Corona Daily 181: Virus Math: Step-by-Step

Dr Christian Yates, a Mathematician at UK’s Bath university, was asked to calculate the total volume of the Covid-19 virus in the world. If it was possible to collect in one place all virus particles from all the infected humans, how much space would that collection occupy? A small room? A soccer field? A stadium?  His step-by-step calculations and the result they led to are fascinating.

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The first step is to estimate the total number of covid infected people in the world. (Viruses in animals and those lingering in air or on surfaces are ignored). Recently, the number of daily cases has declined from a high of 800,000 to 400,000. Dr Yates takes half a million people testing positive every day as the base estimate. This number, however, doesn’t include the asymptomatic cases, and those unable or unwilling to test. The models of IHME (Institute for Health Metrics and Evaluations) estimate the true number to be 3 million cases every day.

When 3 million cases are added every day for seven days (average time the virus lasts in a human body), it gives 21 million people who at any given point of time are likely to carry some amount of virus.

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Having ascertained the 21 million infected humans, the volume of virus (viral load) in them should be estimated. Studies have shown people infected six days ago carry the highest viral load. Before and after that day, the virus quantum declines. A study measured the virus particles in grammes in monkeys, and extrapolated to humans. The viral load ranges from 1 billion to 100 billion virus particles. Dr Yates has taken 10 billion particles as the geometric (not arithmetic) mean.

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The next step is to multiply the number of infected people (21 million) by the volume (10 billion particles). Rounding it off gives a large figure of two hundred quadrillion, or two hundred million billion. (2x10¹⁷). This number may be intimidating. It is almost as large as the number of grains of sand on earth. But then the SARS-CoV-2 particles are much smaller than a grain of sand. To calculate the space they will occupy, the size of the virus must be taken into the equation.

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The diameter of the covid virus is estimated to be about 100 nanometres. Billion nanometres make a meter. By way of perspective, Dr Yates compares it to a human hair which is a 1000 times thicker than the virus.

The virus being spherical, we use the sphere volume equation we learnt (or didn’t) in school days (V = 4 π r³/3). With a radius of 50 nanometre (If nothing else, each of us probably remembers radius being half of diameter), the volume of a single virus particle is 523,000 cubic nanometres.

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Having estimated the total number of viruses existing at any given time (2x10¹⁷), and the size or volume of each (523,000 cubic nanometres), Dr Yates uses more formulas and adjustments to get the final result. The total volume of the covid virus in the world is about 120 ml (millilitres). Since the microscopic particles are sphere-shaped, they will leave gaps when packed together. (Like round oranges in a box). Statisticians estimate this empty space between round balls to be 26%. Taking that into account, the total collected volume of the Covid-19 virus is 160 ml. Dr Yates compares it to a standard Coke can which is more than double this size.

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The world’s entire covid virus population can be fitted in half of a Coke can. Just like an atom in an atom bomb, it shows that size doesn’t matter when it comes to massive destruction and devastation.

Ravi 

Corona Daily 182: Astronauts on Valentine’s Day

Jancee Dunn, the author of “How Not to Hate Your Husband After Kids” offers an interesting perspective on this very different Valentine’s day. Many people are imprisoned in their houses, working remotely or perhaps jobless. In an NYT article this week, she seeks advice from astronauts and submarine commanders. After all, their professions require them to remain in prolonged isolation with a few others under extreme conditions.

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Jane Poynter was one of the eight crew members, part of the mission Biosphere-2 (1991-1993). The experiment was to check the viability of ecological systems to support human life in outer space. She said the first couple of months were fine. Beyond four months, it became a “long duration isolation” and people started freaking out.   

Establishing regular routines was important to feel normal. But occasionally they needed to create some sort of a positive event, some celebration. Jane Poynter spent two years away from normal life in the early 1990s. Even managing a phone call with someone was a big event then.

She also found that creating different environments within Biosphere-2’s living space was helpful. She suggests making similar compartments during the pandemic. For example, making work calls on zoom at the desk, exercising on a yoga mat in another space, reading books in another corner of the living room.

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Chris Hadfield, a retired Canadian astronaut lived in space for six months. To cope, he suggests accepting the full reality of the situation. This isn’t a timeout, an interruption or an imposition on your life, he says. This is your life.

