This is my reaction to Kay Rivera’s article “An uphill battle (2)” (Opinion, 10/26/20). I agree that alternative medicine, which includes natural remedies and traditional cures, should not be outrightly dismissed.
This is so because they can be effective. However, they should also not be outrightly accepted because they haven’t been tested. Promoters may claim that they have been proven effective and safe, but they haven’t undergone clinical trials. In contrast, mainstream practices and medicines have been thoroughly studied for efficacy, dosage, precautions, limitations, risks, contraindications, and safety. This cannot be said of alternative medicine.
Testimonials seem to show that alternative medicine works. However medical testimonials are unacceptable in scientific journals, and court and Food and Drug Administration approval, for three reasons. First, since some conditions are self-limiting, the improved condition may not be due to the intervention. For example, common colds disappear in about one week. Some cancers simply disappear without intervention.
Second, the symptoms of some diseases vary. Thus, the cessation of a symptom may not be due to the intervention. Third, the cure may be due to the placebo effect, placebos being around only 20 to 30 percent effective.
Accepting an untested medical cure has three dangers. First, if the cure does not work, you will have wasted money. Second, if you don’t avail yourself of or discontinue a mainstream cure, you might deteriorate. Third, if the unconventional approach is dangerous, your life will be at risk. For example, some leaves used as herbal medicine may contain toxic alkaloids.
Rivera wishes to integrate mainstream and alternative medicine, but I think the latter must be thoroughly studied first. If not, such integration will simply blend effective and safe medicine with a possibly ineffective and dangerous one. The good news is that there has been research on traditional medicinal plants as Rivera mentioned.
Some people do not trust Western medicine. Would they rather trust untested medicine based on unreliable testimonials? If mainstream medicine is risky, untested alternative medicine is far riskier.
Jori Gervasio R. Benzon,Zamora, Pandacan, Manila, [email protected]
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The following essay is reprinted with permission from The Conversation, an online publication covering the latest research.
White House advisers have made the case recently for a “natural” approach to herd immunity as a way to reduce the need for public health measures to control the SARS-CoV-2 pandemic while still keeping people safe. This idea is summed up in something called the Great Barrington Declaration, a proposal put out by the American Institute for Economic Research, a libertarian think tank.
The basic idea behind this proposal is to let low-risk people in the U.S. socialize and naturally become infected with the coronavirus, while vulnerable people would maintain social distancing and continue to shelter in place. Proponents of this strategy claim so-called “natural herd immunity” will emerge and minimize harm from SARS-CoV-2 while protecting the economy.
Another way to get to herd immunity is through mass vaccinations, as we have done with measles, smallpox and largely with polio.
A population has achieved herd immunity when a large enough percentage of individuals become immune to a disease. When this happens, infected people are no longer able to transmit the disease, and the epidemic will burn out.
As a professor of behavioral and community health sciences, I am acutely aware that mental, social and economic health are important for a person to thrive, and that public health measures such as social distancing have imposed severe restrictions on daily life. But based on all the research and science available, the leadership at the University of Pittsburgh Graduate School of Public Health and I believe this infection-based approach would almost certainly fail.
Dropping social distancing and mask wearing, reopening restaurants and allowing large gatherings will result in overwhelmed hospital systems and skyrocketing mortality. Furthermore, according to recent research, this reckless approach is unlikely to even produce the herd immunity that’s the whole point of such a plan.
Vaccination, in comparison, offers a much safer and likely more effective approach.
An uncertain path to herd immunity
Herd immunity is an effective way to limit a deadly epidemic, but it requires a huge number of people to be immune.
The proportion of the population required for herd immunity depends on how infectious a virus is. This is measured by the basic reproduction number, R0, how many people a single contagious person would infect in a susceptible population. For SARS-CoV-2, R0 is between 2 and 3.2. At that level of infectiousness, between 50% and 67% of the population would need to develop immunity through exposure or vaccination to contain the pandemic.
The Great Barrington Declaration suggests the U.S. should aim for this immune threshold through infection rather than vaccination.
To get to 60% immunity in the U.S., about 198 million individuals would need to be infected, survive and develop resistance to the coronavirus. The demand on hospital care from infections would be overwhelming. And according to the WHO estimated infection fatality rate of 0.5%, that would mean nearly a million deaths if the country were to open up
ANCHORAGE, Alaska — Officials in Anchorage, Alaska, say the city is on a “dangerous path” as coronavirus cases rise and are urging people to avoid gatherings and follow orders to wear masks in public.
