What might a vaccine mean? It’s the pandemic news from Britain

Now that we (may) have a vaccine, let’s talk about what it could mean. Because it’s not all Problem Solved. We’ve had a little time to feel good, so now we get to look for monsters under the bed. They may turn out not to be there, but let’s take a look while it’s daytime. Just to be safe.

Potential monster number one: We don’t know yet whether the Pfizer vaccine will keep people who’ve been exposed to the virus from spreading it. It may, but it’s also possible that it–or any other vaccine–will keep people from getting sick but not keep them from being silent spreaders. That would mean we can’t end social distancing and can’t burn our masks.

I can’t tell if those are beady little monster eyes I’m seeing or if it’s the buttons I lost a couple of years back.

I really should clean under there more often.

Potential monster number two: If the Pfizer vaccine is the one we all go with initially, logistical problems are a certainty. It has to be kept at an insanely cold temperature–minus 70 C. That’s minus 94 F. Not even forty years in Minnesota prepared me to understand how cold that is. The worst I saw was minus 40 F., and I think that counted the wind chill. It was cold enough to freeze any thought other than How do I get indoors but wasn’t cold enough to impress this vaccine.

That’s going to be more of a problem in countries without a well-developed infrastructure and without the money for a supply of–um, what do you use to keep a drug at that temperature? Something with more insulation than your average lunch bucket. 

Irrelevant photo: mallow

Potential monster number three: How much of the vaccine can be produced how quickly, and at what cost. And how much of what’s produced will be available to poorer countries? Because until the virus is under control everywhere, it won’t be fully under control anywhere. 

Potential monster number three and a half: Initial supplies will be limited, and the British government’s drawn up a tentative list of what sort of people will be priorities, but no country’s likely to have enough doses for all of its population. So what does that mean?

Say a vaccine protects 70% of the people who get it. (This is based on an article that came out before the preliminary Pfizer announcement of 90% protection, so the numbers will change but the structure of the problem won’t.) If 70% of the population is vaccinated, which is unlikely at first, 49% of the population will be immune.

Why 49%? Why not 49%. It’s a nice number–just off balance enough to be convincing. What it’s not, though, is enough to give us herd immunity. If the priorities for vaccination are the oldest people, the most vulnerable, and (please!) the front-line workers, that will still mean that younger healthy people need to maintain social distancing, wear masks, and generally continue to live the way we’ve been living. And people who’ve been vaccinated probably will as well if the vaccine doesn’t keep them from being contagious. Otherwise they’ll endanger both the 51% of vulnerable people who haven’t been protected. And (I know, I keep saying this) younger people are more vulnerable to this than we tend to think, so they’ll endanger them as well.

But it’s not all monsters and buttons and dust bunnies under the bed. We’ve got some potential monster-slayers too. 

Sorry, I don’t mean to get bloodthirsty about this. If you’re squeamish about killing a virus, take heart: A virus is not actually alive. Or else it is. This is something microbiologists argue about. It all depends on how you define life. Either way, though, it’s them or us. It’s enough to drive even the most dedicated pacifist to sit down and have a good long think.

So, potential monster-slayer one: On a very long-term basis, it’s possible that young kids who catch the virus but don’t get sick will build up a generational semi-immunity and Covid will eventually become just another cold. It’s possible that the four coronaviruses that cause colds started out like Covid. One of the four left cattle and discovered humans around 1890–the same year as what’s been thought of as a flu pandemic but might, in hindsight, have been a cousin of Covid. 

It’s possible. It’s also possible that all that is wrong. And of course most of us have to live long enough and emerge healthy enough for that to matter.

Potential monster-slayer two: More immediately, with the introduction of a vaccine, testing and tracing come into their own. They’re most effective when case numbers are relatively low–much lower than Britain has at the moment– because a country needs to track and quarantine every case. A vaccine could put us in a position to use testing and tracing well. 

Of course, even if you only have three cases, you still need a competent track and trace system. I’m not sure ours is up to the challenge of three cases yet.

Early in the pandemic, South Korea used track and trace well and Joshua Gans of the University of Toronto says, “We need to all become South Korea as quickly as possible.”