With life so radically altered, pre-pandemic rituals are important, says David Marquet, a retired submarine commander. He once spent 87 days underwater, isolated, closeted with a few colleagues and never able to see the sun. He said festivals like Valentine’s day were crucial for raising their depressed spirits. On the submarine they tried to maintain a calendar and replicate holidays. They put the necessary decorations on each holiday. That allowed them to maintain the rhythm of the year and rhythm of their life. Without such underwater celebrations, they would have been completely cut from life on land.

When the submarine crew went out from January to June, families prepared Valentine’s day cards in December. They were kept in a sealed box and opened only on 14 February. David Marquet feels this sense of ritual is important for human beings, and what is true for astronauts and submarine crew is true for people locked down during the pandemic.

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Mike Massimino, a former NASA astronaut confirms setting routines on space shuttle missions was vital to boost spirits. Having a set schedule, he says, is very important in space. If there is nothing on the schedule, the mind starts wandering.

Jeffrey Donenfeld worked as a cook in Antarctica for three months. What got the group through was their sense of mission. They were all together in it, they kept on repeating. Now in the pandemic, he says the same to his wife and family. “We’re having tough times, let’s just stick together and stay safe and we’ll get through this.”

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Astronaut Chris Hadfield made it a point to send flowers to his wife, Helene, on Valentine’s day. Jancee Dunn asked him whether he had arranged for the delivery before he left for the Space Station mission.

No, said Astronaut Hadfield. He simply called the flower shop from space.

Ravi   

Corona Daily 183: Are Your Ears Hurting?

Joe Biden has requested Americans to wear masks for the first one hundred days of his presidency. CDC has this month asked people to wear two masks, one over the other, for additional protection. (Joe Biden does). Many European countries have introduced strict regulations about masks in public places. Most masks have tautly stretched ear loops, causing ears to become sore and start hurting. Taut elastic ear loops can damage the backs of our ears. Nurses and other health workers are particularly vulnerable.

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Mask efficacy is studied nearly as enthusiastically as vaccine efficacy. There are fears vaccines may not be effective against certain variants. Not the case with masks. Masks protect you from viruses equally, no matter which variant.

CDC conducted experiments in January to test effectiveness of different mask combos. The experiments included dummy heads and simulated coughs. A three-ply surgical mask blocked 42% of particles from a simulated cough, and a three-ply cloth mask blocked 44%. But a cloth mask over a medical mask blocked 92% of particles.

Double masking can put an even greater pressure on the ears.

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Creating products connected with masks is a whole new industry.

Anti-fog spray for glasses saves bespectacled people from touching their glasses all the time. When they take a deep breath under their mask, the glasses get fogged up. This spray and the portable dry wipes solve that problem.

Transparent masks help the deaf or partly deaf people and patients lip-read. Beaded mask chains allow you to put on and take off masks without putting them aside. Matt non-smearing lipstick is available for women. Wireless headphones are sold to keep the masks intact. Face mask holders are little colorful purses to keep the masks clean. Mask refreshing sprays and moisture absorbent masks make sure the mask remains fresh in sweaty conditions. You also can buy a mask-hanger that hangs the mask and your keys or jewelry together so you don’t forget the mask when leaving the house.

The maximum innovations, however, have tried to keep our ears safe.

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 The key element in all novel products is to find a substitute for ears to loop the mask around.

Headbands with buttons on both sides are one option. The buttons are placed behind the ears. (Or you can sew them on). Rather than looping the mask around the ears, it is looped around the buttons. This takes the pressure off the skin and increases comfort.

Paper clips or strap clips are used in another variation. If you don’t mind wearing a headgear, baseball caps or hats with buttons on sides are available.

Face mask extenders connect the ear straps and extend them to wrap around the back of your head.

Women or (men with long hair) have more natural options. You can tie your hair long enough to make a ponytail or bun. The mask straps are then hooked to the bun instead of the ears. Women can have two pigtails on the sides, like in the 1950s films.

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Moisture and friction can cause irritation, prolonged mask use can irritate sensitive skin. Mask straps rubbing against the ears create friction that can result in inflammation and blistering. This may cause open wounds or skin scabbing, increasing the risk of an ear infection. Using silicon-foam dressing (like on a wound) before wearing a mask is one suggestion. In hot or humid weather, cotton mask and cotton ear ties are better. People wearing masks for long durations are advised to include ears in their skin care routine. They may want to apply Vaseline petroleum jelly or honey on sore ears.

Unless your uniform forbids it, you may consider neck gaiters or simple handkerchiefs to cover your face. You may look like a bank robber, but your ears will not hurt.

