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Emergent Biosolutions and anthrax: how a pharmaceutical company fleeces the American public year after year

2021-05-02

Emergent Biosolutions is a privately owned pharmaceutical company whose main business is supplying anthrax vaccine to the American government. The government maintains doses in the Strategic National Stockpile (SNS.) The SNS, previously called the National Pharmaceutical Stockpile, is the main repository of emergency medical equipment kept by the federal government of the United States (US.)

The Strategic National Stockpile

According to Wikipedia, “[The SNS] contents include broad-spectrum oral and intravenous antibiotics, emergency medicines, IV fluids and kits, airway equipment, bandages, vaccines, antitoxins, and ventilators. The material deploys by unmarked trucks and airplanes within 12 hours of the receipt of a request by the CDC.” Some states also have their own stockpiles as well. These supplies are meant to help the people in the event of an outbreak of serious disease.

The predecessor to this stockpile was an un-named supply of medical supplies in 32 regional storage facilities accumulated during the Cold War. These supplies began to degrade, and the program was officially closed in 1974.

In 1998, then-president Bill Clinton read a fictional account about a terror attack with a virus in New York City. He was so impressed by this book that he convened a group of bio-terror experts and Cabinet officials to discuss the problem. The result was a law that he signed in October 1998 establishing the National Pharmaceutical Stockpile with an initial appropriation of $51 million. Prior to this law, only the military had been stockpiling essential drugs and equipment for its own use.

Over the succeeding years, the stockpile added personal protective equipment (PPE) and vaccines. The federal government used the stockpiles after such incidents as the terror attacks on September 11, 2001, major hurricanes like Katrina and Rita in 2005, Superstorm Sandy, and the H1N1 influenza outbreak in 2009.

Experts at the SNS developed Federal Medical Stations (FMS) and deployed them to provide medical care in cases where hospitals were destroyed or overwhelmed. The SNS included 50 and 250 bed versions of the FMS.

In the 2009 influenza pandemic the SNS distributed large quantities of Tamiflu and Relenza (drugs effective in the treatment of influenza) and most of the stockpile of N95 face masks. These were not replenished due to budgetary constraints ($600 million annual budget) when it was felt that other items were more important. As a result, at the outset of the coronavirus pandemic there was a dire shortage of N95 face masks for distribution.

During the years 2017-2019, the federal administration failed to act on warnings that the stockpile of N95 face masks needed augmentation and replacement (many of the masks were expired and had flexible straps that had become brittle.) According to Wikipedia, ” As of March 2020, the national strategic stockpile had 40 million masks while 100 times more were expected to be necessary to handle the pandemic crisis.”

The SNS is hobbled by the expense of purchasing anthrax vaccine, which uses up half of its yearly budget.

Anthrax and bioterrorism

Anthrax is a very rare but deadly bacterial infection which humans acquire from animal sources, mostly cows and goats. The incidence of human anthrax has dramatically declined over the last 150 years, in part because Pasteur pioneered a vaccine for animals in 1881– one of the earliest vaccines to be achieved, after smallpox.

Anthrax is unusual among bacterial diseases in that an inactive form of the bacterium, a spore, is present in the soil. The bacterium reverts to spore form when its animal host dies, and in this form it can persist for decades or even centuries.

The spore form of anthrax is nearly ideal for use in bioterrorism since it can be produced in large quantities and powdered to produce an inhaled weapon. The spores penetrate deep into the lungs, where they germinate within immune cells over a period of a few days (up to 60 days in rare cases.) Once symptoms develop, the victim dies within a couple of days, so treatment is often too late unless it is started before the symptoms appear.

Anthrax has been studied and developed as a terror weapon since The Great War (World War One.) The most ambitious known program was undertaken in Great Britain during World War Two (WW II.) The Japanese studied anthrax and other bioweapons in Manchuria from 1932 to the end of WW II, and sprayed anthrax over Chinese cities. Despite an international treaty banning bioweapons signed in 1972, the Soviet Union maintained a secret anthrax program that was not abandoned until after the Union was disbanded; it may still be extant.

