Instapundit: BIG TECH BURNED BY BIDEN BLUNDER

Instapundit, as you well know, has had a weekly column in the mass-circulation newspaper USA Today for many years. For the first time ever, they refused to run his column, as it addresses the Hunter Biden Emails story. So he ran it unedited on his own blog. Respectfully, doing my bit to boost the signal, I am republishing the story below in its entirety.

BIG TECH BURNED BY BIDEN BLUNDER

Glenn Harlan Reynolds

In my 2019 book, The Social Media Upheaval, I warned that the Big Tech companies — especially social media giants like Facebook and Twitter — had grown into powerful monopolists, who were using their power over the national conversation to not only sell ads, but also to promote a political agenda. That was pretty obvious last year, but it was even more obvious last week, when Facebook and Twitter tried to black out the New York Post’s blockbuster report about emails found on a laptop abandoned by Democratic presidential candidate Joe Biden’s son Hunter.

The emails, some of which have been confirmed as genuine with their recipients, show substantial evidence that Hunter Biden used his position as Vice President Joe Biden’s son to extract substantial payments from “clients” in other countries. There are also photos of Hunter with a crack pipe, and engaging in various other unsavory activities. And they demolishedthe elder Biden’s claim that he never discussed business with his son.

That’s a big election-year news story. Some people doubted its genuineness, and of course it’s always fair to question a big election-year news story, especially one that comes out shortly before the election. (Remember CBS newsman Dan Rather’s promotion of what turned out to be forged memos about George W. Bush’s Air National Guard service?)

But the way you debate whether a story is accurate or not is by debating. (In the case of the Rather memos, it turned out the font was from Microsoft Word, which of course didn’t exist back during the Vietnam War era.) Big Tech could have tried an approach that fostered such a debate. But instead of debate, they went for a blackout: Both services actually blocked links to the New York Post story. That’s right: They blocked readers from discussing a major news story by a major paper, one so old that it was founded by none other than Alexander Hamilton.

I wasn’t advising them — they tend not to ask me for my opinion — but I would have advised against such a blackout. There’s a longstanding Internet term called “the Streisand effect,” going back to when Barbara Streisand demanded that people stop sharing pictures of her beach house. Unsurprisingly, the result was a massive increase in the number of people posting pictures of her beach house. The Big Tech Blackout produced the same result: Now even people who didn’t care so much about Hunter Biden’s racket nonetheless became angry, and started talking about the story.

As lefty journalist Glenn Greenwald wrote in The Intercept, Twitter and Facebook crossed a line far more dangerous than what they censored. Greenwald writes: “Just two hours after the story was online, Facebook intervened. The company dispatched a life-long Democratic Party operative who now works for Facebook — Andy Stone, previously a communications operative for Democratic Sen. Barbara Boxer and the Democratic Congressional Campaign Committee, among other D.C. Democratic jobs — to announce that Facebook was ‘reducing [the article’s] distribution on our platform’: in other words, tinkering with its own algorithms to suppress the ability of users to discuss or share the news article. The long-time Democratic Party official did not try to hide his contempt for the article, beginning his censorship announcement by snidely noting: ‘I will intentionally not link to the New York Post.’”

“Twitter’s suppression efforts went far beyond Facebook’s. They banned entirely all users’ ability to share the Post article — not just on their public timeline but even using the platform’s private Direct Messaging feature.”

“Early in the day, users who attempted to link to the New York Post story either publicly or privately received a cryptic message rejecting the attempt as an ‘error.’ Later in the afternoon, Twitter changed the message, advising users that they could not post that link because the company judged its contents to be ‘potentially harmful.’ Even more astonishing still, Twitter locked the account of the New York Post, banning the paper from posting any content all day and, evidently, into Thursday morning.”

This went badly. The heads Facebook and of Twitter, Mark Zuckerberg and Jack Dorsey, are now facing Senate subpoenas,the RNC has filed a complaint with the Federal Election Commission, arguing that Twitter’s action in blacking out a damaging story constituted an illegal in-kind donation to the Biden Campaign, and most significantly, everyone is talking about the story now, with many understandably assuming that if the story were false, it would have been debunked rather than blacked out.

CNN’s Jake Tapper tweeted:  ”Congrats to Twitter on its Streisand Effect award!!!” Big Tech shot itself in the foot, and it didn’t stop the signal.

Regardless of who wins in November, it’s likely that there will be substantial efforts to rein in Big Tech. As Greenwald writes, “State censorship is not the only kind of censorship. Private-sector repression of speech and thought, particularly in the internet era, can be as dangerous and consequential. Imagine, for instance, if these two Silicon Valley giants united with Google to declare: henceforth we will ban all content that is critical of President Trump and/or the Republican Party, but will actively promote criticisms of Joe Biden and the Democrats. 

“Would anyone encounter difficulty understanding why such a decree would constitute dangerous corporate censorship? Would Democrats respond to such a policy by simply shrugging it off on the radical libertarian ground that private corporations have the right to do whatever they want? To ask that question is to answer it.”

“To begin with, Twitter and particularly Facebook are no ordinary companies. Facebook, as the owner not just of its massive social media platform but also other key communication services it has gobbled up such as Instagram and WhatsApp, is one of the most powerful companies ever to exist, if not the most powerful.”

He’s right. And while this heavyhanded censorship effort failed, there’s no reason to assume that other such efforts won’t work in the future. Not many stories are as hard to squash as a major newspaper’s front page expose during an presidential election.

As I wrote in The Social Media Upheaval, the best solution is probably to apply antitrust law to break up these monopolies: Competing companies would police each other, and if they colluded could be prosecuted under antitrust law. There are also moves to strip them of their immunity under Section 230 of the Communications Decency Act, which protects them from being sued for things posted or linked on their sites on the theory that they are platforms, not publishers who make publication decisions. And Justice Clarence Thomas has recently called for the Supreme Court to revisit the lower courts’ interpretation of Section 230, which he argues has been overbroad. A decade ago there would have been much more resistance to such proposals, but Big Tech has tarnished its own image since then.

Had Facebook and Twitter approached this story neutrally, as they would have a decade ago, it would probably already be old news to a degree — as Greenwald notes, Hunter’s pay-for-play efforts were already well known, if not in such detail — but instead the story is still hot. More importantly, their heavy handed action has brought home just how much power they wield, and how crudely they’re willing to wield it. They shouldn’t be surprised at the consequences.

IWROTE 1984 AS a WARNING NOT AN INSTRUCTION MANUAL Memegeneratornet I Wrote  1984 as a Warning Not an Instruction Manual - George Orwell | George Orwell  Meme on ME.ME

COVID19 update, October 17, 2020: Zinc deficiency and supplements; Remdesivir trials; Israel update

(1) Dr. John Campbell reviews two recent studies that show pretty convincingly that zinc deficiency is correlated to severity of COVID19.

He attributes the lack of interest in this work as “there’s no money in it, since zinc and vitamin D supplements are dirt cheap to produce”. (Actually, the lack of interest is not universal: Israeli HMOs are now telling dietitians to recommend vitamin D supplements to the entire population. They are not [yet] doing this for zinc.)

I remember picking up a biochemistry textbook to see what processes zinc plays a role in, and eventually concluding, “OK, I should have asked instead which processes it’s not involved in”.

(2) Dr. Seheult reviews recent studies on Remdesivir. I would have changed the title to “… may not work in patients sick enough to require hospitalization”

While there appears to be some indication it might do some good when administered early (as it was to US President Trump), the WHO “Solidarity Trial” on hospitalized patient shows no statistically significant therapeutic benefit. Actually, this is more or less what I’d expect with our current understanding of the disease: by the time patients are sick enough to require ventilation, the real enemy is no longer the virus but the patient’s own immune system. Look in the graph below at “low-flow O2” vs. the other options. (“No O2” was too few hospitalized patients to gather statistically significant data on.)

(3) a quick update on Israel: we are exiting lockdown tomorrow morning. Our epidemiological stats continue to trend in the right direction:

Severe cases (light green line, top) lowest in nearly a month, daily deaths (dark green line, bottom) finally dropping
Verified infections outside infection foci tapering off
Percentage of positive tests lowest in months (was 15% at peak)

And finally, active infections (=verified – cured – deceased)

Facebook, Twitter, and a free speech watershed

I’ve been taking a break from commenting directly on politics, to better focus limited spare time on COVID-blogging and on my alternate history series.

Yet yesterday something happened that should scare the bejeebus/bemoses out of you, no matter what your political orientation.

In the last two days, the New York Post dropped two bombshell stories about Joe Biden, his never-do-well son Hunter, and bribery and corruption involving communist China and Ukraine.

