Luxury Vaccine Tourism

Most vaccines are commercially available in Sweden. There are two vaccine clinics at the nearest big mall to where I live. Two months ago, on 5 December, I mused on Facebook, “Wonder when covid-19 vaccination will become commercially available in Sweden and what the price will be at first.”

This question met with really strong reactions. People accused me of having no solidarity with the sick and elderly, of being a bad Social Democrat, of undermining social healthcare. But I wasn’t suggesting that the vaccine doses secured by the EU from certain manufacturers should be taken out of that system and sold on the open market. Additional manufacturers will pop up, eager to market their products. And taking a vaccine is not like paying to get good cancer treatment for yourself while someone poor dies. Me getting vaccinated benefits the entire herd’s health, not just mine. And if I pay for vaccination outside of the social healthcare system, then that system saves some money.

Anyway, Expressen reported on 28 January that covid-19 vaccination is now sort of available in Sweden, or more exactly, on the Swedish market. And it costs a bit less than SEK 1 million = U$D 120,000 = € 99,000 for two shots. Pricey? Yes, but it includes airfare to Dubai, the UAE, India or Morocco plus luxury accommodation and meals for two weeks. So the market has spoken: if you pay more than $120,000 for two covid-19 shots today, you are not getting a good price.

Swedish social healthcare expects to offer people like me the vaccine for free in April or May. If I can get it legally and locally for less than $120 prior to that date, I believe I’ll go for it. Watch this space.

A Swedish Perspective on COVID19

Our departmental webmaster in Łódź asked me to write this piece from 23 April about my impressions of the Swedish response to COVID19. I’m posting it here too.


As I write these lines I have been distancing myself from society for 39 days, since Monday 16 March. Voluntarily, because I live in Sweden. Our government’s approach to containing the pandemic has been discussed quite a lot internationally. Before I go into that, let me describe my personal experience.

The big change for me is not that I work from home. That’s what I’ve done mostly for many years as a research scholar without a university office. Instead, the biggest thing is that my 16-year-old daughter’s high school lessons are now all online, so she is also home all day, five days a week. We get along really well and it’s frankly an improvement of my circumstances. Another change is that I have only been once to central Stockholm and the Academy of Letters’ research library, and currently the library is closed except by special appointment. And I buy groceries for my elderly mother. My father and his wife have stubbornly turned down my offers to shop for them.

My work has continued as planned, without any major frustrations. I have a pretty good library of my own, the most important Swedish archaeology databases have been online for decades, and these days you can get a lot of new journal papers in PDF format online or simply by emailing one of the authors. I’ve submitted three pieces of writing in these quarantine weeks.

When I take walks and cycle in the Erstavik woods nearby I meet more people than usual. We nod and say hi to each other, but we keep our distance. My parents also go out walking a lot. In Sweden, most of us feel that we need to avoid crowds, but not necessarily sit indoors and wait. My boardgaming group still convenes every weekend, but we have moved to my buddy’s house that is better situated for people to reach it on foot or by bicycle. Nobody wants to use public transport much. We figure that us meeting three “unnecessary” people every week won’t change the progress of the pandemic, and it does a lot for our mental well-being.

As for the official Swedish policy, I understand that the main difference to what other countries do is that going out and meeting people isn’t actually forbidden here. It’s just very strongly discouraged, for reasons that are very clearly explained. And events with more than 50 participants are forbidden for the time being. Some important reasons for this policy, as I understand them, are:

  • By design, Swedish law makes it really difficult to impose a long-term general curfew with sanctions against those who break it. It’s a civil liberties issue.
  • In the long term, we have to build herd immunity to the virus either by infection or by vaccination. We can’t afford to sit around at home until mid-2021 when scientists hope to have a vaccine ready for mass production. You can stop the pot from boiling over temporarily by putting a really heavy lid on it, but sooner or later the lid will fly off. It’s better to turn down the heat and let off the steam a little bit at a time. After a quiet period, there will be a second wave of the pandemic. How high that wave will go depends on herd immunity.
  • Swedish people largely trust our government, and our government largely trusts our scientific authorities. So when the government tells us that the scientists think it’s really important to avoid crowds, then most of us act accordingly. We don’t view this as a policy driven by ideology. It’s not a partisan issue. I would go along with it even if I hadn’t voted for the party that currently governs the country.
  • If you close daycare centres and schools for young children, then someone has to stay home with those children. That someone will often be their dad who is a nurse, their mother who is a doctor, or their grandmother. This will leave you with insufficient hospital staff and a lot more infected grandmothers in intensive care.
  • If you close down your national economy too severely for too long, then even if you don’t suffer many dead during the first wave of the pandemic, everyone will be in extremely poor financial shape when the second wave hits. This can prove lethal in itself.

