Matt briefly touches on this but I think it is worth pushing back on the anti-CDC, anti-FDA crowd slightly with the obvious observation that every single country has done terribly.
It isn't like Australia or Japan have granted non-emergency authorisation to vaccines. It isn't like New Zealand or Taiwan acted with urgency paying a mere $20 to secure vaccine doses instead of closing their borders for years. It isn't as if Canadian or French agencies have proven especially emulation-worthy. And on and on.
Given the universal failure, I'm dubious that institutional reforms at the CDC or FDA are really the root cause of the problems being faced.
I'm conservative, but I think this is one of the best articles you've written (because I agree with it of course).
Like national defense I believe that pandemic preparedness is a core government function. And even a relatively mild pandemic like COVID (fatality rates could have easily been 10% like SARS, or 30% like MERS) can do enormous amounts of harm to the country.
Thus I believe an extremely robust response is needed to prepare for the next pandemic. As I wrote in April 2020. I believe we need to have enough domestic capacity to churn out enough N95 masks (and other PPE) for everyone to use them daily.
I would suggest government stipends to private companies to keep that domestic capacity online, along with national guard units to be trained to staff that production to bring it online at the time of the next pandemic. It's quite likely you might need to do something similar for testing capacity.
When the next crisis hits we need to be ready. I submit we also need additional funds to be prepared for an EMP/solar flare. Like a pandemic it's not a question of "if", but a question of "when".
Buying insurance is bad politics. Whether it's requiring vaccinations, early lockdowns to stop the spread of disease, paying your costs up front consistently to prevent the rare extremely bad outcome is politically risky. It's super easy to pull a DeSantis and claim to be a genius for saving costs on the insurance.
The thing is, that's true of vaccinations, but it's also true of pandemic preparedness. If we're accepting the political realities around why Inslee and Biden didn't create vaccine mandates/require vaccines for travel, then to be consistent, we should recognize that those same realities mean that we won't pay for pandemic preparedness.
To me this argues that we should be trying to change the politics of disaster preparedness and responses. Changing politics is hard, but we're really screwed as long as the US population is happy to take the short term win whether it's "saving money" from cutting disaster preparedness or "saving freedom" from requiring vaccines.
> Unfortunately, it’s the problem we see over and over again with infectious diseases — it’s better to tackle the problem early, but it’s very hard to get people to treat a crisis like a crisis until you’re already in its throes.
I think this is pretty much the case with almost everything that requires outlays of many resources prior to some event in the future that will happen but we don't know when.
Totally off topic but the evening post/threads don't always appear so I'll post here: I disagree with Matt on crypto but I think his response on Twitter to Nic Carter was exactly right and while I don't always agree with Nic I do listen to his podcast and like some of his work. Pretty sad to see him acting like a complete moron (basic human decency and manners are underrated).
"Delaying a new cancer treatment by six months is sad, but speeding up Covid vaccinations by even a small amount has a much larger value."
Sorry, but I have to respectfully disagree with this take. You know what's sad? People who have a bad sense of judgement who believe that the vaccine is unsafe due to regulatory approval red tape. Give cancer patients - who are lining up for new treatments - the better shot of surviving. These days, you need to earn survival. Cancer patients have earned survival more than those who *choose* not to get vaccinated against COVID-19.
And this is coming from someone who has a couple of very good friends who continue to choose to not vax up.
You'll have to "show your work" when it comes to how you define value. If you mean value to the healthcare system not being overrun by COVID, fine. But how does that cost compare to extended treatment to cancer patients?
Should we put a lot of money now into preparing for the next pandemic? Sure, I guess. The odds thought are that it will be wasted money. You can buy lots of vaccines, PPE, mothballed production capacity etc with a large infusion of money. But if the stocks are not maintained and the factory capacity not prevented from deteriorating, all that money will go to waste unless we're "lucky" enough to have the next pandemic occur soon -- which it likely will not. Otherwise people's attention gets diverted and this will soon enough all become a very low priority.
The key point is not to convince Congress and the White House to provide funds now, but to convince the Congress and the White House of 2030 or 2040 or 2050, when COVID is way in the rearview mirror and no one really remembers it anymore, and whatever national stockpiles we bought in the early 2020s need to be maintained.
We've seen this movie before. When the Republicans took the House in 2010, they refused to maintain funds for the Strategic National Stockpile, even with the H1N1 mini-pandemic shortly before. And then the Obama White House -- which should have known a *lot* better -- decided to play along:
" In its 2013 budget submission, HHS decreased its stockpile funding request from the previous year, asking for $486 million, a cut of nearly $48 million. “The SNS is a key resource in maintaining public health preparedness and response,” the administration said. “However, the current fiscal climate necessitates scaling back.”"
If Matt wanted to do a really hot take, he would look at vital investments we need to maintain now but don't because it's not a hot hot hot issue like COVID is. What should we be paying attention to but aren't because it's not on the front burner? Are we underfunding FEMA? What national stocks are we neglecting to keep up for a devastating earthquake?
I lived this when working with the Army during the Iraq war. Funds for war reserve materiel were cut to the bone in the 1990s which is totally defensible if you intend never to go to war. Going to war without war reserve materiel is, well, not advisable. It took a long time and a lot of pain to recover from that shortsighted strategy.
Yes stuff in warehouses is not enough. We need enough domestic capacity to ramp up for the next pandemic. There will be an annual cost to keep that capacity online
I think we should have national guard troops trained to step in to run those factories as needed.
Use the 2 weeks of training to produce PPE etc that refreshes stuff in the warehouses.
Abbott has had an about-face during the past few months. In 2020 he was somewhere between DeSantis and DeWine, but now that he's got a primary coming up in a few months he's trying to turn into Kristi Noem.
Certainly agree w/ planning for and pre-funding public health to be ready for the next epidemic, whatever it may be. But Matt, I seriously think you are wrong on not having kids and teachers be masked. Highly infectious new variant with R of 5 to 8. Vaccines not available for <12s yet, and UK data today from Imperial showing vaccines 5-60% effective at preventing any disease. I get it that most kids recover well. But some dont - the chief of the largest kids hospital in Louisiana spoke w/ the governor of that state two days ago and the doctor said that it is entirely a fallacy that kids can't catch or transmit COVID and his hospital is full of sick kids with no prior co-morbidities. So with SUCH a low social cost to masking, why wouldn't we double down on BOTH masking and pushing FDA to speed vaccines in < 12s - especially when we that vaccines are NOT entirely effective at preventing any disease especially with a high R. The cost benefit tradeoff with masks seems very much in favor of wearing (realize 2 and 3 year old mask compliance is tougher). Ps. I'm a public health trained MD
Wouldn’t producing a new vaccine to protect against the Delta variant be great practice for rolling out new vaccines on an even more aggressive schedule. I certainly am loathe to embrace the “distance for 13 months while we develop a vaccine strategy” ever again
One of the other stories I saw mentioned that they will include not just four flu strains, but covid, and two "common cold" coronaviruses, in a single shot.
