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17 September 2021
1. "Nonradiological Health Consequences From Evacuation and Relocation":
The U.S. Nuclear Regulatory Commission (NRC) published this document this month. It is an important review of the scientific literature "to examine negative health effects in evacuated and relocated populations in response to various emergencies, including nuclear power plant accidents." They reviewed over 1200 papers, identifying 209 with quantitative information on 14 health effects that were subsequently analyzed. (The statistics are rather complicated; reference available upon request. Or just "google" the above title plus "NRC"!) Of the 14 health effects analyzed, significant increases in prevalence were noted in 9, ranging from depression and diabetes to mortality, PTSD, sleep and weight problems, and others. Prolonged displacement exacerbated these health effects. The report suggested that "evacuation and relocation should not be used purely out of an abundance of caution" and that "[f]or radiological emergencies, protective actions are risk-informed and [can be] carefully planned to ensure the benefit of avoiding or reducing exposure to radiation is not outweighed by the risk to health from a protective action."
For this week's trivia question: for which of these nuclear and radiological incidents would potassium iodide be used as a treatment: nuclear weapon, breached reactor, explosive radiological dispersion device (RDD), or a covert RDD?
2. DHS Master Question List for COVID-19 (caused by SARS-Cov-2):
The most recent monthly update is dated 7 September 2021. Updated topics from the 13 August report include:
a. Infectious dose--unknown. Symptom severity may be dose-dependent.
b. Transmissibility--the viral load transmitted by a "breakthrough" infection in a vaccinated person is similar to the load from an infected unvaccinated person. However, vaccinated persons have a lower load in their own respiratory tracts.
c. Host range--cases of animal to human transmission are rare. However, an asymptomatic, vaccinated Atlanta Zoo worker, who was wearing her protective gear, transmitted the infection to 13 lowland gorillas. Their symptoms were mild coughing, runny noses, and loss of appetite. Infections were confirmed by fecal samples and nasal and oral swabs (don't ask me how this was accomplished!!) Monoclonal antibody treatment has begun, starting with the most senior gorillas. No deaths so far. COVID-19 has been known to infect tigers, lions, snow leopards, cougars, mink, and domestic cats and dogs.
d. Incubation period--estimated range is still 2-14 days for most. Average time between successive cases (serial interval) is around 5 days.
e. Acute clinical presentation--approximately a third of infected individuals remain asymptomatic.
f. Chronic clinical presentation--symptoms can persist for weeks to months in as many as three-fourths of cases. Duration tends to be shorter in infected vaccinated vs. infected unvaccinated persons.
g. Protective immunity--reinfection with SARS-CoV-2 is possible but appears rare. Antibody response is higher in previously infected vs. vaccinated persons, though a booster shot to the former increases antibody response.
h. Vaccines--breakthrough infections are associated with milder illness. They are more common in patients with comorbidities. So far breakthroughs appear more frequent in variant cases than non-variant.
3. Mu (pronounced "moo") variant:
This is the most recent SARS-CoV-2 variant of interest. It comprises 0.1-0.2% of all U.S. cases at present; Delta accounts for 99%. Public Health England believes it is more resistant to vaccines. Although Mu is more transmissible than the non-variant virus, it does not appear to be as infectious as Delta.
4. "Misinformation", narrative-driven data analyses, and mandated medicine:
Recently the UK Joint Committee on Vaccination and Immunisation reviewed a study reporting that "teenage boys are six times more likely to suffer from heart problems from the vaccine than be hospitalised from COVID-19" and cited the numbers (162.2 per million "heart complications" in boys aged 12-15, 94.0 in boys aged 16-17, 13.4 in girls aged 16-17, and 13.0 in girls aged 12-15.) But "the risk of a healthy boy needing hospital treatment owing to Covid-19 in the next 120 days is 26.7 per million." They concluded that the "margin of benefit" of jabbing 12- to 15-year-olds was "considered too small", citing the low risk to health children from the virus. What amazed, and angered, me were the vituperative and profane ad hominem attacks on the authors in the Comments section. The Health Secretary even said he wanted the medical officers to "consider the vaccination of 12- to 15-year-olds from a broader perspective". (The NHS had already started recruiting thousands of vaccinators for the schools prior to the report.) On this side of the Atlantic several medical societies and the Federation of State Medical Boards have stated that "providing misinformation about the COVID-19 vaccine contradicts physicians' ethical and professional responsibilities." Apparently it is "unethical" to have an opinion, even if data-based, that deviates from their current medical consensus. More on this next week. (Source for this report is a doctor who consistently advises his patients to get vaccinated.)
5. Medical WMD Trivia:
Besides Egypt, North Korea has also not signed the Chemical Weapons Convention treaty. Marcia Hartmann and Pat Hebert also mentioned South Sudan, which I hadn't been aware of. Congratulations and thanks to both!
Some interesting history: the earliest recorded use of nerve agents came from west Africa, where the Calabar bean was used as an "ordeal poison"; those accused of witchcraft were forced to ingest the bean. If they survived, they were declared innocent! The active principal was isolated in 1864 and called physostigmine. Physostigmine reversibly bound to cholinesterase (ChE). In 1854 the first organophosphate (OP) ChE inhibitor was synthesized. It bound irreversibly to ChE. Scientists discovered that the reversibly bound inhibitors, or carbamates, could be used in the medical treatment of intestinal atony (intestines don't move), myasthenia gravis, and also glaucoma. But the OP ChE inhibitors couldn't be removed from the receptor binding sites, and could be used to poison insects--and human beings. The first one, tabun, was made in 1936. Sarin was synthesized a year later. Eventually five OP agents were synthesized, and then a sixth one, VX, which was more environmentally persistent. Though available for battlefield use during WWII, they weren't used in combat until Iraq used large quantities of tabun and sarin against Iranian forces in the 1980-1988 war, causing between 45,000-120,000 casualties (Textbook of Military Medicine: Medical Aspects of Chemical Warfare). Most of these are specifically mentioned in the Chemical Weapons Conventions (CWC). But the most recent OP nerve agent, not yet named in the CWC, is Novichok. Novichok may be dispersed as an ultra-fine powder, not a gas; hence it is effective in aerosols and also absorption by the skin. It is also more treatment-resistant.
To your health,
Rad Doc Consultant, Inc