I am glad they’re screening for it. I was born to someone who had the virus, but didn’t know I had Hep C myself until I submitted myself to an exceptionally thorough STI testing panel. I say exceptional, because the standard ones I’d done throughout college and early adulthood do not happen to include that particular test. So I feel a bit lucky to have been able to get diagnosed and treated in my mid-20s, before the disease could do much damage.
A disease that can stay silent for years, but is also highly curable once detected, seems like exactly the thing you want to screen for more aggressively
Hep C screening at least once for adults >= 18 is recommended and considered standard of care in the United States. I checked my medical records and I have a negative Hep C result in an old checkup when I was younger, and another one from a new provider who insisted on a big panel of standard testing for new patients (despite me having no risk factors).
It’s unfortunate that your early providers dropped the ball. I wonder if they assumed you had already been tested for some reason?
Crazy how different healthcare is in different countries.
In the UK once you've had your childhood vaccinations it's entirely possible you'd simply never see a doctor again in your life until you're ready for your prostate exam in older life.
There are no regular checkups or preventative care on the NHS for mid life adults unless you're proactive
I presume you're not a woman, because there's cervical screening for women aged 25-64 every five years. Also depends on what you mean by "mid life", but there's breast screening offered to women aged 50-70 and bowel cancer screening offered to people from 50 to 74 every two years.
There are real trade-offs with screening, and screening too much has harms as well as too little, although I'm not qualified to make a judgement on where that line sits relative to where it is in the UK.
This is the real reason women live longer than men.
Doctors won't see me unless I'm dying, or at least tell them I am. And I am, if I understand things correctly, which I might not tbh, in a high risk group for prostate cancer, given that I was diagnosed with chronic prostatitis at 22. I've even asked for checkups but was denied. And where I live you can't really pay for health care (but you can pay to skip the line, which I guess is almost the same thing).
What country are you in? Not challenging, I'm gathering perspective.
I am in the US with health insurance through my employer and I get blood tests every 6-12 months to check for abnormalities as well as a standard interview for how I'm feeling and whatnot. Also have a few prescriptions that require 3-month checkins.
The Netherlands seems to be more or less similar, although I’ve had a mixed bag with medical knowledge an experience during emergency care: excellent to middling.
When I lived for a while in the UK, my GP strongly suggested close monitoring for a couple of things, and we saw improvements in some measures with lifestyle changes. Others were “we’ll keep an eye on it, if it gets bad, off you go for an inpatient visit to get you an extra 10 good years”.
Back in the Netherlands I have to get pushy and even a bit obnoxious at my GP before they even consider the concern, let alone schedule a blood test.
The HPV vaccination eliminates most forms of cervical cancer. Australia reports a 95% drop in cervical cancer in the cohorts that got mandatory widespread HPV vaccinations. I didn't look into how that changed pap smears.
From a US perspective, even this seems wild to me. I've always been told that at least an annual physical exam with bloodwork is highly recommended as the standard of care for adults of all ages.
Not everyone chooses to get them, of course. But ACA insurance plans here offer at least one annual physical exam free of charge (considered preventative care).
Cynically - this sounds like an opportunity to sell you more medical care.
The NHS isn't perfect, but one of the things it does well because of it's structure is minimise costs holistically. It's cheaper to treat conditions early, so usually implements appropriate screening to catch things. If they don't do regular checkups like this it's because they're of minimal value.
It's free if you don't bring up things that should technically have been a dedicated own appointment.
The idea behind physicals is they're considered preventative care... catching problems early, often before there's any overt symptoms. For example, checking your cholesterol and A1c levels before they progress to heart failure or diabetes.
Once you're showing symptoms, you've left the realm of preventative care and it's now diagnostic/treatment for a established issue.
(ACA only provides 100% free coverage for visits that are 100% within the "preventative care" box.)
Annual exams were included in the ACA but as I understand it there is no evidence to show that they improve health outcomes. I had one once in 15 years when it was incentivised by my employer (presumably trying to show that we were low risk to reduce the rates they paid?) but otherwise my doctor has never tried to book me for one.
I think I'd prefer the UK system where if you worry something is wrong you can see a doctor free of charge.
Anecdotally, I've found yearly physicals with full blood workup very helpful in heading off issues before they become much larger issues. For example, a random blood marker pointed at mold exposure. I thought that was strange, I didn't think we had any mold. Then I tore open one of my ceilings, there was a very slow leak in the bathroom above the top of that drywall was covered in mold. I replaced all of that drywall, and that blood marker shot down, and a few others improved drastically, and my energy levels improved. By going regularly, you get to see the trend lines on various things - those other markers had been going in a worrying direction over time.
I wonder how accurate that is. As in, these screenings are meant to detect early signs of issues like diabetes, liver problems, cholesterol, blood pressure, and so on. Is the case that many people are healthy and don't need it? That we haven't had a long enough sample time to know how screening in the 30s affects outcomes in the 60s?
Actually, I would've have assumed the other way - that the NHS was better than the US system. Which was why I was shocked when you said health checkups aren't allowed before age 40. :)
US healthcare plans offer an annual physical exam every year at all ages. Looking at the UK NHS website, it seems to be only offered there after age 40, and limited to once every 5 years? Am I reading that right?
> Actually, I would've have assumed the other way - that the NHS was better than the US system.
I thought it was relatively uncontroversial that the major problem with US healthcare is not quality but cost. And the UK NHS is widely regarded as one of the lower quality implementations of single payer in any modern social democracy [0].
That's not quite true - there's a 5 yearly Health Check which is offered to those over 40 with no other known health issues (in England, but Scotland/Wales/NI have similar schemes).
Local councils are responsible for arranging invitations for those not currently registered with GPs, so it ought to be more or less universal - though there are inevitably a few people who'll slip through the net.
It's pretty basic, but the evidence suggests it's been reasonably effective at dealing with the "he didn't see a doctor for 40 years and then just dropped dead from a heart attack" stereotype.
well what did you do during covid? Even if your school/employer didn't require vaccination during covid, most schools I attended at different phases of my life, well before covid, required some new vaccine or other. I think in the US it's pretty hard to get through school without visiting a doctor after childhood vaccines.
I get my vaccines at the pharmacy. At my current age its flu and COVID every year. TDAP every decade. I'll be adding more once I'm in my 50s, which is rapidly approaching.
That's interesting, I haven't ever been required to do that. I tend to have an annual checkup around my birthday, though it isn't really a physical exam anymore, more of a "hey lets do some blood tests and discuss if there's anything noteworthy we should talk about." They quit actually poking and prodding about the time I turned 45 or so. Doctor says the physical is mostly a waste of time.
Well that's interesting. Mine always say it is covered, I've never had an insurer (in the US) say its required. I could see it for certain types of life insurance, maybe?
I have never seen or heard of this requirement before. I don’t even see how it could be enforced. What would even be the point, the insurer (even if employer funded) is not allowed to deny or price coverage based on health risks of the insured.
> In the UK once you've had your childhood vaccinations it's entirely possible you'd simply never see a doctor again in your life until you're ready for your prostate exam in older life.
It's entirely possible to do this in the US, too, but it's not the default path. I know some people who think it's a point of pride to brag that they haven't been to a doctor in 20 years. I know other people who never miss their annual checkup and are frustrated that their doctors won't order every test they hear about from their podcasts. The US approach to healthcare is varied and confusing to outsiders, even if you remove all of the unreasonably complex insurance stuff from the equation.
> There are no regular checkups or preventative care on the NHS for mid life adults unless you're proactive
If you wanted to request an annual checkup, could you ask for one and get it without problem? Or would they require a specific reason to visit?
I'm not a big proponent of restricting speech but "Ask your doctor about..." advertising should be banned in the USA. If you don't have medical training you're in no position to decide what medical conditions you may have or what treatments might be appropriate. If you want to be a doctor, go to medical school.
The idea of advertising prescription drugs is absolutely bonkers in and of itself. If I recall correctly, the only reason they say "Ask your doctor about..." was a regulatory compromise that allowed such advertising. Telling the general public to simply "take Procrapin for their constipation" was deemed too extreme: The general public doesn't have the medical training to diagnose themselves or recommend treatment, but instead the manufacturer was allowed to urge the general public to nag their doctor about a medicine--that was seen as fine.
The last insurance carrier I had, through an ACA Marketplace plan, has an incentives program for members. If you go see the PCP for an annual checkup, you get about $50. If you "go paperless" 100%, you get another $50.
There are about four incentives altogether, and the money is loaded on a Prepaid Visa card that is branded by the insurance carrier. The funds are not restricted, and you can spend them on anything where Visa is accepted. The cards are sometimes cycled out and replaced, but I do not know if the funds had an expiration date. There were no fees to hold the funds, and no fees to spend them.
One of my employers had that incentive but only for one year. I assume they wanted to demonstrate that as a population we were low risk but after testing us once there was no reason to do so again.
> In the UK once you've had your childhood vaccinations it's entirely possible you'd simply never see a doctor again in your life until you're ready for your prostate exam in older life.
It is not customary in the UK to see a doctor at regular intervals for checkups?
You can get sti tests and other tests as and when required or requested. I have had blood pressure checks, blood diagnostics etc offered regularly by my doctor. Usually they are just to rule things out but they definitely offered.
> “There are no regular checkups or preventative care on the NHS for mid life adults unless you're proactive”
This isn’t quite true. There is a free “NHS Health check” for adults aged 40-72, which you’re supposed to do every 5 years and includes basic checks like blood pressure and cholesterol. I certainly get messages from my GP nagging me about it from time to time.
To be fair, almost nobody is going from childhood vaccinations > late-middle age without seeing a doctor. And when you do go with an ailment general blood tests seem pretty standard these days at GP's along with standard vitals checks. They also do preventive care where necessary. Every woman is invited for cervical screening once they turn 25 and then every few years until they're in their 60's. Regular mammograms are also a thing after a certain age/depending on risk factors. Bowel cancer screening too. STI testing is free and, depending on where you live, done by post. Also depending on your definition of 'childhood' there are a few vaccines given when you're a teenager (HPV for example). And if you ever travel you'll be visiting the doctor for vaccines then too.
I don't think I've been to a doctor in close to 40 years, except for treatment of a few acute injuries. I've had a few vaccine boosters, but I get those at a pharmacy.
You had me curious about what I was tested for, also in the northeastern USA in the 2010s. It looks like they included Hep C when my PCP ordered STD tests in 2015, along with most of the tests the other commenter mentioned. I'm glad they caught yours in time to treat it well!
In Europe I don't think it's commonly done. For example, the standard Dutch MSM STI test [1] covers HIV, Syphilis, Chlamydia, and Gonorrhoea only while Trichomoniasis, HPV 2 and Herpes are rather common. That being said, it's freely available at most hospitals.
Herpes screening is discouraged in the US unless symptoms are present as the widely available IgG tests have terrible specificity. While the false negative rate is practically 0, they have a false positive rate of around 20%. The only high-accuracy confirmatory test (at least in the US) is the Western Blot but there's only a handful of labs in the country that offer it.
The current tests would result in a substantial fraction of the population running around thinking they have a highly stigmatized STI that they in fact do not have with little to zero ways of getting a more accurate test.
Seems like both HSV-1 and HSV-2 seroprevalences are actually rather low in the Netherlands.
As for STI testing: Serological testing is pretty meaningless regarding infection risk and direct viral detection is only done on visible lesions for differential diagnostics AFAIK. You can shed the virus without lesions, HSV-1 can be contracted without direct mucosa contact, and while HSV-1 is associated with oral herpes and HSV-2 with genital herpes, both types can cause lesions anywhere on the body. Sure someone without positive antibody status very likely can't transmit it, but that's a very small minority of people of relevant age.
I believe talking to Americans about "herpes" can be misleading, as it's weirdly stigmatized over there and people seemingly conflate visible "cold sores", genital herpes and antibody status.
Incidentally, genital herpes and HSV-2 in general is more common in the US, which may be a direct outcome of this cultural dynamic. Due to lower incidences of early oral HSV-1 infections, compared to most western Europe, Americans are more likely to get infected with genital herpes of either type, but in particular HSV-2, too. Prior oral HSV-1 infections are somewhat protective.
Most of the stigmatization of HSV in the US is mostly the result of pharmaceutical companies trying to create a market for HSV antiviral drugs. In the 1980s they ran ads that equated HSV with leprosy. Since that was also the time of the AIDS scare the public was probably very susceptible. Even in my childhood I remember ads on TV for the antiviral drugs promising a way of "living a normal life" despite HSV infection.
That's crazy. Herpes can't be cured, so the implication of those ads can only be to "hide" the infection. Additionally, those antivirals aren't effective at preventing outbreaks unless you take them every day, which would be insane unless you are an unfortunate soul who is prone to constant outbreaks.
Note that doesn't include HSV (especially 2) which can be transmitted asymptomatically, and even with a condom. The medical establishment doesn't consider it a concern, but it's worth having both parties check.
Hep C isn't commonly sexually transmitted so it's odd they would test for it. It's more of a concern in certain occupations, like healthcare, where you may come into contact with blood.
Good for you! Could you share the name of that particular test here? I'm confident I'm clear but might want to include that test in case I need to in the future.
i think during that time / place it was risk based - if you didn't know your parent had it (or didn't tell your dr), and weren't an intravenous drug user, etc. its likely no one would have screened for it.
Interesting that it's just England (and not Scotland, Wales, or NI). I realize they all have independent NHSs, but still would assume a program like this would rolled out across all the constituent countries.
Each nation has different social and health issues, each nation makes its own plan.
All four nations NHSes work with a single charity, the Hep C Trust.
They're all following the WHO targets for elimination -- you're hearing about this now soon after World Hepatitis Day (July 28th, as conceived of by the WHO).
So it is less "England has a program and the others don't" and more that each NHS is pursuing the same WHO goal independently, with different reporting and timelines
I wouldn't have assumed this really because really the whole point of devolution is that they get to choose what to prioritise, so perhaps the other nations choose to do something they consider to be more pressing for their populations.
Sure but there's no real need for it in this case, or in the NHS in general I would say. It's probably just devolved because Scotland and Wales want everything to be devolved even if it makes no sense.
The Scottish NHS has always been a separate organisation, even before devolution, created under a separate Act of Parliament. It's just that it used to be answerable to the UK government (specifically to the Secretary of State for Scotland, rather than the Secretary of State for Health), and now it's answerable to the Scottish government.
Why it was done like that, I'm not sure, but I suspect it was a combination of Scotland having its own legal system and laws (guaranteed by the Acts of Union of 1707) and existing ministerial division of responsibility (where public health in Scotland fell within the purview of the Scottish Secretary, along with Scottish education and a bunch of other areas that had their own distinct Cabinet ministers for England and Wales).
And while the Welsh NHS was originally part of the same NHS as operated in England, control over the NHS in Wales passed from the Health Secretary to the Welsh Secretary with the creation of the Welsh Office in 1969, and then to the devolved Welsh government in 1999.
Northern Ireland already had devolution (or to be precise, home rule) when the NHS was created in 1948, and the Northern Irish equivalent -- the Health and Social Care service -- is a direct creation of the Parliament of Northern Ireland rather than of the UK Parliament.
I don't know if borders matter much in this case. It's approximately just as easy to travel to England from many other countries as it is to travel to England from the rest of the UK.
It is a lot harder to travel into England from outside of the United Kingdom than it is to travel from England to Scotland or Wales. For one, I do not need a passport to get on a train to Scotland. Nor do I need a visa.
But you most likely have a passport, and most (western/european) countries have "automatic" visas to the UK, so for the most part, training from London to Edinburgh isn't much easier than Paris to London. Sure there is no passport control, but UK passport control is typically just scan your passport's chip and look at a camera.
I work with people who actively chose to go to conference in Berlin instead of the UK due to visa issues. The passport control is a real issue one cannot just handwave away.
