Ten years later, MAID in Canada is still strongly supported

At the ten-year anniversary of Canada's Medical Assistance In Dying (MAID) law, there has been a flurry of articles about how successful the initiative has been. In particular, there have been two competing opinion articles in the Globe and Mail, exemplifying the different attitudes to the service.

MAID, or assisted suicide, has been legal in Canada since June 2016, originally just for cases where natural death was "reasonably foreseeable". In March 2021, after much consultation, this was extended to people suffering intolerable whose death was not necessarily reasonably foreseeable. These two types of cases are now known as Track 1 and Track 2, although strict safeguards are of course still maintained, particularly in Track 2 cases.

One of the articles, by the regular Globe health critic André Picard, puts forward what is probably the majority view, that MAID has been an unalloyed good. Over the last ten years, about 100,000 Canadians have been spared unnecessary suffering, 95% of them in cases where death was "reasonably foreseeable" in the language of the law. Picard argues, "Life has not been cheapened by MAID. Dignity, choice and bodily autonomy have all been bolstered". Furthermore  it has not led to the "slippery slope" nay-sayers warned against, and continue to warn against, despite the extension to cases where death is not necessarily reasonably foreseeable (which continue to make up just a small minority of MAID deaths). The law is deliberately couched in very conservative and cautious terms for that very reason.

The other article, by regular contributor Robyn Urback, is more of a nuanced critique, alleging that, while the program has been generally successful, there has still been anecdotal examples where a small minority of Track 2 MAID deaths (where natural death is not necessarily probable) may - or may not - have been botched or mishandled. Improbably, Ms. Urback sees these isolated incidents as evidence that "life has become cheap in Canada", and that the extension to Track 2 MAID in particular is "eating away at the country's soul", a radical conclusion that does not seem to follow from her detailed argument. A few poignant sob stories do not negate the general good the 

My point here is that the negative argument is on much more tenuous ground, and is anyway not completely negative, but rather a relatively minor quibble against an otherwise highly successful initiative. Certainly in terms of general satisfaction, the Canadian public is quite happy with what was initially such a contentious issue. A recent Environics poll shows that between 81% and 89% of seniors and caregivers support MAID. Another recent poll found that 89% of Canadians support in MAID in cases of terminal illnesses, while 84% support MAID for people who are suffering intolerably even if they are not near the end of their lives.

When we get into the area of extending MAID to people whose sole underlying condition is a mental illness, however, the picture muddies considerably. But that is not currently part of Canada's MAID program, and a parliamentary committee recently voted that those with mental illness should not have access to MAID, at least for the foreseeable future. Now, that one IS contentious.

What to do when you get a tick bite (Ontario edution)

I guess it was only a matter of time before I or my wife got bitten by a tick. It happened to my wife this last weekend on an otherwise beautiful walk in the Rouge Valley. Except, we didn't realize it until two days later (it was on her stomach for one thing!)

I knew I had to take it off as soon as possible with tweezers (pull straight out, no twisting or smearing!) But I had no idea what to do next. Well, now I do!

First, I took a photo of it and identified the tick through eTick.ca - some kind of AI application, I guess. We received a positive identification within just a couple of hours and, sure enough, it was a black-legged tick, or deer tick, the kind that potentially carries Lyme Disease. Not all of them carry the disease, so all was not lost at this point. But that was a  pretty impressive service, I thought.

My next stop was the Public Health Ontario webpage on  Lyme Disease. This resource has a flowchart you can follow to decide whether or not you need to get a prophylactic antibiotic shot. The first question is: do you have the tell-tale bulls-eye rash and/or flu-like symptoms (fever, chills, headache, stiff neck, fatigue, decreased appetite, muscle and joint pains, joint swelling, swollen lymph nodes, etc). If so, go straight to see a doctor or nurse practitioner. In our case, though, the answer was no, so go to Question 2.

Question 2 assesses the level of risk of Lyme Disease, and asks if all four of these risk factors apply: the tick has been removed in the last 72 hours; the bite occurred in a high-risk area (Google it); the tick was likely attached for at least 24 hours; and you have no allergy to the antibiotic doxycycline. In our case, we "ticked" all of these, so a dose of doxycycline was recommended (that seems to be the ONLY antibiotic that is recommended). If we had not been able to tick off all four, then the advice is just to monitor the bite and see if any symptoms occur.

