Category: Health

Communists Punished Dr. Li Wenliang For Speaking Truth on Coronavirus

Doctor Li Wenliang. Source of photo: online version of the NYT article quoted and cited below.

(p. B1) The Chinese public has staged what amounts to an online revolt after the death of a doctor, Li Wenliang, who tried to warn of a mysterious virus that has since killed hundreds of people in China, infected tens of thousands and forced the government to corral many of the country’s 1.4 billion people.

. . .

For many people in China, the doctor’s death shook loose pent-up anger and frustration at how the government mishandled the situation by not sharing information earlier and by silencing whistle-blowers. It also seemed, to those online, that the government hadn’t learned lessons from previous crises, continuing to quash online criticism and investigative reports that provide vital information.

Some users of Weibo, China’s Twitter-like social media platform, are saying the doctor’s death resonated because he was an ordinary person who was forced to admit to wrongdoing for doing the right thing.

Dr. Li was reprimanded by the police after he shared concerns about the virus in a social messaging app with medical school classmates on Dec. 30 [2019].

Three days later, the police compelled him to sign a statement that his warning constituted “illegal behavior.”

The doctor eventually went public with his experiences and gave interviews to help the public better understand the unfolding epidemic. (The New York Times interviewed Dr. Li days before his death.)

“He didn’t want to become a hero, but for those of us in 2020, he had reached the upper limit of what we can imagine a hero would do,” one Weibo post read. The post is one of many that users say they wrote out of shame and guilt for not standing up to an authoritarian government, as Dr. Li did.

. . .

The grief was so widespread that it appeared in unlikely corners.

“Refusing to listen to your ‘whistling,’ your country has stopped ticking, and your heart has stopped beating,” Hong Bing, the Shanghai bureau chief of the Communist Party’s official newspaper, People’s Daily, wrote on her timeline on WeChat, an instant-messaging platform. “How big a price do we have to pay to make you and your whistling sound louder, to reach every corner of the East?”

Both the Chinese- and English-language Twitter accounts of People’s Daily tweeted that Dr. Li’s death had prompted “national grief.” Both accounts deleted those messages before replacing them with more neutral, official-sounding posts.

. . .

Wang Gaofei, the chief executive of Weibo, which carries out many of the orders passed down from China’s censors, pondered what lessons China should learn from Dr. Li’s death.

“We should be more tolerant of people who post ‘untruthful information’ that aren’t malicious,” he said in a post. “If we’re only allowed to speak what we can guarantee is fact, we’re going to pay prices.”

. . .

“R.I.P. our hero,” Fan Bao, a prominent tech investor, posted on his WeChat timeline.

. . .

The hashtag #wewantfreedomofspeech# was created on Weibo at 2 a.m. on Friday [February 7, 2020] and had over two million views and over 5,500 posts by 7 a.m. It was deleted by censors, along with related topics, such as ones saying the Wuhan government owed Dr. Li an apology.

“I love my country deeply,” read one post under that topic. “But I don’t like the current system and the ruling style of my country. It covered my eyes, my ears and my mouth.”

The writer of the post complained about not being able to gain access to the internet beyond the Great Firewall. “I’ve been holding back for a long time. I feel we’ve all been holding back for a long time. It erupted today.”

Talking about freedom of speech on the Chinese internet is taboo, even though it’s written into the Constitution. So it’s a small miracle that the freedom of speech hashtag survived for over five hours.

The country’s high-powered executives have been less blunt, but have echoed the same sentiments online.

“It’s time to reflect on the deeply rooted, stability-trumps-everything thinking that’s hurt everyone,” Wang Ran, chairman of the investment bank CEC Capital, wrote on Weibo. “We all want stability,” he asked. “Will you be more stable if you cover the others’ mouths while walking on a tightrope?

For the full story, see:

Li Yuan. “Online Revolt in China as a Doctor Is Lionized.” The New York Times (Saturday, February 8, 2020): B1 & B4.

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

(Note: the online version of the story has the date Feb. 7, 2020, and has the title “Widespread Outcry in China Over Death of Coronavirus Doctor.”)

