Corona Daily 139: Indignity

Even before the pandemic started, USA had a huge problem of unclaimed dead bodies. Around the country, medical examiners were flooded with cadavers nobody claimed. This was partly attributed to the opioid epidemic. The drug overdose deaths grew 10% annually in certain years. Cash-poor cities like Detroit have no policy and few resources. They scatter human remains in haphazard ways. After the earlier financial crisis, there were a couple of high-profile scandals with unclaimed bodies stuffed in refrigerated trailers.

The Coronavirus pandemic made the situation catastrophic. People started dying every minute in hospitals, nursing homes, at homes. Strict covid regulations and lockdowns meant many relatives couldn’t reach the deceased. In some cases, authorities were so overwhelmed, they had to transfer the dead person before finding the family. The dead had to make way for the sick. Funerals and cemetery plots are expensive. Americans in dire economic state sometimes opted to not claim the body.

*****

I mentioned Hart island in the previous article. This place was unknown to most New Yorkers before the pandemic. This largest public cemetery in America is the graveyard of the last resort. Generally, the poor, forgotten or lonely were buried here. Half a mile from the Bronx, this island has served this purpose since 1869, and has sheltered the victims of the Spanish flu, tuberculosis, AIDS and now Covid-19.

Burials here lack dignity. Bodies are stacked by hundreds in long muddy trenches. Plain pine boxes are loaded one on another. Since the 1950s, there are never any ceremonies, just a simple burial. The plots don’t have unique markers. AIDS victims were buried here by those wearing protective gear, until it was found AIDS doesn’t transmit through air or by touch.

Burying is done by prisoners. 10% of New York city is resting on this island. In 2019, 846 New Yorkers were brought here. In 2020, the number shot up to 2,334. Initially, short-term prisoners were put on the job. When the world was not working, why were they made to work, they thought. With the numbers growing, pre-trial detainees were added to the task force. Then the prison officers became ill with covid-19. The virus was spreading among the prisoners. They were released. Private contractors brought in 40 workers, but most of them refused to start the assignment on learning the job description.

Hart island has no electricity. It is isolated from the city. It can be reached only by a ferry. Because the prison department is in charge of the island, visiting it is difficult – unless you are dead. Visits are allowed once a month, and after some serious form-filling. It is expected that by 2027, Hart Island will have no capacity left.

*****

In 2016, New York banned unclaimed body donations. So, pathology students or medical schools can no longer receive them.

In the first year of the pandemic, New York city has lost nearly 35,000 people. Some remains are with foreign consulates, at various funeral homes, makeshift storages and trucks. As of today, some 800 bodies are languishing in refrigerated trucks.

During the first wave, shelves were placed inside trailers at hospitals to double the storage capacity. But the shelves were unstable. When the trailers moved, the shelves and the bodies they carried started collapsing.

In April, it was decided to set up a disaster morgue on the 39th street’s Pier in Sunset Park. This long-term storage facility can hold at least 1500 bodies. Storage is free, and there is no time limit.

Long-term freezer storage in containers is a pandemic outcome. It appears to be more socially acceptable than an unceremonious burial on Hart island. In the second wave; hospitals, funeral directors and city medical examiner’s office started discussing how to store hundreds of bodies over long stretches.

Many of the unclaimed bodies belonged to the uninsured urban poor. Now the Biden administration has offered a reimbursement of up to $9000 for funeral expenses. Cost should no longer be a reason for not claiming a body.

*****

The nearly 3000 toll of 9/11 is dwarfed by covid numbers. New York’s 9/11 memorial and museum are considered the fabric of New York city. Now, there is a demand for building a memorial for Covid-19 victims. Perhaps New York will wait till the end of the pandemic before planning the memorial.

Ravi 

Corona Daily 140: Ellen Torron’s Story: Part Final

At the Mount Richmond Cemetery on Staten island, the chief Rabbi greeted Donofrio. A group of volunteers wearing protective gear dressed Ellen’s corpse in eight separate pieces of white linen clothing, including a bonnet, shirt, pants, gown and belt. They carried the coffin to Ellen’s new burial plot, in section 91 of the cemetery. The Rabbi opened a prayer book and recited prayers in Yiddish. The ritual was over once the coffin was covered with soil.

