Covid-19 Politics

A report from South Dakota on Channel 4 News in the UK last night suggests little is going to change in the State and that as a result more people will fall ill, and too many die. In the same segment one citizen believes his indiviidual liberty cannot, and should not be interfered with by a politician, moments later, a nurse pointing out every hospital bed in the State is full and that they cannot cope with the impact of the virus. She conceded that however angry she is with the irresponsible people who take no action to limit their interactions with others, she is powerless to change the way they behave.

Individual liberty is indeed a precious right, but 'no man is an island, entire unto himself', and until people -in whatever country they live- recognize that their social behaviour has consequences for others that mght threaten their liberty, this virus will have a happy home, and home have unhappy families.

https://www.cnbc.com/2020/11/27/oxfo...e-trials-.html

Over the past few days there have been some concerns about the quality of the data provided from the Oxford/Astrazeneca trials. The larger trial showed efficacy of 62% for two doses of the vaccine. A second protocol, carried out in a smaller cohort that only included people between the ages of 18 and 55, and which used a half dose followed by a full dose, had an efficacy of 90%. The reported efficacy of 70% was the average of these groups.

It turns out that the half shot was administered by mistake. They discovered it was a half dose after the fact and were surprised that this resulted in higher efficacy though there are questions about the fact that the group did not include elderly people. There are also questions about whether it should have been averaged with the data from the two full shot protocol since they were different study designs. Will there be further studies of the half dose/full dose regimen to establish its efficacy?

It will probably get approved in most places and its price and logistical advantages are important. More in the times article below.

https://www.nytimes.com/2020/11/25/b...ca-oxford.html

https://www.sciencemag.org/news/2020...evere-covid-19

This is a good write up on the most recent results from the Moderna vaccine trials. The vaccine had 94% efficacy in preventing symptomatic disease and none of the people in the vaccine arm developed severe disease. That is going to be an important measure to watch as 6% of millions of people is still a substantial number of people with covid once everyone is vaccinated.

So far it looks like Moderna's vaccine is the most promising. It doesn't need to be stored at super cold temperatures like Pfizer's and is much more effective than the Oxford/Astrazeneca vaccine.

The FDA makes the decision on EUA approval on December 17th and Moderna hopes to provide 20 million doses by the end of the year.

On the one hand it seems to me that it is the lack of a robust system of barrier measures in the US that is resulting in record numbers of people falling ill, and dying from Covid 19. The White House holds parties where people without masks congregate, apparently Secretary of State Pompeo will have Christmas parties where people can congregate without masks, and when the White House Press Secretary Kayleigh McEnany spoke to reporters yesterday her husband stood at the back of the room not wearing a mask. As for those Governors who refuse to impose severe limits to human congregation, perhaps iike the President they don't much care how many people die or fall ill when there is Golf to play.

On the other hand, I ought to be pleased to report the first vaccines against Covid 19 have arrived in the UK from Belgium, even that there are signs that the R rate is declining, but even as the UK continues to struggle with this viral infection and its management. Does it mean the US should adopt the social distancing measures the UK has imposed -even though they appear inadequate when compared to countries with a better record?

Designating parts of the country as being in three Tiers of severity means, for example, that in Tier 2 "pubs and bars can also open until 23:00, but only if they operate as a restaurant. Alcohol can only be served with a substantial meal"
https://www.bbc.co.uk/news/business-52977388

But if you thought that was clear, try defining what a 'subsantial meal' actually is, because Michael Gove, who along with Chancellor Rishi Sunak is one of the most favoured replacements for Boris Johnson should he be ousted in the year ahead, has, shall we say, 'egg on his face' by failing to convince anyone, let alone himself, what a 'substantial meal' is.

When it turns on a Scotch Egg, you have to wonder if three tiers make sense -in the space of an hour, Gove on the Radio confirmed that a Scotch Egg is a 'starter' not a substantial meal. An hour later he said ""A scotch egg is a substantial meal. I myself would definitely scoff a couple of scotch eggs if I had the chance".
https://www.thelondoneconomic.com/po...l-farce/01/12/

Hmmm...one Scotch Egg is a Starter, two is a meal? Could that be where the distinction lies?

And for the record, the Scots had nothing to do with this egg, boiled and encased in sand. But the true origins are disputed -it originated as a snack -yes, a snack- for the rich to take with them on long carriage journeys, or to be taken on the long train journey from London to Ediburgh; or it originated in India, and like Kedgeree was brought back to the dining tables of old Colonials...or, whatever. If you must, buy one in a pub with your ale, and get tucked in. And don't worry what the Americans will use as a substitute if they have Tier 2 restrictions and bars can only open if they serve a 'substantial meal'.

I wonder what Tucker Carlson would make of it?

