Public health

Vaping safety — what does science say about electronic cigarettes

I wanted to go back to vaping, and the safety of electronic cigarettes (EC, to save my typing fingers). ECs were originally developed as a tool to quit cigarette smoking, which is factually linked to lung cancer and other respiratory diseases. And if that’s all they did, then this article would be very short. But we really need to look at the science of the safety of vaping, and that’s going to take a lot of writing.

ECs have become much more than a tool to end smoking, they have evolved into a popular subculture phenomenon known as the “vaping community” that, in many respects, seems to parallel the marijuana advocates. The vaping community continues to push a belief that ECs are safer than traditional cigarettes, have little health risk to the vaper (electronic cigarette smoker), and is much more socially acceptable than smoking cigarettes or cigars.

One of the most ironic and amusing stories about ECs is that Jenny McCarthy, the antivaccination expert who thinks that all ingredients in vaccines are dangerous, has become an advocate for vaping. I bought a brand new, upgraded version 4.7, nuclear-powered irony meter, and it just broke. Thanks, Jenny.

During the 2022 midterm election, California voters decided to support a ban on flavored tobacco products, including flavored electronic cigarettes. That’s a step in the right direction to keep people, especially children and teens, from thinking that it’s like candy.

What are the dangers of electronic cigarettes? Are there any at all? Has the safety of vaping ever been adequately researched? This article is going to dig into it. And we’re going to have a boatload of fun from commenters because I have got a feeling that their beliefs matter more than science with respect to the overall safety of vaping.

Public health expert Leana Wen skips talk because of “credible threats”

Many of you know who Dr. Leana Wen, MD, Research Professor of Health Policy and Management at George Washington University, is because she is one of the current voices in public health issues. She has written two books and she has been outspoken during the COVID-19 pandemic. She was also the CEO of Planned Parenthood.

However, you may be like me, and you may have never heard of her before. It’s possible I read something about her in the past, but I just don’t remember it.

Unfortunately, she has been a target of both sides of the political spectrum — during the first part of the pandemic the anti-mask and anti-vaccine community despised her because she supported COVID-19 restrictions. Lately, she has supported the relaxation of those restrictions and has been attacked by some who think that those restrictions should remain, especially masks.

To be clear, I support keeping COVID-19 restrictions, at least through this winter, but I do not advocate violence against anyone, including Dr. Wen. No matter what the source of the attacks is, and I am embarrassed that it is my side that is the attacker, attacking scientists is against everything I stand for.

This week, Dr. Wen was supposed to speak at a panel discussion at the American Public Health Association (APHA) annual meeting in Boston that focused on countering backlash against public health. Ironic, isn’t it? At any rate, she withdrew because of “credible threats” against her.

Whether or not you support her public health policy statements, and I know a lot of my friends don’t, she is a credible scientist that shouldn’t be forced from an important public health forum because of reasons.

Gun control laws and firearms mortality – a public health imperative

Let me start right at the top — gun control laws save lives. These laws prevent firearms mortality, either murder, accidents, or suicide. Gun control laws should always be considered a public health issue in the USA. There have been several good epidemiological studies that have examined whether gun control regulations and firearms mortality risk are related – and the results are surprisingly robust and repeated.

From recent epidemiological research, there is some convincing evidence that establishes a correlation between state-level gun control regulations and firearms mortality rates. However, the link is not as black and white as one might wish – the relationship between gun control regulations and mortality depends on the quality of the laws. In other words, good science seems to show that gun control laws save lives.

Historically, the nation’s leading public health organization, the Centers for Disease Control and Prevention (CDC), is essentially prevented from analyzing and publishing any epidemiological research that would help us understand what, if any, links there are between gun control and firearms mortality. However, things are changing, probably because of what has been happening lately, and the CDC is funding research into firearms mortality.

Previously, because the CDC could not fund research into gun control, there has been a chilling effect on gun control research in academia. According to the Washington Post, “young academics were warned that joining the field was a good way to kill their careers. And the odd gun study that got published went through linguistic gymnastics to hide any connection to firearms.”

But maybe because this public health menace can no longer be ignored, a smattering of well-done epidemiological research is being published in very high-quality medical journals. Let’s look at one.

Public health policy — gun control and vaccines to save children’s lives

Another day, another mass shooting in the USA. Gun control and vaccines should be public health issues, but they aren’t. In fact, anti-vaccine and anti-gun control activists seem to show a huge overlap in the Venn diagram of being opposed to the health of children. They both make the same excuses and the same lies.

There have been over 200 mass shootings in the USA just in 2022 alone. And that’s as of 26 May 2022! Americans are so numb to it that it’s becoming harder and harder to express outrage and disgust.

Gun control should be a public health issue no different than what we do with vaccines. The CDC should be posting rules to reduce gun violence as much as they do to reduce deaths from COVID-19 by pushing vaccines.

