Tom Barrett Says "Scott Walker wants to ban common forms of birth control, including the pill.

Explanation: Tom Barrett says Scott Walker wants to ban the pill and other forms of birth control

Abortion, Message Machine 2010, Wisconsin, Tom Barrett,

Democrat Tom Barrett is using the last days of the Wisconsin governor’s race to paint Republican rival Scott Walker as a radical conservative, with abortion and women’s reproductive rights the centerpiece of his argument. Barrett first criticized Walker’s no-exceptions stance against legal abortions. In a new TV ad, Barrett repeats that claim and then adds this one: "It turns out there's a lot we didn't know about Scott Walker," a narrator says as an image of a birth-control pill case dominates the screen. "Scott Walker wants to ban common forms of birth control, including the pill." We rated as Barely True a claim by Planned Parenthood of Wisconsin that Walker "tried to pass a law to allow pharmacists to block women's access to birth control." That claim centered on a bill that would let pharmacists refuse to dispense contraceptives on moral grounds. Barrett’s new claim goes much further. An outright ban on birth control? As evidence, the Barrett campaign points to an endorsement Walker received by the group Pro-Life Wisconsin (running mate Rebecca Kleefisch was endorsed, too) and a questionnaire he filled out before receiving it. There was little surprise when Walker won the endorsement of Wisconsin Right to Life, the state’s largest anti-abortion group. But the smaller, more staunchly conservative Pro-Life Wisconsin says it has not endorsed a gubernatorial candidate for years. It insists that candidates, to get the endorsement, perfectly line up with its views as expressed on a survey. Walker campaign spokeswoman Jill Bader said the survey, which Walker scored 100 percent on, does not include any birth control questions. That’s not quite true. It includes one that asks the pharmacist question and one that asks if candidates would block minors from receiving taxpayer-funded contraceptives. Walker answered yes to both. Barrett’s campaign, though, points to the first question on the survey:  "Would you sign legislation that declares that a preborn child has an inalienable right to life from the moment of fertilization forward?" Some background:  The question refers to "personhood" rights, a growing national movement in some pro-life circles to use state laws or state constitutions to bestow full citizenship rights and protections to the unborn. Pro-Life Wisconsin and related groups in other states oppose all forms of artificial birth control, They hope that "personhood" rights will bring a ban on all abortions -- and a ban on the pill, the group’s legislative director Matt Sande told PolitiFact Wisconsin. Other anti-abortion groups have focused on a more direct route: The U.S. Supreme Court, which in 1973 held that a woman's decision to have an abortion is a private choice that is protected by the U.S. Constitution. That Roe vs. Wade decision still defines the issue. Pro-Life Wisconsin’s definition of pregnancy as starting at fertilization differs from the worldwide mainstream view that it begins when a fertilized egg implants in the uterus, said Raj Narayan, Medical College of Wisconsin physician and associate professor of obstetrics and gynecology. Birth control pills work, when used properly, by preventing ovulation, not by preventing implantation of a fertilized egg, he said. In theory, birth control pills could prevent implantation, but it is unprovable scientifically, Narayan said. In the view of Pro-Life Wisconsin, there are cases -- even if a very small percentage -- where a fertilized egg (already a full citizen, under the theoretical legislation) is prevented by the pill from attaching to the womb. That, they say, constitutes an abortion. In contrast, Wisconsin Right to Life views the idea that the pill causes abortions as "speculation," according to executive director Barbara Lyons. The view is disputed, too, by the mainstream medical community, as Narayan noted. What’s important for our evaluation, though, is the political realm. Did Walker know about -- and agree with -- the group’s views on birth control as causing abortion? For the 2010 election, candidates were given survey instructions and a memo entitled "Hormonal Birth Control and its Abortion Causing Effect," according to Sande. That memo clearly lays out the group’s view that "any artificial action that works to destroy a human embryo is abortifacient in nature." It lumps "most if not all birth control drugs and devices" into that category. Sande downplays the chances Pro-Life Wisconsin will succeed in its anti birth-control agenda because it believes society is not ready for it. But a birth control ban is the group’s aim. Its mechanism to get there is "personhood" legislation -- Question 1 on the candidate survey. Since 2006, the group has been laying the groundwork for its proposed constitutional amendment. Elsewhere, such efforts are further along. Colorado voters will consider a "personhood" amendment in the Nov. 2, 2010 election. We wanted to ask Walker to clarify his view on the topic. The campaign did not make him available. In an e-mail, Bader said: "Scott is pro-life. He believes that government has no role in whether adults choose to use birth control or not. This was Scott’s view of that question on the survey." She noted -- as do we -- no direct question on a birth control ban was asked. Barrett’s side countered that the implications of the question were made clear. Said spokesman Phil Walzak: "They want to currry favor and get that 100% rating, but when they are called on it they hedge." Where does the group asking the survey question come down? Sande, of Pro-Life Wisconsin, agreed Walker signed onto the concept based on his answer, but said he thought it would be unfair to draw the conclusion Walker supports a particular "personhood" initiative. After all, no proposed language was given. And the birth-control ban is not part of the group’s immediate legislative agenda. Now it’s our turn. The Barrett campaign makes a strong claim against Walker, saying he supports a ban on commonly used contraceptives. It bases its statement on a survey by Pro-Life Wisconsin that did not ask that question directly. Rather, Barrett -- and the group -- say it is embedded in a question about a potential legislation on "personhood," that is giving full human rights at the moment of fertilization. In viewing the pill as abortion, not just birth control, there is no question the group is out of step with medicine -- and the larger group, Wisconsin Right to Life. Barrett argues by supporting the question in the survey, a candidate signs on to this view as well. Walker’s campaign disputes this. Walker did, however, did get the group’s memo which clearly outlined its views and goals. Did he read it? He should have if he is answering the group’s questions. Ultimately, we don’t know -- and neither does the Barrett campaign, which leaves out important details in its hard-line statement. We rate the claim .


Players’ mental health becoming major issue in cricket.

Explanation: A serious health concern is emerging in Australian cricket. The first test of the home summer starts in Brisbane next week and Australia has three players out of the selection frame because of mental health reasons.

Virat Kohli, Cricket, Australia, Mental health, Brisbane, General News, Sports - Asia, India

Veteran allrounder Glenn Maxwell and ex-test batman Nic Maddinson made themselves unavailable for the series against Pakistan before 21-year-old Will Pucovksi informed selectors that he didn’t want to be considered for national duties. Pucovski was playing in an Australia A tour game against Pakistan in Perth when he made the call, and the decision was announced Thursday, hours before Australia’s chairman of selectors, Trevor Hohns, was due to announce the test squad. The mental health issue isn’t isolated or, seemingly, new in cricket. Senior England batsmen have left tours going back more than a decade because of mental health issues. And India captain Virat Kohli spoke openly this week about his own struggles. Kohli is one of the world’s premier batsmen and respected leaders, and is involved in a home series against Bangladesh. “I’ve gone through a phase in my career where I felt like it was the end of the world,” he told a news conference in India. “In England 2014, I didn’t know what to do, what to say to anyone, and how to speak and how to communicate. And to be honest, I couldn’t have said ‘I’m not feeling great mentally and I need to get away from the game.’ Because you never know how that’s taken.” That kind of statement is being taken seriously by the sport’s administrators now. Cricket Australia national teams manager Ben Oliver commended Pucovski “for having the courage to discuss his situation.” “Will’s decision not to nominate for test selection was the right one in the circumstances,” Oliver said. “By Will bravely taking this position, he will undoubtedly inspire others facing similar challenges to speak up and take positive steps toward improving their mental well-being. “The most important thing now is for Will to be given the time, space and expert support that he needs to return to full health as soon as possible.” The 31-year-old Maxwell, who has played seven tests, 110 one-day internationals and 61 Twenty20 internationals, has been in and out of the Australian team throughout his career. He withdrew from selection during a series against Sri Lanka last month. Maddinson, who was rushed into the Australian team against South Africa in 2016, has played three tests but didn’t appear comfortable at the highest level of the game. He ruled himself out of national selection not long after Maxwell’s announcement last month. Pucovski played the first of his 18 first-class games in 2017. He has a high-score of 243 and a first-class average of almost 41. He was set for a test debut in January but withdrew, citing mental health issues. He was back in calculations for this southern summer before making the same call. Cricket Australia’s sports medicine manager, Alex Kountouris, said player welfare was paramount. “There is much society still needs to learn in relation to mental health, but we know enough to say with great certainty that silence is not the answer,” Kountouris said. “Will has demonstrated great strength in being open about his situation. While no one wants to see a fine young man like Will confronting mental well-being issues, we are heartened by the fact he is surrounded by excellent people who will support him.” Kohli described the example set by Maxwell as “remarkable.” “He set the right example for cricketers all over the world — that if you’re not in the best frame of mind, you try and try and try, but as human beings you reach a tipping point and you need time away from the game,” Kolhi said. “These things should be respected and not taken in a negative way. “This is happening on a human level, it’s got nothing to do with what you do on the field. It’s not having the capacity anymore to deal with (everything), which I think can happen to any person in any walk of life.” Ex-England captain Marcus Trescothick quit a tour of India in 2006, initially cited a viral problem, but later said it was related to mental health. “I didn’t have a clue what was happening. I wasn’t aware of depression but whatever was going on, I didn’t want to have to say anything about it on TV,” Trescothick told Men’s Health magazine in 2016. “I was terrified. “There was a lot of naivety and ignorance. People would say ‘What do you have to be depressed about? You play cricket for England. You travel the world. You get paid well.’ To try and experience the dark place when you’ve never experienced it is very tough.” England opener Jonathan Trott left an Ashes series in Australia after one test in 2013, saying later he’d struggled in the previous series and didn’t know how to cope. So-called mental toughness has long been a part of cricket, where sledging — often nasty banter between players — was a fundamental part of the game. That has been changing over the last decade. Cricket Australia has had a full-time sports psychologist working with national teams and player development squads. Robert Craddock, a long-time cricket analysist and television host in Australia, said cricket was facing a mental health crisis. He said while it may not be a contact sport “its mental challenges, with so much waiting time, are much tougher than they look.” “Even though cricket is only starting to go public with its mental issues, it has always been a supremely demanding mental game,” Craddock wrote in a column for News Corp. “The victory of the current crisis is that at least players are talking. “If the current issues have taught us anything it is that success and failure can sometimes have little to do with it, and that the causes of the anguish are many and varied.” ___ More AP sports: https://apnews.com/apf-sports and https://twitter.com/AP_Sports


President Obama has changed the Oath of Allegiance so that new naturalized citizens don’t have to pledge to take up arms to defend the U.S.

