Is it true that nicotine users contract Covid-19 less?

Hello,

Numerous case studies demonstrate this unequivocal : smokers who get Covid-19 have a risk greatly increased to develop severe forms of the disease. In this work, we find that the proportion of smokers is two to four times higher in severely ill patients than in those with a moderate form of the disease.

On the other hand, several publications relayed since the beginning of April report a counterintuitive phenomenon: in several countries, the proportion of smokers infected with SARS-CoV-2 would be lower than the proportion of smokers at regional or national level. The Minister of Health, Olivier Véran, recently mentioned this data.

In France, works being published conducted on a limited number of patients at the Pitié-Salpétrière, as well as a study in a school environment in Crépy-en-Valois (prepublished this April 23), also reported this statistical trend.

Many potential limits

Note now that the link between smoking status and propensity to be infected does not appear in all research. So in a recent study published in the Jama, involving 5,700 New York patients hospitalized for Covid-19, the proportion of smokers was analogous to that observed in the regional population.

The first studies were met with skepticism, not without reason. Indeed, many of these works have sometimes significant biases.

First limitation present in all studies (with the exception of French studies): the age parameter of hospitalized patients. Indeed, a significant proportion of patients with severe forms of Covid-19 are over the age of 65. The prevalence of smokers decreases very strongly with age (for example, in France, 65-75 year olds smoke 2.5 times less than the general population).

In the study conducted at Pitié-Salpêtrière, taking into account the age and sex of the patients, smokers nevertheless appeared to be four times less likely than non-smokers to be Covid +. A rate observed both in hospitalized patients and in patients treated on an outpatient basis. However, in order to draw more solid conclusions, these results should have been put into perspective with the smoking profile of patients who usually attend this hospital, at the same periods in previous years.

Another parameter that seems to be excluded from most analyzes: the socio-economic profile of the groups studied, which can strongly influence the expected proportion of smokers. A limitation mentioned by the authors of the French study, who established their calculations “Assuming that the population studied who lives in a limited area around a Parisian hospital has the same smoking habits as the French population in general”, and who note that “Healthcare workers were overrepresented in the outpatient group due to routine workplace testing when they became symptomatic”. The study conducted at Crépy-en-Valois seems to take this parameter into account. And its results are consistent with the Pitié Salpêtrière study.

Third important pitfall: the quality of the information collected is not always there … far from it. In some studies used by epidemiologists to conduct their analyzes, the smoking status of the sickest Covid + patients was simply not informed. Commentators have also noted that one of these studies considered individuals to be “non-smokers” less than 30 packages per year – preventing any comparison with national statistics which relate to all cigarette consumers.

For its part, the study conducted at Pitié-Salpêtrière seems to consider as “former smoker” any person who had quit smoking at the time of his hospitalization … without mentioning the hypothesis that patients may have stopped smoking because of the first Covid-19 symptoms! A point which would considerably influence the results. Requested by CheckNews, Zahir Amoura, author of this work, has not yet commented on this point.

Is the phenomenon biologically plausible?

The interpretation of these statistics, as well as the extent of the associated phenomenon, are still questionable.

Researchers, however, have begun to explore the hypothesis of a direct causal link between smoking status and primary SARS-CoV-2 infection. The question arises indeed: from a physiological point of view, is it plausible that lungs exposed to tobacco are less permeable to this coronavirus? Could nicotine be involved in the phenomenon?

A possible link with the ACE2 receiver?

SARS-CoV-2 infects cells by binding to the ACE2 receptor, abundant on the surface, in particular, the cells of the mucous membranes and the alveolar pulmonary tissue. The expression of the gene corresponding to ACE2 is not identical in smokers and in non-smokers. Based on animal models, smokers have long been considered to express less ACE2 – which suggests a simple explanation for the phenomenon: less ACE2 induces a lower propensity for infection.

But recent data, which seem to be corroborated by new researchsuggest that in humans, smoking is associated with a higher expression of ACE2. A higher propensity for coronavirus infection would therefore be expected. The epidemiological observations mentioned above, suggesting a protective effect of tobacco, would therefore raise a paradox.

Several explanatory hypotheses have been formulated. Some authors have advanced that in all patients, infection with SARS-CoV-2 would decrease the availability of ACE2 receptors in the lungs. The biological processes that usually mobilize these receptors would be hindered, leading to various symptoms of the disease. People with more ACE2, even if they were infected, would develop fewer symptoms. However, this interpretation is challenged by the Crépy-en-Valois study, where the diagnosis of infection was made on a blood test, and not on a simple clinical assessment of symptoms.

