Many of us remain isolated from friends and family during this pandemic. So imagine how difficult it would be to find yourself newly diagnosed with breast cancer — and with no support system to help you through the crisis.
An organization called Girls Love Mail has a novel way of boosting women’s spirits. Since 2011, it’s enlisted thousands of empathetic people to send words of encouragement to strangers; about 167,000 letters have been mailed to date.
Want to share a little hand-written optimism? Visit girlslovemail.com in honor of Breast Cancer Awareness month in October.
Cholesterol-lowering statin drugs, already one of the most popular medications worldwide, may become even more widely used as evidence grows of their safety and value to the elderly and their potential benefits beyond the heart and blood vessels.
Among the latest are reports of the ability of several leading statins to reduce deaths from common cancers and blunt the decline of memory with age. Perhaps such reports will persuade a reluctant 65-year-old friend who has diabetes, and others like him, that taking the statin his doctor strongly advised is a smart choice.
In addition to accumulating evidence that the benefits of statins far outweigh possible risks for the vast majority of people for whom they are now recommended, nearly all statins on the market are now available as inexpensive generics.
Full disclosure: I have a strong family history of heart disease and have been taking a statin — atorvastatin, originally marketed as Lipitor — for many years after dietary changes failed to control a steadily rising blood level of artery-damaging LDL-cholesterol. My prescription is now fully covered by my Medicare Part D insurance with no co-pay.
But cost of a medication is not the only consideration for a drug that can be lifesaving for many people. The primary indication for taking a statin is to reduce the risk of a heart attack or stroke by lowering serum LDL-cholesterol and, in some cases, also triglycerides, both of which can damage coronary arteries when levels rise above normal.
Statins offer further cardiovascular protection by stabilizing the fatty deposits in arteries called plaque that can break loose, block a major artery and cause a heart attack or stroke.
Current guidelines typically recommend statin therapy for:
People over 40 with diabetes and an LDL-cholesterol level above 70 milligrams per deciliter;
People over 21 with an LDL-cholesterol level of 190 or higher (despite dietary changes to minimize saturated fats and achieve a normal body weight).
Currently, more than 60 percent of older people in the United States who, like me, have high cholesterol take a statin to help prevent a heart attack or stroke.
Still, there’s been a long-simmering debate as to whether statins are advisable for people over 75, even though the risk of suffering life-threatening cardiovascular disease rises precipitously with age. Concerns have been raised about side effects associated with statins, potential adverse effects of the drugs on other ailments common in the elderly and possible harmful interactions with the many other medications they often take.
Writing in the Harvard Health Blog last October, Dr. Dara K. Lee Lewis noted, “The paradox that we face is that as our patients age, they are at increased risk for heart attacks and strokes, and yet they also become more sensitive to medication side effects, so it is a tricky balance.”
Statins can sometimes cause blood sugar abnormalities, resulting in a diagnosis of pre-diabetes or diabetes, and possible toxic effects on the liver that necessitate periodic blood tests for liver enzymes. A very small percentage of people prescribed a statin develop debilitating muscle pain. An elderly friend developed statin-induced nightmares. There have also been reports suggesting statin-associated memory problems and cognitive decline, already a common concern as people age.
But likely the biggest deterrent was the existence of meager evidence for the role statins might play for older people at risk of cardiovascular disease. As is true in most drug trials on new medications, relatively few people over 75 were included in early studies that assessed the benefits and risks of statins.
The latest reports, however, are highly reassuring. One followed more than 120,000 French men and women ages 75 to 79 who had been taking statins for up to four years. Among the 10 percent who stopped taking the drug, the risk of being admitted to a hospital for a cardiovascular event was 25 to 30 percent greater than for those who continued taking a statin.
Another study in Israel, published last year in the Journal of the American Geriatrics Society, involved nearly 20,000 older adults followed for 10 years. Among those who stayed on statin therapy, the chance of dying from any cause was 34 percent lower than among those who failed to adhere to a prescribed statin. The benefits were not reduced for those older than 75 and applied to women and men alike.
This year a study published in JAMA by a team headed by Dr. Ariela R. Orkaby of the VA Boston Healthcare System found that among 326,981 United States veterans whose average age was 81, the initiation of statin use was associated with 25 percent fewer deaths over all and 20 percent fewer cardiovascular deaths during a follow-up of nearly seven years.
However, none of these studies represent “gold standard” research. The results of two such studies, the Staree trial and the Preventable trial, both randomized controlled clinical trials of statin therapy to prevent cardiovascular events in the elderly, have not yet been published. Both will also assess effects on cognition.
Meanwhile, a report last year from Australia published in the Journal of the American College of Cardiology found no difference over a six-year period in the rate of decline in memory or cognitive status between statin users and those who had never taken the drugs. In fact, among those who started a statin during the study, the rate of memory decline was blunted. Another observational study by a Swedish team published in Nature found beneficial effects on reaction time and fluid intelligence among statin takers over 65.
Finally, there are several reports that a major class of statins called lipophilic (including atorvastatin, simvastatin, lovastatin and fluvastatin) may have anticancer effects. One study of nearly 2,000 survivors of early-stage breast cancer found a decreased five-year recurrence rate in women who started a statin within three years of diagnosis.
In a report presented in June to a virtual meeting of the American Association for Cancer Research, Dr. Kala Visvanathan of Johns Hopkins Medicine in Baltimore described a 40 percent reduction in deaths from ovarian cancer among more than 10,000 patients who had used statins either before or after their diagnosis. The patients who benefited in this observational study had the most common and aggressive form of ovarian cancer.
