Vaccine mandates have worked in the past. Can they overcome modern hurdles?

‘While some politicians have touted the new mandates as “un-American,” vaccine mandates are older than the United States itself. “General [George] Washington mandated smallpox inoculation—the precursor to the vaccine, and a more dangerous procedure—for the Revolutionary Army,” says Dorit Reiss, a law professor who specializes in vaccine policy at the University of California, Hastings College of the Law. “And I don't think it’s fair to describe Washington as un-American.”

Read here (National Geographic, Sept 16, 2021)

The plan to stop every respiratory virus at once

‘The benefits of ventilation reach far beyond the coronavirus. What if we stop taking colds and flus for granted, too?

‘The challenge ahead is cost. Piping more outdoor air into a building or adding air filters both require more energy and money to run the HVAC system. (Outdoor air needs to be cooled, heated, humidified, or dehumidified based on the system; adding filters is less energy intensive but it could still require more powerful fans to push the air through.) For decades, engineers have focused on making buildings more energy efficient, and it’s “hard to find a lot of professionals who are really pushing indoor air quality,” Bahnfleth said. He has been helping set COVID-19 ventilation guidelines as chair of the ASHRAE Epidemic Task Force. The pushback based on energy usage, he said, was immediate. In addition to energy costs, retrofitting existing buildings might require significant modifications. For example, if you add air filters but your fans aren’t powerful enough, you’re on the hook for replacing the fans too.

‘The question boils down to: How much disease are we willing to tolerate before we act? When London built its sewage system, its cholera outbreaks were killing thousands of people. What finally spurred Parliament to act was the stench coming off the River Thames during the Great Stink of 1858. At the time, Victorians believed that foul air caused disease, and this was an emergency. (They were wrong about exactly how cholera was spreading from the river—it was through contaminated water—but they had ironically stumbled upon the right solution.)’

Read here (The Atlantic, Sept 8, 2021) 

A coronavirus epidemic may have hit East Asia about 25,000 years ago

‘An ancient coronavirus, or a closely related pathogen, triggered an epidemic among ancestors of present-day East Asians roughly 25,000 years ago, a new study indicates.

‘Analysis of DNA from more than 2,000 people shows that genetic changes in response to that persistent epidemic accumulated over the next 20,000 years or so, David Enard, an evolutionary geneticist at the University of Arizona in Tucson, reported April 8 at the virtual annual meeting of the American Association of Physical Anthropologists. The finding raises the possibility that some East Asians today have inherited biological adaptations to coronaviruses or closely related viruses.

‘The discovery opens the way to exploring how genes linked to ancient viral epidemics may contribute to modern disease outbreaks, such as the COVID-19 pandemic. Genes with ancient viral histories might also provide clues to researchers searching for better antiviral drugs, although that remains to be demonstrated.’

Read here (ScienceNews, Apr 14, 2021)

How the US pandemic response went wrong — and what went right — during a year of Covid

‘Among the biggest shocks was that the U.S. fared worse than most other countries, with more than 29 million cases and nearly 530,000 deaths as of this writing. “We absolutely can’t say that we had the most robust response to the pandemic, up till this point, because we have had a higher death rate per capita than so many other places,” says Monica Gandhi, a professor of medicine at the University of California, San Francisco.

‘As the country raced to react to this new and terrifying scourge, mistakes were made that together cost hundreds of thousands of lives. Yet the tireless efforts of health care workers, along with an unprecedented vaccine push, have saved countless others. Scientific American interviewed scientists and public health experts about the biggest mistakes in the U.S.’s response, some of the key successes and the lingering questions that still need to be answered.’

Read here (Scientific American, Mar 11, 2021)

The raging evolutionary war between humans and Covid-19

‘Fighting the pandemic isn’t only about vaccines and drugs. It’s about understanding how viruses mutate and change inside us, and among us...

‘The major change to the immunity of all the hosts SARS-CoV-2 is likely to try to infect will be, of course, vaccination. That’s human ingenuity fighting viral expertise, but it can also exert a kind of direct adaptive pressure on the virus. History has examples of so-called leaky vaccines—those that aren’t effective enough to prevent all infections or all transmission, and allow better-adapted variants of whatever bug they’re trying to squish to live to fight another day.

‘In fact, one group of researchers has a model that suggests that could even happen with the new batch of vaccines against Covid—especially those that require two doses and seem to confer different levels of immunity depending on how far apart they’re administered, or whether someone skips the second one. Here's how: If one extreme is a population totally naive to a new virus, completely vulnerable and with no immunity, and the other extreme is a population with perfect sterilizing immunity, what happens to a population in between? If a vaccine allows infection but no transmission, the virus doesn’t have a chance to evolve.

