Category: Health

Costs of Covid Lockdowns and Mask Mandates Exceeded Benefits

(p. A15) The Centers for Disease Control and Prevention belatedly admitted failure this week. “For 75 years, CDC and public health have been preparing for Covid-19, and in our big moment, our performance did not reliably meet expectations,” Director Rochelle Walensky said. She vowed to establish an “action-oriented culture.”

. . .

U.S. states with more-restrictive policies fared no better, on average, than states with less-restrictive policies. There’s still no convincing evidence that masks provided any significant benefits. When case rates throughout the pandemic are plotted on a graph, the trajectory in states with mask mandates is virtually identical to the trajectory in states without mandates. (The states without mandates actually had slightly fewer Covid deaths per capita.) International comparisons yield similar results. A Johns Hopkins University meta-analysis of studies around the world concluded that lockdown and mask restrictions have had “little to no effect on COVID-19 mortality.”

. . .

In 2006 he and colleagues at the University of Pittsburgh considered an array of proposed measures to deal with a virus as deadly as the 1918 Spanish flu.

Should schools be closed? Should everyone wear face masks in public places? Should those exposed to an infection be required to quarantine at home? Should public-health officials rely on computer models of viral spread to impose strict limitations on people’s movements? In each case, the answer was no, because there was no evidence these measures would make a significant difference.

“Experience has shown,” Henderson’s team concluded, “that communities faced with epidemics or other adverse events respond best and with the least anxiety when the normal social functioning of the community is least disrupted.” The researchers specifically advised leaders not to be guided by computer models, because no model could reliably predict the effects of the measures or take into account the “devastating” collateral damage. If leaders overreacted and panicked the public, “a manageable epidemic could move toward catastrophe.”

This advice was subsequently heeded in the pre-Covid pandemic plans prepared by the CDC and other public-health agencies. The WHO’s review of the scientific literature concluded that there was “no evidence” that universal masking “is effective in reducing transmission.” The CDC’s pre-2020 planning scenarios didn’t recommend universal masking or extended school and business closures even during a pandemic as severe as the 1918 Spanish flu.

For the full commentary see:

John Tierney. “Fauci and Walensky Double Down on Failure.” The Wall Street Journal (Friday, Aug. 19, 2022): A15.

(Note: ellipses added.)

(Note: the online version of the commentary has the date August 18, 2022, and has the title “Fauci and Walensky Double Down on Failed Covid Response.”)

Human Challenge Trial Sped Phase 3 of Typhoid Vaccine Clinical Trial

Observers Give Thumbs-Up to Matthew Speight as He Prepared to Drink Typhoid Bacteria as Part of a Human Challenge Trial.
Source of Image: NYT commentary cited below.

(p. D3) “I was curious.” That’s how James M. Duggan, an Oxford University medical student, explains why he agreed to swallow a big dose of live typhoid bacteria.

. . .

Mr. Duggan, 33, was not on a self-destructive sympathy bender. Like more than 100 other residents of Oxford, England, he was taking part in a trial of a new typhoid vaccine.

Typhoid fever, caused by the bacteria Salmonella typhi and spread in food and water, kills almost 200,000 victims a year — many of them young children — in Africa, Asia and Latin America. Survivors may suffer perforated intestines, heart problems and other complications.

The experimental vaccine was a big success. The trial’s results were published in The Lancet on Thursday [Sept. 28, 2017]: the vaccine turned out to be 87 percent effective.

. . .

“These are great results,” said Dr. Anita Zaidi, the foundation’s director of diarrheal diseases. “And challenge tests are a great way to short-circuit the process of proving it works.

“If we’d done this in the field, we would have had to follow children for three or four years.”

So-called challenge tests involve giving subjects an experimental vaccine and then deliberately infecting them with the disease to see if it protects them.

These tests can only be done with illnesses — like cholera or malaria — that can be rapidly and completely cured, or with diseases — like seasonal flu — that normally do not damage healthy adults.

. . .

So what would motivate dozens of well-educated Britons to swallow a vial full of the germs that made Typhoid Mary famous? In interviews, they gave various reasons.

