Later On

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Archive for the ‘Health’ Category

How our gut bacteria can use eggs to accelerate cancer

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Written by LeisureGuy

13 August 2020 at 3:20 pm

More on the paleolithic (soapless) shower

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Amy Fleming reports in the Guardian:

When James Hamblin tells people he has not used soap in the shower for five years, they tend not to hold back in expressing their disgust. “It’s one of the few remaining things for which we feel fine telling someone that they’re gross,” he says. “It’s amazing to me, honestly.”

Yet despite people’s “clearly moralising judgments”, Hamblin is no hygiene slouch. Even pre-pandemic, he made a point of washing his hands with soap. He is, after all, a doctor who lectures at the Yale School of Public Health and a medical writer and podcaster for the US magazine the Atlantic. At 37, he looks so youthful that he still gets compared to the fictional child doctor Doogie Howser.

But eschewing soap on your pits and bits does raise awkward technical questions, more on which after some context. Hamblin’s minimalist showering habits evolved gradually, after he relocated from California to a studio apartment in Brooklyn, New York, to pursue a writing career. He needed to save time, money and space. Simultaneously, he says: “I started learning about emerging microbiome science and decided to try going all-out for a bit.”

Even if you have not yet read up on our microbiomes – the trillions of microbes that lead symbiotic lives with humans, colonising our skin and our guts – you may have spotted vague statements such as “microbiome-gentle” printed on bottles of shower gel. This because microbiologists – and brands – are learning more and more about the complex relationship we have with our germs. These include their starring roles in developing our immune systems, protecting us from pathogens (by creating antimicrobial substances and competing with them for space and resources) and lessening the likelihood of autoimmune conditions such as eczema. So, there is a growing awareness that scrubbing them off, along with the natural oils on which they feed, or dousing them with antibacterial products may not be the best idea after all.

Hamblin’s new regime got him thinking about modern notions of cleanliness, what is natural and how these two issues are, frankly, all over the shop. Stigmatism of body odour began as an advertising strategy that helped quadruple the sales of Lifebuoy soap in the 20s. A century later, we still live in fear of anyone detecting the slightest hint of BO on us. We are more perfumed, moisturised and exfoliated than ever.

Yet despite advances in skincare and modern medicine, conditions such as acne, eczema and psoriasis, as well as other autoimmune diseases, have been rising steadily. Also, while we attempt to appear squeaky clean, research has revealed that many of us don’t wash our hands properly – or at all – when it matters most: before eating and after going to the toilet. (That said, awareness of the importance of handwashing has certainly risen as a result of Covid-19.)

“It’s all mixed up right now, right?” says Hamblin, who set out to explore these paradoxes in perceived cleanliness in his book Clean: The New Science of Skin and the Beauty of Doing Less. He says the key to the success of his experiments, which saw him all but give up deodorant, was his “slow-fade” approach. “As I gradually used less and less, I started to need less and less,” he writes. “My skin slowly became less oily, and I got fewer patches of eczema. I didn’t smell like pine trees or lavender, but I also didn’t smell like the oniony body odour that I used to get when my armpits, used to being plastered with deodorant, suddenly went a day without it.” As his girlfriend put it, he smelled “like a person”.

It is not that we were unaware of bodily odours before “BO” was coined, but Hamblin thinks our natural smells are far more nuanced and informative than we give them credit for. “We know from historical writings that certainly people smelled bad. We didn’t just accept all smells,” he says. “Now, if someone smells sweaty or of anything less than soap, perfume or cologne, we think of that as being unclean.”

Hamblin started to notice that he smelled less pleasant when stressed. He interviewed a researcher who could train dogs to sniff out cancer in humans, while lovers he spoke to told him they thought the way their partner smelled naturally was good. He writes: “The hundreds of subtle volatile chemical signals we emit may play roles in communicating with other people (and other species) in ways we’re just beginning to understand.”

Hamblin also highlights the bare-faced cheek behind the rise of the skincare industry, as soap progressed from a multipurpose, often homemade product to a seemingly infinite parade of near-identical concoctions advertised for different problems, genders and occasions, at wildly different prices. Once hooked on daily soapings that remove our natural oils, we needed moisturisers and hair conditioners to replace them. In the 50s, the industry further cashed in by highlighting the drying effects of soap and offering milder detergents. Today, Hamblin writes, we have come full circle; many people seek products that are “as close as possible to nothing at all”.

He writes about a fellow journalist – and soap dodger – Maya Dusenbery, who had been prescribed every acne treatment going. The only one that worked? Nothing at all.

She had tried astringents, to dry out the skin; oral and topical antibiotics; the pill; and isotretinoin, a drug that has been linked to side-effects such as suicidal thoughts and inflammatory bowel disease. Not only were these ineffective, but she also developed rheumatoid arthritis – an agonising autoimmune condition. When she started taking immune-suppressing medication for that, her hair started falling out.

Enough was enough: Dusenbery stopped taking any medication for her skin. After an extremely oily few months, it settled. Now, the only things that touch her face are a microfibre cloth and water. Thanks to her adoption of a more holistic approach to her rheumatoid arthritis, in consultation with a specialist, this has gone into remission, too.

On the subject of antibiotics, Hamblin writes that they have commonly been prescribed for acne; he says they “seem to play a part in causing and exacerbating autoimmune disease” and that “antibiotic overuse is likely to be a bigger threat to biomes than hygiene”. . .

Continue reading. There’s more.

Moreover, James Hamblin himself wrote in the Atlantic in the July/August 2020 issue (and the article is doubtless an extract from his book Clean: The New Science of Skin):

In October, when the Canadian air starts drying out, the men flock to Sandy Skotnicki’s office. The men are itchy. Skotnicki studied microbiology before becoming an assistant professor of dermatology at the University of Toronto. She has been practicing for 23 years, always with an eye to how the environment—including the microbial one on our skin—affects health. “I say to them, ‘How do you shower?’ ” she told me. “They take the squeegee thing and wash their whole body with some sort of men’s body wash. They’re showering twice a day because they’re working out. As soon as I get them to stop doing that and just wash their bits, they’re totally fine.”

Bits?

“Bits would be underarms, groin, feet,” she said. “So when you’re in the shower or the bath, do you need to wash here?” She pointed to her forearm. “No.” Even water alone, especially hot water, slowly strips away the oils in the outer layers of skin that help preserve moisture—and the drier and more porous someone’s skin, the more susceptible it is to irritants and allergens.

Skotnicki believes that this is one way overwashing prompts eczema to flare in people with a genetic predisposition to the disease. While eczema itself can be debilitating, it often does not travel alone. It seems to be part of a constellation of conditions caused by immune-system misfires. Infants with eczema have an increased risk of developing allergic rhinitis or asthma in childhood, part of a cascade of immune-system overreactions known as the “atopic march.”

Now couldn’t be a weirder time to question washing. I’ve spent the past three years reporting on how our notions of what it means to be “clean” have evolved over time—from basic hygiene practices to elaborate rituals that involve dozens of products targeted at each of us by gender and age and “skin type.” At the same time, the incidence of immune-related skin conditions such as eczema and psoriasis has risen in the developed world, while acne is as pernicious as ever, despite the constant stream of expensive new medications and unguents sold to address it.

Though no one would ever wish it to happen this way, the pandemic could mark a chance to reexamine how much cleanliness is good for us, and what practices we’d be better off without. Let’s start with the obvious: Wash your hands, for 20 seconds, many times a day. It’s possibly the single most valuable thing you can do to prevent the spread of the coronavirus. . .

Continue reading.

Written by LeisureGuy

13 August 2020 at 11:56 am

Study links fermented vegetable consumption to low COVID-19 mortality

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Thanks to JvR for pointing out an article by Sally Robertson in News-Medical-Life Sciences. At the link you can download a PDF of the study. Robertson writes:

An intriguing new study by researchers in Europe suggests that coronavirus disease 2019 (COVID-19) mortality rates are likely to be lower in countries where diets are rich in fermented vegetables.

Earlier this year, Jean Bousquet (Charité, Universitätsmedizin Berlin) and colleagues investigated whether diet may contribute to the significant variation in COVID-19 death rates that have been observed between countries. The study found that in some countries with low mortality rates, the consumption of traditional fermented foods was high.

The researchers say that if their hypothesis is confirmed in future studies, COVID-19 will be the first infectious disease epidemic to involve biological mechanisms that are associated with a loss of “nature.”

Significant changes in the microbiome caused by modern life and less fermented food consumption may have increased the spread or severity of the disease, they say.

A pre-print version of the paper is available on the server medRxiv*, while the article undergoes peer review. However, this paper is a preliminary report and should not be regarded as conclusive or established information. . .

Continue reading.

Unfortunately, some fermented foods (sauerkraut, for example) are high in salt. But tempeh is good, and I think I’ll resume making tempeh. While it may not offer total protection against Covid-19, it is a tasty and healthful food.

Written by LeisureGuy

11 August 2020 at 12:25 pm

Mitochondria May Hold Keys to Anxiety and Mental Health

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This is interesting, and surprising only in that it didn’t occur to anyone sooner: of course cellular energy-production problems could affect nerve cells as well as muscle cells, and clearly the effects would differ. Elizabeth Landau writes in Quanta:

Carmen Sandi recalls the skepticism she faced at first. A behavioral neuroscientist at the Swiss Federal Institute of Technology in Lausanne, she had followed a hunch that something going on inside critical neural circuits could explain anxious behavior, something beyond brain cells and the synaptic connections between them. The experiments she began in 2013 showed that neurons involved in anxiety-related behaviors showed abnormalities: Their mitochondria, the organelles often described as cellular power plants, didn’t work well — they produced curiously low levels of energy.

Those results suggested that mitochondria might be involved in stress-related symptoms in the animals. But that idea ran contrary to the “synapto-centric” vision of the brain held by many neuroscientists at the time. Her colleagues found it hard to believe Sandi’s evidence that in anxious individuals — at least in rats — mitochondria inside key neurons might be important.

“Whenever I presented the data, they told me, ‘It’s very interesting, but you got it wrong,’” Sandi said.

Yet a growing number of scientists have joined her during the past decade or so in wondering whether mitochondria might be fundamental not just to our general physical well-being but specifically to our mental health. In particular, they have explored whether mitochondria affect how we respond to stress and conditions like anxiety and depression.

