Categories
Bullshit Health

Salad daze

This, by Amanda Mull for The Atlantic, is brilliant: Don’t Believe The Salad Millionaire.

It’s about the CEO of a salad chain for affluent customers. Said CEO claimed that the solution to COVID wasn’t masks or vaccinations: it’s salad. Americans are too fat, too lazy, and it’s their fault if they get sick.

As Mull writes:

that salad is the ideal medicine for an incredibly contagious respiratory virus might not be a trustworthy argument coming from a literal salad millionaire.

But there’s a wider point here.

More interesting, though, is how telling Neman’s salvational ramblings are of a harmful conviction about health that America’s wealthiest, most privileged class long ago laundered into common sense: that people who, unlike them, end up sick or poor have simply refused to make the right choices and help themselves. Speculating that America’s health-care crisis could be solved if everyone just had to eat some salad is not only lazy and wrong; it’s perpetuating an attitude that is making health—and the pandemic—worse for millions of people.

Although this is a story about the US, it’s just as relevant here: our media and political class has the same contempt. But despite the constant narrative of the undeserving poor, poor people don’t make bad food choices because they are stupid or greedy. They make bad food choices because they’re forced to. Poor people make bad choices because they’re poor.

Research has shown that poor people know what they’re missing from their diets, and they want quite badly to have those things.

Food is expensive. It’s expensive to buy good quality ingredients. It’s expensive to buy cookware and kitchenware. It’s expensive to pay for the energy to heat your food. And it’s expensive in terms of time: time spent preparing, time spent cooking, time spent shopping, time spent getting to and from the shops – shops that in many cases are far away from where many poorer people live.

I love to cook, but I’m doing it in a kitchen full of privilege: I can afford to pay my rent, cover my utility bills and still have enough money left to buy good quality ingredients. I have enough free time that I can afford to spend hours messing around with recipes I don’t know if I’ll even like, and I can make things for the kids in the knowledge that if they don’t like it I can simply whip up something else or get a takeaway. I can afford to waste food. These things are luxuries denied to many people.

I’m reminded of Terry Pratchett’s story about poor people’s boots:

The reason that the rich were so rich, Vimes reasoned, was because they managed to spend less money.

Take boots, for example. He earned thirty-eight dollars a month plus allowances. A really good pair of leather boots cost fifty dollars. But an affordable pair of boots, which were sort of OK for a season or two and then leaked like hell when the cardboard gave out, cost about ten dollars. Those were the kind of boots Vimes always bought, and wore until the soles were so thin that he could tell where he was in Ankh-Morpork on a foggy night by the feel of the cobbles.

But the thing was that good boots lasted for years and years. A man who could afford fifty dollars had a pair of boots that’d still be keeping his feet dry in ten years’ time, while the poor man who could only afford cheap boots would have spent a hundred dollars on boots in the same time and would still have wet feet.

As Mull writes:

The people who benefit most from this belief system tend to be those who have parlayed personal advantages into even more enormous personal wealth; they were born on third base and swear they hit a triple.

Categories
Health LGBTQ+

Trans Broken Arm Syndrome

While I’m on the subject of healthcare, this piece by David Oliver for USA Today is very good.

Ever broken a bone? You know your first thought: “Ouch!”

But what if said health care worker was too busy asking about your gender identity instead of focusing on mending your broken bone? Sure, it’s important to record and review medical history, but why would questions about hormone therapy or gender reassignment surgery be relevant in that case?

The entire UK healthcare system for trans people is based on this.

If you’re a cisgender woman who thinks she needs hormone therapy, the steps are:

  • Go to your GP
  • Get a prescription
  • Get monitored by your GP

If you’re trans:

  • Go to your GP (if you’re in Scotland you can skip this step)
  • Get referred to the gender clinic
  • Wait two to five years depending on where you live
  • Undergo multiple assessments to prove you’re not insane
  • Get your prescription approved
  • Wait four months for it to get typed up
  • Get monitored by the gender clinic for two years

Same medicine, same monitoring. But the turnaround for a cisgender woman is a couple of days; for a trans woman, many years.

Categories
Health LGBTQ+

Screening saves lives

Inclusive language is a favourite topic of right-wingers and bigoted authors: look at what the silly minorities are demanding now! But the reality is that inclusivity can really be a life or death matter.

Writing in the i Paper, Patrick Strudwick talks to deputy House of Lords Speaker Ian Duncan about the death of his brother Sean, a trans man, from ovarian cancer. Duncan is part of a campaign to encourage trans and non-binary people to get screening, and for the system to be more inclusive so trans and non-binary people are not overlooked.