The most serious incident of the twentieth century took place in Sverdlovsk (now known as Ekaterinburg) in the Soviet Union in 1979. A cloud of anthrax spores was accidentally released from a weapons facility in Sverdlovsk that infected about 96 people (the exact number is unknown) and killed about 68. The full story of this outbreak did not come out until 1994. A good summary account of the history of anthrax as a weapon and the Soviet incident can be found here.

In 1995, inspectors discovered that the Iraqi government of Saddam Hussein was developing anthrax as a weapon. The Army decided to protect soldiers by using the anthrax vaccine that had been approved in 1970. Even before this, during the Gulf War, the military vaccinated front-line soldiers. The SNS began to add anthrax vaccine to its stockpile after an incident in the US in 2001.

Anthrax as a terror weapon in the United States

In October 2001, doctors discovered cases of inhalational anthrax in scattered locations on the East Coast after the Postal Service delivered letters containing anthrax to news agencies and two Democratic Senators. A total of eleven people came down with inhalational anthrax, and five of them died. Eleven more cases of cutaneous anthrax occurred, with no fatalities. Forty-three other people tested positive for anthrax infection without symptoms, although thousands of others were thought to have been exposed.

Numerous low-level exposures to anthrax spores may have occurred; the minimum lethal dose of spores is thought to be between 10,000 and 40,000. Modern detection methods may find tiny quantities of spores.

The Federal Bureau of Investigation (FBI) carried out extensive investigations that ended in 2008 with the suicide of the prime suspect (who worked directly with anthrax in a government laboratory.) The suspect may have been motivated by a desire to call attention to the need for better protection against the use of anthrax as a terror weapon. He was also described as being “sociopathic and homicidal.”

Anthrax vaccine and the SNS– this is where Emergent comes in

Emergent Biosolutions began life as BioPort in 1998 and changed its name in 2004. At its inception, BioPort bought an anthrax vaccine manufacturing facility (and the rights to produce the vaccine for the US military) from the State of Michigan, located in Lansing, MI. After changing its name, Emergent acquired several other pharmaceutical companies.

For example, in February 2014, it bought Cangene, a company which made three products for the SNS:  Heptavalent botulism antitoxinVaccinia immune globulin, and Anthrax immune globulin. Cangene also made WinRho, an immune globulin used for hemolytic disease of the newborn and immune thrombocytopenic purpura. Other immune globulin products made by Cangene include those for exposure to hepatitis B and varicella. All of these are specialty products with small markets.

The Bayview, Baltimore plant (discussed below) was the location of an attempt to create a vaccine against the poison ricin in 2017-20. Ricin is a potential bioterrorism toxin which is easy to obtain from castor oil and is extremely potent. The vaccine would have been a prime candidate for purchase by the SNS.

Another product made by Emergent is a skin lotion that neutralizes the nerve agents VX, VR, and soman, which are popularly known as “nerve gas.” This product is supplied to the military and to the SNS; it is also available to the public..

Emergent’s Bayview, Baltimore production plant– not ready for prime time.

Some eight years ago, Emergent entered into a contract with the US government to have a manufacturing facility ready to produce vaccines in case of a pandemic. As a part of the contract, the company was required to show its capabilities by producing 50 million doses of influenza vaccine within four months. The deadline for this “stress test” was June of 2020. However, it never performed the test. Delays in selecting an appropriate vaccine were blamed for its failure.

This facility is being used to produce the Johnson and Johnson (J+J) coronavirus vaccine and the AstraZeneca vaccine. It has not yet been certified by the government, however, and recent developments suggest that it may not be ready for some time.

The company announced at the end of March that it would have to destroy up to 15 million doses of the J+J vaccine because they had been contaminated by the AstraZeneca vaccine. Audits and investigations by the federal government, the vaccine companies, and Emergent itself, “found that Emergent had not followed some basic industry standards at the Baltimore plant, and identified repeated shortcomings in efforts to disinfect and prevent contamination.” (New York Times, April 6, 2021)

As a result of this disaster, J+J has taken over administration of the plant at the direction of the federal government and is limiting it to production of the J+J vaccine only. The Associated Press reported on March 31 on a series of inspections at the Bayview and Camden facilities in Baltimore as well as one in Canton, Massachusetts. These inspections revealed a number of serious deficiencies in the production processes at those plants.

How did Emergent get this way? By lobbying the federal government.

