Can fermented soybeans destroy Covid?

It’s too early to celebrate this, but from Japan comes the news that an extract made from natto–a sticky food involving fermented soybeans–inactivates Covid’s spike protein by digesting the receptor binding domain.

What’s a receptor binding domain? No idea, but Covid’s spike protein needs it, so anything that digests it has got to be good–at least from our point of view.

The extract of natto works on all the existing variants.

The reason it’s not time to celebrate is that so far it’s only worked in a lab. No one’s gotten the natto and the virus together inside the body. Eating natto won’t help. Neither will sending the virus invitations to a party and serving natto hor d’oeuvres. No matter how much it mutates, the virus will continue to be illiterate, so it won’t show up.

Irrelevant photo: a wild orchid.

The next stage is to isolate the molecular mechanism that’s destroying the–what was that called?–the receptor binding domain. Figure that out and you could well have a treatment for Covid. 

Possibly. At some time in the indistinct future. But c’mon, we need all the hope we can find.

 

England’s world-beating experiment in irresponsible government

On July 19, England took what little common sense it had forgotten in the drawers of 10 Downing Street’s desks and set it on fire. It’s been dry lately, but there wasn’t enough common sense to burn for long, so we didn’t get the second Great Fire of London, just another round of Covid stupidity.

To be clearer about this, nightclubs are now open. So are bars, restaurants, and pretty much everything else you can think of. It’s up to you whether to throw your mask away and sit nose to nose, indoors, and sing loudly with six of your favorite strangers and no ventilation. Or with thirty of them if you can get your noses close enough. Crowd limits are out of fashion, along with distancing. 

The first day of that was called Freedom Day. Those of us currently cowering under the covers are free to cower under the covers. Unless of course we have to go to work or in other ways mix with the rest of humanity.

The official justification for this is that vaccination has severed the link between infection and hospitalization. Or weakened it, depending on when you listen to the explanations and who gives it. We have to return to normal life. We have to live with Covid. The economy needs us. And if not now, when? 

Maybe when it’s safe, that’s when. Because the link between infection and hospitalization hasn’t been severed, it’s only been weakened, and that’s not enough. The number of infections is going up, and so is the number of deaths. Not as sharply as it once would have, but more than it would if we kept to a marginally sensible policy.

And the thing about deaths is that once people are dead, they’re gone. It’s kind of irreversible.

The government’s Scientific Advisory Group warns that the combination of a large number of vaccinated people and a high number of infections creates the perfect conditions to create a variant that will escape the vaccines. No one can know whether that will happen–vaccines mutate randomly–but the likelihood increases as the number of infections increases.

And while all this is shoving us in one direction, Boris Johnson says vaccine passports will be required for nightclubs etc.–but not until the end of September. Between now and then, let Covid rip.

What are they thinking? One of the government’s scientific advisors, Robert West, says it’s “a decision by the government to get as many people infected as possible as quickly as possible, while using rhetoric about caution as a way of putting the blame on the public for the consequences.” 

That wave of infections would combine with the number of vaccinated people to push the country toward herd immunity and the virus would no longer spread.

What are the problems with the strategy? Well, in addition to opening the doors to a variant that evades the vaccines, no one knows what level of immunity is needed for herd immunity to Covid. The best guess is 85%. And then there’s long Covid–the long-term damage that some people live with for no one knows how long, after even asymptomatic infections. 

The government says that’s not its strategy. You’re welcome to believe it if you like. 

And a unicorn just pranced down the street outside my window. You’re welcome to believe that as well. It was wearing a tutu and singing a Mozart aria.

Not long ago, the Netherlands opened everything up and Covid infections rose sevenfold. They’ve since closed bars, restaurants, and nightclubs.

England’s reopening has caused the Covid tracing app to warn an annoying number of people that they’ve been exposed to Covid and should self-isolate–more than 600,000 last week–and that in turn has led to a lot of people being off work.

So what’s a responsible government to do about that? 

We don’t have one of those, so who cares? Instead of deciding that too many people are being exposed to Covid because we took all our restrictions out and burned them, the government’s decided that too many people are being notified, so it’s created a list of crucial occupations whose employees can ignore the app if they’re double vaccinated–although they will at least have to test themselves. 

Can people who are doubly vaccinated spread Covid? Why look! It must be time to talk about breakthrough infections! Because buried in that segment somewhere is the news that we don’t have a clear answer to that question yet.

 

Breakthrough infections

First we need a definition of a breakthrough infection, even if you already know it: A breakthrough infection happens when a vaccinated person gets Covid–or (it can happen with any matched pair of disease and vaccination) whatever else they were vaccinated against. When that happens, it doesn’t mean the vaccine isn’t effective. It means the vaccine isn’t 100% effective, much as we wish the Covid ones were. 

That leaves us–or me anyway–wondering why one person will get a breakthrough infection and another won’t. The definitive answer is that it’s hard to say.

Thanks, Ellen. That was really helpful.

