HUB's LIST of medical fun facts

Stephen Colbert, after a blistering opening monologue skewering Trump, will sometimes go to a segment called “Meanwhile. . . ” in which he offers a potpourri of brief unusual, peculiar, or even bizarre events from around the world in an attempt to distract us from the monotony of repetitious news reporting. My collection of these bits and pieces are not at all as funny as Colbert’s, but are offered in the same spirit.

Meanwhile . . . what ever happened to the opioid epidemic? We are still in the midst of it. Even though it has disappeared from the front pages, even the front sections, of our newspapers, it continues. The bad news is that the non-fatal overdose rate has increased by 10% since 2018; about 70,000 more overdoses in 2019. The fatal overdose rate has increased to 3%, primarily due to presence of the synthetic opioid, fentanyl. The good news is that the number of physician prescriptions of opioids has decreased by nearly 40%, and the number of naloxone prescriptions (the “rescue” drug for overdoses) increased by 1 million since 2018.

Meanwhile . . . one of Google’s artificial intelligence (AI) programs that assists pathologists in detecting cancer cells is being tested in the VA medical system under a grant from the Defense Department. Because there is no “gold standard” of cancer detection on tissue review (i.e. different pathologists may interpret tissue slides differently), the AI program “draws an actual line around suspicious areas of the slide being viewed by the pathologist in an augmented-reality microscope”. Previous AI programs like this for breast cancer and prostate cancer detection have decreased “false positives” that can lead to “unnecessary” diagnostic and treatment interventions, but have not led to improved outcomes (i.e. reduced mortality rates). Medicare won’t reimburse for AI efforts until they prove effective in improving outcomes. (Boston Glob,e September 14, 2020)

Meanwhile . . . more Americans have lost their health insurance during the COVID-19 pandemic than ever before in U.S. history. According to a July report from Families U.S.A. 5.4 million adults from February to May 2020 have become uninsured due to job loss. The cost of hospitalization for COVID-19 infection can range from $14,000 to $75,000. Uninsured people hospitalized for COVID-19 are still cared for, but the cost of their care results in more hospital debt, higher premiums for private health insurance, and higher state and federal taxes. The good news: In 1989 we had 40 million uninsured. Prior to COVID-19 we had decreased it to about 28 million uninsured primarily because of the Affordable Care Act (Obamacare). The bad news: the Robert Wood Foundation estimates that by this December 10 million more will remain uninsured as a direct result of pandemic-related job loss.

Meanwhile . . . the percentage of middle school and high school student’s that vape has decreased in the last year. High school student vaping has decreased from 28% to 20% while middle school student vaping has halved from 11% to 5%. The public health media campaigns, price increases, and restriction of sales to those 21 years or older is given credit for this decrease. Also, Juul voluntarily pulled off the market all their vaping flavors except menthol last fall. Teen smoking of tobacco (separate from vaping) has decreased to a low of 6% by the same CDC survey.

Meanwhile . . . the sale of vinyl records has surpassed that of CDs for the first time since 1986; $232 million for vinyl records vs. $130 million for CDs in the first half of 2020. This has nothing to do with medical fun facts, but my son-in-law, a successful singer-songwriter Mark Erelli, continues to try to make a living during the pandemic, so this bit caught my eye.

Meanwhile . . .  under OWS (Operation Warp Speed), the public-private effort to develop and distribute a COVID-19 vaccine, the 9 companies racing to do so have recently issued public announcements that they will rigorously abide by FDA approval protocols for safety and effectiveness. Since there are at least 7 different molecular pathways by which a vaccine might provoke immunity against the virus, we will see several different vaccines being offered. No doubt, making the choice of which vaccine to take will complicate our confusion even more (just do the math; 7×9=63). Other problems that can be anticipated: the Pfizer vaccine must be stored at minus 70 celsius (or minus 94 Fahrenheit) which pretty much rules out vaccine storage  in doctor’s offices , and the FDA staff has had little input and no participation in discussions by OWS on how their $10 billion (B as in billion) has been or is to be spent. The good news: OWS has contracted with McKesson to be a central distributor of a vaccine, a job they have done very well in the past for the annual flu vaccine.

Meanwhile . . . speaking of the flu, Chile and Australia are reporting a much lower incidence of flu infections this year which is attributed to the COVID-19 precautions in both countries. Every year the U.S. watches the flu incidence in Southern hemisphere countries like Chile and Australia during this, their winter season, to gauge the potential flu impact on us for our winter season. This data suggests that if we keep following COVID-19 prevention protocols we might have LESS influenza infections, hospitalizations, and deaths this flu and winter.

Meanwhile . . . in the face of our numbness from relentlessly repetitious statistics (including this blog!) a columnist for the Washington Post has suggested using different measurement units to break through the numbing fog, i.e.:

• “The number of lives lost to COVID-19 is roughly equal to sixty (60) 9/11 attacks. or about 46,000 ‘Benghazis” (4 tragic deaths).”
• “New applications for unemployment benefits during one week in August equaled about 2,300 ‘Carrier plants’ (700 employees) which Trump took credit for saving in 2016.”
• “The national debt increase during Trumps’s single term to date equals two ‘Obama terms’ increase.”
• “The number of senior Trump officials reportedly using private emails for official business equals 8 ‘Hillary Clintons’.”

Meanwhile . . .  Get your flu shot now. Don’t wait.