current events – Page 7 – Go Retire Psychiatrist

Avocado Self-Checkout Flap!

Sena told me about the Walmart avocado self-checkout flap that was reported in the news yesterday. He was having trouble with the self-checkout routine and the register showed he owed $1,300 dollars. I read the New York Post story about it, although the news agency actually got it from a Reddit social media web page.

According to the story, a Walmart employee reported that the customer accidentally overcharged himself for avocados at the self-checkout station. He punched in 999 avocados instead of the 9 he wanted. The customer got excited and he called the police using the 911 line, accusing Walmart of trying to rob him. Store employees and police tried to calm him down but he had to be handcuffed and taken into custody for trespassing because he refused to leave unless Walmart compensated him for his mistake.

I’m not sure how much of the story to believe based on the source, but I’ve used self-checkout a few times at Walmart and I’ve always found the employees to be very helpful when I had a minor problem. Usually, somebody has been immediately available, probably because it’s pretty obvious when I’m puzzling over something, often because I’m not sure how to ring up produce that either has to be weighed or beamed up to extraterrestrials who take charge of stuff like that.

Admittedly, I don’t grocery shop often enough to get the steps down pat, but I can always count on a store employee being available to help me out of a jam. I’ve never been overcharged or hassled. I’ve never called the cops on myself.

Actually, what I really need is more practice arranging the grocery items so that I can bag them and return them to the cart so that I don’t accidentally double scan them or leave them on the counter. I’m a terrible bagger. I use way more bags than necessary. I lost a cucumber once (and it was even bagged) and I still can’t tell how that happened.

The easy part is scanning the items, except when it comes to produce which either needs to be weighed or keyed in by searching for the kind of tomatoes I got (sliced vs deformed or whatever). I once tied up the tomatoes in a plastic bag with a knot so tight I looked silly trying to untie it so I could weigh them. I must look comically inept because somebody always comes to my rescue right away. I don’t know how they keep from laughing.

There are alternate ways of dealing with those situations which don’t entail making 911 calls. You could swear off avocados.

The Wild West Sandbox of AI Enhancement in Psychiatry!

I always find Dr. Moffic’s articles in Psychiatric Times thought-provoking and his latest essay, “Enhancement Psychiatry” is fascinating, especially the part about Artificial Intelligence (AI). I liked the link to the video of Dr. John Luo’s take on AI in psychiatry. That was fascinating.

I have my own concerns about AI and dabbled with “talking” to it a couple of times. I still try to avoid it when I’m searching the web but it seems to creep in no matter how hard I try. I can’t unsee it now.

I think of AI enhancing psychiatry in terms of whether it can cut down on hassles like “pajama time” like taking our work home with us to finish clinic notes and the like. When AI is packaged as a scribe only, I’m a little more comfortable with that although I would get nervous if it listened to a conversation between me and a patient.

That’s because AI gets a lot of things wrong as a scribe. In that sense, it’s a lot like other software I’ve used as an aid to creating clinic notes. I made fun of it a couple of years ago in a blog post “The Dragon Breathes Fire Again.”

I get even more nervous when I read the news stories about AI making delusions and blithely blurting misinformation. It can lie, cheat, and hustle you although a lot of it is discovered in digital experimental environments called “sandboxes” which we hope can keep the mayhem contained.

That made me very eager to learn a little more about Yoshua Bengio’s LawZero and his plan to create the AI Scientist to counter what seems to be a developing career criminal type of AI in the wild west of computer wizardry. The LawZero thing was an idea by Isaac Asimov who wrote the book, “I, Robot,” which inspired the film of the same title in 2004.

However, as I read it, I had an emotional reaction akin to suspicion. Bengio sounds almost too good to be true. A broader web search turned up a 2009 essay by a guy I’ve never heard of named Peter W. Singer. It’s titled “Isaac Asimov’s Laws of Robotics Are Wrong.” I tried to pin down who he is by searching the web and the AI helper was noticeably absent. I couldn’t find out much about him that explained the level of energy in what he wrote.

Singer’s essay was published on the Brookings Institution website and I couldn’t really tell what political side of the fence that organization is on—not that I’m planning to take sides. His aim was to debunk the Laws of Robotics and I got about the same feeling from his essay as I got from Bengio’s.