‘But if a vaccine or vaccination strategy allows some infection and some transmission? “The ones that are the best at getting around the host’s defenses are the ones that are most likely to persist,” says Caroline Wagner, a bioengineer at McGill and one of the people working on the model. If that’s all true, a leaky vaccine or leaky vaccination strategy could actually drive antigenic drift and create even worse variants. Wagner and her colleagues acknowledge that they don’t have enough data to put bounds on their model yet, but they worry about strategies like one proposed in the UK to abandon second doses as a way of speeding the process and husbanding scarce vaccine, or the way some countries are hoarding vaccine while others go without (potentially letting the virus, and variants, circulate and evolve freely).’

Read here (Wired, Mar 1, 2021)

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)

The next pandemic? It may already be upon us

‘Antimicrobial resistance (AMR) won’t race across the world like Covid-19, but its effects will be devastating. Thankfully, we already know what we need to do to defeat it...

‘Reining in the inappropriate use of antibiotics, in humans and in farmed animals, is key to staying ahead of AMR, but we also need novel anti-infectives coming down the pipeline – new last resorts. The thing holding up that pipeline to date has been the same thing that meant we had no coronavirus vaccines at the start of this pandemic: the economic incentives are few. Because antibiotics tend to be needed in relatively small quantities at a time, there are no economies of scale to be had either.

‘That’s the bad news; now for the good. Efforts are afoot to stimulate the development of novel anti-infectives. Outterson is the founder and executive director of CARB-X, which is funded by the British and German governments, the Wellcome Trust, the Bill & Melinda Gates Foundation and several arms of the US government, and which promotes the early stages of R&D – technically, the preclinical and phase 1 clinical phases. Meanwhile, last July the International Federation of Pharmaceutical Manufacturers and Associations launched a $1bn initiative, the AMR Action Fund, to finance the much more expensive phase 2 and 3 clinical trials that bring a drug – the few that get that far – to the threshold of regulatory approval. And the UK is experimenting with a new subscription-style payment model that pays drug companies upfront for access to novel antibiotics, so decoupling profit from volume sold.’

Read here (The Guardian, Feb 15, 2021)

Dawn beckons as Covid vaccines roll out, but the next few months promise to be the darkest yet, and echoes of the AIDS era

‘One strange aspect of plagues is that they often finish strong. I learned this the hard way last time around. Many people have a general sense of AIDS being terrible in the 1980s and then slowly petering out in the 1990s, as treatments improved. It’s intuitive to think this way, and even to remember things this way. But, in reality, the worst ever year for deaths from AIDS in the US was 1995 — over a decade after the first deaths in America — and just before the arrival of the cocktail therapy that turned everything around. The virus killed more people in America in the year right before the medical breakthrough than in any other previous year.

‘...this [Covid] plague, like many others, could become worse yet before it suddenly turns the corner. The next couple of months may be the most fatal of the entire pandemic — even as freedom from this virus is within sight. There’s a special agony to those deaths, as there will be for all those human beings who will die of a virus for which a vaccine already exists.’

Read here (Genetic Literacy Project, Feb 8, 2021)

How to heal the 'mass trauma' of Covid-19

‘When the pandemic is over, how should we process the memories of what happened? Ed Prideaux discovers counter-intuitive answers from the science of trauma... 

• What happens when trauma goes viral
• How trauma affects groups and individuals
• The problem of forgetting

‘Covid-19 is a mass trauma the likes of which we've never seen before. Our most complex social extensions, and the building-blocks of our personal realities, have been coloured indelibly. The ways we live and work together, and view each other as common citizens: everything means something different in the viral era, and with potentially traumatic effect. 

‘All pandemics end, however. And this one will. But to forget the trauma, move on, and pay it no mind, won't help. It'd be a disservice to history and our own minds. Maybe to the future, too. ’

Read here (BBC, Feb 4, 2021) 

Stories from a past pandemic: Readers write in about their ancestors’ experiences during the 1918 flu

‘A recent Scientific American feature explores how the catastrophic 1918 influenza pandemic seemed to quickly slip from public discourse. The event killed more than 50 million people worldwide, yet it takes up comparatively little space in society’s “collective memory.” The article considers, by analogy, how the current COVID-19 pandemic might be remembered by future generations. Scientific American accompanied the feature with a call for letters telling the stories of families affected by the 1918 crisis. Below are some examples of what we received.’

Read here (Scientific American, Jan 28, 2021)

More or less deadly? Which way is SARS-CoV-2 evolving?

