Such a curiously-worded headline, to refer to Ozempic specifically – quite a recognizable & understood term at this point! – as just some "Danish diabetes medicine".
I almost expected the source to be some group with a resentment towards Denmark – maybe Greenland separatists? – but no, it's just a Danish university that doesn't want to say 'Ozempic' in the headline directly.
Maybe the university thinks that Ozempic is not a well known brand in Denmark so being vague will get more clicks. 0.4% of them get a Ozempic prescription per year vs 1.7% of Americans per year. Seems crazy when "Nearly 1 out of every 5 Danish jobs created last year was at Novo", but it's possible.
Another possibility is that they don't wanna tarnish a brand that saved the country from recession last year. No point picking fights with industry over some observational study that has no predictive power
That's suggestive there are far more than the 29 reported California cases - with cases generally remaining mild enough to earn no special attention over routine respiratory infections.
It's very hard to know what to do here, because that's also detecting contaminated milk dumped into the wastewater system, which is a massive signal but also not human.
why is contaminated milk being dumped into the wastewater system? and what is contaminated milk even have to do with H5N1? it's avain flu and last I checked birds don't have tiddies
H5N1 isn't exclusively avian flu, and the current receptors for the strain circulating in the U.S. have much more affinity for binding sites found in human eyes (hence conjunctivitis being one of the most common symptoms) and bovine mammary tissue.
"H5N1" is a crude description of a wide variety of strains, some more amenable to avian hosts, some not.
As for why milk is being dumped into the wastewater system? Because that's where it goes.
I agree there are likely cases not being detected, but there are lots of flying natural reservoirs who also poop in sewer watersheds (no one's keeping them sterile, after all). They may also be getting magnified by agricultural sources; California does a much better job of testing, but there are very likely positive farms that haven't been found yet.
Note: wild bird crap with H5N1 in it gets washed into storm drains, and in many communities this would wind up in wastewater and be detected, so this is probably not direct evidence of human H5N1 infections
Is there any basis to think xylo- is better than the similar oxymetazoline available in the US? Both the efficacy and downsides seem similar from discussion so far.
Yes, and it's an employee's responsibility to not depend on a single job, and to be prepared for the possibility that it might go away. That's the mindset we should be teaching people, because it's REALITY.
Plenty of people are aware of this, and they navigate this successfully by saving part of their income, by maintaining an employable skillset, and by living within their means, while working a job.
When you suggest to people that it's their company's responsibility to take care of them, to guarantee their job into their future, or to look out for their personal financial livelihood, that IS NOT REALITY. That's not how it works. You're telling people that their own responsibilities are someone else's, when that's not in fact true. When people mistakenly believe this drivel, they're far more likely to take bad risks and make huge financial mistakes.
Employers employ many people at once. The risk of a bad employee is divided by the entire workforce.
Employees, on the other hand, put all their eggs into one basket at a time. Many (most?) employers specifically forbid moonlighting and working multiple full-time jobs at once, so employees are forced to depend on a single job at a time. The risk of having a bad employer is shouldered 100% by the employee.
It's this power dynamic that justifies different standards for employers and employees.
Business is not all huge companies with infinite redundancy. There are 30M small businesses in America that employ 60M people. For the vast majority of businesses and teams, losing an employee hurts, and employees have lots of leverage. These business owners have to do the work to ensure redundancy, to plan their budgets and products and systems to ensure they can weather inevitable employee turnover. Plenty of businesses fail to do this and have to close their doors. It happens with regularity.
On the flip side, unemployment is the US is super low. It's true that workers can only hold one job at a time, but they are not "trapped" at a job. In fact, they have more mobility than ever, which also gives them leverage to negotiate for higher salaries or to hop jobs. Not to mention more gig jobs, remote jobs, and contract jobs than ever, even for highly paid positions. Sure, losing a job hurts. But the employees who plan for this possibility, who maintain skills, maintain savings, and live within their means, can find new jobs, just as businesses who plan well can weather employee turnover.
It goes both ways.
So if you're in a position where your employer has some huge power dynamic hold on you, is that some universal truth for all employees resulting from the nature of the employer-employee dynamic? I don't think so. I think that's the result of poor personal decisions, or bad luck at best.
