Some times the quackery makes me laugh

There’s a lot that distresses me about naturopaths and other quacks. They are a genuine danger to the health of all those who encounter them. This may be in the form of an active danger – cases abound of them prescribing contra-indicated drugs – or it may be in the form of a more passive danger, such as when someone with an easily treatable but potentially deadly disease is misdiagnosed by one of these poorly trained charlatans – but they are a danger any way one wishes to look at it. That said, that doesn’t mean the ineffective methods of these quacks can’t be hilarious. Take this interview with Portland quack Sarah Kotzur:

To determine the best course of treatment, including an appropriate homeopathic remedy, Dr. Kotzur spends two hours with a new patient. “I’m trying to know you as a whole person,” she says. “I’m going to ask about what kind of dreams you have, what kind of food you crave. What is your body temperature? Do you sweat? Are you thirsty?”

Emphasis mine, hilarity Kotzur’s. One wonders how she decides to interpret this arbitrary information when ‘treating’ one of her ‘patients’. If the person has dreams where they can’t run fast, does that mean she prescribes a dose of treadmill time? Tough to tell, but I’d venture a guess that most of her ‘treatments’ come down to garlic, some sort of berry, and/or what is basically water.

The rest of the article goes into attempting to legitimize the practice by noting how it works with insurance and licensing:

Naturopathy has come a long way since the 1980s. There are currently six accredited schools of naturopathic medicine in the United States and 16 states now offer practice licenses. Maine has been licensing naturopathic doctors since 1996.

What the article failed to mention, and what naturopaths don’t want people to know, is that naturopathy is specifically banned in South Carolina and Tennessee. It isn’t medicine, it isn’t related to science, and every single one of its practitioners is a quack.

Anti-science quacks find success in Maine in their fight against health and vaccines

Vaccine rates for young people entering school has been declining in recent years:

The rate of unvaccinated kindergartners in Maine continues to climb and is now the fifth highest in the nation, according to a U.S. Centers for Disease Control and Prevention report released Friday.

The percentage of Maine parents voluntarily opting out of vaccines for their children is alarming state public health officials who have been working to bolster immunization.

Nearly 800 public school kindergartners in Maine started the 2013-14 school year without receiving the required vaccinations for diseases such as whooping cough and measles because their parents opted not to immunize. That represents 5.2 percent of all kindergartners in the state, up from 3.9 percent the previous year.

This is in large part due to the anti-vax movement that has been steadily gaining ground since the 90′s. Indeed, although disgraced British doctor Andrew Wakefield had his 1998 study linking vaccines and autism debunked – no one ever reproduced his results, and it was no wonder since he outright made them up – he remains a hero of the anti-vax crowd.

One of the more favored canards of anti-vax quacks is to call herd immunity a myth. Do a quick search and one is liable to find any given quack claiming that herd immunity makes no difference to the health of a state. I recall reading some random anti-vax nobody argue that because vaccines are between 60-80% effective, even with 100% compliance, we could still see an epidemic. Of course, while he spoke of vaccines at-large in an intentionally general sense, he actually linked to CDC statistics on the flu vaccine. I guess it was a coincidence that he found it inconvenient to tell his readers that he was talking about one specific vaccine, huh? So is the high bar set by quacks.

At any rate, for herd immunity to be effective, there needs to be about a 95% vaccination rate. Of course, 100% would be the ideal because we’re talking about saving human lives, but with all the anti-government and anti-science kooks out there, 95% is actually a very achievable number that allows for some bumper space. Unfortunately, sometimes we see areas that fall well below that bumper space. For instance, when vaccine rates for whooping cough fell to 91% in California, communities there saw an outbreak in the disease. Thousands got sick and at least 10 infants died. What makes this all the more heart-breaking is that these infants were too young to be vaccinated, meaning they relied upon the herd immunity around them to remain safe. Anti-vax parents and the quacks they trust are at fault for these deaths. Frighteningly, Maine is on a similar path.

The value of repetition

One of the most important things I heard while in college came from one of my favorite biology professors. It happened in an early intro class half-filled with bio majors, half-filled with people looking for a course with a lab. He was covering the basics of science itself, speaking to the value of repetition:

Science is all about reproducibility. If you can’t reproduce your data, it’s all a load of horseshit.