Sorry, but I can only pass on what I find. The direct quote is, “It’s difficult to determine why any particular breakthrough case happens.” 

How large a dose of the virus you’re exposed to might make a difference–with the emphasis on might. Our individual immune systems will make a difference. They can be affected by health problems and by medications that make an immune system respond to the vaccine less enthusiastically.

And new variants can make a difference. The vaccines were developed for the Covid 1.0, or 2.0. We’re now onto–

Hang on a minute. I have to go look up the Greek alphabet and figure out where Delta comes. 

We’re now at Covid 4.0.

It’s also possible for a person to have gotten a vaccine dose that wasn’t administered correctly, although that’s a lot less likely. And no, I’m not sure how you administer a vaccine the wrong way either. Maybe you let the stuff get too warm. Maybe you let it expire. Maybe you miss the arm entirely and inject it into the hat. That last one is the reason they don’t let me do vaccinations anymore.

People who are (fortunately) better than I am at figuring this stuff out are tracking the number of breakthrough infections, looking for evidence that the vaccines’ are wearing thin and booster shots are needed. So far, they haven’t seen it. 

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We can break breakthrough infections into a few categories, and in order of decreasing likelihood they are: 1, testing positive, 2, having a mild infection, 3, having a serious infection, and 4, dying.

Patients are strongly advised to keep themselves out of category 4. 

If you’ve absorbed that advice–and it is important–we’ll move on to the question of whether fully vaccinated people who’ve been exposed to the virus should have to go into isolation. In the US, the Centers for Disease Control (citing “limited evidence” according to the article I found) says they not only don’t need to go into isolation, they don’t need to get tested unless they develop symptoms. The theory is that they’re less likely to infect other people than unvaccinated people with asymptomatic infections.

Other countries are making different rules.The evidence is limited, the lights are off, and we’re all bumping into the furniture. 

What percentage of fully vaccinated people test positive after being exposed to Covid? If anyone has numbers on that, I haven’t found them.

What does seem to be well established is that breakthrough infections are rare, and we do have statistics (sort of) for categories 3 and 4–the one you want to stay out of and the other one you want to stay out of. In the US, 5,492 vaccinated people were either hospitalized or died and also tested positive for coronavirus. That doesn’t exactly say they were hospitalized for or died of Covid, but it’s as close as we’re going to get. That’s 5,492 out of the 159 million people who’ve been fully vaccinated. I’ll leave someone else to figure out what percent that is and just say it’s small.

Most breakthrough infections are mild, and the number of mild or asymptomatic infections will be larger, but again if numbers are available for that I haven’t found them.

 

A different way to live with Covid

Is it possible to return to normal life in some sane and safe way? A study from Barcelona points us toward a possibility. It followed the 5,000 people who attended a carefully controlled indoor concert. 

People were screened on the way into the concert, using an antigen-detecting rapid diagnostic test (it’s called an Ag-RDT if you want to sound like you know what you’re talking about), and the test was done by nurses. At least with other rapid Covid tests, that makes it more reliable than when people do it themselves, probably because they maneuver those nasty swabs into the right spots.

Everyone wore masks–specifically, filtering facepiece 2 masks–the whole time. Presumably over their noses and mouths, not their chins or back pockets. They look like this.  (I’m conducting a one-person boycott of Amazon, but I’m not above using them as a link if I don’t have to give them money.) They’re a kind of mask that offers more protection than your average cloth mask, but they’re disposable, which if everyone used them everywhere would create its own set of problems. Especially since a few of us out there hate throwing things away when they still look usable. 

But enough of that. Let’s move on.

The event’s described as a concert but people danced. People sang (presumably along with the music but it shouldn’t really matter from a medical point of view.) No one was asked to keep 6 feet away from anyone, at least by the organizers, although some predictable number of individuals will have told some predictable other number of individuals to back off. 

I don’t have details on the ventilation except for a passing mention of improved ventilation. Ventilation’s probably the most overlooked way to make work and public spaces safe. 

The event was held in an area that at the time had a moderate rate of Covid and a low number of vaccinated people. 

What happened? The followup found 6 cases of Covid two weeks after the event. Three of those were traced to sources other than the concert. Another person may have been in the incubation stage when she attended the event and could’ve been missed by the test. No one’s figured out where the other two cases came from. 

Which isn’t bad for 5,000 people. So it can be done if we have the will to do it.

 

. . . and in the schools

In the US, the American Academy of Pediatrics is calling for all students, teachers, and staff to wear masks in school, whether they’ve been vaccinated or not. That runs counter to Centers for Disease Control advice, which exempts the vaccinated and says the unvaccinated should wear masks in school to protect themselves.

Even though–apologies, CDC–your average mask is better at protecting people around the wearer than at protecting the person sporting one.

The article I got this from has the first statistics I’ve seen on how many kids get multi-system inflammatory condition (called MIS-C, in case you have any need to address it directly): It’s 1 out of every 600 infected children and teenagers. That’s not the same as 1 out of every 600 kids, only out of the ones who get infected.