The wondrous contentions of the Scotch Egg are debated here-
https://theculturetrip.com/europe/un...he-scotch-egg/

China's Covid-19 gambit

https://science.sciencemag.org/content/370/6522/1263

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Originally Posted by sukumvit boy

China's Covid-19 gambit

https://science.sciencemag.org/content/370/6522/1263

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Thank you for linking this fascinating article. On the one hand, China is good at a lot of things -science, selling itself abroad, and they now need to use the positives to repair a damaging virus that has possibly slowed foreign investment in China for a decade. On the other hand, China is aso good at lying, deceiving and using 'stuff' -infrastructure development in Africa, these vaccines - to 'make friends and influence people'. So, in the article, it is stated in one paragraph that "With the pandemic vanquished at home, China is vaccinating its people as insurance—often, against a dangerously infected world." A few paragraphs later, "Yip says the government was even considering vaccinating all of Beijing after a COVID-19 outbreak there in June." ---vanquished? Under control? I don't want to demean the Chinese achievement, but I think a) it is too soon to judge the efficacy of its vaccines over the long term, and with a diverse population receiving it in terms of age, medical condition, etc; and b) China does not give open access to its data, so we don't actually know what the health profile of the country is with regard to Covid-19.

But much food for thought.

Yes,great article well worth the read.
I find it interesting that China's gamble in deciding to produce a 'whole killed virus vaccine' seems to have paid off. Whereas 'Operation Warp Speed' rejected the idea from the beginning due to the history horrific side effects and problems with killed vaccines in the past ,which are well documented and explained in the article .
However it gives one pause to consider the cost in lives and commerce we have incurred in waiting for the more sophisticated and expensive 'messenger RNA ' vaccines now being released in the West. After all ,China was vaccinating thousands as early as February and hundreds of thousands beginning with a wide release of vaccines in June(outside of clinical trials).

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Originally Posted by sukumvit boy

I find it interesting that China's gamble in deciding to produce a 'whole killed virus vaccine' seems to have paid off. Whereas 'Operation Warp Speed' rejected the idea from the beginning due to the history horrific side effects and problems with killed vaccines in the past ,which are well documented and explained in the article .

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That's the difference between dictatorship and democracy - an authoritarian regime has more scope to take risks with the lives of its citizens. This doesn't necessarily mean that the Chinese approach is the right one for the future. Sometimes risky gambles pay off through luck. The outcomes might be different if the same approach was repeated many times over.

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Originally Posted by sukumvit boy

Yes,great article well worth the read.
I find it interesting that China's gamble in deciding to produce a 'whole killed virus vaccine' seems to have paid off. Whereas 'Operation Warp Speed' rejected the idea from the beginning due to the history horrific side effects and problems with killed vaccines in the past ,which are well documented and explained in the article .
However it gives one pause to consider the cost in lives and commerce we have incurred in waiting for the more sophisticated and expensive 'messenger RNA ' vaccines now being released in the West. After all ,China was vaccinating thousands as early as February and hundreds of thousands beginning with a wide release of vaccines in June(outside of clinical trials).

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Moderna's mRNA-1273 vaccine was produced in January. Within weeks of the virus being sequenced they had already designed a vaccine. As far as I know almost the entire time was taken up by phase 1-3 clinical trials. I don't believe the time difference was the product of using mrna instead of an inactivated vaccine. https://en.wikipedia.org/wiki/MRNA-1273

I wonder what kind of safety data they could have had by February or even June. Just having read about antibody dependent enhancement makes me think China was risking an ugly outcome for their people. ADE basically means that a person raises an antibody response from the vaccine but the antibodies not only don't block entry of the virus into cells but facilitate it. So people not only don't have protection against the virus but actually get sicker. There are a whole series of other ugly risks that are difficult to rule out without clinical trials.

I stopped reading about vaccines once Moderna's data came out though I am still interested in what happens with Johnson and Johnson's one shot vaccine.

Giving people untested vaccines is a good way to cause widespread harm and reduce confidence in them. Right now for Pfizer and Moderna we've seen data for effectiveness in preventing symptomatic disease. We don't yet know how effective they are at preventing people who are vaccinated from having asymptomatic infections that they can spread to others.

Yes, a large factor in Operation Warp Speeds' decision to forgo a whole killed virus vaccine was the fear that the possible side effects would undermine the public's confidence in vaccines in general in a world already full of 'anti vaccers'.

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Originally Posted by sukumvit boy

Yes, a large factor in Operation Warp Speeds' decision to forgo a whole killed virus vaccine was the fear that the possible side effects would undermine the public's confidence in vaccines in general in a world already full of 'anti vaccers'.

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Before watching all of this unfold I had never followed the clinical trial process and what wasn't intuitive to me I slowly adjusted to because I heard enough scientists explain the process. What wasn't intuitive is that we would have an effective and safe vaccine at the very beginning of a disease that ended up killing more than 300,000 people here in ten months, but that it would take exactly that long to figure out whether it was safe and effective.

Even if we don't take into account the possibility that the public would use a very bad outcome from a poorly tested vaccine to refuse vaccination ever again, I wonder what the expected average outcome would be of vaccinating people after a couple of months with only the quickest of studies to assess tolerability and some optimization of doses while measuring antibody titers, t cell response, trying to guess correlates of immunity, and picking the best option. Then we vaccinate the highest risk people gradually, while telling them not to change their behavior based on the expectation they have immunity and in parallel run the full sequence of clinical trials because some control is needed to actually assess the data although there would be safety and efficacy monitoring of people who are vaccinated. If the vaccine was unsafe, how many people would be impacted by the time they figure it out?

