Zeynep Tufekci | H5N1 Bird Flu is Causing Alarm. Here’s Why We Must Act. – The New York Times

Opinion Columnist

“As the world is just beginning to recover from the devastation of Covid-19, it is facing the possibility of a pandemic of a far more deadly pathogen.

Bird flu — known more formally as avian influenza — has long hovered on the horizons of scientists’ fears. This pathogen, especially the H5N1 strain, hasn’t often infected humans, but when it has, 56 percent of those known to have contracted it have died. Its inability to spread easily, if at all, from one person to another has kept it from causing a pandemic.

But things are changing. The virus, which has long caused outbreaks among poultry, is infecting more and more migratory birds, allowing it to spread more widely, even to various mammals, raising the risk that a new variant could spread to and among people.

Alarmingly, it was recently reported that a mutant H5N1 strain was not only infecting minks at a fur farm in Spain but also most likely spreading among them, unprecedented among mammals. Even worse, minks’ upper respiratory tract is exceptionally well suited to act as a conduit to humans, Thomas Peacock, a virologist who has studied avian influenza, told me.”

How a Drug Company AbbVie Made $114 Billion by Gaming the U.S. Patent System – The New York Times

7 MIN READ

In 2016, a blockbuster drug called Humira was poised to become a lot less valuable.

“The key patent on the best-selling anti-inflammatory medication, used to treat conditions like arthritis, was expiring at the end of the year. Regulators had blessed a rival version of the drug, and more copycats were close behind. The onset of competition seemed likely to push down the medication’s $50,000-a-year list price.

Instead, the opposite happened.

Through its savvy but legal exploitation of the U.S. patent system, Humira’s manufacturer, AbbVie, blocked competitors from entering the market. For the next six years, the drug’s price kept rising. Today, Humira is the most lucrative franchise in pharmaceutical history.

Next week, the curtain is expected to come down on a monopoly that has generated $114 billion in revenue for AbbVie just since the end of 2016. The knockoff drug that regulators authorized more than six years ago, Amgen’s Amjevita, will come to market in the United States, and as many as nine more Humira competitors will follow this year from pharmaceutical giants including Pfizer. Prices are likely to tumble.

The reason that it has taken so long to get to this point is a case study in how drug companies artificially prop up prices on their best-selling drugs.”

David Lindsay: Excellenet article, but upsetting. It appears that there are many solutions, such as passing a law that says all additional patents to a new drug have to use the same start date as the original patent.

COVID-19: What To Know About Isolating Together

“You know that it’s important to help stop the spread of COVID-19 by being extra cautious if you think you’ve been exposed. And there is a good chance that you have been exposed to the virus a few times, and you might have even been infected.

As of August 2022, the Centers for Disease Control and Prevention (CDC) stated that when you’ve been exposed to COVID-19, take immediate precautions for 10 days and get tested at least five days after the date of exposure. Precautions include wearing a mask around others and monitoring yourself for symptoms.1 The CDC no longer recommends quarantine after exposure.

Since the COVID-19 pandemic started, there have been plenty of households where more than one person got sick at the same time. If one person tests positive for COVID-19, the CDC advised to have that person isolate from everyone else in the house.2

 But what if two or more people are infected? Is it OK to isolate together?”

Source: COVID-19: What To Know About Isolating Together

Even a Little Alcohol Can Harm Your Health, Research Shows – The New York Times

6 MIN READ

“Sorry to be a buzz-kill, but that nightly glass or two of wine is not improving your health.

After decades of confusing and sometimes contradictory research (too much alcohol is bad for you but a little bit is good; some types of alcohol are better for you than others; just kidding, it’s all bad), the picture is becoming clearer: Even small amounts of alcohol can have health consequences.

Research published in November revealed that between 2015 and 2019, excessive alcohol use resulted in roughly 140,000 deaths per year in the United States. About 40 percent of those deaths had acute causes, like car crashes, poisonings and homicides. But the majority were caused by chronic conditions attributed to alcohol, such as liver disease, cancer and heart disease.

When experts talk about the dire health consequences linked to excessive alcohol use, people often assume that it’s directed at individuals who have an alcohol use disorder. But the health risks from drinking can come from moderate consumption as well.