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We must make sure that in order to avoid the coronavirus, we don’t end up getting an ear infection.

Ravi 

Corona Daily 184: What Happened to Flu-20?

This is strange and unusual.

Usually, about twice a year, most members of my gym start coughing in the same month. Some complain of a sore throat, runny nose, sinusitis and headache, occasional fever. The symptoms last for a good two to four weeks. Cough and common cold have become more tenacious in the last decade. The general public, less fit than my gym colleagues, also experience ‘the flu’ annually. Because we are Indians, we never take flu vaccines. We suffer, carry on with our life, infecting one another, until the season is over.

I don’t want to jinx it, but I have not had any of these symptoms in the last ten months. 2020 was probably the first flu-less year in my life. And I find this is true for many of my friends, relatives and neighbours. My octogenarian parents are also healthier during the pandemic. Where is the flu-virus 2020-21 hiding?

I will move from empirical evidence, to official statistics. In the flu season 2019-20, USA had 22 million influenza cases, 210,000 hospitalizations and 12,000 deaths. This year, almost nothing. In countries where influenza is tracked, numbers are down by 99.5%. The American CDC map, always red in February, is completely green this year. It’s not that Americans or Europeans have not tested for influenza. Almost all tests have been negative.

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As we well know, the flu virus and Covid-19 are both respiratory and spread in a similar manner. Tiny particles of mucus or saliva spew out when people cough, sneeze, talk or breathe. Handshaking, hugging, being together in a room can enable transmission.

Evidently, the containment measures we take for the coronavirus; masks, hand hygiene and social distancing have helped barricade the flu virus as well. Equally important is our reduced travel, closed offices (and gyms), shut schools and day cares. Children are great transmitters of flu.  

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There is another interesting theory.

It talks about viral interference, the phenomenon of viruses affecting each other. It was noticed in the eighteenth century by Edward Jenner, the English developer of the smallpox vaccine. He would inoculate people with a mild cowpox virus. But when a patient had herpes or another infection, the smallpox vaccine didn’t work. It was almost as if the immune system wouldn’t allow two infections at once.

In September 2009, the H1N1 swine flu had landed in Portugal, Spain and the UK. France prepared for the epidemic. Indeed, the number of cases with respiratory symptoms soon went up. But the infected people didn’t seem to have H1N1. It so happened that France already had rhinovirus, which causes colds. The French population was infected with that virus, and the common cold virus deflected the swine flu. Many studies have been conducted and papers written. They find that people rarely have two viruses at the same time.

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While we are happy about the current low profile of the flu virus, researchers and vaccine developers are worried. The flu virus mutates every year, and new vaccines are developed to fight new mutations. More than 100 countries conduct year-round surveillance by testing thousands of flu virus samples. WHO analyses the data in five centers located in the USA, UK, Australia, Japan and China.

In February, WHO representatives, scientists, academicians review the surveillance results, make predictions for the flu virus next season, and recommend the composition of the flu vaccine. (In September, a similar exercise is done for countries in the southern hemisphere). It takes six months to develop and manufacture the new flu vaccines. Americans are usually advised to take them in October.

The flu’s absence is unsettling for the researchers. They have been starved of data crucial for forecasting and developing vaccines. They are not sure when, how, and in what form the flu will return.

Ravi 

Corona Daily 185: The Future Normal is Holographic

Letters. Stationary phone. Fax. Pager. Cellphone. Messenger. WhatsApp. Facetime. Zoom. What’s next? Holograms, of course.

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Last month, ARHT Media, a Canadian company launched HoloPad, a 3D display system that beams presenters from remote locations into meetings and conferences. At a hologram-enabled innovation summit in Singapore, an executive from Los Angeles performed live.

In the same month, a 3-D graphics company Imverse exhibited their product at the CES global tech conference. Its software enables hologram collaboration within virtual meeting rooms. Imverse tries to use smartphones and inexpensive in-depth cameras. Its goal is to replace 2-D video calls with 3-D conversations.  

Most white-collar workers assume they may never return to the traditional ‘commute-work-commute-sleep at home’ pattern. In a recent American survey only 11% of employees thought they would return to pre-pandemic work routine. Some sort of hybrid system will be developed where people will combine working from home and in office. How to best connect remote and in-office work? Holographic technology offers the middle ground.

