Scientist’s Plasma Shot That Could Prevent COVID-19 Isn’t Being Considered by The Government

That the use of plasma (shown effective in many other cases) isn’t being considered is another inefficiency by the (U.S. at least) governmental response to the coronavirus pandemic.

It might be the next best thing to a coronavirus vaccine.

Scientists have devised a way to use the antibody-rich blood plasma of COVID-19 survivors for an upper-arm injection that they say could inoculate people against the virus for months.

Using technology that’s been proven effective in preventing other diseases such as hepatitis A, the injections would be administered to high-risk healthcare workers, nursing home patients, or even at public drive-through sites — potentially protecting millions of lives, the doctors and other experts say.

The two scientists who spearheaded the proposal — an 83-year-old shingles researcher and his counterpart, an HIV gene therapy expert — have garnered widespread support from leading blood and immunology specialists, including those at the center of the nation’s COVID-19 plasma research.

But the idea exists only on paper. Federal officials have twice rejected requests to discuss the proposal, and pharmaceutical companies — even acknowledging the likely efficacy of the plan — have declined to design or manufacture the shots, according to a Times investigation. The lack of interest in launching development of immunity shots comes amid heightened scrutiny of the federal government’s sluggish pandemic response.

There is little disagreement that the idea holds promise; the dispute is over the timing. Federal health officials and industry groups say the development of plasma-based therapies should focus on treating people who are already sick, not on preventing infections in those who are still healthy.

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health, said an upper-arm injection that would function like a vaccine “is a very attractive concept.”

However, he said, scientists should first demonstrate that the coronavirus antibodies that are currently delivered to patients intravenously in hospital wards across the country actually work. “Once you show the efficacy, then the obvious next step is to convert it into an intramuscular” shot.

But scientists who question the delay argue that the immunity shots are easy to scale up and should enter clinical trials immediately. They say that until there’s a vaccine, the shots offer the only plausible method for preventing potentially millions of infections at a critical moment in the pandemic.

“Beyond being a lost opportunity, this is a real head-scratcher,” said Dr. Michael Joyner, a Mayo Clinic researcher who leads a program sponsored by the Food and Drug Administration to capitalize on coronavirus antibodies from COVID-19 survivors. “It seems obvious.”

The use of so-called convalescent plasma has already become widespread. More than 28,000 patients have already received the IV treatment, and preliminary data suggest that the method is safe. Researchers are also looking at whether the IV drip products would prevent new infections from taking root.

The antibodies in plasma can be concentrated and delivered to patients through a type of drug called immune globulin, or IG, which can be given through either an IV drip or a shot. IG shots have for decades been used to prevent an array of diseases; the IG shot that prevents hepatitis A was first licensed in 1944. They are available to treat patients who have recently been exposed to hepatitis B, tetanus, varicella and rabies.

[…]

The proposal for an injection approach to coronavirus prevention came from an immunization researcher who drew his inspiration from history.

Dr. Michael Oxman knew that, even during the 1918 flu pandemic, the blood of recovered patients appeared to help treat others. Since then, convalescent plasma has been used to fight measles and severe acute respiratory syndrome, or SARS, among other diseases.

Like other doctors, Oxman surmised that, for a limited time, the blood coursing through the veins of coronavirus survivors probably contains immune-rich antibodies that could prevent — or help treat — an infection.

[…]

Throughout May, researchers and doctors at Yale, Harvard, Johns Hopkins, Duke and four University of California schools sent a barrage of letters to dozens of lawmakers. They held virtual meetings with health policy directors on Capitol Hill, but say they have heard no follow-up to date.

Dr. Arturo Casadevall, the chair of the National COVID-19 Convalescent Plasma Project, said he spoke to FDA officials who told him they do not instruct companies on what to produce. Casadevall told The Times that the leaders of the national project were “very supportive of the need to develop” an IG shot rapidly and that he believed it would be “very helpful in stemming the epidemic.”

Joyner, of the Mayo Clinic, said there are probably 10 million to 20 million people in the U.S. carrying coronavirus antibodies — and the number keeps climbing. If just 2% of them were to donate a standard 800 milliliters of plasma on three separate occasions, their plasma alone could generate millions of IG shots for high-risk Americans.

“At a hot-spot meatpacking plant, or at a mobile unit in the parking lot outside a mall — trust me, you can get the plasma,” Joyner said. “This is not a biological problem nor a technology problem. It’s a back-of-the-envelope intelligence problem.”

The antibody injections, for now, do not appear to be a high priority for the government or the industry.

Grifols, on April 28 — the same day that the U.S. topped 1 million confirmed coronavirus cases — made a major product announcement that would “expand its leadership in disease treatment with immunoglobulins.”

The product was a new vial for IG shots — to treat rabies.

How Air Pollution Can Harm Brain Health

It has long been rather stunning to me how careless many people are about air pollution. One of the most important things that people shouldn’t do is drive with their windows down in areas with significant traffic (and thus significant amounts of air pollution from vehicles). The motive for caring is rather simple — air pollution’s negative impact on brain health means possibly reduced performance on a variety of tasks, and that can negatively correlate with achieving life goals, which in turn is detrimental to human happiness and satisfaction.

Long thought to primarily harm the lungs and cardiovascular system, air pollution is now catching the attention of neuroscientists and toxicologists.

The buzz of a leaf blower and its gaseous fumes fill the air outside a lab facility at the University of Washington in Seattle. Inside the building, neurotoxicologist Lucio Costa is investigating how polluted air—such as garden tool exhaust—could be bad for the brain.

Next to the building sits a 5,500-watt diesel generator, enclosed in a metal box. Pipes carry the diesel exhaust—the same stuff emitted by diesel engines in vehicles and heavy equipment—into the facility, across an exposed ceiling and into a room where plastic cages of mice are stacked high against the wall. Tubes filter the diesel exhaust through the cages, Costa explains, in an effort to mimic the contaminated air you might breathe while sitting in traffic or living near a busy road.

After spending most of his career studying mercury, pesticides, and flame retardants, Costa knows well that many toxins in the environment can hurt the brain. But only in the last several years has the possibility of air pollution as a culprit crossed his mind. A growing body of literature on the topic inspired him to begin research in this diesel lab. “For a long time, I thought that air pollution was affecting mostly the lungs and the cardiovascular system and not the brain,” says Costa. “So I stayed away from any issue related to air pollution.”

Now, mounting evidence seems to link a variety of neurological problems to dirty air. Troubling recent findings include hallmarks of Alzheimer’s disease found in the brains of children living in Mexico City (1) and a nearly doubled risk of dementias for older women in highly polluted parts of the United States (2). Costa’s own research has identified autism-like social and behavioral issues in mice exposed to diesel exhaust (3). Today, Costa is among a growing cadre of biologists, toxicologists, and doctors raising the alarm over this pervasive yet overlooked menace to our memory, attention, and behavior.