All that said, I'm 100% on board with legal protections that set a high standard for employers. We have plenty of those already. And I'm 100% on board with government stepping in to help take care of people who fall through the cracks. For example, I love that COBRA allowed me to stay on my previous employer-provided group healthcare plan for 18 months(!) after my last job ended.
What I'm against is any cultural or legal change that begins to suggest that its employers' responsibility to keep their people employed. It's not. Financially, the system can't work that way. Employers are not our parents or our nannies or our caretakers, and we should not try to make them into that.
Hundred percent. Yet, it's also reality, today, that the power asymmetry between individuals and corporations are huge. Anybody trying to bootstrap an independent business is heavily punished, simply because corporations want you to be an employee, just because they can. Unless the system balances the power dynamics, it's futile to tell people that they shouldn't ask for more rights from corporations.
I literally run the biggest website for people trying to bootstrap independent businesses, and I haven't seen anyone complain about being heavily punished for trying to do so. Founders are the most employable people I know, and they typically find it the easiest to go get jobs when their businesses fail (although they hate doing so).
Not everyone has a rich family to fall back on, bud. You could say "fall back on the government" but then this is how the government would do it. They wouldn't want you to fire people for no reason at all. In the same way that people are paid a certain wage as an agreement, there are other conditions too. This can be part of those conditions.
Your claim of:
> Yes, and it's an employee's responsibility to not depend on a single job, and to be prepared for the possibility that it might go away. That's the mindset we should be teaching people, because it's REALITY.
is capitalist mindset that thinks there's never a chance of change. Kinda pathetic for a MIT grad, tbh.
Personal attacks are shite, especially when they dig into someone's background for extra 'bite'.
P.s. what rock have you been living under where you have a preconception that all MIT graduates are ethical white knights that share all of your own opinions?
It's one of the most varietal student bodies at a school that forks people majorly into military programs and research labs.. to expect harmonious homogeny regarding ethical opinions from the graduates is ridiculous.
Gwern's deep dive into Calhoun's scholarship suggests taking his "results", & popular/stylized glosses thereof, with some pretty big grains of salt - in line with the fall from academic prominence described in later parts of this article. Gwern's abstract:
> Did John Calhoun’s 1960s Mouse Utopia really show that animal (and human) populations will expand to arbitrary densities, creating socially-driven pathology and collapse? Reasons for doubt.
Taking assurance from the fact that municipal-flouridation goes to "half or less" some "generally recognized safe level" implies that a low-concentration is enough for safety – "ensure your water's at that level, then have as much as you want!" – but that doesn't seem to be true.
It's total consumption that brings risks. Someone who drinks twice as much water at that presumed "safe" level is at more danger – as are those who might be getting extra flouride elsewhere, such as from higher tea consumption or excessive use of flouridated toothpastes.
Pre-2015, US flouridation standards used to be higher in colder climates, and lower in hotter climates, to account for the added water consumption in hotter climates. As of 2015, they guided everywhere to the originally-only-for-hotter-areas lower level, 0.7 mg/L, which is about half the levels with the decent evidence of harm.
But that could still be putting high-total-consumption people at unnecessary risk, and for a pretty-small benefit (fewer cavities) that can be obtained with non-ingesting tooth surface flouride exposure (as with toothpaste).
Any anti-flouridation advocate who relies on "their groundwater" rather than municipal taps probably does care about its natural concentration levels, and would only have to be concerned with moderate tea drinking if they're also receiving extra surprise flouride via municipal water. (A authentic concern for minimizing total consumption doesn't make any particular neurotic avoidance a good litmus test.)
> It's total consumption that brings risks. Someone who drinks twice as much water at that presumed "safe" level is at more danger – as are those who might be getting extra flouride elsewhere, such as from higher tea consumption or excessive use of flouridated toothpastes.
The safe levels are built around a model of the amount of water a human being can consume, both directly (drinking tap water) and indirectly (cooking, drinks made with tap water, etc.).
> for a pretty-small benefit (fewer cavities) that can be obtained with non-ingesting tooth surface exposure (as with toothpaste).
