Judi L. Nath's Blog, page 2

Censoring and Scrubbing

I’m tired. Tired of the constant conflict. Tired of the indoctrinated idiocy. Tired of stupid soundbites.  Tired, tired, tired. While reading Sunday’s newspaper, I was appalled by the number of school board candidates whose focus was on banning topics like critical race theory and sex education rather than on expanding opportunities for educational enrichment.  If you are onboard with this banning bandwagon, can you accurately articulate what exactly you are banning? Twenty-three states have introduced or passed legislation banning discussion, training, or education on these subjects.  If we pass laws that ban talking about race, doesn’t that indeed show that racism is embedded in laws?

Relative to race, much has been made about the new 2020 census data showing that the U.S. population is more racially and ethnically diverse than it was in 2010.  According to census data, the most prevalent racial or ethnic group was the “White alone non-Hispanic population at 57.8%”, which represents a decrease from 63.7% in 2010.  Yet, categorizing a person into a particular race has no basis in science.  Race is a social biopolitical construct.  The census is a glaring example of this, thus demonstrating the necessity for understanding the intersection of science and society.  Here’s where it gets tricky:  while “race” doesn’t exist, “racism” does; and its history is long. The first census was administered in 1790, and every decade thereafter the racial categories have changed.

• In 1790, the 3 categories on the census form were:

(1) Free White Males, Free White Females;

(2) All other free persons; and

(3) slaves.

• In 2010, there were 7 categories:

(1) White;

(2) Black;

(3) American Indian/Alaskan;

(4) Asian;

(5) Hawaii Pacific Islander;

(6) Other; and

(7) Hispanic.

• 2020 ushered in 5 categories of race AND 8 categories of ethnicity. The races included:

(1) White;

(2) Black or African American;

(3) American Indian or Alaska Native;

(4) Asian; and

(5) Native Hawaiian or Other Pacific Islander.

The ethnic groups included:

(1) Hispanic;

(2) White alone, non-Hispanic;

(3) Black or African American alone, non-Hispanic;

(4) American Indian and Alaska Native alone, non-Hispanic;

(5) Asian alone, non-Hispanic;

(6) Native Hawaiian and Other Pacific Islander alone, non-Hispanic;

(7) Some Other Race alone, non-Hispanic; and

(8) Multiracial, non-Hispanic.

Are you confused?  Did you find this an exercise in stupidity? Do you see anything that stands out to you…like one word that shows up repeatedly?  Did you find any omissions?

I just don’t get it. When and where are America’s students supposed to learn about the biology of skin color, science, our culture, and society if they are forbidden from encountering specific talking points in public schools?  When and where are students supposed to learn about history, racism, sexual behavior, and reproductive health if they are never formally introduced to them? Censorship has been around as long as people have been reading and writing.  What’s particularly troubling is that if we don’t give our students an underlying foundation built on facts and comprehension of those facts, they turn to the internet and other unreliable sources to build their ideology.  Then they become adults unable and ill-equipped to separate fact from fiction. And then these adults run for office.

Our history is ripe with myths, atrocities, and idealized notions.  Remember learning that in 1492 Columbus sailed the ocean blue and discovered America?  Did you ever learn about the cruel acts of the Tuskegee Syphilis Study?  Where did you learn about sex and gender?  Currently, all states have some sort of policy on sex education in schools.  According to the National Conference on State Legislatures, 36 states and the District of Columbia require public schools to teach sex education while 36 states and the District of Columbia allow parents to opt-out on behalf of their children.  After teaching college students for three decades, I can tell you that we’re not doing our students any favors by not showing the intersection of science and society.

Wouldn’t it be great if boards of education were focused on educational approaches and tools that enhance learning?  Our schools are staffed by qualified educators.  Let them do their jobs and assist them by providing the resources they need. Nobody needs drama, particularly when we look at test scores of our students.  Using a standardized test known as PISA (Program for International Student Assessment), which is taken every 3 years by students from 35 countries of the Organization for Economic Cooperation and Development, we find American scores lag behind many countries.  To illustrate, in 2018, the United States ranked 8th in reading, 11th in science, and 30th in math.  For a close-to-home comparison, Canada ranked 3rd, 5th, and 8th respectively.

We don’t need super-charged rhetoric and curriculum scrubbing. We need informed citizens who are capable of informed public dialogue.

What’s really at stake in the ‘642 Things to Write About’ uproar in Hudson

Guest Opinion

Check out my guest column from The Plain Dealer, October 3, 2021.

https://www.cleveland.com/opinion/2021/10/whats-really-at-stake-in-the-642-things-to-write-about-uproar-in-hudson-judi-nath.html

Ignorance is Bliss; Willful Ignorance is a Death Kiss: Summer School

Hello Favorite Humans!  It’s been awhile since we last communicated because I was convinced that humankind surely would have this pandemic under control once those vaccines started rolling out and sleeves started rolling up.  Alas, we seem to have a few hiccups.  I know this because my inbox is starting to fill with questions again.  That’s okay, a little summer school may just be what we all need.  Put down that lemonade or margarita and put on your thinking cap.  Summer school is in session.  Let’s do a little Q&A.  No need to worry about being called on though; the smart kid in the front row who brings his professor Special Dark chocolate has already googled the answers while my colleague and I have checked them for accuracy.  Let’s begin.

Q: What is the Delta Variant?

A: Known officially as SARS-CoV-2 Delta (B.1.617.2 Delta to be exact), it is a mutation of our common enemy, SARS-CoV-2, which causes COVID-19.  The variant was first identified in India in December 2020.  From there, it spread to Great Britain.  When a virus mutates, it is named a variant. In addition to Delta, the CDC is monitoring multiple variants, including alpha, beta, and gamma.  Currently, the delta variant is the dominant strain in the United States.  What is particularly disturbing about the delta variant is the ease with which it spreads, affecting more people and straining more of our already strained healthcare workers.  COVID-19 has already killed 613,000 people in the United States and about 4,194,208 people worldwide. Countless others have been sickened by the virus.  To officially end this pandemic, the entire WORLD must be vaccinated.

Q: Why won’t people get vaccinated?

A: Some countries simply don’t have vaccines available to vaccinate their citizens.  The United States is not one of these countries.  The reasons for vaccine hesitancy are varied, and I’ve written on vaccine hesitancy in the past.  But a reason that keeps popping up centers on the phrase, “emergency use authorization.”  I don’t know what talking head made this phrase the one to latch onto to become the new culture war bomb, but please be a good student and understand what it means before repeating the phrase and citing it as an excuse.

Q: What is emergency use authorization (EUA)?

A:  In the United States, we have guidelines and protocols for vaccine development.  Stop and ask yourself what you know about such guidelines.  Have you ever (and be honest) in your life understood how other vaccines were developed?  If so, can you list them and defend your answer?  Vaccine guidelines and protocols are in place to protect citizens.  The Food and Drug Administration (FDA) has granted emergency use authorization (EUA) for the COVID-19 vaccines because specific criteria such as efficacy and safety have already been met and there are no adequate, approved, and available alternatives.  Rigorous clinical trials have already been conducted and experts have evaluated the data and rendered the vaccines the best thing we have right now to stop the pandemic.

Q: If the vaccines are safe and effective, why aren’t they fully approved?

