Will Americans adopt namaste?

As the meeting ended, I asked the doctor what the health protocols are now about handshakes.  "No more handshakes, and only elbow bumps?"

He didn't even pause to consider the question.  "I don't think I will ever shake hands again.  For 15 months, I haven't even had a cold.  It is because I am not in contact with people."

People have their own preferences.  While I honor his, I am not in agreement.

Social distancing in order to avoid a deathly virus is not the same as social distancing in order to avoid a common cold.  If we take this approach to its logical conclusion, then we can continue with social distancing, work from home, and tele-medicine forever, and such a bubble existence will help us avoid any contagious disease however minor or deadly it is, right?

As much a gregarious hermit I am, the bubble doesn't appeal to me.  It completely redefines what it means to be human.

I hope that in this case, too, public memory will be short.  After a few months, or a couple of years, we will return to handshakes and hugs like we used to before the pandemic upended our ways of life.

Now, it is not that I am a huge fan of hugs.  I have learnt to accept them as a part of life, as much as my balding head is something I need to live with ;)

I grew up in a culture in which there seemed to be lots of emphasis on not touching the other person.  A culture in which there were no handshakes or hugs, particularly across the genders. In the culture in which I grew up, relationships were non-contact sports.  As kids, we might have clung on to grandmothers or uncles, but as grown ups we maintained our distances.  A handshake between men was the most we ever got to in terms of bodily contact to express anything.

I often joked, after a few years of living in the US, that it was because we lived in hot and humid conditions and that the last thing we wanted was the other person's stinky sweat!  Even as a kid, I always sweated more than the rest.  My grandmother often commented that I was like a உப்பு சட்டி (salt container) that was always a tad moist.  (The finely powdered "table salt" was not around during my formative years.  Chunks of sea salt were stored in ceramic containers on which condensation was not unusual.) 

After the pandemic ends, or at least eases, I will pay a visit to the old country, and meet face to face with my relatives and friends.  The older folk won't hug.  We will sit apart, and inquire about each others lives.  It will be a touching visit.

Sex talk

My grandmothers were married in their early teens.  My grandfathers were also only teenagers--only a couple of years older.  It was basically child-marriage, which was the norm back then.  My paternal grandmother delivered her first child when she was only 15!

Now, child marriages are illegal, thankfully.  Girls aren't condemned to be barefoot and pregnant, and they can grow up to become rocket scientists too.

But, the new social and legal structure for marriage does not mean that the reproductive biology has changed.  The hormones begin to kick in, and boys and girls are fully ready to have sex in their teens.  In fact, puberty appears to have been fast-forwarded:

Puberty generally begins between eight and 13 years in girls and nine and 14 years for boys. However, a number of global studies suggest the average age of puberty is falling.

The hormones are kicking and screaming, and porn is all around.  In traditional and conservative societies like India's, this can be a recipe for challenging times for boys and girls alike.

Living with parents tightly circumscribes the sexual lives of teenagers in most countries, including the US.  I have always jokingly hypothesized that this sexual urge is the biggest reason that American teenagers seek their independence after they turn 18 years old.  However, COVID-19 forced many of them to return to their parents' homes.  Even if they were out of the nests, quarantine and social distancing made sexual relations rather challenging, if not impossible.

Now, we have the vaccines, and young people here in America are eager to have sex.  However, more sex will not mean more kids; the fertility rate has been falling.  Within a decade or two, we will find out if this is good or bad news.

The contemporary world is a different planet compared to my grandmothers' teenage years. 

Vaccine apartheid

A week ago, I blogged about the insanity of state governments here in the US falling over each other with incentives so that residents in their states will get themselves the Covid vaccine.  Incentives to get a free vaccine that could be the difference between life and death.  How insane is it to offer a million dollar raffle in order to lure the hesitant crowd to the needle!

Many people in many countries around the world would gladly pay to get the vaccine into their deltoids. (Why always into the arm muscle?  Click here to know why.)  Yet, here, we have to offer people pizza, beer, and even million dollar lotteries!

Poor people in poor countries are screwed because they might not get the vaccines until 2023.  Yes, you read that correctly.  2023.  Most covid vaccines going to high- and middle-income countries.

According to Nature, as of mid-March, those countries had secured more than six billion out of 8.6 billion doses. Less than a week later, the Times reported that “86 percent of shots” that went into arms across the globe were “administered in high- and upper-middle-income countries.”

Why should we care? "simple humanity and simple biology."

If left unchecked, the loss of human life for families and societies worldwide will be staggering. Viruses are international travellers, and over time they mutate. Wherever vaccine coverage is patchy, there is selective pressure for the virus to evolve resistance.

If "vaccine apartheid" makes you feel squishy because you are being compelled to think about the awful apartheid regime, then a more palatable phrase "a two track pandemic" might provide you the incentive to think about how "richer countries having access and poorer ones being left behind."

A recent proposal from IMF staff puts forward a plan with clear targets, pragmatic actions, and at a feasible cost. It builds on and supports the ongoing work of WHO, its partners in the Access to COVID-19 Tools (ACT) Accelerator initiative and its global vaccine access programme COVAX, as well as the work of the World Bank Group, the WTO and many others. 

At an estimated $50 billion, it will bring the pandemic to an end faster in the developing world, reduce infections and loss of lives, accelerate the economic recovery, and generate some $9 trillion in additional global output by 2025.  It is a win for all — while around 60 percent of the gains will go to emerging markets and developing economies, the remaining 40 percent will benefit the developed world. And this is without taking into account the inestimable benefits on people’s health and lives.

Hmmm ... $50 billion.  A big number, right?  Let's compare that number against the US annual spending for its military.  President Biden has proposed spending $715 billion on national defense.  $50 billion is practically a rounding off error. 

