Saturday, January 31, 2015

Distributing the herd

Because of the spreading Disneyland measles cases, there’s been a lot more national conversation about vaccination, exemptions, and herd immunity.

Vaccinations aren’t 100% effective, and populations aren’t 100% vaccinated. Herd immunity protects the unvaccinated as long as the vaccination rate is high enough overall, because there aren’t enough new people for a sick person to infect for the disease to keep spreading. However, our herd immunity to measles is visibly facing two challenges: declining vaccination rates and clustering of unvaccinated populations. An insufficient herd immunity means that parents who choose not to vaccinate their children are endangering lots of other people in addition to their own children.

We have to allow medical exemptions to vaccination, because of allergies and certain medical conditions that would make the vaccine unsafe for those people. A tiny fraction of people claim a religious objection, but an increasing number of people are claiming a nebulous “personal beliefs” exemption. And because those personal beliefs are spread through personal conversations between parents and local peer pressure, there are clusters of people refusing vaccination for their children.

Requiring that parents consult a (hopefully sane) pediatrician and get the pediatrician’s approval before being allowed to opt out of vaccination is a reasonable step, but it doesn’t go quite far enough. There are pediatricians who are willing to go along with skipping vaccinations, as well as many who are not. We need to limit how many exemptions an individual pediatrician can hand out, and setting that limit to the percentage that would preserve our herd immunity is the only safe approach. If we need 97% of people to be vaccinated against measles in order to preserve our herd immunity, and a pediatrician has 1000 patients, the pediatrician should only be allowed to have a maximum of 30 patients who skip the measles vaccination. If you’re the 31st patient and you really want to skip the measles vaccination, you’ll need to find a different pediatrician.

This approach makes it more difficult for parents who want to skip vaccinations for their children, at least until this anti-vaccine nonsense dies down. Good. It should be difficult to endanger other people. This approach prevents pediatricians who don’t have the courage to stand up for their medical training and their other patients from causing too much damage by handing out obscene numbers of exemptions. More importantly, it forces some distribution of the unvaccinated. And forcing the unvaccinated to step away from each other is an important step to take.

Water, water, everywhere

Yesterday our water heater tank failed, leaking water onto our basement floor. The water and mold damage nearby suggests that some leaking started over a week ago.

Step 1: Turn off the incoming water supply. And eventually turn the water heater control knob to off as well, though we should have done that sooner.

Step 2: Get the water heater replaced. A direct replacement would be a 50 gallon gas water heater with chimney venting. A potentially better replacement for us would be a power-vent (aka direct-vent) version, but that would require adding some PVC vent pipes.

The water heater was still under warranty with Sears, so they were my first phone call. After an hour on the phone, I learned the following: Sears was grudgingly willing to admit that I had a warranty, but I would have to pay Sears $79 to have a technician come out in five days to look at the water heater and deem it in need of replacement. At that point, I would have to pay Sears $280 for installation of the replacement, plus $75 for a permit fee, plus unknown other amounts for other unspecified charges, and then Sears would decide when to install a replacement. Which could be weeks later. Total cost: $434 plus. Total time to new water heater: minimum of 1 week, probably 2-4 weeks.

Our furnace maintenance company was here yesterday morning, so their office told their salesman Jason to give me a call about having them replace the water heater. Jason told the office that he would call immediately, but did not actually call until 25 hours later. He had no pricing. That was ok, because I had told their office late yesterday afternoon to have another salesman actually get in touch with me. That salesman did call yesterday, and quoted me $2300 for a direct replacement or $3100 for a power-vent replacement. They could install next Monday or Tuesday, maybe, but definitely sometime next week.

Home Depot could do same-day installation, according to their web site. They actually could not install until next Tuesday at the earliest. Could not do a power-vent replacement, and would cost about $1400 to install a direct replacement. Since the water heater is only $600 in the store, that’s $800 for installation by their poorly-rated local contractor.

Independent top-rated plumber #1 required photos and time before quoting a price. He estimated $3200 for a power-vent replacement. Getting a quote on a direct replacement took until after 5 pm. The quote was $1325 with a 6-year warranty, with installation on Saturday. It would have been another $250 to bring that to a 10-year warranty, but the plumber said he would not recommend that since he thinks it’s the same water heater with a different label. Fastest turn-around time, and a reasonable price.

Independent top-rated plumber #2 did not answer his phone and never called back.

Lowes could do next-day installation, but their phone rep was fuzzy on numbers and dates and recommended going to the store. So we went to the local Lowes in the late afternoon and ordered an $1100 direct replacement, including the $600 water heater and installation. They’re installing the replacement on Monday morning. It would have been another $250 to do it on the weekend.

