#these facts have probably been quoted everywhere ten million times in the last weeks

[paperlovesadness]

No, because I'm not over processing "Now & Then" and freaking out about what a perfect epilogue it is for the Beatles, but also what a perfect homage it is to John & Paul's friendship. And how much it feels like destiny.

The words "Now & Then" have so many strange ties to these boys. Because:

-> John's last words to Paul (during a meeting that no one could expect was their last) were: "think about me every now & then old friend".

-> John was murdered in December 1980. In February of 1981 a friend of Paul's - fellow musician Carl Perkins spent a week with him, participating in a recording of a song for his album. To thank him and Linda for their hospitality during the time, the night before he was meant to leave, Carl sat down and spontaneously wrote them a song titled "My Old Friend". He played it to them the next morning and Paul started crying and had to leave to gather himself. Linda McCartney then assured Carl it was okay and thanked him for helping Paul, because he had problems facing his emotions about the attack before that. And then she stopped and asked him "but how did you know?" and Carl had no idea what she meant. She explained that the only people who knew what John's last words to Paul were was her and Paul himself. And then she revealed what those words were. Carl had no idea, but he ended up accidentally including them in that song.

The chorus of that song went as follows:

My old friend, Thanks for inviting me in My old friend, May this goodbye never mean the end And if we never meet again this side of life In a little while, over yonder, Where it’s peace and quiet My old friend, Won’t you think about me every now and then

Paul then insisted on recording that song with Carl Perkins, which they did - and recalling that story later Carl said that Paul felt like that song was sent to him by John through Carl.

-> By now we all know the story of how this "new" Beatles song came to be - After John's death, Yoko found a demo tape of songs he never completed, that she then handed over to Paul so that him, George & Ringo could record the last new Beatles songs in 1995 as part of an anthology that was being released. (they wanted to record new material, but had promised never to do so without all the members included. So using these demos was the only way).

There's lots of places that claim the tape with the demos had "For Paul" written on it by John - but admittedly, I haven't actually seen a source quoted. Still - the fact that one of the songs on that last demo of new material they ever got from John was titled with some of the last words he ever said to his best friend? The lyrics of that song being what they are? Come on.

(It very much also just felt like a song for Paul to me. With how complex that relationship was - how intense all the emotions were - through love and diss tracks to still calling each other best friends while they weren't on good terms. Missing each other).

Then - destiny working the way it did, not allowing them to record that one track in 1995 because of the awful quality. Making it so that it was their actual last song in 2023. Because only now did the technology allow for seperating those vocals and fixing them up so that they can actually be used.

Like are you kidding me??? It was that one. The one that felt most special.

-> Bonus fact. The back of the record sleeve has a photo of a special art piece on it - from George Harrison's collection. One that provides another serendipitous moment in connection to these words:

Image source: [x]

And I'm just supposed to be alright with all of this?????????

[ghostmartyr]

Hi Immi. I'm new to the fandom--joined around the drop of ch107. Since then there's been a big buzz about historia, regarding her sexuality, her character regressing and her relationship with ymir. i'd seen snk s2 and honestly never occurred to me to ship yumikuri because i hate ships but being on tumblr, well, it's everywhere. I see people get hate on shipping her with males but i'm not sure where i stand. Is she explicitly lesbian? If not then why is it so bad? Is the tumblr fandom just toxic?

Hi.

Uh.

Hell, dude, you pretty much summarized all the reasons I stopped checking the tags. I’m not exactly in the fandom anymore. I do my stuff, but I am actively avoiding mostly everyone, and that’s just because of the immediate aftermath of the chapter. So uh, welcome, I guess, I’m not here.

I answered–well. No, I covered a bit of what I’m going to go over here in my chapter post, aka the unfun section of it. Making this a bit of a rehash, but most things I type are anyway.

The most obvious thing is that people should not be getting hate. That is a general statement, disconnected from anything that’s going on. It is applicable in every fandom, in every situation. Even in the cases where someone is doing something that poses a very real danger, the solution is not sending hate. Sending hate is exactly what it sounds like, and people should behave themselves better.

Where you end up standing on any of this does not make the behavior magically okay.

And again, I basically left the fandom. I have no idea what’s going on, and frankly, I do not want to, so none of this is based on anything that’s happened in the past three weeks.

My perspective on fiction is that it is entirely selfish. People want what they want from it. While I don’t like most of what other people like, the fact that they’re capable of enjoying things should be celebrated. Go them.

That doesn’t mean I think stories are beyond reproach, or what happens in fiction can’t be offensive or damaging.

Fandom is not the same as canon. A personal pet project is very different from something being consumed by millions of people. Fandom currently has a very black and white style of thinking, and so it neglects that difference.

For an easy and relevant example, Kurt and Rachel from Glee getting it on in a fanfic is not equal to it happening in the show. One is someone’s random fantasy, the other, unless it’s handled with the kind of respect Glee has never dealt in, is going to be very inflammatory.

(See: Blaine and Rachel (for different–-but still relevant!-–reasons))

A lot of people do not agree that the difference between fanon and canon is relevant to some of the things people end up enjoying. The reason being that stories never feel that different to the individual experiencing them. Who creates it, or how wide its reach is, is not automatically something that matters to the emotional experience. It will hurt in roughly the same way, so often the argument that one is excusable and the other isn’t is done before it starts.

I’m meandering a little because I do not really know how to handle this delicately. So far this is all just foundational. stuff.

