Category: Health

Alleged Upper Bounds to Lifespans Continue to Be Surpassed

(p. A2) In a 2002 paper, “Broken Limits to Life Expectancy” the demographers Jim Oeppen and James Vaupel showed that for nearly 100 years, estimates of when life expectancy would hit its limit were proven wrong, often in just a few years. In 2020, Max Roser of the University of Oxford noted that this trend was still intact.

There is no guarantee, of course, that this trend will continue over time or everywhere. Perhaps pandemics, weather disasters or fentanyl deaths will become widespread enough to outweigh improvements in cancer treatment and so on. But I wouldn’t bet on it.

The better bet, according to demographers, is that children born this year will live longer than children born in any previous year.

For the full commentary, see:

Josh Zumbrun. “THE NUMBERS; The Good News About Life Expectancy.” The Wall Street Journal (Saturday, December 16, 2023): A2.

(Note: the online version of the commentary has the date December 15, 2023, and has the title “THE NUMBERS; The (Surprisingly) Good News on Life Expectancy: It’s Still Going Up.”)

The Oeppen and Vaupel article mentioned above is:

Oeppen, Jim, and James W. Vaupel. “Broken Limits to Life Expectancy.” Science 296, no. 5570 (May 10, 2002): 1029-31.

The 2020 article by Roser, updating the Oeppen and Vaupel paper, is:

Roser, Max. “The Rise of Maximum Life Expectancy: Predictions of a Maximum Limit of Life Expectancy Have Been Broken Again and Again.” Last updated March 1, 2020 [cited Sat., Dec. 16, 2023]. Available from https://ourworldindata.org/the-rise-of-maximum-life-expectancy.

If You Are Pained to Wait Over Two Years for Socialist Surgery in Britain, Seek Timely Free Market Surgery in Lithuania

(p. 4) For David Haselgrove, it was a battle each day to get out of bed, then another struggle to put on his socks. Stairs were often impossible, and the pain made him tetchy and difficult to live with.

But when he sought medical help for his arthritis, Mr. Haselgrove was told the wait for a specialist consultation was more than two years. It might be another two years before surgery.

“If I wasn’t the person I am, I would have been losing the will to live because the pain takes over your life,” said Mr. Haselgrove, 71, who is now fully mobile after a successful hip replacement.

His recovery has nothing to do with Britain’s National Health Service.

Instead, Mr. Haselgrove, who ran several small businesses during his working life, flew to a clinic in Lithuania to have surgery, becoming one of a growing number of Britons who have dipped into their own pockets to pay for procedures to which they are entitled free on the N.H.S.

. . .

Investment in buildings and equipment, including in vital diagnostic tools such as CT and M.R.I. scanners, has significantly lagged medical systems in other advanced economies, according to the King’s Fund, a health-focused think tank.

That contributed to a backlog of 4.6 million procedures even before the pandemic, a number that swelled to six million as planned procedures made way for emergency care during the Covid crisis. The line for treatment has only grown since. It is now about 7.7 million procedures, representing about a 10th of the population. Thousands have waited more than two years, often in pain.

Little wonder, then, that many Britons who can afford to pay to cut the line are doing so, while some of more limited means are dipping into savings or taking on debt. Yet that trend, some critics say, could undermine a health care system that has been a bedrock of British life for three-quarters of a century.

Private medical insurance is costly in Britain, and taxable when offered as a benefit by employers, so the shift is most visible when people pay for operations and other medical help out of pocket.

According to the Private Healthcare Information Network, which publishes data on the sector, there were about 50,000 “self-pay” medical admissions in a typical quarter before the pandemic. That figure is now steadily substantially higher; in the first quarter of this year, it was 71,000, close to a record.

That does not include patients who go overseas, like Mr. Haselgrove. At 7,000 euros, about $7,500, a hip replacement at the Nord Clinic in Lithuania was significantly cheaper than it would have been in a private hospital in Britain.

. . .