Dr. Visvanathan explained that statins inhibit an enzyme in a chemical pathway involved in the growth and proliferation of tumors. At a press briefing, Dr. Antoni Ribas, president of the association, said that if the finding is confirmed in a randomized clinical trial, “this would be a great outcome.”
Mumbai may be among the cities that have already achieved herd immunity, scientists say.Indranil Mukherjee/Agence France-Presse — Getty Images
Today, we’re turning this section over to our colleague Apoorva Mandavilli, who has been covering the pandemic for The Times’s Science desk.
The pandemic will end only when enough people are protected against the coronavirus, whether by a vaccine or by already having been infected. Reaching this threshold, known as herd immunity, doesn’t mean the virus will disappear. But with fewer hosts to infect, it will make its way through a community much more slowly.
In the early days of the crisis, scientists estimated that perhaps 70 percent of the population would need to be immune in this way to be free from large outbreaks. But over the past few weeks, more than a dozen scientists told me they now felt comfortable saying that herd immunity probably lies from 45 percent to 50 percent.
If they’re right, then we may be a lot closer to turning back this virus than we initially thought.
It may also mean that pockets of New York City, London, Mumbai and other cities may already have reached the threshold, and may be spared a devastating second wave.
The initial calculations into herd immunity assumed that everyone in a community was equally susceptible to the virus and mixed randomly with everyone else.
The new estimates are the product of more sophisticated statistical modeling. When scientists factor in variations in density, demographics and socialization patterns, the estimated threshold for herd immunity falls.
In some clinics in hard-hit Brooklyn neighborhoods, up to 80 percent of people who were tested at the beginning of the summer had antibodies for the virus. Over the past eight weeks, fewer than 1 percent of people tested at those same neighborhood clinics have had the virus.
Likewise in Mumbai, a randomized household survey found that about 57 percent of people who live in the poorest areas and share toilets had antibodies, compared with just 11 percent elsewhere in the city.
It’s too early to say with certainty that those communities have reached herd immunity. We don’t know, for example, how long someone who was infected stays protected from the coronavirus. But the data suggests that the virus may move more slowly in those areas the next time around.
The first coronavirus vaccine to be tested in people appears to be safe and able to stimulate an immune response against the virus, its manufacturer, Moderna, announced on Monday.
The findings are based on results from the first eight people who each received two doses of the vaccine, starting in March.
Those people, healthy volunteers, made antibodies that were then tested in human cells in the lab, and were able to stop the virus from replicating — the key requirement for an effective vaccine. The levels of those so-called neutralizing antibodies matched the levels found in patients who had recovered after contracting the virus in the community.
The company has said that it is proceeding on an accelerated timetable, with the next phase involving 600 people to begin soon. But U.S. government officials have warned that producing a vaccine that would be widely available could take a year to 18 months. There is no proven treatment or vaccine against the coronavirus at this time.
If the trials go well, a vaccine could become available for widespread use by the end of this year or early 2021, Moderna’s chief medical officer said. [Note the contradiction between the company projection and the government statement.]
Ever wished your partner would spend more time with you? How quaint! This is the universe’s way of testing our relationships. And if the data from China is any indication, we’ll be seeing a wave of divorces once people can get to their lawyers.
Not me, though; one nasty divorce was enough for a lifetime. But since 24-hour togetherness can strain any partnership, I’m trying to follow a few rules.
Spend time apart. Encourage separate activities to create some alone time; for instance, I’ll bake or write while my husband paints or works on his computer. And if you live in a studio apartment, try to at least identify separate work spaces. With luck, this will give each of you something to talk about every evening besides the virus.
Share a laugh: a book, video, joke, photo or film. We’ve just gone through all three Cage Aux Folles movies (note: the subtitled versions are funnier than the dubbed ones).
Plan things to look forward to once life returns to normal — a trip, dinner at a special restaurant, going out with friends, etc. Fantasizing encouraged.
Connect with others. We enjoyed a Zoom cocktail hour with two of our favorite couples the other night and are going to make this a regular routine. Cheers!
Make a big bowl of popcorn and find something fun on TV. We’ve been watching old Nick and Nora movies from the ’30’s and adventure films such as the James Bond, Kingsman and Indiana Jones franchises. Pretty much anything that bears no resemblance to today’s world is a good choice.
Stop obsessing over the news. It helps nothing and makes both parties depressed, which isn’t conducive to a happy home. Being informed is one thing; worrying about anything outside your own control is counterproductive.
Go for a walk. It’s reassuring to see the flowers blooming and hear the birds chirping as if the whole world weren’t going to hell in a handbasket.
Take deep breaths whenever your beloved is getting on your last nerve.
My mantra: “Whatever doesn’t make you want to kill your partner makes you stronger.”
If the word “drone” conjures negative thoughts of spying and remote warfare, here’s something cheerful to contemplate.
Drones and digital tags are helping scientists study humpback whales in remote areas of the Antarctic, where in-person access is limited.
A partnership among Duke University Marine Robotics and Remote Sensing Lab (MaRRS), Friedlaender Lab, California Ocean Alliance, and the World Wildlife Fund is using drone photography to study how the whales feed, how healthy they are, and how they’re being affected by climate change. Drone images are also used to count local populations.
13-year old techie Amanda Southworth had suffered from anxiety, depression and suicidal thoughts for most of her young life. When she couldn’t find an easy, affordable alternative to traditional modes of therapy, this brilliant coder invented it.
Three years later, her app AnxietyHelper has helped more than 68,000 people. The app provides information on mental health conditions, links to hotlines, and tools such as a stress relieving game to help its users cope with daily challenges.
Southworth hasn’t stopped there. She’s created a safety app for the LGBTQ+ community, an app to help psychosis patients manage their hallucinations, and a social media platform for protest groups so they can mobilize more safely and efficiently.