I guess I’ll go with blunt.

yumikuri is a canon romantic bond. Ymir is implied to be a lesbian because one character says she looks like one, Historia is a complete blank slate outside of that relationship because Ymir is her sole love interest.

The status of Historia’s sexuality is that she is romantically interested in Ymir, a girl. That is the entire sum of what the manga’s covered.

107 heavily indicates that Historia is coerced into having sex.

That should never have opened up a discussion into what her sexuality is. Someone being forced into sexual intercourse is indicative of nothing except that they are being forced into it. That is the exact opposite of desire.

Yet it opened the door to people reminding everyone that it is absolutely okay for a character to be bisexual.

That is a true statement.

(Editing in emphasis, because it really is.)

I do not know how to adequately describe why the context makes that statement so tone deaf and infuriating.

The manga has been running for almost ten years. In that time, there has been no indication of Historia having interest in anyone outside of Ymir, a girl. That could cover a lot of different sexualities, and there’s nothing wrong with someone wanting any of them.

That doesn’t mean there aren’t incredibly insulting ways of going about introducing them.

Historia’s first major appearance after her girlfriend is killed off-screen (if you believe that, which all but three people reading this and the person writing this do) is all about forcing her to fuck a guy to make babies.

Even in some hypothetical where her pregnancy is the result of a happy relationship, it would be insulting. As far as we know, it isn’t, so we are dealing with the full brunt of how disrespectful that summation is.

There is this common thing that happens in stories, where you have the gay relationship, one dies, the other lives on to go have a happy life with someone of the opposite sex. The subtext is that this weird one-off sexual thing may have happened, but don’t worry, they’re still normal.

I don’t know how to say that convincingly, because it’s a subtext that I’ve picked up on throughout hundreds of different stories. I don’t know how to cram that history into one post.

Girls liking girls is seen as an aberration, even in stories about liking girls. The relationship will be an exception. The more femme character won’t really like girls, just this one. The concept of a girl liking another girl as a normal facet of her sexuality, which exists outside this relationship, is commonly disregarded, or given to the non-POV partner.

This should be a problem that it’s easy to agree on. Lesbians like girls as a rule. Bisexuals like girls as a rule. Not exclusively, but Likes Girls is still very much a part of the identity (unless we get into discussions of bi covering multiple genders but not necessarily binary ones).

Then there’s fandom.

I can’t count the number of times I have seen the argument that Historia only sees Ymir as a friend. I have been invested in her character and that relationship for five years. Barring the last month, which I don’t want to know about, probably at least once a week, someone would make the case that okay, maybe Ymir likes Historia, but Historia doesn’t like her back.

Many, many times before I left the tags last month, people were saying that Historia’s pregnancy isn’t an LGBT issue, because Historia’s interest in Ymir was never canon.

I get twitchy when people are staunch supporters of her being bisexual. Because as much as I want to trust people, and as much as I know that every marginalized identity is desperate for scraps, the conversation about Historia has always felt like, “it’s important to remember you can’t prove she doesn’t like men.”

When it’s not full on, “it’s important to remember her liking a girl is in your imagination.”

Because she’s the pretty one in the girl on girl couple.

I want her to be gay or ace. Nothing disproves that, but I feel like an idiot for wanting that, because the classically pretty one isn’t going to be a lesbian, and years of consuming anime and manga should have taught me that. Beyond the first sentence, none of that perspective is particularly healthy.

Queer fandom can be really complicated to navigate, because some of the things people want to see–-which are fundamental to their identities, and that’s why they want to see them–-run exactly counter to what other people want to see.

There’s a post from Yuri on Ice fandom that I think encapsulates this. I don’t know the background, or what has been shouted back and forth since I saw it, but here’s the gist. Someone suggests that one of the figure skating gays could be ace. Dozens of people go, “bad post op,” and it’s treated humorously.

Asexual representation sucks. An episode of House, noteworthy for using the word and having someone quote the statistic occurrence of asexuality, ends with one half of an asexual couple having a hormone imbalance, and the other lying about her interest in sex so she could date him.

Yeah.

Gay guys also have a hard time with their sexuality being policed. Holding hands is okay (sometimes), but kissing? Sex? The dirty homosexuals are depraved for enjoying such things. Gay women can have degrading sex because it’s hot.

People want their identities respected.

That is not an unreasonable thing.

What tends to happen on Tumblr is that people forget that they aren’t the only ones being treated like crap. There are layers of pain and anger they bring to every fight, and over and over again, people who should know what that pain is like, and help each other through it, sharpen theirs until they can use it to chop off someone’s head.

107 is insulting in a lot of ways. The aftermath was worse for me. From what little I saw, many people were very eager to say that the part where a queer woman was dealing with a coercive pregnancy shouldn’t be judged for the queer part. Because there are people issues, like war and tragedy, and then social justice issues, which aren’t about people. They don’t really matter in a war story with internment camps and genocide.

I’m being glib, but… that’s what it felt like. That’s what a lot of people I liked shrugged and agreed with.

I want Historia to be a lesbian (or ace), but for right now, we do know she’s queer. That is a part of her character, and it is one that people have been talking over for years. Having post after post reminding everyone that her being queer does not matter to the story? That her being queer is not a lens worthy of being looked through when it’s clearly not about that?

I don’t agree with… basically any of the fandom behavior I’ve seen touching this. I think people should behave themselves better, and treat each other more kindly, and pain is no excuse for bleeding all over everyone.

But where that pain comes from has been repeatedly dismissed, and where it comes from is not insignificant, no matter what route you want canon to go.

