“Operation Warp Speed, . . . , Is More Imaginative Than the Bureaucratic Norm”

(p. 11) . . . the blundering of the Trump administration, while real and deadly, may not be responsible for the bulk of America’s coronavirus fatalities.

. . .

. . . : the absence of challenge trials for vaccines (in which young, healthy participants agree to be vaccinated and then infected with the virus), the predictable expert resistance to at-home testing. But the most important one was the straightforward bureaucratic calamity at the C.D.C. that delayed effective testing for a fateful month.

An effective president might have addressed some of these problems. (Although Operation Warp Speed, the White House’s vaccine initiative, is more imaginative than the bureaucratic norm.) But overall they are problems with structures and habits rather than personalities — an institutional decadence that predated Trump and will persist when he is gone.

. . .

. . . the third thing you see when you look beyond Trump [is] the fact that so many countries in Western Europe, to say nothing of our neighbors in the Americas, have had death rates similar to ours.

This reality speaks not of exceptionalism but of convergence — and the possibility that the trends of the early 21st century have left us sharing more in common not only with France and Spain but also with Mexico and Brazil than most Americans might expect.

This, too, may matter long after Trump is gone. Where there are crises, in this dispensation, they are likely to be general rather than just American. Where there is decadence, it is the shared experience of late modernity. And if renewal comes to an exhausted West, it will not necessarily come through America alone.

For the full commentary, see:

Ross Douthat. “What Isn’t Trump’s Fault.” The New York Times, SundayReview Section (Sunday, September 13, 2020): 11.

(Note: ellipses added.)

(Note: the online version of the commentary has the date Sept. 12, 2020, and has the same title as the print version.)

Open Offices Reduce Productivity and Spread Diseases

(p. B4) When historians of the early 21st century look back on the pre-Covid era, one of the absurdities they might highlight is the vogue for gigantic, open-plan offices. The apotheosis of this trend of breaking down barriers between co-workers must surely be Facebook Inc.’s 433,555-square-foot Frank Gehry-designed open-plan office at its headquarters in Menlo Park, Calif. Opened in 2015, it’s now a ghost town, a monument to offices vacated by the pandemic.

Cramming cavernous spaces with as many desks as they could hold might have increased serendipitous interactions, but it almost certainly reduced productivity and helped spread communicable diseases, including coronavirus.

. . .

Cue the “dynamic workplace,” a pivot away from the open plan, built on the idea that with fewer employees coming to work on any given day, offices can offer them more flexibility of layout and management.

While open offices and dynamic workplaces share similar components—privacy booths and huddle rooms to escape the hubbub, cafe-like networking spaces, etc.—they’re philosophically distinct. One is intended to be a place where people come (at least) five days a week, and get most of their work done on site. The other is planned for people rotating in and out of the office, on flexible schedules they have more control over than ever.

. . .

Research on hot-desking in office spaces, for example—where employees give up a dedicated space in favor of first-come-first-serve seating—finds that it decreases socialization and trust. This happens because employees figure they might never again see the person they sit next to on a given day, says Dr. Sander. In other studies, employees complain they can’t find their colleagues, that it’s a hassle to find a new spot to work every day, and that such arrangements ignore humans’ innate territoriality and desire to make a space their own.

For the full commentary, see:

Christopher Mims. “Goodbye, Open Office. Hello, ‘Dynamic Workplace.” The Wall Street Journal (Saturday, September 12, 2020): B4.

(Note: ellipses added.)

(Note: the online version of the commentary has the same date and title as the print version.)

Whole Live Covid-19 Virus, Not Just Fragments, Found in Hospital Aerosols

(p. A4) Skeptics of the notion that the coronavirus spreads through the air — including many expert advisers to the World Health Organization — have held out for one missing piece of evidence: proof that floating respiratory droplets called aerosols contain live virus, and not just fragments of genetic material.

Now a team of virologists and aerosol scientists has produced exactly that: confirmation of infectious virus in the air.

“This is what people have been clamoring for,” said Linsey Marr, an expert in airborne spread of viruses who was not involved in the work. “It’s unambiguous evidence that there is infectious virus in aerosols.”

For the full story, see:

Apoorva Mandavilli. “Scientists Find Respiratory Droplets in Hospital Air.” The New York Times (Wednesday, August 12, 2020): A4.

