Health

BE PURITAN:

Stricter Covid mask rules could’ve saved hundreds of thousands of lives, new study finds
Restrictions in Northeastern states likely ‘saved many lives’ say researchers
(Josh Marcus, 7/28/24, The Independent)


The US could have avoided almost 250,000 Covid-19 deaths if every state had adopted stricter mask and vaccine requirements seen in the Northeast during the height of the pandemic, according to a new study.

Researchers say that the country, which saw more than 1.1 million Covid deaths, could have been spared an estimated 118,000 to 248,000 more lives.

TAX EXTERNALITIES:

The “Deaths of Despair” narrative is wrong: It’s time to be a little ruder about this (Matthew Yglesias, Oct 10, 2023, Slow Boring)

Over the past few years, Anne Case and Angus Deaton have unleashed upon the world a powerful meme that seems to link together America’s troublingly bad life expectancy outcomes with a number of salient social and political trends like the unexpected rise of Donald Trump.

Their “deaths of despair” narrative linking declining life expectancy to populist-right politics and to profound social and economic decay has proven to be extremely powerful. But their analysis suffers from fundamental statistical flaws that critics have been pointing out for years and that Case and Deaton just keep blustering through as if the objections don’t matter. Beyond that, they are operating within the confines of a construct — “despair” — that has little evidentiary basis. The rise in deaths of despair turns out to overwhelmingly be a rise in opioid overdoses. This increase is not happening in European countries that have not only been buffeted by the same broad economic trends as the United States, but are also seeing the rise of right-populist backlash politics. […]

Novosad, Rafkin, and Asher have provided a compelling analysis of a very concentrated problem of worsening health outcomes for the worst-off Americans. Case and Deaton, by contrast, have delivered a very misleading portrait of worsening health outcomes for the majority of Americans that (because they mistakenly think it’s a majority) they attribute to broad economic forces that exist internationally but which for some reason only cause “despair” in the United States. And then it gets worse, because as Matthews argues (citing Raj Chetty’s Opportunity Insights Project data), the growing disparities are located in specific parts of the country:

While it’s true that rich people in America live significantly longer than poor people, that’s much less true in New York City. It’s not true in California as a whole. Heavily urban areas with high education levels see a modest relationship between income and death rates. More-rural, less-educated areas, by contrast, see a very strong relationship between the two.

Areas with smaller mortality gaps tend to be places, the researchers find, with lower rates of smoking and higher rates of exercise, which makes sense when you consider that the variation in death rates between cities is driven not by factors like car crashes or suicide but conditions like heart disease and cancer, which are themselves driven in part by lifestyle conditions. Local unemployment rates and other indicators of the health of the local labor market did not seem to be associated with longevity, nor did income inequality. These aren’t firmly causal findings, to be clear, but they might be suggestive of potential causes to investigate.

Conveniently, there’s a new piece out in the Washington Post by Lauren Weber, Dan Diamond, and Dan Keating that I think explains this geographic variation very well: Places that adopt nanny state policies to improve public health get better public health.

ALL IN YOUR HEAD:

Who’s Afraid of the Placebo Effect?: New research into the healing power of placebos could upend our understanding of medicine, if the medical industry is willing to listen (Josh Sims, July 26, 2024, Inside Hook)

The placebo effect involves the release of feel-good neurotransmitters, plus increased activity in parts of the brain related to mood and emotions. It appears to be the product of our positive expectations and some Pavlovian conditioning.

IT’LL BE LONG BIRD FLU ONCE THAT’S TRENDY:

Looking for Long Covid: A Clash of Definition and Study Design (SARA TALPOS, 07.25.2024, UnDark)

Few experts dispute that long Covid can be debilitating, or that it warrants careful study. But in interviews with Undark, a number of experts said that it is misleading to frame long Covid as an increasing threat. The best data, they say, suggest that most people recover from the disorder and that long Covid rates will decline as people develop immunity. (A July study by the VA St. Louis team also found that rates of long Covid declined over the course of the pandemic.)