I suppose from the standpoint of the Chinese, they are probably able to force people to get vaccinated and so public confidence in vaccines matters a bit less (I am not trying to take a gratuitous shot at their government but I don't think they would have an issue with forcing people to get vaccinated). Maybe they thought they could run parallel trials while vaccinating at risk individuals that they think would produce a better average outcome.

The vaccine has become a Seventh Cavalry in the siege. I read today that with regard to the 'Flu, there are currently 'four flavours' and that immunologists who specalize in 'flu have learned how to identify them and modify the vaccine, so the 'flu jab I get every year (I had my last one in early November, free of charge, of course) is not precisely the same vaccine as the one I had in 2019.

On one level we should not underestimate the science, which may not be in control of Covid-19 + variants, but has not lost control either. What we have seen in the UK is a loss of control by Government. The new strain of Covid-19 that has led to this panic and the end of free movement outside the UK was first identified in September, and we don't know if relaxations on social mixing encouraged it to spread -but it has already reached Australia from the UK and I think just from two people entering the country.

This re-emphasizes how wickedly clever this virus is in attaching itself to our organs, and the need to either maintain, increase, or in the case of some countries (hint: the US) introduce social restrictions with an inevitable economic effect. Indeed, the ban on travel into Europe from the UK ought to have been part of the UK Government's stategy in March, but there was no strategy, no national co-ordination, just a few wings and some prayers. Prayers may soothe the soul, they don't end pandemics.

2021, from the UK's perspective, looks as bleak as 2020. I doubt we will see an end to the persistence of this virus for most the year, maybe late Summer if you want a positive view. Brexit complicates everything, which is why a sense of gloom is descending on the country even Boris Johnson won't be able to raise, assuming he stays in office long enough to try it.

Science can only do so much, the rest is up to us.

Flu viruses:
https://www.cdc.gov/flu/about/viruses/types.htm#:~:text=There%20are%20four%20types%20of, global%20epidemics%20of%20flu%20disease.
Corona viruses:
https://www.cdc.gov/coronavirus/types.html

Nine months into a pandemic in which 330,000+ people have died in the U.S. we still have people complaining about the tyranny of public health guidelines. What is the end game they asked one month into the pandemic when we were already a month into the greatest collective effort to develop a life-saving vaccine the world has ever seen.

The end game was to develop herd immunity by vaccine instead of through mass sickness and death. What we did was operate in limbo where the economy could not thrive but people would still get sick and die. By ignoring what has happened in the rest of the world some people continue to insist that the burdens imposed by mask wearing and distancing have been too great. What is their model of excellence? Sweden? Belgium? What country has decided to take the "stoic" approach and not hesitated when it became obvious they were condemning their citizens to the worst of both worlds?

There can only be so much delusional wish fulfillment until all of the lies are laid bare. It is the most vulnerable who suffer the consequences. Keep the elderly safe while everyone else goes about life as normal? Has that worked anywhere? Don't elderly people depend on younger people for healthcare and assisted living? Isn't their risk tied to how much the virus is spreading?

Now we have all of the vaccines that can help us deal with this virus and the federal government has already done a poor job with logistics. Could it be more obvious that what we heard from the beginning was laziness and incompetence hiding behind a wall of ignorance?

The sad fact of the matter is that science is bullshit as far as a substantial number of Americans are concerned, the ones who really don't care if you live or die. The majority of Americans do care, and the majority probably do behave responsibly, but enough do not, and tragically for you they are in positions of authority. In a country where so so much power is devolved to the States, maybe Kristi Noem and Ron DeSantis should be charged with being accessories to murder, though they won't be. As for the President, the slogan that sums up his Presidency should probably be Drop Dead, America, My Golf is More Important Than You Lives.

Trump has now made more money playing golf in less than four years than Tiger Woods has in 23. If I were Prime Minister I would ban all travel to and from the US for an indefinite period. I feel sorry for decent Americans, but there are too many of you on the wrong side of science who bring shame and disrespect to the country. And for the record, we have plenty of morons in the UK, and not just those choosing to ski in Switzerland, or have maskless beach parties in Sydney. It is simple really, they don't care. Thanks to these people, the impact of the vaccine will take much longer to sideline a viral infection which may now become endemic for years, even if the volume of cases declines so that it no longer becomes a public health emergency. We have a long way to go. And miles and mles and miles to go before we can sleep.

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Originally Posted by Stavros

The majority of Americans do care, and the majority probably do behave responsibly, but enough do not, and tragically for you they are in positions of authority.

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I think this is the key point. I'm sure our scientific literacy is not great but one can say that about many places that have been more responsible than we have. The average person will not know very much about disease dynamics or viral spread and won't even be motivated to learn about it during a pandemic. People in positions of authority have a responsibility to learn as the public depends on them to provide responsible advice.

There was always going to be some bullshit circulating among the fringes, and there is in most countries, but Republicans have made it much more mainstream than it would have been. Just as viral spread is exponential, lies told about the virus have effects that are magnified. And the lying and obfuscation has been very pervasive so one can't really deny our incredibly poor outcome is tied to it.

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Originally Posted by Stavros

Thanks to these people, the impact of the vaccine will take much longer to sideline a viral infection which may now become endemic for years.

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Without saying too much I think there are good reasons to think it will be endemic for a while. One is that we don't know how durable protection is from the vaccines. The second point is that it's a highly transmissible virus and we don't know what the compliance with vaccination will be in many countries. The good news is that the vaccines are much more effective than a lot of people thought they would be.

