TWiV 675: Forget what you’ve herd about immunity

October 25, 2020

Daniel Griffin provides a clinical report on COVID-19, then we discuss Bill Foege’s letter to CDC director Robert Redfield, the false promise of herd immunity for COVID-19, secret blueprints for SARS-CoV-2 vaccine trials released, and neuropilin-1 as a possible entry protein for the virus.

Hosts: Vincent Racaniello, Dickson Despommier, Alan Dove, Rich Condit, and Brianne Barker

Guest: Daniel Griffin

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Links for this episode

Weekly Science Picks 2:41:55

DicksonNikon Small World Photography Competition
BrianneModeling Herd Immunity for measles
AlanSmall Gods by Terry Pratchett
RichBoundless Body Radio Bethany and Casey Ruff
VincentThe Twenty-One Balloons by William Pene du Bois

Intro music is by Ronald Jenkees

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7 comments on “TWiV 675: Forget what you’ve herd about immunity

  1. Richard Cornell Oct 25, 2020

    Herd Immunity.
    Well if you get it and live and in six months we meet I hope you would still be immune. If I would be wrong then you being part of the herd would be that your a spreader and I’m dead.
    Go back to #584 that a certain number will get sick and die and the rest will live.
    It could be call the Darwin effect where the weak die off.
    Remember that the HIV virus where thousands still become infected. Why is that.
    There is no immunity to the HIV virus nor vaccine, but it is only transfer by sex with a infected person not air borne.

    Unless your just born or just got out of a cave your aware that this virus and how to protect yourself from others. Wear a mask, stay away from others and do not touch surfaces if possible then wash your hands.
    Also about a second wave are those who have not been effected before included in the second wave or are those who have been infected are again infected.
    No matter what you do we who are old must stay away from everyone else until the vaccine is proven and it works among us old folks.

    As in past plagues if you sing songs loud enough, stump your feet hard enough and pray to your God you will not get the virus and the disease will past you by.
    There are millions of people who pray to there God and this virus will not past them by.
    It is still the Darwin effect.

  2. Ann McKerrow Oct 25, 2020

    Not sure if “herd” is somehow a play on the correct spelling of “heard” re: all the discussions on herd immunity.

  3. Hello TWiV Team,
    It’s now finally chilling down to a proper fall temp of 47 F at night here in Cambridge, MA. I have been lucky enough to make some good use of the unseasonably warm weather by keeping my restaurant open a little bit longer on the patio. It’s not lost on me that I have profited (that’s kind of a stretch to be honest) from what is an alarming trend of warming and drought conditions in Massachusetts.
    Pretty soon, I’ll start using Celsius, because after going to college at McGill University in Montreal, that became the unit I understood better for extremely cold weather.
    As you imagine, I am keenly interested anytime anyone mentions restaurants on your show and on TWiV 675 a discussion arose in response to Ben from Palmdale’s letter. He made the argument that schools should be opened which in part turned on the idea that “places where spread is known to occur – e.g. restaurants, bars, and coffeeshops – are largely open” and if that risk is to be considered acceptable, then schools should also be open. There are two things that this comparison elides which are a lot more important than people might realize, but as (just) a restaurateur, I’m quite sensitive to them.
    Firstly, the statement about “restaurants, bars, and coffee shops” is a very specific reference to a CDC memo that has been frequently cited in numerous media articles about the going to restaurants. The MMWR even admits that the limitation of their findings stem from failing to distinguish between restaurants, bars, and coffee shops or indoor and outdoor seating. That’s…I’m gonna say, a BIG distinction. And yet, articles like the one in last Monday’s Boston Globe generated enough “outsized emotional responses” (thanks Carla!) that by Wednesday our 70F and sunny patio was empty.
    When we fail to make these distinctions, the narrative becomes that there is no way restaurants, bars and coffeeshops can be safe. Meanwhile, there is good evidence that public health interventions can in fact be identified and deployed specifically in restaurants and bars.
    Once upon a time, refrigeration standards and other sanitary practices for food handling were absent or unenforced. Now in place, the transmission of food-borne illnesses has been reduced. Once upon a time, young people were permitted to drink at bars, but now we are criminally and civilly liable for any harm that comes from underage consumption or over-serving. My favorite is the more recent example of banning smoking at restaurants and bars. It reminds me that prior to the adoption of these measures, there was widespread skepticism that such things could be accomplished. Public health said “Hey we need to stop all this second hand smoke, we should ban indoor smoking” and then pretty much everyone moaned and groaned that there was no way that could possibly work in drinking establishments. The same bellyaching preceded pretty much all the other interventions until one day (week, month, year, yes it takes a little time), *boom* we just did it and it was perfectly fine. Ultimately, these all lead to more people going out to eat and drink because the healthier conditions are a net positive.
    Right now, I hear, even from Alan Dove on the podcast, the same sentiment that there is no way we could possibly make it safe to eat and drink in public. The attitude is that reopening (restaurants and schools alike) must needs be dangerous and that the only choices are to proceed recklessly because the alternative is also dangerous (to our economy, our kids educations, or our mental health), or to hold that all of these downside effects are just the price we have to pay to manage the pandemic. This puts us on a bad trajectory that is doomed to result in destruction no matter what.
    The other thing that Ben’s schools v. restaurants/bars/coffeeshop comparison elides is the implicit value judgement contained in the question of “why one and not the other”. When confronted with the very real possibility of living with coronavirus for years, the notion that my industry is somehow more “optional” than in-person school is hard to justify. Keeping us closed will cause just as much downstream damage to our world. When confronted with the short-term reality, Alan’s wish to return to dining when this is all over will not be granted. All of us will close forever if we don’t start answering “how can we open safely?” with more than a shrug of pity.
    I also have a much better analogy about restaurants that supports Ben from Palmdale’s challenge to Dr. Daniel Griffin’s hypothesis that school re-openings could indirectly drive infections: Imagine, if you will, the previous pandemic, the AIDS pandemic. Dr. Griffin may have then made a similar hypothesis: Because people are more likely to engage in risky sexual behavior after spending time out at a bar or club, the spread of AIDS is indirectly driven by people attending bars or clubs. It’s a reasonable inference, and thankfully, there was never any discussion of closing down nightlife. Instead, back when I was running around in bars in the late 1980’s and 1990’s, you literally couldn’t take a p*ss without being confronted with a poster promoting safe sex and condom use. You couldn’t swing a disco bag without hitting a condom dispenser at all types of bars and clubs. These efforts were helpful because the bars provided a way to target the messaging, and deliver the resources to people who were (in real time) likely on a path towards risky behavior. It didn’t divert everyone all the time, but it diverted many over time by instilling the norms in a setting where the social feedback created pressure to adopt the new normal.
    Schools are a fantastic place to accomplish a similar tactic to improve the adoption of the behavioral modifications that are proven to make a difference.
    It’s okay to admit we don’t know what’s going to happen, but not if it keeps us from putting some faith in what we do know, and examining our successes for ways to replicate them in different use cases. It’s okay to personally value the education of children over the mental and emotional health of the regulars down at the pub. However, when we treat the challenge of improving safety at restaurants as unimportant or lesser, we’re engaging in the same kind of moralizing that hampered efforts to encourage safe sex at the beginning of the AIDS pandemic, and in the end, this intervention is considered more effective and long-lasting than abstinence.
    If we want to keep Gus and Lola’s 5th birthday party from killing grandma, it’s a good idea to consider how we convinced the Jennifer’s and Jason’s of my generation to use a very uncomfortable contraption in the most awkward and intimate of moments. The pub and café as much as the school or the temple are places we have always promulgated the adoption of new behaviors that reduce the spread of disease. In-person settings such as bars, restaurants, coffeeshops, schools, gyms, churches are places where peership and community can best be leveraged. Please can we stop asking “How can we?” and start answering “How will we?”