Some, like Mr. Duggan, were curious. Some wanted to help poor people. And some mostly wanted the cash.

Participants who followed all the steps, which included recording their temperatures online, making daily clinic visits and providing regular blood and stool samples, received about $4,000.

They all said they understood the risks.

For the full commentary see:

Donald G. McNeil Jr. “Curiosity, and Cash, Fight a Fever.” The New York Times (Tuesday, October 3, 2017): D3.

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

(Note: the online version of the commentary has the date Sept. 28, 2017, and has the title “They Swallowed Live Typhoid Bacteria — On Purpose.”)

The print version of The Lancet article mentioned above is:

Jin, Celina, Malick M. Gibani, Maria Moore, Helene B. Juel, Elizabeth Jones, James Meiring, Victoria Harris, Jonathan Gardner, Anna Nebykova, Simon A. Kerridge, Jennifer Hill, Helena Thomaides-Brears, Christoph J. Blohmke, Ly-Mee Yu, Brian Angus, and Andrew J. Pollard. “Efficacy and Immunogenicity of a Vi-Tetanus Toxoid Conjugate Vaccine in the Prevention of Typhoid Fever Using a Controlled Human Infection Model of Salmonella Typhi: A Randomised Controlled, Phase 2b Trial.” The Lancet 390, no. 10111 (Dec. 2, 2017): 2472-80.

Jellyfish Genome Suggests Multiple Pathways Can Synergize to Extend Healthy Lifespans

(p. A3) A team of scientists in Spain has succeeded in mapping the genome of a jellyfish known for its ability to cheat death by rebirthing itself.

. . .

In a study published Monday [Aug. 29, 2022] in the Proceedings of the National Academy of Sciences, the authors said they hoped their genome mapping might lead to discoveries relevant to human aging and efforts to improve the human healthspan.

. . .

Three types can rejuvenate after adulthood and of those three, only one, the Turritopsis dohrnii, keeps its capacity at 100%, according to the study.

. . .

The scientists compared their genome mapping of T. dohrnii to that of a closely related species that isn’t known to have post-reproductive rejuvenation.

. . .

Dr. Jan Karlseder, a molecular biologist and director of the Glenn Center for Biology of Aging Research at the Salk Institute, said the study contained an important message about extending the healthspan, or healthy years, of an organism.

“The most interesting thing is that it’s not a single molecular pathway . . . It is a combination of many of them,” he said. “If we want to look for an extension of healthspan, we cannot just focus on one pathway. That will not be sufficient. We need to look at many of them and how they synergize.”

For the full story see:

Ginger Adams Otis and Alyssa Lukpat. “Scientists Map the Genome of an ‘Immortal Jellyfish’.” The Wall Street Journal (Tuesday, Aug. 30, 2022): A3.

(Note: ellipses between paragraphs, added; ellipsis within paragraph, in original. Bracketed date added.)

(Note: the online version of the story has the date August 29, 2022, and has the title “Scientists Move Closer to Unlocking the Secrets of the Immortal Jellyfish, and Possibly Human Aging.”)

To Avoid Death, Northwestern U.S. Finally Embraces Air-Conditioning

(p. A15) SEATTLE — Road crews sprayed water on century-old bridges in Seattle on Thursday to keep the steel from expanding in the sizzling heat. In Portland, Ore., where heat has already killed dozens of people this summer, volunteers delivered water door to door. Restaurants and even some ice cream shops decided it was too hot to open.

For the second time this summer, a part of the country known for its snow-capped mountains and fleece-clad inhabitants was enduring a heat wave so intense that it threatened lives and critical infrastructure.

. . .

It is not just a matter of comfort. The region is still tallying a death toll from the June heat wave, and mortality data analyzed by The New York Times shows that about 600 more people died in Washington and Oregon during that week than would have been typical.

Officials in Portland’s Multnomah County pointed to a lack of air conditioning in homes as a key factor in deaths. Unlike large swaths of the country where air conditioning is now standard, many in the Pacific Northwest live without such relief. Just 44 percent of residents in Seattle reported having some sort of air conditioning in 2019, although those numbers have been on the rise, with installers struggling to keep up with demand.

