Health, Evolution & Human Physiology

https://twitter.com/PeterKolchinsky/status/1240498037958545410

Anti-vaxxers would tell you that it causes horrors. Some people would get diagnosed with, let’s say, MS or cancer a few days after they got the vaccine simply because that happens to some people by chance at random... it’s a coincidence but anti-vaxxers would blame the vaccine.

It won’t be true and data will show its not true, but that won’t matter, because many people will think “why risk it, I’ll get over a cold”. Investors look at all this and see a multi-billion dollar sinkhole of risk that will probably be as unrewarding as the Lyme vaccine GSK developed, launched, & pulled off the market after a few years for same reasons I just listed. (And we really need a Lyme vaccine b/c ticks are spreading & carry a host of horrors. But that’s a slower, quieter pandemic we can talk about another time.)

But Covid is different. It’s serious, more so than the flu. So we’ll develop a vaccine for it just as we have for the flu and dog/cow coronaviruses. It might cost a few billion dollars across a dozen different programs, but there will be a market.

Just as Sanofi, GSK, & several others companies compete on price & still make billions each year supplying the world with a constantly evolving yet affordable flu vaccine (usually $10-20), similarly industry can develop & supply world w/ a covid vaccine.

Maybe even mix it w/ annual flu shot for convenience. — By the way, I’ve heard people say that industry doesn’t even care to make a universal flu vaccine. That’s also not true. There have long been efforts and investors willing to fund credible projects, but this is really hard.

Despite decades of failure, there are still biotech companies toiling on a universal flu vaccine (would protect us against most strains w/ one shot every 5-10 years). It’s hard, yet I think doable. By comparison, covid is simple. It definitely ain’t herpes (simplex is misnomer).

Covid is so technically doable we already have vaccines for dog & cow coronaviruses. We’ll definitely make one for covid, trials will be simple since we’ll be specifically trying to prevent Covid, which is only caused by SARS-CoV-2 (not by dozen different viruses), and...

insurance will pay for it just as it pays for the flu vaccine, in many cases without a copay. For those without insurance (shame on us, America!), there are free flu shot clinics. Google “free flu shot near me”. Similarly, there will be affordable covid vaccines for everyone...

because this is a serious public health problem. America can be heartless in its poor coverage of many medicines, eg insulin (I wrote a book about drug affordability and how to fix our system) but America is pretty good about making vaccines affordable.

Btw, if you’re interested in learning more about the drug industry, why medicines aren’t affordable for some, & what we need to change to make innovation work for all, then do read my book. You’ll never see healthcare the same.

I’ll leave you with following insight from flu & what it means for covid vaccine development. Vaccine is like a mugshot of criminal you show to police so they know who to look out for. As we get older, our immune systems become weaker & vaccines don’t work as well.

You show our immune systems the mugshot, & it doesn’t react very strongly. Biotech industry is working on vaccines that compensate, essentially illuminating better mugshots so more immune cells notice them. We’ll need that advanced technology for covid since it’s hell on elderly.

I should add that when I say “investors” have been hesitant to invest in common cold vaccine, I don’t mean just billionaires. I mean people who manage money on behalf of pension funds, endowments; eg ordinary Americans rely on mutual funds not to make unprofitable investments.

It would be wrong for fund managers to fund development of drug they know will be a commercial flop b/c America isn’t willing to pay for it. You can donate to such a cause, & gov can fund it w/taxes (eg Barda) but investment professionals can’t waste people’s savings on it.

That’s key reason we don’t have more antibiotics. Current ones work so well there is only a small (terrifying though) need for new ones, & hospitals resist paying high price for the few patients who need them. Small market, small incentive, little investment, few new antibiotics.

Matthew Walker's "Why We Sleep" Is Riddled with Scientific and Factual Errors

  • No, shorter sleep does not imply shorter life span

  • No, sleeping less than 6 hours a night does not double your risk of cancer

  • No, a good night’s sleep is not always beneficial: sleep deprivation therapy in depression

  • No, lack of sleep will not outright kill you

  • No, the World Health Organization never declared a sleep loss epidemic

  • No, two-thirds of adults in developed nations do not fail to obtain the recommended amount of sleep

  • People who sleep just 6 hours a day might have the lowest mortality

Save 12 hours A Week Sleeping + 4 Tips On How To Fall Asleep Fast

Everyman 1 (E1)

  • 20 minute nap after work

  • 6 hours of sleep at night

  • 12 hours extra per week, and a bit of flexibility on when we nap

How to fall asleep quickly

  • Have a before sleep routine and don’t break it

  • Stick to similar hours for sleep, always set alarms, stick to similar on weekends. Especially for first 3 weeks

  • Mandy’s tip: focus on breathing to prevent you from thinking

  • Best Tip: Quickly find a position to sleep in, close your eyes, don’t move, don’t open your eyes, just wait

Missed nap -> extra 90 minutes the next day.

The Evolutionary Theory of Depression

In the functional model of depression, hyperactivity in the limbic area (the amygdala, hippocampus, anterior cingulate cortex) is not sufficiently controlled by the medial cortex of the frontal lobe in response to emotional stimuli of a negative charge. On the other hand, positive stimuli cause excessive inhibition in the frontal cortex.

In depressed subjects, the hippocampus (responsible for memory and learning) is smaller and shrinking with time.

In depressed subjects, the amygdala (responsible for associating emotions and physiological/behavioural response to stimuli) is overactive in case of negative stimulus, while the frontal lobes are inhibited. In case of positive stimulus, the amygdala is inhibited.

Such neurobiological changes can result from chronic cortisol activation, which increases atrophy of certain brain regions such as the prefrontal cortex and the hippocampus, hence affecting the ability of blocking negative emotions. The presence of ruminations in patients with depression is also linked with the dysregulation of cortisol secretion. In patients with a tendency to dwelling on unpleasant events, the level of cortisol was higher than in a comparative group of healthy people and among people with diagnosed depression who did not mention any rumination.