Two Thirds Done

Thoughts and experiences of an eighty one year old Wild Duck.

Avram Miller by the sea
EN | IT

587 posts since 2006

Tag: Covid 19

  • My most outrageous blog post ever

    Here we are, almost two years from the time the Covid 19 changed the world, and this is far from over. I have watched with interest and concern how various governments, institutions, and people have dealt with this challenge. The rapid development of vaccines has been a bright start on a somewhat cloudy night.

    While the virus has not vanquish civilization, it certainly has disrupted many lives and taken many lives.

    I have been encouraged about how so many people have taken personal responsibility not only for their health but also for others, including people they do not even know. But, Equally, I have been horrified by the selflessness and ignorance of others who refuse to get vaccinated or, even worse, spread falsehoods and even profit from selling products that do not help but can harm those who use them.

    I can’t even write about the selfish behavior of the former president of the USA without feeling ill myself.

    Viruses are not alive (although some disagree). They are snippets of genetic material (DNA or RNA) that can enter cells of living things and reprogram them. They cause the cells of living organisms to reproduce copies of themselves, creating high virus qualities. The objective of the virus is replication, although, of course, the virus is now aware of that. The virus has no interest in harming its host, although that may result from the infection. What is motivating the virus is making more copies of itself. However, it will very often make altered copies that we call mutations in the process. It is not in the self-interest of a virus to kill its host or even make the host very sick, although that is often the result. It wants to make lots of copies, and to do that; it has to go from host to host, infecting as many organisms as possible. It is in the virus’s interest to infect a host without causing symptoms. A host with symptoms will likely have less chance to help the virus with its mission to infect others. Therefore, a virus that does not produce symptoms will have a greater chance of propagating than one that does.

    The evolutionary pressure on the virus is to become more infectious. This can be accomplished in several ways. The increased transition between organisms is one of the primary ways. But it also means in the case of humans, people that are very infectious but not aware that they are infected. When a version of the virus is more contagious than a previous version, it will out-compete it and become the dominant version. We saw that with the Delta variant of Covid. We now believe that this might happen with the Omicron version.

    The more people infected with the virus, the more variants will develop. The variants are just random mutations. Most harm the virus itself. But given enough replications, variants that are superior in replication will emerge to the variant that created them. The overwhelming majority of human beings have no immunity from Covid. They are not vaccinated or recently infected. They are each a factory to produce new variants.

    There is a lot of talk about vaccinating the world. Frankly, that would be wonderful but not very achievable especially given that the vaccines lose effectivity over time, as does natural immunity (having been previously infected).

    That is why I am making an outrageous proposal. First, let’s develop a version of the very infectious but not very destructive virus. Then let’s try to infect everyone. We did this in the 50s when I was a child. There were measles and chickenpox parties where kids gathered together to infect each other.

    With the advanced technologies we have, such as the mRNA capabilities, we could develop a version of the very infectious version of the virus but one that was not very serious. Then instead of someone being vaccinated so they could not get infected and infect others, they would spread the virus. Eventually, everyone would be infected.

    Remember, I said this was an outrageous proposal.

  • More thoughts about the Delta

    I monitor the covid numbers in Israel closely not only because I live in Israel (although I am spending the summer in California), but I think so much can be learned from the Israeli experience.

    Many of my friends write to me citing stories about how the Delta is raging in Israel. Not only are they concerned for Israel but also because they wonder what that will mean for them wherever they live.

    Please note that what I am writing is just my opinion. Don’t take my opinion as facts. So what is going on in Israel.

    Israel is one of the most vaccinated countries in the world. About 70% of the total population has been vaccinated. However, that may be close to 90% of the eligible population since children under 12 are not being vaccinated yet. There are communities where vaccinations are lagging as for example within the Arab communities but even their 70% of those eligible have been vaccinated.

    The Delta variant is about four times as infectious as the original virus. It also appears to develop more quickly. So we are seeing a lot of breakthrough cases. But what we are not seeing is a lot of hospitalization and deaths. In fact, the number of serous cases is less than 1%. Never the less, that growth in this number could compromise the health care system.

    It is now clear that the the vaccinations loose effectivity over time in preventing infection. It appears from the data in Israel this is time related. Age also may play a role. Israel is giving all those over 40 years of age, a third shot. Initial studies show that this will restore the ability of the vaccination to prevent infection in 88% of those vaccinated. This will slow down the spread of the disease and reduce the need for hospitalization. But the spread is not all bad. It will result in many people being infected but not seriously. However, they will develop immunity to the virus. Eventually the virus may become something like the flu. But the best defence now is to get vaccinated and take other measures to reduce infection.

    I don’t see the situation in Israel alarming, at least for Israel. In the USA where a large number of people are not willing to be vaccinated, it is a different matter. The virus is going to kill many and for now good reason. But that is another topic.

  • Covid and PCR Disease.

    It has been a while since I have written about the virus. I have been busy with publishing my book, The Flight of a Wild Duck, and I have not had a lot to say. However, the situation with the Delta virus has caused me to reengage. So, here are some of my thoughts. Please take my remarks as being my opinions and not as facts. There is a lot of misinformation out there, and I don’t want to contribute to the noise.