*****

About a month later, Rhoda Fairman, 83, accidentally saw a brochure from the Hebrew Free Burial Association. Normally, it would have been junked, but Rhoda noticed it on her kitchen table. The brochure displayed the names of the 333 people the association had buried in the past few months. Rhoda was stunned to see the name Ellen Torron.

Rhoda and Ellen had worked together for more than twenty years as legal secretaries at a Manhattan law firm. Ellen had never opened a Facebook account, and lost touch with colleagues. The two women would share lunch, shop together, occasionally visit museums. On 9/11, they were together watching the second plane crashing in the South tower from their 49th floor office of One Penn Plaza.

Ellen was born in 1946, the only child of Polish and Lithuanian immigrants. Since the age of 18, she lived on her own, graduating with a double degree in English and classical studies. As far as Rhoda knew, Ellen had never married. She claimed to have a daughter in Brazil, but nobody ever met her or saw any picture. Ellen was intelligent and well travelled. She didn’t mind travelling alone.

*****

In the eight months since her second burial, investigators found over $56,000 in her bank accounts plus jewelry including a pearl necklace, silver brooches and ruby-diamond earrings. By law, the Queens county public administrator must attempt to track down Ellen’s relatives to distribute the estate. No daughter has ever emerged. Only relatives who are siblings or first cousins (till once removed) are eligible.

Meryle Mishkin-Tank, 56, was found to be a daughter of Ellen’s first cousin. She had never met Ellen Torron, nor was she aware of her existence. However, Meryle, a paralegal, has taken great interest in trying to uncover details about Ellen’s life and death. Thanks to this episode, and extensive genealogical research, she has found and contacted five more cousins and an aunt. None of them knew anything about Ellen Torron.

*****

Meryle Mishkin-Tank grew up in Manhattan. But until she was told about the death of Ellen, her unknown cousin, Meryle had not heard of the Hart Island or the Mount Richmond Cemetery. Through her committed research, she found out that Ellen’s paternal grandfather, Zelman, and grandmother, Elka, were buried in the Mount Richmond cemetery as well. In fact, it turned out that their graves were located quite close from their granddaughter’s plot.

In that sense, Ellen Torron is not alone any more.

*****

P.S. In summer 2020, TIME magazine was granted unprecedented access to Hart Island to observe burial and exhumation operations. W. J. Hennigan, a TIME reporter witnessed first hand the retrieval and formal reburial of Ellen Torron. He just happened to be there on that day. TIME was also allowed to join the investigators’ team and visit Ellen’s apartment in July. W.J. Hennigan deserves readers’ thanks for unearthing the story.

More than a million people are buried in unmarked graves on Hart island. Most of them are anonymous and forgotten. But Ellen Torron’s story shows that with the efforts of social workers, government employees and reporters, a biography of an anonymous person can be resurrected.

Ravi 

Corona Daily 141: Ellen Torron’s Story: Part One

On 16 March 2020, the porter of the red brick building in Queens finally called the police. Tenants were complaining of a strange stench from the fifth floor. It came from the apartment of Ellen Torron, a petite 74-year-old with short gray hair and piercing dark brown eyes. She lived alone in the building for more than twenty years. She wore gloves even before the pandemic.

At around 2 pm, the police broke in. The 800 sq feet studio apartment was full of books, magazines, paperwork boxes, suitcases. On the flat screen television, a cable channel was on. Unopened letters lay at the door. Through the hundreds of things, the police made their way to the bathroom. In the bathtub, they found Ellen’s body under water. She had been dead for quite some time. No signs of struggle or injury, foul play was ruled out. Once the porter identified the body, it was put in a body bag, and carried to the morgue at the Queens Hospital Center.

*****

Neither the porter nor the neighbours knew of Ellen’s family. Nobody came forward to claim her remains. By now, cases and lockdowns had overwhelmed the authorities. Investigators couldn’t return to her house to look for a will, savings or evidence of a burial plot. Her body lay inside a refrigerated drawer for 24 days. Autopsy gave the cause of death as cardiovascular disease. The pathologist couldn’t determine if she had contracted covid or not. New York city’s death toll had passed 27000. There were far more corpses than morgues could hold.

Early in the morning on 9 April, a white truck carrying 24 pine boxes was rolled onto a ferry for a ten-minute voyage to Hart Island. One of the pine boxes had Ellen Torron lying in it. The pine boxes would have a mass burial at America’s biggest public graveyard.

