How many lives have the COVID vaccines saved?

 This really shouldn't be controversial.

In response to a worldwide pandemic, scientists built on decades of research in genetics and virology to design, create, test and deploy multiple COVID vaccines in record time. Three vaccines were approved for use in the US--Johnson and Johnson, Pfizer and Moderna. To date 214 million Americans--65%--are fully vaccinated and 93 million--28%--have gotten a booster. The vaccines and boosters are known to reduce COVID cases, severe illness, hospitalization and deaths.

The question is, how many deaths have the vaccines actually prevented--how many Americans are alive today who would be dead had they remained unvaccinated?

A doctor receiving a COVID vaccination

Credit: DOD

I know that many people's eyes glaze over when numbers are involved, and the next section includes a lot of numbers. For those with a numerical allergy, feel free to jump to the paragraph in bold that starts with "During the 39 weeks . . ."

The numbers:

To address the question of how many lives COVID vaccination has saved, I examined week-by-week US death rates by vaccination status between April 10, 2021 and January 1, 2022, and coordinated those with week-by-week numbers of Americans fully vaccinated.

During those 39 weeks the number of fully vaccinated Americans rose from 82.9 million to 207.4 million. As the pandemic waxed and waned, the weekly rates of COVID deaths among unvaccinated people ranged from 0.92 to 14.27 per 100,000 while the comparable rates for fully vaccinated people varied from 0.07 to 1.23 per 100,000.

The ratio of deaths per 100,000 comparing unvaccinated to vaccinated people ranged from 6.6 to 18 with an average of 11.85. That is, on average over those 39 weeks, unvaccinated Americans died from COVID at 11.85 the rate of their fully vaccinated peers.

The difference between the rate of deaths between unvaccinated and fully vaccinated people ranged from 0.85 deaths per 100,000 people during weeks when the pandemic was at a low ebb to 13.04 per 100,000 at its peak.

Knowing the number of vaccinated people in a given week and the death rate for unvaccinated people at that time, we can calculate the number of deaths that would have occurred among the vaccinated group if they had remained unvaccinated. We can calculate how many lives were saved by subtracting the actual number of deaths in the vaccinated group from the number of people in that group who would have died if unvaccinated.

Here's an example, using the week of December 18, 2021:

Number of fully vaccinated people: 205.3 million

Death rate among unvaccinated people: 92.5 per million

How many would have died at the unvaccinated rate: 205.3 x 92.5 = 18,990

Death rate among fully vaccinated: 8 per million

How many fully vaccinated people actually died: 205.3 x 8 = 1,642

Number of lives saved that week: 18,990 - 1642 = 17,348

We can then calculate that figure for each of the 39 weeks for which we have data and add them up. That gets us the answer to our question:

During the 39 weeks between April 10, 2021 and January 1, 2022, if nobody had been vaccinated we would have seen approximately 416,999 more deaths.

To put it differently, during those 39 weeks, COVID vaccinations saved approximately 417,000 American lives. That's an average of 10,692 lives saved per week, or 1527 per day.

If the COVID vaccines had not been available, the additional lives lost would have surpassed all American lives lost in World War II.

This conservative estimate of lives saved doesn't include those saved during the 20 weeks between the start of vaccinations in the US on December 14, 2020 and April 10, 2021, or the lives saved since January 1, 2022, or the additional lives saved among people who are fully vaccinated and boosted.

We can fill in those gaps at least in part. Researchers at the NIH and Rand Corporation used a modeling approach to estimate the number of lives saved by vaccines from December 14, 2020 through May 9, 2021. They arrived at a figure of 139,000 for that period. If we subtract the 10,436 deaths in the weeks where their figures overlap mine, we can add another 128,564 American lives saved by vaccines before April 10, 2021.

We don't have US COVID death rates by vaccination status after January 1, 2022, but we do have those numbers for two states, Texas and Washington. They show the same pattern, with unvaccinated people dying at between 7 and 18 times the rate of their fully vaccinated peers. It's safe to say that the number of lives saved by the COVID vaccines continues to grow.

So, even without counting the lives saved by vaccines so far in 2022, as a very conservative estimate COVID vaccinations have saved 417,000 + 128,500--more than 545,000 American lives.

What about the rest of the world?

