For years those opposed to vaccination (antivaxxers) have peen plastering social media with their claims that vaccines are harmful, unnecessary, and ineffective. I had addressed the antivaxxer’s claims before, but I recently had a harsh exchange with some of these people on Twitter. These individuals bombarded me with links to articles and other evidence that “proved” their position was true. After I spent several days going over all this evidence, I found that the vast majority of it was nothing more than a mishmash of mediocre science, innuendo, exaggeration, distortion, and lies. So I organized all the evidence to address their claims. I started writing what I expected to be a two or three part blog post exposing the inaccuracy of the antivaxxer’s claims. However, besides getting me into another fight, I realized my effort wouldn’t really convince anyone that antivaxxers where wrong. I sensed the vaccine issue for most people hinged on more emotional rather than rational variables, and antivaxxers had proven particularly adept at stoking the fears of people and manipulating their emotions. For years antivaxxers had thrived due to the fact that our society had become complacent. Today’ parents have never had to live with the horrors of smallpox, polio, diphtheria, whooping cough, tetanus, and other diseases. Even though antivaxxers are a minority, they were vocal and organized. They generated enough doubt in our society to give rise to vaccine hesitancy where parents delay or even refuse to administer some vaccines to their children. Predictably, some of the most contagious diseases like measles started coming back. A few antivaxxers thought that the possibility of a world without vaccines was within their reach, and they sought to articulate for others how that world would look. As it turns out, that was unnecessary. If anybody ever wondered how the world would look without vaccines, the COVID19 pandemic has made it abundantly clear how the world looks without ONE vaccine. As I write this, the worldwide confirmed cases of COVID19 exceed two million with more than 169,000 deaths, and more than 700,000 of those cases and 41,000 of those deaths are in the United States alone. Cities, states, and entire countries on lockdown, health care systems overwhelmed, and economies devastated. If anyone harbored any type of misgiving about the need for vaccines, that doubt has been vanquished. And COVID19 is not going to go away anytime soon. There are likely to be waves of the virus as a result of reintroduction when social distancing measures are eased. If sufficiently high numbers of people become infected and recover, a degree of what is called herd immunity may be able to protect those who have not been infected. However, only a vaccine will confer total immunity against the virus. There are currently around 41 research groups and companies in the race for a vaccine, and the hope is that one of these will prove sufficiently safe and effective to neutralize the COVID19 threat for the long-term.
Now that everyone has had a first-hand emotional experience of what a disease can do without a vaccine, I fully expect the antivaxxer influence to wane in our society. I am also planning not to write those blog posts rebutting the antivaxxer’s arguments, as they have become moot and are now a waste of my time. But there is one thing that I do have to point out, and that is the damage that antivaxxers have caused, but not just the one related to vaccine hesitancy or the wasting of resources investigating nonexistent connections between things like vaccination and autism. Vaccines are safe, but they are not risk-free. While being vaccinated is safer than risking having the disease, there are a very small percentage of individuals that will exhibit serious adverse side effects as a result of a vaccine. As vaccines are applied to hundreds of thousands, there will always be a chance that someone with an unknown susceptibility or condition will experience a serious reaction to a vaccine. Here is where antivaxxers could have made a difference for the greater good of society. They could have accepted the effectiveness and safety of vaccines and the need for them, while at the same time advocating for researching vaccine side effects and defining the characteristics of the susceptibility of individuals to developing adverse effects to vaccination. But instead of becoming advocates, they chose to become opponents. Antivaxxers sought out every possible side effect of a vaccine to paint it in the worst possible light. The interest that should exist in the side effects of vaccines has become linked to the antivaxxer position giving it a social stigma. Many people who accept the need for vaccines, but who are genuinely interested in studying and defining the side effects of vaccines, have found out to their chagrin that what they do is often associated with opposition to vaccination. How many people have antivaxxers impacted negatively by creating this stigma may never be known. It is unlikely however, that the antivaxxers will let up anytime soon. As the world anxiously awaits a COVID19 vaccine, antivaxxers may not have the influence that they once had. But if there is anything I have learned from arguing with climate change deniers, creationists, and proponents of 911 conspiracies, chemtrails, the flat Earth and other irrational skeptics is that they will move the goalposts. They will rationalize their failure, rework their arguments around any new evidence or situation, and fan new conspiracies. However, now that the sheer lunacy of the antivaxxer’s dream of a world without vaccines has been exposed, I am hopeful that society will not be as receptive to their arguments. The image by TheDigitalArtist from pixabay is free for public use.