…And as far as Historia’s character goes, this is a regression, and the writing should be ashamed of itself. It violates the themes of her arc with such direct intent that it’s painfully easy to believe there’s a twist to it, but for now it’s just infuriating, because the girl who fights fate has been made its tool, and Ymir, aka her love interest, is very relevant to the whole arc where we covered this. 107 is bad and should feel bad, and I am extremely not happy that I think that is exactly the feeling I am intended to have, because being emotionally manipulated is much more annoying when it works.

Hopefully that gives your questions an answer.

[chaos-weekly]

stamp of approval

Esther had in fact taken Bishop up on his offer of previewing his art over tea. They’d met at his studio one more time, where he revealed he was working on a secret project that would be done by the end of the next month. She was excited to see it. His work, whether it was his poetry or his art, was phenomenal. She related to the first-generation American child struggle, she related slightly to parents’ disapproval of their child’s chosen career. She got it.

And she got Bishop, too. The way their minds worked was so similar and yet fascinatingly different. As colleagues, they sharpened each other. As friends, dare she say, they understood each other’s daily struggles and routine, what made them laugh, what made them tick. He was truly a pleasure to be around, and Esther was glad to be his friend.

Friend. That word sat uncomfortably on her tongue. Esther was selective about her friends, and Bishop met all of the criteria, so why didn’t it seem to fit? She didn’t enjoy puzzles, and definitely not ones like this.

Today, Bishop was meeting her at the MAP to help with final arrangements for the exhibit on Asian American culture. His pieces were showcased beautifully, but she wanted his final stamp of approval, just as she’d received every other artists’. She had a million things to get done before the exhibit opened that weekend and with meetings with potential benefactors tomorrow and the following day, this was her last day to make any big changes. Needless to say, Esther was stressed.

She was sending a text to Taylor, a curator and essentially her personal assistant, about last minute food and drink details when Bishop walked in, startling her with a:

“Hi, Es.” She looked up to see him standing there, an iced matcha with her name written on the side of it in one hand. “I brought this for you. I figured you could probably use a pick-me-up.”

She pressed send on the text and shoved her phone into her pocket, sighing and giving him a tired smile. 

“Thanks, Bishop,” Esther said, taking a long sip of the drink. “This is exactly what I needed. It’s like you can read my mind.”

“That’s the goal, but I just remembered you saying you had a bunch of meetings the rest of the week and figured this must be your last big day to get everything done.”

“I can’t believe you remembered that!” she exclaimed, a look of pure shock on her face. “I had to remind almost everyone here. I know they’ve all got busy schedules, but someone should have remembered.” 

To have someone remember her schedule and care for her during it… it meant a lot to Esther. Acts of service were her love language, and Bishop had clued in to this way faster than her friends, parents, and employees. He was certainly something special. Bishop looked embarrassed, and she smiled warmly at him, hoping to put him at ease. She knew he didn’t like when people made a huge deal out of his small gestures of friendship, but Esther couldn’t help it. She just felt so seen.

“Let me take you through the exhibit. You get a sneak peak.” She nodded her head and he joined her. They meandered side by side through the exhibit, her explaining her choices in set up and how she found the artists and all she had left to do and Bishop making commentary about the pieces so intensely detailed she could only nod and agree. He certainly knew a lot about art and what made a quality piece, and all of these seemed to live up to his high standards.

They arrived at his section and stopped in front of his two paintings. Esther looked at him, waiting for his approval, but all she saw were his teary eyes.

“Bishop?” she asked, placing a hand on his arm. “Is everything okay?” Had she managed to offend him somehow? This was her worst nightmare.

“No, no, everything’s fine,” he said, wiping his eyes with the back of his hand. “This is just the first time my art has been on display in a museum before. I’ve had showings and been part of galleries, but nothing I’ve made has ever been part of an exhibit. All of these artists are so great and so well known. I can’t believe my work is next to theirs, you know?”

“It deserves to be here, Bishop. It’s fantastic. To be honest, these are my favorite pieces in the whole exhibit, if not the whole museum.” She smiled warmly at him and gave his bicep a friendly squeeze before dropping it. 

“You flatter me, Es.” But he was smiling down at her, and she knew he wasn’t lying.

“Is it working?” she teased, looking back at the piece in front of him. It was of his family gathering for a home cooked Korean meal, happy and free and light. There was a quote written in Korean on the painting: “This is my favorite meal, Mom.” This painting was deeply personal for him. There was a longing for his family, a longing for another taste of home and Korean culture. Esther felt that deeply.

“Your parents would be proud, Bishop,” she said softly.

It took a few moments for him to respond.

“I hope so.” He swallowed and cleared his throat, taking a step back and looking at Esther. “Now, what do we need to get done today?”

“Well, after I get your stamp of approval, you’re good to go.” This made Bishop laugh and shake his head.

“That’s funny, Esther. I’m not leaving the MAP until you do. You’ve got my approval for the exhibit. Now, what else needs to get done?”

Another act of service. Esther could have sobbed, but she was too shocked to. But he was looking at her expectantly, so she shook it off. She wouldn’t fight him on this one, no matter how stubborn she was.

“Let me take you back to my office. I’ve got a whole list.” 

///

Bishop wasn’t kidding when he said he would stay the whole day. It was ten o’clock, and they were just now locking up for the night. He’d been such a big help.

“Gosh, how am I ever going to repay you?” she yawned, tossing her keys in her backpack. 

“You don’t,” he said, laughing. “This is what friends are for.”

“Still.” Her stomach growled, and she laughed lightly. “You want to get something to eat?”