That will mean ensuring that quarantine actually works. Estimates of the percentage of people in England who fully self-isolate when they’re supposed to are low (11% according to one study), and the situation isn’t helped by the lack of genuine financial support. Some people can’t afford to stay home. Others, presumably, don’t take it seriously.

One problem with testing has been that the fast tests are less accurate than the slow ones. A test that is 90% sensitive will miss 10% of positives. But don’t despair. Baffling math may save us here. “Two tests five to seven days apart are 99% sensitive in finding you positive–if you actually are,” according to epidemiologist Tim Sly.

No, don’t ask me. They’re numbers. I can’t explain why they do what they do. The main thing is not to let them sense your fear.

The recommendation is to test people frequently–frontline workers, people who fly, people who breathe. Some of the rapid tests can spot people who are actually transmitting the virus, not just people who have symptoms. 

So we’re not ready to have a massive, maskless, indoor party the day after the vaccine arrives. Or maybe even the year after the vaccine arrives. Put away the confetti. Take a bite of the ice cream, then shove it back in the freezer.

But the picture is changing, and even though we have a government that’s elevated incompetence to an art form, I’m hopeful.

Why young adults don’t have a get-out-of-Covid-free card

As the pandemic lumbers onward, we’re hearing more about long Covid–the debilitating long-term effects that some people experience after the disease has passed. Here’s what I’ve been able to scrape together:

No one who catches the virus knows what card they’ll pull out of the Covid deck. Some people have no symptoms, some people get sick and recover, and some people die. As far as most discussions are concerned, that’s it. Cards distributed. Can we play something else, please? 

Well, no, we can’t, because that middle group isn’t done drawing cards. Some of them recover fully, regardless of whether they had serious cases or mild ones, and some–even people who had mild cases–don’t go back to being the people they were before they got sick. And that includes young adults, the people we thought had a get-out-of-jail-free card for this disease. 

The symptoms of long Covid range all over the place. They can include exhaustion, brain fog, memory problems, breathlessness, depression, hair loss, concentration problems, loss of the senses of taste and smell, joint pain, muscle aches, chest pain, chills, sweats, digestive issues, coughs. Trouble going upstairs and trouble walking to the end of the street (the road, the lane, the whatever) get mentioned a lot. Fatigue sounds like the most common symptom.

Some people slowly get better and move on. Some improve a bit and slip back a bit and improve again and slip back again. Some seem to be stuck at the bottom. And it goes on for months. 

Does it get better? We don’t know yet. 

Semi-relevant photo: This is called honesty. I can’t recommend it highly enough, especially to politicians in the middle of a pandemic. It’s out of season at the moment, but let’s not draw any overarching conclusions from that. 

The Covid Symptom Study app–that’s not the official British test and trace app but it’s been downloaded by 3 million people and one cockatoo–says one person in twenty has long-term symptoms. Another app, this one in Scotland and Wales, comes up with one in ten having symptoms for longer than three weeks, some of them for months.

An article in the BMJ quotes Tim Spector, of the Covid Symptom Study, saying that if your version of Covid includes “a persistent cough, hoarse voice, headache, diarrhoea, skipping meals, and shortness of breath in the first week, you are two to three times more likely to get longer term symptoms.” 

Long Covid seems to be about twice as common in women as in men.

Or in one Paris hospital, four times more common. The same hospital said the average age of the long-haulers they saw was forty.

I know. The numbers are all over the place. These are early reports, a lot of them involving a small number of cases. They’re not carefully designed studies. It’s too early for that.

Another study said a third of patients who had mild symptoms hadn’t gotten back to their pre-Covid health after two to three weeks. The older the patient, the more likely that was, but a quarter of the people between eighteen and thirty-four hadn’t bounced back.

Many long-haulers report that many doctors don’t take them or their symptoms seriously–especially if they’re women. And gee, no, we wouldn’t want to draw any overarching conclusions from that either.

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Meanwhile, back at the Journal of the American Medical Association, a study reports that older people are underrepresented in trials of both Covid vaccines and treatments. 

Why’s that when they’re the most vulnerable to the disease? Because participation often depends on not having other diseases, or on having smart phones or internet access. 