“Risk starts to go up well below levels where people would think, ‘Oh, that person has an alcohol problem,’” said Dr. Tim Naimi, director of the University of Victoria’s Canadian Institute for Substance Use Research. “Alcohol is harmful to the health starting at very low levels.” “

Scientists think that the main way alcohol causes health problems is by damaging DNA. When you drink alcohol, your body metabolizes it into acetaldehyde, a chemical that is toxic to cells. Acetaldehyde both “damages your DNA and prevents your body from repairing the damage,” Dr. Esser explained. “Once your DNA is damaged, then a cell can grow out of control and create a cancer tumor.” “

David Lindsay. Terrific update, and excellent comments. Such as:

Lynn

I so wish someone had advised me to try removing alcohol from my life decades ago. At nearly five years sober now I care not so much about the benefits to my physical health, but the vast improvements to my state of mind are priceless. Fabulous deep sleep, each and every night, zero low grade depression anymore, intense clarity of thought, profound improvements in communication style and thus relationships. While you are using a drug it looks marvelous – how could you ever give up such a “pleasure”. But give it up and the rewards are huge – so beyond any pleasure I ever got from what now looks purely like the poison it is.

25 Replies1478 Recommended

 
Kennedy commented January 13

Kennedy

No more moderate drinking, I can’t use my stove and I’m turning my house upside down checking for any classified documents.

2 Replies1354 Recommended

Jaspal
HoustonJan. 13

Recent research that led to the mantra “Even small amounts of alcohol can have health consequences.” is widely misunderstood. The results from the supporting studies show none to extremely low population level health impact of low level alcohol consumption – marginally positive for some cardiovascular outcomes and slightly negative for cancer outcomes. The point is that drinking alcohol for the purpose of improving health does not seem to be justified as was claimed in some previous studies. However stopping low level alcohol consumption that may be enjoyable based on the studies is like stopping driving because “Any amount of driving increases your risk of death due to an accident”. The story is completely different for high levels of alcohol consumption.

8 Replies681 Recommended
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Do Gas Stoves Have Health Risks? What to Know and How to Mitigate Them – The New York Times

4 MIN READ

“Mounting evidence of the potential health risks of gas stoves, including a link to childhood asthma, ignited a debate in Washington this week, after a commissioner of the United States Consumer Product Safety Commission suggested that his agency might move to regulate these kitchen appliances.

Responding to the firestorm, Alexander Hoehn-Saric, the agency’s chairman, issued a statement on Wednesday saying, “Research indicates that emissions from gas stoves can be hazardous, and the C.P.S.C. is looking for ways to reduce related indoor air quality hazards. But to be clear, I am not looking to ban gas stoves and the C.P.S.C. has no proceeding to do so.” “

Why Am I Allowed to Drink Clear Fluids Before Surgery, but Not Eat? | Office for Science and Society – McGill University

“In 1946 Curtis Mendelson published this paper examining the details surrounding 66 women who, while giving birth, had some of their stomach contents travel into their lungs. Mendelson concluded that this aspiration was occurring while patients were under general anesthesia. While sedated their throat reflexes were inhibited, which allowed food matter from the stomach to travel up the esophagus and enter the trachea and lungs. In some cases, this resulted in the patient asphyxiating or choking to death, whereas in others it went undetected until after labour had been completed when it caused infections, pneumonia, and other pulmonary complications.

Thus, to help avoid pulmonary aspiration he recommended several things, including that women in labour not be allowed to eat, as they might need to be unexpectedly placed under general anesthesia. These recommendations have been adjusted and refined in the last 74 years, but Mendelson’s main direction, that those preparing to be sedated should fast, has stuck.

The reason clear, particulate-free liquids are allowed when eating isn’t has to do with how quickly foods and drinks of different compositions leave the stomach. While food, especially fat- or protein-rich food, can take up to 8 hours to leave your stomach, studies have shown that clear fluids like coffee, water or pulp-free orange juice are clear of your stomach within two hours or faster. Therefore, clear fluids can be safely consumed up until two hours before surgery. This is true for almost all patients, including those who are pregnantyoungobese or anxious.

Thus, patients should be allowed to freely consume clear fluids like apple juice, coffee, Gatorade, tea (with no or little milk), or chew gum, up to two hours before surgery. This practice has some obvious benefits. For one, patients are less thirsty. I was given the traditional “nil par os” after midnight order (NPO, Latin for “nothing by mouth”) but because my operation took place in the early morning, I only went about three hours without water. Nonetheless, I still felt quite parched. When I woke up after my surgery the very first thing I asked was if I could have a drink.”

Source: Why Am I Allowed to Drink Clear Fluids Before Surgery, but Not Eat? | Office for Science and Society – McGill University

David Wallace-Wells | Our History of the Pandemic Is a Mess – The New York Times

Opinion Writer

You’re reading the David Wallace-Wells newsletter, for Times subscribers only.  The best-selling science writer and essayist explores climate change, technology, the future of the planet and how we live on it.

