Greece heads to the polls

A hair's-breadth victory for the right is predicted, but time will tell.

The Greek polls have opened, and will stay open until around 4pm British time, with the first exit polls being released around 6:30. Although opinion polling isn't allowed in the country in the two weeks leading up to the election, various organisations have been conducting their own private polls, many of which reportedly point to the conservative New Democrats winning by a hair's breadth.

There are still a number of undecideds in the Greek electorate, however, and analysis has been devoted to trying to determine what is likely to swing them. Some jokingly suggest that the results of Saturday's football match against Russia (which Greece won in a surprise 1-0 result) may lead to the Greeks feeling more emboldened to elect a candidate who will stand up to Europe; others that it may make them feel better about the whole situation and just want to play along.

Something which may have a real effect on the polls was suggested by Business Insider's Joe Weisenthal: taxes. Owing to the backwards nature of the Greek tax system (which still involves paying much of the bills in person with cash), the caretaker government hasn't levied any taxes in the run-up to the election. But they are widely expected to be raised in the next couple of days, which means many Greeks are heading to their accountants:

Okay, so in the past several days people have begun preparing their post-election taxes, and they've been hit with sticker shock. The new austerity reforms have seen some major increases in tax bills for the average Greek... sometimes to the tune of 300-400 per cent, according to one person familiar with the intricacies of it all.

This has got people particularly angry, and it could be this trend which causes people at the last second to turn away from [the leader of the New Democrats, Antonis] Samaras with disgust, and vote for [the leader of the SYRIZA, Alexis] Tsipras.

Many in the European establishment see the election of Tsipras as the worst case scenario for Greece, fearing that it will lead him and Angela Merkel to enter into a game of chicken which will result in Greece being ejected from the euro. But the Financial Times is reporting that one even worse outcome may be about to occur; a hung parliament:

Private opinion polls showed that none of the parties would win a parliamentary majority. The centre-right New Democracy party had a three-point lead over the radical left Syriza coalition, but neither party would capture even 30 per cent of the vote, according to two private polls seen by the FT. . .

A delay in forming a coalition, or in the worst case, a recourse to a third election if negotiations fail, could cause Greek public finances to collapse. Officials at the finance ministry said last week that unless a delayed €1bn tranche of EU-IMF funding is paid, funds to pay pensions and public sector wages would be exhausted by July 20.

The World Bank's outgoing head, Rober Zoellick, has told the Observer that Europe is one step away from a "Lehmans moment", but much of his criticism was focused on the deleterious effects of uncertainty in Europe on developing nations. That uncertainty will either be cleared up, or magnified greatly, by events today.

Polling slips for the two main parties, SYRIZA and New Democracy, in a polling station in Athens. Photograph: Getty Images

Alex Hern is a technology reporter for the Guardian. He was formerly staff writer at the New Statesman. You should follow Alex on Twitter.

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When it comes to the "Statin Wars", it's the patients I pity

Underlying the Statin Wars are two different world-views: the technological and holistic.

September saw the latest salvos in what has become known in medical circles as the Statin Wars. The struggle is being waged most publicly in the pages of Britain’s two leading medical journals. In the red corner is the British Medical Journal, which in 2014 published two papers highly critical of statins, arguing that they cause far more side effects than supposed and pointing out that, although they do produce a modest reduction in risk of cardiovascular disease, they don’t make much difference to overall mortality (you may avoid a heart attack, only to succumb to something else).

In the blue corner is the Lancet, which has long been the publishing platform for the Cholesterol Treatment Trialists’ (CTT) Collaboration, a group of academics whose careers have been spent defining and expounding the benefits of statins. The CTT was infuriated by the BMJ papers, and attempted to force the journal to retract them. When that failed, they set about a systematic review of the entire statin literature. Their 30-page paper appeared in the Lancet last month, and was widely press-released as being the final word on the subject.

A summary would be: statins do lots of good and virtually no harm, and there really is no need for anyone to fuss about prescribing or taking them. In addition, the Lancet couldn’t resist a pop at the BMJ, which it asserts acted irresponsibly in publishing the sceptical papers two years ago.

Where does all this leave the average patient, trying to weigh up the usefulness or otherwise of these drugs? And what about the jobbing doctor, trying to give advice? The view from no-man’s-land goes something like this. If you’ve had a heart attack or stroke, or if you suffer from angina or other conditions arising from furred-up arteries, then you should consider taking a statin. They’re not the miracle pill their proponents crack them up to be, but they do tip the odds a little in your favour. Equally, if you try them and suffer debilitating side effects (many people do), don’t stress about stopping them. There are lots more effective things you could be doing – a brisk daily walk effects a greater risk reduction than any cholesterol-lowering pill.

What of the millions of healthy people currently prescribed statins because they have been deemed to be “at risk” of future heart disease? This is where it gets decidedly murky. The published evidence, with its focus on cardiovascular outcomes alone, overstates the case. In healthy people, statins don’t make any appreciable difference to overall survival and they cause substantially more ill-effects than the literature suggests. No one should be prescribed them without a frank discussion of these drawbacks, and they should never be taken in lieu of making lifestyle changes. Smoking cessation, a healthy diet, regular modest exercise, and keeping trim, are all far more important determinants of long-term health.

Underlying the Statin Wars are two different world-views. One is technological: we can rely on drugs to prevent future health problems. This perspective suffers substantial bias from vested interests – there’s a heck of a lot of money to be made if millions of people are put on to medication, and those who stand to profit make huge sums available to pay for research that happens to advance their cause.

The other world-view is holistic: we can take care of ourselves better simply by living well, and the fetishising of pharmaceutical solutions negates this message. I have great sympathy with this perspective. It certainly chimes with the beliefs of many patients, very few of whom welcome the prospect of taking drugs indefinitely.

Yet the sad truth is that, irrespective of our lifestyles, we will all of us one day run into some kind of trouble, and having medical treatments to help – however imperfectly – is one of mankind’s greatest achievements. In arguing for a greater emphasis on lifestyle medicine, we must be careful not to swing the pendulum too far the other way.

Phil Whitaker’s latest novel is “Sister Sebastian’s Library” (Salt)

This article first appeared in the 20 October 2016 issue of the New Statesman, Brothers in blood