AND NOW A WORD FROM OUR CHIEF OPERATING OFFICER…

Using This Time to Focus on Your Health in Healthy Ways

Critica COO Catherine DiDesidero posted the note below on her Instagram feed and we felt that everyone should see it:

I’m pretty convinced that the obesity epidemic in America is a large contributor to the vast and rapid spread of Covid-19. This article suggests I’m correct. Indeed, obesity has been shown to be a risk factor for serious complications from infection with the novel coronavirus that causes COVID-19. Obesity is one of those blanket terms that can be applied to various aspects of health.

Another epidemic America was suffering before all of this was the one where we back burner our health and general well-being in favor of other responsibilities – also seconded by this article in relation to blood pressure and hypertension (one doesn’t need to be classified as “obese” to have underlying conditions). One thing that I think this pause has gifted is time– to start creating new and healthy habits. And time to realize that everything else is secondary…HEALTH IS MOST IMPORTANT.

You can’t take care of anyone else until you care for yourself first. Providing for a family is much easier to do from a healthy state of mind and body. So get started now. Learn quick and healthy recipes to integrate into your diet. Find a class or trainer and build your workout into your routine. We can control a lot of these risk factors with a more proactive approach. Taking care of yourself is the best protection you can hope for. Stay home. Stay safe. Be healthy.

Wired

The evolution of a connected world

By Peter McKenzie-Brown

Editor’s Note: How did we get to this point in which cell phones are ubiquitous and dominate our lives? Here, Peter McKenzie-Brown reminds us that there are some downsides to constant cell phone use and then reviews for us the fascinating history of how we have become progressively “wired.”

The Canadian city I live in, Calgary, got top marks in the last report from The Economist Intelligence Unit (EIU), which ranked it as the most liveable city in North America, and number five in the world – after Vienna, Austria; Sidney and Melbourne, Australia; and Osaka, Japan. Two other Canadian cities, Vancouver and Toronto, were also in the top ten.

The EIU index ranks the world’s 140 largest cities on 30 factors bunched into five categories. These include political and economic stability, for example, health care, culture and environment, education and infrastructure. In the most recent report, Vienna topped the list. It ranked ahead perfect 99.1 out of 100, putting it just ahead of Melbourne. Sydney and Osaka. Then came Calgary. According to the EIU report, “higher crime rates and ropey infrastructure pull some bigger cities like London, New York and Paris down the league table, despite their cultural and culinary attractions.”

Yet as I walk the streets of this city, or get on public transit, I’m always amazed to observe that endless majorities of people on sidewalks, on trains and buses, in restaurants, and even in parks seem to spend endless hours on the communication devices that seem to dominate their lives. Personally, I can’t imagine spending a walk in my favourite park staring at an iPhone – in my case, a device I parked some years ago. The more I watched this behaviour, the odder it seemed. I quickly found a great deal of online research that worried about our collective online obsession.

Sure, it’s easy to pass a cell phone addiction off as something that comes with the technological advances of the last 20 years; however, with cell phones come real risks. For example, a study at Temple University’s College of Health Professions and Social Work compared the volume of text messages college students with the amount of neck and shoulder pain they experienced. The result was no surprise: The more you text, the more pain you are likely to experience.

There’s also the matter of dangerous driving. America’s Insurance Institute for Highway Safety not surprisingly found that drivers who use cell phones while behind the wheel were four times more likely to have an accident than those who did not. What’s more, using a hands-free device instead of a hand-held phone doesn’t improve safety.

 Finally, there are sleep disturbances. Using a cell phone before bed can keep you awake, according to a study conducted by Wayne State University School of Medicine in Detroit and researchers in Sweden. Conducted over an 18-month period, the study involved 35 men and 36 women between the ages of 18 and 45. Their conclusion? The radiation emitted by cell phones disrupts sleep patterns.

I’ve always been interested in how things develop, so I started investigating the origins of today’s intensely interconnected world – one that hosts both promise and risk. The balance of this paper shows how this took place nearly two centuries to evolve.

How did this begin?

The world began to get wired with the invention (in present-day Germany in the 1840s) of the electrical telegraph. These point-to-point text messaging systems used coded pulses of electric current to transmit text messages over ever-longer distances.

Albeit brief and ineffectual, the first scientific attempt to illustrate the speed and power of electricity dates back to a 1764 experiment by Jean-Antoine Nollet. A French physicist during the Enlightenment, he had also been a deacon in the Catholic church and was thus able to call on former colleagues to help him with his work.

To test the speed of electrical transmission, Nollet gathered hundreds of lengths of iron wire, roughly two hundred monks, and an array of Leyden jars. These primitive devices, which stored static electricity, were the discovery of a Dutch physicist at the University of Leiden in 1746 – hence the name. (Independently, German inventor Ewald Georg von Kleist had developed a similar device the year before.) The French monks distributed themselves in a circle a mile or so in circumference, each holding a length of wire in each hand to link himself to compatriots on his right and left. Without a word of warning, Nollet discharged the contents of the batteries into the wire, sending an electric shock through the chain of monks.

Nollet was unable to successfully measure the actual speed of electricity with the experiment since all the monks reacted to the electric shock simultaneously. His notes recorded that transmission speed of electricity was extremely high and appeared to transverse the circle of monks almost instantaneously. To entertain the king of France, he later conducted the same “experiment” on 180 French soldiers.

Semaphores

The Nollet experiment may have planted the seed for the concept of telegraphy—the transmission of data over long lengths of wires using only electrical impulses. However, it has nothing to do with the origin of the word “telegraph,” which originally did not involve wires at all. The term originated with Frenchman Claude Chappe, but the system he developed was mechanical rather than electrical. His invention was a system of semaphores, with people signaling with flags from tower to tower. Napoléon used the system to coordinate his empire and army, and other European states copied the system.

Today, the word telegraph suggests dots and dashes transmitted by Morse code over long-distance cables which ultimately yield telegrams. But the word was originally a reference to Chappe’s semaphore system and used no electricity at all. There were moveable arms on the top of the towers and operators could use telescopes to read these mechanical messages from other towers. Thus, these towers could be quite a distance apart. This system could transmit messages quickly and efficiently, so the French government built a national network. The French word télégraphe comes from the French télé (at a distance) and graphe (writing) – thus, “far writer.”

Before moving on to electrical message transmission, it is worth noting that the Leyden jar did contribute significantly to serious science. Around the time American was gaining independence, American rebel and diplomat Benjamin Franklin used one to show that lightning is an electrical discharge.

