Sunday, May 31, 2020



The World Health Organization Was Against Quarantines Only Last Year

I recommend to you a document written in saner times, and published by the World Health Organization: “Non-pharmaceutical public health measures for mitigating the risk and impact of epidemic and pandemic influenza.” It came out in 2019. I’ve embedded it below.

When the document says influenza, it is referring to any influenza-like infection which is inclusive of COVID-19; that is, any pandemic virus that happens to come along. In the last 100 years, they give examples of four prior to the current virus.

The point of the report is to examine a series of what are called non-pharmaceutical interventions, which can cover the full range of strategies of disease control, from hand washing to surface cleaning to mask wearing to quarantines to travel restrictions. The document contains both good and regrettable material, both of which are covered below. But the standout points for us today are that the World Health Organization only last year solidly recommended against quarantines even if it is only limited to the exposed and sick.

It never even considered the notion of universally locking down an entire population. In that sense, it is an improvement over current practice, and evidence that governments around the world threw out long-standing law and tradition in a disease panic, shattering human relationships and the global economy.

That said, a major problem with the document is its overly formal approach that seeks to model disease severity and government response.

The pandemic influenza severity assessment (PISA) framework was introduced by WHO in 2017. The severity of an influenza epidemic or pandemic is evaluated and monitored through three specific indicators: transmissibility (referring to incidence), seriousness of disease, and impact on health care system and society. The severity is categorized into five levels: no activity or below seasonal threshold, low, moderate, high or extraordinary. The PISA framework is being tested and improved during seasonal influenza epidemics; the aim is to help public health authorities to monitor and assess the severity of influenza, and to inform appropriate decisions and recommendations on interventions.

Almost everything here rests on the ability to discern and model disease severity in real time. The trouble is that we have to make the judgement call in the midst of this pandemic. Dr. Fauci in late February wrote that “the overall clinical consequences of Covid-19 may ultimately be more akin to those of a severe seasonal influenza.” By WHO standards, that would qualify as “moderate.”

A few weeks later, fear of hospital bed shortages and a lack of ventilators caused that assessment to change. In a few short days, we moved from thinking this was a seasonal problem to treating it as the most severe pandemic since 1918, and it’s not really clear why. The more we know about the virus, the more we realize that Fauci’s original assessment was closer to the truth, especially when considering how it targets especially those with very low life expectancy, exactly as John Ioannidis predicted on March 7.

Deciding whether and to what extent non-pharmaceutical interventions might be necessary is easily modelled on paper but far more difficult to assess in real time. Everything is clear looking backwards. We can know what we need to know about managing the pandemics of 1968, 1957, 1948-51 (during which times government did almost nothing and left disease mitigation to the professionals), and 1918, when some governments used powers condemned by medical professionals later.

But planning backwards in time is not what the WHO proposed last year. They expected high-end health professionals to become central planners in real time, in the midst of enormous confusion over data. It’s just not possible to do that. Empowering governments with the responsibility to make such extra decisions over people’s lives and freedom might not be the wisest route to take.

Nonetheless, there is a fairly large gap between what the WHO recommended in 2019 and what governments actually did in 2020.

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Here's a Relief: Corpus Christi Jihad Attack Condemned by...Catholic Bishop

Few Americans even know that there was a jihad attack in Corpus Christi, Texas last week. But Michael Mulvey, the Roman Catholic Bishop of Corpus Christi, is well aware. Last Thursday, a 20-year-old Muslim migrant from Syria named Adam Salim Alsahli, according to CNN, “attempted to rush the security gate with a vehicle.” Then, after “security deployed a barrier to stop the vehicle,” Alsahli “exited the vehicle and opened fire…and naval security forces returned fire.”

Alsahli was “neutralized.” After his attack, officials “identified various social media accounts, which initial reports indicate are likely associated with the shooter….Online postings by these accounts expressed support for ISIS and Al Qaeda in the Arabian Peninsula (AQAP).” But you can relax now: the Roman Catholic Bishop of Corpus Christi has condemned the attack, so all is well.

