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COVID-19 in Sweden vs the US; different approaches, near identical outcomes.

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Today, Michigan and several other, Democrat-run states are in fairly broad COVID lockdown. The justification for this is that it is “THE science”, as if this were the only possible behavior if you believe the disease is deadly and contagious. The other fellows, the governors of Republican-run states are framed as deniers of the science. Strangely enough, although this disease is most -definitely contagious and deadly, killing 209,000 Americans so far, about 0.064% of the US this year, it is far from clear that a broad lockdown is the only way to stop the disease. Sweden avoided a general lockdown, leaving its schools and restaurants open, and has seen the disease follow an almost destructive path to that of the US, with a death rate that is currently slightly lower than ours. See the excess death plot below. Sweden seems to have avoided a second, summer spike.

Mortality is Sweden vs the US; Ignore the last 2-3 weeks, it takes time for this data to be compiled

It’s bad enough for “THE SCIENCE” when you see the anti-science, no-lockdown solution provide the same result, or close. Earlier in the summer I noted that Sweden and Michigan had near the same outcome, with Sweden slightly better. It’s now the case that Sweden is doing better than the US, and much better than the D-lead lockdown states. The highest six death rate states are all D-lead, lockdown states, NY, NJ, Mass, Conn, LA, and RI, and rates are double the US average in New York and New Jersey. Perhaps the solution is a general opening, like in Sweden, but before we rush to this, it’s probably worthwhile to do some re-thinking.

Deaths per week, under 18. Any excess deaths caused by COVID-19 are invisible here, lost in the scatter.

One thing that Swedes seem to have appreciated that the US experts didn’t is that the disease hardly affects those the under 18, and that’s basically the entire K-12 student body. Sweden therefore left their K-12 schools open, while we closed ours in the US beginning in early April. At right I’ve plotted the US deaths per week for under 18 for the last three years, that is from before COVID till now. There is no evidence of excess COVID-19 deaths for this group. If anything anything, the under 18 death death rate is lower after COVID than before. This resistance of this group helps explain part of why the Swedish approach didn’t cause increased deaths. Kids in Sweden got the disease, but didn’t die of it, and likely infected their parents. The Swedes didn’t bother trying to protect everyone, but only the most vulnerable, the old people. Sweden was not completely successful at this, but we were perhaps worse, despite the general lockdown.

The excess deaths US for the 65+ bracket plotted by week of the year for 2020 (blue), 2019 (grey) and 2018 (yellow). Nearly 200,000 of the excess deaths of 2020 — the vast majority — are in this age bracket.

But what about the middle-age people that the kids would have infected, the parents and teachers. For middle age people, those in the 18-65 range, it seems to make a difference how physically fit you are, and the Swedes tend to be fit. Obesity is a big co-morbidity for this disease, and Americans tend to be obese, with things getting worse during the lockdown. Swedes also wash their hands more than we do (or so is their reputation) and they go out in the sun. There is evidence that the sun helps, and vitamin D too. A stark way of seeing how much fitness helps, for even those over 18 is to consider that, of the 1.3 million men and women of the US military, there have been only 7 COVID deaths. That is a rate 1/100 of the national average for a population that is entirely over 18. This is not to say that the death rate is quite 5 per million, (7/ 1.3 million = 5 per million), but it’s probably below 50 per million. That is to say, at least 10% of the military was likely infected.

I’m inclined to agree with Dr. Fauchi that we are not yet at herd immunity, or even close, even in states like Michigan where death rates have leveled out. Only 20% of the state shows antibodies and real herd immunity would require 75% or so. Further supporting this, our death rates are 1/2 that of New Jersey. If we were at herd immunity, that could not have happened. It is possible though that we have a sort of pseudo herd immunity, where many people in the MI population have some level of T-cell immunity. T-cells do a good job eating disease (here’s a video) but they get overwhelmed when we are exposed to more than a low dose of virus. This dose-response is common in respiratory diseases, and Dr. Fauchi has related it to T-cell immunity, though he does not speak in these directions often.

Michigan death rates to September 2020 The disease seems to be over, though only about 20% of the state shows antibodies.

T-cells can cause someone to be immune to a few viral hits, but not immune to higher doses. Assuming that’s what’s going on in MI and MA, and NJ, I’m inclined to suggest we can open up these states a bit, according to the Swedish model. That is make careful efforts to clean public transport, and encourage hand washing and surface cleaning. That we prohibit large gatherings, and we take care isolate those over 65 and protect old age homes. In the US, virtually all the deaths were of people over 65, and about half were people over 85, with men being particularly vulnerable. A heterogeneous opening of this sort has been recommended by scientists as early as March.

There are three major problems with lockdowns that keep us from all virus particles. These lockdowns kill the economy, they leave us with lousy education, and they likely leave us as at-risk for the disease later on, when the lockdown is lifted. Instead a heterogeneous opening leaves the economy running and exposes us to some small exposure, at a level that our typical level of T-cell immunity may be able to handle. Over time we expect our T-cell immunity will rise and we’ll be able to take off our masks entirely. It’s a nice route to a cure that does not require a vaccine.

The above approach requires us to trust that people will do the right thing, and requires us to accept that each may do it in his/her own way. Some may not wear the mask all the time, but may chose exercising, or staying in the sun and taking vitamin D. Some may keep to masks, or focus on hand washing. Some may try unapproved drugs, like hydroxychloroquine. We will have to be able to accept that, and our experts will have to be able to step back from running everything. In China and Russia, the experts tried run every aspect of farm production, using only science methods. The result was famine. A similar thing happened in Ireland and got a potato famine. It’s good to have expert advice, but as far as making the actual decision in each location, I put a lot of weight on the choices of those who will bear the consequences.

