Ricarda writes:

Dear TWIV team,

Please find enclosed a rough summary of an interview our GCG (German Corona Guru, not his official title 😉 gave to National Radio on Monday. Thought it might interest you.

https://www.deutschlandfunk.de/coronavirus-mutation-in-grossbritannien-virologe-drosten.694.de.html?dram:article_id=489655

Q: How worried are you about this?

CD: I’m not overly worried at the moment <but no detailed information, UK scientists have said that they’ll need a week for detailed data analyses>

Q: What are the most important questions that need to be answered now?

CD: <Is it easier to transmit?> We have this virus in the Southeast of England, including London… The question is: Has this virus just been noticed in the wake of a new rise of cases in the region, or has the virus caused this rise? <the area where the virus was found had experienced exponential growth in December, whereas in other regions in the UK, which had been in lockdown, numbers were beginning to stabilise.>

Q: What about the statement that the new variant is 70% more transmissible?

CD: <who knows, maybe a scientist was asked to give an estimate which then developed a life of its own.> rc: it comes from the NERVTAG summary: “Growth rate from genomic data: which suggest a growth rate of VUI-202012/01 that is 71% (95%CI: 67%-75%) higher than other variants.”  There is a formula for calculating growth rate in the PHE technical briefing, though I can’t be sure it’s the same formula used here.

Zimmer article quotes Neil Ferguson, epidemiologist at Imperial College London as estimating that the variant has an increased transmission rate of 50 to 70% compared to other variants in the UK

Q: Is it justified that countries have started to close their borders to the UK?

CD: <I’d call it being cautious; we should wait and see what UK scientists will tell us in a week> “What British scientists really said, was: Look, this could be something but we don’t know. We’ll know more in a week’s time… If you want to know whether a virus is easier to transmit, you have to examine pairs of transmission: who infected whom, and how long did it take.” <an epidemiological parameter called serial interval>… “Considering all the things we already know about the virus, it would be surprising if this parameter was still changing in a big way.”

Q: So you reckon, it’s not more transmissible?

CD: <I don’t know, I’m keeping an open mind, there are some other properties of this virus that are worrying à mutation in receptor-binding domain> “This mutation appeared before, and it always vanished. It has appeared now in South Africa, and it seems to be passed on. But no-one knows whether it has any effect. It increases the binding to the receptor, but this doesn’t need to be a good thing. A virus needs to be able to let go of the receptor at some stage. So this virus has spent a lot of time, trying out all sorts of things in order to optimize itself to humans, and did not change this spot. Bit of a coincidence. So I’m doubtful this mutation is actually beneficial for the virus.”

Q: Will it be possible to stop this variant from coming to Germany?

CD: <I reckon it’s already here – no need to go all panicky; it was first identified in England in September/October, and has slowly become more widespread all through November – but only locally in this region. It’s been found in Denmark, Italy, Belgium… It reached the Netherlands in early December and did not cause a sudden flare-up in cases there. But we’ll see. I keep an open mind.>

Q: What about the vaccine? Could it reduce efficacy?

CD: No, I don’t see that at the moment. A virus with improved receptor binding might mean that there is more competition and that antibodies could be binding less well. But we make a big multitude of antibodies following vaccination, and only one or very few of these antibodies would be affected by this change. Plus, the T cells which are induced through most of these vaccines (which almost always contain the entire spike protein) will have many other points of recognition and will be as efficient as before.”

As I said – a rough estimate. I’m not a scientist.

Regards,
Ricarda

Mark Martin writes:

Here is a haiku about you (wrongly) called a curmudgeon.

Data do not lie
It is not “Racanyelling”
To think critically 

Robert writes:

 Dear Twiv gang,

A big reason the Janenisch et. al. paper got so much attention was because it came from the Whitehead. Don’t forget David Baltimore was the founding director. So the place has RT in its DNA (please forgive a bad molecular biology pun).

You were right to spend time pointing  out all the paper’s faults, but the status of an institution plays a big part in whether a journalist pays attention and it does when  the journalist asks other scientists for comments.

