Light At The End Of The Tunnel

One of the things that has made endurance difficult through the pandemic is the lack of an endpoint. A great many yardsticks are available from many sources – cases by day or month, numbers of hospital beds available, hospitalizations, deaths – but not when things are likely to get better, when we can see our friends and family in person again, when children can return to school, when we can feel safer.

The measures we have go up and slightly down, then up again. They can be tied to the early call to “open things up” long before it was wise to, with no plans for stopping the spread. They can be tied to the politicization of measures, like mask-wearing, that might have helped to stop the spread. The general movement in numbers has been upwards, to our current state of almost 4000 deaths daily and a total of 400,000 dead, a medium-sized city of Americans gone forever.

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Dr. Fauci’s Warning

Dr. Fauci is warning us that it may take more than we thought to get to herd immunity. Now that anti-science Donald Trump is on the way out and Fauci is advising President-elect Joe Biden, he’s telling us what he thinks.

A year ago, we knew next to nothing about SARS-CoV-2. Since then, experts have bootstrapped us all the way to effective vaccines. The bootstrapping started from what we know about other coronaviruses and pandemics in general. It’s a matter of informed guesses, testing them against each other and observations, modifying them, and testing again.

Because the math of epidemiology is similar to the math of chemical kinetics, I’ve been following the modeling. It is also bootstrapping, guessing parameters, testing them, and modifying them. It’s a set of multiple parameters (an unknown number of them) being fitted to data that has serious limitations. The estimates get better as we get more data. That’s what Fauci is saying. Our first guess for herd immunity was around 70%. With almost a year of data, it looks like that could be as high as 90%.

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The Pandemic Cabinet

Job One for the Biden administration is controlling the pandemic. The economy won’t recover until people feel safe going shopping, to restaurants and movies, and all the rest. We can’t effectively work with other countries until we can think beyond full hospitals and people sick and dying and losing housing and going hungry. The justice system can’t work well with Zoom hearings and prisons as hotbeds of infection. We need to sort out priorities among education, bars, gyms, and yoga classes.

Simultaneously, the Biden administration must repair the government, hiring back to full agency capabilities and reversing malign policies. Assessment of the situation has already started in the transition. We need a fully staffed government, not hobbled by ridiculous policies, to control the pandemic.

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The Biden Administration’s Job One

Congratulations to President-Elect Joe Biden and Vice President-Elect Kamala Harris! Biden has already announced Job One.

The numbers of sick and dead from Covid-19 are shooting up the steep part of the exponential curve, where they become hard to control. Most of the country is seeing uncontrolled spread of the virus – that means that people don’t know how they contracted it. The numbers set records every day now.

Biden has already announced that he will name, on Monday, a 12-member COVID task force.

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How To Tell A Real Vaccine From A Political Stunt

Donald Trump hinted that he could have an “October surprise” in a SARS-CoV-2 vaccine. That isn’t going to happen. The closest is Pfizer’s announcement that it may apply for emergency authorization for its vaccine before the end of November. But, of course, that’s after the election.

The pharmaceutical companies, fortunately, are more interested in preserving their credibility than in currying Trump’s favor. Perhaps they have calculated that Trump is unlikely to win a second term.

ProPublica has a long article on how vaccines are approved. If you want the whole story, check it out. Here’s a tl;dr to provide more of a checklist.

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Where We Are – 36 Days Out

The New York Times now has Donald Trump’s income tax returns “extending over two decades”. They say that the returns come from a person who had legal access to them. The Times’s first article provides eighteen takeaways. They promise more to come. Each takeaway is a string that other news organizations can pull.

Trump runs through money and then manages to find yet another source to bankroll him. At this point, he owes $421 million to unknown parties. There are hints and guesses about connections to a hotel deal in Azerbaijan that appears to have laundered money for Iran’s Revolutionary Guard and to Deutsche Bank through Supreme Court Justice Anthony Kennedy’s son.

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PSA: Donald’s New Drug Can Kill You

Man, I hate articles like the one in Axios about Donald’s latest snake oil. I’m not going to link to it. It should have started with

OLEANDRIN CAN KILL YOU, AND OTHER EXTRACTS FROM THE OLEANDER PLANT WILL KILL YOU

Instead, it cites papers to look authoritative and buries a quote from one researcher that translates to

DO NOT DO THIS

and shows pretty flowers in the pill bottle.

