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 

Corona Daily 217: B.1.1.7 – Variant of Concern

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

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

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

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

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

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

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

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

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

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

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

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

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

Ravi

Corona Daily 218: Holocaust to Covid-19

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

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

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

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

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

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

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

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

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

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

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

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

Ravi 

Corona Daily 219: Hear Them Out

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

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

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

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

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

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

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

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

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

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

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

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

Ravi 

Corona Daily 220: The American Thabo Mbeki

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

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

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

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

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

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

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

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

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

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

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

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

Ravi 

Corona Daily 221: In Search of a Halal Vaccine

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

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

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

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

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

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

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

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

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

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

Ravi 

Corona Daily 222: New Occupation for Jobless Cambodians

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

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

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

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

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

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

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

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

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

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

Ravi