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World

Hong Kong is criminalizing CBD as a ‘dangerous drug’ alongside heroin

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Hong Kong
CNN
 — 

Two years ago, cannabidiol was booming in Hong Kong. The compound, known as CBD, was popping up in cafes, restaurants and stores, with businesses eager to join an exciting new market already well-established in countries around the world.

That all came to an end on Wednesday, when CBD was criminalized in the city and declared a “dangerous drug” on the same level as heroin and fentanyl.

CBD is a chemical found in hemp and marijuana plants. It’s non-psychoactive, meaning it won’t get you high; instead, CBD is often marketed for everything from helping to relieve pain and inflammation to reducing stress and anxiety.

It has surged in global popularity in recent years, with brands adding it to shampoos, drinks, body oils, gummy bears and dog treats. In the United States and Europe, you might find it sold in coffee shops and farmers’ markets, mom-and-pop and high-end department stores, and even drugstore chain CVS.

But last June, draft legislation banning CBD was introduced to Hong Kong lawmakers, and went into effect February 1.

Under the new legislation, possession and consumption of any amount of CBD is punishable by seven years in prison and a fine of 1 million Hong Kong dollars ($127,607). Manufacturing, importing or exporting CBD is punishable by life imprisonment.

Even travelers could face penalties, with the government warning people not to risk “buying these products or bringing them back to Hong Kong.”

The same penalties and conditions apply for cannabis, also known as marijuana.

The ban has forced CBD-focused businesses to close, while other brands have had to roll back or get rid of CBD products.

“It’s a shame because there’s a missed opportunity for sure,” said Luke Yardley, founder of Yardley Brothers Craft Brewery, which had previously sold four products containing CBD – a lager and three nonalcoholic drinks. “I think that anything that you can’t get intoxicated from, and helps you to relax, is probably a good thing.”

The health benefits and risks of CBD have long been debated. In the US, most CBD products are not regulated by the Food and Drug Administration (FDA), which means that people can purchase items off the shelf.

Some research has found that the compound can ease pain and may be useful for those who have trouble sleeping. The FDA has approved one drug with CBD to treat rare, severe forms of epilepsy.

But concerns have also been raised, with some experts saying there isn’t enough scientific research into how CBD works or its potential effects.

In January, the FDA announced CBD products will require a new regulatory pathway in the US, saying: “We have not found adequate evidence to determine how much CBD can be consumed, and for how long, before causing harm.”

In Hong Kong, which has strict cannabis laws, the government’s concern revolves around the possible presence of its sister compound THC (tetrahydrocannabinol) in CBD products. THC is also found in cannabis plants and is responsible for the “high.”

In the US and Europe, CBD products can carry up to 0.3% – a trace amount – of THC, but even that is not acceptable in Hong Kong. And while CBD products could avoid this trace amount by using a pure form of CBD, most manufacturers mix other compounds for higher potency.

From 2019 to early 2022, Hong Kong authorities launched nearly 120 “operations” seizing and testing CBD products from restaurants and shops to warehouses, Secretary for Security Tang Ping-keung said last year. He added that more than 3,800 products were found to contain THC, though did not give further detail on the proportion or percentage of THC in those products.

In a written response to questions raised in the Legislative Council, Tang suggested the government’s traditionally tough stance on THC should be applied to CBD “to protect public heath.”

“We have adopted ‘zero tolerance’ towards drugs and we understand that it is a matter of public concern,” he said. “Therefore, the government plans to control CBD.”

The Action Committee Against Narcotics, a group of representatives from “the fields of social work, education, medical and community service” that advises the government on anti-drug policy, said in a statement last November that it supported the CBD ban and the government’s goal of “a drug-free Hong Kong.”

Many businesses began bracing themselves for regulatory changes in 2022, ahead of the government’s official announcement this January.

Yardley Brothers Craft Brewery stopped making its CBD beverages late last year in anticipation of the ban, and all its leftover products had sold out by December, said Yardley.

He said the CBD drinks had been “very popular,” amounting to roughly 8% of the business, as they offered adults a nonalcoholic option to enjoy when out with friends. At some bars, regulars “come in every weekend for a glass of CBD lemonade,” he said.

Now “there’s less choice for consumers in Hong Kong. That’s not necessarily a step in the right direction,” he said.

Some companies have been forced to shut down completely.

Med Chef, a restaurant that opened in 2021, once boasted of offering Hong Kong’s “first full menu of CBD-infused cocktails, appetizers and entrees.” In a news release during its launch, the restaurant founder emphasized the health and wellness benefits of CBD.

But by early November 2022, it had closed its doors. “We have worked hard in the past to present CBD in its most acceptable form and integrate our food and beverage concepts,” the restaurant wrote in a farewell post on Instagram. “It’s a pity that things didn’t go the way we hoped. Under the latest policies of those in power, we ultimately aren’t able to continue forward with everyone.”

Hong Kong’s first CBD cafe, Found, had also made headlines when it opened in 2020. It sold a variety of CBD products including infused coffee and beers, oils to help sleep, powder to sprinkle into food and pet products to help ease stiff joints.

It closed at the end of September 2022, telling patrons on Instagram that their positive feedback had shown that “CBD could help to cope with the stresses of daily life.”

“Sadly, in spite of the demonstrable positive impact, it has now become apparent that the Hong Kong government intends to adopt new legislation to prohibit the sale and possession of CBD,” it wrote.

