Tag Archives: Covid

Covid news: Should we be losing sleep over the new variants?

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If you’re even vaguely awake (or as our former and once again active home secretary would say, if you’re a Guardian-reading, tofu-eating wokeanista), then you’ll know that Covid has some new variants, and that they have good publicity agents. So how much sleep exactly should you lose?

Not as much as some of the nightmare-on-Covid-Street headlines would have you think.

Let’s sort the variants into separate piles and talk about them.

 

Irrelevant photo: A California poppy. Or since it’s growing in Cornwall and is at least four generations in, maybe by now it’s a Cornish poppy. (That’s a bit of an in joke and I’ll explain it if anyone’s interested.)

The BA variants

BA.2.75 begat BA.2.75.2, because viruses are good at begatting, even if they’re useless at naming their begotten, and since they work under pressure from both our immune systems and the vaccines that are loose in the world, the descendants that survive tend to be the ones that spread most easily or have some sort of hyped up immunity–and .2 does indeed have some of that.

According to Ben Murrell of the Karolinksa Institutet (that’s not a typo; it’s Swedish), “While antibody immunity is not completely gone, BA.2.75.2 exhibited far more dramatic resistance than variants we’ve previously studied. “

In layperson’s terms, that means, “Well, damn.” It also means some of the antiviral treatments given to people who’ve been hit the hardest won’t work against this one, but all is not lost because one still does. 

That was what passes for good news. (Don’t go away–there’s more good news later on.) On the other side of the balance, the antibodies running around in the blood of anyone with antibodies (that’d be people who’ve been vaccinated or who’ve had Covid) are only about a sixth as effective.

Still, a sixth means they’re not completely ineffective. This is good, but it’s not the good news I was waving signs about. For that, you have to wait. Or skip ahead.

What’s not known yet is how quickly the variant will spread. It’s in several countries but can claim only a minority of cases, so it may not become dominant. It’s also not known whether it’ll drive up hospitalization rates or how protective the vaccines will be against it

Balancing all that out, I’d say it’s not time to panic yet. If you’ll wait a bit, you can always panic later. 

 

The BQ variants

BQ.1 and BQ.1.1 are not to be mistaken for either meat cooked with a sticky sauce–that’s BBQ–or B&Q, which is a chain of British stores that claims to have everything you need for your home and garden. What my home needs is a good coat of paint, and they do have paint supplies, but the problem is getting the paint and the walls in the right relationship to each other. The last time I tried, the dog and the rug somehow got into the relationship and–

Anyway, no, they don’t really have everything I need.

The BQ variants are making headlines and US influencers are running around saying they’re worse than the CDC is admitting. 

The CDC is the Centers for Disease Control, which technically speaking should get a plural, but never mind. What matters is that if the CDC had said they were world-ending, somebody would jump up and say the CDC was trying to panic us all for dastardly reasons of their own. You can’t win this game.

The BQs were begat by BA.5 and last I looked (that was Octover 23) made up 11% of Covid cases in the US. Like BA.2.75.2, they’re pretty good at dodging the neutralizing antibodies we’ve spent so much time and effort developing.

By the beginning of 2023, the BQs are expected to make of 80% of Covid cases. I think that means the world’s Covid cases, but they could be talking about Europe’s. Let’s not split hairs. They spread, probably because of the way they dodge our antibodies. There’s no evidence so far that they’re more severe than the earlier versions or that they’ve completely sidelined the vaccines.

 

The XBB variants

Finally, we have the XBB variant, which instead of being begotten combines two earlier variants. I’m not going to try to explain that–let’s just say viruses have many ways to mutate–and you don’t really care which variants they were, do you?

XBB is already creating subvariants. You know, XBB.1 and all that mess. By October 20, it had popped up in 26 countries and was collecting headlines calling it a nightmare variant. It seems to spread rapidly and it too knows how to slip past our neutralizing antibodies–even more so than the new BQ and BA variants. The last of the monoclonal antibodies–the one that works on the B and BQ variants–doesn’t work here. 

It’s not clear yet whether it causes a more severe form of Covid, but in Singapore, where it’s spread widely and which has a 79% vaccination-and-booster rate and  strict control measures in place, it’s been milder. “The number of people dying or in the ICU is really low,” according to Eric Topol of Scripps Research. “Their protection level is really solid.”

What kind of strict measures? 

“Facemasks remain compulsory on public transport and in most healthcare facilities. Contact tracing requirements remain in effect for events with more than 500 people. Authorities continue to bar unvaccinated people from dine-in services.” People who test positive are quarantined at home.

There’s no evidence XBB and its kiddies make anybody sicker than the earlier variants, and it’s too early to tell how well the new booster shots will work against it, but educated guesses say they’re still be well worth having.

“We’re going to have another wave,” Topol said. “The question is, how bad is it going to be?”

Can’t remember who Topol is? He’s up a few paragraphs.

 

On the other hand

Should we all just go out and slit our wrists?

No. It’s messy, it causes pain, and it’s not necessary. The new variants are a problem, but–and it’s a big but (with one T, thank you very much)–neutralizing antibodies aren’t the only insult in our immune systems’ vocabulary. We focus on them because they’re easy to measure, but our immune systems know other ways to get under Covid’s skin–or maybe that’s its spike protein. Or–

You know what? Never mind. Failed metaphor. Move on. Nothing to see here.

Our immune systems have T cells. And B cells. And if they’re English speakers, they’ve still got 24 letters in the alphabet once they use those up. What’s more, people who’ve had Covid have some letterless (as far as I know) immune cells throwing parties in their lungs.

We’re not completely unprotected.

The phrase Immune escape (which I’ve avoided using but which serious people will) has been misinterpreted. It sounds like it means time to panic. It doesn’t. 

Especially since multiple articles are telling us about research groups edging closer to a universal (or near-universal–I’ll settle for that) coronavirus vaccine which would, at long last, put an end to this damn pandemic. So put the knife back in the drawer. We can do without the drama, thanks.

It’s variant day at the Covid Cafe

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Welcome to the Covid Cafe, my friends. We have two variants on the menu today.

 

BA.5

Our first variant, BA.5, has gotten better than previous versions at evading both the vaccines and the immunity people acquired from earlier infections. But where previous omicron variants tended to stay in the upper respiratory tract, making it somewhat milder, BA.5 has picked up some mutations from the delta variant–that’s the most damaging variant to date–and it’s very pleased with them, thanks, and with itself for being so clever. 

They may be the reason it’s better at infecting cells than those respiratory-type omicron variants, and why it may be more serious. 

Seeing it circle back in this way doesn’t make me want to go out and celebrate. On the positive side, though, the current vaccines do still protect against its worst effects. But sensible people are recommending masks, ventilation, and distance–all those things governments and a lot of our fellow citizens have gotten bored with. 

 

Irrelevant photo: thistle with bee

BA.2.75

Are we having fun yet? 

Our second variant is BA.2.75. It seems to spread quickly and to evade immunity. How hard it hits people is yet to be determined. It’s also called Centaurus. I have no idea why and my brain isn’t willing to expend any bandwidth on it, but since it’s also possible that the thing has peaked, it has a second name: scariant. 

Come fall, updated vaccines are expected to target the omicron mutations. I’m in line already, and rolling my sleeve up.

 

However

Efforts to create a pan-coronavirus vaccine have slowed down for lack of funding, lack of any sense of pressure, and lack of even marginal good sense. The current vaccines are still keeping death and destruction to a minimum, and hey, that’s good enough. Let’s just stagger on.  I could toss in a quote or two here, but hell, you get the point. Follow the link if you like. It’s find-your-own-quote day here at the cafe.