Franklin called a series of linked Leyden jars, which can store greater electric charges, a “battery.” Unlike modern-day batteries, no matter how many of these devices were linked together, they released all their energy in a single burst.

That said, this early electrical storage system did not entirely end up on history’s junk heap. In miniaturized form, a descendent of the Leyden jar is hard at work in most of today’s electronic products. Today, it’s called a capacitor. Charged by an electrical current, these devices still release their charge all at once. Their instant charge/discharge operates the flash attachments on cameras, for example, and tuning dials on radios. They also control loudspeakers, making music audible and measured, rather than an incomprehensible burst of sound.

Electrical Telegraphy

In the 1790s, at the tail end of the Enlightenment, an argument about electricity between two Italian scientists—Luigi Galvani and Alessandro Volta—led to Volta inventing the first true battery. For the first time, electricity could be put to continuous work. This led to experiments using steady electrical currents for message transmission.

As we have seen, the Napoleonic empire desperately needed a new, high-speed communications system – preferably one that used wires and could instantly reach places that were beyond line of sight. These systems did not develop until Volta’s battery became widely known, however – well after the war was over.

Inventors came up with many schemes for encoding information electrically. As is often the case, the most successful approach was the simplest. The telegraph code still bears the last name of its American inventor, Samuel Morse, who developed the system in 1838. The system required a single wire, which made the system simple and less expensive than others. In addition, Morse’s approach reduced the complexity of the technology by putting it into the hands – literally – of the operator, who needed to learn to both send and receive Morse code.

In the beginning, there was a widespread view that the dot-and-dash system would be too difficult, but it turned out to be a bit like learning to play a musical instrument. Not everybody, but some became quite skilled. Once they mastered the system, they could quickly and easily send and receive messages.

By the second half of the nineteenth century, nations across the world had created commercial telegraph networks, with local telegraph offices in most cities and towns. These systems enabled people to send messages telegrams to anyone, for a fee. Although an 1854 attempt failed, telegraph companies were ultimately successful in laying submarine telegraph cables, which created a system of rapid communication between continents. By 1865, the Morse system was becoming the standard for domestic and international communications in Europe and much of the Americas, and in distant parts of the European empires.

These networks permitted people and businesses to transmit messages across continents and oceans almost instantly, with widespread social and economic impacts. Telegraphs are still in use, although teletype networks have been replacing them for a hundred years.

Canada’s Telephone?

Did Canada really invent the telephone? We Canucks think so, and the first long-distance tests certainly took place on Canadian soil. That said, inventor Alexander Graham Bell – a Scot who had migrated to Canada with his family as a child – did his work in Boston, became an American citizen and was one of the founders of media giant American Telephone and Telegraph, now known as AT&T.

It was in Boston that the telephone – it did not yet have a name – first showed signs of life. On March 10, 1876, Bell used the instrument in Boston to call his colleague, Thomas Watson who was in another room and out of earshot. He famously said, “Mr. Watson, come here – I want to see you” and Watson soon appeared at his side.

Continuing his experiments during a visit to the Bell homestead in Brantford, Bell brought home a working model of the device. On August 3, 1876, from the telegraph office in Brantford, Ontario, Bell sent a tentative telegram to the village of Mount Pleasant six kilometres distant, indicating that he was ready. He then made a telephone call via telegraph wires and heard faint voices replying.

The following night, he amazed guests as well as his family with a call from his parents’ home to the office of the Dominion Telegraph Company in Brantford along an improvised wire strung up along telegraph lines and fences and laid through a tunnel. This time, guests at the household distinctly heard people in Brantford reading and singing. The third test on August 10, 1876, was made via the telegraph line between Brantford and Paris, a town in Ontario thirteen kilometers distant. Often called the world’s first long distance call, this test demonstrated that the telephone could work over long distances, and Canada now recognizes the Bell homestead as a national historic site.

Commercialization of the telephone soon began. In the earliest days, instruments were paired for private use between two locations. Users who wanted to communicate with persons at multiple locations had as many telephones as necessary for the purpose.

Later telephones took advantage of the exchange principle which developed for telegraph networks. Each telephone was wired to a telephone exchange established for a town or area. For communications outside this exchange area, trunks were installed between exchanges. Networks were designed in a hierarchical manner until they spanned cities, countries, continents and oceans.

Going Wireless

These developments were soon superseded by other technologies that transformed human connectivity. Known to our grandparents and as “the wireless,” the radio transmitted signals through the transmission of signals by the modulation of electromagnetic waves.

In 1895, Italian inventor Guglielmo Marconi became the first person to “cut the cord” of electronic communications, sending wireless signals across the Italian countryside. In 1900 he patented this invention, calling it tuned, or syntonic, telegraphy. We call it the radio, and it quickly broke new ground.

Italian-born Marconi studied physics and became interested in the transmission of radio waves after learning of the experiments of the German physicist Heinrich Hertz. He began his own experiments in Bologna in 1894 and soon succeeded in transmitting a radio signal which he could receive three kilometres away.

Receiving little encouragement for his experiments in Italy, he went to England two years later. He formed a wireless telegraph company and was soon sending transmissions from distances 15 kilometers and more. In 1899, he transmitted a signal across the English Channel. That year, he also equipped two U.S. ships to report to New York newspapers on the progress of the America’s Cup yacht race. That successful endeavour aroused widespread interest in Marconi and his wireless company.

To put the wireless in perspective, electrical telegraphy had sped up the spread of information from a few days or weeks or months to a few hours. Reporters could receive the news, write it up, send it to print in a newspaper, and people would read about it, perhaps, half a day later. As the radio developed, numerous people could hear news broadcasts at the same time. As radio networks developed their programming, it became the most powerful medium yet invented for spreading information and shaping public opinion.

Marconi’s greatest achievement came on December 12, 1901, when one of his wireless systems at Cornwall, England, successfully transmitted a message (simply the Morse-code signal for the letter “s”) across the Atlantic to St. John’s, Newfoundland – then, a British colony; today, a Canadian province. That transatlantic transmission won him worldwide fame.

Ironically, detractors of the project had been correct when they declared that radio waves would not follow the curvature of the earth: Marconi’s transatlantic radio signal had indeed been headed into space but bounced off ionosphere and back toward Earth. Much remained to be learned about the laws of the radio wave and the role of the atmosphere in radio transmissions, and Marconi played a leading role in radio development and innovations for three more decades.

Experiments in television development began in the 1920s, but The Great Depression and World War II slowed development. Once the war was over television ownership exploded.

