For Cold Virus, Zinc May Edge Out Even Chicken Soup

Explanation: This story discusses the results of a systematic review from the Cochrane Collaboration suggesting that zinc reduces the duration and severity of the common cold. While the column does a nice job of pointing out some of the limitations of the studies included in the review and highlights the fact the review authors cannot make a recommendation for the dosage or preparation, it missed the mark on a few key points. For instance, there was no discussion of costs, (which seems like an important omission, as many readers will want to try the over-the-counter products), there was little mention of the adverse effects of zinc, and there was no commentary from an independent expert. Although most of us view the common cold as a mere nuisance, the infection can have serious clinical and economic impact. The common cold is responsible for a large number of lost work days, lost school days and physician visits. Over $400 million is spent annually in the US for over-the-counter remedies. Unfortunately, the common cold is also responsible for significant number of prescriptions for antibiotics despite the fact that antibiotics do not work against viral infections. The common cold can also trigger ear infections, sinusitis and worsen lung disease. The Cochrane review of published studies assessing the value of a number of different zinc products as both preventives and for treatment provides a new look at a long standing question: Do zinc salts provide any benefit in the treatment or prevention of the common cold?

Although researchers have not reached a consensus about the optimal dose or formulation, the story could have provided cost information for the various over-the-counter zinc products. In addition, this story could have been enhanced by a brief discussion of the general costs of treatment and the cost of lost work days, school absenteeism, and physician visits. The story indicates that when zinc is taken within the first 24 hours of developing cold symptoms, it cuts the duration of a cold by an average of 1 day. No data from the review were provided regarding other outcomes, such as severity of symptoms, reduced absences from school, and reduced antibiotic use. Also, the story should have noted that a preventive effect was found after 5 months of zinc use and people who experienced a therapeutic benefit took zinc for at least 5 days during their cold. The story pointed out that nasal zinc products, associated with loss of smell, were not evaluated in the Cochrane review and it quotes one of the authors of the study suggesting that the potential harms of zinc products are limited to a bad taste and some nausea. However, the full listing includes constipation, diarrhea, abdominal pain, dry mouth and oral irritation. While the story did a nice job of explaining some of the limitations of the studies included in the systematic review, particularly the issue of not adequately blinding participants to their assigned treatment, it failed to mention a few important points. For example, trial participants were between the age of 1 and 65 years and were in good health; therefore, the results may not apply to the elderly or those who have underlying illnesses. Also, the story is somewhat misleading in how the data was evaluated. While the review included 15 studies with a combined 1,360 participants, it would have been useful to note that 13 trials (966 participants) analyzed the therapeutic benefit for zinc, while 2 trials (394 participants) evaluated its preventive effect. Furthermore, not all the trial results could be pooled due to the nonstandarized approach to reporting outcomes. The story should have also noted that the authors had a good deal of confidence in the conclusions drawn about the duration of sickness and severity of symptoms, but they were far less confident in the other outcomes, such as prevention, fewer school absences, and less antibiotic use. The story places equal credence in the ability of zinc to influence all of these outcomes. The story did not engage in disease-mongering. And while we recognize that the majority of readers are familiar with the common cold, we would have liked to have seen some information on the estimated number of cases of the common cold, days out of work or other estimates to put the story into perspective. The story includes commentary from the review’s lead author, as well as Dr. Prasad, “an early pioneer of research into zinc as an essential mineral.” Two of Dr. Prasad’s many articles were included in the Cochrane Review. Quotes from an independent expert would have been welcomed. While the review only includes trials comparing zinc to a placebo, the story could have briefly discussed the efficacy of other types of over-the-counter cold remedies. Furthermore, we would have liked to have seen some comment on the best ways to protect yourself and your family from getting a cold besides zinc products. A few words about hand hygiene and keeping your hands away from your eyes, mouth, and nose would have been helpful to readers. There is no question regarding the availability of products containing zinc; however, as the writer points out, the most effective formulation and dosage for reducing cold symptoms is currently unknown. Of note, the story specifically mentions that zinc lozenges from Coldcure.com were used in many of the trials evaluated in the Cochrane systematic review, but failed to note that they are no longer manufactured. The story makes it clear that the first trial evaluating the efficacy of zinc for treating symptoms of the common cold was published in 1984. This story does not appear to rely on a news release.


Explanation: This release reports on an NIH-funded study to determine if the use of the drug metformin by diabetic patients may affect their risk of developing lung cancer. The overall answer is that it does not, but the release takes five paragraphs to say that. Instead, it focuses on a very small subset of patients who had never smoked and whose lung cancer risk appeared to be lower than never-smokers who didn’t take metformin. By trumpeting findings from that subgroup — and burying the main results of the study, which were negative — this release misrepresents the research findings and misleads its readers. We’d suggest that the findings of this study probably did not warrant the spotlight provided by a news release. But if a news release is to be issued, it should lead with the results for the primary outcome and give second billing to provocative but preliminary findings from subgroups. While not as egregious as another example of subgroup “spin” that we recently reported on, this news release will certainly give readers the impression that there’s something special about metformin when it comes to preventing cancer in people with diabetes, when that hasn’t been established with any certainty. Diabetes is a chronic disease requiring long-term use of drugs such as metformin. Some research suggests that metformin may decrease the risk of lung cancer — making the results of this study an important addition to the scientific literature. Unfortunately, the release focuses almost entirely on the results seen in a small subgroup of patients. As such, it doesn’t accurately reflect the totality of the research in question. Subgroup findings can be included, but should never supersede the main outcome.

cancer,news release spin,subgroup analysis

There is no discussion of the cost of metformin, which is available as a generic and is comparatively cheap. Nevertheless, since diabetes often requires a lifetime of drug use, costs of metformin versus other drugs would be useful to readers, especially in cases such as this when the drug under study is suspected of providing additional benefits or bringing negative side effects. We appreciate that the release attempts to quantify the reduction in risk associated with metformin use. However, there’s a problem with the release’s description of these results. The research paper points to a statistically significant reduction in lung cancer risk only among diabetic patients who have never smoked. But the release generalizes this finding to all “nonsmokers.” The release doesn’t delineate between people who have never smoked and those who did smoke but quit. The benefits appear to apply only to the group of never smokers. This is an important distinction. There is no mention in the release about potential harms that may arise with the administration of metformin. The drug is known to produce harmful side effects in more than 10 percent of people taking it, largely affecting the stomach or bowel such as vomiting, diarrhea, and loss of appetite. Our concerns about the treatment of evidence start with the headline: “Metformin may lower lung cancer risk in diabetic nonsmokers.” Since this is an observational study that cannot prove cause and effect — only associations — we think the use of an active verb here (“may lower risk”) is inappropriate. The release should have said that metformin is “linked with” or  “associated with” lower risk, but not that it “lowered” risk. We offer a primer on this issue for health writers here. The release does provide considerable data derived from the actual research paper, compared to many such releases, but then points to the lack of statistical significance for that data. Releases are intended to simplify and clarify research so that general readers can understand the importance of the findings. In this case, the release centers on a minor finding that applies to only a small subset of individuals in the study while mentioning the larger overall findings in passing. (The finding of “decreased risk” is based on just 80 people in the study who developed lung cancer despite never smoking.) That overall finding — that metformin generally has no effect on lung cancer risk — hardly qualifies as news. The decision to do a news release on this study at all is questionable. The release does not commit disease-mongering. The release clearly identifies the funding source for the research and also adequately discloses conflicts among the authors of the paper. The release investigates the possibility that metformin may decrease the risk of lung cancer in people who never smoked. This would have been an opportune place to add that not smoking — or quitting smoking, if you are a smoker — is probably the most important thing one can do to reduce the risk of lung cancer. The story does not directly address the availability of metformin. However, it’s apparent that the drug is available, since thousands of people in the study have been taking it for years. The release does reference earlier research that offered conflicting findings and supports the need for this larger study. The release is cautious in its choice and use of language in explaining the current research. It is troubling, however, that a small aspect of the research’s findings is the main emphasis of the release, while the research paper itself keeps that aspect in proper perspective.


Bill Gates is quoted in the February 1997 issue of George magazine as saying an "over-populated planet" would be "choked to extinction by a lung-attacking virus.

Explanation: For example, in 1997, the year this interview was published, the Gates Foundation awarded a $2.2 million grant to Johns Hopkins University to “support the Institute for Population and Reproductive Health to strengthen leadership and institutions in the developing countries.” Two years later in 1999, Bill and Melinda Gates donated $2.2 billion to United Nations Population Fund (UNFPA).

