Innovative triple pill significantly lowers blood pressure, study finds

Explanation: This news release does a nice job of explaining the basic design of a study investigating whether a once-daily “triple pill” (that combines 3 different blood pressure-lowering medications) is more effective in lowering blood pressure than doctors’ usual approach. But there’s plenty of room for improvement here including: presenting the findings in a more meaningful context for patients, including the substantial adverse outcomes noted by the researchers, and using much more toned down language for results that are neither novel or all that significant. Notably, there is a significant financial conflict of interest involving the authors. This should have been made clear to readers. The global importance of poorly controlled high blood pressure is well-stated by the authors in the introduction to their study published in JAMA (paraphrased): High blood pressure is the leading cause of mortality and cardiovascular disease globally with most of the disease burden occurring in low- and middle-income countries. The availability and affordability of medications is a critical issue. About one-third of individuals with high blood pressure in these settings receive treatment. Only about half of patients treated in high-income countries and about 1-in-4 patients in low- and middle-income countries achieve blood pressure control. A fixed low-dose combination therapy with inexpensive blood pressure-lowering drugs has the potential to address several barriers to improve blood pressure control worldwide. Indeed, there’s significant need for a simple-to-take, effective, and affordable medication to address this issue. If successful, the benefits to patients, and the profits for developers, would be massive.

George Institute for Global Health,High blood pressure

The cost of the three-in-one pill is not mentioned. Two similar pills already on the market (Tribenzor and Exforge HCT). They’re also once-daily pills combining an angiotensin II receptor blocker + calcium channel blocker + thiazide diuretic. They both have a retail price of approximately $10 a pill, or $300 per month [Source: Drugs.com]. The target blood pressure (BP) for this study was below 140/90 (or below 130/80 in patients with diabetes or chronic kidney disease). The news release states that: “70% (of subjects) reached blood pressure targets with the ‘Triple Pill’, compared to just over half receiving normal care.” (Normal or usual care is defined in the release as “their doctor’s choice of blood pressure lowering medication.”) It should have been made more clear this was measured after 6 months in the study. And as a result, the effect on cardiovascular (CV) risk reduction of the combination is unknown. One of the goals of the approach using reduced dosage is to reduce the likelihood of side effects, but the side  effects reported in the study were not mentioned in the news release, and include: Overall, 419 adverse events in 255 patients (about 38% for the triple pill and 35% for usual care) Of note, both groups experienced similar rates of musculoskeletal pain (roughly 7%), but the triple pill group had much more dizziness and fainting (5.2% vs. 2.8%) as well. It should have been mentioned that combination antihypertensive (blood pressure lowering) medications are well known to have dozens of “major” drug interactions, and can also cause swelling and metabolic disturbances. We were glad to see that the basic study design was included: 700 patients randomized to either receive the triple pill or usual care, with an average patient age of 56 years old, and a mean baseline blood pressure of 154/90. This qualifies as “mild” hypertension. But it should have been made clear that while reduced blood pressure is a goal it is a surrogate goal. The real target of blood pressure reduction is reduced cardiovascular (CV) event rates. As we learned from previous research (ALLHAT trial), drugs that reduce blood pressure equally are not all created equally with regard to CV risk reduction. A finding that should have been included in the news release is that — after 6 months of treatment — the triple pill group achieved a mean BP = 125/76 vs. the usual care a mean BP = 134/81. That’s clinically relevant for two reasons. First, it clearly shows the difference in systolic blood pressure achieved by the triple pill group compared to the usual care group is only 9 mm of mercury. Not very clinically significant at the individual level, and arguably a modest achievement at the population level. Finally, it would have been useful to note, as the authors noted in the study, that since the research was conducted in Sri Lanka, with its unique health system and culture, the results may not be generalized to Western, industrialized countries. There is no disease-mongering here and a target blood pressure of <140/90 would be considered appropriate by many medical societies. It provides some context in terms of goals to reduce high blood pressure globally. Although this is mentioned … The study was funded by the National Health and Medical Research Council of Australia … what’s not mentioned is that the two lead authors quoted in the news release both receive a salary from George Health Enterprises (GHE is the product commercialization arm of The George Institute for Global Health). According to disclosures cited in the published study: George Health Enterprises has received investment funds to develop fixed-dose combination products containing aspirin, statin, and blood pressure-lowering drugs and has submitted a patent for the treatment of hypertension The news release calls the pill “innovative” and says it “could transform the way blood pressure is treated around the world” … but it fails to mention that combination blood pressure-lowering medications have been around for decades. And, as mentioned above, there are some once-daily “triple pills” already on the market. It’s implied (but not made very clear for readers) that the pill is in trials and, therefore, not commercially available. Despite the fact that other combination blood pressure-lowering medications are available (but not mentioned), the headline and first paragraph of this news release suggest novelty. That’s potentially misleading for readers. An editorial accompanying the study put this research in context in terms of what has been learned previously: The TRIUMPH investigators have demonstrated the effects of a promising intervention in a triple half-dose combination therapy, which logically extends findings from prior research to improve BP control among patients with mild to moderate hypertension. This study contributes to the existing literature demonstrating the essential role of fixed-dose combination therapy as a viable strategy for BP control on a global scale. This framing is premature, not supported by the study, and therefore unjustified: Could transform the way high blood pressure is treated around the world … expected the findings will change guidelines globally … a major advance.


On COVID-19, Donald Trump said that “maybe if you drank bleach you may be okay.”

Explanation: Joe Biden said President Donald Trump told Americans that drinking bleach could help combat the coronavirus, but that’s not correct. Trump did not explicitly recommend ingesting a disinfectant like bleach. But he did express interest in exploring whether disinfectants could be applied to the site of a coronavirus infection inside the body, such as the lungs. Responding to confusion over Trump’s comments, the maker of Lysol said in a statement that "under no circumstance" should its products be used in the human body.

National, Elections, Pennsylvania, Joe Biden,

Joe Biden criticized President Donald Trump’s handling of the coronavirus pandemic, saying during a speech on the economy that Trump had given up trying to manage a crisis he’s ill equipped to solve. "And when it comes to COVID-19, after months of doing nothing, other than predicting the virus would disappear, or maybe if you drank bleach you may be okay, Trump has simply given up," said Biden, who delivered his remarks at a metalworks factory near his hometown of Scranton on Thursday. Trump spoke about the role he thought disinfectants could play in tackling an infection caused by the virus during a now infamous April 23 briefing. But he didn’t say people should drink bleach. His comments came after William Bryan, the undersecretary for science and technology at the Department of Homeland Security, presented a study that found sun exposure and cleaning agents like bleach can kill the virus when it lingers on surfaces. Trump remarked on the effectiveness of those methods and wondered if they could help address infections in the human body. Here are his full comments: "A question that probably some of you are thinking of if you’re totally into that world, which I find to be very interesting. So, supposedly we hit the body with a tremendous, whether it’s ultraviolet or just very powerful light, and I think you said that hasn’t been checked, but you’re going to test it. And then I said supposing you brought the light inside the body, which you can do either through the skin or in some other way. (To Bryan) And I think you said you’re going to test that, too. Sounds interesting, right?" He continued. "And then I see the disinfectant, where it knocks it out in one minute. And is there a way we can do something like that, by injection inside or almost a cleaning, because you see it gets in the lungs and it does a tremendous number on the lungs, so it’d be interesting to check that, so that you’re going to have to use medical doctors with, but it sounds interesting to me. So, we’ll see, but the whole concept of the light, the way it kills it in one minute. That’s pretty powerful." Later, Trump clarified his comments after a reporter asked Bryan whether disinfectants could actually be injected into COVID-19 patients. "It wouldn’t be through injections, almost a cleaning and sterilization of an area. Maybe it works, maybe it doesn’t work, but it certainly has a big effect if it’s on a stationary object." Trump did not explicitly recommend ingesting a disinfectant like bleach. Nevertheless, his remarks led some companies and state agencies to issue warnings about ingesting disinfectants. The maker of Lysol said in a statement that "under no circumstance" should its products be used in the human body. The Biden campaign did not respond to a request for comment about what evidence the former vice president relied on when he claimed the president suggested Americans drink bleach to combat the virus. Biden said Trump said drinking bleach could help fight the coronavirus. Trump did not specifically recommend ingesting disinfectants, but he did express interest in exploring whether disinfectants could be applied to the site of a coronavirus infection inside the body, such as the lungs.


Viral text accurately outlines how biotechnology company Moderna is linked to Dr. Anthony Fauci, Bill Gates, George Soros, and Jeffrey Epstein.

Explanation: For the “Is this true?” record, we note the following:

In mid-2020, the American biotechnology company Moderna received prominent news coverage about their efforts to develop a vaccine to deal with the COVID-19 coronavirus disease pandemic. At that time, internet users were circulating a bit of text tying Moderna to infectious disease expert Dr. Anthony Fauci, Microsoft co-founder Bill Gates, Hungarian-born financier George Soros, and American financier and convicted sex offender Jeffrey Epstein, figures who previously had all been the subjects of various baseless conspiracy theories. The text linking Moderna with all of these public figures and implying they were involved in some nebulous but nefarious plot appeared to have been a completely tongue-in-cheek spoof of groundless conspiracy theories, but many readers who skimmed it at least wondered if it might have at least some substance to it:  The vaccine that is coming… As many of you heard Moderna is in stage 3 of their vaccine testing. If all goes well it’ll become federal law to get the vaccine. Here’s something many of you don’t know,  guess who the first CEO of Moderna was? A Cornell graduate by the name of Anthony Fauci, who was a roommate with none other than Bill Gates. Are you paying attention? It was at Cornell that Bill Gates designed the RFID (Radio-frequency identification) and patented it under US2006257852. Are you awake yet? Now let’s really go down the rabbit hole. Moderna was a pharmaceutical company that started in Germany under the name IG Farben. IG Farben is infamous for it’s mass production of Zyklon-B, the primary gas used to kill millions during the Holocaust. After Germany fell, IG Farben was dissolved and its assets sold off by a Nazi turned American by the name of, you guessed it, George Soros. Soros rebranded the company as Moderna. And who was the primary stockholder of Moderna until his death? Jeffrey Epstein. His role in Moderna is where he made his fortune and established his connections. Let that sink in. Wake up people! You are being conditioned and controlled.


