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Monday, January 30, 2017

Experts Are Seriously Worried About Trump's Science Information Blackout. Here's Why

Early last week, news broke that the Trump administration had issued an information blackout for the Environmental Protection Agency (EPA). The agency was directed to stop issuing press releases, posting to their social media pages, and speaking to members of the press or directly to the public.

The Boston Globe reported on Tuesday that EPA transition-team member Doug Ericksen expected the communications ban to be lifted by the end of last week. “We’re just trying to get a handle on everything and make sure what goes out reflects the priorities of the new administration,” he said.

On Thursday, however, USA Today reported that—although a temporary freeze on EPA research grants had been lifted—the “tight control on how the agency communicates with the public through social media and news outlets will remain in place for now.” The EPA has not published any press releases, or updated its Facebook or Twitter pages, since January 20. Calls and emails from Health to the agency’s press office were not immediately returned.

The EPA’s not the only science agency that’s been in the news, either: The Department of the Interior and the Department of Agriculture were both given temporary gag orders last week, which have since been lifted. It also came to light last week that the Centers for Disease Control and Prevention (CDC) had canceled or postponed two conferences planned around the topics of climate change and LGBT youth. (These decisions were made before President Trump took office, the agency says.)

So what does this mean for our day-to-day health and safety?

The answer isn’t entirely clear, but public health experts are concerned about the messages being sent to the scientific community—and to American citizens—so far.

“The worry is generated by the administration’s willingness to censor information for what appears to be political purposes,” says Arthur Caplan, PhD, professor of bioethics at NYU Langone Medical Center. “There’s hinting that there could be requirements to clear things through political operatives before they get released to the public, and this type of thing hasn’t really been done before.”

Experts have serious concerns about the EPA’s uncertain future, and its policies regarding clean air, clean water, and climate change—all things that inevitably affect human health. But in addition to its research and environmental clean-up efforts, the EPA also communicates with the public about issues directly related to health and safety. For example, its Facebook page includes posts (pre-January 20) about the dangers of wood-smoke inhalation, carbon monoxide poisoning, and radon—a gas that’s present in many homes and causes lung cancer.

If these types of media bans were to extend to other science agencies, the impacts on our health would likely be even greater. The CDC, for example, monitors the spread of illness and disease all over the world. “But this information really only matters to the extent that they are able to communicate it,” says Tara McKay, PhD, assistant professor of medicine, health, and society at Vanderbilt University.

“If the CDC notices a big spike in flu hospitalizations, but isn’t able to provide any public messaging or prevention around this because of a gag order, then some people will die from infections that might have been avoided,” she says. “Resources will not be directed to the appropriate prevention, identification, and treatment activities.”

The CDC also plays an important role in decreasing panic around issues that really aren’t as scary as they seem. When Ebola virus was diagnosed in the United States in 2014, for example, the agency provided reassurance that treatment and prevention of transmission were top priorities.

At that time, Donald Trump criticized the government’s approach to the Ebola scare, advocating on Twitter for quarantines and travel bans not supported by scientific research. It's not outlandish to think that, as President, he might similarly go against—or try to change—the CDC’s recommendations in the event of another major health scare, says Caplan.

“If these agencies are seen as untrustworthy or censored, or they can’t get in a fast enough response, it can lead to widespread panic,” he says. That could mean unfair treatment of people seen as disease risks, he adds, or to a misallocation of resources that would make the situation worse.

“Nobody ever called up Steve Bannon or Sean Spicer or Kellyanne Conway to find out what to do about Zika; they want to know what the CDC says and they want to know fast,” Caplan continues. “These agencies shouldn’t have to wait to find out what the administration thinks in order to answer factual questions.”

Similar concerns would apply to the Food and Drug Administration (FDA), which is tasked with warning the public about dangers posed by foods and medicines currently on store shelves. “We don’t want to worry about whether an E. coli outbreak is being covered up because you don’t want to see certain businesses being damaged, or exaggerated because it comes from a country you don’t like, like Mexico,” says Caplan.