In April 2020, as conspiracy theories swirled about former Microsoft CEO Bill Gates’ alleged connections to the COVID-19 coronavirus disease pandemic, images supposedly showing an eerie quote ostensibly uttered by him circulated on social media. Text from a February 1997 issue of George magazine was presented in such a way that suggested Gates had said an “over-populated planet” would be “choked to extinction by a lung-attacking virus”:  Practically the only thing connecting Gates to the quote in this image is the neon green line drawn between them. The above-displayed images are both genuine and both come from the February 1997 issue of George, a magazine founded by John F. Kennedy, Jr. and published between 1995 and 2001. Although this issue does feature a lengthy interview with Gates, the quote featured here comes from an entirely different article. The February 1997 issue of George magazine included a “Survival Guide to the Future” that featured various commentators describing how the world was “now” and providing their thoughts on what the world would be like in 2020. The actual article, titled “A Nation’s Future Foretold,” was divided into themed sections such as transportation, education, environment, crime, warfare, and food. The quote shown in the viral image comes from the disease section of this article. Here’s a screenshot from a digital copy of the magazine, which more clearly shows the author of this text:  The end of the article comes after a page break, where you can read the pull-quote in context:  Gates did not write that an “over-populated planet” would be “choked to extinction by a lung-attacking virus.” This article was actually written by poet and science writer Arno Karlen. However, social media users did find an actual quote from Gates in this issue of George that they presented as equally controversial as the “lung-attacking virus” quote. A second image showing an excerpt from this issue appears to show Gates talking about “funding population control”: This, again, is a genuine image from the February 1997 issue of George magazine. And this time, it is a genuine quote from Gates. He made this comment shortly after he was asked about how he keeps his personal opinions separate from his business decisions:  While this quote is often shared as if it revealed some secret and nefarious plot from the former Microsoft CEO, the truth is a bit more mundane. This quote was widely circulated by those who adhere to the idea that Gates was using the COVID-19 pandemic to give himself an opportunity to microchip the population via vaccines. The above-displayed quote shows, according to proponents of this conspiracy theory, that Gates has long been planning to take control of the global population. We took a deeper look into the “ID2020” conspiracy theory here. However, the term “population control” isn’t as literal as it may seem in this context. This term was widely used in the 1970s and ’80s, but it fell out of fashion in the ’90s and was replaced by terms such as “reproductive health,” “family planning,” and “women’s empowerment.” In writing about the United Nations International Conference on Population and Development in 1994, the Christian Science Monitor noted a major philosophical difference between that year’s conference and conferences from years past: If there is a major philosophical difference in the 1994 version of the once-a-decade international conference on population, it is the shift from “population control” to “women’s empowerment” — especially in areas of reproductive health, education, and economic opportunities, which planners of the UN conference see as closely linked to fertility rates. “Economic growth and improvement of quality of life have been fastest in those areas where women have higher status, and slowest where they face the greatest disadvantages,” states the draft “Programme of Action” now being debated in New York. Gates’ quote in this 1997 interview may have been a bit outdated, but it was not indicative of a nefarious plot to enslave humankind. Rather, Gates was noting his charitable work with global organizations that support reproductive health programs.


Three additives in peanut butter cups, soy lecithin, PGPR, and TBHQ, are inherently dangerous and should be avoided.

Explanation: Ultimately, the claims presented in Wolfe’s post rely on outdated, irrelevant, or factually incomplete information. Reese’s Peanut Butter Cups do, along with many other foods, contain the listed ingredients. This point, however, is close to the only factual one made by the author of the post.

On 24 March 2017, David “Avocado” Wolfe, prolific pseudoscience media mogul, purveyor of life-extending USB-chargeable “longevity zappers”, and self-described “wealthiest hippie on Earth”, published a post that went viral on Facebook titled “3 Reasons Why You Should Stop Eating Peanut Butter Cups!” This post, though essentially a word-for-word rip-off of a 2015 post from a website named “Living Traditionally,” is still somehow classic Wolfe: a highly shareable story crafted at the expense of a beloved childhood candy through the willful misrepresentation of the science surrounding its ingredients. In this case, Wolfe (or whoever wrote the article) points to three chemicals which, as a matter of fact, are present in Reese’s Peanut Butter cups: Soy Lecithin Research has shown that as much as 93% of soy is genetically modified. Soy lecithin has been found to have detrimental effects on fertility and reproduction. It can cause behavioral and cerebral abnormalities. It has also been linked to breast cancer. PGPR PGPR is short for polyglycerol polyricinoleate. The manufacturer of this popular candy replaced cocoa butter with PGPR to lower the cost of production. PGPR comes from castor beans and it’s used to reduce the viscosity of chocolate. It has been connected to gastrointestinal problems and allergic reactions in children. TBHQ TBHQ stands for tertiary butylhdroquinone. It’s derived from petroleum and can be extremely toxic. Side effects of ingesting TBHQ include nausea, vomiting, ringing in the ears, delirium and collapse. Research has shown that TBHQ can damage the lungs and umbilical cells in humans. It can also cause stomach cancer. Children who are exposed to this chemical may show anxiety, restlessness and intensified ADHD symptoms. Soy Lecithin Lecithin is a mixture of naturally organic compounds separated from their source by way of their shared chemical properties and added to a variety of foods to improve texture and aid in the mixing of ingredients. As defined by the United States Code of Federal Regulations: Commercial lecithin is a naturally occurring mixture of the phosphatides [derivatives of a specific chemical] of choline, ethanolamine, and inositol, with smaller amounts of other lipids. It is isolated as a gum following hydration of solvent-extracted soy, safflower, or corn oils. In terms of the soy-GMO link, this issue is somewhat moot because If GMO’s aren’t a person’s jam, then that individual probably wouldn’t be purchasing Reese’s Peanut Butter Cups anyway, as the Hershey’s Company discloses the possibility of GMO ingredients, broadly, in this line of products. The remaining claims are either misleading or factually impoverished. To support the notion that soy lecithin has “detrimental effects on fertility and reproduction”, causes “behavioral and cerebral abnormalities” and has been “linked to breast cancer”, the author of the post links to a different post by “Dr. Axe”, a naturopathic doctor, chiropractor, and nutritionist. In this post, Axe briefly mentions a largely irrelevant 1985 study that looked at the effects of feeding pregnant laboratory rats and their offspring with an absurdly high soy lecithin diet. In that study, rats were given 10 grams of standardized of food per day with either 2 percent or 5 percent of the mass of that food replaced by soy lecithin. This study, which had a narrow and specific aim of investigating a proposed mechanism behind a number of neurologic conditions, found that: The results indicate that dietary soy lecithin preparation enrichment during development leads to behavioral and neurochemical abnormalities in the exposed offspring. However, the amount of lecithin used in this experiment are multiple orders of magnitude more than any human could reasonably expect to be exposed to, even on a daily basis. Using the rough estimate 1800 grams of food consumed per day by the average human, a 5 percent lecithin diet would represent 90 grams of soy lecithin per day, which is roughly 1000 times more soy lecithin than the FDA estimates Americans get in their daily diet through additives (96 milligrams per day). Using an over 30 year old study of pregnant and developing rats fed absurdly unrealistic doses of a chemical to say that peanut butter cups are dangerous is a reach, even by Wolfe standards. By FDA “Generally Recognized as Safe (GRAS)” standards: There is no evidence in the available information on lecithin and lecithin bleached with hydrogen peroxide that demonstrates or suggests reasonable grounds to suspect a hazard to the public when they are used at levels that are now current or that might reasonably be expected in the future. The remaining claims regarding breast cancer, fertility, and reproduction are made by conflating soy protein and soy lecithin. Soy protein is chemically similarity to estrogen, a point that has been the subject of much scientific and internet debate about its potential adverse affects. While the mechanisms linking soy to any hormone-derived maladies have yet to be demonstrated, it is another moot point, as at most only trace amounts of soy protein, if any, remain in soy lecithin. PGPR Polyglycerol polyricinoleate (PGPR), per Food and Industrial Bioproducts and Bioprocessing, is a common additive that is used: For improved texture and enhanced volume of bakery products, in salad dressings, and in chocolate to decrease the occurrence of fat bloom [a visual separation of fat from the rest of the chocolate]. While not hesitating to use its scary scientific name, the only allegation of note the Wolfe post makes is that PGPR has been “connected” to gastrointestinal problems and allergic reactions in children. Ignoring the fact that the same could be said about the ingredients in the natural version of peanut butter cups presented below Wolfe’s article, it is also a broad misrepresentation of PGPR’s risk, which is, at best, negligible. The most recent review of its safety, performed by the European Food Safety Authority (EFSA) and adopted on 3 March 2017, reaffirmed its safety: PGPR […] is not of concern with regard to genotoxicity or carcinogenicity. The single reproductive toxicity study with PGPR was limited and was not an appropriate study for deriving a health-based guidance value. Human studies with PGPR demonstrated that there is no indication of significant adverse effect. TBHQ TBHQ, used as an antioxidant preservative in many food items, is indeed a petroleum derivative (as are almost all carbon containing compounds not produced by living organisms), but that doesn’t mean it carries the same risks as ingesting raw petroleum sludge — it’s a specific, singular, isolated, and modified chemical. There have, in fact, been animal studies that report harmful effects after extremely large doses of TBHQ as well as other cases of extremely high or chronic exposure resulting in harm. As we wrote in a similar Wolfe debunker about the dangers of Pop Tarts, however, while the long-term health effects in humans exposed to high or chronic doses of TBQH (i.e. industrial or laboratory workers handing pure TBHQ occupationally) is not a settled issue, the long-term effects of humans exposed to it in doses legally allowed by USA and European regulatory agencies is settled. EFSA reevaluated its earlier (similar) conclusion regarding TBQH in 2004, finding that it is “not carcinogenic and that further genotoxicity studies are unnecessary.” The Wolfe post also claims that children exposed to TBHQ “may show anxiety, restlessness and intensified ADHD symptoms” despite the fact that no peer-reviewed studies link TBHQ specifically to ADHD, restlessness, or anxiety. This notion stems from the controversial ideas of Dr. Benjamin Feingold, who advocates the removal of myriad food additives, including TBHQ, as a cure for attention deficit and hyperactivity disorder and other behavioral issues. Despite his claims, however, no research specifically focused on TBHQ has documented any connection, and those diets he promotes generally treat a broad collection of additives as the same, despite clear chemical differences.


A notorious pedophile was killed by a mother who blew his head off with a shotgun when he tried to rape her 12-year-old child.

Explanation: What's true: A woman fatally shot an intruder who had concealed himself in a closet of her home. What's false: The woman did not use a shotgun or "blow [the intruder's] head off," nor was the intruder attempting to rape the woman's child at the time he was shot.