Emergent spent over $3.6 million on lobbying in 2020. It has benefitted during the last Republican federal administration by having a highly placed official, Dr. Robert Kadlec, gain control over the SNS. Dr. Kadlec was formerly a consultant for Emergent. The company has carved out a lucrative niche by being (or acquiring) the sole supplier of several critical vaccines and other drugs for the SNS. It was perfectly placed to get a large contract to supply coronavirus vaccine last year.

Based on the inspections, it appears that Emergent’s corporate culture doesn’t seem to be very interested in quality control.

Emergent has misrepresented its Bayview, Baltimore plant as being ready to take up manufacture of large quantities of vaccine for the federal government and pharmaceutical companies, despite having failed to perform the necessary “stress tests” to prove that it can do so. It has profited greatly from its misrepresentation and its lobbying connections to government.

The situation at Emergent is scandalous, but it is only one of many pharmaceutical industry companies that have been doing much the same things, with the connivance of government. Something needs to be done to clean up this industry.

photo by Liz Masoner via pixabay.com

The Emergent scandal just keeps getting worse and worse. Why has only known supplier of a critical vaccine– anthrax– not been nationalized by US gov’t?

2021-04-26

Emergent Biosolutions is the company with the sole-source contract to supply anthrax vaccine to the Strategic National Stockpile. In March, Emergent was forced to discard up to 15 million doses of coronavirus vaccine due to fears of contamination between the two vaccines that it was contracted to produce at its Bayview plant in Baltimore.

In June 2020, a top pandemic official (a manufacturing expert who has been a vaccine production supervisor for Operation “Warp Speed” since last year) warned after a visit to the plant (shortly after the company was awarded a contract worth up to $628 million to prepare the plant to produce coronavirus vaccines) that the plant was a “key risk” due to problems with quality control and lack of sufficient trained staff. See this New York Times (NYT) article from April 7 about the official’s warning– in a document that was not publicly released.

Another NYT article updated April 13 describes the company’s history as the sole producer of anthrax vaccine and a standby emergency provider of vaccines for the federal government over the last eight years.

A recent inspection of the plant showed major problems, from peeling paint to evidence that bags of contaminated trash had been dragged across the floors of supposedly clean rooms. Some personnel had not followed protocol before entering clean rooms, including not showering or changing into clean overalls.

The plant has been the sole source of the anthrax vaccine which has been stockpiled for almost twenty years, since an attack by an unknown terrorist killed several people using weaponized anthrax spores. The prime suspect committed suicide when he was tracked down by the FBI. Ever since then, producing anthrax vaccine to prevent the use of anthrax as a terror weapon has been a top priority among US counter-terrorist officials.

Emergent Biosolutions has been the sole provider of anthrax vaccine to the US for over eight years. Emergent is owned by a private equity company that has not been shy about raising its prices, to the point where almost half the annual expense for the Strategic National Stockpile has gone to Emergent for its anthrax vaccine. As a result, other emergency medical equipment (including face N95 face masks) has not been replenished.

The expense of anthrax vaccine was blamed for a lack of sufficient personal protective equipment in the stockpile, which led to a severe shortage of N95 masks early in the pandemic.

Emergent has been derelict in its management of this factory, possibly for many years. The full wrath of the inspectors should fall upon Emergent and its CEO soon. The business of manufacturing anthrax vaccine is too important to our national security to be left in the hands of corrupt or incompetent managers.

(photo by Liz Masoner via pixabay.com)

“The second COVID-19 wave has come like a storm” says Prime Minister Modi. India is overwhelmed and has a new variant: B1617. This is really dangerous.

2021-04-22

According to NPR, India has been overrun by COVID-19, with daily case rates shooting up like a wall. The perfect storm has hit; hospitals are full and running out of oxygen. People are dying in the hospital parking lot and crematoriums can’t keep up.

Known daily cases has hit a world record, over 300,000, beating the US from January, and known deaths are over 2,250. The rate of cases and even deaths is widely believed to be a gross underestimate due to testing limitations and the death of many who have not been tested.

What is worse for the rest of the world, a new variant has appeared, B1617, with probable enhanced contagiousness, lethality, and ability to evade vaccination.

Former Prime Minister Manmohan Singh, 88, came down with the virus three weeks after being vaccinated. His condition is said to be “stable” as of Tuesday.