The flu vaccine, for instance, is only about 50% effective at preventing disease in many years. As you say above, one of the reasons is that the flu mutates very quickly and scientists are presented with a constantly moving target as they reformulate the vaccine each season. The most recent mutation of sars-cov-2 is not the first documented mutation of it but I think the first one that changed transmissibility (though not virulence) a lot. Still most of the scientists think the approved vaccines will be effective against it and the amount of tweaking of the vaccines to accommodate further mutation will not be as challenging as with the flu. We'll see. Clearly leaders in every country should realize that time is of the essence and the faster they mobilize their vaccine efforts the greater service they provide to their citizens.

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Originally Posted by broncofan

Without saying too much I think there are good reasons to think it will be endemic for a while. One is that we don't know how durable protection is from the vaccines. The second point is that it's a highly transmissible virus and we don't know what the compliance with vaccination will be in many countries. The good news is that the vaccines are much more effective than a lot of people thought they would be.

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I agree with you, and I think we can agree that it has been a colossal failure of politics, rather than science, and that the opportunity to show how effective politics can be was missed, because the man in charge was only interested in himself, not the country.

The New York Times article linked below (not behind a paywall) documents the in-fighting and deluded decision-making in the White House, where it appears Mark Meadows was as destructive as Trump, but I like this comment from one of the readers, from Portlan, Oregon:

"Michael Kennedy
Portland, Oregon9h ago

Times Pick
He never figured it out. His lack of historical knowledge was his end. Americans rally behind their president in a crisis. If he'd come on national television, called all Americans to work together against this common enemy, he would have won the election in a landslide. Americans want a strong leader during a crisis. Americans are willing to set aside their differences to work together and overcome problems that are common to everyone. Instead, he took a cowards stance. He dug in, and presumed - erroneously - that it was something to do with only him. Trump manufactured his own demise, and in the midst of his hubris, millions became ill, and tens of thousands of Americans died. Donald Trump couldn't see beyond his own quest for superficial popularity. History will not be kind."


https://www.nytimes.com/2020/12/31/u...mentsContainer

I think that person's post is right. Trump had a better chance to do it than a Democratic leader would have because the latter would have had Republicans in opposition. Republican congressmen could have done nearly as much damage speaking over a Democratic President as Trump did as President.

But with Trump as President, if he had decided to pull the country together and had taken the lead of the vast majority of epidemiologists and infectious disease specialists, it would have saved hundreds of thousands of lives and probably gotten him a second term.

The purpose of operation warp speed was not only to subsidize the development of vaccines but to manufacture doses at risk so that they were available by the time clinical trial results came in. They should have also worked out any and all logistical issues about their delivery in advance.

Trump had more than 9 months to work through these logistical hurdles. His supporters can pretend that anyone would make the mistakes he made but they simply wouldn't have. Most competent leaders would have had a plan in place in the event the vaccine trials were successful. The purpose of operation warp speed was to anticipate success at every stage so that each successive stage would proceed without delay.

I can't wait for him to be gone. We'll see what Biden is able to do even without the cooperation of about 45% of the country.

Excellent 40 page article in the current issue of the "New Yorker" magazine "The Plague Year" about how and why the US failed so badly in controlling the pandemic.
https://www.newyorker.com/magazine/2...sam&stream=top

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Originally Posted by sukumvit boy

Excellent 40 page article in the current issue of the "New Yorker" magazine "The Plague Year" about how and why the US failed so badly in controlling the pandemic.
https://www.newyorker.com/magazine/2...sam&stream=top

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Lawrence Wright is an impeccable source, so this is compelling reading. I think we can all agree that where many of our governments have failed -and where others have succeeded- it is in the failure to establish a test and trace system early on, and to mandate mask wearing by the public -two of the three major failures Wright identifies. I would also add the national co-ordination thay Wright refers to, and its absence, notably in the US and in the UK. That the UK was promised a 'world-beating' test and trace system that flopped at its first trial is sadly typical of the grandiose drivel Boris Johnson excels at, to the extent that I no longer bother taking anything he says seriously, as far as I am concerned, he can talk to the wall.

The area of difficulty is in the first phase, when the first cases were identified in China, and how the Chinese handled information exchange, but also how demanding or not extermal actors were. I think we can say that in the three years prior to January 2020, the US made not the slightest effort to improve its influence at the highest levels of the WHO, and that this indifference, exaggerrated by Trump's disdain for anything and everything associated with the UN and in particular its agencies, helped the US to take a more distant stand than it probably should have. The clinical issues to me must relate to the previous SARS epidemic that was successfully contained, so begs the question why the Chinese do not appear to have been more willing to share all of their information, and in particular the evidence which I think was there in December that human-to-human infection was already taking place. The seriousness of the first SARS epidemic ought surely to have created an emergency mind-set, and I wonder if the difference is that President Xi, as a more activist premier, and one developing his own cult, has induced a fear mentality among those Chinese officials who factor in a fear of 'bad news = failure' where their failure becomes Xi's failure and his failure becomes China's, the sad irony being that if this is what they wanted to prevent, they ended up making it worse than it needed to be.