Junk News, georgia, neon nettle, neonnettle.com

On 11 February 2018, the Neon Nettle web site published a vivid article under the headline “Mom Catches Pedophile Trying to Rape Child, Blows His Head Off with Shotgun,” which opened as follows: A notorious pedophile has been found dead by police after a mother blew his head off with a shotgun when he tried to rape her 12-year-old child. The furious mom found convicted child sex offender Michael Lindsey in her daughter’s bedroom and took matters into her own hands. The woman from Blakely, Georgia, became suspicious and went into her young daughter’s room to find Lindsey attempting to rape her daughter after breaking into their home. In broad strokes, this report conformed to an incident reported by local news media in which a Georgia woman fatally shot a burglar who had concealed himself within a closet in her home: A Blakely woman shot a convicted sex offender to death after he allegedly broke into her home. During a 9-1-1 call the victim reported she was assaulted after discovering 53-year old Michael Lindsey hiding in a closet of her home. The woman’s 12-year old daughter was also present. “Deputies arrived at the scene and insured the safety of the victims who had locked themselves inside a room because they weren’t sure if the intruder was still inside the home,” Early County Investigator Captain Will Caudill said. Officers also discovered 53-year old Michael Lindsey outside the home. He was taken to a Blakely hospital and pronounced dead. He’s believed to have stumbled from inside before collapsing. Prior to the shooting she fought off her attacker with a spoon, a police report states. However, Neon Nettle is a notorious fake news blog with a predilection for publishing sensationalized (if not completely fabricated) stories about pedophiles, and true to form, Neon Nettle added multiple false elements to this particular report to enhance its luridness. For example, as we confirmed with Early County Investigator Captain Will Caudill, the woman referenced in this report did not “blow [the intruder’s] off with a shotgun.” The weapon she used was a handgun, and the intruder, Michael Lindsey, had “no gunshot wounds above the torso of his body.” Furthermore, the mother did not find Lindsey “trying to rape her 12-year-old child.” Lindsey had concealed himself in a closet of the home for reasons that remain indeterminate, as Captain Caudill told us that investigators “did not factually determine the motive for the burglary.” Finally, although Lindsey was a sex offender, he would likely not be described by any responsible news account as a “notorious pedophile,” given that he had but a single related conviction on his record, and that was from nearly twenty years earlier (1999).


Explanation: Nowhere do we hear how far along the research is. The main section doesn’t even allude to evidence, other than to state that more research is to be done, which is true about most everything in medicine except limes for scurvy. As far as a reader can tell, the “new portable scanner” may have yet to leave a laboratory setting. All we know is that it’s been submitted to, and is a finalist for, an engineering & technology award. It’s not the same as clinical research. The article is quick to point out mammography’s low detection rates (sensitivity, perhaps?) in younger women, identifying the problem to be solved, but it never tells us the detection rates for the new tool. The data very well may be unknown. Which means detection rates could be worse! But from the structure of this article, focusing on technology but not evidence, a reader could only conclude the new kid on the block is superior. If we’re lucky, the new kid will make the world a better place. But filing a patent for a device is not the same level of proof as clinical research. People would be shocked to learn how many promising ideas from labs and napkins never survive clinical trials, how many prove to be worse for mankind than what we already do. Science is hard and complex. Last year’s uproar over the new mammography guidelines highlighted that there are important subtleties about screening for cancer, and that clear, balanced communication is crucial. It may sound like we ask a lot of journalists. But really, asking one more question would’ve turned this story around: How far along is this idea? The answer leads us to look beyond the novelty, beyond the theoretical benefits, beyond the entangled claims of the institution and inventor who stand to benefit, and see, simply, whether this idea is better or worse or needs 4 more years in the oven before we can even ask. Mammography isn’t perfect, and an improved screening technique for breast cancer could reduce pain, suffering, and death for many women. But that need doesn’t give journalists a license to hype.

We wouldn’t expect a discussion of cost implications for a technique still in its formative years. But since the article states that “costs are reduced,” we have to address it. First of all, costs compared to what? Mammography? The other investigational techniques using RF or microwaves just mentioned? Let’s assume the comparator is mammography. It may be that, if and once there’s an available product, costs for each screening visit can be reduced. But the total costs depend on how effective it is. Without knowing how good it is at picking up breast cancer (sensitivity) and excluding signals that aren’t breast cancer (specificity), we don’t know its role. It might be too unreliable to replace mammography. Poor sensitivity leads to missing cancers, which cost life and money. Poor specificity leads to more unnecessary biopsies and treatments; if indeed people would screen themselves at home, poor specificity also means more unnecessary doctor visits. Also, will clinic and home uses be covered by insurance? As the independent sources says, we don’t know how the new device will be used. Until trials determine whether it will replace mammography, supplement it, or sink out of memory, we can’t know the total costs. To say vaguely that “costs are reduced” may not, therefore, be correct. They’re not quantified. Again, if it’s because the tool hasn’t been tested, we need to know that. No harms are discussed. If it’s too early to tell the rates of false positives, we need to know that. The article draws a picture of a tool with no potential downsides. The article does not evaluate the existence, no matter the quality, of evidence. If there is no clinical evidence yet, we need to know that. Omitting this discussion paints a picture of a tool that has the same level of proof supporting it as tools like mammography, which have been put through numerous rigorous trials and lived to tell the tale. The way the article puts it, there may have been research in patients, or there may just be a prototype on a workbench and non-clinical data. It’s not enough to say that a tool is novel, or faster, or provides real-time images, or can fit in a lunch box, or even (as the press release cheers) is a finalist for an engineering award. The tool may be promising, but only a sober evaluation of how well it works in human beings, checking its results, will tell us whether it will save more lives than we currently can or join the thousands of ideas that sounded good but didn’t pan out. The article alludes to prior research with RF and microwave technologies in detecting breast cancer. So what do we already know about this approach? Were the prior techniques effective but hampered by lack of speed and portability? While not a critique of the article, we’ll point out that, for this technique to be compared to mammography, it will likely need evidence that it improves survival. Part of the challenge in breast cancer screening is distinguishing between cancer and “pre-cancer” (or “cancer risk”). The word cancer actually refers to a large, strange zoo of different abnormalities. Some grow slower than others, some never causing problems within a patient’s lifetime. That means it can be hard to know the danger of an early finding from screening. Thus, in addition to knowing the benefits and harms, like the rate of false positives, we’ll need to see if this tool used on a schedule makes groups of people live longer. It may some counterintuitive, but the answer isn’t always a clear yes. This uncertainty was one of the embers in last year’s firestorm over the new mammography guidelines. The article cites statistics about mammography and breast cancer in younger women from the press release. They are within the range of key data in this field. (As an aside, the article says the stats are from the research team. We can’t say whether the writer of the press release actually compiled them.)


Nanoparticles loaded with component of common spice kill cancer cells

Explanation: This University of Central Florida news release covers a study published in the journal Nanoscale, which found that curcumin-loaded nanoparticles kill neuroblastoma tumor cells in cell culture (in test tubes or petri dishes). Curcumin is a bright yellow compound found in the spice tumeric. The news release doesn’t disclose any harms and quantitative data to back up its claims and, instead, uses only broad, ambiguous language when describing the treatment’s benefits. For example, researchers found that these molecules may induce “substantial” cell death in neuroblastoma cells without being toxic to healthy cells. The study’s limitations should have been emphasized — namely, that it’s early pre-clinical research with experiments only conducted in undefined cell lines. In addition, research with curcumin-loaded nanoparticles isn’t exactly new. In 2012, a couple of studies looked at the molecule’s effects, including its toxicity, on neuroblastoma cells. Many news releases cover research that is in its pre-clinical phases. This is fair game, of course, but we then expect these reports to caution readers on the treatment’s applicability to clinical medicine. In other words, treatments that are successful in cell lines and animal models usually do not translate to effective clinical outcomes. Furthermore, it also takes years, maybe decades, before a treatment is even ready for clinical trials — a process often referred to as “from bench to bedside.” To avoid giving patients false hope, news releases need to disclose the early nature of the research high up in the release as well as be more explicit in detailing the treatment’s development and timeline.