Explanation: The death toll from a strong earthquake in the southern Philippines has risen to seven, disaster and police officials said on Tuesday, as aftershocks continued to jolt many parts of Mindanao.

The 6.6 magnitude quake hit early on Tuesday, damaging buildings, toppling power lines and triggering landslides in the central area of the Philippines’ southern island. A seven-year-old child and his 44-year old father were among those who were killed in the North Cotabato province after they were struck by a boulder, disaster officials said. Authorities said the death toll could rise further because many injured were not immediately brought to hospitals. “It was depressing to see the damage left by the earthquake,” Abril Espadera, a disaster official in North Cotabato, told Reuters, as he recalled seeing collapsed homes and demolished buildings in the province, including schools. Smaller tremors rattled nervous residents throughout the day and those who were afraid to return to their homes set up tents to shelter near school yards, Espadera said. In Magsaysay town in Davao del Sur province, rescuers were trying to recover three bodies after landslides in two separate towns swallowed parts of agricultural areas, police said. The quake, whose magnitude was initially put at 6.7 by the European-Mediterranean Seismological Centre, was the second powerful quake to strike Mindanao in two weeks. Authorities had flagged the risk of landslides after the 6.3 quake on Oct. 16 in central Mindanao that killed seven and injured more than 200. Earthquakes are common in the Philippines, which is on the geologically active Pacific Ring of Fire. Power cables swayed in Davao city, the home town of President Rodrigo Duterte, where people rushed to open spaces, and some fainted out of fear. The quake also triggered power cuts in nearby General Santos city, media said. Some schools in the area have suspended classes. Duterte’s office has called for calm as it mobilized all government agencies to undertake damage assessment and to coordinate rescue and relief operations.


Profit-hungry tiger breeders behind push to lift China’s trading ban.

Explanation: At the Siberia Tiger Park in the frigid Chinese city of Harbin, visitors can learn about the facility’s successful breeding programme and buy chicken carcasses to toss to around 20 tigers pacing the snow flecked ground of their enclosure.

At the park gates, a shop sells liquor soaked with tiger bones for up to $1,000 a bottle. China has made significant strides in wildlife protection in recent years, including a total ban on ivory and plans to open one of the world’s largest reserves for wild tigers in northeast China in 2020. But it also has formidable, profit-driven wildlife business interests that risk undermining progress on protecting the endangered big cats, conservationists say. “The industry occupies a strategic position which concentrates in the country’s less developed regions where poverty reduction remains a top priority of the local authorities,” said Houston-based Peter Li, a China Policy Specialist at Humane Society International. Operators of tiger breeding farms have told state media that without the ability to sell bones, skins and meat they are not be able to cover the high costs of running their parks and carry out key conservation plans endorsed by the national government. After pressure from some breeders, China’s State Council said in October it would replace a 1993 ban on the trade of tiger bones and rhino horn, opening up exceptions under “special circumstances”, including medical research. But in November, Beijing postponed the move following widespread protests from conservation groups who worry any resumption in the legal trade of tiger parts will be a death knell for the species by enabling the laundering of wild animal parts into farmed supplies. Conservationists also argue that no captive Chinese bred tigers have been released into the wild and there is no scientific or medical need to use rhino horn and tiger bone in traditional Chinese medicine. Still, lifting the ban is backed by China’s powerful State Forestry and Grassland Administration. “If rhino horns and tiger bones can be used for medicinal purposes, and their use causes zero harm to the two endangered species in the wild, why should we oppose it?” Tang Xiaoping, an executive at the administration was quoted in the state-run China Daily newspaper. The Forestry and Grasslands administration did not respond to multiple requests for comment. PROFIT-DRIVEN BUSINESS  At the Siberia Tiger Park, tiger bone wine is sold openly and is recognized by the Forestry Bureau and Commerce Ministry, according to a sales representative in the store. However, the park is not allowed to publicly promote it due to the sensitivity of the situation, the sales rep said. Officials at the park declined to comment on the record. The wine, which ranges in price from 280 yuan-6,888 yuan,  ($40-$1,003) is displayed in large glass cabinets and also sold on China’s Twitter-like WeChat. Park executives, officials and conservation experts say tiger parks have been accumulating stocks of animal skin and bone in freezers, with the aim of selling it for medicinal use in the future. Conservation groups estimate there are now over 6,500 farmed tigers at some 200 facilities in China and around 40 farmed rhinos. Chinese media say tiger bone can fetch 5,000-9,000 yuan ($727-$1,308) per kg - tens of thousands of dollars per animal. The World Wildlife Fund believes there are only around 40-50 wild tigers left in China out of around 3,900 globally. Debate over lifting the ban on tiger trade comes as China seeks to develop its traditional medicine industry, worth some $50 billion annually, and position it as a key pillar of its ‘One Belt One Road’ strategy. The World Health Organization is set to recognize traditional Chinese medicine for the first time next year in its global medical compendium according to Nature International Journal of Science, citing the governing body. The Siberian Tiger Park has more than 1,300 tigers spread across three locations. Selling tiger bone wine is a way to subsidize the daily expenses of the park, said one of the park’s tour guides. Currently, visitor fees are the parks’ main source of income, along with government subsidies. Ticket prices are 100 yuan and visitors can pay extra to feed the tigers. A menu of meat displays prices for a live chicken at 120 yuan while a raw cutlet is 10 yuan. In a CCTV documentary shown in November, Liu Dan, the chief engineer of the Northeast Tiger Forest park, near China’s border with Russia, says his 1,000-plus tigers each eat around 3,000 yuan ($435) worth of chicken per month. Liu, who has raised tigers for over 30 years and has repeatedly called for the ban on trading tiger parts to be lifted, told state media that government tax breaks are not enough for the park to be financially viable. Currently, parks make most of their money from visitors. Liu and the park declined to comment for this article. Chinese medicine experts say there is no need to use tiger bone and rhino horn in treatments as substitutes are readily available. Tiger bone, for example, is often used to treat arthritis and joint pain, but there are dozens of other herbs with similar properties, said Eric Karchmer, chief medicine officer at Dao Labs. Lixin Huang, the president of the American College of Traditional medicine, said a reversal of the ban would create a huge challenge for the Chinese medicine community. “We stopped using it 25 years ago. We don’t understand. I don’t think the Chinese medicine community and medical professionals would understand.”


Talk Therapy Found to Ease Schizophrenia

Explanation: Update: The Times has issued a correction to this story. The correction states that the story erroneously claimed that the experimental approach in the study used lower drug dosages. “Though it studied a program intended to reduce medication dosages, the researchers do not yet know for sure if dosages were lowered or by how much,” the correction notes.”Therefore, the study did not conclude ‘that schizophrenia patients who received smaller doses of antipsychotic medication and a bigger emphasis on one-on-one talk therapy and family support made greater strides in recovery.’ (The study did conclude that the alternative treatment program as a whole led to better outcomes. )” We changed the headline of our review from “Times captures impact of new, less drug-intensive schizophrenia treatment” to “Times explores impact of integrated care model for schizophrenia treatment.” The correction does not affect our ratings for the story, but the references we made in the review to the lowered drug dosages are no longer appropriate and have been stricken. In addition, the tone of the review would have been more circumspect had we known that the intended reduction in drug dosages had not been confirmed by the researchers. In a large randomized controlled trial in 34 community clinics across the U.S., researchers compared usual care for first episode psychosis with a program of integrated care that included not only drugs, but also help with school and work, family education about the problems and how best to help, as well as one-on-one talk therapy. The government (National Institute of Mental Health)-funded study found that those receiving the integrated program of care experienced more symptom relief and functioned better than those in the treatment-as-usual group. Their doses of medication were also 20-50% lower. Those receiving treatment earlier on in their psychotic episodes also did better. The story overall does a solid job of covering the study and its implications. But we wish it had pushed a bit harder to quantify the benefits shown in the 2-year trial with some hard numbers. We applaud the discussion of federal policy and financing, but also wish there had been some discussion of the costs of therapy itself. The inclusion of a variety of perspectives on the research brings depth and nuance to the coverage. Psychiatric treatment in the U.S. has become very drug focused. Other countries are ahead of us on using more integrated care models like the one described in this story, so it’s great to see its success “proven” with a randomized trial. With solid evidence to back it, this model will hopefully become a more accepted approach to practice in the U.S.

