Corona Daily 217: B.1.1.7 – Variant of Concern

For the UK, it has started all over again. On 8 January, it surpassed a record 68000 infections, and 1325 deaths. UK’s toll of 81000 deaths till date is the highest in Europe. More worryingly, at least one person in 50 is infected in England, and one in 30 in London. Coronavirus’s new avatar has isolated Britain more than Brexit. Next week, the ritual of weekly clapping for health workers will start again. The crisis is termed as UK’s biggest since the Second World War.

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B.1.1.7 is a mutation, a new incarnation, of the coronavirus that hit the world a year ago. Viruses mutate all the time. It’s like Apple coming up with a new i-phone version every year. The company adds or enhances features, but the core of the i-phone is recognizable. (If you are lucky, your old charger may fit the new i-phone.)

Thousands of mutations of the covid virus have been identified. What is so special about B.1.1.7? Is it not possible that the British population simply flouted lockdown rules in winter, socialised more than necessary and the increase in transmission coincided with a new mutation?

Now, the people movement is verifiable. Smartphones are our traceable limbs. We value our smartphones more than our privacy. Google records data giving precise movements of smartphone users. The analysis of such data in the UK has shown that people movement was not changed even in regions with soaring virus transmission.

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Did this variant start in the UK? Not necessarily, but it was first identified there. In March, UK started a well-run national programme to track mutations. It invested £20 million ($27 million) to create a consortium that sought samples from hospitals across the country. Their labs started analyzing and sequencing each mutation, and fit them on an evolutionary tree. UK has sequenced 209,038 coronavirus genomes, more than any other country.

The virus tests currently offer only binary results: positive or negative. Imagine a sophisticated system saying you are positive with the English variant, or with the South African variant. That would greatly assist in contact tracing as well. If pandemics become a way of life, testing can reach that level of detail in future. We are not there yet.

The worrying thing the UK’s sequencing consortium found was that the nation’s November multi-tier lockdown did an excellent job of driving down the spread of the ordinary variant, but it couldn’t stop the spread of B.1.1.7.

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What is special about this variant is its exceptionally large number of mutations – 23 in all. Only six of them are silent, meaning they make no significant difference. The 17 remaining mutations, the non-silent ones, make it better at infecting cells, at making more copies of itself once it enters the cells, and at evading antibodies generated by an earlier infection. In other words, someone who had covid with other variants is liable to be reinfected with this variant.

Twenty-three is a large number. If a virus going into a dressing room is expected to come out with a changed tie or a changed hat, now it emerges with a whole new outfit.

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Available data suggests the new variant arose fully formed in a single person. (This is the best hypothesis, that person is not known).

For the virus, each person it infects is like a lab, a playground for it to experiment. In a patient with compromised immunity, the virus can live for weeks or months. It is believed one such patient was treated with antibodies from a recovered patient. Having enough time at hand to experiment, the virus assumed a new form to beat those antibodies. Antibodies wiped out the weak variants, leaving others like this variant resistant to treatment.

Hospitals have been giving some patients a buffet of therapies, hoping some combination will work. But that could have contributed to the development of new variants. It is suggested the medical community should use treatment options carefully. Saving a single immunocompromised patient may have the side effect of starting a new variant globally.

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The new variant is a critical subject. More on it tomorrow.

Ravi

Corona Daily 218: Holocaust to Covid-19

Toby Levy is an 87-year-old volunteer lecturer for Manhattan’s Museum of Jewish Heritage. This week the New York Times has published her opinion piece titled “the Holocaust stole my youth. Covid-19 is stealing my last years”. For those who haven’t read it, I am taking the liberty of re-telling her story.

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Toby was born in 1933 in Chodorow, a small Polish town then, now part of Ukraine. Her family lived in her grandfather’s house. The Russians occupied the town from 1939 to 1941, followed by the Germans from 1941 to 1944. Her father was popular among Jews as well as non-Jews. In 1942, after a neighbour warning about Germans planning a mass killing, Toby’s father built a hiding place in the cellar. Her grandfather who didn’t wish to hide was shot in the kitchen. The family heard the shots.