“Let me cook for you. I’ve got stuff for my mom’s kimchi stew back at my place.”

So now he was inviting her back to his apartment and offering to cook for her. Bishop could either really see she needed company and a home cooked meal or he felt bad turning down her request for food.

“Bishop, you don’t have to do that.”

“But I want to. Come on, you’re not saying no. It’s my mom’s recipe, Esther. It’s good.”

“Fine,” she said, again unwilling to argue. 

Bishop had walked to the MAP as he lived downtown in a little studio apartment. Esther did the same. She savored being able to walk everywhere. Even at night. The air was cool, the stars were barely out. It was beautiful. The pair walked together back to Bishop’s, the opposite direction of where she lived. They passed a still-open tattoo parlor, and Bishop pointed inside.

“My best friend works there. London Lovell,” he said, continuing to walk.

“Oh! Do you want to stop in and say hi?” Esther had never met London, but she’d heard plenty about him. She didn’t know why, but him and Bishop being friends kind of made sense.

“Nah,” he replied, shoving his hands into his pockets. “He’s working and I’m not in the mood to get tased.” She raised an eyebrow. Tased? If so, he said that way too casually.

“I’m sorry, tased?” she questioned.

“Yeah, tased.”

“I’m not going to ask.”

“It’s probably better that way.” He chuckled, and Esther grinned. There was still a lot about Bishop that she didn’t know yet, but she was enjoying getting to know him.

[kristinsimmons]

The Problem With “Herd Immunity” as a COVID-19 Strategy

By e-PATIENT DAVE DEBRONKART

Caution: This post is not a prediction. It’s just a tutorial about the concept of herd immunity, with an eye to why it’s probably not an approach the US wants to take in solving the complex problems we’ve gotten ourselves into with COVID-19.

Click this graphic to go see a six second animation of these images, created in 2017 by Reddit user TheOtherEdmund. You many need to watch a few times. Get a feel for the differences in what happens in the different blocks, and come back to discuss:

This weekend I’ve labored to understand this concept, which first came to my ears regarding coronavirus in March, when British prime minister Boris Johnson proposed it as a possible approach for Britain to take: let the virus take its course, and they’d end up with “herd immunity,” and that would be the end of that.

In my unsophisticated knowledge “herd immunity” meant “you let the weak cows die, and the rest of the herd will be fine.” And in fact in April a Tennessee protestor held up a sign saying “Sacrifice the Weak – Reopen TN.” (It’s not clear whether the sign was mocking or real (Snopes), but it illustrates the point.)

But it turns out there’s a lot more to the concept than just “sacrifice the weak.” There’s a specific way herd immunity works – and it does work for things like measles and mumps and polio, via vaccines. But in the absence of a vaccine, it’s an absolute disaster.

Here’s why. Here’s a snapshot from the start of the animation.

Each blue dot is a healthy uninfected person – you.

Each yellow dot is someone who’s immune – “can’t touch this,” if you’re into MC Hammer.

Each red line is where someone uninfected crossed paths with an infected person and got infected.

Notice: the more people get vaccinated, the fewer red lines happen. Vaccines prevent infection – who knew??

As time goes by (in the animation and during an epidemic), here’s what it looks like a while later.

If nobody is vaccinated, the disease spreads pretty rapidly; as more of the population is vaccinated (more yellow dots), the frequency of new red lines drops dramatically.

The explosion of infections among the unprotected is exactly what happened before vaccines. Epidemics were rampant and unstoppable.

And here’s what it’s like at the end of this animation (though in real life it doesn’t stop):

See how around 90% in this example there are nearly no infection connections – few red lines? For any given disease situation, this point is called the herd immunity threshold. When you get to this many yellow dots, it’s manageable. Hospitals aren’t overwhelmed, and you can do contact tracing, as South Korea and others do: you can hunt down every single remaining case and find out everyone they contacted. In other words, you can find and protect the blue uninfected dots … and you can stamp out the disease.

Of course there are a zillion variables that change the speed: how contagious is it? (Each mumps patient infects 10-12 others; each polio patient infects 5-6 others, etc. This is what’s called the “R” number.) How tightly packed is the population? (It’s believed that New York’s crammed subway system was a major factor in the early explosion.) Etc.

Regardless of the variables, that’s the basic concept. (For coronavirus the R number is around 3, and the herd immunity threshold is tentatively believed to be somewhere around 60%.)

But here’s the problem:

We ain’t got no vaccines.

So we’re stuck at “0% vaccinated.”

That’s why, everyplace the virus shows up, it spreads. It surprises everyone, because at first it’s slow, because infected people are invisible for days or weeks (which is why forehead thermometers are dumb), so it’s spreading silently. Then BOOM, a certain percentage get sick. And by that time it’s spread all over the place.

It’s not unlike a wildfire that spreads underground. By the time it erupts, you’ve got a widespread problem on your hands. And the longer you take to notice it and start fighting, the bigger a problem it has become. Which is exactly what happened in the US. (Nobody disputes this; the only argument is whom to blame, but that won’t save your life or mine.)

The other approach: get infected and survive.

Here’s where we get to the COVID-19 version of the story.

There’s another way for a herd to be immune, aside from vaccines: have a lot of critters get sick. Some die, and the rest develop antibodies.

This doesn’t always work – we don’t know yet whether COVID-19 survivors are immune, because the disease is too new. Plus, it’s just a new coronavirus (“novel,” as they say); other coronaviruses cause the common cold, which people get year after year – there’s no immunity and no vaccine. (If you’re thinking “Yikes!!”, that’s appropriate.) But no cold virus has ever been fatal before, so we didn’t have much motivation to solve it.

