Friday, December 23, 2016

Zika Part 5
The Case of the Missing Birth Defects

Did you notice that once the CDC got the big bucks for Zika, the virus and the “epidemic” wasn’t relentlessly covered in the press anymore? Gone are the breaking news reports from CNN, missing are the wrenching pictures of microcephalic babies from the pages of the Washington Post, no more lists of why we MUST believe that Zika causes birth defects from the NY Times. There have been stories here and there, but the intensity is gone – I wonder why? Maybe we aren’t supposed to notice that all those babies with microcephaly and other severe birth defects aren’t being born in Columbia, Puerto Rico and the US mainland????

Oh my - were you, my few, but loyal readers, hoping I would give up on this story too? Well, sorry – now that I’ve pulled my eyeballs away from election coverage, (and now that some of my chronic pain issues have settled down) I just have to keep going. Why? Because even without a lot of press coverage, with all that money in hand, the CDC and the NIH are marching forward. Just because we’re not looking, just because it appears few people in the US are getting sick, just because it’s not in the headlines, doesn’t mean the CDC-fueled Zika genie has been put back in the bottle. No. And as I write this, millions of dollars are being spent developing diagnostic tests for a disease that most people won’t even ever know they have or have had. Hundreds of CDC employees have been pulled from real health programs – 750 employees to be exact – to work on Zika. Despite the fact that NO safe and effective vaccine has ever been developed  for any of the viruses closely related to Zika, such as dengue or West Nile, millions are being spent on 23 different research efforts to develop a vaccine for Zika. In fact, on a recent 60 Minutes segment Tony Fauci of the NIH proudly showed off how they are modifying a DNA segment of the failed West Nile virus vaccine to try to make it work for Zika. (We aren’t, however, told that the West Nile vaccine was abandoned - for safety or efficacy issues, or both – who knows? No need to confuse us with the facts - just keep that money coming Congress!)

I have to admit – it would be easy to ignore this – to put the manufactured Zika crisis in the same CDC/NIH post-fear mongering “it’s over” file where West Nile, SARS, Ebola, H1N1 et al have gone to rest and just be OK with the fact that it never impacted you or your family. Clearly this is the play book that the CDC has used successfully over and over and over again. Scare the bejeezus and the dollars out of the American public and Congress by relentlessly feeding the 24/7 media machine until the desired amount of money is collected and then slip off into the night when we all stop looking and fail to notice that the promised world-wide pandemic has not occurred. But I just can’t. The enormity of the tax dollars being wasted on this health hoax makes My Inner Wonk really Angry. The continuing slaughter of our bees and other pollinators and the poisoning of our environment in the name of ineffective and unnecessary mosquito control just churns my stomach. And the on-going campaign to terrorize pregnant women to the point that some (how many we have no idea because no one is asking) are actually pursuing traumatic late term abortions and terminating wanted pregnancies based on manufactured hysteria, false data, greed and unreliable ultrasound diagnosis of birth defects*…… is beyond heartbreaking – it’s beyond words really. It is almost too much to let it all sink in….. And so no, I will not let it go.

To be fair, there have been a couple of tiny Zika peeps from the press here and there. On Wednesday, October 26th, next to a pic of Hilary Clinton, the front page of the Washington Post noted that Brazil’s Ministry of Health has noticed that not only does it appear that Brazil is the only Zika-affected country having babies born with microcephaly – those babies are only being born in certain parts of Brazil.

In fact, Brazil is so confounded by the birth clusters that they have convened a panel of infectious disease and epidemiological experts to try to determine what may be going on. Hmmmm – very specific, limited geographical clusters of a birth defect thought to be caused by a virus spread far and wide across South and Central America by mosquitoes – what would be your first line of inquiry when faced with such a conundrum? Maybe rethink the whole Zika-microcephaly equation? Nope. Investigate whether there is something else that is present in those environments or only occurring in those geographic areas which might lead to birth defects? Maybe? Well, no - that’s just crazy talk! No, instead of logically looking at geographically unique factors which might be causing geographically isolated birth defects, our intrepid public health officials and journalists have once again resorted to the data-free world of speculation.

The mothers of these microcephaly babies in Brazil, are, on average, young and live in poverty – so one expert suggests to the Washington Post that “sexual habits and hygiene may play a role” (smacking my forehead). What that even actually means, or how whatever that means might lead to severe birth defects is left unasked and unanswered. I mean really – bad hygiene is leading to severe birth defects??? And what evidence at all does anyone have that being poor in certain areas of Brazil leads to “sexual habits” that are different from other poor areas of Brazil? Or Columbia? Or Puerto Rico? But wait - the speculation continues - maybe in other geographical areas of Brazil, Central and South America, where Zika is rampant but few, if any, babies with microcephaly have been born, thousands and thousands of pregnant women have been secretly aborting brain damaged fetuses – at week 20 or later, which is the earliest microcephaly can be identified via ultrasound - in countries where abortion is both illegal and culturally taboo. The logistics, logic, probability, evidence of microcephaly ultrasound diagnosis, all required if this scenario were true, are also left unexplored.

