Current expenditures could likely cover the estimated costs of Medicare for All.

Explanation: ‘Medicare for All? How Are We Gonna Pay for That? With THIS Money’ Post

On December 12 2019, the Facebook page “Fully Automated Luxury Gay Space Communism” shared the following screenshot of a retweet opining that a $738 billion expenditure for defense (and a Space Force) could be used to fund Medicare for All:Medicare for All? How are we gonna pay for that? ?With THIS money. ⬇There it is, right there, the money that could be used to give people decent healthcare.THERE IT IS, FUCKERS. https://t.co/Leh24y3dy8— Bill Corbett (@BillCorbett) December 12, 2019In a December 11 2019 tweet, Politico reported that Congress “overwhelmingly passed a $738 billion compromise defense policy bill that would create a Space Force as the newest military service.” @BillCorbett retweeted the tweet, proposing that discretionary spending on a Space Force could be re-appropriated to fund Medicare for All:Medicare for All? How are we gonna pay for that? ?With THIS money. ⬇There it is, right there, the money that could be used to give people decent healthcare.THERE IT IS, FUCKERS.To start, the claim fell squarely across the line between opinion and verifiable fact; the United States could appropriate more of its budget to a universal health care system like Medicare for All, but budgetary appropriations are to a large degree a matter of partisan opinion. Politicians like Sen. Bernie Sanders (I-Vermont) and Democratic Reps. Alexandria Ocasio-Cortez and Ilhan Omar advocated a shift in spending to Medicare for All and similar investments; fellow Democrats like Pete Buttigieg seemed to oppose that initiative:Not true.Bernie Sanders’s #MedicareForAll plan provides billions of dollars to help displaced workers transition to new employment including job training, relocation support, wage replacement during the transition and pension fund guarantees. No workers will be left behind. https://t.co/hpGUtezKKp— Dr. Victoria Dooley (@DrDooleyMD) December 11, 2019The tweet above didn’t suggest that the $738 billion 2020 defense budget would, alone, fund Medicare for All — it appeared to merely say that some or all of those funds could be diverted from initiatives like a Space Force to universal health care. Even if such a comparison were attempted, variables such as average household spending on health insurance and wildly variable out-of-pocket expenses made such a comparison virtually irrelevant.Finally, the sum would benefit from context against government spending projections and trends. A $738 billion “compromise defense policy bill” mentioned by Politico in the retweeted tweet referenced the National Defense Authorization Act (NDAA) for fiscal year 2020:The $738 billion bill would authorize $635 billion for the base Pentagon spending and $23.1 billion for nuclear weapons programs under the Energy Department as well as $71.5 billion for war operations. It also would authorize another $5.3 billion in emergency disaster recovery for military bases damaged by extreme weather.The NDAA’s appropriations amount to only a portion of the federal budget for fiscal year 2020; a version proposed by the White House in March 2019 (FY 2020 began on October 1 2019) totaled “a record $4.746 trillion.” Sixty percent of that $4.746 trillion went to a category of spending which included Medicare and Medicaid as well as Social Security:The government expects to spend $4.746 trillion [in fiscal year 2020]. Almost 60% pays for mandated benefits such as Social Security, Medicare, and Medicaid.According to a breakdown of the proposed FY 2020 budget of $4.746 trillion, Medicare and Medicaid combined totaled more than a trillion dollars (and Social Security cost $1.102 trillion):Medicare will cost $679 billion in FY 2020. It subsidizes health care for those over age 65. […]Medicaid costs will be $418 billion in FY 2020. Medicaid provides health care to those with low incomes.A trillion is a thousand billion or a million million. As such, Medicare’s $679 billion projected cost added to Medicaid’s $418 billion projected cost totaled $1.097 billion. We were unable to locate costs to maintain the Affordable Care Act (often referred to as the ACA or, more colloquially, Obamacare) provisions in 2020, and additional issues such as the $938 billion estimated cost of waste (a quarter of healthcare spending) in the current healthcare system further obscured the real costs of the current system in 2019 and 2020:Administrative complexity accounted for the most waste, at $265.6 billion annually. Below that was waste due to pricing failure, which costs $230.7 billion to $240.5 billion annually. Failure of care delivery accounts for $102.4 billion to $165.7 billion annually. Overtreatment or low-value care results in $75.7 billion to $101.2 billion in waste annually. Waste related to fraud and abuse costs between $58.5 billion and $83.9 billion annually. Finally, failure of care coordination generates $27.2 billion to $78.2 billion in waste annually.A clear factor in estimating current spending on healthcare involved individual taxpayer costs, which again, varied widely. Among those costs were premiums, deductibles, co-payments, prescription drugs, uncovered services, uncovered medications, and other expenses borne solely by individual Americans.Sanders’ campaign website page for Medicare for All maintains that the United States spends far more of its National Gross Domestic Product (GDP) on health care costs than other countries, and that many Americans in turn receive substandard health care (or for about 30 million people, no health coverage at all):Today, more than 30 million Americans still don’t have health insurance and even more are underinsured. Even for those with insurance, costs are so high that medical bills are the number one cause of bankruptcy in the United States. Incredibly, we spend significantly more of our national GDP on this inadequate health care system — far more per person than any other major country. And despite doing so, Americans have worse health outcomes and a higher infant mortality rate than countries that spend much less on health care. Our people deserve better.According to the U.S. Census, 27.5 million people were uninsured in 2018 [PDF]; Sanders’ number appeared to be rounded to 30 million. The World Bank provides annual estimates of the cost of GDP per country compared to the cost of healthcare.Sanders site says the United States spends “significantly more of our national GDP on this inadequate health care system — far more per person than any other major country.” According to the World Bank’s most recent figures for 2016, that claim is true. The United States spent 17 percent of its GDP on healthcare in 2016, compared to Switzerland (12.3), Germany (11.1), Sweden and Japan (10.9), Canada (10.5), and the United Kingdom (9.8. )Iceland’s healthcare to GDP spending was 8.3 percent, less than half that of the United States. In many of those countries (such as Germany, the United Kingdom, and Japan, healthcare is also free at the point of delivery — meaning that citizens are not charged anything by providers. That again leads to a variable in an attempted contrast of outlays due to the amount of money paid at the point of service in co-payments and related costs such as premiums and deductibles.In formulating a comparison, it would be helpful to put a price tag on Medicare for All. And as with the individual outlays (such as co-pays, deductibles, or yearly premiums), those figures are variable to the point that they are nearly meaningless.According to the non-partisan Committee for a Responsible Federal Budget (CRFB) examination, there’s no real terra firma when it comes to breaking out the cost of Medicare for All. Buckle up:Representative Pramila Jayapal (D-WA), a co-chair of the Medicare for All Caucus, released a bill [in February 2019] that would adopt a single-payer system, where the federal government replaces private health insurance companies as the sole provider of most health care financing. While we are not aware of any estimates of this particular proposal, similar proposals have been estimated to cost the federal government roughly $28-32 trillion over a decade. […]The proposal is broadly similar to Senator Sanders’s proposed single-payer plan introduced during the 2016 Presidential campaign. While the campaign itself estimated that plan would cost the federal government about $14 trillion over a decade, most other estimates that we are aware of are at least twice that high.At the time, for example, the Committee for a Responsible Federal Budget estimated roughly that the plan would cost $28 trillion through 2026 (we estimated the Sanders plan in particular would also raise $11 trillion of revenue, leading to $17 trillion of net costs). All other estimates come to similar conclusions.For example, economist Kenneth Thorpe estimated that single-payer health care would cost the federal government $24.7 trillion through 2026, excluding the costs associated with long-term care benefits (likely about $3 trillion). The Urban Institute estimated a $32 trillion cost over the same period, including those long-term care benefits. The Center for Health and Economy (H&E) produced an estimate that the American Action Forum calculates would cost the federal government $36 trillion through 2029.In that grouping of estimates, the cost in trillions was measured in decade-long terms. CFRB cited a ten-year estimate of $28-32 trillion, or $2.8 to $3.2 trillion per year; a 2016 plan estimate issued by Sanders’ campaign in 2016 (through 2026) totaled $14 trillion, or $1.4 trillion annually. Going back to the budget estimates of Medicare and Medicaid in FY 2020 at $679 billion and $418 billion respectively, the then-current outlay for those two programs alone was $1.097 trillion.Sen. Elizabeth Warren estimated a ten-year cost of $20 trillion in new federal spending for Medicare for All, or $2.05 trillion annually — funded in part by employer-supplied contributions. Sanders did not cite a cost for Medicare for All in an undated document, instead tacking costs to an estimated $3.2 trillion annual total spending on healthcare. In that document, Sanders’ proposes revenue totaling several times the current total expenditure.In September 2019, PolitiFact pointed to a debate exchange between former U.S. Vice President Joe Biden and Sen. Sanders over the cost of Medicare for All. Biden, who opposed the plan, claimed it would cost $30 trillion over ten years (or $3 trillion a year). Sanders did not dispute that figure, instead saying the cost of the current system without Medicare for All would cost $50 trillion over the same period:“Joe said that Medicare for All would cost over $30 trillion,” Sanders said. “Status quo, over 10 years, will be $50 trillion.”[…]But if it’s a better deal for citizens depends on the other number Sanders put out there, the $50 trillion cost for keeping the system as it is.That’s not federal health care spending. That’s the government’s estimate of total health care spending across the board, both public and private, over the coming decade. (It’s actually $47 trillion by 2027. )As the site noted, the federal government estimated total health care costs through 2027 at nearly $50 trillion, citing a slightly higher proportion of GDP than the World Bank’s latest 2016 figures, a rise to 17.7 percent (or 17.9 percent, [PDF]). As PolitiFact indicated, the costs were “both public and private,” estimated at $47 trillion. But the highest estimate of $38 trillion (versus the campaign’s lowest estimate of $14 trillion in 2016) involved Medicare for All’s abolishment of co-payments, deductibles, and other point of delivery expenses for Americans.If we split the down the middle the estimate of $14 trillion over ten years with $38 trillion over ten years, we get $26 trillion, or $2.6 trillion per year in government spending. In 2018, all spending on healthcare between the government and individuals was estimated at $3.6 trillion, rising to $6 trillion by 2027 — both figures provided by Centers for Medicaid and Medicare Services (CMS) for 2018. (That figure was similar to even the highest estimate of $38 trillion over 10 years, or $3.8 trillion per year. )The tweet we started with said that the $738 billion appropriation for defense (and, of course, the Space Force) could fund Medicare for All, and fairly there was no indication that sum alone would cover that cost. Although we found no solid projection for the cost of Medicare for All, it seemed to range from $1.4 trillion to $3.8 trillion when ten year estimates were averaged out over a year. Adding the $738 billion to the $1.097 trillion bill for Medicaid and Medicare totaled $1.8 trillion, more than the Sanders’ campaign 2016 estimate for a ten-year cost — but lower than most projected costs broken down to annual amounts. Without a consensus on at least a tight range of Medicare for All costs, any such comparison was largely speculative — but total healthcare spending was about $3.6 trillion in 2018, lower than almost all estimated Medicare for All annual costs.