Chinese Communist Officials Rewarded for Loyalty, Not for Competence or Boldness

(p. A1) The Chinese people are getting a rare glimpse of how China’s giant, opaque bureaucratic system works — or, rather, how it fails to work. Too many of its officials have become political apparatchiks, fearful of making decisions that anger their superiors and too removed and haughty when dealing with the public to admit mistakes and learn from them.

“The most important issue this outbreak exposed is the local government’s lack of action and fear of action,” said Xu Kaizhen, a best-selling author who is famous for his novels that explore the intricate workings of China’s bureaucratic politics.

“Under the high-pressure environment of an anticorruption campaign, most people, including senior government officials, only care about self-preservation,” Mr. Xu said. “They don’t want to be the first to speak up. They wait for their superiors to make decisions and are only accountable to their superiors instead of the people.”

The Chinese government appears to be aware of the problem. The Communist Party’s top leadership acknowledged in a meeting on Monday [February 3, 2020] that the (p. A9) epidemic was “a major test of China’s system and capacity for governance.”

. . .

Chinese officials are spending as much as one-third of their time on political studying sessions, a lot of which are about Mr. Xi’s speeches. Political loyalty weighs much more in performance evaluations than before. Now the rule of thumb in Chinese officialdom seems to be demonstrating loyalty as explicitly as possible, keeping everything else vague and evading responsibility at all costs when things go wrong.

. . .

On social media, low-level cadres are complaining that they are receiving so many instructions from the higher-ups that they spend most of their time filling out spreadsheets instead of getting real work done. In a social media post headlined “The Formalism Under the Mask,” the author wrote, “Most people in the system don’t do things to solve problems. They do things to solve responsibilities.”

For the full story, see:

Li Yuan. “In China, Virus Spurred Rush of Blame Shifting.” The New York Times (Wednesday, February 5, 2020): A1 & A9.

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

(Note: the online version of the story was updated Feb. 14 [sic], 2020, and has the title “Coronavirus Crisis Shows China’s Governance Failure.”)

A.I. Makes Surgeons More Efficient, but Does Not Replace Them

(p. B6) Brain surgeons are bringing artificial intelligence and new imaging techniques into the operating room, to diagnose tumors as accurately as pathologists, and much faster, according to a report in the journal Nature Medicine.

The new approach streamlines the standard practice of analyzing tissue samples while the patient is still on the operating table, to help guide brain surgery and later treatment.

The traditional method, which requires sending the tissue to a lab, freezing and staining it, then peering at it through a microscope, takes 20 to 30 minutes or longer. The new technique takes two and a half minutes. Like the old method, it requires that tissue be removed from the brain, but uses lasers to create images and a computer to read them in the operating room.

. . .

Some types of brain tumor are so rare that there is not enough data on them to train an A.I. system, so the system in the study was designed to essentially toss out samples it could not identify.

Over all, the system did make mistakes: It misdiagnosed 14 cases that the humans got right. And the doctors missed 17 cases that the computer got right.

“I couldn’t have hoped for a better result,” Dr. Orringer said. “It’s exciting. It says the combination of an algorithm plus human intuition improves our ability to predict diagnosis.”

In his own practice, Dr. Orringer said that he often used the system to determine quickly whether he had removed as much of a brain tumor as possible, or should keep cutting.

“If I have six questions during an operation, I can get them answered without having six times 30 or 40 minutes,” he said. “I didn’t do this before. It’s a lot of burden to the patient to be under anesthesia for that long.”

Dr. Bederson said that he had participated in a pilot study of a system similar to the one in the study and wanted to use it, and that his hospital was considering acquiring the technology.

“It won’t change brain surgery,” he said, “but it’s going to add a significant new tool, more significant than they’ve stated.”

For the full story, see:

Denise Grady. “Speedy and Unerring, A.I. Comes to the Operating Room.” The New York Times (Tuesday, January 7, 2020): B6.

(Note: ellipsis added.)

(Note: the online version of the story has the date Jan. 6, 2020, and has the title “A.I. Comes to the Operating Room.”)

