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quakerjoe · 5 years ago

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In the first employment report after social distancing measures had taken hold in many US states, the Department of Labor announced that 3.3 million people had filed jobless claims. A week later, in the first week in April, an additional 6.6 million claims came in—almost unfathomable compared with the previous record of 695,000, which was set in 1982.

As bad as those numbers are, though, they greatly understate the crisis, since they don’t take into account many part-time, self-employed, and gig workers who are also losing their livelihoods. Financial experts predict that US GDP will drop as much as 30% to 50% by summer.

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In late March, President Donald Trump warned against letting “the cure be worse than the problem itself” and talked of getting the country back to business by Easter, then just two weeks away. Casey Mulligan, a University of Chicago economist and former member of the president’s Council of Economic Advisers, warned that “an optimistic projection” for the cost of closing nonessential businesses until July was almost $10,000 per American household. He told the New York Times that shutting down economic activity to slow the virus would be more damaging than doing nothing at all.

Eventually the White House released models suggesting that letting the virus spread unchecked could kill as many as 2.2 million Americans, in line with the projections of other epidemiologists. Trump backed off his calls for an early reopening, extending guidelines on social distancing through the end of April. But his essential argument remained: that in the coronavirus pandemic, there is an agonizing trade-off between saving the economy and saving lives.

Evidence from research, however, shows that this is a false dichotomy. The best way to limit the economic damage will be to save as many lives as possible.

A novel recession

Part of the difficulty with setting policy now is that the situation is unprecedented in living memory. “It’s impossible to know how the world is changing,” says David Autor, a labor economist at MIT. “It isn’t like anything we’ve seen in a hundred years.” In any past recession or depression, the economic solution has always been to stimulate demand for labor—to get workers back on the job. But in this case, we’re purposely shutting down economic activity and telling people to stay at home. “It’s not just the depth of the recession,” Autor says. “It’s qualitatively different.”

One of the biggest fears is that those least able to withstand the downturn will be hit hardest—low-wage service workers in restaurants and hotels, and the growing number of people in the gig economy. For the last two decades, service workers have become an increasingly large part of the labor force as many of the midlevel office and manufacturing jobs previously open to people without college degrees have dried up, says Autor. It’s people in these service jobs, already low paid and often with few health and other benefits, who will struggle the most.

“On a good day they are vulnerable, and on a bad day they are even more vulnerable,” Autor says. “And this is a very bad day.”

Provisions included in the $2 trillion legislative package passed by Congress in late March were meant to give affected workers and businesses the means to weather the shutdown and, once the outbreak is under control, help restart the economy. Each adult earning less than $75,000 will be given $1,200, and for the first time, gig workers and self-employed people will qualify for unemployment benefits. Hundreds of billions of dollars will also go to helping businesses stay afloat.

But it almost certainly won’t be enough, especially in the hardest-hit areas of the country. Cities like Las Vegas and Orlando, “places with gargantuan leisure hospitality economies,” will be badly affected, says Mark Muro, coauthor of a report from the Brookings Institution analyzing the numbers. But any region with a large service economy is vulnerable. Muro points out that many of these places never recovered from the 2008 financial crisis.

The people losing these low-wage service jobs were already experiencing skyrocketing mortality rates from what economists have begun calling “deaths of despair,” caused by alcoholism, drug abuse, and suicide. The coming crash could make things much worse.

The value of a life

Yet shutting down businesses is the only real choice, given that an unchecked pandemic would itself be hugely destructive to economic activity. If tens of millions of people become sick and millions die, the economy suffers, and not just because the workforce is being depleted. Widespread fear is bad for business: consumers won’t flock back to restaurants, book air travel, or spend on activities that might put them at risk of getting sick. In a recent survey of leading economists by Chicago’s Booth School, 88% believed that “a comprehensive policy response” will need to involve tolerating “a very large contraction in economic activity” to get the outbreak under control. Some 80% thought that “abandoning severe lockdowns” too early will lead to even greater economic damage.

Meanwhile, any measures to slow deaths from the virus will have huge downstream economic benefits. Michael Greenstone, an economist at the University of Chicago, finds that even moderate social distancing will save 1.7 million lives between March 1 and October 1, according to disease-spread models done at Imperial College London. Avoiding those deaths translates into a benefit of around $8 trillion to the economy, or about one-third of the US GDP, he estimates, on the basis of a widely accepted economic measure, the “value of a statistical life.” And if the outbreak is less severe than predicted by the Imperial College work, Greenstone predicts, social distancing could still save some $3.6 trillion.

“Our choice is not whether we intervene or whether we go back to the normal economy,” says Emil Verner, an economist at MIT’s Sloan School who has recently looked at the flu pandemic of 1918 for insights into today’s outbreak. “Our choice is whether we intervene—and the economy will be really bad now and will be better in the future—versus doing nothing and the pandemic goes out of control and really destroys the economy.”

Overall, Verner and his coauthors found that the 1918 pandemic reduced national manufacturing output in the US by 18%; but cities that implemented restrictions earlier and for longer had much better economic outcomes in the year after the outbreak.

Verner points to the fates of two cities in particular: Cleveland and Philadelphia. Cleveland acted aggressively, closing schools and banning gatherings early in the outbreak and keeping the restrictions in place for far longer. Philadelphia was slower to react and maintained restrictions for about half as long. Not only did far fewer people die in Cleveland (600 per 100,000, compared with 900 per 100,000 in Philadelphia), but its economy fared better and was much stronger in the year after the outbreak. By 1919 job growth was 5% there, while in Philadelphia it was around 2%.

Today’s economy is much different—it’s geared more toward services, and far less toward manufacturing than it was 100 years ago. Nevertheless, the cities’ stories are suggestive. Verner says that even a conservative interpretation of the data suggests there is “no evidence that interventions are worse for the economy.” And most likely they had a significant benefit. “A pandemic is so destructive,” he says. “Ultimately any policy to mitigate it is going to be good for the economy.”

The cure, then, isn’t worse than the disease. But for every day that normal economic activity is shut down, a huge number of Americans won’t be earning an income. Many already live paycheck to paycheck. Many may in fact succumb to diseases of despair. Families will fall apart under the stress. Hard-hit cities will feel abandoned. The urgency to open the economy will only grow.

However, a number of influential economists and health-care experts are saying there’s a way to get America quickly back in business while preserving public safety.

Reviving the economy

These days Paul Romer sounds exasperated. “We’re caught up in the trauma: kill the economy or kill more people,” he says. There is so much “learned helplessness, so much hand-wringing.” The New York University economist and Nobel laureate believes he has a relatively simple strategy that will “both contain the virus and let the economy revive.”

The key, says Romer, is repeatedly testing everyone without symptoms to identify who is infected. (People with symptoms should just be assumed to have covid-19 and treated accordingly.) All those who test positive should isolate themselves; those who test negative can return to work, traveling, and socializing, but they should be tested every two weeks or so. If you’re negative, you might have a card saying so that allows you to get on an airplane or freely enter a restaurant.

Testing could be voluntary. Romer acknowledges some might resist it or resist isolating themselves if positive, but “most people want to do the right thing,” he says, and that should be enough to snuff out the spread of the virus.

Romer points to new, faster diagnostic tests, including ones from Silicon Valley’s Cepheid and from the drug giant Roche. Each of Roche’s best machines can handle 4,200 tests a day; build five thousand of those machines, and you can test 20 million people a day. “It’s well within our capacity,” he says. “We just need to bend some metal and make some machines.” If you can identify and isolate those infected with the virus, you can let the rest of the population go back to business.

Indeed, in an early April survey by Chicago’s Booth School, 93% of the economists agreed that “a massive increase in testing” is required for “an economic restart.”

In a piece called “National Coronavirus Response: A roadmap to reopening,” former FDA director Scott Gottlieb also argued for ramping up testing and then isolating those infected rather shutting in the entire population. Likewise, Ezekiel Emanuel, chair of the University of Pennsylvania’s department of medical ethics and health policy, called for increasing testing in a New York Times piece called “We Can Safely Restart the Economy in June. Here’s How.” Harvard medical experts, meanwhile, have outlined similar ideas in “A Detailed Plan for Getting Americans Back to Work.”

The proposals differ in details, but all revolve around widespread testing of various sorts to know who is vulnerable and who isn’t before we risk going back to business.

There is, however, little evidence that massive and frequent testing will be implemented anytime soon. Despite the appearance of new tests, screening is still largely unavailable for anyone but the most severely ill or those at the medical front lines. Test kits and equipment to perform them are still in short supply. Many hospitals and doctors complain they can’t get needed tests; and Roche’s CEO said at the end of March that it will be “weeks, if not months” before there is widespread coronavirus testing in the US.

It’s the type of inertia that clearly frustrates Romer. He calls the $2 trillion legislation passed by Congress “palliative care” for the economy. If you took $100 billion and put it into testing, he says, we would “be far better off.”

One day we will have to reopen the economy. Perhaps we’ll be able to hold out until the pandemic is showing signs of receding, or perhaps the economic suffering will prove intolerable both to those in charge and to those living in hard-hit regions. When that day comes, if we do not have widespread testing, we will be sending people back to work without knowing if they’re at risk of getting the virus or spreading it to others. “We’re thinking about this the wrong way,” Romer says. The idea that one day you will be able to restart the economy without massive testing to see if the outbreak is under control is just “magical thinking.”

It could be a gradual process—those who are found to be free of infection or immune might be allowed back first. But without testing we won’t know how to manage this transition. In that case we will in fact be left with the Trumpian choice: between salvaging the economy and risking countless deaths.

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deniscollins · 5 years ago

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The Hardest Questions Doctors May Face: Who Will Be Saved? Who Won’t?

If you were a medical director and had 10 ventilators with 30 people needing the, thus can only save the life of 10 out of the 30, how would you determine who gets a ventilator by: (1) age (preference to young), (2) highest likelihood of survival, (3) most in need, (4) lottery, (5) first-come, first-served, (6) combination (if so, which ones), (7) something else (if so, what)? Why? What are the ethics underlying your decision?

The medical director of the intensive care unit had to choose which patients’ lives would be supported by ventilators and other equipment. Hurricane Sandy was bearing down on Bellevue Hospital in New York City in 2012, and the main generators were about to fail. Dr. Laura Evans would be left with only six power outlets for the unit’s 50 patients.

Hospital officials asked her to decide which ones would get the lifesaving resources. “Laura,” one official said. “We need a list.” After gathering other professionals, Dr. Evans checked off the names of the lucky few.

Now, she and doctors at hospitals across the country may have to make similarly wrenching decisions about rationing on a far bigger scale. Epidemic experts predict an explosive growth in the number of critically ill patients, combined with severe shortages of equipment, supplies, staffing and hospital beds in areas of the U.S. where coronavirus infections are surging, hot spots that include New York, California and Washington State.

Health workers are urging efforts to suppress the outbreak and expand medical capacity so that rationing will be unnecessary. But if forced, they ask, how do they make the least terrible decision? How do they minimize deaths? Who even gets to decide, and how are their choices justified to the public?

Medical providers are considering these questions based on what first occurred in China, where many sick patients were initially turned away from hospitals, and now is unfolding in Italy, where overwhelmed doctors are withholding ventilators from older, sicker adults so they can go to younger, healthier patients.

Choosing between patients “goes against the way we used to think about our profession, against the way we think about our behavior with patients,” said Dr. Marco Metra, chief of cardiology at a hospital in one of Italy’s hardest-hit regions.

In the United States, some guidelines already exist for this grim task. In an effort little known even among doctors, federal grant programs helped hospitals, states and the Veterans Health Administration develop what are essentially rationing plans for a severe pandemic. Now those plans, some of which may be outdated, are being revisited for the coronavirus outbreak.

But little research has been done to see whether the strategies would save more lives or years of life compared with a random lottery to assign ventilators or critical care beds — an option some support to avoid bias against people with disabilities and others.