Twitter and Facebook decided to actively block people from sharing these stories, as they were supposedly “unverified” and “based on illegally obtained information”. (That is, found on a waterlogged laptop that had been dropped off at a computer repair shop. The repairman tried to figure out from the laptop whom it belonged to so he could return it and get paid, saw the explosive [and in places extremely family-unfriendly] content, and contacted Trump’s attorney Rudy Giuliani.)

I do not recall Facebook or Twitter ever stopping the sharing of damaging stories about Donald Trump or another conservative politician, no matter how obviously ridiculous or specious. [UPDATE: here are twelve stories they would have had to censor on the same grounds as the Hunter Biden story, but didn’t… all of which just happened to be hatchet jobs on Trump.]

Now I know that the Big Social-Big Mediatainment complex is so far in the tank for their guy that they are hitting gravel — that’s nothing new. But for quasi-monopoly social media companies to actively throttle the sharing of a story that is damaging to their favored candidate — this crosses a watershed. Larry Correia (warning: salty language) lays out at great length why: go read the whole thing , but let me just share some paragraphs (slightly edited for family-friendliness):

…these entities being the primary exchange of information for BILLIONS of people[…]it’s kind of hard to put this thing which didn’t exist before into historical context. Facebook has no real competitors, and it has something like 2.7 billion regular users. With the flick of a switch it can stop a third of the Earth’s population from seeing whatever it doesn’t want them to see. Humanity has never had that before.

That’s real [bleep]ing power right there. […] Communications law is not my area, and I’m not going to be a Dunning-Kruger[r]and talking about section 230 or whatever.

However, what I do know is that this is some seriously dangerous bulls[**]t, and if we keep going down this road it is going to lead to some very bad ends. Freedom of speech functionally ceases to exist when both sides speak, but only one side is heard. […]

From somewhere up there, Martin Niemöller nods in recognition.

Mark Steyn (hat tip: the BbESM), less salty but with plenty of black humor, also weighs in—go read that one too.

Look, I’m not a lawyer and am not going to be what Larry calls a Dunning-Krugerrand [heh], but at risk of belaboring the obvious: in plain English, social media quasi-monopolies are trying to have it both ways. Let me explain.

The archetype of a “common carrier” is the US Postal Service. What if the USPS suddenly decided it would not deliver mail from or to the Trump (or Biden) campaign — or from the GOP (or from the Democratic party, for that matter)? Misbehavior by individual employees aside, this does not happen.

In contrast, the New York Times or the Washington Post can be as nauseatingly yellow and partisan as they wish — as long as they don’t cross the line into actionable libel [and good luck securing a conviction for that] This is limited only by how many people cancel their subscription in disgust, or how many advertisers pull out. (Then again, some billionaire may decide that owning a pet newspaper is just the ticket: cough, Carlos Slim, cough, Jeff Bezos.)

Facebook, Twitter, and Big Social more generally are arrogating to themselves the freedom of content creators, like the NYT or the WaPo, to mold/pick/censor/highlight content, while simultaneously wrapping themselves in the mantle of “common carriers” to shield themselves from liability for content posted on them. (Usually, the liability is copyright—YouTube is filled with illegally “ripped” music and videos, though in many cases they have helped me discover music or documentaries I otherwise might never have heard or seen.)

More and more people rely on social media (and instant messaging applications owned by Big Social — e.g., WhatsApp owned by FB) as their primary means of communication and source of news. We can bemoan this trend (I find myself having to school college students on how to write a proper letter), but it is the reality on the ground.

For now, it seems Big Social have overplayed their hand and run into the Streisand Effect, with lots of us sharing the “doubleplusungood” stories: this one and this one and that one. (See also this. Ugh. And that. Yikes.)

Let me give the last word to Larry Correia:

[…]I don’t give a sh[*]t if you are liberal or conservative[:] the idea of some entity like Google determining what mankind is allowed to know or not know should terrify the sh[*]t out of you. Free speech becomes a meaningless concept if only approved speech is ever seen. And if you are cheering this sh[*]t on because right now it is helping your team score points against the other team, you are [a] fool. Because once they have that power it is only a matter of time until one of your beliefs ends up on the naughty list too.

PS: one more thing. If I were otherwise sitting on the fence on who to vote for in the US elections, this would sway my vote. We rely on a vigorous independent press to keep elected officials honest. The Big Social-mediatainment complex is clearly utterly incapable and unwilling to do that to “their” side of the spectrum, except perhaps to ‘cancel’ somebody for not being radical/hyperpartisan enough. That alone would make me pull the lever against the said side—even for Zeeba the syphilitic camel if that were the only viable alternative.

Fisking “Anti-Indigenous Things to Quit Saying/Doing”

What some call “cultural appropriation” I’ve been calling “cultural cross-fertilization” for a while. It’s just another mechanism of evolution in action. (One special form that has been fascinating me for a long time is the evolution of language.) Below is a great fisk.

The Writer in Black

BREAKING NEWS, PASS THIS ON BY EVERY CHANNEL AVAILABLE TO YOU: Emails: Top Ukrainian Exec Asked Hunter How to ‘Use Your Influence’ on Burisma’s Behalf AND Facebook, Twitter ‘Reducing’ the Distribution of New York Post Story on Hunter Biden Emails (And by reducing the distribution, read “banning.”) Pass it on: email, phone, your blogs. Just pass it on. Show them they can’t silence AMERICANS!

So there was this:

As usual, their text is Bold, my response is Italics.

“Stop saying ‘off the reservation’. It’s a reference to the pass system that was in place restricting Native people from leaving without permission.”

Actually, it was a reference to Natives arming up in groups and attacking folk.

“Stop making ‘1/16th, ‘great-great grandmother’, etc. jokes. All of these reference blood quantum, a system designed to ‘breed out the Natives’. Indigeneity isn’t defined by a percentage, fraction, etc. Quit policing Indigenous identities and quit…

View original post 1,234 more words

COVID19 update, October 15, 2020: Israel reopening on Sunday; the Japanese paradox

(1) The epidemiological criteria laid out for Israel’s “exit plan” from the 2nd lockdown apparently have been met:

  • 2,000 or fewer test positive out of at least 30,000 (yesterday we had 2,009 positive out of 38,073 tested, and numbers for today are on track to be even better;
  • our positivity rate has dropped to 5.3% (from 15% at the peak) yesterday, and just 3.9% today until 6pm;
  • the “reproductive number” R is down below 0.8 (in fact, the public health head, Prof. Sharon Alroy-Preis, reported 0.63, which is great news)
  • moreover, severe hospital cases are down to 730 today (from a high of 930), the lowest since late September

Hence the cabinet approved Phase 1 of the return to normality, effective Sunday:

  • the 1 km (0.6mi) limit on nonessential travel is rescinded. (This limitation anyhow carried so many exceptions that one could always come up with an excuse.)
  • non-customer facing businesses can return to normal operation. (Sales of food, medicines, essential household necessities, and telecom equipment were never locked down.)
  • restaurants can offer takeaway (deliveries were already allowed), still no sit-down service
  • national parks and beaches are reopened to the public
  • kindergartens and preschools reopen
  • social meetings between family and friends are now permitted up to 10 people indoors or 20 people outdoors.

In addition, the airport will reopen for outgoing flights starting tonight at midnight.

Customer-facing businesses (e.g., clothing shops, furniture stores, …) and personal care (hairdressers, manicurists,…) will have to wait for future reopening stages. While I completely understand many small business owners are at the end of their tether, and am even more sympathetic to those who say they don’t want government handouts but the chance to earn an honest buck, I also understand concerns that an overly hasty reopening might lead to yet a third lockdown, which would be a death blow to many parts of the economy.

Interior Minister Aryeh Deri, from the Shas (“Sephardi Torah Guardians”) party, “reportedly left the ministerial meeting angrily, after his proposal to allow weddings with up to 200 guests was rejected.” He was being accused of “wanting to drag the country down to a third lockdown” under pressure from his chareidi (“ultra-Orthodox”) constituents.

In unrelated news, the Knesset approved the peace agreement with the United Arab Emirates 80-13, with the 13 “no” votes coming from the Joint Arab[ and Communist] List. Former defense minister (and erstwhile Chief of the General Staff) Lt.-Gen. Moshe “Boogie” Ya`alon boycotted the proceedings, saying the ‘secret’ parts of the agreement should have been presented to the Knesset before the vote.

In other unrelated news, the Attorney-General closed one of the corruption cases against PM Netanyahu (the “submarine case”) for lack of evidence.

(2) Dr. John Campbell, in a video, looks at what I would call “the Japanese paradox”.

