Tag Archives: Medicine

Did COVID Come from a Lab? A Doctor’s Perspective

In southern China near the border with Laos, there is a mine. To this day, it is heavily guarded by the Chinese government. Any journalist who tries to visit is detained.

Inside the mine: the possible origin of the COVID pandemic.

Scientists identified the animal that first transmitted the original SARS virus (SARS-CoV-1) within 6 months. The culprit was the civet cat. But no animal intermediary for SARS-CoV-2, the virus that causes COVID, has ever been found. Meanwhile, we know that bat guano samples from that mine were taken to the Wuhan Institute of Virology and studied. Is that lab the real source of the pandemic?

In an excellent podcast by the eminent Doctor Peter Attia, he and journalist Katherine Eban dig into the possibility that SARS-CoV-2 escaped from the Wuhan lab. There are many precedents for this: SARS-Cov-1 has escaped from labs several times. And the Wuhan Institute was not very secure: some of its labs had biosafety level (BSL)-2 precautions. This is about the same level of security as an American dentist’s office.

There is no longer any scientific consensus on whether the virus came from an animal or a lab. But we may never know for sure where SARS-CoV-2 came from, since China has stonewalled international researchers and the Wuhan Institute’s database of virus info just happened to be taken offline in September 2019, shortly before the pandemic began to rage.

I’m sure it’s just a coincidence.

More on China:

IS CHINA USING ITS COVID VACCINES TO CONTROL OTHER COUNTRIES?

CHINA IS CRUSHING ONE OF ITS MOST INNOVATIVE COMPANIES

HOW CHINA’S TECH INDUSTRY DIES

Note: The doctor I’m referring to is Dr. Attia. I have no scientific or medical background.

Photo: “File:Wuhan Institute of Virology main entrance.jpg” by Ureem2805 is licensed under CC BY-SA 4.0

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India’s COVID Nightmare: “Bring Oxygen or Take Your Father Away”

At 5 a.m. on Saturday, Aparna Bansal’s cellphone rang. “Can you come now?” said a man from the New Delhi hospital where her 76-year-old father is being treated for Covid-19. The instructions were clear, she said: Bring oxygen or take your father away.

Her husband lines up at 4 a.m. every morning at an oxygen-supply store in east Delhi to buy two cylinders of oxygen to take to separate hospitals treating her mother and father. Neither facility has enough supply to treat the waves of patients coming through every hour.

India is fighting the highest COVID caseload of any country so far. Hospital beds and especially oxygen are running critically short, and deaths are increasingly rapidly. The medical system has nearly collapsed:

India has been reporting more than 2,000 deaths a day for five straight days. The real toll is likely much higher. It is expected to grow in the coming weeks.

A general relaxation of caution earlier this year, along with several massive superspreader events, seeded the current crisis:

Life returned to normal. Weddings and parties resumed. Masks slipped, as did social-distancing rules. A new season of state-level elections ushered in big political rallies and street parades. A massive religious festival known as the Kumbh Mela was allowed to take place, bringing millions of Hindu pilgrims to the banks of the river Ganges and sending a message that there was no reason to worry about Covid-19.

By mid-March, cases started climbing again—then accelerated with breathtaking speed, becoming a vertical line rather than an upward sloping curve.

Much more here.

Many had put their faith in an herbal remedy called Coronil, which was even touted by Indian Health Minister Harsh Vardhan. However, there is little evidence behind the treatment.

Reports from people inside India right now are dire:

You can find the full thread on India’s crisis here, and another excellent thread on how it began here.

Dig into these posts for more on COVID:

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Why Aren’t Flu Vaccines Free for Everyone?

If you have health insurance in the United States, you can usually get a flu vaccine for nothing. But for the 28.9 million Americans who are uninsured, a flu vaccine can cost up to $50. For a population that is often hard pressed, this can be unaffordable. And if you have a family of 4 to vaccinate, the numbers are even worse.

Meanwhile, COVID vaccines cost absolutely nothing, whether you have insurance or not. Why aren’t we doing the same for flu vaccines?

Medicare pays $10-60 for flu vaccines, with an average price of $36 across all the vaccines they cover. If the federal government bought one for every uninsured American, the price would be $1.04 billion.

In the midst of the COVID pandemic, it’s easy to forget just how deadly the common flu can be. But the flu has killed between 12,000 and 61,000 Americans per year since 2010.

How do we decide if a policy is worth it compared to the number of lives it could save? The government uses a figure called the “statistical value of a human life” to measure whether many policies, such as environmental regulations, are worth it or not. That figure is about $10 million.

At that rate, giving a free flu shot to every uninsured American would only have to save 100 lives a year in order to pay for itself entirely. That’s just 0.2% to 0.8% of all flu deaths. Offering free flu vaccines to 8.8% of the entire population would probably prevent a lot more than a fraction of a percent of flu deaths.

Let’s give this policy a try!

