Random thoughts about pig hearts

A man in Maryland has received a pig heart transplant. What an interesting idea! People have been talking about xenotransplants of this magnitude for decades, and now someone actually gets to try it. It’s also a terrifying idea.

  • My first thought was of Baby Fae, the infant in 1984 who received a baboon heart. It was a disaster. The surgeon didn’t believe in evolution and dismissed concerns about the degree of relatedness, and the donor was blood type AB and Fae was type O. They also didn’t have any means of genetically modifying the baboon. Would you believe there are ethical concerns and responsibilities in this sort of thing?
  • The Washington post article is all about the ethics of the surgery, which is good. It takes a really cock-eyed perspective, though: the recipient was a bad guy who stabbed and paralyzed someone, failed to pay court-ordered compensation to his victim, and also has a history of being sloppy and undisciplined about his medications. Should he have been given this gift?
    YES.
    Jesus, it’s not even in question. Doctors should deliver health care based on need, not passing judgment on the worth (in all senses of the word) of their patient. What next? Will doctors decide on my treatment based on my credit score? Yeah, you don’t have to tell me that here in the good ol’ USA that is the de facto situation. It’s not good.
  • For the retribution crowd, relax. He is being punished. He’s an experimental guinea pig for a treatment that’s going to buy him a little time. The pig was extensively manipulated with 10 genes modified to reduce, but not totally eliminate, the chance of rejection. He’s going to be trapped in a hospital bed for a good long while, with nurses waking him up every few hours through the night to do blood tests, and he’s going to be taking so many pills. I’ve been in that place for relatively trivial surgeries, it’s a necessary hell. Have a little pity.
  • He’s probably going to die in a few months, anyway — I’ll be surprised if his new heart isn’t shredded by rejection in short order. I’ll be pleasantly surprised if he gets a significant survival time, though, since that means this could be a very promising treatment for everyone.
  • Except the pigs. You do realize that this implies the existence of pig farms for animals whose fate is to be chopped up as needed for organs, right? It’s a tiny drop in the slaughterhouse bucket, since humans butcher 1.5 billion pigs per year to make pulled pork sandwiches and bacon, so it’s not the numbers that are daunting, it’s the fact that right now there are cloned pigs being modified and raised in artisanal farms in the hopes that genetic refinement will make them incredibly valuable to corporations. These are long term investments!
  • No one is talking about how much these expendable pigs cost. We aren’t talking about the ethics from the pig’s perspective, and we’re suspiciously mum about what the bill is going to be. This lucky (?) fellow in Maryland is benefitting from a bit of scientific curiosity — hey, we’ve been raising all these special pigs for a decade or so, how about if we splice one heart into a test subject and see what happens — but if it works and becomes a relatively routine intervention, who’s going to be able to afford it?
  • While I’m on the pig’s side, what do these gene modifications do to the health of the pig stock? Does this compromise their immune systems? Are these going to be bubble-pigs that need to be raised in a sterile environment?
  • I got to wondering about the scientific methodology behind making pigs with all these genetic modifications. Here’s an article on practical approaches for knock-out gene editing in pigs. It’s a multi-step, multi-generational process to produce pigs with specific mutations. Scientists have been working for years to make these pigs.

    Schematic workflow of the different steps needed to generate a gene edited pig. (A) Efficiency analysis of mutations induced by CRISPR-Cas9 system. (B) Different strategies to generate one-cell stage porcine edited embryos. (C) Gene editing analysis of the founder pigs (F0) and offspring produced by crossbreeding F0 pigs (F1).

  • The above article describes the mechanics, but not the research that goes into discovering candidate genes to reduce the immune response. Everyone is fumbling forward in the dark, finding likely genes that are affecting rejection, but they have to put that pig donor tissue in a human host to see if they actually got ’em all. This man in Maryland is very much a wildly experimental test subject, a scientific experiment in progress. The most likely result is they’ll find that “oops, we missed an important gene” and they’ll go back to the pig farm with a new CRISPR/Cas target and raise another generation with 11 modified genes for the next attempt. Meanwhile, this host is dead. But he will have contributed to Science with his demise!

Anyway, my brain is currently split between a Frankensteinian fascination with this bold experiment, and a humane dismay at the cost in suffering for humans and pigs.

