Lifelong Exercise Shown to Slow Aging

The benefits of exercise are underrated much too often.

Researchers at the University of Birmingham and King’s College London have found that staying active keeps the body young and healthy.

The researchers set out to assess the health of older adults who had exercised most of their adult lives to see if this could slow down ageing.

The study recruited 125 amateur cyclists aged 55 to 79, 84 of which were male and 41 were female. The men had to be able to cycle 100 km in under 6.5 hours, while the women had to be able to cycle 60 km in 5.5 hours. Smokers, heavy drinkers and those with high blood pressure or other health conditions were excluded from the study.

The participants underwent a series of tests in the laboratory and were compared to a group of adults who do not partake in regular physical activity. This group consisted of 75 healthy people aged 57 to 80 and 55 healthy young adults aged 20 to 36.

The study showed that loss of muscle mass and strength did not occur in those who exercise regularly. The cyclists also did not increase their body fat or cholesterol levels with age and the men’s testosterone levels also remained high, suggesting that they may have avoided most of the male menopause.

More surprisingly, the study also revealed that the benefits of exercise extend beyond muscle as the cyclists also had an immune system that did not seem to have aged either.

An organ called the thymus, which makes immune cells called T cells, starts to shrink from the age of 20 and makes less T cells. In this study, however, the cyclists’ thymuses were making as many T cells as those of a young person.

The findings come as figures show that less than half of over 65s do enough exercise to stay healthy and more than half of those aged over 65 suffer from at least two diseases.* Professor Janet Lord, Director of the Institute of Inflammation and Ageing at the University of Birmingham, said: “Hippocrates in 400 BC said that exercise is man’s best medicine, but his message has been lost over time and we are an increasingly sedentary society.

“However, importantly, our findings debunk the assumption that ageing automatically makes us more frail.

“Our research means we now have strong evidence that encouraging people to commit to regular exercise throughout their lives is a viable solution to the problem that we are living longer but not healthier.”

Dr Niharika Arora Duggal, also of the University of Birmingham, said: “We hope these findings prevent the danger that, as a society, we accept that old age and disease are normal bedfellows and that the third age of man is something to be endured and not enjoyed.”

Professor Stephen Harridge, Director of the Centre of Human & Aerospace Physiological Sciences at King’s College London, said: “The findings emphasise the fact that the cyclists do not exercise because they are healthy, but that they are healthy because they have been exercising for such a large proportion of their lives.

“Their bodies have been allowed to age optimally, free from the problems usually caused by inactivity. Remove the activity and their health would likely deteriorate.”

Norman Lazarus, Emeritus Professor at King’s College London and also a master cyclist and Dr Ross Pollock, who undertook the muscle study, both agreed that: “Most of us who exercise have nowhere near the physiological capacities of elite athletes.

“We exercise mainly to enjoy ourselves. Nearly everybody can partake in an exercise that is in keeping with their own physiological capabilities.

“Find an exercise that you enjoy in whatever environment that suits you and make a habit of physical activity. You will reap the rewards in later life by enjoying an independent and productive old age.”

Important COVID-19 Antibody Drugs Aren’t Being Used Enough

“Antibody drugs from Regeneron and Eli Lilly could reduce hospitalizations from Covid-19 by 50-70%,” as the article says.

When President Donald Trump got sick with Covid-19 in October, he credited an antibody drug from Regeneron with making him feel better “immediately.”

“I felt as good three days ago as I do now,” he said in a video shot in front of the White House after he left Walter Reed National Military Medical Center, promising medicines from Regeneron and Eli Lilly would soon be available to the American public to help stop the terrible effects of Covid-19.

The concern, as these drugs were cleared through the FDA and made it to market last month, was that there wouldn’t be enough supply. They’re complicated to manufacture, and Regeneron said there were only enough doses for 80,000 Americans by the end of November. Lilly has 250,000 doses available.

