The Lancet says that zero booze is the healthiest lifestyle - Oh Aye?

The Lancet really surprises with the news that even a little sip of the Demon Booze is the Very Devil:

Overall, the study, which pooled data from 592 studies with 28 million participats, linked alcohol to almost 3 million deaths globally.

The research found it was the seventh leading risk factor for premature death and disease - and the leading cause of death before the age of 50. 

Researchers said the analysis found no safe level of alcoholic consumption, suggesting that going teetotal was the only way to avoid associated health risks. 

Given that this result is entirely different from everything anyone else has ever found out about booze then well, why? Sure, science does indeed say that new evidence outweighs, disproves, old theories. But that evidence had better be pretty good - the larger the claim the better the evidence needs to be.

We have to say that we're not convinced here. And do note that this is tentative as yet, this critique being possibly subject to later revision.

Conclusion

Alcohol use is a leading risk factor for disease burden worldwide, accounting for nearly 10% of global deaths among populations aged 15–49 years, and poses dire ramifications for future population health in the absence of policy action today. The widely held view of the health benefits of alcohol needs revising, particularly as improved methods and analyses continue to show how much alcohol use contributes to global death and disability. Our results show that the safest level of drinking is none. This level is in conflict with most health guidelines, which espouse health benefits associated with consuming up to two drinks per day. Alcohol use contributes to health loss from many causes and exacts its toll across the lifespan, particularly among men. Policies that focus on reducing population-level consumption will be most effective in reducing the health loss from alcohol use.

That is startlingly different from everything else we think we know about the effects of alcohol. So, why?

What intrigues us is the chart of deaths for the US. Page 2085 (yes, really) here. It lists those causes of death which are - usually that is, whether rightly or wrongly - said to be caused by alcohol consumption. What it doesn't do is list all causes of death. Reading from this listing of the leading US causes of death we note that pneumonia and Alzheimer's aren't there, while they are leading causes of death.

As above, this is tentative. But what it looks like to us is that they've added up all the deaths and diseases which could be attributable to alcohol. OK. And those rise monotonically with alcohol consumption. OK. And they've not looked at all causes of death to see whether alcohol consumption reduces the death rate from any other causes. That being the original claim in the first place, that yes of course booze causes problems even as it also salves some others.

It's as if someone looks at the effects of exercise and notes the costs in twisted ankles and strained backs but not the benefits in strengthened hearts and lower weights.

Again, as we say, this critique of ours is subject to revision as those who know more than we do pile in. But we're deeply, deeply, unconvinced of the finding here.  Perhaps the worst of it is that we know very well that there's a political movement to insist that no one should drink at all. We've seen other "research" making similar howlers to try and bolster that case. Meaning that we don't think we can trust research which produces results so amenable to that political campaign.

The entire field is so polluted by policy based evidence making that we assume that this is such. A pity really, as The Lancet did do science at one time but that well has rather been polluted.

Chris Snowdon's take is here.

An interesting illustration of the problems with booze

We're all aware that government guidelines on how much alcohol we might drink have something severely wrong with them. The latest report excised teetotallers from the numbers in order to get rid of that inconvenient fact that less booze can be as dangerous as more. The sweet spot of consumption being, in terms of all risks, more than the maximum we're advised to neck.

It's also true that current weekly limits are rapidly approaching what used to be considered a decent lunch. This might be granting too much to the wowsers. At which point we get this, the very latest research:

Alcohol revenue would decline by two-fifths, or £13 billion, if all drinkers were to comply with the recommended consumption limits, according to a study.

The research found that about two-thirds of alcohol sales in England are to heavy drinkers.

Drinkers who consume more than the Government's low-risk guideline of 14 units a week make up 25% of the population but provide 68% of alcohol industry revenue, according to a paper published in the journal Addiction.

The 4% of the population whose drinking is considered harmful - more than 35 units a week for women and more than 50 for men - account for almost a quarter (23%) of revenue, analysis by researchers at the Institute of Alcohol Studies (IAS) and the University of Sheffield's Alcohol Research Group suggests.

The report said the findings "raise serious questions about the conflicts of interest inherent to voluntary schemes and self-regulation".

It's easy enough to see what the next demand is. If voluntary schemes don't - in the minds of the prodnoses - work then there must be statutory and regulatory ones. It is not farfetched to think of alcohol rations, cards to be presented when asking for a snifter. Actually, that's already been suggested.

As to the basic observation, yes, that's how life works. A large portion of internet usage comes from those who use the internet a lot. Great chunks of road mileage come from those who drive a lot. Significant parts of meat consumption come from those on Atkins diets. People who do a lot of a thing tend to be a goodly portion of the thing being done. We'd be surprised to find that the sexually active and promiscuous are having a decent portion of the new sexual partners going on, would we? 