. . .

The warming particularly threatens residents of low-income neighborhoods. During the last heat wave, Vivek Shandas, a professor of climate adaptation at Portland State University, went to the poorest parts of the city with a calibrated thermometer and got a reading of 121 degrees, five degrees higher than the official high for the day, recorded at the airport.

For the full story see:

Mike Baker and Sergio Olmos. “Broiling Today, Northwest Knows It Must Adapt for a Hotter Tomorrow.” The New York Times (Saturday, August 14, 2021): A15.

(Note: ellipses added.)

(Note: the online version of the article has the date Aug. 13, 2021, and has the title “The Pacific Northwest, Built for Mild Summers, Is Scorching Yet Again.”

Increasing Tax Rates Will Reduce Venture Funding for Cancer Research

(p. A17) In his last year as vice president, Joe Biden launched a “cancer moonshot” to accelerate cures for the disease. It was short-lived, but he did help negotiate an agreement in Congress easing regulation of breakthrough drugs and medical devices.

In February [2022], President Biden revived the initiative, setting a goal of reducing cancer death rates by at least 50% over the next 25 years. It’s ambitious but may be achievable given how rapidly scientific knowledge and treatments are advancing. Other Biden policies, however, are at odds with the goals of this one.

Two pharmaceutical breakthroughs were announced only last week that could save tens of thousands of lives each year and redefine cancer care. Yet the tax hikes and drug-price controls that the Biden administration is pitching would discourage the private investment that has delivered these potential cures.

. . .

Oncologists were blown away by the results reported last week in the New England Journal of Medicine: All 12 patients receiving the drug achieved complete remission after six months of treatment. None needed surgery, chemotherapy or radiation. Although some may relapse, the 100% success rate is unprecedented even for a small trial.

. . .

Last week AstraZeneca in partnership with Daiichi Sankyo reported that Enhertu reduced the risk of death by 36% in patients with metastatic breast cancer with low HER2 and by half for the subset who were hormone-receptor negative. These results blow the outcomes for other metastatic breast-cancer therapies out of the water.

. . .

These treatment breakthroughs aren’t happening because of government programs. They’re happening because pharmaceutical companies have invested decades and hundreds of billions of dollars in drug research and development. It typically takes 10.5 years and $1.3 billion to bring a new drug to market. About 95% of cancer drugs fail.

This is important to keep in mind as Mr. Biden and Democrats in Congress push for Medicare to “negotiate”—i.e., cap—drug prices and raise taxes on corporations and investors. The large profits that drugmakers notch from successful drugs are needed to reward shareholders for their investment risk and encourage future investment. Capital is mobile.

Mr. Biden’s proposal to increase the top marginal individual income-tax rates, including on capital gains, would punish venture capitalists who seed biotech startups, which do most early-stage research on cancer drugs and are often acquired by large drugmakers. At the same time, his proposed corporate global minimum tax would raise costs of intellectual property, which is often taxed at lower rates abroad.

There aren’t many things to celebrate nowadays, but biotech innovation is one. Let’s hope the president doesn’t kill his own cancer moonshot.

For the full commentary see:

Allysia Finley. “Biden May Stop His Cancer Moonshot’s Launch.” The Wall Street Journal (Thursday, June 16, 2022): A17.

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

(Note: the online version of the commentary has the date June 15, 2022, and has the same title as the print version.)

Corrupt Crony “Emergent” Firm Emerges as Incompetent Too

Emergent’s role in crony capitalism was documented in an earlier entry, that documented the donations and lobbying gifts they bestowed on congress and regulators in order to fill the emergency health stockpile with dubious anthrax vaccine instead of the masks and ventilators that were in demand during the Covid-19 pandemic.

(p. A7) WASHINGTON — Workers at a plant in Baltimore manufacturing two coronavirus vaccines accidentally conflated the ingredients several weeks ago, contaminating up to 15 million doses of Johnson & Johnson’s vaccine and forcing regulators to delay authorization of the plant’s production lines.

The plant is run by Emergent BioSolutions, a manufacturing partner to both Johnson & Johnson and AstraZeneca, the British-Swedish company whose vaccine has yet to be authorized for use in the United States. Federal officials attributed the mistake to human error.

