Corona Daily 207: Not an Easy Donation

Even before the pandemic, sperm donation was not an easy business. Each country follows its own logic in introducing regulations. Britain and the Netherlands have made anonymous sperm donation illegal, contributing to sperm shortages. France and Spain hold a contradictory view insisting donors must be anonymous. In Canada, payments to donors are prohibited, in most European countries their expenses can be compensated. USA regulations are more flexible. In Hong Kong and Switzerland, only married straight couples are eligible for treatment with donor sperm. France, surprisingly, also excludes lesbians and single women. This legal mess has created an opportunity for sperm traders to export sperm. All they need to trade sperm is dry ice, the internet and DHL.

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Globally, the sperm business is over $4 billion. But it is not simple.

California Cryobank and Fairfax Cryobank, USA’s two largest sperm banks approve only about 1% of the applicants. Among the key reasons for rejection are low sperm count, donors with health issues, or sperm not doing well after freezing.

White donors must be at least 5 feet 9 inches tall. Shorter people are not eligible, because clients don’t want them. Black or Brown donors can be shorter, but sperm donation is not popular among them. (And white women may not want their sperm).

Donors should be willing to sacrifice their love life. Between donations, they are required to practice abstinence to keep the sperm count and quality high. With two visits a week to the sperm bank for several months, sex has no place between visits.

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FDA requires that the sperm is frozen for six months, and the donor is retested after six months. This is to make sure he doesn’t suffer from AIDS or other diseases. To the innumerable tests, Covid tests are a new addition. Sperm banks don’t pay until the sperm is ready for sale and the donor is added to the bank’s catalogue.

Other than the innumerable tests, including physical, psychological, personality, S.T.D screening, the donor gives blood, urine and semen (this one is not for sale) samples. He then fills a bunch of forms. He must specify his drug use, sexual history, talents, goals in life, education, all the places he has traveled to recently. His features are scrutinized, he should provide a childhood and adult photo, and write an essay or tape an interview. The potential buyer may want to listen to his voice or read his essay.

Genetic testing is added to the tests. Ashkenazi Jews are tested for a maximum number of genetic disorders. The reason could be their strictly marrying within the community, risking inbreeding.

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Donating sperm is not at the donor’s convenience, but the sperm bank’s. They are normally open during office hours from Monday to Friday. This is one operation that has not switched to work-from-home.

Currently, the reopened American sperm banks are trying to make it safe for the few men who are willing to visit them. Only a small number is allowed to donate every hour. They undergo thermal screening, covid tests. Masks must be worn at all times, except during the process of donation.

Pre-pandemic, the reputed sperm banks were already investing close to $2000 per donor for recruitment and testing. They require an agreement for the donor to commit at least one visit per week for 6 to 12 months. An active young man donating twice a week might earn $1500 a month.

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There is no legal limit, but the biggest sperm banks have established policies that one donor’s sperm will not be allowed to father more than 25 to 30 kids.

As to whether the donors can get in touch with their children I will discuss tomorrow.

Ravi 

Corona Daily 208: The Sperm World

Another industry stirred by the coronavirus pandemic is the Sperm World. With the industry not strictly regulated, accurate numbers are difficult to find. In the 1980s, research had estimated the number of children born by donor sperm in the USA was between 30,000 and 60,000 every year. Now with the legalization of gay marriages and gay unions in many countries, the market has dramatically expanded.

In the estimate of Sperm banks in the developed world (USA, Europe, Australia), about 20% of sperm bank clients are infertile straight couples, 60% are gay women, and 20% are single mothers wanting to have and raise own children without a male partner.

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Two things have happened since the start of the pandemic. The demand has shot up everywhere, reaching record levels in the USA, England, Australia and Canada. People working from home (perhaps naïvely) think life now has the flexibility that will allow them to have children. It may also be a way to reduce the gloom or quarantine loneliness.

On the other hand, supply of sperm has dramatically declined, (or should I say drying up). Big sperm banks are running low. To meet the growing demand, men were visiting sperm banks regularly for years. In coronavirus times, they were scared to go. During lockdowns, new donor recruitment stopped, and hasn’t yet restarted. “Smart sperm”, aspired to by many, has become difficult to get.

