Jacob Hyatt 12/12/22 Jacob Hyatt 12/12/22

Adderall Safari

You may have noticed that finding your ADHD medicine has become rather difficult. The Adderall shortage has been ongoing for a few months now and there does not appear to be any end in sight.

You may have noticed that finding your ADHD medicine has become rather difficult. The Adderall shortage has been ongoing for a few months now and there does not appear to be any end in sight. There are many reasons for this shortage and it's almost a perfect storm of factors that have converged to leave many patients without their medication. Supply and demand are still in effect and the biggest issue has been that demand for Adderall has been growing substantially. The supply side has been littered with road bumps as well everything from supply chain disruptions limiting the availability of raw ingredients to foreign labor disputes halting factory production.

The increase in demand should come as no surprise. Adderall has become a household name, like Xanax and Oxycontin it is more popular than Taylor Swift. Pharma advertising is often blamed for this but it's also the reality that these drugs are incredibly effective. Clinicians that treat ADHD are overwhelmed with patients and the next available appointment can be months out in some areas. This led to an increase in patients seeking these prescriptions through telehealth or direct servicing apps.

You may be familiar with some of these companies that market to men; Roman, Hims, Bluechew, all these companies remove the hassle of finding a doctor and getting a prescription for Viagra. Cerebral was one of the first companies to apply this model to Adderall but it did not go so well, resulting in the company falling under investigation by the DEA & DOJ. Who knows how the court case will be decided but it does not look good for the company who is already losing the battle of public opinion. CBS News recently interviewed a mother who blames Cerebral for inappropriately prescribing stimulants that played a role in her son’s death.

One report from Trinity Health concluded that the number of prescriptions written for Adderall far exceeds the number of formal ADHD diagnoses. While this is a little obvious it creates a supply snare trap further down the line. As the prescription to diagnosis discrepancy grew larger a shortage would become almost certain. Manufacturing of Schedule II controlled substances is tightly regulated by the controlled substance act and enforced by DEA scientists who use mathematical models to predict demand. The problem is the amount of diagnosis is likely an input into those models. This resulted in an inaccurate forecast and contributed to the current supply crunch.

Teva is one of the largest generic manufacturers that produces Adderall, but they were plagued with labor shortages in their packaging plants which became a choke point producing further delays in other drugs as well. These companies only have so many manufacturing facilities and they are making one product at a time, so everything gets backed up. In the background of all these issues is a looming global recession that has these vital companies not expanding to meet demand but predictably shrinking to protect profitability. Teva has been steadily closing manufacturing facilities around the world despite that though they are currently operating 56 production facilities that make 76 billion tablets/capsules a year. They produce 3700 products spread across those 56 plants, so it is very easy to see why bottlenecks occur.

Jacob Hyatt Pharm D.
Father of three, Husband, Pharmacist, Realtor, Landlord, Independent Health and Medicine Reporter
https://substack.com/discover/pharmacoconuts

@hyattjn

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China's Zero Covid & no mRNA mystery

China had their large communists party conclave not too long ago with Xi Jinping essentially becoming president in perpetuity and further consolidating power. No surprise on the political front but many expected them to use this as an opportunity to pivot from the blatantly unreachable zero covid policy. Instead, they would publicly double down on that policy but did make a few interesting changes from a western perspective. Vaccine mandates for example have largely been given up by the government. The vaccines that they do offer are local only; they have no interest in allowing Moderna or Pfizer vaccines into the mainland.