A Global Threat

Although the coronavirus disease 2019 (COVID-19) pandemic and associated “shelter in place” policies have reduced fossil fuel use to offer a temporary respite from extreme pollution in some places, most countries face an ongoing epidemic of dirty air as a result of growing urban congestion and an uptick in climate-driven wildfires, among other factors. Indoor air pollution further plagues many of the world’s poorest communities. Around 3 billion people cook indoors over open fires or stoves fueled by wood, biomass, kerosene, or coal. In 2018, the World Health Organization (WHO) identified air pollution as the second-largest risk factor for noncommunicable disease worldwide. And the WHO’s stats don’t include the full range of neurological effects now being discovered, notes neurotoxicologist Deborah Cory-Slechta at the University of Rochester in New York.

Globally, more than 90 percent of people breathe air that fails to meet WHO standards. That includes an estimated four in 10 people in the United States, although efforts such as the US Clean Air Act and its amendments of 1990 have helped. Between 2000 and 2016, the average concentration of particulate matter (PM) with a diameter of less than 2.5 micrometers (PM2.5), tiny particles produced by combustion, fell by around 40 percent in the United States. But the country’s overall air quality has worsened since 2016. Partly to blame is a rise in wildfire smoke, which is now responsible for an estimated 40 percent of particulate matter pollution.

Yet cleaner, healthier air remains achievable, notes Dean Schraufnagel, a pulmonologist at the University of Illinois at Chicago. “There are no death certificates that say air pollution exposure,” he says. “But we know that air pollution affects every organ in the body. If we stop the air pollution at its source, we can get strikingly important health benefits.”

Schraufnagel, also the director of the Forum of International Respiratory Societies, points to one easy target: idling diesel-powered school buses. A 2019 study out of Georgia in the United States found that districts that retrofitted school buses to reduce diesel emissions reported significant increases in students’ English test scores as well as smaller improvements in math (4).

The havoc air pollution can wreak on the brain is also a new area of interest for Schraufnagel, whose research and clinical practice has long focused on lung disease. Today, he is working with international organizations to get air pollution on the minds of not just pulmonologists but also neurologists and other medical experts. “This should be a call to action,” adds Schraufnagel.

Air pollution is a cocktail of suspended gases, solids, and liquid particles. While this mix contains numerous hazardous ingredients, such as ozone, sulfur dioxide, and carbon monoxide, the component that appears most concerning for the brain is PM.

The US Environmental Protection Agency (EPA) regulates PM10 and PM2.5, defined as particles less than 10 and 2.5 micrometers in diameter, respectively. PM2.5, also known as fine particulate matter, generally comes from smoke, dust, and vehicle exhaust. Because PM2.5 is so tiny—30 times smaller than the width of the average human hair—it can remain airborne for long periods of time, infiltrate buildings, and penetrate the body. Ultrafine particles, which measure less than 0.1 micrometer across, may be even worse offenders. Yet the miniscule mass of these particles makes them difficult to monitor. They remain unregulated by the EPA.

Fine and ultrafine particulate matter tends to circumvent the mechanisms that the human body has evolved to deflect, detain, and destroy unwelcome visitors. “The health effects of air pollution are all about particle size,” says Cory-Slechta. Studies suggest that these tiny particles can even go up the nose and be carried straight to the brain via the olfactory nerve (5)—hence bypassing the blood–brain barrier. And they don’t travel alone. On their surfaces these particles carry contaminants, from dioxins and other chemical compounds to metals such as iron and lead. “PM is simply acting as a vector,” says Masashi Kitazawa, a molecular neuropathologist at the University of California, Irvine. “It might be a number of chemicals that get into the brain and act in different ways to cause damage.”

Because of their large surface area relative to their volume, the smallest particles are the biggest offenders. Cory-Slechta’s research has largely focused on lead and mercury, neurotoxic metals that are abundant in air pollution. “Ultrafine particles are like little Trojan horses,” she says. “Pretty much every metal known to humans is on these.”

Metal-toting particles that reach the brain can directly damage neurons. Both the particles themselves and their toxic hitchhikers can also cause widespread harm by dysregulating the activation of microglia, the immune cells in the brain. Microglia may mistake the intruders for pathogens, releasing chemicals to try to kill them. Those chemicals can accumulate and trigger inflammation. And chronic inflammation in the brain has been implicated in neurodegeneration (6).

Particles may also afflict the brain via the bloodstream. Research shows that small particles can slip through the plasma membrane of alveoli—the tiny air sacs in the lungs—and get picked up by capillaries. The particles are then distributed around the body in the blood. Although some of these particles may eventually breach the blood–brain barrier, a pollutant need not enter the brain to cause trouble there. The immune system can react to particles in the lung or bloodstream, too, triggering widespread inflammation that affects the brain.

Even an ingested particle could have indirect neurological effects, via the gut. Researchers now recognize strong connections between the gut microbiome and the brain (7), and studies show that delivering fine particles to the gut can cause systemic inflammation (8).

In January 2010, Cory-Slechta received a surprising request from some University of Rochester environmental medicine colleagues. Typically, the group researched the effects of air pollution on the lungs and hearts of adult animals. But they had just exposed a group of newborn mice and asked Cory-Slechta’s team to look at the brains.

At first she didn’t think much of the request. Cory-Slechta was much more concerned about deadly lead exposure in children, her research focus at the time. “I didn’t think of air pollution as a big problem for the brain,” she says. Then she examined the animals’ tissue. “It was eye-opening. I couldn’t find a brain region that didn’t have some kind of inflammation.”

Her team followed up with their own studies. In addition to inflammation, they saw classic behavioral and biochemical features of autism, attention-deficit disorder, and schizophrenia in mice exposed to pollutants during the first days after birth. The mouse brains had noticeably less white matter, particularly in the corpus callosum connecting the right and left cerebral hemispheres. In work published last November, Cory-Slechta’s group further linked short-term exposures to air pollution with impaired learning and memory in aged mice, based on measures of spontaneous movement, navigation of a maze, short-term object recognition, and the ability to discriminate odors (9). The concentrations of particulate matter used, she notes, “easily include sitting in traffic in major cities.”

[…]

Research in Ontario, Canada, found that living farther away from a major road lowered the risk of developing dementia (13). A study of nearly 3,000 Barcelona schoolchildren found that those attending schools with more traffic pollution had slower cognitive development (14). And in the United States, a study found that living in locations where ambient particulate matter exceeded EPA recommendations nearly doubled women’s risk of developing dementia. When those researchers looked specifically at older women with two copies of the APOE4 gene variant, a strong genetic factor for Alzheimer’s disease, the dementia risk associated with living in those locations jumped almost threefold (2).

Does Vitamin D Help Protect People from COVID-19? Some Evidence Suggests Yes

A comprehensive global study published in 2017 on respiratory infections would say yes:

A new global collaborative study has confirmed that vitamin D supplementation can help protect against acute respiratory infections. The study, a participant data meta-analysis of 25 randomized controlled trials including more than 11,000 participants, has been published online in The BMJ.

