Random Analytica

Random thoughts, charts, infographics & analysis. Not in that order

Tag: UK

19. Mefloquine Dispatches: Lord Dannatt, 28th November 2019

Over the weekend I come across a story from Britain.

Lord Dannatt, who was chief of the general staff in the UK between 2006 and 2009, warns of a suicide epidemic amongst veterans during a visit to the Portsmouth-based military support group Forgotten Veterans UK.

During his visit he talks about the cost effectiveness of the work being undertaken by the charity as well as  how the government of the day and charities should be doing more. Via The News. Former British Army boss brands UK’s veteran suicide crisis the ‘epidemic of our time’. Excerpt:

Britain’s veteran suicide crisis has been branded part of the ‘epidemic of our time’ by the former head of the British Army, who admitted more needs to be done to stop traumatised troops from killing themselves.

General Lord Richard Dannatt admitted he was appalled by the number of people taking their lives in the UK and described the situation as a ‘tragedy’.

Lord Dannatt has come up on my radar previously. Not because he took mefloquine but because he refused it on health grounds. Via The Guardian. Ex-army chief apologises to troops over anti-malaria drug. Excerpt:

Lord Dannatt, who was chief of the general staff between 2006 and 2009, told BBC2’s Victoria Derbyshire programme he would not take the drug because of his son’s experience with it.

Dannatt said his son Bertie had suffered mental health problems after taking two doses of Lariam before visiting Africa in the late 1990s. He was not in the armed forces at the time but had been prescribed the drug by his father’s army doctor.

He is currently the highest ranking officer on record to refuse mefloquine. Mefloquine is a drug that is known to increase the chance of suicide amongst veterans.

Oh, the hypocrisy of old Generals.

191128_Image_LDannatt

Picture: Habibur Rahman (via The News)

 

If you or someone you know needs help, please phone Lifeline on 131 114, Kids Helpline on 1800 55 1800, Beyond Blue on 1300 224 636 or Open Arms on 1800 011 046.

 

Random Analytica: Mefloquine – Colonels & Generals

Mefloquine wasn’t just given to Diggers [Australian slang for Other Ranks]. Colonels and Generals got it too. They get sick and they die. They don’t believe the diagnostic overshadowing of PTSD makes any sense either. Some are even voicing their concerns.

Here is a list of Colonels and Generals who either received Mefloquine on Operations OR (more telling) refused to take it. Correct as at 20th October 2019. I’ll update accordingly.

 

Confirmed Mefloquine Exposure and Symptomology

18th October 2019 (Canada): Lieutenant-General Roméo Antonius Dallaire. UNAMIR (Rwanda 1993/94). Via W5. Romeo Dallaire joining lawsuit against government over anti-malaria drug. Excerpt:

In a W5 exclusive, Dallaire announced that he is joining a lawsuit against the Canadian government and Defence Department over an anti-malaria drug that he, and other soldiers , were forced to take on missions to Rwanda, Somalia and Afghanistan.

Dallaire, who led the international peacekeeping mission in Rwanda in 1994, has become the highest ranking soldier to join an unprecedented legal action by veterans over the use of the anti-malaria drug Mefloquine. He joins nearly 900 other veterans who claim the Canadian government and Department of National Defence “willfully ignored and concealed the risks” of the drug, which is marketed under the brand name Lariam.

Dallaire has been hailed a hero, both for his attempts to stop the genocide in Rwanda, but also for his outspoken admission that he struggles with Post-Traumatic Stress Disorder.

30th January 2019: Colonel Timothy Dunn (USA). Deployed (Sep – Dec 2006). Via the Military Times. ‘I plead with you to look at this very closely,’ retiree tells panel studying health effects of anti-malarial drugs. Excerpt:

Timothy Dunn, a retired Marine Corps colonel, was among those who told the committee they’d be willing to provide information.

” I open my self, my heart and soul and medical records to you,” Dunn said. “You have to do something to look at this closely and make a fair and just determination … there are many more than I who have had this problem.”

Dunn said he still suffers from insomnia, anxiety, depression, ringing in the ears, and dizziness.

22nd May 2016 (UK): General David Julian Richards. Operation Pallisar (2000). Via the Independent. British armed forces set to ban most prescriptions of controversial anti-malarial drug Lariam. Excerpt:

Lady Caroline Richards, the General’s wife, had also taken a keen interest in matter for a long time. She added “Wives and partners of people who had been affected by the use of Lariam approached me and described what had happened. There were some terrible, sad stories of trauma, of relationships ending, psychological problems. We heard about other forces which have stopped using Lariam, so this is obviously something which needed looking into.”