So, we went to our local pharmacy - pharmacists innOntario are now authorized to treat this kind of thing, no need for a doctor's appointment - bought 2 tablets of doxycycline (after the pharmacist briefly went over all of the above), and Bob's your proverbial uncle. Actually, he even waived the $2.99 cost, so the whole thing cost us ... nothing!

What a good system!

China's immovable smoking addiction

By all accounts, Chinese President Xi Jinping gave up an atrocious smoking habit some fifteen years ago. His country, though, is making zero - or rather negative - progress on his attempts to reduce China's awful addiction to smoking.

Over the last twenty years, smoking in the rest of the world has fallen by a respectable 26%; in China, over that period, it increased by 39%. China now accounts for nearly half of the global total of cigarettes smoked, some 2.4 trillion every year. While the percentage of smokers in China has fallen a bit, as fewer young people take up the habit, overall cigarette sales have continued an inexorable rise.

Part of the problem is that cigarettes are ridiculously cheap in China - at around $3 a pack on average, they are about a third of the price of smokes in the USA and Canada. China ratified WHO's tobacco control treaty in 2005, but has never really implemented its strictest provisions. Unlike the graphic health warnings on North American and European cigarettes, Chinese cigarettes have a simple, unobtrusive text warning, all but lost among the patriotic symbols that adorn the cigarette packs produced by the China National Tobacco Corp (CNTC), a vast state-owned monopoly and the world's largest producer of cigarettes. 

Indeed, the CNTC is the main problem. Generating annual profits of $244 billion last year, the CNTC alone contributes an eye-popping 7% of China's tax income each year, about the same as what it spends on defence. (Roughly half of the sales revenue of each cigarette flows into government coffers.) The company has also been called on to help out with specific strategic priorities, like financially shoring up one of China's biggest banks, funding national semi-conductor investment, etc. In short, it has made itself economically indispensable, and accumulated a lot of political influence in the process. 

It's also alarmingly corrupt: seven former top administrators of the CNTC have been arrested on corruption charges in the last seven years. It has successfully blocked a concerted national push for an indoor smoking ban, and even official studies have concluded that the state monopoly has actively interfered in national and local attempts to rein in smoking. It's influence is, obviously, even more marked in tobacco-growing regions like Kunming and Changde, where tobacco taxes can account for more than half of the city's budget. 

There are local "tobacco bureaus" that actively work to water down even modest anti-smoking initiatives. In one city, the local health commission proposed a system of smoke-free public areas, but the local tobacco bureau managed to ensure it did not apply to restaurants and bars, and even tried to limit the smoke-free designation in schools to elementary and middle schools only.

We think of President Xi as ruling China with a rod of iron, but even his attempts to reduce the country's smoking addiction have met with the immovable object of the powerful smoking lobby.

The other disease outbreak that no-one is talking about

With all the attention on hantavirus and ebola outbreaks, the devastating measles outbreak in Bangladesh has gone all but unnoticed. What measles outbreak, you ask? Well, precisely.

In just two short months, since mid-March, Bangladesh has seen 60,000 suspected measles cases and 528 suspected measles-related deaths, the vast majority of them children under 5 years old. Yikes!

The irony is that, under disgraced ex-Prime Minister Sheikh Hasina Wazed, Bangladesh was making good progress on completely eliminating measles in the country, with a robust community-led vaccination campaign. After the July Uprising of 2024, though, the interim government dropped the ball, the vaccination supply was disrupted, and immunization campaigns postponed. The whole thing was made worse by hospital staffing shortages caused by, among other things, foreign aid cuts, principally by the Trump administration in the USA.

And here we see the consequences. UNICEF and the WHO have watched it happening and issued stern warnings, but nothing has changed. This is now the largest measles outbreak in Bangladesh in decades and hospitals are already overwhelmed, with no end in sight.

Remember COVID? It's still with us

I happened to read a letter in the newspaper that gave some rather striking statistics about the death rates from COVID-19 in various countries. Turns out they were true.

According to Wikipedia/Our World In Data, Canada's death rate from COVID to date has been 1,424 per million; the USA's has been 3,624 per million, and for the EU as a whole it was 2,831 per million. I'd say that was a statistically significant difference! Countries that observed even tighter controls than Canada showed even better (lower) death rates: New Zealand (884 per million), Japan (597 per million), Singapore (358 per million), etc. Next time someone complains about government overreach during the pandemic, throw that in their face! Vaccinations and public health controls save lives! Surprise!