An average of more than 200,000 Americans are currently getting diagnosed with Covid-19 every day, according to data compiled by Johns Hopkins University. Policymakers expected to need to ration the antibody drugs.

But a month into their distribution, the opposite problem has emerged: the drugs are not getting used.

“We have a surplus of these monoclonal antibodies right now,” Health Secretary Alex Azar told CNBC’s Shepard Smith Tuesday night. “What’s happening is people are waiting too long to seek out the treatments.”

Moncef Slaoui, chief scientific adviser to the U.S. government’s Operation Warp Speed, told CNBC Tuesday that the federal government is distributing about 65,000 doses of the antibody drugs every week to states.

But, he said, only 5% to 20% of the doses are getting administered to patients.

“It should be used much more,” Slaoui said in a telephone interview, noting the drugs — which are indicated for patients at high risk for severe Covid-19 — could cut down on hospitalizations by 50% to 70%.

The drugs are not simple to administer. For one thing, they’re given by intravenous infusion, so patients must go to health centers where this can be done. But since they’re likely contagious, existing IV facilities, like where patients receive chemotherapy, can’t be used.

Another issue is that the drugs need to be given early in the course of the disease. The FDA’s guidance for health-care providers says they should be administered as soon as possible after diagnosis, and within 10 days of symptom onset. It recommends against use of the drugs once patients are so sick they’re hospitalized.

But many patients don’t feel sick right away, so the idea of an IV-infused drug doesn’t occur to them immediately after diagnosis, Slaoui and Azar suggested.

“If you are over 65 or at risk of serious complications or hospitalization due to co-morbidities, what have you, and you test positive, you need to seek out and get the Lilly or Regeneron monoclonal antibody,” Azar said on the “News With Shepard Smith.” “It can dramatically reduce the risk for us of hospitalizations at a time when hospitals are getting very crowded with people with Covid.”

But it’s a challenge for some health systems to set up the infrastructure to deliver these drugs. Some states are using 100% of their allocation, Slaoui said. Others, like in Georgia and Illinois, may not be using any, according to former FDA Commissioner Dr. Scott Gottlieb.

Georgia’s public health department didn’t immediately respond to questions about their antibody usage. A spokeswoman for Illinois’ Department of Public Health said providers aren’t yet required to report use of monoclonal antibodies, but that the U.S. Department of Health and Human Services will require hospitals to report the information starting Jan. 8.

[…]

He noted the data behind the medicines suggest “the number needed to treat in terms of keeping one patient out of the hospital … is 10.” Lilly has said it will have 950,000 doses available by the end of January, Gottlieb cited the effects if 900,000 doses were used: “That means if all of the drugs got distributed, we could avoid 90,000 hospitalizations or emergency room visits. That would be substantial.”

Lilly noted the IV administration of the antibody drugs “presents unique challenges to the healthcare system,” and said it’s working to address the challenges to ensure patients who need the drug can get it. The company is running a number of pilot programs through Operation Warp Speed, including one with CVS for in-home infusions, a company spokeswoman said.

Honey Has Been Shown to Treat Upper Respiratory Infections Better Than Traditional Remedies

Honey is unique in that its a bacteria-killing agent that hasn’t been shown to trigger antibiotic resistance due to how it naturally contains hydrogen peroxide.

A trio of researchers at Oxford University has found that honey is a better treatment for upper respiratory tract infections (URTIs) than traditional remedies. In their paper published in BMJ Evidence-based Medicine, Hibatullah Abuelgasim, Charlotte Albury, and Joseph Lee describe their study of the results of multiple clinical trials that involved testing of treatments for upper respiratory tract infections (URTIs) and what they learned from the data.

Over the past several years, the medical community has grown alarmed as bacteria have developed resistance to antibacterial agents. Some studies have found that over-prescription of such remedies is hastening the pace. Of particular concern are antibacterial prescriptions written for maladies that they are not likely to help, simply due to demands from patients. One such case is often URTIs, the vast majority of which are caused by viruses, not bacteria. Because of such cases, scientists have been looking for other remedies for these infections, and one therapy in particular has begun to stand out: honey.