A: Clinical trials are still being conducted and more data being gathered to provide everything necessary for drug manufacturers to submit the paperwork for full approval.  All the boxes have to be checked.  As you’ve seen, clinical trials on children were and still are being conducted.  Originally, some vaccines were only available to adults.  Then, as more information became available, the age limit was lowered.  Now, more trials are being conducted to know if and when all children can be vaccinated.  As more information becomes available, more science is conducted, and after the paperwork gets submitted, then the FDA will review again and the authorization rating may change.  If we want to make America great, keep America great, or better yet, keep Americans alive, vaccination can do that.  Currently, 50.2% of people in the United States are fully vaccinated. Compare that percentage to our Canadian neighbors to the north where 59.7% of people are fully vaccinated.  A mere 20.2% of our Mexican neighbors are fully vaccinated.

Q: Why are mask mandates coming back?

A: Mask mandates are coming back because not enough people have been vaccinated to achieve herd immunity.  Herd immunity is the critical number of vaccinated people a population needs for the virus to die out.  If the virus doesn’t have a host, it dies.  Coronavirus likes warm blooded humans.  These humans don’t even have to be gracious hosts.  Without a host, it dies.  End of story.  Why people become outraged about wearing masks is a mystery to me.  I’ve asked my Scooby-Doo stand-in, Gabbi, if she could help solve it.  She couldn’t.  But liken the ever-changing mask-wearing suggestions and mandates to the weather.  The environment changes, so you dress and prepare appropriately.  To go outside without a coat in subzero temperatures just isn’t smart, so you wouldn’t do it.  You’d also gladly accept a face mask if it prevented frost bite. We have lots of children in this great country of ours who are getting sick from the virus because they cannot be vaccinated.  Two ways to halt the spread of the virus are to get vaccinated and wear a mask.  We all care for children, right?

Q: What are breakthrough infections?

A:  This actually is an excellent question.  I’m not a fan of this term, but nobody asked me to give a name to the situation that occurs when a fully vaccinated person tests positive for the virus.  I guess “fully vaccinated infected person, or F-VIP” doesn’t really capture the essence.  These so-called breakthrough infections do occur.  So, yes, a person can get sick, but they don’t get too terribly sick, require hospitalization, or die.  They can also test positive and have no symptoms at all.  Both are proof that the vaccines are working.  Remember that our immune responses are as individualized as we are.

Q: How contagious is the Delta variant?  Can vaccinated people spread the virus?

A:  The CDC reports that the Delta variant is as contagious as chickenpox. Remember that viruses mutate – think of that as changing to a situation in order to survive.  If wearing a mask enabled a virus to survive, it would. Instead, it mutates. Compared to the original coronavirus, SARS-CoV-2, the Delta variant is better able to enter cells and dampen our immune responses, thereby increasing viral load. Reports show that even fully vaccinated people who have breakthrough infections with the Delta variant carry as much virus in the nose and throat as people who are not vaccinated.  This also means that vaccinated people who have a breakthrough infection can readily spread the virus to others.

Q: Isn’t it my birthright as an American to refuse vaccination or mask wearing in this land of the free and home of the brave?

A: For those with this belief, the best we can do is offer up a consideration to change one’s heart in the hope that it will change one’s mind.  Where does personal liberty end and public health begin? Is it okay to ask a healthcare worker to take care of you when you refused to take care of yourself? Is it okay to infect another person because you chose self over others? Living in a society requires us to care for one another, including the youngest and least among us.  It sure would be nice if we all worked together for the common good and created a little COVID-free peace on Earth.

If Only There Was Something We Could Do

Just over 246 years ago, on April 19, 1775, the Revolutionary War began with “the shot heard round the world.” This same shot created the United States of America.  This might also have begun America’s love affair with guns. Before we go any further, note that this column is not about pro-this or pro-that.  In case you doubt, I’ll let you in on a little-known fact:  I grew up shooting trap and skeet with my dad and brothers and when I was a freshman in high school, I was in rifle club.  At this point, you’re probably shaking your head, right?  A high school had a rifle club?  My public high school, with roughly 1200 students at the time, did indeed have a rifle club. Having such an extracurricular activity seems a bit archaic today.  I also hunted with my dad; and by hunting, I mean I traipsed around the woods, carrying my shotgun, having absolutely no intention of ever shooting an animal.  But I did love being outdoors with my dad.  Are you convinced now?  As everything I’ve written in the past, this blog is about showing the intersection between human science and society, even if that intersection involves firearms.

The Centers for Disease Control and Prevention (CDC) considers firearm injuries a serious public health problem.  According to the CDC, “a firearm injury is a gunshot wound or penetrating injury from a weapon that uses a powder charge to fire a projectile.”  It includes handguns, rifles, and shotguns.  Since the beginning of 2021 (we’re talking real time, as in 4 months, not pandemic time which seems like 3 years), there have been 13,613 gun violence deaths in the United States. Mass shootings total 160.  The number of children ages 0-11 killed has been 101 and teens ages 12-17 who have been killed is 357.  These numbers can be viewed on the Gun Violence Archive’s website and were current as of April 26, 2021.  This is not an advocacy group; they collect data from over 7,500 law enforcement, media, government, and commercial sources daily to provide near real-time data.  They just report the numbers, of which there are a lot more divvied up by other categories if you’re interested.  Think of them as the Sargent Joe Friday of somber statistics.  Now that we have all this out of the way, let’s dig a little deeper into my experiences and also see what happens to a body struck with a projectile.

There are three events in my life that shaped my views on why it’s important for people to understand the effects of gun violence.  In chronological order they include viewing photographs a police officer friend showed me of a man’s brains splattered outside his skull; the second involves buckshot raining down on me in my back yard; and the third involves dissecting a body in the gross anatomy lab.  In the first case, the man committed suicide with a gun.  The second case happened right around the time that Vice President Dick Cheney accidentally shot his acquaintance while quail hunting; in my case a neighbor and his son were shooting birds for sport, but it was a windy day, and their pellets flew onto the deck of our house. (Now, before you start thinking we live in an area reminiscent of the movie Deliverance, well, you’re right.)

The third incident involves working on a man who died of a bullet wound.  Everything about the man seemed perfectly normal, except there was this little hole in his abdomen.  This one little hole caused his demise.  In the gross anatomy lab, we view every body as a gift, and students and I pondered if this person ever considered how he would wind up on our stainless steel table.  When you dissect bodies, there is often some little vestige of life, such as polish on fingernails, or pacemakers that are still functioning because the battery is still running, or encountering rods in femurs from hip replacements.  This was different, though.  Once the body cavities were opened, the interior betrayed the normalcy of the exterior.  I had to call colleagues, including a trauma surgeon, who had more experience than I to ask for advice on how to proceed.

Cleaning away the coagulated blood was like an archeological excavation.  It was difficult to tell the difference between blood clump and actual organ. Yet, it was opening the stomach and intestines that gave me pause:  It was like opening a Tupperware container and scooping out fresh chicken salad with onions.  The man had just eaten lunch and digestive enzymes hadn’t had time to break down the food.  It’s moments like these that show you the fine line between life and death.

In a previous post on blood clots, I said that it’s all about location, location, location.  This also holds true for gunshots.  Effects can be devastating, damaging, and deadly.  If the bullet hits a vital organ (heart or lung), blood vessel (large artery or large vein), or nervous system structure (brain, spinal cord, nerve controlling vital functions) it’s really bad news.  In our lab case, a major vessel was severed, which stopped blood flow through vessels and allowed blood to pour into cavities.

