As reminders…

Alpha–Variant first identified in the UK

Beta–Variant first identified in South Africa

Gamma–Variant first identified in Brazil

Delta–Variant first identified in India

Also as a reminder:

Ebola:

–We are now up to at least 6 cases. At least a couple seem likely to include post-mortem testing on the 3 year old’s family and neighbors, but what I have available to me is not detailed enough to be sure. At any rate, there are 3 deaths among those 6 cases, which is par for the Ebola course. There are 478 active contacts, although 54 of those have yet to be seen and one is lost to follow up as of this past Sunday. They are currently trying to ring vaccinate the contacts and further trace the epidemiology. The latest case is a 24 year old known contact who popped positive on October 23rd. Situation is still very much developing and I would expect a few more cases. On the plus side, all the cases so far are in known contact chains, so they still have excellent chances to throw a ring around this current outbreak.

Coronavirus:

–Plenty of news this week. We’ll start around the horn. Putin imposed a one week lockdown in Russia as cases there continue to rise, and China has had a number of border towns report new cases in the last week. This is their highest number of reported new cases in awhile, and comes as the Beijing Olympics draw closer. China is reportedly planning to vaccinate kids as young as 3 with its in house developed vaccines. Most of these new cases appear, as near as we can tell, to be delta continuing to make in roads into the Middle Kingdom. The UK appears to have leveled off its recent bump, but let’s give that another week to confirm. There is no significant update on the AY.4.2 (delta plus) variant that we mentioned last week causing a slightly increasing proportion of new COVID cases in the UK. With their wave leveling, that’s an optimistic sign that vaccine and natural resistance to it remains strong, and its epidemiology may be due more to just increased infectivity and luck. In the US, cases by and large remain in general decline as the delta wave ebbs.

–The big story is the FDA advisory panel recommending the Pfizer vaccine for kids age 5-11. As a reminder, this is a reduced dose vaccine to hopefully minimize chances of myocarditis and pericarditis from the second dose, especially, in younger patients (with male predilection). That said, I have not seen the actual safety data published anywhere yet, and the trial size is too small to detect myocarditis and pericarditis unless it is screamingly common. For the record, you would need to enroll millions of kids in a study to expect to be able to detect myocarditis and pericarditis from the vaccine given the rate it is occurring in younger adults.

This is the most balanced article in its coverage of the FDA expert panel’s discussion, and I highly recommend reading the entire thing. The vote was unanimous in favor, with one abstention. That said, this is from the article I linked and is worth highlighting:

“The vote came after a vigorous debate over the safety of the vaccine, which has been linked to rare heart-related complications, such as myocarditis, an inflammation of the heart muscle. Some members of the committee questioned whether the shot should be used for all children, or just those at higher risk because of underlying medical conditions. Several expressed discomfort about making the decision without more information, while others said the data on safety and efficacy were strong enough to move ahead.“

Personally, I still want to see the safety data. And at this point, I am quite content waiting until mandated, assuming the FDA follows the recommendation and does not restrict to high risk kids. Again, the risk to a 5-11 year old of getting severe COVID is already less than that of a vaccinated 50 year old adult and roughly equivalent to a vaccinated 30 year old:

All before you ever give a 5-11 year old a shot.

I also doubt, given that 18-29 year olds also have young, hale and healthy immune systems that the reduced rate in hospitalization risk following vaccination will exceed that already tiny light tan/pink level on the left in the 18-29 section. So you’re not talking an enormous drop from the 0.06 per 100,000 risk in the data above to an ~0.01 per 100,000 with the vaccine either. Again, why I want to see a robust safety data set, since the expected benefit in risk reduction is the lowest for any age group in the 5-11 year olds.

Now, if your 5-11 has high risk factors already, yeah, I would be much more apt to be first in line if the FDA approves this following their committee’s recommendation.

–Speaking of Pfizer and vaccines, Pfizer announced with much fanfare additional booster work on a subset of its Phase 3 study population to “support” the necessity of a COVID booster shot. You can find it published in the New England Journal of Medicine here.