Unlike South Korea and Taiwan, which nipped the epidemic through early implementation of contact tracing (capitalizing on their experience with the 2002-3 SARS and [in South Korea] 2015 MERS outbreaks), Japan did have significant outbreaks — and serological data in Tokyo indicate that close to half (!) of the population was exposed. (It is pretty hard to get tested in Japan, unlike South Korea where testing centers are open to walk-ins, so the official case number of under 91,000 is a gross underestimate.) https://www.medrxiv.org/content/10.1101/2020.09.21.20198796v1.full.pdf

Yet mortality from the epidemic is enviably low: just 1,646 out of a population of 126.5 million! And that with one of the world’s “oldest” age pyramids.

Nor did Japan resort to extreme lockdowns: it has applied a light touch. (At present, large gatherings are limited to 5,000 people (!). (“Masgramondou” has told me life in rural Japan is pretty much “business as usual”.)

Dr. Campbell tries to come up with various explanations:

  • widespread, deeply ingrained mask wearing culture going back for decades
  • “non-tactile” culture, keeping physical distance, bowing instead of greeting
  • not a “loud” culture: shouting or speaking loudly is highly frowned upon. (This aspect is extremely unlike Israel.)
  • very low rates of obesity
  • a diet rich in seafood of all kinds, and hence rich in vitamin D and zinc. (I looked for studies on vitamin D deficiency in Japan: one study found a figure as low as 5% (!) among active elderly people.

Somehow I wonder if something is missing from these explanations. Green tea? A close relative who has lived in Japan told me the Japanese drink copious quantities of green tea — and as covered here earlier, green tea contains a zinc ionophore nearly as potent as hydroxychloroquine, namely, epigallocatechin gallate (EGCG). Could this be a clue? As I discuss there, however, bioavailability from oral ingestion is problematic.

Then again, it’s not just Japan: all the East Asian countries (except for mainland China) seem to have weathered the COVID storm fairly well to very well. And Mrs. Arbel — very familiar with the region — stresses how widely green tea is drunk in all of them.

There is clearly something going on we don’t know here, and the sooner we find out, the better.

COVID19 update, October 11, 2020: Israel eyeing controlled exit from second lockdown; Senior WHO official: “stop using lockdowns as your primary control method”

Israel just spent the entire High Holidays season under fairly tight lockdown. The choice of dates was at least partly motivated by a desire to mitigate the economic impact by choosing a block of dates that includes many national holidays, and in which many people normally take their annual vacation in any case.

Predictably, no improvement in epidemiological data was seen until about two weeks into the epidemic, but now public health officials are at least guardedly optimistic

  • the positivity rate among tests, at its peak about 15% in the general populations (and as high as 33% in the chareidi and Arab sectors!) has now fallen below 8%, the lowest in a month
  • occupancy in COVID19 wards nationwide, from a high in the mid-900s, has been steadily declining over the past week to about 850. (This only represents moderate and severe cases — mild cases are treated at home or, if home isolation is not feasible, in so-called “corona hotels”.)
  • The total number of active patients (i.e., confirmed infections minus confirmed recoveries and deaths) is finally declining (see 1st graph below)
  • The 7-day moving average of daily new cases (applied to smooth out weekday-weekend testing variations) is likewise clearly trending down (see 2nd graph below).

As an aside, our overall CFR (case fatality rate) stands at 0.85%. It was generally assumed in our epidemiological community, from earlier serological testing, that our Dunkelziffer (undetected asymptomatic or minimally symptomatic infections) is about ten times as much, which would correspond to an IFR (infection fatality rate) of just 0.085%. A more recent serological survey by the health ministry between July and September found that 5.5% of the population had been exposed to COVID.

According to the study, up to half a million people may have caught the virus, about double the number of cases that had been confirmed by the end of September, and about four times the number who had been confirmed infected at the start of September.

It seems we still have a ways to go before we reach even second-order herd immunity.

There is widespread grumbling among the general population that the general lockdown “was forced upon us by the misbehavior of two minority groups” — Arabs and chareidim (so-called “ultra-Orthodox”). In the Arab sector, it was wedding season, and mass wedding parties are the norm there (as well as, through cultural influence, among Israeli Jews whose parents immigrated from Islamic countries). Predictably, packing hundreds of people into wedding halls, with lots of shouting, hugging, kissing, and no social distancing to speak of, is a recipe for ‘super spreader events’. Apparently, after Arab medical professionals reached out to the community with impassioned pleas, the community internalized the message and infection rates are now leveling off toward those of the general population. In the chareidi (“ultra-Orthodox”) sector, however,

Channel 12 also cited figures from Weizmann Institute of Science Professor Eran Segal showing that “46% of the contagion at the moment is in the ultra-Orthodox community,” in what appeared to be a reference to the percentage of active cases countrywide. The ultra-Orthodox make up some 12% of the total population in Israel.

On Friday, Prof. Moti Ravid, the chief of the Ma`ayanei HaYeshua hospital in the largely chareidi town of Bnei Brak resigned after he lashed out vehemently at [certain elements in] the community. (It must be noted that Israeli public discourse tends to be very ‘direct’, to the point of bluntness, and at times hyperbolic.)

Ravid said that, while most of the city’s residents were trying to abide by government regulations, in Bnei Brak there are “Hasidic neighborhoods that are flouting the rules,” and that “talking to the rabbis will not help .. [they] have lost control of their communities to a certain extent.”

“Until today there has never been an entire group of people that has disregarded authority like this, and killed people… I don’t understand what religion has to do with what they’re doing. They were taught to get everything and give nothing back for years,” he said.

Asked about what was happening in the non-Hasidic Haredi community, Ravid said, “The people of Bnei Brak are mostly different, they are people like you and me who try to follow the guidelines. [However,] they don’t really succeed because the city is tightly packed with people, and that is part of their way of life.”

[…] Last week, the government’s COVID-19 czar, Ronni Gamzu, told ministers that ultra-Orthodox Israelis are 2.5 times more likely to test positive for the coronavirus and that 40% of recent cases were in the ultra-Orthodox community.

To be fair, one must not regard this community — no matter how much one disagrees with its way of life — as a monolithic bloc. Anglo-Chareidi rabbi Menachem Bombach lays out the differences between the various subgroups, and what motivates the “social distancing refuseniks“. And here is a report from a small chareidi town — Kiryat Yearim outside Jerusalem — where the community pulled together and got the infestation under control.

Being a rather ‘live and let live’ sort, I am rather more concerned with the role of some specific elected politicians from that community — in particular the incompetent and truly nauseating Yaakov Litzman who was recently forced to resign following a police indictment. As I have mentioned here many times before, our coronavirus czar Prof. Roni Gamzu actually fought against a national lockdown tooth and nail — being an economics professor as well as a doctor (OB/Gyn), he was keenly aware of the catastrophic cost thereof. So he developed a so-called “traffic light plan” for implementing containment (or relaxation thereof) on a town or neighborhood basis, rather than nationally. Health Minister Litzman torpedoed it, together with his Interior Ministry colleague Aryeh Deri (who in the past served time in Ramle prison for accepting bribes) on the tiresomely predictable grounds of being “discriminatory”.

[In tangentially related news, to my great surprise, a senior WHO official has just urged world leaders to “stop using lockdowns as your primary control method”.]

“We in the World Health Organization do not advocate lockdowns as the primary means of control of this virus,” Dr. David Nabarro said to The Spectator’s Andrew Neil. “The only time we believe a lockdown is justified is to buy you time to reorganize, regroup, rebalance your resources, protect your health workers who are exhausted, but by and large, we’d rather not do it.”

Our second lockdown was avoidable and more or less forced upon us by spiraling infections that exceeded the capacity of our track & tracing infrastructure (no thanks to the current health minister Yuli Edelstein, who seems more concerned with protecting the health ministry bureaucracy from unwanted ‘competitors’ than with working with others towards an effective and scalable T & T infrastructure). Hopefully, de-escalating will now be done smartly, in a way that prevents having to go through this exercise a third time. For some of us — we’re the lucky ones — it’s merely annoying. For many others, it ruins their livelihood.

So what’s the plan? Eight, or rather nine, stages, separated by two weeks

  1. First step: fewer than 2,000 confirmed infections/day and R=0.8. Then non-customer facing businesses would return to normal operation, restaurants would be allowed takeaway service (rather than only deliveries as now) beaches and nature reserves open up, as would kindergartens. This could realistically happen as early as next Sunday
  2. Reopening classrooms in grades 1-4
  3. Reopening customer-facing businesses, B & Bs, and synagogues. (Outdoor prayer with adequate distancing is already allowed — and possible because of the weather.)
  4. Restaurants, cafés, gyms reopen. At this point, the “traffic lights” plan would finally be implemented.
  5. Hotels and public pools reopen
  6. Remaining grades of school reopen
  7. Culture, events, concerts reopen
  8. Event halls reopen
  9. Sports stadiums allowed to open to the public.