Image shows New York Gov. Andrew Cuomo's pierced nipples in a white polo shirt.

Explanation: Andrew Cuomo’s Pierced Nipples, Explained

On March 31 2020, a bored-in-quarantine internet turned its attention to a state governor getting national attention, and decided a photograph showed Gov. Andrew Cuomo’s “pierced nipples.”A post to Reddit’s r/TIHI (“thanks, I hate it”) went particularly viral, and and appended photograph of Cuomo (the governor of the state of New York) in the standard lawmaker disaster attire of a white polo shirt appeared to give away Cuomo’s nipple piercings:Thanks I hate governor Cuomos pierced nipples from TIHIIncidentally, post flair on the entry read “Dude’s a hero.” This is quite a claim, so we will take it piece by piece.The White Polo ShirtState governors typically appear in public in suits and ties or pearls, rarely “dressing down” except for on-the-ground emergencies. After Hurricane Sandy in 2012, New Jersey Gov. Chris Christie came to similar national notoriety after working overtime for his state.During that round of press coverage, Christie frequently wore a similarly-logoed fleece pullover. So iconic was Christie’s attire in the weeks after Sandy, he appeared on Saturday Night Live and made fun of (among other things) his own outfits:Christie thanked the Red Cross and first responders. He also thanked his wife, who he said has put up with “a husband who has smelled like a wet fleece for the last three weeks.”“You have been wearing that fleece a lot,” Seth Meyers noted.“Oh yeah, it’s basically fused to my skin at this point,” Christie quipped later adding, “I’m going to die in this fleece.”Christie’s fleece (and Cuomo’s white polo shirt) are examples of nonverbal communication and the sort of symbol that subtly arises in times of national distress. Even governors, who normally take time to dress for the occasion, have bigger fish to fry than wearing suits can handle.The zoom inThe photograph of “Andrew Cuomo’s pierced nipples” didn’t just spread on Reddit. Over on Twitter, the same image was shared with similar captioning:I may be confidentbut I’m not “Andrew Cuomo exposing his pierced nipples during a pandemic press conference” confident😔 pic.twitter.com/WVSoRKu9Oa— Rogan O’Handley 🇺🇸 (@DC_Draino) March 31, 2020Notably, that photograph was not the same as the one shared to Facebook. Cuomo’s facial expression differed — so was this proof positive Andrew Cuomo’s nipple piercings were on unintentional full display?This tweet read:I may be confident but I’m not “Andrew Cuomo exposing his pierced nipples during a pandemic press conference” confident😔Nipple height, jewelry, and Gov. CuomoAs several people pointed out, if those bilateral protrusions were, in fact, nipple rings, they were pretty low on his pectorals. At this point, we are really loath to point out that the design of some nipple rings is such that the ball-clasped edges do fall lower than the pierced appendage, but in the interest of fact-checking we will do so. Although the image below is jeweled and feminine nipple jewelry, you get the idea:Although New York State has its share of beaches, we were unable to locate a photograph of Andrew Cuomo without a shirt.A different theorySecurity protocols for notable politicians tend to be kept close to the vest (no pun intended), because public knowledge of what they might be (and thus their weaknesses) defeats their purpose. That said, Cuomo had been publicly feuding with United States President Donald Trump over COVID-19 preparedness and federal aid — or more specifically, the lack thereof.In fact, pointed comments made by Trump at a March 2020 Fox News Town Hall were widely interpreted as aimed at Andrew Cuomo specifically:Did the President of the United States Tell Governors Seeking Ventilators That Favors Are ‘a Two-Way Street’?In that light, a perhaps more relevant theory was floated about “Andrew Cuomo’s pierced nipples” — that the protrusions, too low to be near his nipples, were in fact the buckles of a bulletproof vest:Bulletproof vests come in many variations and with various purposes; the one depicted above is likely for quasi-military applications. Police officers are often seen wearing black kevlar bulletproof vests, all designed to protect the wearer from gunshots to center body mass.Other vests of the sort have velcro fastenings, and some have plastic, clickable buckles.Our conclusionLook, the COVID-19 pandemic is a rough time for many Americans and New Yorkers in particular, and if the thought of Andrew Cuomo’s pierced nipples make this pandemic in any way more bearable, we have no desire to take that from you.Following on from that, nipple piercings and bulletproof vests are not mutually exclusive; who are we do say Cuomo doesn’t have both Kevlar and pierced nipples? And maybe something else that we haven’t even considered yet? Then again, secrecy around security protocols are such that Cuomo is probably best served by the nipple piercing story.But once again, the “Andrew Cuomo’s pierced nipples” photos depicted protrusions which were quite low relative to his chest, and he was probably already aware that white polo shirts were less preferable than, say, navy blue ones for hiding anything beneath them. The best we can do is mark this Unknown, with the caveat that Andrew Cuomo’s “nipple piercings” were probably Kevlar straps or buckles.


If you have a runny nose and sputum, you have a common cold. These are the symptoms for the common cold, but they don’t rule out Covid-19. Coronavirus pneumonia is a dry cough with no runny nose. Some Covid-19 patients do get pneumonia, and one of the symptoms is a dry cough. A runny nose doesn’t rule out Covid-19. The new virus is not heat-resistant and will be killed by a temperature of 26/27 degrees. It hates the Sun. There’s no evidence for this. There’s evidence that similar viruses transmit less well in the heat, but many countries with reported Covid-19 cases are experiencing temperatures higher than this. If someone with the new coronavirus sneezes, it travels about 10 feet before it drops to the ground and is no longer airborne. Environmental factors impact how far droplets from a sneeze can travel, but it is likely to be several metres. If it drops on a metal surface it will live for at least 12 hours - so if you come into contact with any metal surface - wash your hands as soon as you can with a bacterial soap. It’s not yet known exactly how long the virus survives on surfaces. It can survive for 6-12 hours on fabric and will be killed by normal laundry detergent . There’s no evidence the virus can survive in clothing and be transmitted this way. Drinking warm water is effective for all viruses. Try not to drink liquids with ice. There’s no evidence that the temperature of liquids consumed can protect you from viruses. Wash your hands frequently as the virus can only live on your hands for 5-10 minutes. There is no evidence yet on how long the virus can survive on the skin. But it is important to regularly wash your hands. You should gargle as a prevention with salt in warm water. There’s no evidence this will prevent or cure the virus. Covid-19 starts with a sore throat lasting 3-4 days. It then blends into a nasal fluid that enters the trachea and the lungs, causing pneumonia, which takes about 5 or 6 days. With pneumonia comes high fever and difficulty breathing. The nasal congestion makes you feel like you’re drowning. This is a roughly accurate description of the most common symptoms, although not everyone with Covid-19 gets pneumonia. The symptoms may not come in this order or at these times. There have been no reports of sufferers experiencing nasal congestion that makes them feel they are drowning. Claim 1 of 11


NGOs like Doctors Without Borders are profiting from human smuggling in the Mediterranean Sea.

Explanation: We found no evidence to support the claim that these NGOs are involved in illicit smuggling or trafficking activities. Although allegations has been leveled by critics that their presence encourages migrants to make the dangerous Mediterranean crossing and Italian authorities have at least twice investigated accusations of illegal activities, no concrete proof has appeared. Organizations like Frontex and the United Nations stress that the non-governmental organizations’ role in saving lives is crucial.

