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Showing posts from August, 2021

Durable

  One of the questions about the COVID-19 vaccines is whether they will provide durable immunity six months or more after the last vaccine. Indeed, some folks are already getting boosters. So far, the news appears to be good on the durability of vaccine protection: "Wherry’s group found that memory B cells generated by the mRNA vaccines made by Moderna Inc. and Pfizer Inc. and its partner BioNTech SE appeared better at blocking virus variants including alpha, beta and delta, than those produced in response to a mild case of Covid-19. Additionally, high levels of vaccine-induced T cells, a type of white blood cell capable of finding and killing virus-infected cells, were detected after six months, “maintaining an additional armor to protect us,” Wherry said. The findings help to explain why immunization remains effective at protecting against severe Covid-19, hospitalization and death even as more break-through infections occur. “We’re seeing a drop in efficacy when you only measur...

vaccination vs natural herd immunity

  In the unceasing effort by the right to politicize and weaponize the COVID-19 pandemic, some politicians have seized on a recent paper from Israel claiming that natural infection provides better protection than two doses of the Pfizer vaccine. Setting aside the orders of magnitude difference between COVID-19 deaths in unvaccinated vs vaccinated patients, which render the argument for infection-based herd immunity risible, there are two technical comments to be made: 1. In the Israeli study, the higher hospitalization rate in the 32,000-person analysis was based on just eight hospitalizations in a vaccinated group and one in a previously infected group. And the 13-fold increased risk of infection in the same analysis was based on just 238 infections in the vaccinated population, less than 1.5% of the more than 16,000 people, versus 19 reinfections among a similar number of people who once had SARS-CoV-2. Sorry, but extraordinary claims require extraordinary evidence, and these num...

Judge not

  I've read some posts advocating that we deny hospital care to unvaccinated COVID-19 victims, or at least deny insurance coverage. What about other reckless and avoidable behaviors: the injured motorcyclist who wasn’t wearing a helmet or the injured driver who wasn't wearing a seat belt? the liver-transplant patient who abused alcohol or the cancer patient who smoked? the hurricane or wildfire victim who refused the call to evacuate? the junk-food eater who never exercised and now needs bypass surgery or becomes diabetic? the person who caught chlamydia or HIV during unprotected sex? Health care would be much less expensive if we withheld care/insurance from everyone whose poor judgement put them in a life-threatening situation. There are few of us who don’t contribute in some way to our health problems. If we withhold care from people who caused their own troubles, or rationing it through much higher medical bills, anti-vaxxers will have plenty of company.

About that third shot

  Here's a link to a good think piece about COVID-19 boosters. The money quote: “In short, diminished vaccine effectiveness does not make the case for boosters. A reduction in severe outcomes makes the case for boosters, but we have no such data to date.” Also too, this grabbed my attention: ". . . two people with knowledge of the FDA's deliberation told The Washington Post that the agency was investigating myocarditis signal with the Moderna vaccination. Canadian data suggest the risk may be 2.5 times that of Pfizer's vaccine." https://www.medpagetoday.com/opinion/vinay-prasad/94188?xid=nl_mpt_DHE_2021-08-25&eun=g1700464d0r&utm_source=Sailthru&utm_medium=email&utm_campaign=Daily%20Headlines%20Top%20Cat%20HeC%20%202021-08-25&utm_term=NL_Daily_DHE_dual-gmail-definition

More on ivermectin and COVID-19

  To follow up on the previous ivermectin post, here is a recent summary of the findings on ivermectin as an antiviral. While this article hedges carefully throughout most of the text, here's the money quote on ivermectin and COVID-19: "Notably, the clinical outcomes upon prescribing IVM on its own did not result in significantly improved outcomes for COVID-19 patients and nor should it be particularly encouraged." As they say, read the whole thing: https://www.frontiersin.org/articles/10.3389/fimmu.2021.663586/full?fbclid=IwAR0JtTFLonCXB6agyE7mYzmABaJtZDHAh1IkP9J2jX5BlPR00rrxcvRwsa8

Ivermectin madness

  People are taking the deworming medication ivermectin for COVID-19. This is nuts. There isn't any scientific evidence that ivermectin is an effective antiviral. Don't believe anyone who claims they know of someone who was successfully treated for COVID-19 with ivermectin. They don't know what they're talking about. Here's what the FDA says: • FDA has not approved ivermectin for use in treating or preventing COVID-19 in humans. Ivermectin tablets are approved at very specific doses for some parasitic worms, and there are topical (on the skin) formulations for head lice and skin conditions like rosacea. Ivermectin is not an anti-viral (a drug for treating viruses). • Taking large doses of this drug is dangerous and can cause serious harm. • If you have a prescription for ivermectin for an FDA-approved use, get it from a legitimate source and take it exactly as prescribed. • Never use medications intended for animals on yourself. Ivermectin preparations for animals a...