It is not that we do not have the money.  We clearly lack the will to do the right thing--vaccinate the world. 

The American bubble

The world makes no sense to me.  At some point, I should just give up trying to understand the world.  But, I persist like a mad man!

Here in the US, people are dilly-dallying getting vaccinated.  Some are even refusing the shots.  There is no out-of-pocket cost to get vaccinated, and yet there is a high level of hesitancy!

So much so that state governments are offering lotteries as incentives to get vaccinated.  California has the largest pool of lottery money at $116.5 million.

Meanwhile, there is the rest of the world where there is severe vaccine shortage.  Let them eat cakes!

On my part, I have been regularly tweeting about the urgency for vaccine equity.  It doesn't matter to me if my tweets, like my blog, will not have any effect on the world.  After all, I am a mad man!

If only even the terribly selfish America First person understood that "we risk a forever pandemic with long-term cycles of lockdowns, economic damage and constant fear. We cannot just vaccinate rich countries and hope that we will be safe."

Even if we do not care a damn about the rest of the world, "the longer it takes for the United States to lead a global response, the more the risks compound."

In a politically polarized country in which millions believe that masks are useless, I am not sure how much the President can provide the beacon for the world.  The world "needs a Marshall Plan to invest billions in global health infrastructure, technology transfers, and exports of raw materials, ... and not just a patchwork of disjointed solutions."

The Marshall Plan happened under different circumstances.  But then the plan was also to primarily assist white people in European countries.  Now, the need is to help out a whole lot of brown people all over the world.  The America First voters have made it clear that they do not care about brown people.

Many Americans already struggle to sympathize with their neighbors—convincing them to care about poorer countries, particularly while recovering from what has been a tragic and difficult year, will surely be a tougher pitch.

A very tough pitch! It doesn't have to be that way :(

A shot in the arm

Conversations with my parents these days are only about Covid.  "There is a constant feeling of fear," my father remarked.  So did my mother.

I told them that vaccines are the key, and that there is no way out otherwise.  I drew a parallel with polio.  "They are doing research to develop tablet version of the vaccines," I told them.  Tablet is the Indian usage for a pill; to communicate, one needs to use the relevant usage.  I recall the confusion on a male student's face when as a fresh-off-the-boat student I asked him where the lift.  How would he know that I was referring to the elevator!

The tablet will be easy to administer, without the logistical hassles of the below-freezing temperatures needed for most of the Covid vaccines.  Imagine the Pfizer vaccine as a pill.  That will be a game-changer!

Pfizer’s experimental oral drug to treat Covid-19 at the first sign of illness could be available by the end of the year, CEO Albert Bourla told CNBC on Tuesday.

The company, which developed the first authorized Covid-19 vaccine in the U.S. with German drugmaker BioNTech, began in March an early stage clinical trial testing a new antiviral therapy for the disease.

Of course, there are also others in the race to develop an oral Covid vaccine.  But, until then, it will be shots.  Injections, which is the usage in India.

But, why the shots in the arm?

For one, easy access.  Imagine if every one of us has to get the injections in the buttocks.  It can't be done in the open.  I certainly do not want to reveal my bony butt to the world!

But, the buttocks too are sometimes the locations for injections.  Why the buttocks or the arm?  "Muscles make an excellent vaccine administration site because muscle tissue contains important immune cells."

Aha!

These immune cells recognize the antigen, a tiny piece of a virus or bacteria introduced by the vaccine that stimulates an immune response. In the case of the COVID-19 vaccine, it is not introducing an antigen but rather administering the blueprint for producing antigens. The immune cells in the muscle tissue pick up these antigens and present them to the lymph nodes. Injecting the vaccine into muscle tissue keeps the vaccine localized, allowing immune cells to sound the alarm to other immune cells and get to work.

Hence, the shot in the arm.

And, yes, injections in the arm are recent.  They are one of the many ways in which modern medicine has transformed our lives.  The literal "shot in the arm" that dates back to early 20th century is now also used as an idiom, as a metaphor, in discussions like a Keynesian economic stimulus program.  I suppose taking a pill will not be a powerful metaphor in the stimulus talks!

And on schedule, I had my second #PfizerVaccine shot earlier this morning.
🤞🏽on side effects #freedom starts on #MemorialDay

— K Sriram (@congoboy) May 18, 2021

The good son

The moment the WHO declared the novel coronavirus a pandemic, I started worrying about India.  About my people in India.  About my parents.

What if something happened and I cannot go for months?

A year has passed.  The question remains.

As I noted in this post a few days ago, I am not the only one in the diaspora who is worried about these issues.  It is a surreal situation.

One person writes about this moral dilemma in her (his?) question to to the the NY Times ethics columnist, Kwame Appiah.  She writes about her husband who "is adamant that if his parents or sister become ill (with Covid or anything else), he will return to India to be with them."

She is, naturally, worried about her husband's stance.

In addition, if my husband got sick in India, I doubt he would be able to count on any medical care, and may be unable to return to the United States for many weeks, or even months, if the travel ban goes through and continues. I feel this risk is real, even though my husband is a U.S. citizen. The only things we have going for us are that we are both vaccinated and that we have a place in our home where he would be able to quarantine once he returns.

I have told him that if he goes, I will ready myself for the very real possibility that he may never return. Sadly, I do not think I am being irrational in thinking this.

She requests Appiah to "suggest a few things that both of us should consider so that we can make this decision together, carefully weighing and preparing for all the risks in the calmest state possible."

Before reading Appiah's response, or my excerpts below, think about what you would advise that woman.  Exercise your brain and mind on this ethical issue, which is real and not a hypothetical scenario.

Appiah being Appiah (there are other posts like this one in which I quote his wise words) he carefully weighs the issues and provides a reassuring response.  I am not going to excerpt anything from there; I encourage you to read it in full.

