Rapper Kanye West has long had a reputation for attention-seeking and so, when he announced on July 4 that he was going to stand for the presidency, it was hard to know whether he was being serious or just seeking publicity.
But as his behaviour become increasingly erratic, it began to look as if West, who was diagnosed with bipolar disorder in 2016, was in the throes of a manic episode.
Once known as manic depression, sufferers experience extreme mood swings, with periods of depression — during which they feel extremely low and lethargic — punctuated by manic episodes, when they feel very high and are overactive.
His behaviour has attracted as much mockery as concern yet to me this all suggests someone who is in the throes of something very serious. It deserves our compassion and understanding, regardless of how rich or famous he is
Unlike the mood swings that we are all subject to at one time or another, each extreme episode of bipolar disorder can last for several weeks (or even longer).
And given West’s status as one of the biggest celebrities on the planet, if he has a mental meltdown, it is on display for all to see.
The first signs that all was not well came when he gave a rambling, four-hour interview to the business magazine Forbes but it was when he addressed a campaign rally last weekend sporting a bulletproof vest and with the year ‘2020’ shaved into his hair that his conduct gave major cause for alarm.
His behaviour has attracted as much mockery as concern yet to me this all suggests someone who is in the throes of something very serious.
It deserves our compassion and understanding, regardless of how rich or famous he is.
However, his wife — the reality show star Kim Kardashian — publicly addressed the issue on Instagram, describing him as ‘brilliant but complicated’
Of course, there’s no way of knowing precisely what’s going on in his mind and it would be wrong to speculate.
However, his wife — the reality show star Kim Kardashian — publicly addressed the issue on Instagram, describing him as ‘brilliant but complicated’.
On his bipolar condition, she said: ‘Anyone who has this or has a loved one in their life who does, knows how incredibly complicated and painful it is to understand.’
She said the family were ‘powerless’ and added that ‘people who are unaware or far removed from this experience can be judgmental and not understand that the individual themselves have to engage in the process of getting help no matter how hard family and friends try’.
For me this really summed up the awful impact bipolar can have, not just on the individual but also on those around them.
I know the toll it can take as, sadly, I have both friends and family members who have this illness and it really can be exhausting trying to care for someone when they are in the midst of a manic episode.
It is only afterwards that they come to realise the outlandish way they behaved and are overwhelmed with embarrassment. What can follow is a crash into crippling depression.
The pressure this cycle places on those close to the person can be so great I’ve known it to tear families apart.
Bipolar is the fourth most common mental health problem in the UK after depression, anxiety and schizophrenia, with an estimated 3 million sufferers.
Younger people are more likely to have it than older ones, with 3.4 per cent of 16 to 24 year olds screened positive compared with only 0.4 per cent of 65 to 74 year olds.
Bipolar disorder can be treated with a variety of talking therapies and drugs known as ‘mood stabilisers’, such as lithium, and anti-psychotic medicines.
Sufferers are also advised to take regular exercise, eat a balanced diet and ensure they get a good night’s sleep.
I wince whenever I hear people talk flippantly about ‘being a bit bipolar’ when they describe behaviour that is erratic or temperamental, for, in reality, it is a hugely disabling condition.
While doctors and campaigners have spent years encouraging people to be open about their struggles with mental health, the downside has been that many celebrities have opened up about their battle with bipolar and, as a result, it has come to be viewed as a ‘glamorous’ condition.
Indeed, I’ve had many patients come to me with regular mood swings who have been quite disappointed when I tell them they don’t have it.
Of course, as with many conditions, some have more serious symptoms than others. I know doctors, lawyers, and teachers with the condition who hold down jobs and maintain relationships.
But it is a condition that requires careful monitoring and, for many, serious psychiatric medication — sometimes for life. It’s certainly nothing to joke about.
So don’t shake on it — take a bow…
It’s the standard form of greeting in many Western countries but the days of the handshake could be well and truly over.
Baron Piot, a Belgian professor and microbiologist from the London School of Hygiene and Tropical Medicine, told the Science and Technology Committee this week that the UK should adopt a Japanese-style of greeting to prevent further outbreaks of Covid-19.