It's quicker to travel to London from Paris and Calais than it is from parts of Scotland. Even though much of the UK's infrastructure acts as a feeder into London. No, we don't need passports but some people in London seem to have the idea that it's just down the road from us, which it isn't.
If you want to get to Glasgow from Campbelltown it can take you as long as three hours for example, and that's before you hit the motorway. Trying to get from west Sutherland to London is worse. Trying to get there from the Hebrides or Northen Isles even more so.
The borders between Scotland, England, and Wales are effectively like state borders in the US. Unless you see a street sign, you wouldn't know you crossed it.
NI is physically on a different island, so requires a boat or plane ride.
And all of the UK (ignoring the territories and ex-colonies) is on islands. And require a valid passport, passing through customs/immigration checks, and either a plane, boat, or train ride.
Most of the Scottish border is fairly physically obvious, unlike Wales (although the Severn bridge is).
Tens of thousands of people live on islands other than Britain and Ireland. Much of Scotland is not even considered UK mainland by delivery firms, even major places such as Perth.
What? Perth isn't considered part of the mainland? How is that possible? My family is from Perthshire (Blairgowrie) and I've visited a bunch. It's definitely part of the island!!!
I can understand Lewis and Harris or the Shetlands (they're separate islands without bridge links), but Perth doesn't make much sense. And I would have assumed Skye was considered "mainland" as well, at least now that there's a bridge.
Some delivery firms don't consider substantial parts of mainland Scotland to be "UK mainland". They charge extra. That has been the case for some business deliveries and even flower deliveries for a while.
There was a controversy about Perth in this regard a while back. I'm not even talking about Blairgowrie or Dunkeld or outlying places but someone trying to get deliveries to an industrial estate within the city of Perth itself.
The way things are going, maybe only the Central Belt will get preferential delivery fees.
Some of them don't consider Perth to be part of mainland UK for delivery purposes. It is one of the major arguments against private parcel delivery... They'll either end up with poste restante in major cities or stop delivering to rural areas entirely. (Perth is one of the bigger places in Scotland after the four major cities and not even in the Highlands.)
Given that Great Britain is an island, it is still much easier to drive down the M6/A74(M) or take a hike around the Welsh borders than say, take a flight or swim.
It can be quicker to reach southern England from continental Europe than from Northern Ireland or many parts of Scotland. Or the Isle of Man (which I'm well aware is a Crown Dependency.)
The UK consists of a number of islands. We have hundreds in Scotland with tens of thousands of people living on the other ones. England and Wales have significant ones such as the Isle of Wight, Ynys Môn and Lindisfarne. The IOW has at least 100,000 on it.
Splitting hairs, but the public health bodies are separate from the National Health Services (so there exists Public Health England _and_ NHS England). Public health is slightly different to healthcare, but of course they work together.
Oddly, Public Health Scotland is part of NHS Scotland; but Public Health England is not part of NHS England, it's a parallel department.
Nah we are good - We have our problems (including our own version of your guy but he hasn't won yet and is currently running against a man with a bin on his head) but on the whole, nah we are good.
Well, then, we can offer you measles, instead. How's that? We're also working on bringing back polio and smallpox. Think of it as our contribution to FREEDOM!
Farage isn't quite the same and of course the situation is rather different.
The three jobs are divided up differently, though still between too few people. You have a Figurehead, the Head of State, which here is King Charles and in the US is Donald Trump. That's the part Trump most likes, you get free gold stuff, you're allowed to do whatever you please, everybody is supposed to suck up to you, hooray. Farage would not get that job.
Next you've got Executive leader. Trump doesn't enjoy this as much. People keep trying to blame him for the fact he's bad at it. He appointed people he saw on TV to run things, how is it his fault they're not brilliant? This would be half of Farage's job as Prime Minister and he likes being asked to account for his incompetence even less than Trump.
Finally Head of the Legislature, in the US this isn't Trump's job, Mike Johnson is in the House and John Thune in the Senate. Farage would get this job in full as the Prime Minister. Even before he resigned he was rarely actually in Westminster, it's boring and you need to be good at actual politics, so of course he's not there, he gets paid more to be somewhere else.
I also don't think Nigel can put together the numbers. Trump has Mike and John to try to make the numbers work, and Farage wouldn't have that. "My way or the highway" is what Farage would say, and that doesn't make the numbers work. That's how you lose a Confidence motion and you're back on your arse in six weeks.
[Edited to correct the Senate leader, mistake pointed out by ragnese below]
Good explanation. Just one correction: John Thune is the Senate majority leader (so, the "head" of the Senate). Steve Scalise is in the House and he's the head of the Republican party in the House, whereas Mike Johnson (who is also a Republican) is the House majority leader (so the head of the whole House, not just his party).
So, it's Mike Johnson for the House and John Thune for the Senate.
Seeing a 36% drop in mortality over a decade is huge progress, but it’s a good reminder that "elimination as a public health threat" still relies heavily on reaching hard to find, undiagnosed populations. The free home-testing push should help bridge that last gap.
I guess someone complained about memory safety and they intend to rewrite hepatitis in Rust.
Not everything has to be rewritten in Rust! Hepatitis is a virus, C is much better suited for that kind of project, Rust is for fungal diseases, not viruses.
There is a pretty striking contrast here with the infected blood scandal. The NHS went from being responsible for one of the worst hepatitis C transmission disasters in the country's history to potentially becoming one of the first health systems to eliminate the disease
Currently we have a measles outbreak in Brazil brought from the US, so everybody is getting vaccinated (even those who already were, like me) to try to stop the spreading and protect those who can’t get vaccinated.
Really would love for US social and media networks to get their shit together and stop spreading misinformation in the name of profit…
Strangely, anti-vax sentiment is surging in a lot of countries. Canada has higher rates of vaccine rejection than the United States in some categories, as one example.
It’s a strange global phenomenon and I don’t think there is one single root cause. MAGA/MAHA definitely jumped on to the anti-vax train as it became popular, but many forget that Trump presided over the rushing of the COVID vaccine into availability and production. He hasn’t done vaccination any favors in recent years, but I’m skeptical that the widespread rise of vaccine skepticism can be attributable to this administration alone.
I think there’s a bigger story about the cyclical nature of how the dangers of threats that previous generations faced is slowly lost over time, combined with the rise of contrarianism and conspiratorial thinking on social media.
Given the amount of cultural influence the USA has and the universal nature of the internet it seems likely to me that global anti-vax sentiment could have started with the USA.
I don't think the general public were as influenced by a paper in the Lancet as they were by other members of the public (and media) talking about that study.
The US is a global media and culture juggernaut, so by that token the US can be blamed for most trends. I don't think it's a worthwhile distinction.
Anti-vax culture was prominent in the UK, Australia, Canada, and many other countries at the same time. I'm not seeing any strong reason to blame the US as the root or solo cause.
That paper was followed by a sustained and purposeful PR campaign, by the author, who had an investment in a new vaccine type that only covered one disease, as he was trying to cast doubt on vaccinating multiple things at the same time as "too stressful on the body" or other bullshit.
This also involved, whether he pushed it or it was organic, the tabloid press of the UK.
Eventually this filtered back to the US, despite already being largely debunked and retracted, but that didn't matter to the early 2000s celebrities looking for whatever confirmation bias sources they could.
The histeria started in the UK, slowly crept over the atlantic to the US, and now has filtered back, all while it was based on absolute fraud and lies, the exact criticism all these morons insist applies to real scientists.
The modern anti-vaccine movement was nearly entirely started by a doctor fraudulently publishing fake science to make money. The supporters of course refuse to see that, because it would burst their bubble, so only their enemies can possibly be guilty of it.
Even the 12 or so parents involved in that fraudulent "study" cried foul, as he literally put words in their mouths and made up testimony from them to support his scheme. Actual autistic children continue to suffer from his bullshit, entirely made up illness.
> Andrew Jeremy Wakefield (born 3 September 1956[a]) is an English fraudster and anti-vaccine activist. Formerly a senior surgeon, he was struck off the British medical register in 2010 for "serious professional misconduct" due to his involvement in the fraudulent 1998 Lancet MMR autism report, (wikpedia)
Sadly debunking fraud doesn't seem to stop the misinfo on social media. "Vaccines cause autism!" gets more clicks than the truth and so you get JFK Jr.
The fraudulent Lancet paper gave "credibility" to the grifters and conspiracy theorists world wide.
But the King of Graft installing the halfwit RFK to run HHS is next level and I assume fellow grifters are making serious bank off this shit.
Reminder, the vengeful Orange also installed a climate change denier to run NOAA after he lost the election, who posted bogus claims on the official NOAA website which grifters used to give legitimacy to their bullshit.
Oh, banned him? Don't move too quickly, you might get dizzy.
Wakefield arguably assaulted his patients (most of whom were children, IIRC) when conducting his research. What do you do with people who arguably assaulted someone? You get the Crown to make that argument. Why didn't that happen?
Also worth noting: according to the logic upon which the British system of government is based, no lesser a party than God Himself put a major believer in homeopathy on the throne of the United Kingdom of Great Britain and Northern Ireland.
I'd love to see Wakefield go to jail for fraud, nor am I a fan of Charles even if he's on my passport. But Charles doesn't set UK health policy, or UK policy at all.
> I'd love to see Wakefield go to jail for fraud, nor am I a fan of Charles even if he's on my passport. But Charles doesn't set UK health policy, or UK policy at all.
You're correct. He lives off the civil list and lets his nonce brother crash at a luxury home. But someone else does set UK health policy, and someone else does prosecute crimes, and since that's the case, then why didn't someone else in the UK with the ability to charge him do so?
If that happens, there is no adherent in charge of the DHHS. There are no kids dying of easily-preventable diseases in the UK, US, or anywhere else. Just a quack sitting in a jail cell.
> I've little ability to impact the British criminal justice system, though
Probably more on a per-capita basis than Americans have impact on what DHHS does, though. Especially if it became something focused on by the British public. Which, strangely, it hasn't. Not since 2010 when he was struck off.
> I'll still take "no longer a doctor" over "gets to set American health policy".
You really should aim higher. The man performed colonoscopies and biopsies on autistic children to support a scientific fraud with the hopes of becoming wealthy off of it. In other words, at the very least, he committed battery on disabled kids. That should earn more than getting struck off after twelve years. It should earn prison. It's purely on the British government that it hasn't. And since doing that would have prevented his scientific fraud from reaching the heights it is at now, modern antivax can be pinned on the UK and the lack of action from His Majesty's government.
There is some evidence that anti-vac activism was one of the key topics pushed by foreign influence campaigns at several points. I think the simple explanation is that they pushed any topic which could be used for political divisiveness and unrest, but fomenting anti-vac sentiment is especially damaging due to the physical harms it causes.
Looking at global population stats, you can clearly see where germ theory and vaccines entered human civilization.
All this "natural something" and antivax movement certainly is the other direction. Maybe it's subconscious population control, maybe informational warfare... maybe people just got a little detached from reality by not dying all the time, as you suggested.
I just looked it up and anti-vax arguments predate actual vaccines - they were used for variolation which was similar:
>in a 1722 sermon entitled "The Dangerous and Sinful Practice of Inoculation", the English theologian Reverend Edmund Massey argued that diseases are sent by God to punish sin and that any attempt to prevent smallpox via inoculation is a "diabolical operation"
> There followed a 100-year battle between the authorities and an often sceptical, sometimes aggressive, public. In Britain, a succession of laws made vaccinations free, then compulsory - backed by fines and even imprisonment. While riots flared in some towns, there was also more restrained opposition in the form of anti-vaccination leagues. For an increasingly literate population, pamphlets were produced with titles like "Vaccination: its fallacies and evils", "Vaccination, a Curse" and the suitably Gothic "Horrors of Vaccination".
I am very prepared to get downvoted for bringing this up - but I'm not convinced that the "anti-vax movement" most people think of is truly to blame (that is, crazy people who think it gives you autism or whatever).
At least in my area, there are pockets of (relatively) new immigrants that have MMR vaccination rates at around 30% (that's very low, much lower than the anti-vaxxer population could account for imo), and the reasons for that have nothing to do with MAGA/MAHA as far as I can tell.
It's an entirely different problem (that needs solving), and pretending that this is simply the by-product of uneducated crazies on the internet feels like it's over indexing on a loud and flashy but ultimately small part of the problem.
Before MAGA I'd heard of granola moms, the same people who think that amber helps their kid with teething, were very against vaccinating their kids as well. So it's a wide swath of people who are just oblivious to the benefits of vaccination. It's a reason that they have vaccine schedules to begin with.
the data is quite slow to be released so i haven't updated my charts for a bit but britain saw a decent spike in HIV / AIDS because of the migratory flows under boris johnson. In large part because we don't test on the basis that it's considered racist (I went looking for discourse on testing on entry or not - first article that came up was from the graun, first words "Nigel Farage").
I gotta be honest, I don't really think these immigrant groups see or care what Trump/RFK are saying. If anything they see them as an "enemy" who they should not trust.. This is an incredibly left-leaning city where the majority of public health information (or any other messaging) being disseminated is counter to what the current federal admin is saying (as a rule, it seems).
So to answer your question, I don't personally think it helps or hurts in any significant amount relative to other cultural drivers.
I don't think it was the roll-out or anything along those lines, so much as the lying. Saying people won't get sick or won't catch COVID if they get the vaccines [1] was just false and very myopic. Obviously the intent was to try to get people to take the shots, but they completely destroyed trust in the process. Broader skepticism predictably follows from there.
They are not the progenitors of the skepticism, but they gave the skeptics significantly more authority than they previously had. Over surveillance networks, vaccine scheduling, public health comms, etc. MAGA sees them as useful idiots for the coalition, rather than threats to the US.
Here [1] is a montage of some of the public messaging around the COVID vaccines. [1] It was quite simply dishonest. That, paired alongside the effort to force people to take the shots, completely destroyed public trust on a level that will take many decades to repair. Generalized vaccine skepticism follows naturally from that.
I'm certainly a part of that group. For instance I ended up doing extensive research on e.g. MMR before deciding to vaccinate my kids for it. If this were a decade ago, I almost certainly would have done it without a second thought, just as I took all recommended vaccines before traveling without a second thought. So I'm obviously not anti-vaccine in the least, but I no longer trust public messaging on the topic.
It was just another (of the increasingly endless) examples of governments/companies pursuing short-term interests while ignoring long-term consequences. When it comes to what people put in their bodies, trust is more important than literally anything else.
Why is it bad for a public health communicator to say that vaccines stop spread by lowering the effective reproduction number of a pathogen? Its correct. Your extensive research didn't seem to work.
But this has been building for years ahead of COVID. COVID just gave people something to latch on to. And in spite of COVID vaccine issues, the latest numbers i saw suggest around 80% of people still support standard childhood vaccinations.
The media has been referencing this for years now, but the data don't show that there was any meaningful effect on a national level. Here [1] are CDC data on various childhood vaccines. Childhood DTP/MMR vaccination rates varied very little over the past 15 years and never fell below 94%. They actually hit a record high in 2019 right before COVID - of about 95% each. Now they're both at record lows (around 92%) and continuing to trend lower.
I'm not a trump fan, but the antivax train has nothing to do with him. (Evidence: Canada is doing even worse then us when it comes to measles). If we want to fix this problem (we do), the first step is to recognize the actual problem, not to play the blame game on whichever politician you currently don't like!
The reason there are measles cases is because a decent percentage of people aren't getting vaccinated anymore. If all of the cases were 2 year olds or younger (when RFK was put in charge) then possibly. But not only are they older (https://www.cdc.gov/measles/data-research/index.html), this is also happening in Canada. I don't see how it could possibly be RFK's fault.
True, but RFK (and other politicians and celebrities) have been active in pushing some form of anti-vax ideology for a decade plus, in some cases back to the 1970s.
It's been a growing movement, not something that kicked off when RFK assumed the HHS role.
