All posts filed under: Health

The Coming Post-COVID Global Order

The COVID-19 pandemic has devastated economics in the West, but the harshest impacts may yet be felt in the developing world. After decades of improvement in poorer countries, a regression threatens that could usher in, both economically and politically, a neo-feudal future, leaving billions stranded permanently in poverty. If this threat is not addressed, these conditions could threaten not just the world economy, but prospects for democracy worldwide. In its most recent analysis, the World Bank predicted that the global economy will shrink by 5.2 percent in 2020, with developing countries overall seeing their incomes fall for the first time in 60 years. The United Nations predicts that the pandemic recession could plunge as many as 420 million people into extreme poverty, defined as earning less than $2 a day. The disruption will be particularly notable in the poorest countries. The UN has forecast that Africa could have 30 million more people in poverty. A study by the International Growth Centre spoke of “staggering” implications with 9.1 percent of the population descending into extreme poverty as …

Dr. Norman C. Wang and Selective Outrage

Back in March 2020, a University of Pittsburgh physician by the name of Norman C. Wang published an article in the Journal of the American Heart Association (JAHA) about the use of race and ethnicity considerations when recruiting for the US cardiology workforce. Wang argued that Diversity, Equity, and Inclusivity offices are ultimately unhelpful in promoting minorities in cardiology practice. He also pointed out that these offices may be unconstitutional and that they often make claims that may be unsupported by the relevant empirical evidence. Towards the end, he advocated race-neutral admissions and hiring practices as an alternative to the current model. The article attracted no controversy upon publication, but that all changed a few months later. A physician under fire Over the first weekend of August, a large number of professionals suddenly began condemning Wang online for promoting “historically racist stereotypes” and, as one physician put it, failing to account for the “structural biases” medical students of color face. An interventional cardiologist declared that Wang’s writing aligns with the kind of thinking that “defines …

Patient Safety and the Medical Omerta

September 17th, 2020 will mark the second anniversary of the World Health Organisation’s World Patient Safety Day, a sign of the progress made in highlighting the risks of iatrogenesis—harm caused by medical negligence or error. The loosely defined patient safety movement grew from the work of the American paediatric surgeon Lucian Leape, and the publication of the 1999 Institute of Medicine paper ‘To Err is Human,’ both of which succeeded in drawing attention to the risk of being inadvertently killed or otherwise mistreated by healthcare providers. The patient safety movement has subsequently called for better detection and investigation of error, and while official UK data estimates up to 12,000 deaths from medical error per year, the voice of the medical profession in these matters has been conspicuously quiet. Inquiryitis Here in the UK, there has been no shortage of healthcare scandals within the publicly funded National Health Service (NHS). The history of public inquiries into the NHS reminds us of the inherent power imbalance between healthcare providers and the public. However, over 130 such inquiries have …

The China Syndrome Part IV: Did China Fudge its Data?

Note: This is the concluding part of a four-part series of essays looking in detail at China’s role in the COVID-19 pandemic. Part One looked at the circumstances surrounding the initial outbreak; Part Two looked at the discovery of human-to-human transmission and the immediate response; Part Three investigated allegations that the pandemic began in a “wet market” or that the virus escaped from a lab in Wuhan; this part examines charges that China falsified its pandemic data.  Allegations that China was falsifying its COVID-19 figures began to appear when its death and case rates were overtaken by even more dismal figures in parts of Europe and America. How could a repressive society like China possibly be getting this right while the West’s democracies were getting it wrong? As Western numbers climbed, commentators and politicians declared with growing certainty that China’s claim to have successfully suppressed its epidemic was simply the propagandistic lie of a mendacious totalitarian regime intended to fool its own citizenry and the rest of the world. Back in April, Bloomberg reported that, according …

The China Syndrome Part III: Wet Markets and BioLabs

Note: This is the third part of a four-part series of essays looking in detail at China’s role in the COVID-19 pandemic. Part One looked at the circumstances surrounding the initial outbreak; Part Two looked at the discovery of human-to-human transmission and the immediate response; this part investigates allegations that the pandemic began in a “wet market” or that the virus escaped from a lab in Wuhan; Part Four examines charges that the Chinese have falsified their pandemic data.  Among the most controversial questions debated in the wake of the SARS-CoV-2 outbreak are how and why the pandemic began in China in the first place. In the previous part of this essay, I argued that, to the extent that China was blameworthy for the pandemic, it was down to a matter of chance. Had the pandemic started in the West instead of China, it would likely have been much worse, so unless you believe in moral luck it doesn’t make sense to blame China. However, if the outbreak began as a result of Chinese negligence …