Anecdotal evidence has suggested that honey can be used to treat colds in general and coughs in particular—people have been using it as a therapy for thousands of years. In this new effort, the researchers looked at the results of multiple clinical trials testing the effectiveness of therapies against URTIs. In all, the team looked at data from 14 clinical trials involving 1,761 patients.

In analyzing the data from all of the trials combined, the researchers found that the trials had included studies of virtually all of the traditional remedies such as over-the-counter cold and sinus medicines as well as antibiotics—and honey. They found that honey proved to be the best therapy among all of those tested. In addition to proving more effective in treating coughing (36 percent better at reducing the amount of coughing and 44 percent better at reducing coughing severity), it also led to a reduction in average duration of infection by two days.

The researchers note that the reason honey works as a treatment for URTIs is because it contains hydrogen peroxide—a known bacteria killer—which also makes it useful as a topical treatment for cuts and scrapes. Honey is also of the right consistency—its thickness works to coat the mouth and throat, soothing irritation.

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.

Drinking Tea Regularly Linked to a Longer Life

Scientists found that there really is merit to drinking green tea.

Drinking tea at least three times a week could be linked with a longer and healthier life, scientists say.

According to new research “habitual” consumption of the hot drink is associated with lower risks of cardiovascular disease and all-cause death.

But whether the tea being consumed is green or black may make a difference.

The analysis included 100,902 participants of the China-PAR project2 with no history of heart attack, stroke, or cancer.

Participants were categorised into two groups – habitual tea drinkers, those drinking three or more times a week, and never or non-habitual tea drinkers  – those drinking less than three times a week.

They were followed-up for a median of 7.3 years, in the study published in the European Journal of Preventative Cardiology.

The research suggests a 50-year-old habitual tea drinker would develop coronary heart disease and stroke 1.41 years later, and live 1.26 years, longer than someone who never or seldom drank tea.

Compared with never or non-habitual tea drinkers, habitual tea consumers had a 20% lower risk of incident heart disease and stroke, and a 22% lower risk of fatal heart disease and stroke.

They also had a 15% decreased risk of all-cause death, the study suggests.

First author Dr Xinyan Wang, of the Chinese Academy of Medical Science in Beijing, said: “Habitual tea consumption is associated with lower risks of cardiovascular disease and all-cause death.

“The favourable health effects are the most robust for green tea and for long-term habitual tea drinkers.”

Researchers analysed the potential influence of changes in tea drinking behaviour in a subset of 14,081 participants with assessments at two time points.

The average duration between the two surveys was 8.2 years, and the median follow-up after the second survey was 5.3 years.

Habitual drinkers who maintained their habit in both surveys had a 39% lower risk of incident heart disease and stroke, 56% lower risk of fatal heart disease and stroke, and 29% decreased risk of all-cause death compared to consistent never or non-habitual tea drinkers, the study suggests.

In a sub-analysis by tea type, drinking green tea was linked with around 25% lower risks for incident heart disease and stroke, fatal heart disease and stroke, and all-cause death.

However, no significant associations were observed for black tea.

Scientists found 49% of habitual tea drinkers in the study consumed green tea most frequently, while only 8% preferred black tea.

They noted a preference for green tea in East Asia, and said the small proportion of habitual black tea drinkers might make it more difficult to observe robust associations, but that the findings hint at a differential effect between tea types.

The researchers suggest a number of reasons for this.

They indicate that green tea is a rich source of polyphenols which protect against cardiovascular disease.

While black tea is fully fermented and during this process may lose antioxidant effects.

Gunter Kuhnle, professor of nutrition and food science at the University of Reading, said: “This study is an observational study and can therefore only establish an association – not a causal relationship.”

