Weekly coronavirus-related chat, questions, and minor updates - week of February 8

I'm hesitant to make a standalone post to talk about the state of things in Belgium. I mentioned a few days ago that I'm frustrated with the completely schizophrenic preventative measures.

What do the results look like, concretely? They look like this: https://twitter.com/BartMesuere/status/1358358351340568578/photo/1

There's a lot of self-congratulations in that twitter thread but the reality is, this is a high plateau, and we are sacrificing concretely more than we would if we were trying to get to near-zero.

The first lockdown, from March 2020, lasted two months and lowered the numbers down to near-zero, which lasted until mid-september, with basically everything having reopened for several months (bars, gyms and cinemas included).

Our second lockdown has not been as severe, but has been going on for over four months and THIS IS THE RESULT. A high plateau. Everything is still closed. They're reopening hairdressers because people are going fucking insane.

This is severely affecting people's mental health, mine included. Out of wanting to strike a middle ground between locking down completely and allowing some freedom, we instead have been nationally unable to go to gyms, bars etc for months and people are fed up with it, to the point that it's fueling an anti-science sentiment because right now, the most vocal anti-lockdown people are also anti-science, so they're gaining a lot of support.

This is a serious fucking problem. I don't believe Belgium is alone in this situation, a lot of european countries find themselves in a somewhat similar predicament. The ship is headed for the iceberg and we're completely, collectively powerless to stop it. There is no acknowledgement of this damage. People make it about "health vs economy" but there is so much more to it.

In a previous comment, I talked a bit about this. I know a lot of people here on Tildes, especially those from the other side of the atlantic, are frustrated that their state/country is not taking COVID seriously and I fully understand that. But, dangerous and selfish as it is, the american "fuck it" strategy is a strategy if you commit to it and because of Trump, america did commit to it long enough to start vaccinating. And America, globally, is doing pretty well on vaccinations. So even though the US was doing horribly badly in 2020, it looks a LOT better in 2021 (even if the numbers don't show it quite well).

On the other side of the world, South Korea takes things very seriously and regularly locks down the country and/or individual cities. But it does so strictly, and is able to resume normal life on a regular basis. Does it suck to keep toggling things on and off? Sure does, but at least life is normal on a regular basis.

The Belgian lockdown is planned to last until April 1st, extended from March 1st. I've reached the point where I'm considering moving out of the country for a few months, to get some sanity back, and maybe even potentially get vaccinated earlier than I would be here. Nobody even bothers talking about reopening the rinks. Two of them have shut down permanently due to bankruptcy. I feel like my sport, one which thankfully happens to be extremely COVID-friendly, has been stolen from me right as I was able to fully commit to it.

Ron Wright, a member of the US House from Texas, died last night from COVID-19. He's the first sitting member of Congress to die from it.

New ‘do not resuscitate’ orders imposed on Covid-19 patients with learning difficulties

People with learning disabilities have been given do not resuscitate orders during the second wave of the pandemic, in spite of widespread condemnation of the practice last year and an urgent investigation by the care watchdog.

[...]

The disclosure comes as campaigners put growing pressure on ministers to reconsider a decision not to give people with learning disabilities priority for vaccinations. There is growing evidence that even those with a mild disability are more likely to die if they contract the coronavirus.

I've seen several arguments in favor of this, and they make me so angry.

The first argument is, "people with learning/developmental disabilities won't be able to handle the rehabilitation from severe illness." Firstly, that just means you should devote more resources to helping them recover, not give up and let them die. And secondly, do they think abled people who have been through severe illness don't also need a lot of help? People with residual effects of the ICU and/or long COVID are likely dealing with cognitive effects ("brain fog") or even the results of strokes. They might have difficulties managing their recovery, but again, the solution is to help them.

The other argument I've seen is that disabled people will have reduced "quality of life" after severe COVID. But doctors consistently rate disabled people's quality of life much lower than disabled people do themselves. So it's outright dangerous to take medical opinions about quality of life as an objective measure of illness outcomes. You're relying on a group of people with proven ableist beliefs about what lives are worth living to decide who deserves to live.

A related Tildes topic: Doctors share views on patients with disability.