Some commonly recommended rationing strategies, researchers found, could paradoxically increase the number of deaths. And protocols involve value judgments as much as medical ones, and have to take into account the public’s trust.

If hospitals withhold treatment by age, where do they draw the line? If they give lower priority to those with certain underlying health conditions, they may in effect be offering black Americans less treatment than white Americans. If physicians try to redirect resources — putting a patient on a ventilator for a few days, then giving it to someone else who appears to have better prospects — more people may die because few would get adequate treatment. And if many patients have a similar chance of survival, what fair way is there to make a choice?

The federal government, so far at least, is not providing national rationing guidelines for the coronavirus outbreak. Officials from various states, medical associations and hospitals are discussing their own plans, potentially resulting in very different decisions on life-and-death matters about which there are deep disagreements, even among medical professionals.

“You have to be really clear about what you are trying to achieve,” said Christina Pagel, a British researcher who studied the problem during the 2009 H1N1 flu pandemic. “Maybe you end up saving more people but at the end you have got a society at war with itself. Some people are going to be told they don’t matter enough.”

‘The Most Good’

Just before the coronavirus outbreak, Dr. Evans, the physician at Bellevue, moved across the country to direct the intensive care unit at the University of Washington Medical Center in Seattle. The city became one of the first areas in the United States to see community spread of the virus.

The hospital is doing whatever it can to prevent the need to ration — what Dr. Evans referred to as “an ethical obligation.” Like other institutions, it is trying to increase supplies, training staff to act in roles that may be outside their usual jobs and postponing elective surgeries to free up space for coronavirus patients. Some cities are racing to construct new hospitals.

Strategies to avoid rationing during the pandemic were published by the National Academy of Medicine. But hospitals across the country vary in their adherence to such steps. At the University of Miami’s flagship hospital, surgeons were told last Monday to cancel elective surgeries, but across the street at Jackson Memorial Hospital, they were “given wide discretion over whether to cancel or proceed,” according to an update sent to physicians.

Dr. Evans is working with health leaders in Washington State to figure out how to implement triage plans. Their goal, she said, would be “doing the most good for the most people and being fair and equitable and transparent in the process.”

But guidance endorsed and distributed by the Washington State Health Department last week suggested that triage teams under crisis conditions should consider transferring patients out of the hospital or to palliative care if their baseline functioning was marked by “loss of reserves in energy, physical ability, cognition and general health.”

The concept of triage stems from Napoleon’s battlefields. The French military leader’s chief surgeon, Baron Dominique Jean Larrey, concluded that medics should attend to the most dangerously wounded first, without regard to rank or distinction. Later, doctors added other criteria to mass casualty triage, including how likely someone was to survive treatment or how long it would take to care for them.

Protocols for rationing critical care and ventilators in a pandemic had their beginning during the anthrax mailings after the Sept. 11 attacks, but have not previously been implemented.

Dr. Frederick M. Burkle Jr., a former Vietnam War physician, laid out ideas for how to handle the victims of a large-scale bioterrorist event. After the SARS outbreak stressed Toronto hospitals in 2003, some of his ideas were proposed by Canadian doctors, and they made their way into many American plans after the H1N1 pandemic in 2009. “I have said to my wife, ‘I think I developed a monster here,’” Dr. Burkle said in an interview.

What worried him was that the protocols often had rigid exclusion criteria for ventilators or even hospital admission. Some used age as a cutoff or pre-existing conditions like advanced cancer, kidney failure or severe neurological impairment. Dr. Burkle, though, had emphasized the importance of reassessing the level of resources sometimes on a daily or hourly basis in an effort to minimize the need to deny care.

Also, the plans might not achieve their goals of maximizing survival. For example, most called for reassigning a ventilator after several days if a patient was not improving, allowing it to be allocated to a different patient.

But rapidly cycling ventilators might not give anyone enough chance to improve. When the coronavirus causes severe pneumonia, doctors are finding that patients require treatment for weeks.

In Canada, a study of H1N1 patients found that 70 percent of those who would have been withdrawn from ventilators after a five-day time trial if a rationing plan had been implemented actually survived with continued care.

Researchers at a British hospital had similar findings, concluding that “a new model of triage needs to be developed.”

A Score Card and a Lottery

Many of the original plans in the U.S. were developed exclusively by medical personnel. But in Seattle, public health officials gathered community input on a possible plan more than a decade ago.

Some citizens feared that using predicted survival to determine access to resources — a common strategy — might be inherently discriminatory, according to a report on the exercise. Citing “institutional racism in the health care system,” they were concerned that the metrics for some groups, like African-Americans and immigrants, would be skewed because they had not received the same quality of care.

There were similar findings in Maryland, where researchers at Johns Hopkins engaged residents across the state in deliberations over several years.

The researchers presented them with several options. Hospitals could assign ventilators on a first-come, first-served basis. Some thought that could disadvantage people who lived far from hospitals. A lottery struck other participants as more fair.

Others argued for a more outcome-oriented approach. One goal could be saving the highest number of lives, regardless of factors like age. A different goal could be saving the most years of life, a strategy favoring younger, healthier patients. Participants also considered whether those playing a valuable role in a pandemic, like medical workers who risked their lives, should be made a priority.

After the project ended, the Hopkins researchers designed a framework that assigns scores to patients based on estimated probability of short- and long-term survival. The latter was defined by whether the person had a pre-existing life expectancy of at least a year. Ventilators would be provided, as available, according to their ranking. The framework recommends a lottery for lifesaving resources when patients have identical scores. Stage of life may also be used as a “tiebreaker.” Decisions should be made by designated triage officers, not individual doctors caring for patients, and there should be a limited appeals process in cases of resource withdrawal, the protocol said.

The public input led the Hopkins researchers not to incorporate most exclusion criteria.

Dr. Lee Daugherty Biddison, one of the effort’s leaders, said that was because most participants were uncomfortable excluding patients with underlying health issues. Preconditions don’t always predict survival from respiratory viruses, and having chronic diseases like diabetes, kidney failure and high blood pressure often tracks with access to medical care. Rationing based on these conditions would be “essentially punishing people for their station in life,” Dr. Biddison said.

The Hopkins group published a description of the framework last year, and doctors from other Maryland hospitals are teleconferencing twice a day to prepare to implement the plan if conditions grow extreme. Dr. Biddison has also been sharing the recommendations with doctors across the country.

In Pennsylvania, Dr. Douglas B. White, chairman of ethics in critical care medicine at the University of Pittsburgh School of Medicine, is using the Hopkins protocol to help prepare hospitals in his state.

In Colorado, Dr. Matthew Wynia, a bioethicist and infectious disease doctor, is working on a plan that would also assign a score. In his rubric, the first considerations are odds of survival and expected length of treatment. He said there was wide agreement among planners “not to make decisions on perceived social worth, race, ethnic background and long-term disability status,” which some fear could happen if doctors had to make seat-of-the-pants judgments without guidelines.

He is also trying to ensure that patients on admission to Colorado hospitals are asked whether they would forgo a ventilator if there were not enough for everyone. “One thing everyone agrees on is that the most morally defensible way to decide would be to ask the patients,” Dr. Wynia said.

He supports the idea of reassigning ventilators in certain cases. “If things are clearly getting worse, it’s really hard to justify a stance of once you’re on a vent, you own it, no matter how many people have to die in the meantime,” Dr. Wynia said.

Unlike in Italy, where age has been used in rationing treatment, some people developing protocols elsewhere have de-emphasized it. “There are arguments about valuing the young over the old that I am personally very uncomfortable with,” Dr. Pagel, the British researcher, said, including that young people should be a higher priority because they have more life ahead of them.

“Where is your threshold? Is a 20-year-old really more valuable than a 50-year-old, or are 50-year-olds actually more useful for your economy, because they have experience and skills that 20-year-olds don’t have?”

A Right to Know

As Hurricane Sandy intensified outside Bellevue in 2012, Dr. Evans referred to New York State guidelines, since updated — which some hospital leaders have said they will follow if overwhelmed by the coronavirus — on how to allocate ventilators in a pandemic using a scoring system that tries to estimate someone’s chance of survival. She pulled together an ad hoc committee of doctors, ethicists and nurses. “Having a system and procedures gave us a sense we had some control of the situation,” she recalled.

For those about to lose electricity, she and her colleagues stationed two staff members at the bedside of all patients who relied on ventilators, preparing to manually squeeze oxygen into their lungs with flexible Ambu bags.

Looking back, Dr. Evans feels the patients and their families had the right to know that their machines would lose power, but in the crisis they hadn’t been told. The doctors also did not think to ask whether any patients or their families might volunteer to give up a power outlet so that it could be provided to someone else. “It wasn’t even on my radar,” Dr. Evans said.

In the end, it was improvisation that prevented tragic rationing at Bellevue. The generator fuel pumps failed, but a chain of volunteers hand-carried diesel up 13 flights of stairs. Dr. Evans’s patients were all maintained on backup power until they were transferred to other hospitals.

“I remember it really vividly,” she said of the experience. “It’s going to stay with me my entire professional career.”

#Hospitals #Doctors #Rationing

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liliannorman · 5 years ago

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COVID-19: When will it be safe to go out again?

As COVID-19 sweeps across the globe, everyone seems to be asking: When will the coronavirus pandemic — and social distancing — end?

The disappointing answer: No one knows for sure. Here’s what we do know about when it may be safe to come out of our homes and resume normal life.

It will almost certainly take herd immunity to end the pandemic.

Most experts say it’s now too late to contain the virus. That’s what nations were able to manage with two earlier, related diseases — SARS and MERS. That means that like the flu, COVID-19 is likely here to stay, returning in some form year after year. And the current pandemic? That will end only with “herd immunity.”

How to cope as COVID-19 imposes social distancing

Herd immunity describes what happens when a large share of the population has become immune to a disease. Because so few people at that point can get infected, the germ finds a hard time finding a new host. How many people must get sick and recover for this to happen depends on how infectious a disease is. This is defined by the particular germ’s basic reproduction number. It’s known as R0 (pronounced R naught).

When a brand new virus emerges, no one is immune. A virus that can be spread easily — such as by a cough, handshake or touching a door handle — can spread like wildfire. And the coronavirus behind the current pandemic is just such a virus.

But once enough people are immune, the virus will hit COVID-19 survivors. They will serve as walls of immunity. As they can’t become re-infected (at least not quickly), the pandemic will start to burn out instead of raging ahead. Scientists call that share of people needed to form such a wall the herd-immunity threshold.

For COVID-19, that threshold may be two out of every three people.

Current estimates put the R0 for the new coronavirus at between two and three. That means anyone with COVID-19 tends, on average, to infect two or three more people. In fact, this number can change based on our behavior. Do most people quarantine themselves before the virus arrives? Or do people continue congregating at concerts, parties, sporting events and religious centers? Do sick people wear masks? Do healthy people protect themselves from contaminated surfaces by washing their hands a lot? Do they wear gloves when they go out of the house?

Explainer: What is a coronavirus?

How — and how much — people interact can make a big difference in that R0.

For the new pandemic, researchers now estimate that the herd-immunity threshold will be between one-third and two-thirds of any given population. Worldwide, that could come to between 2.5 billion and 5 billion people!

Scientists aren’t yet sure how long people infected with COVID-19 remain immune. For now, their best guess comes from one small study. Researchers infected rhesus macaques with the virus. Once the monkeys got well, they could not be reinfected, at least for the next month. A research team in Beijing, China described its findings on that March 14 at bioRxiv.org.

Letting the virus burn through the population would be the fastest approach.

People acquire immunity against a virus in two ways: recovering from an infection or getting a vaccine.

Our bodies make antibodies while fighting off a virus. Depending on the virus, those antibodies can linger in the blood for weeks, months — even decades. The next time the body sees the same virus, those antibodies can kill it off. The bad news: You have to suffer through an infection for this to happen.