How much does an mRNA vaccine factory cost? How easy is it to switch to a different vaccine once the capital is in place? I’m more interested in answers to those questions than “throw $30 billion at the problem and hope the results will be better than throwing $30 billion at the northeast corridor.”
Moderna is trialing mRNA-based cold and flu vaccines right now. It sounds like it's much easier to switch an mRNA vaccine factory from one vaccine to another, since all you have to do is change the strand that you're copying, rather than having to grow a new virus for a live/attenuated/dead traditional vaccine, which might require a new growth medium.
"A lot of the reporting on Delta breakthrough infections has been confusing or irresponsible in my view, but the basic point is that if a vaccine is 90% effective at blocking infection, you’re still left to worry about the baseline number of infected people you’re running into. So Delta ends up being a cause for concern among both the vaccinated and the unvaccinated."
This is has been by dilemma for the past 2-4 weeks. Among the medical community right now there is a quiet understanding that the vaccine is not 90% effective for the Delta variant. At my husband's hospital in LA, one infectious disease doctor speculated more like 85-88% effective, and at my brother's hospital in SD - 65-70%. That's a BIG difference. And hospitalizations are 13% vaccinated at my husband's hospital, though only 1% of ICU admissions. So this effects how I counsel my patients. Back in the spring, I told most of my seniors to hug their grandkids: "yes, your grandkids aren't vaccinated, but your risk of illness is 5-10%. It's not 0%, but it's pretty close." Now I'm telling them to be careful again, especially the more vulnerable ones.
I'm frustrated b/c I think CDC is withholding accurate data on vaccine effectiveness b/c they don't want to discourage people from getting the vaccine. They don't want to admit that it's not as effective as they originally claimed. I get it. But people need to know accurate risks in order to alter their behavior.
And I'm completely in favor of vaccine mandates now, where I was hesitant about them before. Especially if the vaccine is not quite as effective as we thought, it becomes abundantly obvious that the unvaccinated are putting everyone at risk. I have to be careful with patients b/c getting angry at the unvaccinated does not help to convince them to vaccinate, but it's difficult not to show how frustrated I am. Yesterday, I had an 83 yr old patient with severe rheumatoid arthritis on immunosuppressive medication who is vaccinated. But b/c he is so severely at risk, I asked at the visit if he is around anyone unvaccinated. His 63 yr-old son who accompanied him to the visit pipes up, "I'm not vaccinated." And when I try to convince him to get vaccinated, he says he's ready to die if need be. "But are you willing to kill your dad?" I asked. Yeah, that didn't go so well.
Is this not a base rate fallacy? If everyone is vaccinated, 100% of hospital admissions will be vaccinated people. That proportion doesn't tell us anything about effectiveness.
I have a lot of complaints with CDC messaging, but I don't think they are intentionally withholding data to push a message.
Yes, but that's an edge case. A lot can be inferred by comparing the proportion of hospitalized or ICU patients to the proportion who are vaccinated. If 70% of the population is vaccinated and 70% of those hospitalized are vaccinated, then it's clear the vaccine isn't doing much. If 70% are vaccinated and 14% of those hospitalized are vaccinated, then (based upon the odds ratio) you are about 14 times less likely to be hospitalized if you are vaccinated.
Fair, so if we take LA county as ~70% vaccinated but 13% of admissions, that suggests that the vaccinated are at a (0.13/0.7) / (0.87/0.3) = 0.064 relative chance of being admitted, i.e., a reduction of 93.6% (I think I did that right).
It could easily be even better than that for the vaccine. It's clear that older people are vaccinated at higher rates and it's clear that they are at higher risk from covid. If those 13% are older than the 87%, and they probably are, then the vaccine is working very well.
Thank you so much. I'm admittedly not so good at statistics so your presentation in numeric terms is extremely helpful to me. I think I still need to counsel my older and sicker patients to be more careful, but this helps me get a mental picture of the risk reduction for most of my vaccinated patients, which is exactly what I was looking for.
Good point. Again - look at the CDC study I sent the link to below. There were flaws with that study but the data is still disconcerting. My complaint is not so much with CDC messaging as frustration with not knowing actual truth in order to accurately protect people -not to either over-represent or under-represent risk. When I got tested for Covid recently after an exposure, there was no question of whether or not I was vaccinated in the list of questions they ask when you register for the test. Is public health even collecting the data on what percentage of people are vaccinated but testing positive? I do have actual data about hospitalizations and that data is somewhat disconcerting. I don't see that data being reported either on the national level, or locally with LA public health.
I know it's futile to bitch about things that cannot be, but, it shouldn't be necessary for the CDC to "ask" this question. Here in the um, "Asian" country in which I reside, this is the way that is handled:
1) Everybody's been using a health status app for the past year, connected to one's phone number, and verified via uploaded, government-issued ID (in the case of foreigners like me, a passport).
2) When you get tested they ask you to scan in (OCR) with your app.
3) Your test results are sent to your app, which then displays updated information. In my case now it reads "264 days" as it's been quite a while now since I've been tested..
4) When you get vaccinated they likewise ask to scan in with your app, which likewise gets updated (my status now indicated "fully vaccinated").
5) Your app, and the government's public health records, are updated in real time.
Is it really disconcerting? "Among persons with breakthrough infection, four (1.2%) were hospitalized, and no deaths were reported." Your experience may be a bit different though.
I agree that would be a good question to ask and collect data on, although a positive test doesn't necessarily imply infectiousness (as myrna pointed out a few days ago).
The problem is if someone arrovea at the Er with Covid and they ask, “Have you been vaccinated?” What percentage of unvaccinated people will claim they were vaccinated? 80%? I wouldn’t be surprised. No one wants to admit they are an idiot.
You'd be surprised. It's a point of pride with a lot of people. They are more than happy to tell you all about government over-reach, their liberty, and the dangers of a new vaccine with emergency authorization only. (eye-roll)
“ They don't want to admit that it's not as effective as they originally claimed.”
I very much object to your phrasing. If you test the vaccine against covid-variant A and it’s 95% effective and then covid-variant B arrises and the vaccine is only 85% effective you don’t have to “admit” anything. The facts have changed. That doesn’t make what you said before untrue.
(I think this is the source of the "confusing" and "irresponsible" reporting that MY is referring to b/c the Washington Post reported about this study last week.) In a population 67% vaccinated, 75% of the cases were in the vaccinated. And of 5 hospitalizations, 4 were in the vaccinated.
