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3 Things: Myths of Overnight Success, Herd Immunity, and COVID-19 Vaccine

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[NB: I’ve spent several days drafting this post only to have today’s FDA’s pause on J&J vaccine throw a wrench in the works. I will try to pull something together about that issue in a separate post. / ~Rayne]

Friends and family tell me they are frustrated by people they know who are dragging their feet getting a COVID-19 vaccine. Some are actively resisting vaccination, refusing to get one.

Nearly all of this has been driven by misinformation, often been spread by well-meaning but skeptical folks. Anti-vaxx disinformation has been spread by those who have a vested interest in seeing Americans getting sick and dying, accepted by the same audience.

One friend told me a skeptical acquaintance explained, “I’m not an anti-vaxxer, I just don’t trust how fast this has been put together.”

Others have waved off the vaccine, saying they “don’t need a vaccine because we’ll reach herd immunity,” or “I already had COVID so I’m fine.”

We are never going to reach herd immunity so long as people refuse to be vaccinated.

And people wonder why CDC Director Dr. Rochelle Walensky was so emotional a couple weeks ago about the need to continue infection prevention and the rate of vaccination.

The problem in my home state is evident in this profile piece (now paywalled) featuring Michigan residents in the 10th congressional district. You’ll recall Rep. Paul Mitchell who won in 2018 declined to run for reelection because of the political atmosphere. It wasn’t just the toxicity in Washington DC from Trump and his backup singers in the GOP-majority Senate, but back at home where constituents have become increasingly unmoored from reality.

Their part of the state is the worst for new cases and deaths; given how thinly populated the rural district is and how small these communities are, they have to know people who are severely ill and dying and yet they just don’t give a flying fuck.

There will be no reaching some of these folks, ever, but we have to reach folks who are on the fence if we are ever going to stop the spread of COVID including new variants.

~ 3 ~

Misinfo/Disinfo 1: The vaccine was developed too fast.

Truth: The mRNA vaccines like Pfizer-BioNTech’s and Moderna’s were at least 31 years in the making. Work on adenovirus-vector vaccines like Johnson & Johnson’s began in the 1950s looking at defenses against adenoviruses. These are the only two types of vaccines currently distributed in the U.S. under Emergency Use Authorizations.

Research for the COVID-19 vaccine began in 2002 with the emergence of severe acute respiratory syndrome (SARS), caused by the coronavirus now known as SARSr-CoV. The epidemic which ran its course from 1 November 2002 – 31 July 2003, resulted in approximately 8,000 cases and nearly 800 deaths.

Research into Middle East respiratory syndrome (MERS), another coronavirus which is very similar to SARSr-CoV and SARS-CoV-2, also contributed to the body of knowledge. MERS epidemic resulted in 2,500 cases and nearly 900 deaths.

In total there were at least 12 years of research into similar coronaviruses before funding dried up because neither then-known coronaviruses were spreading.

In tandem with the research on coronaviruses, technology used for genetic sequencing and analysis improved exponentially in sensitivity, capability, and speed. Once SARS-CoV-2 was isolated and the unique spike protein identified, the vaccine research had most of what it needed to develop a trial-worthy vaccine candidate. The genetic sequencing in January 2020 couldn’t have done so quickly and in such detail in 2002.

The mRNA approach used by Pfizer and Moderna was first proposed in the late 1980s after more than a decade of conjecture; research into HIV and Ebola are among the diseases which contributed to the body of knowledge for these COVID vaccines. That’s more than 30 years of research leading up to the current vaccines.

If funding for research hadn’t stopped in the mid-2010s, COVID vaccines might have been delivered weeks or even months earlier than late October/early November last year.

~ 2 ~

Misinfo/Disinfo 2: Don’t need vaccination because of herd immunity.

Truth: We are nowhere near herd immunity. The safe approach to herd immunity also relies on vaccines.

While there are a number of ways this concept is being distorted, I ran into a situation last week in which someone I know who is a health care provider had begun to doubt the use of vaccines for COVID.

They’d been exposed to a European doctor’s claim that wearing masks and the vaccines themselves prevented our bodies from eliciting a natural immune response.

