(1) The price of Junk Food: Nearly 10% of health spending is for obesity
(2) Doctors Association says junk food ads should be barred from peak children's TV
(3) New Doctors will work in large clinics; they're are no longer patient advocates
(4) A third of British Nurses refuse to have the swine flu vaccination
(5) The vaccines are far more deadly than the swine flu
(1) The price of Junk Food: Nearly 10% of health spending is for obesity
http://www.chinadaily.com.cn/life/2009-07/28/content_8481276.htm
Nearly 10 percent of health spending for obesity
(Agencies)
Updated: 2009-07-28 10:39
WASHINGTON – Obesity's not just dangerous, it's expensive. New research shows medical spending averages $1,400 more a year for an obese person than for someone who's normal weight. Overall obesity-related health spending reaches $147 billion, double what it was nearly a decade ago, says the study published Monday by the journal Health Affairs.
The higher expense reflects the costs of treating diabetes, heart disease and other ailments far more common for the overweight, concluded the study by government scientists and the nonprofit research group RTI International.
RTI health economist Eric Finkelstein offers a blunt message for lawmakers trying to revamp the health care system: "Unless you address obesity, you're never going to address rising health care costs."
Two-thirds of Americans are either overweight or obese, and the average American today is 23 pounds overweight, said Dr. Thomas Frieden, director of the Centers for Disease Control and Prevention.
"Obesity and with it diabetes are the only major health problems that are getting worse in this country, and they're getting worse rapidly," Frieden said Monday at the CDC's first major conference on the obesity crisis.
It's not an individual problem but a societal problem — as the nation's health bill illustrates — that will take society-wide efforts to reverse, Frieden stressed. His agency last week released a list of strategies it wants communities to try. They include: increasing healthy foods and drinks in schools and other public venues; building more supermarkets in poor neighborhoods; encouraging more mothers to breast-feed, which protects against childhood obesity; and discouraging consumption of sodas and other sweetened beverages.
(2) Doctors Association says junk food ads should be barred from peak children's TV
AMA calls time on junk food ads
By Danny Rose
AAP
August 13, 2009 03:15pm
http://www.news.com.au/story/0,27574,25923870-29277,00.html
AUSTRALIA'S top doctors body says junk food ads should be barred from peak children's TV viewing times, as research shows the super-sized health benefits the move would deliver.
A study conducted at Melbourne's Deakin University found banning the ads would lead to a 1.4 per cent - or more than half a kilogram - reduction in weight of the average Australian child.
It would also result in a saving of $300 million which the government would otherwise face in obesity-related health costs.
"While the Food and Grocery Council may be in denial, every parent knows that junk food advertising to children at any time of the day undermines efforts to encourage healthy eating habits," Australian Medical Association (AMA) president Dr Andrew Pesce said.
"The Federal and State Governments have agreed on shared national targets for reducing obesity.
"It is time for the Federal Government to show it's serious about the targets by banning junk food advertising to children."
The Australian Society for the Study of Obesity has estimated that childhood obesity is rising at an annual rate of one per cent.
Dr Pesce said if this continues, around half of all young Australians will be overweight within 20 years.
The Deakin University research - published in the International Journal of Obesity - modelled the effect of banning the ads within a suite of "interventions" all designed to reduce childhood obesity.
Other measures considered include steps to encourage more children to walk to school, in-school fitness programs, lap band surgery for obese children and doctor-led initiatives.
"Banning TV junk food ads was the highest impact and most cost-effective intervention to reduce childhood obesity that we have modelled to date," said Boyd Swinburn, Professor of Population Health at Deakin.
"It would not only reduce childhood obesity but it would do so in an equitable way affecting all children and it would eventually result in savings to the taxpayers of $300 million."
(3) New Doctors will work in large clinics; they're are no longer patient advocates
From: IHR News <news@ihr.org Date: 08.06.2009 04:00 PM
Marcus Welby? He's History
Ronald J. Glasser -- The Washington Post
http://www.washingtonpost.com/wp-dyn/content/article/2009/05/29/AR2009052901547.html
... Of the 15,000 students who will graduate from medical school this year -- and the roughly 8,000 physicians and surgeons who will finish their specialty training -- more than 93 percent will become employees of large clinics, managed-care companies or hospital systems. These physicians, as I have seen in my own practice in Minneapolis, are no longer patient advocates.
