Corona Daily 127: Breakthroughs

Last week, I wrote about a doctor friend who got infected after being fully vaccinated. Such infections are called “Breakthrough infections”. Not breakthroughs for scientists, but for the virus. As if it has managed to break through the vaccine protection. The Hepatitis B virus that infects one after inoculation is called the “vaccine escape mutant”.

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 One immunologist clarifies: Being vaccinated doesn’t mean you are immune. It means you have a better chance of protection. Vaccine is just one variable in the toolbox available for protection. The goal of vaccination is not eradication of covid, and this may surprise many. The goal is to peacefully coexist with the coronavirus, like we do with flu. Of course, eradication would be nice, but at present that is considered too ambitious.

A breakthrough infection can happen in immuno-compromised people. Age and weight of a person can matter. Doses for flu vaccines differ based on such factors. However, for covid vaccines, an identical dose is given to everyone. This may prove to be insufficient or excessive. The good news is that most cases noticed so far have milder symptoms and a shorter duration.

Virus mutations can be a reason. So far, the main approved vaccines – Pfizer, Moderna and AstraZeneca are working against all variants. (A single exception was AstraZeneca not working in South Africa against the locally identified variant). Ideally, every breakthrough case should be subjected to genomic surveillance. A fully vaccinated person’s positive sample should go for a genome analysis. That will tell us exactly which variants are more successful in escaping the vaccine effect. Unfortunately, such data is not available.

Large viral loads may cause infection. If a fully vaccinated person attends a superspreader event or joins a crowd where the virus is rampant, he or she can get infected because of the sheer viral load. Even in that case, the symptoms are likely to be mild.

Improper storage of the vaccine can be a reason. This is rare. However, in a country like India with unstable power supply, it is a challenge to maintain an uninterrupted vaccine cold chain. Vaccines lose potency if stored at wrong temperatures or used after an expiry date. Moderna allows anyone to check online the expiry date of its vaccine based on the batch number.

Some of those testing positive after vaccination are asymptomatic cases. Including them is a bit unfair. In most vaccine trials asymptomatic cases were excluded. Immunologists distinguish between infection and disease. Whenever someone tests positive, the real question is, are they sick, and how sick are they? They may still be isolated for the benefit of others. But in all likelihood, their asymptomatic infection is a successful outcome of the vaccine.

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USA has already administered 66 million doses. The data of breakthrough infections has started trickling in. Based on the state-wise data I have seen so far, one person out of 10,000 can get infected despite being vaccinated. This is excellent news, because it means 9,999 out of 10,000 are protected.

A study published this week in the New England Journal of Medicine offers another piece of good news. The research found that fully vaccinated people have robust levels of antibodies more than six months later. Those levels subside very slowly, giving hope that the vaccine immunity may last for a long time. The study included mainly those who received Moderna, and it is hoped similar studies will show similar results for other vaccines.

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Breakthrough infections are bound to happen. But they shouldn’t stop anyone from getting vaccinated. One doesn’t stop wearing a helmet just because some biker had an accident wearing it.

At the same time, it is important to track the breakthrough data, to look at the percentage and analyse virus variants where possible. If such infections were to climb to unexpectedly high rates, an additional booster shot or tweaking of the vaccine may be needed to improve the immune response.

Ravi 

Corona Daily 128: I Felt Like a God

A chance meeting at a Xerox machine in 1997 may have been responsible for changing the course of the pandemic last year. One of the two at the photocopier was Dr Katalin (Kati) Kariko.

Kati Kariko was born in Communist Hungary in 1955. Her father was a butcher, her mother an accountant. Kati loved biology. She earned a PhD at Hungary’s Szeged University and started working as a post-doctoral fellow at the university’s Biological Research center. In 1985, the research programme ran out of money. By now Kati had a two year old daughter. The family decided to bite the bullet, and move to the USA.

They sold the car on the black market. That time, the communist government allowed people to leave the country with a maximum of $100. The family had raised $1000 by selling everything. Kati hid them in her daughter’s teddy bear. They bought a one way ticket to the USA. When the three landed, they didn’t know anyone there.