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What is smart sperm? Graduate sperm. Preferably bright graduate sperm. You can’t blame a woman for wishing her sperm donor is from Harvard or Stanford. As a matter of fact, many big sperm banks are located near elite colleges. They have sperm collection centers in Palo Alto near Stanford university, and Cambridge, near Harvard university. It’s a mutually beneficial arrangement where academically bright young men can perpetuate their stock by spreading fifty or so biological children around the world.

College educated sperm is something women are willing to pay more for. In pre-pandemic times, those donors would go to a bank once or twice a week over months to produce enough sperm to sell to dozens of families.

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Sperm prices have gone up. But the bigger disturbance in the Sperm World is that women are joining unregulated Facebook groups to bypass the sperm banks. The FB groups connect the buyers and the potential donors, getting rid of the middlemen. Kyle Gordy, 29, has founded a private FB group “Sperm Donation USA” that already has 12700 members. Gordy himself has sired 35 children till date, with five more on the way. Private donors are super-busy. They can contact the mothers-to-be directly.  

England and Australia make it illegal for sperm donors to charge significant amounts of money (even if they are from Harvard or Oxford). In the USA, FDA regulates sperm donation the way it regulates tissue donation. A donor must donate sperm of his free will. Payment should never be his primary motivation. Usually, the payments are considered as reimbursement for travel and time.

Though donors are technically not allowed to charge for donation, buying sperm from a sperm bank is expensive for the buyer. Each vial from a premium sperm bank can cost up to $1100. The bank guarantees a vial will have 10-15 million total motile sperm. Each month, during the prospective mother’s ovulation, her doctor unthaws the vial and injects the sperm.

Sperm banks recommend buying four or five vials per child, since the process can take months for a successful pregnancy. Donors are in demand. If a woman wants to have two children from the same donor, she needs to invest at least $10,000.

In the pandemic, the sperm king donors are exhausted. They are flying and driving around; shipping sperm in vials; taking the latest DNA tests because that is what modern women demand.

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Continued tomorrow.

Ravi 

Corona Daily 209: Human Catastrophe, Markets Boom

Europe and America are stifled by lockdowns. The worldwide case count nears 100 million. Officially, 2 million have died. Jobs have been lost, businesses closing, schools shut. The world is in a catastrophic state, and the stock markets are euphoric, most indexes reaching all-time records. 2020 was the best year for newly listed companies. Share prices of lossmaking companies like Airbnb more than doubled on the day they started trading. Tesla shares are zooming as if Tesla was a rocket.

How can this be explained?

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USA has published its “National Income and Product Accounts data” until November 2020. It captures the aggregate earnings, expenditure and savings of Americans. For those who understand numbers, the table makes for fascinating reading. A New York Times article this month analyses the data well. The analysis compares the Covid time data (March-November 2020) to the previous year (March-November 2019) data.

US markets are a benchmark. World markets now move up and down in a choregraphed fashion. For example, India receives more than $50 billion annually from foreign investors, mostly in stock markets, rather than infrastructure. Withdrawal of foreign funds would cause Indian markets to collapse.

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The US national data table starts with personal income that includes wages and salaries. The total employee compensation in Covid times went down by 0.5%. (March-November 2020 compared to 2019). With severe lockdowns, millions unemployed, half a percent slide is surprisingly small. Number of jobs declined by 6.1%.

The reason is that lost jobs were relatively lowly paid. High paying executive jobs were hardly affected. Most high paid jobs continued online, while wage workers couldn’t work from home. If an executive got a bonus of $100,000 for leading the company successfully through the pandemic, and four restaurant workers earning $25,000 each lost their jobs, the net effect on total income was zero. True, you have one guy who has become wealthier and fatter, and four guys stressed, depressed and perhaps hungry. But the aggregate income is not affected.

Despite the mass unemployment, the total compensation was down only by $43 billion in the nine months.

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On the other hand, Americans’ income from unemployment insurance benefits was a staggering 25 times higher than previous year. The government pumped in $499 billion more into American pockets. The $1200 stimulus checks in the CARES act added another $276 billion to the personal income, though much of it went to families that had maintained their jobs and earnings. The Paycheck Protection Program to protect business and farm owners added another $29 billion. All other income went up by $265 billion, resulting into a total increase of the disposable personal income by an incredible $1.03 trillion.