According to Alroy-Preis, the epidemiological logic of these stages is that places will open early where there is a low risk of infection and those with a high-risk will stay closed until wait until later stages. The higher risk places are those in which people do not wear masks or that are inside.But she cautioned that in order for the exit strategy to work, there is a principle that cannot be broken and that is to manage Israel’s opening of the economy not based on dates but morbidity. She answered a question from The Jerusalem Post about whether populism would get in the way of carrying out the program to plan with the simple answer: “I am not sure.”

COVID19 update, October 8, 2020: The Great Barrington Declaration and the “modified Swedish approach”

At the town of Great Barrington, MA, three leading epidemiologists held a summit where they drafted the Great Barrington Declaration, with 36 initial co-signatories. Meanwhile, an online petition in support has been signed by over 10,000 medical and public health people, and over 100,000 members of the general public.

As infectious disease epidemiologists and public health scientists we have grave concerns about the damaging physical and mental health impacts of the prevailing COVID-19 policies, and recommend an approach we call Focused Protection.

You can read for yourself on their website what they advocate (in nine languages so far). The basic thrust is: no more lockdowns as their economic and collateral medical cost way exceeds any benefit; economic, as entire sectors and large swaths of the population lose their livelihood, and collateral medical, through reduced prevention and treatment availability for the Big Three deadly diseases (cancer, cardiovascular, cerebrovascular). (Reduced vaccinations for other infectious diseases will also cause higher morbidity and mortality from them.) Also, that we cannot wait long for a vaccine; we should instead focus on protecting the most vulnerable and allow the rest of the population to approach herd immunity in a controlled fashion. (If you like, a “Modified Swedish Approach” — the modification consisting of greater protection for the vulnerable.) They also argue that lockdowns disproportionately hurt the disadvantaged (since the jobs that can easily been done from home tend to be upper-middle and upper class jobs), and that suspending schools causes irreversible damage. [*] Because of the exponential dependence of the IFR (infection fatality rate) on age, they argue that school-age children are actually in a regime where influenza is more dangerous than COVID19.

Here the three authors of the declaration are being interviewed on UnHerd

Dr. John Campbell reacts here. While he agrees with some of their points, he is clearly at variance with others, sometimes (in his British understated way) stridently so. Let’s hear him out.

I do wish to say one thing though. He points to the three lead authors

and insinuates that people who come to such prominent positions often do so less because of their professional acumen than because of their skills at politicking. Now even if I granted, for the sake of argument, that this might be the case — how much more so can one say the same thing about the credentialed healthcare bureaucrats that sit at the top of WHO, CDC, NIAID, and the like?!?

UPDATE: White House advisor Dr. Scott Atlas tweets in support of the Great Barrington Declaration.
And in semi-related news, is vitamin D a silver bullet? Dr. Campbell has of course been advocating viatmin D supplements hammer and tongs for months, and very large scale Israeli studies seem to have conclusively proven a link between vitamin D deficiency and susceptibility to COVID19 infection as well as severity thereof. This is at any rate in the category of “things you should be fixing on general principle”, since vitamin D is so crucial in the immune system more generally.

[*] I would be much more sympathetic to this ‘school deprivation’ argument if schools were actually still in the business of education, rather than warehousing, political brainwashing“enlightenment”, and as playgrounds for the latest in pretentious and counterproductive educational theories.

RIP Edward Lodewijk “Eddie” Van Halen (1955-2020)

Rick Beato is devastated

Just the day before, he’d released this video about what the solo in Stairway To Heaven would have sounded like if played/improvised not by Jimmy Page, but by one of several other guitar legends, including Eddie Van Halen.

Many people do not realize Eddie’s first instrument was the piano — he even won some high school-level classical competition. When he picked up the guitar, he ended up trying to translate some of his keyboard finger techniques to the fretboard —- as such, he did not so much invent two-handed tapping as popularize it and become its best-known exponent. (A decade earlier, Steve Hackett had applied two-handed tapping to great effect on Gabriel-era Genesis songs like The Return Of The Giant Hogweed and Dancing With The Moonlit Knight.)

Eddie’s keyboard skills are of course on evidence in the brash synthesizer parts of Van Halen’s blockbuster hit “Jump”. Here is another song that brings out both Eddie’s chops on both axes, as well as the sunny side of the band’s musical personality. Rest In Peace, Eddie.

COVID19 mini-update, October 6, 2020: POTUS back to the White House; cheap paper strip testing; is early social distancing more effective than even tight lockdowns?

(1) The main news is of course that the US President has returned to the White House. I cannot say I am surprised by this outcome: statistically, even at his age of 74, he had 95%+ odds of survival, and he has of course gotten top-notch care from the beginning. Besides, the White House has its own pretty elaborate sickbay/micro-hospital (h/t Mrs. Arbel). Also via Mrs. Arbel, an article in the WSJ about the treatment applied to Trump.

(2) (h/t: Masgramondou) Two interesting articles from the BBC (!):

(3) And of course (again h/t Masgramondou), then there is the estimate by the WHO that as much of 10% of the world population may have had a COVID infection — about 20x the documented case number.

(4) The Jerusalem Post quotes a study from Tel Aviv University, supposedly just accepted for publication in the journal EMBO Molecular Medicine (I could only find a medrXiv preprint, https://doi.org/10.1101/2020.06.11.20128520 ) that analyzes (anonymized) cellular phone mobility data from COVID-afflicted countries and concludes the following:

“Mobility data indicate that a hermetic lockdown, in which everyone must stay at home, is unnecessary. Instead, social distancing measures should be introduced as early as possible,” say Pupko and Mayrose. “We have shown that the countries with the lowest mortality rates in the first outbreak of COVID-19 were not those that imposed the most hermetic lockdowns, but rather those in which mobility decreased (even slightly) at an early stage… as the government considers tightening [Israel’s second lockdown] even further, the import of our research is clear: Extreme restrictions are uncalled for. What we need is fast implementation of social distancing.”

Figure 4 from the preprint

COVID19 update, October 4, 2020: age dependence of infection fatality rate; how this explains why the second wave is much less deadly than the first; new respect for Sweden from.. the NYT?!

(1) Via Dr. Seheult (video here) and Dr. Campbell (video here), a preprint of a meta-analysis (in plain English: a distillation of statistical data from many primary studies) that finds a surprisingly simple “rule of thumb” relationship between infection fatality rate and age:

%IFR=exp( -7.53 + 0.119*age_in_years)=10^(-3.27 + 0.0517*age_in_years)

Image may contain: text that says 'Figure 3: The log-linear relationship between IFR and age 5 2.5 Meta-Regression Confidence Interval Prediction Interval Logarithm of IFR Representative Sample Convenience Sample Comprehensive Tracing -2.5 80 -5- -7.5 10 20 30 40 50 60 70 80 90'
Confusingly, the Y axis is natural logarithms (base e), not common logarithms (base 10)

A money quote from the abstract: “We find that differences in the age structure of the population and the age-specific prevalence of COVID-19 explain nearly 90% of the geographical variation in population IFR.”

(2) On a related note, Dr. Seheult also points to a very detailed data page on the website of the ECDC (the European Centers for Disease Control). One very telling set of graphs is an age breakdown of the per-capita infection rate, when juxtaposed with the graphs of overall infection and fatality rates. For example, below for Belgium:

Note that the 1st wave is dominated by age 80 and over (the darkest line), while the 2nd wave is predominantly young people

As a result, below you see a shark peak in mortality in the first wave, while the rise in infections in the second wave is not accompanied by any significant rise in mortality (yet). Wishful thinking about “the virus getting weaker” need not be invoked, as the exponential dependence of infection fatality rate on age is more than adequate to explain the variation.

But don’t take my word for it: have a look at the corresponding graphs for the other countries. Here, for example, is Germany, more meticulous in data curation than most:

(3) The end times must be upon us, because the New York Times, which has been excoriating Sweden in shrill tones for its “road alone” in handling the COVID19 epidemic, just published an article about Sweden that is surprisingly fair: “Vilified Early Over Lax Virus Strategy, Sweden Seems to Have Scourge Controlled. After having weathered high death rates when it resisted a lockdown in the spring, Sweden now has one of Europe’s lowest rates of daily new cases. Whether that is an aberration remains to be seen.” ( Archive copy here: https://archive.is/99o2J )They even go as far as to say:

In response to the recent outbreaks, many European countries are imposing new restrictions. But political leaders, anxious to avoid unpopular and economically disastrous lockdowns, are relying mostly on social-distancing measures, while trying to preserve a degree of normalcy, with schools, shops, restaurants and even bars open. In essence, some experts say, they are quietly adopting the Swedish approach. “Today, all of the European countries are more or less following the Swedish model, combined with the testing, tracing and quarantine procedures the Germans have introduced, but none will admit it,” said Antoine Flahault, director of the Institute of Global Health, in Geneva. “Instead, they made a caricature out of the Swedish strategy. Almost everyone has called it inhumane and a failure.”

