Archive for the 'Science and Medicine' Category

May 07 2020

Skeptical of Plandemic

A promotional video on YouTube for a new documentary, Plandemic, is making the rounds and promoting quite a response. The video features Dr. Judy Mikovits, and is basically an interview with her. Unfortunately this is a slick piece of utter nonsense and conspiracy mongering. Mikovits has zero credibility in any of her claims, but they are combined with music and clips of videos to create the impression that there is some reality behind her outrageous claims. Let me focus on a few claims to show how low her and the filmmaker’s credibility are.

In her introduction the narrator states that she authors a study in Science that “sent shockwaves through the scientific community” because it showed that fetal and animal tissue in vaccines was causing an epidemic of chronic illness. This is straight up lie, but that is the narrative of this video – that she is a courageous fighter going against the establishment, which is killing people for profit and trying to destroy her for calling them out.

Here is the original Science paper. It alleges to have found the XMRV virus in patients with chronic fatigue syndrome. This did make a splash when it was published because it purported to find a possible cause of an otherwise mysterious illness. It has nothing to do with vaccines at all (although you could argue, falsely that the virus came from vaccines, but that is not what the research was on). But then, here is a retraction of the paper by Science. Was it retracted as part of some global conspiracy against Mikovits? No – it was retracted because:

“Multiple laboratories, including those of the original authors, have failed to reliably detect xenotropic murine leukemia virus-related virus (XMRV) or other murine leukemia virus (MLV)-related viruses in chronic fatigue syndrome (CFS) patients,” says the retraction notice. “In addition, there is evidence of poor quality control in a number of specific experiments in the Report.”

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May 04 2020

COVID-19 Immunity and Vaccines

We appear to be at the beginning of the end of the first wave of COVID-19 (at least in the US – other countries are at different places). We are at the point where states are starting to relax the physical distancing requirements, and there is discussion about how to transition to the next phase. That next phase might include disease tracking, targeted isolation, and “immunity passports.” But planning this next phase is complicated by the fact that we still do not fully understand this virus. We don’t know if there will be a second wave (or more), if it is seasonal, and if you can catch it twice. How we handle this next phase will likely determine if there is a second wave.

But what comes after that? When can we transition to the final phase – return to normal, even if it is a new normal? These next transitions will depend largely on the natural immunity that results from infection, and how long it will take to create a vaccine and how effective that vaccine is. Here is what we know and don’t know so far.

The big question for the next phase is – how much immunity results from natural infection? This is a more complicated question than it may first seem. But the short answer is, we don’t know.

The adaptive part of the immune system will remember infections, B-cells that create specific antibodies targeting the infecting organism will develop throughout an infection, and some of those B-cells are memory B-cells – they will hang around for a long time, ready to produce specific antibodies the next time the same organism is encountered. But there are important variables to how effective this adaptive immune strategy is. the virus or infecting organism itself is the main variable. What parts of itself does it expose to the immune system? Perhaps the critical functional proteins are hidden deep within folds that antibodies cannot get to. Another variable is how quickly does it mutate? If the parts that antibodies can target change quickly, then immunity does not last. Some organisms also evolve specific strategies to evade or compromise the immune system.

Another variable is the severity of the infection itself. The more severe and long lasting the infection, the greater the stimulation to the immune system and the greater the adaptive response.

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May 01 2020

Nanotechnology to Treat Alzheimer’s Disease

This is a very cool study, with the massive caveat that it is extremely preliminary – but scientists have concluded an in vitro study of nanodevices that can reduce one of the pathological changes thought to be a significant cause of Alzheimer’s disease. This has to be put into context, but let me first describe what they did.

Alzheimer’s disease (AD) is a neurodegenerative disorder that affects the brain diffusely. Little by little brain cells die, the brain atrophies, and cognitive ability slowly declines causing dementia. The disease affects about 10% of people over 65, producing a huge burden on individuals, families, and society. As our population ages, it is becoming even more prevalent. There is extensive research on how Alzheimer’s disease progresses, looking for clues that might lead to an effective treatment. However, it has proven a tough nut to crack. We have many clues, but nothing that has lead to a treatment that can prevent, stall, or reverse the neurodegeneration. It is, in short, a complex disease.