Appiah concludes with this:

[Relationships] have an ethics of their own, which isn’t reducible to a set of rational assessments. Love must be responsive to unreason. Your husband should take account of your own fears and needs, then, just as you should take account of his. In the end, however, the wisdom of preparing for the worst has its limits when — all things considered — it keeps us from doing what’s best.

A terrible curse on humanity

A second Covid-related death in the family.  He was my cousin's husband.

Covid is a curse on humanity, I often tell people.  Not only do loved ones die, but friends and family cannot gather to grieve either.  To die alone, and for the bereaved to grieve alone, is a terrible curse that none of us ever imagined.  But, that is the reality that my cousin and millions of others have to deal with in India, which is reeling from a Covid surge that does not seem like it will abate soon.

Meanwhile, the US CDC declared that those who are fully vaccinated can resume normal activities, for all practical purposes. 

This sets up a huge moral dilemma for people like me who live in the bubble that vaccinations have made possible, but watch in horror the conditions in India worrying all the time about the health and welfare of family and friends.

It is an unbearable pandemic guilt.  I am not the only one, of course, to feel that way.

“I have extreme feelings of guilt as someone who has most of my extended family in India,” said Neha Shastry, 30, who lives in Brooklyn. She has been shaken by the deepening Covid crisis there, as infections and deaths rapidly advance from big cities into rural areas. “It’s surreal to wake up a year later in New York City and see the streets full and businesses flourishing again, while my family is fearing for their lives.”

It is surreal.

My logical mind tells me that there is no reason to feel guilty.  And that's what psychologists remind us: "If you’re feeling guilty about things over which you have no control, the guilt you’re feeling is not warranted, the experts said."

In the old faith in which I grew up, we were advised to accept with detachment both the good and bad things that happen in our lives.  Humans that we are, detachment is not easy to practice.

I suppose modern life has conditioned us into thinking that we are in control of events that happen in our lives.  We forget that as much as life itself is an accident, whatever happens in life is also nothing but a series of fortunate and unfortunate accidents.  When that unfortunate event is a death that does not allow us to come together, it is a challenge to remain detached and philosophical.  But, such is life!

Give Pfizer, et al, more money, dammit!

When we all started getting familiar with something called a "novel coronavirus," experts, who were way ahead of us and on top of a hill looking into the future, told us that eventually vaccines will be the only way out of the global pandemic.

A year ago, we knew that we will need vaccines to deliver us from the pandemic into some kind of normalcy.

Right?

Pharmaceutical companies also knew well about the money to be made from vaccines that could beat back COVID-19.  So, their scientists set out on the expedition, and amazed the world with the speed at which they developed, tested, and produced the vaccines.

What I don't understand is this: Why didn't governments, especially in affluent countries, offer all the needed dollars and euros in order to rush the production of billions of doses that can vaccinate the entire world?

Because big-pharma will make lots of money in the process?

Think about this: Isn't vaccinating the world worth the money?

Think about this also: The world's most profitable company is not a pharmaceutical giant.  Nor is it a fossil fuel company (if you set aside the strange monster that Saudi Aramco is.)  It is Apple.

Apple is one hell of a profit-generator:

Apple said on Wednesday that its profits more than doubled to $23.6 billion in the most recent quarter as people embraced its latest iPhones and bought more of its other products, striking results for what is already the world’s most valuable company.

Apple said its revenues soared by 54 percent to $89.6 billion, a record for the March quarter that meant Apple sold more than $1 billion on average each day.

Now, think about the massive profits earned by Apple versus the much lower profit rate that Pfizer earns from the Covid vaccine.  Which profit-maker is more important and valuable to humanity? (BTW, I have been complaining about Apple and its puke-inducing profits for a long time. Like this post from 2013)

We humans have a twisted relationship with vaccine development.  While we want to enjoy the benefits of vaccines, we don't want vaccine developers to profit from it.  Yet, we willingly fork over money to companies like Apple that don't deliver anything comparable to what vaccines do for our wellbeing.

On top of that, given the cost of vaccines, while we in the rich countries get the shots for free, without ever pausing to wonder who pays for the vaccine and its distribution, those in the poorer countries of the world are left to fend for themselves.

“It’s a moral issue,” said Boston Zimba, a doctor and vaccine expert in Malawi, which has vaccinated only 2 percent of its people. “This is something rich countries should be thinking about. It’s their conscience. It’s how they define themselves.”

To me, the solution is simple and is an expression of humanity: Pay the pharmaceutical companies that have already developed the COVID vaccines all the money they need in order to produce vaccines for humans everywhere.  And underwrite the expenses for the logistics of vaccine distribution.  Because, merely waiving patent protections doesn't do a damn thing to begin production at, say, Ghana!

Source

At the very least, do not complain about vaccine developers earning profits, even as big tech's profits dwarf other companies and even the economies of most countries!

This too shall pass ... eventually

As we go about our daily lives, and as I witness India's descent into Covid hell that the government made possible, it is difficult to view the events over a longer time horizon.  Even though I teach students to understand the human condition by looking at trend lines, the Covid catastrophe, which Arundhati Roy correctly describes as the modi government's crime against humanity, preempts looking at tomorrow leave alone history.

But, history does offer a little bit of comfort if we look back at the world in 1918, when the Spanish flu killed many.

Imagine you were there at Camp Devens in late 1918, surveying the bodies stacked in a makeshift morgue. Or you were roaming the streets of Bombay, where more than 5 percent of the population died of influenza in a matter of months. Imagine touring the military hospitals of Europe, seeing the bodies of so many young men simultaneously mutilated by the new technologies of warfare — machine guns and tanks and aerial bombers — and the respiratory violence of H1N1. Imagine knowing the toll this carnage would take on global life expectancy, with the entire planet lurching backward to numbers more suited to the 17th century, not the 20th. What forecast would you have made for the next hundred years?