Explanation: It took until 268 words deep into a 383 word story to learn that the "Compound May Fight Hard-to-Treat Lung Cancer" story was not about human research. This article commits one of the cardinal sins of health journalism: it downplays the fact that the research was not done in humans. The unchallenged projections about the potential applications for patients are premature.

No costs are discussed. But we can understand that since the story is based on an early phase of research – so early that the question might be about its newsworthiness. No potential harms are discussed, nor is it mentioned that the safety profile in humans has yet to be established. The article would have done well to continue the Dr. Eck quote from the press release to include his acknowledgment that "we still have much to learn about their potential liabilities," referring to this new class of compounds. The "hope" that the compound will have fewer harms than currently available drugs appears to be based largely on in vitro data. The article provides no evaluation of the evidence beyond what was in the press release, which itself downplays the fact that the evidence is not from humans. The article presents accurate data on lung cancer mortality and NSCLC from the American Cancer Society. No independent source is cited besides the ACS statistics on lung cancer. Any story that allows a researcher to make bold claims such as that this research "will lead to an effective treatment for the thousands of non-small cell lung cancer patients worldwide" demands an independent perspective. The article mentions that the compound is being developed for NSCLCs that are resistant to 2 other drugs. However, it does not mention whether those 2 drugs are the only available treatment approaches for patients who might conceivably receive the new compound. Not until the very end of the article do we learn that the dramatic results against NSCLC tumors occurred in mice, not human beings. In fact, it never states the setting for any results — an important point because the article fails to reveal that some results, such as the compound’s apparent ability to spare normal tissues, were achieved in cell lines, not even in mice, according to the press release and article published in Nature. Therefore, most of the article is misleading . Read the pivotal sentence below. Without any mention of animals preceding it, how could we not assume that the lungs, cancers, and powerful treatment effects were in humans?


Chicago receives $6.7M to help people living with HIV/AIDS.

Explanation: The city of Chicago is receiving more than $6.7 million in federal grants to help low-income residents with HIV and AIDS.

Health, HIV and AIDS, Tammy Duckworth, Chicago

U.S. Sens. Dick Durbin and Tammy Duckworth say the funds from the Department of Health and Human Services are intended to provide support services to people living with HIV/AIDS and their families. The care will extend beyond essential medical services, and is aimed at improving overall medical outcomes. Durbin says it will improve the quality of life for patients and families. Duckworth says it builds “on the progress we’ve already made addressing the HIV/AIDS epidemic.”


Small increases in physical activity reduce immobility, disability risks in older adults

Explanation: This university news release describes results of a study of sedentary elderly Americans enrolled in a federally funded study designed to document and improve their physical mobility and function. The release does a good job of describing the study methods and the conclusion that a modest increase of at least 48 minutes a week of moderately intense walking and walking-based strengthening exercises achieved significant, if not dramatic, decreases in average overall risk of major mobility disability over a two-year-plus period of time. It also paid appropriate attention to the “dose-dependent” benefits of the exercise regimen as compared to the control group’s health education classes. That is, the greater the increase in minutes of exercise, the greater the benefits on average overall. It also noted the researchers’ conclusion that although 150 minutes of exercise a week was the goal, seeing benefits at just 48 minutes does have implications for exercise compliance rates and the likelihood that even elderly couch potatoes might devote 15 minutes or so a few days a week to stay healthier. The release didn’t include any numbers summarizing and putting the results in context. It also would have been strengthened by including a more detailed description of what “sedentary” referred to. One notable inclusion was a paragraph devoted to weaknesses in the study. Bravo for that. As the U.S. population ages, increasing numbers of elderly signal their desire to live independently, and evidence for the benefits of consistent and persistent exercise grows, researchers, geriatricians and the public are clearly interested in identifying optimal and safe exercise regimens that people can do on their own, that don’t require gym memberships or expensive equipment, and that — most of all– that people will stick to over the long haul. For many over 70 or 75 years of age, even half an hour a day can seem overwhelming. Thus, research suggesting that 20 minutes a day of moderately intense walking (with or without ankle weights), stretching, and balance exercises is a reasonable goal. Studies designed to demonstrate with some confidence that even moderate exercise can contribute to reduced risk of disability are likely to attract interest among caregivers and the public.

older adults,physical activity,Tufts University

Although there could be modest costs to those who participate in the kinds of exercise used in this study (e.g. a good pair of walking shoes, a set of ankle weights), it’s clear to the reader that walking at a fairly modest clip, and performing some stretches and balance exercises, can be done at home, in malls, in hallways, in public parks and at very little, if any, cost beyond one’s time. However, the exercise intervention described here included a twice-weekly supervised program. Although many senior centers offer similar programs for free, there may well be costs associated with participation outside the research program. The release provided only bare-bones results. We’d have liked to see some indication of the changes in mobility — from what to what — following the exercise program. The release says “Changes in activity were significantly greater in the physical activity intervention group than the health education group from baseline through 24 months.” What does that mean exactly? How much improved were those who took part in physical activity compared to those who didn’t? In addition, the headline and text refer often to reduced risks, but we’re never told exactly what those risk factors are. There is no mention of harms. The release could have noted that harm scores were pretty even among all of the study participants, regardless of the duration of their physical activity, and that the protocol was designed to keep the regimen safe for older, sedentary people. The release noted some of the study limitations and we give them kudos for that. There was another limitation we wish they had highlighted: 14,831 elders were screened for participation with 13,196 excluded due to a variety of factors (health related as well as relocations). This suggests that the generalizability of the study conclusions to the general population should be tempered. It’s not clear that the interventions are widely applicable in the elderly population. More information about the study group and the control group would have added context and clarity to the release. No mongering here. The release is clear that the research was supported by the National Institutes of Health. While some of the researchers disclosed pharma funding in the published study, that funding wasn’t relevant to this research and we agree with the decision not to include it in the release. The release doesn’t mention any alternatives to walking as a physical exercise. Multiple studies have shown benefits to the elderly from resistance training, cardiovascular endurance training, balance and flexibility training. The program of exercise training used in the study is not well described but is presumably within the scope of many senior centers and exercise programs designed for the elderly population. The release would ideally have made it clear that the program was not unique and is likely widely available. The release noted what was novel about the research’s endpoint/conclusion: the “dose” response and the search for a “minimum” level of activity that would confer benefit. None here.


Kentucky reports 4 adults have died of the flu this season.

Explanation: Kentucky health officials say four people have died of the flu this season.

Health, General News, Flu, Kentucky, Louisville

The four people who have died of influenza since September are all adults, according to Kentucky’s Department for Public Health. On Thursday, the city of Louisville reported its first death of the flu season. The victim who died Dec. 7 was an elderly person who had not been vaccinated and had underlying medical conditions, the Louisville Metro Department of Health and Wellness said in a news release. Health officials say the current flu season in Kentucky runs from September to May 2020. Louisville has seen a sharp rise in flu cases in the past two weeks, the Louisville health department said. Through Dec. 7, there had been more than 1,600 flu cases this season in the state, according to the Kentucky health department’s weekly influenza report. There have been 124 flu deaths in Louisville since 2015. The Centers for Disease Control and Prevention estimates that influenza has resulted in between 12,000 and 61,000 deaths each year in the United States since 2010, the department said.


Stop-Smoking Drug May Also Curb Problem Drinking

Explanation: Starting with the headline, any suggestion that this drug has been shown to “curb problem drinking” is not supported by this study. This story does not make clear to readers what information comes from the research that is the main subject and what comes from unrelated research or anecdotes. It doesn’t put the research into the effects of Chantix on people who drink into context with existing drug treatments given to some people with alcohol problems. The story does provide cost and side effect information. Overall, this is making news out of a small study of the short-term (only hours) effects of a drug on the way alcohol affects human physiology. One could question the newsworthiness of this story about such a small, short-term study. News stories should make clear what’s news and what’s background. This story confuses things by trying to transform research into how people feel when they mix Chantix and alcohol into an advance in knowledge about how to reduce alcohol consumption, which this research did not test. Many alcoholics smoke. A magic bullet that helps both addictions would indeed be big news. While Chantix is probably effective in improving quit-rates among smokers, it has not been shown to affect drinking. This small, short-term study in humans is only a first step in exploring how Chantix might affect drinkers.

