Pandemic prompts more focus on junk foods, shots, domestic abuse, booze

candymexico-300x169Stepped up vaccinations, bans on junk food for kids, worries about domestic abuse and booze consumption by men — yes, these seemingly disparate things have something in common. They’re all getting heightened attention from experts due to the coronavirus pandemic.

Let’s start with a grito (a whoop) for the leyes antichatarra or anti-junk food laws targeting youngsters and spreading across states in Mexico. The laws take aim at high calorie, low nutritional value foods and drinks, the Washington Post reported:

“[They would prohibit the sale of] chips, candy, soda and other sugar-sweetened beverages to children under 18, putting these foods in the same category as cigarettes and alcohol. The law[s establish] fines, store closures and jail time for repeat offenders. The ban also applies to vending machines in schools.”

Lawmakers have approved ambitious nutrition measures in Oaxaca, Tabasco, and at least 10 states, as well as in Mexico City, the newspaper reported. The junk-food bans build on Mexico’s previous efforts to deal both with the huge national problem of obesity, particularly through sugary drinks like sodas.

But officials also have cited Covid-19 as a compelling reason for Mexicans to take far more action to improve their health and protect themselves from carrying excess weight — an underlying condition that researchers say significantly increases patients’ risks if infected with the novel coronavirus.

The disease has ravaged Mexico, infecting more than 500,000 people and killing almost 60,000 — a toll likely undercounted. Mexico lags only the U.S. and Brazil in the severity of its coronavirus public health crisis, and the nation struggles with a weak health system and its people’s huge mistrust of its quality and safety.

Even as experts in Mexico, as they have elsewhere, have urged people to be meticulous about their hygiene, wear face coverings, keep appropriate distances, and avoid crowded and closed spaces, Mexicans general health condition also has become a hot topic. As the Washington Post reported:

“73% of Mexicans are considered overweight, 34% morbidly obese, according to an Organization for Economic Co-operation and Development study published in January. Oaxaca, one of the country’s poorest states [and one that has passed an anti-junk food measure affecting its kids], has one of the highest levels of obesity, according to a 2019 Mexican National Health and Nutrition Survey. Indigenous communities are exposed through predatory marketing practices and through the cheaper pricing of ultra-processed foods.”

The newspaper noted that the sugary drink and junk food bans are part of a focus across Latin America on improving health:

“In recent years, Latin American countries have been in the vanguard of efforts to tax or regulate sugary beverages and junk foods. In Chile, the Senate passed strict food labeling laws. Mexico imposed a tax on sugary drinks and junk food, and Brazil opted for voluntary measures, such as rewriting its dietary guidelines with clear and forceful language about proper diet, that have proved effective. Barry Popkin, an obesity researcher at the School of Public Health at the University of North Carolina at Chapel Hill, says Colombia and Brazil are pushing to pass laws requiring food warning labeling.”

Agricultural and processed food interests apparently were caught off guard by Mexican lawmakers’ swift action on junk-food measures, and they have begun to fight back. Nutrition and public health experts say they will watch closely to see if the pandemic keeps boosting

Mexican reformers’ movement against foodstuffs with sketchy health value for youngsters. Will it also spread north?

cdcshot-300x199A booster for fall vaccinations

U.S. officials have tweaked the rules so licensed pharmacists nationwide may “administer all scheduled shots to children as young as 3, including the flu vaccine, a step that makes immunization more convenient for parents,” the New York Times reported.

The newspaper also noted that for patients older than 65, the annual flu vaccine will target four rather than three strains of the debilitating and deadly viral infection. That’s because, the newspaper said, “the conventional flu vaccine can be less successful in older people[ and] an enhanced shot to boost their immune system has been offered in recent years and this one is stronger than ever.”

With the novel coronavirus raging unchecked nationwide, public officials hope that aggressive vaccination against a range of familiar infections this fall will help keep the U.S. health system from seeing crushing caseloads of patients with seasonal and preventable illnesses, most notably the flu.

The flu can infect 45 million Americans in a typical season, leading to as many as 810,000 hospitalizations, and more than 60,000 deaths. Measles had been controlled but has burst out in recent times, leading to as many as 4 million cases, with 500,000 reported diagnoses, 48,000 hospitalizations, and 500 deaths.

Pediatricians have expressed big concern that coronavirus infection fears have caused parents to postpone regular medical checks for their children, also sending routine vaccination rates plunging. The medical specialists say they have taken precautions to minimize the Covid-19 risks for young patients and their parents. But they haven’t raced to return to their practices.

The pediatricians said that stepped up vaccinations for the young, ages 3 to 18, at pharmacies could be a beneficial step overall. But they emphasized that the convenience of this option does not address youngsters’ need for the sustained care and attention that pediatricians are trained to provide. Pharmacists cannot, for example, weigh in on youngsters’ wellness, nor can they advise parents if kids are developing according to norms. Pharmacists cannot detect or treat illnesses or conditions, as pediatricians can.