Curcumin,neuroblastoma,University of Central Florida

This news release is about a pre-clinical study that looked at the effects of cerium oxide nanoparticles and curcumin in cell culture. It will be a while before this type of technology is studied in living patients. We rate this one Not Applicable. We caution news release writers that if it’s not too early to talk glowingly about the potential life-saving benefits of an intervention in a news release, it’s not too early to give some attention to the costs. However, this research is clearly far too preliminary to make such projections. The news release does not provide any data to support its claims. Instead, sweeping phrases are used to describe the benefits of curcumin-loaded nanoparticles: “This formulation included substantial cell death in neuroblastoma cells while producing no or only minor toxicity in healthy cells.” Moreover, “nano-therapeutic treatments showed a more pronounced effect” in cell lines of a high-risk form of neuroblastoma, the news release states. No other benefit data are given. We like to see news releases giving a quantitative estimate of the potential benefit using numbers, instead of using broad, ambiguous terms like “substantial,” “minor” and “more pronounced.” Therefore, we give it a Not Satisfactory rating here. No harms are mentioned in the news release. Some scientists are concerned that nanotechnology may have toxic effects on the body, especially the lungs. Depending on the nanotechnology, other organs may also be at a risk for damage. In particular, some nanoparticles may affect the endocrine system, leading to changes in hormone levels, sexual characteristics, reproduction and development. The news release talks only about the benefits of nanoscience research without any description of its potential harms. Consequently, we give it a Not Satisfactory rating. We wish the news release emphasized the fact that this research was in its early pre-clinical stages. This means it will take at least another 10 to 12 years before this technology is tested in humans, if it even makes it that far. Testing treatments in cell culture is usually the first step along the research pipeline. If these experiments are successful, researchers then try the technology in living organisms — like mice, rats and rabbits. It’s important to remember that cells in culture behave very differently than cells in a living organism. And what works in animal models often is not effective when tested in humans, perhaps due to differences in genetics, environmental conditions and physiology. In a physician commentary entitled “The Failing Animal Research Paradigm for Human Disease,” it quotes a former National Cancer Institute director as saying, “We have cured mice of cancer for decades—and it simply didn’t work in humans.” In this study, researchers worked with cell lines containing “a high-risk form of neuroblastoma.” We don’t even know what type of cell lines they were. Were they derived from humans? Or mice? Although the news release talks about future research plans in animal models, we feel it could have been more explicit in pointing out its pre-clinical phase higher up in the report, like in the headline or first sentence. As a result, we give it a Not Satisfactory rating here. There is no disease mongering in this news release. The news release discloses the study’s funding sources, which include the Nemours Foundation and the regional economic development initiative of the Florida High Tech Corridor. We were not able to find any potential conflicts of interests. We rate this one Satisfactory. The news release does not discuss any existing alternatives to treat neuroblastoma. Conventional therapy includes chemotherapy for those with advanced-stage neuroblastoma. Commonly used agents include cisplatin, doxorubicin, cyclophosphamide and epipodophyllotoxins. For those with early-stage neuroblastoma, surgery is often an option. Some patients are also given adrenocortical hormone to treat their symptoms. We give the news release a Not Satisfactory rating here. The beginning of the news release makes it sound like this technology is available at your local hospital. Later in the report, however, the news release makes it clear that this study was conducted in cell lines in a laboratory. Researchers hope to expand this research to animal models and direct the curcumin nanoparticles to tumor sites, the news release adds. We feel this is enough for a Satisfactory rating. Although the news release makes it sound as if this research is completely novel, using curcumin-loaded nanoparticles to treat neuroblastoma is not exactly new. In fact, researchers from Nemours and UCF only confirmed (not found, as the news release claims) that nanoparticles can be used to deliver curcumin to tumor sites. In 2012, an international team of researchers looked at how curcumin-containing nanoparticles induced cell death in neuroblastoma cells in vitro. Another study from 2012 looked at the toxicity of curcumin-loaded nanoparticles. Since none of this was mentioned in the news release, we give it a Not Satisfactory rating here. The news release does not include include unjustifiable, sensational language.


Wine and coffee lovers, drink up! It's great for your microbiome

Explanation: The news article reports on two research studies that attempt to establish the most common microorganisms found in the human digestive system. The news story does a good job of presenting the scientific results in an accessible manner, but it unfortunately made health claims not backed by the evidence. Establishing a “normal” gut microbiome profile may be beneficial for many future clinical studies yet remains under-investigated.

digestive health,gut flora,limits of observational studies,microbiome

These were not “treatment” studies so discussing costs is not relevant. However, the way the story is written could make readers think they should start buying more wine and coffee, which isn’t what the findings showed. There is nothing in the news story that quantifies the benefits of the claim made–that drinking wine or coffee is “great for your microbiome.” This is a major problem with the story, as it’s making a claim not found anywhere in the findings. Because this story puts forth the idea that certain foods (especially coffee and wine) are good for microbial diversity–and that’s a health claim–there should be an acknowledgement that these foods also can carry harms. There was no mention of the size of the dose–how much coffee? How much wine? And people may take that lack of dosing to mean whatever they want, including having more than is beneficial and veers into unhealthy or dangerous. The research is purely observational in nature–as explained earlier, we cannot conclude that increased consumption of wine and coffee leads to greater microbiome diversity, nor if that is even important for overall health. In some ways, the story acknowledges this, by stating certain behaviors are “associated with” microbial diversity. But in other ways it reverts to cause/effect language. Example: “the scientists found that consuming fruits, vegetables and yogurt positively influenced microbial diversity in the gut. So did drinking tea, wine, coffee and buttermilk.” The story needed a clear disclaimer regarding the limits of this type of research. There is no disease-mongering. There do not appear to be any conflicts of interest. However, this story did not include independent sources. Given the context of the research, this is not relevant. Same comment as the “Compare Alternatives” section. The news story did establish the novelty of the research with this quote: “To our knowledge, this is the first study to systematically assess such a broad range of host and environmental factors in relation to gut microbiome and at such a large scale,” said Jingyuan Fu, a systems geneticist at the University of Groningen who worked with Zhernakova. Because it appears to have original statements from one of the researchers, the story does not appear to have relied solely on a news release.


North Carolina ultrasound abortion law ruled illegal by judge.

Explanation: A federal judge on Friday struck down a 2011 North Carolina law requiring abortion providers to perform an ultrasound and explain it to a woman before having an abortion, arguing it violated the constitutional right to free speech of doctors.

U.S. District Judge Catherine Eagles found that a state does not have “the power to compel a health care provider to speak, in his or her own voice, the state’s ideological message in favor of carrying a pregnancy to term.”  The law “compels a health care provider to act as the state’s courier and to disseminate the state’s message discouraging abortion, in the provider’s own voice, in the middle of a medical procedure, and under circumstances where it would seem the message is the provider’s and not the state’s,” she added in her 42-page ruling. “This is not allowed under the First Amendment,” Eagles ruled. The U.S. Supreme Court legalized abortion nationwide in 1973, but lawmakers in more conservative states in recent years have enacted laws that seek to place restrictions on the procedure, especially on late-term abortions. The ultrasound requirement of the law had been blocked by Eagles a few months after it was passed due to concerns over what she described as the “non-medical message” doctors were required to deliver. The law required that an ultrasound image be presented and the sound of the fetal heartbeat be offered at least four hours before an abortion, though a woman is free to look away and ignore an explanation and medical description of what is on the screen. The decision was hailed as a victory for the American Civil Liberties Union, the Center for Reproductive Rights and Planned Parenthood Federation of America which filed a lawsuit challenging the Women’s Right to Know Act. “Today’s ruling protects the rights of women and their doctors from the ideological agenda of extremist lawmakers,” said Jennifer Rudinger, executive director of the ACLU of North Carolina. “This law represented an egregious government intrusion into individuals’ private medical decisions, and we are very pleased that it will not go into effect,” she said. Defenders of the law said it provided crucial information for women making a major and irrevocable decision. “North Carolina’s ultrasound requirement is no different than requiring speech for airlines and cigarette manufacturers for safety reasons,” said Barbara Holt, president of North Carolina Right to Life. “The required information must be given even if the person hearing, seeing or reading the information finds the information upsetting, unnecessary or repetitive.”  A Republican state legislator who advocated the law, House Majority Leader Paul Stam, was not immediately available to comment after normal business hours. North Carolina Governor Beverly Perdue, a Democrat and the state’s first female governor, vetoed the measure in 2011 but the state Senate overrode the veto. In her veto message, Perdue called the legislation a “dangerous intrusion into the confidential relationship that exists between women and their doctors.”  When the law went into effect in October 2011, North Carolina joined 25 other states that require pre-abortion counseling that goes beyond basic medical “informed consent,” according to the Guttmacher Institute, a nonprofit sexual health research organization. It also became the tenth state to include the additional requirement of an ultrasound, which has drawn legal challenges in several states. North Carolina has some of the country’s toughest requirements for clinics performing abortions, including a requirement doctors be present when abortions are performed. It also bans publicly funded health insurance programs from paying for most abortions, and authorizes state health officials to design rules for increased safety standards for abortion clinics. In North Carolina, 17 percent of pregnancies end in induced abortions, according to the Guttmacher Institute. The case is Gretchen S. Stuart, M.D. et al v. Ralph C. Loomis, M.D. et al: 1:11-CV-804.


There’s a “direct correlation” between North Carolina’s mask requirement and COVID-19 stabilization.

Explanation: Mandy Cohen, Secretary of North Carolina's Department of Health and Human Services, says there’s a “direct correlation” between NC’s mask law and COVID-19 stabilization in late July. North Carolina's stats show that the number of new coronavirus cases started to dip about three weeks after the mask mandate. It's fair to say there's a correlation, experts told us. But there's not enough evidence to say the two are linked.