Search speeds up for vaccine against the new coronavirus

A vaccination also causes the body to make those protective antibodies. The vaccine fools the body into thinking it had been invaded by the virus. The bad news here: A vaccine against COVID-19 appears to be at least 12 to 18 months away.

That means that the fastest way to herd immunity would be the old-fashioned way: Let the virus burn through a population without fighting it. A March 16 report by researchers in England at Imperial College London used a computer to model that scenario. And without attempts to stop the virus in the United States, the model calculated, the pandemic could peak in about three months.

The costs of such quick herd immunity, however, would be horrific. Roughly four in every five people throughout the United States might get infected, the model estimated. And more than 2 million of the sickened Americans, it said, could die from the virus alone.

The role of models

Before you panic at those huge numbers, keep in mind that a computer model offers only an educated guess about what might happen. It is based on the data fed into it. Such models often are revised again and again, as new numbers come in or as new insights emerge.

Over time, those predictions will be challenged and tested.

Some people are already doing that, notes Deborah Birx. She is a doctor who works for the U.S. State Department. She specializes in infectious diseases. She also works on a new White House Coronavirus Task Force.

When the London model’s numbers first came out, Birx noted they were worrisome. She said they helped justify a recommendation that Americans undertake widespread social distancing. And people keeping their distance is still wise, she said at a March 26 White House briefing for reporters.

But the model’s estimates were meant to be a worst-case scenario. That means they modeled what the researchers thought could happen if society took no action to stop the spread of the disease. In fact, countries around the world are taking action. Chief among those actions: social distancing.

Imagining worst-case scenarios are useful. They help governments plan for what might happen. Models tend to be revised again and again as new numbers come in or as we learn more about a virus and how it spreads.

And Birx noted that experts are collecting more data. Those data would be used to test how behaviors used by the model match up with how people are behaving (such as staying home while the virus is spreading most actively).

Quicker herd immunity would make conditions harder for doctors.

The new virus has been hitting the elderly and those with underlying disease hardest. But younger people, too, can experience severe illness. That’s a point made in a new report by the U.S. Centers for Disease Control and Prevention (see table below).

It looked at the severity of illness in 2,449 Americans from mid-February to mid-March 2020. The share of those who were hospitalized went up with age, it found. Almost one-third of hospitalized patients were at least 85 years old.

But even 2 to 3 percent of infected children and teens were hospitalized. Kids with asthma and other underlying health conditions could face a higher risk of severe disease than others their age. Clearly, all age groups can be harmed by the new scourge.

A Pediatrics paper by a team in China brought that home. Published online March 16, it followed the health of 2,143 children — babies to teens — who fell ill with the virus. Overall, 5 percent developed severe disease, it reported. Among them, 33 “had critical disease.” Many children had extreme trouble breathing. A few needed oxygen or ventilators to help as their bodies fought the virus. One 14-year-old boy even died.

Almost anyone can fall ill

More than half of admissions to intensive care units (ICUs) and deaths reported among U.S. COVID-19 cases between February 12 to March 16 occurred in people 65 or older. But some younger adults also experienced severe disease, a new analysis by the U.S. CDC found. Among hospitalized adults, 1 in 5 were 20 to 44 years old. So were 12 percent of those admitted to an ICU.

Severe outcomes of U.S. COVID-19 cases by age

C. Chang

The pandemic could also limit the effectiveness of U.S. hospitals. Overwhelmed doctors and hospitals might not get to non-COVID-19 cases that also need prompt care. These could include victims of auto accidents, appendicitis patients, cancer cases needing surgery or pregnant women with difficult deliveries.

The ability of some U.S. hospitals to provide critical care to all of the very sick might be lost as early as the second week of April, the Imperial College London report predicted. Hospitals in some big U.S. cities now report infection rates that support this. While there is much still unknown about the virus, most experts agree with this overall picture.

That’s why countries around the world have focused on social distancing. They are trying to slow the surge in new cases and lessen the strain on hospitals.

Social distancing delays herd immunity.

The flipside of successful social distancing is that it slows the pace at which herd immunity develops, notes Michael Mina. He’s an epidemiologist at the T.H. Chan School of Public Health. It’s part of Harvard University in Boston, Mass. Even if extreme social distancing prevents a surge in the coming weeks, he says, the virus could reemerge as soon restrictions are lifted.

“In the absence of robust herd immunity at the population level,” he says, “we have some risk of a second wave of the epidemic.”

Social distancing will need to last up to 3 months, maybe longer.

Society could keep a lid on such a re-emergence by keeping up their social distancing. The Trump administration on March 16 called for significant social distancing to last 15 days. But most experts expect that’s not nearly long enough. Experts have begun arguing that this distancing will need to last one to three months, at least, in the United States to keep hospitals from being overwhelmed.

See all our coverage of the new coronovirus outbreak

Hospitals could get a big break if spread of the new virus slows with warmer weather. But for now, there are no sure signs that will happen.

A summer break in cases “would be a great stroke of luck,” says Maciej Boni. He’s an epidemiologist at Penn State University in University Park. If that happened, it might allow more people to return to work or school once the number of new cases begins to fall.

Keeping schools closed and encouraging people to generally stay home could suppress the pandemic after five months, according to early numbers from the Imperial College London model. But once such restrictions are lifted the virus would likely come roaring back, it added.

Until a vaccine becomes available, potentially in 12 to 18 months, a report on the model argues that major social distancing measures will be needed.

Such drastic changes to daily life may be difficult to sustain, Boni admits. “It’s like you’re holding back a wave of infections with Saran Wrap.” However, experts note, boredom and feeling cooped up is far better than taking a risk of getting sick.

Wider diagnostic testing could ease the need for extensive social distancing.

Whether strict isolation could be maintained for months on end is unknown. “We’ve never faced anything like this before,” points out Caitlin Rivers. She’s an epidemiologist at the Johns Hopkins Center for Health Security in Baltimore, Md.

“I’m not ready to give up on the lessons from places like South Korea and Taiwan,” Rivers says. “They’ve shown the virus can be [locally] contained.” She notes that those places did extensive social distancing. And they coupled that with extensive virus testing. They also isolated infected people and tracked down everyone they had been in contact with.

South Korea, for instance, reported its highest number of new cases, 909, on February 29. Since then, the number has steadily dropped. On March 24, only 76 new cases were reported.

While the United States is ramping up its testing, the virus has spread undetected across the country. Until testing increases by a lot, the only tool the United States has to slow spreading of the virus is wide social distancing.

The reason: Data indicate the pandemic is being driven largely by people who don’t know they’re sick. Some of those data come from a March 16 study in Science. Its international team of authors concluded that 80 percent of new cases in China seemed to have come from people who did not know they were ill.

A big unknown: Are all these efforts something we can keep up?

Right now, there are still too many unknowns to know how — and when — any particular population will attain protective herd immunity. In the coming weeks, disease-trackers will be closely watching the number of new U.S. cases as well as the total number of tests. This may give a good sense of whether social distancing is working in a particular place.

“It’s been amazing to see the swing in society over the past week,” Mina said on March 17. “Nearly everyone has gotten on board.” But he worries about how well people can keep up such strict measures as the weeks wear on. “Societal forces may end up overwhelming the science.”

.image-mobile { display: none; } @media (max-width: 400px) { .image-mobile { display: block; } .image-desktop { display: none; } } COVID-19: When will it be safe to go out again? published first on https://triviaqaweb.tumblr.com/

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voiceofmigrants · 5 years ago

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Why are migrant children dying in U.S. custody?

By Nicole Acevedo

At least seven children are known to have died in immigration custody since last year, after almost a decade in which no child reportedly died while in the custody of U.S. Customs and Border Protection. The string of cases continue to raise questions around the conditions in which migrant children are being kept at a time when a growing number of migrants, many of them Central American parents with children, are presenting themselves at the border to seek asylum. Aside from the fact that children may have underlying health conditions, most are reaching the United States after arduous journeys during which they have had little access to clean shelter and proper provisions. Many are leaving impoverished and drought-stricken regions.

But the deaths under President Donald Trump's watch have health professionals and some advocates questioning whether the administration's immigration policies — particularly keeping minors in custody for longer periods — are contributing to more minors getting sick and dying while in custody or shortly after they are released. “Children are not like adults. They get sick more quickly and each hour of delay can be associated with serious complications, especially in cases of infectious diseases. Delays can lead to death,” Dr. Julie Linton, co-chair of the immigrant health special interest group at the American Academy of Pediatrics, told NBC News.

The most recent known case is that of Carlos Gregorio Hernández Vásquez. The teenager died in CBP custody this month after being diagnosed with the flu, an infectious disease. In December, medical examiners concluded that 7-year-old Jakelin Caal Maquin, who also died in CBP custody, succumbed to "a rapidly progressive infection" that shut down her vital organs. CBP sent Jakelin on a 90-mile bus ride to another location after she was taken into custody, even though her father had told officials she was vomiting and feeling ill before they left.

CBP officials said last year that Jakelin waited an hour and a half to receive emergency medical care after showing symptoms. Deaths of several other migrant children were reported in just eight months following her death. “We do not need to be talking about the prolonged detention of children. It is dangerous,” Linton said. Seven months before Jakelin's death, 1-year-old Mariee Juarez died after being released from U.S. Immigration and Customs Enforcement custody. Yazmin Juarez and her daughter Mariee, who came seeking asylum from Guatemala. Yazmin Juarez and her daughter, Mariee, came seeking asylum from Guatemala.Courtesy Yazmin Juarez

Mariee died from complications of a respiratory illness her mother and lawyers say she allegedly developed while detained. CBP holding facilities are “basically concrete floors with mats and barbed wire fencing and bright lights 24/7,” Linton said. “That can be a very disorienting environment to children.” Leah Chavla, an international human rights lawyer and policy adviser at the Women's Refugee Commission, has worked with families who have raised many concerns over CBP facilities being “inadequate.” “Families have come with concerns about lack of hygiene, being crammed into holding cells, being served food that has not fully cooked or nutritionally appropriate for kids … being woken up throughout the night," Chavla told NBC News.

The CBP holding facilities are often referred to by the people held in them as "hieleras," which translates to icebox or cooler, because of their frigid temperatures. A Human Rights Watch report about these conditions pointed out that children were sleeping under thin Mylar blankets or foil wrappers. Wilmer Josué Ramírez Vásquez, a 2½-year-old, died this month after being detained by Border Patrol in early April and spending about a month in a hospital, where he was diagnosed with pneumonia. Courtesy : NBC

#African Migrants #Child Refugees #Donald Trump #Migrant Crisis #Save Children #United States #World

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jerrytackettca · 6 years ago

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Awkward Flu Jabs Attempted at Golden Globes

In what can only be described as a new level of propaganda, hosts Andy Samberg and Sandra Oh featured a flu shot stunt during the 76th Golden Globe Awards ceremony. They told the audience to roll up their sleeves, as they would all be getting flu shots, while people in white coats stormed down the aisles, syringes in hand.

Most of the audience looked thoroughly uneasy at the prospect of having a stranger stick them with a needle in the middle of an awards show. But perhaps the worst part of the scene was when Samberg added that anti-vaxxers could put a napkin over their head if they wanted to be skipped, basically suggesting that anyone opposed to a flu shot deserved to be branded with a proverbial scarlet letter.

The flu shots, for the record, were reportedly fake,1 nothing more than a bizarre gag that left many people stunned by the Globe's poor taste in turning a serious medical choice into a publicity gimmick.

