Wherein we rearrange fragments of existing pandemic knowledge.
Introduction: Depending on a person’s profession, field of study and life experience, the mental model she forms of “attacker” and “security” while reading the extract below could diverge wildly from the next person. This divergence can be revealed when, say, a mathematician actually bothers to ask a biologist if public health workers think in the “prevent-detect-respond” framework, which the mathematician had assumed. Assuming. Assuming everyone thinks *the way we think they’re thinking* … isn’t foolproof. So we ask.
Detection Works Where Prevention Fails
"The ideal of any security system is to prevent an attack. but prevention is the hardest aspect of security to implement, and often the most expensive. To be practical as well as effective, almost all modern security systems combine prevention with detection and response, forming a triad that operates as an integrated system to provide dynamic security, resilient failure, and defense in depth. Audits (retrospective detection) and prediction (prospective attempts at detection) don't produce the decisive real-time results that most people associate with security systems, but are extremely important in evaluating and thinking about ways to improve security systems."
- “Beyond Fear: Thinking Sensibly About Security in an Uncertain World” by Bruce Schneier
A biologist with swagger last week responded to my prevent-detect-response query this way:
“This model of prevention sounds totally misguided. They are trying to find markers that will predict a bad event and there's plenty of sci fi that can point out the perils of prosecuting thought crimes. The [prison] abolitionist framework overlaps w/ public health-- what are the conditions that are facilitating the bad outcomes? This is a stupid [expletive] back up to ...”
This particular biologist’s mental model equated prevention with predictive policing via mind reading. This biologist’s attacker was an innocent human. And security was not surgical but blunt, total surveillance of individual actions and thoughts by a police state type authority. That sounds like a form of security too costly for anybody.
The mathematician’s prevent-detect-response attacker was the virus. And that person’s mental model of security involves tradeoffs to maintain dynamism, because total security is blunt never-ending lockdowns costing money and mental well-being. Blunt security is a drag, creating learning loss in children and generally making life far less worth living. Zero security is also a bummer: preventable medieval-style pestilence. Reams of infection survivors drifting in semi-capacitated states, addressing puzzling, at best, inflammation of long COVID (now called PASC), facing 12 months of recovery to reach 85% to 90% of their previous physiology, another 12 months to reach 100%.
But dynamic security in a pandemic could pair restrictions with vitality: masks keep schools open. Masks prevent working parents from having to scramble for last-minute expensive childcare when a COVID-exposed child has to isolate at home. Masks and increasing child vaccinations reduce rates of long PASC, giving each child more consistent vitality over their lifespan.
To make this policy more dynamic, pair mask policies to wastewater COVID data. If community spread is low enough, mask-optional rules can take effect. If a dangerous variant hits the scene showing more escape, mask-on policies rule until rates fall or further notice.
A query to readers: this is how you all have been thinking this entire pandemic, right? Prevent-detect-respond?
The only barrier to implementing this is our culture. The last obstacle of the journey, piece of 🍰.
The full raw file for this digest is on the website for subscribers who wish to see all links.
Response: Post-Infection Treatment
Prevention: Vaccinating, Ventilating & Antibody top-offs
Phizer vs. Omicron Variant
Culture, Politics & Policy
Response: Post-Infection Treatments
We know more this year than we knew the last two years.
Nov 13 Research focuses on inflammatory condition following COVID-19 infection in children (Local 10 WPLG ABC Miami) - Dr. Maryanne Chrisant reviewed the data. “She said investigators believe the antibody treatment called I.V.I.G., which stands for intravenous immune globulin, depletes certain inflammatory immune cells called neutrophils in multisystem inflammatory syndrome in children, or MIS-C. ‘I think it’s intriguing but I don’t think it’s the only part of the puzzle as far as these things go with the immune cascade and the immune puzzle …’”
Dec 6 New monoclonal antibody infusion treatment site opens in El Paso (KFOX 14 El Paso) -
Dec 9 Pima County aims for more antibody treatment options here for high-risk COVID patients (Arizona Daily Star) -
We’re in month number 24 of this pandemic. Wastewater testing gives towns a leading indicator of rising community spread. This is a head start to erect drive-through monoclonal outpatient clinics. To broadcast a facemask advisory. To marshal rapid antigen tests from partner municipalities or out of storage (yes stored for surges) and distribute them to underserved communities. Members of these communities often cannot take time off work. They test in private while wearing a mask, and if they test positive, they can look up directions to the nearest outpatient clinic. Soon these head starts can alert people to stock up on antibody top-off nasal spray supplies.
Dec 07 Omicron variant of COVID-19 spreading at low levels in Boulder, wastewater data shows (Daily Camera) -
Dec 8 Houston detected the omicron variant by testing wastewater — but Dallas isn’t taking that approach People infected with COVID-19 can shed the virus in their feces days before experiencing symptoms, experts say (Dallas Morning News) - "Houston has detected the omicron variant of the coronavirus in eight of its wastewater treatment facilities, city health department officials said Tuesday. And that type of surveillance — which Dallas has not taken on — has helped Houston officials recognize that the new variant is spreading in multiple parts of the city."