Warranties are weird on tank water heaters, especially since they’re all made by a couple of companies and then rebranded to lots of different name brands. From a plumber, you get either a 6-year or 10-year warranty. In a big box store, you get 6, 9, or 12 years. Some places claim the primary difference is in the tank lining or insulation or construction, others claim it’s entirely about the anode rod. One guy said there actually was no difference. But there’s no labor warranty on any of them after the first year, and labor is a huge cost component. We paid an extra $115 to Lowes to get a 12-year labor warranty, so hopefully this is the last expense we have from the water heater for a while. I’m guessing there’s a greater than 25% chance that the water heater will need to be replaced in less than 12 years, in which case the warranty was statistically a good deal for us. And as a purely labor warranty, it’s one of the few cases where the insurance math can work out well for both parties, since I pay retail for labor without the warranty but they pay wholesale for labor with the warranty.

A direct replacement, just for the tank itself, would be $400 to $600. The installed quotes ranged from $1100 to $2300. A power-vent replacement, just for the tank itself, would be $900, and would require about an hour or two of additional labor and $50 of PVC. The installed quotes were $3100 to $3200.

And now we can go back to throwing out the ruined lumber that was stored too close to the water heater.

Update a few days later: Lowes showed up with a water heater that needs a power outlet for no apparent reason. Shouldn’t be a problem since there’s an available outlet right there, except for the installers claiming that it also needs a dedicated circuit. So they left without replacing the water heater.

Meanwhile the condensate pump on our furnace’s humidifier leaked water all over the floor last night, just like the water heater had previously. Hmm. Maybe it was the condensate pump all along. We had asked Central Cooling to check the condensate pump last week, and they had told us that the pump was fine and that the water heater was to blame. But now there’s a new condensate pump in place, this time with a wet switch so it should turn off the humidifier if it overflows, and our old water heater is back in service while we keep an eye on everything and our wet vac at the ready.

I can’t believe that just one malfunctioning device, or possibly two, could make Central Cooling, Sears, and Lowes all look bad. But none of them did what they should have done. Central Cooling didn’t adequately check the condensate pump, and even told us today that they could have changed things around last week really easily so that we wouldn’t have had today’s mess. Sears showed me that their warranty is useless. And Lowes either sold me a water heater that they couldn’t install (and they knew that our previous one didn’t plug in) or sent installers who refused to install a water heater for no good reason. And I’m still throwing out lumber. And carpeting. And a power tool. And some furniture.

Saturday, January 24, 2015

PSIchic warfare

The way footballs apparently work in NFL games is that each team supplies the footballs that they’re going to use on offense, and is allowed to have scuffed them up as much or as little as they want. Officials test the pressure 2 hours before the game, at which point it has to be 12.5 to 13.5 PSI. That’s a fairly tight range of just 1 PSI.

But Tricon Sports demonstrated that a temperature change of 25 degrees will cause a change of 1.5 PSI in an NFL football. And because the air bladder in an NFL football is somewhat insulated, the temperature change (and corresponding PSI change) will not happen immediately.

So if you want to have the PSI on the low side (as Tom Brady prefers) and you want to have it drop further, inflate the ball with warmer air than the game environment. If you want to have the PSI on the high side (as Aaron Rodgers prefers) and you want to have it rise further, inflate the ball with colder air than the game environment. Since the locker room has everything from ice baths to saunas, different temperatures are easy to find.

So without any deliberate shenanigans, if you inflate the ball in a 70 degree equipment room and then take it out to a 20 degree stadium, expect a drop of 3 PSI. That’s a much larger change than the 2 PSI that everyone is screaming about with #deflategate, and it’s going to happen in plenty of games.

Requiring that the ball be filled with field-temperature air (not a current requirement) would result in less PSI change, though the temperature on the field can still easily change quite a lot over the 5+ hours between when the balls are checked and the end of the game. A game ball simply isn’t guaranteed to stay in a tight PSI range unless you keep adjusting it.

A real football isn’t a challenge to throw and catch because it’s inflated to a ridiculous air pressure, and underinflating it doesn’t turn it into a Nerf ball. The PSI standards are there because that makes the football behaves the way people want it to behave, and the allowed initial range recognizes that this is not precision machinery. Do people then get irrationally picky about the exact PSI or the way the balls are scuffed or the color of their shoelaces? Sure. But this isn’t like stealing your opponent’s playbook or replacing the other team’s Gatorade with vodka. This whole scandal seems more appropriate for Mythbusters than for CSI.