I agree. But to be clear the original comment / context is about MAGA / Trump. I think responding 'No, you're wrong! RFK is the reason' to a thread about Trump and then retreating to RFK's activities over the last 20 years is arguing in bad faith.
The entire reason I made my original comment is because it's important to recognize that this is not a Trump thing, and getting rid of Trump / MAGA will not suddenly convince people that vaccines are good.
It's not _solely_ a Trump thing, but he gave RFK an enormous platform and has himself been espousing demonstrably untrue things about vaccines and vaccination schedules. This very week, in fact. [1]
If you don't see this as an enormous amplification, I don't think you're operating in good faith.
Pre-Trump, anti-vaxxers were notorious left-wing granola types. Lots of anti-vaxxers were white liberals living in Marin and NorCal and sending their children to private schools like Waldorf.
Only after Trump did people start lumping them in with right wing.
While It’s fair to point out that RFK is hopping on a train that’s already got momentum, your first comment reads as if it’s not caused by falling vaccination rates (your second comment clarified further).
Also why not blame politicians doing the wrong thing?
Perhaps I should've been clearer. And yes they aren't helping.
And yes, we should blame them for the things they do. T
But the comment I was responding to was acting as if MAGA was the reason for measles outbreaks, which is false. I'm an incredibly strong believer in the truth. An example of why I think this is an important separation: imagine you tried to fix the measles outbreak and miraculously got every single American to hate Trump and got Trump out of office. The problem would still not be fixed! People would still be dying of measles! The effort would have been almost completely wasted!
A major campaign by RFK's replacement could absolutely make a significant difference stopping the spread of measles. That's the whole point of the (proven extremely effective!) vaccine.
Do you believe this? I think it might help a little, but so we're on the same page RFK has only been in charge for 2 years. Why wasn't the previous secretary of health doing this? The measles outbreaks may be relatively new but we've had the vaccination data to see it coming for over a decade.
My personal belief is that there a lot of people who believe stupid things out there (and it's all only amplified by the news and social media), and for anti vaxxers especially I don't think an authority figure saying 'You have to get the measles vaccine!' is going to help much, unfortunate as it is. :(
Inaction (and really, let's be clear - making it worse) is RFK's choice.
We managed to cut the smoking rate pretty dramatically, including in about half over the last decade. Public policy is not ineffective, we just need competent people to wield it.
I think we live in a different age man. Media nowadays is completely different. Example: I have literally never had cable tv in my house. I've probably watched cable TV around 10 times total, all in a hotel room growing up. My media is all online, uncontrolled and (relatively) decentralized. Contrast that with 60 years ago and hopefully you see the difference.
Also smoking smells and has other negative externalities, which doesn't hurt.
I don't think it would be logistically that hard to criminalize the parents or take away their kids in those cases. It would have a lot of other downsides but it would probably reduce the rate pretty directly.
Ok if you want to do this then sure there is an easy solution. I think there are other problems with this though (for example no way this is flying even with the majority of people who are not anti-vax).
I'll bet it would be enough just to make sure that the vaccine waiver signature box is positioned directly below some glossy full color pictures of emaciated, rash covered dead children.
Unlike a lot of pathogenic diseases, measles requires an extraordinarily high amount of herd immunity (upwards of 95%), so this isn't a particularly telling data point on its own.
RFK Jr has been pushing anti-vaccine bullshit for decades. He was already taking defensive stances on his activism (Oh, I'm not anti-vaccine, I'm just providing nonsense arguments and clout for anti-vaccine stances) back in 2015.
Kennedy was already pushing bullshit during the UK Measles vaccine fraud/scare, back in 2005. He was doing this along with a few other celebrities.
I've responded to a few people on this but the comment I was responding to was literally about the last 6 years! The context of this entire thread is about MAGA / Trump! I agree that RFK is hurting and has been for a long time, but that is not what this argument is about!
Most of his criticisms have been about the timing of certain vaccines administrations.
He's not anti vax.
If nobody can challenge science, then it's not science.
Vaccines continues to help us, but that doesn't mean they are perfect and don't cause side effects on certain individuals. Hopefuly the future brings us highly personalized medicine instead of a 1 size fits all.
Claiming RFK is not anti-vax, is like claiming Dario is not anti-open-weights.
(Well, it's way worse that that, but I didn't want to invoke Godwin's law.)
He is not "challenging science" with measured arguments and carefully controlled peer-reviewed research to back his claims. He's deliberately trying to silence science because of a completely unsupported brain fart.
And no, it's not about "timing". It's about spreading baseless FUD to discourage any form of vaccination, because he believes (with no actual evidence, and despite vast amounts of research to the contrary) that vaccination causes autism.
I mean would you let your non coding coke head brainwormed manager challenge your coding choices? He is not a doctor or scientist, why would we listen to him. And any experts relying on using are horse dewormer grifters or worse.
He knows he can't push his base too hard on certain things. He probably knows this about vaccines, he lauds Operation Warp Speed but as a win of his not a vaccine that could have saved millions more with his cooperation. He chooses his power over what's best for all of us. He's the leader of the antivax train by choice.
"The order recommends that all shots be given at separate medical visits, a frequent point Trump has made despite the safety, ease and lower costs of giving vaccines together."
'“Together, there could be a possibility they’re quite lethal,” Trump said of the MMR vaccine at the signing of the order on Monday.'
'Asked if he had evidence that the combined MMR vaccine was “lethal”, Trump said: “No. What I’ve heard is that there are some people who say it is that way.”'
Antivax fundamentally has its contemporary roots in Andrew Wakefield's fraudulent anti-MMR campaign.
So directing by executive order and by his own admission without evidence that the MMR vaccine be split up into separate shots is, very clearly, an antivax action. This is the first victory that Wakefield (a man who had a patent on a single measles vaccine!) wanted, and RFK Jr was pursuing.
But this is Trump saying this and signing it. So as of yesterday, it now has everything to do with Trump, sorry. He has handed the anti-MMR movement its ultimate victory and in so doing validated the entire antivax worldview.
See my other responses. Obviously this is bad. But the current measles outbreak is a symptom of a problem that's been happening over the last 1 or 2 decades. It literally CANNOT be caused by this, neither in the US or Canada.
It's still not too late for anyone who is unvaccinated to get the vaccine! Hopefully the next administration undoes this change, but the really important part is managing to shrink the anti-vax movement (which, if you look at the data in my other comments, you can see has been a problem since before Trump).
FWIW I think Trump #1 (45) wasn't an anti-vax presidency; it might have been suspicious of healthcare professionals (for the good reason that so many people know opioid epidemic victims) and he was always a bit equivocal around hydroxychloroquine and bleach and "powerful light inside the body" but Trump didn't start to lean antivax until not long after Biden took over.
(And let's be clear: Operation Warp Speed was an enormous success even if Trump is an ignoramus)
Some of that might have been expediency — Biden was catching shit from the antivax and healthcare-skeptical movement and moving in on that would be easy — but Trump has always been vulnerable to being influenced by people and RFK Jr appears to be generally so much more persuasive than bears thinking about, so he was a factor later on.
Trump #2 (47) is fully an anti-vax presidency; even Hegseth backed away from flu vaccine mandates, only to have an outbreak in an Army (IIRC?) facility.
They have 10% our population and had twice the cases last year (admittedly, we're starting to catch up). But the truth is that there are huge lag times when it comes to measles / antivax. This is a symptom of a problem that started 10-20 years ago.
RFK and his anti-vax ideas are popular only within a small fringe of the American population. Enough to drop herd immunity to the point where we now have to worry about measles again, but it's far from the majority.
See my other responses. Do you really think RFK could possibly have had an effect on vaccinations over the last 2 decades in the US OR Canada?
Since you seem very emotionally opposed to Trump and his administration: I also don't like Trump or RFK! However, to solve a problem, you have to find the root cause of the problem, and pointing at the most recent politician you hate will never help anyone.
It has a lot to do with him. He doesn't actually have an opinion on any policy issue. For various political reasons, Trump decided to let RFK dictate public health policy according to his extremely delusional ideas. Yes, there was an antivax movement in this country for many years, just as there has been misogyny, racism, and transphobia. Trump has normalized and supercharged all of these moronic and dangerous ideas.
I have not been following measles in Canada, so I can't address that.
See my other comments; it is not possible for RFK to have had any effect on this outbreak. If everyone getting measles was 2 or under, it could be possible; they aren't.
The reason I bring up Canada is as counterevidence; if it was Trump or RFK'S fault, Canada should be doing just fine. They had twice the cases last year in 1/10 the population. The truth is this is a problem with people believing stupid things, and it's going to take a lot more than Trump going out of office to fix.
Trump is trying to hang Fauci. That goes in the completely opposite direction of promoting the trust of medical institutions in general society, and it's trust that will get people back to vaccinating themselves and their children.
He is amplifying the issue, but you're right, Trump is a symptom of the underlying problem. The problem is that internet gave these idiots a platform to mislead people.
Back in the early 90s this wasn't much of a problem. Childhood vaccine requirements weren't some hot-button topic then. Most people would just get them when faced with the requirement. Most opposition was isolated to people who were otherwise contrarians already.
The difference now is that the internet is full of these isolated contrarians who are now influencing gullible people who don't know who to trust.
Neither phones, nor email, not even usenet had this impact. Social media did.
The problem is not with the technology but those that control it. (Some would probably say, the fact that any one actor controls it in the first place.)
Our only means of communication in modern society are a few advertising platforms in hands of even fewer owners, and the engineers hired to run it are busy engagementmaxxing.
I'm blaming the current social media landscape, which amplifies ideas based on the engagement they create, which has an unintended consequence of amplifying exciting controversial falsehoods over long-held boring truths. We have given the largest megaphones to the biggest village idiots.
Completely agree! I will add though: this is a symptom of a problem that started 10-20 years ago. There's a lot of lag time between parents not giving their babies vaccines and outbreaks actually happening. You can see ages here.(https://www.cdc.gov/measles/data-research/index.html) 5 and under are only 20% of cases.
More like 25+ years ago. In the early 2000s you saw a lot of celebrities pushing vaccine fear because they read some book version of "doctors don't want you to know this one wierd fact" that made the best-seller list or another. I remember people arguing about it in college classes, and I graduated in 2003.
"has nothing to do with it" is not the same as "is not the cause of". Trump and antivax definitely are related as both are symptoms of the same public strategy that spreads misinformation, polarizes discourse and weaponizes stupidity.
>> Canada is doing even worse then us when it comes to measles
Not in Canada but unfortunately US nonsense spreads globally pretty quickly these days. The amount of Trump support in the UK is both bizarre and surprising. When someone with the worlds largest megaphone lies about vaccines, unfortunately people everywhere listen.
Right, because tapping one of the world's biggest vaccine truthers to run the Department of HHS and then proceed to link autism with vaccines and change the recommended MMR vaccine scheduling for children has absolutely no impact on anyone.
He was literally spreading FUD about vaccines today. And the measles stuff has got so bad RFK had to mildy backtrack on his previous antivax statements in recent interviews.
From today:
Both Trump and Kennedy made repeated mentions of autism throughout the order signing, emphasizing a scientifically unproven link between vaccines and the condition. Dozens of studies show no link between the two.
“Today we’re proud to officially announce the United States of America’s gold standard childhood vaccination recommendations. That has to do with many subjects including autism in particular,” Trump said at the beginning of the order signing.
“I’ve seen proof of it, where they have a vaccination where it looks like the size of a bottle of soda, poured into a little child’s body and bad things happen in too many cases,” Trump later said on breaking up each shot into an individual medical visit, before adding: “This is an explosion, it’s an epidemic,” in an apparent reference to autism.
>I'm not a trump fan, but the antivax train has nothing to do with him.
Well not nothing. But it predates him and he adopted the movement early in his political career. When I was in high school (2004-8) antivax sentiment was generally associated with liberal Democrats in places like Marin County. This was a favorite retort of conservatives when confronted with their own backwardness on scientific understanding of evolution and climate change. In 2015 Trump began courting the anti-vaccine crowd and the political valence of that flavor of woo-woo nonsense flipped seemingly overnight. It was surreal to see it happen in real time. By 2020 he had lost control of the monster he helped create and the crowd booed him when he said they should get the Covid vaccine.
I've always found it a bit surprising that we don't all celebrate smallpox elimination day. I think it'd be a great reminder of the victories that humanity has had against the four horsemen.
I got really sad reading Good Omens where Pestilence has retired because of all the progress of medical science and thinking "if only". Funny enough, Pratchett has Famine doing exactly what's working for Pestilence today, convincing people to make bad choices despite easy ways to avoid the horsemen's influence.
Just a guess: Ratio of positive results out of previously unknown cases gives a good estimate of the total expected unknown cases. Precision depends on selection bias, and statistics has tools to estimate and/or improve it.
Perhaps raw statistics, or estimates based on measuring traces in wastewater. I know that in the U.S. during covid they traced some new viral strains using that method.
> The target of treating 80% of all known cases has already been met, and deaths from the virus have fallen by 36% in the last decade, just short of what is needed by 2030.
What is needed by 2030? There is no mention prior to this statement.
Later:
> NHS England says that since 2015, more than 100,000 people have been diagnosed and treated for hepatitis C, meaning the country is already meeting that target.
Again, what target are we talking about??
Much later:
> Prof Frankie Swords, NHS national medical director, added: "England is now leading the world in the mission to eliminate this disease and on course to beat the WHO's 2030 target, but we are determined to keep up the momentum and finish the job.
I think you are partially correct. They trained AI on their articles to produce the same style articles. I am not a large consumer of BBC articles. This style of snippet after snippet is annoying. Perhaps that is why I am not a large consumer of BBC articles.
> Style Assist helps BBC journalists quickly adapt trusted content into BBC News house style, speeding up the publication of high-quality local stories. It uses a BBC-trained AI model to generate a draft, which is always reviewed and edited by journalists before publication. This helps save time while maintaining accuracy, tone and editorial standards. Find out more in an article from Rhodri Talfan Davies.
Style Assist is mainly for articles written by journalists that are employed by third-party news organisations (who own the UK's local news outlets) but are subsidised by the BBC - these people are "local democracy reporters".
LDRS articles are made free to everyone in the scheme (including the BBC), but because the content is written primarily for their home news org the articles that end up being published by the BBC need to be modified to comply with the BBC's editorial guidelines and for style reasons.
And I'll add that whether the style guide or the journalists, BBC articles tend to be like this: constantly saying sentences without giving the full context needed to understand them. This is why as a right wing person I tend to read The Guardian (famously left wing) instead of the BBC, because their articles just read better.
It's not AI the BBC is just that bad at news. Serious read anything by them at it's like they hate real information and just want random ass quotes from people.
the other side of this is the science behind the NS5B protein and the meds behind the new hep c cures. This is pretty fascinating stuff. In medicine, it's not often we see a cure like this.
What do you mean by this? The article quotes an NHS director backing up the statement in the title.
> England is now leading the world in the mission to eliminate this disease and on course to beat the WHO's 2030 target, but we are determined to keep up the momentum and finish the job.
There's also a difference between treatment and cure but we call it all a "vaccine" now (I prefer the transitional OED definition from pre 2019). We've already entered 1984s use of good speak especially around healthcare.
Just to understand this: When someone says "country England", do they mean "country" like in "nation", considering England a separate nation, or is it a lapse and they mean UK? Is England usually referred to as a country, or just part of a country?
I usually think of a country as equal to a nation, and as far as I know, Wales and Scotland have not split off yet? Is the term "country" not actually that sharply defined?
EDIT: Thanks people, I just asked a question to better understand the terminology, you know ...
In this case it's health related and each of the countries in the UK have their own National Health Services (or Health and Social Care in NI). It's not a lapse here.
I don't understand. It's an article about England. They only have information to hand about England, from the authority tasked with dealing with health in England.
If I read an article from them about crime in London, quoting the Metropolitan Police, I don't immediately think that they don't care about, say, the West Midlands.