I’m quite a fan of the deferential, stately bow — much better than the jocular elbow bump that we briefly flirted with before lockdown.
And am I the only one who’s also a little relieved that the pandemic means we can’t hurry back to hugging people as a form of greeting?
It’s the standard form of greeting in many Western countries but the days of the handshake could be well and truly over [File photo]
We’ve known for some time that professional footballers are at increased risk of neurodegenerative disorders such as dementia.
However, a Glasgow University study called Football’s Influence On Lifelong Health And Dementia (FIELD) this week found that former footballers are at a considerably lower risk of being hospitalised with depression than the general population.
This would suggest that being a footballer somehow protects against mental illness but I would counter that what it demonstrates is the ‘healthy worker’ effect — the stresses and strains of entering such a competitive area favours those who are less predisposed to developing mental health problems in the first place.
So it’s not that football protects from mental illness, more that those with mental health problems are less likely to make it in professional football.
Couch potatoes are more likely to die from heart disease, cancer and other causes, according a study at Glasgow University. This led me to ponder the effects of watching TV on our mental health, too. I’ve never owned a telly (I know, I know!). But during lockdown I stayed somewhere that had one and, initially, kept it on for company.
I was struck by how my anxiety levels increased thanks to a constant diet of rolling news. I also wonder about its effect on attention levels — so many shows these days dart from one thing to the next, fearful that any lull will make the viewer switch channels.
Things like attention and concentration are skills though that need to be practised. We aren’t even given the chance.
Dr Max prescribes… Bimuno fibre supplement
I’ll admit it: since lockdown, my diet hasn’t always been great, lacking fibre in particular. In fact, most of us need to eat more fibre — it leads to a lower risk of heart disease, strokes, Type 2 diabetes and bowel cancer.
We are increasingly appreciating the vital role that our ‘microbiome’ (the types of bacteria we have in our guts) has, not only in our physical health but also our mental health, with bad bacteria being linked to stress, anxiety and depression.
So I’ve been taking Bimuno, which contains a type of fibre that helps nurture the good bacteria in your gut. It comes in small sachets of tasteless powder, which you can sprinkle over food or mix into drinks that you take daily. And it aims to work within a week.
The truth about shock therapy
This week, the journal Ethical Human Psychology and Psychiatry published a study of ECT, the controversial electric shock therapy used to treat severe depression, that claimed it causes side-effects, such as memory problems, and should therefore be banned.
A group of 40 clinicians, researchers and patients then sent a letter condemning the practice to Health Secretary Matt Hancock.
For many years, I also had concerns about the practice. When I was a junior doctor I was so unsure about the ethics of the procedure that I risked being formally disciplined, when I refused to utilise it until I had investigated it further.
I think ECT has had a bad press because of the way it was used years ago.
Certainly, the image I had was of a screaming patient, tied to a bed in a grotty back room of a 1950s asylum, being given electric shocks until they were gibbering wrecks.
What I found, however, was a treatment that gave hope when all hope was lost. ECT takes place in an operating theatre, where the patient is anaesthetised and given a muscle relaxant to stop them jerking during the seizure.
It also has far fewer side-effects than many of the anti-depressants I happily prescribe. The truth is that depression kills and ECT can be a lifesaver.
When I was a junior doctor I was so unsure about the ethics of the procedure that I risked being formally disciplined, when I refused to utilise it until I had investigated it further. The type of therapy is depicted above
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Black and Asian people may be more likely to die of Covid-19 because of POLLUTION
Black and Asian people may be more likely to die of Covid-19 in England and Wales because many of them live in polluted areas, according to an official report.
The Office for National Statistics (ONS) today said it found a seven per cent increase in the risk of dying of coronavirus in England’s most polluted areas.
But this increase seemed to disappear when experts took people’s race into account, prompting the government agency to admit the link was ‘inconclusive’.
The findings suggest ethnic minority people are more likely to die from the disease because they live in polluted cities.