In addition, testing candidate vaccines won’t be as easy it was at the beginning of the pandemic because Covid isn’t raging through populations the way it was. Pre-existing immunities make their effectiveness harder to measure.

 

Other mutations

A team that’s been analyzing millions of omicron samples in order to study its mutations reports that omicron alone has 130 sublineages. A member of the team, Kamlendra Singh, thinks vaccines might become less effective over time.  

“The ultimate solution,” he said, “will likely be the development of small molecule, antiviral drugs that target parts of the virus that do not mutate. While there is no vaccine for HIV, there are very effective antiviral drugs that help those infected live a healthy life, so hopefully the same can be true with COVID-19.” 

Singh helped develop CoroQuil-Zn, a supplement that infected people can take to help reduce their viral load. It’s currently being used in India, southeast Asia, and Great Britain and is waiting for FDA approval in the United States.

A virologist writing in the Conversation agrees, at least in part, saying that vaccines targeting recent variants will inevitably fall behind as the virus mutates. “Vaccines that generate antibodies against a broad range of SARS-CoV-2 variants and a cocktail of broad-ranging treatments, including monoclonal antibodies and antiviral drugs, will be critical in the fight against COVID-19.”

 

Long Covid news

Long Covid’s too stale for the cafe, but it’s not growing mold yet, so let’s have a nibble out here in the alley. 

The BMJ (formerly known as the British Medical Journal) has summarized 15 studies showing that the vaccinated are less likely than the unvaxxed to end up with long Covid. That’s most true of people over 60 and least true of people between 19 and 35. 

Long covid can range from annoying to life changing (in a bad way, in case that’s not already clear; it won’t make you grow wings or develop superpowers). It also ranges from transient to no-end-in-sight. In the UK, 2% of the population has reported having it and in the US, that’s 7.5%. 

Or by another count, 2 million people in the UK have it. That may or may not work out 2%. Don’t worry about it.  

Why is the percentage in the UK so different from the one in the US and why don’t I care if the UK numbers match? Because no one’s tracking long Covid systematically. It can get pretty weird out there.  

With that out of the way, let’s talk about the important stuff: “hy did the British Medical Journal change its name? I don’t know, but since my father did the same thing, I shouldn’t roll my eyes about it.

Which is unlikely to stop me. Especially since my father didn’t change his name to an abbreviation,but to the last name I use although I have no deep-rooted claim to it.

On the positive side, that bit of history means I know for a fact the Josh Hawley isn’t a relative–even a distant one.

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In the absence of systematic tracking, a UK study compared a big whackin’ number of people’s medical records to see what they could learn about long Covid. 

Among other things, they were able to add 42 symptoms to the existing list. (Yeah, progress comes in some annoying colors.) The new ones include hair loss, reduced sex drive, erectile problems, swelling limbs, and bowel incontinence.

I did tell you it could be serious, didn’t I? You should listen to me. 

They also organized the symptoms into three categories: 80% of the people with long Covid symptoms had a broad spectrum of problems, from fatigue to pain; 15% had mental health and cognitive problems, from depression to brain fog; and 5% had respiratory problems.

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A small study treated long Covid patients with cognitive symptoms by using hyperbaric oxygen therapy, and the results were enough to give a person hope. The group that got the real treatment had “significant improvement in their global cognitive function and more cognitive improvement related to their specific damaged brain regions responsible for attention and executive function,” along with improvement in their energy, sleep, and psychiatric symptoms.

The patients who got the placebo treatment didn’t, although they did get a simpler sentence with no fancy language or quotation marks.

The treatment, unfortunately, isn’t something you can set up in your garage. It involves five treatments a week for two months in a machine that looks like a mid-size submarine. 

 

Protective actions you never thought of

Covid is less likely to kill or hospitalize people who fast at least one day a month than it is to do either of those things to those of us who think eating should be a daily practice. This may be because fasting reduces inflammation or it may be attributable to a couple of other reasons that you can look up yourself by following the link.

The bad news? The study involved people who’d been fasting intermittently for decades. It offers no information on people who took it up twenty minutes before becoming infected.

 

A bit more about vaccines

I’ve found enough shreds of good news that I can spare you one more piece: Vaccination, although it doesn’t prevent Covid, does seem to reduce the odds of infection. Not by as much as we’d all like, but I don’t know about you, I’ll take any percentage I can get.

You want details, though, right? Fine: In the second wave of the pandemic, vaccinated National Health Service employees who worked face to face with patients were 10% less likely to get infected than unvaccinated ones. And I’ll remind the assorted anti-vaxxers who pop up here periodically that the primary value of the vaccines lies in preventing death and serious illness, which (do you really need to be reminded?) is not a bad thing. They haven’t turned out to create sterilizing immunity, and that’s a damn shame but doesn’t mean the people who recommend them should be burned at the stake. 

No one’s offered to do exactly that to me yet, but the conversations do have a way of turning hostile. Or starting out that way. A recent comment opened with, “Stop lying, Ellen.”

And I appreciated the suggestion, since hadn’t thought of that myself. I also appreciated the generous and high-minded approach to discussion. Let it be a model for us all.

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But forget about me. Ben Neuman, a professor in the Department of Biology and chief virologist at the Texas A&M Global Health Research Complex, has another reason to get vaccinated: “to avoid the brain damage that often comes with COVID. During a natural infection, the immune response around your brain will starve cells of oxygen, and the effect is that you will lose a lot of gray matter—something like a stroke. Unlike a stroke, where usually only one part of the brain is affected, COVID seems to affect the entire brain, so you don’t necessarily lose one thing, like the ability to control nerves on one side of the face, you lose a bit from everywhere. COVID-associated brain damage only happens with infection, not with the vaccine, and having a strong set of white blood cells trained by the vaccine is likely to be helpful in preventing brain damage.” 

 

Okay, but what about monkeypox?

Let’s forget about whether monkeypox is a pandemic or an epidemic or just a damned nuisance. Those–especially damned nuisance–have technical definitions that, for a bunch of free-range blog readers, aren’t the most useful standards. The more pressing question is, How much of a problem is this likely to be?

After what sounds like a lot of internal argument, the World Health Organization declared it a global health emergency. The disagreement, as far as I understand it, comes from this: Diseases that spread on the air (think Covid or flu) are bigger worries. They’re easy to catch. Monkeypox is spreading through touch. That doesn’t make it fun and I don’t recommend rubbing up against anyone with a rash right now, but it does mean transmission’s slower and more difficult.

It’s also less deadly than Covid. 

If that’s not reassuring enough, existing vaccines can slow the spread–or they can once production catches up with the need.

On the other hand, it’s popping up in a wide range of countries and seems to have surprised the experts.

Monkeypox could (I’ve read) go in two directions: It could establish itself in many countries as a sexually (an also not-sexually) transmitted disease that people will have to deal with or it could be gotten under control. The first prospect isn’t fun, but it’s still not Covid all over again.

Can a vaccine protect against all Covid variants?

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A vaccine designed to fight off all the current and future Covid variants has gotten through a small early trial and is ready to test on a larger group. 

Instead of targeting only Covid’s spike protein, which has been mutating madly, it backs that attack up with–um, yeah, something else. 

You want details? Fine: It drives “broad CD8+ T cell immunity.” I drive a little Toyota Aygo and the mileage isn’t bad but I bet the vaccine’s is better, because it also “enables inclusion of a wide array of highly conserved viral epitopes.”

