Vol.254 April 15, 2021 . . . MEANWHILE

“History is merely a list of surprises.
It can only prepare us to be surprised again.”
– Kurt Vonnegut

Taking a clue from Stephen Colbert, I am taking a week off from writing about COVID-19 etc. for a change of pace. So here is a bunch of other etc.

Carbon footprint, or carbon rain?
Advocates for doing something to retard climate change keep talking about our carbon footprint. It might be more effective to take our eyes off the ground and look up, to see  those exhaust trails of hydrocarbons from jet planes.  FedEx flies 679 planes A DAY. UPS flies 572 daily. Amazon Air flies an average of 140 a day, which is double that of a year ago. Amazon Air hopes to fly 225 daily by the end of 2022. That’s 1500 jet planes a day in the air a day spewing 53 pounds of carbon dioxide per gallon right into the upper reaches of our atmosphere just to “deliver our packages the same day.” Isn’t capitalism wonderful?! (CNBC.com)

How Medicare controls medical care costs American medical delivery.
As of January 1, 2021 two hundred and sixty-six (266) shoulder, spine,and other musculoskeletal procedures will be reimbursed byMedicare ONLY if performed as an hospital outpatient, i.e. they have been removed from the Medicare reimbursement “inpatient-only list”. Medicare officials say this 180 degree reversal will promote more competition among hospitals and independent ambulatory surgical centers. It will result in lower payments to the hospital by Medicare for the same surgery (reimbursement for outpatient services is lower than inpatient services) and will therefore “lower the cost of medical care”. The Center for Medicare Advocacy calls it “nothing about giving more choices to providers . . . It’s about Medicare billing practices that will further confuse hospital patients.” (BosGlobe 3/22/21, D3)

“Performance” beers?
Some craft brewers are making new potions to help the athlete with the dilemma of what to drink after a long work out, a watery light beer or a high-alcohol IPA. Harpoon offers “Rec. League Hazy Pale Ale”, a low-alcohol IPA “fortified with protein-rich buckwheat kasha, chia seeds, and sea salt.” Another brewer offers “Boulevard Easy Sport” with tangerine peel in their “electrolyte-laden blond ale.” “Some of them are pretty tasty”. Oh boy, kasha and chia seeds in my beer! Is nothing sacred? I’ll stick to Treehouse, Be Hoppy, and Trillium as I just consider a work out. (THE WEEK, 3/12/21)

Children’s colds have decreased this winter, (aka what ever happened to the flu epidemic this year?).
A pediatrician at the Boston Medical Center reports that the reduction in respiratory illnesses among young children is probably a side effect of them wearing masks against “that virus that we can not speak its name” (this week). “I don’t think anyone believes that a 3-year-old would keep on a mask, but they do. It’s amazing”. As a pediatrician who has seen newborns accept foot casts, learn how to mobilize very well with them, and watch elementary school children learn how to give themselves injections or even self-catheterize, I am not surprised. (BosGlobe 2/14/21)

Half a million sign up for ACA premium subsidy
With the number of uninsured Americans rising during the pandemic, the Biden administration on April 1, reopened the Affordable Care Act federal health insurance “markets” offering lower premium options, increased the premium subsides of the ACA, and extended the sign-up window for uninsured Americans to August 15. Despite efforts by the previous administration (another “name we dare not speak” per Colbert) tried to overturn the ACA, more than 20 million people remained under its coverage at the end of “his” term.

Remember the other epidemic?
CVS, Walgreens, Walmart, RiteAid and other pharmacy owners are facing thousands of lawsuits brought by governments in at least nine different states seeking to recover the costs of police work and drug treatments related to opioid overuse. The first trial is scheduled for November 2021 in Ohio. If opioid distributors (pharmaceutical companies) like Johnson & Johnson ,McKesson, and Perdue can seal a deal for settlement of their lawsuits for a total of $21 billion (that is a “B”), there are big bucks involved and the pharmacy chains hope that juries will agree that they were “just following orders from licensed doctors”. (BosGlobe 4/8/21)

. . . and legalization of marijuana?
Tobacco companies are gearing up to enter the booming market of recreational marijuana. In 2018 the makers of Marlboro cigarettes invested $1.8 billion (another “B”) in a cannabis producing company and $12.8 billion (“B” once again) in Juul, the maker of nicotine vape products. It is true that nobody has ever overdosed on marijuana, but there are other lung-damaging chemicals in the smoking products besides the nicotine, which we now know is truly addictive. Data suggests that “rigorous public health regulations for marijuana” that sharply restrict advertising and packaging that appeal to children have resulted in reduced youth usage rates in those states that have legalized adult marijuana use. To avoid the “past tragic public health consequences of cigarettes . . .federal policy makers should work with tobacco control and state-level marijuana experts to prevent Big Tobacco 2.0” from taking over. (BosGlobe 4/8/21 – from Dug Enforcement and Policy Center, Ohio University)

. . . But more marijuana dispensaries reduce opioid deaths
A three year study of 812 counties in 23 states that had legalized marijuana use by 2017 showed that the total number of dispensaries per county was inversely related to the number of opioid-related deaths; doubling the number of dispensaries was associated with a 17% reduction in opioid-related deaths, particularly for synthetic opioids like fentanyl. No cause for this relation was suggested.  “Further research into the role of cannabis in managing chronic pain is needed.” (BMJ Jan 27; 327)

Trading cancer for not having a heart attack?
Poor low-dose aspirin, over the years it has been subject to so many pro and con studies of its role in preventing heart attacks. Most studies show that daily aspirin provides little benefit to those who have not already had a heart attack, i.e. it does not provide “primary prevention”. And now a 5 year follow-up study of 19,000 healthy people over 70 yo. suggests that a low-dose aspirin a day may increase the metastatic spread of a local cancer. No new cancers were associated with the aspirin use, but the study contradicts other studies in younger people suggesting that daily low-dose aspirin might protect against cancer. “Whatever the explanation, this analysis strengthens the case against aspirin prophylaxsis for primary [heart disease] protection in older people.” (JNatlCancerInst 113:258 March 2021)

The science behind a perfect gin and tonic finally revealed
Just in time for summer, Bill Nye, the Science Guy, has revealed that the correct ratio for an excellent gin and tonic is 1 part gin to 3 parts tonic; and “it is impossible to get them too cold.” The fact that 1:3 is the exact ratio of Bombay Sapphire’s newly canned gin and toxic for which Bill Nye, the Science Guy, has been hired to promote is just a coincidence, I’m sure. The brand name may be “RTD G&T”, “Ready To Drink Gin & Tonic”.
Isn’t capitalism wonderful!

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