Marcus Welby? He's History
By Ronald J. Glasser
Sunday, May 31, 2009
A few decades ago, the biggest problem in medicine was diagnosis. Is that a heart attack or heartburn? The beginnings of dementia or a stroke? Is the tumor benign or malignant? Medical technology has changed all that. The biggest problem in medicine today is not determining what's wrong with you. It's knowing whom to call at 2 a.m. -- other than 911 -- when something happens. And the nasty little secret is not that your doctor is no longer available, but that he or she is no longer in charge.
Of the 15,000 students who will graduate from medical school this year -- and the roughly 8,000 physicians and surgeons who will finish their specialty training -- more than 93 percent will become employees of large clinics, managed-care companies or hospital systems.
These physicians, as I have seen in my own practice in Minneapolis, are no longer patient advocates. In many ways, they've abandoned the patient to the work rules of health plans and the professional demands of managed care. The Hippocratic Oath has been discarded, and the Golden Rule has become: He who has the gold sets the rules.
What this means is that the care you get -- and how long you get it -- is only the care your health plan will reimburse your doctor for. You can see your psychiatrist or psychologist for five visits; you can stay in the hospital for 48 hours following a hip replacement, or three days after a radical prostatectomy. Simple mastectomies go home the same day, and gall-bladder removals as soon as they wake up from the anesthesia. If the drug prescribed is not on your health plan's list, then your doctor will have to prescribe an approved alternative that may not be as effective.
This kind of care is simply unsustainable. It's not just the enormous amount of money we already spend on health care or the fact that 45 million Americans are uninsured. America is also graying -- by 2015 there will be more 80-year-olds than children under 8 -- and the elderly need more -- and more personalized -- care. People respond differently to treatment, and it must be tailored to the individual patient. Our current depersonalized, disease-based system is not only dangerous but also dysfunctional. And any dysfunctional system will eventually fail. It happened to the financial system, and it will happen in medicine.
From the end of World War II until the mid-1980s, the average medical or surgical group in the United States was made up of three to five physicians. They ran their practice as a privately held company, treating patients, sending out the bills, setting fees and organizing night-call and weekend coverage while deciding how much charity care they would also provide.
The focus was on maintaining good relationships with patients. Doctors cultivated a trusted bedside manner to maintain referrals and their colleagues' respect. The physicians in a small practice knew one another's patients. When someone called after hours, the answering physician would be able to respond to any questions and give realistic suggestions.
I care for a number of spina bifida patients along with another physician. These children have complex problems that include a malfunctioning central nervous system, orthopedic problems, difficulty breathing and recurrent bladder infections. If I didn't know these patients, all I could do if they called after hours would be to send them to the nearest emergency room, where they would sit for hours while someone else who didn't know them tried to figure out what was wrong.
But personal knowledge and concern have evaporated in the world of employee-physicians, replaced by cookie-cutter best-practice guidelines and rules on prescribing drugs, acceptable lengths of hospital stays and the number of clinic patients a doctor must see per hour.
And why not? Everyone in medicine knows that these are no longer the physician's patients. They belong to the insurance companies, the health plans, the hospitals. With that understanding comes personal indifference and professional exhaustion. Today, it's the rare physician who gives a patient his or her private office phone number, something that was almost universal when I first went into practice. Nowadays, if you want to talk to your doctor, you go through the office coordinator or the nurse associate.
The new tsunami in employed physicians has also led to something quite new in the medical profession -- the part-time doctor. According to a recent survey of one of Minneapolis's largest medical clinics, more than 50 percent of the doctors in the pediatrics and family practice departments and more than 70 percent in the ob/gyn department were working part time.
This is great for the employer, who doesn't have to provide retirement or health care benefits. But as a medical organization, you do best not to mention your part-timers to the patients. When I talk to one of these physicians, I'm reminded of what a professor of mine at Johns Hopkins medical school in the 1960s said when one student complained about having to be on the wards every other night. The professor offered a quote he told us was from the pianist Arthur Rubinstein: "When I don't practice one day, I can tell the difference. When I don't practice two days, my wife can tell the difference. When I don't practice three days, anyone can tell the difference."
