Excellent COVID-19 resource for decisionmakers at various levels

I started attending various webinars some time ago, like lots of people, and like lots of people, I also got a little webinar fatigue at times.

A great series continues to be organised by the National Academy of Medicine and the American Public Health Association in the US, looking into many topics such as the science of the virus, finding vaccines, health inequalities and so on.

Today’s session, on mitigating direct and indirect impacts in the coming months, was excellent for decisionmakers at all levels – also in the UK! – because it addressed a lot of practical aspects and many angles of the pandemic.

It mentioned the need to provide free wifi, talked about telehealth (telemedicine) and developments expected to take a decade suddenly being realised in a mere three weeks, about the complications food deserts pose, about the politicizing of the pandemic, about how to cope with emergencies such as hurricanes and related evacuations, how to remedy the impact the pandemic is having on non-Covid-related healthcare (such as people with heart attacks not seeking help out of fear of catching the virus), the healthcare clinics getting into financial difficulties as a result (as, I think, we saw earlier with those two doctors in California who owned a small chain of facilities and saw their turnover drop so dramatically that they resorted to unorthodox action), the challenge and need to communicate well and perhaps have ambassadors explain the purpose and reasoning behind social distancing, the massive impact social distancing has on the infection rate and the risk of people that people will no longer observe distancing when lockdowns are relaxed and developing a false sense of safety, and so on and so forth.

Here is a link for a model (simulator) that people can play with to explore the effects of lifting lockdowns: https://budgetmodel.wharton.upenn.edu/

The video recording of the webinar will be online soon, at covid19conversations.org:
https://covid19conversations.org/webinars/summer.

The slides have already been uploaded, but not all presenters used slides and the Q&A of course is not online yet either. I’ll post the unedited transcript below.

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COVID-19 makes me lucky

This morning, I read that there appears to be a genetic connection between dementia risk and severity of COVID-19, here:
https://www.theguardian.com/world/2020/may/26/research-reveals-gene-role-in-both-dementia-and-severe-covid-19

That makes me very lucky, should I catch it, if it hasn’t already caught me at some point without affecting me.

Dementia most definitely does not run on either side of the family that I come from. Neither does heart disease, by the way.

Cancer does, but as I’ve already survived almost all of those relatives who succumbed to cancer I have little to worry about. I have already lived ten to twenty years longer than they did.

Good.

And you, where do you stand?

Whoa

Greece: 150 deaths
Population: 10.5 million

The Netherlands: over 5,000 deaths
Population: over 17 million

Canada: almost 5,000 deaths
Population: almost 38 million

UK: over 30,000 deaths
Population: 63 million

Vietnam: 0 deaths
Population: 97 million

US: over 75,000 deaths
Population: almost 329 million

Conclusion: Important lessons to be learned and applied. Because these differences cannot be explained – although some might wish – by some of these countries’ populations being in better health.

I should add population density next.

Working from home

It’s all over the news now that companies do not expect to return to the daily 9-to-5 commuter drudgery.

It will be better for the environment and yes, also better for the work/life balance.

I believe that if you see work as something that needs to be separated from life instead of something that is part of life, work is likely to be experienced as stressful.

As someone who’s been working from home for over twenty years, I know both the benefits and the downsides of working from home. Continue reading

Another COVID-19 resource, on vaccines

By STAT

  • Part 1: Antibody drugs that target the coronavirus: A conversation with George Yancopoulos, the co-founder, president, and chief scientific officer of Regeneron, on their antibody drugs in development to treat Covid-19.
  • Part 2: Fighting on multiple fronts: A discussion with Mikael Dolsten, the chief scientific officer of Pfizer, on the multiple routes the company is taking to fight Covid-19.
  • Part 3: Vaccines — can they come soon enough? With a sponsor introduction by Clem Lewin, Ph.D., associate vice president of R&D strategy for vaccines at Sanofi, as well as Tal Zaks, chief medical officer at Moderna and Matthew Herper, senior writer, medicine, and editorial director of events at STAT

Rights and measures in a pandemic

If you feel that the measures to stop the spread of COVID-19 violate too many of people’s rights, then consider the following.