There have been two killer coronaviruses: (Thanks to Bill Reenstra for pointing to these, which I’d overlooked in the original post.)

SARS-COV-1 infected only 8,000 people, killing 774 (about 10%), and was contained in 7½ months.

MERS has never stopped but is rare. Since arising in 2012 it’s infected 2,519 people, killing 35% of them (866 deaths so far).

Of course we hope the urgency, extreme spread, and enormous death count of COVID-19 will motivate immense investments to achieve new things.

Update next day: But while I was working on this post, CNN Health posted an informative article, What happens if a coronavirus vaccine is never developed? It’s happened before. It quotes British Covid-19 expert Dr David Nabarro: “It’s absolutely essential that all societies everywhere get themselves into a position where they are able to defend against the coronavirus as a constant threat, and to be able to go about social life and economic activity with the virus in our midst.” 

In any case, instead of each of these diagrams being labeled “vaccinated,” our reality today is that each yellow dot doesn’t mean “vaccinated,” it means “got infected & survived”:

Ha ha look how funny – this particular image shows herd immunity kicking in after 75% of the population has gotten infected. In the USA that would be 75% of 328 million is 246 million infected people. Ha! Ha!

That includes 75% of everyone you know getting infected. Including, probably, you! Ha! Ha!

And since our best estimate is that 0.5% to 1% of all infections for this virus die, that would be anywhere from 1.23 million to 2.46 million deaths. What a laugh riot!

(Again, these are not exact numbers; they’re just to convey the principle. But they are in the right ballpark.) (And by the way, in these diagrams, each dot represents around 400,000 Americans.)

A herd immunity policy without vaccines is mass murder. And worse.

It’s not just mass murder; it’s a whole lot of very sick people. A friend had the virus and had a fever of 103 for ten days. She was suffering, and of course with this damn virus there’s the always-present fear: “Will I be one of those who suddenly goes downhill fast and dies?” Think about living that way for a couple weeks or more – both you and your family.

Whoever cares for those very sick people – a relative or a professional – is vulnerable to getting sick, too. More than 200 doctors and nurses had died by April 10 – and last week the stress caused two different New York professionals to commit suicide: a top ER doc and a newly minted EMT, months out of training. And Peter Elias MD wrote on Facebook, “The data I have seen is in the range of 1 in 10 to 1 in 5 household members or caregivers.”

Imagine all that if we have half the population infected.

Your only way out: Avoid contact! Wear masks! Wash your damn hands!

We will, someday, have vaccines or at least treatments. (Either that or the world is ending.) Remember, all those diagrams in the animation have variables, and a big one for this virus is how often people bump into each other – literally or figuratively.

Another big variable, when they do cross paths, is whether the virus passes between them and enters the other one’s body. That’s where distancing, masks, and hand washing come in. They are our only defense right now – but they work.

Avoid getting or spraying the virus. Either you or the other guy may be the sprayer – there’s no way to know. Just be responsible. And every time you come home from outside, wash your hands for “two happy birthdays.” The soap bubbles break open the little virus cases, and poof, they lose their power. Just with soap!

You are not powerless against this bugger. You just gotta do it and keep doing it. Maybe for a year or two. Just avoid being either end of a red-line infection connection.

The more we slow down that animation, the better the chance the geniuses will invent effective medicines before that red line knocks on your door.

Be responsible in your community. Stop the spread, and spread the word: Tell people “It’s not just me. I don’t wanna kill a nurse.”

And if anyone suggests herd immunity, pleaseshow them this. I’ve had smart scientific people check it, and this is true. Herd immunity is fine with vaccines. We ain’t got one.

Additional resources

Here’s Why Herd Immunity Won’t Save Us From The COVID-19 Pandemic – a good, concise, clear and accurate article on ScienceAlert

What the Proponents of ‘Natural’ Herd Immunity Don’t Say (NYTimes)

A 2014 Nova piece on herd immunity

For the nerdy, a surprisingly readable economics policy paper from April 24 discussing different ways to look at the overall COVID-19 problem, including herd immunity as one option. (47 page PDF, but really understandable … if you skip the stuff that’s hard to understand.)

e-Patient Dave deBronkart is a cancer survivor, noted for his activist work in promoting access to health care data. This article originally appeared on his blog here.

The post The Problem With “Herd Immunity” as a COVID-19 Strategy appeared first on The Health Care Blog.

The Problem With “Herd Immunity” as a COVID-19 Strategy published first on https://wittooth.tumblr.com/

[lauramalchowblog]

The Problem With “Herd Immunity” as a COVID-19 Strategy

By e-PATIENT DAVE DEBRONKART

Caution: This post is not a prediction. It’s just a tutorial about the concept of herd immunity, with an eye to why it’s probably not an approach the US wants to take in solving the complex problems we’ve gotten ourselves into with COVID-19.

Click this graphic to go see a six second animation of these images, created in 2017 by Reddit user TheOtherEdmund. You many need to watch a few times. Get a feel for the differences in what happens in the different blocks, and come back to discuss:

This weekend I’ve labored to understand this concept, which first came to my ears regarding coronavirus in March, when British prime minister Boris Johnson proposed it as a possible approach for Britain to take: let the virus take its course, and they’d end up with “herd immunity,” and that would be the end of that.

