Books by serious researchers on how to defeat aging are now coming out almost as fast as I have time to read them.
This one mostly aims to enable us live in good health to 115, preferably via a few simple pills.Continue Reading
Books by serious researchers on how to defeat aging are now coming out almost as fast as I have time to read them.
This one mostly aims to enable us live in good health to 115, preferably via a few simple pills.Continue Reading
A new study has provided evidence that a healthy lifestyle can reverse aging, as measured by epigenetic age: Reversal of Epigenetic Age with Diet and Lifestyle in a Pilot Randomized Clinical Trial. This is the second study to show that epigenetic age can be reversed in humans (here’s a reminder to read the first).
They used the Horvath DNAmAge clock.
After a mere 8 weeks of a healthy lifestyle, the subjects’ DNAmAge was 3.23 years younger than the controls (and 1.96 years younger than the pre-trial DNAmAge of the treatment group).
The lifestyle interventions weren’t labeled as paleo, but they closely resemble the lifestyles that are recommended by Chris Kresser, Steven R. Gundry, and Dale Bredesen. The diet comes about as close as the diet of a typical paleo enthusiast to avoiding foods that have been available for less than 10,000 years. The recommended foods that I consider the least paleo are “coconut, olive, flaxseed and pumpkin seed oil”. The diet is more plant-based than the stereotypical paleo diet, but it’s well within the normal range of hunter-gatherer diets.
The study has a bunch of the usual limitations, such as a small sample size (18 people in the treatment group). There are also reasons for mild concerns about conflicts of interest, as some of the researchers work as functional medicine physicians, so their careers are mildly dependent on the popularity of the lifestyle approach being studied. As far as I can tell, that is likely to cause a level of bias that is rather ordinary for nutrition-related research. Oh, and the instructions are listed as “Patent pending”, but it’s unclear why they would meet the novelty requirements for a patent.
My main doubt comes from the difficulty of figuring out whether DNAmAge measures causes of age-related health problems, or whether it’s just measuring symptoms. I’m slightly more than 50% confident that epigenetic changes have some causal influence on aging.
This kind of trial raises questions about how well patients follow the instructions – most would find it difficult to “Avoid added sugar/candy, dairy, grains, legumes/beans”. The paper describes how they checked on patient compliance, but I didn’t see any data indicating what they found about compliance. So there’s some risk that they were especially lucky about getting patients to follow their instructions, and maybe future studies of this nature will show much weaker results due to poor compliance.
Lastly, it’s a bit odd that the control group appeared to age 1.27 years in 8 weeks. Maybe they were depressed about not getting any treatment? (This isn’t the kind of study where blinding is feasible). More likely it was just noise, but that’s a reminder that the small sample size provides lots of opportunity for luck to dominate the results. Even if we assume perfect measurement, there’s plenty of room for variation in lifestyles. Uncontrolled lifestyle changes, such as someone getting fired, could mess with the results enough to matter.
Book review: Lifespan: Why We Age – and Why We Don’t Have To, by David A. Sinclair.
A decade ago, the belief that aging could be cured was just barely starting to get attention from mainstream science, and the main arguments for a cure came from people with somewhat marginal formal credentials.
Now we have a book by an author who’s a co-chief editor of the scientific journal Aging. He’s the cofounder of 14 biotech companies (i.e. probably more than he’s had enough time to work for full time, so I’m guessing some companies are listing him as a cofounder more for prestige than for full-time work). He’s even respected enough by some supplement companies that they use his name, even after he sends them cease and desist letters.
I’m glad that Sinclair published a book that says aging can be cured, since there’s still a shortage of eminent scientists who are willing to take that position.
Book review: Black Death at the Golden Gate: The Race to Save America from the Bubonic Plague, by David K. Randall.
Imagine a story about an epidemic that reached San Francisco, after devastating parts of China. A few cases are detected, there’s uncertainty about how long it’s been spreading undetected, and a small number of worried public health officials try to mobilize the city to stop an imminent explosion of disease. Nobody knows how fast it’s spreading, and experts only have weak guesses about the mechanism of transmission. News media and politicians react by trying to suppress those nasty rumors which threaten the city’s economy.