Politics may be able to explain the resistance to allowing a western product approval, but they are perfectly capable of creating their own versions. Despite that, mRNA technology appears to be the one piece of intellectual property they are not interested in reproducing for their own benefit. This raises lots of questions, it’s practically narrative on narrative violence with the west screaming that these products are effective until they are blue in the face, but the Chinese have deemed them not even worth stealing. Meanwhile the threat from covid is still severe enough that GPS data from your cell phone alone is enough to justify a government abduction and subsequent detainment. A great piece documenting this was recently published by Thomas Hale, the Shanghai correspondent for the Financial Times who was swept up for a ten-day detention. The full article is behind a paywall, but a free synopsis can be found here.

https://www.zerohedge.com/covid-19/take-rare-glimpse-inside-chinas-zero-covid-madhouse

The United States government excels at hiding information from the public especially if it does not align with their goals. Even a former president can't handle classified information without concerns of legal liability. Releasing any of this information in the states requires an inordinate amount of time, lawyers and FOIA requests. Even if you do manage to pry that data from their clutches it is redacted to the point of uselessness often in the name of national security. Pfizer's recent documents and even Dr. Fauci's emails are good examples. Fortunately, we do have one entity on the planet that sees everything like the eye of Sauron. Chinese espionage operations are unequaled and generational in scope, it really makes me wonder what information about these products they must have to warrant such hesitance even in the face of mounting internal pressure.

They did start down the mRNA road over a year ago and Chinese companies Walvax Biotechnology & Suzhou Ai Biotechnology would publish their first study on 120 volunteers in January. The data from that trial in particular looks pretty good with no real concerns or adverse events reported. To their credit there are quite a few studies comparing the DNA based chinese vaccine (CoronoVac/Sinovac) and the pfizer mRNA product in the one market where they can both be found, Hong Kong. One study showed that both products have the potential to increase herpes zoster related hospitalizations, but the overall risk was still very low. Another study with over 2 million participants would track adverse events from both shots. The most frequent adverse event reported across both treatment groups was thromboembolism. This large study showed few differences in adverse events between the products but a slight increase in Bell's Palsy for the CoronaVac. Finally, a third study with about a quarter of a million diabetic patients was conducted and found no increased adverse events in this population.

Yes, all this data needs to be taken with a grain of salt; the Chinese certainly have a vested interest in pushing their product on the rest of the world (as do we). The conflict-of-interest statements in all these papers are mind bogglingly long as well. The takeaway though is that if you are the Communist party there is not a ton of public evidence even in their own scientific literature to support the actions they have taken. Even the joke that is the associated press managed to ask a Chinese health official what the delay was. Their response given under the conditions of remaining anonymous is that they have held back because they want to master the technology in China and not depend on foreign suppliers.

Jacob Hyatt Pharm D.
Father of three, Husband, Pharmacist, Realtor, Landlord, Independent Health, and Medicine Reporter
https://substack.com/discover/pharmacoconuts

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Further Reading and References
https://www.thelancet.com/action/showPdf?pii=S2666-5247%2821%2900280-9

https://www.cnn.com/2021/12/13/china/china-western-mrna-vaccine-mic-intl-hnk/index.html
https://www.scmp.com/comment/letters/article/3171044/chinas-omicron-surge-whats-stopping-beijing-reaching-mrna-vaccines
https://www.scmp.com/news/china/science/article/3194787/vaccines-shouldnt-be-deciding-factor-chinas-zero-covid-policy?module=perpetual_scroll_0&pgtype=article&campaign=3194787
https://www.voanews.com/a/china-s-bet-on-homegrown-mrna-vaccines-holds-back-nation-/6587593.html
https://www.npr.org/sections/goatsandsoda/2022/02/24/1082529219/looks-like-non-mrna-vaccines-can-be-as-good-as-pfizer-and-moderna-in-certain-sce

https://pubmed.ncbi.nlm.nih.gov/35590336/

https://pubmed.ncbi.nlm.nih.gov/35128500/

https://pubmed.ncbi.nlm.nih.gov/36184720/

Jacob Hyatt 11/6/22 Jacob Hyatt 11/6/22

Saving the Children

The CDC & FDA unanimously approved the new omicron specific boosters for use in children aged five to twelve, going beyond what even the Moderna CEO is recommending. This created a lot of uproar in certain circles, but it should come as no surprise. Anyone who would have thought differently or had concerns about the risk benefit of the vaccines was long ago pushed out. Even with the first round of vaccines the push to market them to children has been dumbfounding. The reason children do not have the same problems with covid is well known and has been for some time. A recent analysis has even confirmed this by reporting that the fatality rate for ages 0-19 from the original Wuhan strain was 0.0003%

