22 studies agree: ‘Medicare for All’ saves money
https://thehill.com/blogs/congress-blog/healthcare/484301-22-studies-agree-medicare-for-all-saves-money
Tag: studies
Unfortunately, Ivermectin Is Not a Miracle Cure for COVID-19
“So what do researchers know about the effectiveness of ivermectin, approved for human use but best known as a horse deworming medicine, in treating COVID-19? At the beginning of the pandemic, scientists around the globe began testing thousands of existing medications in test tubes to see if they could be repurposed to fight against the novel coronavirus. In very preliminary research, researchers found that ivermectin significantly inhibited COVID-19 coronaviruses in cell cultures.
Encouraged by these petri dish findings, some desperate clinicians began administering ivermectin to their COVID-19 patients. The result was a number of hopeful observational studies by clinicians reporting that ivermectin appeared to be effective—in some cases, highly effective—in preventing COVID deaths. Observational studies are notoriously subject to researcher biases and confounders that can mislead clinicians into thinking an intervention works when actually a third factor is responsible.
Nevertheless, a prominent group of American physicians calling themselves the Front Line COVID-19 Critical Care Alliance (FLCCC) combined these preliminary observational and epidemiological studies into a November 13, 2020, preprint meta-analysis asserting that ivermectin “has highly potent real-world, anti-viral, and anti-inflammatory properties against SARS-CoV-2 and COVID-19.” Among other findings, the FLCCC pointed to reports that widespread distribution of ivermectin in Peru had correlated with steep declines in COVID-19 cases and mortality there. According to the group, cases and deaths began to rise dramatically in the same country after the government ceased distributing the drug.”
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“research on ivermectin’s efficacy in treating COVID-19 has been ongoing. Has this subsequent research validated Kory’s claim that ivermectin is a miracle drug against COVID-19? It’s complicated, but the answer is largely no.
First: Those dramatic Peruvian results are highly confounded. The steep rise in COVID-19 cases and deaths in that country can most likely be blamed on the breakout of the highly infectious lambda variant rather than to a halt in ivermectin distribution. Meanwhile, the newly reported results of a highly anticipated randomized controlled study of ivermectin in next door Brazil finds that the medicine had “no effect whatsoever” on the disease.
A lot of the hope that ivermectin would be a COVID-19 silver bullet arose from the findings of various meta-analyses, including the one conducted by the FLCCC, that combined the results of various observational studies and small randomized controlled trials. One of the more prominent recent ones was posted as a preprint in May by a team of British public health researchers led by the Newcastle University statistician Andrew Bryant. But other scientists have faulted that study for significant methodological failures.
Also, though it’s not the preprint’s researchers fault, one of the most important studies bolstering their conclusion has been withdrawn because its results appear to be fraudulent. Once the data from that study are removed, the Bryant meta-analysis finds essentially no efficacy for treating COVID-19 with ivermectin.
On July 28, 2021, the authors of a more painstaking meta-analysis of ivermectin COVID-19 treatment studies, published by the Cochrane Library, concluded:
“Based on the current very low‐ to low-certainty evidence, we are uncertain about the efficacy and safety of ivermectin used to treat or prevent COVID‐19. The completed studies are small and few are considered high quality. Several studies are underway that may produce clearer answers in review updates. Overall, the reliable evidence available does not support the use of ivermectin for treatment or prevention of COVID‐19 outside of well‐designed randomized trials.”
The FLCCC folks are surely sincere, but the best evidence suggests that they are sincerely wrong. The bottom line is that while ivermectin might have some marginal efficacy, it is certainly not a “miracle drug” when it comes to treating COVID-19.”
Rand Paul’s Criticism of Cloth Masks Was Stronger Than the Evidence Justifies
“his flat, categorical statements about cloth masks are stronger than the scientific literature supports, relying on a couple of cherry-picked studies with known limitations while ignoring countervailing evidence.
In a video responding to his YouTube suspension, Paul reiterates that “most of the masks that you get over the counter don’t work” and “don’t prevent infection.” He argues that “saying cloth masks work when they don’t actually risks lives,” describing it as “potentially deadly misinformation.” While N95 respirators are effective at preventing virus transmission, he says, “the other masks don’t work.”
Paul would have been on firm ground if he had said cloth masks offer less protection than N95 masks. But the claim that cloth masks “don’t work,” meaning they offer no protection at all, is inconsistent with multiple studies suggesting that they reduce the risk of infection, especially when worn by carriers but possibly also when worn by other people in their vicinity.”
