Corona Daily 241: Two Yellow Cards – UK’s Allergy Warning

UK has a wonderful “Yellow Card Scheme” since 1964, where any adverse reaction to a drug or vaccine can be immediately reported. Earlier done through actual yellow cards, now it is online. Yesterday, two Pfizer vaccinated NHS workers reported an anaphylactoid reaction, which may cause a skin rash, breathlessness and a drop in blood pressure. Both vaccinees had a history of allergies. UK has now advised people prone to severe allergies to avoid the vaccine. The advice also requires vaccine facilities to have resuscitation measures available.

This has caused concern in the minds of those planning to get the vaccine, and a sadistic joy to the anti-vaccine crowd. This analysis will show why the concern is unfounded.

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Most drugs and vaccines have side effects. The decision for any medical intervention is based on the risk-benefit analysis. Chemotherapy drugs that cause exhaustion, hair loss, anemia, infertility, sleep problems are an extreme example. This known debilitating impact is weighed against possible survival from a terminal cancer.

Vaccines prevent, rather than cure, diseases. Here we must weigh the risk of contracting Covid and dying from it versus the vaccine risks. In the last eight months, nearly one person out of 1000 has died of covid in the USA, UK, Italy or Spain. (In India, one out of 10,000). If you belong to a covid vulnerable group, the probability of death is much higher.  

Against that, the 95% effective Pfizer vaccine reports injection site reactions (84%), fatigue (63%), headache (55%), muscle pain (38%), chills (32%), joint pain (24%) and fever (14%).

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To help your decision on the Pfizer vaccine (in case you can get it), I offer two documents that discuss your eligibility.

The first is the Pfizer protocol where they clearly state who is excluded from the trials. (Pages 37-40). The second is a fresh document. It will be used later today in the FDA meeting to discuss the Pfizer vaccine approval in the USA. (Pages 48-49).

Pfizer protocol clearly excludes: “Those with history of severe allergic reaction (e.g., anaphylaxis).

Without any medical knowledge, it is common sense that categories excluded in the vaccine trials must be excluded from vaccination. The UK regulatory authorities botched this up. The two NHS workers were not eligible (they carried adrenaline pens on them, meaning they were known severe allergic cases). Before vaccinating, it is the duty of the health authorities to ensure the person qualifies for the shot.

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Who else is not eligible?

Mainly anyone below 16 years of age, pregnant or breastfeeding women and immunocompromised people. AIDS patients, for example, have their immunity compromised. In case of doubt, make sure with your doctor you are immunocompetent rather than compromised. The protocol excluded some more: those with a psychiatric condition, suicidal behaviour, prone to prolonged bleeding. Pregnancy is such a sensitive issue that participants needed to promise not to get pregnant, by following highly effective contraception consistently and correctly.

Pfizer hasn’t revealed its vaccine recipe. But we know many flu vaccines contain egg proteins. Those severely allergic to eggs are advised not to take a flu vaccine.

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I will give you two more bits of news from the Pfizer report. Six participants died since the start of the trial, two from the vaccine group and four from the placebo group. This is not a concern, because in very large trials some people are going to die as a matter of natural course. If the UK is giving vaccines to people over 90, some may die in a matter of weeks after receiving a vaccine. Let that news not bother you.

Pfizer also found that four vaccinated participants developed Bell’s Palsy, a temporary facial paralysis. This again can be a chance event. Surprisingly, between April and July, Mumbai and Bangalore reported many cases where Covid-19 had caused Bell’s Palsy.

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In short, if you are older than 16, not pregnant now or in near future, your immunity is not compromised, you don’t suffer from a serious allergy, you can go ahead and get vaccinated.  The risk is worth taking.

Ravi 

Corona Daily 242: Can We Be Forced to Get a Covid Vaccine?

Can democratic nations make covid vaccinations mandatory? Does such a mandate clash with the concept of individual liberty? Are we the sole judge of what can be done with our bodies or can the state legislate to stick a needle in them?

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So far, only the governor of Sao Paulo has announced he will vaccinate all 45 million residents through a legal mandate. Brazil’s president Bolsonaro, a Trump twin, is against. But Bolsonaro forgets that in February Brazil passed emergency legislation that allows mandatory vaccination. The Sao Paulo governor doesn’t yet have the vaccine, but the Chinese coronavac is a top contender.