National Institutes of Health Rejected Funding for Moir’s Radical Theories

(p. B14) Robert D. Moir, a Harvard scientist whose radical theories of the brain plaques in Alzheimer’s defied conventional views of the disease, but whose research ultimately led to important proposals for how to treat it, died on Friday [December 20, 2019] at a hospice in Milton, Mass. He was 58.

His wife, Julie Alperen, said the cause was glioblastoma, a type of brain cancer.

Dr. Moir, who grew up on a farm in Donnybrook, a small town in Western Australia, had a track record for confounding expectations. He did not learn to read or write until he was nearly 12; Ms. Alperen said he had told her that the teacher at his one-room schoolhouse was “a demented nun.” Yet, she said, he also knew from age 7 that he wanted to be a scientist.

. . .

Conventional wisdom held that beta amyloid accumulation was a central part of the disease, and that clearing the brain of beta amyloid would be a good thing for patients.

Dr. Moir proposed instead that beta amyloid is there for a reason: It is the way the brain defends itself against infections. Beta amyloid, he said, forms a sticky web that can trap microbes. The problem is that sometimes the brain goes overboard producing it, and when that happens the brain is damaged.

The implication is that treatments designed to clear the brain of amyloid could be detrimental. The goal would be to remove some of the sticky substance, but not all of it.

The idea, which Dr. Moir first proposed 12 years ago, was met with skepticism. But he kept at it, producing a string of papers with findings that supported the hypothesis. Increasingly, some of the doubters have been won over, said Rudolph Tanzi, a close friend and fellow Alzheimer’s researcher at Harvard.

Dr. Moir’s unconventional ideas made it difficult for him to get federal grants. Nearly every time he submitted a grant proposal to the National Institutes of Health, Dr. Tanzi said in a phone interview, two out of three reviewers would be enthusiastic, while a third would simply not believe it. The proposal would not be funded.

For the full obituary, see:

Gina Kolata. “Robert Moir, 58, Researcher Who Rethought Alzheimer’s.” The New York Times (Saturday, December 21, 2019): B14.

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

(Note: the online version of the obituary was last updated December 23 [sic], 2019, and has the title “Robert Moir, 58, Dies; His Research Changed Views on Alzheimer’s.”)

French Regulations Require Only Doctors Can Identify the Dead

(p. A4) DOUAI, France — Her mother’s death had been expected. Terminally ill with breast cancer, she lay in a medical bed in her living room, visited daily by a nurse.

But when Sandra Lambryczak’s 80-year-old mother died earlier this year, in the predawn hours of a Saturday morning, the daughter suddenly discovered a growing problem in France’s medical system: By law, the body couldn’t be moved until the death was certified by a medical doctor, but a shortage of personnel can sometimes force families to keep their deceased loved ones at home for hours or even days.

. . .

Doctors have resisted pressure from some politicians to delegate the authority to certify deaths to other health care officials. They argue that it is a serious medical procedure and that a mistake in noting the cause of death could have legal consequences.

“There are doctors, if they don’t know the patient well, say to themselves that they don’t want trouble later on,” said Dr. Olivier Bouchy, the vice president of the French Medical Council in the department of Meuse. “Signing a death certificate is not harmless.”

As with many things in France, tradition is perhaps also an obstacle to changing the doctor’s role in certifying deaths. The death certificate process, Dr. Bouchy said, harked back to an earlier time.

. . .

In France, the state’s role in regulating people’s daily lives — including in matters of health — remains strong. So the lack of a doctor, especially at the emotionally vulnerable moment when a family member dies, can feel like a deep betrayal.

“We felt abandoned by the state,” said Frédéric Deleplanque, who had to wait more than two days for a doctor to certify the death of his father-in-law, Jean-Luc Bajeux, a retired autoworker. “We were nothing.”

For the full story, see:

Norimitsu Onishi. “An Agonizing Delay After a Death at Home.” The New York Times (Tuesday, December 17, 2019): A4.

(Note: ellipses added.)

(Note: the online version of the story has the date December 16, 2019, and has the title “In France, Dying at Home Can Mean a Long Wait for a Doctor.”)