Climate change worsens extreme weather. A revolution in attribution science proved it.
“Bolstered with better data and even clearer trends, they’re no longer reluctant to point the finger back at humanity for worsening these calamities. In the latest report from the Intergovernmental Panel on Climate Change (IPCC), a team of leading researchers convened by the United Nations presented some of the most robust research that connects the dots. It shows how some greater weather extremes can be traced back to rising average temperatures, which in turn stem from emissions of greenhouse gases, mainly from countries and corporations burning fossil fuels.
“On a case-by-case basis, scientists can now quantify the contribution of human influences to the magnitude and probability of many extreme events,” according to the report.”
The devastating new UN report on climate change, explained
“The Intergovernmental Panel on Climate Change (IPCC), the United Nations’ climate science research group, concluded in a major report that it is “unequivocal” that humans have warmed the skies, waters, and lands, and that “widespread and rapid changes” have already occurred in every inhabited region across the globe. Many of these changes are irreversible within our lifetimes.
This is the first report of its kind in eight years, and a lot has changed. Scientists have backed away from many of the best-case scenarios. They’re more confident than ever that human-caused climate change is already worsening deadly weather events, from flooding to heat waves. And they’re investigating culprits of climate change that warm the planet even more than carbon dioxide.”
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“The goal of these reports is to compile the best available science and create a solid foundation for decision-makers to act, whether that’s to invest in clean energy, relocate people from high-risk areas, or help the most vulnerable places cope with unavoidable impacts.”
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“While researchers have better answers now on some fronts, they are also blunt about the things they still don’t know, which could have huge effects on the livability of the planet. Certain tipping points, feedbacks, and currently unappreciated mechanisms could further tilt the climate out of balance in ways that are hard to predict.”
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“in the eight years since the last comprehensive IPCC report and the six years since the Paris accords, humanity’s output of heat-trapping gases has only grown. Even with a dip in emissions stemming from the Covid-19 pandemic, carbon dioxide concentrations in the atmosphere reached a record high this year, topping 419 parts per million, a level the planet has not seen for at least 2 million years.
This rise in emissions has given scientists unprecedented opportunities to study climate change in real time. Alongside improvements in computer simulations, measurement technology, laboratory experiments, and historical records, scientists have gained far more insight to, and confidence in, humanity’s role in cranking up the planet’s thermostat.”
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“According to the report, it now seems impossible that the world will get lucky and warming will somehow stay within the Paris agreement targets without massive action to limit emissions, starting right away.”
The Research on Ivermectin and Covid
California mandated masks. Florida opened its restaurants. Did any of it matter?
“the science on masks is clear: They work. Even experts I spoke with who think harsh lockdowns may have been counterproductive say indoor mask mandates were clearly effective.
“Indoor masking guidance was proven to be effective,” Amesh Adalja, senior scholar at the John Hopkins Center for Health Security, told me. “When you look at it all, I think that is probably going to be the one that shows the most effect. … Most things can be done safely if people socially distance and wear a mask indoors in an unvaccinated setting.”
The available research supports that conclusion. In a study published in March 2021, CDC researchers examined case and death rates at the county level after mask mandates were put into place and found the mandates were associated with slower transmission.”
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“An earlier study, published in June 2020 in Health Affairs, had reached the same conclusion. Its authors estimated that mask mandates had averted some 200,000 Covid-19 cases by mid-May; at the time, the US had counted less than 2 million cases, indicating that the mask mandates had a meaningful effect in slowing the virus down early in the pandemic.
Some commentators have questioned why dire warnings about what would happen when Texas lifted its mask mandate for good in March 2021 never materialized. But the mandate’s rollback took place in a very different context from the spring of 2020.
For one, many more people now have protection from the virus, between vaccinations and prior infections. More widespread immunity was already an obstacle for the virus.
But on top of that, because the pandemic has become so politicized, people have already sorted themselves into their different camps, experts indicated — and so a state mandate might not have changed behavior. By now, you are already either a mask-wearer or you’re not. A government mandate probably isn’t going to affect someone’s behavior in June 2021 as much as it would have a year ago, especially after enforcement has been nonexistent.”
Teen Cigarette Smoking Went Up Following Flavored Tobacco Ban
“In newly published research, she looked at youth smoking rates in San Francisco, which banned flavored tobacco products—including flavored cigarettes and flavored vaping liquids—in June 2018. Previous research suggested the ban actually increased cigarette smoking in 18- to 24-year-olds while decreasing overall tobacco product use in 18- to 34-year-olds. Friedman wanted to measure the ban’s effect on high school students under 18.