But the ONS warned toxic air is not necessarily worsening the risk from the virus because London and other pollution-hit areas were the first to be hit, meaning death rates would inevitably be higher.
However, the ONS today acknowledged that air pollution is ‘one of many factors’ that could be driving disproportionate outcomes for black, Asian and minority ethnic (BAME) people. And scientists today said it was ‘very plausible that higher exposure to air pollution will be a contributory factor’.
Numerous reports have found that BAME people in Britain face a higher risk than white people of dying if they catch coronavirus.
The reasons for this remain unclear but may include the fact minority ethnic people are more likely to be poorer and therefore in worse health, and more likely to work in public-facing jobs where they are more likely to catch the illness.
The ONS report said 35 per cent of people who died of Covid-19 up to June had a lung or heart disease — which can be caused by pollution — before they caught the virus.
As the virus spread further outside of polluted cities and around the country – it began in London, which has had the most total deaths – the link between pollution and deaths became weaker (illustrated as graph lines flattened)
The report, the first of its kind published by the ONS, said the effect of pollution on risk of coronavirus death appeared to be smaller than previous research had suggested.
The statistical analysis grouped areas across the country according to levels of deprivation, population density and average exposure to PM2.5 over five years to account for regional differences in infection rates.
It included 46,471 deaths of people in England between March 7 and June 12, using a model that also took into account factors such as pre-existing health conditions and smoking rates. It also looked at ethnicity.
It estimated that there was a seven per cent increase in Covid-19 death risk for people who inhaled an extra one microgram per cubic metre of particulate matter over 10 years.
Particulate matter is pollution made up on tiny particles that are produced by car exhausts, friction between tyres and roads, and construction work.
The World Health Organization said no amount of PM2.5 – the smallest type of particulate matter – is considered safe, but said countries should try to keep levels below 10 micrograms per cubic metre.
Currently, the UK follows EU guidelines which are looser and suggest pollution be limited to 25ug/m3. In London the average was between 12 and 20ug/m3 in 2016.
PM2.5 infiltrates the blood stream and lungs, irritating cells and disrupting DNA, and cause serious damage to the body if absorbed regularly over long periods of time.
The ONS report found that at the peak of Britain’s epidemic, death rates were higher in more polluted areas, typically inner London and Birmingham.
But this was also because of other factors, such as numbers of confirmed cases and the number of people living in poverty.
As the outbreak spread further outside of cities, the link between pollution and deaths became weaker, the report showed.
AIR POLLUTION MAY RAISE RISK OF CATCHING VIRUS
People are more likely to catch Covid-19 in areas with bad air pollution because particles can ‘carry’ the virus, scientists have claimed.
Now, international researchers led by Taipei Medical University in Taiwan have claimed pollution plays a ‘direct role’ in the spread of the disease.
Viruses may be absorbed by particulate matter – produced mostly by car fumes and construction work – and then travel or linger in the air for hours or even days before being inhaled by someone, they said.
This would suggest the coronavirus is airborne, meaning people can inhale it from tiny particles in the air.
Moreover, evidence suggests particulate matter may make the cells in the lungs more susceptible to the coronavirus, increasing the risk of someone becoming badly affected.
As the more polluted — and more populated — areas had higher deaths, so too did the black, Asian and ethnic minority community.
Greater proportions of non-white people live in polluted inner city areas than white people, who are more likely to live outside of town and city centres.
The ONS report noted that pollution may contribute to the deaths of BAME people, or that BAME people may be at risk of dying because of other reasons, which made deaths higher in the polluted areas they happened to live in.
‘A range of structural differences are resulting in higher Covid-19 death rates among people of Black, Asian and Minority Ethnicity (BAME),’ the report said.
‘Air pollution exposure could be a contributing factor if it causes Covid-19 deaths, with the BAME population more likely than those of White ethnicity to live in inner city areas (that are more polluted).
‘Ultimately, our analysis is inconclusive.
‘Without controlling for ethnicity, we find long-term exposure to fine particulate matter (PM2.5) could increase the risk of contracting and dying from Covid-19 by up to 7 per cent.