Kati Kariko managed to find work as a researcher at the University of Pennsylvania. She was intense and single minded. Her singular focus throughout her career was on messenger RNA (mRNA), the genetic script that carries DNA instruction to cells to make their own medicines. “I felt like a god.” She recalls her feeling the first time she saw her idea working in a lab.

Life was difficult and stressful at the University. She was moved from one lab to another. Scientists need to pitch to get grants for their ideas. Some of the brainiest scientists don’t have the skill to write the grant requests. Kati was one of them. Her wild and fanciful ideas could not be sold; nobody was willing to pay for research. Her ideas went against conventional wisdom.

The university expected her to quit. She was demoted, derailed from becoming a professor. A boss tried to get her deported, since she still held a Hungarian passport.

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Kati managed to stay on. In 1997, at a Xerox machine in the university, she saw a balding man. While making copies, she started talking to him. His name was Drew Weissman. He was a professor of Medicine.

“I am an RNA scientist – I can make anything with mRNA” Said Kati. Dr Weissman said he wanted to make a vaccine against HIV. “Yeah, yeah, I can do that” said Kati.

Despite her boasting, her research on mRNA was completely stopped. The two of them started writing grants. Most of them were rejected. Nobody was interested in mRNA. The people who reviewed the grants said mRNA would not be a good therapeutic, so please don’t bother.

Leading scientific journals rejected their work. In 2005, they finally managed to get an academic paper on mRNA published. It received little attention.

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In 2013, Kati finally left the university. She had two job offers. One offer was from Moderna, a company based in Germany. It didn’t even have a website. Kariko took the other offer, from a company called BioNTech. She was given a senior VP role as a researcher.

Kati continued to work day and night. On one New Year Eve, she found herself dozing in the lab chair when the world outside greeted the new year. Kati realized she hadn’t taken a single holiday in the year that had just passed.

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Chinese scientists posted the genetic sequence of the virus found in Wuhan in January 2020. Dr Kati Kariko and her colleagues at BioNTech designed its mRNA vaccine in hours. Moderna designed it in two days.

Pfizer partnered with BioNTech to produce the first covid vaccine. The University of Pennsylvania suddenly began boasting about its former professor Dr Kariko being the original thinker behind the mRNA vaccine. The 2005 paper written by Dr Kariko and Dr Weissman began to be widely cited in 2020-2021. It will be a surprise if the two don’t get the Nobel Prize this year.

On 18 December both were vaccinated at the University of Pennsylvania. It turned out to be a press event. The journalists took photos, those present clapped. Kati Kariko wept.

Ravi   

Corona Daily 129: The Mexican Mariachi

The pandemic has reshaped many businesses.

Mariachi is the regional Mexican music that is at least two centuries old. The size of a Mariachi ensemble varies, but usually includes singers, violinists; trumpet and guitar players. All of them take turns, singing lead and chorus in turns. Performers wear elegant charro outfits, decorated with embroidery and silver or gold buttons.

The lyrics talk about human emotions and life: machismo, love, betrayal, politics, revolutionary heroes and country life. The music is boisterous, it electrifies the surroundings. Mariachi bands play at weddings, quinceaneras (a girl’s fifteenth birthday), serenades (performances for young couples getting engaged), Valentine’s Day, Mother’s day and other joyous festivals. Mexicans can’t imagine a birthday celebration without “Las Mananitas” or a wedding without “Somos Novios”.

For Mexicans living in the USA and other countries, Mariachi music is the sound of home. It’s the music their parents danced to at weddings, teenagers played after a heartbreak, and families crooned while drinking Tequila.

The French believe the word Mariachi comes from marriage.

Though Mexican, the music is spread internationally, hundreds of Mariachi bands operate in the USA. In America, schools and universities have Mariachi music groups. Just like Tortilla or Tequila, Mariachi represents Mexico.

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Mariachi musicians earn only when they perform. Last April, all of a sudden, invitations were replaced with cancellations. Weddings and engagements were off. Restaurants and bars shut. For two or three months, music was silent, the ensembles worried about survival.

And then the invitations began once again. For funerals and burials.