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Although this is a science blog, I often address instances when belief clashes with science. I subscribe to the notion that religion and science have expertise over different areas and should be kept separate as per the concept of non-overlapping magisteria advocated by the late Harvard paleontologist Stephen Jay Gould. But I recognize there will be cases where that separation becomes fuzzy or unworkable. I have made the point several times in my blog that science is the best method we have to discover the truth about the behavior of matter and energy in the world around us, and this is not an opinion. The success of science in discovering how the natural world works is plain for all but the most irrational skeptics to see. However, at the same time I accept that science cannot operate in a vacuum, and we have to contend with the reality of belief. In these trying times when we are in the middle of the coronavirus pandemic, one of the crucial guidelines that scientists have issued to our population is the need for social distancing and avoiding crowds to reduce the spread of the virus. This guideline is derived from our knowledge of how the virus spreads. Because of this I was shocked when I saw the video below. This woman, who had just attended a church gathering where dozens of people hugged and assembled inside, has the firm conviction that the virus won’t infect her, and that she will not give it to others, because Jesus is protecting her. Most people will criticize the belief of this woman and her congregation and view them intellectually in unflattering terms. However, I understand the need that people have for religion, especially during trying times such as the COVID-19 pandemic. In fact this is nothing new. For millennia, human beings have invoked the deity to help them overcome challenges. I also understand that for many individuals, psychological well-being is often as important as physical well-being. This is not to say that all religious congregations have responded in the way this one did. The majority are offering virtual religious services and other activities that follow social distancing guidelines. But there are a substantial number that are still refusing, and these can (and have) become hot beds of virus spread. However, I don’t think this is solely a religious issue. In the United States, there is a distrust of government among many people. Any ordinance that in any way limits freedom is viewed with suspicion. If you include that there is the belief among some religious groups that a war is being waged on Christianity by atheists aligned with liberal organizations that wish to spread socialism and destroy the American way of life, you begin to get the idea of what may really be transpiring behind this opposition to common sense safety rules that interfere with regular worship. To this, of course, you must add the delegitimization of science that has taken place in our society, and the rise of antiscience movements such as those that advocate opposition to vaccination and climate change denial or the acceptance of conspiracy theories ranging from 911 and chemtrails to the flat Earth. I believe, however, that there are ways to harmonize belief with science. If you look at the video of the woman again, you can see that she is wearing a seat belt. This makes sense, as science has generated evidence that seat belts along with air bags save lives during collisions. The woman probably doesn’t even think about this when she adjusts her seat belt upon entering the car. She also probably doesn’t even consider driving without a seat belt expecting Jesus to protect her in case of a crash. Additionally, the church she attends probably has lighting rods on top of the roof to protect the building and the people inside from lighting. It is likely that no one in the congregation has even considered removing the lightning rods and relying just on their faith in Jesus to protect the church. So there are clearly science-derived safety measures that these people accept. Why not then accept the safety measures against the coronavirus? While it’s true that, unlike the acceptance of seat belts or lighting rods, the social distancing guidelines impose a serious restriction in their ability to worship, in essence the occurrence of a viral pandemic is not different from a lighting strike: they are both natural phenomena. Car crashes are a more artificial situation, but they can be rationalized in terms of collisions among moving bodies (a physical phenomenon). If these people have accepted, or at least don’t question, the science and the necessity behind seat belts lighting rods and other such safety measures in their daily lives, how can we convince them that the safety measures against the virus are no different? As it turns out, many religious congregations, including some that share the same brand of Christianity as that of the woman in the video, have already taken care of this issue. They argue that God has responded to our prayers to keep us safe by giving us science, and through science we can understand how the world works and react accordingly. Viewed from this vantage point, applying our