That causes a problem, because older patients may need higher or lower doses of a vaccine or a medicine. Get it wrong and a cure or vaccine can be either toxic or useless.

Dr. Sharon Inouye said, “To be sure, some exclusions are needed to protect the health and safety of older adults—such as poorly controlled comorbidities. However, many are not well-justified, and appear to be more for expediency or convenience of the trialists.”

Did you say something about overarching conclusions?

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Okay, how much do masks, handwashing, and keeping a distance from people limit the spread of Covid? Considerably, according to a study in Thailand.

Wearing a mask all the time lowers the risk by 77%. Wearing it only part of the time you’re with someone does fuck-all. So that business about putting on a mask at a restaurant when you head for the toilets, then taking it off so you can sit back down and shovel food into your face? Useless. 

Keeping a meter away from people reduces infection by 85% and keeping contact down to fifteen minutes or less reduced the risk by 76%. Frequent handwashing? That reduced it by 66%. Add those all together and Covid will end up owing us. Or doesn’t it work that way?

If you’re wondering whether they’re talking about reducing the risk of passing on the disease or of getting it, I wondered the same thing.

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Researchers at Oxford University suggest that the best use of limited Covid testing resources would be to test people who are the most likely to pass on the disease–healthcare workers, transport workers, social care workers, delivery drivers, people who go to large gatherings, people in large cities–and to do it at regular intervals.

Random testing, they say, wastes resources.

Are we going to listen to them? Probably not. What do they know anyway?

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An anti-Covid nasal spray that’s been tested ferrets looks promising. It interacts with cells in the nasal cavity, waking up the immune system, which then kicks in and–

Okay, let’s not pretend I understand this. I’ll quote: It “kicks in like a defence shield which is broad-sprectrum and non-specific.” So presumably it slaughters anything it finds that looks suspicious. It’s odd how a moderately nonviolent person like my own bad-tempered self turns bloodthirsty when we’re discussing the immune system.

It’s too early to know if it’ll translate to humans. Or cause us to grow a glossy fur coat. 

“The hope is that it will reduce the duration and severity of the symptoms and if you reduce the number of viral particles in the nose, the hope is that it would reduce transmission – although they haven’t done those studies yet.” 

Hang onto that word hope. We need as much of it as we can get these days.

Stay well, people. I don’t have so many readers that I can afford to lose any.

Yet another game changer: It’s the pandemic news from Britain

The British government’s buying two new Covid tests that take only 90 minutes to cough out a result. As usual, they’re going to be game changing. I can’t remember how many times we’ve been told that, and here we are, still whacking the same old volleyball over the same old weary net. Or in my case, into the same old weary net. 

The reason I’m expressing just the slightest touch of cynicism about the tests–other than experience and generalized characterological weaknesses–is that next to nothing is known about the tests. How many false negatives do they produce? How many false positives? Dunno and dunno. No data’s been published.

That’s not a good sign. And the government has a track record of leaping in to buy pandemic goodies that then turned out to be somewhere between useless and not much better than.

Every last one of them was going to be either game changing or world beating. And no, we’re not competitive about this. We just don’t see the point of breathing if we’re not better than you lot.

Irrelevant photo: Yes, it’s a dandelion, doing its bit to help its species take over the world. Let’s be grateful it’s not a virus.

Okay, when I say “every last one of them” I’m exaggerating. The swabs they bought and then had to toss in the dumpster didn’t get much fanfare, but the useless personal protective gear that they sent planes to Turkey for? The fraction of it that reached Britain was practically greeted with confetti and marching bands.

The new tests are called DnaNudge and LamPORE. And they detect flu and other viruses and well as Covid-19.

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Watching how the press responded to the announcement of the new tests was interesting. On Monday–that was yesterday as I write this–they made front-page, huge-type, game-changing headlines in the sleazier papers and I wondered why the more responsible ones were either silent or downplaying the news. On Tuesday–today–they ran longer articles with a bit of analysis and skepticism. 

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Meanwhile, a group of not quite 70 virologists publicly criticized the government’s handling of the pandemic, especially the test and trace system, saying virologists are being bypassed.