Although much of the evidence so far is preliminary, it points to a substantial connection. Mitochondria seem to be central to the very existence of a stress response, serving both as mediators of it and targets for the damage it can do. To some of the researchers involved in this work, the stress response even looks like a kind of coordinated action by mitochondria throughout the body that interacts with the neurological processing.

“I think mitochondria are underrated,” said Martin Picard of Columbia University’s Irving Medical Center in New York, whose laboratory has helped to pioneer this research. “They’re the chief executive organelle of the cell.” Now scientists can explore what the implications of the organelles’ importance might be for future therapies.

Mitochondria and Mental Health

Mitochondria are the tiny structures inside complex (eukaryotic) cells that manufacture adenosine triphosphate, or ATP, the chemical fuel for most metabolic processes. “ATP is the energy that sort of allows for living cells to do what they do when they’re alive,” said Lisa Kalynchuk, vice president for research at the University of Victoria in Canada. The organelles are ancient invaders — the remnants of symbiotic bacteria that integrated themselves into host cells about 2 billion years ago and specialized for energy production. Mitochondria still carry a small amount of DNA of their own, although with just 37 genes, they have less genetic material than any living bacteria.

A relationship between mitochondria and disease started to become apparent in 1975, when Douglas Wallace and his colleagues, then at Yale University, described an association between mitochondrial DNA and a genetic disorder. During the 1990s, researchers linked the effects of mutations in mitochondrial DNA to various other conditions. One in 5,000 people has an inherited mitochondrial disease of some kind, with consequences that can include diabetes, vision and hearing problems, learning difficulties and other disorders. Only in the last decade or so, however, have scientists seriously explored the influence of mitochondria on mental health and well-being, especially when it comes to stress, anxiety and depression.

Sandi’s work sprang from an intuition that mitochondria might alter the operation of select brain pathways. Our brains eat up 20% of the oxygen our bodies take in, even though the brain accounts for only 2% of our weight. A deficit of cellular energy production in critical neural circuits, she hypothesized, might explain an overall lack of motivation and self-esteem seen in anxiety-prone people.

When Sandi put rats in competition to establish a social hierarchy, she saw that the animals with less anxiety were more likely to acquire dominant rank. Further study showed that these less anxious animals had greater mitochondrial function in the nucleus accumbens, a part of the brain vital to motivated behavior and the production of effort.

Other research in many laboratories unearthed further ties between stress and mitochondria. In 2018, Picard and the stress research pioneer Bruce McEwen, who died earlier this year, published a meta-analysis of 23 studies on mitochondria and anxiety: 19 demonstrated “significant adverse effects of psychological stress on mitochondria” and even the other four noted changes in mitochondrial size or function in response to stress.

2018 review article by Anke Hoffmann of the Museum of Natural History in Berlin and Dietmar Spengler of the Max Planck Institute of Psychiatry in Munich summarized evidence that mitochondria could mediate the brain’s structural and functional responses to early life stress and serve as “a subcellular substrate in the programming process.” The experimental evidence for connections between mitochondrial function and mental health is still tentative and has important limitations, but it is strong enough to convince scientists to look deeper.

The Cross-Talk of Mitochondria

One mystery still under investigation surrounds the details of what happens to mitochondria under stress. Picard’s best guess is that  . . .

Continue reading.

Written by LeisureGuy

10 August 2020 at 2:37 pm

The health care scare

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Confession relieves one of a moral burden, but this confession strikes me as rather late.

Wendell Potter @wendellpotter is a former vice president of Cigna who became a whistleblower against the health insurance industry. He serves as president of the Center for Health and Democracy.

He writes in the Washington Post:

In my prior life as an insurance executive, it was my job to deceive Americans about their health care. I misled people to protect profits. In fact, one of my major objectives, as a corporate propagandist, was to do my part to “enhance shareholder value.” That work contributed directly to a climate in which fewer people are insured, which has shaped our nation’s struggle against the coronavirus, a condition that we can fight only if everyone is willing and able to get medical treatment. Had spokesmen like me not been paid to obscure important truths about the differences between the U.S. and Canadian health-care systems, tens of thousands of Americans who have died during the pandemic might still be alive.

In 2007, I was working as vice president of corporate communications for Cigna. That summer, Michael Moore was preparing to release his latest documentary, “Sicko,” contrasting American health care with that in other rich countries. (Naturally, we looked terrible.) I spent months meeting secretly with my counterparts at other big insurers to plot our assault on the film, which contained many anecdotes about patients who had been denied coverage for important treatments. One example was 3-year-old Annette Noe. When her parents asked Cigna to pay for two cochlear implants that would allow her to hear, we agreed to cover only one.

Clearly my colleagues and I would need a robust defense. On a task force for the industry’s biggest trade association, America’s Health Insurance Plans (AHIP), we talked about how we might make health-care systems in Canada, France, Britain and even Cuba look just as bad as ours. We enlisted APCO Worldwide, a giant PR firm. Agents there worked with AHIP to put together a binder of laminated talking points for company flacks like me to use in news releases and statements to reporters.

Here’s an example from one AHIP brief in the binder: “A May 2004 poll found that 87% of Canada’s business leaders would support seeking health care outside the government system if they had a pressing medical concern.” The source was a 2004 book by Sally Pipes, president of the industry-supported Pacific Research Institute, titled “Miracle Cure: How to Solve America’s Health Care Crisis and Why Canada Isn’t the Answer.” Another bullet point, from the same book, quoted the CEO of the Canadian Association of Radiologists as saying that “the radiology equipment in Canada is so bad that ‘without immediate action radiologists will no longer be able to guarantee the reliability and quality of examinations.’ ”

Much of this runs against the experience of many Americans, especially the millions who take advantage of low pharmaceutical prices in Canada to meet their prescription needs. But there were more specific reasons to be skeptical of those claims. We didn’t know, for example, who conducted that 2004 survey or anything about the sample size or methodology — or even what criteria were used to determine who qualified as a “business leader.” We didn’t know if the assertion about imaging equipment was based on reliable data or was an opinion. You could easily turn up comparable complaints about outdated equipment at U.S. hospitals.

(Contacted by The Washington Post, an AHIP spokesman said this perspective was “from the pre-ACA past. We are future focused by building on what works and fixing what doesn’t.” He added that the organization “believes everyone deserves affordable, high-quality coverage and care — regardless of health status, income, or pre-existing conditions.” An APCO Worldwide spokesperson told The Post that the company “has been involved in supporting our clients with the evolution of the health care system. We are proud of our work.” Cigna did not respond to requests for comment.)

Nevertheless, I spent much of that year as an industry spokesman, my last after 20 years in the business, spreading AHIP’s “information” to journalists and lawmakers to create the impression that our health-care system was far superior to Canada’s, which we wanted people to believe was on the verge of collapse. The campaign worked. Stories began to appear in the press that cast the Canadian system in a negative light. And when Democrats began writing what would become the Affordable Care Act in early 2009, they gave no serious consideration to a publicly financed system like Canada’s. We succeeded so wildly at defining that idea as radical that Sen. Max Baucus (D-Mont.), then chair of the Senate Finance Committee, had single-payer supporters ejected from a hearing.

Today, the respective responses of Canada and the United States to the coronavirus pandemic prove just how false the ideas I helped spread were. There are more than three times as many coronavirus infections per capita in the United States, and the mortality rate is twice the rate in Canada. And although we now test more people per capita, our northern neighbor had much earlier successes with testing, which helped make a difference throughout the pandemic.

The most effective myth we perpetuated — the industry trots it out whenever major reform is proposed — is that Canadians and people in other single-payer countries have to endure long waits for needed care. Just last year, in a statement submitted to a congressional committee for a hearing on the Medicare for All Act of 2019, AHIP maintained that “patients would pay more to wait longer for worse care” under a single-payer system.

While it’s true that Canadians sometimes have to wait weeks or months for elective procedures (knee replacements are often cited), the truth is that they do not have to wait at all for the vast majority of medical services. And, contrary to another myth I used to peddle — that Canadian doctors are flocking to the United States — there are more doctors per 1,000 people in Canada than here. Canadians see their doctors an average of 6.8 times a year, compared with just four times a year in this country.

Most important, no one in Canada is turned away from doctors because of a lack of funds, and Canadians can get tested and treated for the coronavirus without fear of receiving a budget-busting medical bill. That undoubtedly is one of the reasons Canada’s covid-19 death rate is so much lower than ours. In America, exorbitant bills are a defining feature of our health-care system. Despite the assurances from President Trump and members of Congress that covid-19 patients will not be charged for testing or treatment, they are on the hook for big bills, according to numerous reports.

That is not the case in Canada, where there are no co-pays, deductibles or coinsurance for covered benefits. Care is free at the point of service. And those laid off in Canada don’t face the worry of losing their health insurance. In the United States, by contrast, . . .

Continue reading.

Written by LeisureGuy

8 August 2020 at 5:47 pm

Are we over weight yet? New guidelines aim to reduce obesity stigma in health care

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Sara FL Kirk, Angela Alberga, and Shelly Russell-Mayhew write in The Conversation:

The 2019 report from Canada’s Chief Public Health Officer Dr. Theresa Tam focused on addressing different forms of stigma. Included in the report was one form of stigma — obesity or weight stigma — that has proven remarkably difficult to overcome. We are hoping to change that.

As a team of researchers from across Canada, we have previously written about the harm that weight bias causes. Now, and for the first time, we are ensuring that the newly updated Canadian Clinical Practice Guidelines for obesity management include explicit guidance to reduce weight bias and obesity stigma among health professionals and policy-makers. The newly released guidelines also provide information for the public on advocating for change.

New guidelines reframe weight debate

With recommendations and key messages aimed at health professionals, policy-makers and people living with obesity, we hope that this guidance will help to reframe the weight debate. Shifting the emphasis from weight to health will help us reduce the prevalence and impact of weight bias and stigma.

The guidance is an important step forward because of the systemic nature of stigma and how different stigmas intersect, as highlighted in Dr. Tam’s report. In the United States, the prevalence of weight-based discrimination has increased by 66 per cent over the past decade, and is comparable to rates of racial discrimination, especially among women.

Our health-disrupting environment

Misrepresentations abound that frame obesity as a problem arising from a lack of willpower, or from laziness or greed. We use the language of war, viewing obesity as a battle, or something that needs to be fought.