As far as we know, Mulvey had nothing to do with the attack, but nonetheless, as Catholic News Agency (CNA) reported, he announced Thursday: “I condemned the act of terrorism that was perpetrated this morning at Naval Air Station Corpus Christi. These acts of violence are heinous, but they will not undermine our resolve to work for peace in our hearts, and our society. Our prayer is with the sailor who was injured this morning.” CNA noted that Mulvey “pledged to be a force for peace in the face of evil.”

Well, that’s a relief. You know that concerned citizens all over the country were on the edge of their seats, wondering whether the Catholic Bishop of Corpus Christi was going to applaud or condemn the attack. Now he has come down on the side of the angels, we can all relax and go about our business.

Mulvey’s statement was similar to dozens of condemnations of jihad terror attacks that politicians and other public figures have issued after jihad massacres all over the world in the last few years. It is unclear what moves them to make these statements. Did anyone really think that Michael Mulvey, a Catholic bishop, might be in favor of Adam Alsahli’s jihad attack?

Are there people out there who suspected that Michael Mulvey helped Adam Alsahli buy his gun or otherwise prepare for his jihad, and were such suspicions so persistent that the good bishop felt it necessary to clear the air? Does Michael Mulvey think that his condemnation will stop future jihadis from carrying out their attacks, for fear that the local Roman Catholic bishop will condemn them?

If Michael Mulvey is sane, which presumably he is, then he knows that the answer to all those questions is no, and so there was no reason whatsoever for him to issue his condemnation except to signal his virtue. Mission accomplished.

But the bitter irony here is that no matter how thunderous Mulvey’s condemnation was, and no matter how resoundingly it inspired pangs of conscience in jihadis everywhere, and no matter how hard Mulvey tries to be a “force for peace,” he will find himself unable to persuade jihadis to lay down their arms and stop waging war against unbelievers, because those jihadis consider that war a divine command (cf. Qur’an 9:29).

What’s more, the Roman Catholic Church in general is indefatigably committed to Pope Francis’ ridiculous claim that “authentic Islam and the proper reading of the Koran are opposed to every form of violence.” That is, the Catholic Church is institutionally committed to ignoring and denying the ideological wellsprings that give rise to attacks such as that of Adam Salim Alsahli.

Consequently, no matter how much Mulvey works to be a “force for peace,” he will find himself confronted with jihadis who, in his view, persistently misunderstand their own religion. But he can’t deal with that problem in any realistic manner; to do so would be to deny one of the modern-day Catholic Church’s most cherished newly-minted dogmas, that Islam is a religion of peace.

It is worth noting also that both Adam Alsahli and Mohammed Alshamrani, who attacked another naval air station in Florida in December, were foreign nationals; Alsahli came to the U.S. as a “refugee” and Alshamrani as a foreign student. The Catholic Church strenuously opposes any efforts to reform the programs by which they entered the country.

And so Michael Mulvey might as well go the whole way and have printed a whole pad full of his condemnations of jihad activity, so that all he has to do is fill in blanks for the place and date of the attack. He will find that he will go through such a pad with remarkable speed.

“Leave them; they are blind guides. And if a blind man leads a blind man, both will fall into a pit.” (Matthew 15:14)

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When the personal becomes political

By Scott Sumner

When I was young, the Democratic Party included African Americans, factory workers, nerdy intellectuals, and many other diverse groups. Democrats and Republicans were roughly equally likely to be pro-choice or pro-life. In many ways, that was a healthy state of affairs. Recently, however, we have increasingly sorted into blue and red tribes, in a number of dimensions.

At some point, even seemingly non-political lifestyle issues became political. President Trump recently announced that he was taking the drug hydroxychloroquine as a precautionary step (and then later stopped doing so). A few days ago, he visited a Ford factory and did not wear a mask in the public part of the visit. (Later he did wear a mask when he was off camera.)  President Trump frequently describes himself as a germaphobe.  Thus I suspect that his reluctance to wear masks in public settings has a political dimension.

Inevitably, everything the president does is criticized by some and defended by others. But in this post I’m more interested in the way that lifestyle choices become increasingly seen through a political lens.