It is frustrating, because the 'West' has co-operated with China in the study of zoonotic disease and had we a more collegiate attitude to the internatonal relations of public health, who knows how soon we could all have taken common action to limit its effect?

That said, the usual suspects -false predictions of the course of the viral infection, a hope rather than the fact that it could be/woud be limited to China/Asia, and the greater fear of its economic consequences, clouded decision making. It ends up as a cluster-fuck of global proportions, from which we ought to learn the value of international cooperation and knowledge transfers and sharing.

But also the warning that the human race is fast expanding into wilderness areas where unknown pathogens lie in wait to feast on the human body, and yield exotic animals whose flesh no human need ever eat.

I was also saddened to read about how the CDC ,which since its inception in 1946 has been a beacon and model of public health , was undermined and its' reputation sullied by politics and budget cuts by the Trump administration.

I'mposting this here because it ties directly into Covid. Apparently Governor Cuomo has finally seen the light and has to decided to legalize marijuana because of the economic impact the pandemic has had on the state. You know there was something wrong when South Dakota decided to make weed legal before NY.

Now Cuomo just has to go all in and legalize sports betting.

In Pennsylvania we have medical marijuana cards but the list of conditions one can get a card for is so extensive it seems like the road to legalization of recreational use. Some states have that too. I went to one of the dispensaries pre-pandemic and the place was packed. The salespeople take you back and tell you about thc cbd ratios and ask whether you want to be mellow or less mellow. It hasn't caused any major problems here.

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Originally Posted by sukumvit boy

I was also saddened to read about how the CDC ,which since its inception in 1946 has been a beacon and model of public health , was undermined and its' reputation sullied by politics and budget cuts by the Trump administration.

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Some among the new generation of 'Conservative' politicians and activitist who in reality have never read Gramsci, nevertheless cite the concept of cultural hegemony this famous/notorious Italian Marxist described as the means whereby Capitalism sustains bourgeois power based on the 'means of production'. The argument thus developed that socialists could develop their own narrative and resistance culturally, as well as politically, and that this would become part of a more general 'mind set' or mentaliy to make socialism appear to be a logical as well as a desirable alternative.

To the Conservatives, this explains their allegation that Schools and Universities are now 'woke' factories in which 'Cultural Marxism' has established its hegemony, indoctrinating generations of students who are well-disposed to socialist ideas, and hostile to liberal views of the market, individualism, the family, binary sexuality, religion and so forth -and this in spite of the billions spend by the Koch Brothers, Moral Majorty and Christian organizations in Universities to do the opposite, and the rather obvious fact that in spite of schools and universities in Europe and North America being 'woke' from head to toe, when they become tax-paying workers, all those students and young people vote Republican and Tory as well as Democrat and Labour.

The extension of this view thus sees Government bureaucracy as captive to either 'left-wing' or 'Liberal' ideas, and thus cannot be trusted to implement a radical conservative agenda, be it 'Austerity', Brexit, or whatever consensus-busting acts one associates with Trump. The long term impact has been a civil service in which able people have been filleted out, to be trimmed down for financial purposes, and where, politically, Weber's claim that a neutral civil service is vital for the creation of a stable State, it is replaced with its opposite, a partisan civil service where people are appointed for their political loyalty rather than their expertise.

In the US one saw this when Anthony Fauci was effectively replaced by Scott Atlas, and as you address, the manner in which the CDC has been marginalized. Consider the case of Nancy Messonier, recognized as one of the most brilliant Americans with a lifetime of research and practice in Immunization and Respiratory Disease. Shortly after her statement on February 26th 2020, a furious Trump effectively banned her from speaking in public, indeed, she went from being the first major voice on Covid-19 to silence in the space of 24 hours. Thus:

"It's not so much a question of if this will happen anymore, but rather more a question of exactly when this will happen and how many people in this country will have severe illness,” she said during a briefing on 26 February.
The speech marked a tipping point in the agency’s messaging and sent the stock market plummeting."
"Upon the president’s discovery of the briefing, he was reportedly furious and threatened to fire Dr Messonnier according to The Wall Street Journal.
"By the time Trump lands, the whole thing had spun out of control, and he was livid. He calls Alex Azar, wakes him up screaming, 'What had happened ... did you know Nancy Messonnier had scared the s*** out of people?'" Mr Shear said.
Dr Messonnier was not fired but was sidelined in favour of the newly set up coronavirus taskforce led by Mike Pence, the documentary reports."
https://www.independent.co.uk/news/w...-b1205877.html

From that day to this, Nancy Messonier has been silenced. But who was right? Nancy or Donald? And who has paid the highest price for this institutional failure -that perhaps with the right leadership from day one might have prevented the worst that has happened?

I hope Biden will give this extraordinary woman a voice, if she still has something to say. I would like to hear it.

I read today that Johnson and Johnson will be seeking FDA EUA for its one shot vaccine in February. If they get it that will help supply enormously since the doses go twice as far. I'll post an article when I see one.

So far, two countries have been lauded for their vaccination programmes: Israel and the UK. There is some speculation on the speed with which Israel has acquired so many doses, and at what cost, but as most of the adult population are military reservists who can be called up and with a popuation less than 10 million, one can appreciate the country has an existing infrastructure that makes such national programmes easier than in most others. That the Israelis don't appear to have any intention of vaccinating Palestinians is fairly typical of their attitude, and it is not likely to change, while the rate of infection continues to cause concern.