From Miniaturization to Wi-Fi

In the post-war world, Japan led the miniaturization of electronics, and in the mid-1950s created tiny, wireless radios as small as your hand. Bearing the word “transistorized” on their body, they were the first electronic devices in North America to also bear a Sony logo.

By an odd series of coincidences, these devices were first exported to Canada in the summer of 1955, and there they created quite a stir. They amazed their new owners, who were accustomed to furniture-sized radios plugged into an outlet. North America learned about them from the excitement of those lucky enough to own one.

From those days on, miniaturization has been the trend for communications devices – a trend that began to accelerate in the 1990s, with the rapid growth of the World Wide Web. Today our iPods and other devices fit easily into our pockets, and they make functions available that once required a telephone, a camera, a movie camera, a television, paper calendars, accounting spreadsheets, books, publishing houses – the list goes on, and on, and on. The social media that are part of this panoply are relatively new phenomena; to have a post go viral is many a player’s ultimate dream.

A family of wireless networking technologies commonly used for local area networking of devices and Internet access, Wi‑Fi is a trademark of the non-profit Wi-Fi Alliance, which restricts the use of the term to products that meet its technical protocol.

From the beginning, the primary goal of this organization was that Wi-Fi devices work across all vendors and, as new devices become available, be “backward compatible” in the sense that they would continue to work with older devices – including the original devices made according to this protocol. In this way, the alliance responded to growing demand for Wi-Fi with new technologies and programs that increase connectivity, enhance roaming, and – the organization’s wording – “improve the user experience.” Members of the Wi-Fi alliance now produce desktop and laptop computers, smartphones and tablets, smart TVs, printers, digital audio players, automobile scanners, automobiles, monitors, drones, facial recognition cameras and countless other devices that would have been largely unimaginable at the beginning of this millennium.

In the years since the Enlightenment, electrical devices from telegraphy through radio and radar have played key roles in every aspect of our lives, both during times of peace and war. As I write these words, Wi-Fi devices are moving into a fifth generation of development. The lesson from that reality, perhaps, is that electrical devices are playing ever-more-subtle roles in an electrifyingly complex new world.

A Pandemic On Top of an Epidemic

Is There a Loneliness Epidemic and Will COVID-19 Make it Worse?

Former U.S. Surgeon General Vivek H. Murthy declared a loneliness epidemic in 2017, triggering a plethora of headlines. Now, many are asking whether steps like shelter-at-home and social distancing that are necessary to control the COVID-19 pandemic will exacerbate that loneliness epidemic and increase physical and behavioral health disorders and mortality.

         In an interview with Boston public radio station WBUR earlier this year, Murthy noted research using “rigorous scales” has found that “more than 20%…of the adult population in America admits to struggling with loneliness.” According to the federal Health Resources and Services Administration (HRSA), being lonely increases the chance of dying by 45%, making it as dangerous as obesity and cigarette smoking. Studies link loneliness and isolation to problems with the immune system and to increased risks for heart disease, stroke, cancer, and depression. Although living through a pandemic is not officially listed as a qualifying trauma in the official psychiatric diagnostic manual (DSM-5), there is evidence that social isolation and quarantine can provoke many symptoms characteristic of posttraumatic stress disorder (PTSD).

         Neuroscientists have weighed in on possible mechanisms for the adverse effects of feeling chronically lonely on health. A study in mice showed that solitary isolation led to decreases in the size of neurons in the two brain regions studied, increases in the stress hormone cortisol, and decreases in a brain growth factor called BDNF. In humans, a study using functional magnetic brain imaging (fMRI) showed much less activity in a brain region necessary for experiencing reward, the ventral striatum, in lonely people than non-lonely people. In a not yet peer-reviewed report, scientists compared the effects of an acute social isolation challenge (10 hours of sitting alone in a nearly empty room) to food deprivation and found that the same region of the brain, the substantia nigra, was activated by both conditions. The substantia nigra sends neural projections to the ventral striatum to trigger the release of the neurotransmitter dopamine, which is associated with both craving and reward. Thus, craving food and craving social contact appear to cause similar brain activity and social isolation leaves the brain in a state of deprivation reminiscent of extreme hunger.

Social isolation and loneliness may lead to decreased activity in the brain’s reward pathway that goes from the substantia nigra (shown here in the middle of the brain slice) to the ventral striatum (shown here just above the substantia nigra) (source: Shutterstock).

Loneliness May Not Be of Epidemic Proportions

         Not everyone agrees that there is in fact a loneliness epidemic, however. A 2019 article looked at the data about loneliness and concluded that overall they don’t support the notion of an ongoing loneliness epidemic. “There is an epidemic of headlines that claim we are experiencing a ‘loneliness epidemic,’ writes Esteban Ortiz-Ospina, “but there is no empirical support for the fact that loneliness is increasing, let alone spreading at epidemic rates.” Although many authors point to an increase in the last century of the number of Americans who live alone as evidence that loneliness must be increasing, it is also important not to conflate social isolation with loneliness. For example, many people who live alone do not report feeling lonely.

         Regardless of whether loneliness is an epidemic or not, it is clear that more people than perhaps ever in the last century are undergoing enforced social isolation, forced to stay away from school, work, family, and friends. And experts do agree that even if loneliness is not as widespread in the U.S. as the dramatic headlines might suggest, it is a risk factor for multiple poor health outcomes. Hence, the risk that social isolation and loneliness will produce health problems even beyond the ultimate resolution of the COVID-19 epidemic is a reasonable concern. From a behavioral health viewpoint, a recent paper in Lancet Psychiatry states that “A major adverse consequence of the COVID-19 pandemic is likely to be increased social isolation and loneliness…which are strongly associated with anxiety depression, self-harm and suicide attempts across the lifespan.”  A review of previous quarantine situations, like those during outbreaks of H1N1 influenza, SARS, and Ebola also raised the possibility of increased alcohol abuse and a particularly adverse effect of loneliness on the elderly.

Although neurological signs and symptoms have been noted to be part of the COVID-19 illness for some patients, the paper notes that right now we do not know if and how the novel coronavirus that causes COVID-19 (SARS-CoV-2) gets into the brain. But “post-infectious fatigue and depressive syndromes have been associated with other epidemics and it seems possible that the same will be true of the COVID-19 pandemic.” Indeed, a survey has shown that 84% of Americans believe that if social distancing continues longer than they expect, it will adversely affect their mental health. Most ominous in this regard are studies linking social isolation and loneliness to an increased risk for suicide, leading three authors to call the link between suicide and COVID-19 a “perfect storm” in an article last month in JAMA Psychiatry.