Flu Shot Stunt Reeks of Desperation

Whoever came up with the idea to turn the Golden Globes into a platform for a public health message probably thought it was ingenious, but the stunt only serves as a seemingly desperate attempt to make flu shots relevant and in vogue. During the 2017 to 2018 flu season, only 37 percent of U.S. adults received a flu shot, a 6 percent drop from the prior season.2

"To improve flu vaccination coverage for the 2018-19 flu season, health care providers are encouraged to strongly recommend and offer flu vaccination to all of their patients,” the U.S. Centers for Disease Control and Prevention (CDC) wrote. “People not visiting a provider during the flu season have many convenient places they can go for a flu vaccination."3

Yet, perhaps the decline in people choosing to get vaccinated has nothing to do with convenience and everything to do with their dismal rates of efficacy. In the decade between 2005 and 2015, the influenza vaccine was less than 50 percent effective more than half of the time.4

The 2017/2018 flu vaccine was a perfect example of this trend. The overall adjusted vaccine effectiveness against influenza A and B virus infection was just 36 percent.5

Health officials blamed the flu season’s severity on the dip in vaccination rates, but as Dr. Paul Auwaerter, clinical director of the division of infectious diseases at Johns Hopkins University School of Medicine, told USA Today, “[I]t is also true that the vaccine was not as well matched against the strains that circulated."6

But bringing flu shots to the Golden Globes, and calling out “anti-vaxxers,” is nothing more than “medical care, by shame,” noted Dr. Don Harte, a chiropractic activist in California. “But it was entertaining, in a very weird way, including the shock and disgust of some of the intended victims, notably [Willem Dafoe],” he said, adding:7

"This Hollywood publicity stunt for the flu vaccine is one of the stupidest things I've ever seen from celebrities. But it does go with the flu shot itself, which is, perhaps, the stupidest of all the vaccines available."

Did 80,000 People Really Die From the Flu Last Year?

The CDC reported that 79,400 people died from influenza during the 2017/2018 season, which they said "serves as a reminder of how severe seasonal influenza can be."8 It's important to remember, however, that the 80,000 deaths figure being widely reported in the media is not actually all "flu deaths."

According to the CDC, “We look at death certificates that have pneumonia or influenza causes (P&I), other respiratory and circulatory causes (R&C), or other nonrespiratory, noncirculatory causes of death, because deaths related to flu may not have influenza listed as a cause of death."9

As for why the CDC doesn’t base flu mortality estimates only on death certificates that list influenza, they noted, “Seasonal influenza may lead to death from other causes, such as pneumonia, congestive heart failure or chronic obstructive pulmonary disease … Additionally, some deaths — particularly among the elderly — are associated with secondary complications of seasonal influenza (including bacterial pneumonias)."10

In other words, "flu deaths" are not just deaths directly caused by the influenza virus, but also secondary infections such as pneumonia and other respiratory diseases, as well as sepsis.11

According to the CDC, most of the deaths occurred among those aged 65 years and over, a population that may already have preexisting conditions that makes them more susceptible to infectious diseases. As Harte said of annual flu deaths, “[M]ost if not all, I would assume, are of people who are already in very bad shape.12

CDC Claims Flu Vaccine Reduces Flu Deaths in the Elderly — But Does It?

Since people aged 65 and over are those most at risk from flu complications and death, the CDC has been vocal in their claims that the flu shot significantly reduces flu-related deaths among this population. The research, however, says otherwise.

Research published in 2005 found no correlation between increased vaccination rates among the elderly and reduced mortality. According to the authors, "Because fewer than 10 percent of all winter deaths were attributable to influenza in any season, we conclude that observational studies substantially overestimate vaccination benefit."13

A 2006 study also showed that even though seniors vaccinated against influenza had a 44 percent reduced risk of dying during flu season than unvaccinated seniors, those who were vaccinated were also 61 percent less like to die before the flu season ever started.14

This finding has since been attributed to a "healthy user effect," which suggests that older people who get vaccinated against influenza are already healthier and, therefore, less likely to die anyway, whereas those who do not get the shot have suffered a decline in health in recent months.

Journalist Jeremy Hammond summed up the CDC's continued spreading of misinformation regarding the flu vaccine's effectiveness in the elderly, as they continue to claim it's the best way to prevent the flu:15

"[T]here is no good scientific evidence to support the CDC's claim that the influenza vaccine reduces hospitalizations or deaths among the elderly.

The types of studies the CDC has relied on to support this claim have been thoroughly discredited due to their systemic 'healthy user' selection bias, and the mortality rate has observably increased along with the increase in vaccine uptake — which the CDC has encouraged with its unevidenced claims about the vaccine's benefits, downplaying of its risks, and a marketing strategy of trying to frighten people into getting the flu shot for themselves and their family."

Death of Vaccinated Child Blamed on Not Getting Second Dose

In January 2019, the state of Colorado reported the first child flu death of the 2018/2019 flu season — a child who had received influenza vaccination. But instead of highlighting the vaccine's failure and clear limitations, the Colorado Department of Public Health and Environment blamed the death on the child being only "partially vaccinated."

"It's an unfortunate but important reminder of the importance of two doses of influenza vaccine for young children who are receiving influenza vaccine for the first time," Dr. Rachel Herlihy, who is the state communicable disease epidemiologist, said in a news release.16 For those who aren't aware, the CDC notes that one dose of flu shot may not be enough to protect against the flu. Instead, they state:17

"Children 6 months through 8 years getting vaccinated for the first time, and those who have only previously gotten one dose of vaccine, should get two doses of vaccine this season …

The first dose 'primes' the immune system; the second dose provides immune protection. Children who only get one dose but need two doses can have reduced or no protection from a single dose of flu vaccine."

Not only may the flu vaccine fail to provide protection against the flu, but many people are not aware that other types of viruses are responsible for about 80 percent of all respiratory infections during any given flu season.18 The flu vaccine does not protect against or prevent any of these other types of respiratory infections causing influenza-like illness (ILI) symptoms.

The chance of contracting actual type A or B influenza, caused by one of the three or four influenza virus strains included in the vaccine, is much lower compared to getting sick with another type of viral or bacterial infection during the flu season.

Does Flu Vaccine Increase the Risk of Influenza Infection, Contribute to Vaccine Shedding?

There are serious adverse effects that can come along with annual flu vaccination, including potentially lifelong side effects such as Guillain Barré syndrome and chronic shoulder injury related to vaccine administration (SIRVA). They may also increase your risk of contracting more serious flu infections, as research suggests those who have been vaccinated annually may be less protected than those with no prior flu vaccination history.19

Research presented at the 105th International Conference of the American Thoracic Society in San Diego also revealed that children who get seasonal flu shots are more at risk of hospitalization than children who do not. Children who had received the flu vaccine had three times the risk of hospitalization as children who had not. Among children with asthma, the risk was even higher.20

There's also the potential for vaccine shedding, which has taken on renewed importance with the reintroduction of the live virus vaccine FluMist during the 2018/2019 season. While the CDC states that the live flu virus in FluMist is too weak to actually give recipients the flu, research has raised some serious doubts that this is the case.

One recent study revealed not only that influenza virus may be spread via simple breathing (i.e., no sneezing or coughing required) but also that repeated vaccination increases the amount of virus released into the air.21

MedImmune, the company that developed FluMist, is aware that the vaccine sheds vaccine-strain virus. In its prescribing information, they describe a study on the transmission of vaccine-strain viruses from vaccinated children to nonvaccinated children in a day care setting.

In 80 percent of the FluMist recipients, at least one vaccine-strain virus was isolated anywhere from one to 21 days following vaccination. They further noted, "One placebo subject had mild symptomatic Type B virus infection confirmed as a transmitted vaccine virus by a FluMist recipient in the same playgroup."22

Are There Other Ways to Stay Healthy During Flu Season?

Contrary to the CDC’s and Golden Globe’s claims that flu vaccinations are a great way to prevent flu, other methods exist to help you stay healthy during the flu season and all year, and they’re far safer than annual flu vaccination. Vitamin D testing and optimization have been shown to cut your risk of respiratory infections, including colds and flu, in half if you are vitamin D deficient, for instance.23,24

In my view, optimizing your vitamin D levels is one of the absolute best respiratory illness prevention and optimal health strategies available. Influenza has also been treated with high-dose vitamin C,25 and taking zinc lozenges at the first sign of respiratory illness can also be helpful.

Following other basic tenets of health, like eating right, getting sound sleep, exercising and addressing stress are also important, as is regularly washing your hands.

from http://articles.mercola.com/sites/articles/archive/2019/01/29/golden-globes-flu-shot-stunt.aspx

source http://niapurenaturecom.weebly.com/blog/awkward-flu-jabs-attempted-at-golden-globes

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paullassiterca · 6 years ago

Text

Awkward Flu Jabs Attempted at Golden Globes

youtube

The flu shots, for the record, were reportedly fake,1 nothing more than a bizarre gag that left many people stunned by the Globe’s poor taste in turning a serious medical choice into a publicity gimmick.

Flu Shot Stunt Reeks of Desperation

“To improve flu vaccination coverage for the 2018-19 flu season, health care providers are encouraged to strongly recommend and offer flu vaccination to all of their patients,” the U.S. Centers for Disease Control and Prevention (CDC) wrote. “People not visiting a provider during the flu season have many convenient places they can go for a flu vaccination.”3

The 2017/2018 flu vaccine was a perfect example of this trend. The overall adjusted vaccine effectiveness against influenza A and B virus infection was just 36 percent.5

"This Hollywood publicity stunt for the flu vaccine is one of the stupidest things I’ve ever seen from celebrities. But it does go with the flu shot itself, which is, perhaps, the stupidest of all the vaccines available.”

Did 80,000 People Really Die From the Flu Last Year?

The CDC reported that 79,400 people died from influenza during the 2017/2018 season, which they said “serves as a reminder of how severe seasonal influenza can be.”8 It’s important to remember, however, that the 80,000 deaths figure being widely reported in the media is not actually all “flu deaths.”

In other words, “flu deaths” are not just deaths directly caused by the influenza virus, but also secondary infections such as pneumonia and other respiratory diseases, as well as sepsis.11

CDC Claims Flu Vaccine Reduces Flu Deaths in the Elderly — But Does It?

Research published in 2005 found no correlation between increased vaccination rates among the elderly and reduced mortality. According to the authors, “Because fewer than 10 percent of all winter deaths were attributable to influenza in any season, we conclude that observational studies substantially overestimate vaccination benefit.”13

This finding has since been attributed to a “healthy user effect,” which suggests that older people who get vaccinated against influenza are already healthier and, therefore, less likely to die anyway, whereas those who do not get the shot have suffered a decline in health in recent months.

Journalist Jeremy Hammond summed up the CDC’s continued spreading of misinformation regarding the flu vaccine’s effectiveness in the elderly, as they continue to claim it’s the best way to prevent the flu:15

“[T]here is no good scientific evidence to support the CDC’s claim that the influenza vaccine reduces hospitalizations or deaths among the elderly.

The types of studies the CDC has relied on to support this claim have been thoroughly discredited due to their systemic ‘healthy user’ selection bias, and the mortality rate has observably increased along with the increase in vaccine uptake — which the CDC has encouraged with its unevidenced claims about the vaccine’s benefits, downplaying of its risks, and a marketing strategy of trying to frighten people into getting the flu shot for themselves and their family.”

Death of Vaccinated Child Blamed on Not Getting Second Dose

In January 2019, the state of Colorado reported the first child flu death of the 2018/2019 flu season — a child who had received influenza vaccination. But instead of highlighting the vaccine’s failure and clear limitations, the Colorado Department of Public Health and Environment blamed the death on the child being only “partially vaccinated.”

“It’s an unfortunate but important reminder of the importance of two doses of influenza vaccine for young children who are receiving influenza vaccine for the first time,” Dr. Rachel Herlihy, who is the state communicable disease epidemiologist, said in a news release.16 For those who aren’t aware, the CDC notes that one dose of flu shot may not be enough to protect against the flu. Instead, they state:17

“Children 6 months through 8 years getting vaccinated for the first time, and those who have only previously gotten one dose of vaccine, should get two doses of vaccine this season …

The first dose 'primes’ the immune system; the second dose provides immune protection. Children who only get one dose but need two doses can have reduced or no protection from a single dose of flu vaccine.”

