Tag Archives: Morton Tavel

COVID Facts And Fictions

Okay–you are all probably as tired of discussing COVID and the insanity of anti-vaxxers as I am, but my cousin the cardiologist has written an important summary of the issues, and maybe–just maybe–sharing considered information from a medical professional might trigger productive discussion.

Yeah, I know. Dreaming…

As Mort says, as a member of the conventional medical/scientific community, he grieves at the number of needless deaths that have occurred, and he agrees with the Surgeon General about the need to understand and counter the large amounts of disinformation  flooding social media. He proceeds by offering facts about the vaccines–their efficacy, a history of their development, where they can be accessed, the fact that they’re free, and much more…He’s compiled a very useful, one-stop overview of most of the questions people have. You should click through to see the entire compilation.

Undoubtedly the most important part of his message, however, has to do with safety. With his permission, I am quoting that section at length.

Even before the vaccines were given emergency use authorization, the FDA reviewed months of safety data on tens of thousands of participants in vaccine trials. Since then, regulators have tracked people who received a vaccine in the real world, because it’s possible that very rare side effects might emerge once millions of people receive a shot.

In the U.S., more than half of adults are now fully vaccinated, and even more have received at least one dose. With more than 300 million doses of vaccine administered and an intense safety monitoring program that’s able to track even extremely rare side effects, researchers have been able to track vaccinated people for months, and are confident that the COVID-19 vaccines currently authorized for use by the FDA are safe.

For the vast majority of people, side effects have been similar to those from other vaccines, like the shingles vaccine, though they have been more common and severe than they are with the typical flu shot. These side effects include fever, headaches, feeling run-down, and soreness in the arm. These are more common after the second shot than the first, and generally go away within a few days. A few rare side effects have been detected, now that millions of vaccine doses have been administered.

After receiving the J&J vaccine, a very small number of people—primarily women younger than 50—have developed a type of rare but serious blood clot. In women between 18 and 49, there have been about 7 cases per million vaccinations, and the FDA and CDC still recommend this vaccine. Similar rare blood clots have been observed with the Astrazeneca vaccine in Europe. In July, the CDC also announced that the agency had detected preliminary reports of about 100 cases of Guillain-Barré syndrome, a neurological disorder, among 12.8 million people who received the J&J vaccine. Most were men, many of them 50 and older. Another concern is that early data suggest that this vaccine may not be quite as effective as the other vaccines against the delta variant of the virus.

After receiving either the Moderna or Pfizer vaccines, a small number of people have had a severe allergic reaction, called anaphylaxis, which can occur after any type of vaccination. These have occurred in about two to five people per million vaccinated, and while serious, they are treatable—this is why people are asked to stick around for 15 to 30 minutes after getting a shot.

The CDC is currently investigating higher than normal rates of suspected myocarditis (heart inflammation) in adolescents and young adults who have received the Pfizer or Moderna vaccines. These incidents are rare, and in 81 percent of suspected cases with a known outcome, patients have fully recovered. Any longer-term side effect is extremely unlikely, according to the CDC. Typically, any vaccine side effects would emerge during these first two months after immunization. Moreover, it’s difficult to clearly link any adverse health events that occur after two months with a vaccination. But regulators will continue to monitor vaccine trial participants for two years to see how long immunity lasts and note any adverse events.

Initial reports of several severe but treatable potentially life-threatening allergic reactions called anaphylaxis raised concern about whether the vaccines would be safe for people with severe allergies. There were 71 cases of anaphylaxis reported after the first 18 million vaccine doses were administered in the U.S. That works out to 2.8 cases of anaphylaxis per 1 million people vaccinated with the Moderna vaccine and 5 cases per 1 million doses of the Pfizer vaccine, with no reported deaths linked to anaphylaxis. The risks of dying from COVID-19 are much worse—about 16,500 people per 1 million diagnosed with COVID-19 will die. Now, the only people being told to avoid the vaccine are those allergic to vaccine ingredients such as polyethylene glycol or the related substance polysorbate.

Of course, the most dangerous allergy is the allergy to science and fact that apparently afflicts a significant percentage of the American population.

Share his post with any non-vaccinated folks for whom facts might still be persuasive…

Lie Detectors and the First Amendment

Anyone who watches dramatized detective shows–especially those of the CSI variety–knows that the real starring role is played by technology: cool, highly sophisticated devices that virtually no real-life crime lab can afford. These shows are fun, but accuracy isn’t the strong suit of storylines that need to be resolved in an hour’s time. (Fingerprint identification isn’t the slam dunk that Abby’s computer makes it seem on NCIS.)

Even the popular culture shows that don’t rely on “gee whiz” gadgetry, however, routinely use lie detectors. So the general public can be forgiven for thinking that lie detectors work.

They don’t. At least, not reliably. As Morton Tavel has noted

In 2003, the National Academy of Sciences (NAS), after a comprehensive review, issued a report entitled “The Polygraph and Lie Detection,” stating that the majority of polygraph research was “unreliable, unscientific and biased”, concluding that 57 of approximately 80 research studies—upon which the American Polygraph Association relies—were significantly flawed. It concluded that, although the test performed better than chance in catching lies—although far from perfect—perhaps most importantly, they found the test produced too many false positives.