Acting Mayor Austin Quinn-Davidson says she has been meeting with business leaders, health officials and others to make decisions that protect health but also impose minimal restrictions so businesses can stay open.… Read more
During necrotizing soft tissue infections ordinary bacteria infect our body, spread rapidly and cause tissue death. Treatment with antibiotics is not sufficient and infected tissue needs to be removed through surgery. 22% of people who suffer from this disease need to amputate a limb and 18% do not survive.
A common cause of these infections is group A streptococcus. These bacteria form toxins that lead to overactivation of the body’s otherwise helpful immune cells, causing a so called “cytokine storm” which contributes to a severe course of the disease and the need of intensive care.
Recently, a study called INSTINCT was performed. In this study patients with necrotizing soft tissue infections were randomized to treatment with either intravenous immunoglobulin (IVIG) or placebo, in addition to other treatment. This study showed a trend towards better health after treatment with IVIG in the subgroup often caused by group A streptococcus, but no clear correlation during infections caused by other bacteria. However, the study used a lower dose than in previous studies: 25 g per day.
Bergsten et. al. tested blood samples from infected patients before and after treatment with IVIG, and found that treatment with IVIG leads to decreased effect of the toxins produced by the bacteria—even at the low dose of 25 g per day that was used in the INSTINCT study. Based on these results, the researchers suggest a new dosage regime of IVIG during these infections. It is still not proven that IVIG leads to better health during these devastating infections and the researchers suggest that the new dosage is tested in a controlled clinical trial of patients with necrotizing soft tissue infections caused by group A streptococcus.
IV immunoglobulin use up in interstitial lung disease
Helena Bergsten et al. Correlation Between Immunoglobulin Dose Administered and Plasma Neutralization of Streptococcal Superantigens in Patients With Necrotizing Soft Tissue Infections, Clinical Infectious Diseases (2020). DOI: 10.1093/cid/ciaa022
Low dose of the medicine intravenous immunoglobulin decreases the effect of dangerous toxins during severe infections (2020, October 28)
retrieved 28 October 2020
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Many people turn to TikTok to stay up to date on the latest trends, from home improvement hacks to makeup tips. It can even be a resource for wellness and oral hygiene advice.
But, there are also plenty of dangerous fads that go viral on social media with little transparency about the harmful effects. The disastrous Kylie Jenner lip challenge from a few years ago and the more recent Benadryl challenge are two examples that come to mind.
Lately, TikTok has seen a wave of tooth-related videos that could potentially encourage young people to do irreversible damage to their dental health. We spoke to Dr. Ingrid Murra, DDS, founder of Two Front orthodontic care, about the risks of these concerning trends.
Nail-Glue Vampire Fangs
Some TikTok users are going to extreme lengths to celebrate spooky season this year, prioritizing frightfully realistic costumes over their dental health. The latest DIY look to gain traction on the app involves using nail adhesive, which contains similar ingredients to super glue, to attach vampire fangs to your teeth.
One video with over one million likes documents the moment user @muawk realizes her fake fangs are stuck and appears to hyperventilate as she tries to pull them from her teeth. In a follow-up video, she brushes and flosses frantically until they finally fall off.
According to Dr. Murra, this trend is unsafe because “nail glue can strip off the enamel of your teeth, which can increase the chance of getting cavities and cause sensitivity.” The powerful glue can also damage your gums.
If you do make the mistake of trying the damaging technique at home, Dr. Murra warns against trying to fix it yourself. Not only should your dentist be the one to get you out of the sticky situation, but they can actually safely place fangs on your teeth so you can channel the undead look, risk-free.
Shaving Teeth With a Nail File
Another concerning hack on the app could have even more permanent ramifications. Some users are taking a nail file to their teeth to even them out or make them smaller and filming the process. Once again, this can cause damage to your enamel.
“You risk removing too much enamel and causing sensitivity and increasing the chance of getting cavities,” Dr. Murra said. “Removing enamel is also permanent – unlike hair and nails, teeth don’t grow – so I highly recommend cosmetic changes by your dentist, prosthodontist, or orthodontist.” These professionals will do a more precise job, while being attentive to preserving tooth structure.