Does Flu Vaccine Increase the Risk of Influenza Infection, Contribute to Vaccine Shedding?

There’s also the potential for vaccine shedding, which has taken on renewed importance with the reintroduction of the live virus vaccine FluMist during the 2018/2019 season. While the CDC states that the live flu virus in FluMist is too weak to actually give recipients the flu, research has raised some serious doubts that this is the case.

In 80 percent of the FluMist recipients, at least one vaccine-strain virus was isolated anywhere from one to 21 days following vaccination. They further noted, “One placebo subject had mild symptomatic Type B virus infection confirmed as a transmitted vaccine virus by a FluMist recipient in the same playgroup.”22

Are There Other Ways to Stay Healthy During Flu Season?

Following other basic tenets of health, like eating right, getting sound sleep, exercising and addressing stress are also important, as is regularly washing your hands.

from Articles http://articles.mercola.com/sites/articles/archive/2019/01/29/golden-globes-flu-shot-stunt.aspx source https://niapurenaturecom.tumblr.com/post/182391544281

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jakehglover · 6 years ago

Text

Awkward Flu Jabs Attempted at Golden Globes

youtube

Flu Shot Stunt Reeks of Desperation

The 2017/2018 flu vaccine was a perfect example of this trend. The overall adjusted vaccine effectiveness against influenza A and B virus infection was just 36 percent.5

Did 80,000 People Really Die From the Flu Last Year?

In other words, "flu deaths" are not just deaths directly caused by the influenza virus, but also secondary infections such as pneumonia and other respiratory diseases, as well as sepsis.11

CDC Claims Flu Vaccine Reduces Flu Deaths in the Elderly — But Does It?

"[T]here is no good scientific evidence to support the CDC's claim that the influenza vaccine reduces hospitalizations or deaths among the elderly.

Death of Vaccinated Child Blamed on Not Getting Second Dose

"Children 6 months through 8 years getting vaccinated for the first time, and those who have only previously gotten one dose of vaccine, should get two doses of vaccine this season …

Does Flu Vaccine Increase the Risk of Influenza Infection, Contribute to Vaccine Shedding?

Are There Other Ways to Stay Healthy During Flu Season?

Following other basic tenets of health, like eating right, getting sound sleep, exercising and addressing stress are also important, as is regularly washing your hands.

from HealthyLife via Jake Glover on Inoreader http://articles.mercola.com/sites/articles/archive/2019/01/29/golden-globes-flu-shot-stunt.aspx

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prosperopedia · 6 years ago

Text

Fixing the United States Healthcare System in Three Steps

Since the very first times I can remember paying for my own healthcare expenses – shortly after I became an adult – I’ve often found myself puzzled at how healthcare is done in America and wondering why it often seems so inefficient and expensive. As a now two-decades-long consumer (a purchase-with-my-own-hard-earned-money kind of healthcare consumer) of healthcare for myself and my family members, I’ve found a need to self-educate on a micro and macro level.

Over the past twenty years, I’ve learned as much as I can about health care premiums, deductibles, maximum out-of-pocket, healthcare provider networks, how billing is done, and many other aspects of the convoluted labyrinth that comprises the contemporary healthcare system in the United States. I’ve often wondered how things got to be this way, in the most prosperous, most innovative country known to this planet. I’ve also tried to articulate, based upon my limited experiences along with information from discussions with doctors, hospital administrators, insurance agents, medical products manufacturers, and lots of others in the healthcare industry.

Today I read a recently-written article by John Steele Gordon in the Imprimis monthly publication distributed by Hillsdale College. The article is titled, “A Short History of American Medical Insurance.” The points made in Mr. Gordon’s article sum up what I’ve observed to be the most direct answers to the problem most Americans face when it comes to an inefficient and exorbitant healthcare system. I’ll summarize the three-pronged solution here really quickly for you. Then I’ll review the history and background that makes this solution so practical.

To fix the broken healthcare system that exists today in the United States of America, these three things need to be done:

1: Medical providers need to be required to make the prices for their procedures publicly available for consumers.

As with other markets that operate more efficiently, when consumers have sufficient information about pricing and can compare options, competition lowers prices and makes the market much more efficient.

2: Fix the out of control malpractice lawsuit racket by requiring those who sue meritlessly and lose to pay not only their own legal fees, but also the defense fees of those they have sued.

When a situation exists that makes it profitable to wrongly accuse healthcare providers of malpractice, fraud and abuse naturally enter the system and create substantial waste. Reports from two of the most influential organizations in healthcare provider liability insurance, American Society for Healthcare Risk Management ASHRM and the Physicians Insurers Association of America (PIAA) estimate that the cost of each claim “closed with no indemnity” (meritless) to be between $17,400 and $24,000 for defense related expenses. It is estimated that only about 24% of malpractice cases result in valid claims for which indemnity payments must be made to claimants.

3: Increase the accountability healthcare consumers have for the cost of the healthcare they’re purchasing. Get rid of the cost abstraction that’s done through the current health insurance scenario.

Today’s “insurance” policies are not really insurance. Instead, it’s a “very expensive pre-payment plan that jacks up premiums,” as described by Mr. Gordon.

When I pay for insurance for my car, I don’t expect it to cover oil changes, gas, and wear on the tires. However, the expectation that has arisen out of the current healthcare environment has caused insured consumers to have their plans cover things like flu shots and minor illnesses and injuries that should not be covered, but should be paid for out of pocket.

Make pricing from healthcare providers publicly available.

Crack down on meritless medical malpractice lawsuits.

Increase consumer price accountability for healthcare product and services.

How Did We Get Here?

The historical innovation that has created healthcare products and services that make us much more comfortable and that have allowed us to live longer seems to have been absent from the factors that have created what we now experience with healthcare.

John Steel Gordon in his article reviews the historical costs of healthcare in this country. In 1930, healthcare expenses by Americans made up only 3.5% of our Gross Domestic Product. In 2015, that figure had moved up to 15%. Something happened over that 85-year period that skyrocketed healthcare costs so much that it becomes obvious that there is something else involved besides standard market economics. During the 1980s, healthcare costs went up 117%. After the experts account for increases due to factors such as general inflation, an aging population and expensive advances in technology, there is still a missing 24% of that total increase that is unaccounted for. The extra 24% can be attributed to the combination of two major developments. A new hospital-centered insurance cartel emerged in the medical industry the early- to mid-1900s. This cartel is now the accepted norm for medical treatment. Corresponding to the formation and propagation of the cartel was the removal of price transparency from that healthcare related services .

I will describe two major developments that led to what we experience in modern times as simply unaffordable healthcare.

Insurance for Hospital Visits

Before the 1900s, medical treatments were most commonly done in a person’s home, through doctor visits, or at small clinics operated by medical professionals. During a period spanning nearly a century, from 1873 to the late 1900s, the number of hospitals in the United States went from 149 to over 7,000. The nature of a hospital also changed at the beginning of that time period. Whereas they had been simply a place for the sick and the old to die, like a modern day hospice, they became medical clinic centers and cutting edge medical research institutions.

To become and remain profitable, hospitals in the early 1900s had to find a way to build a subscriber base, people who would pay consistent premiums to have access to the hospital’s resources.

Baylor University’s insurance plan for school teachers in the Dallas area, who paid $6 annually in exchange for up to 21 days in the Baylor hospital, was launched in 1929. The model provided cash flow to the hospital which offset and overcame the large fix costs it incurred.

This hospital “insurance” model worked well. Blue Cross adopted it in 1932. This system generated a steady demand for medical services and a consistent cash flow. However, this wasn’t really “insurance”, as the plans covered pretty much everything a person could need up to a certain limit.

This model differed from insurance in another important way. They didn’t provide indemnification payments to those covered, who would use the payment to shop for the best option for them. Instead, this version of insurance paid the bill for services used at the hospital in a way that made it appear not important to the consumer how much the service cost.

Other hospitals had to follow this model to be able to compete.

Employer-Paid Health Insurance Benefits

During World War II, the federal government enacted wage and price controls because of the tight labor market. To attract talent and manpower, and without the ability to offer higher salaries, companies began offering healthcare benefits to employees.

Employers’ payment of healthcare served to further distance people from the cost of their medical expenses. It also led to a lack of plan fluidity, as employees essentially had little other option than to “choose” the healthcare plan their employer provided.

In recent years, as small businesses and those who choose to work for themselves as contractors or simply self-employed, there are some options that are springing up, but those options are still very limited.

Catastrophic health plans pretty much disappeared with the introduction of Obamacare in 2010. [I like to tell people that Obamacare essentially made ALL health insurance plans catastrophic.] In recent years, health share options and others alternatives to employer plans have been promoted to provide flexibility in choice and cost, but those plans still tend to have too many unknowns to make the generally practical as they attempt to find a place among the rest of the health insurance world.

Can Our Failing Healthcare Environment Be Fixed?

As described above, there are some major flaws in the structure of our healthcare system that don’t seem like they can be easily removed, like a metastasized tumor. There are lobbyists and those they represent who are making far too much money to allow their golden goose to be easily moved. Also, the public servant mentality miraculously found among those who founded this country and led it in its infancy seems to have all but disappeared from Washington, DC as well as from the mines of power opportunities in state governments.

Can our healthcare issue be fixed? We can only hope. It would take a miracle.

In the meantime, the best approach I’ve found is to be highly accountable for your own health, and to depend as little as possible upon the public system. Eat healthy. Exercise. Try to avoid major unnecessary risks (like riding a motorcycle or skydiving).

And hope that something better comes along.

The post Fixing the United States Healthcare System in Three Steps appeared first on The Handbook for Happiness, and Success, and Prosperity Prosperopedia.

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#Prosperity #Wealth #Riches

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sherristockman · 7 years ago

