May 22, 2023
Reading a weekly newsletter can often be a study in frustration regarding that which we learn about that is either against what we wish to do or just annoying to know about. This weeks literature review is one of these. This week we see a lot of frustrating science and policy reality that goes against our health and is controlled at the government level. Whether it is masking children, legalizing marijuana and or increasing potency legally, finding plastics in our bodies and so much more.
The reality is that we must read this information anyway as to be aware to make whatever change that we can to limit disease risk for us and our children.
Literature Review
1) Inhalation of polyamides or nylon in microsizes from the environment may lead to inflammation in humans based on translational research. "Inhalation of combustion-derived, metallic, and carbonaceous aerosols generate pulmonary inflammation, cardiovascular dysfunction, and systemic inflammation. Additionally, due to the additives present in plastics, MNPs may act as endocrine disruptors. " They noted that the micro-plastics caused elevations in IL6 and abnormalities in 17-beta estradiol. This means that there are signs of inflammation and endocrine disruption. (Cary et. al. 2023)
2) The mask mandate for children was never based on good science. The CDC recommended it despite opposing views from the World Health Organization and The European Centre for Disease Prevention and Control which recommends against the use of masks for any children in primary school. The risks of masking in schools was obvious and known while the benefit was unknown and likely low at best. The European CDC had this to say: "As in other confined spaces, important measures to prevent the spread of infection in schools include:
- physical distancing
- improved ventilation
- promotion of ‘stay-at-home when sick’ policies
- promotion of respiratory etiquette
- proper hand hygiene and regular hand washing
- use of masks when feasible (considerations may differ by age of the child).
Physical distancing measures should aim to decrease the number of individuals in tight or closed spaces, while ensuring schooling can take place. Physical distancing can be achieved by:
- grouping classes and groups based on infection risk and status (i.e. cohorting)
- ensuring physical distance in the classroom (e.g. separating tables)
- reducing class sizes
- staggering arrival times, as well as meal and break times
- holding classes outdoors.
"The use of face masks is generally recommended, particularly in indoor settings when it is not possible to maintain physical distancing. However, implementing this measure in school settings is challenging, as children younger than 12 years old may have a lower tolerance to wearing masks for extended periods of time and may fail to wear them properly. In primary schools, the use of face masks is recommended for teachers and other adults when physical distancing cannot be guaranteed, but it is not recommended for students. In secondary schools, the use of face masks is recommended for both students and adults (i.e. masks for children older than 12 years) living in areas with community transmission of SARS-CoV-2. The use of face masks should be seen as a complementary measure, rather than a stand-alone measure to prevent transmission within schools." (European CDC) They had the right of it and we were far off in left field.
I think that it is amazing that the US CDC never studied masking before making massive social decisions that affected children to such a negative degree. Science and medical decision making must be made on clinical grounds with the oath of do no harm at the forefront. Harm was done to children nationally on so many fronts that we must discuss it in order to never allow this again. The CDC masking policy was in direct conflict with this oath. Read Vinay Prasad's Substack article to see the trail of missed opportunities by the most powerful public health agency in the US, the CDC. Let us hope that we have learned our lesson. I am entirely grateful for the state of North Carolina for taking a more measured approach and trying to follow the science as with studies by Dr. Benjamin at Duke. Although we did mask children, a bad decision, it ended reasonably early compared to other states. The state also allowed local schools to end mandates based on their view of risk in the county. Many ended in early 2021, a year before the North east and West coast states.
3) Cannabis or Marijuana use and incident schizophrenia risk - are they linked? From Psychological Medicine: Almost 7 million individuals were followed and 45,327 cases of incident schizophrenia were identified during the study period. The hazard ratio was slightly higher among males among the whole population. However, among 16–20-year-olds, the adjusted risk for males was more than twice that for females. (Hjorthaj et. al. 2023) The authors believe that 20% of these cases could have been avoided by avoiding the use of THC. As marjiuana becomes more legal, used and non stigmatized for the adolescents of the US, we are likely to see more incident psychiatric disease. Not a good thing as the drug is being made more potent by cross hybridization. See next....
4) From the Journal Missouri Medicine we see the following regarding THC: THC potency is rising - from the 1960's to the 1990's the potency was less than 2%. Since then 1990s it has grown from 2% up at 95% at the highest concentration. Unfortunately, the CBD content is not following along side the THC rise as most potent THC products have little to no protective CBD and it's medicinal benefits. There is zero evidence in the research that this level of THC is beneficial for any human disease state. These drugs are purely for a recreational high and are now very dangerous to human health. "Because there was initially no regulation on the edibles they have been made to look very similar to regular products that people consume such as chocolates, gummy bears, PopTarts etc. As a result there has been a significant increase in the accidental exposure/overdoses of children younger than nine in Colorado compared with the US at large.”"Since legalization in Colorado, marijuana use in adolescents and those 18–25 has steadily climbed, well outpacing the national average. Colorado leads the nation in first time marijuana use by those aged 12–17, representing a 65% increase in adolescent use since legalization." (Stuyt E. 2018)
This is a big problem - educate your teens daily about these risks.
5) A new article in JAMA notes that influenza and Covid 19 had the same death rate for all individuals below 65 years of age and a 2x risk for those older than 65 years of age. Vaccination aided the at risk elderly group. Unfortunately, here is the authors results discussion: "This study found that, in a VA population in fall-winter 2022-2023, being hospitalized for COVID-19 vs seasonal influenza was associated with an increased risk of death. This finding should be interpreted in the context of a 2 to 3 times greater number of people being hospitalized for COVID-19 vs influenza in the US in this period. However, the difference in mortality rates between COVID-19 and influenza appears to have decreased since early in the pandemic; death rates among people hospitalized for COVID-19 were 17% to 21% in 2020 vs 6% in this study, while death rates for those hospitalized for influenza were 3.8% in 2020 vs 3.7% in this study. The decline in death rates among people hospitalized for COVID-19 may be due to changes in SARS-CoV-2 variants, increased immunity levels (from vaccination and prior infection), and improved clinical care. The increased risk of death was greater among unvaccinated individuals compared with those vaccinated or boosted—findings that highlight the importance of vaccination in reducing risk of COVID-19 death." (Xie et al. 2023)
Again, we see zero risk stratification in the discussion. Leading to summaries that are misleading and encouraging all comers to vaccinate despite the lack of need for most of the United States population under 65 years of age. The other take away that is not discussed but noted in the data is that primary and secondary natural infections had the exact same effect on death as vaccination and booster events comparably. Pick your poison and the result is the same again making the "importance of vaccination" statement misleading.
These studies are the root of the scientific communities problem with mistrust. The data is there but you must decipher truth among the tea leaves as the abstracts are misleading. You would think by the headlines that vaccinations are better and save lives over natural infection and death is higher for all comers. Unfortunately, this is entirely untrue. Frustrating me thoroughly.
That's all this week,
Dr. M
