Corona Daily 081: Chinese Lab Leak Theory: Part Two

In this debate of natural spillover vs lab leak, it is critical to understand a term “Gain of Function Research.”

In virology, this research is done with the intention of better forecasting future pandemics and developing solutions to them. Scientists take a virus, usually known to endanger humans, and start tweaking it to make it more transmissible or more lethal. This is a dangerous game. The idea is to develop in the laboratory viruses that may start deadly pandemics in the future, so as to develop medicines and vaccines in advance.

Scientists who support such research argue this is the only way to stay ahead of the epidemics. New diseases emerge all the time and viruses keep evolving. This research allows the world to stockpile vaccines and antibodies.

The opponents agree this objective may be noble, but the research is capable of building Frankensteins. Robert Oppenheimer, the father of the atomic bomb, and Albert Einstein, the greatest theoretical physicist, were scientists and professors. In their scientific endevour, they probably didn’t plan to drop nuclear bombs on Hiroshima and Nagasaki – but that is what happened in the end.

The troubling thing is that the Wuhan laboratories routinely create viruses more dangerous than those existing in nature. The Chinese don’t deny those man-made mutations. They argue they can do it safely, and stay ahead of nature in the game. Dr Shi Zhengli, the Chinese Batwoman, and her team has done work on inserting cleavage sites into viruses to check if that enhanced their ability to infect humans.

Such man-made viruses are called Chimera viruses. Combining two pathogenic viruses increases the lethality of the new virus. That is why Chimeric viruses are generally considered a bio-weapon. The USSR had secretly tried combining encephalitis and small pox, and later Ebola and smallpox.

There have been cases of lab leaks before. But most have infected and killed very few people. Scientists believe that the annual H1N1 flu (1977-2009) was the result of a leak. The strain first appeared in Eastern Russia, and its genes were identical to a 1950 strain that was presumably stored in a Russian freezer for 27 years. The virus behaved as if it was deliberately weakened. The assumption is that Russian virologists were trying to develop a vaccine against the return of the 1918 flu.

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Having established that the Wuhan scientists have worked on developing Chimera viruses, let us now go through all the evidence that has emerged so far.

On 23 May, the Wall Street Journal published a report that three researchers from Wuhan Institute of Virology had become sick and were hospitalized in November 2019. Their symptoms were consistent with both Covid-19 and common seasonal illnesses. This is part of the US intelligence report that was not previously disclosed.

Shi Zhengli and the Chinese government have denied anybody from the institute was ill. So, it is the American word against the Chinese word. We live in a world where it is difficult to trust any government. If US intelligence really had any evidence, it is impossible that Donald Trump would have let it go. Unless more specific evidence is produced, it is difficult to take the WSJ report as proof of anything.

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On 19 February 2020, a group of public health scientists had issued a statement in the Lancet in support of the Chinese scientists. It strongly condemned conspiracy theories that covid-19 doesn’t have a natural origin. Genome analysis, the statement said, overwhelmingly concludes that the coronavirus originated in wildlife.

One of the authors was Peter Daszak, a British zoologist and president of the EcoHealth Alliance in New York. Now it turns out that the letter was organized and drafted by him. Dr Daszak’s organization funded coronavirus research at the Wuhan Institute of Virology. If the covid virus really leaked from the research he financed, he may be held potentially guilty. Dr Daszak pro-actively hid this conflict of interest. The lancet letter ends with: “We declare no competing interests”.

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(Story continued tomorrow)

Ravi 

Corona Daily 082: Chinese Lab Leak Theory: Part One

In January 2020, from what we read in the news, the coronavirus first appeared at Wuhan’s Huanan seafood market. Wet markets around the world are literally wet because of live fish splashing in tubs of water, melting ice to keep meat cold and the blood and organs of slaughtered animals.

Wuhan’s market was not only a wet market, but a wildlife market. It sold exotic live and killed species: snakes, beavers, porcupines, baby crocodiles and others that people in other continents would not imagine eating.

The non-vegetarian food in Europe, USA or India is usually made from animals that are themselves largely vegetarian: cow, lamb, duck, chicken. Chinese, on the other hand, can eat carnivores. Some people wondered if this could be the cause of the virus appearing at the market. It is true that wildlife and human life should have some distance from one another, to prevent a virus spillover. In the beginning of 2020, the world demanded that China should shut its wildlife markets.

