Everything is as expected, even the Covid-19 pandemic

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When I was in graduate school, four things happened at almost the same time (probably within a three year time frame, but who’s counting?) 1) The publication of The Coming Plague: Newly Emerging Diseases in a World Out of Balance by Laurie Garrett (well, and my reading of the book); 2) the cultural phenomenon of “hot zone” movies and books, of which the most memorable is probably Outbreak starting Dustin Hoffman; and 3) the realization that a good part of the archaeology I was doing in the Congo was of villages that had been abandoned because a plague of some kind came along and killed enough people that everyone moved elsewhere, which is apparently a tradition in that area; and 4) the Zaire Ebola outbreak in Kikwit. Since I had been working in the area, I got involved, in a minor way, with some of the Ebola research, and I produced evidence for a model for the virus jumping from fuit bats to humans that turned out to be exactly what had happened about ten years later when the West African Ebola epidemic occurred.

This combination of things got me interested in both epidemiology and immunology, and I’ve been studying it (and teaching the topics) since then.

Do you remember the H1N1 pandemic of 2009? Compared to our current pandemic, it was minor. But it wasn’t nothing. There were a half million lab-confirmed cases, which is probably a fairly small percent of acutal cases, with the real number being up to 1.4 billion. The estimated death toll was well over a quarter of a million. My memories of that pandemic are sharp, because my son, Huxley, was born right in the middle of it. The Maternity Ward was on lock down. But, the vaccine was around and nobody in our extended family actually got sick.

Also at that time, epidemiologists and other infectious disease experts were doing a lot of talking-head work, and among them, was Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. (See for example: H1N1 could overwhelm U.S. in the next two months).

I remember at the time, or probably a year or two later, Osterholm was on a talk show with two or three other experts, including one who had written a recent definitive history of the 1918 pandemic. At one point, each of the experts had a chance to opine about the next version of such a pandemic. Interestingly, they were all fairly up beat. We have, after all, vaccines, something not really developed in 1918. And great doctors and medical ablities and stuff. There really can’t be another pandemic like 1918.

Then, Osterholm spoke. He said this: The next pandemic may be worse than 1918. It will be harder, not easier, to deal with. Yes, we will have a vaccine for the next pandemic virus, but it will take at least a year, maybe a couple of years, to get it. The virus will not wait. It will ravage our population. There will be, plain and simple, a major pandemic with no vaccine for it, for a very long time, many months at least. Meanwhile, the virus will be worse than 1918, because in 1918 we had far more hospital beds per person than we do now. Basic nursing, in a hospital, will be what will save lives, more so than fancy medical stuff.

We have transformed our medical system today to one in which people spend very little time in hospitals, and hospital stays have become something for the very sick or the very rich. Note that the first thing sane US states did (the ones run by Democratic governors, and a couple of others) when Covid-19 emerged was to figure out how to build out hospital capacity at lighting speed. That was because of Osterholm and a few of his colleagues, and their predictions of what would happen. The response plan was already in place, and has been for years. Something like this state level response was also in place at the federal level, until the Trump Crime Family dismantled it early in Trump’s term.

A bunch of smart people had studied past epidemics and pandemics. A bunch of smart people had studied epidemiology and immunology, and viruses. A bunch of smart people described what a pandemic would look like. All you had to do was to be one of the few people who happened, by chance or circumstance, to have read that literature and listened to those individuals, to remain today pretty much unsurprised by everything that has happened over the last year, and that will happen over the next year. Nobody knew the timing, but this one corner of science and public health knew this would happen, and what it would look like.

One thing none of these smart people expected was that the US would be taken over by a nefarious anti-science political party (Republicans) that would set us back decades in our ability to manage a pandemic, just when the big pandemic came along.

And, there is one other unexpected surprise, and this is surprisingly little talked about. The vaccines that are now being distributed are nothing like vaccines have ever been before. In fact, they only barely fit the definition of a vaccine. Vaccination normally involves introducing substances into the body that cause an immune reaction that doesn’t make you sick, or not too sick, but that cause the adaptive immune system to prepare for a future infection by a specific pathogen. The new RNA technology does not do that. Rather, it programs a few thousand cells in your body to produce a molecule that is the substance that causes the immune system to react. The vaccine factory is in your cells.

