It has been a bad week, borderline flu, just like everyone else in the office since the new year (with 7 of 18 having had a COVID relapse earlier). Plus, and more important, with each passing day of Trump v2.0 it gets harder to keep up, so straight to the predicament of our scientific friends, colleagues, and benefactors. With minor league baseball at the end.
Part the First: COVID-19 is still here despite what our leaders want to believe. Trump administration says it will pull back billions in Covid funding from local health departments:
“The COVID-19 pandemic is over, and HHS will no longer waste billions of taxpayer dollars responding to a non-existent pandemic that Americans moved on from years ago,” the U.S. Department of Health and Human Services said in a statement.
In a related move, more than two dozen Covid-related research grants funded by the National Institutes of Health have been canceled. Earlier this month, the Trump administration shut down ordering from covidtest.gov, the site where Americans could have COVID-19 tests delivered to their mailboxes for no charge.
Although the Covid federal public health emergency has ended, the virus is still killing Americans: 458 people per week on average have died from Covid over the past four weeks, according to CDC data.
Nothing to see here, move along, the pandemic is so over. Not exactly. I suppose if you suspect you have COVID-19, you should just let it go, ride it out, without a test. That is one way to make “COVID-19” disappear. And as has been covered here before, going on to the next shiny new object is exactly the wrong thing to do. Would COVID-19 have been a pandemic if research had continued on SARS-CoV and MERS-CoV instead of languishing? Perhaps. But more likely not. Our leaders act like those who think they can wait to buy property insurance until the National Hurricane Center predicts that within seven days their house is in the path of the fifteenth hurricane of the season, this one likely to be Category 4 or 5 at landfall. On that note, I have heard from real estate peeps on the Georgia coast that hurricane damage to dwelling and contents is currently limited to $250,000 on an island where that will get you a 47-year-old condo with the original appliances still in place. But that is another story.
Part the Second: The Great Barrington Declaration is still with us. I had planned to include a discussion of In Covid’s Wake: How Our Politics Failed Us in a future essay here. I find the responses to historians and political scientists to scientific issues to generally add a useful and productive perspective to the science of the past and the present, while most of my colleagues have no use for “outsiders’” views. In this case Dr. Jonathan Howard has covered the book and especially the Great Barrington Declaration like a blanket. BTW, I am convinced the name, Great Barrington Declaration, accounts for 80% of the “likes” it has gotten in the form of about a million signatures. Dr. Howard:
Before deciding whether to read the whole book, I skipped to the section on the Great Barrington Declaration (GBD) and it’s three authors, Drs. Sunetra Gupta, Martin Kulldorff, and Jay Bhattacharya. Based on that chapter, I am not going to waste my time reading further. There are so many things wrong with it, it’s hard to know where to begin. I feel nearly every paragraph should come with some sort of disclaimer that reads, “No one who worked on a COVID unit would ever say anything like that.”
Rather than going into detail here, I recommend a cup of coffee and a comfortable chair. TL;DR will be the reaction to many by this piece by Dr. Howard. I strongly disagree. Earlier this week The Rev Kev noted I was showed great restraint by not calling Dr. Jay Bhattacharya a quack. Since that post was published Bhattacharya has been confirmed as Director of the National Institutes of Health – the one agency that dwarfs all others in impact in advances in the biomedical sciences over the past sixty years. Perhaps crank would be the better term? Jay Bhattacharya has an MD but that is as useful as the JD who graduated from law school but never passed a Bar Exam. Regarding the other ancient term “quack,” suffice it to say there are waddlings of quacking animals dispersed all over the current landscape.
Part the Third. SARS-CoV-2 is a persistent pathogen, but we already knew that. Whole-body visualization of SARS-CoV-2 biodistribution in vivo by immunoPET imaging in non-human primates. This is a remarkable paper from Nature last week. Heavy technical going, but the high-resolution pictures are worth the proverbial thousand words. From the Abstract:
The COVID-19 pandemic has caused at least 780 million cases globally. While available treatments and vaccines have reduced the mortality rate, spread and evolution of the virus are ongoing processes. Despite extensive research, the long-term impact of SARS-CoV-2 infection is still poorly understood and requires further investigation. Routine analysis provides limited access to the tissues of patients, necessitating alternative approaches to investigate viral dissemination in the organism. We address this issue by implementing a whole-body in vivo imaging strategy to longitudinally assess the biodistribution of SARS-CoV-2. We demonstrate in a COVID-19 non-human primate model that a single injection of radiolabeled…human monoclonal antibody targeting a preserved epitope of the SARS-CoV-2 spike protein allows longitudinal tracking of the virus by positron emission tomography with computed tomography (PET/CT). Convalescent animals exhibit a persistent…PET signal in the lungs, as well as in the brain, three months following infection. This imaging approach also allows viral detection in various organs, including the airways and kidneys, of exposed animals during the acute infection phase. Overall, the technology we developed offers a comprehensive assessment of SARS-CoV-2 distribution in vivo and provides a promising approach for the non-invasive study of long-COVID pathophysiology.