MIS-C is seriously serious and more often than not will land a kid in intensive care. It comes several weeks after the primary infection.

It’s the sex, not the money: a small political scandal hits Britain

Nothing’s as delicious as a scandal unless it’s a scandal involving a government you dislike. So forgive me, but I’m enjoying the resignation of Britain’s former secretary of state for health. 

What brought Matt Hancock down was sharing a kiss with an aide. Or more accurately, sharing a kiss with an aide within range of the office CCTV, which an anonymous someone released to the press. Or even more accurately than that, sharing a kiss with an aide within range of the office CCTV during LockdownLite, when people weren’t supposed to even be hugging people outside their household (or “bubble,” in pandemic-speak), nevermind trading long and apparently passionate (CCTV can only tell us so much) kisses with them.

It was the pandemic hypocrisy that gave it resonance. Lots of people wouldn’t have minded making physical contact with a wider range of humans, but they were sticking to government guidance and here was the person allegedly responsible for that guidance conducting an extensive germ exchange with someone he was supposed to stay two meters away from. Because the health of the nation was at stake. 

Irrelevant photo: a rose.

Both Hancock and the aide are both married. To other people. So it’s a safe bet that their bubbles burst at the point where they wedged each other inside.

And just to give the story a bit more resonance, in the early stages of the pandemic Hancock criticized a scientist on the government’s scientific advisory board for breaking lockdown by getting together with someone he was in a long-term relationship with. Hancock said at the time that it left him speechless. 

The scientist resigned, taking his expertise with him. 

The real scandal, though, is that Hancock had appointed his aide to a (well paid) position as a non-executive director of the Department of Health and Social Care, which ever so incidentally oversaw his performance as secretary of state for et cetera. Without either of them mentioning their relationship. But that’s less fun than two people playing grab-ass in the office, so although it gets mentioned I doubt it’s what brought him down. 

How well paid is well paid? For 15 hours of work a year, the position pays £15,000 pounds. Unless I’m hallucinating, that’s £1,000 an hour. The aide has now resigned too. 

The role of the non-executive directors is to challenge the government as well as provide oversight, and fifteen other people with tight connections to the Conservative Party hold the positions in various departments. They include donors, former Members of Parliament, and peers. Let’s say it all gives the appearance that it wasn’t their expertise that got them their jobs.

But that’s nowhere near as much fun. 

 

A report from the Not out of the Woods Yet Department

One of the world’s most highly vaccinated countries, Israel, has reimposed indoor mask rules as the Delta variant becomes Covid’s dominant strain. The number of Covid cases was doubling every few days. Admittedly, it was starting from a low number, but so does any spike. 

And the same thing’s happening in other highly vaccinated countries–and even more so in largely unvaccinated countries. Delta has raised the stakes in the herd immunity poker game. People who’ve recovered from earlier Covid infections–the kind caused by other variants–seem to be vulnerable to Delta. 

A good news/bad news study shows that while two doses of the vaccines that Britain’s using are 96% effective against hospitalization and 79% effective against symptomatic infection, one dose is only 35% effective against Delta. 

Delta is so contagious that over 80% of a population would need to be fully vaccinated in order to contain it. So far, only 1% of Africa’s population has been vaccinated, and the Delta variant has been identified in 14 African countries. 

In spite of all the promises to get vaccines to poorer countries, contributions to the Covax vaccine program have dried up. “The world is failing,” a spokesperson for the World Health Organization said. “Just give us the vaccines.”

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Six cases of the Lambda variant have been identified in Britain. That’s a variant that the World Health Organization has labeled a variant of interest, which translates to Don’t panic yet, but we’re watching it. It was first identified in Peru and has now been found in 26 countries. 

Don’t panic yet. At this point, it’s just something to know.

 

And a counter-report from the On the Other Hand Department

In the US, according to a study, almost all Covid deaths are of unvaccinated people. Breakthrough infections–the ones that happen to people who’ve been vaccinated–are 0.1% of the total hospitalizations. Of the Covid deaths recorded in May, 0.8% were among people who’d been vaccinated.

If I’m not mistaken (and I can’t be trusted with numbers), the second percentage is larger than the first, which does seem odd. I’m guessing here, but it could be because breakthrough infections happen in people whose immune systems are in one way or another out of order, so they’re not only vulnerable to infections in spite of vaccination, but having once gotten infected, are more vulnerable to the disease–again, in spite of being vaccinated. But that comes with a wild-ass guesswork alert. If anyone has some solid information on that, I’d love to hear it.

What does “we have to live with Covid” mean?

Periodically, someone announces, as if it ends the discussion, that we’ll just have to live with Covid. But that doesn’t end the discussion, it only begins it. What does living with Covid mean?

To some people, it means, end the lockdowns, burn the masks, and get together in an unventilated space with a few thousand of our closest friends so we can all get shitfaced and dance. Because that’s what normal looked like, at least in retrospect, and we need to get back to normal.