Robert Buxbaum September 30, 2020. As a summary, I’m for opening schools, opening most states, with masks, and hand-sanitizer, at lower occupancy ( ~50%), limiting large gatherings, going to zoom as much as possible, and isolating the aged particularly the old age homes. I also recommend vitamin D and iodine hand sanitizer.

Sweden v Michigan: different approaches, same outcome.

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Sweden has scientists; Michigan has scientists. Sweden’s scientists said to trust people to social distance and let the COVID-19 disease run its course. It was a highly controversial take, but Sweden didn’t close the schools, didn’t enforce masks, and let people social distance as they would. Michigan’s scientists said to wear masks and close everything, and the governor enforced just that. She closed the schools, the restaurants, the golf courses, and even the parks for a while. In Michigan you can not attend a baseball game, and you can be fined for not wearing a mask in public. The net result: Michigan and Sweden had almost the same death totals and rates, as the graphs below show. As of July 28, 2020: Sweden had 5,702 dead of COVID-19, Michigan had 6,402. That’s 13 more dead for a population that’s 20% smaller.

Sweden’s deaths pre day. There are 5,702 COVID dead since the start, out of a population of 10.63 million. There are 79,494 confirmed COVID cases, but likely a lot more infected.

Sweden and Michigan are equally industrial, with populations in a few dense cities and a rural back-country. Both banned large-scale use of hydroxy-chloroquine. Given the large difference in social distance laws, you’d expect a vastly different death rate, with Michigan’s, presumably lower, but there is hardly any difference at all, and it’s worthwhile to consider what we might learn from this.

Michigan’s deaths pre day. There are 6,426 COVID dead since the start, out of a population of 9.99 million. There are 88,025 confirmed COVID cases, but likely a lot more infected.

What I learn from this is not that social distance is unimportant, and not that hand washing and masks don’t work, but rather it seems to me that people are more likely to social distance if they themselves are in control of the rules. This is something I also notice comparing freezer economies to communist or controlled ones: people work harder when they have more of a say in what they do. Some call this self -exploitation, but it seems to be a universal lesson.

Both Sweden and the US began the epidemic with some moderate testing of a drug called hydroxychloroquine (HCQ)and both mostly stopped in April when the drug became a political football. President Trump recommended it based on studies in France and China, but the response was many publications showing the didn’t work and was even deadly. Virtually ever western country cut back use of the drug. Brazil’s scientists objected — see here where they claim that those studies were crooked. It seems that countries that continued to use the drug had fewer COVID deaths, see graph, but it’s hard to say. The Brazilians claim that the anti HCQ studies were politically motivated, but doctors in both Sweden and the US largely stopped prescribing the drug. This seems to have been a mistake.

US hospitals stopped using HCQ in early April almost as soon as Trump recommended it. Sweden did the same.

In July, Henry Ford hospitals published this large-scale study showing a strong benefit: for HCQ: out of 2,541 patients in six hospitals, the death rate for those treated with HCQ was 13%. For those not treated with HCQ, the death rate was more than double: 26.4%. It’s not clear that this is cause and effect. It’s suggestive, but there is room for unconscious bias in who got the drug. Similarly, last week, a Yale researcher this week used epidemiological evidence to say HCQ works. This might be proof, or not. Since epidemiology is not double-blind, there is more than common room for confounding variables. By and large the newspaper experts are unconvinced by epidemiology and say there is no real evidence of HCQ benefit. In Michigan and Sweden the politicians strongly recommend continuing their approaches, by and large avoiding HCQ. In Brazil, India and much of the mideast, HCQ is popular. The countries that use HCQ claim it works. The countries that don’t claim it does not. The countries with strict lock-down say that science shows this is what’s working. The countries without, claim they are right to go without. All claim SCIENCE to support their behaviors, and likely that’s faulty logic.

Hydroxychloroquine and COVID-19 fatality rates in different countries as of early June 2020. This isn’t enough to prove HCQ effectiveness, but it’s promising, and suggests that increased use is warranted, at least among those without heart problems.

Given my choice, I’d like to see more use of HCQ. I’m not sure it works, but I’m ,sure there’s enough evidence to put it into the top tier of testing. I’d also prefer the Sweden method, of nor enforced lockdown, or a very moderate lockdown, but I live I’m Michigan where the governor claims she knows science, and I’m willing to live within the governor’s lockdown.There is good, scientific evidence that, if you don’t you get fined or go to jail.

Robert Buxbaum, July 29, 2020. As I side issue, I think iodine hand wash is a good thing. I may be wrong, but here’s my case.

When prostitution was legal in America, 1863-65.

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Readers of this blog know that I am not a fan of very harsh punishments for crime, in particular for crimes that have no direct victim, e.g. drug possession and sales. Prostitution is another crime with no direct victim. One could argue that society as a whole is the victim, but my sense is that punishments should be minimal and targeted, e.g. to prevent involuntary human trafficking and disease. Our current laws, depicted here, are clearly not designed for this, but there was a brief period where prostitution laws did make more sense. During the civil war, civil war, prostitution was legal and regulated to prevent disease.

In 1862, Union forces captured the southern cities of Nashville and Memphis, Tenn. Major Gen. William Rosecrans set up headquarters in Nashville. Before the war, Nashville was home to 198 white prostitutes and nine  “mulatto,” operating in a two-block area known as “Smoky Row.” 