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The other part of the story was the fall in expenditure. Spending on services fell by $575 billion (8%). This included savings on flights, hotels, restaurants, sports, concert tickets and all other services that were banned. On the other hand, Americans spent more on goods; $60 billion on durable goods (computer chairs, bicycles) and $39 billion on fast moving consumer goods (food at home). Thanks to reduction in spending on services, the interest payments dropped by $59 billion.  

The net expenditure went down by $535 billion (575+59- 60-39).

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In effect Americans’ savings, in aggregate, went up by $1.56 trillion ($1.03 trillion additional income+ $535 billion reduction in expenditure). This is a 173% increase compared to the equivalent period in 2019.

What to do with the $1.56 trillion extra money? Currency in circulation went up by $260 billion (14%). Deposits in banks by 19%. But holding cash and deposits don’t grow wealth, with central bank lowering interest rates to near zero.

Those willing to risk threw all that money into shares and assets. S&P 500 went up by 16%. Home sales in the USA surprisingly surged, with prices up 8.4% in October. Even a fictional asset like bitcoin skyrocketed. The Fed is still pumping $120 billion into markets every month. Joe Biden this month will give an additional stimulus of $1.9 trillion. So, the market euphoria may continue for some more time before crashing to the ground.

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Does that mean it is a mistake to offer stimulus? I don’t think so. Anyway, the rich will get richer and poor will get poorer. But a $2000 check may allow someone to survive who wouldn’t otherwise.

Ravi 

Corona Daily 210: World’s Biggest Pilgrimage Kicks Off: Part Final

UNESCO has recognized Kumbh Mela as intangible cultural heritage.

Last year, many religious gatherings were cancelled or dramatically curtailed. Hajj, the annual pilgrimage to Mecca, allowed a few thousand local visitors, compared to the two million every year. On Christmas eve, the pope celebrated midnight mass with a few dozen instead of the usual 10,000.  

Religious gatherings held last year have sometimes turned into super-spreader events. The earliest and best-known case was the Shincheonji religious group, which became the source of South Korea’s outbreak last February. By March, half of all the cases of that nation, numbering in thousands, were traced back to its members. US churches have contributed to the contagion. One Californian church caused seventy cases, one in Ohio ninety.

India faced its own crisis, when Tablighi Jamaat, a conservative Muslim missionary group led to a coronavirus cluster. The publicity for that event in social media was equally toxic and widespread.

Hinduism has 330 million gods. Mathematically, this pantheon offers a much better protection than a single Allah or Jesus. When questioned about a million people congregating in covid times, Kumbh mela’s chief organizer said, “I am sure mother Ganga will take care of their safety.”

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Indian newspapers are surprisingly silent about the Kumbh mela. No pictures, and no reports. Indian parliament is still shut because of covid-19. What about the courts? Why didn’t anyone go to the courts to point out the risks?

As a matter of fact, five different Public Interest Litigations (PIL) were filed in the State High Court last year. On 11 January, the bench met the relevant officials on Zoom and on 13 January issued an order.

At the beginning of the order, the court says the possibility of a congregation of millions emerging as a hot bed for the spread of coronavirus cannot be ruled out.

The learned chief secretary of the State informs the court that other states have been requested not to send too many pilgrims, but borders cannot be closed. To dissuade people, the state government has decided not to erect any tents for housing. Lack of tents would discourage the arrival of many pilgrims. (The pilgrims don’t know any of this.)

Court observes that Haridwar’s population is 2 million. On special days, 5 million visitors are expected, which takes the number to 7 million. What are the medical facilities available in case of a covid explosion?

The state government replied it has 5493 beds, and they should be sufficient. When the court expressed surprise, the learned chief secretary added that the Government Mela hospital in Haridwar has an ICU of 10 beds. Rishikesh, a nearby town has 165 beds with oxygen cylinders.

The court didn’t exactly agree with the learned state officials. In its order, it asked the state to write to the central government asking them to immediately issue SOP (standard operating procedures) for the Kumbh mela, 2021.

The state government should consider erecting sufficient number of tents to house the large number of devotees. It should also seriously consider increasing the medical equipment and health workers available. Other state governments across the country should be informed about the necessity of reducing the numbers at the mela.