Wait, a third of the people traveling to Provinceton for gay party weekend were unvaccinated?! That seems crazy to me! Urban gay party people are almost certainly far more vaccinated than the counties they live in, and those counties are almost certainly far more vaccinated than the county Provincetown is in!
Wouldn't they be young, though? Party weekend sounds like younger people to me. And under 40s are, on average, not vaccinated at high rates. When you subtract out the highly vaccinated 65+ pop the overall rate is much lower.
Yeah, I think it's hard to know. Middle of July is typically "bear week" in Provincetown, which probably has a median age in the 40s. It's hard to know if being a party *destination* makes it higher income/education (therefore more vaccinated) or if being a *party* destination makes it more reckless (therefore less vaccinated). And it's hard to know whether the timing in early July of *this* year means that it's the first time out for everyone who was cautiously isolating at home and just got vaccinated, or if it's the people who were jetting off to Puerto Vallarta every weekend last winter.
Sure, makes sense. All I'm saying is 67% vaccinated actually is a good bit higher than the baseline if the partiers are mostly under 50, so you're original assumptions sound correct to me.
I have read that while the population in Barnstable County is 67% vaccinated, the percent vaccinated in Provincetown itself is much higher-like 90-95%. And in Provincetown during the 2 week period, the weather was crummy and most people there were hanging out in crowded bars, not outside. If you take that such a high percentage was vaccinated, then of course most of the Covid cases were among the vaccinated. What this tells me is that everyone should avoid crowded indoor spaces as the vaccines are not perfect. Here is an article which I read--I know the author makes assumptions, but he really makes the point that probably, only about 1-2% of those vaccinated people, many of whom crowded into bars,Provincetown got sick.
Provincetown is a resort town and it was one of if not the busiest weeks of year for them. The number of visitors wildly outnumbered the number of residence so the vaccination rate of the locals wouldn’t tell you much.
I know the guy in the article made assumptions. But the fact still remains that when you have a high percentage of people vaccinated and breakthrough infections are possible, the absolute number of breakthrough infections of vaccinated people will also be higher. So I wish that instead of implying that "the vaccine doesn't work well with Delta," (which is what a lot of people hear) we give the message, "Don't crowd in indoor spaces, even if you are vaccinated." This is the reasoning that masks were always still required on public transportation and trains and airports
Don't know what to tell you. Perhaps this reflects the underlying vaccinated population. Here in LA, the vaccinated are mostly likely a higher proportion of the population than Miami (I assume that's where you are based "MIA") and the older and sicker are more vaccinated than the younger -- who are still getting it and spreading it, but less likely to be hospitalized. I just looked at today's data btw - now 5% vaccinated in the ICU at my husband's hospital, not 1%.
I feel like it is really important to actually define what we mean by “pandemic preparedness,” since likely everyone has their own ideas. I could easily imagine that $30 billion going to increase the number of bureaucrats and medical ethicists at the CDC, which would be counterproductive. Alternatively, recall that Peter Daszak told us that the best way to be prepared for the next pandemic was to go collect lots of bat viruses in caves and bring them to the Wuhan lab, which at best has been completely useless in this pandemic. I strongly approve of your suggestion to stockpile equipment and factories, but I worry that since that money is largely going to industry and not the agencies tasked with disease prevention it will not be popular with the public health community.
Yes, the CDC needs a complete revamp. It should be completely focused on actual diseases. It's mission creep into other things has distracted it from what IMHO should be it's core mission. Infectious disease control.
Planning for the next pandemic is smart, but since this pandemic was man-made, simply avoiding the deliberate development of unnaturally virulent pathogens in labs with sloppy safety protocols would be even smarter (and cheaper).
Except gain of function is pretty easy to do. It's easy to envision terrorists/jihadists doing so, or maybe kidnapping the family of some scientists and making them to so.
But surely, since HIV and swine flu and Zika and Ebola were *not* man-made, it would *also* be smart to prepare for the next one of *those* that turns into a dangerous pandemic?
Sure. But we (well, people in Hong Kong, China, Africa, the Middle East, etc) have already experienced those outbreaks, and the fact they were all contained handily suggests we already are prepared for them, for the most part. That level of preparedness is supposed to be the entire purpose, for example, of the CDC.
COVID-19 was (nearly) unprecedented in its effect on global humanity, and what made it so unusually dangerous was it was deliberately engineered to be so. So given our previous success at taming naturally occurring diseases like the ones you mention, and our failure at dealing effectively with artificially boosted pathogens, it seems to me the best and BTW most economical approach to avoiding another COVID-like pandemic is to ensure no one develops another COVID-like virus.
Has covid actually caused more death and destruction than HIV? That seems very unclear to me, especially given that HIV is still causing half a million deaths a year, while covid seems likely not to do so beyond 2022 or so. It seems like the natural pathogens are still more dangerous than the putatively human-engineered ones.
(Also, do you have any good reason to believe that covid had human intervention? Everything I've seen suggests that it's very possible it escaped from the lab, and within the realm of possibility that it had undergone some amount of undirected selection, but very unlikely to have been intentionally designed - and thinking that someone could design a virus to intentionally affect the world in a particular way is getting into Xanatos Gambit territory.)
Yes. He showed that the virus doesn't look like anything that humans have designed, and it has some codons that are uncommon (but found) in related viruses. Although he mentions that furin cleavage sites are not found in any other known virus in the *specific* branch of the coronavirus family that SARS-COV-2 is from, he doesn't mention that it *is* found in MERS (which I guess is in a different branch of the family).
He seems to interpret the evidence against natural origin as much stronger than the evidence against human design, but the evidence seems to be of the exact same form (there are specific features of SARS-COV-2 that, in our limited study of artificial and natural viruses, we haven't seen in human-designed ones, or are uncommon in natural ones) and he doesn't give any particular motivation for his stronger interpretation of the one than the other.
Okay. I'm more interested in circumstantial evidence, things we know are true and can't argue about. For example, Leighton Woodhouse has helpfully compiled this list of indisputable facts:
o For years, researchers at the Wuhan Institute of Virology have collected naturally occurring bat coronaviruses from distant locales and tinkered with them in a lab, fusing them with other viruses that are more highly transmissible and deadlier to humans, in order to create synthetic hybrid superviruses. This type of work is called “gain-of-function” research. The justification behind it is that it allows us to stay one step ahead of either bioterrorists or natural selection, either of which could, theoretically, generate such a virus. By making it ourselves in a lab, the rationale goes, scientists can develop the knowledge base to rapidly create a vaccine should such a nightmare scenario at some point unfold.
o This kind of research was undertaken for years in the United States, beginning shortly after 9/11. It continued until the Obama administration banned it. At the University of North Carolina, scientists even synthesized human airway tissues with which to, essentially, train SARS viruses to attack the human respiratory system (interestingly, the scientist who pioneered that work now supports a full investigation into the lab leak hypothesis). Once it was prohibited in the U.S., much of this research shifted to China, with American funding attached to it, with the approval of Anthony Fauci. The Wuhan Institute of Virology was the primary site of this research in China, and its security protocols were lax enough to draw the alarm of the U.S. Embassy two years before the outbreak.
