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Reviewed by Megan Craig, M.Sc. Jul 12 2023

Excessive drinking during the covid-19 pandemic increased alcoholic liver disease deaths so much that the condition killed more Californians than car accidents or breast cancer, a KFF Health News analysis has found.

Lockdowns made people feel isolated, depressed, and anxious, leading some to increase their alcohol intake. Alcohol sales rose during the pandemic, with especially large jumps in the consumption of spirits.

While this led to a rise in all sorts of alcohol-related deaths, the number of Californians dying from alcoholic liver disease spiked dramatically, with 14,209 deaths between 2020 and 2022, according to provisional data from the Centers for Disease Control and Prevention.

Alcoholic liver disease is the most common cause of alcohol-induced deaths nationally. In California, the death rate from the disease during the last three years was 25% higher than in the three years before the pandemic. The rate peaked at 13.2 deaths per 100,000 residents in 2021, nearly double the rate from two decades ago.

The disease is usually caused by years of excessive drinking, though it can sometimes occur after a short period of heavy alcohol use. There are often no symptoms until late in the disease, when weakness, confusion, and jaundice can occur.

Many who increased their drinking during the pandemic were already on the verge of developing severe alcoholic liver disease, said Jovan Julien, a postdoctoral researcher at Harvard Medical School. The extra alcohol sped up the process, killing them earlier than they would have otherwise died, said Julien, who co-wrote a modeling study during the pandemic that predicted many of the trends that occurred.

Even before the pandemic, lifestyle and dietary changes were contributing to more deaths from alcoholic liver disease, despite little change in alcohol sales, said Brian Lee, a hepatologist and liver transplant specialist with Keck School of Medicine of the University of Southern California.

Lee and other researchers found a connection between alcoholic liver disease and metabolic syndrome, a condition often characterized by excess body fat around the waist. Metabolic syndrome — often caused by poor diet and an inactive lifestyle — has risen across the country.

"Having metabolic syndrome, which is associated with obesity, high blood pressure, and diabetes, more than doubles your risk of having advanced liver disease at the same level of drinking," Lee said.

The Californians alcoholic liver disease most often kills are those between 55 and 74 years old. They make up about a quarter of the state's adults but more than half the deaths from alcoholic liver disease.

However, death rates among Californians 25 to 44 roughly doubled during the last decade. About 2,650 Californians in that age group died of the disease during the last three years, compared with 1,270 deaths from 2010 through 2012.

"People are drinking at earlier levels," Lee said. "People are developing obesity at younger ages."

The highest death rates from alcoholic liver disease occur in rural eastern and Northern California. In Humboldt County, for instance, the death rate from alcoholic liver disease is more than double the statewide rate.

Jeremy Campbell, executive director of Waterfront Recovery Services in Eureka, said Humboldt County and other rural areas often don't have the resources and facilities to address high rates of alcohol use disorder. His facility provides high-intensity residential services and uses medication to get people through detox.

"The two other inpatient treatment facilities in Eureka are also at capacity," he said. "This is just a situation that there's just not enough treatment."

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Campbell also pointed to the demographics of Humboldt County, which has a much higher proportion of white and Native American residents than the rest of the state. Alcoholic liver disease death rates in California are highest among Native American and white residents.

Death rates rose more among Native American, Latino, Asian, and Black Californians during the last decade than among non-Latino white Californians, CDC data shows. Part of that is due to disparities in insurance coverage and access to care, said Lee. In addition, Lee said, rates of metabolic syndrome have increased more quickly among nonwhites than among whites. Racial health disparities also manifest in differing survival rates for Black and white patients after liver transplants, he added.

The trend is expected to continue. Julien projects a temporary dip in deaths because many people who would have died of the disease in 2022 or 2023 instead died sooner, after a boost in drinking during the pandemic, but that deaths will rise later as bad habits developed during the pandemic begin to take a long-term toll.

"As people increased their consumption during covid-19, we have more folks who have now initiated alcohol use disorder," Julien said.

Phillip Reese is a data reporting specialist and an assistant professor of journalism at California State University-Sacramento.

This article was produced by KFF Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.

This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

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Robbie Williams addresses Glastonbury rumours – as excitement builds for ‘secret’ sets

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Robbie Williams addresses Glastonbury rumours - as excitement builds for 'secret' sets

Pulp tried to quash the rumours, Robbie Williams was happy to fuel them – sharing a picture of a blue plaque in his name apparently slapped over a famous Glastonbury sign, before seemingly backtracking.

“30 years later…” he captioned his first social media post early on Friday morning – a reference to his headline-grabbing attendance in 1995.

This was the year Williams was famously pictured partying with Oasis‘s Liam and Noel Gallagher, shunning the boyband shackles with bleached-blonde hair and a blacked-out tooth. The writing was on the wall, and the announcement of his departure from Take That came just a few weeks later.

At Glastonbury this year, is the writing quite literally on the wall for a comeback?

Well, maybe not. A few hours after his post, Williams shared another, less cryptic message to say he would not be performing, along with his list of recommended acts to go and see – The 1975, Busta Rhymes, Charli XCX, Self Esteem and Reverend And The Makers, if you’re interested.