The mistake they made is to directly say "one of the first countries" in the article title, which immediately implies a comparison to foreign countries. But clearly, since they're talking about England, which is a subdivision of the UK, why aren't they comparing this achievement to equivalent subdivisions, such as states or provinces, in other nations instead? This isn't a direct comparison (which might also make it an unfair one), so it makes sense why people would misread them by assuming that this is an error and that they meant to compare equivalents.
The BBC do use a consistent naming scheme, you're just not understanding the scheme. Scotland has their own devolved NHS, and track their own health statistics. Scotland not being mentioned is because the Hepatitis C Trust were talking about England's Hep C numbers, it wasn't an intentional slight on Scotland.
Confusingly the proper term for England, Scotland, Wales, and NI is country individually, the UK is a country of countries. They should probably be called states but they never have been, I'd pretty much always assume when someone says England to become the first country... that they mean England exclusively.
The bit that gets me is that people often refer to the UK but actually mean GB or vice versa.
"England" is meant because that's the scope of the health service "NHS England" (1)
> That would insinuate they don't care about Scotland though.
You forgot the other states of the United Kingdom: Wales and Northern Ireland. But I disagree, it says nothing at all about Scotland - this seems like the "I like pancakes!" "So you hate waffles?" faulty reasoning. (2)
If you disagree, why don't you care about Wales? /s
When I've heard the distinction (often in a historical context), 'nation' is usually meant to mean a set of people in a place with some sense of collective identity or origin, while 'state' is the governing body which has a monopoly on the legitimate use of violence within well defined borders. When these overlap the result is a nation-state, but they don't always line up so nearly. Using those definitions England, Wales, and Scotland are nations. Ireland (including northern Ireland) could also be called a nation (though, of course, as should be obvious by the fact that this does not line up with the borders of the state, this is a contentious topic). The United Kingdom is the state (and of course Ireland-minus-northern-ireland is also a state). 'Country' as a term generally doesn't imply either of these (it's just a name for some chunk of land, notionally), though it's often synonymous with the nation-state when the borders all actually line up neatly, as opposed to in the UK.
England, Wales, Scotland, and Northern Ireland are constituent countries in a larger country called the United Kingdom. When dealing with international affairs, you typically want to be talking about the UK (unless the subject is sport), as that is the sovereign state. But for domestic affairs, it’s often split in ways that are confusing if you don’t understand various bits of history stretching back about a thousand years.
For instance, England and Wales share a legal system, but Scotland and Northern Ireland have their own. There’s bunch of special things about Northern Ireland and its relation to Ireland. And all of the constituent countries have their own parliament / assembly except for England (the parliament in London is for the whole of the UK where MPs for all constituent countries can vote).
In this particular case, the constituent countries have their own health systems, so it’s normally England we would be talking about, not the UK.
1) Most Commonwealth countries are republics, not monarchies.
2) The monarchies in the Commonwealth countries are ruled by different crowns; but, for historical reasons, most of those crowns are worn by the same physical head. (But not all of them. The King of Malaysia is a different natural person from the King of the UK, for example.)
Yeah England is a country. Like what else do we have the name “England” for? We talk a lot more about England than some non-country geography like Anatolia (Asian Turkey). For example there was no UK in the World Cup, but England made it quite far.
If that’s a bit eccentric, well this is the same place that refers to Europe as a different place even though France borders the UK by automobile road.
OK, so now we have the following terms: State, nation, country, sovereign country.
For example in Germany one would say there are 16 states, but one wouldn't say that there are 16 countries. Never heard anyone claim that. So state seems to be different from country, at least here. Would people in the UK say that Scotland or Wales are "nations"? Or is at least that term very clearly only for units that could participate under a flag in lets say the olympics? (I assume here, that Scotland and Wales are not separately competing, but are under UK flag.)
"And by 'country' we mean a sovereign state that is a member of the UN in its own right" to quote the famous UK Quiz Show "Pointless".
Team GB enters the Olympics but as you may have noticed it was England who came Third in the World Cup recently, and likewise England play international rugby, including against Wales and Scotland.
That's a citizenship thing though right? The Republic is of the opinion that everybody on Ireland† is a citizen of the Republic. If my mother had happened to be in Portavogie when she gave birth to me last century, my understanding is that the RoI considers I am automatically a citizen, because I was born on "their" island even if certainly Portavogie is not under their control.
† The exact rules are complicated, but they don't depend on where on the island you were born or stuff like that.
I don't think so. My understanding was "confirmed" by ChatGPT, though I haven't looked at the sources.
> Rugby in Ireland is governed by the Irish Rugby Football Union (IRFU), which was established in 1879, decades before Ireland was partitioned in 1921. It has always organised rugby on an all-Ireland basis.
The "Länder" in Bundesländer is plural of Land, which is the same land as in "land of the free" and would be translated to "nation", "land", "country" or "state" depending on context.
So in modern English they may be states, but there sure is a lot of overlap between "country" and "state".
"State" has lots of meanings depending on context, as it can also refer to the highest level of governments for example: State actors or "head of state". In the U.S., the head of state refers to the President, not to governors in individual states, typically.
The UK, crown dependencies and overseas territories compete as Great Britain in the Olympics rather than the UK. Northern Irish folks can compete for Ireland or GB.
As an English person I would say that Scotland and Wales are nations and countries; constituent countries of the country that is the UK.
Until today I didn't consider, that countries can be compound/consist of countries. That countries can be recursive. I always thought, that any lower level would be called differently. TIL.
People in the UK would refer to England as a country and most people would actually be confused if you referred to the UK as a country, even though it technically is. People in England don’t really think of the UK as anything other than “the UK”. People from Scotland, Wales, and Ireland have more nuanced takes.
I'm English and I don't think England or Scotland or Wales are countries. People get confused because of football and rugby. They're nations. The country is the United Kingdom.
England, Scotland, Wales and Northern Ireland are constituent countries of the United Kingdom. The United Kingdom is also a country. You can disagree, but you're disagreeing with the government and the international community.
The UK seems fairly relaxed about constituent parts leaving (Scotland was given a referendum, NI has option to leave if they want) - which I don't believe applies to US states?
Relaxed is not the word at all. Northern Ireland is a powderkeg and the UK government has known that for decades.
The Scottish referendum did not use neutral international observers, and had extremely biased coverage by state media. The BBC itself even tried to stir up forms of violent unionism. (Look up the so called "passionate Highlander", a drunken loyalist type who talked about defending the union to the death "in the name of Jesus Christ".)
Well, I'm an independence supporting Scot and I don't have any concerns about the actual running of the referendum - I do agree that the BBC coverage was biased but I think that is largely because they are "conservative" (note the small C) in the sense of having a bias towards preserving the status-quo. This was pretty clear from the Brexit referendum where I thought they favoured the status-quo there and, as a Remainer, I guess I was pretty happy with that!
The BBC is institutionally biased because they stand to lose 10% of their licence fee. I have heard they received some EU funding, but from their POV they probably made some money from exporting programming within the common market. I voted Remain myself although I do have some misgivings about the EU. (I recently debated an American online who thought the BBC's current panic about licence fees was to do with USAID. Not even close. Although British TV has been swamped with US imports.)
"The 45" has a resonance in Scottish history and it is a bit of a coincidence the Yes vote was stuck at that rather than 47 or 44.
Having neutral international observers was a no brainer, but the SNP often seems to trust the system they're trying to break up much more than it should.
Scotland, Wales, and NI have their own parliaments at least, so from a constitutional perspective one could argue England is not a country but a state, but that is only one narrow definition.
I am glad they’re screening for it. I was born to someone who had the virus, but didn’t know I had Hep C myself until I submitted myself to an exceptionally thorough STI testing panel. I say exceptional, because the standard ones I’d done throughout college and early adulthood do not happen to include that particular test. So I feel a bit lucky to have been able to get diagnosed and treated in my mid-20s, before the disease could do much damage.
A disease that can stay silent for years, but is also highly curable once detected, seems like exactly the thing you want to screen for more aggressively
That's odd. I just looked at what I thought was a pretty standard piss and blood STI test results of my own, and it covered:
- Syphilis
- Hep B
- Hep C
- HIV 1 and 2 and P24
- Chlamydia
- Gonorrhoea
I forgot to mention my experience was in the northeastern USA in the 2000s-2010s. I’m happy you got a better standard of care than I did!
Hep C screening at least once for adults >= 18 is recommended and considered standard of care in the United States. I checked my medical records and I have a negative Hep C result in an old checkup when I was younger, and another one from a new provider who insisted on a big panel of standard testing for new patients (despite me having no risk factors).
It’s unfortunate that your early providers dropped the ball. I wonder if they assumed you had already been tested for some reason?
Crazy how different healthcare is in different countries.
In the UK once you've had your childhood vaccinations it's entirely possible you'd simply never see a doctor again in your life until you're ready for your prostate exam in older life.
There are no regular checkups or preventative care on the NHS for mid life adults unless you're proactive
I presume you're not a woman, because there's cervical screening for women aged 25-64 every five years. Also depends on what you mean by "mid life", but there's breast screening offered to women aged 50-70 and bowel cancer screening offered to people from 50 to 74 every two years.
There are real trade-offs with screening, and screening too much has harms as well as too little, although I'm not qualified to make a judgement on where that line sits relative to where it is in the UK.
This is the real reason women live longer than men.
Doctors won't see me unless I'm dying, or at least tell them I am. And I am, if I understand things correctly, which I might not tbh, in a high risk group for prostate cancer, given that I was diagnosed with chronic prostatitis at 22. I've even asked for checkups but was denied. And where I live you can't really pay for health care (but you can pay to skip the line, which I guess is almost the same thing).
What country are you in? Not challenging, I'm gathering perspective.
I am in the US with health insurance through my employer and I get blood tests every 6-12 months to check for abnormalities as well as a standard interview for how I'm feeling and whatnot. Also have a few prescriptions that require 3-month checkins.
Sweden. Our system is pretty good at emergency care, but absolutely abysmal at preventive care, imo.
The Netherlands seems to be more or less similar, although I’ve had a mixed bag with medical knowledge an experience during emergency care: excellent to middling.
When I lived for a while in the UK, my GP strongly suggested close monitoring for a couple of things, and we saw improvements in some measures with lifestyle changes. Others were “we’ll keep an eye on it, if it gets bad, off you go for an inpatient visit to get you an extra 10 good years”.
Back in the Netherlands I have to get pushy and even a bit obnoxious at my GP before they even consider the concern, let alone schedule a blood test.
The HPV vaccination eliminates most forms of cervical cancer. Australia reports a 95% drop in cervical cancer in the cohorts that got mandatory widespread HPV vaccinations. I didn't look into how that changed pap smears.
I don't want to pile into the - this is not true.
But it's not true. We get regular bowel cancer screening - you get it every 2 years once you hit 50 - https://www.nhs.uk/tests-and-treatments/bowel-cancer-screeni...
And there are also regular health checks available once you hit 40 - https://www.nhs.uk/tests-and-treatments/nhs-health-check/
From a US perspective, even this seems wild to me. I've always been told that at least an annual physical exam with bloodwork is highly recommended as the standard of care for adults of all ages.
Not everyone chooses to get them, of course. But ACA insurance plans here offer at least one annual physical exam free of charge (considered preventative care).
Cynically - this sounds like an opportunity to sell you more medical care.
The NHS isn't perfect, but one of the things it does well because of it's structure is minimise costs holistically. It's cheaper to treat conditions early, so usually implements appropriate screening to catch things. If they don't do regular checkups like this it's because they're of minimal value.
There’s a decent amount of public health research that suggests that annual physical exams don’t actually have a large impact on health.
In the US case specifically, I always wonder how much of the benefit is just “here’s a free appointment with a doctor once a year”.
It's not free. If you bring anything up, you will be charged. I know because I've paid hundreds of dollars for "free" physicals that way.
It's free if you don't bring up things that should technically have been a dedicated own appointment.
The idea behind physicals is they're considered preventative care... catching problems early, often before there's any overt symptoms. For example, checking your cholesterol and A1c levels before they progress to heart failure or diabetes.
Once you're showing symptoms, you've left the realm of preventative care and it's now diagnostic/treatment for a established issue.
(ACA only provides 100% free coverage for visits that are 100% within the "preventative care" box.)
Annual exams were included in the ACA but as I understand it there is no evidence to show that they improve health outcomes. I had one once in 15 years when it was incentivised by my employer (presumably trying to show that we were low risk to reduce the rates they paid?) but otherwise my doctor has never tried to book me for one.
I think I'd prefer the UK system where if you worry something is wrong you can see a doctor free of charge.
Anecdotally, I've found yearly physicals with full blood workup very helpful in heading off issues before they become much larger issues. For example, a random blood marker pointed at mold exposure. I thought that was strange, I didn't think we had any mold. Then I tore open one of my ceilings, there was a very slow leak in the bathroom above the top of that drywall was covered in mold. I replaced all of that drywall, and that blood marker shot down, and a few others improved drastically, and my energy levels improved. By going regularly, you get to see the trend lines on various things - those other markers had been going in a worrying direction over time.
Do you happen to recall, which blood marker this was? In my living situation, mold might be an issue, but it seems to be hard to actually test for it.
I wonder how accurate that is. As in, these screenings are meant to detect early signs of issues like diabetes, liver problems, cholesterol, blood pressure, and so on. Is the case that many people are healthy and don't need it? That we haven't had a long enough sample time to know how screening in the 30s affects outcomes in the 60s?
That tends to be part of the regular health checkup.
I think that there's a working assumption amongst US folk that because the NHS is is publicly funded, it must be terrible.
Actually, I would've have assumed the other way - that the NHS was better than the US system. Which was why I was shocked when you said health checkups aren't allowed before age 40. :)
US healthcare plans offer an annual physical exam every year at all ages. Looking at the UK NHS website, it seems to be only offered there after age 40, and limited to once every 5 years? Am I reading that right?
> Actually, I would've have assumed the other way - that the NHS was better than the US system.
I thought it was relatively uncontroversial that the major problem with US healthcare is not quality but cost. And the UK NHS is widely regarded as one of the lower quality implementations of single payer in any modern social democracy [0].
[0] https://www.usnews.com/news/best-countries/rankings/health (#23, but Canada is actually worse!)
That’s exactly what they said?
> it's entirely possible you'd simply never see a doctor again in your life until you're ready for your prostate exam in older life
I'm confused too. Prostrate screening starts at age 50 in the US. Every response seemed to corroborate the original point at least as applied to men.
That's not quite true - there's a 5 yearly Health Check which is offered to those over 40 with no other known health issues (in England, but Scotland/Wales/NI have similar schemes).
Local councils are responsible for arranging invitations for those not currently registered with GPs, so it ought to be more or less universal - though there are inevitably a few people who'll slip through the net.
It's pretty basic, but the evidence suggests it's been reasonably effective at dealing with the "he didn't see a doctor for 40 years and then just dropped dead from a heart attack" stereotype.
https://www.nhs.uk/tests-and-treatments/nhs-health-check/
In the US it's entirely possible to do that as well. I've never been forced to see a doctor outside of getting a form signed before grad school.
well what did you do during covid? Even if your school/employer didn't require vaccination during covid, most schools I attended at different phases of my life, well before covid, required some new vaccine or other. I think in the US it's pretty hard to get through school without visiting a doctor after childhood vaccines.
I get my vaccines at the pharmacy. At my current age its flu and COVID every year. TDAP every decade. I'll be adding more once I'm in my 50s, which is rapidly approaching.
Interesting, my insurers, through my employers, have always required a annual physical
Required in what way? Better coverage (or lower rates) if you do it? Or is it literally no coverage if you don’t?
Maybe they meant life insurers, not health insurers?
That's interesting, I haven't ever been required to do that. I tend to have an annual checkup around my birthday, though it isn't really a physical exam anymore, more of a "hey lets do some blood tests and discuss if there's anything noteworthy we should talk about." They quit actually poking and prodding about the time I turned 45 or so. Doctor says the physical is mostly a waste of time.