Mariachi Nuevo San Diego started playing at a funeral on a daily basis. In the past, they would do it once a month. This is true of most bands. They have turned to playing songs of pain and sorrow to ease the passing. It is not discussed, but they suspect in most cases, the cause of death was covid-19.

When the Mariachi singers arrive, people are grieving and crying.

“When you are singing, it’s not just singing.” Said one performer. “You have to interpret the song, and you have to also feel what you’re signing, and it does take an emotional toll. For me, the hardest part is when I am at a funeral and it’s an open casket.”

“We have work because people are dying. We cry with them. It is emotionally draining.” Said a lady singer.

Mariachi groups have now been playing at funerals for months. Just like doctors in the covid wards, they feel overwhelmed as well.

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In February, facing the stone archway of a retreat center near Los Angeles, the dark wooden coffin holding the body of Juan Jimenez was wheeled next to the masked Mariachis. The group lifted violin bows, hands went on a golden harp, and fingers plucked at the bass guitars. After the priest’s prayer, the group played for an hour: songs of grief and goodbyes, like “Las Goondrinas” (the Swallows). The playing was particularly passionate, the sombreros were off. Juan was one of their own, a respected guitarron player, 58, a victim of the coronavirus.

The Latinos are particularly susceptible to the virus. Mariachi musicians have lost family and friends and music teachers and band members. They have been coming in contact with mourning people on a daily basis. Not all of them are masked, or observe safety protocols. California has an Organization of Independent Mariachis. Of its 400 active members, 80 Mariachis died during the pandemic.

“Every time I go to work, I pray that I am one of the lucky ones to return home.” Said a Mariachi singer, the secretary of that Californian organization.

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Mariachi groups now look forward to summer time, hoping they can go back to playing their noisy and cheerful repertoire.

Ravi 

Corona Daily 130: Two Morbid Paradoxes

In 2019, every month nearly 117,000 had perished in road accidents around the world. Recently, the Indian transport minister said more Indians die on roads every year than India’s covid-19 toll till date. Of course, road accidents are not infectious and they don’t spread like wildfire. But the point is that road fatalities are high in number. The pandemic and the ensuing lockdowns may have reduced them significantly.

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USA has started issuing data on all sorts of pandemic morbidity. Americans, like everyone else, spent more time at home, white collar workers rarely drove to offices. Less driving means fewer accidents and fewer deaths. The National Safety Council reports that in 2020 Americans drove 13% fewer miles as compared to 2019.

So far so good.

Counter-intuitively, fatalities on American roads increased by 8%. In other words, in the pandemic year, fatalities per mile went up by 24%. This is the biggest increase since 1924, when four-wheel brakes were not yet introduced.

California publishes great details about road crashes. In California, driven miles were down 13% as well. Even better, vehicle collisions were down by 24%. And yet, those fewer crashes were more deadly, causing 19% more deaths than in 2019. What were the reasons for such contradiction?

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Drivers in the USA reduced their use of seat belts. (Liberty. Freedom. No seat belts. No masks). Road patrol caught 5% more unfastened seat belts. In covid-19, alcohol consumption increased, binge drinking became popular. Drinks and drugs caused reckless driving, ignoring red lights. Statistics in California and Iowa show that the number of speeding tickets more than doubled. (Going over 100 miles an hour). On average, speeds in number of cities rose by 22%. Reduction in traffic congestion and slack law enforcement may have added to reckless driving. Combined, it contributed to greater force and fatal crashes.

In normal times, in rural America, roads are emptier, speeds higher, and accidents more serious. The pandemic reduced the gap between rural and urban. Urban drivers started treating cities like rural areas. Pandemic and lockdowns tempted the drivers to whizz faster than was good for them.

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President Biden said a lot of folks were reaching breaking point. Suicides were up, he said. It is no surprise that prolonged lockdowns, school closures, social isolation, job losses should result in a spike in suicides. Before the pandemic, suicides in the United States had increased every year, increased by 35% in the previous twenty years.

Again, logic and facts don’t match. On 31 March, the National Center for Health Statistics published statistics on the leading causes of deaths. In 2020, suicides decreased by 5% (from 47,511 in 2019 to 44,814 in 2020). It is inexplicable.

