Covid variants, vaccines, and all our clean hands

An assistant professor of food science says that all the hand washing, surface cleaning, and food washing we’re doing may or may not keep Covid in check but has kept us from spreading salmonella, e.coli, and listeria.

It’s not what we’re trying to do, but it is good for us.

There’s no evidence that Covid is spread through food, although that’s not the same as saying that it isn’t spread that way. 

But having (with her team) overdosed on US and Canadian internet videos telling us how to clean everything in sight, Yaohua “Betty” Feng reports that a bunch of them have it wrong. Of the videos telling people how to wash their hands, only 41% of the presenters used soap. The remainder, presumably, relied on good wishes and intense looks. Less than 33% mentioned hand sanitizer. And how many of us, since the start of the pandemic, can get through a day without mentioning hand sanitizer?

Like–I’m going to assume–you, I thought I knew how to wash my hands. I’ve been doing it for better than 70 years now, most of the time without supervision, but there’s no predicting what people will feel the need to learn in these difficult times. Maybe I’ve been doing it wrong. Maybe, for instance, I’ve mistaken my hands for some other body parts.

Irrelevant photo: The first spring violets.

Other videos were about washing produce, and 16% of the presenters used soap while 12% used other chemical cleansers. That sounds promising, but they’re both no-nos. If you don’t rinse them off completely, they can cause diarrhea.

Feng didn’t say this, but you might draw the conclusion that random internet videos aren’t the best places to look for reliable information. Or you might not. 

 

British and (eek!) foreign Covid variants

The British Covid variant, which to make things more complicated is now called the Kent variant, after the part of England where it was first found–

Let’s start that over: The Kent Covid variant has mutated since it was first identified. That’s standard operating procedure in the viral world. Every new infection is a chance for the disease to pick up a mutation. Some of those won’t work well for it and will die out and others will make the disease better at hiding from the immune system. Those are the ones that will spread.

So the Kent variant has picked up a new mutation, and it’s similar to one of the mutations on the South African variant. The going theory is that it evolved the change on its own rather than picking it up like an STD after a one-night stand with the South African variant. Which basically means that two strains of the virus have found the same way to partially evade the human immune system. 

There’s been a lot of focus on stopping, or at least getting control of, the imported Covid variants. In parts of the UK, house-to-house testing is looking for the South African variant.

But that may be a sideshow. Virologist Julian Tang wrote, “Unfortunately, the lack of control of these different variants in the UK may lead this population to become a melting pot for different emerging SARS-COV-2/COVID-19 variants–so we really need to reduce our contact rates to reduce the opportunities for viral spread/replication to reduce the speed with which these different virus variants can evolve.

“Closing borders/restricting travel may help a little with this, but there is now probably already a sufficient critical mass of virus-infected people within the endemic UK population to allow this natural selection/evolution to proceed . . . so we really need to stick to the COVID-19 lockdown restrictions as much as possible.”

In other words, the more the people get infected, the more times the virus gets to mutate, and the more times it mutates the more chances it has of presenting us with a more difficult problem.

There’s something tempting about focusing on imported strains of the virus–Eek! South African! Argh, Brazilian!–but all Covid infections are dangerous. That’s what we need to focus on. 

 

Symptoms

In England–possibly in all of Britain, but don’t trust me on that; I’m at least as confused as you are–the only way to book a Covid test is to claim at least one of three symptoms: cough, loss of smell or taste, and a high temperature. But a GP and senior lecturer in primary care, Alex Sohal, writes that the list should include a runny or blocked nose, a sore throat, hoarseness, muscle pain, fatigue, headache, vomiting, and diarrhea. She’s seen patients come in with them and go on to test positive for Covid.

“These patients have frequently not even considered that they may have Covid-19 and have not self-isolated in the crucial early days when they were most infectious.”

She advocates telling “the public, especially those who have to go out to work and their employers, that even those with mild symptoms . . . should not go out, prioritizing the first five days of self-isolation when they are most likely to be infectious.

“This will help to get—and keep—us out of this indefinite lockdown, as Covid-19 becomes increasingly endemic globally. Ignoring this will be at our peril.”

As it stands, if you have good reason to book a Covid test and don’t have the magic three symptoms, the best thing to do is lie. And almost none of us recognize the full list she gives as possible Covid symptoms.

 

The bad news

Some of the recent Covid mutations have outpaced the monoclonal antibodies we’d all been counting on as a treatment in case we did catch it. 

Mono-whats? 

Okay, if you have to ask, that says we haven’t all been counting on them, but let’s pretend we were so I can explain what’s happening.