Never mind. I didn’t understand it either. That’s why it’s in quotation marks: to keep it safe from sticky little editorial hands.

The vaccine’s designed as a booster shot, and it works at a much lower dose than the current ones. 

Irrelevant photo: A neighbor’s camellias just came into bloom. In January.

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The U.S. Army is also working on a vaccine that could be effective against all Covid variants, although I don’t think it’s progressed as far. A press release quotes Dr. Kayvon Modjarrad as saying, “Our strategy has been to develop a ‘pan-coronavirus’ vaccine technology that could potentially offer safe, effective and durable protection against multiple coronavirus strains and species.”

Notice that they’re talking about not just Covid but coronaviruses in general. And also that they’re talking about long-lasting protection, so we wouldn’t need repeated boosters. But the key word in the quote is potentially. Don’t bet a large sum of money on this one yet, or even on the first one I mentioned, but do allow yourself a nice jolt of hope. And maybe a little ice cream to wash it down. 

This may or may not be the universal vaccine that gets to the finish line, either first or at all, but like the one above, it’s a reminder: These aren’t the only efforts to find a vaccine that puts us ahead of a mutating virus instead of always running to keep up. The article I stole this from is oriented to the U.S. and mentions that major figures in the National Institutes of Health are behind the effort, indicating the government’s willingness to fork out some cash.

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Meanwhile, researchers from the University of Hong Kong are working on a vaccine that will–assuming everything works out as planned (and as the saying goes, the crick don’t rise)–keep Covid from setting up a home in people’s noses. 

That would close a gap left by the current vaccines: They’re good at reducing serious disease, hospitalization, and death, but they’re not as good at keeping Covid from spreading. This one, if it works out, could stop the spread, because in spite of what people who wear masks under their noses think, the nose has an active role in both catching and spreading Covid.

The vaccine’s at the human-trials stage of development.

You remember humans. A two-legged, furless species, and a problematic one.  

Professor Chen Zhiwei, who co-leads the research, said, “The biggest challenge for our COVID-19 vaccine development is that we do not have a vaccine manufacturing plant in Hong Kong, which has delayed the translation of scientific discovery into clinical use.”

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This next item isn’t about a vaccine, but since we’re talking about Covid and noses, let’s slip it in here: Researchers in Australia are playing with a nasal spray that they hope will stop the progression and spread of Covid. It involves heparin, which is used widely to treat and prevent blood clots and which can be kept at room temperature.

I never knew how friendly the phrase room temperature would come to sound.

Professor Gary Anderson explained how it works: “Covid-19 first infects cells in the nose, and to do that the virus must bind to Heparan Sulfate on the surface of nasal cells lining the nose.

“Heparin—the active ingredient in our spray—has a structure that is very similar to Heparan Sulfate, so it behaves as a ‘decoy’ and can rapidly wrap around the virus’s spike protein like a python, preventing it from infecting you or spreading the virus to others.

“Importantly, this nasal spray should prove effective for all Coivd-19 variants because the Heparan Sulfate binding site is essential for infection, and is likely to be preserved in new variants. Heparin binds avidly to the Omicron variant currently sweeping through the country.”

They expect to start clinical trials in the first quarter of this year. If it works out and promises to bring back what we so nostalgically call normality, some troll farm will unearth that python image and convince 24% of the population that they’d be spraying python eggs up their noses.

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In 2020, Amazon’s charitable arm, Amazon Smile, donated more than $40,000 to anti-vax groups. That’s a small proportion of Amazon Smile’s donations, but it can be a hefty amount for a small organization. 

Smile, everyone. The python eggs you ordered will be at your door tomorrow.

 

Antiviral pills

Meanwhile, Covid cases are still climbing, and even though the Omicron variant seems to be less fierce than the earlier ones, a hell of a lot of people are hospitalized with it. 

But “hospitalized with it” doesn’t mean that Omicron, or any other Covid variant, drove all of them to the hospital. Some of them were hospitalized for other reasons but also turned out to have Covid. So the good news is that not everyone included in that statistic is so sick from Covid that it’s driving them to the hospital, but the bad news is that since they have it coincidentally, the hospital has to turn itself inside out to keep them from spreading the damn thing. 

Okay, I admit, “a hell of a lot of people” isn’t, strictly speaking, a statistic.

But never mind that. How helpful are the new antiviral pills?

It turns out that they’re not a magic wand. And they won’t be given to everyone. They’re for people with mild to moderate Covid who have risk factors of one sort or another–people with chronic illnesses, compromised immune systems, a history of having celebrated too many birthdays. That sort of person. The sort of people Covid’s most likely to hospitalize. 

And the pills come with a list of thou-shalt-nots. One of them isn’t okay for kids under twelve or pregnant women. (It hasn’t been tested on pregnant men yet.) The other isn’t safe for people with kidney or liver problems. Both interact with other medications, which will rule them out for some people. 

According to William Schaffner of the National Foundation for Infectious Diseases, “It’s not like going to a machine, putting in a quarter and getting out a candy bar. It’s a serious prescription of a medication, and the health care professionals need to do some screening and education.” 

That’s me you hear out in the hallway, pounding on the vending machine and yelling that I want my candy bar. You know how much good it does.

The pills have other limitations: If they’re going to work, they have to be taken within five days of the first symptoms, so people in high-risk categories will need to get tested quickly. The Covid symptoms that the article lists (again, this is a U.S.-oriented article) are: fever or chills, cough, headache, difficulty breathing, loss of taste or smell, sore throat, fatigue, runny nose, and muscle or body aches.

But Britain, in its wisdom, is still listing only the original Covid symptoms: a high temperature, a new continuous cough, or changes in your sense of smell or taste. In other words, they’re not listing the new variant’s symptoms, and last time I looked if you’re  in Britain and want to book a PCR test–the slower, more accurate Covid test–you have to swear that you have one of the three symptoms or have been exposed to someone who et cetera. So if you have the newer symptoms and want to do the responsible thing and get tested, your best course of action is to lie through your teeth and claim the old ones.

You’re dealing with an algorithm. There’s no point in arguing. 

 

Shortages

So we’ve established that you need to get tested as soon as possible, right? Well, guess what both Britain and the U.S. are short of: No, it’s not irony, it’s Covid tests. 

They’re not the only countries where they’re running short, but I can barely keep up with two. Let’s focus on Britain, since that’s where I live.

In Britain, pharmacies–those things that Americans call drug stores–sent out a warning in December that they were going to run short of home test kits. Guess what the government did: zilch. It didn’t even answer the letter. So pharmacies are running out, and you can’t necessarily get home tests from the government website either. 

But the Department of Good Planning did offer to shorten the quarantine period for anyone with two negative tests on day whatever and whatever plus something, and it also urged people to test themselves before going to a New Year’s Eve Germ Exchange, thus increasing the demand for tests. And now that the schools have reopened, students are urged to test themselves more often. Somehow.

And to complete the picture, the country’s lone distributor of the home test kits received 2.5 million of the things, then shut for Christmas. It reopened on the 29th. 

Pharmacies can order 55 packs per day. Each pack has seven tests. 

It reminds me of an old rhyme: As I was going to St. Ives, I met a man with seven wives. Each wife had seven bags, each bag had seven cats, each cat had seven kits. How many were going to St. Ives?

One. No doubt someone high up in the government who thought it was a good time for a vacation.

In the meantime, health care workers haven’t been able to get tests, many hospitals are short-staffed, and the government’s talking about building temporary hospitals in parking lots to deal with any overflow.

If they’re talking about how to staff them, the word hasn’t filtered down to me.

