“To me, the main lesson here is that we currently live in a world where junk science goes unquestioned and gets published in peer-reviewed journals as long as it feeds in to the dominant narrative. If this study had been claiming, say, that face masks didn’t work, then it would remain stuck at the pre-print stage forever, or, if it ever did get published, it would immediately have been retracted. It has become blatantly obvious over the past year and a half that it is not primarily the quality of studies that determines where and whether they get published, but rather their acceptability to the powers that be.”

Read more: Does covid cause brain damage?, Sebastian Rushworth, July 26, 2021.

Theoretically, science is the contrary of religion because, while the latter is dogmatic, science should be anti-dogmatic, based on rationality and on an objective and empirical methodology. However,… science contributes to create the cultural system whereby we live and that gives meaning to our reality, which is based on some basic assumptions/beliefs: our “faith”.

The core of science has embodied the heritage of Christianity and Hebraism and, in a different way, could be practiced as a religion from many people. For western religions, the past was evil, the present redemption and future heaven. For science the past is ignorance/superstition, the present consists of progress using the tools of science, and the future consists in the positivistic promise of a sort of heaven in the real world.

Quoted from: Aillon, J. L., and M. Cardito. “Health and Degrowth in times of Pandemic.” Visions for Sustainability 14 (2020): 3-23.

Full issue of the magazine (Health and Degrowth Special).

Image by Kārlis Dambrāns – Mobile World Congress 2018, CC BY 2.0.

Hospital beds are defined as beds that are maintained, staffed, and immediately available for use. Total hospital beds include acute care beds, rehabilitative beds and other beds in hospitals.

North America: 2-3 beds

The USA had 9.18 hospital beds per 1,000 inhabitants in 1960, compared to 2.87 beds in 2017. Canada had 2.52 beds per 1,000 in 2017.

Europe: 2-8 beds

Europe had 9.52 hospital beds per 1,000 inhabitants in 1980, compared to 5.38 beds in 2018. However, there are notable differences between European countries.

In Central Europe, the decrease is relatively limited and the number of hospital beds remains at 6-8 per 1,000 inhabitants:

• Germany: 10.5 (1960) → 10.12 (1991) → 8.24 (2007) → 8.3 (2013) → 8.0 (2017)
• Austria: 9.94 (1985) → 7.75 (2007) → 7.27 (2018)
• Hungary: 9.30 (1994) → 8.16 (2000) → 7.19 (2007) → 7.01 (2018)
• Czechia: 10.11 (1980) → 6.62 (2018)
• Poland: 6.68 (2003) → 6.54 (2018)

In some Western European countries, the decrease is more pronounced, with the number of hospital beds now at 5-6 per 1,000 inhabitants:

• France: 10.5 (1974) → 8.34 (1998) → 7.06 (2007) → 5.91 (2018)
• Belgium: 8.30 (1970) → 7.64 (1989) → 6.27 (2007) → 6.20 (2013) → 5.62 (2018) → 5.58 (2019)

In many other European countries, the number of hospital beds has decreased to around 2-3 per 1,000 inhabitants — similar to the numbers in the US:

• Norway: 3.60 (2017)
• Finland: 8.25 (1993) → 3.61 (2018)
• Netherlands: 7.5 (1965) → 5.8 (1990) → 4.34 (2007) → 4.7 (2009) → 3.17 (2018)
• Italy: 8.97 (1960) → 3.91 (2007) → 3.40 (2012) → 3.14 (2018)
• Ireland: 9.03 (1980) → 2.97 (2018)
• UK: 4.08 (2000) → 2.76 (2013) → 2.54 (2017)
• Denmark: 8.10 (1970) → 4.54 (1997) → 3.69 (2007) → 2.43 (2018)
• Sweden: 14.18 (1960) → 2.86 (2007) → 2.14 (2018)

Finally, some European countries started with much lower numbers:

• Spain: 4.66 (1970) → 3.25 (2007) → 2.97 (2018)
• Greece: 5.79 (1960) → 4.2 (2018)
• Portugal: 3.96 (1985) → 3.45 (2018)

Asia: +10 beds

If we look at China, we see the opposite trend. The number of hospital beds per 1,000 inhabitants grew from 1.44 in 1965 to 4.31 in 2017. China now has more hospital capacity per capita  than the US and a great deal of European countries. The countries with the most hospital beds are also in Asia. In 2017, Japan and South Korea had 13.05 and 12.27 hospital beds per 1,000 inhabitants, respectively.