Uncategorized, alt-right, defend europe, europe

In mid-July 2017, a group of young adults from Europe and North America chartered a boat and set out on a mission (named “Defend Europe”) in which their stated goal was to block migrants making the dangerous sea crossing from Libya to Italy into Europe. Their plan involved blocking rescue ships operated by non-governmental organizations (NGOs) working to prevent those migrants from drowning. Defend Europe’s pretext is their claim that the charities are profiting off illicit human smuggling or trafficking, which has become endemic in the migratory route. For example, Martin Sellner, a representative from the group, told Reuters at the Sicilian port city of Catania on 21 July 2017: There is a difference between saving lives and smuggling people to Europe. What they are doing in fact is making millions of dollars for human trafficking rings. We have found absolutely no evidence to suggest the NGOs involved in search and rescue in the Mediterranean are enriching themselves with smuggling, although this is a popular conspiracy theory among anti-immigrant groups angry at the high number of people making the journey into Europe. Defend Europe did not respond to questions we sent them asking for proof of their accusation, but they appear to be conflating the fact that while smugglers are involved in putting people on dangerous vessels and sending them out to sea, NGOs are rescuing migrants from these conditions, not profiting from them. Although the NGOs have been accused of creating a “pull”, or at least a link in transit for stranded migrants headed to Europe, they have not ever been officially accused of criminal smuggling or trafficking. There are eight NGOs operating rescue ships on the Mediterranean, including Médecins Sans Frontières (Doctors Without Borders, known best by the French acronym MSF); SOS Méditerranée (France); Save the Children; Migrant Offshore Aid Station (MOAS) (Malta); Proactiva Open Arms (Spain); and the German groups Sea-Watch, Sea-Eye and Jugend Rettet. Izabella Cooper, spokeswoman for the European Union border management agency Frontex, told us in an e-mailed statement: I would like to make it very clear that Frontex has never accused the NGOs of collusion. Saving lives is an international obligation for all those who operate at sea. The smugglers operating in Libya are taking advantage of this. Frontex has noted an important change in the way the smugglers operating in Libya run their dirty business since 2014: (1) The Search and rescue area has changed in the past: while in 2011 the boats were arriving all the way to Lampedusa, in 2014 the SAR area was half way between Italy and Libya, in 2016 and 2017 SAR area moved to the limit of the Libyan territorial waters. (2) The number of people travelling on board of the dinghies has increased: While in 2014 smugglers put on average 90 persons on board of a 10-meter-long dinghies, in 2016 and in 2017 we see as many as 170 travelling on boats of the same size. (3) The quality of the materials from which the boats are made has dramatically worsened in the past 2 years — the rubber is thinner and the boats made of one chamber now (used to be thicker and made of multiple chambers). (4) While in 2014 the quantity of fuel was sufficient for the boats to make longer journeys, now the fuel is only sufficient for the boats to leave the Libyan territorial waters. The same is valid for the drinking water and food. (5) Furthermore, recently we have also noticed that the smugglers remove the engines from the boats when they see a rescue boat nearby leaving the boat full of people adrift and in danger, in order to re-use the engine for another trip. The Italian coast guard on 2 August 2017 seized the Iuventa, a ship operated by the German NGO Jugend Rettet, on suspicion of aiding illegal immigration, and accused the crew of having contact with smugglers. However, Italian authorities stopped short of saying the NGO had colluded with smugglers for financial benefit, saying they believe the motivation was “exclusively humanitarian”. A previous investigation concluded in May 2017 by Catania’s chief prosecutor Carmelo Zuccaro also found no evidence that the humanitarian groups were or are receiving illicit money from smugglers. The Defend Europe group, which is part of the white nationalist “Identitarian” movement, crowdfunded nearly USD$200,000 by way of notorious Internet troll Chuck C. Johnson’s web site WeSearchr to hire a Mongolian-flagged boat called the C-Star to carry out their mission — although it’s unclear what they are doing. According to media reports, they had been detained at least twice, once by authorities at the Suez Canal and again in Cyprus, where they lost five Sri Lankan members of the ship’s crew who disembarked and then immediately applied for asylum. Meanwhile, Enzo Bianco, mayor of Catania, has asked authorities to block the ship from docking in that city’s port because he feared their presence would further inflame an already tense situation. Defend Europe did not respond to our questions, which included a query about their current location and where they planned to travel, but posted videos in several European languages of themselves aboard the boat on 3 August 2017. Of all the routes that migrants cross globally, the Mediterranean via Libya is by far the deadliest. Yet hundreds of thousands are making that journey to Europe and are expected to continue to do so for the foreseeable future. They come from a mixture of mainly Middle Eastern and African countries for a variety of reasons, according to a United Nations High Commissioner for Refugees report; some flee violence or conflict from war-torn places like Syria to seek asylum, while others are looking for better economic prospects. Others still are victims of human trafficking or environmental crises that drive them from their home regions. The instability and general lawlessness in Libya that currently prevails creates fertile ground for human smugglers, who pack people onto increasingly dangerous vessels. As many as 950 people are believed to have died in 2015 when one such vessel capsized. NGOs took on a high profile role in pulling people to safety after the Italian navy shuttered a short-lived but successful rescue operation known as “Mare Nostrum” (“Our Sea” in Latin) that ran from October 2013 to October 2014, but was cut due to lack of support from other European Union countries. Mare Nostrum was initially launched in response to public outcry over a shipwreck that killed more than 300 people near the Italian island of Lampedusa in 2013. When that program ended, aid agency MSF — a 45-year-old NGO that brings doctors and medical personnel to crisis areas — took up the mission along with Frontex, which provided search and rescue resources (but at a fraction of the budget of Mare Nostrum). Other aid groups also joined in. MSF spokeswoman Sandra Murillo told us: MSF currently has two boats actively searching for boats in distress in international waters north of Libya: MV Aquarius run in in partnership with SOS MEDITERRANEE, and Prudence. MSF medical teams onboard treat violence-related injuries linked to detention, torture and other ill-treatment, including sexual violence, that people experienced in Libya. Medics treat skin diseases, dehydration, hypothermia, scabies and serious injuries such as chemical burns caused by fuel mixing with sea water in the boats. Pregnant women are cared for by midwives onboard and several babies have been born safely at sea. Lifesaving emergency care is also provided in emergency rooms on the boats or through medical evacuations, when needed. In the first six months of 2017, NGOs have completed 35 percent of the total of rescue operations in the Central Mediterranean. MSF alone has rescued and brought to safety more than 16,000 people. As of the end of July, just over 100,000 people have arrived on European shores in 2017, 94,802 of them in Italy. In the same timeframe, 2,385 people died while making the journey, according to the International Organization for Migrants. In the most recent reported tragedy, a boat carrying two women and five children capsized off the Turkish coast, killing all aboard.


Immunotherapy shows promise in preventing leukemia relapse

Explanation: This release about a small trial of immunotherapy applied to a dozen leukemia patients who are at unusually high risk of relapse leaps to premature interpretations and inflates the meaning of the results far beyond the limited guidance for future research that this sort of study can offer. It inappropriately elevates the importance of relapse rates, implying that they predict vital outcomes, such as survival or quality life improvements, which this trial did not measure. Even as it puffs up the potential benefits, the release neglects to note either the short-term harms reported by researchers in their scientific conference abstract or the potential life-threatening harms that immunotherapy may expose patients to. The release doesn’t provide context for how these trial results relate to  existing or other experimental treatments, and it makes makes only an oblique reference to the personal financial stakes of a lead researcher. It does not make any reference to cost, even though recently-approved immunotherapy treatments suggest the price tag could be in the hundreds of thousands of dollars. On the positive side, the release does a good job of explaining why adjuvant treatment to enhance the immune system after bone marrow transplant may be necessary in certain leukemia patients. Relapse rates may reveal important clues to how long patients may live or how they will feel, but then again they may not. Any surmised connection between this sort of intermediate endpoint and the things that really mean something to patients must be tested. Until survival or quality of life trials are performed, news releases should not imply that an intermediate endpoint result, such as relapse rate, predicts better or longer life for patients.

Fred Hutchinson Cancer Research Center,leukemia,T-cell therapy

Although this research in still in early stages, the release could have noted that immunotherapy can be very expensive. Some courses of treatment cost $100,000, while others need to be given continually at a cost that can exceed $10,000/month. The release reports that all 12 participants in the trial (those who received the T-cell therapy after a transplant) remained in remission during a median follow-up period of more than two years, while more than a quarter of transplant-only patients relapsed within 10 months. Although that seems like clear quantification of benefits, there are many examples of cancer treatments that have produced higher remission rates, but ultimately failed to help patients live longer or better. To be clear, we have no problem with the release reporting on the surrogate outcome, which may be the only measure available to estimate the treatment’s effects in these patients. However, we believe that the release should have cautioned that the remission rates do not necessarily predict survival or even quality of life…and that these factors, the ones that really matter to patients, will be measured only in future experiments. Not only does the release omit side effects or other potential harms from this type of treatment, it emphasizes the harms of conventional treatment, thus presenting an unbalanced comparison. The conference abstract summarizing the research noted that adverse events included short-term flu-like symptoms that are common to certain types of immunotherapy, as well as temporary reductions in white blood cell counts. In addition to failing to mention these reported harms, the release did not alert readers to potential life-threatening risks of immunotherapy which sometimes do not become apparent until the therapies have been given to many people over many years. Of note: a similar experimental immunotherapy trial by the same company (with acute lymphoblastic leukemia rather than AML patients) was halted after some patients died, according to this conference recap. The growing awareness of potential hazards of immunotherapy was recently highlighted in this post on HealthNewsReview.org. The release should have mentioned that the absence of life-threatening complications in this small trial does not prove the treatment is safe. The release reports that the trial involved only 12 patients and that the comparison group was made up of “similar” patients. But it does not explain that this comparison is not as clear-cut as a trial that randomizes patients to different treatments. Also, there is no mention of the amount or type of study that remains to be done. The release notes that the trial involved only acute myeloid leukemia (AML) patients considered at high risk of relapse. It gives readers a sense that these patients are not typical of patients with AML. The release would have been better if it had provided some sense of the proportion of AML patients who fit the description of those in this trial. The release reports that funding came from the National Institutes of Health and from Juno Therapeutics. It says that one of the researchers is “a scientific co-founder” of Juno Therapeutics. So we will give the release a passing grade on this criterion. However, readers have to have sharp eyes to intuit that this disclosure means that the researcher owns part of the company and so stands to profit from any treatments that result from this work. Without any information on the extent of the type of leukemia relapse risk that is the target of this research or any evidence that a reduction in relapse rates ultimately gives patients longer or better quality life, there is no way to make an informed comparison with existing treatments. Nevertheless, the release makes unsupported assertions that this treatment appears to be superior to conventional treatment. The release also leaves out any mention of similar experimental therapies. The release reports that this is the first test of this particular treatment, so it is clear that it is just at the beginning of the research process. The release does not discuss similar experiments, including one that was outlined in the conference abstract, so readers cannot get a sense of how this experiment fits into a broad view of efforts to improve treatment of AML. The release doesn’t rely on sensationalism to describe the findings. However, researchers are quoted as saying the experimental treatment “might actually be helping patients who have a high risk of relapsing to not relapse down the line.” Then again, the reverse may be true and it might not be. While leukemia relapse is unwelcome, it cannot be known from this trial whether lower relapse rates mean longer or better lives for patients. Highlighting this sort of intermediate (or surrogate) endpoint distracts attention from the things that really matter to patients: the length and quality of their lives.