That is new.

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15 thoughts on “Everything is as expected, even the Covid-19 pandemic

  1. Michael Osterholm’s podcasts during all of this have been quite interesting.

    “One thing none of these smart people expected was that the US would be taken over by a nefarious anti-science political party (Republicans) that would set us back decades in our ability to manage a pandemic…”

    Well, in our ability to do many things. The current republican world has been building since reagan. We can hope it goes away in much less time than it took to develop.

    1. We can hope it goes away in much less time than it took to develop.

      But part of Hollywood is trying to ensure that doesn’t happen as they raise the ghost of Joe McCarthy.

      On 11 November, Midnight Cowboy and Coming Home star Jon Voight posted a video on Twitter. “This is our greatest battle since the civil war,” he said, referring to the election results. “The battle of righteousness versus Satan, yes, Satan. Because these leftists are evil, corrupt and they want to tear down this nation.” Voight’s support of President Trump has been full-throated.

      Voight, perhaps, has forgotten some of the messages of Midnight Cowboy.

  2. Tonight on Amanpour & Company, the CEO of Moderna speculated that RNA technology might lead to a cure for cancer. (I should say “cures,” for cancer is not one disease.)

    I wonder how far the technique might reach. If it can teach human-body cells to recognize and attack a specific virus, could it also teach those cells to recognize and attack the causes of inflammation — or cell senescence?

  3. The vaccine factory is in your cells.

    Or not as the case may be if you are too poor, or otherwise disadvantaged, to obtain a balanced diet that contains the essential amino acids not produced by the body but which are required to manufacture the antibodies from within.

    See e.g. ‘Organic Chemistry: A Short Course’ by Hart. I have the Eighth Edition.

    1. “Or not as the case may be if you are too poor, or otherwise disadvantaged”

      Or, if you have the bad luck to be a florida resident, it might be too late, since desantis meddled with the state health agency’s reporting on numbers and spread from the start of the problem, and actually ordered it to stop all messaging around covid 19 in the month leading up to the election in order to give the message that things were under control.

      It’s hard to get through things in the best of settings: when you have leaders who are morally bankrupt, which is the case for republicans now, it’s exponentially more difficult.

  4. Trump continues with his morally repugnant deeds, he should be removed from such decision making.

    Donald Trump has pardoned four security guards from the private military firm Blackwater who were serving jail sentences for killing 14 civilians including two children in Baghdad in 2007, a massacre that sparked an international outcry over the use of mercenaries in war.

    Trump pardons Blackwater contractors jailed for massacre of Iraq civilians

    Betsy DeVos must be pleased that her brother Erik Prince is off the hook.

    Once a pardon is given can it be rescinded? If not then this is another charge to add to Trump’s list of fell deeds.

    Dark days before the light has a chance to shine.

  5. More on Trump pardons:

    Pardons sink Trump further into swamp of his own shamelessness

    Analysis: President sanctions first federal execution of a woman in 67 years – but war criminals, fraudsters and Russia-linked cronies go free…

    Nicholas Slatten, Paul Slough, Evan Liberty and Dustin Heards worked as security guards for Blackwater, owned by Erik Prince, a prominent supporter of Trump and brother of his education secretary, Betsy DeVos. All were serving long prison terms for a 2007 massacre of 14 unarmed civilians in Baghdad.

    After their trial in 2014, Ronald Machen Jr, the US attorney for the District of Columbia, said: “These Blackwater contractors unleashed powerful sniper fire, machine guns, and grenade launchers on innocent men, women, and children. Today they were held accountable for that outrageous attack and its devastating consequences for so many Iraqi families.”

    The pardoning of the four led political opponents and legal commentators, even those who thought they had grown immune to Trump outrage, to reach for words like “disgusting” and “grotesque”. With just 29 days left in office his burn-it-all-down brazenness knows no bounds.

    And this is by the creature that RickA supported, if you lie down with those who have fleas so you will be similarly afflicted. Trump is the true traitor of the USA, the penalty for that is….?

    1. “…as security guards…”

      I’ve never understood why mercenaries were referred to as security guards.

