19 May 2020 – Tuesday – #65

Wall Street is dying for good Covid-19 news. Yesterday, Moderna’s Covid-19 vaccine trial results pushed up the Dow Jones Industrial Average 912 points, or nearly 4%. Can we relax now?

Watching the hydroxychloroquine birthers, I worry that everyone could jump on the wrong Covid-19 bandwagon again. Trump’s strange revelation that he’s been taking hydroxychloroquine for two weeks (most of my social media feed either don’t believe him or want proof of his claim) adds fuel to the distracting fire. Check the comments in this Twitter thread about a hydroxychloroquine study.

The hydroxychloroquine birthers really want the stuff to work, regardless of the data. I don’t expect the data from Dr. Boulware’s study will show a different outcome from two previous studies: hydroxychloroquine has no benefit to Covid-19 patients and increases their cardiac risks.

Back to Moderna’s vaccine announcement. The study size was miniscule, eight people on the low dose vaccine and four on the high dose. MIT Technology Review provides a succinct summary of Moderna’s Phase 1 trial results.

The results are encouraging, but we can’t draw conclusions from a phase 1 trial, with data from only eight participants so far. Way more data is needed. The FDA has already given Moderna approval for a phase 2 trial (testing the drug’s biological effect on patients), and Moderna says it will add a 50-microgram arm to the phase 2 study.

MIT Technology Review, “Moderna’s latest vaccine results are promising—but it’s still too early,” 18 May 2020

In other words, at least Moderna’s vaccine didn’t fail in Phase 1.

Moderna created its vaccine using Covid-19 mRNA, which is a quick method to create a vaccine. Before you start your love affair with Moderna, though, remember that no mRNA vaccines have been approved before. I’m not saying the mRNA approach won’t work, but it’s unproven at this point. Wait for the data.

And remember, even if the data are good in Phase 2, it’s another 12-18 months to billions of doses.

Lots of places are lifting Covid-19 lockdown restrictions. It’s hard to know when to start and anticipate all the consequences of reopening. There are lots of details like how to screen airline passengers safely. In France, 70 schoolchildren have contracted Covid-19 since the country re-opened schools. Now what?

In the US, none of that is keeping states from reopening before they’re ready. According to Covid Exit Strategy, two states are ready.

States’ preparedness to re-open after Covid-19 restrictions, 18 May 2020

To be fair, Covid Act Now, which I posted in the Covid-19 beauty contest last week, paints a yellower picture of the Covid–19 preparedness situation. In either case, few states in the US meet the public health criteria for relaxing Covid-19 restrictions.

People can’t stay cooped forever, though. It’s a recipe for at least a mental health disaster, if not widespread unrest. Even Spain’s 1% has had it with Covid-19 restrictions in Madrid.

Harvard Medical School Professor Julia Marcus writes about how public health officials can help people identify high- and low-risk Covid-19 behavior as Covid-19 restrictions are relaxed.

A sustainable anti-coronavirus strategy would still advise against house parties. But it could also involve redesigning outdoor and indoor spaces to reduce crowding, increase ventilation, and promote physical distancing, thereby allowing people to live their lives while mitigating—but not eliminating—risk.

The Atlantic, “Quarantine Fatigue Is Real,” Julia Marcus, 11 May 2020

Marcus uses AIDS public health programs as a successful example of how to educate about virus risk. She points out that, as with HIV, shaming people’s risky behavior is less effective than educating them to reduce their risks.

A little detour through Florida, where Governor DeSantis says the state is ready to reopen, but the data suggest otherwise. Well, suggested otherwise. The Governor is fixing the state’s Covid-19 data problem by replacing Rebekah Jones whose work was making Florida Covid-19 data just a little too transparent. In an email to colleagues, Jones warned about the accuracy of Covid-19 data the state is providing.

As a word of caution, I would not expect the new team to continue the same level of accessibility and transparency that I made central to the process during the first two months. After all, my commitment to both is largely [arguably entirely] the reason I am no longer managing it.

Rebekah Jones, PhD., in email to colleagues regarding accuracy of Florida Covid-19 data.

I’ll also note that unlike every other Covid-19 map I can remember, Florida paints its worst hit communities in cooler shades of blue rather than hotter shades of red.

Florida Covid-19 portal, 18 May 2020.

No telling whether the 1,997 reported deaths include non-residents who died while living in their Florida winter homes. Probably not.

Anyway, back to relaxing restrictions. Shane emailed some useful links about what’s going on as Europe unlocks. Italy will open its borders in a couple weeks and Germany will follow suite in about a month. Some restriction apply, so check before you book tickets.

Travel is at the crossroads of discretionary spending, safety, and profitability. Restarting the travel industry is tricky. Spain expects domestic tourism to restart at the end of next month. I assume other European countries are expecting domestic tourism this summer as well. In the US, my friends Neil and Tim were going to join me in Barcelona, but have decided instead to buy an RV and tour the US. I assume other Americans are doing the same.

The first international travel proposals involve travel “bubbles” or European transit corridors that link jurisdictions with similar levels of Covid-19 containment. Lots of hygiene issues to work out with trains and planes.

Skift provides 22 hopeful signs the travel industry is on its way back. That seemed impossible a month ago, but not so crazy now. Especially in light of my final topic today: masks.

Where did masks come from? A mask story from NPR’s Throughline answers that question and is worth a listen. Masks have been used from at least the time of the Black Plague, but the precursor to today’s medical and industrial masks was invented by Dr. Wu Lien-Teh after the pneumonic plague outbreak in Manchuria in 1910. He demonstrated that masks can stop airborne transmission of a bacterium at a time when germ theory wasn’t very well understood.

Plague doctor wearing a bird mask.

Years later, the American designer Sara Little Turnbull took mask technology an important step forward. She applied new forms of non-woven fabric technology to improve mask design for the 3M company. Her innovations were the basis for the N95 masks used in hospitals today.

“If you don’t stretch, you don’t know where the edge is.”

Sara Little Turnbull, inventor of the modern industrial masks

As Spain and the rest of the world don our masks, perhaps we owe a debt of gratitude to Wu Lien-Teh and Sara Little Turnbull.

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