“Most people understand that vitamin D is critical for bone and muscle health,” said Carlos Camargo of the Department of Emergency Medicine at Massachusetts General Hospital (MGH), the study’s senior author. “Our analysis has also found that it helps the body fight acute respiratory infection, which is responsible for millions of deaths globally each year.”

Additionally, a professor of respiratory infection and immunity at Queen Mary University of London had this to say about vitamin D:

“Vitamin D could almost be thought of as a designer drug for helping the body to handle viral respiratory infections,” he said. “It boosts the ability of cells to kill and resist viruses and simultaneously dampens down harmful inflammation, which is one of the big problems with Covid.”

The pharmaceutical industry obviously can’t make enormous profits from vitamin D, and that’s part of why it hasn’t been explored more as a protective mechanism. With all the benefits of vitamin D and the lack of downsides to it however, it is worth getting enough vitamin D (through sufficient sunlight exposure and a good diet) to protect against respiratory infections such as the flu and COVID-19.

Widely Available Drug Dexamethasone Shown to Cut Deaths by a Third in Severely Ill COVID-19 Patients

The coronavirus pandemic remains severe, but dexamethasone (a steroid) is a cheap and relatively common drug that has apparently been shown in a rigorous trial to significantly reduce mortality rates in the most severely ill COVID-19 patients. This drug is not a cure and it wasn’t shown to help patients with moderate COVID-19 symptoms, but the drug has been shown to save lives, and that’s important since presumably more people will eventually be able to recover instead of dying to the coronavirus.

An inexpensive and commonly used steroid can save the lives of people seriously ill with COVID-19, a randomized, controlled clinical trial in the United Kingdom has found. The drug, called dexamethasone, is the first shown to reduce deaths from the coronavirus that has killed more than 430,000 people globally. In the trial, it cut deaths by about one-third in patients who were on ventilators because of coronavirus infection.

“It’s a startling result,” says Kenneth Baillie, an intensive-care physician at the University of Edinburgh, UK, who serves on the steering committee of the trial, called RECOVERY. “It will clearly have a massive global impact.” The RECOVERY study announced the findings in a press release on 16 June, but its researchers say that they are aiming to publish their results quickly and that they are sharing their findings with regulators in the United Kingdom and internationally.

The RECOVERY trial, launched in March, is one of the world’s biggest randomized, controlled trials for coronavirus treatments; it is testing a range of potential therapies. The study enrolled 2,100 participants who received dexamethasone at a low or moderate dose of six milligrams per day for ten days, and compared how they fared against about 4,300 people who received standard care for coronavirus infection.

The effect of dexamethasone was most striking among critically ill patients on ventilators. Those who were receiving oxygen therapy but were not on ventilators also saw improvement: their risk of dying was reduced by 20%. The steroid had no effect on people with mild cases of COVID-19 — those not receiving oxygen or ventilation.

Shortly after the results were released, the UK government announced that it had immediately authorized use of dexamethasone for patients hospitalized with COVID-19 who required oxygen, including those on ventilators.

Rigorous study

“It is a major breakthrough,” says Peter Horby, an infectious-disease specialist at the University of Oxford, UK, and a chief investigator on the trial. Use of steroids to treat viral respiratory infections such as COVID-19 has been controversial, Horby notes. Data from steroid trials during outbreaks of SARS (severe acute respiratory syndrome) and Middle East respiratory syndrome caused by related coronaviruses were inconclusive, he says. Nevertheless, given dexamethasone’s widespread availability, and some promising results from steroid studies in previous outbreaks, Horby says RECOVERY investigators felt it important to test the treatment in a rigorous clinical trial.

Treatment guidelines from the World Health Organization and many countries have cautioned against treating people with coronavirus with steroids, and some investigators were concerned about anecdotal reports of widespread steroid treatment. The drugs suppress the immune system, which could provide some relief from patients whose lungs are ravaged by an over-active immune response that sometimes manifests in severe cases of COVID-19. But such patients may still need a fully functioning immune system to fend off the virus itself.

The RECOVERY trial suggests that at the doses tested, the benefits of steroid treatment may outweigh the potential harm. The study found no outstanding adverse events from the treatment, investigators said. “This treatment can be given to pretty much anyone,” says Horby.

And the pattern of response — with a greater impact on severe COVID-19 and no effect on mild infections — matches the notion that a hyperactive immune response is more likely to be harmful in long-term, serious infections, says Anthony Fauci, head of the US National Institute of Allergy and Infectious Disease. “When you’re so far advanced that you’re on a ventilator, it’s usually that you have an aberrant or hyperactive inflammatory response that contributes as much to the morbidity and mortality as any direct viral effect.”

“Finding effective treatments like this will transform the impact of the COVID-19 pandemic on lives and economies across the world,” said Nick Cammack, head of the COVID-19 Therapeutics Accelerator at Wellcome, a UK biomedical research charity in London, in a statement. “While this study suggests dexamethasone only benefits severe cases, countless lives will be saved globally.”

Easy to administer

So far, the only drug shown to benefit COVID-19 patients in a large, randomized, controlled clinical trial is the antiviral drug remdesivir. Although remdesivir1 was shown to shorten the amount of time that patients may need to spend in the hospital, it did not have a statistically significant effect on deaths.

Remdesivir is also in short supply. Although the drug’s maker — Gilead Sciences of Foster City, California — has taken steps to ramp up production of remdesivir, it is currently available only to a limited number of hospitals around the world. And remdesivir is complex to administer: it must be given by injection over the course of several days.

Dexamethasone, by contrast, is a medical staple found on pharmaceutical shelves worldwide and is available as a pill — a particular benefit as coronavirus infections continue to rise in countries with limited access to healthcare. “For less than £50, you can treat 8 patients and save one life,” said Martin Landray, an epidemiologist at the University of Oxford, and another chief investigator on the RECOVERY trial.

The findings could also have implications for other severe respiratory illnesses, Baillie adds. For example, steroid treatments for a condition called acute respiratory distress syndrome are also controversial. “This really gives us a very good reason to look closely at that, because the mortality benefit is so extraordinarily large,” Baillie says. “I think this will affect patients well beyond COVID-19.”

Low Vitamin D Levels Associated With Higher Coronavirus Mortality Rates

Patients with severe vitamin D deficiencies have been found in research to experience more coronavirus-related complications. Exposure to 20 or 30 minutes of sunlight a day and a healthy diet are good ways to keep high vitamin D levels.

After studying global data from the novel coronavirus (COVID-19) pandemic, researchers have discovered a strong correlation between severe vitamin D deficiency and mortality rates.

Led by Northwestern University, the research team conducted a statistical analysis of data from hospitals and clinics across China, France, Germany, Italy, Iran, South Korea, Spain, Switzerland, the United Kingdom (UK) and the United States.

The researchers noted that patients from countries with high COVID-19 mortality rates, such as Italy, Spain and the UK, had lower levels of vitamin D compared to patients in countries that were not as severely affected.

This does not mean that everyone — especially those without a known deficiency — needs to start hoarding supplements, the researchers caution.

