Dr. Alex Lickerman, my GP, has a new post on his website about the coronavirus and vaccines, the twelfth since he began posting during the pandemic. Click on the screenshot below to read it (it’s free).
The short answer to the title question is “yes”, but there are lots of other questions answered (and some raised without known answers). One is whether you can be an asymptomatic carrier if you’ve been vaccinated. Alex’s answer:
The study didn’t present enough data to prove the vaccine prevents asymptomatic infection. Nor did it assess whether subjects who developed COVID-19 despite vaccination are less likely to transmit the virus. Thus, it’s not yet clear how effective the vaccine will be in containing the spread of the infection. (A recent study from the CDC, however, strongly suggests that both mRNA vaccines—Pfizer’s and Moderna’s—do indeed prevent even asymptomatic COVID-19 infection by 90 percent in real-world circumstances, which is great news. We need more studies to learn if this is also the case for J & J’s vaccine.)
Jerry and I were both working independently on posts about the coronavirus. When we realized this, we conferred and decided to continue our efforts, but with some coordination and cross-fertilization. Jerry’s piece was posted on Friday.
[JAC: Greg has a “technical notes” section at the end which clarifies terms in the text that might confuse nonbiologists.]
1). Getting people vaccinated will impede the origin of new variants, because adaptive evolution is faster in larger populations. Widespread vaccination, by reducing the number of cases, will reduce the population size of the virus. Adaptive evolution is faster in large populations because selection is more effective in large populations; this is a well-known population-genetical result. And it’s also faster because large populations, by having a greater total number of mutations, explore more of the total mutational space—including the possibility of favorable double (or more) mutations in which the component single mutations are not favored but the combinations are. This is, in part, the principle behind the AIDS “cocktail” treatments: by attacking HIV in multiple ways at once, no single resistance-conferring mutation will allow the virus to escape, because if one drug doesn’t get it, another one will. Only having multiple mutations will confer resistance to the whole “cocktail”, but this is very improbable because the individual mutations, not being favored, will not accumulate. But in a very large sample (i.e., a large population), improbable things can happen.
There are also interesting issues of components of fitness or levels of selection in the evolution of viruses (or any disease-causing micro-organism, for that matter). Jerry discussed this in his piece, contrasting the evolution of virulence within an infected host versus transmissibility between hosts. These can be viewed as two components of reproductive fitness: competition to reproduce within the host, and competition to move to new hosts. Or it can be viewed as different levels of selection—individual selection among virus particles within hosts, and group selection between the populations of viruses between the hosts—they all get sneezed out to the next host as a group. The evolution of myxoma virus in rabbits in Australia, which Jerry discusses, has been interpreted from both points of view. The interest comes from the potential conflict between what’s “good” within the host (reproducing very rapidly), and getting to the next host. If you are too good at “taking over” the host, you might kill off the host before you can spread to the next host. And if you don’t spread, you go extinct. So, what’s good in the host may not be good for getting to the next host.
There’s also an interesting issue of what is the proper estimate of population size for the virus. Is it the number of viral particles? The number of hosts? For within-host selection, it would be the number of viral particles in that host. For selection between host populations, it might be nearer to the number of hosts. (I would guess that the theory for this has already been developed in the context of group selection theory.) Either way, fewer hosts, with lower viral loads within hosts, lowers the rate of adaptive evolution of the virus.
2.) By a *very* crude analysis, the UK variant does not show evidence of selection on its protein sequences. The ratio of Nonsynonymous (N) to Synonymous (S) mutations is 13/6 = 2.17, which is very close to the expected ratio of 2.66 for neutral (i.e., unselected) mutation in a completely *random* genome. The defect of this analysis is that the virus’s genome is of course not random. I would expect that someone with the genomic sequence and the right software is already carrying out a proper analysis using the actual nucleotide and codon distribution of the virus. (In fact, I wouldn’t be surprised if it’s already been done; not being a virologist, I don’t follow that literature.) A second, and perhaps more important defect, which would apply even to a proper analysis, is that nonsynonymous/synonmymous ratios average over sites for a whole protein or genomic sequence, so even strong selection at one or a few sites in a protein can be lost in a sea of neutral change in the rest of the protein. (See Technical note below for more details.)
There are other ways of inferring selection, and Jerry stressed one of those: if the virus evolves in parallel in multiple locations, that suggests the action of selection. We seem to be seeing that, independently, in several different locations, the same variant is spreading widely and increasing in frequency. If the variants were neutral, their frequencies would change only due to chances of sampling and which variant happened to get somewhere first, so we wouldn’t expect the same variant to “get lucky” and take over all the time.
Another hint of selection would be if substitutions affecting function (such as nonsynonymous mutations and deletions) are concentrated in a part of the genome known to be of adaptive significance, such as the spike protein. That protein is a highly functional part of the virus, for it’s the part it uses to stick to host cells. The UK variant shows at least two nonsynonymous mutations and one deletion in the spike protein, but without full data, I can’t say if this is a greater than expected number for the spike protein (which forms ca. 10% of the genome).
3). The variants are differentiated strains, not “mutations”. The identified variants differ by multiple substitutions, and thus are not a mutation, but the accumulation of multiple mutations. Some substitutions in a strain may be subject to selection, but others will not be. If we think of the virus as a “species” (which, being a collection of asexual lineages, is not quite what the virus is), then the variants or strains are like “subspecies”: differentiated descendants of a common ancestor, differing in a number of ways, some of which may be adaptive, while others may not be. (In biological species, subspecies interbreed, and thus are a form of geographical variation; in viruses, however, the variants can exist without interbreeding in the same geographic area, including inside the same host, so the analogy to subspecies is inexact.)
4). Some of the media, or at least reporter Apoorva Mandavilli of the NY Times, are grasping that virus evolution is key to the course of the pandemic. Words and phrases in her article include: “selection pressure”, “evolve” (4 times!), “evolving”, “evolutionary biologist”, “adaptation”, and “coronavirus can evolve to avoid recognition”. And here’s a statement in the article of the distinction between genetic drift and selection:
Some variants become more common in a population simply by luck, not because the changes somehow supercharge the virus. But as it becomes more difficult for the pathogen to survive — because of vaccinations and growing immunity in human populations — researchers also expect the virus to gain useful mutations enabling it to spread more easily or to escape detection by the immune system.
This article is a pretty direct affirmation of the importance of understanding how evolution works when dealing with viral diseases.
5). After the AIDS epidemic, we all should have learned the importance of evolutionary biology for transmissible diseases. The lessons learned during the spread, evolution, and control of HIV and other viruses are so clear that they have become textbook examples of evolutionary principles, from elementary grades to collegetexts. Epidemics are all about evolution.