Judge denies Publix’s request to dismiss COVID-19 wrongful death case

Gerardo Gutierrez, a 70-year-old Publix deli employee in Miami Beach, died of complications from COVID-19 in April. The lawsuit, filed by his adult daughter, Ariane Gutierrez, alleges he contracted the virus from a coworker while he was barred from wearing a mask to work. The judge’s decision means the case will continue to move forward in court.

In its filing seeking to dismiss the case, Publix’s attorneys wrote the lawsuit was “littered with inflammatory and unsupported rhetoric” and that the death was a workplace accident that should be handled as a worker’s compensation claim.

The defense of "this should be handled by worker's comp" seems plausible on its face, but is really a subtle bit of legal trickery:

Florida worker’s compensation law says only children younger than 18 or under 22 and a full-time student or spouses can be benefactors in a case involving an accident that resulted in death. The case has been filed on behalf of Gutierrez’s four adult children, none of whom would be considered dependents.

Apparently in Florida, if you're not married and all your children are adults, there is no legal recourse for your employer negligently killing you.

If opening schools is so important, why are we skimping on protections that curb COVID?

Yet the recent assertion by the new director of the Centers for Disease Control and Prevention, that vaccines may not be necessary to return students to classrooms, has added fresh fuel to a grinding debate centered on the minimal conditions for achieving this goal.

Here’s what we have learned as a teacher, public health worker, and parents of young children in Vermont: Reopening schools requires abandoning a mindset of scarcity that has long dominated our approach to both the pandemic and education. Instead of rationalizing bare-minimum policies, we should ask the question: How can we marshal all of our country’s resources to support educators entrusted with carrying out this important work?

Reddit AskScience having an AMA today:
AskScience AMA Series at 5 PM ET (22 UT): We are Bechara Choucair, Carole Johnson, and Tim Manning, the vaccine, testing, and supply coordinators for the White House COVID-19 Response Team. AUA!

Judge grants eviction against St. Peters woman too sick from COVID-19 to be allowed in courthouse

She catches covid, which means she can't work. Which means she can't pay rent. Which means her landlord files for eviction.

Still has covid on her court date, which meant she wasn't allowed to enter the courthouse for her eviction proceeding, and her eviction was approved.

Oh, also she's recovering from cancer.

0 deaths, only 4 severe cases among 523,000 fully vaccinated Israelis

Maccabi’s statistics are being closely monitored around the world, for giving the first major insight into how the vaccine performs outside of clinical trials. And they are being widely hailed for indicating that real-word effectiveness is close to the 95% efficacy cited after Pfizer’s clinical trials.

“This data unequivocally proves that the vaccine is very effective and we have no doubt that it has saved the lives of many Israelis,” said senior Maccabi official Dr. Miri Mizrahi Reuveni after the new data release.

She stressed that among those who have vaccinated and become infected, the vast majority have experienced the coronavirus lightly. Out of the 523,000 fully vaccinated people, 544 were infected with COVID-19, of whom 15 needed hospitalization: Eight are in mild condition, three in moderate condition, and four in severe condition.

How You Make an Adenovirus Vaccine

The other day I had a look at the process used to make the mRNA vaccines, so I thought it would be a good idea to do the same for the adenovirus vector ones, such as J&J, Oxford/AstraZeneca, CanSino, Gamaleya et al.

[...]

Now it’s time to get those linear DNA molecules into human cells. Here we get into some controversy, depending on your beliefs. It looks like Oxford/AZ is using a complementation-engineered version of HEK293 cells for this process, as are Gamaleya and CanSino, while J&J is using a line called PER.C6. These two have both been around for a while. The HEK initials stand for “human embryonic kidney”, and it was indeed first isolated from aborted fetal tissue in the early 1970s at Leiden University. PER.C6 as a complementation strain goes back to 1998, but the origin of the cell line is back in 1985 in Leiden as well, also from aborted tissue, with the “ER” part standing for “embryonic retinoblasts”. As you can well imagine, people with strong anti-abortion beliefs are not enthusiastic about taking vaccines that touch on this area in any way for their production, while other with different beliefs are not bothered at all. No matter what, though, it seems crucial for the linear DNA to be transfected into some sort of human cell complementation line; that’s the only way you’re going to get amplified yields of the final viral particles used in the vaccine.