That isn’t to say a person can automatically discredit some new piece of research simply because it’s new and has therefore not yet been reproduced. What it means is that when scientists do attempt to reproduce previously found results, they need to be successful in order for the results to be accepted. An unfortunate side effect of human nature means that we don’t see negative results published as often as we should – unless, of course, they disprove what someone else has already published – but these results do still happen every single day. That’s just science.

This all brings me to a recent piece of news:

Scientists have managed to repeat one of the biggest medical breakthroughs of the last few years.

Almost exactly one year ago, Johns Hopkins researchers made national headlines when they announced that they’ve vanquished the AIDS-causing virus from a child born to an HIV-positive mother in Mississippi. They began antiretroival treatment before the baby was 30 hours old. She’s now 3.5 years old and still virus-free, even without treatment in the last two years. Researchers have puzzled over how it happened, and many remain skeptical. The child was only the second person ever to be “cured” of HIV; the first was an adult through a stem-cell transplant. Since it’s difficult to prove that the body has been completely cleared of HIV, Nature explains, being “functionally cured” means the virus is effectively controlled and the immune system stays healthy without treatment.

Just yesterday, doctors announced that they have cleared the virus from a second baby infected with HIV. This girl was born in Los Angeles last April to a mother with advanced AIDS who had not been taking her medication. With aggressive treatment beginning just four hours after her birth, the virus was undetectable within 11 days, the New York Times reports.

A sample size of 2 does not scientific fact make (though there are upwards of 8 other unconfirmed cases around the world), but it cannot be understated how much this bolsters the legitimacy of attacking HIV in infants this way. It could turn out that the virus is still living somewhere in the bodies of these children – adults who have been functionally cured have had the virus return shortly after certain surgeries such as bone marrow transplants – so this remains a game of wait-and-see. However, if this proves to be an effect method for curing HIV, then not only will there be immediate benefits to HIV-positive newborns, but some insight may be spread into how we can better detect the hidden HIV in adults patients who are functionally cured.

The Second Law of Thermodynamics

To the right is one picture out of a series that was taken after the Bill Nye-Ken Ham debate the other night. Creationist question Creationists were asked to write questions that they would like to ask of Nye. (I’d link the whole series, but it came from BuzzFeed. I already feel dirty enough having clicked the link myself.)

To answer the man’s question, the second law of thermodynamics does not disprove evolution. The second law states that the entropy of an isolated system never decreases. That is, things because less orderly and more chaotic over time without an input of energy from an outside source. Since the Universe is an isolated system as near as we can tell, all the organization we see will eventually dissipate – no more stars or planets or black holes or anything else that uses energy. Eventually even all atoms will cease to move.

Creationists believe this fact of the Universe applies to evolution because they view evolution as greater and greater organization over time, and that requires an input of energy. They’re right so far. Where they fail is in their belief that greater and greater organization is not possible over time. As best as any rational person can tell, creationists appear to believe Earth is a closed system and that with enough time it should all fall away. Except it isn’t closed. That big yellow ball in the sky has a tendency to provide us with more energy than we know what to do with. (Not that we’ve been the best at harnessing it.)

Of course, we don’t need to even go as far as the Sun – at least so long as we aren’t talking about plants or photosynthesizing bacteria. We take in energy all the time. It ultimately comes from the Sun and, to an extent, Earth’s core and magnetic field, but on a day-to-day level, we don’t exist in a closed system at all. A dinosaur that killed another dinosaur had a source of energy to take in: the dead dino. An early hunter-gatherer would find energy by hunting and gathering. And right now I’m about to go find some energy in a hot chai tea.

Avoid these sources for your science

This is a very brief and very far from exhaustive list of sources one ought to avoid when looking for any sort of scientific information. After each person and/or organization is a list of the area in which they most commonly spread lies:

Deepak Chopra – Quantum physics, alternative medicine

NaturalNews.com/Mike Adams – Alternative medicine, vaccines

EvolutionNews.org – Evolution, intelligent design

Dr. Oz – Alternative medicine, apple juice

Andreas Moritz (though he is now deceased) – Cancer, HIV/AIDS, Diabetes, all around quack