Basically, monoclonal antibodies are human antibodies that have been cloned. In this case, they’re antibodies to Covid, and they’ve been used to treat serious Covid cases. The problem is that the humans who developed them did so in the presence of one form of Covid, not all of them. As the virus mutates, they can get left behind.  

They also have another problem, which is that they’re expensive and not easy to make. Other than that, though, they’re great.

 

The good news

At the beginning of February, after a 25-day lockdown, the Isle of Man (population 84,000) lifted almost all  its Covid restrictions. The exceptions are its border controls, which–well, I was going to say they take no prisoners, but in fact taking prisoners is exactly what they do. Someone who tried to get onto the island on a jet ski was jailed for four weeks. 

They seem to have eliminated the virus. Before the lockdown, the island had 400 cases and it’s had 25 deaths. 

The Isle of Man is in the water somewhere between Scotland and Northern Ireland. It’s a self-governing British crown dependency, and don’t ask what that means because it’s complicated and we’re running out of space here in the infinite internet.  

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Two bits of news about the AstraZeneca vaccine. 

One, a single dose (which is what the UK is focused on at the moment, with the second one delayed for up to twelve weeks) is still 76% effective after three months. That’s not as good as the 82% protection it offers after the second dose, but it ain’t bad, and there’s finally some data backing up the government’s decision to focus on getting an initial dose to as many people as possible–at least for this vaccine.

Delaying the second dose may strengthen the protection, but that’s not definite.

Two, the vaccine may reduce the number of Covid transmissions by two-thirds. That’s not definite–it’s still preliminary–but it’s promising. 

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A late-stage trial reports that Russia’s Sputnik V vaccine is both safe and 92% effective. It can be stored in a normal refrigerator and comes in two doses, but the second dose is slightly different than the first one. They use different vectors–the neutralized viruses that they ride on. The idea is that this will give the immune system an extra boost and protect people for longer.

 

The little-bit-of-both news

Britain’s vaccinated over 10 million people with at least one dose of one vaccine or another, and the number of hospitalized Covid patients is coming down, but it’s still higher than it was during the first peak of the pandemic. England’s chief medical officer, Chris Whitty, said infection rates are also coming down“but they are still incredibly high.” That may mean, in the American tradition of Groundhog Day, that we get six more weeks of winter. Or lockdown. 

How the pandemic tempts us into insults and sports metaphors

Britain has approved the first Covid vaccine, thereby starting a robust exchange of insults with a random sampling of other countries, and in case that didn’t bring enough joy to the world, setting off another round of the sort of chaos that allows us to recognize Boris Johnson’s government even when we’re blindfolded in the woods on a moonless night. 

I look at each day’s news with a mixture of dread and glee.

The insult exchange

It started with Gavin Williamson, the education secretary, who you might think (being the education secretary and all) would know better but, hey, silly you.

Williamson went on the radio and said Britain was the first country to approve the vaccine because “we’ve got the very best people in this country and we’ve obviously got the best medical regulator, much better than the French have, much better than the Belgians have, much better than the Americans have.

“That doesn’t surprise me at all, because we’re a much better country than every single one of them.”

Several winces later, Conservative peer Michael Forsyth (his friends and family call him Lord Forsyth; you can call him Mikey) tweeted, “Frankly, [that’s]  just unseemly.” 

European Commission spokesperson Eric Mamer pointed vaguely in the direction of the high road and said, “This is not a football competition.”

 

Irrelevant photo: erigeron

Anthony Fauci, on the other hand,  ignored all of that, but he was critical of how quick Britain was to approve the vaccine, saying the UK hadn’t reviewed it “as carefully” as US health regulators.

The next day he backtracked, saying, “I have a great deal of confidence in what the UK does both scientifically and from a regulator standpoint” and on top of that, “I did not mean to imply any sloppiness.”

The difference in speed is because the US regulator often goes back to the raw test data while both UK and European Union regulators work from the reports the companies assemble. 

A few people have commented not that the slower approval process would be any safer but that people might have more confidence that it was safe. It could be a valid point, but where’s the fun in that?

 

The Brexit connection

Unable to see a flap going on and not jump into the middle of it, prominent Brexiteers in the government waded in and claimed that Brexit was the reason Britain had been able to approve the vaccine so quickly. 

“Prominent Brexiteers” describes pretty much the whole government, but this was only a couple of them, Matt Hancock and Jacob Rees-Mogg. Their quotes, sadly, are as boring as they’ve turned out to be inaccurate, so we’ll skip them, but you can follow the link if you want all the Ts dotted and the Is crossed.