Ten other countries report COVID deaths by vaccination status. You can find the details here. On average across those countries unvaccinated people died from COVID at 9.5 times the rate of vaccinated people, quite comparable to the 11.85 ratio seen in the U.S. over time. The average difference between the death rates per 100,000 for unvaccinated vs fully vaccinated people was actually greater than the comparable figure for the US. Thus it seems reasonable to use the lives saved in the U.S. to estimate lives saved worldwide.

This is supported by data from Europe. A study jointly published by WHO and the European Centre for Disease Prevention and Control estimates that between the beginning of vaccination in Europe in December, 2020 through November of 2021, vaccines saved nearly 470,000 lives just in those aged 60 and older.

The 214 million Americans who are fully vaccinated represent slightly less than one-twentieth of the number of fully vaccinated people worldwide, currently estimated at 4.355 billion. If we multiply 545,000 lives saved in the US by a factor of 20, we get an admittedly rough estimate of how many lives the vaccines have saved worldwide--10,900,000.

That's a lot of mothers and fathers, grandparents and grandchildren, husbands and wives, workers and homemakers, friends and lovers, regular people who are still alive because they chose to get vaccinated.

Perhaps we should be thanking Anthony Fauci and other public figures and leaders who have encouraged and advocated vaccination rather than calling them mass murderers who should be jailed or executed-- tropes that far too frequently appear on right-wing news sources and saturate social media.

 

The Real Risks of the COVID Vaccines

 Anyone following social media could be excused for thinking that the vaccines against COVID-19 are not just ineffective but extremely dangerous. Here are a few of the categorical assertions from a recent post on a nominally progressive news site:

"The COVID vaccines are the most dangerous vaccines in human history. They are 800 times more deadly than the smallpox vaccine, which was the previous record holder. The vaccines have killed over 150,000 Americans and permanently disabled even more. They don't make sense for anyone of any age. The younger you are, the worse it gets. For kids, it is estimated that we kill 117 kids for every COVID death we prevent...”

Credit: Marco Vetch

"So we are 'saving' fewer than 10,000 lives at the expense of over 150,000 (vaccine) deaths. In short, we kill 15 people to save 1. That's incredibly stupid."

“The eminent Dr. Peter McCollough has emphasized: "You are about five times as likely to die of the vaccine than you are to take your risks with COVID-19.”

“A recent medical research article said: "A novel best-case scenario cost-benefit analysis showed very conservatively that there are five times the number of deaths attributable to each inoculation vs those attributable to COVID-19 in the most vulnerable 65+ demographic."

We can now test such frequently repeated claims against actual data:

Currently 454 million COVID-19 vaccine doses have been administered in the US, and 195 million US residents have received two or more of the shots. Logically, if the vaccines were as dangerous as vaccine critics want us to believe, taking 5, 15, or, for children 117 lives for every life saved, those hundreds of thousands of deaths should be showing up somewhere. To put it crudely—show us the bodies.

Here's some striking new research that tells us that those bodies are never going to be found because they simply don't exist.

We already know that COVID-related deaths are consistently far lower among vaccinated compared to unvaccinated people. So the deaths supposedly caused by the vaccines must show up among deaths that are not COVID-related. Unfortunately for vaccine critics (but fortunately for everyone else), a large new study shows that the death rate from all causes other than COVID-19 is significantly lower among vaccinated compared to unvaccinated Americans.

If the hundreds of thousands of deaths from the COVID vaccinations don't show up as COVID-related, or as non-COVID-related, they don't exist. Period. The bodies will never be found because they were never there.

The new research appears in the Morbidity and Mortality Weekly Report (MMWR) of October 29, 2021. It's open access, so you can read the entire article here. (I know from experience that true-blue COVID vaccine critics pre-emptively discount all information from the CDC, JAMA, the New England Journal of Medicine and other "mainstream" sources. So they will doubtlessly discount this study too.)

Researchers at 9 large healthcare organizations across the US extracted anonymized data from the medical records of 6.4 million vaccinated people and 4.6 million unvaccinated people 12 years old or older. The data included vaccination dates, the kind of vaccine received, and subsequent health outcomes, including any deaths. In order to control for generalized vaccine or healthcare avoidance, the group who did not receive COVID vaccination was selected from people who had chosen to get flu vaccinations within the last two years.

 The researchers calculated and compared deaths per 100 person-years at risk between December, 2020 and July, 2021.

