Does a shot of vitamin B protect against Covid?

Thirty years ago there were some who envisioned a new united Germany combining the best of east and west: A vibrant market economy with an expanded commitment to economic justice, a confident democratic federal government balanced by a greater variety of states, and a commitment to individual liberty reinforced by the recent experience of dictatorship. A bridge between the solid democracy in America and the rising democracy in Russia.

Instead, Covid has revealed the modern Federal Republic as the combined worst of both systems: A timid central government in thrall to private business interests, unable to take decisive action to protect public health because of a lack of confidence that their authority would be seen as sufficiently legitimate. A resurgent right wing inspired by American and Russian ethnonationalists to express their individual liberty by rejecting even elementary public health measures. And now, a public vaccination campaign dominated by the financial and status needs of private physicians, and prioritising those people with high levels of what the East Germans called Vitamin B — “B” for “Beziehungen“, connections, the way scarce resources were distributed under socialism.

When the vaccination program started it was concentrated in large vaccination centres (Impfzentren). These were highly efficient, providing rapid throughput and simple logistics, and the official priorities of the Permanent Vaccination Commission (Ständige Impfkomission, or STIKO) — covering people over 60 years old, those with serious medical conditions putting them at elevated risk of Covid complications (including pregnant women and their companions), police, teachers, and government officials — could be securely monitored.

There were two major problems with this system: First, the physicians in private practice, for whom vaccinations were traditionally a great money spinner, felt that they were losing money and influence; Second, there was no unobtrusive path to providing priority immunisation to people who were important, influential, or just rich, threatening to lead to the sort of blatant corruption that just embarrasses everyone. This led the government* to bring the GPs into the vaccination program, paying them upwards of €50 per vaccine. The GPs, unsurprisingly, rushed to vaccinate their friends and favourite patients — particularly those patients with private insurance, who they are generally keen to hold on to, as the private insurance covers all manner of treatments that the public insurance won’t pay for, and the payment levels are generally significantly higher.

How should one respond to this? The Ethics commission is very concerned… that people who haven’t been clever enough to work the system might be jealous of the superior people who have. Here is a comment from a recent podcast interview with commission chair Alena Buyx:

AB: We shouldn’t confuse the people who have gone the extra mile and somehow managed to get it organised, or had a stroke of luck, with those who have cheated.

Spiegel: … It could be that someone who isn’t so resourceful… for various reasons, it could be social background, it could be language, it could be some lack of access to information –and I can understand that they might feel he or she feels like you’re taking something away from them.

AB: These are things that one couldn’t have imagined earlier. We have vaccine envy and also vaccine guilty conscience. But all I can say is: Good People, every vaccination is a good vaccination… Those who have been lucky, or who have profited from this “flexibility” — if they haven’t cheated anyone — they should enjoy their good fortune.

From there to full social Darwinism is just a small step, and that step was taken by one Christoph S. in the comments section of the national newspaper Die Welt:

In my social circle — definitely well off — is just about everyone vaccinated, and always the whole family, including the university-age children. None of them in the vaccination centre, always in the GP practice or through doctors they know personally. In other words, since the GPs have been doing vaccinations the prioritisation has fallen away de facto, at least for the “higher” levels of the population. This is not pretty, but as long as they’re managing to vaccinate up to a million people a day in Germany, I find it acceptable. One shouldn’t make a fuss about the people who try to cut ahead at the vaccination centres; Germany has much bigger problems than someone getting vaccinated a few days early. And, by the way, this is how it’s always been, that those who make the most noise prevail, and presumably that’s why Homo sapiens has managed to survive.***

* Just to be clear, this is not the official justification. This is a purely speculative exercise on my part. It’s hard to think of any other justification, though. It’s not as though the GPs were otherwise unoccupied, with huge amounts of spare capacity for taking on vaccination duty.

Continue reading “Does a shot of vitamin B protect against Covid?”

Is it Father day or Sonday?

Pietro Perugino, San Pietro Polyptych, 1496–1500, Christ's Ascension.
Sorry, bye, gotta go…

I just discovered that German Fathers’ Day (today) is identical with the national religious holiday Christi Himmelfahrt, or Feast of the Ascension. Thus is the recognition of fathers identified with the single most famous example in Western culture of a man abandoning his family to finish his work. And he was going to join up with his own “true” father, who (as he had just remarked) had already abandoned him.

Last and First Antisemites

There’s something fascinating about 19th and 20th century English antisemitism. In continental Europe hatred of Jews was seen as fundamentally political, hence controversial, and was viewed with some distaste by many bien-pensant intellectuals.