SARS-CoV-2 hits and stays. And once again, the choice of experimental model is critical in such studies. The scientists who do this work give thanks every day and hope their research will provide answers.
Part the Fourth: The waddlings whack cancer research. Cancer research, long protected, feels ‘devastating’ effects under Trump (paywall). Has the War on Cancer succeeded yet, after more than 50 years? That depends on the definitions of “success” and “cure.” In the first place cancer is a thousand different diseases, not one, not two, not twenty. A friend recently published a paper that took a careful look at the genetics of colon cancer. Transformation can effect literally everything a cell does in colon cancer. Thus, the refractoriness colon cancer in so many patients. Too many targets. Too many variables for the number of nonlinear equations. The matrix will not compute and AI cannot solve a time-dependent problem that has more variables than equations, no matter how slick it is.
In the second place, modern clinical oncology has made wondrous advances. Many of these are covered in The Emperor of All Maladies and virtually all of them have been supported by the National Institutes of Health. I can attest to this personally. Three years ago this week, I finished a long course chemotherapy and radiation. My oropharyngeal squamous cell carcinoma remains resolved (so far, fingers crossed), and I weigh what I did as a high school senior. Could have done without making that lemonade out of seven bushels of lemons, though. Twenty years ago, I would still be recovering from ugly, invasive surgery and a much rougher version of both radiation and chemotherapy with long-lasting side effects from both. My current mild dry mouth is trivial. Twenty years from now, my cancer will be much rarer because of a vaccine that works, if my grandchildren’s children have vaccines available to them. So, cutting cancer research funding is just plain nuts:
The policy changes strike at a time when progress against cancer is at a high point. Federal investment has seeded a plethora of new therapies and driven a rapid decline in cancer deaths. “Every-freaking-body should be waking up and saying 34% more people are living with cancer instead of dying from it in the last 30 years. It’s anti-smoking campaigns, screening technologies, new tests, new therapies, new surgeries,” said Robert Winn, the director of the VCU Massey Comprehensive Cancer Center. That’s directly thanks to dollars from the federal government and the National Cancer Institute in particular, Winn said.
All that investment over the decades…has brought cancer science to the point where new discoveries are accelerating. In many ways, the stage is poised to bring a dizzying number of advances to cancer for the next 10 years, including new targeted therapies, immunotherapies, and multi-cancer screening technologies.
Yes, just plain nuts. Period. And the thing is, given that every person in this country, including MAGA nation, knows the costs, consequences, and outcomes of cancer, does Trump v2.0 really think this is a good idea? Good question.
Part the Fifth: The hits, they keep on coming. Dr. Oz and the Plot Against Medicare. Dr. Mehmet Oz, former TV talking head and Senate candidate in a state in which he did not really live, was a legitimate physician. He was nevertheless disaffiliated by Columbia University College of Physicians & Surgeons. Dr. Oz will be in charge of Medicare and Medicaid in Trump v2.0. For years, Dr. Oz has been a “spokesman” for Medicare Advantage plans. Medicare Advantage is a grift from the get-go that was supposed to make Medicare more efficient (that word, again) by doing more with less. Not so much, actually:
Yet the mortal threat Oz poses to American healthcare goes deeper than his six-figure stake in the country’s biggest and most notorious private insurer. For years, Oz has worked as a pitchman for Medicare Advantage (MA) plans. This managed care alternative allows corporations to bill the federal government for administering Medicare benefits on its behalf, and is a boon for private insurers. As a UnitedHealth shareholder and licensed insurance broker, Oz has long been financially and ideologically committed to the takeover of traditional Medicare by private insurers. Led by UnitedHealth, the insurance industry has made a hugely profitable algorithmic science out of denying and delaying care to maximize profits.
Another complete takedown that needed to be done by Alexander Zaitchik, who is very well prepared for the task. His Owning the Sun: A People’s History of Monopoly Medicine from Aspirin to COVID-19 Vaccines (Counterpoint Press, 2023) was reviewed here in July 2023. If I am able, I just might work until I die so I don’t have to ever deal with United Healthcare again is this lifetime.