6.) You should call it the “UK variant”. The article at Ars Technica from which I got the (limited) genomic data I used above, falls over itself trying not to use geographic terms because they cause “stigma”. This is stupid. One of the oldest practices in taxonomy is to name species after the place they are found. The native anole of the southern United States is named Anolis carolinensis, because the description was based on lizards supposed to be from Carolina. It was later found to occur all over the southeastern United States, with closely related forms (sometimes considered conspecific) on a number of West Indian islands. It has also been introduced all over the world, from California to Hawaii to Japan. It is still Anolis carolinensis. Stability of names is important, and names related to place are a useful mnemonic, since they require no knowledge of Latin or an arcane numbering system. (The article refers to the UK variant as “B.1.1.7”. If there’s only one variant this might do, but with multiple ones it becomes an exercise in memorization.)
Technical note. “Nonsynonymous” mutations are mutations of the DNA sequence which change the amino acid structure of the resulting protein. Because the genetic code is redundant (DNA codes for the same amino acid in more than one way), some mutations are “synonymous”, resulting in an unchanged protein. There are 549 possible mutations of the 61 amino acid coding codons (61 codons X 3 nucleotides per codon X 3 possible nucleotides to change into). Of these possible mutations, 399 are nonsynonymous and 150 are synonymous. (I couldn’t find these numbers anywhere, so I counted them up myself from the table in Muse and Gaut (1994); my count could be off, but, I hope, not by much.) If a protein coding DNA sequence has a completely random sequence (i.e. all 61 protein coding codons are equally represented), then mutations occurring at random will occur with a nonsynonymous to synoymous ratio of
N/S = 399/150 = 2.66
and, if the mutations are neutral, will be fixed (i.e. will reach a frequency of 100%) in the same ratio, which is where I got the expected N/S ratio of 2.66 for evolution by neutral mutation.
However, the DNA sequence is not random, so we usually express the nonsynonymous/synonymous ratio by looking at the rate of substitution per site. Thus, we divide the the number of nonsynonymous mutations by the number of nonsynonymous sites (i.e. the number of nucleotide positions which would give rise to a nonsynonymous amino acid if mutated), and similarly for synonymous mutations. This gives us the dN/dS ratio, which is expected to be 1 under neutrality, because we have normalized by the expected rates of each type of mutation. It is greater than 1 when there is positive selection in favor of new mutations. In calculating dN/dS, adjustments can be made for known biases in the process of mutation (e.g. the different rates at which mutations which change the ring structure of the nucleotides occur).
dN/dS ratios are subject to some of the same limitations as raw N/S ratios, including the averaging effect noted above. Yang and Bielawski (2000) is a modestly readable introduction to using rates of nonsynonymous versus synonymous substitution to detect selection.
Charlesworth, B. and D. Charlesworth. 2010. Elements of Evolutionary Genetics. Roberts, Greenwood Village Colorado. An upper level text, but not as daunting as some. Amazon
Diamond, J., ed. Virus and the Whale: Exploring Evolution in Creatures Small and Large. NSTA Press, Arlington, Va. Uses HIV as an example of viral evolution. Amazon
Emlen, D. J. and C. Zimmer. 2020. Evolution: Making Sense of Life. 3rd ed. Macmillan, New York. Uses influenza as an example of viral evolution. Amazon
Herron, J.C. and S. Freeman. 2014. Evolutionary Analysis. 5th ed. Pearson. Uses HIV as an example of viral evolution. publisher
Muse, S.V. and B.S. Gaut. 1994. A likelihood approach for comparing synonymous and nonsynonymous nucleotide substitution rates, with application to the chloroplast genome. Molecular Biology and Evolution 11:715-724. pdf
Yang, Z. and J.P. Bielawski. 2000. Statistical methods for detecting molecular adaptation. Trends in Ecology and Evolution 15:496-503. pdf
As I’ve mentioned in passing, I’ve had two coronavirus shots; these used the Pfizer vaccine. The university hospital has been vaccinating a gazillion people, starting with healthcare workers on the front line, hospital employees, local oldsters (like me) and then residents of the South Side, mostly black, as well as healthcare workers who aren’t affiliated with the hospital but work on the South Side. It was heartening to go to the Covid clinic, an efficient and dedicated facility in the hospital, and wait in line with a cross-section of Chicago, including healthcare workers in their scrubs, all of us “in it together.” I have nothing but praise for that organization and its efficiency, and everyone was uber-friendly. I even got a “congratulations” after my second shot.
And as I stood in line, I realized what a fantastic thing these vaccines are, and, indeed, what all vaccines are. If our immune system had no memory, if scientists hadn’t figured out that you could stave off disease by tweaking that memory, and if they hadn’t figured out how to do it without causing the disease, humanity would have been driven down over and over again.
The Pfizer vaccine is even more marvelous: a vaccine made by injecting into your arm a liquid solution of RNA “code” for the virus’s spike protein, with that code encapsulated in little fat bubbles. Once in your arm, the specially designed code makes its way to your cells, which then use the code to make many copies of the virus’s spike protein. Those free-floating copies are themselves harmless, but are the parts of the virus that adhere to cells when you get Covid-19. The immune system then recognizes the spike proteins as foreign, goes to work destroying them, and then the memory of those proteins is stored in our immune system (this is the way that all vaccines work). When you get a second shot, the immune system recognizes the spike proteins that it’s seen before, and mounts a huge defense against them, creating not only greater memory but often producing some side effects for the second jab. When you’ve mounted two defenses, your immune system is ready to go when it sees the spike protein on a virus that infects you.
In late December I wrote a post about how scientists had tweaked the spike protein’s RNA code to get it into our cells intact and make it produce many copies of the protein. That tweaking itself rested on years of molecular-genetic work done without the goal of making a vaccine. It’s a testament to the power of pure research and human curiosity.
All in all, I consider the mRNA vaccines, like the Pfizer and Moderna ones, as “miracles”—except I don’t like the word because it smacks of religion. But they do show what our evolved neurons are capable of doing when faced with a medical problem. I don’t know a secular word for “miracle”, but if there is one then it should be used with these vaccines. And remember, jabs went into arms less than a year after the virus first began its depredations in China. Further, the vaccine was designed within just a few days after the genome of the virus was decoded, which itself took less than a week.
But people want to know what the shots were like. The first one was a piece of cake: it was a simple jab (they manage to get six doses out of a vial at the hospital, increasing the number of jabs by 20%), and I didn’t even have a sore arm. The only side effect was a very slight soreness at the injection site, but a soreness that could be detected only by pressing on the site.
It was 18 days between jab 1 and jab 2, though the usual period is 21 days. I took the shorter period because it was within CDC and Pfizer recommendations, and I was eager to become immune. I’m not sure how they know that 13-21 days is the right interval, and I don’t think they really did a lot of tests about that.
The second jab went into my arm on Monday. I was informed in great detail, and given an instruction sheet, that this jab was likely to cause more side effects, including chills, fever, muscle aches, and even vomiting. I was prepared for that: it’s better to suffer for a day or so than to get infected! I felt fine throughout Monday, but my arm was a little bit more sore than after the first jab. On Tuesday morning I also felt pretty good, and, because they said symptoms may begin within 12-24 hours, I thought I was home free.