. . .

The mistake is a major embarrassment both for Johnson & Johnson, whose one-dose vaccine has been credited with speeding up the national immunization program, and for Emergent, its subcontractor, which has faced fierce criticism for its heavy lobbying for federal contracts, especially for the government’s emergency health stockpile.

For the full story see:

Sharon LaFraniere and Noah Weiland. “Factory Mix-Up Ruins 15 Million Doses Of Vaccine From Johnson & Johnson.” The New York Times (Thursday, April 1, 2021): A7.

(Note: ellipsis added.)

(Note: the online version of the article was updated Aug. [sic] 1, 2021, and has the title “Factory Mix-Up Ruins Up to 15 Million Vaccine Doses From Johnson & Johnson.”

Drug Extending Life of Breast Cancer Patients by Six Months Is “Unheard-Of”

(p. A16) The patients had metastatic breast cancer that had been progressing despite rounds of harsh chemotherapy. But a treatment with a drug that targeted cancer cells with laserlike precision was stunningly successful, slowing tumor growth and extending life to an extent rarely seen with advanced cancers.

The new study, presented at the annual meeting of the American Society of Clinical Oncology and published on Sunday [June 5, 2022] in the New England Journal of Medicine, would change how medicine was practiced, cancer specialists said.

. . .

The clinical trial, sponsored by the pharmaceutical companies Daiichi Sankyo and AstraZeneca and led by Dr. Shanu Modi of Memorial Sloan Kettering Cancer Center, involved 557 patients with metastatic breast cancer who were HER2-low. Two-thirds took the experimental drug, trastuzumab deruxtecan, sold as Enhertu; the rest underwent standard chemotherapy.

. . .

“It is unheard-of for chemotherapy trials in metastatic breast cancer to improve survival in patients by six months,” said Dr. Moore, who enrolled some patients in the study. Usually, she says, success in a clinical trial is an extra few weeks of life or no survival benefit at all but an improved quality of life.

The results were so impressive that the researchers received a standing ovation when they presented their data at the oncology conference in Chicago on Sunday.

. . .

“This strategy is the real breakthrough,” he said, explaining that it would enable researchers to zoom in on molecular targets on tumor cells that were only sparsely present.

“This is about more than just this drug or even breast cancer,” Dr. Winer said. “Its real advantage is that it enables us to take potent therapies directly to cancer cells.”

For the full story see:

Gina Kolata. “Trial of New Breast Cancer Drug Results in ‘Unheard-Of’ Survival Rates.” The New York Times (Wednesday, June 8, 2022): A16.

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

(Note: the online version of the story has the date June 7, 2022, and has the title “Breast Cancer Drug Trial Results in ‘Unheard-Of’ Survival.” Where there are minor differences in wording between the versions, the passages quoted above follow the online version.)

The academic NEJM article reporting the results summarized in the passages quoted above is:

Modi, Shanu, William Jacot, Toshinari Yamashita, Joohyuk Sohn, Maria Vidal, Eriko Tokunaga, Junji Tsurutani, Naoto T. Ueno, Aleix Prat, Yee Soo Chae, Keun Seok Lee, Naoki Niikura, Yeon Hee Park, Binghe Xu, Xiaojia Wang, Miguel Gil-Gil, Wei Li, Jean-Yves Pierga, Seock-Ah Im, Halle C.F. Moore, Hope S. Rugo, Rinat Yerushalmi, Flora Zagouri, Andrea Gombos, Sung-Bae Kim, Qiang Liu, Ting Luo, Cristina Saura, Peter Schmid, Tao Sun, Dhiraj Gambhire, Lotus Yung, Yibin Wang, Jasmeet Singh, Patrik Vitazka, Gerold Meinhardt, Nadia Harbeck, and David A. Cameron. “Trastuzumab Deruxtecan in Previously Treated Her2-Low Advanced Breast Cancer.” New England Journal of Medicine 387, no. 1 (July 7, 2022): 9-20.

