What are some examples of this type of decentralization scenario playing out before? What you’re saying makes sense to me, but my hope would be that the decentralization would serve more as a supplement than a replacement - therefore still requiring ongoing maintenance and investment to main infra. The alternative without these microgrids and other microinfra is almost guaranteed to result in the half or fully rotten systems you predict as the prevailing recent political climate doesn’t give much confidence in terms of getting such massive projects planned and completed successfully (US-centric response).

> What are some examples of this type of decentralization scenario playing out before?

I am not very knowledgeable about this, but the public/private school debate seems to be one possibility.

> Phasing out natural gas in new construction is going to cause this passion play in slow motion. Have you priced out induction stoves? Phew.

More than two thirds of US households already have electric stoves, and normal non-induction electric stoves are about the same price as gas ones. A ban on gas stoves would only affect rich people for the most part.

> A ban on gas stoves would only affect rich people for the most part.

And professional kitchens.

For the record I agree with phasing them out but I can see restaurant chefs fighting hard against it.

Mostly the old guard who doesn't want to adapt to induction ovens and Döner Kebab shops where there really is no replacement for a proper gas grill.

At least here in Europe, many restaurants are switching because the writing is on the wall that natural gas will get very expensive very soon.

So soon it that became expensive since the last year or so

Sure, but all actual bans in the US so far have made exceptions for commercial kitchens.

Indication stoves are claimed to be as good as gas. However the cheapest induction stove in the US is 3x the price of the cheapest gas or electric. And if you go stove shopping you with find lots of options for gas or regular electric, but often only one induction model - if you want some combination of features and are willing to pay - you often still can't get it with induction. (dual ovens, number of burners, burner configuration, non-standard widths - there are lots of options that are at least interesting to someone who is cooking)

Respectfully - all of these "issues" get solved when you go from ~1%->100% market share.

100x increases in manufacturing volumes will do amazing things for final cost. Expanded market share to 100% will lead to every features imaginable being offered to the market.

Ending gas stoves, and gas distribution in general, is a huge win. Just as phasing out incandescent light bulbs was a huge win. Each "infrastructure grid" that we run to every building (Electricity, Water/Sewer, Roads, IT, natural gas) is overwhelmingly expensive to build and maintain. And if you don't maintain it - you blow up San Bruno[1]. It would be great to delete one!

https://en.wikipedia.org/wiki/San_Bruno_pipeline_explosion

The problem is we are not at a high market share (in the US), and it will be a while before they gain.

I hate my current stove, but no way am I paying the cost for a new one. I also have vacations and other things I want. (As a programmer my income is well above average, so I have to assume the costs are only more prohibitive for most people)

Agreed. I was shocked at the cost of an induction stove top in the US when I looked recently. £350 buys you a great induction stove top in the UK (I paid less for a neff nN50 just before COVID). $1000 only just buys you an entry level one on the US.

Won't happen but a bit of communism would help. Government specs and purchases induction stoves and sends a trucks around and replaces all the crap electric stoves one neighborhood at a time. Basic idea better to just do it as a coordinated project than piecemeal.

Other thought about decommissioning gas lines. When doing infrastructure projects that require digging moving gas utilities is a big big hassle and expense. Getting rid of natural gas lines would make that stuff easier.

I claim that ordinary electric coil stoves are as good as gas for nearly every non-commercial use case, and the moderate popularity of gas stoves was almost entirely manufactured by the gas industry. I understand that some things are harder, like using a wok, but there are easy workarounds, and most Americans never try to do these things anyway.

Electric stoves are also strictly better at a lot of things - very high heat, very low heat, cleaning, repairing, not polluting the air, etc.

And then the step up to induction is even more so a no brainer. That way, just the benefits of gas (fast hot, fast cool) are added on top of electric. Without the cleaning hassles.

People act like home cooks are too braindead to remove a pan from a hot coil for 45 seconds while it cools down so the food doesn't burn. As though this is a good reason to burn fossil fuels and pollute your home.

Induction stoves are really not expensive,fast and easier to clean. Also the pans are easier to clean (less chance of burnt grease inside and outside). The shift from gas to electric is a tiny step compared to combustion to EV. I guess it is more a hard-to-shift cultural thing?

This seems pretty reasonable: https://www.ikea.com/us/en/p/blackstad-induction-cooktop-bla...

