Have a look at (CNN) White House frustrated with Irresponsible Delta Variant Coverage…Napkin Calculation #4. I’ll drop in some text.

So let’s try another intervention, vaccine+masks. (PNAS) Face masks considerably reduce COVID-19 cases in Germany. Quoting,

…Weighing various estimates, we conclude that 20 d after becoming mandatory face masks have reduced the number of new infections by around 45%.

This approximates a relative risk reduction of 1/2 = 0.5.  In combination with 100% vaccination,

• • • For Pfizer and Delta, R_mask = 9*( 0.2 to 0.4)*0.5 = 0.9 to 1.8.

This is a bad number. If napkin calculations have credibility, it implies disaster. Though not fact,  it should not be dismissed. It is the result of high viral load of Delta breakthroughs.

The implication  is that R remains above 1, implying runaway, forest fire growth. This glum observation is based on the typical public-use mask, which is derived from the fluid barrier procedure mask, which is not designed for infectious disease control. This class of masks is relatively comfortable to wear; it reduces transmission by about half. In the above calc, it’s the factor 0.5.

Healthcare workers in infectious disease wards use far more effective and uncomfortable N95 masks, which are designed to protect against most aerosols. Experimental factors for transmission reduction may not exist; let’s guess 0.1, a tenth.

So substitute 0.1 for 0.5:

• For Pfizer and Delta, R_mask = 9*( 0.2 to 0.4)*0.1 = 0.18  to 0.36

Less than 1, these are good numbers! If everyone in the U.S. wore N95 masks and practiced perfect aseptic  technique, COVID would vanish. Given the political climate,  unreasoning resistance to masks, and general impracticality, why have I written this?

Many people might be eager to make limited use of N95 masks, in situations they perceive as hazardous. Mask receptivity may jump in those who meet Delta up close and personal. So this is a proposal for the White House task force:

• Subsidize N95 production.
• Make the masks widely available.
• Possibly be surprised at the uptake.

As for refusniks, you do what you can; they do what they will. They may soon become more receptive.

 

 

(CNN) How safe is it for vaccinated people to return to in-person work? An expert weighs in. Quoting,

However, the chance of actually contracting Covid-19 is greatly reduced if you’re vaccinated. According to Dr. Anthony Fauci, you have an estimated eight-fold reduction in risk of having coronavirus if you’re vaccinated compared to if you’re not – and an estimated 25-fold reduction in risk of having severe enough disease to cause hospitalization and death, which is truly remarkable.

This is a boo-boo. Fauci knows what he’s talking about; a statistician knows the true meaning of 8X risk reduction, but the statement is missing context for the typical reader.

Relative risk is not a simple number; it does not mean what it appears to. It is the expectation value of a random variable, which means it has value only in the context of a trial with some group, and the exposures of that group, as in,

“We did vaccine trials on a group, shot versus placebo, and this is the risk ratio for this group.”

You probably aren’t into math, so I’m going to make it real for you. Consider these types of groups of fully vaccinated people, in which there is initially one contagious Delta individual. Our sample has 10 Type A groups, 10 Type B groups, and 10 Type C groups.

• Type A: 8 college students jammed into a payphone booth.
• Type B: 8 employees doing phone sales out of a 10×10 room in a converted residence.
• Type C:  Skeleton crew of 8 in a large ventilated newsroom with forced air HEPA filtration.

The 8X risk reduction of Fauci, or the 2.5X – 5X  I previously computed in Delta Strain of COVID — We’re in for a Rough Ride; Napkin Calculation #3 are based on different groups. Provincetown tourists are a healthy bunch. Both numbers permit these results:

• Everybody in every one of the 10  Type A groups (payphone booth) get  Delta.
• 9 out of 10 Type B groups (small room)  get 6 or more Delta cases.
• 3 out of 10 Type C groups (newsroom) get 3 or more Delta cases.

This is completely compatible with an 8X risk reduction, because random variables do not follow ordinary arithmetic.