“While I think it is important for people to know that vitamin D deficiency might play a role in mortality, we don’t need to push vitamin D on everybody,” said Northwestern’s Vadim Backman, who led the research. “This needs further study, and I hope our work will stimulate interest in this area. The data also may illuminate the mechanism of mortality, which, if proven, could lead to new therapeutic targets.”

The research is available on medRxiv, a preprint server for health sciences.

Backman is the Walter Dill Scott Professor of Biomedical Engineering at Northwestern’s McCormick School of Engineering. Ali Daneshkhah, a postdoctoral research associate in Backman’s laboratory, is the paper’s first author.

Backman and his team were inspired to examine vitamin D levels after noticing unexplained differences in COVID-19 mortality rates from country to country. Some people hypothesized that differences in healthcare quality, age distributions in population, testing rates or different strains of the coronavirus might be responsible. But Backman remained skeptical.

“None of these factors appears to play a significant role,” Backman said. “The healthcare system in northern Italy is one of the best in the world. Differences in mortality exist even if one looks across the same age group. And, while the restrictions on testing do indeed vary, the disparities in mortality still exist even when we looked at countries or populations for which similar testing rates apply.

“Instead, we saw a significant correlation with vitamin D deficiency,” he said.

By analyzing publicly available patient data from around the globe, Backman and his team discovered a strong correlation between vitamin D levels and cytokine storm — a hyperinflammatory condition caused by an overactive immune system — as well as a correlation between vitamin D deficiency and mortality.

“Cytokine storm can severely damage lungs and lead to acute respiratory distress syndrome and death in patients,” Daneshkhah said. “This is what seems to kill a majority of COVID-19 patients, not the destruction of the lungs by the virus itself. It is the complications from the misdirected fire from the immune system.”

This is exactly where Backman believes vitamin D plays a major role. Not only does vitamin D enhance our innate immune systems, it also prevents our immune systems from becoming dangerously overactive. This means that having healthy levels of vitamin D could protect patients against severe complications, including death, from COVID-19.

“Our analysis shows that it might be as high as cutting the mortality rate in half,” Backman said. “It will not prevent a patient from contracting the virus, but it may reduce complications and prevent death in those who are infected.”

Backman said this correlation might help explain the many mysteries surrounding COVID-19, such as why children are less likely to die. Children do not yet have a fully developed acquired immune system, which is the immune system’s second line of defense and more likely to overreact.

“Children primarily rely on their innate immune system,” Backman said. “This may explain why their mortality rate is lower.”

Backman is careful to note that people should not take excessive doses of vitamin D, which might come with negative side effects. He said the subject needs much more research to know how vitamin D could be used most effectively to protect against COVID-19 complications.

“It is hard to say which dose is most beneficial for COVID-19,” Backman said. “However, it is clear that vitamin D deficiency is harmful, and it can be easily addressed with appropriate supplementation. This might be another key to helping protect vulnerable populations, such as African-American and elderly patients, who have a prevalence of vitamin D deficiency.”

Backman is the director of Northwestern’s Center for Physical Genomics and Engineering and the associate director for Research Technology and Infrastructure at the Robert H. Lurie Comprehensive Cancer Center at Northwestern University.

New Blood Test Offers Detection of 50 Types of Cancer

Another helpful advance in modern medicine.

A new blood test that can detect more than 50 types of cancer has been revealed by researchers in the latest study to offer hope for early detection.

The test is based on DNA that is shed by tumours and found circulating in the blood. More specifically, it focuses on chemical changes to this DNA, known as methylation patterns.

Researchers say the test can not only tell whether someone has cancer, but can also shed light on the type of cancer they have.

Dr Geoffrey Oxnard of Boston’s Dana-Farber Cancer Institute, part of Harvard Medical School, said the test was now being explored in clinical trials. “You need to use a test like this in an independent group at risk of cancer to actually show that you can find the cancers, and figure out what to do about it when you find them,” he said.

Writing in the journal Annals of Oncology, the team reveal how the test was developed using a machine learning algorithm – a type of artificial intelligence. Such systems pick up on patterns within data and as a result learn to classify it.

The team initially fed the system with data on methylation patterns in DNA from within blood samples taken from more than 2,800 patients, before further training it with data from 3,052 participants, 1,531 of whom had cancer and 1,521 of whom did not.

Using this information, the system sorted the samples into groups based on the methylation patterns. The team then taught the system which groups reflected which type of cancer.

“In pregnant women we look in their free-floating DNA for foetal abnormalities,” said Oxnard. “We know this [approach] exists, the question is how do you fine-tune and perfect the art of looking for cancer in this free-floating DNA? And that is what the machine learning did.”

The team then tested the trained system on another set of samples from 1,264 individuals, about half of whom had cancer.

The results reveal that less than 1% of those without cancer were wrongly identified by the system as having the disease. “It is really important you don’t tell non-cancer patients they have cancer,” said Oxnard.

When it came to identifying people with cancers the team found that, across more than 50 different types of cancer, the system correctly detected that the disease was present 44% of the time – although the team stress that figure could differ if the test was used to screen a general population, rather than those known to have cancer.

Detection was better the more advanced the disease was. Overall, cancer was correctly detected in 18% of those with stage I cancer, but in 93% of those with stage IV cancer.

The team say the results are exciting as they offer the possibility of a new way to screen for cancers that are otherwise difficult to detect. For example, the system correctly identified 63% of those with stage I pancreatic cancer, rising to 100% in stage IV.

The team further found that the system could shed light on the type of cancer. For 96% of samples deemed to show cancer, the test was able to offer a prediction for in which the tissue the cancer originated, with 93% of these predictions found to be correct.

Dr David Crosby, head of early detection at Cancer Research UK, said that detecting cancers in their early stages is important as they are less aggressive and more treatable.

Although this test was still at an early stage of development, the initial results were encouraging, he said. “And if the test can be fine-tuned to be more efficient at catching cancers in their earliest stages, it could become a tool for early detection.”

But Crosby added there was work to do. “More research is needed to improve the test’s ability to catch early cancers and we still need to explore how it might work in a real cancer screening scenario,” he said.

Noam Chomsky Interview on Popular Movements

A notable interview:

It is Sen. Bernie Sanders who is regarded by the political establishment as the most dangerous politician because of his commitment to a just and equitable social order and a sustainable future. Meanwhile, the conclusion of the Davos meeting in January demonstrated the global elites’ ongoing commitment to unimpeded planetary destruction.

This is indeed the state of the contemporary U.S. political environment, as the great public intellectual Noam Chomsky points out in this exclusive interview for Truthout.

C.J. Polychroniou: The impeachment trial of Donald Trump isnearly over, and what a farce it has been — something you had predicted from the start, which is also the reason why you thought that an impeachment inquiry was a rather foolish move on the part of the Democrats. With that in mind, what does this farcical episode tell us about the contemporary state of U.S. politics, and do you anticipate any political fallout in the 2020 election?