‘However, when controlling for ethnicity, air pollution exposure has no statistically significant impact on Covid-19 deaths.
‘As air pollution is just one of many factors that could be driving disproportionate outcomes for minority ethnic groups, the increased risk of dying from Covid-19 (found when ethnicity is not controlled for) is likely to be an overestimate of the true effect.’
Professor Alastair Lewis, an atmospheric chemistry expert at the University of York, said: ‘The study shows that some of the early associations made between exposure to air pollution and an increased risk of Covid-19 mortality were artificially enhanced because the disease initially spread in large cities.
‘As Covid-19 became more evenly distributed through the UK over time the effect of air pollution on mortality became less pronounced.
‘The ONS analysis shows that long-term exposure to air pollution does still potentially increase the risk of mortality from Covid-19’.
He added: ‘Ethnic minority communities have been some of the most affected by Covid-19 and it is very plausible that higher exposure to air pollution will be a contributory factor.’
The ONS report comes after a paper published by Public Health England in June found that BAME Brits had a noticeably higher risk of dying if they caught Covid-19.
The PHE report revealed Britons of Bangladeshi ethnicity have around twice the risk of white Brits of dying with the coronavirus.
And it showed black people, as well as those of Chinese, Indian, Pakistani, other Asian, or Caribbean backgrounds had between a 10 and 50 per cent higher risk of death. The analysis did not take into account higher rates of long-term health conditions among these people, which experts say probably account for some of the differences.
SAGE STUDY CLAIMS ILLNESS AND DEPRIVATION ACCOUNT FOR HIGHER DEATH RATE AMONG BAME BRITONS
Black, Asian and minority ethnic people are no more likely to die from coronavirus than white people, a study given to government scientists has found.
Research presented to Number 10’s SAGE panel found there was no greater risk of death for Brits of BAME backgrounds when all factors were taken into account.
It showed that ‘comorbidities’ – long-term health problems – appeared to account for higher rates of hospitalisation and intensive care among ethnic minority people.
Risk among BAME communities has been a sensitive topic during Britain’s outbreak and even given rise to calls for extra protection for non-white NHS staff.
Statistics show BAME people in Britain are dying of COVID-19 at disproportionate rates, but scientists have struggled to explain why.
The research – done by scientists from the universities of Edinburgh and Liverpool – was one of around a dozen secret papers published last night by the government.
It did, however, claim BAME people did seem to be more likely to end up in intensive care in the first place.
The SAGE paper was met with scepticism, however, with one intensive care doctor saying the data it contained did not line up with what the scientists claimed.
Oxford University’s Professor Duncan Young said: ‘I’m not sure why they thought black patients were more at risk of ICU care.
‘The take-home message is that BAME patients admitted to hospital with COVID-19 are no more likely to end up in ICU nor are they more likely to die.’
Evidence compiled in the report also revealed that age is the single biggest risk factor that determines how likely people are to die with the virus – those over the age of 80 are 70 times more likely to be killed than under-40s.
And health conditions which appeared often on people’s death certificates were heart disease, diabetes – understood to be type 2 diabetes, high blood pressure and dementia. More than one in five victims had diabetes, the data showed, which was a significantly higher rate than in people who died of other causes.
Poorer, more deprived people faced a higher risk of dying and men working in lower-paid jobs – such as security guards, bus drivers and construction workers – also had worse chances of survival if they contracted the virus.
Health chiefs launched a probe to investigate the disproportionate impact of Covid-19 on BAME Brits in April, prompted by a wave of evidence that showed white people were less likely to die from the disease.
Mr Hancock admitted that the report has ‘exposed huge disparities in the health of our nation’ and his counterpart in the Labour Party, Shadow Health Secretary Jonathan Ashworth, noted: ‘Covid thrives on inequalities’.
Doctors still don’t know exactly what is increasing non-white people’s risk of death, but PHE’s report adds to a growing body of evidence proving the link exists.
One paper presented to government advisers in SAGE suggested that higher-than-average rates of type 2 diabetes among black and south Asian people may be to blame – the condition is known to increase risk of Covid-19 death.