Consider the following two lifestyles: One person likes to eat lots of juicy steaks. They get high cholesterol and take a statin to control the problem. Another person likes to eat lots of sushi and kale salads, which they view as a healthy diet. Which person is more likely to vote for Trump?

In the 1950s, the question would have seemed absurd. What does diet preference have to do with political affiliation? Today I suspect that most people would see the steak eater who takes a statin as more likely to vote for Trump.

If I told you I had a somewhat “macho” friend who thought wearing a mask was effeminate, and who strongly believed in the effectiveness of taking hydroxychloroquine, who would you guess that he would vote for?   And is it a healthy state of affairs to be able to predict political affiliation based on lifestyle issues (or scientific judgments) with no obvious connection to politics?  Is it healthy for a country to increasingly sort into red and blue tribes?

I see libertarianism as the ideology that tries to make fewer things political.  Thus I’m not pleased to see us move toward an “everything’s political” world.  It’s not so much that there’s anything wrong with different points of view on wearing masks or taking particular drugs, it’s that I’d prefer those points of view not be linked to unrelated political ideologies.

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‘This virus doesn’t want to kill us’

This is the inside story of how Australian scientists in some ways got the jump on the world.  Australia has had great success in controlling the virus.  Was the early understanding of the virus among Australian scientists part of that?

“This virus doesn’t want to kill us. It has no brain, no will. It just wants to grow and reproduce, to obey the laws of evolution and natural selection.” So says Professor Peter Doherty, a man who knows a thing or two about unpicking a virus. If the virus that causes COVID-19 did have a brain it would probably avoid coming up against the 79-year-old, Brisbane-raised, Nobel prize-winning immunologist who in the mid-1990s unlocked the secret of how our body’s immune system gives viruses a good kicking.

His name has suddenly been thrust into the spotlight again as patron of the research and public health organisation that bears his name, the Peter Doherty Institute for Infection and Immunity. No organisation in Australia has been more prominent in tackling COVID-19, not only in the lab but in shaping government policy through the findings of its public health scenario modellings. “I’d just written my retirement book,” Doherty laughs down the phone from his home in Melbourne, where his age means he’s under strict isolation. “I thought I was fading into the distance and now suddenly I’m back as a talking head.”

There’s a lot to talk about. If we are in an ­enviable position in this war against COVID-19, with the tantalising prospect of life returning to normal seeming closer every day, it’s in part due to the early work of scientists at the Doherty Institute.

It’s easy to forget those early days back in ­January, when bushfires preoccupied the country and no one suspected a mysterious virus in China would within two months result in unimaginable global upheaval. But in the age of globalisation, viruses can move faster than even the news cycle, and so can those who fight them. Within hours of Australia’s first confirmed case of COVID-19 landing on our shores, the Doherty Institute had grown the virus in culture and shared it with the world (the first lab outside China to do so), sequenced the entire genome of the virus, mapped the human body’s immune response to the infection and was supplying the modelling that informed the Federal Government’s response in imposing the lockdown restrictions. Now its ­scientists are collaborating on a vaccine and testing possible treatments. Things have happened so fast that you could almost swear they were waiting for this virus.

Actually, they were. Doherty director Sharon Lewin calls it “peacetime preparations”: all the work that goes on when you’re not in the grip of a pandemic, when you’re not sure what sort of infectious disease will hit next but you know it will and you’d better be ready for it. It was SARS that primed the institute for COVID-19, but its bread-and-butter work is annual outbreaks of influenza, tracking cases in the community and developing new vaccines and treatments. “SARS was very infectious but the difference was people would only spread the virus when they were unwell,” says Lewin, “so you knew who was spreading it because they were sick and usually in hospital. But nothing like this new coronavirus has ever affected us.”

A collaboration between The University of ­Melbourne and Royal Melbourne Hospital, the Doherty Institute was born out of another disaster – the Global Financial Crisis – as a recipient of the Rudd government’s 2009 stimulus splash in the tertiary sector. It was established to deal with the exact sort of crisis we’re in right now.