It is noteworthy this order was issued one day before 700,000+ devotees arrived at Haridwar.

The Court has specified the next steps. After considering the court order, the State government should submit a report on or before 15 February. The learned secretaries of the state should appear on the video conference with the court on 22 February. Court has asked the registrar to give this case the top priority on that day.

As the judicial system normally works, the court will express unhappiness at the report and give a further date for hearing in March. This will continue until the Kumbh Mela is over. Unless there is a real outbreak, in which case the central government will issue an order closing the Kumbh Mela and banning entry in Haridwar. Something it could have done before the start of the mela.

Ravi 

Corona Daily 211: World’s Biggest Pilgrimage Kicks Off: Part Two

On day one, instead of the usual million, only seven hundred and eleven thousand (711,000) devotees arrived to perform rituals. Everyone coming to Kumbh mela was expected to carry a Covid-negative test certificate. The certificates would be checked randomly. There are no reports about this. A total of 974 people were fined, presumably for not wearing masks. Judging by the videos (1,2,3,4,5), this was also done on a random sampling basis.

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Records show that Haridwar Kumbh melas have been taking place since the early 1600’s.

During the 1783 Kumbh Mela in Haridwar, a cholera epidemic had broken out. That year around 1.5 million attended the fair. Within the first eight days, more than 20,000 succumbed to cholera.

In 1891, a massive cholera epidemic claimed 724,384 victims. That year, the sanitation arrangements at the Kumbh mela were improved. 332 policemen were deployed with the exclusive, awkward duty of preventing people from defecating in the open. However, the mela still had a cholera outbreak. A ban was issued to prevent its spread. More than 200,000 pilgrims were asked to leave the area. The railway authorities were asked to stop issuing tickets on trains to Haridwar. By the end of the mela, 169,013 cholera deaths were reported in Haridwar.

Leonard Rogers records that following the Kumbh mela, this cholera epidemic spread to Europe via Punjab, Afghanistan, Persia and southern Russia that resulted in the Sixth Cholera Pandemic (1899-1923).

The Kumbh Mela of 1918 took place during the Spanish Flu Pandemic. The British colonial government cancelled all passenger trains. Despite that, the gathering was attended by three million devotees who travelled on foot or in bullock carts.

Shaunak Das, Director of the Oxford centre’s Hindu studies in the UK says it is not unexpected for Hindus to die on pilgrimage. Some even manage to get death certificates from authorities to save their families from bureaucratic hassle if they don’t return. To die on a pilgrimage is a reward in itself. Though the pilgrim is not necessarily aiming for it, it is nothing to be afraid of. Das adds pilgrimage in India was always risky, with diseases, mosquitoes, snakes and scorpions. This time the coronavirus is added to that list, that’s all.

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‘The pandemic is a bit of a worry, but we are taking all precautions’, said the chief organizer Siddharth Chakrapani, whose mask-less face is clearly visible in the videos. He expects about 1 million devotees to arrive on any given day, and 5 million on special days. There are more than 1000 CCTVs installed to manage the mela.

‘India is not like Europe. When it comes to immunity, we are better’ said Sanjay Sharma, a 50-year-old pilgrim. (Because of the better immunity, India has had only 10 million cases, and 150,000 deaths so far).

‘It’s really sad to see people not gathering at Kumbh in the same numbers as they would earlier, just because of a sneeze or a cough’ said a devotee disappointed to learn only 700,000 attended on the first day.

India’s Prime Minister Narendra Modi has not arrived at the world’s largest gathering, because he is busy with the world’s largest covid vaccination campaign. However, on Thursday, he tweeted offering his best wishes.

“Makar Sankranti (the first day for Holy baths) is marked with enthusiasm in several parts of India. This auspicious festival illustrates India’s diversity and the vibrancy of our traditions.” His cheer-up tweet said. So as not to play spoilsport, his message didn’t mention Covid-19 or any of the precautionary measures.

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The third and final part tomorrow.

Ravi 

Corona Daily 212: World’s Biggest Pilgrimage Kicks Off: Part One

Yesterday, in India’s Haridwar, hundreds of thousands of pilgrims gathered to wash away their sins in the river Ganga (Ganges).