Here are some scenarios for gunshots, focusing on pellets and bullets, and keeping in mind many factors come into play.  Pellets can get swept away in the bloodstream, migrating to areas distant from the injury; pellets can remain in hollow organs just hanging out; and gravity can affect where pellets lodge.  Location and number matter. Swept away pellets can get stuck in places just like blood clots, except pellets can’t dissolve.  A few pellets might be swept to the stomach and eventually make their way out through the digestive tract, but the initial entry into the body must be fixed.  Gravity might cause pellets to lodge in a lower extremity like a rock in the bottom of the pool where it can be sequestered by immune responses.  To get a sense of a single shot, deer hunters have a motto, “one shot, one kill.”  Switching to bullets now.  Like different shotgun shells, there are a variety of bullet types, and learning about those that do the most harm to the human body was sad. Bullets enter the body and destroy every tissue in their pathway. I’m not venturing into rifles, carbines, machine guns, submachine guns, automatic rifles, assault rifles, and whatever else there is.  The take-home message is that bullet type is just as important as the type of gun firing them.

In the United States, the pollsters are checking the pulse of Americans and their approval ratings of President Biden on his handling of guns.  The Fox News survey found 36%-49% net disapproval, while the NBC News poll showed 34%-55% net disapproval. Strikingly, these percentages show we have common ground.  I live in Ohio, and Ohio’s Republican governor, Mike DeWine, added gun regulations to reduce gun violence into the state’s recent budget proposal.  (Remember that there was a deadly mass shooting in Dayton, Ohio, in 2019.)  However, this part of the budget was just axed by GOP lawmakers.  This has people scratching their heads. And just today, the Supreme Court decided to take up a major Second Amendment concealed handgun case to determine whether a New York state law that makes it difficult to get a handgun permit is constitutional. Worldwide, the United States has the second-highest number of firearm-related deaths per 100,000 people– we’re just behind Brazil, and ahead of Mexico, Venezuela, Colombia, and Guatemala. Stop and think about that.

Anything firing ammunition can be dangerous; and like anything or anyone taking a life, there is collateral damage.  We sometimes forget that there is an entire staff of first responders and medical professionals who are expected to deal with the carnage yet are also psychologically affected.  Loved ones of wounded and killed people are affected on levels too numerous to mention.  Wounded but living people are affected.  Witnesses are affected with memories and emotions they can never erase. Communities are affected.  Students learning to be healthcare professionals are affected.  Even seasoned professors might not eat onions for years.  Our time on this planet is finite, but it doesn’t have to be cut short.  Peace, love, and dogs!

Photo is of me with my Schutzhund (protection dog), Sasha.  Back in the day, Sasha and I worked with the county sheriff’s department showcasing the value of dogs over guns.  Here she is in action at a mall demonstration.

What is the Magic Number in Which You Start Caring?

This past week, the FDA halted distribution of the Johnson & Johnson COVID-19 vaccine “out of an abundance of caution” because 6 women had developed blood clots and one of those six died. The type of blood clot they developed is called a cerebral venous sinus thrombosis (CVST).  The word “sinus” in this context does not refer to those air chambers in your facial bones whose membranes can get inflamed with sinus infections.  The cerebral venous sinus is a network of veins in the brain that collects oxygen-poor blood.  If a clot forms here, it prevents blood from draining out of the brain.  This interrupts blood flow causing cells to break, leading to blood leaking (hemorrhaging) into brain tissues. This isn’t a good thing because it can lead to a stroke. The number six represents a very small percentage of the vaccinated population who developed this life-threatening condition.  This got me thinking about two things:

(1) How many people does something have to affect before a person starts caring?

AND

(2) Do you know how blood clots kill you?

Starting with the first query, I remember the very first blog that I wrote in March 2020.  That same blog was peppered with nasty reader comments, which were deleted because the sky is always blue in my world.  Comments centered on how this virus was no more deadly than the flu, and it killed relatively few people.  At the time 5,619 people were diagnosed with COVID-19. Then, I think about car companies and the data they collect.  For example, in 2010, Toyota knew they had a problem with their braking system – unintended acceleration – yet because only 89 deaths occurred over a decade, they were reluctant to issue a recall.  In 2019 Fisher-Price recalled its Rock ‘n Play Sleepers after they were linked to 30 infant deaths over ten years. So, what number is “big enough” for concern?  In each case, those deaths represent once-living people who were loved by someone.  If you knew one of these people affected, it’s probably a safe bet that ANY number was too many.  If it didn’t affect you personally, that number takes on a different meaning.  In all cases, doesn’t it make sense that if you KNEW something resulted in the death of somebody else, wouldn’t you want to know WHY before more people died?  If you knew why, perhaps it could be fixed to prevent future deaths.  Or would you be okay so long as it didn’t affect you?  As humans, we do plenty of things we shouldn’t do and live to see another day.  Until that one time we do something we know we shouldn’t do, and then somebody’s life is upended forever.  Discretion (caution?) is the better part of valor.  I knew I shouldn’t have made my all-time favorite dessert, a 9×13 pan of calorie-laden goodness of cherries, pineapple, butter, cake mix, and pecans.  But I did it anyway.  And I ate nearly the whole gosh darn 2 pounds of sugar and fat by myself in 3 days.  And as always happens after doing something I shouldn’t…I regretted it.  It was a totally avoidable situation, yet caution was thrown to the wind.

On to query number two.  The issue with the J&J vaccine stems from the development of blood clots.  We hear about blood clots so routinely that you’d think there was an app for it: chart your blood clot here.  Where was your blood clot?  Did you feel pain with your blood clot?  At what point did it kill you?  The truth is, blood clots can kill you; but, have you ever stopped to consider how or why?  After all, if you’ve ever skinned your knee or had a minor boo-boo, the injury healed because your blood clotted, formed a scab, the scab fell off when the underlying tissue healed, and life went on.  However, blood clots in key blood vessels can have devastating effects.

Time to insert a little anatomy and physiology here.  Our blood coagulates (clots) to keep us from bleeding out when we do injure ourselves.  It forms a nice, tight seal to keep our innards in and nasty infectious agents out.  It does this through a complex coagulation pathway known as the clotting cascade, which involves extrinsic, intrinsic, and common paths along with a bunch of fancy chemicals, clotting factors, calcium, and feedback mechanisms.  This topic covers an entire section in the textbook and a half-hour lecture with students.  You’re getting the less expensive lesson here.  The point is, that each step in the cascade is important.  You may have heard of hemophilia, a medical condition in which a person’s blood doesn’t clot or clotting is severely diminished.  Hemophilia is a hereditary condition in which a clotting factor is missing (most often clotting factor VIII, but it can be others) and there are different types of hemophilia, named according to the absent clotting factor, with some forms being more severe than others.  The issue with the J&J vaccine is blood CLOTTING, not failing to clot (also known as BLEEDING).  In fully functioning blood systems, our bodies maintain this clotting-bleeding dance without our conscious awareness.  Blood has to flow freely, but it has to clot when necessary.  However, if we remain stationary for too long (like sitting at a computer or on an airplane for hours on end), or if we have some other underlying genetic disorder that makes us prone to clotting (protein C deficiency), or we have a disease (some cancers), or we take a vaccine (unknown mechanism at the time of this blog), then we have a problem.  It can be a BIG problem depending on where that clot is hanging out.