One piece of this complex puzzle is the β-amyloid peptide (Aβ), which is a breakdown product of an amyloid protein precursor. The simple version is that this peptide is normally cleared from brain cells as a waste product, but in some individuals it is not sufficiently cleared and there is enough hanging around to form conglomerations or clumps of the protein. These clumps form plaques, which are a major pathological sign of AD. However, the picture is more complex than that. The amount of plaques in the brain don’t necessarily correlate with the severity of the dementia in AD, so it is clearly not the whole picture. More recent studies have found:

Substantial evidence now indicates that the solubility of Aβ, and the quantity of Aβ in different pools, may be more closely related to disease state. The composition of these pools of Aβ reflects different populations of amyloid deposits, and has definite correlates with the clinical status of the patient.

There are also pathological processes in AD that are not related to amyloid plaques, so again we are only dealing with part of the picture here. Still, researchers have been looking for ways to prevent plaque formation as a possible way to slow, stop, or even reverse AD. So far nothing has led to an approved treatment. (Current treatments for AD are only symptomatic.)

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Apr 30 2020

COVID-19 – This is the Harm

Perhaps the most persistent and annoying question promoters of science-based medicine get is, “What’s the harm?” The implication is we should just let people use their Reiki or magic potions if it makes them feel like they are doing something, as long as the treatment is not directly physically harmful. As you can see, I have been addressing it for years, including the fact that I will have to address it for years. There is also well documented real physical harm from many unscientific treatments, but even without that the harm is substantial.

As a physician I have seen first hand much of the harm that can result – such as wasted time and effort, expenditure of limited resources, the psychological harm of false hope, and delaying effective treatment. But I have also warned about the harm to our scientific, medical, and societal infrastructures. This is difficult to quantify, but what is happening is that we are allowing to thrive a multi-billion dollar industry funneling money to charlatans, quacks, con-artists, pseudoscientists, those who discount science, and conspiracy theorists. Do you think they are just taking their money and staying quiet? No. They are using some of those billions to lobby for laws to water down public protections, weaken regulations, and funnel taxpayer money into promoting their snake oil.

This multi-billion dollar industry is also engaged in a massive advertising campaign, which amounts to a disinformation campaign, for their “brand”, which is alternative, complementary, integrative, functional, whatever medicine. They have spent decades misinforming the public about the relative significance of various health risks and benefits, the nature of disease, and the trustworthiness of scientists and experts. They have been a major component in the war on expertise, and to a large extent they are winning.

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Apr 24 2020

UVC and Covid-19

On this week’s SGU (which will go online tomorrow) I talked about the use of ultraviolet light as an anti-viral strategy. I wasn’t planning on also writing about it, but then the president decided to make some incredibly dubious comments about is, so I thought I would address it here. Here’s what he said:

“So, supposing we hit the body with a tremendous – whether it’s ultraviolet or just very powerful light,” the president said, turning to Dr Deborah Birx, the White House coronavirus response co-ordinator, “and I think you said that hasn’t been checked but you’re going to test it.

“And then I said, supposing you brought the light inside of the body, which you can do either through the skin or in some other way. And I think you said you’re going to test that too. Sounds interesting,” the president continued.

He also made some ever sillier comments about injecting people with disinfectant – both comments commit the same error, confusing an external treatment for an internal one., and also suggesting that treatments meant for objects be used on people. So what is the deal with UV light as an antiseptic? The antiseptic effects of UV light have been known for a long time. In 1878, Arthur Downes and Thomas P. Blunt published the first paper describing this effect. Ultraviolet light has enough energy to cause tissue damage – that is why you get a sunburn if you get too much sun exposure.

UV light is electromagnetic radiation between visible light and X-rays on the spectrum, from 10-400 nm wavelength. These are higher energy waves than visible light, with enough energy to cause chemical reactions and damage DNA. UV light is further divided into biological relevant categories of UVA (400-315 nm), UVB (315-280 nm) and UVC (280-100 nm). The ozone layer filters out 97-99% of UV radiation from 315-200 nm, so the UVB and part of the UVC spectrum. Otherwise the suns rays would be much more harmful. On the Earth’s surface there is about 500 times the intensity of UVA than UVB, and almost no UVC. Biologically, UVA penetrates deeper into the skin and does cause long term aging effects. UVB affects the skin surface but causes sunburns and damage that can lead to skin cancer. UVC could cause extreme damage even with minutes of exposure (depending on the intensity).