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The latest Economist talks of the record number of USA opioid deaths during the pandemic. Earlier if an addict could take drugs along with friends, now he started taking them alone. And in case of an overdose, there was nobody around to call for help or administer naloxone, an antidote medicine against opioid overdose.

Some of the overdose cases might have been suicide attempts. Experts say suicides and overdose deaths should be considered together. The American data has a category called “unintentional injuries”. Drug overdose deaths are included here. This category rose by more than 10%. Deaths from Fentanyl and other synthetic opioids rose 52% year-on-year till August. Those drugs killed 52,000 Americans, cocaine 16,000 and heroin 4,000. While the pandemic is on, few people are watching these figures.

When the final tally is published for 2020, that year will be the deadliest year in America’s opioid epidemic. And there is no talk about a vaccine for it.

Ravi 

Corona Daily 131: UK’s Puppy Mafia

Tilly was snatched from her bed, Moet grabbed from her home, Angel carried off from her garden. A thief showed a knife to a former boxer to steal his Rosie. Nala disappeared with her dog walker’s van. Denzel and Welly, a pair of Labradors were carried off from an upscale supermarket.

In The Canine Year, I wrote about a pandemic boom to the dog business. In the UK, its dark twin has emerged. Britain is facing a huge dog stealing crime wave. This week 27 stolen dogs, including spaniels, a French bulldog, terriers, and a Rottweiler were seized in Essex. In a raid in Suffolk in March, 83 dogs were seized. The crime is becoming so acute; Nottinghamshire has appointed a “dog theft police officer” – a novel designation.

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Since the pandemic began, nearly 3.2 million UK households have bought an animal companion. As a result, prices for dogs have gone through the roof, two to five times more expensive. The extraordinarily high demand means rescue shelters are out of mutts. Desperate people have paid £3000 in a parking lot to buy a puppy with no papers and no shots. A litter of six puppies can yield £10,000. A stolen smart phone is worth a few hundred pounds, but a stolen dog can fetch thousands.

This is an average price list for the top end breeds: Chow Chow (£3700), Golden Retriever (£3360), English Bulldog (£3300), Cavapoo (£3030), Golden Doodle (£2976), Miniature Schnauzer (£2930), Cavalier King Charles Spaniel (£2784), Standard poodle (£2770), Cockapoo (£2740), Labradoodle (£2700).

This has led to the emergence of a new “puppy mafia”. Those dealing earlier with prostitution, guns and drugs have added this lucrative line to their business.

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One organization that deals with missing dogs had 400 cases just in England. None of them had run off or lost their way. They were all stolen.

British law requires that puppy buyers should see the puppy’s mother before buying the puppy. Puppies must be microchipped with their contact details, and accompanied by paperwork from licenced operators. Buyers are either not aware of the law, or don’t bother about obeying it. The dog thieves remove the microchips via crude surgery, or with a pair of pliers, or disable them with powerful magnets.

Thieves look for good breeds, preference being fertile females. They are stolen from stationary cars, yards, outside stores and kennels. Those selling puppies on the internet are targeted. First an innocent fake customer visits and makes notes of the layout of the house. Thieves visit the same place later and take the puppies away without paying for them.

Stolen male dogs are quickly sold off in the black market. Females are sent to illegal breeding farms.

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In Britain, stealing dogs is a high-reward, low-risk business. Because English law treats dogs as property, with punishment in line with the value of the object. Prosecutions are rare; in 2019 only 1% resulted in conviction. Even when convicted, the criminals are usually sent home with a fine of £250.

London’s puppy mafia has become more brazen and violent as a result. Like purse-snatchers, they are now willing to slash at owner’s or walker’s wrists to nab the dog.

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It is time the law is changed. It considers a dog as an object similar to a mobile phone, TV or car stereo. Even an expensive TV stolen from the house can be replaced. But to an owner, a stolen dog is like a kidnapped child. For causing that emotional trauma a convicted thief may escape by paying a £250 fine.

Two petitions with hundreds of thousands of signatures have now urged the authorities to take action. They want dog stealing to be a serious offence, punishable by eight years in prison and £5000 in fines. The UK parliament will debate the matter now. Whatever the parliament decides, if you live in Britain and own a dog, be on your guard.  