According to other works, the nAChR nicotinic receptor could modulate the activity of ACE2. Could stimulating nAChR make infection through ACE2 more difficult? This fact is not yet proven. “The possibility of a reciprocal modulation between ACE2 and the nicotinic receptor is an interesting scientific question for which we have no answer”, insists Professor Jean-Pierre Changeux, co-author of a scientific article inviting this hypothesis to be explored.

La Pitié-Salpêtrière has announced the launch of several clinical trials in this direction. The first, conducted on caregivers, aims to compare the infection rate between a group carrying nicotine patches and a group carrying placebos patches. More trials need to be done on Covid + patients in hospital to assess whether nicotine affects the course of the disease – especially in smokers who are forced to quit as a result of hospitalization.

Nicotine and vaping: preliminary data not very encouraging

The return of associations of electronic cigarette users does not seem to go in this direction, however. According to the analysis of a questionnaire sent in early April to several thousand members of the AIDUCE and SOVAPE associations, the rate of patients suspected of being Covid + was similar whether or not there was nicotine consumption – around 2.5 %. “Although it concerns nearly 10,000 people, this citizen survey is inconclusive on a major protective effect of nicotine, note the associations in a press release. The first data show no major positive or negative effect of vaping when faced with the risk of contracting Covid-19 for vapers and their entourage. ”

Tobaccoologist Bertrand Dautzenberg, who had encouraged these associations to explore this hypothesis, notes on Twitter that the data was not collected under conditions “Respecting all the obligations of scientific studies”. He nevertheless considers that they are not showing strong signs of a beneficial effect of nicotine in reducing Covid-19 levels. ” He invites an analysis of the Health Database to further explore this hypothesis.

No reason to start smoking

The tobacco specialist recalls “That tobacco certainly brings a negative effect greater than that of a small benefit which is not confirmed at all”. “This leads to encouraging all doctors to advise and support smoking cessation for all smokers.” The authors of the Crépy-en-Valois study abound in this sense, recalling that tobacco is responsible for 75,000 deaths per year in France. “Smoking cannot therefore be offered as a way of protecting oneself against the new coronavirus”, they insist.

Unsurprisingly, this finding is similar to that of the authors of a review on the complications of Covid-19 related to smoking. “Risk factors for severe forms of Covid-19 (pulmonary and cardiovascular disorders, diabetes, etc.) are more common in smokers. Smokers with comorbidities should quit smoking by all means. ” They also observe that confinement can lead to social isolation and psychological distress that increase the need for smoking. [En outre], smoking is more prevalent among the economically less advantaged groups, and they are potentially more at risk for Covid-19. ”

For its part, the association Alliance contre le tabac urged the greatest caution with regard to speculative information in circulation. In the absence of more evidence, nicotine users, “Should not expect to be more protected than the population from the current epidemic”, she recalls. In addition, she advises non-smokers to use nicotine substitutes. A warning also formulated by the promoters of the Pitié-Salpétrière study or by the Minister of Health.

In summary

Although well publicized, epidemiological observations associating smoking and the risk of developing the symptoms of Covid-19 are difficult to interpret at this time. Under the hypothesis of a real cause and effect link, the biological mechanisms mentioned in the press are still hypothetical. None have yet been formally tested.

Listen to the weekly behind the scenes podcast of CheckNews. This week: Covid-19: what are the real figures for deaths in intensive care?

Jérôme Salomon, the Director General of Health, mentioned a mortality of 10% in intensive care of patients hospitalized for Covid-19. In this episode, Luc Peillon explains why this figure is largely underestimated.


Florian Gouthière

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Atomic Veterans of America – NBC Connecticut

The enemy Hank Bolden
faced did not come from a distant front line.

It came from the skies.

It’s a battle that’s still going on 65 years later. Bolden, who is now 82 years old, is an atomic veteran – one of hundreds of thousands of American service members used in human testing by the United States government during post-WWII nuclear tests and sworn to a secret life.

