Category Archives: medical

current affairs, medical, science

More on Covid Vaccines etc.

[Warning: LONG READ]

Last week’s New Scientist carried several good articles on Covid-19 vaccines etc. If you have access to New Scientist or their website (which is paywalled) they’re worth reading. As usual, as they’re paywalled I’m going to be a little naughty and give you a key extracts from three of the articles. (Links to the articles are at the foot of the page.)

We can’t be certain the coronavirus vaccines will stop the pandemic

So things look good. But we are still a long, long way from a vaccine that will get us back to life as normal. That is in no small part due to the huge challenge of manufacturing, distributing and administering one … plus the reluctance of a significant minority of people to get vaccinated.

How long will immunity last? … We simply don’t know yet how long protection from any vaccine will last.

Vaccine efficacy does not always predict vaccine effectiveness … various reasons …a major one is that the deployment of a vaccine on the ground, to millions or billions of people, is much more challenging than administering it within a tightly regimented clinical trial. That is especially true of a two-shot vaccine that relies on people showing up to two appointments, often weeks apart.

The trials aren’t going to tell us what, if any, effect a vaccine has on severe illness … unless urgent changes are made to the way the trials are designed and evaluated, we could end up with approved vaccines that reduce the risk of a mild infection but do not decrease the risk of hospitalisation, [ICU] use or death. This seems outlandish, but … it comes down to the trials’ end point. In all the phase III trials, this is defined as the prevention of mild covid-19 symptoms … such a result tells us next to nothing about whether the vaccine is stopping infected people from getting really sick.

The trials appear designed to answer the easiest questions in the least amount of time, not the most clinically important ones … It is possible to do a Covid-19 clinical trial with severe disease as an end point … but it would be a major undertaking because that outcome is still quite rare. The studies do not have adequate numbers of patients to be able to reliably tell us if they prevent severe disease.

We don’t know how people who have had the virus and recovered will respond to any of the vaccines … We also don’t know whether the vaccines will put pressure on the virus to mutate.

The seemingly simple question “does this Covid-19 vaccine work?” is surprisingly hard to answer.

The Biggest Logistics Challenge in History: What will it take to get a covid-19 vaccine to the world?

Vaccines don’t save lives … Vaccination does.

When a Covid-19 vaccine is approved, it will trigger a staggeringly complex chain of events. These events must occur in perfect lockstep using a global supply chain that needs to reach even the planet’s most remote areas – the same supply chain that left parts of the world in desperate need of things like disposable gloves and protective equipment just months ago. The scale and magnitude of what we’re talking about doing is just unparalleled.

The key to overcoming complexity is planning and planning early.

How many people need to be vaccinated to end the pandemic depends on how effective the vaccine is, and how long the immunity it provides lasts … that figure [may be] 60 per cent. Given we now number 7.7 billion, and most of the vaccine candidates in late-stage trials require at least one booster, that is a staggering 9 billion or so doses.

Pfizer and BioNTech plan to make enough doses to vaccinate 25 million people by the end of 2020, and 630 million people in 2021 … Making all this vaccine requires a lot of upfront cash.

The US government has invested $6.5 billion in Covid-19 therapeutics and vaccines … [and] … will own more than 700 million doses from at least six different companies. The UK government has signed [deals] agreeing to buy a total of 340 million doses at set prices from at least six firms.

Once vaccines have been approved and manufactured … the challenge remains to package, ship and administer them to more people and in a shorter … time than ever before. While supplies like alcohol swabs, gloves, bins for used needles, pallets, plastic wrap and syringes can all be made by a wide array of manufacturers, the scale of the demand may be hard to cope with.

One of the challenges … is that vaccines are shipped by air and can arrive almost anywhere on the planet in one to three days. Syringes, being bulkier and with a shelf life of around five years, are typically sent by boat and truck. They can take two to four months to reach their destination.

Covid-19 vaccines will be stored and shipped in special glass vials. These are resistant to shattering at temperature extremes and less chemically reactive than standard glass … almost exclusively made from borosilicate glass. The main worry is that this glass requires special sand … and a breakdown at any point in the chain could bring vaccination efforts to a halt.

Once the vials are filled, they will need to be distributed – and quickly. The … airline industry … has estimated that providing a single dose to everyone on the planet would require enough vaccine to fill 8000 Boeing 747 cargo planes.

How they are transported is another challenge: all 12 of the leading vaccine candidates will need to be kept cold to stabilise the sensitive ingredients. Moderna’s [vaccine] will need to be stored at -20°C, a temperature that can be reached by most household freezers. [Pfizer’s] vaccine will need to be far colder: -70°C. That requires special freezers that can reach -80°C, the kind used to store things like bacterial cells in labs or sperm in fertility clinics. Pfizer has designed new insulated, suitcase-sized containers that will be packed with dry ice to maintain temperatures below -70°C and can keep the vaccine stable for up to 15 days. Each container can hold up to 4875 doses and will need to be refilled with 23 kilograms of dry ice every five days.