Are there  fatalities in A, B, or C? With extreme exposure, as in the payphone booth,  and Type B with the windows shut, it’s possible.

Is this anti-vaccine? No! You might even pick up a few new advocates. 14% of people have intelligence in the range of “bright.” The paradox exposed above makes bright people uncomfortable about something that doesn’t make sense. They are important  to the rest of us as trusted peers and guides.

In (CNN) Covid news coverage needs to start from this fact: ‘The vaccines work’, Brian Stelter is down on media fear-mongering and CDC messaging.  He states, almost true for the moment, that Delta is a disease of the unvaccinated.

That implies unjustified optimism. COVID-19 is not static. It has a huge tendency to mutate. There is already Delta+; virologists cannot set a limit.  We don’t yet know the consequence, in vaccinated individuals, of simultaneous infection with influenza and Delta.

Will vaccine uptake be maximized by hand-holding, with inaccurate, anodyne medical journalism? Something to think about.

Lay it all out.

 

.

 

 

(CNN) White House frustrated with ‘hyperbolic’ and ‘irresponsible’ Delta variant coverage, sources say. Quoting,

“The media’s coverage doesn’t match the moment,” one of the Biden officials told me. “It has been hyperbolic and frankly irresponsible in a way that hardens vaccine hesitancy. The biggest problem we have is unvaccinated people getting and spreading the virus.”

A legitimate concern. Mainstream media made headline mistakes. Where I quoted WaPo in the text of (CNN)Washington Post: CDC Document Warns Fully Vaccinated Might Spread Delta at Same Rate as Unvaccinated, I edited (7/31) to add a correction in square brackets.

This blog is not mass media; it’s read by  intelligent people, so let’s get down to business. Breakthrough infections are said to be rare, yet

• Pfizer, large scale pre-Delta breakthrough = 5%
• Pfizer, Delta breakthrough,(Napkin Calculation #3) = 20-40%

This apparent contradiction of small-large stems from subtle definition. These numbers are not chances of getting COVID. They are relative risks:

(chance of  getting COVID with vaccination)

DIVIDED BY

(chance of getting COVID if unvaccinated)

Whether this definition of breakthrough satisfies “rare” depends on the chance of getting COVID in the first place. People in areas with low vaccination rates, where COVID is just beginning to have a heavy presence, have the illusion that  COVID will miss them. They erroneously believe the risk reduction is not worth the shot. They are tragically wrong.

Takeaway #1: If your chance of catching COVID in some interval is small, vaccination will make it smaller, conceivably satisfying the definition of “rare.” if your chance of infection is moderate or high, vaccination reduces risk, which remains significant.

The White House used the word “hyperbolic” in criticism of the media. Here we have a little disagreement. The immediate future, if not hyperbolic, looks exponential. So let’s do  Napkin Calculation #4.

• A public health intervention is a vaccine, a mask, or lockdown.
• R_o, the basic reproduction number, is the average number of infections caused by an infected individual without interventions.
• R is the average number of infections caused by an infected individual with interventions.
• The original COVID R_o, is roughly 2. (PLOS) Estimating the basic reproduction number for COVID-19 in Western Europe.
• For Delta,  R_o is said to be 9, an absolutely monstrous value, implying the need for refrigerated morgue trucks.
• Effect of a vaccine: R = R_o * (breakthrough%)/100.

Let’s do the calc. We assume a fully vaccinated population, so R is based entirely on breakthrough cases. It uses the new finding that Delta breakthroughs are as infectious as unvaccinated breakthroughs. We need less than 1 to stop COVID:

• For Pfizer and original COVID, R = 2 * 0.05 = 0.1. Success!
• For Pfizer and Delta, R = 9*( 0.2 to 0.4) = 1.8 to 3.6. Disaster!

Takeaway #2: Even 100%  vaccination with the original Pfizer vaccine, although immensely effective against hospitalization/death, cannot reduce community presence of Delta COVID to an acceptable level.

