Some merry happy seasons greetings

 

... Merry Xmas!!!

...... Seasons Greetings!!!

......... Happy New Year!!!

We wished everyone a Happy New Year two years ago 

    and look what happened in 2020 #!@!#

We wished everyone a Happy New Year last year 

    and look what happened in 2021 #!@!#

Although everyone knows that the third time is the charm, 

   we're hedging our bets this year. 

         So here's to wishing that you won't have to learn more than 

         two new letters in the Greek alphabet in 2022 ... :-)

An Omicron paradox -- UPDATED

Last update: Monday 1/3/22

A recent op ed in the NY Times suggested that given Omicron's rapid conquest of the United Kingdom, a highly vaccinated country, it was better to make pandemic management policies based on surges in hospitalizations, rather than surges in infections. The ultimate objective has always been to keep hospitals (and other treatment facilities) from being overloaded. 

Please remind me again: Why are we vaccinating? Why are we boosting?

Last update: Friday 12/10/21 

Throughout 2020 everyone agreed that the purpose of vaccines was to protect people from severe illness and death. Our scientists developed highly effective vaccines in record time, "highly effective" as in: our vaccines reduced the likelihood of becoming severely ill or of dying by 95 percent compared to the severe illness and deaths suffered by unvaccinated persons. Things became a bit confused by mid-2021 with the sudden emergence of Delta as the dominant variant because Delta produced a substantial number of breakthrough cases, i.e., infections of vaccinated persons, even among persons who had been vaccinated within the previous three months.

President Biden's new winter Covid agenda ==> Vaccinations + rapid self-tests

Last update: Saturday 12/4/21

A few days ago President Biden announced a new nine point agenda for fighting Covid. Yes he's still pushing full vaccinations and boosters, but his new agenda's big news is rapid home tests. This good news is long overdue. Yes, everyone should be vaccinated, but breakthrough cases, i.e., infections of vaccinated persons, have been occurring with increasing frequency.  Without widely available, affordable rapid self tests, previous recommendations for "safe" gatherings of families and friends on holidays, other celebrations, and workplace meetings have been fraught with substantial unacknowledged risks. 

Omicron, Omega, and de facto Covid-Zero

Last update: 11/30/21

We are now at a most unwelcome inflection point. If Omicron is "merely" far more transmissible, but not more deadly than Delta, we just have to continue our vaccination efforts and apply well known mitigation procedures for a while longer. But if Omicron evades our vaccines, we should rename it "Omega", the last letter in the Greek alphabet, as acknowledgement that we are at the end of one pandemic, and at the beginning of a new one that will require new vaccines for everyone plus a return to extensive reliance on quarantines and lockdowns until the new vaccines are developed and widely distributed.

Tis the season for jolly folly

Last update: Saturday 11/27/21

Dr. Fauci has often complained about being misquoted. Well, the sad fact is that Dr. Fauci and too many other prominent public health officials are eminently "misquotable". The sudden emergence of the Omicron variant will greatly exacerbate this problem as our public health experts are pressed once again to address questions for which science has not yet determined reliable answers, thereby providing countless opportunities for new misunderstandings.

Living with Delta on campus from August 2021 to November 2021

Last update: Tuesday 12/28/21

During the first half of 2021, the U.S. focused on vaccinating its residents; but its focus shifted to living with the virus in the months that followed. Other countries have also refocused. Unfortunately, efforts to refocus have been impeded by large unvaccinated segments of the populations and by the emergence of substantial breakthrough infections. Although breakthroughs have been overwhelmingly mild or asymptomatic, they contribute to the continuing presence of the virus by thwarting the achievement of herd immunity.

Vaccinating our young children will not accelerate our return to normal living

Last update: Sunday 11/7/21

Throughout the pandemic our de facto goal has been the suppression of the spread of the virus so that our health care facilities would not be overwhelmed. In 2020, we employed various mitigation techniques, mainly face masks and various forms of distancing, e.g., social distancing (6 feet), isolation, quarantine, and lockdowns. 

From one pandemic to two overlapping endemics

 Last update: Wednesday 3/10/22

It now appears that our pandemic might end in two overlapping endemics: The first will be an endemic among the unvaccinated members of our society. Its worst consequences will be surges in hospitalizations and deaths, but not as large as the surges that occurred during the pandemic. This endemic will be the stuff of headlines in all media.