Later, when they feared they would be sent to a ghetto, another neighbour hid them. Toby’s father built a wall inside the barn and a small hiding place for nine people. Just four feet by five feet, Toby, her siblings, parents, aunt, uncle and grandmother were compressed in that place along with pigs and chickens. The place was infested with lice and rats. Later, they added a window from which kids would look out. Toby spent two years in that minuscule barn room. They considered every day a miracle.  

Toby calls herself a miracle child, because most Jews who were sent from Chodorow never came back.

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Now in her eighty seventh year, when coronavirus came, Toby reminded herself she was a miracle. She must make it through the pandemic.

These days, she feels a little bored. She used to play canasta with some friends, that has stopped. Her grandkids call her on Zoom. She gives a few online lectures for the museum when possible. She reads, cooks a little bit, solves puzzles. She keeps herself busy, tries not to give up. It bothers her that valuable time is slipping away in her old age.

She feels sad a whole year is lost. She lost her childhood, her teens, and now one full year from whatever few years left. As a Holocaust survivor, it is her mission to tell her story to as many people as possible. She misses her live audiences. One of her grandchildren, living in Maine, had a baby boy last year. Toby has seen him only on Zoom and fears he will never know her.

She has a male friend from a synagogue with whom she would take car trips, even went to Israel once. She can’t do those trips any more. She has the feeling her life is shortened.

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Toby understands the fear people have, and they must take care.

However, she emphasizes, the virus fear is no comparison to the terror she felt as a child. Fear without any boundary. During the war and the holocaust times, she didn’t know if she would survive the day. She had no freedom whatsoever. She couldn’t speak loudly, couldn’t laugh, couldn’t cry, could hardly move.

But in coronavirus times, she has freedom. On waking up, she looks out to see the world, feels happy she is alive. She reminds herself: No one wants to kill her.

Toby knows this is going to end. She is already planning which places she will visit first, and all the things she will do, when the pandemic ends.

Ravi 

Corona Daily 219: Hear Them Out

In several countries, the pandemic has brought to light a certain breed of interpreters. These are sign language interpreters for the deaf and people hard of hearing. They are energetic, expressive, emotional. Instead of looking at politicians or health experts, viewers may prefer watching them for enjoyment.

In the USA, 15% of adults report hearing loss. More than one million use sign language. There are five key parameters to any sign language: handshapes, palm orientation, location on the body, movement and facial expressions.

There is no single sign language, there are at least 130 of them. American sign language (ASL) is different from the Black American sign language (BASL). America started special schools for the deaf in 1817, but no Blacks were admitted there until 1952. That gave birth to a separate Black language.

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Mask wearing in the pandemic was a major blow for the deaf. Lip reading is an important part of their comprehension. Regular press briefings on TV giving life-and-death information about the virus was lost on them, filling them with confusion and panic.  

In the USA, the National Association for the deaf launched a case against the Trump administration. Trump, as is his habit, lost the federal lawsuit. The judge made it mandatory to have a live sign interpreter for any Covid briefing from the White House. Since 11 November, this was complied with.

In the UK, British Sign Language (BSL) users have complained against discrimination and launched a #WhereIsTheInterpreter twitter campaign. So far, BBC has agreed to use interpreters on news channels.

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Interpretation is a certified profession that requires a 3-year degree education. There are ‘Deaf interpreters’ and ‘hearing interpreters. They work in teams. The message can go first to the hearing interpreter, who translates it to the Deaf interpreter who takes it to the Deaf viewers. They are placed strategically so that the viewer sees only one interpreter.

The Deaf interpreter can sometimes explain concepts better than the hearing one. For example, the word ‘odd’ was translated as ‘strange’, however in the mathematics context, the Deaf interpreter gestured different numbers to show ‘odd’ numbers. In any case, a team of interpreters can work, because the job requires physical and mental stamina. Facial expressions are equivalent to intonation, revealing feelings, thoughts and moods. At the same time, they use the grammar markers (eye-gazing, eyebrows raised or lowered) to distinguish the punctuation signs. It may come across as overdramatization, but in fact it is essential to sign language.

