Vaccine 'error' report was misleading: My letter-to-the-editor

There were many reports over 2 or 3 days last week in the Observer-Reporter (a newspaper in Washington, PA) about the misuse of Moderna vaccine, namely using the vaccine intended as second dose for the first dose.  We read the headlines of  “Error costs 200K doses” and “DOH talks vaccine error”.  It also said the second doses were “accidentally” or “inadvertently” used as the first doses, even blaming “First, second Modern doses in identical packaging”, as seen in the headline.  It led Washington Health System CEO to announce in the newspaper, saying they were not impacted as they use Pfizer vaccine.  The PA health officials even said they knew which vaccine centers “made a mistake”, but preferred not to make public.

I am befuddled. The first dose and the second dose are identical for either Moderna or Pfizer vaccine.  How can it be a mistake or cost anything using the same vaccine as the first or second dose.  This is what prompted me to write the letter-to-the-editor, in which I state the pro and con of the two different strategies: One is to give out vaccines received as soon as possible, the other is to reserve for the scheduled second doses before taking appointments for the first doses.  This is not a right or wrong approach.  Which option to pursue depends on the vaccine supply status.

We are racing for the vaccinations of the whole population against the emergence and spread of new variants.  Having a sense of urgency we need to stride for the most efficient vaccine use.

Cavalier: Connecting Capitol insurrection to British Civil War and to pandemic

Being a history buff, I tend to look things in historical perspective.  While the Capitol was being seized by the White House-incited mobs, Oliver Cromwell and Charles I came to my mind.

While visiting London 5-6 years ago, I noticed there were only two statues in the yard of the Parliament; one is Henry II, the other is Oliver Cromwell (see photo right).  The fact/design that he still needs a lion to protect him tells a lot.

I know it is inappropriate to liken Trump’s White  House to Charles I royalist and Nancy Pelosi’s Congress/Capitol to Oliver Cromwell’s Parliament.  But . . .

I hold the view that the Capitol insurrection and America being the worst in the whole world when it comes to pandemic control are related, the two manifestations of the same thing（一體兩面）.

The word “cavalier” (lack of proper concern, disregard of others’ interest, high-handed, arrogant, supercilious) connects these two things and events.

Cromwell’s Roundheads (Parliamentarians) first used “Cavaliers” to describe the wealthier supporters (knights) of Charles I, with a negative tone of contempt.  The term was later adopted by Royalists themselves.

Chris Christie

After spending seven days in an intensive unit before recovering from COVID-19, the former New Jersey Governor Chris Christie implored Americans to wear masks and take the pandemic very seriously.  "The ramifications are wildly random and potentially deadly.  No one should be happy to get the virus and no one should be cavalier about being infected or infecting others."  He said.

Christie used “cavalier” to describe those so-called pandemic deniers, treating it with indifference or even with contempt.  The cult is led by Trump, and unfortunately many Republicans “follow the leader” blindly or as Chinese say 被牽著鼻子走。

So everything comes into place. The mobs that seized the Capitol are Trump’s people who, like their leader, take cavalier attitude toward the pandemic, so they are the Royalists, the Cavaliers. The price we pay is America being the worst when it comes to the pandemic control. Trump indeed achieved the “America First” which is not only a slogan but a reality.  America, the “shining City upon the Hill”, its storied democracy was once marveled, envied and emulated by the world, now scorned, mocked and mourned.

I firmly believe that most of the more than 74 millions that voted Trump did it for various reasons, political or otherwise, some of them I personally embrace, thus I treat them with respect and understanding.

My argument against Trump is entirely not political.  To paraphrase Fou Lei (傅雷）from the letter to his son, Fou Ts’ong (傅聰）:

First you must be a person, then a public servant, and then a politician, and only then can you be a President.

Fou Ts’ong said in one interview, “Even now, I believe in this order — that it should be this way and that I am this way.”

Not a thread of moral fiber can be found in Trump’s very being.  He failed the first step as a decent person.  His character fault lies in his narcissistic personality and lack of empathy and compassion. A powerful politician without morality is a dangerous thing.

