This is a great article from Open Culture – even if I hadn’t read it (I did), the pictures alone made me laugh out loud. However, beyond the laughs, the interesting and educational part was the description of how each and every new vaccine that comes out causes some fear and resistance, and this has been going on since vaccines were invented. Smallpox was a horrible disease, and the first vaccine was derived from a related virus that afflicts cows. People at the time were concerned that the vaccine would make them grow horns and start mooing. The early vaccine technology was in fact riskier than what we have now, although much less risky than the diseases they were vaccinating against, which is the whole point. The only silver lining is that once a vaccine has been out for a few decades to a couple centuries at most, we all seem to just accept it as the new normal and move on to complaining about the next one that comes out. Almost everyone screaming about the (incredibly effective, low-risk in absolute terms, and absolutely negligible risk relative to the disease it is preventing) Covid-19 vaccine is going to have been inoculated for polio, measles, tetanus, and many other diseases as a child. We don’t appreciate the suffering these vaccines have prevented (at least in developed countries) because we have not suffered ourselves or lost people we care about to these diseases in living memory.
Tag Archives: health
Why I’m not fully vaccinated (for Lyme disease)
I’m not fully vaccinated for Lyme disease because there is no vaccine available and I have no choice in the matter. I remember the vaccine being available, but recently I was discussing this with a friend who looked at me as though I had grown two heads when I mentioned it. Anyway, this Slate article explains what happened:
We had one, once. The Food and Drug Administration approved LYMErix, manufactured by SmithKline Beecham (now GlaxoSmithKline), for use in 1998. LYMErix worked by inducing antibodies into human blood, which would then go into any ticks that attached to your body. There, they would neutralize the bacteria that cause Lyme, Borrelia burgdorferi, before the bacteria could go from the tick into you. In clinical trials, the shot showed about 78 percent effectiveness after the required three doses (hey, I’d take it). But some patients who got the shot after it went on the market testified that they developed arthritis after vaccination. The FDA investigated, but decided the evidence that the vaccine was linked to patients’ arthritis wasn’t strong enough to withdraw its approval for LYMErix. Sales fell nonetheless, and the company pulled the vaccine in 2002.
Slate
So if the vaccine was approved, isn’t it still approved? This would lead me to believe there is a working, approved vaccine, but it is not commercially available because there is not enough of a market for it for companies to make a profit. But to have a market, wouldn’t it be helpful if the general public were aware of its existence?
The article reaches some ridiculous conclusions about a Lyme vaccine mostly benefitting the affluent, and this sounds like nonsense to me. They don’t offer any evidence for this claim. Which sounds ridiculous to me, because the hunting/hiking/camping crowd most at risk is going to be a decidedly working- to middle-class one. Maybe the working class is more familiar with and therefore less afraid of this disease than the more affluent? There could be a grain of truth here.
I think everyone knows someone who has had a brush with this disease. I can think of a work colleague who was incorrectly diagnosed with early-onset arthritis and lived in pain for some time before Lyme disease was correctly diagnosed and appropriately treated. Second, a cousin who was rushed to the hospital with a racing heart and difficulty breathing during the height of the Covid crisis in 2020 – in this case, it was correctly diagnosed and appropriately treated, and he is fine after going through a somewhat harrowing episode. So this is a serious disease. But beyond the pain and suffering it causes directly, it just really takes away a lot of peoples’ desire and excitement to be in the woods. And it keeps children of some risk-averse parents out of the woods, which is a shame but understandable. It’s also a shame if you’re a gardener in a tick infested area who wants to grow anything other than neatly-trimmed grass. Your neighbors can complain you are putting them at risk of Lyme disease, and they may have a point. So really, it would be nice to have a vaccine for this disease available so we can all weigh the evidence and make up our minds.
Incidentally, a Lyme disease vaccine for dogs is approved and commercially available. And the public charity and savior of humanity known as Pfizer is working on a new vaccine and hoping to have it on the market by 2025 (but really, if there is a 100% approved vaccine out there and Pfizer believes there is now a market, can’t somebody just buy the recipe and start making it right now?)
sleep apps and gadgets
Here’s a roundup of some sleep apps and gadgets from Wired. They sought an independent doctor’s opinion on each. And just a reminder there is nothing for sale on this blog, at least at the moment.
- Withings Sleep Tracking Mat – technically more of a medical monitoring device, it “goes under your mattress and tracks your sleep cycles, heart rate, and snoring through the night to give you a detailed breakdown of how well you slept, all summed up with an overall sleep score.”