Let's stop repeating COVID myths

Last update: Monday 11/1/21

Unfortunately, valid assertions about the original coronavirus variant that was dominant throughout 2020 are being repeated by the media with regards to the Delta variant in late 2021. Those old "facts" are now myths, remnants of a bygone age. One obsolete "fact" stands head and shoulders above the rest -- the assertion that by vaccinating a large enough percentage of the population, e.g., 80 or 90 percent, we will achieve herd immunity and the pandemic will end shortly thereafter. The media pundits seem to understand that Delta is far more contagious than its predecessors. But many of the pundit doctors on television fail to grasp the strategic implications of the fact that Delta also produces far more so-called "breakthrough" cases than previous variants.  These highly contagious breakthroughs will make herd immunity impossible to achieve.

Acceptable costs of living with the virus

 Last update: Sunday 10/24/21

The Covid-19 page on this blog characterizes the final phases of the pandemic as "Delta vs. mandates and vaccines" -- thereby warning readers that most of the reports linked to the page will discuss the Delta variant and our most powerful tools for addressing it. Unfortunately, this succinct phrasing provides no indications of the massive tectonic shifts in the underlying paradigms that govern our efforts to manage the pandemic.

A tribute to the parents of unvaccinated children, the unsung heroes of the pandemic

 Last update: Thursday 10/14/21

Sir Francis Bacon once wrote, "He who hath children hath given hostages to fortune." His bygone aphorism acquired new bite during the COVID pandemic 

‘Go out there and enjoy Halloween,’ Dr. Fauci says ... Oh, really???

Last update: Sunday 10/10/21

“This is a time that children love,” Dr. Fauci said according to the NY Times. "It’s a very important part of the year for children.” Yes, kids love Halloween, even kids who live in apartment buildings love Halloween, kids who knock on every apartment door, indoors not outdoors, crying "Trick or Treat!" ... kids who live in urban neighborhoods where every "house" is an apartment building, knocking on every door until someone opens the door ... not wearing a mask ... breathing on the kids in the hallway outside their apartment ... where aerosols float freely throughout the night ... Happy Halloween!!!  ... One piece of advice for every child in every kind of neighborhood -- suburban, rural and, oh yes, urban -- because, as per so many previous guidelines from the nation's pandemic pundits, one size fits all, right??? ... Now that's scary, really scary... :-(

Another reason why some Black Americans may have been vaccine hesitant

 Last update: Monday 10/4/21

During the first few months of 2021, coronavirus vaccination rates among Black Americans were substantially lower than the rates for White and Asian Americans. One reason often cited for this hesitancy was Black awareness of the CDC's unethical Tuskegee syphilis experiment, an awareness that might make some Black Americans more distrustful of new medications endorsed by the CDC. Another oft cited reason was the inadequate access of many Black Americans to adequate health care. Lack of access would provide fewer opportunities to learn about the safety of the coronavirus vaccines. This note suggests one more reason why even the best informed, best educated Black Americans might be hesitant. 

Policy junk -- Old COVID policies overcome by new data

Last update: Thursday 9/30/21

A previous note on this blog referred to the "fog of war" to describe the conundrum faced by pandemic managers who must make important judgement calls based on unreliable data. Another martial insight also has unfortunate relevance for our mishandling of the COVID pandemic: 
"fighting the last war". Significant new variants have become new enemies with new advantages. But at times, our pandemic managers have continued to press old policies even when data about the new variant has signaled the start of a new kind of war that must be waged with new policies. This note considers two examples. In 20-20 hindsight one was understandable;  the other was an unforced error. 

FDA vs CDC vs "the science" vs. wisdom

Last update: Friday 9/24/21

The advisory panel of experts for the CDC recently recommended booster shots, but their recommendations contained substantial differences from the recommendations submitted by the advisory panel of experts for the FDA a few days before. There was also considerable disagreement among the experts on each panel. Fortunately, Dr. Rochelle Walensky, Director of the CDC, immediately modified the recommendations of the CDC panel so as to bring them into substantial agreement with the FDA recommendations. She made the modifications in order to avoid paralyzing confusion among potential booster recipients and booster administrators, e.g., hospitals, pharmacies, and other health care providers -- as to who was or was not qualified to receive the shots.