Read the report on NPR for the gory details. It’s free and there’s no ads. (Parenthetically, I have learned that you should use an ad blocker because some ads are now infected with malware, known as “malvertising”.)

This disaster has dangerous implications for the entire world. Just quarantining the country will not be enough; the country needs assistance to increase vaccination rates dramatically.

While India produces her own vaccine, said to be highly effective, she needs raw materials that are in short supply. The US needs to help with production– something we should all support. The pandemic cannot be controlled anywhere until it is controlled everywhere.

(photo: sars-cov-2 virions by EM: NIAID)

Senate Approves Anti-hate crimes bill 94-1; Josh Hawley disapproves.

2021-04-22
Josh Hawley via AP

According to The Hill, the Senate has passed anti-AAPI (Asian-American and Pacific Islander) legislation by a vote of 94-1. This law provides a common-sense way to reduce and react to hate crimes. It will establish a Justice Department position specifically designated to oversee the prosecution of hate crimes; a voluntary database of AAPI hate crimes (not limited to acts specifically related to the pandemic); and guidance to local law enforcement on dealing with hate crimes.

The lone dissenter in the Senate was Josh Hawley. This “no” vote is typical for his political orientation, which is militantly anti-Chinese and has been characterized as “performative politics”.

At this time, I would like to post a shout-out to my fellow blogger, who posts at “megaworthit.com”, and has published on this subject quite recently. She identifies as Pacific Islander.

Also, thanks to Cristian Mihai for the information that there are some 500 million bloggers in current circulation. My wish is to have 4 billion bloggers (on the way to 10 billion) by 2030. I personally don’t care (very much) how many people follow my blog. That’s your business whether you have time for that.

You see, I buy into the notion that we should reduce our carbon output by 50% by 2030, just as does President Biden.

PS On a personal note, I would like to inform all and sundry that I identify as really and truly Anglo-Saxon, as my ancestors are from Germany, Ireland, and Sweden. I come by the name Conrad Seitz honestly. As a true Anglo-Saxon, I deplore the presumption of certain Republican Congresscritters who think they can tell me what Anglo-Saxon politics, culture, and architecture is! With much clashing of sword upon mail-covered breast and swilling of mead, I reject the notion that thains should not show fealty to the king! (Just kidding!)

Update of previous post on pandemic mental disorders, particularly suicide: higher in nonwhites, unchanged in whites.

2021-04-22

Previous early-pandemic warnings of increased suicide rates have not been borne out in an English, mostly white population. In nonwhite populations, however, there has been an apparent increase in suicide rates. A Japanese study, published in JAMANetwork Open, found an increase in suicides among young men and young- and middle-aged women during the fall of 2020.

Americans, black and brown, have had an increased suicide rate, as shown in a study in Maryland where rates among black people doubled..

There have been robust increases in distress, manifested in an increased need for psychiatric services and a sort of existential dread that we are in a horror movie subjected to never-ending peril of death, and even vaccination won’t save us.

(photo: Boris the dog on Muscat Avenue facing East– personal photo collection)

Comment of the Day: 71 y/o man changes party affiliation to “Democratic”.

2021-04-22

I am a White person.

I am an evangelical Christian.

I am seventy one. Upon turning seventy, I changed my party affiliation to “Democrat.” I am an elder in my church (Norm speaking, not Susan) and have many conservative friends.

Including (as I believe) the interim senior pastor and the associate pastor. I care about these people–deeply. I love and admire them. That being said– –the thought has crossed my mind more than once. That it might be necessary to deal with at least some of today’s conservatives–with the unrestrained use of force.

Making me think–sorry, New York Times! of the old south after Lincoln’s election. When as Professor MacPherson (Princeton) pointed out: they brought upon themselves the very denouement they professed to dread. Mr. Trump’s “big lie” seems to have crystalized everything.

The inveterate contempt for truth displayed by this man–the contempt for laws–the contempt for norms and standards–the contempt for the ordinary decencies– –which were zealously adopted by thousands or millions of his fans and followers– –culminating in the storming of the Capitol back in January–

–well gosh, New York Times! What else IS there for me to think? Especially considering the pure LUNACY of Ms. Greens–the cynical opportunism displayed by Senator Hawley–the inimitable SPINELESSNESS exhibited by Senator Graham. . .