Three Cups of Coffee a Day Lowers Risk of Death

(p. D6) That morning cup of coffee may be linked to a lower risk of dying, researchers from a study published Monday [June 6, 2022] in The Annals of Internal Medicine concluded. Those who drank 1.5 to 3.5 cups of coffee per day, even with a teaspoon of sugar, were up to 30 percent less likely to die during the study period than those who didn’t drink coffee. Those who drank unsweetened coffee were 16 to 21 percent less likely to die during the study period, with those drinking about three cups per day having the lowest risk of death when compared with noncoffee drinkers.

Researchers analyzed coffee consumption data collected from the U.K. Biobank, a large medical database with health information from people across Britain. They analyzed demographic, lifestyle and dietary information collected from more than 170,000 people between the ages of 37 and 73 over a median follow-up period of seven years. The mortality risk remained lower for people who drank both decaffeinated and caffeinated coffee. The data was inconclusive for those who drank coffee with artificial sweeteners.

“It’s huge. There are very few things that reduce your mortality by 30 percent,” said Dr. Christina Wee, an associate professor of medicine at Harvard Medical School and a deputy editor of the scientific journal where the study was published. Dr. Wee edited the study and published a corresponding editorial in the same journal.

. . .

The study showed that the benefits of coffee tapered off for people who drank more than 4.5 cups of coffee each day.

For the full story see:

Dani Blum. “Have a Cup of Coffee. It Could Extend Your Life.” The New York Times (Tuesday, June 7, 2022): D6.

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

(Note: the online version of the story has the date June 1, 2022, and has the title “Coffee Drinking Linked to Lower Mortality Risk, New Study Finds.” Where there are minor differences in wording between the versions, the passages quoted above follow the online version.)

The academic article summarized in the passages quoted above is:

Liu, Dan, Zhi-Hao Li, Dong Shen, Pei-Dong Zhang, Wei-Qi Song, Wen-Ting Zhang, Qing-Mei Huang, Pei-Liang Chen, Xi-Ru Zhang, and Chen Mao. “Association of Sugar-Sweetened, Artificially Sweetened, and Unsweetened Coffee Consumption with All-Cause and Cause-Specific Mortality.” Annals of Internal Medicine 175, no. 7 (July 2022): 909-17.

CDC’s “Rigid Checklist” Leads Doctors to Misdiagnose Atypical Cases

(p. A17) In his “memoir of illness and discovery,” Mr. Douthat tells us of his descent into a netherworld of consternation, paranoia and despair after contracting a chronic form of Lyme disease six years ago. Although he experienced physical pain that was often unbearable, he was stonewalled and scoffed at by skeptical doctors who refused to accept the existence of a long-lingering form of Lyme.

. . .

Lyme—a debilitating bacterial disease acquired from deer-tick bites—was ruled out because many of his symptoms didn’t match a rigid checklist drawn up for the ailment by the Centers for Disease Control and Prevention. This “diagnostic standardization,” Mr. Douthat writes, was “supposed to establish a consistent baseline for national case reporting, not rule out the possibility of atypical cases or constrain doctors from diagnosing them.” As a result of such inflexibility, he tells us, doctors miss “anywhere from a third to half of early Lyme cases.”

For the full review, see:

Tunku Varadarajan. “BOOKSHELF; Patient, Heal Thyself.” The Wall Street Journal (Saturday, Oct. 14, 2021): A17.

(Note: ellipsis added.)

(Note: the online version of the review has the date October 13, 2021, and has the title “BOOKSHELF; ‘The Deep Places’ Review: Patient, Heal Thyself.”)

The book under review is:

Douthat, Ross. The Deep Places: A Memoir of Illness and Discovery. New York: Convergent Books, 2021.

Sri Lankan Ban on Synthetic Fertilizer Causes Soaring Food Prices and Hunger

(p. A17) The Green Revolution of Norman Borlaug, the American agronomist who did more to feed the world than any man before or since, set Sri Lanka on the path to agricultural abundance in 1970. It was built around chemical fertilizers and crops bred to be disease-resistant. Fifty-two years later, Sri Lanka has pulled off a revolution that is “antigreen” in the modern sense, toppling its president, Gotabaya Rajapaksa. In an uprising that has its roots in Mr. Rajapaksa’s imperious decision to impose organic farming on the entire country—which led to widespread hunger after the agricultural economy collapsed—Sri Lanka’s people have wrought the first contra-organic national uprising in history.