Massachusetts provides a glimpse of the endemic ending of our pandemic

Last update: Tuesday 9/21/21

As per the opening words of the previous note on this blog, we should expect that our pandemic will fade into a "forever" endemic wherein the number of new infections will remain more or less the same from one month to the next for some indefinite future time frame. Most people still believe that the Delta variant only survives because vaccine holdouts are infecting each other; they believe this because they also believe that there aren't enough Delta breakthrough cases to sustain the virus; and they believe this because data that could be used to estimate the percentage of new infections involving breakthroughs has not been available for most states. However, Massachusetts has been publishing this kind of data on a Webpage since 8/24/21 (perhaps earlier).

Protecting ourselves as our 18 month pandemic fades into a "forever" endemic

Last update: Friday 9/17/21

If we assume that there will be no more Delta surprises, i.e., variants that profoundly disrupt our vaccination and mitigation efforts ... a very big "if" ... then we should expect that our pandemic will fade into an endless endemic wherein the number of new infections will remain more or less the same from one month to the next for some indefinite future time frame. The endemic will be self-sustaining, like seasonal flu; it won't require boosts from travelers returning from countries having higher rates of infection. New infections will occur (1) among the unvaccinated holdouts and (2) as breakthrough infections among the vaccinated.

Tracking Delta breakthroughs ... Part 4 (Mitigation via testing and contact tracing)

Last update: Sunday 9/5/21

Why don't we know how many Delta  breakthrough infections occurred last month and where? Why don't we know which population segments are most likely to be infected by Delta, even if they have been fully vaccinated? Are cloth masks as effective in suppressing the spread of Delta as they were in suppressing previous variants?  Are breakthroughs more likely because (a) Delta is more transmissible, (b) vaccine effectiveness weakens after six to eight months, (c) encouraged by the CDC in May 2021, many people abandoned their mitigation habits just as Delta was becoming the dominant variant, or (d) some combination of (a), (b), and (c)? 

Tracking Delta breakthroughs -- Part 3 (Mitigation via distancing)

Last update: Monday 9/6/21

This is the third in a series of notes on this blog that briefly summarize what every health conscious U.S. resident should know about the Delta variant.  Part 1 discussed Delta's most disruptive properties. Part 2 discussed masks. This third part discusses distancing, the most effective way that individuals can help to mitigate the spread of Delta to those who have not been vaccinated yet and to those who need a booster shot to achieve full immunity. 

Tracking Delta breakthroughs -- Part 2 (Mitigation via masks)

 Last update: Friday 8/27/21

This is the second in a series of notes on this blog that briefly summarize what every health conscious U.S. resident should know about the Delta variant. Part 1 discussed Delta's most disruptive properties. This second part focuses on the most visible way that vaccinated persons can help to mitigate the spread of Delta to those who have not been vaccinated yet and to those who need a booster shot to achieve full immunity. 

Tracking Delta breakthroughs -- Part 1 (Three disruptive properties)

Last update: Sunday 8/22/21

This is the first in a series of notes that will briefly summarize what every health conscious U.S. resident should know about the Delta variant. It focuses on three properties of Delta that are disrupting the efforts of the U.S. and other nations to employ highly effective vaccines to manage the pandemic in ways that minimize severe illness and death: (1) Delta is far more transmissible than previous variants of the virus, (2) Delta can infect people who have been vaccinated, and (3) These "breakthrough" cases are highly contagious.
 

Undetected breakthroughs spreading Delta everywhere

Last update: Saturday 8/17/21

In March 2020, Dr. Deborah Birx, the response coordinator for President Trump's coronavirus task force, vehemently opposed the suggestion that people who were not healthcare professionals wear cloth masks. Her opposition was based on two judgement calls: first, cloth masks provided no protection against the coronavirus for their wearers; and second, cloth masks might give their wearers a false sense of protection that might cause them to neglect more powerful mitigations, like social distancing. Her pessimistic judgements were soon cast aside; nevertheless in mid-2021 her judgements may prove to be accurate predictions as a result of the most recent flip-flop in CDC guidance. 