As Strudwick writes:

trans men are automatically removed from GP surgeries’ lists of patients needing smear tests when they register as male, regardless of the extent of their medical transition. Overall, transitioning can reduce the risk of some cancers and increase the risk of others, which in turn can escape detection because no one is looking for them.

The same thing happens with trans women: I get invitations for cervical cancer screening but I won’t for prostate cancer screening; I don’t have a cervix but I do have a prostate.

Anti-trans activists are blaming us for this, claiming that if we didn’t change our gender markers that wouldn’t be a problem. As ever, this is coming from a place of profound ignorance about trans people’s bodies and healthcare. If we don’t change our NHS gender markers then that throws the system into disarray too: our blood tests are returned as abnormal (this happened to me several times) and we are not invited to screenings for things that do affect us, such as breast cancer screening for trans women.

There’s another important issue around this, which is the often appalling way trans and non-binary people are treated by healthcare providers. I know a few trans men who’ve been utterly humiliated by ignorant or openly transphobic healthcare workers, and that humiliation has very understandably made them wary and even avoidant of the NHS.

Screening saves lives, so this is an area where exclusion can kill people. And so can transphobic healthcare providers.

In 2012, former emergency worker Jay Kallio’s doctor didn’t tell him he had breast cancer: he found out by accident when a lab tech asked him how he was coping. As ABC News reported:

Having to find new doctors delayed the start of chemotherapy beyond the so-called “therapeutic window” for his particularly aggressive form of breast cancer.

Kallio was fortunate: despite the late start the treatment was effective. But other people haven’t been so lucky. One of the most horrific things I’ve ever read is the story of Robert Eads, an American trans man who was diagnosed with ovarian cancer in 1996. More than a dozen doctors refused to treat him, fearing damage to their reputation if they were known to have treated a trans person. By the time Eads found a doctor willing to treat him, the cancer had already metastasized to other parts of his body. Despite very aggressive treatment, he died in 1999 aged 53.

I read somewhere that there are two kinds of people in the world: those who think there is too much suffering, and those who think there isn’t enough. The people railing against inclusive language and inclusive services are in the second camp.

Categories
Health Hell in a handcart

Glasgow to exit lockdown in 2093

I know it’s necessary but I’m long past the point of expecting Glasgow’s COVID restrictions to be lifted any time soon: that’s us going into week 38 of the temporary 2-week restrictions that we’ve been living under since September. As Fraser Stewart pointed out on Twitter, there are Glaswegians who fell pregnant at the start of those measures who’ll be due to give birth soon.

Categories
Health Hell in a handcart LGBTQ+

A global hate campaign

The horrific new anti-women legislation in Poland, a near-total ban on abortion, is already harming women. The country already had some of the strongest anti-abortion legislation in Europe, and it has now removed the exception for foetal abnormalities. According to the New York Times, 1,074 of the 1,100 abortions performed in Poland last year were for that reason.

Poland’s right-wing government is not the only evil here. Its bigotry and intolerance has been assisted legally and financially by the US Christian Right. As OpenDemocracy reported late last year, Trump-linked religious groups in the US have spent hundreds of millions globally to assault women’s rights and LGBT+ people’s rights: in its report it noted that one organisation had taken part in multiple Polish cases “to defend that country’s conservative policies including against divorce and abortion”.

One of the organisations in the report is the Alliance Defending Freedom, which operates in the UK too: it has been a loud voice against Scots hate crime legislation and against trans people.

The EPF’s [European Parliamentary Forum for Sexual and Reproductive Rights] Neil Datta said: “As Europeans, we cannot sit back and watch what’s happening in the US with distance, thinking that the erosion of democratic norms and human rights cannot happen here. The same US Christian groups pushing for this in the US are now spending millions in Europe trying to achieve the same over here.”

Categories
Health Hell in a handcart

100,000 grieving families

You don’t need me to tell you that Boris Johnson lied when he said the UK government had done everything possible to minimise the COVID-19 death toll.

There is a reason we have a death toll exceeding 100,000 while New Zealand has 25, Vietnam 35 and Taiwan 7. As Devi Shridhar writes in the Guardian, we didn’t close our borders, we abandoned community testing, we didn’t lock down quickly enough, we didn’t have enough PPE for key workers and our government messaging has been incoherent and incompetent. So many of the UK’s deaths were completely preventable.

But this is not just about the Government’s incompetence and corruption. It’s also about a media that’s consistently failed in its most basic function, which is to hold power to account. For more than a year, too much of the press has been more interested in parroting the government line, platforming cranks and giving airtime to dubiously funded pressure groups than holding our failing government to account.

Journalist Mic Wright:

Every newspaper front page that heralded ‘Independence Day’ last summer when the first lockdown was eased, every headline that passed on the government’s message that people should get back to offices, every report that passed on demands from bloviating backbenchers and astroturfing groups of suddenly ‘militant’ mums contributed in its own way to reaching that number that is so abstracted in today’s newspapers — 100,000 people have died.