North Carolina, Coronavirus, Mandy Cohen,

North Carolina’s top health official says there’s evidence that a statewide mask requirement is helping stabilize coronavirus cases in the state. In a press conference on July 28, Health Secretary Mandy Cohen said: "Our actions to slow the spread of this virus are having an impact. Specifically, we see a direct correlation to the start of the statewide mask requirement at the end of June. Two to three weeks after implementing this requirement, we started to see the beginning of these more stable trends." Is it true that there’s a "direct correlation" between North Carolina’s mask requirement and COVID-19 stabilization? Data shows that the number of new reported COVID-19 cases is beginning to stabilize. Experts told PolitiFact the mask law and case count could be related, but that it’s hard to quantify the law’s impact. Gov. Roy Cooper announced the mask requirement on June 24 and it went into effect on June 26. Cohen said North Carolina’s case count started to level about three weeks later. Why is Cohen judging the rule’s effectiveness three weeks after its implementation, rather than immediately after its implementation? It can take up to 14 days between the time someone was infected and the time they start showing symptoms, according to the U.S. Centers for Disease Control and Prevention. That means someone could have contracted the virus before the mask mandate, but not shown symptoms or tested positive until after the mask requirement was in effect. So let’s look at North Carolina’s case counts. One way experts measure coronavirus trends is by calculating the 7-day rolling average for the number of new cases or deaths per day. The N.C. Department of Health and Human Services (DHHS) and WRAL both track this metric. The average number of new cases per day rose until about July 18, when DHHS reported 2,481 cases. The daily count started to drop after that date, and the rolling 7-day average has been less than 2,000 cases ever since. So Cohen is right that the number of new cases is stabilizing. Is that a direct result of the mandate? There’s evidence that widespread mask-wearing has helped reduce the spread of the novel coronavirus, as we’ve previously reported. We spoke with experts at the University of North Carolina, Harvard University, the University of Nebraska and the University of Toronto. While they agreed that there may be a correlation, they say there’s not enough evidence yet to determine how much influence the mask rule had on the stabilization. Other factors -- such as social distancing or testing availability -- could also play a role. But reviewing that data typically takes months, said Ryan McNamara, a research associate in UNC’s Department of Microbiology and Immunology. "There's just a lot of variables at play that need to be accounted for," he said. There’s a popular saying in research: "correlation does not mean causation." In this context, it means that the mask law may not have caused the dip in new COVID-19 cases, even though there are signs a cause-and-effect relationship could exist. "That said, Dr. Cohen and her team are in possession of much more data than I am. I think her statement was carefully worded and has scientific merit." Ali Khan, dean of the College of Public Health and professor of epidemiology at the University of Nebraska Medical Center, agreed that it’s premature to directly credit the mask rule for the leveling-off of cases. But he believes Cohen’s claim is fair, given that "other data that (shows) masks work and accounting for numerous caveats such as what else happened 2-3 weeks ago." Dr. Barry Bloom, a research professor of public health at Harvard University, said it’s "difficult to disaggregate a single intervention from the other standard public health behaviors." However, Bloom said it’s possible that the mask requirement not only prompted more people to wear masks -- but to start taking other precautionary measures as well. "I think it is safe to say they may have contributed to the more stable trends, assuming the trends are indeed stable for a couple of weeks," Bloom said. As of August 3, the state’s rolling 7-day average remained below 2,000 cases and was still declining. Cohen said there’s a "direct correlation" between North Carolina’s mask requirement and COVID-19 stabilization. Based on the data available in late July, experts said there does appear to be a correlation, but it’s too early to draw conclusions about it. Verifying the strength of the correlation can take months. The statement is accurate but needs clarification or additional information.


Explanation: Experts say the Federal Reserve is likely to be the largest source of funds for the $3 trillion. China is expected to buy little, if any, of the debt, because it does not have the money to lend.

China, Debt, Economy, Coronavirus, Rand Paul,

To finance its response to the coronavirus pandemic, will the United States borrow trillions of dollars from China? That’s the claim of Kentucky Republican Rand Paul, the first senator known to have been stricken by COVID-19. On May 4, the U.S. Treasury announced plans to borrow $3 trillion during the second quarter of 2020, largely to cover three packages approved by Congress and President Donald Trump that contain more than $2 trillion worth of stimulus in response to the coronavirus outbreak. The third and largest package included one-time $1,200 payments to many Americans, temporary $600-per-week bonuses on unemployment checks, and loans and grants to small businesses. Two days after the Treasury announcement, Paul was asked on Fox News' "America's Newsroom" whether there will be a fourth stimulus. "To people who ask me, I remind them that we have no money. We have no rainy day account, we have no savings account," he said. "The $3 trillion that we've already passed out is imaginary money. It's being borrowed basically from China. So the irony is we got the virus from China, and now we're going to be more dependent by borrowing more money from China." China, where the COVID-19 outbreak was first detected in December, is the second-largest foreign holder of U.S. debt. But experts told us there is no reason to believe it will be a large purchaser of the $3 trillion. To finance the government’s activities, the Treasury issues securities to various U.S. buyers (such as the Federal Reserve System, mutual funds, financial institutions and individual investors), to private investors overseas, and to the central banks of other countries, notably Japan and China. Because Congress suspended the "debt ceiling" for two years in 2019, the government can go into as much debt as it wishes, as long as there are takers for Treasury securities. The total federal debt eclipsed $25 trillion on May 4, two days before Paul made his statement. Of that $25 trillion, about $6 trillion is "intragovernmental holdings" — debt held by, for example, government trust funds, including the one that endows Social Security. The other $19 trillion is called public debt, which refers to all federal securities held by institutions and individuals outside the U.S. government, including individuals, corporations and foreign governments. China buys U.S. Treasury bonds in public auctions, the same way other nations and investment companies do. The latest Treasury Department figures, as of April 15, show that Japan, along with Japanese companies and investment groups, was the largest foreign holder of U.S. debt, at $1.27 trillion. China was second, with $1.09 trillion. Asked for information to support Paul’s statement, a spokesman for the senator cited the amount of U.S. debt held by China and said foreign holdings account for about 39% of public debt. Asked to elaborate, he didn’t reply. Several experts told us that those figures do not support Paul’s claim and that there is no other evidence to back it, either. Most of the debt incurred so far to deal with the coronavirus has been purchased by the Federal Reserve, not foreign or domestic savers, said Joshua Gordon, senior policy adviser at the Concord Coalition, a group that advocates for fiscal responsibility. David Dollar, a senior fellow in the China Center at the Brookings Institution and a former U.S. Treasury emissary to China, told PolitiFact that China lacks funds and "there is no reason to expect" China’s holdings of U.S. debt to increase in 2020. "In theory it could borrow dollars on the international market in order to buy Treasurys, but this does not make any sense, as it would pay more in interest on its borrowing than it earns on the Treasurys, which is basically zero these days," he said. China has been reducing its U.S. debt holdings in recent years as a result of having less foreign currency, said economist Derek Scissors, resident scholar specializing in China with the American Enterprise Institute. "We won’t be borrowing from China this year because China doesn’t have the money to lend us," he said. "There probably isn’t enough global liquidity for most of the money to come from overseas. The largest portion is likely to come from U.S. institutions, which have few diversification options given economic contraction, and thus ultimately from American savers. The Fed itself may become the prime buyer." Mark Cabana, head of U.S. rates strategy at Bank of America Merrill Lynch, told Newsweek the Fed is set to be the biggest source of Treasury demand this year "and we think by a long shot." China and other emerging market governments are selling their Treasury holdings to create dollars they can use to buy their own currencies, which are weak, he said. Barry Bosworth, a senior fellow in economic studies at Brookings, told PolitiFact "there is no factual basis" for Paul’s claim, "since holdings of individual countries are only reported with a long lag. Most recently, new Treasury debt has been purchased by the Federal Reserve, and I expect that to continue." "The Treasury issues securities in an open, very active market where investors, including other governments, are free to buy and sell as they wish," Bosworth added. "We don’t know or care who are net purchasers. If investors are willing to buy U.S. securities at a time of chaos, it is good news." Paul said $3 trillion for federal coronavirus stimulus packages is "being borrowed basically from China." Experts say that the Federal Reserve is likely to be a major source of funds for the $3 trillion and that China, with relatively little available funds, is expected to buy little if any of the debt. We rate Paul’s statement .


Counterfeit masks reaching frontline health workers in US.

Explanation: On a day when COVID-19 cases soared, healthcare supplies were scarce and an anguished doctor warned he was being sent to war without bullets, a cargo plane landed at the Los Angeles International Airport, supposedly loaded with the ammo doctors and nurses were begging for: some of the first N95 medical masks to reach the U.S. in almost six weeks.

Los Angeles, Understanding the Outbreak, Health, General News, Politics, Business, AP Top News, Asia Pacific, Virus Outbreak