God-given science to come up with safety guidelines for the coronavirus is no different from applying it to come up with things like seat belts or lighting rods. No conspiracy. No attack on Christianity, No atheism or socialism. Science does not have an ideology. Science is a tool, and it the right hands it can be used for good. Of course, the above argument that God has given us science is a religious argument and therefore outside the scope of science. But if it means having people accept safety measures that will save lives, I am all for it. Rather than condemn and berate these people for their beliefs, I am of the opinion that the best way to proceed is to search for individuals whom these religious denominations will trust, and have them deliver this argument. Then it can be worked out how to adapt the coronavirus safety guidelines to meet the needs of these religious congregations. Image by geralt from pixabay is for public use. The American writer, Robert Heinlein, wrote a controversial military science fiction novel in 1959 entitled, Starship Troopers, in which a militaristic human society in the future is locked in a war with an alien species that are referred to as “arachnids” or “bugs”. The novel has been turned into an excellent 1997 movie with the same title featuring the actor Casper Van Dien. In the movie, after a particularly disastrous engagement during which the human forces suffers hundreds of thousands of casualties, a new commander is installed (Sky Marshal, Tehat Meru), and in her speech to the United Citizen Federation she summarizes her strategy in one sentence, “To fight the bug, we must understand the bug.” There is a lot of anxiety and fear about the coronavirus now, and the most common questions on everyone’s mind are along the lines of “fighting the bug”. For example: “how can I avoid getting it”, “how can we cure infected people”, or “how can we kill it”. These questions are understandable, but the answer to them can only derive from answers to more fundamental questions along the lines of “understanding the bug”, such as “What is the coronavirus?” or “How does the coronavirus work?” Only if we have the answers to these questions will we be able to “fight the bug”. Fortunately, unlike our fictitious human counterparts in Starship Troopers, we already know a great deal about viruses like the coronavirus and how they work, and this information allows us to “fight the bug”. First of all, what are viruses? Imagine something that is not alive, such as a rock, and something that is alive such as a bacterium. What separates life from non-life? A bacterium reacts to its environment, metabolizes nutrients, and reproduces, while a rock doesn’t. But between these two extremes, there is a shadowy realm populated by entities that retain only one crucial characteristic of living things: they reproduce or rather, they replicate. They either make copies of themselves or act as a template to induce changes in other entities to become like them. But to do this, they must gain access to living things. Viruses are denizens of this realm that exists between life and non-life which they share with other peculiar entities such as plasmids, transposons, and prions. However, unlike the bugs in Starship Troopers, viruses are not an alien entity. Over the course of millions of years in our evolutionary history, viruses infected our ancestors several times and the viral genetic information was incorporated into our own. Today about 8% of our genome bears homology to a class of viruses called retroviruses, and proteins with a viral origin have been coopted by our bodies to perform vital functions such as the development of the placenta. Now let’s move on to coronaviruses. There are several coronavirus strains that infect human beings, causing up to a third of upper respiratory tract infections. When infected people cough, the virus spreads in tiny droplets expelled from the mouth. This is a useful piece of information to “fight the bug” and the basis for doctors telling us to practice social distancing, avoid crowded places, cover our mouths when coughing, and isolate ourselves from others when we are sick so we will not infect them. Knowledge of the time it takes for the symptoms of a viral infection to set in, which is about 5-14 days, is also useful to “fight the bug” and is the basis for a quarantine period of 2 weeks for individuals suspected of having been exposed to the virus. The most serious and sometimes lethal coronavirus infections are those of the lower respiratory tract. These can induce severe inflammation (severe acute respiratory syndrome) of the lung structures involved in oxygenation of the blood impairing their function. This is compounded by the propensity of weakened lungs to have secondary infections, such as those by bacteria. Knowing this is vital to “fight the bug”. Secondary infections can be treated with antibiotics, but people with serious infections of the lung need help with breathing. This is why there is a need for ventilators. Although the current coronavirus is a new strain (SARS-CoV-2), coronaviruses are found both in animals and humans, and they have been intensively studied. The coronavirus is made up of a molecule that carries the genetic information to make more viruses (in this case an RNA molecule) surrounded by a coating of lipids (fats) and protein. Whereas the proteins are unique viral proteins, the lipids aren’t. The virus particles obtain these lipids from the membranes of the cells they