o One of the first people on the planet to worry that Covid-19 had emerged from an accidental leak at the Wuhan Institute of Virology was Shi Zhengli, the lead bat coronavirus researcher at that very lab. We know this because she said so in an interview with Scientific American. But, she reassured the interviewer, she ran tests and checked her records and is now certain that it did not, in fact, come from her lab. Yet the Chinese government has prohibited any outsiders, including the World Health Organization, from seeing those lab logs.
o From the beginning, the possibility of a lab leak was dismissed almost immediately by most brand name media outlets. One of the major reasons for this was an open letter signed by numerous renowned scientists and published in The Lancet in February of 2020 that called any hypothesis of a non-natural origin of Covid-19 a “conspiracy theory.”
o That letter was drafted and organized by Peter Daszak. Peter Daszak heads a New York-based non-profit called EcoHealth Alliance. EcoHealth Alliance was the conduit for NIH funding of field collection of bat coronaviruses for the Wuhan Institute of Virology.
o The last sentence of Daszak’s letter asserts that the signers have “no competing interests.” Reasonable minds might disagree with that characterization.
Now, it took far less evidence than this to begin an FBI investigation in 2017 and spark two years of nightly hysterical swooning by Rachel Maddow and her colleagues on cable news. But somehow the media stenographers can't work up enough interest to see where these particular facts might lead. Personally, based on these facts alone, a lab leak seems far more likely to me than the notion that a bat virus mutated in a cave in China and somehow traveled 1,500 kilometers before spreading among humans in the same city where gain-of-function research was being conducted on a variant of the same virus. But everyone's welcome to their opinion.
Of course, until the Chinese let us see the Wuhan records, we may never know for sure what happened, but the facts above certainly invite more Pulitzer-potential scrutiny. Based on the last two bullet points, for example, we know Peter Daszak is a liar.
Consider, if some energetic young journalist can pull herself away from Twitter long enough to investigate this, we might not need the cooperation of the Chinese to get to the bottom of it. After all, Woodward and Bernstein weren't getting any cooperation from Richard Nixon.
"The entire novel virus sequence from the children’s samples most resembles a canine coronavirus. However, the sequence for its spike protein, which attaches to host cell receptors to initiate an infection, is closely related to the spike sequence of canine coronavirus type I and the one for a porcine coronavirus known as transmissible gastroenteritis virus. And one part of the spike protein bears a 97% similarity to the spike of a feline coronavirus."
Even granting your premise as proven when it’s not, could we agree that we can’t permanently and for all time make every lab in the world conduct its research safely, so it behooves us to focus on preparedness?
Well, we can invest treasure in preparing in advance for something that is easily preventable, or we can prevent its re-occurence. The problem was no so much the sloppy lab conditions as it was the nature of the research itself, which was mind-blowingly irresponsible (as Obama Administration officials recognized when they banned the practice in the US).
Geneticists, for example, have arrived at a self-imposed code of acceptable research; only rogue scientists would go beyond what this code allows (and some do, though of course they aren't going to enjoy the financial and moral backing of superpowers, as the Wuhan researchers did). Broadly, international genetic research occurs only within internationally accepted bounds.
Since discussions along these lines are off the table (as lines of inquiry inevitably lead to St Anthony Fauci's NIH funding for research so dangerous it was banned in the US, and who wants to go there?), I guess we are now limited to worrying about what to do when the next man-made pandemic occurs, instead of collaborating to ensure there is no next man-made pandemic.
So it’s our Fauci-inspired squeamishness on the topic that keeps us from preventing it, not the fact that China is a sovereign country that can (and unfortunately often does) act contrary to the preferences of the international community?
We can't do anything about China. But we can investigate the origins and the funding of the project itself (since it was a US project). But the national media stenographers seemed disinclined to get to the bottom of the worst viral pandemic in a century.
I can't be the only American who is getting pretty tired of incurious humanities graduates making careers out of ignorantly bleating about Science.
This seems representative of the kind of magical thinking that seems to motivate the lab leak hypothesis. If we can show that this was all China’s fault (well, China and Fauci) then we will finally have won! But won what? As you acknowledge, nothing will change going forward, except some people you don’t like will have been humbled. That is low on my list of priorities for pandemic response.
I’m not saying the origins don’t matter. But to bring them up as a way of dismissing the importance of pandemic preparedness seems, as I said, like magical thinking.
Calling my thesis magical thinking is not unreasonable. We are all prone to magical thinking in some realms or other, and I'm certainly not immune.
I guess my reaction to the plea that "We Must Prepare for the Next Pandemic" is based on the fact that I have heard this for most of the nearly six decades my life (well, five decades, I wasn't paying attention for the first decade), and there never really was a Next Pandemic, until (based on the evidence) human beings invented one. And just by going by the averages, there probably won't be another one . . . until humans beings invent it too.
Given these facts, it just seems to me it would be extremely beneficial if we actually understood where this pandemic came from, if for no other reason so we know what exactly it is we are supposed to be preparing for, and perhaps how to head it off before it emerges as a regional or global problem. But the lack of natural curiosity on this matter among the lettered is truly breathtaking.
Matt briefly touches on this but I think it is worth pushing back on the anti-CDC, anti-FDA crowd slightly with the obvious observation that every single country has done terribly.
It isn't like Australia or Japan have granted non-emergency authorisation to vaccines. It isn't like New Zealand or Taiwan acted with urgency paying a mere $20 to secure vaccine doses instead of closing their borders for years. It isn't as if Canadian or French agencies have proven especially emulation-worthy. And on and on.
Given the universal failure, I'm dubious that institutional reforms at the CDC or FDA are really the root cause of the problems being faced.
"Disney requires COVID vaccine for salaried and non-union hourly employees in US" https://nypost.com/2021/08/02/disney-requires-us-employees-to-be-fully-vaccinated/
I'm conservative, but I think this is one of the best articles you've written (because I agree with it of course).
Like national defense I believe that pandemic preparedness is a core government function. And even a relatively mild pandemic like COVID (fatality rates could have easily been 10% like SARS, or 30% like MERS) can do enormous amounts of harm to the country.
Thus I believe an extremely robust response is needed to prepare for the next pandemic. As I wrote in April 2020. I believe we need to have enough domestic capacity to churn out enough N95 masks (and other PPE) for everyone to use them daily.
I would suggest government stipends to private companies to keep that domestic capacity online, along with national guard units to be trained to staff that production to bring it online at the time of the next pandemic. It's quite likely you might need to do something similar for testing capacity.
