Thursday, December 03, 2020

War of words after UK approves COVID-19 vaccine

This week Britain was the first country to approve a COVID-19 vaccine, namely the Pfizer/BioNTech mRNA vaccine. However, the swift approval has already triggered a war of words as the UK defends its approval process whilst being criticised by several corners of the EU and the US.

Claims that Brexit aided quick approval

Soon after the news was announced some UK politicians inferred that Britain's swift approval process was only possible because of Brexit.

"We could only approve this vaccine so quickly because we have left the EU. Last month we changed the regulations so a vaccine did not need EU approval which is slower," Tory MP for North East Somerset and Leader of the House of Commons, tweeted.

However he was immediately slammed down by the Senior Correspondent and Bureau Chief of ARD German TV in London.

Rees-Mogg's claim was, "Not true," Annette Dittert retorted on Twitter. "It was and is possible to accelerate the process while being a member of the EU. Which Britain did. While still formally being a member of the EU."

"The predictable attempts to make this into a big Brexit show are just misleading. Again," Dittert added.

Earlier the health secretary Matt Hancock had also asserted on Wednesday morning that "because of Brexit" the UK had been able to approve the Pfizer/BioNTech vaccine, rather than wait for the European Medicines Agency [EMA] to do so [Guardian / Sky News]. 

The MHRA was given power to approve the vaccine by the government under special regulations before 1 January, when it will become fully responsible for medicines authorisation in the UK after Brexit [Guardian].

Brexit was possibly a factor in Britain's approval process. But it was likely to mitigate potential problems of distribution and hold ups at ports due to extra documentation required.

Should the EMA have approved the vaccine prior to 31st December Brexit would not have been an issue per se, at least as regards its use. However, a late rubber stamp might have created issues concerning imports if paperwork wasn't in order post-Brexit. 

British exceptionalism

Adding further fuel to the fire on Thursday, Education Secretary Gavin Williamson claimed Britain's regulators were simply better than those in other countries. "We have obviously got the best medical regulators, much better than the French have, much better than the Belgians have, much better than the Americans have," he told LBC Radio, adding, "That does not surprise me at all because we are a much better country than every single one of them." [Evening Standard].

Business Secretary Alok Sharma also drew criticism after saying history would remember the "UK led humanity's charge against this disease."

Andreas Michaelis, Germany's ambassador to the UK, criticised his comments saying, "Why is it so difficult to recognize this important step forward as a great international effort and success. I really don't think this is a national story. In spite of the German company BioNTech having made a crucial contribution this is European and transatlantic."  

Indeed the criticism didn't stop on this side of the Atlantic. In the United States Dr Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, also appeared to echo sentiments expressed in Europe that Britain's approval of the vaccine was "hasty".

Undermining confidence

Speaking to Fox News overnight, one of the leading figures from America's response to the pandemic offered some criticism of the UK's approval process.

"If you go quickly and you do it superficially, people are not going to want to get vaccinated," Dr Anthony Fauci said.

"We have the gold standard of a regulatory approach with the FDA [Food and Drug Administration]," Fauci asserted while calling into question the speed at which Britain approved the vaccine.

"The UK did not do it as carefully. They got a couple of days ahead. I don't think that makes much difference. We'll be there, we'll be there very soon." [CNN / FNLondon / Sky News].

Meanwhile in an unusually blunt statement, the European Medicines Agency, which is in charge of approving COVID-19 vaccines for the EU, said its longer approval procedure was more appropriate as it was based on more evidence and required more checks than the emergency procedure chosen by the UK [Al Jazeera]. 

European legislators also weighed in on the issue, with Italian health minister Roberto Speranza telling the country's parliament he would demand the EMA continues to keep "the bar on surveillance very high" concerning possible approval of vaccines.

"When the vaccine will be administered to people it will certainly have to be a safe vaccine but it will have to be an effective vaccine," Speranza said.

Peter Liese, an EU legislator and member of German Chancellor Angela Merkel's Christian Democratic Union party, struck a firmer tone, saying he considered the MHRA's approval to be "problematic".

"I recommend that EU member states do not repeat the process in the same way," he said. "A few weeks of thorough examination by the European Medicines Agency is better than a hasty emergency marketing authorisation of a vaccine."

UK health agency defends approval

Announcing its decision less than four weeks after Pfizer published the results of a clinical trial, the MHRA said it had used overlapping trials and "rolling reviews".

"This vaccine has only been approved because those strict tests have been done and complied with and everyone can be absolutely confident that no corners whatsoever have been cut," said June Raine, the agency's head.

However, Britain's quick decision to rubber stamp a vaccine within days of initial results of a phase 3 trial will likely dampen confidence and increase doubts in others concerning safety and side effects. 

[pictured: Matt Hancock, Health Secretary, prime minister Boris Johnson, Dr June Raine, head of MHRA, and Alok Sharma Business Secretary]

tvnewswatch, London, UK

Thursday, November 26, 2020

COVID-19 vaccine still some way off

There are now at least 5 vaccines which are being prepared for approval and rollout to the general population. But despite the vaccine candidates showing strong efficaciousness in phase 3 trials it is only the beginning of the end. It will be many months before a vaccine is approved and a widespread vaccination program begins.  

The top five vaccine candidates

In the game are Pfizer/BioNTech's vaccine codenamed BNT162, Moderna's vaccine mRNA-1273, AstraZeneca's AZD1222 and the Russian made Sputnik V developed at the Gamaleya Research Institute. There are also at least three Chinese developed vaccines, though only one has been approved thus far and only for military personnel.

For the West and much of the world, the main focus has been on the vaccines produced by Pfizer, Moderna and AstraZeneca.

The news of a breakthrough with the Pfizer/BioNTech vaccine on the 9th November brought a collective sigh of relief around the world as it seemed there was finally a glimmer of hope to finally consign the global pandemic to history. With efficacy levels of over 90% BNT162b2 certainly seemed to offer hope. The only major flaw seemed to be the fact that the vaccine needed to be stored and transported at ultracold temperatures below −70 °C, something would make distribution difficult and challenging at the very least.

Within a week Moderna announced it had also completed phase 3 trials which showed its vaccine mRNA-1273 had 95% efficacy. It also had an advantage that it could be stored at the temperature of a standard medical refrigerator of 2–8 °C for up to 30 days or −20 °C for up to 4 months.

The biggest game changer was the news that emerged on Monday 25th November when details were released concerning AstraZeneca's vaccine AZD1222.

Oxford University/ AstraZeneca announced their coronavirus vaccine's successful trial, preventing 70% of people developing symptoms with a higher efficacy of 90% by tweaking the dose. The vaccine also benefited from being able to be stored at temperatures of a standard medical refrigerator of 2–8 °C.

Costs and availability

Aside from the logistics and efficacy there is the subject of cost. The Sputnik V vaccine is reported to be rolled out with a cost of around $10 (£7.50). Meanwhile the Pfizer/BioNTech mRNA vaccine and Moderna mRNA vaccine are set to cost in the region of $20.00 (£15.00). However the Financial Times this week reported that Moderna could charge as much as $37 (£27.75) down from the earlier reported $50-60 (£37-45) price tag for the required double shot.

In this context the AstraZeneca vaccine has a further advantage in that it is being pitched at around $3-4 (£2.25-3.00). Part of the reason for AstraZeneca's low price point is their commitment at selling their vaccine 'at cost' during the pandemic.

Of course with the millions of doses required, and the infrastructure needed to immunise entire populations, government budgets will still be hard hit.

Approval process

The biggest issue facing the world, now that there are vaccines which have completed phase 3 trials, is the wait for the approval process to be completed.

In normal times the approval and rubber stamping a new drug or vaccine takes years with some agencies slower than others to process submissions.

The UK faces a more nuanced issue given the political decision to leave the EU. Across the EU all drugs, vaccines and medicines are approved by the European Medicines Agency [EMA]. 

Prior to the end of the Transition Period ending on 31st December 2020 the EU's approval by the EMA would be required. But after the 1st January 2020 any vaccine would require approval by the Medicines and Healthcare products Regulatory Agency [MHRA].

The MHRA is the UK's answer to the EMA or FDA in the US.

However, the MHRA is slow in approving new vaccines. The MenB (Meningitis B vaccine), took nearly 20 years from the first idea to the vaccine being licensed for use. In October the UK government sought to speed up the process [Guardian]. But delays could still slow the process of approval and rolling out of a COVID-19 vaccine.