Yardley said the government’s concerns about THC were valid – but argued they could have implemented better regulations, such as requiring certifications or standards of safety around CBD samples.

“It’s quite an extreme response to just fully ban it,” he said.

And while the brewery will continue operating, with plans for alternative nonalcoholic beverages to fill the gap, Yardley hopes CBD will be back on the menu. “I hope for the future that it might become legal again,” he said.

This story has been updated to include details of the draft legislation and its introduction.



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Health

Adult drug use rose during pandemic, but dropped dramatically in youth, study says

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CNN
 — 

Use of marijuana and other substances dropped in teenagers during the first year of the pandemic, according to a new study.

But adults’ use of cannabis, illegal drugs and alcohol, including binge drinking, either stayed the same or increased compared to the two years before Covid-19.

“Substance use decreased between 2019 and 2020 among those aged 13 to 20 years,” wrote first author Dr. Wilson Compton, deputy director of the National Institute on Drug Abuse.

However, “consistent declines were not seen in older persons other than tobacco use reductions, and cannabis use increased among adults ages 25 years and older,” he and his coauthors wrote.

The study analyzed data from the Population Assessment of Tobacco and Health Study, which follows tobacco and other substance use over time among 49,000 US youths and adults.

“A particular strength of this study was the longitudinal design,” said Joseph Palamar, an associate professor of population health at NYU Grossman School of Medicine, who was not involved in the study.

“This design allows us to look at changes among the same people over time as opposed to other national studies which compare different groups of people across time,” he said.

Substance abuse dropped in teenagers between ages 13 and 17, according to the study published Tuesday in the journal JAMA Network Open.

Cannabis use among teenagers ages 13 and 15 dropped by 3.4 percentage points in 2020 compared to 2018 and 2019, while tobacco use declined by about 4 points, the study found. The use of other illegal or misused prescription drugs also fell 2.5 percentage points in this age group.

Use of marijuana in teens ages 16 and 17 dropped 7.3 percentage points in 2020 compared to 2018 and 2019. Tobacco use fell by over 10 points and misuse of drugs sank by nearly 3 percentage points. Binge drinking dipped by 1.6 percentage points across the age group.

“I think availability plays a big part,” Palamar said. “If high schoolers are separated from their friends for a long time and stuck inside, they’ll likely have decreased access to drugs.

“Even if a teen successfully obtained weed, this doesn’t mean he or she had somewhere away from parents to smoke it if the whole family was on lockdown,” he added.

The use of alcohol increased by over five percentage points (from 60.2% to 65.2%) among adults ages 21 to 24 years old in 2020 compared to the previous two years. Binge drinking, however, fell by 2.2 points.

Tobacco use fell by about 8 percentage points, but use of marijuana and other illegal or prescription drugs did not change significantly in this age group, according to the study.

Use of marijuana increased slightly in adults 25 and up, by 1.2 percentage points. Declines in other substance abuse in this age group were not significant, the study authors said.

Tobacco use fell for all adults, the study found. The number of young adults ages 18 to 20 smoking tobacco dropped by just over 15 percentage points in 2020 compared to 2018 and 2019. Smoking also declined by about 8 points in adults ages 21 and up over the same period.

However, a drop in drug use during the early days of Covid did not mean the reduction continued as the pandemic wore on, said Palamar, who has been studying drug availability during that period.

“Decreases in use during the early months of Covid are meaningful, but we need to keep in mind that use of some drugs rebounded,” Palamar said. “For example, we found that seizures of marijuana and methamphetamine decreased after the start of Covid, and then rebounded to a much higher rate later in the year.”

A separate survey of people ages 19 to 30 found they were using marijuana and hallucinogens at high rates in 2021. The Monitoring the Future Study, published in 2022, found 11% of people in this age group used marijuana on a daily basis in 2021, while 43% said they had used it in the past year.

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Entertainment

Rapper Young Thug, co-defendant ara accused of in-court drug transaction

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CNN
 — 

Grammy-winning rapper Young Thug and a racketeering co-defendant conducted a hand-to-hand drug transaction during a court hearing, prosecutors said in a motion filed in Atlanta.

Fulton County prosecutors say the alleged exchange was captured on courtroom surveillance video Wednesday.

The rapper, whose real name is Jeffery Lamar Williams, and Kahlieff Adams are charged with conspiracy to violate the Racketeer Influenced and Corrupt Organizations Act and participation in criminal street gang activity, among other charges.

According to the motion seeking clarification of the record, Adams “stood up from his chair (…) and walked unattended” to Young Thug and gave him Percocet.

The motion said Young Thug tried to conceal his hand under the table. Sheriff’s deputies took the painkiller and searched Adams, who resisted. He was taken to Grady Memorial Hospital after “he appeared to ingest other items of contraband that he held on his person, in an effort to conceal the extent of his crimes within the courtroom.”

During the search of Adams, the deputies found Percocet, marijuana, tobacco, and other contraband, “wrapped in plastic and food seasonings to mask the odor of the marijuana,” the motion said.

Percocet is the brand name of a drug that mixes oxycodone, which is an opioid, and acetaminophen, which is the generic name for drugs such as Tylenol.

Keith Adams, one of Young Thug’s attorneys, told CNN on Friday, “The State is purposely misrepresenting and embellishing Wednesday’s events.”

He said Young Thug neither requested nor accepted the pill.