Sounds too familiar?
The story is about a bubonic plague outbreak that started in 1900. It happens shortly after the dawn of the Great Sanitary Awakening, when the germ theory of disease is fairly controversial. A few experts in the new-fangled field of bacteriology have advanced the radical new claim that rats have some sort of connection to the spread of the plague, and one has proposed that the connection involves fleas transmitting the infection through bites. But the evidence isn’t yet strong enough to widely displace the standard hypothesis that the disease is caused by filth.
There was a vaccine for the bubonic plague, which maybe helped a bit. It was only 50% effective, the benefits lasted about 6 months, and the side effects sound like cruel and unusual punishment. It was controversial and often resisted, much like the compulsory smallpox vaccinations of the time.
Yet the plague didn’t seem to know that it was supposed to grow at exponential rates. That left an eerie sense of mystery about how the plague could linger for years, with people continuing to disagree about whether it existed.
Book review: The Driving Force, by Michael Crawford and David Marsh.
I read this book mainly to improve my understanding of what diets humans are adapted to. The book was mildly successful at that. Unfortunately, most of that improved understanding came from researching some suspicious parts of the book.
New infections have been declining at an almost adequate pace (10% per week?) in most parts of the US, and probably the rest of the developed world.
The overall reported new cases look more discouraging, for two reasons.
One reason is the increase in testing. I estimate that two months ago, a bit less than 10% of new infections were being confirmed by tests, and I estimate that now it’s above 20%, maybe getting close to 25%. That means that if the new infection rate were unchanged, we’d be seeing a roughly 10% per week increase in reported cases.
Nearly all parts of the country have done a good deal better than that.
I estimate the change in new infections since the early April peak by multiplying the early April confirmed daily cases by 10 or 12, and the June ones by 4 or 5, and I get a current rate that’s about 1/4 to 1/3 of the peak.
The bad news is that there are some heavily populated areas for which the trend doesn’t look very good over the past few weeks. When the rate of new infections remains constant in some areas, but declines at exponential rates in others, the exponential declines stop affecting the total numbers before too long. E.g. much of California has suppressed the pandemic, but a few cities, such as Los Angeles and Oakland, are enough to keep the state’s total count of new infections steady.
Elon Musk has gotten some well-deserved flack for predicting (in March) close to zero new infections in the U.S. by now.
Yet the focus on national or statewide infections has obscured a curious phenomenon: if he’d just predicted infections in Santa Clara county, he’d have been partly right – new cases peaked on April 10 at 83, were down to 23 on April 27, and appear to have dropped more since then (reporting may be incomplete for more recent days). (Santa Clara county roughly coincides with Silicon Valley; Tesla’s plants are a few miles from the Santa Clara county border, technically in Alameda county, but in most senses Tesla’s plants are part of Silicon Valley, which I’ll treat as a city, even though it’s more a city-less suburb).
Meanwhile, the statewide totals fail to show a trend of doing much more than stabilizing the rate of new cases. A good deal of that is due to Los Angeles.
What’s different between LA and Silicon Valley that would explain this difference?
It’s probably not much due to differences in government policy. California is using a mix of statewide rules and county rules, which makes it tricky to say whether there are policy differences. My impression is that most differences between county policies have relatively minor effects. I guessed that the most important difference would be in when they required facemasks use. Yet it looks like LA required facemasks on April 17, in synchrony with most of the bay area. But Santa Clara county differed by strongly urging, but not requiring, facemasks.
Maybe the reason that Santa Clara county didn’t create a formal facemask rule is that residents were sufficiently quick to adopt them that there was less need than in other counties? That fits my intuitions fairly well.
The LA area has been in the news for having crowded beaches. Outdoor activity in warm, sunny weather seems relatively low risk, but I doubt that the people on those beaches carefully evaluated the effects of ventilation, sun, and temperature on their risk, so it’s likely that the crowded beaches are at least a symptom of attitudes which cause the spread of infections.