    The Delta virus is twice as infectious as the original alpha variant. We should all be thankful that we started with the alpha. Viruses all mutate. Generally, there will be a mutation for every 100 million cases. RNA virus mutates faster than DNA virus. Successful mutations have high infection rates than the ones prior to the mutation. It is a positive loop. The higher the rate of infection, the more people infected and the more mutations. But it is not the number of people infected that matters. It is the number of viruses produced by those that are infected. So those having a high viral load will have a great chance to produce mutations than those with a low viral load.

    The PCR test was developed to determine if someone is infected. But the infection means that one has some amount of a virus present. While it would be possible to categorize the amount of disease present in the nasal passage, this is not regularly reported—one of the factors that predict how infectious someone is is the amount of viral load they have.

    )Being vaccinated does not prevent a person from getting the virus in their nasal passage, for example. But does affect how the body responds to the virus. People who have been fully vaccinated can test positive for the virus but not have any symptoms. However, recent studies in Israel (I check today with someone who knows) indicate that people who are fully vaccinated but have no symptoms can infect others. If they infect people that are fully vaccinated, those people will probably not have any symptoms, but some portion of them can infect others as well. People who are not vaccinated can get infected by someone fully vaccinated; they can become seriously ill and even die. In a country like Israel, where I live most of the time, it is unlikely as the overwhelming majority of people have been vaccinated.

    Like many countries, Israel requires travelers to have a PCR test before flying to Israel. But they also need a PCR once they arrive. One of my Hebrew teachers (we study via zoom) had a negative PCR when flying to Israel. Then she had to stand in line for 90 minutes with many others crowding her to get a second PCR test. A few days later, she came down with the virus and had symptoms. She had not been vaccinated because she lived in a European country and was too young to get vaccinated. Forcing people to stand together at the airport to get a PCR test is insane, in my opinion. My contact at the Ministry of Health recently told me that one flight from Russia had 200 people that tested positive. Once only has to wonder how many they infected while waiting to take a PCR test.

    I don’t think that administrating the PCR test does much. The critical thing is to get everyone vaccinated. If you test people flying into a country, you will miss many people that have the virus but do not have enough virus to test positive at that time. However, you will find people that test positive but will not develop symptoms. These people may be forced into quarantine or denied the ability to fly to a country.

    At some point, we have to say that if you can get a vaccination and choose not to get it, it is on you if you get ill. It works in places like Israel with high vaccination rates since the chances that the hospital system will be overrun are low. In areas where the vaccination rate is low, mitigation like masks and social distancing are needed.

    While I don’t think PCR tests are beneficial as a screen device, I don’t have a big issue with them being required to take a flight, although they can result in some people not being able to fly. In some cases as in Seychelles, Israelis that were fully vaccinated tested positive and were forced into 14 quarantine, needlessly in my opinion.

    While vaccinated people can be contagious, my gut tells me they are much less virulent than nonvaccinated people. This needs to be studied. There is so much to be learned.

    As someone who has been fully vaccinated since last December and has had a test for antibodies (I have a lot of them), I am personally not worried. However, I will start wearing a mask again in places with a high number of infections, such as Los Angeles. It does not hurt.

  • It takes only one person to infect the world. More of my thoughts about COVID 19 from Israel

     

    If the Ro-the transition rate or the. number of people an infected person infects, the virus will spread. For instance, if one person infects four people in two weeks, those people can infect four people each, or sixteen people. The growth is always exponential. If the Ro is less than 1, the virus will eventually disappear.

    It only takes one person to infect the world. COVID 19 started with one person in China.

    Mitigation is the process of reducing the spread. At one time, here in Israel where I live, we got Ro down to 0.6, but that required an almost total lockdown, closure of the borders, and careful testing.

    Many more people likely have the virus than is reported. Here in Israel, we see that about 2.5% of people tested for antibodies have had the virus. That is almost ten times the reported number. These people had no or almost no symptoms. However, herd immunity will take a long time unless the Ro is allowed to go up to a large number. That would not be wise because the result would overwhelm the medical system and result in an increase in the mortality rate.

    Mortality in Israel is very low. We have had 300 deaths out of 18,000 confirmed cases. This is about 0.015%. Dying is not the only number to be concerned with, as many patients that do not die are left with issues like lung scarring. The USA has 353 deaths per million. Israel has had one-tenth of that or 33 per million. Why is that? There are man factors that influence this statistic. Demographics are critical. Death occurs almost exclusively in patients with comorbidities like diabetes, lung disease, Obstructive Sleep Apnea, and obesity. Many of these are correlated with age. Being old by itself is not the issue. It is just that many more older people have other things wrong with them. The average age in Israel is 30.2 years. In the USA, it is 37.7 years. About 14.5% of the USA population is over 65 years old. The number of people in Israel over 65 is not much different. However, Israel was able to keep the older substantially safer. There is many reasons for this which I won’t go into here.

    A key regarding mortality is the ability of the hospital system to deal with patients with severe COVID 19. In this regard, we can’t look at the national numbers for the USA. Israel is a small country about the size of the San Francisco Bay Area. The USA is vast. Averaging places with little disease and those with lots of the disease can be very misleading.