As the saying goes, location, location, location.  If the clot is in a little superficial vessel – one that is toward the surface- it’s generally no big deal because it’ll become trapped, will eventually dissolve (our bodies have a mechanism for dissolving clots, too), and life goes on. However, if that clot forms in a big vein, that can be a matter of life or death.  You likely have heard of a DVT.  DVT stands for deep vein thrombosis – a thrombosis is the fancy term for blood clot, and deep vein means it is toward the body’s interior, hence it is deep.  Deep veins generally are positioned next to deep arteries and they oftentimes (not always) share the same name, like femoral vein and femoral artery.  It’s important to know that blood flows AWAY from the heart in arteries and TOWARD the heart in veins. Forget what you learned in grade school about veins carrying deoxygenated blood while arteries carry oxygenated blood.  The most oxygenated blood in the body comes straight from your lungs and flows TOWARD your heart via pulmonary veins.  If a clot breaks loose, it is now called an embolus.  Like the traveling circus that makes the routes, the traveling embolus can go a few places where it gets stuck and leads to bad outcomes.  In my physiology courses, students learn to trace a drop of blood throughout the body.  It’s a predictable pattern with no need to stop and ask directions.  Most DVTs form in the lower extremities (legs), but upper extremity (arm) DVTs also occur. If a lower extremity clot breaks off, it travels to the lung arteries and is now called a pulmonary embolism (PE).  You don’t want this.  Depending on how big the clot is, what lung tissue is being blocked, and whether or not treatment is available will determine the outcome.  This is definitely something to think about as outcomes range from restricted blood flow causing decreased oxygenation to death.  None of that is good. Like Vermont maple syrup poured over your blueberry pancakes, you want your blood flowing freely so you can live to see another day and stave off diabetes.

[Mike Nath took the photo of our garage refrigerator, i.e., the gridge. Prominently featured are two important items: our mushy reminder to each other and our cold beer inventory. Cheers to life!]

Red, Red Wine: Stay Close to Me

Whenever I hear the words, “red wine,” I automatically get an ear worm as the song reminiscent of Bob Marley begins streaming in my head, and reggae music brings that warm fuzzy feeling…long before the wine does.  One year ago, I wrote my first blog.  Yes, that was March 14, 2020.  Little did I know that these musings linking science with society would be so popular- thank you!  But, after another trip around the sun, I’m paying homage to that beverage that has been so near and dear to many throughout these past months: wine. Even if you’re not a fan of the alcoholic drink made from fermented grape juice, good wine needs no bush.  (If that last phrase makes no sense to you, keep reading.)

In February 2021 (just last month), Sister Andre, a nun residing at the Ste. Catherine Laboure nursing home in Toulon, France, celebrated her 117th birthday eating foie gras with port, capon with mushrooms, and drinking red wine – something she routinely drinks.  She had also beaten coronavirus infection.  Another centenarian who made headlines by beating the virus this year was 105-year-old New Jersey resident, Lucia DeClerck, who credits eating 9 gin-soaked raisins daily as her secret to longevity.  Anecdotally you often hear of the health benefits of alcohol, but is it the elixir for longevity and immunity?

The scientific literature is ripe with research on the health benefits of red wine.  These range from lowering cardiovascular disease risk to boosting life expectancy.  Like yin and yang, there is a counterbalance as too much alcohol has the opposite effect.  However, light drinking seems to be associated with good health, and wine drinking seems to be a common denominator in the Blue Zones – societies where people have the longest life expectancy.  Diving deeper into the studies, one discovers that there is no single magic potion.  Rather, the refrain we’ve been hearing for years continues to echo: Complement that red wine with beans, greens, grains, and nuts.  Yeah, yeah, but what’s IN the wine?  The answer is resveratrol, found in grape skins.  Does it have to be red wine? Can it be white wine? Yes, it has to be red wine because red is richer in resveratrol. (Say that three times fast.)  The reason red wine contains more resveratrol than white wine does has to do with how the wine is made: Red wine is fermented with grape skins longer than white wine is, so the compound survives the wine-making process.

In addition to being a 4-syllable word that would score you 14 points playing Scrabble, resveratrol is a natural polyphenol that is a powerful antioxidant, antifungal, and antibacterial agent found in some foods, like grapes.  Studies done both in vitro (test tubes) and in vivo (in living organisms) have shown it to have a laundry list of benefits and effects.  Its beneficial properties include: anti-inflammatory, anti-cancer, and anti-aging effects; being cardioprotective and neuroprotective; and dilating blood vessels (this lowers blood pressure).  Grapes likely have high concentrations of resveratrol to naturally ward off plant fungal infections.

Resveratrol is not found in either gin or raisins though.  Despite raisins being dried grapes, resveratrol is destroyed during the drying process.  But raisins are an excellent source of anti-oxidants, fiber, potassium, and iron.  Going through each purported benefit and its mechanism of action is beyond our attention span here.

The take-home message is that resveratrol can be considered a nutraceutical, which is a substance found in food that has extra health benefits.  While you can take a resveratrol supplement, your body absorbs the compound better from food. If you’re not inclined to drink red wine, no worries:  blueberries, bilberries, cranberries, dark chocolate, grapes, grape juice, peanuts, pistachios, and plums also contain resveratrol.

Cheers to Neil Diamond, who originally wrote, performed, and recorded Red Red Wine in 1967.  And cheers to you for living through a pandemic!

*According to the Merriam-Webster dictionary, the phrase “good wine needs no bush” is a proverb meaning “there’s no need to advertise or boast about something of good quality as people will always discover its merits.”

Photo Credit:  My good friend, Jim Obergefell; co-founder of Equality Vines – premium wines supporting equality for all

The COVID-19 Vaccines: Apple, Apple, Orange

Over this past weekend, the FDA granted emergency authorization to a 3rd COVID-19 vaccine from Johnson & Johnson (J&J).  This vaccine is a single shot in the arm – a one and done. So, you might be wondering how this one compares to the two we already have from Pfizer-BioNTech and Moderna.  Before getting into the weeds, note that it’s wise to avail yourself to whatever vaccine becomes available to you.  As Yogi Berra would say, “If you see a fork in the road, take it!”  Let’s break it down.

Comparing the newcomer with the previous two is a little challenging, because it’s a different type of vaccine, yet, like apples and oranges, it provides what we need. While the Pfizer and Moderna varieties are mRNA vaccines, J&J’s is an adenovirus vaccine.  This means that they work by different mechanisms in the body.  You’re already quite familiar with drugs that work by different mechanisms or have different molecular formulations-yet achieve the same results-if you’ve ever taken Tylenol (acetaminophen), aspirin (acetylsalicylic acid), or Aleve (naproxen) for pain.  Did it matter to you which one you took as long as your ache went away?

What is an adenovirus vaccine?  Adenovirus vaccines are the type we’re already accustomed to using, because they’ve been used for many flu vaccines. Adenovirus vaccines are double-stranded DNA vaccines that use a modified adenovirus to target those coronavirus spikes.  Let’s circle back to a few terms: adenovirus, double-stranded DNA, and modified adenovirus.  Adenoviruses are a group of DNA viruses that were first discovered in adenoid tissue.  The word part “adeno-” means gland, and adenoid tissue is found in lymphatic tissues, which play major roles in our immune response.  You’ve heard of “adenoids,” those inflamed tonsils at the back of the throat that become enlarged with an infection.  Guess what?  Those tonsils are masses of lymphatic tissue, and if they become enlarged, your immune system is just doing its job.  These adenoviruses typically cause respiratory infections, like the flu.  Double-stranded DNA is our next term.  DNA carries our genetic information, and each molecule of DNA has two coiled strands.  RNA, in comparison, is single-stranded. Our last term, “modified adenovirus” requires a little focus.  Take a sip of your coffee.  Modified means that the virus has been manipulated in the lab to serve as a vector. A vector is just a fancy term for vaccine delivery device.  Now it’s called an “adenovector vaccine,” which won’t harm you, but can mount an immune response against the coronavirus.