Even the EU's EMA could take weeks to approve a vaccine despite also undertaking an ongoing oversight of the development of vaccine candidates [MarketWatch].

In the US the FDA has announced that its vaccine advisory committee will meet on 10th December. The committee will assess the companies' data and decide whether the vaccines are safe and effective enough for restricted use [Nature].

Some companies have already put forward their vaccine for approval, most notably Pfizer which is seeking approval for 'emergency use' [Politico]. But even with fast tracking, approval could still take some time [CNN].

What might concern some, is not just efficacy but also the safety of any new vaccine that gets approval [Guardian].

Safety concerns

While phase 3 trials are intended to determine what side effects a potential vaccine might have, due to the relatively small size of the numbers taking part in such trials, very small percentages of individuals affected by adverse effects often don't show up until rolled out on a mass scale.

The swine flu vaccine, Pandemrix, made by GlaxoSmithKline, is a case in point. It was given to 6 million people in Britain during the 2009-10 swine flu pandemic but was withdrawn after doctors noticed a sharp rise in narcolepsy among those who received it [Guardian].

The regulator said because the sleep disorder was so rare in people vaccinated – approximately 100 are believed to have been affected in the UK – it could not have been detected in any clinical trial.

This may all be moot after doubts were raised over AstraZeneca's vaccine data. While AstraZenica say their trials were conducted under the highest standards. But on Thursday 26th November the Financial Times called this into question.

Geoffrey Porges, an analyst at SVB Leerink [a specialist investment bank focusing on the healthcare sector, headquartered in Boston], said he thought it was unlikely the AstraZeneca jab would get approval in the US after the company "tried to embellish their results" by highlighting higher efficacy in a "relatively small subset of subjects in the study".

Anti-vaxxers, conspiracies and disinformation

The biggest threat comes not from the risks that a vaccine in itself might pose, but from the concerns of individuals in society which could be overblown and dissuade many from getting vaccinated.

False information relation to the MMR jab resulted in many parents not getting their children inoculated. The fear that there was a link between the MMR jab and autism was unfounded, but the failure by many not to have their children immunised resulted in a surge of measles cases over the coming years.

Already on Twitter and other social networks there are concerns raised. Many cite science fiction plots such as I Am Legend where a vaccine originally created to cure cancer wipes out most of mankind.

There are others that will refuse a vaccine merely on the fact that they believe the whole COVID-19 coronavirus pandemic to be a hoax.

Whatever the motivation, a number of surveys do appear to show a strong level of distrust or skepticism. One such survey conducted by Euronews in October showed just 37% of French people questioned would take a low-cost vaccine if it came available in the next year. This despite France being among the worst-hit countries in Europe from the disease, with more than 33,000 deaths as of the 16th October.

This compares starkly to several of France's neighbours, where a majority say they would get vaccinated. Respondents in the United Kingdom were keenest, with 63% backing vaccination, followed by Germany at 57% and Italy at 55%. Another poll seemed to indicate that globally around 75% of the population would take a vaccine. Asian countries seemed to show the most trust in a vaccine with 97% of people in China saying they would take a vaccine as soon as it became available. But the further West one goes vaccine skepticism grows with safety cited as people's biggest concern.

New waves ahead of vaccine

In the meantime there are far more pressing matters to deal with, that of keeping the virus under control until a vaccine is distributed. With Thanksgiving and Christmas on the horizon it will likely be impossible to prevent further spread as rules are relaxed [Guardian].

Britain, the US and parts of Europe are likely to be hit by a third wave in the new year. Meanwhile the UK will take a further hit economically, not only due to the coronavirus but also due to a likely no-deal Brexit which could hit Britain harder than the pandemic according to the governor of the Bank of England [Guardian].

Add to that the longer wait that Britain might endure whilst the MHRA ponders the approval of a vaccine whilst other countries are already vaccinating their populations. There could be a very real situation where Britain misses the boat as the EU's EMA approves a vaccine just days after the transition period ends. This would leave Britain having to lean on the MHRA to approve the very same vaccine before it could be rolled out.

Even with the vaccine, which will of course be welcome, a new battle will begin to save battered economies some of which have been harder hit than others. 

Lessons not learned

All of this was avoidable. Countries and regions that acted in January - e.g. China [4,634 deaths*], Taiwan [7 deaths], Singapore [28 deaths], South Korea [515 deaths], New Zealand [25 deaths] - and imposed strict rules concerning masks, lockdowns, testing and imposing travel bans, are now seeing their economies thriving. Furthermore many had only had a handful of deaths and cases in the hundreds. Hindsight is a wonderful thing, but it was exceptionalism that affected the way some counties failed to act rather than not knowing the threat . 

Taiwan acted within days of the first reported case of a strange pneumonia in Wuhan on 31st December and still has only 7 deaths [Wikipedia]. And many other Asian countries followed suit in the days and weeks to come. It wasn't until eleven weeks after the first case in China that Britain locked down. It wasn't just Britain, however. Many European countries were slow to react as was the US. And despite claims that governments have been following the science there have been different approaches in different countries concerning masks, social distancing and even whether testing of people was important [tvnewswatch]. 
But while there is a light at the end of the tunnel and a vaccine is on the horizon there is a danger that many countries are relaxing too soon and failing to learn by the mistakes they have made thus far.

tvnewswatch, London, UK

* While China's figures concerning the numbers of cases and deaths in the country are disputed, lockdown and quarantine measures do appear to have largely eradicated or controlled the virus with much of the country now returning to normality.

Tuesday, November 24, 2020

Repeating past mistakes as COVID-19 cases rise

In  a little over a week Britain is about to relax Britain's month long lockdown and relaxes rules for Christmas gatherings. And in the US millions are preparing to celebrate Thanksgiving with Christmas also on the horizon.

But medical experts both sides of the pond have warned that Thanksgiving and Christmas gatherings could come with a risk [Guardian]. As COVID-19 cases rise US and UK in danger of repeating past mistakes.

Growing numbers

In the US 3 million passed through airports in the US over the weekend ignoring CDC advice not to travel as COVID-19 cases rose exponentially.

In fact some 3 million people were found to have contracted COVID-19 in November thus far, the worst month of the pandemic in the US.

Meanwhile deaths have also risen to more than 257 thousand people across the United States.

The numbers in the UK have also risen significantly with deaths varying from between 300 to 500 daily. In the US the daily numbers of those dying have averaged at about 1000 a day over the past few weeks.

The numbers seen in Britain are more worrying given the size of the population. The UK population is about a sixth that of the US and yet the weekly death toll is near to a half that seen across the United States.

Relaxing before Christmas

No-one can deny that for many people Thanksgiving in the US and Christmas in both the US and Britain are important festive occasions. But the mixing of people during a pandemic could well bring disaster.

In a televised address to the nation Boris Johnson, the UK prime minister, quipped that this was "the season to be jolly careful."

And yet on the 4th December shops will reopen, and while some areas will remain under tough restrictions, pubs and restaurants will also start serving once again. And in the lead up to the festive period it is likely the mix of alcohol and festive spirit could see a dramatic increase of COVID-19 cases.

Positive news

The UK PM's announcement came on the day of positive news from AstraZeneca as it announced that its vaccine could be a game changer as trials showed efficacy of some 90% in those that received two doses over two weeks.

But the news has to be tempered by the fact that it will take some time to manufacture millions of doses and for governments to put a mass vaccination program in place.

Repeating past mistakes

It is certainly true that major advances have been made since the 1918 pandemic especially concerning vaccines. But it appears that society has failed to learn the lessons of controlling the spread of the virus [USA Today].

On 28th November 1918 the Omaha World Herald ran a notice asking that people limit their Thanksgiving festivities.

However, despite over 200,000 deaths since March 1918, as Thanksgiving rolled around, some cities celebrated the relaxation of flu-related restrictions – partly due to opposition campaigns by retailers, theatre owners, unions, mass transportation companies and other economically stressed stakeholders.

The relaxation of rules brought more cases and more deaths. On 27th November, the day before Thanksgiving, St. Louis reported its highest new daily case count since the epidemic began, and Buffalo, New York, reported its largest jump in daily cases since the lifting of its pandemic ban weeks earlier.

While some towns and cities began to reintroduce curbs and restrictions, it all proved too late. On Dec. 6, the St. Paul Daily News announced that more than 40 Minneapolis schools were closed because of the flu, below the headline "SANTA CLAUS IS DOWN WITH THE FLU."