At some air hubs in the US and Europe, UPS is building freezer farms. Each of the 600 freezers in one of its farms will be able to hold 48,000 doses of vaccine.

Things get trickier when products are on the road … it gets most difficult in the “last mile” … In low and middle-income countries, drivers on motorbikes typically deliver vaccines and other medical products to villages in remote areas.

More worrisome are unanticipated shortages … there are a lot of hypotheticals and you have to plan and prepare for all of them … you need to have the right infrastructure and capacity in place to handle what’s going to be a relatively short, sharp shock to the supply system … coordinating the administration of a vaccine and booster on a global scale isn’t something the world has experience with … at [the scale] needed to open up society.

Political challenges to overcome, not least the willingness of people to actually get vaccinated.

In the UK … there are concerns that changing trade agreements under Brexit could delay the transit of vaccines or even leave them stranded at the border.

As long as we leave a region or country without access, the virus will come back

Heidi Larson interview: How to stop covid-19 vaccine hesitancy

One of the reasons rumours and misinformation are getting more traction now is because we have a lot of uncertainty. Things are changing every day, and people are anxious and want an answer. We have a perfect storm for rumour spread.

In the UK, the US and other countries, in May only 5 per cent said they would definitely not take a vaccine. Now, that’s up to more like 15 per cent.

Across the UK and US is if you are lower income … you are non-white and female, you are more likely to refuse a Covid vaccine … These communities could benefit the most but they are the least trusting of government.

We don’t have a misinformation problem as much as we have a relationship problem [between the public and health systems].

What reasons do people give for not wanting to use the vaccine?
Safety … It’s “too new” … Could we get long covid from the vaccine?

We have to do a better job of explaining why things are moving faster. We are not short-cutting old processes. It’s because we have brand new [vaccine] platforms, new technology.

On the health authority side you get more formalistic “everybody do this” messages, it’s almost monotone. The public has a lot of different questions. So when they hear the same message they think we [public health officials] really don’t hear them, that’s not answering their questions.

The Covid response is a real opportunity to change [health authorities’] relationship with the public. If we rebuild our relationship with the public so they feel we are a caring, listening health authority or government, that will make a huge difference.

https://www.newscientist.com/article/mg24833093-100-we-cant-be-certain-the-coronavirus-vaccines-will-stop-the-pandemic/
https://www.newscientist.com/article/mg24833093-800-what-will-it-take-to-get-a-covid-19-vaccine-to-the-world/
https://www.newscientist.com/article/2259876-heidi-larson-interview-how-to-stop-covid-19-vaccine-hesitancy/

current affairs, medical

Covid #3

Let’s have another catch-up on some of the Covid-19 news (as of yesterday).
[References at the bottom of the page.]

Vaccination Programmes

There have been a number of news reports recently about how the NHS is going to meet the challenge of a mass vaccination against Covid-19 – when we do eventually get a vaccine.

As already hinted, this no trivial task.

  1. There is the question of space – real estate – to do the work. Space which is secure, safe and can be easily disinfected; and available for an extended period.
  2. Then, as we’ve discussed before, a large number of heavyweight freezers may be required to store the Pfizer vaccine at around -75°C ±15°C. Your domestic freezer can’t get near that! And of course the cold supply chain.
    Even if vaccines are stable long-term at domestic fridge temperatures (2-8°C) large numbers of commercial-grade fridges will be needed.
  3. And not least there is the question of manpower. Pulling doctors and nurses away from their day-to-day work will be essential, but will have a knock-on effect on “normal” healthcare:

    Health leaders warned that surgeries will not be able to offer their full range of care for patients from next month as doctors and nurses will be immersed in administering jabs at more than 1,200 mass vaccination centres across England, potentially including sports halls, conference centres and open air venues.

  4. All of which assumes there is enough vaccine, in the right places, at the right time, every time, with no supply issues.

The availability of manpower is why the programme will take the length of time (up to 18 months) that’s being discussed. Here’s my very rough demonstration of why (in very crude figures and assumptions; but it is a demonstration):

  1. The UK population is around 70 million and every one will need two doses of vaccine.
  2. Assume we have 7000 FTE** clinicians sticking needles in people.
  3. And assume each of those can give 70 injections (1 every 5 minutes) in a single shift. (That’s 6 productive hours in an 8 hour day, which is fairly standard productivity.)
  4. That means we need (70 million x 2) / (7000 x 70) or roughly 300 days to complete the work.

    5. [** FTE = Full Time Equivalent. 1 person working 5 days a week is 1 FTE. 5 part-timers each working 1 day a week is also 1 FTE.]

    But it isn’t that simple because:

  5. No-one can work flat out, every day, for the duration (a year plus). They need time out, rest days etc. Add 20% (ie. let them have “weekends” off).
  6. Then there is sickness and other absences. Add another 15%.
  7. And you’ll never achieve 100% occupancy; there will always be gaps in the schedule where people don’t turn up, the appointment can’t be filled, people decline, etc. Add another 20%.
  8. That means we need to increase the time by 55%, which gives us 465 days.
    Or 67 weeks (15-16 months) if working 7 days a week.
    Or 93 weeks (21-22 months) if working 5 days a week

You see why this is such a huge logistical challenge. As one of the Guardian articles linked below says:

[There is] concern that the NHS does not have enough staff or infrastructure, such as freezers to store vaccines and lorries to transport them, and could become embroiled in the sort of “desperate scramble” for kit seen in the spring with personal protective equipment (PPE) and ventilators.