But I could be wrong.

God grant that I am!

Please, God. Please.

those with no religion went from 15% of US people in 2016 to 22% in 2020; only 47% of those polled by Gallup belong to a congregation but 87% “believe in God.”

2021-04-20

Gallup published a poll on Monday that revealed fewer than half of people in the US belong to a church, synagogue, or mosque. This proportion has fallen from highs of 73% reported in Gallup’s first survey in 1937 and 76% in 1945. Their report noted that “Over the past two decades, the percentage of Americans who do not identify with any religion has grown from 8% in 1998-2000 to 13% in 2008-2010 and 21% over the past three years.”

Additional detail is available in this article from NPR.

Another Gallup poll from November 2019 showed that between 87% of Americans “believe in God” to 64% are “convinced that God exists”.

In a side note, Derek Chauvin has just been convicted of second degree murder, third degree murder, and second degree manslaughter. It is raining dollar bills in George Floyd square, according to the New York Times.

(photo of Santa Magdalena Alta in Italian Alps (the Dolomites, Funes or Villnoss) by alexy82 via pixabay.com)

The COVID vaccine is less effective against SARS-COV-2 variant B.1.351. The virus will continue to evolve. Pfizer is working to adapt the vaccine.

2021-04-19

A study of neutralizing antibodies to SARS-COV-2 variants in vaccinated people and those who had recovered from natural infection was published in “Nature Medicine” on March 26, 2021. The conclusions of the study are troubling: vaccination (from Pfizer) produced less neutralizing antibody against the B.1.351 variant from South Africa, suggesting that it will be less effective.

The abstract of the study is worth quoting in full:

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) B.1.1.7 and B.1.351 variants were first identified in the United Kingdom and South Africa, respectively, and have since spread to many countries. These variants harboring diverse mutations in the gene encoding the spike protein raise important concerns about their immune evasion potential. Here, we isolated infectious B.1.1.7 and B.1.351 strains from acutely infected individuals. We examined sensitivity of the two variants to SARS-CoV-2 antibodies present in sera and nasal swabs from individuals infected with previously circulating strains or who were recently vaccinated, in comparison with a D614G reference virus. We utilized a new rapid neutralization assay, based on reporter cells that become positive for GFP after overnight infection. Sera from 58 convalescent individuals collected up to 9 months after symptoms, similarly neutralized B.1.1.7 and D614G. In contrast, after 9 months, convalescent sera had a mean sixfold reduction in neutralizing titers, and 40% of the samples lacked any activity against B.1.351. Sera from 19 individuals vaccinated twice with Pfizer Cominarty, longitudinally tested up to 6 weeks after vaccination, were similarly potent against B.1.1.7 but less efficacious against B.1.351, when compared to D614G. Neutralizing titers increased after the second vaccine dose, but remained 14-fold lower against B.1.351. In contrast, sera from convalescent or vaccinated individuals similarly bound the three spike proteins in a flow cytometry-based serological assay. Neutralizing antibodies were rarely detected in nasal swabs from vaccinees. Thus, faster-spreading SARS-CoV-2 variants acquired a partial resistance to neutralizing antibodies generated by natural infection or vaccination, which was most frequently detected in individuals with low antibody levels. Our results indicate that B1.351, but not B.1.1.7, may increase the risk of infection in immunized individuals.

https://www.nature.com/articles/s41591-021-01318-5

(I have added emphasis to some statements in order to make a point)

The South African variant may escape antibodies produced by vaccination in some cases, leading to productive infection. A Pfizer press release claims that the vaccine is fully effective against this variant, although it admits that antibody levels are lower.

The presence of lower neutralizing antibody titers warns us that a new vaccine will be necessary in a few months. Officials are saying that a “booster” shot will be given in six months to a year after the initial two-dose vaccination. They have not stated what the booster would consist of, but it is clear that the vaccine will have to be changed to reflect the RNA sequence of the South African variant and possibly other variants that will appear in the next few months.