23rd November 2015 (UK): Major-General Alistair Duncan. Sierra Leone (1999). Via the Daily Mail. Has this highly decorated hero been driven mentally ill by an anti-malaria drug tourists are still given? Excerpt:

Today, however, he is locked up in a secure psychiatric unit near his home in Somerset. Tragically diminished, he has been incarcerated for ten months. He has lost the capacity to read and write; outbursts of aggression are punctuated by periods of torpor. He can be sweet-tempered and affectionate; remote and belligerent by turns. His wife, and a growing body of expert medical opinion, believe his psychiatric disorder has been caused, in part, by the controversial anti-malarial drug mefloquine, or Lariam, which he was given for six months in 1999 before being deployed to West Africa.

The Abstainers

31st August 2016 (UK): General Francis Richard Dannatt. Refused Mefloquine. Via The Guardian. Ex-army chief apologises to troops over anti-malaria drug. Excerpt:

Lord Dannatt, who was chief of the general staff between 2006 and 2009, told BBC2’s Victoria Derbyshire programme he would not take the drug because of his son’s experience with it.

Dannatt said his son Bertie had suffered mental health problems after taking two doses of Lariam before visiting Africa in the late 1990s. He was not in the armed forces at the time but had been prescribed the drug by his father’s army doctor.

 

If you or someone you know needs help, please phone Lifeline on 131 114, Kids Helpline on 1800 55 1800, Beyond Blue on 1300 224 636 or Open Arms on 1800 011 046.

Random Analytica: A ‘Soldiers-Five’ [trans. Basic Reading Guide] on Mefloquine

An old ‘soldiers-five’ on Mefloquine. When I first thought I was given Mefloquine I wasn’t sure where to look first. I initially got some good and some bad information. I’m not the tree of knowledge on Mefloquine but here is a suggested reading list and resource guide concerning Mefloquine. I’ve focused on veterans because that is my lived experience. Remember, this is a guide only. Consult your doctor.

Last updated 7th October 2019

World Health Organisation

8th August 1989: World Health Organisation. The original warning from WHO way back in 1989.

Consumer Medicine Information

9th October 2017: The Consumer Medicine Information guide for Lariam (linked here: 171009_ConsumerMedicineInformation_Roche_Lariam). A veteran mate has underlined the important health warnings.

Mefloquine Articles (non-specific)

27th April 1996: New Scientist.  Malaria pill stands accused – Lariam fends off malaria more effectively than any other drug, but growing evidence of disturbing side effects may soon land its manufacturer in court (via 960427_Article_NewScientist_Mefloquine). Thanks to the veteran mate who sent this through. He was given Lariam in 1994 and 1999 without the serious side-effects.

Mefloquine Articles for Veterans

27th January 2003: CBS News. The Dark Side Of Lariam. How Dangerous Is It? One of the first ‘deep-dives’ into mefloquine by a news outlet. Discusses the Fort Bragg suicide cluster where mefloquine was a factor.

19th September 2013: CBS News. Elite Army units to stop taking anti-malarial drug. The US Army’s Special Forces banned from using mefloquine in 2013.

25th September 2013: Huffpost. Mefloquine: The Military’s Suicide Pill. Dr Remington Nevin writes about mefloquine including the 2013 FDA’s ‘black-box’ warning. The world is waking up to the dangers of mefloquine. Dr Nevin is one of the leading experts in the field.

12th October 2014: Army Technology. Mefloquine – the military’s deadly malaria treatment. Dr Remington Nevin discusses the downside to mefloquine including his own personal deployment experience with the drug.

11th August 2016: Military Times. Malaria drug causes brain damage that mimics PTSD: case study. A different take on mefloquine exposure from the USA.

22nd August 2016: Australian Broadcasting Corporation. Defence force admits soldier shouldn’t have been included in East Timor anti-malaria drug trial. One of the first articles I read. Also includes a link to a 2016 7.30 Report about the Australian mefloquine/tafenoquine trials.

30th August 2018: The Irish Times. Vivid nightmares and suicidal thoughts – ex-soldiers blame drug for destroyed lives. An Irish perspective. With a standing Army of approximately 10,000 they have still administered Lariam to approx. 5,500 – 6,000 over the years.