I haven't thought too much about COVID in a while, except to get our biannual vaccination, which I did just last week. It wasn't easy to find a vaccination - what a change from the good old bad old days! - but I did eventually track down a Moderna jab. This was not my first preference: I have always had a much worse reaction to Moderna than to Pfizer, but beggars can't be choosers. 

Several of the pharmacies I spoke to said that the government either didn't send them any stocks of the new vaccine, or sent so few that they ran out in a couple of days. That's just how it is these days, they griped. It seems ridiculous that we had to jump through so many hoops to get hold of a vaccine that should be part of our regular routine, like the flu jab.

That said, though, it does seem like, at the moment anyway, in the slow period of the year as we now are, there are very few reported/diagnosed/confirmed cases of COVID in our neck of the woods. 

The important part there, though, is "reported/diagnosed/confirmed". Most people do not report it or have it checked out these days unless they actually end up in hospital; many just assume it was a mild flu or some other infection. I've only had COVID once, about three years ago, but it was pretty nasty, and I'd prefer to avoid it if possible.

Kratom is not just a made-up word

It's funny how cultural innovations and fads can completely pass me by until they are no longer either modish or edgy. I guess it's just the circles I move in (or don't).

Either way, I had never heard of "kratom" until I read an article about how it has become wildly popular and even a significant source of addiction and other mental health problems in the USA (and, I'm guessing, also in Canada, to a lesser extent).

Kratom, it turns out, is a plant from southeast Asia that is widely used - in the form of powders, liquid shots, pills and teas - to treat a variety of illnesses. Recently, though, it has become extremely popular in the USA, even though about half of US states either ban or severely restrict and regulate it, and it is not approved for any medical use by the US Drug Enforcement Administration. An estimated 5 million Americans use or have used kratom, with the 21-34 year old demographic reporting the highest use.

It is used at low doses as a stimulant to boost physical energy, focus and alertness, and at higher doses as an opioid-like pain and anxiety treatment, and also for opioid withdrawal symptoms.

The DEA has flagged kratom as a drug or chemical of concern, especially given that synthetic derivatives of kratom, which can be easily bought at gas stations, smoke shops and online, may be five to fifty times more potent than regular kratom. According to studies, "most people" who currently use or have used kratom have a substance abuse disorder, report cannabis use, or exhibit some kind of psychological distress or major depression, although it is not yet clear from the studies whether the kratom use or the mental health symptoms came first. Another area of concern is the ease with which minors can obtain kratom or its analogues.

So, there you go: kratom. Never heard of it, but lots of other people clearly have.

This is not the next pandemic

People can perhaps be forgiven for having panicky flashbacks to the early days of the COVID-19 outbreak six years ago (yes, six years!) But, rest assured, scientists tell us that this is a very different situation.

The outbreak of hantavirus on a Dutch cruise ship in the South Atlantic is a localized concern, and is being dealt with in a rational, sensible way. As a World Health Organization spokesperson put it, "This is not COVID, this is not influenza, it spreads very, very differently". This particular variant of hantavirus, known as the Andes Virus for its origins in Argentina, can spread from human to human, unlike most hantaviruses that require exposure to the urine, feces or saliva of infected rats and other rodents. But it does not spread easily, and it requires extended close-quarters or intimate exposure.

It is thought (but not proven) that the first cruise victim may have caught the virus while birdwatching at a garbage dump outside of Ushuaia, Argentina (birders!), before boarding the ship. He passed it on to his wife and then others, both husband and wife ultimately dying, along with a German woman. Thus far, a total of eight passengers on the small cruise ship have been infected, five confirmed by testing, three suspected. However, the incubation period can be as long as four to six weeks, so it is quite possible that more cases will show, especially given that, until the illness was diagnosed, passengers were eating, socializing and interacting together as usual on the ship.

Hantaviruses like the Andes variant cause generic flu-like symptoms (fatigue, fever, muscle aches, occasionally diarrhea and vomiting), which can make them hard to diagnose. In some patients it can then progress into a severe, sometimes deadly, respiratory infection. The death rate may be as high as 30-40%, although it is probably much lower than that in practice. There is currently no specific treatment or vaccine available, but medical care (including ventilators) can help.

Unlike COVID-19 when it arrived, hantaviruses are relatively well-known and studied, and they do not spread or mutate as quickly and easily as COVID. The hundred or so passengers on the cruise ship who may have been exposed to the virus are being monitored closely, and are being asked to stay in their cabins, which have been thoroughly disinfected. The remaining passengers will disembark at Tenerife, in the Spanish Canary Islands, where they will be isolated and medically assessed.