Thus, it is clear that attention must be given to the development of loneliness that will affect an unknown number of people subjected to forced isolation during the pandemic. For these people, the effects of being isolated on their health and well-being may well last for months or even years after the pandemic is officially declared resolved.

How To Combat Loneliness

         Multiple authors have already weighed in on ways to mitigate the loneliness effects of social distancing. For many of these interventions, however, there are limited data about effectiveness. For example, we do not know the extent to which socializing via video platforms like Zoom with friends and family works to relieve some of the adverse effects of loneliness. One study from the University of Pennsylvania actually showed that cutting down on social media reduces loneliness, but that was done before technology became our only way of staying connected.  Elderly people who are also lonely may not be fluent with video conferencing platforms.

         In a Perspective essay in the New England Journal of Medicine, Betty Pfefferbaum and Carol S. North remind us that “After disasters, most people are resilient and do not succumb to psychopathology. Indeed, some people find new strengths.” But they go on to warn that a variety of negative emotions are inevitable the longer social distancing rules remain in effect. “In the current pandemic,” they write, “home confinement of large swaths of the population for indefinite periods, differences among the stay-at-home orders issued by various jurisdictions, and conflicting messages from government and public health authorities will most likely intensify distress.” While we all are likely to suffer some emotional distress during and even after the pandemic, a subset of us will feel profoundly lonely and prone to the physical and emotional disorders known to be associated with loneliness.

It is not known what interventions may help decrease loneliness while practicing social isolation but using the internet to establish social contacts could be helpful (source: Shutterstock).

         What can we do? People vary in how they experience loneliness and there are many interventions that have been tried to ameliorate loneliness. This makes it hard to make firm, evidence-based statements about what might work, especially when we are facing so unique a situation as the current pandemic. From studies that are available we would recommend the following as possibly effective interventions:

1. Attempt to schedule a regular one-on-one meeting with an isolated individual by video conference or telephone. This can be once per week or more frequent but should be on a predefined schedule.

2. Use the internet as much as possible to establish social contacts, but limit its use for acquiring news about the pandemic.

3. Encourage group activities by video conference. There are innumerable opportunities now to join in groups from a diverse range of interests and the isolated person can be encouraged to join one or more activity and discussion groups online, even if he or she only listens.

4. A pet may help

We cannot vouch that these will ultimately be proven effective if and when high-quality studies are done but given the state of the evidence they seem among the most promising. We need to make sure people understand that while on the one hand emotional distress is expected at this time and shared with a huge group of people, it is still painful, and everyone’s distress has unique elements. Knowing that the pain is a shared phenomenon may help but dismissing it as “just what everybody is experiencing” will not. When people use telemedicine for any reasons, a clinician should inquire about mental health issues and distress and query whether the individual has social support. Telementalhealth is also now increasingly available for people who need more intense and professional interventions.

   We conclude that there is reason to doubt that loneliness is a true “epidemic” at this time, but it is likely to emerge as a significant comorbidity from this pandemic and pose all kinds of long-term threats to health and well-being. At the very least, we must be certain that we are identifying people who are suffering from loneliness and do our best to relieve their discomfort and establish some social contact for them.

0n Climate-change Denial

By Peter McKenzie-Brown

“Let not men say ‘These are their reasons; they are natural;’ for, I believe, they are portentous things unto the climate that they point upon.” – William Shakespeare, Julius Caesar

Some months ago, an American friend sent me a link to an article on climate change from the Washington Post. The compelling story described the impact of a changing climate on one island among Les Îles-de-la-Madeleine – a chain of islands off the shores of Québec, our primarily French-speaking province.

“The more than 12,000 residents of this windswept Canadian archipelago are facing a growing number of gut-wrenching choices, as extreme climate change transforms the land and water around them,” Brady Dennis wrote. The “12,000 residents of this windswept Canadian archipelago are facing a growing number of gut-wrenching choices, as extreme climate change transforms the land and water around them. Season after season, storm after storm, it is becoming clearer that the sea, which has always sustained these islands, is now their greatest threat.” He added that, like much of the rest of Canada, the Magdalen Islands, as they are known in English, have warmed 2.3o Celsius since the late 19th century – twice the global average.

The Arctic is an important and fragile ecosystem, he continued, and it’s warming at a faster rate than much of the rest of the world. Scientists are already seeing dramatic reductions in Arctic sea ice cover, particularly in the summertime. This shrinking sea ice disrupts normal ocean circulation and creates changes in climate and weather around the globe. “Season after season, storm after storm, it is becoming clearer that the sea, which has always sustained these islands, is now their greatest threat.”

I live almost 5,000 km away from the Magdalene Islands, in the Texas-sized province Alberta. I appreciated the item, and posted it on Facebook and on Microsoft’s LinkedIn, which is supposedly a social media site aimed at professionals. There were likes from Facebook, but I could never have imagined the outcome from the other social media platform.

An instructor at Canada’s online Athabasca University took the first stab at me.  “BS,” he opined. I’ve forgotten his name, but his bio boasted a master’s degree. “Surely that’s academic short-hand for “beautiful story,” I replied.

Then the trolls began to swarm. Over the course of several hours, perhaps 150 chimed in. Most of them essentially said I was full of it. One invited me to visit his website, which “proved” that climate change is nonsense. What he forgot to mention was that his sorry blog asked visitors for donations.

Another person observed that every island undergoes erosion. How stupid, he implied, to suggest that the problem had to do with the loss of the sea ice that used to encase the islands most winters, shielding them from the Atlantic’s (higher) currents. The “Wa-Po” article is dumb, someone else added. The rest – I suspect, without proof, that they were this instructor’s students – mostly wrote mindless things, including jeering at my self-descriptor on LinkedIn as a “writer, author and historian.” After a while I went to bed, but in the morning, the trolls were still at work.

I went online to find out how to stop this nonsense, and remove its inanity from the site and my memory. Removing it from the platform was easy. It didn’t so easily leave my memory.

Puzzling it out

But it was so odd. The polite behaviour of Canadians is well-known. Even more so, however, is the science of climate change, which goes back two centuries. As the industrial revolution charged on, in the early 19th century, science began to speculate on ice ages and other natural changes in paleoclimate. The science of those days also began speculating on the possibility of a natural greenhouse effect.