By January, the USA was fully engulfed in its third wave of influenza. The virus spread throughout the winter and spring, killing thousands more. It infected one-third of the world's population and killed approximately 675,000 Americans before subsiding in the summer of 1919 [CDC].

There is a popular aphorism which states, "Those who cannot remember the past are condemned to repeat it". The history books of the future will likely look back on how the US and Britain in particular failed to heed the warning of the past and unnecessarily added to the misery of the COVID-19 pandemic in the West. And all for the sake of a few days partying.

tvnewswatch, London, UK

Tuesday, November 17, 2020

Could a no-deal Brexit affect COVID-19 vaccine imports?

With just 45 days until Britain leaves the EU, there are fears that a deal may not be struck and that this could seriously impact the UK's ability to secure, ship in and distribute a COVID-19 vaccine.

Such a scenario might be considered scaremongering, but there are many warnings from ports, customs and experts that suggest a no-deal Brexit could affect the import and export of all goods to and from the UK as companies and the ports themselves are ill prepared [Guardian].

Hope of a vaccine

Last week markets were lifted by the hope of a COVID-19 vaccine on the horizon. On the 9th November Pfizer BioNTech vaccine released data which showed it had developed a vaccine with some 90% efficacy [Pfizer / BBC]. Global stocks soared and headlines speculated that life could soon return to normal. But the euphoria soon subsided after details emerged that the new Pfizer BioNTech vaccine had to be stored in very specific conditions, specifically that it had to be stored at -80°C.

However, within hours of the announcement of the breakthrough the UK Health Secretary Matt Hancock said the NHS and GPs should prepare from December to roll out the new coronavirus vaccine if it gets approved [BBC].

This week Moderna, another US drug company, announced it had also developed a vaccine with 94.5% efficacy. The Moderna vaccine also had the advantage that it could be stored in a normal refrigerator and could even remain stable for short periods of time at room temperature [Guardian].

On the face of it breakthroughs in the development of a COVID-19 vaccine are indeed positive news. Indeed, Dr Tal Zaks, Moderna's Chief Medical Officer, described the latest breakthrough as "the greatest moment of my life."

But there are a great many hurdles ahead. Despite the positive headlines, the news has to be tempered by stark realities.

The first major hurdle is production. Pfizer has said it should be able to produce up to 1 billion doses by the end of 2021. "Based on current projections we expect to produce globally up to 50 million vaccine doses in 2020 and up to 1.3 billion doses in 2021," the company said. Meanwhile Moderna said in September that it was on track to produce 20 million doses of its experimental coronavirus vaccine by the end of the year, though given the positive news this week it is likely to up production.

Even so, even at full capacity, neither company is likely to provide the numbers of doses needed to help restore a sense of normalcy.

The US population exceeds 330 million people and with current estimates only Pfizer could potentially roll out enough doses for the entire population before it could offer the product to other countries. To further emphasise the issue the US government has stated that it has purchased at least the first 100,000 doses [HHS].

Of course there are other vaccines being researched, at least 50 though only 10 have entered phase 3 trials. But even if the companies researching these vaccines make breakthroughs in the coming weeks or months they will face an uphill struggle to catch-up Moderna and Pfizer BioNTech in terms of rolling out production of doses [RAPS-COVID-19 vaccine tracker].

Securing a vaccine 

Moreover, the big hurdle for some countries will be securing and purchasing the vaccine.

The EU has already made deals with Moderna having been in talks with the company for its experimental COVID-19 vaccine at least since July, an internal EU document seen by Reuters showed.

On 24th Aug the EU Commission, which conducts talks with vaccine makers on behalf of EU states, said exploratory talks with Moderna had been concluded with the aim of signing a contract for the supply of 80 million doses of its vaccine, with the option of buying another 80 million [Reuters]. And on 16th November it emerged that the EU had also established plans to authorise a deal with German biotech firm CureVac, which is still in phase 2 trials, to secure up to 405 million doses of its potential COVID-19 vaccine [Reuters]. Both deals would easily enable, if properly distributed, allow the EU to vaccinate the entire block.

Earlier this year the UK government rejected the chance to join the EU's COVID-19 vaccine scheme [Euronews]. Thus Great Britain will have to make its own plans. In this regard the UK has agreed to purchase vaccines from several companies including 90 million doses from Janssen [BBC / UK Govt], and has reportedly ordered 30 million doses of  the Pfizer vaccine and hopes to receive 10 million doses by the end of the year [Mirror].

The UK has also reportedly signed a deal to purchase some 190 million doses of another, as yet unapproved, vaccine VLA2001 from the French pharmaceutical company Valneva [Pharmaphorum / Valneva]. 

Aside from the potential challenges faced by the UK concerning securing the right vaccines and its distribution, there have been questions as to whether Britain's leaving the EU could affect the import of the vaccine.

Brexit "won't delay supplies", govt claims

Grant Shapps, the UK Transport Secretary has insisted that Brexit will not cause disruption to the import of a vital coronavirus vaccine into the UK should talks with the EU conclude in a no deal scenario, and the Health Secretary Matt Hancock has also said he is "confident" a no-deal Brexit won't delay supplies, amid concern the Pfizer vaccine could be affected by Britain's EU departure.

However, only a week before the announcement concerning the Moderna vaccine, the National Audit Office warned that the government had not done enough to get the UK's borders ready for leaving the single market and customs union and that there would be disruption whether or not a trade deal was signed [Independent]. 

No-deal risks

Last year as a potential no-deal Brexit loomed in October some experts warned that some disruption was inevitable. "Despite intensive preparation by industry for every scenario, a no-deal Brexit risks disruption to the supply of medicines" throughout the EU, Andy Powrie-Smith, an official at the European Federation of Pharmaceutical Industries and Associations, told Reuters.

The warnings were echoed by the Guild of Healthcare Pharmacists who said that leaving the EU without a deal would bring a "significant risk" of disruption to the supply of medicines and medical devices [Pharmaceutical journal].

With less than 45 days to secure and ratify a deal with the EU many fear that a no-deal Brexit is more likely than ever.

And with ports warning that such a scenario will cause unprecedented chaos, even if vaccines are fast tracked the physical problems shipments might encounter on the road could hold up supplies [Sky News].

Whilst it may be the case that a vaccine may not be available well into 2021 due to the approval process required, the issues surrounding the importing of medicines and particularly much needed COVID-19 vaccines might well be impacted negatively by a no-deal Brexit.

tvnewswatch, London, UK

Tuesday, October 20, 2020

Herd immunity & letting the virus rip is a bad idea

There is much talked about so-called herd immunity. Many people are under the impression that by 'letting the virus rip' the general population would get the virus, people would become immune and life could return to normal. But this fails to understand the science.

Herd immunity

Herd immunity occurs when a virus is allowed to spread freely and thus many people would become immune. However, at least 60-70% of any one population would need to become immune in order for such a strategy to work. In a country of some 100 million people this could mean around 1.8 million people dying given the currently estimated fatality rate of around 3%. This also does not take into account those that would become seriously ill and not die, further stretching national health resources. 

[Concerning the death rate from COVID-19, it is very difficult to evaluate given low testing rates. Initial statistics from New York appeared to indicate a massive 8% fatality rate [Atlantic]. However, as the numbers of tests increase and are measured against death rates statistic appear to show fatality is more likely between 1-3%]

Globally, the numbers would be many times higher. The head of the World Health Organization worries a herd immunity approach could lead to more problems.

"Allowing a dangerous virus that we don't fully understand to run free is simply unethical," according to Tedros Adhanom Ghebreyesus, the World Health Organization's director-general. "It's not an option."

Dr. Anthony Fauci agrees. "There will be so many people in the community that you can't shelter, that you can't protect, who are going to get sick and get serious consequences," the director of the National Institute of Allergy and Infectious Diseases said. "So, this idea that we have the power to protect the vulnerable is total nonsense."

Even if this death rate were to be acceptable in order to 'return society to normal' there are still many unknowns concerning the COVID-19 coronavirus. It remains uncertain how long immunity lasts once you get coronavirus. Indeed there are at least two documented cases of reinfection, one in Hong Kong and another in the US. There is also the possibility that COVID-19 could mutate, making immunity to the current strain meaningless with regards to the contracting of a mutated version of the virus [Al Jazeera]. 

A safe vaccine is only route out

A safe and effective COVID-19 vaccine is the only safe way out of the COVID-19 coronavirus pandemic, though any mutation in the virus itself could nullify the effort to immunise a population to some extent. That said, a vaccine for COVID-19 is still the best route though further vaccines may need to be developed should the virus mutate significantly.  