This is very complex stuff. Two jabs, three weeks apart, with people having to recover somewhere for 15 minutes after they have it – that is far more complex than administering the winter flu jab.

That’s before one even starts thinking about the priorities – and you’d better have some bloody good reasons why the priorities are what they are, because whatever they are they’ll be challenged.

Herd Immunity

Looking at the other side of the coin, there is a long article by Dr Tara C Smith, an academic epidemiologist and infectious disease researcher, discussing why The Concept of Coronavirus Herd Immunity is Deadly and Dangerous. This looks at, inter alia, issues with the Great Barrington Declaration.

[T]he actual implementation of this strategy would fail for a number of reasons … First, “vulnerable people” is not limited to just the elderly … There are no details to how we would protect these people other than requiring them to stay in lockdown indefinitely … separating the “vulnerable” from the rest of society is, essentially, impossible. Both our lived experiences and data say that we cannot separate the vulnerable from others. We share homes and workplaces with them … We need to consider whether asking these people to isolate from society will compound the disadvantages many already experience in society.

Add to that … We don’t yet have a vaccine to help speed up any herd immunity. We don’t have a firm handle on how long any immunity might last; so there is no guarantee that herd immunity is even possible for Covid-19. There’s a significant minority of people who have “Long Covid” – is it fair to knowingly inflict this on more people, or indeed to knowingly increase the number of deaths? How and where do you draw an ethical line?

Basically the idea of herd immunity without a vaccine is a non-starter.

https://www.theguardian.com/world/2020/nov/11/thousands-of-hospital-staff-to-be-deployed-in-covid-vaccine-rollout
https://www.theguardian.com/world/2020/nov/10/gps-in-england-will-scale-back-care-to-deliver-covid-vaccines
https://www.bbc.co.uk/news/health-54902909
https://www.self.com/story/coronavirus-herd-immunity

current affairs, medical

Covid & Others News Update

1 Comment

For those that have missed it, a quick update of yesterday’s news on the Covid-19 vaccine, as a follow-up to my post of yesterday.

First of all the Guardian expands on the huge logistical problems distributing a vaccine: Pfizer and BioNTech’s vaccine poses global logistics challenge. The scale of the operations required is just mind-boggling.

Secondly the Guardian also reports that GP clinics are expected to administer 975 injections a week in 12-hour days, 7 days a week – roughly one every 5 minutes. (That’s 975 per clinic, there will be one clinic per area.)

The same Guardian piece reports Health Secretary, Matt Hancock, sounding some good words of caution in the House of Commons:

[T]he best way to liberate and to get life closer to normal is a vaccine … [but] … We do not have a vaccine yet but we are one step closer … There are many steps still to take. The full safety data is not yet available and our strong and independent regulator, the MHRA, will not approve a vaccine until it is clinically safe. And until it’s rolled out we won’t know how long the effect lasts for or its impact, not just on keeping people safe, but also on reducing transmission.

(One fly in that ointment is that the MHRA is not entirely independent, as it’s a government funded body.)

In other news former Prime Minister, Sir John Major, that as a result of the stupidity and ineptitude of the current government, the outlook for next year is bleak:

It now seems that on 1 January next year, Brexit may be even more brutal than anyone expected.

current affairs, medical

Covid-19 Vaccine

I didn’t blog this yesterday as I wanted to catch up on all the news reports …

Pfizer/BioNTech have announced that their vaccine against Covid-19 is 90% effective. So of course everyone is jumping about in delight and expecting that everything is going to be fixed by next week (slight, but only slight, exaggeration).

[T]he results are preliminary, have been shared only by press release, and the trials are not yet complete.

Frankly I consider this scientifically and medically irresponsible as it will get many people demanding the vaccine now, create disenchantment when they can’t, and undermine the current lockdown. The trials are continuing, the final data has not been analysed, nor peer-reviewed, nor published, nor submitted to the regulators. Press release is not the way to publish scientific research; it is purely a mechanism for bumping up a company’s share price.

So for once I was pleased to see Boris Johnson adding a touch of realism to the proceedings. Here are some more of the key snippets from the news items which show why this is not a magic bullet (references at the bottom).

[T]the announcement is just the first hurdle of many … regulatory hurdles will have to be overcome – and that is before we even think about manufacture and distribution.

Nothing in medicine is 100% safe – even something we take without thinking, like paracetamol, poses risks.

We also don’t [yet!] know how protective the vaccine is in different age groups.

[I]t must be approved by licensing authorities.

The prime minister said “if and when” the vaccine was approved for use, the UK “will be ready to use it”.

[W]hen scientists succeed in making a coronavirus vaccine, there won’t be enough to go around.