In 1904, Rio de Janeiro was in the grip of a smallpox epidemic. Sanitary workers accompanied by the police were authorized to enter people’s homes to vaccinate them. People rioted, with a few dozens killed. This was known as the Vaccine Revolt.

A couple of years before that, Massachusetts had adopted a law to make smallpox vaccination obligatory. Failure attracted cash fines. The courts upheld the mandate by dismissing the challenges.

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Democratic nations currently may have compulsory vaccination in three areas. (a) School going children (b) military and (c) healthcare workers.

American laws require vaccination for students. In France, parents can be punished if children miss vaccinations. India relies on ancient British laws, and certain state laws. Where acceptance is widespread, vaccines appear to be voluntary.

US military troops must be immunized against tetanus, diphtheria, hepatitis A, polio and other diseases. Hospital doctors and staff may be required vaccination against pertussis, chickenpox, measles, mumps and rubella.

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Let’s talk specifically about the Covid-19 vaccines.

First, until FDA and other regulatory bodies issue a full licence, a vaccine can’t be made mandatory by the State. Vaccines given an EUA (Emergency Use Authorisation) are considered investigational. Their long-term impact is not known. It may take a few years before any Covid vaccine gets a full licence. In the past, Anthrax (2005) vaccine has been the only one where the FDA had issued an EUA.

Secondly, unless vaccines are widely available, they can’t be made compulsory. Again, until 2022, it is not certain the vaccine supply will be able to meet the population size.

Thirdly, children and pregnant women have not been included in any trials. An EUA can’t allow untried sections of the populations to be vaccinated.

Fourth, the cost of the vaccines. Unless they are supplied free of cost or very cheaply, a government doesn’t have the moral ground to make the covid vaccine mandatory.

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There are ways, though, to make vaccines mandatory without passing laws. Qantas, the Australian airline which calls itself the safest airline, has announced vaccines will be mandatory to fly Qantas. This is not fantasy. Today, to board an Emirates flight to Dubai, all passengers must present a negative Covid-19 test certificate. When my family went to Kenya on vacation, all of us had to queue up to take a yellow fever vaccine, with a document to prove it.

Employers have the right to make vaccines mandatory for employees. To be fair, in such a case the employer should sponsor the vaccines. In 2001, when I worked in Poland, my employer had arranged a drive in the office for an influenza vaccine. People generally don’t resist vaccine mandates by those who give them monthly paychecks.

Depending on the length of the pandemic, and vaccine availability; sports stadiums, music concerts, cinemas, restaurants can all require a “COVID-19 vaccine certificate” for entry. The Indian biometric ID, Aadhar, issued to 1.3 billion Indians, is legally not mandatory. But without it, Indians can’t open bank accounts, buy sim cards, execute agreements, buy or sell apartments.

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I hope by 2022, the world will be reasonably free of the coronavirus. I don’t really fancy the idea of carrying a vaccine certificate to attend a music concert.

Ravi 

Corona Daily 243: Dummy Parachutes

At 06.45 UK time this morning, 90-year-old Margaret Keenan became the first person in the West to receive a covid vaccine. The UK government has decided to prioritise 80+ year old patients in the hospitals. Just by way of trivia, the second recipient was an 81-year-old male named William Shakespeare. This is not English humour.

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Last week, Moderna published the interim results of its trials. Out of the 196 corona positive cases, 185 were in the placebo group, only 11 in the vaccine group. (Which makes the vaccine 94.1% effective). All thirty severe cases were in the placebo group. None in the vaccine group. There was one covid-death among the volunteers. It occurred in the placebo group.

As you know, half of the participants are delivered a real vaccine, the other half a placebo. The double-blinded trials don’t let the participants or the medical staff know who has got what.

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Placebo is a major ethical issue in medical science. Though administered with the volunteer’s informed consent, it is essentially deception. When no drug or vaccine exists, such altruism is justifiable in the name of the greater good. What happens when an effective vaccine exists?

It’s almost certain the Moderna volunteer would have been alive today had he received a vaccine instead of a placebo. But neither Pfizer nor Moderna had published their results when he/she died. So, that can be attributed to bad luck. The trials will continue for the next two years to assess long-term effects. Not only that, more than 75 different vaccines are conducting trials, injecting thousands of volunteers with salt water or some other dummy shot. Like the Moderna participant, some placebo recipients may die in the future.