Of course, there are particular problems in Sweden too. The most important one is that a lot of our very elderly people are in care homes, and the care workers there are generally poorly paid and cannot afford large apartments or cars. So it is a tragic coincidence: the people who run the greatest risk of dying from the virus are cared for by the people who have the greatest difficulty in distancing themselves from crowds: they ride the subway from their crowded homes to work. With predictable results.

A sillier problem is that people have been hoarding goods. First it was pasta and toilet paper, which is ridiculous because Sweden is well supplied with wheat and has one of the world’s largest and most efficient paper industries. The last thing Sweden will ever run out of is toilet paper. But when people calmed down about that, they started hoarding baking yeast. And apparently the one single company that makes yeast in Sweden does not have production capacity enough to capitalise on this sudden enormous rise in demand. But I am OK, I always have a couple of packets of powdered yeast sitting in the cupboard.

Last week was the first one since the pandemic reached Sweden that the number of new intensive care admissions for covid-19 shrank – by 11% . I hope this means that we’re past the crest of the first wave now. We can’t go back completely to normal until after the second wave. And whether our policy is better or worse or indifferent compared to those of other countries, nobody can tell until a couple of years from now.

Update 28 April: ICU admissions have continued to decline: -15% last week. We’re past the crest of the first wave. Phew!

2015 Enlightener & Deceiver Awards

The Institutet radio show: 2015 Enlighteners of the Year
The Institutet radio show: 2015 Enlighteners of the Year
The Swedish Skeptics have announced their annual awards for 2015.

The Enlightener of the Year award is given to a radio show on Swedish Broadcasting’s channel 3, Institutet, “The Institute”. Show hosts Karin Gyllenklev and Jesper Rönndahl use humour to reach out with science content to a wide audience.

The Deceiver of the Year anti-award is given to a neighbouring show of the aforementioned, channel 1’s Kaliber, “Calibre”. They get this doubtful honour for a show where they suggested that vaccination against HPV, Human Papilloma Virus, carries serious risks. Their slanted and selective reporting of the science may cause some people to withhold this life-saving jab from their kids. I talked to a similarly angle-pushing TV reporter about this in 2013.

I’m Donating White Blood Cells

I’ve been a blood donor for over twenty years. The other day a doctor called me and asked me if instead of my normal quarterly donation, I’d be willing to give a few extra hours of my time along with a chunk of white blood cells. I said yes.

There’s this transplant patient at a hospital in Stockholm. Like all such patients this person, let’s call her Joan (I have no idea what her real name is), is on immune suppressant drugs to keep her body from tossing out the transplanted organ. She now seems to have contracted a difficult infection. Unfortunately she’s developed antibodies against run-of-the-mill donated blood that would work in most cases. So in order to give Joan white blood cells to beat the infection, you can’t just look at the AB and Rh factors, you need to look at tens of genetic markers until you find a rare match. Me, in this case.

For me, it’s three visits to the hospital. Monday morning, they first checked my health, which turned out to be very good. Then they drew some of my blood and mixed it with Joan’s in a tube to see if it would provoke an immune response. When it did not, they injected me with filgrastim. This is a synthetic analogue of the hormone G-GSF, granulocyte-colony stimulating factor. In the body, G-CSF is secreted here and there, and it causes the bone marrow to make granulocytes and stem cells and release them into the bloodstream. Granulocytes are a category of white blood cells, the immune system’s foot soldiers.

After the doctor and nurse had seen that the injection didn’t cause me to keel over, they sent me off with some dexamethasone pills to take Monday evening. This is a steroid similar to the hormone cortisone, which has a wider range of functions, one of which is apparently to get those granulocytes out into my blood quicker.

The doctor warned me that I might feel a little creaky in the evening from the sudden flooding of my system with unneeded white cells. And I did, like if I had the flu coming on distantly. But I consoled myself with the thought that I was still in much better shape than Joan. This morning I was back at the hospital and got hooked up to a centrifuge. They’re taking blood out of my left arm, spinning it up in the centrifuge until it separates into layers by density, grabbing the bottom part of the layer of white blood cells (the youngest ones), and then sending the rest back into my right arm. They’ll keep at this for two hours, then shoot me up with more filgrastim and send me off with some more dexamethasone, for the whole procedure to be repeated tomorrow morning.