Of course even with rates of vaccination above 93%, herd immunity offers no guarantees. Relocation, travel or even a new circle of friends can change the composition of one's herd, and thus its shared protection against infection. Therefore, any COVID-19 vaccine needs to be rolled out globally [Global Health Now-John Hopkins].

The measles vaccine has not only prevented deaths and other long-term effects of the disease but also prevented 'immune amnesia' whereby the body's immune system forgets immunity to other diseases [Harvard].

Low seroprevalence of COVID-19

As regards the COVID-19 coronavirus herd immunity is unlikely to work. Studies in June and July 2020 cast doubt on prospects for herd immunity. Despite months of exposure, antibody surveys found a low seroprevalence, less than 10%, in cities in Spain and Switzerland. Commentators in The Lancet concluded that "In light of these findings, any proposed approach to achieve herd immunity through natural infection is not only highly unethical, but also unachievable" [Lancet].

Seroprevalence is the number of persons in a population who test positive for a specific disease based on serology specimens; often presented as a percent of the total specimens tested or as a proportion per 100,000 persons tested. However, as an article published by the BMJ in September highlights, the seroprevalence of SARS-CoV-2 may be underestimated. Indeed current seroprevalence studies may fail to detect people who have had mild COVID-19. In addition due to the fact that antibody tests have not been widely deployed - often reserved for key workers in the health industry - those that missed the boat for regular coronavirus testing, and who perhaps even had relatively serious symptoms but who were not hospitalised, have not been added to the figures.

So estimations as to the numbers that have had the coronavirus within many populations are simply that; estimations. That said, it is still not clear whether contracting and recovery from the COVID-19 coronavirus produces long-term immunity.

No guaranteed immunity

In the first such case documented by a team of researchers at the University of Hong Kong a man was shown to have contracted the virus for a second time. The man, a 33-year-old IT worker, recovered from coronavirus and was released from hospital in April. However, he again tested positive for the virus when he returned from Spain early in August [AA / CNN].

Meanwhile in Nevada in the United States another man was reported to have contracted the virus twice, the first time in April and subsequently in May [BBC].

While such cases appear to be isolated, they do raise questions concerning long term immunity. "Our findings signal that a previous infection may not necessarily protect against future infection," said Dr Mark Pandori, from the University of Nevada.

So far, reinfection seems to be rare - there have been only a few examples out of more than 37 million confirmed cases globally.

Reports from Hong Kong, Belgium and the Netherlands suggest they were no more serious than the first. One in Ecuador mirrored the US case in being more severe, but did not need hospital treatment.

However, it is still early into the pandemic, and the history of other types of coronavirus means protection is expected to wane.

Letting virus rip would be a disaster

What seems clear is that 'letting the virus rip' would bring with it countless deaths while likely collapsing the health service and overstretching services dealing with the disposal of bodies.   

Lockdowns are certainly expensive to the economy. But if strictly enforced and planned properly with a proper escape plan of widespread testing, track & trace, hygiene and social distancing measures, lockdowns work. 

Countries that have done the best, New Zealand, Taiwan, Iceland, Singapore and South Korea - to name a few - imposed swift travel bans with testing and quarantining for arrivals, implemented track & trace, and imposed swift lockdowns on identified outbreaks. Clear messaging has also played a part for countries that have slowed the spread, including the advice concerning masks the efficacy of which was dismissed by many countries that have done particularly badly. 

There will be no quick way out of the pandemic, but what is clear that letting the virus go is not the correct route. 

[CNN  - herd immunity / WBRC - herd immunity / Kurzgesagt-COVID-19 / Kurzgesagt-Vaccines Explained].

tvnewswatch, London, UK

Thursday, October 01, 2020

Google kills off GPM, replaced with YouTube Music

YouTube Music is replacing Google Play Music but there are already groans from GPM users over missing features and differences in the new platform.

For those who primarily want to play music, YTM makes no sense since YTM incorporates the ability to play videos. The interface is also very different and takes some getting used to.

That's not to say GPM could not have been improved upon. On the web interface of GPM artist's albums are in chronological order. Yet on the Android phone app they are listed alphabetically. And in either interface there is no choice to change, though I prefer the chronological listing.

As regards YTM the web interface is a mess. I have pretty much every Zappa album uploaded, but the arrangement of albums within the app is all over the place. They are neither in alphabetical or chronological order. 

The default position on opening YTM populates the app or browser with Google's own suggestions. But to be perfectly frank I am not interested in Google's, nor anyone else's suggestions. From day one, I have used Google Music, as it was called when launched in 2011, as a depository for music that I like. Of course there was no subscription service initially and radio stations are still only free in the US, India and few other territories. Even when I have had access to GPM's free radio stations, when abroad or using a VPN, I've never used them. When I listen to music I know what I want to listen to and pick accordingly. I don't want Google's or anyone else's suggestions. I've a regular radio for that, that isn't reliant on a reliable Internet connection!

YTM's display of albums is counterintuitive. On the app albums listed as small thumbnails with additional information to the right whilst the web interface has  a similar GUI to GPM. However the scrolling through the listing is extremely slow.  

As said the default opening position is Home which offers Google's YTM suggestions. To access one's uploads one has to click Library whereupon one is presented with Playlists, Albums, Songs, Artists and subscriptions.

Of course I have no subscriptions. So nothing there. But all my Playlists, Albums, Songs, and Artists appear to be listed. That said it's hard to say as there is no information available in YTM. Furthermore there is no genre tab in YTM meaning finding all my jazz and shuffling all songs is now now longer an option. Audio books are no longer easily accessible for similar reasons unless you know the name of the book or writer.

Hit GPM and I can with one glance on each tab see I have 698 Artists, 1,987 Albums, and 19,076 Songs as well as 142 Playlists. And as regards genres I have 83.

While casting is not a huge issue it is a slight issue on the web interface in that you have to cast the tab. There is also no obvious way of downloading one's library though in the dropdown menu there is an upload music function. However this is rubbish compared to GPM's drag and drop approach or automatic music manager which this week stopped operating for many users. In YTM one has to go through the "open file from menu" and pick the music one wishes to upload.

There is also no way to edit or change any of the Metadata of existing or uploaded music. This could really create issues especially if songs are incorrectly named. Indeed having transferred my library to YTM some albums and artists have been erroneously named. 

From one's phone the interface is slightly better than the web interface, but still not as intuitive as GPM. Also when casting the display is a little different. While Google Play Music shows the album art repositioning itself around a black screen every few seconds, YouTube Music retains a static picture of the album against a grey background centrally placed throughout the whole song.

GPM also shows more data such as the Album name and time whilst YTM only shows a progress bar and does not give the album name.

So all in all YTM is a pale imitation of GPM. For some, who perhaps like videos and suggested music, it might tick all the boxes. But for those who like pure music it's a big step backwards.

Whilst having transferred my GPM library to YTM I am reluctant to use it until forced. Overall GPM is better all round.

GPM has a cleaner and easier to use interface. One can upload and download songs and albums easily as well as edit metadata and album covers, heck Google even offered suggestions at times. Music is easily found and cast both from the phone app and web interface. One could also download playlists, albums or songs for offline playback. Indeed making a particular playlist available for offline playback resulted in any further songs added to that said playlist also becoming available for offline access. 

This offline access was particularly useful when using the app in a car or whilst travelling where there might be no data access. With my phone connected via bluetooth to the car stereo I can, via the GPM app, quickly access playlists available offline and have them played over the speakers. Similarly during a long haul flight I can listen to cached music whilst in flight mode. While YTM does allow the downloading of songs or playlists it again is less intuitive than GPM's approach.

Many have suggested moving to Spotify and various other online alternatives. However many of these are a compromise and still don't address the issues or features lost from the GPM/YTM move.

Google has over the years improved on many of its products. And while there has been much criticism for its dropping services over the years, sending them to a virtual graveyard, this move is probably one of the worst decisions it's made.

There are many Google services people lament the passing. Google+ was not as popular as other social networks, but was nonetheless extensively used. Wave was a great experiment but there were few that mourned its passing. The same with Google Health, Buzz, and Google Video. But the decision to ditch iGoogle, a customisable start page with RSS feed integration, was widely criticised. Later this year Google Cloud Print, a technology that allows one to print over the web from anywhere, including a phone, to any printer, is being consigned to history. This is not a good move on many fronts. Ditching Google Cloud Print will anger many who have specifically bought a printer that was specifically made for the technology.