The results were striking:

After one dose of the Pfizer mRNA vaccine, vaccinated people's risk of dying from all causes other than COVID-19 was just 41 percent of the risk of unvaccinated people.

After two Pfizer doses, that relative risk went down to 34 percent.

After one dose of the Moderna mRNA vaccine, the non-COVID death risk was 34 percent.

After two doses of the Moderna vaccine, that relative risk went down to 31 percent.

After a single dose of the Johnson & Johnson adenovirus-vector vaccine, the risk of death from all causes other the COVID-19 was 54 percent compared to unvaccinated people.

With the exception of children age 12 -17, for whom the risk of death was equally low regardless of vaccination status, these findings held for all age groups, for men and women, and for all racial and ethnic groups.

The study's understated, but extremely clear conclusion:

“There is no increased risk for mortality among COVID-19 vaccine recipients.”

To restate the implication of these findings from the actual medical histories of 11 million people across the US:

There have not been 363,000 deaths (expected if the vaccines were in fact “800 times more deadly than the smallpox vaccine.”)

There have not been “over 150,000 Americans” killed by the COVID vaccines.

The vaccines are not killing 15 people to save 1.

You are not “5 times more likely to die of the vaccine than … your risks with COVID-19.”

There have not been 5 times the number of deaths from each inoculation compared to COVID among people 65 and older.

It's actually just the opposite. Not only do the COVID vaccines prevent deaths from or related to COVID, they are strongly associated with reduced deaths not related to COVID.

The researchers raise the intriguing question of just how the COVID vaccines lead to these additional lives saved. They suggest three plausible factors—it's possible that people who have chosen to get vaccinated have healthier lifestyles, they may be healthier in general, and perhaps there were some deaths from COVID in the unvaccinated cohort that were attributed to other causes. Further research is needed and is being planned.

Whatever the reasons for the strikingly reduced rates of non-COVID-related death among these 11 million Americans, the fact remains that the vaccines emphatically do not put us at risk, or “only” reduce COVID-related deaths, they actually reduce our risk of dying from causes other than COVID.

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A slightly different version of this article appeared on OpEdNews on 12/1/21.

There is no increased risk for mortality among COVID-19 vaccine recipients.

Let's start with the claim that the COVID vaccines are “800 times more deadly than the smallpox vaccine.” According to the National Library of Medicine, the death rate from smallpox vaccination was one death per million vaccinations. If it's true that the COVID vaccines are 800 times more deadly, then the 454 million COVID shots must have killed 800 x 454 = 363,200 Americans. That's about 45 percent of the 800,000 CoVID-related deaths that have dominated headlines, filled and sometimes overwhelmed hospitals and intensive care units, and orphaned 150,000 to 200,000 children.

If the vaccine critics want to be taken seriously—show us the bodies.

Another claim in the same paragraph: “It is estimated that we kill 117 kids for every COVID death we prevent.”

[TK—go directly to new data about deaths, put the discussion of VAERS, etc. below]

When pressed, the vaccine critics start by citing VAERS, the US Vaccine Adverse Event Reporting System. VAERS has received over 10,000 reports of deaths following COVID vaccinations. VAERS emphasizes that:

“FDA requires healthcare providers to report any death after COVID-19 vaccination to VAERS, even if it’s unclear whether the vaccine was the cause. Reports of adverse events to VAERS following vaccination, including deaths, do not necessarily mean that a vaccine caused a health problem.”

Despite that unambiguous warning, vaccine critics typically take the number of deaths reported to VAERS as definitely caused by the COVID vaccines, and then multiply that number by a large factor—up to 100--based on assumed under-reporting.

There are many reasons why the VAERS data can't be taken literally, but a basic one is the background rate of deaths that would be expected in the weeks following the 450,000,000 vaccinations Americans have received—or 450,000,000 events of any kind.

You can check the math at the end of this post, but the fact is that if you picked 450,000,000 random weeks in the lives of Americans, you would register more than 75,000 deaths. In other words, it's basically impossible to know if any of the deaths reported to VAERS following COVID vaccinations are caused by the shots, related to the shots, or just part of the much larger number of deaths that occur among hundreds of millions of people any given week. Clearly, multiplying a meaningless number by 15, 50 or 100 doesn't make it any more meaningful.