One question made me uneasy. Why now? Chinese people have been eating wild animals for over 1000 years. Earlier, China was extremely poor. For survival, they had to eat whatever moved on four legs. After developing a taste for centuries, the habit continued even for well-off Chinese. If the Chinese have been buying exotic animals for centuries and eating them, why should that cause a pandemic now?

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Trump called it the Chinese virus. Conspiracy theorists said this was China’s bio-weapon to become the ultimate superpower. Scientists analyzing the DNA of the virus said it was a natural virus, not made in any lab.

Now eighteen months later, more information is available. Last week, 18 leading biologists have published a letter calling for a new investigation. Once again the Chinese Lab Leak theory is in the news, big time.

It is like a murder mystery where only circumstantial evidence is available. The balance of probabilities can help us form a judgment.

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The four possibilities discussed last year were:

(a)  Natural: From the Wuhan seafood market or somewhere else. A few infected Chinese patients at the beginning of the pandemic had nothing to do with the seafood market. It is possible the food from the market reached and infected them. However, it is increasingly accepted the seafood market was not the primary source.

(b) Regular scientific work, but bad safety: The Wuhan lab may have been researching tests or vaccines, which is a legitimate activity. Accidentally, a breach caused the leak.

(c)  Bad intentions, and bad safety: Chinese scientists were trying to create an engineered bio-weapon. Just like nations developing nuclear weapons, without planning to use them. Sadly, an accidental leak occurred.

(d) China deliberately released the covid virus: This theory is considered unlikely. If it was deliberate, China didn’t need to launch the weapon in its own territory.

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In late December 2019, doctors at hospitals near Wuhan’s Huanan seafood market began seeing patients with a strange viral pneumonia. On 30 December, the Wuhan Municipal Health commission issued a warning. On the following day, WHO put out a global alert.

On 1 January, the Huanan seafood market was closed and hosed down with water. This was a crime scene that might have contained clues. Before the market closure, sellers were driven away with their animals. Some sellers may have had infected animals. Some live animals or fresh meat may have gone to other markets or in the trash. Customers left the market. And then the hosepipes cleaned it. The best epidemiological evidence was probably lost.

The Chinese health commissions then ordered diagnostic and genetic labs to destroy the samples of viruses they held, or pass them to the high level biosecurity lab. Most labs burned them. This was cited as a cover-up by the Trump administration. However, this is a standard safety procedure to prevent an outbreak. In 2014, CDC USA had given a similar order when Ebola was detected.

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(Continued tomorrow) 

Corona Daily 083: Father of Social Distancing

Sanitary measures described include: (III) Through edicts, the population must be warned that citizens who do not declare new cases - cases that occur in their houses and in other houses - within six hours will be prosecuted.

(IX) Meetings, dances and entertainments are strictly forbidden.

(XXII) The pharmacists must provide the poorest with the necessary treatments. A list of the citizens must be kept to distinguish between the poorer and the richer. The richer will pay for their treatments and the city government will pay for the paupers.

(XXXIII) It is highly recommended to be careful when shaking hands.

(XXXIV) All citizens are compelled not to leave their houses. Only one member per household is allowed to go out for shopping.

(XXXVI) People allowed to go out must bear with them a cane measuring 6 feet long. It is mandatory that people keep this distance from one another.

(XXXVIII) A large rail (parabanda) must be positioned in front of the counters in the shops in which meat, bread, wine and foodstuff are sold so that citizens will keep their distance from the counter itself.

These measures are from a manual (1588) published 433 years ago.

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Alghero is a small town on the island of Sardinia, in Italy. In November 1582, a sailor arriving from Marseille imported plague from France. The disease was known as Buboes that affected the groin area. Alghero had Morbers, plague guardians, to check outsiders at the borders and stop them if they showed symptoms. This French sailor escaped scrutiny, became ill and died, but not before starting an epidemic.

This was much before modern science; diseases were still considered a divine punishment. They were caused by “bad air” (mal aria) and vinegar was the sole antiseptic. Plague treatments ranged from bathing in one’s urine (disgusting), to drawing the poison out of buboes by rubbing that part with the rump of a live chicken (absurd).