Many rights exist only by the grace of other people respecting them. This means that rights also create duties.

You observing measures can stop you from harming other people. That’s the duty you may have that translates into other people’s rights.

COVID-19: What’s next?

This is a short video I created for Twitter, without intro as Twitter videos have to be short. I’ll make a longer one and a few short ones after this one. There is much more to this topic.

The person talking about dialing up and dialing down any measures taken to halt the spread of COVID-19 and who believes that this should be done on a relatively small scale (and not mandatory but in the form of a recommendation) is Lindsay Wiley, by the way. (Who was very patient with me when I kept asking strange questions, I should add. A little bit too patient perhaps… She’s much more a legal scholar than an epidemiologist, I realised later when I looked into her. That may explain a lot.)

 

 

I can see what she means and why it might be needed – we’ve just seen Hokkaido dial measures up again after the infection numbers went up – but if you do this country-wide or island-wide as in the case of Hokkaido, it’s a very different story than if you do it regionally.

Regionally, though, has been the approach in the US so far as far as I can tell. I don’t know whether that has led to any problems with people travelling from a location with no or limited restrictions to a location with strict measures. County borders, state borders, city borders.

People have been protesting against various measures – unfortunately partly inspired by the hogwash spread by two doctors in California who would lose their licences if it were up to me – but these protests make bigger headlines than the news about Americans who have been defying their governor who eased or lifted a lockdown.

(And if you keep people in a lockdown too long, their physical health will start to decline because their lives have become so much more static, particularly for people who live in small apartments. That might make them more susceptible to COVID-19. When does that effect start to kick in and make a real difference? After two months? Three?)

What I don’t know is how it would work out longer-term if you were to dial up and dial down measures regionally or locally.

Would it cause chaos, such as when someone has a job interview or a project planned for which he or she needs to be in Chicago and then all of a sudden, the recommendation changes?

If it is not mandatory, then how effective would such measures be? Effective enough, presumably, as this is the approach that’s most strongly endorsed by expert panels in pre-pandemic plans/studies, so I understand.

If such measures are not mandatory and you have a job interview, then not many people are involved and the situation can be resolved.

But for anything involving more people – say, a large company – it may be tricky. If the company does not follow the recommendations, it may be sued by its staff. If the company does follow the recommendations, it may be sued by its clients.

Imagine having to construct a hotel for a famous real estate mogul and not showing up because the recommendation for the location in question has changed (been dialed up). Or having to install new computers and networks for a bank or a call center.

(There is also the question of how you would keep people informed. I think it could be part of the weather predictions, just like UV radiation and pollen counts are. If you travel, you usually check the weather at your destination before you travel or on the way.)

If, on the other hand, you limit people to traveling within their own city or county or state, you cause fewer problems for people who normally never travel beyond those geographical borders.

But how would you ensure that people would do that? If it costs them their job if they follow the recommendation or if their job is ten miles away but in a different county, how likely are they to follow that recommendation?

Then you might have spreading from the borders of your geographical area, inward, if the neighboring counties have a higher rate of infection. Do you use travel permits?

Do you test everyone within a certain distance of such a geographical border to identify new cases and quickly isolate them?

From a purely epidemiological point of view, it probably all makes perfect sense.

Does it also make sense from a practical point of view? That’s less easy to figure out. What does small-scale dialing up and down of measures mean for Joe and Jamie Public when they get up in the morning and prepare to take their kids to school? I can’t get a clear response to that question.

Besides, there also is a strong cultural angle to this. In some countries, citizens will be more likely to follow recommendations than in others, I’ve noticed. Socioeconomic aspects – level of inequality – as I’ve mentioned, play a role as well.

I have to conclude that the experts don’t have all the answers yet either. The experience is new for almost all of us, with the exception of people in parts of Asia that have gone through MERS and through SARS aka SARS-CoV-1.