Every puff piece about Boris Johnson and his cute little family, every shot of his future mother-in-law coming to Downing Street, every photo spread about their dog, every column that made excuses for Dominic Cummings, sneered at ‘hipster analysis’ in the early days of this avoidable disaster, or told us about ‘Dishy’ Rishi and how much he cares, contributed to 100,000 people dead.

Every jingoistic throwback pun to a war that none of us fought and to a history that most people misremember contributed to 100,000 people dead, ever ‘Eat Out to Help Out’ promo plastered on a tabloid front-page, every syllable uttered by political hyena Matt Chorley played its part, every Rod Liddle column, every Fraser Nelson quote, every Sarah Vine column oscillating between bafflement at government policy and insidery snideness, every story that poured more shame on celebrities and influencers than the government that got us here shares a piece of the blame.

None of these people will be held to account.

Categories
Bullshit Health Hell in a handcart

Conspiracy magnets

Something that’s become really apparent in the final days of the Trump administration is that cranks of a feather flock together. If you believe that the US election has been stolen, chances are you also believe that the COVID vaccine contains microchips, and that furniture shop Wayfair traffics stolen children.

Thanks to Twitter I discovered that there’s a name for this phenomenon: crank magnetism. As RationalWiki puts it:

A sovereign citizen, a creationist, an anti-vaxxer, and a conspiracy theorist walk into a bar. He orders a drink.

The reason for it is very simple. Believing in a conspiracy theory means denying evidence, denying authority, denying reality. And once you do that once, once you decide that despite overwhelming evidence to the contrary the people in authority are covering something up, you’re much more open to the idea that they’re covering other things up too.

To put it simply: once you believe they’re covering up one thing, it’s easy to believe that they’re covering up everything.

For example, if you believe that mainstream medicine is covering up the efficacy of homeopathy or of ancient Chinese medicine, it isn’t much of a leap to believe that mainstream medicine is covering up the links between MMR and autism. If you believe that Big Pharma is being funded by the Jews to turn everybody trans, it’s hardly a stretch to believe that Big Pharma created COVID to sell vaccines or that those vaccines contain microchips.

Once you deny one reality, you can easily end up denying all reality. You can see that in the COVID deniers, in the QAnon craze, in the ludicrous things people believe about marginalised groups.

The conspiracies don’t even need to make sense, or fit with a coherent worldview. Studies have found that conspiracists will happily believe conspiracies that contradict each other – so if you believe that Princess Diana faked her own death, you’re also highly likely to believe that Princess Diana was murdered. The specifics don’t really matter: either way, there’s a cover-up.

It’d be fascinating if it weren’t so frightening.

Categories
Health

COVID year two

Ed Yong is one of the best science reporters we have, and his COVID reporting for The Atlantic has been superb. He’s just published his final piece of 2020: Where Year Two of the Pandemic Will Take Us. It’s for a US audience but it’s relevant to many other countries too.

How does a country learn from its mistakes if it cannot even agree on whether it made any?

Categories
Health

Mistakes were made

As far as I’m aware, The New Yorker has only devoted its entire issue to a single story once before, for reporting on Hiroshima. And now it’s done it again for this incredible piece of journalism, The Plague Year. It’s very long, very detailed and very powerful.

There are three moments in the yearlong catastrophe of the covid-19 pandemic when events might have turned out differently. The first occurred on January 3, 2020, when Robert Redfield, the director of the Centers for Disease Control and Prevention, spoke with George Fu Gao, the head of the Chinese Center for Disease Control and Prevention, which was modelled on the American institution. Redfield had just received a report about an unexplained respiratory virus emerging in the city of Wuhan.

Categories
Health

Happy days are (nearly) here again

It’s hard to be optimistic in these dark days (I don’t just mean metaphorically: I live in Scotland, where the sun doesn’t so much rise at this time of year as send a few expletives into the sky before going back to bed). And it’s harder still with more serious COVID restrictions about to come into force: from Friday, Glasgow will effectively be in lockdown apart from supermarkets and schools. So here’s a reason to be cautiously cheerful: the end of the pandemic is now in sight.

The piece, by Sarah Zhang for The Atlantic, is a fascinating explanation of what the new vaccines are, why they’re revolutionary and most of all, why they’re probably going to work. And if they don’t, why we probably won’t be vaccine-less for long.

The vaccine by itself cannot slow the dangerous trajectory of COVID-19 hospitalizations this fall or save the many people who may die by Christmas. But it can give us hope that the pandemic will end. Every infection we prevent now—through masking and social distancing—is an infection that can, eventually, be prevented forever through vaccines.