When the next crisis hits we need to be ready. I submit we also need additional funds to be prepared for an EMP/solar flare. Like a pandemic it's not a question of "if", but a question of "when".
https://medium.com/the-national-discussion/face-masks-use-them-love-them-24c627ab9f3d
Buying insurance is bad politics. Whether it's requiring vaccinations, early lockdowns to stop the spread of disease, paying your costs up front consistently to prevent the rare extremely bad outcome is politically risky. It's super easy to pull a DeSantis and claim to be a genius for saving costs on the insurance.
The thing is, that's true of vaccinations, but it's also true of pandemic preparedness. If we're accepting the political realities around why Inslee and Biden didn't create vaccine mandates/require vaccines for travel, then to be consistent, we should recognize that those same realities mean that we won't pay for pandemic preparedness.
To me this argues that we should be trying to change the politics of disaster preparedness and responses. Changing politics is hard, but we're really screwed as long as the US population is happy to take the short term win whether it's "saving money" from cutting disaster preparedness or "saving freedom" from requiring vaccines.
> Unfortunately, it’s the problem we see over and over again with infectious diseases — it’s better to tackle the problem early, but it’s very hard to get people to treat a crisis like a crisis until you’re already in its throes.
I think this is pretty much the case with almost everything that requires outlays of many resources prior to some event in the future that will happen but we don't know when.
Except apparently terrorism protection. People were mostly happy to spend hundreds of billions on that
Totally off topic but the evening post/threads don't always appear so I'll post here: I disagree with Matt on crypto but I think his response on Twitter to Nic Carter was exactly right and while I don't always agree with Nic I do listen to his podcast and like some of his work. Pretty sad to see him acting like a complete moron (basic human decency and manners are underrated).
"Delaying a new cancer treatment by six months is sad, but speeding up Covid vaccinations by even a small amount has a much larger value."
Sorry, but I have to respectfully disagree with this take. You know what's sad? People who have a bad sense of judgement who believe that the vaccine is unsafe due to regulatory approval red tape. Give cancer patients - who are lining up for new treatments - the better shot of surviving. These days, you need to earn survival. Cancer patients have earned survival more than those who *choose* not to get vaccinated against COVID-19.
And this is coming from someone who has a couple of very good friends who continue to choose to not vax up.
You'll have to "show your work" when it comes to how you define value. If you mean value to the healthcare system not being overrun by COVID, fine. But how does that cost compare to extended treatment to cancer patients?
You forget about all the people that can't get the vaccine for medical reasons (including cancer patients).
Should we put a lot of money now into preparing for the next pandemic? Sure, I guess. The odds thought are that it will be wasted money. You can buy lots of vaccines, PPE, mothballed production capacity etc with a large infusion of money. But if the stocks are not maintained and the factory capacity not prevented from deteriorating, all that money will go to waste unless we're "lucky" enough to have the next pandemic occur soon -- which it likely will not. Otherwise people's attention gets diverted and this will soon enough all become a very low priority.
The key point is not to convince Congress and the White House to provide funds now, but to convince the Congress and the White House of 2030 or 2040 or 2050, when COVID is way in the rearview mirror and no one really remembers it anymore, and whatever national stockpiles we bought in the early 2020s need to be maintained.
We've seen this movie before. When the Republicans took the House in 2010, they refused to maintain funds for the Strategic National Stockpile, even with the H1N1 mini-pandemic shortly before. And then the Obama White House -- which should have known a *lot* better -- decided to play along:
" In its 2013 budget submission, HHS decreased its stockpile funding request from the previous year, asking for $486 million, a cut of nearly $48 million. “The SNS is a key resource in maintaining public health preparedness and response,” the administration said. “However, the current fiscal climate necessitates scaling back.”"
https://www.propublica.org/article/us-emergency-medical-stockpile-funding-unprepared-coronavirus
If Matt wanted to do a really hot take, he would look at vital investments we need to maintain now but don't because it's not a hot hot hot issue like COVID is. What should we be paying attention to but aren't because it's not on the front burner? Are we underfunding FEMA? What national stocks are we neglecting to keep up for a devastating earthquake?
I lived this when working with the Army during the Iraq war. Funds for war reserve materiel were cut to the bone in the 1990s which is totally defensible if you intend never to go to war. Going to war without war reserve materiel is, well, not advisable. It took a long time and a lot of pain to recover from that shortsighted strategy.
Yes stuff in warehouses is not enough. We need enough domestic capacity to ramp up for the next pandemic. There will be an annual cost to keep that capacity online
I think we should have national guard troops trained to step in to run those factories as needed.
Use the 2 weeks of training to produce PPE etc that refreshes stuff in the warehouses.
We should be referring to Abbott, DeSantis and their followers as the Freedom Death Cult
Typhoid Marian Devotion
Abbott has had an about-face during the past few months. In 2020 he was somewhere between DeSantis and DeWine, but now that he's got a primary coming up in a few months he's trying to turn into Kristi Noem.
Yes. Last year Lt. Gov. Patrick was the face of the Texas Death Cult
Certainly agree w/ planning for and pre-funding public health to be ready for the next epidemic, whatever it may be. But Matt, I seriously think you are wrong on not having kids and teachers be masked. Highly infectious new variant with R of 5 to 8. Vaccines not available for <12s yet, and UK data today from Imperial showing vaccines 5-60% effective at preventing any disease. I get it that most kids recover well. But some dont - the chief of the largest kids hospital in Louisiana spoke w/ the governor of that state two days ago and the doctor said that it is entirely a fallacy that kids can't catch or transmit COVID and his hospital is full of sick kids with no prior co-morbidities. So with SUCH a low social cost to masking, why wouldn't we double down on BOTH masking and pushing FDA to speed vaccines in < 12s - especially when we that vaccines are NOT entirely effective at preventing any disease especially with a high R. The cost benefit tradeoff with masks seems very much in favor of wearing (realize 2 and 3 year old mask compliance is tougher). Ps. I'm a public health trained MD
Wouldn’t producing a new vaccine to protect against the Delta variant be great practice for rolling out new vaccines on an even more aggressive schedule. I certainly am loathe to embrace the “distance for 13 months while we develop a vaccine strategy” ever again
Yes. But I think Moderna's plans to make annual flu vaccines using mRNA technology will also do this: https://www.healthline.com/health-news/why-a-new-mrna-based-flu-vaccine-may-be-the-most-effective-yet
One of the other stories I saw mentioned that they will include not just four flu strains, but covid, and two "common cold" coronaviruses, in a single shot.
How much does an mRNA vaccine factory cost? How easy is it to switch to a different vaccine once the capital is in place? I’m more interested in answers to those questions than “throw $30 billion at the problem and hope the results will be better than throwing $30 billion at the northeast corridor.”