I want to stress that all the comments I am about to make on this paper are my own, and have not been reviewed by my employer.

This is an underwhelming study. First off, lost in the credulous lay headlines that covered this paper, you have a grand total of 23 participants in this subset analysis.

Twenty-three.

Their main finding is that anti-spike protein antibodies from the vaccine waned in some, but not all, patients over a number of months since receiving the Pfizer vaccine. At that point, they got a Pfizer booster shot, and then Pfizer re-assessed their antibodies 7 days later.

What they have shown, unsurprisingly, is that the vaccine restored antibody titers to previous high levels strongly correlated with virus neutralization.

Huzzah!

Of course, I could shoot spike protein into it, or let SARS-CoV-2 bring it naturally to you if you are exposed in the wild, and expect to see the exact same damn thing at 7 days. Because that is ample time for the memory B-cells they and others have previously shown their vaccines induce to fire back up and flood the zone with antibodies again. Exactly what your immune system does for any virus or bacteria that you have caught before, became immune to, and have now encountered again.

More informative would have been testing at 24 hours and 7 days after a booster. If the antibody titers have shot the moon at 24 hours, that’s good evidence that the memory B-cells are still plentiful and you are still functionally immune. Yes, you might get mild breakthrough symptoms as we discussed as the immune system roars back to life–but your immune system is responding strongly enough that hospitalization should be vanishingly rare. On the other hand, if it takes a full 7 days to get the full antibody response back, that is better evidence that memory B-cell numbers were dwindling and some patients really might benefit by a booster prompting new memory B-cell production.

That would have been a better study design.

Even better would have been to get some actual clinical relevance, rather than just pointing to lab values in 23 patients. Enroll patients whose antibody titers have dwindled, and give some a booster and some a placebo. If the breakthrough infection rate is higher, and especially if the hospitalization rate is higher, in the placebo group you have a good argument that a booster might be needed. But that would take time and a lot of money, and a lot of patients, because as the chart above for the 5-11 vaccine benefit also shows, the vaccine is already pretty effective at reducing hospitalization. Showing the booster reduces that even more would take a LOT more patients–or the non-booster group with dwindled (but not absent) antibodies to act like they have never seen a vaccine before at all in terms of hospitalization risk. Since the real world experience so far shows that patients, even many months removed from their second dose are NOT getting sick and hospitalized like they were completely unvaccinated. So to do this definitive study of booster effectiveness and need, Pfizer was looking at a pretty big study–and chose to do this much smaller study that looked only at lab values with essentially no clinical relevance attached instead.

On twenty-three total patients.

So I guess the question is whether you want science behind the booster question, or Science!^TM behind the booster question. Guess which one this study is?

–Just to show you I am not the only questioning the need for a universal adult booster, we have this collection of expert opinion for your perusal (a Yahoo reprint of a NYT article).

But you should really read that for the description from the expert panelists themselves on the FDA and CDC advisory panels on how they thought about the data, and how they felt influenced by the process for some of the votes and decisions they made.

–A better paper comes to us this week from the CDC in their MMWR. We won’t sciencepalooza this one too much. The main findings are that when CDC looked, the delta variant was indeed more contagious than previous variants, but was NOT causing more severe disease on a case by case basis.

As we have covered before, “more contagious, less severe” is the general expected evolutionary trend of an epidemic or pandemic virus over time. It wants to maximize the number of susceptible hosts it can reach, and it does that by getting better able to infect someone with a narrow exposure window (since susceptible hosts are becoming rarer) and by being better able to hide. If you are sick, you are likely not hanging out with other hosts and other hosts probably don’t want to be around you–neither of which helps the virus.

–Headlines today are catching up to the research we discussed previously showing a generic antidepressant reduces the hospitalization from COVID significantly in clinical trials.

They are only a month behind us, guys. Don’t worry–they get there eventually.