That was not to be. At about noon yesterday (28 hours after my second jab), I begin feeling muscle aches, overall tiredness, and a general malaise, as if I were getting the flu. I recognized this as side effects and went home, dosing myself with Tylenol. My temperature, which is normally low (about 97.3° F, went up a bit, to 99.5°F). I did not lose either my appetite or sense of taste or smell, and I had a decent dinner but abjured the vino. I went to bed still feeling out of it.
But I woke up this morning feeling right as rain. As the instructions said, the side effects pass within 48 hours. One has to wait two weeks, I understand, to acquire the vaunted 95% immunity that comes with this vaccine. From this my advice would be “when you get your injection, schedule it for late in the afternoon, go home, and then be prepared to not go to work the next day.” A Friday afternoon would be ideal for that second shot.
I asked the nurse who gave me the second jab if there was any correlation between the severity of one’s side effects and the effectiveness of the immunization. One would think that a vigorous immune response to the second dose, indicating that your immune response was quite active against the protein, would mean that you’d be better protected against the real virus. In other words, the worse the side effects, the better off you are. She said there was no correlation, as did the instruction sheet I got. I still am a bit dubious, but if there is a correlation, that I’m good to go against the virus.
Of course I urge everyone to get their jab. I asked a staff member on campus with whom I’m friends if she got the jab. I was surprised when she said “no.” When I asked why, she said because “people had died from the vaccine.” She was afraid of it, which I think is a fairly common feeling. But I looked up the deaths associated with the Pfizer vaccine, and, as we know, it’s not risky. There were six deaths during the phase 3 trials, but four of those were in the control group. Two died in the vaccine (experimental) group, one from arteriosclerosis and the other from a heart attack. Those deaths were probably the results not of the vaccine, but of underlying conditions. Of course some people will die after being vaccinated: as the control group shows, that will happen in any large group of people! On balance, though, all the experts say it’s better for your own welfare to get vaccinated than to risk Covid-19. And it’s better for society as well, since the more people who get vaccinated, the quicker we’ll attain herd immunity.
I went back to my friend and told her the statistics, but she was unmoved, and clearly didn’t want to discuss the point. Although I was concerned with her health, I realized that there was no point in arguing, as vaccination avoidance is almost a form of religion, and certainly a type of faith. I won’t bring up the subject again.
I’m sure all readers here are eager to get their shots, and it’s frustrating to watch while others get them but you can’t get an appointment. Biden and his administration are working hard on the issue. But we should be cognizant of the vaccine shortages in other countries, which are far more severe than in America or Europe. The news last night reported that America will have five times the number of doses necessary to vaccinate the entire population, and Canada six times. Couldn’t the excess be used in places like Latin America, where the Covid rate is high but vaccines rare? I know that Bill Gates and others are donating lots of dosh to buy vaccines for poor countries, but we will need about 18 billion dollars to do that job. This is not a U.S. or European issue, but a world issue, and with the vaccine we should be far more concerned about other countries than we usually are. Even from a selfish point of view, if you don’t go after Covid everywhere, the whole world remains in danger.
I didn’t take a “vaccine selfie”; here’s the best I can do:
Reader Simon sent me a link to this free paper about coronavirus vaccines written by several researchers, including Anthony Fauci (“senior author” means “last author”, and the convention that this spot is occupied by the Boss or lab head). It’s a useful summary of where we are, which other vaccines are coming, and what we don’t know, and is understandable by the layperson. (Here’s a link to one term you might not know: “mucosal immunity“, while “parenterally” refers to medicines taken outside the digestive tract, usually through injection.)
Click on the screenshot to read:
There’s a useful table of vaccines already used compared to those in development. Of the five remaining vaccines, three involve viruses: mostly inactivated viruses that can’t replicate but can produce the spike protein that activates your antibodies, while two others involve injecting spike proteins themselves, made in insect cells. Click to enlarge:
Here’s a figure I’ve posted before showing the protection you get from the two vaccines in use in America now: the Pfizer/BioNTech and Moderna formulations.
Note that you’ve already gotten substantial protection before you get to the second jab. For both vaccines the efficacy (the reduction in the chance you’ll catch the virus if exposed) is about 95%.
The paper raises several concerns about the vaccines and people’s willingness to take them.
A.) What are the side effects? Monitoring of those injected has only taken place for several months, and there may be long-term effects we don’t know about. The authors note, though, that some of the vaccinated would have had stuff like cancer and heart attacks anyway—effects having nothing to do with the injection. The frequencies of such incidents and diseases need to be compared to those in unvaccinated groups or base rates already known.
B.) We don’t know the efficacy in some important groups, including “children, pregnant women, individuals with underlying illnesses, and those taking medications that might influence the immune response to a disease.”
C.) The duration of protection provided by the vaccines. We know that the efficacy of flu vaccines wanes substantially between six months and a year after injection. Will we have to get yearly injections of coronavirus vaccines as we do with flu shots? Of course they will continue developing vaccines, so they will get better over time.
D.) How well do the vaccines protect against (asymptomatic) infection and transmission of the virus? We should have the answer to this question in a while, and the authors consider this the most important unknown in trying to stem the pandemic. If after injection you can get infected and not show symptoms, as well as transmit the virus, this will dramatically curtail efforts to stop the pandemic cold, and mandate different strategies, like testing those already injected.
And a paragraph from the paper, which is disturbing given that roughly half of Americans plan to get vaccinated. That is INSANE! Tell your worried friends to get their jabs, as it’s better than getting coronavirus.
The point made is that the vaccines currently in use don’t provide immunity in the mucosal membranes (as in the nose), while polio vaccine did bestow that immunity, but only if made with live weakened virus. (Current flu vaccines don’t provide it either.) Active immunity in the mucosa kills the virus in the respiratory system before it has a chance to get into the blood. The coronavirus vaccines now available don’t seem to provide mucosal immunity and, as the authors say, we need vaccines that will do that. A summary:
Given that recent polling suggests that only 40% to 60% of people in the United States are currently planning to get vaccinated, it is conceivable that without some impact on transmission, the virus will continue to circulate, infect, and cause serious disease in certain segments of the unvaccinated population. Administration of parenterally administered vaccines alone typically does not result in potent mucosal immunity that might interrupt infection or transmission. In the case of poliovirus, induction of mucosal immunity through vaccination with the live attenuated oral polio vaccine, in contrast to the parenterally administered inactivated vaccine, was thought to have played a critical role in interruption of transmission and control of poliovirus epidemics. For these reasons, additional data regarding protection from infection should be generated as soon as possible. If these vaccines do not provide durable, high levels of protection from infection, and do not drive the prevalence of virus in the community to near zero, a thorough analysis of shedding and transmission will need to be done through additional study. Armed with such data, public health officials can make decisions regarding prioritization of populations to receive the vaccine, and researchers could potentially improve upon the first wave of vaccines.