. . .

. . ., Mr. Rajapaksa was driven from office in part because he was an overzealous green warrior, who imposed on his countrymen a policy that the American environmental left holds sacred.

. . .

. . ., Mr. Rajapaksa took a step that poleaxed Sri Lanka. On April 27, 2021—with no warning, and with no attempt to teach farmers how to cope with the change—he announced a ban on all synthetic fertilizers and pesticides. Henceforth, he decreed, Sri Lankan agriculture would be 100% organic. Agronomists and other scientists warned loudly of the catastrophe that would ensue, but they were ignored. This Sri Lankan Nero listened to no one.

. . .

What happened next? Rice production fell by 20% in the first 180 days of the ban on synthetic fertilizer. Tea, Sri Lanka’s main cash crop, has been hit hard, with exports at their lowest level in nearly a quarter-century. Whether from indignation over the new laws or an inability to go organic, farmers left a third of all farmland fallow. Food prices soared as a result of scarcity and Sri Lanka’s people, their pockets already hit by the pandemic, began to go hungry. To add to the stench of failure, a shipload of manure from China had to be turned back after samples revealed dangerous levels of bacteria. The farmers had no synthetic fertilizer, and hardly any of the organic kind.

For the full commentary see:

Tunku Varadarajan. “Sri Lanka’s Green New Deal Was a Human Disaster.” The Wall Street Journal (Friday, July 15, 2022): A17.

(Note: ellipses added.)

(Note: the online version of the commentary has the date July 14, 2022, and has the same title as the print version.

Insurers Claim Curing Obesity Is “Vanity”

(p. A17) Maya Cohen’s entree into the world of obesity medicine came as a shock.

In despair over her weight, she saw Dr. Caroline Apovian, an obesity specialist at Brigham and Women’s Hospital, who prescribed Saxenda, a recently approved weight-loss drug. Ms. Cohen, who is 55 and lives in Cape Elizabeth, Maine, hastened to get it filled.

Then she saw the price her pharmacy was charging: $1,500 a month. Her insurer classified it as a “vanity drug” and would not cover it.

“I’m being treated for obesity,” she complained to her insurer, but to no avail.

. . .

More than 40 percent of Americans have obesity, and most have tried repeatedly to lose weight and keep it off, only to fail. Many suffer from medical conditions that are linked to obesity, including diabetes, joint and back pain and heart disease, and those conditions often improve with weight loss.

“The evidence is now overwhelming that there are physical changes in weight regulating pathways that make it difficult for people to lose weight and maintain their weight loss,” said Dr. Louis Aronne, an obesity medicine specialist who directs the comprehensive weight control center at Weill Cornell Medicine. “It’s not that they don’t have willpower. Something physical is holding them back.”

. . .

“Access to medicines for the treatment of obesity is dismal in this country,” said Dr. Fatima Cody Stanford, an obesity medicine specialist at Massachusetts General Hospital and Harvard Medical School.

. . .

Douglas Langa, an executive vice president at Novo Nordisk, . . . said that diabetes and obesity were “separate categories, separate marketplaces” to explain the difference in price between the companies’ two drugs that were based on the same medicine, semaglutide. He said Wegovy’s price “reflects efficacy and clinical value in this area of unmet need.”

Dr. Stanford was appalled.

“It’s unbelievable,” she said, adding that it was a gross inequity to charge people more for the same drug because of their obesity. She finds herself in an untenable situation: getting excited when her patients with obesity also have diabetes because their insurers pay for the drug.

For the full story, see:

Gina Kolata. “Many Insurers Won’t Cover New Weight Loss Drugs.” The New York Times (Wednesday, June 1, 2022): A17.

(Note: ellipses added.)

(Note: the online version of the story has the date May 31, 2022, and has the title “The Doctor Prescribed an Obesity Drug. Her Insurer Called It ‘Vanity.’.”)