"The North Texas Municipal Water District took part in a nationwide survey in the spring of 2020 to test wastewater for COVID-19. 'After the 10-week survey, [the water district] discontinued its participation in the study due to inconsistent data that required continuous interpretation by local and state public health officials,' said Kathleen Vaught, public relations specialist at the water district. Public health experts have long used wastewater samples to track the growth and spread of bacteria and viruses, like the poliovirus.”
Dec 9 Canada 'grossly underutilizing' rapid tests, experts warn — even as COVID-19 cases tick up 94 million rapid tests purchased by Ottawa, yet many Canadians face limited access (Canadian Broadcasting Company) -
Prevention: Vaccinating, Ventilating & Antibody top-offs
Dec 9 COVID-19 booster shots save lives and reduce new infections for all ages, research indicates (LATimes via Oregonian) - Booster shots drove down cases of severe COVID-19 and death in older Israelis and reduced infections in senior citizens and middle-aged adults, the research shows. But boosters prevented new infections most dramatically in 16- to 29-year-olds — a finding with potentially far-reaching implications.
=>Vaccines & Other Preventatives
Dec 07 Vaccine mandates 'absolute last resort', WHO Europe head says (Christian Science Monitor) - “World Health Organisation's Regional Director for Europe Hans Kluge speaks during a news conference about the coronavirus disease (COVID-19) at Eigtveds Pakhus, in Copenhagen, Denmark March 27, 2020.”
Dec 8 The world is unprepared for the next pandemic, study finds (CNN) - “Not a single country scored well on the Global Health Security index -- a measure of preparedness for various health emergencies and problems put together by the Nuclear Threat Initiative and the Johns Hopkins Center for Health Security at the Bloomberg School of Public Health.” "The 2021 GHS Index continues to show that all countries still lack some critical capacities, which hinders their ability to respond effectively to COVID-19 and reduces their preparedness for future epidemic and pandemic threats.”
Dec 9 U of T researchers discover a new way to take on COVID-19. Could it change the way we combat cancer? (Toronto Star) - “Prevention and treatment of COVID-19 and its variants may one day be a few spritzes of nasal spray away, according to one University of Toronto researcher.”
Dec 9 Slovakia to pay people over 60 if they are vaccinated (ABC) - BRATISLAVA, Slovakia -- “Slovakia’s Parliament approved a plan on Thursday to give people 60 and older up to 300 euros ($339) if they are vaccinated against COVID-19. The measure drafted by Finance Minister Igor Matovic should boost inoculations in the European Union country with one of the bloc’s lowest vaccination rates.”
Dec 9 Germany vaccine panel OKs shots for children aged 5-11 (ABC) -
Dec 9 WHO warns fears of omicron could spark new vaccine hoarding (ABC) - GENEVA -- “The World Health Organization expressed concerns Thursday that rich countries spooked by the emergence of the omicron variant could step up the hoarding of COVID-19 vaccines and strain global supplies again, complicating efforts to stamp out the pandemic.”
Dec 9 Kids are driving up COVID cases, but parents are still reluctant to vaccinate them, poll shows (ABC) - “Cases among kids, teens spiked 884% since summer, the most of any age group.” “Parents of teens are more willing to get their kids vaccinated, but only about half of that age group have gotten the shot so far, KFF found.”
Dec 1 Dear Doctor: I got COVID and have natural immunity. Why would I need a vaccination? (Oregonian) - “Dear Dr. Roach, I am told by doctors that the natural immunity your body develops by having had the COVID-19 virus is just as, or even more, effective at protecting you as one of the three vaccines that you are pushing people to get. Like I’ve read up on natural immunity. It is science also. Will you please confirm or deny that statement? -- J.B.D.” Doctor responds to J.B.D. with a thorough answer, worth reading.
Dec 3 Study suggests past COVID infection may not fend off omicron (ABC) - “A research group has been tracking reinfections in South Africa and reported a jump with the arrival of omicron that they hadn't seen when two previous variants, including the extra-contagious delta variant, moved through the country. The findings, posted online Thursday, are preliminary and haven't yet undergone scientific review.”
Dec 5 Do you still need a booster shot if you just had COVID? (KDVR Fox 31 Denver) -
Phizer vs. Omicron Variant
Studies show a Phizer booster shot can top off antibodies in the short term to face off an omicron or other COVID infection. Long term, this vaccine is less effective fending off omicron than other variants.
Dec 7 Pfizer vaccine may be less effective against omicron, early lab data indicate (NBC) - “The Pfizer-BioNTech Covid-19 vaccine appears to be less effective against the heavily mutated omicron variant of the coronavirus, according to early data from South Africa posted Tuesday.”
Dec 7 Pfizer shot offers partial protection against Omicron variant, study finds (CBS) - “Pfizer's COVID-19 vaccine offers some protection against the Omicron variant ‘but not complete’ protection, according to an early study by South African scientists.”
