What Europeans have learned from a year of pandemic

‘From the first case diagnosed a year ago at a hospital in northern Italy to the empty shops, restaurants and stadiums of Europe's cities, the lives of Europeans have been changed forever. Curbs on movement have forced every country and society to adapt its rules and rethink its culture. There have been hard truths and unexpected innovations in a year that changed Europe.

• Restrictions are tough for societies used to freedom
• Experts are essential, but mistakes have been made
• The EU wasn't set up for a pan-European health crisis
• Societies have responded in different ways
• A Europe without borders is fine in theory
• Hard truths about how we slaughter animals
• Europeans embraced lifestyle change in different ways

Read here (BBC, Feb 20, 2021)

Experts answer the biggest Covid vaccine questions

‘The lack of informed messaging from the Trump administration, combined with the range of different COVID vaccines, the emergence of new coronavirus variants, and inconsistent state and municipal rollout plans, have caused confusion and driven vaccine hesitancy. Scientific American asked Namandjé Bumpus, a pharmacologist at Johns Hopkins Medicine in Baltimore, and Ashley Lauren St. John, an immunologist at Duke-NUS Medical School in Singapore to answer some of the biggest questions about the currently available COVID vaccines:

• Should you get an authorized COVID vaccine now if you are eligible?
• Should you get vaccinated if you have already had COVID?
• How should you interpret vaccine efficacy—what does “95 percent efficacy” or “66 percent efficacy” even mean?
• If you get the vaccine and still get infected, does the vaccine still make a difference? 
• Will it prevent severe disease or death?
• Do the vaccines protect against the new virus variants, including those first identified in the U.K., South Africa and Brazil?
• What is the difference between mRNA and viral vector vaccines?
• Is there a “best” vaccine?
• Will the vaccine protect you from giving the virus to others?
• Will the vaccine’s effectiveness “wear off” over time?
• Should you be worried about allergic reactions to the vaccine?
• How can you ensure you’re getting a legitimate, authorized vaccine?

Read here (Scientific American, Feb 19, 2021)

WHO experts slam NYT for twisting, misquoting their words on virus origins probe

‘WHO experts who recently visited Wuhan slammed the New York Times for twisting their words and casting shadows over the efforts to uncover the origins of the virus, after the newspaper accused China of refusing to hand over sensitive data to WHO experts.

‘The report by New York Times titled “On WHO Trip, China Refused to Hand Over Important Data” accuses China of failing to share important data that may help in identifying the origins of the virus and prevent future outbreaks.

 ‘After the report was published, two WHO experts [Peter Daszak, British zoologist and Thea Kølsen Fischer, a Danish epidemiologist] slammed New York Times for misquoting them in the report to fit its own narrative, with the report casting a shadow over the scientific work of seeking for virus origin.’

Read here (Global Times, Feb 14, 2021)

On WHO trip, China refused to hand over important data

‘Chinese scientists refused to share raw data that might bring the world closer to understanding the origins of the coronavirus pandemic, independent investigators for the World Health Organization said Friday.

‘The investigators, who recently returned from a fact-finding trip to the Chinese city of Wuhan, said disagreements over patient records and other issues were so tense that they sometimes erupted into shouts among the typically mild-mannered scientists on both sides.

‘China’s continued resistance to revealing information about the early days of the coronavirus outbreak, the scientists say, makes it difficult for them to uncover important clues that could help stop future outbreaks of such dangerous diseases.

“If you are data focused, and if you are a professional,” said Thea Kølsen Fischer, a Danish epidemiologist on the team, then obtaining data is “like for a clinical doctor looking at the patient and seeing them by your own eyes.”

‘For 27 days in January and February, the team of 14 experts for the WHO led the mission to trace the origins of the pandemic. Several say their Chinese counterparts were frustrated by the team’s persistent questioning and demands for data.’

Read here (New York Times via Economic Times, India, Feb 13, 2021)

Pfizer withdraws vaccine application in India [after failing to present needed information to experts]

‘Pfizer Inc says it has withdrawn its application for emergency use of its COVID-19 vaccine in India. The company said Friday that it participated in a meeting of experts of the drug regulator on Feb. 3. Based on the deliberation of that meeting and “our understanding of additional information that the regulator may need, the company has decided to withdraw its application at this time,” it said in a statement.