In other words, nervous people who are telling the truth can easily fail the test. And many do.

This lack of reliability is widely understood in the legal community and among police officers; it’s why most courtrooms don’t admit lie detector results into evidence. It’s also why several ex-police officers have spoken out against their use, and why a subset of them has helped job applicants and others who face “screening” by detectors learn techniques that will help them pass.

And that brings us to a fascinating question. Is helping people pass a lie detector test a crime? What if you aren’t just helping Nervous Nellie tell the truth in a way that won’t trip the machine, but you are helping Sneaky Sam lie?

Douglas Gene Williams, a former Oklahoma City police polygraphist and the proprietor of Polygraph.com,  has been teaching individuals how to pass polygraph tests since 1979. He has recently been indicted for mail fraud and witness tampering for allegedly “persuad[ing] or attempting to persuade” two undercover agents posing as customers “to conceal material facts and make false statements with the intent to influence, delay, and prevent the testimony” of the undercover agents “in an official proceeding….”

Williams’ defenders say this is entrapment, that the attempt to shut him down is implicit acknowledgment that the tests don’t work, and that Williams has a free speech right to criticize their use by demonstrating their manifest unreliability. Others–including many polygraph critics and yours truly–say that helping guilty people fool the tests goes beyond advocacy, and is a bridge too far.

What say you?

 

Health and the Market

Well, I see that the Congressional GOP is threatening to shut down the government in October if the Democrats block repeal of the Affordable Care Act, aka Obamacare, and the partisan rhetoric is predictably flying.

A Democratic friend sent me an email listing the multiple sins of the Bush Administration, from wars of choice to decimation of the economy to the massive increase in the national debt; the message was something like “You didn’t get mad about any of these things, but now a black guy wants to provide healthcare to Americans who don’t have it, and that makes you mad!?” A Republican friend sent me a similarly incendiary message insisting that Obama is a “socialist” who hates capitalism and wants to destroy the market “that made American health care the best in the world.”

Let’s stipulate that not everyone who opposes Obamacare is a racist, and that American healthcare before the ACA was not only not the best in the world, but actually ranks around 37th. Other than that, my purpose is not to engage these arguments, but to point to a perfect example of the way “the market” works in areas like healthcare, where buyers and sellers are not on equal footing, and do not possess the sort of equivalent information that is necessary for markets to work.

I have previously referred to a book written my cousin, Morton Tavel, in which he takes on the “snake oil” aspects of the healthcare industry. He has now created a blog devoted to the subject, and his first post is a perfect example of “the market” in medicine–a discussion of all the ads about “low T”–testosterone deficiency. I encourage you to click through and read the whole post, but the bottom line is that  “low T” is extremely rare. The numbers the manufacturers are hyping are misleading at best and fraudulent at worst, and the “remedy” they are promoting is expensive, unnecessary and unlikely to restore the virility of the aging men who miss their morning erections.

Markets are wonderful where they work. And they work more often than they don’t. But in those areas where they don’t work, they enable the snake oil salesmen who prey on the unwary and drive up costs for everyone.

As with so many policy debates, this isn’t an “either-or” debate between all market all the time and socializing every aspect of the economy. We “socialize” functions that markets cannot efficiently provide–police and fire protection, infrastructure provision, national defense, public education. We leave to the market those economic areas where markets have proven their effectiveness.

The decision whether to leave an activity to the market or provide it through government should be based on evidence, not ideology. And as every other western industrialized country has long recognized, the evidence for government’s role in healthcare is overwhelming, just as the evidence for the market in consumer goods and manufacturing is overwhelming.

The evidence also tells us a lot about elected representatives who–having lost the argument–are willing to shut down the American government in order to protect the profits of health insurers and drug companies.

The Persistence of Snake Oil

Morton Tavel, a well-known Indianapolis cardiologist, has previously confined his writing to medical journals and textbooks. Recently, however, he has written a very readable book intended to discomfit most of its readers. “Snake Oil is Alive and Well: the Clash Between Myths and Reality” takes on the logical fallacies and medical frauds so near and dear to the hearts of most Americans.

Full disclosure here: I would never have come across this e-book on my own; the author is my cousin. That said, I downloaded it from Amazon a few weeks ago and have now finished reading it. And my connection to the author is absolutely irrelevant to my recommendation–honestly!

For most readers, the value of the book will lie in its clear explanations, especially its exhaustive lists of medical/dietary hocus-pocus and distinction between good and bad science. Most of us have fallen for at least some of the identified quackery at one time or another.

For me, however, the central “take-away” was a meditation on the unquenchable desire of most of us humans for quick and easy solutions to our problems.

That desire is in tension with the scientific method, which is slow and painstaking and requires empirical observation and the accumulation of evidence over time before (inevitably conditional) conclusions are drawn. We want answers and we want them NOW!

If you would enjoy a brief jaunt through the history of folks who have preyed upon that all-too-human desire for instant gratification, a look at some of the con men and quacks whose nostrums are usually intended to “cure” our solvency rather than our aches and pains, this is a good read.

Be warned, though: it won’t cure what ails you.