The China Syndrome Part II: Transmission and Response

Note: This is the second part of a four-part series of essays looking in detail at China’s role in the COVID-19 pandemic. Part One looked at the circumstances surrounding the initial outbreak; this part looks at the discovery of human-to-human transmission and the immediate response; Part Three investigates allegations that the pandemic began in a “wet market” or that the virus escaped from a lab in Wuhan; Part Four examines charges that the Chinese have falsified their pandemic data.  There is evidence that, in mid-January, Chinese officials withheld suspicions that sustained human-to-human transmission was occurring. Nevertheless, most of the claims about Chinese mendacity and its implications have been wildly exaggerated. A useful account of the ways in which the local health authorities delayed the release of crucial information was published on February 5th, 2020, in China News Weekly, but apparently deleted from their website almost immediately. Fortunately, it was archived and eventually translated by China Change, a website created by Chinese human rights activists in the US. A fair-minded story published by Associated Press also illuminates the role played by …

The China Syndrome Part I: Outbreak

Note: This is the first part of a four-part series of essays looking in detail at China’s role in the COVID-19 pandemic. This part looks at the circumstances surrounding the initial outbreak; Part Two looks at the discovery of human-to-human transmission and the immediate response; Part Three investigates allegations that the pandemic began in a “wet market” or that the virus escaped from a lab in Wuhan; Part Four examines charges that China falsified its pandemic data. Introduction According to a poll conducted in France, Italy, Spain, the UK, and the US at the end of March, a majority of the population in each of those countries believes that China is at least somewhat to blame for the pandemic and, in both the UK and the US, a plurality believe it’s significantly to blame. Another survey taken in the US at the end of April found that a plurality of people believe that SARS-CoV-2 was probably or definitely created in a lab. At the beginning of that month, another poll had found that a majority of Americans believed that China …

The Problems with Discrimination Research in Medicine

Like many professions in Western society, medicine is examining itself for the presence of racial inequities and strategies that can ameliorate these differences. Many publications have focused on the disproportionately poor outcomes of minorities in our healthcare system with an emphasis on systemic and structural forces that shape such inequities. As I concluded in my last article for Quillette, these discussions should proceed with the utmost scientific caution, as the answers and implications stand to affect the most vulnerable populations. With this in mind, there are limitations in the current literature on alleged medical discrimination and the associated health outcomes. In addition, much of the literature on this topic relies heavily on surveys and patient self-reports to assess bias and discrimination while downplaying or ignoring alternative hypotheses. The narrative that has emerged from the conclusions of these limited studies could inadvertently cause some populations to avoid medical follow-up and form an inaccurate view of healthcare practices. As background, the relevant literature appears to show that black and Hispanic patients tend to view medicine as more …

At the NHS and BBC, Important Steps Toward Restoring Balance in the Gender Debate

In recent months, a sense has emerged that the tide might finally be starting to turn in the gender debate: Things that most everyone believes to be true, but that no one has been allowed to say, are now increasingly being said by writers, lawmakers, and litigants. Certainly, the battle is still far from over. CNN is referring to women as “individuals with a cervix.” Last month, J.K. Rowling was trolled yet again for stating ordinary views about men and women (though thankfully, the media is no longer getting away with defaming her). And best-selling children’s author Gillian Phillip has been sacked by her publisher, Working Partners, because she added the hashtag #IStandWithJKRowling to her Twitter bio. But at least now, in mid-2020, these acts attract growing criticism. We are no longer in 2018, when the most militant gender activists could still pretend that they spoke for the entire LGBT community, with the “debate,” such as it then was, consisting mostly of endless mobbing campaigns against so-called “TERFs.” One reason it has taken time to …

Why Have So Many American Conservatives Embraced COVID-19 Pseudoscience?

With almost 150,000 COVID-19 deaths, the United States, putative leader of the free world, now is competing with Brazil and Russia for global supremacy in pandemic mismanagement. Not only does the United States lack any kind of coherent federal leadership on this issue, but even state and city leaders have fallen into bickering—and even lawsuits—over the correct response. While many Western nations have all but extinguished COVID-19 within their borders, the American pandemic is raging with a new ferocity. Yet some conservatives continue to protest even basic public-health measures, including masks. How could some of America’s best and brightest abet their country’s collapse into dysfunction in the face of a once-in-a-century pandemic? The most obvious answer lies with their president, Donald Trump, who has continued to hold large rallies even into July. He and his most fervent supporters boosted the patchwork of conspiracy theories, crank medical science, and plain apathy that informed much of the American response. At the Conservative Political Action Conference (CPAC) conference in Washington, D.C. back in February, the president’s then acting …