But killing off services, particularly popular ones, is also about the reputation of a company whose motto once claimed to "do no evil".

Many millions of users around the world have invested their time and money using Google products. Buying a Google Cloud Print compatible printer specifically for a Chromebook only to find one can't use it a few months down the line is just one example.

Killing off social networks such as Google+ can kill off contact with individuals that may have only been on that particular platform.

Last year Google stopped the ability to sync photos between Google Drive and Google Photos and vice versa. Their claim was that users were confused. Rather than kill off the sync between the two services completely, Google needed only to have turned off sync by default and allowed users to turn it on if they desired. Now, those that want to access photos uploaded to Drive in their Google Photos application need to do so separately resulting in using up twice the amount of data. 

There are some who no doubt like to discover new music and have suggestions foisted upon them. But for a great many others their entire library is of music they have purchased, often physically, and which has been ripped to store in the cloud - thus preserving wear and tear on the original disc and also making for easier and quicker access.

For the most part I am not interested in Google's or anyone else's musical suggestions. If not particularly fussed about what songs I wish to listen to I can flip the radio on to Absolute Classic Rock or Jazz FM!

Otherwise I want easy, quick access to my music library. The current state of YTM makes it more likely that I'll be whipping out the CDs once again rather than trying to trawl through the slow and user unfriendly mess that is YouTube Music.

tvnewswatch, London, UK

Sunday, July 12, 2020

Changing face of Britain in the face of COVID-19

Despite furlough schemes, bailouts and tax breaks UK businesses are struggling in the face of the pandemic that has tightened its noose around the world. But with no sign the virus is going away and with a hard Brexit on the horizon there are greater uncertainties ahead.

Job cuts and closures

Almost everyday in recent weeks there have been headlines reporting the closure of familiar high street names or the shedding of jobs.

In June thousands of jobs were lost with Rolls-Royce, BP, BA, easyJet and Ryanair amongst those announcing redundancies [Guardian].

In early July fashion giant H&M said it was planning to shut 170 of its stores across Europe after accelerating closure plans in the face of coronavirus.

Takeaway outlets have been particularly hard hit. Uppercrust owner SSP Group has said that up to 5,000 jobs could be cut across its UK outlets and head office as it struggled with the reduction in passenger travel [BBC]. Meanwhile Pret A Manger has announced it will close 30 shops and cut up to 1000 jobs after a steep fall in sales [Ev Standard].

Fast food outlet Burger King has also said it could be forced to shut one in 10 of its 530 UK branches with loss of up to 1,600 jobs [Daily Mail]

Even the popular Greggs has been hit by the pandemic and the resulting lockdown with some 50 stores set to close permanently and plans to open further stores put on hold [Food Service Equipment Journal / Guardian].

Reopening issues

Reopening has presented an enormous challenge to many businesses, even those who may have used furlough, or had rent waived. When the doors open, the bills will come in again. In many cases, the limitations of social distancing guidelines will mean operators can't seat enough customers to match their outgoings.

As such it is not cost effective for businesses to reopen and it is likely that reports of heavy redundancies will grow as those in the hospitality industry look to cut staffing costs.

Even with such measures, not every business will be able to reduce their outgoings sufficiently, and cannot afford to operate at a loss [Ev Standard].

Retail sector hit

It's not just the hospitality sector that's been hard hit. Retail has also been severely affected by the lockdown. With many people shifting to online shopping, physical stores have struggled to draw customers back.

Harrods, Boots, Debenhams and John Lewis have all announced job cuts with John Lewis to close eight stores permanently. Boots have meanwhile said it is to shed some 4000 jobs and close around 40 of its opticians [BBC].

Changing habits, brought about by weeks of being trapped in one's home, has had a marked effect on how people shop and even what they buy. Uncertainty over employment has also resulted in a slowing of public expenditure.

While there was a mad rush for some to queue at IKEA, Primark, JD Sports, Nike and other stores as they were allowed to reopen, customers have since dwindled.

Even the numbers hitting cafes, restaurants and pubs have dropped sharply since so-called Super Saturday [Ev Standard / Business Live].

Some restaurants, however, did not even make it to the 4th of July and boarded up pubs and closed restaurants are now a common sight across the country.

People have become used to drinking at home. And even with pubs open who wants to run the risk of catching the virus for the sake of a pint or even be advised they might have to self-isolate should someone in the same establishment be found to have contracted the coronavirus? The same is true of restaurants as people have learned to make do with cooking at home. Cost might be one factor for some customers. But fear is another hurdle as is the issue over how comfortable customers might feel as they sit in an environment with waiters walking around in PPE.

Other businesses are set to open soon but will customers return? Pools, gyms, nail bars and tattoo parlours are set to open in the coming weeks [BBC]. 

But while there may be a trickle of customers desperate to get back on the running machine, have their nails manicured or obtain that much desired tattoo, it remains to be seen whether enough numbers return to such businesses for them to break even, let alone make a profit.

Risks remain

As Britain, and other nations open up it is clear that the increase in numbers of people mixing is pushing up the numbers of coronavirus cases and deaths. The US in particular has seen a dramatic rise in the number of cases and fatalities in the past month. Britain and a number of European countries have also seen numbers spike.

As such there have already been lockdown and restriction reimposed. And the much debated issue concerning the use of face-masks has been reignited with the UK government now pondering whether to mandate the wearing of face coverings in shops and other indoor environments.

Efficacy of masks

The UK in particular has been slow to advocate the use of masks. Initially their position was that masks had little if any benefit to prevent transmission or infection. This position was likely not based on science but rather attempting to prevent the depletion of much needed PPE stocks for health professionals.

However, it is clear from the numbers seen in places  where masks are commonplace that the rates of infection are much lower. The Czech republic imposed rules concerning the use of masks in mid March and has kept numbers of infections to below 50,000 whilst the numbers of deaths is only a little over 1,600 [Euronews]. Britain by comparison has nearly 45,000 deaths and some 290,000 cases.  

No mask is 100% effective in terms of preventing infection. But masks can seriously impact the spread from symptomatic and asymptomatic carriers [UCSF].

Indeed in May the Czech republic relaxed its rules on masks [Guardian].However, within days cases began to increase dramatically [Reuters].

Moreover, the number of deaths seen in the nearly two months since the relaxing of mask restrictions [May-July] has nearly quadrupled from the number of fatalities registered between March and mid-May.

Given the recent reports that the COVID-19 virus might be airborne, the use of masks, especially in a confined space, might well reduce the number of infections considerably [Guardian].

Much of what the West is now doing to combat the spread is somewhat late in terms of slowing the spread and 'defeating the virus'. Many Asian countries - most notably South Korea, Singapore and Taiwan - implemented rules on masks and rolled out Track & Trace programs as early as January.

But perhaps it's better late than never if the West is to prevent a total collapse of the economy and get things working to some sense of normality. 

The 'New Normal'

Like it or not - and there are few who revel in the so-called 'new normal' - the way life is conducted is going to be very different for some time.

Social Distancing, hand washing, hand sanitiser, masks, face shields and queues will be with us for some time to come.

How much this 'New Normal' further affects the economy remains to be seen. But the pandemic will certainly hit some economies more than others.

Britain is in a far worse position than most given its decision to pull out of the EU and go it alone. And with a so-called No-Deal Brexit almost certain at the end of the year, Britain's economy will face far greater challenges as prices rise and UK exporters struggle to sell their products overseas with punitive tariffs in place until trade deals are established.

tvnewswatch, London, UK

Sunday, May 31, 2020

UK risks a second wave as its lockdown breaks down

Eleven weeks since Britain entered into lockdown the UK government has further relaxed the rules. People may now gather in groups of up to six. Shops and markets may open as long as social distancing is implemented. And sport is now back on the agenda, albeit behind closed doors.

However, many scientists believe it is still far too early to lift restrictions with some fearing a second wave of the virus emerging [BBC].

But despite the warnings, the messages from government, the mixed messages emanating from a blatant disregard of the rules by Boris Johnson's advisor Dominic Cummings during the early days of the lockdown, and a general frustration being experienced by a significant percentage of the population wanting things to get 'back to normal', has meant the lockdown has all but fallen apart.

Even before official announcements large numbers of people have filled beaches and parks and overwhelmed beauty spots.

Masks are far less evident than they were only a few short weeks ago and social distancing is being ignored by many people.