However, the thing which really struck us. There we've got - accurately enough too - the amounts which are actually harmful drinking, those 35 and 50 units a week. That is the sort of level, perhaps a little beyond, at which the risks significantly outweigh those of none at all.

So why are the government guidelines 14 units? The answer being that those limits are entirely invented, there's no medical justification at all. Just plucked from the air they are. Or from the prejudices of the anti-booze movement for all should know that alcohol is the very devil. 

Now for the important point. Yes, there's an education function to government, it's fair enough that we be told of scientific results. Not drinking from where the latrine flows out is good advice, it's saved many hundreds of millions of lives and it wasn't known before we were all told about it. It's not well enough known in some parts of the world today. But that is where that function ends, informing.

A free society allows properly informed people to do as they wish simply because that's what freedom is, it's the definition of liberty. People desire to drink more booze than is good for them physically? Well? 

Aid those who wish to drink less but find they cannot, most certainly, but our livers, ours to pickle if that's that we wish.

What are, quite frankly, lies about safe drinking annoy but what should enrage is this idea that we should be forced, forced, to consume as they think we should. We do actually see signs, protestations, saying "Our Bodies, Ourselves," books with titles like "Our Bodies, Our Souls." Booze is one of those issues over which this is all true.

Madsen Moment – Conservatism

The soul of parties that use the moniker conservative across the Western world appears to be up for grabs. Dr Pirie tackles just what Conservatism really means in this week's Madsen Moment. 

Well, yes, but if only we could trust the NHS and public health authorities

There's an analogy to those who cry wolf here:

In the early 2000s, after the link between the MMR vaccine and autism was thoroughly debunked, healthcare professionals, including GPs and our teams, worked hard to re-establish public confidence in vaccinations. It took years to restore, but uptake rates in children receiving the MMR vaccine began to improve and there was a time, not so long ago, when we thought we had eradicated measles entirely.

That is why recent data about the surge in measles cases across Europe will come as distressing news – even to us here in the UK.

It's entirely true that vaccines are one of the great health saving innovations, an essential if we're not to have dying children littering the streets. Those against them are indeed deluded.

No, they're not 100% safe, we'd not have a compensation scheme if that were true. But the damage is perhaps 1 in a million, the damage from not vaccination being perhaps a quarter of all children dying before their fifth birthday. You know, those child mortality rates that were common to our history.

However, it's not just the Woo! from people like Wakefield. We've another problem here, which is how the varied public health authorities mislead themselves, giving that opening for the belief that they tell untruths elsewhere.

We've told, vehemently, that smoking, drinking and obesity cost the NHS money - they don't they save it. That there's an epidemic of rising child obesity - when no one is actually measuring child obesity in the first place. That sugar consumption is rising and causing our ills - it ain't, it's falling. Vaping should be limited or banned because Big Tobacco when it's the best anti-tobacco smoking aid yet devised. A few grammes too much salt will murder us all in our beds when those without kidney problems do in fact have self-regulation mechanisms in the body which work rather well.

On the basis of no more than these misunderstandings - to be extremely polite about what we're being told about some of them - the diet of the entire nation is to be reformulated.

And that's before we get to the decades long insistence that animal fats are the root of all dietary evil, recently replaced with a well, err, umm, that might have been an error (*Ahem*, *foot shuffle*).

All of which is a bit of a problem, isn't it? Our public health "authorities" have been telling us untruths - at the very least - on a number of subjects. Which rather undermines their authority when we meet real untruths from the other side, as with the desirability of vaccination.

The solution being obvious here. If they were to wind their necks in and only comment upon or do those things which are absolutely true then we'd all listen to them a bit more. Given that, you know, they' be being truthful all the time?

Another way to put this is that the anti-vaccination idiocy gains traction precisely because of the over reach and error of the public health maniacs. Stop it people, you're damaging the health of the nation.

Paying the blood price is the way to end donation shortages

Blood has a tendency to make people quite squeamish, and talking about money has the same effect on the British. But it's important that we talk about both. Saying that you can’t put a price on blood or plasma has created the shortages we see today. This then forces the United Kingdom to purchase blood and plasma from the United States. This is still placing a monetary price on blood or plasma in a way that is less visible to the everyday british citizen. 

People’s lives end up being lost because there is simply no need or pressure to donate blood if you don't have a loved one who needs it or you've never needed it. Often by the time you realise that you or someone close to you needs blood it’s too late. In the western world the donor rate is around 3-4%, across the EU as a whole it stands at just 3.4%, while in the US the blood donation rate is three times higher at 10%.