The previous whopper of a pandemic we had occurred a century ago, after all (Spanish flu). Even the Hong Kong flu that hit around 1968 happened too long ago to be able to translate that experience into the way we are living now. In those days, most women in my home country stayed at home all the time anyway because they were home makers, for example.

But that’s for the here and now and short term. How about the longer term?

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Hang on to your umbrella against COVID-19

Two doctors in California have been telling everyone that COVID-19 is not a problem at all, that they have tested lots of people and that most had the virus and that many were not ill.

But they were testing people who were screened and suspected of having the virus. It means that there are many more people out there that do not have the virus yet (and preferably should not get it either). I could say a lot more about these two doctors, but I won’t.

I also see a lot of confusion about what is called the prevention paradox. If you prevent something bad, some people will stop believing that it exists (or think it’s not actually that bad).

That’s like noticing that using an umbrella stops you from getting wet and then concluding that there is no rain.

That Kern County Dr Erickson who talks about COVID-19 on YouTube

Update 3 May 2020: YouTube has meanwhile removed the two doctors’ “presser”. YouTube also sometimes deletes videos and channels when it shouldn’t. This time, I am very pleased that it did.

To my dismay, I had also received these doctors’ rubbish as news in an email a few days after I posted the stuff below. (If you subscribe to news media other people follow, people whose views may not overlap with your own, you get a much better idea of what is out there, what people outside of your own circles are thinking.) So I emailed them.

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COVID-19 resources at US National Academy of Sciences and elsewhere:

First of all, here are two living documents elsewhere:

https://rega.kuleuven.be/if/pdf_corona

https://covid19treatmentguidelines.nih.gov/

Here are some resources at the US National Academy of Sciences:

https://t.co/ezodPowbg6 (lab testing)
https://t.co/QHR4Gjborg (effectiveness of fabric masks)
https://t.co/iDArCYuk99 (viral shedding)
https://t.co/19VZuy0Oz5 (effects of temperature etc)
https://t.co/djGokzK7Eg (bioaerosol spread)
https://t.co/pwmYVxfX38 (stability on surfaces)

Apprentice Johnson, you are fired!

“Ministers declare the NHS Nightingale project a great success”, but staff tell The Independent’s health correspondent Shaun Lintern they want to do more – and they fear prominent PR is not helping.”

We’ve now also had the cheerful optimism beyond what is medically rational about a delayed shipment of gear from Turkey to protect frontline NHS staff against corona virus that apparently contained only 32,000 gowns. Worth several hours of protection.

And now US President Donald Trump has suggested injecting disinfectant may be a good treatment for COVID-19 patients.

With Boris Johnson sharing the optimism of Trump and wanting to cooperate with him closely on tackling the corona virus crisis, we should all be afraid, very afraid.

In spite of having all the information that was coming from China, the UK took TWICE AS LONG to respond effectively than China. Because on 3 February 2020, ten days after the lock-down began in Wuhan, Boris Johnson declared very loudly that he did not feel a need to respond strongly and swiftly to the virus. He said that imposing a lock-down went “beyond what is medically rational”.

Apprentice Johnson, you are fired!

Okay, now I can retire to Checkers

The UK government is finally really catching up with the information I have had on my website for… I don’t know how long!

It’s not rocket science! It’s all practical common sense. You do not need the latest minute scientific details before you can start applying plain common sense.

But has it updated the information for those who are advised to shield or is that still many weeks out of date?

Let’s check.

No, it has not been updated.

Okay, no retirement for me yet, then.

(I’ve meanwhile provided my criticisms to .gov.uk.)

 

About politicians failing to lead (sad parody)

I duct-taped this together today. I hope that YouTube won’t take it down. I have a shorter version, but the music is so cheerful and that’s what we all need lots of. And I didn’t want to leave any of the names out.

I was both crying and laughing while I made this. See for yourself. You’ll have to watch to the 3-minute point to get it.

