News from the Anti-Viral Front

I was very surprised to learn today that we may be just months away from an anti-viral treatment for COVID-19 - a pill that could reduce or eliminate the symptoms, both mild and severe, of the virus.  This is, apparently, not a surprise to those who understand the world of viruses, because anti-viral medications are already playing a big role in our healthcare landscape:

“Oral antivirals have the potential to not only curtail the duration of one’s Covid-19 syndrome, but also have the potential to limit transmission to people in your household if you are sick,” said Timothy Sheahan, a virologist at the University of North Carolina-Chapel Hill who has helped pioneer the therapies.

Antivirals are already essential treatments for other viral infections, including hepatitis C and HIV. One of the best known is Tamiflu, the widely prescribed pill that can shorten the duration of influenza and reduce the risk of hospitalization if it is given quickly.

I was not familiar with Tamiflu, although the fact that I've never had a serious case of the flu may have something to do with that.  And I keep reading that AIDS is a virus and is treated with an anti-viral, and I keep forgetting.

So now, encouraging news about a COVID anti-viral - by Christmas?  The new year?

At least three promising antivirals for Covid are being tested in clinical trials,* with results expected as soon as late fall or winter, said Carl Dieffenbach, director of the Division of AIDS at the National Institute of Allergy and Infectious Diseases, who is overseeing antiviral development.

“I think that we will have answers as to what these pills are capable of within the next several months,” Dieffenbach said.

So - to our short list of things we are pretty sure we'll find in the new world, we can add a medication that will effectively treat COVID - if taken early in the course of the infection.  

This is good news for those of us medically vulnerable folks who are looking ahead to the world of endemic COVID.  If the COVID vaccine can be included in our annual flu shot, and we have medication that will reduce the symptoms and limit transmission, maybe we can upgrade our picture of post-pandemic life.

 * = Here are the study details.

The New World is Not an Island; It's a World

Here's something that's true about the reporting on the pandemic and, specifically, the "end" of the pandemic:  the stories are just about the United States.  When the phrase "the end of the pandemic" is used, it actually means "the end of conditions in the United States which remind us that there's a pandemic, and the beginning of conditions which have some resemblance to normal life."  Using this understanding, we can see the "end" of the pandemic, anywhere between late 2021 and mid-2022.  However, long after we've declared, victory, the pandemic will still be raging in the rest of the world, with a non-zero chance of raging right back here with some new variant.

However, that doesn't mean that there's nothing of interest in this kind of reporting.  Researchers at Penn State are "co-coordinating" work by a consortium of researchers who are, in turn, consulting with the US Centers for Disease Control and Prevention (CDC).  The “COVID-19 Scenario Modeling Hub"* has combined nine different research projections, using mathematical models, and we are told -

The most likely scenario is that children age 5 to 11 will be approved for vaccination and that no new superspreading variant will emerge... In this case, by March 2022, COVID-19 infections across the United States could slowly and steadily drop from about 140,000 per day today to about 9,000 per day, and deaths could decline from about 1,500 per day today to fewer than 100 per day.

As I've said elsewhere (and don't remember where), we won't know we're at the end of the pandemic unless we have a definition of what that means.  In this case, that means "fewer than 100" deaths per day.  You can pick a number below 100 and do the math, but the higher of those numbers brings us within the range of the historic annual death toll from the just plain normal flu.  

So we'll know we've reached the new world - and this will be, apparently, next March - when COVID is killing about as many of us as flu has in the past.  Assuming that the just plain normal flu will continue to kill us (the upcoming flu season is being described as "severe"), that in the new world, some kind of flu will be killing twice as many of us as some kind of flu did before COVID.

All of which assumes, of course, that the pandemic in the rest of the world will not intrude on our pandemic-free haven.  Sounds like a mirage to me, and a new world that I'd prefer to move through on the way to a truly healthy world world.

 * = Don't follow this link unless you know all the statistical jargon.

Public Service

I've gone way too long without acknowledging Annie Laurie, at Balloon Juice, who has, nearly every day for a year and a half, put up an extensive post with COVID updates from around the world.  It shows up around oh-dark-thirty every morning, and if you only read one COVID post on a regular basis, this should be it.

Thanks, AL!

Lookout report

No sign of land yet.

Follow the link to stay up-to-date on the progress toward the new world.

The Social Office

Remember WFH?*  I have no intention of trying to solve this problem - mostly because it is still a problem, in that no one seems able to predict what percentage of workers who can will be working from home once we have become comfortably ensconced in the world of endemic COVID, which, it seems, will be how we know the pandemic is over.

This seems like a pretty simple issue, but it has become about as complex as possible.  Kevin Drum has weighed in again (be sure to read the comments), as has Ed Zitron (ditto).  The New York Times has something to say, as well, but that article is almost universally an object of scorn, especially among those who feel that managers who insist that WFHers return to the office are playing out a capitalist agenda which has nothing to do with their employees' efficiency or, heaven forbid, satisfaction.  Lots is being written, but I'll let you find it yourself.