I would have forecast that it was the end times.  That we were all going to die.  And that it would be a miracle if humanity recovered from such a catastrophe. 

I would have been proven wrong! 

A hundred years ago, an impoverished resident of Bombay or Delhi would beat the odds simply by surviving into his or her late 20s. Today average life expectancy in India is roughly 70 years.

Sriram in 1918 would never have predicted such a positive transformation.

How did this happen?

Of course scientific breakthroughs helped.  But it was not science alone that did it.

Those breakthroughs might have been initiated by scientists, but it took the work of activists and public intellectuals and legal reformers to bring their benefits to everyday people. From this perspective, the doubling of human life span is an achievement that is closer to something like universal suffrage or the abolition of slavery: progress that required new social movements, new forms of persuasion and new kinds of public institutions to take root.

(I hope the ardent advocates for STEM will read the long read in the NY Times Magazine, which is what I am referring to here.)

Perhaps you don't have the time to read that long essay, and want an example of how science alone didn't deliver progress.  In that case, here is an example: Pasteurization.  The scientific method led Pasteur to understand the role that bacteria played in spoiling the milk, which then caused sickness in people who drank it.  He then figured out that heating milk and then quickly cooling it down did the trick. But, this didn't take effect right away.

In the United States, it would not become standard practice in the milk industry until a half century after Pasteur conceived it. That’s because progress is never a result of scientific discovery alone. It also requires other forces: crusading journalism, activism, politics.

My favorite examples, as I have blogged in plenty, will always be the elimination of small pox, and piped drinking water supply. In both, science alone wasn't enough; it required an army of non-scientists, and sometimes the literal army too.

So, yes, over the long run, the trend lines tell a story that is vastly different from what most would have predicted in 1918.

But, then there is the reality of daily life.

I cannot wait for this pandemic to end.

Jobs and Homes

A couple of years ago, reading "WFH" might have made many of say WTF?  A year into the pandemic, we are all well aware of WFH.  There is so much work happening at home that it seems more like we are living at work :(

Technology has stepped up with tools that we didn't know even existed.  We are now emailing, chatting, Zooming, and chatting while Zooming while checking emails while checking personal messages on the smartphone, ... All these make one wonder, well, is this a win-win-win all around?  Or, is something important lost in this WFH?

Microsoft teams "conducted over 50 studies to understand how the nature of work itself has changed since early 2020." What did they do?

Microsoft’s annual Work Trend Index is part of this initiative and includes an analysis of trillions of productivity signals — think emails, meetings, chats, and posts — across Microsoft and LinkedIn’s user base. It also includes a survey of more than 30,000 people in 31 countries around the world.

That's a pretty good survey.  What did they find?

The effort revealed a significant impact on "organizational connections — the fundamental basis of social capital."

People consistently report feeling disconnected, and in studying anonymized collaboration trends between billions of Outlook emails and Microsoft Teams meetings, we saw a clear trend: the shift to remote work shrunk people’s networks.

It doesn't surprise me one bit. But, before I add my editorial comments, let me present more from that report:

[Interactions] within close networks increased, while interactions with distant networks diminished. As people shifted into lockdown, they focused on connecting with the people they were used to seeing regularly, letting weaker relationships fall to the wayside. Simply put, companies became more siloed than they were pre-pandemic. And while interactions with close networks are still frequent, we’re seeing that now — one year in — even these close team interactions have started to diminish.

Now, this is also the time when big organizations are beginning to think about office structure post-pandemic.  Microsoft announced that from March 29th, it will open its headquarters to a limited number of employees.  As more and more organizations think about these issues, will everything be remote?  WFH forever?  Or, fully back to how things were pre-pandemic? Or, a hybrid of sorts?

Most of us hypothesize that it will be a hybrid.  Employers realize that productivity does not mean everybody has to be in the same place at the same time. Employees have experienced the advantage of doing laundry in the background while working on reports.  So, will a hybrid mode restore people's networks and the social capital in the organization?

When we studied trends in countries where more people had returned to hybrid work environments, we saw improvements in team isolation. For example, in New Zealand, we saw spikes in team isolation — measured by the amount of communication with distant networks — when lockdowns were issued. When lockdowns were eased, team isolation improved. We saw this trend in other countries as well, like Korea.

This data supports our hypothesis: remote work makes teams more siloed, but adding some in-person time back to the workplace will help.

The pandemic has changed the world in many ways.  There's no going back.    

A terrible year it has been. Now, roll up your sleeve!

Earlier this morning, I emailed my colleagues marking the completion of a year since the World Health Organization (WHO) declared coronavirus to be a global pandemic.

Sending that email is consistent with how I behave: I mark the passing of time, whether it is birthdays or deaths or, yes, even the awful pandemic.

Even as we struggled with the pandemic, here in Oregon we also had to deal with unprecedented fires and smoke, and snow/ice storms that triggered power outage also.  And, oh, I am also waiting for the final layoff decision, which could send me into premature retirement.

No wonder I am anxious all the time, and panicky quite a bit.

But, hey, I am alive.  Beats the alternative, right?

Like millions around the world, I am waiting for my turn to get vaccinated. A year ago, when the pandemic forced us to learn about a whole bunch of epidemiology, experts suggested that a vaccine might be not available for a while, and that it might take 18 to 24 months.

The reality has turned out to be much, much rosier than that.  Scientists set out to develop a vaccine well before WHO's announcement, and as soon as the coronavirus structure was figured out.  As I noted in this post about the Turkish immigrant scientists in Germany who developed the vaccine that Pfizer markets and distributes:

BioNTech began work on the vaccine in January, after Dr. Sahin read an article in the medical journal The Lancet that left him convinced that the coronavirus, at the time spreading quickly in parts of China, would explode into a full-blown pandemic.