The first cases of a mysterious pneumonia-like illness emerged from the wet markets of Wuhan, China in late December. It was soon confirmed to be a new type of coronavirus, and on January 7 China revealed to the world its genetic sequence – like sharing a fingerprint from a crime scene. “That’s when people started getting nervous,” says Lewin. “It was different to SARS. It set alarms off around the world.” The impetus for countries outside China was then on designing a diagnostic molecular test (called a PCR assay), so they’d know if the virus washed up on their shores. But Australia was a step ahead. We already had the test.

“The tests were designed in the wake of SARS and MERS, predicting that this would happen again and we’d need a test capable of detecting an unknown coronavirus,” says Mike Catton, director of the Doherty Institute’s Victorian Infectious ­Diseases Reference Laboratory (VIDRL).

Having the virus’s genetic sequence meant ­Catton and his team could quickly tailor their test to the new virus. From January 15 they started testing samples from anyone arriving from Wuhan displaying cold-like symptoms. Catton jokes that if anything urgent is going to happen, it’ll be on the Friday night before a long weekend. On Friday January 24, the lab got a call from Monash Hospital. Another return traveller from China had presented with corona­virus symptoms and a sample from the patient was taken back to the lab for testing. By 2am they had preliminary results, and by 4am had completed the entire genome sequencing, confirming the matter beyond all doubt that the fingerprints matched. COVID-19 was here.

Getting a positive ID was just the beginning. The next step was to try to grow the virus in cell culture. If growing a virus is an art form then Julian Druce is the artist. Druce is the senior scientist at VIDRL’s viral identification laboratory, where he tends to cultures in flasks with the tender touch of the finest orchid grower. Other labs had failed to get it to sprout, but Catton says if anyone in the world could grow it, Druce could. The practice of growing cultures was once de rigueur, but is now almost antiquated since the molecular test revolutionised virology in the late 1980s. While a molecular test will place your suspect at the crime scene, only by having a viable virus strain grown in culture can you fully interrogate the virus and learn its nature and characteristics, allowing you to potentially design antiviral drugs and vaccines.

Over the weekend Druce and Catton watched their virus grow, sometimes in the lab during the day, sometimes in the middle of the night. When unable to sleep, they would periodically open the laptop and hook into a webcam pointed at the flask back at the office. “It was really exciting,” says ­Catton, adding drolly: “if that’s your idea of excitement.” By the time Australians were back at work on the Tuesday, VIDRL had uploaded the genome sequence to an international database and were spreading the virus round the world, but in a good way, with the hope it could still be contained.

Sharing the virus before having it accepted into an academic journal was a bold and unusual move. Researchers will usually keep their discoveries closely guarded until the findings can be published. It’s possible that at least two other labs around the world had grown the virus before the Doherty Institute, but were sitting on it. Julian Druce says they didn’t have time for that. “We wanted to get the genie back in the bottle. It was clear to us here that public health came before publication.”

Collaboration would also come before commercialisation, with the COVID-19 crisis heralding an unprecedented flurry of global scientific ­co-operation through the sharing of information, materials, expertise and facilities. “I think it sent a message to the world about how we should be playing this thing,” says Catton.

Immediately after sharing the virus, VIDRL focused on helping public health labs, diagnosing samples sent in from New Zealand and states without local capacity. Throughout March the focus was on getting Victorian hospitals and ­community pathology labs set up with their own testing programs. Australia now has the highest per capita testing rate in the world.

Having a viable virus in the lab meant that labs around the world could start work designing antiviral drugs to treat patients, test vaccine candidates and begin serology testing to detect antibodies deployed by our immune system to fight the virus.

At the same time as VIDRL was growing the virus, the institute was claiming another world-first. An early patient had her immune response to the virus scrutinised, providing vital information on how the body fights COVID-19. The 47-year-old woman from Wuhan became the first person in Australia to be tested under a platform called ­Sentinel Travellers and Research Preparedness Platform for Emerging Infectious Disease (SETREP-ID). Doherty Institute infectious disease physician Irani Thevarajan helped set up SETREP-ID two years ago, around the time when the world was getting jumpy over new diseases such as ebola and zika. The platform – with pre-approved ethics – allows for testing and research of any travellers returning to the country with an emerging infectious disease. “We set it up knowing that new infections could walk through the door any day,” says Thevarajan. “So we wanted to be able to do immediate detection and research, to gain an understanding of it when it arrived.”