Against this background, appeared Quinto Tiberio Angelerio, a 50 year old doctor who had studied abroad. Fortunately, he was fresh from Sicily, which had experienced its own plague epidemic in 1575.

Angelerio took charge and set up a triple sanitary cordon around the city walls. The measures suggested by him: no handshakes, 6 foot distance, cancellation of all entertainment made him so unpopular; people wanted to lynch him. However, as more and more people died, his authority came to be accepted. People began self-isolating for forty days. (Quarantine comes from quaranta giorni, meaning forty days in Italian).

Some Italians secretly visited the houses of the infected, to meet friends, play the guitar and drink together. They were duly prosecuted.

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Angelerio also passed a decree specifying the eligibility of the gravediggers. Only those who had already contracted and survived the plague qualified. Theirs was a high risk job because they would transport confessional booths to the bedsides of dying patients, and deal with the dead bodies. Angelerio was ahead of his time, because the concept of immunity was not yet known.

A plague hospital, lazaretto, to isolate infected patients was an Italian concept. They were built all over Sardinia. Part-hospital, part-prison, patients were usually taken there by the city’s plague guardians.

Angelerio made certain the lazarettos in Alghero were efficient and humane. The plague guardians had to record everything that came in and went out – beds, furniture and food. The lazarettos were free for the poorest. Orphaned babies without a wet nurse were bottle-fed with goat milk. Goats were allowed to roam freely within the complex.

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The outbreak in Anghero lasted eight months, and then there was no epidemic for the next sixty years. When the next plague happened, the first thing that was referred to was Angelerio’s manual. (He had died in 1617). During the 1652 outbreak, the island followed to the letter his instructions, including the 6 feet social distancing. (I recommend reading the 57 instructions from his book).

Recent research suggests that 6 feet is indeed safer than three or four feet.

Ravi 

Corona Daily 084: Crew Change Crisis

Ordering online on Amazon has become so easy. Few people realize that most things we order sit in a container on a ship at some point.

The Pandemic brought to a near halt all passenger cruises. But cargo, oil, component parts, food and finished goods must still be transported by ships. 90% of the world’s goods are transported by water. Seafarers’ work is demanding, working hours are long and irregular.  To avoid a burnout, they usually work in months-on, months-off rotation. In March 2020, shipping ports and airports closed. Shipping companies stopped shore leave for crews. Naval orders prevented military and civilian sailors from leaving the ships. Some are stuck for as long as 20 months, though 11 months is the maximum allowed by the Maritime Labour Convention. Seafarers stranded at home don’t earn anything. At the peak of the crisis, 400,000 seafarers were stranded. Today, that number is still as high as 200,000.

The situation may get worse. Most sailors have no access to vaccines due to the logistical challenges.

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In the maritime industry, licences and certifications are critical. The education and updating include in-person instruction and on-the-job training with equipment. But all classroom training has stopped for over a year now. Without proper certification, workers can’t get new jobs; no new cadets can be recruited. A chief mate can’t become a captain, and a second engineer can’t be promoted to the post of a first engineer.

It is estimated it may take five years to get back to the normal cycle. My next-door neighbor in Bombay, 61, an engineer who was scheduled to sail on an oil tanker, opted to retire instead once the pandemic began. Such unplanned retirements are aggravating the situation.                

Extended time on vessels causes worsening fatigue. Human errors induced by fatigue are a contributing factor in 75%-96% of marine accidents. A single mistake or accident can have a domino effect throughout the global supply chain. The Taiwanese Ship Ever Given that accidentally blockaded the Suez Canal delayed roughly $10 billion a day of trade for moving oil and manufactured goods.

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In numerous incidents, mariners suffering medical emergencies onboard were unable to go ashore for vital treatment. In January this year, a Greek captain tried to obtain medical care for a crew member off the coast of China. The captain spent hours negotiating with the port authorities to take the man to a Chinese hospital. He failed. The ill man was a Chinese citizen.

“We are spending our lives here.” The Greek captain said in a video. “We’re all prisoners and our freedom is sacrificed in order to maintain worldwide trading.”

The UN requested world governments to designate seafarers and other marine personnel as “essential workers”. Sadly, 118 out of 174 countries haven’t done so. This is another reason there has been no effort to vaccinate them.