One of the group, Deenan Pillay, said, “There’s always new tests being developed. And it’s almost as if they’re being pushed as a sort of magic bullet.” But what really needs to be done, he said, is “the more boring but really hard work of doing proper contact tracing.” 

Part of the problem is that the testing that is being done–much of it by private contractors –isn’t feeding data to the National Health Service or local public health officials, who would be able to follow up on it. 

The link for that is the same one as the one in the volleyball paragraph.

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The British government has told drug suppliers that they should have six weeks’ worth of drugs stockpiled before the Brexit cut-off date of December 31. In case the supply chain gets disrupted, what with this little pandemic we’re experiencing and all. Because there isn’t going to be an extension, no matter what. 

During  the Brexit referendum, Remainers warned that this sort of thing would happen. Brexiteers–a.k.a. the people who are now in government–called it Project Fear.

I wouldn’t say I’m afraid exactly, although maybe I should be. But I’d be a damn fool not to take notice. Excuse me while I go check our stash of omeprazole. It doesn’t get you high, but it does control acid reflux.

If that doesn’t tell you my age, nothing will.

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Russia says it will start production on a Covid vaccine in September and begin mass immunizations by October. Non-Russian experts are waving a few caution flags, though. The trials have been rushed, they say. 

Not much is known about the development process, but there’ve been rumors that Russia’s elite got a prototype vaccine in July. Emphasis on rumors. The Russian media reports that doctors and teachers will be among the first people to be immunized.

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A family went to a drive-in Covid testing center in a London parking lot, got tested without leaving the car, and were sent a notice that they owed a £90 fine for not paying for parking. 

The company that issued the ticket is canceling it. I’m not sure if the driver managed to get that done before the press got involved–they don’t make that easy–or if it was the publicity that magicked it away.

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A few more possible Covid risk factors and symptoms are being reported–still somewhat tentatively. 

Possible symptoms are hair loss, rashes, and hearing loss.  

Possible new risk factors might include being tall and being bald. Emphasis on might, but as a short, hairy woman I’m doing my best not to gloat.

The study on tall people has been criticized for not being well designed. It’s working theory, however, is that being tall exposes people to more of the aerosols that carry the virus. In other words, it’s nothing personal.

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According to a study by the Office of National Statistics, less than half of British adults are keeping to the distancing guidelines when they see family and friends, and 8% never keep to the guidelines.

The survey was based on people’s own estimates of their behavior, which is notoriously faulty. In an earlier survey, 79% of the people surveyed thought they were doing better than average on keeping to the guidelines. So we can probably figure the true figure is less than less-than-half. 

Speaking of notoriously faulty, I’m pulling that 79% figure from a notoriously unreliable memory–mine–so it may be off by a percentage point or two. But the original was well over the 50% you might reasonably expect.

The pandemic update from Britain: sniffer dogs and the return to work

England has approved a coronavirus antibody test that’s 100% accurate and highly specific. If England goes ahead and adopts it, Scotland, Wales, and Northern Ireland will probably do the same.

Being highly specific? That means it’s able to detect even a fairly weak antibody response. Being 100% accurate? That means it’s right. It’s a technical concept that sciency people like to use, but we can all get our heads around it if we pay attention.

The problem with the test is that it depends on a blood sample, so it has to be done by a medical person with a big, scary needle, and then processed in a lab. 

Why, other than the big, scary needle, is that a problem? Because you can’t just toss a bunch of tests in the mail for people to do at home and go home for a beer. You’ll have to organize testing. Preferably competently, and that’s where we hit a snag.

Irrelevant photo: love-in-a-mist

In the UK, the best way to do that would, almost inevitably, be through the National Health Service and, most heavily, local GPs, although they might need some extra (is anybody paying attention here?) money and staff. 

The government will probably centralize it, though, and hand the contract to huge private companies who’ve proved their competence by screwing up the testing program that’s in use now, which isn’t for antibodies but for current infections. Believing that private companies are more efficient than governments is a religious cult. 

And when the evidence shows that the opposite is true? You just draw the circle tighter and pray harder.