For non-Canadian readers, it is worth putting the western province I live in, Alberta, into context. About the size of Texas, but with one sixth the population, this province is a big natural gas producer and an important supplier to North American markets of various grades of crude oil. More importantly, it also hosts the Athabasca oil sands – the largest known reservoir of crude bitumen (an ultra-heavy oil) – on the planet. In addition, we have huge bitumen deposits at Peace River and Cold Lake – a field that borders the more easterly province of Saskatchewan. Given these realities, you could say that these two oil-producing provinces have skin in the petroleum game. After all, since 1930 the western provinces have been the owners of most of the country’s vast natural resources. After serious volumes of oil production began in 1947, those governments have been taking in substantial royalties during the good times. Especially in good times, when oil prices are high, provincial coffers are full. This has become an addiction.

 “Climate change is a serious threat to development everywhere,” said Rajendra Pachauri, who served as chair of a 2007 United Nations conference on the topic in the Pacific island paradise of BaliHe said – I take this from a magazine article I wrote at the time – “today, the time for doubt has passed. (We have) unequivocally affirmed the warming of our climate system and linked it directly to human activity.”

To make sure there was no doubting his message, he added that “slowing or even reversing the existing trend of global warming is the defining challenge of our age.” According to Pachauri, global warming would lead to melting ice caps and rising sea levels, the drowning of some island nations, the extinction of species, desertification of tropical forests, and more frequent and deadlier storms. The world’s media soon became focused as never before on greenhouse gases (GHG) – the emissions (mainly carbon dioxide and methane) causing Earth to warm and its climates to change.

The occasion was a United Nations conference meant to negotiate national targets for reducing greenhouse gases. The US, Canada, and Japan became villains in the piece as they argued that the targets of the 1997 Kyoto Protocol were unrealistic. To live up to that agreement would have required Canada, for example, to cut its GHG emissions by perhaps 50 per cent during the next twelve years.

The three villains complained that Kyoto required nothing from emerging economies like China and India, which were big polluters even in those days. They and others also observed that, at the time of the original Kyoto discussions, science had little understanding of the impact on global warming of tropical deforestation. Deforestation amounts to destruction of some of the vital CO2 reservoirs often called “carbon sinks.” Factor in the loss of sinks from rainforest destruction, and Brazil and Indonesia become the world’s third- and fourth-largest GHG emitters.

At the beginning of these comments, I quoted Shakespeare’s famous passage on climate change from Julius Caesar. There are no trolls in that great historical play, but before he spoke – and before Caesar’s assassination – Casca spoke of signs he has seen I encountered on that memorable evening that gave him pause. “all the sway of earth shakes like a thing unfirm,” he reported. “I have seen tempests, when the scolding winds have rived the knotty oaks, and I have seen the ambitious ocean swell and rage and foam, to be exalted with the threatening clouds.”

He continued, “but never till to-night, never till now, did I go through a tempest dropping fire. Either there is a civil strife in heaven, or else the world, too saucy with the gods, incenses them to send destruction.” If that weren’t enough, he saw a common slave hold “up his left hand, which did flame and burn like twenty torches join’d, and yet his hand, not sensible of fire, remain’d unscorch’d.”

For another minute or so, he continues in this vein, describing unworldly horrors he has seen in the streets of Rome. “They are portentous things unto the climate that they point upon,” he concludes. Today, more than ever: think wildfires in many parts of the world; record flooding in many parts of the world; and, according to many reports, heat records.

Don’t End Social Distancing Yet

Theories That We Can End the Coronavirus Pandemic by Reopening Things Now Lack Scientific Support

As the coronavirus pandemic continues in the U.S. and around the world, it is natural that people are becoming increasingly weary and frustrated with stay-at-home and social distancing orders. We are also all fearful about the economic repercussions of the COVID-19 outbreak, which affect the most vulnerable people with the lowest incomes among us. We yearn for the time when we can finally go back to work and to socializing in person with friends and family.

         These understandable emotions make some of us prone to believe a theory that everyone but the elderly and chronically ill should return to work and school right away. According to this notion, isolating the elderly and those with chronic underlying medical illnesses, who are the two groups most likely to develop serious complications from coronavirus infection, while allowing everyone else to get infected will ultimately lead to the development of widespread (also called “herd”) immunity to the virus and it will simply peter out.

         We noted with alarm, then, a widely circulated article titled “Epidemiologist: Coronavirus could be ‘exterminated’ if lockdowns lifted,” which we first saw in an online publication called WND News, a politically conservative news source. The piece, which was picked up by other online media, was written by Kurt Wittkowski, Ph.D., who is described as “former head of the Department of Biostatistics, Epidemiology and Research Design at the Rockefeller University in New York City.” He asserts that our current efforts to “flatten the curve” of new coronavirus infections actually widen it and that “the only thing that stops respiratory diseases is herd immunity.” Given Wittkowski’s credentials, his ideas may be harder for some to recognize as faulty.

         Most urgent is the concern that people will read what he says, believe it, and relax social distancing efforts. The result of prematurely relaxing those efforts, scientists tell us, would be an overwhelmed healthcare system and even more deaths than currently predicted.

         We will focus on two questionable aspects of Wittkowski’s proposal: 1.) that we could protect the elderly and medically vulnerable by isolating only them and not the rest of the population and 2.) that herd immunity will develop in a matter of weeks if the virus is allowed to run rampant through the 80% of the population believed to be less vulnerable to serious complications and death.

Isolating Only the Elderly Unlikely to Work

         It is true that except for those with underlying chronic illnesses like diabetes and asthma, most children who get infected with the coronavirus experience either no or mild symptoms. But it is not true that only elderly people can get very sick from coronavirus infection. Adults of all ages, especially those with conditions like diabetes, hypertension, and chronic lung diseases and those who are undergoing chemotherapy for cancer or taking steroids on a long-term basis, can get very sick and die from coronavirus infection. Who will get serious complications from the coronavirus depends on multiple factors and is hard to predict. In some cases, although less common, even young and healthy adults have died.

When children go to school, they risk not only passing the virus among themselves but also to teachers, school administrators, school bus drivers, janitorial and kitchen staff, and so forth. These adults can then pass the virus around among themselves and inevitably to elderly people with whom they come into contact. Instead of flattening the curve and reducing the number of new infections and deaths, doing this according to our best mathematical models would prolong the pandemic, cause more people to get infected, and result in more deaths.

         Moreover, flattening the curve is essential to preventing our already strained healthcare system from becoming completely overwhelmed. Critica’s Chief Medical Officer, David Scales, reports that the New York City hospital at which he works had to break down walls to create space for additional ICU beds to accommodate very sick COVID-19 patients. And, he tells us, many of those patients are less than 65-years old. Doctors, nurses, and other healthcare professionals are already stretched to the maximum; allowing the virus to run rampant throughout the population as would happen under Wittkowski’s proposal, would only make this already intolerable situation worse.