We are entering the fourth year of the pandemic, believe it or not: Freshmen are now seniors, toddlers now kindergartners and medical students now doctors. We’ve completed two American election cycles and one World Cup cycle. Army volunteers are nearing the end of their active-duty commitment. It’s been a long haul but in other ways a short jump: Three years is not so much time that it should be hard to clearly remember what happened. And yet it seems to me, on many important points our conventional pandemic history is already quite smudged.

Opinion | I’m an N.Y.C. Paramedic. I’ve Never Witnessed a Mental Health Crisis Like This One. – The New York Times

Mr. Almojera is a lieutenant paramedic with the New York City Fire Department Bureau of Emergency Medical Services and the author of “Riding the Lightning: A Year in the Life of a New York City Paramedic.”

“There are New Yorkers who rant on street corners and slump on sidewalks beside overloaded pushcarts. They can be friendly or angry or distrustful. To me and my colleagues, they’re patients.

I’m a lieutenant paramedic with the Fire Department’s Bureau of Emergency Medical Services, and it’s rare to go a day without a call to help a mentally ill New Yorker. Medical responders are often their first, or only, point of contact with the chain of health professionals who should be treating them. We know their names and their routines, their delusions, even their birthdays.

It is a sad, scattered community. And it has mushroomed. In nearly 20 years as a medical responder, I’ve never witnessed a mental health crisis like the one New York is currently experiencing. During the last week of November, 911 dispatchers received on average 425 calls a day for “emotionally disturbed persons,” or E.D.P.s. Even in the decade before the pandemic, those calls had almost doubled. E.D.P.s are people who have fallen through the cracks of a chronically underfunded mental health system, a house of cards built on sand that the Covid pandemic crushed.

Now Mayor Eric Adams wants medical responders and police officers to force more mentally ill people in distress into care. I get it — they desperately need professional help, and somewhere safe to sleep and to get a meal. Forceful action makes for splashy headlines.”

As one commenter put it, we just need universal health care, like other wealthy nations.

Paul Krugman | How China Lost the Covid War – The New York Times

Opinion Columnist

Do you remember when Covid was going to establish China as the world’s dominant power? As late as mid-2021, my inbox was full of assertions that China’s apparent success in containing the coronavirus showed the superiority of the Chinese system over Western societies that, as one commentator put it, “did not have the ability to quickly organize every citizen around a single goal.”

At this point, however, China is flailing even as other nations are more or less getting back to normal life. It’s still pursuing its zero-Covid policy, enforcing draconian restrictions on everyday activities every time new cases emerge. This is creating immense personal hardship and cramping the economy; cities under lockdown account for almost 60 percent of China’s G.D.P.

In early November many workers reportedly fled the giant Foxconn plant that produces iPhones, fearing not just that they would be locked in but that they would go hungry. And in the last few days many Chinese, in cities across the nation, have braved harsh repression to demonstrate against government policies.

I’m not a China expert, and I have no idea where this is going. As far as I can tell, actual China experts don’t know, either. But I think it’s worth asking what lessons we can draw from China’s journey from would-be role model to debacle.

Crucially, the lesson is not that we shouldn’t pursue public health measures in the face of a pandemic. Sometimes such measures are necessary. But governments need to be able to change policy in the face of changing circumstances and new evidence.

And what we’re seeing in China is the problem with autocratic governments that can’t admit mistakes and won’t accept evidence they don’t like.

In the first year of the pandemic, strong, even draconian restrictions made sense. It was never realistic to imagine that mask mandates and even lockdowns could prevent the coronavirus from spreading. What they could do, however, was slow the spread.

At first, the goal in the U.S. and many other countries was to “flatten the curve,” avoiding a peak in cases that would overwhelm the health care system. Then, once it became clear that effective vaccines would become available, the goal was or should have been to delay infections until widespread vaccination could provide protection.

You could see this strategy at work in places like New Zealand and Taiwan, which initially imposed stringent rules that held cases and deaths to very low levels, then relaxed these rules once their populations were widely vaccinated. Even with vaccines, opening up led to a large rise in cases and deaths — but not nearly as severe as would have happened if these places had opened up earlier, so that overall deaths per capita have been far lower than in the United States.

China’s leaders, however, seem to have believed that lockdowns could permanently stomp out the coronavirus, and they have been acting as if they still believe this even in the face of overwhelming contrary evidence.