anti-psychotic drugs,mental illness,schizophrenia,talk therapy

The story does not touch on costs for the more comprehensive treatment — including educating families and providing more counseling for patients. True costs and potential savings would be very hard to quantify, and would accrue over time as people hopefully stay in school and jobs, and have fewer admissions to the hospital etc. Even if the story couldn’t address these issues precisely, some mention of them would have been helpful. We do applaud the story for exploring the political and reimbursement context. This was especially good: Its [study] findings have already trickled out to government agencies: On Friday, the Centers for Medicare & Medicaid Services published in its influential guidelines a strong endorsement of the combined-therapy approach.Mental health reform bills now being circulated in Congress “mention the study by name,” said Dr. Robert K. Heinssen, the director of services and intervention research at the centers, who oversaw the research. The story says drug doses were 20-50% lower, which is a very big deal considering the side effects of these drugs. But overall it leaves us hungry for numbers. It says patients in the therapy group, who received more one-on-one talk therapy and family counseling “made greater strides in recovery over the first two years of treatment than patients who got the usual drug-focused care.” But nowhere in the story does it tell us how “strides” were measured or give us a percentage by which they exceeded those for the control group. It would have taken some additional legwork to find these numbers, which were not reported in plain English in the study itself. But the paper did report some numbers that were very easy to understand and were not mentioned in the story: “Over the 2 years, 34% of the NAVIGATE group and 37% of the community care group (adjusted for length of exposure) had been hospitalized for psychiatric indications (not significant).” We wished the story had pressed the study authors more about this. It’s conceivable that changing the standard of care for patients by reducing drug doses may carry some risk. Could some patients’ symptoms be less-well controlled? Then again, drugs are very much overused in this area. And on average the study showed better symptom relief with the lower doses. No harms were documented in the study–no increase in hospitalizations at least. So while we can’t give credit here, we won’t ding the story either. We’ll rate it Not Applicable. While we would have liked a few more numbers, the story does explain that the comprehensive study included many clinics nationwide and two years of follow up on 404 patients. Since schizophrenia is a chronic condition, studies going beyond two years would help solidify these results — and the study itself mentioned that the researchers plan to follow patients out to five years. Overall, however, we think the description of the evidence is sufficient to warrant a Satisfactory rating. There was no disease mongering. The story quotes experts who were not authors on the study. There were good explanations of the two alternatives being compared by the research itself — the drug-focused standard and the more comprehensive integrated care. The story touches on availability when it says, “In 2014, Congress awarded $25 million in block grants to the states to be set aside for early-intervention mental health programs. So far, 32 states have begun using those grants to fund combined-treatment services, Dr. Heinssen said.” That doesn’t provide as much detail as readers might like as to when and where they might find these services, but it gives a general idea of where things stand. The story makes it clear that this was the most rigorous trial of this particular version of treatment in the United States. It notes that such treatment has been more widely used in Europe. The story shows original reporting and does not rely on a news release.


Prostate Cancer Studies Find Benefit in Daily Acetaminophen and Brisk Walks

Explanation: Here’s some of what was missing in the story:  Not all prostate cancers are equal. So the acetaminophen/aggressive cancer study – especially – required some perspective; Observational studies can’t prove cause and effect. So a headline that says “studies find benefit” is wrong. You can’t prove benefit when you can’t establish a causal link. There was no evaluation of the quality of the evidence. Without knowing the screening history and risk factor profile of the aceteminophen users, it is very difficult to interpret the observed association. Cancer progression is a very heterogeneous endpoint and the article did not address this issue or report meaningful results (absolute risk). There’s been a lot of prostate cancer news in the past two weeks, largely because the American Urological Association annual conference was just held. But are we really telling men something they need to know with a story like this? Or are we just turning up the force on the firehose of information that we flood readers with?

Not applicable. Cost is not much of an issue here. We think a story like this should present raw numbers. So, instead of: Why not explain 38% of what baseline? And 51% of what baseline? Projected benefits may be exaggerated by presenting them in the manner of this story. No drug – not even acetaminophen – is without risk. So, when the story starts in cavalier fashion – “Pop a Tylenol…” it should also find time and space somewhere to mention that popping pills comes with some risk – especially given that the safe daily maximal dose of acetaminophen has been lowered in recent years. There was NO evaluation of the quality of the evidence. There is not one word about the limitations of such observational studies – on walking or on acetaminophen use. Aside from general problems with adjusting for confounders in observational studies, both exposure measures–exercise and acetaminophen use–were self-reported and thus of uncertain validity. Also, interpreting “daily use” is difficult–is this one pill a day, the maximal dose, somewhere in between? Do you have to use acetaminophen for 5 consecutive years or just a total of 5 years? Another issue related to acetaminophen is that for a variety of medical conditions (kidney disease, heart failure, gastrointestinal bleeding), the non-steroidals are contraindicated and so patients are preferentially placed on acetaminophen. Sicker patients may also be less likely to be screened for cancer, so the observed “protective” effect could be quite spurious. Further, the column lifted material from another news source (MedPageToday): The casual reader may assume that the study actually analyzed such physiological reactions, which it did not. The researchers projected interesting hypotheses, but they should have been labeled as such. We do think there was a subtle element of disease mongering in this story. The facts at the end are all correct – “Prostate cancer is the second leading cause of cancer death in men. According to the National Cancer Institute, about 32,050 men died from prostate cancer in 2010 and 217,000 new cases were diagnosed. More than 2.2 million men in the U.S. are living with prostate cancer.” But there is no context given about prostate cancers not being the same as other cancers – that many are not killers – that many men die WITH prostate cancer, not FROM it. And crediting acetaminophen for a “51% reduced risk of developing an aggressive form of the disease” without every quantifying how relatively few men develop an aggressive form of the disease among the 217,000 new cases diagnosed each year is not helpful. 51% of what? No independent expert source was cited to comment on either finding. Neither finding was put into the context of other treatment/prevention approaches for prostate cancer. For example, the 5-alpha reductase inhibitor drugs (finasteride and dutasteride) have been rigorously evaluated for chemoprevention. Not applicable. There’s no question about the availability of the two “interventions” – walking and acetaminophen. The story explained that there’s been prior research in both fields – studying effects of anti-inflammatory drugs and walking on prostate cancer. So it didn’t inappropriately paint either pursuit as totally new. Not applicable because no one was directly interviewed and quoted. The story did draw from another news source – MedPage Today – but we don’t know if any original reporting was done.


John Bel Edwards Says of the coronavirus threat, “there was not a single suggestion by anyone, a doctor, a scientist, a political figure, that we needed to cancel Mardi Gras.”

Explanation: The Carnival season in New Orleans kicked off early January and ended Feb. 25. There were few coronavirus cases in the United States at the time, and health officials then said there was no community spread. The earliest indication we found from a federal agency saying that large events may need to be canceled came Feb. 26, after Mardi Gras celebrations.

Public Health, Public Safety, Coronavirus, John Bel Edwards,

Louisiana Gov. John Bel Edwards on CNN was asked whether Mardi Gras celebrations in his state should have been called off earlier this year, in light of Louisiana now being considered a hotspot in the coronavirus pandemic. In New Orleans, the Carnival parades and celebrations started early January and ended Feb. 25 on Mardi Gras (Fat Tuesday). It’s estimated that more than 1 million people go to New Orleans annually for the Carnival season and experts now believe the festivities fueled the outbreak. "The biggest Mardi Gras parades in Louisiana took place on Feb. 25, just as the national outbreak was starting. In retrospect, if you knew then what you know now, would you have canceled Mardi Gras?" CNN’s Jake Tapper asked Edwards on April 5. "Well, you know you don't get a do-over like that, Jake," Edwards said. "There was not a single suggestion by anyone, a doctor, a scientist, a political figure, that we needed to cancel Mardi Gras. And, you know, in February, we had a Super Bowl, and it wasn't canceled and so forth." Edwards’ comments echoed a similar statement from New Orleans Mayor LaToya Cantrell 10 days earlier on CNN that there were "no red flags" from federal officials to suggest the festivities should be aborted. PolitiFact wondered if it’s  that there were no suggestions back in January or February that mass gatherings like Mardi Gras be canceled. We reviewed statements from President Donald Trump, and guidance from federal and state public health agencies and found that Edwards was right. Public health professors in Louisiana also told PolitiFact that there was no suggestion, prior to Mardi Gras, of community spread in the United States, much less New Orleans. The earliest suggestion we found from a federal agency saying that large events may need to be canceled came Feb. 26, after Mardi Gras celebrations. On Twitter and in public remarks, Trump did not suggest that large public events be canceled. In India on Feb. 25 and before leaving for India on Feb. 23, Trump said the coronavirus was very "under control" in the United States. Trump tweeted about the virus at least eight times from January to Feb. 25. His tweets generally said that his administration was in contact with China and others about the coronavirus, offered praise for Chinese President Xi Jinping’s handling of the outbreak, and said that his administration was monitoring developments and had it under control. On Lundi Gras, the day before Mardi Gras, he tweeted: The Coronavirus is very much under control in the USA. We are in contact with everyone and all relevant countries. CDC & World Health have been working hard and very smart. Stock Market starting to look very good to me! When the U.S. declared the coronavirus a public health emergency on Jan. 31, the government did not say that mass gatherings be canceled. Throughout January and most of February, U.S. officials said that the coronavirus risk to the American public was low and that they were not seeing community spread of the virus. By Feb. 25, there were 53 confirmed COVID-19 cases in the United States and no deaths, according to data compiled by the World Health Organization. On Feb. 26, the day after Mardi Gras, a Centers for Disease Control and Prevention doctor told reporters that the coronavirus situation was rapidly evolving and that the virus was spreading worldwide. There were still only a few cases in the United States and no reports of community spread, but that would eventually change, said Nancy Messonnier, director of the CDC’s National Center for Immunization and Respiratory Diseases. She said there were mitigation guidelines that people and communities could take during a pandemic when there wasn’t a vaccine or proven medical treatment for the disease. "On a larger scale, communities and cities may need to modify, postpone, or cancel mass gatherings," Messonnier said. Local communities would need to figure out which guidelines to implement and when, she said, based on the severity and the transmission of the disease and what could be done locally. On Feb. 28, Messonnier said it was possible that a reported case in California "could be the first instance of community spread — meaning the illness was acquired through an unknown exposure in the community." But it could also be that the patient was exposed through contact to a traveler who was infected, Messonnier said. The immediate risk to the general American public remained low, she said. On Feb. 29, a health official from Washington state, where there were four presumptive cases of COVID-19, joined a CDC press briefing and said the state was "starting to see some spread in the community" and the public risk was increasing. "Should we start to see more spread in Washington, we might consider recommending measures like cancelling large public events," said Kathy Lofy, the state health officer at the Washington state department of health. There were no reported cases of coronavirus in Louisiana during the weeks-long Carnival celebrations. The state’s department of health in blog posts as late as Feb. 21 said that the coronavirus threat to Louisiana was very low and that people should be more worried about the flu. It recommended that people wash their hands and get a flu shot, since it was still flu season. Louisiana’s first presumptive case of coronavirus was reported March 9, two days before the World Health Organization declared the new coronavirus a pandemic. On March 13, when Louisiana had 33 presumptive positive cases of COVID-19, Edwards signed a proclamation to stop gatherings of more than 250 people and close all K-12 public schools statewide to slow the spread of the disease. Based on models created mid-March, it’s assumed that infections silently spread in crowded parades during Mardi Gras, said Susanne Straif-Bourgeois, an associate professor of epidemiology at Louisiana State University Health Sciences Center New Orleans. Soon after Mardi Gras, epidemiologists from nearby states began reporting confirmed cases of coronavirus in people who had traveled to New Orleans for the festivities. But at the time that parade-goers gathered in streets with family and friends, it was not known that the virus was in the state, Straif-Bourgeois said. In his CNN interview with Edwards, Tapper said the Washington Post reported that governors had a gala in Washington, D.C. in early February, and that a group of governors met with federal experts who gave "the same dire warning that they’re giving now." Maryland Gov. Larry Hogan told the Washington Post, "The doctors and the scientists, they were telling us then exactly what they are saying now." Edwards told Tapper that in that Feb. 9 briefing, "we spoke generally about the novel coronavirus" and that it was "not accurate to say that they gave the same sort of information that they are providing right now," since a lot more is now known about the virus. Edwards’ deputy chief of staff, Christina Stephens, told PolitiFact that at that briefing, the virus was described as low risk and there was no suggestion that large gatherings be canceled. In a Feb. 9 press release about the briefing, the U.S. Health and Human Services department said the task force "reiterated that while this is a serious public health matter, the risk to the American public remains low at this time, and that the federal government will continue working in close coordination with state and local governments to keep it that way." Edwards said of the coronavirus threat, "there was not a single suggestion by anyone, a doctor, a scientist, a political figure, that we needed to cancel Mardi Gras." New Orleans Mardi Gras celebrations began early January and ended Feb. 25. PolitiFact reviewed public comments from Trump, federal and state health officials on and before Feb. 25 and did not find suggestions that large public events be cancelled. At that time, there was no report of community spread of the virus. Edwards’ statement is accurate. We rate it .