They began the work in January of 2020!

If not for the scientific advancements, the past year would have been even more disastrous for humans.  Beyond our wildest imaginations!

Now, a year after WHO's determination that it was a pandemic, a summer of near-normalcy seems within reach.  

Wait for your turn to get jabbed. 

A year into the pandemic :(

On February 28th,  year ago, we had the first confirmed case of Covid-19 here in Oregon. 

We must continue to keep each other safe by wearing masks, avoiding gatherings, and maintaining distance.

But, while we must continue to keep our physical distance from one another, we will get through the rest of this pandemic the same way we have come this far: together.

— Governor Kate Brown (@OregonGovBrown) February 28, 2021

The following is an unedited post from a year ago--from March 1, 2020.

********************************************************************

During the H1N1 scare, when I was visiting India, one of the relatives simply pooh-poohed the global worries by declaring that the virus is not new and that it has always been there.  Having learnt my lessons well, I decided that I would not argue with fools like him.  I smiled.  He then launched into a rant about how the controversy was manufactured by the pharmaceuticals industry.

More than a decade later, as I recall those interactions, I am now amazed at how much conspiracy theories have always been there even in medical contexts.  With every real threat, there are always nutcases that spout crazy theories.  Now it is COVID19.  The most recent Presidential Medal of Freedom honoree said this: “The coronavirus is the common cold, folks”.  He continued on: “It looks like the coronavirus is being weaponized as yet another element to bring down Donald Trump”.

As public health experts warn that the spread of the coronavirus is inevitable and urge Americans to take precautions, the pro-Trump media world has presented the subject as more fodder for partisan debate.

And then there are the rest of us who don't care about crazy conspiracies, but instead focus on the science and the evidence.  We understand the importance of this: "Getting ready for the possibility of major disruptions is not only smart; it’s also our civic duty."

It is a civic duty.  Indeed.

We should prepare, not because we may feel personally at risk, but so that we can help lessen the risk for everyone. We should prepare not because we are facing a doomsday scenario out of our control, but because we can alter every aspect of this risk we face as a society.
That’s right, you should prepare because your neighbors need you to prepare—especially your elderly neighbors, your neighbors who work at hospitals, your neighbors with chronic illnesses, and your neighbors who may not have the means or the time to prepare because of lack of resources or time.

I might be healthy enough that the virus might just about make me sneeze a few times.  But, I could also be spreading the virus through the sneeze. Or by carrying it in my fingers.  We need to play our part to flatten the curve of how it spreads:

Epidemiologists often talk about two important numbers: R0 or how infectious a disease might be, expressed as the number of people that are infected by each person who’s been infected; and the case fatality ratio (CFR): the number of people who die as a result of being infected. For example, an R0 of two means each infected person infects two people on average, while a number less than one means the disease is likely dying out in the population.

The CFR is out of my individual control--that is the task of the government machinery and hospitals and various organizations.  But, I can personally address the R0.

The infectiousness of a virus, for example, depends on how much we encounter one another; how well we quarantine individuals who are ill; how often we wash our hands; whether those treating the ill have proper protective equipment; how healthy we are to begin with—and such factors are all under our control. After active measures were implemented, the R0 for the 2003 SARS epidemic, for example, went from around three, meaning each person infected three others, to 0.04. It was our response to SARS in 2003 that made sure the disease died out from earth, with less than a thousand victims globally.

So, what are the estimates of R0 in the case of COVID19?  It is a wide range at this point, as epidemiologists try to make sense of the data.

Meanwhile, an epidemiologist cautions: “things are going to get shut down. And this virus is probably going to be with us for some time to come. It might become endemic, like measles.”

Who you gonna believe?  This President and the likes of his Presidential Medal of Freedom honoree on Faux News, or public health experts?  Oh, of course, if you are reading this, it means you are not one of the 63 million here in the US.  Good for you for being a responsible citizen!

When developed countries are worse

When Covid went global, we worried in our own ways about nightmarish scenarios in India, Bangladesh, Pakistan, Nigeria, and other countries.  These are countries with huge populations, and with very little medical infrastructure.

I was practically getting panic attacks from thinking about the old country.  My sleep was getting disturbed, and no amount of playing bridge was of help.

A year into the pandemic, conditions in India and elsewhere have become a medical mystery, which Siddhartha Mukherjee writes about in The New Yorker: "While the virus has ravaged rich nations, reported death rates in poorer ones remain relatively low." 

[If] you look at the pattern of covid-19 deaths reported per capita—deaths, not infections—Belgium, Italy, Spain, the United States, and the United Kingdom are among the worst off. The reported death rate in India, which has 1.3 billion people and a rickety, ad-hoc public-health infrastructure, is roughly a tenth of what it is in the United States. In Nigeria, with a population of some two hundred million, the reported death rate is less than a hundredth of the U.S. rate. Rich countries, with sophisticated health-care systems, seem to have suffered the worst ravages of the infection. Death rates in poorer countries—particularly in South Asia and large swaths of sub-Saharan Africa—appear curiously low.

How do we explain this?

Mukherjee goes through the typical hypothesis you and I might propose--from younger population to prevalence of infectious diseases leading to immunity, to undercounting , to ... you name the possibility and Mukherjee addresses them all. It is a wonderful read, and an awesomely informative one.

Towards the end, Mukherjee writes:

The covid-19 pandemic will teach us many lessons—about virological surveillance, immunology, vaccine development, and social policy, among other topics. One of the lessons concerns not just epidemiology but also epistemology: the theory of how we know what we know. Epidemiology isn’t physics. Human bodies are not Newtonian bodies. When it comes to a crisis that combines social and biological forces, we’ll do well to acknowledge the causal patchwork.