It’s an contradictory situation, though. Here’s a government demonstrating governmental incompetence through incompetent privatization and people who argue that government would be more competent criticizing the government for incompetence.

Did you follow that?

You might think that both sides of the disagreement should be equally unhappy, but you’d be wrong. Money’s being made. Someone’s happy.

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Just so’s we all understand this: It’s still not clear whether having antibodies to Covid-19 means you’re immune to it. Widespread use of the antibody test should give us some information about that.

What immediate good does the test do, then? Almost everything I read on the subject talks about people who’ve been exposed going back to work, happy in the knowledge that they won’t get the bug again, although we don’t exactly know that and neither do they. They might be immune. We hope they’re immune.

And, since I’m splashing cold water on things, the test having been approved isn’t the same and the test having been bought. Or produced in large enough numbers. The government and the test’s developer, Roche, are talking. You know, price, quantities, delivery dates, can we get it in blue? 

No? We really like blue.

The government’s also talking to the developers of other tests. Hang in there. We’ll know something eventually.

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Last weekend, lockdown restrictions were eased here in England and people who couldn’t work from home were urged to go back to work if they could do it safely, so Grant Shapps, Britain’s transport secretary, was flung to the press so he could reassure the nation. 

How’d he do that? He told us that the government doesn’t “know how the virus will respond” to lockdown’s semi-end. 

I feel deeply reassured, and I hope you do as well. 

Why was the transport secretary the one to get thrown to the press? Partly because people–having been told to avoid public transportation if they could–are using public transportation because how else are they supposed to get to work? Most people don’t have private planes. 

Also because he drew the slip of paper with the big red X on it.

He was especially reassuring about public transportation in London. 

“We have got the British Transport Police out there and we are even bringing in volunteers to remind people that we don’t want to see platforms crowded.”

Anyone who sees a crowded platform will then understand that they’re surplus to requirements and disappear in a cloud of blue smoke.

Would Shapps himself get on a crowded bus or train? an interviewer asked. Well, no, he said. And no one else should either. Please see cloud of blue smoke, above. 

In a different interview, he said, “Even with all the trains and buses back to running when they are, there will not be enough space. One in 10 people will be able to travel without overcrowding.” 

The news is full of pictures of packed tubes, trains, and buses in London. He’s an asset to the nation, Shapps is.

I’m still trying to figure out what “back to running when they are” means. 

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I suppose this is where I have to write about a railway ticket office worker, Belly Mujinga, who was told she had to work out on the concourse instead of behind the ticket office’s barrier, although she had respiratory problems. 

“We begged not to go out,” a colleague said. “We said, ‘Our lives are in danger.’ We were told that we are not even allowed to put on masks.”

A passenger spat at her and a co-worker and said he had the virus. Both women came down sick and Mujinga has died of the virus, leaving a widower and an eleven-year-old daughter.

A GoFundMe campaign has raised over £27,000 for the family. Which is heartening, but she’s still dead.

Mujinga’s employer, Govia Thameslink, has only just given CCTV footage of the spitting incident to police, after weeks of being asked for it. The spitter was described by a witness as male, white, fiftyish, and well dressed. The women he spat at asked their managers to call the police. That was on March 22. The police say they only got a report on Monday. 

Rail unions are threatening to strike if drivers and passengers aren’t protected from overcrowding. Let’s hope they include other workers as well, in memory of Mujinga if nothing else.

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So what are you supposed to do if your boss pressures you to go back to work but you don’t feel it’s safe–if, say, you’ve got a medical condition, or a family member who does, or an eight-year-old with no school to go to, or the workplace is too crowded, or your boss says you have to work out on the concourse? You probably have some protection under the law, but you’ll have to be pretty damn brave to claim it, because it could mean taking your case to an employment tribunal. It may mean risking your job.

How much money did you say do you have to fall back on?

Yup. That’s what most people say.  

In an interview, an employment lawyer said government guidance “seems to be suggesting that everyone who is not attending work but is unable to work from home should return to work, but they haven’t given much guidance to employers and employees about what exactly is expected if they have these difficulties turning up.”