He added that the two cups per week as cut-off point was very little when compared to the average consumption of three to four cups per day in the UK.

Prof Kuhnle said: “It is not clear from the study whether there is any benefit from higher tea intake – and therefore there is no likely benefit from increasing tea intake by the majority of the British public.”

AI Becomes Very Good at Diagnosing Breast Cancer

Artificial intelligence is becoming more of a hot topic, and people should remember more that AI can be used both to hurt humans and (as in this case) help humans.

A computer programme can identify breast cancer from routine scans with greater accuracy than human experts, researchers said in what they hoped could prove a breakthrough in the fight against the global killer.

Breast cancer is one of the most common cancers in women, with more than 2 million new diagnoses last year alone.

Regular screening is vital in detecting the earliest signs of the disease in patients who show no obvious symptoms.

In Britain, women over 50 are advised to get a mammogram every three years, the results of which are analysed by two independent experts.

But interpreting the scans leaves room for error, and a small percentage of all mammograms either return a false positive – misdiagnosing a healthy patient as having cancer – or false negative – missing the disease as it spreads.

Now researchers at Google Health have trained an artificial intelligence model to detect cancer in breast scans from thousands of women in Britain and the United States.

The images had already been reviewed by doctors in real life but unlike in a clinical setting, the machine had no patient history to inform its diagnoses.

The team found that their AI model could predict breast cancer from the scans with a similar accuracy level to expert radiographers.

Further, the AI showed a reduction in the proportion of cases where cancer was incorrectly identified – 5.7 percent in the US and 1.2 percent in Britain, respectively.

It also reduced the percentage of missed diagnoses by 9.4 percent among US patients and by 2.7 percent in Britain.

“The earlier you identify a breast cancer the better it is for the patient,” Dominic King, UK lead at Google Health, told AFP.

“We think about this technology in a way that supports and enables an expert, or a patient ultimately, to get the best outcome from whatever diagnostics they’ve had.”

Computer ‘second opinion’

In Britain all mammograms are reviewed by two radiologists, a necessary but labour-intensive process.

The team at Google Health also conducted experiments comparing the computer’s decision with that of the first human scan reader.​

If the two diagnoses agreed, the case was marked as resolved. Only with discordant outcomes was the machine then asked to compare with the second reader’s decision.

The study by King and his team, published in Nature, showed that using AI to verify the first human expert reviewer’s diagnosis could save up to 88 percent of the workload for the second clinician.

“Find me a country where you can find a nurse or doctor that isn’t busy,” said King.

“There’s the opportunity for this technology to support the existing excellent service of the (human) reviewers.”

Ken Young, a doctor who manages mammogram collection for Cancer Research UK, contributed to the study.

He said it was unique for its use of real-life diagnosis scenarios from nearly 30,000 scans.

“We have a sample that is representative of all the women that might come through breast screening,” he said.

“It includes easy cases, difficult cases and everything in between.”

The team said further research was needed but they hoped that the technology could one day act as a “second opinion” for cancer diagnoses.

Major Benefits of Reducing Air Pollution

Air pollution has for many years been a major public health problem that doesn’t receive much attention despite its significant effects on the population. It has been estimated that the majority of people in the world are regularly breathing unclean air.

Reductions in air pollution yielded fast and dramatic impacts on health-outcomes, as well as decreases in all-cause morbidity, according to findings in “Health Benefits of Air Pollution Reduction,” new research published in the American Thoracic Society’s journal, Annals of the American Thoracic Society.

The study by the Environmental Committee of the Forum of International Respiratory Societies (FIRS) reviewed interventions that have reduced air pollution at its source. It looked for outcomes and time to achieve those outcomes in several settings, finding that the improvements in health were striking. Starting at week one of a ban on smoking in Ireland, for example, there was a 13 percent drop in all-cause mortality, a 26 percent reduction in ischemic heart disease, a 32 percent reduction in stroke, and a 38 percent reduction in chronic obstructive pulmonary disease (COPD). Interestingly, the greatest benefits in that case occurred among non-smokers.

