Introduction. In recent discussions surrounding measles and public health, a somewhat perplexing notion has emerged: the distinction between people who die “of” versus “with” a disease. This idea often muddles the gravity of a health crisis. In this article, we explore this topic alongside the broader implications of pharmaceutical practices and the enduring impact of human folly.
Part the First: Die with the Measles or Die of the Measles? One of the more vexing aspects of the MAHA movement revolves around the question of whether individuals die from a disease or simply with it. As highlighted in an opinion piece on STAT News, The ‘died with’ vs. ‘died of’ measles discussion misses something very important, the nature of death is more fluid than this debate suggests:
During the pandemic, we often heard variations of the statement, “they died with Covid, not from it.”
This phrase has resurfaced, this time concerning measles. On August 25, Pennsylvania reported two deaths related to measles in Lancaster. A county commissioner relayed the coroner’s perspective that one individual had died “WITH measles, but not FROM measles.” The coroner attributed that death, an infant’s, to a ruptured spleen, leaving the public dependent on the coroner’s reported information for clarity.
The Centers for Disease Control and Prevention (CDC) then excluded both deaths from its national measles update, ultimately marking the deaths with an asterisk. Pennsylvania has since reported two additional cases, reaching a total of four. On a recent Wednesday, the CDC included one of these deaths in its data, but the other three remain unlisted.
In her inaugural interview as head of the CDC, Erica Schwartz was questioned about the agency’s decision to omit the Pennsylvania deaths from its tally. She referenced Covid, noting that instances where someone with COVID was struck by a bus were often labeled as Covid-related deaths, emphasizing the importance of definitions.
It is indisputable that measles has made a resurgence. This increase can be directly linked to the decline in vaccination rates necessary for herd immunity against measles (measles at 0:50). Furthermore, the origins of this troubling trend can be traced back to scientific misconduct by former physician Andrew Wakefield. Regarding the cascade of consequences that can lead to death:
If we were to be brutally literal, the cause of death for almost everyone would be cardiac arrest, as our hearts ultimately stop beating. However, we do not classify deaths this way because, in nearly every scenario, something leads to that cardiac failure. The CDC’s manual for physicians advises certifiers not to denote cardiac or respiratory arrest as causes of death for this very reason. Similarly, Pennsylvania’s death certificate manual states clearly: “DO NOT enter terminal events such as cardiac arrest” without specifying what resulted in them.
Death typically follows a sequence, and death certificates are designed to encapsulate this progression. The first section of the U.S. standard death certificate outlines the sequence in reverse order: the immediate cause appears at the top, followed by conditions that contributed to it, culminating in the underlying cause, which instigated the chain of events. The second part notes other significant conditions that played a role in the death without being direct contributors.
The Pennsylvania Department of Health’s training for certifiers illustrates this with an example: a patient dying from bleeding esophageal varices due to portal hypertension, stemming from liver cirrhosis, caused by hepatitis B. The death certificate’s top line states bleeding, while hepatitis B is labeled as the underlying cause since it initiated the series of events. This logic also applies in cases of homicide, where a victim succumbs to complications from a gunshot wound weeks or months later. We apply this reasoning consistently in matters such as traffic accidents and infections.
When a previously healthy child dies from encephalitis due to measles—complications from an illness that was preventable through vaccination—the cause of this tragedy is measles itself. This concept should not be hard to grasp, yet the Current Administration seems to suggest otherwise. ICYMI, recent reports indicate that we are indeed living in strange and increasingly perplexing times.
Part the Second: Big Pharma and Our Health. It would be disingenuous to ignore the significant role Big Pharma plays in the healthcare landscape. While the majority of drugs brought to market stem from publicly funded research, Big Pharma handles much of the development and distribution, warranting recognition. Yet, things occasionally take a troubling turn, as described in Merck discontinues a crucial antibiotic despite concerns over superbug resistance:
In an unexpected move, Merck opted to discontinue an important antibiotic in the U.S. market earlier this month, highlighting concerns about the commitment large pharmaceutical companies are willing to make to a sector vital for public health. (emphasis added)
The drugmaker is no longer supplying Recarbrio, an antibiotic approved seven years ago that treats serious infections in adults and children, including pneumonia arising from hospital settings or ventilators, as well as complicated urinary tract and stomach infections when few alternative options exist.
The company did not clarify its reasoning behind the discontinuation. Initially, the antibiotic—a three-drug combination injection—was identified by the Food and Drug Administration as a treatment of last resort intended to combat antibiotic resistance. However, this designation also impacts its marketability. Merck’s regulatory filings did not reveal any sales figures for Recarbrio.
A Merck spokesperson simply stated, “As part of our ongoing portfolio review, our company has made the decision to voluntarily discontinue the manufacturing and marketing of Recarbrio in the U.S. This decision is not related to any product safety or quality issues.”
Consequently, the U.S. market is now left with only one approved antibiotic for the same three applications against KPC (Klebsiella pneumoniae carbapenemase), a superbug that produces an enzyme rendering most bacteria resistant to antibiotics, according to John Rex, editor of the AMR Solutions newsletter and chief medical officer at F2G, which creates novel treatments for fungal infections.
This situation prompts reflection on the complex decisions behind pharmaceuticals. I once had a brilliant friend—a molecular microbiologist—who transitioned from academia to Little Pharma and eventually to Big Pharma (specifically, Merck). His final assignment involved leading a research group dedicated to innovative antibiotic solutions aimed at mitigating the burgeoning antibiotic resistance crisis:
It is projected that, without significant intervention, 39 million deaths linked to antibiotic resistance could occur by 2050, according to an analysis published in The Lancet two years ago. In the U.S., more than 2.8 million antimicrobial-resistant infections occur annually, based on data from the CDC.
