Few Americans are Aware of Links Between Alcohol and Cancer Risk

 Despite conclusive research that shows that all alcoholic beverages, including wine, increase the risk of many types of cancer, Americans demonstrated low awareness of this risk, and some perceived alcohol as having health benefits, according to results published in Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research. Awareness varied significantly for various types of alcohol, the study showed.

“Alcohol is a leading modifiable risk factor for cancer in the United States and previous research has shown that most Americans don’t know this,” said the study’s lead author, Andrew Seidenberg, MPH, PhD, who conducted this research while serving as a Cancer Prevention Fellow at the National Cancer Institute.

Seidenberg cited research that shows that alcohol contributed to an average of more than 75,000 cancer cases and almost 19,000 cancer deaths per year between 2013-2016. All beverage types containing ethanol, such as wine, beer, and liquor, increase cancer risk. To date, seven cancer types have been linked to alcohol consumption, including cancers of the breast, mouth, and colon.

To assess Americans’ awareness of the links between alcohol and cancer, Seidenberg and colleagues analyzed data from the 2020 Health Information National Trends Survey 5 Cycle 4, encompassing survey responses from 3,865 adults. Respondents were asked, “In your opinion, how much does drinking the following types of alcohol affect the risk of getting cancer?” Responses were recorded for wine, beer, and liquor. Further questions assessed the respondents’ awareness of links between alcohol and heart disease. Researchers also asked respondents about their current alcohol intake.

Key findings:

• Awareness of the alcohol-cancer link was highest for liquor, with 31.2 percent of U.S. adults being aware of the risk, followed by beer (24.9 percent) and wine (20.3 percent).
• Ten percent of U.S. adults said wine decreases cancer risk, while 2.2 percent said beer decreases risk and 1.7 percent said liquor decreases risk.
• More than 50 percent of U.S. adults reported not knowing how these beverages affected cancer risk.
• U.S. adults who were aware that alcoholic beverages increased heart disease risk had higher adjusted predicted probabilities of being aware of the alcohol-cancer link. Heart disease awareness followed similar patterns to cancer awareness, with 38.9 percent, 36.4 percent, and 25.1 percent of U.S. adults believing that liquor, beer, and wine, respectively, increased heart disease risk.  
• Older adults demonstrated lower awareness of alcohol as a risk factor for cancer. Among U.S. adults over age 60, 15.7 percent were aware of the risk for wine; 17.8 percent for beer; and 23.7 percent for liquor. By comparison, among U.S. adults aged 18-39, 26.1 percent were aware of the risk for wine; 33.1 percent for beer; and 39.1 percent for liquor. Seidenberg said this may be due to more long-standing drinking habits among older adults.
• Drinking status was not associated with awareness, with similar rates for non-drinkers, drinkers, and heavier drinkers.

The authors said the study confirms that many Americans would benefit from further education about the links between alcohol and cancer. Such education would be especially useful given that studies suggesting that wine confers possible health benefits have received significant media attention, they noted.

“All types of alcoholic beverages, including wine, increase cancer risk,” said senior author William M.P. Klein, PhD, associate director of the National Cancer Institute’s Behavioral Research Program. “This study’s findings underscore the need to develop interventions for educating the public about the cancer risks of alcohol use, particularly in the prevailing context of national dialogue about the purported heart health benefits of wine.”

The authors suggested that interventions could include mass media campaigns, cancer warning labels, and patient-provider communications. Tailoring messages to desired audiences could help increase message relevance, Klein said.

“Educating the public about how alcohol increases cancer risk will not only empower consumers to make more informed decisions, but may also prevent and reduce excessive alcohol use, as well as cancer morbidity and mortality,” he said.  

The authors noted potential limitations include the unconditional structure of some survey questions; for example, questions about awareness of the alcohol-cancer link were not stratified according to how much a respondent drank. They also noted that some data were collected during the COVID-19 pandemic, when many Americans reported drinking more than usual.

This study was supported by the Division of Cancer Control and Population Sciences at the National Cancer Institute, a part of the National Institutes of Health.

https://www.aacr.org/about-the-aacr/newsroom/news-releases/few-americans-are-aware-of-links-between-alcohol-and-cancer-risk/

LA County set to reinstate indoor-mask mandate as COVID surges

 Here we go again.

