By the numbers: how to help Covid outrun the vaccines

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. 

Why England’s ditching the face mask

England’s preparing to declare a half-assed victory over Covid (“We have to live with it”) and celebrate with a nationwide germfest. Starting on July 19–or yesterday, if you want to be the first kid on the block–masks will be voluntary. Social distancing will be a memory. Getting drunk and hugging strangers will be an Olympic sport.

No, sorry. England doesn’t get to decide on Olympic sports. I got carried away.

If you want to gather a few thousand of your closest friends in a closet for snacks and drinkies, you’re free to. Sporting events will be back. If you’ve been working from home, you can go back to the office. 

Cases, our alleged prime minister Boris Johnson predicted, will rise to 50,000 a day and “we must reconcile ourselves, sadly, to more deaths from Covid.” But as long as we slip the word sadly in there, who gives a damn? I mean, these are people who’d die sooner or later, wouldn’t they? Of something.

Irrelevant photo: The Cornish coast

What they’re counting on is that vaccination has–in the phrase that’s being used so often that it’s started sticking to the walls–weakened the link between infection and hospitalization. Or sometimes the phrase is broken the link.

Broken it ain’t, and although the link’s weaker, the number of Covid hospitalizations has risen.

The main regulation that’s left is that you have to self-isolate if you’ve been exposed to the virus. Unless you’re fully vaccinated, in which case you get to collect £200 pounds in Monopoly money and start the game again.

A lot of this is about the economy, although how face masks damage the economy is beyond me and in the long run I expect all this will do more damage than good. The rhetoric on it is particularly brainless. You’re welcome to keep wearing masks, but it’s now a personal choice. Johnson said that we need to “move away from legal restrictions and allow people to make their own informed decisions about how to manage the virus.”

The next logical step is to let people make their own informed decisions on drunk driving. They’re in charge of a heavy chunk of machinery that can kill or maim someone. Other people’s lives are in their inebriated hands. But hey, it’s not for the government to tell them what to do.

Long live the extreme edge of libertarian logic.

 

Do masks actually make a difference?

Well, a study compared counties in Kansas that had face mask mandates with those that didn’t. Mask mandates reduced Covid cases, hospitalizations, and fatalities by 60%.

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And since we’re talking about masks, a new Covid test has been developed that takes the form of a facemask. You wear it for 90 minutes and it either detects Covid or doesn’t, with the same accuracy as the PCR test–those slow, lab-based tests that are the gold standard for Covid testing. 

The team that invented it is looking for a manufacturing partner to mass produce it.

I see articles about new, fast, accurate Covid tests fairly regularly, and for a while I was mentioning them here. But after that, I’d hear nothing more about them and I kind of gave up on the topic. This one, however, has the potential to be tweaked so it detects all sorts of pathogens and toxins. I thought it might be worth a mention.

 

What about wind instruments and Covid?

It turns out that blowing through wind instrument generates fewer aerosols than either singing or talking. In fact, it’s no more than a person generates by breathing.

The amount of aerosols that singers and speakers generate rises with their volume. That holds true for both amateur and professional singers, regardless of their vocal training, their lack of vocal training, and how good or bad they sound. You run as much risk listening to a terrible singer as a good one, and get less back for it.

 

And what did you do with your time in lockdown?

A civil engineer set a new Guinness world record for the tallest stack of M&Ms. It took him hours, but it was raining, he was in lockdown, and he eventually managed to balance five on top of each other.

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On the other hand, a six-year-old, Apollo Premadasa, wrote a string quartet, “Pandemia,”  and at the height of the pandemic emailed a London hospital to tell them about it. 

“I wrote this piece to say thank you to all the doctors, nurses and scientists around in the UK and around the world for all their hard work during the pandemic,” he said. “It’s been a really hard time for them and they have all been heroes.”

He plays the trombone, cello, and timpani, and he composes music. And in case you’ve forgotten, he’s six years old. 

To celebrate the National Health Service’s 73rd birthday, it was performed at the hospital

How kids learned to fake positive Covid tests–and why

TikTok videos have taught kids that they can get out of school by faking positive Covid tests. All they have to do is pour lemon juice or Coke on them. Or apple sauce, or vinegar, or hand sanitiser, or assorted other acidic liquids. Or they can rub a kiwi across them.

And here I thought TikTok was about dancing.

In Britain, at least, if they do that it means other kids in their imaginary school bubbles get sent home for ten days along with them. And their families have to stay home. But hey, if you’ve got a math test coming up–

It’s a short-term strategy, because in Britain a positive lateral flow test has to be followed up with a PCR test, which you can’t take home and use as a stir-stick for your Coke. Still, it’s a strange enough story to earn its word count here.