(4) A third of British Nurses refuse to have the swine flu vaccination
From: Paul de Burgh-Day <pdeburgh@harboursat.com.au> Date: 21.08.2009 09:18 PM
http://www.globalresearch.ca/index.php?context=va&aid=14828
A third of nurses will refuse to have the swine flu jab
by Daniel Martin
August 18, 2009
Daily Mail
http://www.dailymail.co.uk/health/article-1207270/A-nurses-refuse-swine-flu-jab.html
Up to a third of nurses will say no to the swine flu jab because of concerns over its safety, a poll has found.
NHS workers are first in line for the vaccine, but a survey of 1,500 nurses found many will reject it.
Last night a Government scientist condemned the results saying nurses who do not have the jab are putting patients at risk.
Nevertheless the poll, by Nursing Times magazine, will raise questions over the Government's planned mass vaccination programme.
Of 1,500 readers, 30 per cent would not say yes to the vaccine, while 33 per cent said maybe. Just 37 per cent said they would definitely have the jab.
Of those who said they would refuse the jab, 60 per cent said their main reason was concern about the safety of the vaccine.
A further 31 per cent said they did not consider the risks to their health from swine flu to be great enough, while 9 per cent thought they would not be able to take time off work to get immunised.
Some 91 per cent described themselves as frontline nurses.
One told the magazine: 'I would not be willing to put myself at risk of unknown long-term effects to facilitate a short-term solution.'
Another added: 'I have yet to be convinced there is a genuine health risk and it's not just Government propaganda.'
(5) The vaccines are far more deadly than the swine flu
by Dr. Mae-Wan Ho and Prof. Joe Cummins
Institute of Science in Society - 2009-07-27
Global Research, August 21, 2009
http://www.i-sis.org.uk/index.php
http://www.globalresearch.ca/index.php?context=va&aid=14869
The vaccines are far more deadly than the swine flu. Mass vaccinations is a recipe for disaster Dr. Mae-Wan Ho and Prof. Joe Cummins
This report has been submitted to Sir Liam Donaldson, Chief Medical Officer of the UK, and to the US Food and Drugs Administration
A swine flu outbreak occurred in Mexico and the United States in April 2009 and spread rapidly around the world by human-to human transmission. The new type A H1N1 influenza virus is unlike any that had been previously isolated [1, 2], judging from the first data released in May.
It is a messy combination of sequences from bird, human and swine flu virus lineages from North America and Eurasia. A senior virologist based in Canberra, Australia, told the press he thought that the virus could have been created in a laboratory and released by accident [3]. Some analysts even suggest, without corroborating evidence, that it was made intentionally as a bioweapon [4], while others blame the intensive livestock industry and extensive trafficking of love animals over long distances, which provide plenty of opportunity for generating exotic recombinants [5].
But what worries the public most is the mass vaccination programmes governments are putting in place to combat the emerging pandemic, which could well be worse than the pandemic itself.
Watchdog opposes fast-track vaccine for school children
The US government is intending to vaccinate all children in September when school re-opens, and the country’s vaccine watchdog National Vaccine Information Center (NVIC) has called on the Obama Administration and all state Governors to provide evidence that the move is [6] “necessary and safe”, demanding “strong mechanisms for vaccine safety screening, recording, monitoring, reporting and vaccine injury compensation.”
The US Departments of Health and Homeland Security had declared a national public health emergency in April soon after the swine flu outbreak. As a result, some schools were closed, people quarantined, and drug companies were given contracts worth $7billon to make vaccines that are being fast tracked by the Food and Drugs Administration [7]. That means they will only be tested for a few weeks on several hundred children and adult volunteers before being given to all school children this fall.
Furthermore, under federal legislation passed by Congress since 2001, an Emergency Use Authorization allows drug companies, health officials and anyone administering experimental vaccines to Americans during a declared public health emergency to be protected from liability if people get injured. US Secretary of Health and Human Services Kathleen Sebelius has granted vaccine makers total legal immunity from any lawsuits that may result from any new swine flu vaccine. And some states may make the vaccination mandatory by law.
The NVIC is asking whether the states are prepared to obey vaccine safety provisions in the 1986 National Childhood Vaccine Injury Act, which include: 1. Giving parents written information about vaccine benefits and risks before children are vaccinated; 2. Keeping a record of which vaccines the children get, including the manufacturer’s name and lot number; 3. Recording which vaccines were given in the child’s medical record; and 4. Recording serious health problems that develop after vaccination in the child’s medical record and immediately making a report to the federal Vaccine Adverse Event Reporting System.