“We knew there were benefits from pollution control, but the magnitude and relatively short time duration to accomplish them were impressive,” said lead author of the report, Dean Schraufnagel, MD, ATSF. “Our findings indicate almost immediate and substantial effects on health outcomes followed reduced exposure to air pollution. It’s critical that governments adopt and enforce WHO guidelines for air pollution immediately.”

In the United States, a 13-month closure of a steel mill in Utah resulted in reducing hospitalizations for pneumonia, pleurisy, bronchitis and asthma by half. School absenteeism decreased by 40 percent, and daily mortality fell by 16 percent for every 100 ?g/m3 PM10 (a pollutant) decrease. Women who were pregnant during the mill closing were less likely to have premature births.

A 17-day “transportation strategy,” in Atlanta, Georgia during the 1996 Olympic Games involved closing parts of the city to help athletes make it to their events on time, but also greatly decreased air pollution. In the following four weeks, children’s visits for asthma to clinics dropped by more than 40 percent and trips to emergency departments by 11 percent. Hospitalizations for asthma decreased by 19 percent. Similarly, when China imposed factory and travel restrictions for the Beijing Olympics, lung function improved within two months, with fewer asthma-related physician visits and less cardiovascular mortality.

In addition to city-wide polices, reducing air pollution within the home also led to health benefits. In Nigeria, families who had clean cook stoves that reduced indoor air pollution during a nine-month pregnancy term saw higher birthweights, greater gestational age at delivery, and less perinatal mortality.

The report also examines the impact of environmental policies economically. It highlights that 25 years after enactment of the Clean Air Act, the U.S. EPA estimated that the health benefits exceeded the cost by 32:1, saving 2 trillion dollars, and has been heralded as one of the most effective public health policies of all time in the United States. Emissions of the major pollutants (particulate matter [PM], sulfur oxides, nitrogen oxides, carbon monoxide, volatile organic compounds, and lead) were reduced by 73 percent between 1990 and 2015 while the U.S. gross domestic product grew by more than 250 percent.

Given these findings, Dr. Schraufnagel has hope. “Air pollution is largely an avoidable health risk that affects everyone. Urban growth, expanding industrialization, global warming, and new knowledge of the harm of air pollution raise the degree of urgency for pollution control and stress the consequences of inaction,” he says. “Fortunately, reducing air pollution can result in prompt and substantial health gains. Sweeping policies affecting a whole country can reduce all-cause mortality within weeks. Local programs, such as reducing traffic, have also promptly improved many health measures.”

Dangers of Vaping: It Can Cause Real Harm

Vaping comes with serious risks to one’s health — it isn’t always the harmless activity that many think it is. A significant part of today’s youth are now addicted to nicotine, and it’s in the news more and more what some of the terrible problems heavy vaping users have had. There are people now facing permanent damage to their lungs as a result of vaping. By comparison, smoking cigarettes is of course terrible for one’s health as well, and more studies need to be done on vaping, but people at least need to see much more that vaping can cause major health problems. The reason so many teens are addicted today is because they view vaping as safe when it really isn’t that safe of an activity.

Anthony Mayo, 19, fell seriously ill last week in Erie, Pennsylvania and he was unable to breathe on his own because his lungs had became severely congested with solidified vape oil.

Anthony’s father, ieth Mayo, told Metro US that doctors warned him ‘right now, at the age of 19, (Anthony’s) got the lungs of a 60-year-old, two-pack-a-day, smoker.’ The teen’s lungs are likely to be scarred for life, according to his doctor.

Keith said his son had been vaping for approximately two years and had tried flavored oils such as blue raspberry, Swedish fish, cotton candy, cinnamon toast crunch, among others. He also vaped THC on occasion, which is the psychoactive ingredient in marijuana.