The origin of SARS-CoV-2

  One of the difficult things for the lay public and popular press to grasp is that science doesn't deal in proof. Science deals in facts and evidence. All scientific conclusions are provisional and subject to refinement or falsification by further experiment. Accordingly, the origin of the SARS-CoV-2 virus that caused the COVID-19 pandemic is the subject of scientific debate. There are certainly gaps in our knowledge, but we know enough about Sarbecovirus transmission to adopt the null hypothesis that SARS-C0V-2 was of zoonotic origin. The alternative hypothesis, that it originated from the Wuhan Institute of Virology is so far unsupported by the available evidence. While the Institute may not have been as forthcoming as some might wish, that isn't evidence of a lab origin. Here's the latest I've read on the topic of SARS-CoV-2 origins: “Overall, SARSr-CoV animal-to-human transmission associated with infected live animals is the most likely cause of the COVID19 pandem...

Doing your own research

"Do your own research" is objectively good advice, but it has now become the bleat of the Qanon conspiracy mongers. The “research” valorized by the anti-science (anti-vax, creationist, climate change denialist, etc) crowd is just another form of argument from authority, the sort of “research” the religions do. While authoritative voices in science and medicine are valuable, quoting authority isn’t research, and it lends itself too much to confirmation bias. In this sense, Ronald Reagan had it right–trust, but verify. If you’re not actually doing the research at the bench or bedside yourself, your research must involve reading and critically appraising the primary literature. Tedious details like study design, controls, sample sizes, are all part of researching the literature. Simply parroting the headlines and abstracts isn’t research.  And one final thought: critical thinking isn’t the same as criticizing, and ad hominem attacks are the refuge of scoundrels. 

Will the COVID-19 vaccine alter my DNA?

Indirectly, yes. The vaccine causes a few of your cells to express the SARS-CoV-2 spike protein, which triggers your B and T cells to respond by making specific DNA rearrangements to enable them to recognize the virus. Neither the mRNA vaccines (Moderna and Pfizer) nor the recombinant adenovirus vaccines (J&J and AstraZenica) interact directly with your DNA. The alterations these vaccines trigger indirectly in B and T cells are analogous to the alterations in those cells that occur in a natural infection, and to the alterations that occur in response to all infections and vaccines. This is how adaptive immunity and immune memory work. So technically the vaccine, like all vaccines, alters your DNA. That's a feature, not a bug.

The march of progress

  Back when we were both younger, Rebecca and I used to sing along with They Might Be Giants "Why does the sun shine": "The sun is a mass of incandescent gas . . ." Which turns out not to be accurate. The sun is comprised of plasma, not gas. Accordingly, They Might Be Giants recorded a revised version, "Why does the sun really shine": "The sun is a miasma of incandescent plasma . . . " https://www.youtube.com/watch?v=sLkGSV9WDMA

Update on vaccination and the Delta variant

As with any hot field, the question of how the Delta variant interacts with the vaccine is fraught with conflicting evidence. One concern I have, not mentioned in the link below, is that the PCR test cannot distinguish between infectious virus particles and RNA remnants from damaged/destroyed virus. Therefore, what is being measured isn't necessarily viral burden or the ability to infect others. Probably the best data is described at the end (h/t Nature): "One massive analysis of Delta transmission comes from the UK REACT-1 programme, led by a team at Imperial College London, which tests more than 100,000 UK volunteers every few weeks. The team ran Ct analyses for samples received in May, June and July, when Delta was rapidly replacing other variants to become the dominant driver of COVID-19 in the country. The results suggested that among people testing positive, those who had been vaccinated had a lower viral load on average than did unvaccinated people. Paul Elliott, an epi...