The danger with this language is that it demonizes obesity and by extension, those experiencing obesity-related complications. This, in turn, affects their care. The new guidance seeks instead to humanize people with obesity, and ensure that they receive appropriate support.

The thing is, it’s not just about obesity. It is now well established that a complex web of factors affect every single one of us, regardless of weight status. We are all exposed to a health-disrupting environment. This manifests as excess body fatness in some, or as chronic disease markers in others.

None of us is immune to these powerful environmental prompts. Just like Sisyphus in Greek mythology was doomed to keep pushing a rock up a hill, only for it to roll back down again, our health-disrupting environment means that, as individuals, we are constantly pushing a boulder of health hazards up a ramp of social determinants.

It takes an enormous amount of cognitive effort to adopt and maintain healthy behaviours, such as being active or eating healthy foods, when everything around us is modelling the opposite. In essence, healthy behaviours are abnormal behaviours within our modern environment and unhealthy behaviours the default.

Furthermore, body weight and energy regulation are significantly controlled by genetics and neural networks, more so than our personal food and exercise choices.

Supporting health

Rather than focusing on a person’s weight status, we should turn our attention to supporting every individual to achieve their best health.

Health-care providers, and others, need to: . . .

Continue reading.

Written by LeisureGuy

5 August 2020 at 7:34 pm

How the Pandemic Defeated America

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Ed Yong  writes in the Atlantic:

How did it come to this? A virus a thousand times smaller than a dust mote has humbled and humiliated the planet’s most powerful nation. America has failed to protect its people, leaving them with illness and financial ruin. It has lost its status as a global leader. It has careened between inaction and ineptitude. The breadth and magnitude of its errors are difficult, in the moment, to truly fathom.

In the first half of 2020, SARS‑CoV‑2—the new coronavirus behind the disease COVID‑19—infected 10 million people around the world and killed about half a million. But few countries have been as severely hit as the United States, which has just 4 percent of the world’s population but a quarter of its confirmed COVID‑19 cases and deaths. These numbers are estimates. The actual toll, though undoubtedly higher, is unknown, because the richest country in the world still lacks sufficient testing to accurately count its sick citizens.

Despite ample warning, the U.S. squandered every possible opportunity to control the coronavirus. And despite its considerable advantages—immense resources, biomedical might, scientific expertise—it floundered. While countries as different as South Korea, Thailand, Iceland, Slovakia, and Australia acted decisively to bend the curve of infections downward, the U.S. achieved merely a plateau in the spring, which changed to an appalling upward slope in the summer. “The U.S. fundamentally failed in ways that were worse than I ever could have imagined,” Julia Marcus, an infectious-disease epidemiologist at Harvard Medical School, told me.

Since the pandemic began, I have spoken with more than 100 experts in a variety of fields. I’ve learned that almost everything that went wrong with America’s response to the pandemic was predictable and preventable. A sluggish response by a government denuded of expertise allowed the coronavirus to gain a foothold. Chronic underfunding of public health neutered the nation’s ability to prevent the pathogen’s spread. A bloated, inefficient health-care system left hospitals ill-prepared for the ensuing wave of sickness. Racist policies that have endured since the days of colonization and slavery left Indigenous and Black Americans especially vulnerable to COVID‑19. The decades-long process of shredding the nation’s social safety net forced millions of essential workers in low-paying jobs to risk their life for their livelihood. The same social-media platforms that sowed partisanship and misinformation during the 2014 Ebola outbreak in Africa and the 2016 U.S. election became vectors for conspiracy theories during the 2020 pandemic.

The U.S. has little excuse for its inattention. In recent decades, epidemics of SARS, MERS, Ebola, H1N1 flu, Zika, and monkeypox showed the havoc that new and reemergent pathogens could wreak. Health experts, business leaders, and even middle schoolers ran simulated exercises to game out the spread of new diseases. In 2018, I wrote an article for The Atlantic arguing that the U.S. was not ready for a pandemic, and sounded warnings about the fragility of the nation’s health-care system and the slow process of creating a vaccine. But the COVID‑19 debacle has also touched—and implicated—nearly every other facet of American society: its shortsighted leadership, its disregard for expertise, its racial inequities, its social-media culture, and its fealty to a dangerous strain of individualism.

SARS‑CoV‑2 is something of an anti-Goldilocks virus: just bad enough in every way. Its symptoms can be severe enough to kill millions but are often mild enough to allow infections to move undetected through a population. It spreads quickly enough to overload hospitals, but slowly enough that statistics don’t spike until too late. These traits made the virus harder to control, but they also softened the pandemic’s punch. SARS‑CoV‑2 is neither as lethal as some other coronaviruses, such as SARS and MERS, nor as contagious as measles. Deadlier pathogens almost certainly exist. Wild animals harbor an estimated 40,000 unknown viruses, a quarter of which could potentially jump into humans. How will the U.S. fare when “we can’t even deal with a starter pandemic?,” Zeynep Tufekci, a sociologist at the University of North Carolina and an Atlantic contributing writer, asked me.

Despite its epochal effects, COVID‑19 is merely a harbinger of worse plagues to come. The U.S. cannot prepare for these inevitable crises if it returns to normal, as many of its people ache to do. Normal led to this. Normal was a world ever more prone to a pandemic but ever less ready for one. To avert another catastrophe, the U.S. needs to grapple with all the ways normal failed us. It needs a full accounting of every recent misstep and foundational sin, every unattended weakness and unheeded warning, every festering wound and reopened scar.

Apandemic can be prevented in two ways: Stop an infection from ever arising, or stop an infection from becoming thousands more. The first way is likely impossible. There are simply too many viruses and too many animals that harbor them. Bats alone could host thousands of unknown coronaviruses; in some Chinese caves, one out of every 20 bats is infected. Many people live near these caves, shelter in them, or collect guano from them for fertilizer. Thousands of bats also fly over these people’s villages and roost in their homes, creating opportunities for the bats’ viral stowaways to spill over into human hosts. Based on antibody testing in rural parts of China, Peter Daszak of EcoHealth Alliance, a nonprofit that studies emerging diseases, estimates that such viruses infect a substantial number of people every year. “Most infected people don’t know about it, and most of the viruses aren’t transmissible,” Daszak says. But it takes just one transmissible virus to start a pandemic.

Sometime in late 2019, the wrong virus left a bat and ended up, perhaps via an intermediate host, in a human—and another, and another. Eventually it found its way to the Huanan seafood market, and jumped into dozens of new hosts in an explosive super-spreading event. The COVID‑19 pandemic had begun.

“There is no way to get spillover of everything to zero,” Colin Carlson, an ecologist at Georgetown University, told me. Many conservationists jump on epidemics as opportunities to ban the wildlife trade or the eating of “bush meat,” an exoticized term for “game,” but few diseases have emerged through either route. Carlson said the biggest factors behind spillovers are land-use change and climate change, both of which are hard to control. Our species has relentlessly expanded into previously wild spaces. Through intensive agriculture, habitat destruction, and rising temperatures, we have uprooted the planet’s animals, forcing them into new and narrower ranges that are on our own doorsteps. Humanity has squeezed the world’s wildlife in a crushing grip—and viruses have come bursting out.

Curtailing those viruses after they spill over is more feasible, but requires knowledge, transparency, and decisiveness that were lacking in 2020. Much about coronaviruses is still unknown. There are no surveillance networks for detecting them as there are for influenza. There are no approved treatments or vaccines. Coronaviruses were formerly a niche family, of mainly veterinary importance. Four decades ago, just 60 or so scientists attended the first international meeting on coronaviruses. Their ranks swelled after SARS swept the world in 2003, but quickly dwindled as a spike in funding vanished. The same thing happened after MERS emerged in 2012. This year, the world’s coronavirus experts—and there still aren’t many—had to postpone their triennial conference in the Netherlands because SARS‑CoV‑2 made flying too risky.

In the age of cheap air travel, an outbreak that begins on one continent can easily reach the others. SARS already demonstrated that in 2003, and more than twice as many people now travel by plane every year. To avert a pandemic, affected nations must alert their neighbors quickly. In 2003, China covered up the early spread of SARS, allowing the new disease to gain a foothold, and in 2020, history repeated itself. The Chinese government downplayed the possibility that SARS‑CoV‑2 was spreading among humans, and only confirmed as much on January 20, after millions had traveled around the country for the lunar new year. Doctors who tried to raise the alarm were censured and threatened. One, Li Wenliang, later died of COVID‑19. The World Health Organization initially parroted China’s line and did not declare a public-health emergency of international concern until January 30. By then, an estimated 10,000 people in 20 countries had been infected, and the virus was spreading fast.

The United States has correctly castigated China for its duplicity and the WHO for its laxity—but the U.S. has also failed the international community. Under President Donald Trump, the U.S. has withdrawn from several international partnerships and antagonized its allies. It has a seat on the WHO’s executive board, but left that position empty for more than two years, only filling it this May, when the pandemic was in full swing. Since 2017, Trump has pulled more than 30 staffers out of the Centers for Disease Control and Prevention’s office in China, who could have warned about the spreading coronavirus. Last July, he defunded an American epidemiologist embedded within China’s CDC. America First was America oblivious.

Even after warnings reached the U.S., they fell on the wrong ears. Since before his election, Trump has cavalierly dismissed expertise and evidence. He filled his administration with inexperienced newcomers, while depicting career civil servants as part of a “deep state.” In 2018, he dismantled an office that had been assembled specifically to prepare for nascent pandemics. American intelligence agencies warned about the coronavirus threat in January, but Trump habitually disregards intelligence briefings. The secretary of health and human services, Alex Azar, offered similar counsel, and was twice ignored.

Being prepared means being ready to . . .

Continue reading. There’s more — and no paywall.

Written by LeisureGuy

5 August 2020 at 4:09 pm

Vegetarians/vegans and stroke risk

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This is a very interesting video. For one thing, it shows how “adjusting” can be done to undermine the actual findings of a study: that happens when you “adjust” factors in the causal change and not irrelevant facts. Worth watching.