One of the heuristics I’ve carried with me from my time in California is “Oleander is poison. Do not eat.” The flowers are pretty, and it’s everywhere in California. So when I saw this a week or so ago, I did some research. Apparently oleandrin is one of the less toxic oleander components. It’s being used experimentally against cancer. God only knows why anyone is researching it for COVID-19, because it’s still pretty toxic. Not a path I would take until less toxic alternatives are exhausted.

It also looked like people refer to broader extracts from oleander as “oleandrin,” not just one component. So it’s only a matter of time until someone dies.

LALALALA Redux

A little more than a year ago, when Donald Trump was in the throes of a love affair with Kim Jong Un, I advanced a theory of his behavior. He wanted the photo-ops and signatures and the sense of a nuclear nonproliferation deal, but was incapable of making a deal, in his words. His incapacity lay in his ignorance about how treaties are negotiated.

At some point, my North Korea watching colleagues maintained, Trump would have to recognize that his photo-ops had no effect whatsoever. Would he freak out against the unfaithful “Little Rocket Man”? Would he admit failure? No problem, I said. His continuing response would be “LALALALA I can’t hear you.”

How would he proceed from those photo-ops, as North Korea was continued to accumulate fissile material and build weapons, even test missiles? When North Korea issued statements insulting Trump and the people working for him? When there were no talks to develop a path towards Secretary of State Mike Pompeo’s Complete, Verified, and Irreversible Disarmament (CVID) and variants on that theme? When North Korea explicitly said that no way would that happen?

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Where We Are With COVID-19

If you’re hoping to go back to normal, it’s not going to happen. The normal of November 2019, before SARS-CoV-2 got a foothold in the human population, will not return. There will be a time when COVID-19 is no longer one of the top causes of death in the United States and a primary topic of concern around the world. But we can’t know when that will be. I’m guessing it’s at least two years away.

Because of negligence by leaders, particularly President Donald Trump, the virus is everywhere. It will take serious effort to bring it under control. The United States has handled the pandemic almost uniquely badly, but even countries that have minimized cases continue to be affected as well. Vigilance must be constant to keep the virus from returning with travelers. Where there are outbreaks, they will have to be tamped down with isolation, testing, and tracing.

After the long, hard slog to where virus cases and deaths are few, repercussions will continue. Some people continue to have symptoms for months. Because we have only seven months’ experience with the virus, we don’t know how many people will suffer virus-related disabilities, how long they will last or if they will flare up again later.

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This Is Definitive On Masks

The Journal of the American Medical Association has a short article saying that the evidence is strong for wearing masks in public.

There is good evidence that masks help both in keeping viruses from being spread by the wearer and also in preventing the wearer from breathing viruses in. Further, wearing a mask does little harm, which is greatly outweighed by the benefit of reducing transmission.

Some selections:

After emerging data documented transmission of SARS-CoV-2 from persons without symptoms, the recommendation was expanded to the general community, with an emphasis on cloth face coverings that could be made more widely available in the community than surgical masks and to preserve personal protective equipment such as N95 respirators to the highest-risk exposures in health care settings. Now, there is ample evidence that persons without symptoms spread infection and may be the critical driver needed to maintain epidemic momentum.

…recent research of household textiles’ performance when used as source control suggests cloth face coverings may be able to do so with acceptable efficiency and breathability.

Like herd immunity with vaccines, the more individuals wear cloth face coverings in public places where they may be close together, the more the entire community is protected. Community-level protection afforded by use of cloth face coverings can reduce the number of new infections and facilitate cautious easing of more societally disruptive community interventions such as stay-at-home orders and business closings.

At this critical juncture when COVID-19 is resurging, broad adoption of cloth face coverings is a civic duty, a small sacrifice reliant on a highly effective low-tech solution that can help turn the tide favorably in national and global efforts against COVID-19.

The article is easy to read and gives examples with references. Check it out.

Cross-posted to Balloon Juice