Herd Immunity Won’t Occur in Just a Few Weeks

         What about his suggestion that if we just allow people considered less vulnerable to serious complications from COVID-19 the virus would be exterminated “within weeks?” The problem here is that at present we have very little notion about what kind of immunity people who have recovered from COVID-19 actually develop. Let’s take a look at some basic immunology here for a moment.

         One major line of defense against viruses is the development by the immune system of antibodies (aka immunoglobulins) that recognize proteins on the surfaces of a specific virus. These antibodies are produced by a type of immune cell called the B lymphocyte. There are five categories of antibodies, and two classes are particularly important for the fight against a viral invader: IgM and IgG. B cells produce IgM first, but these antibodies tend to be “generalists” and not specific to a particular virus. IgM antibodies typically show up in a person’s blood about ten days after being infected with SARS-CoV-2, the virus that causes COVID-19. A few days later, IgG antibodies, which are more specific than IgM, start to appear and the person usually—but not always–begins to recover.

Antibodies that can neutralize the COVID-19 virus take up to two weeks to develop and are more effective in some patients than others in promoting recovery (source: Shutterstock).

         For some viral illnesses, a second exposure to the virus causes a much more rapid antibody response and the virus is neutralized before it has a chance to set in and cause disease. Before the measles vaccine was available, for example, most people who had measles developed lifelong immunity and reinfections were uncommon. For other infections, however, the virus mutates rapidly, and the IgG antibodies produced the first time around are no longer effective. This is the case for viruses that cause the common cold and the flu.

         Scientists think that people may develop immunity for a year or more after a first encounter with the coronavirus, but this is not yet certain. It is also possible, we are told, that people who have no or mild symptoms the first time may have such a weak initial immune response that they do not develop any form of immunity to repeat exposures to the virus. That means they could be reinfected and contagious again. Indeed, a troubling report from the South Korean CDC identified cases of coronavirus reinfection in people who had recovered from a first infection.

         So Wittkowski’s prediction that allowing the bulk of the population to be exposed to the coronavirus would result in the rapid development of herd immunity is based on no science at all. Right now, the only appropriate public health response to the pandemic is to keep everyone in relative isolation by staying at home, social distancing, and closing of schools and other public spaces. There are already data that this approach, rather than allowing unchecked infection, is working. Once the new infection rate has dropped substantially, we can then ease up on those measures and institute a policy of widespread testing for the virus and for antibodies against it and quarantine only those with active infection. A cogent plan for national surveillance and testing has been advanced. But we are not at that point yet and probably won’t be until this summer at the earliest.

Social distancing appears to be working to reduce the number of new cases of and deaths from COVID-19 (source: Shutterstock).

         Anti-viral drugs will hopefully be developed soon that will lessen the burden of severe complications and death from coronavirus infection. Ultimately, we should have a vaccine against it that will cause protective antibodies to be produced without itself inducing illness. Ordinarily it takes many years to develop a safe and effective vaccine and, in some cases, like HIV infection, even years of research do not produce one. With the focused international effort now underway, and the fact that this coronavirus mutates slowly, it is hoped that a vaccine might be available a year from now, although that is probably a bit optimistic.

         We all want to see our families and friends in person again, to be able to shop and go to the movies, and to go back to school and work. As the pandemic drags on, it is understandable that we are going to find any theory that would allow those things to happen right away very attractive. These theories are unfortunately now not uncommon across the internet. Our fear with denialist ideas like those of Wittkowski and a handful of other doctors and self-proclaimed experts is that they will weaken our resolve to stay at home and practice social distancing. Those are among the most essential ways we have right now to control the pandemic and maintain a functioning healthcare system. The notion of rapidly developing herd immunity to the coronavirus is unsubstantiated by science and at present dangerous to follow. We all can’t wait to be let outside again. Unfortunately, waiting is exactly what we must do.

The Medicare-for-All Debate Causes Confusion and Stress

Can’t We Get Some Reliable Data?

There is much bemoaning these days about the supposed inability of people to incorporate facts into their beliefs about politics, science, and health. We hear a great deal about confirmation bias and motivated reasoning as the basis behind our constitutive inability to accept the facts.

         While cognitive biases certainly make it difficult for us to accept data when we form beliefs and make decisions, that still does not mean that facts are unimportant. When it comes to healthcare reform, however, it seems nearly impossible to get even the most basic facts that might help us make informed policy decisions. The resulting confusion is the cause in some of us of profound anxiety and even despair.

         There are two things about the American healthcare system that seem universally agreed upon: we spend more money per person than any other high-income country and we have the shortest lifespans. Those facts should surely merit a serious effort at reforming how we deliver healthcare in the United States.

We spend more for healthcare and live shorter lives than other high-income countries, but we aren’t given reliable information about why (image: Shutterstock).

         What has cropped up on the political scene, however, is a contentious debate about whether or not we would be better off with a single payer, national healthcare system similar to that employed in every other developed country. Some have called the proposed plan for universal health care “Medicare for All,” while others use the derisive term “socialized medicine.” For some of us, this debate might even produce things that can require healthcare interventions, like anxiety and depression. The debate is confusing and almost entirely devoid of facts we can get our arms around and believe in. In our effort to promote the use of scientific evidence in public policymaking, we are often shocked by the inability of people discussing healthcare to be able to give us anything like reliable data.

The Things We Want to Know

         Here are some of our questions about our current healthcare system and proposed reforms that we believe should be answerable with reliable information:

·  What are the things we spend more money on than countries that do have national healthcare systems? Is it on drugs, doctors’ fees, hospital bills, advanced laboratory and imaging studies, administrative costs, or some combination of these? It turns out that the conditions that generate the largest share of healthcare spending in the U.S. are not life-threatening conditions like cancer or coronary artery disease but neck and back pain and other musculoskeletal disorders. According to the federal Centers for Medicare and Medicaid Services (CMS), the U.S. spent $3.6 trillion or $11,172 per person on healthcare in 2018. By contrast, the United Kingdom spends about half as much as we do on healthcare. To be told that the reasons for this difference are complex is unhelpful. We are sure there are many complex factors that go into how much a country spends on healthcare, but it should not be that hard to give the public the sources of the huge difference in spending on healthcare between us and the rest of the developed world in terms that are understandable. In other words, can someone please explain to us what is it that we spend all the extra money on and is it necessary that we do so?