So let’s try another intervention, vaccine+masks. (PNAS) Face masks considerably reduce COVID-19 cases in Germany. Quoting,

…Weighing various estimates, we conclude that 20 d after becoming mandatory face masks have reduced the number of new infections by around 45%.

This approximates a relative risk reduction of 1/2 = 0.5.  In combination with 100% vaccination,

• For Pfizer and Delta, R_mask = 9*( 0.2 to 0.4)*0.5 = 0.9 to 1.8.

This is a bad number. If napkin calculations have credibility, it implies disaster. Though not fact,  it should not be dismissed. It is the result of high viral load of Delta breakthroughs.

It is possible that a Delta specific booster would both

• Reduce the relative risk, which stands at 20-40%
• Reduce the viral load of breakthroughs.

Time relevant delivery of  boosters and strain adjustments requires a policy tweak that is actually baked into seasonal flu vaccines, and was the crux of Operation Warp Speed, production in advance of proof.

Warp Speed did not violate the statutory roles of CDC/FDA. The National Institute of Allergy and Infectious Diseases (NIAID) under Dr. Fauci co-developed the Moderna vaccine. But Warp Speed, with large speculative grants, could not be executed by CDC/FDA.

Takeaway #3. Warp Speed was a novel response. We thought we were done with novelty. COVID  isn’t. So let’s get novel!

 

 

 

(CNN) Washington Post: CDC document warns Delta variant appears to spread as easily as chicken pox and cause more severe infection. Quoting,

The document — a slide presentation — outlines unpublished data that shows fully vaccinated people [edit 7/31: with breakthrough infections] might spread the Delta variant at the same rate as unvaccinated people, according to the Post.

The CDC findings are much worse than the possibilities of Pfizer Booster is Needed? Breakthrough Case Infectivity; Managing Public Health Communications, when I wrote,

Yet it allows the possibility that in Arkansas, and even in locales with borderline vaccine uptake, such as LA, community infectivity may overwhelm the protection of the vaccine.

It may be worse. A few more mutations could threaten regions with high vaccination rates. We must rid ourselves of the idea that the COVID threat is stationary. It appears to evolve faster than our thinking:  Pfizer versus FDA & CDC; Booster Shot Needed Sooner than Later.

In this light, the FDA/CDC rebuke of Pfizer’s booster shot intent is tragic nonsense. Yet FDA/CDC staff are individuals of high intelligence. How can this be explained? The FDA/CDC are policy driven bureaucracies.

• Policies are instruction manuals for bureaucracies on how to execute statutory responsibilities. In the best of times, a policy is optimal for  the scenario.
• Bureaucracies are constrained by, or in the extreme, prisoners of policies.
• A policy drives a typically suboptimal response, the cost of insurance against expensive or dangerous error.
• In the extreme, a policy obstructs a necessary response, while providing no substitute value, such as consumer safety.

In the future, new policies can address threats like this. There is no time now. We need to roll our own.

In (CNN) Fauci: You get vaccinated… Smouldering Epidemic or Western Wildfire?, I wrote,

I hope with Dr. Fauci for no worse than a smouldering epidemic. The above logic allows for much worse, a  Western wildfire.

Had I said more, the accusation of yellow journalism might have resulted.  So in a very soft voice,

***Welcome to 2020.***

 

 

(CNN) Fauci: You get vaccinated because you want to save your life.

Chris Cuomo leads with the question (paraphrasing) “If people should now wear masks, why should people get vaccinated at all?” Fauci’s reply deserves attention.

The math behind this is given in Delta Strain; the Rough Ride Begins. Quoting,

A breakthrough infection percentage of between 5X and 10X the percentage of hospitalized patients, breakthrough of 20%-40%. compared to 5% for the viruses of the original Phase 3 study.

In consequence,

• Delta has put us in a situation closely resembling the early days. Then, a substantial fraction of transmission swere due to asymptomatic carriers.
• Now a substantial fraction may be due to asymptomatic vaccine breakthroughs.