When it comes to cooking, non-induction electric stoves are a downgrade from gas stoves, even if they're the same price. Induction stoves are at least an upgrade in some respects, but a downgrade in terms of cookware compatibility. Phasing out gas stoves might be the future, but I wouldn't describe it as something that only affects rich people.

I disagree. For all common tasks (and most uncommon tasks) that Americans do with a stove, non-induction electric stoves are as good or better than gas.

I’ve cooked on both and prefer gas. For pots with curvature (woks), induction doesn’t work well. Induction is nice for boiling water/soups, but frying is better with gas. Gas is also more user friendly as a broiler in the oven for toasting than a slow to heat electric element.

gas is also incredibly wasteful. the efficiency of a resistive element stove is in the 80-90% range while for gas, it is in the 20s if you are lucky. most of the heat in a gas stove is lost to the environment.

The “better” you report is just perception. there is zero evidence or measurements to back that up.

Errr, assuming that your electricity comes from a combustion source and a simple cycle power plant, at _best_ the work derived from the heat is about 35%. You need to account for that in your 80-90% calculation. (That is, .9 * .35 = .315 using the upper range of your guesstimate.)

In other words, the waste heat has already been lost to the environment at the power generation source in that case.

As always "it depends"... (In this case on the power generation mix in your local grid)

The specific mix depends on the local grid, but nobody in the US gets electricity entirely from combustion, unless you're in like an Alaskan village that only has a generator.

I agree there are a couple niche cases like woks, but very few Americans ever use them, and if you do there are easy workarounds like electric woks. Electric ovens are typically better for broiling (https://www.consumerreports.org/appliances/ranges/gas-or-ele..., https://www.consumerreports.org/ranges/how-to-get-the-most-f...). Why do you think frying is better with gas?

Obviously some good gas stoves will still be better than bad electric ones, so I'm not discounting your individual experience, but I don't think your experience generalizes well.

The only thing gas has any claim of being better at is woks. Or anything else that really must have all that extra heat blasting up the sides of the pan. In every other way induction just kicks the crap out of gas. Far more powerful, faster to change heat settings, more precise. I grew up using OG electric coil stoves, had gas for the next 20 years, and induction for the last year. I could never go back to gas. Electric coil at least has the upside of being stupidly hot when you want. The high end temperature for gas isn't great.

This is total nonsense. I used to believe it as someone who only grew up with gas. Now, I've worked as a professional cook and lived in a variety of places with a variety of electric stoves at different price points. Electric is absolutely just as good as gas if you are a competent cook. It makes no difference whatsoever what the source of heat is on my stove anymore.

As a non-chef this has always been my suspicion, so I'll happily support you. I'm sure the immediacy of the temperature change matters to a degree (zing!) but how hard is it to wait a few seconds?

Its not a few seconds. The difference between high and low heat can easily exceed 1-1.5 minutes for gas vs typical electric most people have.

This makes cooking very difficult. When you turn down the knob from high to low, the element continues to cook your food at high to medium heat for another minute. This can burn or overcook your food. The converse of turning the knob from low to high is less bad, but can still be quite problematic.

You can easily anticipate this and turn down the nob early. When you inevitably fail to anticipate it, just remove the pan/pot from the stove for that time period. This is not rocket science. I get headaches from the gas fumes while cooking and I regret making the change every day. Yes I have a powerful vent hood. It is not enough for me personally.

Perhaps you are a better cook than I am. I look at physical signs like color changes, bubbling, texture changes etc, to move on to the next step. I can't always anticipate these changes ahead of time, and if I make a mistake in the anticipation, then getting back to the right temperature can easily add a few minutes to the cooking and potentially cause harm to the taste.

Of course, there are hacks like physically removing the pot that work, but it is added complexity on top of gas stoves.

The above obviously does not mean the gas stoves are objectively better - it only establishes that on one critical dimension gas is better than electric.

> the element continues to cook your food at high to medium heat for another minute

To be fair, so does the cookware. (Probably more so considering the lack of mass in a heating element.)

I have no professional experience, but I've used gas, coil top, glass top induction, and glass top non-induction. Of those four types induction is by far my favorite, but having to replace half of our pots and pans was annoying.

