CNN takes on CDC and FDA! “These unlikely events are still more likely than a blood clot after the J&J vaccine

John Avlon takes on the medical establishment in video: These unlikely events are still more likely than a blood clot after the J&J vaccine.

All news teams encounter a  universal problem when the issue goes beyond the general competence implied by a modern, liberal education. Avlon’s team has grabbed statistics for a way into the problem. But as I wrote in AstraZeneca, What to Do?,

Statistics needs mechanisms. If peculiarities of cases are not correctly weighted, the statistical  threshold, surpassing chance, could be missed. Mechanisms  focus statistics.

Without the mechanism of these clots, the stats of the video are useless as reassurance. The FDA and CDC are concerned about adverse effects that are buried in noise of the unknown future. With mechanisms, you know what you are looking for. With knowledge of mechanisms, you can rule things out, like future mass casualties.

If you were to time travel back 60 years, to the time of dark ignorance preceding molecular biology,  to a med school class in tropical diseases, the prof might remark, if not in writing,  “Eventually, if an individual receives enough immunizations, the recipient will probably die.”

The current state of knowledge is vastly greater. Nevertheless, it might surprise that it is still  not possible to predict with certainty whether a particular virus, for which the genome is completely known, can reproduce in a particular host. The viral landscape remains shrouded in twilight, with at least the possibility of long term effects that must be ruled out by rigorous investigation. Statistics  by itself does not suffice.

The chance of widespread harm, from a vaccine administered to a mass population, is the nightmare of vaccinology. Here presents a hazard, on a scale Hippocrates could not have imagined, which reminds us of the first principle of bioethics: “First, do no harm.”

News teams cannot be expected to have specialist knowledge. They may rely on individuals who have been misqualified as competent on the issue. What systematic could a news team find useful to plug this gap? It’s worth taking a look at the (Wikipedia) Delphi method. Quoting,

Delphi is based on the principle that forecasts (or decisions) from a structured group of individuals are more accurate than those from unstructured groups.[6]

CNN, you might find it fascinating to assemble a group to address John Avlon’s question, and watch them work. Just by watching, you get insights into the structure of knowledge of the field in question.

AstraZeneca, What to Do?

Suppose the  rare but multiple deaths/injuries, by cerebral venous sinus thrombosis, have been caused by the AstraZeneca vaccine. Although my suspicions date to August 2020, a blog like this is in no position to establish causality. As with the Havana Sonic attacks, the determination of causality/reality requires national resources to acquire and analyze data.

Statistics needs mechanisms. If peculiarities of cases are not correctly weighted, the statistical  threshold, surpassing chance, could be missed. Mechanisms  focus statistics. (CNN) More European nations pause AstraZeneca vaccine use as blood clot reports investigated offers a possible mechanism.

The dilemma may recapitulate the yellow fever vaccine. It saves many lives, and takes a few. Over generations, inhabitants of regions where yellow fever is endemic  have learned the penalty, and correctly weigh the two risks. If COVID goes on long enough, we might arrive at the same understanding.

It is possible the AstraZeneca vaccine saves many lives and takes a few. The choice would be clear, except that the alternatives save many lives and take no lives, or far fewer. With the push of AstraZeneca, justified in the race against time, public health planners should be aware of the primitive logic people use to get by:

  • Random risk. Ever present and possibly avoidable, “if I am careful”, “if I have no risk factors”, and so forth.
  • Severe risk. For example, advanced cancer.
  • Assumed risk. From a choice you make.

We are willing to assume just a little risk to minimize random risk. With severe risk, we are willing to assume considerably more, as with a bone marrow transplant. All the sophistication of the human brain permits just this simple weighing of pros and cons. COVID straddles the border of random and severe.

Unless strong counter-evidence emerges, as opposed to “no evidence”, that AstraZeneca is blameless of CVST, a blow back may result, playing into the hands of the antivaxers, in a highly disruptive way.

There are less fortunate places than the developed countries, where life is cheap and death is plentiful, where the inhabitants will be more appreciative of AstraZeneca.

 

 

Biden versus Putin Part 1

We begin with the reality of political murder in Russia; then to bilateral relations.

With implied reference to the attempted Novichok poisoning of Alexei Navalny, Biden called Putin a killer. Putin responded with “It takes one to know one”, which shows that snappy retorts are multicultural. Putin may occasionally view this blog. I will not convict him here. A crime detective would note that he has the means and motive to kill Alexei Navalny, but open source proof is unavailable. Proof from clandestine sources could exist, but such proof could never be revealed without endangering the sources.