- Bose Sleepbuds II – ear buds that block external sound and play noises to help you sleep. I can attest this works because I use my $10 Sony earbuds this way. Sometimes I just use them to block external sound, with no sound playing. Occasionally I use the Mynoise app (not mentioned in this article). Other times I play the Audible app or podcasts (I’m currently trying Overcast because Apple podcasts seems to be f—ed up). This makes insomnia entertaining and informative whether it actually helps me fall asleep or not. But I think it does, because 15 minutes of listening to a book quiets my mind from whatever was troubling it, unless the book itself is troubling. Doctor endorsed: yes
- Calm meditation app (doctor recommended: no)
- Somtryst, Sleepio, Headspace apps (doctor recommended: yes, and the article says the first is FDA approved as a medical treatment for chronic insomnia)
- Somnox – a pillow that you “spoon” as it breathes. Weird, but no sex dolls were reviewed in the article. If you are lonely and want to try a sex doll, I say go for it. Think of all those jokes about guys rolling over and snoring within seconds of completing their objective. (Ladies, not so much if the jokes are medically accurate.) Doctor endorsed: neutral
- Muse S – a headband that “tracks electrical activity in your brain” and translates it into “something like weather”, so you listen and try to make the weather calm down. Doctor endorsed: yes, at least for meditation if not necessarily for sleep. The author of the article didn’t like it however.
- Moona – a chilled pillow and Chilipad, which cools your whole body. Doctor endorsed: yes, at least the Chilipad. I find this interesting having sweated out some hot nights in the tropics. Could you set the air conditioning warmer or forego it entirely? This could allow different people with different temperature preferences (not husbands and wives though, because they never disagree on this one…) get a good night’s sleep in the same room. This could also be nice on long-haul flights. Or if this really works, why not build it into clothes so people can be comfortable wherever they are. Maybe this could actually be a big energy saver compared to mechanical heating and air conditioning. Maybe you could incorporate more outside air in buildings and focus more on air flow rather than just temperature.
May 2021 in Review
Most frightening and/or depressing story: The Colorado River basin is drying out.
Most hopeful story: An effective vaccine for malaria may be on the way. Malaria kills more children in Africa every year than Covid-19 killed people of all ages in Africa during the worst year of the pandemic. And malaria has been killing children every year for centuries and will continue long after Covid-19 is gone unless something is done.
Most interesting story, that was not particularly frightening or hopeful, or perhaps was a mixture of both: I learned about Lawrence Kohlberg, who had some ideas on the use of moral dilemmas in education.
“breakthrough malaria vaccine”
Forbes reports a promising malaria vaccine produced by “the Oxford University team behind the Oxford-AstraZeneca Covid-19 shot”. It doesn’t say whether the technology developed for the Covid shot did anything to hasten this vaccine along. It still has some testing and licensing to go through.
The article has some horrifying stats on malaria, which is a major killer of children.
229 million. This is roughly how many cases of malaria there were around the world in 2019, according to the WHO. Around 400,000 died from the disease, which consistently ranks as one of the top ten causes of death in low income countries, despite falling significantly in recent years. Africa is disproportionately affected by the disease, with over 90% of cases occurring there. Children account for almost 70% of deaths.
Forbes
Doing the math here (journalists, why can’t you do the math for me?), the death rate is about 0.2% of cases. If this is the death rate in Africa (but it could be higher if Africans receive less or lower quality treatment) and the other percentages hold, around 250,000 children in Africa die of malaria each year. From Our World in Data, the death toll in Africa from Covid-19 over the last year is around 120,000.
It occurs to me that countries where people deal with horrible diseases that mass murder children every year might be less horrified by Covid-19, which kills a fraction of older people. Of course I am not saying the lives of poor people have less value or the lives of older people have less value (although this is a perennial debate and people of all ages have a variety of reasonable opinions), but I think you can legitimately ask whether an available dollar should be invested in stopping Covid vs. other horrible diseases people have been dealing with for decades.
and vaccinated people don’t spread the virus…much
The confusion among the public continues. Basically, vaccinated people have a 10% or so chance of getting infected Covid-19 if they are exposed to it. If they are infected, they won’t get seriously ill but they might be able to spread it to un-vaccinated people who might then get seriously ill. If you multiply the probabilities, the odds of getting infected by a vaccinated person and then getting seriously ill are low, and the odds that a given person we are exposed to will be vaccinated is getting higher all the time, so the risk is getting lower all the time. Vaccinated people are being asked to wear masks to help that risk drop as quickly as possible. BUT half the population is hearing “the government is sugar-coating the science” and the other half of the population is hearing “vaccinated people are likely to spread the virus”. Neither of these messages is accurate in my view – I’m hearing the risk is low and getting lower, and we all need to get vaccinated to get the risk as low as possible (which will not be zero, but we can all move on to worrying about other diseases such as antibiotic-resistant syphilis).
some new Covid-related numbers
Here are some new numbers, because I like numbers.
- The CDC is citing the 100 cases per 100,000 population per day number as the threshold for “high transmission”. Here in Pennsylvania, our health department has been citing this number for when school should go all virtual. But the CDC says elementary schools should be having hybrid (reduced attendance) school right now. Here in Philadelphia our public school children have not been given this chance at any time since March 2020, and it is uncertain whether it will happen before the end of the school year in June. (I’m writing on Sunday, February 14).
- New data on effectiveness of masks: something like 70-100%, and these studies cited were mostly in public or job settings, not medical settings.
another way to look at slipping U.S. life expectancy
Just in case we need another metric to believe that the U.S. is slipping behind its peers, there is this new study from Lancet, summarized in a Quartz article:
…if the US had a life expectancy equal to the average of countries of comparable wealth (in the study, the group is identified as G7 countries: Canada, France, Germany, Italy, Japan, UK, and US), its population would be nearly half a million more.