Despite what I consider my strong refutation of the idea that “faith” is pervasive in both science and religion, that idea persists. I won’t go through the arguments that I made in Faith Versus Fact or, more concisely, in an article in Slate, “No Faith in Science,” but people nevertheless persist in their nescience. The latest attempt to argue that science is faith-based is in the pages of The Post Millennial, a conservative Canadian news magazine. It’s just so tiresome in every way that I get no pleasure from putting fingers to keys. But since that rag is fairly widely read, I’ll say a few words.
The article is really a disguised harangue about how mandates to wear face masks during the coronavirus pandemic are infringements on our liberty. In other words, it’s the right-wing libertarian argument against masks that we see so often in the U.S. And, says Andrew Mahon—identified as “a Canadian-British writer based in London who has written for the Spectator, the Daily Wire, Conservative Woman, New English Review, Brexit Central, Catholic Journal and others”—the notion that masks reduce Covid-19 transmission is based on faith, because there’s supposedly no evidence behind it.
Click on the screenshot to read and weep:
You can read my Slate piece to see that when scientists use the word “faith”, they use it differently from believers. Scientists use it to mean “confidence born of experience.” And when people say “I have faith in my doctor” or “I have faith in Anthony Fauci’s views”, they mean that they trust authority figures who have a good track record. That’s not the same as religious faith, characterized by philosopher Walter Kaufmann as ” “intense, usually confident, belief that is not based on evidence sufficient to command assent from every reasonable person.”
Read my piece if you want more. The upshot is that the scientific notion of “faith” does not turn science into a religion, as Mahon implies in his headline. If you look up “religion” in the Oxford English Dictionary, you find this definition:
Action or conduct indicating belief in, obedience to, and reverence for a god, gods, or similar superhuman power; the performance of religious rites or observances.
Even if science were based on a religious-like faith, which it isn’t, it couldn’t be described as a religion. We have no obedience to or reverence for gods or the supernatural. End of story.
Mahon, who I suspect is a believer, has a weird notion of religion, claiming that it is not based on evidence or claims about reality. That’s of course untrue, but it does adhere to the Gouldian “Non-overlapping magisteria” view of science and religion:
The religious impulse cannot be avoided. Alongside faith, everyone participates in ritual and follows prohibitions in one form or another. We do it in every human interaction, and we certainly notice whenever anyone doesn’t follow conventional norms. The question becomes where to direct the religious impulse. And, leaving aside the truth or falsehood of its claims, what Christianity achieved was to direct man’s religious impulse to the ideal place, away from the empirically knowable. Unlike other religions, Christianity directed it wholly towards things unknowable, unprovable and unfalsifiable. This effectively freed up the knowable world, severing it from the realm of faith, and allowed the scientific method to step in and transform human civilization.
Away from the empirically knowable? But if you’re a Christian, don’t you have to have some “knowledge” about the existence of Jesus and God, and of their powers and their plans? In fact, empiricism is the only way to know about these things, making the term “empirically knowable” a bit of an redundancy. I guess he’s talking about “other ways of knowing,” i.e., revelation, authority, and sacred books, which are non-empirical. Neither are they a way to arrive at the truth, as we know from all the contradictory claims of the world’s diverse religions. As Mike Aus, a pastor who quit the church, said:
When I was working as a pastor I would often gloss over the clash between the scientific world view and the perspective of religion. I would say that the insights of science were no threat to faith because science and religion are “different ways of knowing” and are not in conflict because they are trying to answer different questions. Science focuses on “how” the world came to be and religion addresses the question of “why” we are here. I was dead wrong. There are not different ways of knowing. There is knowing and not knowing, and those are the only two options in this world.
So, although Mahon gives credit for science to religion’s wise decision to step away from empirical claims, I can’t be all that grateful. And I wish that religion would keep its mitts off evolution. But of course Mahon’s claim bespeaks a profound ignorance of religion, many of whose proponents really do make claims about reality that they believe absolutely, and are constantly trying to buttress with evidence (viz. Biblical archaeology, miracles, and so on).
But the “religious impulse” that “can’t be avoided” is now, argues Mahon, directed towards the pandemic, in particularly those nasty mandates to wear masks. He gets into his anti-mask argument slowly, as he doesn’t want to look like a crazy right-winger at the very beginning.
Step 1: A general assertion:
The rush to accept the claims of scientists with blind faith rather than insisting on proof is a distinct sign of our times, as is the demand for proof of unprovable tenets of Christianity. In thrall to this topsy-turvydom, many scientists expect politicians to trust them in the absence of evidence and many Christians try to construe the book of Genesis as if it were a scientific treatise.
Step 2: Mahon gets more specific:
Surely, given the unprecedented disruption to people’s lives, the suppression of basic liberties and the destruction of the economy, the decision to shut down society ought to have been evidence-based rather than faith-based. But with few exceptions, our politicians didn’t insist upon evidence, choosing instead to defer to (or should we say, hide behind) their scientific advisors, who presented them with predictions, models, worst-case estimates and beliefs.
And of course those scientific advisors, who were blindsided like many of us, initially went on the best guesses they could make from evidence derived from previous coronavirus epidemics and from epidemiology. In other words, they went on evidence, scanty as it was at the beginning of 2020. They weren’t always right, but they did not rely on revelation, sacred books, or mere unevidenced pronouncements of authorities. And of course those scientists eventually presented the politicians with a vaccine. That vaccine wasn’t, of course, based on faith.
Step 3: Mahon reveals his real animus:
Take mask mandates. People who believe in wearing masks think that they’re basing those beliefs on science. But if that were true, they’d be able to show evidence. What you get instead is a patronizing cartoon of people peeing on each other, or Paul Rudd trying to be funny and then yelling at you from his celebrity pedestal. “It’s science!” he shouts. But is it?
Wearing masks makes some people feel better. It also satisfies a naive intuition. The mask is clearly a barrier that will at some level prevent fluids travelling through fabric, just like your pants. But that doesn’t constitute scientific proof that masks prevent the spread of a virus. Scientific proof in this case would take the form of randomized controlled trials. There was one five years ago which compared medical masks to cloth masks and found that “Moisture retention, reuse of cloth masks and poor filtration may result in increased risk of infection.” This was the line that most governments were taking at first, in the absence of any evidence to the contrary. But then they altered course without any new evidence, and the vast majority of people now accept it as an article of faith that masks save lives.
There has been a grand total of one randomized controlled trial conducted to determine the efficacy of masks in preventing the spread of SARS-CoV-2. The Danish study that initially struggled to find a publisher conclusively showed that there is a statistically insignificant difference between wearing a mask and not wearing a mask. Add to this the fact that masks are disgusting, unhygienic sneeze receptacles that in practice are rarely washed or replaced, that people touch their masks and faces constantly before feeling up avocados in the supermarket, that because of the false sense of security, people wearing masks are less likely to do other, more effective things, like wash their hands, and finally, that there is little to no evidence of asymptomatic transmission, and we have to wonder why all these healthy people are still walking around with their faces covered. The answer is quite simply that their faith is misplaced.