I remember thinking that Israel, under new COVID19 czar Roni Gamzu, had adopted a “modified Swedish model” for the second wave, until we were blindsided by steep rises in infections in two minority sectors of the population, and a second lockdown was declared in response to hospitals in affected areas approaching capacity limits.

Is Sweden approaching higher-order herd immunity? Or has the virus just run out of ‘low-hanging fruit’? Or is it merely between two waves? Public health chief Dr. Anders Tegnell addresses the question:

Mr. Tegnell stressed, as he has many times before, that Sweden did not set out to achieve “herd immunity,” calling it a “myth that has been created.” “We are happy that the number of cases is going down rapidly and we do believe immunity in the population has something to do with that,” he said in the interview, conducted just before the case numbers rose slightly. “And we hope that the immunity in the population will help us get thought this fall with cases at a low level.”

COVID19 update, POTUS edition: update from Presidential medical team on his condition

Happy Sukkot to my fellow Jewish readers. It has been all over the news that President Donald J. Trump and the First Lady tested positive for COVID19 and, “out of an abundance of caution”, have been admitted to Walter Reed Medical Center. We just got a press conference from his medical team here:


In brief: he ran a fever Thursday and Friday —- and it is implied he was on oxygen yesterday — but is off oxygen and fever today doing much better, says “he feels ready to walk out today”. He got both remdesivir IV (2nd day of a 5-day course) and a polyclonal antibody treatment (Regeneron). During Q&A a doc says his pO2 is 96% without an oxygen feed — which is one notch less than I get when I’m perfectly healthy, and I’m nearly two decades younger.

Below follows another video, from yesterday, by pulmonologist and medical school tutor Dr. Roger Seheult, who also dives into the science of interferon response and how deficiencies in it can cause patients to progress to the severe stage. We also learn there that the POTUS was on a prophylactic regime of vitamin D, zinc, melatonin, and low-dose aspirin (as an anticoagulant), much of it overlapping with what Dr. Seheult has been taking himself and has been advocating for other patients.
Dr. Seheult quotes a BMI of just over 30 (the threshold for “obese”) as a risk factor, but balances that with blood pressure readings of 121/79, which at that age and with such a stressful job are nothing short of astonishing. (Trump does not smoke and is a teetotaler.)


UPDATE: more on Regeneron here from Fox Business

UPDATE 2: Instapundit’s “developing” thread

COVID19 update, October 1, 2020: interview with Scott Atlas; vitamin D recap; loss of faith in the media

(1) Around September 11, the Hoover Institute’s Uncommon Knowledge series had an interview with Stanford epidemiologist Scott Atlas MD, currently an advisor to the US President.

YouTube deleted the video as “misinformation” (a classic example of why tech monopolies need to be disrupted). At least they could not just ignore the Hoover Institute, and now (following two ‘corrections’ to the video) it is online again.

UPDATE: Victor Davis Hanson weighs in.

(2) Dr. John Campbell again on vitamin D, recapping the science, and the increasing evidence that deficiency is very strongly correlated with bad outcomes for COVID19 (as for respiratory infections more generally).

See also this preprint: https://www.medrxiv.org/content/10.1101/2020.04.08.20058578v4

He is not given to conspiracy theories, but does sarcastically note “there is no money in it, since vitamin D is dirt cheap”.

(3) I mentioned in a previous installment how the local outbreak that has pushed us into a second lockdown is primarily due to surges in the chareidi (“ultra-Orthodox”) and Arab sectors, the latter (and to a lesser degree the former) owing to mass indoor wedding celebrations acting as superspreader events.

A medical source in Belgium, apparently unaware of this aspect of the situation here, told me they have been seeing the same among the Turkish and Moroccan immigrant communities. (The first mass breakouts in Belgium — and parts of Germany — came from a different type of superspreader events, among the “native” population: indoor carnival celebrations. In Israel, it was Purim parties ).

(4) One of the greatest assets a public health authority has is the public’s trust: particularly the US public health authorities have been doing a great job of squandering that (through zig-zagging and mutually contradictory guidelines, plus ‘bait-and-switch’ like ‘two weeks to flatten the curve’), as Instapundit does not tire of reminding people.

But the media seem to be taking the cake in this regard. According to a recent Gallup poll, to the question “”How much do you trust the media?”, the answers were:

  • “A great deal”: 9% (nine percent!)
  • “A fair amount”: 31%
  • “Not very much”: 27%
  • “Not at all”: 33% (an all-time high)

If the two positive answers (“a great deal” and “a fair amount”) are added up and broken down by party affiliation, we get:

  • “Democrats”: 73%
  • “Republicans”: 10% (an all-time low)
  • Independents: 36% (again, an all-time low)

I know Russian immigrants who, when reading the US mainstream media, wonder if they are reading the Pravda or the Izvestia.

(5) Die Welt (in German) reports on how the reintroduction of returnee quarantine requirements is a body blow to the tourism and travel industry in Germany. Said industry instead proposes mandatory COVID19 testing upon arrival: this was nixed during the 1st wave, citing capacity limitations, but now there is about 20-25% spare testing capacity in the system.

(6) ScienceAlert reports claims that sniffer dogs at Helsinki Airport can detect COVID19 cases with nearly 100% accuracy. I have no difficulty whatsoever believing dogs can detect metabolic anomalies in humans…

COVID19 mini-update, September 29, 2020: anti-bacterial T-cells linked to severe COVID-19; false positive RT-PCR tests

(1) (Via instapundit). Researchers at Sweden’s premier biomedical research center, the Karolinska Institute: “Strong activation of anti-bacterial T cells linked to severe COVID-19

cells are a type of white blood cells that are specialized in recognizing infected cells, and are an essential part of the immune system. About 1 to 5 percent of T cells in the blood of healthy people consist of so-called MAIT cells (mucosa-associated invariant T cells), which are primarily important for controlling bacteria but can also be recruited by the immune system to fight some viral infections.

In this study, the researchers wanted to find out which role MAIT cells play in COVID-19 disease pathogenesis. They examined the presence and character of MAIT cells in blood samples from 24 patients admitted to Karolinska University Hospital with moderate to severe COVID-19 disease and compared these with blood samples from 14 healthy controls and 45 individuals who had recovered from COVID-19. Four of the patients died in the hospital.

The results show that the number of MAIT cells in the blood decline sharply in patients with moderate or severe COVID-19 and that the remaining cells in circulation are highly activated, which suggests they are engaged in the immune response against SARS-CoV-2.

“The findings of our study show that the MAIT cells are highly engaged in the immunological response against COVID-19,” Johan Sandberg says. “A likely interpretation is that the characteristics of MAIT cells make them engaged early on in both the systemic immune response and in the local immune response in the airways to which they are recruited from the blood by inflammatory signals. There, they are likely to contribute to the fast, innate immune response against the virus. In some people with COVID-19, the activation of MAIT cells becomes excessive and this correlates with severe disease.”

(2) “Casey”, a contact on FB asked about PCR running abnormally high numbers of amplification cycles—up to 45—and whether that isn’t basically “running until you test positive”. “Lissa K.” points to this NYT (!) piece which I’ve had on the blog earlier, “Your test is positive — maybe it shouldn’t be” and at least one senior doctor in Israel, Dr. Amir Shachar who runs the Emergency Medicine department at Laniado in Netanya, has said the same about our own labs. Jordan Schachtel discusses the false positives for NFL players found this way (and eventually set aside). From an interview with the NFL Chief Medical Officer (screenshot from the article):

Image

(3) The more I see of our new Health Minister, Yuli Edelstein, the more he strikes me as a “Politruk”. He is probably more responsible for the mess we are in now than anybody else on the political level. Had he not fought tooth and nail to keep “track and trace” under the auspices of a health machinery that clearly was overwhelmed, and had this been transferred to the IDF months ago over Edelstein’s veto, methinks we could have dammed in our current outbreak much earlier.

COVID19 update, pre-Yom Kippur edition: some Yom Kippur links

(1) Israel’s “coronavirus czar” Prof. Roni Gamzu apologizes for failing to prevent a second lockdown. At least this writer realizes he did what he could. As the Yes song goes, “Yours Is No Disgrace“.
Even PM Netanyahu, uncharacteristically, admitted failure in handling the epidemic “by reopening too soon, too fast”. I frankly think one person who could do with reciting a few additional “al chet”s this kippur is Health Minister Yuli Edelstein, for the foundering of the “track and trace” effort because of turf wars between the health establishment (claiming it needed to be run by health professionals) and those (starting with former Defense Minister Naftali Bennett) who correctly recognized it as a logistical and scalability challenge first and advocated from the start for its transfer to the IDF.