However, about 25 passengers have already disembarked at the South Atlantic island of Saint Helena, from where they have already dispersed to a dozen or so countries including Turkey, Singapore, New Zealand and the United States (you can fly to all those places from Saint Helena?) These passengers have been contacted, and their national health authorities will make the decisions about monitoring and quarantining.

So, worthy of close attention? Sure. Time to panic? Absolutely not.

A generational ban on smoking

I don't know anyone who likes smoking. Even people who smoke don't tend to like smoking. Most countries have been discouraging it (i.e. making it more unpleasant and more onerous) for decades now. There is a distinct stigma against smoking now. Hardly anywhere has actually banned it, though.

Britain is now part of an exclusive club that is moving to actually ban it. It's doing so by what is usually known as a "generational ban" on tobacco: a couple of weeks ago, Britain passed a law whereby anyone born after 1 January 2009 (i.e. those under 18 years old on New Year's Day 2027) will find it illegal to buy cigarettes or other tobacco products in British shops. Or rather, it is illegal for shops to sell cigarettes to them. Ever. 

The ban is to begin on January 1st 2027. Going forward, the legal age will increase by one year annually. Thus, by 2037, for example, no-one under the age of 28 would be allowed to buy cigarettes; by 2050, the age requirement would be 41.

So, the whole of the current younger generation - and subsequent generations, in perpetuity, at least in theory - will never be able to smoke (legally). This conjures up the prospect, one day, of a whole country where no-one smokes. Unless, of course, the law is later repealed - and you have to believe that it will be one day - smoking will be actively prohibited. 

Some are calling it the boldest public health move in generations. Healthcare advocates and cancer charities are lauding the bold move (smoking is one of the leading causes of preventable death, disability and ill health). Some conservatives are worried about its effects on employment in the industry, and others are howling about government overreach. But, in general, there has been a surprising consensus across the political spectrum, and it does seem like the legislation is indeed going through.

The only other country to have passed a similar law is the Maldives. New Zealand was on the cusp of it until a change in government derailed the legislation. Also, 22 individual towns in the US state of Massachusetts have also passed generational bans (although that does make it rather easy to evade...)

In the meantime, though, all eyes are on the UK. How will it be policed? How easy will it be to evade? How will stores check people's ages?  Will there be riots? How will black market smugglers be dealt with? How will the government cope without such a large tax generator? What about people with clinical addictions? (In theory, very few current under-18s should be addicts.) 

A large-scale social and medical experiment is going forward before our very eyes. It will be fascinating.

Trump selects a Surgeon General nominee purely based on merit

And now, right back to... Donald Trump. 

Trump's new nominee for the vacant position for Surgeon General is someone called Nicole Saphier. You probably won't have heard of her unless you watch Fox News. She's a radioligist (so, almost a doctor) who does an occasional segment on the right-wing news show in which she mainly engages in culture war issues, and only incidentally in "medical" matters, where she espouses some rather iffy stances on vaccinations and transgender ideology, among other things.

But you only have to see a picture of Ms. Saphier to get a pretty clear idea of why Trump selected her. The man has a certain recognizable style. Are you seeing a trend here?

I kind of feel sorry for the poor woman in some ways. How is she supposed to head up a huge medical bureaucracy with zero experience and not much medical knowledge? What could possibly go wrong? There again, she could always say no...

Don't skimp on your medications

A friend whose judgement I trust implicitly was talking recently about her niece who is a doctor in the UK. My friend also trusts her niece's judgement implicitly, so therefore so do I.

Anyway, the point is, this doctor had been kvetching about people who misuse everyday drugs (think, acetaminophen, ibuprofen) by not taking as much as they were allowed, according to the label. They may be worried about overdosing, or concerned about developing a tolerance, a dependence, an addiction, that kind of thing.

Well, my wife is that kind of cautious drug-user. So, given that she is now having to rely on extra-strength Tylenol (acetaminophen) to mask some pretty severe back pain, at least until her appointment with a pain management clinic comes through, I decided to check on the dosage rules and recommendations.

According to Harvard Health Publishing, which I'm also inclined to trust, one should "be cautious but not afraid" of Tylenol, and trust the dosage information on the label. Yes, people occasionally suffer liver damage and some even (very occasionally) die from overdoses, but you'd have to work very hard at it. Some small portion of the drug is converted in the body to a by-product that is toxic to the liver, but you'd have to take an awful lot to build up more than the body can handle. Also, unlike NSAIDS (ibuprofen/Advil and naproxen/Aleve), high doses of acetaminophen will not irritate the stomach and intestinal lining. As for President Trump and Robert F. Kennedy's conspiracy theories about Tylenol, treat them with the contempt they deserve.