For more on health, check out these posts:

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Photo: “01a.UStreet.NW.WDC.13September2015” by Elvert Barnes is licensed under CC BY-SA 2.0

This Tiny Country Beat COVID

On the southern tip of Spain, the tiny UK territory of Gibraltar has vaccinated almost its entire population. COVID deaths have dropped to zero:

Life is beginning to get back to normal. Masks are no longer required outside, curfews are gone, and bars and restaurants are full. Even sporting events have resumed:

Events have also returned to the Rock as Gibraltar hosted what’s thought to be the first fully vaccinated major sporting fixture in the world on Saturday.

Five hundred spectators, each tested for Covid-19 prior to the event, were able to witness British heavyweight fighter Dillian Whyte claim victory over Russia’s Alexander Povetkin at Gibraltar’s Europa Sports Complex.

The fight, called the Rumble on the Rock, was originally meant to take place at the Matchroom HQ, a venue in southeastern England, but was switched to Gibraltar thanks to its Covid-19 safe environment.

Soccer fans were also allowed to witness sporting matches starting with Gibraltar’s World Cup qualifier clash against the Netherlands on Tuesday.

Victoria Stadium welcomed 600 attendees who had previously received two doses of the vaccine and tested negative for the virus on the day of the match.

Only 3% of residents refused the vaccine, which may be one reason why Gibraltar’s results are so good. That may be difficult to recreate in the US or other nations, but Gibraltar provides a welcome view of what life could look like soon as the world races to vaccinate.

I encourage you to get your shot if you haven’t already. Let’s get back to normal life!

For more on COVID and vaccines, check out these posts:

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Photo: “Gibraltar – Rosia” by Roy McGrail (krm gib) is licensed under CC BY-SA 2.0

Amazing Drugs Are Going from the University to the Graveyard, While Patients Pay the Price

Was the cure for cancer invented in a university, only to be shelved for a lack of funding?

University labs are creating incredible drugs on a regular basis. Unfortunately, most will never get to the patients that need them so desperately. This is the conclusion of an intriguing book I just read, Preserving the Promise: Improving the Culture of Biotech Investment, by Scott Desain and Scott Fishman.

The problem is that universities don’t have the massive funds it takes to bring a drug candidate through clinical trials to FDA approval. What about Big Pharma? Well, they’ve been cutting their R&D budgets drastically for years.

This leaves early stage biotech investors to fund much of the commercialization of new drugs, and there simply aren’t enough of them to fund all the good candidates. Indeed, the number of investors specializing in this area is shrinking. This doesn’t surprise me given that most early-stage investors focus on software startups and have a software background themselves.

This does leave the few angel investors who specialize in biotech in an enviable position though: more great companies out there than there are angels to fund them means big slices of great companies for less money, and thus higher returns. This is an area that I may be branching out into in the future. Being even a tiny part of creating a new lifesaving drug or medical device would be incredible.

University policies also hinder the effective commercialization of research, the book notes. Technology Transfer Offices own the patent, but sometimes are hesitant to license it unless they can get lots of revenue for it right away, which is hard for a fledgling company to provide. In other cases, they bury the patent, thinking it unpromising. And university conflict of interest policies can often stop the inventor from continuing to work on the research with company funds. This separates the technology from the person who is best positioned to advance it.

In all, this seems like a neglected area with a lot of problems. That we rely on it for virtually all new drugs is scary. But investors like myself should eye the area with interest, especially given rich valuations in software startups.

For more posts on biotech, check these out:

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Photo: The co-founders of BioNTech, a biotech success story. “Forschungszentrum der Biotech-Unternehmen BioNTech AG und Ganymed Pharmaceuticals AG” by MWKEL-RLP is licensed under CC BY-NC 2.0

What if Your Mask Could Test You for COVID?

Harvard researchers have invented a mask that can test the wearer for COVID:

Researchers at Harvard University’s Wyss Institute for Biologically Inspired Engineering have figured out how to integrate a freeze-dried diagnostic Covid-19 test into a face mask. The test reacts with exhaled particles and gives a diagnosis in 90 minutes or less.

The tests and a tiny blister pack of water can be mounted on any mask. After the mask has been worn for at least 30 minutes, a person punctures the blister pack to release the water needed to rehydrate and run the reactions. The test result is indicated by one or two lines, similar to a pregnancy test

The masks will be affordable and could be useful for a lot more than COVID:

The Wyss team…expects the product to cost about $5. The technology can be targeted to identify other viruses and variants as well.

Any such masks would be subject to FDA approval. Another team at University of California, San Diego is working on a sticker that could be stuck to any mask to test the wearer. Those stickers could cost mere cents.

Incredible ingenuity!

For more on COVID, check out these posts:

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Photo: “Fit testing the N95 Mask” by AlamosaCountyPublicHealth is licensed under CC BY 2.0

For the Vaccinated, Masks May Be Over

If you’ve been vaccinated for COVID, can you finally take off the mask? Early data from Israel says yes:

Pfizer Inc and BioNTech SE said on Wednesday that real-world data from Israel suggests that their COVID-19 vaccine is 94% effective in preventing asymptomatic infections, meaning the vaccine could significantly reduce transmission.