The good news is, the CDC and FDA still appear to be functioning normally; both organizations are updating their social media sites, and the FDA put out a press release just Friday. And not everyone thinks the existing blackouts are cause for alarm: Last week the New York Times quoted several agency staff members who viewed the Trump directives as a normal part of a presidential transition.

Vox.com also points out that these agencies are protected by scientific integrity policies put in place by the Obama administration. The FDA’s policy, for example, states that staff is allowed to “communicate their personal scientific or policy views to the public, even when those views differ from official Agency opinions.” (As FiveThirtyEight reports, however, there’s also no legal consequence for violating these protections.)

With the exception of the EPA, there’s been no indication that government agencies won’t be able to continue studying and monitoring imminent health threats, including disease outbreaks and foodborne illnesses. (The EPA’s research projects will reportedly be approved by the administration on a case-by-case basis.)

McKay is more concerned about the second part of both the FDA’s and CDC’s mission: to inform decision-makers about how to address these health concerns, and provide people with information so they can take responsibility for their own health.

“That second part is just as important, if not more so, than the first,” she says. “It does the agency little to know these things are happening and not be able to do or say anything about them.”

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Wednesday, January 18, 2017

What You Should Know About Meningitis, the Deadly Infection That Killed a Man in California

Imagine getting an alert from your gym that a member has died of meningitis, an infection that can be passed via close contact. You’d probably be worried, to say the least.

This is what happened after 48-year-old Sevin Philips, a frequent visitor to a SoulCycle studio in Larkspur, California, died of bacterial meningitis on January 7. Out of an abundance of caution, health officials have since contacted more than 200 of his fellow riders who may have been exposed; but they are being told not to panic, according to NBC Bay Area news.

So what is meningitis, exactly—and how contagious is it really?

Meningitis is an inflammation of the membranes covering the spinal cord and brain. There are many possible causes, including viruses, fungi, parasites, drugs, and cancer. But the type that frequently appears in the news is a bacterial form called meningococcal meningitis, caused by the bacterium Neisseria meningitidis.

“This can be horrifically serious,” says Aileen Marty, MD, professor of infectious diseases at the Florida International University Herbert Wertheim College of Medicine. It can cause brain damage and hearing loss. In the worst cases, it can lead to death in just a few hours.

“Meningitis is not uncommon,” says Dr. Marty. “But it’s especially common in populations that are living in tight quarters, like the military or college students.“ (Many universities recommend the meningococcal vaccine if you live in student housing.)

That’s because bacterial meningitis is transmitted via close interaction. But it’s unlikely that working out next to someone who’s infected would put you at risk, as health officials told SoulCycle regulars in Larkspur.

You need to be in contact with an infected person’s saliva, which can happen when you live together, for example, or kiss, says Jessica MacNeil, an epidemiologist in the Division of Bacterial Diseases at the U.S. Centers for Disease Control and Prevention. “The bacteria that cause meningococcal disease require prolonged (lengthy) or very close, person-to-person contact in order to spread,” she explained in an email to Health.

It’s not like catching a cold or the flu, she added: “The bacteria are not spread by casual contact, being in the same room as someone who is sick, or breathing the air where a person with meningococcal disease has been."

And the bacteria can’t live outside the body for long. So you can’t catch the disease by touching surfaces like a spin bike, a keyboard, or a doorknob that someone who is sick has also touched, MacNeil said.

The classic symptoms are sudden fever, headache, and a stiff neck. "When we say headache, we mean it’s among the worst headaches that somebody’s had in their life. And with the stiff neck, they really can’t move their neck, or they can’t, for example, touch their chin to their chest,” MacNeil said. Other symptoms include nausea and vomiting, confusion, exhaustion, and sensitivity to light. It can be mistaken for a bad flu, says Dr. Marty. But because meningococcal meningitis is so serious, you should seek treatment immediately.

As for protecting yourself, the best defense is washing your hands, says Dr. Marty. “Hand washing is unbelievably underrated and so important. But people don’t know how to do it,” she says.

Here’s a quick refresher: Under running water, scrub your hands (get in all the crevices!) for at least 20 seconds. Rinse, and then dry with a clean towel. Wash after you go to the bathroom, before you eat, and whenever you’re around someone who’s sick.