Los Angeles County is set to reinstate indoor-mask mandates as local COVID-19 infections and related hospital admissions continue to surge.

“There is this common line of thinking that the pandemic is over and COVID is no longer of concern, but these numbers clearly demonstrate that COVID is still with us,” County Public Health Director Barbara Ferrer said at a press conference Thursday. 

The county now averages more than 2,700 new COVID infections per day, up 180% since Nov. 1. Virus-related hospital admissions are now at 192 per day, a 200% increase from the same date, she said.

Los Angeles County’s weekly rate of new cases also rose to 185 per 100,000 residents, which boosted the county from “low” virus activity to “medium,” as per CDC guidelines. 

Masked customers at Los Angeles’ Grand Central Market in July 2022.

Xinhua News Agency via Getty Ima

The “medium” risk level still only makes masking “strongly recommended.”

But Ferrer warned that the county is on track to move to the “high” viral level by next week, which would prompt an indoor-mask mandate.

To hit the “high” designation, the county’s weekly case rate would have to be at least 200 per 100,000 residents and its hospital admissions reach more than 10 per 100,000 residents. More than than 10% of staffed hospital beds also would have to occupied by COVID patients. 

As of Thursday, the hospital admission rate already exceeded the CDC’s threshold, with 11.9 new admissions per 100,000 residents. Still, only 5.6% of inpatient beds in the county were occupied by COVID patients.

Los Angeles County reported over 4,000 new COVID cases on Thursday.

Getty Images

“Given both the increases in hospitalizations and the lack of certainty in the winter trajectory for COVID-19, continuing some common-sense mitigation strategies that we know work to limit transmission and illness, including masking and being up to date on vaccines and boosters, remains a very sensible approach,” Ferrer said.

“However, [the current trend] does signal that case rates and hospitalizations are elevated, and we could be in the ‘high’ community level as soon as next week,” she said. 

Ferrer’s announcement quickly generated a reaction on social media.

LA County Director of Public Health Barbara Ferrer announced a possible indoor-mask mandate if the surge continues.

Los Angeles Times via Getty Imag

“They push false data and fearporn through their daily news,” a Twitter user lamented. 

Another person tweeted, “The only city that is chomping at the bit to bring masks back is Los Angeles.

“They’ll have rolling mandates forever,” the writer said, adding that “it’s been very normal” in their hometown of Louisville, KY.

Other commenters were more open to the idea, with one person writing, “How do you prevent long Covid?

“Vaccines. Masks. Treatments like Paxlovid. The greatest crime is telling people that Covid is ‘just a cold.’”

Another Twitter user went so far as to say the mandate should already be in place.

“Why wait to implement a simple measure that could temper the surge, reduce deaths, long Covid, hospitalizations, & even more mutations?” the person argued.

Masks soon might be required everywhere in the county, not just healthcare facilities.

Los Angeles Times via Getty Imag

At the end of the day Thursday, the department reported 4,493 new COVID cases and 14 additional deaths, with current hospitalizations hovering at 1,164.

Department officials previously stated that about 40% of hospital admissions were brought in for COVID-related symptoms, while the rest tested positive after arriving for separate issues.

Concerns about the LA County COVID surge are compounded by an uptick in flu and RSV cases.

MediaNews Group via Getty Images

Although masks are currently optional throughout the county, they are still required in healthcare facilities and congregate care locations like nursing homes, per the department’s website.

Concerns about the LA County COVID surge are compounded by an uptick in flu and RSV cases in the winter months. Earlier this month, The Post reported on staggering pediatric RSV numbers in New York City hospitals.

“We’re caring for more kids than we have beds for,” Dr. James Schneider, head of the pediatric intensive care unit at Long Island Jewish Hospital, said at the time. 

As COVID infections continue to climb, Los Angeles authorities are urging residents to follow through with vaccination. While a vaccinated person can still catch and transmit COVID, vaccines offer protection from the most severe symptoms. 

https://nypost.com/2022/12/02/la-county-set-to-reinstate-indoor-mask-mandate-as-covid-surges/

Something Is Rigged: Unexplained, Record 2.7 Million Jobs Gap Emerges In Broken Payrolls Report

 A superficial take of today's jobs report would note that both jobs and earnings "blew past expectations, flying in the face of Fed rate hikes", and while that is accurate at the headline level, it couldn't be further from the truth if one actually digs a little deeper in today's jobs numbers.