Why am I a blood donor? Why am I doing this complicated thing for Joan, whom I’ll never meet? Well, because I’ve been helped many times by modern medicine, I believe in solidarity and I’ve been taught to feel good about myself when I’m altruistic. And really, it doesn’t cost me much to help out here.

If you want to be all Darwinist, then you can actually say that I’m acting in my evolutionary self-interest. Joan and I are genetically similar. In helping her stay alive, I improve the chances of my genes spreading in the population. Joan is a transplantee and might neither have any kids nor be in any shape to bear them in the future, what do I know. But maybe she has nieces and nephews, whose evolutionary environment will be a bit less harsh if their aunt is around to help feed, protect and raise them. And then they may go on to have five kids each who share a lot of my genes. Anyway, me and Joan are blood kin now.

Talking To Stubbornly Angle-Pushing Journalist About Vaccine

As part of my duties as chairman of the Swedish Skeptics, earlier tonight I took part in a studio discussion on Swedish TV4 about Gardasil, the vaccine against human papilloma virus that is offered to all 12-y-o Swedish girls. It was a pretty silly affair. The TV people had decided on the angle that the information given about the vaccine to young girls isn’t detailed enough. For instance, the school hallway fliers don’t tell the kids that the protection rate against HPV isn’t 100% (duh) or that very rarely the vaccine can provoke some serious side effects (duh again). These are traits, I should probably explain, that Gardasil shares with all other vaccines. And they had invited a young lady who suffers from a rare side effect. Not, as I pointed out on air, the 10,000 contemporaries of hers who have not experienced any side effects.

In my opinion, the crew had taken on a feeble story from a feeble angle and run way too far with it. Wouldn’t surprise me if they get their fingers slapped by the Swedish Broadcasting Commission. But still fun to practice my TV skillz.

2012 Enlightener & Deceiver Awards

The Swedish Skeptics have announced their annual awards for 2012. Both the Enlightener award and the Deceiver award are given to the editorial staff of programmes on Swedish national radio.

Medierna is a weekly media criticism show. They roast journalists in an excellently skeptical fashion and have during the year touched upon mistreatment of subjects such as climatology, alternative medicine and vaccination.

Nyhetsguiden is a daily news analysis show. In April and May they ran several anecdote-based antivaccine stories about the ongoing effort to vaccinate prepubescent girls against the cancer-causing HPV virus. This was particularly irresponsible as the Swedish public has a heightened vulnerability to antivax propaganda after the nationwide swine flu vaccination programme was found to correlate with a heightened incidence of narcolepsy. Nyhetsguiden also flirted with climate denialism in November. This kind of reporting is alas what often happens when the science beat is left to general news reporters.

The Huskvarna Drug

Recently while reading Mats Keyet’s 2000 biography of Swedish beat novelist Sture Dahlström, I came across the sad story of the Huskvarna drug. It killed Dahlström’s father and many others.

In 1961 Dr. Hjorton’s powder was made a prescription drug. This measure was of no great consequence anywhere except in Huskvarna, a small single-company industrial town on Lake Vättern. To Americans, it’s probably mostly known for the old Husqvarna motor bike brand. In the mid-1950s the company doctor realised that Dr. Hjorton’s powder was not only dependency-forming but in fact caused lethal kidney damage when taken too often and for too long. Workers at the Huskvarna factory had been taking it regularly even when not ill. They were in fact chemically dependent on a lethal drug. But outside of Huskvarna, few had even heard of Dr. Hjorton or his drug. What had happened here?

The powder was no patent medicine: its composition was known and it was made at the local druggist’s. The ingredients of a dose were:

  • A pain killer and fever reducer: 500 mg phenacetin (Now known to cause cancer and kidney damage)
  • Another pain killer and fever reducer: 500 mg phenazone
  • A stimulant: 100 mg caffeine

Herman Hjorton opened his medical practice in Huskvarna in 1903, the year of his graduation and the year when the gun factory expanded into motorcycles. He was 34 and had sensed an opportunity in the expansive little town. Hjorton was the town’s first doctor and he soon got a reputation for diligence, compassion and approachability, making house calls at all hours. In 1906 a drug store opened in Huskvarna and Hjorton moved his home and practice to the same building.