Kris De Decker

Data: Eric Wagner. Graph: Kathy Vanhout.

Sources

• https://www.oecd-ilibrary.org/social-issues-migration-health/hospital-beds/indicator/english_0191328e-en
• https://data.worldbank.org/indicator/SH.MED.BEDS.ZS?end=2015&start=1960&view=map&year=1960
• https://data.oecd.org/healtheqt/hospital-beds.htm
• https://data.oecd.org/healthres/health-spending.htm
• https://ec.europa.eu/eurostat/databrowser/view/hlth_sha11_hf/default/table?lang=en
• https://www.statista.com/statistics/184955/us-national-health-expenditures-per-capita-since-1960/

Owing to the liberal utilisation of capital equipment and single-use supplies, surgical care in high-income countries is increasingly recognised as a significant source of greenhouse gases and other environmental impacts that adversely affect human health. Regulations require many potentially reusable supplies and drugs to be discarded after single use. Supply manufacturers may label drugs or products as single-use to increase profit, reduce liability or facilitate regulatory approval. Many high-income countries struggle to increase the value of care while maximising quality and outcomes, and minimising cost and resource use.

For most high-income countries, cataract surgery is the highest volume and most expensive surgical procedure (in aggregate) in all of medicine. Studies analysing global cataract care found few differences in outcomes, such as surgical infection, despite large differences in carbon footprint and cost. A single cataract procedure in the UK emits an estimated 180kg CO2e (carbon dioxide equivalents) whereas the same surgery with similar outcomes in India emits only 6kg CO2e, 5% of that in the UK.

Source: Steyn, A., et al. “Frugal innovation for global surgery: leveraging lessons from low-and middle-income countries to optimise resource use and promote value-based care.” The Bulletin of the Royal College of Surgeons of England 102.5 (2020): 198-200. [open access]

After probing conflicts between promoting health and protecting the environment we highlight the essential role that environmental resources play in health and healthcare to show that environmental protection is a form of health promotion. We then explore relationships between three radical forms of health promotion and the environment: (1) lowering the human birth rate; (2) transforming the food system; and (3) genetically modifying mosquitos.

We conclude that healthcare and other industries and their institutions and leaders have responsibilities to re-consider and modify their priorities, policies, and practices.”

Read more (open access): Cheryl C. Macpherson, Elise Smith & Travis N. Rieder (2020) Does Health Promotion Harm the Environment?, The New Bioethics, DOI: 10.1080/20502877.2020.1767918

These ancient civilizations were referring to copper, a material that cultures across the globe have recognized as vital to our health for more than 5,o00 years. When influenzas, bacteria like E. coli, superbugs like MRSA, or even coronaviruses land on most hard surfaces, they can live for up to four to five days. But when they land on copper, and copper alloys like brass, they die within minutes. “We’ve seen viruses just blow apart,” says Bill Keevil, professor of environmental healthcare at the University of Southampton. “They land on copper and it just degrades them.”

Read more: Copper kills coronavirus. Why aren’t our surfaces covered in it?

The high price of machine ventilators forces many hospitals in the poorest regions of the world to rely on a simple solution known as an Ambu Bag that requires constant manual pressure in order to get oxygen to the lungs.The Umbulizer is a mechanically powered version of the Ambu Bag.

