COVID-19: Vaccines and Air Travel

Written by Stafford Clarry, a senior NCF member in Iraq, this update explains some of the mechanisms that will (hopefully) make safe our travel via airlines in the future, as well as looking into the hunt for a vaccine.

Travel, especially air travel, requires thoughtful consideration and action. Rules, regulations, guidelines, and advice may vary from country to country, state to state, place to place.

On most modern, large commercial aircraft, air filters remove dust and moisture. More importantly, HEPA (high-efficiency particulate air) filters are installed to remove airborne microbes (bacteria, fungi, larger viruses and virus clumps). Of concern, however, is the path these microbes take as they flow through an aircraft before they are filtered out.

Covid-19 became a pandemic that has shut down the world within less than four months. Little is known about the behavior of this coronavirus and more is being learned daily. Medical observations of actual experiences are being collected and analyzed to determine significance and to recommend responses.

There are no vaccines and therapeutic drugs that have been approved for widespread use. Vaccines to prevent and drugs to treat covid-19 are being developed by many companies, institutions, laboratories, and foundations, largely in China, Europe, and the United States.

To avoid another thalidomide-type tragedy, all vaccines and therapeutic drugs must pass carefully conducted and approved testing procedures to determine effectiveness and safety. Successfully passing the first three of four phases of clinical trials that are required for approval can take at least 12 months, perhaps much longer. No rush, no shortcuts. Clinical trials on a few vaccines have begun and some progress is being noted.

Human “challenge studies”, are currently being considered and debated largely due to ethical considerations. These studies would deliberately expose volunteers to infection to test vaccines. They could speed up the development of a Covid-19 vaccine but would mean purposely infecting people with a disease that could kill them. See: https://www.wired.co.uk/article/coronavirus-vaccine-challenge-trial AND https://www.who.int/ethics/publications/key-criteria-ethical-acceptability-of-covid-19-human-challenge/en/


After effective and safe vaccines and therapeutic drugs are determined, production and distribution of many hundreds of millions of doses are the next challenges. Efforts are already being made to minimize the time involved.

In addition to production capacities, other challenges to be faced include:

  • Will the vaccine/therapeutic drug need to be refrigerated to maintain potency?
  • Will enough vials be available in view of the limited supply of raw materials to make medical glass and stoppers?
  • Instead of injections, are unrefrigerated drops and skin patches viable/effective options?

The coronavirus that causes the covid-19 disease is highly infectious and easily transmitted from infected persons to uninfected persons. This coronavirus has infected 213 countries and territories. Only uninhabited areas, the Polar regions, and a few remote inhabited islands in the South Atlantic and South Pacific have not been infected, so far.

Some infected persons are asymptomatic; they do not show symptoms. One study indicates that 80% of transmissions are caused by only 9% of infected persons. Outdoors is definitely safer than indoors, non-peak hours are safer than peak hours, non-crowded areas are safer than crowded areas.

While the risk cannot be completely eliminated, we need to learn to live with this coronavirus while minimizing risk. It may take at least another two years before effective and safe vaccines become available to all of us that would allow us to freely move again.

 

Quarantined Music – by Quarantined Musicians

This comes in from Ambassador Hambley, our senior NCF member in The United States of America. We thought you might be cheered up by it. He says, “I hope you enjoy this as much as I did!” :

And this from Stafford Clarry, our senior NCF member in Iraq: There are some things even a pandemic can’t stop. Perhaps something beautiful is rising up out of this pandemic. It is very much needed. 

All the music on the list below was produced by quarantined musicians within the past six weeks or so. Yes, some tunes are repeated by others. Mostly from Europe and North America, some are also from Africa, East Asia, and Australia. 

They are really quite amazing. The collection is a meadow of music to wander through and roam in. 