Britain is chronically short of health workers, with over 100,000 N.H.S. positions vacant.

. . .

. . . the deepest risk of the rise in self-pay patients, according to Chris Thomas, principal health fellow at the Institute for Public Policy Research, a progressive think tank, is not to the health service’s operations, but to its political underpinnings.

The British health system, he said, is built around the idea of “universalizing the best” — creating a system “as good for a rich person” as for a poor one, Mr. Thomas said.

If wealthier people increasingly opt out, Mr. Thomas said, the N.H.S. will become a second-class system for those who cannot afford to do so, resulting in “a slow erosion of support.”

For the full story, see:

Stephen Castle. “Long Wait Lists Threaten U.K. Promise of Free Care.” The New York Times, First Section (Sunday, December 10, 2023): 4.

(Note: ellipses added.)

(Note: the online version of the story has the date Dec. 9, 2023, and has the title “Britons Love the N.H.S. Some Will Also Pay to Avoid It.”)

British Colonial Authorities in India “Eased Out” Vaccine Innovator

(p. 19) The story of Waldemar Mordechai Wolff Haffkine, little told in the West beyond the world of bacteriology and within the annals of Judaica, is thrilling in its nobility and verve, and it might have better served Schama’s purpose had he devoted the entire book to the tale of a man he so clearly adores.

. . .

He was born in Odessa in 1860, and as a teenager was set to defending his community from the endless Russian pogroms. In time he moved to Switzerland and then to France, where he trained at the Pasteur Institute and, after studying paramecium, threw his energies into the scourge of cholera. He treated himself with an experimental vaccine and took off to India in 1893 to see how it worked.

That it did, brilliantly, and by today’s reckoning his invention saved millions. His more remarkable eventual success came five years later with a vaccine for eradicating bubonic plague.

Schama — by his own admission no biologist — describes the painstaking method of making a plague vaccine with enthralling technical precision. He writes of the gentle and respectful means of extracting the noxious fluids from the swollen buboes that dangled in the intimate parts of the infected and the dying; of the subsequent culturation process, in ghee-covered flasks of goat broth — no cow or pig could be used, since the vaccines would be given to Hindu and Muslim alike — and then of the nurturing of the resulting silky threads that held the trove of bacilli, ready to be injected.

Notwithstanding Haffkine’s immense contribution to India’s public health, the British colonial authorities, haughty and racist by turn, eventually wearied of the man. Their own means of dealing with infection had, after all, relied on brawn and bombast — the wholesale destruction of villages, the eviction of natives, the smothering of everything with lime and carbolic acid. Such schemes had generally failed, and it irritated the burra sahibs that a foreigner, and moreover a keen adherent to an alien belief, could succeed where they had not.

And so Haffkine was eased out, first from his Calcutta laboratory across to Bombay, and then out of the empire’s crown jewel altogether. He later went to Lausanne, where he would spend his final years.

For the full review, see:

Simon Winchester. “The Vaccinator.” The New York Times Book Review (Sunday, November 5, 2023): 19.

(Note: ellipsis added. In the original only the words “burra sahibs” are in italics.)

(Note: the online version of the review was updated Oct. 28, 2023, and has the title “Not All Heroes Wear Capes. Some Prefer Lab Coats.”)

The book under review is:

Schama, Simon. Foreign Bodies: Pandemics, Vaccines, and the Health of Nations. New York: Ecco Press, 2023.

Zoliflodacin Is First New Antibiotic in Decades

(p. A12) A new antibiotic, the first to be developed in decades, can cure gonorrhea infections at least as effectively as the most powerful current treatment, a large clinical trial has found. The drug, zoliflodacin, is taken as a single dose, and it has not yet been approved for use in any country.

. . .

Pharmaceutical companies have largely abandoned antibiotic development as unprofitable. The development of zoliflodacin represents a new model: G.A.R.D.P., which is funded by many Group of 20 countries and the European Union, developed the drug in collaboration with an American pharmaceutical company called Innoviva Specialty Therapeutics.