·  How much do the things we are paying for actually cost? It seems almost impossible to get even the most basic information on how much things cost in the U.S. healthcare system. If you have a headache and the doctor orders an MRI of your head, how much does the MRI cost? Most likely no one will be able to tell you, not the doctor, your health insurance company, or the facility that actually does the MRI. About to have a baby? If you have, like most women, an uncomplicated labor and delivery, ou’ll get a bill from the hospital where you deliver but try to find out how much that bill will be beforehand and you’ll just get frustrated. When the government recently proposed a new rule ordering hospitals and health insurance companies to be transparent about their prices, they recoiled in horror, claiming to do so would cost billions and just confuse the public. And when you get the bill for medical services, chances are you won’t be able to understand it, leading two Johns Hopkins physicians to recently propose in the Journal of the American Medical Association (JAMA Network) that the quality of bills sent to patients should become the subject of metrics upon which hospitals are judged, just as they are for things like the number of surgical infections they have annually and how many people survive ICU care. “The financial harm of medical care should not be separated from the clinical consequences of care, because both outcomes can have a major influence on the health and well-being of patients,” they wrote. Of even more concern than the quality of bills is the fact that many people who do have health insurance still cannot afford to get the care they need According to one recent study, “In 2017 nearly one-fifth of individuals with any chronic condition (diabetes, obesity, or cardiovascular disease) said they were unable to see a physician owing to cost.”

·  Why don’t we have better health outcomes if we are spending so much extra money? The current life expectancy in the U.S. is 78. 6 years, compared to an average of 82.3 in 12 high-income countries.  Life expectancy in the U.K. is 81.3 years and in Canada it is 82.0 years. Once again, there is no doubt that the reasons for this difference are complicated. And of course, life expectancy is not the only way to measure the success or lack thereof of a healthcare system. But critics of national healthcare systems in other countries often insist they don’t deliver the same high quality of care as we get in the U.S. They point, for example, to allegedly long waits for some medical procedures, like gallbladder removal and spine surgery. It is unclear that this claim about longer waiting times for national healthcare systems is actually true. Isn’t it possible, however, to give us some real, objective sense about whether the quality of care in national health care systems is indeed better, equal to, or worse than the system we have in the U.S.?

·  How much would it cost the U.S. to convert to a single payer, national healthcare system? Here, we get a lot of numbers, none of which make much sense. One number that is often cited is that Medicare-for-all would cost the United States $32 trillion. But that number turns out to be over ten years and includes increased U.S. government commitments. Now, it is hard to figure out how much of that average $3.2 trillion per year spending would replace what we are already now spending on healthcare (remember that $3.6 trillion annual healthcare spend figure above). How much would be offset by the profits made by the health insurance industry, which amounted to $35 billion in 2019. And if taxes must be raised on middle-class taxpayers to help fund the national healthcare system, how much of that would be offset by people no longer paying premiums to the health insurance companies, either directly or through salary taken out of their paychecks? In order to afford the ever-increasing cost of health insurance, employers have increasingly adopted plans that include higher co-pays and deductibles for their employees and that have narrow networks of providers, leaving many visits to doctors completely uncovered. Would a universal healthcare system reduce the burden of premiums, high copays, and large deductibles for working people? It might even result in higher wages, because higher premiums in employer-based health insurance plans are said by some economists to drive wages down

·  Is it true that most people like their current health insurance? That is certainly a consistent finding when surveys are conducted. But who are these people? Right now, 44 million people are enrolled in Medicare, 64.5 million Americans are covered by Medicaid, and 9 million veterans are enrolled in the Veterans Administration’s health care system. Altogether, then, 117.5 million Americans are covered by government-sponsored, single payer health care systems. That’s more than a third of the US population. A recent RAND Corporation study showed that Medicare beneficiaries “see the largest return on the money they pay for their healthcare,” whereas people with employer-sponsored plans “see the least amount of value.” We can also ask the question, how many of the people who say they like their health insurance have actually ever used it for more than the occasional doctor’s office visit or antibiotic prescription? Complaints may be more frequent among people who have had more significant medical bills and found themselves drowning in paperwork and responsible for thousands of dollars in co-pays, deductibles, and out-of-network costs. As noted above, increases in deductibles and copays are increasing the number of people who have health insurance but still cannot afford to see a doctor. In fact, a recent poll showed that nearly one third of likely voters “are very or moderately worried about being able to afford their health insurance…and out-of-pocket costs for prescription drugs…”Then there are the 27.5 million Americans who have no health insurance at all. They were probably not asked if they are happy with the situation.

Is our system of health insurance better than the universal health care systems used in other high-income countries? We wish we could have impartial information to answer this question (image: Shutterstock).

People running for public office will, or course, be very willing to answer these questions. Some will tell us that national healthcare is unaffordable in this country and that the only way other countries afford it is by restricting care below acceptable standards. Others will tell us that national healthcare will actually save us money, as a study by Yale University investigators published in The Lancet showed.

         It should be possible for us to get objective and understandable answers to the questions we have posed. If the federal government can’t do it for political reasons, then let’s figure out which non-governmental agencies we trust to analyze the data and explain them to us. If a universal healthcare system really would result in massive debt and poor healthcare, then of course we would reject it. If it would instead decrease total healthcare spending and result in everyone having insurance and better overall outcomes, we would demand it. The current information situation seems only designed to make us feel anxious and threatened. We are being frightened by a myriad of statistics that threaten us with catastrophes—losing our healthcare coverage, having to pay exorbitant taxes, and getting second-rate care. We know that many other high-income countries have somehow been able to provide universal healthcare and that it is cheaper and associated with longer life than our system. What we have a right to insist on is that we get a clear and unbiased explanation of why the United States has (or doesn’t have) a unique situation such that what works in the UK, France, and Germany cannot possibly work here.

         As much as we dislike making arguments on the basis of anecdotes, we could not resist mentioning this one, most but not all of which we were able to verify from news reports : recently we heard about a 43-year old woman who was attacked in the Bronx, NY and severely beaten. A few days later she went to a local hospital complaining of leg pain and was told she needed immediate hospital admission and treatment, but she feared getting hospital bills she wouldn’t be able to afford and decided instead to go home. She died a few days later when a blood clot in her leg embolized her lung. Obviously, nobody should refuse emergency medical care because they are afraid about how much it will cost, but we suspect that in our dysfunctional healthcare environment this is not an isolated example. All we are asking for is a straightforward, data-driven, and politics-free answer to basic questions about our healthcare economy. It’s time to stop confusing and stressing us with vague answers and inexact statistics.

Is it Really Possible to Boost Your Immune System?