Mexican troops provided aid to U.S. residents in the chaotic aftermath of Hurricane Katrina.

Explanation: The Mexican government takes this opportunity to express its full solidarity with the people and government of the United States as a result of the damages caused by Hurricane Harvey in Texas, and expresses that it has offered to provide help and cooperation to the US government in order to deal with the impact of this natural disaster — as good neighbors should always do in trying times.

Hurricane Katrina, donald trump, hurricane harvey, hurricane hermine

In early September 2016, the confluence of Hurricane Hermine and a viral comment made by a televised Donald Trump supporter (about how taco trucks would be appearing on every corner in the U.S. should Trump lose the presidential election) revived interest in Mexico’s September 2005 response to Hurricane Katrina:   On 30 August 2016, the Facebook page for Mic. published a video reporting that Mexico’s purported response to Hurricane Katrina was “an encouraging moment which counteracts” the notion the country is “constantly in need,” adding that when Mexico sends its people across our border “history shows they’ve sent their best and bravest”:  Hurricane Katrina marked the costliest natural disaster in American history and the third most deadly, claiming at least 1,800 lives after the failure of levees caused catastrophic flooding in some of New Orleans’ most populous areas. Katrina was both newsworthy and culturally significant, inspiring multiple television documentaries and programs as well as rumors that continue to circulate years after the fact. The latter circumstance was likely due to the chaos that ensued after Katrina, as myriad accounts surfaced well after the floodwaters receded and the news media had moved on to other stories. Mic.‘s assertion that Mexico sent troops across the American border to assist what was by most accounts a stilted federal response to the tragedy was news to many social media users when it cropped up again in August 2016. Mexico’s response to Hurricane Katrina was well-documented at the time, but rarely included in retrospectives and long-form accounts of the storm and its aftermath, leading many social media users to question whether the claim was truly accurate. In July 2015, the Associated Press published archival footage of Mexican soldiers providing aid in Biloxi:  In a scene that would have given Donald Trump heart palpitations, 200 flag-waving Mexican troops breached the U.S. border outside Laredo, Tex., 10 years ago and advanced unopposed up Interstate 35 to San Antonio. It was the first time a Mexican army had marched on San Antonio since 1836 when Gen. Santa Ana massacred besieged Texas independence fighters at the Alamo. This time, however, the Mexican soldiers were on a relief mission to feed tens of thousands of homeless and hungry Americans displaced by Hurricane Katrina. Setting up camp at a former Air Force base outside San Antonio, they distributed potable water, medical supplies and 7,000 hot meals a day for the next three weeks. If this doesn’t sound like the Mexico you’ve been hearing about lately — the one that has been ripping America off, the one that sends rapists and criminals across the border — you might want to consider this little-known gesture of humanity from our abused southern neighbor as you think about Katrina 10 years later. I was serving as the No. 2 at the U.S. Embassy in Mexico City in August 2005 when Katrina made landfall on the Gulf Coast. The storm’s track posed no danger to Mexico, and we followed events like most expatriate Americans — aghast, but at a distance. But not Mexicans. They were watching the same scenes of floating corpses and botched relief efforts in New Orleans. My chief contact at Mexico’s Foreign Ministry called to say the Mexican army had two field kitchens that could feed storm victims who had made their way to Texas, he said, and the navy had two ships that could help with cleanup efforts in New Orleans. To put this in context, the United States likes to think of itself as the country that does the helping, as we had done when Mexico City was struck by a devastating earthquake in 1985. But few had contemplated the possibility that Mexico would be coming to help us … The 45-vehicle convoy crossed the border at Laredo at dawn on Sept. 8 and arrived in San Antonio later that day. The only glitch was that the USDA would not allow the Mexicans to serve the beef they had brought because they couldn’t prove it had been produced in a mad-cow-free facility. Undeterred — and un-insulted — the Mexicans bought their beef locally. By the time their mission in San Antonio ended Sept. 25, the Mexicans had served 170,000 meals, helped distribute more than 184,000 tons of supplies and conducted more than 500 medical consultations. Disasters such as Hurricane Katrina, or the spectacle of U.S. presidential politics, often force to the surface the true character of the players. The Mexicans proved they were neighbors we can count on. A few traces of the years-old news story remained online as of 2017: A Mexican army convoy rolled into the United States with food, water and medicine for Hurricane Katrina victims, the first Mexican military operation on U.S. soil in 90 years. Part of an aid package that includes ships and rescue teams, the convoy of 45 olive-green vehicles and some 200 troops went over the Rio Grande into Texas from the city of Nuevo Laredo, witnesses said … The Mexican army trucks, filled with of thousands of ready-to-eat meals, drinking water and medical equipment, were searched like regular vehicles as they crossed the border early on Thursday headed for San Antonio, Texas customs officials said. Although Mexico’s response to Katrina was often overlooked in historical accounts of the disaster, the accounts are completely true. Mexican troops crossed the border in a 45-vehicle convoy on 8 September 2005, providing material and physical aid to several areas of the Gulf Coast devastated by Katrina; the Mexican army offered hundreds of thousands of meals and tons of supplies to those in need and performed hundreds of medical consultations during a time when the United States was struggling to provide aid to its own citizens in devastated areas. Hurricane Harvey made landfall in Texas on 25 August 2017. As relief efforts were underway two days later, President Donald Trump tweeted: With Mexico being one of the highest crime Nations in the world, we must have THE WALL. Mexico will pay for it through reimbursement/other. — Donald J. Trump (@realDonaldTrump) August 27, 2017  Twitter users responded to President Trump’s tweet, reiterating the claim about Mexican troops and Hurricane Katrina: Just so you know! #Mexico was there for #Katrina I’m sure they would be willing to help w/ #Harvey but, UR damn wall is more important. pic.twitter.com/Kyy4kDlqyA — Kendra Drake (@KendraDrake94) August 27, 2017  I live in Houston, the flooding is horrible. Mexico sent their own people to help during Katrina and you want to tweet this Shit right now? pic.twitter.com/J9vciee3YW — Kyle Souder (@xSouder) August 27, 2017  Mexico’s government also responded to Trump’s tweet, releasing a statement that read in part:


Warnings about Powassan Virus, a virus transmitted by ticks that can be deadly or cause permanent neurological symptoms, circulated as summer of 2017 began.

Explanation: Warnings About Tick-Transmitted Powassan Virus

Powassan Virus is a real and potentially deadly transmitted virus that has affected about 75 people in the Northeast and Great Lakes region of America over a 10-year period, the Centers for Disease Control and Prevention (CDC) reports. As the number of cases reported over a 10-year period indicate, Powassan Virus has been fairly uncommon. Warnings about an increased risk for the virus were based solely on increases in the number of ticks in the Northeast, and in an uptick in the number of confirmed cases of the virus in deer. Warnings about Powassan Virus, or POW, spread across social media after CNN reported in May 2017 that the number of white-footed ticks in Maine in recent years had sparked some concerns about the virus, which is deadly in about 10% of reported cases. Dr. Jennifer Lyons, chief of the Division of Neurological Infections and Inflammatory Diseases at Brigham and Women’s Hospital in Boston, warned that an increase in Powassan Cases among deer could mean the same is imminent for humans: Scientists also believe Powassan is on the rise based on studies that have identified an increasing number of infections in deer. “So it does seem that there are more and more deer that they’re finding that have been infected with this virus,” Lyons said. “So we should expect it to increase in human disease incidence over the next few years.” By June 1st, Maine public health officials had confirmed two new cases of Powassan Virus, further fueling concerns that it could be spreading. The Maine Medical Research Institute also issued a report that found Powassan Virus was prevalent in the southern portion of the state. There aren’t any known vaccines or treatments for Powassan Virus. Symptoms usually emerge anywhere from a week to a month after being bitten by an infected tick. Some people might not experience any symptoms. Others might experience headache, vomiting, weakness, confusion, loss of coordination, speech difficulties and seizures, CDC reports. About half of people with Powassan Virus have permanent neurological symptoms like memory loss, recurring headaches and muscle wasting. About 10% of Powassan Virus cases are fatal. To help avoid contracting POW, CDC suggests avoiding exposure to natural tick habitats, using over-the-counter repellants when you are in these areas, and removing ticks before they have a chance to bite. Comments


Noninvasive Test May Identify Down Syndrome Early On

Explanation: Good examples:  Emphasis on how the test may “one day” offer a safe way to detect Down syndrome – rather than saying “women may soon be able to have a blood test…” as Reuters did Emphasis on “small study…experimental” Inclusion of an independent perspective   A story like this is going to catch the attention of many women and many couples. Establishing just how preliminary are these findings is essential to avoid promoting false hope and unrealistic expectations in readers.

Only mention of cost was the researcher’s quote: “The cost is much lower than the invasive procedures.”  Oh? What is that cost? How much lower? We’re not told. The story explained that “the test quickly pinpointed the chromosomal variation, identifying 14 Down syndrome cases and 26 normal fetuses.” No discussion of potential harms – of sensitivity and specificity issues still not determined after such a small study. In small, subtle ways the story framed this as an early step in research – experimental, requiring confirmation in larger clinical trials. No disease mongering. The story included the perspective of one independent expert. No discussion of how this compares with any of the other approaches being studied in this field. More reserved than its Reuters competitor, this story emphasizes the test “may one day” be available… “if larger clinical trials confirm the results.” “Small study” and “experimental” stressed in second sentence. No discussion of how this compares with any of the other approaches being studied in this field. The story did not rely solely on a news release.