A BioRxiv paper from an obscure institution is far less likely to get attention.  A place like the Whitehead has an obligation to be especially careful.  In fact, unless there is immediate  public health concern, it should probably not even be posting on BioRxiv.

Keep up your great work.
Robert Bazell — now Yale (formerly NBC)
Adjunct Professor
Molecular, Cellular and Developmental Biology

Jill writes:

Hi Vincent et al –

  “Just” an IT person here.

  You’re right – the breach is a big deal.  It’s estimated that over 18,000 companies/organizations are impacted and that the stow away in the code has been there for months.

  Can you just patch?  Not necessarily – in some cases a total rebuild will be needed which will require builds and testing.  This will take a lot of time to work through.

  Interesting that this was done as most staff are on Christmas break and trying to use PTO prior to year end.  Also interesting that our POTUS is downplaying the significance as he also did the pandemic.

  You are right to be concerned.

  Here is a good go-to person/blog for keeping up with this:

https://krebsonsecurity.com

  Thanks for continuing to try to educate us –

  Jill

John writes:

Hi Twiv,

Love the show and listen all the time. Heard the call out for more info                              Here’s a nice update on what happened and what Microsoft did to mitigate: https://www.geekwire.com/2020/microsoft-unleashes-death-star-solarwinds-hackers-extraordinary-response-breach/

Here’s an emergency webcast update from SANS on the solar winds hack and steps FireEye and DHS have implemented to mitigate and what they recommend customers do.

Hope it helps,

All my best,

John

Robert writes:

Long time listener, thank you for all  your time creating microbe.tv

Just wanted to offer a little perspective on the problem as a software engineer on this event, (in return for the invaluable perspective given to me and many others by twiv):

  • Much of the IT infrastructure in the world today may be described as an abomination of 3rd party vendors on top of more 3rd party vendors.  We “license” software for every purpose and function.  In the SolarWinds case, it is “network monitoring”. 

    On the light side, a company doesn’t have to develop every bit of IT inhouse, and reinvent the wheel over and over again.  However the real benefit here is the ability of a company to defer responsibility and shed liability to these vendors.

    We have seen this in many previous data security events in the last decade:
    • Home Depot – a vendor did not follow good data security guidelines and a password into Home Depot’s system was compromised
    • Target – a vendor’s bad data security practices in combination with a bug in Microsoft Windows Operating System software also allowed a breach
  • Sometimes we see the opposite, where much of the IT prefers to do much of the boot-strapping themselves:
    • Equifax breach – Used a free open-source technology, but had bad data security governance policies.  Failed to install updates, patch vulnerabilities, and renew security keys.  A bug in the open-source tech allowed hackers to breach the system.  Equifax even hired a 3rd party vendor to “audit” their system, but did not enact their recommendations of patching vulnerabilities.

      In this case, Equifax had to begrudgingly eat much of the responsibility as they did not pay for the software used.
  • In the SolarWinds breach, the supply-line itself was compromised.  Malicious code was placed into the source, (possibly in their physical office itself by some bad actor, we don’t know yet), the code was tested, audited and “passed”, it was built and compiled, and then it was “shipped” as a ” Software Update ” to thousands of systems across the country that used SolarWinds as a 3rd party vendor.

    Clearly somewhere in the office of SolarWinds, an essential data security practice was ignored.

We can see from these examples that any system is never truly invulnerable to breach.  Rather, our national defense is more of an “wait, identify, and patch” approach.

Much of this vulnerability detection and patching is managed by CISA: https://us-cert.cisa.gov/ncas/bulletins

“Good” system administrators will carefully monitor these vulnerability publications, and patch them immediately.

So what is my point with these three bullets?  It is wise to go ahead and assume any information placed onto a computer is not safe.  We can in no way audit every 3rd party vendor, or every technology used in our IT infrastructure.  We can not ensure every system administrator clicks the “update” button.  We cannot point our fingers at CEOs and say it was their fault, as they will defer.

Our “wait and identify” strategy is in no way perfect, but is our best “try”.