It may be a coincidence that international travelers no longer have to isolate or take a PCR test after–or before–they arrive in Britain. (Those are the slower, more expensive tests. They’re in short supply too.) Instead, they can take the cheaper, faster test no later than two days after they arrive.

If they can find one. 

To quote PoliticsHome, on January 4, “the UK recorded 218,724 new Covid cases, the first time a daily rate has exceeded 200,000. The Omicron variant now accounts for the majority of infections and it is no longer believed that the travel restrictions will curb the spread of infection.” 

I believe that translates to, “This thing’s so far out of control that, what the fuck, we give up.”

The Foreign Office said it would get back to me about joining the diplomatic corps.

 

So how serious is Covid?

In 2020, Covid decreased in life expectancy in 29 countries. For a number of Western European countries, it was the biggest decrease since World War II. 

Why 29 countries? They had statistics available in a form the study could use, so the study covers the U.S., Chile, and most of Europe. That leaves out a fair number of countries that had severe outbreaks, so can we agree that the study underestimates the decrease?

Thanks. I thought we could.

The largest loss was among males in the U.S., whose life expectancy at birth decreased 2.2 years compared to 2019 levels.

One of the study’s lead authors, Dr. José Manuel Aburto,, said, “To contextualize, it took on average 5.6 years for these countries to achieve a one-year increase in life expectancy recently: progress wiped out over the course of 2020 by Covid-19.”

It might be tempting to think, hell, if we’re talking about one year at the end of a long life, how much difference does it make? But it takes a lot of deaths to lower the average–deaths of real people, with real lives. With real friends and real families, who feel real grief at their loss and whose lives may well have been torn apart by it, emotionally, economically, or both. 

And those deaths don’t necessarily come only to the elderly. 

That’s worth thinking about the next time someone implies that learning to live with Covid means we should all tear off our masks, unvaccinate ourselves, enter into germ exchanges, and go out and play in traffic.

What will it mean if Covid stops being a pandemic?

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The talk these days is that Covid will eventually lose its pandemic status and turn into an ordinary, house-trained endemic disease–the kind of disease that circulates in a population and gets us sick but doesn’t give us nightmares, overwhelm hospitals, or kill huge numbers of people. And (they say) this will happen because of two factors: vaccination and the natural immunity that people who’ve been exposed and survived gain. 

What are the odds, though, that Covid will pull a fast one and evade our immunities? 

Not that high, according to a study that tried to replicate Covid’s mutation pattern using a harmless virus. To completely outrun the immunity we gain from either exposure or vaccination, the virus would have to draw twenty of the right cards out of the mutation deck. 

How many cards are we playing with? I’m not sure. As far as I can figure out, the rules of the game keep shifting. But the scientists–the people who study this stuff, as opposed to the people who read one lone article and call themselves experts–say it would be one hell of a trick for it to pick all twenty.

Irrelevant photo: The north Cornish coast.

On top of that, the virus isn’t the only thing that evolves. So does the human immune system. After it’s met the virus, either in the form of an infection or a vaccine, it sits down and plays with its antibodies. Think of it as a kid with a Lego set. It spends months working out shapes that bind ever more tightly to Covid’s spike proteins. 

People who’ve gotten an mRNA vaccine and also have naturally occurring immunity to Covid have the strongest defense. It’s possible that booster shots will create the same flexible immunity, although that hasn’t been demonstrated yet.

So as surely as the virus doesn’t keep one single form, neither does the human immune system. We will, eventually, get through this mess, although the question is at what cost. 

 

How can we measure Covid’s impact?

In the US, Covid has now killed as many people as the 1918-19 flu epidemic. I’d love to give you comparisons for other countries, but that’s all I’ve found.

To put that into perspective, in 1918 the population of the US was a third of what it is now, so it killed a larger percentage of people. On the other hand, if we’re comparing the inherent danger of the two diseases, massive advances in medicine have kept the death toll lower than it would otherwise have been. 

There must be a dozen ways to measure Covid’s impact, but one of them is cold, hard cash. Again in the US, it’s cost almost $6 billion to hospitalize the unvaccianted in just three months, from June through August 2021

The study’s authors say that’s probably an underestimate.

Yet another study says that by March of 2021, Covid had taken 9 million years of life from the U.S. population. Instead of measuring excess deaths, it looked at the mortality burden of the pandemic. 

What the hell does that mean? You would have to ask, wouldn’t you? The study looked at QALYs, or quality adjusted life years, using them to measure the length of time people would have lived if they hadn’t, um, died. It says that people between 25 and 64 lost 4.67 million years of life, and Black and Hispanic communities were hit hardest, especially men in those groups who were 65 and older.

I know, I know, I’m supposed to be writing about Britain. What can I tell you? Bloggers are irresponsible cheats.

 

Question: If you’re not vaccinated against Covid, will gargling with iodine help? 

Answer: In a test tube, povidone-iodine kills the Covid virus. 

Further information about that answer: Humans aren’t test tubes. 

What happens in a human, then? There haven’t been many studies, but what few there are hint that iodine can inactivate Covid in the mouth for a time, but not for a long one. What happens after that? The same thing that was happening before. If you breathe in the virus, there’ll be nothing there to stop it. If you’re incubating the virus, it’ll move back into your throat and ditto–there’ll be nothing there to stop it. It’s like wiping your kitchen counters with antiseptic wipes. You kill 99 point something percent of the germs that are present in that moment. Then you and your antiseptic wipes go away and wherever the germs came from, they come back. 

In other words, unless you’re going to spend your days and nights gargling with whatsidone-iodine, this isn’t going to work. 

And have I mentioned that the stuff tastes disgusting and smells just as bad?

Other than that, is there any reason not to use it? Well, it can cause skin irritation–sometimes severe, although not necessarily. It can (rarely) cause your thyroid gland to become inactive, especially if you’re pregnant. And especially if you’re both pregnant and a woman.

The most likely side effect, though, is that it will make you think you’re done something to protect either yourself or the people around you when you haven’t. 

*

On Fridays I usually post something about English or British history or culture. This week I’m doing well to do post anything at all. I hope to be back to full speed eventually. In the meantime, bear with me.

By the numbers: how to help Covid outrun the vaccines

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In Europe, a group of experts who model disease spread plugged as assortment of variables into their computers–things like vaccination, transmission, and mutation rates–and asked about the odds, under various conditions, of the virus mutating into something that would escape the vaccines.

It turns out that that highest risk comes when a large proportion of the population has been vaccinated but when it’s still not a high enough proportion to create herd immunity. In other words, exactly the situation in Europe right now. And in the US. 

Britain has a higher percentage of vaccinated adults, but I think I could safely add “and Britain” to that paragraph.

This sounds counter-intuitive, but when a large proportion of the population’s been vaccinated, a vaccine-resistant strain of the virus will have an advantage. So what countries need to do at that stage is control the spread.

Irrelevant photo: The north Cornish coast

“Of course we hope that vaccine-resistance does not evolve over the course of this pandemic, but we urge caution,” one of the study’s co-authors said. “Evolution is a very powerful force and maintaining some reasonable precautions throughout the whole vaccination period may actually be a good tool to control this evolution.”

I mention that just in case anybody’s listening. In Britain, they’re  not. Masks are now optional in most situations, although many people are still wearing them. (Thanks, folks. You’re wonderful.) Nightclubs are reopening. (Thanks, Boris. You’re a fool.) Vaccinated people wearing blue, who say please and thank you, and who come into the country from Covid-safe countries or from countries that might or might not be Covid-safe no longer have to go into isolation, never mind quarantine. 

