Tag Archives: Snake Oil

Herd Immunity

As we get  closer to November 3d, Trump and his sycophants are becoming more agitated about polls that show His Orangeness losing.  Those negative polling results rest in significant part on the widespread ( entirely accurate) perception that Trump has failed spectacularly when it comes to protecting the public against the Coronavirus.

It shouldn’t come as a surprise that we are now hearing about a vaccine that might be ready on November 1st (that date is just a coincidence, of course), or that we are seeing the White House ramp up efforts  to distract from the sort of  sound, science-based advice being offered by actual experts like Dr. Fauci. One of  the more misleading  messages  emanating from the administration involves promises  about achieving “herd  immunity,” so  today I  thought I’d turn the  bulk of  the  blog over  to my cousin the cardiologist, whom I  often quote on these  matters. (You can read his blog, aimed at debunking “Snake Oil” remedies, here.)

This time, he  addresses the  question: What Is Herd Immunity?

Herd immunity occurs when a high percentage of a given population is immune to a disease, either from having recovered from an infection, or having received a prior vaccination. The end result is the prevention of subsequent outbreaks, or epidemics, of the disease within that population. The exact threshold for herd immunity depends on the specific disease, especially on how easily the disease is spread. Measles, which is highly infectious, requires over 90 percent of the population to produce herd immunity. Meanwhile, influenza can be controlled with a 60 percent level of herd immunity. COVID-19 might be somewhere in the middle: Most experts expect that coronavirus would require 70 to 80 percent protection to achieve this level of immunity.

Herd immunity is typically achieved through a vaccine, such as that for polio, a disease which, just a few decades ago brought justifiable fear to parents that their children would be paralyzed for life. And although isolated cases still occur in many places, a high enough proportion of people are immune through vaccination that epidemics no longer occur. Similar success was obtained with measles, until a misguided anti-vaccination movement has partially upended the desired herd immunity levels.

Originally the term “herd immunity” was employed by immunologists and epidemiologists to describe the percentage of the population that must acquire immunity through receipt of an effective vaccine in order to halt spread of infection. Used by Trump, however, herd immunity is interpreted as the percentage of the population that must acquire immunity by becoming infected to stop the infection from spreading further. This no vaccine approach requires a significant portion of the population to become gravely ill or die (as nearly 200,000 Americans already have) to achieve the same result.

Sadly, a New Coronavirus Adviser, Dr. Scott Atlas, misinforms both the White House and general population with deceptive ideas. Dr. Atlas (a radiologist, not versed in epidemiology or infectious diseases) questions controls like masks. He has angered top health officials by pushing various other disputed policy prescriptions. He argued not only that the science of mask wearing is uncertain, but that children cannot pass on the coronavirus and that the role of the government is not to stamp out the virus but to protect its most vulnerable citizens as Covid-19 takes its course. Ideas like these, scientifically incorrect, have propelled Atlas into President Trump’s White House, where he is pushing to reshape the administration’s response to the pandemic.

Not surprisingly, Trump has embraced Dr. Atlas’s cockamamie ideas, as has Mark Meadows, the White House chief of staff, even as he upsets the balance of power within the White House coronavirus task force with ideas that top government doctors and scientists like Anthony S. Fauci, Deborah L. Birx and Jerome Adams, the surgeon general, find at best misguided , and at worst, outright dangerous

“I think Trump clearly does not like the advice he was receiving from the people who are the experts — Fauci, Birx, etc. — so he has slowly shifted from their advice to somebody who tells him what he wants to hear,” said Dr. Carlos del Rio, an infectious disease expert at Emory University, who is close to Dr. Birx, the White House coronavirus response coordinator.

“He (Atlas) has many great ideas,” Mr. Trump told reporters at a White House briefing last month with Dr. Atlas seated feet away. “And he thinks what we’ve done is really good, and now we’ll take it to a new level.”

Let’s all hope that we can prevent this “new level” from materializing until after November, 2020!!

Navigating the Snake (Oil) Pit

If you’re like me, your Facebook feed regularly includes a horrified post confirming just how awful something or someone is. Given the state of our politics, it’s totally understandable that–quite often– the friend posted satirical “news,” believing it to be true. Or was simply taken in by  misinformation promoted by partisans and/or propagandists.

This is a real problem. Most of us have been fooled at one time or another, and the damage done isn’t limited to politics, policy and celebrity culture.

I have previously blogged about my cousin who is a retired cardiologist. He shares what is probably a genetic trait in our family, namely, getting very pissed off when evidence-free,  off-the-wall assertions are taken as fact. Of course, that happens all the time with medical and health “news,” because few of us have the scientific background to evaluate these sorts of claims, or the time to thoroughly research them.

His previous book was “Snake Oil is Alive and Well;” he’s now followed it up with a more in-depth look at the various claims made about foods, diet aids, dietary supplements and much more–all of the information, misinformation and nuttiness that–whatever else they do– generally separate us from our money and our peace of mind. Here’s his description of the book:

Advice on matters of health often comes from companies that sell products on TV, or from individuals who promote treatments stemming from self-serving agendas. Information obtained this way is often unscientific, unbalanced, and, sadly, blatantly fraudulent. Unfortunately, surrounded by all this noise, mainstream physicians are seldom heard from; moreover, few are willing to devote the time necessary to expose those ubiquitous misconceptions and to provide countering advice stemming from sound scientific research. Making matters even more treacherous are the various branches of “alternative medicine” that provide untested or worthless “treatments”, placing patients at risk of being exploited, losing their money and damaging their health. Although such alternative methods are largely employed by non-conventional and unlicensed practitioners, occasional wayward “real” doctors imprudently transcend these boundaries and promote dubious methods to large audiences on TV and other media. It is no wonder that the public is confused!

As a member of the conventional medical community, I have decided to present a balanced picture of what works, what doesn’t work, what are outright frauds, and what we really don’t know. This book is intended to provide an introduction to contemporary scientific thought processes and serve as a guide for everyone on how to follow a healthy lifestyle while, at the same time, how to avoid wasting large resources on useless—sometimes dangerous—techniques and treatments.

For more information, you can visit his blog.

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.