infect when they bud off from them. The lipids are essential for maintaining viral structure and function. This is another useful piece of information to “fight the bug”. The lipids can be dissolved by soap, thus inactivating the virus. This is why doctors are telling you to wash your hands. People can become infected with the virus if they touch a contaminated surface and then touch their faces. And while the virus can remain active on surfaces for several days, a variety of disinfectants applied to surfaces can easily destroy the virus. The genetic information of the coronavirus was sequenced and shared around the world early on in the infection. This is another key piece of information to “fight the bug”, as it is used to make tests. Tests allow us to identify who is sick with the disease, isolate that person, and contact all the people with whom they have interacted and check the places they have been. The genetic information can also be used to make vaccines. There are currently 41 research groups and pharmaceutical companies around the world making experimental vaccines against the virus. While a vaccine will not be a short-term solution, it will prevent a situation where recurring waves of the virus return over the years to infect our societies. An approach that can yield results in the short term involves isolating the antibody rich serum from the bodies of people who have recovered from the virus, and administering that to people still fighting the virus. Finally, knowledge of viral biology is being exploited to come up with therapeutic strategies against the virus, and several possible drugs are being evaluated for activity. The coronavirus pandemic is a serious threat, but as I have written before, thanks to science, we are not as helpless as we were in the past. If Sky Marshal, Tehat Meru, were in charge of dealing with the coronavirus pandemic in our world today, she would probably say that indeed, “We can fight the bug, because we understand the bug.” The photograph by Hadley Paul Garland of the Starship Troopers novel is used here under an Attribution-ShareAlike 2.0 Generic (CC BY-SA 2.0) license. The transmission electron micrograph of a SARS-CoV-2 virus particle (that produces the disease COVID 19) isolated from a patient, was captured and color-enhanced at the National Institute of Allergy and Infectious Diseases (NIAID) Integrated Research Facility (IRF) in Fort Detrick, Maryland, and is used here with modification under an Attribution 2.0 Generic (CC BY 2.0) license. 3/21/2020 How Bad Is the Coronavirus? Aren’t We Overreacting? Is It a Conspiracy? Please Listen to the Scientists!Read NowThere is considerable anxiety regarding the current coronavirus (COVID-19) pandemic. One of the great unknowns is how bad it will be. The worldwide fatality rate for the virus is 4%. Some people say that the total number of cases is being underestimated which inflates death rates. They claim that the COVID-19 pandemic fatality rate will be no worse than that of the seasonal flu (around 0.09%). Therefore it is unnecessary to cancel travel and sporting events, close businesses, or suspend work. Is the response to COVID-19 overblown? Are scientists irresponsibly hyping the disease for the media and the government with ulterior motives? As would be expected from what I explained before in a previous post, there are already several conspiracy theories circulating regarding the virus. As of now, the vast majority of Americans do not know personally any individuals who have contracted COVID-19 or died from the disease. As far as these people are concerned, life seemed to be going on pretty much the same as it always had until the government stepped in and started curtailing their freedom. All they have to go on is what they see and read in the news and science websites. Therefore, they have to accept that what they are being told is true, and they have to trust those who are telling it to them. The problem is that for years these very same people have been told that that scientists are dishonest and have a hidden agenda, that news organizations are biased and peddle fake news, and that the government is not to be trusted. Many of these people have wholeheartedly embraced conspiracy theories. How can individuals who believe, for example, that global warming is a hoax or that vaccines are harmful and unnecessary trust scientists, the news media, or government to relay to them the facts regarding COVID-19? In this post, I will try to do my best to get some points across. As I write this, the worldwide death rate due to COVID-19 is 4% ranging from as high as 8% in Italy to 0.2% in Germany (1.3 % in the United States), and the number of cases is increasing exponentially in some countries. This large variation may be due to many factors such as the makeup of the population and their social characteristics, the quality of healthcare in the country, how early the country responded to the virus, etc. The country that has performed the most tests compared to their total population is South Korea. Although testing has some problems of its own that can result in underestimation of the real number of cases, is likely that South Korea’s numbers regarding the total number of cases of COVID-19 is closer to the real number of total cases. The death rate from the virus in South Korea is 1%, so this lower death rate is probably closer to the “real” death rate of COVID-19. But this figure is still 10 times higher than that for the seasonal flu. It is