In the pandemic, new words are emerging all the time. Interpreters are developing signs for words such as ‘outbreak’ or ‘comorbidities’ which were rarely used in the past. Interpreters have also said their exaggerated gestures should not be misinterpreted to mean the covid situation is worse than it is.

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Inspired by the sign interpreters on TV, some churches are now recruiting them during sermons. A Chicago music school that doesn’t yet allow singing is teaching its students sign language in which they can sing. Canada has developed a video app that allows emergency health services and paramedics to connect with interpreters within 30 seconds.

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Andiswa Gebashe who grew up in South Africa with a deaf father had two ambitions, to be an actor and to be the president. She has sort of managed both. She is now the official South African Sign Language (SASL) interpreter for Cyril Ramaphosa, South Africa’s president. An interpreter embodies the speaker. When on stage with him, she is not Andiswa, she is the president.

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A deaf academic says the world looks at the deaf as disabled, but they look at themselves only as a linguistic minority. The pandemic has created awareness about sign languages. That is one of its positive outcomes.

Ravi 

Corona Daily 220: The American Thabo Mbeki

Thabo Mbeki was South Africa’s president for nine years. He had succeeded Nelson Mandela. Mbeki scorned science, propagated conspiracy theories, avoided the subject when AIDS was spreading rapidly, rejected treatments. Mbeki delayed launching an anti-retro-viral programme, saying the drugs were toxic, part of a Western plot to weaken his country. Mbeki withdrew government support from clinics that started giving azido-thymidine to prevent AIDS transmission from mother-to-child. A pharma company had graciously donated Nevirapine, a drug that protects newborns from contracting HIV. Mbeki actively restricted the supply of that drug.

Mbeki loved to surround himself with sycophants who supported his skepticism, anti-science attitudes and paranoia.

A Harvard study tried to quantify the damage. It concluded that more than 330,000 people died prematurely from HIV/AIDS between 2000 and 2005 due to the Mbeki government’s obstruction of life-saving treatment, and at least 35,000 babies were born with HIV infections that could have been easily prevented.

There were calls to charge Mbeki by a judicial board, similar to what was done with apartheid criminals. Mbeki was never tried. Currently he is the Chancellor of the University of South Africa.

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If there is a Satan, for maximum impact he sent the coronavirus during Donald Trump’s tenure and in the election year. The American Mbeki discouraged mask wearing, showed indifference to contact tracing, scorned shutting businesses and isolating patients, didn’t protect nursing homes, advocated hydroxychloroquine, bleach, UV light and other quackery treatments. He created an anti-intellectual, anti-scientific cult that made hollow optimistic noises. Even during the massive second wave, he argued against action. “Don’t be afraid of covid,” he tweeted, “don’t let it dominate your life”. His attorney general William Barr compared stay-at-home to enslavement.

Trump may have stopped flights by January end, but the virus was already in the USA. He may claim credit for Operation Warp Speed, but the speedy vaccines will not be able to stop the more than million American deaths. Since he lost the election, Trump has lost all interest in covid. He wanted the vaccines for the election, not for the virus.

America’s tribal chief managed to get enough media sycophants to propagate the cult of falsehoods. Brit Hume of Fox News mocked Joe Biden for wearing a large mask. The right-wing website RedState called Dr Fauci a “mask Nazi” and the Washington governor the “public health Gestapo”.

A NYT columnist quotes a Facebook entry: “Create a VIRUS to scare people. Place them in quarantine. Count the number of dead every second of every day in every news headline. Close all businesses. Mask people. Dehumanize them. Close temples and churches. Empty the prisons because of the virus and fill the streets with criminals. Send in Antifa to vandalize property as if they are freedom fighters. Undermine the law. Loot. And, in an election year, have Democrats blame all of it on the President. If you love America, our Constitution, and the Rule of Law, get ready to fight for them.”  The entry is telling and relevant.