WattsUpWithThat/Anthony Watts – Global warming

Dr. Keith Ablow – Psychiatry, youth psychology, gender issues

Stanislaw Burzynski/Burzynski Clinic – Cancer, quack treatments

Marc Stephens – Mostly law, but he lied about being a lawyer in order to try and protect the Burzynski Clinic

By Michael Hawkins Posted in Science

Get vaccinated

It never ceases to amaze me just how many anti-vax people there are out there. Every time I bring up the topic it isn’t the pro-vaccine people who come out in support. No, instead it’s almost exclusively the anti-vax quacks. I suppose the same thing happens with circumcision, 9/11, and a history of Obama’s life: the anti-circumcision crowd, truthers, and birthers are going to immediately overwhelm the discussion. But even with this massive selection bias, the sheer number of nuts out there is incredible. I suspect to see as much regarding this post, should it garner a response at all. However, as a decent human being with a little bit of knowledge, I feel duty-bound to present a few vaccine facts.

Vaccines are incredibly safe. This is true of all vaccines, but especially of the flu vaccine. The most likely side effects anyone is going to suffer are mild soreness or a low grade fever. A study from about 10 years ago did find that one version of the swine flu vaccine from the mid-70′s was associated with a tiny increase in Guillain-Barré syndrome, but correlation is not causation. No one knows why there was such an association, but for this reason those with a history of the syndrome are cautioned and should speak with their doctor to assess their exact situation. Also, those with severe egg allergies are cautioned, plus those who are currently sick with one thing or another should wait.

Vaccines change each year because of evolution. From time to time I’ll hear an objection to the fact that the flu vaccine is different each year. Why, the argument seems to go, scientists are just guessing. That’s not true. While they are making an educated guess, it’s more than just throwing up a prayer and hoping they get it right. Each year’s vaccine is based upon the most recent research and information available. This is necessary because of the speed of a virus’ evolution.

Everyone over 6 months old should get vaccinated. This, of course, takes into account the caveats I’ve already presented, but for the vast majority of people, vaccination is recommended. Vaccines save lives, and if that’s not important enough to you for some crazy reason, they also save money by cutting down on sick days.

The flu vaccine is effective. Exactly how effective the flu vaccine is will vary from year to year, as well as from age group to age group. A person’s overall health is also a factor. In general, though, the vaccine’s effectiveness ranges from 50-80%. The most common (and most annoying) ‘counter’ to this is to look at absolute risk reduction. A person who does this is usually either a quack or has gathered information from a quack. It isn’t that absolute risk reduction is invalid. It’s a perfectly good way to understand how wide-spread a disease or sickness is and how our health policies are dealing with it. For the flu vaccine, the actual reduction in risk is about 1.5%. That sounds miniscule, but we can make a lot of things sound miniscule. What’s happening here is we’re looking at the total population and calculating the number who would get the flu without any vaccine. That’s a very small percentage. Then we’re looking at how likely it is that of the percentage that actually gets vaccinated is going to not get the flu as a result. Again, this is useful. However, when presented in the context of this discussion, it isn’t useful. It would be as if someone argued that since the absolute risk of contracting HIV in Tanzania is very low over, say, intercourse with 5 different partners, the 97-99% effectiveness of condoms is moot. Why, who needs condoms? You probably won’t contract it anyway! Pshaw.

Vaccines, not sanitation, have eradicated or nearly eradicated disease. While it’s obviously true that increased bathing, hand washing, and better filtered water have made us healthier and less likely to contract various diseases, these alone cannot get rid of disease. Smallpox has been eradicated for over 30 years now because of vaccines, not because more people than ever are buying bars of Irish Spring soap. Polio is nearly eradicated because of vaccines; India was recently declared polio free – that isn’t a country exactly known for its impeccable sanitation practices. Yellow fever persists because so many people go unvaccinated (even though the vaccine is 99% effective), and no amount of sanitation is going to change how many people die from it each year since its primary vector is the mosquito.

There are far more thorough sources out there that have vaccine facts covered in much better detail than I have here, so this is far enough for me. I simply wanted to address some of the issues that bother me the most about the vaccine misinformation floating about. For nearly every single person, vaccination is the smart option. The caveats are small and specific, the side effects minor and manageable. Get vaccinated.

Fun fact of the day

Have you ever wondered why the average human body temperature we always hear about is 98.6 F? How did they get so specific? Did they conduct a bunch of studies and actually come to that exact average?