Ignoring, of course, the fact that nearly 600,000 Americans alone have died from the effects of their natural immune response to infection with SARS-CoV-19. That’s the disease, COVID – the response to the infection.

I went and did some digging to check this Euro doc’s credentials and lo, there it is: he’s a fucking DVM. A veterinarian who did some work on viruses in animals, with a handful of papers published a couple decades ago about viruses in donkeys. I won’t even name this bozo because I don’t want to give his nonsense any more oxygen.

In retrospect this guy is akin to the French researcher whose early, extremely small, and utterly lousy study was used to rationalize the use of hydroxychloroquine as COVID therapy. Poor credentials and bad track record combined with inadequate evidence, launched from overseas into American consumers’ social media – and they lapped up his misinfo and disinfo without any skepticism let alone the wherewithal to check credentials.

Just stop them. Cut them off as soon as they start talking about herd immunity.

That includes cutting off morons like Texas Gov. Gregg Abbott:

Nobody should listen to this stupid asshat when it comes to COVID-19 because he’s propagating false information when he should be turning this over to professionals with appropriate credentials.

I’ll let biologist Carl Bergstrom discuss the concept of herd immunity with regard to a pandemic in this Twitter thread:

Bergstrom distills the challenge:

“The key thing to note is that the herd immunity threshold is the point at enough people are immune (by vaccination or previous infection) to prevent a new epidemic from starting from scratch.

It is *not* the point at which an ongoing epidemic disappears.”

COVID will still be with us after a majority of the adult public has been vaccinated because children and unvaccinated adults will constitute 20-30% of the population while the herd immunity threshold for COVID as an airborne disease will be closer to that of other other airborne diseases like pertussis and measles. This means at least 90% percent of the public must be immune before the disease will stop spreading.

And with only 35.9% of the U.S. having had a dose of vaccine, there’s no way in hell any part of the U.S. is close to herd immunity – including Texas where as of today only 19.9% of residents have been fully vaccinated.

All of this assumes there isn’t a new strain mutating in an unvaccinated person which may bypass the existing vaccines. It’s urgent that we vaccinate as many people as possible as quickly as possible to stem the spread of the disease before this can happen, setting off a new epidemic.

Anybody who is waiting for herd immunity while refusing to wear a mask and rejecting the vaccine is a nihilist wishing sickness and death on others if not themselves.

But don’t take my word for it; find virologists, epidemiologists, public health experts, and/or others with solid credentials who’ll explain why we need to be vaccinated to reach herd immunity.

~ 1 ~

And then the excuse used by the oppositional defiant/libertarian/owning the libs crowd –

Misinfo/Disinfo 3: Getting vaccinated means submitting to the federal government which is taking away freedom by issuing “vaccine passports.”

Truth: NO. Fuck, no. The only thing being issued at vaccination sites is a record of vaccination. Vaccination records are shared with one’s doctor under HIPAA privacy regulations.

I am so disappointed with former representative Justin Amash on this point. It’s as if he’s forgotten universities and public schools have long required proof of vaccination for entrance, because education provided in a shared public space requires students who are not at risk of death from other students’ diseases.

It’s as if Amash has forgotten the Constitution is not a suicide pact, and that the nation’s founders lived in a world when travel was often restricted by epidemics like smallpox, measles, and yellow fever requiring mandatory quarantines.

Or that state and federal governments regularly require proof of baseline safety measures like passing vision and driver’s tests for a driver’s license.

Businesses and government functions should not be held hostage by a pandemic. They should be able to ask their employees and customers to act prudently to protect themselves and others, which may include providing proof of vaccination.

(Florida’s Gov. Ron DeSantis can pound sand with his ridiculous executive order banning “vaccine passports,” intended to prevent cruise ships requiring booking passengers to have proof of COVID vaccination. It’s as if he’s completely forgotten what happened to cruise passengers last year.)

Here’s a more personal example as a business case for required vaccination. My youngest contracted mild food poisoning from a chain restaurant’s takeout, but the first question posed by his employer and co-workers who all work in a facility which tests foods and pharmaceuticals, is whether he really contracted COVID since some symptoms like nausea may be present after infection with SARS-CoV-2. Imagine the repercussions to the supply chain if someone asymptomatic simply went to work in that environment.