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In October, unusually, a journal of medicine in a paper titled “dying in a leadership vacuum” held Trump responsible for a large number of covid deaths. (The death certificates can mention the cause of death as – incompetent president). Till date, more than 370,000 Americans have died of covid. Yesterday, more than 4000 died. Wednesday’s putsch has rallied thousands of maskless hoodlums who will further act as super-spreaders.

To put this into perspective, during WWII, American soldiers died at the rate of 9,200 per month. On 9/11, nearly 3000 died. In 8 years of war in Iraq, 4500 Americans died. In 20 years of war in Afghanistan, 2400 Americans lost their lives. Covid-19 threatens to become the most lethal chapter in recent American history, and a large portion of the casualties can be attributed to its self-obsessed leader.

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Despite his cynicism, narcissism, compulsive lying, the gangster president managed to get 74 million votes; senators and representatives to support his falsehoods; and thousands of extremist followers to risk their lives in marching on the Capitol Hill.

The world must thank Coronavirus for getting rid of the bully. Without the virus, in all likelihood, we would have suffered another four years in misery.

Ravi 

Corona Daily 221: In Search of a Halal Vaccine

Today, on 6 January, Indonesia, like many other countries, reported a daily record of cases. The Indonesian archipelago has had 800,000 cases and 23,000 deaths so far. However, the nation and its capital, Jakarta, lead in under-reporting covid deaths.

Like many other countries, Indonesia is now getting desperate to vaccinate its population. It has more than 17,000 islands, so distribution of vaccines was always going to be a problem. Wisely, Indonesia has placed binding orders from AstraZeneca (100 million), Novavax (50 million), Pfizer (50 million), Covax/Gavi (53 million) and China’s Sinovac (125 million).

The vaccination will start from 13 January. The plan is to vaccinate 182 million adult Indonesians in 15 months. The only problem is that not a single vaccine is approved. Except a few doses of Sinovac, no other vaccine is available, either.

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Indonesia has a dual approval process – one by the medical regulating authorities, and the other by the council of Muslim clerics. Indonesia, by the way, is the world’s most populous Islamic nation with 230 million Muslims. The Ulema council is the authority to decide whether any food, drug, cosmetic or vaccine can be certified as per the Quran. At the Global Halal center near Jakarta, the council operates its own labs in biotechnology, physics, chemistry and microbiology which it has recently used to test Sinovac’s vaccine for pig products.

Pork gelatin is a standard product used as a stabilizer to keep vaccines safe and effective during storage and transport. Since the negotiations began with China, the council has asked if Coronavac (the Chinese vaccine) contains any pork. In July, a one sentence reply came from China. “Manufactured free of porcine materials”. Neither the length of the letter nor its source was reassuring. In October, along with the scientists, Muslim clerics visited China to visit the vaccine making factory. Till date, China has not revealed the composition.  

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In 2018, during a measles outbreak in Indonesia, the only vaccine available contained pig products. The Ulema council declared it Haram, forbidden under Islam. It said its use would be allowed because the outbreak was a health emergency. But the word “haram” had done the damage. Many local Muslim leaders opposed the use of a haram vaccine. Ten million children remained unvaccinated. Measles cases subsequently soared, to become the third-highest in the world.

Last month, the Vatican released a statement declaring coronavirus vaccines “morally acceptable” for Catholics who oppose vaccines developed with stem cells from aborted fetuses. The top Rabbis have cleared vaccines for Jews arguing vaccines are not exactly a food item. Malaysia and UAE have approved pork-containing vaccines, because preserving human life is more important.

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Indonesia’s vaccine priorities are also unique. They will vaccinate the young and healthy, age group 18-59 before the elderly. Government’s stated logic is to protect the young, working people; allow them to work and move freely; and stop the virus transmission that so often is started by the young. 40% of the elderly Indonesians live in three-generation households.

The real reason, though, is that the Chinese company Sinovac has only conducted trials among the 18-59 age group. China’s record is not great. In 2018, a scandal ensued over substandard doses of a vaccine for diphtheria, tetanus and whooping cough, and over fabricated data for a rabies vaccine. Indonesia wouldn’t want to risk inoculating the age groups that were not included in the trials.