This has posed a huge dilemma, currently being debated in the scientific world.

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The position of ethicists is clear. Once a successful vaccine exists, it is unethical to give a placebo to anyone. The placebo recipients should be unblinded, vaccine shots given to protect them. This is a reward for the risk they took. No participants in future trials can be given a placebo, once an effective Pfizer, or Moderna or some other vaccine exists.

Which, in effect, means all trials worldwide should be halted with immediate effect.

Moncef Slaoui, the chief advisor to Operation Warp Speed, in fact, said the trial participants (meaning placebo group) should be the first in line to be vaccinated. Pfizer had 44,000 and Moderna 30,000 participants in the USA, collectively 37,000 placebo recipients. Ethically speaking, they should be the first 37,000 people (74,000 doses) vaccinated. But with vaccine scarcity, this is not mentioned in any of the US plans.

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Two professors from the University of Lethbridge are opposed to the concept of placebo. They offer an analogy with parachutes. If during wartime, a new type of parachute is urgently needed, sooner or later it must be tried in a real jump. We won’t let that happen until we are quite sure of its safety. And certainly, we will not give dummy parachutes to a randomly selected control group of volunteers.

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The World Health Organisation deliberated over this dilemma and issued a verdict: While vaccine supplies are limited, and the vaccines are investigational, WHO considers it ethically appropriate to continue the blinded follow-up of placebo recipients as well as new recruitment for vaccine/placebo trials. Trial sponsors are not obliged to reveal to any volunteers if they received a vaccine or a placebo.

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WHO was alarmed at the prospect of stopping trials. The long-term effects of the vaccine are unknown, so running them for another two years is essential, even if that means a few deaths among the placebo recipients.

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I will make an unscientific suggestion to continue the trials. The trial sponsor can invite anti-vaccine volunteers and give them a placebo. Give the vaccine to those who believe in a vaccine. In that case, if the placebo recipient dies of covid, there is no ground for complaint or regret.

Ravi 

Corona Daily 244: The Tuskegee Experiment

Barack Obama, George Bush, Bill Clinton and Joe Biden have offered to get vaccinated on live TV to inspire confidence in the COVID-19 vaccines. This is not new. In 1956, the Salk vaccine against polio had just been invented. Teenagers, vulnerable to the crippling disease, were reluctant or indifferent to getting a shot. To solve that problem, Elvis Presley took a Salk Polio vaccine jab on a popular TV show.

Last year, WHO listed ten major global health threats. They included climate change, cancer, HIV, a pandemic; also, “vaccine hesitancy” – distrust towards vaccines. Drugs are usually given to the ill, vaccines administered to healthy people. That makes the reluctance stronger. Scientific data suggests two to three million deaths are prevented every year due to vaccinations. If all people were to trust in vaccines, annually another 1.5 million deaths could have been prevented. Smallpox has been eradicated, and polio nearly extinct.

Usually, certain historical reasons exist for strong anti-vax feelings.

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In the Covid-19 pandemic, in the USA, a disproportionately large numbers of Blacks are infected, hospitalized and dead. As compared to Whites; Blacks (and Latinos) are hospitalized four times more, and dying three times more. Among the younger age groups, the difference is wider. It’s possible many African Americans work in front line and essential jobs, exposing themselves more. They have high rates of diabetes, hypertension and obesity. It is obvious the vaccines are necessary and will be more useful for the black community. And yet, for the vaccine trials across USA, only 3% of the people who signed up were black.

“I won’t be used as a guinea pig for white people.” One black man declared.

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In 1932, in the state of Alabama, the US Public Health Service started an experiment called TSUS (the Tuskegee Study of Untreated Syphilis in the Negro Male). From the Tuskegee community, 600 poor black men were chosen. 399 of them had the sexually transmitted disease - syphilis. The control group had 201 men who were not infected. They were told the experiment would last for six months. In reality, it lasted for forty years, until 1972.