The non-monetary cost of life that undersupply creates seems a lot greater than the cost of paying an individual to donate their blood. This is forcing the UK to buy blood from other countries instead of paying their own citizens – including from the US where donors can be paid. Blood would end up being cheaper and British citizens better off if we were able to pay them for their blood. While publicly subsidising blood donation at home to avoid purchasing in from overseas may appear protectionist but the UK’s state run NHS means blood purchases are by necessity from the public purse. The real issue is that it is illegal to pay for blood directly from the source but it’s not illegal to buy it from countries that have a surplus. Often this surplus is from paying their citizens to donate - like in the United States for example. 

There are already many requirements in place for blood donations including age, health standards, medication and lifestyle decisions that carry risk such as drug use. This is a starting point for regulation to ensure the safety of donors. There are also restrictions in place that prevent how often you can donate blood and plasma which means it cannot be a primary source of income for people. This makes the price a motivating factor to donate but ensures that those on low incomes are not abused by a private collector of blood. 

This is all a short term solution to the limited supply of blood donations as science progresses. There are many other solutions on the horizon including xenotransfusion, blood substitutes, cultured blood supplies and other means to support people who need blood either regularly or in the case of an emergency. Through xenotransfusion we can use animals, such as pigs, to harvest blood the same way as we do in humans without affecting the well being and quality of life of the animal. 

Right now though we’re in a position where we’re asked to pay a price for blood donations. We have the option to pay our citizens, pay other countries for their surplus, or people pay in the costs of their lives. 
 

New export strategy is a good start but imports too much of the old model

The new UK export strategy has much to commend it. The incoming top team has listened carefully to business representatives and summarized those views as Annex A testifies. The revised 35% of GDP target (up from 30% now) is realistic, not least because no date has been set for achieving it. Export shares of GDP vary somewhat from source to source but the World Bank found in 2016 that most of the large EU countries clustered around 30% with Poland and Germany well ahead at 52% and 46% respectively. Germany’s world ranking is 49 with all the high shares held by small economies.

In other words, we could get to 35% without any change to exports simply by reducing our imports, or GDP as a whole, as some claim Brexit will achieve.

The new strategy is also realistic in focusing government on doing what only government can do, namely:

• Encourage and inspire businesses that can export but have not started or are just beginning; placing a particular focus on peer-to-peer learning;
• Inform businesses by providing information, advice and practical assistance on exporting;
• Connect UK businesses to overseas buyers, markets and each other, using our sector expertise and our networks in the UK and overseas; and
• Place finance at the heart of our offer.

The finance side (UKEF) has long been a strength of the Government’s export support and having an ex-banker (John Mahon) appointed to lead this strategy must be welcomed. Encouraging firms to export, or export more, and networking from the UK into chosen export markets are fundamental and good to see at the top of the agenda.

But, I am sorry to have to say, there are four concerns:

1. The Secretary of State rightly calls this plan “ambitious”. The 42 pages of things that the Department will do, along with other Whitehall Departments, trade associations, export providers (they mean consultants), Trade Commissioners, Export Champions, the Export Strategy Partnership Group and other organisations, look like a spider’s web of confusion. As reported in Annex A, the difficulty firms have encountered in navigating the existing complexity is one of the main reasons the previous strategies did not work. The new strategy seems to be even more bureaucratic. Networking overseas is vital to exporting but this UK-based plethora reminds one of Gerard Hoffnung’s Concerto for Solo Violin and Massed Conductors. Most of it could be swept away and replaced by partnering the British Chambers of Commerce.
2. Baroness Fairhead’s admirable Foreword makes it plain that firms export, government does not. The strategy should be governed by providing what business needs, not imposing top down plans. Yet the strategy is to prioritise (p.13) resources according to DIT Regional Trade Plans confected by Trade Commissioners, Ambassadors and High Commissioners. Admirable diplomats as these people undoubtedly are, how will they know the minds of exporters better than exporters do? Elsewhere the strategy is to push the wishes of DfID and developing countries ahead of what UK exporters may want. Whitehall fat cats do not change their spots.  
3. Similarly, DIT seems to have absolute faith in supplying potential exporters via the “Great” digital platform despite continued evidence of its inadequacy. There has long been an academic debate about whether exporters should begin with economic and market analyses and formal plans or getting into the most likely market(s) and networking. The simple truth is that one cannot plan the unknown. How can one possibly estimate the number of widgets that can be sold into a market when that capacity, as much as anything, depends on how it is marketed. No digital platform will ever be able to do that, no matter how much is spent on it. Many countries do make good use of databases but they're best used as a supplement to networks and introductions, which are the true cornerstone of any real business relationship. 
4. Finally, the strategy does acknowledge that financial incentives are needed because most small firms consider, rightly or wrongly, that they have neither the time nor the finances resources to export. It addresses that merely by telling firms to look elsewhere for those incentives themselves: “assessing the potential for financial incentives such as vouchers, grants and loans, and by improving signposting to the relevant export support in the public and private sector.” Baileys Irish Cream was only launched because of the then Irish Government’s tax incentive and the Portuguese government used to make generous allowance for firms engaged in trade. Surely it is obvious that a government free of the EU should be providing the necessary tax or other financial inducements at home to motivate potential exporters.