(2) A Jerusalem Post writer reflects on spending the High Holidays in Copenhagen, which marks 400 years of Jewish presence.

(3) Prof. Mark Last from Ben-Gurion University claims Israel is approaching herd immunity. Some of the papers I have been discussing here figure in the article. Also quoted is Tom Britton, who argues for a number of 43%, in between the classical first-order estimate of 60+% and the second-order estimate of Prof. Gabriela Gomes, who arrives at numbers in the 20-25%.

(4) Interesting interview with British epidemiologist Michael Edelstein, who recently immigrated to Israel. Read the whole thing: I can’t do it justice by selective quoting.

The blog will now observe “radio silence” until after the holiday.

May you be sealed in the Book of Life on this Yom Kippur.
Those of you who do fast, have an easy fast.
And great health in mind and body to us all.

Gmar chatima tova.

Embassy of Israel on Twitter: "Gmar Chatima Tova! 🕊️🇮🇱… "

On not ever giving up: unexpected inspiration from the tragic story of “The Singing Nun”

Some of you may be old enough to remember a singing nun from Belgium on the Ed Sullivan Show, performing her surprise hit “Dominique” that sat at the top of the US charts for four weeks and went on to win a Grammy Award. Her real name was Jeanne Deckers: she went by the stage name Soeur Sourire (literally, Sister Smile).

She was born to a master confectionary baker and his strict wife in the town of Laeken, where the Royal Palace stands. (According to some sources, her parents were strict Catholics, but according to an article in the French Catholic paper La Croix, she grew up with a secular humanist background and came to religion on her own.)

Always something of a tomboy, she was very active in the Belgian version of the Girl-scouts. Her parents’ wish was that she would get married and take over the family business, but she decided that life wasn’t for her and literally got herself to the nunnery.

The new novice was well liked, especially her singing —and as one of the few worldly possessions she was allowed to keep was a portable musical instrument, she got an acoustic guitar and learned to play it well enough to accompany herself. Her superiors actually encouraged her to perform, and somehow a tape of her got played to an A & R person at the Philips record label (a subsidiary of the electronics giant) .

They immediately latched upon this one catchy song, which most non-Catholics (myself included: this isn’t exactly my musical cup of tea) don’t realize is actually a paean to the eponymous founder of the Dominican Order (to which her monastery belonged).

That it became a hit in Belgium and France was not that much of a surprise: that a song in French would climb to the top of the charts in the USA definitely was. An American tour and a successful first album followed.[French Wikipedia claims the “Dominique-nique-nique” chorus was risqué, since in modern French slang “niquer” means “to scr*w” —- but I believe this became common colloquial French only long after she was dead, slipping in from Arabic via North African immigrants.]

Anyway, during Vatican II and its aftermath she became disillusioned with monastic life and with her church’s religious establishment more generally, and sought a new way that she thought would be more relevant to today’s world. Her song lyrics also took on a more provocative character, praising contraception and excoriating what she called “con-conservateurs” (conservative c**ts/*ssholes). To cut a long story short, confrontations with her order were inevitable and eventually she was voluntarily laicized.

And now her troubles truly began — not with her former religious superiors but with the Belgian tax authorities. They came after her for back taxes on “her” royalties — of which she had never seen a penny. After all, she had made vows of poverty, so the 5% or so that would have been hers were kept by her monastery, with Philips keeping the remainder for themselves. Her pleas fell on deaf ears with the tax authorities, and Philips argued that they had discharged their obligations according to the contract.

Her monastery bought or donated her an apartment in Wavre, in exchange for signing a document relinquishing all further claims and agreeing not to slander the order in public. She went to live there with a former classmate, a therapist working with autistic children named Annie Pecher. (It is pretty clear that the relationship between them was no ordinary friendship but an amitié particulaire, as the French euphemism goes — although they always denied that it had a physical component.)

They started a school for autistic children named Claire-Joie (“clear joy”), but sank ever further in debt, with no hope of ever paying the Belgian tax authorities back. (I am not a Belgian tax lawyer, but I believe this would have been an easily winnable case.)

All her attempts to reboot her singing career, in order to generate income, met with failure — the last attempt was a collaboration with Belgian electronic music pioneer and producer Marc Moulin (of “Telex” fame).

The couple sank into depression fueled by alcohol and prescription medications. After their school went bankrupt, they took their lives in a suicide pact. They left detailed instructions on each item in the apartment whom to give it to, and how they wished to be buried together.

Now get this: the very same day, her royalties statement from SABAM (the Belgian equivalent of ASCAP) was issued (it must have arrived in the mail the next day or so): it was about ten times the amount owed to the taxman.

Moral of the story: salvation may be just around the corner when you feel you absolutely are “done”. In the immortal last words to the House of Commons of WInston Churchill: “Never flinch, never weary, never despair.”

ADDENDUM: Kudos to D. Jason Fleming, who drew my attention to parallels with the case of “Golden Age” science fiction and alternate history writer H. Beam Piper. “He committed suicide, leaving a note apologizing for the mess, never knowing that his agent, who had died a short time before, actually sold a number of stories and books of his, which would have erased the problems that led him to do it in the first place.”

COVID19 update, September 26, 2020: updates from readers edition

[I am blessed to have a number of readers who scour the primary and secondary biomedical literature for interesting articles and tip me off to them. Many thanks, much appreciated.]
(1) (Hat tip: Jeff Duntemann) A Spanish study appears to show a statistical link between zinc deficiency and mortality among COVID19 hospital patients.

Also via Jeff Duntemann: two blog posts (here and here) about a zinc ionophore that appears to be more effective as such than hydroxychloroquine and — get this — is a component of a hot beverage already consumed daily by hundreds of millions of people in East Asia: green tea.

Taking Clioquinol (CQ) as the standard, as is its the most potent ionophore we have tested in our liposomal assay, and assigning a 100% value to the clioquinol ionophoric activity , then pyrithione (PYR), which is not a polyphenol, displays also almost a 100% activity relative to clioquinol, whereas epigallocatechin gallate (EGCG) has 60% activity and quercetin (QCT) has only 30% the efficiency of clioquinol, on a equimolar basis.Nonetheless, this is a proof of concept assay, and exact ionophoric capacity of each compound will vary with the absolute and relative concentrations of the ionophore and of zinc; it will also depend on temperature, pH of the solution and lipid composition of the liposome (absolute and relative amounts of lecithin, other phospholipids, cholesterol, etc). It will also vary dependent on the fluorochrome used to detect zinc in the interior of the liposome (FluoZinc, Zinquin, etc) and on the concentration of the fluorochrome within the liposome, since different fluorochromes display different strengths to separate zinc from the polyphenol zinc complex.

In any case, in the exact standardized conditions used in our assay, we can conclude the relative ionophoric effect of the different compounds tested.It is, I think, important to remark that the liposomal assay allows to elaborate a scale or a standard of ionophoric strength or ionophoric capacity or potential; and that, once established through this assay that a compound behaves as an ionophore in a liposome, we can say that it will also be ionophoric in any type of cell, as this effect is independent of content of protein, glycoprotein, glycolipids, of the cell membrane, although of course it will vary according to the fluidity of the cell membrane, that depends on its exact lipid composition.

The interviewer asked Dr. Larrea how well zinc is absorbed by cells in the absence of an ionophore.  His answer:

Zinc, 10 micromolar (Zn10), alone, by itself, renders just circa 2% fluorescence of that obtained with CQ. Control means, fluorescence of liposomes without the addition of any substance. That means that zinc alone, by itself is not able to enter the liposomes, as expected. This 1-2% is the background fluorescence of the whole system.

Structural formula of epigallocatechin gallate
epigallocatechin gallate (EGCG)

Bioavailability of EGCG from oral ingestion (read: drinking green tea) appears to be somewhat problematic though. Then again, this is definitely in the category of “can’t hurt even if it won’t help”.