By the end of 1862,  Smokey row had grown and these numbers swelled to 1,500 “public women”. White southern women turned to prostitution out of poverty, largely. Their husbands were dead, or ill paid, and they were joined by recently freed slaves. Benton E. Dubbs, a Union private, reported a saying that “no man culd [sic] be a soldier unless he had gone through Smokey Row,” … “The street was about three-fourths of a mile long and every house or shanty on both sides was a house of ill fame. Women had no thought of dress or decency. They say Smokey Row killed more soldiers than the war.” 

By 1863, venerial disease was becoming a major problem. The Surgeon General would document 183,000 cases of venereal disease in the Union Army alone, “…the Pocks and the Clap. The cases of this complaint is numerous, especially among the officers.”  

Permit for Legal prostitution signed by Col George Spaulding.

At first General Rosecrans directed his assistant, Colonel Spaulding, to remove the women by sending them to other states, first by train, and then by boat commandeering the ship, Idaho for the purpose. The effect was horrible, not only was the ship turned back by every city, but the departure of these ladies just resulted in the appearance of a new cohort of sex-workers. By the time the Idaho had returned, Rosecrans had been relieved of command following embarrassing defeats at Chickamauga and Chattanooga . Col. Spaulding now tried a new technique to stop the plague of VD: legalized prostitution. It worked.

Women’s hospital during the war, Nashville.

For a $5/month fee a “public woman” could become a legal prostitute, or “Public Woman” so long as she submitted to monthly health inspections for a certificate of her soundness. If found infected, she was to report to a hospital dedicated to this treatment, was subject to imprisonment if she operated without the license and certificate. The effect was a major decline in sexually-transmitted disease, and an improvement (so it is claimed) in the quality of the services. The fees collected were sufficient to cover the cost of the operation and hospital, nearly.

At the end of the war, Col Spaulding and the union soldiers left Nashville, and prostitution returned to being illegal, if tolerated. One assumes that the VD rates went up as well.

George Spaulding, Congressman..

Colonel Spaulding and man. General Rosecrans are interesting characters beyond the above. Spaulding had entered the war as a private, and rose through the ranks to be a colonel. After the war, he became postmaster of Monroe Michigan, 1866 to 1870, Treasury agent, 1871 to 1875, Mayor of Monroe, 1876 to ?, President of the board of education, a lawyer in 1878, On the board of the Home for Girls 1885 to 1897, and congressman for the MI 2nd district (Republican) 1894 -1898. In his later years, he served as postmaster in Monroe, 1899 to 1907.

William Rosecrans was a Catholic, and an engineer-inventor graduate from West Point. In 1853, he designed St. Mary’s Roman Catholic Church, one of the largest US churches at the time, site of the wedding of John Kennedy and Jacqueline Bouvier. He designed and installed one of the first lock systems in Western Virginia. He and two partners built an early oil refinery. He patented a method of soap making and the first kerosene lamp to burn a round wick, and was one of the eleven incorporators of the Southern Pacific Railroad. He served as Ambassador to Mexico, 1868-69 and was congressman from California, 1st district (Democrat) 1880 – 1884. A success story, Rosecrans could not stand either Grant or Garfield, and fought against Grant getting a retirement package.

Robert Buxbaum, June 5, 2020. There are other ways to stop the spread of sexual diseases. During the AIDS epidemic, condoms were the preferred method, and during the current COVID crisis, face masks are being touted. My preference is iodine hand wash. All methods work if they can reduce the transmission rate, Ro below 1.

Iodine is far better than soap or alcohol sanitizer.

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I’m a fan of iodine both as a hand sanitizer, and as a sanitizer for surfaces. II’ve made gallons of the stuff for my own use and to give away. Perhaps I’ll come to sell it too. Unlike soap washing or alcohol sanitizer, iodine stays on your hands for hours after you use it. Alcohol evaporates in a few seconds, and soap washes off. The result is that iodine retains killing power after you use it. The iodine that I make and use is 0.1%, a concentration that is non-toxic to humans but very toxic to viruses. Here is an article about the effectiveness of iodine against viruses and bacteria Iodine works both on external surfaces, and internally, e.g. when used as a mouthwash. Iodine kills germs in all environments, and has been used for this purpose for a century.

With normal soap or sanitizer it’s almost impossible to keep from reinfecting your hands almost as soon as you wash. I’ve embedded a video showing why that is. It should play below, but here’s the link to the video on youtube, just in case it does not.

The problem with washing your hands after you receive an item, like food, is that you’re likely to infect the sink faucet and the door knob, and the place where you set the food. Even after you wash, you’re likely to re-infect yourself almost immediately and then infect the towel. Because iodine lasts on your hands for hours, killing germs, you have a good chance of not infecting yourself. If you live locally, come by for a free bottle of sanitizer.

For those who’d like more clinical data to back up the effectiveness of iodine, here’s a link to a study, I also made a video on the chemistry of iodine relevant to why it kills germs. You might find it interesting. It appears below, but if it does not play right, Here’s a link.

The video shows two possible virus fighting interactions, including my own version of the clock reaction. The first of these is the iodine starch interaction, where iodine bonds forms an I<sub>3</sub><sup>-</sup> complex, I then show that vitamin C unbinds the iodine, somewhat, by reducing the iodine to iodide, I<sup>-</sup>. I then add hydrogen peroxide to deoxidize the iodine, remove an electron. The interaction of vitamin C and hydrogen peroxide creates my version of the clock reaction. Fun stuff.

The actual virus fighting mechanism of iodine is not known, though the data we have suggests the mechanism is a binding with the fatty starches of the viral shell, the oleo-polysaccharides. Backing this mechanism is the observation that the shape of the virus does not change when attacked by iodine, and that the iodine is somewhat removable, as in the video. It is also possible that iodine works by direct oxidation, as does hydrogen peroxide or chlorine. Finally, I’ve seen a paper showing that internal iodine, more properly called iodide works too. My best guess about how that would work is that the iodide is oxidized to iodine once it is in the body.