This does not rise above suspicion — until it does; epidemiology is a weak science. In science, this is hypothesis, supported by Pfizer Booster is Needed? Breakthrough Case Infectivity; Managing Public Health Communications.

The same arguments support booster and/or face masks.

Fauci says we could have a smouldering epidemic. It’s subtle optimism, implying it is unlikely to fulminate. I can’t put a cap on it; Delta has potential to surpass the previous peaks. A sociological argument renormalizes this epidemic:

• People tend to cluster with others of similar attitudes.
• The U..S. is in a state of deep division which accentuates clustering.
• Antivaxers comprise such a group, with social interactions biased to stay within this group.
• This group of perhaps 140 million moves through a vacuum in which groups with other attitudes do not socially exist.
• This is in effect an unvaccinated nation of 140M, as was the U.S. in February 2020, except the virus is much worse.
• Fulmination is possible.

This is why I advocate for a Delta-specific booster dose.  The legally mandated CDC/FDA criteria of need may be structurally suboptimal for COVID.

I hope with Dr. Fauci for no worse than a smouldering epidemic. The above logic allows for much worse, a  Western wildfire.

 

 

 

 

 

Academic writing is generally boring. Part of this may be due to the lack of interest in good writing for the sake of writing. Interesting writing can get in the way of the exquisite precision  required of the conveyance of scientific information. There is simply no margin for error.

As a writer obliged to interest readers, Katherine Eban may have found herself in a jam, searching for the story hook that would make this palatable to the readers of that most interesting magazine, Vanity Fair. I wish I had a subscription. I wish I were writing for the magazine. Though, if I had written Eban’s article, the editors might not be happy. It would be a little dry. It would lack good guys, bad guys, and infallible Nobel prize winners. It would also lack a writer’s choice of definition. It would provide an as-perfect-as-possible summation, which in this case consists of  perfectly balanced uncertainties.

The (CNN) Smerconish interview of Katherine Eban  piqued a read of her Vanity Fair article, The Lab-Leak Theory: Inside the Fight to Uncover COVID-19’s Origins.

Up till 1: 10 in the interview, Eban’s statements accurately depict the mainstream of expert opinion, which is: It has so far been impossible to assert or deny a lab leak, which evolved from earlier, strident denial of the lab leak possibility.

After 1:10, there is a digression from the technical, in depiction of cover-your-ass moves and postures that contaminate the lab-leak question. The reporting is credible, but a major distraction from the technical. Barring witness revelations that are unlikely to come from that quarter, this part of Eban’s inquiry is a dead end.

Around 2:33, Eban slips in gain-of-function as a fact of this matter. In doing so, she made a journalist’s choice from a range of informed opinion that spans definitely-not—borderline—definitely-is. She should not be the arbiter of that.

The experiments at WIV were patterned after (Baric, 2015 Naturemedicine) A SARS-like cluster of circulating bat coronaviruses shows potential for human emergence. If this procedure was replicated at WIV, it could not produce COVID-19. If it resulted in general competence that was used in some other way, anything is possible.

For perspective, read (Healthfeedback) What is known about the claims that the Wuhan Institute of Virology conducted research to bioengineer bat coronaviruses? The first thing you should ask yourself is “why the hell should I trust them?” The article quotes the full range of sources on the gain-of-function question, from which Eban picks just  one.

A hedgehog is a small animal with quills, but the quills are not as effective against predators as those of a porcupine, which has quills that detach, embedding in the predator, often causing death. Suppose you perform a recombinant genetics experiment that gives a hedgehog the quills of a porcupine. You  find that the hedgehog is unable to deploy its quills as effectively as the porcupine. Is this gain of function?

• No, because the hedgehog is not as lethal as the porcupine.
• Yes, because the hedgehog is more lethal than an unmodified hedgehog.
• No, because the intent of the ban is met; hedgehogs are not, and will never become a principal threat.
• Yes, because it is impossible to rule out hedgehogs taking over gardens all over the world.
• Which is it? Not all definitions work as precisely as intended.