Recall that back in August, September, and October we showed that a stark divergence had opened between the Household and Establishment surveys that comprise the monthly jobs report, and since March the former has been stagnant while the latter has been rising every single month. In addition to that, full-time jobs were plunging while part-time jobs were surging and the number of multiple-jobholders soared.

Fast forward to today when the inconsistencies not only continue to grow, but have become  downright grotesque.

Consider the following: the closely followed Establishment survey came in above expectations at 263K, above the 200K expected - a record 7th consecutive beat vs expectations -  and down modestly from last month's upward revised 284K...

... numbers which confirm that at a time when virtually every major tech company is announcing mass layoffs...

... the BLS has a single, laser-focused political agenda - not to spoil the political climate at a time when Democrats just lost control of the House as somehow both construction (+20K) and manufacturing (+14K) added jobs according to the BLS, when even ADP now reports that these two sectors combined shed more than 100,000 workers in November.

Alas, there is only so much the Department of Labor can hide under the rug because when looking at the abovementioned gap between the Household and Establishment surveys which we have been pounding the table on since the summer, it just blew out by a whopping 401K as a result of the 263K increase in the number of nonfarm payrolls (tracked by the Household survey) offset by a perplexing plunge in the number of people actually employed which tumbled by 138K (tracked by Household survey). Furthermore, as shown in the next chart, since March the number of employed workers has declined on 4 of the past 8 months, while the much more gamed nonfarm payrolls (goalseeked by the Establishment survey) have been up every single month.

What is even more perplexing, is that despite the continued rise in nonfarm payrolls, the Household survey continues to telegraph growing weakness, and as of Nov 30, the gap that opened in March has since grown to a whopping 2.7 million "workers" which may or may not exist anywhere besides the spreadsheet model of some BLS (or is that BLM) political activist. In fact, one look at the chart below confirms all one needs to know about BLS "data integrity."

Showing this another way, there were 158.458 million employed workers in March 2022... and 158.470 million in November 2022 an increase of just 12,000 over 8 months, a period in which the number of payrolls (which as a reminder is the number the market follows) reportedly increased by 2.7 million!

As an aside, it appears this is not the first time the "apolitical" Bureau of Labor Statistics has pulled such a bizarre divergence off: it happened right before Obama's reelection:

And then again: right before Hillary's "100% guaranteed election (because one wouldn't want a soft economy to adversely impact her re-election odds).

It gets better: digging in even deeper into the far more accurate and nuanced Household Survey, we find that the November drop in Employment was the result of a plunge in part-time workers, more than offsetting the modest increase in part-time workers which had declined in 3 of the past 4 months heading into November.

Further to this point, as shown below, since March, the US has lost 398K full-time employees offset by amodest gain of 190K part-time employees, while a whopping 291k workers were forced to get more than one job over the same period.

And while none of the above is really new - we have documented the record divergence between payrolls and employment for half a year now - there were two new developments: first, to facilitate its rigging of the data, the BLS has resorted to the oldest trick in the book, boosting the core goal-seek factor, the business "birth death" adjustments, which in October hit a record high 455K, and although it has since dipped to 14K in November, the trend in speculative BLS assumptions about the viability of the US economy (more businesses are created than are shut down only when there is economic solid growth) is clearly visible in the chart below.

Another point: it appears that the BLS is now aggressively estimating the so-called hard data. As Goldman's Jan Hatzius observed, the 49% Establishment survey response rate was much lower than the 70-75% rate typical in November. The chart below shows just how much of an outlier the Nov 2022 payrolls report: it confirms that roughly a third of the report was not based on reality at all but on aggressive excel modeling and estimates.

One final point: a former Fed staffer Julia Coronado points out, we have reached the absurd part of the business cycle when average hours are declining in certain sectors even as hourly earnings are rising, prompting her to wonder if we are not in fact seeing a spike in hourly income courtesy of lump-sump severance payments.