Now let’s grant that we lack the direct controlled, randomized trials that we need to show with absolute certainty that masks are useful in helping contain the epidemic. (Of course other things are very useful as well: hand-washing, avoiding big social gatherings, quarantining, and so on.) Doing those types of experiments would be unethical. But we have correlational evidence that show mask wearing by symptomatic and asymptomic people, whether the latter be infected or not, reduces the incidence of transmission; that masks contain respiratory droplets, a source of infection; and so on. All the evidence is summarized in this post on the website of my doctor, Alex Lickerman—a post I’ve mentioned before (click on screenshot to read it):
You won’t find any faith in the post above, just data—data sufficient to buttress the argument that we should all be wearing masks.
At the end, Mahon reprises his claim that mask-wearing is a religious act, and makes what I call “The Argument from the Norm”:
Not wearing masks is the norm, freedom to visit family and friends is the norm, freedom to conduct business is the norm, and evidence should be required to displace by legal compulsion each and every one of these norms. But too many people aren’t interested in that, preferring instead to trust in the government’s claim to be following “the science,” and if challenged, they often react the way a religious person reacts when his beliefs are criticized — offended and scandalized.
Well, read Alex’s post above and see if you think there’s no “science” behind mask mandates.
But the best part of Mahon’s argument is his claim, at the very end, that because the erosion of Christianity in our society has also eroded the distinction between “the knowable and the unknowable”, then perhaps a return of Christianity will actually help revive science! I kid you not:
I’m not sure whether a return to Christianity is necessary to salvage the unknowable/knowable partition and preserve the utility of the scientific method. But whatever direction our society chooses to go in future, one thing’s for sure: we will have a religion. We may not have science.
Can you believe that? Mahon’s not even wrong here. Eventually religion will largely disappear from Western society, but science never will because it cannot. In the modern world, we don’t really need religion that much, but we’ll always need science. How else would we have gotten a vaccine? Science is the only good way to materially improve humanity, whether it be through technology, nutrition, or health. And, of course, it’s the only way to satisfy our insatiable curiosity about the cosmos.
The Post Millennial was in fact irresponsible in printing this piece, implying as it does that mask-wearing has no effect on viral infection rates. Mahon may have the right to endanger Canadians with his pabulum, but the paper should exercise better judgement in allowing columnists to make misleading statements about science, particularly when they affect public health. If this column were on Twitter, it would have gotten one of those “false tweets” warnings.
p.s. If you saw a mattress ad, ignore it. I had to turn off adblocker to get the article, and accidentally copied that ad. It should be removed now.
Once again we have a professor who said stupid stuff—not hateful this time, but medically wonky and potentially dangerous—and was officially condemned by his University.
Hot off the press from The Stanford News (click on screenshot): Scott Atlas, a senior fellow at Stanford’s Hoover Institution—and formerly a professor and chief of neuroradiology at the Stanford University Medical Center—became a coronavirus advisor in the Trump administration, and proceeded to make a number of pronouncements about the pandemic that contravened medical wisdom. Last Thursday he was condemned in a Stanford faculty resolution, with 85% of the faculty voting for that resolution.
So here we have the usual conflict between freedom of speech and the “harm” imputed to that speech. And once again, while condemning the speaker, I defend Atlas’s right to say what he wants without institutional condemnation.
From the report:
A resolution, introduced by members of the Faculty Senate Steering Committee and approved by 85 percent of the senate membership, specified six actions that Atlas has taken that “promote a view of COVID-19 that contradicts medical science.”
Among the actions cited are: discouraging the use of masks and other protective measures, misrepresenting knowledge and opinion regarding the management of pandemics, endangering citizens and public officials, showing disdain for established medical knowledge and damaging Stanford’s reputation and academic standing. The resolution states that Atlas’ behavior is “anathema to our community, our values and our belief that we should use knowledge for good.”
The resolution singles out for criticism Atlas’ recent Twitter call to the people of Michigan to “rise up” against new public health measures introduced by Gov. Gretchen Whitmer to curb disease spread.
“As elected representatives of the Stanford faculty, we strongly condemn his behavior,” the resolution states. “It violates the core values of our faculty and the expectations under the Stanford Code of Conduct, which states that we all ‘are responsible for sustaining the high ethical standards of this institution.’”
In approving the resolution, members of the senate called on university leadership to “forcefully disavow Atlas’ actions as objectionable on the basis of the university’s core values and at odds with our own policies and guidelines concerning COVID-19 and campus life.”
The indictment goes beyond simply damning Atlas for misrepresenting the scientific consensus in a potentially harmful way (presumably if he misrepresented continental drift there would have been no faculty resolution), but criticizes him for giving the imprimatur of Stanford and the Hoover Institution to his words. This is a common way to criticize speech: by saying that the speaker is an authority figure and puts the weight of his/her position behind the words.
In discussion, David Spiegel, the Jack, Samuel and Lulu Willson Professor in Medicine, who has been among Atlas’ most vocal critics, reiterated his belief that the university has an obligation to act because Atlas has inappropriately used his position at the Hoover Institution to give credibility to his COVID-19 positions.
“What Atlas has done is an embarrassment to the university,” Spiegel said. “He is using his real affiliation with Hoover to provide credibility in issues he has no professional expertise to discuss in a professional way.”
Yes, of course what Atlas said was dumb, and would have potentially harmful effects on those who followed his public statements. (But be mindful that there have been dissenters from the received wisdom about how to control the pandemic. Sweden, for instance, initially (and fruitlessly) sought to stem the pandemic through herd immunity—one of Atlas’s recommendations.)
But stupid pronouncements, even when made as an official of the Trump administration (and a fellow on leave from Hoover) constitute free speech. Atlas’s intent, or so he said in his response to the resolution, was neither intended to cause harm (the guy was just clueless), nor, if harmful, did it cause immediate harm. Ergo it’s free speech under the First Amendment.
And it doesn’t violate freedom of speech to make a pronouncement as an individual affiliated with Stanford. As far as I know, if I tweeted, as Professor Jerry Coyne, “Face masks are useless for preventing spread of the virus,” I would not be violating the First Amendment simply because I mentioned my position. I might be violating a company’s regulations, or Stanford’s regulations (though I don’t know if that’s the case), but Stanford, although a private university, should not have rules that prevent free speech among its faculty.
Indeed, faculty who voted against Atlas recognized the tension between free speech and “harmful speech”, but resolved it in favor of preventing harm. It’s a case of “we favor free speech BUT. . . ”
In his comments on the issue, [Stanford] President Marc Tessier-Lavigne said he was “deeply troubled by the views by Dr. Atlas, including his call to ‘rise up’ in Michigan.” Tessier-Lavigne noted that Atlas later clarified his statements, but he said that the tweet “was widely interpreted as an undermining of local health authorities, and even a call to violence.”