Facetime or Zoom, though way advanced than our communication two decades ago, present only headshots in 2-D. Holograms offer the entire person, allowing body language so essential in human interaction. When without wearing any 3-D glasses you see somebody in a live hologram, and they appear to be in 3-D, your brain tells you they are in the same room.

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On the remote side, the presenter (say in Los Angeles) usually stands in front of a green screen, and looks at a shot of the (Singapore) audience on the monitor. Meanwhile, cameras capture the speaker from all angles. At the backend worksite, someone rolls the HoloPod, turns on a computer and connects to a live stream. A hologram photographically records a light field rather than an image formed by a lens. The current demonstrations still lack perfect clarity, viewers know it’s not the real person. Still, it succeeds in being in the presence of a life-size, 3-D representation of people.

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Live simultaneous music concerts are a real possibility. Michael Jackson may have missed it, but Justin Beiber or Taylor Swift will be able to perform live in London, Paris, Rome and New York at the same time. India’s PM Narendra Modi actually used the technology to give election speeches at thousands of venues. They were pre-recorded and played locally, but even in a small town; people could attend standing only a few feet away from the 3-D Modi. In a country of 900 million voters, this technology will become essential for charismatic leaders.

In theory, Madonna can sing inside your house, and Obama can join you at the dining table. But the hardware is currently too expensive. Only big companies and plush events can afford holographic technology.

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The company Blank XR goes a step ahead and tries to create what is called a mixed reality. Shah Rukh Khan will dance and give a personalized speech at your daughter’s wedding. How is that done? The company captures Shah Rukh Khan with 360-degree cameras. His voice is cloned based on audio clips. The rest is done by the Artificial Intelligence software. At your daughter’s wedding, AI will put the names of your family members in Shah Rukh Khan’s speech. The more information the artist chooses to feed, the more accurate his holo-clone will be. Blank XR specializes in mixing AI with video and sound manipulation.

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Last Sunday, at the Florida Superbowl final, one of the world’s most watched events, the opening speech was given by the legendary football coach Vince Lombardi. It was not him, but his hologram. The hologram talked about the current pandemic situation as well. Not everyone applauded, particularly since Vince Lombardi has been dead for fifty years.

Walt Disney Co. has a written policy of not creating holograms of dead people.

Ravi 

Corona Daily 186: This is Dangerous Stuff

On Friday, 5 February, an unnamed technician working at the Oldsmar Water Plant in Florida saw the curser moving by itself on his computer screen. He was six feet away from his desk. It didn’t bother him much, because the TeamViewer program allows his bosses to remotely view his computer. In pandemic times, much work was managed remotely. In the afternoon, the curser started moving again. This time, the technician noticed the curser went to the Sodium Hydroxide (NaOH) levels and started giving commands.

NaOH is the main ingredient in drain cleaners. In small quantities, it controls the acidity of drinking water. On the screen, the invisible hand changed its level from 100 parts per million to 11,100 parts per million. In the best case, people drinking water with that level of NaOH are likely to suffer burns, skin irritation and other complications.

The shocked technician re-set the level, called his colleagues from IT, and let the management know about the cyberattack. Yesterday, in a televised press conference, the Oldsmar Sheriff said, “this is dangerous stuff.” Florida senator Marco Rubio asked the incident to be treated as a matter of national security.

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Cyberattacks on power grids, water plants, oil pipelines, industrial facilities, traffic lights, aviation control are a nightmare scenario for modern governments.

The attacks can be carried out by bored teenagers, disgruntled employees or State actors. Not known who carried last week’s amateurish attack. It lacked sophistication.

In April 2020, Iranian hackers tried to change the level of chlorine in a water plant in central Israel. Yigal Unna, head of Israel’s national security said, “Cyber winter is coming even faster than I expected. We will remember this as a changing point in the history of modern cyber warfare.” Israel counterattacked an Iranian port.

In 2007, USA and Israel had joined hands in a project codenamed “Olympic Games.” The aim was to sabotage Iran’s nuclear program. The project succeeded in using the malicious computer worm Stuxnet to target the Siemens control system and tricked Iranian centrifuges to self-destruct.

More recently, in 2016, Russia was suspected of using the same Stuxnet to disrupt Ukraine’s power grid, and throw most of Kiev into darkness and cold in the middle of a harsh winter.

America and Russia have started the Cyber cold war. Both have reportedly entered each other’s networks, and parked malware and bugs. They are willing to be patient for years. At the right time, if required, the power in an enemy city can be switched off, or drinking water can be poisoned by changing the levels of chemicals.

