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.

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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.

This is incredibly impressive

Daniel Radcliffe (perhaps better known as Harry Potter) recited “The Element Song” on The Graham Norton Show several years back. It’s damn impressive.

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.

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

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.

Marketing that tricks you

A show on the National Geographic Channel called Brain Games has a good track record of exploring and explaining how our brains work, especially in every day circumstances. It’s probable that a good deal of why they work how they do has an evolutionary basis, but it’s also likely that some of their operation is simply incidental, an accident of our emergence from the jungles to the savannah to civilization.

One of my favorite episodes is called “Power of Persuasion”. It’s all about how marketers and advertisers get you to think what they want you to think. The show conducted an experiment (for which there was already ample, controlled evidence) where they sold popcorn to unsuspecting movie-goers. The first set of movie-goers was given a choice between a $3 small bucket and a $7 large bucket. Even when prodded to go for the more expensive choice, most people chose the $3 bucket. When interviewed later, people said they felt like $7 was way too much, and besides, the smaller bucket was more than enough anyway. The second set of movie-goers, however, was given a different set of choices. In addition to the $3 and $7 buckets, they had the option of a $6.50 medium bucket. Many of the patrons chose the medium bucket. When they did, the person behind the counter asked if they wanted to upgrade to the $7 bucket. After all, it was only another 50 cents. A significant percentage of people took the bait, purchasing the large bucket. In their interviews, they said it seemed like they were getting a better deal. Even while making the purchase, some could be heard saying, “Well, it’s only another 50 cents.” People believed they were getting a better deal.

What underlies this exercise is that an extra data point was introduced. In the first scenario the information was limited. Regardless of the price per ounce (which wasn’t given), the $7 bucket was well over twice the price of the small, but it certainly didn’t appear to be twice as big. The perception of the large bucket’s value was low. However, people in the second scenario had a third data point. The small bucket may have still been the best deal, but the $6.50 bucket normalized the prices on the higher end. The $7 bucket’s price was still over twice the price of the small bucket, but it was relatively close in price to the medium bucket; two of the choices had similar prices, so the highest price no longer seemed so extreme. Then when given the choice to spend a relatively small amount more (50 cents), the most expensive bucket seemed like a downright deal.

Now think to all the times you’ve done this. When you look into buying an item, are you only looking at the quality? Or are you looking at the value you’re getting? How often have we all opted to buy the medium-priced item because we don’t want something cheap, but the highest priced items are too much? And how often have we allowed ourselves to spend just a little more because the next product level was so close to what we were willing to spend on a slightly inferior item? I don’t know about you, but I think about this every time an employee at my local cafe asks if I want to upgrade from a medium to a large for just another 30 cents. It seems like a good deal, and maybe it is, but do I actually want more chai tea or do I just want more value?

New warning labels for junk alt-med vaccines

The alt-med crowd is notoriously anti-vaccine despite the high level of safety of vaccines – even despite how many lives vaccines save every year. Real medicine being so effective against what were once devastating, wide-spread diseases just doesn’t fit the alt-med narrative. Yet does that stop them from peddling their own ‘vaccines’? Of course not. And would you believe it? Their vaccines aren’t even effective:

Health Canada is cracking down on the sale of so-called homeopathic vaccines that are falsely promoted by some naturopaths and homeopaths as safer and more effective than traditional vaccines.

The department has altered the document that outlines how homeopathic vaccines should be used, saying they must now contain the following warning: “This product is not intended to be an alternative to vaccination.” The document, called a product monograph, was updated June 24, one month after The Globe and Mail published a story outlining the concerns with homeopathic vaccines.

“We’re very glad … they’ve taken this step,” said Jamie Williams, executive director of Bad Science Watch, a Canadian advocacy organization that led a campaign against homeopathic vaccines. “We feel that it will be a help to consumers who might not have been getting the full information to make a more informed health choice before this.”

But what’s in these so-called vaccines, you ask? Well, ultimately nothing. But they made sure to take a gross path to that nothing:

Homeopathic vaccines, also known as nosodes, are made from infected saliva, feces or other material. The substance is mixed with alcohol and diluted until it is harmless, according to the homeopathic and naturopathic practitioners who sell the products. They say nosodes produce an immune response and that research shows it protects as well, if not better, than traditional vaccines.

In other words, they disinfect some feces or spit before essentially filtering it back to water. Anyone looking to imbibe this malarkey would be better off spitting into their Brita water filter and drinking the purified water that comes out. At least then they would have a water filter in addition to having wasted their time. And as for what research shows? It’s a lie. People who promote this sort of quackery cite poorly done studies with a tiny number of participants; the studies are never replicated and they never appear in any journal with any dignity. It’s all agenda-driven drivel that, in the end, makes the homeopath a butt-load of undue money. Take this advice from Jamie Williams, executive director of Bad Science Watch:

“Do not listen to somebody in a health store who’s trying to sell you $30 worth of sugar pills,” he said.