  6. It used to be that it was the lack of knowledge that led to many disasters so increased scientific and allied knowledge should have made the number of out-of-control disasters much lower than before. Instead the necessary knowledge relating to the Global Warming and COVID-19 disasters was largely derailed and drowned out by the misinformation and lies resulting, in large part, from the evolution of Republicans into “a criminal conspiracy for the purposes of maintaining power for self-interest and the self-interest of the donor class.”*

    Had Donald Trump been more intelligent with an inkling about governance, we might well be on the verge of a second term for a President of that criminal organization and on the verge of the second stage of the metamorphosis of the U. S. A. into a full-fledged oligarchy like the Russia so admired by Trump and minions such as Michael Flynn.

    * Quoted from a television conversation with Steven Schmidt, founder of the Lincoln Project.

    1. “Had Donald Trump been more intelligent with an inkling about governance,…”

      The fact that roughly 70 million people voted for that shitbag despite is continuous criminal behavior and complete lack of even an attempt to deal with the covid issue is appalling.

      The fact that we have rickA and mikeN as examples of the type of morality- and integrity-free racists that support him is also chilling.

  7. The fact that roughly 70 million people voted for that shitbag despite (h)is continuous criminal behavior and complete lack of even an attempt to deal with the covid issue is appalling.

    That lack of concern, and, the mentality behind Brexit in the UK (disaster capitalism sold as freedom from foreigners to white Brits), anti-maskers, anti-vaxxers across the western world, to name but a few reasons, leaves me in despair regarding our ability to solve the current climate crisis in time to prevent even bigger disasters than we are already seeing. It’s a wholesale rejection of science, particularly when science interferes with the comfort of one’s own lifestyle, or even worse threatens to raise the lifestyle of those you’ve been taught to hate.

    Acting like, or actually being, a psychopath is advantageous to executive status in the corporate world (https://www.washingtonpost.com/news/on-small-business/wp/2016/09/16/gene-marks-21-percent-of-ceos-are-psychopaths-only-21-percent/.) At a fundamental level capitalist societies encourage a dog-eat-dog view of the world, a pathology that is inimical to nature, while religions blind people to reality and personal responsibility by stating it’s all “God’s” will and promising a better “next life” as long as you do what they say and pay them for it.

    “Reality is that which, when you stop believing in it, doesn’t go away.” ~Philip K. Dick should be taught in school.

    Industrialization led to mass urbanization where every sq. m. of land is deemed to valuable to leave wild, where parks are carefully groomed or absent, has, in turn, led to a dulling of people’s sense of connection to nature. Without that connection disregard for environmental woes becomes ever more apparent.

    Excuse me while I go out to hug a tree and go for a hike in ungroomed nature with my dog.

    Happy winter solstice to all. May we find some sanity in the new year.

  8. Will the US really have lost its way going forward post-Trump?

    Trump has brought impunity to the highest office in the land, wielding a wrecking ball to American democracy

    Most of the 74,222,957 Americans who voted to re-elect Donald Trump – 46.8%of the votes cast in the 2020 presidential election – don’t hold Trump accountable for what he’s done to America.

    Their acceptance of Trump’s behavior will be his vilest legacy.

    Nearly forty years ago, political scientist James Q Wilson and criminologist George Kelling observed that a broken window left unattended in a community signals that no one cares if windows are broken there. The broken window is thereby an invitation to throw more stones and break more windows.

    The message: do whatever you want here because others have done it and got away with it.

    Americans’ acceptance of Trump’s behavior will be his vilest legacy

    Can those wayward Americans learn that with freedom comes responsibility? Time the GOP was held accountable for what it has allowed, even encouraged.

    1. The mechanism for holding members of the modern Republican Party seems almost non-existent.

      Although taking an oath in a court trial and then lying leaves the liar open to a charge of perjury which carries a penalty, there are no penalties for breaking oaths in public office carries no such penalties. This was on display when the leader of the Senate majority told the world that he was coordinating their response with the President’s impeachment defense team and then he and they obviously lied when taking the oath as jurors in that trial. No penalties at all were levied.

      Similarly, there was no penalty involved when President Trump was blackmailing the President of Ukraine into announcing an official inquiry into the Bidens. He definitely broke the “law” that required him to notify Congress when he held up money already voted for Ukraine’s defense against Russia. Except for the fact that his action happened to have been brought to public attention, he would have gotten away with it.

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