[...]

Human cell culture – any cell culture – is simultaneously a scientific process and an art form. Ask anyone, literally anyone who’s done it, and if you can find someone who’s worked on it at an industrial scale, they’ll confirm that all the more vigorously. This is (or can be) the weak point of the entire viral-vector production process. When everything is working, this method for infecting living cells and turning them into virus factories is hard to beat. But it doesn’t aways work the way it’s supposed to. It appears that AstraZeneca has been having problems because one of their largest production facilities has been experiencing problems with low yields of virus, even though everything should be the same (same viral DNA, same cell line, etc.)

In a major new pandemic trend, people are turning to carbon dioxide monitoring devices to help assess ventilation quality

It’s part of a new wave as scientists, citizens and businesses including gyms, restaurants and bars try to quantify the airborne coronavirus risk in hopes of staying open. Sales of handheld carbon dioxide monitors have boomed, so much that one popular model, the $250 Aranet4, sold out rapidly, requiring its Latvia-based manufacturer, SAF Tehnika, to dramatically ramp up production.

I don’t know if it will work, but I’m glad they’re allowed to try. If it were a medical test, it would be illegal.

The B117 variant is apparently at ~9.5% in Florida, ~3.9% in California:

https://twitter.com/alexbolze/status/1359749742922665990

I have an odd question and was wondering if any of the Tildes folks might have an insight. How are the vaccine side effects different from standard Covid side effects. I have a number of people within my daily life saying they are unsure about the vaccine because we don't know about the side effects and my thinking is that any side effect you might get with the vaccine would be an equivalent or lesser version of what you would get by actually getting Covid. Is this true or is there the possibility of getting a more severe reaction to the vaccine than the virus itself?

My brother who had a doctor's appointment last Wednesday, was checked by someone who he was just informed tested Covid positive today, and now I am off work until I'm clear to put a poke up my nose and prove that I'm not contagious with the thing I've already had in May. Normally I wouldn't mind missing work, and I can be courteous and understanding in that we're living in trying time, but I'm frustrated in no particular direction because if there was damage, it's already done, and I'm missing work on a new job. (And I know that I'm justified in missing work since it's policy and morally the right thing to do, but I'm still not happy about it.)

Prof Abdool Karim outlines future usage of AstraZeneca vaccine in South Africa

“The doses that we have should be used. But they should be used in a manner that we can first assess if it is effective against severe disease and hospitalisation. Once we can answer that question, when the first 100 000 or so have been vaccinated. If the answer is yes, it reduces hospitalisation substantially, then we proceed and use up the rest.”

“If it doesn’t, then we need to go back to the drawing board because then we need to wait for the booster doses to become available, or to switch to a different vaccine,” explains Abdool Karim.

Top Seattle PD officials asked King County Jail officials to override COVID restrictions and book nonviolent protestors. They complied.

The King County Jail has been accepting bookings of protestors on nonviolent misdemeanor charges that would appear not to rise to the level of serious public threat. These charges include the broad charge of “property destruction” — which appears to include writing on walls with charcoal and chalk — and “trespassing” and “obstruction” in a temporarily closed public park.

On March 24, 2020, the DAJD issued a press release that included updated jail booking directives.

“Jails will not accept people brought in for misdemeanor charges, except for misdemeanor assaults, violations of no contact or protection orders, DUIs, sex crimes or other charges which present a serious public safety concern,” the first bullet point reads, before continuing. “Jails will continue to accept people booked for felony investigations for now. In the meantime, jail administrators have asked all law enforcement to prioritize bookings for those who pose an imminent risk to public safety.”

Nature has a very in-depth article about rapid testing:

Rapid coronavirus tests: a guide for the perplexed

These speedy tests, which typically mix nasal or throat swabs with liquid on a paper strip to return results within half an hour, are thought of as tests of infectiousness, not of infection. They can detect only high viral loads, so they will miss many people with lower levels of the SARS-CoV-2 virus. But the hope is that they will help to curb the pandemic by quickly identifying the most contagious people, who might otherwise unknowingly pass on the virus.