This pretty drastically understates the public health impact of fluoridation, and overstates how likely people are to apply elective equivalents (e.g. sufficient fluoridated toothpaste). The good news is that we have concrete numbers for these impacts[1], which consistently show that even developed areas show significant dental health improvements with municipal fluoridation.
>The safe levels are built around a model of the amount of water a human being can consume, both directly (drinking tap water) and indirectly (cooking, drinks made with tap water, etc.).
The epidemiological studies suggesting detectable harm at 1.5mg/L are from whatever amounts are actually consumed in affected areas, not some "model" of the max any person could consume.
Given the variety of human practices – preferences for packaged drinks, different food-preparation approaches, etc – the same tap levels could easily result in gigantic differences in net consumption among different individuals.
If the standard is half the "safe" level, but some people consume 4x or 10x as much tap water, & perhaps even have a higher baseline of non-tap-water flouride consumption, then some percentage N of the population could be developmentally-harmed, even at levels "safe" for "most". How high of an N should we accept for the modest benefit of fewer cavities?
Your link shows no public benefits other than less tooth decay, doesn't compare flouridation to other interventions, & doesn't weigh costs versus benefits.
If I'm reading its "DMFT Index" ("Decayed, Missing, Filled Teeth [per capita]") values right, it also shows a very modest benefit: a "DMFT" of 0.06 in flouridated areas, and 0.115 in non-flouridated areas. Roughly, instead of one cavity-affected-tooth per 17 kids, there's one cavity-affected-tooth per 9 kids.
Yes, we should try to minimize cavities, but what N% of outlier-consumption overflouridated kids should get a 5-IQ-point drop for that marginal benefit?
What if we shifted the flouridation expense into reminding kids to brush or use a flouridated rinse? What if we just paid a cash bonus to kids who manage to avoid permanent-tooth cavities through whatever interventions work? (The same funds would go to treatment/amelioration for those who wind up with decay anyway.)
> How high of an N should we accept for the modest benefit of fewer cavities?
You do realize dental issues kill people, right? If you are going to be actually honest in your argument, then you should be comparing the # of people that die as a result of poorer health outcomes as a result of dental complications versus the band of people having overexposure to fluoride especially since you immediately jump to the worst possible outcome on your end of the argument.
Yea, all the costs and benefits should be weighed!
I suspect a lot more people die over their lifetime from being -5 IQ than cavities. But, let's be sure all the effects are net-tallied – not just an unquantified hand-wavy "saves lives via dental health" with zero consideration to any stupidity or behavioral issues created.
1. You're presumably talking about the HHS review in your adjacent comment. Here's the actual monograph[1]. Notably, the review's authors consider it a "medium confidence" finding. In the NTP's taxonomy[2], that makes it a lower impact conclusion than the voluminous findings that show that fluoridation at 1.5mg/dL (much less 0.7mg/dL) has no adverse developmental effects.
2. The monograph is explicit about the limitations of its conclusions. In particular, the monograph explicitly says that it doesn't offer a quantitative account of fluoride-for-lost-IQ-points, and explicitly concludes that its findings do not address fluoridation at levels used in the US or Canada.
3. The monograph is focused on fluoridation at or above 1.5mg/dL, with extensive consideration given to much higher fluoridation levels.
As a whole, the monograph doesn't not present the cohesive, "closed case" for a relationship between municipal water fluoridation and developmental risk that you're suggesting exists. At best, it presents a body of evidence showing a moderate correlation between negative developmental effects and natural/dietary fluoride consumption at levels that are 5-10x times the level introduced in the US.
> If the standard is half the "safe" level, but some people consume 4x or 10x as much tap water, & perhaps even have a higher baseline of non-tap-water flouride consumption, then some percentage N of the population could developmentally-harmed, even at levels "safe" for "most".
First: neither your source (nor any source I'm aware of) shows developmental effects in adults, i.e. a general population sampling. Not even at extremely high naturally occurring fluoride levels.
