The New Neo

Yes, there’s been a rise in heart attacks in the young. I’ve yet to see a really good analysis of why, and I don’t plan to sit on a hot stove till I do. But one shouldn’t minimize the effects of COVID itself:

Los Angeles County paramedic Romeo Robles told TODAY in the Feb. 9 segment that upticks in COVID-19 would often lead to more 911 calls related to heart issues in his community.

“Surprisingly, people my age … we would find them in cardiac arrest, and it was all predicted by these waves,” he said.

Cheng called the connection “more than coincidental, that is for sure.” Explaining why, she pointed out that COVID-19 can greatly impact the cardiovascular system.

“It appears to be able to increase the stickiness of the blood and increase … the likelihood of blood clot formation,” Cheng said. “It seems to stir up inflammation in the blood vessels.

I only am able to read the abstract of the study, so it’s hard to say how rigorous it was. But if it’s anything like most of its kind, my guess is “not very rigorous at all.”

COVID isn’t the only contagious illness that can cause cardiovascular problems; even the flu can so so, for example. I’d like a study on cardiovascular problems that clearly distinguishes between the effects of vaccination and those of COVID itself, and that also makes previous decades-long trends in heart attack incidence clear. In addition, any study involving vaccines also has to deal with the fact that people who have been vaccinated tend to include a higher proportion of the most vulnerable populations: the elderly, the already-infirm, and those with cadiovascular risk factors such as obesity or prior heart defects. That must be corrected for or a study of the vaccinated is worthless.

Then there’s the whole issue of reporting relative risk in a population already at low risk, such as young people and cardiovascular problems. For example, a 30% increase in something that isn’t common to begin with tends to sound a lot worse than it is. For example, if something adverse happens to 1 in 1000 and its incidence increases by 30%, that means it then happens to 1.3 in 1000.

As for the issue of longer trends that began before COVID; see this (from March of 2019):

WASHINGTON (Mar 07, 2019) – Even though fewer heart attacks are occurring in the U.S.—in large part due to the use of medications like statins and a decline in smoking—these events are steadily rising in very young adults. New data not only validate this trend but also reveal that more heart attacks are striking those under age 40, according to research being presented at the American College of Cardiology’s 68th Annual Scientific Session.

The study, which is the first to compare young (41-50 years old) to very young (40 or younger) heart attack survivors, found that among patients who suffer a heart attack at a young age overall, 1 in 5 is 40 or younger. Moreover, during the 16-year study period (2000 to 2016), the proportion of very young people having a heart attack has been increasing, rising by 2 percent each year for the last 10 years.

“It used to be incredibly rare to see anyone under age 40 come in with a heart attack—and some of these people are now in their 20s and early 30s,” said Ron Blankstein, MD, a preventive cardiologist at Brigham and Women’s Hospital, associate professor at Harvard Medical School in Boston and the study’s senior author. “Based on what we are seeing, it seems that we are moving in the wrong direction.”…

In a related study, Blankstein and his team found that 1 in 5 patients who suffer a heart attack at a young age overall—defined as younger than 50 years of age—also have diabetes. Data show that if someone has diabetes they are more likely to die and have repeat events than heart attack survivors without diabetes. Not only is diabetes one of the strongest risk factors for having a heart attack, it also predicts future events in young people who have previously had a heart attack.

Type 2 diabetes has been on the rise in young people for decades, and it may be a strong factor in what’s going on.

[NOTE: Here it is, and I think it holds up quite nicely]

I have gotten to the point where I no longer put any trust in the prognostications of scientists about COVID-19 and the comparison of various social policy tactics for dealing with it. These people have lost credibility – and I was already skeptical in the first place.

Some no doubt are well-intentioned and trying their best to do a good job. Others probably have a political agenda. But at this point I think even the first group simply doesn’t know. The country-by-country data gives us some information, to be sure – enough to bring me to the conclusion that there is no simple relationship between any of the rules and the outcomes claimed to be a result of those rules. But it doesn’t tell us what to do going forward.

Sweden is encouraging in terms of relaxing the rules, but the US is not Sweden. Georgia, likewise. But it still doesn’t tell us enough.

However, I also concluded a few weeks ago that we must go forward and open up the economy or the amount of human suffering as a result of the shutdown will be absolutely enormous, too. In fact, it already has been. Those at greater risk (like me) will have to make our own decisions about how and when we’ll venture forth. But the greater good requires that we end this stalemate.

I’m with Rand Paul who said this today to Dr. Fauci:

We need to uh, observe with an open mind what went on in Sweden, where the kids kept going to school. The mortality per capita in Sweden is actually less than France, less than Italy, less than Spain, less than Belgium, less than the Netherlands, about the same as Switzerland. But basically I don’t think there’s anybody arguing that what happened in Sweden is an unacceptable result. I think people are intrigued by it and we should be, I don’t think any of us are certain when we do all these modelings, there’ve been more people wrong with modeling than right. We’re opening up a lot of economies around the, around the U S and I hope that people who are predicting doom and gloom and saying, Oh, we can’t do this, there’s going to be, the surge will admit that they were wrong…

…We can listen to your advice, but there are people on the other side saying there’s not going to be a surge and that we can safely open the economy and the facts will bear this out.

About two months ago [that is: March, 2020] I wrote a post entitled “Gone are the days: assuming the risk.” In it I wrote:

Of course, I wasn’t around in 1918. I wasn’t around when smallpox and tuberculosis or the Black Death killed far far more of the people on earth than any of the plagues of my lifetime have come close to killing. I cannot even imagine how terrible those things were; I don’t even want to imagine. And I doubt that people took them in stride at all. And I think a good part of the dread and fear now is that in the back of our minds – or for some people, even the front of our minds – we know that such catastrophes are still possible. Human beings know they are intensely vulnerable.

But COVID-19 is not shaping up to be that sort of event, and there’s no reason to think it will be. However, although many measures are prudent – handwashing, increased testing, hospital preparedness, some measure of social distancing at least for a while – the degree of fear I see and hear is far greater than anything I can recall in my lifetime around a medical event.

And COVID-19 still isn’t shaping up to be that kind of event. We have a lot more information now. It seems, though, that people have become less able to assume any risks at all, and more demanding of total or nearly total safety. Meanwhile, to achieve that safety, many advocate the continuation of measures that are bound to sink this country – not to mention causing people to die of or suffer from other diseases or phenomena such as domestic abuse or suicide.

Of course, some who advocate continual shutdown have other motives than near-total safety. Some on the left would like the economy to sink and are merely using the fear sparked by COVID to achieve those aims. And there are plenty of people who would like to use all of it to destroy Trump’s and the GOP’s chances of victory in November.