Irrelevant photo: Another wildflower I can’t identify. [It’s an elderflower. Thanks to DinahMow for identifying it. Somewhere in this strange thing I call my brain, I knew that.]

A spokesperson for the National Education Union suggested that Covid tests be taken in school. But that wasn’t about lemon juice and Coke. Many kids have simply stopped using the ones they’re sent home with. 

A determined spoilsport, it turns out, can override a faked positive. You can pursue that one on your own if you’re interested. The link is here.

But the story doesn’t end there. A claim’s making the rounds that lateral flow tests are useless because if you test a glass or Coke and a kiwi it will register as having Covid. And since any reasonable person knows Coke and kiwis are immune, there must be something wrong with the tests.

Shout, “Conspiracy,” here if you would.

Thank you.

A fact-checking site called, factually enough, Fact Check points to the directions from one test, which say, “This kit has been evaluated for use with human specimen material only.” This goes to the root of the problem, which is that neither the kiwi nor the Coke is human.

You can shout, “Conspiracy,” again if you want, but I won’t orchestrate it this time. I don’t think it takes a conspiracy to prove that claim. 

Alexander Edwards, associate professor in Biomedical Technology and professional spoilsport, puts it another way: “If you completely ignore the manufacturer’s instructions or in fact use the test for something completely different, then you shouldn’t really be surprised if you get a silly result.” 

 

At last: a way that Covid doesn’t spread

A study of Covid samples from hospital surfaces found that they weren’t likely to infect anyone. That lends support to the belief that contaminated surfaces aren’t a major way to spread Covid. I’d love to explain that to you in more depth but the explanation went over my head. You’ll have to follow the link and see where your head is in relation to the information.

Even without understanding the explanation, though, it reassured  me to know that the damn virus has found a way not to spread. 

 

High fashion in the Covid era

With British kids back in school (when they can’t talk their parents into parting with a lemon) and Covid restrictions easing (in spite of a more aggressive form of the virus), colds are coming back into fashion. 

I’m not basing this on personal experience. I haven’t seen anyone with a cold in a year and a half, but then I’ve never been in the front ranks of fashion. When a style starts making sense to me, that’s a signal that it’s on its way out. But I read this in multiple publications, and those of you who care about trends need to go out and get yourselves a cold. 

Parents haven’t quite caught onto this, so they’re dragging their kids into Britain’s A&E departments. (A&E stands for accident and emergency and it’s the equivalent of US emergency room.) They–that’s the panicky parents–have forgotten what it is to have a kid with a fever, a cough, and a runny nose. 

In fairness to everyone, those are also Covid symptoms and I might panic myself.

Britain’s hospitals are already overwhelmed and have been for the past year and a half. Or for the past decade or so–ever since the government started cutting funds and saying, cheerily, “We’ve never given the NHS so much money.” So they’re not in shape to add kids with minor problems to the major-problem mix. Last month, fewer than 1% of children under 15 who went to A&E needed immediate attention and more than 72% weren’t seriously ill.

And 4.36% asked their parents if they couldn’t get a Coke from the vending machine, please.

The US is also seeing a rise in the number of colds as face masks come off. 

 

A petri dish for the world

The British government’s gone sports mad lately. We’re in the midst of the Euro tournament where they play–oh, I don’t know. Some damn thing involving a ball. The game’s not the point; the crowds are, because fans travel here and there to watch the games. They eat out. They drink. For all I know, they get happy and hug.

Then they go home, and so does Covid.

In Scotland, nearly 2,000 cases have now been linked to people gathering in public fanzones, pubs, and house parties to watch the games–not to mention stadiums. Some two-thirds of those are among the 1,300 people who went to London to watch the Scottish team play there. 

For a semifinal game in Wembley, the British government plans to allow the stadium to reach 75% of its capacity–the largest crowd at a sports event in over a year. 

The World Health Organization has warned that tournament crowds (in general, not specifically this one) can act as Covid amplifiers. And the European parliament’s committee on public health warned that such a large crowd at Wembley would be “a recipe for disaster.” But Britain’s left the European Union, so we don’t have to listen to them. The reason we left the EU was so we’d be free to spread our own germs in any way we want.

If the EU passes the law of gravity, we don’t have to follow that either.

The government’s making noises about lifting most of the remaining Covid restrictions in mid-July. When it isn’t saying that we may have to take some precautions. It’s hard to know which Boris Johnson to believe, but my money’s on him lifting most restrictions. I’m basing that on how many decibels are devoted to each side.