But here’s what’s going to happen. After 19 children and two adults were killed at an elementary school in Texas, a state which thinks all guns are good, politicians will express their useless “thoughts and prayers,” and in a few days, all will be forgotten. If 19 children and two adults had died of COVID-19, we’d try to fix it. If 19 children and two adults had died in a school bus crash, we’d try to fix it. But gun violence? There seems to be no willpower among the political elite to do anything, especially in our nation of minority rule.

What some of the anti-gun control people are saying is that the risk of dying from a gun is so small, that gun control is outweighed by the benefits of owning guns. I’ve heard this logic before, and it’s from the anti-vaccine zealots. They argue that because only a few children will die of measles (or any vaccine-preventable disease), vaccines should not be mandated.

Yes, the chances of dying from measles are rare (thanks to vaccines). Yes, the chances of one person dying in a mass murder are small. The problem with the logic of the anti-vaccine and anti-gun control activists is the same — we have the power to prevent both. And we should prevent both. Our public health advocates should be on the side of vaccines and gun control.

No personal liability for officials who impose COVID public health restrictions in California schools

This article about personal liability for officials who impose public health mandates in schools was written by Dorit Rubinstein Reiss, Professor of Law at the University of California Hastings College of the Law (San Francisco, CA), who is a frequent contributor to this and many other blogs, providing in-depth, and intellectually stimulating, articles about vaccines, medical issues, social policy, and the law.

Professor Reiss writes extensively in law journals about the social and legal policies of vaccination. Additionally, Reiss is also a member of the Parent Advisory Board of Voices for Vaccines, a parent-led organization that supports and advocates for on-time vaccination and the reduction of vaccine-preventable disease. She is also a member of the Vaccines Working Group on Ethics and Policy.

I was asked to address a piece of misinformation that has, apparently, taken off in anti-vaccine circles. Starting from the end — no, activists (or parents) cannot hold school boards and superintendents personally liable for imposing COVID-19 restrictions. No, there is no surety bond that would freeze school funds. The threat to use a surety bond in this context is not a valid legal threat.

If school boards and superintendents receive such threats, they should realize this is, in fact, pseudo-law used by science deniers to try and intimidate, just as sovereign citizens use similar tactics to attack traffic courts, and the officials’ job is not to give in.

The claim I am addressing appears to be a national effort, with a California-specific branch. In this post, I will try to explain why this personal liability does not hold generally, but also give specific points for California.

COVID vaccine mandates are working

I know we keep reading about lawsuits and protest about COVID-19 vaccine mandates, but I think we (pro-science, pro-vaxxers) are too focused on the negative. Actual data is showing us that these mandates are working and they are substantially increasing vaccination rates.

There have been a ton of court rulings and public protests about COVID-19 vaccine mandates. Dorit Rubinstein Reiss has written about a few of them, but she is barely keeping up with them. I’m on a mailing list from her, and I swear that it appears that there is a new lawsuit against these mandates every single day. And court rulings have been both positive and negative.

But, as I said above, there is good news. The mandates are actually working. So, let’s take a look at what we know.

Thanks to COVID-19, we beat the flu for the first time in history

by Michael Simpson
2021-10-24
COVID-19, Flu vaccine, Infectious disease, Public health, Vaccines

The COVID-19 pandemic has been a horrible experience for the past two years, but it had one silver lining – beating the flu.

As I have written before, the annual rite of winter life, flu outbreaks, became almost nothing during the 2020-21 flu season. On average, the flu infects roughly 30 million Americans every year and kills over 30,000. Worldwide, the World Health Organization estimates that over 650,000 people die of respiratory illnesses related to the flu.

As with COVID-19, the elderly, the poor, and people of color are all overrepresented among the victims of the flu. Moreover, the annual economic cost of the flu in the USA averages nearly $90 billion.

Of course, things changed during the 2020-21 flu season. The US had only around 2,000 cases of the flu. No, that is not a typo, there were only 2,000 flu cases in the USA during the 2020-21 flu season. In other words, there were 17,000 times fewer flu cases than the 35 million cases during the 2019-2020 flu season.

During the 2019-20 flu season, 199 children died of the virus. In 2020-21, only one child died.

In fact, other respiratory viruses nearly disappeared during the COVID-19 pandemic – respiratory syncytial virus, parainfluenza, rhinovirus, and adenovirus. I’ve been watching infectious diseases for decades, and this was truly amazing.

So how can we stop the flu once the COVID-19 pandemic is done? And that’s where it gets complicated.

Create an independent FDA, CDC – new COVID-19 vaccines required it

The COVID-19 pandemic and the subsequent rush for treatments and vaccines for the virus have renewed calls for a more independent FDA and CDC. Professor Dorit Rubinstein Reiss, who is a frequent contributor to this space, has written two powerful articles arguing for an independent CDC and FDA.

If you have followed the progression of the COVID-19 pandemic in the USA, the Centers for Disease Control and Prevention (CDC) and the United States Food and Drug Administration (FDA) responses have been politicized to the point that even those of us who have strongly supported those two agencies are appalled.