The days of a massive American military presence in Afghanistan are over. Afghan forces might benefit from about 10,000 U.S. trainers and advisers, but otherwise, the country’s security is in their hands. Yet after more than a dozen years of American engagement, the situation is fragile in the extreme. Talks between the government of President Ashraf Ghani and the Taliban are on hold with no date to restart. Military casualties are up 50 percent from last year. Nearly 5,000 civilians have died so far in 2015. In this context, Politico cartoonist Matt Wuerker offered his take on the results of billions of American taxpayer dollars invested in rebuilding the country. In an Aug. 4, 2015, cartoon, a bewildered Uncle Sam stands on top of a pipeline of aid to Afghanistan riven with cracks that spell the word "corruption." Superimposed is a box that says, "The U.S. has now spent more on reconstructing Afghanistan than was spent on the Marshall Plan and the reconstruction of Europe." A reader asked us to verify that comparison. In terms of inflation-adjusted dollars, the statement holds up. But, as we’ll explain, it falls short on two points. The primary source of the claim Wuerker pointed us to one of many news reports during 2014. In June that year, the Office of the Special Inspector General for Afghanistan Reconstruction released one of its regular updates for Congress. In a short section, it compared the two programs. "Adjusted for inflation, U.S. appropriations for the reconstruction of Afghanistan exceed the funds committed to the Marshall Plan, the U.S. aid program that delivered billions of dollars between 1948 and 1952 to help 16 European countries recover in the aftermath of World War II," the report said. The Inspector General analysts wrote that in inflation-adjusted dollars, the United States had spent $103 billion on the Marshall Plan and $109 billion on Afghanistan. The investment of American dollars is a fair yardstick, but experts noted others. Two very different programs While both efforts aimed to rebuild war-torn nations, the most striking difference is the Marshall Plan spent no money on the European armed forces. In contrast, about 60 percent of the aid spent on Afghanistan went towards arming and training the military and police. In fact, the Inspector General’s report makes note of that distinction. By its tally, building the Afghan security forces absorbed nearly $62 billion of the total. (To clarify, the total for Afghanistan excludes the cost of American military operations.) The Marshall Plan unfolded long ago, so a short summary is in order for those who might not know it well. The Truman administration and Congress created the Marshall Plan to stabilize the economies of Western Europe. In the early part, the program delivered hard goods such as food, animal feed, fertilizer and fuel. Later, direct aid shifted to providing raw materials and production equipment. Aid also came in the form of grants and loans. In the dollars of the time, spending reached $10.3 billion. About half was invested in power plants, roads, railroads and agriculture. Another portion went towards debt relief. There were loan guarantees to spur American firms to invest in Europe. Charles Maier, a Harvard historian, is a leading authority on post-World War II Europe. Maier told us that making comparisons across a span of more than 50 years is "notoriously tricky." The circumstances on the ground in Europe in the later 1940s and Afghanistan today are fundamentally different, Maier said. "The European countries — outside Greece — were really functioning administrative systems," Maier said. "Few of those societal infrastructures have been operative in Afghanistan. Also, when the aid was being provided, there was no fighting in the recipient countries, except for the civil war in Greece, 1946-49." Maier also emphasized that while the inflation-adjusted dollars might put the Afghanistan price tag above that of the Marshall Plan, when compared to the size of the American economy at the time, the Marshall Plan represented a much heftier commitment than U.S. aid to Afghanistan. U.S. GDP then and now During the years of the Marshall Plan, the size of the U.S. economy was in the neighborhood of $310 billion (in dollars at that time). So, with total spending of $10.3 billion on European reconstruction, the Marshall Plan represented about 4.3 percent of average GDP. Maier then contrasted that with the Afghanistan spending between 2002 and 2014. During those years, the economy averaged about $14.3 trillion. The money spent on Afghanistan represented about 0.75 percent of average GDP. "That's about one-twentieth of the Marshall Plan burden," Maier said. "This seems a much more rational way of thinking about the burden the U.S. was bearing." Seen through the lens of the strain on the American economy, the Marshall Plan required more effort than rebuilding Afghanistan. Our ruling Wuerker said that the United States has spent more for Afghanistan reconstruction than it did to rebuild Europe under the Marshall Plan. While the math behind the claim adds up, it's important to know that the reconstruction programs are not identical. The Marshall Plan spent no funds on military projects, while about 60 percent of Afghanistan aid was spent on security. The Marshall Plan was entirely focused on economic investments, while the spending in Afghanistan has been weighted much more toward establishing a secure space in which economic growth can occur. The statement is accurate but needs clarification or additional information. We rate it .


Anti-terrorism presentation warns about women in burqas buying up cell phones.

Explanation: Lt. Col. Cotter was kind enough to send us a copy of his Eagle Eyes presentation, and it was indeed merely a general outline describing how citizens can help deter terrorism by recognizing and reporting pre-attack activities. It contained nothing about women in burqas buying up cell phones or “ragheads” probing the Air National Guard base in Fresno.

The account quoted above is a second-hand forwarding of a report by Earl Wright, who was in attendance at a December 2009 presentation given by Lt. Col. John G. Cotter of the California Air National Guard to the Rotary Club in Clovis, California, about the EagleEyes program for teaching military personnel and civilians to “recognize elements of potential terror planning when they see it.”   However, in reference to the above-reproduced report, Lt. Col. Cotter told us,  “That is my real name, and I am the Antiterrorism Officer at the 144th, but that’s the end of the accuracy of Mr Wright’s viral e-mail account”:  This is a viral e-mail that went out from a fellow named Earl Wright following my Eagle Eyes presentation to the Clovis Rotary Club in December. It has gone around the world several times and I have heard back from folks who know me all over the place. The purpose of the Eagle Eyes program is to familiarize military and civilian folks with the eight observable steps leading up to a terrorist event and to encourage them to call the phone numbers I provided to the FBI, Fresno Police or Air Force OSI if they see something that doesn’t look right. That way the appropriate agencies can intervene and stop an attack from taking place. Our program has been very effective and has been cited as the best in the Air Guard for two years in a row. I’ve given this presentation hundreds of times to military and civilian organizations, and this is the first time something like this has happened. The quotes apparently attributed to me are false. I never refer to people as “ragheads” or f***ers, although I do stress that we don’t profile. The examples cited in this e-mail have been distorted, mis-represented and inaccurately reported and attributed to me. If you or your agency would ever like to see the real presentation, I’ll be happy to come and give it at your convenience. The Fresno Bee also reported that other attendees did not recall Lt. Col. Cotter’s having made the remarks attributed to him:  Rotary member Bill Mayhugh, who is in charge of lining up speakers for the club, backs up Cotter. “It was typical community outreach,” Mayhugh says. “He said that if you see something suspicious, call the police, FBI or Homeland Security. I sure didn’t hear the stuff that’s in the e-mail.”


A $10 million fire fee proposal in St. Petersburg was "inspired" by Gov. Rick Scott.

City Budget, City Government, Taxes, Florida, Fact Check Florida,

To political operatives, campaign mailers are often considered the most effective way to target voters, particularly in local elections. To fact-checkers, they’re often home to glaring distortions. Today’s example: A flier in the St. Petersburg mayor race that links incumbent Bill Foster, a $10 million fire fee and Republican Gov. Rick Scott. A headline on the mailer reads, "Bill Foster's $10 million Rick Scott-inspired fire fee." "Foster’s $10 million fire fee would have charged you for services you already pay for. Sound familiar?" the text continues. "Instead of taking leadership by cutting fluff out of the budget, Bill Foster took a page out of Rick Scott’s Tallahassee playbook and tried to charge us millions of dollars in ‘fees’ that taxed you for services the government should have already been providing -- $10 million of them!" The flier comes from Fact Check Florida, an electioneering communication organization, or ECO, that supports liberal candidates and is run by Jacksonville resident Matthew Martz. As an ECO, Fact Check Florida (nice name, by the way) can pay for ads that attack candidates, but it cannot expressly advocate for a candidate’s defeat or election. It can tell you why it thinks Foster is a bad guy but can’t tell you to vote for Foster’s opponent, Rick Kriseman. About the fire fee Yes, Foster pitched a fire readiness assessment, or "fire fee" in 2012 as a way to plug the city’s budget gap after another year of disappearing property tax revenues. But the idea was not "inspired" by Scott in any way. "It was funny because it was from Fact Check Florida," Foster told us, "and there was nothing factual about it." In Foster’s first two years in office, the city made up for lost property tax revenues (a result of declining home values) by reducing positions and program spending. Foster criticized a potential fire fee as a "backdoor tax increase" in those years. But in 2012, he suggested that instead of more cuts, the City Council approve a new fire readiness fee that would total $9 million a year, which was about the amount needed to close its gap for 2013. The latest version of the proposal called for property owners to pay $50 a year per parcel and $.21 per $1,000 of its appraised structural value annually, according to Tampa Bay Times archives. Some council members criticized the fire fee as disproportionately punishing low-income residents by asking them to pay the same amount as wealthier residents. The council rejected the idea and instead raised the city’s property tax rate for the first time in two decades. Foster recently tried to distance himself from the fire fee that he was linked to so closely in news coverage. With Kriseman using it as an example of failed leadership, Foster told the Tampa Bay Times that he did not come up with the proposal, pointing to records that showed council members asked the idea to be considered at a workshop eight months before they ultimately rejected it. (This revelation came after the mailpiece was distributed, so we don’t hold it against the group for not including.) The connection to Scott Let’s go back to the ad. At its most generous reading, the ad implies Foster followed Scott’s lead of raising fees for existing services. But that does not align with Scott’s record in office, which has not seen major tax or fee increases beyond increases to tuition. The state also has cut taxes and fees for Floridians since Scott took office. You can read about that here. Fact Check Florida's Martz defended the mailer. While the fee was "obviously" not Scott’s idea, he said, it’s similar to Tallahassee Republicans who "keep coming up with tiny ways to take money out of voters’ pockets without them noticing." "Under Rick Scott, it was with tuition rates," he said. "And before he got there, the Republicans did it with driver’s license renewals and things." Martz’s last point refers to $2.2 billion in increased taxes and fees that Republican lawmakers passed in 2009 -- before Scott became governor. The St. Petersburg mayor’s race is nonpartisan, but the injection of Scott highlights the political differences between the two candidates. Foster is a Republican who has Scott’s endorsement, while Kriseman is Democrat whose campaign is being partly financed by the Florida Democratic Party. Another third-party group led by Tallahassee lobbyist David Ramba is attacking Kriseman in a separate mailer for sharing partisan policies akin to the ones that brought about the government shutdown. The evolution was inevitable after the city voted in 1993 to move to a strong mayor system, argues Darryl Paulson, University of South Florida St. Petersburg professor emeritus of government. In the case of this ad, tying Foster with an unpopular governor appeals to the emotions of voters, Paulson said. "The Democrats are in essence trying to say that even though it’s not a partisan race, look who is supporting Foster, and we as Democrats hate the governor," Paulson said. "It’s really designed as a get out the vote effort to get Democratic voters to to vote in a nonpartisan election." Our ruling A mailpiece attempts to connect Foster’s rejected proposal for a fire readiness fee with Scott. This is junk mail. We rate it !