The nonprofit sponsored the Phase 3 trial of the drug. In exchange, it holds the license to sell the antibiotic in about 160 countries while Innoviva retains marketing rights for high-income countries.

“I’ll go out on a limb and say that’s probably the only way in which we develop antibiotics going forward, because the old model is simply not going to work,” said Ramanan Laxminarayan, a senior research scholar at Princeton University who chairs the G.A.R.D.P. board.

. . .

“Nobody’s making a boatload of money off treatment of gonorrhea, especially when you’re using a single dose of an oral antibiotic,” said Dr. Jeanne Marrazzo, director of the National Institute of Allergy and Infectious Diseases.

“This is a path forward to solve the dilemma of getting pathways for products that don’t guarantee profits,” Dr. Marrazzo said.

For the full story, see:

Apoorva Mandavilli. “A New Drug Is Developed To Combat Gonorrhea.” The New York Times (Friday, November 11, 2023): A12.

(Note: ellipses added.)

(Note: the online version of the story has the date Nov. 10, 2023, and has the title “Gonorrhea Is Becoming Drug Resistant. Scientists Just Found a Solution.”)

“Serendipitous” Discoveries Related to Two “Odd-Looking” Animals Was Source of Weight-Loss Drugs

(p. A1) The blockbuster diabetes drugs that have revolutionized obesity treatment seem to have come out of nowhere, turning the diet industry upside down in just the past year. But they didn’t arrive suddenly. They are the unlikely result of two separate bodies of science that date back decades and began with the study of (p. A2) two unsightly creatures: a carnivorous fish and a poisonous lizard.

In 1980, researchers at Massachusetts General Hospital wanted to use new technology to find the gene that encodes a hormone called glucagon. The team decided to study Anglerfish, which have special organs that make the hormone, simplifying the task of gathering samples of pure tissue.

. . .

After plucking out organs the size of Lima beans with scalpels, they dropped them into liquid nitrogen and drove back to Boston. Then they determined the genetic sequence of glucagon, which is how they learned that the same gene encodes related hormones known as peptides. One of them was a key discovery that would soon be found in humans, too.

It was called glucagon-like peptide-1 and its nickname was GLP-1.

After they found GLP-1, others would determine its significance. Scientists in Massachusetts and Europe learned that it encourages insulin release and lowers blood sugar. That held out hope that it could help treat diabetes. Later they discovered that GLP-1 makes people feel fuller faster and slows down emptying of food from the stomach.

. . .

The key to the first drug would come from a serendipitous discovery inside another odd-looking animal.

Around the time Goodman was cutting open fish, Jean-Pierre Raufman was studying insect and animal venoms to see if they stimulated digestive enzymes in mammals.

“We got a tremendous response from Gila monster venom,” he recalled.

It was a small discovery that could have been forgotten, but for a lucky break nearly a decade later when Raufman gave a lecture on that work at the Bronx Veterans Administration. John Eng, an expert in identifying peptides, was intrigued. The pair had collaborated on unrelated work a few years before. Eng proposed they study Gila monsters.

. . .

Eng isolated a small peptide that he called Exendin-4, which they found was similar to human GLP-1.

Eng then tested his new peptide on diabetic mice and found something intriguing: It not only reduced blood glucose, it did so for hours. If the same effect were to be observed in humans, it could be the key to turning GLP-1 into a meaningful advance in diabetes treatment, not just a seasickness simulator in an IV bag.

Jens Juul Holst, a pioneering GLP-1 researcher, remembers standing in an exhibit hall at a European conference next to Eng. The two had put up posters that displayed their work, hoping top researchers would stop by to discuss it. But other scientists were skeptical that anything derived from a lizard would work in humans.

“He was extremely frustrated,” recalled Holst. “Nobody was interested in his work. None of the important people. It was too strange for people to accept.”

After three years, tens of thousands of dollars in patent-related fees and thousands of miles traveled, Eng found himself standing with his poster in San Francisco. This time, he caught the attention of Andrew Young, an executive from a small pharmaceutical company named Amylin.