Monday, January 19, 2015

Is it still a shul without nuts?

I’m trying to figure out what I want my synagogue to do to keep my son safe given his nut allergy, and to keep other children safe given their food allergies. Many events at the synagogue include food, and people also bring in food of their own. My thoughts on this are very scattered.

The synagogue bans pork and shellfish, so it seems they could also ban nuts.

A Jewish-oriented argument for respecting the health needs of others is at if I need to point someone at the synagogue to such a thing.

The synagogue doesn’t know which members have any particular allergies, or if any members do. It seems sensible to ask on the annual membership form.

Even if no members have allergies, guests might. A welcoming environment is not one in which people are worried for their safety or the safety of their children.

I’d like to see dairy items clearly labeled. Kosher baked goods and kosher bakeries are easy for me to deal with, as someone who is severely lactose-intolerant, since I can check if something is pareve (meaning that it contains neither meat nor dairy ingredients). It surprises me that a Conservative synagogue does not identify dairy vs pareve baked goods, since members who keep kosher may need to avoid dairy for religious reasons. But perhaps there are no members who keep kosher, or perhaps they all assume that everything at shul is dairy for kashrut purposes.

My son is also allergic to mango (which is related to certain tree nuts). How many ingredients does it make sense to ban?

Plenty of schools draw the line at nuts. The reactions are more likely to be serious than with other allergens, the residue from nuts is more problematic (easier to spread, harder to see, harder to eliminate) than from many other allergens, and nut allergies are frighteningly common. If schools can comfortably go nut-free, why can’t a synagogue?

Keeping kosher to many people is about mindful eating. Saying blessings before eating and saying grace after meals is about mindful eating. Mindful eating is a Jewish value. So asking people to be mindful of one more aspect of their food is consistent with what we should already be doing. (Though I’ve not seen anyone saying blessings before eating or saying grace after meals.)

“Processed in a facility which also processes nuts” is a constant on food packaging. So far we haven’t had to worry about that, but some people have to. It becomes much more difficult to be nut-free if you also have to avoid all ingredients and foods that have been processed in a facility which also processes nuts.

As with any policy, I strongly believe that whatever the synagogue’s food policy is, it should be clear, consistent, and communicated frequently so that everyone can know it and follow it. I don’t actually know what the synagogue’s food policy is, despite having been there many dozens of times over the past several years. That seems bizarre.

Friday, January 9, 2015

What's in your food?

Whole Foods at Charles River Plaza had a nice-looking pumpkin bundt cake today which they had baked themselves. The ingredients list did not list any milk products. The allergens list did not include milk. But the chocolate fondant on the cake was made with heavy cream, as the bakery manager confirmed, so heavy cream should have been in the ingredients list and milk should have been included in the allergens list.

Once the bakery manager confirmed that the cake actually contained milk, I knew that I could not safely eat it. But I thought I should point out that the ingredients list and allergens list were both wrong, which can make people with a milk allergy or with lactose intolerance very ill.

The bakery counter person was very pleasant and had no idea why I wanted them to correct their label.

The bakery manager was very pleasant and thought that she should send a message to regional telling them that they should correct the label at some future point, while leaving the cakes out with wrong labeling.

The customer service person was very pleasant and had no idea why I wanted them to correct their label.

The store manager was very pleasant and immediately went to pull the cakes off the display until the labels could be corrected.

Everyone was very pleasant, but three out of four Whole Foods employees clearly had no idea why food products have ingredients lists.

Food products have ingredients lists so that people with food allergies, food intolerances, or medications that interact badly with certain foods can keep themselves safe. Food products have ingredients lists so that people can make conscious choices about what they eat. Food products have ingredients lists so that people can compare their possible food choices.

All of these are reasons why Whole Foods is so successful. Whole Foods offers a wide range of food products with more limited or alternative ingredients when compared to a regular supermarket’s offerings. Whole Foods touts the health benefits of various food choices. Whole Foods is designed to appeal to people who have to be careful about what they eat, or who choose to be careful about what they eat. And Whole Foods promotes and reinforces the idea that we should be careful about what we eat in every aspect of their advertising.

So when Whole Foods is sloppy about their ingredients lists, as happens with alarming frequency, Whole Foods is betraying their customers in a way that challenges the exact reason why many of those customers are Whole Foods customers in the first place.

Having common allergens missing from a food label (undeclared allergen) is a sufficient reason for food to be recalled. At the corporate level, Whole Foods knows this. But at the store level, Whole Foods desperately needs to get a clue.