“As can be seen in the courtroom video footage, Mr. Williams IMMEDIATELY gave it to the courtroom deputy that was directly in front of him,” he wrote in a message.

Adams said an investigation cleared Young Thug of any wrongdoing and the responsible party was charged. He said the prosecutors’ allegations were “a blatant fabrication and disappointing.”

Teombre Calland, an attorney representing Kahlieff Adams, released a statement via text message to CNN affiliate WSB-TV saying: “On behalf of Mr. Adams, these allegations are simply that: mere statements made by the state in an effort to thwart the lengthiness of the jury selection process.”

CNN has reached out to Brian Steel, another Young Thug attorney, and Calland.

Young Thug won a Grammy Award in 2019 for his work with Childish Gambino and Ludwig Göransson on the hit song “This is America.”

The rapper was initially indicted in May on charges of conspiracy to violate the RICO Act and participation in criminal street gang activity.

A re-indictment filed on August 5 in Fulton County Superior Court accuses him of nine new charges, including participating in criminal street gang activity and violating the Georgia Controlled Substances Act.

He also was indicted on other charges of possession of a firearm during the commission of a felony and possession of a machine gun.

Jury selection is ongoing.

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US

Locally caught fish are full of dangerous chemicals called PFAS

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CNN
 — 

Fish caught in the fresh waters of the nation’s streams and rivers and the Great Lakes contain dangerously high levels of PFOS, short for perfluorooctane sulfonic acid, a known synthetic toxin phased out by the federal government, according to a study of data from the US Environmental Protection Agency.

The chemical PFOS is part of a family of manufactured additives known as perfluoroalkyl and polyfluoroalkyl substances, or PFAS, widely used since the 1950s to make consumer products nonstick and resistant to stains, water and grease damage.

Called “forever chemicals” because they fail to break down easily in the environment, PFAS has leached into the nation’s drinking water via public water systems and private wells. The chemicals then accumulate in the bodies of fish, shellfish, livestock, dairy and game animals that people eat, experts say.

“The levels of PFOS found in freshwater fish often exceeded an astounding 8,000 parts per trillion,” said study coauthor David Andrews, a senior scientist at Environmental Working Group, the nonprofit environmental health organization that analyzed the data. The report was published Wednesday in the journal Environmental Research.

In comparison, the EPA has allowed only 70 parts per trillion of PFOS in the nation’s drinking water. Due to growing health concerns, in 2022 the EPA recommended the allowable level of PFOS in drinking water be lowered from 70 to 0.02 parts per trillion.

“You’d have to drink an incredible amount of water — we estimate a month of contaminated water — to get the same exposure as you would from a single serving of freshwater fish,” Andrews said.

“Consuming even a single (locally caught freshwater) fish per year can measurably and significantly change the levels of PFOS in your blood,” Andrews said.

Chemicals in the PFAS family are linked to high cholesterol, cancer and various chronic diseases, as well as a limited antibody response to vaccines in both adults and children, according to a report by the National Academies of Sciences, Engineering, and Medicine.

“This is an important paper,” said toxicologist Linda Birnbaum, former director of the National Institute for Environmental Health Sciences and the National Toxicology Program.

“To find this level of contamination in fish across the country, even in areas not close to industry where you might expect heavy contamination, is very concerning. These chemicals are everywhere,” she said.

Read more: Doctors should test levels of PFAS in people at high risk, report says

It’s nearly impossible to avoid PFAS, experts say. Manufacturers add the chemicals to thousands of products, including nonstick cookware, mobile phones, carpeting, clothing, makeup, furniture and food packaging.

A 2020 investigation found PFAS in the wrapping of many fast foods and “environmentally friendly” molded fiber bowls and containers.

A 2021 study found PFAS in 52% of tested cosmetics, with the highest levels in waterproof mascara (82%), foundations (63%) and long-lasting lipstick (62%). Polytetrafluoroethylene, the coating on nonstick pans, was the most common additive.

Read more: Makeup may contain potentially toxic chemicals called PFAS, study finds

In fact, PFAS chemicals have been found in the blood serum of 98% of Americans, according to a 2019 report using data from the US Centers for Disease Control and Prevention’s National Health and Nutrition Examination Survey.

“These chemicals are ubiquitous in the American environment. More than 2,800 communities in the US, including all 50 states and two territories, have documented PFAS contamination,” Dr. Ned Calonge, an associate professor of epidemiology at the Colorado School of Public Health and chair of the Academies committee that wrote the report, told CNN previously.

Read more: Dangerous chemicals found in food wrappers at major fast-food restaurants and grocery chains, report says

Scientists at the Environmental Working Group used data from the EPA’s own monitoring programs — the National Rivers and Streams Assessment, which has been periodically testing stream conditions since 2008, and the Great Lakes Human Health Fish Fillet Tissue Study, which tests lake water every five years.

“The analysis focused on EPA wild-caught fish in rivers, streams and throughout the Great Lakes from 2013 to 2015 as that was the latest data available,” Andrews said.

The contamination was widespread, impacting “nearly every fish across the country,” he said. “I believe there was one sample without detected levels of PFOS.”

The EWG created an interactive map of the results with details for each state. Fish caught near urban areas contained nearly three times more PFOS and overall PFAS than those caught in nonurban locations, the study found. The highest levels were found in fish from the Great Lakes.

The analysis showed PFOS accounted for an average 74% of the contamination in the fish. The remaining 25% was a mixture of other PFAS known to be equally damaging to human health, Andrews said.