Link

Top Tips to Boost Your Immunity Dr. Mercola By Dr. Mercola While many people may find themselves succumbing to the common cold and other respiratory illnesses that are so prevalent in the winter, there are several things you can do (and not do) to help keep yourself in top form. Some may not even seem to be an important part of staying healthy, but they are. When it comes to averting sickness, even while all-around you people might be coughing, sneezing and blowing their noses, successfully running the gauntlet of flu season may be simply a matter of keeping your immune system boosted by applying a few key health strategies. Besides going to school and work, times your immune system might be especially compromised include when you travel or are sleep deprived or stressed out. These are times you want to make sure your immune system is at its best. Nutrition may be the most vital component in maintaining — or gaining — a healthy immune system. It makes all the difference in the way your body fights off germs, but just as importantly, plays an important role in more minute functions like helping tissues repair and rebuild themselves and how your body reclaims flagging energy. Foods (and the Nutrients Therein) to Boost Your Immune System Not just vitamins and minerals, but proteins like collagen and free radical-fighting antioxidants can be introduced to your body through the foods you eat, and play vital roles in helping to keep your body functioning at its best. As the Chicago Tribune observes: “Collagen and its amino acids are essential to healing because they build tissues such as skin, muscles, tendons, ligaments, cartilage, blood vessels, bones and more. Antioxidants remove the harmful free radicals from the bloodstream that can impair the immune system, and vitamins and minerals play specialized roles in healing.”1 In the same way that cross training can keep your body fit and toned by working groups of different muscles, eating a variety of foods will target and work toward healing and restoring many different areas of your body, from your brain to your gut to your immune system. Protein found in lean meats, bone broth, fish, eggs, nuts and seeds help your body repair tissue and fight infection. Studies show that amino acids in protein, such as arginine and glutamine, increase your body’s ability to heal and decrease inflammation.2 Vitamins and Minerals to the Immune System Rescue Eating foods chock-full of vitamins is an excellent way to strengthen your immune system to stay healthy all season: Vitamin A boosts immunity, lowers your risk of infection and supports wound healing through collagen strength. Snack on carrots, squash, sweet potatoes, dark leafy greens, cantaloupe, wild-caught Alaskan salmon, organic pastured eggs and grass fed beef. Vitamin D plays a big part in immune health and can be found in limited quantities in raw grass fed milk, wild-caught Alaskan salmon and organic pastured eggs, but the ideal way to optimize your levels is via sunshine Some of the most vitamin C-rich foods include citrus fruits, from tangerines to limes, along with leafy greens, bell peppers and broccoli. Berries are another great source, and they all provide this and other potent antioxidants, which support your immune response and help to rebuild collagen. Vitamin K1, important for healthy blood clotting, is abundant in dark leafy green vegetables. Vitamin K2 refers to a collection of bacterial menaquinones (MKs) that are found in a variety of different foods, namely animal foods and fermented foods. MK-4 is most abundant in animal foods while you can find MK-7, MK-8 and MK-9 in fermented foods. Important for collagen production, zinc is another protective antioxidant that helps create and activate your immune system’s white blood cells and is essential in the enzymatic reactions needed for wound healing. Zinc-containing foods include grass fed red meat (optimal amounts per day range from 5 to 7 ounces), pastured, organic chicken, spinach, nuts and pumpkin seeds. Selenium is another powerful antioxidant for immune system protection, found in Brazil nuts and organic, grass fed beef, turkey and chicken. In addition, as important as any food you eat, drinking adequate water is vital for flushing food through your system, flushing toxins and keeping your body hydrated. Many turn to so-called “sports drinks” for hydrating while working out, but clear, pure water is the ideal beverage. Immune-Strengthening Vitamins: ‘B’ Is for Boost B vitamins may constitute a long list, but each one is important for different reasons. Other “B’s” for boosting your immunity are especially effective when you combine the foods containing them so they can all work together for maximum effect. These include vitamin B1 (thiamin), B2 (riboflavin), B3 (niacin), B5 (pantothenic acid) and B7 (biotin). B12, also known as cobalamin, is a powerful cold- and flu-fighting nutrient in your system, as is vitamin B6, another important, germ-combating vitamin that naturally benefits and strengthens your immune system and even protects against the damaging effects of air pollution. Vitamin B9 and folic acid help repair tissues and aid in cell metabolism and immune support. They’re found in dark leafy greens, wild-caught, cold water fish like herring, mackerel, sardines, anchovies and wild-caught Alaskan salmon, and pastured, organic chicken. Nutritional yeast and other foods fortified with B12 present one way vegetarians (or anyone else, for that matter) can augment their B12 intake through their diet. Raw, organic grass fed milk, yogurt and cheese are additional options with naturally high B12 content. Optimizing Your Gut Health With Probiotics The health benefits derived from probiotics are rooted in balancing your intestinal bacteria. One of the easiest and quickest ways to do that is by eating fermented vegetables, which have long been a mainstay in many ancient cultures. However, it’s only been in recent decades that this method of optimizing gut health has reemerged. The traditional method for preparing fermented vegetables is very much like it was thousands of years ago. Fermenting helps introduce friendly bacteria to your system and is one of the best ways to optimize your immune system, about 80 percent of which resides in your gastrointestinal tract. It’s not an overstatement to say it’s a key line of defense against pathogens, as well as an aid in the production of antibodies. Aside from fermented vegetables, one of the most healthful fermented foods is kefir, an enzyme-rich food full of friendly microorganisms that help balance your microbiome as well as strengthen your immune defenses. Other beneficial fermented foods include natto, kimchi, pickles, sauerkraut, miso, tempeh and raw grass fed yogurt, but make sure you watch out for added sugar in most commercial varieties. The fact that including probiotics in your diet has been shown to reduce incidences of psoriasis, colitis, allergies and many other diseases and conditions is a testament to their effectiveness in protecting your immune system. In addition, pregnant women who take probiotics help reduce their child’s risk of developing allergies.3 Fiber to Optimize Digestion and ‘Up’ Your Immunity Not only does fiber help balance your gut microbiome, it, too, helps improve your immune system, as resistant starches act as prebiotics to feed healthy bacteria in your gut. As a result, it promotes bowel movements and keeps waste moving smoothly through your colon, while at the same time benefiting your heart health and controlling your blood sugar. There are two types of fiber: soluble, which easily dissolves in water and becomes gel-like, and insoluble, which doesn’t dissolve but stays basically intact as it moves through your colon; both types are important for digestion. Eating a fiber-rich diet, which in turn may improve the microbial diversity in your gut, may be linked to better responses during immunotherapy cancer treatment.4 In fact, your gut microbiome more directly influences your health and disease than previously thought. The fact is, your diet can make or break not just the ecosystem in which your gut bacteria reside, but your mental health as well. And it’s not just the food you eat but all kinds of other factors, including the chemicals and pollution you’re exposed to, and all of it can alter the composition of gut bacteria and thereby influence your immune system health. As the Belfast Telegraph notes, “Want to avoid winter flu? Start eating with your gut in mind. Studies have found that having a healthy microbiome is important in fostering a strong immune system and keeping us healthy.”5 Getting Your Z’s: Not Optional for Optimal Immunity Sleep is something that kids may resist, but as adults start the “adulting” that comes with jobs, growing families and paying the mortgage, sleep is something that can all too often go by the wayside. Studies show that not getting the sleep you need — for most people eight hours is the minimum for functioning at your best — can compromise your health in ways you may not have considered. In fact, several nights in a row with less than restful, adequate sleep puts your body at greater risk for illness. Some of the ways lack of sleep manifests itself in disease include: Dementia, including Alzheimer’s disease Diabetes, which is true even for children6 Increased cardiovascular disease, especially for African-Americans7 Higher incidence of depression and anxiety8 Increased risk of obesity Another study notes that cutting just one hour of sleep a night increases the expression of genes associated with inflammation, immune excitability, diabetes, cancer risk and stress.9 Consistently sleeping less than six hours a night increases your risk for numerous psychological and physical effects. The upshot is, lack of sleep quickly decreases your immune function, leaving your system wide-open for environmental influences, including viruses like colds and flu, that you would feel much better off if you avoided. Sugar: Just As Bad for You Now as It Ever Was If you were looking for a food to eat that would compromise your health in numerous ways and absolutely ruin your health, sugar in its many forms — and there are several, thanks to ever-changing food manufacturing gimmicks and money-making strategies — would win the prize. Not only is sugar identified as a carcinogen,10 it’s also contributing to the ever-increasing rates of chronic disease in the U.S. and throughout the world. In the last century, sugar has become a daily habit that happens to coincide with increasing rates of obesity, Type 2 diabetes, heart disease, cancer and other chronic illnesses. One of the most insidious ways sugar works in your body is to damage both mitochondrial function and energy production, which triggers cell mutations that are then fed by continued sugar consumption. What’s amazing is the number of ways sugar can show up, depending on the labels, in the foods you buy at the grocery store, including fruit juices, high fructose corn syrup (HFCS), evaporated cane juice, pancake syrup and cane juice, just to name a few, and the sugar industry has been manipulating the data for decades for the purpose of increasing profits. To keep your immune system functioning at its best, one of the most effective strategies is to avoid sugar, pure and simple. It’s hard to do, though certainly doable, even if you know you’re suffering from a bad case of sweet tooth; research indicates that sugar impacts the function of dopamine in your brain, the neurotransmitter that triggers your reward system, in the same way narcotics affect your brain, and may trigger a strong addictive response.11 More Tips for Keeping Your Immune System in Tip-Top Shape Whether your body is in recovery mode or you want to stave off the bug-of-the-month that might be going around at work or school, there are a few more options to prepare your system to fight back. One way to pack vitamins, minerals and other powerful nutrients into your day is to pack your blender or food processor with the makings for a super smoothie, making use of ingredients like spinach and other dark, leafy greens, carrots, berries like raspberries and strawberries, and even pumpkin seeds and Brazil nuts. For a different (and more decadent) flavor, try going the chocolate route for your smoothie, but stick with dark chocolate with the lowest sugar content you can find for the antioxidant and anti-inflammatory effects courtesy of beneficial compounds such as epicatechin and resveratrol, known for being neuroprotective. Cacao also benefits your brain, nervous system, heart and blood vessels while helping to combat diabetes and other inflammation-related conditions. Eating locally grown foods that are in season is better nutritionally because foods that are picked at peak ripeness and placed on shelves quickly retain the optimal amount of nutrients compared to foods shipped from long distances. These foods are also sometimes injected or sprayed with chemicals to either slow down or speed up the ripening process or otherwise make them appear fresher. Fruits that are “in season” in winter include oranges, kiwifruit, cactus pear, dates, cherimoya, mandarins, red currants and passion fruit. Vegetables have their own season in which they grow best and offer the highest nutritional profile, and in winter this includes sweet potatoes, leeks, turnips, Brussels sprouts, kale, Belgian endive and winter squash varieties. Last, but certainly not least, keeping stress out of your life, at least to the highest degree possible, will go a long way toward preparing yourself to live disease- and even flu-free. As Rediff.com12 maintains, there are several ways you can help protect your immunity: Avoid processed foods, as they make you vulnerable to developing chronic conditions Avoid excessive alcohol, which can impede the functioning of immune cells Avoid obesity, as it can affect the ability of white blood cells to multiply, produce antibodies and prevent inflammation Include activity, especially if you know you’re not getting enough; as little as 20 minutes of walking five days a week can increase your immune system function Avoid taking unnecessary medications, as even nonprescription drugs, antibiotics and cold and fever fighting medications may weaken your immune system Additionally: “Chronic stress can make you more susceptible to colds and the flu, as well as more serious health problems like heart disease, diabetes and other diseases. By practicing stress-reducing activities like yoga, meditation and laughter, you can keep your body from going into chronic stress mode.”13

#VitalityPath

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liliannorman · 5 years ago

Text

COVID-19: When will it be safe to go out again?

As COVID-19 sweeps across the globe, everyone seems to be asking: When will the coronavirus pandemic — and social distancing — end?

The disappointing answer: No one knows for sure. Here’s what we do know about when it may be safe to come out of our homes and resume normal life.

It will almost certainly take herd immunity to end the pandemic.

How to cope as COVID-19 imposes social distancing

For COVID-19, that threshold may be two out of every three people.

Explainer: What is a coronavirus?

How — and how much — people interact can make a big difference in that R0.

Letting the virus burn through the population would be the fastest approach.

People acquire immunity against a virus in two ways: recovering from an infection or getting a vaccine.

Search speeds up for vaccine against the new coronavirus

The role of models

Over time, those predictions will be challenged and tested.

Quicker herd immunity would make conditions harder for doctors.

Almost anyone can fall ill

Severe outcomes of U.S. COVID-19 cases by age

C. Chang

That’s why countries around the world have focused on social distancing. They are trying to slow the surge in new cases and lessen the strain on hospitals.

Social distancing delays herd immunity.

“In the absence of robust herd immunity at the population level,” he says, “we have some risk of a second wave of the epidemic.”

Social distancing will need to last up to 3 months, maybe longer.

See all our coverage of the new coronovirus outbreak

Hospitals could get a big break if spread of the new virus slows with warmer weather. But for now, there are no sure signs that will happen.

Until a vaccine becomes available, potentially in 12 to 18 months, a report on the model argues that major social distancing measures will be needed.

Wider diagnostic testing could ease the need for extensive social distancing.

South Korea, for instance, reported its highest number of new cases, 909, on February 29. Since then, the number has steadily dropped. On March 24, only 76 new cases were reported.

A big unknown: Are all these efforts something we can keep up?

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jakehglover · 7 years ago

Text

Top Tips to Boost Your Immunity

By Dr. Mercola

While many people may find themselves succumbing to the common cold and other respiratory illnesses that are so prevalent in the winter, there are several things you can do (and not do) to help keep yourself in top form. Some may not even seem to be an important part of staying healthy, but they are.