The other country is the UK. Here, we have an in-built, national structure called the NHS which not only has large general hospitals serving the commnity (and often more than one), I get my annual 'flu jab at my GP surgery, where most of the vaccinations can and will be done that are not being transported to care homes, hospitals, or pop-up clinics in town. But what this also does is beg the question, why at the beginning of the pandemic, did the Govt fail to anchor a test and trace system on the existing network of GP surgeries, Hospitals and Clinics all of which could do it, or do it with extra help? The 'world beating' test and trace system Boris Johnson promised has not materiaized, though millions has been spent on it. It is all very well people applauding the UK but we still have high rates of infection in some areas, and there is a long way to go before we can relax the restrictions that are in place.

Intially I stated I did not think this Pandemic would kill a lot of people, and I was wrong. I thought last year that as a SARS-variant virus, the same measures that controlled the first outbreak would be sufficient to control this one, and I was wrong. In part it is because this strain of the virus is more efficient than the first, and because, as discussed with Sukumvit Boy above, there has been a catastrophic institutional failure, in the US, in the UK and to some extent across the EU. Any success in China as filghy2 has said must be the result of China's merciless party dictatorshp, plus our not knowing what the cost has been in terms of lives lost and lives ruined. Where the success has also been recorded, such as Taiwan -population 23.78 million, 855 cases, 7 deaths- the success may be due to the ease with which an Island can isolate, but also institutional success, and public support for measures it has dealt with before in the fist SARS episodes ten or so years ago.

Where it has failed, the consequences have been grim. Had I been told last year the US would record 24 million cases, I would have disbelieved it as even being possible, but it is a fact.

I think the incoming Administration not only has a major vaccination programme to co-ordinate nationally, it is still essential to create a test and trace system and I would hope this is given as much urgency as the vaccination drive. It makes no sense to me to live in a country where the authorities don't know who is infected, or where and how they were infected, and who they were in contact with. There needs to be national co-ordination of data management, as well as clinical treatment.

And I would add, that for at least a month, the US needs to shut down, including minimal entry and exit from the Lower 48 and Alaska. I hate the phrase because it was made up by a UK Chancellor in the 1990s as an excuse for Govt cuts to expenditure, but is appropriate in this case:
If it's not hurting, it's not working. And the US has a whole lot of pain yet to live.

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Originally Posted by Stavros

Intially I stated I did not think this Pandemic would kill a lot of people, and I was wrong. I thought last year that as a SARS-variant virus, the same measures that controlled the first outbreak would be sufficient to control this one, and I was wrong. In part it is because this strain of the virus is more efficient than the first,

Where it has failed, the consequences have been grim. Had I been told last year the US would record 24 million cases, I would have disbelieved it as even being possible, but it is a fact.

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Sars-cov-2 isn't more efficient, it just results in a contagious pre-symptomatic period that makes it more difficult to contain. This was already suspected in February 2020 and the virus looked like it was going to be a major problem as soon as it was in South Korea and Italy.

The UK is one of a handful of countries that has done as poorly as the US in deaths per capita. Perhaps the mistakes weren't as obvious in the UK as the US (I haven't been paying attention) but there are many countries that have done a better job.

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Originally Posted by broncofan

Sars-cov-2 isn't more efficient, it just results in a contagious pre-symptomatic period that makes it more difficult to contain.

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Anyhow, if by efficient you mean transmissible, the r0 of sarscov1 and sarscov2 are about the same. The biggest difference is interval between symptom onset and maximum infectivity which makes it harder to contain. It's why by April 3 most health agencies were on the same page about mask wearing, though Trump didn't quite understand the guidance.

https://www.thelancet.com/journals/l...484-9/fulltext

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Originally Posted by Stavros

Intially I stated I did not think this Pandemic would kill a lot of people, and I was wrong. I thought last year that as a SARS-variant virus, the same measures that controlled the first outbreak would be sufficient to control this one, and I was wrong.

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Many people made mistakes early on. In my first post on this last January I said that we should keep it in perspective because loads of people die every year from regular flu. There's a world of difference between making mistakes in an unprecedented situation and refusing to learn from mistakes as more information becomes available. That's why it's so annoying when Covid minimisers argue that we should not listen to the experts because some early predictions were wrong or their initial advice was changed later (while ignoring their own poor record).

The vaccination program in Australia isn't expected to commence until March. As the virus is well under control there is not the same imperative to bypass the normal drug approval processes. That means we have the luxury of being able to assess what happens in other countries. https://www.abc.net.au/news/2021-01-...ation/13066948

We have had some restrictions being re-imposed in response to recent outbreaks in some cities (albeit minor by US or European standards). There's clearly a bit of fatigue, but public acceptance seems to be holding up and there's still generally bipartisan support apart from some quibbling at the margins. The key to success seems to be creating a virtuous circle, in which administrative competence, demonstrated success, political support and public support become mutually reinforcing.

One doesn't have to be able to predict how many people will die to know something will be an issue governments have to prepare themselves for. I still am surprised by the complacency of most governments up until March because it did seem clear China was not able to contain the virus and nobody else was willing to take more extreme measures that they took. It turns out many of the measures they took probably weren't that effective but the effort was obvious.

