Lots of words spent in the New York Times on how Starbucks lost its magic and not one mention of the most straightforward way to bring that magic back: have it be a coffee shop again, and not a drive-through dessert stand.

No, I am not canceling my Washington Post subscription; the free one I had through my previous federal job expired and I never renewed it, so there was nothing left to cancel. My main source of local news has been Axios DC but The 51st popped up recently and is now getting amplified. It has fewer tips on where to get the best Cinco de Mayo margarita and more in-depth news, which is great. It also lists Old Town Alexandria as the number 1 spot for a fall walk around D.C. so they’re not perfect, but then no-one is. And of course, they are opportunistic about the recent local events (headline: D.C. Deserves Billionaire-Free Local News).

Andrew Gelman recently wrote about Columbia surgery professor’s research missconduct. I haven’t looked into the details but it seems like the retracted papers were all about lab research with no true clinical relevancy. In that context, this part of the post stuck out:

Can you imagine, you come to this guy with cancer of the spleen and he might be pushing some unproven treatment supported by faked evidence? Scary.

I can’t tell whether this was supposed to be a joke or if Gelman truly believes that faking mouse experiments directly leads to using unproven treatments, but in case it’s the latter I have to say that the logic is stretched. Yes, the kind of person who has no qualms about fake data is probably not all that rigorous about the evidence for surgical procedures, but for all we know he could be a master surgeon with excellent technique and great outcomes who also happens to have been a bad judge of character and trusted a bad actor. I suspect it’s the latter: the kind of multi-tasking surgery “superstar” that the professor in question seems to be tends to spend a lot more time in the the operating room (or, for another kind of a superstar, the board room), than the lab.

Now, if he were a medical oncologist or any other kind of doctor that gives cancer treatment then maybe things would have been more dubious — that kind of research tends to jump to clinic too quickly and without merit. But unless you’re transplanting pig’s hearts and working on other large animals, the lab is so far removed from the operating room that it is extremely unlikely any such evidence could be used to back up actual surgical treatment.

Incidentally, that last link is to Siddharta Mukherjee’s abomination of an article titled “The Improvisational Oncologist” (subtitle: “In an era of rapidly proliferating, precisely targeted treatments, every cancer case has to be played by ear.") from the May 2016 edition of The New York Times Magazine (it’s a gift link so feel free to read it; caveat lector) and it describes actual scientific and medical malpractice of bringing half-baked — though, admittedly, not faked — ideas from the lab into clinic. Gelman didn’t comment on his blog back then, but he did praise Mukherjee the following year for a New York Times opinion piece “A Failure to Heal” (another gift link there) that is about — wait for it — clinical trials that show the treatment that you thought would work doesn’t. ⊕ These kinds of trials tend to be called “negative” but there’s nothing negative about them! They bring positive value to the world. Maybe our improvisational oncologist learn something in those 18 months that separate the two texts?

To be clear, what Mukherjee artfully called “improvisational oncology” was (lab) bench to (hospital) bedside medicine, which is distinct from bench to bedside research: the concept of bringing laboratory findings to clinical practice quickly, but still with some semblance of a clinical trial that includes a pre-specified protocol, informed consent and regulatory oversight. You know, all the stuff that decreases the odds of laboratory malfeasance endangering patient care. I say decreases the odds and not prevents them completely because we do have a case of a bad actor completely destroying an entire field of clinical research (Alzheimer’s disease). Can you imagine the damage that kind of shenanigans would do if we didn’t have clinical trials standing between the lab and the commercial drug market?

COI statement: I am involved in a [course about clinical trials][6 and think they are the best thing that has happened to medicine since a cloth merchant wanted to take a closer look at some garments so there is some bias involved, but then again say what you’ll do and do as you say is both a major tenet of clinical trialists and good general practice.

Facts about The New York Times, from 2016

Historically, the Los Angeles Times, where I worked twice, for instance, was a reporter-driven, bottom-up newspaper. Most editors wanted to know, every day, before the first morning meeting: “What are you hearing? What have you got?”

It was a shock on arriving at the New York Times in 2004, as the paper’s movie editor, to realize that its editorial dynamic was essentially the reverse. By and large, talented reporters scrambled to match stories with what internally was often called “the narrative.” We were occasionally asked to map a narrative for our various beats a year in advance, square the plan with editors, then generate stories that fit the pre-designated line.

No wonder then that NYT crowded out all other newspapers: they brought a narrative gun to a journalistic knife fight. Story wins, reality be damned. (↬Mark Palko)

This morning on Axios DC:

Metro fixed its fare evasion problem on trains, and now they are focusing on the 70% of bus riders who don’t pay. That eye-popping rate is up from 17% pre-pandemic.

Yowza. There is more at WaPo. Kids and I take the metro bus to school from time to time and I can confirm that:

1. School children in general don’t use their free ride cards. It improves the flow of people and drivers don’t seem to care.
2. More than half of the adults just waltz in as well. That too improves the flow of traffic, and drivers don’t seem to care about that either.

A head-scratcher, that.

The Nobel Prize in physiology or medicine went to Victor Ambros and Gary Ruvkun, two American scientists for their discovery of micro RNA:

The pair began studying gene regulation while they were postdoctoral fellows at the Massachusetts Institute of Technology in the lab of H. Robert Horvitz, who won his own Nobel Prize in 2002.