.
The virus binds to the ACE2 receptor to gain access into the cell. It binds so well to this receptor it is as if thousands of generations of virus were screened and selected for such a result. Perhaps Mother nature hit the lottery several times in a row to achieve this evolutionary advantage, but it is far more likely that human tinkering is the culprit. Call it viral research, gene amplification, bioterrorism, or the search for future cures. The end result is the same with viruses making incredible evolutionary leaps that while theoretically possible in nature are incredibly unlikely. Meanwhile the risk of an accidental release outweighs the potential benefits of this research.

Whatever the original source, the reality is we have a novel coronavirus that sticks to the ACE2 receptor like super glue. This is incredibly unfortunate for the elderly and the obese who have greater expression of the enzyme and thus a greater chance of infection. It is a blessing from God however that children simply do not express this enzyme to the same extent as their parents. Therefore, they contract the virus less often and if they do the cases are mild or asymptomatic. This is not new information, but it may seem that way since it is rarely discussed. Despite that fact fear mongering, intimidation and outright lies have been used to market an unlicensed product to the population least likely to receive a benefit. Call me old fashioned but I believe pharmaceutical intervention in children especially needs to have a clear and demonstrable benefit which I have not seen.

Speaking of children, however we do currently have an issue with RSV in children. Emergency room and urgent care visits have shown a recent spike in these diagnoses. The chart below is for Virginia, but other states are seeing a sharp increase as well. Some have argued that this is due to a lingering immunity gap left over from the lockdowns. Human isolation is known to have a negative effect on the immune system and the theory is that these children and potentially their mothers never had the opportunity to build immunity to these common pathogens; and the bill is now coming due.

If that were the case, I would expect to see some discrepancy between the states that locked down differently. Texas and California are about as opposite as can be when it comes to lock down policy, but they are both seeing the same increased caseload. The graphs for New York and Florida also look remarkably similar. Whatever is happening here appears to be across the board despite differences in lockdown policy or vaccination. This early spike of RSV is a foreboding sign as we head into the fall with flu season around the corner and covid is going nowhere soon. The press is referring to this convergence as a "tridemic".

That thought reminded me of an opinion article posted yesterday to the Washington Post saying it is time to push for an RSV vaccine for children. They are truly prescient because Moderna just so happens to have a new mRNA RSV vaccine in development. If you are feeling frisky and over 60 you can sign up for the trial here https://conquerrsv.com/.

MRNA technology is the latest and greatest tool, and the pharmaceutical industry is planning to use it extensively for anything they can get away with. A recent BBC interview features the founders of BioNTech publicizing the technology as a cure for cancer by 2030. We have a long way to go before we are at that point, but the following statement made during the interview is very telling.

Türeci told Kuenssberg that BioNTech had learned how to manufacture mRNA vaccines faster during the pandemic and had a better understanding of how people’s immune systems responded to mRNA. The intense development and rapid rollout of the Covid shot had also helped medicines regulators work out how to approve the vaccines. “This will definitely accelerate also our cancer vaccine,”

I am certainly glad that the process of making these products has advanced our understanding of them, better late than never but the kicker here is the line about figuring out how to get it approved. There is of course the old-fashioned way of obtaining approval by proving it is safe and effective but that takes forever and there is no guarantee you will even make it to market. Daily cancer deaths dwarf covid deaths so the argument for an emergency use authorization practically makes itself. President Pfizer has been promising a moonshot to cure cancer for a while now and he may be closer than he is aware.

