On Monday, May 4, Jim Blasingame, the host of his nationally syndicated “The Small Business Advocate” radio show, interviewed me on issues related to my book Openness to Creative Destruction, and “Free to Choose a Possible Cure,” my April 17 op-ed piece on the web site of the American Institute for Economic Research. You can click on the links below to listen to each segment of the interview.
Category: Health
Early Promising Results from Gilead-Sponsored Study on Remdesivir
(p. B3) A doctor in Chicago told colleagues that Gilead’s drug remdesivir appeared to help many patients enrolled in a clinical trial site at the University of Chicago Medicine hospital, according to a news report in online health publication STAT, which cited a video of the remarks. The doctor said that the hospital had enrolled 125 patients in two remdesivir studies sponsored by Gilead, and that most had been discharged from the hospital, and two had died.
. . .
“Partial data from an ongoing clinical trial is by definition incomplete and should never be used to draw conclusions about the safety or efficacy of a potential treatment that is under investigation,” a University of Chicago spokeswoman said in an email. “Drawing any conclusions at this point is premature and scientifically unsound.”
. . .
Last week, Gilead reported in the New England Journal of Medicine that remdesivir showed encouraging results in treating 53 patients with severe Covid-19 symptoms. The patients were given the drug under so-called compassionate use, which allows for doctors to request unapproved drugs for patients in emergency situations.
Of the 53 compassionate use patients who received remdesivir, nearly half were discharged from the hospital and seven patients died, or 13% of the total, according to the New England Journal paper. Of 30 patients using breathing tubes connected to ventilators, 17 had their tubes disconnected after remdesivir treatment.
For the full story, see:
(Note: ellipses added.)
(Note: the online version of the story has the date April 17, 2020, and has the title “Coronavirus Drug Report, Though Inconclusive, Sends Gilead Higher.” Where the versions differ, the passages quoted above follow the somewhat longer online version.)
An Informed Public Can Protect Themselves Better than Central Planners Can Protect Them
(p. A15) China teaches one thing: When a novel respiratory virus emerges, a free press is on balance an indispensable medical asset. The steps an informed public can take to protect itself are far more potent than any top-down action. Unknown is whether the new disease really originated in a meat market in Wuhan, as was first reported. But suppressing news of its outbreak once it was discovered was China’s most fatal mistake.
For the full commentary, see:
(Note: the online version of the commentary has the date Feb. 11, 2020, and has the same title as the print version.)
A Map as Large as the Territory It Represents
(p. A4) As more reliable data comes in, said Dr. Spiegelhalter, “the Covid-19 pandemic is rapidly becoming a constrained problem.”
. . .
Statistical science, he said, “is a machine, in a sense, to turn the variability that we see in the world — the unpredictability, the enormous amount of scatter and randomness that we see around us — into a tool that can quantify our uncertainty about facts and numbers and science.”
But as he acknowledged in his book, “The Art of Statistics,” models “are simplifications of the real world — they are the maps not the territory.” (This is reminiscent of Jorge Luis Borges’s story, “On Exactitude in Science,” about a map growing as large as the territory it was meant to represent.)
For the full review, see:
(Note: ellipsis added.)
(Note: the online version of the review has the date April 7, and has the title “Embracing the Uncertainties.”)
The Spiegelhalter book mentioned above, is:
Spiegelhalter, David. The Art of Statistics: How to Learn from Data. New York: Basic Books, 2019.
Since SARS, Japanese Protect One Another by Wearing Masks
(p. A4) PARIS — Until a few weeks ago, Asian tourists were the only mask-wearers in Paris, eliciting puzzlement or suspicion from French locals, or even hostility as the coronavirus began sweeping across Europe.
. . .
This taboo is falling fast, not only in France but across Western countries, after mounting cries from experts who say the practice is effective in curbing the coronavirus pandemic.
The shift for Western nations is profound and has had to overcome not merely the logistical challenges of securing enough masks, which are significant enough, but also a deep cultural resistance and even stigma associated with mask-wearing, which some Western leaders described flatly as “alien.”
Seemingly, it won’t be for much longer. After discouraging people from wearing face masks, France, like the United States, has begun urging its citizens to wear basic or homemade ones outside. And some parts of Europe are moving faster than the United States by requiring masks instead of simply recommending their use.
. . .
. . . masks were . . . alien to Asia until it was struck by the SARS pandemic in 2003.
In Japan, after people got used to masks, they continued to wear them against seasonal allergies or to protect one another from germs. Unlike in other Asian nations, where many wear masks against air pollution, mask-wearing became widespread despite the absence of immediate threats.
Mask-wearing has become such a part of daily life that it now plays a role in maintaining an overall feeling of being “reassured” in Japanese society, said Yukiko Iida, an expert on masks at the Environmental Control Center, an environmental consulting company based in Tokyo.