How does the new vaccine work?  When you get the vaccine, your body starts making antibodies to coronavirus.  These antibodies will then become memory cells.  (That’s actually their biological name.). They are called memory cells because they remember a virus they have seen before.  That means if they encounter the coronavirus in the future, they know what to do:  they pull out those antibodies, mount an immune response, fight off the virus, and you live happily ever after.

To understand how these vaccines differ, you need a short biology lesson explaining how DNA and RNA are related. Stay with me here, and I’ll give you the really simple version. If you want the lecture, come to physiology class.  Here goes: DNA is a molecule that has the instructions for making proteins, but it needs mRNA to actually make those proteins. Think of DNA as the code, mRNA as the recipe, and protein as the product. It’s the cellular version of the telephone game, and the 3-step pathway goes like this:

Step one = DNA, step two = mRNA, step three = Protein

DNA–>mRNA–>Protein

How do the three vaccines compare?  All are effective!  Ongoing trials, incoming data from vaccinated populations, and variant strains will continue playing a role in tweaking and dosing. It’s science in real time with real people.  Here’s a quick summary:

Johnson & Johnson

– Type: DNA vaccine: begins at step one; code is already there –> tells mRNA to make coronavirus spike protein–> activates immune response and antibodies

–  Dosage:1 dose

– Storage: standard refrigerator for 3 months

Pfizer-BioNTech

-Type: mRNA vaccine: begins at step two; recipe is already there to make coronavirus spike protein –> activates immune response and antibodies

-Dosage: 2 doses, second dose 21 days after first

– Storage: ultra-cold for extended periods, standard freezer for 2 weeks, refrigerator for 5 days after thawing, cannot be refrozen

Moderna

-Type: mRNA vaccine: begins at step two; recipe is already there to make coronavirus spike protein –> activates immune response and antibodies

– Dosage: 2 doses, second dose 28 days after first

– Storage: standard freezers, refrigerator for 30 days after thawing, cannot be refrozen

The worldwide scientific community came together to develop these vaccines to eradicate the virus.  Keep in mind that in order for COVID-19 to go away, people across the globe – not just in the United States-have to be vaccinated.  And, we have to achieve herd immunity.  While we’ve had to limit our togetherness, we are truly in this together.

COVID-19: An Ounce of Prevention is Worth a Pound of Cure

Hey, Folks!  Just reminding you that there’s a pandemic out there, and this virus is doing what all viruses need to do to survive:  mutating.  And, if we’re going to get through this, we’ll need to channel the ethos of those Mutant Ninja Turtles.  So, what’s going on?  There are several variants working the globe: From the United Kingdom we have B.1.1.7, South Africa’s version is 1.351, and Brazil has P.1.  Not very fancy names, but all seem to spread easier than SARS-CoV-2, the one for which vaccines have been developed.  Some new coronavirus variants may have evolved in the United States, too.  We’ll call these homegrown variants. Now, before you start freaking out, keep in mind that virus mutation is a natural occurrence and is totally expected.  This was one reason why we needed to keep it contained; and if I’ve said it once, I’ve said it a thousand times to Gabbi (the only mammal who really listens to me in my garret): be smarter than an ultramicroscopic, invisible to the naked eye, non-cellular particle!  You already know the drill: wear a mask, socially distance, wash your hands, stay home if you can, and limit contact with other people until the vast majority of us are vaccinated and we achieve herd immunity.  You can also call it community immunity, but our actions this past year showed that we humans behave a lot more like a herd than a community.  Enough of that.  Let’s focus on other things we’ve learned, such as treatments that work and don’t work, and what we can do to boost our own immunity. Note that I’m giving the CliffsNotes version here.

Hydroxychloroquine

This drug is used to treat malaria and some auto-immune diseases.  It is not a recommended treatment for COVID-19, and it doesn’t reduce deaths in hospitalized patients with the disease.  Don’t combine it with bleach, either.

Ivermectin

This drug is used to treat parasitic infections.  The drug manufacturer, Merck, has issued a statement stating that there is “no scientific basis for a potential therapeutic effect against COVID-19 from pre-clinical studies; no meaningful evidence for clinical activity or clinical efficacy in patients with COVID-19 disease; and a concerning lack of safety data in the majority of studies.” The National Institute of Health (NIH) has also issued a statement stating that there is insufficient evidence to use this drug as a treatment for COVID-19.  If you are a dog owner, you’re likely quite familiar with ivermectin because it’s the active ingredient in the once-per-month heartworm prevention medication.  Use it for worms, not viruses.

Convalescent plasma

This treatment involves taking the plasma (fluid part of blood) that contains the antibodies from a patient who has recovered from COVID-19 disease.  Using antibody-filled plasma is actually a very old practice: in 1901 the Nobel Prize in Physiology or Medicine was given to Emil von Behring for treating diphtheria patients using this therapy. The therapy is approved by the FDA because it may lessen the severity of the disease or shorten its duration. The jury is still out.

Vitamin C

Vitamin C is a water-soluble vitamin that has been touted for decades as THE vitamin to boost the immune response; and the biggest champion of vitamin C was two-time Nobel Prize winner, Dr. Linus Pauling.  Vitamin C is important for our body’s optimal functioning (just as having adequate amounts of all nutrients is), and among its many roles is dampening inflammation and moderating the immune response.  Here’s a fun factoid about this vitamin:  most animals can make it; humans and guinea pigs cannot. It may be a likely candidate as supplemental treatment in the COVID-19 medicine bag.

Vitamin D

Vitamin D is a fat-soluble vitamin that’s important for calcium absorption.  Without vitamin D, calcium can’t make its way into our body to build strong bones and teeth.  This vitamin has a few forms, we get it in foods, and we make some naturally by exposing our skin to sunlight.  But at temperatures hovering around freezing, you probably aren’t exposing your skin to much sunshine.  Moreover, vitamin D is a hot research topic.  Some research shows a link between decreased vitamin D level and increased risk of COVID-19 infection, others show no link, and others show that decreased vitamin D level is associated with the cytokine storm.  Cytokines are chemicals released by specific immune cells that act on other cells. The cytokine storm is an overzealous response to fighting a viral infection.  When we have an infection, our body reacts with cytokines, but we need just the right amount. We need more research on vitamin D and COVID-19. That’s okay, because that’s how science works.

Melatonin

Melatonin is a hormone secreted by this tiny structure deep within the brain called the pineal gland.  Melatonin regulates our sleep-wake (and reproductive) cycles.  You’re probably familiar with it as a supplement for inducing sleep.  It may also be another pill in the COVID-19 prevention medicine cabinet as some research from the Cleveland Clinic showed melatonin usage may help prevent infection. Melatonin is also used for cancer prevention and treatment.

Zinc

Like vitamins D and C, zinc is a micronutrient that the body needs for overall health.  However, there are currently no recommendations for using it to treat COVID-19.

Dexamethasone

Dexamethasone is a steroid drug that reduces lung inflammation.  It is given either by mouth (orally) or through a vein (IV; intravenously). When given to COVID-19 patients who were receiving oxygen alone or through mechanical ventilation, it reduced mortality.

Remdesivir.

