Wednesday, January 20, 2021

Five Minute Roundup

 Ding dong.

You can still buy a high-grade reusable mask (don't forget the vent plugs).

Don't try to re-use your N95 type masks more than a couple times, or you might as well be wearing a cloth mask.

Better masks would be good but people covering up their !@$!% noses would help.

The reason new strains look like they're springing up out of nowhere (they're not) is because sequencing surveillance is so terrible, especially places with the worst outbreaks (AHEM, the US, the UK, South Africa, and Brazil...)

Dreaming of spring. (Though it's not even really cold in the South!)

Tuesday, January 12, 2021

Why Do Right-Wing Extremists Still Surprise People?

 I've been thinking about the right-wing terrorist attacks at the Capitol building last week.  The number of news articles, people in real life, and instance of Internet Commentary I've seen saying "We had no idea they would go this far!" truly astonishes me.  The lengths to which right-wing terrorists have always gone, however, does not surprise me.  (That link is to a literal list on Wikipedia of domestic terrorist attacks.)

Right wing terrorists have always been in the background of my life. For over twenty years, every synagogue I've entered has had armed guards at the front, who interrogate you and search your bags. Sometimes they won't let you in if you don't seem Jewish enough.  Before I hang up a Hanukkah decoration, I ask myself it will lead to these kinds of people vandalizing my house? Will this be the day someone leaves a burning cross on my lawn?  Is it safe?

Is this a Leopards Eating People's Faces kind of thing?  Suddenly it's real to people that those bigoted wastes of oxygen might harm them, instead of other minorities somewhere else?  I get why the police like to ignore white supremacist groups but... how does everyone else?


And now a brief story:

Twenty years ago, I was a college student in France.  I was travelling to Germany via Strasbourg, and tried to go to services one Shabbat.  The security guards- who are usually whatever ethnic minority in that country does the most menial labor, were Maghrebain.  (In the US, they're usually Black; in France, they're usually North African and Muslim.)  They interrogated me, checked my passport, called over a couple of older congregation members, and argued for a while.  

Finally, one of them said "Well, it doesn't say in your passport that you're Jewish."

I literally saw red, hissed "In AMERICA we don't put yellow STARS on the Jews' passports," and marched out the front door.*

Security theater!  It's the best!

* Yes, I was aware that there were stamps in Jews' passports that were not yellow stars; I was being dramatic.

Thursday, January 07, 2021

Infrastructure Failures

 Dear Readers,


As you know, I currently teach science at a small liberal arts school.  Classes are scheduled to maybe start again in a couple weeks (no, they haven't told us what's actually happening yet).  All of this is mere background to the fact that I am ordering lab supplies for teaching labs.

You know how messed up shipping and ordering are in general?  Science supplies are worse. The most basic pipette tips are backordered until May.  Some have a delivery date of July. Things that should have already shipped two weeks ago are still in limbo.  I ordered eppies and I have no idea when they will arrive (I can filch some from someone else and replace them later but... what???).  These aren't even medical supplies.  This is the science equivalent of toilet paper: basic necessities without which everything becomes difficult and unpleasant.

I don't know how much further our basic supply chain will degrade, and I don't know when it will recover, but this is not good.  


Friday, December 11, 2020

Let's Also Talk About Vaccine Hesitancy and Convincing People

 Let's start with the facts: any approved COVID-19 vaccine will be, for sure, safer than getting the disease.  Vaccination remains a public good.  I have told everyone I know they should be vaccinated, and I expect I'll have to argue my mother into it (WHY MOM, YOU ARE A LICENSED MEDICAL PROFESSIONAL).  Also, you don't want to infect your nearest and dearest!  That is not good!

However. If one more person tells me there's totally nothing to worry about and it's definitely 100% safe I will flip a goddamn table. 

First go read this article on all the shady nonsense the FDA has pulled since March, including approving therapies that actually raise the death rate.  

Then you can go read the entire Pfizer trial preliminary results (in two documents!).

First note that the median Phase 2/3 follow-up after the second dose is one month, for a total of two months.  Yes. Two.  When you hear people expressing concern over long-term effects- which there will be, there always are a few- don't bullshit them and say there's plenty of good long term data.  There isn't.  This is a novel technology not previously approved in humans.  But you are less likely to die, or kill others, if you get vaccinated.  There's your talking point. 