Tessier-Lavigne reiterated Stanford’s commitment to free speech and academic freedom. Atlas, he asserted, remains free to express his opinions.
“But we also believe that inflammatory remarks of the kind at issue here by someone with the prominence and influence of Dr. Atlas have no place in the context of the current global health emergency,” he said. “We’re therefore compelled to distance the university from Dr. Atlas’s views in the strongest possible terms.”
No, President Tessier-Lavigne, Atlas’s misguided statements were NOT a “call to violence”, at least of the immediate and predictable kind that does violate the First Amendment. Atlas even made that clear. How a statement is interpreted by people is not important; what’s important, if you’re seeking to damn someone for free speech, is what they intended to do.
The instrument of dissent and criticism is the individual faculty member or the individual student. The university is the home and sponsor of critics; it is not itself the critic. It is, to go back once again to the classic phrase, a community of scholars. To perform its mission in the society, a university must sustain an extraordinary environment of freedom of inquiry and maintain an independence from political fashions, passions, and pressures. A university, if it is to be true to its faith in intellectual inquiry, must embrace, be hospitable to, and encourage the widest diversity of views within its own community. It is a community but only for the limited, albeit great, purposes of teaching and research. It is not a club, it is not a trade association, it is not a lobby.
In this case the University (Stanford) is the critic, making public pronouncements so it looks good. And by so doing, it chills the speech of those faculty who would advance renegade views. Some of the faculty even recognized this:
The discussion of Atlas’ actions raised issues of academic freedom and freedom of speech, as it has in the past. Among those expressing concern about the resolution’s effect on freedom of speech and academic freedom was John Etchemendy, former provost, the Patrick Suppes Family Professor in the School of Humanities and Sciences and the Denning Family Co-Director of the Stanford Institute for Human-Centered Artificial Intelligence.
Etchemendy said that the resolution could be interpreted as suggesting Stanford faculty members have less freedom of speech rights than members of society in general.
But Etchemendy said, “As far as the statements that have been made by Atlas, as a private citizen he has the right to make those statements. I am troubled by the idea that a person who has those rights to speak and to assert certain things – however outrageous – have fewer rights to speak, given that they are Stanford faculty. I find that to be contrary to what is, I think, the highest value of the university, which is the value and promotion of free speech and open dialogue.”
I agree wholly with Etchemendy. But clearly most faculty, even if they do favor free speech and academic freedom, favor the “free speech BUT. . .” variety. One more quote:
Debra Satz, dean of the School of Humanities and Sciences, said she believes the resolution has reminded the university of the importance of leading with its values.
“In our messaging, we have sometimes been more focused on the legal issues rather than the value issues,” she said. “This brings the value issues front and center. We have been pretty good at pointing to the value of freedom of speech and freedom of inquiry, which I believe are central. But there are other values at stake. As a university, we have a commitment to push back against the undermining of expertise and knowledge. That is one of the great threats to our democracy at the moment.”
In my view (others may differ), those “other values”, which constitute misinformation—even potentially harmful misinformation—do not outweigh the great value of freedom of speech, especially at a university. Stanford should have kept its collective mouth shut.
Now you might be asking, “Well, what’s the difference between what Atlas said and false advertising, which DOES violate the First Amendment?” After all, Atlas’s statement, like false advertising of drugs, could be harmful to people’s health.
As far as I know, commercial advertising has a bit less leeway than other forms of speech, and what has been prohibited by the courts is deceptive commercial advertising, when a firm makes claims it knows to be wrong. That is not the case for Atlas, who believed what he said. But even if he knew what he said was wrong, he should be damned and excoriated for it by counterspeech, not subject to official university condemnation. Universities, after all, should be kept as unsullied as possible by the chilling of speech, for they are places where ideas should be freely expressed and debated.
Atlas is a moron, but even morons get to say dumb things under the First Amendment.
I was going to put a poll here, “Do you agree that Stanford should have had a vote on condemning Atlas?” But I’d rather hear what you have to say in the comments, so speak up.
When I heard that Illinois was giving covid-vaccine priority to all “essential workers” over the aged, I was puzzled. Not because “essential” workers should all queue up behind older people, but because some “essential workers” weren’t really essential in a sense that should give them priority over older people whose chance of dying from the infection was much higher. “Essential workers” include, according to Yascha Mounk, bankers, liquor-store employees, hardware-store employees, and movie crews. On what grounds, especially considering the differential risk of death or serious illness, should these “essential workers” be given vaccination priority over adults with high-risk medical conditions or older folks (over 65, 70, or 75, depending on the state and the ordering)?
Yet that is what the CDC decided not long ago, realizing, even by their own accounting, that such a decision would cause more people to die than if the order was reversed. The decision to let people die was apparently based on social-justice considerations, as older people were deemed to be more white than were essential workers.
In this article from Persuasion, Yascha Mounk, Associate Professor of Practice at Johns Hopkins University’s School of Advanced International Studies, argues that such a decision is unethical. Click to read:
Mounk begins with some premises that he thinks people will agree on about what what is just and unjust:
. . . there are also some bedrock principles on which virtually all moral philosophers have long agreed.
The first is that we should avoid “leveling down” everyone’s quality of life for the purpose of achieving equality. It is unjust when some people have plenty of food while others are starving. But alleviating that inequality by making sure that an even greater number of people starve is clearly wrong. The second is that we should not use ascriptive characteristics like race or ethnicity to allocate medical resources. To save one patient rather than another based on the color of their skin rightly strikes most philosophers—and most Americans—as barbaric. The Centers for Disease Control have just thrown both of these principles overboard in the name of social justice.
In one of the most shocking moral misjudgments by a public body I have ever seen, the CDC invoked considerations of “social justice” to recommend providing vaccinations to essential workers before older Americans even though this would, according to its own models, lead to a much greater death toll. After a massive public outcry, the agency has adopted revised recommendations. But though these are a clear improvement, they still violate the two bedrock principles of allocative justice—and are likely to cause unnecessary suffering on a significant scale.
He then recounts a talk that Kathleen Dooling, a public-health official, gave at the CDC, a talk that wound up undergirding the initial order of non-healthcare-essential workers > older adults that the organization mandated for vaccination. The decision was based on “feasibility [ease of implementing vaccination in an identified population], science, and ethics.” Dooling presented a chart, below, purporting to show that implementation was easier in a group based solely on age (true: it’s substantially harder to identify “essential non-healthcare workers” as well as define whether someone has a “high-risk medical condition”), and the science itself, she said, showed no difference in outcomes based on priority. (The “+” signs are indices of priority, and are somehow combined to create the order of vaccination.)
The “science” bit is especially wonky. Although older adults without comorbidities are given the same science rating as essential non-healthcare workers (column 1 versus 3), Mounk says this:
According to the CDC’s model, prioritizing essential workers over the elderly would therefore increase the overall number of deaths by between 0.5% and 6.5%. In other words, it would likely result in the preventable deaths of thousands of Americans.