Noam Chomsky: It seemed clear from the outset that the impeachment effort could not be serious, and would end up being another gift by the Democrats to Trump, much as the Mueller affair was. Any doubts about its farcical nature were put to rest by its opening spectacle: Supreme Court Chief Justice John Roberts struggling to keep a straight face while swearing in senators who solemnly pledged that they would be unmoved by partisan concerns, and at once proceeded — as everyone know they would — to behave and vote along strictly party lines. Could there be a clearer exhibition of pure farce?

Are the crimes discussed a basis for impeachment? Seems so to me. Has Trump committed vastly more serious crimes? That is hardly debatable. What might be debatable is whether he is indeed the most dangerous criminal in human history (which happens to be my personal view). Hitler had been perhaps the leading candidate for this honor. His goal was to rid the German-run world of Jews, Roma, homosexuals and other “deviants,” along with tens of millions of Slav “Untermenschen.” But Hitler was not dedicated with fervor to destroying the prospects of organized human life on Earth in the not-distant future (along with millions of other species).

Trump is. And those who think he doesn’t know what he’s doing haven’t been looking closely.

Is that a wild and ludicrous exaggeration? Or the very simple and apparent truth? It’s not difficult to figure out the answer. We’ve discussed it often before. There is no need to review what is happening on Trump’s watch while he devotes every effort to accelerating the race to catastrophe, trailed by such lesser lights as Brazil’s Jair Bolsonaro and Australia’s Scott Morrison.

Every day brings new forebodings. We have just learned, for example, that the gigantic Thwaites Glacier in West Antarctica has been eroding from warm water below. The Washington Post describes this as “a troubling finding that could speed its melt in a region with the potential to eventually unleash more than 10 feet of sea-level rise,” adding, “Scientists already knew that Thwaites was losing massive amounts of ice — more than 600 billion tons over the past several decades, and most recently as much as 50 billion tons per year.” It has now been confirmed, as suspected, that “this was occurring because a layer of relatively warmer ocean water, which circles Antarctica below the colder surface layer, had moved closer to shore and begun to eat away at the glaciers themselves, affecting West Antarctica in particular.” The chief scientist involved in the study warns that this may signal “an unstoppable retreat that has huge implications for global sea-level rise.

That’s today. Tomorrow will be something worse.

What’s causing the warmer water? No secret. This is only one of the likely irreversible tipping points that may be reached if “the Chosen One,” as he modestly describes himself, is granted another four years to carry out his project of global destruction.

We have just witnessed an extraordinary event at the January Davos meeting of the Masters of the Universe, as they are called; for Adam Smith, they were only “the masters of mankind,” but 250 years ago it was just British merchants and manufacturers.

The conference opened with Trump’s oration about what a fabulous creature he is. The encomium was interrupted only by a comment that we should not be “alarmist” about the climate. His Magnificence was followed by the quiet and informed comments of a 17-year old girl instructing the heads of state, CEOs, media leaders and grand intellectuals about what it means to be a responsible adult.

Quite a spectacle.

Trump’s war on organized life on Earth is only the barest beginning. More narrowly, in recent days, the Chosen One has issued executive orders ridding the country of the plague of regulations that protect children from mercury poisoning and preserve the country’s water supplies and lands, along with other impediments to further enrichment of Trump’s primary constituency, extreme wealth and corporate power.

On the side, he has been casually proceeding to dismantle the last vestiges of the arms control regime that has provided some limited degree of security from terminal nuclear war, eliciting cheers from the military industry. And as we have just learned, the great pacifist who is committed to end interventions “dropped more bombs and other munitions in Afghanistan last year than any other year since documentation began in 2006, Air Force data shows.”

He is also ramping up his acts of war — which is what they are — against Iran. I won’t even go into his giving Israel what the Israeli press calls “a gift to the right,” formally giving the back of his imperial hand to international law, the World Court, the UN Security Council and overwhelming international opinion, while shoring up the Evangelical vote for the 2020 election. The prerogative of supreme power.

In brief, the list of Trump’s crimes is immense, not least the worst crime in human history. But none merit a nod in the impeachment proceedings. This is hardly a novelty; rather the norm. The current proceedings are often compared with Watergate. Nixon’s hideous crimes were eliminated from the charges against him despite the efforts of Rep. Robert Frederick Drinan and a few others. The Nixon impeachment charges focused on his illegal acts to harm Democrats.

Any resemblance to the farce that is now winding up? Does it suggest some insight into what motivates the powerful?

Speaking of the 2020 election, the corporate Democratic establishment and the liberal media are once again mobilizing to undermine Bernie Sanders, even though he may very well be the most electable Democrat. First, can you summarize for us what you perceive to be the core of Sanders’s politico-ideological gestalt, and then explain what scares both conservatives and liberals the possibility of someone like Sanders leading the country?

The core of Sanders’s “politico-ideological gestalt” is his long-standing commitment to the interests of the large majority of the population, not the top 0.1 percent (not 1 percent, 0.1 percent) who hold more than 20 percent of the country’s wealth, not the very rich who were the prime beneficiaries of the slow recovery from the 2008 disaster caused by financial capital. The U.S. achievement in this regard far surpasses that of other developed countries, so we learn from recently released studies, which show that in the U.S., 65 percent of the growth of the past decade went to the very rich; next in line was Germany, at 5percent, then declining sharply. The same studies show that if current trends persist, in the next decade all growth in the U.S. will go to the rich.

The welfare of these sectors has never been Sanders’s concern.

The Democratic establishment and liberal media are hardly likely to look kindly on someone who forthrightly proclaims, I have no use for those  regardless of their political party — who hold some foolish dream of spinning the clock back to days when unorganized labor was a huddled, almost helpless mass…. Only a handful of unreconstructed reactionaries harbor the ugly thought of breaking unions. Only a fool would try to deprive working men and women of the right to join the union of their choice.” By right to work” laws, for example, or by hiring scabs, or by threatening to ship jobs to Mexico to undermine organizing efforts, to sample the bipartisan political leadership.

That’s surely the kind of socialist wild man whom the country is not ready to tolerate.

The wild man in this case is President Dwight Eisenhower, the last conservative president. His remarks are a good illustration of how far the political class has shifted to the right under Clintonite “New Democrats” and the Reagan-Gingrich Republicans. The latter have drifted so far off the political spectrum that they are ranked near neo-fascist parties in the international spectrum, well to the right of “conservatives.”

Even more threatening than Sanders’s proposals to carry forward New Deal-style policies, I think, is his inspiring a popular movement that is steadily engaged in political action and direct activism to change the social order — a movement of people, mostly young, who have not internalized the norms of liberal democracy: that the public are “ignorant and meddlesome outsiders” who are to be “spectators, not participants in action,” entitled to push a lever every four years but are then to return to their TV sets and video games while the “responsible men” look after serious matters.

