Health Care

Good God

It’s long been known that African Americans have a higher incidence of diabetes than white Americans. Usually ascribed to racism in the economy and health treatment.

Hmm:

In an interesting new paper, Andersen et al. (2021) use the Putterman-Weil historical migration index to show that life-expectancy is lower in countries where a large proportion of that country’s population emigrated from places with more sunlight (UV-R). Ethiopians in Israel, Indians in the UK and blacks in the United States, for example, tend to have Vitamin D deficiency and higher levels of mortality and morbidity from a wide variety of diseases. The effect at the global level is small but significant, about the same order of magnitude as the effect of income, inequality, and schooling.

And:

Vitamin D deficiency has been linked to the onset of diabetes. This review summarizes the role of Vitamin D in maintaining the normal release of insulin by the pancreatic beta cells (β-cells). Diabetes is initiated by the onset of insulin resistance. The β-cells can overcome this resistance by releasing more insulin, thus preventing hyperglycaemia. However, as this hyperactivity increases, the β-cells experience excessive Ca2+ and reactive oxygen species (ROS) signalling that results in cell death and the onset of diabetes. Vitamin D deficiency contributes to both the initial insulin resistance and the subsequent onset of diabetes caused by β-cell death. Vitamin D acts to reduce inflammation, which is a major process in inducing insulin resistance.

Umm?

Iodine? Dairy?

I know what iodine deficiency does – goitre and thus cretinism. But dairy?

Don’t cut down on dairy, the British Nutrition Foundation has said, as it warned focus on the environment may lead to poorer diets.

The charity said that the supply of key nutrients such as iron and iodine needed to be taken into account when considering food advice, particularly for teenage girls and young women.

Thought it was about being too far from the sea – therefore no salt water fish etc. The solution being iodised salt. Which pretty much everywhere does have now.

Or am I getting confused with where it was prevalent, for other reasons, up in the Alps?

It ain’t over ’till it’s over

That is a bonus for the already booming British production industry of course, especially in the aftermath of our departure from the EU, but it is something more important as well. It is an early sign that the “zero-Covid” countries are turning into “hermit economies”.

Of course, controlling Covid through lockdowns and closed borders was a triumph to start with. As the pandemic has dragged on, and borders remain sealed for years without end, it is going to take a huge economic toll. Australia is heading back into recession even as the rest of the world recovers. New Zealand is seeing investment flee.

My best guess is that Sweden will, in the fullness of time, be the place shown to have got this right.

Care in the community

In the chat rooms and forums dedicated to the extreme incel misogynistic subculture, Jake Davison was praised as a “saint” on Saturday night.

In a series of bizarre and invariably deeply offensive comments, the Plymouth mass shooting was hailed as marking the beginning of a new “season” of attacks by young men filled with hatred towards women.

One incel – an involuntary celibate – expressed disappointment that Davison’s “score”, or the number of people he had killed, was not higher.

Another warned that he feared Davison’s murders could erode the rights of British incels to arm themselves to carry out more attacks. Many blamed women who had spurned Davison’s advances as responsible for his actions.

Doesn’t seem to be working, does it?

As to whether the culture actually has changed, some rise in sexually frustrated young men etc I’m not sure. It’s never been all that far away from being a worry in any and every society. Round the 17 year olds up, together, send ’em off to fight the equivalent others over the hill has long been a standard manouevre. It could be that, sa with so many other things, this social media is just raising the visibility. As with libertarians and other such generally unfashionable thought processes.

Stand by for the spluttering

The delta variant has wrecked any chance of herd immunity, a panel of experts including the head of the Oxford vaccine team said as they called for an end to mass testing so Britain can start to live with Covid.

Scientists said it was time to accept that there was no way of stopping the virus spreading through the entire population, and monitoring people with mild symptoms was no longer helpful.

Prof Andrew Pollard, who led the Oxford vaccine team, said it was clear that the delta variant could infect people who had been vaccinated, which made herd immunity impossible to reach even with high vaccine uptake.

There will be those who insist that this means the base idea of herd immunity was wrong. Those who insist that therefore society should always remain closed down. And an awful lot of shrieking at the sensible ones who say, well, that’s that. Just have to live – and die – with it being in the population, just like ‘flu and so on.

The people to look out for – and to biff, hard – are those who will argue for continued population controls…..