Meanwhile, another Indian-American medical writer, Atul Gawande reports on the worst-hit county in the worst-hit state in the worst-hit country.  The county is the US.  North Dakota is the state.

Gawande writes:

When an entire community must decide how to tackle a serious problem—must choose what it is and is not willing to sacrifice—matters get more complicated. In business, the decision-maker is generally clear, and, if you don’t like the decision, too bad. The boss can insist on obedience. But that’s not how democracy works. We designate decision-makers, but the community has to live with dissent. This is why businesspeople so often make terrible government leaders. They’ve never had to manage civic conflict and endure unending battles over priorities and limits.

Keep in mind who presided over the federal government when the pandemic broke.

As of writing this post, 510,458 have died because of Covid here in the US.

I hope we will learn the lessons from this pandemic and be absolutely ready for the next one.

Is there a vaccine for loneliness?

"All of humanity’s problems stem from man’s inability to sit quietly in a room alone.”

Well, maybe "all" is an exaggeration.  But, most people do seem to be unable to sit quietly in a room with other people or by themselves.

Covid is testing our abilities to sit quietly in a room alone.  Like the recent case of a woman who was placed in a 14-day mandatory hotel quarantine upon returning from abroad.  The woman couldn't stand her loneliness, I suppose; the hotel security caught her and a man working in the hotel in an inappropriate encounter.  He was fired. 

That quote about man's inability to sit quietly is from 1654.  All I am saying is that this is not a new problem.

There is a difference between loneliness and solitude.  A huge difference.

One can be in the middle of the noisiest and tightest crowds like in the congested Ranganathan Street and yet feel lonely.  Loneliness is a state of mind where the person is craving for company because the person does not like being alone. Perhaps even hates being alone.

Solitude is different.

Solitude is not boredom either.  Boredom begins when people do not know what to with their "free" time. Solitude is intentional.  It is activity even when being inactive, or inactive even when being active.  It is that wonderful combination of actively doing nothing while being all by oneself.

We do not often seek loneliness, but there are times that we seek solitude.

You end up isolated if you don't cultivate the capacity for solitude, the ability to be separate, to gather yourself. Solitude is where you find yourself so that you can reach out to other people and form real attachments. When we don't have the capacity for solitude, we turn to other people in order to feel less anxious or in order to feel alive. When this happens, we're not able to appreciate who they are. It's as though we're using them as spare parts to support our fragile sense of self. We slip into thinking that always being connected is going to make us feel less alone. But we're at risk, because actually it's the opposite that's true. If we're not able to be alone, we're going to be more lonely.

"If we're not able to be alone, we're going to be more lonely."

Loneliness is a serious health issue.

The health implications of loneliness have become clearer over time. According to the research of Julianne Holt-Lunstad, professor of psychology and neuroscience at Brigham Young University, and colleagues, the heightened risk of mortality from loneliness equals that of smoking 15 cigarettes a day or being an alcoholic, and exceeds the health risks associated with obesity. Researchers are now actively studying the mechanisms by which loneliness affects health, including its relationship with inflammation and harmful changes in DNA expression.

Now, add the effect of COVID-19--the social distancing and shelter-in-place and more.

“A major adverse consequence of the COVID-19 pandemic is likely to be increased social isolation and loneliness,” argued several professors in The Lancet Psychiatry in April. “Tracking loneliness and intervening early are important priorities.”

We have to wait for the world to be vaccinated for us to end this new wave of loneliness.  It will be quite a wait though :(

The philosophy of life?

We are into the second year of the pandemic.

On January 21, 2020, there was confirmation of Patient One.  Six weeks after that, schools and offices closed, and working from home became the norm.

We knew that eventually vaccines will be needed to deliver us from the pandemic.  We knew that right when schools and offices closed.  Many of us assumed that the machinery of the government would create various task-forces in order to deal with the multiple aspects of vaccine delivery.

While that assumption is logical, it did not work out that way.  It has been a colossal failure.

They didn't even bother to layout a clear plan for priority among the population.  Who gets the vaccine first?  Who are the people who can be sent to the back of the line for vaccination?  Even worse has been the messaging about it.

The World Health Organization (WHO) developed a blueprint, which notes: "Setting priorities and rationing resources in this context means making tragic choices, but these tragic choices can be ethically justified. This is why we have ethics."

That is why we have ethics.  What a concept!

A commentary, in The American Journal of Medicine, on the ethical dimension of allocating vaccines during a pandemic, reminds us that "the benefits of vaccines are communal in the sense that vaccinating 1 individual confers benefits on other members of the community as well. What is to be fairly allocated, then,is not the vaccines per se but, rather, the benefits thereof."

If it is about the benefits of vaccination, then who gets priority?  What are the ethics in this?

Allocating vaccines to those most responsible for the trans-mission of COVID-19 may confer more benefit to the population at large. Allocation guidelines must balance the obligation to assist individuals most likely to benefit against the obligation to secure the greatest aggregate benefit across the population.

The greatest benefit across the population.  So, who gets priority?

It is one hell of a tough question, and I don't want to pretend that I know better than others.

Think about a person like my 91-year old father, who hasn't stepped out over the year, versus a 31-year old high school teacher.  Vaccinating which of these two will "secure the greatest aggregate benefit across the population"?  The elderly, in this logic, will have to step away from the line for now, right?

WHO notes in that blueprint that the population "falling into each category may change over time."  This is also something that leaders should have communicated to people, right?  They did not.

So, it is clear that confusion will reign.  "Is there something that you would offer us as a general guideline as people wait their turn?"