estimated that the current seasonal flu has infected an average of 46 million American producing 41,000 deaths. If COVID-19, were to infect 46 million Americans, it could produce 460,000 deaths, which is greater than the number of Americans who died during World War II. It must also be stressed that COVID-19 is a new virus. This means that, unlike the seasonal flu, there is no immunity against it in human populations. Also, the ability of the COVID-19 virus to spread in a population seems to be as high as, or even higher than that of the seasonal flu. One final aspect of the disease is hospitalizations and intensive care. In China 15% of the people afflicted with the virus required hospitalization and 5% ended up in intensive care. In Italy the numbers are much grimmer, 50% required hospitalization and 10% ended up in intensive care. By comparison people infected with the flu in the United States have a rate of hospitalization of less than 1.2%. Even if COVID-19 in the United States results in 10% of patients being hospitalized, this level of hospitalizations has the potential to overwhelm the health care system. While older people with preexisting conditions seem to be at higher risk of hospitalizations, so far in the United States 38% of those sick enough to be hospitalized are younger than 55, so that is also a cause of concern. Do you see now why scientists are spooked and are advising the media and the government to report and proceed accordingly? And this is not just scientists in the United States. Scientists from every country in the world are sounding the alarm. These are individuals who have different religious and philosophical beliefs, different political opinions, and come from various ethnic and social backgrounds, but they are all saying the same thing. How can this be a conspiracy? It is true that there are unknowns. It is true that the real effect of the virus may turn out to be milder than expected, but do we want to risk it? Some people complain that in the last pandemic that affected the United States, the Swine flu of 2009, apart from some school closings, no further drastic measures were taken. It must be understood that drastic measures to curtail the spread of a virus will harm the economy and may even cause a recession. Recessions lead to layoffs, they stress individuals and families, and they affect the physical and mental health of the population. Recessions kill and harm individuals and have long lasting consequences. Therefore, drastic measures to curtail the spread of a virus may harm the economy and should not be taken lightly. Early on in the Swine Flu pandemic scientists obtained data that indicated that the virus would not be as bad as it seemed to be initially and recommended against drastic measures to curtail the spread of the virus. The recommendation turned out to be accurate. The Swine Flu resulted in the hospitalization of 0.45% of those affected producing a 0.02% mortality. This mortality still represented 12,500 deaths, but was substantially below those of the seasonal flu. Scientists tell us that we should be concerned about COVID-19 and that we should modify our behavior to protect ourselves and others. They do so based on the best available data, and they inform the news media and advise the government accordingly. What these scientists do is not different from what other scientists are doing raising the alarm about global warming and telling us that vaccines do not cause autism and explaining how important they are in protecting us from disease. Please listen to the scientists! The image of the worldwide spread of COVID-19 from the Wikipedia Commons is used here under an Attribution-ShareAlike 4.0 International (CC BY-SA 4.0) license. We are now in the midst of pandemic of a coronavirus disease called COVID-19 caused by a virus called “severe acute respiratory syndrome coronavirus 2” (SARS-CoV-2), and there is some anxiety regarding certain unknown aspects of this virus. For example, the death rates appear significantly higher than those of the regular flu (note however that COVID-19 is not a flu or even related to the flu), but there is uncertainty as to whether this is due to an underreporting of milder non-lethal cases. However, the majority of deaths seem to occur among older weak people with previous health problems, and infected people that do not yet have symptoms upon viral infection do not seem to be a major driver behind the spread of the virus. Will COVID-19 turn out to be a disease no more serious than the flu, or will it be much worse? In a previous post I quoted the late horror writer, H. P. Lovecraft, who wrote that “The oldest and strongest emotion of mankind is fear, and the oldest and strongest kind of fear is fear of the unknown.” But even as we remain somewhat fearful about what we don’t know regarding COVID-19, we must remember not only what we do know about diseases today and the fact that we have the tools fight them, but also how little we knew about them in the past and how helpless we were. Let’s start with the Black Death. The Bubonic Plague or Black Death ravaged many areas of the world in antiquity. The disease is caused by a bacillus, Yersinia pestis, which infects rats (although other animal hosts are also common) and is then transmitted to humans by fleas that bite infected rats. The most famous outbreak of the plague was that which occurred in Europe from 1347 to 1351 and which wiped out an estimated two thirds of the continent’s population (about 50 