Why? Because the government’s thrown up its hands and said, “This is making us confused and we’re not going to bother anymore.”

So yes, we’re being perfectly sensible here. Wish us luck.

Thank you.

 

Breakthrough infections and the Delta variant

When vaccinated people get infected with the Delta variant, as some small percentage of them will inevitably, they’re very likely to get mild or asymptomatic cases of Covid, but that doesn’t tell us whether they’ll be as infectious as an unvaccinated person who gets infected. 

Stop the presses, though. For the first time, we have a gesture toward a move in the direction of an answer: They will have as high a viral load as an unvaccinated person. That seems to mean that they’re every bit as likely to transmit the virus, although no one seems willing to say that without a plugging in some sort of word that creates wiggle room in the sentence.. 

As the US Centers for Disease Control director put it, they “have the potential to spread the virus to others.”

That’s a large part of the reason that the CDC reversed its throw-away-your-mask-if-you’re-vaccinated policy and now recommends masks for all students, teachers, visitors, and school staff when they’re indoors. And all includes people who’ve been vaccinated. 

The CDC also recommends masks in indoor public places in parts of the country that have had at least 50 new cases per 100,000 people in the last week. That’s something like 60% of the counties in the US. 

And it says that vaccinated people should be tested for Covid after they come into contact with an infected person. Even if they don’t develop symptoms. 

In a couple of months, we may get definitive news on just how infectious fully vaccinated people who have mild or symptomless Covid are. In the meantime, we’ll have to go with seems and as high a viral load. Common sense might indicate caution.

 

Covid and public policy

A paper from the Commission for Pandemic Research of the Deutsche Forschungsgemeinschaft–a group whose name is almost as long as the paper itself–makes a heroic effort to talk sense to people (and more to the point, governments) who are still recommending hand washing to combat the spread of Covid. 

Okay, that interpretation is strictly my own. What the article I stole this information from says is that they “aim to contribute to establishing a reliable information base that is broadly coordinated among specialists as well as offering concrete advice on how to guard against infection.” 

So to be objective and reliable and not at all snarky about this, they’re aiming to contribute to establishing a coordinated effort to offer the world an extended string of verbs with the intervention of a few nouns. And they’re damn good at it. 

The article’s headline is an even better source of fun: “Prevention of coronavirus infection spread through aerosols.” I spent an unconscionable amount of time wondering how to spread the prevention of infection before I worked out that prevention isn’t being spread; spread has taken a part-time job as a noun.

To be fair, the committee with the long name probably didn’t write the headline.

Are you following any of this? I’ll get to the information any minute now.

For all its oddity, the headline doesn’t approach the genius of a newspaper headline published during the Falklands War that said, “British left waffles on Falkland Islands.” I had a carton of maple syrup all packed up and ready to send to the Falklands before I realized that left was the noun (political leftists, presumably in Parliament) and waffles the verb. 

Maybe this is only funny if you’ve worked as an editor.

But to go back to our article: It breaks infections into two categories, direct and indirect. 

Direct infection happens when one generous soul is close to someone else and passes the virus on to them. That usually happens indoors. 

Indirect infection happens when infectious aerosols accumulate indoors. The first person–the one with the virus–doesn’t have to stay in the room to make sure the second person breathes the germs in. If they’ve spent time in the room, exhaling, when they leave, unless the room’s well ventilated, their germs will not follow them out.They’ll stay there, available for the second person to inhale and take home.

And all of this is free. Just imagine! No one has to pay a red cent for it.

Indirect infections are what make it pretty much pointless when people put on their masks only when another person comes into the room, the shop, the wherever. They’ve been in there breathing. They can’t unbreathe those aerosols. 

Indirect infection is somewhere between hard and impossible to accomplish outdoors, although direct infection is possible if the people are in close enough contact for a longish time. So if you’re spending time in a bus shelter, at a demonstration, at a football game, or in a brawl, you might want to wear a mask, even though you’re outdoors. And you might want to ask the people you’re brawling with to also wear masks. 

In closed rooms, though, they (that’s the experts, not the people in the brawl) suggest using–well, pretty much every breath-related protective measure you can think of: avoiding contact, keeping a distance, wearing masks, using protective panels, and ventilating the hell out of the room.

Yes, “ventilating the hell out of” is a thoroughly scientific term. It means opening windows and using permanent ventilation systems as well as mobile air purifiers.  

“Only regulations that are as consistent and uniform as possible guarantee a high level of safety with as few restrictions as possible,” the article says, paraphrasing the experts, something that becomes necessary when the nouns and verbs grow exhausted from holding down two jobs. 

I’d love to think that the world’s governments will get their heads around the idea that consistent regulation is the way to live (relatively) safely with Covid, and that ventilation and masks are essential parts of that. But then I’d love to think all kinds of things, including that our problematic species will still be around in, oh, say seven generations, and that it will have gained some wisdom. Those aren’t impossible, but I’m unable at this time to issue the money-back guarantee that we inadvertently advertised. 

How well are China’s vaccines working?

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China is exporting two vaccines, and although they’re less effective than the gold standard vaccines like Pfizer and AstraZeneca, they do work. Sinopharm is 78% effective and Sinovac is somewhere between 50% and 78%. I’m not sure why the range is so large there. Sorry. And while I’m apologizing, apologies for not having a link on this. It’s from an email newsletter the New York Times sends out. It usually has links. Maybe I’m being particularly dense today.

There’ve been questions about the vaccines, especially after vaccinated people in the Seychelles became infected, but they do seem to be useful. In the Seychelles, when vaccinated people got Covid they had mild cases and recovered at home. It’s not what we’d all hope for, but it’s a lot better than being hospitalized. Or dying. China says it can make 5 billion doses a year. The U.S. has promised to donate 500 million doses of other vaccines (I don’t think they’ve specified which) to poorer countries. Britain has promised 100 million. 

The world’s population–since this is relevant to the discussion–is 7.6 billion. Or it was in 2019. I haven’t counted it since. I did try last month but I lost track somewhere around 5 billion and didn’t have the heart to start over. The vaccine rollout in poorer countries is beyond dismal. The vaccines are going to rich countries and poor ones just can’t get them.

So weigh 600 million against 5 billion, then weigh both of those against the number of countries that can’t get hold of any useful amount of vaccine and it makes the two Sino- vaccines appealing. 

Irrelevant photo: a rose

Not much is known yet about how well they protect against the variants. There seems to be some reduction against the Beta and Gamma variants, but that’s still not solidly established. 

China, having gotten off to a slow start in vaccinating its population, is now working at high speed. 

I had links for all that and have succeeded in losing them. Apologies.

*

Early reports are that mixing vaccines–I think they were playing mix-and-match with the Pfizer and AstraZeneca, although the Moderna might have slipped in as well–may make them more effective, and Canada and a few European countries have started doing that. 

 

How times have changed

To boost the number of people getting vaccinated, Washington State is allowing marijuana retailers to offer a free joint to anyone who can show proof that they’ve had either their first shot or second shot. Or both at once. What the hell. If the stuff they’re offering is strong enough, who can count that high?

It also allows other businesses to offer a beer, a cocktail, or a glass of wine. Arizona and New Jersey have done similar things. Other states are running lotteries.

What are they up against in their effort to promote the vaccine? People who think getting vaccinated will cause keys to stick to their faces and forks to–

I stopped listening right about there, so I’m not sure where the forks stick. I’ve heard of food that sticks to your ribs, but we seem to have entered new territory here.  