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Apr 23 2020

Hydroxychloroquine Not Looking Good for Covid-19

We have been tracking the story of the hype surrounding hydroxychloroquine over at Science-Based Medicine, but there is a brief follow up I wanted to comment on. The short version of the story so far is that one very bad French study claimed to show dramatic reduction in detected virus in those treated. This study, however, was not only preliminary, it was a horrible study, so much so that the results are uninterpretable. The big problem was that it did not count patients who became too sick or died. That is a classic way to make a treatment look better than it is. The author is also a climate change denier who initially mocked China for taking steps to mitigate Covid-19. He does not exactly have street cred within the scientific community.

But that one horrible study from a sketchy researcher was enough to spark media hype, at least in certain circles, and capture the attention of a president apparently desperate to make this problem go away. Amid the fear of a pandemic, that was a toxic combination. The notion that hydroxychloroquine (with our without the antibiotic, azythromycin) might fight the SARS-Cov2 virus is not implausible. But most things in medicine that are “not implausible” don’t work out. We need high quality clinical science to ultimately tell.

The big question always is – what is the risk vs benefit? Hydroxychloroquine and Azythromycin both have the same potentially deadly side effect, prolonging the QT interval of the heart, which increases the risk for sudden cardiac death. This is a manageable side effect in the right setting, but is potentially serious. This is not a good drug or combination to be taking just on the chance it might help.

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Apr 17 2020

Mixed Feelings About the WHO

The World Health Organization (WHO) is one of those entities that are so essential if it didn’t exist it would need to be invented. But at the same time, it is a frustratingly flawed institution.  Some of those flaws are being highlighted during the Covid-19 pandemic. But the WHO is not alone in this – Covid-19 is an extreme stress on the system, and it is revealing multiple weaknesses. The big lesson I hope at least a majority of people take from this entire episode is that we actually need continuity of competent government.

The WHO is essential for establishing international standards of medical care, and helping deliver modern medicine to the developing world. They are a critical source of information on epidemiology, and often the first source I go to when researching a medical topic. They have become a critical trust of medical, public health, and epidemiological expertise. They are also critical in dealing with things like pandemics. Here is their list of their primary goals, but in short:

Our goal is to ensure that a billion more people have universal health coverage, to protect a billion more people from health emergencies, and provide a further billion people with better health and well-being.

The WHO is a creature of the UN and came into existence in 1948 (just three years after the UN itself). They have 7,000 employees in offices in 150 countries. Ideally, an organization dedicated to health would be apolitical, nonpartisan, and heavily science-based. In a way the WHO represents the highest ideals of the UN – many nations getting together to cooperate for mutual benefit. But predictably it’s difficult to get so many different cultures and perspectives to collaborate seamlessly, and this has lead to what I consider some major problems with the WHO.

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Apr 06 2020

COVID-19 Is Not Due to 5G

What do the following things have in common? A train engineer deliberately derails his train trying to crash it into a hospital ship in port to relieve overstressed hospital. In 2016 a man entered a pizza parlor and began shooting his assault rifle. And in the last few days several cell towers in the UK were the victims of apparent arson. These strange acts were all apparently motivated by bizarre conspiracy theories. Conspiracy thinking can be dangerous on many levels. It creates an alternate view of realty, one insulated from facts and refutation. Grand conspiracy theories also commonly create a narrative in which the enlightened few are struggling against a powerful and dark secretive cabal. It can motivate people to think they must do something – something desperate, dramatic, and heroic. The train conductor sums up this mind set:

“You only get this chance once. The whole world is watching. … I had to. People don’t know what’s going on here. Now they will.”

But let’s get back to this notion that 5G networks are somehow responsible for the coronavirus pandemic, or at least making it worse. This claim occurs in the context of general fear of the health effects of 5G. As I discussed at length in this SBM article, these concerns are not valid and are confusing the implications of the science. Here’s the quick version – 5G is operating at a relatively low frequency and low energy level, too low to cause direct harm to tissue. This is what is called non-ionizing radiation, because it is too low power to break chemical bonds. 5G critics make much of the fact that 5G is at a higher frequency than 4G or 3G , operating in the 28 and 39 gigahertz range. But as I and others point out, as you go higher still in EM frequency you get to visible light. Visible light has a frequency rage of 430–770 THz – that’s terahertz, which is 1,000 gigahertz – so visible light is at a frequency about 12,000 times higher than 5G. 5G networks are also low power, in the tens or at most hundreds of watts. In other words, that computer screen you are looking at right now is bathing you is much more powerful and higher frequency EM radiation than any 5G network.