(2) In my inbox I found an older message by “Yves not-Cohen” mentioning a review article in a cardiology journal, “QT prolongation, torsades de pointes, and sudden death with short courses of chloroquine or hydroxychloroquine as used in COVID-19: A systematic review” by Lior Jankelson et al., https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7211688/

Note that these doctors are not saying: “ZOMG! This drug is poison and teh debbil!” but, rather more prudently:

 [… from] data on 1515 COVID-19 patients. Approximately 10% of COVID-19 patients treated with these drugs developed QT prolongation. We found evidence of ventricular arrhythmia in 2 COVID-19 patients from a group of 28 treated with high-dose chloroquine. Limitations of these results are unclear follow-up and possible publication/reporting bias, but there is compelling evidence that chloroquine and hydroxychloroquine induce significant QT-interval prolongation and potentially increase the risk of arrhythmia. Daily electrocardiographic monitoring and other risk mitigation strategies should be considered in order to prevent possible harms from what is currently an unproven therapy.

Torsades de pointes“, BTW, reads like a ballet term, but is the term a French cardiologist first used in 1966 for a specific types of cardiac arrhytmia, and has since become the standard term (“twisting of peaks”, literally). “Torsades occurs as both an inherited (linked to at least 17 genes)[3] and as an acquired form caused most often by drugs and/or electrolyte disorders that cause excessive lengthening of the QT interval.[4]

(3) (Hat tip: Wayne B.) Florida doctors claim to have found a “cocktail” drug regimen that has a 96.4% survival rate among hospitalized patients.

ICAM isn’t a new drug, it’s an acronym for a combination of existing medications used simultaneously on patients. It uses Immunosupport drugs (Vitamin C and Zinc), Corticosteroids against inflammation, Anticoagulants against blood clots, and Macrolides to help fight infection.

As discussed here previously, multiple studies (including the English RECOVERY trial) have already come out in support of corticosteroids like dexamethasone, and there is enough evidence for blood clotting that a number of places are already applying anticoagulants. Vitamin C and zinc seems sensible as immune system boosters — though I would have added vitamin D or its first metabolite to the cocktail. Finally, macrolide antibiotics like azithromycin probably are more effective in preventing secondary bacterial pneumonia than in combating the viral infection.

To my Jewish readers, gmar chatima tova and have an easy fast if you observe one for Yom Kippur.

COVID19 update, September 25, 2020: CDC publishes revised fatality rates per age group; The new normal in Italy; petition by Belgian physicians; Israel tightens lockdown starting tomorrow

(1) (H/t: Instapundit) The Centers for Disease Control, which has a very detailed website, published a report that contains new “best estimates” for infection fatality rates, broken down by age group. According to Table 1, last column:

ages 0 tot 19: 0.003% (i.e., 1 in 33,333)
ages 20-49: 0.02% (1 in 5,000)
ages 50-69: 0.5% (1 in 200)
70 and over: 5.4%  (alas, 1 out of 19)

Especially the figures for the young and fairly young are way lower than what the average person on the street has picked up from the sensationalist media.

The same report claims an estimated asymptomatic infection rate of 40%, but it could be as low as 10% or as high as 70%. Let that sink in for a moment: of 10 people who get infected, 7 will never even notice being ill. (My guess is their T-cell system works properly and nips the infection in the bud. T-cell immunity weakens with age…)

(2) The Wall Street Journal has an article on how people in the hard-hit Northern regions of Italy are coping with the aftermath of the lockdown. While current regulations there are pretty lenient, the population exercises caution of its own initiative, moving activities outdoors even when it is not required, and avoiding crowded places. Also, the common reliance on grandparents as “unpaid babysitters” has been toned down a little.

Months after Italy’s lockdown against the coronavirus ended, Enrica Grazioli still sanitizes everything that comes into her Milan apartment, wears face masks diligently and limits interactions between her sons and their grandparents. […] Ms. Grazioli, a self-proclaimed social butterfly who loves to cook for guests, still hasn’t had friends over for dinner since the virus struck. “Am I overdoing it?” says Ms. Grazioli. “Maybe, but we had a national tragedy of epic proportions and you don’t quickly forget something like that.” […] Italy, the first nation outside Asia to suffer a major coronavirus outbreak, had one of the world’s worst death tolls this spring. Overflowing hospitals in parts of northern Italy had to choose which patients got the last intensive-care beds. The Italian army drove truckloads of victims out of the city of Bergamo, which couldn’t cope with the dead. […] That shocking experience helps explain why Italy is so far having greater success than many other European countries in limiting the pandemic’s second wave.

I frankly also think that many of the hardest-hit towns in Italy being infected at near-herd immunity levels has a lot to do with it. Witness:

The percentage of tests that come back positive—a measure of whether testing is sufficiently comprehensive—is 2.1% in Italy, higher than it was in June but lower than in most of Europe, according to official data. A low positivity rate indicates that testing is widespread and not restricted to people who show symptoms. The World Health Organization recommends a positivity rate of 5% or less as a condition for reopening.

The percentage of positive tests is lower still in Lombardy, the epicenter of Italy’s pandemic, according to the regional government.

In Spain, by comparison, government data shows 11.9% of tests are positive, suggesting many infections go undetected.

“Reynaert”, one of my sources in Belgium, pointed to an article from De Standaard (in Dutch) discussing the second wave there — and how the province of Limburg, which was so hard-hit in the first wave, is now doing well in part because people are quite cautious.

(3) A libertarian think tank has picked up the English translation of an open letter by a group of Belgian doctors who are calling on the government to discontinue disruptive social distancing mandates and instead to adopt the Swedish model, rather than ruin the economy (and public health other than COVID19). The English version is definitely worth a read.

(4) Israel’s “lockdown lite” changes to a more severe lockdown starting tomorrow at 2pm local. Escalating hospitalizations, and “unprecedented” positive testing figures led to this move: PM Netanyahu wanted to impose it now, as an escalation of the existing lockdown, because this is a Jewish holiday season where stores are closed several days anyhow and people often take many of the remaining days off. Hence the economic cost is lighter than to have to do it anyhow after the current lockdown.

One goal is to bring down new infection figures to a range that the “track and trace” system can manage. Privacy concerns aside (not that Israelis are very privacy-minded to begin with), South Korea and Taiwan have shown this is one way to “tame” an epidemic without lockdowns (in this case, further lockdowns).

I am personally at best ambivalent about this second hard lockdown (after the one in the spring). Indeed, health professionals as senior as “Corona czar” Prof. Roni Gamzu say it goes too far. See also here. I’m aware that several hospitals (Assuta in Ashdod and Shaarei Tzedek in Jerusalem, off the top of my head) have announced they cannot admit more COVID19 patients, so I realize something had to be done. I just do not believe this is the best of all somethings.

ADDENDUM: the “KAN” news had a segment (in Hebrew) about the situation at the HaEmek [“The Valley”] hospital in the town of Afula (North of the West Bank). They are currently full up on one corona ward, the reserve ward has room for another 10 patients if they do not require respirators. Some of the patients on the ward actually only have mild corona but are in hospital for other ailments and cannot be placed in general hospital population lest they infect staff and patients. (Mild corona cases who otherwise have no need to be in hospital are generally kept at home or in a “corona hotel”, as per their preference.)
An (Arab Israeli) doctor being interviewed explains the difference between the two waves: “The first time around, we saw mostly Jews: returned from trips abroad, or got infected at Purim parties. Also some Arabs returning from Turkey. This time around? 90% Arabs. Most got infected at mass wedding parties. This is the result of taking things lightly and of fatalism. (He did not use the term “inshallah” but paraphrased it.)

Their local positive rate on tests is 15% —- in another segment, we are told that the rate in Arab East Jerusalem is 18%, vs. 10.5% national average.

In a third segment, we hear that the Rambam academic hospital in Haifa opened its emergency underground ward (originally meant for war or mass casualty events), adding capacity for 110 COVID patients immediately, with maximum capacity of up to 700 patients (of which some 170 can be on respirators).