Those who ran the experiment, white men, wanted to see what course nature takes if the syphilis patients are not given any treatment. The black men were promised free medical care, but were never told about the diagnosis, nor the risk of infecting others, nor the fact that the disease could affect a variety of organs and lead to death. Participants were subjected to blood draws; spine taps and finally autopsies. They were told they were being treated for “bad blood”. Penicillin was available from 1947, and could have cured many of the infected men. The participants were never told about penicillin.

By 1972, only 74 subjects were still alive. Of the original 399 men, 28 had died of syphilis, 100 of related complications, 40 of their wives were infected, and 19 of their children were born with congenital syphilis.

The unethical and deadly forty-year experiment was one of the most appalling examples of medical exploitation.

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The other example is more recent. In 2011, to locate Osama Bin Laden in Pakistan, the CIA ran a fake vaccination clinic. A Pakistani doctor announced a free hepatitis B vaccination campaign in Abbottabad. The real purpose was to see if a DNA sample could be obtained from anybody from Bin Laden’s family. The doctor is now serving a 33-year prison sentence.

Worse, the distrust in vaccinations grew. Islamist preachers and militant groups in Pakistan and Taliban suspect vaccination is a plot to kill or sterilize Muslims. Vaccinators are attacked and sometimes killed.

This is the key reason why polio now exists in only two countries – Pakistan and Afghanistan.

Ravi 

Corona Daily 245: The Sputnik-V Story

Yesterday, Russians finally received a dose of good news. Just like Russia had won the vaccine race, it became the first nation to start vaccinating its citizens. Russia’s daily cases (25000+) and daily deaths (500+) are setting new records every day. These are official, rather than actual, figures. In the spring itself, the federal government had directed local authorities to classify deaths as resulting from heart disease, HIV, or other conditions that may have been made worse by coronavirus, rather than list covid-19 as the cause of death.

Sputnik-V is a great brand name reminding the old generation of Russia’s superpower status in the 1950s. The vaccine has been pronounced as 95% effective, based on 20 cases. The data hasn’t been published or shared. The phase III trials continue. They will end in May or June 2021. But vaccination began in Moscow yesterday.

Dmitry Kisilyov, the TV anchor (Russia’s Sean Hannity or Arnab Goswami) said: “Sputnik-V is like a Kalashnikov, simple and reliable.” I would say this is a rather unfortunate comparison given the outcome of using a Kalashnikov.

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Russia wishes to compete with China on vaccine diplomacy. It says it has orders for 1.2 billion doses from 50 countries. Sputnik-V is free for Russians. Foreigners will pay less than $20 for two doses. Cheaper than the Western vaccines.

In July, Russia announced it will produce 200 million doses by December 2020. In September, this was reduced to 10 mn. And the latest estimate is 2 million.

There is a further complication. The two doses need to be given with a gap of 21 days. It seems the two adenovirus doses have different compositions – the first based on serotype 26, second on serotype 5. Technical problems have developed in producing the second dose. But few Russians were injected with the first dose yesterday. It is hoped the production problems with the second dose will be resolved before the second dose is due. Now the authorities have said 21 days doesn’t really mean 21 days – it can be anywhere between 21 days and 50 days. (Meaning they think the problem may take up to fifty days to resolve).

Tatyana Golikova, the deputy Prime Minister, delivered another shock in her announcement. There is a long list of those who are not eligible to get the vaccine – people with a heart condition, tuberculosis, hepatitis, syphilis etc. In the west, elderly are the priority. In Russia, eligibility is restricted to between 18 and 60 years of age.  Golikova said it would take 42 days after vaccination to develop immunity. During those 42 days, the vaccinated person must wear a mask, avoid crowds – and not drink alcohol. This instantly made the entire Russian male population join the anti-vaxx movement. Forty-two days sobriety is an inhuman requirement.

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Sputnik-V needs a constant minus 18 C temperature. Unless vaccination is exclusively carried out in the Siberian winter, this requires special freezers. The plans for transport or storage are not clear. The problem is solved for the moment because the production for the foreseeable future will be so low, it can be entirely used in Moscow, where freezers are available.

In Soviet times, the drugs and vaccine production happened in the Baltic republics and Hungary. Russia has not registered a single drug or vaccine in the EU or USA. It has some experience of developing, but not production. Some of the production lines are from Soviet times, manufactured in a country that no longer exists. Production for trials is not the same thing as production for mass vaccination. Russia could outsource production to India, as they plan to, but Indian companies will not touch the Russian vaccines until they fulfill the American and European orders.