ALS Drug Entrepreneurs Developed Idea in Dorm Room and Self-Funded the Early Development

(p. B3) An experimental drug slowed the paralyzing march of amyotrophic lateral sclerosis, or Lou Gehrig’s disease, in a clinical trial, according to researchers who say the results are a fresh sign that recent insights into the condition may soon bring new medicines.

. . .

The idea for the drug came to Amylyx Chief Executive Josh Cohen, he said, while he was a Brown University junior in 2012 and 2013 majoring in biomedical engineering and reading scientific papers on how neurons die.

Mr. Cohen told Mr. Klee, whom he had first met playing club tennis in college. Mr. Klee, a neuroscience major, spent the following night reading up on his friend’s idea.

“We did what most people in our generation do” when trying to learn about a topic, Mr. Klee said. “We went to the Internet. We Googled it.”

The research shed light on some molecular routes that neurodegeneration follows, which Mr. Cohen said sparked his interest in combining drugs that attacked two important pathways. The problem was, each drug alone hadn’t worked in studies.

Unfamiliar with both drug research and the industry, Messrs. Cohen and Klee sounded out experts, including Dr. Cudkowicz, to learn how to test their hypothesis in a laboratory, start a company and conduct testing in patients.

Their project took off after the pair scraped together $6,000 from personal savings and family donations to pay contract researchers in Finland, who found their combination drug worked in a petri dish.

Mr. Cohen took all his courses during his final year of college on Thursdays so he could devote the rest of the week to Amylyx.

Mr. Klee, who had moved to Cambridge, Mass., after graduating, took odd jobs coaching swimming, working as a research technician and participating in medical-research studies to earn money for the fledgling startup then based in his apartment.

The company, based in Cambridge, had three employees last March and seven today, but plans to add 100 employees next year.

For the full story, see:

Jonathan D. Rockoff. “ALS Drug Shows Promise in Study.” The Wall Street Journal (Tuesday, December 17, 2019): B3.

(Note: ellipsis added.)

(Note: the online version of the story has the same date as the print version, and has the title “ALS Drug Works in Study, Researchers Say.” The sentences quoted after the ellipsis above, appear in the online, but not in the print, version of the article.)

Muyembe Had Knowledge of an Ebola Cure Before Clinical Trial

(p. A1) In a medical breakthrough that compares to the use of penicillin for war wounds, two new drugs are saving lives from the virus and helping uncover tools against other deadly infectious diseases. They were proven effective in a gold-standard clinical trial conducted by an international coalition of doctors and researchers in the middle of armed violence.

. . .

(p. A10) Dr. Muyembe set out on his path to an Ebola treatment during the 1995 outbreak. He transferred blood from five survivors to eight patients, hoping that the antibodies that kept some people alive would keep others from dying. Seven of the patients who received the blood transfusion recovered.

He published the results in a scientific journal in 1999. Other researchers said the study was small and had failed to include a control group, a comparison set of patients who weren’t given the treatment, to fully test its efficacy.

For the full story, see:

Betsy McKay. “From a War Zone Came an Unexpected Cure for Ebola.” The Wall Street Journal (Thursday, October 31, 2019): A1 & A10.

(Note: ellipsis added.)

(Note: the online version of the story has the date Oct. 30, 2019, and has the title “‘Ebola Is Now a Disease We Can Treat.’ How a Cure Emerged From a War Zone.”)

Stents Do Not Reduce Heart Attacks or Deaths

(p. A17) The findings of a large federal study on bypass surgeries and stents call into question the medical care provided to tens of thousands of heart disease patients with blocked coronary arteries, scientists reported at the annual meeting of the American Heart Association on Saturday [Nov. 16, 2019].

The new study found that patients who received drug therapy alone did not experience more heart attacks or die more often than those who also received bypass surgery or stents, tiny wire cages used to open narrowed arteries.

That finding held true for patients with several severely blocked coronary arteries. Stenting and bypass procedures, however, did help some patients with intractable chest pain, called angina.

. . .