To others, it means that we keep wearing our masks and hoping to hell other people do the same, because someone out there is contagious and someone else is vulnerable. It means staying out of closed, crowded spaces. It means admitting that we only liked six of those few thousand closest friends anyway and haven’t missed them this past year and a half.

But forget what we think. I’m making it up anyway. Let’s turn to the experts. 

An article in the Medical Xpress says that we may never reach full herd immunity–that point where so many people are immune to a disease that those who aren’t immune are protected by not being exposed to it, ever. 

Irrelevant photo: poppies

Why aren’t we likely to reach that point? Because Covid immunity seems to wane over time. Because the disease continues to evolve, especially where unvaccinated groups of people create pools that the virus can spread through and evolve in. And because animals can harbor the virus and pass it back to humans. 

There may be conflicting arguments that say we will reach herd immunity, but I haven’t found them. Let’s go with what we’ve got. 

The article’s authors say that even if we don’t reach full herd immunity, we could still reach practical herd immunity, allowing us to go back to near-normal levels of activity. Their measure of near normality seems to be how far a country can open up without overwhelming the health-care system. It depresses the hell out of me that we measure safety not by the deaths and disabilities the disease would cause but by how many cases of it a health system can sustain, but–well, there it is, written in black and white. That’s what happens, I guess, when you enter the land of policy making.

How many people need to be immune to reach practical herd immunity? It depends on the level of restrictions–or adaptations, if you want a more user-friendly word–we’re willing to live with. Masks? Contact tracing? Mass testing of asymptomatic people? Measures to stamp out outbreaks? 

It’s interesting that although this is a consideration, how many deaths and disabilities we’re willing to live with isn’t. 

Practical herd immunity also depends on vaccination levels: “Some estimates,” the article says, “suggest that we may need two-thirds of the population to be protected either by successful vaccination or natural infection. If 90 percent of the population is eligible for vaccination, and vaccines are 85 percent effective against infection, we can obtain this two thirds with about 90 percent of the eligible population being vaccinated or infected naturally.”

Don’t let those numbers scare you. They’re safely contained within quotation marks.

There’s still a possibility that new variants will escape our immunity, but the fewer outbreaks we have, the fewer chances we’ll give the disease to reach escape velocity.

And we’ll all live happily–if cautiously–ever after.

I hope.

 

The cost of herd immunity in cold, hard cash

But if you’re in love with the idea of restricting nothing and either pursuing herd immunity or in letting Covid circulate freely because it’s no worse than the flu–or if you want to argue with someone who is–academics have calculated the cost to Western Australia if it had pursued a herd immunity strategy: They say the state saved $4.9 billion and avoided 1,700 deaths in a year by locking down hard. It also prevented 4,500 hospitalizations.

In Britain, it was the cost of a hard lockdown that made the government hesitate, repeatedly, to either stamp out or contain the virus. It sounds like it was an expensive savings.

 

Vaccination news

In Britain 52% of the people who said they’d never get vaccinated have now gotten vaccinated, along with 84% of the people who said they weren’t likely to. The percentages shift when you break the population down into religious and ethnic subgroups, but in all of them the trend is in the direction of vaccination.

Part of the change, I’m sure, comes from work that’s being done with community leaders and work to counter misinformation campaigns, but I can’t help wondering if a kind of herd immunity isn’t at work here too: People around us have been vaccinated. We see that keys don’t stick to their faces and that axe heads don’t pursue them down the street, so we figure they probably haven’t been magnetized after all–or at least not heavily. There probably hasn’t been enough time for them to demonstrate that they can still get pregnant–at least those of them who could’ve gotten pregnant in the first place. That–allow me to remind you–excludes all males of the species and enough categories of females that I won’t list them. Even the real but very rare serious side effects of some vaccines–well, they’re very rare. Have they happened to anyone we know? Um, no.

It’s an odd thing, but a 1 in 100,000 chance looks more likely to happen if it happens to someone you know and less likely to if it doesn’t. Even if the numbers don’t care who your friends and acquaintances are.

Humans do seem to be herd animals. We see people around us getting vaccinated and going on with their lives, not visibly marked by the vaccine, and it starts to look like a safe thing to do. Even a smart one. 

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The Netherlands is offering pickled herring to people who get vaccinated. Traditionally, the year’s first barrel of Hollandse nieuwe is auctioned off to raise money for a good cause, but since that couldn’t happen this year it was given, “on behalf of the Dutch people” to the head of the health services. Other barrels were sent to vaccination sites and people are being offered herring when they show up.

 

Counterfeit and Covid

Counterfeit Covid vaccines, tests, and vaccination passports are becoming big businesses. Vaccines and test kits are sold through online pharmacies. Amazon, Etsy, and I’m sure other places sell vaccine passports, with no proof of vaccination required. 

Why not? Everything’s available online. This Christmas, I bought my partner a certificate making her a minister in the Church of the 400 Rabbits. All I had to do was make a donation (it went to a food bank) and print it myself.