Written by LeisureGuy

5 August 2020 at 11:31 am

New findings on cinnamon for blood glucose control

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Very interesting and useful video, particularly if you have diabetes but even if you do not:

And this video points out something many do not know:

Written by LeisureGuy

2 August 2020 at 12:53 pm

This was the week America lost the war on misinformation

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Margaret Sullivan was the only good Public Editor the NY Times had. (The Times has since abolished the post, presumably because it kept pointing out errors and misjudgments by the Times.) She writes in the Washington Post:

You may have heard about the viral video featuring a group of fringe doctors spouting dangerous falsehoods about hydroxychloroquine as a covid-19 wonder cure.

In fact, it’s very possible you saw the video since it was shared on social media tens of millions of times — partly thanks to President Trump who retweeted it more than once, and who described the group’s Stella Immanuel, also known for promoting wacky notions about demon sperm and alien DNA, as “very impressive” and even “spectacular.”

Given this and a few other hideous developments, it’s time to acknowledge the painfully obvious: America has waved the white flag and surrendered.

With nearly 150,000 dead from covid-19, we’ve not only lost the public-health war, we’ve lost the war for truth. Misinformation and lies have captured the castle.

And the bad guys’ most powerful weapon? Social media — in particular, Facebook.

Some new research, out just this morning from Pew, tells us in painstaking numerical form exactly what’s going on, and it’s not pretty: Americans who rely on social media as their pathway to news are more ignorant and more misinformed than those who come to news through print, a news app on their phones or network TV.

And that group is growing.

The report’s language may be formal and restrained, but the meaning is utterly clear — and while not surprising, it’s downright scary in its implications.

“Even as Americans who primarily turn to social media for political news are less aware and knowledgeable about a wide range of events and issues in the news, they are more likely than other Americans to have heard about a number of false or unproven claims.”

Media coverage of the 2016 campaign was disastrous. Now’s the last chance to get 2020 right.

Specifically, they’ve been far more exposed to the conspiracy theory that powerful people intentionally planned the pandemic. Yet this group, says Pew, is also less concerned about the impact of made-up news like this than the rest of the U.S. population.

They’re absorbing fake news, but they don’t see it as a problem. In a society that depends on an informed citizenry to make reasonably intelligent decisions about self-governance, this is the worst kind of trouble.

And the president — who knows exactly what he is doing — is making it far, far worse. His war on the nation’s traditional press is a part of the same scheme: information warfare, meant to mess with reality and sow as much confusion as possible.

Will Sommer of the Daily Beast took a deeper look this week into the beliefs of Stella Immanuel — the Houston doctor whom Trump has termed “very impressive” and “spectacular.”

“She has often claimed that gynecological problems like cysts and endometriosis are in fact caused by people having sex in their dreams with demons and witches,” Sommer wrote. “She alleges alien DNA is currently used in medical treatments, and that scientists are cooking up a vaccine to prevent people from being religious. And, despite appearing in Washington, D.C., to lobby Congress on Monday, she has said that the government is run in part not by humans but by ‘reptilians’ and other aliens.”

Immanuel said in a recent speech in Washington that the power of hydroxychloroquine as a treatment means that protective face masks aren’t necessary. None of this has a basis in fact — but try telling that to the tens of millions who have not only seen it but been urged to believe it.

The video featuring Immanuel and others eventually was taken down by Facebook. But as usual, it was far too late.

And Donald Trump Jr., who tweeted it out calling it a “must watch,” got his hand slapped by Twitter — briefly losing his right to sully the truth and jam the gears of reality. . . .

Continue reading. There’s even more. The US is becoming a basket case.

Written by LeisureGuy

30 July 2020 at 11:59 am

Is Your Blood Sugar Undermining Your Workouts?

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Another strike against a diet high in refined sugar and highly processed foods. Gretchen Reynolds writes in the NY Times:

People with consistently high levels of blood sugar could get less benefit from exercise than those whose blood sugar levels are normal, according to a cautionary new study of nutrition, blood sugar and exercise. The study, which involved rodents and people, suggests that eating a diet high in sugar and processed foods, which may set the stage for poor blood sugar control, could dent our long-term health in part by changing how well our bodies respond to a workout.

We already have plenty of evidence, of course, that elevated blood sugar is unhealthy. People with hyperglycemia tend to be overweight and face greater long-term risks for heart disease and Type 2 diabetes, even if, in the early stages, their condition does not meet the criteria for those diseases.

They also tend to be out of shape. In epidemiological studies, people with elevated blood sugar often also have low aerobic fitness, while, in animal studies, rats bred with low endurance from birth show early blood-sugar problems, as well. This interrelationship between blood sugar and fitness is consequential in part because low aerobic fitness is closely linked to a high risk of premature death.

But most past studies of blood sugar and fitness have been epidemiological, meaning they have identified links between the two conditions but not their sequence or mechanisms. They have not clarified whether hyperglycemia usually precedes and leads to low fitness, or the other way around, or how either condition manages to influence the other.

So, for the new study, which was published this month in Nature Metabolism, researchers at the Joslin Diabetes Center in Boston and other institutions decided to raise blood sugar levels in mice and see what happened when they exercised.

They started with adult mice, switching some from normal chow to a diet high in sugar and saturated fat, similar to what many of us in the developed world eat nowadays. These mice rapidly gained weight and developed habitually high blood sugar.

They injected other mice with a substance that reduces their ability to produce insulin, a hormone that helps to control blood sugar, similar to when people have certain forms of diabetes. Those animals did not get fatter, but their blood sugar levels rose to the same extent as among the mice in the sugary diet group.

Other animals remained on their normal chow, as a control group.

After four months, the scientists checked each mouse’s fitness by measuring how long it could run on a treadmill before exhaustion. They then put a running wheel in each animal’s cage and let them jog at will for the next six weeks, which they did. On average, each mouse ran about 300 miles during that month and a half.

But they did not all gain the same level of fitness. The control group now ran for a much longer period of time on the treadmill before exhaustion; they were much fitter. But the animals with high blood sugar showed little improvement. Their aerobic fitness had barely budged.

Interestingly, their exercise resistance was the same, whether their blood sugar problems stemmed from poor diet or lack of insulin, and whether they were overweight or slimmer. If they had high blood sugar, they resisted the benefits of exercise.

To better understand why, the scientists next looked inside muscles. And conditions there were telling. The muscles of the control animals teemed with healthy, new muscle fibers and a network of new blood vessels ferrying extra oxygen and fuel to them. But the muscle tissues of the animals with high blood sugar displayed mostly new deposits of collagen, a rigid substance that seems to have crowded out new blood vessels and prevented the muscles from adapting to the exercise and contributing to better fitness.

Finally, . . .

Continue reading.

Written by LeisureGuy

29 July 2020 at 10:41 am

My dental routine

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I got a request for this information, so I though a summarizing post might be useful. I should acknowledge that Eddie from Australia, a blog reader, first told me about these products. I’m glad he did.

My routine comprises the following steps:

  1. Brush with a Sonicare toothbrush and a fluoride toothpaste. I avoid the “whitening” formula ones since they basically bleach the teeth.
  2. Use a Waterpik following the brushing, which always rinses out at least some debris and sometimes a fair amount. I use a portable Waterpik.
  3. Brush using a 3-row Bass toothbrush and OraWellness’s HealThy Mouth Blend (1-2 drops), following the instructions in the videos (i.e., angled and with small movements). (I believe the 3-row does a better job than the 4-row at getting between the teeth.)
  4. Brush using using Shine toothpowder following instructions in video (i.e., up and down motion). I don’t rinse after brushing with Shine.
  5. At least in the evening, I follow the above with flossing. Sometimes I also floss after breakfast on lunch, depending on what I’ve eaten.

You can find the Bass toothbrush, HealThy Mouth Blend, and Shine at the OraWellness online store. I bought a dozen of the toothbrushes to avoid having to reorder so soon, and I also bought the 3-bottle pack of HealThy Mouth Blend and the bulk bag of Shine — however, that I did after an order of one of each, to make sure I liked them. I like them a lot.

Watch these videos:

Example:

Written by LeisureGuy

27 July 2020 at 10:59 am

Posted in Daily life, Health, Medical

Predictable catastrophe: Mass migration from global warming

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Although everyone can see it will happen, no one seems to be preparing for it. Abrahm Lustgarten reports in ProPublica:

This article, the first in a series on global climate migration, is a partnership between ProPublica and The New York Times Magazine, with support from the Pulitzer CenterRead more about the data project that underlies the reporting.

EARLY IN 2019, a year before the world shut its borders completely, Jorge A. knew he had to get out of Guatemala. The land was turning against him. For five years, it almost never rained. Then it did rain, and Jorge rushed his last seeds into the ground. The corn sprouted into healthy green stalks, and there was hope — until, without warning, the river flooded. Jorge waded chest-deep into his fields searching in vain for cobs he could still eat. Soon he made a last desperate bet, signing away the tin-roof hut where he lived with his wife and three children against a $1,500 advance in okra seed. But after the flood, the rain stopped again, and everything died. Jorge knew then that if he didn’t get out of Guatemala, his family might die, too.

Even as hundreds of thousands of Guatemalans fled north toward the United States in recent years, in Jorge’s region — a state called Alta Verapaz, where precipitous mountains covered in coffee plantations and dense, dry forest give way to broader gentle valleys — the residents have largely stayed. Now, though, under a relentless confluence of drought, flood, bankruptcy and starvation, they, too, have begun to leave. Almost everyone here experiences some degree of uncertainty about where their next meal will come from. Half the children are chronically hungry, and many are short for their age, with weak bones and bloated bellies. Their families are all facing the same excruciating decision that confronted Jorge.

The odd weather phenomenon that many blame for the suffering here — the drought and sudden storm pattern known as El Niño — is expected to become more frequent as the planet warms. Many semiarid parts of Guatemala will soon be more like a desert. Rainfall is expected to decrease by 60% in some parts of the country, and the amount of water replenishing streams and keeping soil moist will drop by as much as 83%. Researchers project that by 2070, yields of some staple crops in the state where Jorge lives will decline by nearly a third.

Scientists have learned to project such changes around the world with surprising precision, but — until recently — little has been known about the human consequences of those changes. As their land fails them, hundreds of millions of people from Central America to Sudan to the Mekong Delta will be forced to choose between flight or death. The result will almost certainly be the greatest wave of global migration the world has seen.

In March, Jorge and his 7-year-old son each packed a pair of pants, three T-shirts, underwear and a toothbrush into a single thin black nylon sack with a drawstring. Jorge’s father had pawned his last four goats for $2,000 to help pay for their transit, another loan the family would have to repay at 100% interest. The coyote called at 10 p.m. — they would go that night. They had no idea then where they would wind up, or what they would do when they got there.