With regards to our most essential or dangerous systems, such as our nuclear arsenal or ,  we often use a method called “air gapping“, where the system is physically disconnected from any other networks.  However, even this method is not invulnerable to attack:

  • Stuxnet, a virus that was used to infect airgapped Iranian nuclear systems by way of a physical USB flash drive
  • Some creative scientists have demonstrated ways to “read” data from airgapped systems by measuring other metrics like acoustics, thermal energy, and radio frequencies emitted by the system.

We hope that our most secure systems do not allow for remote execution of launching missiles or shutting down power grids, but that is getting into national security secrets.  We trust our systems are continuously monitored with the most vigilant eyes.  But as we can plainly see, it is not always the case.

In conclusion here, we can see data security is not really security at all, but perhaps much like virology where you vaccinate/patch in hopes of not allowing a virus to cause damage, and then wait for new symptom onsets, and patch accordingly.  It requires “rapid” testing, and often.  It requires good leadership that embraces responsibility, not defer it.  Curiously, ignorance is not the key to survival in data security, much like a pandemic.

— 

Robert

Dan writes:

Finally, I know something about a topic brought up on TWiV! It’s sunny and we’ve recently started our “winter” in Phoenix (which feels like it lasts all of about 6 weeks). The high today was 70 degrees. Freezing cold!!

I find news sources to be severely lacking these days so I really enjoy listening to TWiV to get as close to the primary science as I can understand. Facts are wonderful, rare gems these days and TWiV has more SARS-CoV-2 facts per minute than any other source I’ve found. It’s great. However, listening to PhDs talking about their area of expertise can be quite humbling, so saying I “understand” TWiV content is a real stretch… but luckily, I do know a bit about Industrial Control Systems’ (ICS) security. I have spent some time working in the ICS field, so maybe I can offer a bit of insight, since Vincent asked. 

Hacking of power plants and other industrial systems is legitimately an area of concern. Hacking power plants and other physical infrastructure has seen heightened interest from governments to malicious hackers alike, but a cascading takedown of the entire national power grid is very, very unlikely. 

The difficulty of doing a nationwide takedown isn’t so much an artifact of brilliant planning as much as it is dumb luck. When we think of computer viruses taking over systems, we’ll often think of a hacker devising a way to compromise Windows or maybe an email or web server. Even if you’re not familiar with the details of what these systems are, they are often dominated by a single company that runs the same code all over the world, across all industries. Because there’s relatively little variability between software programs running across vast swaths of the world, computer viruses can generally spread fairly easily and hackers can choose from a wide variety of targets. To put it succinctly, hacking in the world of Information Technology (IT) scales massively. 

(Though the analogy is imperfect, it’s not entirely inaccurate to compare the world of today’s IT topologies to a biological ecosystem where asexual reproduction reigns supreme). 

The world of Operational Technology (power plants, manufacturing plants, etc) is the exact opposite. OT systems (which run many ICS systems) are like snowflakes – they’re all a little bit different from one another. Not only will a gas power plant’s computer systems differ quite a bit from a nuclear plant, one gas plant’s systems will be different from a gas plant 20 miles away. This heterogeneity has to do with the peculiarities of geography, regulation, company policies, who happens to build the system when the plant is constructed, etc. Being “different”, definitely does not mean OT systems are unhackable. It means hacking OT systems doesn’t scale like hacking IT systems. So if an adversary puts in the time and effort to hack one power plant, they’ll have to put nearly as much effort into hacking the next one. And hacking a power plant to the point where permanent physical damage occurs isn’t trivial.

We can see this lack of scaling in the most famous example of a power plant hack seen to date, in Ukraine. An “adversary” (read: Russia) was able to knock power offline for a few hours. Few doubt Russia would’ve shut down Ukraine’s entire power grid had they been able to, but they didn’t. This is likely due to the difficulty in scaling attacks. 

In terms of recent news, the “SolarWinds/Orion hack” is a big deal and likely has resulted in some important systems being compromised, but even if adversaries have gained a foothold into sensitive ICS systems, there’s still quite a bit of work to do after that. And even if they do manage to cause physical damage (which, unlike obtaining illicit systems access, is very likely an act of war), that damage will be localized. It’s also important to note that we’ve got a very robust grid in the US, so if hackers managed to take out production in your local power plant, odds are pretty high you wouldn’t even notice. So to me, the takeaway is that yes, we absolutely need to be concerned about cyber security in ICS systems, but the simultaneous takedown of all critical US national infrastructure is not a realistic threat. Living in the middle of the desert I worry much more about the neglected water systems being hacked than I do about power. 

