STATES OF DISEASE
“States vs. Health,” by the Editors [Science Agenda], explains how politicians in several states are trying to prevent the lifesaving work that public health officials are executing to protect the population by requiring masking and physical distancing.
I agree with the presentation of the article and the position that the Editors take on the importance of letting science and good medical practice lead the way to deal with the devastating effects that the COVID pandemic is having in the U.S. and throughout the world. When state legislatures pass laws that take control of public health and safety measures away from local agencies, as the article exposes, the entire population is at risk of contamination and the spread of the virus that causes COVID.
In the piece, Georges Benjamin, executive director of the American Public Health Association, is eloquent in describing how the health strategies being applied by the public health agencies have been proved to be effective for hundreds of years and how what some state legislatures are doing is “equivalent to taking away the ability of doctors to write prescriptions.”
I congratulate Scientific American for publishing this article and invite the readers to reflect on and support the science and public health strategies that have protected lives from many viruses, including the present one, and to avoid the intrusion of politics in this essential and life-threatening matter.
EMMANUEL PADIN Clermont, Fla.
“Vapor Storms,” by Jennifer A. Francis, describes how increased moisture in a warmer atmosphere is fueling intense hurricanes and flooding rains. Reading the article reminded me of an experience I had camping on the eastern edge of Lake Superior, probably 35 years ago.
That October I was sitting on the shore late in the afternoon. The sky was cloudless several hundred meters offshore, with a breeze blowing in from the lake. The sky above the shore was overcast, tending toward drizzle.
This pattern stayed constant for the hour or so I watched; the clouds were forming over that short distance. Watching weather change over such a small area gave me some appreciation for how difficult climate modeling has to be.
ERICK ERICKSON South Orange, N.J.
“IPCC, Your Job Is Partly Done,” by Naomi Oreskes [Observatory], argues that the Intergovernmental Panel on Climate Change (IPCC) has fully established the “physical science basis” of climate change and should now focus entirely on analyzing its impacts and potential ways to stop it.
I wonder if Oreskes has heard of the University of Victoria professor Andrew Weaver’s recent comment that limiting warming to 1.5 degrees Celsius is now impossible. Weaver, whose Ph.D. is in applied mathematics, has numerous accomplishments, including more than 200 published scientific works and a period as leader of the provincial Green Party here in British Columbia. But most pertinent to his comment is that he was a lead author in several of the IPCC’s past assessment reports. I was thus somewhat surprised that he was publicly rebuked by those offended by his assertion.
I happened to hear Weaver interviewed on the CBC, and he clarified that his intention was not to advocate abandonment of the goal of limiting warming as much as possible. Rather it was to recognize that we have passed a point where, if we were to fix levels of greenhouse gases today, we would still see average global temperatures rise by more than 1.5 degrees C.
My observation is that, so far, the public has been somewhat lulled by the nature of scientific statements. That is, science is cautious; science does not practice hyperbole even when it may be necessary from a social perspective. All the projections of climate change I have seen appear to be underestimates of the severity of this accelerating crisis. It may be more in the interest of the greater good to speak plainly.
This dovetails with Oreskes’s suggestion that the IPCC’s working group on climate change’s physical science basis should be wrapped up and that the organization’s focus should be directed to its working groups devoted to impacts and mitigation. I would add that the urgency be emphasized by all possible means.
RICHARD “DICK” FAHLMAN Tla’amin Nation, British Columbia
THE PROBLEM WITH PAINKILLERS
In “Painkiller Risks” [The Science of Health], Claudia Wallis discusses the downsides of high doses of analgesics, including kidney damage from nonsteroidal anti-inflammatory drugs (NSAIDs). I find it lacking, though, that she does not expand on the connection between over-the-counter painkillers and kidney issues other than a brief mention of potential adverse use of NSAIDs during pregnancy.
Long before the current opioid crisis, the scientific community and literature knew of the dangers of NSAIDs and acetaminophen (Tylenol). NSAIDs have been clearly associated with damage to kidneys, and there is evidence that high doses of acetaminophen can harm them as well. In 1994 the New England Journal of Medicine published a study entitled “Risk of Kidney Failure Associated with the Use of Acetaminophen, Aspirin, and Nonsteroidal Antiinflammatory Drugs.” This 27-year-old paper estimated that up to approximately 10 percent of the incidence of end-stage renal disease (ESRD), or kidney failure, could be the result of long-term acetaminophen use and that such use of the drug could be responsible for up to $700 million (in 1994 dollars) in annual ESRD-related medical costs.
I applaud Wallis for highlighting the overall risk of acetaminophen toward the end of her article: She quotes pain researcher and professor of medicine Erin Krebs as noting the drug “is very safe up to a certain threshold, and above that line it is very hazardous.” Wallis then adds that the same researcher “says it’s ‘crazy’ that the drug is present in more than 600 products,” which “makes it all too easy to go overboard.”
I believe all products that contain acetaminophen or NSAIDs should require warning labels regarding potential damage to kidneys.
DAVID ROGERS Northport, N.Y.
“Overcoming Gene Therapy’s Long Shadow,” by Tanya Lewis [Innovations In: Gene Therapy], did not give Mark Batshaw’s current affiliation. He is now a developmental pediatrician at Children’s National Hospital in Washington, D.C.
“The Power of Agroecology,” by Raj Patel, should have described the small Malawian town of Ekwendeni, not “Ekwendi.”
“Painkiller Risks,” by Claudia Wallis [The Science of Health], incorrectly describes acetaminophen poisoning as the most common reason people need a liver transplant in the U.S. It is the most common reason for acute liver failure, a condition that leads to about 6 percent of all liver transplants in the country.
“IPCC, Your Job Is Partly Done,” by Naomi Oreskes [Observatory], should have given the organization’s full name as the Intergovernmental Panel on Climate Change, not the “International Panel on Climate Change.”