    One of the critical factors in understanding the spread of the disease in any given location is how early actions were taken to mitigate the spread of the disease. Israel closed its borders very quickly, although there was a delay of a week in closing the USA border do to interference by the Trump Administration. It is estimated that 70% of the cases can be traced to people who entered Israel from the USA during that extra seven days.

    If two locations had the same program to reduce the spread and the same population, but one started with 100 active cases and the other with 1000 active cases, it is likely that everything that happens later would be identical. However, in the second case, there would be ten times as many people. That is why the delays in mitigation in many states in the USA resulted in many more cases. It has been estimated that if locked downs had happened a week early a 60% reduction in the number of cases could have resulted. There would have probably an even more significant reduction in the number of deaths. It was, of course, much easier to lock things down in Israel since it is easy to close the border. Israel is a very family-oriented society, and older people are well taken care of. Everyone pretty much has health insurance/

    I think one of the biggest differences is how the initial testing was done. In the early days, those suspected of having the virus were tested in their homes. If they were tested outside, there was a great effort taken to make sure they did not expose others. Evidently, in the USA, many people that suspected they had COVID 19, went to emergency rooms. So if you have ten people in the room that suspect they might have the virus but only one that does, you may have created nine more that are now positive. Isolation of those that are infected is critical. Israel set up hospitals only to treat COVID 19 patients. Staff would not mix. The staff is tested every week.

    Contact tracing is critical. Israel used technology to trace cell phones so they could alert people that had come into contact with people that tested positive. I have such an app on my phone.

    Quarantining is critical. If someone has been in contact with COVID 19, they have to be quarantined for two weeks. Also, if someone did come into Israel from abroad (Israeli citizens primarily), they had to be in quarantine for two weeks.

    The USA has a much more challenging situation. USA citizens can fly to any of the 50 states without being tested or quarantined.

    We have learned that wearing masks can significantly lower the probability of transmission. I guess that it can reduce the transmission rate by at least 50%. I can understand people in Israel and the USA that do not wear masks when they are in the presence of others nearby. They are either ignorant or selfish or both. But it takes real leadership to explain this to people. Unfortunately, the USA does not have that kind of leader, sadly.

    I think the Ro can be reduced to close to 1 if masks, social distancing, and hygiene are applied. It is a small price to pay for saying the lives of so many and for being able to open up the economy.

  • COVID 19-Handshaking can kill you

    There is so much to learn about COVID 19. I think we will eventually be very surprised. 

    Why are Korea and Japan’s numbers so low

    I think there are two reasons.  They don’t shake hands and they wear masks.  Handshaking seems to me to be a very efficient means of transferring the virus.  Let us say someone has the virus and is coughing a bit or has a runny nose.  Maybe they use a tissue but still, some of the viral material gets on their hands.  They shake hands with someone and transfer the virus to that person.  That person then touches their face, nose, or eyes.  There you have it!!

    Masks offer great protection of both people use the mask.  So if you bow and do not shake hands, and you both have a mask, I think the probability of transferring the disease could drop by 100 times.

    Just think, what if we only had to do those two things and did not have to close down the economy?

    Sweden and Norway-the great experiment

    Sweden and Norway have similar populations but have taken very different approaches to handle the virus.

    Norway went on lockdown.  They have had 224 deaths out of a population of about 5 million.  Sweden is business as usual.  They have 3,256 deaths with a popular of a bit more than 10 million.  Sweden is letting people get infected and hoping for herd immunity.  Norway is flattening the curb.

    As I have written before, a delay is not a cure.  The reason to flatten the curb is primarily to make sure that the health care system is not overrun and also to hope that we can learn more about how to treat the disease and thereby reduce the mortality rate. 

    So while the number in Sweden looks awful, I want to see how the two numbers compare adjusted for population in a year. 

    By the way, Israel, where I live,  has a population close to that of Sweden. It did go on lockdown but is now exiting.  We have only had 258 deaths.   The median age in Sweden and Norway is around 40.  In Israel, the median age is 30 which is part of the reason.

    By the way, we don’t really shake hands in Israel.  We are huggers.  I think hugging is a lot safer than handshaking.

  • Some more thoughts about the Coronavirus

     

    The Chinese Century

    China will be coming out of the problems due to the Covid 19 virus before the USA.  Right now the USA looks like it is in real trouble medically and financially.  China will fill the vacuum left by the major decline of the USA.  

    The world’s experience with democracy is ending

    Democracies are struggling to cope with the changes that globalization and technology are creating. Democracies are short term oriented and what is needed now is long term thinking. This is another reason that it will be the Chinese Century.

    We have been preparing for the wrong wars

    The USA has been spending a large percentage of its budget making sure we could fight WWIII. We have an army and weapons not because we need them now but because we could need them to fight a future war. We have to look at Virus the same way. We need to be prepared for that war.

    Some good may come out of all this

    We will learn that we do not have to travel as much or even need offices. This will help our planet. The trend towards online retail, home delivery of meals etc will continue and accelerate.

    It is time to reevaluate what is really important in our lives

    It is the people you love and that love you.