I can see from Ohio that there are significant regional differences in people’s willingness to wear facemasks. I’m surprised that Ohio voters won’t put up with a rule to make them wear masks in order to enter stores. (Ohio’s Governor DeWine deserves much better constituents than he’s currently stuck with. Here in Berkeley, I get the impression that a majority decided that we needed to follow that rule before our government got around to announcing it).
Another relevant difference is that Silicon Valley workers switched to working from home more readily than most other places. This is likely a moderate factor, but I’d have expected a peak before April 10 if it explained more than half of Silicon Valley’s success.
Another influence might be blood types: type A blood creates higher risk of COVID-19, while type O lowers risk. Judging from the blood type differences between the U.S. and China, the large Chinese population in Silicon Valley ought to lower risk a bit.
LA’s apparently steady number of new cases can’t be very stable. People’s willingness to take precautions will decline at some point if herd immunity looks inevitable. Pushing in the other direction: increasing numbers of people will become immune, reducing the virus’ ability to spread. It seems almost impossible for these forces to balance out.
Robin Hanson sees a world polarized between regions that prevent infections and regions that get something like herd immunity. I expect that many regions, such as LA, will end up at various places in between, with maybe 10% of the population becoming immune. Since the people most likely get infected and to spread the virus will be over-represented in that fraction, it will put a sizable dent in R, enough to enable significant periods of suppression.
I mostly agree with Zvi here. The cost of restricting nearly all travel to commuting distance or less from home is much lower than the cost of the current drastic restrictions, so voters will typically demand a shift in that direction. My main concern is that these travel restrictions are getting lumped in with “lockdown measures” such as stay at home, and shut down “nonessential” businesses. That means that pressure to reopen activities that ought to be reopened could become pressure to remove most travel restrictions.
How many politicians will see beyond simple categories such as lockdowns versus reopening the economy, to pick and choose between the good and bad pieces of lockdowns? My impression is that at least half of the state and local politicians are on track to doing so, and have enough power to sidestep whatever problems exist at the federal level.
I sympathize with Musk’s desire to reopen Tesla plants, and it’s somewhat plausible that now is the right time for that. But I’m reluctant to side with him until he alters his tweets to be more narrowly targeted on specific, arguably safe, changes. I don’t want the world polarized between openers and closers.
I recently made a bet with Robin Hanson that US COVID-19 deaths will be less than 250,000 by Jan 1, 2022 (details hiding in these Facebook comments).
I gave a few hints here about my reasons for optimism (based on healthweather.us). I’ll add some more thoughts here, but won’t try to fully explain my intuitions. Note that these are more carefully thought out than my reasoning at the time of the bet, and the evidence has been steadily improving between then and now.
First, a quick sanity check. Metaculus has been estimating about 2 million deaths from COVID-19 worldwide this year. It also predicts that diagnosed cases will decline each quarter from this quarter through at least Q4 2020, and stabilize in Q1 2021 at 1/10 the rate of the current quarter, suggesting that most deaths will occur this year.
U.S. population is roughly 4% of the world, suggesting a bit over 80k deaths if the U.S. is fairly average. The U.S. looks about a factor of 5 worse than average as measured by currently confirmed deaths, but a bit of that is due to a few countries doing a poorer job of confirming the deaths that happen (Iran?), and more importantly, the Metaculus forecasts likely anticipate that countries such as India, Brazil, and Indonesia will eventually have a much higher fraction of the world’s deaths than is the case now. So I’m fairly comfortable with betting that the U.S. will end up well within a factor of 3 of the world per capita average.
I was about 75% confident in late March that R0 had dropped below 1, and my confidence has been slowly increasing since then.
Note a contrary opinion here. It appears to produce results that are slightly pessimistic, due to assuming that testing effort hasn’t increased.
Yet even if it’s currently a little bit above 1, there’s still a fair amount of reason for hope.
Many people have been talking as if strict shelter-in-place rules (lockdowns) are the main tools for keeping R0 < 1. That’s a misleading half-truth. Something like those rules may have been critical last month for generating quick coordination around some drastic and urgent changes. But the best longer-term strategies are less drastic and more effective.
One obstacle to lowering R0 is that hospitals are a source of infection. I’m pretty sure that will be solved, on a lousy schedule that’s unconnected with the lockdowns.
