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Tuesday, January 18, 2022

With 100M adults fully vaccinated COVID-19 improves in U.S., but the disaster in India is growing

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How long you’ll be immune to COVID-19 could be written in your blood

On Thursday, NPR reported a new kind of COVID-19 test being created at the University of Oxford. The university—which was also key to developing the AstraZeneca vaccine widely used outside the United States—is engaged in an experiment that involves deliberately exposing volunteers to the SARS-CoV-2 coronavirus. That idea alone may seem scream-worthy, but all the volunteers in this experiment are those who have recovered after previously being ill with COVID-19.

That doesn’t mean this exposure is completely safe, because the whole point of this experiment is to see which, if any, of the volunteers get sick for a second time. The hope is that by carefully monitoring antibody levels in the blood of these volunteers, researchers can pinpoint a minimum level necessary for providing protection against the virus. So, check volunteers for antibody levels, expose them to virus. Wait. Repeat until someone gets sick.

At the end of this, researchers should have a very good idea whether a certain level of antibodies can be connected to complete protection, as well as whether lower levels will provide protection enough to mean that a second infection is either asymptomatic or mild. 

From that, researchers hope to work backwards to a statement that would let scientists provide some more definitive statements about the duration of protection provided by vaccination, as well as by previous infection. Based on continued monitoring by vaccine companies, it’s already known that some vaccines provide protection for at least six months. However, it’s hard to project whether that protection will extend into the future because the vaccines simply haven’t been around that long. With the pandemic itself having been around for months before the first vaccines rolled out in large-scale trials, testing those who have previously been infected gives researchers a view into the future. 

Unfortunately, even if researchers do come up with that magic number (and there’s no guarantee, as the immune system contains a good deal more moving parts than just antibodies, which could prove to not be all that predictive) it will only provide an average duration for protection by vaccines. That’s because everyone’s immune system is different. 

The best we can hope for is that very, very few of the people in this experiment get ill over the next few months, indicating that protection from COVID-19 is long-lasting, whether generated by infection or vaccine. That could also signal other vaccines that didn’t produce the desired level of antibody production—like the vaccine from Sanofi and GlaxoSmithKline, which was halted even though it was actually the largest recipient of funds from Operation Warp Speed—might also be effective.

COVID-19 and the failure of Republican governors

Over a year into the pandemic, there is no end to the statistics available when it comes to cases, deaths, or vaccinations. Some of those numbers are still in flux, but when it comes to the United States some values are now so etched in stone that—barring a significant new outbreak—they’re unlikely to change.

With that in mind, it’s worth revisiting the evidence that the absolute failure of Republican policies when it came to protecting the public against the virus extended way beyond Trump. Across the country, Republican governors and even local officials also share in the blame.

For example, the top 10 states when it comes to cases of COVID-19 by population are: North Dakota, Rhode Island, South Dakota, Iowa, Tennessee, Utah, Arizona, Nebraska, Oklahoma, and South Carolina. Just one state out of 10 enjoyed Democratic leadership over the course of the pandemic. Instead, this list included Republican governors like Kristi Noem of South Dakota and Doug Ducey of Arizona, who proudly bragged about their failure to enact social distancing guidelines and their opposition to mask mandates.

The difference is even more stark when looking at neighboring states. Tennessee had a 20% higher rate of infection compared to Kentucky, and that was in spite of a Republican supermajority in the Kentucky legislature doing everything possible to hamstring Democratic Gov. Andy Beshear. Democratic Gov. Michelle Grisham led her state to a 21% better rate than neighboring Arizona. In Minnesota, the policies of Democratic Gov. Timothy Walz produced a 28% lower rate of infection than either of the adjacent Dakotas. 

This sort of pattern is consistent across the nation. There’s only a literal handful of Democratically controlled states in the top 20 by rate of infection, and all but one are states that were blindsided by the initial outbreak before either testing or treatment was available. Solid estimates have suggested that 400,000 Americans have died because of bad policy decisions by Donald Trump. Of the remainder, a significant fraction is due to bad policies proudly declared by Republican governors. 

And it doesn’t stop at the state level. In Texas—home to two of the top 10 counties when it comes to deaths per capita—at least eight sheriffs declared they would not enforce mask mandates, or even require their deputies to wear masks. Republican sheriffs in Arizona, Michigan, North Carolina, California, New Mexico, Tennessee, Washington, and Nevada made similar statements. That included claims that mask mandates were unconstitutional, or unenforceable.

One of those sheriffs—Republican Rob Snaza of Lewis County, Washington—became a “hero” after he gave a viral speech calling Washington Democratic Gov. Jay Inslee an “idiot,” attacking neighboring sheriffs who did enforce a mask mandate, and calling everyone who donned a mask a “sheep.” Washington State, despite being caught up in one of the first outbreaks in the nation, is currently number 47 out of 50 states when it comes to rate of infection. Under Inslee’s leadership, the state has seen infections at half the rate of Republican Ron DeSantis in Florida, and just over a third the rate of Kristi Noem.

Out of every governor in the nation, if there’s one to pick who did the best job of handling the pandemic in spite of being handed a horrible situation, it was Inslee. 

Meanwhile in India

Accusations of vaccine hoarding against the United States as well as wealthy nations in Europe and the Middle East are being highlighted by the growing disaster in India. Despite producing 60% of the world’s pharmaceuticals and being a major manufacturer of COVID-19 vaccine, India is now facing a desperate shortage. But really, the decisions that drove India to over 386,000 cases on Thursday and seem set to break that number on Friday didn’t involve a shortage of vaccine. They involved dropping everything else while relying on vaccine.

The decision by Prime Minister Narendra Modi to drop almost all restrictions, resume holding massive campaign rallies, and allow a religious pilgrimage that saw millions moving across the nation opened the door for disaster at the time when not only were new, aggressive variants becoming dominant, but cases in India were already surging.

Modi apparently believed India could be vaccinated out of danger, but the rollout of the process was at least as flawed as the initial distribution of vaccine in the United States. And just as the beginning of U.S. vaccinations in December of 2020 could not stop a spike in cases that soared to a new record in the following months, India’s attempts to jab through a rising number of cases has barely been a speed bump to an epidemic that is rolling along at ever-increasing speed.

Daily cases of COVID-19 in India continue to break records.

In the last week, there is a slight indication that the rate of increase may be slowing. The curve isn’t exactly flattening, but at least it might have stopped steepening. However, the rate of positive tests in India is extremely high—almost 20% every day of the last week. Combined with multiple statements complaining of test shortages, and complaints that daily death counts over 3,000 don’t come close to the number of bodies being burned at 24/7 makeshift crematoria in parks and parking lots, it’s unclear whether any of the numbers in India show anything other than that the situation is bad and getting worse.

As The Washington Post reported on Thursday, this is leading to a wave of unrest that could potentially unseat Modi and reverse what seemed to be an untouchable majority in Indian politics. Modi’s reputation as a Hindu nationalist who was also a technologically savvy leader ready to lead India forward to a position where it contended with China and the U.S. for the top spot on the global stage is “in tatters.” Opposition leaders are openly calling for Modi’s resignation as the situation there is being called “a crime against humanity.”

But while the portion of the backlash directed at the United States may focus on freeing up more doses of vaccine more quickly, it’s clear that’s not what India needs most at the moment. With a healthcare system that’s completely overwhelmed, what India needs is oxygen, ventilators, and people who know how to use them. What’s really horrific is that, when a nation of 1.4 billion is ill, there may not be enough resources in the world to prevent catastrophe. But that doesn’t mean we shouldn’t try.


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