It’s not a new phenomenon. The US has trailed the rest of the advanced world in life expectancy since the 1980s, and it’s now 3.4 years shorter than the average of other G7 countries in 2018, the last year for which international data is available. On average, in 2018, people in G7 countries had a life expectancy of 81.9 years, while in the US (prior to Covid-19) it was 78.5 years. In 2018 in Japan, the G7 country with the highest life expectancy, it was 84.2 years.
Quartz
Note that the average we are comparing the U.S. to presumably includes the U.S., so the gap between the U.S. and its peers would be even slightly worse if we were just comparing the U.S. to the average of its peers. Japanese people are living 5-6 years longer than us, on average. This is before Covid-19, of course. Checking Our World in Data, Japan has a reported death rate from Covid-19 of about 55 per million population, and the U.S. of about 1,500 per million population! (I don’t use exclamation points lightly on this blog.)
aerosols
A group of academic scientists has put together a long paper with scientific information intended for the public on Covid-19 aerosol transmission. I think this is pretty nice science communication. It is not dumbed down, but it avoids jargon. The graphics they include are mostly helpful. Here are a few takeaways:
- Secondhand cigarette smoke is a useful analogy to think about. If you are around smokers outside, you are inhaling much less of their poison than if you are around them inside. The amount of time you are around them makes a huge difference – however, this group says the 15 minute CDC guidance is not supported by good evidence. Outside, distance makes a big difference. Inside, being closer is probably worse, but if you are in an enclosed space with them for any period of time you are at pretty high risk. Opening a window should help, but not as much as being outside.
- Scientists disagree on the relative importance of the three pathways – surfaces, droplets, and aerosols. In the face of uncertainty, it is probably prudent (this is my opinion) to treat them as roughly equal and take precautions against each. Someone coughing or sneezing in your face is a big problem – stay 6 feet away for that reason alone, especially from anyone un-masked.
- Aerosols probably persist for 1-2 hours. (My thought – this suggests staying in a hotel should be relatively safe. The room has been cleaned, hopefully the maids were wearing masks, and hopefully they cleaned the room in the morning and you are checking in in the afternoon.)
- Sun and wind tend to reduce risk. All other things being equal, low temperatures and low humidity seem to aid transmission. (Don’t count on the opposite helping you in a sealed room, though. But I am a proponent of humidifying in the winter anyway.)
- The time it takes air in your house to turn over varies widely – “30 minutes to 10 hours”. For commercial buildings, 12 minutes to 2 hours. Hospitals around 5 minutes!
- A carbon dioxide concentration of 800-950 ppm is indicative of good ventilation indoors. A carbon dioxide meter costs about $150.
- Air filters should help, and yes you can tape a furnace filter to a box fan. (I knew it!)
- “There is no evidence that COVID-19 has been transmitted when people walk past each other outdoors. (But I’m using the bandanna system just because people are scared and confused out there.)
- Taxis and rideshare are not zero risk, but reasonably probably, maybe reasonably low risk if everyone is masked and windows are open. If it is too cold to open windows, it is better to be drawing in outside air than just recirculating air.
- Airplanes have very good ventilation, so it is a myth that one infected person on an airplane can infect everyone. If they are sitting right next to you, not wearing a mask, and/or coughing/sneezing, they can infect you. The airport itself is also probably higher risk than the plane. (But let’s remember people are working in all these places.)
- They say “schools should operate in person only if the levels of infection in the community are low.”
- Elevators are also actually quite well ventilated, and you are not in there for very long. Again, you don’t want people unmasked and/or coughing/sneezing on you. No singing allowed in elevators.
- The dental office is suspect. Technology exists to ventilate them safely (but I didn’t see anything obviously new or high tech at my dentist recently.)
- Masks still help with aerosols. Even though the particles are tiny, they are still inside droplets, which are tiny but not as tiny. Nothing in the air moves around in straight lines, it is turbulent and random, so even if particles are smaller than the openings in the fabric many of them will hit the sides and the risk will be significantly reduced. (Also suggests one reason having multiple layers is better.)
- Masks work better if they fit well. (I’m a little tired of this, my family has about 100 masks now and not one of them fits well. If there are 1 or 2 I think fit pretty well, they are always in the dirty laundry when I need them. The same gremlins that steal one of each of my favorite socks also steal masks on occasion.)
- Face shields and plexiglass barriers don’t help a lot with aerosols. You need a mask.
the Oura
The Oura is a fitness tracker, but unlike others it is a ring you wear on a single finger. See Wired article here and company website here. It seems to focus mostly on measuring your heart beat and temperature – all the time – and coming up with a variety of metrics and feedback for you based on that. The NBA and NASCAR have apparently given them to all their athletes (yes, I maintain that race car drivers are athletes, but we can continue the debate down at the corner bar when and if it reopens.)
I’m curious about fitness trackers, but if I ever invest in something I would like blood pressure and nutrition to somehow be incorporated.