Don't tell people that just because the FDA approved something, it's safe and effective. (See above, also, any time these last 100 years.) Say that this disease is deadly, and the trials are pretty large, and COVID definitely will kill you faster than two months.  

When you hear people saying there were Bell's Palsy cases, that is true, and the incidence (over two months) was the same as the normal incidence over a year (though incidence varies widely by sex and age).  Don't bullshit people and say it's totally within normal range.  It may or may not be.  Say that Bell's Palsy mostly resolves, and also, it will not kill you. 

When you hear people saying there is insufficient safety data on people with previous infection, that is also true.  The Pfizer trial gave 670 people (see p. 28) with serological evidence of previous infection their vaccine.  Among these people, adverse events may or may not be more common.  (Also, the US is about to do an accidental trial on all the medical personnel who were infected and didn't know it, so adverse events will show up there.)  But also, please do not try to tell me, personally, that we know 100% for sure it's safe in people with previous infection. You can tell me that by the summer, we will have those data!  We do not have the data now.  But the vaccine still won't kill you.* 

And also, there were at least two credible reports- in hospitals, in medical personnel! - of anaphylactic or anaphylactoid reactions (the latter can still kill you).  The ingredients list is unconclusive as to what might have caused this- basically, PEG, the mRNA itself, or maybe one of the lipid components- but this is a legitimate reason to be concerned.  Again, we do not have enough data now.  For this one, I would say, don't dismiss the concerns of people with severe allergies; tell them to watch for more data.

So, overall: people are hesitant with good reasons.  Some of these reasons can be addressed.  By the time normal people can be vaccinated- in about six months- we will have enough data.  But please don't tell people who legitimately want more data that everything's fine.  That's how the FDA and CDC burned all that trust to start with


* There will, eventually, be a fatal adverse event, which will be a one-in-ten-million event.  On average, however, this will remain true.

Tuesday, December 08, 2020

Let's Talk About Vaccine Safety

 A friend asked me last weekend, 'Will the vaccines really be safe?'

'Will they kill 1000 people a day?' I replied.*

Even if - as I do- you believe that coronavirus numbers are vastly undersampled in the US- let's assume it's still by a factor of 5 - the net death rate is still going to be around 0.5%.  (If you believe we've caught all the cases, I have a bridge to sell you.)  

A vaccine is not going to kill 0.5% of vaccinated people.  On average, almost nobody dies of vaccine side effects (there was a bad batch of diphtheria toxin in 1948; there was a polio vaccine problem in 1955; there are rare cases of Guillan-Barre syndrome;** etc.) 

Please remember that people get sick and die all on their own, all the time, and not all relationships are causal.  People will be vaccinated; there will be adverse events; most will be on the order of "redness, swelling, aches"; some will require medical attention.  

But they will not kill 1000 Americans a day.

(Also, vaccine effectiveness is an observed parameter. Don't expect it to be 95% - which is in fact the efficacy, not the effectiveness- in the real world.)

__

* As of 12/4 the US is up to 329,000 excess deaths.  1000 a day, 3000 a day, it hardly matters; vaccines are, generally speaking, safe.

** Which you can also get from having... a viral infection.

Thursday, December 03, 2020

Dissonance

 Someone of whom I am very fond just tried to argue to me that single-payer health insurance is Bad, Actually, because it might average out less good than what some people currently have.  This same person stayed in a government job long enough to be able to buy the good government health insurance, at a greatly discounted rate, for the rest of their life.  They also have Medicare.  

I gave up on the argument before spontaneously combusting but oooh boy. What a position to take. 

Wednesday, November 18, 2020

Nobody Listens to Scientists

 I have been saying this since July (YES I AM PROBABLY IMMUNE), when the first good papers on the topic came out.  Also, it has been apparent that NYC, for example, would be having another massive outbreak if nobody got immunity.  This is literally how everything works.  

If one person says to me, 'Well, you just never know...' I will blow a gasket. We do know!  That is what science is for!  

(Vaccines are still a good idea.  Herd immunity doesn't exist as long as people are being born.)