Cancer-fighting spices offer flavorful way to eat healthy

Explanation: This story relies on the musings of chef Floyd Cardoz, backed by references to petri dish studies, to support its claims about the “cancer-fighting” properties of various spices. If this half-baked story were a dish at one of Cardoz’s restaurants, it’d be sent back to the kitchen for a refire. We offer a variety of suggestions below in this review for how the story could have been more accurate and informative. Stories like this one — which don’t make even the most cursory effort to get their facts straight — are dangerous. They reinforce the idea that there are “quick fixes” to preventing a disease as implacable as cancer. They contribute to the confusing mix of health messages that cause consumers to tune out in frustration. They make it harder to reach readers with potentially useful, evidence-based information that could improve health.

The spice aisle can get pricey, but we won’t ding the story for not discussing the cost of cardamom. The story is peppered with references to the cancer-fighting properties of spices. Tumeric is “a great antioxidant, it’s got great anti-cancer properties.” And “garlic, onions, shallots and leeks can also act as cancer preventers. Freshly ground pepper can “even help prevent breast cancer tumors from growing.”  But nothing in the story is quantified. Whatever studies these claims are based on are not described in any way. We won’t penalize the story for not delving into the potential downsides of too much spicy food. The story does contain a warning “not to overdo it.” The claim about pepper “prevent[ing] breast cancer tumors from growing” seems to be based on this petri dish study from 2009. But the news release for that study warned, “Note: This work has not been tested in patients, and patients are not encouraged to add curcumin or piperine supplements to their diet at this time.” The story contained no such caveat. We’re not sure where the story gets the idea that a fennel-ginger broth  “can help to fight off harmful cancer cells.” Neither this nor any of the other claims are adequately sourced and no description of the underlying evidence is provided. The story refers vaguely to “studies.” What studies? By whom? Providing links to the underlying studies would at least have allowed readers to see where this evidence came from and what kind of research we’re talking about. The story doesn’t exaggerate the impact of cancer. Nor does it provide any context about the disease. We’ll rate this Not Applicable. The only source quoted is the celebrity chef, who also happens to be hawking a book with spicy recipes. Consulting a physician or someone else with nutrition or cancer expertise would have boosted the credibility of this information. The story missed an opportunity to discuss which diet and lifestyle factors are actually associated with reduced cancer risk and might be worth adopting. For instance, maintaining a healthy bodyweight, regular physical activity, avoiding excessive alcohol, etc. Merely adding spice to unhealthy foods will not reduce the risk of cancer — something the story could have been clearer about. The availability of spicy food is not in question. Is there anything new here besides the chef’s forthcoming cookbook, which will be publishing this year according to his website? If so, the story doesn’t establish what that is. This promotional-themed story seems like it could have been prompted by a news release. But the video accompanying the story seems to provide evidence of an actual interview that forms the basis for the quotes in the story. We’ll give the benefit of the doubt here.


Ohio’s stockpile got its start after the attacks of Sept. 11.

Explanation: An Associated Press review of more than 20 states has found that before the coronavirus outbreak most had only a modest supply of N95 masks, gowns, gloves and other medical equipment. In many cases, those supplies were well past their expiration dates — left over from the H1N1 influenza outbreak a decade ago.

Health, General News, Flu, Ohio, Virus Outbreak, Public health

Here’s a look at the history of Ohio’s stockpile: A TERRORIST ACT  Ohio first began stockpiling after 9/11, storing the very few items it accumulated at National Guard hangars around the state, said Ohio Department of Health spokeswoman Melanie Amato. Amid heightened awareness, Ohio created its own Bureau of Public Health Emergency Preparedness within the Health Department in 2005. State preparedness was initially funded through a $34.9 million federal bioterrorism grant, budget documents show. STOCKPILE GROWS The H1N1 pandemic of 2008-2009 left Ohio with a surplus of personal protective equipment and the antiviral Tamiflu, Amato said. The Health Department began at that point to lease and manage its own warehouse, where assets could be stored and later deployed in the event of public health emergencies. During a public water crisis in Toledo in 2014, the state Environmental Protection Agency purchased water for the stockpile, she said. In 2016, during the Zika outbreak, the Health Department added a large supply of bug spray that could be dispatched to hard-hit communities. Many of those supplies were exhausted or expired. ___ STOCKPILE FLOWS  Beth Bickford, executive director of the Association of Ohio Health Commissioners, said, with the exception of the annual flu vaccine, county health departments get their emergency supplies through the state. It’s a process generally set in motion by a governor’s emergency order, she said. “At the local level, there isn’t a cache maintained on a regular basis,” she said. “We aren’t in the usual business of buying and putting things away that we aren’t going to use right away.” John Palmer, a spokesman for the Ohio Hospital Association, said hospitals typically keep only about a two-week supply of personal protective equipment and other supplies on hand. Vendors who typically could address high demand are now swamped. ___ RESOURCES SPREAD THIN  Pots of money Ohio created to fund emergency preparedness tend to wane when the latest crisis is over. The Health Department is authorized under a governor’s directive to purchase supplies for the stockpile, Amato said, but the state also has been in talks with the federal government for years to ensure Ohio was prepared for any outbreak, Amato said. “This is not new,” she said. “However, the scale of this incident across the United States is. We are having ongoing conversations with the federal government, FEMA, HHS and other outside vendors to add to our stockpile to help fight this pandemic.”


Explanation: Firefighters battling wildfires in Australia made the most of cooler weather on Sunday to access badly burned towns and contain blazes before the expected return of hotter conditions at the end of the week.

The reprieve came as Prime Minister Scott Morrison defended both his government’s climate change policies and his decision to go on holiday to Hawaii last week. The leader of New South Wales, Gladys Berejiklian, said “catastrophic” fire conditions on Saturday in parts of the prime minister’s home state had destroyed communities. “We’ve got the devastating news there’s not much left in the town of Balmoral,” Berejiklian told journalists. Balmoral is about 120 kilometers (75 miles) south west of Sydney with a population of some 400. No fatalities were reported. Morrison visited the Rural Fire Service (RFS) headquarters in Sydney after returning on Saturday night from a holiday that drew sharp criticism as the wildfires crisis deepened. GRAPHIC: Forests in flames - Images from space show Australia's bushfires in different light: here  After the deaths of two firefighters on Thursday night, Morrison announced he would return home early, and on Sunday he acknowledged his holiday had caused anxiety. “I get it that people would have been upset to know that I was holidaying with my family while their families were under great stress,” Morrison said. Nearly 100 fires were still burning across New South Wales late on Sunday afternoon, though none were rated as emergencies. Conditions are expected to remain favorable over coming days allowing firefighters to work to contain fires encroaching on communities, particularly in the Blue Mountains region to the west of Sydney. But authorities stated that large fires would continue to burn across New South Wales without significant rainfall, which is not forecast for many weeks. “That’s still a way to go,” state Rural Fire Services Commissioner Shane Fitzsimmons said on Sunday. “We’re still talking four to six weeks at best before we start to see a meaningful reprieve in the weather.”  Fitzsimmons said Saturday’s fire conditions may have added another hundred buildings to the tally of those already destroyed during this year’s fire season. Not all of those would be homes lost, he said. Near the town of Lithgow, about 140 km (85 miles) west of Sydney, one man who had been unaccounted for early on Sunday was later found safe. Lithgow is also home to a prison facility, which the state’s Department of Justice said had significant capability to fight fires and was not evacuated. Staff and inmates were given masks on Saturday to protect against heavy smoke in the area. Australia has been fighting wildfires for months as hot, dry conditions brought about an early start to the fire season, with blazes destroying more than 800 homes and close to 3 million acres (1.2 million hectares) of bushland. The states of South Australia and Victoria have also faced extreme fire conditions in recent days, with authorities in the former saying on Sunday that 72 homes had been destroyed by one fire. Morrison addressed his conservative Liberal-National coalition’s climate policies on Sunday, which his government has been forced to defend following the severity of this year’s bushfires. Morrison said there was no argument that there is a link between climate change and weather events around the world but said it was not credible make a direct connection to any single fire event and climate change. Earlier this month, Australia drew criticism at a United Nations summit in Madrid for its climate-change policy of using old carbon credits to count toward future emissions targets. Australia is one of the world’s largest carbon emitters per capita because of its reliance on coal-fired power plants. It has pledged to cut carbon emissions by 26% by 2030 from 2005 levels, but critics accuse Morrison of a lack of action toward. Morrison on Sunday re-committed to those policies, which he took to a general election in May.