At the same time, China utterly failed to develop a Plan B. Many older Chinese — the most vulnerable group — still aren’t fully vaccinated. China has also refused to use foreign-made vaccines, even though its homegrown vaccines, which don’t use mRNA technology, are less effective than the shots the rest of the world is getting.

All of this leaves Xi Jinping’s regime in a trap of its own making. The zero-Covid policy is obviously unsustainable, but ending it would mean tacitly admitting error, which autocrats never find easy. Furthermore, loosening the rules would mean a huge spike in cases and deaths.

Not only have many of the most vulnerable Chinese remained unvaccinated or received inferior shots, but because the coronavirus has been suppressed, few Chinese have natural immunity, and the nation also has very few intensive care beds, leaving it without the capacity to deal with a Covid surge.

It’s a nightmare, and nobody knows how it ends. But what can the rest of us learn from China?

First, autocracy is not, in fact, superior to democracy. Autocrats can act quickly and decisively, but they can also make huge mistakes because nobody can tell them when they’re wrong. At a fundamental level there’s a clear resemblance between Xi’s refusal to back off zero Covid and Vladimir Putin’s disaster in Ukraine.

Second, we’re seeing why it’s important for leaders to be open to evidence and be willing to change course when they’ve been proved wrong.

Ironically, in the United States the politicians whose dogmatism most resembles that of Chinese leaders are right-wing Republicans. China has rejected foreign mRNA vaccines, despite clear evidence of their superiority; many Republican leaders have rejected vaccines in general, even in the face of a huge partisan divide in death rates linked to differential vaccination rates. This contrasts with Democrats, who have in general followed something like New Zealand’s approach, if much less effectively — restrictions early on, relaxed as vaccination spread.

In short, what we can learn from China is broader than the failure of specific policies; it is that we should beware of would-be autocrats who insist, regardless of the evidence, that they’re always right.”    -30-

Paul Krugman | Wonking Out: Stealing Away the Golden Years of the Working Class – The New York Times

Opinion Columnist

“My Thursday column is about the assault on Medicare and Social Security that is almost certain to follow if Republicans prevail on Tuesday. If the G.O.P. wins control of Congress, we can expect it to hold the economy hostage, most obviously by weaponizing the debt ceiling, in an attempt to force big cuts in Medicare and Social Security.

This isn’t an outlandish scenario. It already happened once. In 2011, after taking control of the House, Republicans sought to extort major cuts in the social safety net from the Obama administration — and they almost succeeded. In fact, President Barack Obama agreed to a rise in the age of Medicare eligibility, from 65 to 67. The deal fell through only because Republicans were unwilling to accept even modest tax increases as their part of the bargain.

This time around, the demands are likely to be even bigger. A report from the Republican Study Committee, which probably gives a good idea of where the G.O.P. will go, calls for upping the retirement age and the age of Medicare eligibility to 70.

The report justifies such a rise by pointing to the long-term increase in the number of years Americans can expect to live after age 65, which it calls a “miracle.”

What the report doesn’t note are two probably related caveats for this miracle. First, the increase in seniors’ life expectancy has actually been much smaller here than in other wealthy nations. Second, progress has been very uneven within America, with much bigger gains for groups with high socioeconomic status — precisely the people who need Medicare and Social Security the least — than for the less fortunate.”

“. . . . . . . How does all this bear on Republican proposals to raise the retirement and Medicare eligibility ages? Because seniors’ life expectancy varies so much by class, an increase in the age of eligibility for major programs will take a much bigger bite out of retirement for Americans with low socioeconomic status, and correspondingly fewer years to collect benefits, than it will on those higher on the ladder.

And because disparities have been rising over time, the disproportionality of that effect has been rising, too.

Look back at the figure on life expectancies by quartile. According to these estimates, American men in the bottom quartile born in 1960 can expect to live only 1.9 more years after 65 than their counterparts born in 1928. That’s slightly less than the increase in the retirement age that has already taken place. And even men in that quartile born in 1990 are expected to have only 3.5 years more time after 65 than those born in 1928; meanwhile, Republicans are proposing a rise in the retirement age to 70, a five-year total increase, and an equal rise in the Medicare age.

One way to think about all of this, which is only a slight caricature, is that Republicans are telling janitors in Oklahoma that they can’t get benefits in their 60s — even though their life expectancy hasn’t gone up by much — because lawyers in New York are living longer.

It’s quite a position to take, and it would surely provoke a huge backlash — if voters knew about it, which most of them seem not to.”  -30-