Washington, DC, a besieged city: “Why don’t they come! Why don’t they come!” Lincoln exclaimed

I thought Washington DC is preparing for a presidential inauguration, but it looks more like preparing for a major attack.  Vice President Pence just came to inspect the troops just like a general did before the imminent battle.  If Lincoln could see the 21,000 (expects to be 26,000) troops (National Guard) amassed in Washington on April 23, 1861, he would be very pleased and relieved.

At the outset of the Civil War, Lincoln first called for troops to defend the Capital on April 15, 1861.  The following excerpts are from Carl Sandburg’s monumental work, Abraham Lincoln, from which one can see how anxious Lincolns were in those days.

On the afternoon of April 23 [1861] Lincoln was alone in his office in the White House—or believed he was alone, though John Hay, [Lincoln’s secretary] quiet and unobtrusive, was there.  And Hay saw Lincoln “after walking the floor alone in silent thought for nearly half an hour,” stop at a window and gaze long and wistfully down the Potomac in the direction of the expected ships.  And as he gazed he broke out with irrepressible anguish in the repeated exclamation “Why don’t they come!  Why don’t they come!”

The day of the President’s call for 75,000 troops had passed, and not a troop arrived in Washington.  And the next day and the next passed, and not a regiment nor a company came—not a corporal’s squad.

Mrs. Lincoln, a few nights since, heard whispering in the hall in front of her room; she rose from bed, dressed, and sat up the remainder of the night, watching for the Southern army to blow up the White House, as they are confidently expecting it.”

Our daughter bought me this four-volume set of Carl Sandburg's Abraham Lincoln: War Years some years ago.

Muse on pandemic: Should you be concerned or worried about the new Corona-variant?

When it comes to the pandemic here I trust Dr. Anthony Fauci, in Germany I trust Dr. Christian Drosten, He is German answer to our Dr. Fauci, much younger, though. He is 48 years of age, Dr. Fauci just turned 80.  Both Dr. Fauci and Dr. Drosten received death threats (even Dr. Fauci’s 3 daughters were not spared) by corona-deniers.

Dr. Anthony Fauci and President Trump

Dr. Drosten is a virologist from Charity, Berlin, which is touted as the best research hospital in Europe.  More than half of all German Nobel Prize laureates in Medicine have worked at Charite.

Dr. Christian Drosten

Their views on the new corona-variant are very similar: Dr. Fauci said, “I would not be surprised if it is already here.” Dr. Drosten said, “I think it is already in Germany.   It is in Europe, even in Australia, why shouldn’t it be in Germany?” Dr. Drosten said.

The CDC said that the new strain is more rapidly transmissible (the reported 70% more transmissible is just an estimate), but there is no evidence that it is more serious or deadly (i,e. more virulent).  Scientists are working hard to better understand how easily the new variant might be transmitted and whether the currently approved vaccines will provide the same protection against the new strain.

Dr. Moncef Slaoui

According to Dr. Moncef Slaoui, head of the Operation Warp Speed, that antibodies produced in response to COVID-19 vaccines would continue to be effective as they bind to several “epitopes” (or regions) of the spike protein, which is a three-dimensional surface molecule that virus uses to invade human cell.  The chance that a single mutation would alter all the regions at once are “extremely low” or highly unlikely.

Dr. Drosten holds the same view, by saying the change of the virus is not extensive enough/sufficient and the vaccines are too broad in effect.  In fact, the vaccine was designed in anticipating that the virus may mutate somehow and somewhere along the way.

Der Tagesspiegel (a German newspaper) had an article 12/21/2020, after interviewing Dr. Christian Drosten on this topic.  The following is the English translation.

Drosten on Corona-mutation: “I think it is already in Germany”

Virologist Christian Drosten is not too worried about the Corona-mutation. Charite virologist Drosten warns the panic mongering (inciting panic) in connection to the new virus variant from Great Britain. As yet there is hardly any definite findings.