Already healthcare workers who lacked the crucial protection had caught COVID-19 after treating patients infected with the highly contagious new coronavirus. That very day an emergency room doctor who earlier texted a friend that he felt unsafe without protective supplies or an N95 mask, died of the infection. It was the first such death reported in the U.S., according to the American College of Emergency Physicians. But the shipment arriving that night in late March wasn’t going to solve the problem. An Associated Press investigation has found those masks were counterfeits — as are millions of medical masks, gloves, gowns and other supplies being used in hospitals across the country, putting lives at risk. ___ EDITOR’S NOTE -- This story is part of an ongoing investigation by The Associated Press, the PBS series FRONTLINE and the Global Reporting Centre that examines the deadly consequences of the fragmented worldwide medical supply chain. ___ Before the pandemic, federal trade law enforcement agencies were focused on busting knockoffs such as luxury goods and computer software, mostly from China. As America fell sick, the mission shifted to medical supplies. To date, Operation Stolen Promise, spearheaded by Immigration and Customs Enforcement’s Homeland Security Investigations, has netted 11 arrests and 519 seizures. And yet counterfeit goods continue to pour in — not just masks, but also mislabeled medicines, and fake COVID-19 tests and cures, according to the agency. “It’s just unprecedented,” said Steve Francis, HSI’s assistant director for global trade investigations. “These are really bad times for people who are out there trying to do the right thing and be helpful, and they end up being exploited.” The story of how one brand of counterfeits has infiltrated America’s supply chains illustrates how the lack of coordination amid massive shortages has plunged the country’s medical system into chaos. ___ EAR LOOPS  AP identified the counterfeit masks when reviewing film of the Los Angeles shipment. The telltale sign: these masks had ear loops, while authentic ones have bands that stretch across the back of the head, making for a tighter fit. The blue and yellow boxes being unloaded in a Southern California warehouse bore the name of the Chinese factory Shanghai Dasheng. The masks inside were stamped as if approved by the U.S. National Institute for Occupational Safety and Health — signifying they had been certified by the U.S. government as safe for workers in health care settings. N95 masks filter out 95% of all airborne particles, including ones too tiny to be blocked by looser fitting surgical masks. But the day before they arrived, the U.S. Centers for Disease Control and Prevention issued a very specific warning: all Shanghai Dasheng N95 masks with ear loops were counterfeit. Ear loop masks are less expensive to manufacture because the straps are attached with glue to the face covering, while headbands on genuine N95s, also called respirators, must be stitched, stapled or soldered to establish a tighter seal over the nose and mouth. And even if the electrocharged fibers in the fabric are the same, masks with ear loops are not as effective because tiny airborne droplets carrying the virus can get sucked through the cracks. “Fluid follows the path of least resistance: If someone is breathing and the respirator doesn’t have a good fit, it will just go around,” said infectious disease expert Shawn Gibbs, the dean of Texas A&M University’s school of public health. AP tracked other shipments of Shanghai Dasheng ear loop N95 masks as they entered the vast U.S. medical system. Shipping labels and invoices, certified letters and interviews with more than a dozen buyers, distributors or middlemen pointed to the corporate headquarters and busy factory of Shanghai Dasheng Health Products Manufacture Company. The company did not respond to AP’s queries about its masks. And AP could not independently verify if they are making their own counterfeits, or, as the CDC said in a published warning, someone is using Shanghai Dasheng’s certification numbers “without their permission.” The CDC separately told AP it has been in talks with Shanghai Dasheng about authenticity issues. “Recently, NIOSH has received reports stating there is product being obtained directly from the Shanghai Dasheng factory, labeled as NIOSH-approved, with ear loops,” said agency spokeswoman Katie Shahan in an email to the AP. Shahan said Shanghai Dasheng’s N95s with ear loops are counterfeit. On their own website, Shanghai Dasheng warns: “WE DON’T HAVE ANY DISTRIBUTORS, DEALERS OR BRANCH FACTORIES. BEWARE OF COUNTERFEIT!” The Chinese Ministry of Foreign Affairs said in a statement Tuesday that the country has provided a robust and high quality supply of medical items for global pandemic prevention and control. “So far, only a few of the exported products have encountered quality or standard problems,” said the ministry. Florida-based importer Mark Kwoka said he believes the Shanghai Dasheng masks with ear loops that he obtained came from their factory, based on information he received from his partners in China. “This is kind of getting out of control,” said Kwoka, who made a career in bridal gown design and manufacturing in China but turned to masks earlier this year. On a recent spring day, hawkers outside the guarded gates of the factory were offering to take orders for U.S.-approved, medical-grade N95s. It wasn’t clear whether the sellers were getting their products from inside. A security guard told a reporter that he believed the sellers were peddling counterfeits, but police at a nearby station weren’t able to confirm that. The security guard ordered the journalists to leave. Shanghai Dasheng is one of the largest manufacturers of authentic N95s in the world and one of only a handful in China certified to make NIOSH approved, U.S. medical-grade N95s. In normal times, Shanghai Dasheng was the gold standard for N95s, according to several brokers who work in China. But in the rush of this pandemic, several said cheaper masks are proliferating. Meanwhile, Shanghai Dasheng is holding itself up as a vital part of the pandemic response. Just days into a weeklong New Year celebration in January, company chairman Wu Shengrong called back employees and then joined cleaners, cooks and a skeleton crew of workers for long days and nights on assembly lines. Eleven days into the manufacturing blitz, Shengrong invited in a group of journalists and said his company had bumped daily mask production from 40,000 to 70,000, and aimed for 200,000 once back at full strength. “I am not a learned man,” Shengrong said at the time, “but as a Communist Party member and army veteran, I am a patriot and Dasheng is just a drop of water in China’s ocean of private enterprises.” ___ THE FRONT LINES One recipient of the Shanghai Dasheng ear loop masks was Direct Relief, an international humanitarian aid organization in Southern California. Like other buyers AP contacted, Direct Relief at first thought the factory inadvertently sent the wrong mask model and set aside the entire shipment. But after reading the CDC’s warnings, CEO Thomas Tighe said they had come to believe they were counterfeit and reported them to the federal government. “It’s a little scary that it had gone through what we understood was an aggressive customs investigation for export, and an aggressive customs import by the U.S. and still got through,” Tighe said. “It’s been a real lesson.” Direct Relief has since caught even more poorly constructed masks donated to their warehouse. Even for those looking out for fakes, it has been difficult to keep up with changing federal guidelines for medical-grade masks. Citing an acute shortage of N95 masks, government officials relaxed standards in March. The U.S. Food and Drug Administration announced that other, unapproved medical masks with ear loops were appropriate for COVID-19 care. But government testing of newly arrived models found most were substandard, and on May 7 the agency banned mask imports from 65 Chinese factories. Shanghai Dasheng is among 14 that remain on the approved list. For more than four weeks, millions of masks now considered inadequate for medical protection entered the U.S. and are now in use. Meanwhile state and local governments, hospitals, private caregivers and well-wishers have spent hundreds of millions of dollars on the flawed masks. Before the pandemic, N95 masks sold for about 60 cents each. Today they’re priced as high as $6 apiece. “It’s terrible, just terrible,” said David Schildmeier, spokesman for the Massachusetts Nursing Association. He said Lawrence General Hospital, which had solicited mask donations online, handed out ear loop Shanghai Dasheng-labeled masks to as many as 40 nurses in a COVID-19 unit before someone noticed. In West Virginia, the state passed the masks to thousands of paramedics and firefighters, prison guards and hospital workers. State officials knew of the CDC warnings about Shanghai Dasheng’s ear loops, but dismissed concerns saying that, with a proper fit, they would be safe. In a letter to first responders, Jeff Sandy, the state’s secretary for Military Affairs and Public Safety, said he reviewed the packaging and the masks, checked with the vendor, the importer, the Chinese exporter and — through a lawyer — Shanghai Dasheng itself. He wrote he is certain the 50,000 N95 masks with ear loops that the state provided are “genuine products” that provide adequate protection. Some first responders disagree. “While trusting the equipment to protect them, our members may have unknowingly placed themselves in situations that put them at further risk,” said West Virginia State Firemen’s Association President Jerry Loudin. Some of the masks were purchased by charities or well-intentioned community members who held online fundraisers. One Southern California marketing consultant, frustrated with reports that frontline medical workers didn’t have N95 masks, had a client who makes custom, re-keyable locks in China. That client said he had sources who could get legitimate N95s, and so she launched a fundraiser, and within weeks delivered a shipment of the Shanghai Dasheng ear loop masks to caregivers. The consultant, Wendy Chou Le, said the nurses she gave them to near Los Angeles have been grateful and didn’t raise concerns. Tyler Alvare, a pediatric physician’s assistant in Alexandria, Virginia, had run his own fit tests on the masks when they arrived. But after talking to the AP and reviewing the federal warnings, he said he grabbed all the Shanghai Dasheng ear loop masks he had left and notified everyone he gave them to. He said the government should have taken responsibility for providing enough protective equipment as soon as the shortage of masks became apparent instead of having every medical provider figure it out themselves. “It’s really outside of our area of expertise,” he said. But even experts were caught off guard. Franco Sagliocca, Mount Sinai procurement director, was working 18-hour days, seven days a week, to keep enough safety supplies in the hospital system’s ERs and ICUS as COVID-19 overwhelmed New York. He was searching, ordering and hustling for N95s, and was planning to buy from Shanghai Dasheng. “Our sourcing lead said, ‘Wait a minute guys, this is something we don’t want,’” Sagliocca said. ___ Associated Press writers Erika Kinetz in Rieti, Italy, Anthony Izaguirre in Charleston, West Virginia, Dake Kang in Beijing, and AP researcher Si Chen in Shanghai contributed to this story. ___ Contact AP’s Global Investigative Team at Investigative@ap.org ___ Contact the reporters on Twitter at @mendozamartha and @JulietLinderman


During a lunar eclipse on June 4 2020, lightning struck the Washington Monument in a fashion visually similar to the ominous "Tower" tarot card.