“I saw the results in the mice and realized this could be druggable,” Young said.

When an Eli Lilly executive leaned over his shoulder to look at Eng’s work, Young worried he might miss his chance. Not long after, Amylin licensed the patent.

They worked to develop Exendin-4 into a drug by synthesizing the Gila monster peptide. They weren’t sure what would happen in humans. “We couldn’t predict weight loss or weight gain with these drugs,” recalled Young. “They enhance insulin secretion. Usually that increases body weight.” But the effect on slowing the stomach’s processing of food was more pronounced and Young’s team found as they tested their new drug that it caused weight loss.

To get a better understanding of Exendin-4, Young consulted with Mark Seward, a dentist raising more than 100 Gila monsters in his Colorado Springs, Colo., basement. The lizard enthusiast’s task was to feed them and draw blood. One took exception to the needle in its tail, slipped its restraint and snapped its teeth on Seward’s palm—the only time he’s been bitten in the decades he’s raised the animals. “It’s like a wasp sting,” he said, “but much worse.”

Nine years after the chance San Francisco meeting between Eng and Young, the Food and Drug Administration approved the first GLP-1-based treatment in 2005.

The twice-daily injection remained in the bloodstream for hours, helping patients manage Type 2 diabetes. Eng would be paid royalties as high as $6.7 million per year for the drug, . . .

For the full story, see:

Rolfe Winkler and Ben Cohen. “Two Monsters Spawned Huge Drugs.” The Wall Street Journal (Friday, June 24, 2023): A1-A2.

(Note: ellipsis added.)

(Note: the online version of the story has the date June 23, 2023, and has the title “Monster Diet Drugs Like Ozempic Started With Actual Monsters.” The sentence about “a serendipitous discovery” appears in the online, but not the print, version of the article. The passages quoted above also include several other sentences that appear in the more extensive online version, but not in the print version.)

Many Long-Lived Ashkenazi Jews Did NOT Follow Usual Advice on Exercise, Diet, Sleep, and Social Connectivity

(p. B10) Louise Levy, who along with hundreds of others 95 and older was part of a study to understand how their genetic makeup led to their good physical and cognitive health during extremely long lives, died on July 17 [2023] in Greenwich, Conn. She was 112.

. . .

Mrs. Levy was one of more than 700 people, all 95 or older, recruited since 1998 to participate in a study by the Institute for Aging Research at the Albert Einstein School of Medicine in the Bronx to learn the genetic reasons for their unusually long, healthy lives.

“It’s not luck,” Dr. Nir Barzilai, an endocrinologist who directs the institute, said by phone. “They exceeded luck. The biggest answer is genetics.”

Using the blood and plasma of the test group, all Ashkenazi Jews — a comparatively homogeneous population whose genetic variations are easier to spot — the institute’s Longevity Genes Project has discovered gene mutations that are believed to be responsible for slowing the impact of aging on people like Mrs. Levy and protecting them against high cholesterol, heart disease, diabetes and Alzheimer’s disease.

“The most striking thing about them is they had a contraction of morbidity,” Dr. Barzilai said. “They are sick, as a group, for very little time at the end of their lives.”

He added, “Did they do what we know we should do — exercise, diet and sleep and have social connectivity? The answer is mostly no. Sixty percent were smoking. Less than 50 percent did much household activity or biking. Fifty percent were overweight or obese. Less than three percent were vegetarians. So they weren’t special in that sense.”

The goal of the research is the development of drugs that would imitate what the centenarians’ genes do to protect their health.

For the full obituary, see:

Richard Sandomir. “Louise Levy, 112, Longtime Subject in a Genetic Study of Human Longevity.” The New York Times (Saturday, July 29, 2023): B10.

(Note: ellipsis, and bracketed year, added.)

(Note: the online version of the obituary was updated July 31, 2023, and has the title “Louise Levy, Who Was Studied for Her Very Long Life, Is Dead at 112.”)