And so the Nobel family tree grows.

Ben Werdmuller is an FT subscriber:

There’s a lot to be said for reading on paper. One of my more recent indulgences has been a daily subscription to The Financial Times, which on weekdays is a sober paper that reports the news fairly objectively. On weekends it’s a different beast: in particular it includes a magazine pull-out called How to Spend It that is apparently aimed at the worst people on earth and is generally indistinguishable from satire.

Of course HTSI — which is now the actual name of the weekend supplement — is tongue-in-cheek. They’re Brits. My favorite part are interviews with old-money Zoomer scions. “Q: What do you do these days? A: My wellness company Zubeeyqyo which makes fantastic goat milk-based facial creams has recently expanded to Asia. Thanks so much to my dear friends for their support.” Brilliant.

Halloween is nigh. This year, our eldest decided to dress up as a plague doctor, and looking through costume options reminded me of one of the worst pieces of doomscrolling churnalism that proliferated after covid. It is titled Get Ready for the Forever Plague, by one Andrew Nikiforuk, “an award-winning journalist whose books and articles focus on epidemics, the energy industry, nature and more”. ⊕ Of course, back in March 2020 he was just “an award-winning journalist who has been writing about the energy industry for two decades”. So it goes.

Such is the nature of echo chambers that he continues to write, putting out articles like this month’s As COVID Surges, the High Price of Viral Denial. At first glance they are meticulously sourced, a hyperlink to a peer-review journal underlining each claim:

COVID can even whittle away your intelligence. A recent New England Journal of Medicine study looked at the memory, planning and spatial reasoning of nearly 113,000 people who had previously had COVID. Almost all had significant deficits “in memory and executive task performance” regardless of the variant.

Alas, the linked NEJM article says no such thing. In fact:

Participants with resolved persistent symptoms after Covid-19 had objectively measured cognitive function similar to that in participants with shorter-duration symptoms, although short-duration Covid-19 was still associated with small cognitive deficits after recovery. Longer-term persistence of cognitive deficits and any clinical implications remain uncertain.

And as for the “regardless of the variant” claim:

The largest deficits in global cognitive scores were observed in the group of participants with SARS-CoV-2 infection during periods in which the original virus or the alpha variant was predominant as compared with those infected with later variants.

Crucially, the control group was people with no documented covid infection; we have no idea how covid-19 compares to other coronavirus infections, other viral infections in general, and even any illness requiring hospitalization. Staying in the ICU takes a toll regardless of what put you there, and last I checked covid has been putting fewer and fewer people in the hospital, let alone the intensive care unit.

This is a common theme for most covid-19-related research. Here, again, is Nikiforuk’s latest article:

No COVID infection is completely benign because each infection plays a role in deregulating the immune system. Even a mild infection, as one recent study noted, can increase “autoantibodies associated with rheumatic autoimmune diseases and diabetes in most individuals, regardless of vaccination status prior to infection.”

Two things here. One, autoantibodies associated with a disease do not imply a disease: I myself have had high titer for antibodies associated with Sjogren’s syndrome for more than a decade without ever having symptoms of the disease (how I found out about those antibodies is a story for another day). Two, note that the study compared autoantibody levels of three groups of people: those with long covid and persistent neurologic and fatigue symptoms (“neuro-PASC”), covid convalescents, and healthy controls with no known exposure. Ideally it would have included people with non-covid “neuro-PASC” and/or convalescents of other, non-covid viral infections. But at the very least it should have mentioned prior similar research in other viral diseases and put the findings in context of other viruses and hypothesis for autoimmunity. Presented like this, SARS-CoV-2 is a celestial bugaboo unchained from other parts of reality — no wonder that the lab leak hypothesis is so tempting!

Because there are two things that could be happening here. Either a humanity-ending event occurred somewhere near the end of 2021 and we are living a somewhat prolonged but inevitable decline in which so many people will have symptoms of long covid that civilization as we know it will end (queue “the Forever Plague”). Or maybe, just maybe, we experienced a once-in-a generation spread of a new virus — new to us but something humanity has had to deal with throughout its existence — at a time when we have the means to analyze its genome, our genome, its proteins, ⊕ Kudos to the Nature group of journals for their SEO. our proteins, the cells it infects, our cells responding to the infection, the microbiome, the food, the water, the air, the animals and yes, even art. And all that without the context of other viruses and other pandemics.

The family looking forward to one last weekend at the beach, but no:

Swimming was banned at beaches in Ocean City and on Assateague Island on Sunday after used hypodermic needles and other medical waste washed ashore, authorities said.

Maryland officials closed Assateague State Park to swimming, wading, surfing or any other activities in the ocean. The Assateague Island National Seashore, which is in both Maryland and Virginia, prohibited swimming along “ALL” ocean-facing beaches, according to alerts sent Sunday. The island is 37 miles long.

Most news is noise; local news is an exception.

Here are a few unrelated articles that crossed my inbox this morning:

• “Studios start at $1,927”
• "$1,134: The amount I paid for my round-trip cross-country Amtrak ride"
• “A six-bedroom apartment costs about $50,000, and the maximum income for a family of four is $160,000."