A hedgehog with porcupine quills is a chimera, having the parts of several organisms. Baric did this in 2015. WIV continued along these lines, with possible unknown variations, in 2017. Baric’s hedgehog was MA15,  a replication-competent, mouse-adapted SARS-CoV backbone. Baric’s porcupine was SHC014 spike.

MA15 could not lead to COVID. Neither could RaTG13. (Healthfeedback) Could scientists use the bat coronavirus RaTG13 to engineer SARS-CoV-2, the virus that causes COVID-19, in a lab?

So what possible unknown variations of  procedure at WIV could have included the construction of something approaching the COVID-19 backbone? The literature has so far failed to portray the inability of gene splicing to approach the diversity of mutation in the natural world. It comes down to numbers. Quoting (PMC) The total number and mass of SARS-CoV-2 virions,

Similarly, the arithmetic mean of the number of particles produced over the course of infection of an average individual is 10¹²–3×10¹³ viral particles.

As concluded above, about 0.5 mutations are accumulated in every host infection cycle. Without accounting for the effects of selection (i.e. assuming the mutant virions are equally capable of infection and propagation), or the varying chances of mutation among nucleotides,

and for a single, specific, mutation (30,000 are possible),

we expect that such a specific mutation will be observed in one out of every ~200,000 infections.

Every infected human , or animal, is a part of a huge mutation machine, which raises the unlikely above to the realm of events which actually occur. It has been asserted that recombination is limited by the species barrier. This is not true in the natural world, where the synthetically improbable is probable.

Eban refers to (Nicholas Wade, Medium.com ) Origin of Covid — Following the Clues, which is mostly correct, though it falls down on the furin site splicing idea of David Baltimore. Wade quotes David Baltimore, Nobel laureate:

“When I first saw the furin cleavage site in the viral sequence, with its arginine codons, I said to my wife it was the smoking gun for the origin of the virus,” said David Baltimore, an eminent virologist and former president of CalTech. “These features make a powerful challenge to the idea of a natural origin for SARS2,” he said.

Baltimore has since backpedaled, because his reasoning, given in The Debate over Origins of SARS-CoV-2, is factually incorrect. He is a great mind, but mortal. His argument centers on improbability, which I addressed a few paragraphs up. Now for the zinger, the nail in the coffin, from 1992. (Springer, M.M.C. Lai, pdf) Genetic Recombination in RNA Viruses. Quoting page 26,

Besides homologous recombination, some RNA viruses can incorporate either unrelated viral genes or cellular genes into the viral genome, possibly by a nonhomologous recombination mechanism. A characteristic of this type of recombination is that the cellular RNAs or individual viral RNAs involved either do not replicate by themselves or replicate by a mechanism different from that of the RNA virus in question. Therefore, the recombination cannot be explained simply by polymerase jumping from one viral RNA to a different RNA during the course of RNA synthesis. There are several examples of this kind of recombination:

1. Coronavirus MHV contains a HE gene, which was probably derived from influenza C virus by recombination (LUYTJES et al. 1988). These two viruses are unrelated, and the mechanisms of their RNA synthesis are quite different.

…

This is an example of the power of the natural world to create a viable recombinant virus unlikely to be discovered in the lab. This kind of event occurs in nature, underlying the evolution of new species, such as SARS-COV2.

Does China have a secret? Did WIV diverge from Baric’s methodology? The answer remains infuriatingly beyond our reach. One thing we have on our side, now challenged, is our introspective honesty. Let’s not sacrifice it for the sake of an answer.

Ms. Eban, if you still like me, would you please put me in for a comp subscription? I love the magazine.

 

 

 

 

 

 

 

 

(CNN) New Trump revelations underscore his undimmed danger.