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America, presumed to be a developed country, has its water supply made of 70,000 separate, independent utilities. It is hard to have uniform security standards across them. Experts acknowledge USA is ill-prepared to defend itself against cyberattacks on water plants.

Ideally, these facilities should not have remote access at all. But the world in which we live, this is difficult. With the pandemic on, remote work has become even more widespread. Most public utilities, the local municipalities, have low budgets, little cash, old computers and not enough attention to cyber security. (I am attaching a 56-page booklet called Cybersecurity fundamentals for water utilities. It may be useful for any place. And by the way, if you have TeamViewer on your computer, and you don’t use it or don’t know how to use it, please uninstall it immediately).

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The incident at Florida’s water plant last week is a wake-up call for every public utility in the world. In times of remote working, the cybersecurity must be even tighter. Always working remotely, hackers are capable of causing devastation.

Ravi 

Corona Daily 187: Will Business Cards Survive?

The ritual of exchanging business cards is nowhere more sacred than in Japan. When two Japanese, in complete formal attire, meet for the first time, they ceremoniously exchange their pristine business cards. Not a wallet, but an expensive looking metal cardholder contains them. They bow deeply and accept the card with both hands. Each slowly scrutinizes the business card, reading every word on it as if it were a Haiku. This is also the trigger for icebreaking and small talk. This sacred ritual is called Meishi-Koukan (card swapping). Along with masks, social distancing, handwashing, the Japanese government also recommended an online Meishi-Koukan.

For the Japanese, the card is like a gift, and the gifting is mutual. If a foreigner forgets giving a business card (a Japanese never will), it is an offence akin to not shaking a proffered hand.

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Sansan has started virtual cards where smartphones can swap the QR (Quick Response) codes. The software also allows a Japanese worker to send all virtual cards to his boss. The boss wants to know whom you have met.

It is said a business card is your face. The Japanese company Nagaya has taken this literally. It has produced Meishi masks where your visiting card details are printed on your mask. The 100% cotton, three-layer Meishi masks are available online for Yen 1500 ($14), in three different models: “reception mask”, “sales mask” and “business activity mask”.

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The cards are an ancient product that started in China in the fifteenth century. The Chinese introduced calling cards to let people know of their planned visit. By the seventeenth century, European traders had developed trade cards that served as small advertisements of their businesses.

In later centuries, the upper classes in Europe carried a visiting card/calling card. One side contained the person’s information, and the reverse side was for handwritten messages. When you visited someone, didn’t find the person home, you would leave your card with a handwritten message. As per etiquette, if the card was left with its corner turned, it meant the card had been left in person and not by a servant.

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The card represents the quality of the person and the company. It creates the first impression. The card’s visual appeal, thick paper, background colour, fonts are part of the brand appeal. Some super-wealthy Chinese were rumoured to carry cards made of gold. Who wouldn’t want to do business with a guy who gives you a 24-carat business card?

McDonalds executives have their cards shaped like French fries. A Kodak manager, a friend of mine, always complained nobody forgets him because his photo was on his business card. A Canadian divorce lawyer has a business card that can be torn in half – one for each spouse. Mark Zuckerburg’s first business card simply read: “I’m CEO, bitch”. Well, Zuckerburg could afford to have a card like that.  

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I have a habit of writing the date and time of the meeting on the back of every business card I receive. Now when I look at my visiting card albums from the 1990s, many cards resurrect memories of the person, and the history surrounding the meeting.

Several attempts have been made to replace business cards with something virtual. A Californian company Bump technology had developed an app that allowed two smartphones to tap and the contact details would be swapped.

The demise of the business card has long been predicted, with the rise of LinkedIn and smartphones. However, the card has lasted for more than five centuries, through world wars and pandemics. It will be interesting to see if it survives the Covid-19 pandemic.

Ravi 

Corona Daily 188: No More Bon Appetit

France knows best how life should be lived- with food, love and leisure.

Cuisine is a French word. Try to find an exact equivalent in your language, you will struggle. In Paris, I saw for the first time, rows and rows of people at restaurant tables facing the streets.  Eating out is a spectacularly social and boisterous event in the evenings. In places like Paris, every day is a food festival. French culture is the culture of the table.

And un baiser amoureux, the French kiss, is the only kiss I know that is named after a nation. The French know how to love, with abandon, without inhibition, without worrying about hygiene or diseases.