Isn’t cremation a more sensible option, when all systems are overwhelmed? “What if someone is sent by mistake?” answers Captain Thompson, in charge of the operations on Hart island for the last fifteen years. “You can’t reverse a cremation”.

When Ellen arrived, the rate of burials at the island had gone up from 25 a week to 25 a day. The mass grave trench was supposed to last for a year, instead it was full within two months.

*****

Captain Thompson was right, cremation is irreversible, burial is not.

On 26 June, two and a half months after Ellen Torren was buried, a black van arrived. James Donofrio, 61, stepped out, and handed the necessary paperwork to Captain Thompson. It showed he was authorized to take custody of Ellen’s exhumed coffin.

Fifteen workers began digging. In a football field size pit, 1165 identical pine caskets were stacked three high, two wide. The men in the Hazmat suits were given the task of digging up casket no. 40-3. Masks on their face, shovels in gloved hands, they climbed ten feet down. The numbers are engraved at a corner of the pine boxes. After a search, the casket 40-3 was retrieved and along with its occupant brought back aboveground.

*****

City investigators couldn’t revisit Ellen’s apartment, but discovered her birth certificate. It showed she was born at the Jewish maternity hospital in Manhattan. Hebrew Free Burial Association (HFBA) is a 132-year-old nonprofit organization that offers free burials for Jews.

James Donofrio was sent by that association to recover Ellen Torron’s body. He had come prepared. To guard against the stench, he had brought a second large casket that would take the pine box in. Between the two caskets Donofrio generously spread packets of espresso coffee. Espresso can kill any odors.

Once the twin coffin was loaded into the van, Donofrio left for the opposite side of the city to bury Ellen Torron for the second time.

*****

(Continued tomorrow)

Ravi 

Corona Daily 142: They Love Bad News

In the last twelve months, there have been many occasions when I am back from my morning run, the phone rings, my mother starts telling me how terrible the pandemic is getting in Bombay. Cases have gone up, the state is thinking of another lockdown, five buildings are sealed.

“I’m just back from my run.” I tell my mother. “there were about two thousand people at Shivaji Park, some of them wearing masks - properly. Shops and cafes are open. The market is flooded with people. There are traffic jams, and buses are packed.”

“Now they have found a virus with double mutation.” Mother continues. “Vaccines won’t have any effect on them – they are saying.”

“Well, I’ve told you to stop watching TV.” I tell mother. “I’m telling you about real life, as it exists. You’re telling me about the life the TV channel shows you.”

*****

Bruce Sacerdote, an Economics professor at Dartmouth, noticed that the British media began reporting encouraging progress on covid vaccine developments in February 2020. American media didn’t report those results until April, and with caveats that suggested developing vaccines in 2020 was a pipe dream. The professor wondered if the American mainstream media specialized in giving negative stories about the pandemic.

Along with two other professors, Sacerdote actually conducted a comprehensive study. The group studied over 9.4 million published news stories on Covid-19 since 1 January 2020. They conducted several forms of textual analysis, human and algorithmic, to examine levels of negativity. (The software used Hu-Liu (2004) dictionary of positive and negative words. For example, the phrase ‘clinical trial’ is positive, but ‘death toll’ is negative.)

The study found that 87% stories by US major media outlets are negative in tone versus 50% for non-US major sources, and 64% for scientific journals.

The negativity of the US media stories didn’t change whether the cases were going up or down. When cases went down nationally, the media picked on states and counties where they were rising. The most popular stories watched on CNN or read in the New York Times had high levels of negativity, but the level was particularly high for covid-19.

Surprisingly, the negativity didn’t depend on political leanings. Liberal (MSNBC) and conservative (Fox News) were equally negative.

This could have practical consequences. The school re-opening decision might have been influenced by the level of negativity in the local media.

 The top newspapers in the study included Newsweek, USA today, Politico, New York Times and others. The TV channels (transcripts were analysed) included CNN, CBS, ABC, Fox news, NBC, MSNBC. Science, Nature, the Lancet, The New England Journal of medicine, JAMA represented some of the scientific journals.

Ranjan Sehgal, a co-author of the study said, “The media is painting a picture that is a little bit different from what the scientists are saying.”