Independent Bookstores Shun Wuhan Book by Independent Robert F. Kennedy Jr.

I am generally not as skeptical of the safety and efficacy of vaccines as is Robert F. Kennedy Jr. But I strongly believe in the right to free speech. And I believe that truth in general, and truth in science in particular, advance fastest when we defend free speech and open discussion.

(p. B3) Independent presidential candidate Robert F. Kennedy Jr. is a member of the most famous political family in the U.S. and a bestselling author. But it may be hard to find his newest book at the local bookstore when it comes out next week [on Dec. 5, 2023].

Some booksellers have decided not to stock Kennedy’s latest, “The Wuhan Cover-Up and the Terrifying Bioweapons Arms Race,” citing concerns about the author’s past positions.

. . .

Kennedy expressed disappointment that independent bookstores may not be stocking his new book. “Independent bookstores are the traditional bulwarks against corporate propaganda and government censorship,” he said.

Kennedy, the nephew of the late president John F. Kennedy and son of the late attorney general and senator Robert F. Kennedy, has become a vocal critic of U.S. government agencies, in particular their response to the coronavirus pandemic.

. . .

In an interview, Kennedy, 69 years old, said he thinks “The Wuhan Cover-Up” will appeal to anybody interested in learning more about the origins of Covid-19 as well as foreign-policy issues.

. . .

The Federal Bureau of Investigation and Energy Department have said that a “laboratory-related incident” was most likely responsible for the pandemic, while other agencies believe natural infection was the cause.

For the full story, see:

Jeffrey A. Trachtenberg and Eliza Collins. “Small Bookstores Shun RFK Jr.’s Coming Book.” The Wall Street Journal (Wednesday, Nov. 29, 2023): B3.

(Note: ellipses, and bracketed date, added.)

(Note: the online version of the story has the date November 28, 2023, and has the title “Small Bookstores Shun Robert F. Kennedy Jr.’s Upcoming Book.”)

The book shunned by many independent bookstores is:

Kennedy, Robert F. , Jr. The Wuhan Cover-Up: And the Terrifying Bioweapons Arms Race. New York: Skyhorse Publishing, Inc., 2023.

Cancer “Vaccines Are Probably the Next Big Thing”

(p. A5) “Vaccines are probably the next big thing” in the quest to reduce cancer deaths, said Dr. Steve Lipkin, a medical geneticist at New York’s Weill Cornell Medicine, who is leading one effort funded by the National Cancer Institute. “We’re dedicating our lives to that.”

For the full story, see:

ARLA K. JOHNSON, Associated Press. “Vaccine Against Cancer Could Be Closer Than Ever.” Omaha World-Herald (Sunday, July 9, 2023): A11.

(Note: bracketed date added.)

(Note: the online version of the story was updated Nov 2, 2023, and has the title “The next big advance in cancer treatment could be a vaccine.”)

Biden’s Centrally Planned Cancer “Moonshot” Funds Surgery as Key to a Cure

(p. A5) WASHINGTON — President Joe Biden’s administration on Thursday [July 27, 2023] announced the first cancer-focused initiative under its advanced health research agency, aiming to help doctors more easily distinguish between cancerous cells and healthy tissue during surgery and improve outcomes for patients.

The administration’s Advanced Research Projects Agency for Health, or ARPA-H, is launching a Precision Surgical Interventions program, seeking ideas from the public and private sectors to explore how to dramatically improve cancer outcomes in the coming decades by developing better surgical interventions to treat the disease.

. . .

The initiative could markedly improve cancer treatments and make scientific breakthroughs that have as yet unknown applications, said Arati Prabhakar, director of the White House Office of Science and Technology.

“What’s true is that many cancer treatments still start with surgery,” she told The Associated Press in an interview. “So being really smart and attacking and developing new technology to make that first step better could really revolutionize how we are able to treat cancer for so many Americans.”