Perhaps the first signs of a fraying of the edges of the lockdown was the VE Day commemorations. All across Britain people came together to mark the 75th anniversary of Victory in Europe Day. Most people were well intentioned as they practiced social distancing; placing tables and chairs on their own driveways and talking to neighbours at a distance. However as dusk drew in, and as people consumed more and more alcohol, the concept of social distancing evaporated as people's inhibitions dissolved.

Only days later, as the warm May sunshine continued, people began to venture out filling parks or descending on the coast. While most stayed off the beaches, promenades were crowded with people dying to get away from lockdown.

As week 8 of the lockdown began some businesses began to open up. McDonald's started a delivery only service at some 15 of its restaurants across southern England. Only cooler temperatures kept the coasts clear at the weekend even though some businesses such as snack bars and ice cream vendors had begun to open.

The lockdown disintegrated further into week 9 as a hot Wednesday saw thousands descending on beaches whilst others excitedly queued to pick up a McDonald's after the fast food outlet opened many of its restaurants for Drive-Thru.

By the beginning of week 10 and social distancing was almost non existent as beaches across Britain became thronged with sunseekers on Bank Holiday Monday.

There were no masks, beaches were packed, and whilst beach patrols attempted to enforce social distancing, policing such large numbers was virtually impossible. This was a recipe for disaster in the making.

Such scenes came on the back of revelations that Dominic Cummings broke lockdown rules in the early stages of the UK lockdown, giving some commentators to suggest that his actions only emboldened many members of the public to stretch any remaining lockdown restrictions [Guardian].

As the week came to an end so too did the weekly Clap for the NHS event. The event was called time by the woman who began the tradition, suggesting it had become politicized.

It had also become an event which was rather awkward to reconcile given the backdrop of widespread flouting of lockdown rules and advice concerning social distancing.

Indeed, some NHS staff and carers publicly criticised those that had filled the beaches earlier in the week suggesting that they not come out and clap for the NHS, labelling such actions hypocritical [Twitter].

While on the face of it the curve of deaths and infections is reducing, there is a strong belief amongst scientists that a second wave is not far off.

It may well be argued that balancing getting the economy back on track is important, the government is not focused on the most important elements of Britain's economy.

Sport, restaurants and shops might bring an all important psychological boost to a nation's well being after weeks in lockdown, but there are arguably more important and less risky sectors that can be restarted.

It is of course difficult for any government or decision maker to say that one business is less important over another, but unfortunately barbers, restaurants and the like are probably not as important, economically speaking, than the financial sector and manufacturing.

Mixed messages over masks, which has been shown to dramatically slow the spread of the virus in other countries, has left only very concerned groups wearing them in Britain. Of course there were initially supply issues and a worry that public use might deplete and take away much needed stocks from health workers. But even homemade masks, scarves and bandannas have been shown to prevent the spread.

Unless mandated, even TfL's request that masks be worn on London Transport's networks likely to be ignored by most people [Standard]. And of course it does not help when leaders, be it UK politicians, special advisors or US presidents fail to lead by example.

tvnewswatch, London, UK

Wednesday, April 29, 2020

COVID-19 - Truth, lies and uncertainty

It's often said that truth is the first casualty of war. And in the war against the COVID-19 coronavirus, truth has also been a casualty with lies, half truths and conspiracy theories circulating wildly both on mainstream media and on social media.

Learning curves

Not even scientists say they fully understand the epidemiology of the virus and that there is much still to be learned. However, from presidents to the lay person in the street, everyone suddenly thinks themselves an expert.

Spreading false information, and even false hope, can do much harm. Indeed, whilst president Trump points a finger of blame at both China and the WHO in failing to share information about the virus, Trump's own dismissal of the risk lulled much of America into a false sense of complacency.

From assertions that the virus was "a hoax" to little more risk than the flu, Trump not only wasted valuable time in preparing for the pandemic but also failed to prepare the public for the crisis.

Trump wasn't the only leader failing to heed the warnings. In Britain, the prime minister Boris Johnson was so focused on Brexit that the growing crisis in China failed to register.

Of course there has been much made of the fact that China failed to warn the world of the dangers and the WHO also were too slow to declare a pandemic.

But it was all too clear that the situation in China was serious. Whilst it is extremely likely that the numbers of infections and those dying, as well as the exact data concerning the epidemiology of the disease was being controlled and even stifled, the very fact that China had locked down entire cities should have been warning enough.

Wasted time

Many countries did not need direct warnings to see the potential crisis that might unfold. The first case of the COVID-19 coronavirus in Taiwan was announced on 21st January 2020. Immediately after the Taiwanese government announced a temporary ban on the export of face masks for a month on 24th January to secure a supply of masks for its own citizens. It also began ramping up the production of alcohol for disinfection as well as increasing the manufacture of PPE - protective gowns, gloves and masks [Wikipedia-Taiwan response].

Even before the first case was identified, the Taiwan Centers for Disease Control (CDC) implemented inspection measures for inbound flights from Wuhan, China in response to reports of an unidentified outbreak of a strange pneumonia.

Such reports were published in many news outlets [SCMP]. And while news was certainly censored within China, anyone outside of China's censorship machine could have reacted just as swiftly as Taiwan and other countries which have kept both the numbers of those infected and deaths to extremely small numbers.

By 29th of April Taiwan had a total of only 429 cases with only 6 deaths. Hong Kong also reacted swiftly to learning of the potential SARS like outbreak in Wuhan and to date has only 4 deaths and around 1038 cases [Wikipedia-Hong Kong response].

Of course not all countries that acted early have kept deaths to single digits. South Korea also saw its first identified case on the 20th January. However, testing, contact tracing and appropriate quarantining has kept the death toll to 246 as of the 29th of April. One problem South Korea encountered was that many members of the Shincheonji Church of Jesus were uncooperative with Centers for Disease Control and Prevention Korea and could not be contacted. An outbreak was linked with the church, and its failure to cooperate with authorities hampered efforts to contain the disease [Wikipedia-Sth Korean response].

The list of other Asian countries that have, by acting early with testing and contact tracing, kept deaths down include Singapore [Wikipedia-Singapore response] which to date have 14 deaths and a total of 15,641 cases. Meanwhile as of 20th April 2020, there were only 268 confirmed cases in Vietnam, 214 recoveries, and no deaths. This success has again been put down to widespread testing as well as mandating the use of masks.

It hasn't just been Asian counties that have kept the numbers down. European counties that acted swiftly and decisively on seeing the first positive cases have kept deaths extremely low. Portugal for example has a little under 1,000 deaths [Guardian]. Meanwhile Iceland has kept numbers even smaller with the numbers of cases at 1,797 and only 10 deaths.

[Note: All figures cited are as published on 29th April 2020]

Misinformation concerning masks

There has been much talk over the use of masks in recent weeks in the West with many health experts and politicians discouraging their use claiming there was little or no efficacy in preventing an individual from catching the virus by wearing a mask.

However, whilst partly true, the wearing of masks can prevent the spread significantly. But when PPE and masks are in short supply for those that arguably need it more, such as health workers, it is perhaps unsurprising that there has been a certain amount of disinformation disseminated.

The WHO has previously recommended the use of masks to prevent the spread of a virus during "severe epidemics or pandemics" especially if asymptomatic people can transmit the virus. However, the shortage of PPE has affected both their position and that of many governments [WHO].

In a document published in 2019 the WHO says, "Face masks worn by asymptomatic people are conditionally recommended in severe epidemics or pandemics, to reduce transmission in the community. Although there is no evidence that this is effective in reducing transmission, there is mechanistic plausibility for the potential effectiveness of this measure."  

But in February 2020, likely influenced by a global shortage of masks, the WHO said that, "For asymptomatic individuals, wearing a mask of any type is not recommended. Wearing medical masks when they are not indicated may cause unnecessary cost and a procurement burden and create a false sense of security that can lead to the neglect of other essential preventive measures."

Whilst it is true to say that a mask may well "create a false sense of security" there is a growing amount of evidence that the spread of a respiratory virus can be reduced by the use of even the most rudimentary mask.

As regards protection, even the best PPE is not foolproof. A basic surgical mask is only likely to give a minimal amount of protection, as it is not tight fitting. Even a properly fitted N95 [or PPF3] mask is only good for 2-3 hours. Furthermore failing to remove and dispose of it correctly could result in self-contamination [WHO-How to use masks] .

The truth is, that only a full biohazard suit with appropriate breathing apparatus or similar would be likely to prevent exposure. But few of us could even afford such kit nor would we likely want to stroll to the shops in it. After all, who wants to walk around town looking like Dustin Hoffman in the film Outbreak?