Delta breakthroughs cancel herd immunity

 Last update: Thursday 8/12/21

Hotspots are everywhere. At this point every highly vaccinated state, county, city, town, or neighborhood contains hotspots, i.e., smaller communities in which the percentage of people who are not vaccinated is much higher than the percentage within the highly vaccinated surrounding area. Indeed, if you are not vaccinated and you somehow find yourself in a highly vaccinated area for work, dining, or entertainment, you are a hotspot.

Is the CDC misguiding us again, this time with regards to Delta breakthrough infections???

Last update: Friday 8/13/21

The CDC's Interim Public Health Recommendations for Fully Vaccinated People (7/28/21) declares that "Infections happen in only a small proportion of people who are fully vaccinated, even with the Delta variant." Let's ask ourselves the crucial question: how would the CDC know that the proportion of Delta breakthrough cases is small? 

Downgrading the CDC's guidance

 Last Update: Saturday 7/25/21

The CDC continues to exacerbate confusion in the final phases of the pandemic. For example, in March 2021, two months into the Biden administration's intensive campaign to administer one to three million vaccine doses every day, the director of the CDC, a Biden appointee, proclaimed that she feared that our nation faced "impending doom" ... whereas common sense anticipated a decline in infections and a precipitous drop in COVID-related deaths given that rigorous double blind clinical trials had shown the Moderna and Pfizer vaccines were 95 percent effective in preventing infections and almost 100 percent effective in preventing deaths

Is the Delta variant making masks less effective, but more significant?

 Last update: Saturday 7/17/21

Wearing masks reduces the spread of the coronavirus through unvaccinated communities, but by how much? Rigorous clinical trials showed that the Moderna and Pfizer vaccines were 95% effective. Unfortunately there are no reliable estimates of the effectiveness of masks. So why do sensible people wear masks? Common sense suggests two reasons: (1) our prior personal experience with colds and the flu, and (2) our desire to use our masks to provide visible reminders to others that COVID is still a threat in some local communities. The highly contagious Delta virus (and more lethal variants yet to come) may render our prior experience less relevant, but will underscore the value of our masks as reminders.

The pandemic is almost over according to our major media, but for whom?

Last update: Sunday 7/18/21

The coverage of the pandemic by major media is down to a small fraction of what it was just a few months ago, this being their not too subtle declaration that the pandemic is almost over so they have more important news to cover. Yes, it's almost over for most of us, but by no means all of us. The percentage of the U.S. adult population that was received at least one dose of vaccine was about 68% on 7/16/21 according to the CDC, leaving about one third of our population unvaccinated.

A tale of two Fauci's -- Part 3 (Explanation)

 Last update: Sunday 7/11/21

Editor's caveat -- Readers are strongly advised to read Part 1 and Part 2 of this trio of notes before reading Part 3.

This final leg of the triad provides a logical explanation for why "Dr. Fauci" repeatedly claimed that some of the most important task force/CDC guidelines were based on science, rather than admit that they were judgement calls made in the fog of our war against the coronavirus.

A tale of two Fauci's -- Part 2 ("Dr. Fauci")

Last update: Tuesday 7/6/21 

Editor's caveat -- Readers are strongly advised to read Part 1 of this pair of notes before reading the following Part 2.

Spoiler alert -- Part 2 will reveal that "Dr. Fauci" is really Dr. Fauci.

A tale of two Fauci's -- Part 1 (Dr. Fauci)

Last update: Saturday 6/26/21

It was the best of times. It was the worst of times. The year 2020 witnessed the most deadly pandemic in over 100 years. This note discusses two doctors named "Fauci" at the center of this tragedy, one a hero to all; the other a villain to many. 

National COVID statistics can frame dangerous national goals

 Last update: Wednesday 6/23/21

Editor's comment: Previous notes on this blog highlighted crucial flaws in President Trump's pandemic management. Unfortunately, some of these flaws now enjoy new life under President Biden. Case in point: the president's vaccination goal that at least 70 percent of the U.S. adult population become vaccinated by July 4th.