Maybe it's a time to think about character and personal values and emphasize the importance now more than ever of the virtues of patience, of empathy, of recognizing that not everybody can protect themselves the way perhaps I might be positioned or you might be positioned to protect themselves from infection and disease, and of solidarity. It maybe is a little bit too trite to say that we're all in this together. Some of us are suffering far more than others of us, but we are all really suffering. And so if we can remember - right? - to be patient, to be empathetic and to be committed to making this world better than it was before, I think we can get through this.

As we wait our turns, perhaps we can also read up and think more about ethics.  We don't have to abandon that effort just because philosophy departments are being closed down!

We fiddle ... while Rome burns :(

Consider this:

If a corporate executive gets a $100,000 bonus for steering a company through a difficult year, while four $25,000-per-year restaurant workers lose their jobs entirely, the net effect on total compensation is zero — even though in human terms a great deal of pain has been incurred.

This is a perfect illustration of why quantitative literacy is important in this modern world.  I wonder what percentage of a literate population, heck even college graduates, will be able to make sense of that simple arithmetic.  I have done my part to educate a few and will perhaps have one final opportunity in the fall term that could even be in the real world, after all the virtual interactions.

It is also a perfect illustration of why we need an economic restructuring, and create a new political economy that will address the human suffering when four workers lose their jobs.

So ... "Even as millions of individuals faced great financial hardship this year, Americans in the aggregate were building savings at a startling rate."

One of the most counter-intuitive outcomes ever, right, when we might have expected differently in what has been awful loss of jobs?

The trend became clear six months into the pandemic.  Professionals and high-income earners didn't seem to lose jobs.  Low-wage workers bore the brunt of the recession.

Back in September, as the university's president and his aides were developing the plans for firing quite a few tenured and adjunct faculty and staff because of the Covid-induced budgetary crisis, I wrote to the president: "It certainly is surprising that Oregon’s current budget won't be significantly affected by COVID-19, and that projections into the future might not be that dark after all."  Always evidence-based in my arguments, I attached the report from the Oregon Office of Economic Analysis.

It has been more than three months since I sent that email; I am yet to hear from the president or his aides.  I suppose I will soon hear from them!

Will there be protection for low-wage workers not only through this pandemic but--and more importantly--even after conditions return to "normal"?

I worry it won't.

Why this pessimism?

For the same reason that I have offered many times.  Like here:

I will once again say the same thing: We work out the solutions politically.  Unlike a challenge of how to get humans to the moon and back, or how to vaccinate people, these are not technical issues.  In a democracy, we are, therefore, at the mercy of voters and politicians.

At the mercy of politicians.  Picture in your mind the likes of mItch mcConnell, tEd cRuz, mArco rUbio, kEvin mcCarthy, ... who will do everything that they can to stop doing anything good for the less-privileged, even as they kiss rich white asses!

Your money or your health?

"I'm worried about the surge," my friend said as he prepared to roll the garbage can home from the street.

Neither one of us can understand why some people refuse to follow the public health protocols.  Nine months into the pandemic, it is no longer about any lack of information about the virus and the damage it could cause to the infected person.  If the specter of being lonely in the hospital and perhaps even intubated doesn't humble them enough to wear a mask and maintain a social distance, well, what will?

What motivates these deviant minds?

Researchers set out to do just that: "Just who are these unmasked deviants, and what motivates them to ignore COVID-19 restrictions?"

I would hypothesize a few motives: Money (jobs/income); youthful indiscretion; and political affiliation.

What did the researchers find from 60,000 responses from more than 30 countries?

not a single country ranked the likelihood of getting infected with COVID-19 as a higher risk than suffering economic consequences stemming from the coronavirus. On average, people around the world are more motivated by their wallets than their health.

So, the jobs/income motive hypothesis is validated.

In many countries experiencing second and third waves, there are people who simply ignore or actively protest against governmental restrictions on their movement.The politicization of COVID-19 suggests that people have other pressing concerns that motivate them to de-emphasize the pandemic.

Do these people protest because the restrictions affect their jobs and incomes, or ... The article doesn't include a discussion on this.

The youth angle? "age is not a reliable indicator of rule flaunting."  Interesting.  This finding contradicts the general opinion that is ready to blame the youth.

So, what can be done?

To help mitigate financial strains, a key concern of publics around the world, policy makers can do more to support state-run welfare systems and encourage private solidarity. To depoliticize virus control, bipartisan leaders can communicate the long-term economic benefits of virus control. To reduce grievances, there can be public recognition of essential workers and less blame applied to entire groups. In other words, we recommend a focus on addressing human needs and motivations that could determine whether individuals are willing and able to participate in virus control.

Bipartisan?  With these maniacal Republicans actively engaging in partisan politics contesting the election results and telling their voters that Covid is a hoax?  Bipartisan ain't gonna happen!

Focusing on human needs?  Of course we must.  But, not with these maniacal Republican leaders who are eager to help only one kind of a person--corporation!  A bipartisan deal is not looking possible anytime soon.

Such is life in the good ol' US of A!

Wait

These are stressful times in many ways.  Not that life in 2019 was hunky-dory, before pandemic became a household word in 2020.  Living has never been without stress, but COVID-19 has taken us all to a whole new level of stress.

Prior to the global pandemic, America had already been dealing with a host of pervasive stressors such as health care access, mass shootings, climate change, rising suicide rates, and an opioid epidemic. Fast forward to the present day, as our country continues to struggle with our new reality amidst the global pandemic, select groups of our country are facing greater stress and poorer outcomes.

A few months ago, in my Twitter feed, I read a comedian's comment that the coronavirus has made us forget mass shootings because we are not gathering in groups anywhere now--not in schools, churches, movie halls, and open-air concerts, which have all been the favored venues for the armed sociopaths.

Re-working another comedian's joke, I wonder how many of us ever thought in 2019 that it was one heck of a good year and that the year that followed--2020--would suck.

We feel acedia.  We feel lots of things.  We are dealing with stress.  