Sense/Anti-sense

First, I must remind everyone that billionaire Rupert Murdoch elbowed his way to the front of the queue to get the vaccine as soon as it was announced, and that all those blithering conservative on-air personalities on Fox News are required to be vaccinated, just to put this story on Fox News’ promotion of quacks in perspective. It lists ten of the COVID denialist and anti-vax and tepid apologists for inaction who have been featured on the network many hundreds of times. Names you should learn to recognize and scorn: Marc Siegel, Martin Makary, Nicole Saphier, Rand Paul, Brett Giroir, Janette Nesheiwat, Jayanta Bhattacharya, Harvey Risch, Scott Atlas, and Peter McCullough. They all have the title of “Dr”, but you should know that the majority of doctors disagree with these scam artists; Fox News has been carefully distilling the population of MDs to purify and isolate the most untrustworthy scum to selectively display on popular programs by even more reprehensible filth like Carlson and Ingraham and Kudlow. You don’t get a prime time opinion/bloviation slot on Fox if you hold a reasonable view of the science.

Contrast that with this genuinely excellent interview with Jonathan Eisen, a biologist at UC Davis. Eisen simply and plainly says what every biologist and informed citizen knows about SARS-CoV-2.

The Omicron variant is way more infectious [than Delta]. It’s horribly contagious. Even people who are boosted are still getting infected. [The vaccine] does not seem to provide a huge protection against getting infected. I think that’s part of why it’s spreading so fast—people who have been vaccinated and/or boosted have mistakenly thought they were not going to get infected, and so they were going maskless everywhere. But if you have five times as many people infected, that’s going to create havoc, and that’s what is happening in New York and the Northeast, where the hospitals are full. They’re already sending people away who have any other types of emergency or nonemergency health needs. I think we’re in for some tough times; that’s my prediction.

Exactly. This is what I’m expecting, too. It’s also what everyone who isn’t brainwashed by Fox News can figure out. So what should we do?

All the evidence right now shows that vaccines are incredibly effective in reducing the risk of severe illness and death from Covid. And this is true even for new variants such as Delta and Omicron, even though the vaccines were not specifically designed for them. One can reduce the risk of severe illness even more by getting a booster shot. This reduction in risk is very, very clear from all the data. The one issue with Omicron that is different than with other variants is that just getting the regular vaccine dose (e.g., two Pfizer shots) does not reduce the risk of severe illness as much as it did for other variants. In other words, to reduce the risk of severe illness or death, it seems that a booster is very important here.

This is what infuriates me. Everyone wants the quick fix, the easy treatment, the simplest, most painless way to prevent this disease, and science provides one: the vaccine. Go in to the clinic or pharmacy, poke, you’re done, death averted. And what happens? People who listen to Fox News whine, “I want an insta-fix, but not that one.” They’d rather dose themselves with hydroxychloroquine or ivermectin or bleach or betadine, treatments that don’t work, than take the medicine proven to work.

In a world with people who refuse the treatment that works, and other people who can’t, for other medical reasons, get the vaccine, what can we do to protect ourselves. That’s also easy. Wear a mask in public.

What I’m hoping is that people do a lot of behavioral intervention that can slow down the spread of the Omicron variant. It goes back to the whole “flattening the curve” thing from before, and there are many things we can do. If you’re in crowded indoor spaces, you can avoid doing things where you have to take off your mask—so, no eating. But even with your mask on, not all masks are created equal. There’s new guidance that has come out in the last few days that cloth masks just aren’t going to cut it against Omicron. They just do not, on their own, filter enough particles out to reduce your exposure when airspace is getting filled with virus. What you want is a KN95 or N95 mask.

Yes. Masks aren’t the imposition the whiny-ass-titty-babies of conservatism pretend they are. When I’m teaching, I wear them continuously all day long with no difficulty, other than that I’m generally soft-voiced and muffling me doesn’t help (I’m working on it by TALKING LOUDER with my teaching voice). I tried to order some N95 masks in time for spring classes, but right now they’re backlogged and horribly expensive, so I settled for N94…still expensive with slow delivery — I think they’re all coming from South Korea — but I’ll double-up with a cloth mask until N95s become more available, I hope. If they do.

