STILL DEBATING A COVID VACCINE? HERE'S SOME CRYSTAL-CLEAR DATA FOR YOU

As of the end of August, 2021, 51 percent of the US population have been fully vaccinated for Covid-19. That means that 49 percent have not, despite the vaccine being widely available and free. Still, 61 percent have gotten at least one shot, so that leaves "only" 39 percent of the US population who have so far chosen not to seek or accept Covid-19 vaccination.

That means that more than 129 million Americans remain un-vaccinated, giving the SARS-CoV-2 virus, and especially the highly contagious delta mutant more than enough unprotected targets to continue to cause widespread illness, hospitalizations and death. Those 129 million unvaccinated people also comprise an enormous human petri dish in which the virus can continue to multiply and mutate.

Vaccination vs. hospitalization by state

Credit: NYT

Just in case some of those 129 million might be amenable to real-life, on-the-ground data about the life-saving benefits of the vaccine, here are some brand-new, nation-wide county-by-county research findings:

                                                                          Credit: Jeffrey Harris, MD

Jeffrey Harris, a physician and emeritus professor of economics at the Massachusetts Institute of Technology, gathered data on vaccination rates, Covid-19 case rates and Covid-related hospitalizations in the 112 most populated US counties, a total of 147 million people. He used vaccination data as of mid-July, 2020 and compared them to Covid cases and hospitalizations between July 30 and August 12. You can read a pre-print of the research report here.

The results are striking. 

In the 56 counties in the lower half of the vaccination range, there were 548 cases per 100,000 population during the two-week study period, but just 281 cases per 100,000 in the 56 counties in the upper half of the vaccination rates. 

People in the less-vaccinated counties suffered 1.95 times as many diagnosed Covid-19 cases than people in the more-vaccinated counties.

A ten percent increase in vaccination rate correlated with a 28.3 percent reduction in Covid-19 cases.

The difference in Covid-caused hospitalizations in less- compared to more-vaccinated counties was even more dramatic. In the 56 less-vaccinated counties there were 55.4 hospitalizations per 100,000 people during the two-week study period, compared to 20.5 per 100,000 in the more-vaccinated counties. 

That means that for every hospitalization in the more-vaccinated counties, there were 2.7 hospitalizations in the less-vaccinated ones.

A ten-percent increase in vaccination rate correlated with a whopping 44.9 percent decrease in Covid hospitalizations.

So what's the bottom line of this large, detailed nationwide study? Basically, any region that can get 10 percent more of its citizens to get vaccinated can expect to cut its Covid case rate by 28 percent and its Covid hospitalization rate by 45 percent.

Lets translate those reductions in Covid cases and hospitalizations into lives saved:

In the US to date, we've suffered 39,662,129 confirmed Covid-19 cases. Among those, 2,675,000 have been hospitalized and 654,668 people have died. 

That means that for every 100,000 US cases, we're likely to see 1650 deaths. 

Thanks to an incredibly quick learning curve within the medical profession, the percentage of Americans who survive after being hospitalized for Covid-19 increased from 78.9 percent in early 2021 to 93.5 percent in August. Still, that means that even now the death rate for hospitalized Covid patients is 6.5 percent, meaning that out of every 100,000 Americans hospitalized for Covid, 6500 are likely to die.

As of the end of August, 2021, the US is registering more than 140,000 new Covid cases per day, or 980,000 per week. We're seeing an average of 12,297 new hospitalization per day, or 86,079 per week, and 1163 deaths per day, or 8,141 deaths per week.

Looking just weeks into the future, this study tells us that if just 10 percent of the 129,000,000 un-vaccinated Americans were to get vaccinated, we could avoid approximately 275,000 new Covid-19 cases, prevent 38,650 hospitalizations, and save at least 2500 lives--every week!

Dr. Harris believes we can do this. He says that among his patients he has encountered many "reasons" for not getting vaccinated. He recognizes that some people are "encapsulated in a misinformation bubble from which there seems to be no escape." Others, however, may be reachable, especially if there are tangible, real-life consequences to not be being vaccinated, such as loss of a job or not being able to enter restaurants or other businesses. 