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This week, a Fatwa from the Ulema Council is awaited. For the sake of the Indonesian population, one hopes the council declares the vaccine as Halal.

Ravi 

Corona Daily 222: New Occupation for Jobless Cambodians

Joel Brinkley, a Pulitzer winning correspondent had written an opinion piece describing his trip to Vietnam. “You don’t have to spend much time in Vietnam before you notice something unusual. You hear no birds singing, no squirrels scrambling up trees or rats scurrying among the garbage. No dogs out for a walk.” He wrote. “Where’d they all go? You might be surprised to know: Most have been eaten.”

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Rat meat is a protein-provider and a delicacy in Vietnam. Rat on a stick (Rat Kebab) is popular. Rat meat can be grilled, curried, fried, boiled in a soup or minced up in a pate. Vietnamese restaurants slaughter live rats, marinate them in garlic, chilies, lemongrass and fish sauce; and then fry or delicately grill them. Some Vietnamese believe rat meat possesses medicinal properties. It can relieve backache when cooked in soup with vegetables and herbs. Those who have tasted it compare the rat meat to pork or rabbit meat.

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Catching rats and exporting them to Vietnam is big business in neighbouring Cambodia. (Somewhat like the UK fleet catching a lot of herring in their own waters, and exporting most of it to Norway and the Netherlands).  Every day, Cambodians catch three tonnes of rats to feed the growing demand in Vietnam. A lot more expensive in Vietnam, a kilo of rat meat would cost $2.50 a kilo there in pre-pandemic times.

The common city rats we are familiar with are dirty, eat all sorts of junk, may have scabies. In Southeast Asia, mostly the Ricefield rats (Rattus argentiventer) are eaten. These rats eat only rice stalks and vegetables. They are perceived as healthier and safer because of their organic diet and free-range lifestyle.

Rat-catching season begins after the rice harvest in June and July, when rats are famished. This lack of food coincides with seasonal rain that brings all the rodents into the open. Hundreds of rat traps are set in the fields. Sometimes electricity is used. A farmer can go to bed and catch 30 kilos of electrocuted rats in the rice field the next morning. However, many customers prefer to buy live rats. That ensures they have not died of pesticides.

Rat-catching serves two purposes for the Cambodians. It keeps the crops safe, and earns revenue from Vietnam.  

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Since March, unemployment in Cambodia has risen dramatically. The Asian Development Bank estimates that out of the 9 million working population, half a million Cambodians have lost jobs. Many of them are now turning to rat-catching as a full-time occupation. In some parts of Cambodia, the number of rat-catchers has doubled. Competition has forced the prices down. Many rat-catchers barely get $1 per kilo.

To make matters worse, borders are closed. Middlemen must bribe the Vietnamese border guards to smuggle rats across a river, in the process risking fines and imprisonment.

Vietnamese are now less enthusiastic about the rodent delicacy. An extensive research conducted before the pandemic found that 20% of traded field rats, 30% of those sold at large markets, and 55% of the field rats sold in the restaurants tested positive for at least one of the six coronaviruses. And this study was conducted before the Covid pandemic.

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As a result of the decade long trade, Cambodians are slowly developing a taste for rat meat. If the pandemic continues to make export to Vietnam difficult, they will finally end up making it a daily staple meal in their own diet.

Ravi 

Corona Daily 223: Why Prioritise Nathan Dunlap?

Epidemiologists and bioethicists in many countries have recommended including prisoners in the top priority list for covid vaccinations. USA, the country with the highest per capita prisoners, (in total 2.3 million behind bars) had initially placed the incarcerated among the earlier vaccinees. In March 2020, the state of Colorado abolished the death sentence. Nathan Dunlap was one of three prisoners on death row whose sentence was commuted to life imprisonment as a result. In 1993, the 19-year-old Dunlap was fired by the restaurant where he worked. Frustrated, he had taken revenge by shooting and killing four employees.

