Sorry, I was just practicing, to get the “standard media reporting tone” for new media (and some old media) reporting regarding variants of COVID. Because mindless panic is the order of the day. The Omicron variant is going to sweep down like the scimitar of god and reap us all.

Actually, what is particularly annoying about all this is that the media is, of course, focused on the wrong thing. Normally I’m not one to counsel optimism, but all this “the sky is falling” nonsense is crap. Another bit of absolute crap is the persistent Chinese lab conspiracy, started by incompetents in the permanent war party, which has now continued, but evolved (see what I did there?) with a tinge of conspiracy thinking.

First is the matter of “break through infections” and the Omicron variant. Since humanity collectively lacked the ability (or the sense) to prevent millions of people from catching the original variant, it was inevitable that there would be mutations. Some of those mutations/variants are going to be more or less infections, more or less damaging; it’s the way evolution works. The media have been able to, generally, follow the basics of that. Where they get things wrong is regarding “breakthrough” infections and the infectiousness of the other strains. If you go by the breathless reporting you’d get the impression that people who have been fully vaccinated are dropping dead right and left from the Omicron variant. That’s simply wrong except with regard to what happens when we’re dealing with large numbers: a small percentage of patients experiencing a negative outcome is going to be a very large number when you look at it across the entire human population. What the media isn’t getting right is that the vast majority of people suffering badly from the Omicron variant are people who are unvaccinated. And they’d be suffering badly from the original variant, too. Also, whoever started using the term “breakthrough infection” needs a respectful beating – it was probably some scientist who didn’t spare a thought for the public’s perception. A “breakthrough” infection can be one of a range of things, from someone feeling ill, testing positive, and then getting better – a typical experience that you might have if you have been vaccinated against flu, but still get the flu and your body’s immune system is prepared for that variant and crushes it quickly. There are a very very small number of people who have more adverse reactions than that, but in a huge population that’s going to number hundreds or thousands of people. But that is nothing compared to the kind of hospital-clogging collapse that the unvaccinated are suffering.

A friend of mine recently came down with “COVID toe” – a rare reaction to the virus, apparently somewhat similar to shingles (which is an immune reaction to chicken pox). Part of the problem is that the term “immunity” really isn’t very good, either. It should be something more like “has SWAT teams in their body that know to be on the lookout for a certain virus” – you still get the virus (and may feel “sick” and experience symptoms) but your body already has a head start on defeating the infection. Defeating a viral infection in our bodies is a biological miracle, really, as our bodies are able to recognize huge numbers of pathogens and muster a response to destroy them, quickly. But, the key words are “muster a response” and “destroy them quickly” – you still get “sick” (that’s the “response”) and may be feverish or cough or whatever, and it still takes some time to destroy the virus. Some people, who are immune compromised or otherwise have bad reactions may get very sick or may even die. When I get a viral outbreak I get what I call “fever head” which is a sort of dizziness and displaced feeling, accompanied by mild fever and sometimes auditory hallucinations and the shakes. I figured out a long time ago (which is why I am still here) that when I feel that way, I shouldn’t drive or operate a table-saw or lathe. But I could test positive for some virus and then die of a stupid accident and depending on how they score things, I might appear to be a statistic related to the virus. That’s an important point, because it cuts both ways: there are probably lots of old people who went to bed feeling like crap not knowing they had COVID, and died quietly at home. Those people don’t become hospital statistics for COVID, which is partly why the virus took a foothold up in the Seattle area in old people’s homes, and nobody knew it was the leading edge of a pandemic because old people get sick and die. It only was noticeable when clusters of deaths began to register.

So, “covid toe” or a fever or night sweats is a “breakthrough infection” because you did get COVID and you’d test positive, but if you’ve been vaccinated and have a well-functioning immune system, you’ll get better in a couple days. You’ve still gotten COVID but your odds of needing to go to an emergency room are 1/1000th or so of the normal odds, which were around 1.5% but have dropped a bit since humans are better at treating COVID patients, now. That means 15 in a million people (give or take) who have been fully vaccinated are still going to wind up visiting an emergency room. Meanwhile, the unvaccinated are still looking at 10,000-15,000 in a million (give or take) making that emergency room visit. From there, there are questions like whether you take monoclonal antibodies or steroids or whatever, which also affect the outcome. But the media is reporting “breakthrough infections” and doesn’t really seem to understand that for fully vaccinated people, a “breakthrough infection” means you got some symptoms and test positive but it’s like you got a cold or a flu.