"I expect many will come around," he says. Let's hope he's right.

Worth getting the jabs? You decide.

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REA/8-29-21

Vaccination rates ranged from below 30 percent in three counties in Georgia to over 65 percent in several counties in Maryland, Massachusetts, California and Washington. 

BEWARE OF SYMPTOMLESS SUPERSPREADERS

A just-published research article in the Proceedings of the National Academy of Sciences (PNAS) reveals some striking new information about how the coronavirus spreads. A study testing thousands of people at the University of Colorado, Boulder, found that the distribution of virus particles among symptomless individuals matched the distribution among people hospitalized for Covid-19, with a few individuals in both groups carrying enormous numbers of virus particles and so having the potential to act as COVID-19 superspreaders. In other words, some people with no COVID-19 symptoms at all can spread the disease as easily as the most contagious hospitalized patients.

Virus loads in asymptomatic people matched those in hospitalized patients

Credit: Yang et al., University of Colorado, Boulder

The researchers found that, regardless of symptoms, just two percent of people who test positive for the coronavirus carry 90 percent of the virus particles circulating in a given population. "The highest observed viral load was over 6 trillion virions [complete, infective virus particles] per Ml, which was only observed in one individual," they write. "It is remarkable to consider that this individual was on campus and reported no symptoms . . .." 

They add that just 10 percent of symptom-free people who test positive for the virus, plus 14 percent of hospitalized Covid-19 patients account for 99 percent of circulating, active virus particles. 

In addition to such potential super-carriers, the researchers estimate that 50 percent of symptomless individuals who test positive for the coronavirus carry enough virus particles in their saliva to spread COVID-19 to to others.

These finding have several important implications. One is that being symptom free does not guarantee that someone isn't a COVID spreader or super-spreader. As more people get vaccinated and people become more relaxed about mask-wearing social distancing and avoiding groups and crowds indoors, it's very likely that we'll see continuing outbursts of Covid cases seeded by such symptomless but highy contagious non-vaccinated individuals. 

Anyone concerned for their own safety or that of their family, friends or contacts should probably not be in a hurry to stop wearing a face mask to minimize their own risk and the risk they potentially pose to others.

A second, public-health implication is the importance of continued, widespread screening, including of people without any COVID symptoms. ". . . it is imperative that we find virus supercarriers, and inform them of their infection status in a way that is fast, easy, and accessible," the researchers write. "Finding viral supercarriers will have a disproportionately large impact on curbing new COVID-19 infections."

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REA/5-10-21

THE CORONAVIRUS AS A REALITY CHECK

To paraphrase a quote usually attributed to Abraham Lincoln:

You can fool all the people some of the time and some of the people all the time, but you cannot fool a virus.

                                                     The coronavirus--"It is what it is."

                        Credit: NIAID

As historian Yuval Noah Harari brilliantly explains in Sapiens: A Brief History of Humankind, it's our uniquely human capacity to believe in shared fictions such as the value of money or the necessity for daily prayers that sets humans apart, allows millions of strangers to cooperate, but that also divides us into adversarial and sometimes murderous tribes. 

As symbol-using animals, we are able to convince ourselves of all kinds of ideas, from bible stories to trickle-down economics and act by the millions or hundreds of millions as if they were real, sometimes defending them with our lives (or all too frequently the lives of others). 

It's belief in a shared narrative that lets you go to an ATM anywhere in the world and retrieve a handful of paper for which a merchant will hand you actual food or clothing. But that same propensity to accept and believe in pervasive, communal myths also means you may not be able to share a Thanksgiving meal with friends or relatives on the other side of a political or ideological fence. 

We humans swim in a sea of memes, concepts, ideas and narratives, and we're usually as unaware of it as fish are of the ocean. 

In stark contrast, the coronavirus is completely immune to the web of narratives that we clever, cognitive, symbol-using humans weave within and around and ourselves. It has no ears so it doesn't hear that it will surely be defeated next week, month or year.  It has no eyes so it isn't deflected or deterred by what we see on our screens or read on the signs so proudly displayed at political rallies. It can't be seduced, bribed, bullied, browbeaten, bargained with or bought off. 