UK’s citizens may be prevented from meeting anyone outside the household; many states in the USA have no ICU beds left; even China has sent 22 million into a strict lockdown following a covid death after months. In India, the Kumbh Mela, humanity’s biggest gathering, kicked off yesterday.

Indian railways have organized special trains. I am still prohibited from travelling in Bombay’s local trains, but I can take a train to Haridwar if I wish. Uttarakhand’s Chief Minister said the Kumbh Mela will be held in its divine form despite the practical problems connected with the pandemic. Religious scholar Shiv Naudiyal asserted the pilgrims will arrive for Kumbh and the holy Ganga dip irrespective of the coronavirus. Because faith transcends all hurdles and boundaries. Not a single school in India has functioned since last March. But faith transcends knowledge and education.

On 16 January, India will start its first phase of the campaign to inoculate 300 million Indians. (As a result, the polio vaccination campaign is postponed. There are only so many vaccines that can be produced, transported and administered.) It may be a good thing that the kumbh mela and the vaccination campaign will run parallelly.

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According to Indian mythology, gods and demons fought over the sacred kumbh (pitcher or urn) of amrit (nectar of immortality). Lord Vishnu, disguised as Mohini, a beautiful enchantress, grabbed it from the demons and whisked it away to heaven. During that journey, four drops of nectar fell from the kumbh on four sacred sites, currently known as Haridwar, Ujjain, Nashik, and Prayag. The battle and pursuit lasted for twelve divine days. Each venue celebrates the kumbh mela (fair) every twelve years. The cosmic moment has turned the rivers into amrit, giving pilgrims the chance to bathe in the reservoir of purity, auspiciousness and immortality.

Haridwar had its last Kumbh Mela in 2010. Idiosyncrasies of the Hindu calendar specified 2021 to be an auspicious year, so unusually this Haridwar gathering happens after eleven years. As a pandemic precaution, Kumbh mela 2021 will last for only 48 days instead of the usual three and a half months.

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Unlike in 2010, now the Ganga is clean. The Modi government, in power since 2014, has launched a mission to clean the river. To help the mission, the water ministry has asked for extra funds for toilets and urinals.

Forty companies of central paramilitary forces are deployed to manage the grand jamboree. This year a special COVID officer is appointed. Usually, 100 million visitors may visit the mela. This year, fewer millions are expected due to the pandemic. Haridwar’s 800 hotels and 350 ashramas are ready to welcome the pilgrims.

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Special measures have been introduced for crowd management. For taking a holy dip in the Ganga on the four specified auspicious days (11 March, 12 April, 14 April and 27 April), pilgrims must register at a website and select a specific venue to bathe. The website algorithm will allot a time slot of 15 minutes to each devotee. An e-pass will be issued that will have the route map to make reaching the venue easier.

Hindu ascetics, monks, many of them ash-smeared, some of them naked, enthusiastically take the holy bath. It will be curious to see how they will manage the online registration, and get the e-pass printed. By the way, they also have an option to carry the e-pass on their smartphones.

The mela area and all the 107 ghats (steps leading to a river) are marked with red, yellow and green codes according to the level of vulnerability. The vulnerability refers to crowds rather than the virus. The entire mela is GPS mapped. As soon as any particular site has more than the specified number of people (a few thousands?), the police control room will issue an alert and the security teams will rush there. This is to avoid stampedes rather than contagion.

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(Continued tomorrow.)

Ravi 

Corona Daily 213: The Sunshine Vitamin

In December 2020, sales for Vitamin D supplements increased 42% year on year in the USA. Since the beginning of the pandemic, interest in Vitamin D has been growing on both sides of the Atlantic. Vitamin D is said to protect bone health, improve functions of cells like T cells. Low levels of the vitamin may increase susceptibilities to infection.

This perception is not new. In 1940, when Winston Churchill’s government feared the British population was at risk of the musculo-skeletal condition rickets, margarine makers were ordered to strengthen their products with vitamin D “to safeguard the nutritional status of the nation”. Until 2013, margarine strengthening was required by UK law.