I considered this on three occasions:

• 12/21/2020: Coup in the United States? In May of 1964, this almost happened… The plot of Seven Days in May, in which the chairman of the Joint Chiefs plots to overthrow a president, is the opposite of the actual threat. There is no equivalent dramatic work, because it’s hard for our imaginations to embrace the fragility of our democracy.
• 1/6/2021: (CNN) Top White House national security officials are considering resigning; Please Don’t.
• 1/8/2021: 12 Days Till Inauguration, a Very Dangerous Time, Lacking Statutory Authority..

My nagging fear became epiphany  on 12/5/2020, with (CNN) Trump purges Pentagon advisory board and gives seats to former campaign managers. Unlike earlier appointments, with conceivable policy objectives, 12/5 aligns most closely with state capture. Quoting Wikipedia,

The classical definition of state capture refers to the way formal procedures (such as laws and social norms) and government bureaucracy are manipulated by government officials, state-backed companies, private companies and/or private individuals, so as to influence state policies and laws in their favour. private individuals and firms so as to influence state policies and laws in their favour.

The World Bank originated the term in (pdf) State Capture, Corruption, and Influence in Transition. It is not a perfect fit, since in the World Bank definition, pecuniary gain is the motive.

The  motive may have been to obtain declarative justification from the advisory board, for employment of the military as an ultimate, personally controlled police power, bypassing the justice system.

 

 

 

(CNN) FDA warns of potential rare nerve complication with Johnson & Johnson coronavirus vaccine. Quoting,

“Today, the FDA is announcing revisions to the vaccine recipient and vaccination provider fact sheets for the Johnson & Johnson (Janssen) COVID-19 Vaccine to include information pertaining to an observed increased risk of Guillain-Barré Syndrome (GBS) following vaccination,”

Guillain-Barré Syndrome has infrequently been linked to vaccination, most famously with the 1976 swine flu outbreak. In clinical settings, unrelated to vaccination, one cause is well understood. Refer to (PubMed) Campylobacter jejuni infection in Guillain-Barré syndrome: a prospective case control study in a tertiary care hospital.  (full text here) Quoting,

The commonest implicated causative organism the world over is Campylobacter jejuni (C. jejuni).

C. jejuni is a bacteria.  The coat of campylobacter jejuni contains antigen sub sequences common with human nervous tissue. Antibodies created by the immune system cross-react with nervous tissue. This autoimmune response, not the bacteria itself, causes GBS. Presence of the bacteria itself in the vaccine is neither expected or required; the antigen sequences, molecular chains, are sufficient to provoke GBS.

The 1976 swine flu vaccine was cultured in eggs. In poultry, C. jejuni is endemic. Sterile eggs are required, but sterile-chain failures occurred with unknown frequency. C. jejuni was never isolated from the vaccine, though with the coincidence of mechanism and event, C. jejuni  contamination remains the leading hypothesis to this day.

In five-part Johnson & Johnson, Explanations for Clotting ?, I developed a hypothesis, left incomplete. Part 5 set the stage for unwritten Part 6: nucleation of platelets, with subsequent clot formation, around focal bacterial infections in the cerebral venous sinuses. But there was at that time no legitimate reason, surviving Occam’s Razor, to introduce bacterial infection. Since the literature does not support viral infection as a cause of platelet nucleation, Part 6 remained unwritten.

With GBS as a clue, there is enough to look at bacterial contamination of batches of PER.C6, the human cell line used to culture the adenovirus vector. If it exists, it won’t be  C. jejuni, which is far too conspicuous. This is not an easy job.

For a very few special cases, the light microscope you last saw in high school remains a clinical tool. But a microbial contaminant of PER.C6 would likely be too small and too fugitive to visualize except after the fact. The detection of novel pathogens remains a research topic.

Possible batch dependence of Astrazeneca clotting hints at a similar mechanism.

Takeaway: Explanations linking the J&J shot to  both CVS thrombosis and GBS could be linked by bacterial contamination. 

Pasteur: “Chance favors the prepared mind.”