My kid is taking the day off and getting tested for COVID to assure their workplace is safe, but imagine this happens again next week to a different employee, and the week after that to yet another. The cost to business and to workers could be staggering when simply requiring vaccination with proof could resolve the challenge.

And your own foods and drugs might also be safer for it.

Fortunately my youngest will be vaccinated soon; my oldest already is as of last week when Michigan opened vaccinations to all ages.

~ 0 ~

As of this morning we have lost 562,007 Americans to COVID – 476 died yesterday, the lowest number of daily deaths since last autumn.

Most of these deaths were not caused by UK variant B.1.1.7 which is now dominant in the US, nor by Brazilian variant P1, nor by South African varian B.1.351, all three of which appear to be more transmissible, and in the case of P1, more deadly, sickening younger people more often, and re-infecting those who already had an earlier strain.

Had we not mitigated the first strains of COVID with a combination of social distancing, mask wearing, increased hygiene, and lockdowns as well as vaccines, we would be on our way to several million dead.

But we are still on our way to that number if people do not continue mitigation measures and get vaccinated. Brazil’s 1,480 deaths yesterday alone, most caused by P1, offers proof.

Wednesday Morning: Whip It Good

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When a problem comes along you must whip it
Before the cream sits out too long you must whip it
When something’s going wrong you must whip it

— excerpt, Whip It by Devo

Can’t tell you how many times I’ve thought of this song in the last couple of days.

Panama Papers fallout
Still not as much reporting showing up in global media as one might expect from a collaborative effort the size of that mustered by the International Consortium of Investigative Journalists (ICIJ) and German news outlet Süddeutsche Zeitung (SZ) around the leaked Panama Papers. But there is a slowly building debris field accumulating in the leak’s wake.

  • Iceland’s Prime Minister Sigmundur David Gunnlaugsson resigned after ~7.5% of the population showed up at a protest rally (Channel NewsAsia) — But you probably know this much already, right? Icelanders don’t mess around with even so much as the appearance of conflict. Hope somebody will tell us if bananas are a thing at protests in addition to eggs, yogurt, and tissue paper. (see photo).
  • Chair of Transparency International’s Chile chapter resigned (Transparency.org) — Oops. But kudos to Transparency for the prompt and direct reaction after the leak revealed the Chilean chair had been involved with
  • China squelched reporting ties to leadership and revelations in Panama Papers (SCMP) — The suppression includes redirecting search engine queries to stories about sports figures involved in the scandal.
  • Amazon’s cloud now home to the Panama Papers source documents (Forbes) — And tiny Australian software firm Nuix has been helping with sifting through the documents.

What will today bring?

Related? Pfizer and Allergan nix their merger
Proposed changes to Treasury Department rules are blamed for the breakup of this corporate marriage, in which Pfizer would have moved its headquarters to Allergan’s location in Ireland to avoid U.S. tax rates. Public sentiment about offshoring after the Panama Papers leak may have clinched this split.

Miscellany

  • Heat pump technology could reduce energy use in clothing dryers by 40% (Phys.org) — Here’s a great use of our tax dollars, this research by U.S. Department of Energy’s Oak Ridge National Laboratories. Dryers are the largest consumer of electricity in households equipped with them. As much of U.S. energy is produced by fossil fuel, this could have a dramatic impact on CO2 output. Let’s hope Congress encourages more of this kind of research as well as tax credits for related corporate R&D and consumer purchases.
  • Orbeus, a photo-recognition software company, has been acquired by Amazon (Business Insider) — Imagine getting this message the next time you upload your personal photos to your Amazon Prime Photo account: “People who purchased your spouse’s belt on Amazon also purchased this underwear/lubricant/sex toy.” Just, no.
  • STARZ premium cable channel will now offer a direct streaming service for cord cutters (Ars Technica) — The offering will work much like HBO Direct. But will ISPs that offer STARZ (like Comcast and Charter) attempt to throttle this service as it cuts into their bundled sales? Net neutrality is going to get a work out as more cable channels offer their content straight to consumers.