[A] huge level of production will be required, and then there is the matter of who gets the vaccine first and how mass vaccination would be rolled out.

Each … country will have to determine who it immunises first and how it does that.

[S]hould the Pfizer vaccine pass all the vigorous safety checks … older people would be first in line for the vaccination.

As the initial supply will be limited, reducing deaths and protecting health care systems are likely to be prioritised.

In the UK, older care home residents and care home staff are top of the preliminary priority list. They are followed by health workers such as hospital staff and the over 80s.

There are also logistical challenges, not least as the vaccine needs to be stored at -80°C, meaning that even in developed countries there could be difficulties in distributing the jab.

The Pfizer/BioNTech candidate … needs -80°C storage, and that is not available down at your local pharmacy [or GP]. Pfizer has been rounding up as many ultracold freezers (and as much dry ice production) as they can, but … this is going to be a tough one … the press release talks about getting 1.3 billion doses of this vaccine during 2021, but actually getting 1.3 billion doses out there is going to take an extraordinary effort, because you’re getting into some regions where such relatively high-tech storage and handling becomes far more difficult … With demanding storage requirements, the more people that are within a short distance of a Big Really Cold Freezer, the better. And the more trucks (etc.) that you have to send down isolated roads to find the spread-out patients, the worse.

Given that this vaccine needs two shots to be effective 1.3 billion doses is a nowhere near what is needed; it would provide enough to fully vaccinate only about half of India and nowhere else!

Maintaining vaccines under cold chain is already one of the biggest challenges countries face and this will be exacerbated with the introduction of a new vaccine … You will need to add more cold chain equipment, make sure you always have fuel (to run freezer and refrigerators in absence of electricity) and repair/replace them when they break and transport them wherever you need them.

Frankly, we’re in the middle of the second wave, and I [Prof Jonathan Van-Tam, England’s Deputy Chief Medical Officer] don’t see the vaccine making any difference for the wave we are now in. I’m hopeful that it may prevent future waves, but this one we have to battle through to the end without vaccine.

WHO has said it does not expect to see widespread vaccinations against Covid-19 until the middle of 2021.

[Boris Johnson] added it was “very, very early days”. He warned people not to “rely on this news as a solution” to the pandemic. “The biggest mistake we could make now would be to slacken our resolve at a critical moment,” he said.

So yes, this is good news and there is light at the end of the tunnel, but it is a very long tunnel! We will get out of the tunnel, but meanwhile stay safe!

https://blogs.sciencemag.org/pipeline/archives/2020/11/09/vaccine-efficacy-data
https://www.theguardian.com/world/2020/nov/09/uk-rollout-of-covid-vaccine-could-start-before-christmas
https://www.theguardian.com/world/2020/nov/09/what-has-pfizers-covid-vaccine-trial-found-and-is-this-a-breakthrough
https://www.bbc.co.uk/news/uk-54879676
https://www.bbc.co.uk/news/explainers-54880084
https://www.bbc.co.uk/news/health-54027269

environment, history, links, medical, science

Monthly Links

And so we come inexorably to the end of another month, and our round-up of links to items you missed before and really don’t want to miss again. There’s lots in this month’s pack, so here goes …

Science, Technology, Natural World

DON’T PANIC! The massive star Betelgeuse could be 175m light years closer to us than was previously thought.

How does 2 meters of DNA fold up by a factor of 250,000 to fit in the cell nucleus (which has a diameter of around 10 millionths of a meter)? [LONG READ]

Who knew that the Victorians were into collecting and pressing seaweeds? Turns out to be a useful resource for studying the oceans.

Small bird flies 12,000km in 11 days, non-stop.

Why do some birds have a small downturned overhang on their bill?

Here’s a rather stunning chimera grosbeak – a half male, half female gynandromorph.

Health, Medicine

In a quick segue into the medical, a look at why scientists say bats are not to blame for Covid-19. [LONG READ]

Are we too anxious about the risks of nuclear power? [LONG READ]

Sexuality

Female journalist visits a sex doll factory and learns about male sexual desire. [LONG READ]

Environment

Why many dual-flush toilets waste more water than they save.

There’s often more tree cover in towns and cities than in the countryside.

Social Sciences, Business, Law

The airline industry has been hit hard by Covid-19. Samanth Subramanian in the Guardian takes a look. [LONG READ]

History, Archaeology, Anthropology

The giant geoglyphs of Peru’s Nazca Lines remain an enigma especially when researchers uncover a lounging cat! (Are we really sure it’s not April Fool’s Day?)

Sculpted head, possibly of Edward II, unearthed at Shaftesbury Abbey.

A look at the history of Waltham Abbey, from Saxon times to its destruction by Henry VIII. This is especially interesting for me as it is just across the marshes from where I grew up.

The myth of medieval Europe’s isolation from the Islamic world. [LONG READ]

The importance of Michaelmas in the medieval world. [LONG READ]

St Procopius of Sázava, a saint for Halloween.

On masculinity and the medieval theories of disease [LONG READ]

The British Library has released 18,000 maps from the Topographical Collection of King George III, free to download and with no copyright restrictions.

