendment, that decision will be rendered irrelevant.

None of this is to say that the U.S. government is above reproach. The unconscionable drone bombing campaign in Pakistan, the warrantless wiretapping just renewed by the Senate, the impossibility of Guantanamo inmates challenging the legality of their indefinite imprisonment without trial, the shocking rate of incarceration… all of these are black marks on our American democracy, and the list could go sadly on.

But NONE of these abuses are effectively opposed by increased gun ownership. One can very well believe that, say, the first amendment (a free press) and the fourth amendment (habeas corpus) are critical to our democracy, while also believing that the second amendment has outlived its usefulness and is now poisoning America. Attacking one amendment is not the same as attacking them all.

Those of us who believe in reducing gun violence must, and eventually shall, take back the moral high ground from those who equate gun ownership with patriotism.

(Why, then, did the founders consider the second amendment so critical? I argue that, in a terrible accident of history, the founders did not trust the democracy they were creating. Seeking to defend against its corruption, they instead undermined it. The second amendment is undemocratic, but the founders did not realize this at the time. In short: they were wrong. Though see this interesting interpretation that says the original purpose of the amendment was not to facilitate overthrow of a tyrannical national government, but to allow local militias to suppress rebellions against the national government! That purpose, also, is now moot.)


Gun Self-Defense Is Insignificant Compared To Gun Assault And Intimidation

The single argument that most drove me to write this essay was that if all teachers were armed, Newtown wouldn’t have happened.

This argument’s fatal flaw is that, taken to an extreme, it results in every citizen being armed specifically to defend against all other citizens at any moment. It advocates for more gun violence as the best way to prevent gun violence. And, far more problematically, it puts all non-gun-owners at a severe disadvantage. This is morally unacceptable to me; a society in which peaceful non-gun-owners are disadvantaged relative to gun owners is an immoral society. We must be free to not own guns.

Moreover, the number of actual uses of a gun in self-defense are minute in comparison to the number of assaults or intimidations involving guns.

And finally, safe storage of guns — that will not permit minors or unauthorized persons to obtain access — impedes the quick use of guns in self-defense. In other words: a gun that is quickly available for self-defense is also quickly available for misuse.


The Freedom To Not Be Shot Must Trump The Freedom To Shoot

What about the freedom to own guns in and of itself?

The famous saying “your freedom to swing your fist ends at the tip of my nose” applies here. But any gun is just a finger-pull away from a murder. So any gun I can see is a deadly threat to me, since its holder can grab it and shoot me likely before I can reach cover. To me, this implies that any gun held or carried by anyone near me in public is as good as a punch in the face, in terms of the actual risk to me. And this directly implies that my freedom to not be shot must outweigh the freedom of gun owners to wield their weapons in public.

A broader libertarian argument is that government monopoly on violence is not legitimate. The most insightful take on this question I have encountered is in Steven Pinker’s excellent book The Better Angels Of Our Nature: How Violence Has Declined. Pinker describes the political theory of the Leviathan, the governmental monopoly on violence, as being instrumental in systematically reducing violence worldwide. While Pinker overlooks some important elements (such as the unconscionable rate of incarceration in America), the overall claim holds true. Moreover, the police and the military are subject to oversight, unlike private citizens. While oversight fails all too often, it is still fundamental to legitimizing the governmental monopoly on violence, and the libertarian argument completely ignores this.

If you do not believe the government should have a monopoly on violence, it seems to me you should move to Somalia, which sounds like your ideal nation-state — one which does not actually exist at all. Making this argument while remaining an American citizen is hypocritical at best.


Guns Are Deadlier Than Cars, Bombs, Or Knives, And Gun Control Will Restrict Outlaws Too

One friend of mine has passionately argued that cars are just as lethal as guns — that a madman could drive their car into a crowd of schoolchildren just as easily as shooting them. To me, this argument fails on two fronts: first, a car is much harder to conceal and target; second, school massacres are the small minority of gun violence in this country, and the strongest arguments for gun control relate to that large majority of suicidal or intimidation-driven gun violence, especially in homes that own guns. My friend recommended gun training that is just as strict and detailed as driver’s education; this seems like an entirely wise idea, but still does not address the immediate hazard posed by anyone carrying a concealed weapon to anyone they can see.

It’s often cited that on nearly the same day as the Newtown massacre, a madman in China attacked a school of children with a large knife and wounded 22 of them. But in that case, all 22 survived. Knives are radically less lethal than guns and equating the two is an irrelevant argument.

There’s a cliche that “when guns are outlawed, only outlaws will have guns.” And indeed the insane number of guns circulating in America (almost one per U.S. citizen) does make reducing them a daunting task, to say the very least. But that in itself does not mean that it is not a desirable goal. Measures to reduce illegal gun ownership, to limit ammunition and sales of new guns, to greatly expand buyback programs, to stigmatize gun ownership and reduce the number of young gun purchasers, all can combine to stem and eventually ebb the tide. It may take many decades, but all the more reason to start now.

Guns are imported from states with weaker gun laws into states with stricter laws. This is evidence that illegal gun traffic is significantly impacted by stricter laws, and is a strong argument for tougher federal laws applying to all states; these would restrict illegal supply. It is inadequate to argue that guns will still be available; we must focus on how to reduce their availability, knowing that reductions, iterated over time, can eventually have dramatic results.