[Many] Americans are taking their anxiety, frustration, anger and stress out on their jaws and teeth. “There’s effectively an epidemic of jaw muscle pain in the country right now because of COVID,” said Dr. Mark Drangsholt, chair of the Department of Oral Medicine at the University of Washington’s School of Dentistry.

I suppose the jaw, not the entire face, is the index of the mind!

Here's one easy way to unclench your jaw, and to put your worries and stress aside.

Listen to Wait, read aloud by Amanda Holmes.

Maria Popova writes that Galway Kinnell's poem addresses the "elemental question of existence with extraordinary compassion and spiritual grace in a poem he wrote for a student of his who was contemplating suicide after the abrupt end of a romance."

The poem works for any kind of disappointment, frustration, stress, anxiety, anger, ...

I’m feeling acedia

Perhaps the title of this post is all Greek to you.

It should be.  

Etymologically, acedia joins the negative prefix a- to the Greek noun kēdos, which means “care, concern, or grief”.

Of course, the moment that we read that, we might jump to the conclusion about the negative of "care, concern, or grief" to be something like apathy.  Not so.  The author writes that "acedia is much more daunting and complex than that."

So, what does acedia mean, and why blog about that now?

We are trapped in this age of the coronavirus.  We are working from home (if we are lucky enough.)  Sit-down restaurants have become distant memories.  Travel we can only dream about.  Even friends and relations, well, we keep away from them.

In such a setting, it seems like everything is a drag.  Even though we have all the time to do stuff, it ain't happening.  At the same time, months have gone by really quickly.

Acedia.  "We’re bored, listless, afraid and uncertain."

Often we catch ourselves wondering if we are coming or going.  We begin to do something, and soon decide it is not worth the time.  We are all feeling acedia.

John Cassian, a monk and theologian wrote in the early 5th century about an ancient Greek emotion called acedia. A mind “seized” by this emotion is “horrified at where he is, disgusted with his room … It does not allow him to stay still in his cell or to devote any effort to reading”. He feels: 

such bodily listlessness and yawning hunger as though he were worn by a long journey or a prolonged fast … Next he glances about and sighs that no one is coming to see him. Constantly in and out of his cell, he looks at the sun as if it were too slow in setting.

Recognize this emotion now?

Can you do anything about it?

Decrease your engagement with the media.  That itself will do you a lot of good.  Maintain your relationships with the friends and relatives who matter to you.  And, "maintain healthy sleep, exercise, food and drink habits. Keep a journal, too. Research shows that expressive writing helps people process difficult emotions and find meaning."

Blog, like I do.  Eat, drink, and be merry.

Oh, it is totally ok to admit that you, too, are feeling acedia.

Immigrants and Project Lightspeed

The tRump regime--"administration" doesn't really describe it--loudly and openly beat up on immigrants and Muslims.  Remember how one of the first things he tried to do was a blatant Muslim ban?  He then had to scale it down and pretend it was not really a Muslim ban when it was.

During those dark days, social media--from the anti-tRump side--pointed out how Apple might not have happened if a certain Syrian immigrant had not come to the US.  Steve Jobs' biological father, Abdulfattah Jandali, was an Arab Muslim from Syria, who came to the US to pursue a PhD.

Now, it is another Muslim immigrant to the rescue.  Make that two immigrants.  Not here in the US, but in Germany.  But, it is also an American story.

Scientists have greeted with cautious optimism a press release declaring positive interim results from a coronavirus vaccine phase III trial — the first to report on the final round of human testing.

New York City-based drug company Pfizer made the announcement on 9 November. It offers the first compelling evidence that a vaccine can prevent COVID-19 — and bodes well for other COVID-19 vaccines in development.

Pfizer being a US-based company.  But, the immigrants who provided the scientific breakthrough are not here.  They are in Germany, born to Turkish immigrants.

Dr. [Ugur] Sahin, 55, was born in Iskenderun, Turkey. When he was 4, his family moved to Cologne, Germany, where his parents worked at a Ford factory. He grew up wanting to be a doctor, and became a physician at the University of Cologne. In 1993, he earned a doctorate from the university for his work on immunotherapy in tumor cells.

Early in his career, he met Dr. [Özlem] Türeci. She had early hopes to become a nun and ultimately wound up studying medicine. Dr. Türeci, now 53 and the chief medical officer of BioNTech, was born in Germany, the daughter of a Turkish physician who immigrated from Istanbul.

BioNTech is the firm that the couple founded.

BioNTech began work on the vaccine in January, after Dr. Sahin read an article in the medical journal The Lancet that left him convinced that the coronavirus, at the time spreading quickly in parts of China, would explode into a full-blown pandemic. Scientists at the company, based in Mainz, Germany, canceled vacations and set to work on what they called Project Lightspeed.

They partnered with Pfizer, whose CEO is Greek!

Albert Bourla was born and raised in Thessaloniki, Greece.^[2] Born into a Jewish family, he earned his doctorate in the biotechnology of reproduction at Aristotle University of Thessaloniki's Veterinary School.^[3] He left Greece with his wife when he was 34 and since then he has lived in seven different cities, in four different countries.

The tRump regime eagerly broadcast the Pfizer success as one that was made possible through its Operation Warp Speed.  Controversies are in plenty on how much Warp Speed really made it possible.  Whatever that might be, did the regime say anything about how it was immigrants who created this success?  Did the regime say anything about the Turkish Muslim backgrounds of the two scientists in Germany?

I am glad that the fucking tRump regime is on its way out, though they will torch everything they possibly can during the exit.  I can only hope that we Americans have inoculated ourselves against that kind of a political virus.

Meanwhile, I hope that the Pfizer vaccine and the others under development will deliver us from the global pandemic in a matter of mere months from now.