When it comes to averting sickness, even while all-around you people might be coughing, sneezing and blowing their noses, successfully running the gauntlet of flu season may be simply a matter of keeping your immune system boosted by applying a few key health strategies. Besides going to school and work, times your immune system might be especially compromised include when you travel or are sleep deprived or stressed out. These are times you want to make sure your immune system is at its best.

Nutrition may be the most vital component in maintaining — or gaining — a healthy immune system. It makes all the difference in the way your body fights off germs, but just as importantly, plays an important role in more minute functions like helping tissues repair and rebuild themselves and how your body reclaims flagging energy.

Foods (and the Nutrients Therein) to Boost Your Immune System

Not just vitamins and minerals, but proteins like collagen and free radical-fighting antioxidants can be introduced to your body through the foods you eat, and play vital roles in helping to keep your body functioning at its best. As the Chicago Tribune observes:

“Collagen and its amino acids are essential to healing because they build tissues such as skin, muscles, tendons, ligaments, cartilage, blood vessels, bones and more. Antioxidants remove the harmful free radicals from the bloodstream that can impair the immune system, and vitamins and minerals play specialized roles in healing.”1

In the same way that cross training can keep your body fit and toned by working groups of different muscles, eating a variety of foods will target and work toward healing and restoring many different areas of your body, from your brain to your gut to your immune system. Protein found in lean meats, bone broth, fish, eggs, nuts and seeds help your body repair tissue and fight infection. Studies show that amino acids in protein, such as arginine and glutamine, increase your body’s ability to heal and decrease inflammation.2

Vitamins and Minerals to the Immune System Rescue

Eating foods chock-full of vitamins is an excellent way to strengthen your immune system to stay healthy all season:

Vitamin A boosts immunity, lowers your risk of infection and supports wound healing through collagen strength. Snack on carrots, squash, sweet potatoes, dark leafy greens, cantaloupe, wild-caught Alaskan salmon, organic pastured eggs and grass fed beef.

Vitamin D plays a big part in immune health and can be found in limited quantities in raw grass fed milk, wild-caught Alaskan salmon and organic pastured eggs, but the ideal way to optimize your levels is via sunshine

Some of the most vitamin C-rich foods include citrus fruits, from tangerines to limes, along with leafy greens, bell peppers and broccoli. Berries are another great source, and they all provide this and other potent antioxidants, which support your immune response and help to rebuild collagen.

Vitamin K1, important for healthy blood clotting, is abundant in dark leafy green vegetables. Vitamin K2 refers to a collection of bacterial menaquinones (MKs) that are found in a variety of different foods, namely animal foods and fermented foods. MK-4 is most abundant in animal foods while you can find MK-7, MK-8 and MK-9 in fermented foods.

Important for collagen production, zinc is another protective antioxidant that helps create and activate your immune system’s white blood cells and is essential in the enzymatic reactions needed for wound healing. Zinc-containing foods include grass fed red meat (optimal amounts per day range from 5 to 7 ounces), pastured, organic chicken, spinach, nuts and pumpkin seeds.

Selenium is another powerful antioxidant for immune system protection, found in Brazil nuts and organic, grass fed beef, turkey and chicken. In addition, as important as any food you eat, drinking adequate water is vital for flushing food through your system, flushing toxins and keeping your body hydrated. Many turn to so-called “sports drinks” for hydrating while working out, but clear, pure water is the ideal beverage.

Immune-Strengthening Vitamins: ‘B’ Is for Boost

B vitamins may constitute a long list, but each one is important for different reasons. Other “B’s” for boosting your immunity are especially effective when you combine the foods containing them so they can all work together for maximum effect. These include vitamin B1 (thiamin), B2 (riboflavin), B3 (niacin), B5 (pantothenic acid) and B7 (biotin).

B12, also known as cobalamin, is a powerful cold- and flu-fighting nutrient in your system, as is vitamin B6, another important, germ-combating vitamin that naturally benefits and strengthens your immune system and even protects against the damaging effects of air pollution.

Vitamin B9 and folic acid help repair tissues and aid in cell metabolism and immune support. They’re found in dark leafy greens, wild-caught, cold water fish like herring, mackerel, sardines, anchovies and wild-caught Alaskan salmon, and pastured, organic chicken. Nutritional yeast and other foods fortified with B12 present one way vegetarians (or anyone else, for that matter) can augment their B12 intake through their diet. Raw, organic grass fed milk, yogurt and cheese are additional options with naturally high B12 content.

Optimizing Your Gut Health With Probiotics

The health benefits derived from probiotics are rooted in balancing your intestinal bacteria. One of the easiest and quickest ways to do that is by eating fermented vegetables, which have long been a mainstay in many ancient cultures. However, it’s only been in recent decades that this method of optimizing gut health has reemerged.

The traditional method for preparing fermented vegetables is very much like it was thousands of years ago. Fermenting helps introduce friendly bacteria to your system and is one of the best ways to optimize your immune system, about 80 percent of which resides in your gastrointestinal tract. It’s not an overstatement to say it’s a key line of defense against pathogens, as well as an aid in the production of antibodies.

Aside from fermented vegetables, one of the most healthful fermented foods is kefir, an enzyme-rich food full of friendly microorganisms that help balance your microbiome as well as strengthen your immune defenses. Other beneficial fermented foods include natto, kimchi, pickles, sauerkraut, miso, tempeh and raw grass fed yogurt, but make sure you watch out for added sugar in most commercial varieties.

The fact that including probiotics in your diet has been shown to reduce incidences of psoriasis, colitis, allergies and many other diseases and conditions is a testament to their effectiveness in protecting your immune system. In addition, pregnant women who take probiotics help reduce their child’s risk of developing allergies.3

Fiber to Optimize Digestion and ‘Up’ Your Immunity

Not only does fiber help balance your gut microbiome, it, too, helps improve your immune system, as resistant starches act as prebiotics to feed healthy bacteria in your gut. As a result, it promotes bowel movements and keeps waste moving smoothly through your colon, while at the same time benefiting your heart health and controlling your blood sugar.

There are two types of fiber: soluble, which easily dissolves in water and becomes gel-like, and insoluble, which doesn’t dissolve but stays basically intact as it moves through your colon; both types are important for digestion.

Eating a fiber-rich diet, which in turn may improve the microbial diversity in your gut, may be linked to better responses during immunotherapy cancer treatment.4 In fact, your gut microbiome more directly influences your health and disease than previously thought. The fact is, your diet can make or break not just the ecosystem in which your gut bacteria reside, but your mental health as well.

And it’s not just the food you eat but all kinds of other factors, including the chemicals and pollution you’re exposed to, and all of it can alter the composition of gut bacteria and thereby influence your immune system health. As the Belfast Telegraph notes, “Want to avoid winter flu? Start eating with your gut in mind. Studies have found that having a healthy microbiome is important in fostering a strong immune system and keeping us healthy.”5

Getting Your Z’s: Not Optional for Optimal Immunity

Sleep is something that kids may resist, but as adults start the “adulting” that comes with jobs, growing families and paying the mortgage, sleep is something that can all too often go by the wayside. Studies show that not getting the sleep you need — for most people eight hours is the minimum for functioning at your best — can compromise your health in ways you may not have considered.

In fact, several nights in a row with less than restful, adequate sleep puts your body at greater risk for illness. Some of the ways lack of sleep manifests itself in disease include:

Dementia, including Alzheimer’s disease

Diabetes, which is true even for children6

Increased cardiovascular disease, especially for African-Americans7

Higher incidence of depression and anxiety8

Increased risk of obesity

Another study notes that cutting just one hour of sleep a night increases the expression of genes associated with inflammation, immune excitability, diabetes, cancer risk and stress.9 Consistently sleeping less than six hours a night increases your risk for numerous psychological and physical effects. The upshot is, lack of sleep quickly decreases your immune function, leaving your system wide-open for environmental influences, including viruses like colds and flu, that you would feel much better off if you avoided.

Sugar: Just As Bad for You Now as It Ever Was

If you were looking for a food to eat that would compromise your health in numerous ways and absolutely ruin your health, sugar in its many forms — and there are several, thanks to ever-changing food manufacturing gimmicks and money-making strategies — would win the prize. Not only is sugar identified as a carcinogen,10 it’s also contributing to the ever-increasing rates of chronic disease in the U.S. and throughout the world.

In the last century, sugar has become a daily habit that happens to coincide with increasing rates of obesity, Type 2 diabetes, heart disease, cancer and other chronic illnesses. One of the most insidious ways sugar works in your body is to damage both mitochondrial function and energy production, which triggers cell mutations that are then fed by continued sugar consumption.

What’s amazing is the number of ways sugar can show up, depending on the labels, in the foods you buy at the grocery store, including fruit juices, high fructose corn syrup (HFCS), evaporated cane juice, pancake syrup and cane juice, just to name a few, and the sugar industry has been manipulating the data for decades for the purpose of increasing profits.

To keep your immune system functioning at its best, one of the most effective strategies is to avoid sugar, pure and simple. It’s hard to do, though certainly doable, even if you know you’re suffering from a bad case of sweet tooth; research indicates that sugar impacts the function of dopamine in your brain, the neurotransmitter that triggers your reward system, in the same way narcotics affect your brain, and may trigger a strong addictive response.11

More Tips for Keeping Your Immune System in Tip-Top Shape

Whether your body is in recovery mode or you want to stave off the bug-of-the-month that might be going around at work or school, there are a few more options to prepare your system to fight back. One way to pack vitamins, minerals and other powerful nutrients into your day is to pack your blender or food processor with the makings for a super smoothie, making use of ingredients like spinach and other dark, leafy greens, carrots, berries like raspberries and strawberries, and even pumpkin seeds and Brazil nuts.

For a different (and more decadent) flavor, try going the chocolate route for your smoothie, but stick with dark chocolate with the lowest sugar content you can find for the antioxidant and anti-inflammatory effects courtesy of beneficial compounds such as epicatechin and resveratrol, known for being neuroprotective. Cacao also benefits your brain, nervous system, heart and blood vessels while helping to combat diabetes and other inflammation-related conditions.

Eating locally grown foods that are in season is better nutritionally because foods that are picked at peak ripeness and placed on shelves quickly retain the optimal amount of nutrients compared to foods shipped from long distances. These foods are also sometimes injected or sprayed with chemicals to either slow down or speed up the ripening process or otherwise make them appear fresher. Fruits that are “in season” in winter include oranges, kiwifruit, cactus pear, dates, cherimoya, mandarins, red currants and passion fruit.

