Tuesday, April 28, 2020

Interview with Jerome Kim of International Vaccine Institute


IVI Building (1)

Asian Boss: “We Asked the World’s Leading Vaccine Expert About COVID-19 Vaccine”, from Asian Boss, and interview with Dr. Jerome Kim of the International Vaccine Institute

The interview (43 minutes) occurred April 25, 2020.

Kim explains how T-helper cells direct B-cells to make specific antibodies.  He explains why we don’t have a vaccine for HIV: because the virus infects the very helper cell that directs other cells, so it is a recursion or logical loop.  He notes that today’s tests for HIV antigen are much more sensitive than in the past, which could me that some people (active gay men) should be retested again.

He also discusses the “reactivation” vs. “reinfection” issue that has come up in South Korea.

He discusses the steps of vaccine trials in detail.  A typical vaccine costs about $500 million to develop at the low end.
   
Attribution for picture of IVI building in Seoul available by clicking on picture (Wikipedia credits, CCSA).

Sunday, April 26, 2020

"Why Is America's Death Toll So High?" for Covid-19? Video from The Economist



The Economist examines “Why Is America’s Death Toll So High?” for Covid-19.


The basic answers are a more individualistic personal value system (at least compared to China and most of Asia) and a polarized political situation, complicated by how federalism works (leaving states so much discretion).
  
The cases, hospitalizations, ICU and deaths exploded in early to mid March 2020, right around St. Patrick’s Day, after deceptively low numbers because of ineffective testing and contact tracing.  There only a handful of officially counted cases in the U.S. until around March 1. Right now the US approaches 1 million officially confirmed cases with a case fatality ratio of 5.61%.  Early indications that the number of undetected minimal infections may be much higher, reducing the infection fatality ratio.  But some deaths at home have not been counted. 

Wednesday, April 22, 2020

PBS Frontline: "Coronavirus Pandemic: A Tale of Two Washingtons" documents the first outbreak in the US, and Trump's cold shouldering


Seattle Skyline-

Coronavirus Pandemic: A Tale of Two Washingtons”, directed and narrated by Miles O’Brien, aired on many PBS stations Tuesday April 21.


The documentary traced the emergence of the COVID19 pandemic in the state of Washington, where the first patient, a traveler from China, was much sicker than we realized at Providence Hospital, and got a compassionate user approval for remdisivir.

The documentary moves to the nursing home in Kirkland WA, where investigators were at first shocked to find that two random patients tested positive, which already meant that there had to be considerable community spread in the area.

The hospitals depended on armies of home sewing machine operators and little construction shops to home-make their equipment, as the country was so completely unprepared for this unprecedented pandemic.
   
(Downtown Seattle picture embedded from Wikipedia;  click on picture for attribution, CCSA and photographer credits).

Sunday, April 19, 2020

"Briefing on Virginia COVID-19 Models" explains how UVa models work and what Virginians can expect this summer


I’ll treat the video from the Commonwealth of Virginia April 13, 2020, “Briefing on Virginia Covid-19 Models” as appropriate for this blog.  You can watch it on Facebook here or slightly abridge on YT


The presentation compares the University of Washington model (based on IHME), University of Pennsylvania CHIME, and the University of Virginia’s own Biocomplexity model.

The IHME models put Virginia resource utilization maxing in late April. UVa has it in late August, but there is a different assumption. UVA models 5 scenarios: No mitigation, slow (April 30, June 10), and a Pause (same dates).  A Pause is supposed to stop the increase in new cases.  One problem with that will be that case increases can occur because of increase in testing (catching more asymptomatic).  But UVA says it assumes there are about 7 times as many cases as documented, and that 50% are asymptomatic (which means that 10% are serious enough for hospitalization and about 2.5% result in ventilation, which not only leads to deaths but also other outcomes like kidney failure). 
   
UVA assumes social distancing is eliminated June 10 in Virginia. Obviously, it you can have completely containment (with testing and contact tracing and quarantines) the volume at peak goes way down as new cases should not increase in a perfect world.  The rules for people identified by contact tracing need to be very specific:  do they go to hotels?  Do they pay for their own isolation if able?  Is their income intact?  Do they keep full internet access? 

Tuesday, April 07, 2020

Men: "Do you have to shave your beard for COVID-19?" You do for N95 masks to fit (what about anything else?)


Do You Have to Shave Your Beard for COVID-19?”,  by critical care physician Mike Hansen.


He says, well, no, but if you need an N95 mask for work as a health care worker, you do, because the mask can’t fit over a beard.  Small mustaches’s may be OK.  He goes through a CDC document naming all the styles from the “Dollars” Italian westerns.

Given all the attention not just to vigorous hand-washing, two things come to mind. First, most things an ordinary person touches are with the undersides of the fingers and palms.  So it sounds like common sense they should get attention first, rather harmless.  The rest of it, of course, is the incredible tedium of putting on and taking off all the space-suit gear. I can recall a particular scene in “The Andromeda Strain”.  Can body hair hold virus?  Well, no, it’s actually dead, but the roots in the skin are very alive. Sone day there will be a virus that holds them (at least there is in my sci-fi novel “Angel’s Brother”).  This gets a lot more sensitive for men (Caucasians) than just the beard.
   
You have to trim your fingernails, too.  That doesn’t mean anything to most people.  But a woman who worked at the election in early March had trouble with one of the machines because of long decorative fingernails and she didn’t want to give them up.

Update: April 20

A WSJ article April 3 by Sumatha Reddy, despite being a bit ho-him, recommends that men remove beards for tighter fit on all masks. 

Wednesday, April 01, 2020

"The Coronavirus Is Not a Black Swan", video with Nassim Nicholas Taleb



The Coronavirus Is Not a Black Swan” with Nassim Nicholas Taleb speaking on Bloomberg.


The channel is N N Taleb’s Probability Moocs.  Taleb is a professor of Risk Engineering at CUNY, I believe, and author of the 2018 book “Skin in the Game”.

Taleb here instead calls it a “white swan” because we could have anticipated and prepared for it.
    
But nobody – not even the science fiction writers – connected the dots about how it could suddenly become so devastating. 

We could have realized that a coronavirus like this could be bizarre.