The antiviral medication, remdesivir, is the only drug approved by the FDA to treat COVID-19.  It is given intravenously.  When compared against placebo in adults hospitalized with COVID-19 and respiratory infection, recovery time was shortened.

Pralatrexate

Pralatrexate is a chemotherapy drug used for treating lymphoma, a type of cancer.  It is given intravenously. Lab experiments show pralatrexate inhibits coronavirus replication and appears to be better than remdesivir.

Vaccines

Yes, get the vaccines!  They ready the immune system so that when you encounter the actual virus, you’ll be able to fight it off.  Many people are reporting that the second dose in the two-dose series is worse than the first.  This is a common immune system reaction, and clinical trials predicted this.  When you get the second dose, the immune system has been primed to recognize it and mount a stronger response.  It’s better to feel crummy for a day than to have the disease or its long-term consequences.

Sleep

While there is still much that isn’t known about sleep, from an immunological perspective, it is known that good things happen to body cells when we sleep.  Sleep seems to strengthen our immune response while sleep deprivation hampers our immune response. During sleep, cytokines (remember them?) are released; conversely, sleep deprivation leads to decreased antibody production.  The “perfect” number of hours per night needed varies; but research suggests 7-8 hours for adults, 9-10 hours for teens, and 10 or more for grade-schoolers.  Pre-pandemic studies in some school districts showed that when the school day started later and students got more sleep, both grades and attendance improved.  Puberty and circadian rhythms are the reason. Long-term sleep deprivation increases the risk for obesity, cardiovascular disease, diabetes, and infectious diseases (hello, coronavirus).

Exercise

While it is known that we get lots of benefits from exercise, such as decreasing cardiovascular disease risk, it’s not entirely clear what role exercise plays in the immune response.  We know that exercise decreases stress hormones (those chemicals that dampen the immune system); and aerobic exercise clears the lungs and enhances cardiorespiratory responses.  Physical activity makes us feel better, and that’s enough to keep doing it.

The Great Outdoors

In addition to eating well, getting plenty of sleep, and exercising, just being outdoors has therapeutic effects.  As little as two hours per week of spending time in nature boosts immune cells.  You don’t have to do much other than walking around outside, taking in the sights, smells, sounds, and other stimuli of being outdoors. The Japanese call it “shinrin-yoku,” which means forest bathing.  It’s a practice that has been around for quite some time and is making the news-waves right now because it’s good preventive medicine.  Research shows that it has both physiological and psychological benefits like lowering cortisol (stress hormone) levels, pulse, and blood pressure.  Moreover, it increases parasympathetic (rest-and-digest) activity and decreases sympathetic (fight-or-flight) activity.

While it might be cold, we know the benefits of getting outside, breathing fresh air, and connecting with our natural world.  Good ole nature therapy.  Time for magic mushrooms, er, forest medicine.

[Photos Courtesy of Mike Nath and Kelsey Lindsley]

Hydroxychloroquine

This drug is used to treat malaria and some auto-immune diseases.  It is not a recommended treatment for COVID-19, and it doesn’t reduce deaths in hospitalized patients with the disease.  Don’t combine it with bleach, either.

Ivermectin

This drug is used to treat parasitic infections.  The drug manufacturer, Merck, has issued a statement stating that there is “no scientific basis for a potential therapeutic effect against COVID-19 from pre-clinical studies; no meaningful evidence for clinical activity or clinical efficacy in patients with COVID-19 disease; and a concerning lack of safety data in the majority of studies.” The National Institute of Health (NIH) has also issued a statement stating that there is insufficient evidence to use this drug as a treatment for COVID-19.  If you are a dog owner, you’re likely quite familiar with ivermectin because it’s the active ingredient in the once-per-month heartworm prevention medication.  Use it for worms, not viruses.

Convalescent plasma

This treatment involves taking the plasma (fluid part of blood) that contains the antibodies from a patient who has recovered from COVID-19 disease.  Using antibody-filled plasma is actually a very old practice: in 1901 the Nobel Prize in Physiology or Medicine was given to Emil von Behring for treating diphtheria patients using this therapy. The therapy is approved by the FDA because it may lessen the severity of the disease or shorten its duration. The jury is still out.

Vitamin C

Vitamin C is a water-soluble vitamin that has been touted for decades as THE vitamin to boost the immune response; and the biggest champion of vitamin C was two-time Nobel Prize winner, Dr. Linus Pauling.  Vitamin C is important for our body’s optimal functioning (just as having adequate amounts of all nutrients is), and among its many roles is dampening inflammation and moderating the immune response.  Here’s a fun factoid about this vitamin:  most animals can make it; humans and guinea pigs cannot. It may be a likely candidate as supplemental treatment in the COVID-19 medicine bag.

Vitamin D

Vitamin D is a fat-soluble vitamin that’s important for calcium absorption.  Without vitamin D, calcium can’t make its way into our body to build strong bones and teeth.  This vitamin has a few forms, we get it in foods, and we make some naturally by exposing our skin to sunlight.  But at temperatures hovering around freezing, you probably aren’t exposing your skin to much sunshine.  Moreover, vitamin D is a hot research topic.  Some research shows a link between decreased vitamin D level and increased risk of COVID-19 infection, others show no link, and others show that decreased vitamin D level is associated with the cytokine storm.  Cytokines are chemicals released by specific immune cells that act on other cells. The cytokine storm is an overzealous response to fighting a viral infection.  When we have an infection, our body reacts with cytokines, but we need just the right amount. We need more research on vitamin D and COVID-19. That’s okay, because that’s how science works.

Melatonin

Melatonin is a hormone secreted by this tiny structure deep within the brain called the pineal gland.  Melatonin regulates our sleep-wake (and reproductive) cycles.  You’re probably familiar with it as a supplement for inducing sleep.  It may also be another pill in the COVID-19 prevention medicine cabinet as some research from the Cleveland Clinic showed melatonin usage may help prevent infection. Melatonin is also used for cancer prevention and treatment.

Zinc

Like vitamins D and C, zinc is a micronutrient that the body needs for overall health.  However, there are currently no recommendations for using it to treat COVID-19.

Dexamethasone

Dexamethasone is a steroid drug that reduces lung inflammation.  It is given either by mouth (orally) or through a vein (IV; intravenously). When given to COVID-19 patients who were receiving oxygen alone or through mechanical ventilation, it reduced mortality.

Remdesivir

The antiviral medication, remdesivir, is the only drug approved by the FDA to treat COVID-19.  It is given intravenously.  When compared against placebo in adults hospitalized with COVID-19 and respiratory infection, recovery time was shortened.

Pralatrexate

Pralatrexate is a chemotherapy drug used for treating lymphoma, a type of cancer.  It is given intravenously. Lab experiments show pralatrexate inhibits coronavirus replication and appears to be better than remdesivir.

Vaccines

Yes, get the vaccines!  They ready the immune system so that when you encounter the actual virus, you’ll be able to fight it off.  Many people are reporting that the second dose in the two-dose series is worse than the first.  This is a common immune system reaction, and clinical trials predicted this.  When you get the second dose, the immune system has been primed to recognize it and mount a stronger response.  It’s better to feel crummy for a day than to have the disease or its long-term consequences.