The way this is going to play itself out, going forward, is going to be similar to chicken pox, it seems: if you get your shots early or develop immunity after an encounter with the virus (I’ve seen other kids get chicken pox and it was not exactly a great time!) if you get it as an adult, when you’re older or fatter or have new reactions to the virus, you can have a pretty nasty reaction. I am/was terrified of COVID when it first came around because I had adult onset chicken pox in 1999 and wound up under an oxygen tent for a week. All the stuff they talked about about COVID, I had that: giant bubbles in my lungs, crackling sounds when I breathed like it was through a straw, and horrific goo-coughing sessions as my body struggled to expel rotting lung and pus. Also, blisters in my mouth and on my nutsack. When I encounter tough guys talking about COVID like it’s just another virus, I want to put my foot up their ass with my boots on, as a sort of preview of the experience. Anyhow, sensible people will get their shots (there’s a shot for shingles, which is sort of a chicken pox booster, if I understand correctly) and will maintain their immunity either by getting a bit sick now and again, or taking booster shots. The “a bit sick now and again” is the “breakthrough infection” and it’s not the death-knell the media is making it. Unless you’re unvaccinated, of course.

Part of the problem is that a vaccinated person can still incubate the virus and spread it, and if they spread it to an unvaccinated person, that person may get severely ill. I think history is going to record that the tragedy of this whole thing, other than the stupidity of its not having had to happen, is that kids are going to suffer unknown long-term consequences (like they do with chicken pox) because of their parents’ stupidity and the stupidity of other adults around them. I had a friend who, in 2000, got a nasty case of parvovirus and a doctor mis-diagnosed the problem as an autoimmune problem, put her on immunosuppresants (just the thing when you have a virus) and she suffered some viral neuropathy. It affected her memory pretty severely. Viral neuropathy is also something kids can suffer from – it manifests itself as high fever, delirium, night sweats, and a slight reduction in what we might call “intelligence” long-term. I know that’s a touchy subject, and I know IQ tests are a touchy subject, but you can measure before/after with an IQ test and see a reduction in performance, whatever that means.

This is the stuff that the media doesn’t and didn’t explain well. They were too busy doing a “horse race” analysis of who/where the outbreaks were worst and they were too busy with their damned “both sides-ism” to just say straight out, “this is going to evolve and giving it millions of reservoirs to evolve in is going to be a horrible mistake.” But some Americans choke when they try to say the “Evolve”-word, and the scientists were too busy waffling, as good scientists do, instead of saying, “look: this can damage you long-term, including your kids.” Scientists’ reluctance to come down hard and assert something unproven left the door open for interpretation and for conspiracy theories and anti-vaxxers to creep in with their bullshit. I love Dr Fauci and respect him, but I wish he had come down hard and immediately on the “this is a pandemic, stupid, mask and distance and wait for a vaccine” – that was the correct answer all along and I’ve been listening to TWIV consistently through the last 2 years (!) and they have been unwavering on that issue: mask and distance, test and vaccinate. For one thing, Racagniello and his friends were sensible enough to say, “even if masking doesn’t help much it doesn’t cost a lot and it’s not a big hardship, so do it.” How refreshing. Unfortunately, the reporters who were busy talking up the horse-race aspects of the outbreak, never stooped to deal in common sense, because I suppose that was too close to opinion for their taste.

Currently under test are COVID-specific antivirals, which are believed to reduce the reproduction speed of the virus in a patient’s body. Mjolnupiravir is one, I think there are a couple in test. These work very differently from the Remdesivir monoclonal antibody package – in the case of Remdesivir, you’re getting a shot of immunity that immediately starts fighting the virus in your body. But, you’ve got to get the shot fast because if the virus is too far along in its geometric growth-cycle, the antibodies may not be able to do the job once it’s gone too far. The antivirals slow the virus replication and hopefully do it enough that your body’s immune system has time to mount a full response and crush the virus. If you think about that, it could be that both approaches might synergize, but for obvious reasons each drug is being tested on its own for now. The model with Mjolnupiravir is that as soon as you start feeling symptoms, you take a series of pills. It appears that they are hoping/expecting it will reduce that 15,000 in a million down to 500 on a million for the unvaccinated, and the 15 in a million down to nobody goes to the emergency room at all for the vaccinated. Note: you still get sick – you might have a cough or a fever or some kind of reaction, but the people who will continue to get hammered are the unvaccinated and the kids.