Cocoa mulch contains a chemical (theobromine) that can be harmful to pets.

Explanation: Veterinarians have warned that cacao shells contain the same ingredient that makes chocolate toxic to dogs.

Critter Country, Crusader Habit, dogs, gardening

This warning about the potential danger to pets posed by cocoa mulch began appearing in our inbox in May 2003. Example:  Cocoa Mulch, which is sold by Home Depot, Foreman’s Garden Supply and other Garden supply stores, contains a lethal ingredient called “Theobromine”. It is lethal to dogs and cats. It smells like chocolate and it really attracts dogs. They will ingest this stuff and die. Several deaths already occurred in the last 2-3 weeks. Just a word of caution — check what you are using in your gardens and be aware of what your gardeners are using in your gardens. Theobromine is the ingredient that is used to make all chocolate — especially dark or baker’s chocolate — which is toxic to dogs. Cocoa bean shells contain potentially toxic quantities of theobromine, a xanthine compound similar in effects to caffeine and theophylline. A dog that ingested a lethal quantity of garden mulch made from cacao bean shells developed severe convulsions and died 17 hours later. Analysis of the stomach contents and the ingested cacao bean shells revealed the presence of lethal amounts of theobromine. Although there is at least some truth to this one, the dangers it warns about are by now somewhat outdated and exaggerated: most dogs aren’t really interested in eating cocoa mulch, some brands of that product have been reformulated to reduce or eliminate the potentially dog-dangerous substance it contains (theobromine), and we know of only one substantiated case of a pet death caused by ingestion of the substance. (In July 2007, “Moose,” a 3-year-old Labrador belonging to a Minneapolis couple, died after eating cocoa mulch purchased at a local store. His owners had a veterinarian at the University of Minnesota perform a necropsy to determine the likely cause of death of their young and previously healthy pet. The vet found cocoa shells in Moose’s stomach and evidence of theobromine in the shells.) Cocoa mulch, made of cacao shells, is popular with gardeners and landscapers for a number of reasons: it has an aromatic scent, it repels garden pests, it retains moisture well, and it has a rich brown color that darkens (rather than fades) over time. However, veterinarians have warned pet owners that cacao shells also naturally contain theobromine, the same ingredient that makes chocolate toxic to dogs:  “Cocoa mulch is a risk, especially to dogs,” said Dr. Larry Family of Aqueduct Animal Hospital. Found in most home garden centers, cocoa mulch is known for its fine texture and the sweet smell the fresh mulch gives off. But getting past the scent, Family says cocoa mulch can be dangerous if a dog starts eating it. It contains two key ingredients found in chocolate: theobromine and caffeine. Similar to eating chocolate, he says a dog that eats just a few ounces of cocoa mulch could starting having stomach problems and it could get worse if it eats more. “As time goes on they might act restless, excited, it can produce tremors and seriously seizures,” Family explained. “Puppies are very curious animals. So they’re going to be attracted to various things around the yard and [the effect of eating cocoa mulch] seems to be more severe in the small breeds, and it depends on the amount they actually ingest,” Family said. The American Society for the Prevention of Cruelty to Animals (ASPCA) confirms the potential effects of theobromine and caffeine on dogs:  Cocoa beans contain the stimulants caffeine and theobromine. Dogs are highly sensitive to these chemicals, called methylxanthines. In dogs, low doses of methylxanthine can cause mild gastrointestinal upset (vomiting, diarrhea, and/or abdominal pain); higher doses can cause rapid heart rate, muscle tremors, seizures, and death. Eaten by a 50-pound dog, about 2 ounces of cocoa bean mulch may cause gastrointestinal upset; about 4.5 ounces, increased heart rate; about 5.3 ounces, seizures; and over 9 ounces, death. (In contrast, a 50-pound dog can eat up to about 7.5 ounces of milk chocolate without gastrointestinal upset and up to about a pound of milk chocolate without increased heart rate.) According to tables we’ve examined, cocoa mulch contains  300-1200 mg. of theobromine per ounce, making cocoa mulch one of the strongest concentrations of theobromine a pet is likely to encounter in any chocolate product. However, the question of the gravity of the risk presented by this type of gardening mulch remains a matter of debate. According to Hershey‘s, for example:  It is true that studies have shown that 50% of the dogs that eat Cocoa Mulch can suffer physical harm to a variety of degrees (depending on each individual dog). However, 98% of all dogs won’t eat it. And some of those who vend cocoa mulch note that although they’re aware of the pet warnings, they’ve never encountered a case of a dog’s being sickened by the product:  “The weird thing is, it smells like a chocolate Pop Tart. That’s the best way I can describe it. It really does have a chocolate scent to it,” explained Shane Compton of Hewitt’s Garden Center. Compton says cocoa mulch is not that popular at his store, but says it has its regular customers who every now and then wonder about the rumors they hear and the effect it has on man’s best friend. “There’s always stories on the Internet, but in the 30 years we’ve been here we’ve actually never heard of any body’s dog getting sick,” Compton said. Some manufacturers of cocoa mulch (such as the Cocoa Mulch brand) now proclaim that their products are theobromine-free and pet safe. Responsible pet owners should take care in their selection of cocoa mulch brands; some might prefer  to choose another form of soil enhancement for their gardens, such as cedar-based products, rather than gamble their dogs won’t be attracted to or harmed by cocoa mulch. (Although Home Depot is named as a vendor of cocoa mulch in the example cited at the head of this page, the company told us in May 2006 that: “The Home Depot does not and will not sell mulch harmful to pets. The mulch sold by The Home Depot containing cocoa shells goes through several cleaning processes, including a high heat system in order to strip the cocoa fat from the shells without the use of any chemicals.”) The danger of canine theobromine poisoning does not begin and end with cocoa mulch, however: chocolate in any form poses substantial risks to some pets. This most beloved of foodstuffs contains theobromine and small amounts of caffeine, both of which can sicken and even kill cats and dogs. Chocolate’s toxicity to animals is directly related to three factors: the type of chocolate, the size of the animal, and the amount of chocolate ingested. Unsweetened baking chocolate presents the greatest danger to pets because it contains the highest amount of theobromine, approximately 390-450 mg. per ounce. White chocolate contains the least. As a general rule of thumb, one ounce of milk chocolate per pound of body weight can be lethal for dogs and cats. (Milk chocolate contains approximately 44-66 mg of theobromine per ounce.) Theobromine affects the heart, central nervous system, and kidneys, causing nausea and vomiting, restlessness, diarrhea, muscle tremors, and increased urination. Cardiac arrhythmia and seizures are symptoms of more advanced poisoning. Other than induced vomiting, vets have no treatment or antidote for theobromine poisoning. Death can occur in 12 to 24 hours. This type of poisoning is uncommon because it is rare that a dog, even a small dog, will eat enough chocolate to cause anything more than an upset stomach. Yet it can happen, especially if the animal gets into baking chocolate or powdered cocoa, two forms of the sweet particularly loaded with theobromine. Do not feed chocolate to dogs or cats. If you keep a pet, do not leave chocolate lying about lest your critter help himself to it and in so doing poison himself. If your animal begins exhibiting signs of distress and you believe he might have gotten into some chocolate, call your veterinarian immediately. (It will help if you can supply information about the approximate weight of your critter, what sort of chocolate was ingested — white, milk, dark, cocoa powder, baking — and roughly how much.) But time is of the essence if such a poisoning has indeed taken place, so make the call right away.


Robotic surgery grows, but so do questions

Explanation: It’s a rare story that counters all of the claims made for robotic surgery. This story scores so well because, one by one, it addresses our criteria in a way we expect stories about new technologies to analyze claims. This was a story that had consumers in mind – and the take-home should be clear to any reader as a result. Robotic surgery has increasingly gained acceptance recently despite the fact that the true benefits of the device may be minimal. Given the expense of the device and the per case costs of the disposables, a story that looks hard at the existing evidence is more than welcome.

Good analysis of cost impact of use of robotics – for patients and health care institutions. The story raises many questions about claims of benefits from robotic surgery. Examples: The story didn’t quantify harms – something it could have attempted to do – but we’ll give it a satisfactory score nonetheless because it raised an issue many stories don’t – the loss of sensory feedback upon which surgeons rely. It also cited one study showing that people who had an adrenal gland removed by robot were more likely to have complications. The story allowed the manufacturer to have its say and then countered each claim with a Johns Hopkins surgeon’s evaluation of the evidence. No disease mongering here. Several independent sources were quoted. The story included comparisons between robotic surgery and other laparascopic and traditional surgery throughout. The growing use of robotic surgery – despite questions about the evidence – is the focus of the story. The story stated “Despite the DaVinci’s popularity, its surgical talents may not surpass those of flesh-and-blood physicians.” It’s clear the story didn’t rely on a news release.