This is a fundamental principle of democracy as expounded by prominent and influential liberal 20thcentury American intellectuals, who took cognizance of “the stupidity of the average man” and recognized that we should not be deluded by “democratic dogmatisms about men being the best judges of their own interests.” They are not; we are — the “responsible men,” the “intelligent minority.” The “bewildered herd” must therefore be “put in their place” by “necessary illusions” and “emotionally potent simplifications.” These are among the pronouncements of the most influential 20thcentury public intellectual, Walter Lippmann, in his “progressive essays on democracy”; Harold Lasswell, one of the founders of modern political science; and Reinhold Niebuhr, the admired “theologian of the (liberal) establishment.” All highly respected Wilson-FDR-Kennedy liberals.

Inspiring a popular movement that violates these norms is a serious attack on democracy, so conceived, an intolerable assault against good order.

I believe we witnessed something similar in the last U.K. elections in the case of Jeremy Corbyn. Do you agree? And, if so, what does this tell us about liberal democracy, which is nowadays in serious trouble itself on account of the rise and spread of authoritarianism and the far right in many parts of the world?

There are definite similarities. Corbyn, a decent and honorable man, was subjected to an extraordinary flood of vilification and defamation, which he was unable to confront. At the same time, polls indicated that the policies that he put forth — and that had led to a remarkable victory for Labour in 2017 — remained popular. A special feature in the U.K. was Brexit, a matter I won’t go into here (my personal opinion, for what it’s worth, is that it is a serious blow to both Britain and the EU, and is likely to cause Britain — or what remains of it — to become even more of a vassal of the U.S. than it has been under Blair’s New Labour and the Tories, whose social and economic policies have caused the country great harm). Corbyn’s vacillation on the Brexit issue, which became a toxic one, surely contributed to the negative feelings about him that seem to have been a major factor in the electoral disaster for Labour, but it was only one.

As in the case of Sanders, I suspect that the prime reason for the bitter hatred of Corbyn on the part of a very wide spectrum of the British establishment is his effort to turn the Labour Party into a participatory organization that would not leave electoral politics in the hands of the Labour bureaucracy and would proceed beyond the narrow realm of electoral politics to far broader and constant activism and engagement in public affairs.

More generally, much of the world is aflame. As the men of Davos recognized with trepidation at their January meeting, the peasants are coming with their pitchforks: The neoliberal order they have imposed for the past 40 years, while ultra-generous to them and their class, has had a bitter impact on the general population. A leading theme at Davos was that the Masters must declare that they are changing their stance from service to the rich to attending to the concerns of “stakeholders” — working people and communities. Another theme was that while not “alarmists,” they acknowledge the threat of global warming.

The unstated implication is that there is no need for regulations and other actions about climate change: We Big Boys will take care of it. Greta Thunberg and the other children demonstrating out there can go back to school. And now that we see the flaws in our neoliberal model of capitalism, you can put aside all those disruptive political programs calling for health care, rights of workers, women, the poor. We’re taking care of it, so just go back to your private pursuits, keeping to democratic norms.

As the neoliberal order is visibly collapsing, it is giving rise to “morbid symptoms” (to borrow Gramsci’s famous phrase when the fascist plague was looming). Among these are the spread of authoritarianism and the far right that you mention. More generally, what we are witnessing is quite understandable anger, resentment and contempt for the political institutions that have implemented the neoliberal assault — but also the rise of activist movements that seek to overcome the ills of global society and to stem and reverse the race to destruction.

The confrontation could hardly have been exhibited more dramatically than by the appearance of Greta Thunberg immediately after the most powerful man in the world — the leader in the race to destruction — had admonished the Masters to disdain the “heirs of yesterday’s foolish fortune tellers” (virtually 100 percent of climate scientists) and to take up his wrecking ball.

The Science Behind Friendship and Its Largely Overlooked Importance

Yes, there’s scientific research on that too.

For many of us, the top of our life priority list might look something like this: family, work—maybe exercise. Time with friends can sometimes end up near the bottom.

That’s a mistake, says Lydia Denworth, a science journalist and the author of the new book “Friendship,” which was published last month by W.W. Norton & Co. Ms. Denworth interviews animal biologists studying baboons and rhesus macaque monkeys, anthropologists and neuroscientists to uncover just how important friendship is not only for happiness and emotional health, but, she argues, physical health, too. In fact, friends are key to our very survival, Ms. Denworth asserts.

Here are edited excerpts from an interview.

What does studying how animals relate to each other tell us about human friendships?

At its simplest, it’s just how critical quality social bonds and friendships are. In animals, the big measures that evolutionary biologists study are reproductive success, which they count as either how many babies you have or how long those babies live, and longevity, or how long you survive. Nonhuman primates have very structured hierarchies that they exist in, and everyone assumed that that must have more importance for how long you live and how many babies you have and how healthy they are. And it wasn’t. The most important thing was the strength of the social bonds, how positively and well and regularly an individual animal interacted with other animals. Scientists really couldn’t believe it.

How does friendship affect physical health?

Friendship literally improves your body’s cardiovascular functioning, how your immune system works, how you sleep. You can imagine the food you put in your body makes you healthy or not. But sitting in a coffee shop with someone and just chatting about what’s going on with your life, we always thought emotionally that made you feel good. But actually it really is doing much more.

A big study at Harvard of men across their lives from 20 to 80 found that the single best predictor of your health and happiness at 80 was not your wealth or your professional success. It was your relationships at 50.

What makes a good friendship?

The simple definition that biologists use is a friendship is positive, it makes you feel good, it is long-lasting and stable and it has reciprocity and cooperation in it. So there’s a little give and take. Friendship is about setting up your life so you have people you can rely on when you need them. Literally, it was for when the lions came hunting for your friends. Baboons and monkeys do better when they are together. It’s why humans were never really alone.

There’s not one way to do friendship. Some people are introverts and that’s fine. The difference between not having any close friends and having one is enormous in terms of your emotional health and physical health. Quality matters so much more than quantity. Most people only have an average of four really close friends.

Why do we become friends with one person and not another?

There’s this interesting chemistry to friendship. Just like in romance, you are more drawn to some people than you are others. Some of it is very straightforward: You are interested in the same things, you spend time in the same place. That’s one reason why we are close to relatives, because you have a head start, you spend more time with them than you do anyone else. We do tend to be better friends with people who are more like us.

Having a shared world-view turns out to be important. Scientists looked at all these people in a social network, showed them the same sets of videos and looked at how their brains responded to these videos. They could predict just by looking at the brain processing who was friends with whom. Literally, you hear and see the world more like the people you are friends with. The big question is: Is it cause or effect? Are you drawn to people who already see and process the world more similarly from the start or do you become more similar? Of course, as with so many things, the answer is probably both.

What impact is digital communication and social media having on friendships?

With relationships, it usually is net positive. One reason is just because people who are active on social media tend to have wider, bigger, more diverse social networks. What the research is showing is we tend to use social media as just an extra way to communicate with your good friends. And older adults, relationally, they absolutely benefit from social media because they have a harder time getting out or getting around or they’re further from their families. It really has opened up a new channel for people.