If only they had been battling, eh?

Medics who have battled coronavirus on the frontline for more than a year and a half have faced a torrent of abuse from patients, a new poll has revealed.

The British Medical Association (BMA) warned of a “rising level of abuse” towards GPs as it called on the public to be kind to NHS workers.

As opposed to their 18 months of hiding behind the answering machine……

Wouldn’t this joyously change things?

In Oz at the moment. One of the great things here is freedom of choice on GP’s.

Call your GP for an urgent appointment: Too busy to see you? Call another one or fire up the app and ask “Who around here has free appointments?”. The GP you see is the one that gets the money from Medicare, the one who was too busy misses out.

It’s funny how easy it can be to see a GP when they are incentivised to actually see patients

Now do the same with every specialist, every hospital, every penumbran service like MRIs etc and we’d have solved the system pretty much.

NHS not so good

To understand this you have to understand what is being measured:

The NHS has lost its prestigious ranking as the best health system in a study of 11 rich countries by an influential US thinktank.

The UK has fallen from first to fourth in the Commonwealth Fund’s latest analysis of the performance of the healthcare systems in the nations it studied.

Also, why it is being measured. The Commonwealth Fund desires that the American health care system be replaced with something much more like the NHS. Thus their measurement system is created to make something like the NHS look good:

Analysis of 71 performance measures across five domains — access to care, care process, administrative efficiency, equity, and health care outcomes

The actual health care bit is only that last. Any and every system that has equality of access will do well by such measures whatever the excellence – or not – at treating people.

Access to Care. The access to care domain encompasses two subdomains: affordability and timeliness. The five measures of affordability include patient reports of avoiding medical care or dental care because of cost, having high out-of-pocket expenses, facing insurance shortfalls, or having problems paying medical bills.
….
Equity. The equity domain compares performance for higher- and lower-income individuals within each country, using 11 selected survey measures from the care process and access to care domains. The analysis stratifies the surveyed populations based on reported income (above-average vs. below-average, relative to the country’s median income) and calculates a percentage-point difference in performance between the two groups.

The entire measurement system is biased towards equality rather than actual health care.

Interesting

The world is at a perilous point and we, the special envoys of the World Health Organization’s director general, are calling for a renewed commitment to a comprehensive approach to defeating this pandemic. We have to accelerate along two tracks – one where governments and vaccine manufacturers support all WHO member states in their efforts to create vaccine manufacturing capacity and vaccinate their most vulnerable populations, and the other where individuals and communities maintain a steely focus on continuing essential public health measures to break transmission chains.

Note that there’s nothing there at all about patents. The problem is not premission to manufacture vaccines it’s how to manufacture vaccines.

Meaning that Global Justice Now and their boss, Dearden, are just producing their usual bullshit when they do scream about patents.

As the Swedish pointed out

Rising numbers of people testing positive for Covid-19 are refusing to hand over details of close contacts, as the numbers forced to self-isolate reached a record high.

Official statistics show almost one quarter of people who tested positive for Covid-19 in the week ending July 21 would not provide details of any recent close contacts.

In total, 76.9 per cent of such cases provided such details – with compliance falling by almost 10 per cent in the past month.

Folks will only do whatever for some limited period of time. Therefore save the imposition of doing whatever until it is really necessary.

And the Swedish experience is looking better all the time, isn’t it?

Are we now claiming they got something right?

People advised to shield in the first wave of the pandemic were five times more likely to die after a confirmed Covid infection than those considered at low risk from the disease, according to research in Scotland.

The study, led by the University of Glasgow, found that efforts to shield the most vulnerable did not prevent substantial levels of infection in the most high-risk groups, with many patients succumbing to the virus.

So the people advised to shield were those who should have shielded, being the more vulnerable?

Be interesting if government actually got something right, wouldn’t it?

The findings raise questions about how effective shielding was in the first wave of the pandemic and show that other measures, from reducing transmission in the community to Covid-safe support at home, are crucial for those most vulnerable to the disease.

“The only way you can protect these people is by stopping them getting infected in the first place because they are such a high-risk group,” said Prof Jill Pell, the director of the University of Glasgow’s Institute of Health and Wellbeing. “You cannot simply dump the responsibility on high-risk people to protect themselves because, as we’ve shown, they cannot protect themselves 100%.”