Part the Sixth. The hits, they keep on coming, again. Why RFK Jr.’s pick for a vaccine-autism review may be familiar to Retraction Watch readers. Short read, a story not unlike one that puts Peter Duesberg in charge of HIV/AIDS research. Here is a snippet:
Geier has a long history of promoting the debunked claim of a link between vaccines and autism, STAT and others report. He has published on the topic as recently as 2020. A December 2020 paper lists his affiliation as the Institute of Chronic Illnesses, an organization he founded with his father Mark Geier, court documents say. In 2011, the Maryland State Board of Physicians disciplined Geier for practicing medicine without a license. He’s currently listed in the HHS employee directory as a senior data analyst, the Post reports.
Another episode in the continuing saga, “This will not end well.”
Part the Seventh. The richest country in the world hordes its money in a snit instead of sharing its expertise to reduce the horrific burden of disease in the Global South. Agency moves to terminate nearly 1000 awards, including programs involving “DEI.” I suppose I am naïve but I really do expect better of us, US, despite our many failings. From Abraham Lincoln’s Address to Congress in 1862, when the Union was in grave danger then, too. His prose is neither presentist nor anachronistic. It absolutely fits in today (link from the National Park Service, God save it):
“The dogmas of the quiet past are inadequate to the stormy present. The occasion is piled high with difficulty, and we must rise with the occasion. As our case is new, so we must think anew, and act anew. We must disenthrall ourselves, and then we shall save our country. Fellow-citizens, we cannot escape history. We of this Congress and this administration, will be remembered in spite of ourselves. No personal significance, or insignificance, can spare one or another of us. The fiery trial through which we pass, will light us down, in honor or dishonor, to the latest generation.
We say we are for the Union. The world will not forget that we say this. We know how to save the Union. The world knows we do know how to save it. We, even we here, hold the power, and bear the responsibility. In giving freedom to the slave, we assure freedom to the free — honorable alike in what we give, and what we preserve. We shall nobly save or meanly lose the last best hope of earth. Other means may succeed; this could not fail. The way is plain, peaceful, generous, just — a way which if followed, the world will forever applaud, and God must forever bless.”
Should South Africa and other countries in the Global South fund their own research? There are at least two ways of looking at this. One is that this is their problem, so let them deal with it. This perspective is exactly backwards. The other, of course, is that disease is everyone’s problem, so the more human and humane way to consider supporting science in the Global South is to understand that “we are all in this together” and that we do still have “the better angels of our nature,” however effaced they are at the national political level. Yes, there is a reason why Lincoln is at the top of his list. Anyway:
(Glenda) Gray, chief scientific officer and former head of South Africa’s Medical Research Council, notes that the country, which has more people living with HIV than any other, has played a pivotal role in clinical trials that have shaped international guidelines about the most effective ways to use anti-HIV and TB drugs. The trials have also helped lead to approvals of new drugs by the U.S. Food and Drug Administration. Landmark studies in South Africa have, for example, shown that anti-HIV drugs taken by breastfeeding mothers reduce the risk of transmission to their babies and demonstrated the power of long-acting pre-exposure prophylaxis for HIV that was Science’s Breakthrough of the Year in 2024.
Personally, I think the very term “pre-exposure prophylaxis” is the problem with a lot of people…Past time to wake up, fellow citizens.
Part the Eighth. And in other, better news, local will win in the long run. In Praise of Communitarian-not Corporate-Baseball. A paean to minor league baseball as the baseball season begins once again. This, at a time when Shohei Ohtani’s former factotum and interpreter goes to prison for taking millions out of Ohtani’s bank accounts to gamble. We, of course, are supposed to believe this happened without Ohtani knowing a thing. OK, this just might be believable in a world in which the only thing Shohei the Magnificent must keep up with in his bubble is the thousand-dollar set of headphones he wears in the clubhouse and on the Dodgers jet. It is not believable for a nanosecond that his waddling of financial managers and agents did not see the money disappearing. But the $700M second coming of Babe Ruth, pitching and hitting homeruns at the same time, being cast into the outer darkness like either Shoeless Joe Jackson (took the money and still hit .375) or Pete Rose (RIP but willfully guilty of the cardinal sin of a professional baseball player)? Inconceivable.
Short and sweet and worth the read. In my hometown when I was very young we had a Class D team filled with dreamers of all ages. A handful eventually made it to the Major Leagues and one became Governor of New York. Alas, the league folded just before I would have been old enough to sit in the bleachers by myself. I am still a bit put out by that, but I did play in the same stadium years later. I think the ghosts remain there to this day.
Remember, life is good but only if we make it so. See you next week.