As for older patients and the prospect of a more robust flu shot, its timing may be a slight issue. It can take patients weeks after inoculation for their bodies to develop the infection protections prompted by a vaccine. Though officials are pushing Americans to get vaccinated and to do so early (Massachusetts has gotten ahead of the crowd and decided that flu shots will be mandatory by year’s end for young people wanting to attend schools), patients may want to target mid-October to mid-November as the period for their flu shot to ensure it gives them optimal and sustained protection.

With so many people focusing on hygiene, face covering, distancing, and sticking around the house, infectious diseases like flu, pneumonia, measles, and others may not see outbreaks at their traditional and seasonal levels. Many workers won’t be stampeding back to offices after Labor Day. Schools and universities are trending toward online and not in-person classes. Sporting, cultural, and entertainment events continue to be online, in limbo, or canceled.

Although less than half of Americans get a seasonal flu shot (or jab, as the British call it), this may be the year to overcome the hoary myths and objections about vaccines. The inoculation cannot give you the flu. It varies in its effectiveness in preventing the disease, but it has been shown to lessen the infection if you get it. It often is covered by health insurance or given at low cost, including for free at many workplaces and through schools and public health clinics. As with any medical intervention, inoculations carry risks. These are far outweighed by their benefits.

boozer-225x300Worries about men’s drinking and domestic abuse

Here are two datapoints that formally are not connected but which common sense can’t help but tie together, even a bit:

  1. Experts want to roll back the recommended alcohol consumption by men to not more than one (not two) drinks per day. They say the guidelines should be stricter, not only due to the steady rise in booze abuse by Americans but also because of increasing worry about excess drinking by guys with lives constrained due to the coronavirus pandemic.
  2. Concerned specialists warn that domestic violence cases may be spiking during the pandemic, with unhappy partners inflicting ever more serious harms on their intimates during outbursts that may be going un- or under-reported. As reports of child abuse plummet, experts also fear that harms to youngsters also may be drastically under reported, too.

The latest edition of the federal Dietary Guidelines for Americans, including with the advice for less drinking by men, is not formal yet and will not become U.S. government policy for a while. The experts are weighing in at this point, and they, as always, are battling about the best evidence for the national advisories on how people should eat and drink in the most healthful ways.

Too much of nutrition, however, cannot be powered by rigorous science, as critics have noted. It would be a formidable if not impossible undertaking to try to isolate how one given factor, like a glass of booze, weighs against many others in determining individuals’ or groups’ well-being. Clinical trials with human subjects and involving food and drink might be prohibitive in cost or logistics. With alcohol, experts battle over associations and links — not tough evidence.

Still, a rollback in men’s recommended daily drinking may send an important signal that experts may be less inclined to buy into the argument that low levels of alcohol consumption may be beneficial for all or most of us. There is ample reason, too, to look at excess drinking and alcohol abuse and their health harms to see why the official view of boozing might need to be conservative to a fault.

Common sense, experience, and research argues, separately, that abuse of substances, including alcohol, often can be an aggravating and significant factor in domestic abuse and child abuse.

As the pandemic has raged, joblessness and economic worries have soared, purchases of booze and other legalized intoxicants have risen, and men, women, and children have experienced greater isolation and extreme stress, is it a surprise that violence — notably of the domestic kind — has worsened, including in the severity of its injuries.

Not good. In my practice, I see not only the harms that patients suffer while seeking medical services, but also the high value they can experience by staying as healthy as they can — and outside of the U.S. health care system. That system had its big problems before the pandemic, including with infections acquired in care giving institutions (hospitals and nursing homes), misdiagnoses, and medical errors — the third leading cause of death in the nation, by some expert estimates.

That said, we need to protect and improve the health system more than ever, notably with big support for public health and medicine based in science and evidence.

With the federal pandemic response becoming more shambolic by the moment, Americans, alas, have been left more than ever on their own to safeguard their own health and the well-being of their loved ones and communities. As leaders outside the White House are urging us, we need to be better, do better, and to rebuild the world after Covid-19 into a better place.

That means, for now, that we need to be meticulous with hygiene, face covering, distancing, and avoiding crowded and closed spaces. We should hang out close to home and not hit bars, casinos, and parties. We can exercise, eat more healthfully, and aim to lose that excess weight. We can get the recommended shots for ourselves and those we love — young and old. The occasional quarantini may be OK. But we all can think hard about use and abuse of intoxicants of all kinds — and no drinking, dope smoking, or pill popping while driving, please. We also can open our eyes, ears, minds, and hearts to be aware of those around us who are struggling, notably to do what we can, including getting experts and authorities involved, if we suspect domestic or child abuse may be occurring in situations we know about.

We’ve got a lot of work to do, and here’s hoping we all stay healthy enough to get it done …

Patrick Malone & Associates, P.C. listed in Best Lawyers Rated by Super Lawyers Patrick A. Malone
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