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Daily Archives: January 5, 2022

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Kulldorff and Bhattacharya Respond: The Collins and Fauci Attack on Traditional Public Health

Martin Kulldorff and Jay Bhattacharya wrote . . . . . . . . .

On Oct. 4, 2020, with professor Sunetra Gupta of Oxford University, we wrote the Great Barrington Declaration (GBD). Our purpose was to express our grave concerns over the inadequate protection of the vulnerable and the devastating harms of the lockdown pandemic policy adopted by much of the world; we proposed an alternative strategy of focused protection.

The key scientific fact on which the GBD was based—a more than thousand-fold higher risk of death for the old compared to the young—meant that better protection of the old would minimize COVID deaths. At the same time, opening schools and lifting lockdowns would reduce the collateral harm to the rest of the population.

The declaration received enormous support, ultimately attracting signatures from more than 50,000 scientists and medical professionals and more than 800,000 members of the public. Our hope in writing was two-fold. First, we wanted to help the public understand that—contrary to the prevailing narrative—there was no scientific consensus in favor of lockdown. In this, we succeeded.

Second, we wanted to spur a discussion among public health scientists about how to better protect the vulnerable, both those living in nursing homes (where approximately 40 percent of all COVID deaths have occurred) and those living in the community. We provided specific proposals for focused protection in the GBD and supporting documents to spur the discussion. Though some in public health did engage civilly in productive discussions with us, in this aim we had limited success.

Unbeknownst to us, our call for a more focused pandemic strategy posed a political problem for Dr. Francis Collins and Dr. Anthony Fauci. The former is a geneticist who, until Dec. 19, 2021, was the director of the U.S. National Institutes of Health (NIH); the latter is an immunologist who directs the National Institute of Allergy and Infectious Diseases (NIAID). They are the biggest funders of medical and infectious disease research worldwide.

Collins and Fauci played critical roles in designing and advocating for the pandemic lockdown strategy adopted by the United States and many other countries. In emails written four days after the Great Barrington Declaration and disclosed recently after a FOIA request, it was revealed that the two conspired to undermine the declaration. Rather than engaging in scientific discourse, they authorized “a quick and devastating published takedown” of this proposal, which they characterized as by “three fringe epidemiologists” from Harvard, Oxford, and Stanford.

Across the pond, they were joined by their close colleague, Dr. Jeremy Farrar, the head of the Wellcome Trust, one of the world’s largest nongovernmental funders of medical research. He worked with Dominic Cummings, the political strategist of UK Prime Minister Boris Johnson. Together, they orchestrated “an aggressive press campaign against those behind the Great Barrington Declaration and others opposed to blanket COVID-19 restrictions.”

Ignoring the call for focused protection of the vulnerable, Collins and Fauci purposely mischaracterized the GBD as a “let-it-rip” “herd immunity strategy,” even though focused protection is the very opposite of a let-it-rip strategy. It’s more appropriate to call the lockdown strategy that has been followed a “let-it-rip” strategy. Without focused protection, every age group will eventually be exposed in equal proportion, albeit at a prolonged “let-it-drip” pace compared to a do-nothing strategy.

When journalists started asking us why we wanted to “let the virus rip,” we were puzzled. Those words aren’t in the GBD, and they are contrary to the central idea of focused protection. It’s unclear whether Collins and Fauci ever read the GBD, whether they deliberately mischaracterized it, or whether their understanding of epidemiology and public health is more limited than we had thought. In any case, it was a lie.

We were also puzzled by the mischaracterization of the GBD as a “herd immunity strategy.” Herd immunity is a scientifically proven phenomenon, as fundamental in infectious disease epidemiology as gravity is in physics. Every COVID strategy leads to herd immunity, and the pandemic ends when a sufficient number of people have immunity through either COVID-recovery or a vaccine. It makes as much sense to claim that an epidemiologist is advocating for a “herd immunity strategy” as it does to claim that a pilot is advocating a “gravity strategy” when landing an airplane. The issue is how to land the plane safely, and whatever strategy the pilot uses, gravity ensures that the plane will eventually return to earth.

The fundamental goal of the GBD is to get through this terrible pandemic with the least harm to the public’s health. Health, of course, is broader than just COVID. Any reasonable evaluation of lockdowns should consider their collateral damage to patients with cancer, cardiovascular disease, diabetes, and other infectious diseases, as well as mental health and much else. Based on long-standing principles of public health, the GBD and focused protection of the high-risk population is a middle ground between devastating lockdowns and a do-nothing, let-it rip strategy.