Vaccine critics perform another trick to minimize the effectiveness of the vaccines. They cite a CDC report that just 6 percent of COVID-related deaths are in people with no known risk factors (such as obesity) or co-morbidities (such as diabetes). They then assume that the remaining 94 percent of COVID-related deaths must actually be from something other than COVID. This trick reduces the number of COVID deaths by 94 percent, so currently from 770,000 down to 46,200.

So, with a little hand waving and a few abracadabras, the vaccine critics manage to “find” 150,000 or more deaths from the vaccines compared to only 46,000 deaths from COVID itself. Clearly we should be far more scared of the vaccines than by COVID, right?

Luckily, we have some new and much more reliable data about the alleged dangers of the COVID vaccines.

How many Americans can be expected to die in the week following a COVID-19 shot (or in the week following any given event)?

About 2,855,000 Americans die every year. That's 870 per 100,000 person-years or 16.7 per 100,000 person-weeks.

Let's suppose that vaccine administrators report any deaths that occur within one week following a COVID shot. That means that any deaths among 454,000,000 people for one week, or 450,000,000 person-weeks would potentially be reported. But we would expect 16.7 natural deaths per 100,000 person-weeks, or 167 deaths per million person-weeks, so 167 x 454 = 75,818 natural, but potentially reportable deaths.

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Seven thousand steps is the new magic number

 If, like me, you've been trying for years to fit those widely recommended 10,000 steps per day into your schedule without great success, you may be able to breathe a sigh of relief. New research published in the prestigious Journal of the American Medical Association (JAMA) shows that just 7,000 steps per day significantly reduces deaths from all causes among middle-aged Americans, regardless of race or gender. 

It's not that taking more than 7,000 steps per day would be bad for you--increasing benefits were found up to 10,000 steps per day. However, the benefits of moderate walking--just 7000 to 9000 steps per day--were massive, a 50 to 70 percent reduction in the risk of dying over the years of the study.

Credit: MabelAmber

"You see this gradual risk reduction in mortality as you get more steps," says Amanda Paluch, an assistant professor of kinesiology at the University of Massachusetts, Amherst, and corresponding author for the JAMA study. "There were substantial health benefits between 7,000 and 10,000 steps but we didn't see an additional benefit from going beyond 10,000 steps."

(It turns out that 10,000 steps per day was not a scientifically determined goal, but a catchy number that gained traction because of an advertising campaign for a Japanese pedometer!)

Paluch and her colleagues utilized data from the Coronary Artery Risk Development in Young Adults (CARDIA) study. The study started in 1983 and is still continuing. It involved over 5,000 men and women from four US states, and is notable for both its duration--now approaching 40 years--and for its racial balance. 

Participants activity levels were measured over the course of one year, and they were re-assessed ten years later. Overall, participants who walked 7,000 to 9,000 steps per day at the start of the study were just 28 percent as likely to die as those who walked fewer than 7,000 steps per day--a more than 70 percent risk reduction. Women and Blacks showed the greatest benefits of higher activity levels, but men and Whites still showed a 60 percent reduction in mortality risk over 7,000 steps per day.

Interestingly, walking faster was not associated with decreased mortality. The number of steps turned out to be much more important than the minute-by-minute intensity of the exercize.

The clear implication is that no matter who you are, you can increase your odds of living a longer and healthier life simply by taking 7,000 or more steps per day. 

"Showing that steps per day could be associated with premature mortality is a new contribution to the field," says Paluch. "Preventing those deaths before average life expectancy--that is a big deal."

Let's all make Professor Paluch happy, and click off those 7,000 steps starting today!

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REA 9/30/21

SPEEDING PAST ANOTHER TRAGIC COVID-19 MILESTONE

On April 27, just 11 days ago,  I posted a piece noting that the world had just passed the grim milestone of three million COVID-19 cases and 210,000 deaths. It took this highly contagious and dangerous virus just 11 more days to infect another million people and kill another 65,000.  In the US during those same 11 days, 320,000 more people caught the virus and more than 22,000 died. 

To try to remind ourselves that these are people, not statistics, that means that every minute of those 11 days four husbands, wives, fathers, mothers and children died miserable deaths from this pandemic disease.

Anti-quarantine demonstrators in Colombus, Ohio, 4/18/20

Credit: M/Creative Commons

Nonetheless, countries, states and cities around the world are "re-opening," loosening the restrictions that have, when applied with determination and followed in good faith, slowed and in a few places even stopped the virus. This is said to be necessary to get the economy moving again. 