Shortages of crew and cost-cutting have meant that the ship is usually very tightly crewed. There are no reserves for any position, and those working overwork. If the cook falls sick, crew must still eat, and no matter how many people are unwell, someone must stand watch. If there is a case or an outbreak, the ship will be out of commission at least for two weeks.

Pre-pandemic, the global supply chains also try the “just-in-time” principle for cost efficiency. A ship stopping for two weeks can stop several factories at the destination.    

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Major shipping lines have tried to increase the internet bandwidth on ships to allow sailors to connect with their families easily. Maersk and CMA CGM have chartered flights to change crews.                                      

USA or Britain getting out of the pandemic is no comfort for the seafarers. They must have restriction-free situations at the starting point, transit ports and the destination. The Pandemic is over for the shipping industry only once the whole world is free of coronavirus.

Until then, what you order on Amazon may occasionally be delayed. Unless the world unites to resolve the crew change crisis, it is likely the prices for many goods carried on ships will zoom upwards. That is when this crisis will be truly appreciated.

Ravi                                                                                                                 

Corona Daily 085: Copycat

India’s vaccination drive is in a mess. At least 130 million Indians are waiting for their second dose; their appointments cancelled, and promises broken. The initial gap of 28 days between two doses was extended to 45 days, and now 84 days. Even while India didn’t have enough vaccines for 45+, it made them available for everyone above 18.   

 Today, the executive director of the Serum Institute, the world’s largest vaccine maker, said the government (euphemism for Modi) widened the vaccination drive without considering stock levels or the WHO guidelines.

I will try to offer a logical explanation for PM Modi’s actions.

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Last year, on 19 March, Narendra Modi, in his address to the nation asked Indians to applaud the doctors and nurses. On 22 March, everyone should come out of the house, clap, bang pots and pans, ring bells at 5 pm, for 5 minutes. It was a passionate speech. Modi is an orator and actor of a high caliber. If instead of politics, he had joined the film industry, both Bollywood and India would have greatly benefited.

Neither in his address nor Twitter was there any hint that something similar had been done before. Millions of Indians still believe this was Modi’s original initiative.

In Europe, Italy started with pots, accordions, songs and clapping. Paris followed. Before Modi suggested it, the idea was implemented in Wuhan, Istanbul, Atlanta, and Buenos Aires. Of course, Modi was not obliged to mention the other places. But it showed the man was capable of copy-pasting ideas without acknowledging their origin.

It is noteworthy that in all other places, even in Wuhan, the clapping and pot banging was done by the people spontaneously, no government was involved.

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On 27 March, 2020, the USA passed the CARES Act, a revolutionary stimulus bill that offered $2.2 trillion for the survival of Americans and the US economy during the pandemic. This unprecedented Act contributed to the development of vaccines.

On the same day, 27 March, 2020, India launched the PM CARES fund. There were certain differences. Before Trump’s signing the CARES act into a law, the US Congress had to debate and pass it. That is a lengthy, bureaucratic and inefficient process. Narendra Modi simply launched the fund, which was private, with no public debate before or scrutiny after. A narcissistic prefix was added to let Indians know who cares about them. America’s CARES act package was almost 70% of India’s GDP, it was impossible to match it. Instead, the PM CARES fund decided to collect money from the people. $400 million were collected.

Serum institute’s owner had asked for $10 billion. PM CARES allocated $14 million for vaccine development.

Most importantly, India managed to launch its own CARES on the same day as the USA. Since America first debated the bill, it gave Modi enough time to synchronise the date. Just like a smart copying student changes little bits here and there, the full form was altered. USA’s CARES stood for Coronavirus Aid, Relief, and Economic Security. Modi’s CARES meant Citizen Assistance and Relief in Emergency Situations.

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There was no plan to vaccinate people younger than 45. But then on 11 March, Joe Biden made an announcement: As part of America’s war-time effort, he would make every adult (18+) in the US eligible for vaccination no later than 1 May.

Modi was busy addressing election rallies in front of record crowds. He hurriedly noted the news. At the first opportunity, back in office, he announced India would make every 18+ Indian eligible for vaccination from 1 May. Vaccine shortage didn’t matter. Once again, Modi managed to match America word for word, date for date.