USA, I havnt had a physical in ten years. I would be shocked if someone asked for it in a professional setting.
Well that's interesting. Mine always say it is covered, I've never had an insurer (in the US) say its required. I could see it for certain types of life insurance, maybe?
I have never seen or heard of this requirement before. I don’t even see how it could be enforced. What would even be the point, the insurer (even if employer funded) is not allowed to deny or price coverage based on health risks of the insured.
Early detection, while things can be cheaper to mitigate?
Fixing hole in tooth is far cheaper than replacing a full tooth, for example.
> In the UK once you've had your childhood vaccinations it's entirely possible you'd simply never see a doctor again in your life until you're ready for your prostate exam in older life.
It's entirely possible to do this in the US, too, but it's not the default path. I know some people who think it's a point of pride to brag that they haven't been to a doctor in 20 years. I know other people who never miss their annual checkup and are frustrated that their doctors won't order every test they hear about from their podcasts. The US approach to healthcare is varied and confusing to outsiders, even if you remove all of the unreasonably complex insurance stuff from the equation.
> There are no regular checkups or preventative care on the NHS for mid life adults unless you're proactive
If you wanted to request an annual checkup, could you ask for one and get it without problem? Or would they require a specific reason to visit?
I'm not a big proponent of restricting speech but "Ask your doctor about..." advertising should be banned in the USA. If you don't have medical training you're in no position to decide what medical conditions you may have or what treatments might be appropriate. If you want to be a doctor, go to medical school.
The idea of advertising prescription drugs is absolutely bonkers in and of itself. If I recall correctly, the only reason they say "Ask your doctor about..." was a regulatory compromise that allowed such advertising. Telling the general public to simply "take Procrapin for their constipation" was deemed too extreme: The general public doesn't have the medical training to diagnose themselves or recommend treatment, but instead the manufacturer was allowed to urge the general public to nag their doctor about a medicine--that was seen as fine.
> "Ask your doctor about..." advertising should be banned in the USA.
That advertising is illegal in almost all other first world countries.
> The US approach to healthcare is varied and confusing to outsiders
Is it? If find it to be very much in line with the "personal freedom above all else" which permeates US culture.
The last insurance carrier I had, through an ACA Marketplace plan, has an incentives program for members. If you go see the PCP for an annual checkup, you get about $50. If you "go paperless" 100%, you get another $50.
There are about four incentives altogether, and the money is loaded on a Prepaid Visa card that is branded by the insurance carrier. The funds are not restricted, and you can spend them on anything where Visa is accepted. The cards are sometimes cycled out and replaced, but I do not know if the funds had an expiration date. There were no fees to hold the funds, and no fees to spend them.
One of my employers had that incentive but only for one year. I assume they wanted to demonstrate that as a population we were low risk but after testing us once there was no reason to do so again.
> In the UK once you've had your childhood vaccinations it's entirely possible you'd simply never see a doctor again in your life until you're ready for your prostate exam in older life.
It is not customary in the UK to see a doctor at regular intervals for checkups?
How.. do people find out they’re diabetic before organs are borderline failing?
There are actually periodic tests for people over 40 in the UK. The GP comment is wrong.
You can get sti tests and other tests as and when required or requested. I have had blood pressure checks, blood diagnostics etc offered regularly by my doctor. Usually they are just to rule things out but they definitely offered.
> “There are no regular checkups or preventative care on the NHS for mid life adults unless you're proactive”
This isn’t quite true. There is a free “NHS Health check” for adults aged 40-72, which you’re supposed to do every 5 years and includes basic checks like blood pressure and cholesterol. I certainly get messages from my GP nagging me about it from time to time.
The downside of that model is that "be proactive" assumes people know what they should be proactive about
Is that necessarily bad? I mean, aren't there studies showing that annual checkups don't make much difference in mortality or healthy longevity?
This isn’t true. Women have regular smear tests and there’s also the midlife MOT every 5 years, to give but two examples.
Birth control? Pap smear? Mammogram?
To be fair, almost nobody is going from childhood vaccinations > late-middle age without seeing a doctor. And when you do go with an ailment general blood tests seem pretty standard these days at GP's along with standard vitals checks. They also do preventive care where necessary. Every woman is invited for cervical screening once they turn 25 and then every few years until they're in their 60's. Regular mammograms are also a thing after a certain age/depending on risk factors. Bowel cancer screening too. STI testing is free and, depending on where you live, done by post. Also depending on your definition of 'childhood' there are a few vaccines given when you're a teenager (HPV for example). And if you ever travel you'll be visiting the doctor for vaccines then too.
I don't think I've been to a doctor in close to 40 years, except for treatment of a few acute injuries. I've had a few vaccine boosters, but I get those at a pharmacy.
You had me curious about what I was tested for, also in the northeastern USA in the 2010s. It looks like they included Hep C when my PCP ordered STD tests in 2015, along with most of the tests the other commenter mentioned. I'm glad they caught yours in time to treat it well!
Ah OK, this was in London
In Europe I don't think it's commonly done. For example, the standard Dutch MSM STI test [1] covers HIV, Syphilis, Chlamydia, and Gonorrhoea only while Trichomoniasis, HPV 2 and Herpes are rather common. That being said, it's freely available at most hospitals.
[1] https://www.mantotman.nl/
Herpes screening is discouraged in the US unless symptoms are present as the widely available IgG tests have terrible specificity. While the false negative rate is practically 0, they have a false positive rate of around 20%. The only high-accuracy confirmatory test (at least in the US) is the Western Blot but there's only a handful of labs in the country that offer it.
The current tests would result in a substantial fraction of the population running around thinking they have a highly stigmatized STI that they in fact do not have with little to zero ways of getting a more accurate test.
> HPV 2 and Herpes are rather common
Seems like both HSV-1 and HSV-2 seroprevalences are actually rather low in the Netherlands.
As for STI testing: Serological testing is pretty meaningless regarding infection risk and direct viral detection is only done on visible lesions for differential diagnostics AFAIK. You can shed the virus without lesions, HSV-1 can be contracted without direct mucosa contact, and while HSV-1 is associated with oral herpes and HSV-2 with genital herpes, both types can cause lesions anywhere on the body. Sure someone without positive antibody status very likely can't transmit it, but that's a very small minority of people of relevant age.
I believe talking to Americans about "herpes" can be misleading, as it's weirdly stigmatized over there and people seemingly conflate visible "cold sores", genital herpes and antibody status.
Incidentally, genital herpes and HSV-2 in general is more common in the US, which may be a direct outcome of this cultural dynamic. Due to lower incidences of early oral HSV-1 infections, compared to most western Europe, Americans are more likely to get infected with genital herpes of either type, but in particular HSV-2, too. Prior oral HSV-1 infections are somewhat protective.
https://en.wikipedia.org/wiki/Epidemiology_of_herpes_simplex
Most of the stigmatization of HSV in the US is mostly the result of pharmaceutical companies trying to create a market for HSV antiviral drugs. In the 1980s they ran ads that equated HSV with leprosy. Since that was also the time of the AIDS scare the public was probably very susceptible. Even in my childhood I remember ads on TV for the antiviral drugs promising a way of "living a normal life" despite HSV infection.
That's crazy. Herpes can't be cured, so the implication of those ads can only be to "hide" the infection. Additionally, those antivirals aren't effective at preventing outbreaks unless you take them every day, which would be insane unless you are an unfortunate soul who is prone to constant outbreaks.
Note that doesn't include HSV (especially 2) which can be transmitted asymptomatically, and even with a condom. The medical establishment doesn't consider it a concern, but it's worth having both parties check.
I've never had a piss or blood test.
Hep C isn't commonly sexually transmitted so it's odd they would test for it. It's more of a concern in certain occupations, like healthcare, where you may come into contact with blood.
It's definitely sexually transmitted.
Lol, you are both right:
- It's not commonly transmitted sexually
- It can definitely be transmitted sexually
https://en.wikipedia.org/wiki/Hepatitis_C#Sexual_intercourse
Good for you! Could you share the name of that particular test here? I'm confident I'm clear but might want to include that test in case I need to in the future.
hep c antibody basically if positive they will probably do hep c viral load
https://www.labcorp.com/tests/144050/hepatitis-c-virus-hcv-a...
A standard STi clinic should have you covered. They should do the full pipecleaner wee and blood check
i think during that time / place it was risk based - if you didn't know your parent had it (or didn't tell your dr), and weren't an intravenous drug user, etc. its likely no one would have screened for it.
If you're comfortable sharing, did you have any symptoms? Or was it just latent/dormant?
Just latent, never suspected a thing.
Makes me wonder if this project is the reason for a slight downturn in Liver cancer from 2019 forward in the UK.
https://crukcancerintelligence.shinyapps.io/CancerStatsDataH...
Interesting that it's just England (and not Scotland, Wales, or NI). I realize they all have independent NHSs, but still would assume a program like this would rolled out across all the constituent countries.
Each nation has different social and health issues, each nation makes its own plan.
All four nations NHSes work with a single charity, the Hep C Trust.
They're all following the WHO targets for elimination -- you're hearing about this now soon after World Hepatitis Day (July 28th, as conceived of by the WHO).
https://www.hepctrust.org.uk/blog/2026/07/four-nations-on-th...
As for progress:
- July 2026: Wales doesn't have percentage-of-population counts but here's its latest report: https://phw.nhs.wales/reports/trends-in-the-prevention-diagn...
- November 2025: Scotland believes it has identified and is treating 85% of chronic sufferers: https://publichealthscotland.scot/publications/surveillance-...
- January 2021: Northern Ireland doesn't publish stats, but has a 2021-2025 plan (there's no 2026- plan issued as far as I know) https://www.health-ni.gov.uk/publications/northern-ireland-h...
So it is less "England has a program and the others don't" and more that each NHS is pursuing the same WHO goal independently, with different reporting and timelines
I wouldn't have assumed this really because really the whole point of devolution is that they get to choose what to prioritise, so perhaps the other nations choose to do something they consider to be more pressing for their populations.
Yeah... but there aren't any borders really.
Indeed but there are still different decision makers and sets of voters electing them.
Sure but there's no real need for it in this case, or in the NHS in general I would say. It's probably just devolved because Scotland and Wales want everything to be devolved even if it makes no sense.
The Scottish NHS has always been a separate organisation, even before devolution, created under a separate Act of Parliament. It's just that it used to be answerable to the UK government (specifically to the Secretary of State for Scotland, rather than the Secretary of State for Health), and now it's answerable to the Scottish government.
Why it was done like that, I'm not sure, but I suspect it was a combination of Scotland having its own legal system and laws (guaranteed by the Acts of Union of 1707) and existing ministerial division of responsibility (where public health in Scotland fell within the purview of the Scottish Secretary, along with Scottish education and a bunch of other areas that had their own distinct Cabinet ministers for England and Wales).
And while the Welsh NHS was originally part of the same NHS as operated in England, control over the NHS in Wales passed from the Health Secretary to the Welsh Secretary with the creation of the Welsh Office in 1969, and then to the devolved Welsh government in 1999.
Northern Ireland already had devolution (or to be precise, home rule) when the NHS was created in 1948, and the Northern Irish equivalent -- the Health and Social Care service -- is a direct creation of the Parliament of Northern Ireland rather than of the UK Parliament.
It has the advantage you can test what works in an A B testing kind of way.
I don't know if borders matter much in this case. It's approximately just as easy to travel to England from many other countries as it is to travel to England from the rest of the UK.
It is a lot harder to travel into England from outside of the United Kingdom than it is to travel from England to Scotland or Wales. For one, I do not need a passport to get on a train to Scotland. Nor do I need a visa.
But you most likely have a passport, and most (western/european) countries have "automatic" visas to the UK, so for the most part, training from London to Edinburgh isn't much easier than Paris to London. Sure there is no passport control, but UK passport control is typically just scan your passport's chip and look at a camera.
>there is no passport control
There's no anything. Getting to Wales is easier than getting to Devon for most of England. You can do it accidentally.
I work with people who actively chose to go to conference in Berlin instead of the UK due to visa issues. The passport control is a real issue one cannot just handwave away.
Do they have an EU passport? I've never heard of anyone with an EU passport having trouble travelling to the UK.
If they emigrated to the EU and want to travel to the UK then I could see that.
It's quicker to travel to London from Paris and Calais than it is from parts of Scotland. Even though much of the UK's infrastructure acts as a feeder into London. No, we don't need passports but some people in London seem to have the idea that it's just down the road from us, which it isn't.
If you want to get to Glasgow from Campbelltown it can take you as long as three hours for example, and that's before you hit the motorway. Trying to get from west Sutherland to London is worse. Trying to get there from the Hebrides or Northen Isles even more so.
LOL, no that's simply not true.
The borders between Scotland, England, and Wales are effectively like state borders in the US. Unless you see a street sign, you wouldn't know you crossed it.
NI is physically on a different island, so requires a boat or plane ride.
And all of the UK (ignoring the territories and ex-colonies) is on islands. And require a valid passport, passing through customs/immigration checks, and either a plane, boat, or train ride.
Most of the Scottish border is fairly physically obvious, unlike Wales (although the Severn bridge is).
Tens of thousands of people live on islands other than Britain and Ireland. Much of Scotland is not even considered UK mainland by delivery firms, even major places such as Perth.
What? Perth isn't considered part of the mainland? How is that possible? My family is from Perthshire (Blairgowrie) and I've visited a bunch. It's definitely part of the island!!!
I can understand Lewis and Harris or the Shetlands (they're separate islands without bridge links), but Perth doesn't make much sense. And I would have assumed Skye was considered "mainland" as well, at least now that there's a bridge.
Some delivery firms don't consider substantial parts of mainland Scotland to be "UK mainland". They charge extra. That has been the case for some business deliveries and even flower deliveries for a while.
There was a controversy about Perth in this regard a while back. I'm not even talking about Blairgowrie or Dunkeld or outlying places but someone trying to get deliveries to an industrial estate within the city of Perth itself.
The way things are going, maybe only the Central Belt will get preferential delivery fees.
Really? Perth? You can go on uninterrupted 70mph roads from London to Perth.
Some of them don't consider Perth to be part of mainland UK for delivery purposes. It is one of the major arguments against private parcel delivery... They'll either end up with poste restante in major cities or stop delivering to rural areas entirely. (Perth is one of the bigger places in Scotland after the four major cities and not even in the Highlands.)
Given that Great Britain is an island, it is still much easier to drive down the M6/A74(M) or take a hike around the Welsh borders than say, take a flight or swim.
It can be quicker to reach southern England from continental Europe than from Northern Ireland or many parts of Scotland. Or the Isle of Man (which I'm well aware is a Crown Dependency.)
The UK consists of a number of islands. We have hundreds in Scotland with tens of thousands of people living on the other ones. England and Wales have significant ones such as the Isle of Wight, Ynys Môn and Lindisfarne. The IOW has at least 100,000 on it.
What? No it's not just as easy, especially since Brexit now there are real border issues compared to driving down the road.
My guess is that devolution makes these programs and statistics look more separate than they really are
Each country also has their own Public Health bodies, so pretty much everything related to health is devolved
Yes, that's what I said - each is named "NHS [country]" (National Health Service [England | Scotland | etc]).
Splitting hairs, but the public health bodies are separate from the National Health Services (so there exists Public Health England _and_ NHS England). Public health is slightly different to healthcare, but of course they work together.
Oddly, Public Health Scotland is part of NHS Scotland; but Public Health England is not part of NHS England, it's a parallel department.
Gotcha, clearly I know just enough about the UK government to prove how little I know about the UK government. :)
I'm British by birth (well, UAE, but they don't do jus soli), but been in the US since kindergarten and naturalized since college.
Good for you. We get explosive diarrhea as the prize in the States. Wanna trade?
Nah we are good - We have our problems (including our own version of your guy but he hasn't won yet and is currently running against a man with a bin on his head) but on the whole, nah we are good.