Eisen mentions also that he avoids big indoor events, even restaurants, and won’t fly, although he thinks if everyone on the plane takes reasonable precautions it’s probably safe. It’s just that too many people have been infected with the Fox brain-rot. Just glance at YouTube fights over masks on airplanes — people are getting into brawls in the aisles because they refuse to wear a mask. It’s nuts.

I avoid going out because I live in a county where practically no one wears a mask, ever. Even when our governor imposed a mask mandate, briefly, a lot of people ignored it, and our local business wouldn’t enforce it — and even then, half the population was incapable of figuring out that the mask covers your mouth and nose. It was good news when my university reluctantly decided to require masks and vaccines for all of our incoming students, but we’re a tiny island of common sense in an ocean of conservative denialists of basic medical facts.

We also need to worry about the long-term consequences of infection. Idiots like those talking heads on Fox News want to pretend it’s just a kind of flu, you get over it and carry on, but COVID has complications you ignore at your own peril.

That is one of my biggest concerns with this attitude of not worrying about Omicron too much because it might cause less severe symptoms. We know that long Covid is a problem for the other variants. It’s a big problem that is poorly understood medically, but is very clearly a real thing. These are real medical problems that people are having for months to now years after infection. Some people are saying everybody is going to eventually get Omicron, and that’s just the wrong attitude. We can make it so that not everybody gets it, and therefore reduce the risk of long Covid in too many people. We can’t just let it spread to everyone on the globe, because that’s going to be a medical catastrophe. Now is not the time to do nothing and hope for the best. It is the time to take measures while at the same time trying not to damage people’s lifestyles and lives and the economy.

Eisen’s is the kind of sensible voice we ought to have been hearing all along in our news media, providing accurate, honest information. I guess Rupert Murdoch knows that that doesn’t sell, unfortunately. And that’s why we’re screwed right now.

Nice big experimental animals

Prison populations are hotbeds of COVID-19 infections, and they’re full of surplus people society doesn’t really need, and gosh, a lot of them are black, even, so you know what we should do? An experiment!

An Arkansas doctor under investigation for prescribing an anti-parasite drug called ivermectin to jail detainees with COVID-19, even though federal health officials specifically warn against it, has said that those patients took the drug willingly. But several inmates at the Washington County jail say that is not the case — that they were given the pills with no indication of what they really were.

CBS News spoke with 29-year-old Edrick Floreal-Wooten over a video call from the jail on Friday. After testing positive for COVID-19 in August, he said he and other inmates went to “pill call” and were given several pills with the explanation that it would help them “get better.” He said he and others asked repeatedly what the pills were.

“They said they were vitamins, steroids and antibiotics,” Floreal-Wooten told CBS News. “We were running fevers, throwing up, diarrhea … and so we figured that they were here to help us. … We never knew that they were running experiments on us, giving us ivermectin. We never knew that.”

Except it wasn’t even an experiment. The doctor, Rob Karas, took it upon himself to dose the patients, despite the fact that every credible medical organization says it is dangerous and not recommended.

Karas, who has treated people at the jail for six years, confirmed prescribing the drug to CBS News on Friday, saying that vaccines are a “tremendous asset in the fight against COVID,” but that their availability “does not change the day-to-day reality of caring for sick patients.”

Karas said in an email he obtained ivermectin from a licensed pharmacist “in dosages and compounds formulated for humans” to give to COVID patients.

“I do not have the luxury of conducting my own clinical trial or study and am not attempting to do so. I am on the front line of trying to prevent death and serious illness,” he told CBS News. “I am proud of our track record in both of my clinics and at the jail in particular.”

Karas is now under investigation by the Arkansas State Medical Board. That’s weak sauce — he’s been poisoning his patients, and needs a rather more severe and immediate punishment.

But what the hey, they’re just prison inmates, they probably deserve some mild poisoning.

Colonoscopy prep day!

Good morning, everybody! It’s colonoscopy prep day, and I am so excited!

For you young’uns out there, this is a rite of passage you get to enjoy once you turn 50, or maybe earlier if you have risk factors. This is a process where a doctor invasively scrutinizes every inch of your colon to screen for cancer, and you get to do it every 5 years (or in my case, every 3 years because last time they found a few harmless polyps). So today is the day I get ready for an outpatient trip to the local hospital.