‘The company was the first to approach the Indian regulator in December for its messenger RNA vaccine that it has developed with Germany’s BioNTech. They were closely followed by applications for two other vaccines --- a version of the AstraZeneca made by Serum Institute of India and another by Indian company Bharat Biotech -- which eventually got the nod for emergency use on Jan. 3. However, India’s Health Ministry has said that Pfizer hadn’t made its presentation to experts who needed to clear the vaccine, before the regulator could green-light its use in India.’

Read here (The Independent, Feb 6, 2021)

Covid-19: Social murder, they wrote — elected, unaccountable, and unrepentant

‘After two million deaths, we must have redress for mishandling the pandemic... Murder is an emotive word. In law, it requires premeditation. Death must be deemed to be unlawful. How could “murder” apply to failures of a pandemic response? Perhaps it can’t, and never will, but it is worth considering. When politicians and experts say that they are willing to allow tens of thousands of premature deaths for the sake of population immunity or in the hope of propping up the economy, is that not premeditated and reckless indifference to human life? If policy failures lead to recurrent and mistimed lockdowns, who is responsible for the resulting non-covid excess deaths? When politicians wilfully neglect scientific advice, international and historical experience, and their own alarming statistics and modelling because to act goes against their political strategy or ideology, is that lawful? Is inaction, action?1 How big an omission is not acting immediately after the World Health Organization declared a public health emergency of international concern on 30 January 2020?

‘At the very least, covid-19 might be classified as “social murder,” as recently explained by two professors of criminology. The philosopher Friedrich Engels coined the phrase when describing the political and social power held by the ruling elite over the working classes in 19th century England. His argument was that the conditions created by privileged classes inevitably led to premature and “unnatural” death among the poorest classes. In The Road to Wigan Pier, George Orwell echoed these themes in describing the life and living conditions of working class people in England’s industrial north. Today, “social murder” may describe the lack of political attention to social determinants and inequities that exacerbate the pandemic. Michael Marmot argues that as we emerge from covid-19 we must build back fairer...

Getting redress

‘Where then should citizens turn for accountability, if they don’t find it in their leaders and feel unsupported by experts and the media? The law remains one form of redress, and indeed some legal avenues, including criminal negligence and misconduct in public office, are being explored, although proving any such claims will be difficult and drawn out. But the notion of murder, at least “social murder,” is hard to shake emotionally, and strengthens with every denial of responsibility and every refusal to be held accountable or to change course.

‘That leaves three options. The first is to push for a public inquiry, as The BMJ and others argued for in the summer of 2020—a rapid, forward looking review rather than an exercise in apportioning blame that will identify lessons and save lives. The second is to vote out elected leaders and governments that avoid accountability and remain unrepentant. The US showed that a political reckoning is possible, and perhaps a legal one can follow, although research suggests that mishandling a pandemic may not lose votes.21 The third is for mechanisms of global governance, such as the International Criminal Court, to be broadened to cover state failings in pandemics...

‘The “social murder” of populations is more than a relic of a bygone age. It is very real today, exposed and magnified by covid-19. It cannot be ignored or spun away. Politicians must be held to account by legal and electoral means, indeed by any national and international constitutional means necessary. State failures that led us to two million deaths are “actions” and “inactions” that should shame us all.’

Read here (British Medical Journal, Feb 4, 2021)

CommuniVax: A coalition to strengthen the community’s involvement in an equitable vaccination rollout

‘CommuniVax is a national alliance of social scientists, public health experts, and community advocates who seek lasting solutions to a serious problem: in the United States, historically underserved Black, Indigenous, and Latino populations have endured negative health and economic impacts from the COVID-19 pandemic at tragic and disproportionate rates. While these communities could benefit greatly from safe and effective COVID-19 vaccines, longstanding biases and barriers hinder their access to and acceptance of vaccination.

‘The coalition is strengthening national and local COVID-19 vaccination efforts in the United States by putting communities of color at the center of those endeavors. The coalition is listening to Black, Indigenous, and Latino/Latinx individuals on how best to promote awareness of, access to, and acceptability of COVID-19 vaccines in their respective communities; and developing longstanding, local governance systems that enable underserved groups to exercise collective agency over their own health and wellness, during this pandemic and going forward. Funding for CommuniVax is provided by the Chan Zuckerberg Initiative.