Friday Morning: Afro-Cuban Coffee

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I should just dedicate Fridays to different genres of jazz. Today feels like a good day for Afro-Cuban jazz.

This chap, Francisco Raúl Gutiérrez Grillo, who performed under the name Machito with his Afro-Cubans, was an incredibly important innovator shaping Afro-Cuban jazz as well as modern American music. He was important to race in the music industry as well, as his Afro-Cubans may have been the first multi-racial band.

I’m brewing some Café Bustelo before I bust out my dancing shoes. ¡Vamonos!

Judge applies ‘Parkinson’s Law’ to VW emissions cheat case
You know the adage, “work expands so as to fill the time available for its completion”? U.S. District Court Judge Charles Breyer gave Volkswagen 30 days to come up with a fix* for all the emissions standards cheating passenger diesel engine cars in the class action lawsuits he oversees in San Francisco. Gotta’ love this:

“It’s an ongoing harm that has to be addressed … I’ve found the process is a function of how much time people have available to fill. The story about lawyers is that that if you give them a year to do something, it will take them a year to do something. If you give them 30 days to do something, they’ll do something in 30 days.”

As time passes, vehicle owners are increasingly damaged as no one wants to buy their cars and their investment is lost. Hence the aggressive time limit.

* Caution: that link to SFGate may autoplay video and ad content. Really, SFGate? That’s such hideously bad form.

Rough road ahead in Saudi Arabia to a post-oil world
This piece in WaPo paints a grim picture of cheap oil’s impact on Saudi Arabia — and there are huge pieces missing. Worth a read while asking yourself how much Saudis are spending on military efforts against Yemen and Syria, and what new industries they’re investing in to replace oil-based employment.

Took long enough: Software and social media firms get Apple’s back
Did their legal departments finally read the case thoroughly and realize they had skin in this game, too? Who knows — but Google as well as Microsoft are planning to file amicus briefs in support of Apple. Microsoft had already indicated they would support Apple in a congressional hearing yesterday morning; Google piped up later. The latest skinny is that Facebook and Twitter both intend to file briefs as well in favor of Apple. Looks like Microsoft’s current management took an 180-degree turn away from progenitor Bill Gates’ initial response, hmm?

Hit and run

That’s a wrap on this week. Keep your eyes peeled for news dumps while folks are still picking apart last night’s GOP-cast reality TV show. And make time to dance.

EDIT — 8:40 AM — Ugh, why didn’t the Detroit News publish this piece *yesterday* instead of a Friday morning? Michigan’s Gov. Snyder’s “inner circle” exchanged emails advising a switchback from Flint River a year before the switchback took place, and only three weeks before Snyder’s re-election. There was enough content in this to go to press without waiting for a quote from one of the former advisers.

Pfizer’s Vision of R&D

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Recently I saw Ian Read, the CEO of Pfizer, on CNBC explaining that the Pfizer/Allergan merger would enable the combined companies to spend more on research and development of new drugs. He also confirmed that Pfizer raised prices on at least 105 drugs for no apparent reason. You can watch a small part of the interview here.

Read tries to pass the price hikes off as some kind of market-driven thing, which is stupid because price hikes are mostly either for drugs protected by patents or for generics which have no competition. The increases averaged 9.4%, far in excess of inflation, and faster than the expected increase of 5.4% in total health care spending. It’s a money grab pure and simple. The CEO then explained that these prices are a drop in the bucket, since drugs account for only about 10% of total health care spending, which comes to a total of about $310 billion, or roughly $1000 per person in the US. Drug prices rose by an average of 10.4% in 2014, so a drop in the bucket is roughly $100 per US person. And anyway, Read says, they do negotiate prices with some providers and cut prices for some poor people; meaning that the rest is paid by drug insurance policy holders. All this public talk is just politics, says Read, who in 2014 received total compensation of $23.3 million. Surely for that kind of money he could do a better job of defending his company’s rapacious behavior.