Sleep

While there is still much that isn’t known about sleep, from an immunological perspective, it is known that good things happen to body cells when we sleep.  Sleep seems to strengthen our immune response while sleep deprivation hampers our immune response. During sleep, cytokines (remember them?) are released; conversely, sleep deprivation leads to decreased antibody production.  The “perfect” number of hours per night needed varies; but research suggests 7-8 hours for adults, 9-10 hours for teens, and 10 or more for grade-schoolers.  Pre-pandemic studies in some school districts showed that when the school day started later and students got more sleep, both grades and attendance improved.  Puberty and circadian rhythms are the reason. Long-term sleep deprivation increases the risk for obesity, cardiovascular disease, diabetes, and infectious diseases (hello, coronavirus).

Exercise

While it is known that we get lots of benefits from exercise, such as decreasing cardiovascular disease risk, it’s not entirely clear what role exercise plays in the immune response.  We know that exercise decreases stress hormones (those chemicals that dampen the immune system); and aerobic exercise clears the lungs and enhances cardiorespiratory responses.  Physical activity makes us feel better, and that’s enough to keep doing it.

The Great Outdoors

In addition to eating well, getting plenty of sleep, and exercising, just being outdoors has therapeutic effects.  As little as two hours per week of spending time in nature boosts immune cells.  You don’t have to do much other than walking around outside, taking in the sights, smells, sounds, and other stimuli of being outdoors. The Japanese call it “shinrin-yoku,” which means forest bathing.  It’s a practice that has been around for quite some time and is making the news-waves right now because it’s good preventive medicine.  Research shows that it has both physiological and psychological benefits like lowering cortisol (stress hormone) levels, pulse, and blood pressure.  Moreover, it increases parasympathetic (rest-and-digest) activity and decreases sympathetic (fight-or-flight) activity.

While it might be cold, we know the benefits of getting outside, breathing fresh air, and connecting with our natural world.  Good ole nature therapy.  Time for magic mushrooms, er, forest medicine.

[Photos Courtesy of Mike Nath and Kelsey Lindsley]

Vaccine Hesitancy: The Woman That Deliberates is Lost

There’s an old saying that goes something like this: “A lie can travel halfway around the world while the truth is still putting on its shoes.”  This 1710 maxim, attributed to prose satirist, Jonathan Swift, is as relevant today as it was 311 years ago.  I bring up the point because there’s a lot of misinformation – and misunderstanding- surrounding vaccines.  Oftentimes it is difficult to tell the difference; but in many cases, it is leading to COVID-19 vaccination hesitancy.  Like our three-century old quote, vaccine hesitancy is not new and has been around since the first vaccine was developed.  However, vaccine hesitancy is a growing trend, and for the world to eradicate and manage SARS-CoV-2 (the name for the virus that causes COVID-19), about 67% of the population needs to be vaccinated to achieve herd immunity.  Herd immunity is the percentage of the people in a community who need to be vaccinated to decrease the risk of infection in a population.  The percentage varies depending on the infectious disease, but scientists right now think this is the magic number.  Note that this number may change because our novel coronavirus has mutated (as expected – that’s what viruses do to survive), and there are several variants working the globe: From the United Kingdom we have B.1.1.7, South Africa’s version is 1.351, and Brazil has P.1.  Not very fancy names, but all seem to spread easier than SARS-CoV-2, the one for which vaccines have been developed.  Let’s go through a little Q&A.

Why get vaccinated?  The main reasons are to protect yourself and your family.  The vaccine will protect you by creating an antibody response and it will protect you from getting sick.  Getting sick can lead to serious complications, life-long debilitating issues, or death.  If you are vaccinated, you also protect those around you, especially people who are at increased risk of getting sick because of age or underlying health condition.  According to the CDC, 60% of Americans have an underlying health condition or chronic disease – we’re not a healthy people on the whole.  Look at the number of people who have died from the dreaded disease: As of today, over 433,000 people in the United States have died from COVID-19.  Without widespread vaccination, we can get sick from the disease or spread the disease.  It’s a travesty when someone dies from a vaccine-preventable disease.

How do the vaccines work?  Both the Moderna and Pfizer-BioNTech vaccine use messenger RNA (mRNA).  Think back to high school biology; mRNA gives the instructions for making protein.  The coronavirus has these spikes (you’re familiar with the picture by now) on their surface called S proteins. The vaccine gives our cells the instructions to make harmless S proteins, which are then displayed on our cells.  Our body recognizes this as foreign and begins mounting an immune response and making antibodies to it.  So, when the real deal does come along, the body can pull out these antibodies it learned to make from the mRNA vaccine and render the real virus harmless.

Weren’t those vaccines rushed?  While the vaccines were rolled out within a year, the technology behind them was decades in the making.  Plus, coronaviruses are not new.  Remember the SARS outbreak in 2003?  That was a coronavirus (SARS-CoV).  Moreover, one has to consider that scientists around the world were working on this vaccine.  Many interrupted their own research projects to come aboard in a global effort to combat the pandemic.  Time is of the essence here, because the virus is mutating, thus we have to get enough people vaccinated so the virus has nowhere to go.  Right now, the world is its playground.  This virus only lives if it has a host, and that host is us.  It’ll play the odds:  it won’t kill everyone because that would be self-limiting.  But it certainly will kill lots of us, make lots sick without killing, or hunker down so there are just silent spreaders.  It will do whatever it takes to survive.  You’d think we would do the same – especially since we have a brain and viruses don’t.

What are the risks or side effects of the COVID-19 vaccine? As with anything you put in your body, there is risk.  When I teach pharmacology, the first lecture begins with, “Any drug has the potential for a side effect because each person is an individual with an equally individualized immune response.”  As an example, you might be able to eat peanuts or shrimp just fine and dandy, but your nephew might have a life-threatening severe reaction.  Risks from COVID-19 vaccines range from swelling and pain at the injection site, to fever, chills, tiredness, fatigue, achy muscles, and malaise to nothing at all.  If side effects do occur, they usually subside within one to three days. According to the CDC, about 23.5 million doses of vaccine have been given.  If serious reactions occurred, it was generally within 15 minutes.  There have been 129 deaths, but these were patients in long-term care facilities and the deaths could not be linked directly to vaccine administration.  That is, when looking at deaths that generally occur across the same amount of time in these facilities, this number matches expected death numbers for the population.

Will Bill Gates be tracking me?  No.  There is this wild conspiracy theory that Microsoft co-founder Bill Gates has a diabolical plan for implanting trackable microchips, using vaccines as the vector.  These stories are being spread by anti-vaxxers, and like many online medical myths, they spread faster than truths.  There are so many Bill Gates conspiracy theories out there that my blood pressure was reaching stroke level, so I had to stop reading.  While it is true that Bill and Melinda Gates are keenly interested in vaccines, their goal is to fund research, development, and dissemination of vaccines to eradicate the world of deadly infectious diseases.  Whereas they care about humanity, they really don’t give two hoots about where you are or what you had for breakfast.

How can I trust the government or medical people to administer the vaccine?  This is an excellent question because history hasn’t been kind to some people.  The notorious 40-year Tuskegee syphilis study (1932-1972) tells the horrific tale of enrolling poor black males into a research project under the guise of treating “bad blood,” which was the phrase used by people in Alabama for syphilis.  The federal government recruited people by offering free medical health care, when in reality, the doctors were chronicling what happens to men affected with syphilis who were not treated.  The study continued even when there was available treatment for this infectious disease.  Were it not for a whistle blower, who knows how long this disgraceful practice would have continued?  History is replete with other immoral and unethical experiments including gynecological experiments on enslaved women by Dr. James Marion Sims (1840s), using radioactive substances in developmentally-impaired male children at Fernald State School (1946-1953; Waltham, Massachusetts), and injecting cancer cells into noncancerous patients at Jewish Chronic Disease Hospital (1963; Brooklyn, New York). Since this time, measures like review boards have been in place to ensure informed consent along with ethical research protocols for using human subjects.  People also have the right to quit the study at any time. The Belmont Report of 1974 forms the founding principles upon which research using humans must adhere.  These include respect for persons, beneficence (producing good with moral obligation), and justice.  Under FDA regulations, institutional review boards (IRBs) are established to protect human subjects before and during clinical trials. So, hesitancy on this front is understandable; but we must remain hopeful that we’ve learned from our past and science is done ethically and responsibly for the greater good.