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This narration should make the Russians happy. It shows there is little possibility of having to abstain from drinking for forty-two days.

Ravi 

Corona Daily 246: China’s Efficient Vaccine Approval Process

The media is currently buzzing with talk of approvals for Pfizer, Moderna and AstraZeneca vaccines. But much before that, in July, “Coronavac”, a vaccine by the Chinese company “Sinovac Biotech” was approved for limited use in China.

Beijing based Sinovac was the first company to conduct SARS vaccine clinical trials (2003). it was also the first to develop a swine flu vaccine (2009). Yin Weidong (in picture), 56, its founder and chairman, started his career in the early 1980s at a public health unit. On his first day, he was assigned to a group investigating hepatitis outbreaks. After spending two decades in working on preventing liver disease in rural China, he founded Sinovac in 2001. Sinovac prefers the traditional method of using an inactivated virus. Not fancy like the Pfizer vaccine, it can be mass produced, easily stored and distributed. In September 2020, Yin Weidong stated his ambition of applying to the US FDA for approval, and supplying coronavac around the world, including the USA and Europe.

Will he succeed in that ambition?

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To answer this question, two written judgments issued by Beijing’s no.1 Intermediate People’s Court may help. The criminal case judgments are called “Hongzhang Yin’s Acceptance of Bribes” and “Guo’s Acceptance of Bribes”. Yin Hongzhang was in charge of approving drugs and vaccines. Guo is his wife.

That story begins in 2002, a year after the founding of Sinovac. Yin Hongzhang told Yin Weidong he wanted a car. Sinovac made a $15,200 cash gift to enable him buy a car. A few months later, Healive hepatitis A vaccine, Sinovac’s first flagship product, was approved for sale.

In 2006, Hongzhang’s wife Guo wished to furnish their new apartment. Yin Weidong gifted $7600 to sponsor the furnishing. When Weidong visited the furnished house, he gave the couple another $15,200 in cash for housewarming. During that period, Sinovac gained approvals to sell influenza, avian flu and swine flu vaccines in China. Swine flu vaccine was the fastest, launched six months after the virus was first detected in Mexico.

In 2011, Yin Hongzhang asked Yin Weidong for a “loan” of $45,600 to buy a villa in Beijing’s northern outskirts. This time Weidong used a middleman who handed over the cash to the couple in a hotel lobby. Guo admitted the thought of returning the loan never occurred to them.

Yin Hongzhang was sentenced to 10 years in prison and fined 500,000 yuan ($72,000). His wife and son were also sent to prison. Hongzhang admitted to receiving cash bribes as well as ivory products to speed up vaccine approvals.

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Yin Hongzhang was fortunate. Earlier in 2007, China had executed Zheng Xiaoyu, the Head of China’s Food and Drug Administration. During Zheng’s tenure from 1998 to 2005, he had approved six drugs that turned out to be fake. One approved antibiotic was contaminated and killed at least ten people.

It is possible the Sinovac vaccines are good, thereby sparing Hongzhang a death sentence.

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Yin Weidong, the head of Sinovac who had bribed his way to speed up the vaccine approvals was not charged by the courts. “How could I refuse demands for money from a regulatory official?” he said in his testimony. The impeccable logic of the question and his cooperation in divulging the precise amounts and dates of bribing meant he was adjudged an innocent man. He continues to head Sinovac.

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In a boardroom scandal, minority shareholders of Sinovac tried a coup to overthrow Yin Weidong. The coup was unsuccessful. However, following that attempt, Nasdaq, the US stock exchange, has frozen Sinovac shares since February 2019. Even if Sinovac were to become a roaring success, the price of its frozen shares will not alter.

Coronavac has been actively marketed in poor countries. When there are no options and a pandemic is raging, you take what you get. In any case, Sinovac is unlikely to face hurdles in getting speedy approvals.

Ravi 

Corona Daily 247: Hackers - Vaccines, Hospitals, now the Cold Chain

Yesterday, IBM’s cybersecurity issued details about a sophisticated, coordinated hacking campaign to penetrate the vital “cold chain” for the vaccines. The attackers were working to get access to how the vaccine is shipped, stored, refrigerated, and distributed.