Maybe I need a little more education about this whole AI enhancement issue. I wonder whether Bengio and Singer could hold a public debate about it? Maybe they would need a kind of sandbox for the event?

So, I Got the Covid-19 Booster Today

After giving the Covid-19 summer booster a lot of thought, I got it today. What the heck. I’m an old guy and the experts all agree that the summer surge is real, including the current leaders of the FDA Center for Biologics Evaluation and Research (Vinay Prasad, M.D., M.P.H and Martin A. Makary, M.D., M.P.H.).

I read their article “An Evidence-Based Approach to Covid-19 Vaccination” published in the New England Journal of Medicine on May 20, 2025. It sounds like they’re going to require placebo-controlled trials for new vaccines for almost everybody except those over age 65 and high risk because they’re not recommending it for certain other groups such as healthy children.

I didn’t think it was worth the wait for the upcoming CDC ACIP meeting on June 22, 2025 in order to decide whether or not to get the summer vaccine. It’s the same one I got last fall and the same one the FDA advisory committee decided at this month’s meeting would be appropriate going forward (the JN.1 lineage).

It wasn’t like there was a long wait time to get the vaccine today. There wasn’t a line. I scheduled it but I didn’t have to because I got right in.

It’s true that vaccine uptake has been low. However, I think on balance they’ve been proven to be safe and effective so I’m not sure that placebo-controlled trials are warranted. I guess we’ll just have to agree to disagree.

Reference:

An Evidence-Based Approach to Covid-19 Vaccination

Authors: Vinay Prasad, M.D., M.P.H., and Martin A. Makary, M.D., M.P.H.Author Info & Affiliations

Published May 20, 2025

DOI: 10.1056/NEJMsb2506929

The FDA VRBPAC Meeting Today on Covid-19 Vaccines for 2025-26

The FDA VRBPAC meeting today on the Covid-19 vaccines for 2025-26 is so far leading me to believe that the best choice for the voting question-

Based on the evidence presented, please discuss considerations for the selection of JN.1 and/or a specific JN.1-lineage strain for COVID-19 vaccines (2025-2026 Formula) to be used in the U.S.

-might just be sticking with last year’s Covid-19 JN.1 lineage vaccine rather than targeting the newest LP.8.1 strain. The strains so far aren’t suggesting a seasonal pattern. Some strains only last for weeks and it seems getting or making a vaccine for a Covid-19 strain that disappears by the time the manufacturer rolls out a vaccine for it could turn out to be a waste of time.

Neverthe less, all three of the industry presenters are calling this a “seasonal” update to their Covid-19 vaccine products. They’re hedging their bets, so to speak, and would be ready to market a vaccine targeting LP.8.1 if the FDA decides to license the product.

I’ve held off getting the JN.1 vaccine so far in anticipation of today’s meeting, to see if there’s any reason not to get it based on today’s decision.

But the day is young. I’ll probably be making periodic updates to this post today. I think Dr. Jerry Weir’s slides are excellent, as usual.

“Voting Question
For the 2025-2026 Formula of COVID-19 vaccines in the U.S., does the committee recommend a monovalent JN.1-lineage vaccine composition?
Please vote “Yes” or “No” or “Abstain”

“Discussion Topic
Based on the evidence presented, please discuss considerations for the selection of
JN.1 and/or a specific JN.1-lineage strain for COVID-19 vaccines (2025-2026 Formula) to be used in the U.S.”

Update: Of course, the committee voted unanimously for the JN.1 lineage because there was no alternate choice. The only choice for the members was to vote for the JN.1-lineage or against it. Although I agree with the “vote,” I think they should have had the alternate of LP.8.1 available, otherwise why have a vote at all? I wonder what the FDA will do now.

FDA Vaccines and Related Biological Products Advisory Committee Meeting May 22, 2025

The meeting of the FDA VRBPAC on the composition of Covid-19 vaccines will be tomorrow, May 22, 2025 at 8:30 am-4:30 pm EST. Some materials have recently become available on the FDA website.

The briefing document indicates that there will be a discussion of the most recent Covid-19 variants and whether the current vaccine needs to be modified as the viral antigenic strain has mutated.