Can brain disease explain Aaron Hernandez’s behavior?.

Explanation: Former football star Aaron Hernandez’ brain was riddled with damage from a degenerative brain disease linked with head blows, but that doesn’t necessarily explain the troubles that plagued his young life.

NFL football, Health, Aaron Hernandez, Sports, Science, U.S. News, Football

The diagnosis comes from a Boston University researcher who has studied hundreds of brains from football players, college athletes and even younger players, donated after their deaths. Dr. Ann McKee announced Thursday she found evidence of severe chronic traumatic encephalopathy, or CTE, in Hernandez’ brain. Her autopsy also found signs of early brain shrinkage even though Hernandez was only 27 when he hung himself in prison in April. His lawyer filed a lawsuit against the NFL and the New England Patriots on Thursday, claiming they failed to protect their players’ safety. What’s known about CTE and how it affects the brain: DOES CTE MAKE PEOPLE VIOLENT? CTE can affect areas of the brain involved with regulating behavior and emotions. Aggression, depression, memory loss and dementia are among symptoms in former football players whose brains were donated to research, and some died by suicide. But substance abuse and other illnesses may be linked with those symptoms and there is no proof that CTE-related brain damage causes those behaviors. Hernandez was serving a life sentence for a 2013 murder when he died, and had been acquitted in two other killings. An associate had earlier accused Hernandez of shooting him in the face after an argument at a strip club. Hernandez’ background included other aggressive behavior and drug use. WHAT CAUSES CTE? Repeated head blows from contact sports and military combat are the most likely causes, scientists say. These hits can cause the brain to ricochet inside the skull, damaging nerve cells. Researchers are seeking to identify genes that may make certain people susceptible to damage from head blows, and they believe drugs and alcohol might also play a role. CTE can only be diagnosed after death. A defining feature is abnormal deposits of tau, a protein that occurs naturally in the brain but is displaced in CTE. Tau build-up can damage or destroy brain cells. HOW COMMON IS CTE? In an account published in July, McKee reported finding CTE in the brains of all but one of 111 ex-NFL players studied. Most donated brains from former college players studied also showed signs, as did 20 percent of donated brains from high school players, most of whom died by suicide or drug overdoses. But experts say most people recover from repeated head blows and the true frequency of CTE in football, other sports, the military and the general population is not known. It is not known how many head hits Hernandez experienced; he was a star in high school and college football and played most of three seasons with the New England Patriots. He was released in 2013 after his arrest. WASN’T HERNANDEZ TOO YOUNG TO HAVE CTE? Most brains donated for research are from older players but McKee has found CTE in an 18-year-old and her recent study found evidence of the disease in three high school players. ___ Follow AP Medical Writer Lindsey Tanner on Twitter at @Lindsey Tanner . Her work can be found here .


The Healthy Skeptic: telomerase activators

Explanation: This is a story about two over-the-counter products being sold to help counteract age-related changes because of their reputed capacity to affect telomere length. The story presented a generally cautious view of the value of these products but failed to question the very premise that doing something about telomere length is an assured means of slowing the aging process. We wish the column had been stronger in questioning the validity of information not backed up with data. There is historical precedence for searching for magical elixirs of youth and agents said to affect telomere length are the current sweethearts. It is telling that at the bottom of the TA Sciences website it states: “This product is not intended to diagnose, treat, cure, or prevent any disease.” Yet aging is often framed as just that – a disease that could and should be treated.

The costs for the treatments mentioned were discussed. The story did an adequate job raising questions about the evidence for alleged benefits. The independent sources interviewed helped in this regard. It’s not very strong evidence to allow a statement from a company founder that, to his knowledge, no one has developed cancer while taking TA-65. The point could have been made earlier and more clearly that since neither TA-65 nor Reneuve are considered to be drugs by the FDA, there is no standard of safety or efficacy that they are held to. (Hinted at only in final sentence.) Jump ball call. Could have done better. The column did detail the extremely limited quantity and quality of the evidence that the products mentioned are effective. However some important details or context about some of the research were missing. A study in the journal Rejuvenation Research was cited – “TA-65 boosted the activity of telomerase in 114 people who took the supplement for a year.”  This was, appropriately, followed by an expert questioning the significance of this report. Such a direct challenge could have been made for each claim made in the piece. Aging is not a disease. But this column opened with a catchy disease mongering riff engaging readers to consider ‘wrinkled skin, gray hair, a growing need to turn up the volume on ‘Jeopardy’,” and to consider the “dream” and “glimmer of hope” that the process of aging could be slowed. The first statement is a list of examples of age-related changes which often have contributing factors other than chronology. Even though the overall tone of the piece was in keeping with the “Healthy Skeptic” series title, we feel it went a bit too far on this criterion. We don’t know why so much space was given to comments by company officials. But the independent expertise of Drs. Cawthon and Hornsby were important in countering conflicted claims. There was no comparison of the compounds discussed with the impact of maintaining healthy body weight, engaging in exercise or other interventions which have a more measurable track record of ameliorating age-related changes. One simple additional sentence could have satisfied this criterion. The story provided readers with insight about how to obtain the products discussed. The story did not provide any sort of historical context about telomerase research. Its first mention dates back more than 20 years and in 2009, the Nobel prize in medicine went to the scientists that discovered it. Many readers may have walked away with the impression that this field of research is far newer than it reallly is. It’s clear that the story did not rely on a news release given the strong input from independent experts.


Price tag on gene therapy for rare form of blindness: $850K.

Explanation: A first-of-its kind genetic treatment for blindness will cost $850,000 per patient, making it one of the most expensive medicines in the world and raising questions about the affordability of a coming wave of similar gene-targeting therapies.

AP Top News, Health, Gene therapy, Genetic Frontiers, North America, Technology, Business

The injectable treatment from Spark Therapeutics can improve the eyesight of patients with a rare genetic mutation that affects just a few thousand people in the U.S. Previously there has been no treatment for the condition, which eventually causes complete blindness by adulthood. Pricing questions have swirled around the treatment due to a number of unusual factors — it is intended to be a one-time treatment, it treats a very small number of patients and represents a medical breakthrough. Previously, Spark suggested its therapy, Luxturna, could be worth more than $1 million. But the company said Wednesday it decided on the lower price after hearing concerns from health insurers about the affordability of the treatment. Consternation over skyrocketing drug prices, especially in the U.S., has led to intense scrutiny from patients, politicians, insurers and hospitals. “We wanted to balance the value and the affordability concerns with a responsible price that would ensure access to patients,” said CEO Jeffrey Marrazzo, in an interview with The Associated Press. Luxturna is still significantly more expensive than nearly every other medicine on the global market, including two other gene therapies approved earlier last year in the U.S. Pharmaceutical industry critics said the slightly lower cost is a distraction from the ongoing problem of unsustainable drug prices. “The company very cleverly convinced everyone that they were going to charge a million dollars, so now they are being credited for being reasonable,” said Dr. Peter Bach, director of a policy center at Memorial Sloan Kettering Cancer Center in New York. Approved last month, Luxturna, is the nation’s first gene therapy for an inherited disease. It requires a 45-minute operation in which a tiny needle delivers a replacement gene to the retina, tissue at the back of the eye that converts light into electric signals that produce vision. The therapy will cost $425,000 per injection. The price does not include the cost of the operation, which Spark estimates will cost between $4,000 and $5,000. The treatment is part of an emerging field of medicine that could produce dozens of new gene-targeting medications in the next few years. Like Luxturna, these therapies are generally intended to be taken once, a fact which drug developers argue sets them apart from traditional drugs taken for months or years. Even compared to other one-time gene therapies Luxturna is still an outlier. Two customized gene therapies for blood cancer approved last year are priced at $373,000 and $475,000. Many older drugs for ultra-rare diseases also cost hundreds of thousands of dollars per year, and can quickly exceed a million dollars. For instance, a drug from Biogen called Spinraza, which treats a rare neuromuscular disorder, costs $750,000 for the first year’s supply and $375,000 for subsequent years. The drug is intended to be taken for life. Drug prices are not regulated in the U.S., as they are in many other countries, so drugmakers can price their goods like any other manufacturer. Drugmakers have historically offered little explanation for the prices they charge, other than to cite the high cost of developing a drug and the fact that so many drugs fail during trials and must be abandoned. However, some companies have begun to offer more detailed reasoning as the backlash against drug prices has grown more heated. Spark Therapeutics, based in Philadelphia, has said that the cost for a lifetime of blindness — including lost earnings and caregiver wages — can easily exceed $1 million. Not everyone agrees with that argument. Even at $850,000 a preliminary analysis by one group found that the drug would need to be priced significantly lower to be a good value. The estimate by the non-profit Institute for Clinical and Economic Review assumes the drug will maintain patients’ vision for 10 years. However, Spark expects the drug’s effect to be long-lasting, if not lifelong, though it has only tracked patients for about four years. The group’s director, Dr. Steven Pearson, said paying for gene therapies that have not yet shown lasting benefits will be an ongoing issue. “If the payment is going to be done all at once that will create real affordability concerns if we don’t have tremendous confidence about how long the effects of the treatment will last,” he said. At least one gene therapy sold overseas already crossed the $1-million price threshold, a treatment for a rare protein disorder launched in Europe. Manufacturer uniQure stopped selling the therapy last year due to a lack of demand. It was never approved in the U.S. Like most prescription medicines in the U.S., most of the immediate costs of Luxturna will be borne by insurers — not patients — including private plans and government programs. For patients, Spark said it will cover all out-of-pocket expenses needed to obtain the medication, including transportation to hospitals trained to administer the injections. Given Luxturna’s federal approval and strong study results, experts say U.S. insurers will likely cover the drug. Spark will try to deflect some pricing concerns by offering unconventional payment plans to insurers. Under one arrangement with the non-profit insurer Harvard Pilgrim, Spark will refund some costs if patients don’t experience the expected improvements in vision. The company did not disclose how much money would be returned to the insurer, which covers more than a million people in New England. Spark said it is also discussing a proposal in which insurers would pay for the drug in installments over several years. That idea would apply to government programs like Medicare and Medicaid, which provide health coverage to the poor and elderly.


