Carvings             April 15, 2021

In the News

Another COVID surprise!

* Caveat: any numbers in this post should be considered temporary estimates. The input from government and academic institutions changes by the hour.

          The good news: we have two effective vaccines against the virus that has taken the lives of millions of people and disrupted the lives of almost everyone else.

            The bad news: two other vaccines by Johnson and Johnson and Astra-Zeneca that have the advantage of requiring only one dose have been associated with about a dozen deaths from a rare blood clotting disorder. Those deaths have mostly occurred in women of early middle age who should have had decades more of life with their families.

            It’s called Vaccine-Induced Thrombotic Thrombocytopenia (VITT). Thrombocytes, known as “platelets” because they resemble small dinner plates, are sharply reduced, partly because they are taken up in the formation of blood clots in various organs. This results in thrombocytopenia, meaning scarcity of platelets and some patients have simultaneous hemorrhages when there aren’t enough platelets remaining to control bleeding.

            The condition typically arises during the second week after vaccination. Clots in the brain cause headaches; those in the blood vessels that supply the intestines produce abdominal pain; clots in the legs result in leg pain and those in the lungs cause shortness of breath. Anyone with these symptoms following receipt of the Johnson and Johnson or Astra- Zeneca vaccine should seek medical attention without delay in order to present stroke or even death.

            We have a long way to go before we can unravel the cause, provide lifesaving treatment and perhaps modify the vaccines. Fatalities have so far occurred only in about once for every million doses of vaccine in the U.S. To put this in perspective, the loss of life among a million persons with COVID-19 would be about twenty thousand! A report from the University of Oxford states that this clotting disorder is about forty times as likely from COVID-19 infection as it is from the vaccine.

            A further perspective: the CDC estimates that deep vein thrombosis (DVT), sometimes associated with air travel, causes death in from 60,000 to 100,000 persons every year.      

            Why have most of the deaths occurred in women? One reason might be that they have higher levels of estrogen, somehow making them more susceptible to the condition. Another reason is that women are more often affected by autoimmune diseases such as lupus, rheumatoid arthritis and multiple sclerosis, all of which are autoimmune diseases, which VITT appears to be.

            Some reassuring thoughts: the disease is rare, especially in males. More than 600 million doses of the current vaccines have been administered so far and this clotting disorder has been reported in fewer than 300 persons with about a dozen deaths. We have two vaccines that are known to be safe – to my knowledge there have been no deaths attributed to either the Pfizer or the Moderna vaccines — and effective, more than 90 percent at the six-month mark.

            It would seem prudent that women of childbearing age should not receive either of the one-dose vaccines. They should opt for either the Pfizer or the Moderna vaccine, neither of which has been linked to deaths from VITT. The risk to men appears to be vanishingly small.

            There are several more vaccines in the pipeline and some of these employ new technology. You can be sure that there are more surprises among them.

Lifestyle

Some Stone Age humans were probably aware of plant products that gave them a caffeine-like jolt but they never started the day with a good old cup of coffee. It was just a few years ago though, that America’s favorite beverage caught the blame for causing a variety of ills, including cancer of the pancreas. Fortunately for Starbucks devotees, coffee now has a clean rap sheet and is taking credit for some genuine health benefits.

The pancreatic cancer issue has been put completely to rest and there is convincing research showing that coffee lowers the risk of several types of cancer, including liver, brain, prostate, uterus, mouth and throat. Except for a link to bladder cancer in men who drink several cups a day, there is no evidence that it causes cancer.

Coffee is a plant product and like red wine and dark chocolate it contains thousands of chemicals that have beneficial health effects. These include antioxidants that protect blood vessels from damage by harmful free radicals and substances known as antimutagens that keep cells from becoming malignant. There are chemicals in coffee that rein in inflammation, a contributor to heart disease, stroke and rheumatoid arthritis.

In spite of coffee’s growing list of advantages, drinking more than three eight-ounce cups a day can cause nausea, irritability and insomnia. Even decaffeinated versions are not entirely free of caffeine and may lead to poor sleep in caffeine-sensitive individuals. Excess caffeine can increase heart rate and raise blood pressure.

Adding milk to coffee appears to diminish at least some of its benefits in the same way that converting dark chocolate to milk chocolate does. Of course, when the addition of lots of cream and sugar transforms a large cup of black coffee into a 500-calorie “specialty of the house” you can kiss the heart-health benefits goodbye. Moderation, as usual, is a good thing.

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