Take care of each other. “This won’t end for anyone until it ends for everyone.”–  Samantha Power, former US ambassador to the UN 

“We will get through this.”–  New York State Governor Andrew Cuomo 


 We Are the World – COVID-19 Tribute (Cover)
17 April 2020
https://youtu.be/2CEKm_4X520
ORFEOI TXIKIA koarentenan: ‘Lore dantza
14 April 2020
https://youtu.be/yW_vjiKHWEI
College Church Hallelujah chorus
12 April 2020
https://youtu.be/Ag6CYY0cbFc 
L’ONLyon vous réveille en musique pendant le confinement
11 April 2020
https://youtu.be/Y5XbC1oEe2s
Havana – par les musiciens confinés de l’Orchestre d’Harmonie Saint Jean le Vieux / Ambronay (OHSJA)
11 April 2020
https://youtu.be/JwBL0aqkxsI
We are the World (2020) | Together At Home Edition by Channel Aid, KHS & YouTube Artists
10 April 2020
https://youtu.be/0MWNW_a35oY
NHS Staff Choir sing ‘Lean on Me’ by Bill Withers
10 April 2020
https://youtu.be/bfbK9FBJ5BU
ROYAL CHORAL SOCIETY: Hallelujah Chorus in Isolation
10 April 2020
https://youtu.be/_PQYVbd1Gwg
Here Comes The Sun – Camden Voices (self-isolation/virtual choir cover)
10 April 2020
https://youtu.be/2xWUL4N26vM
A Hope or the Future
9 April 2020
https://youtu.be/eR_7P5_7kh4
2020: An Isolation Odyssey | 40 musicians play epic intro from Kubrick classic during UK lockdown
9 April 2020
https://youtu.be/nt8FhIVmR8M
Les musiciens de l’Orchestre philharmonique de Strasbourg en télétravail
9 April 2020
https://youtu.be/PNi51kBUs1o
YOU’VE GOT A FRIEND performed by the worldwide cast of BEAUTIFUL (in quarantine) for The Actors Fund
7 April 2020
https://youtu.be/CDdxXL6fdwA
From Our Homes to Yours: Milwaukee Symphony (Virtual) Orchestra performs Elgar’s “Nimrod”
7 April 2020
https://youtu.be/E8T7Y-E6E_w
Les musiciens de l’ONCT se réinventent!
7 April 2020
https://youtu.be/i3myMBJ28XY
Go Big & Stay Home – Socially Distant Orchestra Plays Wagner
6 April 2020
https://youtu.be/5KF9O7G_eC4
Thank You for the Music – Ukulele Orchestra of Great Britain
5 April 2020
https://youtu.be/eUeoUlvB-e8
Europa InCanto – 700 bambini cantano Nessun Dorma – Turandot
5 April 2020
https://youtu.be/MZWmikiJVIQ
Carmen
5 April 2020
https://youtu.be/5OXVKfvsayg
Bella Ciao/La Casa de papel – Musicians in Covid19 Quarantine – Delirium Musicum
4 April 2020
https://youtu.be/OZ5MOKJStYM
ORFEÓN DONOSTIARRA – DONOSTIAKO ORFEOIA: Hallelujah
4 April 2020
https://youtu.be/slPxyL8jwFs
The Lahti Symphony Orchestra: Sibelius: Finlandia op 26
3 April 2020
https://youtu.be/Sh1L-8T5hu0
A Boléro from New York: NY Philharmonic Musicians Send Musical Tribute to Healthcare Workers
3 April 2020
https://youtu.be/D3UW218_zPo
Un obsequio para el mundo | Edward Elgar, Enigma Variations, IX Nimrod – OSNC
31 March 2020
https://youtu.be/_dRYiPRqQKs
Philip Glass by Cello Octet Amsterdam feat. Maki Namekawa
1 April 2020
https://youtu.be/edHyyv3afwQ
Lockdown Sessions – Set You Free (N-Trance)
31 March 2020
https://youtu.be/_5imMhUsKqg
Remerciements – Le Boléro De Ravel interprété en confinement par l’Orchestre Philharmonique de Nice
30 March 2020
https://youtu.be/xEhPyT0mi8I
Aussie Pops Orchestra Phones It In – What a Wonderful World
30 March 2020
https://youtu.be/-Hc_1c_Ask0
Rise UP | Boston’s Children’s Chorus and other children’s choirs
30 March 2020
https://youtu.be/G_YDpP-nU6w
“Stayin’ Inside” – Corona Virus Bee Gees Parody
27 March 2020
https://youtu.be/nmUXntGlqFI
Roedean School (South Africa) – Hallelujah (Virtual Choir)
27 March 2020
https://youtu.be/3y51WWrYodI 
“Stayin’ Home” – Socially Distant Orchestra Plays Dvořák’s “New World”
27 March 2020
https://youtu.be/kayw0iXoK7g
A Virtual Choir in quarantine sing Florence + The Machine
26 March 2020
https://youtu.be/LEEn-OkOyUU
Kaleidoscope Orchestra Lockdown Sessions – Don’t You Worry Child (Swedish House Mafia)
24 March 2020
https://youtu.be/de8LYHWgjGM 
GRIEG – Holberg Suite – Preludium “á la Quarantine”
24 March 2020
https://youtu.be/iUGaXB-bJeA
Tonkünstler-Orchester / Tonkunstler Orchestra – Boléro
23 March 2020
https://youtu.be/ab58lYR50-Y 
Helplessly Hoping – il coro che non c’è
23 March 2020
https://youtu.be/KtX1r0SzxlI 
What the World Needs Now – for Virtual Orchestra
22 March 2020
https://youtu.be/QagzdvzzHBQ
StrongerTogether – SocialSymphony (Ode to Joy, Bamberger Orchestra)
22 March 2020
https://youtu.be/nZHOJHP33Ps
Socially Distant Orchestra Plays Ode to Joy
22 March 2020
https://youtu.be/nG29VFMphpo
True Colors – Camden Voices (self-isolation/virtual choir cover)
22 March 2020
https://youtu.be/lqWQCWc_zCc
Hallelujah – from a balcony in Italia
21 March 2020
https://youtu.be/S6r2XtuKEto
CORO VIRTUALE – VIRTUAL CHOIR – Hallelujah (Leonard Cohen)
20 March 2020
https://youtu.be/ovwbHsKS6gA
Good Times, Ghali – Gaga Symphony Orchestra
18 March 2020
https://youtu.be/C6_YLveKNCo
Chino Valley USD Students Spread Hope During School Closures Due to COVID-19
17 March 2020
https://youtu.be/k3_crTZ0NHg
Daddy Daughter Duet – The Prayer
7 March 2020
https://youtu.be/cqFCbtRz1Z0