What is not said nearly as loudly if at all is that this promised economic recovery will be purchased at the price of tens or hundreds of thousands of human lives. Nor should we forget that the majority of those lives cut short will not be those of the rich, nor or the well-educated, highly skilled occupants of the kinds of jobs that can be managed largely online. No. Most of those who die will be ordinary people whose jobs require face-to-face contact or working close to others, and who have no choice but to go back to work when they're told to. 

The boosters shout, "Liberate out state,"  or "Let's get the economy going again." Trump eggs them on, and so it is happening now. That despite the fact that few places in the US are in a condition to do so safely. 

Let's at least be honest about the price, and who will pay it. 

REA

HOW GOOD IS EXERCISE FOR SENIORS? LET ME COUNT THE WAYS!

A new review of reviews of the benefits of exercise tells us that exercise is as close as we're likely to get to a panacea.

Seniors exercising

Credit: Asahia/Wikimedia Commons

Writing in the Scandanavian Journal of Medicine & Science in Sports, an international team of researchers reviewed all of the highest quality reviews and meta-analyses to date on the relationship between exercise and health in people in their sixties or older. The smallest group studied comprised 855 individuals, while the largest study tracked more than 400,000. The results are impressive:

If you're 60 or more and physically active, compared to your less-active peers, you're:

     22 percent less likely to die from any cause during a comparable time period

     25 to 40 percent less likely die from cardiovascular disease

     12 percent less likely to develop breast or prostate cancer

     29 to 39 percent less likely to fracture a bone

     50 percent less likely to become disabled (unable to perform basic activities              of daily living)

     26 to 38 percent less likely to experience cognitive decline or impairment

     32 to 42 percent less likely to develop Alzheimer's Disease

     14 to 21 percent less likely to develop some other kind of dementia

     17 to 21 percent less likely to suffer from depression

      and significantly more likely to experience healthy aging, a better
      quality of life and more years spent in good mental and physical health.

To some extent, the range of outcomes comes from different studies using different criteria. However, for most of these relationships, more exercise produced better outcomes. The researchers conclude that any amount of physical activity has some benefit, but recommend at least 75 minutes per week of moderate to vigorous physical activity.

"Physical activity plays a key role in the 'compression of morbidity,'" the authors write, "decreasing the time spent in ill-health as people age and ensuring that an increase in life expectancy is also an increase in life-time spent in good health."

Not a bad payoff for investing at 10 to 15 minutes a day exercising.

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REA




   

CYCLING TO WORK CUTS CANCER AND HEART-DISEASE RISK NEARLY IN HALF

A five-year study of 260,000 men and women in the UK found that bicycling to work every day reduced their risk of dying by more than 40 percent compared to commuters who drove or used public transport. In addition, the risk of developing cancer fell by 45 percent, and of being diagnosed with heart disease by 46 percent.

"This is really clear evidence that people who commute in an active way, particularly by cycling, were at lower risk," says Jason Gill, a physician-researcher at the University of Glasgow and corresponding author of the study.

New Yorkers bicycling to work
Credit: Streetfilms

Walking to work had a similar but smaller protective effect, probably because people who used bicycles for their commute exercised longer and more intensely than walkers. 

The powerful protective effect of active rather than passive commuting held up even when the researchers controlled for known risk factors such as smoking, weight and diet.

One benefit of bicycling to work, the researchers point out, is that unlike going to the gym or planned workouts, commuting becomes a no-willpower-needed habit. "You need to get to work every day, so if you build cycling into the day it essentially takes willpower out of the equation," says Gill.

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You can read the original article, in BMJ, the British Medical Journal, here.

HERE'S TO "WEEKEND WARRIORS"--THE EXERCISE YOU GET IS LIFE-SAVING

We all know that exercise is good for us. Decades of research has shown that even moderate physical activity--such as brisk walking--improves health and lengthens lives.

Based on this, both the US Department of Health and Human Services (HHS) and the World Health Organization (WHO) recommend at least 2 1/2 hours of moderate physical activity or 1 1/4 hours of intense exercise per week, spread throughout the week.