 

 

 

Prior to Delta, studies of breakthrough COVID in vaccinated individuals indicated low viral load. The implication is that breakthrough cases are unlikely to be infectious.  This may not be true with Delta, a bullet point for a Pfizer booster.

Refer to (Rxiv, pdf)  SARS-CoV-2 B.1.617.2 Delta variant emergence and vaccine breakthrough . Quoting from the abstract,

In an analysis of vaccine breakthrough in over 100 healthcare workers across three centres in India, the Delta variant was responsible for greater transmission between HCW as compared to B.1.1.7 or B.1.617.1 18 (mean cluster size 3.2 versus 1.1, p<0.05)….Whilst severe disease in fully vaccinated HCW [health care worker] was rare, breakthrough transmission clusters in hospitals associated with the  Delta variant are concerning and indicate that infection control measures need continue in the post-vaccination era.

Let’s interpret.

• An infection cluster is a bunch of cases in the same place around the same time.
• Although it’s hard to tell who gave COVID to who, a cluster is statistical, not absolute evidence that COVID was passed around the cluster.
• All the workers were vaccinated, though the vaccines used were not quite as stellar as those in common use in the U.S.
• Statistically, vaccinated workers were infected with Delta, and infected other vaccinated workers.
• Certainty (statistical, confidence) grows with time. If you’re a decision maker, you have to pick a point in time.

The concerns of this paper overlap my own. in Delta Strain; the Rough Ride Begins, I wrote,

Yet it allows the possibility that in Arkansas, and even in locales with borderline vaccine uptake, such as LA, community infectivity may overwhelm the protection of the vaccine.

It may be worse. A few more mutations could threaten regions with high vaccination rates. We must rid ourselves of the idea that the COVID threat is stationary. It appears to evolve faster than our thinking.

If you’re in media, you probably want to hear it from an authority. The Institute for Health Metrics and Evaluation, though somewhat tarnished by a poorly performing model, is a source. Search for “Vaccinated People Can Spread the Delta Variant.” Independent has “Warning that fully vaccinated may be spreading Delta variant as cases rise across US.”

(CNBC) WHO urges fully vaccinated people to continue to wear masks as delta Covid variant spreads. Quoting,

“People cannot feel safe just because they had the two doses. They still need to protect themselves,” Dr. Mariangela Simao, WHO assistant director-general for access to medicines and health products, said during a news briefing from the agency’s Geneva headquarters.

“Vaccine alone won’t stop community transmission,” Simao added. “People need to continue to use masks consistently, be in ventilated spaces, hand hygiene … the physical distance, avoid crowding. This still continues to be extremely important, even if you’re vaccinated when you have a community transmission ongoing.”

Two bureaucracies in conflict: WHO versus FDA/CDC. Who are we to believe? Credibility whiplash is the price of public health communicating with the public in a highly managed way. Officials may think of minimizing near-term risk, yet COVID destroys assumptions at a rate too rapid to build credibility. All that’s left is immediate motivation:

• WHO has few doses, but plenty of masks.
• FDA/CDC has plenty of doses, rejected by common ignorance.

With the Delta debacle, WHO-speak  will be a little more durable than FDA/CDC-speak. This has not always been the case. But it may augur yet another crisis in credibility, if we have to go to full-mask lockdown. This is the price of managed communication:

You’re just fine if you do this…It was last week’s advice. Do this instead.

Only one player is sure of what it’s doing: COVID-19. With jabs and feints that belie its brainless, roulette-wheel mutations, it uses managed communication by health authority against the speaker, a grotesque genomic performance.

 

 

 

 

 

 

I agree with Pfizer; a booster shot will be necessary. It would be beneficial if it existed now.

The reasoning is given in Delta Strain; the Rough Ride Begins, with links to napkin calculation #3.

While CDC/FDA are dedicated to science, their response to Pfizer is uncharacteristically brittle. Their difficult task is convincing refusniks that any vaccine now is better than none, or  a later, improved one.

The dialog is abnormally simple, but we will get the booster.