So what's going on here?

The simple answer: as shocking as this may sound, there has been no change in the number of people actually employed in the past 8 months, but due to deterioration in the economy, more people are losing their higher-paying, full-time jobs, and switching into much lower- paying, benefits-free part-time jobs, which also forces many to work more than one job, a rotation which picked up in earnest some time in March and which has only been captured by the Household survey. Meanwhile the Establishment survey plows on ahead with its politically-motivated approximations, seasonal adjustments, and other labor market goalseeking meant to make the Biden admin look good and provide the Fed with ammo to keep rates high (thus forcing even more real layoffs, which unfortunately the BLS is incapable of capturing due to political reasons).

And since the Establishment survey is far slower to pick up on the nuances in employment composition, while the Household Survey has gone nowhere since March, the BLS data engineers have been busy goalseeking the Establishment Survey (with the occasional nudge from the White House especially now that the Biden admin needs something to hang its hat on after the GOP recaptured the House) to make it appear as if the economy is growing strongly, when in reality all they are doing is applying the same erroneous seasonal adjustment factor that gave such a wrong perspective of the labor market in the aftermath of the covid pandemic (until it was all adjusted away a year ago). In other words, while the labor market is already cracking, it will take the BLS several months of veering away from reality before the government bureaucrats accept and admit what is truly taking place.

As an aside, here we admit we were wrong: back in August we said that "we expect that "realization" to take place just after the midterms, because the last thing the Biden administration can afford is admit the labor market is crashing in addition to the continued surge in inflation." Little did we know just how stubborn and intent the White House is to stick to the broken narrative that all is well in the US.

Or, putting it otherwise as BofA's Michael Hartnett did earlier today (and as we will discuss in a subsequent post) - "unemployment in ’23 will be as shocking to Main St consumer sentiment as inflation in ’22."

https://www.zerohedge.com/markets/something-rigged-unexplained-record-27-million-jobs-gap-emerges-broken-payrolls-report

As the amoxicillin shortage drags on, several senators pressure FDA and HHS for solutions

 With the US staring down several drug shortages this year, one in particular is now catching lawmakers’ attention.

A bipartisan group of senators sent a letter to HHS Secretary Xavier Becerra and FDA commissioner Robert Califf expressing “strong concern” about the amoxicillin shortage for patients and general public health. Sens. Amy Klobuchar (D-MN), Sherrod Brown (D-OH), Ed Markey (D-MA) and Bill Cassidy (R-LA) are pushing for FDA and HHS to start working more forcefully to address the amoxicillin shortage along with the other drug shortages.

The letter says, in part:

We urge the Department of Health and Human Services and the Food and Drug Administration (FDA) to convene the Drug Shortage Task Force and work with stakeholders, including providers, on identifying factors and potential solutions to mitigating the amoxicillin shortage. Further, we request an update on FDA initiatives to prevent and mitigate drug shortages.

The letter noted that amoxicillin, often used to treat pediatric illnesses, is in short supply due to a “record high level of respiratory illnesses” that spiked demand for it and other medicines, leading to delays in care.

Erin Fox, the senior pharmacy director at the University of Utah Health, noted that while senators such as Klobuchar have been vocal about drug shortages for years, the situation is not cut and dried.

“FDA can’t make any drug company make any drug no matter how critical or life-saving. This is really up to the generic drug makers to make these products. Most of the companies refuse to provide a real reason for what is going on – and they don’t have to do so publicly,” Fox told Endpoints News via email.

Fox noted that the FDA’s drug shortage task force has outlined solutions. However, none of them have been implemented yet.

Michael Ganio, the senior director of pharmacy practice and quality at the American Society of Health System Pharmacists (ASHP), said that while it is a good thing to see members of congress devoting attention to drug shortages because shortages can have a detrimental effect, it’s not just amoxicillin in short supply.

“Amoxicillin is one of more than 260 drugs currently in short supply, so it is imperative that we implement some critical measures to shore up the resilience of our national drug supply chain to ensure that patients are able to get the medication therapy they need,” Ganio said.

For the current situation on amoxicillin, Ganio said that the shortage will likely last until at least early 2023 and will depend on the duration and scope of the outbreak of “pediatric respiratory infections.” He also noted that ASHP is noticing reported shortages of amoxicillin alternatives such as amoxicillin/clavulanate.