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Repealing Obamacare Would Take Insurance Away From 32 Million Americans and Double Premiums

How to Make Your Resolutions Last All Year

Did you resolve to make a change this year? Whether your goal was to eat healthier, run a marathon, or finally start meditating, keep those shiny new resolutions and avoid backsliding with these proven strategies from Gretchen Rubin, author of Better Than Before: What I Learned About Making and Breaking Habits—to Sleep More, Quit Sugar, Procrastinate Less, and Generally Build a Happier Life ($16; amazon.com).

1. Name it

Aiming to be fitter or healthier is a laudable goal, but what does that mean? “Choose a goal that is concrete and measurable and tied to an actual behavior,” says Rubin. Examples: You want to be more active, so you’ll walk your dog every morning in the park. You want to eat better, so you’ll snack on fruit instead of chips.

2. Know yourself

Ask, “What kind of person am I, really?” If you’re not a morning person, don’t resolve to wake up at 5 a.m. to go to the gym before work—that approach is not only unrealistic, it’s going to fail fast. Rubin suggests recalling past successes to clue you in to what will work for you.

3. Plan for failure

Things are bound to go wrong along the way (you’ll attend a party and be surrounded by to-die-for cupcakes, say). The key is to anticipate those challenges and make an if-then plan, notes Rubin. For instance, tell yourself: “If there are cupcakes at this party, then I’ll take one, relish every bite and walk away.”

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4. Show yourself some love

“When you feel energized and cared for, it’s easier to resist temptation,” says Rubin. So beyond basic self-care, make sure you’re regularly treating yourself in healthy (i.e., not food- or shopping related) ways: Do a crossword puzzle when you drink your coffee, or burn a scented candle.

5. Reframe it

People sometimes feel “done” when they achieve their goal, says Rubin. “Don’t think of it as a finish line. Consider it just one milestone out of many,” she says. Think about how you can build on your original goal so you have a new target to shoot for—even before you reach the first one. That way, the good-for-you momentum will carry on

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Tuesday, January 17, 2017

What Your Doctor Isn’t Telling You on Twitter

This article originally appeared on Time.com.

Cancer doctors with Twitter accounts have something else in common: more than 70% of them receive funding from drug companies, according to a new research letter published in JAMA Internal Medicine.

In the study, researchers identified 634 hematologist-oncologists who were active on Twitter and looked up whether they received personal payments from drug companies, unrelated to research or grants, in 2014. Most of them did: 72% received payments from drug companies and 44% were paid more than a thousand dollars. Payments received by the doctors in the study ranged from $100 to more than $50,000 in a single year.

The topic has fascinated study author Dr. Vinay Prasad, an assistant professor of medicine at the Oregon Health and Science University, ever since he noticed that cancer doctors were tweeting about drugs and clinical trials. He and his team didn’t analyze the content of the tweets in this study, so they can’t show whether the doctors were tweeting about drugs from those companies—and whether the doctors’ conflicts of interest influence what they share on social media.

However, Prasad says his team is currently answering that question in a second study, and while the research is still ongoing, Prasad says the practice is prevalent. “It is 100% happening that doctors who have conflicts of interest are tweeting about those specific drugs,” he says.

Regulatory agencies have struggled to come up with rules on promoting prescription drugs through social media. In 2014, the U.S. Food and Drug Administration (FDA) introduced voluntary guidelines for companies on how to present the risks and benefits of a given product online, even with character restrictions. Among them are suggestions to post messages about risks with a hyperlink that can direct people to a more detailed listing of side effects. Currently there is no official guidance for doctors on social media.

The study authors say that their findings raise the important issue of whether, and how, a doctor’s conflict of interest should be disclosed on social media like Twitter. Prasad says he thinks doctors should disclose their conflicts in their social media bios and consider flagging them when tweeting about drugs or clinical trials by companies they are paid by.

“Although there are cancer drugs with tremendous benefits, most cancer drugs have marginal benefits and real risk and harms,” says Prasad. “People deciding what treatment is right for them are in a tough situation. If part of what’s shaping your view of these drugs is the opinion of thought leaders on Twitter, then I think you have the right to know if they are paid by drug companies.”

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