“When you put on a mask, you’re not inconveniencing others when you cough,” Ms. Iida said. “You’re showing others that you’re abiding by social etiquette, and so people feel reassured.”
. . .
Daniel Illouz, a pharmacist in eastern Paris, said that he had been skeptical of the government’s repeated message that widespread mask-wearing was not helpful in fighting the epidemic.
“I don’t see why in all the Asian countries, where they have masks, it would work, but it wouldn’t work for us,” he said.
For the full story, see:
(Note: ellipses added.)
(Note: the online version of the story has the date April 9, 2020, and has the title “Mask-Wearing Is a Very New Fashion in Paris (and a Lot of Other Places).”)
Low Quality Parts from Corrupt Contractors Endanger Russian Sailors in Deep-Diving Subs
(p. A22) OFF THE COAST OF NORWAY — There could hardly have been a more terrifying place to fight a fire than in the belly of the Losharik, a mysterious deep-diving Russian submarine.
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A fire on any submarine may be a mariner’s worst nightmare, but a fire on the Losharik was a threat of another order altogether. The vessel is able to dive far deeper than almost any other sub, but the feats of engineering that allow it do so may have helped seal the fate of the 14 sailors killed in the disaster.
. . .
(p. A23) As for the accident itself, few expressed surprise that a jewel of the Russian submarine fleet might catch fire not very far from its home base — probably in water no more than 1,000 feet deep — leaving most of its crew dead. The Russians, some experts said, seem to have a greater tolerance for risk than the West.
. . .
Mr. Lobner, the former American submarine officer, said “we have nothing except unmanned vehicles” operating at such depths.
Still, while some see an engineering marvel, others see evidence that Russia may be unable to build the kind of sophisticated, autonomous underwater drones the United States appears to rely on.
“They would rather adapt existing systems, modernize them, and try to muddle through,” Mr. Boulègue said. “So, no wonder these things keep exploding,” he said. Mr. Boulègue believes accidents have been far more common than publicly known.
John Pike, director of the think tank GlobalSecurity.org, said the Losharik fire suggested that the Russian military was still contending with some longstanding issues: corrupt contractors, and problems with quality control in manufacturing, spare parts supply chains and maintenance.
“I assume that every other sub in the Russian fleet has similar problems,” Mr. Pike said. “I just think the whole thing is held together with a lot of baling wire and spit.”
For the full story, see:
(Note: ellipses added.)
(Note: the online version of the story was updated April 21, 2020, and has the title “A Deep-Diving Sub. A Deadly Fire. And Russia’s Secret Undersea Agenda.”)
“A Clinical Hunch by a Lot of Really Smart People”
(p. A1) Thomas Oxley wasn’t even on call the day he received the page to come to Mount Sinai Beth Israel Hospital in Manhattan. There weren’t enough doctors to treat all the emergency stroke patients, and he was needed in the operating room.
The patient’s chart appeared unremarkable at first glance. He took no medications and had no history of chronic conditions. He had been feeling fine, hanging out at home during the lockdown like the rest of the country, when suddenly, he had trouble talking and moving the right side of his body. Imaging showed a large blockage on the left side of his head.
Oxley gasped when he got to the patient’s age and covid-19 status: 44, positive.
The man was among several recent stroke patients in their 30s to 40s who were all infected with the novel coronavirus. The median age for that type of severe stroke is 74.
As Oxley, an interventional neurologist, began the procedure to remove the clot, he observed something he had never seen before. On the monitors, the brain typically shows up as a tangle of black squiggles – “like a can of spaghetti,” he said – that provide a map of blood vessels. A clot shows up as a blank spot. As he used a needlelike device to pull out the clot, he saw new clots forming in real-time around it.
“This is crazy,” he remembers telling his boss.
A SURGE
Reports of strokes in the young and middle-aged – not just at Mount Sinai but in many other hospitals in communities hit hard by the coronavirus – are the latest twist in our evolving understanding of its connected disease, covid-19. Even as the virus has infected nearly 2.8 million people worldwide and killed 195,000 as of Friday, its biological mechanisms continue to elude top scientific minds. Once thought to be a pathogen that primarily attacks the lungs, it has turned out to be a much more formidable foe – impacting nearly every major organ system in the body.
Until recently, there was little hard data on strokes and covid-19.
There was one report out of Wuhan, China, that showed that some hospitalized patients had experienced strokes but many of those were seriously ill and elderly. But the linkage was considered more of “a clinical hunch by a lot of really smart people,” said Sherry H-Y Chou, a University of Pittsburgh Medical Center neurologist and critical care doctor.
Now for the first time, three large U.S. medical centers are preparing to publish data on the stroke phenomenon. The numbers are small, only a few dozen per location, but they provide new insights into what the virus does to our bodies.