Well, then, we can offer you measles, instead. How's that? We're also working on bringing back polio and smallpox. Think of it as our contribution to FREEDOM!
Farage isn't quite the same and of course the situation is rather different.
The three jobs are divided up differently, though still between too few people. You have a Figurehead, the Head of State, which here is King Charles and in the US is Donald Trump. That's the part Trump most likes, you get free gold stuff, you're allowed to do whatever you please, everybody is supposed to suck up to you, hooray. Farage would not get that job.
Next you've got Executive leader. Trump doesn't enjoy this as much. People keep trying to blame him for the fact he's bad at it. He appointed people he saw on TV to run things, how is it his fault they're not brilliant? This would be half of Farage's job as Prime Minister and he likes being asked to account for his incompetence even less than Trump.
Finally Head of the Legislature, in the US this isn't Trump's job, Mike Johnson is in the House and John Thune in the Senate. Farage would get this job in full as the Prime Minister. Even before he resigned he was rarely actually in Westminster, it's boring and you need to be good at actual politics, so of course he's not there, he gets paid more to be somewhere else.
I also don't think Nigel can put together the numbers. Trump has Mike and John to try to make the numbers work, and Farage wouldn't have that. "My way or the highway" is what Farage would say, and that doesn't make the numbers work. That's how you lose a Confidence motion and you're back on your arse in six weeks.
[Edited to correct the Senate leader, mistake pointed out by ragnese below]
Good explanation. Just one correction: John Thune is the Senate majority leader (so, the "head" of the Senate). Steve Scalise is in the House and he's the head of the Republican party in the House, whereas Mike Johnson (who is also a Republican) is the House majority leader (so the head of the whole House, not just his party).
So, it's Mike Johnson for the House and John Thune for the Senate.
Thanks, fixed.
And that same problem leading to him is the same reason why we have 3rd world diseases coming back...
I'm quite sure you can cure then with Paracetamol /s
and your freedom model named fable even refuse to answer lots of questions relate to the explosive diarrhea.
Seeing a 36% drop in mortality over a decade is huge progress, but it’s a good reminder that "elimination as a public health threat" still relies heavily on reaching hard to find, undiagnosed populations. The free home-testing push should help bridge that last gap.
I guess someone complained about memory safety and they intend to rewrite hepatitis in Rust.
Not everything has to be rewritten in Rust! Hepatitis is a virus, C is much better suited for that kind of project, Rust is for fungal diseases, not viruses.
Safe needle practices have been known for decades, it's really not that hard.
If I say I'm going to borrow a needle and just look at it, you should just trust me. If I use it, I make sure to sterilize it before returning it.
Wouldn't measles be the better (immune) memory safety joke?
You don’t have to ask theoretical questions. Write one yourself and post it in the comments, see how it goes! I’m rooting for you!
There is a pretty striking contrast here with the infected blood scandal. The NHS went from being responsible for one of the worst hepatitis C transmission disasters in the country's history to potentially becoming one of the first health systems to eliminate the disease
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and screw worms
America: hold my syringe...
Future to the Back!
I blame Facebook and not MAGA for this. Amplification is insane.
Not only bringing back but also exporting it.
Currently we have a measles outbreak in Brazil brought from the US, so everybody is getting vaccinated (even those who already were, like me) to try to stop the spreading and protect those who can’t get vaccinated.
Really would love for US social and media networks to get their shit together and stop spreading misinformation in the name of profit…
Strangely, anti-vax sentiment is surging in a lot of countries. Canada has higher rates of vaccine rejection than the United States in some categories, as one example.
It’s a strange global phenomenon and I don’t think there is one single root cause. MAGA/MAHA definitely jumped on to the anti-vax train as it became popular, but many forget that Trump presided over the rushing of the COVID vaccine into availability and production. He hasn’t done vaccination any favors in recent years, but I’m skeptical that the widespread rise of vaccine skepticism can be attributable to this administration alone.
I think there’s a bigger story about the cyclical nature of how the dangers of threats that previous generations faced is slowly lost over time, combined with the rise of contrarianism and conspiratorial thinking on social media.
Given the amount of cultural influence the USA has and the universal nature of the internet it seems likely to me that global anti-vax sentiment could have started with the USA.
The pivotal paper that tried to link vaccines to autism came out of the UK and was published in The Lancet.
Assuming that the US was the root of the current surge of anti-vax idealism is not supported by the facts.
I don't think the general public were as influenced by a paper in the Lancet as they were by other members of the public (and media) talking about that study.
The US is a global media and culture juggernaut, so by that token the US can be blamed for most trends. I don't think it's a worthwhile distinction.
Anti-vax culture was prominent in the UK, Australia, Canada, and many other countries at the same time. I'm not seeing any strong reason to blame the US as the root or solo cause.
> The US is a global media and culture juggernaut, so by that token the US can be blamed for most trends.
Hmmm. By that logic, does it mean the US can also take credit for most trends?
That paper was followed by a sustained and purposeful PR campaign, by the author, who had an investment in a new vaccine type that only covered one disease, as he was trying to cast doubt on vaccinating multiple things at the same time as "too stressful on the body" or other bullshit.
This also involved, whether he pushed it or it was organic, the tabloid press of the UK.
Eventually this filtered back to the US, despite already being largely debunked and retracted, but that didn't matter to the early 2000s celebrities looking for whatever confirmation bias sources they could.
The histeria started in the UK, slowly crept over the atlantic to the US, and now has filtered back, all while it was based on absolute fraud and lies, the exact criticism all these morons insist applies to real scientists.
The modern anti-vaccine movement was nearly entirely started by a doctor fraudulently publishing fake science to make money. The supporters of course refuse to see that, because it would burst their bubble, so only their enemies can possibly be guilty of it.
Even the 12 or so parents involved in that fraudulent "study" cried foul, as he literally put words in their mouths and made up testimony from them to support his scheme. Actual autistic children continue to suffer from his bullshit, entirely made up illness.
And that guy ended up losing his medical license permanently over it.
Yeah, I guess:
> Andrew Jeremy Wakefield (born 3 September 1956[a]) is an English fraudster and anti-vaccine activist. Formerly a senior surgeon, he was struck off the British medical register in 2010 for "serious professional misconduct" due to his involvement in the fraudulent 1998 Lancet MMR autism report, (wikpedia)
Sadly debunking fraud doesn't seem to stop the misinfo on social media. "Vaccines cause autism!" gets more clicks than the truth and so you get JFK Jr.
It's Robert F. Kennedy Jr., not John.
I wonder where that guy lives now
The fraudulent Lancet paper gave "credibility" to the grifters and conspiracy theorists world wide.
But the King of Graft installing the halfwit RFK to run HHS is next level and I assume fellow grifters are making serious bank off this shit.
Reminder, the vengeful Orange also installed a climate change denier to run NOAA after he lost the election, who posted bogus claims on the official NOAA website which grifters used to give legitimacy to their bullshit.
Yeah, but the facts don't support the narrative that's being pushed here, which is "America bad".
The UK banned him from practicing because of it, citing "serious professional misconduct". He moved to the US.
America made one of his adherents the Secretary of Health and Human Services.
Oh, banned him? Don't move too quickly, you might get dizzy.
Wakefield arguably assaulted his patients (most of whom were children, IIRC) when conducting his research. What do you do with people who arguably assaulted someone? You get the Crown to make that argument. Why didn't that happen?
Also worth noting: according to the logic upon which the British system of government is based, no lesser a party than God Himself put a major believer in homeopathy on the throne of the United Kingdom of Great Britain and Northern Ireland.
https://x.com/raffysoanti/status/1403093629086965760
I'd love to see Wakefield go to jail for fraud, nor am I a fan of Charles even if he's on my passport. But Charles doesn't set UK health policy, or UK policy at all.
> I'd love to see Wakefield go to jail for fraud, nor am I a fan of Charles even if he's on my passport. But Charles doesn't set UK health policy, or UK policy at all.
You're correct. He lives off the civil list and lets his nonce brother crash at a luxury home. But someone else does set UK health policy, and someone else does prosecute crimes, and since that's the case, then why didn't someone else in the UK with the ability to charge him do so?
If that happens, there is no adherent in charge of the DHHS. There are no kids dying of easily-preventable diseases in the UK, US, or anywhere else. Just a quack sitting in a jail cell.
Again: I'm all for it. I've little ability to impact the British criminal justice system, though, nor much patience for whataboutism.
I'll still take "no longer a doctor" over "gets to set American health policy".
I like pancakes and waffles, in other words.
> I've little ability to impact the British criminal justice system, though
Probably more on a per-capita basis than Americans have impact on what DHHS does, though. Especially if it became something focused on by the British public. Which, strangely, it hasn't. Not since 2010 when he was struck off.
> I'll still take "no longer a doctor" over "gets to set American health policy".
You really should aim higher. The man performed colonoscopies and biopsies on autistic children to support a scientific fraud with the hopes of becoming wealthy off of it. In other words, at the very least, he committed battery on disabled kids. That should earn more than getting struck off after twelve years. It should earn prison. It's purely on the British government that it hasn't. And since doing that would have prevented his scientific fraud from reaching the heights it is at now, modern antivax can be pinned on the UK and the lack of action from His Majesty's government.
In fact, you can bet that other states deliberately stirred the pot
There is some evidence that anti-vac activism was one of the key topics pushed by foreign influence campaigns at several points. I think the simple explanation is that they pushed any topic which could be used for political divisiveness and unrest, but fomenting anti-vac sentiment is especially damaging due to the physical harms it causes.
Looks like Russia did that: https://firstdraftnews.org/articles/anti-pfizer-vaccine-narr...
... and the USA did it too, trying to discredit China’s Sinovac: https://www.reuters.com/investigates/special-report/usa-covi...
Looking at global population stats, you can clearly see where germ theory and vaccines entered human civilization.
All this "natural something" and antivax movement certainly is the other direction. Maybe it's subconscious population control, maybe informational warfare... maybe people just got a little detached from reality by not dying all the time, as you suggested.
Anti-vaxxing goes back literally centuries, but the internet definitely made it a THING.
I just looked it up and anti-vax arguments predate actual vaccines - they were used for variolation which was similar:
>in a 1722 sermon entitled "The Dangerous and Sinful Practice of Inoculation", the English theologian Reverend Edmund Massey argued that diseases are sent by God to punish sin and that any attempt to prevent smallpox via inoculation is a "diabolical operation"
Vaccines date from about 1800.
I would blame the "social" media, on the old internet they had barely any visibility.
Now that we have the blame let's talk about the punishment.
> I would blame the "social" media, on the old internet they had barely any visibility.
They managed to get plenty of visibility long before computers.
https://www.bbc.com/news/uk-england-leicestershire-50713991
> There followed a 100-year battle between the authorities and an often sceptical, sometimes aggressive, public. In Britain, a succession of laws made vaccinations free, then compulsory - backed by fines and even imprisonment. While riots flared in some towns, there was also more restrained opposition in the form of anti-vaccination leagues. For an increasingly literate population, pamphlets were produced with titles like "Vaccination: its fallacies and evils", "Vaccination, a Curse" and the suitably Gothic "Horrors of Vaccination".
I do not disagree, but I don't remember antivax to be visible in pre-facebook internet either, so I only blame it for ~current wave
It was there, and growing for decades. Pre Facebook it was a small niche but don't blame Facebook, that is mostly coincidence
Pre-facebook, the barrier of entry was high enough that only fairly educated, students, and the nerds were driving the content.
Once the barrier came down and the floodgates of "average intelligence" were opened, it was over.
I am very prepared to get downvoted for bringing this up - but I'm not convinced that the "anti-vax movement" most people think of is truly to blame (that is, crazy people who think it gives you autism or whatever).
At least in my area, there are pockets of (relatively) new immigrants that have MMR vaccination rates at around 30% (that's very low, much lower than the anti-vaxxer population could account for imo), and the reasons for that have nothing to do with MAGA/MAHA as far as I can tell.
It's an entirely different problem (that needs solving), and pretending that this is simply the by-product of uneducated crazies on the internet feels like it's over indexing on a loud and flashy but ultimately small part of the problem.
Before MAGA I'd heard of granola moms, the same people who think that amber helps their kid with teething, were very against vaccinating their kids as well. So it's a wide swath of people who are just oblivious to the benefits of vaccination. It's a reason that they have vaccine schedules to begin with.
the data is quite slow to be released so i haven't updated my charts for a bit but britain saw a decent spike in HIV / AIDS because of the migratory flows under boris johnson. In large part because we don't test on the basis that it's considered racist (I went looking for discourse on testing on entry or not - first article that came up was from the graun, first words "Nigel Farage").
Would you say that the government telling those people that they should be afraid of vaccines will help or hurt in this case?
I gotta be honest, I don't really think these immigrant groups see or care what Trump/RFK are saying. If anything they see them as an "enemy" who they should not trust.. This is an incredibly left-leaning city where the majority of public health information (or any other messaging) being disseminated is counter to what the current federal admin is saying (as a rule, it seems).
So to answer your question, I don't personally think it helps or hurts in any significant amount relative to other cultural drivers.
I don't think people base their beliefs purely based on what the administration says
the whole rollout and lockdowns, Fauci, etc. were a perfect storm to cause skepticism towards vaccines
I don't think it was the roll-out or anything along those lines, so much as the lying. Saying people won't get sick or won't catch COVID if they get the vaccines [1] was just false and very myopic. Obviously the intent was to try to get people to take the shots, but they completely destroyed trust in the process. Broader skepticism predictably follows from there.
[1] - https://xcancel.com/ITGuy1959/status/1581034815700488192
They are not the progenitors of the skepticism, but they gave the skeptics significantly more authority than they previously had. Over surveillance networks, vaccine scheduling, public health comms, etc. MAGA sees them as useful idiots for the coalition, rather than threats to the US.
Here [1] is a montage of some of the public messaging around the COVID vaccines. [1] It was quite simply dishonest. That, paired alongside the effort to force people to take the shots, completely destroyed public trust on a level that will take many decades to repair. Generalized vaccine skepticism follows naturally from that.
I'm certainly a part of that group. For instance I ended up doing extensive research on e.g. MMR before deciding to vaccinate my kids for it. If this were a decade ago, I almost certainly would have done it without a second thought, just as I took all recommended vaccines before traveling without a second thought. So I'm obviously not anti-vaccine in the least, but I no longer trust public messaging on the topic.
It was just another (of the increasingly endless) examples of governments/companies pursuing short-term interests while ignoring long-term consequences. When it comes to what people put in their bodies, trust is more important than literally anything else.
[1] - https://xcancel.com/ITGuy1959/status/1581034815700488192
Why is it bad for a public health communicator to say that vaccines stop spread by lowering the effective reproduction number of a pathogen? Its correct. Your extensive research didn't seem to work.
But this has been building for years ahead of COVID. COVID just gave people something to latch on to. And in spite of COVID vaccine issues, the latest numbers i saw suggest around 80% of people still support standard childhood vaccinations.
The media has been referencing this for years now, but the data don't show that there was any meaningful effect on a national level. Here [1] are CDC data on various childhood vaccines. Childhood DTP/MMR vaccination rates varied very little over the past 15 years and never fell below 94%. They actually hit a record high in 2019 right before COVID - of about 95% each. Now they're both at record lows (around 92%) and continuing to trend lower.
[1] - https://www.cdc.gov/schoolvaxview/data/index.html
You have your chain of logic backwards. You wanted to be skeptical and "concerned" and so forth so you went out and found reasons to justify it.
People were refusing the measles vaccine back in 2000
I'm not a trump fan, but the antivax train has nothing to do with him. (Evidence: Canada is doing even worse then us when it comes to measles). If we want to fix this problem (we do), the first step is to recognize the actual problem, not to play the blame game on whichever politician you currently don't like!
You don't think RFK has anything to do with it?