If you don’t even have an asymptomatic infection, you shouldn’t be able to transmit the disease to others. That said, this data is preliminary and is not yet peer reviewed.

The problem with real world application of this knowledge is that anyone can say they’re vaccinated. At a grocery store, for example, it would be hard to check everyone given constraints on time and manpower. So, I expect to see masks continue in public places until case rates are very low and everyone who wants a vaccine has had a chance.

That said, this data can inform our actions in private settings. I look forward to being able to wear one less frequently!

For more posts on COVID, check these out:

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Photo:

Has Merck Found the Cure for COVID?

Merck has come out with great results from a new drug for COVID:

Over the weekend, the Big Pharma and its biotech partner Ridgeback announced their drug, molnupiravir, hit one of its secondary objectives from a new trial, namely to reduce time to negativity of infectious SARS-CoV-2 virus isolation from swabs in patients with symptomatic COVID-19.

The data show that, at Day 5, there was a reduction in positive viral culture in subjects who received molnupiravir (all doses) compared to placebo: 0% (0/47) for molnupiravir and 24% (6/25) for placebo.

These findings are preliminary, and more data will come out soon:

This is just a peek, with primary endpoints and more secondaries “to be presented at an upcoming medical meeting,” which will show a much clearer picture of how well this drug may be working.

We should know a lot more within the next few weeks:

Data from the phase 2/3 pivotal studies of the med are expected this quarter.

This drug could be great for people who are hesitant to get a vaccine, who haven’t been able to get one yet, or for whom the vaccine did not prevent infection (rare but possible). Good news!

For more on COVID drugs and vaccines, check out these posts:

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Photo: Merck CEO Kenneth Frazier, “File:Kenneth C. Frazier.jpg” by Merck (www. Merck.com) is licensed under CC BY-SA 3.0

Why Someone Dying After Getting Vaccinated Doesn’t Mean Anything

We keep hearing scary stories about people getting sick or dying shortly after getting a COVID vaccine. But we shouldn’t confuse correlation with causation. From the mathematician Gary Cornell’s excellent blog:

For example, within one week after vaccinating 10,000,000 people, you will likely have around 98 people keel over and die for no apparent reason and if all of them were pregnant women, almost 27,800 miscarriages.

In this post, he has a table with the expected rate of many diseases we often hear are associated with vaccines, such as Guillain-Barre syndrome. It turns out, a substantial number of people are going to get those illnesses anyway, with or without a vaccine.

My wife made an excellent analogy on this subject recently. “Someone might have drank tea and had a stroke in the same day. But it probably wasn’t the tea.”

Same idea here. And with the US having given out over 90 million shots, mostly to the elderly and frail, the fact is some people are going to die shortly thereafter. But it doesn’t say anything about the vaccine.

The clinical trials carefully compared the vaccinated and unvaccinated groups in the trial and found no higher rate of complications amongst the vaccinated. And that’s the data to act on.

Photo: Me getting the Moderna vaccine on February 22. I am alive and well as of this writing.

For more on COVID and vaccines, check out these posts:

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I Got The Moderna Vaccine! Here’s What It’s Like.

At 1:48pm today New Jersey time, I got my vaccine!

I’ve been waiting for this moment for many months, and I’m so grateful to have a chance to get it. It was the Moderna vaccine and I got it through the Hudson County vaccination site. So far, I feel 100%!

Having lived through the dark period of spring 2020 in the New York City area, when sirens were almost constant and my neighbors were dying in huge numbers, reaching this moment is cathartic. It prompted a lot of feelings for me: relief, gratitude, and hope!

So, what’s it like? This is a drive through site, and I don’t own a car, so I took an Uber. The driver very patiently waited with me in the lengthy line to get the jab. Many cars slowly snaked ahead in the cold snow.

Once we finally made it to the front, I showed a QR code on my phone that the county had e-mailed me. Shortly therafter, the nurse came up and asked if I had been feeling sick today. Then, she gave me the shot!

I barely felt a thing, which was surprising. Since then, I’ve had no side effects that I can discern. I hope it stays that way!

Just after the shot, we took the picture above. It’s actually staged…she had already given me the jab before we ever thought to document the moment for posterity! So she posed with the needle near my arm, and I took a snap to record this wonderful moment in my life that I’ve waited so long for.

“This is a historic moment,” she said. I agreed.

If you’re still trying to get an appointment, don’t give up! I’ve been checking every area provider’s website repeatedly for months. And I almost wasn’t going to check again today, but I did, and found an appointment for just 90 minutes away! Perhaps someone cancelled last minute. The best strategy seems to be to check over and over.

Now, I can begin to plan for a life after COVID. A week after the 2nd dose, which will be around the end of March, it should have achieved its full 94% efficacy. I will finally be able to get on a plane and visit my mom for the first time since December 2019! And I’m looking forward to getting some great protection even sooner: just 2 weeks after the first dose, the vaccine is 80% effective.

I really encourage everyone to get this vaccine, although I know each person has to make their own decision. COVID may be something to fear, but this really isn’t! If I didn’t keel over after, you won’t either! 🙂