That doesn’t mean if you only operate online, you get all those benefits. You don’t. You need a lot of face-to-face time to get the health benefits. But it’s just not true that being online is automatically this big negative. The people for whom social media has a clearer negative effect seem to be people who are already suffering from depression maybe or loneliness.

Experimental Drugs Reverse Arthritis in Rats Study

The science shows potential results in treating a debilitating condition.

People with osteoarthritis, or “wear and tear” arthritis, have limited treatment options: pain relievers or joint replacement surgery. Now, Salk researchers have discovered that a powerful combination of two experimental drugs reverses the cellular and molecular signs of osteoarthritis in rats as well as in isolated human cartilage cells. Their results were published in the journal Protein & Cell on January 16, 2020.

“What’s really exciting is that this is potentially a therapy that can be translated to the clinic quite easily,” says Juan Carlos Izpisua Belmonte, lead author and a professor in Salk’s Gene Expression Laboratory. “We are excited to continue refining this promising combination therapy for human use.”

Affecting 30 million adults, osteoarthritis is the most common joint disorder in the United States and its prevalence is expected to rise in coming years due to the aging population and increasing rate of obesity. The disease is caused by gradual changes to cartilage that cushions bones and joints. During aging and repetitive stress, molecules and genes in the cells of this articular cartilage change, eventually leading to the breakdown of the cartilage and the overgrowth of underlying bone, causing chronic pain and stiffness.

Previous research had pinpointed two molecules, alpha-KLOTHO and TGF beta receptor 2 (TGFβR2), as potential drugs to treat osteoarthritis. αKLOTHO acts on the mesh of molecules surrounding articular cartilage cells, keeping this extra-cellular matrix from degrading. TGFβR2 acts more directly on cartilage cells, stimulating their proliferation and preventing their breakdown.

While each drug alone had only moderately curbed osteoarthritis in animal models of the disease, Izpisua Belmonte and his colleagues wondered if the two drugs would act more effectively in concert.

“We thought that by mixing these two molecules that work in different ways, maybe we could make something better,” says Paloma Martinez-Redondo, a Salk postdoctoral fellow and co-first author of the new study.

The researchers treated young, otherwise healthy rats with osteoarthritis with viral particles containing the DNA instructions for making αKLOTHO and TGFβR2.

Six weeks after the treatment, rats that had received control particles had more severe osteoarthritis in their knees, with the disease progressing from stage 2 to stage 4. However, rats that had received particles containing αKLOTHO and TGFβR2 DNA showed recovery of their cartilage: the cartilage was thicker, fewer cells were dying, and actively proliferating cells were present. These animals’ disease improved from stage 2 to stage 1, a mild form of osteoarthritis, and no negative side effects were observed.

“From the very first time we tested this drug combination on just a few animals, we saw a huge improvement,” says Isabel Guillen-Guillen, the paper’s co-first author. “We kept checking more animals and seeing the same encouraging results.”

Further experiments revealed 136 genes that were more active and 18 genes that were less active in the cartilage cells of treated rats compared to control rats. Among those were genes involved in inflammation and immune responses, suggesting some pathways by which the combination treatment works.

To test the applicability of the drug combination to humans, the team treated isolated human articular cartilage cells with αKLOTHO and TGFβR2. Levels of molecules involved in cell proliferation, extra-cellular matrix formation and cartilage cell identity all increased.

“That’s not the same as showing how these drugs affect the knee joint in humans, but we think it’s a good sign that this could potentially work for patients,” says Martinez-Redondo.

The research team plans to develop the treatment further, including investigating whether soluble molecules of the αKLOTHO and TGFβR2 proteins can be taken directly, rather than administered through viral particles. They also will study whether the combination of drugs can prevent the development of osteoarthritis before symptoms develop.

“We think that this could be a viable treatment for osteoarthritis in humans,” says Pedro Guillen, director of the Clinica CEMTRO and co-corresponding author.

U.S. Drinking Water Contamination Far Worse Than Previously Thought

Dark humor comedian George Carlin liked to say that he didn’t consider himself a good American if he didn’t let his food and water poison himself a bit every day. For real though, if you want at least some defense against the contamination, the people in the know recommend robust water filtration systems.

America is great again! Keep this version of America great 2020, don’t change it! Only over a hundred million people there drink contaminated water every day!

The contamination of US drinking water with manmade “forever chemicals” is far worse than previously estimated with some of the highest levels found in Miami, Philadelphia and New Orleans, said a report on Wednesday by an environmental watchdog group.

The chemicals, resistant to breaking down in the environment, are known as perfluoroalkyl substances, or PFAS. Some have been linked to cancers, liver damage, low birth weight and other health problems.

The findings here by the Environmental Working Group (EWG) show the group’s previous estimate in 2018, based on unpublished US Environmental Protection Agency (EPA) data, that 110 million Americans may be contaminated with PFAS, could be far too low.

“It’s nearly impossible to avoid contaminated drinking water from these chemicals,” said David Andrews, a senior scientist at EWG and co-author of the report.

The chemicals were used in products like Teflon and Scotchguard and in firefighting foam. Some are used in a variety of other products and industrial processes, and their replacements also pose risks.

Of tap water samples taken by EWG from 44 sites in 31 states and Washington DC, only one location, Meridian, Mississippi, which relies on 700ft (215m) deep wells, had no detectable PFAS. Only Seattle and Tuscaloosa, Alabama had levels below 1 part per trillion (PPT), the limit EWG recommends.

In addition, EWG found that on average six to seven PFAS compounds were found at the tested sites, and the effects on health of the mixtures are little understood. “Everyone’s really exposed to a toxic soup of these PFAS chemicals,” Andrews said.

In 34 places where EWG’s tests found PFAS, contamination had not been publicly reported by the EPA or state environmental agencies.

The EPA has known since at least 2001 about the problem of PFAS in drinking water but has so far failed to set an enforceable, nationwide legal limit. The EPA said early last year it would begin the process to set limits on two of the chemicals, PFOA and PFOS.

The EPA said it has helped states and communities address PFAS and that it is working to put limits on the two main chemicals but did not give a timeline.

In 2018 a draft report from an office of the US Department of Health and Human Services said the risk level for exposure to the chemicals should be up to 10 times lower than the 70 PPT threshold the EPA recommends. The White House and the EPA had tried to stop the report from being published.

If Worker Pay Had Kept Pace With U.S. Productivity Gains Since 1968, Today’s Minimum Wage Would Be $24 an Hour

A full-time minimum wage worker would be earning $48,000 a year in the United States if they made $24 an hour.

If the minimum wage had kept pace with inflation since 1968, it would be close to $12 an hour today, more than 65 percent higher than the national minimum wage of $7.25 an hour. While this would make a huge difference in the lives of many people earning close to the national minimum wage, it is actually a relatively unambitious target.

Until 1968, the minimum wage not only kept pace with inflation, it rose in step with productivity growth. The logic is straightforward; we expect that wages in general will rise in step with productivity growth. For workers at the bottom to share in the overall improvement in society’s living standards, the minimum wage should also rise with productivity.