From decision to departure, it was three days. And then they were gone.

FOR MOST OF HUMAN history, people have lived within a surprisingly narrow range of temperatures, in the places where the climate supported abundant food production. But as the planet warms, that band is suddenly shifting north. According to a pathbreaking recent study in the journal Proceedings of the National Academy of Sciences, the planet could see a greater temperature increase in the next 50 years than it did in the last 6,000 years combined. By 2070, the kind of extremely hot zones, like in the Sahara, that now cover less than 1% of the earth’s land surface could cover nearly a fifth of the land, potentially placing 1 of every 3 people alive outside the climate niche where humans have thrived for thousands of years. Many will dig in, suffering through heat, hunger and political chaos, but others will be forced to move on. A 2017 study in Science Advances found that by 2100, temperatures could rise to the point that just going outside for a few hours in some places, including parts of India and Eastern China, “will result in death even for the fittest of humans.”

People are already beginning to flee. In Southeast Asia, where increasingly unpredictable monsoon rainfall and drought have made farming more difficult, the World Bank points to more than 8 million people who have moved toward the Middle East, Europe and North America. In the African Sahel, millions of rural people have been streaming toward the coasts and the cities amid drought and widespread crop failures. Should the flight away from hot climates reach the scale that current research suggests is likely, it will amount to a vast remapping of the world’s populations.

Migration can bring great opportunity not just to migrants but also to the places they go. As the United States and other parts of the global North face a demographic decline, for instance, an injection of new people into an aging workforce could be to everyone’s benefit. But securing these benefits starts with a choice: Northern nations can relieve pressures on the fastest-warming countries by allowing more migrants to move north across their borders, or they can seal themselves off, trapping hundreds of millions of people in places that are increasingly unlivable. The best outcome requires not only goodwill and the careful management of turbulent political forces; without preparation and planning, the sweeping scale of change could prove wildly destabilizing. The United Nations and others warn that in the worst case, the governments of the nations most affected by climate change could topple as whole regions devolve into war.

The stark policy choices are already becoming apparent. As refugees stream out of the Middle East and North Africa into Europe and from Central America into the United States, an anti-immigrant backlash has propelled nationalist governments into power around the world. The alternative, driven by a better understanding of how and when people will move, is governments that are actively preparing, both materially and politically, for the greater changes to come.

Last summer, I went to Central America to learn how people like Jorge will respond to changes in their climates. I followed the decisions of people in rural Guatemala and their routes to the region’s biggest cities, then north through Mexico to Texas. I found an astonishing need for food and witnessed the ways competition and poverty among the displaced broke down cultural and moral boundaries. But the picture on the ground is scattered. To better understand the forces and scale of climate migration over a broader area, The New York Times Magazine and ProPublica joined with the Pulitzer Center in an effort to model, for the first time, how people will move across borders.

We focused on changes in Central America and used climate and economic-development data to examine a range of scenarios. Our model projects that migration will rise every year regardless of climate, but that the amount of migration increases substantially as the climate changes. In the most extreme climate scenarios, more than 30 million migrants would head toward the U.S. border over the course of the next 30 years.

Migrants move for many reasons, of course. The model helps us see which migrants are driven primarily by climate, finding that they would make up as much as 5% of the total. If governments take modest action to reduce climate emissions, about 680,000 climate migrants might move from Central America and Mexico to the United States between now and 2050. If emissions continue unabated, leading to more extreme warming, that number jumps to more than a million people. (None of these figures include undocumented immigrants, whose numbers could be twice as high.)

The model shows that the political responses to both climate change and migration can lead to drastically different futures. . .

Continue reading. There’s much more, including informative graphics.

Later in the article:

IN NOVEMBER 2007, Alan B. Krueger, a labor economist known for his statistical work on inequality, walked into the Princeton University offices of Michael Oppenheimer, a leading climate geoscientist, and asked him whether anyone had ever tried to quantify how and where climate change would cause people to move.

Earlier that year, Oppenheimer helped write the U.N. Intergovernmental Panel on Climate Change report that, for the first time, explored in depth how climate disruption might uproot large segments of the global population. But as groundbreaking as the report was — the U.N. was recognized for its work with a Nobel Peace Prize — the academic disciplines whose work it synthesized were largely siloed from one another. Demographers, agronomists and economists were all doing their work on climate change in isolation, but understanding the question of migration would have to include all of them.

Together, Oppenheimer and Krueger, who died in 2019, began to chip away at the question, asking whether tools typically used by economists might yield insight into the environment’s effects on people’s decision to migrate. They began to examine the statistical relationships — say, between census data and crop yields and historical weather patterns — in Mexico to try to understand how farmers there respond to drought. The data helped them create a mathematical measure of farmers’ sensitivity to environmental change — a factor that Krueger could use the same way he might evaluate fiscal policies, but to model future migration.

Their study, published in 2010 in Proceedings of the National Academy of Sciences, found that Mexican migration to the United States pulsed upward during periods of drought and projected that by 2080, climate change there could drive 6.7 million more people toward the southern U.S. border. “It was,” Oppenheimer said, “one of the first applications of econometric modeling to the climate-migration problem.”

The modeling was a start. But it was hyperlocal instead of global, and it left open huge questions: how cultural differences might change outcomes, for example, or how population shifts might occur across larger regions. It was also controversial, igniting a backlash among climate-change skeptics, who attacked the modeling effort as “guesswork” built on “tenuous assumptions” and argued that a model couldn’t untangle the effect of climate change from all the other complex influences that determine human decision-making and migration. That argument eventually found some traction with migration researchers, many of whom remain reluctant to model precise migration figures.

But to Oppenheimer and Krueger, the risks of putting a specific shape to this well established but amorphous threat seemed worth taking. In the early 1970s, after all, many researchers had made a similar argument against using computer models to forecast climate change, arguing that scientists shouldn’t traffic in predictions. Others ignored that advice, producing some of the earliest projections about the dire impact of climate change, and with them some of the earliest opportunities to try to steer away from that fate. Trying to project the consequences of climate-driven migration, to Oppenheimer, called for similarly provocative efforts. “If others have better ideas for estimating how climate change affects migration,” he wrote in 2010, “they should publish them.”

Since then, Oppenheimer’s approach has become common. Dozens more studies have applied econometric modeling to climate-related problems, seizing on troves of data to better understand how environmental change and conflict each lead to migration and clarify how the cycle works. Climate is rarely the main cause of migration, the studies have generally found, but it is almost always an exacerbating one.

As they have looked more closely, migration researchers have found climate’s subtle fingerprints almost everywhere. Drought helped push many Syrians into cities before the war, worsening tensions and leading to rising discontent; crop losses led to unemployment that stoked Arab Spring uprisings in Egypt and Libya; Brexit, even, was arguably a ripple effect of the influx of migrants brought to Europe by the wars that followed. And all those effects were bound up with the movement of just 2 million people. As the mechanisms of climate migration have come into sharper focus — food scarcity, water scarcity and heat — the latent potential for large-scale movement comes to seem astronomically larger.

Written by LeisureGuy

23 July 2020 at 12:43 pm

Inside Trump’s Failure: The Rush to Abandon Leadership Role on the Virus

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Michael D. Shear, Noah Weiland, Eric Lipton, Maggie Haberman, and David E. Sanger report in the NY Times:

Each morning at 8 as the coronavirus crisis was raging in April, Mark Meadows, the White House chief of staff, convened a small group of aides to steer the administration through what had become a public health, economic and political disaster.

Seated around Mr. Meadows’s conference table and on a couch in his office down the hall from the Oval Office, they saw their immediate role as practical problem solvers. Produce more ventilators. Find more personal protective equipment. Provide more testing.

But their ultimate goal was to shift responsibility for leading the fight against the pandemic from the White House to the states. They referred to this as “state authority handoff,” and it was at the heart of what would become at once a catastrophic policy blunder and an attempt to escape blame for a crisis that had engulfed the country — perhaps one of the greatest failures of presidential leadership in generations.

Over a critical period beginning in mid-April, President Trump and his team convinced themselves that the outbreak was fading, that they had given state governments all the resources they needed to contain its remaining “embers” and that it was time to ease up on the lockdown.

In doing so, he was ignoring warnings that the numbers would continue to drop only if social distancing was kept in place, rushing instead to restart the economy and tend to his battered re-election hopes.

Casting the decision in ideological terms, Mr. Meadows would tell people: “Only in Washington, D.C., do they think that they have the answer for all of America.”

For scientific affirmation, they turned to Dr. Deborah L. Birx, the sole public health professional in the Meadows group. A highly regarded infectious diseases expert, she was a constant source of upbeat news for the president and his aides, walking the halls with charts emphasizing that outbreaks were gradually easing. The country, she insisted, was likely to resemble Italy, where virus cases declined steadily from frightening heights.

On April 11, she told the coronavirus task force in the Situation Room that the nation was in good shape. Boston and Chicago are two weeks away from the peak, she cautioned, but the numbers in Detroit and other hard-hit cities are heading down.

A sharp pivot soon followed, with consequences that continue to plague the country today as the virus surges anew.

Even as a chorus of state officials and health experts warned that the pandemic was far from under control, Mr. Trump went, in a matter of days, from proclaiming that he alone had the authority to decide when the economy would reopen to pushing that responsibility onto the states. The government issued detailed reopening guidelines, but almost immediately, Mr. Trump began criticizing Democratic governors who did not “liberate” their states.

Mr. Trump’s bet that the crisis would fade away proved wrong. But an examination of the shift in April and its aftermath shows that the approach he embraced was not just a misjudgment. Instead, it was a deliberate strategy that he would stick doggedly to as evidence mounted that, in the absence of strong leadership from the White House, the virus would continue to infect and kill large numbers of Americans.

He and his top aides would openly disdain the scientific research into the disease and the advice of experts on how to contain it, seek to muzzle more authoritative voices like Dr. Anthony S. Fauci and continue to distort reality even as it became clear that his hopes for a rapid rebound in the economy and his electoral prospects were not materializing.

Mr. Trump had missed or dismissed mounting signals of the impending crisis in the early months of the year. Now, interviews with more than two dozen officials inside the administration and in the states, and a review of emails and documents, reveal previously unreported details about how the White House put the nation on its current course during a fateful period this spring.