Is he bluffing? Double-bluffing? Who knows, but along with celeb spotting and mud, if there’s one topic of conversation that makes headlines when it comes to Glastonbury, it’s speculation about secret artists. Williams has got everybody talking.

Even before his posts, the Let Me Entertain You singer was among the artists rumoured to be performing secret sets this year, along with Pulp and Haim. Lewis Capaldi and Lorde too, with both “TBA” acts turning out to huge crowds on Friday.

Liam Gallagher And Robbie Williams at Glastonbury Festival in 1995. Pic: Brian Rasic/Getty Images
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Liam Gallagher And Robbie Williams at Glastonbury Festival in 1995. Pic: Brian Rasic/Getty Images

In recent years, these surprise sets have turned into some of the event’s most memorable moments – think Foo Fighters as “The ChurnUps” in 2023, Pulp’s comeback in 2011, and Lady Gaga treating fans to a small performance in one of the festival’s after hours areas, Shangri-La, in 2009.

Franz Ferdinand, famous for hits including Take Me Out and Do You Want To in the mid-2000s, were the first to do it back in 2008. This was actually due to Pete Doherty’s band Babyshambles pulling out last-minute, but the approach to announcing the switch was, at the time, a novel one.

While officially, the act was “TBA”, frontman Alex Kapranos wasn’t great at keeping the secret, worried people might not turn up. He and bandmates handed out fliers, and word spread.

Franz Ferdinand perform a secret gig on the Park Stage during day one of the Glastonbury Festival, Somerset. Pic: Yui Mok/ PA
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Franz Ferdinand played the first ever big ‘secret’ set back in 2008. Pic: Yui Mok/ PA

“We played on the Park Stage and we thought, ‘nobody’s going to know we’re playing’,” Kapranos told Sky News ahead of a return performance on Friday. “It actually ended up being one of the most amazing gigs we’ve ever played, people were so up for it and going crazy.

“We weren’t keeping it secret. We were walking about like, ‘we’re playing later on, check it out’. We’re a band from Glasgow called Franz Ferdinand.”

These now not-so-secret performances have become bigger and bigger as each festival rolls around, with leaks making headlines in the run-up to the event.

Providing handy tips and hints – and often eventually confirmation, just in time for fans to be in position – is the Secret Glasto team. They have no official ties to Glastonbury, but over the years have become a reliable source of information.

The account’s founder, who now works in a team of six, spoke to us on site – incognito, of course.

“We’ve got our own sources and we can start checking things because we’ve now had enough years that we can check in with several people,” he said. “And they trust us because we are quite sensible with when we time announcements, which I think is the key thing.”

Sometimes acts themselves will confirm, they said. Their success rate for predictions is “in the low 90%” – but dragged down mainly by inexperience in their first year, which was 2014.

Capaldi’s comeback yesterday, two years after struggling on stage at Glastonbury in 2023, was a special moment.

“It was really, really heartwarming to see him get back up,” Secret Glasto said. “There was such goodwill in the crowd and it was just magical. It’s just what secret sets should be about.”

British band Pulp perform on the Arena Stage as 'surprise guests' at Glastonbury Festival in Glastonbury, England on Saturday June 25, 2011. (AP Photo/Mark Allan)
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Pulp’s Jarvis Cocker performing on the Park Stage for a secret set at Glastonbury 2011. Pic: AP/ Mark Allan


On Saturday evening, a non-existent act called Patchwork have a pretty important billing just before Raye and then headliner Neil Young on the Pyramid Stage.

Pulp keyboard player Candida Doyle dampened rumours by reportedly saying in an interview earlier this month Glastonbury “weren’t interested” in booking the band.

But is this true?

“It happens a few times,” Secret Glasto said, of artists maybe telling little white lies to keep the secret for as long as possible. “They’ve got to keep the suspense somehow…

“Sources that we got for Pulp were really, really strong. It’s just so exciting for us, for the whole team. This is the most exciting secret set that Glastonbury’s ever done.”

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It’s a fine balance – not spoiling the surprise but giving fans enough time to get where they want to be. When a festival is this big – home to around 200,000 people over the weekend – at a lot of stages, fans need to be in place early.

“The point is to always make sure people can get to the set if they wanted to.” But if a huge artist is going to surprise fans on a very small stage, sometimes they have to keep schtum for safety concerns over huge crowds. “Sometimes we’re like, we can’t print this.”

So, will Williams be playing? The rumour is that he could be joining his mate Rod Stewart, who is performing on the Pyramid Stage in the “legends” slot on Sunday.

“Robbie Williams entered this area without accreditation, authorisation, or alignment with prevailing taste,” according to the blue plaque in his social media tease, of his attendance in 1995. “His presence was uninvited, unofficial and ultimately inevitable.”

In his candid documentary series, and biopic Better Man, both released last year, Williams has been open about his struggles with fame and imposter syndrome, and how as an artist known for pop he craved respect from those seen as more credible at a time when indie music reigned.