Moderna is trialing mRNA-based cold and flu vaccines right now. It sounds like it's much easier to switch an mRNA vaccine factory from one vaccine to another, since all you have to do is change the strand that you're copying, rather than having to grow a new virus for a live/attenuated/dead traditional vaccine, which might require a new growth medium.
"A lot of the reporting on Delta breakthrough infections has been confusing or irresponsible in my view, but the basic point is that if a vaccine is 90% effective at blocking infection, you’re still left to worry about the baseline number of infected people you’re running into. So Delta ends up being a cause for concern among both the vaccinated and the unvaccinated."
This is has been by dilemma for the past 2-4 weeks. Among the medical community right now there is a quiet understanding that the vaccine is not 90% effective for the Delta variant. At my husband's hospital in LA, one infectious disease doctor speculated more like 85-88% effective, and at my brother's hospital in SD - 65-70%. That's a BIG difference. And hospitalizations are 13% vaccinated at my husband's hospital, though only 1% of ICU admissions. So this effects how I counsel my patients. Back in the spring, I told most of my seniors to hug their grandkids: "yes, your grandkids aren't vaccinated, but your risk of illness is 5-10%. It's not 0%, but it's pretty close." Now I'm telling them to be careful again, especially the more vulnerable ones.
I'm frustrated b/c I think CDC is withholding accurate data on vaccine effectiveness b/c they don't want to discourage people from getting the vaccine. They don't want to admit that it's not as effective as they originally claimed. I get it. But people need to know accurate risks in order to alter their behavior.
And I'm completely in favor of vaccine mandates now, where I was hesitant about them before. Especially if the vaccine is not quite as effective as we thought, it becomes abundantly obvious that the unvaccinated are putting everyone at risk. I have to be careful with patients b/c getting angry at the unvaccinated does not help to convince them to vaccinate, but it's difficult not to show how frustrated I am. Yesterday, I had an 83 yr old patient with severe rheumatoid arthritis on immunosuppressive medication who is vaccinated. But b/c he is so severely at risk, I asked at the visit if he is around anyone unvaccinated. His 63 yr-old son who accompanied him to the visit pipes up, "I'm not vaccinated." And when I try to convince him to get vaccinated, he says he's ready to die if need be. "But are you willing to kill your dad?" I asked. Yeah, that didn't go so well.
Is this not a base rate fallacy? If everyone is vaccinated, 100% of hospital admissions will be vaccinated people. That proportion doesn't tell us anything about effectiveness.
I have a lot of complaints with CDC messaging, but I don't think they are intentionally withholding data to push a message.
Yes, but that's an edge case. A lot can be inferred by comparing the proportion of hospitalized or ICU patients to the proportion who are vaccinated. If 70% of the population is vaccinated and 70% of those hospitalized are vaccinated, then it's clear the vaccine isn't doing much. If 70% are vaccinated and 14% of those hospitalized are vaccinated, then (based upon the odds ratio) you are about 14 times less likely to be hospitalized if you are vaccinated.
Fair, so if we take LA county as ~70% vaccinated but 13% of admissions, that suggests that the vaccinated are at a (0.13/0.7) / (0.87/0.3) = 0.064 relative chance of being admitted, i.e., a reduction of 93.6% (I think I did that right).
It could easily be even better than that for the vaccine. It's clear that older people are vaccinated at higher rates and it's clear that they are at higher risk from covid. If those 13% are older than the 87%, and they probably are, then the vaccine is working very well.
Thank you so much. I'm admittedly not so good at statistics so your presentation in numeric terms is extremely helpful to me. I think I still need to counsel my older and sicker patients to be more careful, but this helps me get a mental picture of the risk reduction for most of my vaccinated patients, which is exactly what I was looking for.
Yes
Oh sorry, I realize now that you did the same math and that we agree!
Good point. Again - look at the CDC study I sent the link to below. There were flaws with that study but the data is still disconcerting. My complaint is not so much with CDC messaging as frustration with not knowing actual truth in order to accurately protect people -not to either over-represent or under-represent risk. When I got tested for Covid recently after an exposure, there was no question of whether or not I was vaccinated in the list of questions they ask when you register for the test. Is public health even collecting the data on what percentage of people are vaccinated but testing positive? I do have actual data about hospitalizations and that data is somewhat disconcerting. I don't see that data being reported either on the national level, or locally with LA public health.
CDC decided to stop asking this back in May. It makes no sense.
I know it's futile to bitch about things that cannot be, but, it shouldn't be necessary for the CDC to "ask" this question. Here in the um, "Asian" country in which I reside, this is the way that is handled:
1) Everybody's been using a health status app for the past year, connected to one's phone number, and verified via uploaded, government-issued ID (in the case of foreigners like me, a passport).
2) When you get tested they ask you to scan in (OCR) with your app.
3) Your test results are sent to your app, which then displays updated information. In my case now it reads "264 days" as it's been quite a while now since I've been tested..
4) When you get vaccinated they likewise ask to scan in with your app, which likewise gets updated (my status now indicated "fully vaccinated").
5) Your app, and the government's public health records, are updated in real time.
Technocracy in action!
If the responses weren’t accurate it would make sense to stop asking.
Is it really disconcerting? "Among persons with breakthrough infection, four (1.2%) were hospitalized, and no deaths were reported." Your experience may be a bit different though.
I agree that would be a good question to ask and collect data on, although a positive test doesn't necessarily imply infectiousness (as myrna pointed out a few days ago).
The problem is if someone arrovea at the Er with Covid and they ask, “Have you been vaccinated?” What percentage of unvaccinated people will claim they were vaccinated? 80%? I wouldn’t be surprised. No one wants to admit they are an idiot.
You'd be surprised. It's a point of pride with a lot of people. They are more than happy to tell you all about government over-reach, their liberty, and the dangers of a new vaccine with emergency authorization only. (eye-roll)
As they are gasping for breath in the ER?
See my comment about the Freedom Death Cult
“ They don't want to admit that it's not as effective as they originally claimed.”
I very much object to your phrasing. If you test the vaccine against covid-variant A and it’s 95% effective and then covid-variant B arrises and the vaccine is only 85% effective you don’t have to “admit” anything. The facts have changed. That doesn’t make what you said before untrue.
Absolutely. Totally agree. But you need to update people on the current truth and I don't see that happening.
“And hospitalizations are 13% vaccinated at my husband's hospital”
Around here it has been pretty consistently reported that less than 5% are unvaccinated and considerably less than 1% of ICU cases are unvaccinated.
Look at the study from the CDC of the outbreak from Massachusetts. https://www.cdc.gov/mmwr/volumes/70/wr/mm7031e2.htm
(I think this is the source of the "confusing" and "irresponsible" reporting that MY is referring to b/c the Washington Post reported about this study last week.) In a population 67% vaccinated, 75% of the cases were in the vaccinated. And of 5 hospitalizations, 4 were in the vaccinated.