Remember, that is a model that supposedly takes into account all scenarios for mortality, including deaths produced by non-vaccinated “essential non-healthcare workers” who spread the virus to others:
Thus, deciding to prioritize non-healthcare essential workers over adults over 65 rested on grounds of “ethics” is deciding to prioritize “ethical considerations” over life (as if differential death was not an ethical matter!) Mounk says the “ethics” came down to race:
And yet, the presentation concluded that science does not provide a reason to prioritize the elderly. For, as Kathleen Dooling wrote in one of the most jaw-dropping sentences I have ever seen in a document written by a public official, differences in expected consequences that could amount to thousands of additional deaths are “minimal.”
This allowed Dooling to focus on “ethical” principles in selecting the best course of action. Highlighting the most important consideration in red, Dooling emphasized that “racial and ethnic minority groups are underrepresented among adults > 65.” In other words, America’s elderly are too white to be considered a top priority for the distribution of the vaccine against Covid. It is on this basis that ACIP awarded three times as many points to prioritizing the more racially diverse group of essential workers, making the crucial difference in the overall determination. Astonishingly, the higher overall death toll that would have resulted from this course of action does not feature as an ethical reason to prioritize older Americans.
As far as I know, Mounck is correct is stating that this is the basis of the decision. It is based on social-justice optics. Now nobody would want to take a path in which one could foresee a worse outcome—in terms of death or anything else—for members of different races. If one could predict that the death rate among such groups would differ as a result of such a policy decision, that would violate the ethical principles above. But that’s not the outcome here. In fact, as Mounck notes, the proportion of people of color among essential non-healthcare workers isn’t much different from their proportion among the elderly, and it’s in fact conceivable that prioritizing column 1 over column 3 could lead to the deaths of more people of color than the other way around!
The difference in the percentage of white people across age groups is comparatively small. The difference in the percentage of infected people who succumb to Covid across all age groups is massive. Giving the vaccine to African-American essential workers before elderly African-Americans would likely raise the overall death toll of African-Americans even if a somewhat greater number of African-Americans were to receive the vaccine as a result.
Indeed, a few people noticed and objected to this order:
In the days after ACIP published its preliminary recommendations, barely any epidemiologists or health officials publicly criticized its findings or its reasoning. But thankfully, prominent journalists like Zeynep Tufecki, Matt Yglesias and Nate Silver publicly made the case against them. (So did I.)
You might look at the data in Silver’s tweet, since many people seem to trust him.
Age needs to be a higher priority than pre-existing conditions in vaccine rollout plans. Or a lot of people are going to die, unnecessarily. It really is that sample.
Finally, as the controversy grew, the CDC changed its recommendations, putting (after medical workers) Americans over 74 AND essential frontline workers in the second phase. Mounk sees this as an improvement, but one that could still lead to higher deaths (for example, prioritizing frontline workers over those 65-74 could still lead to overall higher mortality).
Although I’m over 65, I don’t really have a dog in this fight. I will patiently wait my turn to be vaccinated whatever and whenever the state of Illinois decides. But what the CDC was trying to do originally—and may be doing to a lesser extent now—smacks of prioritizing the appearance of equity above the lives of Americans—and that includes black lives. I see no other explanation once you realize that the CDC is supposed to have done the math about overall deaths caused by their different strategies—and then opted for a ranking that would increase the number of dead. We all know the importance of optics (Glenn Loury calls it “ass covering”) over substantive and meaningful progress these days, especially when it comes to alleviating inequalities among groups. To use one example, optics rather than achievement is the basis of land acknowledgments.
In the end, Mounk uses this ranking as an example of why we shouldn’t even trust government institutions like the CDC, which is supposed to be using science to make its decisions. Although ethics has to figure in somewhere, if you can’t trust the CDC’s science, what can you trust? And I agree that there was a misstep in the CDC which only public scrutiny prevented. Mounk is especially exercised by the failure of the press to notice and call out the CDC’s priorities, unlike Nate Silver:
Until a few years ago, it was obvious to me that I can trust what is written in the newspaper or what I am told by public health authorities.
Now, I am losing that trust. I still believe that most people, including the journalists who write for established newspapers and the civil servants who staff federal agencies, are the heroes in their own stories. They genuinely mean well. And yet, I no longer trust any institution in American life to such an extent that I am willing to rely on its account of the world without looking into important matters on my own.
The reasons for this mistrust are perfectly encapsulated in the reports that mainstream newspapers published about the CDC’s recommendation. The write-up in the New York Times, for example, barely mentions the committee’s last-minute change of heart. A faithful reader of the newspaper of record would not even know that an important public body was, until it received massive criticism from the public, about to sacrifice thousands of American lives on the altar of a dangerous and deeply illiberal ideology.
Reader Jim Batterson sent me this 25-minute video with the comment:
I know you prefer to read rather than watch a video, but I wanted to make you aware of a 24-minute YouTube video from Vince Racaniello, a virologist at Columbia University who leads a cast of virology geezers and one younger immunologist in a weekly zoomcast production of “This Week in Virology”. He did this standalone presentation to rant a bit on the way that this latest variant in the UK is being hyped to the world. I think he does a pretty good job for any viewer who has had a biology course in the past five or so years.
The point is that viruses are mutating constantly, and yet none the coronavirus mutations have yielded a new “strain”—that is, a mutant type that has new biological properties. The property touted for the new virus is its purportedly increased “spreadability”, but, as Racaniello notes repeatedly, that simply hasn’t been demonstrated. As he shows, you can get some variants spreading more widely than others simply by accident: the variant may not have any effect on spreadability itself but can increase in frequency as a byproduct of “superspreader events”—the main way the virus spreads—because only a small subset of all viruses get passed to other humans.
Racaniello then shows the changes in the new mutant “strain”, noting that only one of the several mutants in the spike protein is even a candidate for a change in spreadability, but there is not an iota of evidence that any of those mutations actually make the strain more spreadable. Nevertheless, all of us are inundated with media scare stories about this “superspreader virus”.
Racaniello’s point is that though there are epidemiological data showing a correlation between the presence of the mutant in some areas and a greater spread of the virus, that’s just a correlation without evidence of causation. And there could be several causes, including accidents. To show this mutant is a “super virus”, you simply have to do lab experiments; epidemiological correlations show nothing.
Racaniello doesn’t rule out that this mutant spreads faster than its ancestors, but he’s not convinced it is, and doesn’t think that we yet have a reason to be concerned. In fact, he suggests that the changes in the new strain may make it less spreadable. Let me add that Racaniello knows what he’s talking about, as he’s co-author on a well known textbook of virology.
Like all good scientists, Racaniello isn’t declaring that this virus is “neutral” compared to its competitors—he’s simply saying that we don’t have any data suggesting it’s more nefarious. In fact, the same story happened earlier with a different mutant that spread widely, but nothing ever came of that. We need experimental cell-culture data from the lab on viral shedding, and that doesn’t exist.
His final comment:
“We should move on from the scary headlines, and get ahead with vaccination programs, which are underway—and that is going to be the way we get away from this pandemic.”
