First, there is now a Resources Page here for the most commonly asked questions I'm getting.
Happy to continue to answer your questions/concerns as best I can, so don't be shy about that.
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No surprise: A federal judge Kacsmaryk in Texas has ruled that the Food and Drug Administration’s initial authorization of the abortion pill Mifepristone was improper and has suspended the pill’s FDA approval. The ruling will take effect in 7 days if not stayed by the 5th circuit or SCOTUS.
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Our very conservative local news paper had this remarkable editorial about the new abortion clinic due to open here in this "abortion desert" to serve WV, W MD, Ohio women:
A Path to Real-World Evidence in Critical Care Using Open-Source Data Harmonization Tools
COVID-19 highlighted the need for use of real-world data (RWD) in critical care as a near real-time resource for clinical, research, and policy efforts. Analysis of RWD is gaining momentum and can generate important evidence for policy makers and regulators. Extracting high quality RWD from electronic health records (EHRs) requires sophisticated infrastructure and dedicated resources. We sought to customize freely available public tools, supporting all phases of data harmonization, from data quality assessments to de-identification procedures, and generation of robust, data science ready RWD from EHRs. These data are made available to clinicians and researchers through CURE ID, a free platform which facilitates access to case reports of challenging clinical cases and repurposed treatments
Air pollution is linked to lower COVID-19 vaccine responses
People exposed to higher levels of air pollution before the pandemic had lower antibody responses to COVID-19 vaccines, according to a study led by the Barcelona Institute for Global Health (ISGlobal), in collaboration with the Germans Trias i Pujol Research Institute (IGTP). In particular, exposure to fine particulate matter (PM2.5), nitrogen dioxide (NO2) and blank carbon (BC) was associated with about a 10% decrease in IgM and IgG antibody responses in people without prior infection.
The findings, published in Environmental Health Perspectives, provide further evidence on the adverse effects of air pollution on the immune system.
[Another reason for racial disparities and higher death rate among Blacks and Latinos?]
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FDA expected to authorize second bivalent COVID booster for risk groups
The Food and Drug Administration (FDA) within the next few weeks will authorize second bivalent (two-strain) COVID vaccine boosters for the highest risk groups, officials with knowledge of the plans told the Washington Post.
[A more recent interview w FDA's Rob Califf suggests we shouldn't hold our breath waiting for this decision.]
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Two infants born to COVID-infected mothers suffer severe brain damage
A University of Miami case study published today in Pediatrics suggests that SARS-CoV-2 breached the placenta, causing brain damage in two newborns.
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The highly pathogenic avian influenza (HPAI) viruses have been detected in U.S. wild aquatic birds, commercial poultry, and backyard or hobbyist flocks since January 2022, causing the destruction of 58,645,211 birds. These are the first detections of HPAI viruses A (H5N1) in the U.S. since 2016.
The virus is increasingly being found in mammals in the United States and other countries.
[No vaccine is in sight...]
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Dog Dies from Bird Flu in Canada
dog was infected with bird flu after chewing on a wild goose.
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Nigeria records 823 Lassa fever cases, 144 deaths (among 4108 suspected cases)
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The US Centers for Disease Control and Prevention (CDC) recently issued a level 2 travel alert for Equatorial Guinea due to its Marburg virus, the country's first. The CDC urged people to avoid nonessential travel to affected provinces. The CDC has also issued a level 1 travel watch notice for Tanzania, another African country battling its first Marburg virus outbreak.
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Is Polio coming back to America?
Why we should worry about that case in Rockland County, NY - Paul Offit
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...The authors propose that four goals should be considered in the pandemic agreement being negotiated, to prevent pandemics originating from the wildlife trade (including markets and other aspects along the trade chain):
* The risk that the wildlife trade poses to human health needs to be better understood.
* It is imperative for each country to conduct an assessment of the risk posed from the wildlife trade.
* Countries need to make pledges to reduce or eliminate such risk, from wildlife trade, or to reduce deforestation and forest degradation.
* Funding commitments need to be made to ensure the three previous goals can be met.