‘CommuniVax relies on efforts from 3 groups: local teams, a central working group, and national stakeholders.

• Local Teams are composed of resident researchers, grassroots leaders, and public health implementers. They will engage local communities of color to identify improvements needed to vaccine delivery and communication strategies in their communities.
• The Central Working Group includes experts in public health, public policy, medical science, anthropology, and public involvement. With input from diverse stakeholders, the working group will coordinate the local research processes and ensure the implementation of findings nationwide
• National Stakeholders represent groups with political, technical, cultural, and social justice perspectives on vaccine delivery and uptake. These associations will amplify information generated from local teams within their networks and provide feedback to the central working group.

Read here (John Hopkins Center for Health Security, Feb 2021)

Vaccine wars: The global battle for a precious resource

‘Armed guards are patrolling the perimeter fence of a sleek factory. Software experts are fending off hackers. Border officials are checking trucks and ferries, not for weapons or illegal immigrants, but for a mysterious biochemical soup, while spies and spin doctors are feeding social media with scare stories flaming one national champion or another. Welcome to the first great geopolitical battle of the 21st century. It may sound like something ripped from the pages of a dystopian sci-fi novel, but in truth we’re seeing the opening salvos in the vaccine wars.

‘Rather than co-operating with one another to roll out a global vaccination campaign to rid the world of Covid-19, the major powers of the world are instead descending into a fierce, increasingly nationalistic competition. The EU is threatening to hold back supplies from Britain, the Americans are scooping up supplies wherever they can, and the Russians and the Chinese are engaged in a form of ‘vial diplomacy’ reminiscent of the Cold War. It is all starting to turn very, very nasty. We are seeing how quickly our globalised world collapses when push comes to shove. The effect of all this on national security, on industrial policy and on the movement of people around the world will be felt for many years to come.’

Read here (The Spectator, Jan 30, 2021)

How influencers, celebrities, and FOMO [fear of missing out] can win over vaccine skeptics

‘Drawing from product innovation theory, Rohit Deshpandé and colleagues offer three recommendations to speed adoption of COVID-19 vaccines...

‘Governments are prioritizing certain groups to receive the vaccine, with medical professionals and certain government personnel at the top, followed by first responders and vulnerable populations, and then the general population. The diffusion of innovations model indicates that each of these groups will have five customer segments based on their willingness to get vaccinated earlier or later. For example, some medical professionals will be eager to get vaccinated early (the innovators, early adopters, and majority) while others will wait (the late majority and laggards).

‘So, how do we maximize the number of individuals in any prioritized group who are willing, if not eager, to get vaccinated as soon as possible?

‘The answer requires keen understanding of each segment, for example, of both the seniors in the early majority and the seniors that are laggards less keen on taking the vaccine. The diffusion of innovations research indicates that a combination of personal and societal factors influence the rate of adoption within and between segments factors, with the ultimate driver being word of mouth.

‘For the COVID-19 vaccine, the personal factors include people’s perceived efficacy and need for the vaccine, past immunization experiences, and opinions about vaccines more generally, along with those of their families.

‘Societal drivers include the advice of experts, media, and other influencers within their demographic, socioeconomic, and innovation adoption segment. Influencers will need to mitigate concerns about the “newness” of the vaccine, such as the probability of side effects and solutions when they occur. They will also need to reinforce the positive consequences of taking the vaccine, such as the ability to visit family, go to work, and have more entertainment options.’

Read here (Harvard Business School, Jan 29, 2021)

Chinese health experts call to suspend Pfizer's mRNA vaccine for elderly after Norwegian deaths

‘Chinese health experts called on Norway and other countries to suspend the use of mRNA-based COVID-19 vaccines produced by companies such as Pfizer, especially among elderly people, due to the vaccines' safety uncertainties following the deaths of 23 elderly Norwegian people who received the vaccine. 

‘The new mRNA vaccine was developed in haste and had never been used on a large scale for the prevention of infectious disease, and its safety had not been confirmed for large-scale use in humans, a Chinese immunologist said. The death incidents in Norway also proved that the mRNA COVID-19 vaccines' efficacy was not as good as expected, experts said. 