Although the article I found talked about the danger of counterfeits infiltrating the supply chain that countries use for genuine vaccines and tests, it didn’t say it had happened. So we’re talking about individuals–people made desperate enough by the world’s uneven rollout that they’re willing to roll the dice and hope that luck will lead them to the real thing.

 

Odd ways to fight Covid

Okay, just one odd way, but the plural made a better subhead. Scientists have developed a sticky wall surface that uses ingredients in hair conditioners to trap the aerosolized droplets that contribute so heavily to the spread of Covid. 

The theory works like this: Droplets bounce off indoor surfaces all the time. Add sticky stuff to your plexiglass divider, though, and their bouncing days are done. 

The developers coated a barrier and it captured almost all the aerosolized microdroplets and 80% of plain old droplet-size droplets. (The comparison point for those numbers is an uncoated barrier. I have no idea how you compare them.) The coated barrier didn’t need cleaning any more often than the uncoated one did, and once it was wiped down with water the coating could be reapplied.

It also works on fabric, concrete, and metal, turning low-touch surfaces into Covid fighters.

This won’t eliminate the need for ventilation, though. We’ll still need air filtration systems and open windows. But it does give us another tool. 

The bad news? A lot more work needs to be done to confirm its usefulness and get it authorized. 

“We understood that the current pandemic may end before this concept is implemented,” said engineering professor Jiaxing Huang. “It may or may not be used now. But next time, when an outbreak like this happens, I think we will be better equipped.”

When Covid proximity sensors go wrong

Wanting to be responsible journalists–and responsible bureaucrats who are responsible for responsible journalists–the BBC bought proximity sensors in January. Thousands of them. They were to protect the newsroom staff during the pandemic. Because not everyone could work from home. Some of them had to show up, so they’d wear these gizmos and if anyone got too close to anyone, they’d scream.

Not the people, the sensors. 

It was a great plan, and it worked: The sensors screamed. Especially when people were recording. You know: “This afternoon in Birmingham–” 

“Nyeee-ah, nyeee-ah, nyee-ah.”

Take two.

“This aftern–”

“Nyeee-ah, nyeee-ah.”

Before long, most people had stopped using them. Not everyone, though, because one started smoking and threatened to set itself on fire. Why? No other sensors were being around to scream at and it lost its sense of purpose and became suicidal. 

Irrelevant photo: strawberry blossoms

A BBC spokesperson said staff were still using them.

Staff members stopped giggling long enough to say they weren’t. 

“We are surprised that a problem with a single electronic device is a news story,” the spokesperson said

Her or his proximity sensor said, “Nyeee-ah, nyeee-ah.”

Here at Notes, we aren’t surprised that a single sensor that entered a smoldering, screaming state of despair is a good story. We’ve all been there during this past year and a fraction. At least once. It spoke for us all.

 

Britain wonders if it’s out of the woods yet

June 1 was the first day since last summer that no Covid deaths were reported in Britain for twenty-four hours. But before we celebrate being out of the woods, let’s check in with the scientists peskily pointing to trees and saying, “Woods, people. If we have enough trees, that means we’re in the woods.”

What’s the problem? We do have an effective (although distinctly incomplete) vaccination campaign. We also have a new Covid variant that seems to spread faster than the dominant variant that used to scare the pants off us because it spread more rapidly than the one before it but that we now look back at nostalgically and think of as our old friend. 

Never mind if you didn’t entirely follow that. We can say the new variant’s scary and leave it at that. The day before we had no deaths, the country reported 3,000 new Covid cases for six days running. We hadn’t been at those levels since early April. 

So which way is the country going to tip? Herd immunity? Third wave?

Several experts that the Relevant Authorities don’t particularly want to hear from are sending out warnings. A third wave, they say, is likely. 

Nyeee-ah. Nyeee-ah. 

Martin McKee, from the London School of Hygiene and Tropical Medicine, said he thinks the third wave had already started. 

“The current measures are not stopping cases rising rapidly in many parts of the country,” he said. “Unless there is a miracle, opening up further in June is a huge risk.”

Why June? The 21st is the still somewhat tentative target date for the next stage of opening up. 

Ravi Gupta, who’s on the New and Emerging Respiratory Virus Threats Advisory Group–called Nervtag, said, “If things go as I think they are going to go, we will likely end up with a third wave. It will be a big wave of infections and there will be deaths and severe illness.”

All waves, he reminded us, start small. 

My best guess is that the government will open the country up regardless of the warnings, regardless of what’s happening as the date comes closer. Because the business community’s pushing for it. Because there’s money to be made. Because they want to deliver good news. Because they seem to be wired for it. 

I would love to be wrong about this.

 

Renaming the Covid variants

The World Health Organization is renaming the Covid variants to avoid calling them by names no one outside the field can remember (B.1.617.2, anyone?) or after the places they were first identified, which has led people to blame them on the places. So the former Kent (or UK, or British) variant is now Alpha. The former South African variant is Beta. The former Brazilian variant is Gamma. And the former Indian variant is Delta.