CNN reached out to the EPA for comment but did not hear back before this story published.

Based on the study’s findings, people who fish for sport might “strongly” consider releasing their catch instead of taking the fish home for a meal, Andrews said.

Yet many people in lower socioeconomic groups, indigenous peoples and immigrants in the US rely on eating freshly caught fish.

“They need it for food or because it’s their culture,” Birnbaum said. “There are Native American tribes and Burmese immigrants and others who fish because this is who they are. This is key to their culture. And you can’t just tell them not to fish.”

Read more: Water- and stain-resistant products contain toxic plastics, study says. Here’s what to do

The predominant chemical in the fish, PFOS, and its sister perfluorooctanoic acid, or PFOA, are known as “long-chain” PFAS, made from an 8-carbon chain.

Read more: Plastics and pesticides: Health impacts of synthetic chemicals in US products doubled in last 5 years, study finds

Manufacturers agreed in the early 2000s to voluntarily stop using long-chain PFAS in US consumer products, although they can still be found in some imported items. Due to growing health concerns, the use of PFOS and PFOA in food packaging was phased out in 2016 by the US Food and Drug Administration.

However, industry reworked the chemicals by making them into 4- and 6-carbon chains — today over 9,000 different PFAS exist, according to the CDC. Experts say these newer versions appear to have many of the same dangerous health effects as the 8-chain PFAS, leaving consumers and the environment still at risk.

Many of these longer-chain PFAS can be stored for years in different organs in the human body, according to the National Academies report. Scientists are examining the impact of newer versions.

“Some of these chemicals have half-lives in the range of five years,” National Academies report committee member Jane Hoppin, an environmental epidemiologist and director of the Center for Human Health and the Environment at North Carolina State University in Raleigh, told CNN previously.

Read more: FDA must do more to regulate thousands of chemicals added to your food, petitioners say

“Let’s say you have 10 nanograms of PFAS in your body right now. Even with no additional exposure, five years from now you would still have 5 nanograms,” she said. “Five years later, you would have 2.5 and then five years after that, you’d have one 1.25 nanograms. It would be about 25 years before all the PFAS leave your body.”

That’s why it’s “no surprise” to find such high levels of PFOA in freshwater fish, said the director of environmental pediatrics at NYU Langone Health, Dr. Leonardo Trasande, who was not involved in the new study.

“These truly are ‘forever chemicals,’” Trasande said. “This reinforces the reality that we need to get all PFAS out of consumer products and people’s lives.”

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US

Keenan Anderson, cousin of Black Lives Matter co-founder, dies from cardiac arrest after being tased by Los Angeles police

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CNN
 — 

A 31-year-old father and English teacher died from cardiac arrest last week after he was repeatedly tased by police, according to the Los Angeles Police Department, marking the third officer-involved death in the city this year.

Police encountered Keenan Anderson, who is the cousin of Black Lives Matter co-founder Patrisse Cullors, on January 3 at the site of a traffic collision in Los Angeles’ Venice neighborhood, police said in a news release last week.

As police struggled to arrest Anderson, they tased him repeatedly, edited body-worn camera footage released by police shows. After being arrested, Anderson was brought to a local hospital, where he went into cardiac arrest and was pronounced dead, according to police.

Cullors said in an Instagram tribute post that her cousin was “killed by LAPD.”

“Keenan deserves to be alive right now, his child deserves to be raised by his father,” Cullors wrote in the post. “Keenan we will fight for you and for all of our loved ones impacted by state violence. I love you.”

Anderson taught tenth-grade English at Digital Pioneers Academy in Washington, DC, according to a statement from the school’s founder, Mashea Ashton. Anderson was visiting family in Los Angeles over winter break, Ashton said.

“The details of his death are as disturbing as they are tragic,” Ashton said in the statement, adding, “Keenan was a deeply committed educator and father of a six-year-old son. … He was beloved by all.”

“Our community is grieving. But we’re also angry. Angry that, once again, a known, loved, and respected member of our community is no longer with us. Angry that another talented, beautiful black soul is gone too soon,” Ashton said.

Detectives from the police department’s Force Investigation Division responded to the scene where Anderson was taken into custody and are investigating the use of force, police said, explaining in the video that the department’s policy defines any death of a person in their custody as a “categorical” use of force.

So far this year, Los Angeles police are also investigating the police shooting deaths of Takar Smith, 45, and Oscar Sanchez, 35, and has released footage of those incidents.

Police said they responded to a traffic collision the afternoon of January 3 and saw Anderson “running in the middle of the street and exhibiting erratic behavior.” On one officer’s body-worn camera, released and edited by police, a woman at the traffic collision site tells police, “I think that guy up there needs help though, because the guy’s trying to run away.”

Body-worn camera video shows Anderson initially stopped and spoke to an officer before the video cuts to a text screen that says Anderson “attempted to run away.”

When the video resumes, Anderson is seen jogging into the street as the officer pursues him and stops him in a busy intersection, commanding Anderson to lay down on his stomach.

Anderson does not appear to comply immediately, and two other officers arrive and move him to lie prone on his stomach on the street, telling Anderson to “relax.” As officers struggle on top of him, Anderson can be heard screaming, “Help, they’re trying to kill me” and “Please, don’t do this.”

In footage from another responding officer, an officer can be heard repeatedly warning Anderson to stop resisting and turn over, and threatening several times to tase Anderson.