Officially this year, there is no Robbie Williams on the line-up. Unofficially, who knows? But 30 years since his partying with the Gallaghers, pop music is embraced – and there would be a lot of love for the star if he did make an appearance now.

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Lewis Capaldi plays emotional not-so-secret comeback set at Glastonbury

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Lewis Capaldi plays emotional not-so-secret comeback set at Glastonbury

Lewis Capaldi has made an emotional comeback with a “secret” performance at Glastonbury – two years after announcing a break from the spotlight, where he struggled on stage at the festival.

After revealing his new song, Survive, earlier in the day, Capaldi took to the Pyramid Stage and surveyed the huge crowd in front of him as he launched into his 2019 hit, Before You Go.

Glastonbury, how you doing?” was the simple introduction after the first chorus, and then came his second song, Grace.

Fan support for Lewis Capaldi was clear. Pic: Yui Mok/ PA
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Fan support for Lewis Capaldi was clear. Pic: PA

Before the next one, the Scottish star took it all in again and told the audience: “Glastonbury, it’s so good to be back… I’m not going to say much up here today because if I do, I’ll probably start crying.”

But, he added, he wanted to thank his fans, and “finish what I couldn’t the first time round”.

Along with the headliners and the Sunday afternoon “legends slots”, secret sets from the likes of Foo Fighters, The Killers, and Radiohead have become some of the most talked-about performances at Glastonbury in recent years.

This time round, there had been much speculation about some of the big unannounced slots on the bill – in particular the TBA act scheduled to appear on the festival’s main stage, the Pyramid Stage, just before Alanis Morissette on Friday afternoon.

With various clues trailed on social media and in Glasgow, where Capaldi was born, and Castle Cary, near Glastonbury, by the time Capaldi walked on stage, it was in reality no secret to all but a few of the huge crowd that had turned out for the “surprise”.

Lewis Capaldi performing on the Pyramid Stage at Glastonbury. Pic: Yui Mok/PA
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Lewis Capaldi performing on the Pyramid Stage at Glastonbury. Pic: PA

The 28-year-old acknowledged the absurdity of his set being “TBA”, describing it as the “worst kept secret” and joking: “I don’t know who’s been f*****g telling people.”

There were chants of “Oh, Lewis Capaldi!” from the crowd before he began his next songs, including Hold Me While You Wait, Bruises, Forget Me, and Someone You Loved.

Read more: Glastonbury performers criticise political interference in festival

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His performance was more than just a surprise set.

A few months before his last appearance at Glastonbury, again on the Pyramid Stage, in 2023, Capaldi had released the all-access documentary, How I’m Feeling Now.

It showed his rise from viral hit-maker to a star whose debut album, Divinely Uninspired To A Hellish Extent, became the biggest-selling in the UK in its year of release – and the year after, too.

No mean feat when you consider his competition – Ed Sheeran was second in 2019 and Harry Styles in 2020.

Pic: PA
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Capaldi on stage at the festival in 2023. Pic: PA

Fans have always loved Capaldi not just for his talent as a singer and songwriter, but for his class-clown humour and his unfiltered, indifferent style.

But his sense of humour and anti-celebrity attitude masked struggles with his mental health and Tourette’s, which he spoke about candidly in the film.

At Glastonbury in 2023, the strain was clear.

Prior to the performance, he had cancelled several shows to rest and recover. On stage, he apologised as he prepared to belt out his hit song Someone You Loved.

“I’m going to be honest, everybody, but I’m starting to lose my voice up here, but we’re going to keep going and we’re going to go until the end,” he told the crowd.

“I just need you all to sing with me as loud as you can, if that’s okay?”

Lewis Capaldi: How I'm Feeling Now. Pic: Netflix
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Lewis Capaldi: How I’m Feeling Now. Pic: Netflix

And of course they did, the voices of tens of thousands of people carrying him through.

In a statement afterwards, the star said the sentiment had meant “the world”, before announcing a break for “the foreseeable future”.

“I used to be able to enjoy every second of shows like this, and I’d hoped three weeks away would sort me out,” he said.

“But the truth is I’m still learning to adjust to the impact of my Tourette’s and on Saturday it became obvious that I need to spend much more time getting my mental and physical health in order, so I can keep doing everything I love for a long time to come.”

In May, Capaldi performed his first show in two years – a charity gig in Edinburgh to raise funds for the Campaign Against Living Miserably (Calm), a mental health charity he has supported over the years.

For most artists, playing the Pyramid Stage at Glastonbury is a dream. Now, Capaldi has achieved it once again – this time, fans didn’t need to help him with the sing-along, but of course they joined him anyway. The love from the audience was clear.

“How far will you go to get back to the place you belong?” is one of the lines from Survive.

With this performance, Capaldi showed that this, one of the world’s most famous stages, is still that place for him.

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Politics

Crypto exchange Bitvavo receives MiCA license from the Netherlands

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Crypto exchange Bitvavo receives MiCA license from the Netherlands

Crypto exchange Bitvavo receives MiCA license from the Netherlands

Bitvavo’s chief risk officer Jeetan Patel says the process of securing a MiCA license “progressed efficiently.”

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