–The other big science-related news around COVID this week concerned the multiple headlines and Congressional and/or TV interviews “without coffee” of Drs. Fauci and Collins. The gist is accumulating evidence that their oversight of grants to study infectious diseases in their respective roles within NIH as directors of the infectious disease division of NIH (Fauci) and NIH as a whole (Collins) was inadequate.

The storm began after press last week when Lawrence Tabak of the NIH admitted in a letter to Congress that the NIH, with great regret, had learned that EcoHealth had taken a grant from the NIH to fund gain of function testing in Wuhan that modified the spike protein bat coronaviruses to see if they could become infectious in humanized mouse models, as we have previously discussed and entered Taleb’s casino to explain why that is a terrible idea.

In the letter, the NIH laid the blame fully at EcoHealth’s feet, whom they claim “misled” the NIH about the work they were doing. The NIH said they were giving EcoHealth 5 days to submit “any and all unpublished data” relating to the grant, before spilling a bunch of ink on how the gain of function virus evolutionarily removed from SARS-CoV-2 and could not be its origin.

Again, go back to our previous where having these kinds of modified viruses around in a lab with other coronaviruses can also seed the possibility of natural crossovers–which is plausible, although improbable, as the source for SARS-CoV-2. As Taleb’s casino shows though, with enough chances over time, an event which is improbable on any given chance can eventually become probable.

It took EcoHealth considerably less than 5 days to respond, as they reported to Vanity Fair (among others) that “these data were reported as soon as we were made aware, in [their] year four report in April 2018.”

NIH claims that Dr. Fauci was “truthful in his statements to Congress in July” and that he did not have the progress report that detailed the gain of function research at the time he testified.

Taking that at face value, at best, the director of the NIH infectious disease division that issued the grant to EcoHealth, Dr. Anthony Fauci, somehow did -not- have all of the reports available for research his organization funded on the possibility of pandemic coronaviruses being conducted in Wuhan over a year after a global pandemic caused by a coronavirus, originating in Wuhan.

All when testifying to Congress about that pandemic.

Not a great look.

Further, only one of two possibilities is now true. Either NIH did not have enough oversight on EcoHealth, and a grantee could run off the rails for years doing highly risky research in a foreign country for years with NIH knowing -or- NIH was told in that year 4 report in 2018, and either did not read or did not react appropriately. In either case, the buck for those significant failings should stop at the top–Drs. Fauci and Collins.

In fact it was this exact failure of oversight that saw Dr. Collins take an uncomfortable interview that you can read in summarized form here:

https://threadreaderapp.com/thread/1452787954947088385.html

You may have also read reports that Fauci’s division in the NIH funded experiments in Tunisia that were rather cruelly conducted, where dogs were immobilized, their vocal cords cut, and their faces covered in mesh to allow sandflies to bite them as a test of a treatment for a parasite that sandlfies transmit (and dogs happen to be an important reservoir of).

While in that experiment immobilization and dog’s faces trapped in cages of sandflies did happen, it was not funded by the NIH. The original paper cited NIH funding, but this was a mistake, and the journal has issued a correction of the source of funding. That ethically dubious design is entirely on the researchers from Tunisia who conducted it.

Fauci and Collins at least get a pass on the dogs.

As for appropriate oversight of what EcoHealth was doing in Wuhan, stay tuned…

–Finally, on things socioeconomic…

–Apple had its first revenue miss in 4 years, and warned of $6 billion dollars of “supply constraints” with “most product categories to be constrained during the 4th quarter.”

–There are multiple mentions from various CEOs and shippers that supply chains may not normalize until 2023.

Yes, 3.

I am not expert enough on global supply chains to know how accurate that projection might be, but that appears to be the “pessimist case” for the moment.

