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by Tom Chivers
Friday, 23
October 2020
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07:25

Maybe the US travel ban wasn’t stupid

A few months ago I wrote a short piece with the trenchant headline “Memo to Donald Trump: travel bans don’t work”, about the US blocking travel from mainland Europe early in the pandemic. I wanted to revisit it, and see whether I still agreed with myself.

The piece was a little more cautious than the headline — I said that “draconian” travel bans preventing more than 90% of travel from the affected country “could delay the outbreak peak by about three weeks”. But, I implied, it wouldn’t really be possible, because people would travel around them — if you ban flights from Italy, people in Italy will hop to Switzerland and fly from there. Also, I said, in the US case at least, it was shutting the stable door after the horse had bolted, because the disease was already rampant there. ...  Continue reading

by Tom Chivers
Thursday, 15
October 2020
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15:00

Will this new ‘lockdown’ make any difference?

It’s just been announced that London is moving into Tier 2 restrictions, meaning (in short) that people can no longer meet people from outside their household or bubble indoors. Which means my plans to play Warhammer in a bar in Stratford next Tuesday night are off. Won’t anyone think of the real victims, etc.

But here are two other points for consideration. First, I’ve seen people talking about “lockdown” — one of the Google autocomplete results for “Tier 2…” is “Tier 2 lockdown”. It’s really worth remembering what lockdown actually involved.

For months, we were only supposed to leave our house for exercising outdoors (once a day) and essential shopping (as rarely as possible). I sometimes would go for a run in the mornings and take my kids for their walk in the afternoon. If a police officer (or a busybody neighbour) had noticed me doing that, the police could have stopped me; I don’t think it was quite breaking the law exactly, but I was definitely aware that it was not permitted, and I am almost uncomfortable even now admitting that I did it. That rule remained in place until 11 May. Pubs didn’t open until July. Some schoolchildren went back part-time in early June, but most weren’t back until the new school year started in September. ...  Continue reading

by Tom Chivers
Saturday, 3
October 2020
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09:47

Why does Trump get to choose if Regeneron works?

I had never heard of Regeneron or its antibody cocktail before 11pm last night, at which point we learned the President had taken a dose of the experimental drug. So I wanted to preface what follows with: “deeply uncertain”. Here are a few thoughts.

First, it looks like a promising treatment. It is a combination of two antibodies, the proteins your body produces to attack pathogens. They bind to and destroy the spike protein on the outside of the virus.

The only study I’m aware of is quite small (275 patients) and is not, as far as I can tell, publicly available. I can find two promising studies (1, 2) in mice, but the most recent study looking at viral load in humans only appears to be available as an (admittedly fairly in-depth) press release and some powerpoint slides – if I find the real thing I’ll add it in here.  ...  Continue reading

by Tom Chivers
Friday, 2
October 2020
Chart
11:27

Vitamin D is no silver bullet

Earlier this week I wrote about what appears to be a fall in the fatality rate from Covid. Part of the reason for the fall, I wrote, was that treatments for patients have improved. I listed a few — proning, use of anticoagulants, dexamethasone.

A few people, though, asked me why I hadn’t mentioned vitamin D. They seemed quite excited about it; a few even DMed me on Twitter, or emailed me, which is unusually high-effort for people replying to pieces I’ve written.

Vitamin D has been mooted for a long time as a treatment, or more accurately a prophylactic, for Covid-19. The former Brexit secretary David Davis was tweeting about it in May and July, calling for the British government to do “what Sweden, Finland and the USA do and fortify flour and milk with vitamin D to help protect the most vulnerable”. A report commissioned by Sir Patrick Vallance in July recommended its use. ...  Continue reading

by Tom Chivers
Thursday, 24
September 2020
Reaction
11:55

How risky are the human challenge trials?

I’m a subject in the Oxford/AstraZeneca Covid vaccine trial (As I keep on droning on about). It seems to be progressing well, insofar as I can tell as Guinea Pig #9385. And other vaccine candidates are also coming along — Johnson & Johnson’s vaccine has entered phase 3 trials, the fourth to do so.

There is a real and significant problem for developing vaccines, though, which is that not very many people have the disease. That sounds like a good thing — it is a good thing — but if you’re testing a vaccine, it’s a problem.

Here’s why. In Oxford’s case, they’ve given 5,000ish people the real vaccine and 5,000 a control. Then they watch to see whether the real-vaccine group gets Covid less than the control group. But if the disease is very rare, you’ll hardly see any cases in either group, so it’ll be really hard to compare; I go into the issues in more detail here. Oxford is running trials in other countries, such as Brazil, where the prevalence is higher, but it’s a real problem. ...  Continue reading

by Tom Chivers
Thursday, 17
September 2020
Explainer
15:46

If your child has the sniffles, is it Covid or a cold?

My eldest kid has been back at school for nearly two weeks; my youngest has her very first day on Monday. As usual, the first few days of term are an absolute crucible for colds and flu.

“At this time of year children get colds and viral infections,” says Dr Sunil Bhopal, a paediatrician and epidemiologist at Newcastle University. “I spend the whole summer in paediatric A&E with hardly any children, and then in September we get an onslaught. It’s totally normal.”

But what’s not normal is that now, if a child has a runny nose or a sore throat, there is a risk it might be Covid-19. And, depending on the school, that child might be sent home — or, in some cases, their whole class might be. In my children’s school, if a child persistently sneezes, he/she has to self-isolate; in another school up the road, literally any sort of feeling-unwellness will get them sent home. ...  Continue reading

by Tom Chivers
Friday, 11
September 2020
Explainer
07:00

The paranoid style in vaccine science

As I may have mentioned, I’m taking part in the Oxford vaccine trial. As I predicted at the time, sticking a big stick up your nose and against your tonsils every week for a year is deeply unpleasant, but I am willing to make these sacrifices for the common good.

A few weeks after I had the vaccine, I was asked to come in again. They’d established that a second, booster dose had led to an improved immune response, so they offered one to anyone who wanted it.

(Of course, I may have had the control dose, a meningitis vaccine; if so, I’ll have had it in the booster shot as well. Since it’s double-blind, the doctors and nurses administering wouldn’t know either, but it has to be the same as the first or the whole trial gets buggered up. It feels like a logistical nightmare, but it’s probably got some simple system.) ...  Continue reading

by Tom Chivers
Thursday, 27
August 2020
Spotted
15:00

A lesson in statistics… for the FDA

Here’s a nice, if somewhat terrifying, demonstration of how easily numbers can go wrong if you’re not careful. Even if you’re the commissioner of the US Food and Drug Administration who — you’d think – would know the difference between absolute risk and relative risk, and percentage increases and percentage point increases, and so on.

The FDA has issued an emergency approval for “convalescent plasma” as a treatment for Covid-19. Convalescent plasma is basically the blood of people who’ve got better from the disease, with the actual blood cells taken out. The plasma contains antibodies for coronavirus and, it is hoped, will help fight the disease in the patient’s body. ...  Continue reading

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