Using data from the 2011-2019 Youth Risk Behavior Surveillance System (YRBSS), Friedman was able to look at under-18 cigarette smoking rates in Los Angeles, New York City, Philadelphia, San Diego, San Francisco, and Florida’s Broward, Palm Beach, and Orange counties. This allowed her to compare youth smoking in San Francisco with districts that did not ban flavored cigarettes and vaping products.
“Comparing recent smoking rates by wave revealed similar trends in San Francisco vs other districts prior to 2018 but subsequent divergence,” writes Friedman of her findings. “San Francisco’s flavor ban was associated with more than doubled odds of recent smoking among underage high school students relative to concurrent changes in other districts.”
“While the policy applied to all tobacco products, its outcome was likely greater for youths who vaped than those who smoked due to higher rates of flavored tobacco use among those who vaped,” she adds. “This raises concerns that reducing access to flavored electronic nicotine delivery systems may motivate youths who would otherwise vape to substitute smoking. Indeed, analyses of how minimum legal sales ages for electronic nicotine delivery systems are associated with youth smoking also suggest such substitution.””
Marijuana and Pregnancy: What Does the Science Say?
“Studies on marijuana use during pregnancy are inconsistent and inconclusive. But cannabis is not known to be teratogenic—that is, to cause birth defects—in humans. The bulk of scientific evidence suggests that risks posed to developing fetuses are relatively minor and babies exposed to marijuana in utero still fall within normal ranges of outcomes.
A 2020 review looked at longitudinal studies on “the impact of prenatal cannabis exposure on multiple domains of cognitive functioning in individuals aged 0 to 22 years” and found that “evidence does not suggest that prenatal cannabis exposure alone is associated with clinically significant cognitive functioning impairments.” Researchers did note some differences—”those exposed performed differently on a minority of cognitive outcomes (worse on < 3.5 percent and better in < 1 percent)" — although "cognitive performance scores of cannabis-exposed groups overwhelmingly fell within the normal range." A 2016 review of studies on potential ties between in utero marijuana exposure and adverse birth outcomes—things like low birth weight and preterm delivery to miscarriage and stillbirth—found "maternal marijuana use during pregnancy is not an independent risk factor for adverse neonatal outcomes after adjusting for confounding factors." Instead, any increases in adverse outcomes appeared "attributable to concomitant tobacco use and other confounding factors."" ... ""The best new evidence on this comes from a 2019 study out of Canada," Oster writes. Matching women who used cannabis with demographically similar women who didn't, researchers did "find evidence of worse birth outcomes among the cannabis users," including "an increased risk of prematurity and NICU transfer. The increases are moderate but statistically significant: preterm birth occurred in 10% of cannabis users and 7% of non-users." An August 2020 study from the same authors found marijuana use correlated with slightly higher incidences of intellectual disability and learning disorders, as well as higher chances of having autism spectrum disorder. "The percent increase is large—about 50%—and significant," Oster points out, though the researchers do note that the overall incidence rate is still small. Though the researchers tried to demographically match participants between groups, it can still be hard to totally compensate for the ways marijuana users may differ from non-users." ... "The biggest problem is that it's hard to isolate specific factors like marijuana consumption. The population of women who not only use marijuana during pregnancy but are also willing to admit to researchers that they do may differ from those who don't." ... "A review of evidence published in February 2020 "points to the possibility of lower birth weight, diminished IQ and more behavior problems among children whose mothers used cannabis during pregnancy, but notes it is very difficult to separate the marijuana use from other demographics or other variables,"" ... " With the limited evidence available, it may make sense for most pregnant women to avoid marijuana to minimize possible risks to their offspring. But the best choice for one woman and her baby won't be the best choice universally. For women who have extreme morning sickness that makes getting adequate nutrients through food and vitamins difficult, and for whom marijuana mitigates nausea, using cannabis might make sense. Likewise, women with certain mental health conditions helped by marijuana may deem it safer than their usual prescription drugs."
Will Biden’s Tax Plan Discourage Work? We Already Know the Answer.
“the international experience shows that a child allowance is not anti-work. The vast majority of countries in the Organization for Economic Cooperation and Development already provide an unconditional child benefit, and most have a higher labor force participation rate than the U.S. In fact, research suggests that parents receiving allowances actually work more: “After Canada enacted a national child allowance in 2006, employment rates for mothers actually increased across the board,” according to one report. In 2016, Canada increased its annual child allowance to $4,800 per young child and $4,000 per older child — and the economy added jobs.”