Still, the past twenty years have seen very few new antibiotics reach pharmacies or hospital shelves. Last October, the World Health Organization reported a decline in the number of antibacterial drugs in development, dropping from 97 in 2023 to just 90 by early last year. Out of these, merely 15 were classified as innovative.
My friend was tight-lipped about project specifics, and I never pressed him for details. His endorsement was enough for me. Yet, despite the promise of revolutionary antibiotics, Merck eventually shuttered the program after concluding that, even if successful, it would not yield sufficient profit to justify the development costs. This undoubtedly represents a lost opportunity. Once again, I’m reminded of a sentiment expressed by Aneurin Bevan, who established the National Health Service in less than two years, stating, “The field in which the claims of individual commercialism come into most immediate conflict with reputable notions of social values is that of health.” This truth remains relevant, even in our modern context.
Part the Third: Carlo M. Cipolla Was Right. Professor Cipolla was a distinguished historian of political economy at the University of California – Berkeley. His works, including Between Two Cultures and Clocks and Culture, are well-regarded. Nonetheless, his most famous contribution—resting on my Shelf of Little Books—is The Basic Laws of Human Stupidity. This work outlines Five Basic Laws of Human Stupidity, yet we will focus on The Second Law of Human Stupidity (an inescapable truth, much like the other Second Law):
The probability that a certain person be stupid is independent of any other characteristic of that person.
This implies that the prevalence of stupidity among members of the Royal Society, the immortals of L’Académie française, and the National Academy of Sciences is comparable to that within any other group. A recent article published in Nature provides further evidence for this law: Exclusive: Sham scientific societies are misleading star researchers. I must admit, this compelling revelation caught me off guard:
Julia Hirschberg believed she had reason to celebrate. In July, she was elected to the European Academy of Engineering (EAE), lauded as the “premier institution representing the highest professional distinction in engineering” and boasting 35 Nobel laureates among its 400-plus members.
This recognition came swiftly after another unexpected honor: election to the Austrian Academy of Engineering. Furthermore, she received an election to the National Academy of Artificial Intelligence (NAAI) in 2025.
Achieving three prestigious international distinctions in such rapid succession is a remarkable feat. Hirschberg, a computer scientist at Columbia University, was elated, and congratulatory notes flooded in following a public announcement from the university. “I was really excited,” she says. “I’ve never had anything quite like this happen before.”
However, shortly thereafter, Michael Chu, identifying himself as a representative of the EAE, reached out to Hirschberg, indicating that the organization was electing a rotating chairperson and intended to nominate her for the position, offering compensation of US$2,000 per year.
Things then took a bizarre turn. Upon checking the EAE’s website, she found her name prominently listed atop the leadership masthead, even though she had never agreed to the role, had not been asked for references, nor had attended a single meeting. In reality, she had not even heard of these societies prior to this. (Chu later stated, in written correspondence to Nature, that he had “inferred a preliminary consent” based on their dialogues. However, a review by Nature revealed that Hirschberg’s response was merely an inquiry about the role’s responsibilities—she had never accepted the position.)
She is by no means alone. Following multiple concerns raised by researchers regarding these academic organizations, Nature initiated an investigation. The findings revealed Chu’s connections to all three organizations and that much of the available online information appeared to be fabricated.
These entities are part of a vast global network of dubious academies and societies that have successfully misled numerous leading scientists and esteemed institutions, including Stanford University and the US National Academies of Sciences (NAS). The misleading websites often contain plagiarized or altered content, false information about their institutional histories, and offers of honorary titles available for purchase.
The fact that these esteemed scientists fell victim to such deception parallels the experience of individuals falling for typical Nigerian Prince scams. In the current climate, one might compare it to offers to serve on the editorial board of purportedly distinguished publications that are, in reality, shams.
The revelation is both amusing and alarming, complete with digitally manipulated images and misleading claims. I encourage you to read it and witness the reality of The Second Law of Human Stupidity.
Part the Fourth: Dolly Parton in The New York Review. The tributes continue to pour in for a true American icon, nearly two months after her passing. I recently came across a remarkable piece that encapsulates her essence, beginning and concluding with striking clarity, especially this paragraph:
Her shimmering, rainbow-colored exterior was always a clever shield for a profound interiority. Despite over fifty years of fame, very little is known about her long marriage or her closest friendships. She understood that her tireless work ethic was her own achievement, yet her extraordinary talents were not, for which she remained endlessly thankful. This blend of gratitude shaped her innate goodness and unmatched generosity. She viewed the space of creativity as sacred, explaining the act of songwriting as entering the “god zone” or “spirit zone.” This realm necessitated solitude, transcending the self—offering a vantage point to observe life in a contemplative manner. The most authentic portrayal of Dolly Parton, her values as an artist and person alike, is captured perfectly in lyrics she penned in the early Sixties, before she even left her hometown:
Words can’t describe what I feel inside
When I see the beauty in each coming day
What my eyes behold can’t be bought or sold
And everything’s beautiful in its own way.
Indeed, she was an American angel who graced the Earth.
Parting Shot: The Democrats still grapple with internal struggles. Nat expertly covered this aspect yesterday. Additional evidence is presented in a The New York Times article regarding “Rahmbo” Emanuel: Rahm Emanuel, Eyeing 2028, Makes His 2026 Play. As the tagline succinctly states, “The longtime Democratic insider has emerged as the behind-the-scenes force in his party’s bid to reclaim Congress. Afterward, he’ll contemplate the next presidential race.” Regrettably, our national politicians—save for a select few—seem primarily invested in their positions and reputations in Washington and K Street. The Uniparty persists, and until it changes, prospects for genuine progress remain dim.
Thank you for taking the time to read this! Your support of Naked Capitalism is greatly appreciated. Until next week!