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In April 2020, dozens of doctors wrote to the British Medical Journal advocating correction of vitamin D deficiencies as a no-brainer, safe, simple remedy to mitigate Covid-19. In hospitals in Newcastle, D-deficient patients were given excessive oral doses, sometimes 750 times the recommended dose.

David Davis, a Tory MP earlier in charge of Brexit, has been a relentless campaigner. (Maybe he is attracted to this vitamin because of his name). He is 71, and takes D-supplements every day. He believes that Covid-19 exists seriously above 40 degrees latitude because of the lightless winters. His campaign points out that Finland (where dairy products are fortified with D-vitamin) and New Zealand (which prescribes vitamin D to all care home residents) have fewer cases and deaths. Blacks and Asians have higher levels of melanin in the skin, which reduces the creation of vitamin D from sunlight. They have been disproportionately affected in the UK.

At the end of November, the UK Government announced four months of free vitamin D supplements to all care homes and prisons, a total of 2.7 million people.  

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In the last nine months, dozens of studies have been conducted to find the relationship between Vitamin D and Covid-19.

A Chicago study found D-deficient people were 77% more likely to test positive. Italian researchers learnt that 81% of those hospitalized with acute respiratory failure were vitamin D deficient. The mortality risk was also higher for the D-deficient. A French study said the D vitamin supplements were associated with less severe cases, and the survival rates were higher. Korean scientists found that deficiencies decreased immune defences, and could cause a severe covid. Singapore offered a combination of vitamin D, magnesium and B 12, and believes it reduced the worst outcomes. In a large, pivotal study in Spain, vitamin D reduced the disease severity for the hospitalized patients.

On the other hand, a professional double-blind study with a placebo in Brazil found that vitamin D had no impact.

The key message of the Australian research was that if you are not vitamin D deficient, boosting it is not likely to stop you from getting a head cold or the flu. More is not better.

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Despite the universal noise, scientists are reluctant to promote vitamin D supplements. The key problem is that all the evidence so far shows correlation but not causation. They suggest caution, excessive intake can lead to toxicity, higher level of calcium in the blood, may cause kidney stones and other problems.

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After going through all the available material, I will summarise my thoughts on this subject.

(a) if you choose to take vitamin D supplements, adults should have 10 micrograms (and never more than 100 micrograms) a day, children half of it. Anyone with kidney malfunction should not take it.

(b)  Diet such as fatty fish or fortified dairy products can be a good source of vitamin D.

(c) Aim to be physically active for at least 150 minutes a week, go outdoors for 15-20 minutes a day.

Dr Anthony Fauci does not mind recommending it, he takes vitamin D supplements himself. That may boost your confidence.

Ravi 

Corona Daily 214: The Swiss Cheese Model

Joe Biden wears two masks, a surgical mask over an N95 mask. It is not to compensate for the outgoing president who doesn’t wear any.

Layering two less specialized masks over each other can provide protection comparable to the N95 masks. It is recommended that face shields must be used with a mask. Though the clear plastic shield is impermeable, air seeps out and comes in around the edges. Each additional layer makes it difficult for the virus to get in or out of the nose and mouth.

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Dr James Reason, a British cognitive psychologist and professor, first introduced the Swiss Cheese concept in his 1990 book called “Human Error”. A series of disasters in the previous decade including the catastrophic accidents in Chernobyl, Bhopal and the Challenger shuttle explosion motivated the analogy.

In the Swiss cheese model, an organisation’s defences against accidents or failures are modeled as a series of slices of Swiss cheese with holes known as “eyes”. Holes in every slice represent a weakness of that individual slice. The slices have holes in different positions. The system produces failures when a hole in each slice momentarily aligns, permitting “a trajectory of accident opportunity”, says Dr Reason. When the danger passes through holes in all of the slices, it results in a failure, sometimes catastrophes.

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Even without reading Dr Reason’s book, we usually know examples of the implementation of multi-layered protection.

Take Google’s 2-step verification. When we want to recover the forgotten Gmail password, Google may want to send an email plus a code to our phone. Despite using our login and password, our bank may send us an OTP before we can carry out a transaction.

There is always a balance to be struck between convenience and safety. Google can, of course, make it a 5-step verification to make it hacker-proof, but we may get sick and stop using Gmail. Wearing three or four masks one on top of another will certainly offer better protection, but we risk dying of suffocation before the virus can strike.