Taliban Islam

  It is a cliché to call the internet a wasteland. Yes, most of the activity on the internet is related to pornography, and too much of the rest is either political propaganda or trivia. But as the mainstream media has become clickbait and bothsiderism, the internet does provide access to thoughtful discourse. As my FB peeps know, I read Kevin Drum (now blogging at Jabberwocky) and Josh Marshall at Talking Points Memo. For analysis of the Middle East and Islam, I’ve followed Juan Cole, a professor of Middle East studies at the University of Michigan. With the restoration of the Taliban in Afghanistan, the mainstream media are focused on the fact that the Taliban are identifiably Muslim, without doing the hard work of explaining that practitioners of Islam are as diverse as practitioners of Christianity: “You have your Kentucky snake handlers and your QAnon militants, some of whom carried guns at the Capitol insurrection. Then you have your mainstream Presbyterians and Congregationa...

The Future of Afghanistan

  The popular press treats “the Taliban” like a state entity. It isn’t. In its present form, the Taliban that took control of Afghanistan is, at best, a patchwork of fluid alliances with uncertain loyalties. The fall of the US puppet government in Kabul was made possible by manpower and resources drawn from various ethnicities and nationalities. Currently, what passes for leadership is trying to paper over this fractious alliance by branding itself the “Islamic Emirate of Afghanistan” and issuing unenforceable edicts. Whether any recognizable central government will emerge from the current chaos seems doubtful, and neighboring countries, fearing Islamist violence, will present further challenges as factions within Afghanistan seek patrons by extortion. Don’t be fooled by the simpleminded and ahistorical commentaries that analogize the Taliban to Nazi Germany and Biden to Chamberlain. The Taliban don’t have a navy or air force and their blitzkrieg takeover was possible only because ...

Reaganland

  I just finished “Reganland,” the third and longest book in the trilogy by Rick Perlstein that began with “Nixonland,” followed by “The Invisible Bridge.” Reaganland begins with Nixon’s resignation and the short presidency of Gerald Ford, the only American president who was neither elected president nor vice president. The book takes us through the 1976 presidential nomination, which Reagan contested and nearly took from Ford, and the surprising nomination and election of Jimmy Carter. This was the first presidential election I got to vote in. The Carter presidency was cursed with “stagflation,” and near the end with the Iranian hostage crisis. The latter was self-inflicted when Carter let the Shah into the country for cancer treatment and Iranian students invaded the US embassy. The story Perlstein tells make it seem as though the students were like the dog that catches the car: they didn’t expect to be successful in taking over the embassy and they didn’t plan to take captives. ...

Afghanistan

The headlines today are filled with news about the collapse of the Afghan puppet "government." The Afghan government was never anything more than a convenient myth to justify the US military occupation of the country. Yes, Osama bin Laden and al Qaida had to be evicted, but we should have left when bin Laden was assassinated. The military occupation was a never-ending drain on American lives and treasure, not to mention the lives of Afghanis who depended on the US occupation. As Mullah Omar famously stated: 'The Americans may have the clocks. But we have the time.' It was a matter of time. The time has come.

No excuses

 Recent research challenges the widely accepted belief that after the teenage years, our metabolism starts to slow down, accounting for middle-age spread.  " Pontzer  et al.  report that energy expenditure (adjusted for weight) in neonates was like that of adults but increased substantially in the first year of life. It then gradually declined until young individuals reached adult characteristics, which were maintained from age 20 to 60 years. Older individuals showed reduced energy expenditure. Tissue metabolism thus appears not to be constant but rather to undergo transitions at critical junctures." Pontzer and his collaborators previously used the same approach to show that African hunter-gatherers burn about the same number of calories as western adults, and that exercise only has a modest effect on weight control. Until age 60, adults can best control body weight by controlling their diet. Exercise has plenty of benefits, don't get me wrong, but it is the slow p...

Moderna v Pfizer

  I ended up in the Moderna Phase III trial because that was the vaccine being trialed at our Vaccine Center. The clinic is on the first floor of the same building where my office is, so it was easy. I ended up in the vaccine arm, not the placebo arm, by chance, although everyone was offered the vaccine last January. Next week, it will be a full year since my first injection. Both the Moderna and Pfizer vaccines are mRNA for the SARS-CoV-2 spike protein. I was intrigued by this approach and that was one of several reasons I volunteered. The data so far show that both vaccines are comparable in their protection, even with the Delta variant, although by several metrics the Moderna vaccine has a small numerical edge in protection. Since the vaccines themselves are nearly identical, the most logical thing to infer is that the higher dose in the Moderna vaccine explains the difference. The durability of protection is still unclear, since the vaccines are so new. Data out to six months i...