London

A London Inheritance takes a look at London’s long-lost Broad Street Station.

Lifestyle, Personal Development, Beliefs

Now here’s an interesting idea: when things look bleak, thinking in terms of “hope horizons” can help. [£££££]

And finally … If our scientific theories are correct you don’t have free will, and you can’t change it, so don’t worry about it. But believe in free will if you wish, because in the words of Edward N Lorenz:

We must wholeheartedly believe in free will. If free will is a reality, we shall have made the correct choice. If it is not, we shall still not have made an incorrect choice, because we shall not have made any choice at all, not having a free will to do so.

current affairs, medical, thoughts

On Vaccine Logistics

Let’s think first about flu vaccination – not the vaccine itself but the logistics involved to get a needle stuck in my arm.

It is very tempting to ridicule the NHS and the UK government for failures to supply sufficient vaccines – especially flu vaccine – in sufficient quantity, and on time, when the requirements are apparently well understood. And indeed there have been supply failures in recent years. However it is salutary to consider the complexities of the logistics involved.

Somewhere around 30 million doses of vaccine have to be manufactured, packaged and shipped. Those 30 million are split between six different vaccines, made by five different companies. And there are tens of thousands of shipping endpoints (almost 10,000 GP practices in England alone, plus pharmacies, hospitals, …), all with differing requirements.

30 million doses can’t be manufactured, packed and shipped in the twinkling of a politician’s brain. It takes time, and the NHS isn’t the only customer of the manufacturers. So the supply from manufacturer to NHS warehouse will be phased; so the final shipping to the endpoint will also likely be phased. Which means at any time a given vaccine may not be available at every outlet, even if they did get their requirements correct the first time.

Keep in mind too that these vaccines are temperature sensitive and must be held in refrigerated storage at all times. That too complicates the distribution.

All of that is before one even thinks about the GP identifying, and calling those eligible for vaccination, and making enough clinic time (space, appointments, clinicians) available to actually stick needles in arms. Oh and chasing up those who don’t respond.

I know from experience of logistics at a much simpler level it is almost impossible to get this 100% correct every single time — hard though one might try! It’s almost inevitable that on this scale things will go wrong; and the further back in the chain the problem occurs the bigger the knock on effect out at the clinic.

(Incidentally it’s the same with supermarkets and getting things like loo roll on the shelves. Don’t just blame people for panic buying – although, yes, they do – but think about the logistics and supply chain involved.)

Amazingly this works the vast majority of times in developed countries. For instance, the UK currently has among the highest national coverage of flu vaccine in the world, vaccinating around 75% of the over-65s against flu every year; most countries either do worse or have no vaccination programmes for older people. But in places where the infrastructure and healthcare systems are more fragile, things break down quite quickly.

Now let’s extend this to vaccine(s) for Covid-19.

First of all let’s say that all of the above logistics still apply, but things get worse …

We don’t yet have a vaccine (or vaccines), so as yet we have no clue how many of what we are trying to deploy, or where, or how.

We don’t know if the vaccine(s) will require refrigerated storage, or actual cold storage. If cold storage (ie. freezer temperatures) is required – and this seems likely for many of the vaccines currently being trialled – this hugely complicates the distribution chain (and makes it pretty much impossible in developing countries).

How many shots of vaccine are required to provide immunity? Will just a single shot be enough? Or will patients need a booster (or two, or three, …). Again it looks as is many of the potential vaccines will need a booster shot after a few weeks. That doesn’t just double the amount of vaccine required; it doubles everything right down to ensuring patients get their booster.

And who is eligible for the vaccine? And when? Government is likely to plan on getting the vaccine to the most important people (eg. healthcare workers, food supply people) first, followed by vulnerable groups, and then everyone else. Ultimately they will want to catch everyone (barring the small number of nay-sayers): that’s 60+ million in England alone, with potentially two shots of vaccine – so four or five times the flu programme.

That’s a potential 120+ million doses of vaccine for England alone together with a huge amount of distribution and a great deal of clinical effort. That deployment will take time; maybe as much as an elapsed year! By which time the first recipients may need repeat vaccination if the immunity decays, as it well may.

All of that is before we even think about … How effective the vaccine(s) are (no vaccine is 100% effective). How many vaccines are available. Are particular vaccines (in)appropriate for particular groups of patients. How do we handle the case where the first vaccine available is followed up by one which is much more effective? – Do we revaccinate the first recipients now, or later, or not at all? What advertising campaign, or other incentives (maybe even legislation?), do we need to ensure the vast majority of people get vaccinated?

Of course, we don’t yet have a vaccine to deploy. The front runners are all still in Phase III trials which are unlikely to complete until at least the end of this year. Even if one (or more) of the candidate vaccines looks really good, it is very unlikely we’ll see an emergency approval much before next Spring. And then there may be the question of how that affects other ongoing trials.

Now you can be pretty sure that there will be people in the Department of Health and the NHS sweating blood to try to work all this out, now, even before we have a vaccine. And however well they do their job you can be sure they will get some of it wrong – because the problem is just too complex and contains too many risks and pitfalls. It isn’t at all easy, and it’s human nature to complain when things don’t work perfectly, but it helps to try to see the bigger picture.