The story reports that Chantix costs about $3 per pill. The lead of the story misstates the results of the study. These researchers measured how a few participants felt after taking Chantix or a placebo and drinking alcohol or a placebo drink. They found that overall the participants did not feel as good after drinking a low dose of alcohol, if they had taken a Chantix pill earlier. However, they didn’t see the same difference with higher doses of alcohol. This test did not look at whether these people voluntarily would change the amount of alcohol they drank when they took Chantix. The story headline and lead both focus on the possibility that Chantix could curb problem drinking. Although some other reports indicate people taking Chantix might drink less that is not what this test looked at. The story does report that Chantix carries a “black box” warning and that there are concerns about depression, suicidal thoughts, and the risk of heart attacks and strokes. The story does note that this test included only 15 people. But it doesn’t remind readers of the limitations in trying to draw conclusions from such a limited sample size. It also points out the researchers are not studying whether Chantix can help problem drinkers. But even though the story’s headline and lead refer to “problem drinkers,” readers are not told that although the participants were considered heavy social drinkers and did smoke some, they were not considered either problem drinkers nor addicted to cigarettes. The story also confuses readers by interchanging endpoints, sometimes referring to reducing alcohol consumption, sometimes talking about how people respond to alcohol. The researchers wrote that this test helps define how people respond to alcohol after taking Chantix. The test did not look at whether Chantix helps people drink less. The story switches back and forth between background from other studies and reports about Chantix and alcohol consumption and the results of this specific test of the specific types of negative feelings produced by combining Chantix and alcohol. The story notes that it “remains to be seen” whether Chantix might ever be recommended to help problem drinkers. However, the overall tone is that the drug could be useful, a message which may encourage people to try using the drug even though this test does not provide evidence that it works to curb alcohol consumption. More important is this point: The source research study excluded alcoholics. Because the news article refers to the effect of Chantix on “problem drinkers” without defining what that means, and includes speculation that there might be a “niche” for this drug for those with “alcohol-dependence issues,”  the reader would be expected to think this article might apply to alcoholics. The story does include an independent source. There was no disclosure statement included with the preview copy of the research article, so it is not known whether any of the researchers have ties to Pfizer (the maker of Chantix) or other pharmaceutical companies in this area. There is no reference to alternatives other than comments from one source that “that new ways of treating alcoholism are much needed.” It could have told readers about naltrexone, acamprosate, or disulfiram, which are already approved by the FDA for the treatment of alcohol dependence (alcoholism). There is no mention of the role of behavioral and psychiatric treatments as alternative or adjunctive care for alcoholics. It is clear that Chantix is currently available to help smokers quit. As mentioned above, other drugs are already used to treat alcohol addiction. Readers of this story should have been given that background. The story does not appear to rely on a news release.


Minnesota bets fiscal future on osteopathic medical school.

Explanation: In December of 2014, Gaylord banker Philip Keithahn met with six leaders in this small Sibley County town to discuss an audacious question. A month earlier, voters in the Sibley East Public Schools district had agreed to build a new elementary school in Gaylord, a decision that would eventually leave the existing school sitting abandoned a few blocks from downtown. Why not turn that building into an osteopathic medical school?

Keithahn likened the idea to being on a safari, and his pitch to the group went something like this: It wasn’t a sure thing — far from it. We might never find an elephant. But at the very least, we would all learn some things about economic development, improving life in Gaylord in the process. And we just might pull it off, creating an osteopathic medical school that could generate physicians where more of them are needed: right here in rural Minnesota. Nearly five years later, that imagined pursuit is beginning to look like a success. The Minnesota College of Osteopathic Medicine, co-founded by Keithahn, is renovating the old school, developing curriculum and working to win accreditation from the American Osteopathic Association. If all goes well, the school plans to open in the fall of 2020 with an inaugural class of 75 students. ___ The nonprofit news outlet MinnPost provided this article to The Associated Press through a collaboration with Institute for Nonprofit News. ___ Keithahn emphasized that the project won’t be complete until the school is accredited. Nothing is set in stone, just yet. But in further recalling his message to those Gaylord leaders, his aspirations shined through. “If/when we were successful, we would also fill a deep need for physicians who have a passion to live and practice medicine in rural and underserved communities,” he wrote. “This expanded physician workforce could provide the foundation for improving the health of vulnerable populations throughout Minnesota, our country, and the world.” Gaylord, the largest town in Sibley County with about 2,300 residents, might seem like an unusual place for a medical school. It’s located in a remote agricultural region. It’s not a university town. It has no major medical center. Over the past few decades, however, several osteopathic medical schools have opened in small communities across the country. In fact, new osteopathic schools, or branches of existing ones, have opened in 16 states in the past five years, according to the American Osteopathic Association. (Osteopathic training is similar to traditional medicine, though it emphasizes a holistic approach and strong physician-patient relationships. Moreover, few osteopathic schools are designed to produce scientific researchers). The trend has given hope to rural regions that have had difficulty recruiting primary care physicians. Dr. Boyd Buser, a past president of the AOA, said most of the osteopathic colleges that have opened in the past decade are located in areas that have been, as he put it, “medically underserved.” Osteopathic schools, he said, “have a track record of supplying physicians for those areas.” Besides his post at the AOA, Buser also once served as vice president and dean at the Kentucky College of Osteopathic Medicine, in the Appalachian region, which opened about two decades ago. The school, Buser said, is committed to serving areas that need physicians; as of 2016, 42% of its graduates were practicing in rural areas. “It’s kept its promise,” he said of the school. He added: “There’s no strategy, profession-wide, for starting new schools, but often when areas are looking to increase their physician supply they have naturally turned to osteopathic schools.” According to the AOA, there were nearly 31,000 osteopathic medical students in the United States during the 2018-19 school year — a 34% increase from five years earlier — and about 114,000 doctors of osteopathy in the United States in 2018. The organization declined to comment on the proposed Gaylord school. On a late morning in June, foot traffic in Gaylord was light, though several people ate lunch at the Prairie House Family Restaurant, a popular stop along Highway 19. At the school renovation site, workers took a break under the shade of overgrown trees whose branches dangled across the entrance. Many of those trees were marked with an X, to be removed to make way for an entryway and plaza for the medical college. Two years ago, as they explored the possibility of starting a medical school, Keithahn, his wife, Sue Keithahn — who is also an investor in the project — Mayor Don Boeder and other civic leaders took field trips to three osteopathic schools: the Kentucky school, which is in Pikeville; the DeBusk College of Osteopathic Medicine in Harrogate, Tennessee; and the West Virginia School of Osteopathic Medicine in Lewisburg. The largest of those towns, Pikeville, has fewer than 7,000 residents. Ahead of its visits, the group sent a list of questions to leaders in the three communities. One of them: “Describe your city before the medical school started and how it changed as a result of the school.” Several osteopathic schools have pipeline agreements with nearby colleges, an arrangement also envisioned by the proposed Gaylord school. (Earlier this year, leaders of the college, including Dr. Barbara Ross-Lee, slated to be the dean, discussed the possibility of collaboration at a health care panel at Minnesota State University-Mankato). In their research, community leaders found that Gaylord is in a pretty good geographic location for such a school — not too far from regional health care centers in St. Cloud and Mankato, just an hour’s drive from the Twin Cities. The idea began to take shape. Not surprisingly, Boeder didn’t expect to work on a medical school when he became the mayor. He has no background in health care. But these days, time is set aside during each City Council meeting for updates on the medical school. “I didn’t want to lose this opportunity, so I hung on to it as tightly as I could,” he said. Joe Deis dropped a stack of recent editions of The Gaylord Hub, the paper he publishes and edits, on a counter inside the newspaper’s office. Deis is a third-generation owner of the paper, so he has been around to see the city’s fortunes ebb and flow. The weekly newspaper has been covering the progress of the medical school since it was only an idea. The June 20 issue featured two pictures of the school renovation work on the front page; the issue being prepared the day I stopped by included a small update on the project. Deis said the plan was met with some skepticism, initially. ”‘We’ll believe it when we see it’” was kind of the thinking around town,” he said. “But now that all of that construction is going on, it looks promising.” Gaylord’s major employers include Michael Foods — a food processor that specializes in egg products — the door-maker Unidoor Corporation and county government (Gaylord is the seat of Sibley County). A walk through the downtown reveals two banks, a law firm, a barber shop and an insurance agent — all set against the iconic backdrop of a grain elevator. But there’s little retail — not even a coffee shop. “People are looking at the medical school to give us a boost,” Deis said. “Maybe it could lead to a cafe, a coffee shop, maybe a hotel.” Indeed, along with the school renovation, the medical school project includes attached housing for 45 students. City officials also credit the promise of the school with two planned projects: a Grandstay Hotel and an 80-unit apartment complex. Keithahn shared an economic report that suggests the medical school could generate $75 million to $125 million for the local economy, factoring in the renovation project, housing for students, spending at local businesses and other variables. The report used an economic model used by other medical schools, Keithahn said. In sending the report, he added: “The economic impact could eventually be exceeded by the impact on health care from a healthier population that lives longer.” The Minnesota College of Osteopathic Medicine would be the first osteopathic medical school in Minnesota. The University of Minnesota and the Mayo Clinic both have traditional medical schools. Students at the Gaylord school would follow the familiar med-student road: two years in the classroom, two years of training at clinics and hospitals, several years in residency at a large medical center. The school is working on residency agreements with clinics and health systems in Minnesota and other states in the Upper Midwest. The project would not have been possible without the high-speed internet fiber that RS Fiber Cooperative, an initiative involving several towns in this region, laid through town a few years ago. (Philip Keithahn was also involved in that project). Students will use simulation labs, 3D technology and other technological innovations. While the initial class is expected to have 75 students, classes should eventually double in size, meaning as many as 600 students could be enrolled in the college one day. It’s hoped that by immersing medical students in a rural area, some will want to practice in such a place. Keithahn hopes so. He also hopes the project will change the community’s perception of itself. “Any business that expands in Gaylord or other communities throughout Rural America brings hope to people,” he wrote. “New opportunities are created. People see their community differently, because visitors and people who move to the community made a choice to live and work in the community.” He added: “A rural-focused medical school in Minnesota can showcase the best talents of my friends and neighbors.”