Pfizer is planning to merge with Allergan and move to Ireland to cut taxes. Read claims he needs the money for research and development of wonderful new drugs. That suggests that Read thinks he doesn’t have enough money for R&D right now. Let’s see what the 2014 financial statements say about that. In 2014, Pfizer reported net income of $9.1 billion. P. 58. It paid dividends of $6.6 billion, and repurchased stock for $5.0 billion, a total return to shareholders of $11.1 billion. With that kind of management, no wonder there is no money for an increase in R&D.

Remember that R&D expenses are deductible in full in the year incurred, a temporary tax law now permanent thanks to Congress. So let’s see what we get for that tax cut. Pfizer reports that in 2012, it had an R&D expense of $250 million to “obtain the exclusive, global, OTC rights to Nexium”. P. 28. Pfizer get Uncle Sam to pay about $80 million of that price. In 2014, Pfizer counted as part of its increase in R&D this gem: “$309 million, reflecting the estimated fair value of certain co-promotion rights for Xalkori given to Merck KGaA”. That’s a non-cash transaction that cut Pfizer’s taxes.

And here’s a description of the R&D program at Pfizer:

We take a holistic approach to our R&D operations and manage the operations on a total-company basis through our matrix organizations described above. Specifically, a single committee, co-chaired by members of our R&D and commercial organizations, is accountable for aligning resources among all of our R&D projects and for seeking to ensure that our company is focusing its R&D resources in the areas where we believe that we can be most successful and maximize our return on investment. We believe that this approach also serves to maximize accountability and flexibility.

That’s management speak for “we make drugs that will maximize our income.”

Turning to the Allergan deal, CEO Read assures us that Pfizer will use the tax savings for R&D. Let’s first see what the savings might be. According to Americans for Tax Freedom, Pfizer paid effective world-wide tax rate of 7.5%. That compares with the 25.5% reported on its 10-K. P. 28. ATF offers a detailed explanation of the accounting, and explains that most US multinationals don’t use the same accounting treatment. ATF adds that Pfizer had as much as $148 billion parked overseas and untaxed in the US. At least that explains where they get the money to pay off their shareholders and keep Wall Street happy.

Let’s just ignore the claim of Frank D’Amelio, Pfizer’s CFO, that half the tax savings will go to shareholders as dividends. Pfizer has shut down a bunch of R&D facilities after each of its recent mergers.

Writing in Nature, former Pfizer R&D executive John LaMattina noted that the company’s three largest buyouts–Warner-Lambert, Pharmacia and Wyeth–resulted in sweeping research cuts and site closures, leaving more than 20,000 scientists out of work. And those who stick around were saddled with major R&D delays, LaMattina wrote, as integrating two large companies involves a painstaking review of assets that can slow development down to a crawl. Even more difficult to quantify is the effect on productivity, he wrote, as word of potential layoffs spreads fast throughout a large company and distracts workers from their projects.

After the merger the number two man, Brent Saunders of Allergan will oversee operations, including R&D. Here’s Saunders in August, 2015, discussing his vision of R&D with Randall Pierson of Reuters.

Saunders said discovery research, where researchers test ideas and compounds in test tubes and animals, typically eats up about 30 percent of pharmaceutical company research budgets, although only about one of every 20 such products that enters human trials succeeds and is approved.

“Discovery is where the industry has its lowest return on investment,” he said, “and not a good (use) of Allergan’s research dollars.”

Instead, he said Allergan will acquire products from companies that have already done the research spadework, and then itself develop the medicines and submit them for regulatory approvals.

In other words, Saunders and Read like the business of buying other people’s research and then doing some tests and filling out the paperwork for drug approvals. This gets them a patent/monopoly, and a fat tax deduction for all the paperwork. Then they can sell the drugs for a profit that is taxed (if at all) at capital gain rates, and if a US company buys it, the US company gets to treat the price it paid as a fully deductible R&D expense. Sweet.

Remember that Read is magnificently compensated for running this business, but what does he bring to the table? It has nothing to do with drug creation and manufacture. His contribution is measured by how little Pfizer pays in taxes, and how well he engineers earnings, and certainly not by any contribution to the well-being of humans.

We don’t have to allow this business model to flourish with tax cuts and benefits. It’s corrupt to the bone.