Ravi 

Corona Daily 132: An Analogy

Have you ever memorized a poem? Surely you have - as a student in school. One rarely loves anything in textbooks strongly enough to store it in memory. And yet the academic systems until recently needed students to memorise a lot of things: poems, Mendelev’s table, math formulas and so on.

In India, we call the memorisation process “learning by heart”, even when the learner’s heart is somewhere else. In my school days, I memorised at least three chapters of Bhagvad-Geeta, Sanskrit conjugation, film songs, dozens of prayers, multiplication tables till thirty, all phone numbers I knew, value of π till fifty decimals (fairly useless unless you want to impress your first love) and poems – lots of poems. Because I loved Marathi poetry.  

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Years later, as a thinking adult, I asked myself how I managed to memorise so many poems. And some of them were fairly long. Certainly I would read it once, then again, a few times more, and the poem became part of me. Exactly at which reading I learnt a particular poem ‘by heart’ I can’t tell. But I can confidently say it didn’t happen in one reading. Only freaks or accidental brains or professional memory practitioners may be able to memorise a poem without repetitive learning.

In my life, I have been fortunate to meet many stage and film actors closely. With cultivated skill, they are capable of memorising passages quickly, particularly before shooting for a TV serial. Stage actors don’t even have the liberty of twisting the playwright’s words. How do they store pages of dialogue to reproduce it verbatim?

Curious about this, in 2009, I played a role in a full-length Marathi play at our annual neighbourhood event. I dreaded watching the DVD recording, but am proud to say I didn’t miss a single line of several lengthy dialogues. It was, unfortunately or fortunately, my only performance. Twelve years have passed since. Today, I am not able to remember any of the lines.

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My friends or readers sometimes ask me why covid vaccines require two shots, two identical shots at that. Not trained in science, but fond of poetry, I tell them that a poem needs to be repeated before it can be memorized. The first time you read it, you may remember a few lines, or the rhythm, or the skeleton, but not the poem in its entirety. If you need to perform it on stage, would you do it after the first reading? Our immune system needs repetition of the vaccine dose before it is confident to go to the battlefield against coronavirus.

And now Pfizer and others are developing a third shot- called a booster. What is that? That is simply because the coronavirus is changing certain lines of the poem or adding new stanzas. We don’t need to memorise the poem from scratch, only memorise the amended couplets.

Are two shots, two repetitions, enough? Well, if we were to take a Moderna shot eight or ten times, certainly its imprint on our body’s memory will be fantastic. But the whole world will be working only in the vaccine business. Pragmatically, two is the number currently decided, particularly because the virus may keep changing the stanzas in the poem.

What about the gap between the shots? The second shot must be given before the first is forgotten. Four weeks is that point as determined by scientists. Of course, it can be delayed, and delayed, but who knows at which point the first shot is forgotten.

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How is it that several childhood vaccines are taken only once, and the effect lasts for life? That is an important question with relation to covid vaccines. The world of science is trying to grapple with “vaccines for adults”, which is not a norm.

I don’t remember a single line from the play enacted twelve years ago. But I flawlessly remember my childhood poetry more than forty years later. Can this be done for covid? Will the scientists be able to develop an infant coronavirus vaccine that will protect a child lifelong? That is the question.

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Ravi 

Corona Daily 133: The Balmis Expedition

P.S. By way of postscript to yesterday’s piece, all vaccine-afflicted people mentioned in it are miraculously back to normal today. The immense readers’ response, apart from good wishes, mentioned their own post-vaccine experiences that ranged from no effect to becoming vegetables for a day or two. No reader has reported two bad shots so far. One kind reader has sent a link that says reactions after the second dose of AstraZeneca/Oxford’s are milder. Thanks to all.

For the record, my vaccine after-effects began 12 hours after the shot, lasted for 36 hours (i.e., 48 hours from the shot). In our domestic experiment, my wife and brother took Dolo (paracetamol tablets), I didn’t take any. That made no difference whatsoever (except to the Dolo sales). For those waiting for their first shot, I suggest budgeting 48 hours of inactivity after it.