“They’re trying to George Floyd me,” says Anderson, as officers try to roll him onto his stomach.

Then, an officer deploys a taser multiple times on Anderson, who says, “I’m not resisting.”

Officers eventually handcuff and place ankle hobbles on Anderson, the video shows.

Later in the video, the Los Angeles Fire Department places Anderson, who appears conscious, onto a gurney near an ambulance. Police say in the news release that Anderson was given medical care at the scene by fire department personnel before being transported to a local hospital.

“While at the hospital, Anderson went into cardiac arrest and was pronounced deceased,” the release says.

Los Angeles police captain Kelly Muñiz said in the video that Anderson died approximately four-and-a-half hours after the use of force.

A preliminary toxicology-blood screen of Anderson’s blood samples tested positive for cocaine and marijuana, police said, adding the Los Angeles County coroner’s office is expected to conduct their own independent toxicology tests.

LAPD Chief Michel Moore said the videos were published in response to calls for their release from families.

“This is not, again, to do anything other than to demonstrate our commitment to full transparency and to judge this on the merits of what the investigation shows us and to ask for the public’s patience as we go about this engagement,” he said at a news conference Wednesday.



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Business

CDC identifies possible safety issue with Pfizer’s updated Covid-19 vaccine but says people should still get boosted

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CNN
 — 

The US Centers for Disease Control and Prevention said Friday that there is a possible safety issue with the bivalent Covid-19 vaccine made by Pfizer and BioNTech but that it is unlikely to represent a true risk. The agency said it continues to recommend that people stay up-to-date with Covid-19 vaccines.

The CDC said one of its vaccine safety monitoring systems – a “near real-time surveillance system” called the Vaccine Safety Datalink – detected a possible increase in a certain kind of stroke in people 65 and older who recently got one of Pfizer’s updated booster shots.

A rapid response analysis of that signal revealed that seniors who got an bivalent booster might be more likely to have ischemic strokes within the first three weeks after their shots, compared with weeks four through six.

Ischemic strokes, the most common form, are blockages of blood to the brain. They’re usually caused by clots.

The Vaccine Safety Datalink, or VSD, is a network of large health systems across the nation that provides data about the safety and efficacy of vaccines through patients’ electronic health records. The CDC said it had identified possible confounding factors in the data coming from the VSD that may be biasing the data and need further investigation.

Of about 550,000 seniors who got Pfizer bivalent boosters and were tracked by the VSD, 130 had strokes in the three weeks after the shot, according to a CDC official who spoke to CNN on condition of anonymity because they weren’t authorized to share the data. None of the 130 people died.

The number of strokes detected is relatively small, said Dr. William Schaffner, an infectious disease expert at Vanderbilt University and a member of the CDC Advisory Committee on Immunization Practices’ Covid-19 Vaccine Work Group.

“These strokes are not a confirmed adverse event at the moment,” he said. “It’s like a radar system. You’re getting a blip on the radar, and you have to do further investigation to discover whether that airplane is friend or foe.”

The same safety signal has not been detected with the bivalent Moderna booster, the CDC said in its notice.

The agency noted that it has looked for and failed to find the same increase in strokes in other large collections of medical records, including those maintained by Medicare, the US Department of Veterans Affairs, as well as its Vaccine Adverse Event Reporting System, known as VAERS.

Neither Pfizer nor other countries that are using the vaccine have seen any increase in this kind of stroke, the agency said, and the signal was not detected in any other databases.

The CDC says that it does not recommend any change to vaccination practices at this time and that the risks of Covid-19 for older adults continue to outweigh any possible safety issues with the vaccine.

“Although the totality of the data currently suggests that it is very unlikely that the signal in VSD represents a true clinical risk, we believe it is important to share this information with the public, as we have in the past, when one of our safety monitoring systems detects a signal,” the notice says.

“CDC and FDA will continue to evaluate additional data from these and other vaccine safety systems. These data and additional analyses will be discussed at the upcoming January 26 meeting of the FDA’s Vaccines and Related Biological Products Advisory Committee.”

Pfizer said in a statement Friday, “Neither Pfizer and BioNTech nor the CDC or the U.S. Food and Drug Administration (FDA) have observed similar findings across numerous other monitoring systems in the U.S. and globally and there is no evidence to conclude that ischemic stroke is associated with the use of the companies’ COVID-19 vaccines.

“Compared to published incidence rates of ischemic stroke in this older population, the companies to date have observed a lower number of reported ischemic strokes following the vaccination with the Omicron BA.4/BA.5-adapted bivalent vaccine.”

The bivalent boosters from Pfizer/BioNTech and Moderna protect against the original strain of the coronavirus as well as the Omicron BA.4 and BA.5 subvariants. Only about 50 million Americans ages 5 and up have gotten them since they were authorized last fall, according to CDC data.

Schaffner said he was part of a briefing Thursday with members of the Covid-19 Vaccine Work Group. He couldn’t share specific details about the briefing but said the safety signal was discussed.

His biggest takeaway was that the safety surveillance system is working.

It’s very likely that this is a false signal, he said, but it’s being investigated, which is important.

“You want a surveillance system that occasionally sends up false signals. If you don’t get any signals, you’re worried that you’re missing stuff.”

Schaffner said he would absolutely tell people to get their Covid-19 booster if they haven’t done so yet – even those 65 and older.