Wait, a third of the people traveling to Provinceton for gay party weekend were unvaccinated?! That seems crazy to me! Urban gay party people are almost certainly far more vaccinated than the counties they live in, and those counties are almost certainly far more vaccinated than the county Provincetown is in!
Wouldn't they be young, though? Party weekend sounds like younger people to me. And under 40s are, on average, not vaccinated at high rates. When you subtract out the highly vaccinated 65+ pop the overall rate is much lower.
Yeah, I think it's hard to know. Middle of July is typically "bear week" in Provincetown, which probably has a median age in the 40s. It's hard to know if being a party *destination* makes it higher income/education (therefore more vaccinated) or if being a *party* destination makes it more reckless (therefore less vaccinated). And it's hard to know whether the timing in early July of *this* year means that it's the first time out for everyone who was cautiously isolating at home and just got vaccinated, or if it's the people who were jetting off to Puerto Vallarta every weekend last winter.
Sure, makes sense. All I'm saying is 67% vaccinated actually is a good bit higher than the baseline if the partiers are mostly under 50, so you're original assumptions sound correct to me.
I have read that while the population in Barnstable County is 67% vaccinated, the percent vaccinated in Provincetown itself is much higher-like 90-95%. And in Provincetown during the 2 week period, the weather was crummy and most people there were hanging out in crowded bars, not outside. If you take that such a high percentage was vaccinated, then of course most of the Covid cases were among the vaccinated. What this tells me is that everyone should avoid crowded indoor spaces as the vaccines are not perfect. Here is an article which I read--I know the author makes assumptions, but he really makes the point that probably, only about 1-2% of those vaccinated people, many of whom crowded into bars,Provincetown got sick.
https://inguyun.medium.com/the-provincetown-outbreak-is-actually-good-news-if-you-are-vaccinated-93a1edd763b6
Provincetown is a resort town and it was one of if not the busiest weeks of year for them. The number of visitors wildly outnumbered the number of residence so the vaccination rate of the locals wouldn’t tell you much.
I know the guy in the article made assumptions. But the fact still remains that when you have a high percentage of people vaccinated and breakthrough infections are possible, the absolute number of breakthrough infections of vaccinated people will also be higher. So I wish that instead of implying that "the vaccine doesn't work well with Delta," (which is what a lot of people hear) we give the message, "Don't crowd in indoor spaces, even if you are vaccinated." This is the reasoning that masks were always still required on public transportation and trains and airports
Don't know what to tell you. Perhaps this reflects the underlying vaccinated population. Here in LA, the vaccinated are mostly likely a higher proportion of the population than Miami (I assume that's where you are based "MIA") and the older and sicker are more vaccinated than the younger -- who are still getting it and spreading it, but less likely to be hospitalized. I just looked at today's data btw - now 5% vaccinated in the ICU at my husband's hospital, not 1%.
“Here in LA, the vaccinated are mostly likely a higher proportion of the population than Miami”
Looking at the WSJ’s map, based on CDC data and updated 22 minutes ago:
Miami-Dade Los Angeles
All ages 61.6% 53.9%
12+ 71.2% 62.6%
18+ 74.2% 64.2%
65+ 83.9% 73.9%
I feel like it is really important to actually define what we mean by “pandemic preparedness,” since likely everyone has their own ideas. I could easily imagine that $30 billion going to increase the number of bureaucrats and medical ethicists at the CDC, which would be counterproductive. Alternatively, recall that Peter Daszak told us that the best way to be prepared for the next pandemic was to go collect lots of bat viruses in caves and bring them to the Wuhan lab, which at best has been completely useless in this pandemic. I strongly approve of your suggestion to stockpile equipment and factories, but I worry that since that money is largely going to industry and not the agencies tasked with disease prevention it will not be popular with the public health community.
Yes, the CDC needs a complete revamp. It should be completely focused on actual diseases. It's mission creep into other things has distracted it from what IMHO should be it's core mission. Infectious disease control.
I like the way you think. this is spot on...
Planning for the next pandemic is smart, but since this pandemic was man-made, simply avoiding the deliberate development of unnaturally virulent pathogens in labs with sloppy safety protocols would be even smarter (and cheaper).
Except gain of function is pretty easy to do. It's easy to envision terrorists/jihadists doing so, or maybe kidnapping the family of some scientists and making them to so.
But surely, since HIV and swine flu and Zika and Ebola were *not* man-made, it would *also* be smart to prepare for the next one of *those* that turns into a dangerous pandemic?
Sure. But we (well, people in Hong Kong, China, Africa, the Middle East, etc) have already experienced those outbreaks, and the fact they were all contained handily suggests we already are prepared for them, for the most part. That level of preparedness is supposed to be the entire purpose, for example, of the CDC.
COVID-19 was (nearly) unprecedented in its effect on global humanity, and what made it so unusually dangerous was it was deliberately engineered to be so. So given our previous success at taming naturally occurring diseases like the ones you mention, and our failure at dealing effectively with artificially boosted pathogens, it seems to me the best and BTW most economical approach to avoiding another COVID-like pandemic is to ensure no one develops another COVID-like virus.
We contained HIV/AIDS handily?
Has covid actually caused more death and destruction than HIV? That seems very unclear to me, especially given that HIV is still causing half a million deaths a year, while covid seems likely not to do so beyond 2022 or so. It seems like the natural pathogens are still more dangerous than the putatively human-engineered ones.
(Also, do you have any good reason to believe that covid had human intervention? Everything I've seen suggests that it's very possible it escaped from the lab, and within the realm of possibility that it had undergone some amount of undirected selection, but very unlikely to have been intentionally designed - and thinking that someone could design a virus to intentionally affect the world in a particular way is getting into Xanatos Gambit territory.)
https://tvtropes.org/pmwiki/pmwiki.php/Main/XanatosGambit
Does everything you've read include Nicholas Wade's article from last May in Bulletin of the Atomic Scientists?
https://thebulletin.org/2021/05/the-origin-of-covid-did-people-or-nature-open-pandoras-box-at-wuhan/
Yes. He showed that the virus doesn't look like anything that humans have designed, and it has some codons that are uncommon (but found) in related viruses. Although he mentions that furin cleavage sites are not found in any other known virus in the *specific* branch of the coronavirus family that SARS-COV-2 is from, he doesn't mention that it *is* found in MERS (which I guess is in a different branch of the family).
He seems to interpret the evidence against natural origin as much stronger than the evidence against human design, but the evidence seems to be of the exact same form (there are specific features of SARS-COV-2 that, in our limited study of artificial and natural viruses, we haven't seen in human-designed ones, or are uncommon in natural ones) and he doesn't give any particular motivation for his stronger interpretation of the one than the other.