One of the producers of the drug, Sandoz, told Endpoints in late October that factors including manufacturing capacity, scarcity of raw materials and the energy crisis, among others, are affecting production, but the company added it is “on track” to bolster its supply and is trying several ways to boost its manufacturing capacity.

https://endpts.com/as-the-amoxicillin-shortage-drags-on-several-senators-pressure-fda-and-hhs-for-solutions/

Landmark trial on Arkansas trans youth medical ban wraps up

 The nation’s first trial on a ban on gender-confirming care for children ended Thursday, as Arkansas wrapped up its case defending the prohibition with testimony from an endocrinologist opposed to such treatments for minors.

U.S. District Judge Jay Moody, who is considering whether to strike down the law after hearing nearly two weeks of testimony, didn’t indicate when he would rule. Moody asked attorneys for the state and the American Civil Liberties Union to come up with a schedule for filing additional briefs in the case.

Arkansas’ law, which Moody temporarily blocked last year, would prohibit doctors from providing gender-confirming hormone treatment, puberty blockers or surgery to anyone younger than 18. It also would prohibit doctors from referring patients elsewhere for such care.

The state’s final witness was Dr. Paul Hruz, a pediatric endocrinologist in St. Louis, who said the research in support of such care for minors with gender dysphoria is flawed. He said the risks were too great to administer such treatment to minors.

“There remains a question as to whether the risks outweigh the benefits and whether alternatives exist,” Hruz said. “It’s still an area that needs scientific investigation.”

Experts say such treatments are safe if properly administered. The American Medical Association and the American Academy of Pediatrics, the Endocrine Society and the Pediatric Endocrine Society are among the multiple medical groups that have opposed Arkansas’ ban in court.

Under cross-examination by an attorney from the American Civil Liberties Union, Hruz acknowledged that he has never treated a patient for gender dysphoria or diagnosed a patient with it. Hruz also was questioned about briefs he’s signed onto in other court cases regarding transgender youth.

One brief — in a case regarding a school preventing a transgender teen from using the bathroom that corresponded with his gender identity — said “conditioning children into believing that a lifetime of impersonating someone of the opposite sex, achievable only through chemical and surgical interventions, is a form of child abuse.”

Hruz said he “would not have chosen that wording.”

Arkansas was the first state to enact a ban on gender-confirming care for children, with Republican lawmakers in 2021 overriding GOP Gov. Asa Hutchinson’s veto of the legislation. Hutchinson, who had signed other restrictions on transgender youths into law, said the prohibition went too far by cutting off the care for those currently receiving it.

The ACLU, which sued Arkansas on behalf of four families of transgender children in the state, called the law one of the most dangerous it has challenged.

“Not only does it threaten medically necessary, lifesaving care, but this and bills and resolutions like it singling out LGBTQ Arkansans send a clear, toxic message from the state legislature that all people are not welcome in Arkansas,” Holly Dickson, executive director of the ACLU of Arkansas, said in a statement Thursday afternoon.

The state has argued that the prohibition is within its authority to regulate the medical profession. People opposed to such treatments for children argue they are too young to make such decisions about their futures.

“The (law) protects children from life-altering, permanent decisions that they may desire to make as an underage child but could regret as an adult; no law in Arkansas prevents someone from making these decisions as an adult,” Republican Attorney General Leslie Rutledge, whose office is defending the ban, said in a statement.

A similar ban has been blocked by a federal judge in Alabama, and other states have taken steps to restrict such care. Florida medical officials last month approved a rule banning gender-confirming care for minors, at the urging of Republican Gov. Ron DeSantis.

A judge in Texas has blocked that state’s efforts to investigate gender-confirming care for minors as child abuse. Children’s hospitals around the country have faced harassment and threats of violence for providing gender-confirming care.

The Arkansas trial, which resumed Monday after a five-week recess, included testimony from one of the transgender youth challenging the state’s ban. The teenager testified in October that the hormone therapy he’s received has transformed his life and that the ban would force him to leave the state.