“They wanted to see how the living soldiers would resist the exposure
to radiation, ”recalls Bolden. “Before using live soldiers they were using
mannequins. But you don’t get real results using mannequins as you would
live bodies. “


A DIFFERENT TIME

While accompanying a friend to a New Haven recruiting station in 1953, Bolden was invited to join the army. At just 16 years old then and already out of high school, he admits that he “pulled down” his birth certificate to move to the age of 18, joining the approximately 200,000 underage soldiers who would have served during the Second World War and the eras of the Korean War.

After basic training in
Fort Dix was assigned to work as a tank mechanic in Texas before moving to Texas
California and becoming a surface-to-air missile mechanic.

Despite an executive order issued in July
26, 1948, by President Harry S. Truman to desegregate the armed forces, the last one
the all black units of the army were not abolished until 1954. And in 1955, Bolden
he says, racist attitudes persist even after the units have been racially integrated.

“The residual thoughts of people were firm
linger, “he says.” My outfit was 800 people strong. Thirteen of us were
black. Ten were from the South, who were more tolerant of treatment
they got racially. But the three of us from the North couldn’t tolerate it,
so I have had many fights over this. So I was the guy they wanted
get rid of.”

It would not be the only race
discrimination Bolden would witness as a soldier.


SECRET
ASSIGNMENT

In 1955, the seventeen year old
he was suddenly ordered to the Nevada desert without explanation.

“They don’t tell you what you’re going to face,” he said. “Nobody
they knew what they were going to face. ”

What he would eventually face was a classified operation known as Operation Teapot at the Nevada Test Site. In a series of 14 bomb throws, or “hits”, military officials tried to test the effects of nuclear bombs on structures and strategies, animals and people.

All races of military personnel
participated in the Teapot operation. But upon arrival in Nevada, Bolden was
astounded to accomplish all the other soldiers in his new specially selected unit
for a mysterious assignment they were also black.

“There was this myth about black people
be able to resist, tolerate certain things more than any other race “, he
He says. “So it was a test on that too.”


AN ATOMIC NIGHT

One morning in February, Bolden
the unit was ordered in a desert trench. Unbeknownst to them, it was excavated
the expected route of the fallout, only 2.8 miles away from what it would have become
ground zero for the launch of an atomic bomb.

Even though a countdown sounded on the speakers, Bolden says, the soldiers still had no idea what they were about to face. Without protective gear in addition to the normal fabrics and helmets, they waited and looked.

“They tell you to cover your eyes”
he says.

On February 18, 1955, Shot Wasp, the first nuclear test of Operation Teapot, detonated a Mark 6 nuclear bomb dropped by a B-36 exactly at noon. A monstrous cloud of mushrooms filled the sky, reaching 21,500 feet in height.

“With radiation, when you put your arms over your eyes or hands, you actually see the bones, you see the bones in your body from the exposure. You can see your skeleton. “

After the relapse the warning came.

“You swore not to speak
“said Bolden. The soldiers were threatened with imprisonment and fines for violation
The oath.

For 60 years, Bolden didn’t tell anyone. No this
family, not his wife, not his children. Not even her doctors when she spies on her
tumors have started to show. He developed bladder and posterior subcapsular cancer
cataract and in 1990 multiple myeloma was diagnosed.

“They actually gave me three and a half years
four years to live, ”recalls Bolden.
So in 1995 I should have been a statistic. “

But in 1995, Bolden was in remission. He is a citizen
the secret was coming to light.


HIDDEN STORY

Government figures estimate between 400,000 and 550,000 US military personnel who participated in a series of nuclear tests between 1946 and 1992. According to the Department of Defense’s Defense Threat Reduction Agency, this includes post occupation forces -Second World War of Hiroshima and Nagasaki, prisoners of war in Japan at the end of the Second World War, participants in the atmospheric nuclear tests in Nevada and the Pacific from 1945 to 1962 and participants in the underground nuclear tests in Nevada from 1951 to 1992.

Many of these “atomic veterans” have succumbed before their own
the stories have become public, their bodies are full of tumors. In
1990, the veil of secrecy began to lift.

After setting up the Advisory Committee on Human Radiation Experiments to investigate 10-year experiments, President Clinton made a formal apology to American atomic veterans on October 3, 1995. By order of the president, Congress would repeal the nuclear radiation agreement law. and secrecy, allowing atomic veterans to talk about their experiences without fear of fines or treason charges. And financial compensation has been opened to all qualified atomic veterans.