Yet, as the government announced its plan, a furious argument broke out. Some scientists were delighted by the United Kingdom’s testing strategy. Others said that the tests would miss so many infections that, if rolled out in their millions, they could cause more harm than good. Many people might be falsely reassured by a negative test result and change their behaviour, argued Jon Deeks, who specializes in test evaluation at the University of Birmingham, UK. And, he said, the tests would miss even more infections if people self-administered them, rather than relying on trained professionals. He and his Birmingham colleague Jac Dinnes are among scientists who want more data on rapid coronavirus tests before they’re used widely

But other researchers soon fired back, saying that the claim that the tests could cause harm was wrong and “irresponsible” (see go.nature.com/3bcyzfm). They included Michael Mina, an epidemiologist at the Harvard T. H. Chan School of Public Health in Boston, Massachusetts, who says that the arguments are delaying a much-needed solution to the pandemic. “We continue to say we don’t have enough data yet, but we’re in the middle of a war — we really can’t get any worse than we are at the moment in terms of the case counts,” he says.

[...]

But differently calibrated PCR systems mean that Ct levels can’t easily be compared between labs, and don’t always indicate the same level of virus in a sample. Innova says that the UK and US studies used different PCR systems, and that only direct comparisons on the same system are valid. They pointed to a UK government report, written by Porton Down scientists in late December, which ran the Innova test head-to-head with an Abbott Panbio test (similar to the BinaxNOW kit that Abbott sells in the United States). On just over two dozen samples with Ct levels lower than 27, both returned 93% as positive (see go.nature.com/3at82vm).

[...]

Slovakia, a country of 5.5 million people, was the first to attempt to test its entire adult population. Widespread testing has helped to cut the infection rate by nearly 60%5. But the testing was done in combination with tough restrictions that are not implemented in other countries, as well as government financial support for those who tested positive, to help them stay at home. So although the combination of testing and restrictions seemed to reduce the infection rate more quickly than restrictions alone, it’s unclear whether the approach could work elsewhere, experts say.

[...]

In the United States, the Food and Drug Administration has granted emergency-use approval for 13 antigen tests, but wonly one — the Ellume COVID-19 Home Test — can be used in people without symptoms. According to Ellume, a firm in Brisbane, Australia, the test detected coronavirus in 10 of 11 asymptomatic people who had already tested positive with PCR. In February, the US government announced it would buy 8.5 million of the tests.

Some California Schools Are Testing Kids For the Coronavirus Twice a Week Before Letting Them Inside

These self-administered swabs are part of rapid COVID-19 antigen testing, now used by nine school systems across California willing to pilot the twice-weekly testing of all students who have parental permission. Part of an attempt to reopen campuses, the program is also under consideration by several more districts, and the surveillance testing of students it offers could help build confidence in the tests as a way to prevent coronavirus transmission in schools, as well as limit the spread of the disease in communities.

[...]

With mounting evidence that students are suffering from mental health issues and learning loss, and nearly a year after schools shut their doors due to the pandemic, the hope is that rapid testing will help schools bring their students back into classrooms. The California Endowment, an organization that works to bring health care to underserved communities, is funding the program with $2 million.

[...]

Oakland Unified School District has expressed interest in the tests, Iton says. Some of the city's parents have joined a growing movement across the state trying to pressure Gov. Gavin Newsom to do more to reopen schools. Teachers unions in larger urban districts such as Oakland, San Francisco and West Contra Costa County, which includes Richmond, have resisted, saying many communities they serve have been hit hard by COVID-19, and reopening campuses would only further the spread due to students mixing in classrooms.

[...]

Iton says Abbott’s BinaxNOW rapid antigen test, the type used in the pilot program, is efficient, cheap and highly accurate in detecting symptomatic cases, though it has been faulted for missing the virus in asymptomatic people who do not have high enough levels of the virus to test positive. The Centers for Disease Control and Prevention says antigen tests can be an important tool in an overall community testing strategy to reduce transmission, recommending serial testing to better capture cases of infection, which is what La Honda-Pescadero will do.

It seems encouraging. I wonder why it's twice a week and not every day?