An op-ed in a Denver newspaper criticized giving vaccines in shortage to prisoners before giving them to honest citizens. The author of the op-ed rebuked the plan to inoculate Nathan Dunlap ahead of his own law-abiding 78-year-old father. This was followed by an infuriated backlash on social media supporting this argument.

Colorado governor Jared Polis, a generally liberal man, an openly gay governor, announced at a press briefing there was “no way the limited supply of shots would go to prisoners before it goes to people who haven’t committed any crime”.

Prisoners have now disappeared from the priority lists of many American states. Countries in the EU, UK and India haven’t given much attention to prisoners. Prima facie, it seems a fair and sensible argument that free people must receive vaccines before incarcerated people.

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Inmates live in extremely crowded conditions, sharing bathrooms and eating facilities. Social distancing is out of the question. Their access to protective gear is unheard of. Prisoners have high rates of hypertension, heart conditions and other comorbidities. In the USA, they are disproportionately Black and Hispanics, the vulnerable groups.

14 out of Colorado’s 15 largest outbreaks occurred in prisons or jails. Nationally, in the USA, more than 40 out of 50 cluster outbreaks began in prisons. The viral spread doesn’t stay in the prison walls. Contrary to what people think, an average sentence in the USA is just seven months. Jails hold many suspects for very short periods of time, sometimes only for a few hours before sending them back. The prison staff, often from the minority communities, goes home. They can carry the virus to their families and neighbours. Visitors and those released can act as transmission agents.

It is important to note there are 500,000 people in American jails awaiting trial, who are presumed innocent until convicted. In Texas jail, 80% of those who died of covid-19 were never convicted of a crime. Another 44,000 are in juvenile facilities and 42,000 in immigration detention centers.  

Guarding them are the 400,000 correction officers. One plan is to vaccinate only the prison staff (because they are not criminals). That doesn’t solve the issue of jails and prisons becoming the Covid-19 hotspots. So far in the USA, the covid case rate is four times higher in prisons than in general population, and the death percentage double inside than outside.

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Prisoners are already punished by deprivation of freedom. One health-care director described prisons as essentially long-term care facilities with bars. Morally speaking, it is debatable whether the state has a right to impose on prisoners additional punishment by exposing them to the virus or denying them vaccine protection.

Even if moralistic arguments are kept aside, data shows that prisons are some of the worst super-spreading places in any country. Immunizing incarcerated people is a practical necessity. Vaccinating those inside can make the lives of those outside safer.

Ravi 

Corona Daily 224: Treating the Present as History

Most galleries, libraries, archives and museums (GLAMs); the institutions that preserve our cultural heritage, are shut since March. A third of the museums worldwide are at risk of permanent closure in the next twelve months. I could write a couple of articles about the sorry state of museums, but it makes for depressing reading. Recently, though, I came across an interesting article by Andrew Dickson in the New Yorker. He talks to Alexandra Lord, a curator at the National Museum of American History in Washington. In a normal year, this museum gets more than four million visitors.

As luck would have it, in February the museum was preparing an exhibition called “In Sickness and in Health” about the Philadelphia yellow-fever epidemic in 1793. Alexandra Lord was collecting materials for it, when the coronavirus struck. On 14 March, the museum abruptly shut.

Curators like Lord instantly recognize the hugeness of a story. They start thinking about how to tell the coronavirus story to the future visitors of the museum. The New Yorker says after 11 September, the rapid response teams from different museums had started collecting objects while the dust was, literally, still settling.

In the current pandemic, some museums collected diaries kept by children, essays by passengers infected on a Carnival cruise ship, masks, hand sanitisers, PPEs, ventilators and vaccines. The National Museum of American History alone has 1.8 million objects, most of them in storage. To bring in more objects requires serious justification.

Some ordinary artifacts can have great historic significance. Examples are a glass bottle melted by the bomb at Hiroshima. Or the desk clock recovered from the debris of the Twin Towers, with its hands frozen at 09.04. Finding such objects and preserving them for decades is a challenge for curators.