If you think these are mere coincidences, remember Modi is fiercely competitive. In 2016, with shocking abruptness, he made 86% of the Indian currency illegal. He ensured the timing synchronized with the US presidential election. For the entire day, Indian TV channels were focused on the loss of currency rather than loss of Hillary.

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In academic institutions, the plagiarizing student gets disciplined. Here, Indians are being punished for copy-pasting by the man supposed to govern them.

Ravi 

Corona Daily 086: Miscarrying Cows

In the beginning of the twentieth century, USA had an epidemic among cows. A bacterial infection called brucellosis was spreading through the cattle, causing spontaneous miscarriages, known as “contagious abortion”. By the 1910s, the miscarriages threatened livestock across the USA.

Worried about the disease, farmers would kill the diseased animals, to try to eradicate bacteria from their herds. George Potter, a vet from Kansas had an epiphany: a cow getting brucellosis may lose its calf, but at the same time acquire immunity to the disease. An immune cow was more valuable than an uninfected one.

In a 1918 article in the Lancet, Potter compared the miscarriage disease to a fire, which unless new fuel is constantly added, dies down. “Herd immunity is developed, thereby retaining the immune cows, raising the calves and avoiding the introduction of foreign cattle. This was the first known use of the term “Herd Immunity”.

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In the 1920s this concept made some scientists curious. They began deliberately infecting mice to see how the disease spread through their colonies. They discovered that above a certain threshold, the infection couldn’t find new hosts, and stopped spreading.

In 1923, a British pathologist Sheldon Dudley studied a diphtheria outbreak at a crowded navy school. One thousand children of naval officers ate together in a dining hall, and slept in cramped military-style barracks. Dudley found that every time new students joined the school, the diphtheria bacteria would attack the newcomers, and an outbreak would start again. In 1924, Dudley applied, possibly for the first time, the term “herd immunity” to humans.

Now in covid times, a semi-literate person uses the expression. Equating us to cattle may sound offensive. But the term’s origin was in the herd of miscarrying cows.

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While Dudley was studying diphtheria, a diphtheria vaccine was developed. He began wondering: What is the best way to reach herd immunity: natural exposure or vaccination?

Last year, several heads of states thought of reaching herd immunity through natural exposure. To be fair, there were no vaccines then. Johnson started with it in the UK. Trump’s advisor Scott Atlas, who called himself anti-Dr Fauci, recommended it. (Trump was so unengaged; he often called it herd mentality). Sweden took it as an official state policy. And Russia adopted it without an official pronouncement.

All these nations were heavily punished. The UK and USA had to rethink. Sweden acknowledged the unnecessary loss of thousands. Russia has unofficially lost more than half a million to covid.

It is possible to opt for mass natural exposure if the virus is not deadly. Without vaccinations, Indians develop herd immunity against the flu every season. Because flu is not so deadly. Covid virus kills and maims. Such a plan inevitably leads to catastrophic loss of lives and suffering. We usually look at the death count. But many infected people suffer long covid, with damaged organs. They may take years to recover, or not recover at all.

Herd immunity against covid through natural exposure is rejected by scientists as unrealistic and unethical. Vaccination is the only ethical road.

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The formula for calculating the required herd immunity percentage is 1- (1/R0), which in simple language means the more transmissible the virus, the higher is the %. For example, measles, an extremely infectious disease, has an R0 between 12 and 18, which translates into a herd immunity threshold of 92-94% of the population.

Looking at this number on a national basis is a mistake. In large countries like the USA or India, some places may be vaccinated enough to reach immunity, but less vaccinated pockets may still be vulnerable.

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Finally, when the USA or UK currently say their R0 (spreading rate) is low, it is low because of the lockdowns, masks, handwashing, and distancing. When human behavior changes; people start throwing masks away, and hugging; the R0 can go up, and with it the herd immunity % required shoots up. Coming months will show whether the joy of these nations was premature.

This is why fully vaccinating an entire nation and the entire world may be the only effective way to achieve herd immunity.

Ravi   

Corona Daily 087: Inseparable

In 1997, when Joefred and Ralfred were born with a gap of three minutes, their parents couldn’t tell them apart. Along with an older brother, they grew up in a one-story house in Meerut, a satellite town of New Delhi. Their parents were teachers in a Christian school. In their neighbourhood in Meerut, there were not many Christian families.