*****

It is not that US journalists are producing false stories. They may simply be picking negative stories. One reason, the authors suggest, is that there is consumer demand for negativity. This is seen by our private gossip and social media. Schadenfreude, the German term, describes the feeling of joy at reading or watching others in trouble.

Other countries have dominant channels such as BBC (UK), CBC (Canada), Doordarshan (India) financed by the respective governments. They have no particular reason to cater to consumer demand. USA, among the democratic countries, has the highest level of media competition. They are competing on using negativity as a tool to attract viewers.

In 1987, USA eliminated its “fairness doctrine regulation” that required broadcasters to fairly represent opposing views. Such regulations exist in most other countries.

*****

As part of the research for my daily articles, I read many newspapers and TV websites. My view is that ideology is a key factor that decides the level of negativity. The Economist, for example, is far more positive than the Guardian, though both are British. I personally find Guardian more negative than NYT, though I enjoy reading both.

I don’t have television in my house. I recommend not watching covid-19 news on TV, just as advise my mother not to. That brings a lot of positivity to life.

Ravi 

Corona Daily 143: A Raid and an Ambush

The coronavirus vaccines have become a precious commodity. Not for their value, but for the perception they make a difference between life and death, between economic recovery and chronic recession.

Brexit has happened, and the sovereign UK has managed to vaccinate 40% of Britons, while only 10% of EU citizens have received the first shot. The Oxford/AstraZeneca is manufactured in Belgium and shipped to the UK. How can you ethically justify vaccinating a 30-year-old Briton, while keeping a 70-year-old Belgian waiting, asks the EU’s trade commissioner.

*****

Last weekend, the Italian paper La Stampa reported a police raid on the Catalent factory in Angani near Rome. The EU commission suspected the plant was hiding vaccine stocks for shipment to the UK. Tipped by them, the Italian police raided the place and found 29 million AstraZeneca doses “hidden”. After four days of investigation, it was confirmed yesterday the facility was a legitimate one for quality control. The doses were made outside the EU and brought here to be filled into vials. After the quality control, 13 million will be dispatched to Covax, for distribution to poor nations. The other 16 million were earmarked for Europe.

The European commission, satisfied, will still likely announce a ban on export of vaccines from the EU, particularly to the UK.

*****

In an incident on another continent, on Monday, 22 March, at 09.00 a.m. three unmarked white vans left an armory in Lubbock, Texas. Eleven uniformed soldiers from the Texas National Guard were given the responsibility of transporting coronavirus vaccine stocks in those vans. Some of the soldiers were so young, they could be mistaken for fresh trainees. After driving for ten miles, the vans stopped at a gas station across the highway for drinks. The guards were aware of the precious packages they were carrying.

After leaving the gas station, one of the three drivers noticed a truck trying to bully the vans off the road. This road rage went on for a few minutes. Finally, the truck swerved into oncoming traffic and blocked the convoy. A white bearded man in his late sixties, flashed a colt 1911 pistol .45 Caliber. He ordered the 11 soldiers to stand on the side of the road, hands raised above their heads. The bearded man had an additional loaded magazine on his person. On that small town highway road there were hardly any witnesses to this bizarre event.

The man said he was a detective, and that he wished to inspect the three vans. While he examined the first van, a young soldier managed to call 911.

In a few minutes, the Idalou Police Chief Eric Williams arrived with his team on the scene. He was made aware the vans contained the precious coronavirus vaccines. From a distance, the police chief saw the eleven captive soldiers and the bearded elderly gunman.

At the sight of the police, the man surprisingly put his pistol back in his trouser pocket. Before he could blink, the police had overpowered and handcuffed him.

The man’s name was Larry Harris, a 66-year-old from Alabama. A third magazine and more ammunition were found in the truck. He said he chased the vans on the suspicion that a woman and a child were being kidnapped. He is arrested on the charges of assault with a deadly weapon, unlawful restraint of eleven soldiers, impersonating a public servant, and interference with Texas military forces. The police chief said Larry Harris appeared to be mentally disturbed.

After the arrest, the three vans moved without any further incident and delivered the vaccines to the town of Matador, seventy miles further.

*****

In the Texas story, I found it interesting that the 66-year-old truck driver, possibly mentally disturbed, was armed to the teeth, while the eleven American soldiers had absolutely no weapons.