Stenting costs an average of $25,000 per patient; bypass surgery costs an average of $45,000 in the United States. The nation could save more than $775 million a year by not giving stents to the 31,000 patients who get the devices even though they have no chest pain, Dr. Hochman said.

. . .

But getting a stent does not obviate the need for medical therapy, Dr. Boden noted. Since patients with stents need an additional anti-clotting drug, they actually wind up taking more medication than patients who are treated with drugs alone.

About a third of stent patients develop chest pain again within 30 days to six months and end up with receiving another stent, Dr. Boden added.

For the full story, see:

Kolata, Gina. “Drugs Are Shown to Reduce Need For Surgery to Fix Blocked Arteries.” The New York Times, First Section (Sunday, November 17, 2019): A17.

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

(Note: the online version of the story has the date Nov. 16, 2019, and has the title “Surgery for Blocked Arteries Is Often Unwarranted, Researchers Find.” The online version says that the page number of the New York print edition was A19. The page number of my National edition was A17.)

Rapamycin Will Be Tested to Extend Lifespan of Dogs

(p. 1A) SEATTLE (AP) — Can old dogs teach us new tricks? Scientists are looking for 10,000 pets for the largest-ever study of aging in canines. They hope to shed light on human longevity too.

The project will collect a pile of pooch data: vet records, DNA samples, gut microbes and information on food and walks. Five hundred dogs will test a pill that could slow the aging process.

“What we learn will potentially be good for dogs and has great potential to translate to human health,” said project co-director Daniel Promislow of the University of Washington School of Medicine.

. . .

(p. 2A) Dogs weighing at least 40 pounds will be eligible for an experiment with rapamycin, now taken by humans to prevent rejection of transplanted kidneys. The drug has extended lifespan in mice. A small safety study in dogs found no dangerous side effects, said project co-director Matt Kaeberlein of the University of Washington.

For the full story, see:

Carla K. Johnson of The Associated Press. “Needed: 10,000 Dogs for Project That Could Also Benefit Humans.” Omaha World-Herald (Thursday, Nov. 15, 2019): 1A-2A.

(Note: ellipsis added.)

(Note: the online version of the story has the date Nov. 17 [sic], 2019, and has the title “Old dogs, new tricks: 10,000 pets needed for science.”)

“Rejuvenate Bio” Startup Succeeds in Using Gene Therapy to Fight Age-Related Diseases in Mice

The online PNAS article mentioned below includes the information that one of the article’s referees was Aubrey de Grey, Cambridge scientist, and co-author of The End of Aging. Aubrey de Grey has been arguing for many years that anti-aging research will only take-off when proof-of-concept is achieved with mice. The PNAS article summarized below, appears to provide that proof-of-concept.

(p. A13) North Grafton, Mass.

A Cavalier King Charles spaniel named Shadow was at the front lines of a new approach to gene therapy.

Earlier this month, 7-year-old Shadow was the first dog to be screened at Tufts University for a pilot study attempting to use gene therapy to treat a type of heart disease that often afflicts aging cavaliers.

It’s part of a novel approach to gene therapy that has successfully treated age-related ailments in mice. Now it is being studied in dogs, with eventual hopes to test it in humans.

Researchers reported their success in mice in a study published Monday [Nov. 4, 2019] in the journal PNAS. They treated four age-related diseases in mice using genetic therapy: heart and kidney failure, Type 2 diabetes and obesity. On average, the mice experienced a 58% increase in heart function, a 75% reduction in kidney degradation, and normalized weight and blood-sugar levels in mice fed a high-fat diet, the study found.

. . .

What’s interesting about the new research in mice is that it is broader—targeting not a single rare defect, but common age-related ailments. The experiments injected mice with DNA to create an extra copy of a healthy gene, expressing more healthy material in cells linked to common diseases of aging.

The goal of the biotech company behind the mice study, Rejuvenate Bio —which sprang from research out of the lab of Harvard geneticist George Church, who is a co-founder—is to treat multiple aging-related diseases in dogs. It recently started working with Tufts University’s Cummings School of Veterinary Medicine on the dog pilot. If successful in dogs, the company hopes to treat similar human diseases but says that will take a lot more resources and time.

