Sunday, December 19, 2021
We cannot stop the spread of COVID, but we CAN end the pandemic: Protect the old and vulnerable, forget lockdowns - and learn to live with the virus
By Jay Bhattacharya, MD, PhD a professor at the Stanford University School of Medicine. This is about what I have been saying all along
The arrival of the omicron variant has led some politicians and public health grandees to call for a return to business closures and 'circuit-breaker' lockdowns.
The variant has been found worldwide, including in the US and the UK. The variant has already surpassed delta – dominant before omicron – in the UK.
Early reports from South Africa confirm that the variant is more transmissible but produces a milder disease, with a lower chance of hospitalization and death upon infection.
My message is this: we can’t stop the spread of COVID, but we can end the pandemic.
In October 2020, I wrote the Great Barrington Declaration (GBD) along with Prof. Sunetra Gupta of Oxford University and Prof. Martin Kulldorff of Harvard University.
The centerpiece of the declaration is a call for increased focused protection of the vulnerable older population, who are more than a thousand times more likely to die from COVID infection than the young.
We can protect the vulnerable without harming the rest of the population.
As I stated above, we do not have any technology that can stop viral spread. While excellent vaccines protect the vaccinated versus hospitalization or death if infected, they provide only temporary and marginal protection from infection and disease transmission.
The same is likely true for booster shots, which use the same technology as the initial doses.
What about lockdowns? It is now abundantly clear that they have failed to contain the virus while wreaking enormous collateral damage worldwide.
The simplistic allure of lockdowns is that we can break the chain of viral transmission by staying apart.
Only the laptop class -- those who can just as easily work from home as in the office -- can abide by a lockdown in actual practice, and even they have trouble.
Essential workers who keep society going cannot afford the luxury, so the disease will keep spreading.
Will the same policies that failed against a more virulent strain succeed in containing a more transmissible strain? The answer is self-evidently no.
The harms of lockdown on children and the non-elderly are catastrophic, including worse physical and mental health and irretrievably lost life opportunities.
Lockdowns imposed in rich countries mean starvation, poverty, and death for the residents of poor countries.
There is, however, a good alternative to lockdown. The Great Barrington Declaration (GBD) calls for a return to normal life for low-risk children and non-elderly adults.
The principles at the heart of the GBD are as important today as they were a year ago. In fact, they are more important now because we now have technological tools that make focused protection of the vulnerable much more straightforward than it was a year ago.
First and most importantly, the vaccine.
Because unvaccinated older people face such a high risk for a poor outcome on infection, and because the vaccine is so effective at blunting severe disease and death, vaccinating older people is the top priority if life-saving is to be the top priority.
But to preserve doses, they should be reserved for those who have not previously had COVID and were vaccinated more than 6 to 8 months ago.
According to a careful study conducted by Swedish scientists, vaccine efficacy versus severe disease also starts to wane around that point, so boosting before then does not provide a substantial benefit.
Second, we should make available effective early treatment options.
During Florida’s summer wave, Gov. Ron DeSantis promoted the use of monoclonal antibodies – an FDA-approved treatment – by patients early in the course of the disease, an action that saved many lives.
Safe and inexpensive supplements like Vitamin D have been shown effective. Promising new treatments from Pfizer and a new antibody treatment for the immunocompromised by Astra Zeneca promise to become more widely available. Until that happens, they should be preserved for use by the most vulnerable when sick.
Third, the widespread availability of inexpensive, privately conducted, rapid antigen tests in the UK has empowered everyone to make wise choices that reduce the risk of infecting vulnerable people. So far, the FDA says that these tests work to detect omicron.
Even if you have no COVID-like symptoms, these tests accurately read whether you harbor the virus and pose a risk of spreading it to close contacts. With this test in hand, anyone can check if it is safe to visit grandma before heading over to her care home. It is a perfect tool for focused protection of the vulnerable. US COVID policy should focus on making these tests cheaper and more widely available, as they are in the UK.
Finally, since the virus very often spreads via aerosolization events, upgrades to ventilation systems in public spaces will reduce the risk of older people participating in everyday social life outside the home.
It is no accident that COVID disease spread is so rare on airplanes since they are all outfitted with excellent air filtration systems. Upgrading other public facilities, such as other public transportation systems, would reduce the risk of infection for the vulnerable.
There are some hopeful signs that the political and ideological winds are shifting, while other developments signal a return to failed strategies.
Colorado's Democrat Governor Jared Polis recently declared that the widespread availability of vaccines spells ‘the end of the medical emergency,’ and he is resisting calls to impose new statewide mask mandates.
Yet on the coasts, in California and New York, elected officials are renewing mask requirements for all – regardless of health or vaccination status.
The end of the pandemic is primarily a social and political decision.
Since we have no technology to eradicate the virus, we must learn to live with it. The fear-based lockdown policies of the past two years are no template for a healthy society.
The good news is that with the new and effective technologies available and the focused protection ideas outlined in the GBD, we can end the pandemic if only we can muster the courage and political will to do so.
In Sweden and many US states that have eschewed lockdowns, the pandemic is effectively over, even as the virus continues to circulate.
As normal society resumes, the vast majority will find that living with the virus is not so hard after all.
**************************************************
Many omicron cases at Cornell in fully vaccinated: official
Cornell University is seeing an uptick in coronavirus cases and has detected the “highly contagious” omicron variant on campus, particularly in fully vaccinated individuals, according to campus officials.
Between Dec. 7 and 13, the Ivy League school in Ithaca, New York, reported 883 students testing positive for COVID-19, its online dashboard shows.
“Virtually every case of the Omicron variant to date has been found in fully vaccinated students, a portion of whom had also received a booster shot,” Joel M. Malina, the school’s vice president for university relations, said in a statement provided to McClatchy News.
On Dec. 13, Cornell’s COVID-19 testing lab found “evidence of the highly contagious Omicron variant in a significant number of Monday’s positive student samples,” university President Martha E. Pollack said in a letter to the campus community.
Out of the students infected with COVID-19, the school has “not seen severe illness” as of Dec. 14, Pollack assured.
The on-campus population of Cornell is 97% fully vaccinated, according to its virus data tracker that has recorded 26,008 students and 13,311 faculty and staff members who are fully vaccinated.
Pollack noted that the evidence of omicron, first identified by South African researchers on Nov. 24, is “preliminary.”
“PCR testing has identified its hallmark (the so-called S-gene dropout) in a substantial number of virus samples,” Pollack said. “While we must await confirmatory sequencing information to be sure that the source is Omicron, we are proceeding as if it is.”
*******************************************************
Omicron easier on the lungs, British study suggests
Omicron may be less efficient at replicating in the lungs than previous COVID variants, British laboratory research has suggested.
A study conducted by scientists at the Cambridge Institute of Therapeutic Immunology and Infectious Disease found that mutations on the virus’s spike protein, which make it able to evade antibodies, may also reduce its ability to attack the lungs and cause severe disease.
“We demonstrate significantly lower infectivity of lung organoids and Calu-3 lung cells,” says the Cambridge preprint, which was posted late on Friday night.
“These observations highlight that Omicron has gained immune evasion properties whilst compromising on properties associated with replication and pathogenicity [harm].”
The study was led by Ravi Gupta, professor of clinical microbiology at the University of Cambridge and a contributor to Scientific Advisory Group for Emergencies.
“The Omicron spike protein induces relatively poor [lung] cell-cell fusion compared to Wuhan and Delta,” said Gupta, announcing the findings on Twitter. “The difference is significant.”
Gupta said the findings could point to Omicron causing less severe disease but said more work was needed.
“In summary this work suggests that Omicron does appear to have become more immune evasive, but that properties associated with disease progression may be attenuated [weakened] to some extent,” he said. “The significant growth of Omicron nevertheless represents a major public health challenge”.
Scientists are rushing to understand if Omicron is more severe in unvaccinated people than previous variants. The signals are mixed.
Early data on hospital admissions and deaths from South Africa suggest that Omicron is so far doing significantly less damage there than previous waves. A hospital group reported last week that 29 per cent fewer adults were being admitted to hospital than in the Delta wave, and far fewer of those required intensive care.
On the other hand, there was a 20 per cent jump in the number of children being hospitalised, and a double dose of Pfizer vaccine was shown to be just 70 per cent effective at preventing hospital admissions, falling further in the old.
Professor Chris Whitty, the Chief Medical Officer for England, warned against “overinterpretation” of the South African data last week, noting its population was much younger and with more prior exposure to COVID than our own.
“The amount of immunity for this wave because of prior Delta wave and vaccination is far higher than it was for their last wave and, therefore the fact they have a lower hospitalisation rate this time is unsurprising.”
*********************************************
Also see my other blogs. Main ones below:
http://edwatch.blogspot.com (EDUCATION WATCH)
http://antigreen.blogspot.com (GREENIE WATCH)
http://pcwatch.blogspot.com (POLITICAL CORRECTNESS WATCH)
http://australian-politics.blogspot.com/ (AUSTRALIAN POLITICS)
http://snorphty.blogspot.com/ (TONGUE-TIED)
*************************************
Subscribe to:
Post Comments (Atom)
No comments:
Post a Comment