‘Like plague, Covid-19 is a stealth infection, and that might ultimately slow evolution toward lower virulence. Yersinia pestis, the germ that causes plague, tamps down the early immune response, so that infected people can travel and spread infection for days before they feel sick. Similarly, people infected with SARS-CoV-2 seem capable of infecting others before experiencing any symptoms. This sly mode of viral spread may make the evolution of lower virulence less likely, as infected but asymptomatic people are the perfect mobile viral delivery systems.

‘Yet even without an evolutionary process pushing SARS-CoV-2 towards lower virulence, over time, the virus might affect people differently, said Columbia University virologist Vincent Racaniello. “SARS-CoV-2 may become less deadly, not because the virus changes, but because very few people will have no immunity,” he said. In other words, if you’re exposed to the virus as a child (when it doesn’t seem to make people particularly sick) and then again and again in adulthood, you’ll only get a mild infection. Racaniello points out that the four circulating common cold coronaviruses “all came into humans from animal hosts, and they may have been initially quite virulent.” Now, he says, they infect 90 percent of children at young ages. At later ages, all you get is the common cold.’

Read here (Genetic Literacy Project, Jan 7, 2021)

Vietnam is fighting Covid without pitting economic growth against public health

‘The motto for the first phase was that if we stay alive, the question of wealth and the economy can come later. Ordinary people did suffer, such as the gig economy workers: whenever I order a Grabcar (a south-east Asian version of Uber) these days, the vehicle that arrives is always newer and more expensive that what I’m used to; as a driver explained, those who used to pick me up in their cheaper cars have had to sell them to stay afloat, leaving only those with deeper pockets left in the market.

‘But now the government has shifted its anti-Covid strategy towards the economy. The tactics for the second wave are more sophisticated. Contact tracing is still prompt and aggressive but lockdown and isolation are more selective; international flights have been opened for foreign workers, such as engineers from South Korea’s LG, who are needed to keep the economy functioning.’

Read here (The Guardian, Oct 20, 2020)

When will Covid-19 end? History suggests diseases fade but are never truly gone

‘Whether bacterial, viral or parasitic, virtually every disease pathogen that has affected people over the last several thousand years is still with us, because it is nearly impossible to fully eradicate them. The only disease that has been eradicated through vaccination is smallpox. Mass vaccination campaigns led by the World Health Organization in the 1960s and 1970s were successful, and in 1980, smallpox was declared the first – and still, the only – human disease to be fully eradicated. So success stories like smallpox are exceptional. It is rather the rule that diseases come to stay.’

Read here (Channel News Asia, Oct 17, 2020)

The long shadow of the pandemic: 2024 and beyond

‘Even when the world returns to ‘normal,’ the legacy of Covid-19 will transform everything from wages and health care to political attitudes and global supply chains...

‘One impact of the Covid-19 pandemic may be that society will begin to take scientists and scientific information more seriously. In medieval times, the manifest inability of rulers, priests, doctors and others in positions of power to control the plague led to a wholesale loss of faith in corresponding political, religious and medical institutions, and a strong desire for new sources of authority.

‘It is possible that the inability of our political institutions to fight the virus will have similar implications. The public’s expectation of effective state action will likely rise in the immediate and intermediate periods, if deaths continue or accelerate. And if the response continues to be incompetent, confidence in existing political institutions will fall. The many failures of American government at every level in confronting the pandemic, especially when compared with other countries, may result in a shift in political preferences aimed at undoing the existing order.’

Read here (Wall Street Journal, Oct 16, 2020)

How three prior pandemics triggered massive societal shifts

‘None of this is to argue that the still-ongoing COVID-19 pandemic will have similarly earth-shattering outcomes. The mortality rate of COVID-19 is nothing like that of the plagues discussed above, and therefore the consequences may not be as seismic. But there are some indications that they could be... 

‘Will the bumbling efforts of the open societies of the West to come to grips with the virus shattering already-wavering faith in liberal democracy, creating a space for other ideologies to evolve and metastasize? In a similar fashion, COVID-19 may be accelerating an already ongoing geopolitical shift in the balance of power between the U.S. and China... Finally, COVID-19 seems to be accelerating the unraveling of long-established patterns and practices of work, with repercussions that could affect the future of office towers, big cities and mass transit, to name just a few. The implications of this and related economic developments may prove as profoundly transformative as those triggered by the Black Death in 1347.’

Read here (The Conversation, Oct 1, 2020)

In a pandemic we learn again what Sartre meant by being free

‘One of the most powerful effects of the COVID-19 pandemic, after its terrible toll on human life, has been on our liberty. Around the world, people’s movements have been severely curtailed, tracked and monitored. This has had an impact on our abilities to earn a living, study and even be with loved ones at the end of their lives. Freedom, it seems, is one of this virus’s biggest casualties.