A woman became pregnant from being struck by a bullet that had passed through the scrotum of a Civil War soldier.

Explanation: Sightings:   This legend was told during an episode of the television series House (“Joy to the World,” original air date 9 December 2008) in response to a patient asking how a virgin could become pregnant.

Sometimes touted as the origin of the phrase “son of a gun,” the apocryphal tale of “the bullet through the balls” is a well-traveled legend, often reported by such infamous urban legend vectors as “Dear Abby,” as in this example from her 6 November 1982 column:  It seems that during the Civil War (May 12, 1863, to be exact), a young Virginia farm girl was standing on her front porch while a battle was raging nearby. A stray bullet first passed through the scrotum of a young Union cavalryman, then lodged in the reproductive tract of the young woman, who thus became pregnant by a man she had not been within 100 feet of! And nine months later she gave birth to a healthy baby! The story, in fact, is completely false. The claim for the miraculous “bullet pregnancy” originated with an article that was printed as a joke in the journal The American Medical Weekly on 7 November 1874. Subsequent journals and books cited the article as fact without checking the original source or realizing that it was a put-on, and the story has been passed down through the years as an “actual case that appeared in a real medical journal many years ago.” The long and tortuous history of this legend begins with an article entitled “ATTENTION GYNAECOLOGISTS! — NOTES FROM THE DIARY OF A FIELD AND HOSPITAL SURGEON, C.S.A.” appearing under the name of an “L.G. Capers, M.D., Vicksburg, Miss.” in the 7 November 1874 issue of The American Medical Weekly. It recounts the now-familiar story of a Confederate field surgeon who dressed the wound of a soldier injured by a bullet that had entered the soldier’s leg, ricocheted off the bone, and carried away his left testicle. Coincidentally, the same surgeon was then called upon a few moments later to administer aid to a young lady who had received a gunshot wound to the abdomen. Exactly 278 days later, the surgeon returned to the village and delivered a baby boy of the wounded women, although she steadfastly maintained that she was still a virgin. The general tone and style of the article should have indicated to the astute reader that the whole thing was a gag. Even if they didn’t, at least a few more obvious clues gave away the joke: The baby was said to have been born “with something wrong about the genitals,” and upon examination the surgeon discovered that the ball which had wounded the soldier and impregnated the woman was lodged in the newborn infant’s scrotum! Even more implausibly, the soldier, when told of his astonishingly-achieved fatherhood, quickly wed the child’s mother! For those who still didn’t catch on to the article’s facetiousness, a note from the editor explaining that the whole thing was a bit of “fun” (complete with a pun on the putative author’s name) was printed in the same journal two weeks later. (Note: The details of battle given in the original article do correspond to actual events. In May of 1863, Union troops under the command of Major General James B. McPherson set out for Raymond, Mississippi, a town about fifteen miles from Jackson, the state capital. On May 12 a unit led by Major General John A. Logan ran into a Confederate brigade under the command of General John Gregg, and the battle of Raymond ensued, with Gregg eventually withdrawing his outnumbered forces from Raymond and heading down the road to Jackson.) Several months later, the British medical journal The Lancet reprinted (portions of) the 1874 article. Then, in 1896, George M. Gould and Walter L. Pyle cited (and quoted from) The Lancet as a footnote to a section about artificial impregnation in their book Anomalies and Curiosities of Medicine. Even Gould and Pyle seem to have recognized the original article’s drollery, however, as they mention that it is included “not because it bears any semblance of possibility, but as a curious example from the realms of imagination in medicine.”  F. Donald Napolitani, M.D., evidently didn’t catch the article’s whimsicality, though, as he presented all the same details as an “authenticated case report” in his 1959 article about “Two Unusual Cases of Gunshot Wounds of the Uterus” for the New York State Journal of Medicine. From then on, one or more of these sources has been cited as proof of an actual occurrence “carefully recorded for the annals of medicine” in everything from American Heritage magazine to “Dear Abby,” with each source accepting the previous ones’ references as accurate citations of a “real” medical journal article. The documents transcribed below include the original 1874 article from The American Medical Weekly that started it all, an editor’s note from a subsequent issue of the same publication explaining the whole thing as a gag, an oft misinterpreted summation from the 1896 book Anomalies and Curiosities of Medicine, and a 1959 article from the New York State Journal of Medicine by a doctor who didn’t quite get the joke (or do his homework):   by L.G. Capers, M.D., Vicksburg, Miss. How common it is now-a-days, and how natural, too, for men to tell wonderful stories about “the war”; their desperate charges; hair-breadth escapes; numbers who have fallen victims to their feats of personal valor, etc., etc. Then every surgeon has performed any number of wonderful operations before unheard of in the annals of surgery! Until the present moment, I have refrained from bringing before the public, and more particularly the Profession, any of my daring exploits or remarkable surgical procedures; and even now I feel a delicacy in offering the remarkable case, the relation of which is prompted only by a sense of duty to my professional brethren. Doubtless many will pronounce the facts to be presently related as unusual or impossible; to such I need only say, if not, why not? Here are the proofs: On the 12th day of May, 1863, the battle of R. was fought. Gen. G.’s brigade met the advance of Grant’s army, under Gen. L., about one mile from the village of R.  About three hundred yards in rear of my regiment was situated a fine residence, the occupants being a matron, her two daughters, and servants (the host being absent in another army). About 3 o’clock P.M., when the battle was raging most furiously, the above-mentioned lady and her two daughters (aged respectively fifteen and seventeen), filled with interest and enthusiasm, stood bravely in front of their homestead, ready and eager to minister to their wounded countrymen whould they fall in the dreadful fray. Our men were fighting nobly, but pressed by superior numbers, had gradually fallen back to within one hundred and fifty yards of the house. My position being near my regiment, suddenly I beheld a noble, gallant young friend staggering closer, and then fall to the earth. In the same moment a piercing scream from the house reached my ear! I was soon by the side of the young man, and, upon examination, found a compound fracture, with extensive comminution of the left tibia; the ball having ricochetted from these parts, and, in its onward flight, passed through the scrotum, carrying away the left testicle. Scarcely had I finished dressing the wounds of this poor fellow, when the estimable matron came running to me in the greatest distress, begging me to go to one of her daughters, who, she informed me, had been badly wounded a few minutes before. Hastening to the house, I found that the eldest of the young ladies had indeed received a most serious wound. A minnie ball had penetrated the left abdominal parietes, about midway between the umbilicus and anterior spinal process of the ilium, and was lost in the abdominal cavity, leaving a ragged wound behind. Believing there was little or no hope of her recovery, I had only time to prescribe an anodyne, when our army fell back, leaving both field and village in the hands of the enemy. Having remained with my wounded at the village of R., I had the opportunity of visiting the young lady the next day, and, interruptedly, for a period of nearly two months, at the end of which time she had entirely recovered, with no untoward symptoms during treatment; save a severe peritonitis, she seemed as well as ever! About six months after her recovery, the movements of our army brought me again to the village of R., and I was again sent for to see the young lady. She appeared in excellent health and spirits, but her abdomen had become enormously enlarged, so much so as to resemble pregnancy at the seventh or eighth month. Indeed, had I not known the family and the facts of the abdominal wound, I should have so pronounced the case. Under the above circumstances, I failed to give a positive diagnosis, determining to keep the case under surveillance. This I did. Just two hundred and seventy-eight days from the date of the receipt of the wound by the minnie ball, I delivered this same young lady of a fine boy, weighing eight pounds. I was not very much surprised; but imagine the surprise and mortification of the young lady herself, her entire family. This can be better imagined than described. Although I found the hymen intact in my examination before delivery, I gave no credence to the earnest and oft-repeated assertions of the young lady of her innocence and virgin purity. About three weeks from the date of this remarkable birth, I was called to see the child, the grandmother insisting there was “something wrong about the genitals.”  Examination revealed an enlarged, swollen, sensitive scrotum, containing on the right side a hard, roughened substance, evidently foreign. I decided upon operating for its removal at once, and in so doing, extracted from the scrotum a minnie ball, mashed and battered as if it had met in its flight some hard, unyielding substance. To attempt to picture my astonishment would be impossible! What may already seem very plain to my readers, as they glance over this paper, was, to me, at the time, mysterious. It was only after several days and nights of sleepless reflection that a solution flashed before me, and ever since has appeared as clear as the noon-day sun! “What is it?”  The ball I took from the scrotum of the babe was the identical one which, on the 12th of May, shattered the tibia of my young friend, and in its mutilated condition, plunged through his testicle, carrying with it particles of semen and spermatozoa into the abdomen of the young lady, then through her left ovary, and into the uterus, in this manner impregnating her! There can be no other solution of the phenomenon! These convictions I expressed to the family, and, at their solicitations, visited my young soldier friend, laying the case before him in its proper light. At first, most naturally, he appeared skeptical, but concluded to visit the young mother. Whether convinced or not, he soon married her, ere the little boy had attained his fourth month. As a matter of additional interest, I may mention having received a letter during the past year, reporting a happy married state and three children, but neither resembling, to the same marked degree, as the first — our hero — Pater familias! DR. L.G. CAPERS, of Vicksburg, Miss., disclaims responsibility for the truth of that remarkable case of impregnation by a minnie ball, as reported in No. 19 of this Journal. He tells the story as it was told to him. He does not say it is untrue, but is disposed to appositely remember the truth of the old adage, that “accidents may happen in the best regulated families.”  The joke is, that the Doctor reported the case without any signature, but as the editor is indisposed to be made the victim of canards, and recognized the writing sent, he was unwilling to deprive the author of the contemplated fun, and allowed him to enjoy even more of this than was anticipated. The readers have enjoyed the story much, but not enough “to cut capers” after reading it. The following extraordinary incident of accidental impregnation, quoted from the American Medical Weekly1 by the Lancet,2 is given in brief, not because it bears any semblance of possibility, but as a curious example from the realms of imagination in medicine. L. G. Capers of Vicksburg, Miss., relates an incident during the late Civil War, as follows: &nbsp A matron and her two daughters, aged fifteen and seventeen years, filled with the enthusiasm of patriotism, stood ready to minister to the wounds of their countrymen in their fine residence near the scene of the battle of R______, May 12, 1863, between a portion of Grant’s army and some Confederates. During the fray a gallant and noble young friend of the narrator staggered and fell to the earth; at the same time a piercing cry was heard in the house near by. Examination of the wounded soldier showed that a bullet had passed through the scrotum and carried away the left testicle. The same bullet had apparently penetrated the left side of the abdomen of the elder young lady, midway between the umbilicus and the anterior superior spinous process of the ilium, and had become lost in the abdomen. This daughter suffered an attack of peritonitis, but recovered in two months under the treatment administered. Marvelous to relate, just two hundred and seventy-eight days after the reception of the minnie-ball, she was delivered of a fine boy, weighing 8 pounds, to the surprise of herself and the mortification of her parents and friends. The hymen was intact, and the young mother strenuously insisted on her virginity and innocence. About three weeks after this remarkable birth Dr. Capers was called to see the infant, and the grandmother insisted that there was something wrong with the child’s genitals. Examination showed a rough, swollen and sensitive scrotum, containing some hard substance. He operated, and extracted a smashed and battered minie-ball. The doctor, after some meditation, theorized in this manner: &nbsp He concluded that this was the same ball that had carried away the testicle of his young friend, that had penetrated the ovary of the young lady, and, with some spermatozoa upon it, had impregnated her. With this conviction he approached the young man and told him the circumstances; the soldier appeared skeptical at first, but consented to visit the young mother; a friendship ensued which soon ripened into a happy marriage, and the pair had three children, none resembling, in the same degree as the first, the heroic pater familias. &nbsp &nbsp 1131, Nov. 7, 1874. 2476, 1875, i., 35. The following two case histories show the diversity of treatment for gunshot wounds of the uterus. Although not revolutionary in treatment, these two cases are presented for their unusual results. Both cases have been authenticated. Case Reports CASE 2. — This case of a seventeen-year-old girl was reported by Captain L. G. Capers after the Civil War. It is remarkable in its unusualness and in the treatment of the gunshot wounds of the uterus which resulted. While stationed with a regiment on May 12 during the battle of R, his regiment met the advance of the enemy. One mile from the village of R about 100 yards in the rear of the regiment was a fine mansion where a matron and her two daughters and servants were standing about 3:00 P.M. in the afternoon. The battle was raging furiously, and the woman and her two daughters were filled with extreme interest, standing bravely in front of the house, hoping to give some degree of aid to any of the wounded soldiers. Our men were fighting bravely, but pressed by superior forces, they had gradually fallen back to about 100 yards of the house. Since Captain Capers was stationed with the brigade, he suddenly beheld a gallant young lad stagger and fall to the earth. At the same moment a piercing scream came from the vicinity of the house. The young man was examined and found to have a compound fracture with extensive involvement of the left tibia. The bullet evidently had ricocheted from the left portion of the abdomen and in its upward flight passed through the scrotum, carrying away the left testicle. The matron came running in the greatest distress, begging Captain Capers to go to the assistance of one of her daughters, who had been badly wounded. A few moments later, after examining the young lady, who was sitting on the steps and groaning severely, the seriousness of the wound was apparent. The bullet evidently had perforated the girl’s abdomen in the left abdominal parietes about midway between the umbilicus and the interior spinal process of the ilium. Evidently the bullet was still in the spinal canal, and the wound itself was very ragged and irregular. Dressings were applied and medication given, and since the Army had first call on Captain Capers’ services, he left after prescribing a sedative. The town was soon left in the hands of the enemy, but several days later the rest of the brigade settle in the village of R, and Captain Capers had the opportunity of treating the young lady for the next few months. It was apparent that she seemed to have recovered from the severe peritonitis which resulted from the injury. About six months after her recovery, the movement of our Army again brought Captain Capers to the village of R, and again he was sent for by the young lady’s mother. The young lady herself appeared to be in excellent health, but her abdomen had become enormously enlarged, resembling pregnancy of the seventh or eighth month. Captain Capers stated that if it were not for the fact that he knew the injury and had known the family, he should have diagnosed the case as a definite pregnancy. Therefore, under the circumstances, he failed to give a positive diagnosis, determining to keep the young lady under surveillance. Two hundred and seventy-eight days from the receipt of the wound by the young lady, a fine boy weighing 8 pounds was delivered by Captain Capers, since there were very few doctors available at this time in the vicinity of the town. The mortification and mystification of the young lady and her entire family was apparent! In fact, before the examination Captain Capers stated that he gave no credence to the young girl’s assertion of her innocence and virgin purity! About three weeks after this remarkable birth, the Captain was called to see the baby by the grandmother, who stated that there was something wrong about the infant’s genitals. Examination revealed an enlarged, swollen, sensitive scrotum containing in the right side a hard and roughened substance, evidently foreign. The doctor decided to operate for the removal  of this object at once. In doing so, he extracted from the scrotum a mass which was mashed and battered as if it had met in its flight some hard, unyielding substance. Captain Capers stated that he was astonished and that he finally decided, after several days of seriously considering the matter, just how the incident had occurred. He surmised and stated that no other way was possible — that the mass taken from the scrotum of the baby was the identical one which on the twelfth of May had shattered the tibia of the young soldier and then had plunged through the air into the abdomen of the young lady, carrying particles of semen and spermatozoa through her left ovary and into the uterus, in this manner impregnating her! No other solution to this birth was apparent. Captain Capers explained this to the family, and at their solicitation visited the same young soldier, who at first was most skeptical but then appeared very interested in the young lady. Before four months had passed, he had married the young girl. Several years later Captain Capers received a letter from the young man stating that they were happily married and that they now had three children but the last two not resembling to the same marked degree as the first, the young hero, or the young soldier. This case occurred on May 12, 1863, and was reported November 7, 1874, in the medical annals.1               1381 BRONX RIVER AVENUE, BRONX 59 Reference      1. Med. Ann. 1:62 (Nov. 7) 1874.