Nope!

It’s simple, actually: The rest of the world uses the metric system, so we tend to list the average human body temperature at 37 degrees Celsius. That isn’t to say that’s the exact number. It isn’t; human body temperature naturally fluctuates slightly throughout the day, so there really is no exact number. It just so happens that the average temperature is around 37 degrees Celsius, which, you guessed it, is equivalent to 98.6 degrees Fahrenheit.

Circumcision as a public health policy

At this point it has been established that circumcision reduces female-to-male HIV transmission rates by around 60%. Like it or not, the science is in. Now the question has shifted to being about why it reduces transmission, as well as how we can best introduce circumcision has a public health policy. On the first point, the general answer is that the foreskin is a relatively large surface area subject to tearing and softer (non-keratinized) skin. On the second point, though, I wasn’t aware of any actual policies in place to save the lives of men and women in regions particularly vulnerable to the spread of HIV. As it turns out, multiple sub-Saharan countries have undertaken measures to dramatically increase circumcision rates – though much work is still required:

Zambia is still 75 per cent short of its target of two million circumcisions by 2015. So is Uganda, having completed 1.5 million towards its 4.1 million target. Kenya has achieved its target in numbers – but not among the “right” men.

The donors who are pouring cash into male circumcision following the landmark 2006 study which showed that it reduced the risk of HIV infection by 60 per cent, have neglected a crucial factor – the attitude of women.

A man who gets circumcised is often viewed as a man who is looking to sleep around as much as possible. And, indeed, this has become something of a problem, as HIV rates in some areas have remained steady. This may also be due to men not waiting the necessary 6 week healing period – 40% of newly circumcised men had sex while still healing, actually resulting in an increase in their likelihood of contracting HIV. Furthermore, we may be seeing the problem of moral hazards at play. This is where risk is reduced for one thing or another, so people are less cautious in return. Some examples are playground materials and car safety. In playgrounds, children are often getting hurt as much if not more than in previous years because they’re playing on soft wood chips or rubber, leading them to believe they can fall harder and get hurt less. With cars, safety has greatly increased and deaths have fallen, but accidents remain steady or on the rise. People with seat belts are willing to speed more than those without them.

But the real problem in these sub-Saharan nations is a lack of education and peer support:

Carol Musimami, one of 30 “technical advisers” who counsel the men, said: “You will see the older ones come after dark. They don’t want to be with the youth. We are targeting the 25 to 35-year-olds –they are the ones with the money, they buy the women, they are exposing themselves [to infection]. But they are hard to get. They don’t want others to know,” she says.

Leadership is key. In Kenya, the circumcision programme in Nyanza province in the west – one of the three centres in the landmark 2006 trial that proved its effectiveness – was faltering when Raila Odinga, the Prime Minister and a member of the non-circumcising Luo tribe, responded to protests from tribal elders fearing the loss of their identity by declaring: “We don’t lead with our foreskins, we lead with other faculties. This is a medical issue.”

The speech, in 2008, proved a pivotal moment and more than 500,000 Luos have since been circumcised.

This is a major issue in global health. Science can find all sorts of answers to major problems, but that doesn’t mean it’s all just a matter of policy implementation after that. For instance, Jimmy Carter and WHO launched a campaign to eradicate Guinea worm disease in 20 African nations in the 1980′s. The primary approach to this was to make sure people had clean drinking water. With funding, wells were built and larvacide was added. However, one of the biggest pushes was to get people to drink clean water was to give them simple cloth filters. Unfortunately, this came with two problems. One was simply logistical: the filters clogged. The other was that the cloth material was too aesthetically pleasing, so people would often use them as decorative items. When the Carter Center, Precision Fabrics, and DuPont worked together to distribute plain nylon cloth filters (and education), the problem quickly shrank. There were 3.5 million cases of Guinea worm disease in 1986. As of 2005, the number had dropped to 11,000. This underlines the need for cultural understanding in addition to the simple cold science of the matter. Greater peer interaction and promotion of circumcision may be the key in getting places like Zambia to that 2 million goal.

At any rate, I’m very pleased to hear about these ongoing efforts to spread circumcision in developing nations in order to curb the spread of HIV. This is a triumph of common sense, global health initiatives, science, and basic humanity.