In September, I had reported about Chinese and Russian hackers trying to steal vaccine technology. In October, hackers attacked American hospitals asking for ransom in many cases. Now the latest discovery finds hackers interested in the cold chain.

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Haier Biomedical, a Chinese company, is perhaps the world’s only complete chain provider. The hacker impersonated a business executive from Haier, and sent phishing emails to organisations connected with the covid-19 cold chain. The email said “we want to place an order with your company”, and included a draft contract. Haier biomedical is a reputed and legitimate company in this business, so most recipients believed the emails. The draft contract contained malware that would give the hackers access to the network.

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This is a well-planned attack with targets chosen systematically and thoroughly. They included the European customs, something that can impact 27 countries. Energy companies providing solar panels were targeted. The solar panels would provide power for the cold chain in places where electric supply is not reliable. The hacking attack was launched in six countries. Along with vaccine manufacturers; website, software and internet security solution sectors; UNICEF which is planning delivery of vaccines to poorer countries were also targeted. The vaccine alliance’s CCEOP (Cold Chain Equipment Optimisation Platform) was a targete. The scale and coordination make security experts believe there is some State behind these attacks. The same experts rule out China, because it is unlikely the Chinese hackers would impersonate a Chinese company.

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What could be the reasons for the hacking?

It could be stealing of useful information – theft of intellectual property. Criminals may want to illegally obtain a hot black-market commodity; vaccines are likely to be scarce for at least six months. Ransom is a popular motive. The hackers can lock up the distribution network, or the energy supply, and ask for huge money to unlock it.

Or it could be pure evil – disruption and sabotage. A similar motive as of those who fly airplanes into tall towers.

Considering the threat, FBI officials also issued a warning yesterday.

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American media mentions North Korea and Russia as probable suspects, without any proof yet. We may think of North Korea as a backward nation, but in cyberattacks it is well advanced. They have been blamed for some of the most daring and damaging attacks, including the hacking of emails from Sony Pictures in 2014; theft of $81 million from the Central Bank of Bangladesh in 2016 and unleashing the Wannacry ransomware virus in 2017. Russia is a suspect because there was some evidence in the hacking of vaccines and attacks on the hospitals.

The attacks on American hospitals continue. Six hospitals in the Vermont health network were attacked. Griffin hospital in Derby had a major ransomware incident. Cyberattacks on America’s health systems have become a pandemic of its own kind. Why don’t we see too many reports? Because in many cases multimillion-dollar ransoms are demanded. It’s like family members not going to the media after kidnappers demand money to release hostages. For fear of losing reputation and patients, hospitals are trying to resolve the issues without making too much noise about it.   

In keeping with his character, Trump has complicated matters by sacking Christopher Krebs, the director of CISA, the cybersecurity agency responsible for defending critical systems, including hospitals and elections against cyberattacks. Mr Krebs disputed Trump’s absurd claims of voter fraud.

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Within the war against the coronavirus, there are several battles that need to be fought.

Ravi 

Corona Daily 248: An Online School Student Speaks

This week, I interviewed a 17-year old student M, who spoke on condition of anonymity. I was keen to know the student’s experience of online school and exams.

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-        First feelings on hearing about classes shifting online, in March.

M: I was excited because I hadn’t done online school before. I thought it would be fun. Also, because I would save two hours commute every day, but our year-end exams were due and I was a bit stressed because I didn’t know how they would be conducted.

-        More independence as a result of shifting online?

M: Not really. Many teachers become paranoid about kids bunking classes or cheating in the exams. They become authoritative and restrictive. The cameras must be on all the time. To go to the washroom in your own house, you have to ask the teacher. Some teachers give me my own time- to work asynchronously. But not all, varies from teacher to teacher.

-        Benefits and downsides.

M: I get more time to myself. With no commute, I can do more things outside school hours, which I really like. Talking of downsides, sitting in front of the screen for eight hours is really exhausting. Teachers become paranoid and give us more work, without realizing we have eight subjects. In normal times, they have an eye on each of us. Teachers see what we’re doing in the class. Not having that rapport with my friends is something I really miss. Each of us has different relationships with different classmates. Online school has changed the class dynamics. In a class like English, there are always lots of jokes going around. I miss that liveliness.