It follows from this that the world will have to beat this beast before the Greek alphabet runs out of letters. It has twenty-four. Get with it, people.

The Covid chronicles: Is herd immunity still possible?

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?

The herd immunity debates

Professors at University College London grabbed some headlines with the news that Britain’s almost achieved herd immunity.

Should we celebrate? 

Nope. The small print said we can’t ease restrictions yet. “If we let up, that threshold will go up again and we will find ourselves below the threshold and it will explode again,” Karl Friston said.

This makes it sound like we’ve probably misunderstood what herd immunity means. Or else that the people who wrote the study have. I thought it marked the point where we could all wander back to whatever we can reconstruct of our normal lives, trusting that the virus will stay in retreat. Apparently not, though–at least not by this definition. 

Irrelevant photo: a rose. Indoors. It’s too early in the year for them outdoors yet.

In a rare moment when the health secretary, Matt Hancock, and I agree (I’m sure that upsets him as much as it does me; sorry Matt; it won’t happen often), he’s dismissed the suggestion of herd immunity, although his comments are oblique enough to be unquotable. They’re not incoherent but they’re not exactly to the point either. Never mind, though. I have agreed with him. It’s a rare moment. We need to mark the occasion.

Cup of tea, anyone?

Another estimate of herd immunity, this one from Airfinity (it “provides real time life science intelligence as a subscription service” and as part of that tracks vaccination programs around the world), sets it at the point where 75% of the population is vaccinated. The U.K.’s expected to reach that point in August, shortly after the U.S. and a few weeks before Europe.

Sorry about the rest of the world. It seems to have dropped off the map the article I found was using. 

There will, of course, still be a need to booster vaccines to keep up with the variants, at least until those countries that fell off the map get access to vaccines so are species can stop producing variants so prolifically. 

 

Creeping out of lockdown

As Covid deaths go down, Britain’s taken another step toward ending its lockdown, opening gyms, shops, pubs and cafes with outdoor seating, assorted other businesses. Internal tourism is causing traffic jams in all the usual places. 

About half the population has at least one dose of a vaccine. Will that be enough to keep the virus from rebounding? I wish I knew. Chile has an impressive vaccination program and unlocked too early, giving the virus the gift of a trampoline. Cases there have spiked. 

Optimist that I am, my mind snags on Britain’s remaining virus hotspots and on the two London boroughs where the government’s chasing cases of the South African variant. I expect they’ll do better with the variant than with the hotspots, because one of the things the government resolutely refuses to do is pay people a workable amount of money to self-isolate, and if you’re broke you’ll go to work, regardless of what the test says. Because you have to. 

On the other hand–and before I go on I should issue an Unimportant Personal Story Warning–I’m grateful to have stores open. I have a battery-operated watch whose battery stopped operating a while ago. (Whose idea was it to run watches on batteries, anyway? I seem to remember winding my watch every day without feeling unduly burdened. I didn’t even break a sweat.) 

How long ago did the battery run out? No idea. We were in lockdown. Who needs a watch? But eventually I did need a watch and I noticed that mine was no longer in touch with consensual reality. So I got a battery (thanks, Tony). I opened up the back (thanks, Ellen), took out the old battery, put in the new one, put the innards back together, and was just starting to congratulate myself when I found that I couldn’t fit the back on, making the whole project pointless. I put a rubber band around the thing and left it alone.

I still didn’t have a watch.

On Monday, the first day that unimportant stores were open, I took it to a jeweler. Jewelers have a little gizmo to hold the back in place while they thump it shut. I now have a working watch.

I don’t need it more than once a week. We’re still halfway locked down. 

So yes, it’s nice to be able to do that sort of small thing. It also makes me nervous–and it should.

 

Lockdown and the economy

Britain’s economy’s now in the worst recession it’s had in 300 years. Worse than the Great Depression of the 1930s? Apparently. To find one that was worse, you have to go back to the great frost of 1709, when Britain was an agricultural country.

On the other hand, having shrunk 9.9%, the economy then grew by 1% in the last quarter of (I believe) 2020. Household savings during the pandemic reached £140 billion–16.3% of people’s disposable income. That’s compared to 6.8% in 2019. Predictably, that’s unevenly distributed, with some people building up savings while others struggle to hold onto their homes and food banks struggle to keep up with need. 

It’s a lovely way to organize a world. 

 

The Covid risk indoors and out

Want to figure out the Covid risk people face indoors? Measure the carbon dioxide level

This works because–well, the thing about infectious people is that they exhale. Admittedly, uninfected people do too. You probably do it yourself. And all that exhaled carbon dioxide joins together and either stays in the room or doesn’t. The Covid virus does exactly the same thing: It either stays in the room or if the room has enough ventilation it wanders out into the world, where it poses next to no danger.