Ravi 

Corona Daily 144: Unidentified Flying Objects and Covid

In November 2004, David Fravor, the fighter pilot commander of a large US navy warship saw an object on his radar. He described it as white and oval, like the mint Tic Tac, probably forty feet long. It was hovering above the ocean. A team of fighters took off to investigate. One of the pilots recorded the UFO (unidentified flying object) on an FLIR, an advanced infrared camera.

*****

On 27 December 2020, Donald Trump signed a $2.3 trillion Coronavirus Relief and Government Funding legislation. The massive Act is 5593 pages long. Hidden among those pages is a demand that the US intelligence agencies and Defence Department tell the Congress and general public all they know about UFOs. They must report on UAPs (Unidentified Aerial Phenomena, also called “anomalous aerial vehicles”), including observed airborne objects that have not been identified. All documents must be submitted within 180 days (by June 2021) in unclassified form, in other words open in the public domain. A classified annex to the report is allowed as a concession.

*****

The mystique around UFOs goes back several decades. The CIA holds a massive trove of documents related to UFO sightings over the last 70 years. Various US agencies have been collecting information on UFOs using geospatial intelligence, signals, human intelligence, all information held in secret. The US government was officially very active between 2007 and 2012, with Pentagon running a program to look for threats from space. In the $600 billion annual defence department budget, the $22 million budget for this program was cleverly hidden.

Last April, after the start of the pandemic, the Pentagon officially acknowledged three UFO incidents and released the videos. The first was the 2004 tic tac incident, the other two were from 2015. The Pentagon spokesman said release of these videos didn’t compromise any investigations or sensitive information.

It is not clear what the unidentified objects are. The rational explanation is some kind of drones by earthly rivals (Russia, China, Iran, North Korea?) seeking to gather intelligence, rather than the more exciting extra-terrestrials usually associated with UFOs.

In August 2020, a Navy-led UFO task force was created. Its mission is to detect, analyze, catalogue UAPs (official term for UFO) that could potentially pose a threat to US national security.

Though the deadline is June, already nearly 3000 documents have been declassified. For those who take interest in UFOs, the documents can be found on the black vault website.     

*****

Several newspapers and TV channels have asked as to why the congress demand for declassifying UFO materials should be part of the Coronavirus Relief legislation. Nobody has answered that question.

Marco Rubio on the Senate Intelligence Committee has pushed aggressively for systems and transparency. He says the American public deserves the right to know as much as possible and the matter should not be kept secret simply because of the stigma associated with the term UFO. Rubio’s explanation doesn’t answer why the measure was pushed through the covid bill.

On the signing of the Covid bill, Republicans expressed joy saying they had ensured “safeguards to prohibit illegal aliens from receiving payment.” It is possible they took the term illegal aliens in its widest sense.

A senator opposing the bill may offer a clue. Senator Wyden mentions the costs of “digital classification” are ever rising, and now exceed $18 billion a year. $18 billion for keeping information secret. Year after year, the USA keeps increasing the mountain of classified information, spending billions of dollars. The classified information is generally useless for protecting national security as 9/11 showed.

The system of classification and declassification are broken. They are hugely expensive. It is possible this initiative was added to the Covid relief legislation, because it is easier to hide billions among trillions.

*****

Whatever the answer to the mystery, 2021 is a bonanza for UFO lovers. They can spend their lockdown time reading UFO records from the last seventy years.

Ravi 

Corona Daily 145: More on Bottlenecks

Vaccine developers are secretive about sharing the exact formula. Vaccines are patented products. Manufacturers have not shared the inventory of ingredients. But the supply chain has other critical products. The world is racing to have enough syringes to administer the vaccines.  USA and EU have been asking for more. Brazil has restricted exports of syringes and needles.              

In pre-covid years, the world used about 16 billion syringes a year. But only 5%-10% of them were meant for vaccination. In 2021, 10 billion syringes will be needed for covid vaccines alone.

Not any syringes will do the job. They must be smart, the auto-disable type (after using them once, they automatically become disabled.)

To maximise the output from a vial of the Pfizer vaccine, a syringe must carry an exact dose of 0.3 millimeters. The syringes also must have the so called low dead space – that minuscule distance between the plunger and the needle after the dose is fully injected- in order to minimize waste. Japan learnt this the hard way. It had paid for and secured 144 shots of the Pfizer vaccine for 72 million Japanese, assuming each vial contains six doses. But since Japan had standard syringes and not the “dead space” ones, they could extract only five doses per vial and vaccinate 60 million instead of 72 million.

