Tag Archives: Operation Moonshot

Do vaccines keep us from transmitting Covid?

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One of the endless unanswered Covid questions has been whether people who’ve been vaccinated will still spread the disease, and evidence is piling up that they’ll spread it less. 

During their early trials, Pfizer didn’t test for asymptomatic cases, but AstraZeneca did and they fell by 50%. That matters, because asymptomatic people can still spread the disease, so fewer cases means less spread. Not to be outdone, Pfizer did its own study and reported that one dose of vaccine cut the risk of transmission by 70% and two doses by 85%. 

Don’t put too much weight on the differences in those numbers. They were measuring different things.

In Scotland, people living with vaccinated NHS staff were considerably less likely to catch the virus than people living with unvaccinated NHS staff. 

How much less likely? Considerably. Will you stop asking awkward questions?

Irrelevant photo: More daffodils.

Hospital workers in Cambridge showed a 75% decrease in asymptomatic infections, and an Israeli study showed that when vaccinated people did have infections they had lower viral loads, which would make them less infectious than people with higher viral loads. 

So if we’ve been vaccinated, can we throw a party for a few hundred of our closest friends as long as they’ve also been vaccinated? ‘Fraid not. The British government’s advice is that “the full impact on infection rates will not become clear until a large number of people have been vaccinated” and we should please keep our heads on straight and be cautious. 

Why? Well, consider what’s happened in Chile. 

 

Okay, what has happened in Chile?

It’s vaccinated about a third of its population with at least one dose–it’s vaccination program has been impressive–and even so it’s going into another wave of the pandemic. Both deaths and case numbers are rising and they’re threatening to overwhelm the health system. Some 20% to 30% of the country’s medical professionals have gone on leave because they’re exhausted, wrestling with health problems of their own and with thoughts of suicide.

“When transmission rates are high, the vaccine does not rein in new infections right away,” said Dr. Denise Garrett, an epidemiologist at the Sabin Vaccine Institute in Washington. “And with the new variants, which are more contagious, we’re not likely to see a big impact until the vast majority of the population is vaccinated.”

According to Dr. Francisca Crispi of the Chilean medical association, the government unlocked the country too quickly. It reopened its borders and loosened restrictions on businesses. It introduced a permit system that let people go on summer vacations–or holidays, if you speak British. So people came into the country. People went out of the country. People traveled around the country. Gyms, churches, malls, restaurants, and casinos reopened. Experts fretted, but the government stuck with it, reopening the schools at the beginning of March. 

Nobody traced anybody.

And it all felt so good.

So no. No parties for the time being. Sorry.

 

The mass testing report

A study of mass Covid testing in British universities and colleges reports that it was haphazard, expensive, and a lost opportunity.

The BMJ–a medical journal–sent freedom of information requests to 216 schools and got full information from only 16, leading me to think that information may be free but it’s still elusive. But never mind that. They got partial information from others and it was enough to draw some tentative conclusions.

The testing was part of the government’s Operation Moonshot, which was going to make the country Covid safe and avoid a second lockdown by testing people–lots of people–whether they had symptoms or not. Since it started, we’ve had not just a second lockdown but also a third.

Never mind, though. It’s been a good use of £100 billion. 

The university and college testing was just a small part of Op Moonshot, and the study estimates that every positive test result cost £3,000. It also says that’s likely to be a massive underestimate because it doesn’t include the staffing of test sites and whatever other costs are hidden under the rug. 

You’d noticed that the rug was lumpy? I tripped on it just this morning.

Angela Raffle, consultant in Public Health and honorary senior lecturer at Bristol University, said the testing program was “a desperate exercise in trying to get favourable publicity for number 10, trying to get rid of the Innova test mountain, and trying to change the culture in this country so that we start to think that regular tests for everybody is a worthwhile use of public resources, which it isn’t.”

Number 10? That’s the center of the British government.

And the Innova test mountain? It’s made up of £1 billion (as far as I could figure out) worth of quick-result Covid tests that the government bought and which turn out to work best on people who have a high viral load. In other words, they’re exactly what you don’t want to use on asymptomatic people–the program’s target audience. 

And they’re even less accurate in the hands of non-experts. 

So who’s using them? Non-experts. 

We’ll skip the most confusing of the numbers involved in this and settle for these: Let’s say you use them to test 100,000 people and get 630 positives. Of those, 400 of those will be false positives, and you will have missed half the positive cases (that should, I think, be 230) in your sample. If that isn’t worth £1 billion, I don’t know what is. Or even £100 billion. Because what’s £99 billion between friends? 