More info & on-going efforts to design low-cost (incl. DIY/3d-printed) ventilators:

• https://gitlab.com/TrevorSmale/low-resource-ambu-bag-ventilor 
• Open Source COVID19 Medical Supplies: http://facebook.com/groups/670932227050506/
• https://coronavirustechhandbook.com/hardware 
• https://projectopenair.org
• http://news.mit.edu/2019/umbulizer-sloan-health-care-innovation-prize-0225
• https://www.instructables.com/id/The-Pandemic-Ventilator 

At the turn of the twentieth century, Dr. Charles A. Campbell, a physician and former city bacteriologist in San Antonio, Texas, began the first experiments with attracting bats to artificial roosts. Although he had the highest regard for bats, the motive behind his experiments was not that he thought bats needed homes. The real reason was to find a way to control a disease that caused millions of deaths throughout the world each year: malaria. In his native Texas, mosquitoes and disease rendered countless acres of fertile land uninhabitable, and Campbell, who treated victims of malaria, knew the suffering it caused.

In the beginning Campbell thought the answer was simple: recruit great numbers of bats who, he believed, were the natural predators of mosquitoes… But after years of unsuccessful experimentation with boxes of assorted sizes and shapes, he learned that bats did not choose any old ramshackle roost at random. Undaunted, his solution was to build a bigger bat house. With a personal investment of $500.00, Campbell built the first Malaria-Eradicating, Guano-Producing Bat Roost in 1907 at the U.S. Experimental Farm near San Antonio.

He called the 30 foot tall tower “my monument.” Inside, a series of inclined shelves had been carefully crafted for the bats to roost upon, and 20 yards of guano saturated cheesecloth were festooned on the inside walls for their further comfort. The hopper, from which he intended to collect their droppings, was seeded with about 100 pounds of fresh guano. And to further attract visitors, he provided a meal: “three perfectly good hams with a nice slice cut out of each, exhibiting their splendid quality for the delection of the intended guests.”

Read more: Murphi, M. “Dr. Campbell’s malaria-eradicating, guano-produding bat roosts.” BATS Magazine7 2 (1989). See also: The Bat Tower: The 30-Foot Monument to Biological Pest Control and Cross-Species Design, The Atlantic, 2012. Via Aaron Vansintjan. Image.

Most people with hearing problems are not using hearing aids, mainly because the electronic devices often do not provide enough benefit. Research shows that non-electric hearing aids from earlier centuries are performing significantly better.

Digital Hearing Aids

Roughly 40% of people between the ages of 55 to 74 suffer hearing loss. Eighty percent of them do not wear a hearing aid, even though their disability often has a negative impact on their quality of life as well as others around them. According to a 2013 research paper, the main reason is the limited performance of the devices.

Interestingly, these results are in line with those of studies performed at the end of the twentieth century, meaning that the introduction of digital hearing aids has had no positive effect on the popularity of the technology. Electric hearing aids consist of a battery, a microphone, an amplifier and a speaker. The more compact electronic hearing aids also contain a microchip.

An additional obstacle in poorer countries is the cost of the technology, which concerns the device as well as the batteries, which need to be replaced regularly. Worldwide, roughly 1 billion people suffer from hearing loss. According to the World Health Organisation, only one fifth of them wears a hearing aid.

Ear Trumpets & Speaking Tubes

From the seventeenth century onwards, several types of non-electric hearing aids were developed, based on different acoustical principles. The most important devices were ear trumpets and speaking tubes.

An ear trumpet

In the ear trumpet, sound from a funnel-shaped metal tube was conducted to a small opening that was inserted in the listener’s ear. Ear trumpets were often slighty curved at one end so that they could be aimed at the sound source more easily. Some models were collapsible for easy carrying.

The speaking tube consisted of a flexible tube with a funnel-shaped opening on one end through which the speaker could talk, while the other end of the tube was put in the ear of the listener.

Stationary Hearing Aids

Speaking tubes and ear trumpets were also combined, especially in stationary hearing aids such as the acoustical chair. This seating had a pair of large trumpets on each side, which amplified the sound and led it through flexible tubes to the listener’s ears.