‘As of Thursday, Norway has reported 23 deaths in connection with vaccination."So far, 13 of these have been assessed. Common side effects may have contributed to a severe course in frail elderly people," the Norwegian Medicines Agency said on its website. All the deaths have occurred in frail, elderly patients in nursing homes. All are over 80 years old and some of them over 90, Norwegian media NRK reported.’

Read here (Global Times, Jan 15, 2021)

Indian nasal Covid vaccine can be potential gamechanger: Experts

 Indian nasal Covid vaccine can be potential gamechanger: Experts

‘Public health experts believe that intranasal vaccines for coronavirus, administered through nose rather than muscles, can be a potential gamechanger in Indias fight against the coronavirus pandemic. The nasal vaccine is different from two intramuscular vaccines which recently got approval, as it is non-invasive, needle-free, doesn't require trained healthcare workers, eliminates needle-associated risks, suits children and adults and has scalable manufacturing.

‘Several studies have proved that the clinical efficacy of intranasal vaccine is superior to that of injectable vaccine. In India, Hyderabad-based Bharat Biotech has sought Drugs Controller General of India's (DCGI) approval to conduct clinical trials of its nasal vaccine for coronavirus.’

Read here (Khaleej Tinmes, Jan 10, 2021)

10 steps to prevent Malaysia's Covid-19 pandemic slipping into ICU

This back-to-basics public health management of a pandemic, endorsed by 46 experts in their respective fields, was sent to the Malaysian Prime Minister on January 7. They are:

1. To ramp up testing with triaged, mass and frequent testing regimen, utilising inexpensive rapid testing kits (RTK-Ag), instead of PCR, to help slow the transmission of Covid-19.
2. Early RTK-Ag diagnosis of cases within 24 hours will enable rapid isolation of cases and facilitate prompt contact tracing.
3. Automating contact tracing with digital apps will hasten the tracking process, while leveraging on data science and machine learning can identify the hotspots in the nation for targeted screening. Only this find-test-trace-isolate rapid response will bust the Covid-19 clusters and mitigate the sporadic spread of the virus.
4. In anticipation of the increasing Covid-19 cases and to protect the healthcare capacity, we advocate that clinical stage 1 and 2 cases be isolated at home with clear guidelines from the health ministry. Their well-being can be tracked daily with digital apps supported by empowering the local community, and urgent transfers to Covid-19 hospitals organised for cases that deteriorate.
5. We must protect the excellent work of our medical professionals in the Covid-19 hospitals by decanting all non-Covid cases to non-Covid government and private hospitals. This will allow them to focus on the most severe cases and not be distracted by asymptomatic and mild cases, thus ensuring the best outcomes.
6. The POIS initiative (Preventing and early detection of Outbreaks at Ignition Sites) is a tripartite government, private sector and NGO partnership which emphasises early detection testing regime, enhances public health measures and health education of industry and migrant workers. This POIS initiative developed in consultation with industry and WHO can be replicated elsewhere as a public health operational tool, truly embracing a whole-of-government and whole-of-society approach.
7. Similar initiatives must be developed for the other hotspots of Covid-19 outbreaks, namely the prison and detention centres.
8. Expedite the regulatory processes so that immunisation can begin as soon as the first doses of vaccines arrive at the airport. Debunking Covid-19 and vaccine disinformation will empower our rakyat with informed consent when the vaccines arrive. Apart from prioritising the high-risk groups, seriously consider vaccinating migrant workers to protect our industries and the refugee community who are silent epicentres of Covid-19 outbreaks. The cost of the vaccines must be capped at less than RM100 per dose for those getting their shots privately and by extension, the rapid test kits must be capped at less than RM100 per test to ensure more affordable and wider coverage as well as uptake of both vaccines and rapid testing.
9. A Covid-19 task force comprising a cross-sectoral and empowered team of subject matter experts must be immediately formed to provide evidence-based advice on a harmonised whole-of-government response across ministries and agencies. The task force will help steer the nation out of this pandemic by regularly presenting its recommendations and audit of the health economic impact of key decisions to the Cabinet. To ensure independence of the task force, the Malaysian Medical Association, Academy of Medicine Malaysia, Malaysian Public Health Physicians’ Association and Association of Private Hospitals Malaysia are best positioned to select the members.
10. Do not politicise the pandemic but instead secure a bipartisan consensus and approach to flatten the pandemic curve, accelerate efforts to achieve herd immunity as a form of community protection to coexist with the virus. GE15 in the midst of an uncontained pandemic is an unmitigated disaster waiting to happen as the Sabah election has exemplified.