Regular testing of secondary school students was rolled out this spring, although it’s too early for anyone to have statistics on how effective or expensive that will be. The program was sold to us as a way to reopen the schools safely. 

Stephen Reicher, a member of Sage, the government’s science advisory group, said, “The government keeps on seeking quick fixes based on one intervention. What they consistently fail to do is build a system in which all the parts work together to contain the virus.” 

 

Vaccine passports vs. mass testing 

All of this is particularly relevant because Boris Johnson–our prime minister when he’s working, which he does sometimes do–just backed off his plan to introduce vaccine passports and announced that we’ll use mass testing instead. But only in England. Scotland, Wales, and Northern Ireland are doing whatever the hell they want because that’s how it works around here. 

Are you confused? Then you understand the situation.

The vaccine passports were supposed to allow people into crowded events, but MPs from across the political spectrum opposed them, including a good number from his own party, and they were joined by an assortment of civil liberties groups he wouldn’t normally listen to but what the hell, let’s mention them anyway. They’re particularly problematic because not everyone’s eligible for the vaccine yet. 

So instead of vaccination passports, everyone in Britain is going to be offered two rapid Covid tests a week. 

How many of us will use them? My best guess is not many, given the odds of coming up with a false positive and having to self-isolate. For someone who’s retired, that’s a minor inconvenience. For someone who’s working and can’t afford to miss a paycheck, that’s a disaster. 

The usual suspects are saying this would work better if people were paid enough to live on when they can’t work. And if the contacts of anyone who tests positive were traced effectively.

The usual suspects will be ignored. 

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Last weekend, the government announced a pilot program of nine events to try out Covid passports. Presumably that was before it abandoned the idea, who your guess is as good as mine, which is roughly as good as theirs. Five of the nine venues said they had nothing to do with the program. 

You have to love this government. It’s a gift to satirists everywhere. If only it wasn’t supposed to run the country as well.

 

Other vaccine news

Russia has announced a Covid vaccine for animals, Carnivak-Cov. The idea is to prevent the virus circulating in dense animal populations, where it can mutate and spread back to humans. 

And Pfizer reports that its vaccine is effective in kids between 12 and 15. It’s still testing kids between 5 and 11 and any minute now will begin tests with kids between 2 and 5. All of that’s important because although kids are less susceptible to Covid, they can sometimes get very sick indeed and can less rarely get long Covid after a mild bout of the disease. 

They can also form a nice reservoir where the disease can sit and breed before returning to the more susceptible adult population.

 

And your light relief for the day is…

An art director, David Marriott, was stuck in Australian quarantine after flying back from his father’s funeral and was going ever so slightly nuts with boredom, so he made himself a cowboy outfit out of the brown bags that his meals came in when they were left at his door.

Then–as anyone would do–he realized that any serious cowboy needs a horse, so he made one, also from brown paper, but plus the ironing board and a lamp. Its–or, I guess, his–name is Russell, and Marriott’s asked for a pet walking service.

The photos are worth clicking through for–not just Marriott brushing Russell’s teeth, but Russell lined up to use the toilet since the management turned down the pet walking request. Russell’s in quarantine too.

Marriott’s thinking about adding a cat and a dog next. 

Can you catch Covid outdoors? 

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If you work at it, yes, you can catch Covid out of door, but fresh air dilutes the virus, moves it off in directions that aren’t toward you, and it dries up the little liquid space suits it travels in. And sunlight kills it. 

Zap. Take that, virus.

So far, somewhere between one case and very few cases of outdoor transmission have been documented. But not documented isn’t the same as impossible, so let’s look at the risks.

At the riskier end of outdoor contact are extended face-to-face conversations where people get too close to each other. We still need to keep our distance, especially during the colder weather, because the virus likes the cold. 

Also risky are what in Britain are called market stalls–outdoor markets that are often under three-sided tents–don’t have the advantage of being fully ventilated. They’re safer than the indoors, but the air doesn’t circulate freely through them. Ditto bus shelters. 

And crowds. 

In those situations, the experts recommend masks, even outdoors.

Irrelevant photo: A wallflower. Yes, it’s a plant, not just someone who clings to the wall at a dance.

But Professor Cath Noakes said she doesn’t “want people to be terrified of passing each other in the street.” To transmit the virus that way, someone would have to cough right at you and you’d have to inhale at just the wrong moment. On the other hand, running with someone so that you’re following in their slipstream for an extended period of time might be a problem.