The highest diagnosis rates per 100,000 population were in black people (486 females and 649 males), the PHE review found. The lowest were in white people (220 in females and 224 in males).
Compared to previous years, death from all causes was almost four times higher than expected among black males, almost three times higher in Asian males and almost two times higher in white males.
Among females, deaths were almost three times higher in this period in black, mixed and other females, and 2.4 times higher in Asian females compared with 1.6 times in white females.
The highest death rates of confirmed cases per 100,000 population were among people in ‘other’ ethnic groups (234 females and 427 males) followed by people of black ethnic groups (119 females and 257 males) and Asian ethnic groups (78 females and 163 males).
In comparison, the death rates of confirmed cases in white people was 36 per 100,000 females and 70 per 100,000 males.
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Nasal spray could prevent people from catching the coronavirus, scientists claim
A nasal spray may prevent humans from catching Covid-19 and could even be more effective than wearing PPE, scientists claim.
Experts at the University of California, San Francisco created ‘AeroNabs’, which can also be inhaled.
They hope it will act as a short-term tool to prevent thousands of people becoming infected before a vaccine is eventually discovered.
AeroNabs contains nanobodies, which are antibody-like immune proteins found in the blood of llamas, camels and alpacas.
But the nanobodies in the formula are synthetic and have been engineered to target SARS-CoV-2, the virus behind the pandemic.
Lab tests have shown the tiny proteins — about a quarter of the size of antibodies found in humans — can block the coronavirus from entering cells.
But the AeroNabs formula still needs to be proven in clinical trials, to see whether it really can prevent a person from actually getting infected.
Nanobodies are so small that synthetic versions could be mass produced quickly, the researchers say.
A nasal spray may prevent humans from catching the coronavirus and be more effective than wearing PPE, scientists in California claim (stock)
AeroNabs contains nanobodies which are antibody-like immune proteins that naturally occur in llamas (stock), camels and alpacas . But the nanobodies are synthetic
Dr Peter Walter, a professor of biochemistry and biophysics at UCSF and co-inventor, said: ‘Far more effective than wearable forms of personal protective equipment, we think of AeroNabs as a molecular form of PPE that could serve as an important stopgap until vaccines provide a more permanent solution to Covid-19.
‘For those who cannot access or don’t respond to SARS-CoV-2 vaccines, AeroNabs could be a more permanent line of defense against Covid-19.’
Nanobodies were originally discovered in a Belgian lab in the late 1980s and have intrigued scientists worldwide ever since.
Researchers across the world have turned their attention to nanobodies, in hope that they can be tailored to neutralise the coronavirus.
WHAT ARE NANOBODIES?
The remarkable properties of antibodies found in the blood of camelids – camels, llamas and alpacas – were first uncovered by experts at Brussels University in 1989.
Since their discovery in the Belgian lab, the distinctive properties of nanobodies have intrigued scientists worldwide.
Dr Aashish Manglik, a co-creator of AeroNabs and an assistant professor of pharmaceutical chemistry, has frequently employed nanobodies as a tool in his research.
He said: ‘Though they function much like the antibodies found in the human immune system, nanobodies offer a number of unique advantages for effective therapeutics against SARS-CoV-2.’
The small size of the antibodies allows scientists to target microscopic viruses more effectively in what is known as nanobody technology.
Because nanobodies are so much smaller than human antibodies, they are easier to manipulate and modify in the lab. Their small size and relatively simple structure also makes them significantly more stable than the antibodies of other mammals.
Plus, unlike human antibodies, nanobodies can be easily and inexpensively mass-produced.
Scientists insert the genes that contain the molecular blueprints to build nanobodies into E. coli or yeast, and transform these microbes into high-output nanobody factories. The same method has been used safely for decades to mass-produce insulin.
Another South Korean study, reported in the Cell Host and Microbe journal, has found ferrets infected with Covid-19 responded similarly to humans and could be ‘a useful tool to evaluate the efficacy of [antiviral treatments] and preventive vaccines.’