Okay. I'm more interested in circumstantial evidence, things we know are true and can't argue about. For example, Leighton Woodhouse has helpfully compiled this list of indisputable facts:
o For years, researchers at the Wuhan Institute of Virology have collected naturally occurring bat coronaviruses from distant locales and tinkered with them in a lab, fusing them with other viruses that are more highly transmissible and deadlier to humans, in order to create synthetic hybrid superviruses. This type of work is called “gain-of-function” research. The justification behind it is that it allows us to stay one step ahead of either bioterrorists or natural selection, either of which could, theoretically, generate such a virus. By making it ourselves in a lab, the rationale goes, scientists can develop the knowledge base to rapidly create a vaccine should such a nightmare scenario at some point unfold.
o This kind of research was undertaken for years in the United States, beginning shortly after 9/11. It continued until the Obama administration banned it. At the University of North Carolina, scientists even synthesized human airway tissues with which to, essentially, train SARS viruses to attack the human respiratory system (interestingly, the scientist who pioneered that work now supports a full investigation into the lab leak hypothesis). Once it was prohibited in the U.S., much of this research shifted to China, with American funding attached to it, with the approval of Anthony Fauci. The Wuhan Institute of Virology was the primary site of this research in China, and its security protocols were lax enough to draw the alarm of the U.S. Embassy two years before the outbreak.
o One of the first people on the planet to worry that Covid-19 had emerged from an accidental leak at the Wuhan Institute of Virology was Shi Zhengli, the lead bat coronavirus researcher at that very lab. We know this because she said so in an interview with Scientific American. But, she reassured the interviewer, she ran tests and checked her records and is now certain that it did not, in fact, come from her lab. Yet the Chinese government has prohibited any outsiders, including the World Health Organization, from seeing those lab logs.
o From the beginning, the possibility of a lab leak was dismissed almost immediately by most brand name media outlets. One of the major reasons for this was an open letter signed by numerous renowned scientists and published in The Lancet in February of 2020 that called any hypothesis of a non-natural origin of Covid-19 a “conspiracy theory.”
o That letter was drafted and organized by Peter Daszak. Peter Daszak heads a New York-based non-profit called EcoHealth Alliance. EcoHealth Alliance was the conduit for NIH funding of field collection of bat coronaviruses for the Wuhan Institute of Virology.
o The last sentence of Daszak’s letter asserts that the signers have “no competing interests.” Reasonable minds might disagree with that characterization.
Now, it took far less evidence than this to begin an FBI investigation in 2017 and spark two years of nightly hysterical swooning by Rachel Maddow and her colleagues on cable news. But somehow the media stenographers can't work up enough interest to see where these particular facts might lead. Personally, based on these facts alone, a lab leak seems far more likely to me than the notion that a bat virus mutated in a cave in China and somehow traveled 1,500 kilometers before spreading among humans in the same city where gain-of-function research was being conducted on a variant of the same virus. But everyone's welcome to their opinion.
Of course, until the Chinese let us see the Wuhan records, we may never know for sure what happened, but the facts above certainly invite more Pulitzer-potential scrutiny. Based on the last two bullet points, for example, we know Peter Daszak is a liar.
Consider, if some energetic young journalist can pull herself away from Twitter long enough to investigate this, we might not need the cooperation of the Chinese to get to the bottom of it. After all, Woodward and Bernstein weren't getting any cooperation from Richard Nixon.
This has been my go-to article for demonstrating that viruses can exchange genetic material in ways we can hardly imagine: https://www.sciencemag.org/news/2021/05/two-more-coronaviruses-can-infect-people-studies-suggest
"The entire novel virus sequence from the children’s samples most resembles a canine coronavirus. However, the sequence for its spike protein, which attaches to host cell receptors to initiate an infection, is closely related to the spike sequence of canine coronavirus type I and the one for a porcine coronavirus known as transmissible gastroenteritis virus. And one part of the spike protein bears a 97% similarity to the spike of a feline coronavirus."
Even granting your premise as proven when it’s not, could we agree that we can’t permanently and for all time make every lab in the world conduct its research safely, so it behooves us to focus on preparedness?
Well, we can invest treasure in preparing in advance for something that is easily preventable, or we can prevent its re-occurence. The problem was no so much the sloppy lab conditions as it was the nature of the research itself, which was mind-blowingly irresponsible (as Obama Administration officials recognized when they banned the practice in the US).
Geneticists, for example, have arrived at a self-imposed code of acceptable research; only rogue scientists would go beyond what this code allows (and some do, though of course they aren't going to enjoy the financial and moral backing of superpowers, as the Wuhan researchers did). Broadly, international genetic research occurs only within internationally accepted bounds.
Since discussions along these lines are off the table (as lines of inquiry inevitably lead to St Anthony Fauci's NIH funding for research so dangerous it was banned in the US, and who wants to go there?), I guess we are now limited to worrying about what to do when the next man-made pandemic occurs, instead of collaborating to ensure there is no next man-made pandemic.
"Well, we can invest treasure in preparing in advance for something that is easily preventable, or we can prevent its re-occurence."
It is impossible to prevent it's re-occurance.
So it’s our Fauci-inspired squeamishness on the topic that keeps us from preventing it, not the fact that China is a sovereign country that can (and unfortunately often does) act contrary to the preferences of the international community?
We can't do anything about China. But we can investigate the origins and the funding of the project itself (since it was a US project). But the national media stenographers seemed disinclined to get to the bottom of the worst viral pandemic in a century.
I can't be the only American who is getting pretty tired of incurious humanities graduates making careers out of ignorantly bleating about Science.
This seems representative of the kind of magical thinking that seems to motivate the lab leak hypothesis. If we can show that this was all China’s fault (well, China and Fauci) then we will finally have won! But won what? As you acknowledge, nothing will change going forward, except some people you don’t like will have been humbled. That is low on my list of priorities for pandemic response.
I’m not saying the origins don’t matter. But to bring them up as a way of dismissing the importance of pandemic preparedness seems, as I said, like magical thinking.
Calling my thesis magical thinking is not unreasonable. We are all prone to magical thinking in some realms or other, and I'm certainly not immune.
I guess my reaction to the plea that "We Must Prepare for the Next Pandemic" is based on the fact that I have heard this for most of the nearly six decades my life (well, five decades, I wasn't paying attention for the first decade), and there never really was a Next Pandemic, until (based on the evidence) human beings invented one. And just by going by the averages, there probably won't be another one . . . until humans beings invent it too.
Given these facts, it just seems to me it would be extremely beneficial if we actually understood where this pandemic came from, if for no other reason so we know what exactly it is we are supposed to be preparing for, and perhaps how to head it off before it emerges as a regional or global problem. But the lack of natural curiosity on this matter among the lettered is truly breathtaking.