NVIC also wants to know if the states are prepared to provide financial compensation to children injured by the swine flu vaccines, whether parents will be given “complete, truthful information about swine flu vaccine risks”, and have the right to say “no” to vaccination.
Co-founder and president of NVIC Barbara Loe Fisher said [6]: “Parents and legislators should be asking themselves right now: Why are children the first to get experimental swine flu vaccines? Are schools equipped to get signed informed consent from parents before vaccination, keep accurate vaccination records and screen out children biologically at high risk for suffering vaccine reactions? Will people giving these vaccines know how to monitor children afterwards and immediately record, report and treat serious health problems that develop? And will states have the financial resources to compensate children who are injured?”
WHO and mass vaccination fever
The mass vaccination order has come from the World Health Organization (WHO) [8]. In early July 2009, a group of vaccination experts concluded that the pandemic is unstoppable, and Marie-Paul Kieny, WHO director on vaccine research said all nations will need access to vaccines, and that a vaccine should be available as early as September.
Critics point out that the ‘vaccination experts’ are dominated by the vaccine makers standing to gain from the enormously lucrative vaccine and antiviral contracts awarded by governments. But the decisive argument against mass vaccinations is that flu shots simply don’t work and are dangerous [9].
Flu shots ineffective and increase risks of asthma
There are widely acknowledged reasons why flu vaccines won’t work, as already pointed out with regard to the much touted vaccines against the ‘pandemic bird flu’ that has yet to materialize [10] (How to Stop Bird Flu Instead, SiS 35). The flu virus changes quickly - even without the help of genetic engineering in the laboratory, and especially with the help of the intensive livestock industry - whereas the vaccines target specific strains. Furthermore, flu vaccination does not give permanent protection, and must be repeated annually; the vaccines are difficult to mass-produce, and some strains won’t grow at all under laboratory conditions.
Numerous studies have documented that flu shots give little or no protection against infection and illness, and there is no reason to believe that swine flu vaccines will be different.
A review of 51 separate studies involving more than 294 000 children found that in children aged from two years, nasal spray vaccines made from weakened influenza viruses and injected vaccines made from the killed virus prevented 82 and 59 percent of illnesses. The prevention of 'flu-like illness' caused by other types of viruses was only 33 and 36 percent respectively. In children under the age of two, the efficacy of inactivated vaccine was similar to placebo. It was not possible to analyse the safety of vaccines from the studies due to the lack of information, and lack of standardization on the little information available [11]. A report published in 2008 found flu vaccines in young children made no difference in the number of flu-related doctor and hospital visits [12].
On the other hand, a study of 800 children with asthma found that those receiving a flu vaccine had a significantly increased risk of asthma-related doctor and emergency room visits [13]; the odds ratios were 3.4 and 1.9 respectively. This was confirmed in a report published in 2009, which showed children with asthma who received FluMist had a 3-fold increased risk of hospitalization [14]
Flu vaccines are equally useless for adults, including the elderly, giving little or no protection against infection or illnesses including pneumonia (see [9]).
Toxic adjuvants in flu vaccines
Vaccines themselves can be dangerous, especially live, attenuated viral vaccines or the new recombinant nucleic acid vaccines [10], they have the potential to generate virulent viruses by recombination and the recombinant nucleic acids could cause autoimmune diseases.
A further major source of toxicity in the case of the flu vaccines are the adjuvants, substances added in order to boost the immunogenicity of the vaccines. There is a large literature on the toxicities of adjuvants. Most flu vaccines contain dangerous levels of mercury in the form of thimerosal, a deadly preservative 50 times more toxic than mercury itself [9]. At high enough doses, it can cause long-term immune, sensory, neurological, motor, and behavioural dysfunctions. Also associated with mercury poisoning are autism, attention deficit disorder, multiple sclerosis, and speech and language deficiencies. The Institute of Medicine has warned that infants, children, and pregnant women should not be injected with thimerosal, yet the majority of flu shots contain 25 micrograms of it.
Another common adjuvant is alum or aluminium hydroxide, which can cause vaccine allergy, anaphylaxis, and macrophage myofascitis, a chronic inflammation syndrome, In cats, alum also gives rise to fibrosarcomas at the site of injection [15]. Numerous new adjuvants are no better, and could be worse. According to a recent review in a science and business pharmaceutical publication [15], most newer adjuvants including MF59, ISCOMS, QS21, AS02, and AS04 have “substantially higher local reactogenicity and systemic toxicity than alum.”