All the virus has is a genetic code that equips it to infect one person, multiply, turn that victim into a vector, sicken or kill, and spread. To the coronavirus we are not republicans or democrats, billionaires or beggars, sentient, sophisticated, symbol-using beings; we're just meat. That's the truth, and as Ghandi said, " . . . truth overrides all our plans."

As President Trump so succinctly pointed out, the coronavirus is what it is. Precisely because of that it has the potential to serve as a painful and costly yet vital teacher to us. It can be the "whack on the side of the head" that awakens us to reality, to the ground truth behind the crazy-making swarm of buzzwords, memes, slogans and contradictory narratives that befuddles us. 

I doubt that Trump, now personally suffering from the virus, will get the message. More than anyone else I know of, he seems to believe that he can impose his will on reality. He's spent his life mastering an armamentarium of manipulations that have worked to get him what he wants and where he wants to be.  My guess is that he has travelled too far down the ever-narrowing tunnel of narcissism to turn back. If he survives his bout with Covid-19, my guess is that he will brag about his superior genes and tell us how his resilience and toughness let him beat the virus.

However, that doesn't mean that the rest of us can't benefit from the raw reality that the virus makes us face. Beyond taking the by-now-well-known steps to protect ourselves and others from the virus, it can and should prod us to question our assumptions and preconceptions, to search for and be open to facts, to remember that there's an actual reality that we can strive to know and have to respect. 

It's worth noting that we have access to a highly developed methodology for doing that. It's called science. Scientists have spent centuries honing tools to track fact to its lair by stripping away as many as possible of the myths, wishes and cognitive biases we project onto it. They too spin their theories, but they constantly check them against reality. We need to listen to them, not just about the coronavirus, but about the increasingly urgent threats of climate destabilization and ecological collapse.

Rather than groping and wandering in a fog of myths and memes or choking on the smog of outright lies, let's use this implacable virus to spur us to at least start the hard climb to where we can breathe the cold but bracing air of truth.

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REA

GOING CORONAVIRAL-- A COMMENT ABOUT EXPONENTIAL GROWTH

We humans are pretty good at understanding linear change. It's all around us:

--eat more, gain some weight; eat less, lose some weight
--press on the gas pedal, speed up; press on the brake, slow down
--turn up the heat, feel warmer; turn down the heat, feel cooler
--someone can't hear you, talk louder; someone moves closer, talk more softly
--and thousands of other daily experiences in which a small change produces a small result and a larger change produces a larger result.

However, some events don't behave linearly. There are situations where a small change can quickly produce a big effect. We're living through at least two of them right now--climate change and the Covid-19 pandemic. We're failing miserably in understanding and dealing with both of them.

A sneeze--a few tiny droplets can cause massive disruption

Photo credit: CDC

Let's do a little math--please bear with me:

Step number     Linear growth (n x 2)     Exponential growth (2 to the n) 

         1                        2                                                    2                                       
         2                        4                                                    4                                         
         3                        6                                                    8                                         
         4                        8                                                   16                                       
         5                      10                                                   32                                       
         6                      12                                                   64                                       
         7                      14                                                 128                                       
         8                      16                                                 256                                         
         9                      18                                                 512                                         
       10                      20                                               1024 
       11                      22                                               2048                                     

Let's pretend that these numbers represent two different responses to the Covid-19 virus.

The steps might represent weeks. The first column might represent a situation where the virus is fairly well controlled (e.g. through some combination of social distancing, mask wearing, testing, tracing and isolating people likely to shed the virus). On average one infected person infects approximately one other person, with the result that the number of cases grows linearly. The third column represents exponential growth--where the virus truly is "going viral." All that takes is for one infected person to pass the virus on to more than one new victim.

Notice the enormous and rapidly expanding difference as the weeks tick by. At week three, exponential growth has infected just two more people than in the linear growth model, but at ten weeks the difference is more than 1,000, and one week later, more than 2,000.