What I have to add to the debate involves social skills.  Like so many "statistics" and "studies," approaches to studying the effects of WFH treat all remote workers the same, as if there were no differences among them as regards characteristics which are essential to understanding what is happening.

And a "characteristic which is essential to understanding" is the individual's social skills, and therefor their comfort with socialization.  Working in an office requires that the employee exhibit countless different social skills in the hundreds of personal interactions that occur each day, from passing someone in the hall to the hour and a half of "networking time" before a conference starts.  Some are naturally good at this; some are not.**  Those of us in the second group find those interactions stressful, because we're not sure we're going to be able to behave successfully in enough of them to stay out of trouble.

So the second group - those who are not good at these interactions - have been ecstatic about WFH, and would like to keep at it until the end of the universe.  This, of course, will come as a surprise to noone.

However, I wonder:  are those who are socially adept more likely to become managers because of those skills?  "It's not what you know, but who you know" refers, I think, to schmoozing and networking.  Those who can do it best get noticed, and promoted.

So are the managers who are advocating the return to the office really just lonely?  Their preferred environment was disassembled a year and a half ago, and they have spent the time planning to rebuild it.  

Add to this the possibility that these managers, who have found such success by being like they be, don't understand that it's a skill they've been blessed with, and that others in the office - good workers, productive, reliable - have not been blessed with those skills and really, really don't want to help them rebuild their social environment.

What do you think?  Where do you fall on the social distribution, and how do you feel about WFH?  

 * - Work From Home.  I know.  It's been a long time.

 ** - Those of you who are saying, "What skills?  You just go to work and interact with people normally!  What are you talking about?" are in the first group.

Behave Differently

COVAX notwithstanding, we are behaving the way we have always behaved:

We will not reach the new world until we have learned to behave differently.

Boost?

If the road to the new world goes through booster shots, then the new world will be further away than it is now.  Right now, every booster shot in a first world arm is a shot that is not in a third world arm.  Africa's vaccination rate is three percent.  Over a billion Africans remain unvaccinated.  Every shot that goes somewhere other than into an un-fully-vaccinated arm will make the pandemic longer and more people will die.

It's like those awful moral choice games people play - the train full of people, the bridge, and your son, for instance.  My first impulse was to refuse the booster until Africa is 70% vaccinated, but that's beginning to feel a little hyperbolic.  What do you think?  Booster or not, and why?

More Patience

 

Just how long do you expect this plague to go on?

                                                                                                   The New Yorker, August 30

As we know, the plague referenced in the cartoon is still with us - it "went on" indefinitely.  There have been three major outbreaks - pandemics - including one on the 20th century.  

Abbey and I were startled, to say the least, last Sunday when the pastor announced, "COVID is over!"  Turns out he was celebrating the possibility of a women's conference in November, which will, if all goes well, be held under pre-COVID rules.  As for us, however, we still had our masks on.

As you know, I find it hard to resist the temptation to read any article with a title like "When Will the COVID-19 Pandemic End?"  This time, it was by McKinsey & Co., a wide-spectrum management consulting firm, and their take on the end of the pandemic - the arrival of the new world! - is extensive and comprehensive.

We've talked and read a lot about the endemic future of COVID, as a general concept, but what will it look like?  Well, it may look like "shifting the focus of public-health efforts from managing case counts to managing severe illnesses and deaths."  Singapore is heading down that road now.  

It will also include conversations about what level of risk we are willing to live with indefinitely.  To assist us in this conversation, we are presented with data regarding the "normal flu" that we've lived with all our lives; as we noted last time, it is not a benign disease.  In fact, the the US, there was a period of time this spring when COVID deaths and hospitalizations were occurring at a lower level than the ten-year average for deaths and hospitalizations for flu.  Here's some data for those who need it (you know who you are):

The graphs of flu hospitalizations and deaths are straight lines because they are a ten-year average, not discrete data points.

So we see that, if we can get the pandemic back to a point similar to where most places in the US were this spring, we may have an endemic equilibrium that we can live with.  Especially given that those of us who are vaccinated have a significantly lower chance of serious illness from COVID than we do from regular flu.  One way to look at it:  from the perspective of a vaccinated person, once the really scary waves in the unvaccinated states burn out, life should be able to go back to normal, although we probably won't be able to put our masks in mothballs.  For those who choose to remain unvaccinated - well, who knows.

McKinsey & Co. suggests that, given this perspective, the shift from pandemic to endemic management may take place as soon as the fourth quarter of 2021, and be complete in the first quarter of 2022, at least in many developed Western countries.  

So - the new world isn't in sight, but there seem to be rumors - actually, pretty credible stories - that we're heading in sort of the right direction.  Patience - and get the vax and wear your mask.