The firm says it expects the cost of dog genetic therapies would be similar to dog cancer treatments, including surgery, which range from about $500 to $8,000.

. . .

Nir Barzilai, director of the Institute for Aging Research at the Albert Einstein College of Medicine in New York City, praised the PNAS study as a proof of concept . . .

For the full story, see:

Sumathi Reddy. “YOUR HEALTH; Gene Therapy Targets Aging.” The Wall Street Journal (Tuesday, Nov. 4, 2019): A13.

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

(Note: the online version of the story has the date Nov. 4, 2019, and has the title “YOUR HEALTH; A New Approach to Gene Therapy—Now In Dogs, Maybe Later In Humans.”)

The PNAS article, summarized in the passages quoted above, is:

Davidsohn, Noah, Matthew Pezzone, Andyna Vernet, Amanda Graveline, Daniel Oliver, Shimyn Slomovic, Sukanya Punthambaker, Xiaoming Sun, Ronglih Liao, Joseph V. Bonventre, and George M. Church. “A Single Combination Gene Therapy Treats Multiple Age-Related Diseases.” Proceedings of the National Academy of Sciences (PNAS) (Nov. 4, 2019): https://doi.org/10.1073/pnas.1910073116.

The book co-authored by Aubrey de Grey, and mentioned way above, is:

de Grey, Aubrey, and Michael Rae. Ending Aging: The Rejuvenation Breakthroughs That Could Reverse Human Aging in Our Lifetime. New York: St. Martin’s Press, 2007.

New York City Regs Force Arthritic Woman to Push Cart to Laundromat Instead of Using Her Laundry Room

(p. A1) When Jean Harrow got a ticket in 2016 for unauthorized renovations to her Queens home, she thought it was a misunderstanding. Yes, she had put a powder room in her basement without realizing she needed a permit. But surely, she said, she wasn’t responsible for the washer and dryer a previous owner had installed downstairs — illegally, according to the $1,600 citation. She would simply explain that at her hearing.

As she waited to do just that, Ms. Harrow got a second ticket — for “failure to comply” with the first. In the 14 months after the original citation, she received five others for the same issue: $15,600 in additional fines. Each meant another hearing, and although she never missed a court date, the tickets kept coming.

Thousands of small property owners in New York City have been hit with a similar pileup of fines, an unintended result of a decade-long crackdown set off by fatal construction accidents. In recent years, the city’s Buildings Department has hired hundreds of new inspectors and doled out harsher penalties for violators. But rules introduced as a safeguard have become a costly trap for ordinary people, The New York Times found.

. . .

(p. A23) Ms. Harrow admits she made a mistake: She should have sought a permit to install the toilet and sink that piggybacked on plumbing already in her laundry room. But, she said she told the inspector, “I didn’t run those pipes — I bought it like this.”

To correct the violation, Ms. Harrow needed to have the unauthorized plumbing removed. Before she could get the permit, however, she had to pay a $1,500 civil penalty.

Pulling the money together took months. The receipt for the payment was lost, then found. Her permit request was rejected several times, because of errors a plumber had made on the application. She received another fine during this period.

At Ms. Harrow’s final hearing, the agency lawyer reduced two fines imposed after the permit came through. But Ms. Harrow was on the hook for the rest. Besides losing the bathroom, she would be out $13,100 in fines plus interest, as well as permit costs, plumbers’ fees, two taxi fares, and a washer and dryer. A different permit would have allowed her to keep the laundry room, but the process would have been even more expensive.

“Now I have to be pushing a cart to go to the wash,” she said. “I have rheumatoid arthritis.”

Ms. Harrow said she tried to put $50 a month toward the fines. “But sometimes, to tell you the truth, I can’t make it.”

For the full story, see:

Grace Ashford. “Snowballing Tickets Bury Homeowners in Debt.” The New York Times (Monday, September 9, 2019): A1 & A22-A23.

(Note: ellipsis added.)

(Note: the online version of the story has the same date as the print version, and has the title “The Law Was Aimed at Deadly Machinery. It Hit Her Washer.”)