The CDC has been pushed to scrub information and data to make the Trump administration look good. Recently, it was reported that one of Trump’s minions tried to pressure CDC regarding the transmission of the virus to kids to get it in line with the nonsense being pushed during Trump’s failed presidential campaign.

And then the FDA gave Emergency Use Authorizations (EUA) to hydroxychloroquine and remdesivir for treatment of COVID-19. Unfortunately, the data showed that hydroxychloroquine does not work and remdesivir has only a marginal effect on outcomes. In each case, it appears that the FDA was more interested in promoting these drugs to support President Trump’s wild claims that he was “doing something” about the pandemic, rather than relying upon robust science.

Professor Reiss has written two articles about how we might create a more powerful and independent FDA and CDC by utilizing the types of structures of actual independent agencies within the Federal Government. I want to quickly review what she proposes because I think it’s a conversation that we hope that President-elect Joe Biden might embrace during the next few years.

The problem is that

Public health and vaccines commentaries – employment repercussions

When employees speak up on matters of public health and vaccines in their free time, those who do not like the speech may retaliate by complaining to their employers, who may be tempted – or feel forced – to act against the employee. But employers should not, and some types of employers – public employers – are likely barred from doing so.

This post considers mostly employees in public institutions – department of health, teaching hospitals, or universities – because these employees have legal protection against sanctions – an employer is likely legally prohibited from acting against them because of speech on matters of public health and vaccines in their free time.

However, the points made about defamation and the policy considerations also apply to private employers, those who can fire employees at will, at least when the employees provide mostly accurate, fact-based information.

These issues can come up in a variety of contexts, some of which the employer may appreciate more than others. One situation is when an employee working for a public institution spends part of his personal time commenting on public health and vaccines issues and informing the public through a personal blog, on which his position is mentioned, or by commenting on social media, Facebook or Twitter.

The employee provides information, corrects misconceptions, and criticizes those offering bad advice or factually inaccurate information, sometimes with strong language. A person so criticized contacts the public institution and threatens to sue for defamation if the blogging does not stop and the statements are not retracted, or if the employee is not otherwise dealt with.

Or, for example, an employee makes a joke about a public health issue – in good or bad taste – in her personal time. People offended complain to the employer, either just criticizing the employee or threatening legal action. In both cases, employers should not take measures against the employee.

First, in most circumstances, there would almost certainly be no defamation case here. Second, limits created by the First Amendment on the ability of public employers (though not private ones) to fire an employee for their speech likely apply here. Finally, there are public benefits from allowing the employee to speak in this manner.Read More »Public health and vaccines commentaries – employment repercussions

Gun control and vaccines – the deniers use the same twisted logic

Because of the lack of willpower to implement serious gun control, thirty-one children, brothers, sisters, grandparents, mothers, and fathers died this past weekend. But another week will pass, and there will probably be another week of horrible killings by hate-filled mostly white, mostly men.

Dayton, 10
El Paso, 20
Gilroy, CA, 4
Virginia Beach, 12
Aurora, IL, 5
Thousand Oaks, CA 12
Pittsburgh, 11
Annapolis, 5
Santa Fe, TX, 10
Parkland, FL, 17
Sutherland Springs, TX, 26
Las Vegas, 58
Orlando, 5
Ft. Lauderdale, 5
Burlington, Wash., 5
Sandy Hook, 26

The dates and locations change, but the will to make substantive changes to our gun control laws evaporates after each mass murder. The Republican Party, which effectively controls our government, knows that it really doesn’t have to do anything. After a few weeks pass, we’ll forget about it, and they don’t have to do anything. It’s cynical, but that’s what happens when a political party is beholden to racism and the gun lobby.

So you’re probably asking, “what the hell does this have to do with vaccines?”

Two days ago, I would have shrugged. Then, while getting coffee from my local venti Americano shop, I overheard two older (and lily-white) men discussing the shooting. Setting aside their overt racism, they thought that killing a few “illegals” is “heroic,” they said that “just because a handful of people died out of 300 million Americans, that’s not a reason to take our guns.”

In other words, they’re saying that the risk of dying from a gun is so small, it’s not a consideration for gun control. I’ve heard this logic before, and it’s from the anti-vaccine religion. They argue that because only a few children will die of measles (or any vaccine-preventable disease), vaccines should not be mandated.

Yes, the chances of dying from measles are rare (thanks to vaccines). Yes, the chances of one person dying in a mass murder are small. The problem with the logic of the anti-vaccine and anti-gun control nutjobs are the same – we have the power to prevent both. And we should prevent both.

The old racist white guys talking too loud in my local coffee establishment probably thought they were immune (sorry, had to go there) from being killed in a mass killing because only brown people were targeted (which wasn’t true about either El Paso or Dayton this past weekend). The murders were indiscriminate. And all of those murdered did not deserve to have their lives cut short.Read More »Gun control and vaccines – the deniers use the same twisted logic