Everybody knows

  "Everybody knows" that business must pay the lowest wage possible in order to stay in business. Econ 101, amirite? In the eternal combat between theory and reality, I'll take reality every time, thankyouverymuch. "Labor costs, including taxes and benefits, now account for about 17% of sales, up from 12% eight years ago. But the extra labor has helped CRC to fill more orders, and sales rose nearly 50% in the first seven months of 2021 versus a year earlier. That allowed better use of equipment and other fixed assets—to a degree that surprised Mr. Braun. The higher margins are good for him, and employees also benefit through the company’s profit-sharing plan. Eligible employees received $355 in the second quarter of this year, the most the company has paid since 2012." The actual content at the WSJ is behind a paywall, so I'll just leave this link: https://www.lawyersgunsmoneyblog.com/2021/08/just-crazy-enough-to-work?fbclid=IwAR2znijinwtcFbtfwG1c_HnCGDni5k...

Remembering the Mann Gulch fire, 1949

  I missed noting that 5 August is the anniversary of the Mann Gulch fire. With all the wildfires still going on out west, it's an important story to know. If you don't, here's a summary: https://www.youtube.com/watch?v=wbs1Uqc-y4c There's much more detail in the book "Young Men and Fire" by Norman Maclean. James Keelaghan's song "Cold Missouri Waters" tells the story from the point of view of Wagner Dodge, the jump crew leader who survived by lighting a safety fire. https://www.youtube.com/watch?v=eN2DVFX8X0M

In Texas, everything is bigger, including folly

  Barbara Tuchman defined political folly as “the pursuit of policies [by rulers and leaders] contrary to the government’s own interests, despite the availability and knowledge of feasible alternatives.” What is happening today in Florida and Texas qualifies as folly. "As cases of COVID-19 soar in Texas, all parents won’t be informed if there’s an outbreak of coronavirus in their children’s public schools. Notifications will only be required if a district learns a child was a “close contact” of someone with the virus. Those parents can then “opt” to keep their child at home, according to new guidelines issued earlier this week by the Texas Education Agency. Vaccinated people are not considered a close contact who should be informed, according to the guidelines, even though vaccinated individuals can catch and spread the disease. The TEA also warns: “School systems cannot require students or staff to wear a mask.” In addition, schools will no longer be required to carry out contact...

The meaning of life

  The Storyworth question of the week is “What do you think is the meaning of life?” Imbedded in this question is the assumption that there is a "meaning of life.” I don’t share that assumption. What’s interesting to me is the things that give my life meaning to me. Basically, I wake up each morning hoping to make a positive difference in the world. For my family and friends. For my pets. For my colleagues and students. For the people who read my writing, both in publications and on blogs. It’s hard to know how much of that goes on. For my scientific publications, I can look on Web of Science, SCOPUS or Google Scholar to see how many times my pubs have been cited. Reads and comments on my various blog and Facebook posts. Interactions with students, in person and online. As I head into retirement, I don’t expect to teach or publish much in the years that remain to me. That’s one reason why I’ve stepped up blogging on my own site and elsewhere. I have my family and pets, but my circ...

Vaccine effectiveness

  Over at angrybearblog.com , Peter Dorman asks “what does vaccine effectiveness mean.” https://angrybearblog.com/.../what-does-vaccine... This question is on the minds of those who are vaccinated and those contemplating vaccination, as well as physicians, vaccine developers, the CDC and government officials. Dorman writes: “ The everyday use of “effectiveness” is effectiveness against the virus. The research use is effectiveness relative to the control group. This is immense, but widely misunderstood and seldom explained.” Yes, effectiveness in drug, device and vaccine trials is measured by comparing control/placebo group results to treatment group results. In the particular case of the COVID-19 vaccines, the trials are not challenge trials. It would be unethical to infect subjects with a potentially lethal virus like SARS-CoV-2. So the idea was that both groups would have some significant likelihood of natural infection that would be reportable in the trial (Disclosure: I’m i...

COVID-19 update

" Delta infections among vaccinated likely contagious; Lambda variant shows vaccine resistance in lab" https://www.reuters.com/article/idUSKBN2F321F?fbclid=IwAR3mhXtnY3UME9Clx2ku15TkSpfbWE50Cn_jyHAlsUoE-RpeOGPJuG8hL1U