Depending on the cosmetic fix you want to make, there are a couple of different procedures a dentist may consider. If your teeth are too long, a dentist can carefully remove parts of your teeth to even them out, whereas if they are too short, they can build a composite to match your tooth shade. Either
GENEVA (Reuters) – The world is now at a critical juncture in the COVID-19 pandemic and some countries are on a dangerous path, facing the prospect of health services collapsing under the strain, the head of the World Health Organization said on Friday.
“We are at a critical juncture in the COVID-19 pandemic, particularly in the Northern hemisphere,” WHO Director-General Tedros Adhanom Ghebreyesus told a news conference. “The next few months are going to be very tough and some countries are on a dangerous track.”
“We urge leaders to take immediate action, to prevent further unnecessary deaths, essential health services from collapsing and schools shutting again. As I said it in February and I’m repeating it today: This is not a drill.”
Tedros said too many countries were now seeing an exponential increase in infections, “and that is now leading to hospitals and intensive care units running close or above capacity — and we’re still only in October”.
He said countries should take action to limit the spread of the virus quickly. Improving testing, tracing of contacts of those infected and isolation of those at risk of spreading the virus would enable countries to avoid mandatory lockdowns.
(Writing by Peter Graff; Editing by Kevin Liffey)
Copyright 2020 Thomson Reuters.
LANSING, Mich. (AP) — Gov. Gretchen Whitmer warned Wednesday that Michigan on average has more confirmed daily cases of the coronavirus than ever, noting a sharp increase since the state Supreme Court invalidated her sweeping orders earlier this month.
The number of COVID-19 cases had been gradually rising for months prior to the Oct. 2 ruling, from a seven-day average of 119 in June to 984 — as the Democratic governor loosened economic restrictions and allowed schools to reopen. Since the court decision, the seven-day average is up to 1,818 — nearly double — though surrounding states without legal rulings have also seen similarly big spikes over the same time period.… Read more
“I suspect if we had a chance to talk with Dr. Collins about what these ideas actually say instead of the misrepresentations, he wouldn’t have that response,” Bhattacharya told me in an interview yesterday.
The Barrington Declaration is triggering a heated and fraught debate over shutdowns as the winter approaches and infections rise.
The paper, co-written by two epidemiologists at Harvard University and the University of Oxford and signed by other academics and scientists, says measures to protect those most vulnerable to the virus should be the central goal of the public health response, rather than current shutdown policies.
The authors argue that the harm from shuttering schools and businesses is so extensive that it’s not worth trying to limit the virus’s spread among healthy children and non-elderly adults. Targeted protections for the elderly and sick are the best way to minimize mortality and social harm, they wrote.
“The most compassionate approach that balances the risks and benefits … is to allow those who are at minimal risk of death to live their lives normally to build up immunity to the virus through natural infection, while better protecting those who are at highest risk,” the paper says.
Yet the paper has provoked a firestorm within the scientific community — and is exposing fractures in the Trump administration.
The online document, published Wednesday by the medical journal Lancet, acknowledges the shutdowns have been damaging to people and the economy. Yet it rejects the idea that allowing the virus to spread unchecked among low-risk populations – an idea known as gaining herd immunity – would ultimately protect the vulnerable. The authors point to the nation’s already-steep death toll, noting that there could a hundreds of thousands more deaths if the virus is allowed to spread even among healthier Americans.
“This is a dangerous fallacy unsupported by scientific evidence,” says the memo, co-written by Harvard epidemiologists Bill Hanage and Marc Lipsitch and signed by more than 80 scientists. “Any pandemic management strategy relying upon immunity from natural infections for COVID-19 is flawed.”
Bhattacharya and his co-authors met last week with Health and Human Services Secretary Alex Azar, who tweeted praise of their ideas afterward.
Azar tweeted this last week:
But both Collins and Fauci have sharply criticized the declaration as departing from consensus among epidemiologists.
“Anybody who knows anything about epidemiology will tell you that that is nonsense and very dangerous, because … you will have killed a lot of people that would have been avoidable,” Fauci said.
Bhattacharya called the tension provoked by his letter “overwhelming.”
But he feels it sparked a conversation that was ignored up until now. While some have interpreted the declaration as a “let ‘er rip” strategy, he says that is a mischaracterization of the approach he is promoting. While the country will eventually reach herd immunity, the point at which 60 to 70 percent of the country is immune either from being infected or getting vaccinated, his aim is to protect the lives and well-being of the