In testing for allergies, a single shot may suffice

Explanation: This story reports on the use of a blood test, Immunoglobulin E (IgE), to diagnose allergies. The shots would replace the traditional method of diagnosis – a series of skin pricks to show a reaction to various allergens. While this story does a good job of explaining the benefits of having one blood test compared to a series of skin pricks, the story does not adequately describe the strength of the available evidence. The story states that the blood tests were developed in the 1970s but that newer tests have become available more recently. The story does say that the test is available and comments that its use is limited in the U.S. However, the story does not quantify the benefits of the blood test compared to the skin test. It is not clear from the story if the blood test results in better outcomes for the patient other than convenience and fewer side effects. The question of whether using the blood test in combination with treatment results in better outcomes for the patient is unanswered. Furthermore, the story only mentions one harm of the blood test – getting the blood drawn itself. The story should have mentioned other harms such as what happens with false positive or negative results or how the results may be misinterpreted by non-allergy specialist clinicians. Finally, the story commits disease mongering by not explaining that the blood and skin tests are only used in those with severe allergies. Most people with common pet or seasonal allergies will not require this kind of testing. Furthermore, the story overstates the risk that children with allergies have of developing respiratory problems and asthma later on.

The story does not mention the cost of the blood test compared to the skin prick test. While it does refer to the contention by some that "allergists resist blood testing in part to protect their revenue," the story does not describe the actual fees surrounding either the blood tests or the skin-prick tests. The story does not quantify the benefits of the blood test compared to the skin test. It is not clear from the story if the blood test results in better outcomes for the patient other than convenience and fewer side effects. The question of whether using the blood test in combination with treatment results in better outcomes for the patient is unanswered. The story only mentions one harm of the blood test – getting the blood drawn itself. The story should have mentioned other harms such as what happens with false positive or negative results or how the results may be misinterpreted by non-allergy specialist clinicians. The story does not describe the strength of the available evidence to support the use of the blood test. Specifically, no data are presented on whether more diagnostic testing will result in better outcomes. The story commits disease mongering by not emphasizing that the blood and skin tests are only used in those with severe allergies. Most people with common pet or seasonal allergies will not require this kind of testing. Furthermore, the story overstates the risk that children with allergies have of developing respiratory problems and asthma later on. The story quotes multiple experts. The story mentions the skin testing and talking with their primary care doctors about their symptoms as alternatives to the blood test. The story does say that the test is available and comments that its use is limited in the U.S. The story does state that the blood tests were developed in the 1970s but that newer tests have become available more recently. Because the story quotes multiple experts, the reader can assume the story does not rely on a press release as the sole source of information.