However, even if we reduce to children, neither your source (nor any I'm aware of) shows a multiplicative effect to fluoridated water consumption. In other words: children in areas with 5mg/dL of naturally occurring fluoride appear to have blood levels that consistently correlate with that natural level, regardless of variations in dietary patterns. The parsimonious explanation for this is that fluoride doesn't bioaccumulate in soft tissues and is mostly excreted when not accumulated in teeth and bones, which research supports[3].
The TL;DR for this is that there's no positive evidence (and a lot of negative evidence) for differences in consumption during normal human activity having any effect on blood/urine fluoride levels. Baseline changes result in changes; volume does not.
(This ties in with the earlier point: you can definitely increase the amount of fluoride in your system over a point in time by, say, drinking 3 cups of green tea in a row. But children aren't doing that, and their most accessible equivalent - drinking water - is not something that they can chug liters of at a time.)
> Roughly, instead of one cavity-affected-tooth per 17 kids, there's one cavity-affected-tooth per 9 kids.
I personally wouldn't describe that kind of reduction as modest. On the city scale, that's thousands of dental procedures averted per year. Factored with differences in dental care (e.g. childhood cavities correlating with worse adult dental outcomes), and you have an expensive, easily preventable public health problem.
> What if we shifted the flouridation expense into reminding kids to brush or use a flouridated rinse?
Brushing reminders and basic dental hygiene are exceedingly well-messaged in developed countries. Despite that the problem remains, as evidenced by studies consistently showing differences between fluoridated and un-fluoridated populations with generally good dental practices[4].
I suppose we could always spend more on educating parents and children on good dental hygiene. But municipal fluoridation is cheap, effective, and most importantly pervasive: it addresses the last X% of the population that can't or won't practice good dental hygiene.
Just to note, the words "medium confidence" appear in neither the NTP monograph nor the taxonomy you referenced. They use the term "moderate confidence", which I guess has a similar meaning, but given the scale is from very low to low to moderate to high, I don't think this alleviates any of my concerns.
> the lower level, 0.7 mg/L, which is about half the levels with the decent evidence of harm.
Do you have a source for this claim?
This summary of a meta-analysis[1] says that there was only very weak evidence for measurable IQ harm in the range 8-16 mg/L, which is 10-20 times the recommended level. The highest quality studies in the meta-analysis showed no relationship at all between fluoride exposure and IQ[2].
> The long-awaited report released this week comes from the National Toxicology Program, part of the Department of Health and Human Services (HHS). It summarizes a review of studies, conducted in Canada, China, India, Iran, Pakistan and Mexico, and concludes that drinking water containing more than 1.5 milligrams of fluoride per liter is consistently associated with lower IQs in kids.
>The report did not try to quantify exactly how many IQ points might be lost at different levels of fluoride exposure. But some of the studies reviewed in the report suggested IQ was two to five points lower in children who had had higher exposures.
>Since 2015, federal health officials have recommended a fluoridation level of 0.7 milligrams per liter of water, and for five decades before the recommended upper range was 1.2. The World Health Organization has set a safe limit for fluoride in drinking water of 1.5.
Good summary. This is a good example of people making bijective errors around public health: the presence of a "safe level" does not itself imply that levels above it are unsafe; all it does is express confidence that the level itself is safe.
Except that fluoride naturally occurs in drinking water around the world. Some places have far too much. Would removing the excess amount also be "mass medication"?
Not all sunshine would be 'medication', but if a doctor recommended an extra hour in the noonday sun (or equivalent time under appropriate lamps) over a patient's baseline, that extra increment of light would be 'medication'.
Here's a question for you then: If you had drinking water that had an excessively high natural amount of fluoride that was causing medical issues, is it considered medicating to then filter that water to reduce the fluoridation? Why is it only 'adding' and not 'removing'?
As "medicating" implies addition, I'd not call such filtering "medicating", but it's definitely still be a "medical intervention", a purposeful change from the default motivated by health concerns.
Drop-in compatibility with all human-shaped legacy interfaces, for the most-rapid deprecation of homo sapiens as soon as the ASI can teleoperate humanoid proxies.
I almost expected the source to be some group with a resentment towards Denmark – maybe Greenland separatists? – but no, it's just a Danish university that doesn't want to say 'Ozempic' in the headline directly.
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