“The sad fact is that your greatest risk is from the people you know.”

It’s not impossible to pick the virus up from a contaminated surface, but it’s a lot less likely than breathing it in. 

 

Lockdown: the effect and the politics

On Saturday, Covid cases in parts of England were starting to level off. Or by a different set of calculations, the number of infections  is declining in the country as a whole, although it’s still going up in a few regions (including mine, thanks). Either way, the lockdown seems to be having an impact. But I’m going to have to leave you linkless on that, because every link I can find is behind a paywall. I got it from an actual piece of newspaper that I spilled tea on yesterday.

Quite a lot of tea. 

You can’t do that to your computer and expect it to survive.

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A former Supreme Court judge, Jonathan Sumption–known to his friends and family and all the kids who were in kindergarten with him as Lord Sumption–has made a name for himself as an anti-lockdown advocate. Let the old and vulnerable isolate themselves, he argues, while the rest of the world carries on as usual. 

And so it came to be, children, that he was on a TV show telling a woman with stage four bowel cancer that he hadn’t said her life wasn’t valuable, he’d only said it was less valuable than other lives.

Not just telling her, interrupting her to tell her. Because what some people have to say is more important than what other people have to say.

Don’t feel bad for her. She held her own.

“Who are you to put a value on life?” she said. “In my view, and I think in many others, life is sacred and I don’t think we should make those judgment calls. All life is worth saving regardless of what life it is people are living.”

Lord S. has since said that his comments were taken out of context.

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A group of Conservative Members of Parliament, though, is getting twitchy about lockdown. Some 70 of them have formed the Covid Recovery Group, which worries about “draconian restrictions” and wants to know when “our full freedoms will be restored.” They can be assumed to be after Boris Johnson’s job–but that’s an assumption. And they can’t all have it.

 

Covid testing and the schools

Somewhere back there, Boris Johnson presented us with a plan to reopen the schools safely by testing the kids every week. Or every day. Or every minute of every day. It was going to be miraculous and world beating and headline grabbing. What’s more, it was going to work, which would make a nice change. 

Or maybe it wasn’t going to work, because the Medicines and Healthcare products Regulatory Agency (known to its friends as MHRA) wouldn’t authorize the tests. It’ll give people a false sense of safety if they test negative, it said. 

This is a £78 million plan and part of the government’s £100 billion Operation Moonshot, which involves not putting a shot glass on the moon but mass Covid testing of various and miraculous sorts. 

The testing started in secondary schools and was scheduled to expand into primary schools (vulnerable kids and the kids of key workers are still in school), and move from there to universities and workplaces. 

The government’s already spent £1.5 billion on lateral flow tests made by Innova, which are fast and, unfortunately, not accurate. They miss a lot of people who are carrying the disease, and miss even more when nonprofessionals use them. 

In response to the MHRA not approving the plan, the government said, “So what? We don’t need regulatory approval because this is assisted testing.” (You understand that I made up that quote, right? But it’s true to the spirit of what they said.) 

Assisted testing is when someone sticks the swab down their own throat and up their own nose. Under supervision–that’s the assisted part, I believe. So it’ll be a seven-year-old supervised by a teacher with no medical background. Using a test that works its imperfect best when done by a professional.

I don’t have a problem with that. Do you?

The plan is that the close contacts of confirmed cases will be tested every day for seven days. If they’re negative, they can stay in school.

The MHRA, on the other hand, said it “continues to advise that close contacts of positive cases identified using the self test device continue to self-isolate in line with current guidelines.”

 

Tipping right over the edge

A super-Orthodox rabbi in Israel has warned people not to get vaccinated because the vaccine can turn people gay. 

He should be so lucky.

The logic is as follows: “Any vaccine made using an embryonic substrate, and we have evidence of this, causes opposite tendencies. Vaccines are taken from an embryonic substrate, and they did that here, too, so … it can cause opposite tendencies.” 

Are you following this? 

I’m not doing so well with it either. I did ask Lord Google about embryonic substrates and he was resolutely unhelpful, so I’ll nod vaguely, say, “Uh huh,” and sidle quietly out of the room while the good rebbe’s attention is distracted. Being ultra-Orthodox, he (and I admit I’m guessing here, and probably being influenced by stereotypes as well) probably doesn’t have a lot of time to talk with women anyway. 