For the full story, see:
(Note: bold in original.)
(Note: some of the above quote may have been continued onto a later page than A1.)
“The Licensing and Rollout” of Ebola Vaccine Was Accelerated
(p. 4) To combat Ebola in Congo, one of the world’s poorest nations, health workers are taking a multifaceted approach.
They have worked to win over communities that were sometimes uncooperative — even hostile.
They have drawn on technological innovations, notably a transparent enclosure known as the cube that allows medical workers to reach in and treat patients suffering from the contagious disease through plastic sleeves.
And they have used vaccines, developed relatively recently, which have made it possible to limit the spread of the epidemic.
. . .
The “cube” was . . . a big trust builder.
With transparent walls and integrated plastic sleeves and gloves, the air-conditioned chambers allowed medical teams to tend to Ebola patients without having to put on cumbersome protective gear. The cubes also allowed patients and their family members to see each other without risk of infection.
People were afraid of the treatment centers, where so many had died. But the cubes won trust for the health care workers, said Augustin Augier, chief executive of the Alliance for International Medical Action, the nonprofit aid group that developed the chambers.
“We asked the community to come and visit so they could see what was actually happening,” Mr. Augier said.
At least 500 patients were fully treated in the cubes, which could be set up in 90 minutes and reused up to 10 times, Mr. Augier, said.
But the key factor in curbing the spread of Ebola was the introduction of powerful vaccines and lifesaving antiviral drugs.
In early November 2018, the W.H.O. accelerated the licensing and rollout of the injectable Ebola vaccine Ervebo, made by the American pharmaceutical company Merck. Preliminary study results showed a 97.5 percent efficacy rate, prompting Congo, along with Burundi, Ghana and Zambia, to license the vaccine for wider distribution.
Nearly 300,000 doses of the vaccine have been administered in Congo, said Dr. Moeti of the W.H.O.
For the full story, see:
(Note: ellipses added.)
(Note: the online version of the story has the date April 11, 2020, and has the title “Congo Was Close to Defeating Ebola. Then One More Case Emerged.”)
For Venturesome Amazon Toilet Paper Shoppers, “Like Sandpaper” Is “Better than Nothing”
(p. B5) Where name-brand products sell out, off-brand products sold by third-party sellers have filled the void. Many of the top search results for toilet paper with regular Prime delivery were novelty rolls with zombies or the faces of politicians like Hillary Clinton.
In early April, Arielle Ogletree and her mother, who live near Tampa, Fla., were almost out of toilet paper when they turned to Amazon. They found a 16-pack of the large commercial toilet paper rolls found in public restrooms for $42. A few days later, it was at their door.
“It was the only one they had, and we figured it would last a while,” Ms. Ogletree said.
The roll, too big for a regular holder, sits awkwardly on their bathroom counter. Though the single ply feels “like sandpaper,” Ms. Ogletree said, it was better than nothing.
For the full story, see:
(Note: the online version of the story has the date April 17, 2020, and has the title “When Even Amazon Is Sold Out of Exploding Kittens.”)
Free to Choose a Possible Cure
Chinese Doctors Wear Adult Diapers to Avoid Taking Off Their One-Per-Day One-Piece Protective Suit
(p. A1) The coronavirus outbreak has exposed the jarring absence in China of a vibrant civil society — the civic associations like business groups, nonprofit organizations, charities and churches that bring people together without involving the government.
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(p. A10) “The traditional management mechanism of ‘big government’ is no longer efficient, and is even failing,” Duan Zhanjiang, a management consultant, wrote in an article about managing the epidemic. “The government is very busy but not effective.
. . .
The Communist Party has never liked or trusted civil society. It is suspicious of any organization that could potentially pose challenge to its rule, including big private enterprises. It has cracked down on nongovernment organizations like rights groups and charities as well as churches and mosques. The party wants nothing to stand between its government and China’s 1.4 billion people.
Big Chinese corporations and wealthy individuals have been donating, many generously. But they also try to keep low profiles for fear of offending a government that is eager to take credit for any success and quick to suspect outside groups of challenging it.
Those gaps are evident on the front lines of the outbreak, where workers have lacked the proper equipment to keep themselves safe. Doctors and nurses wear disposable raincoats instead of protective gowns. They wear ordinary, and inadequate, surgical masks while conducting dangerous throat swab tests. They wear adult diapers because, once they take off their one-piece protective suits, the suits will have to be thrown away. They get only one per day.
For the full commentary, see:
(Note: ellipses added.)
(Note: the online version of the commentary has the date April 5, 2020, and has the same title “THE NEW NEW WORLD; In Coronavirus Fight, China Sidelines an Ally: Its Own People.”)