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Another good example is our crossing the road, particularly in places like Bombay with speeding bikes, narrow or absent pavements, and shaky road discipline. We look both ways, cross when the pedestrian light is green, continue to keep a wary eye on traffic as we cross, avoid the temptation of looking at our smartphone. Though it may be impossible to eliminate the risk, each of these precautions reduces the risk drastically.

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Avoiding getting infected, hospitalized or dying by the coronavirus is similar to avoiding getting hit by the car when crossing the road.

No single layer is perfect, each has holes. When several holes align, the risk of infection increases. When multiple layers are combined – social distancing, plus masks, plus handwashing with soap, plus testing and tracing, plus ventilation, plus strong government messaging plus vaccines - multiple fencing reduces overall risk. People who think vaccines offer a magic bullet may be wrong. Vaccination is simply one of the cheese slices.

A coronavirus sceptic is called the “misinformation mouse”. Such people will confidently tell you about the uselessness of masks, or the impracticality of contact tracing. Without being experts, they confidently and loudly start making new holes for the virus to pass through.

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Until the pandemic ends, all of us, and particularly those in the vulnerable categories, will benefit by remembering the Swiss cheese model.

Ravi    

Corona Daily 215: Better Normal for All

Yesterday, CES 2021, the biggest show of the tech industry, started.  Originally called the Consumer Electronics Show, it happens annually in Las Vegas. This year it is online. Unaware of the gravity of the coronavirus then, last January 171,268 people had visited it.

More than fifty years old, CES was the first to display the world’s best known tech products: VCR (Philips: 1970), CD player (Philips/Sony: 1981), Nitendo entertainment system (1985), Play Station (Sony, 1991), handycam camcorders (Sony, 2003), Plasma TV (Samsung, 2005), smartphones (2013), self-driving car (2019) to name a few.

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In keeping with the times we live in, the first online CES presents several pandemic specific products. Among the newspapers, the Washington Post has offered the best review of such products.

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 Biobutton: The size of a postal stamp, the Biobutton sticks to your upper chest like a Band-aid. It uses sensors to track your temperature, respiratory and heart rates, activity level and sleep. Glued to your chest, in a few days, Biobutton can detect if you possibly have Covid symptoms, even when you are feeling fine. Colorado’s UCHealth is using Biobuttons to monitor vaccinated health workers. The device has been cleared by USA’s Food and Drug administration.

BioIntelliSense, the maker, hopes it can be used effectively to make vacations, cruises and workplaces safer. It costs $1 a day for up to 60 days of continuous monitoring.

Biobutton has won the best innovation award at this show. One of its identified shortcomings is that it can’t tell the difference between covid-19 and the flu yet.

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Petit Qoobo: is a furry robot, your safe and comforting companion. Developed by Japan’s Yukai Engineering, it is like a real skittish, young animal. It has eighty different movements to respond to your voice or touch. Ladies can easily carry it in a shopping bag. Petit Qoobo has a regular heartbeat that gives you the feeling of a live creature when you cuddle it. Doesn’t require food or maintenance. Its cost is $110.

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WiFi 6E: With the sudden explosion in online work and education, many of us experience frustration with our existing Wi-Fi.

WiFi 6E routers offer a new wireless spectrum previously unavailable for Wi-Fi. WiFi 6E adds a new band 6GHz. For all your apps and devices streaming data, this is like adding a whole new lane to your home’s information super-highway. It’s not faster than the existing wifi, but far less crowded, making your connection more reliable.

It is priced at $600. Like other wifis, its signals don’t travel very far in the house. It works well when devices are closer together.

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Gardyn: This 5-feet tall device brings the farmers market to your living room. The gardening machine helps you cultivate fresh leafy greens indoors. Seeds are placed in cups called yCubes. Gardyn’s vertical towers hold up to 30 different varieties, including cilantro, mint, kale and tomatoes. The buyer has to refill the water jug once in 30 days, and the vegetables are ready in a few weeks. The company says for $60 a month, a family of four can be fed.

Gardyn costs $899 or $44 per month. (I don’t think it will find any buyers in India).