Joefi and Ralfi as they were called went to the same school. Identical twins tend to share a special bond; they cooperate more and are usually gentle with each other. It is also a norm that as children, twins wear identical clothes. What was a little unusual was that Joefred and Ralfred continued this habit in teens and beyond. They dressed the same at parties, weddings and community functions. They wore matching clothes, and trimmed beards to the same length. Next door neighbours confessed they couldn’t tell who was who. Both were around six feet tall, with similar muscular build.

 The parents, in their defense, said they didn’t raise the twins to copy one another, it was their own initiative.

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Not surprisingly, Joefred and Ralfred went to the same college. This was away from home, in Coimbatore. The committed pair graduated in computer engineering from Karunya University. Neither Coimbatore nor Meerut had big international companies that would give them suitable jobs.

Both applied to companies in India’s technology hubs, and managed to get their first jobs in Hyderabad. Not in the same company, though. Joefred joined Accenture, while Ralphred was recruited by Hyundai Mubis. With substantial research, the twins had mapped out their future path. They wanted to move first to South Korea, and after working there for a few years, to Germany. Had the pandemic not happened, they could have already left for Seoul, and their life story would have taken a different turn.

However, once Hyderabad went into lockdown, the brothers started working from home. They spent a few months working from home in Hyderabad. When everyone understood the pandemic would last for more than a year, Joefred and Ralfred decided they should move back to Meerut and spend the locked up time with their family. For computer engineers working for software companies, it doesn’t really matter where they are located. Had they not taken that decision, they would still be working from their Hyderabad home.

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Last month, on 23 April, both celebrated their 24th birthday quietly with their family. In 2020, stuck in Hyderabad, they had sought their parents’ blessings over the phone.

The following day, on 24 April, both Joefred and Ralfred tested positive. After a week of fever, and discomfort in lungs, the family decided to move them to Anand Hospital, a reputed private facility. Realising their oxygen levels were low, the doctors put them on ventilators in the intensive care unit, a few beds apart, Joefred in bed 10, and Ralfred in 14.

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A week ago, on the morning of 13 May, Joefred, the twin older by three minutes, had his oxygen level fall to 48. The twins’ mother was sat outside the ICU. The doctors requested her to go home. In the afternoon, they broke the news of Joefred’s death to the parents.  

When the parents went back to the ICU to check on Ralfred, he kept asking: “Where is Joefi? Where is Joefi?”

“He has been moved to a bigger hospital in Delhi.” Said the mother. The parents had agreed that’s what they would tell Ralfred. They thought his condition would get worse if he was told what happened.

“You are lying, mom. You are lying.” Said Ralfred as loudly as he could through the oxygen mask.

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The next morning, Ralfred died. The depression on suspecting the news about his twin probably hastened his death.

His father told the Times of India he intuitively knew both sons would come back home, or both wouldn’t. “Whatever happened to one, always happened to the other.”

Under a young Neem tree, Joefred and Ralfred are buried in two coffins, but a single grave.

*****

Ravi   

Corona Daily 088: Truck Drivers Wanted. Pay $100,000

Many of us visit the nearby supermarket or mall to buy dozens of different items. We don’t see their journey from the factory to the supermarket. In large geographies like the USA, Canada, Australia; truck drivers drive thousands of miles to bring the products closer to the household. In the USA, more than 70% of goods hit the highway at some point before they reach the shopper. Coca-Cola, the world’s best distributed brand, owes its success partly to the trucks that distribute the drink. (One may add distribution of vaccines now. With few manufacturing plants, vaccines travel long distances.)

Driving an 18-wheeler truck requires a special license and prolonged training. Working hours are long, some of them not paid for. In many countries, when loaders are loading the truck, the driver stands next to it, or helps with the loading. However, his clock and payment generally starts only once he begins to drive. He may have to drive for days alone, stay away from his family for weeks. A cigarette may be his only companion on the journey. Truck drivers suffer from sleep disorders and sleep deprivation. Their eating habits are poor, irregular, the food junk. With no exercise, a sedentary lifestyle and lack of access to care, 86% of American truck drivers are overweight or obese. Despite all this, they are treated like dirt and are the lowest rung in the economic caste system.