There is one more item that is called iodine, that one might confuse with the “metallic” iodine solutions that I made, or that are sold as a tincture. These are the iodine compounds used for CAT-scan contrast. These are not iodine itself, but complex try-iodo-benzine compounds. Perhaps the simplest of these is diatrizoate. Many people are allergic to this, particularly those who are allergic to sea food. If you are allergic to this dye, that does not mean that you will be allergic to a simple iodine solution as made below.

The solution I made is essentially 0.1% iodine in water, a concentration that has been shown to be particularly effective. I add potassium iodide, plus isopropyl alcohol, 1%, 1% glycerine and 0.5% mild soap. The glycerine and soap are there to maintain the pH and to make the mix easier on your hands when it dries. I apply 5-10 ml to my hands and let the liquid dry in place.

Robert Buxbaum April 27, 2020; I’m running for water commissioner again. Wishing you a safe and happy lockdown,

The main route of lead poisoning is from the soil by way of food, dust, and smoke.

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While several towns have had problems with lead in their water, the main route for lead entering the bloodstream seems to be from the soil. The lead content in the water can be controlled by chemical means that I reviewed recently. Lead in the soil can not be controlled. The average concentration of lead in US water is less than 1 ppb, with 15 ppb as the legal limit. According to the US geological survey, of lead in the soil, 2014., the average concentration of lead in US soil is about 20 ppm. That’s more than 1000 times the legal limit for drinking water, and more than 20,000 times the typical water concentration. Lead is associated with a variety of health problems, including development problems in children, and 20 ppm is certainly a dangerous level. Here are the symtoms of lead poisoning.

Several areas have deadly concentrations of lead and other heavy metals. Central Colorado, Kansas, Washington, and Nevada is particularly indicated. These areas are associated with mining towns with names like Leadville, Telluride, Silverton, Radium, or Galena. If you live in an areas of high lead, you should probably not grow a vegetable garden, nor by produce at the local farmer’s market. Even outside of these towns, it’s a good idea to wash your vegetables to avoid eating the dirt attached. There are hardly any areas of the US where the dust contains less than 1000 times the lead level allowed for water.

Lead content of US soils, from the US geological survey of soils, 2014. Michigan doesn’t look half bad.

Breathing the dust near high-lead towns is a problem too. The soil near Telluride Colorado contains 1010 mg/kg lead, or 0.1%. On a dust-blown day in the area, you could breath several grams of the dust, each containing 1 mg of lead. That’s far more lead than you’d get from 1000 kg of water (1000 liters). Tests of blood lead levels, show they rise significantly in the summer, and drop in the winter. The likely cause is dust: There is more dust in the summer.

Recalled brand of curry powder associated with recent poisoning.

Produce is another route for lead entering the bloodstream. Michigan produce is relatively safe, as the soil contains only about 15 ppm, and levels in produce are generally far smaller than in the soil. Ohio soils contains about three times as much lead, and I’d expect the produce to similarly contain 3 times more lead. That should still be safe if you wash your food before eating. When buying from high-lead states, like Colorado and Washington, you might want to avoid produce that concentrates heavy metals. According Michigan State University’s outreach program, those are leafy and root vegetables including mustard, carrots, radishes, potatoes, lettuce, spices, and collard. Fruits do not concentrate metals, and you should be able to buy them anywhere. (I’d still avoid Leadville, Telluride, Radium, etc.). Spices tend to be particularly bad routes for heavy metal poisoning. Spices imported from India and Soviet Georgia have been observed to have as much as 1-2% lead and heavy metal content; saffron, curry and fenugreek among the worst. A recent outbreak of lead poisoning in Oakland county, MI in 2018 was associated with the brand of curry powder shown at left. It was imported from India.

Marijuana tends to be grown in metal polluted soil because it tolerates soil that is too polluted fro most other produce. The marijuana plant concentrates the lead into the leaves and buds, and smoking sends it to the lungs. While tobacco smoking is bad, tobacco leaves are washed and the tobacco products are regulated and tested for lead and other heavy metals. If you choose to smoke cigarettes, I’d suggest you chose brands that are low in lead. Here is an article comparing the lead levels of various brands. . Better yet, I’s suggest that you vape. There are several advantages of vaping relative to smoking the leaf directly. One of them is that the lead is removed in the process of making concentrate.

Some states test the lead content of marijuana; Michigans and Colorado do not, and even in products that are tested, there have been scandals that the labs under-report metal levels to help keep tainted products on the shelves. There is also a sense that the high cost encourages importers to add lead dust deliberately to increase the apparent density. I would encourage the customer to buy vape or tested products, only.

Here is a little song, “pollution” from Tom Lehrer, to lighten the mood.

Robert Buxbaum, November 24, 2019. I ran for water commissioner in 2016 and lost. I may run again in 2020. Who knows, this time I may win.

Vitamin A and E, killer supplements; B, C, and D are meh.

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It’s often assumed that vitamins and minerals are good for you, so good for you that people buy all sorts of supplements providing more than the normal does in hopes of curing disease. Extra doses are a mistake unless you really have a mis-balanced diet. I know of no material that is good in small does that is not toxic in large doses. This has been shown to be so for water, exercise, weight loss, and it’s true for vitamins, too. That’s why there is an RDA (a Recommended Daily Allowance). 