In an interview with the Deutschlandfunk Monday morning (Dec. 21) the Charite virologist warns the panic mongering (panic inciting) in connection to the emerging new virus variant.

Much of what is said and written about the new virus variant is still not scientifically confirmed, he said. British researchers have announced that the relevant information for the coming days.

Current statements such as the number that the mutation is 70% more contagious, were not based on solid findings, but are estimates. They find their way into media via politics. It will now simply take a few days until “clear messages” from the researchers received.

“At present I am not so very worried,” Drosten further added, “there can be scientific surprise, but I am anything but worry.” At the same time the current action of restricting travel traffic from Great Britain is “cautious” and appropriate. If there is more information then politics can react accordingly.

Looking at the Southern England where the new virus variant is currently mainly spreading, Drosten asked, “Does the virus wash up a new wave or is the virus responsible for the wave?” [I think he said the new wave could be the result of human behavior?] This is an important question that cannot be answered easily.

He referred to other countries where the new virus variant has been proven, and yet no direct and strong increase of cases in the same time, Drosten emphasized. He doesn't want to play down the new virus variant, especially the fact that the binding to human cell would become stronger, he called interesting. However, Drosten said, this circumstance could even weaken the virus. “That is not necessary good for the virus.”

According to Drosten the new virus has long since overcome many limits. “I think it is already in Germany” he said. The new virus has already been in England for several months and has found their way to various European countries.

“We know it is in Europe, even in Australia, why shouldn't it be in Germany?” Drosten doesn't believe the mutation has an effect on the effectiveness of the vaccine. The change of the virus is not extensive enough/sufficient and the vaccines are too broad in effect.

Three Russia-born female performers that happen to be immigrants with distinguished achievements

(朋友送來 Andrea Bocelli and Helene Fischer 合唱的 The Prayer, https://youtu.be/mI0x97D8N8g 寫 response 時發現談到的三個女藝人都是來自蘇俄的移民, 所以決定放在部落格上.）

Andrea Bocelli 也應該算是 Opera singer, 可惜因為視力的關係他很少在 opera 出現，但也演了不少 operas (每一opera, 演的次數不多）: La Boheme, Madama Butterfly, Tosca, Carmen, Romeo and Juliet and Macbeth (這些 operas 我們最近都看過) 我們 1974 or 1975 曾在紐約 Lincoln Center 的 City Opera 看過 Carmen. Andrea Bocelli plays Don Jose in Carmen, 算是男主角。Elina Garanca (Russian born, studied in Vienna and US) 演我們最近看的 Carmen, 非常好，we are very impressed. 把我了解的 Carmen 的性格演得非常傳神。

跟 Andrea Bocelli 一起唱的是德國歌星 Helene Fischer, 唱得非常不錯, 她是當今德國最紅的歌星，不下於咱們的 Taylor Swift and Beyoncé, 2018 年的收入 $32 million. 2018 年在柏林的 Olympiastadion 演出非常轟動。這個 Olympia Satdium 就是 1936 Hitler showcased 德國的 宣傳地點。2018 年初她因生病（”infection”) 而取消七場表演, 這期間全國觀望等不及她趕快復原開始表演。德國報紙 Der Tagesspiegel 這期間有一篇文章說 “No ‘breathless’ for Berlin, when the concerts will be made up is still not clear” [Kein ‘Atemlos‘ für Berlin] ‘Atemlos’ is ‘Breathless’ 是 Helene Fischer 的暢銷曲, 所以說 “No breathless for Berlin” 表示柏林還是要繼續等她。

Helene Fischer 是蘇俄出生（西伯利亞的 Krasnoyarsk) 小時候去德國的移民，所以有很多人要求她利用她的背景及聲望在 social media speaks out against right wing radicalism and xenophobia and she did, at least on her Facebook page that I know of.  