Everyone will tell you the prep is worse than the procedure, and it is. You have to completely empty your bowels so the doctor’s view isn’t impeded by, umm, shall we call them Deplorables? Today I’m purging the Deplorables.

First thing, I’m fasting. No solid foods at all today. I made some pineapple jello yesterday, and I get to have clear broth, but otherwise, it’s all drinking down fluids and nothing else. I do get to drink all the coffee I want, so I will.

I have to take 4 Dulcolax pills this morning, a stool softener.

At 3pm this afternoon, I get to fill up this jug with four liters of water, and start drinking it. I’m supposed to finish all four liters by 6pm. Chug, chug, chug!

It says “lemon flavor”. This is only sort of true, if your lemonade tastes more like watery mucus. I will cope. This is really the worst part of the worst day. Well, maybe the worst part — I do get to spend the rest of the evening expelling Deplorables.

Then, as of midnight, I go dry. No water, nothing, shall pass these lips, and prep day will have passed.

Tomorrow I go into the hospital at 8:15. I get to strip naked and put on one of those chic hospital gowns that opens at the back, and the nurse will stick a needle in my arm, and Dr Sam will walk in and tell me to lie on my side and bring my knees up to my chest, and then deliver the magic drugs and a veil of darkness will fall over the unspeakable events that ensue. He’s going to stick a tube up my butt with a small flashlight and a camera at the end, and also little snippy scissors so he can chop out anything he wants to take a closer look at.

By 10am I’ll be groggily putting my clothes back on and my wife will drive me home, where I’m told I’m supposed to be lazy all day. I can do that! I might also be hungry.

Why am I doing all this? Consider the payoff matrix. It’s the only rational thing to do.

I get a colonoscopy I don’t get a colonoscopy
I have cancer I catch it early! I have to get cancer treatments, but I have a better chance of not dying, and the treatments won’t be as debilitating as if I let the cancer grow. I have cancer, but I don’t know it. It grows until the unpleasant symptoms become noticeable and require more serious intervention. Or I die.
I don’t have cancer Yay! And I know it! Relax, resume my decadent lifestyle until the next colonoscopy. I’m OK! But do I know for sure? I do not. I might have to hold some reservations, rather than plunging into my life of careless hedonism.

As you can easily see, all the possible outcomes from the decision to get a colonoscopy are positive, while all the outcomes from shirking my responsibilities range from negligible concerns to dire, horrible consequences.

We even have graphic examples right here on Freethoughtblogs!

Caine’s Journey.

The Fight, ©Caine, all right reserved

Caine died of this terrible disease in 2018, after a long struggle.

Iris discovers a serious problem.

Fortunately, Iris is surviving, but read her account of her travails: no one wants to go through that. I don’t want to experience that.

So, yeah, get your butt checked regularly. It inconveniently wrecks a day, but that’s better than wrecking your life.

Please stop dithering, CDC and everyone

It’s driving me nuts. We are in a serious pandemic, and authorities everywhere are acting as if the best strategy is to pretend we’re already back to normal, full speed ahead, don’t deviate from the pretense that everything is just dandy. Yet…

The delta variant of the coronavirus appears to cause more severe illness than earlier variants and spreads as easily as chickenpox, according to an internal federal health document that argues officials must “acknowledge the war has changed.”

Public schools are opening in a few weeks, as is my university. No one is acknowledging that the war has changed. Instead, we’re all planning to march right into the maw of the pandemic.

My prediction: they’re all going to be frantically backpedaling by October. I fully expect my school to shut down in-person classes by the middle of the semester.

I could be wrong, and I would be very happy if I were — we could have a gentle, delightful Fall with brightly colored leaves and soft snows and a world that embraces love and peace, and all the homeless would be given homes, and all the sick cared for, the QAnoners could all wake and look at each other and say “What are we doing?” and go home to their families, and peace could reign across all the lands. Sure. It could happen. But only if we struggle to make it all happen. And that’s what I’m not seeing, a will to change and do what needs to be done.

The CDC isn’t helping, either. They keep dithering. Recommendations change at the first breeze of new data, and change back a few weeks later. There is a difference between being responsive to new information, and being too quick to accept new suggestions in the face of uncertainty; it’s also important to build the public trust with consistent messages.