Ireland and COVID-19

According to the novelist John Green, there is ‘no honour in illness’, likewise there is no honour in a poor response to one. The vastly different approaches to COVID-19 taken in the Republic of Ireland and Northern Ireland put the entire island in danger. It is a stain on Irish politics that a failure to co-ordinate health policy on this issue threatens the efficacy of both approaches.

The Republic has followed a containment approach since the outbreak came into prominence in March. Northern Ireland followed the UK’s ‘ignore’ approach thus rendering the restrictions taken on the rest of the island redundant. Indeed, the Republic’s proactive strategy caused undue panic in the more laissez-faire Northern part of Ireland.

The Republic’s current approach is almost  a carbon copy of the measures taken regarding TB in the 1940’s. At that time provisions were made in legislation to isolate, and even forcefully isolate, TB patients. Indeed, the elimination of TB in Ireland largely came through the creation of the sanatorium.

TB and COVID are, as well publicised, vastly different diseases such that using sanatoriums for the airborne COVID-19 would be ineffective. Regardless, there is a demonstrated history of proactive health policy in the Republic. Thus the Republic will continue to tighten measures as long as the virus persists.

Thankfully, the curve has appeared to flatten in the Republic. New cases have declined from a high of 400 in late April to 20 yesterday. Government policy has worked south of the border but what about on the other side?

According to Dr. Bamford of Queen’s University Belfast, the COVID vaccine is about a year away, plenty of time for the situation to suddenly take a turn and get much worse. There are currently no available death rate figures for the North so it is impossible to gauge how many more, and it is more, people the lackadaisical UK response has killed in Northern Ireland compared to the south.

UK deaths are continuing to rise whilst the Republic’s death rate is falling so it is natural to assume Northern death rates are increasing. The people of Northern Ireland deserve better.

However, some immunologists expect another surge in new cases as the summer warms. Cases in the Republic could therefore shoot up as the North possibly has the herd immunity sought by the UK approach.

This is the best case scenario as the disease would simply ravage one part of the island though this assumes immunity to the current strand of COVID implies immunity, or at least some protection, against subsequent strains which may be wishful thinking.