This new export strategy has good features but when it gets down to the nitty gritty too much of it is the same old. Baroness Fairbairn misquotes the modern version of Abraham Lincoln’s governing principle (Government should only do what only government can do) by missing out the crucial first “only”. From that omission, flow all the excesses in this strategy which is not the radical focused provision that we need. But maybe, just maybe, we are getting there.

As we've been saying, advancing technology saves the NHS money

Some of us here are men of a certain age, those others of us male here hope to reach that maturity. So, this is good news:

Anew five-minute steam treatment for an enlarged prostate has been hailed as a breakthrough by NHS surgeons following tests on British patients.

The simple procedure was found to shrink glands on average by 36 per cent - but while the result is similar to other treatments, it has far less side effects.

The process, conducted by surgeons at Imperial College Healthcare NHS Trust in London and Hampshire Hospitals NHS Foundation Trust on 150 men, involves injecting an enlarged prostate with jets of steam without the need for surgery.

Current procedures, while effective, can lead to loss of sexual function,bleeding and incontinence with patients kept in hospitals for days at a time. 

It was reported that health watchdogs are ready to give it the green light for NHS use.

This is indeed the sort of thing that men of a certain age welcome. Also those who desire to reach age. 

However, we're all aware of the current mantra. That as technology marches on the NHS needs ever more money to be able to deploy those new technologies. This is though just the standard bleating from a bureaucracy that they must have more of our money. For look at what the effects upon costs are of our new technology:

Professor Hashim Ahmed, a consultant urological surgeon at Imperial, said other hospitals are poised to roll out the treatment as soon as they get the okay from health watchdog NICE.

"It frees up huge NHS resources because you need much less theatre time," he told the Daily Mail. "You are also opening up tens of thousands of days of bed occupation around the country."

As is true of new technologies in general - it's cheaper. For that's rather what a new technology is, being able to do that old task with fewer inputs, to be able to do it cheaper.

This technological revolution is going to reduce the costs of the NHS, not increase, and don't let anyone tell you different.

Quite what anyone thinks we do in a market.....

This is a common enough misapprehension but we're surprised to see it in the pages of The Times.  Hmm, given our varied interactions with those who write that newspaper, perhaps not.

On the subject of new technology, the suggestion is that we should consider both the benefits of it and also the downsides. 

There is another response, though. Radical as it may sound, we — consumers and governments — could choose to have less of this connected technology in our lives. Not stubbornly preserving ourselves in the aspic of 2018, but being more discriminating about which innovations we wish to welcome into our lives; which are necessary; which are worth the risk they may bring.

What is it that anyone thinks we do when we consider a technology? Or a purchase, or even a choice in life? Us humans being at least somewhat rational beings a portion of the time?

That's right, we consider how much we'd like that thing and what we'll have to give up to gain it. Opportunity costs in the jargon but it is the way that everyone does think. We know that extra gallon of beer comes at the cost of a headache, having a smartphone or email account means that people can spam us. 

As it all works out those things we don't think are worth it - New Coke, Ford Edsels, MySpace and socialism - end up not happening, those we think are worth the costs do. Look out the window at those mighty works to see which we do consider of such value.

The suggestion is thus that we should consider new technology in just the same manner we do anything else in life. Well, yes, and?

We're still not enamoured with politics being the way to plan things

We are all familiar with the argument stemming from over to our left - that politics really should be running life, the economy and society. For if people get to vote on what they want then that democratic economy and society will provide what it is that people say they want.

We've a number of problems with this, starting with the freedom and liberty argument. The minority, absent third party harm, should be allowed to live their lives as they wish absent those insistences of everyone else - the tyranny of the majority argument.

To leave such lofty logic aside, there's also how these things work out in practice. For it's important to note how politics does end up framing an issue and thus decisions about it. Take the idea of building upon brownfield or greenfield land:

A£200million Government fund to pay for more homes on industrial land has resulted in the opposite effect, with fewer homes built on brownfield areas than before it was set up.