Jacob Hyatt Pharm D.
Father of three, Husband, Pharmacist, Realtor, Landlord, Independent Health, and Medicine Reporter
https://substack.com/discover/pharmacoconuts

hyattjn@gmail.com

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Further Reading and References

https://www.theguardian.com/society/2022/oct/16/vaccines-to-treat-cancer-possible-by-2030-say-biontech-founders

https://www.thelancet.com/article/S0140-6736(22)01277-6/fulltext
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)02046-8/fulltext
https://pubmed.ncbi.nlm.nih.gov/32496587/
https://www.zerohedge.com/covid-19/closer-look-covid-mortality-rate
https://pubmed.ncbi.nlm.nih.gov/33168188/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7461228/
https://pubmed.ncbi.nlm.nih.gov/34735717/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9277324/
https://pubmed.ncbi.nlm.nih.gov/35992140/
https://pubmed.ncbi.nlm.nih.gov/36209167/
https://www.washingtonpost.com/opinions/2022/10/27/rsv-surge-pediatric-vaccine/

Jacob Hyatt 10/21/22 Jacob Hyatt 10/21/22

Getting to the Heart of things

This week a lawsuit against the CDC has given us access to some of the V-safe data. This is the smartphone app created by the CDC that lets you register for the vaccine and report side effects and other health information. As with any user reported data it should be taken with a grain of salt but there are people who argue that reporting systems like this and VAERS undercount adverse events because most people don’t bother reporting. Either way this is data that the CDC has been sitting on and only released due to a recent court order. The data provided is from 10.1 million users and the headline number is 7.7% of those required medical attention after vaccination. It is such an absurdly high number that if I was working at the CDC, I would insist it was incorrect and there must be something wrong with the software. It will be very interesting moving forward to know how many employees were privy to this information or if there was any internal debate about releasing or debunking it. Data like this would create a liability nightmare, that is if liability existed for such a thing.

The dashboard for the data can be found here https://www.icandecide.org/v-safe-data/

The Florida surgeon general has also released a statement recently recommending that males 18-39 should not receive mRNA vaccines. Along with the statement was an analysis conducted by the state revealing an 84% increase of cardiac related incidence of death within 28 days of vaccination.

The guidance statement can be found here

https://floridahealthcovid19.gov/wp-content/uploads/2022/10/20221007-guidance-mrna-covid19-vaccines-doc.pdf?utm_medium=email&utm_source=govdelivery

The analysis itself is here

https://floridahealthcovid19.gov/wp-content/uploads/2022/10/20221007-guidance-mrna-covid19-vaccines-analysis.pdf?utm_medium=email&utm_source=govdelivery

The most egregious example of a drug product causing excess heart attacks was not that long ago. Vioxx was brought to market in 1999 ironically as a safer alternative to traditional NSAID drugs like naproxen or aspirin which can cause ulcers and other gastrointestinal complications. In that respect the drug did work but the cardiovascular risks far outweighed that benefit. Merck was very aware of these risks and that would be proven in court with internal memos and even unpublished studies showing heart attacks and strokes were six times more likely in Vioxx compared to placebo. Despite that knowledge they would turn into a magician selectively hiding data to make the product appear less dangerous in their VIGOR trial. Even worse, the data they did publish still showed more heart attacks compared to aspirin, but they would double down insisting that aspirin was known to reduce heart attacks. So, the problem was not the Vioxx causing heart attacks, but the pesky aspirin preventing them.

Merck would manage to sell Vioxx for five years to an estimated twenty million patients before voluntarily recalling the drug as the APROVE study would reveal an increased risk of heart attacks. Later the Lancet would estimate that Vioxx caused 88,000 heart attacks of which 32,000 were fatal. Lawsuits would begin piling up and despite several successful trial defenses Merck would establish a settlement fund to the tune of 4.85 billion dollars.