The World Health Organization has formed a new technical advisory group: “Technical Advisory Group on COVID19 Vaccine Composition (TAG-CO-VAC) to review and assess the public health implications of emerging SARS-CoV-2 variants of concern (VOCs) on the performance of COVID-19 vaccines and to provide recommendations to WHO on proposed modifications to COVID-19 vaccine antigen composition. Recently, the TAG-CO-VAC advised that a monovalent JN.1 or KP.2 vaccines remain as appropriate vaccine antigen, while a monovalent LP.8.1 is a suitable alternative vaccine antigen (Ref: https://www.who.int/news/item/15-05-2025-statement-on-the-antigen-composition-of-covid-19-vaccines) to be included in the composition of COVID-19 vaccines (2025-2026 Formula).”

The VRBPAC meeting topics:

“On May 22, 2025, VRBPAC will meet in open session to discuss and make recommendations on the selection of the 2025-2026 Formula for COVID-19 vaccines for use in the U.S. The committee will be asked to discuss available evidence on recent and currently circulating SARS-CoV-2 variants, including data from virus surveillance and genomic analyses, antigenic characterization analyses, vaccine effectiveness and clinical immunogenicity studies of current U.S.- authorized/approved COVID-19 vaccines and nonclinical immunogenicity studies of candidate vaccines expressing or containing updated Spike antigens.”

The attendees include:

The TAG-CO-VAC presenter:

Kanta Subbarao, M.B.B.S., M.P.H. Professor Department of Microbiology and Immunology Faculty of Medicine Laval University (Laval University is in Quebec City, Quebec, Canada).

There’s an Iowa City member on the committee roster:

Stanley M. Perlman, M.D., Ph.D. Expertise: Pediatrics, Infectious Diseases Term: 08/23/2022 – 01/31/2026 Professor University of Iowa Distinguished Chair Department of Microbiology and Immunology Carver College of Medicine University of Iowa, Iowa City, IA 52242.

And the acting chair of the meeting will once again be: Arnold Monto, M.D. Expertise: Epidemiology Term: 02/01/2022 – 01/31/2026 Thomas Francis Jr. Collegiate Professor Emeritus of Public Health and Epidemiology School of Public Health University of Michigan Ann Arbor, MI 48109.

Vaccine manufacturer presentations will be from Moderna, Pfizer, Novavax, and Sanofi.

Further Thoughts on Ray Bradbury’s Short Story, “I See You Never”

This is an update to my post from lasts night on Ray Bradbury’s short story, “I See You Never.” My wife, Sena, happened to mention the naturalization process in the U.S. today.

In fact, we both saw the televised naturalization ceremony at the Iowa State Fair of 2024. During that ceremony, 47 children became citizens. In fact, the U.S. Citizenship and Immigration Services has held a celebratory naturalization ceremony at the Iowa State Fair for at least the last ten years.

There was just such a ceremony last month of 69 immigrants at the University of Northern Iowa.

I had a quick peek at the U.S. citizenship and civics test questions and I’m pretty sure I would have a lot of trouble passing it. I’d probably get shipped back to Mars—which Ray Bradbury wrote a lot about.

The naturalization process isn’t easy. Under federal law, you have to live here in the U.S. at least five years as a lawful permanent resident to be eligible for naturalization, three years if you’re the spouse of a U.S. citizen. You have to learn the language. Many other countries have a similar naturalization process.

There’s no exact number of the USCIS naturalization ceremonies per year, but 818,500 took part in 2024.

Many of those who go through the naturalization process think it’s unfair for others to bypass it by getting into the country by other means.

So, I guess that’s the other side of the short story—the one Ray Bradbury probably didn’t write.

May Mental Health Awareness Month Calendar and Checklist (look below this sticky post for other new posts)

Do We See Each Other?

I know that what I’m writing here this evening is going to sound foolishly sentimental and maybe even a little spooky, but I was struck by this weird experience I had tonight. It was just a little odd and too fortuitous. I’m not going to talk at any length about the politics of it, just the strangeness.

We have these two books by Ray Bradbury, and when I was a kid, I loved his science fiction stories. I read many of them, but never like the one I read tonight.