“Those who led the government when these decisions were made are no longer here to take responsibility for what they have done. They are not here to apologize to survivors, family members or their communities whose lives have been overshadowed by shadow of these choices So today, on behalf of another generation of American leaders and another generation of American citizens, the United States of America offers sincere apologies to those of our citizens who have undergone these experiments. the government is wrong, we have a moral responsibility to admit it, “said President Bill Clinton on October 3, 1995

But the television address has been obscured. The same happened
day when OJ Simpson’s verdict was issued in a live classroom feed, taking
on televisions and news cycles across America.

As a result, many skilled veterans had no idea of ​​the ban
the secrecy had been lifted, nor that they could claim benefits. Bolden no
find out until he researched the Internet, he says, in 2015.

“I was once so angry and so aggravating with the government that I thought I would be murdered to keep me from talking,” he says.

When Bolden attempted to apply for subsidies, he found that the burden of proof was placed on his fellow atomic veterans. The government would give compensation from the date a complaint was filed, but not retroactively, and only if the veteran could prove that he had participated in the tests – which proved to be an almost impossible task after millions of military documents were destroyed in a 1973 fire against the National Staff Registration Center. As many as 18 million documents were burned, including 80% of all army personnel discharged between 1912 and 1960.

“They hoped for it
would have died sooner or would have been one of those guys who surrendered ”
says Anthony Bolden, Hank’s son. “No thanks. Hank doesn’t have it.”

After paying her
own pocket for a polygraph lie detector pouch, Hank eventually claimed
approved, setting a precedent for other atomic veterans whose records were
destroyed.

Photo: Hidden story: the atomic veterans of America

Hit a high note

“The love of music has
I’ve always been there. “

After his honorable discharge
from the army, Bolden went to work as an engineer before deciding to pursue a
career as a jazz musician who works while his family grows. Tell the story
while cradling the tenor saxophone that has been at his side since 1967. The “Rolls
Royce “of tools, he says.

The brand is Selmer. IS
in a strange coincidence, the model is a 6 sign. It is the same name as the shot
Wasp atomic bomb design.

But this is where the
the similarities end. The bomb was his nightmare. Music, his dream and his
outlet to work through the trauma of what lived in Nevada
desert.

“It’s like the blood inside
my veins. It takes away all my other thoughts, “he says

Bolden is finally
he receives compensation from the government and is now using it to help make his dream come true.
He returned to school, studying jazz performances at Hartt University of Hartford
School.

“They are like the relic
here with all these kids, you know, “he chuckles.

Professor Javon Jackson
says that the 82-year-old is leaving a unique mark on the prestigious program.

“He has a lot of emotion,” says Jackson. “He is a very bluesy, very full of feeling, a natural player. His life, wisdom and the things he has acquired allow him to play the way it sounds.”

LIVING HISTORY

The vast majority of
Today, the American atomic veterans of the atmospheric test era are gone. About
400,000 veterans were present during these tests, according to the veterans
Administration. Survivors’ numbers vary, from around 10,000 to 80,000
still alive.

Bolden believes he is one of only two surviving African American atomic veterans who are recognized and receive compensation from the government. He is on a mission to reach as many survivors as possible and help them request the long-awaited recognition and compensation.

And he’s sharing his story, he says, to make sure the plight of American atomic veterans is no longer ignored.

“When people like me pass by, this won’t be part of the story unless someone makes sure it’s kept alive.”

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An MIT study finds no statistical evidence of fraud in Bolivia’s elections | International

A study by electoral integrity specialists Jack Williams and John Curiel of the MIT Election Data and Science Lab has concluded that “there is no statistical evidence of fraud” in the presidential elections last October in Bolivia, which gave former president Evo as winner Morales. Due to military pressures, the Bolivian leader left office. Scholars rate the conclusions of the report published by the Organization of American States (OAS) last November as “deeply flawed,” as they wrote in an article published Thursday in The Washington Post and remember that the Latin American country is preparing for new elections on May 3 “after the coup d’etat backed by the Army” on November 10.

The regional agency document, which reported burned minutes, redirection of votes to hidden servers and duplicate names, accused that when the count was resumed after a suspension of the Preliminary Results Transmission System (TREP), they showed a “highly” trend. unlikely “in favor of the candidate of the Movement for Socialism (MAS). However, research by MIT specialists has revealed that there does not appear to be a “statistically significant” difference in the margin between the results before and after the transmission stop.