It’s not a prospect that makes me happy. As Mark Woolhouse, a professor of infectious disease epidemiology, said, “The UK is in a unique position. We’ve the biggest Delta outbreak in a well-vaccinated country. We are a petri dish for the world.”

The question is whether vaccination breaks the link between infection on the one hand and hospitalization and death on the other. The government seems to be betting that it will. My best guess is that vaccination will weaken the link but that without other controls–masks; an effective contact tracing system; reasonable sick pay for people who are supposed to stay off work–it won’t be enough.

 

Updating the list of Covid symptoms

Assorted experts are calling for the UK to expand its list of Covid symptoms. It currently lists only the Big Three: cough, loss of the senses of smell and taste, and a high fever. 

Europe’s list includes headache, weakness, tiredness, muscle aches, runny nose, loss of appetite, and sore throat–symptoms that often begin before the Big Three and are more common in young, unvaccinated people. 

But hey, we left Europe. We get to enact our own symptoms.

 

Your small dose of hopeful news

A small study showed the Johnson & Johnson single-shot vaccine to be effective against the Delta variant.

Is it safe to lift Covid restrictions?

The latest Covid statistics from Britain are both cheering and worrying, although they’re starting to tip toward worrying. 

Nothing’s ever simple, is it?

On May 12, the country had only 11 Covid deaths and 2,284 cases. Compare that to January 22, when 1,401 people died of Covid and January 8, when the country had 68,053 cases. (Deaths peak a bit later than cases, which is why I seem to be cheating here.)

Some 67% of the British population is at least partially vaccinated. 

That’s the cheery part. So why don’t I just shut up and celebrate?

Blame those pesky experts. Also the pesky data they work with. And more to the point, blame the government–I’d think something was missing from my day if I didn’t–which dithered about whether to quarantine travelers coming in from India and about changing its let’s-all-proclaim-lockdown-over-and-be-happy plans.

 

Irrelevant photo: Ornamental cherry blossoms. We tried growing non-ornamental cherries. The birds didn’t even bother to say thanks.

Stephen Reicher, from Sage, the government’s science advisory group, is warning that the government has to be prepared to not to “dither and delay as in the past” if it turns out that one of the Indian variants has figured out how to sidestep the vaccines. He talks about acting hard and fast, which–well, unless the government gets a politico-personality transplant, isn’t in the cards.

Three of the Indian variants are known to be in the U.K., and one of them in particular is keeping the scientists up at night. It’s called B.1.617.2 by people who can remember that it’s called that, and in a week the number of cases showing its profile doubled in Britain. 

Sorry, It didn’t double, it more than doubled, although we’re not talking about a big block of people yet. A few days back, it was 520. What’s worrying is that it could be more transmissible than the Kent strain of the virus, which is the one that used to keep scientists up at night. Possibly as much as 50% more transmissible.

To some scientists, the tea leaves are looking frighteningly similar to the ones they saw before the Kent variant caused a surge in December of last year.

Come Monday, pubs and restaurants will get the okay to serve people indoors, and indoors among maskless people is exactly where the Covid virus likes to come out and play. So that adds to the worry.

Other restrictions are on a let’s-get-rid-of-these-soon list, including working from home if at all possible. And the travel industry’s been pushing hard to get people going on vacations again. Or on holiday if you speak British.

The new system to allow overseas travel involves traffic lights. Red, yellow, green–all those soothingly familiar colors. Arrive from a red-light country and you go into the kind of hotel quarantine that signals We’re Serious about This. Right after you mixed in the airport with people coming from green-light countries, who get to take a test and go home. 

What’s on the test? Three math questions, one logic question that the government will get wrong, and the old standby, Who was buried in Grant’s tomb? (The answer’s below.)

Any virus that violates the rules will pay a fine. 

Assorted scientists are warning that viruses don’t play by the rules and that it’s very hard to collect fines from them. 

Will the government back away from the planned reopenings? It’s dithering. 

The assumptions behind this are: 1. that 72% of the population will be vaccinated by August or will be protected by having recovered from Covid. 2. that most of the deaths will occur in people who’ve been vaccinated, since although the vaccines are startlingly effective none of them gives 100% immunity–not even against hospitalizations and deaths, although early reports said they did. No one’s to blame there. We’re learning as we go, every last weary one of us.

 

Controlling the variant

One way that Britain’s hoping to keep control of the variant is by intensifying the vaccination programs in areas where clusters are found. I have no argument with vaccinating more people, but there’s a two-week delay between vaccination and a decent level of protection, this isn’t an immediate solution.

On top of that, although the vaccines provide a much greater level of protection than we had any right to expect, they’re not like having your big sister or brother ride the school bus with you. In other words, they don’t give you 100% protection against either bullies or Covid. And when we’re talking about numbers as large as, say, the population of a country, a 2% gap in the protection can end up affecting a lot of people. 