This is an important distinction. If the minimum wage rises in step with inflation, we are effectively ensuring that it will allow minimum wage earners to buy the same amount of goods and services through time, protecting them against higher prices. However, if it rises with productivity that means that as workers are able to produce more goods and services per hour, on average, minimum wage earners will be able to buy more goods and services through time.

While the national minimum wage did rise roughly in step with productivity growth from its inception in 1938 until 1968, in the more than five decades since then, it has not even kept pace with inflation. However, if the minimum wage did rise in step with productivity growth since 1968 it would be over $24 an hour today, as shown in the Figure below.[1]

Graph (1)

It is worth considering what the world would look like if this were the case. A minimum wage of $24 an hour would mean that a full-time full year minimum wage worker would be earning $48,000 a year. A two minimum wage earning couple would have a family income of $96,000 a year, enough to put them in the top quintile of the current income distribution.

It is worth noting the standard counter to the argument that the minimum wage should keep pace with productivity growth. It would be claimed that the productivity of minimum wage workers has not kept pace with average productivity growth, so that it would not be feasible for minimum wage workers to earn pay that rises in step with average productivity growth.

There is some truth to this claim, but only at a superficial level. The productivity of any individual worker is determined not just by their skills and technology, but also by the institutional structure we put in place. In a world without patent and copyright monopolies, the skills of bio-technicians and software designers would likely be much less valuable than they are today.

Similarly, the skills of experts in stock trading and designing complex financial instruments would have much less value if we had a financial transactions tax in place and allowed large banks to fail when their mistakes made them insolvent. And, the skills of doctors and other highly paid professionals would have much less value if our trade policy was as committed to subjecting them to international competition, as has been the case with auto and textile workers.

Lower pay for those at the top increases the real pay for those at the bottom and middle. A $15 an hour wage goes much further when all drugs are selling as low costs generics, the financial sector is not sucking 2 percent of GDP ($230 billion a year) out of the economy, and doctors get paid the same as their West European counterparts.

If the productivity of less-skilled workers has not kept pace with average productivity, this was by design. It was not the fault of these workers; it was the fault of those who designed policies that had the effect of devaluing their skills.

This raises a final point: we can’t imagine that we can just raise the minimum wage to $24 an hour without serious disruptions to the economy, many of which would have bad effects (i.e., unemployment) for those at the bottom. While there is certainly room to raise the minimum wage, and many states have done so with no measureable impact on employment, there clearly is a limit to how far and how fast we can go.

It is quite reasonable to have a target where the minimum wage returns to where it would be, if it had tracked productivity growth over the last 50 years. But we will have to reverse many of the institutional changes that have been put in place over this period to get there. This is where the sort of policies described in Rigged (it’s free) come in, but that is a much longer story.


[1] This calculation uses a productivity growth figure that is economy-wide, is based on net output, and adjusts for differences between the NDP deflator and the consumer price index. These issues are discussed in more detail here.

America’s Economy Outside of Unemployment and GDP

It’s rather striking that median male wages in America are 3 percent lower today than they were 40 years ago. Where the hell is the societal progress with damning statistics like that? And other stats worth mentioning are that 75 percent of Americans live paycheck to paycheck while their country’s child poverty rate is well over 20 percent. It is rather appalling that people are saying that America’s economy is booming.

As the world’s business elites trek to Davos for their annual gathering, people should be asking a simple question: Have they overcome their infatuation with US President Donald Trump?

Two years ago, a few rare corporate leaders were concerned about climate change, or upset at Trump’s misogyny and bigotry. Most, however, were celebrating the president’s tax cuts for billionaires and corporations and looking forward to his efforts to deregulate the economy. That would allow businesses to pollute the air more, get more Americans hooked on opioids, entice more children to eat their diabetes-inducing foods, and engage in the sort of financial shenanigans that brought on the 2008 crisis.

Today, many corporate bosses are still talking about the continued GDP growth and record stock prices. But neither GDP nor the Dow is a good measure of economic performance. Neither tells us what’s happening to ordinary citizens’ living standards or anything about sustainability. In fact, US economic performance over the past four years is Exhibit A in the indictment against relying on these indicators.

To get a good reading on a country’s economic health, start by looking at the health of its citizens. If they are happy and prosperous, they will be healthy and live longer. Among developed countries, America sits at the bottom in this regard. US life expectancy, already relatively low, fell in each of the first two years of Trump’s presidency, and in 2017, midlife mortality reached its highest rate since World War II. This is not a surprise, because no president has worked harder to make sure that more Americans lack health insurance. Millions have lost their coverage, and the uninsured rate has risen, in just two years, from 10.9% to 13.7%.

One reason for declining life expectancy in America is what Anne Case and Nobel laureate economist Angus Deaton call deaths of despair, caused by alcohol, drug overdoses, and suicide. In 2017 (the most recent year for which good data are available), such deaths stood at almost four times their 1999 level.

The only time I have seen anything like these declines in health—outside of war or epidemics—was when I was chief economist of the World Bank and found out that mortality and morbidity data confirmed what our economic indicators suggested about the dismal state of the post-Soviet Russian economy.

Trump may be a good president for the top 1%—and especially for the top 0.1%—but he has not been good for everyone else. If fully implemented, the 2017 tax cut will result in tax increases for most households in the second, third, and fourth income quintiles.

Given tax cuts that disproportionately benefit the ultrarich and corporations, it should come as no surprise that there was no significant change in the median US household’s disposable incomebetween 2017 and 2018 (again, the most recent year with good data). The lion’s share of the increase in GDP is also going to those at the top. Real median weekly earnings are just 2.6% above their level when Trump took office. And these increases have not offset long periods of wage stagnation. For example, the median wage of a full-time male worker (and those with full-time jobs are the lucky ones) is still more than 3% below what it was 40 years ago. Nor has there been much progress on reducing racial disparities: in the third quarter of 2019, median weekly earnings for black men working full-time were less than three-quarters the level for white men.

[…]

And despite Trump’s vaunted promises to bring manufacturing jobs back to the US, the increase in manufacturing employment is still lower than it was under his predecessor, Barack Obama, once the post-2008 recovery set in, and is still markedly below its pre-crisis level. Even the unemployment rate, at a 50-year low, masks economic fragility. The employment rate for working-age males and females, while rising, has increased less than during the Obama recovery, and is still significantly below that of other developed countries. The pace of job creation is also markedly slower than it was under Obama.

Again, the low employment rate is not a surprise, not least because unhealthy people can’t work. Moreover, those on disability benefits, in prison—the US incarceration rate has increased more than sixfold since 1970, with some two million people currently behind bars – or so discouraged that they are not actively seeking jobs are not counted as “unemployed.” But, of course, they are not employed. Nor is it a surprise that a country that doesn’t provide affordable childcare or guarantee family leave would have lower female employment—adjusted for population, more than ten percentage points lower—than other developed countries.