Thevarajan activated SETREP-ID on January 7, back when the world wasn’t even sure if human to human transmission was possible, and calibrated it to recruit data from any return travellers from China. When the woman arrived at hospital in late January and tested positive to COVID-19, a team led by Dr Oanh Nguyen and Dr Katherine Kedzierska immediately started taking blood samples and mapping her immune system response.

“We wanted to know right away what the immune system does when it sees this new coronavirus, because no one knew at that stage,” Thevarajan says. It was mild case of COVID-19 but the study revealed valuable information about the immune response. However, Thevarajan says a vital part of the puzzle is still missing. “What we don’t fully understand is what’s driving the really severe disease. We don’t yet fully understand why most people recover but some don’t.”

Nor do we fully understand what we stand to lose as collateral damage in the battle against COVID-19. On February 3, a collaboration of researchers led by the Doherty Institute convened a workshop with the Office of Health Protection and jurisdictional representatives in Canberra to discuss modelling the impact of COVID-19 on our health system.

Modelling was released to the public on April 7, two months after being provided to the Federal Government, which used it to inform its public health response. It’s this modelling and the delay in releasing it to the public that’s subsequently become the most controversial and debated element of the early initiatives, and the one that may prove to have the most serious long-term consequences. Doherty director of epidemiology Jodie McVernon led the team that built the model. She says at that early meeting the team proposed a “very broad brush set of initial scenarios based on influenza pandemic preparedness assumptions about severity, which was then highly uncertain”.

Back in 2009, McVernon had led a team of modellers responding to the H1N1 influenza ­pandemic that killed half a million people globally. So when COVID-19 came along and a preparedness model was needed in a hurry they brought out the influenza plan as a template, updating data specific for COVID-19 as it came in. “It’s our business to be surprised. That’s what emergencies are about,” says McVernon. “The reason this [modelling] could be done so fast was because the government had invested in preparedness for a very long time. So the toolkit, the thinking and the strategies were ready, but as the data came in it became clear this was beyond the influenza scenarios.”

The modelling, though, came in for criticism for basing its assumptions on overseas data, for not taking into account Australia’s case numbers, ­different demographics, geography and health care system. Australia never saw the widespread virus transmission of places like Italy, Spain and New York. Some say this is because of the strict social distancing measures the government put in place. Others say it’s because Australia never had the effective reproduction number (the number of people infected by each person carrying the virus) that Wuhan did, our population isn’t as elderly as ­Italy’s, our rate of smoking is relatively low, we don’t have high-density slums, and a thousand other differences that mean a one-size-fits-all model was never going to be an accurate representation.

McVernon says they had no choice but to use overseas data, as that’s where the epidemics were occurring. She says they simply didn’t have time to wait. “We’re acutely attuned to the fact we have to contextualise this to our local setting,” she says, “but you have to start with what you have. Yes, there were uncertainties, but the model is there to help you come to a consistent set of decisions. You ask yourself if any of those uncertainties would change your decisions.”

The modelling revealed that an unmitigated COVID-19 epidemic in Australia would have been a disaster, quickly overwhelming the health system. Suddenly “flattening the curve” became a phrase every Australian was familiar with. The curve was soon flattened, but at what cost? We won’t know until later the legacy of shutting down the economy, consigning so many Australians to the unemployment queue, or the other social impacts. One million Australians have become unemployed, and the Federal Government’s economic support packages are costing the country $320 billion.

McVernon admits she’s nervous about the ­collateral damage but stands by the measures. She says it was their job to avert a crisis. “It’s not a stretch to compare COVID-19 with the plague. ­People are saying that public health is being allowed to run the ­government. Well, I think there was definitely a need for public health to lead the charge to avert a catastrophe. That was our single task.”

The world waits for a vaccine. Doherty Institute virologist Dr Damian Purcell says more than 100 vaccine concepts are being worked on. “It doesn’t take a lot of time to produce a vaccine candidate,” he says, “what really takes time is the testing.” The institute’s collaboration with the University of Queensland to design a vaccine is one of those 100. Purcell says UQ started the work on ­January 20 and it’s now being tested on ferrets in the Netherlands prior to human trials. Elsewhere overseas, other vaccine candidates are already at the human trial stage.