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Airpop’s Active Plus Mask: A smartmask that allows you to exercise vigourously and monitor the air quality without losing your breath. The mask’s censor called “halo” is connected to your smartphone via Bluetooth. It monitors the health of the mask’s filter and alerts you when it needs to be replaced.

The price is $150.

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There are other products including touch-free and disinfecting products, virus catchers. Targus UV-C LED disinfection light for the keyboard along with an antimicrobial backpack are aimed at office-going employees. Many products, not surprisingly, kill up to 99.9% viruses and bacteria.

Not all innovations take off. Last year, CES had displayed a toilet paper robot which didn’t attract any customers.

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In the opening speech, “Better Normal for All” was a phrase used to describe CES 2021. Rather than wishing the pandemic-special innovations success, consumers will hope to return to a previous normal. Who wants to wear a mask- however smart?

Ravi 

Corona Daily 216: B.1.1.7 – Three Questions

‘Variant of concern’ is not a descriptor of our feelings, but one of the working names of B.1.1.7. When a new, different strain is found such as in the UK, South Africa or today in Japan, scientists ask three critical questions. (a) Is the variant more transmissible? (b) is it more deadly, more severe? (c) Can it bypass vaccines?

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On transmissibility, there is no doubt. Scientists initially estimated it was 70% more transmissible, but the latest modelling puts it at 56% higher. When R-zero, the reproductive number is 1, an infected person on average passes it to one other person. The pandemic grows when R0 is greater than one, declines when below 1. British researchers estimate that during lockdown, coronaviruses other than the B.1.1.7 variant have R0 at 0.95. The reproductive number of B.1.1.7 is 1.45. Genetic sequence traced it back to 20 September in Kent, another case in Greater London the following day. By now, 45 countries have confirmed existence of cases with this variant.

One theory for the rapid spread is that the variant has a heightened viral load, a higher concentration of the virus in the upper respiratory tract. Until now, this theory is not backed by credible data.

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Scientists have said B.1.17 spreads faster, but it is neither more deadly, more damaging or more severe. Presenting this fact as good news is misleading for two reasons.

First, there is a clearly established sequence: cases – hospitalizations – deaths. The more the cases, more patients get admitted and a certain proportion dies. By spreading faster, the new variant infects some vulnerable people who would be safe in a less transmissible variant. As ICU beds reach capacity and the health care system gets overwhelmed, non-covid patients are unable to treat their ailments or get operated. That increases the toll. The excess mortality tracker shows the total pandemic-related casualty figures.

Second, mathematically a more deadly virus does less damage than a more transmissible virus. Professor Kucharski takes a realistic scenario, where the reproduction rate is 1.1, fatality risk 0.8% and 10,000 active infections. With those numbers, we expect 129 deaths in a month. If fatality rate increases by 50%, that leads to 193 deaths. On the other hand, a 50% increase in transmissibility causes a shocking 978 deaths in just one month.

A more deadly variant can be tragic for an infected individual, that person may not survive. But the rapidly spreading variant is tragic for society. By spreading faster, it manages to kill far more people. (This is because a small % of a large number can be much bigger than a big % of a small number.)

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The third question is if it can bypass vaccination.

Here we have some truly good news. The consensus among the scientists is that the vaccines will work against this variant. One virologist compares the vaccine to a thousand big guns pointed at the virus. Even with the 23 mutations, it is not easy for the virus to find a genetic solution to combat all the antibody specificities and the overall immune response.  

Viruses like influenza amass mutations relatively quickly. But others, such as the measles virus, are stable over a long time. Even the influenza virus needs five to seven years to collect enough mutations to escape immune recognition.

Despite the growing spread across the world, the covid virus can still attack armies of uninfected people. That is why it has no reason currently to do anything spectacular. At will, it is able to find new hosts for it to enter and multiply. So, it is felt that the coronavirus is not yet interested in developing anti-vaccine weapons of its own. However, once enough people are vaccinated, the virus may evolve into an incarnation that will bypass the vaccine.

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In short, B.1.1.7 spreads faster. Though not inherently more deadly, its impact on the countries and the world is more deadly because of the faster spread. Currently, it is understood that vaccines can protect us against this variant. That comfort is available until such point when there are too many people vaccinated for the coronavirus’s comfort.

Ravi