Within-home transmission likely has a significant effect on R0. Lockdowns didn’t cause any immediate drop in that transmission, but that transmission drops a good deal as the fraction of people who have been staying at home for 2+ weeks rises, so R0 is likely declining now due to that effect.
Most buildings that are open to the public should soon require good masks for anyone to enter. It wasn’t feasible to include such a rule in the initial lockdown orders, but there’s a steady move toward following that rule.
I expect those 3 changes to reduce R0 at least 20%, and probably more, between late March and late April.
Robin is right to be concerned about the competence of institutions that we relied on to prevent the pandemic. Yet I see modest reasons for optimism that the U.S. will mostly use different institutions for test and trace: Google, Apple, LabCorp, etc., and they’re moderately competent. Also, most institutions are more competent at handling problems which they recall vividly than they are at handling problems which have been insignificant in the lifetimes of most executives.
We can be pretty sure based on China’s results that R0 < 1 is not a narrow target. Wuhan got R0 lower than the key threshold by a factor of something like two. They did that in roughly the worst weather conditions – most of the time, warmer (or occasionally colder) weather will modestly reduce R0. So we’ll be able to survive a fair amount of incompetence.
But there’s still plenty of uncertainty about whether next week’s R0 will be just barely acceptable, or comfortably below 1.
The challenges of adapting to the most likely scenarios took nearly all of my attention in March. So I had no remaining slack to adequately prepare for a scenario that looked unlikely to me, but which looked likely to Robin. For one thing, I ought to have evaluated the possibility that money will be significantly more valuable to me if Robin wins the bet than if he loses.
It is certainly possible to imagine circumstances where deliberate coronavirus infection is quite valuable. But it looks rather low value in the scenario I think we’re in.
I don’t have much hope of getting a sensible program of deliberate infection in a society that couldn’t even stockpile facemasks in February.
I also see only a small chance that talking about deliberate infection now will help in a future pandemic. I expect this to be humanity’s last major natural pandemic (note: I’m too lazy today to evaluate the relevance of bioterrorist risks). I don’t know exactly how we’ll deal with future pandemics, but the current crisis is likely to speed up some approaches that could prevent a future virus from becoming a crisis. Some conjectures about what might be possible within a decade:
Still, I do think deliberate infection should be tried in a few places, in case the situation is as desperate as Robin believes. I’ll suggest Australia as a top choice. It has weather-related reasons for worrying that the peak will come in a few months. It has substantial tuberculosis vaccination, which may reduce the death rate among infected people by a large margin (see Correlation between universal BCG vaccination policy and reduced morbidity and mortality for COVID-19: an epidemiological study).
Note that tuberculosis vaccination looks a good deal more promising than deliberate infection, so it should be getting more attention.
Some of the concerns about a lasting economic slowdown are due to expectations that the restaurant industry will be shut down for years. I expect many other businesses to reopen within months with strict requirements that everyone wear masks, but it’s rather hard to eat while wearing a mask. So I see a large uncertainty about which year the restaurant business will return to normal. Yet I also don’t see people who used to rely on restaurants putting up with cooking at home for long. I see plenty of room for improvement in providing restaurant-like food to the home.
Current apps for delivery from restaurants seem like clumsy attempts to tack on a service as an afterthought. There’s plenty of room to redesign food preparation around home delivery, in ways that more efficiently and conveniently handle more of the volume that restaurants were handling before.
We have significant unemployment among restaurant workers, combined with food being hard to acquire for reasons which often boil down to labor shortages (combined with rules against price gouging). That’s not the kind of disruption that causes a lasting depression. The widespread opposition to price gouging is slowing down the adjustments a bit, but even so, it shouldn’t be long before the unemployed food service workers manage to become redeployed in whatever roles are appropriate to this year’s food preparation and delivery needs.
Finally, what should we think about this news: SuperCom Ships Coronavirus Quarantine Compliance Technology for Immediate Pilot?
Book review: Nutrient Power: Heal Your Biochemistry and Heal Your Brain, by William J. Walsh.
Nutrient Power is an eccentric book about nutritional problems and their effects on the brain. It’s full of information that’s somewhat at odds with conventional wisdom.