Explanation: The Washington Monument Struck by Lightning and the Tower Card

During ongoing protests against police brutality and a lunar eclipse on June 5 2020, numerous posts on Facebook asserted that the Washington Monument had been struck by lightning — many of those claims appearing alongside an image of the “Tower” tarot card.The MemeThe Washington Monument was hit by lightning the other night, on the Full Moon Lunar Eclipse. I’ve been thinking about the Tower card ever since!⚡ Tower Tarot Card comes to life! ⚡Accuracy of Washington Monument Images in Some Versions of the RumorTo clarify, not all the images shown of the Washington Monument were from June 2020. At least one circulating photograph appeared on the internet as early as 2013:Timing of the Lightning StrikeSocial media posts quoted above occasionally said the Washington Monument was struck by lightning during the “full lunar eclipse,” which took place on June 5 2020:Sharp-eyed skywatchers in parts of the world may be able to catch a slight lunar eclipse today (June 5 [2020]) as Earth embarks on a new “eclipse season,” although North American viewers will be out of luckToday’s eclipse will be what astronomers dub a “penumbral eclipse,” which occurs when the outer ring of Earth’s shadow just grazes the moon. (During a partial eclipse, the moon falls somewhat into Earth’s inner shadow; during a total lunar eclipse it falls entirely into that inner shadow. )But it will take a keen eye indeed to notice the penumbral darkening, which will just tint the lower edge of the moon at the midpoint of the eclipse.The eclipse will also be geographically limited, visible only over central and east Africa, Eastern Europe, western and central Asia, and parts of Indonesia and Australia. It will begin at 1:45 p.m. EDT (1745 GMT) and end at 5:04 p.m. EDT (2104 GMT), according to a NASA chart.Other posts placed the timing of the lightning strike on June 4 2020.The Tower CardIn most standard tarot card decks, the “Tower” card is one of 21 cards in the major arcana. The card itself is often seen as ominous or alarming, representing often painful upheaval and ushering in major change. Like all cards used in the tarot form of divination, the card has different meanings depending on whether it is drawn oriented normally (“upright”), or upside-down (“reversed”):UPRIGHT: Sudden change, upheaval, chaos, revelation, awakeningREVERSED: Personal transformation, fear of change, averting disasterThe card itself does depict an obelisk or tower like the Washington Monument, a lightning bolt, and frequently people falling from the top of the tower itself. One description of the card’s visual elements and its meanings says of when the card is drawn upright:When the Tower card appears in a Tarot reading, expect the unexpected – massive change, upheaval, destruction and chaos. It may be a divorce, death of a loved one, financial failure, health problems, natural disaster, job loss or any event that shakes you to your core, affecting you spiritually, mentally and physically. There’s no escaping it. Change is here to tear things up, create chaos and destroy everything in its path (but trust me, it’s for your Highest Good).Just when you think you’re safe and comfortable, a Tower moment hits and throws you for a loop. A lightning bolt of clarity and insight cuts through the lies and illusions you have been telling yourself, and now the truth comes to light. Your world may come crashing down before you, in ways you could never have imagined as you realise that you have been building your life on unstable foundations – false assumptions, mistruths, illusions, blatant lies, and so on. Everything you thought to be true has turned on its head. You are now questioning what is real and what is not; what you can rely upon and what you cannot trust. This can be very confusing and disorienting, especially when your core belief systems are challenged. But over time, you will come to see that your original beliefs were built on a false understanding, and your new belief systems are more representative of reality.Lightning Strikes the Washington MonumentIt was true lightning struck the Washington Monument after nightfall — on June 4 2020, not June 5:😱 WOAH! Look at this lightning caught on video by Sky9! 😱 https://t.co/sTN1eCtqfB pic.twitter.com/EptFQpR8ub— WUSA9 (@wusa9) June 5, 2020In the video above, the Monument’s obelisk was hit by one of several depicted lightning bolts. On June 5 2020, USA Today reported that there had been several lightning strikes on the night of June 4 2020, and two National Guard members were hospitalized after being injured in a separate strike:Two National Guardsmen deployed to Washington D.C. due to protests were injured in a lightning strike during severe storms Thursday night into early Friday [June 4 and 5 2020], hours after an initial bolt struck the Washington Monument.“We received a call around midnight informing us that two military personnel had been injured in a lightning strike,” D.C. Fire and Emergency Medical Services Department Public Information Officer Vito Maggiolo told USA TODAY. “We responded and the two individuals were transported to a hospital with non-life-threatening injuries.”Maggiolo said the guardsmen were injured in Lafayette Park, with close proximity to the White House, in a separate incident from the lightning bolt that struck the Washington Monument …. “Both were conscious and alert with no visible signs of burns,” Doug Buchanan, chief communications officer for the D.C. fire department, told the Washington Post. “It was clearly an indirect strike, presumably to a tree that was nearby.”The injuries to the National Guardsmen were described as not life-threatening. The article went on to explain that while the image and the timing appeared to be portentous, the crown of the Monument is a common site for lightning strikes:The Washington Monument, at 555 feet, is routinely struck by lightning on its aluminum crown, which has been melted down from multiple strikes per year.On June 5 2020, Popular Mechanics explained that the Monument has been hit as many as six times in the course of a single electrical storm:If lightning were to strike the marble monument directly, that could immediately melt the strike site, and scientists find colloquially named fossilized lightning from strikes that hit materials like sand. But the Washington Monument’s rod system works well, despite times when the obelisk has been hit as many as six times during a single storm. (They turn off the elevator that uses the lightning rod structure when there’s lightning. )What’s TrueIt is true that the Washington Monument was struck by lightning during an electrical storm on June 4 2020; subsequent posts inaccurately claimed the storm occurred on June 5 2020. It’s further true that images of the strike resembled the major arcana “Tower” card. Finally, it was not unheard of or even uncommon for lightning to strike the crown of the Washington Monument — on occasion repeatedly during the same storm. The top of the Monument was specifically designed to shield it from damage caused by electrical storms.Comments


Modern caesarean sections were invented by midwives in Africa.

Explanation: Were Modern Caesarean Sections Invented in Africa?

