Yes, it’s EARLY! It’s also super short this week because obviously.

Ebola:

The WHO officially declared the most recent outbreak over. I still can’t get much off the WHO Africa site, but no new confirmed or suspected cases at least. As mentioned before, we’ll follow to the New Year just in case some of the known contacts who dropped off the radar turned out to be positive and re-ignited things.

Coronavirus:

–The US and most of Europe appear to be hitting the top of the second wave. In the US, this progress will be challenged by Thanksgiving tomorrow–we’ll see how the next couple weeks play out. But the Midwest and Big Sky (including Indiana) have all seen new cases plateau, and positivity rates start to come down in the last week. Hospital census and admissions are a bit of a lagging indicator, but are coming down as well. Just in time for a number of hospitals, as headlines this week speak to issues in rural hospitals in particular with both space and staffing (not on quarantine). That said, bit of an uptick in places that had been quiet lately, such as Arizona, Florida, New York and California. As mentioned before, most of those states already got clobbered, so we’ll see how big and “sticky” these upticks are in those states.

–In vaccine news, AstraZeneca was your Monday Vaccine Data Drop of the week, again via press release. Efficacy is a little cloudy, because some of the people on the study got two doses of the vaccine–they were only supposed to get one. BUT, all the people who got two appear to be doing better. As a reminder, both the Moderna and Pfizer vaccines are a shot and a booster. The AZ vaccine is very similar to both, and depending on what the final data show, may need to be dosed like the others too. Some rumblings from Russia about their vaccine being over 90% effective as well, but as before, no actual publication and Russia is still climbing the second wave. I have no doubt many average Russians will be asking themselves “why” given that Putin announced early vaccine success months ago.

–What has been most interesting, and finally saw the questions posed in news stories this week, is the second wave in China. As far as we know, there has not been one. Given the second wave elsewhere, including regions that border China, this seems improbable. There are no reports of economic or traffic indicators suggesting the expected “draconian shutdown” response of the Chinese government. There are some vaccines in development by Chinese companies, but they are still very much in development. Similarly, Japan, although coming down from a bit of a second wave, has not been hit as hard per capita as much of the West–despite being enriched for an at risk population by virtue of having one of the oldest average populations on Earth.

So why the difference? And why, especially, is it not worse in Japan?

The obvious conspiracy theory seems unlikely on face–namely, that it WAS a bioweapon from China after all, man, and they’ve just, like, kept the secret vaccine for themselves and all their lockdowns were really just cover for their vast vaccination program as they sought to topple the West. Well, first, they did a LOT of economic damage to themselves, and lasting economic damage at that as many companies found out they were more dependent on Chinese supply lines than they really wanted to be going forward. So if it was a bioweapon, man, it was a really poor strategic choice in retrospect. But most damning to the conspiracy theory is Japan. China and Japan realllllllllllly don’t like each other. If this was a weapon, there is an almost zero percent chance that China gave the antidote to Japan–and nearly 100% chance they would have used it on Japan -first-, given the opportunity. Relatively mild pandemic course in Japan, especially given their at risk demographics, argues against this.

The most likely explanation (aside from “hasn’t happened yet” or “China is just not reporting it again”) is a combination of biology and geography. Both of the SARS-CoV viruses (1 caused the original SARS decades ago) came from this part of the world. As we have mentioned before, both are cousins of other coronaviruses that cause the common cold. This means the common cold coronaviruses that circulate in Japan, China, the Koreas etc. are much more likely to be closely related to SARS-CoV-2. In short and simple, there is more likely to be a “close enough” common cold coronavirus in that region for higher levels of T- and B-cell cross reaction, and thus a higher percentage of patients with at least some degree of immunity. If that hypothesis is true, one would expect that people of Japanese/Chinese/Korean etc. origin who lived elsewhere in the world for a long period of time would show susceptibility to SARS-CoV-2 that is closer to their new home country. Basically, the longer they have been living abroad (and certainly generationally), the less likely they are to have SARS-CoV-2 resistance by virtue of catching the “cousin cold” that might be circulating back in that region.

While the data needs (and probably will get at some point) a closer look, that does appear to be what you see. In the US and the UK, which have broken down population demographics, the Asian populations in those countries are catching SARS-CoV-2 at about the same clip as their percent of the population. Mortality is also roughly equivalent (and in some more local instances, higher than) to the overall average for the UK and the US as well.

So if China and Japan’s second wave stays mild, but populations of Chinese and Japanese descent in other countries continue to have SARS-CoV-2 at the rate of their new country, I think there will be good reason to suspect that local factors, like a circulating “close enough” common cold coronavirus, made those populations more resistant, despite SARS-CoV-2 originating and then spreading out from that part of the world.

–Some food for thought on the holiday:

1) You should absolutely read this piece on the American Medical Association (and follow the link for what went down at the University of Chicago hospitals too–also very common). This is exactly why I have not been a member of the AMA for something like a decade: https://www.epsilontheory.com/ama-bitfd/

2) “The Social Dilemma” documentary on Netflix is a must watch. I have changed what I do as a result of it. You’ll know why by the time it ends.

–Your chances of catching coronavirus are equivalent to the chances that you will watch the Detroit Lions play football tomorrow.

–Your chances of catching Ebola are equivalent to the chances the Lions will win (sorry Lions fans–just going by their Thanksgiving Day win percentage).

Happy Thanksgiving all.

<Paladin>