The 8th U.S. Circuit Court of Appeals last month said it wouldn’t reconsider its ruling keeping the temporary order against Arkansas’ ban in place.

https://apnews.com/article/health-business-arkansas-american-civil-liberties-union-4d93ef6d5f1978832949f8a46da2a871

Widespread outage shuts down 988 mental health hotline

 The nation’s new 988 hotline, intended to help anyone experiencing a mental health emergency, has been out of service for several hours Thursday.

Those trying to reach the line for help with suicide, depression or other mental health crises are greeted with a message that says the line is “experiencing a service outage.”

People can still reach a mental health counselor through the lifeline by texting “988” or opening a chat at 988lifeline.org.

The Department of Health and Human Services, which oversaw the launch of the three-digit lifeline earlier this year, is in communication with the contractor that supports the line, HHS spokeswoman Sarah Lovenheim said in a tweet Thursday.

“We’ve taken immediate action to ensure alternative 988 channels are available to the public,” Lovenheim tweeted. The outage had been ongoing for several hours Thursday, she said.

Veterans who are looking to reach the helpline can call the Veterans Crisis Line directly at 877-267-6030. The outage is also affecting the Substance Abuse and Mental Health Services Administration’s Disaster Distress Helpline.

The 988 helpline, launched in July, is a national helpline staffed with mental health counselors around the country that’s designed to be as easy to remember as the emergency line, 911.

Intrado, the telecommunications provider for the service, could not immediately be reached for comment. In a statement on its website, the company said it is “experiencing an incident that is impacting production across numerous systems” and is “working diligently to restore service.”

https://apnews.com/article/health-mental-service-outages-government-and-politics-d39ecadd27541c7c37c71caff95f975e

Federal claims court rules in favor of Gilead in CDC Truvada patent case

 Gilead pulled a win last week in its ongoing patent battle with the CDC over the HIV drug Truvada for pre-exposure prophylaxis (PrEP).

The US Court of Federal Claims ruled on Nov. 21 that the government breached certain agreements with Gilead by failing to promptly notify the company of its patent applications for Truvada for PrEP, according to documents unsealed on Wednesday.

The issue traces back to around 2004 when Truvada won an accelerated approval to treat HIV. Because HIV is known to develop resistance to therapy, patients at the time were often required to take more than one drug at a time. Truvada combines Gilead’s prior HIV drugs, Emtriva and Viread, making life easier for patients who were taking separate pills daily. Shortly after, the CDC and Gilead struck up a partnership to research Truvada’s use as a preventative measure prior to exposure.

The duo inked multiple material transfer and clinical trial agreements, referred to as MTAs and CTAs in the court documents.

Truvada won a label expansion in 2012 for PrEP, allowing individuals at high risk for HIV to take medicine daily to lower their chances of contracting HIV. In 2016, the government notified Gilead that it had acquired patents for Truvada’s use in PrEP, and three years later, it sued Gilead in Delaware court for infringing on those patents by marketing Truvada and its follow-on drug, Descovy, for PrEP. The Yale Global Health Justice Partnership published a report that year finding that CDC scientists were the first to determine that the drugs comprising Gilead’s Truvada could be used to prevent HIV transmission.

Gilead CEO Daniel O’Day has refuted those claims, arguing before the House Oversight Committee in May 2019 that the patents are invalid “because the use of Truvada as prophylaxis was widely known at the time the CDC sought these patents.”

In addition to challenging the validity of the patents, Gilead took the issue to federal claims court in 2020, alleging that the government breached its MTAs and CTAs with Gilead.

The court sided with Gilead last week, finding that the government failed to notify Gilead of its patent applications in a timely manner. The email notification in 2016 came a year after the first patent was granted.

“To be able to exercise its rights under the MTAs, Gilead would need to know about the government’s patent application,” the court said. Under the MTAs, the government must give Gilead “serious and reasonable consideration to [a] request for a . . . license,” the opinion states. “Gilead’s ability to exercise this right is forestalled if it does not know a patent application exists, especially in a timely manner.”

The Delaware case is set to go to trial in May 2023. The federal claims court did not come to a decision on whether the CTAs were breached.

https://endpts.com/federal-claims-court-rules-in-favor-of-gilead-in-cdc-truvada-patent-case/