Explanation: Do formula-fed children face increased risk of leukemia? This news release summarizes a published report on data from 18 separate studies worldwide that, when analyzed together, suggest breastfeeding is associated with reduced risk of developing childhood or adolescent leukemia. But that’s basically the only message conveyed by the news release, which is otherwise devoid of important context, including — most importantly — on the limitations of the observational design used by all of studies in the analysis. The release’s incomplete, one-sided presentation will most likely lead to a flurry of overblown media coverage that could have negative repercussions for the many women who cannot or choose not to breastfeed. There are many reasons for women to think that breastfeeding is a good choice for their babies. Is leukemia prevention one of them? That’s the suggestion of the study reported on here, which is a re-analysis of previous studies examining the question. It’s worthwhile research, but let’s remember that these underlying studies all relied on a backward-looking case-control design that is subject to selection bias and a variety of other potential problems. And the scope of the potential benefit for this condition, which is thankfully quite rare, is limited. Our worry here is that women face a number of physical and lifestyle constraints that may affect their ability to breastfeed. And women who can’t breastfeed already experience guilt that they aren’t doing enough for their babies. Should they also be made to feel as if they are putting their children at increased risk of cancer? That’s not a justifiable message based on this study. But without more careful communication of study limitations and other context, we’re afraid that that’s the message that could ultimately reach the public.

While it’s obvious that breastfeeding is free of charge, readers might not appreciate what an advantage this is compared with prepared formulas. This is an especially important consideration in the developing world where a desire for westernization has caused a significant bump in infant formula sales. The average annual cost of a brand-name infant formula is approximately $1200 in the US. Then again, there’s potentially a cost to breastfeeding in terms of work/career advancement for the mother and the labor value of time spent breastfeeding/pumping. Breast pumps can be expensive, too. The news release didn’t need to explore all of this, but some acknowledgment of the issues at play would have been welcome. According to the release, this analysis of 18 studies found that “breastfeeding for six months or longer was associated with a 19 percent lower risk compared with no breastfeeding or breastfeeding for a shorter period of time.” A sub-analysis of 15 studies further showed that “ever being breastfeed” for a shorter period of time was associated with an 11 percent lower risk in developing leukemia compared to those who were never breastfed. But how big really is a “19% lower risk”? That depends upon whether leukemia is generally common or rare. A 19% reduction in a rare condition like childhood leukemia won’t amount to a very large absolute benefit. The release could have put a number on it. We’re on the fence here. We’re not suggesting that breastfeeding causes serious harm to mother or child, except perhaps in some cases of infectious disease transmission. However, breastfeeding isn’t always the peaceful scene of contentedly suckling infant often portrayed in the media. Cracked nipples, nipple pain, engorgement, mastitis (breast infections) are not uncommon and can reduce breastfeeding success. In addition, breast milk is low in vitamin D, and exclusive breastfeeding may increase the risk of rickets. Some acknowledgment of these issues could potentially encourage steps to prevent and address these problems, which would be beneficial. This was a meta-analysis of observational studies of breastfeeding and leukemia risk. As we’re often fond of saying, these types of studies are incapable of proving cause and effect. And yet the release is headlined, “Study Suggests Breastfeeding May Lower Risk of Childhood Leukemia” — the clear implication being that breastfeeding may have “caused” the reduction in leukemia. The release also fails to mention any weaknesses or limitations in the study design. This is important, because case-control studies sit near the bottom of the evidence pyramid and their findings should be viewed cautiously. And this study doesn’t control for confounding factors that could affect leukemia risk. The weaknesses that were cataloged in the original study (but not the release) include the following: the voluntary responses from mothers were collected in most of the studies years after the time of breast-feeding which might affect accurate recall; the response rates varied from 47 percent to 98 percent in the leukemia cases in a majority of the studies; and the response rates from controls were believed to be skewed toward a higher response rate from people with a higher socioeconomic status (which itself might be associated with lower rates of leukemia). Further, and perhaps most importantly, some studies didn’t define whether the breastfeeding was exclusive or if the babies were concurrently fed with formula or other foods. The news release also doesn’t define how many children were followed and for how long. This is an unfortunate oversight since the size, length and global nature of the study are its strong points. According to the research paper published in JAMA Pediatrics upon which the release is based, data from 10,292 leukemia cases and 17,517 controls were analyzed. Many of the studies followed children from 0 years to 14 years, some longer. The analysis includes 18 studies published over a 54-year period in 13 developed countries and five lesser developed countries. While the findings must still be viewed cautiously, the depth of data analyzed lends it more credence than research involving a small sample size and a brief time frame. The release states that “Leukemia is the most common childhood cancer and accounts for about 30 percent of all childhood cancers.”  And it suggests that breastfeeding can prevent these leukemias, which has the potential to make mothers feel badly if they’re unable to successfully breastfeed (a common phenomenon). But the release never provides the comforting information that cancer in children is, according to the National Cancer Institute, a “rare” disease. This is important context. Neither the news release nor the study cited any outside sponsors. The study was completed by epidemiologists at the School of Public Health in Haifa, Israel, and the Ministry of Health in Ramat Gan, Israel. Perhaps it goes without saying that the alternative to breast milk is infant formula, but the release could have stated this explicitly, which would have provided an opportunity to point out the other potential health advantages of breastmilk as well as the financial advantages. Not doing so provides a rather incomplete narrative. While it may be assumed that breastfeeding is available to all, this is an oversimplification. Many women have trouble initiating breastfeeding and may have jobs or other limitations that make it difficult to breastfeed. The public can be hostile to breastfeeding women. Some women do not produce enough milk to exclusively breastfeed their babies. Studies have found that while about 75% of women attempt to breastfeed in the first week, only about 30% are still exclusively breastfeeding by three months. Some acknowledgment of the difficulties involved would have provided an opportunity to mention programs and interventions, including postpartum skin-to-skin contact, partner education, lactation consultants, etc, that may improve breastfeeding success. The news release did not comment on the novelty of the research, and doesn’t tell us how this study differs from other meta-analyses of studies of breastfeeding and childhood leukemia. As the study authors claimed in the published report, “to our knowledge, this is significantly the largest and most up-to-date review and analysis of current knowledge on childhood leukemia and breastfeeding.” While the suggestion that breastfeeding reduces leukemia rates is questionable, we’ve already flagged the release for that concern. The release makes no other unwarranted claims and its tone is generally measured.


“U.S. hospitals are preparing for 96 million coronavirus infections and nearly half a million deaths, leaked documents reveal.”

Explanation: An infectious disease expert presenting to the American Hospital Association estimated there could be as many as 96 million cases of COVID-19 in the U.S. in a year. He encouraged hospitals to prepare for an outbreak of this magnitude. But there is no indication that hospitals are preparing, covertly, for an outbreak of that magnitude, as this headline suggests.