<p value="<amp-fit-text layout="fixed-height" min-font-size="6" max-font-size="72" height="80">Another<a rel="noreferrer noopener" href="https://www.pfizer.com/news/press-release/press-release-detail/pfizer-and-biontech-initiate-study-part-broad-development&quot; target="_blank"> Pfizer press release</a> posted February 25, 2021 proposes to produce variations of the vaccine to adjust to the changes seen in B.1.351..Another Pfizer press release posted February 25, 2021 proposes to produce variations of the vaccine to adjust to the changes seen in B.1.351..

The coronavirus represents a moving target. Vaccines will only be effective for a year or even less. Until the spread of the virus has been stopped, it will continue producing variations that elude our best efforts at vaccination. The uncontrolled spread of the virus has allowed it wide latitude to evolve, especially when it infects people with weak immune systems and continues to percolate for months within compromised hosts.

Another concerning issue is the absence of neutralizing antibody in the nasal secretions of immunized people. This may allow virus to replicate in the nasopharynx (although it may not be able to invade the body). The implications of this finding are equally troubling. It is possible that immunized people may asymptomatically carry virus in the nasal cavity and allow it to spread to others.

The answer to this conundrum may be found by challenging immunized people with live virus in the nose– how will their bodies respond and how long will they carry replicating virus? We need to know this, and the only way to find out is to look at the responses of immunized people to exposure. Perhaps testing all immunized people to see if they ever carry the virus in the nose will help– although very large numbers of subjects will be needed to determine what happens under natural conditions.

(SARS-COV-2 EM photo courtesy NIAID)

Microplastic is raining down upon you. Right now. Everywhere. From article in WIRED and PNAS: plastic in the air, from the sea and land.

2021-04-18

A new report in “Wired” describes microplastics floating in the sky and raining down upon everyone, even in the most apparently pristine wilderness. The report describes a modeling study published in “Proceedings of the National Academy of Sciences” on April 11, 2021. The model “constrains” the source of the roughly 1,100 tons of plastics suspended in the air over the western United States (US) at any given time.

Since the appearance of microplastics is anonymous (only tire dust can be distinguished from other types of plastics) it was incumbent upon the researchers to calculate the sources from various parameters. For example, once suspended in air, the average plastic particle remains floating for about a week. Circulation of the air, therefore, suggests that a large proportion of plastic in the air comes from the marine environment and is probably launched by wave action from the sea.

Plastic dust from land sources is probably launched into the air by car and truck tires on the roads. Some of this dust comes from the tires themselves. A significant amount of plastic comes from cloth: tiny particles break off when you wash your clothes and are suspended in the water, then go to waste treatment plants and end up in the sewage sludge which is spread on fields as fertilizer. Much of the rest is produced by degrading plastic debris left as trash on the roadsides.

Despite these uncertainties, the authors of the study say: ” Results suggest that atmospheric microplastics in the western United States are primarily derived from secondary re-emission sources including roads (84%), the ocean (11%), and agricultural soil dust (5%).”

Studies of this type are necessary because microplastics have become an universal scourge of the twenty-first century. Plastic debris is everywhere, especially in the ocean, and the amount in circulation increases every year. No effective, practical means has yet been found to remove significant amounts of plastic waste from the ocean. Organisms from single-cell to whales ingest plastic, often mistaking it for food. Malnourished or starving fish, birds, and marine mammals wash up on beaches with their stomachs full of plastic, especially plastic bags.

Over the next few years, our planet will be increasingly blanketed with invisible microplastics. Unsightly plastic bags, toys, shoes, and other debris will appear more and more often on our beaches. Often, animals will choke on larger pieces of plastic or be strangled by plastic objects (like the rings that hold six-packs of beer together).

Micro-organisms that use plastic as a source of energy (that is, feed on plastic) are evolving only too slowly. We can encourage this evolution by searching for these “bugs” and seeding them into environments that are already saturated with plastic debris. Before spreading such organisms we will need to test them to make sure they are benign.

We can imagine a nightmare scenario in which plastic boat hulls will suddenly begin to disintegrate in seas that are overtaken by plastic-eating bacteria. The alternative will be malnourished fish and birds and ugliness over all our coastlines.

Overpopulation and “convenience” have led to ubiquitous plastic littering our planet. People must do our best to try to clean up the environment, literally by picking up after ourselves.