In Western law, conviction of a crime requires proof beyond reasonable doubt. Since this is unlikely to ever be available in Russia for a particular individual, only the Court of Public Opinion can convict. The proof exists for the Kremlin as a whole. (Guardian) Russian FSB hit squad poisoned Alexei Navalny, report says.

Motive: Navalny really is a mortal danger to Putin’s Russia. In Alexei Navalny, Poisoned Again? The Russian Poison Trick, I wrote

But why must Navalny be silenced now? Navalny has recently positioned himself as a pro-Western democrat, but his history includes association with the ultra-right. While his impulsive rants are harmless to the Kremlin, Navalny-the-strategist is the ultimate of danger…

(New Yorker, paywall) How Putin Controls Russia interviews Masha Lipman, a Moscow-based political analyst. Quoting one of the few points I actually agree with,

There’s reluctance to organize, as I mentioned earlier, around a political cause, a political leader, or form a political party or a movement. And this protest being limited to a particular cause or a locality is beneficial for the government…

Navalny is pan-Russian, attempting to forge a coalition of disparate and contradictory groups: Western, liberal, fascist, racist, nationalist-excluding the Caucasus, et. al., united only in opposition.

State execution by poisoning dates back to at least December 17 1916, when Prince Felix Felixovich Yusupov fed Grigori Rasputin cakes and wine laced with cyanide. Nothing happened; the Russians had adventitiously discovered the protective effect of sucrose.  The Bolsheviks got better; they established a  lab to make reliable poisons. This has been going on a long time. As with Navalny, failures occasionally happen. We don’t hear much about the successes.

Having committed the sin of surviving state-executed poisoning, Navalny is now in Penal Colony No. 2. How do you kill someone without making a martyr? It would not be surprising for Navalny to be murdered by well-paid convicts, guards, or plants. It would be tragic, since Navalny, the unrealistic idealist, is in many ways a man too good for today’s Russia. History is full  of deconstructions of governments that lead to renaissances. Russia desperately needs a renaissance.

As Putin himself has remarked, Russia ‘s government is historically paternal. In the West we think our way to our own destinies. In Russia,there is an almost universal, quasi-religious faith in rulers. So resulted the initial denial, in emotional terms, by Vladimir Kara-Murza Sr.,  that his son had been poisoned. (RFE) Kremlin Critic Emerges From Coma. Vladimir Kara-Murza Sr. died in 2019 at age 59. In Russia, you have to wonder.

We now have a circular sustaining loop. You can start at any point and work your way around:

  • Paternal government, sustained by popular attitudes which deny misdeeds of government, such as political murder.
  • Opposition, rejecting paternal tradition, who seek to overthrow the paternal government by political means, via the existing facade of democracy.
  • Political murders of the opposition, with  effect to sustain the paternal government.
  • Loop to the top.

Putin might say that the paternal government must be maintained because there is no bridge to something better. This was explored in:

Takeaway: Political murder is organic in Russia. It has a long tradition, it is not rooted in a single individual, and we have zero chance to keep Navalny breathing if the Kremlin wishes otherwise.

To be continued shortly.

 

 

 

 

 

(CNN) More European nations pause AstraZeneca vaccine use as blood clot reports investigated

(CNN) More European nations pause AstraZeneca vaccine use as blood clot reports investigated. Quoting,

Denmark, Iceland and Norway have suspended the use of the Oxford-AstraZeneca Covid-19 vaccine while the European Union’s medicines regulator investigates whether the shot could be linked to a number of reports of blood clots.

Please refer to:

An adenovirus vaccine uses an adenovirus vector to  transport a transgene cassette, a complete set of  instructions for making spike protein, into cells at the injection site.

The manufacturing process  of an adenovirus based vaccine uses a live “helper virus” to grow the vector virus, which cannot replicate. The proposed mechanism exploits the inability to completely purify the vaccine product of trace amounts of helper virus.  There is more to this, which is explained in (CNN)NIH ‘very concerned’ about serious side effect in AstraZeneca coronavirus vaccine trial.

It is frequently stated that adenoviruses are stable against recombination. This has been found to be false. For this mechanism to generate an actual adverse event would depend upon random recombination, and the particular strain of adenovirus used as a helper.

J&J’s vaccine uses similar technology, adenovirus-as-a-vector, but a different adenovirus strain. This may be why, for unknown reasons of detail, adverse events have not occurred with a frequency that suggests causality.