Podcasts

12th June 2019: The Medical Republic. TMR podcast: Can this anti-malarial drug really cause “brain damage”? Thanks to my GP, Dr Mary Lamond for sending this to me. Along with other subjects the podcast covers mefloquine/tafenoquine exposure and its risks in simple language.

Books

23rd January 2014: ‘The Answer to the Riddle Is Me’ by David Stuart MacLean. The Washington Post book review can be found here.

Official Mefloquine Sites (Information & Policy)

Last accessed 7th October 2019: Department of Defence (Australia). Mefloquine. An excellent resource. One of the first sites I visited. Mefloquine Loading Doses are also explained.

Experts

Dr Remington Nevin (USA). Possibly the leading expert in the field of Quinism in 2019 when I suspected my exposure. US Army (Major – Retired). A Vermont-based physician epidemiologist and expert consultant in the adverse effects of antimalarial drugs, particularly mefloquine and tafenoquine.

 

If you or someone you know needs help, please phone Lifeline on 131 114, Kids Helpline on 1800 55 1800, Beyond Blue on 1300 224 636 or Open Arms on 1800 011 046.

QuikStats: MERS-CoV (September 2013)

“I think the take-home message is: MERS is not SARS” (Zaid Memish, Deputy Health Minister, Kingdom of Saudi Arabia, 30th August 2013).

1 - MERS_Infographic_131001

***** Please note that this infographic of the Middle East Respiratory Syndrome Coronavirus (MERS-CoV) was updated with public source information to 1200hrs 1 October 2013 EST *****

The above infographic shows the distribution of MERS-CoV by onset country. The Kingdom of Saudi Arabia (KSA) has had the most cases and the numbers are reflective of the latest KSA Ministry of Health figures. The most recent fatality outside of the KSA that I have included in my data was from Tunisia. Some countries, such as France and the UK have had fatalities that are not shown above due to the fact that the onset occurred elsewhere in the Middle East. The Tunisia index case seems to have occurred in Qatar or the KSA but at this time is still included under that countries flag. Italy initially reported two cases but these were later amended to probably by WHO due to testing issues. A number of fatalities are not shown as their details have not been made public.

Ian M. Mackay, via his VDU blog has been discussing the spike in case numbers during the month of September. To emphasise his point here is the index chart that I published on the 4th September 2013 (110-cases & 50-deaths).

1 - MERS_Infographic_130904

Data can be many things to many people. For health investigators it is a critical resource to build a story about new or emerging diseases, for medical professionals it is a tool to inform while for the public it is a way to tell a complex epidemiological story in a more manageable format.

It has its drawbacks though. Data alone often tells a non-contextual story only.

Reading the back story on MERS-CoV I couldn’t help but reflect on the story of Abid Hussain (case number 10). Abid had travelled to his former home of Pakistan then visited Mecca to pray for his 39-year old son who had been diagnosed with cancer and was in the process of receiving chemotherapy. Upon his return to the UK he became unwell with severe flu like symptoms and either prior to being hospitalised or during his hospitalisation managed to pass on the disease to both of his adult children. The daughter only showed mild symptoms, did not require hospital admission and made a full recovery. The son, Khalid, a father of two and in the battle of his life could not stop a second assault on his system by MERS-CoV and succumbed to the disease just eight days after being admitted to hospital.

What terrible luck.

Acknowledgements: Data for this infographic was sourced largely from CIDRAP, H5N1, FluTrackers and the WHO. Background reading supplied mainly via Pandemic Information News, Ian at Virology Down Under and Helen Branswell.

Updates

  • Case numbers and fatalities have been updated regularly by multiple agencies. Here are the CIDRAP daily overviews which included case updates for the 3rd – 4th – 6th – 9th – 11th – 17th18th – 20th and the 30th of September 2013.

Random Analytics: Peak Employment (Part II): UK

I recently published a blog looking at Australian Peak Employment. Given some very good feedback and responses from the UK especially I thought it might be useful to have a similar look at the situation there.

Although the Office of National Statistics longitudinal depth was not as good as the Australian Bureau of Statistics in breaking down full-time and part-time employment pre 1992 there was some very good data not readily available in legacy ABS data captures, especially in areas like the self-employed.

Although I could only get data as far back as 1992 the picture it tells is as interesting as the Australian story (with data going back as far as 1978).