The maximum recommended daily dose of acetaminophen is 4,000 milligrams (mg) from all sources, although 3,000 mg is recommended, to be on the safe side. 

So, if you are taking regular (325 mg) tablets, no more than 8 to 10 a day are recommended. The label suggests 1 or 2 tablets every 4 to 6 hours, which is about at the top end of the recommended daily dosage (although few people would continue taking them every 4 hours overnight, I think).

Extra-strength tablets are 500 mg, and no more than 6 a day are recommended. The label suggests 1 or 2 tablets every 6 to 8 hours. Some extra-strength tablets (e.g. for arthritis) are 650 mg, and no more than 4 a day are recommended. The label says take 1 every 8 hours (i.e. 3 a day).

So, as can be seen, the recommended dosages are quite conservative, and you'd have to be flouting them pretty cavalierly to run any risk at all of liver damage. So, don't skimp, take the recommended doses. You'll feel better and you're very, very unlikely to do any damage to your internal organs.

I don't recommend tattoos

I don't have any tattoos. I don't actually like tattoos; I don't find them cool or attractive. But they are ubiquitous these days, as much among soccer moms and college students as among gang members and criminals. And it turns out they are not risk-free.

Setting aside the risk of infection inherent in any procedure that involves piecing the skin, which can be largely mitigated by using a reputable and licensed tattoo parlour, tattoo pigments can interact with the body's immune system in ways we are only beginning to understand.

Tattoo inks are not biologically inert - some inks can contain heavy metals like nickel, chromium, cobalt, even lead, as well as organic compounds like azo dyes and polycyclic hydrocarbons aromatics. They remain in the body for decades, interacting with the sun and breaking down into other chemicals, potentially triggering allergic reactions, immune sensitivities, genetic damage and cancers. They can also reduce the effectiveness of certain vaccines.

Tattoo ink does not stay just under the skin; it can migrate through the lymphatic system and accumulate in the lymph nodes, structures that help coordinate immune responses. There is evidence from animal studies (although, as yet, not human studies) suggesting that tattoo inks can cause carcinogenic by-products as they degrade over time or from exposure to ultraviolet light or laser removal. Cancers can take decades to develop in humans, so definitive research is difficult.

And, just for good measure, here's something else tattoos can affect: your vision. Tattoos, particularly among the very young, can lead to tattoo-related uveitus, where the immune system reacts to tattoo ink, causing eye pain, light sensitivity and some vision loss.

So, it's not absolutely certain that tattoos are dangerous (except for the immuno-compromised). But the odds are pretty strong. I won't be getting a tattoo any time soon, although not necessarily for that reason.

Sure, learn to breathe better, but it's probably not going to change the world

I'm not big on medical self-help books, that oh-so-popular sub-genre of a popular genre. If someone has to resort to writing a best-seller rather than going down the much less sexy (and lucrative) route of double-blind experiments and the scientific method, if someone tells anecdotal tale after anecdotal tale, however fascinating, then I start to worry, I start to get suspicious, especially where large royalty advances are involved.

And if Product X or life-habit Y really is a panacea and the cure for all known ills, then it would probably be much better-known and already integrated into mainstream medical practice, wouldn't it? If something looks like snake oil and smells like snake oil ... well, you know the rest.

But occasionally something comes along under the radar. This particular something was suggested to me by my daughter, who has a higher degree in biology and is a pretty smart cookie. She's also a fellow skeptic, and I have a lot of respect for her opinions.

Anyway, pre-amble aside, I am currently reading Breath by James Nestor. Mr. Nestor is not a medical practitioner; he's a journalist and someone who has a long history of health issues which he claims to have miraculously cured - red flags straight away for me. But his work does seem to be pretty thoroughly researched, and replete with endless references and sources. His prose is accessible and compelling. And he's not actually selling anything, maybe apart from media appearances, professional speaking engagements, and his hosted retreats and classes... (The book itself was a bestseller.) So actually he is selling something, I guess, but, on the strength of my daughter's recommendation, I have persisted with Breath.