Whether or not you’ve been vaccinated, plastic forks will not attack you. Covid restrictions allowing, you can go back to the food courts.

Antiviral drug update

If an antiviral drug that’s in late-stage testing works–and that’s not guaranteed–it could stop a Covid infection in its early stages. It could be available by the end of 2021–again, if it works.

With all those coulds in there, that sentence has a lot of wiggle room. Still, as everything we read lately says repeatedly, it could (there’s that word again) be a game changer. 

Cards? Jenga? A football team crashing through the front door and out the back?

The drug is one of several attempts to tackle Covid by treating the infection rather than vaccinating people, so let’s not bother to name this particular one and instead hope one of them comes through. Even the people weren’t cranking themselves up to be afraid of flying forks might accept this.

Or possibly not. It’s gotten so crazy out there that I’ve given up trying to predict where we’re headed.

Fighting Covid: the useless gestures and the useful ones

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An article in a Canadian medical journal notes that the country’s Covid prevention advice hasn’t caught up with the current knowledge about how the disease spreads. It’s airborne, so the advice, the article says, should focus on ventilation, filtration, and better masks. 

Having recently been at a meeting where before going home we dutifully sprayed and wiped the furniture, even though it’s pointless–

Yeah. How many other people are ending meetings that way? It’s like sanitizing our hands when we walk into a shop. It’s not a useful way to keep Covid from spreading, but it’s basic politeness these days–one of those many meaningless gestures that you do to keep from scaring people.

Irrelevant photo: I wish I could tell you what this is. It’s one of a whole set of large white wildflowers that I’ve never been able to tell apart. They don’t look all that much alike, but somehow I just can’t sort out large white flowers.

A fair number of people seem to think of masks the same way, putting on masks only when other people come in, even though if they have any virus to share the breathing they did when they were alone in the room would go a long way toward sharing it.

At the meeting, we did at least open the windows, keep a decent distance, and wear masks, although not all the masks covered all the relevant body parts. You have to hope people do better with the placement of their underwear. 

As far as I know, Britain’s advice hasn’t caught up with what’s now known any better than Canada’s has.

*

Someone I know likes to tell me, with great confidence, that face masks funnel air–along with whatever germs the wearer’s sporting–off to the sides and from there to whoever’s behind the wearer. 

Okay, when I say “likes,” what I mean is “seems to like,” basing that on how often she talks about it. Maybe it’s just that my caution annoys her. I have that effect on some people.

So allow me to smugly report on a new study that measured the leakage from the sides of everyday masks. These weren’t the surgical masks that are made to have a tight fit but the ones civilians buy and, with luck, wear. They reduced the escape of particles–and that would include the Covid virus if it’s present–by an average of 93% They reduce escape from the bottom by 91%, from the sides by 85%, and from the top by 47%.

The moral of this story is that if you’re worried about masks funneling the virus toward you, do not lie on top of a mask-wearer’s head. 

You’re welcome.

The protection’s best when both people are wearing masks.

Covid and kids

During the first half of 2020, no one had reliable information about Covid’s effect on kids. Early reports on the hospitalization rate among kids spanned a jaw-dropping range from 5.7% to 63%. Estimates of its impact ranged from “it’s no worse than the flu” to fears that kids’ immature immune systems would be overwhelmed.

What can I tell you? It was new on the scene and they were working with limited information. 

So now there’s a study of 242,000 kids and adolescents from five countries who’ve been diagnosed with Covid. It compares them with 2 million who’ve been diagnosed with the flu.

What do we now know?

Epidemiologist Talita Duarte-Salles said, “It was a relief to see that fatality was rare, but clearly both complications and symptoms showed the COVID-19 was no flu in children and adolescents.” To translate that (forgive me: I just have to), kids aren’t likely to die of it, but the symptoms and complications can be serious.

We’re switching sources here, so bear with me. I had a very useful article on this that I accidentally deleted and now can’t find, so I’ll slip backwards to a somewhat less useful one that came out in April. It has estimates for the number of kids who had Covid symptoms five weeks after they were diagnosed. 

The percentages clearly aren’t of all kids, and I’m reasonably sure it’s not of all kids diagnosed with Covid. Let’s put our chips on the number of kids who got symptomatic Covid. Five weeks after they were diagnosed, 12.9% of kids between 2 and 11 still had symptoms, as did 14.5% of kids between 12 and 15 and 17.!% of teenagers and young adults. That’s a bizarre set of age categories, since the last one includes one of the earlier ones plus a few other random folks. 

Don’t worry about it. Any statisticians who accidentally read Notes have long since fled.

Another study followed 129 children who’d had Covid and found that 52.7% had at least one symptom four months later.

Some of the individual stories are frightening. They’re typical–they’re rare–but they do happen and it’s important to know that. One nine-year-old developed long Covid that included severe fatigue, sensitive skin, painful rashes, headaches, and indigestion. She lost her senses of taste and smell. Another–also a nine-year-old–had slurred speech, tremors, and brain fog. He became so weak that he had to use first a walker and then a wheelchair.

Again, none of that is typical, but as the epidemiologist said, this is not the flu.

The Covid chronicles: Is herd immunity still possible?

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With Covid raging in India and Brazil, it’s a strange time to be talking about herd immunity, but a cluster of scientific articles are doing just that. 

How many people need to be immune to a disease in order for the population as a whole to be protected? The answer varies with the disease. For measles, which is very contagious, the estimate is 95%. Vaccinate that many (or wait till they get sick and grow their own immunity) and the other 5% will get protection simply from not being around anyone covered with itchy little spots. 

For the initial Covid strain, the best guess was that herd immunity would come when 70% of the population was immune. But as a planet, we handled the disease so badly that we’re not dealing with that strain anymore. Instead, we have a small raft of more contagious strains, so the bar we have to jump over before we reach herd immunity has probably gone from–oh, let’s say waist height to shoulder height. 

Oh, yes, lucky us.

Irrelevant photo: Wood anemones.

So far, the countries with widespread vaccination programs also have groups of people who refuse to be vaccinated–that’s in addition to some who for medical reasons can’t be. They also have groups who for social and political reasons haven’t been reached. The US and UK haven’t done as well at vaccinating ethnic minority groups as they have at vaccinating whites. When I last checked, in April, Israel had gotten only dribbles of vaccine to the occupied territories, saying they weren’t its problem.

And most importantly, the world at large has done a shit job of getting vaccine to the poorer countries. So all those pools of unvaccinated people are where the disease will spread and mutate and create new variants, each of which carries in its itty bitty little pockets the possibility of outrunning the vaccines that those of us who are vaccinated are so relieved to have. 

Israel has vaccinated just upwards of 60% of its population and has in large part returned to normal life, but that normality depends on keeping its borders largely closed and wearing masks indoors. Countries like New Zealand and Australia, which have in large part stamped out the virus, rely on tight border control and strict quarantine. How long they can or have the will to keep those barriers in place remains to be seen.

One article (the link’s above) says that the trick will be keeping restrictions in place once case and hospitalization numbers drop. Primarily, it says, these will be Covid tests and masks. 

And just so’s you know: There’s no agreed-upon definition of herd immunity. I’m going to skip the details and say only that this doesn’t make the conversation about it any clearer. For a sensible discussion, go here.

Some of the articles I’ve read say we’re unlikely to ever completely eliminate Covid. In countries that have been heavily (but not completely) vaccinated, it’s likely to continue circulating and causing deaths, but at dramatically lower rates.  

Sorry. It’s not the knock-out punch we were all hoping for, but it’s a hell of a lot better than the alternative.  