Here are the analytics.

1 - UK FT & PT Employment 1992-2012

Figure 1: UK Full-Time and Part-Time Employment (Mar – May 1992 to Oct-Dec 2012). Source: ONS.

Like the Australian example, the first graph highlights the almost identical increase in contingent (part-time) and full-time employment over the past decade. Since early 1992 full-time employment has increased by 10.3% (2.021-million) while part-time employment increased by 34.5% (2.072-million).

2 - UK FT & PT Employment Increases 1992-2012

Figure 2: Increases in UK Full-Time and Part-Time Employment (Mar-May 1992 to Oct-Dec 2012). Source: ONS.

Like the Australian example the increases in both full and part-time employment are identical. Unlike the Australian example which has not seen a downturn since 1991/92 the UK data shows a massive 1-million full-time jobs disappearing post GFC but over the past 12-months or so that has improved by around 400,000 new positions. Additionally, the start of this data series showed negative full-time employment through to early 1994 as the UK struggled out of the late 1980’s and early 1990’s downturns (oh, how I wish I had the data going back to 1987).

3 - UK Employment vs. Working Age Labour Force 1992-2012

Figure 3: Overall UK Employment versus Working Age Labour Force (Mar-May 1992 to Oct-Dec 2012). Source: ONS.

Here’s a look at the differential between total employment creation and the UK defined, economically inactive numbers. The UK created an additional 4.093-million new jobs; from 25.635-million in early 1992 to a record 29.729-million jobs at the end of 2012 (the pre-GFC high was 29.572-million in Mar-May 2008). The UK has steadily increased its working age population since 1992 (due to a combination a slightly lower than replacement fertility rate plus a higher immigration to migration ratio) which has left it with 3,734,000-million less jobs than that required to employ the 7.828-million increase in the working age labour force.

A quick point on the above. Like my previous article on this subject (avoiding wonkish angst) it should be noted that my Working Age Labour Force number in this graphic has been worked out utilising the ONS economically active rate data rather than my preferred method of using actual population statistics (you can see an example of this in my 2012 Abbott’s Promise piece).

In conclusion looking at the UK ‘employment type’ data is further confirmation of a global trend toward greater reliance on part-time employment, which on one hand is increasing employment to record levels while at the same time decreasing the amount of work available.

Has the UK reached peak employment yet? I’m not convinced it has but the more I look at the global data the more I am convinced we are reaching that point in the next decade. As I stated in my initial Australian analysis:

With an increasing working age population and a growing gap between jobs available the future is looking anything but certain, especially with the rise of labour augmentation and robotics replacing jobs quicker than they can be created.

Random Analytics: Australian Unemployment: A Global Perspective (Oct 2007 – Sep 2012)

I had an interesting discussion today about Australia’s recent increase in its official unemployment rate which rose to 5.4% (seasonally adjusted). That percentile equates to 662,700 unemployed persons. It has been my consistent view that the current unemployment and participation rate data is softened by factors such as seasonal adjustment and under-reporting. My point here is that the real unreported figure could be higher due to severance economy issues and as Australia transitions from an overall boom economy to, at best, a more globally normalised economy.

Rather than focus on that rather negative sentiment I thought it might be useful to have a look at some global data to get a sense of perspective. Here is a look at the official (seasonally adjusted) unemployment figures for Australia, the USA, UK, Spain & Greece.

Figure 1: Unemployment (seasonally adjusted) for Australia, USA, UK, Spain & Greece. Data sourced from the ABS, BLS, ONS & EuroStat.

That gold line which has trended under or around 5% for the entirety of the Global Financial Crisis is Australia.

For the other countries represented in the graph the last five years have been dark days indeed. The US (dark blue), still the world’s largest economy has an official unemployment figure of 7.8% (or 12.1-million persons). The UK (in green) sits at 7.9% (2.57-million) trending at 8% or thereabouts since mid-2009. Then there are the current horror stories of Greece & Spain, both of which now have official Euro high unemployment figures of 25.1%. For Spain there are 5.77-million and Greece 1.26-million unemployed, a total of 7.03 million unemployed for both countries. Put in context this equals more than 60% of the total current Australian Labour force.

So things might not be great in Australia at the moment as we see layoffs across some sectors of the economy and our official unemployment figures nudge up.

I’m happy to bet that you would still rather be in Australia with this economy than in Greece or Spain with their economies?