Current status of swine flu vaccines
Five different companies have been contracted to produce vaccines worldwide: Baxter International, GlaxoSmithKline, Novartis and Sanofi-Aventis and AstroZeneca [16]. Already stretched beyond capacity, there is every intention to make smaller vaccine doses go further with a range of new adjuvants [17], with the blessing of the WHO (see later).
Flu vaccines are traditionally produced from non-virulent (attenuated or weakened) influenza viruses (see Box for a description of the viruses). To be effective, the genes of the non- virulent virus used must match those of the viral strain spreading in the population. Activation of the immune system by exposure to the non pathogenic form of the circulating pathogenic strain leads to the production of antibodies that will confer protection against the pathogenic strain. Producing the non-virulent virus involves first identifying and then recreating the subtypes of two of the virus’s surface proteins, haemagglutinin (H) and neuraminidase (N), which determine the strain’s virulence and ability to spread, and are also the target proteins for vaccine production.
Influenza viruses
There are 3 types of influenza viruses, A, B and C. The influenza A type virus is the main one that cause diseases in birds and mammals. Its genome consists of 8 segments of RNA coding for 11 proteins, and the viruses are further classified by subtype on the basis of the two main surface glycoproteins (proteins with complex carbohydrate side chains): haemagglutinin (H) and neuraminidase (N) [18]. The segmented genome enables the virus to’ reassort’ (shuffle) segments as well as recombine within segments, thereby greatly increasing the rate of evolution and generation of new strains. Reassortment is also widely exploited in the laboratory in the process of creating vaccine strains. To-date, 16 H and 9 N subtypes have been detected in numerous combinations circulating in wild birds [19].
Seed viruses are first made to provide the starting material for large scale production of live non-virulent flu viruses. The seed viruses are approved by the WHO or the United States Food and Drug Administration (USFDA). The usual method of seed virus production is reassortment (see Box). Fertilized chicken eggs are injected with both a standard non-pathogenic influenza strain known to grow well in eggs and the strain that carries the genes expressing the desired vaccine H and N protein subtypes. The two viruses multiply, and their eight genome segments reassort with 256 possible combinations. The resulting recombinant viruses are then screened for the desired virus with the six genome segments that allow the standard strain to grow so well in eggs and the H and N genes from the circulating strain. The seed virus is then injected into millions of eggs for mass production of vaccine. This conventional method of seed stock production takes about one to two months to complete [20].
Cell culture systems may eventually replace chicken eggs. Baxter International applied for a patent on a process using cell culture to produce quantities of infecting virus, which are harvested, inactivated with formaldehyde and ultraviolet light, and then detergent [21]. Baxter has produced H5N1 whole virus vaccines in a Vero cell line derived from the kidney of an African green monkey, and conducted phase 1 and 2 clinical trials with and without aluminium hydroxide as adjuvant [22, 23]. The main finding was that the toxic adjuvant did not increase neutralising antibodies against the vaccine strain. Baxter has agreed to ship H1N1 vaccine by the end of July or early August 2009 but details of the production of that vaccine have not yet been released to the public [16].
In December, a Baxter facility in Austria sent a human flu vaccine contaminated with the deadly H5N1 live avian flu virus to 18 countries, including the Czech Republic, where testing showed it killed the ferrets inoculated [24]. Czech newspapers questioned whether Baxter was involved in a deliberate attempt to start a pandemic.
Norvatis, another big pharma, announced on 13 June that it, too, has produced a swine flu vaccine using cell-based technology and the proprietary adjuvant MF59®. The MF59® adjuvant is oil based and contains Tween80, Span85, and squalene [25]. In studies of oil-based adjuvants in rats, the animals were rendered crippled and paralyzed. Squalene brought on severe arthritis symptoms in rats, and studies in humans given from 10 to 20 ppb (parts per billion) of squalene showed severe immune system impact and development of autoimmune disorders [26].
Novartis was in the news in 2008 for a clinical trial of a H5N1 vaccine in Poland. The trial was administered by local nurses and doctors who gave the vaccine to 350 homeless people, leaving 21 died; and were prosecuted by the Polish police [27, 28]. Novartis claimed the deaths were unrelated to the H5N1 vaccine [29], which had been “tested on 3500 other people without any deaths.”