Lets begin with Vitamin A. That’s beta carotene and its relatives, a vitamin found in green and orange fruits and vegetables. In small doses it’s good. It prevents night blindness, and is an anti-oxidant. It was hoped that Vitamin A would turn out to cure cancer too. It didn’t. In fact, it seems to make cancer worse. A study was preformed with 1029 men and women chosen random from a pool that was considered high risk for cancer: smokers, former smokers, and people exposed to asbestos. They were given either15 mg of beta carotene and 25,000 IU of vitamin A (5 times the RDA) or a placebo. Those taking the placebo did better than those taking the vitamin A. The results were presented in the New England Journal of Medicine, read it here, with some key findings summarized in the graph below.

Comparison of cumulative mortality and cardiovascular disease between those receiving Vitamin A (5 times RDA) and those receiving a placebo. From Omenn et. al, Clearly, this much vitamin A does more harm than good.

The main causes of death were, as typical, cardiovascular disease and cancer. As the graph shows, the rates of death were higher among people getting the Vitamin A than among those getting nothing, the placebo. Why that is so is not totally clear, but I have a theory that I presented in a paper at Michigan state. The theory is that your body uses oxidation to fight cancer. The theory might be right, or wrong, but what is always noticed is that too much of a good thing is never a good thing. The excess deaths from vitamin A were so significant that the study had to be cancelled after 5 1/2 years. There was no responsible way to continue. 

Vitamin E is another popular vitamin, an anti-oxidant, proposed to cure cancer. As with the vitamin A study, a large number of people who were at high risk  were selected and given either a large dose  of vitamin or a placebo. In this case, 35,000 men over 50 years old were given either vitamin E (400 to 660 IU, about 20 times the RDA) and/or selenium or a placebo. Selenium was added to the test because, while it isn’t an antioxidant, it is associated with elevated levels of an anti-oxidant enzyme. The hope was that these supplements would prevent cancer and perhaps ward off Alzheimer’s too. The full results are presented here, and the key data is summarized in the figure below. As with vitamin A, it turns out that high doses of vitamin E did more harm than good. It dramatically increased the rate of cancer and promoted some other problems too, including diabetes.  This study had to be cut short, to only 7 years, because  of the health damage observed. The long term effects were tracked for another two years; the negative effects are seen to level out, but there is still significant excess mortality among the vitamin takers. 

Cumulative incidence of prostate cancer with supplements of selenium and/or vitamin E compared to placebo.

Cumulative incidence of prostate cancer with supplements of selenium and/or vitamin E compared to placebo.

Selenium did not show any harmful or particularly beneficial effects in these tests, by the way, and it may have reduced the deadliness of the Vitamin A.. 

My theory, that the body fights cancer and other disease by oxidation, by rusting it away, would explain why too much antioxidant will kill you. It laves you defenseless against disease As for why selenium didn’t cause excess deaths, perhaps there are other mechanisms in play when the body sees excess selenium when already pumped with other anti oxidant. We studied antioxidant health foods (on rats) at Michigan State and found the same negative effects. The above studies are among the few done with humans. Meanwhile, as I’ve noted, small doses of radiation seem to do some good, as do small doses of chocolate, alcohol, and caffeine. The key words here are “small doses.” Alcoholics do die young. Exercise helps too, but only in moderation, and since bicycle helmets discourage bicycling, the net result of bicycle helmet laws may be to decrease life-span. 

What about vitamins B, C, and D? In normal doses, they’re OK, but as with vitamin A and E you start to see medical problems as soon as you start taking more– about  12 times the RDA. Large does of vitamin B are sometimes recommended by ‘health experts’ for headaches and sleeplessness. Instead they are known to produce skin problems, headaches and memory problems; fatigue, numbness, bowel problems, sensitivity to light, and in yet-larger doses, twitching nerves. That’s not as bad as cancer, but it’s enough that you might want to take something else for headaches and sleeplessness. Large does of Vitamin C and D are not known to provide any health benefits, but result in depression, stomach problems, bowel problems, frequent urination, and kidney stones. Vitamin C degrades to uric acid and oxalic acid, key components of kidney stones. Vitamin D produces kidney stones too, in this case by increasing calcium uptake and excretion. A recent report on vitamin D from the Mayo clinic is titled: Vitamin D, not as toxic as first thought. (see it here). The danger level is 12 times of the RDA, but many pills contain that much, or more. And some put the mega does in a form, like gummy vitamins” that is just asking to be abused by a child. The pills positively scream, “Take too many of me and be super healthy.”

It strikes me that the stomach, bowel, and skin problems that result from excess vitamins are just the problems that supplement sellers claim to cure: headaches, tiredness, problems of the nerves, stomach, and skin.  I’d suggest not taking vitamins in excess of the RDA — especially if you have skin, stomach or nerve problems. For stomach problems; try some peniiiain cheese. If you have a headache, try an aspirin or an advil. 

In case you should want to know what I do for myself, every other day or so, I take 1/2 of a multivitamin, a “One-A-Day Men’s Health Formula.” This 1/2 pill provides 35% of the RDA of Vitamin A, 37% of the RDA of Vitamin E, and 78% of the RDA of selenium, etc. I figure these are good amounts and that I’ll get the rest of my vitamins and minerals from food. I don’t take any other herbs, oils, or spices, either, but do take a baby aspirin daily for my heart. 

Robert Buxbaum, May 23, 2019. I was responsible for the statistics on several health studies while at MichiganState University (the test subjects were rats), and I did work on nerves, and on hydrogen in metals, and nuclear stuff.  I’ve written about statistics too, like here, talking about abnormal distributions. They’re common in health studies. If you don’t do this analysis, it will mess up the validity of your ANOVA tests. That said,  here’s how you do an anova test. 