Collins and Fauci surprisingly claimed that focused protection of the old is impossible without a vaccine. Scientists have their own specialties, but not every scientist has deep expertise in public health. The natural approach would have been to engage with epidemiologists and public health scientists for whom this is their bread and butter. Had they done so, Collins and Fauci would have learned that public health is fundamentally about focused protection.

It’s impossible to shut down society completely. Lockdowns protected young low-risk affluent work-from-home professionals, such as administrators, scientists, professors, journalists, and lawyers, while older high-risk members of the working class were exposed and died in necessarily high numbers. This failure to understand that lockdowns couldn’t protect the vulnerable led to the tragically high death counts from COVID.

We don’t know why Collins and Fauci decided to do a “takedown” rather than use their esteemed positions to build and promote vigorous scientific discussions on these critical issues, engaging scientists with different expertise and perspectives. Part of the answer may lie in another puzzle—their blindness to the devastating effects of lockdowns on other public health outcomes.

Lockdown harms have affected everyone, with an extra-heavy burden on the chronically ill; on children, for whom schools were closed; on the working class, especially those in the densely populated inner cities; and on the global poor, with tens of millions suffering from malnutrition and starvation. For example, Fauci was a major advocate for school closures. These are now widely recognized as an enormous mistake that harmed children without affecting disease spread. In the coming years, we must work hard to reverse the damage caused by our misguided pandemic strategy.

While tens of thousands of scientists and medical professionals signed the Great Barrington Declaration, why didn’t more speak up in the media? Some did, some tried but failed, while others were very cautious about doing so. When we wrote the declaration, we knew that we were putting our professional careers at risk, as well as our ability to provide for our families. That was a conscious decision on our part, and we fully sympathize with those who instead decided to focus on maintaining their important research laboratories and activities.

Scientists will naturally hesitate before putting themselves in a situation in which the NIH director, with an annual scientific research budget of $42.9 billion, wants to take them down. It may also be unwise to upset the director of NIAID, with an annual budget of $6.1 billion for infectious disease research, or the director of the Wellcome Trust, with an annual budget of $1.5 billion. Sitting atop powerful funding agencies, Collins, Fauci, and Farrar channel research dollars to nearly every infectious disease epidemiologist, immunologist, and virologist of note in the United States and UK.

Collins, Fauci, and Farrar got the pandemic strategy they advocated for, and they own the results together with other lockdown proponents. The GBD was and is inconvenient for them because it stands as clear evidence that a better, less deadly alternative was available.

We now have more than 800,000 COVID deaths in the United States, plus the collateral damage. Sweden and other Scandinavian countries—less focused on lockdowns and more focused on protecting the old—have had fewer COVID deaths per population than the United States, the UK, and most other European countries. Florida, which avoided much of the collateral lockdown harms, currently ranks 22nd best in the United States in age-adjusted COVID mortality.

In academic medicine, landing an NIH grant makes or breaks careers, so scientists have a strong incentive to stay on the right side of NIH and NIAID priorities. If we want scientists to speak freely in the future, we should avoid having the same people in charge of public health policy and medical research funding.


Source : The Epoch Times


Read more at Great Barrington Declaraton

Focused Protection: The Middle Ground between Lockdowns and “Let it Rip.” . . . . .

How Osteoarthritis and Rheumatoid Arthritis Differ

Rene Wisely wrote . . . . . . . . .

It begins with a sort of deception. Osteoarthritis and rheumatoid arthritis (RA) — the two most common forms of arthritis — closely resemble each other when symptoms arise.

While the common denominator is joint pain brought on by inflammation, other similar symptoms include limited range of motion, stiff joints, warmth or tenderness at the afflicted area, and intensity of symptoms first thing in the morning. And both diseases are chronic and have no cure.

Still, they have different causes, symptoms (eventually) and treatments. What are the differences between osteoarthritis and RA?

The root cause

The nature of each type of arthritis is drastically different.

Osteoarthritis is a degenerative condition resulting in wear and tear on the joints that destroys cartilage over a lifetime. RA is an autoimmune disorder in which the immune system thinks the healthy synovial membrane within the joints is a threat — like a virus or bacteria — and attacks it, targeting several joints at once. This produces inflammation and pain.

“It’s important for a physician to figure out which arthritic condition you have because we have treatments to help put RA into remission,” says rheumatologist David Fox, M.D., a professor at University of Michigan Medical School.