Event 201 “gave out stuffed souvenir coronavirus toys” to “commemorate” Novel coronavirus outbreak

Explanation: The toy at the center of the controversy is supposed to be a coronavirus microbe. Event 201 offered the plushies to people who registered to attend an October 2019 gathering that was designed to help plan for a global pandemic by bringing together business, government, and public health leaders. Event 201 used a fictionalized coronavirus outbreak as its pandemic scenario but did not "predict" the outbreak of a strain that would be detected two months later in December 2019 in Wuhan, China. Microbe plushies representing a number of diseases are widely available for sale. The Event 201 plushies were not intended to commemorate the toll that the coming outbreak would bring.

Public Health, Coronavirus, Facebook posts,

A small stuffed toy is fanning the flames of another coronavirus conspiracy theory. A Jan. 27 Facebook post about an adorable plushie drew attention to an October 2019 gathering called Event 201. It was designed to help plan for a global pandemic by bringing together business, government, and public health leaders. "Nobody has been able to explain why they gave out stuffed souvenir Coronavirus toys at #Event201 yet," the post reads. "Almost like this is big fun — for them. Or maybe it’s to commemorate the virus that’ll make them a fortune on vaccines & other treatments we will be forced to buy — Thoughts?" Underneath the post are three photos: a screen grab of Jan. 27 tweet from the Daily Mail showing images of the coronavirus under a microscope and two images showing small, stuffed toys shaped like orange suns with red rays and black eyes. The post was flagged as part of Facebook’s efforts to combat false news and misinformation on its News Feed. (Read more about our partnership with Facebook.) We noticed that there have also been many tweets speculating about Event 201’s pandemic simulation. So is it true that this plushie was distributed in commemoration of the coronavirus outbreak? Did the organizers of Event 201 have insider knowledge about this global health scare? No. Here’s what we know. The toy at the center of the controversy is supposed to be a microbe. Two months before the outbreak of Novel Coronavirus (2019-nCoV) was detected in Wuhan, China, the Event 201 scenario — which was organized by John Hopkins Center for Health Security World Economic Forum and Bill & Melinda Gates Foundation —"simulated a novel zoonotic coronavirus transmitted from bats to pigs to people that eventually becomes efficiently transmissible from person to person, leading to a severe pandemic," according to the Event 201 website. The fictionalized scenario, which was planned in part because there have been two worldwide outbreaks of coronaviruses in the last 20 years, also included 65 million related deaths in 18 months from the pretend coronavirus. Johns Hopkins Center for Health Security on Oct. 16, 2019, tweeted a picture of the stuffed microbe as part of its Event 201 registration drive: "Have you registered for the #Event201 virtual pandemic exercise yet?" the tweet read. "See the story of #Event201 play out in real-time and answer tough questions that could arise in a severe pandemic. Register today and be entered to win one of our Event201 giant microbes!" Have you registered for the #Event201 virtual pandemic exercise yet? See the story of #Event201 play out in real-time and answer tough questions that could arise in a severe pandemic. Register today and be entered to win one of our Event201 giant microbes! https://t.co/phz7Qc0LQL pic.twitter.com/fJZdjH1fVi On Jan. 24, 2020, the John Hopkins Center for Health Security released a statement clarifying that they had not been predicting the current coronavirus outbreak: "To be clear, the Center for Health Security and partners did not make a prediction during our tabletop exercise. For the scenario, we modeled a fictional coronavirus pandemic, but we explicitly stated that it was not a prediction." A World Economic Forum article stated that the Event 201 simulation of a pandemic was meant to "bring together public and private leaders to inform multi-stakeholder cooperation for pandemic preparedness and response." The article argues there needs to be pandemic simulations like these to prepare for the average of 200 epidemics that take place annually. Johns Hopkins has hosted other simulations in recent years, including Dark Winter in 2001, Atlantic Storm in 2005, and Clade X in 2018. A Facebook post says that Event 201 in October 2019 gave out stuffed coronavirus plushies to commemorate a coronavirus outbreak that didn’t start until December 2019. Yes, these plushies are meant to represent coronavirus microbes. They were given out in October — two months before the first cases of the current 2019 coronavirus outbreak appeared — but this was not because the event’s organizers had predicted the Novel Coronavirus to come. They were distributed as part of the registration for a New York event that was centered on preparing for a new coronavirus pandemic because of the history of outbreaks. These plushies were not intended to commemorate the toll that outbreak would bring. Context is everything.


Health officials have seen a surge in the number of people using "bug spray" to get high.

Explanation: There are two cases, though only one has been confirmed, in which a crystallized form of bug spray is alleged to have been added to methamphetamine, and these events resulted in symptoms consistent with an aggressive methamphetamine high. The final case, in contrast, involved the unconfirmed assertion that bug spray, in liquid form, was sprayed to synthetic marijuana (to enhance the high or perhaps throw drug dogs off the scent) and resulted in symptoms consistent with a synthetic marijuana overdose. The collection of these three events does not coherently create a narrative that can be considered an “alarming trend,” but because at least one credible report documents a case in which someone intentionally injected Raid (mixed with methamphetamine), we rank the assertion of a surge in the number of people using “bug spray” to get high as mostly false.

Medical, bug spray, daily mail, drug trends

On 19 March 2018, the often-inaccurate Daily Mail added a new story to their ever-popular “alarming new drug trend” collection of reportage. In this case, the scary new drug was “bug spray” (referring generally to insecticide products such as Raid, which contain pyrethroid compounds), with the Daily Mail reporting that “US health officials have seen a surge in the number of people using bug spray to get high. In the last year the alarming trend has been reported in Mississippi, Tennessee and most recently Indiana.” Here, the Daily Mail was attempting to tie three separate incidents, speculatively and sometimes inaccurately reported on by local news outlets, into a single, surging trend. The Mail was able to do by capitalizing on the flaws and ambiguities inherent in the original local news reports — a prime example of the local news-Daily Mail misinformation complex. In reality, no evidence establishes such an “alarming trend,” because only one of the three incidents cited by the Daily Mail involved a confirmed case of a person using an insecticide intentionally as a form of recreational drug. The remaining two reports were based on conjecture and hearsay that either referenced the same incident or were too different to be considered part of the same alleged trend (and were also just as speculative). In July 2017, the Monroe County Sheriff’s Department in Mississippi reported that a person had combined methamphetamine with crystals produced from spraying Raid “Hot Shots” on an electrified screen, and then injected that material into his veins. Both local media reports and the Daily Mail used vague language to make it sound as if the situation in Mississippi were part of an increasingly common occurrence, but Chief Deputy Curtis Knight told us that the occurrence was an isolated case: “The incident where an individual was arrested at our facility for allegedly injecting ‘Hot Shot’ bug spray has been an isolated incident. The user and a witness to the use both stated, ‘Hot Shot’ bug spray was sprayed on a screen and electricity applied to crystalize the bug spray then mixed with methamphetamine and injected.” The second “bug-spray” related incident allegedly took place in Tennessee, and it is a memorable tale involving a man allegedly high on a mix of “wasp spray” and methamphetamine breaking into a random family’s home and drinking water from their sink before cutting himself with a knife, jumping out of the house’s second floor window, and throwing feces at police from a nearby tree. While some second-hand news reports suggested the perpetrator admitted to intentionally using this combination of drugs, more detailed reporting held that this suggestion was just an assmuption based on an interpretation of drug trends greatly mirroring the description of the earlier Mississippi event: It’s likely possible because of a dangerous new drug known as ‘Wasp Spray Dope.’ Officials in Lawrence County said drug dealers are crystallizing wasp spray, then mixing them with meth. “It’s fairly new but it seems to be spreading, rapidly,” said Zach Ferguson, an investigator with the Lawrence County Sheriff’s Office. The Lawrence County Sheriff’s Department did not respond to multiple requests for clarification via e-mail, phone, and voicemail, but news reports and a lack of readily available forensic tests for wasp spray imply no confirmation was made that “wasp spray” was found in the perpetrator’s system, or that he knowingly consumed the substance or admitted to intentionally using it, as insinuated by most accounts reporting on this alleged trend. It bears mentioning that a number of drugs, including methamphetamine on its own, can produce similarly bizarre or violent reactions in users. The final and most recent in the list of incidents pointing to this “alarming trend” potentially involved no bug spray at all. The event itself, a series of overdoses at an Indianapolis men’s shelter named Wheeler Mission, occurred in January 2018 and as reported at the time involved no mention of “bug spray”: Over the last two days, 27 people have overdosed on suspected bath salts in or around Wheeler Mission, including 17 who were guests at the downtown men’s shelter. Steve Kerr, Wheeler’s chief development officer, said seven men overdosed inside the building, while another 10 overdosed directly outside the building. All are suspected to have taken bath salts that may have been laced with another drug, he said. According to a follow up report by IndyStar (published a day before the Daily Mail story ran), investigators later concluded that the cause of the overdose was Spice (a name for a synthetic form of cannabis) mixed with some “unknown chemical”: At least 17 guests were believed to have overdosed on “Katie” [or KD] — another mix of spice and an unknown chemical or drug. Most of the men were able to bounce back, but at least one was taken to the hospital and placed on a ventilator that week, according to mission leadership. Indianapolis police said a subsequent investigation led them to several drug houses connected to the distribution of spice mixed with an unknown chemical. Officers made six arrests in connection with the overdoses and confiscated nearly 10 pounds of synthetic marijuana and five handguns. The assertion that the additional chemical was some form of bug spray, and not merely another one of the hundreds of largely unknown chemicals being sold as synthetic marijuana, came from an emergency responder with the Indianapolis Fire Department who was quoted in that same March story: “Indianapolis firefighter Scott Lebherz told IndyStar this variation of KD can take many forms — marijuana, spice, tobacco, even banana leaves — but shares a common trait: all laced with a heavy-duty household bug spray.” We reached out to the Indianapolis Fire Department to ask how they reached the conclusion that the adulterating chemical in these cases was some form of insecticide. An official there told us via e-mail that this was based on stories heard in the field, not from testing: We do not test for Wasp Spray. We have on scene stories told to us — of people spraying their drugs with this and similar products to either enhance the high or confuse drug sniffing dogs. The Indiana Star, the Daily Mail, and numerous other outlets quoted Daniel Rusyniak, the Medical Director of the Indiana Poison Center, to describe the theoretical effects of using pyrethroid as a recreational drug. What is sometimes left out in these reports, however, is his skepticism that pyrethroids would produce the symptoms attributed to them, or that they would be able to cause any enhancement to a high whatsoever. Over the phone, he told us that pyrethroids can cause problems in humans, but only “at concentrations that are probably not going to be achieved unless somebody’s got some good chemistry skills,” adding that “There are a few case reports of people getting [central nervous system] excitation and some seizures and coma, but most people tolerate fairly large amounts of this without a lot of medical complications.” Indeed, the medical literature includes numerous stories of people consuming or even injecting large volumes of pyrethroids and being generally fine without any detour into violent, psychotic, or zombie-like behavior. A 2005 case report, for example, described a 36-year old man who attempted to kill himself by injecting himself with 6 mL of pyrethroid-containing insecticides: A 36-year-old man injected 6 mL of Real Kill Ant and Roach Killer 2 into his antecubital fossa and 2 mL subcutaneously into his abdomen in a suicide attempt. Upon evaluation in the emergency department, 1 hour later, he had pain at the injection site and no other symptoms … He was admitted to inpatient psychiatry and remained clinically well throughout his 3-day course. Speaking specifically of the Indiana incident, Rusyniak — who actually treated some of the people involved in the January 2018 Wheeler Mission overdose incident — told us that the symptoms described were not a unique occurrence, and could be explained by as a result of synthetic cannabis and similar chemicals: “I saw some of the people at the Wheeler Mission, and took care of some of them. [Their symptoms were] indistinguishable from a lot of outbreaks that we’ve seen [that involved only] synthetic cannabinoids.” “The idea that this is somehow unique or different from the clinical effects of the synthetic cannabinoids alone [has not been demonstrated], at least so far,” Rusyniak said. The Indiana incident, is, however, distinct from the previous events alleged to be part of the trend in that the primary drug was synthetic marijuana, not methamphetamine.