The Japanese diet, a recipe for stomach cancer.

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Japan has the highest life expectancy in the world, an average about 84.1 years, compared to 78.6 years for the US. That difference is used to suggest that the Japanese diet must be far healthier than the American. We should all drink green tea and eat such: rice with seaweed and raw or smoked fish. Let me begin by saying that correlation does not imply causation, and go further to say that, to the extent that correlation suggests causation, the Japanese diet seems worse. It seems to me that the quantity of food (and some other things) are responsible for Americans have a shorter life-span than Japanese, the quality our diet does not appear to be the problem. That is, Americans eat too much, but what we eat is actually healthier than what the Japanese eat.

Top 15 causes of death in Japan and the US in order of Japanese relevance.

Top 15 causes of death in Japan and the US in order of Japanese relevance.

Let’s look at top 15 causes of deaths in Japan and the US in order of significance for Japan (2016). The top cause of disease death is the same for Japan and the US: it’s heart disease. Per-capita, 14.5% of Japanese people die of this, and 20.9% of Americans. I suspect the reason that we have more heart disease is that we are more overweight, but the difference is not by that much currently. The Japanese are getting fatter. Similarly, we exceed the Japanese in lung cancer deaths (not by that much) a hold-over of smoking, and by liver disease (not by that much either), a holdover of drinking, I suspect.

Japan exceeds the US in Stroke death (emotional pressure?) and suicide (emotional pressure?) and influenza deaths (climate-related?). The emotional pressure is not something we’d want to emulate. The Japanese work long hours, and face enormous social pressure to look prosperous, even when they are not. There is a male-female imbalance in Japan that is a likely part of the emotional pressure. There is a similar imbalance in China, and a worse one in Qatar. I would expect to see social problems in both in the near future. So far, the Japanese deal with this by alcoholism, something that shows up as liver cancer and cirrhosis. I expect the same in China and Qatar, but have little direct data.

Returning to diet, Japan has more far more stomach cancer deaths than the US; it’s a margin of nine to one. It’s the number 5 killer in Japan, taking 5.08% of Japanese, but only 0.57% of Americans. I suspect the difference is the Japanese love of smoked and raw fish. Other diet-related diseases tell the same story. Japan has double our rate of Colon-rectal cancers, and higher rates of kidney disease, pancreatic cancer, and liver cancer. The conclusion that I draw is that green tea and sushi are not as healthy as you might think. The Japanese would do well to switch the Trump staples of burgers, pizza, fries, and diet coke.

The three horsemen of the US death-toll: Automobiles, firearms, and poisoning (drugs). 2008 data.

The three horsemen of the US death-toll: Automobiles, firearms, and poisoning (drugs). 2008 data.

At this point you can ask why our lives are so much shorter than the Japanese, on average. The difference in smoking and weight-related diseases are significant but explain only part of the story. There is also guns. About 0.7% of Americans are killed by guns, compared to 0.07% of Japanese. Still, guns give Americans a not-unjustified sense of safety from worse crime. Then there is traffic death, 1.5% in the US vs 0.5% in Japan. But the biggest single reason that Americans live shorter lives  is drugs. Drugs kill about 1.5% of Americans, but mostly the young and middle ages. They show up in US death statistics mostly as over-dose and unintentional poisoning (overdose deaths), but also contribute to many other problems like dementia in the old. Drugs and poisoning do not shown on the chart above, because the rate of both is insignificant in Japan, but it is the single main cause of US death in middle age Americans.

The king of the killer drugs are the opioids, a problem that was bad in the 60s, the days of Mother’s Little helper, but that have gotten dramatically worse in the last 20 years as the chart above shows. Often it is a doctor who gets us hooked on the opioids. The doctor may think it’s a favor to us to keep us from pain, but it’s also a favor to him since the drug companies give kickbacks. Often people manage to become un-hooked, but then some doctor comes by and re-hooks us up. Unlike LSD or cocaine, opioid drugs strike women and men equally. It is the single major reason we live 5 1/2 years shorter than the Japanese, with a life-span that is shrinking.

Drug overuse seems like the most serious health problem Americans face, and we seem intent on ignoring it. The other major causes of death are declining, but drug-death numbers keep rising. By 2007, more people died of drugs than guns, and nearly as many as from automobile accidents. It’s passed automobile accidents since then. A first suggestion here: do not elect any politician who has taken significant money from the drug companies. A second suggestion: avoid the Japanese diet.

Robert Buxbaum, April 28, 2019.

Penicillin, cheese allergy, and stomach cancer

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penecillin molecule

The penicillin molecule is a product of the penicillin mold

Many people believe they are allergic to penicillin — it’s the most common perceived drug allergy — but several studies have shown that most folks who think they are allergic are not. Perhaps they once were, but when people who thought they were allergic were tested, virtually none showed allergic reaction. In a test of 146, presumably allergic patients at McMaster University, only two had their penicillin allergy confirmed; 98.6% of the patients tested negative. A similar study at the Mayo Clinic tested 384 pre-surgical patients with a history of penicillin allergy; 94% tested negative. They were given clearance to receive penicillin antibiotics before, during, and after surgery. Read a summary here.

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Orange showing three different strains of the penicillin mold; some of these are toxic.

This is very good news. Penicillin is a low-cost, low side-effect antibiotic, effective against many diseases including salmonella, botulism, gonorrhea, and scarlet fever. The penicillin molecule is a common product of nature, produced by a variety of molds, e.g. on the orange at right, and in cheese. It is thus something people have been exposed to, whether they realize it or not.