USA and China are the biggest producers of syringes. But now, companies from other countries are entering the business. Mr Nath from Hindustan Syringes calls it a “bloodsucker” business, where upfront costs are astronomical and profits marginal.

*****

Lipid nanoparticles, the fat droplets used to deliver RNA into cells are a crucial piece of the Pfizer and Moderna vaccines that use the mRNA technology. In the past, this substance was used for research and a single approved treatment for a rare disease. Now it is suddenly in urgent demand for production of billions of vaccines.

Scaling up production of lipid nanoparticles has been identified as one of the most complex challenges. The Biden administration marked their shortage among “urgent gaps” in the vaccine supply chain. In December, the USA agreed to use the Defence Production Act to help Pfizer gain access to more lipids. Moderna has invented its own ionizable lipid and is also in a rush to build production capacity.

In the production process of the mRNA vaccines, a machine shoots two streams of solution – one containing mRNA and one containing lipids – into a high-speed collision. Such machines didn’t exist before the pandemic. The Biden administration has promised the use of the DPA to help Pfizer procure more specialized industrial machines. Pfizer and Moderna are committed to produce 300 million doses each for the USA till the end of July, and hundreds of millions more for Europe.

It is difficult to know the extent of possible shortfalls, because these companies don’t reveal such details. Though the USA has pumped millions of dollars into them, the vaccine makers have kept the raw materials supply chain secret, citing proprietary licensing deals and confidential contracts. Lipids were made in grams or kilograms pre-covid, now in tons.

*****

I will offer some basic figures to understand the vaccine production challenge.

Pre-covid, the world’s annual vaccine production capacity was 5 billion doses. One hopes that this capacity will not be diverted to covid, allowing resurgence of diseases like meningitis or HPV.

In 2020, the vaccine makers promised to produce 837 million covid vaccine doses. In reality, 31 million were produced (-96%)

In 2021, to vaccinate 75% of the world population with two doses, 11.5 billion doses will be needed.

With the existing capacity, expansion, no wastages, best-case scenarios, and a miracle, the production target is 9.5 billion (-18% of what is needed).

The first quarter (Jan-March) has produced 500 million doses. On a straight-line basis, if you multiply it by four, you get 2 billion for the year, much short of the 9.5 billion promise. That shows the level of the challenge.

In short, vaccination alone is unlikely to take us out of the pandemic in 2021. Share prices of AstraZeneca or Pfizer can shoot up suddenly, not their production capacities.

Ravi 

Corona Daily 146: Bottlenecks

On the fifth of March, my parents got their first shot of Oxford/AstraZeneca vaccine (called Covishield in India). They were told to get the second shot four weeks later. Today, the Indian government asked the states to increase the gap between doses to 6-8 weeks. Reportedly, the Oxford vaccine will henceforth be given only as a second dose. Anyone coming for the first dose will be given Covaxin, a locally developed vaccine by Bharat Biotech.

The Serum Institute of India, the world’s largest vaccine producer, has informed several countries of possible delays in supply. The European Union, embarrassingly lagging in vaccination, is considering banning export of vaccines. UK’s ambitious plans have suddenly hit a roadblock.

Why are the vaccine shipments getting delayed everywhere?

*****

Anyone who has worked in the manufacturing industry knows how complicated supply chains can be. The i-phone, the size of our palm, is assembled in China with components coming from over 27 countries. Each product has suppliers for equipment and raw materials, and the suppliers in turn have other suppliers. The logistics of this entire pyramid must work as planned. Even in our personal lives, we know the wide variance between our plans, our desires, and reality.

Industries get close to their targets after decades of trial. But covid vaccine production is an infant.  A year ago, the USA invested billions of dollars to develop the vaccines, but not enough attention was paid to the supply of the raw materials.

The raw material suppliers had full sets of orders from pharma companies for items totally unrelated to covid. Now suddenly, they have been asked to set everything aside, expand their capacities, build new equipment, employ skilled workers, and refuse supplying to their earlier customers.