Explanation: This in-depth story takes a look at the work of scientists who are trying to repair gene-deficient mice using “gene therapy.” These researchers hope to one day apply these still-experimental treatments to people who suffer from a variety of serious neurological conditions, but the focus in this story is mostly on a rare fatal condition known as Canavan disease. The heart-rending narratives that dot this account make for vivid reading, and the story does an admirable job of reflecting the hope and enthusiasm of some of the scientists on the front lines of this work. It offers readable explanations of how these researchers are modifying gene delivery strategies to overcome tragic problems uncovered by earlier clinical studies that led to a wholesale halt in work with humans. But the bottom line here is that nearly all of the promising research of the present has been conducted in mice, making the enthusiasm that permeates this story premature. Instead of deeply discussing the challenges in moving from animal data into medical interventions, the story spends more time on the growing financial interest among investors. The first quote in the story is from a venture capitalist, for example. While it’s important to discuss the biotech buzz surrounding gene therapy research, it’s also important to provide clarity on how challenging it will be to turn the research into actual treatments, even when experiments are amply funded. Genetic diseases of the brain are difficult to treat. If gene therapy offers an avenue for intervention, it would offer hope where there currently is little.

While some therapeutic strategies appear to have been approved in China and Europe, according to the story, none has been approved in the Unites States, suggesting that cost information isn’t yet relevant. But the story does indicate how expensive these therapies might be, by mentioning a breathtaking bit of pricing by one European company: $1.4 million per injection. This is enough to rate as Satisfactory, though the story could have done more to help patients understand what pricing might look like for gene therapies, which is surely on the minds of the venture capitalists funding the research. The story reports chiefly on what appear to be full recoveries in some mice engineered to have genetic deficiencies, but we’re given no details on the quantified results nor any words of caution on the limitations of extrapolating these benefits to humans. For the one human research trial that’s discussed (for a vision disorder unrelated to Canavan disease), we’re told 21 vision-impaired patients experienced “maximum possible benefit” of vision restoration, a description that sounds like good news, but falls short of quantifying the actual benefits. This one is difficult to evaluate, since most of the current research relates only to animal studies. However, early in the story, the writer reflects on the well-publicized death of a clinical trial participant in 1999 that brought gene therapy trials to an abrupt halt in the United States. Other passages in the story also suggest caution, as does a source later in the story, who notes that risk accompanies many therapies. These details are sufficient to indicate there could be significant harms if these methods move into human testing, and that’s enough to rate as Satisfactory. However, it could have been made clearer that researchers really don’t know the harms yet. The premise of this story is that gene therapy is re-emerging as a promising and investment-worthy treatment. But the bulk of this premise is staked upon two things: Early-stage animal research, and the growing interest of financial backers. It does not balance the enthusiastic statements from researchers and investors by discussing the actual quality of this evidence as it pertains to patients waiting for a cure, except for the ending anecdote where the mother of a terminally ill child can only muster a wordless smile at the news of a promising animal study. It was a poetic way to emotionally portray the hurdles of evidence-backed treatments actually arriving for this woman’s daughter, but we also wanted to see a more analytical discussion of the limitations of animal research to better balance the story. The diseases discussed here are relentless and ultimately lethal. The writer devotes a big chunk of the story to a discussion of investor excitement regarding gene therapy. So although we do not learn who is funding specific scientists or studies, we do learn the venture firms are providing many millions of dollars to support the development effort. The relationship between investors and scientists included as sources in this story is not clear. The story also would have benefitted from quoting researchers who are not part of the studies in question. The story is explicit that at least some of the diseases mentioned have no alternative treatments. However, we did want to note that only at the end does the story explain that this type of is not appropriate for all conditions of the brain, especially those that involve multiple genes. We would have preferred to have that read that at the start of the story, to better balance the blanket statement in the headline (“GENE THERAPY MIGHT BE THE BEST, AND PERHAPS ONLY, CHANCE AT CURING BRAIN DISEASES.”) We’re told early on “there is no treatment and no cure for Canavan disease,” but then later a researcher is quoted as saying: “We have the therapy. We are ready.” The word “therapy” implies effective treatment of people. Therapeutic misconception like this is confusing to readers, and the story needed to counter this confusion by more strongly indicating this specific intervention is and will be experimental for years to come. This was made more confusing by the discussions of available gene therapies for other illnesses, including two that are in use in China and Europe, and one that might be approved in the U.S. How far behind are all the gene therapy approaches discussed in the piece? This is important to counter false hope among patients who may read this story and think that these are signals that availability of these other therapies can’t be far away. The story is clear that scientists have been trying to develop effective gene therapy strategies for years. It also makes a good case that the recent modifications in delivery mechanisms discussed here are indeed news. This story seems independent of news releases and appears to stem from a good bit of reporting work by the journalist.


Drinking one diet drink a day triples a person's risk of dementia and strokes.

Explanation: Some studies show an association between increased consumption of artificially sweetened beverages and stroke or dementia risk, but that does not mean one causes the other.