Nestor does indeed present correct breathing as the elixir of life and the single solution to conditions as varied as hypertension, hypotension, asthma, pneumonia, emphysema, insomnia, sleep apnea, headaches, ADHD, scoliosis, obesity, yes even cancer. He, and many of the practitioners and other people he quotes, claim that it can add decades to life spans, and coax significantly improved performances out of athletes and opera singers alike.

He approaches his life-changing revelations in the tried-and-tested journalistic manner, with dramatic "personal story" anecdotes, and his own health issues, his academic study participations, and his apparent Paulian conversion, very much take centre stage. He draws some pretty extreme and far-reaching conclusions from his experiences and his research, though. And hey, who wouldn't like to believe that something as simple as breathing through your nose might be the solution to so many societal ills and life-changing illnesses?

So, am I convinced? Well, the jury is still out. I might try some of his exercises, a little self-experimentation of my own (although my own medical issues are not particularly bad or life-changing at this point). I do remain a bit skeptical, though, particularly about the sheer breadth of Nestor's claims.

Nestor makes some extraordinary claims, so this requires extraordinary evidence, in my view. He does provide some evidence, but some of it dates back to the 1960s or the 1930s or the 1900s (and some of it MUCH older than that). Some evidence is very limited in scope, and some is definitely in the realm of the anecdotal. When he starts to tie in religious prayer and chants, Shakespeare's iambic pentameter, and ocean swells, for example, he definitely veers towards the realm of book-padding, and my eyes start to glaze over. If you ask me, it detracts from his main arguments. 

Then, when Nestor gets into.some of the more extreme, controversial, even dangerous, breathing routines - respiratory acidosis, sympathetic nervous system overload, holotropic breathwork, hypocapnia, extreme apnea, etc - he lost me completely, and I started to skip sections. To be fair, he is up-front about the contentious and risky character of some of these methods. But, in that case, why include them?

Yes, it makes some common and intuitive sense to me that breathing through the nose and slowing down breathing would be beneficial, for a whole host of reasons. But let's not make this all-encompassing and world-changing.

And now we need to think about "fungal storms"?

Fungal storms are not so much a storm of fungi, but fungi that spread through storms, and these events are becoming much more prevalent as climate change amps up the intensity and the frequency of storms. In particular, they are affecting the dry, dusty and hot south-west of America.

In south-western USA, storms often manifest as dust storms, where clouds of sand, soil and dust are whipped up by extreme temperatures, including the fast-moving walls of dust known as "haboobs". Construction, agriculture and wildfires also add to the particles carried in these intense storms. 

As well as dirty windows and hazy skies, these storms can disrupt air and ground transportation, agriculture, and solar power generation. They can also trigger heavy rain, flooding and mud flows. But it's now becoming clear that these storms also carry fungal spores from disturbed or contaminated soil hundreds of kilometers from where they were once safely buried.

Once airborne, these microscopic spores are easily ingested by humans and animals alike. Fungal infections are spiking in desert states like Arizona, California, New Mexico and Texas, but also even further afield, like Oregon, Washington, Colorado, Kansas. 

Infections from fungus species like coccidoides, aspergillus, candida auris, histoplasma capsulatum and blastomyces dermititidis are being found far from their traditional stomping grounds, making diagnosis tricky. They are expected to spread still further into the Midwest, even Canada, in the comimg decades. Coccidoides causes "valley fever" and severe pulmonary disease in some cases. Aspergillis, particularly drug-resistant strains, can lead to life-threatening infections in people with weakened immune systems. 

These dangerous species, of course, only represent a small fraction of fungi, the vast majority of which are harmless, even beneficial. But it's an important minority, and becoming ever more important.

Even teabags are full of microplastics

By now, we have pretty much come to understand that microplastics and nanoplastics.(collectively, MNPs) are everywhere, in the food we eat, the water we drink, the very air we breathe. Our bodies are therefore just full of them.

A recent meta-study shows just how many are entering our system through as innocent an activity as drinking a cup of tea. Setting aside MNPs in the water, MNPs leaching from the cup/mug/teapot, and MNPs from the packaging and processing operations, the studies show that the teabags themselves are a significant source of micro- and nano- plastics.

I try to avoid those fancy pyramid-shaped "silk" teabags, which are essentially made of nylon (i.e. plastic). Pour boiling water over them and you have to expect a flood of plastic bits to be released. But traditional "paper" teabags (which are actually primarily made of bleached wood pulp and abaca, a banana plant derivative) are also a source, made worse by the fact that many such paper teabags are treated with polypropylene, epichlorohydrin, etc, to help strengthen and seal them. Not even "biodegradable", "compostable" and PLA "bioplastic" teabags are exempt.