NSAIDS work to reduce inflammation by reducing the activity of cyclooxygenase or Cox enzymes. These enzymes help turn arachidonic acid into prostaglandins. Traditional NSAIDS like aspirin are much more selective for the Cox-1 enzyme by about 170-fold. Decreased prostaglandin production does reduce inflammation but those same prostaglandins have a protective effect on the gut and disrupting them leads to ulcers. The thought was if we could develop more Cox-2 selective drugs we could avoid negative side effects. Vioxx, Bextra, and Celebrex all selective Cox-2 inhibitors would be developed and marketed extensively. Vioxx would be the most advertised prescription product in the year 2000 and Pfizer would promote Bextra for so many off-label indications that it would be part of a 2.3-billion-dollar settlement with the Justice Department for fraudulent marketing. Bextra was removed from the market in 2004 leaving Celebrex as the real winner and the only Cox-2 inhibitor on the market. Celebrex would enjoy essentially a monopoly on the market that was so extensive they would halt advertising the product. Celebrex would stay on the market despite the FDA adding a black box warning to its label.

If the vaccines are causing an issue all signs seem to point to the young male age group as where the signal will be found. I have been looking through the CDC database to track the number of reported cardiovascular and cerebrovascular deaths in males between the age of 15-34. Going back to 2011 the amount of these reported deaths is rare and consistent but begins to spike in 2020 the last year we have complete data for. I would bet that this line continues to increase as we get data for 2021 the only question is how much? The good news is that if we are accidentally causing excess heart attacks the Moderna CEO has promised a new breakthrough MRNA treatment to repair damaged heart muscle. God bless his heart for being so far ahead of the curve.

https://www.thegatewaypundit.com/2022/10/cant-make-moderna-ceo-announces-development-new-mrna-injection-repair-heart-muscle-heart-attack/

Jacob Hyatt Pharm D.
Father of three, Husband, Pharmacist, Realtor, Landlord, Independent Health, and Medicine Reporter
https://substack.com/discover/pharmacoconuts

hyattjn@gmail.com

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Additional Reading and References

https://scholarship.law.stjohns.edu/cgi/viewcontent.cgi?article=1054&context=jcred

https://money.cnn.com/2006/09/19/news/companies/celebrex/index.htm

https://pubmed.ncbi.nlm.nih.gov/18030055/

https://www.fdanews.com/articles/75244-black-box-warning-added-to-celebrex-labeling

https://www.justice.gov/opa/pr/justice-department-announces-largest-health-care-fraud-settlement-its-history

https://www.npr.org/2007/11/10/5470430/timeline-the-rise-and-fall-of-vioxx

Jacob Hyatt 10/2/22 Jacob Hyatt 10/2/22

Measuring Cognitive Function

Science can only advance as far as we can accurately measure, and this applies to healthcare as well. There are lots of lab values that we can obtain to get a better picture of your overall health, if we are concerned about your diabetes your blood sugar can now be tracked 24/7. Some things in healthcare are not as easy to measure though, depression, pain, anxiety these are all subjective issues that are highly dependent upon patient perception. The murkier the measurements the harder these conditions are to properly treat and the potential increases for that treatment to go awry. The traditional pain scale is a good example of a vague and practically useless metric.

Perhaps nothing is harder to measure than cognitive ability. As we age our mental faculties decline and diseases like Alzheimer's and dementia become more and more prevalent. Brain fog has become an increasingly popular term as long covid spreads throughout the population with patients reporting decreases in executive function. The pharmacy is usually the first to notice these issues because managing multiple medications for these patients becomes an increasingly impossible task. Unfortunately, by the time friends, family, or the pharmacy are noticing these issues it may be too late. Identifying and treating cognitive impairment early and aggressively is key to preserving what brain function remains. You may think that this is only for the elderly but that is not the case. Concussions and head trauma in sports is another great reason to have a baseline test like this on file. Currently the Miami Dolphins are dealing with a sad situation which has resulted in their star quarterback being injured after multiple concussions. The physician who cleared him to play has now been fired. I cannot help but think that better testing has the potential to better quantify damage from head trauma to avoid incidents like this in the future.