For the full story, see:

ZEKE MILLER Associated Press. “Cancer Research Initiative Part of Biden ‘Moonshot’.” Omaha World-Herald (Friday, July 28, 2023): A5.

(Note: ellipsis, and bracketed date, added.)

(Note: the online version of the story was updated Nov. 2, 2023, and has the title “Biden announces an advanced cancer research initiative as part of his ‘moonshot’ effort.”)

“Cochrane Reviews Are Often Referred to as Gold Standard Evidence in Medicine”

The credibility of Cochrane reviews matters. One of their most important reviews, that I cite in my in-progress work on clinical trials, suggests that results of randomized double-blind clinical trials, usually agree with results of observational studies on the same topic. This matters a lot, because observational studies can give us more and quicker actionable results, saving lives.

(p. A23) Cochrane reviews are often referred to as gold standard evidence in medicine because they aggregate results from many randomized trials to reach an overall conclusion — a great method for evaluating drugs, for example, which often are subjected to rigorous but small trials. Combining their results can lead to more confident conclusions.

. . .

. . . what we learn from the Cochrane review is that, especially before the pandemic, distributing masks didn’t lead people to wear them, which is why their effect on transmission couldn’t be confidently evaluated.

For the full commentary, see:

Zeynep Tufekci. “In Fact, the Science Is Clear That Masks Work.” The New York Times (Saturday, March 11, 2023): A23.

(Note: ellipses added.)

(Note: the online version of the commentary has the date March 10, 2023, and has the title “Here’s Why the Science Is Clear That Masks Work.”)

To Force Use of Organic Farming, Government Banned Chemical Fertilizers; A Ban Which “Devastated” Crops and “Destroyed the Farmers”

(p. A6) GALENBINDUNUWEWA, Sri Lanka—For more than half a century, Pahatha Mellange Jayaappu has tilled the field on his modest farm in Sri Lanka’s agricultural heartland, unswayed by recurrent political and economic turmoil.

Now the 71-year-old is just trying to eke out enough of a harvest to feed his family after an abrupt ban on chemical fertilizers last year devastated his crops. He says he has given up on planting for profit.

“We have lived through armed insurrections and bad government policies,” Mr. Jayaappu said. “This is the worst year I’ve ever seen. They have destroyed the farmers.”

Many Sri Lankans aren’t getting enough to eat, and farmers and agricultural experts say the food shortages are set to worsen. The government reversed the ban in November and promised fresh supplies of chemical fertilizers, but farmers said many received only a small amount, and too late for the current growing season.

. . .

The ban on imports of agricultural chemicals took effect in May 2021, and the rice harvest the following March was down 40%, according to government data. Prices soared. Sri Lanka, which had been largely self-sufficient in rice, was forced to use some of its fast-dwindling foreign reserves to import the key staple. Other crops, like tea, an important foreign-exchange earner, have also suffered. In May, the country defaulted on its external debt.

. . .

Mr. Wickremesinghe was installed by Parliament last month after his predecessor, Gotabaya Rajapaksa, fled the country and resigned in the face of mass protests over fuel shortages and food prices.  . . .

Mr. Rajapaksa billed the ban as a nationwide shift to organic farming, but agricultural experts say that requires a yearslong transition. Opposition lawmakers said cutting off imports of fertilizer, which the government heavily subsidizes for farmers, was a shortsighted attempt to hold on to foreign reserves.

. . .

Farmers complained that the organic fertilizers that came on the market after the ban took effect were poor quality, full of material that wasn’t fully decomposed. And the haste of the ban left insufficient time to make their own compost, or learn how to farm organically.

For the full story, see:

Shan Li and Philip Wen. “Sri Lanka’s Farmers Struggle to Survive.” The Wall Street Journal (Saturday, August 20, 2022): A6.

(Note: ellipses added.)

(Note: the online version of the story was updated Aug. 19, 2022, and has the title “Sri Lanka’s Farmers Struggle to Feed the Country—and Themselves.”)