The work produced by Al-Aly and his colleagues, which relies on electronic health records of U.S. veterans, is also a key point of contention. In interviews, several experts questioned the VA St. Louis’ methods. At the request of Undark, Harvard epidemiologist Marc Lipsitch reviewed the group’s first long Covid study and raised a range of concerns. Many of them related to the handling of negative controls, a statistical technique that, when deployed properly, can help researchers detect problems in the analysis of their dataset. Some of the negative controls “are simply misused in the paper,” Lipsitch wrote in an email to Undark.

Additionally, some experts suggested that the VA St. Louis studies are not truly measuring long Covid. “They’re not studying post-viral illness, in my opinion, in these VA studies,” said Anders Hviid, a professor at the University of Copenhagen and head of the Department of Epidemiology Research at the Statens Serum Institut. Post-viral syndromes, said Hviid, are relatively rare and are usually characterized by fatigue and cognitive difficulties. Al-Aly’s research, meanwhile, looks at what Hviid described as a gamut of outcomes: dementia, thromboembolisms, psychiatric diseases, kidney diseases — “everything under the sun,” he said.

At best, the studies are detecting health problems known to occur when people with poor baseline health experience a severe infection of any kind, said Hviid. At worst, the findings simply reflect bias in the study design, and are picking up on symptoms that are not caused by Covid-19 at all. “It’s a disappointment that not more U.S. scientists have spoken up about this,” said Hviid.

Heck, they still pretend fibromyalgia is a thing.

SCIENCE VS SINOPHOBIA:

Lab Leak Mania: Why did the New York Times publish an op-ed supporting the lab leak theory? (PAUL OFFIT, JUN 24, 2024, Beyond the Noise)

In a one-hour video, the TWiV team addressed each of the “Five Key Points” proffered by Chan. The group consisted of Vincent Racaniello (virologist), Alan Dove (microbiologist), Rich Condit (viral geneticist), Brianne Barker (immunologist), and Jolene Ramsey (microbiologist). The video was released on June 10, 2024, one week after Chan’s publication in the New York Times. This wasn’t the first time that the TWiV team had discussed the origin of SARS-CoV-2; it was the ninth. Previous guests have included evolutionary biologists who had directly investigated the events in Wuhan; specifically, Michael Worobey, Kristian Anderson, Eddie Holmes, Marion Koopmans, and Robert Garry, who had collectively published a paper in the journal Science in 2022 titled, “The Huanan Seafood Wholesale Market in Wuhan Was the Early Epicenter of the COVID-19 Pandemic.” This paper showed that all the early cases of SARS-CoV-2 clustered around the southwestern section of a wet market in Wuhan where animals susceptible to coronavirus were illegally sold and inadequately housed. Worobey and his team had shown that 1) the early cases had direct or indirect contact with the market and 2) none of the early cases occurred around the Wuhan Institute of Virology. This single paper was devastating to Chan’s hypothesis.

AMELIORATING A MISTAKE:

How Congestion Pricing Makes Cities More Livable: As New York puts its gridlock-busting plans on hold, the success of congestion pricing elsewhere proves it’s not just smart — it’s popular. (Eric Krebs, June 7, 2024, Reasons to be Cheerful)


In just a few short decades during the mid-twentieth century, cars conquered the 750-year-old city of Stockholm. As early as the 1980s, various schemes for reclaiming the city’s fourteen islands from gridlock had been proposed, but politics kept getting in the way and plans never materialized. In 2002, as part of political compromise, a divided Swedish parliament began to work toward a long-desired goal: a trial run of congestion pricing in Stockholm, with a public referendum on the policy to follow.

On January 3, 2006, the trial began. Watching it unfold, Jonas Eliasson, a life-long transit researcher (and enthusiast) who has served as director of transport accessibility at the Swedish Transport Administration since 2019, was excited — and worried. Neither emotion was unwarranted.

Congestion pricing had succeeded before. In 1975, Singapore pioneered its Area Licensing Scheme, a precursor to its modern Electronic Road Pricing system in which drivers are tolled automatically based on their location, type of car, and the time of day. In 2003, London began charging drivers for entering its city-center — an idea first proposed in the 1950s. By 2006, there were 33 percent fewer car trips into central London than in 2002, 25 percent more bus trips and 49 percent more bicycle trips. Congestion, pollution and traffic accidents all fell in tow.