And work-life balance is far tilted towards life. This is one capitalist country with strict labour laws. France gave the world a 35-hour working week. I have first-hand experience of teams of French office employees disappearing for lunch, and not at all concerned about returning to the office in time, or returning at all. If it is best to be an employer in America, it is best to be an employee in France. The leisure and well being of an employee is governed by labour laws.

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Code du Travail (French labour code) is a 3,324-page document. Its length should tell you how serious the French are about protecting workers.

Article R4228-19 in that code has the following beautiful wording:  It is forbidden to let workers eat their meals in the premises assigned to work.

French are not allowed to eat where they work, no grabbing a sandwich next to your keyboard. That is considered a repulsive American habit in France. Each company must have a canteen or a separate eating place for the employees. Anybody eating at their desks can be fined and disciplinary action taken against them. The French have understood that we work in order to eat, and not the other way round. So, eating away from work is the revered practice. That is why it is legitimate to disappear from office for long hours during lunch. People must detach themselves from work and enjoy meals. Food and excel spreadsheets can never be mixed.

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The news coming from the French labour ministry last week is catastrophic. The pandemic has already affected France in several ways. Teletravail (work from home) is encouraged. But in January, only 64% of those who could work from home did so. A 6 pm curfew prevents the pre-dinner stop at the boulangerie. Closure of cafes and restaurants has prompted “le click and collect”. From 29 January, a distance of two meters is mandatory between people at work when masks can’t be worn, including in canteens and lunch halls.

And now the labour ministry has announced it will allow eating at the work desk. The twentieth century regulation that prevented the ruthless capitalists from exploiting workers during their lunch hours has fallen apart for the first time. The French are devastated by the news.

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For the sake of the French, and for the global labour movement, one hopes the measure is temporary, and once the pandemic is over, Parisians will continue to disappear for those interminable hours called their lunch break.

Ravi 

Corona Daily 189: Virus Politics

Ayatollah Ali Khamenei, Iran’s supreme leader, addressed the nation on television on 8 January. He said the vaccines from United States and United Kingdom were forbidden in Iran. “They are completely untrustworthy. It’s not unlikely they would want to contaminate other nations.” He tweeted. 

The Red Crescent Society is a humanitarian organization in Iran. US based Iranian scientists were planning to send 150,000 doses of Pfizer vaccine to Iran. That shipment was cancelled following Ayatollah Khamenei’s comments.

Minoo Mohraz, an epidemiologist who heads Iran’s coronavirus task force, announced the Ministry of Health would import the AstraZeneca vaccine from Sweden. Since 1999, Astra (Sweden) and Zeneca (UK) merged to form a multinational company with headquarters in the UK. Minoo Mohraz emphasized this was a Swedish company, and omitted all references to Oxford to bypass Khamenei’s ban.

In late January, Iran approved the Russian vaccine, Sputnik V. Its first doses are expected to arrive next week. China has also promised to deliver one million doses to Iran.

Iran has had nearly 1.5 million cases, and 59,000 deaths.

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While Iran approved the Russian vaccine, the Ukrainian parliament approved a bill that officially banned any vaccines made in Russia.

Ukraine is the largest country in Europe with 42 million people, and no covid vaccines. It has had 1.25 million cases, and 24,000 deaths. Ukraine’s talks with the USA collapsed when the Trump administration banned vaccine exports. Ukraine’s leaders, who would prefer to literally die before accepting help from Russia, turned to China. In hurried negotiations with China, 1.9 million doses have been promised by Sinovac Biotech, the Chinese supplier. They may arrive this month.

“Russia, as always, uses this in its hybrid war, as an information weapon.” Said Ukraine’s health minister. “One political force just created some hysteria over the registration of the Russian vaccine. I can say at once: You can be hysterical for a very long time, no one will register the Russian vaccine in Ukraine.”

“It’s in Russia’s political interest that Ukraine receive the vaccines from elsewhere as late as possible,” said another minister. “We cannot rely on a Russian state company during an armed aggression against Ukraine” said the government’s medical director. “It’s so politicized it can’t be used.”

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In January, Taiwan once again confirmed that any vaccines made in China were banned from import. Taiwan’s Mainland Affairs council said vaccination was a medical matter and that it “should not be used as political propaganda”. This announcement was made after China offered to vaccinate the 400,000 Taiwanese citizens who live in China.