million people). Poor public hygiene and crowded living conditions in Europe created an excellent environment for the spread of disease. The role of germs or insects in the causation of disease was unknown, and physicians were helpless against the onslaught of the disease which was blamed on several things ranging from foul air and unfavorable planetary alignments to divine punishment for sins. Today it is difficult to comprehend the sheer level of terror triggered by the plague in Europe and the breakdown of society and institutions that it caused. Corpses accumulated in the streets. Family members abandoned their dead and dying. Government officials, doctors, and priests deserted their posts. In some cities up to 80% of the population was wiped out. Some rulers instituted draconian measures like boarding up houses with all the occupants inside if one person in the house was infected, thus condemning all those inside to die. Ignorance, superstition, and fear combined to trigger barbaric behavior in mobs of people that targeted and killed individuals or certain groups of people like gypsies or Jews who were rumored to be behind the causation of the plague. Several plague pandemics ravaged Europe over hundreds of years causing the death of millions. It was only in 1894 that the Swiss-French physician, Alexandre Yersin, discovered the plague bacillus and the role of rodents in its spread, and in 1898 the French physician Paul-Louis Simond discovered the role of fleas in the transmission process. This allowed the implementation of effective public hygiene measures that finally controlled the disease. Now let’s move on to the so called Spanish Flu. From 1918 to 1919 an influenza pandemic called the Spanish Flu killed 50 million people in the world and 500,000 in the United States. Due to World War I, any news about the flu that could be used as propaganda by the enemy was censored in many countries including the US, but the general public could tell that something out of the ordinary was going on. Unlike previous flu infections, this strain of influenza mostly affected and killed people in the prime of their life (20 - 40 years old), and it quickly overwhelmed the health care system in many localities which had to resort to interring the dead in mass graves. There was no way to treat influenza or the deadly secondary infections it generated, so fighting the disease consisted on mostly preventive measures such as good hygiene, quarantine, closing venues where large numbers of people congregated, and supportive care for those infected. The fear of the times of the plague returned. Scores of people locked themselves in their houses, refused to help their neighbors, and refused to go to work emptying the streets of some cities and towns. The causative agent of the flu was originally believed to be a very small bacterium, but the development of the field of virology eventually led to the understanding that the flu is caused by viruses. With the invention of the electron microscope in the 1930s, viruses like the ones that cause the flu could be visualized. In 1999 the Spanish Flu virus was recovered from people who died during the pandemic. The virus was reconstructed in 2005 and studied to figure out what made it so virulent. So how do the last two pandemics compare to the COVID-19 pandemic today? Unlike what happened with the Black Death or the Spanish Flu, we know exactly what COVID-19 is. We know what the virus looks like, and what it does and how it does it. We have a good idea of where it originated and how. We have sequenced its genome in record time, and used that information to make test kits that permit the identification of those people that are infected, so they can be quarantined and questioned about their contacts and the places they have been. We have antibiotics to treat secondary infections triggered by the virus. We are testing antivirals that may be of use against the virus, and we have also begun to develop vaccines. There is a vast worldwide network of organizations such as the Global Virus Network and the World Health Organization that are tracking the spread of COVID-19 and coordinating the sharing of information among experts in different disciplines at every level and informing the public. There are government agencies such as the Centers for Disease Control and Prevention (CDC) in the U.S. that are monitoring the individual cases in a given country, coordinating the public health response, and advising the government and the general population. Humanity’s knowledge of disease and its response to it has come a long way since the times of the Black Death and the Spanish Flu. We will continue fearing the unknown, but thanks to science this “unknown” has been made much smaller. Today we fear less. The painting of Marseille during the Great Plague by Michel Serre is in the public domain. The photograph of an emergency hospital during influenza epidemic in Camp Funston, Kansas, circa 1918 is from the National Museum of Health and Medicine, and is used here under an Attribution 2.0 Generic (CC BY 2.0) license. The transmission electron micrograph of a SARS-CoV-2 virus particle (that produces the disease COVID-19), isolated from a patient, was captured and color-enhanced at the National Institute of Allergy and Infectious Diseases (NIAID) Integrated Research Facility (IRF) in Fort Detrick, Maryland, and is used here under an Attribution 2.0 Generic (CC BY 2.0) license. |
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