  • Key elements of the administration’s strategy were formulated out of sight in Mr. Meadows’s daily meetings, by aides who for the most part had no experience with public health emergencies and were taking their cues from the president. Officials in the West Wing saw the better-known White House coronavirus task force as dysfunctional, came to view Dr. Fauci as a purveyor of dire warnings but no solutions and blamed officials from the Centers for Disease Control and Prevention for mishandling the early stages of the virus.

  • Dr. Birx was more central than publicly known to the judgment inside the West Wing that the virus was on a downward path. Colleagues described her as dedicated to public health and working herself to exhaustion to get the data right, but her model-based assessment nonetheless failed to account for a vital variable: how Mr. Trump’s rush to urge a return to normal would help undercut the social distancing and other measures that were holding down the numbers.

  • The president quickly came to feel trapped by his own reopening guidelines. States needed declining cases to reopen, or at least a declining rate of positive tests. But more testing meant overall cases were destined to go up, undercutting the president’s push to crank up the economy. The result was to intensify Mr. Trump’s remarkable public campaign against testing, a vivid example of how he often waged war with science and his own administration’s experts and stated policies.

  • Mr. Trump’s bizarre public statements, his refusal to wear a mask and his pressure on states to get their economies going again left governors and other state officials scrambling to deal with a leadership vacuum. At one stage, Gov. Gavin Newsom of California was told that if he wanted the federal government to help obtain the swabs needed to test for the virus, he would have to ask Mr. Trump himself — and thank him.

  • Not until early June did White House officials even begin to recognize that their assumptions about the course of the pandemic had proved wrong. Even now there are internal divisions over how far to go in having officials publicly acknowledge the reality of the situation.

Judd Deere, a White House spokesman, said the president had imposed travel restrictions on China early in the pandemic, signed economic relief measures that have provided Americans with critical assistance and dealt with other issues including supplies of personal protective equipment, testing capacity and vaccine development.

“President Trump and his bold actions from the very beginning of this pandemic stand in stark contrast to the do-nothing Democrats and radical left who just complain, criticize and condemn anything this president does to preserve this nation,” he said.

At a briefing on April 10, Mr. Trump predicted that the number of deaths in the United States from the pandemic would be “substantially” fewer than 100,000. As of Saturday, the death toll stood at 139,186, the pace of new deaths was rising again and the country, logging a seven-day average of 65,790 new cases a day, had more confirmed cases per capita than any other major industrial nation.

The president had a decision to make.

It was the end of March and his initial, 15-day effort to slow the spread of the virus by essentially shutting down the country was expiring in days. Sitting in front of the Resolute Desk in the Oval Office were Drs. Fauci and Birx, along with other top officials. Days earlier, Mr. Trump had said he envisioned the country being “opened up and raring to go” by Easter, but now he was on the verge of announcing that he would keep the country shut down for another 30 days.

“Do you really think we need to do this?” the president asked Dr. Fauci. “Yeah, we really do need to do it,” Dr. Fauci replied, explaining again the federal government’s role in making sure the virus did not explode across the country.

Mr. Trump’s willingness to go along — driven in part by grim television images of bodies piling up at Elmhurst Hospital Center in New York City — was a concession that federal responsibility was crucial to defeating a virus that did not respect state boundaries. In a later Rose Garden appearance, he appeared resigned to continuing the battle.

“Nothing would be worse than declaring victory before the victory is won,” Mr. Trump said.

But even as the president was acknowledging the need for tough decisions, he and his aides would soon be looking to do the opposite — build a public case that the federal government had completed its job and unshackle the president from ownership of the response. . .

Continue reading. There’s much more.

Written by LeisureGuy

19 July 2020 at 8:05 am

A doctor’s comment on the novel coronavirus — and Trump’s support for the spread of Covid-19

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Seen on Facebook

Chickenpox is a virus. Lots of people have had it, and probably don’t think about it much once the initial illness has passed. But it stays in your body and lives there forever, and maybe when you’re older, you have debilitatingly painful outbreaks of shingles. You don’t just get over this virus in a few weeks, never to have another health effect. We know this because it’s been around for years, and has been studied medically for years.
Herpes is also a virus. And once someone has it, it stays in your body and lives there forever, and anytime they get a little run down or stressed-out they’re going to have an outbreak. Maybe every time you have a big event coming up (school pictures, job interview, big date) you’re going to get a cold sore. For the rest of your life. You don’t just get over it in a few weeks. We know this because it’s been around for years, and been studied medically for years.
HIV is a virus. It attacks the immune system and makes the carrier far more vulnerable to other illnesses. It has a list of symptoms and negative health impacts that goes on and on. It was decades before viable treatments were developed that allowed people to live with a reasonable quality of life. Once you have it, it lives in your body forever and there is no cure. Over time, that takes a toll on the body, putting people living with HIV at greater risk for health conditions such as cardiovascular disease, kidney disease, diabetes, bone disease, liver disease, cognitive disorders, and some types of cancer. We know this because it has been around for years, and had been studied medically for years.
Now with COVID-19, we have a novel virus that spreads rapidly and easily. The full spectrum of symptoms and health effects is only just beginning to be cataloged, much less understood.
So far the symptoms may include:
Fever
Fatigue
Coughing
Pneumonia
Chills/Trembling
Acute respiratory distress
Lung damage (potentially permanent)
Loss of taste (a neurological symptom)
Sore throat
Headaches
Difficulty breathing
Mental confusion
Diarrhea
Nausea or vomiting
Loss of appetite
Strokes have also been reported in some people who have COVID-19 (even in the relatively young)
Swollen eyes
Blood clots
Seizures
Liver damage
Kidney damage
Rash
COVID toes (weird, right?)
People testing positive for COVID-19 have been documented to be sick even after 60 days. Many people are sick for weeks, get better, and then experience a rapid and sudden flare up and get sick all over again. A man in Seattle was hospitalized for 62 days, and while well enough to be released, still has a long road of recovery ahead of him. Not to mention a $1.1 million medical bill.
Then there is MIS-C. Multisystem inflammatory syndrome in children is a condition where different body parts can become inflamed, including the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs. Children with MIS-C may have a fever and various symptoms, including abdominal pain, vomiting, diarrhea, neck pain, rash, bloodshot eyes, or feeling extra tired. While rare, it has caused deaths.
This disease has not been around for years. It has basically been 6 months. No one knows yet the long-term health effects, or how it may present itself years down the road for people who have been exposed. We literally *do not know* what we do not know.
For those in our society who suggest that people being cautious are cowards, for people who refuse to take even the simplest of precautions to protect themselves and those around them, I want to ask, without hyperbole and in all sincerity:
How dare you?
How dare you risk the lives of others so cavalierly. How dare you decide for others that they should welcome exposure as “getting it over with”, when literally no one knows who will be the lucky “mild symptoms” case, and who may fall ill and die. Because while we know that some people are more susceptible to suffering a more serious case, we also know that 20 and 30-year-olds have died, marathon runners and fitness nuts have died, children and infants have died.
How dare you behave as though you know more than medical experts, when those same experts acknowledge that there is so much we don’t yet know, but with what we DO know, are smart enough to be scared of how easily this is spread, and recommend baseline precautions such as:
Frequent hand-washing
Physical distancing
Reduced social/public contact or interaction
Mask wearing
Covering your cough or sneeze
Avoiding touching your face
Sanitizing frequently touched surfaces
The more things we can all do to mitigate our risk of exposure, the better off we all are, in my opinion. Not only does it flatten the curve and allow health care providers to maintain levels of service that aren’t immediately and catastrophically overwhelmed; it also reduces unnecessary suffering and deaths, and buys time for the scientific community to study the virus in order to come to a more full understanding of the breadth of its impacts in both the short and long term.
I reject the notion that it’s “just a virus” and we’ll all get it eventually. What a careless, lazy, heartless stance.”
Meanwhile, the NY Times reportsThe White House is pushing to eliminate billions for coronavirus testing and tracing from a relief proposal drafted by Senate Republicans.”

The Trump administration has objected to the inclusion of billions of dollars for coronavirus testing and tracing across the country in an opening draft proposal from Senate Republicans for the next coronavirus relief package, further complicating efforts to reach an agreement on the legislation.

The draft suggested allocating $25 billion to states for testing and contact tracing, as well as almost $10 billion to shore up the Centers for Disease Control and Prevention and $15 billion to bolster the National Institutes of Health, according to a person familiar with the tentative plans, who cautioned that the final dollar figures remained in flux.

The administration has instead pushed to eliminate all of those funds and has also called for cutting billions of dollars set aside for the Pentagon and the State Department to help counter the outbreak and potentially distribute a vaccine at home and abroad.

The suggestions from the administration, according to two people familiar with the proposals, included funding priorities unrelated to the spread of the coronavirus, including the contentious effort to construct a new building for the F.B.I. The people asked for anonymity to disclose private details of the talks, which were first reported by The Washington Post.

Spokespeople for the White House and the Treasury Department did not immediately respond to requests for comment. A senior administration official, speaking on the condition of anonymity, said on Saturday that discussions were just beginning and that the White House team remained committed to ensuring “appropriate levels across all agencies to address this crisis.”

Lawmakers are expected to start an intense round of negotiations before the end of the month, as a number of provisions approved in the existing $2.2 trillion stimulus package are set to expire and as coronavirus cases are skyrocketing across the country. . .

The Trump administration actively supports the spread of Covid-19.

Written by LeisureGuy

18 July 2020 at 4:44 pm

Who would kick millions off health insurance in the middle of a pandemic?

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Catherine Rampell writes in the Washington Post:

In the midst of a pandemic — when Americans most need health insurance, and millions can’t find work — the Trump administration wants to kick Americans off their health insurance if they aren’t working.

Heartless, but it’s true.

This week, the Trump administration and the state of Arkansas asked the Supreme Court to allow reinstatement of Medicaid work requirements. This disastrous policy was struck down by lower courts last year after causing 18,000 low-income Arkansans to lose their insurance. Subsequent research found that 95 percent of residents targeted by the policy were working, or had qualified for an exemption. They were kicked off Medicaid all the same.

That’s because the program’s reporting requirements were so onerous and confusing that it was nearly impossible to prove compliance.