In response, an Israeli GLBT etc. organization (that stands for gay, lesbian, bacon, and tomato, with whatever else you can fit between two slices of bread without disaster ensuing)–

I’ve lost the thread there, haven’t I? An Israeli GLBT etc, organization has announced that it’s gearing up for a massive influx of new members. 

Israel has managed to vaccinate a large swath of its population–2 million people in a population of 9 million have had at least the first shot. So far, no noticeable change in their sexuality has registered on the Richter Scale. 

What Israel isn’t doing is vaccinating the Palestinians who live in territories under its control. 

A public service announcement

For the record: I am not related to Senator Josh Hawley–much to his relief. 

The problems with mass Covid testing

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Britain started a £100 billion Covid testing program, Operation Moonshot, which is supposed to catch asymptomatic cases so people can quarantine themselves instead of transmitting the disease and life can return to normal. The plan is to screen millions of asymptomatic people every week, and it’s being tried out in Liverpool as I type. 

Which sounds great, but Dr. Angela Raffle, a consultant to the UK national screening programmes, said, “It worries me that ministers . . . can wake up one morning saying let’s spend £100 billioin on this and not have it scrutinised–it would be like building a Channel tunnel without asking civil engineers to look at the plans. . . . This seemed to me to be the most unethical proposal for use of public funds or for screening that I’d ever seen.”

Other than that, though, it’s a good plan.

Irrelevant photo: apple blossoms–a photo I stole from last spring. 

The program relies on the Innova lateral flow test, which when it’s used by research nurses catches 76.8% of positive cases. When it’s used in the real world by what the article I read called “self-trained staff,” though, it picks up only 57% of positive cases. And Jon Deeks, professor of biostatistics, said people aren’t being told that they still might be carrying the disease, so if they test negative they feel safe to do–well, whatever they haven’t felt safe to do. Visit granny in the nursing home or tear off their masks and run through twelve supermarkets breathing heavily on staff and fellow shoppers. 

Nursing homes in three counties, including mine, are trying out rapid tests to allow visitors in. The publicity I’ve seen doesn’t mention the possibility of false negatives. It’s all how great it is that granny got a visitor. And up to a point it is great. I’m sure granny was pleased. I also hope it doesn’t end up killing her.

The good news is that the test doesn’t generate a lot of false positives. 

Italy was the first country to use mass testing–they used antigen tests–to control the virus, and it seemed to be working, which encouraged other countries to try it, including Britain. Italy’s now in its second wave of Covid. It went from  500 cases a day in August to more than 35,000.

So what went wrong?

Andrea Crisanti of the University of Padua says the tests were used the wrong way and that using them to protect vulnerable people in care homes was “absolutely criminal,” because of the infected people they miss–the false negatives.

The tests they used are 80% to 90% accurate and give both false negatives and false positives, but they’re quick and they’re cheap. If they’re used, say, before people catch a train, they could reduce travelers’ exposure. But they wouldn’t eliminate it because, again, they don’t catch every case.

Crisanti said, “If your objective is to screen a community to know if transmission is there, fine.” But the quick tests, he said, need to be backed up with the more accurate but slower PCR tests, along with stay-at-home orders.

There doesn’t seem to have been–or to be–any strategy for what to do with the information beyond simply boosting the number of tests.

In an article about how antigen tests were used in the US, the website ProPublica writes that “When health care workers in Nevada and Vermont reported false positives [from the tests], HHS [that’s Health and Human Services, a federal agency] defended the tests and threatened Nevada with unspecified sanctions until state officials agreed to continue using them in nursing homes. It took several more weeks for the U.S. Food and Drug Administration to issue an alert . . . that confirmed what Nevada had experienced: Antigen tests were prone to giving false positives.”

In nursing homes, false positives are as dangerous as false negatives. A person who tests positive will be moved in with other people who test positive. If the test gives out some false positives, healthy people will be exposed to Covid, making the test a self-fulfilling prophecy.

The tests HHS recommended are meant for people with Covid symptoms, and when they’re used that way they produce virtually no false positives and catch 84% to 97%  of positive samples in a lab test. But a study–like many Covid studies, it hasn’t been peer reviewed yet–found them catching only 32% of positives in people without symptoms.

Still, HHS is recommending them for use on nursing home residents without symptoms and suggesting repeated tests to reduce false negatives. An October survey found that a third of nursing homes hadn’t touched the antigen tests they’d been given. They didn’t trust them, they didn’t have the staff time, and the paperwork and reporting requirements were more than they wanted to deal with.