PLEASE NOTE: Everything I’ve said here is public knowledge. 

I could write pages and pages about this stuff so I’ve taken some liberties with generalizing, not mentioning exceptions, nuance, details, etc. One could semantically quibble with most of what I wrote but this is the high level executive summary, as per Vincent’s request. Just FYI. 

If you’re interested in diving into a mostly understandable presentation from an industry leader in the same spirit that I consume TWiV content, please check out this 40 minute video I’ve linked to below. It’s techy, but Robert mostly speaks in English and it gives a decent feel for the ICS security industry.

And thank you for sharing your knowledge on TWiV!

— Dan

Video definitions: 

IT – The people and functions you’d normally associate with computer systems: email, computer programmers, etc. 

OT – The technical systems that run on or close to the physical machines. OT technicians in the plant literally get their hands dirty working on big machines in the plant. 

Spearphishing – Emails targeted and crafted for specific people. Targets are usually VIPs with unique system access or very high ranking corporate officer types. 

***

(P.S. You mentioned watching a music theory video you didn’t understand but still enjoyed. Here’s the best music theory video I’ve yet found. Only 30 minutes and I think it’s actually pretty understandable, though he does talk fast. https://www.youtube.com/watch?v=rgaTLrZGlk0)

Rachael writes:

Dear Vincent et al., 

I am a big fan of the podcast, thank you for what you are doing !

I listened to #696 this weekend, and wanted to share some resources that might be helpful for the question on school testing and the availability of the new Ellume OTC test.

First a quick plug for NIH, as the Ellume test benefited from funding from the NIH’s RADx program: 

https://www.nih.gov/news-events/news-releases/nih-funded-covid-19-home-test-first-receive-over-counter-authorization-fda

It will likely be a couple of months before the Ellume test is commercially available in stores as they are still ramping up production. Here is the link to article in the Washington Post that has a bit of info on that.https://www.washingtonpost.com/health/2020/12/15/covid-home-rapid-test/

Your listener might also be interested in this free tool developed by MIT (with NIH funding)  to help organizations such as schools and businesses explore different testing strategies:

Best wishes, 

Rachael  

Rachael L. Fleurence, PhD
Special Assistant to the NIH Director for COVID-19 Diagnostics

Tom writes:

Love the show. I’m in the Moderna trial, so responding to the discussion around the review coming up on Thursday in TWIV 694. Nasal swabs (NP) are done at the time of shot 1 and again at shot 2. There is a third visit at 30 days post shot 2 for blood samples (about 9), but no additional NP swabs at this visit. As far as I know, the only reporting of infection after shot 2 is triggered by reporting of symptoms. The app also asks for exposure to others that are infected, so they may sample people who have been exposed, but I don’t think they do unless one is symptomatic. 

Swabs are NP swabs done by the medical staff. None are self swabs. 

When in the “sick” arm of the trial, NP swabs are collected immediately for various respiratory diseases (RSV, flu, others) and for SARS-CoV2. Self-collected saliva samples are collected on day 3,5, 7, 9, 14 and 21 post symptoms in the sick arm. These are used for viral quantitation to monitor disease progress. 

I have been impressed with the team running the Moderna trial. Great science, great logistics and great impact on the pandemic. I am unbelievably excited by the progress being made by RNA vaccines this year. We’ll look back 20 years from now and be amazed at the impact that RNA vaccine technology will have on our ability to respond rapidly to future emerging disease threats. 

Best, 

Tom

N writes:

Hi!

Thanks so much for your podcast. It keeps me calm to hear someone knowing what they’re talking about. 

My question for y’all is: who is deciding which healthcare workers get the vaccine right now? And how?

I’m a physician in a psychiatric hospital in the suburbs of NYC. Many patients and several staff died here during the peak of the pandemic when there was no PPE. As of right now, I have been given no information on when to expect a vaccine, except recently I was told that the state won’t pay for the freezers so we’ll “probably get the Moderna vaccine.”