[Good luck achieving any of this...and most recent pandemics are spillover from animals]
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Big Brother's NIH plan:
The National Institutes on Aging (NIA), part of the National Institutes of Health, is launching a $300 million research fund focused on Alzheimer’s disease.
The research fund aims to track the health of Americans for decades, with the intent of housing the long-term health information of 70% to 90% of the population. The news was first reported by Reuters.
NIA will fund the project, with the platform using data from medical records, insurance claims, pharmacies, mobile devices, sensors and various government agencies. By tracking health data, researchers are hopeful to make advancements in Alzheimer’s with the health information of patients before and after they are diagnosed. For example, Alzheimer’s symptoms can be seen up to 20 years before memory issues arise.
Ideally, the database will help identify healthy people at risk for Alzheimer’s, which impacts six million Americans. These identified people could be eligible for drug trials.
[Sounds like a bad idea. What kind of protections are there for patients from insurers or discrimination?]
still an incredible, negligent last of testing.
Over-the-counter Narcan: A big win for public health
Narcan, the naloxone nasal spray used to reverse opioid overdose, was approved Wednesday for over-the-counter sale by the Food and Drug Administration. It's a major victory for harm-reduction advocates and public health professionals—and a much needed step toward preventing thousands of overdose deaths each year. The Centers for Disease Control and Prevention reports that almost half of fatal overdoses had a bystander present.
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'Morning after' antibiotics could slash odds for common STDs
A "morning after" dose of a common antibiotic can greatly lower the chances of sexually transmitted bacterial infections in high-risk people, a new clinical trial has found.
[But at what cost in terms of antibiotic resistance?]
COVID XBB.1.16 Strain 'One to Watch,' Says WHO
— Reports so far on highly infectious "Arcturus" subvariant do not indicate a rise in severe cases, It's been detected in over 20 countries and contributing to a recent surge of COVID cases in India. XBB.1.16 has replaced the other variants that are in circulation, so this is one to watch." XBB.1.16 has high infectivity and pathogenicity, Van Kerkhove noted. It's estimated that the lineage comprises 2.9% of current U.S. cases.
Influenza D - Cow flu
A new flu is spilling over from cows to people in the U.S. How worried should we be? #InfluenzaD #FluD
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Hands and surfaces play a role
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NEW: I’m not sure people fully appreciate how dire the US life expectancy / mortality situation has got.— John Burn-Murdoch (@jburnmurdoch) March 31, 2023
My column: https://t.co/dBIhT9eZLv
And some utterly damning charts.
1) at *every* point on the income distribution, Americans live shorter lives than the English. pic.twitter.com/pOoziEK5mZ
2) It’s actually worse than that chart made out, because at most points on the income distribution, Americans earn much more than Brits. If we plot the same data by actual income instead of percentile, the US deficit is vast. 5 fewer years even among the comfortably-off.
Things have deteriorated so much that the average American now has the same healthy life expectancy (years lived in good health) as someone in Blackpool, the town with England’s lowest life expectancy (by far), synonymous with deep-rooted social decline ft.com/blackpool
I think that bears repeating. *The average American* has the same chance of a long and healthy life as someone born in the most deprived part of England, a place with the highest rates of relationship breakdown and some of the highest rates of antidepressant prescribing.
So what’s happening? When people hear about life expectancy they often think about older people, broad-based health problems, but the US problem is quite specific and quite different: it’s young people dying from external causes.
Time for perhaps the most damning stat of all: One in 25 American five-year-olds today will not make it to their 40th birthday. No parent should ever have to bury their child, but on average across the US one set of parents from every kindergarten class most likely will.
Here’s another way of showing the same thing: Beyond age 70, US mortality/survival rates are very similar to other rich countries. But between teenage years and early middle age there is a vast gulf.
This has an outsized impact on life exp because deaths at early ages erase far more life than even a large number of older folks dying slightly early. More years of American lives were erased by drugs, guns & road deaths in 2021 alone than from Covid during the whole pandemic.
The result is that the US is the only developed country where even if you strip out all Covid deaths, life expectancy still dropped by a year since 2019
So we have a steady climb in “deaths of despair” and other violent/external deaths, plus the heavy toll exacted by very high rates of diet-related disease (cardiovascular diseases etc). Why is the US so badly afflicted?