三個多月來看了很多 Anna Netrebko 的歌劇, 好像「認識」她了：她是 Don Pasquale 裡的 Norina, Anna Bolena 裡的 Anne Boleyn (Henry VIII 的第二任妻子, 幾年前參觀 London Tower 時我在她上斷頭台的地方哀思一番）最近看 Macbeth, 她是 Lady Macbeth. Anna Netrebko 也是蘇俄出生去 Vienna, Austria 的移民. 幾個月前她回蘇俄表演得了 Civid-19 (從跟她一起唱歌的男歌星得到的, 中獎沒症狀, aerosol 更容易從口裡流出。本來 Metropolitan Opera 十月份有她的一個 special concert (ticket price $20) 臨時取消。

這 email 提到的三個 female performers (pop star or opera singers) 都是蘇俄出生到其他國家的移民, is it coincidence?

Not knowing Chinese Trump lost White House (Trump 不懂中文, 失去了江山）and America First

Trump 不懂中文使他失去了江山。如果沒有 pandemic, 他連任的機會應該很大, 何況 Biden 也不是一個 very strong candidate, all things considered.  Pandemic is a crisis (疫情一來是危機）Trump 不了解危機就是危險帶來的機會 （opportunity). 沒有人會怪他疫情的到來, 只要他處理適當, 加上美國的 resources and scientific know-how.  一定可以領導全球做全世界的榜樣, truly make America great again. 九個月來, 確診及死亡人數, 全球美國第一, America First, indeed!

（下面的 graph 來自德國報紙 Frankfurter Allgemeine, 其 data 來自 Johns Hopkins University）

八個國家的確診數目的比較 （即每 100,000 人囗有多少確診。最近一兩個月歐洲疫情也很厲害, 但是還是大大趕不上美國.

最上面的是美國：幾乎 4,500 (America first, indeed)

第二名（西班牙）及第三名（法國）：約 3,400

Trump 最喜歡跟德國比, 說美國跟德國一樣好, 他説謊是不會臉紅的.

德國：1,155-1,160

瑞典對疫情處理惡名昭張, 其數目也只約 2,810.

南韓數目非常低可能 100 以下（not shown on graph）

When daily confirmed coronavius cases are 1,313 on September 27, Chancellor Angela Merkel warned that the  daily cases may reach 19,200 by Christmas unless strict measures taken, some called her alarmist.  It turns out she was indeed wrong in her dire prediction: The daily cases reached 19,382 on Oct. 30, 31,480 on Nov. 4 and 32,687 on Nov. 25.

The following two graphs show the German ICU bed capacity was rapidly dwindling in November and was overwhelmed by December 4.

German ICU bed capacity [green line] as of 11/21/2020

German ICU bed capacity as of 12/4/2020

Germany 12/4/2020

The following graph shows the comparison of the confirmed cases per 100,000 population of each country: On the very top of the list is United States nearly 4,500 ("America First" indeed!), by comparison Germany s about 1155-1160.  The runner-ups are Spain and France (around 3,400). South Korea's number is extremely low, probably less than 100 (not shown on the graph). Italy is known to have its healthcare capacity overwhelmed and overrun, Sweden has notorious reputation when it comes to the management of andemic, their numbers are around 2,810.

Germany reproducton number 12/4/2020

Muse on pandemic: The cautious Angela Merkel

On September 28 when German daily coronavirus cases numbered 1,313 (on 9/27/2020) Chancellor Angela Merkel, in preparation of meeting federal state governors to discuss the next step for the pandemic controlled measures, warned the daily cases will rise to 19,200 by Christmas unless something done.  It certainly sounds as if Merkel were an alarmist.  But her figure came from public health officials and experts that she respects and listens.

As of October 14, the daily cases in Germany was 7,173, increasing from 1,313 just two and half weeks ago.

It hasn’t escaped my notice that the leaders of the poorly controlled nations tended to talk down the threat of coronavirus, whereas those leading the better-controlled nations tended to be more cautious and vigilant.