So … (a) cut the healthcare system some slack when things don’t work 100% every time, but (b) do call the government to account if it’s their policies which cause the failures, and (c) don’t pin all your hopes on a Covid-19 vaccine being available to everyone (anyone?) real soon.

Further Reading

  1. Derek Lowe; “The Vaccine Tightrope”; Science Translational Medicine; 21 October 2020; https://blogs.sciencemag.org/pipeline/archives/2020/10/21/the-vaccine-tightrope
  2. David Salisbury; “If you’re pinning your hopes on a Covid vaccine, here’s a dose of realism”; Guardian; 21 October 2020; https://www.theguardian.com/commentisfree/2020/oct/21/covid-vaccine-immunisation-protection
  3. Jeremy Farrar; “Let’s get real. No vaccine will work as if by magic, returning us to ‘normal’”; Guardian; 6 September 2020; https://www.theguardian.com/commentisfree/2020/sep/06/lets-get-real-no-vaccine-will-work-as-if-by-magic-returning-us-to-normal
  4. Derek Lowe; “Cold Chain (And Colder Chain) Distribution”; Science Translational Medicine; 31 August 2020; https://blogs.sciencemag.org/pipeline/archives/2020/08/31/cold-chain-and-colder-chain-distribution
  5. Derek Lowe; “Preparing For the Vaccine Results”; Science Translational Medicine; 25 August 2020; https://blogs.sciencemag.org/pipeline/archives/2020/08/25/preparing-for-the-vaccine-results
  6. Megan Scudellari; “How the pandemic might play out in 2021 and beyond”; Nature; 5 August 2020; https://www.nature.com/articles/d41586-020-02278-5
amusements, environment, history, links, medical, science

Monthly Links

Once more unto the breach, dear comrades, to bring you this month’s selection of links to items you may have missed the first time round. And an e-glass of e-ale to anyone who can knit the links into a coat of mail!

Science, Technology, Natural World

Let’s begin with another look at why wasps are so annoying, but yet so useful.

Oh and for anyone wanting to scare their visitors, you can buy a roughly five times life-size model of an Asian Giant Hornet (aka. “murder hornet”).

If you never understood why mathematics is so fascinating, take a look at odd perfect numbers. [LONG READ]

And changing topic again, scientists think they’ve found phosphine gas in Venus’ upper atmosphere, and say this could be a sign of life (albeit microbial life). Meanwhile Derek Lowe explains about phosphine but remains somewhat sceptical of the latest results.

Health, Medicine

The logistics around distribution of any vaccine (well any drug really) are complex, especially when one gets into the realm of Cold Chain Distribution.

But then we need to keep our feet in the real world as no vaccine will work by magic and return us to normality.

Girls: have you ever needed to pee standing up and envied us men our flexible hose? If so, the Shewee may be your friend.

Environment

Rewilding as an environment improvement method is taking time to get going, but not if one maverick Devon farmer has anything to do with it.

Social Sciences, Business, Law

So who thinks Scottish bank notes are legal tender in England? Spoiler: they aren’t! And what is legal tender anyway?

History, Archaeology, Anthropology

There’s some new archaeology at Pompeii which is uncovering more of its past.

Medieval sermons were one of the most effective and wide-reaching forms of propaganda, but that only works if they are in the vernacular. [LONG READ]

The people of medieval Europe were devoted to their dogs. [LONG READ]

Transport until the early part of the 20th century was largely dependent on the horse: either being ridden or pulling a wagon of some description. Here’s a look at horse transport in Victorian times.

Lifestyle, Personal Development, Beliefs

Oliver Burkeman, writing his last regular column for the Guardian, talks about his eight secrets for a fulfilled life.

If you’re dreading a long, dark winter lockdown, then maybe the Norwegians have something for you.

So what does your cat mean by “miaow”? A Japanese vet is apparently earning a fortune telling people what their cats are saying. Personally I thought we had a fairly good idea!

Shock, Horror, Humour, Wow!

Magawa, an African giant pouched rat, has been awarded a gold medal for his work detecting landmines in Cambodia. I must say he’s a rather handsome animal, and well deserving of his apparently upcoming retirement.

And finally, what is the connexion between frozen shit and narcissists’ eyebrows? Yes, of course, it’s this year’s Ig Nobel prizes.

arts, history, links, medical, science

Monthly Links

It’s been quiet round here recently. Nevertheless we’ve been collecting our usual list of links to items you missed the first time. And this month we have an edition packed with some good (long) reads …

Science, Technology, Natural World

Astronomer Martin Rees looks at how we’ve discovered that the universe is much bigger and weirder than anyone thought … [£££] [LONG READ]

… or as our favourite theoretical physicist, Katie Mack, points out: space is big and our planet a tiny porthole, looking over a cosmic sea.

Whoops! We didn’t see it coming and it nearly got us. [£££]

Flat Earthers’ “science” may be wrong, but they aren’t entirely stupid.