Researchers in Hong Kong have also found Syrian hamsters had a reaction to Covid-19 which ‘closely [resembles] the manifestations of upper and lower respiratory tract infection in humans.’
The study, published in Science magazine, found eight hamsters ‘lost weight, became lethargic, and developed ruffled fur, a hunched posture, and rapid breathing’ when infected with the virus.
Nanobodies have proven to work against similar coronaviruses in the past, including the one that causes Severe Acute Respiratory Syndrome (SARS).
They are similar to human antibodies, which are immune proteins produced by the body in response to a pathogen.
The antibodies latch on to the pathogen and either tag it for other immune cells, or disable it themselves.
Nanobodies function much like human antibodies, which are also being synthetically produced on mass to create therapies against Covid-19.
But nanobodies have a number of unique advantages for medicines, AeroNabs co-inventor Dr Aashish Manglik said.
He said nanobodies are much smaller, so they are easier to manipulate and modify in the lab and gear towards attacking viruses.
The researchers, led by graduate student Michael Schoof, engineered a completely synthetic molecule based on nanobodies.
Their findings are published in a paper on the preprint server bioRxiv, meaning it has not yet been reviewed by other scientists.
To find effective nanobody candidates, the scientists analysed more than two billion synthetic ones from a library in Dr Manglik’s lab. It was not clear when and how these synthetic nanobodies were created and for what purpose.
Tests ruled out weaker nanobodies. The team ended up with 21 nanobodies that had the potential to work against the coronavirus.
SARS-CoV-2 is covered in spikes which are used to infect human cells.
The spikes attach to ACE-2 receptors found on the surface of human cells, including those that line the nasal passageway, lungs and airways.
ACE-2 receptors act like a doorway for the virus to enter cells, and the researchers essentially want to block that doorway.
The select 21 synthetic nanobodies bounded to the spikes of the coronavirus and blocked the ACE-2 interaction.
The nanobodies function a bit like a sheath that coat the spikes, or the ‘key’, and prevent it from being inserted into an ACE-2 ‘lock’, the release said.
In further experiments, Dr Veronica Rezelj, a virologist at Institut Pasteur in Paris, tested the three most promising nanobodies against the SARS-CoV-2.
She found the nanobodies to be ‘extraordinarily potent, preventing infection even at extremely low doses’.
The most potent nanobodies not only act as a sheath, but also as a ‘mousetrap’. They clamp down on the virus’s spikes when it is in an inactive state so that it cannot open up again.
The scientists then engineered this nanobody to create two more genetically similar ones, using the three to make AeroNabs.
It was 200,000 times more potent than a single nanobody alone. Professor Walter said its results against SARS-Cov-2 were ‘off the charts’.
‘It was so effective that it exceeded our ability to measure its potency’, he claimed.
The researchers still need to demonstrate that the synthetic nanobodies, and AeroNabs, could prevent the real virus from infecting cells.
Dr Manglik, an assistant professor of pharmaceutical chemistry, said: ‘Our team is in ongoing discussions with potential commercial partners who are interested in manufacturing and distributing AeroNabs, and we hope to commence human trials soon.
‘If AeroNabs prove as effective as we anticipate, they may help reshape the course of the pandemic worldwide.’
Early research using llama nanobodies has also been taking place at the Rosalind Franklin Institute at Oxford University.
Academics hope the llama-derived proteins could eventually be developed as a treatment for humans struck down with a severe case of Covid-19.
Scientists took nanobodies from the blood of a llama called Fifi and tweaked them in a lab to target the interaction between the virus’s spikes.
Some experts say it could be used like convalescent serum therapy, which is when the antibody-rich blood of a Covid-19 survivor is injected into a patient.
But AeroNabs, the creators say, does not need to be administered in the blood and can be given directly to the lungs and or nasal passages.
Early research using llama nanobodies has also been taking place at the Rosalind Franklin Institute at Oxford University. Pictured: A diagram showing how scientists turned tiny antibodies from a llama, called nanobodies, into potential Covid-19 treatment in a lab
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Family Told to Let Their Baby Die Instead of Raising Money For His Rare Disease
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