Dr. Anthony Fauci tells us not to worry about herd immunity.

“People were getting confused and thinking you’re never going to get the infections down until you reach this mystical level of herd immunity, whatever that number is.

“That’s why we stopped using herd immunity in the classic sense. I’m saying: Forget that for a second. You vaccinate enough people, the infections are going to go down.”

 

The search for a Covid pill

At least three of the big drug companies are working on pills to keep mild Covid from turning into severe Covid. If they succeed, they’d make Covid’s continued presence in our lives a hell of a lot more manageable.

The first days after the virus moves into a human host are its busiest. It sets up housekeeping in a cell and creates a family to admire its work. And then the family spreads out, setting up housekeeping in new cells. And so forth. It multiplies like mad, and that’s when we’d need to drop that little pill–you know: the one that doesn’t quite exist yet–down our throats to disrupt the sequence. 

Researchers have trolled through existing drugs, hoping to find one that would, by chance, do the job but so far haven’t come up with anything. Hence the search for new ones.

One that’s in development is a protease inhibitor, which would interfere with the enzymes the virus needs to multiply. (No, don’t ask me. I’m just playing parrot here.) Drugs that treat AIDS and hepatitis C are protease inhibitors, in case that gives you the same illusion of understanding that glowed so nicely in my brain until I realizes I didn’t really understand a thing.

Other drugs in development target the virus itself. That does’t glow quite as nicely and I’d love to say more about the process but that’s all I’ve got, although I can repeat that they’d disrupt the virus’s ability to replicate itself.

The companies are hoping to have the first of the drugs on the market by the end of the year. And they may end up being used in combination to keep the virus from evolving some form of resistance. 

Don’t give up, folks. We’ll get through this, even if life isn’t quite the same as it used to be.

It wasn’t perfect then either, was it?

Is a universal coronavirus vaccine a pipe dream?

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Scientists are in the (very) early stages of working out a universal vaccine against coronaviruses–one that would block not only Covid’s existing and future variants but any new coronaviruses that emerge.

Okay, let’s call that a possible vaccine. It could easily not work out, but on the other hand no law of nature says that it can’t. Scientists have been doing the next-to-impossible a lot lately. I’ve started to take it for granted. 

IMG_0082 (1)

Irrelevant photo: A camellia bud, stolen from an old post because I’m trapped in WordPress’s horrible new editing program and haven’t found a way to drop in new photos at full size. I had a way to avoid the new system, but they’ve blocked it.  

They can approach the task in two ways. One is to make a mosaic vaccine. That has nothing to do with Moses–you know, the guy with the stone tablets. It’s from the word for those tiny pieces of colored tile that make up a picture. The vaccine takes particles from several Covid variants or other coronaviruses and sticks them onto a nanoparticle–a very tiny biological structure made up of proteins. Think of it as sticking some olives on a toothpick.

Or don’t. It’s your mind. I’ll never know. But if you do want to go out on that imaginary limb with me, watch while I saw it off behind us: We’re going to take that toothpick with its olives and drop it into the martini of your immune system.

Thwack. That was the sound of us hitting the ground, olives and all.

It would make a nice lullabye, don’t you think?

Now that we’ve dusted ourselves off, we can let our immune systems figure out what those bits of virus have in common and arm itself–and us–against that.

When this was tried in mice, their immune systems created a broad range of neutralizing antibodies. And creating neutralizing antibodies is the main goal of any vaccine.

Mice–as no doubt you already know–are not humans. They’re also not martinis, so this may not transfer seamlessly from them to us. But it holds some promise.

If you’ll let me brush those twigs out of your hair, we can go on.

The second approach has the scientists looking for features that are common to all coronaviruses. That could mean analyzing their genetic sequences to see where they overlap. It could also mean looking for immune cells that react to either all coronaviruses or to a number of variants, and then mapping the parts of the virus that they target. After that, all that’s left is to create a vaccine aimed at that spot.

Nothing to it.

Those of you who don’t drink will be relieved to know that no martinis are involved in this approach.

Now I’ll throw cold water on the whole project and tell you that scientists have been trying to come up with a universal flu vaccine and a universal HIV vaccine for years. The candidates have been safe but not impressively effective. Still, Covid doesn’t mutate as quickly as either HIV or the flu.

Yes, really. In spite of everything we’ve been reading about variants. This is what’s called slow mutation. 

So no one’s offering guarantees that this will work, but it’s a bright spot on the horizon. 

The horizon, unfortunately, is a good long way away.

Policy-type stuff

An international survey of how countries handled the pandemic shows that autocracies and democracies did equally well and equally badly, as did rich countries and poor countries and countries governed by populists and countries governed by technocrats. In other words, none of those were decisive factors.

Lockdowns of one sort or another do break the chain of infection, but they’re not universally successful. If the population doesn’t trust the government, they don’t seem to work. (I’m stretching the study’s conclusion a bit there. It sounds more tentative about it.) Economic support may make lockdowns more effective. (“May”? I can’t imagine the part of the world where making sure people who can’t work can still eat and pay their rent wouldn’t help. Never mind. It’s not my study. They’re not my conclusions.)

Some countries with strong scientific capacity and healthcare systems have responded badly, and some countries with far less (Mongolia, Thailand, Senegal) have both kept their people healthy and the economy running. 

Some countries (Taiwan, Vietnam, and New Zealand get a mention) did well in controlling the first wave and kept control from there on. Others did well in the first wave but the waves that followed swept over them. 

I’ll get out of the way now and let the people involved in the study have the last word:

“While our work has tracked individual governments’ responses, it is clear that exiting the pandemic will require global cooperation. Until transmission is curtailed throughout the world with restrictions and vaccinations, the risk of new variants sending us back to square one cannot be ignored.”

In other words, we’re all in this together. Even when we don’t act as if we are.

*

So let’s check in on a country that’s managed well and hasn’t gotten a lot of publicity. 

Before it had its first Covid case, Iceland had a testing system and a contact-tracing team, ready to go to work as soon as they found their first case. They put everyone who tested positive into isolation and traced their contacts. The word one of the people involved uses, with no apology, is aggressively.

Isolation–as least in Reykjavik–is in a hotel that was converted for the purpose. In response to which the staff walked out. The man in charge (I have no idea what his title is–sorry; let’s call him Gylfi Thor Thorsteinsson, since that’s his name) coaxed them back. They work in full protective gear. Thorsteinsson at least goes into people’s rooms to keep them company.  I assume many of the others go in as well, but the article I read didn’t say. In the past year, the hotel’s taken care of more patients than all the hospitals in Iceland rolled into one.

After Iceland got its first wave under control, they closed the hotel. Then they immediately had to reopen it when two tourists who’d tested positive went a-wandering. And by immediately, I do mean immediately. They just had a goodbye party for the staff when they had to say hello again. 

Now anyone who lands at the airport is tested and put into quarantine. As a result, Iceland is a country where people can go to bars, eat out, and generally wander the world without masks, as if life was normal. Not because they’re risking their lives and other people’s but because it’s safe.

At one point, someone carrying the UK Covid variant slipped through the net and spread it to a second person, who went to work in a hospital and in case that wasn’t bad enough went to a concert with 800 other people, who all crammed into the bar during the intermission. 

Whee. Viral playtime.

Within hours, the tracing system had contacted every one of them. Within days, they’d tested 1,000 people, finding two cases, and they were taken to the isolation hotel. 

And that was it. The virus was contained. 