In-house, the institute is working on its own vaccine candidates, thanks to a $3.2 million donation from the Jack Ma Foundation. Meanwhile, two ­international groups, one from Britain’s Oxford University and another from US group Inovio, are testing vaccine ­candidates at the CSIRO in Geelong. CSIRO has partnered with the Coalition for Epidemic Preparedness Innovations (CEPI), part of a global alliance aiming to speed up the development of vaccines, and in April was given $220 million by the Federal Government to upgrade its biosecurity research facilities and help expedite the quest for a vaccine.

Purcell says international collaboration and funding are the keys to unlocking a vaccine. “Funding is the thing that fires up the rocket sled. But things are highly accelerated now because people are sharing information in real time. A lot of the problems with vaccine development is it’s so expensive to manufacture at a high grade and going through the larger scale testing, so we’re speeding up the process of the early phase testing. As soon as things look remotely good and we get the safety signals, we pull the trigger and manufacture.”

If it sounds simple, don’t kid yourself. Developing a vaccine is one thing, but working out how to safely mass produce what is a very complex biological product for the consumption of millions, to fight a virus we still don’t know a lot about, and doing it by yesterday, requires navigating seemingly insurmountable problems. Purcell believes we will get a vaccine, but he’s just not sure if it will be the elixir the world is expecting. “It may be difficult to achieve effective vaccination of the elderly, we just don’t know. Therapeutic antibodies or anti-­viral drugs may turn out to be more important. That’s why we need to advance all fronts.”

Other fronts include a trial led by the institute involving 2500 people in more than 80 hospitals in Australia and New Zealand (called the ASCOT trial) to assess the effectiveness of two antiviral drugs, lopinavir/ritonavir (used to treat HIV) and hydroxy­chloroquine, the antimalarial drug touted by ­Donald Trump and Clive Palmer.

It’s also partnering with Monash University on a study of the anti-parasitic drug Ivermectin. Early experiments done at the Doherty Institute days after the virus was identified in Australia showed that Ivermectin killed SARS-CoV-2, the virus that causes COVID-19, within 48 hours in cell culture. Dr Kylie Wagstaff from Monash Biomedical Discovery Institute says anecdotal evidence is good, but getting the dosing right is the key before human trials in Australia can start.

Peter Doherty, who still has a key research advisory role with the institute, remains relaxed and grounded, an endearing everyman infected with an incurable case of humility. On April 27 he tweeted what was meant to be a Google search: “Dan Murphy opening hours.” Even strict isolation comes with occasional caveats. Rather than delete the tweet, he let it stay and gather likes and laughs. “Only flawed humans can be loved,” he later tweeted. “And I certainly qualify.”

The real work is more sobering. Doherty says the worst virus he’s ever seen is smallpox. It killed about 300 million people in the 20th century, about 30 per cent of those it infected. Ironically, it’s also the only human infectious disease ever to be eradicated, the last case occurring in 1978. “We’re probably not going to eradicate COVID-19,” says Doherty. “So whatever people think of what’s being done, we need to build up the armamentarium against this thing. It’s lethal.”

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Political correctness is most pervasive in universities and colleges but I rarely report the  incidents concerned here as I have a separate blog for educational matters.

American "liberals" often deny being Leftists and say that they are very different from the Communist rulers of  other countries.  The only real difference, however, is how much power they have.  In America, their power is limited by democracy.  To see what they WOULD be like with more power, look at where they ARE already  very powerful: in America's educational system -- particularly in the universities and colleges.  They show there the same respect for free-speech and political diversity that Stalin did:  None.  So look to the colleges to see  what the whole country would be like if "liberals" had their way.  It would be a dictatorship.

For more postings from me, see TONGUE-TIED, GREENIE WATCH,   EDUCATION WATCH INTERNATIONAL, AUSTRALIAN POLITICS and  DISSECTING LEFTISM.   My Home Pages are here or   here or   here.  Email me (John Ray) here.  Email me (John Ray) here
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