So even though we don’t have any indication yet that B.whatever-whatever can run faster than the vaccines, its transmissibility alone means it’s dangerous. 

Modelers are warning about the possibility of a third wave of infections that could be larger than last January’s. If, that is, the new variant’s as transmissible as they fear.

Am I worried? I’m not losing sleep, but I wouldn’t advise anyone I love to start a travel business right now. Or to eat indoors at a cafe or pub. Because there’s no way to eat or drink without taking that damn mask off, and busy as scientists have been since the pandemic hit, they haven’t sunk their teeth into a solution to that problem.

 

WHO weighs in on a related topic

The World Health Organization has warned that vaccinations are “life-saving, but on their own, they are not enough.” 

That’s in response to the US’s optimistic and (I think) mistaken decision that fully vaccinated people don’t have to wear masks in many indoor settings. 

According to WHO’s Mike Ryan, “Relaxing measures and taking away mask mandates should only be done in the context of considering both the intensity and transmission in your area, and the level of vaccination coverage.

“Even in situations where you have high vaccine coverage, if you’ve got a lot of transmission, then you wouldn’t take your mask off.”

 

Collapsing the curve or watching it skyrocket

Almost from the beginning of the pandemic we heard the phrase flattening the curve. It was one of those word clusters–a bit like herd immunity–that we came to think we understood because we’d heard so often. Or read it.

Well, a new approach to modeling the epidemic says that if you make enough changes at a crucial stage, the curve doesn’t flatten, it collapses. In other words, you get to lace on your big muddy boots and stomp the little bastard. 

And if you miss that crucial time? 

Um, yeah. You have a massive damn outbreak on your hands. Or feet, if we want to hang in there with the boots metaphor. 

The most interesting thing is that the modelers couldn’t come up with a scenario that put the results anywhere between those two extremes.

One of the most powerful ways to control an epidemic is to test known contacts of infected people (which of course means finding them first and quarantine them if they test positive). But there’s a limit to how many people you can trace and test every day. If the number of cases goes past that limit, the disease spreads and congratulations, you’ve just lost control of your epidemic.

The key is to act early and decisively. (See above, Mr. Johnson.)

“A policy that would have worked yesterday will not only take much longer to take effect, but it may fail entirely if it is implemented a single day too late.” Björn Hof, the central mind behind the modeling, said: “Most European countries only reacted when health capacity limits became threatened. Actually, policy makers should have paid attention to their contact tracing teams and locked down before this protective shield fell apart.”

What Hof didn’t say but what seems to be implied here is that Britain’s strategy of lifting restrictions anytime the virus settles down to a less threatening level is self-defeating and leads to another spike later on. 

 

 

All right, gloomy guts, how about some good news?

Okay. In animal trials, a nasal spray vaccine has created sterilizing immunity. That’s the kind of immunity that (in words of one syllable) could wipe this bug from the face of the earth–or at least from your lungs. It would stop you from getting Covid and it would stop you from giving it to someone else. 

The current vaccines can’t go that far. They minimize the risk, and with it they minimize transmission, but they don’t eliminate it.

The vaccine needs only one dose, you don’t have to look away while someone pokes a needle into your arm, and it doesn’t have to be transported at temperatures so cold that sound freezes from the air and thoughts shatter. You probably wouldn’t want to deep fry it, but you don’t need to refrigerate it either. 

But it’s still got a series of trials to go through before we can get our mitts on it. Keep your eye on this one, though. It sounds promising.

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A cheap Covid test is being developed that reports back in four minutes and is 90% accurate. 

This one can work with either a nasal swab or a saliva sample and it’s actually a bit more accurate with saliva samples, meaning people could stop sticking thin objects up their noses. 

Didn’t our mothers all warn us not to stick things up our noses? Do you have any idea what we’re messing with, using swabs to test ourselves?

It can also spot infections in the early stages, which is important since that’s when they’re most contagious.

Have I written about this one before? I’ve lost track. It seems like some fast, accurate test is always in development. And then we hear nothing more about it. I’m hoping we’ll hear more about this one.

 

So who is buried in Grant’s tomb?

Grant is buried in Grant’s tomb. (That’s Ulysses S., Union general during the Civil War and later president.) 

When I was a kid, some hundred or so years ago, we used to ask each other this. Repeatedly. Maybe we thought the answer would’ve changed. I don’t know if kids in New York still do it. Grant’s tomb is along the Hudson River, begging for kids to use it as the base of stupid questions. 

I haven’t tried the question on anyone in a British airport. I probably should.