The reason there are measles cases is because a decent percentage of people aren't getting vaccinated anymore. If all of the cases were 2 year olds or younger (when RFK was put in charge) then possibly. But not only are they older (https://www.cdc.gov/measles/data-research/index.html), this is also happening in Canada. I don't see how it could possibly be RFK's fault.
True, but RFK (and other politicians and celebrities) have been active in pushing some form of anti-vax ideology for a decade plus, in some cases back to the 1970s.
It's been a growing movement, not something that kicked off when RFK assumed the HHS role.
I agree. But to be clear the original comment / context is about MAGA / Trump. I think responding 'No, you're wrong! RFK is the reason' to a thread about Trump and then retreating to RFK's activities over the last 20 years is arguing in bad faith.
The entire reason I made my original comment is because it's important to recognize that this is not a Trump thing, and getting rid of Trump / MAGA will not suddenly convince people that vaccines are good.
It's not _solely_ a Trump thing, but he gave RFK an enormous platform and has himself been espousing demonstrably untrue things about vaccines and vaccination schedules. This very week, in fact. [1]
If you don't see this as an enormous amplification, I don't think you're operating in good faith.
1. https://www.nytimes.com/2026/08/10/well/trump-vaccines-fact-...
Pre-Trump, anti-vaxxers were notorious left-wing granola types. Lots of anti-vaxxers were white liberals living in Marin and NorCal and sending their children to private schools like Waldorf.
Only after Trump did people start lumping them in with right wing.
Trump gave them official government support and promoted them.
Well that’s just not true, anti vax has always been a theme of the far right, infowars and i’m sure others have a long history of it.
The left wing libs types are far more recent, and i would lump them more in with the wellness brigade.
You are completely wrong. It's always been a far left concept until COVID.
This is from Mother Jones, a very liberal web site.
https://www.motherjones.com/politics/2020/06/the-anti-vax-mo...
Here’s an earlier article from another leftist site https://www.theguardian.com/society/2013/apr/25/mmr-scare-an...
> Pre-Trump, anti-vaxxers were notorious left-wing granola types
so, exactly RFK's type :)
While It’s fair to point out that RFK is hopping on a train that’s already got momentum, your first comment reads as if it’s not caused by falling vaccination rates (your second comment clarified further).
Also why not blame politicians doing the wrong thing?
Perhaps I should've been clearer. And yes they aren't helping.
And yes, we should blame them for the things they do. T But the comment I was responding to was acting as if MAGA was the reason for measles outbreaks, which is false. I'm an incredibly strong believer in the truth. An example of why I think this is an important separation: imagine you tried to fix the measles outbreak and miraculously got every single American to hate Trump and got Trump out of office. The problem would still not be fixed! People would still be dying of measles! The effort would have been almost completely wasted!
A major campaign by RFK's replacement could absolutely make a significant difference stopping the spread of measles. That's the whole point of the (proven extremely effective!) vaccine.
Do you believe this? I think it might help a little, but so we're on the same page RFK has only been in charge for 2 years. Why wasn't the previous secretary of health doing this? The measles outbreaks may be relatively new but we've had the vaccination data to see it coming for over a decade.
My personal belief is that there a lot of people who believe stupid things out there (and it's all only amplified by the news and social media), and for anti vaxxers especially I don't think an authority figure saying 'You have to get the measles vaccine!' is going to help much, unfortunate as it is. :(
Inaction (and really, let's be clear - making it worse) is RFK's choice.
We managed to cut the smoking rate pretty dramatically, including in about half over the last decade. Public policy is not ineffective, we just need competent people to wield it.
I think we live in a different age man. Media nowadays is completely different. Example: I have literally never had cable tv in my house. I've probably watched cable TV around 10 times total, all in a hotel room growing up. My media is all online, uncontrolled and (relatively) decentralized. Contrast that with 60 years ago and hopefully you see the difference.
Also smoking smells and has other negative externalities, which doesn't hurt.
I don't think it would be logistically that hard to criminalize the parents or take away their kids in those cases. It would have a lot of other downsides but it would probably reduce the rate pretty directly.
Ok if you want to do this then sure there is an easy solution. I think there are other problems with this though (for example no way this is flying even with the majority of people who are not anti-vax).
I'll bet it would be enough just to make sure that the vaccine waiver signature box is positioned directly below some glossy full color pictures of emaciated, rash covered dead children.
Excepting the turbo fascism, that is. People must be able feel agency while parenting or they can’t parent well.
COVID and anti-vaxxing explosion happened 6 years ago.
Look at the source I linked! Only 20% of cases are under 5!
Unlike a lot of pathogenic diseases, measles requires an extraordinarily high amount of herd immunity (upwards of 95%), so this isn't a particularly telling data point on its own.
RFK Jr has been pushing anti-vaccine bullshit for decades. He was already taking defensive stances on his activism (Oh, I'm not anti-vaccine, I'm just providing nonsense arguments and clout for anti-vaccine stances) back in 2015.
Kennedy was already pushing bullshit during the UK Measles vaccine fraud/scare, back in 2005. He was doing this along with a few other celebrities.
I've responded to a few people on this but the comment I was responding to was literally about the last 6 years! The context of this entire thread is about MAGA / Trump! I agree that RFK is hurting and has been for a long time, but that is not what this argument is about!
In fact, he is blamed for spreading vaccination hesitancy in Samoa and the deaths of multiple children there as the result even before COVID: https://www.pbs.org/newshour/health/newly-obtained-emails-un...
RFK has publicly come out and encouraged parents to get vaccinated for measles. I don't know why you are spreading disinformation.
https://www.yahoo.com/news/politics/article/rfk-jr-says-pare...
Oh great he's doing it now after causing fear and doubt about them for decades, getting many people killed, in Samoa for example.
Most of his criticisms have been about the timing of certain vaccines administrations.
He's not anti vax. If nobody can challenge science, then it's not science.
Vaccines continues to help us, but that doesn't mean they are perfect and don't cause side effects on certain individuals. Hopefuly the future brings us highly personalized medicine instead of a 1 size fits all.
> If nobody can challenge science, then it's not science.
If someone has spent some time actually learning science then of course they can challenge science.
If they are a lazy halfwit parroting crap they listened to on the latest podcast (because reading is hard!)... no. Not so much.
Claiming RFK is not anti-vax, is like claiming Dario is not anti-open-weights.
(Well, it's way worse that that, but I didn't want to invoke Godwin's law.)
He is not "challenging science" with measured arguments and carefully controlled peer-reviewed research to back his claims. He's deliberately trying to silence science because of a completely unsupported brain fart.
And no, it's not about "timing". It's about spreading baseless FUD to discourage any form of vaccination, because he believes (with no actual evidence, and despite vast amounts of research to the contrary) that vaccination causes autism.
I mean would you let your non coding coke head brainwormed manager challenge your coding choices? He is not a doctor or scientist, why would we listen to him. And any experts relying on using are horse dewormer grifters or worse.
You think the Trump influence magically stops at the border? There are _plenty_ of Canadians who think Trump has all the answers and can't be wrong.
He knows he can't push his base too hard on certain things. He probably knows this about vaccines, he lauds Operation Warp Speed but as a win of his not a vaccine that could have saved millions more with his cooperation. He chooses his power over what's best for all of us. He's the leader of the antivax train by choice.
https://www.theguardian.com/us-news/2026/aug/10/trump-vaccin...
"The order recommends that all shots be given at separate medical visits, a frequent point Trump has made despite the safety, ease and lower costs of giving vaccines together."
'“Together, there could be a possibility they’re quite lethal,” Trump said of the MMR vaccine at the signing of the order on Monday.'
'Asked if he had evidence that the combined MMR vaccine was “lethal”, Trump said: “No. What I’ve heard is that there are some people who say it is that way.”'
Antivax fundamentally has its contemporary roots in Andrew Wakefield's fraudulent anti-MMR campaign.
So directing by executive order and by his own admission without evidence that the MMR vaccine be split up into separate shots is, very clearly, an antivax action. This is the first victory that Wakefield (a man who had a patent on a single measles vaccine!) wanted, and RFK Jr was pursuing.
But this is Trump saying this and signing it. So as of yesterday, it now has everything to do with Trump, sorry. He has handed the anti-MMR movement its ultimate victory and in so doing validated the entire antivax worldview.
See my other responses. Obviously this is bad. But the current measles outbreak is a symptom of a problem that's been happening over the last 1 or 2 decades. It literally CANNOT be caused by this, neither in the US or Canada.
It's still not too late for anyone who is unvaccinated to get the vaccine! Hopefully the next administration undoes this change, but the really important part is managing to shrink the anti-vax movement (which, if you look at the data in my other comments, you can see has been a problem since before Trump).
What exactly do you consider "before trump"?
Also, trump, as a representative, represents a large group of people. It's colloquial to refer to political parties by their leaders.
FWIW I think Trump #1 (45) wasn't an anti-vax presidency; it might have been suspicious of healthcare professionals (for the good reason that so many people know opioid epidemic victims) and he was always a bit equivocal around hydroxychloroquine and bleach and "powerful light inside the body" but Trump didn't start to lean antivax until not long after Biden took over.
(And let's be clear: Operation Warp Speed was an enormous success even if Trump is an ignoramus)
Some of that might have been expediency — Biden was catching shit from the antivax and healthcare-skeptical movement and moving in on that would be easy — but Trump has always been vulnerable to being influenced by people and RFK Jr appears to be generally so much more persuasive than bears thinking about, so he was a factor later on.
Trump #2 (47) is fully an anti-vax presidency; even Hegseth backed away from flu vaccine mandates, only to have an outbreak in an Army (IIRC?) facility.
"Evidence" requires citations.
US: https://www.cdc.gov/measles/data-research/index.html
Canada: https://health-infobase.canada.ca/measles-rubella/archive/20...
They have 10% our population and had twice the cases last year (admittedly, we're starting to catch up). But the truth is that there are huge lag times when it comes to measles / antivax. This is a symptom of a problem that started 10-20 years ago.
You are willfully deluding yourself if you believe that. He put an anti-vax idiot as head of HHS. How is that "nothing"?
He was appointed and holds those views because these ideas are now popular... not the other way around.
RFK and his anti-vax ideas are popular only within a small fringe of the American population. Enough to drop herd immunity to the point where we now have to worry about measles again, but it's far from the majority.
I'm aware. The issue is that group, albeit small, is larger than it was.
See my other responses. Do you really think RFK could possibly have had an effect on vaccinations over the last 2 decades in the US OR Canada?
Since you seem very emotionally opposed to Trump and his administration: I also don't like Trump or RFK! However, to solve a problem, you have to find the root cause of the problem, and pointing at the most recent politician you hate will never help anyone.
We can't solve the root cause until we fight our way through trump and his party.
YES.
Do you really think RFK appeared out of the ether? What do you think he's spent the last 2 decades doing?
It has a lot to do with him. He doesn't actually have an opinion on any policy issue. For various political reasons, Trump decided to let RFK dictate public health policy according to his extremely delusional ideas. Yes, there was an antivax movement in this country for many years, just as there has been misogyny, racism, and transphobia. Trump has normalized and supercharged all of these moronic and dangerous ideas.
I have not been following measles in Canada, so I can't address that.
See my other comments; it is not possible for RFK to have had any effect on this outbreak. If everyone getting measles was 2 or under, it could be possible; they aren't.
The reason I bring up Canada is as counterevidence; if it was Trump or RFK'S fault, Canada should be doing just fine. They had twice the cases last year in 1/10 the population. The truth is this is a problem with people believing stupid things, and it's going to take a lot more than Trump going out of office to fix.
RFK has been the person behind the antivax movement for a long time.
> it's going to take a lot more than Trump going out of office to fix
Probably true, but it's nevertheless a necessary condition.
1) Vaccines are not 100% effective. 2) Herd immunity is a thing.
Trump is trying to hang Fauci. That goes in the completely opposite direction of promoting the trust of medical institutions in general society, and it's trust that will get people back to vaccinating themselves and their children.
Fauci case is weird. Fauci did pretty much what every other country was doing. If he did anything wrong it was doing too little too late.
He is amplifying the issue, but you're right, Trump is a symptom of the underlying problem. The problem is that internet gave these idiots a platform to mislead people.
Back in the early 90s this wasn't much of a problem. Childhood vaccine requirements weren't some hot-button topic then. Most people would just get them when faced with the requirement. Most opposition was isolated to people who were otherwise contrarians already.
The difference now is that the internet is full of these isolated contrarians who are now influencing gullible people who don't know who to trust.
Are you blaming communication technology?
Neither phones, nor email, not even usenet had this impact. Social media did.
The problem is not with the technology but those that control it. (Some would probably say, the fact that any one actor controls it in the first place.)
Our only means of communication in modern society are a few advertising platforms in hands of even fewer owners, and the engineers hired to run it are busy engagementmaxxing.
I'm blaming the current social media landscape, which amplifies ideas based on the engagement they create, which has an unintended consequence of amplifying exciting controversial falsehoods over long-held boring truths. We have given the largest megaphones to the biggest village idiots.
Do you think it's also helpful that they see these things being pushed "for profit)
Completely agree! I will add though: this is a symptom of a problem that started 10-20 years ago. There's a lot of lag time between parents not giving their babies vaccines and outbreaks actually happening. You can see ages here.(https://www.cdc.gov/measles/data-research/index.html) 5 and under are only 20% of cases.
> this is a symptom of a problem that started 10-20 years ago.
... and that's right when social media gained majority adoption among US adults.
More like 25+ years ago. In the early 2000s you saw a lot of celebrities pushing vaccine fear because they read some book version of "doctors don't want you to know this one wierd fact" that made the best-seller list or another. I remember people arguing about it in college classes, and I graduated in 2003.
Putting an anti-vax conspiracy theorist in charge of health is not the way to do it.
"has nothing to do with it" is not the same as "is not the cause of". Trump and antivax definitely are related as both are symptoms of the same public strategy that spreads misinformation, polarizes discourse and weaponizes stupidity.
>> Canada is doing even worse then us when it comes to measles
Not in Canada but unfortunately US nonsense spreads globally pretty quickly these days. The amount of Trump support in the UK is both bizarre and surprising. When someone with the worlds largest megaphone lies about vaccines, unfortunately people everywhere listen.
Right, because tapping one of the world's biggest vaccine truthers to run the Department of HHS and then proceed to link autism with vaccines and change the recommended MMR vaccine scheduling for children has absolutely no impact on anyone.
I can't help but feel this is ragebait or a bot.
He was literally spreading FUD about vaccines today. And the measles stuff has got so bad RFK had to mildy backtrack on his previous antivax statements in recent interviews.
From today:
Both Trump and Kennedy made repeated mentions of autism throughout the order signing, emphasizing a scientifically unproven link between vaccines and the condition. Dozens of studies show no link between the two.
“Today we’re proud to officially announce the United States of America’s gold standard childhood vaccination recommendations. That has to do with many subjects including autism in particular,” Trump said at the beginning of the order signing.
“I’ve seen proof of it, where they have a vaccination where it looks like the size of a bottle of soda, poured into a little child’s body and bad things happen in too many cases,” Trump later said on breaking up each shot into an individual medical visit, before adding: “This is an explosion, it’s an epidemic,” in an apparent reference to autism.
>I'm not a trump fan, but the antivax train has nothing to do with him.
Well not nothing. But it predates him and he adopted the movement early in his political career. When I was in high school (2004-8) antivax sentiment was generally associated with liberal Democrats in places like Marin County. This was a favorite retort of conservatives when confronted with their own backwardness on scientific understanding of evolution and climate change. In 2015 Trump began courting the anti-vaccine crowd and the political valence of that flavor of woo-woo nonsense flipped seemingly overnight. It was surreal to see it happen in real time. By 2020 he had lost control of the monster he helped create and the crowd booed him when he said they should get the Covid vaccine.