GlaxoSmithKline’s vaccine will be made up of antigens of the recently isolated influenza strain, and also contains its own proprietary adjuvant system AS03 that has been approved in the EU along with its H5N1 bird flu vaccine in 2008. According to the European Public Assessment Report [30], AS03 adjuvant is composed of squalene (10.68 milligrams), DL-?-tocopherol (11.86 milligrams) and polysorbate 80 (4.85 milligrams). The H5N1 vaccine also contains 5 micrograms thiomersal, as well as Polysorbate 80, Octoxynol 10, and various inorganic salts. The company is aggressively promoting various adjuvant systems as its ‘adjuvant advantage’ that reduces the dose of vaccines [31].
A recent WHO survey of primary vaccine producers concluded that the potential output of 4.9 Billion doses of H1N1 vaccine per year is a best-case scenario, assuming among other factors that the most dose-sparing formulation (that will include toxic adjuvants) be selected by each manufacturer and that production will take place at full capacity. WHO Director-General, Dr .Margaret Chan, and the United Nations Secretary-General, Mr Ban Ki-moon, met with senior officials of vaccine manufacturers on 19 May and asked them to reserve part of their production capacity for poor countries that would otherwise have no or little access to vaccine in the case of a pandemic [32].
The last mass-vaccination in the US was a disaster. In 1976, cases of swine flu were found in soldiers at Fort Dix, New Jersey, and one of them died, most likely of physical overexertion rather than from the infection [7]. This led to the launch of a mass vaccination of 40 million against a pandemic that never materialized. Thousands filed claims for injury. At least 25 died and 500 developed paralyzing Guillain-Barre syndrome [33, 34].
Swine flu syndromes mostly mild
As of 22 July 2009, the CDC listed a total of 40 617 cases in the US, with 319 fatalities, giving a fatalites/case ratio of 0.8 percent [35]; though the real death rate – among all cases of infection including the mild ones that go unreported – is probably much lower. Experts estimate that only 1 out of 20 cases are reported [36].
The UK is the worst affected European country, and the pandemic is in the headlines everyday in July. A new telephone helpline was set up on 23 July to let people get advice and tamiflu without seeing a doctor. In that week, there has been a record rise in cases to 100 000 and a total of 30 deaths so far [37], giving a fatalities/case ratio of 0.03 percent, a more accurate reflection of the actual death rate.
UK’s chief medical officer Sir Liam Donaldson has ordered the NHS to plan for as many as 65 000 deaths, with 350 a day at the peak [38]. There has been no plan as yet for mass vaccination; but the UK government has advance orders for 195 million doses of vaccine with GlaxoSmithKline (GSK).
The vaccine that GSK is developing will be tested on a limited number of people as the UK drug company reportedly [39] “weighs the pandemic danger against the risks of an unsafe shot.” This was criticized as “risky” by Prof. Hugh Pennington, a retired microbiologist at the University of Aberdeen, Scotland. “By limiting clinical trials, Glaxo raises the danger that the vaccine dose isn’t properly calibrated, and could lead to shots that don’t protect people from the virus or at worse are unsafe,” Pennington said.
Pennington added that the shot’s ability to trigger the body’s defences is crucial and requires tests to determine the best dose and whether an adjuvant is needed to bolster the immunity. (As we know, GSK is definitely promoting its new range of toxic adjuvants.) He also referred to the Fort Dix incident in 1976 (see earlier).
France has ordered vaccines from Sanofi, GSK and Novartis, but sees no reason to ask vaccine makers to shorten or skip clinical trials [16]. Sanofi-Aventis, the French drug maker developing its own swine flu vaccine will begin testing the product in early August, and estimates it will need as much as two and a half months of tests before having a shot that’s “both safe and protective”, according to Albert Garcia, speaking for the company’s vaccine unit, “the vaccine will be ready in November or December, he said.
Baxter, however, will produce a vaccine by early August for clinical tests.
Glaxo also said it is developing a face mask coated with antivirals to prevent infection and boosting production of its Relenza drug for patients already suffering from swine flu.
There are obviously safer and more effective ways to combat the pandemic than mass vaccinations: washing hands often, sneezing into a tissue that can be safely disposed of, avoiding unnecessary gatherings, and delay opening schools – all advised by governments - and we would add, eating healthily, exercise, and getting enough vitamin D to boost your natural immunity [10].
References
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