“Undoubtedly, the risk of a whole series of adverse events, including hospitalization, is much, much greater with Covid-19 than it is from the vaccine,” he said.

He also said the signal – if real – may be more a factor of numbers than an indication that one manufacturer’s vaccine is riskier than the other.

Nearly two-thirds of the people in the US who’ve gotten an updated booster – 32 million – have gotten Pfizer, compared with about 18 million Moderna shots.

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Health

US cancer death rate drops 33% since 1991, partly due to advances in treatment, early detection and less smoking, new report says

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CNN
 — 

The rate of people dying from cancer in the United States has continuously declined over the past three decades, according to a new report from the American Cancer Society.

The US cancer death rate has fallen 33% since 1991, which corresponds to an estimated 3.8 million deaths averted, according to the report, published Thursday in CA: A Cancer Journal for Clinicians. The rate of lives lost to cancer continued to shrink in the most recent year for which data is available, between 2019 and 2020, by 1.5%.

The 33% decline in cancer mortality is “truly formidable,” said Karen Knudsen, chief executive officer of the American Cancer Society.

The report attributes this steady progress to improvements in cancer treatment, drops in smoking and increases in early detection.

“New revelations for prevention, for early detection and for treatment have resulted in true, meaningful gains in many of the 200 diseases that we call cancer,” Knudsen said.

In their report, researchers from the American Cancer Society also pointed to HPV vaccinations as connected to reductions in cancer deaths. HPV, or human papillomavirus, infections can cause cervical cancer and other cancer types, and vaccination has been linked with a decrease in new cervical cancer cases.

Among women in their early 20s, there was a 65% drop in cervical cancer rates from 2012 through 2019, “which totally follows the time when HPV vaccines were put into use,” said Dr. William Dahut, the society’s chief scientific officer.

“There are other cancers that are HPV-related – whether that’s head and neck cancers or anal cancers – so there’s optimism this will have importance beyond this,” he said.

The lifetime probability of being diagnosed with any invasive cancer is estimated to be 40.9% for men and 39.1% for women in the US, according to the new report.

The report also includes projections for 2023, estimating that there could be nearly 2 million new cancer cases – the equivalent of about 5,000 cases a day – and more than 600,000 cancer deaths in the United States this year.

During the early days of the Covid-19 pandemic, many people skipped regular medical exams, and some doctors have seen a rise in advanced cancer cases in the wake of pandemic-delayed screenings and treatment.

The American Cancer Society researchers were not able to track “that reduction in screening that we know we all observed across the country during the pandemic,” Knudsen said. “This time next year, I believe our report will give some initial insight into what the impact was in the pandemic of cancer incidence and cancer mortality.”

The new report includes data from national programs and registries, including those at the National Cancer Institute, the US Centers for Disease Control and Prevention and the North American Association of Central Cancer Registries.

Data showed that the US cancer death rate rose during most of the 20th century, largely due to an increase in lung cancer deaths related to smoking. Then, as smoking rates fell and improvements in early detection and treatments for some cancers increased, there was a decline in the cancer death rate from its peak in 1991.

Since then, the pace of the decline has slowly accelerated.

The new report found that the five-year relative survival rate for all cancers combined has increased from 49% for diagnoses in the mid-1970s to 68% for diagnoses during 2012-18.

The cancer types that now have the highest survival rates are thyroid at 98%, prostate at 97%, testis at 95% and melanoma at 94%, according to the report.

Current survival rates are lowest for cancers of the pancreas, at 12%.

The finding about a decreasing cancer death rate shows “the continuation of good news,” said Dr. Otis Brawley, an oncology professor at Johns Hopkins University who was not involved in the research.

“The biggest reason for the decline that started in 1991 was the prevalence of smoking in the United States started going down in 1965,” said Brawley, a former chief medical officer of the American Cancer Society.

“That’s the reason why we started having a decline in 1991, and that decline has continued because the prevalence of people smoking in the United States has continued to go down,” he said. “Now, in certain diseases, our ability to treat has improved, and there are some people who are not dying because of treatment.”

Although the death rate for cancer has been on a steady decline, the new report also highlights that new cases of breast, uterine and prostate cancer have been “of concern” and rising in the United States.

Incidence rates of breast cancer in women have been increasing by about 0.5% per year since the mid-2000s, according to the report.

Uterine corpus cancer incidence has gone up about 1% per year since the mid-2000s among women 50 and older and nearly 2% per year since at least the mid-1990s in younger women.

The prostate cancer incidence rate rose 3% per year from 2014 through 2019, after two decades of decline.

Knudsen called prostate cancer “an outlier” since its previous decline in incidence has reversed, appearing to be driven by diagnoses of advanced disease.

On Thursday, the American Cancer Society announced the launch of the Impact initiative, geared toward improving prostate cancer incidence and death rates by funding new research programs and expanding support for patients, among other efforts.

“Unfortunately, prostate cancer remains the number one most frequently diagnosed malignancy amongst men in this country, with almost 290,000 men expected to be diagnosed with prostate cancer this year,” Knudsen said. Cancer diagnosed when it is confined to the prostate has a five-year survival rate of “upwards of 99%,” she said, but for metastatic prostate cancer, there is no durable cure.

“Prostate cancer is the second leading cause of cancer death for men in this country,” she said. “What we’re reporting is not only an increase in the incidence of prostate cancer across all demographics but a 5% year-over-year increase in diagnosis of men with more advanced disease. So we are not catching these cancers early when we have an opportunity to cure men of prostate cancer.”