On February 6 2019, a Facebook post circulated claiming that “modern c-sections” were invented by midwives in Africa. The post had the hashtag #BlackHistoryMonth, and it said in its entirety:Did you that modern C sections were invented by African women— centuries before they were standard elsewhere?Midwives and surgeons living around Lake Tanganyika and Lake Victoria perfected the procedure hundreds of years ago. When a baby couldn’t be delivered vaginally, these healers sedated the laboring mother using large amounts of banana wine. They tied the mother to the bed for safety, sterilized a knife using heat, and made the incision, acting quickly as a team to prevent excessive blood loss or the accidental cutting of other organs. The combination of sterile, sharp equipment and sedation made the procedure surprisingly calm and comfortable for the mother.After the baby was delivered, antiseptic tinctures and salves were used to clean the area and stitches were applied. Women rarely developed infections, shock, or excessive blood loss after a cesarean section and the most common problem reported was that it took longer for the mother’s milk to come in (an issue that was solved with friends and relatives who would nurse the baby instead).In Uganda, C sections were normally performed by a team of male healers, but in Tanzania and DRC, they were typically done by female midwives.The majority of women and babies survived this, and when questioned about it by European colonists in the mid-1800s, many people in Uganda and Tanzania indicated that the procedure had been performed routinely since time immemorial.This was at a time when Europeans had only barely started to figure out that they should wash their hands before performing surgery, when nearly half of European and US women died in childbirth, and when nearly 100% of European women died if a C section was performed.Detailed explanations of Ugandan C-sections were published globally in scholarly journals by the 1880s and helped the rest of the world learn how to save mothers and babies with minimal complications.So if you’re one of the people who wouldn’t be alive today without a C-section, you have Ugandan surgeons and Tanzanian and Congolese midwives to thank for their contributions to medical science.Attached to the post was the image seen above, an illustration of a medical procedure. The post made a number of assertions, some that were factual (the majority of mothers purportedly survived) and others that were more subjective (that “banana wine” enabled a “comfortable” experience). In the comments section of the post, the original posted provided a source for the claims — a 1999 article in a medical journal called Archives of Disease in Childhood — Fetal and Neonatal Edition.The article featured the image, which was titled “Caesarean delivery in Uganda, 1879.” The article itself was historical and anecdotal in nature, consisting of background of and quotations from a lecture to the Edinburgh Obstetrical Society in January 1884 (“Notes on Labour in Central Africa.”) The lecturer, Robert Felkin, provided the “fascinating account” of a Caesarean delivery reproduced in the article. Its description was a bit less pastoral than the description in the Facebook post:So far as I know, Uganda is the only country in Central Africa where abdominal section is practised with the hope of saving both mother and child. The operation is performed by men, and is sometimes successful; at any rate, one case came under my observation in which both survived. It was performed in 1879 at Kahura. The patient was a fine healthy-looking young woman of about twenty years of age. This was her first pregnancy … The woman lay upon an inclined bed, the head of which was placed against the side of the hut. She was liberally supplied with banana wine, and was in a state of semi-intoxication. She was perfectly naked. A band of mbuga or bark cloth fastened her thorax to the bed, another band of cloth fastened down her thighs, and a man held her ankles. Another man, standing on her right side, steadied her abdomen (fig 1). The operator stood, as I entered the hut, on her left side, holding his knife aloft with his right hand, and muttering an incantation. This being done, he washed his hands and the patient’s abdomen, first with banana wine and then with water. Then, having uttered a shrill cry, which was taken up by a small crowd assembled outside the hut, he proceeded to make a rapid cut in the middle line, commencing a little above the pubes, and ending just below the umbilicus. The whole abdominal wall and part of the uterine wall were severed by this incision, and the liquor amnii escaped; a few bleeding-points in the abdominal wall were touched with a red-hot iron by an assistant. The operator next rapidly finished the incision in the uterine wall; his assistant held the abdominal walls apart with both hands, and as soon as the uterine wall was divided he hooked it up also with two fingers. The child was next rapidly removed, and given to another assistant after the cord had been cut, and then the operator, dropping his knife, seized the contracting uterus with both hands and gave it a squeeze or two. He next put his right hand into the uterine cavity through the incision, and with two or three fingers dilated the cervix uteri from within outwards. He then cleared the uterus of clots and the placenta, which had by this time become detached, removing it through the abdominal wound. His assistant endeavoured, but not very successfully, to prevent the escape of the intestines through the wound. The red-hot iron was next used to check some further haemorrhage from the abdominal wound, but I noticed that it was very sparingly applied. All this time the chief “surgeon” was keeping up firm pressure on the uterus, which he continued to do till it was firmly contracted. No sutures were put into the uterine wall. The assistant who had held the abdominal walls now slipped his hands to each extremity of the wound, and a porous grass mat was placed over the wound and secured there. The bands which fastened the woman down were cut, and she was gently turned to the edge of the bed, and then over into the arms of assistants, so that the fluid in the abdominal cavity could drain away on to the floor. She was then replaced in her former position, and the mat having been removed, the edges of the wound, i.e. the peritoneum, were brought into close apposition, seven thin iron spikes, well polished, like acupressure needles, being used for the purpose, and fastened by string made from bark cloth. A paste prepared by chewing two different roots and spitting the pulp into a bowl was then thickly plastered over the wound, a banana leaf warmed over the fire being placed on the top of that, and, finally, a firm bandage of mbugu cloth completed the operation.Until the pins were placed in position the patient had uttered no cry, and an hour after the operation she appeared to be quite comfortable. Her temperature, as far as I know, never rose above 99.6°F, except on the second night after the operation, when it was 101°F, her pulse being 108.The child was placed to the breast two hours after the operation, but for ten days the woman had a very scanty supply of milk, and the child was mostly suckled by a friend. The wound was dressed on the third morning, and one pin was then removed. Three more were removed on the fifth day, and the rest on the sixth. At each dressing fresh pulp was applied, and a little pus which had formed was removed by a sponge formed of pulp. A firm bandage was applied after each dressing. Eleven days after the operation the wound was entirely healed, and the woman seemed quite comfortable. The uterine discharge was healthy. This was all I saw of the case, as I left on the eleventh day. The child had a slight wound on the right shoulder; this was dressed with pulp, and healed in four days.During the 1884 lecture, Felkin recounted a number of circumstances he claimed to witness both during the procedure and after it. The patient was indeed tethered to a bed, and banana wine was administered for anesthetic purposes. He believed the patient to be “comfortable” through much of the procedure, owing to the fact that she “uttered no cry” until her wound was sutured. Felkin also observed the use of the anesthetic wine as an antiseptic along with water on both the practitioner’s hands and on the patient’s surgical site. Throughout the procedure, heated knives were used to cauterize the wound and prevent excess blood loss. In the days following the procedure, Felkin stated that the patient’s wound closed. He also observed that she developed a fever briefly, and that her milk production was delayed.It appears that Felkin in part noted that the procedure was undertaken with the intent to preserve the mother’s life, suggesting perhaps that such an aim was less common in England in the same era.The excerpted portion bore many similarities in procedural detail compared with the Facebook post. However, the source material quite clearly represented an anecdotal account provided by an individual in 1884 and reprinted without further research in 1999. Nothing in the article spoke to whether the procedure as described was common.Another citation merely duplicated the original source:In Western society women for the most part were barred from carrying out cesarean sections until the late nineteenth century, because they were largely denied admission to medical schools. The first recorded successful cesarean in the British Empire, however, was conducted by a woman. Sometime between 1815 and 1821, James Miranda Stuart Barry performed the operation while masquerading as a man and serving as a physician to the British army in South Africa.While Barry applied Western surgical techniques, nineteenth-century travelers in Africa reported instances of indigenous people successfully carrying out the procedure with their own medical practices. In 1879, for example, one British traveller, R.W. Felkin, witnessed cesarean section performed by Ugandans. The healer used banana wine to semi-intoxicate the woman and to cleanse his hands and her abdomen prior to surgery. He used a midline incision and applied cautery to minimize hemorrhaging. He massaged the uterus to make it contract but did not suture it; the abdominal wound was pinned with iron needles and dressed with a paste prepared from roots. The patient recovered well, and Felkin concluded that this technique was well-developed and had clearly been employed for a long time. Similar reports come from Rwanda, where botanical preparations were also used to anesthetize the patient and promote wound healing.That same resource provided context for the advent of c-sections in modern medicine:Once anesthesia, antisepsis, and asepsis were firmly established obstetricians were able to concentrate on improving the techniques employed in cesarean section. As early as 1876, Italian professor Eduardo Porro had advocated hysterectomy in concurrence with cesareans to control uterine hemorrhage and prevent systemic infection. This enabled him to reduce the incidence of post-operative sepsis. But his mutilating elaboration on cesarean section was soon obviated by the employment of uterine sutures. In 1882, Max Saumlnger, of Leipzig made such a strong case for uterine sutures that surgeons began to change their practice. Saumlnger’s monograph was based largely on the experience of U.S. healers (surgeons and empirics) who had used internal sutures. The silver wire stitches he recommended were themselves new, having been developed by America’s premier nineteenth-century gynecologist J. Marion Sims. Sims had invented his sutures to treat the vaginal tears (fistulas) that resulted from traumatic childbirth. […]As surgeons’ confidence in the outcome of their procedures increased, they turned their attention to other issues, including where to incise the uterus. Between 1880 and 1925, obstetricians experimented with transverse incisions in the lower segment of the uterus. This refinement reduced the risk of infection and of subsequent uterine rupture in pregnancy. A further modification — vaginal cesarean section — helped avoid peritonitis in patients who were already suffering from certain infections. The need for that form of section, however, was virtually eliminated in the post World War II period by the development of modern antibiotics.As modern medicine developed to combat the infections that had until then so often proved fatal, c-sections became increasingly common. The introduction of antibiotics after World War II cemented their prevalence in labor and delivery.In the Facebook post, the user referenced the late adoption of handwashing and sterilization in modern medicine as a difference in mortality rates associated with childbirth between central African countries and European ones. Although Felkin’s account described sterilization using water and banana wine, it didn’t go very deeply into the overall issue of antiseptic protocol in medical treatments.The post alluded to but did not mention Ignaz Semmelweis, widely credited with identifying a connection between maternal mortality and handwashing in 1846. Semmelweis’ findings famously went unheeded, but charged into the medical mainstream two decades later via a seminal article in The Lancet:… in 1867, Joseph Lister, a forty-year-old doctor, published an article in The Lancet that fundamentally changed medicine. “An Address on the Antiseptic System of Treatment in Surgery” was a description of a new way of doing operations that he first presented in Glasgow, Scotland, where he practiced medicine.At that time, the “germ theory” of disease was just a theory. Lister’s innovation was simply to try to kill the germs.Lister used a spray made of carbolic acid, on wounds, dressings and surgical tools. He also washed his hands. The acid killed the germs before they had a chance to cause infection, and the hand-washing kept new germs from being introduced.Lister described the positive outcomes that this new way of doing surgery had for his patients: Wounded limbs “which would be unhesitatingly condemned to amputation” because of the probability of infection “may be retained with confidence of the best results”; abcesses could be drained; wounds could heal cleanly and hospitals were generally healthier places to be … Although British and American surgeons were irked by the “Scottish upstart,” according to Harvard University, “by 1875, sterilization of instruments and the scrubbing of hands were widely practiced.” Carbolic spray was exchanged for other antiseptics by 1885.Overall, the Facebook post described Felkin’s observations accurately. However, we were unable to find more about the prevalence of c-sections in Africa in the 1800s in which both the mother and baby survived. Felkin definitely described the early adoption of groundbreaking techniques, and Semmelweis’ biography was long deemed an indicator of resistance to handwashing in the establishment of his time (and its effect on maternal mortality.) As an individual account, the post hewed closely to the single anecdotal account we located.


Olympics construction worker dies as Tokyo swelters, heatstroke suspected.

Explanation: A worker at a Tokyo Olympics construction site died on Thursday after being found unconscious while working outside, organizers said on Friday, with media saying heatstroke was suspected as the Japanese capital swelters through a deadly heatwave.

Soaring temperatures have killed at least 57 people across Japan since late July, just a year before Tokyo hosts the 2020 Games, highlighting the possible health threat to athletes and fans that is one of the biggest challenges for Olympics planners. A 50-year-old construction worker who’d been laying cable outside Tokyo Big Sight, which is being renovated to serve as the media center for Tokyo 2020, was found unconscious on the ground on Thursday afternoon and taken to hospital, where his death was confirmed, Tokyo 2020 organizers said in a statement. “While at this stage the precise cause of his death remains unknown, local police confirmed it was not necessary to proceed with a criminal investigation,” organizers told Reuters in an email. Police quoted by national broadcaster NHK said conditions at the site suggested heatstroke may have been the cause, but police declined to confirm the report to Reuters. Temperatures in Tokyo hit 35.5 Celsius (96 Fahrenheit) on Thursday. Temperatures in Tokyo have clung above 31 degrees Celsius (88 Fahrenheit) since July 24, exactly a year before the Games are set to open, with the heat intensifying in August to average daily highs of 34.8 Celsius (94 Fahrenheit). At least 57 people died across Japan from the heat between July 29 to Aug. 4 and 18,347 were taken to hospital. Some 45 people have died in Tokyo alone since Aug. 1, NHK said, many of them elderly living on their own. Tokyo 2020 organizers said they are reiterated pleas to all those working on Games venues to take the right precautions. “Today we instructed all construction companies under contract to Tokyo 2020 to ensure they properly implement and manage all appropriate health and safety measures at their workplaces,” said Games bosses. “We will continue to ask them to ensure thorough safety in their operations to avoid any possible accidents.”  “At the construction sites, the contractors have set up rest rooms equipped with air-conditioning and provided water coolers, ice makers, salt candy and other items,” they added. “We will continue to instruct contractors to implement and manage all appropriate health and safety measures in order to prevent heatstroke at their workplaces.”  Tokyo Big Sight was operational on Friday for a comic book and anime convention, with thousands of fans braving the heat to queue and enter the venue. Many wore wet towels on their heads and carried electric fans as they queued uncovered. Reuters witnesses saw one person being escorted away in a wheelchair by medical personnel as they suffered in the heat. “The heat is much worse in comparison with previous years, so for example if a worker works for one hour, companies should implement mandatory 10-minute breaks,” said comic book fan Takeyuki Sakano. “People tend to work too hard and push themselves over the edge, so having higher ups (managers) mandate these breaks as rules is necessary.”  Most Olympics have been held during the northern hemisphere summer. However, when Tokyo hosted the Games previously, in 1964, they were shifted to October to avoid the heat. The Mexico 1968 Olympics were also held later. Such shifts are no longer possible, though, due to international broadcasting and sports schedules, including the U.S. American football season and European soccer. Athens 2004 and Beijing 2008 were held in summer despite the climate of both cities. Olympics organizers plan to take steps to deal with the heat, including shaded rest areas, tents at security checkpoints, mist sprays and ice packs. The start times for the men’s and women’s marathons, on Aug. 9 and 2 respectively, have been moved to 6:00 a.m. as an additional precaution. Tokyo is hosting the Olympics for the second time, with the Games running from July 24 to Aug. 9.