Our patients mostly come from jail and are too psychiatrically ill to understand masking and social distancing. It’s not unusual for these patients to become violent or spit on people. We don’t have a way to effectively quarantine them away from other patients. Now there’s surgical masks and face shields, and we’re being told that that’s sufficient if a patient tests positive, even though it’s obviously not.

When I see my colleagues who work in high-risk but sterile environments getting vaccinated, and Congress getting vaccinated for some reason, I can’t help but wonder if we’ll be forgotten about because no one thinks of a psychiatric hospital when they think of covid. 

Thanks,

N

Liz writes:

Please help! I can’t find what I think I heard! On an earlier episode I think I remember a conversation about an initiative to bring testing availability to schools through parent-teacher organizations. Our community might finally be amenable to such a generous initiative and I can’t find the information any longer. We are in a fastest-growth-in-the-country metro and really need to do something! I’d love to take this information before our ptas. 

Thank you for your valuable podcasts. I’m a regular listener and recommend TWiV to everyone who will listen.

Thanks again,

Liz
Knoxville, TN

Your listener might also be interested in this free tool developed by MIT (with NIH funding)  to help organizations such as schools and businesses explore different testing strategies:

· https://whentotest.org

· https://www.nih.gov/news-events/news-releases/nih-funded-tool-helps-organizations-plan-covid-19-testing

Sonrisa writes:

Math teacher

Jose writes:

Hi Twivers! Only a single question this time. Do you know if either in the Pfizer or in the Moderna trial autoantibodies against muscle developed after the VAX? Are they safe to be recommended in patients with myositis?

Thank you

Loren writes:

Dear TWiV – 

Greetings from Seattle, where it is dark, cloudy, and 8°C/46°F/281°K.

A brief update from inside the Moderna study: If the EUA is granted, they say they will offer us phase 3 participants some options: stay in the study, or get unblinded.  See their below for details.

Unblinded control group members would then also have the option of getting the vaccine; possible as soon as the next 2 or 3 weeks.  

Staying in the study would be good for science, but I feel like I should really just get the vaccine.  I am assuming that any vaccine I get would be coming from the study and Moderna, not from my state’s allotment of the Federal Government’s purchases.  I may have to ask.

Is this unfamiliar feeling in my chest some form of optimism?

Loren

Dear COVE Study Volunteer:

THANK YOU for your dedication and sacrifice to make this study a success on our path together to end this terrible pandemic!  We can’t do this without you!

We are writing today to explain the next steps of the study and the process of how we intend to make the mRNA-1273 vaccine available to those of you that may have received placebo. 

Moderna filed an application for Emergency Use Authorization (EUA) on November 30, 2020.  The FDA will convene a panel of vaccine experts (also called “VRBPAC”) to review this application at a meeting on December 17, 2020. VRBPAC will advise the FDA whether available efficacy and safety data are sufficient to authorize the mRNA-1273 vaccine for Emergency Use.  We hope FDA will be able to decide on this application soon after the meeting, but we don’t know exactly how long this will take.   

It is important for you to understand that the study doesn’t end if an EUA is granted and we still need your contributions to this important study.

What happens to you after EUA is granted for mRNA-1273?

If the FDA grants an EUA for mRNA-1273, we intend to implement the following plan:

  • You will be provided a new Informed Consent Form (like the one you got at the beginning of the study) that describes updated risks and benefits about your continued participation in the study, including alternative options given that the vaccine is available under EUA (including other COVID-19 vaccines). 
  • If you would like to know whether you have received the mRNA-1273 vaccine or placebo, then you will be offered the opportunity to be unblinded. Another option would be to stay in the study to continue to capture data in a blinded fashion.
  • If you find out that you received mRNA-1273, we will ask you to continue to be followed in the study as originally planned.  Your contribution is still very important to learning more about the vaccine and how long it might be protective against COVID-19.
  • If you find out that you received placebo, we plan to offer you the opportunity to receive the mRNA-1273 vaccine and to continue to be followed in the study. We hope to start offering the vaccine within approximately 1-2 weeks after EUA is granted for mRNA-1273.