Or, maybe, it is suggested, in this same Washington Post article full of bizarre data-free, logic-free speculation, maybe in the other parts of Brazil and Columbia where there were many cases of Zika, but not birth defects, woman managed not to get pregnant during the Zika outbreak (look at birth records perhaps??? Ummm, no) – Or, conversely, or maybe in addition, pregnant women there doused themselves in copious amounts of deet and magically didn’t get Zika, resulting in no birth defects…. So, we are to believe that women in these areas either managed not to get pregnant during those months or managed not to get Zika while pregnant……all without leaving a measurable data trail – quite the party trick. In addition, if any of this speculation turns out to be true – either missing Zika infections in pregnant women, or women not getting pregnant - the public health specialists interviewed for the article are already giving themselves the credit for adequately scaring pregnant women to take some type of action, resulting in the missing cases of microcephaly……

Finally, there is my personal favorite piece of conjecture – also lacking any scientific based information…..the Zika birth defects have yet to reveal themselves in these other populations. Unlike in those very specific parts of Brazil where microcephaly has occurred, the Zika affected babies in these other geographic areas were born with normal head circumferences and are developing normally so far, but just wait, these babies are actually ticking time bombs with severe birth defects and deficits just waiting to reveal themselves in the months or years to come – by what mechanism? No idea – but that’s what makes Zika so SCARY!

Conveniently, this particular theory requires the CDC and other public health entities in multiple countries to follow, examine and test all potentially affected children all over South, Central and North America as well as Puerto Rico and the mainland U.S. for 3 or more years – Cha-Ching! Ironically, these same public health officials and employees of the CDC currently arguing that the Zika virus can lurk in the body and cause severe neurological impairment, autoimmune diseases, learning disabilities, cerebral palsy or even autism (all are suggested in the Washington Post article and by a researcher on the 60 Minutes segment among other places) years later, are the same folks who in the next breath would assure you that the viruses routinely injected into babies via a vaccine could never, ever harm. Vaccine reactions or injuries are fairy tales, they say. In other words, the same types of viruses waiting to unleash Zika devastation in unsuspecting babies, when injected into you or your child in the name of health – sometimes as many as 9 viruses at a time (look at our current childhood vaccination schedule if you think I am exaggerating) - can never harm - over any time frame. Those viruses (not to mention the toxins) in vaccines most certainly cannot cause allergies, eczema, asthma, autoimmune disease, seizure disorders or autism! A virus spread by a mosquito, however, is apparently an entirely different thing…..please explain that logic to me. And how about a scientific explanation for the biological mechanism for any of these half-baked theories? Not to be found…..

All the missing microcephaly cases begs the question – why exactly was the CDC so sure it was Zika causing the severe birth defects to begin with? What did the data for THAT look like? Certainly the CDC had great data there? This is the part of this story that blows my Wonky mind. In their New England Journal of Medicine article “proving” Zika causes microcephaly "Zika Virus and Birth Defects — Reviewingthe Evidence for Causality", the CDC admits that while epidemiological evidence to prove causality would be nice, in the case of Zika they declare “no “smoking gun” (a single definitive piece of evidence that confirms Zika virus as a cause of congenital defects) should have been anticipated.” (Quotation marks from CDC) Why, exactly, we shouldn’t expect a direct causality link is not really explored. Instead, the CDC says we should be satisfied if the cause of these birth defects is “identified by means of the rare exposure–rare defect approach”. What do they mean by that? Traditionally, this means when a cause (Zika) is rare, and the birth defect (microcephaly) is rare and they happen temporally together, it is reasonable to declare causation.

But wait, you ask, hasn’t the CDC spent the last year hammering us over the head with the message that Zika is no longer rare? Yes, they have to admit, Zika isn’t so rare – so a little more explanation may be needed. Therefore, instead of epidemiological data proving causality, the CDC falls back on a check-list paradigm known as the “Shepard’s Criteria” to “prove” the Zika-Microcephaly connection. What in the world are Shepard’s Criteria one might reasonably ask? Hard to answer since not one media account I could find touting the certainty of the Zika-Microcephaly connection explained that the CDC had used this method to establish causality. I had to do some digging.