In the interim, while there are still so absurdly many guns in circulation, there is a legitimate debate about whether properly trained civilian gun owners can de-escalate conflicts. But it’s indisputable that proper training requirements are not in place nationwide at the federal level, as they must be for such a solution to have merit.


Even So, Not All Gun Ownership Is Wrong

Now, that said, I do think that guns should be able to be owned by private citizens. But a legislative regime such as Japan’s seems far more appropriate. These are devices deliberately designed to be as hazardous as possible to anyone in sight. What technology could be more deserving of tight restrictions?

There are many reasons to think that effective no-loopholes bans on assault rifles, more effective laws (with enforcement) around secure storage, and mental health and background checks proportional to the lethality of the weapon / ammunition being purchased might well have prevented several recent massacres.

Japan has some of the strictest gun control laws in the world: mental and physical tests, strict training and required re-training, law enforcement verification of separate seccure storage of gun and ammunition. And virtually no gun crime.

England at one time had a law allowing private ownership, but requiring storage at a shooting range. That also seems appropriate — getting all semiautomatic guns out of the home, and ensuring no concealable or semi-automatic guns carried in public, would allow shooters to practice their art safely on the range (with assault rifles, even), without risk to the rest of the citizenry. I would probably even own a gun, and store it at my local range, in that world. (I may yet do so in this world.) Evidence shows that restricting soldiers from bringing firearms home with them reduces the incidence of suicides in soldiers’ families.

Australia found that gun homicides dropped sharply after adopting stricter gun control legislation, with no corresponding increase in non-gun homicides.

Germany passed laws after a 2009 school massacre there requiring random law enforcement checks of secure storage, a nationwide electronic gun registry, and plans to mandate biometric security on all firearms as soon as technologically practical. All of these are excellent ideas as well.

It is also reasonable to consider legalizing only single-shot rifles and manual revolvers for home ownership, limiting semiautomatics to shooting ranges only. This would address the legitimate needs of hunters without permitting private ownership of combat weapons.


Mental Health and Violent Video Games

Gun advocates often seek to shift the debate to mental health, or violent video games, or other social factors. I don’t deny these are related to the causes of violence in our society. But I radically disagree that they are anywhere near as important as more gun control.

One of the central themes of this essay is that school shootings are terrible enough to be worth strong efforts to prevent them, but that broader gun violence (especially in the home) is in and of itself a toxic blight on America. So focusing solely on the severely deranged individuals who commit massacres is actually a distraction from addressing the much more widespread and lethal violence overall.

Our mental health oversight system in this country has been seriously broken since the 1980s. This must be fixed, but none of the arguments in this essay are weakened by this fact; better gun control is still critical for all the reasons given here, even if we improve our mental health care system immensely.

Violent video games, likewise, do seem to be triggers especially for borderline psychotic individuals. But there are many rich countries with violent video game players, and only one with as many gun deaths as the USA. A video game player without a gun is no threat; a shooter who doesn’t play video games can be deadly. The NRA’s attempt to shift the debate from guns to games is an absurd act of political theater that will backfire on them in 2013.


The Road To A Post-Gun-Culture America

Finally, the fundamental issue I have with many of my gun-advocate friends is that they argue so passionately for the status quo. I have not heard them, for the most part, admitting even such basic concessions as that assault rifles are deadlier than handguns, or that secure storage should be not merely required by law but actively checked by law enforcement.

We seem to be at a terrible impasse, in which any action towards more regulation is opposed tooth and nail, reflexively, by most gun owners. I am disappointed in my gun-advocate friends who share in this wholehearted resistance. I understand it, but I hope it changes.

My sincere hope is that over time, three things happen.

  • Home storage of guns and public concealed carry becomes seen, even by gang members (thanks to social interventions), as not only uncool but actually wrong, morally wrong, thus continuing the trend towards lower levels of gun ownership nationwide.
  • Gun buybacks and other disposal strategies reduce the number of guns in circulation generally.
  • Gun laws become more restrictive and more effective at preventing unsafe, impulsive, and malicious gun use.

Obama plans to push for stricter gun control legislation early in 2013, which is very hopeful.

I intend to monitor and support political movements towards these ends. I recommend the Occupy the NRA feed on Facebook — while sometimes too strident, it is a great clearinghouse for those who agree that it’s time to reverse the two-century-old tide of pro-gun culture in America. Moreover, it’s conceivable that social change on this issue may happen faster than anyone expects — that’s certainly been the case with both gay marriage and drug legalization recently. Let’s push, push hard, and keep pushing.

Anyone who agrees that these shootings were terrible, and that gun violence is too common in America, must start pressing for stronger gun control, and never stop. Any other gesture in support of the Newtown victims is hollow at best.

This will not be a quick process — social change seldom is. And there are many who are quite serious that their guns will only be pried from their cold, dead fingers. But if we can decrease gun ownership among the young, age will take care of the old gun owners naturally.

It may take a century or more to reach an America that is as gun-free as the other first-world nations are right now. Even so, our great-grandchildren, living in that world, will thank us for having had faith that America is defined by freedom from violence through democracy, not freedom to be violent in the false defense of democracy.

(And a postscript: I will be editing the comments here to reject any that are flat-out insulting, such as the one calling me a “degenerate, Marxist piece of gutter trash.” If you see no such comments here, it’s not because I’m not getting them, I assure you! But I’m using a John Scalzi-style comment policy here, so if you flame me, don’t be surprised when I delete your post. If you want to call me terrible names, you’re welcome to do so on your own blog.)