While the study has met its main objective, all participants are still contributing valuable information for the medical community and the public to learn about our vaccine. We ask that you please consider staying in the study for as long as possible.  

What happens if another COVID-19 vaccine is available to you before we can offer you mRNA-1273?

It is possible that another COVID-19 vaccine under EUA may become available to you based on your status relative to the CDC recommendation for priority populations (i.e., healthcare workers and assisted living/ nursing home residents).

Our plan is to provide mRNA-1273 to all placebo participants who contributed so much to the success of this study.  However, if mRNA-1273 is not yet available and you have the opportunity to protect yourself by receiving another COVID-19 vaccine, you can reach out to your study doctor to request unblinding and discontinuation from the study (if you received placebo).

It is important that you have this discussion first with your study doctor to know what you received in this study before receiving another COVID-19 vaccine. Getting another COVID-19 vaccine after you have already received mRNA-1273 has never been studied and we don’t know how safe this is.

Even once you know you have been vaccinated against COVID-19, please continue other public health measures to limit the spread of disease, including wearing of masks and social distancing. 

We are grateful for your continued dedication and participation in this trial to make it successful. Feel free to contact us if you have questions.

Omer writes:

Hi TWIV gang,

I just listened to Sunday’s episode. Great episode as always. I just wanted to point out that the 95% confidence interval for ChAdOx1 vaccine (LD/SD) effectiveness at preventing asymptomatic infections is 1% to 83%. In other words, we really don’t have a clue. The Pfizer and Moderna papers/submissions don’t speculate on the matter since they also don’t have enough data. I thought simply quoting the point estimate of 58.9% could be misleading (especially with that level of precision). Decisions about who should get the vaccines first should probably rely on data from other vaccines/viruses as a prior. Maybe you can address this in the next episode.

Keep up the good work!

Omer

Amy writes:

Hi TWIVers,

I’m a 38 year old Graphic Designer from Wisconsin. It’s currently 34 and cloudy. I’m writing to comment on the discussion on episode 696 about my age group not feeling threatened by the virus. I agree that it’s a huge problem and I’m wholeheartedly with Alan that a unified message from the government would be a great solution. In March I realized that I needed to find some good sources of scientific information about covid-19 beyond the short amounts of time that the health officials were actually allowed to speak during the coronavirus press briefings. It took some work to find you guys but once I did I regularly listened to TWIV, JAMA network, the Osterholm Update and Med Cram. This added up to many hours a week but I am used to listening to podcasts and audio books while working, exercising and doing household chores so making time for science education was easy and enjoyable. I eagerly started sharing what I was learning with my friends. They listened at first but soon came to think that I was overreacting. They had heard nurses that they know express doubts about the pandemic’s severity early on. They saw the commercials from CDC that seemed to only be warning of bad outcomes from those with serious health conditions or over 65. I can’t even blame them for not believing me. I don’t have any background in science or medicine and I was the only person telling them that this virus was killing people even younger than us. At the time the media seemed to have more stories about 90 year olds that recovered than of young people who ended up in the hospital or of long haulers. Eventually one of my friends knew 2 people that ended up in the hospital. It was only then that she wanted to talk about covid-19 with me and was very interested in what I said. In my office there have been several people who have gotten the virus. The ones who’ve had mild symptoms only reinforce to others that they don’t need to be afraid. One person in her 20’s experienced severe symptoms but she was an anti-masker and a Trump supporter so she might’ve felt a little embarrassed to talk about it. On social media most of the posts in my feed lean liberal but even there I only saw messages about wearing masks as a kindness to others and not because there is reason for everyone to fear getting the virus. The altruism message is probably enough to motivate most people to mask up when going into a store or to physically distance from grandma but it’s not enough to make them change their behavior around their peers. We all know that some people seem to be so brainwashed from misinformation that there is no convincing them but I think if every American was listening to someone speak as frankly and honestly as Daniel Griffin, Mike Olsterholm or all of you TWIV superstars the country would be in a much different place. I think most people will make the responsible decision when they have all the facts. It’s human nature though, to avoid doing the hard thing, the thing you desperately don’t want to do, if you’re given reason to think it’s not that important. In my opinion younger people in the country have constantly been bombarded with information leading them to believe that serious outcomes among people like them are outliers and not many people are willing to alter their lives for something that seems like a long shot.