Read here (Free Malaysia Today, Jan 7, 2021)

Open letter to PM: 10 critical actions to manage Covid-19 — Health experts

Read here (Code Blue, Jan 7, 2021)

How did Britain get its coronavirus response so wrong? Three factors

Lack of long-term planning and ignoring experts: ‘When the investigations into the UK’s response to Covid-19 come to be written, there is widespread recognition among experts that this lack of long-term strategic planning will be at the centre of it. So too should be the need to ensure that the views of experts are fed into government more efficiently and widely.

Going on its own: ‘Britain was still doing quite well in containing the disease by testing, tracing contact and setting up quarantine for those suspected of being infected with Covid-19 at this time [February]. “Then, in March, the government decided to abandon this approach and shift from containing the disease to delaying its progress,” says Wingfield. “I would really like to know why the decision to give up testing and contact tracing was taken.”

Absence of social memory of epidemics: ‘One conclusion that experts are already drawing is that it was those countries close to China, with memories of Sars, or cultural ties to their neighbour, which were much faster to act in response to Covid-19. Perhaps most notable in its success was Taiwan...’

Read here (The Guardian, April 18, 2020)

The Malaysian Health Coalition (MHC), representing 44 member societies and 16 individuals, calls for four measures to effect a rationalised opening-up

They are (please look at letter for full text}:

1. Decision-making on a phased restart that includes MOH, other relevant ministries or agencies and relevant medical health experts.
2. An exit strategy for the post-MCO period based on the advice of medical health and public health experts with guidelines according to the colour-coded zoning system: green, yellow and red.
3. Large-scale disinfection and sanitisation efforts that follow evidence-based procedures.
4. Work with religious authorities to adapt upcoming religious and cultural traditions to prevent mass gatherings that would further spread Covid-19.

Read here (The Star, April 17, 2020)

‘On cronies, cranks and the coronavirus’: Opinion piece by Paul Krugman

‘So where’s this [push to open up the economy quickly] coming from? I’ve seen some people portray it as a conflict between epidemiologists and economists, but that’s all wrong. No, this push to reopen is coming not from economists but from cranks and cronies. That is, it’s coming on one side from people who may describe themselves as economists but whom the professionals consider cranks...’

Read here (New York Times, April 14, 2020)

Behind Trump’s failure on the Covid-19 virus

‘An examination reveals the president was warned about the potential for a pandemic but that internal divisions, lack of planning and his faith in his own instincts led to a halting response…

‘During the last week in March, Kellyanne Conway, a senior White House adviser involved in task force meetings, gave voice to concerns other aides had. She warned Mr. Trump that his wished-for date of Easter to reopen the country likely couldn’t be accomplished. Among other things, she told him, he would end up being blamed by critics for every subsequent death caused by the virus.

‘Within days, he watched images on television of a calamitous situation at Elmhurst Hospital Center, miles from his childhood home in Queens, NY. where 13 people had died from the coronavirus in 24 hours.’

NOTE: On April 13, when NY Governor Cuomo said the ‘worst is over’, the total cases in New York was 195,031 with 10,056 deaths (NYT report of April 13)

Read here (New York Times, April 11, 2020)

Bringing in the experts: Blame deflection and the COVID-19 crisis

“The contemporary visibility and political emphasis on ‘the experts’ is therefore a double-edged sword. On the one hand, it is completely rational to heed the advice of those who have dedicated their professional lives to understanding and protecting public health; on the other hand, it is also a depoliticisation strategy in the sense that politicians who have dedicated their professional lives to not going MAD (i.e. falling foul of ‘multiple accountabilities disorder’) will understand the benefit of allowing ‘the experts’ to become the public face of the crisis.”

Read here (LSE, April 3, 2020)