Now to more mundane matters … here are two articles, one from the Conversation the other from the Guardian, on how vets identified Coronavirus in a cat.

A few weeks back, when the weather was nicely tropical, Diamond Geezer took a look at the technical definition of a heatwave – and it isn’t as simple as you might think.

Really tiny, but really cute: Leaf Sheep,
apparently the only animal that can photosynthesise.

The Somali Sengi (a species of elephant shrew) is a really cool critter: it mates for life, can race around at 30km/h and sucks up ants with its trunk-like nose – and having been thought extinct ecologists have recently rediscovered it in Djibouti.

Health, Medicine

A view from inside the NHS on what it was like trying to cope with a sudden deluge of Covid-19 patients. [LONG READ]

Covid-19 is here for the long haul: here’s how scientists predict the pandemic might play out over the next months and years.

Ed Yong looks at the totally non-intuitive complexity of the immune system, and why trying to understand it is so important. [LONG READ]

Here’s one doctor who avoids soap (except for hand-washing) and says we’re showering all wrong.

[TRIGGER WARNING] Unlike in animals, we know that around 25% of all pregnancies end in an early miscarriage, but do we really understand why? [£££] [LONG READ]

Then again, we’ve only just discovered that human sperm swim differently than we thought they did.

Social Sciences, Business, Law

For two decades scientists and officials played pandemic war games, but they didn’t factor in the effects of a Donald Trump. [LONG READ]

Be concerned; be very concerned. A lawyer looks at the government’s current review of Judicial Review.

History, Archaeology, Anthropology

Pace Richard Dawkins, it is suggested that humans aren’t inherently selfish, but hardwired to work together. (Until the ship gets overcrowded that is.)

The origins of modern humans get more complex with every new twist of DNA analysed. I have to ask whether we’re actually sure that Homo sapiens, Neanderthals, Denisovans, H. erectus (and maybe others) aren’t actually just one species with some very well-defined sub-species. [LONG READ]

Archaeologists believe they’ve found the source of Stonehenge’s giant sarsen stones.

It turns out that our medieval friends had a thing about sex with demons. [LONG READ]

And now to almost modern demons of a different kind. Here’s an old article about a potentially huge explosion lurking in a wreck off the Kent coast. [LONG READ]

London

Archaeologists have uncovered the lost medieval Great Sacristy of Westminster Abbey.

The history and workings of the Port of London in Tudor times. [LONG READ]

On the dissolution of London’s monasteries.

And another piece from The History of London on the building of Regents Canal.

A short history of the London Hackney Coach and the Horse Cab.

Food, Drink

At long last someone is waking up to the ideas that dieting per se doesn’t work and that we all have different food and metabolic requirements.

Lifestyle, Personal Development, Beliefs

There’s a Zoroastrian centre not far from here, so I’ve always wondered what they’re about. Here’s a look into the very closed world of a strange religion. [LONG READ]

Here are nine common myths about naturism which are totally wrong.

Postcrossing has been around for a while. It’s an interesting idea involving swapping postcards with unknown people around the world as a way of building global friendship.

Shock, Horror, Humour, Wow!

And finally … Only the Japanese could invent a public toilet with transparent walls. They’re quite pretty really.

arts, history, links, medical, natural history, science

Monthly Interesting Links

Once again we come to our monthly collection of links to items you missed the first time round and which you’ll find interesting. This month we have a well packed collection (lots of science and lots of history), so it’s straight in the deep end.

Science, Technology, Natural World

Astronomers still think there’s a large planet out beyond Pluto, so of course they’re still hunting for it (artist’s impression above).

So when you have this new vaccine how are you going to package it? Pharmaceutical Chemist Derek Lowe takes a look.

Many plants have stingers (think, stinging nettles), and it seems they have achieved optimal pointiness. [£££]

Oh dear! It seems likely the world’s smallest dinosaur is a lizard. [£££]

Ornithologists are revealing the long-distance travels and longevity of British birds.

Scientists still don’t know how birds navigate, though it is likely magnetic and they’re narrowing down the options.

30 years ago Red Kites were reintroduced to the Chilterns to the west of London, and this has proven to be a huge conservation success. (I’m 30 miles east of the release area, and in suburban London, and I now regularly see Red Kites over this area.)

Where have all our swifts gone? Are they on the Grand Tour?

There’s a growing realisation that old paintings can provide valuable information about agriculture both livestock and arable. [£££]

Here’s a brief look at the chemistry of cat allergies, catnip and cat pee.

Health, Medicine

How on Earth do you do surgery in the weightlessness of space without having bits of body floating around?

I find this hard to believe, but seemingly damaged human lungs can be revived for transplant by connecting them to a pig. [£££]

Researchers are worried that a new swine flu identified in China has pandemic potential.

Researchers are also looking at the potential for using magic mushrooms to help ex-soldiers overcome trauma.

Art, Literature, Language

Where are the bones of Hans Holbein? Jonathan Jones went looking, but we still don’t know. [LONG READ]

An astronomer has finally(?) pinpointed the exact date and time of Vermeer’s “View of Delft” (above).