(seagull by Eveline de Bruin courtesy of Pixabay.com)

Unusual sequelae of COVID-19: Texas Roadhouse CEO Kent Taylor kills himself after persistent tinnitus from COVID. Is suicide a complication of this virus?

2021-03-23

A 65 year old man came down with COVID-19 a few months ago. He recovered, mostly, but suffered from debilitating tinnitus and other post-COVID symptoms afterwards. He killed himself a few days ago. This blog post is based on a report in the Washington Post.

This man was very successful, rich even. He worked hard all his life as a restaurant entrepeneur, becoming known as the CEO of a chain, the Texas Roadhouse. When his company went public in 2004, he got a $60 million payout. He was said to have sacrificed part of his fortune to support the employees of his restaurants when they were hit by the pandemic, showing his humanity and empathy.

His death highlights some of the more painful aspects of the last year. Reports of mental illness or emotional distress have dramatically increased since the pandemic encouraged shutdowns all over the world. Suicides have increased both among those affected only by isolation and among those with persistent COVID symptoms.

What is tinnitus?

Tinnitus (the sensation of hearing a noise when there is no sound, derived from the Latin word which means “tinkling” or “ringing”) is a common symptom that can be trivial or completely debilitating. It is most often a consequence of hearing loss due to exposure to loud noises, like gunfire or music, but can also be caused by ear canal blockage, middle ear infections, medications, or, rarely, brain disorders.

The sensation of tinnitus is usually described as a buzzing noise, roaring, ringing, clicking, or humming. The sound of tinnitus may be constant or intermittent. It is most obvious (and distressing) in quiet places and at night. There are no really good treatments for tinnitus, but the most effective remedy in mild or moderate cases is to have a blocking noise going– like music, or specially adapted hearing aids that produce a buzzing sound.

The symptoms of tinnitus may be completely destructive to a person’s feeling of well-being or even sanity. There are anecdotes of people committing suicide because they cannot tolerate the symptoms. Another Washington Post article on tinnitus and COVID states that 50 million Americans have experiences with tinnitus, and some 2 million have “extreme and debilitating cases” that could cause severe distress.

Does COVID cause tinnitus or predispose to suicide?

The virus can cause damage to the audio-vestibular system, which helps us with standing upright and maintaining our balance as well as hearing. This systematic review discusses what is known about COVID and the audio-vestibular system.

This being said, one wonders whether the single symptom of tinnitus alone could cause a person to kill themselves unless the sensation is overwhelming. Surely there are contributing symptoms that lead to the decision to end your life? Despair, self-hatred, failure, unrelenting pain, loss of loved ones?

A famous case of suicide occurred many months ago, at the beginning of the pandemic: a highly accomplished, young emergency room physician who appeared to recover quickly from the virus returned to work but was unable to tolerate it or even fulfill the functions of her job. She killed herself within a few weeks after coming down with COVID. She was said to have no prior history of depression (although no-one knows for sure about this subtle and often hidden symptom.)

COVID and psychosis

What if COVID itself is the cause of this psychotic breakdown?

I raise this possibility because it has been raised by others, including in the comments section to the article in the Washington Post. Many people have suffered neurological and psychological problems related to COVID, so it is not outside the realm of possibility that suicidal depression could be caused by the virus as well.

Even a commenter to the above-mentioned article mentioned that they had remarkably strange dreams for months after a severe bout of COVID. They were hospitalized with pneumonia but recovered, apparently completely. The only residual was a new onset of frighteningly strange, memorable dreams. It may be that this person remembered their dreams for the first time– after all, dreams are strange, even scary, routinely, but you normally don’t remember them at all or only in scraps.

Other people have had psychotic episodes labelled as schizophrenia with no remission (yet)– see, again, the comment section of the above-mentioned article.

The possibility that infection with this virus leads to a risk of depression and suicidal impulses deserves to be carefully researched. If a causative relation can be found, it may be advisable to closely observe recovered patients for subtle signs of depression. Close observation is essential because symptoms may be covered up or unrecognized by the patient.

Remember, if you yourself or a close one (or even someone you just care about) feels suicidal, help is always available. If worse comes to worst, call the National Suicide Prevention Lifeline at 800-273-8255.

(photo by Jakub Orisek courtesy of pixabay.com)