Hormone therapy raises risk quickly, study finds

Explanation: The focus of this story is a report of new data showing a statistically significant association between lobular breast cancer and short-term HRT (3 years or less). The story creates an exaggerated sense of risk because there is no mention of absolute risk. For breast cancer, estimated excess risk is 8 women/10,000 women per year developing breast cancer after 4 years of combined HRT use as compared with no hormone use. A current treatment approach for bothersome menopausal symptoms is a course of low-dose HRT for 3-5 years with frequent monitoring. This course of treatment is considered safe for most women not already at high risk of developing breast cancer. The clinician interviewed stresses frequent monitoring and an individualized approach to managing symptoms. The story notes various combinations of hormone replacement therapy (HRT)  available for reducing menopaual symptoms, such as hot flashes and vaginal dryness. However, there is no discussion that menopause is a natural part of aging and unless symptoms are very bothersome, many women do not need to take HRT to ease symptoms common in menopause such as hot flashes, night sweats and vaginal dryness and discomfort. The story does strike a balance by interviewing the lead author of the study and a gynecologist who put the new information in clinical perspective. It would be helpful to hear from researchers of the Women’s Health Initiative for comment on how their data on breast cancer risk compared to the present study.

The story does not specifically address cost of treatment. However, since the focus is on causation of disease, the cost issue does not seem important here. The interview with a clinician puts the benefit of taking HRT in perspective; however, we are given no quantitative data to compare the risk of devleoping lobular cancer against the benefit of reduced menopausal symtoms via HRT. The clinician interviewed stresses frequent monitoring and an individualized approach to managing symptoms. The focus of this story is a report of new data showing a statistically significant association between lobular breast cancer and short-term HRT. Yet there is no mention of absolute risk. For breast cancer estimated excess risk is 8 women/10,000 women per year developing breast cancer after 4 years of combined HRT use as compared with no hormone use. The story describes the  design of this case-control study and discusses the connection between increased risk of developing lobular cancer and shorter-duration HRT . However, the story could have mentioned that the case-control design of the study carries some inherent limitations in establishing causality vs association (e.g. recall bias). The story leaves the reader with an impression of an exaggerated sense of risk with short-term HRT, because it gives relative, not absolute risk data. Also, lobular carcinoma is detected in the same way as ductal carcinoma – either because of a palpable lump detected on exam by woman or physician, or on a screening mammogram. The story interviews the lead author of the study, as well as a gynecologist who puts the study in clinical perspective. The latter interview gives balance to the report. It would be nice to hear from researchers of the Women’s Health Initiative, or other clinicians who could discuss treatment options for women considering HRT. The story does not discuss other treatment options for managing menopausal symptoms. There is no discussion here that menopause is a natural part of aging and not a condition which necessitates medical intervention. Unless symptoms are very bothersome, many women do not need to take HRT to ease symptoms common in menopause such as hot flashes, night sweats and vaginal dryness and discomfort. The story notes various combinations of hormone replacement therapy (HRT) available for  reducing menopaual symptoms, such as hot flashes and vaginal dryness. The story notes that data from the Women’s Health Initiative on the risks of HRT have been available since 2002. (These risks include a slight increase risk of breast cancer for some women who take a longer course of HRT (> 4 years) and an increased risk of heart disease in older women. Satisfactory because the story indicates that the treatment itself is not novel. The story does not appear to rely solely or largely on a news release


Shortage of drugs and equipment: Brussels hospitals sound the alarm.

Explanation: Hospitals in the Belgian capital called on the federal government on Wednesday to address a shortage of medicines and equipment, as COVID-19 patients continue to arrive at intensive care units that are starting to fill up.

“Federal authorities do not seem to see or hear that the reality is that hospitals are in a massive shortage of all protective gear and drugs needed to treat COVID-19 patients and other categories of equipment like syringes,” around 10 public and private hospitals said in a statement issued via the federation of hospitals and care homes for Belgium’s regions of Brussels and Wallonia known as Santhea. Belgium, with some 11.5 million people, is one of the countries hardest hit by the coronavirus in Europe. Some 4,995 people have been hospitalized with COVID-19 symptoms in the country, meaning around half of the health services’ capacity has been taken up treating the disease. The health ministry says it expects the spread of the coronavirus that causes COVID-19 to peak in the coming days and weeks. Except for real emergencies, hospitals are focused on COVID-19 patients only. “The situation is really dramatic,” the statement said, adding that the hospitals are currently working with a three-day stock of medicines and fear they would soon no longer be able to offer adequate care. Belgium’s health ministry announced earlier on Wednesday that its stock of drugs such as curare, a drug to relax muscles of intubated patients, would last until mid-April. The reality on the ground seems different as “there is a real shortage of curare-type drugs and for other drugs, it becomes really very difficult,” said Valerie Victoor, general adviser at Santhea. Belgium reported its death toll rose by 123 to a total of 828 people on Wednesday, and its number of cases was up 1,189 to 13,964. Officials said the nation’s testing capacity would reach 10,000 daily by the end of the week.


Illinois nurse express regret for bar visit without mask.

Explanation: A northern Illinois nurse expressed regret Friday for not taking better precautions while visiting her sister’s Wisconsin bar after the Supreme Court overturned the state’s “Safer at Home” order.

Wisconsin, Health, Aurora, Illinois, Milwaukee, Virus Outbreak

Katie Koutsky, a nurse with the Downers Grove-based Advocate Aurora Health system, says she was helping her sister reopen her suburban Milwaukee bar Wednesday when she was interviewed by a local television station. She told WTMJ-TV being in the bar was no greater risk than being in a grocery. Koutsky said her latest comments are a result of the “intense media scrutiny” she has received because of her decision to help her sister. “First, while my priority was to support my sister and her attempt to restart her business which has been devastated by this pandemic, I’d like to express my regret for not wearing a mask or practicing social distancing while there,” Koutsky said in a statement released by Advocate Aurora Health. Koutsky said she doesn’t have COVID-19 symptoms and has no indication she was exposed to the virus. However, “out of an abundance of caution” she will self-quarantine and undergo screening before she returns to work. Advocate Aurora Health said in a statement it was “disappointed” in Koutsky’s decision not to wear a mask in a bar that wasn’t practicing social distancing. “We’ve also been doing a lot of education actually with our team members for what they can do to be safe once they leave our hospital walls,” said Advocate Aurora Health chief nurse Mary Beth Kingston, adding the health system will follow up with individual nurses as needed.


The Democratic Congressional Campaign Committee released a bizarre ad in October warning that a vote for Congressman David Jolly in the 13th Congressional District is a vote for Donald Trump's right-hand man. The ad ties Jolly and Trump together through photoshopped images and shared views on opposing abortion rights and defunding Planned Parenthood. "Just like Donald Trump, David Jolly wants to outlaw a woman's right to choose," says the narrator in the ad. This remark stood out to us, so we wanted to take a look at each man’s view on abortions. Moreover, the goal of the ad and its methods have been widely criticized, so we’ll examine the relationship between Trump and Jolly. The evidence linking Trump and Jolly’s stances on abortion is hard to pinpoint, given the fact both have talked about abortion in different ways. What’s not hard to pinpoint is the relationship between Trump and Jolly, which just doesn’t exist. Jolly has never met Trump, nor is he supporting him for president. Trump and Jolly on abortion Trump and Jolly are are on the same side of the abortion spectrum, but their views are hard to lump together as one and the same. Jolly’s campaign told PolitiFact Florida he calls himself pro-life, but has never supported or voted to outlaw abortion entirely. At the congressional debate on Sept. 19, Jolly was asked if it's right for a woman to abort her baby if she finds out she has Zika in the early stages of pregnancy. Jolly responded: "I think that is her choice, but for the health of the mother or the health of the baby, or the life of the mother, I think there should be exceptions permitted to terminate the pregnancy. Yes, I do." There are other exceptions Jolly embraces, too, including instances of rape or incest. Jolly may say he doesn’t support outlawing abortion, but what does his voting record say? The DCCC points to the "Life at Conception Act" (H.R. 1091) that Jolly co-sponsored in 2014. This act would give a fetus the same rights as a human beings from the moment of fertilization. This is clearly an anti-abortion rights bill, but as PolitiFact concluded in 2014, there’s a lot of murkiness that courts would have to sort through before it would be clear if abortion would be outlawed. Whether or not Trump wants to outlaw abortion is hard to determine. In March, Trump stated women should be punished for having an abortion. (You can read the whole remark in context here.) But he backed off saying women should specifically be punished to stating general opposition to abortion. "If Congress were to pass legislation making abortion illegal and the federal courts upheld this legislation, or any state were permitted to ban abortion under state and federal law, the doctor or any other person performing this illegal act upon a woman would be held legally responsible, not the woman," the Trump statement says. "The woman is a victim in this case as is the life in her womb. My position has not changed — like Ronald Reagan, I am pro-life with exceptions." Recently at the third presidential debate, Trump was asked if he wants the Supreme Court to overturn Roe vs. Wade, which would essentially dissolve a woman’s right to abortions. Trump said: "Well, if that would happen, because I am pro-life, and I will be appointing pro-life judges, I would think that that will go back to the individual states." Jolly does not support Trump This ad has been highly criticized for its bogus images showing Trump and Jolly photoshopped together. Like the claim, the ad attempts to paint Trump and Jolly as one in the same — and allies if both Jolly and Trump win. This association is not accurate. At the congressional debate, Jolly said he doesn’t support Trump and told the Tampa Bay Times he never met him. Jolly’s spokesperson reiterated that point to PolitiFact Florida on Oct. 20 and said Jolly will not be supporting Trump in this election. Jolly called on Trump to drop out of the presidential race in December after Trump called for a temporary ban on Muslims. At the time of the press release, Jolly was running for Marco Rubio’s seat in the U.S. Senate. "While ISIS is beheading innocent people for their religious practices, Trump is betraying our freedoms," Jolly said in a statement. "His brutal, bullying bigotry runs contrary to the very principles our forefathers fought so hard to defend. We are either a party of protecting the constitution and religious liberties or we're not. America should insist on a security test but never a religious test." Our ruling An ad from the DCCC said, "Just like Donald Trump, David Jolly wants to outlaw a woman's right to choose." Trump and Jolly both favor restrictions on abortion, but their views cannot be directly equated to outlawing all instances of abortion. Moreover, the claim, and the overall theme of the ad — that Jolly would be an ally to Trump — is highly misleading. Jolly does not support Trump. We rate the DCCC’s claim .