The British Library has acquired an important archive of Mervyn Peake‘s original illustrations, preliminary drawings and unpublished early works (example below).

History, Archaeology, Anthropology

Archaeologists have uncovered stone tools which they believe show that humans occupied the Americas around 33,000 years ago – that’s over 10,000 years earlier than previously thought.

Work on the UK’s HS2 rail link has unearthed the skeleton of a possible iron age murder victim.

Drinking games have a long history. Michael Fontaine, in History Today, takes a look.

So how old is the Cerne Abbas Giant (right)? New archaeological thinking by the National Trust suggests it is not prehistoric.

Our favourite medieval historian, Dr Eleanor Janega, takes a look at colonialism, imperialism, and the perils of ignoring medieval history. [LONG READ]

Going Medieval also take a brief look at the medieval obsession with the Moon.

A look at the symbolism of the medieval haircut. Scissors or sword, Sir?

Coming closer to our time, apparently Georgian London was a haven for sexual diseases.

Even closer to home, a look at what happened on the morning of the first nuclear test in 1945. [LONG READ]

And almost up to date, the purrrplexing story of the British Museum cats.

ARCHI is a UK archaeological site containing old maps (largely Victorian, it seems) which you can overlay on the current map to see what was there before we were.

London

Here are two pieces from the History of London on the area to the east of the Tower of London. First, the St Katherine’s area, and second the development of the area around Stepney.

Going Medieval (again) introduces us to the magnificent Agas Map of London (it’s detailed and zoomable!) as well as the lfe of medieval and early modern cities. [LONG READ]

Lifestyle, Personal Development, Beliefs

And finally for this month … Dungeness is one of my favourite places and the late Derek Jarman’s cottage and garden (thankfully saved for the nation) is an absolute delight (below). Now there’s an exhibition about Jarman’s garden at the Garden Museum in London.

environment, history, links, medical, natural history, science

Monthly Links

Here are our links to items you may have missed in the last month. There’s a lot this month, so let’s dive in.

Incidentally [£££] indicates the article may be behind a paywall, although most of these sites do offer a limited number of free articles so don’t ignore them.

Science, Technology, Natural World

First off, here’s an old article from New Scientist in which Roger Penrose asks What is Reality? [£££]

However there’s a warning that we should beware of Theories of Everything. [£££]

Meanwhile scientists have calculated the most likely number of alien civilisations we could contact. [Spoiler: it isn’t 42.]

Maybe the search for extraterrestrial life is why the Americans are embarking on another round of major upgrades to their U-2 spy plane. [£££]

But back to Earth … Researchers have used camera traps to complete a thorough survey of the inhabitants of African rainforest.

Surprisingly in this day and age we still don’t fully understand where eels come from. [£££]

Ecologists have tracked the astonishing migration of one particular European Cuckoo.

Equally astonishing, scientists have managed to record and translate the sounds made by honeybee queens.

After which we shouldn’t really be surprised that crows are aware of different human languages.

Health, Medicine

So out of the crow’s nest and into the fire … What you always thought you knew about why males are the taller sex is probably wrong.

It seems there is growing evidence that we should be taking seriously the potential of psychedelic drugs to treat depression. Well I’d certainly be up for trying it.

Tick-borne Lyme Disease can develop into a debilitating chronic condition. [£££] [LONG READ]

Have you ever wondered how medical students are trained to do those intimate examinations?

Environment

There’s a movement to establish fast-growing mini-forests to help fight the climate crisis.

Barn Owls are one of our most iconic species, and the good news is that they’re growing in numbers thnks to human help.

Here’s just one example of the huge amount of rarer elements in old computers which we need to recycle.

We’re used to places like Iceland using geothermal energy, but now there’s a plan to heat some UK homes using warm water from flooded mines.

History, Archaeology, Anthropology

Archaeologists have found clues to the earliest known bow-and-arrow hunting outside Africa.

DNA from the 5,200-year-old Newgrange passage tomb in Ireland hints at ancient royal incest.

And DNA is also being used to provide clues about the origins of the Dead Sea Scrolls.

On health and safety in the ancient world – or maybe the lack of it!

Religious iconography always was about marketing and PR.

The Medievals had notions about the ideal shape of women which curiously don’t coincide with our modern ideals. [LONG READ]

But then the Medievals lived in a world without police, and it wasn’t quite a brutal as one might think.

Archaeologists think they’ve found London’s earliest theatre, the Red Lion.

If we thought Medievals had odd ideas, then Enlightened Man (in 17th and 18th centuries) was in many ways stranger; shaving and periwigs were the least of it. [LONG READ]

London

On the first few hundred years of Westminster Abbey. [LONG READ]

From Tudor times Protestants have been intermittently persecuted in mainland Europe, and escaped to Britain. Here’s a piece on the history of the Huguenots in London. [LONG READ]

Lifestyle, Personal Development, Beliefs

Is it OK for your kids to see you naked? Here’s an uptight American article which nonetheless concludes it is OK, as we all know.