Anyway, this is a good and clear mini-lecture, and listening to it should calm you down a bit if the media have gotten you worried.
My GP has written another post on vaccines, this time on the new Moderna vaccine, which has just been approved by the FDA. Click on the screenshot to read it, or you’ll likely be satisfied with the conclusions and unanswered questions below, which were remarkably similar to his take on the Pfizer vaccine.
That’s because, except for a difference in storage conditions (the Moderna vaccine requires far less cold than does the Pfizer one), the trials show both are about equally effective (94.1% for Pfizer, 95% for Moderna, which are probably not statistically significant. Both are also mRNA vaccines that inject the code for making part of the virus’s spike protein into the body, where part of the protein is made, activating antiviral antibodies, and then the mRNA is degraded. (See below for an article about how these vaccines work.) There’s a slightly higher incidents of side effects with the Moderna vaccine as well: muscle pain and joint pain after the jabs are about 20% higher for Moderna’s vaccine (an incidence of around 40%) than for Pfizer’s (incidence about 20%). But these aren’t severe side effects.
The Pfizer vaccine was tested on individuals older than 16, while Moderna’s on individuals older than 18, so efficacy in that two-year age range remains an unanswered question for Moderna.
Finally, the two doses of Moderna’s vaccine were spaced 28 days apart rather than Pfizer’s 21, but this may not be important since there seems to be a leeway of a few days. Consult your doctor.
The overall take (these quoted from the post):
The vaccine is highly effective in preventing symptomatic COVID-19 infection.
The vaccine is safe. Adverse reactions, both local and systemic, are mostly minor. Though the study hasn’t yet gone on long enough to prove there are no serious long-term adverse affects, such adverse affects, if they exist, are likely to be rare and non-life-threatening based on other Phase I and II studies of other RNA vaccines.
We recommend everyone who is eligible to receive the vaccine should receive it when it becomes available to them.
It very well may take all of 2021 to get everyone who’s willing to be vaccinated to receive the shots, which means it likely won’t be until early 2022 that life returns to pre-pandemic normal. In the meantime, continue to wear a mask when indoors with anyone you don’t live with, wash your hands frequently, and refrain from dining indoors at restaurants.
And the unanswered questions:
While suggested by the study, still left unproven is whether BNT162b2 prevents severe COVID-19 infection, whether it prevents COVID-19 infection after just one dose, and whether it prevents COVID-19 infection in subjects who’ve already had COVID-19.
The study didn’t look to see if the vaccine prevents asymptomatic infection. Nor did it assess whether subjects who developed COVID-19 despite vaccination are less likely to transmit the virus. Thus, it’s not yet clear how effective the vaccine will be in containing the spread of the infection.
The study hasn’t gone on long enough to tell if subjects who were vaccinated yet still contracted COVID-19 have a lower risk of long-term effects of COVID-19.
We don’t yet know if the vaccine reduces the risk of dying from COVID-19.
There was insufficient data to draw conclusions about safety and efficacy of the vaccine in children younger than 18, pregnant or lactating women, and patients who are immunocompromised.
We don’t yet know how long immunity lasts and whether or not booster shots will be necessary.
As far as which one you should take, I think Alex’s recommendation would be to take whichever one is offered to you. The news last night said that big pharmacies like CVS may well stock both types, in which case you should consult your doctor.
Here’s a new NYT article by Jonathan Corum and Carl Zimmer about how Moderna’s vaccine works (click on the screenshot; I think the article is free for all). It’s a comic-book-like series of graphics which are very good, and I’ve put a summary at the bottom.
You’ll have to click on the screenshot below, perhaps twice, if you want the whole story in one place.
Shoot me now! According to the Vanity Fair article below (click on screenshot) Van Morrison wrote a song, “Stand and Deliver”, clearly meant to denigrate Britain’s public-health restrictions during the coronavirus pandemic. Worse—the song was performed by Eric Clapton (below). Both of these guys were musical heroes of mine, but now I’m not so sure. And I wasn’t aware that this is Morrison’s fourth anti-lockdown song. Well, nobody ever claimed the guy was fully on the rails, but—et tu, Clapton?
You know, a lot of rock stars were loons or nasty s.o.b.s, but so long as they produced good songs, I didn’t much care. But this time they’ve released an odious song!
A few words from the Vanity Fair article:
Eric Clapton and Van Morrison, both age 75 and therefore at 220 times the risk of death from COVID-19 compared to people 18 to 29, have released a blues-rock track raging against public health codes.
“Stand and Deliver,” written by Morrison and sung by Clapton, includes couplets like “Do you wanna be a free man / Or do you wanna be a slave? / Do you wanna wear these chains / Until you’re lying in the grave?”
It continues “Magna Carta, Bill of Rights/The constitution, what’s it worth?/You know they’re gonna grind us down/Until it really hurts/Is this a sovereign nation/Or just a police state?/You better look out, people/Before it gets too late.”
The phrase “stand and deliver” is associated with highwaymen, suggesting that Morrison and Clapton feel that governments scrambling to keep their populations alive are somehow stealing from them. The track concludes with the line “Dick Turpin wore a mask too.” Turpin was an 18th century British criminal known for highway robbery.
In late 2020, music legends Van Morrison and Eric Clapton announced they had collaborated on a new a single, to be released on Dec. 4. They announced the profits were going to Morrison’s Lockdown Financial Hardship Fund, a philanthropic project to support musicians whose livelihoods have been harmed by a series of lockdowns in the U.K., designed to combat the spread of the COVID-19 coronavirus pandemic.
Here’s the song, with the lyrics below. There’s no doubt it’s about opposing pandemic restrictions. If you don’t believe that, read the lyrics—especially the last line. I have to say, though, that this is a pretty crappy song. I doubt you’ll be hearing it on the oldies stations in the future.
Stand and deliver
You let them put the fear on you
Stand and deliver
But not a word you heard was true
But if there’s nothing you can say
There may be nothing you can do
Do you wanna be a free man
Or do you wanna be a slave?
Do you wanna be a free man
Or do you wanna be a slave?
Do you wanna wear these chains
Until you’re lying in the grave?
I don’t wanna be a pauper
And I don’t wanna be a prince
I don’t wanna be a pauper
And I don’t wanna be a prince
I just wanna do my job
Playing the blues for friends
Magna Carta, Bill of Rights
The constitution, what’s it worth?
You know they’re gonna grind us down, ah
Until it really hurts
Is this a sovereign nation
Or just a police state?
You better look out, people
Before it gets too late
You wanna be your own driver
Or keep on flogging a dead horse?
You wanna be your own driver
Or keep on flogging a dead horse?
Do you wanna make it better
Or do you wanna make it worse?
Stand and deliver
You let them put the fear on you
Slow down the river
But not a word of it was true
If there’s nothing you can say
There may be nothing you can do
Stand and deliver
Stand and deliver Dick Turpin wore a mask too