Official Government’s land use change statistics show that the proportion of new homes registered on previously developed land has fallen by 4 percentage points since 2014, when the fund was set up.

Yet over the same period the number of new residential addresses on supposedly heavily protected Green Belt land has increased by the same proportion - 4 per cent.

Thus, obviously, all government action upon housebuilding is a failure and we must build however many hundreds of thousands of council houses it is:

However John Healey MP, Labour’s Shadow Housing Secretary, said the figures showed that the Government had gone backwards on its pledge to encourage more building on brownfield sites.

He said: “If hot air built homes then Ministers would have fixed our housing crisis. Despite big promises to get building on brownfield land, official Government figures show we’ve gone backwards.  

“It’s clear that Ministers are failing to get good value-for-money for taxpayers.

“By giving developers a free rein to do what they want, the Government is failing get homes for local people built where they are needed.”

Matt Thomson, Head of Planning at the Campaign to Protect Rural England, backed the findings, saying that “promises to build the homes the nation needs while protecting the countryside are not being carried through.

“Our analysis of the government’s new ‘planning rulebook’ suggests that despite a lot of warm words current trends will continue, to the detriment of both town and country.  

“The government must stick to its guns and end this constant cycle of broken promises.

“They need to rein back greenfield development where suitable brownfield land is available, and discourage growth where it cannot happen without compromising their own policies intended to manage sprawl and protect open land.”

A fairly clear set of political demands there.

It is entirely possible that the government plan isn't working or is even counterprodutive. It's, well, possible at least, that central building and planning is the solution. Neither of those are our argument today. Rather, the proponents of the democratic planning idea tell us that this will be more efficient. That it will be the bright, committed and impartial technocrats who do the work on telling the rest of us what to do, guided by those preferences of the populace.

And yet what is it that is actually motivating this set of whines bout current policy? From the statistics release being used here:

These proportions tend to fluctuate from year-to-year, as shown – including conversions - in Table 1 below. This is due partly to variations in the location and timing of developments between years.

The figures tend to bounce around just because houses are built and put onto the market in gobs, possibly gobbets, not as a consistent flow of individual units. But this bouncing around between time periods simply because the counting is not entirely granular is enough to insist upon an entire change of policy?

Now d'ye see why we're not such fans of that political planning as a result of democratic decision making? The process simply isn't that disinterested technocracy determining things, is it? It's the result of whatever a propagandist can mine out of the passing scene. Which, we are really very sure about this, isn't the way to run a country.

The problem with that democratic economy and society is that it is and will be politics that runs it. Which, given the way politics works, isn't a good idea. 

Venezuela Campaign: The tragedy of failing zoos and starving strays

Animals in Venezuela are suffering from acute malnutrition in a country where even most people find it difficult to feed themselves. They are often simply allowed to starve to death, despite efforts to transport them abroad to better conditions.

As early as 2016, more than 50 animals in the Caricuao zoo in Caracas died of starvation. After an inspection in February 2018, the Zulia Metropolitan Zoological Park was declared ‘unsuitable to receive visitors’ and was closed until further notice. Some of Zulia’s weaker animals were being fed to bigger ones. Several of their specimens were eating each other out of sheer desperation. Of its 1000 animals, 80% are still in critical condition.

‘What is being seen in Zulia can only be understood in countries with armed conflict’, said the zoo’s chief veterinary officer, Dr Carlos Silva. Dr Silva was later arrested without a warrant for “obstruction of justice” when he published a damning report on the park’s management.

It is not only Venezuela’s zoo animals that have suffered. Footage emerged in January 2018 of a crowd of people stoning a cow to death in an open field, hacking at it with machetes when it fell. There have been dozens of incidents in the state of Merida of cows being slaughtered in a similar way. In 2015, a kilogram of meat cost more than 40% of the average person’s monthly wage. Venezuela’s price control regime has meant that the costs of basic items is spiralling out of control, which is why people are turning to unconventional sources of meat to sustain themselves.

Yet another sign of the suffering in Venezuela is the situation faced by domestic pets. El Nacional reports that the cost of basic pet food as well as vaccines has forced owners to abandon their animals. Families who leave the country have to leave their pets behind. The high cost of dog food due to price controls and difficulty importing goods from abroad have pushed families to abandon their pets, which in some cases have become meat for a desperate population.

Marlene Sifontes who is responsible for workers at Venezuela’s zoos, has said: "The story of these animals is a metaphor for Venezuelan suffering." It remains to be seen, however, if any action will be taken to alleviate the suffering of the humans and the animals, as the country slides deeper into crisis.

More information on the Venezuela Campaign can be found on their website.