There was more or different stuff that I could have added such as Trump having called pharmaceutical companies, “big ones with offices in London”, and them having “contacted all of Boris’s doctors” and doctors standing ready to help the doctors in London and “we’re getting more than we ever bargained for”, but hey, it’s all obvious anyway.

And here is a shorter, tweetable version:

The corona virus crisis: My message to the police in the UK

In this video, I ask British police to be understanding toward us when enforcing the social distancing rules because, in spite of the fact that the lock-down resembles being imprisoned to some degree, we haven’t actually done anything wrong.

Police officers should also comply with the rules themselves.

Why governments in the west have responded the way they have

A friend of mine in Florida responded that she had really enjoyed listening to this. That is a great compliment, coming from her. She is a microbiologist who used to work at the HRS Sarasota County Public Health Unit (now retired). I remember a fierce discussion we had when I was setting up some lab experiments of my own and wanted to add a guaranteed abiotic control.

Thoughts about the corona virus crisis

This video is a slide show with some thoughts on the corona virus crisis. It has no sound and is not synchronized with the written text, so you may want to pause the video from time to time to read the lower lines. Sorry about that.

I’ll probably make another video later, a real one, with head shots and spoken text.

Guardian editor’s Twitter account hacked (and 5G)

A Twitter account appearing to be in the name of a technology editor for The Guardian just accused me of spreading lies about (corona virus and) 5G. WTF?!

I was utterly totally flabbergasted – and angry – until I realised that this was typical troll-like behaviour and that account apparently got hacked.

So I blocked the account and reported it to Twitter as hacked.

It’s amazing how quick I was to assume that the tweets from that account were genuine.

The only thing I have done is say that a lack of good information / understanding provided by governments about why people were suddenly no longer allowed to shake hands and told to wash hands all the time may have led some people to assume or conclude that something was getting onto their hands through their phones, in the letter I sent to the Evening Standard.

Confusion about biological viruses versus IT-related viruses might have caused such a misunderstanding. As this new virus emerged more or less at the same time that 5G is being rolled out…

Logical reasoning is not only what WE think is logical reasoning.

I learned that from quaker parrots.

An apple can look like a big intimidating object to a small bird.

Then cutting off a slice of that apple and give it to the apple-loving bird might make a human conclude that as the slice is okay, the apple has to be okay too, but we humans do that on the basis of knowing that the apple is okay.

For a bird that has no prior experience with whole apples, the conclusion that the slice – maybe only that particular slice – might not be good is actually also logical, isn’t it?

Logical reasoning is easy – i.e. limited because it can arrive at one conclusion only – if you already have the answer that you want to arrive at.

If you don’t possess all the answers yet, you might draw different conclusions.

Fortunately, the bird in question also had a terrific sense of humour and often poked fun at me. I learned a lot from her about the arrogance of humans.

 

 

And we have a posterboy !

Boris Johnson is in hospital (and to my surprise, I managed to tweet the news before most of the UK news sites posted it because a financial news popup on my screen beat them to it).

I wish him and his pregnant partner well. Of course I do!

The good news?

He may now become the posterboy for making people take this thing seriously and stop assuming that only “dumb people in other countries” and “old folks” get knocked down by it.

This is no time for cavalier attitudes, unless it is the kind of attitude that Captain Crozier displayed. He is the kind of hero we need now.

And the kind of heroes who work and volunteer on the front lines of all care as well as the people who continue to deliver postal mail, who are at work at the supermarkets, supply them with stock and all the others who continue to keep as many things working as possible.

 

 

Disaster and emergency planning

Did western governments really have no plans to deal with this emergency at all?

GCHQ. Source: Wikipedia.

Yet we regularly hear about bioterrorism threats… Should I conclude that there is not really such a massive threat – no, not really – because if there was, there would have been plans in place? Was it only used to gain votes by scaring voters?

I am ASTONISHED that there seems to have been zero preparedness for dealing with events like this new corona virus.