These efforts to erect artificial barriers to safety-net services that Americans are legally entitled to, and desperately need, are of apiece with other Trump regulatory actions.

President Trump claims to favor slashing red tape and bureaucracy. He boasts about his “historic deregulation.” Yet his administration has repeatedly raised regulatory costs for disfavored groups or perceived enemies (poor people, immigrants, media companies). It has been especially active in heightening administrative burdens as a backdoor way to limit access to safety-net programs, even when Congress rejected proposals to cut these programs directly.

For example, the administration has tried, also during the pandemic, to raise work requirements for the Supplemental Nutrition Assistance Program (SNAP, a.k.a. food stamps). Another proposed rule would restrict states’ ability to make families “categorically eligible” for nutritional services based on their receipt of another government benefit; this would cause nearly 1 million schoolchildren to lose automatic eligibility for free lunches.

It has required states to get more frequent and onerous documentation from families re-enrolling in Medicaid — even when those states have the necessary information on file from administrative records. This has caused sick children to abruptly lose access to care.

The strategy is not unique to the Trump administration. Florida, for instance, made its application process for unemployment insurance more difficult to reduce spending.

Many such policies have been added under the pretext of reducing waste, fraud and abuse. If genuine, this would perhaps be a worthy goal. But the (over) emphasis on compliance — when there are relatively few errors in benefit use, and takeup rates for eligible families remain pitifully low — appears at best misguided. At worst, it may be racially motivated, the latest iteration in the ugly myth of (black) “welfare queens.”

Better 10 poor families go hungry, the thinking goes, than one possibly “undeserving” moocher get food stamps. But in an economy suffering double-digit unemployment, shouldn’t critical safety-net programs be accessible to all the families they’re supposed to serve?

It’s tempting to think of this as a partisan divide: Democrats prefer big government, and tend to err on the side of slashing administrative burdens to serve as many people as possible; Republicans prefer small government, so tilt toward more paperwork that will catch the cheats. But that’s not entirely right.

As Pamela Herd and Donald P. Moynihan argue in their excellent book, “Administrative Burden: Policymaking by Other Means,” conservatives want government to operate efficiently, too. Requiring reams of unnecessary or duplicative paperwork creates costs for both beneficiaries and the government agencies that process applications.

And there are good examples of Republican efforts to reduce administrative burden in order to improve program access and efficiency.

The George W. Bush administration, for example, reduced compliance costs for SNAP enrollment when officials noticed participation had plummeted. Republican-controlled Idaho had also been a leader in making Medicaid re-enrollment relatively painless — until the Trump administration intervened.

There are also ways to streamline benefit enrollment and root out fraud without making applicants’ lives a living hell.

In Michigan, for example, the state’s previous (Republican) administration was so hyperfocused on benefit fraud it falsely accused 40,000 residents of it. This obsession — and the additional administrative burdens it inspired — appears somewhat motivated by a widely circulated anecdote about a person arriving at a benefits office in a Hummer.

When a Democratic administration took office last year, it redesigned policies and reduced paperwork requirements to make safety-net programs more accessible. But it also requested more inspector-general funding to help develop “targeted, analytically informed enforcement,” according to Robert Gordon, director of Michigan’s Department of Health and Human Services. . .

Continue reading.

Written by LeisureGuy

16 July 2020 at 8:41 pm

What Happens if You Have Red Wine or Avocados with a Meal?

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Dr. Michael Greger blogs:

Whole plant sources of sugar and fat can ameliorate some of the postprandial (after meal) inflammation caused by the consumption of refined carbohydrates and meat.

Studies have shown how adding even steamed skinless chicken breast can exacerbate the insulin spike from white rice, but fish may be worse. At 0:18 in my video The Effects of Avocados and Red Wine on Meal-Induced Inflammation, you can see how the insulin scores of a low-carbohydrate plant food, peanuts, is lower compared to common low-carb animal foods—eggs, cheese, and beef. Fish was even worse, with an insulin score closer to doughnut territory.

At 0:36 in my video, you can see the insulin spike when people are fed mashed white potatoes. What do you think happens when they’re also given tuna fish? Twice the insulin spike. The same is seen with white flour spaghetti versus white flour spaghetti with meat. The addition of animal protein may make the pancreas work twice as hard.

You can do it with straight sugar water, too. If you perform a glucose challenge to test for diabetes, drinking a certain amount of sugar, at 1:10 in my video, you can see the kind of spike in insulin you get. But, if you take in the exact same amount of sugar but with some meat added, you get a higher spike. And, as you can see at 1:25 in my video, the more meat you add, the worse it gets. Just adding a little meat to carbs doesn’t seem to do much, but once you get up to around a third of a chicken’s breast worth, you can elicit a significantly increased surge of insulin.

So, a chicken sandwich may aggravate the metabolic harm of the refined carb white bread it’s on, but what about a PB&J? At 1:49 in my video, you can see that adding nuts to Wonder Bread actually calms the insulin and blood sugar response. What if, instead of nuts, you smeared on an all fruit [i.e., no sugar – LG] strawberry jam? Berries, which have even more antioxidants than nuts, can squelch the oxidation of cholesterol in response to a typical American breakfast and even reduce the amount of fat in your blood after the meal. And, with less oxidation, there is less inflammation when berries are added to a meal.

So, a whole plant food source of sugar can decrease inflammation in response to an “inflammatory stressor” meal, but what about a whole plant food source of fat? As you can see at 2:38 in my video, within hours of eating a burger topped with half an avocado, the level of an inflammatory biomarker goes up in your blood, but not as high as eating the burger without the avocado. This may be because all whole plant foods contain antioxidants, which decrease inflammation, and also contain fiber, which is one reason even high fat whole plant foods like nuts can lower cholesterol. And, the same could be said for avocados. At 3:12 in my video, you can see avocado causing a significant drop in cholesterol levels, especially in those with high cholesterol, with even a drop in triglycerides.

If eating berries with a meal decreases inflammation, what about drinking berries? Sipping wine with your white bread significantly blunts the blood sugar spike from the bread, but the alcohol increases the fat in the blood by about the same amount. As you can see at 3:40 in my video, you’ll get a triglycerides bump when you eat some cheese and crackers, but if you sip some wine with the same snack, triglycerides shoot through the roof. How do we know it was the alcohol? Because if you use dealcoholized red wine, the same wine but with the alcohol removed, you don’t get the same reaction. This has been shown in about a half dozen other studies, along with an increase in inflammatory markers. So, the dealcoholized red wine helps in some ways but not others.

A similar paradoxical effect was found with exercise. If people cycle at high intensity for about an hour a half-day before drinking a milkshake, the triglycerides response is less than without the prior exercise, yet the inflammatory response to the meal appeared worse, as you can see at 4:18 in my video. The bottom line is not to avoid exercise but to avoid milkshakes.

The healthiest approach is a whole food, plant-based diet, but there are “promising pharmacologic approaches to the normalization” of high blood sugars and fat by taking medications. “However, resorting to drug therapy for an epidemic caused by a maladaptive diet is less rational than simply realigning our eating habits with our physiological needs.”

Protein from meat can cause more of an insulin spike than pure table sugar. See the comparisons in my video Paleo Diets May Negate Benefits of Exercise.

Interested in more information on the almond butter study I mentioned? . . .

Continue reading.

Written by LeisureGuy

16 July 2020 at 10:51 am

The Single Most Important Lesson From the 1918 Influenza

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Back in March, John M. Barry (see previous post) wrote in the NY Times:

In 1918, a new respiratory virus invaded the human population and killed between 50 million and 100 million people — adjusted for population, that would equal 220 million to 430 million people today. Late last year another new respiratory virus invaded the human population, and the reality of a pandemic is now upon us. Although clearly a serious threat to human health, it does not appear to be as deadly as the 1918 influenza pandemic. But it is far more lethal than 2009’s H1N1 (swine flu) pandemic, and the coronavirus does not resemble SARS, MERS or Ebola, all of which can be easily contained.

About 15 years ago, after yet another global contagion — the so-called bird flu — emerged in Asia, killing about 60 percent of the people it infected and threatening a catastrophic influenza pandemic, governments worldwide began to prepare for the worst. This effort included analyzing what happened in 1918 to identify public-health strategies to mitigate the impact of an outbreak. Since I had a historian’s knowledge of 1918 events, I was asked to serve on the initial working groups that recommended what became known as non-pharmaceutical interventions, that is, things to do when you don’t have drugs.

They involve only advice constantly reiterated today: social distancing, washing hands, coughing into elbows, staying home when sick. None alone provides great protection, but the hope was that if most people followed most of the advice most of the time, the interventions could significantly reduce the spread of the disease, or “flatten the curve,” a phrase now all too familiar. This may sound simple, but it is not. As with a diet, people know what to eat but often stray; here straying can kill.

As we begin employing these interventions now, we need to recognize what they can and cannot accomplish. Containment — the attempt to limit spread of a virus and even eliminate it — has failed. China has achieved far more than the most optimistic models predicted, but its initial slowness in responding allowed the virus to spread globally. Once that happened, the virus could not be stopped. Right now it is circulating invisibly in developed countries as well as in developing ones with little public-health infrastructure. That means it is here to stay and will constantly threaten to reinfect even countries that initially control it.

The United States is now in a phase of intervention labeled “suppression” by the infectious-disease expert Michael Osterholm: identifying infected people, isolating them, tracing contacts and asking contacts to self-quarantine. Because its incubation period is longer than influenza’s, Covid-19, caused by the coronavirus, allows that time. Whether we use that time well will determine whether a month from now the United States looks like Italy, where the virus seems out of control, or South Korea, which seems to have gained control by testing more than 270,000 of its 51 million people.

Right now virtually every state in America is in suppression mode, but suppression has no chance of succeeding unless cases are identified. With the United States having tested only about 40,000 of its nearly 330 million people — the worst record in the developed world — we are struggling to catch up, which will take weeks, all while the virus spreads, possibly so widely that it becomes entrenched and impossible to suppress. Nonetheless, suppression is worth trying because even partial success will slow the virus, giving us precious time to develop therapeutic drugs and vaccines.

Assuming suppression fails, we must initiate aggressive mitigation, where communities try to lessen the impact of the disease. The crucial statistic from China is that the case fatality rate inside Wuhan is 5.8 percent but only 0.7 percent in other areas in China, an eightfold difference — explained by an overwhelmed health care system. That illustrates why flattening the curve matters; lessening stress on the health care system, especially the availability of intensive care beds, saves lives.