–I am certain you can find other headlines about supply issues without me having to summarize them…

–There is a mini think piece from Rabobank that I will link here so you don’t have to join Rabobank’s email list to download it off their site. They cover in brief China’s latest on Evergrande, where the billionaire CEO founder was “encouraged” by the CCP to use his personal wealth to make Evergande’s debt payments. As Evergrande has $300 billion in debts and the CEO has much less than that, the CEO is likely getting wiped out. I know, no tears were shed. In fact, the idea of “bailing in” the senior levels of “systemically important” entities that blow up and then require taxpayer bailouts, forcing them to convert their personal assets into equity in the failing company and then zeroing that equity out as part of the bailout deserves some consideration. The risk of that happening should encourage less leverage, planning beyond simply the next quarter, and a more prudent approach to debt and emergency reserves than seems to take place in may corporations.

Food for thought, along with those on actively testing resilience to supply crisis BEFORE a supply crisis happens at the personal, company and government levels.

–Speaking of food, was talking this week with a guy at jiu jitsu who is a district manager for a food service company that covers a lot of school lunches around the area. He was complaining a lot about the supply crisis. Two schools just this week in Indiana did not get all of their food delivered at least one day.

Not because it’s not available. The food itself is there. In fact, when he called to complain that the order was short, they told him if he could get a truck to the warehouse, he could have it.

“All they keep telling me is staff shortage, staff shortage and it’s all fallout from COVID last year.”

The way the contracts run is interesting too. They’ll cover a year, and say, pledge to deliver 10,000 pounds of chicken to, for example, Tyson and then get it returned as X pounds of tenders, X pounds of nuggets, X pounds of chicken breast etc. as they ask for it. So the processors already have the order, the money and the material. But not enough people to do the processing or load the trucks consistently to fill those orders.

I asked, but I kind of already know the answer. You can’t just replace that from local farmers direct because they sold their crop to their distributor already, and they don’t have abbatoirs on the farm of the size and scale to process their chickens, pigs and beef for a company that then supplies food for entire school systems.

“No wonder everyone in food service is getting burned out and quitting. As an industry, we have one of the highest quit rates right now. And they’re not leaving for new jobs. The guys ahead of me say there is nothing at a director level or better anywhere they are looking right now.”

“We also can’t get paper products to save our lives…”

–And so the cascading disruptions go…

–Your chances of catching Ebola are equivalent to the chances the mainstream media got this one right too (thanks to the reader for sending this along).  On the surface, this is a pretty benign article, with pictures and alarmist commentary on just how ripped the average chimpanzee is, especially when they are suffering from alopecia like the chimps in this particular preserve. 

But you, as readers of this update, know better.  For this article is not alarmist enough.

So let’s break this down.  Monkeys… losing their hair… with increased aggression …and putting on way more muscle (while cutting fat) beyond what would seem possible for normal human beings on the same workout regimen?

Clearly, these chimps are on tren.

And this is, indeed, another diabolical action by the Army of the Bioterrorist Monkeys.  What you see in this article is just not the difference between chimps and humans that lets them be, pound for pound, substantially stronger than humans.  No, this is their version of the Soviet doping program, seeking to create an elite class of super chimp soldiers for their army.

Stronger.  Faster.  More aggressive.

This shows the chilling resolve of the Army of the Bioterrorist Monkeys.

While you were trying to “eat clean” and walk at lunch as part of your New Year’s “resolution,” these chimps were past resolving, beyond commitment, and deep into dedication–under iron and juicing the whole way. All for the gainz, and to hell with the long term cardiac risks and endocrine disruption that might take years to recover (if it ever does).

So while you skipped leg day, they didn’t. 

Just look at the definition on their calves, bro.

And while you were hopping off the elliptical’s heart rate training program, taking out your AirPods, you were turning and looking with the rest of the gym at the sudden primal scream coming from the free weight area.

Just “ARRAHHARRRRRGH!” like Arnold Schwarzeneggerishardtospell getting Conan on his constipation, and then the clang of bouncing metal.

But it wasn’t someone dying under a dropped bar, clutching some horrific injury, like you and the rest of the gym expected.

No, that was them.