The thing is that carbon dioxide levels can be monitored cheaply. If you see them rise, you still won’t know if anyone infectious is breathing into the mix, but you will know that the ventilation isn’t what it needs to be and it’s a risky place to stand around inhaling. At that point you can (a) limit yourself to exhaling, (b) leave, or (c) improve the ventilation. Preferably (b), since that will help everyone.

*

An Irish study reports that roughly one Covid case out of a thousand is caught out of doors. 

Professor Orla Hegarty said, “During Spanish flu people were advised to talk side by side, rather than face to face, and this is borne out by how viral particles have been measured moving in the air when people breath and speak.

“The risk of infection is low outdoors because unless you are up close to someone infected, most of the virus will likely be blown away and diluted in the breeze, like cigarette smoke.”

Herd immunity, sterilizing immunity, and the current best guesses

Britain is now the proud operator of several mass vaccination centers, with more promised shortly, and general practitioners are scheduling their oldest patients for vaccination. But that doesn’t mean we’re out of trouble. The number of hospital cases is still rising and there’s talk of the current lockdown not being tight enough.

And we just approved a third vaccine, Moderna’s. Not long ago, Boris Johnson was crowing at Scotland (which on average isn’t happy about having left the European Union) that if they’d stayed in the EU they wouldn’t have gotten vaccines so quickly. So it’s a nice little piece of irony to read that, approved or not, we won’t get or hands on this third vaccine until April because we’ve left the European Union.

I know I shouldn’t think that’s funny, but I can’t help myself.

 

Irrelevant photo: heather

Are we close to herd immunity?

The latest statistical modeling says one in five people in England may have already had Covid. How did they come up with that number? Since the official statistics inevitably underestimate the number of infections (a big chunk of people don’t get sick but carry the disease without knowing it or showing up in the statistics) and since the track and trace system is widely recognized as being roughly as useless as it is expensive, they get their statistics by comparing the number of deaths in an area to the estimated infection rate, putting them in a blender with a few other number and a dash of cinnamon, then baking at 160 C. for fifty minutes. 

In some areas, they estimate that one person in two has had the disease. The number of infected people may be up to five times higher than the number on the test and trace books.

Is that herd immunity? 

Nope. Exactly how many people would have to have had the bug to create herd immunity is still unknown, but a computational biologist estimates that 70% of the population will need to be vaccinated to stop the pandemic in the US. But that only applies to the US; it’s not a fixed number. People behave differently in different places, which upsets the numbers–they’re touchy little beasts–so they arrange themselves into different patterns. 

The number also depends on how long immunity lasts–no one knows yet–and on whether the vaccine turns out to keep people from passing on the infection. 

Most of our commonly used vaccines prevent severe illness but don’t give us what’s called sterilizing immunity. In other words, they keep us from getting sick–or at least from getting very sick–but they don’t kill off every bit of the disease that’s running around inside us. 

On the positive side, having less of the disease circulating inside our complicated little innards may (notice how much wiggle room I’ve left myself there) mean we pass on a milder form of the disease if we do give it to someone else.

An experiment with a chicken virus and a flock that was half vaccinated found that the unvaccinated birds came down with a milder disease than if the whole flock had been left unvaccinated. So even if the current vaccines don’t give us sterilizing immunity, Covid may yet follow that pattern and become milder once a significant portion of our flock has been vaccinated.

May. No one’s offering us a guarantee.

And no, none of the vaccines currently in use will cause us to grow feathers.

 

Transmission and hospitalization

In Britain, the current crop of hospitalized Covid patients are younger than they were during the first peak of the virus. People under 65 now make up 39% of hospital admissions. In March that was 36%. It’s not a huge change, but it is a change, and it’s worth noticing. 

The best guess is that the over 65s are more likely to be out of circulation. We left the party early and are tucked up in our little beds just now. That makes us less likely to become infected and less likely to show up in either the hospital or the statistics. But so much emphasis has been put on the elderly being vulnerable that we tend to think the non-elderly are made of steel.

They’re not. They can get very sick from this thing. In particular, pregnant women seem to be more vulnerable than non-pregnant women (or non-pregnant men, for that matter) in their age groups. 

*

Half of all Covid transmissions come from people with no symptoms, including from people who never do develop symptoms. 

What does that mean in practice? That every one of us needs to act as if we could be carrying it. And that we need to look at our friends and family and neighbors as if they could be carrying it. That we need to look at other human beings and think, Oooh, yuck, germs! 

That’s not, I admit, a policy recommendation. It’s not even a real recommendation. It’s just an observation on how much it goes against the grain to live this way.

*

A study reports that Covid can still be transmitted after seven days. Or after ten days. After ten days, 76% of the people tested still had detectable levels and 86% did after seven. 

So recommending a shorter period of isolation is a gamble. On the one hand, the theory goes that people are more likely to actually isolate themselves if you demand a shorter time. On the other hand, they can still be shedding the virus at the end of it.