An open letter to President Biden regarding the critical need to reorganize the CDC immediately

Last update: Thursday 6/17/21 

Dear President Biden,

On Sunday 3/21/21 you tweeted the following words of high praise for the CDC:  "The CDC represents the best of this nation. Brilliant minds. Deep faith in science. And a strong commitment to public service. On Friday, Vice President Harris and I stopped by to thank them for all the work they do."

A rough estimate of future COVID deaths now that herd immunity is unlikely

Last update: Monday 5/10/21

Apoorva Mandavilli, a highly respected NY Times reporter focused on the coronavirus, recently published an article that was derived from her interviews with prominent epidemic experts. She reported that a consensus among these experts has quietly emerged  that achieving herd immunity is no longer a realistic goal for the U.S.  

(Please read "Reaching ‘Herd Immunity’ Is Unlikely in the U.S., Experts Now Believe", Apoorva Mandavilli, NY Times, 5/3/21 ...  or listen to a podcast of Mandovilli discussing her article and why she wrote it, The Daily, 5/7/21)

Ending the coronavirus pandemic when it becomes a "flu"

Last update: Friday 3/5/21

Who is going to ring the bell that signals the official end of the coronavirus pandemic? President Biden? His medical policy advisers? U.S. governors? Since March 2020 the U.S. has been engaged in a total war against the coronavirus, but lately no one has been saying what victory will look like. 

Winning a Pyrrhic victory by mismanaging our total war against the coronavirus

Last update: Monday 3/1/21

Wars are won by generalists, not specialists; the highest ranking warriors are usually called "generals". This is true for all wars, but it is especially true for total wars wherein large segments of the population are at risk. Generals have to understand the "big picture".

The coming uneven, messy, confusing end of the COVID pandemic

Last Update: Saturday 2/27/21

Today's media are abuzz with talk about the light at the end of the long pandemic tunnel, a sighting enabled by the widespread distribution of multiple vaccines. Unfortunately, our exit from the pandemic will probably be as uneven, messy, and confusing as our entry. Why? Because our current roster of medical policy advisers are misapplying the same national framework that caused their predecessors under President Trump to call for a national lockdown in March 2020 when there were fewer than 20 thousand known cases in the entire country, and those cases were located in just a few states.

Winning and losing pandemic wars

Last update: Wednesday 2/24/21

 

There seems to be widespread agreement that the primary goal of our total war against the coronavirus is to save as many lives as possible. This is not surprising given the fact that we have allowed health care experts, i.e., doctors and other medical specialists, to oversee our war efforts. 

"COVID-shaming" -- As odious and as ineffective as "fat-shaming"

Last update: Friday 2/19/21

Editor's note: Regular readers of this blog know that as a retired college professor, I have been continuously disappointed by the persistent tendency of the members of the president's task force, first Trump's and now Biden's, to attempt to get more people to adhere to the social mitigation guidelines or, more recently, to get more people to get vaccinated by "shaming" them. As per the title of this blog note, shaming is an odious and ineffective practice that doesn't belong in the school yards, where most of us first encountered it, in sports, in doctor's offices, nor in task force briefings. 

N95 masks for everyone!!! ...Groundhog Day mutations

 Last update: Friday 1/29/21

President Biden has issued an executive order that requires that everyone wear masks on federal properties and that everyone wear masks during interstate travel. In October 2020, as candidate Biden, he said that if elected he would mandate that all Americans wear mask during the first100 days of his administration. Although his limited executive order is more feasible politically, there is still cause for concern that he may be setting his new administration up for what might be misperceived as an early "failure".

Our war against COVID-19, 2020-2021

 Last update: Monday 1/11/21

Thus far, the U.S. war against the coronavirus has been conducted in two phases. Phase 1 began in early February 2020 and ended in early December 2020. We entered Phase 2 in mid-December 2020 with the approval of two vaccines and with the emergence of significant COVID-19 mutations that were far more infectious than previous versions.

Will we return to normal in 2021?

Last update: Wednesday 1/6/21

There's one thing about which Republicans and Democrats are in unanimous agreement ==> 2020 was a nightmare, so 2021 will bring a welcome return to normal living, right? Well, maybe. It all depends on the answers to a few questions, some of which are not known at this time.