RA advances rapidly at onset and is progressive. It may disable a person, deforming joints like fingers, forcing them into a bent position that hampers movement, so early intervention is critical, Fox says.

Scientists are working to pinpoint the cause of RA. The risk factors are thought to be genetic, environmental, hormonal and linked to smoking and obesity. It affects 1.5 million people in the United States. Nearly three times more women than men are diagnosed with RA, according to the Arthritis Foundation.

While the onset of RA can occur even in childhood, it typically begins in middle age.

Osteoarthritis, on the other hand, gets worse slowly with age. Activities that involve repetitive strain on joints, perhaps a job or sport, often lead to developing osteoarthritis. Other causes are old injuries or ones that healed improperly.

In some cases, osteoarthritis is hereditary. People who are overweight or who have joint deformities, gout and diabetes are also more likely to get it.

More than 31 million Americans — almost 10 percent of the population — have the condition, making it the most common form of arthritis.

Unique symptoms

Key symptoms are telltale signs of RA, Fox says. Early on, a patient may experience fatigue, fever, anemia and loss of appetite. It’s considered systemic, so the disease affects organs such as the heart, eyes and lungs in some patients.

RA is symmetrical, where a patient feels symptoms in the same spot on both sides of the body, often in the joints in the feet and hands. Osteoarthritis, in contrast, begins in an isolated joint, often in the knee, fingers, hands, spine and hips. While both sides may hurt, one side is more painful.

Morning stiffness is another indicator. If it lasts longer than 30 minutes, it’s RA or another inflammatory arthritis, but if the stiffness improves in less time than that, it is more likely osteoarthritis.

Treatment options

Once a doctor diagnoses the type of arthritis, treatment begins. The goal is identical in both cases: Reduce pain, manage symptoms, maintain function and prevent joint destruction, Fox says.

Ibuprofen and other nonsteroidal anti-inflammatory medications are used in both arthritis types to reduce swelling and pain. Similarly, corticosteroids like prednisone target inflammation.

Medicines that suppress the immune system work for RA, helping send the disease into remission, decreasing flare-ups and preventing further damage.

Fox also suggests physical and occupational therapy to help patients improve mobility and adapt their daily routines, providing strategies on how to accomplish difficult tasks.

“Healthy living habits, like exercise and weight management, are keys to feeling better, too,” Fox says.

Smoking cessation also is essential. Smoking not only increases the risk of getting RA, but it also interferes with the effectiveness of medications that treat RA.

A last resort is surgery. Whether it’s a hip replacement, removing the swollen tissue or repairing damaged tendons, the goal is to eliminate pain and improve the joint’s function.

“Rheumatoid arthritis and osteoarthritis are common and potentially disabling diseases, but treatment options have become more numerous and more effective,” Fox says. “Research continues towards achieving true cures and even prevention for rheumatoid arthritis and osteoarthritis.”


Source: University of Michigan

A Plant-Based Diet May Protect Against Stroke

If you have had a stroke or want to lower your risk for one, the case for eating more fruits, vegetables, and other healthy plant foods—and cutting back on meat and other animal products—gets stronger every year. A recent study published in Neurology adds to the evidence that a plant-based diet can reduce the odds of a stroke and preserve overall brain health. The study also indicates that the types of plant-based foods consumed may make a difference.

Earlier studies have looked at the benefits of plant-based diets, but this one focused on the quality of those diets, says Kathryn M. Rexrode, MD, senior author of the study and a family physician at Brigham and Women’s Hospital in Boston. “Not all plant-based diets are healthy,” she notes. “After all, you can be a vegetarian and eat pasta and cake all day.”

Dr. Rexrode and colleagues at the Harvard T.H. Chan School of Public Health in Boston studied the diets of 209,508 men and women over a roughly 25-year period and found that people who ate mostly fruit, vegetables, whole grains, legumes (such as beans), and nuts reduced their overall risk for stroke by 10 percent. By contrast, they found no benefit against stroke among people who ate six daily servings of refined grains (such as white pasta and rice), potatoes (which convert to sugar rapidly in the body), fruit juice and sugar-sweetened beverages, and sugary desserts.

“If everyone in the United States followed healthy plant-based diets, we could see a reduction of about 80,000 strokes per year,” says Dr. Rexrode. “As someone who has seen the devastating impact of stroke on individuals and families, that sounds like a pretty substantial impact, and a reason to focus on diet.” Every year nearly 800,000 Americans experience a stroke, and survivors stand a one in four chance of having a second one.