(7,173 new cases in Germany o 10/14/2020. You may click the picture to enlarge it)

(1,313 new cases in Germany on 9/27/2020.  You may click the picture to enlarge it)

This also gives hint how German federal government and states work together in combating this horrendous pandemic.  As of October 14 there are 216,904 deaths in the US, compared with 9,721 deaths in Germany.  The US population is about 4 times that of Germany.

Muse on pandemic: How did my view on Covid-19 come into being?

Rarely did I write about Covid-19 of late, it is not because I lost interest or quit reading about it, but because I have been keenly aware that many of my potential readers are “pandemic-fatigue”, getting tired of reading anything about virus, some even suspected I am an alarmist. I recall in one of the ZOOM meetings with friends in April, I warned the potential aerosol transmission (through talking, breathing or singing), one gentleman (whom I personally do not know) responded by retorting “aerosol transmission? Impossible!” But I took comfort in knowing that one friend called me “Dr. Fauci” in our midst in one of the group LINEs I participated. That was quite a compliment.

How did my view on Covid-19 come into being? First and foremost it is not because I am a physician, as I’ve never seen any infectious disease like Covid-19 in my entire professional career. I have no experience in dealing with it. My views on Covid-19 come from voracious readings of scientific, credible or trustworthy journals. My paid subscriptions include: New England Journal of Medicine, Scientific American, Harvard Health Letter, New York Times, and Boston Globe.

But one can read solid science on Covid-19 without paying a cent on the subscriptions, as most prestigious, credible, peer-reviewed scientific journals make the Covid-19 related articles available online for “open access”, or at least one can read the abstract. I presume this is their public service. Those I routinely consulted include: Nature, Science, Lancet, Proceeding of the National Academy of Science, The Atlantic, etc. MIT Technology Review has excellent articles, allowing one to have free access to several articles. Reading Bill Gates' blog is worth your while.

Those readings led me to believe very early on that SARS-CoV-2 is the most smart and cunning infectious virus that I have ever seen. Their ingenious and tricky way to “jump” from one person to another is astonishing (令人嘆為觀止）It occurs in the least suspected or expected moment. I would unhesitatingly vote Covid-19 the disease of the century.  I treat this dreaded virus with respect and fear (敬畏有加）. One does not cause pandemic for no reason.

With that being said, one may get an impression that one needs to read to know how to combat this virus. No, that is not true. It s so easy and simple for an individual to do: wear face mask and keep social distancing whenever the occasions call for. That is all there is to it. You may add wash the hands as frequent as needed.  Avoid the crowd or large gatherings, size of which goes by the local authority. One needs to assume anyone other than one’s own household members may potentially have Covid-19 and act accordingly, constantly keep in mind that an infected person become very contagious several days before the first symptoms, in addition, up to 40% of the infected never develop symptoms, yet they are as contagious.

I will write a series of “muse on pandemic” as time goes by.

Wearing face coverings may reduce the severity of Covid-19 if the full protection fails

It is unfortunate or even sad that wearing face covering has been politicized, thus reducing the effectiveness of public health policy implementation. I never got tired of saying something exhorting general public to wear face covering whenever the occasions call for it. I wrote a letter-to-the-editor to the Observer-Reporter (a newspaper at Washington, PA) to this effect in early April. I had another letter published today (Sept. 22) advocating a new concept that has been supported by many evidences observed. I wrote an article of “The scientific basis of wearing face mask” in my blog, although article like this is inherently dull and dry.

I basically want people to be aware that wearing face covering may not fully protect one from getting COVID-19, but it may potentially decrease the severity of the disease as wearing face covering may reduce the amount of viruses one receives. This is consistent with a well-established theory of viral pathogenesis, which says that the severity of the disease is proportionate to the viral inoculum received. An article in the July 14 Proceedings of the National Academy of Sciences reveals that “higher doses of administered virus led to more severe manifestations of Covid-19 in a Syrian hamster model of SARS-CoV-2 infection.”

The rate of asymptomatic infection with SARS-CoV-2 infections was estimated to be up to 40% according to a CDC report in mid-July, whereas the rate of asymptomatic infection was more than 80% in the setting of universal facial masking.