‘It’s solidified. It’s caking everything inside of his lungs,’ Keith said.

[…]

Anthony is now recovering at Millcreek Community Hospital where doctors put him on 100% oxygen to allow him to breathe and help him expel some of the oil.

‘And then they heat (the oxygen mixture) and put a little moisture in it, so it will go in there and liquefy some of that stuff (caked oil) and encourage him to cough it up…the first couple days he has been coughing and it was blood-tinged, now it’s just brown, dark dark green,’ Keith said.

‘He is going to have some scarring. Whether it’s profound, we don’t know yet. It’s a wait and see type of thing. He’s young, he’s 19, so he can recover from this.’

Keith said his son vaped two to three times a day outside their home, but said he did not realize how detrimental vaping could be to his son’s lungs.

‘His whole spin on it was it was cool and not that bad for you. I was just as guilty. I went along with it. I never got into it, but I didn’t also prevent it either,’ he said, adding that he believes vape companies are targeting young people like his son.

‘The flavors that they’re coming out with…It’s not for your construction worker who can’t afford to light up at a building that they’re working, or the executive who is walking to a meeting smoking a cigarette. No, these flavors are all targeting kids or young adults.’

Anthony’s condition is the first recorded instance of its kind in Pennsylvania, Keith said, however it appears similar to a Texas woman who was just officially diagnosed with acute respiratory distress syndrome, a rapidly progressive disease in which fluid leaks into the lungs making it difficult or impossible to breathe.

The Mayos’ situation come as both state and federal governments have begun to crack down on flavored e-cigarettes and vape oil.

New York became the first state to ban flavored e-cigarettes on Tuesday. Last week, President Donald Trump revealed plans to enact a similar ban on a federal level, as the CDC announced there are now 530 confirmed cases of lung injury associated with vaping on Thursday.

Vaping shot to popularity after being marketed as a healthier way of getting a nicotine hit than traditional cigarettes.

Secondhand vaping exposure also presents a danger, and here’s another article:

Adam Hergenreder started vaping about two years ago at age 16. The mint and mango flavors were his favorites.

Now Hergenreder, of Gurnee, is hospitalized and unable to breathe without a steady flow of oxygen through tubes affixed to his nostrils. Doctors have told the 18-year-old that images of his lungs from a chest X-ray look like those of a man in his 70s. His lungs may never be the same again, and vaping is likely to blame.

Hergenreder said he started off using nicotine vapes and bought them in convenience stores, even though he was underage. But last year he also began buying THC-filled devices, called dab sticks, off the street. These products are often altered by those who sell them illegally. Those in the vaping industry have blamed homemade, illegal devices for the recent rash of hospitalizations, though public health experts have said they can’t confirm that.
[…]
Even before the hospitalizations, physicians and addiction experts warned of the danger of vapes, or e-cigarettes, popular among young people. Besides the addictive properties of nicotine, they also contain chemicals used for flavoring that can cause harm to the lungs.

Hergenreder said he and his peers heard the warnings from teachers and parents, but didn’t believe “how dangerous it is.” He continued to vape — up to one and a half pods a day.

 

“People just see that little (vape) pod and think, how could that do anything to my body?” Hergenreder said Tuesday from his hospital bed at Advocate Condell Medical Center in Libertyville, where his mother took him late Saturday after he spent days throwing up violently. “I’m glad I could be an example and show people that (vaping products) aren’t good at all. They will mess up your lungs.”

[…]

The family said they want to share their story in hopes that others will stay away from e-cigarettes, which experts say are appealing to teens because the slim, rectangular devices are easy to hide and don’t have the smell of traditional tobacco cigarettes. The devices heat up a pod filled with a flavored liquid that can contain nicotine or THC, which creates an aerosol to inhale.

“I feel stupid,” Adam Hergenreder said. “I want other people to stop (vaping). It’s going to attack your lungs.”