Coronavirus cases top half a million, protective gear lacking: WHO.

Explanation: Coronavirus has infected more than half a million people and killed more than 20,000 globally, the head of the World Health Organization (WHO) said on Friday, as he appealed again for protective gear for medical staff working to save lives.

Tedros Adhanom Ghebreyesus, WHO director-general, urged countries to refrain from using medicines that have not been demonstrated to be effective against COVID-19, the disease caused by the virus. “The chronic global shortage of personal protective gear is now one of most urgent threats to our collective ability to save lives,” Tedros told a Geneva news conference. “Health workers in low- and middle-income countries deserve the same protection as those in the wealthiest countries,” he said, adding that the U.N. agency was shipping more supplies. Dr. Mike Ryan, WHO’s top emergencies expert, said the world was “moving to an uncertain future”. “You see many countries around the world are just beginning the cycle of this epidemic. Some have been through the cycle of the epidemic like Singapore and China and are now desperately trying not to have the disease re-emerge and cause another wave of infections because of disease importations,” he said. Elderly people and those with underlying medical conditions have been the hardest hit, but 10 to 15% of people under the age of 50 have moderate to severe infection, Ryan said. Asked about reports of infections in young adults, Ryan said: “For most people it is a very mild infection, most young people. But for a significant minority of people between the age of 20 and 60 this is a significant infection.”  “What is really emerging is a perception that this disease, while not fatal and not causing critical disease in a younger age group, is causing severe illness in many people,” Ryan said. Every infection of COVID-19 presents an opportunity for onward spread, said Dr. Maria van Kerkhove. “So even in younger populations, if you do have a mild disease and you think it’s no big deal, what the big deal is is that you may transmit to somebody else who may be part of that vulnerable population who may advance to severe disease and who may die,” she said. The data showed that “the majority of children that are infected are experiencing mild disease,” ver Kerkhove said. “But we do have reports, and there are some publications now that describe severe disease in children. We have reports of deaths in children. There is one in China, and I believe one in the United States as well,” she said.


Progesterone may be key to preventing recurrent miscarriage

Explanation: This is a somewhat confusing news release that contained very few of the most important details from the study — effectiveness, safety and cost, for example — that anyone would want to know if they were interested in preventing miscarriage. The confusion arises around what is being tested: is it the progesterone, the nCyclinE molecular marker or the Endometrial Function Test (EFT) used in this experiment to identify a subset of women who would benefit from progesterone? Our reviewers were baffled and readers likely will be, too. Progesterone has been clinically used to prevent unexplained early miscarriage. Some early meta-analyses had suggested a reduction in miscarriages, but later trials showed no difference. If you are going to make a claim that progesterone prevents miscarriage, you should have more than a 116-person study to back up that claim. Preventing miscarriages could be a major public health advance and have a very profound effect on the lives of parents and families. If a cheap, safe and effective treatment could be prescribed to prevent untimely deaths of fetuses that would be welcome news. Potential mothers who have experienced the pain of miscarriage, however, should not be inadvertently led astray from headlines that promise miscarriage prevention without adequate study of the safety and effectiveness of that treatment. We’ve noted concerns with Yale’s PR communications previously, for example here and here.

The release does not discuss costs. Cost for generic progesterone range from about $20 to $30 for 30 – 100mg capsules, according to GoodRx’s drug prices tracker. The release claims that progesterone prevents miscarriages. How many miscarriages did it help prevent and how was this assessed? There aren’t any numbers. With any drug treatment related to pregnancy it is absolutely essential to discuss the effects of the drug on both mother and child. This news release doesn’t address safety risks to either. The Mayo Clinic’s website for patients offers a long list of possible side effects from progesterone in adults. Much less information is available about progesterone’s risk to a developing fetus. There was no basic information provided about what kind of study this was, and few explanatory statements that would help readers to assess the quality of the evidence. At the end we receive this helpful quote — “The positive results show us that next we need to study progesterone as a treatment for recurrent pregnancy loss with a prospective randomized trial to validate the findings. — but it’s too late and insufficient to help readers evaluate the study. There is no obvious disease mongering here. The release does provide some context about miscarriages, stating that it “affects 30,000 women each year in the United States. About 25% of all women who become pregnant have a first-trimester loss.” The release doesn’t mention who funded the study, which is necessary to meet our standard. It does note that the “research team used the endometrial function test (EFT®), which was created by study co-author Harvey J. Kliman, M.D., director of the Reproductive and Placental Research Unit in the Department of Obstetrics, Gynecology and Reproductive Sciences at Yale School of Medicine.” However, the release doesn’t acknowledge an important conflict of interest that is addressed in the study manuscript itself: “H.J.K. is the inventor of a patent related to the monitoring of endometrial glandular development.” Are there alternative methods to determine the health of a fetus and other potential treatments to prevent miscarriage? The release doesn’t say. Progesterone is widely available, but what about the EFT? We don’t have any idea after reading this news release. We found no evidence relating to EFT in a review of clinical reproductive medicine guidelines. This release doesn’t establish the novelty of this approach. Other research studies have looked at the use of progesterone in preventing miscarriages. According to the reference site “UpToDate” by medical publishers Wolter Kluwer, more than 50 research studies have examined the use of progesterone in preventing miscarriage or pre-term birth, with mixed results. There is no obvious use of unjustified language, but the last paragraph contains some somewhat intemperate language from one of the co-investigators who said: “We are very pleased to find that these results reinforce the evidence that progesterone could be a very beneficial, inexpensive, and safe treatment for many women with a history of recurrent pregnancy loss.” Beneficial? Inexpensive? Safe? None of these attributes were described adequately in this news release.


Pepsi admitted that their soda contains cancer-causing ingredients.

Explanation: The CEH was able to pressure PepsiCo into imposing strict guidelines on the manufacturing of the caramel color they use and to make a legal commitment to have 4-MEI levels in their soda regularly tested. They did not however, compel PepsiCo to admit, as claimed, that their sodas “contain cancer-causing ingredients.”

In 2016, the one-stop paranoia and supplement shop “Natural News” web site published an article, headlined “Pepsi Admits Its Soda Contains Cancer-Causing Ingredients,” that discussed a legal battle between the environmental health watchdog Center for Environmental Health (CEH) and PepsiCo which took place between 2011 and 2015. Clickbait websites have aggregated that story and ensured its continued virality by sharing it on highly followed Facebook accounts such as “March Against Monsanto.” The 2016 Natural News article documented the Center for Environmental Health’s effort to uncover levels of a chemical called 4-Methylimidazole (4-MEI) in cola products that were higher than the legal limits imposed by the state of California’s Proposition 65. 4-MEI is not directly added to colas, but it is a byproduct of processes that produce the caramel coloring that is typically added to such soft drinks: “4-methylimidazole (4-MEI) is a chemical compound that is not directly added to food; rather it is formed as a byproduct in some foods and beverages during the normal cooking process. [4-MEI] forms as a trace impurity during the manufacturing of certain types of caramel coloring … that are used to color cola-type beverages and other foods.” To understand the legal challenge from the Center for Environmental Health and the claims made about this case by Natural News, though, one need first understand the regulatory history that culminated in efforts to reduce the chemical’s occurrence in soda. Is 4-Methylimidazole a Carcinogen? A number of international, national, and state or local governmental agencies evaluate the safety and possible carcinogenicity of various food or cosmetic products, and they don’t always reach the same conclusions. The first group that raised specific alarm about the carcinogenic potential of 4-MEI was the U.S. National Toxicology Program (NTP), which released a study in 2007 suggesting that massively high doses of 4-MEI may have given male and female mice lung cancer and may have given female rats Leukemia. The state of California has some of the strictest laws in the world regarding required warnings about chemicals that may produce carcinogenic or reproductive harm. This situation is due to Proposition 65, also called the Safe Drinking Water and Toxic Enforcement Act, which since 1986 has mandated the publication of a list of chemicals that are “known to the State of California to cause cancer or reproductive toxicity” and imposed labeling requirements on any product sold in California that includes relevant concentrations of these chemicals. When the 2007 National Toxicology Program study was published, the state of California was given their first legal rationale to include 4-MEI in the Proposition 65 list, because the National Toxicology Program is one of the organizations the act defines as a valid arbiter of carcinogenicity. In January 2011, after a period of review, 4-MEI was indeed added to California’s Proposition 65 list. While the National Toxicology Program and the State of California consider 4-MEI a potential carcinogen, the U.S. Food and Drug Administration (FDA) and the European Food Safety Authority (EFSA) are far less concerned with it as a potential cancer risk in food products. In 2011, the EFSA re-evaluated 4-MEI and other byproducts of caramel color processing, finding that the levels Europeans were exposed to through food consumption were far lower than those that would raise any plausible carcinogenicity concerns. Currently, the FDA’s position on 4-MEI is that the National Toxicology Program study showing harm in rodents had limited relevance to humans, because it was performed on laboratory animals exposed to levels of 4-MEI higher than any human would reasonably be exposed to: “Based on the available information, FDA has no reason to believe that there is any immediate or short-term danger presented by 4-MEI at the levels expected in food from the use of caramel coloring.” However, the State of California, basing their decision on numbers derived from those animal studies, ruled that any product containing levels of 4-MEI exceeding a certain concentration would have to be labeled as a potential carcinogen. Did Pepsi “Admit” That Their Products Contain “Cancer-Causing Ingredients”? After 4-MEI was added to the Proposition 65 list, the Center for Environmental Health sampled cola products from California for compliance with that regulation and found that a number of Pepsi and Coca-Cola products contained levels of 4-MEI exceeding the allowable limits established by California’s Proposition 65. The CEH filed a legal complaint on 23 February 2012, whereupon both Coca-Cola and Pepsi announced their intent to bring 4-MEI levels in the sodas into compliance with California law, as reported in a 9 March 2012 Reuters article: Coca-Cola Co and PepsiCo Inc are making changes to the production of an ingredient in their namesake colas to avoid the need to label the packages with a cancer warning. The change is meant to reduce the amount of a chemical called 4-methylimidazole, or [4-MEI], which in January was added to the list of chemicals covered by California’s Safe Drinking Water and Toxic Enforcement Act of 1986, also known as Proposition 65 … Both companies said they started in California, and would expand the use of the reduced [4-MEI] caramel coloring over time. Subsequent to this announcement, the CEH once again tested a variety of colas from California and elsewhere around the country, finding that both Pepsi and Coca-Cola were now compliant in California, but that Pepsi had not changed their soft drink formulations outside of that state. As a result, the CEH continued their legal efforts against PepsiCo. On 17 September 2015, lawyers for PepsiCo and the CEH settled their dispute when they signed a consent judgement described thusly by the CEH: Under the settlement, finalized in Superior Court in Alameda County, Pepsi will require its ingredient suppliers to meet strict limits on the 4-MEI levels, which CEH found at high levels in 2012 in some colas made by Pepsi and other major companies. The settlement also requires Pepsi to test its cola products to ensure that the 4-MEI levels remain below the required level, and allows CEH to request further testing of Pepsi’s products. Although this agreement represented a major legal victory for the CEH (which was also awarded financial damages for their legal and scientific fees), it actually represented (legally, at least) the exact opposite of Pepsi’s “admitting its soda contains cancer-causing ingredients” as stated in viral headlines. This is clear in the section of the judgement labeled “NO ADMISSIONS”, which stipulates that PepsiCo never violated any law and that they were not required to admit or accept 4-MEI’s classification as a carcinogen: By executing this Consent Judgment and agreeing to provide the relief and remedies specified herein, [PepsiCo] does not admit (a) that it has violated, or threatened to violate Proposition 65 … or any other law or legal duty; or (b) that the chemical 4-MEI in [their colas] or in other foods or beverages poses any risk to human health or requires any disclosure or warning to consumers.