I threw in another info that taking vaccine may potentially reduce the severity of the disease when the full protection fails. The targeted readers would be those who refuse to take vaccine for whatever reasons.

Glorious gladiolus

這些 劍蘭 （gladiolus）都是去年種的，冬天來時挖出來在窒內過冬.  春天到時因疫情的關係我們沒有出去買新的 花苞，所幸這些去年種的花苞 今年還算爭氣，也花姿招展一番. 最下面的兩張是 2017 及 2013 年拍的。

The open letter of Stanford medical school faculties condemns Dr. Scott Atlas

Since Dr. Scott Atlas was appointed as the new medical adviser for the White House coronavirus task force in mid-August, I have been checking Stanford Medicine website numerous times, trying to find out what they would say about their former colleague (He is currently a senior fellow in health care policy at Hoover Institution, a conservative think tank at Stanford University. So theoretically, he is still a Stanford man.). But I was disappointed at finding nothing until yesterday when I finally read an open letter, which condemns Dr. Atlas’s radical and dangerous view and behavior about this pandemic. The letter was signed by over one hundred doctors and researchers. The following link is to the open letter.

(The Open Letter on Stanford Medicine was taken out a day or two after it was posted. The law firm representing the White House threatened to sue those doctors.)

The Open Letter is still available online (the following is a NYT document)

https://int.nyt.com/data/documenttools/read-the-open-letter-from-stanford-doctors-on-scott-atlas/813b50f72b6543b4/full.pdf

There was an article on 8/172020 Frankfurter Allgemeine (German newspaper) with a title of Sie simulieren Wissenschaft (They simulate/feign science), using Dr. Scott Atlas at White House as the title photo. One can read “corona-pseudoexperten” (corona-pseudoexperts) on it. 

(I translate two short paragraphs so you may get the idea of what this article is all about.)

. . . there are almost always a bunch of pseudo-experts from outside their fields, who wrapped themselves in the “information bubble”, isolated, but present their academic position when they felt rebuke is needed.

It is happening now in the White House. In fact Trump has not yet showed the door to Fauci, the popular immunologist, but by placing the former neuroradiologist, Scott Atlas, of Hoover Institution at Stanford University at the top of his Corona-advisory board, a pseudo-expert, who is capable of getting conspiratorial fantasies going while standing along the honest/credible virologists and epidemiologists. In his first interview Atlas corrected the cautious epidemic expert, Fauci, regarding his lock down strategy. Scott Atlas wants it—and Trump wanted it for a long while—that American people should be able to cheer again in the college-football-stadiums.

The unknown purple wild flower 不知名的紫色野花

幾個月前花園後頭的走道長了一棵很大的 weed, Katy 說她會開紫色的花，因為我們幾乎沒有走那一個地方，所以也留著沒有抜掉。看看這個紫色花（Katy 也不知道其名字）我說野花也是花, 你一定會同意。難怪 Emily Dickinson 非常喜歡野花. 她在 Holyoke Female Seminary (Mount Holyoke College 的前身）時寫了一封信, 其內有, “There are not many wild flowers near, for the girls have driven them to a distance, and we are obliged to walk quite a distance to find them, but they repay us by their sweet smiles and fragrance.” 我們這個紫色花也 repay us with her beauty.

我在 Emily Dickinson 的詩有讀到一句：”From just a Purple Flower beyond”.  所以不是只有我們不知道 Purple Flower 的名字。

The unknown beans happen to be the one we like the most, 誤打誤中

朋友給 Katy 一些 翼豆種子, 我們不知道是什麼豆, 開紫色花時非常好看 （我說豆好吃比花好看更重要）Katy online 一查, 看它的花的確叫翼豆, 但豆長出來後, 越長越長, 有一天 Katy 讓美玉看，美玉說這就是他們家種的長豇豆, 這下子可真是誤打誤中了，因為美玉楊錚幾年前給我們的長豇豆是我們最愛吃的。這種長豇豆煮稀飯是上品.