One strong possibility is because the US is the ultimate “individual responsibility” country. Every person for themselves, weaker social safety nets. So, far more people slip through the cracks and find themselves in situations that make obesity, violence and drugs more likely.
Plus (directly related): huge emphasis on personal freedoms means more guns, more dangerous/unsafe driving, more lethal vehicles than similarly developed countries. So a perfect storm of 1) more people pushed into bad situations, 2) easier for bad situations to become deadly.
Wider inequalities don’t help. Look back at the first charts: despite being a richer society on average, the poorest in the US are even poorer than the poorest English. That’s taking the society-wide US disadvantage and multiplying it.
Worse access to healthcare will certainly be playing a part too, but the types and ages of deaths suggest the US’s life expectancy problem is as much (if not more) a social problem than a health problem in terms of the way we should think about it.
long thread and graphics continues...
Tips, general reading for public:
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Woman warns scam kidnappers are now spoofing real family members’ numbers to convince victims
“If you get a call like this, I read that it’s recommended that you hang up and then immediately call back because it’ll call your actual contact,” she said.
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Party officials across the country have sought to erect more barriers for young voters, who tilt heavily Democratic, after several cycles in which their turnout surged.
Idaho banned student ID cards as a form of voter identification.
Texas, where 2019 legislation shuttered early voting sites on many college campuses,
TX introduced the bill to eliminate all polling places on college campuses this year,
Idaho will join Texas and only four others — North Dakota, Ohio, South Carolina and Tennessee — that do not accept any student IDs, Arizona and Wisconsin have rigid rules on student IDs that colleges and universities have struggled to meet
Georgia has accepted student IDs only from public colleges and universities since 2006,
Gift article link:
"It was 2004 when the LA Times disclosed that Supreme Court Justice Clarence Thomas had accepted expensive gifts & private plane trips paid for by Harlan Crow"
Oregon’s attorney general says a lawsuit led by Oregon and Washington won its case to preserve mifepristone access.
The case, which was joined by 16 other states, was decided by a federal judge Thomas Rice in eastern Washington, according to Oregon AG Ellen Rosenblum.
Rice ruled that mifepristone — a drug used in medical abortions — is safe and effective, and ordered the FDA to preserve the “status quo.”
His ruling only applies to 17 states and the DC however.
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Meanwhile.. Parents are wondering who TF is funding school shooters. Here are 9 leaders pic.twitter.com/z6QoC1M6UG— Rubicon (@Rubicon1313) April 1, 2023
Artist's portrait of America. pic.twitter.com/sCovPj4MDx— Mark Elliott (@markmobility) March 29, 2023
This is actually what a hosptial gave out on #DoctorsDay— Alok Patel (@AlokPatelMD) March 30, 2023
Each item featured has some metaphorical meaning.
I.e. a rubberband as a reminder to stay flexible, a quarter as a reminder you "call" for help, etc
Welcome to how you give thanks to "healthcare heroes"#MedTwitter pic.twitter.com/ZCwaTqoKJT
Alan Turning, who cracked Nazi Germany’s enigma code during WWII, is estimated to have shortened the war by 2 years & saved 14 M lives. His reward? Chemical castration bc he was gay. MAGAs are making it ok again to demonize homosexuality. I am terrified 4 the LGBTQ+ community. 1/ pic.twitter.com/yLo2gMNLXI— firstname.lastname@example.org ✍🏻 📢 (@jennycohn1) September 18, 2022
Vladimir Kara-Murza seeks a free Russia. The Kremlin gives him jail.
Feel good du jour:
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Credit: Marco Mancinelli: “I had been on assignment at a Detroit Montessori school for two days, and shot hundreds of photos. Some were very good, but I knew I hadn't gotten THE shot. That afternoon, as we all sat on the floor in a circle listening to a story, I bowed my head.… pic.twitter.com/J4hfIfC7jR— #RandyResistING Authoritarianism (@RandyResist) April 1, 2023
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Bits of beauty: