The Los Angeles Times has their annual Festival of Books. This year, of course, the discussion panels are being held online. That's my favorite part of the book festival. This was the final panel discussion I watched. This panel discussion was called, "Science & Medicine: Looking at the Coronavirus and Pandemics." Per YouTube, here's the introduction to the discussion:
Here we are – more than half a year into the corornavirus pandemic, and what do we know, what went wrong, and how can we do better? Let’s hear from the experts: science journalist Debora MacKenzie, prize-winning author/journalist Sonia Shah, and sociologist, physician, and author Nicholas Christakis. L.A. Times health-care reporter Soumya Karlamangla will guide the conversation tracking the history of pandemics, how migrations spread disease, and how coronavirus will change the way we live.
The following are my notes from the panel discussion:
Debora MacKenzie - Prize Winning Science Journalist and Author
Coronavirus should never have happened. It was predicted by scientists. Labs were working on this and knew it posed a risk for a pandemic. We didn't continue vaccine research after SARS. All preparation was on a flu pandemic, not a coronavirus. We had rules in place to tell people, but the information didn't get out. People didn't believe something like this could happen.
SARS was really virulent with a CFR % of 10%. COVID-19 is more like 1%. The advantage of SARS was that it wasn't spread asymmetric. This isn't true about COVID-19. We were also lucky in 2009, H1N1.
Our immune systems really remember the 1st flu we come across. Old folks weren't dying from the 1918 flu, because they got exposed to a similar flu in 1850.
We've lost the idea that freedom includes responsibility. Masks as an example. That connection isn't made anymore.
We've got to be serious about a lockdown. Where she is, France, she needs to explain why she is out of her house. You've got to lockdown until you can track the cases; such as what China and South Korea did. Do test and trace once you have the lockdown. In the states, we're not that strict. There is no reason to have a lockdown if you aren't willing to do test and trace.
No one is saying we're all in this together.
The way it elicits immunity is puzzling. Common cold is driven by coronavirus.
In 2022, we'll be able to mobilize the vaccine. How will we get to immunity: through attack rate or herd immunity. The 1st vaccines will stop the virus from getting people sick. People will still get infected, but they just wont get sick. Yet, once infected, they can still pass it on to others who aren't vaccinated.
My thoughts: The bat poop comment was perhaps the most interesting point of the whole conversation. It was also interesting about how the 1918 flu didn't kill older folks, because they had gotten exposed to a similar strain in 1850. There was an interesting disagreement between Debora MacKenzie who was advocating for lackdowns and Nicholas Christakis who wanted to go about it a different way. The vaccine comment was just scary.
Sonia Shah - Science Journalist and Prize-Winning Author
We've known since the 1940s of these pathogens. Ebola, Zika, HIV. This idea of a pandemic has been brewing for a long time.
We blame travel a lot, but other factors are critical. We still have HIV and cholera pandemics. Most of these other pandemics are isolated to poor countries. There is an interface between humans and wildlife. We are destroying wildlife habitats, which results in a closer interaction between humans and animals.
Cholera in the 19th century was a new disease. They blamed the Irish then Muslims then Eastern Europeans. They refused to realize that ship travel was bringing cholera. It is how we frame the narrative that might not be true. It lends to scapegoating and lends certain responses. It led to closing the boarders. At that point, we figured we were done. There was a lack of collective action.
HIV had the quilts to represent the dead. We're not doing something similar to remember the dead from COVID-19.
We need a massive stay at home order along with massive financial support.
Only time there is political will to do something is when hospitals become over-whelmed.
Will be constrained by vaccine. Like the Pfizer vaccine needs special temperature and logistical support.
Need to get to herd immunity through either vaccine or attack rate. We'll probably just watch it peter out. The 3rd and 4th waves will be less significant.
My thoughts: I'm not sure if she was pro-travel restrictions or not. But New Zealand did implement travel restrictions in March. Though they also did test and trace. When she was talking about memorials to the dead, I think she over-looked the chairs that are being set up in Washington DC. Also, I'm not sure the timeline between the HIV quilt and when HIV was identified. Honestly, in the United States, we're not even a year into this virus.
Nicholas Christakis - Physician, Scientist, Author
Theory on why viruses are coming from bats. Bats are mammals and so viruses that hit bats are easier to transfer to us. There are avian viruses, of course. The bat has a unique immune system and can also fly. So exposure is greater. Climate change results in movement of animals and humans that increase contact. Older viruses also came from animals. Measles probably came from cows -- via domestication. We did have an H1N1 pandemic, but it was so mild that no one remembers it. In 1957/1918, we had influenza pandemics and people remember those. We get a pandemic every 10 - 20 years and a big one every 50 years.
Got contacted in January by those in China via phone data. Was able to use phone data on Wuhan and track 11 million transits. Were able to show that by late February, the intensity of the virus was based on movements from Wuhan. It had his full attention in January. When Wuhan confined people to their homes, that really got his attention -- January 24th. When this was happening in China, why weren't we preparing, getting PPE and mentally preparing Americans. In February, it hit Italy. Then it hit New York City. Why the denial that what happens elsewhere would not impact us. Lies and denials are part of a plague.
COVID-19 IFR % is between 0.5 to 0.8%. The CFR % might be twice those numbers. Let's just say 1% die. Let's say the R0 is 3. Maybe 40% to 50% of Americans will be infected. That might result in 1.65 million deaths if there is no vaccine and we do nothing. We have perhaps 300K deaths when including excess deaths. We will surpass 500K, maybe 1 million. There will be 3rd and 4th waves, but less intense due to a vaccine. Even if 1 million Americans die, only 10 million will really know those individuals. By the grace of god we're not facing a MERS or SARS situation.
We need good leadership to see the other side of the pandemic, but plagues always end.
We can do better testing and masking. People need to take it more seriously. We haven't had a good public health message. Trump was wrong to be saying that the virus would go away and talking about HCQ.
Who should get the first doses of the vaccine: doctors, nurses and those who were in the trial but got the placebo. After that, one point of view is to give it to the elderly. But they're not out and about spreading it. Instead, give it to those at low risk of death, but are out and about and can spread it. Probably want some combination of giving it to the high risk and those who are out and about. Giving it to the popular people will multiply the impact.
Use the friendship paradox. You randomly pick people and then they nominate a friend, because people will pick the most popular people.
Why did George Floyd protests not increase the spread. Because some people interacted, but others saw this and said they better stay home.
The virus is transmissible before people are systematic, which is irritating.
Schools/Universities shouldn't go back to school for Spring Semester. Colleges could put in certain procedures. You might be allowed on campus, but classes will be virtual. Worry about spread of pathogen off campus. Difficult to assume colleges are safe with in-person classes.
My thoughts: I think the other two showed him some deference and allowed him to speak the most. I'm guessing because he is the most knowledgeable. I am an avid watcher of Peak Prosperity videos and they are still backing HCQ. There might be an interesting conversation between these two at some point on the topic. I thought his idea about giving the vaccine to social butterflies was an interesting one.
I've got to say it was interesting to end the Los Angeles Times Festival of Books watching a conversation about COVID-19 -- considering how many blog posts I've done on the topic.
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