It is also an ageing profession in North America, because the young are not willing to join it. 94% truck drivers are male. Desperate young men from Eastern Europe, some staying illegally in the US, work as truck drivers. Because the shortage is huge, and continued, the pay is good. $73000 per annum is the average, but $100,000 is possible for the Class A drivers.

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Last year, most driver schools were shut since the first lockdown. As a result, the new inflow stopped. As luck would have it, just before the pandemic, in January 2020, USA had fired 60,000 truck drivers for drug or alcohol violations. Since April, many aged drivers opted to retire instead of driving in these challenging times. In April 2020, turnover of drivers was 70%.

The Pandemic forced them to work longer hours. The scheduled truck stops became very crowded. It was difficult to find food. Though the driver is isolated most of the time, when he comes out of the truck, he is using common public bathrooms and restaurants. Because of poor health and obesity, the risk of catching the virus and taking it home was high. Drivers were no longer allowed to use personal mugs for coffee, but use disposable cups. Lounges where drivers typically gather to watch TV were closed. Sit-down meals were banned. The driver, after a long drive, had to sit in his truck and eat the takeaway.

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Carrying gas (petrol) in America has been a bigger issue. Now 20-25% of the tank trucks are idle for want of qualified drivers. Many drivers left the business when gasoline demand ground to a near halt during the shutdowns. Some transport companies shifted their drivers to work for Amazon, simply to not lose them. The elderly drivers were not keen to follow what they considered draconian shutdown protocols.  

Some of the drivers who worked during the first months shared their stories. One driver said somebody came up alongside, blew the horn, and asked him to roll the window down. Then he was asked whether he was carrying toilet paper in the truck.

Another driver, who has been working for 40 years, had a few people thanking him for working during the pandemic. Truck drivers had made sure people locked up home were able to get all essential goods.

Driving trucks for thousands of miles was termed a patriotic duty. The pandemic was the first time many truck drivers, in their long career, received thanks for their thankless job.

Ravi 

Corona Daily 089: That Pandemic and This Pandemic

This week, the USA and UK are kind of celebrating the end of the pandemic, in their respective countries. America has allowed people not to wear masks, both outdoors and indoors, provided one is fully vaccinated. However, since vaccination doesn’t create a visible tattoo for others to see, the maskless mingling is based on trust. In Britain, since yesterday, people are madly hugging, a revenge for year-long missed hugs.

In Brazil and India, systems are overwhelmed and broken. Far more patients than hospital beds. Far more bodies than pyres at the crematorium.

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When will the pandemic end, I mean truly end in the whole world and not specific parts of it? The 1918 Spanish flu pandemic may offer some lessons.

Laura Spinney, the author of Pale Rider: The Spanish Flu of 1918 and How It Changed the World lives in France. In France, she says, there are 170,000 monuments to World War I, but not a single one to the pandemic. Despite the pandemic killing 50-100 million globally, many more than the world war. Wars produce enough material for novels, films, have good and evil, and plenty of human drama. (Think Mahabharata or War and Peace). Spanish flu apparently produced fewer stories. In that book, the author says that wars destroy both infrastructure and people. Pandemic usually kills only people, so it is easier to rebound once it is over.

Covid-19 Pandemic has offered enough human stories, I think. Not having experienced a world war, for most people this is the first experience of a global shock.

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One key difference is that in 1918, infectious diseases were the major killer anyway. Until last year, cancer or heart disease is what would kill modern people. Alzheimer’s worries people more than measles.

The other thing is the 2020 media: Television and internet have ensured everyone in the world fully understands the global nature of the pandemic. One hundred years ago, in the absence of visual media, the perceived impact was essentially local.

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John Barry wrote: The Great Influenza: The Story of the Deadliest Pandemic in History.

He says the 1918 pandemic began in spring, with its first wave not deadlier than influenza. A more contagious and more lethal variant caused the deadly second wave. Then it also seemed to disappear. In March 1919, another variant triggered a third wave less deadly than the second, but more lethal than seasonal flu. First wave illness protected against the second wave (meaning people who were infected in the first wave were spared in the second). But neither the first nor second wave infections could protect against the variant in the third wave. In the absence of vaccines, the immune system of the survivors kept improving, and turned the virus into an ordinary seasonal flu virus.