The chimps on tren in the Army of the Bioterrorist Monkeys.

All the screaming, all the slamming weight? Just them squeezing out the last rep on a set of bicep curls in the squat rack.  Full plates on the ends.

Of course.

And now the chimp is just sitting quietly at the end of a bench, ignoring the stares of the entire gym.  Like the shrill cries of the Valkyries to end high rep sets are normal.  And now the chimp is just bobbing its head between its pharmacologically enhanced, cannonball delts, clearly visible through the missing sleeves of its “Westside Barbell” cut-off. You can hear The Rock’s workout playlist blasting through its air pods all the way across the gym. And the chimp just sits there, oblivious, all through its precisely timed rest period, flicking through articles on hair plugs and acne control on its iPhone before stepping up to rip off another set of curls…

And then, there you were, vlogging your peloton workout.

Meanwhile, the chimps on tren of the Army of the Bioterrorist Monkeys were riding the mighty Gainz of Gear to a top 10 fitness channel on TikTok, sharing their broscience with 500,000 subscribers.  You think the chimps got that ripped with the horny goat weed supplement in their last post?  First off, that’s from the cheapest factory the manufacturer could source in China–so there’s at least a chance there’s some actual horny goat weed in there.  And maybe even within a log of the dose on the label.  It’s a supplement, so no one is really checking on its contents or the dose for accuracy–especially not the Army of the Bioterrorist Monkeys.

Not so long as the check clears, bro. 

Second, the only time they actually took that supplement was in the TikTok video they were paid to make.  Yeah, I know they said it was the “most effective supplement they have ever tried” and part of “their every day stack.” 

Bro. Broooooooooooo.  Come on.  The only supplement they actually use is the one that works–a needle full of ‘roids they order off the internet which are no longer approved for human use.   Forget the horse de-wormer, they’re using legit veterinary test, and at doses that turn Mr. Ed into Mr. T.

Hell, even the testimonials for that horny goat weed supplement all come from the one time the manufacturer’s in theory “quality control” got an entire lot contaminated with anavar.  Yeah, no kidding everyone who got that lot and dumped it in their protein shake was impressed with the results…

Not that anyone knew about the accidental ingredient until that track and field chick at the University of Iowa or whatever was trying out for the Olympics and popped for trace amounts after using this cheap ass powder in her post-workout stack.  It was the only one she could really afford. But no worries–WADA and USADA only care about punishing her.  She’ll be back in four years after the suspension.  No harm, no foul right?  

Regardless, -no one- is coming for the fly by night supplement company that paid the Army of the Bioterrorist Monkeys for their social media advertising just because they contaminated an Olympic hopeful.  Oh, and a UFC fighter.  And maybe that NBA bench player too.

And now, dear reader?  Now? 

They are jacked and internet rich, with all the TikTok cloutz, and the only thing keeping them from stealing yo’ girl and tossing you a DYEL while they do it is one, and only one, thing…

Why do the monkeys pin? Because they know. They know Jane squats 800. They remember when Jane worked in on their bench set–with her high rep close grip. Just to pump her tris a bit for the gun show. And what lingers in the minds of the chimps the most? The knowledge that Jane does it clean. All natty. 

So every time the chimps sink the needle in, alone with the shame in the harsh fluorescence behind a locked bathroom door? That’s just Jane’s deadlift numbers living rent free in their heads.

And that’s your chances of catching Ebola.

–Your chances of catching coronavirus are equivalent to the chances that if there was really an elite group of personalized diet and nutrition experts who could get any number of Hollywood stars with a wide array of body types, ages, genetics and dietary preferences into “Superhero Movie Spandex” shape in the 6 months before shooting starts, then those experts could simply run a digital personal training business in this day and age.  Where they would make far more because they could take on more clients via the internet.  But I know what you’re saying–this doesn’t happen.  Why doesn’t this happen? Well, your odds of catching coronavirus are equivalent to the chances this video gets close to the real reason for some of that.

<Paladin>