The problem is not only that some people are jerks and don’t put the safety of others first. The larger problem is that a lot of people can’t afford to miss a day’s work–they’re living on the edge as it is. So when mass testing’s offered, they don’t show up because they can’t afford to be told to stay home. If they do end up getting tested and are positive, they stagger to work for as long as they can anyway. Because the hounds of hell are nipping at their heels. 

Already 70,000 households have become homeless during the pandemic and some 200,000 are teetering on the edge. There’s money available to people who have to self-isolate, but not to everyone and it’s not enough to cover the bills anyway. 

And if that doesn’t hold your attention, some people are still being told they’ll be fired if they don’t come to work.

*

On a happier note, my partner’s been scheduled for her first vaccination. If all goes well (stop laughing–it could) I should be in line in mid-February. 

Moles, pizza, and remdesivir: It’s the pandemic news from Britain

A local spike in coronavirus cases in Leicester has been handled with all the grace and efficiency we expect of our government. It announced a local lockdown. The health secretary said the police would enforce it as needed. The message was, we’re tough. We’re efficient. We’re gonna win this thing.

The local police and crime commissioner still didn’t know where he was supposed to enforce the lockdown, though, because he hadn’t been sent a map. Then he got a map but still didn’t know the details of what they were supposed to enforce. 

But it’s okay, because we have a prime minister who can do at least one pushup while keeping two yards away from a photographer.

*

Irrelevant photo: St. Nectan’s Kieve

Chaand Nagpaul, from the British Medical Association, said Prime Minister Boris Johnson’s strategy of dealing with local outbreaks will be no use if the local people who are expected to contain them aren’t given the data they need. 

I could have said that, but it sounds better coming from someone with a medical degree. Leicester could’ve responded earlier if they’d been told they had a problem, and where and how and why.

When Johnson introduced his strategy of containing local outbreaks, he described it as whack-a-mole–a game where you whack a plastic mole with a plastic hammer and even if you’re fast enough to hit it, it pops up out of another hole. 

It was a rare moment of honesty in political discourse.

While we wait to see where the mole’s going to pop up next, Johnson tells us that local authorities have been sent the data they need. 

And the check is in the mail.

*

You’ve probably heard by now that the U.S. bought up almost the entire stock of remdesivir–500,000 doses: 100% of the manufacturer’s July production, 90% of August’s and 90% of September’s.

Remdesivir cuts Covid-19 recovery times, although it’s not clear whether it improves survival rates. Other counties have pointed out that buying up almost the entire stock might, um, undercut international cooperation in the face of the pandemic. 

“International what?” Donald Trump replied. 

Okay, he didn’t actually say that. I can’t remember ever seeing a quote in which he asks a question. 

The sale makes it sound like other countries are thoroughly screwed, but in fact they should be able to get the drug via compulsory license, which allows countries to override patents and buy generic versions from countries where the patent isn’t registered. This one is widely registered, but there will, it seems, be gaps.

The drug is made by Gilead, which sounds like it escaped from The Handmaid’s Tale. I’d love to tell you that it didn’t, but I don’t really know that. Lots of things have escaped from fiction lately, and nothing is more bizarre than reality. 

The UK’s Department of Health and Social Care tells us it’ll be fine and it has enough remdesivir “to treat every patient who needs the drug.” 

For how long?

They didn’t say.

*

The New Scientist says, “There is no longer any serious doubt that our bodies can form an immune memory to the SARS-CoV-2 virus.” 

The bad news is that we still don’t know how effective that memory will be. In other words, we don’t know if an immune memory’s the same thing as immunity.

Don’t you just love to hear from me? Don’t I just lift your spirits?

And from the Department of Confusing Information comes this snippet: For every person testing positive for Covid-19 antibodies, two more turn out to have specific T-cells that identify and destroy Covid-infected cells. That’s true even in people who had asymptomatic cases or mild ones.

What does that mean in everyday English? It means that for every person who registers positive on an antibody test, two more have some sort of immune response that doesn’t register. 

Those T-cells the two people have might give them some immunity to the disease. They might keep them from passing the disease on to other people.

They also might not.

The reason T-cells don’t register on an antibody test is antibodies are a whole ‘nother part of the immune system. Expecting to notice T-cells on an antibody test is like making yourself a pizza and wondering why it doesn’t come out of the oven with a side salad.

Basically, antibodies–that’s the pizza–attack the virus before it enters the body’s cells. T-cells–they’re  the salad, and it’s important to remember which is which–go into action once cells have been infected, attacking  them so they won’t infect  new ones. A balanced immune system meal needs both pizza and that salad.

You’re welcome. I’m here to clarify every baffling bit of our world, just for you.

What does all that mean for herd immunity? Not much, because for all anyone knows at this point, those T-cells could protect the bearer without keeping him or her from passing the virus on. 

If you worked this many twists into a pandemic movie, I’d throw my popcorn at the screen and stomp out, muttering, “Enough already.” 

Then I’d go out for pizza and a salad.

I’m just about old enough to remember a world where it was safe to go to movies and pizza joints.