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Apr 03 2020

A Stupidity Pandemic

As a skeptical science communicator I am constantly walking the line between hope and cynicism. On the one hand, I very much take to heart Carl Sagan’s approach to science – focusing on the absolute wonder of the universe, and celebrating the curiosity and ingenuity of humanity. We have peered into the past, walked on the moon, and decoded many of the secrets of life. Science is a powerful tool that has transformed the world more in the last few centuries than in tens of thousands of years beforehand. And yet, humanity still struggles with the demons of our evolutionary history. We are tribal, superstitious, and capable of surrendering our critical thinking to a charismatic leader.

What this all means is that when we are faced with a challenge, even a crisis, we are capable of meeting it. We can bring the tools of science, philosophy, and politics to bear to solve almost any problem. And yet the extent to which we will fail to do so is a consequence of our own stupidity and lack of critical thinking. There is nothing like a pandemic to reveal all of this – the good and the bad.

On the bright side, there have already been thousands of studies of the novel coronavirus (SARS-COV-2) and the disease it produces, COVID-19. Researchers are already exploring possible treatments and developing a vaccine. Meanwhile, we have solid mechanisms everyone can use to protect themselves and slow the spread of disease. Where implemented properly and in time, these strategies work. Compare this to just 100 years ago, during the 1918 flu pandemic. That pandemic killed at least 50 million people worldwide – and that magnitude was created largely by the world’s collective failure to properly understand and deal with the virus. They had no treatment, no vaccine, and utterly failed to enact adequate public health measures (for sure, this was partly due to the fact that they were fighting a world war and many politicians prioritized the war effort over mitigating the pandemic). Go back a bit further to the black death, which killed a third of Europe, and they did not even understand the nature of the pandemic. Their ignorance made them all but helpful before it.

Today, through science we understand exactly what is going on, down to the molecular level. And we have the methods to quickly (relatively speaking) figure our how best to address it. It is still a challenge, because the pandemic is moving quickly, but all we really have to do collectively is not panic and listen to our own experts. But of course, it’s never that simple. Some people will find a way to screw it up, because humanity is a complex mixture of motivations, biases, and emotions.

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Mar 26 2020

Boosting Your Immune System During a Pandemic

The short answer to the question – how do you boost your immune system – is that you can’t. The very concept of “boosting” the immune system is not scientific and does not exist within mainstream medicine. That’s because it is based on a fundamental misunderstanding of immunity, and of biological systems. Having said that there are legitimate things you can do to optimize immune function, which all are simply ways of avoiding things that inhibit immune function. But first let’s cover some basic principles.

Basic Principles

Biological organisms are complex, dynamic, homeostatic systems. This may seem obvious when you think about it, but many dubious health claims violate this basic understanding of biology. The immune system itself is a highly complex system – so complex that even though we have a vast amount of knowledge about the immune system, we have a hard time predicting the net effect of specific changes to the system. We have studied drugs in auto immune diseases, for example, that have had the opposite of the predicted net effect. This means we need to be very wary of any study that purports to show a change in some measure of immune function, and then concludes that this is a good thing, a “boosting” of immunity.

But perhaps even more important is the homeostatic bit. Immunity is a delicate balance, and evolution has tinkered with this system for hundreds of millions of year. If there were a simple way to make this system function better, we would have evolved it already. Put another way, there is no simple way to hack this system with a supplement or other measure. Immunity is also a double-edged sword – it fights off invaders and damaged cells, while trying to minimize harm to our own tissue. Think of inflammation – this is a good thing when it is killing bacteria, but also causes a lot of harm. When this delicate balance is disturbed, the result can be an auto-immune disease.

Therefore, we should think twice or thrice before doing something meant to disturb this delicate balance. Chances are greater we will make things worse than better. We need carefully conducted clinical trials to determine the net effect of doing anything to immunity in specific clinical contexts. Also, there is nothing better than a healthy immune system – there is no “super” immunity you can get from your diet or taking a supplement.

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