Penicillin allergy is a deadly danger for the few who really are allergic, and it’s worthwhile to find out if that means you. The good news: that penicillin is found in common cheeses suggests, to me, a simple test for penicillin allergy. Anyone who suspects penicillin allergy and does not have a general dairy allergy can try eating appropriate cheese: brie, blue, camembert, or Stilton. That is any of the cheeses made with penicillin molds. If you don’t break out in a rash or suffer stomach cramps, you’re very likely not allergic to penicillin.

There is some difference between cheeses, so if you have problems with Roquefort, but not brie or camembert, there’s still a good chance you’re not allergic to penicillin. Brie and camembert have a white fuzzy mold coat of Penicillium camemberti. This mold exudes penicillin — not in enough quantity to cure gonorrhea, but enough to give taste and avoid spoilage, and enough to test for allergy. Danish blue and Roquefort, shown below, have a different look and a sharper flavor . They’re made with blue-green, Penicillium roqueforti. This mold produces penicillin, but also a small amount of neurotoxin, roquefortine C. It’s not enough to harm most people, but it could cause an allergic reaction to folks who are not allergic to penicillin. Don’t eat a moldy orange, by the way; some forms of the mold produce a lot of neurotoxin.

For people who are not allergic, a thought I had is that one could, perhaps treat heartburn or ulcers with cheese; perhaps even cancer? H-Pylori, the bacteria associated with heartburn, is effectively treated by amoxicillin, a penicillin variant. If a penicillin variant kills the bacteria, it seems plausible that penicillin cheese might too. And since amoxicillin, is found to reduce the risk of gastric cancer, it’s reasonable to expect that penicillin or penicillin cheese might be cancer-protective. To my knowledge, this has never been studied, but it seems worth considering. The other, standard treatment for heartburn, pantoprazole / Protonix, is known to cause osteoporosis, and increase the risk of cancer, and it doesn’t taste as good as cheese.

A culture of Penicillium roqueforti. Most people are not allergic to it.

The blue in blue cheese is Penicillium roqueforti. Most people are not allergic.

Penicillin was discovered by Alexander Fleming, who noticed that a single spore of the mold killed the bacteria near it on a Petrie dish. He tried to produce significant quantities of the drug from the mold with limited success, but was able to halt disease in patients, and was able to interest others who had more skill in large-scale fungus growing. Kids looking for a good science fair project, might consider penicillin growing, penicillin allergy, treatment of stomach ailments using cheese, or anything else related to the drug. Three Swedish journals declared that penicillin was the most important discovery of the last 1000 years. It would be cool if the dilute form, the one available in your supermarket, could be shown to treat heartburn and/or cancer. Another drug you could study is Lysozyme, a chemical found in tears, in saliva, and in human milk (but not in cow milk). Alexander Fleming found that tears killed bacteria, as did penicillin. Lysozyme, the active ingredient, is currently used to treat animals, but not humans.

Robert Buxbaum, November 9, 2017. Since starting work on this essay I’ve been eating blue cheese. It tastes good and seems to cure heartburn. As a personal note: my first science fair project (4th grade) involved growing molds on moistened bread. For an incubator, I used the underside of our home radiator. The location kept my mom from finding the experiment and throwing it out.

Fat people live longer, show less dementia

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Life expectancy is hardly affected by weight in the normal - overweight- obese range. BMI 30-34.9 = obese.

Life expectancy is hardly affected by weight in the normal – overweight – obese range. BMI 30-34.9 = obese.

Lets imagine you are a 5’10” man and you weigh 140 lbs. In that case, you have a BMI of 20, and you probably think you’re pretty healthy, or perhaps you think you’re a bit overweight. Our institutes of health will say that you are an “average-wight” or “normal-weight” American, and then claim that the average-weight American is overweight. What they don’t tell you, is that low weight, and so-called average weight people in the US live shorter lives. Other things being equal, the morbidity (chance of death) for a thin American, BMI 18.5 is nearly triple that of someone who’s obese, BMI 32. The morbidity of the normal-weight American is better, but is still nearly double that of the obese fellow whose BMI is 32.

Our NIH has created a crisis of overweight Americans, that is not based on health. They work hard to solve this obesity crisis by telling people to jog to work, and by creating ever-more complicated food pyramids. Those who listen live shorter lives. A prime example is Jim Fixx, author of several running books including “The complete Book of Running.” He was 52 when he died of a heart attack while running. Similar to this is the diet-expert, Adelle Davis, author of “Let’s eat right to keep fit”. She died at 70 of cancer — somewhat younger than the average American woman. She attributed her cancer to having eaten junk food as a youth. I would attribute it to being thin. Not only do thin people live shorter lives, but their chances of recovering from cancer, or living with it, seem to improve if you start with some fat.

The same patter exists where age-related dementia is concerned. If you divide the population into quartiles of weight, the heaviest has the least likelihood of dementia, the second heaviest has the second-least, the third has the third-least, and the lightest Americans have the highest likelihood of dementia. Here are two studies to that effect, “Association between late-life body mass index and dementia”, The Kame Project, Neurology. 2009 May 19; 72(20): 1741–1746. And “BMI and risk of dementia in two million people over two decades: a retrospective cohort study” The Lancet, Volume 3, No. 6, p431–436, June 2015.

Morbidity and weight, uncorrected data, and corrected by removing the demented.

Morbidity and weight, uncorrected data, and corrected by removing the demented. The likelihood of dementia decreases with weight.