I would not be surprised if professional electric stoves are better, but the consumer experience is lacking. Coil top stoves often heat unevenly. The non-induction glass top experience is overall not great, with them seemingly being a downgrade from coil tops in all aspects other than cleaning and aesthetics.

If they're so bad, then why do so many people have them, and seem to be able to cook good food on them?

I appreciate that there are better stoves out there that might make certain things easier but the stove is not the thing that's holding back my cooking.

> ... downgrade in terms of cookware compatibility.

Induction plate adapters exist [1] - I haven't used one specifically for that purpose, but have used a diffuser plate which works on a similar principle.

The adapters are around AUD $20-50 which sounds like a cheap way to to start migrating your cookware collection to ferro bases.

I gather they're not great -- somewhat inefficient, and will necessarily have a more torpid response to temperature changes on the induction cooktop, shouldn't be used at high-temperatures -- but they do mean you don't have to replace all your cookware instantly.

If someone needs high temp and doesn't have a suitable pan already, cast iron is ridiculously cheap.

[1] https://www.amazon.com.au/s?k=induction+plate+adapter+conver...

Sounds like it would effect 1/3 of US households

Moving from gas stove to induction electric stove is trivial. Upgrading from water and space heater to heat pump is neither simple nor cheap.

When solar was becoming affordable, there was a lot of talk in the industry about "grid defection" exactly as you describe, but it didn't come to pass.

Now that energy storage is getting radically cheaper too, I think there's a decent chance that what you predict could happen. It would be... enormously bad.

And I agree load growth plays a part in all this. The big growth will come from electric vehicles--once cars are all electric, that will roughly double the electricity demand.

Roofs generally last for 30 years. In my neighborhood at least, which was all built-out in a 3 year period in the mid-1970s, most of the roofs were replaced about 10-15 years ago (they're rated for 30 years, but everyone pushes their luck as far as possible). Because they replaced their roof pre-~2014 it wasn't cheap or common to do so and thus very little solar was installed at that point.

Those who have had their roof replaced in the last 5-7 years went ahead and put solar on top. My guess would be that when the neighborhood "cycles" through new roofs again in ~15 years, more than half will elect to put in solar or solar/battery combo. We are due for a new roof in 2-3 years and plan on doing solar at that time, and possibly even battery.

The 2022 Inflation Reduction Act has provisions where low-income households can get an electric or electric induction stove fully reimbursed, up to $840. Middle-income households can get half the price of the stove reimbursed.

Apparently, individual states have to do stuff, so it might be like the medicaid expansions where some states opt out of providing stuff for poor people to make a political point.

> opt out of providing stuff for poor people to make a political point.

I would certainly hope my state isn’t giving out tax-payer funded luxury stoves.

There is no such thing as “free” here.

My Bosch 36" mid-range induction cook top was about $2500. High-end ones are like $4000-8000 or even more. So nobody's getting a luxury anything.

I really do not get this. We have twice a 300 euros AEG in two kitchens already running 10 years. How many pits do you cook on simultaneously?

Mine has 2 round elements and one rectangular flex element. Generally 1-2.

One for simmering sauce, one for boiling pasta, and a third for frying up some sausage, veggies, etc. Three at a time isn't unreasonable if you know how long everything takes and do it in parallel to all finish at the same time.

Mine is very similar to [0]. We use 4 pits max, which i think is comfortable. 7kW combined, it does a kind of qos when you set all pits to max power, which works out just fine. It has pause/resume and a countdown timer per pit that works intuitively. I would say the price is not a holding back factor. That's why I really do not get what people in this thread are talking about.

[0] https://www.eldi.be/nl/aeg-ikb64301xb-inductie-kookplaat

One of the few durable consumer goods that is a lot cheaper in Germany: a new 60cm (24”) Bosch induction range is about 800 EUR. 80cm ones are also available, but I wasn’t looking at them, as 60cm works better with our existing kitchen, though I doubt they start at 2500 EUR.

Off-topic but I just don't get why we means-test this. So what if 1% of Americans get $840 so long as the other 99% also get $840 towards a new stove. Surely the cost of means testing and administration is more than 1%?

I think you're totally correct. Unfortunately, lots of people have trouble thinking rationally about people getting things they don't deserve (for whatever definition of "deserve").

I don't understand the math that you're doing. 10% of Americans qualify as low income. We're talking about 31 billion to replace the stoves for every low income person and 310 billion dollars to replace the stoves for everyone. Do you really think that means testing cost $280 billion dollars?