So, our first takeaway is that when we're dealing with any situation involving exponential growth, at first it's hard to distinguish from a normal linear situation that we're used to, but sooner or later it takes off explosively.

Now let's examine that phrase "sooner or later."

      Week    Doubling stopped sooner           Doubling stopped later
         1                        2                                                    2                                     
         2                        4                                                    4                                       
         3                        8                                                    8                                       
         4                      16                                                   16                                       
         5                      18                                                   32                                       
         6                      20                                                   64                                       
         7                      22                                                 128                                       
         8                      24                                                 256                                         
         9                      26                                                 258                                         
       10                      28                                                 260 
       11                      30                                                 262
Total Cases:          198                                               1290

What a difference a delay makes.  This might represent two states, one of which sees the exponential handwriting on the wall after just four weeks, institutes effective controls and ends up with 198 cases, while the other delays control measures one month more and ends up with with 6.5 times as many cases. (Or these numbers could equally well represent deaths, in which case that one month delay would have caused over a thousand needless deaths.

Obviously the numbers above are meant to be an illustration; they don't match exactly with the real world. However, you can see this in the real world if you compare the impact of a one-week delay in responding to the pandemic in New York vs. California. Here's a zerospinzone.blogspot post from March 30:

In this comparison of coronavirus cases in New York vs California, you can see what difference even a few days lag in imposing strict stay-at-home orders makes. California--population 39.5 million, first state to impose strict controls: current # of cases 6358, deaths 132. New York--population 19.5 million, delayed a week before imposing controls: current # of cases 60,679, deaths 1063. The number of cases per population in NY is 19 times greater than in California, and the number of deaths per population 17 times greater. What a tragic difference a week's delay makes.

A lot has happened in New York and California in the subsequent three months, with start-and-stop openings and closings in both states. Through all that, however, California has managed to keep a tighter lid on the explosive potential of the coronavirus. As of today, June 28, New York has documented 416,769 cases and 31,483 deaths while Callifornia has had 215,575 cases and just 5,934 deaths. Adjusted for population, late-starting New York has suffered nearly four times as many cases and more than ten times as many deaths as California. Clamping down just one week earlier in California almost certainly saved tens of thousands of lives.

Our second takeaway, then, is that when dealing with the potential for exponential growth, getting control of the rate of growth as early as possible--before the number of cases explodes-- makes a huge difference.

It's pretty clear that we, as a species, aren't very good at dealing with things that have the potential for exponential growth, and so can blast out of control at any time.  We're seeing the results of this globally as we try to put a cap on the coronavirus. Similarly, experts have been warning us for decades that, because of a number of looming tipping points, climate change too has the potential to spin wildly out of control.

However, we don't have a good excuse for continued ignorance; it's not as though the potential for dangerous exponential growth has been a secret. Consider this old proverb, a version of which goes like this:

For want of a nail a horseshoe was lost,
for want of a horseshoe a horse went lame,
for want of a horse a rider never got through,
for want of a rider a message never arrived,
for want of a message an army was never sent,
for want of an army a battle was lost,
for want of a battle a war was lost,
for want of a war a kingdom fell,
and all for want of a nail.

Clearly we've had folk knowledge about exponentially large consequences from a small event for a lot time.

Even more ancient is a story from India about a chess-loving king who promised to reward a visitor with whatever he wanted. The visitor "modestly" asked for one grain of rice on the first square of a chessboard, 2 grains on the second square, 4 on the third, 8 on the fourth, etc. It didn't take the King many squares before he realized he'd taken on an impossible task. Sixty-four doublings would have required some 18,000,000,000,000,000,000 grains of rice, enough to cover all of India a meter deep.

That ancient king learned a striking and costly lesson about exponential growth. It seems as though we--and our current leaders--need to learn it all over again, and quickly. That is, if we don't want our kingdom to fall for want of an adequate response to this microscopic but immensely dangerous virus.

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REA

AN INFECTIOUS IDEA -- A VIRUS-LIKE PROTEIN MAY BE CRUCIAL TO LEARNING AND MEMORY

We've all heard the phrase, "an infectious idea." It turns out that this may not just be a metaphor--new research has revealed that a virus-like protein in all of our brains may be vital for learning and memory.