Dr. Rebecca Lee Smith, an epidemiology at the University of Illinois, said, “It’s how you use the tests, not just how many tests you have.” If you have a million tests, is it better to test a million people once, or test half a million people who are at high risk twice, or test essential workers five or 10 times? 

If anyone has an answer to that question, I haven’t seen it in print yet.

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Earlier this week I introduced the game Where’d the Money Go? and missed some of the more outrageous examples of where the money’s gone. I plead extenuating circumstances, because a National Audit Office report hadn’t hit the news yet. So let’s make up for my lapse. 

Sorry. I do try to sneak some good news into these posts. Some weeks, it’s like fighting gravity.

Early in the pandemic, in an effort to get protective gear for the health and social care systems, the government set up a high priority contracting channel for businesses that were recommended by ministers’ offices, lords, politicians, or officials. Oddly enough, those lords and politicians seem to all have ties to the ruling party, the Conservatives.

The rule of the playground is that we don’t share.

Their bids that went through that channel were ten times more likely to be successful than the bids that went through ordinary channels. One source said their pitches were automatically treated as credible. The documentation is–

Quick, someone, what’s a shoddier word than shoddy? Paperwork documenting why a particular supplier was chosen is sometimes missing. Contracts were sometimes drawn up after the work had been started. 

The person who recommended the company to the priority channel is documented less than half the time. No rules for how the priority channel should operate seem to have been written.

This was in the first six months of the pandemic, when £18 billion was spent on Covid-related contracts.

Liz David-Barrett, a professor of governance and integrity (that’s what she studies–I’m not commenting on her personal qualities), said that firms recommended in this way are usually treated as higher risk rather than lower.  

In a related story, although I can’t say what channel this contract went through, Gabriel Gonzales Andersson made £21 million for wandering through a deal between the UK government and an American jewellery designer, Michael Saiger, to procure protective gloves and gowns from China. 

According to the BBC, Gonzales Andersson was paid to find a manufacturer for deals that had already been arranged.

If you can figure out what happened between the two, you’re doing better than I am, but they’re both in court in Florida–suing each other, I think, although I can’t swear to that. Saiger had several follow-up contracts, and the gear he was supposed to supply was delayed, possibly because the relationship between the two men fell apart.

One more example before I stop: Lord Feldman, a former chair of the Conservative Party, and a managing director of the lobbying firm Tulchan Communications, acted as an unpaid advisor on Covid. 

Tulchan is also called a public relations firm; flip a coin if you care.

After the firm Oxford Nanopore signed a £28 million contract with the Department of Health, and also after Feldman stepped down as an unpaid advisor, Nanopore hired Tulchan. The health secretary, Matt Hancock, happens to have met with both Feldman and Oxford Nanopore before the contract was signed. I have no idea what they talked about. Movies, probably. Pornography. Gummi bears. Surely not whose money would end up in whose pockets. I wasn’t there. That’s how the gummi bears came into it. 

Tulchan says Oxford Nanopore was already in discussions with the Department of Health before the meetings, so everything’s fine.

Nanopore later picked up another £100 million in contracts.

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The British Medical Association has gone public with advice on how to lift the current lockdown. The approach last time was, “Wheeee, that’s over. Go out, have fun, spend money. Don’t work from home. The economy needs you.”

That was followed by a faint, “And, oh, do be careful, okay? Wash your hands or something.” 

Which is one of several reasons that we’re now in a second lockdown. 

What the BMA advises includes giving local public health teams more of the test and trace budget, along with more oversight of the program; limiting socializing to two households instead of six people; keeping the local tiered lockdown system that imposes varying restrictions depending on an area’s level of infection but banning travel between areas in different tiers; encouraging people to work from home if they can; and replacing guidance about how to keep workplaces and public areas safe with rules about how to keep workplaces etc. safe. The theory goes that rules are enforceable and might be taken more seriously.

Dr. Chaand Nagpaul, the BMA’s chair of council, said, “The big question in practical terms is can we reopen hospitality venues–pubs and restaurants–in the run-up to Christmas and still avoid infection levels increasing?

“I suspect we can’t, but the decision may be made to do so anyhow on the basis that any increase will be slow and may be able to be counteracted later.”

Because what the hell, it’s Christmas. What do a few extra deaths matter?

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If I haven’t managed to be funny this time–and I’m pretty sure I haven’t–I’ll try to do better next time. It’s not that this stuff isn’t funny, in a demented sort of way. But it takes time to find the humor and I want to get this posted before the next wave on insanity breaks over us. 

Stay well. It’s dangerous out there.