To help in this endeavor Williamsburg Drug has purchased a new testing device to offer patients called the Cognivue Thrive. This test is designed to measure three domains memory, visuospatial, and executive function. It also provides two metrics to measure your cognitive speed and performance. The test only takes a few minutes to complete and is a standard part of our health checkup consultations. If you would like to come in and check it out, you can schedule a consult at williamsburgdrug.com

Example of test results

Jacob Hyatt Pharm D.
Father of three, Husband, Pharmacist, Realtor, Landlord, Independent Health, and Medicine Reporter
https://substack.com/discover/pharmacoconuts

hyattjn@gmail.com

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Thank you for Reading feel free to share!

Further reading and references

https://www.theatlantic.com/health/archive/2022/09/long-covid-brain-fog-symptom-executive-function/671393/
https://pubmed.ncbi.nlm.nih.gov/34327120/
https://www.wjgnet.com/2220-3206/full/v10/i1/1.htm
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5993067/
https://www.cognivue.com/product-tour/cognivue-thrive/

Jacob Hyatt 9/11/22 Jacob Hyatt 9/11/22

Huffing for your Health

While water is an essential element to life that can be found for free most everywhere you look that does not stop industry from turning it into a profitable commodity. There is a whole aisle at the store dedicated to bottled water in a variety of forms and while some of us are too cheap to splurge on fancy water it still manages to be a 283-billion-dollar global industry. With that in mind it was only a matter of time before we circled fully around an went full Spaceballs selling air in a can.

Boost Oxygen is the most popular brand of OTC pure oxygen in a can. I have noticed these popping up at a variety of retailers during covid. Compressed pure oxygen available in a variety of flavors and small enough to fit in your purse.

Oxygen as a medical treatment has been around forever and is incredibly effective in patients who have trouble breathing or maintaining their oxygen saturation on room air. Normally a prescription is needed to supply Oxygen tanks which can be large and obtrusive while also a fire hazard. To improve access modern portable oxygen concentrators have been developed and now are small enough to fit in a backpack. Monitoring of your oxygen saturation can be accomplished quickly and easily by using a pulse oximeter or smartwatch. This is an excellent tool to use especially when sick at home with a respiratory illness and wondering when to seek professional care, being unable to maintain a steady oxygen saturation is your seek medical care now sign.

Like all therapies under the proper conditions oxygen makes a ton of sense, but how about just as a supplement or to enhance athletic performance? Oxygen supplementation is routinely used by mountain climbers when exploring extreme elevations so if it’s good enough for them why not for you? One man’s stairs are another man's mountain, and the thing oxygen supplementation has been shown to do is increase the V02 Max for a brief period. Still the human respiratory system is designed to match your oxygen supply with demand and if you need more oxygen your respiration rate increases to provide it and auxiliary oxygen should only be necessary in extreme environments. For the average healthy person oxygen concentration is not the rate limiting step and if the athletic benefits were that great, we would see it all over the sidelines of professional sports. They are missing a big marketing angle here and a NASCAR sponsorship practically writes itself.

The reality is that if you truly need supplemental oxygen the concentrators are your best bet, but these O2 cans are a perfectly safe and interesting product. They may have a diagnostic function as well to help identify elderly patients who are not currently receiving therapy but may benefit from it. Hyperbaric Oxygen therapy has always had a place in the training regimen for world class athletes, but recent studies are showing its effectiveness against a variety of age-related cognitive concerns.

Jacob Hyatt Pharm D.
Father of three, Husband, Pharmacist, Realtor, Landlord, Independent Health, and Medicine Reporter
https://substack.com/discover/pharmacoconuts

hyattjn@gmail.com

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Masks Mania

Duality of Masking

We live in a very bipolar society and one of the most obvious examples of this is the tenacity of masking. The unfortunate truth is that an aerosolized virus particle is so small that the only sure way to prevent an encounter with it is with your own self-contained breathing apparatus. How many scuba suits are you seeing on the streets of New York? Can a surgical mask stop a particle or two? Well, it is certainly possible in the same way that fishnet stockings may prevent some sunburn but not what anyone would call overall effective. Early on there were multiple articles exaggerating the necessity of public masking, none of them particularly convincing or well done but they danced around the truth and pushed their preconceived notions in the name of public health.