That is expected to be the best case scenario this time as well. Coronavirus turning into an annual flu-like virus that kills, but doesn’t require any lockdowns.

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As far as society was concerned, in the USA, only during the second wave were schools, theatres and salons shut. Masks were introduced. One big difference was the duration of the restrictions and lockdowns. The 1918 disease usually affected a given community for 6 to 8 weeks, and restrictions lasted 3-5 weeks. The working people’s behavior didn’t alter significantly.

This time, the world has accepted the Zoom way of working, and at least partially it is likely to remain longer than the virus.

Spanish flu was more active in winters. That had triggered a naïve hope of safety in summers. Brazil and India have shown there is no real correlation this time.

On 28 September 1918, Philadelphia organized the Liberty Loan parade to celebrate the soldiers returning from the WW. Intellectuals opposed that gathering. Ignoring them, the patriotic event gathered 200,000 people. Within the next few days, 47,000 fresh cases were reported and 12,000 people died. The second wave was particularly deadly for the 25-35 year olds.

The world would be a better place if Presidents and Prime Ministers were students of history.

Ravi 

Corona Daily 090: A Paradigm Shift

When I worked for a tobacco company, I came across research that said the smoke exhaled by a single cigarette is roughly the size of a golf ball. Now if you were to stand next to the smoker in a park, that golf ball dissipates into the vast open space. The risk of secondhand smoke is almost non-existent. However, if you were sharing with a smoker a table in an office or a restaurant, the passive smoking can be a risk factor. That learning can be applied to the coronavirus.

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Three days ago, on 14 May, 40 scientists from 14 countries presented a policy paper called “a paradigm shift to combat indoor respiratory infection”.

“We expect to have clean water from the taps,” said Lidia Morawska, the group’s leader and an aerosol specialist.  “We expect to have clean, safe food when we buy it in the supermarket. In the same way, we should expect clean air in our buildings and any shared spaces.”

In 1842, a landmark report on sanitation by Edwin Chadwick highlighted the shocking plight of poor urban residents suffering from diseases caused by contaminated water. It led to a major investment programme to supply clean water and to better handle sewage. A similar effort is needed now to clean indoor air, say experts.

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Current WHO guidelines on indoor air quality cover benzene and carbon monoxide, but there are no standards for bacteria or viruses. We know air pollution affects our health. But air quality inside the offices or other closed spaces is invisible, so we ignore it, though it may affect us on a daily basis. Experts are now proposing the public places should have “ventilation certificates” like those for hygiene.

Adding filters to existing ventilation systems, using portable air cleaners, and UV light to kill bacteria are some suggestions. Something simple like opening the windows, where possible, can also help. These are not expensive suggestions. In-room air filters are priced at 50 cents per square foot, UV lights incorporated in the building’s ventilation system cost $1 per sq foot. Those installed in individual rooms would be more expensive, but may be still worth it when compared to the cost of the pandemic.

We live for years with cold and flu and accept them as a way of life. One expert says we don’t really have to.

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This month, for the first time, CDC acknowledged in large, bold letters that airborne virus can be inhaled (indoors) even when one is more than six feet away.

Lancet has published a paper offering enough evidence that the virus can be airborne. (a) Superspreading events, such as choir concerts, cruise ships, care homes. (b) People in adjacent rooms in quarantine hotels got infected without meeting one another. (c) Asymptomatic transmission. (d) The virus was found in the air in lab experiments. (e) Found in air filters and building ducts in hospitals. (f) Caged animals got it from other caged animals.

The WHO had long held that the coronavirus is spread by large respiratory droplets expelled by infected people in coughs and sneezes. The organization was, unfortunately, relying on an outdated concept of airborne transmission. It believed an airborne pathogen, like the measles virus, has to be highly infectious and travel long distances. The droplets can hang in the air, drift down streets, and find their way to people’s homes.

Experts agree coronavirus doesn’t behave that way. Prolonged contact at close range indoors allows aerosol transmission. That is where cleaning indoor air, and building special ventilation systems become critical.

To bring indoor air on the same platform as clean water and safe food is indeed a paradigm shift. Our current life has made us understand the importance of this initiative for the future.

Ravi