“Instead, it is very likely that Morales has exceeded the margin of 10 percentage points in the first round,” they say in the Post. According to the Bolivian Constitution, a candidate wins presidential elections when he obtains an absolute majority or 40% of the votes, with at least a 10 percentage point advantage over the second candidate. If this is not the case, a second round is made.

The preliminary counting of the votes stopped with about 84% of the votes counted, when Morales had an advantage of 7.87 percentage points, according to the study. When counting resumed, Morales’ margin exceeded the second most voted candidate, former president Carlos Mesa, by more than 10 points. The audit report commissioned by the OAS – with the consent of Bolivia – determined that “an irregularity on that scale is a determining factor in the outcome” in favor of Morales. In addition, that “manipulations” and “irregularities” prevented knowing with certainty the margin between Morales and Mesa. “What is possible to say is that there have been a series of malicious operations aimed at altering the will expressed at the polls,” he concluded.

“Was there a discontinuity between the votes counted before and after the unofficial count? Of course, discontinuities can be evidence of manipulation, ”said Williams and Curiel, but based only on“ evidence of statistics ”they have not found the“ anomalies ”that the OAS accuses in the voter trend. In the study commissioned by the Center for Economic and Political Research (CEPR) they found a correlation of 0.946 between Morales’ margin between the results before and after the suspension of the vote count. This correlation discredits the report of the regional body, which dated that the last 5% of the votes presented a different trend from the previous 95%. “The statistical analysis carried out reveals that Evo Morales’ first-round victory was statistically unlikely.”

When the result was revealed with 95% of the minutes scrutinized, the OAS made a statement revealing its concern about “the change in trend.” Once all the votes were counted, the result gave Morales an advantage of 10.6% over Mesa. Protests in the street, the shadow of irregularities and pressure from the Armed Forces, forced the Bolivian president to leave office. The Bolivian leader published on Thursday the article of Post affirming that the OAS, its president Luis Almagro and the commission responsible for auditing the results of the elections “owe many explanations to the Bolivian people and the entire world.” Almagro has said that “the only coup d’etat in Bolivia” happened when Morales “committed electoral fraud.”

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Hollywood, not a boulevard for women

When it comes to equality between men and women, we may well think what we want from the taste of Hollywood and its democratic gotha ​​for preach-preach activism. At its best, the documentary produced by Geena Davis (forever the gunsling tough Thelma and Louise, but also the founder of a statistical institute on gender disparities in the media) reminds us that it would be difficult to find a more frontal voluntarism in the matter. Were it likely to hurt beliefs in force in the country of cultural exception.

We learn in particular that in the 80s (!), A group of six female directors, exhausted victims of unemployment, prided themselves on suing the majors for discrimination at work, and made gender equality in the cinema a stake in the fight for civil liberties. (It smells like a biopic project, or we don’t know anything about it.) Nor will we take away from the Americans their know-how in terms of documentary didacticism and display of hypercommunicative conviction: panel of eloquent heroines (from Meryl Streep to Cate Blanchett, via the activist Tarana Burke at the origin of #MeToo, among other more anonymous figures), speeches chopped to keep only the punchlines, sense of the cheerful demonstration which makes the enthusiasm get carried away, music in every corner. Starting from the downstream – the representation of women in films -, Everything can change begins by examining the gendered myths of American cinema, before going backwards on the upstream side of manufacturing. Who embraces too badly embraces, we say unfortunately when discursive side roads end up amalgamating all the symptoms of discrimination in a same mixture of indignation, where the exactions of Harvey Weinstein rub shoulders with the question of the quotas of scriptwriters and the gravelly exits from Donald Trump.

Nevertheless, the objectification of inequalities by the figures gives an unstoppable force to the film, moreover marked by two biases: the fight is on the level of legal action, and the cinema, defrocked with the aura of work dear to our countries, is only apprehended as an object of mass communication, a vector of messages capable of lastingly informing psyches – the striking force of the dream factory thus implies great responsibilities. What to wish for more complexity than what the film presents of the debate in a limpid and unequivocal light, but also to make one strangle a little more the counter-revolutionaries who quickly made see in the movement of redistribution of the powers started l advent of a feminist dictatorship. Too bad for them.


Sandra Onana

Everything can change: what if women counted in Hollywood? of Tom donahue 1 h 35.

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