Public Health, Facebook Fact-checks, Coronavirus, Facebook posts,

In a U.S. population of 329 million, is it possible that 96 million of them will suffer COVID-19? Yes, according to an infectious diseases expert who presented a webinar to members of the American Hospitals Association. But a story being shared on social media ominously refers to "leaked documents" and carries an alarmist headline that makes it sound as though hospitals are secretly preparing for an outbreak of that size: "U.S. hospitals are preparing for 96 million coronavirus infections and nearly half a million deaths, leaked documents reveal," reads a March 7, 2020, headline on an article from the Daily Mail, a British newspaper. The post was flagged as part of Facebook’s efforts to combat  news and misinformation on its News Feed. (Read more about our partnership with Facebook.) One expert addressing an American Hospital Association webinar estimated there could be 96 million coronavirus cases and 480,000 deaths in the United States. But there isn’t evidence to indicate that American hospitals are covertly preparing for an outbreak of this magnitude, as the original headline implies. The Daily Mail says the "leaked documents" were obtained by Business Insider. When we contacted the Daily Mail for this fact-check, a spokesman said the headline would be changed. The headline was changed to: "US hospitals should prepare for 96 million coronavirus infections and nearly half a million deaths, leaked documents reveal." That is, "are preparing" was changed to "should," but the leaked documents reference remained. Business Insider, a U.S.-based news website, also used "leaked" in the headline of its article, which requires a subscription to access. Business Insider reported that it obtained slides from a webinar on COVID-19, the disease caused by the current coronavirus, that was hosted by the American Hospital Association on Feb. 26, 2020. The article said one slide, presented by Dr. James Lawler, an infectious diseases expert and internal medicine professor at the University of Nebraska Medical Center. He is director of international programs and innovation at its Global Center for Health Security. Lawler, who has treated patients infected with the coronavirus who have been evacuated from China, estimated there could be as many 96 million coronavirus cases and 480,000 deaths in the United States. "Overall, the slide points out that hospitals should prepare for an impact to the system that's 10 times a severe flu season," the Business Insider story says. The hospital association confirmed to Business Insider that the slides it reported on were authentic. It said that the information represented the views of the experts who participated, not the association. The association told us the same thing. It did not respond to our questions about whether hospitals are preparing for coronavirus in the numbers estimated by Lawler. No other American mainstream news media have reported on the estimates, according to a Nexis search. Though clearly, with such guidance, hospitals are preparing for a large outbreak. A separate March 7, 2020, story about Lawler’s estimates in another United Kingdom-based newspaper, The Independent, said Lawler "advised hospitals to prepare" for an outbreak of this size. That’s a different tone than is implied by the Daily Mail headline. "I HOPE hospitals are preparing for this," Lawler told PolitiFact by email. "Word is percolating through groundswell of professional networks as people hear ground truth from Italy, but I am afraid official sources for information are way behind." The original post said, "U.S. hospitals are preparing for 96 million coronavirus infections and nearly half a million deaths, leaked documents reveal." One expert estimated at an American Hospital Association webinar that there could be 96 million coronavirus cases and 480,000 deaths in the United States. But these supposedly "leaked" documents were slides presented by one epidemiologist during a webinar to members of the American Hospital Association. They don’t represent some official attempt to conceal information, as the original Daily Mail headline, later changed, suggests. They also don’t provide evidence that hospitals are preparing for coronavirus cases in those numbers, though clearly this information is being used as guidance for hospitals’ preparations. The statement is not accurate. We rate it .


COVID-19 contact-tracing apps like Healthy Together and ABTraceTogether are tracking you and also the people in your phone contacts and Facebook friends lists.

Explanation: What's true: Different mobile applications are using Bluetooth and/or GPS technology to trace various users' locations (on a voluntary basis) to inform public health workers about transmission zones and contact patterns. What's false: However, these applications don't have access to contact numbers stored on your phone, unless you voluntarily provide them, or to your Facebook friends list. Only voluntary app users' locations can be tracked; the locations of people in their contacts list who have not installed the app cannot be tracked. What's undetermined: Many of these applications are in the early stages of testing, and their effectiveness is still being determined, as well as their overall impact on data privacy.

In early 2020, a number of smartphone applications (apps) were tested and launched across North America to help regions identify which users have been infected with the COVID-19 coronavirus disease, who they came into contact with, and transmission zones. These apps are attempting to help make contact tracing easier, a form of disease control that the Centers for Disease Control and Prevention (CDC) calls a key strategy for preventing further spread of the disease. The process involves public health staff who work with COVID-19 patients to help them recall everyone they came into contact with during the time they may have been infectious. Staff then warn exposed individuals in a rapid and sensitive manner (while protecting the identity of the patient) and provide support and information on how to mitigate the spread. In May 2020, a number of Facebook posts claimed that mobile apps that are using contact tracing to research COVID-19 transmission patterns are also taking information from the user’s device to “identify, track or locate” various contacts on their phones or their Facebook friends lists. Most posts refer to one of two such apps: Healthy Together or ABTraceTogether. The posts say:   These posts greatly exaggerate the extent to which apps have access to contact lists and particularly to Facebook accounts. Healthy Together, built by Twenty Holdings, Inc., was rolled out by the state of Utah in April and May 2020, as part of an effort to help public health officials trace contacts of those infected with the disease, and to allow Utahns to track their symptoms and find the nearest testing center. The app uses GPS, location data, and Bluetooth technology to identify potential contacts. Bluetooth technology allows health officials to gather data by connecting devices to each other, while GPS data allows them to track a person’s movements and their location to within 5 to 10 feet. Thus, Bluetooth determines potential person-to-person transmission of the disease while GPS tracking figures out potential transmission zones and how contagious diseases can move through populations and regions. The Utah government is encouraging more people to download this application. As of May 13, more than 45,000 people had done so, at least 2% of the state’s population, according to CNBC. The app is opt-in and voluntary and allows users to control what data they release. They own their personal data and can delete it at any time. Location data is automatically deleted after 30 days, symptom data becomes anonymous after 30 days, and users can identify what data they would like to share, which includes Bluetooth data, location data, or contact lists. The FAQ on the Utah government’s coronavirus resources website suggest that officials are taking precautions around user privacy as well: Will anyone have access to personally identifiable information? Public health officials and a limited number of development employees with Twenty Holdings, Inc. will have access to your name, phone number, and location data for COVID-19 tracing purposes only. What collective data would the Utah government like to share publicly in the weeks following the launch? The State of Utah values the role of limited government and recognizes that asking you to provide personal information may be uncomfortable and concerning to some. However, you can be assured that your personal data will be used only for the purpose of fighting COVID-19. Utah will investigate GPS and location data to help understand transmission zones, with the goal of informing policy makers so they can make swift and smart decisions in the coming weeks or months. Healthy Together’s privacy policy also states users may provide the following, among other details:  We may receive: Registration and Profile Information. We may receive information from you when you register to use Healthy Together. That information may include, among other things, your full name, phone numbers, and device identifiers. Contact List. If you choose to share your mobile device contacts or address book with Healthy Together, we will store your contacts or address book information, including the phone numbers and names of your contacts, to enable you to invite your contacts to Healthy Together and help facilitate your user experience. Healthy Together responded to Snopes’ questions about these rumors: Only if a user opts-in to share their phone’s contact list, can they then invite friends on their contact list to use the app. Sending this invitation will prompt their contact to join Healthy Together, but this invitation to join the app is also opt-in. Sending an invitation to a friend does not mean Healthy Together will track or automatically collect data. If someone chooses to download the app by accepting their friend’s invitation, they too have to opt-in to share any data permissions. The app is not connected to Facebook and Healthy Together users cannot invite their Facebook friends to use the app. Healthy Together is not tracing anyone who is not a user of the app, and is not tracing anyone who does not opt in to the Bluetooth or location data permissions. Healthy Together is completely opt-in, users own their data, and can delete it at any time. Thus the app’s ability to access your contact list is in the user’s control and is available only to invite friends to download the app. The app does not appear to have the ability to access your Facebook friends list. Furthermore, the app can only track and identify people who have downloaded it, so those people without the app cannot be tracked. The app ABTraceTogether requires even less information from the user. The other app at the center of the Facebook/phone contacts rumor mill has been downloaded in the Canadian province of Alberta 100,000 times as of May 5. This voluntary app also does not connect to your phone contact list or Facebook friends list but collects only the following information: During the app set up, the only personal data we collect is your mobile number, so Alberta Health Services can contact you quickly if you were in close proximity to a COVID-19 case. With your consent, the ABTraceTogether app exchanges Bluetooth proximity data with nearby phones running the same app. This data is anonymized and encrypted, and does not reveal your identity or the other person’s identity. In order to measure distance, information about your phone model and the signal strength recorded is also shared, since different phone models transmit at a different power. This data is stored only on your phone, and is not shared with Alberta Health Services. Should Alberta Health Services need the data for contact tracing, they will ask you directly to share it with them and enable an upload of your contact tracing logs. Contact tracers, health officials who are trying to track down people exposed to the virus, may ask users about their locations in verbal interviews. The app’s privacy policy states: The information you provide will be collected by Alberta Health and Alberta Health Services for the purpose of conducting contact-tracing during the COVID-19 pandemic response to manage the public health emergency under the Public Health Act. […] ABTraceTogether enables you to exchange non-identifying information with other users via Bluetooth; other users will not have access to any of your individually identifying information. If you receive a positive diagnosis for COVID-19, Alberta Health or Alberta Health Services will send you a code to enter into the Application. Your information will then be accessed and potentially disclosed by Alberta Health and Alberta Health Services to one another, for the purpose of facilitating contact-tracing during the COVID-19 pandemic. The privacy policy further points out that because tracers rely only on Bluetooth technology and not GPS, they do not collect data about users’ locations; they only communicate with nearby phones through Bluetooth for a limited period. Privacy advocates like the Electronic Frontier Foundation (EFF) are critical of apps that ask for names and phone numbers of users, arguing that will erode trust and discourage people from signing on. They argue that developers need to be as transparent as possible to ensure their app is effective. Bennett Cyphers, a Staff Technologist with EFF spoke to Snopes, arguing that ultimately these apps should only get what is absolutely necessary from the user, with “as little private information [and] strict data minimization,” something they don’t agree apps like Healthy Together and ABTraceTogether are doing:  [The government] doesn’t need [this information], they want it … Apple’s and Google’s proposals [have] ways to do it where the user’s phone is able to give push notifications to the user through anonymized data.