*****

A new production facility for a vaccine like Oxford can take six to nine months. The biggest issue, unrelated to raw materials, is with yields. Yields depend on the health of the underlying cell culture. Quality control issues, such as those relating to temperature, humidity or compromised sterility, lead to less vaccine at the end of the process. Surprisingly, at two identical facilities, the yields can vary by a as much as an order of three. Human nature, particularly in an emergency, tends to take the best-case scenario. Even running three shifts doesn’t help when the output can vary wildly.

*****

A shortage of any critical item results in irreplaceable shortage of vaccines. Pfizer, Moderna and Novavax vaccines use bioreactor tanks. If it was a restaurant kitchen, you could call them containers for vaccine soup. The bioreactor tanks need giant disposable plastic bags as sterile liners. Without them the vaccine may get contaminated. In EU and some other countries, this has emerged as a production bottleneck. The sterile plastic bags are produced by a small number of suppliers, and vaccine producers have struggled to source them. Merck has now announced expansion plans to address this issue.

*****

Or take the case of vials. The liquid vaccine has to be put into vials before it can be distributed. Pfizer and Moderna vaccines require ultra-cold temperatures to preserve them. Normal glass vials would break in the super-freezers. Just a single damaged vial can ruin an entire batch of doses and stop the production line. Corning, the US manufacturer, was asked to supply special super strong Pharma grade glass called Valor.

Most vials need rubber stoppers. In autumn 2020, tropical storms in Thailand, Vietnam and India led to rubber shortages.

United States of America is now hoarding rubber. Both Trump and Biden used a 1950 act from the Korean war times called “the defence production act”. This allows US presidents to order a private company to divert manufacturing to what the State needs. A year ago, for example, General motors was ordered to produce ventilators. Biden is likely to use this act to use the scarce rubber for vaccine needs.

Rubber gloves are recommended to administer a vaccine. Except the USA, all other nations are likely to face shortages of rubber.

*****

More on the bottlenecks tomorrow.

Ravi 

Corona Daily 147: Two Lonely Generations

At the beginning of this month, I came across ShareAmi, a website that connects French language students with elderly people in France. With the pandemic, many foreign students learning French had their internships, summer camps, cultural exchanges cancelled. They were worried about losing touch with the language. ShareAmi has managed to link nearly 7000 students with elderly native speakers, many in Parisian care homes. The Zoom calls have proven mutually beneficial. Students reported that finding subjects for conversation was much easier than they had imagined. (My own experience when learning foreign languages is that the older generation has superior phonetics and diction. Elderly ladies are the easiest to understand for a foreigner).  

*****

Last week, I came across a study conducted in the USA. Based on the interaction with 950 Americans, the study finds that the loneliest group in the pandemic is age group 18-25. Even before the pandemic, young adults were shifting to virtual interactions. The pandemic has made them lonelier. Their main grievance, the study finds, is that nobody sincerely bothers about how they are doing.

The second loneliest group is the elderly 70+.

It seems the pandemic has further widened the gap between those two groups.

*****

I must point out this is an American study. Its results may apply to rich nations and rich households. In countries like India, where three generations routinely live together, this is not a problem, before or during the pandemic. As a child, I was raised by my grandmother, while my professor mother taught at the university.

The elderly possess a certain wisdom and life-long experiences about love, work, friendship, mortality they can share with the young. Young people, on the other hand, can teach them technology, have more pronounced views on racism or climate change. The grandparent generation produced lots of children, but the youngest have better sex education. My daughter can explain LGBTQ+ to my mother. The elderly have lived through wars and epidemics. They find it easier to believe the pandemic is temporary and will pass. During the Spanish flu, multigenerational households were a global norm.

Covid-19 is the first pandemic where millions of elderly and millions of young people are lonely. Loneliness is a pandemic itself that is getting worse.

*****

Like the ShareAmi French language initiative, there are other reports about these two lonely generations connecting with each other.

18-year-old Ella Gardner volunteered to shop and do chores for the elders. For her anthropology paper, she extensively Zoom interviewed her grandfather. Ella was always nervous about getting old. Her interaction during the pandemic has convinced her ageing is a natural process, and that older people can be very happy as well.

Sam Cozolino, 14, decided to use the lockdown to build a family tree. He started contacting his relatives in the USA, and Italy where his ancestors came from. This made Sam’s life busy and full of social interactions. His paternal grandmother told him stories about the family growing up in poverty in the USA during WWII. After hearing them, Sam realized the pandemic was not half as bad.