It therefore seems best to assume, as some doctors already do, that it may be impossible to become immune to COVID. The landscape in a few months time could be one of skyrocketing disease contractions in the south which would increase contractions in an already strained north. Both healthcare regimes are struggling, a little more pressure could cause a collapse. It is no use allowing two states on an island the size of Ireland to follow divergent approaches to a pandemic. The people of Ireland deserve better.

Covid-19 Pandemic; what language do we use?

This comes in from Rev Larry Wright, a Board Member of the Next Century Foundation:

What language do we use when speaking about the Covid-19 pandemic? Do we see it as a ‘battle’ to be fought, a ‘monster’ to be slain, an ‘invisible enemy’ to be defeated? Such terms may be helpful for evoking a sense of unity among those who are most at risk but it also perpetuates the questionable idea that human beings and nature are in a perpetual struggle for survival. Covid-19 is a viral mutation whose origins are obscure, but its effects are the same as any other viral mutation, it moves from host to host (human to human) to live and multiple. The fact that it multiples most effectively in human beings is tragic for us but it could have been a mutation which infected other species; remember the swine flu and foot and mouth epidemics? Mutations in nature are a natural phenomenon and will keep occuring as part of creation’s diversity. We as the human species are in a unique position to resist and overcome threats to our survival but it will always be at a cost to us in illness and lives lost. It may feel like an ‘enemy’ among us but it is nature being nature and we will adapt and overcome, until the next time . . .

Keep well, Keep safe, Keep praying

Revd Larry Wright
Team Rector
Kings Norton Team Ministry

https://www.kingsnorton.org.uk/

Covid-19: Lessons from the East?

Are there lessons still to be learnt about the way the East has handled coronavirus? As Europe and the US adopt increasingly draconian measures to stop the spreading of the virus, Asia is slowly recovering. Within a similar period of time, the virus has made a greater number of victims in Europe and the US than in Asia. This imbalance is not only a matter of governance or national health systems – a lot of it is cultural.

The People’s Republic of China, a country of 1.4 billion people, managed to contain the virus in about ten weeks reporting the first day without deaths on April 7th. Vietnam, one of the PRC’s neighbours and home to the first registered case outside of China back in January, has only a few hundred infections within its territory and, seemingly, no deaths. The government in Hanoi was even praised by the World Health Organisation for its performance. South Korea, one of the virus epicentres back in February, managed to slow down the spread and now has about 10,000 cases (one seventh of those registered in the UK) and only 222 deaths.

What made Asian countries’ response to the virus effective? Many have found an answer in the ability of governments to strictly control their citizens. This capacity is seen as the direct result of the presence of authoritarian governments – China, Vietnam – or authoritarian traits within formally established democracies – South Korea – and has been dismissed in the West as something neither possible nor desirable. But this view might be simplistic. As much as a country’s policy-making reflects the nature of its political systems, political arrangements result from the mindset, customs and social behaviour of a people or a society. To put simple, politics rests upon culture.

There are a few societal behaviours shared by China, Vietnam and South Korea that are absent in the Western cultural tradition. First, the general tendency to value the collective over the individual. This fundamental premise is a legacy of Confucianism and an underlying concept to the notion of citizenship in China and culturally proximate countries. Confucius preached that the virtuous individual should be willing to sacrifice for the family, the neighbouring social circles, and ultimately the state.

Valuing the collective over the individual is a two-fold asset at a time like this: first, the Chinese, the Vietnamese and the South Koreans have arguably had less troubles than Europeans or Americans in accepting the idea of suffering any form of discomfort – isolation, in this case – for the common good. As such, they proved more disciplined. This is evidenced by the Chinese experts that were sent to Europe to help fighting the virus: “The main problem is that too many people are still out in the streets,” they declared to China’s State News Agency.

Secondly, the importance conferred by the individual on the state, combined with centralized policy-making, allowed the government to adopt cost-cutting strategies to deal with the crisis. For instance, central governments in China and Vietnam have been able to elude market rules in order to prioritize production of certain goods over others: this allowed to avoid the risk that key products – such as food, surgical masks, and sanitary products – get out of stock or become overly expensive.