-        On exams that were conducted online.

M: Online exams have made the playing field more uneven. Some teachers opted to ignore students who were cheating. I could see some students using their phones, calling friends. That is frustrating for students like me who don’t cheat. The pressures are different. You are not in the exam hall, not sitting in a school uniform.  

-        On technical difficulties.

M: Fortunately, absolutely none. But it’s a great excuse. (smiles). If you want to disappear from class, you can always blame it on the WiFi connection.

-        On millions of Indian children studying on their smartphones.

M: Fortunately, I have a laptop. But school on the smartphone is a real challenge. Not only the screen size, but a laptop is different. We use our phones to text, to take pictures, to listen to music, and just that makes our phones overheat. The battery runs out. I can’t imagine zoom calls and submissions through a phone. Schools should be more accommodative if they know students don’t have laptops.

-        How do students cheat on exams?

M: Extensions, multiple devices, blurring zoom screens or google meets. We give exams on exam.net, a special platform. It doesn’t allow you to leave the screen during exams. You can’t press escape. You can’t switch screens. I’ve heard some students split screens between two windows. Also heard about “exam.net hack”, a software that has become popular worldwide in the last couple of months.  Don’t know how it works, but schools are now banning it.

-        Would you like to keep elements of online school post-pandemic?

M: We are still being treated like we are in a physical school. A physical school achieves a variety of interactions in eight hours. An online school doesn’t have to go on for eight continuous hours. Online courses (like Coursera) are different. The teachers there don’t know you personally. But our school teachers know us well. They have a good idea about our performance and participation. Online learning is usually voluntary. Here the online school counts in my scores and university admissions. The accountability is high. I sincerely hope after pandemic the world goes back to the physical school.

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Ravi 

Corona Daily 249: The Algorithmic Kingdom

United Kingdom has some of the world’s oldest universities. To apply to the old and the new Universities, British teenagers must score well at the A-level exams. In March, with the onset of the pandemic, schools were shut and exams cancelled.

Schools were asked to offer the predicted grades based on the student’s ability and past performance. But as we know; teachers are human. Some schools grade students leniently, some strictly. The purpose of most external exams, conducted on a state or a national level, is to create a level playing field for all students.

England has an exam watchdog called Ofqual (the office of qualifications and examinations regulations). At the end of March, Gavin Williamson, the education secretary asked Ofqual to ensure qualification standards are maintained, and grade distribution patterns are similar to those in the previous years.

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Ofqual was one of the few super-busy organisations during the pandemic. Over the next few months, it started developing a series of algorithms. To find that formula which will standardize the grades given by public and private schools, by indulgent and harsh-marking teachers. In June, schools began submitting teacher-assessed grades which were fed into the algorithm.

In July, Sir Jon Coles, former Director-General of the Department of Education, warned that the algorithm would be 75% accurate at best. A bit like the effectiveness of vaccines. Williamson had a video conference with Sir Coles, but decided to press ahead with the algorithm. External experts issued warnings that the Ofqual formula was as volatile as the stock market, and the outcomes were bound to be erratic.

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In mid-July, MPs on the education committee asked Ofqual to publish the algorithm for transparency and scrutiny. The exam watchdog refused, saying it would allow schools to calculate the awarded grades. In the last two weeks of July, Ofqual ran summer symposiums, but refused to divulge the algorithm. It admitted testing 12 different approaches, and finalizing one.

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On 13 August, the A-level results were published. They caused a mayhem greater than covid or Brexit.

40% of the students were downgraded, 36% by one grade, 3.5% by two grades and others by three grades. As a result, most of them would not be able to join the university of their choice. The proportion of private (elite) school students receiving A and A* was more than double that of students at the comprehensive (public) schools.

For your benefit, I give the algorithm here.

P_kj = (1-r_j)C_kj + r_j(C_kj + q_kj - p_kj)  

The ugly-looking formula considers factors like the history of the school, grades and distribution in the previous years, teacher-student ratio and availability of historical data. If a school has had low average performance in the past, and suddenly there is a bright student from that school, the formula makes sure that he/she is downgraded to be in line with the school’s past.