    Thank you Vincent et al for a thoroughly enjoyable few hours a week during which I get to over hear intelligent conversation and genuine camaraderie. I used to get this at the bar and really really miss it. You all have been a wonderful substitute and genuinely inspire me to do what I can to make a difference.
    Cheers,
    Kari
    Cambridge, MA
    Owner and Operator of Grendel’s Den Restaurant & Bar

  4. JJackson Oct 26, 2020

    Vincent, at time point 2:22, was talking about the Chinese attenuated vaccine. I understood him to say the sequence was the same as the wild type at the AA level but very different in its NT sequence but with all changes being silent. Did I misunderstand, if not how does that work?

  5. hightrekker Oct 26, 2020

    Hint:
    This maybe a predicament, not a problem.
    Problems have solutions.
    Predicaments don’t.
    We shall see——

  6. Sharon Mozley-Standridge Oct 26, 2020

    You guys discussed how k-12 is not seeing a real increase in cases from in-class exposures but what about college/university level cases? The concern and question that I and my fellow faculty have teaching college students, is that they don’t stay in pods, they move around both during the day going from class to class (different buildings/campuses) and have moved around the country (or within states/communities) to attend classes and we wonder if this could lead to increased rates of infection in college communities. Is anyone tracking this?

  7. Kimona Oct 28, 2020

    Firstly, I am new to TWiV and love it – but….I am a Swedish native (and MD/PhD from Goff’s lab, just down from Racaniello’s back in 90’s!). I feel like Sweden is getting an unfair rap…..My teenage children are attending high school just outside of Stockholm, and I go back regularly – despite the pandemic. Sweden’s “death/capita” remains below that of the US, and they are NOT aiming for herd immunity. Anders Tegnell, the state epidemiologist, has received much negative press for Sweden’s current approach – which was mainly aimed at maintaining the rate of infections low enough such that the health care system would not get overwhelmed (like NYC back in spring). All non-essential workers, who can, are working remotely. Kids were kept in school, on the premise that if they are sent home, then their parents, many of whom are essential workers, would also need to stay home. They abide strictly to the 2 meter distancing rules in stores, all 70 and up have been home and isolating since springtime, not seeing their grandkids, schools have adapted with smaller classes, rotating lunch schedules…….. Currently, they are debating the mask-wearing heavily in media, and whether it should be implemented. Yet even without it, they are doing better than US. So what gives? I believe it is the people…..if they are advised something by their health authorities – they listen and do their best to abide, whereas in the US, certain people take it as an infringement on their “rights” – and act opposingly. At least in Sweden everyone has access to equal healthcare. Just expressing a little frustration at all the negative media Sweden is receiving! But I love TWiV!

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