Vegetables have their own season in which they grow best and offer the highest nutritional profile, and in winter this includes sweet potatoes, leeks, turnips, Brussels sprouts, kale, Belgian endive and winter squash varieties. Last, but certainly not least, keeping stress out of your life, at least to the highest degree possible, will go a long way toward preparing yourself to live disease- and even flu-free. As Rediff.com12 maintains, there are several ways you can help protect your immunity:

Avoid processed foods, as they make you vulnerable to developing chronic conditions

Avoid excessive alcohol, which can impede the functioning of immune cells

Avoid obesity, as it can affect the ability of white blood cells to multiply, produce antibodies and prevent inflammation

Include activity, especially if you know you’re not getting enough; as little as 20 minutes of walking five days a week can increase your immune system function

Avoid taking unnecessary medications, as even nonprescription drugs, antibiotics and cold and fever fighting medications may weaken your immune system

Additionally:

“Chronic stress can make you more susceptible to colds and the flu, as well as more serious health problems like heart disease, diabetes and other diseases. By practicing stress-reducing activities like yoga, meditation and laughter, you can keep your body from going into chronic stress mode.”13

from HealthyLife via Jake Glover on Inoreader https://articles.mercola.com/sites/articles/archive/2018/02/01/boost-immune-system.aspx

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sherristockman · 7 years ago

Link

Officials Admit Flu Vaccine 2017 Likely Worthless Dr. Mercola By Dr. Mercola Flu season in Australia, located in the Southern Hemisphere, occurs while residents of the U.S. in the Northern Hemisphere are enjoying summer. What happens in Australia is a good bellwether for how bad the flu season in the U.S. will be come winter. And if this holds true for the 2017-2018 flu season, influenza vaccine experts are warning that the U.S. could be in for a doozy. Writing in the New England Journal of Medicine, health officials with the National Institute of Allergy and Infectious Diseases (NIAID), the World Health Organization (WHO) and in Australia described “record-high numbers of laboratory-confirmed influenza notifications and outbreaks and higher-than-average numbers of hospitalizations and deaths” during Australia’s 2017 influenza season.1 What’s more, the influenza vaccine, which is still described by public health officials as the best tool to stay healthy during flu season despite years of dismal failures, turned out to be mostly worthless in Australia this year. The predominant circulating flu viruses were influenza A (H3N2), against which the 2017-2018 flu vaccine had a preliminary effectiveness of just 10 percent. Health officials have admitted that this season’s influenza vaccine is likely to be a major flop in the U.S. and other countries in the Northern Hemisphere. “Given that … the composition of the 2017–2018 Northern Hemisphere vaccine is identical to that used in Australia, it is possible that we will experience low vaccine effectiveness against influenza A (H3N2) viruses and a relatively severe influenza season if they predominate,” they noted.2 As of early December 2017, more than 7,000 U.S. influenza cases have been lab confirmed, which is more than twice the number confirmed one year ago at this time,3 and 90 percent of states have reported some type of influenza activity.4 Multiple Reasons Why the 2017 Flu Vaccine Is Likely to Fail There are many reasons why flu vaccines are often ineffective, starting with vaccine mismatches. Each year, health officials make educated guesses as to which influenza virus strains will be circulating in order to include them in that year’s vaccine. For the past 12 years, influenza vaccines have failed to work more than half the time.5 “Even in years when influenza vaccines are well matched to circulating viruses, estimates of vaccine effectiveness range from 40 percent to 60 percent, which is lower than that for most licensed noninfluenza vaccines,” the researchers wrote in NEJM.6 But in cases when they’re not well matched, the flu shot’s effectiveness is even lower — such as this year’s preliminary estimate of 10 percent, or less. Another factor is the substrate used to produce the flu vaccine, namely eggs. In the U.S., for decades most selected influenza viruses for influenza vaccine production have been grown in eggs. Now researchers are reporting that use of eggs to grow influenza viruses can cause the vaccine-strain viruses to mutate, which can render the vaccine ineffective in preventing infection with circulating influenza viruses. According to the NEJM report: “During the egg-based production process, the vaccine virus acquires amino acid changes that facilitate replication in eggs, notably changes in the hemagglutinin (HA) protein that mediates receptor binding. Since the influenza HA is the primary target of neutralizing antibodies, small modifications in this protein can cause antigenic changes in the virus and decrease vaccine effectiveness. Egg adaptation has been postulated to contribute to low vaccine effectiveness, particularly with influenza A (H3N2) viruses [the type predicted to be most widely circulating this year].”7 Studies have repeatedly shown that, since 2005, in most flu seasons influenza vaccines have been from zero to less than 50 percent effective in preventing type A or B influenza.8 Yet, even as the flu vaccine’s effectiveness for the 2017-2018 flu season appears to have a dismal outlook, public health officials continue to push vaccination harder than ever and recommend that everyone 6 months of age and older get a flu shot every year. “However imperfect, though, current influenza vaccines remain a valuable public health tool, and it is always better to get vaccinated than not to get vaccinated,” the researchers wrote,9 although they gave no rationale for this absolute statement. Perhaps they don’t want to admit that the long-term effects of annual flu vaccination on human health and the evolution of influenza viruses are not known. Now, this closed-minded approach appears to be backfiring, as evidence mounts to suggest that people who get flu shots every year are actually less protected and more likely to get a serious case of influenza than those with no prior flu vaccination history.10 Research presented in 2009 at the 105th International Conference of the American Thoracic Society in San Diego revealed that children who get seasonal flu shots are more at risk of hospitalization than children who do not. Children with a history of receiving the flu vaccine had three times the risk of hospitalization as children who had not been vaccinated. Among children with asthma, the risk was even higher.11 Most Influenza-Like Illness During Flu Season Is NOT Influenza The CDC states that, “Most people who get influenza will recover in a few days to less than two weeks, but some people will develop complications (such as pneumonia) as a result of the flu, some of which can be life-threatening and result in death.”12 An important point to remember that gets lost in the CDC’s promotion of annual flu shots is that most of the time when you get sick with a respiratory infection during the flu season, you do not have type A or B influenza. In fact, the vast majority of “influenza like illness” (ILI), which often includes symptoms like fever, fatigue, body aches, runny nose and cough, is caused by other kinds of viruses and bacteria. The only way to positively identify whether or not you have influenza or another type of infection is for your doctor to send a respiratory specimen to a lab to be tested.13 Statistics from the 2015-2016 flu season show that only 3 percent to 4 percent of suspected cases of influenza that were lab tested were actually positive for influenza virus infection.14 This year, for the week ending December 2, 2017, the CDC reported there have been 170,372 influenza specimens tested and 7,178 specimens have come back positive for influenza type A or B, with 74 percent of those testing positive for influenza A.15 That means that so far this flu season, about 4.2 percent of all suspected influenza infections that were lab tested turned out to be another type of viral or bacterial infection not caused by a type A or B influenza virus. So just how much respiratory illness are flu shots really preventing during a given flu season, especially when the vaccine is only 10 percent effective against selected influenza strains in a season like this one? Noncompliance Becoming a Crime Should you go to jail or lose your job because you make an informed decision to opt out of a medical procedure like vaccination for yourself or your child? This is increasingly becoming the reality in the U.S. Recently, there have been reports of people who have been jailed, lost jobs or been refused registration in college classes if they declined various vaccines for themselves or their child, from the flu shot to the meningitis vaccine. In other countries, such as Australia, a law beginning in January 2018 will fine day care operators more than $4,000 if they admit unvaccinated children. In Italy, parents may also be fined for not vaccinating their children, starting in 2018.16 Vaccine orthodoxy dictates that humans must believe vaccination is safe and effective, and that government-mandated vaccines are always a good thing. In the beginning, it was just one vaccine — smallpox — but now the U.S. childhood vaccine schedule calls for 50 doses of 14 vaccines given before age 6.17 But the fact is, although vaccines may be tolerated by some people, they can be devastating for others.18 The U.S. government claims it does not impose vaccine mandates for adults, except for those entering the military. However, it’s not unusual for hospitals and other employers to fire workers who refuse certain vaccines, such as annual flu shots — even though research has shown, for instance, that vaccinating nursing home workers had no effect on lab-confirmed influenza cases among the elderly residents of nursing homes.19 According to Dr. Meryl Nass, an internist and vaccine blogger with expertise in vaccine-induced illnesses, it appears American hospitals do not actually have a legal leg to stand on when firing health care workers over vaccine refusals, although they do have financial incentive to do. In short, hospitals that have higher vaccination rates for patients and health care workers get higher Medicare reimbursement rates. Vitamin D Much More Effective Than Flu Vaccine If health and safety is the first priority of public health officials, why not implement a universal public health program for vitamin D testing and optimization, since vitamin D supplementation has been shown to cut the risk of respiratory infections in half for those who are vitamin D deficient?20,21 In fact, in one systematic review of 25 studies, “Vitamin D supplementation was safe and it protected against acute respiratory tract infection overall,” researchers noted.22 In a study published in 2010, researchers also investigated the effect of vitamin D on the incidence of seasonal influenza A in schoolchildren. The randomized, double blind, placebo-controlled study included 430 children, half of whom were given 1,200 IUs of vitamin D3 per day while the other half received a placebo. Overall, children in the treatment group were 42 percent less likely to come down with the flu. According to the authors, "This study suggests that vitamin D3 supplementation during the winter may reduce the incidence of influenza A, especially in specific subgroups of schoolchildren."23 Another study published that same year concluded that infection-fighting T-cells need help from vitamin D in order to activate.24 This is yet another mechanism that helps explain why vitamin D is so effective against infections. I believe sensible sun exposure is the ideal way to optimize your vitamin D levels. Taking a vitamin D3 supplement is only recommended in cases when you simply cannot obtain sufficient amounts of sensible sun exposure. In the latter case, you may need 8,000 IUs of vitamin D3 per day (or more) in order to reach and maintain a clinically relevant level of 40 to 60 nanograms per milliliter (ng/mL). The only way to know how much vitamin D you need is to get tested at least once or twice each year. If you've been supplementing for some time and your levels are still below 40 ng/mL, you then know you have to increase your dose further (or strive to get out in the sun more often). If using an oral supplement, also make sure to boost your vitamin K2 and magnesium intake for proper balance. Optimizing your vitamin D level is a basic step that virtually everyone should take year-round, but especially during flu season. How to Protect Yourself Against the Flu Without Vaccination Public health officials now recommend every person over the age of 6 months get an annual flu shot, whether the person is healthy or not, low risk or high. But what will receiving a flu shot, which may have an effectiveness rate of 10 percent or less, every year for decades on end do to your immune system? No one can answer that question because it has never been studied. Fortunately, there are proactive steps you can take to avoid getting sick during the flu season that do not require getting a flu shot every year. By following these simple guidelines, you can keep your immune system in optimal working order so you're far less likely to acquire the infection to begin with or, if you do get sick, you will be better prepared to move through it without complications. Optimize your vitamin D levels. As mentioned, this is one of the absolute best strategies for avoiding infections of all kinds, and research suggests vitamin D deficiency may actually be the true culprit behind the seasonality of the flu — not the flu virus itself. Raising your vitamin D to a therapeutic level of 40 to 60 nanograms per milliliter (ng/mL) is probably the single most important and least expensive action you can take to avoid getting the flu. Avoid sugar and processed foods. Sugar impairs the function of your immune system almost immediately, and a healthy immune system is one of the most important keys to dealing with viruses and other pathogens so you can stay well or return to health more quickly and without complications if you do get sick. Get plenty of rest. Just like it becomes harder for you to get your daily tasks done if you're tired, if your body is overly fatigued, it will be harder for it to maintain health or heal. Be sure to check out my article Guide to a Good Night's Sleep for some great tips to help you get quality rest. Address your stress. When stress becomes overwhelming, your body will be less able to fight off the flu and other illness. If you feel stress is taking a toll on your health, consider using an energy psychology tool such as the Emotional Freedom Techniques (EFT), which is remarkably effective in relieving stress associated with all kinds of events, from work to family to trauma. Exercise. When you exercise, you increase your circulation and your blood flow throughout your body. The components of your immune system are also better circulated, which means your immune system has a better chance of naturally responding to and resisting illness. Consume animal-based omega-3 fat. Increase your intake of healthy and essential fats like the omega-3 found in sardines, anchovies and krill oil, which is crucial for maintaining health. Also avoid damaged omega-6 oils and trans fats found in processed foods as they will damage your immune response. Wash your hands. Washing your hands will decrease your likelihood of spreading a virus to your nose, mouth or other people. Antibacterial soaps are completely unnecessary, however, and cause far more harm than good. Instead, just use a mild, toxin-free soap and warm water. Use natural immune boosters. Examples include colloidal silver, oil of oregano and garlic. These have potent antibiotic activity, boosting your body's ability to fend off harmful bacteria, viruses and protozoa. Unlike pharmaceutical antibiotics, they do not appear to lead to resistance. Avoid hospitals. Last but not least, I recommend staying clear of hospitals unless you're having an emergency and need expert medical care, as hospitals are prime breeding grounds for infections of all kinds. The best place to get plenty of rest and recover from illness that is not life-threatening is usually in the comfort of your own home.

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