Eliasson was aware of these benefits, but he still feared that politics would squash Stockholm’s program before its results were realized. The trial (whose start-day had been delayed by, again, politics) was slated to last just seven months. “Having a congestion pricing trial meant building up all the technical stuff in the business district, the gantries and the cameras and everything, and just for a trial,” says Eliasson. “I thought that in order to make congestion pricing acceptable, we would have to spend the revenues in a really salient, tangible way. And at the time, we didn’t have that.”

Eliasson was wrong, and happily so. Despite negative media coverage and public suspicion, the tide of approval turned on congestion pricing in Stockholm almost as soon as it was implemented. “I think that what surprised everyone was that the effects on traffic were just so visible. From day one, you could see the benefits with your naked eye,” says Eliasson.

Road traffic into Stockholm’s central district fell by 20 percent almost as soon as the program began, as drivers swapped their individual trips for carpooling and alternative means of transit. The streets grew quieter, and air pollution decreased by 12 percent — all from a maximum charge equivalent to just $2. In September of 2006, congestion pricing was made permanent by a majority vote, and by 2011, the policy saw nearly 70 percent public support.

THERE IS NO PRO-LIFE PARTY:

New research shows gas stove emissions contribute to 19,000 deaths annually (VICTORIA ST. MARTIN, 5/19/24, INSIDE CLIMATE NEWS)

The study, published in the journal Science Advances, found that gas stoves contribute to about 19,000 adult deaths each year and increase long-time exposure to nitrogen dioxide to 75 percent of the World Health Organization’s exposure guideline.

That last figure was one of the most significant findings by the research team, said the study’s lead author, Yannai Kashtan.

“This study’s main contribution is quantifying how much of that pollution really makes it to your nose, if you will,” Kashtan said in an interview.

Kashtan said that the study found that the most pressing dangers to gas stove owners—estimated to be as much as 40 percent of the population—stemmed from long-term exposure to harmful gases.

“The exposures that we’re estimating, they’re not going to cause immediate, terrible health outcomes tomorrow,” Kashtan said. “So we certainly don’t want to be alarmist. On the other hand, day after day, year after year, using a stove that the exposure really does build up and does increase the risk of all these respiratory diseases.

“It’s most important that people are aware of the risks and on the one hand, don’t freak out tomorrow, but also think seriously about indoor air pollution when they’re thinking about, ‘OK, you know, what’s my next appliance going to be?’” he added.

Researchers also found that people of color are disproportionately affected by the stoves.

MEDICALIZING OUR DIFFERENCES:

An Absurd Umbrella: Neurodiversity and the Autism Spectrum (Jason Garshfield, 21 Apr 2024, Quillette)

There is a core of truth to the arguments undergirding neurodiversity. Human minds cannot be whittled down to a unitary norm, and people with unusual or eccentric approaches can make great contributions to society. To “cure” autism might be said to be akin to “curing” creativity or introversion.

Yet the arguments against regarding autism as merely a benign form of neurodiversity are compelling, too. One prominent critic is Jill Escher, president of the National Council on Severe Autism. Escher has two autistic children, both of whom are profoundly impaired in their ability to perform basic life functions. As she has pointed out, the diagnosis of autism has taken on “an absurd umbrella aspect that can cover quirky people like Elon Musk, sensitive artists like the singer Sia, and even elite athletes like Tony Snell,” some of whom “are so high-functioning I would consider my kids completely cured if they had similar abilities.”

The problem is inherent in the absurdity of an “autism spectrum” that groups together highly disparate individuals and conditions. On one end of the spectrum are people who may be different from the norm, but who are perfectly capable of living full and dignified lives. For them, the notion of a cure is sinister, even dystopian. On the other end are people who are severely disabled by the condition, for whom a cure might be an immeasurable gift. […]

Rates of autism have skyrocketed in recent decades, from well below 1 in 1,000 children in the 1960s to 1 in 36 today. This is almost certainly partially attributable to a broadening of the diagnostic parameters. People who might have been considered merely somewhat abnormal in 1960 are liable to be classified as high-functioning autistic in 2024—a shift that has led to considerable confusion.

We’re all on the spectrum somewhere.