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A year ago, I wrote about Smallpox, one of the deadliest viruses that killed eight European kings and queens. In the sixteenth century, Spain actually sent an infected African slave to spread smallpox to defeat the Aztec and Inca empires. In today’s world, we would call it bioterrorism. The Aztec population of 26 million before the Spanish conquest (1520) was reduced to 1.6 million (1620). (If conspiracy theorists were to study that history, they may believe China did the same in 2020 to defeat America and Europe.)

In 1797, Edward Jenner, the English scientist, used pus from blisters due to cowpox, a relatively minor infectious disease, to offer immunity against smallpox. Jenner coined the term vaccine from “vacca”, Latin for cow.

King Carlos IV was the king of Spain then. His brother and sister-in-law had succumbed to smallpox. It was a difficult time for Europe. Napoleon had invaded Spain; Nelson had defeated French and Spanish armies at Trafalgar. Still, the compassionate Spanish King decided to send a warship to vaccinate people from different continents for smallpox.

But how to carry the live virus around the world to vaccinate millions? We must remember this was a time when there was no refrigeration, no sterilization, and no concept of asepsis. A decision was made to bring to the project 22 orphaned children, aged between eight and ten. In November 1803, Maria Pita, a warship sailed on its global expedition. It was led by Francisco Xavier de Balmis, an enthusiastic physician, world traveller and one who had translated a book on vaccines in Spanish.

Before the warship sailed, Balmis infected two orphans with cowpox. By passing of vesicle fluid from the skin of one child to another, it was decided to form a living transmission chain. Over the next four years, the infection was kept alive by carefully transferring it from boy to boy, in the process inoculating hundreds of thousands of people from Peru to Philippines.   

In February 1805, when the ship planned to leave Mexico for Philippines, 25 orphaned Mexican children were recruited as human carriers. The orphaned children from Spain stayed back in Mexico.

The orphan story tells us about a basic truth. Creating vaccines is a job for biology, and biology requires living systems. That is why some flu vaccines are cultivated in eggs.

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The territory covered by the Balmis expedition was not only vast, but brutally harsh, with dense jungles, mountains, and uncharted rivers. They encountered political rivalry, tribal attacks, cultural beliefs preventing vaccination attempts. The mission took the vaccine to the Canary islands, Columbia, Ecuador, Peru, Mexico, the Philippines and China.

King Carlos IV’s vaccination campaign was visionary, launched 150 years before the formation of the WHO. Balmis expedition was successful due to the heroic perseverance and dedication of those who took part in it, the creativity to use human carriers, and the orphans who served humanity in this way. In A Coruna, a Spanish city, a monument (picture above) is built in honour of the orphan children who took part in the expedition.

Ravi 

Corona Daily 134: First Hand Experience

I am writing today’s column on my reserves. It was a struggle to get up from bed, and reach my computer chair. My body is aching. Last night was awful. An uncontrolled shivering attack meant I went to bed wearing a jacket, enveloped in a duvet. I lost count of how many times I had to visit the bathroom. My fever is about 101 F (38.5 C). Haven’t measured it, but I know because my wife, my brother, my neighbours, and a couple of friends have 101 F. No, none of us has covid-19, I don’t think. This is sort of self-inflicted. This week, India made 45+ eligible for vaccines. We all took our Oxford shot (called Covishield in India) yesterday, and are in bad shape today.

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There is nothing like a first-hand experience (or first-arm experience). You can spend hours and weeks studying everything on the coronavirus. But nothing can match empirical evidence. Yes, my left arm is sore and sensitive. During last night’s sleep, I was like a circus acrobat, trying to avoid leaning on that arm.

Honestly, despite my year-long research, I was not prepared for this. My parents in their eighties had no after effects. They have had both their shots. If they didn’t suffer, how can a marathon runner like me suffer? Well, it seems science is exactly the reverse of common sense.

Younger people with higher immunity suffer more. Because their bodies start fighting the vaccine with all their strength. Elderly people, their immunity weak with ageing, report few side effects. In short, I am supposed to feel happy for my flattened state. If I am bad, my immunity system is good.

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Are the side effects worse if you already had Covid-19? It appears so. My brother was under house arrest for five weeks last August-September. He had symptoms for about ten days, but his tests continued to be positive. Of all of us, he is in the worst state. He says he is almost in the same physical condition today as he was when he contracted Covid-19 last year.