Saying that is easier than doing it. The difficulties lie in timing and compliance. Analysis of when cities in 1918 closed schools, saloons and theaters; banned public events; urged social distancing and the like demonstrated that intervening early, before a virus spreads throughout the community, did flatten the curve. That’s why cities like New York and Los Angeles have closed schools and the Centers for Disease Control and Prevention has recommended that all events of more than 50 people be canceled for the next eight weeks.

But this raises another issue: compliance. The need for early intervention was well known in 1918. The Army surgeon general demanded “influenza be kept out” of the basic-training camps, where new soldiers were being prepared to fight in World War I. “Epidemics of the disease can often be prevented,” he said, “but once established they cannot well be stopped.” He barred civilians from the camps and ordered that soldiers entering them be quarantined, soldiers showing symptoms be isolated and whole units quarantined if several soldiers were ill. Of 120 camps, 99 imposed those measures.

But  . . .

Continue reading. There’s much more.

Those who do not learn from history are doomed to repeat it.

Later in that column:

That brings us back to the most important lesson of 1918, one that all the working groups on pandemic planning agreed upon: Tell the truth. That instruction is built into the federal pandemic preparedness plans and the plan for every state and territory.

In 1918, pressured to maintain wartime morale, neither national nor local government officials told the truth. The disease was called “Spanish flu,” and one national public-health leader said, “This is ordinary influenza by another name.” Most local health commissioners followed that lead. Newspapers echoed them. After Philadelphia began digging mass graves; closed schools, saloons and theaters; and banned public gatherings, one newspaper even wrote: “This is not a public health measure. There is no cause for alarm.”

Trust in authority disintegrated, and at its core, society is based on trust. Not knowing whom or what to believe, people also lost trust in one another. They became alienated, isolated. Intimacy was destroyed. “You had no school life, you had no church life, you had nothing,” a survivor recalled. “People were afraid to kiss one another, people were afraid to eat with one another.” Some people actually starved to death because no one would deliver food to them.

Society began fraying — so much that the scientist who was in charge of the armed forces’ division of communicable disease worried that if the pandemic continued its accelerating for a few more weeks, “civilization could easily disappear from the face of the earth.”

The few places where leadership told the truth had a different experience. In San Francisco, . . .

Written by LeisureGuy

15 July 2020 at 12:19 pm

The Pandemic Could Get Much, Much Worse. We Must Act Now.

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John M. Barry is the author of The Great Influenza: The Story of the Deadliest Pandemic in History, a book on the list of books I repeatedly recommend. He writes in the NY Times:

When you mix science and politics, you get politics. With the coronavirus, the United States has proved politics hasn’t worked. If we are to fully reopen both the economy and schools safely — which can be done — we have to return to science.

To understand just how bad things are in the United States and, more important, what can be done about it requires comparison. At this writing, Italy, once the poster child of coronavirus devastation and with a population twice that of Texas, has recently averaged about 200 new cases a day when Texas has had over 9,000. Germany, with a population four times that of Florida, has had fewer than 400 new cases a day. On Sunday, Florida reported over 15,300, the highest single-day total of any state.

The White House says the country has to learn to live with the virus. That’s one thing if new cases occurred at the rates in Italy or Germany, not to mention South Korea or Australia or Vietnam (which so far has zero deaths). It’s another thing when the United States has the highest growth rate of new cases in the world, ahead even of Brazil.

Italy, Germany and dozens of other countries have reopened almost entirely, and they had every reason to do so. They all took the virus seriously and acted decisively, and they continue to: Australia just issued fines totaling $18,000 because too many people attended a birthday party in someone’s home.

In the United States, public health experts were virtually unanimous that replicating European success required, first, maintaining the shutdown until we achieved a steep downward slope in cases; second, getting widespread compliance with public health advice; and third, creating a work force of at least 100,000 — some experts felt 300,000 were needed — to test, trace and isolate cases. Nationally we came nowhere near any of those goals, although some states did and are now reopening carefully and safely. Other states fell far short but reopened anyway. We now see the results.

While New York City just recorded its first day in months without a Covid-19 death, the pandemic is growing across 39 states. In Miami-Dade County in Florida, six hospitals have reached capacity. In Houston, where one of the country’s worst outbreaks rages, officials have called on the governor to issue a stay-at-home order.

As if explosive growth in too many states isn’t bad enough, we are also suffering the same shortages that haunted hospitals in March and April. In New Orleans, testing supplies are so limited that one site started testing at 8 a.m. but had only enough to handle the people lined up by 7:33 a.m.

And testing by itself does little without an infrastructure to not only trace and contact potentially infected people but also manage and support those who test positive and are isolated along with those urged to quarantine. Too often this has not been done; in Miami, only 17 percent of those testing positive for the coronavirus had completed questionnaires to help with contact tracing, critical to slowing spread. Many states now have so many cases that contact tracing has become impossible anyway.

What’s the answer?

Social distancing, masks, hand washing and self-quarantine remain crucial. Too little emphasis has been placed on ventilation, which also matters. Ultraviolet lights can be installed in public areas. These things will reduce spread, and President Trump finally wore a mask publicly, which may somewhat depoliticize the issue. But at this point all these things together, even with widespread compliance, can only blunt dangerous trends where they are occurring. The virus is already too widely disseminated for these actions to quickly bend the curve downward.

To reopen schools in the safest way, which may be impossible in some instances, and to get the economy fully back on track, we must get the case counts down to manageable levels — down to the levels of European countries. The Trump administration’s threat to withhold federal funds from schools that don’t reopen won’t accomplish that goal. To do that, only decisive action will work in places experiencing explosive growth — at the very least, limits even on private gatherings and selective shutdowns that must include not just such obvious places as bars but churchesalso a well-documented source of large-scale spread.

Depending on local circumstances, that may prove insufficient; a comprehensive April-like shutdown may be required. This could be on a county-by-county basis, but half-measures will do little more than prevent hospitals from being overrun. Half-measures will leave transmission at a level vastly exceeding those of the many countries that have contained the virus. Half-measures will leave too many Americans not living with the virus but dying from it.

During the 1918 influenza pandemic, almost every city closed down much of its activity. Fear and caring for sick family members did . . .

Continue reading.

Written by LeisureGuy

15 July 2020 at 12:09 pm

Alas, hummus! Contamination in most hummus

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A press release from the Environmental Working Group:

Independent laboratory tests commissioned by the Environmental Working Group found glyphosate, the notorious weedkiller linked to cancer, in more than 80 percent of non-organic hummus and chickpeas samples, and detected at far lower levels in several organic versions.

Glyphosate is the most widely used herbicide in the world. It was sold for decades by Monsanto, now Bayer AG, under the brand name Roundup. The International Agency for Research on Cancer has classified glyphosate a probable human carcinogen, and the state of California lists it as chemical known to cause cancer.

One-third of the 27 conventional hummus samples exceeded EWG’s health-based benchmark of 160 parts per billion, or ppb, for daily consumption, based on a 60-gram serving of hummus (about four tablespoons). The Environmental Protection Agency’s woefully inadequate legal limit for glyphosate in chickpeas, known as a tolerance level, is 5,000 ppb, or more than 30 times EWG’s benchmark.

The conventional hummus product with the highest level of glyphosate – more than 2,000 ppb in Whole Foods Market Original Hummus – was nearly 15 times the EWG benchmark. Overall, 10 hummus samples exceeded EWG’s benchmark for glyphosate: three samples of Sabra Classic Hummus; Sabra Roasted Pine Nut Hummus; two sample of Whole Foods Market Original Hummus; Whole Foods Market organic-label Original Hummus; Cava Traditional Hummus; and two samples of Harris Teeter Fresh Foods Market Traditional Artisan Hummus.

EWG also tested 12 samples of organic hummus and six samples of organic chickpeas. All but two contained detectable concentrations of glyphosate. Although glyphosate levels in organic samples were much lower than those of their conventional counterparts, one dry chickpea sample had the highest glyphosate concentration of all samples tested in the study.

“Beans, peas and lentils are a nutritious, affordable source of protein and an important part of the American diet,” said Olga V. Naidenko, Ph.D., EWG’s vice president for science investigations. “These excellent foods would be much better without glyphosate. Toxic weedkiller should never be allowed to contaminate these products, or any other foods, that millions of American families eat every day.”

The beans and bean-based products such as hummus tested in the study were purchased online or at major food retailers in the Washington, D.C., New York City, and San Francisco metropolitan areas, including Aldi, Costco, Giant, Harris Teeter, Safeway, ShopRite, Target, Trader Joes, Walmart and Whole Foods grocery stores.

Glyphosate was first brought to market in 1974, but its use exploded after 1996, when Monsanto introduced genetically modified “Roundup Ready” crops that were resistant to the herbicide. For consumers, most worrisome is use of the chemical on beans and grains as a drying agent just before harvest. This spraying can lead to high levels of glyphosate in beans, hummus, oat cereals and other foods.

By law, organic farmers are not allowed to spray Roundup or other toxic pesticides to grow and harvest crops. The detections of glyphosate on the organic samples may be due to pesticide drift from conventional crop fields or contamination at processing and packaging facilities.

“Organic foods, including organic hummus and chickpeas, remain a better choice for consumers,” said EWG Toxicologist Alexis M. Temkin, Ph.D. “EWG testing of both conventional and organic bean products for glyphosate helps increase the transparency in the marketplace and protect the integrity of the Department of Agriculture’s organic certification.”

Hummus and chickpeas, as well as other beans, offer multiple nutritional benefits, and are an important part of a healthy diet. EWG’s findings show the need for a ban on pre-harvest uses of glyphosate, a much stricter EPA standard, and increased testing by the USDA and the Food and Drug Administration for this cancer-causing chemical in the American diet.

EWG’s research on beans and hummus builds on EWG’s tests of oats and oat-based products for glyphosate, which found the weedkiller in nearly every sample of cereal and breakfast bars tested.

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The Environmental Working Group is a nonprofit, non-partisan organization that empowers people to live healthier lives in a healthier environment. Through research, advocacy and unique education tools, EWG drives consumer choice and civic action.

 

Written by LeisureGuy

15 July 2020 at 8:49 am

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