The inaccuracy, though? EU law allows individual countries to distribute a vaccine in an emergency. They don’t have to wait for the European Medicines Agency to approve it. In fact, since Britain’s in a transition period until the end of the year, we’re still running on EU law and yes, that’s what we’ve done.

 

The chaos

Having approved the vaccine so quickly, we’re kind of like the kid who snatched the first potato out of the oven. Yes, he made sure he got the big one, and yes he gets to boast to everyone else about that, but he might’ve been smart to grab a potholder first. It would only have taken a few seconds.

In other words, as far as I can tell, from my vantage point on the couch, we’re having trouble figuring out what to do with the vaccine now that we have it. Because it all happened so fast and we haven’t exactly been (I know this’ll surprise you) planning for it. 

I seem to remember some loose talk, oh, maybe last week sometime, about frontline staff being a top priority for the vaccine, although I don’t remember hearing a definition of frontline staff. There was equally loose talk about NHS staff being at the top of the list. Whether those two were the same thing or not is anyone’s guess. 

During the first lockdown, we were all governmentally cranked up to respect the underpaid people who kept the buses and trains running, the stores stocked, the cash registers registering, the packages delivered, the food produced, and the cabs zipping around our towns. They put their lives on the line, we were reminded, and if they didn’t get the pay they deserve and need, they did at least get a bit of recognition.

Now that a vaccine’s imminent, are they still frontline staff? 

Well, um, it doesn’t look like it.

The government’s circulated (and the newspapers have duly published) a priority list with nine categories, starting with care home residents and the people who take care of them and working its way down to people over fifty. The list has some oddities, including putting frontline medical (and only medical) staff in the second category instead of the first and not bringing in the clinically vulnerable until the fourth category, where they keep company with the over-seventies. The Black and minority ethnic people (it’s a category in Britain, however vague it may seem to me as a foreigner) who are statistically at higher risk are mentioned nowhere. It also leaves out teachers and people who work in public transportation and food processing and retail the many other jobs that put people at risk. You know, all those people we appreciated so much the first time around and have now forgotten.

Then, after the list had been circulated, it somehow looked like care home residents and their carers might have to wait, because the vaccine has to be stored at the temperature of dry ice and you can’t just toss it in your back seat and drive it to the nearest care home. But hospital inpatients and outpatients who are over eighty might just skip to the top of the list because they’re easy to find. 

I have a picture of NHS staff running down hospital corridors vaccinating any random person who looks old enough. Whether they’ll find them again when it’s time for their booster shot is a whole different problem. But we have weeks  before we have to solve that one.

What we do know is that the first batch of the vaccine has arrived in the UK and that it will be distributed to hubs–places selected because they have the equipment to keep it cold enough. 

How many doses do we have? 

Um. Dunno. The business secretary, Alok Sharma, said that by next week, when vaccinations are supposed to start, the government’s “absolutely confident” that it will have 800,000 of them. 

I wasn’t worried until I saw that “absolutely confident.” 

Are they going to divide those 800,000 doses so they cover 400,000 people at two doses each? Or is the plan is to give one each to 800,000 people and trust that the second dose will be available when it’s needed? More doses are expected before the end of the year, but Sharma couldn’t say how many and NHS Providers said the UK would have to assume that more doses might not arrive “for some time.”

Sober-sounding voices on the radio advise us not to try to book a vaccination. The NHS will contact people to let them know their vaccination category is open and tell them how to register. But the NHS generally communicates with patients by letter. You know letters? Those paper things that appear in your mailbox or fall through a slot in your door? They take time to write, to print, to seal into envelopes, to move from wherever they started to wherever they’re going.

In theory, the vaccination program begins on Tuesday.

Independent of all this, I’ve read that it may be April before everyone in the nine at-risk categories is vaccinated. 

 

Mass testing

In the meantime, we have lots of twenty-minute Covid tests, which are also called lateral flow tests, in case it makes your life better to know that. They were supposed to be game changing, but the government’s announced so many game changers since the start of the pandemic that I’m not sure if I’m supposed to be running around with a tennis racket or a pool cue. 

The tests were rolled out on a mass scale in Liverpool, which has a high infection rate, and Dr. Angela Raffle, a consultant in public health and an honorary senior lecturer at the University of Bristol, said, “The infection rate in Liverpool has come down no quicker than in many other places that haven’t got mass testing and we haven’t yet seen a proper evaluation report from Liverpool.”

I read elsewhere else that mass testing alone isn’t a solution. You have to do something useful with the results if testing’s going to bring down the infection rate, and we seem to have missed that part of the plan. Possibly because it involves different sports equipment, which is stuck in the government’s Warehouse of Sports Metaphors. We filed forms that will let us get our hands on it long ago, but they’re still waiting for approval.