A single teabag, it seems, can release between 1.3 and 14.7 billion MNPs, depending on the study and the methodology. Those are huge and scary numbers, but they do not mean that teabags are killing us, merely that they are contributing to the plastic load in our bodies and the environment, which over time will degrade our health in subtle and opaque ways.

Makes you feel like throwing your hands up in despair and having a cup of tea, doesn't it? Oh, wait...

Another little-discussed Ozempic side effect

It seems like every time you read about Ozempic/Wegovy/semaglutide/GLP-1, it's being touted as the ultimate cure for pretty much everything. It's probably the most successful drug in the world, and many people are referring to it as the "everything drug" because it does seem to have an effect on many different conditions, not just diabetes and obesity.

The other times you read about it, though, is when some of the more unfortunate side-effects are discussed: Ozempic face, Ozempic ears, Ozempic butt, Ozempic breasts, Ozempic wallet, Oxempic hair, etc, etc. Gastrointestinal discomfort and nausea are the most common side effects, but these appearance issues are much more top-of-mind for many people. It seems like the rapid weight loss and, particularly, the loss of fat and muscle, causes pretty much everything to sag, wrinkle and loosen. Well, that might be the price people have to pay for the "good stuff", and who knows, it may not be a permanent or irremediable condition (although fixing it can certainly be difficult).

More recently, though, I have been reading about another commonly-reported side effect: intolerable itching. Red, itchy patches and/or swelling affect 3-8% of users, usually restricted to the injection site, but sometimes body-wide, depending on the individual. This may just be a reaction to the injection itself or to the drug, but it can be a big issue for some people.

Also, people seem to forget that Ozempic and other GLP-1 drugs, as well as reducing the craving to eat, also reduce any pleasure in eating they may once have had. Once-loved dishes may now taste disgusting to them, or best indifferent. This loss of the joy of eating is an underestimated challenge, and not one to be dimissed lightly. It may also lead to mental health problems for some people.

Just a reminder that miracles don't really exist (or, at least, come with complications).

Productivity and life expectancy are inversely correlated?

Here's an interesting, and probably statistically spurious, factoid: economic output per person seems to be inversely correlated with life expectancy.

Best illustrated by the graphic above (which I had to scan from the print copy of the Globe and Mail article for some reason), GDP per person - what you might call productivity - of G7 countries, in order, are: USA, Germany, Canada, France, Italy, Britain, Japan. Average life expectancy in those countries, IN REVERSE ORDER (worst to best) are: USA, Britain, Germany, Canada, France, Italy, Japan.

Almost an exact match (apart from Britain, which seems to manage poor productivity AND shorter lives).

While this is not necessarily a causative relationship, it COULD be. It is certainly a striking correspondence.

Why are oil prices spiking when the US is the largest oil producer?

If only 20% of the world's oil is shipped through the Strait of Hormuz, and that Strait is in dire straits due to the USA's war with Iran (and Iran's war with everywhere else), why are oil prices going through the roof?

Oil is currently (6th March 2026) hovering around $90 a barrel - $86, $88, $99, depending on which metric you look at - and is expected to leap past $100 very soon, levels not seen since the early days of the Russia-Ukraine war. It was below $60 just a couple of months ago.

Doesn't that seem like an exaggerated reaction? I mean, 80% of oil production still goes nowhere near the Strait of Hormuz. The USA is the largest single producer followed by Russia (here's a fascinating animation of how the main producers have changed over the years). But in terms of regions, the Middle East is still the biggest producer, followed by North America and then Russia and its satellites, and all of Middle East's production is being affected by the US-Iran conflict, regardless of how it is transported.

Another factor is the destination of the oil that flows though the Strait of Hormuz: some 89% of the oil that is shipped through the Strait is bound for Asia, and 83% of.the liquid natural gas. So, it's regional effect is much more marked than the overall average might suggest. The war in Iran is already causing  an energy crisis in South Asia. The markets take that into account too.

Oil is a global, fungible commodity. We are told to think of oil as the contents of a bathtub with many taps and many drains. So, regardless of who produces the oil (fills the bathtub) and who uses it (drains the tub), there is essentially one global price (a bath full of homogeneous water). Or here's another good explanation using a swimming pool analogy. So, if one part of the global supply becomes more expensive, say because of an unnecessary and ill-advised regional war, the price rises for everyone. The same applies to liquid natural gas, pharmaceuticals, helium, and any number of other commodities that typically use the Strait for delivery purposes. Such is the consequence of globalized trade.