Not only do too many politicians appear to have assumed that the Chinese (and the people in other Asian countries) were being stupid… They had no scripts and had no information on the shelves to tell the public about what was going on.

While corona viruses don’t all behave the exact same way and some facts only become clear after a while, governments could have given clear general information about how corona viruses tend to spread.

Instead we heard:

  • “Wash your hands.” So these viruses are excreted by hands, perhaps from fingertips or from sweaty hands? (No!) It’s bound to have made many people assume that as long as they were washing their hands or wearing gloves, they couldn’t get or transmit the virus.
  • “I’ve just been to a hospital that had several corona virus patients and I shook hands with all of them.” (Said by Boris Johnson at a press conference on 3 March 2020.) So people are just being silly, there is no real health danger, and the Chinese are overreacting and being stupid?
  • “Be wary of people who cough. Or sneeze.” But talking and laughing spread these droplets as well! This is general, very basic knowledge. It was not available??? Really???
  • “Stay inside.” This must have caused confusion all over because now it sounds like it’s something in the air, maybe like radioactivity. Or air pollution. (Or maybe something that only posh people who exa-cise get?)

What the hell is the public supposed to think and do on the basis of all this?

Clear general information could have been provided, with a note that more details would be added later.

We didn’t know, for example, whether our pets could become ill as well, whether they could spread the virus too. If so, might it be only dogs? Or cats too, or both? We didn’t have that kind of detail yet.

But we did have the kind of detail that said: IT IS SPREAD FROM HUMAN TO HUMAN because that was clear enough to conclude from what was happening in China. COVID-19 is caused by a corona virus, so it was likely to spread like other corona viruses like the flu and the common cold. We know how they spread among us.

And, with hindsight, I say: It seemed to be highly infectious, so the possibility that asymptomatic people were spreading the virus too should have been identified early on.

(Instead, we in the west must have assumed that Asians were just being really really stupid and coughing and spitting in each other’s faces?)

I was and remain quite flabbergasted to see that my own information which was mostly pulled out of my hat (head) and from the internet has been much more complete and accurate – earlier – than what the western world’s leaders had. How on earth can this be???

A long time ago, I was a member of the American Society for Microbiology (ASM), for about ten years, but I certainly do not consider myself a microbiologist or virologist. I know very little. I consider myself completely out of touch these days.

So how come I – with near-zero financial resources and no staff – appear to know and understand so much more than the western’s world’s top leaders?

Last night, I saw an American governor (Georgia’s Brian Kemp) state that he had no idea – until yesterday – that asymptomatic people can spread the virus. I’ve known that for what feels like weeks. Ten days? Two weeks?

I also note that many Asian countries have actually been doing well relative to the west, in spite of all the blaming that some politicians are doing. China is sending medical teams to help all over the world, also to the UK.

Taiwan continues to be dismissed and excluded (by the WHO; no exchange of information is formally taking place). Taiwan learned a heck of a lot from SARS (also called SARS-CoV or SARS-CoV-1) in 2002-2004 and it remembered and applied those lessons.

In theory, we in the west had access to that information too. We saw what happened in Taiwan back then, didn’t we?

Is it the decision-making that takes too long? But that too would point in the direction of a lack of preparedness.

People!

We need to change a few more things than starting to respect non-human animals more so that we stop making ourselves ill with diseases that come from what is essentially animal abuse.

The lock-down in Wuhan, China started on 23 January 2020… And the west knew about it.

There are lessons to be learned, on all sides.

It seems weird to be saying all that from the sidelines.

https://www.theguardian.com/world/2020/mar/23/how-coronavirus-advice-from-boris-johnson-has-changed

But this here, this too, seems to be saying that leadership is “not done”:

“Coronavirus: US Navy removes Captain Brett Crozier who raised alarm”

“The commander of the USS Theodore Roosevelt has been removed after saying the US Navy was not doing enough to halt a coronavirus outbreak on board the aircraft carrier.”