Ah, no, don;t be silly. They’re looking for someone to blame. The insistence apparently being on a zero infection rate during a pandemic.

Sigh.

What a terrible surprise

More than half of Covid hospitalisations are patients who only tested positive after admission, leaked data reveal.

The figures suggest vast numbers are being classed as hospitalised by Covid when they were admitted with other ailments, with the virus picked up by routine testing.

Experts said it meant the national statistics, published daily on the government website and frequently referred to by ministers, may far overstate the levels of pressures on the NHS.

The leaked data – covering all NHS trusts in England – show that, as of last Thursday, just 44 per cent of patients classed as being hospitalised with Covid had tested positive by the time they were admitted.

The majority of cases were not detected until patients underwent standard Covid tests, carried out on everyone admitted to hospital for any reason.

Overall, 56 per cent of Covid hospitalisations fell into this category, the data, seen by The Telegraph, show.

Now some of those will be, obviously, those suffering from Covid but not known to be at time of admission. As in suffering meaning the reason they were being admitted. Some other will not be. They’ll be people who have – just to have an example – a broken leg, this is the reason for admission and the Covid is purely a byblow.

Then, of course, there will be those who catch it while in there.

Be useful to know the relevant numbers, wouldn’t it?

I wonder who will misunderstand this?

However, the study authors said problems were also commonplace in younger, previously healthy adults.

The findings showed that 27 per cent of 19 to 29-year-olds and 37 per cent of 30 to 39-year-olds experienced a complication. These figures rise to 54 per cent of 60 to 69-year-olds and to 52 per cent for people in their 80s.

One in eight (13 per cent) of the youngest group, aged 19 to 29, suffered acute complications which meant they were unable to look after themselves after being discharged.

Some will think that’s true. Which it isn’t, not without this qualification:

Half of hospitalised Covid patients develop at least one other serious health complication,

It’s of those hospitalised. And the portion of those infected who are hospitalised in these younger groups is what?

An interesting business idea

These vaccination certificates. Or the NHS app. Or however it is that it’s possible to prove that a double jab has been done.

OK, these are supposed to aid travel. Cool.

Strictly speaking – this is definitely true of Portugal and likely of everywhere else – one in English, one of those proofs, isn’t good enough. It must be in the local language.

Now, I’m guessing here, but I assume that the certificates are electronic? So, devising an app that translates them isn’t going to be hugely difficult. Some combination of a template and running through Google Translate might work.

The point being that an app which does provide – acknowledged to be accurate in some manner – translations of those certificates will find something of an audience.

That’s OK, you can send me a cheque for the idea after you’re raking in the cash.

Snigger

I await the outrage:

Hundreds of GPs are administering second Covid jabs just three weeks after the first in defiance of NHS advice, triggering a rebuke from the UK’s vaccines authority.

The rollout of second doses up to nine weeks earlier than official guidance – as well as instances of vaccines distributed to 16- and 17-year-olds – has prompted concern over a postcode lottery in access to protection against coronavirus.

6 months back we were all told that first doses first was a terrible idea because the vaccines had been tested using a 3 week gap. The move to a 12 week gap – an entirely pragmatic one, designed to get some protection to many in the face of shortages – was decried by the usual suspects.

So, who wants to bet on the reverse ferret where using the vaccines as they were actually tested is now decried?

First Nations school deaths

An interesting question here.

So, those residential boarding schools in Canada. With graves of kids around them. An important subject because the death of a child is an important subject.

At which point an interesting question. What was the death rate?

No, not did children die – because this is, however shattering, something that happens. But how many children? How many compared to the death rate for children on the reservations (I know, they’re not called that in Canada but you know what I mean)? Even, compared to the death rate in the society more generally at that time?

Two hundred years ago child mortality – and yes, that was much more about under ones than school age children but still – was horrific for everyone. Something largely solved by drains. It’s still horrific in some parts of the world.

It’s Sowell’s question all over again. “Compared to what?”

The death rate at those schools was what and compared to what?

That third wave

This little corner of Portugal has gone backwards. Bars close early, at lunchtime on weekends. The primary schools are now closed again.

A certain amount of performance theatre stuff here. However. We also have news today that while cases in the UK are rising hospitalisations aren’t. Which puts those claims that Boris et al have handled vaccinations badly into focus. That is, if Britain is doing vastly better than other paces then what does that say about relative performances?