All posts filed under: Health

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 …

To Be Useful, Health Data Must Go Deeper Than ‘Black’ and ‘White’

All over the world, the COVID-19 pandemic has disproportionately affected patients based on a variety of identifiable factors, from age to sex to occupation. Data such as these are crucial to public-health officials and researchers tasked with improving care for all citizens. But in some cases, the quest for data seems driven as much by political factors as by the need to protect public health. In Canada, where I work as a resident physician in the field of head and neck surgery, the federal government has proposed that racial data be tracked as part of our national response to the COVID-19 pandemic, as is already the case in the United States. On the surface, there would seem to be an obvious parallel with the need to collect race-based policing data, especially in the wake of George Floyd’s death and the worldwide protests that followed. Collecting such data makes sense in the context of policing, since race corresponds to a visible marker that can prompt radically different responses from police officers. But the situation is different when …

Reducing the Chance of New Pandemics

It has been months since the novel coronavirus hit Western countries, and many are now wondering how and when normality will return and what a new normal might look like. Some expect that a second wave of infection will be avoided by seasonal properties inherent in the virus, while others contend that this will only happen if strong action is taken to contain it. Some expect that a vaccine will allow a rapid return to the world we had before, while others argue that even if such a vaccine were to be developed, it would permit no such thing. Absent from many of these discussions is how to avoid another situation like this one. The argument can be framed in simple economic terms or in more complex terms related to existential risk and the very future of our species on Earth. The current pandemic is estimated to have cost nations on average a third of the world’s GDP—over 30 trillion US dollars—so spending billions on even a marginal reduction of the probability of another such …

COVID-19 and the College Football Debate

Why should we have to go to class if we come here to play FOOTBALL, we ain’t come to play SCHOOL, classes are POINTLESS. ~Ohio State University football quarterback Cardale Jones, October 2012 tweet Last week, the question of whether or not the American college football season would start on time in the early fall got complicated. Some schools (with enrollments of up to about 50,000 students in total) had already opened for voluntary workouts. Now, the National Collegiate Athletic Association (NCAA) has approved a six-week plan that would allow student athletes to return to campus for pre-season workouts, and so testing for COVID-19 has begun. The results so far have been stark. Clemson University had 23 players test positive. There were 13 players with COVID-19 at the University of Texas in Austin. Ten athletes at Iowa State tested positive. The University of Alabama had eight, as did Kansas State University. University of Houston had six, Texas A&M had five, and Mississippi State had four. The list went on and on with more schools reporting …

Rethinking Health Disparities

In the last few decades, the proliferation of diversity, inclusivity, and equity literature throughout the medical profession has become institutionalized. Medical organizations such as the World Health Organization (WHO), the National Institute of Health (NIH), and the American College of Cardiology (ACC) have embraced this ideology and its accompanying bureaucracies and web-based material, and have called for cultural changes in some of our most important fields of study. Reforms are ostensibly intended to address healthcare disparities between groups, and new initiatives are frequently justified with reference to what the Sullivan Commission called the “ghosts of discrimination.” 1 The authors of reports like these will invariably go on to talk about implicit bias, the need for diversity in the healthcare workforce, and an examination of structural forces and power distributions that shape group disparities in health outcomes. In January 2020, the ACC published a cover story stating that healthcare group disparities and the lack of diversity in healthcare were a “national emergency” and strongly promoted the use of the Implicit Association Test (IAT).2 Even as late as …