The way this started was I was looking for something to do. I thought about watching old reruns of The Red Green Show on YouTube, which always struck me as funny when I watched them long ago. I still do, but couldn’t get into it tonight.

I turned on the TV and flipped through the channels which, as always, were reruns. I was not even interested in the X-Files reruns and I’m a fan. And I couldn’t stand the thought of seeing any more in-your-face commercials about total body deodorant.

So, I picked up the hefty paperback of a big collection of a hundred of Ray Bradbury’s short stories, entitled oddly enough, “Bradbury Stories.” I just opened up the book with no particular story in mind and it fell open right to one I’d never read before, “I See you Never.”

It’s all of 3 pages long and it’s about a Mexican immigrant named Mr. Ramirez. He’s been brought by the police to the front door of the rooming house where he’s been living on a temporary visa, which has been revoked. He’s just there to say goodbye to his landlady. He’s being deported and has this sad conversation with her on the doorstep. He just keeps telling her in broken English, “I see you never.” The landlady, Mrs. O’Brian (no accident she has an Irish name, of course) just says repeatedly that he’s been a good tenant and that she’s sorry. Then he leaves with the police. She goes back inside and can’t finish her dinner with her family and realizes she’ll never see Mr. Ramirez again.

There’s a much better summary and analysis than mine written by a professional reviewer. This story was published back in 1947 and is set in the historical context of post WWII America.

I hate politics, and I’m not going to say anything specific about how this little story struck me with its irony given what’s going on this country right now. I was just looking for a little science fiction distraction and instead got irony. I didn’t go looking for this and I’ll be brutally frank—I actively avoid political news and I hate like hell to get reminded of it every day. All I did was open a damn book. I wish I had never seen this story.

I guess maybe that’s what I get for my avoidant approach to certain things. How’s that for a Mental Health Awareness month event?

May is Mental Health Awareness Month!

This is May and it’s Mental Health Awareness Month. I just found out about something exciting and it’s the Iowa Healthiest State Initiative.

See the Calendar of Events and the Checklist.

Procrastinate on Getting the Covid Vaccine?

This post is sort of my thinking out loud about whether or not I should get the Covid vaccine ahead of this summer that was approved last year as being appropriate to get twice a year by the CDC—once in the fall along with the flu shot and once to protect against the Covid summer surge that some experts argue has been happening every summer since the pandemic onset.

The trouble is that the dominant subvariant is no longer the JN.1 or KP.3.11. The currently dominant circulating bug is LP.8.1 according to the CDC Nowcast chart.

And what confuses me is that one expert still recommends getting the September 2023 updated vaccine, but recommends getting the “bivalent booster.”

And a recent article from the University of Minnesota Center for Infectious Disease Research and Policy (CIDRAP) says that a preprint study (not yet peer-reviewed) says the current Covid vaccine was only 53% effective against hospitalization and 39% medically attended Covid-19. Most patients got the vaccine targeting the XBB.1.5 variant. I think that’s related somehow to the KP.2 variant. I have a vague memory of hearing about the XBB.1.5 during the CDC meeting in September 2023.

I’m a retired psychiatrist, not a retired virologist. The information available to the public seems confusing to me and I imagine I’m not the only one so affected.

The CDC is recommending the 2024-2025 Covid-19 vaccines, which target the JN.1 variant, which is now 0% of circulating variants on the list. But I’m not sure whether the current vaccines would be as protective against the different variants now dominant.

The CDC April indicators show downward trends for test positivity, ER visits, hospitalizations, and deaths.

On the other hand, an August 2024 article from Johns Hopkins warns that Covid-19 rates have consistently risen in July-August risen since 2020. The author says that it’s still unclear whether Covid-19 will continue to have dual seasonality. Other factors that affect this in addition to the emergence of more transmissible variants are human behavior, such as staying in air-conditioned spaces more and traveling.

My big question is should an old guy get the 2024-2025 Covid-19 vaccine or just wait and see, especially in light of the difficult political situation with HHS sounding like it might require new, placebo-controlled trials of some vaccines before “tweaking” them to target more current variants—which could take several months.

But it doesn’t look like there’s a plan to tweak the 2024-2025 Covid-19 vaccine in any case. I’m probably worrying too much, but I’m on the fence. I’m already too good at procrastinating.