Also, bear in mind that oil markets, like stock exchanges, do tend to over-react to everything before correcting themselves if the sky turns out not to be falling after all.

BC opts for permanent daylight saving time - but is that wise?

British Columbia is that brave Canadian province willing to put its money where its mouth is and do away with those tedious biannual clock changes. 

Several other provinces have been talking about it for years, but BC is actually making it happen. This comes after a "public engagement" (actually involving just 5% of the population) voted overwhelmingly (93%!) to adopt year-round daylight saving time.

It seems clear that few people really want the hassle of clock changes every six or eight months, but why choose daylight saving time (DST) not standard time (ST)? 

It's argued that people want longer, lighter evenings in the winter, and even that it will increase winter tourism, which seems like a bit of a stretch. 

Except BC's public consultations didn't even offer the option of permanent ST, only DST, so it's not known which option the populace would actually prefer. There's certainly a vocal contingent (minority? majority? who knows?) that would prefer to see ST become the year-round permanent time, and most health experts argue that, from a health and safety point of view, standard time, not daylight saving time, is much preferable (kids walking to school in the dark, sleepy drivers driving on dark roads, etc).

It's further argued by BC that DST would align better with neighbouring states Washington, Oregon and California, all of which also WANT to switch to year-round DST. But states require federal buy-in before they can make such a change - Donald Trump's personal seal of approval? Like he's going to offer California and Oregon anything they might want! - so BC is now out of sync with those states in the winter, at least for the foreseeable future. 

It's interesting that BC is more concerned with aligning with Western US states than with its eastern neighbour, Alberta. Alberta too is considering changing to year-round time, although the last referendum, in 2021, narrowly voted against it. Further to the east, Saskatchewan is already on permanent time - and has been since 1966! - but they chose ST, not DST, just to confuse things.

It will be interesting to see whether BC's unilateral decision opens the floodgates on clock-changing in Canada. Whether it's the "right" decision or not remains to be seen - I'm sure there's an army of chronologists, health researchers and statisticians out there monitoring its every move.

Trump's "great hospital boat" is a joke ... right?

I thought this was precious. Just when you thought he had finally understood the situation in Greenland, Donald Trump has despatched "a great hospital boat" to Greenland to service the many Greenlanders he says are "not being taken care of". This is presumably his idea of a PR coup of some sort.

In fact, Greenlanders have pretty good healthcare, provided free by Denmark. There are five regional hospitals across the island to care for the scattered population of 56,000. Any more complex cases that cannot by dealt with by the main hospital in Nuuk are sent for treatment in Denmark, also free of charge. Denmark has one of the best healthcare systems in the world, better than countries like the UK, France and Spain.

But this is best of all: coincidentally, just this weekend, Denmark's Arctic Command revealed that it had evacuated a crew member of a US submarine off the coast of Greenland who required urgent medical attention for treatment in Nuuk.

It all sounds like a comedy sketch to me.

What is Influenza D, and should we be worried about it?

Influenza D has, historically, mainly affected farm animals like cattle and pigs, but there is evidence that it is now spreading through the human population. It has been found among farm workers, in hospitals, and even in airports. It spreads stealthily and quickly, barely triggering immune alarms. Infectious disease scientists are concerned that it might mark the start of the next global pandemic, and some are calling it "a legitimate pandemic threat requiring immediate surveillance".

Researchers have found that Influenza D replicates in human lungs just as efficiently as seasonal flu, but it had learnt to suppress the cellular alarm systems that normally alert the immune system to viral infection, allowing it to take hold and start replicating before normal defences can kick in.

Thing is, though, unlike the usual symptoms of seasonal flu - fever, aches, cough, runny nose - Influenza D has very mild or even no symptoms at all. So, people can go about their normal business while potentially spreading the virus to others unknowingly - ideal pandemic conditions.

But, if it usually has few or no symptoms, why should we even worry about it? Well, scientists worry that it could learn to exchange genetic material with other viruses, allowing it to mutate into something more concerning for humans, and it could evade immune responses and antiviral interventions.

Well, maybe. But this is still very much in the realm of "what if". It may spread widely with little or no injurious symptoms. Or it may mutate, a little or a lot. Or an entirely different virus may appear on the scene with much greater pandemic potential. It's good that scientists are monitoring these things, but to call Influenza D the next big pandemic threat is probably a stretch.