If I had a kid, I’d be trying to suck up to someone who was giving the shots, and get the kid vaccinated with a 1/3 of an adult dose. Fortunately, I don’t have that problem. But, frankly, the whole “let’s thoroughly test this stuff on kids before we roll it out” is a stupid overreaction to the media’s constant nagging questions about the science, and the drumbeat of anti-vaxxers in the background. Kids have immune systems that are pretty much like an adult’s and there are kids right now getting COVID and developing immunity, as well as suffering long-term symptoms – it’s an emergency and I think the doctors are making a big mistake by being so careful. The history of medicine is full of stories of scientists taking risky measures and they are mostly recorded as great victories for science. This is a serious issue – when you do placebo trials on thousands of kids you are deliberately not vaccinating thousands of kids, and scientists know the vaccines work. They’re just worried about the right dosage. OK, then, do tests of cohorts of different dosages, but leave the damn placebos out. It’s just kowtowing to the media and Americans’ ridiculous fears and conspiracy theories. Fuck ’em. Roll up your sleeve.

The media’s reporting has failed to be frank with the public, and has failed to emphasize that the problem is really mostly a problem if you’re in the 30% of stupid people and kids who have not been vaccinated. Their silence about the affect of COVID on children really creeps me out – they are willing to talk to drooling ignarts in Iowa who are worried about microchips in the shot, but not to a thoughtful scientist who says “vaccinate your kid. Any fever over 103F causes brain damage.” Really, for fuck’s sake, this is not a horse race. If they want something to be asking scientists probing questions about it should be: “vaccinations for the kids? WHEN?” every time a scientist steps up to a microphone. And, of course, “vaccination mandates? WHY NOT?” Basically, the republicans have managed a vast, unregulated, involuntary experiment in how to pandemic – the good guys should maybe let their guard down a bit and respond with a few short-cuts in kind. What really chaps my ass is that dumpsterheads like Trump and Joe Rogan are allowed (again by the media) to confuse their listeners about their miracle cures: the media didn’t emphasize when Rogan said he took Ivermectin and some other stuff the other stuff was steroids and the monoclonal antibody package. Same as Trump. The liberal media could have been interviewing talking heads about that for hours, but they just brushed by it as if it were ordinary, and not exceptionally deceptive. If Rogan was so skeptical about the vaccine, why wasn’t he skeptical about the monoclonal antibody shot? They should have told him they wouldn’t give it to him unless he recorded a spot saying, “no really this is OK stuff.” And now that it’s thoroughly too late, they mention casually that Trump was in a really bad way with a dropping oxygen level before they rushed him to the Naval Observatory and gave him the monoclonal shot and steroids and oxygen to get him back on his feet. Speaking of viral neuropathy…

I saw that the air force lost 120 or so employees who refused vaccines. The army lost a few thousand. It is absurd that anyone who wants to consider themself a “warrior” and is willing to drop high explosives on someone when ordered to is going to opt out of a vaccine. When every soldier goes through the induction phase of basic training they get shots, head shaved, and a delousing shower. Nobody asks what’s in the shot, nobody asks what’s in the spray, and nobody complains about their haircut looking stupid.

Final item: I was horrified and disappointed to hear The Intercept interviewing some ass who was going on about the possibility that COVID was a lab experiment that got loose. This sort of crap is possible because real scientists equivocate when you ask them a simple stupid question:

Reporter: “Is it possible this came from a lab?”
Scientist: “It’s definitely possible but really it’s unlikely, probably a vanishingly small chance blah blah blah…”

They only quote the part where you say “it’s definitely possible.”

TWIV Episode 836 (OMG Omicron!) inspired a lot of this posting but I suspect the TWIVvers would disagree with me about scientists needing to run more risks. [TWIV] As you’d expect they go into this in much greater detail and length than I do. (about 2 hours length to be exact) But, around @1:38 is this gem I flagged. There is some fascinating discussion around the problem with testing MRNA vaccines because it’s a whole new kind of vaccine and they first had to figure out what “works” means.