Students came out on the streets in thousands and protested vocally, with emphasis on the F verb, against the algorithm, against Boris Johnson and Williamson. Many felt their life and future career were ruined.

Boris Johnson, having nothing to do with education for a long time, said the exam results were “robust” and “dependable”. Ofqual said any statistical model, no matter how good, would produce anomalies.

Labour and LibDems supported students starting a legal action, with legal costs paid by the State.

Williamson imagined more than 200,000 students launching court cases against the government in pandemic times. He acknowledged the unfairness of the algorithm, pointed to the danger that a high-performing child in a low-performing school will not get deserving grades. (Something known for months). He apologized, England’s government made a U-turn, scrapped the algorithm and allowed the students to proceed with the grades the teachers had given them.

More than 400,000 students had their places confirmed in the universities. Human beings showed they were superior to algorithms.

Ravi 

Corona Daily 250: The Indian Institute of Technology

IIT (the Indian Institute of Technology) is probably the toughest university in the world to enter. The competition is so brutal that children whose parents can afford it, apply to America’s Ivy league as a backup.

The 17-year olds have to clear three hurdles. Each of India’s 28 states has its own education board. The student must be in the top 20 percentile in the state’s grade 12 exam. This is a necessary but not sufficient condition. A million students then appear for the Joint Entrance Exam (Main), a national exam for all engineering students. The top 250,000 students qualify for the Joint Entrance Exam (Advanced). In the end, 16,000 of the brightest Indians triumph.

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Several states reduced the state board syllabus by 30% to recognize the pandemic impact on studies. Ramgopal Rao, the IIT Delhi director, was asked if IIT would do the same. Mr Rao was surprised at the question. JEE Advanced is a deliberately tough exam, he said. Its job is to pick up 16,000 students from among a million. It is an “elimination exam”, not a selection or a certifying exam. Certainly, no question of making the exam easier.

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JEE (Mains) is conducted every January and April. The January exam happened as scheduled, but the April exam was postponed. There is another national exam called NEET (national eligibility cum entrance test) for admissions into medical colleges. The competition here is just as cruel as for engineering.

Students start preparing for IIT and medical entrance exams years in advance. In the two years prior to exams, as a rule, students attend specialized coaching classes. Some classes are pre-dawn to enable students attend their regular classes in time. In March, three million engineering and medical aspirants were thrown into an abyss of uncertainty.

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First there was a case in India’s Supreme Court trying to stop the IIT and medical entrance exams in coronavirus times. The Supreme Court is made of human beings. They understand the possible chaos if India has a backlog of three million students. They dismissed the case, saying students’ careers can’t be risked. Then ministers of six states filed a review petition. That was duly dismissed as well.

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Despite the pandemic, the IIT Advanced took place in September. 160,000 candidates appeared in 222 cities. Students were given different reporting times to avoid crowding. They wore masks and hand gloves, and were required to carry a personal 50 ml sanitizer bottle and a simple ballpoint pen. Chirag Falor, who topped, complained later he felt suffocated. The mask obstructs flow of oxygen to the brain, and slows you down, he said. Unrelated to the complaint, he opted not to join IIT, and flew to the Massachusetts Institute of Technology where he had gained admission as an alternative.

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For undergraduates, IIT is now conducting online exams. The students are required to sit in front of the cameras in full view. IIT plans to introduce AI (artificial intelligence) to proctor the online exams. AI algorithms will detect any cheating attempts. IIT has asked for recorded videos of students giving exams. These will be used for machine learning, to educate the AI. Last month, 70 IIT Bombay students were found cheating. At the time of the exam, they were using a WhatsApp group. Now that exam is cancelled, and a reexam ordered. Surely, IIT can develop a top caliber AI to avoid these situations in future.

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Microsoft offers $200,000 as a starting package to top fresh IIT graduates. Goldman Sachs, Facebook, Qualcomm, Salesforce, Amazon queue up to pick the talent. Google’s Sundar Pichai is just one example of IIT graduates’ prominence in the software industry. IIT was criticized for India’s brain drain with 80% of the graduates settling in the USA. Now the percent has come down to 30%. Narendra Modi’s government has 22 top civil service secretaries who graduated from the IIT.

No matter how severe the pandemic, it is not possible to halt the IIT inflow and outflow processes.

Ravi