Science matters

Trump said at the WH briefing on Aug 10, 2020 that the 1917 Spanish flu probably ended WW2.  An internet-age saying: There is no the baddest (silliest, etc), only the badder (sillier, etc).  People are rightly pouncing on the WW2 thing.  Many also jump on the 1917 thing, which Trump has been saying for months.  They can’t understand why he keeps repeating 1917 when the history books say 1918, and think it just one of the many wrong concepts of Trump.  Wrong for sure, but Trump was fed by his Sinophobic sycophants. 

 

The 1918 Spanish flu was first identified in a military camp in the US, and the consensus is it spread to Europe when the Americans entered WWI.  But a few people suspected the Chinese had the flu earlier (more on this next), so in a tiny circle it became 1917.  There is, however, no evidence.  Flu happens every year, so how does one know they are the same without real data?  China were affected but less so by the Spanish flu than many countries, taken as the Chinese having immunity, yet cross-immunity is entirely plausible.  Like American soldiers, Chinese laborers also went to Europe for WWI, but they were not as devastated as the Europeans by the flu, leading to the conclusion that the Chinese didn’t bring the flu to Europe, and/or they had immunity; but, again, nobody can say the immunity was specific to the Spanish flu.  BTW, because of the 1882 Chinese Exclusion Act, it is extremely unlikely the US military got the flu from a Chinese.  Thus, even Trump’s advisors don’t say it publicly, and Trump secretly implies it by insisting on 1917. 

Scientists monitor and predict flus years around, often using data from Asia, especially from Southern China, like HK.  This is done mostly by tradition.  China is a big, populous country, and Southern China is crowded and trades intensively with other countries, so stationing here can do the job economically.  But South China is well connected to SE Asia (and other places), and HK is a major trading stop.  So finding a flu there first doesn’t mean it originates from China, sounding familiar?  A tenet in epidemiology, not just on flu or COVID-19, because nobody monitors whatever upstream, yet laymen don’t know the nuances.  Take the US-Mexico border for analogy.  One might think Mexicans enter the US through the border.  True, but so are US citizens, and Central and South Americans.  In other words, seeing a guy entering the US from the border (finding a flu in China), doesn’t mean he is a Mexican (China has the flu first).   Besides, in 1918 the Chinese Communist Party didn’t even exist yet.  So blaming flus and whatever on China is not only scientifically wrong, but also fundamentally racist.  They are all natural disasters.  Blame no one. 

Onto the COVID-19 news, a South Korean study reporting asymptomatic and symptomatic patients had the same level of viral shedding has received a lot of attention in the media (https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2769235).  Many commentators take it as evidence that the asymptomatic transmit as much as the symptomatic.  It is not.  The authors didn’t conclude that, either.  My 6/9 and 6/12/2020 blogs still stand.  

Many COVID-19 questions remain, like what is the asymptomatic ratio?  The earliest Chinese data said lower than 10%.  Dr Fauci often says 40%.  And the South Korea paper said 36%.  As my blogs mention, defining asymptomatic is hard and often subjective, hence the wide range of estimates.  Even the South Korea paper, which distinguishes between the asymptomatic and pre-symptomatic, might not have examined all the COVID-19 symptoms, in March.  But it has more important limitations.  One is that it looked at people between 22 and 36 years old, not representative of a population.  Young adults presumably handle COVID-19 well, no wonder many were asymptomatic.  The other is it looked at RNA level, not live viruses, so didn’t reveal how infectious the asymptomatic were.  The asymptomatic could just produce cell debris with dead viruses or viral RNA fragments.  

No needs to ring an alarm bell.  There are other studies showing asymptomatic transmission is low or finding no evidence for the asymptomatic being the major cause.  One still needs to be careful, since we don’t know who is asymptomatic and who is pre-asymptomatic, but use common sense before the science is established.  If one is asymptomatic, the virus is unlikely to propagate in vivo much to produce a high level of live viruses.  Since he is not coughing or sneezing either, definition of asymptomatic, how many viruses can he leave in the environment to infect others?  

The biggest story today is perhaps Russia announces approval of the world’s first COVID-19 vaccine, and Putin says his daughter has got it, amid reports that the Russian scientist developing the vaccine took it as well early on.  The reactions in the West is 100% negative, with valid concerns.  There has been no published data, and Russia can’t possibly have had time to finish a phase 3 trial.  Vaccine phase 3 trial is important not only to see the effectiveness but also to show safety.  When a disease may infect 10-20% of the population and kills <1% of the patients, and you vaccinate 100% of population, your vaccine must be safe at least 99.9% of the time.  This is actually a low bar-no worse vaccine exists.  But people prefer a vaccine much safer than 99.9%, and knowing other side-effects of a vaccine is important too.

On the other hand, I doubt very much the Russian vaccine is any different from those developed by China, US, and other European countries.  Specifically, it is based on the same strategy as one  Chinese and one UK vaccines, which published the same results from phase 2 trials in July (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31611-1/fulltext).  No apparent reason why the Russian vaccine will not be like these two vaccine candidates in terms of responses and side-effects.  Indeed, all the vaccine papers published so far, from scientists around the world, show the same positive pattern.  Maybe there is a publication bias, but can’t imagine any qualitative differences among various vaccines.  

This is a good thing, because without monopoly of vaccines, everybody needing one can get one.  But there is a problem: production (distribution later).  7 billion people need vaccination, and if a booster is needed, 14 billion doses.  Hopefully, don’t need it every year.  Current tallies indicate the world capacity of all the vaccines is only around 2 billion or so per year.  Companies can add facilities, but 14 billion is still a long way to go.  So adding Russia is good for humanity.  Of course being safer is better, and Russia may gamble a bit, but these are not normal times.  

The West universally dismisses the Russian vaccine at least partly because Russia, like China, is another bogeyman for the West, which has accused Russia, China as well, of hacking vaccine data, although, as always, with mere statements and press releases.  Leaving aside everything nefarious online, does anybody really need to steal vaccine info?  Only an average Joe might be scared, but biologists know that vaccines have been well-established science, for many years.  Myriad strategies and vectors are open and years old.  Russia, China, India, and other countries have made all kinds of vaccines, sometimes unique ones, for years.  And every COVID-19 study is published in lightening speed.   Why steal it when you have it yourself already, or will know it the next min?   

  

At this point, the best hope is that the world will have vaccines, and the best guess is that they all will be similar.  Mass production will be an issue, especially for China due to its large population, which “stealing” can’t possibly solve.