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Perishable Thoughts

Jim Prevor’s Perishable Pundit, September 9, 2008

In the midst of the Salmonella Saintpaul outbreak, we received a contribution to our Perishable Thoughts section quoting an important governmental official:

The note came from a distinguished academic:

Donald W. Schaffner, Ph.D.
Director, Center for Advanced Food Technology
Extension Specialist in Food Science
Department of Food Science
School of Environmental and Biological Sciences
New Jersey Agricultural Experiment Station
Rutgers, The State University of New Jersey
New Brunswick, NJ

The quote Dr. Schaffner sent was as follows:

“Food safety recalls are always either too early or too late. If you’re right, it’s always too late. If you’re wrong, it’s always too early.”

Dr. Paul Mead
Epidemiologist, US Centers for Disease Control

This statement was quoted in a United Press International syndicated story that was written by Ken Kolker, a staff writer for The Grand Rapids Press, and appeared under the headline “Agency Had ‘Strong Hunch’ About Bil Mar” on January 31, 1999.

We thank Dr. Schaffner for sending this along for several reasons. First, Dr. Mead is identified in the article as just a government epidemiologist; perhaps he was at that time but now he is a big shot:

Paul Mead is chief of epidemiology, microbiology, and diagnostic activity in the bacterial zoonosis branch in the division of vector-borne infectious diseases at the Centers for Disease Control and Prevention’s National Center for Infectious Diseases in Fort Collins, Colorado. Mead received his medical degree from the University of Colorado Health Sciences Center in Denver and his MPH at the University of California, Berkeley. Prior to his present position, he served as chief of the outbreak response and surveillance unit in the CDC’s foodborne and diarrheal diseases branch in Atlanta, Georgia, where he was also an Epidemic Intelligence Service Fellow.

Mead is the recipient of numerous awards, including, among others, the US Public Health Service’s Crisis Response Service Award (2002); CDC’s Group Award, Statistical Research and Services, CDC (2002); and CDC’s James H. Nakano Citation, National Center for Infectious Diseases (2000).

Second, Dr. Shaffner has sent along one of the rare opportunities for us to honor the thoughts of a living person highlighted in this section.

Mostly though, we appreciate the thought because it strikes at one of the central questions of the recent Salmonella Saintpaul outbreak: Is the produce industry on shaky ground in objections to the FDA actions because there was, in fact, a compelling need to act to protect public health?

Certainly it strikes us as a PR nightmare for any industry to be seen as quibbling over the actions of public health authorities when the authorities are trying to protect public health. The public health authorities will argue that even if they make an occasional mistake, they have an obligation to act.

As far as the argument goes, it is unassailable. Yet it also strikes us as incomplete.

Sure public health authorities have to act but because they have the word “public” in their titles, they also ultimately have to be answerable to people.

Logically, some public health personnel will do very good jobs and some will do very poor jobs. We certainly can’t just adopt a carte blanche attitude that anything done by public health authorities is always the right thing to do.

The answer is that in public life we need more of what we demand every day of private employees — an expectation that people will not merely explain what is going on but actually justify it.

We ran a poignant interview with a US grower who was losing his chili pepper crop in Baja due to the ban. It is pretty easy to articulate the costs to this farmer of the ban. But what were the benefits?

Surely it is not too much to expect public health authorities to explain their motives when they take such actions as banning entry of chili peppers from a whole country. What is the benefit we expect to derive? How many deaths or illnesses avoided? Electing not to justify one’s actions in these ways raises many suspicions.

Partly one wonders if the officials simply prefer to avoid accountability. One also wonders if they fear sounding faintly ridiculous.

One of the most pointed comments that famed public health expert Michael T. Osterholm made during our interview with him during the Salmonella Saintpaul crisis was the simple observation that “for every numerator there is a denominator.” If public health authorities were required to quantify their decisions on a regular basis, what would they have argued was the benefit to blocking Mexican jalapeno and Serrano peppers during the last week of the ban? And what small percentage of that tiny number would have been due to keeping the ban in Baja as well?

And, of course, since there are so many Salmonella cases in the food supply anyway, how much safer during that last week did officials believe the chili peppers from other sources were than the Mexican product?

We’ve run the math different ways, but it seems to us that the public health authorities would sound faintly ridiculous if they came out and said something like “We estimate the risk of a consumer getting a serious illness from the general chili pepper supply at, say, .00056%, but the risk of getting a serious illness from chili peppers from Mexico is .00058%, so to protect public health we are going to impose a ban.”

Dr. Mead’s quote is correct. Nobody ever gets the information perfect and on time. But the public policy implications of this uncertainty of knowledge are less clear.

We appreciate Dr. Shaffner’s bringing this timely quote to our attention.

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