Introducing: Hepatitis C++
...followed by Hepatitis Rust
I've always found it a bit surprising that we don't all celebrate smallpox elimination day. I think it'd be a great reminder of the victories that humanity has had against the four horsemen.
I got really sad reading Good Omens where Pestilence has retired because of all the progress of medical science and thinking "if only". Funny enough, Pratchett has Famine doing exactly what's working for Pestilence today, convincing people to make bad choices despite easy ways to avoid the horsemen's influence.
Given the recent outbreaks of diseases we should have already eliminated here (for other reasons that "we shouldn't discuss")...
I view this as a wonderful "they don't report in and the coroner doesn't check" type of elimination
> Around 50,200 adults are living with hepatitis C, figures for England in 2024 suggest.
> Estimates indicate 84.6% of those living with hepatitis C have been diagnosed - just short of the 90% target.
How do they know there are that many Hep C patients if they haven’t been diagnosed?
Just a guess: Ratio of positive results out of previously unknown cases gives a good estimate of the total expected unknown cases. Precision depends on selection bias, and statistics has tools to estimate and/or improve it.
Perhaps raw statistics, or estimates based on measuring traces in wastewater. I know that in the U.S. during covid they traced some new viral strains using that method.
Second paraggraph:
> The target of treating 80% of all known cases has already been met, and deaths from the virus have fallen by 36% in the last decade, just short of what is needed by 2030.
What is needed by 2030? There is no mention prior to this statement.
Later:
> NHS England says that since 2015, more than 100,000 people have been diagnosed and treated for hepatitis C, meaning the country is already meeting that target.
Again, what target are we talking about??
Much later:
> Prof Frankie Swords, NHS national medical director, added: "England is now leading the world in the mission to eliminate this disease and on course to beat the WHO's 2030 target, but we are determined to keep up the momentum and finish the job.
Finally a target!
FUCK AI
This isn't written by AI, this is just how BBC news articles are written. I find it frustrating too.
I think you are partially correct. They trained AI on their articles to produce the same style articles. I am not a large consumer of BBC articles. This style of snippet after snippet is annoying. Perhaps that is why I am not a large consumer of BBC articles.
> Style Assist helps BBC journalists quickly adapt trusted content into BBC News house style, speeding up the publication of high-quality local stories. It uses a BBC-trained AI model to generate a draft, which is always reviewed and edited by journalists before publication. This helps save time while maintaining accuracy, tone and editorial standards. Find out more in an article from Rhodri Talfan Davies.
https://www.bbc.co.uk/aboutthebbc/reports/policies/what-were...
Style Assist is mainly for articles written by journalists that are employed by third-party news organisations (who own the UK's local news outlets) but are subsidised by the BBC - these people are "local democracy reporters".
LDRS articles are made free to everyone in the scheme (including the BBC), but because the content is written primarily for their home news org the articles that end up being published by the BBC need to be modified to comply with the BBC's editorial guidelines and for style reasons.
Hence, Style Assist.
I see. Journalism is much more nuanced than I had imagined. The article I linked mentions there are 1,200 rules in the BBC News style guide!
And I'll add that whether the style guide or the journalists, BBC articles tend to be like this: constantly saying sentences without giving the full context needed to understand them. This is why as a right wing person I tend to read The Guardian (famously left wing) instead of the BBC, because their articles just read better.
It's not AI the BBC is just that bad at news. Serious read anything by them at it's like they hate real information and just want random ass quotes from people.
Instead of not including the target, AI would have confidently stated some incorrect number.
In America people still die of tetanus, because vaccines are the devil's love juice.
What a funny headline. It has virtually nothing to do with the actual content of the article.
the other side of this is the science behind the NS5B protein and the meds behind the new hep c cures. This is pretty fascinating stuff. In medicine, it's not often we see a cure like this.
This is great news. Healthcare is such an asset in our pockets.
For a second, I thought Hepatitis C was some 1980s C dialect that had memory safety issues.
You're thinking of Objective Chlamydia, I believe.
Such determination seems pretty subjective to me
We eliminated TB too. Then it came back.
TB?
Trigger me, thought you meant Tony Blair for a minute!
The symptoms of Tony Blair take a long while to fully manifest and are significantly worse than TB.
So will it be replaced by Hepatitis Rust for memory safety? (I'm sorry, and I'll see myself out, thanks)
Take your upvote...not happy about it....but here
The title shows a lack of understanding. BBC has become really low quality.
What do you mean by this? The article quotes an NHS director backing up the statement in the title.
> England is now leading the world in the mission to eliminate this disease and on course to beat the WHO's 2030 target, but we are determined to keep up the momentum and finish the job.
Seems fairly unambiguous to me
There is a lack of understanding, but it's coming from you not the BBC.
There is a difference between elimination and eradication.
As usual you fail to understand nuance.
There's also a difference between treatment and cure but we call it all a "vaccine" now (I prefer the transitional OED definition from pre 2019). We've already entered 1984s use of good speak especially around healthcare.
Just to understand this: When someone says "country England", do they mean "country" like in "nation", considering England a separate nation, or is it a lapse and they mean UK? Is England usually referred to as a country, or just part of a country?
I usually think of a country as equal to a nation, and as far as I know, Wales and Scotland have not split off yet? Is the term "country" not actually that sharply defined?
EDIT: Thanks people, I just asked a question to better understand the terminology, you know ...
In this case it's health related and each of the countries in the UK have their own National Health Services (or Health and Social Care in NI). It's not a lapse here.
I kind of assumed that they actually meant UK. It's indeed confusing. I'd wish the BBC would use a consistent naming scheme.
Guess only England was meant. That would insinuate they don't care about scotland though.
I don't understand. It's an article about England. They only have information to hand about England, from the authority tasked with dealing with health in England.
If I read an article from them about crime in London, quoting the Metropolitan Police, I don't immediately think that they don't care about, say, the West Midlands.
The mistake they made is to directly say "one of the first countries" in the article title, which immediately implies a comparison to foreign countries. But clearly, since they're talking about England, which is a subdivision of the UK, why aren't they comparing this achievement to equivalent subdivisions, such as states or provinces, in other nations instead? This isn't a direct comparison (which might also make it an unfair one), so it makes sense why people would misread them by assuming that this is an error and that they meant to compare equivalents.
England and Scotland are separate countries, the UK is a federation of them both.
Point of pedantry: federation usually implies a federal government, and the UK is a unitary state.
The BBC do use a consistent naming scheme, you're just not understanding the scheme. Scotland has their own devolved NHS, and track their own health statistics. Scotland not being mentioned is because the Hepatitis C Trust were talking about England's Hep C numbers, it wasn't an intentional slight on Scotland.
Confusingly the proper term for England, Scotland, Wales, and NI is country individually, the UK is a country of countries. They should probably be called states but they never have been, I'd pretty much always assume when someone says England to become the first country... that they mean England exclusively.
The bit that gets me is that people often refer to the UK but actually mean GB or vice versa.
"England" is meant because that's the scope of the health service "NHS England" (1)
> That would insinuate they don't care about Scotland though.
You forgot the other states of the United Kingdom: Wales and Northern Ireland. But I disagree, it says nothing at all about Scotland - this seems like the "I like pancakes!" "So you hate waffles?" faulty reasoning. (2)
If you disagree, why don't you care about Wales? /s
1) https://en.wikipedia.org/wiki/NHS_England https://www.england.nhs.uk/about/
2) https://knowyourmeme.com/memes/no-bitch-dats-a-whole-new-x-w...
Some of the confusion here is from our history. This is my (likely confused) understanding:
James VI/I (https://en.wikipedia.org/wiki/James_VI_and_I) was king of _both_ England and Scotland and only later did the Union https://en.wikipedia.org/wiki/Treaty_of_Union combine the two. You might notice I've neglected Wales which was (considered?) part of England.
In any case, England is a country, yes. Also the UK is a country.
When I've heard the distinction (often in a historical context), 'nation' is usually meant to mean a set of people in a place with some sense of collective identity or origin, while 'state' is the governing body which has a monopoly on the legitimate use of violence within well defined borders. When these overlap the result is a nation-state, but they don't always line up so nearly. Using those definitions England, Wales, and Scotland are nations. Ireland (including northern Ireland) could also be called a nation (though, of course, as should be obvious by the fact that this does not line up with the borders of the state, this is a contentious topic). The United Kingdom is the state (and of course Ireland-minus-northern-ireland is also a state). 'Country' as a term generally doesn't imply either of these (it's just a name for some chunk of land, notionally), though it's often synonymous with the nation-state when the borders all actually line up neatly, as opposed to in the UK.
England, Wales, Scotland, and Northern Ireland are constituent countries in a larger country called the United Kingdom. When dealing with international affairs, you typically want to be talking about the UK (unless the subject is sport), as that is the sovereign state. But for domestic affairs, it’s often split in ways that are confusing if you don’t understand various bits of history stretching back about a thousand years.
For instance, England and Wales share a legal system, but Scotland and Northern Ireland have their own. There’s bunch of special things about Northern Ireland and its relation to Ireland. And all of the constituent countries have their own parliament / assembly except for England (the parliament in London is for the whole of the UK where MPs for all constituent countries can vote).
In this particular case, the constituent countries have their own health systems, so it’s normally England we would be talking about, not the UK.
CGP Grey: The United Kingdom Explained (2015) https://www.youtube.com/watch?v=rNu8XDBSn10
Here's a venn diagram that may help:
https://commons.wikimedia.org/wiki/File:British_Isles_Venn_D...
The green circles are each a single island. The yellow circle are a bunch of islands.
Wales and Scotland are separate countries to England.
A lot of powers are devolved away from England to each other country in the UK. https://en.wikipedia.org/wiki/Devolution_in_the_United_Kingd...
England is the country, part of the United Kingdom. Kingdom being the key word there, the US is a collection of countries ruled by the crown.
The commonwealth is also a collection of countries ruled by the crown; but it's not a country whereas the UK is a country.
1) Most Commonwealth countries are republics, not monarchies.
2) The monarchies in the Commonwealth countries are ruled by different crowns; but, for historical reasons, most of those crowns are worn by the same physical head. (But not all of them. The King of Malaysia is a different natural person from the King of the UK, for example.)
Yeah England is a country. Like what else do we have the name “England” for? We talk a lot more about England than some non-country geography like Anatolia (Asian Turkey). For example there was no UK in the World Cup, but England made it quite far.
If that’s a bit eccentric, well this is the same place that refers to Europe as a different place even though France borders the UK by automobile road.
To make things worse, sometimes team GB competes :) (Edit: in other sports)
England is a country, and if you're reading this on the BBC they most certainly are using the correct terminology.
It is not a sovereign country, but instead is a part of the constituents comprising the UK state.
OK, so now we have the following terms: State, nation, country, sovereign country.
For example in Germany one would say there are 16 states, but one wouldn't say that there are 16 countries. Never heard anyone claim that. So state seems to be different from country, at least here. Would people in the UK say that Scotland or Wales are "nations"? Or is at least that term very clearly only for units that could participate under a flag in lets say the olympics? (I assume here, that Scotland and Wales are not separately competing, but are under UK flag.)
"And by 'country' we mean a sovereign state that is a member of the UN in its own right" to quote the famous UK Quiz Show "Pointless".
Team GB enters the Olympics but as you may have noticed it was England who came Third in the World Cup recently, and likewise England play international rugby, including against Wales and Scotland.
And, of course, the Ireland rugby team picks players from both the Republic of Ireland & Northern Ireland.
That's a citizenship thing though right? The Republic is of the opinion that everybody on Ireland† is a citizen of the Republic. If my mother had happened to be in Portavogie when she gave birth to me last century, my understanding is that the RoI considers I am automatically a citizen, because I was born on "their" island even if certainly Portavogie is not under their control.
† The exact rules are complicated, but they don't depend on where on the island you were born or stuff like that.
I don't think so. My understanding was "confirmed" by ChatGPT, though I haven't looked at the sources.
> Rugby in Ireland is governed by the Irish Rugby Football Union (IRFU), which was established in 1879, decades before Ireland was partitioned in 1921. It has always organised rugby on an all-Ireland basis.
>and likewise England play international rugby, including against Wales and Scotland.
Except when they play as part of the British & Irish Lions!
The "Länder" in Bundesländer is plural of Land, which is the same land as in "land of the free" and would be translated to "nation", "land", "country" or "state" depending on context.
So in modern English they may be states, but there sure is a lot of overlap between "country" and "state".
"State" has lots of meanings depending on context, as it can also refer to the highest level of governments for example: State actors or "head of state". In the U.S., the head of state refers to the President, not to governors in individual states, typically.
The UK, crown dependencies and overseas territories compete as Great Britain in the Olympics rather than the UK. Northern Irish folks can compete for Ireland or GB.
As an English person I would say that Scotland and Wales are nations and countries; constituent countries of the country that is the UK.
Until today I didn't consider, that countries can be compound/consist of countries. That countries can be recursive. I always thought, that any lower level would be called differently. TIL.
England is a country. The UK is a country.
People in the UK would refer to England as a country and most people would actually be confused if you referred to the UK as a country, even though it technically is. People in England don’t really think of the UK as anything other than “the UK”. People from Scotland, Wales, and Ireland have more nuanced takes.
No one is confused if you can the UK a country, or if you call England, Wales, or Scotland a country.
You might get a tedious person saying something like "actually, Wales is a principality".
I must admit I've never heard NI being called a country... wouldn't be the UK if there wasn't some horrible complication involved.
Maybe not in isolation, but if you call the UK and England both countries in the same conversation you’re going to be met with confusion.
Maybe...? I mean not anyone I know but i'm in the UK to be fair.
It's like if you put four boxes in a box, it's not too confusing that the outer box is still a box.
I would be confused if someone called Wales a country. I thought Wales (unlike Scotland) was a region of England and had little autonomy. TIL.
Say that in Wales and the locals will stick a leek up your arse.
I'm English and I don't think England or Scotland or Wales are countries. People get confused because of football and rugby. They're nations. The country is the United Kingdom.
England, Scotland, Wales and Northern Ireland are constituent countries of the United Kingdom. The United Kingdom is also a country. You can disagree, but you're disagreeing with the government and the international community.
Not a problem, I disagree with the government all the time. Scotland has less sovereignty than US states, it's not a country.
The UK seems fairly relaxed about constituent parts leaving (Scotland was given a referendum, NI has option to leave if they want) - which I don't believe applies to US states?
The Scottish referendum was gifted by the UK, as was its parliament which can theoretically be dissolved by the UK at any time.
The NI thing is different, involving a peace treaty between the UK and Ireland.
Relaxed is not the word at all. Northern Ireland is a powderkeg and the UK government has known that for decades.
The Scottish referendum did not use neutral international observers, and had extremely biased coverage by state media. The BBC itself even tried to stir up forms of violent unionism. (Look up the so called "passionate Highlander", a drunken loyalist type who talked about defending the union to the death "in the name of Jesus Christ".)
Well, I'm an independence supporting Scot and I don't have any concerns about the actual running of the referendum - I do agree that the BBC coverage was biased but I think that is largely because they are "conservative" (note the small C) in the sense of having a bias towards preserving the status-quo. This was pretty clear from the Brexit referendum where I thought they favoured the status-quo there and, as a Remainer, I guess I was pretty happy with that!
The BBC is institutionally biased because they stand to lose 10% of their licence fee. I have heard they received some EU funding, but from their POV they probably made some money from exporting programming within the common market. I voted Remain myself although I do have some misgivings about the EU. (I recently debated an American online who thought the BBC's current panic about licence fees was to do with USAID. Not even close. Although British TV has been swamped with US imports.)
"The 45" has a resonance in Scottish history and it is a bit of a coincidence the Yes vote was stuck at that rather than 47 or 44.
Having neutral international observers was a no brainer, but the SNP often seems to trust the system they're trying to break up much more than it should.
Scotland, Wales, and NI have their own parliaments at least, so from a constitutional perspective one could argue England is not a country but a state, but that is only one narrow definition.