(Note: ellipsis, and bracketed date, added. The online version say that the New York print version had the title “Scientists Retrieve Live Virus From Hospital Air.” My National print version had the title “Scientists Find Respiratory Droplets in Hospital Air.”)

(Note: the online version of the story has the date Aug. 11, 2020, and has the title “‘A Smoking Gun’: Infectious Coronavirus Retrieved From Hospital Air.”)

Former FDA Commissioners Urge Early “Emergency Use Authorization” for Covid-19 Vaccine

(p. A17) As former FDA commissioners, we are confident in the FDA’s career scientists to oversee vaccine development rigorously.

If a Covid vaccine clears this process, it could be made available initially to specific groups of people through an Emergency Use Authorization. This emergency authority enables the FDA to make products available before a full application is approved by the agency. Congress created the emergency-use pathway as part of the Project BioShield Act of 2004, which provided for the development of medical countermeasures against chemical, biological, radiological and nuclear threats. Following 9/11 and anthrax, lawmakers expected an urgent need for such defenses.

After the 2009 swine flu, Congress expanded this pathway in the Pandemic and All-Hazards Preparedness Reauthorization Act of 2013, a bipartisan measure aimed at preparing the country to weather a pandemic. The law streamlined the application process for emergency use, expanded the classes of drugs eligible, and broadened the testing the FDA could require.

. . .

This authority enables the staged entry of a vaccine. It’s unlikely that a Covid-19 vaccine will receive full approval and broad distribution right away. Instead, the FDA will probably authorize vaccines for use in targeted groups of people at high risk from Covid and most likely to benefit from the vaccine. For them, it may make sense to provide access to the vaccine before long-term follow-up studies that address very remote risks.

This might include health-care providers or first responders, who face greater exposure, or older people, who are more prone to severe complications if infected.

. . .

This process exists precisely to deal with public-health emergencies like Covid-19. It isn’t a lower standard for FDA approval. It’s a more tailored, flexible standard that helps protect those who need it most while developing the evidence needed to make the public confident about getting a Covid-19 vaccine.

For the full commentary, see:

Mark McClellan, and Scott Gottlieb. “How ‘Emergency Use’ Can Help Roll Out a Covid Vaccine.” The Wall Street Journal (Monday, September 15, 2020): A17.

(Note: ellipses added.)

(Note: the online version of the commentary has the date Sep. 13, 2020, and has the same title as the print version.)

Russia Approves Covid-19 Vaccine Before Completing Phase 3 Clinical Trial

(p. A6) MOSCOW — Russia has become the first country in the world to approve a vaccine for the coronavirus, President Vladimir V. Putin announced on Tuesday, though global health authorities say the vaccine has yet to complete critical, late-stage clinical trials to determine its safety and effectiveness.

Mr. Putin, who told a cabinet meeting on Tuesday [Aug. 11, 2020] morning that the vaccine “works effectively enough,” said that his own daughter had taken it. And in a congratulatory note to the nation, he thanked the scientists who developed the vaccine for “this first, very important step for our country, and generally for the whole world.”

. . .

If Russian scientists have taken an unorthodox route to the coronavirus vaccine, it would not be the first time. Back in the 1950s, a team of researchers tested a promising, and ultimately successful, polio vaccine on their own children.

For the full story, see:

Andrew E. Kramer. “Putin Says Russia Is First to Approve Vaccine, but Skepticism Abounds.” The New York Times (Wednesday, August 12, 2020): A6.

(Note: ellipsis, and bracketed date, added.)

(Note: the online version of the story was updated Aug. 11, 2020, and has the title “Russia Approves Coronavirus Vaccine Before Completing Tests.”)

Shanghai Immunologist Says Phase 1 and Phase 2 Tests Show Chinese Vaccine Is Safe and “Highly Likely” to Protect Against Covid-19

(p. A8) The United Arab Emirates has become the first country outside China to approve emergency usage of a Chinese Covid-19 vaccine candidate, in a vote of confidence for a state-backed drugmaker racing global rivals to stop the spread of the coronavirus.

. . .

Tao Lina, a former immunologist with the Shanghai CDC, said in an interview that it makes sense for authorities to approve the usage of Chinese vaccines that have proved safe during the first two phases of clinical trials, given the scale of the Covid-19 crisis. Unlike medical drug treatments, vaccines work by triggering a person’s own immunity, he said. “I’m not at all worried about the safety of the vaccines,” Mr. Tao said.