Breast, uterine and prostate cancers also have a wide racial disparity, in which communities of color have higher death rates and lower survival rates.

In 2020, the risk of overall cancer death was 12% higher in Black people compared with White people, according to the new report.

“Not every individual or every family is affected equally,” Knudsen said.

For instance, “Black men unfortunately have a 70% increase in incidence of prostate cancer compared to White men and a two- to four-fold increase in prostate cancer mortality as related to any other ethnic and racial group in the United States,” she said.

The data in the new report demonstrates “important and consistent” advances against cancer, Dr. Ernest Hawk, vice president of cancer prevention and population sciences at the University of Texas MD Anderson Cancer Center, said in an email.

“Cancer is preventable in many instances and detectable at an early stage with better outcomes in many others. When necessary, treatments are improving in both their efficacy and safety. That’s all great news,” Hawk wrote.

“However, it’s well past time for us to take health inequities seriously and make them a much greater national priority. Inequities in cancer risks, cancer care and cancer outcomes are intolerable, and we should not be complacent with these regular reminders of avoidable inequities,” he said. “With deliberate and devoted effort, I believe we can eliminate these disparities and make even greater progress to end cancer.”

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Health

Dr. Sanjay Gupta: After two years of Covid-19 vaccines, here’s why they’re still vital

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CNN
 — 

In the United States, approximately 658 million Covid-19 vaccine doses have been administered since they were first distributed exactly two years ago Wednesday.

Framing the significance of preventive measures like vaccines can be challenging, which is why a new report from the Commonwealth Fund and Yale School of Public Health made headlines: According to their modeling of disease transmission across all age demographics and taking into account the existing health conditions in so many Americans, Covid vaccines prevented an estimated 3.2 million deaths and 18.5 million hospitalizations from their introduction in December 2020 to November 30, 2022.

That is why it is surprising to hear, according to a Kaiser Family Foundation analysis of data from the US Centers for Disease Control and Prevention, that from April through August – the last month included in the analysis – there were more vaccinated than unvaccinated people dying of Covid. The vaccinated categories include people who were vaccinated with the primary series and people who had been vaccinated and received at least one non-bivalent booster.

According to a CNN analysis of additional CDC data for September, 12,593 people died of Covid. A CDC sample of the deaths found 39% were unvaccinated, and 61% were vaccinated.

This phenomenon has many people – especially vaccine skeptics, but even stalwart vaccine supporters – confused and wondering if Covid vaccines and boosters are still effective and warranted.

The short answer is yes – but understanding why requires a crash course in statistics. We enlisted the help of Jeffrey Morris, a professor and the director of the Division of Biostatistics at the Perelman School of Medicine at the University of Pennsylvania, who helped us define three key reasons more vaccinated than unvaccinated people are dying of Covid.

One of the main reasons we see more vaccinated than unvaccinated people dying of Covid is a basic one. At this point in time, there are simply many more people who are vaccinated.

Think of it like this: If we round the September deaths to 13,000 and use the CDC sampling percentages, approximately 7,800 were vaccinated and approximately 5,200 were unvaccinated. The conclusion might be that you are far more likely to die if you are vaccinated. And, mathematically that would be true based on the raw numbers alone. If you stopped your analysis at this point, you will have committed a statistical error known as a base rate fallacy.

If instead, you take the extra step of accounting for the total number of fully vaccinated adults 18 and older in the United States (around 203 million) versus the total number of unvaccinated adults (around 55 million), a very different picture emerges.

Among the vaccinated population, 7,800/203 million died in September, which equals a rate of 38 deaths for every 1 million people. For the unvaccinated population, 5,200/55 million died, which equals a rate of 95 deaths for every 1 million people. That means an adult who is unvaccinated is roughly 2.5 times more likely to die than one who is vaccinated.

“You have to take into account the size of those groups,” explained Morris, who also publishes a blog, COVID-19 Data Science, to “just communicate what the emerging data suggest.”

There is another important difference when looking at the vaccinated versus unvaccinated populations in the United States. The vaccinated population skews older and has more health conditions. These are the same groups that are much more likely to have worse outcomes, like hospitalization and death, when infected with SARS-CoV-2, the virus that causes Covid-19. For example, CDC data show more than 90% of deaths through mid-November have been in those 65 or older.

“So those things lead to a higher risk of death and also a higher probability of being vaccinated,” Morris said. “That’s the key: if the vaccine uptake of those high-risk groups is high enough, then we can have a majority of the hospitalized or fatal cases be higher in the vaccinated population.”

You are more likely to die if you are older, and also more likely to be vaccinated if you are older. It does not mean vaccination is more likely to lead to death.

So if age isn’t taken into account when assessing vaccine efficacy, it can lead to something known as Simpson’s paradox, where a trend can appear to be the opposite of reality.

Morris said those kinds of errors not only result in a serious underestimation of the benefit of vaccines but also to downright wrong conclusions, even flipping the results – in this case, making it appear that vaccines increase the risk of death.

This happened in August 2021, with a study out of Israel – a highly vaccinated country – showed 60% of those hospitalized with severe Covid were fully vaccinated, causing misinterpretation and raising questions about the continued value of vaccination.

Morris said he has also seen Simpson’s paradox when people look at the rate of Covid deaths before vaccines were rolled out in 2020 versus since then, or comparing countries with higher vaccination rates to countries with lower vaccination rates.