There has always been a lot of talk–and commerce–about immune system boosters in wellness circles, but attention to the notion of enhancing the immune system is even greater since the onslaught of the COVID-19 pandemic. People understandably want to know if there are things beyond social distancing and handwashing they can do to lower their risks of contracting the virus that causes COVID-19.

         As will be detailed below, there are some steps we can take to enhance our immune systems’ ability to fight off infectious agents. When it comes to supplements, however, the immediate answer to the question of whether it is possible to take something that will strengthen the immune system’s ability to fight off the novel coronavirus is, unfortunately, no. As we will explain, no over-the-counter pills have ever been shown definitively to have that ability for any type of infection, be it bacterial, viral, fungal, or parasitic.

Immune System 101

         There are some supplements, however, for which limited data suggest a possibility of enhancing some parts of the immune system that might be relevant to dealing with a viral infection. Before detailing them, however, it is necessary to give a brief overview of the human immune system. You can read other, informative overviews of the immune system in this posting from the NIH and here.

         After the central nervous system (i.e. brain and spinal cord), our immune systems are the most complex we have. It is designed to recognize and destroy abnormal cells, examples of which are bacteria, viruses, and cancer cells. The immune system is divided into two separate but interrelated systems, innate and adaptive. The innate immune system is hardwired into our genes and responds to proteins called antigens that are common to abnormal cells but generally not present on the surface of our own body’s cells. Examples of cells that make up the innate immune system are neutrophils, which are very important in the response to viral infection, and eosinophils, which respond to parasitic and fungal infections and also increase during allergic reactions. Cells of the innate system also continuously destroy malignant cells as they crop up, helping to prevent many cancers. These are our first line of immune defense, but because they are generalists, they often fall short of the job of eliminating specific abnormal cells.

         The adaptive immune system, by contrast, learns to recognize specific abnormal or pathogenic cells that can cause disease. We are constantly bombarded by abnormal cells every time we touch something or take a breath. Immune cells called lymphocytes are the primary weapons of the adaptive immune system. After a first exposure to an antigen-presenting pathogenic (i.e. disease-causing) cell, lymphocytes called T and B cells express new proteins that are targeted at specific antigens on a single type of invading pathogen. Then, if we are exposed to the same abnormal cell again, specific T and B cells can rapidly emerge to knock it out. B cells make antibodies, which is one way they can react swiftly to infectious agents. For many illnesses, B and T lymphocyte memory is long-lived, sometimes for a lifetime. That is why before the measles vaccine was available, it was observed that no one could get measles twice.

The human immune system contains hundreds of different kinds of cells and thousands of genes and proteins, all serving different purposes in preventing disease caused by abnormal cells (source: Shutterstock).

Vaccination works by stimulating the creation of a reservoir of immune cells that remember proteins (antigens) from a disease-causing organism like a virus or bacteria. When we receive an immunization, we are given an inactivated form of a bacteria or virus, which cannot cause disease but does stimulate an adaptive immune system response. Then, if we are exposed to those abnormal cells again by nature in their active form, specific T and B cells are ready to recognize and neutralize them. Vaccines are right now the only proven pharmaceutical method of “boosting” the immune system. Unfortunately, some viruses, like the flu virus, mutate so quickly that it has been very difficult to find proteins on them that are stable enough to permit development of a vaccine. Every year we have to come up with a new flu vaccine to account for new strains of the flu virus, although there is some hope that common proteins to all strains of the flu virus are coming to light that will allow a universal vaccine.

We don’t know yet whether SARS-CoV-2 provokes an immune response that is long-lived enough to prevent a person who has been infected from getting re-infected. It is known that this virus mutates very slowly, which is good news for vaccine development.

         In the last 50 years, immunologists have identified hundreds of different types of immune cells and thousands of genes and proteins in and on those cells that are involved in fighting off infection. This is the reason that boosting the entire immune system is hard to conceive. No single pharmaceutical agent—or even combinations of several medications–could seemingly influence the thousands of disparate proteins and genes involved in the human immune system. And even if there is a pill or pills that could do that, it wouldn’t necessarily be a good thing; autoimmune diseases like lupus and type I diabetes occur when our immune system is tricked into making cells that recognize some of our own cells as dangerous and attack them, causing serious disease. An overabundance of immune system activity could cause more harm than good.

Weak Evidence for Immune Boosting Supplements

What about all the supplements that are said to boost or support the immune system? Because these are not advertised as treating any specific disease, the FDA by law has limited authority to regulate them. Most importantly, no “immune boosting” supplement has ever been subjected to the kind of rigorous clinical trials that are required before FDA approves a new medication for an illness. Consequently, we simply do not know if any supplements are really effective.

         There are a few for which preliminary evidence suggests a benefit. These include:

·   Statins, prescription medications used to lower elevated cholesterol levels. These do seem to have some positive effects on the immune system, but also have important potential adverse side effects.

·   Vitamin E, but only in small doses, because higher doses cause toxicities

·   Vitamin D, again with caution because high doses can be dangerous

·   Zinc, which may have antiviral effects but at higher doses may actually increase the risk for viral infection.

·   Probiotics, because we are gaining increasing information that there are beneficial bacteria in the human intestines that may have important benefits for immune system health.

·   Restricting calories, such as what is accomplished by intermittent fasting (but see our previous commentary on that topic).

There are many claims about supplements for boosting the immune system, but these are generally based on weak evidence or pure speculation (source: Shutterstock).

We stress, however, that for each one of these, the evidence in favor of an immune system benefit is very weak and the possibility exists that long-term use, especially at higher doses, can have toxic consequences. At the present time, it is inappropriate to tout any supplement as having an immune system boosting effect. We simply do not have the evidence to support such a claim.

There are a few things that we know are safe and beneficial for health in general, including the immune system. They include:

Although children and young adults clearly can get infected with SARS-CoV-2, unless they have a preexisting illness that compromises the immune system they are much less likely to get severely ill than elderly people. That is in part because the immune system’s ability to fight infection declines with age, although at different speeds for different people. Exercise and stress reduction may slow this “immunosenescence” and vaccinations can prevent some forms of pneumonia that sometimes occur on top of COVID-19 and increase the risks for severe illness and death.

  To reduce your risk for COVID-19 the best advice remains social distancing and self-quarantine, frequent handwashing, don’t touch your face, stay as calm as possible, stop smoking if you smoke, and exercise. You can be sure that as soon as any medication, prescription or over-the-counter, musters enough evidence for scientists to say it works to further decrease risk for COVID-19, the news will be quickly broadcast by responsible sources.