Thank you so much for all you guys do. I’m so grateful. I’ll continue to be a listener even after we’re past this current  tragedy. Keep on TWIVing, my friends!

Sincerely,

Amy

New paper from Linsey Marr & Gandhi about masks

https://www.sciencedirect.com/science/article/pii/S2666634020300726

https://www.gocomics.com/doonesbury/2020/12/20

Colin writes:

Hello,

First time listener here. Saw your podcast shared on social media. Near the start of the latest episode there was dialogue around COVID-19 being harmful to young people (25-44), and the cast seemed to be stuck on the question of “how do we convince the youth to take this seriously?” I’m a 25/M resident of Seattle. So if you *genuinely* want an answer to that question, you’re welcome to my perspective.

I’m very selective with my response to COVID-19. I wear a mask in closed, public spaces (supermarkets) because this is where I risk transmitting something to someone else who had no choice to interact with me. I haven’t seen my parents since the start of this because  their age group is at higher risk of death. However, I still gather regularly — and indoors now that it’s cold — with my friends. We are all < 30 y/o, we’ve done our best to understand what we can about the disease, and after evaluating the risks we’ve decided that the likelihood/possibility of ill outcomes are worth the benefit of each other’s company when asymptomatic. *Plain and simple*.

It’s possible I’ve evaluated the risks incorrectly (Mostly I’ve been using CDC numbers which put my age group at about 1100 deaths since March: https://data.cdc.gov/NCHS/Provisional-COVID-19-Death-Counts-by-Sex-Age-and-S/9bhg-hcku and 1 hospitalized per 1000: https://gis.cdc.gov/grasp/covidnet/COVID19_3.html). If that’s the case, I can be convinced to act differently by being presented with good data that presents a better view of the risks. And I’m being truthful there: I embrace changing my opinions because I have a lifelong love for learning. Up through August I was way more cautious, but by September we had solid enough measurements for everything — except long-term effects of the disease by age group — that I re- evaluated the risks.

Like you said, a national mask mandate wouldn’t be likely to have actual significant effects. Nor would the US supreme court enforce that kind of a measure. We can’t legislate our way out of a pandemic (though legislation can help). Science can inform us of the risks, but it doesn’t command us to respond to those risks in any particular way. The history of this country is based on individuality, where every person is responsible for making their own decisions. If you want a person to behave differently, the way to do that is to listen to their opinions, understand why they hold the beliefs they do, and then share a more compelling story than the one they’re presently embracing.

Anyway, if you were looking for some insight into “how do we convince the youth to take this seriously”, there’s my perspective. It’s sometimes hard for me to tell genuine curiosity apart from willful ignorance. So if any of this letter was worthwhile to you, please write back with at least some acknowledgement. That way I know to continue sharing my opinion with those who claim to not understand the behavior of my demographic during this time we’re in.

Be well,

Colin

Nanette writes:

Thank you all twix-ers (TWIV and Immune especially) You have been a lifesaver to me this year. I am not a virologist but make my living from viruses! (I’m a veterinarian and discuss viral diseases every single day…some treatment and a lot of prevention via vaccination.) 

Anyway, Brianne had these viral snowflakes as a pic of the week and I made some for our tree. I was happy to see calici, adeno, and bluetongue since they are veterinary pathogens. But of course I also had to make the  corona and an RNA vaccine!  It was therapeutic to sit quietly and cut while appreciating science and all it does for the world. 

Thank you again for your dissemination of information. This year has been made bearable by listening to you all calmly and rationally talk about the latest developments. It has permitted me to share solid information and advice with my family and friends. I feel we are all safer for it.

Nan Rosenberry, DVM

(72 degrees F in Sarasota FL)

Junji writes:

WATCH LIVE: Dr. Anthony Fauci receives COVID-19 vaccine

“Biden Receives Coronavirus Vaccine | NBC News”