 

(CNN) Vaccinated Americans allowed to taste freedom; Not So Fast; Napkin Calculation #2

(CNN) Vaccinated Americans allowed to taste freedom. The article also contains an interview with Dr. Wen, who thinks CDC should have loosened more. In the past 12 hours, (Nature) Antibody Resistance of SARS-CoV-2 Variants B.1.351 and B.1.1.7 has brought The Outer Limits to your browser. It becomes suddenly urgent to do another napkin calculation. 

A napkin calculation was presented in Misplaced Hopes for COVID Herd Immunity; Napkin Calculation, with the implication that classic herd immunity, when COVID would drop down to occasional events, is not likely to happen any time soon.

(Reuters) ‘When will it end?’: Reuters vs. CNN vs. Intel9 explores why COVID reportage seems mired in platitudinous wishful thinking. Part of it stems from the difficulty for news teams of qualifying experts.  Dr. Wen of the video, former Health Commissioner for the City of Baltimore, has proven competence  at executing public health policy.

A keen intuitive connection with numbers is another affair. Not working spreadsheets and designing budgets, but the kind of innate, intuitive sense that the best modelers, mathematicians, engineers, and scientists have. When you have a serious disease, you look for a specialist.  The same goes for numbers. Clinical and administrative experience does not imply expertise in epidemiology, which is a highly mathematical sport.

Let’s do another napkin calculation, which will solidify (The Lancet) An action plan for pan-European defence against new SARS-CoV-2 variants.When you’re done, don’t wipe your chin with it.  Hold onto the napkin and show it around.

R_o, the basic reproduction number, is  the average number of new infections caused by a single infected individual, in a naive population, before public health interventions.  R (without the 0) is the number after interventions. From (NCBI) Time-Varying COVID-19 Reproduction Number in the United States,

… For the entire United States, the reproduction number declined from 4.02 to 1.51 between March 17 and April 1, 2020. We also found that the reproduction number for COVID-19 has declined in most states over the past two weeks which suggests that social isolation measures may be having a beneficial effect.

Why the sudden drop of R ? People got scared,  stopped  “going in your face”, and shaking hands.  That’s how variable it is.  R_o and R are weak concepts, useful to conceptualize, useless for prediction. The numbers vary too much with social activity. February tends to be an unsocial month.

Some conservative statements:

  • No matter what, vaccination is personally beneficial.
  • Vaccination benefits society. Only how much is in question.
  • If, having been vaccinated, you still catch COVID, vaccination could reduce your infectivity.
  • Then again, it might not. Asymptomatic cases are infectious.

The CDC goal is to reduce R to less than 1. Then, according to the prevailing bullshit, COVID will almost vanish. The goal is supposed to be accomplished by vaccination. Now try to swallow this pill, which assumes a worst-case vaccine efficacy of 60%, which avoids the assumption that vaccines are perfectly on target:

  • The current value of R = 1.51
  • Vaccination is 60% effective at preventing disease. 40% experience vaccine failure and contract COVID.
  • Assume that this is equivalent to reduction of R to R*0.4 which isn’t supported by anything. If this looks sloppy, too bad. This is what hope looks like when you put it under the microscope.
  • After the public has been vaccinated, R becomes (1-0.6)*1.51 = 0.4*1.51 = 0.604,  less than 1. COVID goes away!

Hold onto that napkin, even if the pill didn’t go down. In March 2020, R was 4.02. All it takes to be there again is bars, restaurants,  sports, choirs, and all the things we love to do.  It doesn’t even need French kissing. Then R after vaccination becomes 0.4*4.02 =   1.608, disaster!  Would a 75% effective vaccine fix this? To avoid catastrophe requires more than 75% protection against clinical disease. It requires the same number for infectivity.

We didn’t cook the numbers by use of  an efficacy 95% for “original COVID.” U.K. B.1.1.7 has been deemed manageable, but the South African variant,  B1.351,  is already here. Darwin’s selection decrees that B1.351 will become dominant; all the strains for which effective vaccines exist will vanish. See (The Lancet) An action plan for pan-European defence against new SARS-CoV-2 variants. Quoting,

…epidemiological data suggest they have a higher admissibility than the original variant…These viral properties could increase the effective reproduction number R in the population. In the case of B.1.1.7, estimates suggest R could increase from 1 to about 1.4 with no change in population behavior. If true, many countries that have succeeded in reducing R to 1 or less will be confronted with a novel wave of viral spread despite the current measures.

When B1.351 is vanquished, other variants will compete for dominance, with each other, and with vaccine makers.  Ad infinitum.  Ground Hog Day. Is this certain?  No, but to assume otherwise is wishful thinking.

Now you know why CDC doesn’t want you to fly. Statements from government are colored by awareness that many Americans have reached  the brink of madness. There seems little appetite in the press to dig. In normal times, the Reuters article  would not be exceptional. Now it is.