In many countries, teenagers are volunteering to book vaccine appointments for the elderly. Where vaccines are scarce, getting an online appointment may require technical expertise and perseverance.

In Boston, a company called Nesterley has started a home sharing service. Elders with extra rooms are matched with young people looking for affordable accommodation. Nesterley has some uplifting stories. In one home share that started during the pandemic, Michael Nelson, 28, a Harvard student from Denmark rented a room from Laurinda Bedingfield, 67, a retired civil engineer. Michael now bakes bread and cooks vegetarian meals for Laurinda. They go for walks together. Once she gets both her shots, she has promised to teach him photography and art.

“I feel much less isolated knowing that Michael is nearby. I have a friend who lives on my property and I can call him any time if I need help.” Said Laurinda.

Ravi 

Corona Daily 148: Living in the Right Place

To get a covid vaccine, where you are is as important as who you are. An article by Allison McCann and Lazaro Gamio in yesterday’s NYT illustrates the point well. Here are its main points with my additional analysis and comments.

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As on 18 March, a 16-year-old in Israel, a 16-year-old in the American city of Mississippi, or an 18-year-old in Shanghai could get a vaccine.  

 On the other hand, a 70-year-old in Shanghai, 80-year-old in Kenya or 90-year-old in South Korea can’t get vaccines. In China, trials were conducted only on those below sixty, so China is reluctant to vaccinate the elderly. Kenya’s very few vaccines are reserved for medical workers. Koreans older than 75 are not yet eligible.

In 67 countries, mainly African, nobody can get vaccines, because they are not available.

Covax, a global vaccine sharing project, was conceived to distribute vaccines equitably around the world. The rich nations, however, placed direct orders with the vaccine makers, and grabbed more than enough doses. USA currently holds millions of AstraZeneca doses in storage, which they don’t use because the vaccine is not approved. In Brazil, where it is approved, more than 2000 people are dying daily partly because of vaccine shortage.

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Anyone who can pay $13,000, is above 65, and with comorbidities can book a three-week holiday to the UAE and get vaccinated in Dubai.

Any member of Congress in the USA has top priority irrespective of age, health or gender.

In Manaus, the highly infected capital of Brazil, friends of Virgilio Neto, the mayor of Manaus can easily get vaccinated. The same with Lebanon lawmakers and military leaders in Spain. Families of ministers in Peru and some other Latin American countries qualify.

A smoker in Illinois can get it, because he is a smoker. But a smoker in Georgia doesn’t qualify. A grocery worker in Oklahoma can, but one in Texas can’t. A postal worker in North Carolina is allowed, but not one in California. The state of Connecticut doesn’t prioritise a diabetic, whereas the United Kingdom puts diabetics ahead in the line.

A pregnant woman is allowed to get a vaccine in New York. Germany doesn’t allow pregnant women to be vaccinated. However, two close contacts of a pregnant German woman get the vaccine to keep her safe.

Belgium has a high covid death rate per million. But teachers in Belgium have no priority, whereas all teachers in Mexico do.

Correctional officers working in Tennessee prisons are vaccinated, but the prisoners they deal with are not eligible because they have committed crimes.

Refugees in Germany and illegal immigrants in the UK can get the vaccines, because the virus has shown little respect for a person’s legal status.

France prioritises chauffeurs and taxi drivers. Japan gives priority to people with a body mass index of more than 30.

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Israel is the best vaccinated country with half its population fully vaccinated. However, Palestinians who live in the lands occupied by Israel don’t get the vaccines, unless they hold a work permit to work in Israel.

A gorilla or orangutan in the San Diego zoo can get the vaccine.

In total, 43 rich countries, mainly from North America and Europe, will complete their vaccination campaigns this year. Low-income countries, 148 of them, are looking at 2023 and beyond.

USA has given at least one shot to 23% of its population, UK 39%. South Africa has lost 52,000 people (870 per million). It has vaccinated 0.3%. Iran with 61,000 deaths (728 per million) has so far managed 10,000 doses for the whole nation. Peru is another country with a high number of cases, and hardly any vaccinations.

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In India, you get a vaccine if you have internet access, are above 60, or above 45 with comorbidities. However, I know Indians as young as 37 who have managed to get the shot.

If you live in the right place, then it becomes important to have the right connections.

Ravi