The document strikes an urgent note, revealing the agency knows it must revamp its public messaging to emphasize vaccination as the best defense against a variant so contagious that it acts almost like a different novel virus, leaping from target to target more swiftly than Ebola or the common cold.

It cites a combination of recently obtained, still-unpublished data from outbreak investigations and outside studies showing that vaccinated individuals infected with delta may be able to transmit the virus as easily as those who are unvaccinated. Vaccinated people infected with delta have measurable viral loads similar to those who are unvaccinated and infected with the variant.

Right. So the appropriate message from the very beginning should have been conservative, assuming the worst and establishing a consistent policy. I want to hear the words, “It wasn’t as bad as we feared, now that we’ve got solid evidence from three months of hard science we can think about easing some restrictions,” rather than “Oh, I guess we shouldn’t have told everyone to have orgies, you’ve all got three months to live.”

Be decisive for a change. I wrote to my university president urging her to take a stronger stand, but I’ll make another bold prediction: she’ll dither. It’s all the rage.

Important qualifier to the CDC’s “ebola” comment:

You know, it’s becoming really obvious that the CDC is very bad at science communication, at a time when we need the science communicated effectively.

This cannot end well, Tennessee

The insanity is going too far. Tennessee (or rather, Republicans in Tennessee) want to shut down access to vaccines. All vaccines.

The Tennessee Department of Health will halt all adolescent vaccine outreach – not just for coronavirus, but all diseases – amid pressure from Republican state lawmakers, according to an internal report and agency emails obtained by the Tennessean. If the health department must issue any information about vaccines, staff are instructed to strip the agency logo off the documents.

The health department will also stop all COVID-19 vaccine events on school property, despite holding at least one such event this month. The decisions to end vaccine outreach and school events come directly from Health Commissioner Dr. Lisa Piercey, the internal report states.

Additionally, the health department will take steps to ensure it no longer sends postcards or other notices reminding teenagers to get their second dose of the coronavirus vaccines. Postcards will still be sent to adults, but teens will be excluded from the mailing list so the postcards are not “potentially interpreted as solicitation to minors,” the report states.

That’s amazing. I’m used to Republicans opposing fundamental ideas in science, but now the prion disease that rots their brains has progressed so far that they want to silence information about basic health care. There will be dead teenagers as a result of this policy, and this will lead to another spike in coronavirus infections.

And these changes will take effect just as the coronavirus pandemic shows new signs of spread in Tennessee. After months of declining infections, the average number of new cases per day has more than doubled in the past two weeks – from 177 to 418. The average test positivity rate has jumped from 2.2% to 5.4% in the same time period.

Oh, it already has.

Republicans are a menace to society.

Plagues in history

Here’s an interesting chart (although, portraying pandemics as spiky spheres is a bad choice — people are not good at visualizing relative volumes, and putting those volumes in a perspective that reduces the size of older one is a terrible idea) showing various afflictions on the human species over time.

The Black Death was the big one, but look at HIV — it’s amazing how our culture diminished the significance of that one, pretending it wasn’t happening even as its victims were dying in hospitals, and as prominent figures fell to it.

Smallpox coulda been a contender for the biggest plague of them all, but humans invented something that stopped it in its tracks: vaccination. If only people recognized the importance of that today…

For the love of dog, GET VACCINATED

In hospitals across the country, doctors are noticing an unsurprising phenomenon: the people who are getting admitted to critical care are all unvaccinated.

The trend appears to be occurring at hospitals nationwide.

“I haven’t had anyone that’s been fully vaccinated become critically ill,” said Dr. Josh Denson, a pulmonary medicine and critical care physician at Tulane University Medical Center in New Orleans.

It’s been the same for Dr. Ken Lyn-Kew, a pulmonologist in the critical care department at Denver’s National Jewish Health: “None of our ICU patients has been vaccinated.”

Unvaccinated children, too, seem to be at increased risk for severe illness.

“In our local hospitals, the kids that are getting sick are the ones that are not vaccinated,” said Dr. Natasha Burgert, a pediatrician in Overland Park, Kansas, and a national spokesperson for the American Academy of Pediatrics.

I saw the strangest thing on a television in Washington state: I watched Biden make his announcement that the US was going to ship 500 million vaccine doses to economically disadvantaged countries, then cut to commercial — the state is giving out all kinds of incentives to get people to come in for the COVID vaccine, like automatically entering your name into a lottery with a $250,000 prize.