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While London’s Victoria and Albert Museum was shut, its rapid response curators created an online series called “Pandemic objects”. It features the history of handwashing, including a seventeenth century Iranian ewer used for the Muslim ritual of wudu, and a 1960 British sink. Some museum blog posts addressed pandemic beards, toilet paper, and mourning jewellery. In England, in pre-Victorian times, it was customary to set aside money in the will so your friends could buy a ring to remember you.

The Vienna museum has had more than 3000 pandemic items submitted to it. They include notices from the Vienna police department, hospital passes, homemade face masks, special contact-free door openers. There are funeral photos with only two attendees at a grave. Body bags are a heartbreaking artifact.

In Germany, a soccer ball from the first Bundesliga match with empty stadiums is considered to have historical value. Also, the holy water in packets distributed by churches to their members.

National Museum of American History has received objects and digital photos from the public. One of them is from the daughter of a pilot who flew the last commercial flight from the USA to China before travel was stopped in January. The digital photo shows a message her father received in the cockpit telling him to turn around and “deadhead” home, with no passengers.

*****

Alexandra Lord was surprised how few objects the museum had about Spanish flu, almost nothing. One reason, she says, was that back then museums weren’t interested in the lives of ordinary people, only royalty and aristocracy. Secondly, perhaps in the chaos of the second world war, it took people time to realise how serious the Spanish flu pandemic was. Lord also cites a more important reason: people wanted to forget the whole thing, rather than preserve any memories of it.

*****

Towards the end of the interview, Lord was asked about her feelings witnessing the great coronavirus story. She paused and said, “Back in May my mother died of Covid-19. We as curators, are part of a story we are collecting. It’s not just an unfolding event, many of us are experiencing it, too” she said.

Ravi 

Corona Daily 225: Out-of-the-Fridge Thinking

46-year-old Steven Brandenburg, wearing his hospital uniform, opened the fridge door. He once again looked behind him to make sure he was alone. His gloved hand took out a box of Moderna vaccine vials. Shutting the fridge, he scanned the room for a good place to hide them. A pile of scientific magazines lay in the corner. Brandenburg stuffed the box of vials behind them. In the semi-dark room, he checked the time on his smartphone. 18.39. That was good enough. He tiptoed out, closed the room, and headed home. Despite the rampage of the virus, nothing much should happen this week. It was Christmas eve.

*****

Next morning, he was back in the room. As a licensed pharmacist employed by the hospital, he had legitimate access to the room. But his heart was in his mouth. Fortunately, nothing had changed. The box of the vaccine vials was still in the corner behind the magazines. He checked the time. 09.38. Excellent. He gently picked up the box and kept it in the fridge, exactly from where he had dislodged it.

That same evening, he returned to the room and repeated yesterday’s procedure. He resisted the temptation to remove more boxes from the fridge. 500-600 was a good number to start with. This was working well. Post-Christmas, the hospital may get more crowded. He would make any necessary adjustments.

*****

Next morning, Steven Brandenburg was in for a shock. With gloves on, he was about to pick the box up from behind the magazines, but the box was gone. Bizarre. He opened the fridge to locate the cavity where the box had been. It had vanished. When he checked the phone for time, he saw a message asking him to meet the hospital director. It said the matter was urgent.

*****

On Monday, 28 December, the Aurora Medical center issued a press statement: “We learnt that about 50 vials of Moderna vaccine were inadvertently removed from a pharmacy refrigerator overnight. Our internal review determined that as a result of the unintended human error, the vials were not replaced after temporarily being removed to access other items. While some of the vaccine was administered within the approved 12-hour post-refrigeration window, most of it had to be discarded.”

*****

The pharmacist colleague who was bewildered to find the precious box in the corner continued to question Brandenburg. The review team kept probing him. Brandenburg had never played poker in his life. In two days, he broke down. He confessed in writing his act was intentional. FBI and FDA representatives were summoned. Brandenburg was sent to the Ozaukee County jail.

*****

Moderna vaccine, if kept outside the fridge for more than 12 hours, becomes useless. Once thawed, it can’t be refrozen. 57 people were unfortunately given shots that would probably be ineffective. Each of them was contacted, and the situation explained to them. Moderna scientists said the useless vaccines won’t have any adverse effect. The 57 people will need to be given the first shot once again. In total, more than 500 doses worth $11,000 had to be thrown away. In times where the state of Wisconsin was losing forty residents to Covid-19 every day, that was a significant loss.