A healthy diet can also help lower blood pressure and cholesterol, says Eliza Miller, MD, MS, assistant professor of neurology at Columbia University’s Irving Medical Center in New York City. While medication is typically prescribed for people with high blood pressure or high cholesterol, a diet that includes plenty of plant foods and limits red meat addresses those cardiovascular risk factors too. A plant-based diet could guard against cognitive impairment and dementia as well, says Dr. Miller.

Avoiding red meat and egg yolks may help prevent strokes and heart attacks for yet another reason, says J. David Spence, MD, professor of neurology and clinical pharmacology at the University of Western Ontario in Canada. His research and that of others show that these foods interact with naturally occurring bacteria in the intestines of some people to produce trimethylamine N-oxide (TMAO), a gut metabolite that clogs arteries and can trigger strokes and heart attacks.

Dr. Spence cites a “defining” study from 2013 in the New England Journal of Medicine that found that among subjects who produced the highest levels of TMAO, risk for a stroke or heart attack was two and a half times higher than for those with the lowest levels. How much TMAO is produced in response to eating red meat and eggs depends on the strains of bacteria in the intestines (known as the gut microbiome), which differ from one person to another. Now researchers, including Dr. Spence, are trying to identify which microbes are the culprits, with the goal of developing a therapy to replace bad bacteria with healthier bacteria.

Shifting from a traditional American diet—high in unhealthy fats and sugar, low in produce and whole grains—to one emphasizing healthy plant-based foods can start with simple changes. Here are some strategies to adopt.

Keep it lean

Dr. Spence recommends limiting consumption of meat—sticking mainly to chicken and fish—to no more than about four ounces (a palm-size serving) every other day. Eat red meat even more sparingly. You can reduce your meat intake with some culinary sleight of hand. For example, when you make meatballs or burgers, replace one-third to one-half of the ground meat with finely diced mushrooms or eggplant. “You’ll be hard-pressed to tell the difference,” says Molly Kimball, RD, CSSD, a sports and lifestyle dietitian who manages the nutrition program at Ochsner Fitness Center in New Orleans. Also consider nonmeat substitutes such as the Impossible Burger, which is made with soy and potato protein instead of beef. “It tastes surprisingly similar to meat,” says Kimball, who ran a blind taste test in which the Impossible Burger beat out all-beef burgers.

Skip egg yolks

Egg whites or egg-white-based substitutes can be purchased by the carton at most grocers. “You can make amazingly good egg salad sandwiches with egg substitutes,” says Dr. Spence. Egg-white frittatas and omelets are good meatless options too.

Join club Med

Traditional diets of people in the Mediterranean region tend to focus on fruits, vegetables, whole grains, legumes, nuts, and olive or canola oil; they include few servings of meat, dairy products, and processed foods. In a study published in the New England Journal of Medicine in 2018, the Mediterranean diet reduced the risk of strokes and heart attacks by about 30 percent versus a low-fat diet over a five-year period.

Go natural

Choose fresh foods whenever you can and eliminate as many processed products as possible. “With that change, you can reduce the amount of salt, sugar, refined carbohydrates, and unhealthy fats you consume,” says neurologist Ayesha Sherzai, MD, of Loma Linda University Health in Loma Linda, CA. Eat fruit instead of drinking juice, and opt for fruit over pastries or other prepared desserts. An apple, for example, provides nutrients and fiber but not the 5 grams of artery-clogging saturated fat and additional 175 or so calories in a slice of store-bought apple pie. If fresh or frozen foods are hard to come by where you live, look for canned vegetables, says Dr. Sherzai. “They’re not ideal, but they’re better than potato chips.”

Avoid refined carbohydrates

When people eat less meat, they may load up on pasta instead. But the standard types made from refined wheat convert to sugar rapidly during digestion, which can promote hyperglycemia—a risk factor for severe strokes. Look for whole-grain pasta or varieties made from nonwheat sources, such as zucchini and hearts of palm, says Kimball. Similarly, when buying bread, select whole-grain rather than white bread.