I don’t get it. Not dying is not enough of a reward?

I’m keeping my mask

Everywhere I go now, people are running around without a mask, like all our concerns about public health have evaporated. Not me. I’m keeping mine for when I’m out and about.

I double-checked those numbers — they’re about right.

According to Scientific American, influenza cases all over the globe have dropped to “minuscule levels.” We’re not seeing nearly the same numbers as we have in previous years because of the health measures in place to help slow the spread of COVID19 — hand-washing, mask-wearing, staying home when sick, and socially distancing.

The publication reports approximately 600 deaths attributed to influenza during the 2020-2021 flu season in the United States, which typically peaks between December and February. Compared to previous years, where the numbers in the 2019-2020 season saw roughly 22,000 deaths, and the 2018-2019 season had more at 34,000 deaths, 600 is a 97 percent drop. So why is that happening? Are the typical flu deaths being categorized as something else?

Nope. The numbers are so low because the flu isn’t around. “There’s just no flu circulating,” Greg Poland, a researcher who has been studying the flu for the Mayo Clinic for decades, told Scientific American. Because of the measures in place for COVID, including increased handwashing, wearing masks, and staying home when sick, no one is out there spreading the flu either.

Who knew just improving the general level of hygiene would be so effective?

The real question is, why are people so eager to return to living in filth? I didn’t have a single day last year where I was too sick to get out of bed, and I didn’t even have the prolonged snotty sniffles of a cold. I don’t miss that.

Wake up, America

I’ve been disturbed by American selfishness — we seriously have swarms of people who are anti-vaccinations, and conspiracy theorists who believe the pandemic is a “plandemic” — and maybe we should look beyond our shores for the global perspective.

So, India…brace yourself for the horrific news.

On Friday, India reported more than 332,000 coronavirus cases in one day – the highest ever recorded by a single country.

Since the start of the pandemic, the country has recorded more than 16 million cases and 186,000 deaths, according to a tracker by Johns Hopkins University.

This means it has now overtaken Brazil, with the second-highest number of confirmed cases worldwide. The first remains the US.

The hospitals are full. People are dying in stretchers outside the hospital, waiting for care. And then, once they’ve died, they’re overwhelming the crematoria.

The unprecedented death rates are overwhelming the nation’s crematoriums.

“No one in Delhi would have ever witnessed such a scene. Children who were 5 years old, 15 years old, 25 years old are being cremated. Newlyweds are being cremated. It’s difficult to watch,” Jitender Singh Shunty, who runs a makeshift crematorium, told Reuters.

As the crematoriums are overrun, people are turning t mass burials in makeshift facilities like parking lots.

We have a moral obligation to make sure everyone in the world gets the best treatment. If you need a selfish reason, one of the reasons for the recent surge in India is the rise of new COVID variants.

How about some good news, though? We might have a successful malaria vaccine!

A vaccine against malaria has been shown to be highly effective in trials in Africa, holding out the real possibility of slashing the death toll of a disease that kills 400,000 mostly small children every year.

The vaccine, developed by scientists at the Jenner Institute of Oxford University, showed up to 77% efficacy in a trial of 450 children in Burkina Faso over 12 months.

Yes! This has the potential to be the biggest medical breakthrough of the 21st century. Defeating malaria would be huge.

Now we just have to get regulatory agencies to attach as high a priority to controlling tropical diseases as we do those that afflict temperate countries.

Hill said the institute might apply for emergency approval for the malaria vaccine just as it did for the Covid jab. “I’m making the argument as forcefully as I can, that because malaria kills a lot more people than Covid in Africa, you should think about emergency-use authorisation for a malaria vaccine for use in Africa. And that’s never been done before.”

The institute would probably ask the regulatory bodies in Europe or the UK for a scientific opinion on the vaccine and then apply to the World Health Organization for approval for use in Africa. “They did Covid in months – why shouldn’t they do malaria in a similar length of time as the health problem is an even greater scale in Africa?” Hill said.

They’ve arranged to have the vaccine mass produced by the Serum Institute of India…uh-oh. You might have guessed this: those facilities are overwhelmed right now by the need to churn out COVID-19 vaccines to deal with the pandemic surge.

Everything is interconnected! Wake up!