Because my wife, neighbours, friends and I have fatigue and fever, scientists say it is possible we have had covid-19 without knowing.

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Dr D.V., our family friend is 59. As a doctor, on priority basis, he was fully vaccinated. This week, he has tested positive, is feeling terrible, has all the symptoms. For the next two weeks, he is to be isolated. Dr D.V. is an ENT (Ear, Nose, Throat) doctor. That may make social distancing difficult. But his case shows that fully vaccinated people can still contract covid-19, and presumably spread it as well. Two vaccine shots offer no guarantee it won’t happen again. Scientists say full vaccination reduces the chances of hospitalization and death. Until we collect enough evidence to support that, better to continue life as if we haven’t taken the vaccine.

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There is still some confusion in India about the gap between the shots. It was meant to be four weeks. Now Covishield (Oxford) gap can be stretched up to 56 days. Covaxin (Bharat Biotech) up to 42 days.

Britain took a pragmatic and unscientific decision to give first shots to a lot more people by widening the gap between the doses. Luckily, it has worked for them. Top epidemiologists insist the gap should be whatever it was in the trials. (Four weeks for Oxford). If you ask me, take the second shot after 28 days. Cowin, the government website, allows it. My parents took their second shot yesterday after 28 days.

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When I browsed the internet to find out how long my misery would last, it says “a few days”. What on earth is meant by a few days? Why can’t they specify the exact number of days? Anyway, now I will be able to know empirically.

In my research, I came across the following: The Covid vaccine side effects, especially after the second dose, can be really bad. That immediately lifted my spirits. What I am experiencing today is not as bad as what will follow after four weeks.

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Ravi 

Corona Daily 135: Her Vogue Outfits

For La Verne Ford Wimberley, the coming Sunday will be the second Easter Sunday when she will attend the church service virtually.

La Verne from Oklahoma is 82, a widow living on her own since 2009. She is formally referred to as Dr Wimberley. Holding a doctorate in education, she was a school principal for many years.

For more than twenty years, she has been going to the Metropolitan Baptist Church on Sunday mornings. She had picked up a little routine from her mother. On Saturday evening, she would choose a nice outfit and a matching church hat and lay it out. She wanted to be prepared and presentable before going to the church. She always sat in the last row, section two, dressed to the nines.

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On 29 March 2020, Le Verne learnt that the Sunday mass would be streamed online due to the coronavirus threat. She couldn’t imagine herself wearing her gown and slippers to attend the service on screen. ‘Oh my goodness’, she said to herself, ‘I can’t sit here looking slouchy in my robe.’ That Sunday, she woke up early as always to style her hair, put on some lipstick and wore a favorite white dress trimmed with eyelets, a pure white ruffled hat, matching shoes and a beaded turquoise and gold necklace.

On a whim, after the service, she took a selfie and posted it on Facebook.

The following Sunday she was all blue, and on Easter Sunday last year, she chose a pink skirt, a beaded sweater jacket, and a hat decorated with pink and yellow lilies.

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She started dressing up every Sunday, and posting her selfies. She kept a calendar so as to never repeat an outfit. (Clever, because in photos it is easier to notice someone repeating an attire). On the previous fifty-three Sundays, she has worn fifty-three different outfits, all coordinated down to the smallest detail. Her fashion includes a variety of hats with huge bows and ribbons, statement jewelry, matching shoes, pearl necklaces, lipstick, tidy hair.

Le Verne is no Princess Diana, but her outfits are tasteful and diverse. On social media, her outfits started receiving hundreds of comments, positive. The photos made them smile. She said she wanted people to focus not on the selfies but on the message that her fellow churchgoers should keep faith. She wished to inspire people and make them feel good. On her facebook page, so many strangers wrote their spirits were boosted seeing her enthusiasm and optimism.

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Recently, she was interviewed by the media. People notice she hasn’t repeated an outfit for an entire year.

Le Verne said being 82 years old had its advantages. She has been buying clothes for many years, and she has kept most of them because they are of good quality. She has three wardrobes and a collection of church hats, neatly placed in hatboxes.