That's more money than the entire state budget for every state but California.

On the flip side, do you think looking at a single tax return for 10 seconds cost more than $840?

> do you think looking at a single tax return for 10 seconds cost more than $840?

This isn't the real cost. The real cost is when people turn down promotions at work or new jobs because it puts them 2,000 above the poverty line, and they no longer qualify for subsidies. That means that in 10 years they cannot become comfortably middle class after another 3 promotions or new jobs.

That's why we shouldn't have welfare cliffs. Earning 1 more dollar should never incur 2 dollars of benefit loss. That's an argument against hard cut offs and having benefits as a linear function of income.

I wholeheartedly agree that well Fair Cliffs are one of the most problematic elements of us subsidies. They punish people for bettering their situation and being more independent.

Any help should gradually Fade Out and provide an incentive for earning more.

It's still a punishment though. It means instead of a 2k raise you got a $0 raise, and why should you take that risk, plus extra learning required for the promotion?

Stop means-testing for things like this, and raise taxes at the higher brackets to cover it.

I think you misunderstand me. It should never be a $0 raise - that's my point. A $1 raise can be less than 1, but should always be positive.

The thing is, means-testing affects the people with the lowest incomes who don't qualify the most. It's like an extra tax on the lowest earners (of the class of people who don't qualify fully).

If you just passed the poverty threshold and get a 2k raise, that 2k is going to be "taxed" twice - once with regular taxes and once with losing out on your benefits. That's just not fair.

Whereas if I make 150k/year or 180k, depending which bracket you want to put it at (also idr where the brackets are exactly), as a single person, I can afford to have my taxes on everything over 120k/180k/whatever go up by a bit to make sure I'm reimbursing that 3k that I got from the government in various grants just to make sure I was doing ok.

And if you look at it real close, tax brackets are indeed a sort of means testing, so in the end it all works out.

I agree with you, but I think you're talking about welfare cliffs, not means testing.

Well designed subsidies for the poor don't have sharp monetary drop offs like these [1].

Ideally it would be something like for every extra dollar you earn, you get 10 cents less benefit. That way if you get up $1,000 raise, your subsidies go down by a hundred bucks, but you're still up $900 total. There should be no magic number where if you make $1 more you lose a huge benefit.

nobody should lose $500 of food stamps because they picked up a shift and earned and extra $100. that doesn't mean every single American needs food stamps. If you make $150k, you dont need food stamps, and the government shouldnt be giving them to you.

https://fee.org/media/17757/welfare_cliff.png?width=600&heig...

No, what I'm saying is, if you make a 1000 raise, your subsidies should go down by 0. Otherwise you're effectively being taxed by losing the subsidies (even if gradually).

Make the subsidies universal. You make 500k a year and want food stamps? Sure thing. You're being taxed so much on every dollar above 180k that it hardly makes a difference.

That seems completely backwards to me. If you make more you should have be effectively taxed more, just gradually. Why would we ever want to have higher taxes just so someone who makes a hundred or 500K gets food stamps they don't need. You just get a bunch of people that don't need food stamps using food stamps as a tragedy of the commons. If you make 100k you still have to pay for everyone else's food stamps, so you want to use them too.

How is it a tragedy if everyone is using the food stamps? That means they find value in them. So they're paying for them in taxes, then spending them. Where I come from that's called getting what you pay for.

That's no more a tragedy than everyone paying for then using the highway. We don't really means test the highway right? Why shouldn't the rich have to pay for their own roads? ;)

> We don't really means test the highway right?

Wow, that's a fantastic analogy, thank you

So far I believe only one state has opted out, Florida. It's not really comparable to opting out of expanded Medicaid because at least with expanded Medicaid a state could make a somewhat colorable non-political argument for not participating.

Under the ACA Medicaid expansion the federal government covered 90% of the cost and the state covered 10% of the cost. I believe some of the states claimed that they could not afford that 10%.

With the energy efficiency rebates under the Inflation Reduction Act (IRA) and the Bipartisan Infrastructure Law (BIL) each state has to administer the rebates for that state's consumers, but the allows the states to use a portion of their gran for for the cost of that, including hiring staff.

So basically a state just has to apply, get the administrative money to cover setting up a program to distribute the rebates, then get their share of the IRA and BIL money and distribute it.