Biking and other exercises add miles--and years--to your life/Credit Connie Ma

Recognizing that many people can't build daily exercise into their schedules, but might hit the streets, the courts or the trails on weekends, a team of British researchers set out to see if even "weekend warriors" are healthier because of the the exercise they do.

The short answer is--you bet they are.

Writing in this week's edition of the prestigious medical journal, JAMA Internal Medicine, Gary O'Donovan and his colleagues conclude that men and women who got the recommended amount of exercise in just one or two outings per week were 40 percent less likely to die from cardiovascular disease, 30 percent less likely to die from any cause, and nearly 20 percent less likely to die of cancer, compared to inactive adults.

The health benefits for weekend warriors were similar to those for people who exercised the same amount, but more regularly during the week.

"The weekend warrior and other physical activity patterns characterized by 1 or 2 sessions per week of moderate or vigorous-intensity physical activity may be sufficient to reduce risks for all-cause, CVD [cardiovascular disease], and cancer mortality regardless of adherence to prevailing physical activity guidelines," the researchers write.

Their study tracked almost 64,000 men and women 40 years and older over the course of 8 years, as part of a long-term English-Scottish health survey. Exercise patterns were determined from self reports while causes of death came from death certificates. The study's findings are particularly useful because of its length and the large number of participants.

Here's the take-home message from O'Donovan:

If you already are a weekend warrior, keep up the good work. If you are thinking of becoming more active, begin with a moderate-intensity exercise like brisk walking. Walking is associated with low risk of injury and it's important to set realistic goals that provide motivation and build confidence. I would recommend that middle-aged and older adults take part in at least 12 weeks of moderate-intensity exercise before introducing any vigorous-intensity exercise.

A new study, published in the prestigious British Medical Journal, analyzed 39 separate studies and concluded that both aerobic and resistance exercise can improve cognitive functioning in people over the age of 50. The exercise can be moderate, yet the cognitive gains are significant.

The bottom line--get up, get out, and exercise, even if you can only manage it once or twice a week.

YOU'RE LESS LIKELY TO DIE IN HOSPITAL IF YOU'RE TREATED BY A FEMALE PHYSICIAN

Women doctors treat differently, save lives

Male and female physicians practice medicine differently. For example, women doctors spend more time with their patients, communicate more, offer more encouragement, and are more likely to adhere to the latest clinical guidelines.

A major new national study shows that those or other differences save lives. The study found that hospitalized elderly patients treated by female rather than male internists were 4 percent less likely to die and 5 percent less likely to be re-hospitalized within 30 days of admission. This was true across a wide range of conditions. And the sicker the patient, the bigger the difference between patient outcomes for female vs. male physicians.

Female physicians practice medicine differently--and more effectively

Credit: Ilmicrofono Oggiono

"The difference in mortality rates surprised us," said Yusuke Tsugawa, a researcher at Harvard University's T. H. Chan School of Public Health and the study's lead author. "The gender of the physician appears to be particularly significant for the sickest patients."

A four or five percent difference in survival rates may not seem like a lot, but since 10,000,000 patients like those in this study are hospitalized in the US every year, the authors estimate that if male physicians performed as well as their female colleagues, 32,000 lives would be saved--more than the number of Americans who die in traffic accidents every year.

The study, published today in the prestigious JAMA Internal Medicine, tracked the outcomes of more than 1.5 million Medicare hospitalizations from 2011 through 2014. All of the patients were 65 years old or older, 40 percent were men, 60 percent women. These were seriously ill patients--within 30 days of being admitted to the hospital, more than 15 percent were re-hospitalized and more than 11 percent died. About one third of patients were treated by female internists or hospitalists, two thirds by male physicians. Although earlier research has identified a number of differences between how female and male physicians practice, this is the first national study to see if those differences impact patient outcomes.

Although this study shows conclusively that the physician's gender does affect the risk that hospitalized elderly patients will die or be re-hospitalized, it does not pin down just what produces those differences.

"There was ample evidence that male and female physicians practice medicine differently," says Ashish Jha, Director of the Harvard Global Health Institute. "Our findings suggest that those differences matter and are important to patient health. We need to understand why female physicians have lower mortality so that all patients can have the best possible outcomes."

In the meantime, an accompanying editorial in the same journal points out that the medical profession needs to take a hard look at the gap in both pay and career advancement between female physicians and their male colleagues.

You can listen to an interview with the authors at this URL.