She also said, “For example, if you’re a single parent with childcare obligations, we’ve seen some really unfortunate stories of mothers who are the sole parent and they’re stuck with children and they’ve been issued unfair ultimatums by their employer, wanting them to attend work on short notice when it’s just not possible.”

In the meantime, the business secretary, Alok Sharma, said workers don’t have an automatic right to walk out if they feel their workplaces are unsafe. 

“If somebody feels their workplace is not safe, they have to take that up with their employer,” he said. “If they don’t feel they are getting any traction they absolutely should get in touch with the Health and Safety Executive or the local authority.”

If I can translate that, if your workplace isn’t safe, you should follow the steps outlined above, keep on working, and hope you don’t die. 

Jason Moyer-Lee of the Independent Workers of Great Britain, which represents gig workers, said, “The return to work instruction is predicated on workplaces being safe because they follow new Government guidelines. The guidance is not law and is not mandatory.” In other words, he doesn’t think there’s much way to enforce it.

Just I think I’m too cynical–.

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Teachers’ unions are saying the proposals to reopen schools in England on June 1 are unworkable. They’ve urged teachers not to “engage with” preparations.

No, I’m not sure what “engage with” means either. Teachers will, though. They teach things. Whatever needs to be known, they know it. 

Schools have been told that they don’t need protective gear, that they don’t need to keep the recommended six feet of distance between people, and that smaller classes and hand washing (sorry–stringent hygiene; maybe we’re talking about deodorant) will keep them safe.

They have not been told to sing “Happy Birthday” while stringently hygienizing themselves.

None of the teachers’ unions were contacted about the reopening before it was announced last Sunday.

Stay tuned. It should be interesting. 

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A group of scientists who set up an alternative to the government’s official science advisory group have warned that the current strategy will bring more outbreaks of the virus and rolling lockdowns. It called for a campaign to test and trace, and to isolate infected people–and to scrap centralized testing and rely on GPs and local health teams, who can respond quickly to local outbreaks.

The current testing system doesn’t bother to send the results to GPs. And (anecdotal evidence warning here) doesn’t necessarily send the results to the people who’ve been tested either. Because what’re they going to do with them anyway? They’re all ignorant savages and it’ll only frighten them.

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Oh, hell, let’s take a break for a little good news. The furlough scheme, which pays up to 80% of furloughed workers’ wages while they’re off work in the pandemic, will be continued until the end of October, although the small and medium-size print is changing. As of August, furloughed workers can go back to work part time. And at some point–and no one knows where the point is right now–companies will have to start picking up part of the bill. 

How much does it cost? About £12 billion per month.

How much did the 2008 bank bailout cost? About £850 billion.

There is support for the self-employed, but everything I read about it leaves me more confused than I was before. A program exists. It leaves some people out. It seems to have just started registering claims and what self-employed people were doing for money until now is anyone’s guess. But it’s better than no support at all.

Sorry, this was supposed to be our good news break, wasn’t it? Okay, how about this: 

Sniffer dogs are being trained to detect the virus. Dogs can already be used to spot cancer, Parkinson’s, and malaria. It’s still in the trial stages, but if it works they should be able to spot people with no symptoms. Our dogs know when we’re carrying treats, even when we think we show no symptoms, so yes, I do believe this could work.

My thanks to Catladymac for pointing me at this story. I’d have missed it.

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And from the Department of Silver Linings comes this bit of news: The coronavirus lockdown could break the chain of transmission for HIV. The problem with HIV–other, of course, than that it kills people quite horribly–is that there’s a period of up to a month between the time a person’s exposed and the time current tests can detect it. And people can pass it on during that time. 

People who are on the current treatments can’t pass on the infection, and a drug that people can take both before and after sex reduces the risk of getting it, so the number of new cases in Britain is dropping anyway. But if no one has sex with new partners, it just might be possible to find everyone incubating the disease before they pass it on, treat them, and stop the spread of the infection. 

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When I started doing more frequent virus updates, I thought they’d be short. What’s happened, though, is that the more attention I pay to this, the more I find to include. I’m oddly apologetic about that, although I didn’t invent the virus. Or the idea of an update. Hell, if you don’t want to read them, you won’t.

Take care, everyone. Listen to doctors and scientists and your own good sense. Stay well.