“It’s a lot more subtle, but the pandemic has provided a number of pure examples of it. So the bottom line with all of that is, we can’t accurately assess the effects of vaccines from simple summaries,” Morris said, however “seemingly intuitive” they may appear.

A more telling and accurate comparison is between the death rate per 100,000 among unvaccinated people compared to the death rate of vaccinated people, adjusted for age.

CDC data show that for the week of September 25, people age 12 and older who were unvaccinated had a death rate of 1.32 per 100,000. Those who were vaccinated (but without an updated, bivalent booster) had a death rate of 0.26 per 100,000. And those who were vaccinated and boosted had a death rate of 0.07 per 100,000.

Broken down further by age, the numbers are even starker: The death rate during that week for those in the oldest age group, 80 and above, was 14.16 per 100,000 for the unvaccinated, 3.69 for those who were vaccinated but had not received the bivalent booster, and 0.0 for those who were vaccinated and boosted.

Overall, the CDC estimates that for the whole month of September, among those 12 and older, there was an almost 15 times lower risk of dying from Covid-19 for the vaccinated and boosted compared to the unvaccinated.

Unfortunately, uptake of the booster is low: Only 13.5% of the US population 5 and older is vaccinated and has gotten the new updated (bivalent) booster. Among those 65 and older, that percentage is 34.2%.

It’s not to say that vaccines are entirely risk free. For example, in people – especially males – between the ages of 5 and 39, there were 224 verified cases of myocarditis or pericarditis, inflammation of the heart and lining, reported to the CDC after vaccination with an mRNA vaccine between December 14, 2020, and May 31, 2022. But that was out of almost 7 million vaccine doses administered.

A study examining those figures found myocarditis/pericarditis occurred within seven days approximately 0.0005% of the time after the first dose, 0.0033% of the time after the second dose of the primary series, and 0.002% after the first booster – but it varied by age and sex, and was much more common among 16- to-17-year-old males after a second shot or a booster.

According to a separate analysis of nearly 43 million people in England, the researchers found that for younger men, the Moderna vaccine in particular had the highest rates of post vaccine myocarditis – although this number was still very low, 97 per million people exposed (0.0097%) – leading some to suggest a different vaccine for that age group or a longer interval between vaccine doses.

Statistical optical illusions aside, the fact is, there are more so-called breakthrough cases among the vaccinated. They have always existed. Since December 2020, we have known these vaccines are not 100% effective at preventing severe illness and death, let alone infection. When vaccines were first introduced, their efficacy was estimated to be an astonishing 95% against severe illness and death. They even protected people at a very high rate against infection.

But the efficacy keeps ticking downward. Part of it is waning immunity: Over the course of several months, antibody levels fade away – that’s just how the body works – even though there is still some protection, thanks to B cells and T cells. Getting boosted – or catching Covid – can help increase antibody levels for a few months at least. Between those two options, it’s far safer and less disruptive to get a booster than to risk illness.

Meanwhile, new variants keep cropping up, and they are increasingly able to evade our immune system. Unlike earlier variants, including the highly transmissible Delta variant, descendants of the Omicron lineage are escape artists.

“The emergence of Omicron at the end of 2021 was a game changer, as Omicron and its subsequent subvariants demonstrated strong immune evasion properties, with mutations in the spike protein and especially the [receptor binding domain] that reduced the neutralizing ability of the vaccine-induced antibodies,” Morris noted. The result is a great reduction in vaccine efficacy against infection, as well as against severe and fatal disease.

This actually means it’s more important to get boosted, especially if you are in a high-risk category, and as the weather gets colder and we gather indoors to spend time together.

The newest booster – the bivalent booster – is designed to protect against the original SARS-CoV-2 virus and against the more recent Omicron subvariants, although how much and for how long is still unknown.

Covid cases, and deaths have slowed down in recent months, but those numbers are trending up like they’ve done during the holidays in previous pandemic years. For the week of December 7, weekly new cases topped 65,000 and Covid claimed the lives of almost 3,000 people. Both represent an increase of around 50% from the week before, according to CDC data.

All of this is happening at a time when hospitals are already full of patients sick with the flu and RSV.

I know we’re all tired of hearing that we need to roll up our sleeves and get yet another Covid-19 booster.

But remember, many of us get the flu shot every year: We don’t assume we are protected from a flu vaccine a year ago. We get the shot even in seasons when the flu vaccine is much less effective than the Covid vaccine (the latest one appears to be a good match). We don’t call it a booster – it’s just the annual flu vaccine. And we don’t track the rate of so-called breakthrough flu infections; unlike Covid, we don’t routinely test people for flu unless they are demonstrably sick, so we have no way of knowing how many people, vaccinated or not, are infected and asymptomatic or mildly ill.

For some diseases, like measles, a single vaccine or a previous infection provides us with a near lifetime of protection. Even though we hoped for a one-and-done scenario when the Covid vaccines rolled out two years ago, the virus didn’t lend itself to that. Newer vaccines are being studied that could offer far more durable protection.

Analyzing all of this data without falling into the trap of a base rate fallacy or Simpson’s paradox isn’t easy, as you can see. And it is also clear the overall effectiveness of the vaccines have waned over time and with new variants.

However, two years later, a more thorough statistical analysis of vaccine effectiveness shows they are still cause for celebration.

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