Now march your two napkins around the office, or show them on Instagram.  If someone tries authority,

 

(Reuters) ‘When will it end?’: Reuters vs. CNN vs. Intel9

(Reuters) ‘When will it end?’: How a changing virus is reshaping scientists’ views on COVID-19. Quoting,

 “I couldn’t sleep” after seeing the data, Murray, director of the Seattle-based Institute for Health Metrics and Evaluation, told Reuters. “When will it end?” he asked himself…

…data in recent weeks on new variants from South Africa and Brazil has undercut that optimism. They now believe that SARS-CoV-2 will not only remain with us as an endemic virus, continuing to circulate in communities, but will likely cause a significant burden of illness and death for years to come.

Murray’s thoughts align with mine. Quoting from Misplaced Hopes for COVID Herd Immunity; Napkin Calculation,

With anticipation of widespread SARS-CoV-2 501Y.V2 and other mutations, the factor of 1/2 could imply we are currently, not at 40%, but  20% immunity.The implies herd immunity in November/December, not August….This is possible, not factual, if COVID doesn’t have more tricks up its sleeve. It takes influenza A about 25 years to cycle through its range of antigen permutations.

Even with the not-quite promise of herd immunity, COVID-19 is likely to remain a nasty, prevalent disease,  sparing only those with lucky genes,  and those who are exposed as children.

Contrast with (CNN) US could reach herd immunity by summer through vaccinations alone, CNN analysis finds. Quoting,

But experts generally agree that somewhere between 70% and 85% of the population must be protected to suppress the spread, a range that Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases has recently cited.

You have enough to compare the two predictions, by Chris Murray at University of Washington, Intel9, and CNN. Look at these points:

  • Which argument has the most visible logic?
  • Which article asserts a consensus of experts?
  • Of the two predictions, how many supporters? How many dissenters?
  • Which article cites an authority figure for support?
  • Which article lays claim to authority as an argument in itself? Hint: Look at the title.
  • Which articles emphasize COVID variants? Which mentions in  a minor closing remark?

Your comparison could be completely subjective, in which case, ask yourself, “What kind of a thinker am I?” Or you could apply (Decision Science News) Benjamin Franklin’s rule for decision making.

What do you come up with? You could just “pass”, but it’s a good exercise.

 

 

 

 

Saving American Democracy, Part 1

This continues March 4: QAnon Mythology and CNN: The Flat Earth Conspiracy, a Darker Core? Part 1.

Intro

Walter Lippmann, a candidate for “most influential journalist” of the 20th century, and advisor to 6(?) presidents, explored the intersection of political science, social philosophy, and communications in a series of books. The centerpiece, Public Opinion, remains controversial, challenging the foundations of democracy. He  got away with his huge reputation intact. Today, cancel culture might X him off.

Lippmann’s world is unpleasantly at odds with the the myth of informed decision of the electorate. His ideas are vulnerable to exploit by the dictator.  So why look? The answer will come in a bit. We should examine the epochs of Lippmann’s life to  understand his freedom to write.

If I were to advocate Public Opinion as a solution to the fragile state of U.S. democracy, my minuscule reputation might be extinguished. Nor  would it be good advice.  But we should be free to  find points of inspiration. Perhaps we don’t have to repudiate the myth; instead of calling informed decision of the electorate fact, call it aspiration.

Lippmann’s World

 America is a much kinder place than it used to be.  All the old cruelties are still around, but they tend to hide in the corners and run from the light. More people accept  that for a significant proportion of Americans, their heritage is  oppression and victimization.  Still, for the majority, this is  not the preferred way to remember the past.

We prefer to remember the past for elegance, fine diction, natty attire, the piano, clever lyrics with inside jokes, speakeasies, and cigarettes that didn’t kill, hard-bound best sellers, and movie stars of aristocratic bearing. (That’s fine for memories; I wear tee shirts, and shoes with holes.)

America had social mobility, but to rise meant to join a business elite, or the one centered around the Ivy League. Inevitably, the two merged, so that by 1920, a classical elite was joined to the political establishment, vying with trade union organizers and ward heelers. The Progressive Era had been gone for a few years.

Walter Lippmann wrote Public Opinion in 1922. As background for thought, the year was perfect. Still young, Lippmann had seen the rapid evolution of U.S. politics: Diminished domination of the big city ward,  rise of Big Labor, and the still-current Dem-pro/GOP-anti union  alignments.