The Democratic health care bill in the House would "create 53 new government bureaucracies.

Explanation: Boustany and other Republicans say health care plan would create 53 new government bureaucracies

National, Health Care, Charles Boustany,

In the Republican response to President Barack Obama's address on health care before a joint session of Congress on Sept. 9, 2009, U.S. Rep. Charles Boustany, R-La., a heart surgeon by profession, repeated a popular Republican talking point, saying the health care reform bill introduced in the House would  "create 53 new government bureaucracies." This claim originates with a detailed list complied by the House Republican Conference, which you can view  here  . Fifty-three new bureaucracies sounds like a lot, and the list is so specific, we decided to dig into it to see if it's legitimate. "Bureaucracy" can mean different things to different people, so we began with a trip to the Merriam-Webster dictionary to set some parameters. It defines it like this: "a body of nonelective government officials; an administrative policy-making group; government characterized by specialization of functions, adherence to fixed rules, and a hierarchy of authority; a system of administration marked by officialism, red tape, and proliferation." So, to the list... The first two are no-doubt-abouters. No. 1 is a Health Benefits Advisory Committee (Section 123, p. 30). This is a new panel of experts that will make recommendations to the secretary of Health and Human Services on covered health benefits. It's an advisory board, but a new entity nonetheless. New bureaucracy, check. No. 2 on the list is the creation of a Health Choices Administration (Section 141, p. 41). This is a biggie. The Health Choices Administration would be an independent executive branch agency charged with establishing qualified plan standards, creating the health insurance exchange and administering affordability credits for low-income people. New bureaucracy, check. After this, however, the list gets murkier. Consider No. 3, Qualified Health Benefits Plan Ombudsman. This person, or office, would be charged with helping people navigate the new health reform system and report to Congress on recommendations for improvements in administration of the program. It's part of the Health Choices Administration (No. 2 on the list). That sounds like double-counting to us. And that's true of a number of other items on the list as well. We're not going to detail all 53 items on the list. But here are a few general observations from our examination of them. Four of the items on the list include the creation of various trust funds. These are new funds, but they are to be created by existing agencies. These are essentially bank accounts. Those aren't new government bureaucracies in our book. The list also includes six pilot programs and three demonstration programs. These are small-scale demo programs. If the programs turn out to improve care and save money, the government will roll them out nationally. There's already an office in place in Medicare that runs demonstration programs. In fact, the Medicare Prescription Drug, Improvement, and Modernization Act signed by President George W. Bush in 2003 included 14 new demonstration projects. It wouldn't be fair to call that 14 new bureaucracies then, and it's not fair to call these demonstration programs new bureaucracies now. "The programs and demonstration projects they list aren't new agencies but rather new projects, and they're sensible ways to test new policies before more broadly implementing them," said Brian Cook, press secretary for Rep. Pete Stark, D-Calif., chair of the Ways and Means Health Subcommittee. And, he said, "many of the programs and demonstration projects are things that Republicans themselves have called for and supported." The list also includes three new ombudsmen and a special inspector general for the Health Insurance Exchange. And again, these are individual offices in existing agencies — not bureaucracies. Three items on the list deal with comparative effectiveness research. Although the government already does such research, we think it's fair to count the creation of a new Center for Comparative Effectiveness Research on the list. But the next two items, a comparative effectiveness research commission and a patient ombudsman for comparative effectiveness research seems like triple-dipping. Ironically, said Stan Dorn, senior research associate at the left-leaning Urban Institute, those safeguards were put in to assure Republicans that the program would not be used to force insurers to comply with the council's research findings. "Some of these things are new government bureaucracies," Dorn said. "But a lot of these items are not new government agencies, they are new activities that existing agencies would be asked to perform." By Dorn's count, 36 of the 53 items on the Republican list fall in that latter category. An example is an item on the list for a program of administrative simplification (Section 163, p. 57). It would be up to the department of Health and Human Services to implement the updated standards. "That is not a new bureaucracy," Dorn said. "That's an activity required of an existing government agency." "Just eyeballing this list," Dorn said, "it is clearly way over the top." We agree that there are lots of suspect items on the list and the Republicans' methodology in choosing them is inconsistent. But we also think it's fair for them to claim that the Democratic health plan would create new government bureaucracy. The plan would create new ways to subsidize health insurance for millions of low-income people. It would establish a health insurance exchange in which people not on plans provided by large companies could shop for competitive rates. That requires the creation of some new institutions. But they are wrong to cite 53 as the number. In fact, the number is clearly much smaller.


In 2020, two school boys in China died suddenly after wearing face masks during physical exercise.

Explanation: What's true: In April and May 2020, multiple Chinese news outlets reported that two boys, aged 15 and 14, had died in late April after collapsing during gym class at schools in Henan and Hunah provinces. What's undetermined: It's unknown whether the boys' wearing face masks played any role in their deaths, or was coincidental.

During the spring and summer of 2020, multiple readers asked Snopes to examine the accuracy of news articles that claimed two school boys in China had died suddenly during physical exercise while each wearing a face mask, as part of broader efforts to prevent the spread of the COVID-19 coronavirus pandemic. On May 6, the New York Post published an article with the headline “Two Boys Drop Dead in China While Wearing Masks During Gym Class,” while the Australian television network 7News reported that: “Two schoolboys have died within a week of one another while taking part in compulsory physical education examinations while wearing face masks in China. Major Chinese cities and provinces are moving to cancel this term’s running tests amid concerns over student fitness following three months of lockdown and school closures. “Possible breathing difficulties during the exam while mask-wearing remains mandatory in the absence of a vaccine have also led to the decision, reports said. It comes after two 14-year-old boys ‘suddenly’ collapsed on their school running track and were subsequently declared dead in the county of Dancheng in Henan Province and the city of Changsha in Hunan Province — both in Central China.” The Daily Mail published a similar report on May 4. Those reports contained a high degree of accuracy, although some misrepresented the respective ages of the boys. The deaths were widely reported in China in May 2020, providing corroboration of the following core facts.


This             email says that in the event of a heart attack when you are by             yourself, coughing repeatedly and vigorously can keep the heart             beating until help arrives.

Explanation: A self-administered CPR procedure involving coughing can save you during a heart attack

TruthOrFiction.com             has checked with several sources, including the American Heart             Association, and none of them recommends relying on this procedure. The version of the eRumor that has gotten the most circulation on the             Internet originated from an article in a newsletter published by a             chapter of the Mended Hearts organization, whose members are heart             attack survivors. Mended Hearts has retracted the article. Doctors say the coughing procedure has been used on limited and             experimental occasions with patients experiencing cardiac             arrhythmia, or irregular heartbeat. Even then, the patients             were in the hospital, connected to monitors, and the coughing was             used to try to buy a few extra seconds before other, life saving             equipment was used. There aren’t any known cases where a             person who was alone suffered a heart attack and sustained himself             or herself while waiting for paramedics to arrive. In a             true heart attack where the blood supply to the heart is blocked,             the “coughing CPR” would not do any good. All the sources we checked with agreed:  If a heart episode is             happening, call 9-1-1. Comments