That said, the wearing of a facial covering could well slow the spread of the spread of the virus [Science Media CentreWashington Post].

Social Distancing, herd immunity & the future

Much emphasis has been put on social distancing in order to contain or slow the spread of the virus. But prior to implementing a lockdown in Britain, Boris Johnson was openly talking of herd immunity and saying that 'loved ones would die' [Guardian].

Sadly, it has to be said that with all the best efforts most people will contract the virus, and that some will become seriously ill and die.

A vaccine, which will be the only surefire way of eradicating the threat, will be unlikely to surface for at least 12 to 18 months. Given this, and the fact that lockdowns are likely to be eased as time goes on, there will be many more people who will contract the virus over time.

Thus far, it is unclear whether individuals who have recovered from the virus are immune. Indeed there is some indication that some people might have caught COVID-19 twice. But it is believed that most of those who have recovered have at least some immunity from the virus.

Whilst the WHO has said there is "no evidence that people who have recovered from COVID-19 and have antibodies are protected from a second infection," there's a consensus that the key to ending the coronavirus pandemic is establishing co-called herd immunity. But there are many unknowns, and only time will tell [TIME].  

One big unknown is how long the lockdowns will go on for, how they'll be relaxed and if there'll be secondary waves, as was seen in the 1918 pandemic.

Robert Redfield the CDC director, has warned that a secondary wave in the autumn could be much worse, compounded by the seasonal flu [Washington Post]. However his outspoken statement was almost immediately downplayed by the US president Donald Trump.

The "CDC Director was totally misquoted by Fake News @CNN on Covid 19," Trump said on Twitter [CNN]. Except of course, he was not misquoted, as he later confirmed in a subsequent press conference.

Other misleading claims

President Trump seems to have the monopoly when it comes to lies and misleading claims. Indeed a whole post could be written just covering the waffle, lies and obfuscation emanating from the US president.

But perhaps the real clangers have been Trump's pushing dangerous cures for COVID-19 including Hydroxychloroquine, Chloroquine and more recently the ingestion of household disinfectants or bleach. The latest blunder even prompted manufacturers to issue statements saying that under no circumstances should bleach or disinfectants be injected or taken internally [BBC]. Despite such warnings there has been a spike in the numbers of calls to poison control centers in the US concerning the use of bleach and disinfectants [Daily Mail].

Whilst there have been no actual cases reported of people actually drinking bleach there was a report of one person garling a diluted mixture in mouthwash [The Hill]. Meanwhile doctors and public health officials fear the attention could boost purveyors of dangerous elixirs who push 'miracle cures' with no basis in science [NYT].

Some people have already touted the misnomer that eating garlic or drinking copious amounts of water could promise a cure.

And it's not just Donald Trump endangering people's lives with fake or dangerous cures. Conspiracy theorist Alex Jones has been forced to stop selling a toothpaste which could literally turn users permanently blue [NYT].

The New York State attorney general issued a cease-and-desist order to Alex Jones, the conservative radio host, alarmed by false claims on his website that his diet supplements and toothpaste could be used to fight the coronavirus.

Jones has made much from previous crises. From Y2K to the current pandemic, the radio host has profited a great deal from revenue in the form of online ads and gained a reputation amongst some as being a snake-oil salesman [New Yorker].

The "nano-silver" toothpaste, which Jones said "kills the whole SARS-corona family at point-blank range" appears to be in a league of its own. While perhaps not as dangerous as drinking bleach, using too much of the product could lead to the users' skin turning blue due to the colloidal silver contained in the product.

To date there are no cures for COVID-19. Indeed, the FDA, prompted by Alex Jones' promotion of the Super Silver Toothpaste and related products released a statement saying, "There currently are no vaccines, pills, potions, lotions, lozenges or other prescription or over-the-counter products available to treat or cure coronavirus disease."

Pets & animals

There are many other conspiracy theories circulating about COVID-19. And one particular issue concerns our pets. There has been a worry that cats and dogs can catch the virus with the added concern that they in turn could pass it on.

Thus far there is only anecdotal evidence that pets can contract the virus. But there is no evidence the virus can be passed back to humans. However, there is a potential risk that pets could pass the virus on by touch. In other words a pet could come into contact with contaminated surfaces and bring the virus back to its owner.

Another conspiracy doing the rounds concerns the risk of pets dying from ingestion of hand sanitiser. However, the amounts a cat or dog might encounter from contact with humans would be so small as not to cause any harm [Factcheck AFP].

Bio-weapons, bats and wet markets

As has been discussed in previous posts, one of the biggest conspiracies concerns over where the originated. Some people believe the germ escaped from the Wuhan Institute of Virology or had even been developed as a bio-weapon. It has even been suggested the US released the virus in China itself [SCMP].

While there are many unexplained factors concerning how the virus came about. But the truth is likely to be rather mundane and be more connected to man's exploitation of animals, bad animal husbandry and a failure to observe appropriate hygiene practices. 

The way Trump uses the phrase the Chinese virus, certainly encourages a certain hostility towards Chinese and Asian people, especially those who would grab any excuse to embolden their own prejudice and racism. However, in itself calling a virus after its origins is not necessarily new. Comedian and chat show host highlighted this in a recent monologue in which he pointed to the Zika virus named after Zika forest of Uganda, where the virus was first isolated in 1947. Ebola named after the Ebola river Hantavirus named after the Hantan river. The list is almost endless. To call COVID-19 the Wuhan virus is essentially factual, at least in terms of its origins - unless the bat in question did come from Yunnan, in which case it could be called the Yanzidong virus [see previous post*]!

As Bill Maher states, "This isn't about vilifying a culture, it's about facts." To criticise another culture for bad practices should not be considered racist, Maher asserts. "It's not racist to say that eating bats is batshit crazy." Some of what Maher has to say is indeed hard hitting, but one cannot hold back if bad sanitary practice and animal husbandry in any country can create the devastation the COVID-19 virus has caused thus far.

Of course, whilst fingers should quite rightly point to China concerning this pandemic, things could have been so very different and might have pointed elsewhere due to bad practices in other countries. AIDS, BSE [Bovine Spongiform Encephalopathy or Mad Cow Disease] and Swine Flu [H1N1] came from Africa, Britain and North America respectively. AIDS has killed countless millions. BSE resulted in only a couple of hundred deaths in the form of CJD. And the 2009 Swine Flu pandemic resulted in at least 18,000 deaths although 2012 research showed that as many as 579,000 people could have been killed by the disease worldwide.

Of course, many blindly ignore bad farming practices in the West. From battery hens, to intensely reared pigs or cows pumped with hormones, such practices are no less dangerous than the ticking time bombs of China's wet markets as was warned in papers published as far back as 2007 [CMR / The Print]. In a follow-up to his lambasting China's wet markets, Maher points a finger closer to home, criticising Western farming practices that could well come back to bite us [You Tube].

Dangerous conspiracies

Perhaps one of the most dangerous conspiracies being disseminated is the assertion by the likes of David Icke that the virus doesn't even exist.

Icke, well known for his conspiracies, was recently featured in a documentary broadcast on the TV channel London Live in which he claimed the pandemic was cover for a supposed global world order to purposefully crash the economy, end the use of cash payments, and track every individual [Guardian].

Whilst it might be true to say there will be some governments, institutions and individuals capitalising or exploiting the pandemic for their own nefarious ends, to claim the virus itself is a hoax foisted on mankind by 'the new world order' is stretching things a little far.

Conspiracy theories put lives at risk. But how much do Google, Facebook and other social networks care? Perhaps driven more by the fact that there will be little advertising revenue to be made from fake news being spread on social media, many networks have been proactive in stemming the flow of fake news.

Facebook said it was "committed to removing misinformation which could contribute to physical harm" as it took down the interview with Icke and the London Real conspiracist site. The social network has reportedly also removed countless other posts disseminating false information about the virus or encouraging people to hold gatherings that break social distancing rules [Guardian].

However, the company has nonetheless come under criticism for not being proactive enough especially concerning false posts in languages other than English [BBC].

Twitter too has made attempts to remove harmful posts [Guardian]. However, there have been reports of fake Twitter accounts appearing on the social network with some suggesting the government might themselves be behind the accounts [Twitter] something denied by the government themselves [Twitter]. Indeed the government themselves say they are actively trying to stop the flow of fake news on the Internet [BBC].