Taiwan’s government find the vaccines made by the Chinese companies Sinovac and Sinopharm suspect. Any Taiwanese who has received the Chinese vaccines is required to quarantine for fourteen days upon arrival in Taiwan. “There are political concerns, but there are also big concerns about the safety and effectiveness of China-made vaccines.” Its official said.

Having refused the Chinese vaccines, Taiwan currently has no vaccines. It has placed orders with Astra-Zeneca and the Covax, the global initiative. The stocks are expected to arrive in March.

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India, in January, supplied most of its neighbours free doses as a friendship gesture. Bhutan (150,000 doses), the Maldives (100,000), Bangladesh (2 million), Nepal (1 million), Myanmar (1.5 million), Mauritius (100,000) and Seychelles (50,000) received the grant. Pakistan with 550,000 cases and 12,000 deaths till today hasn’t ordered nor granted any vaccines from India.

China has donated 500,000 doses to Pakistan, they will be given to the health workers next week. Pakistani regulators have approved Sinopharm (China), Sputnik V (Russia) and Oxford (UK).

Strangely, 90% of all vaccines (non-covid) administered in Pakistan come from India. Pakistan’s pharma annual imports from India exceed $70 million. 70% of the active ingredients in medicines sold in Pakistan are imported from India. But Covid Vaccines are newsworthy.

Covid Vaccines are an instrument to make new friendships and to emphasize old enmities.

Ravi 

Corona Daily 190: On Efficacy and Herd Immunity

In my research, I increasingly come across the words “efficacy” and the more awkward “efficacious”. When newspapers say the Pfizer-BioNTech vaccine has a 95 percent efficacy, why don’t they say it is 95% effective? Because in the pharma and medical world, the two terms are technically different. 

Efficacy is the number we get from a clinical trial, in research settings. Though the trials had tens of thousands of volunteers who lived lives as they normally do, it wasn’t the “real world” test of the vaccine.

Effectiveness is what happens in the real world.

In many other fields of life, we know there may be a difference between the controlled setting and the real world. In cricket, batting in the nets, and playing in a real match in front of crowds. Between rehearsals and on-stage theatrical performances. Projections in the corporate board rooms, and actual company performance.

As we already know, some pregnant women are opting to take the vaccines. They were not included in any trials. Also, the racial and ethnic composition of the trials didn’t exactly represent the populations where trials were conducted.

As a rule, the effectiveness of the vaccines will be lower than the efficacy. The coming years would show how effective Moderna, Pfizer or Oxford were. Neither the efficacy nor the effectiveness can accurately tell you your personal risk. It depends on your immune system, health conditions, and exposure to the virus. At this stage in the pandemic, experts are urging people not to focus on the efficacy numbers, but just go ahead and take whichever authorized vaccine that is offered.

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Herd immunity is another popular expression few people had heard before the pandemic. When a significant percentage of the population is vaccinated, or has recovered naturally, it is difficult for the virus to spread. Think of an unsuspecting village, in which a burglar goes from house to house robbing households. In the beginning, he can enter any house of his choice and take cash and jewelry. Over time, he can’t enter houses which are well locked (vaccines) and houses he has already broken into (antibodies). Finally, unable to penetrate an unburgled house, he leaves the village or dies. I imagine the virus to be like that burglar.

Depending on the virus, there is a certain % that needs to achieve immunity before herd immunity is reached. That % is called the “herd immunity threshold”. Measles, a particularly contagious disease, slows down only after 95% of people become immune. Herd immunity doesn’t protect against all vaccine-preventable diseases. Tetanus, for example, is caught from bacteria in the environment, rather than from other people. No matter what percentage of population is vaccinated for tetanus, it doesn’t protect an unvaccinated person; for tetanus herd immunity is not possible.

Herd immunity is important for people with low or compromised immunity, people with HIV, newborn babies too young for a vaccine, elderly or very ill people who can’t safely get vaccinated.

Currently, India is doing very well, with low numbers of cases and deaths, and except for mask-wearing, life is returning to normal. In Delhi, a recent survey suggested more than half of Delhi’s population had antibodies. Many Indians attribute India’s current well-being to the presumed herd immunity. I would like to wait till the monsoon season is over to pass that judgement. June to September is India’s annual infection season, just like winter is Europe’s and America’s. In my view, if India’s numbers remain low till the end of September, it may be out of the woods.

Ravi