Two personal anecdotes: In 2020 I had a lease in a crowded apartment complex with lots of common areas and the lease did not expire until May 1. On February 25th I signed a one year lease for a house because I thought if we ended up taking some lockdown measures I didn't want to get stuff delivered in the apartment I was in. I paid double rent in March and April and had a number of people I know tell me I was being unreasonable. I know many people wouldn't be able to afford to do what I did but plenty of people who could thought it was odd. It still is and my chances of being infected in the package room or the hallways of an apartment complex was not high.

On March 2nd I told the psychiatrist I had been going to that I was beginning to panic about "coronavirus" and that I was afraid it was going to spread and I would get sick. I also made the mistake of telling him I rented a house. He told me it was an exacerbation of my ocd and that my chances of getting sick with "coronavirus" were less than my chances of being shot. I'm sure this sounds cliche or made up but this was how the conversation went. And it probably was an exacerbation of my ocd but I still cancelled my next appointment with him and found someone else.

My point is that one doesn't have to know most things about a public health menace to be concerned. I don't understand the lack of strategy from officials either or the resignation from many that herd immunity by infection was inevitable and either happens now or five years from now. If we knew there were 15 plus vaccines being tested and that the first round of results could be obtained by the end of the year, why wouldn't the strategy be to limit deaths until the results give you a clue about whether there's light at the end of the tunnel or a potentially protracted problem? The only reason not to do this was because morbidity and lower quality of life from adhering to public health guidelines outweighed the benefit in mortality. There was comparative data very early on to say this wasn't the case.

I also got many things wrong and learned a lot this year. I'm disappointed the learning curve for Republicans and leaders in other countries was not the same.

I think OCD is only a problem if it interferes with the way you live to the extent that you become a prisoner of process rather than outcome. In either an epidemic or a pandemic, the geography is shaped by space and time, so anywhere crowded becomes a threat to be avoided, that would include lifts/elevators and hallways. Obvious other factors would be chronically ill neighbours, feral children, low-income workers who cannot afford to self-isolate and so on. My brother-in-law has significant health issues so my sister has become OCD in her management of their immediate environment, but she had those tendencies to fuss over small things anyway, and I was told of a Great Aunt on my mother's side, whom I was too young to remember, who when she visited, brought a duster and cleaning fluids to wipe down chairs and tables where she was, something of an insult to my mother, but those Victorian women were often a bit strange anyway (my maternal grandmother whom I remember well was born in 1882).

So taking precautions in this pandemic is the right thing to do, and I regret to say in your case even more so in the USA. That said, John Harris in The Guardian has argued something like 90% of the British public have been obeying lockdown rules, and while we hear a lot from the 'Rejection Front' in the US, I wonder if the majority of Americans too are more sensible that we sometimes think. And anyway, costs aside, being in your own house must be safer than an apartment block.

My guess is that if something has changed that is going to be permanent, more and more people in European and North American cities are going to continue wearing masks for years to come, particularly on public transport, and maybe in Malls and shops too. It is common in Asian cities, and it makes sense, and you don't need to be OCD to wear one, now or in the future. From a practical point of view, I find in cold weather the mask protects my face from cold winds, and on my last trip to London, I found it easier to fall asleep on the train. Awareness of the risks of daily life is not OCD anymore, as there are good grounds for believing that we may be entering an age when viral outbreaks are more common than once they were, though we can only hope they do not break out of a locality to become global in their impact.

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Originally Posted by broncofan

One doesn't have to be able to predict how many people will die to know something will be an issue governments have to prepare themselves for. I still am surprised by the complacency of most governments up until March because it did seem clear China was not able to contain the virus and nobody else was willing to take more extreme measures that they took.

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I think a big part of the problem is that most politicians didn't understand how exponential growth works, which meant that it was hard to convince them to act while case numbers were still relatively low. In terms of public messaging we went almost overnight from being assured that things were under control and we could go about our normal lives with a few precautions, to having significant restrictions on our activities.

The other element is a failure to understand risk management principles. There is a common, but fallacious, argument that we should avoid costly actions to avoid a future problem if there is considerable uncertainty about the extent of the problem (climate change is another issue where this argument is often put). But if there is a lag before those actions have an impact, and a risk of very bad outcomes, then it is worth incurring some cost to avoid that possibility. If you wait for more information it will already be too late to avoid the bad case scenario. I'm sure the people making this argument don't actually apply it to their own lives - for instance, the whole point of insurance is that you pay a certain cost to avoid any risk of very bad outcomes, even though the probability of those outcomes make be low.

Vaccine distribution is picking up in the U.S. I can link an article later but probably better you just do a google search if you're interested. Moderna says it has tested whether its vaccine is responsive to the virus variants that have been found in UK and South Africa. It says people develop the same antibody response to the UK variant as to the most common one and that people have a reduced antibody response to the South African variant but they believe it will still be protective (I think they inferred this from comparing it to antibody levels of people with natural infection). In the meantime they want to develop booster shots more tailored to these variants to prevent waning immunity. Immunologists are treated it as mostly good news.