The NHS test and trace program, which is the key to doing something useful with the test results, usually hits the headlines because it misses some absurd percentage of people (4 out of 10 a month ago, which is–holy shit–almost half), but recently it improved its contact rate. 

How’d it do it? 

It changed the way it reports its data. I’d love to give you a link on that, but I heard that on the radio and I can’t find the right combination of words to coax the information out of Lord Google. But it was the BBC, and whatever complaints everyone from all sides has about, it isn’t known for making up its facts.

The rapid tests are also being used to allow relatives to visit people in care homes and do what I’m old enough to remember once seemed natural: hug them. But because the rapid tests miss some problematic percentage of infections, the BBC writes that “there has . . . been concern in some parts of the care home sector over the use of the tests, with homes in Greater Manchester reportedly urged not to use them to allow visits.” 

Some homes report not having received tests, in spite of a government announcement that everything was in place and reunions were possible. Others say they have the tests but not the training to use them

And there I have to leave you. A masked delivery driver is at the door and I hope he’s brought my sports metaphor delivery. 

He’s not on the list of priorities for a vaccination and he’s working on a zero-hours contract.

Brexit, Covid spikes, and lies: It’s the news from Britain

Britain is gearing up to break international law in “a very limited and specific way,” according to Brandon Lewis, the Northern Ireland secretary. 

Last October, Boris Johnson’s government negotiated a withdrawal agreement with the European Union that would avoid a hard border between Ireland and Northern Ireland, something everyone with half a brain and no political advisors with the initials D.C. considers important because a hard border threatens to reignite the Troubles in Northern Ireland. We’ll skip the background there because it’s long and complicated. If you’re not up on it, just nod sagely and pretend you know what I’m talking about. 

It was a patched-together agreement and even at the time it looked unworkable because if Britain left the EU there had to be a hard border somewhere, and if it wasn’t going to be between Ireland and Northern Ireland, then it was going to be in the middle of the Irish Sea, pushing Northern Ireland away from the rest of the UK. 

Wave bye-bye to the nice island, Boris. 

Look! It’s waving back. 

Or maybe that’s Northern Ireland waving hello to the Irish Republic. Either way, aren’t the Irish friendly?

Irrelevant photo: a red hot poker.Not an actual one, you understand. A flower that goes by that name.

Anyway, it was all going to be okay, we were told, because they–they being some unnamed genius in a governmental office somewhere, whose initials were probably D.C.–would figure out a way to make it work.

So what have they figured out? Well, um, nothing. Which is why we’re gearing up for that limited and specific little law-break, Your Honor. See, we were painting the floor. And then we realized we were in a corner and surrounded by wet paint. And we really needed a beer, and on top of that, we had to pee.

Sorry, did I just say pee? We needed to visit the loo and drive to Barnard Castle to test our eyesight. But you understand the difficulty, right?

Sorry: British political in joke implanted there. I couldn’t help myself. It all has to do with a prime ministerial advisor who doesn’t believe laws apply to him.

The former prime minister Theresa May asked how the government planned to “reassure future international partners that the UK can be trusted to abide by the legal obligations of the agreement.” And you know what, no one answered her. Because she’s the former prime minister, not the current one.

Somewhat more noticeably, the most senior legal civil servant resigned over it, and that seems to be creating a few shock waves. He’d advised ministers–or so Westminster gossip (which I get by way of the newspapers) holds–that the changes would be illegal, and since civil servants are required to stay within the law, he quit.

That raises the question of whether the justice secretary and attorney general, who take oaths to uphold the rule of law, will find themselves in deep shit at some point over this.

The government’s said to have asked for independent legal advice and when they didn’t like what the advice advised are said to have ignored it. 

Senior Tories are urging the government to perform yet another U-turn–a maneuver the government does well. The question is, how many senior Tories are we talking about, and how many junior ones? The Tories have a majority of 80, so it’ll take more than a handful to have an impact.

Please ensure that your seat belts are securely fastened. We’re headed for turbulence.

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Britain’s had a spike in Covid cases and is imposing new restrictions to try to stop it. Or to slow it down. Or to be seen to be doing something while still trying to get people who’ve been working at home back into the office so they can support the economy by buying sandwiches and expensive coffees and those sparkly notebooks that eight-year-olds like. Without those sales, the economy’s sinking.

Whatever. We now have new restrictions. 

In England, starting on Monday, social gatherings of more than six people or from more than two households will be illegal. Unless they’re weddings or funerals or organized team sports. Or schools or work, which aren’t exactly social but the health secretary Matt Hancock mentioned them anyway because he was trying to make the point that the ”the rule is really simple.” 