In Florida deSantis used his veto to block authorization for the state to get and use the $5 million portion of their grant that would be for administration and so Florida residents will not be getting the $174 million in energy efficiency improvement rebates, or the $173 million in appliance rebates, or the $7 million for a training program for electrification contracts, or other smaller grants from those laws. All in all, Florida is turning down $377 million.

deSantis has not given a reason, but it is likely part of his "Fight Back Against the Woke Agenda" theme he's basing his campaign on. Reducing emissions and increasing energy efficiency is "woke" in current far right circle.

Other recent actions taken in his fight against "woke"ness are tax breaks for purchasing gas stoves and killing a bill that would have directed state agencies to consider lifetime cost of ownership when purchasing cars.

> Phasing out natural gas in new construction is going to cause this passion play in slow motion. Have you priced out induction stoves? Phew.

Two things here. For one, natural gas has to be removed from the market as the supply of gas is finite, it's bound to raise in price anyway due to CO2 taxes, it emits toxic particulates associated with lung disease, it's more efficient to run a heat pump than burn any kind of fossil fuel, and it's a major fire/explosion hazard particularly when maintenance is neglected.

The other side is, if you're worried about electricity going down, you can always grab a gas cylinder for a camping stove and live off of that for a week and more - personally, I have an Enders Explorer portable grill that can double as a stove and two 5kg cylinders of gas, mostly to run outdoor BBQs but also usable in case of a prolonged grid outage.

> natural gas has to be removed from the market as the supply of gas is finite

I'd drop this argument your other points are good but while gas might technically be finite it's not on any timescale that matters here.

It's also, head and shoulders above all other fossil fuels, highly amenable to being synthetically produced using renewable resources.

... which is still insanely wasteful because methane synthesis from scratch is just 50-60% efficient, and capacities are going to be limited - we need all the synth-fuel we can get for long distance air flight and transoceanic ships because these two usecases can't reasonably be shifted towards electric propulsion.

Making synth-methane just to burn it in a stove which loses a lot of heat to the environment compared to an induction stove.

[1] https://www.nature.com/articles/d42473-022-00166-2

If you worry about electricity going down you can buy a portable generator powerful enough to run at least some of the stove. Odds are you have never had your electric stove using the full power it can in theory consume (all burners on high and the oven heating), so long as your actual use is less than the stove needs this works.

Heat pumps are great, but it sometimes gets cold enough where I live that they are less efficient than a modern gas furnace. (not every year, but still often enough that I need to plan on those days or my pipes will freeze)

Induction stoves want a 220V 40A service.

Then want 220V, but the amp depends on how much you are using. One burner on low will use less power than all burners and the oven all on high.

Yeah it's hard to really push amps unless you actually use every last burner. My cooktop technically wants a 50A circuit, but what I have available is a 40A circuit and it has never been any issue. I'd basically need to have all five burners going, and probably near or at their maximum setting. Not an issue I've run into, which is why I'm being kinda lazy about upgrading the wiring and breaker to 50A.

I don't live in a house, but in an apartment. Running a gas grill works - it's the same stuff that the gas stove is burning - but running a generator indoors is just asking for getting killed off by CO poisoning.

Banning natural gas appliances doesn't stop natural gas production. It's a byproduct of oil production. Fly over any oil field, and you'll see natural gas being burned as a waste product everywhere. Only when natural gas prices go up do oil companies start capturing it to sell.

The thing is, when we start closing down oil fields, there also won't be any gas any more, and synthesizing it is incredibly energy inefficient - particularly if you just burn it.

> the lower class is absolutely fucked

Is it ironic that the technology is being developed and tested in poor neighborhoods? [0]

> Honghao Zheng, an analytics manager for Chicago's electric company, ComEd, described the microgrid as the seed of something bigger. Moving from a centralized energy model to a decentralized one is the goal, he said.

> Zheng said what's novel about the Bronzeville project is that this grid, unlike others, is not a "one-way street" of power — it's designed to be able to "cluster" with other microgrids, such as the one at the nearby Illinois Institute of Technology. Later this year ComEd plans to test the grids' "island" function, meaning its ability to disconnect from the larger grid.

> "This is only a starting point," Zheng said. "We are also thinking about how to expand this kind of innovative technology."