But it's the apparent politicisation of the crisis that has also worried many. Even mainstream media from LBC in Britain to CNN in America has raised concerns over the politicisation of the crisis.


President Trump in America has used the coronavirus press conferences as a staging post for his own propaganda and attempted to divert attention from his own mistakes at handling the crisis by blaming the WHO and withdrawing funding at a crucial time [BBC].

There will be more to come. Not only from the US but in Britain, Europe and to the East. A disastrous Brexit will no doubt be blamed on the pandemic and in turn China. And China too will likely blame the West for a second wave of infections as its lockdown recedes. Even within the EU there will likely be repercussions as countries more affected by the crisis call on the European Parliament for help.

And as the global recession - that will surely come - bites hard, politicians will look anywhere but at their own front door for a scapegoat.

As the world eventually breaks through to the other side of this pandemic, which is some way off yet, finding truth will be even harder as we are bombarded with yet more lies, half truths, misinformation and fake news.

tvnewswatch, London, UK

Tuesday, April 07, 2020

Who was patient zero? And does it matter?

Since the outbreak of the COVID-19 coronavirus there has been much speculation as to where it came from. Most scientists are in general agreement that the virus resulted from a process known as zoonosis whereby a virus jumps from animals to humans. But there has also been wild speculation, amongst netizens both in China and the West as to the specifics.

The original source

Bats are widely believed to be the original source of the COVID-19 coronavirus. Research carried out by at least one team, based at the Wuhan Institute of Virology, indeed seems to point to at least one species of bat, the horseshoe bat found and collected in two caves - Yanzi and Shitou in Yunnan province - as to being reservoirs of a multitude of coronaviruses, some of which bear strong similarities to COVID-19 [NCBI / NYT].

But what remains unclear at the moment is how the virus jumped from the bats to humans. Some scientists believe that the virus jumped from bats to a second animal which in turn was transported to the Wuhan wet market and from which it then crossed to humans.

This is of course entirely plausible. Whilst there are examples of people in China using bats in Traditional Chinese Medicine, the bats used are often sold dried and would be unlikely to harbour viruses for any length of time having been killed and dried. Therefore any zoonosis would likely require a live bat infecting another animal which in turn might be taken to market.

Intermediate host
A whole number of potential candidates exist, though there has been much focus on the pangolin, a rare, exotic and scaled mammal which is prised for its meat as well as its scales, which again are used in Traditional Chinese Medicine. However, less exotic animals such as pigs could also have facilitated the jump from bats to humans.

But there has been wild speculation that the virus might have leaked directly from the Wuhan Institute of Virology itself where the bats were being studied.

Conspiracy theories

One particular piece of information that has fuelled such rumours is the apparent disappearance of Huang Yanling [黄燕玲] who worked out of the laboratory. Whilst it is not denied that Huang Yanling once worked at the institute, official accounts insist she moved on from her post in 2015 [Xinhuanet - Chinese]

However there remains much suspicion about her potential involvement as much information about her has been scrubbed from the Internet. Nor has anyone managed to locate her.

Another anecdote that has also fuelled the theory that the virus came from the Wuhan Institute of Virology is a quote from one of the team who made significant discoveries about coronaviruses in bats.

Shi Zhengli [石正丽], a virologist at the WIV, and a world expert on bat viruses, and known as 'China's Bat Woman', wrote in Scientific American in March this year that when she was urgently contacted by the head of the Wuhan Institute of Virology on 31st December 2019 to investigate coronavirus samples found in two patients with atypical pneumonia, she remembers thinking "If coronaviruses were the culprit, could they have come from our lab?"

Of course, such thoughts might well run through the minds of a scientist working closely with coronaviruses that are later found to have been responsible for starting a pandemic. But feelings or concerns are not proof.


Shi was the focus of personal attacks in Chinese social media who claimed the Wuhan Institute of Virology was the source of the virus, leading Shi to post, "I swear with my life, [the virus] has nothing to do with the lab."

She went further in a follow up statement, saying, "The novel 2019 coronavirus is nature punishing the human race for keeping uncivilized living habits. I, Shi Zhengli, swear on my life that it has nothing to do with our laboratory."

Of course, it might be possible that Huang Yanling was infected whilst working at the laboratory and later infected people in and around the wet market in Wuhan only to be 'disappeared' in order to 'hide the truth'. The police action, early on in the outbreak, against a doctor who tried to bring attention to the new deadly virus does nothing to quell such conspiracy theories. Dr Li Wenliang had, in December 2019, attempted to bring attention to colleagues of a possible outbreak of an illness that resembled severe acute respiratory syndrome [SARS], later acknowledged as COVID-19. However, on 3rd January 2020, Wuhan police summoned and admonished him for "making false comments on the Internet." Li later died from complications after contracting the virus himself. 

Scapegoats and inaction

It is clear that the Communist Party of China manipulated information, silenced individuals and potentially risked more lives by not being upfront with both its own people and the world in general. But even if there were cover-ups, it was clear by mid to late January as stringent lockdowns were implemented and temporary hospitals were constructed, that the situation was serious. To blame China for the West's complacency is merely looking for a scapegoat.

Indeed many countries close to China reacted far swifter and decisively in the face of the spread of the virus. Taiwan, for example, employed temperature and other health checks on all people arriving early on, conducted widespread testing as well as contact tracing and quarantines. As such there are only a little over 300 cases in the region and only 5 deaths amongst a population of over 23 million. Similar procedures in Hong Kong, South Korea and Iceland has also kept the numbers of cases and deaths relatively low.

The first cases appeared in the UK on 31 January, but it was not until the 23rd of March that a lockdown was implemented following a closure of schools and an order that pubs, clubs, restaurants and other public places be shut. In that time there was no widespread testing, people arriving from abroad were not subject to temperature or health checks and there was little effort to perform contact tracing [Wikipedia].

The same was true of the US. On the 19th January 2020, a 35-year-old man presented himself to an urgent care clinic in Snohomish County, Washington having returned from Wuhan [NEJM / NYT]. Having seen a health alert from the US Centers for Disease Control and Prevention [CDC] about the novel coronavirus outbreak in China and suffering from a cough and fever he had decided to seek medical help. The man later recovered. However, it is likely that many others, perhaps asymptomatic, also arrived in the US around this time or before and began to spread the infection. Yet once again, the US dragged its feet in terms of checking arrivals from other countries, delaying testing, and failed to prepare for what later proved to be a major health emergency, though a ban on individuals travelling from China was implemented on the 31st of January.

Learning lessons

Whilst this pandemic is far from over, one can only hope lessons are learnt. All countries must prepare for any future pandemics. The WHO along with governments from all countries must draw up plans and procedures to curtail the spread early on. And information must be freely shared, not only between scientific bodies and governments, but also to the general population.

Many countries around the world are at fault concerning the spread of the COVID-19 coronavirus. China's ruling communist party failed to share and even stifled the flow of information. Many other countries failed to act quickly enough, despite warnings from China and the WHO as early as the 30th of January when the WHO declared a global health emergency.

First world countries in particular could be rightly criticised for maintaining their public health service and for mothballing preparations for future pandemics including the failure to maintain equipment and failing to store Personal Protection Equipment [PPE] appropriately.

As such, in many countries there is a clear shortage of ventilators, PPE and other important equipment, as well as a shortage of properly trained staff, nurses and doctors.

More pandemics to come

This won't be the last pandemic and as Dr Shi Zhengli says, "the mission must go on" to find and identify other coronaviruses. "What we have uncovered is just the tip of an iceberg."

Disease ecologist Peter Daszak, who has collaborated with Shi over many years, says there are as many as 5,000 coronavirus strains waiting to be discovered in bats globally. As far back as 2013 he warned that bats and other animals, through zoonosis, pose a risk to us all [Wired]. 

So who was patient zero?

So, was Huang Yanling patient zero? It is perhaps of little consequence. Whether she was the first person to begin the spread, or whether is was a pangolin or pig that was the first carrier, it is zoonosis that is the driving factor. 

Indeed, it is not the fault of a virology lab or its workers. It isn't the fault of the bats either per se. It is the fault of humans for failing to heed the warnings from scientists.

As Daszak said only this week, "We need to be thinking about pandemics in the same way we think about climate change – it's an existential threat to us, but it's one we can actually control, because we're the drivers of it." [SCMP]

"Bat-borne coronaviruses will cause more outbreaks," says Dr Shi, "We must find them before they find us."  

tvnewswatch, London, UK