Now you may think that there is a confounding, cause and effect here: that crazy old people don’t live as long. You’d be right there, crazy people don’t live as long. Still, if you correct the BMI-mortality data to remove those with dementia, you still find that in terms of life-span, for men and women, it pays to be overweight or obese but not morbidly so. The study concludes as follows: “Weight loss was related to a higher mortality risk (HR = 1.5; 95% CI: 1.2,1.9) but this association was attenuated when persons with short follow-up or persons with dementia were excluded.” As advice to those who are planning a weight loss program, you might go crazy and reduce your life-span a lot, but if you don’t go crazy, you’re only reducing your life-span a little.

In terms of health food, I’ve noticed that many non-health foods, like alcohol and chocolate are associated with longevity and mental health. And while low-impact exercise helps increase life-span, that exercise is only minimally associated with weight loss. Mostly weight loss involves changing the amount you eat and changing your clothes choices to maximize radiant heat loss.

Dr. Robert E. Buxbaum, October 26, 2017. A joke: Last week I was mugged by a vegan. You may ask how I know it was a vegan. He told be before running off with my wallet.

bicycle helmets kill

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There is rarely a silver lining that does not come with a cloud, and often the cloud is bigger than the lining. A fine example is bicycle helmets. They provide such an obvious good that, at first glance, you’d think everyone would wear one, even without a law mandating it. Why would anyone risk their skull in a bicycle accident if injury were prevented by merely wearing a particular hat? Yet half the people ride without, even when there are laws and fines. There are some down-side to helmets, but they are so small that even mentioning them seems small. Helmets are inconvenient, and this causes people to ride a little less, so what?

hospital admissions for bicycle related head injuries, red, left; and bicycle related, non-head injuries, blue, right. Victoria Australia.

Hospital admissions for bicycle-related, head injuries, red, left scale, and bicycle-related, non-head injuries, blue, right scale. The ratio is 1:2 before and after the helmet law suggesting that helmet law did nothing but reduce ridership.

As to turns out, helmets hardly stop accidental injury, yet cause people to ride a lot less, and this lack of exercise causes all sorts of problems — far more than the benefits. In virtually every city where it was studied, bicycle ridership dropped by 30-40% when helmets were required, and as often as not, those who still rode, rode unhelmeted. There was a 30-40% decrease in head-trauma injuries, but it appears that this was just the result of 30-40% less ridership. You’d expect a larger decrease if the helmet helped, as such.

Take the experience of Victoria, Australia; head and non-head bicycle injury data plotted above. Victoria required bicycle helmets in January 1990. Before then, in the peak summer months, hospital records show some 50 bicycle-related head injuries per month, and 100 bicycle-related, non-head injuries — a 1:2 proportion. Later, after the law went into effect, each summer month saw about 35 bicycle-related, head injuries, and 70 bicycle-related, non head injuries. This proportion, 1:2, remained the same suggesting the only effect of the helmet law was to reduce ridership, with no increase in safety. The same 30% decrease was seen by direct count of riders on major streets, though now a greater proportion of those still riding were flaunting the law, and not wearing helmets.

One reason that helmets don’t help much is that the skull is already a very good helmet. As things stand, the main injury in a bicycle flip does not come from your skull cracking, it comes from your brain hitting the inside of your skull, and a second helmet doesn’t help stop that. There’s no increase in safety, and perhaps a decrease as the helmet appears to decrease vision. In a study of bicycle-injury-related highway deaths, Piet de Jong found that countries with the highest helmet use had the highest highway death rates. The country with the highest helmet use (the USA, 38% helmeted) had the highest cyclist death rate, 44 deaths per 1,000,000,000 km. By comparison, the nation with the least helmet use (Holland, 1% helmeted) had among the lowest death rates, only 10.7 deaths per 1,000,000,000 km. There are many explanations for this finding, one sense is that the helmets hurt vision making all types of injury and death more likely.

An hour or three of exercise per week adds years to your life -- especially among the middle aged.

From the national cancer institute. An hour or three of exercise per week adds years to your life — especially among the middle aged. Note these are healthy weight individuals. 

Worse than the effect on visibility, may be the effect on exercise. Exercise is tremendously beneficial, especially for middle-aged people in a sedentary population like the US. The lack of exercise is a lot more deadly, it turns out, than any likelihood of flying over the handlebars. How do I know? From studies like the National Cancer institute, shown at right. To calculate the cost/benefit of a little riding, less say you ride 3 hours per week at 10 mph (slow roll). The chart at right suggests a middle-aged person will add 3.4 years to your life, or about 10% life extension. Now consider the risks. This person will ride 30 miles per week, or 2400 km per year. Over 35 years the chance of death is only 0.36%. In order to get a 10% chance of death, you’d have to ride, over 2.3 million km, or 1000 years. Clearly the life extension benefit far outweighs the risk from fatal accident.

But life extension isn’t the total benefit of exercise. Exercise is shown to improve metal health, reducing depression and ADD in children, and likely in adults. Exercise also helps with weight loss, and that is another big health benefit (the chart above was for healthy body weight riders). So my first suggestion is get rid of bicycle helmet laws. I would not go so far as to ban helmets, but see clear disadvantages to the current laws.

The other suggestion: invent a better helmet. While most helmets are vented, and reasonably cool while you ride. They become uncomfortably hot when you stop. And they look funny in a store or restaurant. You can’t easily take them off, either: Restaurants no longer have hat racks, and stores never had them. What’s needed is a lighter, cooler helmet. Without that, and with helmet laws in place, people in the US tend to drive rather than ride a bicycle — and the lack of exercise is killing them.

Robert Buxbaum, January 19, 2017. One of my favorite writing subjects is the counter-intuitiveness of health science. See, eg. on radiation, or e-cigarettes, or sunshine, or health food. Here is a general overview of how to do science; I picked all the quotes from Sherlock Holmes.