Similar technology could also be hidden in objects like vases. This was meant for several speakers and listeners gathering around a table. In the days before the telephone, speaking tubes were also used by people with normal hearing to communicate between floors of a building or a ship.

Sound Amplification

Measurements from the late twentieth century show that these devices perform better than today’s high-tech hearing aids. Ear trumpets and speaking tubes not only yielded a sound amplification of 10 to 25 decibels, they also suppressed sounds that came from other directions, further improving their workings. The speaking tube also reduced the noise reduction between speaker and listener.

A speaking tube

Another important advantage was that both devices were very visible and thus encouraged the speaker to talk slower and more clearly. However, this visibility was also considered to be a problem: well-functioning, non-electric hearing aids are laughable.

From the nineteenth century onwards, the development of hearing aids took another direction: much smaller ear trumpets and speaking tubes were now hidden in clothing and accessories.

Vanity

The most popular models were worn as a kind of headband, with small trumpets hidden behind the ears, in hats, wigs, beards or scarfs. An extra advantage was that these devices could be operated hands free. Unfortunately, these hearing aids had poor performance compared to earlier models, and sometimes even impaired hearing.

However, a new trend was set. Since the nineteenth century, the main criterium for a hearing aid is no longer its effectivity but its discretion and compactness. Nevertheless, those who can overcome their vanity can revert to technology that has proven to work.

A large collection of images showing non-electric hearing aids can be found at the Bernard Becker Medical Library Image Gallery.

Sources:

• Non-electric aids to hearing: a short history, S.D.G. Stephens & J.C. Goodwin, in Audiology 23: 215-240, 1984. [A full version of the paper can be found online, but for some reason it’s impossible to link to it directly]
• Conceiled hearing aids of the 19th century, Deafness in Disguise, Washington University School of Medicine.
• Why do people with hearing aids do not wear them? Abby McCormack & Heather Fortnum, International Journal of Audiology, Volume 52, issue 5, 2013

Overcrowding was so bad that three babies would have to share an incubator at a time and the rate of cross-infection was high. Death rates were spiraling, and so too was the level of abandonment. Many young, impoverished mothers who never even got to touch their babies found it easier just to take off.

Scouting around for a solution to these problems, Rey happened upon a paper on the physiology of the kangaroo. It mentioned how at birth, kangaroos are bald and roughly the size of a peanut—very immature, just like a human pre-term baby. Once in its mother’s pouch, the kangaroo receives thermal regulation from the direct skin-to-skin contact afforded by its lack of hair. It then latches onto its mother’s nipple, where it remains until it has grown to roughly a quarter of its mother’s weight, when it is finally ready to emerge into the world.

This struck a chord with Rey. He went back to the institute and decided to test it out. He trained mothers of premature babies to carry them just as kangaroos do. Working alongside his colleague Hector Martinez, he taught them the importance of breastfeeding and discharged them just as soon as their babies were able. The results were remarkable. Death rates and infection levels dropped immediately. Overcrowding was reduced because hospital stays were much shorter, incubators were freed up, and the number of abandoned babies fell.

Read more: Kangaroo care—why keeping baby close is better for everyone, Ars Technica. Thanks to Tim Miller.

Growing up in India, Manu Prakash entertained himself with a bottle cap that spun around on two strings that he tugged with his fingers. As a physical biologist at Stanford University in California, he is now transforming that simple toy, called a whirligig, into a cheap tool to help diagnose diseases such as malaria.

Other researchers have come up with low-tech, inexpensive centrifuges that used salad spinners3 and egg beaters4, but these devices could manage only around 1,200 rotations per minute (r.p.m.) and took too long to process samples, says Prakash.

Hoping to do better, his team went on a shopping spree to a toy store, collecting spinning gizmos and filming them with a high-speed camera. Yo-yos spun too slowly (and required training to use). But whirligigs were both easy to operate and reached speeds of 10,000 r.p.m., comparable to a commercial centrifuge.

See & read more at Nature. Thanks to Rodger Kram & Austin Liu.