It’s a short book, and I wasn’t tempted to read all of it. I usually don’t review books unless I’m willing to read the whole thing, yet this time I can’t resist the temptation.
I expect that it’s important reading if you’re building your own model of how nutrition affects cognition, you’re frustrated about how little you’ve found in peer-reviewed publications, and you’re interested enough to treat this as something closer to a career than a hobby. If, like me, you’re less ambitious than that, you should expect to find at least parts of the book frustrating. And if you just want easy-to-follow or rigorously proven advice, this is definitely not the book you want.
I’ll guess that a bit more than half of the unusual ideas are correct and valuable, and that less than 10% of the others are harmful. Don’t expect it to be easy to distinguish the good ideas from the bad.
Some links to information sources that I’ve been using:
Food delivery is erratic in Berkeley. GoodEggs seems to have major food shortages, and maybe some labor shortages. Model Meals has been working almost as smoothly as normal, providing I place my order a day before their deadline – they are selling out of most things near their deadlines. I tried Instacart for the first time, and it seems substantially degraded by high demand – I had problems with getting 2 apples when I ordered 2 3-lb bags of apples (no that wasn’t listed as a substitution – the intentional substitutions worked fine). I’m guessing I’ll want to go back to shopping at grocery stores in person in a week or so. Infection rates are almost certainly dropping here now that the shelter-in-place rules have been around for a while, but it will likely be a week before much evidence confirms that.
I hiked in Briones Regional Park on Friday. I expect to see no more than 5 cars at the trailhead on a weekday; this time there were more than 30! People seemed unusually friendly. Most were making a decent effort to keep a 6 foot distance from me, but a few of the younger ones seemed to not care.
I think OPEC just collapsed, and nobody celebrated. I suppose the climate change implications might be a bit bad, but most effects will be pretty good.
Will auto sales be up or down a year from now? Loss of wealth will delay some purchases, and a fair number of existing drivers will drive less. But some people will switch from public transport to owning a car; others will switch from UberPool to UberX.
A modest number of maids will be replaced by Roombas [disclosure: I just bought stock in iRobot].
Politicians are talking about bailing out airlines, with terms that prevent them from stock buybacks. I expect that restriction to be purely symbolic – it will be a while before airlines are tempted to do buybacks anyway. If politicians were really upset about buybacks, they would instead deny the bailout to a single airline that was the most reckless in buybacks (maybe the one that achieved the worst debt to tangible equity ratio? I think that’s Delta). Alas, politicians won’t do that. After all, it might help people see that bailouts are somewhat targeted at helping bond and stock holders, and that the planes, workers, etc., don’t just vanish in the (somewhat unlikely) event that bankruptcy proceedings cause one company to shut down.
Some senators are under fire for insider trading on some sort of COVID-19 insights. If they profited from improved analysis of public information, I think that’s great! I’d like them to have an incentive to listen to experts. It would be suspicious if they profited from secret data, but I can’t find much reason to think that’s what happened – as far as I can tell, the relevant evidence was made public fairly quickly, and what mattered was competent evaluation of that evidence. And the most important question is what else they did to prepare. If, as the
news storytellers vaguely imply, they did little else to warn people, then either they were more confused than the reports suggest, or they were recklessly negligent.
Shutting borders can hurt:
One issue has been restrictions on travel intended to stem the spread of coronavirus, which has affected [U.S. ventilator maker] ResMed’s Singapore factory which employs many workers from neighbouring Malaysia. He said ResMed has appealed to the Malaysian government for an exemption so its workers can travel to Singapore.
Biomerica has a new COVID-19 test with some apparently nice features that differ from the common PCR-based tests. However:
Biomerica is positioned to begin filling large international orders of this disposable one-use tests within weeks, assuming international product shipping channels remain open and active.
In addition, Biomerica has begun the application process with the FDA under the COVID-19 Emergency Use Authorization (EUA), aimed at the possible clearance and eventual use of the test in the US. At this time, the product is not available for sale or use in the US.
And finally, some related entertainment about flattening the curve of armchair epidemiology.