In my unsophisticated knowledge “herd immunity” meant “you let the weak cows die, and the rest of the herd will be fine.” And in fact in April a Tennessee protestor held up a sign saying “Sacrifice the Weak – Reopen TN.” (It’s not clear whether the sign was mocking or real (Snopes), but it illustrates the point.)

But it turns out there’s a lot more to the concept than just “sacrifice the weak.” There’s a specific way herd immunity works – and it does work for things like measles and mumps and polio, via vaccines. But in the absence of a vaccine, it’s an absolute disaster.

Here’s why. Here’s a snapshot from the start of the animation.

Each blue dot is a healthy uninfected person – you.

Each yellow dot is someone who’s immune – “can’t touch this,” if you’re into MC Hammer.

Each red line is where someone uninfected crossed paths with an infected person and got infected.

Notice: the more people get vaccinated, the fewer red lines happen. Vaccines prevent infection – who knew??

As time goes by (in the animation and during an epidemic), here’s what it looks like a while later.

If nobody is vaccinated, the disease spreads pretty rapidly; as more of the population is vaccinated (more yellow dots), the frequency of new red lines drops dramatically.

The explosion of infections among the unprotected is exactly what happened before vaccines. Epidemics were rampant and unstoppable.

And here’s what it’s like at the end of this animation (though in real life it doesn’t stop):

See how around 90% in this example there are nearly no infection connections – few red lines? For any given disease situation, this point is called the herd immunity threshold. When you get to this many yellow dots, it’s manageable. Hospitals aren’t overwhelmed, and you can do contact tracing, as South Korea and others do: you can hunt down every single remaining case and find out everyone they contacted. In other words, you can find and protect the blue uninfected dots … and you can stamp out the disease.

Of course there are a zillion variables that change the speed: how contagious is it? (Each mumps patient infects 10-12 others; each polio patient infects 5-6 others, etc. This is what’s called the “R” number.) How tightly packed is the population? (It’s believed that New York’s crammed subway system was a major factor in the early explosion.) Etc.

Regardless of the variables, that’s the basic concept. (For coronavirus the R number is around 3, and the herd immunity threshold is tentatively believed to be somewhere around 60%.)

But here’s the problem:

We ain’t got no vaccines.

So we’re stuck at “0% vaccinated.”

That’s why, everyplace the virus shows up, it spreads. It surprises everyone, because at first it’s slow, because infected people are invisible for days or weeks (which is why forehead thermometers are dumb), so it’s spreading silently. Then BOOM, a certain percentage get sick. And by that time it’s spread all over the place.

It’s not unlike a wildfire that spreads underground. By the time it erupts, you’ve got a widespread problem on your hands. And the longer you take to notice it and start fighting, the bigger a problem it has become. Which is exactly what happened in the US. (Nobody disputes this; the only argument is whom to blame, but that won’t save your life or mine.)

The other approach: get infected and survive.

Here’s where we get to the COVID-19 version of the story.

There’s another way for a herd to be immune, aside from vaccines: have a lot of critters get sick. Some die, and the rest develop antibodies.

This doesn’t always work – we don’t know yet whether COVID-19 survivors are immune, because the disease is too new. Plus, it’s just a new coronavirus (“novel,” as they say); other coronaviruses cause the common cold, which people get year after year – there’s no immunity and no vaccine. (If you’re thinking “Yikes!!”, that’s appropriate.) But no cold virus has ever been fatal before, so we didn’t have much motivation to solve it.

There have been two killer coronaviruses: (Thanks to Bill Reenstra for pointing to these, which I’d overlooked in the original post.)

SARS-COV-1 infected only 8,000 people, killing 774 (about 10%), and was contained in 7½ months.

MERS has never stopped but is rare. Since arising in 2012 it’s infected 2,519 people, killing 35% of them (866 deaths so far).

Of course we hope the urgency, extreme spread, and enormous death count of COVID-19 will motivate immense investments to achieve new things.

Update next day: But while I was working on this post, CNN Health posted an informative article, What happens if a coronavirus vaccine is never developed? It’s happened before. It quotes British Covid-19 expert Dr David Nabarro: “It’s absolutely essential that all societies everywhere get themselves into a position where they are able to defend against the coronavirus as a constant threat, and to be able to go about social life and economic activity with the virus in our midst.” 

In any case, instead of each of these diagrams being labeled “vaccinated,” our reality today is that each yellow dot doesn’t mean “vaccinated,” it means “got infected & survived”:

Ha ha look how funny – this particular image shows herd immunity kicking in after 75% of the population has gotten infected. In the USA that would be 75% of 328 million is 246 million infected people. Ha! Ha!

That includes 75% of everyone you know getting infected. Including, probably, you! Ha! Ha!

And since our best estimate is that 0.5% to 1% of all infections for this virus die, that would be anywhere from 1.23 million to 2.46 million deaths. What a laugh riot!

(Again, these are not exact numbers; they’re just to convey the principle. But they are in the right ballpark.) (And by the way, in these diagrams, each dot represents around 400,000 Americans.)

A herd immunity policy without vaccines is mass murder. And worse.

It’s not just mass murder; it’s a whole lot of very sick people. A friend had the virus and had a fever of 103 for ten days. She was suffering, and of course with this damn virus there’s the always-present fear: “Will I be one of those who suddenly goes downhill fast and dies?” Think about living that way for a couple weeks or more – both you and your family.

Whoever cares for those very sick people – a relative or a professional – is vulnerable to getting sick, too. More than 200 doctors and nurses had died by April 10 – and last week the stress caused two different New York professionals to commit suicide: a top ER doc and a newly minted EMT, months out of training. And Peter Elias MD wrote on Facebook, “The data I have seen is in the range of 1 in 10 to 1 in 5 household members or caregivers.”