According to the CDC, “In 1994, Thomas Shepard, a pioneer in the field of teratology, proposed a set of seven criteria for “proof” [again, those quotes aren’t mine – those are from the CDC] of human teratogenicity.” (End of CDC quote) [Teratogenic = an agent that can disturb or halt the development of the embryo or fetus] And to make things easier to determine “proof” (ok, those quotes are mine) you need only check off 4 of the 7 criteria. Has Shepard’s criteria been used in the past to prove a virus – or any agent for that matter - has caused birth defects? Here again, I will give you the CDC’s own words – “These criteria have been used to guide discussions about causation in teratology-related litigation and to assess other potential teratogens” so, once again, according to the CDC themselves a big, fat NO. And – ok – this one is killing me – the CDC decided one of the 7 criteria doesn’t apply to Zika – so they gave themselves a pass – they only needed to meet 3 of the 7 criteria for this one. Proving causation is so much easier when you reject many possibilities out of hand and give yourself a pass on using a given criterion.
The most damning evidence cited by the CDC? One – yes one - pregnant woman from Slovenia who as a volunteer in Brazil had a “Zika-like illness” during her 13th week of pregnancy. She had normal ultrasound results at 14 and 20 weeks of gestation. She returned to Europe where fetal abnormalities were detected on ultrasound at 32 weeks and the pregnancy was terminated. To the CDC this one case, satisfied the Shepard’s Criterion #4 of “rare exposure, rare event”.**

And what of that discarded Shepard's Criterion? It “is aimed at medications or chemical exposures and does not apply to infectious agents”, so it is declared irrelevant. Do you see what they did there? “Doesn’t apply to infectious agents” – the CDC decided before they had even begun exploring causation, that microcephaly is caused by an infection. The only infectious agent studied? Zika. In the rest of the paper, nothing else is even contemplated.

No questions asked about the environment. No questions about toxic exposures, medications or vaccines during pregnancy. This, despite the fact that fetal exposure to various environmental toxins has been proven to cause severe birth defects in the past. And so, while perhaps not having a “smoking gun”, the CDC has instead set up and used a loaded one and Voila – Zika causes microcephaly! Errrgg!   (Note to self – use this type of circular logic in next disagreement with spouse).

I am hoping my next post on Zika is my last on the virus, at least for awhile – I have so many other topics to tackle - I make no hard and fast promises. But, I can’t turn away from Zika until I ask the obvious question - what is really going on in these parts of Brazil? While the numbers of babies born with birth defects seem to be both fluid and more that a bit sketchy, it does appear there is an increase - so why? Unlike the CDC, I don't expect to "prove" what's going on, but let’s explore some hunches…… If the Washington Post can speculate, why can’t My Inner Angry Wonk? I promise to have some data and logic, however…. In the meantime another Zika video from My Incredible Opinion.

*I am not interested here in passing judgement, nor do I wish to engage in a pro-choice or pro-life discussion here. My point is that any woman who has made it to week 20 in her pregnancy and is seeking out ultrasound testing to ensure the health of her fetus is most likely carrying a wanted pregnancy and contemplating abortion at that point would not be done lightly. Additionally, ultrasounds can most certainly be wrong. Of the 6 live births in a March 4th, 2016 CDC study published in The New England Journal of Medicine which is cited in the causation paper, 2 were born normal as expected, 3 babies, each diagnosed as having birth defects in utero were normal at birth. The remaining baby did have microcephaly as diagnosed via ultrasound - not a great track record with ultrasound diagnosis…….However - I cannot link you to this study because it is no longer available. While used as a citation repeatedly in the CDC's New England Journal of Medicine May 19th, 2016 causation paper, the March 4th, 2016 paper - where only 88 women were studied, and only 6 live births occurred prior to the paper's publication is no longer available. It has been replaced with a much larger study of 345 women published on December 16, 2016. You can go to the original May 5, 2016 causation paper and click on the footnotes for the March paper and it takes you to the December study published 9 months after the CDC declared Zika causes microcephaly......

**In another study cited by the CDC in their causation paper, 72 women were diagnosed with Zika during their pregnancy (review the reliability of Zika testing here). (This is the same, now-missing New England Journal of Medicine paper referenced in the footnote above.) Those agreeing to multiple ultrasounds were monitored closely. Of those, 12 fetuses – 16.6% - were diagnosed with problematic ultrasound results around week 20 – of those only 5 were diagnosed in utero as having microcephaly. Of the 12, 2 resulted in fetal deaths. At the time of this paper’s publication only 6 of the babies had been born, and only one had microcephaly. No mention is made in the paper if the 2 stillbirths showed signs of microcephaly. As I said, this paper was published before half of the babies diagnosed with birth defects via ultrasound were born. (If you want to get down and Wonky over the CDC footnotes, I will be happy to discuss the particulars over a cold beverage)