Why has Iceland been so successful? Thorsteinsson said it’s because “it has been the scientists making up the rules, not the politicians. That matters. They know what they are talking about, the politicians do not.”

The prime minister, Katrin Jakobsdottir, seconded that. 

“I think it’s important for a politician to realize what is politics and what needs to be solved by scientific means. It’s my firm belief that we need to listen more to the experts.”

 

A short technical rant

WordPress in its wisdom has blocked the back road that once allowed me to use its manageable Classic Editor, so I’m now trapped in the new one. If anyone knows how to size photos (or knows a back road), pleasepleaseplease let me know. Thanks.

How countries respond to a pandemic: from the competent to the stupid

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What’s the best way to respond to a pandemic? I’m asking out of purely academic interest, you understand, but a study of how twenty-seven countries responded to the pandemic–

Oh, hell, let’s drop twenty-two of those. Life’s complicated enough, and the article I’m relying on already dropped them for us, but let’s pretend we had a choice. We’ll look at two that handled it well and three that blew it. It’s not in depth, but it’s interesting all the same. 

The two? South Korea and Ghana–which is to say, one that I knew about and one that I didn’t. Ghana hasn’t been in any of the news that I’ve seen until now.

South Korea acknowledged the threat in January 2020, encouraged people to wear masks, and introduced a contact-tracing app. They avoided a lockdown. 

Let me quote the article here: “Each change in official alert level, accompanied by new advice regarding social contact, was carefully communicated by Jung Eun-Kyung, the head of the country’s Centre for Disease Control, who used changes in her own life to demonstrate how new guidance should work in practice.”

In other words, they had a human being leading them through it and acting like a human being. Yes, the advice changed over time, but it wasn’t rocket science.

Then Ghana comes in and ruins my theory that politicians should get out of the way and let the public health people handle public health communications. The president, Nana Addo Dankwa Akufo-Addo, “took responsibility for coronavirus policy and explained carefully each measure required, being honest about the challenges the nation faced. Simple demonstrations of empathy earned him acclaim within his nation and also around the world.”

One of the things he said resonates strongly with me, because it’s the opposite of the approach Britain took: “We know how to bring the economy back to life. What we don’t know is how to bring people back to life.”

On the other hand, we have Brazil, India, and the UK, which gave out inconsistent messages about the threat, downplayed the dangers, made impulsive decisions, and ended up with high on the list of deaths per capita. 

In Britain, Boris Johnson prioritized the economy over controlling the virus, and before he came down with Covid himself he was tap dancing through hospitals and shaking hands with infected people. Against all public health advice.

If I were giving out public health advice, I’d advise him not to tap dance. Certainly not in public.

For clarity: I made up the tap dancing in an effort to be funny. It’s been a long week here. Sometimes the jokes work and sometimes they don’t.

A rare relevant photo: Fast Eddie, following the sleep experts’ advice. I know, you haven’t gotten to that part yet, but it’s in here somewhere.

Britain has one of the highest per capita death rates.

Yay us! We’re the envy of the world.

A year into the pandemic, Jair Bolsonaro (who also managed to catch Covid) is still criticizing attempts to control the disease and at the beginning of March told Brazilians to stop whining about it. Well let that stand in from his approach from the beginning.

Brazil’s death rate is behind Britain’s and the US’s, but it’s high.

And in India, Narendra Modi at least took the virus seriously, but he called a lockdown with four hours notice, doing nothing to support people who would be out of work and desperate. That set off a mass migration of the poorest laborers, who left the cities for their home villages. The choice was to was walk home or starve. Those who were carrying the virus spread it. 

India has an impressive death rate too.

The article’s summary is that countries that politicized the virus, made last-minute decisions, or were stupidly optimistic had the most cases and the most deaths. 

They don’t say “stupidly.” They’re professionals. They can’t. 

 

News from assorted scientists

This shouldn’t surprise anyone who’s been paying attention, but with some U.S. states dropping their mask mandates, it might be worth mentioning a study that shows a correlation between wearing masks and a lower number of Covid cases and deaths.

I know. I’m shocked too. Who’d have imagined wearing masks would cut transmission of an air-borne virus? 

The same study also shows that opening restaurants correlates with a rise in the number of cases and deaths. Probably because it’s hard to eat without taking your mask off. 

The study has its limits. It’s hard to isolate a single cause when a lot of factors are bouncing around in the dark and smashing into each other. But we got where we are by not listening to health information that didn’t make us happy. We might outta listen to this.

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A different study–a small one–suggests that it’s safe for healthy people to wear face masks when they exercise indoors–even when they do vigorous workouts. Which is good to know, although I’m still trying to figure out why anyone thought it wouldn’t be. If we were being asked to stuff masks down our throats and up our noses, I’d expect problems, but unless I’m seriously misunderstanding the situation, no one’s asking that.

Masks did have a small effect on the workouts–they reduced people’s peak oxygen uptake by 10%.

“This reduction is modest,” one of the researchers said, “and, crucially, it does not suggest a risk to healthy people doing exercise in a face mask, even when they are working to their highest capacity. While we wait for more people to be vaccinated against COIVD-19, this finding could have practical implications in daily life, for example potentially making it safer to open indoor gyms.

“However, we should not assume that the same is true for people with a heart or lung condition. We need to do more research to investigate this question.”

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Yet another study reports that spacing out the first and second doses of a vaccine does reduce the number of Covid cases in the short term but that in the long term–well, basically no one knows what impact it’ll have. It’s not clear how long immunity from a single dose will last or how (as they put it) robust it’ll be. If the immune response after one dose isn’t as robust as it would be after two, it could increase the size of a later outbreak. 

And then there’s the possibility that people with partial immunity could increase the odds that the virus will mutate in ways that allow it to escape the vaccine.

Isn’t this fun?

Don’t loose sleep over this yet. They’re only raising possibilities.

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Still, though, if you’re feeling paranoid about Covid, sleep experts in Australia have reminded us all that sleep is essential to our immune systems.

Yeah, thanks, folks. We kind of knew that.

Just before I got vaccinated (or half vaccinated, since that’s the way Britain’s handling it) I read that to maximize the vaccine’s impact I should get a good night’s sleep beforehand. That was enough to guarantee that I didn’t. 

One of the many oddities of getting older has been that I–lifelong insomniac that I was–now sleep well. Except when someone tells me that I really need a good night’s sleep before some particularly important event. 

But never mind me. Sleep well. Your health depends on it. 

 

An update on Huge Ma

Remember Huge Ma, a New York programer who spent two weeks and $50 creating a free website, TurboVax, that would simplify the tangle of websites New Yorkers needed to negotiate to get a vaccination appointment? Well, he’s been overwhelmed with gratitude, with requests to set up similar sites in other places, and with so much traffic that the site’s buckling. 

I’m not sure what it means, specifically, when they say the site’s buckling, but when he created it he took shortcuts so he could get it working quickly.

“I think that’s a trade-off that I would still make,” he said. “The response has been incredibly overwhelming. There’s been so much gratitude. Hundreds, thousands of emails from people who have gotten appointments through TurboVax, which is honestly kind of just mind-blowing, and humbling as well. . . .

“I would never have thought that I could have built something that has such tangible impact on other people’s lives.”

Other citizen-led sites have appeared around the U.S., but it’s very much hit and miss. “There is a huge need for tools like this,” Ma said. “But I’m just one developer who did a side project that went viral.”

Ma did suspend the site for a weekend to protest hate crimes against Asian Americans, which have increased recently. 

“While I have this platform,” he said, “as an Asian American myself I can do more than what is expected and highlight a group and an environment that needs changing.”