Imagine all that if we have half the population infected.

Your only way out: Avoid contact! Wear masks! Wash your damn hands!

We will, someday, have vaccines or at least treatments. (Either that or the world is ending.) Remember, all those diagrams in the animation have variables, and a big one for this virus is how often people bump into each other – literally or figuratively.

Another big variable, when they do cross paths, is whether the virus passes between them and enters the other one’s body. That’s where distancing, masks, and hand washing come in. They are our only defense right now – but they work.

Avoid getting or spraying the virus. Either you or the other guy may be the sprayer – there’s no way to know. Just be responsible. And every time you come home from outside, wash your hands for “two happy birthdays.” The soap bubbles break open the little virus cases, and poof, they lose their power. Just with soap!

You are not powerless against this bugger. You just gotta do it and keep doing it. Maybe for a year or two. Just avoid being either end of a red-line infection connection.

The more we slow down that animation, the better the chance the geniuses will invent effective medicines before that red line knocks on your door.

Be responsible in your community. Stop the spread, and spread the word: Tell people “It’s not just me. I don’t wanna kill a nurse.”

And if anyone suggests herd immunity, pleaseshow them this. I’ve had smart scientific people check it, and this is true. Herd immunity is fine with vaccines. We ain’t got one.

Additional resources

Here’s Why Herd Immunity Won’t Save Us From The COVID-19 Pandemic – a good, concise, clear and accurate article on ScienceAlert

What the Proponents of ‘Natural’ Herd Immunity Don’t Say (NYTimes)

A 2014 Nova piece on herd immunity

For the nerdy, a surprisingly readable economics policy paper from April 24 discussing different ways to look at the overall COVID-19 problem, including herd immunity as one option. (47 page PDF, but really understandable … if you skip the stuff that’s hard to understand.)

e-Patient Dave deBronkart is a cancer survivor, noted for his activist work in promoting access to health care data. This article originally appeared on his blog here.

The post The Problem With “Herd Immunity” as a COVID-19 Strategy appeared first on The Health Care Blog.

The Problem With “Herd Immunity” as a COVID-19 Strategy published first on https://venabeahan.tumblr.com

[kristinsimmons]

The Problem With “Herd Immunity” as a COVID-19 Strategy

By e-PATIENT DAVE DEBRONKART

Caution: This post is not a prediction. It’s just a tutorial about the concept of herd immunity, with an eye to why it’s probably not an approach the US wants to take in solving the complex problems we’ve gotten ourselves into with COVID-19.

Click this graphic to go see a six second animation of these images, created in 2017 by Reddit user TheOtherEdmund. You many need to watch a few times. Get a feel for the differences in what happens in the different blocks, and come back to discuss:

This weekend I’ve labored to understand this concept, which first came to my ears regarding coronavirus in March, when British prime minister Boris Johnson proposed it as a possible approach for Britain to take: let the virus take its course, and they’d end up with “herd immunity,” and that would be the end of that.

In my unsophisticated knowledge “herd immunity” meant “you let the weak cows die, and the rest of the herd will be fine.” And in fact in April a Tennessee protestor held up a sign saying “Sacrifice the Weak – Reopen TN.” (It’s not clear whether the sign was mocking or real (Snopes), but it illustrates the point.)

But it turns out there’s a lot more to the concept than just “sacrifice the weak.” There’s a specific way herd immunity works – and it does work for things like measles and mumps and polio, via vaccines. But in the absence of a vaccine, it’s an absolute disaster.

Here’s why. Here’s a snapshot from the start of the animation.

Each blue dot is a healthy uninfected person – you.

Each yellow dot is someone who’s immune – “can’t touch this,” if you’re into MC Hammer.

Each red line is where someone uninfected crossed paths with an infected person and got infected.

Notice: the more people get vaccinated, the fewer red lines happen. Vaccines prevent infection – who knew??

As time goes by (in the animation and during an epidemic), here’s what it looks like a while later.

If nobody is vaccinated, the disease spreads pretty rapidly; as more of the population is vaccinated (more yellow dots), the frequency of new red lines drops dramatically.

The explosion of infections among the unprotected is exactly what happened before vaccines. Epidemics were rampant and unstoppable.

And here’s what it’s like at the end of this animation (though in real life it doesn’t stop):

See how around 90% in this example there are nearly no infection connections – few red lines? For any given disease situation, this point is called the herd immunity threshold. When you get to this many yellow dots, it’s manageable. Hospitals aren’t overwhelmed, and you can do contact tracing, as South Korea and others do: you can hunt down every single remaining case and find out everyone they contacted. In other words, you can find and protect the blue uninfected dots … and you can stamp out the disease.

Of course there are a zillion variables that change the speed: how contagious is it? (Each mumps patient infects 10-12 others; each polio patient infects 5-6 others, etc. This is what’s called the “R” number.) How tightly packed is the population? (It’s believed that New York’s crammed subway system was a major factor in the early explosion.) Etc.

Regardless of the variables, that’s the basic concept. (For coronavirus the R number is around 3, and the herd immunity threshold is tentatively believed to be somewhere around 60%.)

But here’s the problem:

We ain’t got no vaccines.

So we’re stuck at “0% vaccinated.”

