Monday, Monday

Yesterday was Monday. 

My college had scheduled a budget town hall for Monday, which I wanted to attend (all bad news there), but first, after I opened the email with the Zoom link, I had to be locked out of my account. 

That was actually kind of fun, it was so normal. Locked out of my accountyes! I remember being locked out of my account! I used to get locked out of my account with some regularity back in the day, and it felt good to be doing it again. This must be what people mean by “stir crazy.”

So I was up for it, but being locked out of my account during quarantine turned out to be different from being locked out of my account in my old life.

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“wrong, wrong, and wrong” and back to the future

Great line from Michael Osterholm in a recent CIDRAP podcast (Episode 4: The Reality of Testing):

(-24:13: Last week I was at a meeting online with a prominent foundation in which a world-renowned economist, a Nobel Prize Laureate in economy, proposed that we be able to test 30 to 40 million people a week every week starting next week, and when I shared with him that that was not possible, his first reaction was that I’m part of the problem because I’m such a naysayer because I’m in fact you know always beating down these possibilities.

I like to think of myself just as a lighthouse saying, You know you may be a big aircraft carrier, but if you keep coming at me, buddy, I’m not moving, nor is the shore. 

You do like to see Nobel Prize Laureates forcibly informed that supply chains aren’t actual magic every once in a while. At least, I do.

Another great observation:

-26:38: I have raised on multiple occasions … that testing is not going to be widespread available in this country. Just accept that. … It’s what we first put forward more than 7 weeks ago … we are going to have a collision course with destiny called “reagent availability.”

It’s not about money, it’s about physics…. You can’t create the infrastructure overnight.

Wrong, wrong, and wrong:

-17:22: I’m surely not a stranger to or in any way opposed to contact tracing following a valid and comprehensive testing program. I see none of that here. And yet I worry that the whole country opening or reopening or closing or reclosing, or whichever [way] you want to look at [it], are all based on this testing program.

This is wrong, wrong, and wrong.

I had a funny moment yesterday.

As a nonfiction writer, I became pretty good at vetting experts.

With COVID, I chose Osterholm right away, but I was also following Marc Lipsitch, and had just recently discovered John M. Barry. I trust all three.

So this week Osterholm’s program, CIDRAP, came out with its first report.

Authors: Osterholm, Lipsitch, Barry.

Plus Kristin Moore, who I hadn’t yet come across.

I have no idea what nonconscious criteria I used to put those three together.

.

Back to the future

We’re 64 days into lockdown here in New York, and the sun is out. My brain finally feels clear enough to think about education again. Yay!

I’m definitely going back to the classroom in September.  

Assuming classes are held, of course. If they aren’t, Zoom on.

Bad news on viral dose and viral load?

I’ve been harboring hope lockdown might produce herd immunity through milder illness via milder viral “dose.”

That is to say, even under lockdown many of us will still be exposed to COVID-19, but we’ll be exposed to less of it than we would have been if, as in my case, we’d carried on living with a spouse taking the subway 5 days a week.

The freaking subway! Five days a week!

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Known unknowns

Ed read this article earlier today: Sortie de confinement, ou la somme de tous les dangers par Philippe Sansonetti.

Tells me that toward the end the author reports that herd immunity (l’immunité de groupe) to COVID-19 is by no means assured:

Les sujets guéris sont-ils protégés naturellement contre l’infection, qu’ils aient ou non développé ces fameux anticorps spécifiques neutralisants dont on espère tant ? A fortiori, les sujets demeurés asymptomatiques ou pauci-symptomatiques sont-ils protégés et pour combien de temps ? En effet le virus sera demeuré dans ce cas circonscrit à la muqueuse rhinopharyngée, ce qui peut donner lieu à une immunité locale, mais de quelle durée ? De quelle efficacité protectrice ? De quelle capacité à faire transition vers une immunité systémique globalement efficace ? En un mot, l’immunité de groupe offerte par beaucoup de maladies infectieuses et par les vaccins répondra-t-elle aux équations habituelles ?

Google translation: Are the healed subjects naturally protected against infection, whether or not they have developed these famous specific neutralizing antibodies which we so much hope for? A fortiori, are the subjects who remain asymptomatic or pauci-symptomatic protected and for how long? Indeed the virus will have remained in this case circumscribed to the nasopharyngeal mucosa, which can give rise to local immunity, but for how long? How protective is it? What is the ability to transition to globally effective systemic immunity? In a word, will the group immunity offered by many infectious diseases and vaccines meet the usual equations?

Looks like a good opportunity to practice my French.

Social distancing and the 2nd wave

I’m looking at the article I posted a couple of days ago: Public health interventions and epidemic intensity during the 1918 influenza pandemic.

I don’t have the bandwidth to read Hatchett et al closely at the moment … but wanted to clarify that their study does not offer a great deal of hope that we could develop herd immunity via more people infected with milder illness, thus fewer deaths. (It’s the study of immunity in Gangelt Municipality that supports herd-immunity-via-lower-viral-dose/lower-death.)

The authors assume the opposite, in fact: 

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gasstationwithoutpumps on viral load and COVID-19 models

Comment from 4/11:

Models can include viral doses (see Methods of modelling viral disease dynamics across the within- and between-host scales: the impact of virus dose on host population immunity) but you need more information about how the viral load changes with the course of the infection and how contagious people are at different stages. We don’t have that detailed information about SARS-CoV-2, so simpler models have to be used (and we don’t even have all the data we need to set the parameters of even simpler models, which is one reason the predictions have such wide ranges of possible outcomes).

And see:
Know your enemy
Can lockdown produce herd immunity with fewer deaths?

Social distancing and immunity
gasstationwithoutpumps on viral load and COVID-19 models
Social distancing and the 2nd wave
Viral dose, viral load

Social distancing and immunity – German study

First time I’ve seen a researcher suggest we could achieve milder illness and immunity via lockdown:

By adhering to strict hygiene measures it is to be expected that the virus concentration of an infected individual can be reduced to the point that the illness manifests more mildly, with simultaneous development of an immunity. These favourable conditions are not present in a superspreading event (e.g. Karneval meeting, apres-ski bar in Ischgl, Austria). Hygienic measures are expected to have positive effects on overall mortality.

And see:
Know your enemy
Can lockdown produce herd immunity with fewer deaths?

Social distancing and immunity
gasstationwithoutpumps on viral load and COVID-19 models
Social distancing and the 2nd wave
Viral dose, viral load