While the level of efficacy of the Chinese vaccines being used including those of Sinopharm isn’t yet clear, Mr. Tao said the Chinese vaccines’ ability to induce the body to produce antibodies during previous clinical trials meant that they were highly likely to confer some degree of protection from the virus.

For the full story, see:

Chao Deng, and Rory Jones. “U.A.E. Approves Use of China-Made Covid-19 Vaccine.” The Wall Street Journal (Wednesday, September 16, 2020): A8.

(Note: ellipsis added.)

(Note: the online version of the story was updated Sep. 15, 2020, and has the title “In Global Covid-19 Vaccine Race, Chinese Shot Receives First Foreign Approval.”)

China’s “Emergency-Use” Rule Allows Vaccinating Hundreds of Thousands Against Covid-19

(p. A1) A Chinese pharmaceutical company has injected hundreds of thousands of people with experimental Covid-19 vaccines, as its Western counterparts warn against administering mass vaccinations before rigorous scientific studies are complete.

China National Biotec Group Co., a subsidiary of state-owned Sinopharm, has given two experimental vaccine candidates to hundreds of thousands of people under an emergency-use condition approved by Beijing in July [2020], the company said this week.

For the full story, see:

Chao Deng. “China Tests Vaccines on Hundreds of Thousands.” The Wall Street Journal (Saturday, September 12, 2020): A1 & A8.

(Note: bracketed year added.)

(Note: the online version of the story was updated September 12, 2020, and has the title “China Injects Hundreds of Thousands With Experimental Covid-19 Vaccines.”)

Before Covid-19, Poverty and Unemployment Were Lowest in 50 Years

(p. B8) WASHINGTON — A record-low share of Americans were living in poverty, incomes were climbing, and health insurance coverage was little changed in 2019, a government report released on Tuesday showed — though the circumstances of many have deteriorated as pandemic lockdowns and industry disruptions have thrown millions out of work.

The share of Americans living in poverty fell to 10.5 percent in 2019, the Census Bureau reported, down 1.3 percentage points from 2018. That rate is the lowest since estimates were first published in 1959.

Household incomes increased to their highest level on record dating to 1967, at $68,700 in inflation-adjusted terms. That change came as individual workers saw their earnings climb and as the total number of people working increased.

. . .

Unemployment was hovering at around 3.5 percent before the crisis took hold, the lowest in 50 years, and wages were steadily rising.

For the full story, see:

Jeanna Smialek, Sarah Kliff and Alan Rappeport. “Census Shows Record-Low Poverty in U.S. Before Virus Struck.” The New York Times (Wednesday, September 16, 2020): B8.

(Note: ellipsis added.)

(Note: the online version of the story has the date Sept. 15, 2020, and has the title “U.S. Poverty Hit a Record Low Before the Pandemic Recession.”)

Chinese Communist Authoritarian System Inhibited Local Officials From Sharing Covid-19 Information

(p. A5) Communist Party leaders oversee an authoritarian system that inhibits local officials from freely sharing information with national-level officials, they said, and this has had deadly consequences for the world. It is a version of the so-called Chernobyl effect, where local officials avoid telling central authorities about a catastrophic event until it is far too late, American officials said.

Moreover, officials in Beijing have tried to spread disinformation about the origins of the virus. The C.I.A. has said since at least February [2020] that Chinese central officials were not sharing everything they knew about the virus — including a more accurate case count — or doing all they could to help the world prepare for the pandemic.

For the full story, see:

Edward Wong, Julian E. Barnes and Zolan Kanno-Youngs. “Local Officials Hid Dangers From Beijing, Says U.S. Report.” The New York Times (Thursday, August 20, 2020): A5.

(Note: bracketed year added.)

(Note: the online version of the story was updated Sept. [sic] 17, 2020, and has the title “Local Officials in China Hid Coronavirus Dangers From Beijing, U.S. Agencies Find.”)

Blocking Some of the Virus Reduces Odds of Catching Covid-19 and Reduces Odds of a Severe Case, If Covid-19 Is Caught

(p. D8) As the world awaits the arrival of a safe and effective coronavirus vaccine, a team of researchers has come forward with a provocative new theory: that masks might help to crudely immunize some people against the virus.