That’s why, everyplace the virus shows up, it spreads. It surprises everyone, because at first it’s slow, because infected people are invisible for days or weeks (which is why forehead thermometers are dumb), so it’s spreading silently. Then BOOM, a certain percentage get sick. And by that time it’s spread all over the place.

It’s not unlike a wildfire that spreads underground. By the time it erupts, you’ve got a widespread problem on your hands. And the longer you take to notice it and start fighting, the bigger a problem it has become. Which is exactly what happened in the US. (Nobody disputes this; the only argument is whom to blame, but that won’t save your life or mine.)

The other approach: get infected and survive.

Here’s where we get to the COVID-19 version of the story.

There’s another way for a herd to be immune, aside from vaccines: have a lot of critters get sick. Some die, and the rest develop antibodies.

This doesn’t always work – we don’t know yet whether COVID-19 survivors are immune, because the disease is too new. Plus, it’s just a new coronavirus (“novel,” as they say); other coronaviruses cause the common cold, which people get year after year – there’s no immunity and no vaccine. (If you’re thinking “Yikes!!”, that’s appropriate.) But no cold virus has ever been fatal before, so we didn’t have much motivation to solve it.

There have been two killer coronaviruses: (Thanks to Bill Reenstra for pointing to these, which I’d overlooked in the original post.)

SARS-COV-1 infected only 8,000 people, killing 774 (about 10%), and was contained in 7½ months.

MERS has never stopped but is rare. Since arising in 2012 it’s infected 2,519 people, killing 35% of them (866 deaths so far).

Of course we hope the urgency, extreme spread, and enormous death count of COVID-19 will motivate immense investments to achieve new things.

Update next day: But while I was working on this post, CNN Health posted an informative article, What happens if a coronavirus vaccine is never developed? It’s happened before. It quotes British Covid-19 expert Dr David Nabarro: “It’s absolutely essential that all societies everywhere get themselves into a position where they are able to defend against the coronavirus as a constant threat, and to be able to go about social life and economic activity with the virus in our midst.” 

In any case, instead of each of these diagrams being labeled “vaccinated,” our reality today is that each yellow dot doesn’t mean “vaccinated,” it means “got infected & survived”:

Ha ha look how funny – this particular image shows herd immunity kicking in after 75% of the population has gotten infected. In the USA that would be 75% of 328 million is 246 million infected people. Ha! Ha!

That includes 75% of everyone you know getting infected. Including, probably, you! Ha! Ha!

And since our best estimate is that 0.5% to 1% of all infections for this virus die, that would be anywhere from 1.23 million to 2.46 million deaths. What a laugh riot!

(Again, these are not exact numbers; they’re just to convey the principle. But they are in the right ballpark.) (And by the way, in these diagrams, each dot represents around 400,000 Americans.)

A herd immunity policy without vaccines is mass murder. And worse.

It’s not just mass murder; it’s a whole lot of very sick people. A friend had the virus and had a fever of 103 for ten days. She was suffering, and of course with this damn virus there’s the always-present fear: “Will I be one of those who suddenly goes downhill fast and dies?” Think about living that way for a couple weeks or more – both you and your family.

Whoever cares for those very sick people – a relative or a professional – is vulnerable to getting sick, too. More than 200 doctors and nurses had died by April 10 – and last week the stress caused two different New York professionals to commit suicide: a top ER doc and a newly minted EMT, months out of training. And Peter Elias MD wrote on Facebook, “The data I have seen is in the range of 1 in 10 to 1 in 5 household members or caregivers.”

Imagine all that if we have half the population infected.

Your only way out: Avoid contact! Wear masks! Wash your damn hands!

We will, someday, have vaccines or at least treatments. (Either that or the world is ending.) Remember, all those diagrams in the animation have variables, and a big one for this virus is how often people bump into each other – literally or figuratively.

Another big variable, when they do cross paths, is whether the virus passes between them and enters the other one’s body. That’s where distancing, masks, and hand washing come in. They are our only defense right now – but they work.

Avoid getting or spraying the virus. Either you or the other guy may be the sprayer – there’s no way to know. Just be responsible. And every time you come home from outside, wash your hands for “two happy birthdays.” The soap bubbles break open the little virus cases, and poof, they lose their power. Just with soap!

You are not powerless against this bugger. You just gotta do it and keep doing it. Maybe for a year or two. Just avoid being either end of a red-line infection connection.

The more we slow down that animation, the better the chance the geniuses will invent effective medicines before that red line knocks on your door.

Be responsible in your community. Stop the spread, and spread the word: Tell people “It’s not just me. I don’t wanna kill a nurse.”

And if anyone suggests herd immunity, pleaseshow them this. I’ve had smart scientific people check it, and this is true. Herd immunity is fine with vaccines. We ain’t got one.

Additional resources

Here’s Why Herd Immunity Won’t Save Us From The COVID-19 Pandemic – a good, concise, clear and accurate article on ScienceAlert

What the Proponents of ‘Natural’ Herd Immunity Don’t Say (NYTimes)

A 2014 Nova piece on herd immunity

For the nerdy, a surprisingly readable economics policy paper from April 24 discussing different ways to look at the overall COVID-19 problem, including herd immunity as one option. (47 page PDF, but really understandable … if you skip the stuff that’s hard to understand.)

e-Patient Dave deBronkart is a cancer survivor, noted for his activist work in promoting access to health care data. This article originally appeared on his blog here.

The post The Problem With “Herd Immunity” as a COVID-19 Strategy appeared first on The Health Care Blog.

The Problem With “Herd Immunity” as a COVID-19 Strategy published first on https://wittooth.tumblr.com/