Most European countries and the United States have been taking on some of the measures that proved successful in Asia, but recovery is nowhere near in sight. As Westerners, we feed into the idea that this imbalance is the result of the ideological premises of liberal democracy that grant citizens’ individual freedom instead of controlling and restraining them. This might be true. But on closer inspection, we might find that some aspects of existing liberal democracies exceeded those premises: undeterred individualism, the rule of the market, and the lack of state intervention, if unchallenged, may be our doom in the world of the future.

Covid-19 and Protagoras’ Paradox

This interesting reflection explains a lot about how the British Government were handling Covid-19 in the early days. It has been doing the rounds on the internet though we are unaware of the original source. The earliest source we can find for it is the Nigerian publication “City People”

Over 2000 years ago, in Greece, there was a lawyer named Protagoras. A young student, Euthalos, requested to apprentice under him, but was unable to pay the fees. The student struck a deal saying, “I will pay your fee the day I win my first case in the court”. Teacher agreed. When the training was complete and a few years had elapsed without the student paying up, the teacher decided to sue the student in the court of law.

The teacher thought to himself: ‘If I win the case, as per the law, the student will have to pay me, as the case is about non-payment of dues. And if lose the case, the student will still have to pay me, because he would have won his first case. Either way I will get paid’.

The student’s view was, ‘If I win the case, I won’t have to pay the teacher, as the case is about my non-payment of fees. And if I lose the case, I don’t have to pay him since I wouldn’t have won my first case yet. Either way I will not pay the teacher.’

This is known as Protagoras Paradox, which ever way you look both have equally convincing arguments, one can go either way in supporting the teacher or the student and would not be wrong.

Those of us in medical practice often come across such situations, either in making a diagnostic or therapeutic decision. One physician can recommend a course of treatment based on scientific evidence and another can recommend a diametrically opposite course again based on medical evidence. Right or wrong, but some merit would exist on both sides.

Often the physician himself is having an internal struggle to make a decision about the most appropriate course of action, Protagoras & Euthalos are arguing in his mind, to do this or to do that. The horns of dilemma are tearing him apart.

But what prompted this essay was a tweet by Donald Trump, ‘hope the cure is not worse than the disease’. L & G I hate to say, but I find some merit in this tweet. In our global attempt to flatten the COVID curve, I hope we do not flatten the global economy curve. The question is what’s the best way forward. One group recommends ‘total lockdown’ to break the transmission chain, based on evidence from China, they managed to control the spread of the virus by ruthless lock down and 3 months later they are showing that disease is controlled in Wuhan. On the other hand, the other school of thought is graded isolation & protection of elderly and very young and those with co-morbidities, let it spread amongst the young and healthy, after all the disease ultimately will be controlled when we achieve ‘herd immunity’. The medical community is divided in these two groups. To enforce complete lockdown or Graded isolation?

To complicate the issue the epidemiologists have joined the bandwagon with cacophony of statistical analysis. From Rosy to Dooms day predictions. If we don’t do a complete lockdown then a million people will die in 1 year. No say some more like 90 million will die in 1 year. Whose data analysis is correct. Some suggest do nothing, nature will take over in a few months and all will be well, they quote historical data to justify their recommendations. On whose inputs should we base our disaster management strategy.
Then come the economists with their doomsday predictions. If this continues till May our medical resources will be overwhelmed, Agriculture will suffer, food shortages will occur, production will come to a standstill. There will be an economic crisis of the proportions that world has not seen ever. So, break this lockdown nonsense and let’s get back to work as usual.

What will our political masters do. My guess is they will listen to medical experts, epidemiologists & economists. Then they will decide what course of action will ensure their survival, what will get them people’s votes and they will run with that. At present ‘Lockdown” finds favour with them. Boris in UK had to abandon the recommendations of the medical community about graded response, because the people’s perception became that our Government is not doing enough to protect us citizens. That means revolt against him. So, screw it, lets go with total lockdown if that’s what the people want. Gradually people will get tired of lockdown and demand- let life go on. Then with equally convincing arguments the governments will say the time has now come to lift the blockade, we have controlled the contagion, we have won.

Incidentally the Protagoras Paradox has not been resolved till date. Students in Law schools still hold mock trials and give arguments on both sides, without any resolution of the dispute.