*****

Brandenburg has been charged on three first degree counts: recklessly endangering safety, adulterating a prescription drug, and criminal damage to property. All three are serious felony charges that could put him behind bars for several years. As to why he planned the act of sabotage is not yet known.

*****

American hospitals are now thinking of keeping refrigerators in secured areas, installing CCTVs, limiting access.

In 2006, a group of British young men planned to carry liquid explosives disguised as soft drinks on several transatlantic flights. That plot was foiled. But till today, none of us is allowed to carry on flights a bottle of more than 100 ml in our handbags.

Small destructive acts of madmen can have long-term expensive ramifications.

Ravi 

Corona Daily 226: Use it or Lose it – Unused Leave in 2020

The issue of Paid Leave for employees has occupied the minds of the HR policy-makers for decades. A country’s labour laws and an individual employer’s policies decide the length of the paid holidays, whether unused leave can be rolled over to the next year, encashed, or simply allowed to lapse.

In Europe, with strong labour laws and better life-work-balance, paid leave is taken for granted. America and Japan, where work is life, are the worst countries in this regard. A 2018 research found that 55% of Americans and 48% of Japanese didn’t use their holiday allowance, however meagre.

The 2020 pandemic has made the issue of paid leave far more complicated. Until yesterday, Americans becoming sick with Covid-19 were entitled to two weeks of paid leave. While the US cases are reaching new daily records, from today, 1 January, that USA federal mandate has been withdrawn. Some 87 million workers are likely to be affected.

*****

Even before the pandemic, the USA was the world’s only wealthy nation to not have a federal paid sick leave mandate. While countries like Norway or Luxembourg allow up to 50 days of paid sick leave, the USA mandates ZERO. An American worker missing five days due to the flu or one undergoing a 50-day cancer treatment is not entitled to any paid sick leave.

Since March 2020, most workers-from-home have put in at least one extra hour daily. Presenteeism has been a problem. New terms like staycation or holistay (where you become a tourist in your city or during a strict lockdown, in your backyard) are familiar to employees everywhere. Pandemic Year One is over, and the employers must decide what to do with the unused leave of their employees.

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The standard policy across USA has been “use it or lose it”. 42% of the American companies said they are reviewing the policy to make it flexible. Goldman Sachs will allow rollover of 10 days and Bank of America 5 days. General Motors and Ford will give cash compensation for unused leave. Citigroup will offer 1 extra day of holiday if all vacation was used in 2020. Reuters doesn’t allow any rollover.

Cash compensation is a philosophical debate. Why does an employee need a vacation? To recover from the hard work and long hours. Refreshed after the holiday, employees can work with improved productivity. I personally welcome companies forcing employees to take at least a month off from work each year. (That is why I never considered working in the USA). Marathon runners must rest and recover after the run. Should they accept cash and continue running?

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UK normally allows 8 days to be carried forward. Now four weeks of unused leave can be carried over into 2021 or 2022, in effect five weeks can be rolled over. Denmark will allow rollover. Belgium will allow it till the end of March.

I have earlier talked of the software company GitLab which operates remotely, without any offices, since 2011. To recognize the significant rise in working hours, it now organizes “family-and-friends days”. On specified days, the company shuts down all its operations, with none of its more than thousand workers allowed to log in. 15 January is their next mass holiday. Google, Slack and Cloudera are thinking of introducing similar policies.

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With work becoming partly or fully remote, the pandemic offers an excellent opportunity to rethink the paid holiday policy. USA has the most lopsided work-life balance. Even without all the data, I have seen my relatives and friends in the USA relying on strong medicines to suppress illnesses rather than allow natural recovery. This total commitment to work is likely to become worse if the employee is working from home all the time.

Joe Biden would do well to study the European labour laws. The American workers must have sufficient leave, in order to discuss unused leave.  

Ravi