This was the era of grand social experiment. Intellectuals still had the untainted choices of capitalism, socialism, communism, anarchism, syndicalism… Fascism was an  infant, though the seed came from Nietzsche, celebrated in music by Wagner.  Racism itself had intellectual legitimacy, in the works of many authors we have not bothered to cancel. The poisonous fruit  was huge, in war and civil strife, that lasted through and beyond the world wars. Public Opinion was written when ideologies were mostly innocent coffee house conversation, long before the terrible costs were understood.

Future historians may mark the beginning of modern America with the  Civil Rights Act of 1964.  Equality is promoted by enlightened laws, but remains elusive in the last mile, the real world. Cancel culture tackles the last mile. In Lippmann’s time, cancel culture did not exist. Lippmann was one of the elite, with little contact with the blue collar majority. If cancel culture had existed in 1922, it would not have applied to him.

With that freedom from cancellation, which no longer exists, Lippmann sought to undermine the electoral myth, and improve the durability of democracy. It sounds very suspicious. Can we suppress the urge to cancel long enough to see if there is any inspiration for our current situation? A significant portion of the electorate is having a psychotic episode.

To be continued shortly.

 

 

Misplaced Hopes for COVID Herd Immunity; Napkin Calculation

Herd immunity is all the rage. (NYT) When Could the United States Reach Herd Immunity? It’s Complicated. According to charts like these, the future is predictably bright. Not so fast.

When I saw the Penn and Teller  magician duo  show in Vegas, Penn began by insulting the audience (paraphrasing): “If you knew any math, you wouldn’t be in Vegas.” The audience laughed. Since you haven’t paid a hundred bucks to read this, and can X the tab any time you want, I’ll try to be more polite.

After all we’ve been through since Feb 2020, you really shouldn’t give the NY Times chart, or Alabama’s in-state projection, any credence. But, you argue, it is the product of experts? Epidemiologists are honorable scientists who are experts at many sub-specialties and technical tools of the science of epidemiology. One thing they are not experts at  is COVID prediction.

Expertise implies accuracy.  We have only trends, which like fads, continue for a while, ending unpredictably. Legend has J.P. Morgan on the stock market: “It will fluctuate.” Governor Cuomo already knows this. (CNN) Gupta: I’m stunned Gov. Cuomo said this about health experts; Sometimes You Just Have to Lie.

These reports directly challenge the NY Times chart:

So why is the NY Times chart so beguiling? Are we sucked in by an attractive graphic, even though it offers no accounting for mutant strains? Perhaps, like propaganda, it works in the absence of accessible alternative information.

The alternative will come in the form of a napkin calculation. The result will not be fact, but an alternative to the chart, which, in our ignorance, has equal weight. Refer to (Nature) Fast-spreading  COVID variant can elude immune responses. Quoting,

Pseudoviruses with the full package of 501Y.V2 mutations were fully resistant to convalescent serum from 21 out of 44 participants, and were partly resistant to the vast majority of people’s sera, Moore’s team found.

Quoting from (BioRxiv) SARS-CoV-2 501Y.V2 escapes neutralization by South African COVID-19 donor plasma,

SARS-CoV-2 501Y.V2, a novel lineage of the coronavirus causing COVID-19, contains multiple mutations within two immunodominant domains of the spike protein. Here we show that this lineage exhibits complete escape from three classes of therapeutically relevant monoclonal antibodies. Furthermore 501Y.V2 shows substantial or complete escape from neutralizing antibodies in COVID-19 convalescent plasma. These data highlight the prospect of reinfection with antigenically distinct variants and may foreshadow reduced efficacy of current spike-based vaccines.

Let’s get a number out of these citations. The number will be plausible, not factual. It will be on a collision course with the NY Times chart. The number is 1/2.  With respect to the entire population of the U.S., and the number of silent cases, administered vaccines, recovered-diagnosed: divide this sum, the NYT orange line, by half.

The NYT chart orange line of total immunity implies an increase of community immunity from a current 40% to 75% in six months.. This is an increase of  6% per month, which we use to correct the NYT graph. With anticipation of widespread SARS-CoV-2 501Y.V2 and other mutations, the factor of 1/2 could imply we are currently, not at 40%, but  20% immunity. To make up the difference of 20%, at 6% per month, we need 3+ more months.  The implies herd immunity in November/December, not August.

This is possible, not factual, if COVID doesn’t have more tricks up its sleeve. It takes influenza A about 25 years to cycle through its range of antigen permutations.

Even with the not-quite promise of herd immunity, COVID-19 is likely to remain a nasty, prevalent disease,  sparing only those with lucky genes,  and those who are exposed as children.

“There are lies, damned lies, and statistics.

Mark Twain et al.

 

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