Take-Home Message: Using the best science we have at this time, the current COVID-19 vaccines were developed and have a high-efficacy rate.  Vaccination protects against many infectious diseases and can make our communities safer.  The world is suffering right now.  Americans are dying.  Everyone is yearning for a better life.  So, take one for the team – and your loved ones!

[Photo Credit: From the CDC’s Public Health Image Library, ID# 7854. This historic photograph was created during the Tuskegee Syphilis Study, and depicts Eunice Rivers, RN (second from right) with two colleagues, while visiting a patient (far right) in Macon County, Alabama. Nurse Rivers was assigned to the study in 1932 and was the only staff member who remained through the study’s 40-year period.]

Take My Breath Away: Breathing On and Off a Ventilator

Common words heard repeatedly this past week center on breathing, as in “I can finally breathe” and “What a breath of fresh air.”  These phrases remind us of just how important air is, from when newborns take a life-giving breath to poems that are inspirational. Fittingly, “inspirational” is derived from the Latin word “inspirare,” meaning to breathe; and the term for breathing air in is inspiration.

This week also marked a grim milestone as we surpassed 417,000 deaths from COVID-19.  For over a year, we’ve been living with and dying from an invisible enemy. We’ve also expanded our vocabulary as we were introduced to terms that normally resided only within science classrooms, textbooks, and healthcare.  And while Google got a good workout, lots of us did not.  Breathing also became a rallying call for social justice and a plea from medical teams.  On the latter, the news reminds us daily that “The novel coronavirus that causes COVID is leaving hospitals scrambling for ventilators.”  We hear mention of ventilators and breathing so often that we oftentimes don’t stop to think what this is really all about.  What we do know is that this ultramicroscopic enemy cozies up in our lungs.  After all, who wouldn’t love a warm, moist, oxygen-rich environment to call home?  But that germ gets a little too comfortable and wreaks havoc, causing inflammation and breathing difficulty while overwhelming our immune response.  That’s where ventilators came in.  Let’s break this all down to the bare essentials, showing once again how science and society are linked.

Lungs are the organs of breathing; the left lung has 2 lobes while the right one has 3.  Our heart is positioned at an angle toward the left, which is why you place your hand over your left breast while reciting a pledge. Yet, the whole reason you breathe is to get air deep into your lungs where gas exchange occurs.  And the whole reason you need oxygen is to supply your cells so they can make energy in the form of ATP.  Yes, we can make a little energy without oxygen (called anaerobic respiration), but we are landlubbers, so the vast majority of our energy is made with oxygen (called aerobic respiration).  If cells don’t get oxygen, then they can’t make energy, and we die.  While our breath can make sweet music, our body needs us breathing to keep us dancing.  You know breathing is important because you don’t have to think about doing it; you can get a good night’s sleep as automatic responses take over and you awake in the morning. Here’s a quick experiment demonstrating that point:  Take a deep breath and hold it as long as possible.  Within a short amount of time – depending on how aerobically fit you are – you will automatically exhale and take a quick breath because carbon dioxide builds up and causes centers in your brain to override your desire to keep your lips shut.  There are other times when you should keep your lips closed, but that has nothing to do with breathing.

Breathing normally is a switching act between inhaling and exhaling and relies on the interplay of many body systems – it’s not just about the lungs.  And underlying breathing is biochemistry and neurochemistry, which are two topics the body aces… except when it gets infected.  How do we breathe with infected lungs?

First, we cough.  Coughing is a reflex initiated by an irritant.  In many cases, we cough up the gunk, spit it out, and life goes on.  But if the lungs have a severe infection that outpaces the immune response, breathing becomes difficult and additional action is required.  One such action involves repositioning the body from laying on the back (supine) to laying on the front (prone). This one simple act relies on knowing functional anatomy and flipping from back to front can help a person breathe better.  If you peer inside the chest cavity, you’ll see that the majority of the lungs are positioned against the back; so, if you’re lying on your back, pressure is placed on the lung fields.  This doesn’t impede breathing in healthy lungs, but it can with infected lungs.  It’s also easier to spit out phlegm while lying on your frontside.  In medical jargon, this is referred to as “proning a patient”, and it is being used for some COVID cases.  Last spring, author J.K. Rowling tweeted about her proning success story.  However, the practice is quite old and has been used for decades with some patients suffering with respiratory distress syndrome.  You’ve also likely proned naturally.  Pondering when that might have happened outside of the massage table? Here’s a natural example:  After you’ve been short of breath from running, you automatically bend over and position yourself into a prone stance.  Watch athletes after a race or “getting the wind knocked out of them” and you’ll notice they will typically stand, bent forward, with their hands resting on their knees.

Now, let’s talk about the ventilator. (In April 2020 the Defense Production Act was used to contract with manufacturers to produce more ventilators.  Although billions of dollars were spent on them, many that were added to the Strategic National Stockpile didn’t meet the minimum standards for treating COVID-19 patients.) Ventilators are used as last resources to deliver high concentrations of oxygen; patients on ventilators can also be prone positioned.  To work, a tube is placed through the nose or mouth and inserted into the windpipe (trachea), normally under sedation.  This is a foreign object being shoved down your throat, so you’d naturally cough and try to pull the tube out, thus some sort of calming medication is used.  The tube is connected to the machine called a ventilator, which forcefully delivers oxygen using positive end-expiratory pressure (PEEP) into the lungs. Our lungs aren’t accustomed to this type of oxygen delivery, but it works because it expands the tiny air sacs, called alveoli, which are wrapped with capillaries.  This is where oxygen-for-carbon dioxide gas exchange takes place.  These alveoli are work horses and we have anywhere between 300-800 million, depending on lung volume.  But being on a ventilator is no walk in the park.  A person has to be monitored around the clock and every other bodily function has to be addressed.  For example, nutrition must be delivered through a tube or vein, catheters are used for catching urine, and diapers are worn for feces.  Because medical devices are foreign to the body, the risk of other infections besides coronavirus increases. Furthermore, recovering patients must be weaned off, and long-term lung damage can occur.

In a world where we represent 4.25% of the population, we have 20% of the COVID-19 deaths.  We can do better.  If you’re demoralized after reading, do this 3-step belly breathing lung exercise to ease tension: (1) Just stop and take a deep long breath through your nose.  (2) Hold it.  (3) Then let it out slowly through your mouth.  Repeat this several times for about 5 minutes.  Deep breaths activate parasympathetic areas of the brain, which relax us. You’ll see immediate results:  blood pressure, heart rate, and breathing rate all decrease.  Deep breathing exercises are practiced by singers, Navy seals, and students about to take an exam. But in addition to calming effects, anything you can do to enhance lung function is good, because the greatest predictor of health and longevity is pulmonary function.  The longer you breathe, the longer you live.

Signing Off for Humanity

[Photo of Hallstatt, Austria.  One of Judi and Mike’s favorite places on the planet.]