I want to say that although we're not out of this crisis yet and it will probably be a while before circulating levels of virus are low, there is a light at the end of this tunnel. Israel has some data on the people they've vaccinated and hospitalization rates are way down among people over 60. More vaccines are coming in the year ahead and although it's concerning any time there is a new strain of this deadly virus, there is reason to think innovation can outpace it now that we know people can be inoculated. Still, it's a challenge and we will likely know a lot more about 100 days from now when a larger proportion of the U.S. population is vaccinated.

I know this is a press release from Eli Lilly but that is how most of these companies are releasing their data. The latest studies apparently show that monoclonal antibodies from Lilly reduce risk of hospitalization or death by 70%. As I suspected if they are only effective in early disease, which is what the data has shown, there would be logistical problems. But almost no effort has been made to make these drugs available to people in early disease. Unless the only people who qualified for monoclonal antibody treatment were Chris Christie, Ben Carson, Donald Trump, and Rudy Giuliani, all of whom either received Lilly or Regeneron's cocktail.

From what I've read the supplies of these drugs are not being used.

https://investor.lilly.com/news-releases/news-release-details/new-data-show-treatment-lillys-neutralizing-antibodies

https://www.politico.com/news/2021/0...ariants-462425

Here's an article about the available vaccines and their effectiveness for the UK and South African variants. Moderna is testing booster shots for the South African variant even though antibody levels from the Moderna shot are thought to be protective against it (as I said above a lower antibody response might mean it's not effective against this variant for as long). Good to try to stay ahead of this although the scary thing is that if surveillance has not been good there might be other variants out there already.

I had a sms from my GP on Tuesday afternoon asking me to go online and book my Covid-19 Vaccination, which I did. I had the jab on Wednesday evening before 7pm. The vaccine was administered high up on my left arm close to the shoulder, was painless, with no bleeding. I was told the after effects might be -a sore arm, which I have not noticed; a head-ache, which I have not had; and feverish or 'flu like symptoms, and though I have not had that either, I have spent most of Thursday asleep in bed. So no complaints.

The AstraZenica vaccine I have had is at the core of a row between the UK and the EU. The UK both validated the AstraZenica vaccine and ordered it before the EU, which has yet to authorize its use though is expected to this week. The EU is claiming that as the funding was shared between the EU and the UK the factories in Belgium and the Netherlands ought to be distributing it within the EU -AstraZenica is making most of its UK vaccine in the UK. If you want to read more about this row there are two links below.
https://www.bbc.co.uk/news/world-europe-55822602

https://www.euronews.com/2021/01/27/...-war-warns-mep

What it proves, to me, is that the lack of a co-ordinated response for what is, after all, a Pandemic, has caused more problems than it needed to, and that goes for the EU as well as the UK where there has been no attempt to co-ordinate a National Response across England, Scotland, Wales and Northern Ireland.

A broader analysis by Lee Jones in the Telegraph, for once not hidden behind a paywall, argues that the structural changes made to the State since Thatcher, have effectively removed from Central Government the control over both policy-making and delivery that it used to have, largely because Margaret Thatcher was instrumental in arguing, as Ronald Reagan did, that 'Government is the problem, not the solution' -his article may be challeged on his concept of the 'regulatory state' but it is worth reading, and begins thus:

"Why has Britain fared so poorly with Covid-19? Although blaming this or that minister or official offers an easy answer, the deeper causes lie in the transformation of the British state.
Britain inherited from World War II a “command and control” state; a state that could govern. Whitehall was well-practised in strategic planning, good at the rapid and efficient mobilisation of resources and people, and it regularly took authoritative, direct action to meet society’s needs.
Back then, the state could deliver what democratically elected politicians asked of it – to build the NHS, for instance – because it retained the powers, people and resources to do so.
Today, after 40 years of reform, the “command and control” state has been replaced by a “regulatory state”. Decision-making has shifted from parliament to an archipelago of some 400 “arms-length” quangos, employing more than 278,000 people and costing £205 billion per year. Moreover, the state’s assets – its capacity to execute policy on its own accord – have been outsourced or rationalised.

As the regulatory state has grown, its ambition has shrunk. Politicians no longer offer grand visions of the future, just technocratic tweaks. Having dismantled or sold off the levers of power, they downplay public expectations, insisting there is no alternative.
The outsourcing of responsibility and decision-making is clear with respect to the NHS. After successive reforms under governments of all stripes, the Department for Health and Social Care no longer has operational control. Responsibility has been outsourced to dozens of quangos and local commissioners, operating within a fragmented internal market, with scant strategic oversight."
https://www.telegraph.co.uk/global-h...ed-regulatory/

That's interesting Stavros. I'm glad you got your first shot and had no major complications. When do you go back for your second shot?

My Dad got the Moderna vaccine about a week ago. My Mom got her shot two days prior and it was the Pfizer shot. Both of them had sore arms but no other side effects. They were advised that people sometimes get more side effects after their second shot as the immune system recognizes the antigen and mounts a more serious response. Interestingly, people who have been infected earlier in the pandemic are reporting the side effects on their first shot, which would be the second time their immune system sees the spike protein.

Anyhow, I've told my parents that for their vaccines studies don't show any immunity until two weeks after the first shot so not to be complacent. I'm glad to hear you got the shot!

Because of my job, I was able to get my first dose of the Pfizer vaccine today. If everything goes according to plan, I should be getting my second dose on February 22nd.