"If it looks like a duck and quacks like a duck," the saying goes, "it probably is a duck." So, no matter how surprising it is, finding a crucial protein in the brain that looks like a virus and acts like a virus raises the intriguing possibility that our ability to learn and remember may stem from a chance infection of some ancestral four-legged creature by a retrovirus 350 to 400 million years ago.

The protein in question is called Arc. It's found in animals as different as flies, mice and humans. It's been known for some time that Arc is important for learning and memory. Mice lacking Arc forget what they've learned within 24 hours, and lack the kind of brain plasticity that lets young animals, most notably human children, soak up new information quickly and easily. Arc continues to be important for learning and memory throughout life, and impaired Arc functioning is associated with autism, amnesia and Alzheimer's disease.

Arc (long purple proteins inside the perimeter of the vesicle) can encapsulate and deliver its own genetic material to brain cells (light green branching blobs) in a manner similar to the way in which viruses infect host cells.  

Credit: Jacobo Lopez, Yi-Chu Su, Hugo Vaca

Jason Shepherd, a neuroscientist at the University of Utah, and his colleagues first suspected that something was different about Arc when they found that the protein self-assembles into structures called capsids that look like a lunar lander or the HIV retrovirus. Intrigued, they found that not only can the Arc capsid jump from cell to cell like a virus, it also transfers its own genetic material in the form of messenger RNA into the new cell.

Learning takes place when interconnected brain cells are activated at the same time. Intriguingly, the researchers found that when neurons "infected" by Arc are activated, they release newly minted Arc capsids. This suggests that the transfer of this virus-lilke protein from cell to cell may be a previously unknown and unsuspected mechanism for learning and memory.

Neuron expressing Arc and transferring it to other neurons

Credit: Elissa Pastuzyn 

“We went into this line of research knowing that Arc was special in many ways," says the study’s lead author, postdoctoral fellow Elissa Pastuzyn. "But when we discovered that Arc was able to mediate cell-to-cell transport of RNA, we were floored. No other non-viral protein that we know of acts in this way.”

Geneticists have been able to trace back the history of the Arc proteins found in all mammals. Sometime between 350 and 400 million years ago, a primitive four-limbed creature, or tetrapod, was infected by a retrovirus that left some of its genetic material in the animal's DNA. That chance addition to the mammalian genetic code has apparently proven extremely useful, perhaps laying the groundwork for the success of our mammalian ancestors, and even for our remarkable capacity for learning and remembering.

REA

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You can read more about this research at this URL.

The scientific article describing this research can be found in Cell, January 11, 2018.

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QUICK UPDATE ON POLIO ERADICATION PROGRESS -- WE'RE SO CLOSE

Followers of this blog know that I'm fascinated by the international effort to eradicate polio. Wiping out this paralyzing, often deadly disease will be one of humankind's great accomplishments. The only other human disease that we've been able to eradicate is smallpox--the last spontaneous case was in 1977.

According to the Global Polio Eradication Initiative, the effort is incredibly close to success, with just 5 cases reported worldwide this year, to May 24 (vs. 16 this time last year). In the early 1950s, before the Salk and Sabin vaccines were introduced, 15,000 children died or were paralyzed by the poliovirus every year just in the United States, 500,000 worldwide.

It's taken decades of dedicated, sometimes dangerous work by scientists, international organizations, and on-the-ground health providers to reduce that number from 500,000 to 5. The goal now is to shrink it to zero.

It appears that the polio virus now survives in just a few locations--the 5 cases all occurred in Pakistan and Afghanistan, destabilized by war and refugees. In addition, all 5 cases were caused by Wild Polio Virus 1 (WPV1), meaning that the other two strains of wild polio virus, WPV 2 and 3, may already be eradicated.

Wild Polio Virus Type 3

Credit: Manuel Almagro Rivas/CreativeCommons

Massive vaccination programs of at-risk children and adults are continuing, and will need to to continue for some time even after there are no more documented cases.

We're so close . . .

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