High-sugar beverages such as soda are uncontroversially unhealthy, and their regular consumption is causally associated with a variety of adverse health conditions, including coronary heart disease and diabetes. The recognition of this association has led to an increase in the popularity of beverages with alternative sweeteners. The health effects of artificially sweetened products are less clearly understood and remain an active area of research, which unfortunately for rational scientific discourse means the topic also makes for effective clickbait and scare claims. One example of that phenomenon comes from the website “Skinny and Healthy,” which posted an article headlined “Drinking One Diet Drink Daily Can Triple Risk of Dementia and Stroke.” Like most citation-free science clickbait, that article primarily consisted of a copy-pasted press release, in this case for a 2017 study published in the journal Stroke which has been reframed in a way to suggest that the results were more authoritative than they actually were:  Remember that we are what we eat. Sugary drinks are bad, but diet drinks can even be more dangerous! Drinking One Diet Drink A Day Can Triple Risk Of Dementia And Strokes. Bad for our body and our brain too … Boston University researchers found aspartame, a low-calorie sweetener, wreaks havoc on the arteries — as opposed to sugar-sweetened drinks. This means drinking diet soda is far worse for your health than drinking regular soda sweetened with sugar. The results showed that adults who had one or more diet drinks a day were 2.9 times more likely to develop dementia and 3 times more at risk of strokes compared to those who virtually had none at all. Most important is that the study did not indicate that “diet drinks can even be more dangerous” than regular ones, or that the action of drinking a soda sweetened with artificial sweeteners causes an increased risk of stroke or dementia. That study did broadly find that “drinking at least one artificially sweetened beverage daily was associated with almost three times the risk of developing stroke or dementia compared to those who drank artificially-sweetened beverages less than once a week,” but the study was not designed to address causation and did not make any argument regarding it. “The authors caution that the long-term observational study was not designed or able to prove cause and effect, and only shows a trend among one group of people,” the press release also stated. The study authors utilized data from a well-known dataset, the “Framingham Heart Study”, which included questionnaires about food preferences with other health indicators taken from people at multiple times over the course of decades:  The Framingham Heart Study comprises a series of community-based prospective cohorts originating from the town of Framingham, Massachusetts. We studied the Framingham Heart Study Offspring cohort, which commenced in 1971 with the enrollment of 5124 volunteers. Participants have been studied across 9 examination cycles approximately every 4 years, with the latest cycle concluding in 2014. We estimated the 10-year risk of both incident stroke and dementia beginning from the 7th examination cycle (1998–2001). An editorial written to accompany the study raised the possibility of selection biases that could have driven at least some of the associations documented, however. For example, it could be that people with existing risk factors for the cardiovascular issues that lead to stroke and dementia make a switch to artificially sweetened beverages for other health reasons and carry their increased risks with them:  People at increased risk of vascular events because of preexisting vascular risk factors may switch from regular to diet soft drinks in an attempt to control weight and insulin resistance. It is entirely possible that the intake of [artificially sweetened beverages] starts after the cardiovascular risk is increased and, therefore, is a marker of a high-risk profile rather than being a causal risk factor for stroke or dementia. The 2017 study in Stroke also found, as alluded in the viral reports, that people who drank more sugar-sweetened beverages did not see an increase in the risk of stroke or dementia. This also could be the result of a form of selection bias stemming from the fact that the population most at risk from their sugary beverage consumption may have already died, affecting the statistical analysis:  [The finding of no increased stroke or dementia risk from sugar sweetened beverages] could be attributed to selection bias, such that particularly vulnerable participants, that is, long-term [sugar sweetened beverages] consumers with a very high cardiovascular risk died earlier. This could also explain the lower-risk profile of high [sugar-sweetened beverage] consumers compared with high [artificially-sweetened beverage] consumers, the data of which were collected in 1998 to 2001. This 2017 study is not the only one to tackle the topic of adverse health outcomes from the consumption of artificially sweetened beverages. Other studies have looked at this and similar questions and reached differing conclusions:  The Nurses Health Study and Health Professionals Follow-Up Study reported that greater consumption of sugar- and artificially sweetened soft drinks was each independently associated with a higher risk of incident stroke over 28 years of follow-up for women and 22 years of follow-up for men. The Northern Manhattan Study, a population-based multiethnic cohort, reported that daily consumption of artificially sweetened soft drink was associated with a higher risk of combined vascular events but not stroke when examined as an independent outcome. A 2012 study published in the American Journal of Clinical Nutrition also documented an association between low-calorie beverages and stroke but argued the results should be interpreted with caution, as no clear biological mechanism explained a link between low-calorie sweeteners and the circulatory issues that lend themselves to strokes:  Our finding of an association between low-calorie soda intake and stroke risk should be interpreted with caution, because we previously did not find an association between low-calorie beverages and weight gain, diabetes, or [Coronary Artery Disease], and there is not a clear biologic mechanism between low-calorie soda consumption and incident stroke. That study, in contrast to the 2017 paper, found in increased risk of stroke for sugar-sweetened beverage drinkers as well. While the 2017 study at issue here also found an association between stroke and artificially sweetened beverages, its authors pointed to uncertainties regarding what possible mechanism might link artificially sweetened beverages to either stroke or dementia, describing possible links as “incompletely understood.” Ultimately, clinical trials and not prospective cohort studies like the ones that have been used to address this question in the past will be needed to investigate causation and tease apart any possible mechanism that might exist, a point the authors of the 2017 study in Stroke made explicitly:  Clinical trials are needed to establish whether the consumption of artificially sweetened beverages is causally related to dementia or surrogate end points, such as cognitive decline or brain atrophy … Given that clinical trials involving stroke end points are large and costly, clinical trials should investigate whether artificially sweetened beverages are associated with important stroke risk factors, such as high blood pressure.


John O'Bannon Says "some Planned Parenthood chapters have been selling the body parts of aborted fetuses for profit.

Abortion, Crime, Virginia, John O'Bannon,

Appalled by controversial videos about the extraction of fetal organs for research, Del. John O’Bannon, R-Henrico, recently asked his constituents whether Virginia should take action against Planned Parenthood. "Considering the revelation that some Planned Parenthood chapters have been selling the body parts of aborted fetuses for profit, do you support or oppose a state investigation into the Planned Parenthood chapters in Virginia?" he asked in an 11-question survey that was mailed to constituents and remains on his website. Planned Parenthood has acknowledged that one of its clinics in each of two states - Washington and California - supplies fetal tissue to medical researchers and that the one in California has been getting reimbursed. Scientists have used fetal tissue since the 1930s; such experimentation was instrumental in developing the polio vaccine. Current studies are using the tissue to research maladies including AIDS, muscular dystrophy and Parkinson’s. Federal law bars organizations performing abortions from profiting from the sale of fetal tissue. The law does, however, allow them to receive "reasonable payments associated with the transportation, implantation, processing, preservation, quality control, or storage of human fetal tissue." O’Bannon’s statement that some Planned Parenthood chapters have been selling parts for profit - a claim made by many abortion opponents - is noteworthy because it accuses the organization of illegal acts. So we asked O’Bannon, a neurologist, for proof. He replied in an email: "Considering the videos revealing the activities of Planned Parenthood officials, I’m surprised you’d ask this question. "I urge you to watch the videos, obtained by the Center for Medical Progress, in their entirety here," O’Bannon wrote, with a hyperlink to the group’s website. The Center for Medical Progress is an anti-abortion group that made national headlines last summer when it released secretly recorded videos that it claimed showed Planned Parenthood officials trying to sell aborted fetus tissue for profit. The director of the center, David Daleiden, posed as a representative of a fake biotech company that was seeking to buy fetal tissue for research. He approached officials from several abortion-providing organizations, including Planned Parenthood. The footage contains graphic descriptions of abortion procedures and the methods for salvaging issue, which may be done only with the mother’s advance permission. Some of the conversations occurred over meals, and Planned Parenthood later apologized for the casual attitude displayed by one official in her discussion with Daleiden, who was undercover. One video shows Deborah Nucatola, senior director of medical services at the Planned Parenthood Federation of America, telling Daleiden that he "probably" could obtain tissue for fees ranging from $30 to $100 per specimen. The exact cost, she said, could depend on how much staff time is required to extract the tissue and whether shipping costs were involved. Another video shows Daleiden and an unidentified female colleague - both undercover - meeting with Mary Gatter, president of Planned Parenthood Federation of America’s Medical Directors’ Council. Gatter, after much prodding, said the fee for a tissue specimen might be $50 to $75, but she wasn’t sure and would have to consult with others. "We’re not in it for the money, and we don’t want to be in the position of being accused of selling tissues and stuff like that," Gatter said. "On the other hand, there are costs involved with this." Federal law doesn’t define in dollars and cents the "reasonable payments" abortion clinics may charge for their costs in extracting fetal tissue. Arthur Caplan, director of the Division of Medical Ethics at New York University’s Langone Medical Center, has told PolitiFact National that the $30 to $100 range cited by Planned Parenthood officials does "not appear to be out of the ordinary, but no one knows because there is no registry or compendium of fees charged by organizations (or) institutions supplying fetal tissue." The videos have provided new fuel for the efforts of anti-abortion groups to convince Congress and state governments to defund Planned Parenthood. They have prompted separate investigations of the organization in at least 18 states - but not Virginia - and by congressional Republicans. So far, 12 states have concluded their investigations without finding evidence of wrongdoing by Planned Parenthood, according to a Jan. 28 article by National Public Radio.. Perhaps the most significant results came from Washington, one of the two states in which a Planned Parenthood clinic supplied fetal tissue to researchers. Washington Attorney General Bob Ferguson, a Democrat, issued a report in November that concluded the organization did not profit from the activity in his state. Officials in California, the other state where tissue transactions are known to have occurred, have not launched an investigation. Planned Parenthood, seeking to quell the controversy from the videos, announced in October that it no longer would accept reimbursement for fetal tissues. It also should be noted that on Jan. 24, a Texas grand jury cleared Planned Parenthood of wrongdoing and indicted Daleiden on a felony charge of tampering with a government record by fashioning a fake California driver’s license. Sandra Merritt, another center employee who accompanied Daleiden on some of the meetings with Planned Parenthood, was indicted on the same charge. Daleiden also was indicted on a misdemeanor charge related to trying to purchase fetal tissue. Our ruling O’Bannon said "some Planned Parenthood chapters have been selling the body parts of aborted fetuses for profit." As evidence, he points broadly to a series of secretly recorded videos in which anti-abortion advocates - posing undercover as officials of a fake biotech firm seeking to buy fetal tissue for research - met with Planned Parenthood officials. Planned Parenthood acknowledges that one of its clinics in each of two states - Washington and California - supplies fetal tissue to researchers but says they comply with federal law barring a financial profit from the transactions. O’Bannon’s statement implicitly accuses Planned Parenthood of breaking the law, so there’s a burden on him to prove the organization profited from sales. He falls short by simply pointing to the videos in which Planned Parenthood officials, under prodding from the undercover activists, say tissues probably could be obtained for $30 to $100 per sample. A medical ethicist tells us those fees seem to be a "reasonable" reimbursement for the cost of supplying the tissue. An investigation by Washington’s attorney general cleared Planned Parenthood of charges it was profiting from the sales in that state. Investigations in 11 other states also have cleared the organization. There’s simply nothing that proves O’Bannon’s claim and much that contradicts it.