Dec 8 Pfizer-BioNTech Covid-19 shot loses power against Omicron variant (Stat News) - “People who have received two doses of the Pfizer-BioNTech Covid-19 vaccine are likely susceptible to infection from the Omicron variant of the coronavirus, but a third shot restores antibody activity against the virus, the companies said Wednesday. ”
Dec 9 CDC recommends Pfizer booster shots for Americans as young as 16 (CBS) -The Centers for Disease Control and Prevention is recommending that Americans as young as 16 get a booster shot of COVID-19 vaccine.
Dec 9 South Africa approves Pfizer vaccine booster amid COVID wave (ABC) - “South Africa’s regulatory authority has approved the Pfizer-BioNTech vaccine as a booster shot, opening the way for third doses to be administered to battle the current surge driven by the omicron variant. South Africa’s new COVID-19 cases continue to rise.”
Culture, Politics & Policy
Two steps forward, one step back. Outlier: a teacher in rural California alerted me to the new trend of parents opting their kids out of COVID testing. That’s not a typo. The parents demand their kids refrain from vaccinating and avoid testing. One parent delivered his “Opt My Child Out of COVID Testing” form to the charter school in his work uniform: medical scrubs. Outlier.
Dec 5 Chiropractors' association 'appalled and disappointed' by anti-vaccine statements at B.C. meeting (Canadian Broadcasting Corporation) - “At Wednesday's annual general meeting of the College of Chiropractors of B.C., 78 per cent in attendance voted in favour of a resolution to ‘maintain the right to medical freedom of choice’ for chiropractors and called on the college to ‘take a stand’ against an expected public health order mandating COVID-19 vaccination for all regulated health professionals.”
Dec 6 Parliament is checking exemptions from COVID-19 vaccination. A Conservative MP says that’s not fair (Toronto Star) - “A Conservative MP says asking her to resubmit proof of her medical exemption from receiving a COVID-19 vaccination was a case of political overreach by the Liberal government.”
Dec 6 Inside the growing alliance between anti-vaccine activists and pro-Trump Republicans (Oregon Public Broadcasting) - "In October, a conference filled with anti-vaccine activists in Nashville, Tenn., received a high-profile political guest: former President Donald Trump’s son Eric Trump. While portions of the younger Trump's half-hour address were typical political platitudes, some of his biggest applause lines came when he attacked COVID-19 vaccine mandates." "Still, Trump's emphasis was very different from those of many of the other speakers at the event, put on by longtime anti-vaccine activists Ty and Charlene Bollinger. The day before Trump's speech, a homeopathic doctor named Edward Group stood on the same stage and suggested to the audience they should drink their urine as an alternative to getting vaccinated against COVID-19. Another speaker, Carrie Madej, said the vaccines contained microscopic technology designed to put 'another kind of nervous system inside you.' The true purpose of the vaccines, she claimed, was to turn humans into cyborgs."
Dec 6 Boulder’s coronavirus vaccine mandate for employees will be fully effective Wednesday (Daily Camera ) -
Dec 7 Doug Ford’s Tories extend pandemic paid sick leave to July 31 (Toronto Star) - “Pandemic paid sick leave is working well — and is still needed by workers — so Labour Minister Monte McNaughton is extending it to July 31. The temporary provincial program was supposed to wrap up on Dec. 31” but was extended because of the more contagious Omicron variant.
Dec 7 6 states account for more than half of the country’s recent Covid hospitalizations (NBC) - “Among the 30-plus states that have seen increases in Covid-19 hospitalizations over the last two weeks, six stand out. Michigan, Ohio, Indiana, Pennsylvania, New York and Illinois have accounted for the majority of the country’s increase in hospital beds filled, according to an NBC News analysis of U.S.”
Dec 8 Study raises renewed alarm about missed cancer diagnoses during pandemic (ABC) - “Oncologists have been warning about dangerous gaps in cancer care since the start of the COVID-19 pandemic.”
Dec 9 Opinion: The U.S. is at a Kasserine Pass moment for Covid leaders (Stat News) - “In the military, as in business and civilian life, leadership change can be needed to achieve victory or solve a problem.”
Sep 24 Majority in U.S. Supports Biden COVID-19 Vaccine Mandates (Christian Science Monitor) - Roughly six in 10 favor vaccination requirements for various workers.
Dec 7 Judge issues nationwide injunction against Biden's vaccination mandate for federal contractors (NBC) - “A federal judge on Tuesday issued a nationwide injunction against a vaccine mandate for federal contractors, ruling that President Joe Biden probably exceeded his authority by imposing the requirement.”
Dec 8 Vaccine mandates: Why GOP is stepping up its opposition (Christian Science Monitor) -
Oct 6 Data watch: Which U.S. cities have COVID vaccine mandates for employees? (Christian Science Monitor) - “Throughout the pandemic, we’ve seen mayors step up and lead when other levels of government faltered, whether that was on mask mandates, boosting residents’ access to COVID testing, communicating practices like social distancing, and much more. Now, we see mayors leading again—and putting people’s health first—on the latest frontier of pandemic policy making: vaccine mandates.‘
Last week’s edition said all teens were approved for boosters in the U.S. Only some teens were.
The Nov. 18th edition said it was our third holiday season with COVID. It is the second holiday season with COVID.