The reality is very few wear masks of any quality, and nobody is wearing them properly. Even in healthcare settings where a fresh N-95 may be handed out daily most opt for the regular mask so they can breathe easier. I have seen people in public however pick one off the ground and put it on to enter their doctor's office, one of the last places where they are still mandated around here. Most of the time I consider masks to be ineffective and silly but not harmful for adults. Children on the other hand is another story and government actions have been crimes against the speech and societal development of our future generation.

Prior to covid it was commonly known that oxygen masks in young children could cause rebreathing resulting in elevated carbon dioxide. This was such a concern that redesigned masks to limit rebreathing and improve oxygen efficiency would be brought to the market. It appears to be a success and is called an OxyMask. Proper respiration is essential to human health and beneath all of this is the subtle acid base chemistry constantly maintained by our breathing. Inhaled carbon dioxide mixes with water in our bodies to produce carbonic acid. This simple and reversible chemical reaction is one of the ways our bodies maintain their pH balance. If you have not seen it, The Andromeda Strain (1971) is an excellent film where this concept plays a critical role in the story, it is based on the Michael Crichton book of the same name from 1969 so not exactly new science.

https://link.springer.com/article/10.1007/s00431-021-04157-1
https://media.lanecc.edu/users/driscolln/RT127/Softchalk/Acid_Base_Lesson/Acid_Base_Lesson6.html

Last summer amid our muzzle the children to protect the adults debate a German article was published in JAMA Pediatrics examining if there was any risk of rebreathing with nose and mouth coverings in children. It was quickly retracted though with the following vague statement.

"Given fundamental concerns about the study methodology, uncertainty regarding the validity of the findings and conclusions, and the potential public health implications, the editors have retracted this Research Letter."

This raises the question that if the study methodology was so bad why was it ever accepted and published in the first place? There does appear to be some back and forth between the authors and the editor because the retraction clearly states that the authors were invited to respond to these concerns but were unable to provide sufficiently convincing evidence. I have the suspicion that if the authors conclusions were different then the methodology would not have been suspect. Article and retraction links are below.
https://jamanetwork.com/journals/jamapediatrics/fullarticle/2781743 (FULL ARTICLE)
https://jamanetwork.com/journals/jamapediatrics/fullarticle/2782288 (RETRACTION)

The lead author of the study Dr. Harald Walach did respond to a request for comment, and he believes the retraction to be unjustified and has since republished it in another journal where it has undergone three rounds of triple-peer review. That article in its entirety can be found at the link below. The editors who retracted the article have chosen not to respond to my request for comment.

https://pubmed.ncbi.nlm.nih.gov/35636467/

The article concludes that masking increased the carbon dioxide content in inhaled air upwards of 13,000 PPM (parts per million). 2000 PPM is considered the acceptable limit and 1000 PPM is normal for air in enclosed rooms. The most troubling part of this is that the experiment used a brief time interval to achieve these results meanwhile in the real-world children are wearing these masks for a much longer period and sometimes even during physical exertion.

The effects of environmental exposure to carbon dioxide have been a real topic of investigation in certain professions. This exposure can be commonplace for miners, astronauts, and submariners. The data from these appears to be mixed with some suggesting that it could have negative impacts upon cognition, they do all seem to agree that further research is warranted. Extra credit for the conspiracy theorists out there we also have an animal study that concludes carbon dioxide is a robust fear inducing stimulus that discourages exploration in mice.

https://pubmed.ncbi.nlm.nih.gov/31240239/

https://pubmed.ncbi.nlm.nih.gov/29789085/

https://pubmed.ncbi.nlm.nih.gov/33103571/

Jacob Hyatt Pharm D.
Father of three, Husband, Pharmacist, Realtor, Landlord, Independent Health, and Medicine Reporter
https://substack.com/discover/pharmacoconuts

hyattjn@gmail.com

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