The unproven idea, described in a commentary published Tuesday in the New England Journal of Medicine, is inspired by the age-old concept of variolation, the deliberate exposure to a pathogen to generate a protective immune response. First tried against smallpox, the risky practice eventually fell out of favor, but paved the way for the rise of modern vaccines.

Masked exposures are no substitute for a bona fide vaccine. But data from animals infected with the coronavirus, as well as insights gleaned from other diseases, suggest that masks, by cutting down on the number of viruses that encounter a person’s airway, might reduce the wearer’s chances of getting sick. And if a small number of pathogens still slip through, the researchers argue, these might prompt the body to produce immune cells that can remember the virus and stick around to fight it off again.

. . .

Experiments in hamsters have hinted at a connection between dose and disease. Earlier this year, a team of researchers in China found that hamsters housed behind a barrier made of surgical masks were less likely to get infected by the coronavirus. And those who did contract the virus became less sick than other animals without masks to protect them.

. . .

But despite decades of research, the mechanics of airborne transmission largely remain “a black box,” said Jyothi Rengarajan, an expert in vaccines and infectious disease at Emory University who was not involved in the commentary.

That is partly because it is difficult to pin down the infectious dose required to sicken a person, Dr. Rengarajan said. Even if researchers eventually settle on an average dose, the outcome will vary from person to person, since factors like genetics, a person’s immune status and the architecture of their nasal passages can all influence how much virus can colonize the respiratory tract.

For the full story, see:

Katherine J. Wu. “Masks May Act as a Crude Vaccine.” The New York Times (Tuesday, September 15, 2020): D8.

(Note: ellipses added.)

(Note: the online version of the story has the date Sept. 8, 2020, and has the title “A New Theory Asks: Could a Mask Be a Crude ‘Vaccine’?”)

Asymptomatic Transmission of Covid-19 Reduces Value of Fever Checks

(p. A4) . . . while health officials have endorsed masks and social distancing as effective measures for curbing the spread of the coronavirus, some experts scoff at fever checks. Taking temperatures at entry points is nothing more than theater, they say, a gesture that is unlikely to screen out many infected individuals, and one that offers little more than the illusion of safety.

. . .

. . . a growing body of evidence suggests that many of those who are driving transmission are so-called silent carriers — people who have been infected but feel fine, and don’t have a fever or any other symptoms.

. . .

“We now have a better understanding of Covid-19 transmission that indicates symptom-based screening has limited effectiveness because people with Covid-19 may have no symptoms or fever at the time of screening, or only mild symptoms,” the C.D.C. said in a statement.

. . .

Evidence of asymptomatic spread dates back to early in the pandemic, but has been mounting ever since. A recent study from South Korea published in JAMA Internal Medicine in August offered even more proof, finding that infected individuals who don’t feel ill may carry just as much virus in their nose, throat and lungs as those with symptoms — and for almost as long.

. . .

A. David Paltiel, a professor of health policy and management at Yale School of Public Health, says these individuals are the “silent spreaders” who are driving transmission and sparking superspreading events.

“You are maximally infectious before you exhibit symptoms, if you exhibit any symptoms at all,” Dr. Paltiel said. “You can be exposed and incubating the virus, and be beginning to shed massive amounts of transmissible virus and be a superspreader, without actually exhibiting any symptoms like a fever.”

For the full story, see:

Roni Caryn Rabin. “Fever Checks Are on the Rise, but Are They Effective Gatekeepers?” The New York Times (Monday, September 14, 2020): A4.

(Note: ellipses added.)

(Note: the online version of the story was updated September 14, 2020, and has the title “Fever Checks Are No Safeguard Against Covid-19.”)

The paper in JAMA Internal Medicine discussed above is:

Lee, Seungjae, Tark Kim, Eunjung Lee, Cheolgu Lee, Hojung Kim, Heejeong Rhee, Se Yoon Park, Hyo-Ju Son, Shinae Yu, Jung Wan Park, Eun Ju Choo, Suyeon Park, Mark Loeb, and Tae Hyong Kim. “Clinical Course and Molecular Viral Shedding among Asymptomatic and Symptomatic Patients with Sars-Cov-2 Infection in a Community Treatment Center in the Republic of Korea.” JAMA Internal Medicine (published online in advance of print Aug. 6, 2020). Doi:10.1001/jamainternmed.2020.3862