In 1918 the Spanish flu pandemic struck: an aggressive influenza that often caused lethal pneumonia, particularly in young and strong people. Medicine at the time had no antiviral drugs (we still don’t for flu) and the first antibiotics were hard to come by after WW1, so there was not much a doctor could do for the sufferers. Except for the fever, and the muscle pain that was a common symptom of the viral infection. Dr. Hjorton could treat those. And so he came up with his formula, which actually seemed to help.

Hjorton’s 50th birthday party in 1919 was a huge event for the town, whose inhabitants saw him as a hero. When he died of a heart attack four years later, the whole district was rocked by grief and he was given the biggest funeral in Huskvarna’s history. He had been cycling to a patient when his heart gave out. But though the Doctor was dead, his formula lived on and the sales continued to increase.

Sales increased though the pandemic was over? People were no longer taking it as a flu remedy. They took it as a stimulant. Everybody knew about the powder after the pandemic, and since it wasn’t a prescription drug no doctor needed be involved when you bought it at the drug store. Nor was there any limit to how much you could buy. Many working class families took Hjorton’s powder every morning. Factory workers found that the powder made them faster, stronger, less tired and free of pain. This improved their earnings: in the 1920s performance-related pay became common. They took the powder at work, offering each other a baggie of Dr. Hjorton’s like workers elsewhere would share cigarettes or snuff. The medical establishment didn’t react other than to call it a bad habit. And Dr. Hjorton himself had become a silent authority.

During WW2 phenacetin became rationed and Huskvarna’s inhabitants had to mail-order the powder from drug stores all around Sweden. Their use of it peaked in the 1950s, when one Huskvarna drug store sold 8000 baggies a day. The company that made the baggies was told that a million of them would only last for three months in that drug store. And for some reason, the town’s workers were dying young of kidney failure.

Indirectly, the Huskvarna drug decades ended thanks to the labour union. It was making a general demand that major factories employ doctors, and so, in the early 50s when the drug use was approaching its peak, Kurt Grimlund was hired as company doctor. He came from the neighbouring town of Jönköping where he had already seen an unusual number of kidney failure cases. In 1953, Swiss researchers published a study documenting a link between phenacetin use and kidney damage. Phenacetin was a widely prescribed drug, and so the study sparked intensive international research, some of which Grimlund performed in Jönköping. As a result phenacetin became a controlled substance in Sweden in 1961, and in 1983 it was taken off the list of legal drugs entirely.

But what about the Huskvarna substance abusers after 1961? No doctor would prescribe anywhere near the amount of Dr. Hjorton’s that they were used to taking. They were recommended Koffazon powder instead and seemed quite happy with it. It probably helped that Grimlund had run an information campaign about phenacetin and early death at the factory in the mid-50s. Koffazon is still an over-the-counter drug in Sweden. It’s Dr. Hjorton’s powder minus the phenacetin.

*

This blog entry is based on C. Andersson 2009, Sippan som hjälpte mot allt. En studie runt det omfattande bruket av Dr Hjortons pulver som ägde rum i staden Huskvarna och på fabriken Husqvarna AB, BA thesis, Jönköping University College. She refers repeatedly to K. Grimlund 1963, “Phenacetin and renal damage at a Swedish factory”, Acta Medica Scandinavica, Stockholm. Andersson’s maternal grandfather died young from kidney failure in Huskvarna.

El-Mag Crank Gets Galileo Argument Wrong

I got a letter with criticism from a man who believes in electromagnetic hypersensitivity and thinks I should too. Most of the letter is the Galileo argument, where the letter writer refers to an anthropologist whose ideas were, in his view, once highly respected until they were taken apart by critical thinkers. I should be as critical of the current medical consensus regarding radiation phobia as these thinkers were of the anthropologist, says the letter writer, because the current medical consensus has been paid for by the telecomms industry. In other words: it’s a conspiracy.

But who, then, is this anthropologist whom the letter writer selects to represent a mainstream scientific consensus that may soon be toppled by independent critical analysis?

Thor Heyerdahl.

It’s sad but also absolutely priceless.

Skeptic’s Guide Interview

I’m on the latest instalment of the Skeptic’s Guide podcast talking about the Mora/Orsa electrophobia case and the Obscurantist of the Year anti-award. I also mention a bunch of upcoming European skeptics’ conventions, though Steve Novella cut out the bit where I recommended that the skeptical rogues grow mullet hair styles and mustaches for the Berlin meeting in May to honour the German porn industry.

(My previous interview with the SGU, about the Swedish Skeptics and weird archaeology, was almost four years ago! Time flies.)