“What,” a friend asked me as I was explaining how simple this is, “about my brother, who has six kids?”

“Well,” I said, “he should’ve thought of that before he had them.” 

And just so I’d sound all British about this, I added, “Shouldn’t he?”

As it turns out, it really is simple. It’s either six people from any number of households (two households, six households, thousands of households if you can make the numbers work) or any number of people from any two households. Plus either a dessert or an appetizer.

Fizzy drinks and alcohol cost extra. And my friend’s brother can keep all his kids. 

Of course, the rules are different if you’re in one of the cities and towns that have local lockdowns or the restrictions that are an attempt to avoid a full-out lockdown. No two local rules seem to be the same. In some, restrictions involve venues–however the hell they’re defining that–having to close between 10 pm and 5 am, which is when the virus is known to come out and play. In others, you can’t have people over, indoors or in your garden, which in American is called a yard, unless you’ve formed a support bubble, which is created when a household with one adult joins another household and when they add soap to a dishpan of water (glycerine helps) and have a bubble pipe or wand. 

It’s best to do this outdoors, because it’s messy.

With the emphasis on gardens, it sounds like you could get together if you put a fence between one household and the other as long as no more than six people are inside the fence.

Anyway, it’s really very simple. 

I’ve always considered the mess an art form. I should idolize Hancock, but somehow he just doesn’t do it for me. 

All of that, of course, only applies to England. What about in Scotland, Wales, and Northern Ireland (if it hasn’t floated out of sight yet)?

It’s simple, so I’ll quote the BBC to be sure I get it right:

  • In Scotland, up to 15 people from five different households can meet outdoors.
  • In Wales, up to 30 people are allowed to see each other outdoors.
  • In Northern Ireland, the maximum number of people who can meet outdoors has been reduced from 30 to 15.

However, if we’re talking about being indoors, either at your place or in a pub, the rules alllow:

  • In Scotland, up to eight people from three different households
  • In Northern Ireland, up to six people from two households
  • In Wales, up to four households can form an “extended household.”

I don’t know how it can get any clearer than that. But keep in mind that the distance you’re supposed to keep from other people will vary depending on whether you’re in England, Wales, Scotland, or Northern Ireland. Because the virus behaves differently depending on the accent it hears.

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I can’t think why I’m so tired.

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Last week sometime, I told you my tale about trying to get one of Britain’s world-beating Covid tests and being advised to go from Cornwall to Wales. I’m used to being told where to go, and it doesn’t usually involve anyplace as nice as Wales, so I didn’t get my feelings hurt. 

But now it turns out that I’m the reasons Britain is short of Covid testing materials, and that does hurt my feelings. 

Matt Hancock, our secretary of state for health, social care, and public excuses, tells us the shortage of Covid tests is the fault of people getting tested when they don’t need a test. A full 25% of the people asking for tests turn out to be this sort of me-too-ers. They don’t have the symptoms, so what are they up to? 

We’ll get to that, but first let’s talk about symptoms. The government web site gives you a choice of three, but if you bump around the internet, limiting yourself to entirely responsible sites, you’ll find that the virus is more generous than that. You can have five symptoms if you want them. You can probably have more than that, but I’m prone to dizziness when I work with higher numbers so I stopped there.

But even if the government could count to five, it shouldn’t matter whether you have symptoms. One of the things that makes the virus so damn hard to stamp out is that asymptomatic people can and do transmit it. Any chance of controlling it rests on (a) a highly effective vaccine, (b) magic, or (c) testing–lots and lots of testing, including testing people who don’t have any symptoms so they can find out if they’re carrying it and then isolate themselves and not pass it on. 

Let’s pause here for some advice: If you have an off-brand symptom and want to get tested, you should lie. Don’t worry. This is a government that understands lying. 

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Trials for the Oxford/AstraZeneca Covid vaccine hit Pause when a participant was hospitalized with what may be a serious reaction to the vaccine and may be something unrelated. You know, the kind of thing that happens when a satellite flies over your house just as you’re chewing bubble gum and the cat’s litter tray needs cleaning and you’ve got Billie Holiday playing on whatever on earth it is you use to play recorded music these days. And–I almost forgot–you breathe in a virus that isn’t the one we’re concerned about but does still make you very, very sick.

These things do happen and you can’t know in advance what effect they’ll have. Researchers are trying (frantically, I’d think, but we all know I’m not there, so let’s not take me too seriously) to figure out if the participant’s illness is related to the vaccine or not. It may not be, but this is why political pressure to shorten the testing process is really very stupid.