A microgrid as it's known right now disconnects itself into an island that provides power for everything inside of it when the larger grid goes down. But what they're building now is a cluster of microgrids such that one microgrid can send its excess power to neighboring microgrids so they all have power. If this all works out then the rich folks aren't simply isolating themselves, they are also providing resiliency to their less-fortunate neighbors.

[0] https://www.businessinsider.com/chicago-bronzeville-neighbor...

Until someone introduces a bidding mechanism, anyway.

"Man, we had no power for DAYS and I only got $14.75 from that stupid electric grid thing"

This is what happens when general public service infrastructure becomes so bloated and ineffectual that even at huge scale it can not compete with small scale alternatives.

At some point it becomes more efficient to put in a natural gas/water/electric storage in your back yard than pay for public service delivery.

This is needlessly dramatic and negative.

The electric grid is what it is today because several problems can only be addressed at scale. There is no way that individuals will accept all the reliability, maintenance and risk that comes with running their own electrical infrastructure. More importantly, location is a very important metric here.

I always feel that comments on solar or renewable energy on this site come from a California-centric perspective. In almost all regions of the planet, power generation at scale provides security, resilience, stability, reliability and other metrics that are always superior to smaller, individual power generation sources.

You're citing a separate problem... the lack of representation for the lower class. This has nothing to do with decentralization.

> This story of decentralization has played out before.

Citation needed.

This reads just like a really strong defense of centralized systems, ignoring the robustness and economic benefits of a decentralized grid, purely to push a political agenda.

I'm willing to bet most people on here have never actually experienced living with decentralized infrastructure, and only have an abstract understanding of what it entails. I live on the edge of a state forest where the only centralized service we have is electricity (we still have solar). We have gas bottles for cooking and hot water, and when one runs out we switch it over and get it replaced. For sewerage we get the septic tank pumped, and for water we collect rainwater. If we have a dry year or use too much, we have to pay for water cartage. If the pump goes down, I'm either fixing it myself or paying someone else to fix it on short notice.

Now, I chose this and it's how I grew up, so I wouldn't have it any other way. But the beauty of centralized systems is that they offset these burdens to an authority that handles all of that for you. If I were unable to pay for a new pump, well, I would have no water. A centralized system paid for by taxes guarantees that everyone will always have access to water under fairly mild conditions.

The failure of centralized systems and people resorting to locally decentralized solutions isn't indicative of decentralized solutions being better, but more a failure of governance and bureaucracy. I mean, there's a reason we all moved from decentralized systems (like getting water from a well) to centralized systems in the first place. That's not to say that decentralized anything doesn't also have advantages, only that the distinction really matters, and people should be sure of what it is they're advocating for when they want to decentralize infrastructure like electricity and water that are vital for survival.

What? Nobody is saying that decentralized systems can't have centralized backups, or that you can't have a hybrid system. Your whole comment is predicated on a false dichotomy.

Natural gas stoves are unhealthy[1]. Poor people already have worse health than rich people for a multitude of reasons [2]. So if more poor people get access to places with electrical stoves, their health improves.

I only looked at walmart.com: Cheapest gas stove was 122US$, cheapest induction 222US$. If the 100US$ difference is relevant, you're neither building a house nor looking to rent an apt without a kitchen anyway.

[1] https://www.google.com/search?q=natural+gas+stove+health [2] https://www.google.com/search?q=health+of+poor+people e.g. https://health.gov/healthypeople/priority-areas/social-deter...

It's unhelpful to link to Google searches as sources; the first page of results is usually just news or blog articles very thin on facts.

The risks to health of natural gas stoves (basically, just the production of NO2 and particulate matter) are almost all due to insufficient ventilation. Houses will need more and better (active) ventilation going forward anyway, as increasing insulation standards for homes mean they don't "breath" as much as they used to. So there's other ways to mitigate those health risks that don't involve banning something that many people enjoy using.

Poor people as a whole indeed do have overall worth health than rich people, but switching to electric stoves won't move the needle almost at all. Gas stoves are most linked to pediatric asthma[0], but in terms of stuff that affect poor people more than rich people, that's hypertension, arthritis, smoking, and obesity[1], none of which care what kind of stove you cook with at home.

[0]: https://rmi.org/gas-stoves-health-climate-asthma-risk/

[1]: https://www.cdc.gov/pcd/issues/2016/16_0088.htm