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I have a group of international friends covering the global map all the way from America to Australia. All of us studied Russian language together at a Moscow university. On one Sunday every month, despite awkward timings for some, we gather on Zoom and spend a delightful couple of hours.

After reading the story of Le Verne, I have decided to wear a suit, tie and shoes for the next meeting. If I make this suggestion to my friends, I think most of them will be tempted to dress up as well. It is time to come out of the wretched sweatpants and t-shirts. The theatre comes alive only with the right costumes.

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Ravi 

Corona Daily 136: The Worst Pandemic Leader

Which world leader has the worst pandemic record? In yesterday’s Washington Post, Frida Ghitis, a columnist, analyses this interesting question.

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Anyone who didn’t vote for him would think of Donald Trump as a candidate. USA has had 31 million cases, over half a million deaths. With an estimated 3.2 million American deaths, 2020 was the deadliest year in American history. This week Dr Deborah Birx, the former White House Coronavirus Response Coordinator, said only the first 100,000 deaths were unavoidable. (Meaning the next 400,000+ were avoidable). It may be an exaggeration, but America was truly unfortunate in having Trump as the pandemic president. He justified his behaviour by calling himself a cheerleader, when there was little to cheer about.

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When other countries were announcing lockdowns, Nicaragua’s Daniel Ortega organized a festive parade called “Love in the time of Covid-19”, a parade as surreal as Marquez’s novel. His son tweeted Nicaragua was a unique country and asked the citizens to enjoy life as usual. Months later, Nicaragua published a white paper comparing their strategy with Sweden. If you want to criticize Nicaragua, criticize Sweden first.

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I have written earlier about Brazil’s Jair Bolsonaro. He called it “little flu”, to which Brazilians were immune anyway. He coughed in the crowd and shook everyone’s hands to rubbish the social distancing concept. Stop whining, he said to people who pointed out the terrible pandemic toll. Bolsonaro militarized the government, an Army general is his health minister. He is the world’s only leader to use military to oppose lockdowns. Brazil’s supreme court equated his covid policies to genocide. This week heads of the Brazilian army, navy and air force resigned. Brazil is currently the worst placed nation with nearly 4000 deaths a day, and a near collapse of health care. It is also serving as an epicenter for Latin America.

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Mexico’s Andres Manuel Lopez Obrador rejected masks. He also asked people to live life as usual. He promised he would wear a mask only when Mexico is free of corruption. This week, Mexico officially admitted their covid death toll is underreported by 60%. Mexico’s new tally of 321,000 dead suddenly puts it in the second place jointly with Brazil.

Belarus’s dictator Alexander Lukashenko called the whole thing a “psychosis”, and suggested vodka and sauna as the definitive cure.

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Berdimuhamedow’s Turkmenistan has reported no cases, because reporting cases is banned. Mask-wearing is banned, discussing the pandemic is banned. Masks can be worn voluntarily to protect against “airborne dust”. The website of the US embassy in Turkmenistan mentions reports of people with covid-like symptoms placed in hospital quarantine. A human rights group calls the situation in Turkmenistan a disaster. The government’s denial prevents sick people from getting proper treatment or doctors from having the basic knowledge to treat them.

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Tanzania’s John Magufuli belonged to the covid-denial group. He assured the nation that three days of prayer eradicated the virus. The virus was a western hoax and couldn’t survive in Christ’s body. He suggested steam inhalation and traditional herbal medicines.

Trump, Bolsonaro, Lukashenko and most other leaders in this article were infected despite their displayed masculinity. If you have wondered how no political leader dies, well, Tanzania’s president did. Two weeks ago, on 17 March, the 61-year-old Magufuli died, with covid-19 as the suspected cause.

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Who wins the prize for the worst pandemic leader? In my view, it is a tight race between Trump and Bolsonaro, because USA and Brazil are, or are supposed to be, democratic countries.

USA was the best prepared nation for the pandemic. USA has a fearless media, world’s best epidemiologists, and strong financial muscle. Despite all that, the bull-headed Trump managed to bring America to its knees and thousands of Americans to graveyards.

My vote goes to Donald Trump.

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Ravi