COVID19 update, September 23, 2020: another Israeli study on vitamin D; logistics of vaccine distribution

(1) Dr. John Campbell dedicates yet another video to vitamin D, in which he also looks at two large-scale Israeli studies

The first, by Frenkel-Morgenstern and coworkers, I have covered here before:

https://doi.org/10.1111/febs.15495

The second is so far only a preprint, but looks quite promising. It was carried out by a team led by Dr. Ariel Israel from the research division of Clalit Health Services (the country’s largest HMO).

https://doi.org/10.1101/2020.09.04.20188268

 METHODS We carried out a population-based study among 4.6 million members of Clalit Health Services (CHS). We collected results from vitamin D tests performed between 2010 and 2019 and used weighted linear regression to assess the relationship between prevalence of vitamin D deficiency and Covid-19 incidence in 200 localities. Additionally, we matched 52,405 infected patients with 524,050 control individuals of the same sex, age, geographical region and used conditional logistic regression to assess the relationship between baseline vitamin D levels, acquisition of vitamin D supplements in the last 4 months, and positive Covid-19. RESULTS We observe a highly significant correlation between prevalence of vitamin D deficiency and Covid-19 incidence, and between female-to-male ratio for severe vitamin D deficiency and female-to-male ratio for Covid-19 incidence in localities (P<0.001). In the matched cohort, we found a significant association between low vitamin D levels and the risk of Covid-19, with the highest risk observed for severe vitamin D deficiency. A significant protective effect was observed for members who acquired liquid vitamin D formulations (drops) in the last 4 months.

p<0.001 means: less than one chance in a thousand that the different results in the two groups were due to coincidence

Just how prevalent is vitamin D deficiency really in sunny Israel? Table 2 from the preprint: look at the percentages for the first row (less than 30 nanomol per liter). As you can see, it’s relatively rare among the general population, more common in the chareidi (“ultra-Orthodox”) sector, where more of life is spent indoors and both men and women cover most of their skin for reasons of “tzniut” (modesty) — and very common among Arab women (2.6 times more than their male counterparts)…

Dr. Campbell mentions something I’ve discussed here previously: counterintuitively, the problem is much less common in Scandinavia countries than in, say, Spain or Northern Italy. Quite simply: Scandinavians know they will get in trouble in winter unless they fortify their diet with vitamin D (I don’t think I’ll ever forget seeing a bottle of cod liver oil and shot glasses at a breakfast buffet in northern Norway). Northern Italians and Spaniards get enough in summer but falsely assume they won’t need any supplements in winter…

(2) Wendover Productions, a YouTube channel focusing mostly on logistics and the airline industry, has a new video looking at some of the logistical complexities of massive vaccine distribution on a short time scale:

(3) Breaking news: Israel is tightening its lockdown. More details as they develop.

COVID19 update, fall equinox edition: do many people have pre-existing immunity? Also, another look at Sweden

(1) Via “masgramondou” a must-read perspective article in the British Medical Journal by associate editor Peter Doshi

https://doi.org/10.1136/bmj.m3563

Read the whole thing (it’s open access), but just a few highlights:

Even in local areas that have experienced some of the greatest rises in excess deaths during the covid-19 pandemic, serological surveys since the peak indicate that at most only around a fifth of people have antibodies to SARS-CoV-2: 23% in New York, 18% in London, 11% in Madrid.123 Among the general population the numbers are substantially lower, with many national surveys reporting in single digits[…] Yet a stream of studies that have documented SARS-CoV-2 reactive T cells in people without exposure to the virus are raising questions about just how new the pandemic virus really is, with many implications.

In a study of donor blood specimens obtained in the US between 2015 and 2018, 50% displayed various forms of T cell reactivity to SARS-CoV-2.511 A similar study that used specimens from the Netherlands reported T cell reactivity in two of 10 people who had not been exposed to the virus.7

In Germany reactive T cells were detected in a third of SARS-CoV-2 seronegative healthy donors (23 of 68). In Singapore a team analysed specimens taken from people with no contact or personal history of SARS or covid-19; 12 of 26 specimens taken before July 2019 showed reactivity to SARS-CoV-2, as did seven of 11 from people who were seronegative against the virus.8 Reactivity was also discovered in the UK and Sweden.

In fact, the article points out, “we’ve been in this movie before”

SWINE FLU DEJA VU. In late 2009, months after the World Health Organization declared the H1N1 “swine flu” virus to be a global pandemic, Alessandro Sette was part of a team working to explain why the so called “novel” virus did not seem to be causing more severe infections than seasonal flu.12

Their answer was pre-existing immunological responses in the adult population: B cells and, in particular, T cells, which “are known to blunt disease severity.”12 Other studies came to the same conclusion: people with pre-existing reactive T cells had less severe H1N1 disease.1314 In addition, a study carried out during the 2009 outbreak by the US Centers for Disease Control and Prevention reported that 33% of people over 60 years old had cross reactive antibodies to the 2009 H1N1 virus, leading the CDC to conclude that “some degree of pre-existing immunity” to the new H1N1 strains existed, especially among adults over age 60.15

The data forced a change in views at WHO and CDC, from an assumption before 2009 that most people “will have no immunity to the pandemic virus”16 to one that acknowledged that “the vulnerability of a population to a pandemic virus is related in part to the level of pre-existing immunity to the virus.”17 But by 2020 it seems that lesson had been forgotten.

Furthermore, Doshi goes into recent studies that reconsider the herd immunity threshold from a mathematical point of view

Nearly 50 years later, Gabriela Gomes, an infectious disease modeller at the University of Strathclyde, is reviving concerns that the theory’s basic assumptions [behind the common first-order herd immunity estimate] do not hold. Not only do people not mix randomly, infections (and subsequent immunity) do not happen randomly either, her team says. “More susceptible and more connected individuals have a higher propensity to be infected and thus are likely to become immune earlier. Due to this selective immunization by natural infection, heterogeneous populations require less infections to cross their herd immunity threshold,” they wrote.22 While most experts have taken the R0 for SARS-CoV-2 (generally estimated to be between 2 and 3) and concluded that at least 50% of people need to be immune before herd immunity is reached, Gomes and colleagues calculate the threshold at 10% to 20%.2223

(2) If the latter is so — and if you keep in mind that documented COVID19 infections are just the tip of the iceberg, with 90% of more beneath the surface — then these graphs from Sweden make some sense. (H/t: Yves not-Cohen)

Daily deaths in Sweden — clearly dwindles to one here, two there,… despite no lockdowns and only mild social distancing advice.
Daily new cases in Sweden

Swedish public health chief Anders Tegnell, when criticized about the Swedish “Sonderweg” (special road; road alone), said “ask me again in another year”. With 88,000 documented infections out of a population of 10.23 million, they still seem far away from herd immunity — but if you assume a 10:1 to 20:1 Dunkelziffer, and if you also assume a sizable chunk of the population already has some cross-reactivity from common cold coronaviruses, then the virus may simply “be running out of easy targets”.

COVID19 update, Rosh Hashana edition: (1) Israel’s “lockdown lite”; (2) miscellaneous updates

(1) So Israel is entering the new Jewish year with a second lockdown. The multiple “no-work” holidays in these three weeks will mitigate the economic damage somewhat, although unfortunately 1st day of Rosh Hashana and the first and last days of Sukkot all fall on a Sabbath this year.

But it is, in truth, a “lockdown lite”. Businesses that do not have storefronts accessible to the public continue operation as usual, and all “essential businesses” (food, medicine, household products, phone stores,…) remain open. Even the foodsellers in the Machane Yehuda market of Jerusalem are permitted to stay open. Restaurants and eateries are delivery only.

Theoretically, we are restricted to within 500 meter from our house. In practice, there are so many exceptions to this rule (travel to and from work, travel to and from stores selling essential products, sports activity individually or with housemates,…) that one can find an excuse. Public transportation is limited to 50% of capacity.

In my opinion, the most effective component of the lockdown is the closing of schools: I know post hoc is not propter hoc, but I doubt it is just a coincidence that we get a surge in infections a couple weeks after a school system opens or reopens (be it the state school system last May, the state school system again September 1, or the religious seminaries a month ago).

The other component may be that it will impede large family gatherings, where a child who is COVID positive (and likely has no symptoms at all or just some minimal malaise) infects grandparents who are then fighting for their lives 2 weeks later.

(2) Some other updates:

  • (h/t: Laura R.): Persistent lung damages improves gradually after surviving COVID19 infections.
  • Somebody drew my attention to this older article about a 2012 disease outbreak among Chinese miners, in shafts that were also bat caves. The symptoms look remarkably similar to COVID19.
  • After the earlier large-scale Belgian study indicating efficacy of hydroxychloroquine in moderate doses, here is a new Italian study: https://doi.org/10.1016/j.ejim.2020.08.019
  • While the hitech sector is generally fairly resilient to the COVID-19 crisis, some niche segments are hit. WAZE (the popular crowdsourced mapping and route planning app, originally an Israeli startup, now wholly owned by Google) will be laying off people as during lockdowns it made almost no ad revenue — because people weren’t driving (or if they drove at all, not driving anywhere that they needed to open WAZE for).
  • Mike Levitt, Nobel Laureate in Chemistry 2013, muses on COVID19 and thinks that, in the larger scheme of things, we’ll finally be seeing the epidemic wane this year. His earlier back-of-envelope calculation, that the fatalities from the epidemic would amount to about 4 weeks’ worth of all-cause mortality, so far seems plausible for the USA: last year, 2.813 million Americans died from all causes combined. Divide by 13, and you get 216,000 dead, a bit more than what COVID19 has so far wrought in the USA.

“Gone is the year with its curses.
Here beginneth the year with its blessings.”

Shana tova umetuka umevorekhet ve-kol tuv
A wonderful, sweet, and blessed year and all goodness