‘But an article by Jean-Paul Sartre for The Atlantic in 1944 makes me question whether this is a straightforward tale of loss. The French philosopher summed up his thesis in the line: ‘Never were we freer than under the German occupation.’ Sartre’s core insight was that it is only when we are physically stopped from acting that we fully realise the true extent and nature of our freedom. If he is right, then the pandemic is an opportunity to relearn what it means to be free.

‘Of course, our situation is not nearly as extreme as it was for the French under occupation, who, as Sartre said, ‘had lost all our rights, beginning with the right to talk’. Still, like most of us, I have at times found myself unable to do almost everything I had taken for granted. During the strictest lockdown period, nights out at theatres, concert halls and cinemas were cancelled. I couldn’t go for a walk in the countryside, relax in a bar or restaurant, sit on a park bench, visit anyone, even leave my home more than once a day.’

Read here (Aeon, Sept 30, 2020)

The 1918 flu faded in our collective memory: We might ‘forget’ the coronavirus, too

‘This year is not the first time a new pandemic has prompted reexamination of the one in 1918. The 20th century saw two more flu pandemics, which occurred in 1957 and 1968. In both cases, “suddenly the memory of the Great Flu reoccurs,” Beiner says. “People begin looking for this precedent; people begin looking for the cure.” Likewise, during the avian flu scare in 2005 and the swine flu pandemic in 2009, Google searches worldwide for “Spanish flu” spiked (though both increases were dwarfed by the one that occurred this past March). All the while a growing body of historical research has been fleshing out the story of the 1918 flu, providing the foundation for a significant resurgence of its memory in the public sphere.’

Read here (Scientific American, August 13, 2020) 

India’s coronavirus fight and lessons from my family’s struggle with TB in the 1950s

‘During the current Covid-19 pandemic, I often imagine Biji [mother], with her gritty countenance, asking total strangers why they are not wearing a mask, or reprimanding a group of people for not maintaining a minimum social distance. I had already seen her tackling several difficult situations. But how did she get to a position where she could extract compliance and discipline from people around her?

‘The odds were heavily loaded against Biji for most of her wedded life. She lost four children to infant mortality. When Taaya [father, later inflicted with TB and died aged 43] lost his job, she struggled to run our home by stitching clothes or knitting cane chairs. One day in 1956, we had no vegetables, lentils, potatoes or cooking oil left at home. She gave me a one-anna coin to go and buy 200 grams of raw tomatoes, sprinkled salt on them, and we ate them with chapattis (Indian bread).

‘Alone, she braved deprivation but rarely succumbed to hopelessness. Each hardship only made her more determined to face life in a bold, liberated and result-oriented manner...’

J V Yakhmi is a former chairman of the Atomic Energy Education Society in Mumbai and a retired associate director of the physics group at the Bhabha Atomic Research Centre.

Read here (South China Morning Post, August 7, 2020)

The coronavirus may not have originated in China, says Oxford professor

‘The coronavirus may have been lying dormant across the world until emerging under favourable environmental conditions, rather than originating in China, an expert has claimed.

‘Dr Tom Jefferson, from the Centre for Evidence-Based Medicine (CEBM) at Oxford University, has pointed to a string of recent discoveries of the virus’s presence around the world before it emerged in Asia as growing evidence of its true origin as a global organism that was waiting for favourable conditions to finally emerge.

‘Traces of COVID-19 have been found in sewage samples from Spain, Italy and Brazil which pre-date its discovery in China. A preprint study, which has not been peer reviewed, claims to have found the presence of SARS-CoV-2 genomes in a Barcelona sewage sample from 12 March 2019.’

Read here (BBC Science Focus, July 6, 2020)

Lessons for Covid-19 from the early days of AIDS

‘Thirty-six years ago, we were, like today, in the midst of a new and still somewhat mysterious global pandemic. In the U.S. alone, more than one million people were infected with HIV, and 12,000 had already died of AIDS. At the time, we were just beginning to understand how the virus worked. But that didn’t stop some leaders from making wildly optimistic claims about an AIDS vaccine being delivered within two years.

‘Now, with COVID-19, we are in a remarkably similar spot: 2.7 million people have been infected across the U.S., and 128,000 have died of the disease. Despite our limited understanding of how the novel coronavirus works and what it does to the human body, many are putting what I consider a disproportionate amount of faith in the possibility of a COVID-19 vaccine by 2021. My feelings today echo my feelings a third of a century ago: yes, a vaccine may be possible, but it is by no means a certainty.’

Read here (Scientific American, July 6, 2020)