Vincent: They used to treat Hep C with Interferon. And when they tested the first drugs they had to test them alongside, with Interferon, to the same patient, because they couldn’t withhold standard of care. So, does that also apply to vaccines?
Breanne: (Speechless for a few seconds) Maybe you’re right. I’d always assumed the standard of care is you give one population one vaccine, and the other population another.
Vincent: I just don’t know.
Breanne: Maybe you give a Pfizer spike vaccine to which you’ve added another protein, and the regular Pfizer spike vaccine…

I think most of us never realize that there are such subtleties to the situation, at all. On the other hand, the anti-vaxxer population is the placebo trial you don’t need to give anyone who wants a vaccine a placebo because you can compare their outcomes to the idiots on the Group W bench, over there.

Kathy Spindler also makes a profound point that when you’re talking about vaccines that are 95% effective, you need huge sample sizes in order to measure the effects where it doesn’t work, which is – after all – what you’re trying to study if you’ve added a new protein to the existing Pfizer vaccine. Unfortunately, we will wind up with a situation like we have for flu vaccines, in which the vaccines are initially separate families of vaccines that get merged annually at some sort of virologists’ council of Nicea.

But then Alan Dove brings it all to a crux:

Alan: I don’t really think that the end-game of this pandemic is infinite vaccination, forever. That’s not how this goes. We have four other coronaviruses that are established in the human population that we can look to as examples – they have been circulating for a very, very long time and, as we’ve said, you’ve all had them and you continue to get them and we continue to get variants that can come around and infect us again despite our prior exposure and immunity to them – and we had a great paper that looked at historical serum specimens and showed what we going on there. I think that’s where we need to get with SARS-COV2 and I think we are getting there, to a point where the virus becomes the booster. So, the future that I envision, is that you’ve got a highly vaccinated population and a new variant emerges and it goes around and infects people, who are vaccinated, and they don’t go to the hospital or get very sick because they are vaccinated and when they get exposed to the virus it replicates a little and some of them get colds and they get over it and forget about it. But their immunity has been boosted and now they are immune to the variant.

I’m a huge fan of the vaccines but this is a virus that is going to be permanently part of the human population and we’re just going to have to live with it.

That really lifted my mood because suddenly I understood that that’s how the immune system works. “Herd immunity” is that sort of equilibrium (punctuated? nash?) That produces a large body of people that can resist variants because their bodies are used to resisting other variants and the general strain, as well. The “herd immunity” aspect is that the vaccine gives those of us who take it, and the boosters, and get exposed and develop immunity of our own, a place in the core of the herd. It’s the outliers from the herd that are playing russian roulette, not the herd.

There is another piece of TWIVvery I wanted to go into, in which they review a paper dissecting the early spread of the virus in Wuhan. It’s fascinating and it’s worth a review-posting in its own right, so I won’t spoil it here and I’ll just wrap this up and hit “Publish” now.

Fuck ’em. Roll up your sleeve: when I was in basic training (Ft Dix, summer, 1983) I got the big compound military shot – the one they delivered with the pressure spray system. Roll up your sleeve, BANG, next. It wasn’t until years later that I found out that there were all kinds of human subjects experiments going on with that stuff and I had most likely gotten the experimental anti-anthrax deactivated pathogen. It must have worked, since I never got anthrax. (just kidding!) but it was interesting timing, when they started trying to pin anthrax WMD on Saddam Hussein during the gulf wars, and I suspect that if anyone was weaponizing anthrax it was USAMRIID not Saddam.

The Atlantic has a great article about the rollout of sulfa drugs and how they were a crapshoot for the user. [atlantic]

At the time, taking a new drug was like playing Russian roulette. It could bring patients back from the brink, or it could push them over. A year earlier, the president’s own son, Franklin Delano Roosevelt Jr., had been saved by a related but safe antibiotic, Prontosil. Only luck spared Franklin yet condemned Joan.

The scale of the Elixir Sulfanilamide tragedy prompted American lawmakers to ask what could be done to prevent this deadly gamble from happening again. Their simple but effective answer was the Federal Food, Drug, and Cosmetic Act, or FFDCA, which FDR signed into law June 25, 1938.

Since then, mandatory safety testing of new foods and drugs has been the law of the land. Even so, drug safety isn’t guaranteed, and the FDA’s commissioner, who has had ties to the pharmaceutical industry, expressed the desire to reduce drug regulation before he took the helm at the agency.

Taking a new drug is not like playing russian roulette. Getting COVID is.