Beware of salt

“Sodium is sneaky,” says Dr. Miller, since you may not realize how high the sodium content is in certain foods, such as canned soup, deli meats, pizza, and even packaged bread. Too much sodium contributes to high blood pressure, a risk factor for stroke. Read food labels and find products you enjoy that have lower sodium levels, suggests Dr. Miller. Nutritionists encourage people to consume less than 20 percent of the daily value (the amount not to exceed each day) for sodium, which is 2,300 milligrams. A first step in reducing sodium intake could be eliminating crackers and potato chips as snacks; possible replacements include unsalted popcorn with a pinch of Parmesan; apple slices with unsalted peanut butter; or home-baked pita chips flavored with olive oil, paprika, and unsalted garlic powder. Dr. Miller also suggests making your own bread, which allows you to limit how much salt goes in “and can be a fun activity for families.”

Skip sodas

Sugary drinks like colas can spike blood sugar, says Dr. Sherzai. Diet sodas are no better, as artificially sweetened beverages are associated with a higher risk of stroke and dementia, according to a 2017 study in Stroke. If you don’t like water, try iced or hot tea sweetened with agave or honey.

Dine at home

“A lot of people are afraid of cooking,” says Dr. Sherzai, but learning just a few simple, healthy recipes gives you greater control over what you eat and avoids the unhealthy ingredients in processed meals and restaurant fare. “Cooking [a healthy diet at home] can save lives,” says Dr. Sherzai.


Source: Brain&Life

Toyota Dethrones GM as U.S. Sales Leader After Nearly a Century on Top

David Shepardson wrote . . . . . . . . .

Japanese automaker Toyota Motor Corp outsold General Motors Co in the United States in 2021, marking the first time the Detroit automaker has not led U.S. auto sales for a full year since 1931.

Toyota sold 2.332 million vehicles in the United States in 2021, compared with 2.218 million for General Motors, the automakers said on Tuesday.

GM’s U.S. sales were down 13% for 2021 – and down 43% in the fourth quarter – while Toyota was up 10% for the year. GM last had lower sales in 2010 at 2.202 million.

For all of 2020, GM’s U.S. sales totaled 2.55 million, compared with Toyota’s 2.11 million and Ford Motor Co’s (F.N) 2.04 million.

Last year was marred by a shortage of semiconductors used heavily in vehicles, forcing automakers to focus on their most profitable models.

GM said on Tuesday it expects U.S. economic growth will boost U.S. total light-duty vehicle industry sales from around 15 million in 2021 to around 16 million in 2022.

GM has been the largest seller of vehicles in the United States since 1931, when it surpassed Ford, according to data from industry publication Automotive News.

Toyota is not boasting about the accomplishment. Senior Vice President Jack Hollis said the automaker is “grateful” for its loyal customers, but “being No. 1 is never a focus or priority.”

The Japanese automaker does not see it as sustainable that it can retain its U.S. sales lead and had no plans to use the 2021 accomplishment in any kind of advertising, he added. Toyota had been credited by analysts for weathering the chip shortage better than other automakers.

GM spokesman Jim Cain said the Detroit automaker had a very strong sales year in the United States in full-size SUVs and pickup trucks as it has focused on profitability, and as the supply of semiconductors improves, so will sales.

“I wouldn’t rush out if I were (Toyota), and get a ‘We’re No. 1’ tattoo,” he said.

GM under Chief Executive Mary Barra also has emphasized profitability over volume, abandoning such money-losing markets as Europe and Russia.

BULLISH ON 2022

For the entire industry, Cox Automotive forecast U.S. new vehicle sales in December will be down 32% year-on-year – the slowest pace since May 2020, when the country remained mostly closed during the first wave of the COVID-19 pandemic.

Industry analysts forecast around 15 million vehicles sold for all of 2021 in the United States. U.S. vehicle sales will remain well below the five-year average of 17.3 million from 2015-2019.

IHS Markit forecasts U.S. sales are expected to reach nearly 15.5 million in 2022, up an estimated 2.6% from the projected 2021 level of approximately 15.1 million vehicles.

Toyota sees industry sales jumping to 16.5 million this year, with demand even higher if the industry can boost production further, with its own sales topping 2.4 million.

“If you would have asked me to predict how the year was going to go at the beginning of (last) January, I would have gotten it all wrong because this whole microchip shortage just came out of left field and it wreaked a lot of havoc,” Hyundai Motor America sales chief Randy Parker said in an interview. “But at the same time, it sharpened our skill set.”

“I’m very bullish on 2022,” he added. Hyundai’s U.S. sales last year rose 19% to more than 738,000 vehicles, including a record number on the retail side.


Source : Reuters