Not so in England, where anti-Semitism was never so passionate or violent, but also never particularly controversial until the Nazis went and gave it a bad name. It’s all over the literature, hardly seeming to demand any comment, as I noted with some surprise a while back about the gratuitous anti-Semitism in The Picture of Dorian Grey.

Anyway, I just got around to reading for the first time Olaf Stapledon’s Last and First Men. It’s a remarkable piece of work, barely a novel, giving a retrospective overview of about a billion years of human history from the perspective of the dying remnant of humanity eking out its last days on Neptune. And the early parts, at least, are blatantly antisemitic. Chapter 4 tells of a time, still only thousands rather than millions of years in our future, when all racial and national distinctions have vanished through intermixing of populations and the creation of a world state. There is just one exception: the Jews. They are still there, defining themselves as a separate “tribe”, that uses their native “cunning” — specifically, financial cunning — to dominate their weaker-minded and less ruthless fellow humans:

The Jews had made themselves invaluable in the financial organization of the world state, having far outstripped the other races because they alone had preserved a furtive respect for pure intelligence. And so, long after intelligence had come to be regarded as disreputable in ordinary men and women, it was expected of the Jews. In them it was called satanic cunning, and they were held to be embodiments of the powers of evil… Thus in time the Jews had made something like “a corner” in intelligence. This precious commodity they used largely for their own purposes; for two thousand years of persecution had long ago rendered them permanently tribalistic, subconsciously if not consciously. Thus when they had gained control of the few remaining operations which demanded originality rather than routine, they used this advantage chiefly to strengthen their own position in the world… In them intelligence had become utterly subservient to tribalism. There was thus some excuse for the universal hate and even physical repulsion with which they were regarded; for they alone had failed to make the one great advance, from tribalism to a cosmopolitanism which in other races was no longer merely theoretical. There was good reason also for the respect which they received, since they retained and used somewhat ruthlessly a certain degree of the most distinctively human attribute, intelligence.

Finding the mitochondrial Na’ama

I was having a conversation recently about Biblical ancestry and the antediluvian generations, and it got me to thinking about how scientists sometimes like to use biblical references as attention-grabbing devices, without actually bothering to understand what they’re referring to — in this case, the so-called “mitochondrial Eve”. The expression was not used in the 1987 Nature paper that first purported to calculate the genealogical time back to the most recent common ancestor (MRCA) of all present-day humans in the female line, but it was a central to publicity around the paper at the time, including in academic journals such as Science.

The term has come to be fully adopted by the genetics community, even while they lament the misunderstandings that it engenders among laypeople — in particular, the assumption that “Eve” must in some sense have been the first woman, or must have been fundamentally different from all the other humans alive at the time. The implication is that the smart scientists were making a valiant effort to talk to simple people in terms they understand, taking the closest approximation (Eve) to the hard concept (MRCA), and the simple bible-y people need to make an effort on their part to understand what they’re really talking about.

In fact, calling this figure Eve is a blunder, and it reveals a fundamental misunderstanding of the biblical narrative. Eve is genuinely a common ancestor of all humans, according to Genesis, but she is not the most recent in any sense, and suggesting that she is just confusing. The MRCA in the Bible is someone else, namely the wife of Noah. Appropriately, she is not named, but if we want a name for her, the midrashic Genesis Rabbah calls her Na’ama. She has other appropriate characteristics as well, that would lead people toward a more correct understanding. To begin with, she lived many generations after the first humans. She lived amid a large human population, but a catastrophic event led to a genetic bottleneck that only she and her family survived. (That’s not quite the most likely scenario, but it points in the right direction.) And perhaps most important — though this reflects the core sexism of the biblical story — there was nothing special about her. She just happened to be in right place at the right time, namely, partnered with the fanatic boat enthusiast when the great flood happened.

Panic goods

I was listening to a talk by Ian Diamond of the Office for National Statistics, about the statistical response to Covid. He showed the results of a survey that was organised spontaneously a year ago by ONS, of the price changes of various “panic goods”. There were 22 product categories on the list, including

  • antibacterial surface wipes
  • baby food
  • toilet rolls
  • vitamin C
  • tomato puree
  • nappies
  • paracetamol
  • pet food

The choice makes perfect sense. And I found myself imagining showing this list to myself 2 years ago, and being challenged to guess what the theme of the list is…

How to vaccinate all the Germans in two easy steps

One might despair at how hopelessly behind Europe in general, and Germany in particular, is with its vaccination campaign. According to the data below from the Robert Koch Institute, they recovered last week from the collapse of the week before due to the brief rejection of the AstraZeneca vaccine, and resumed their very modest acceleration, but that seems to have stopped, and they’re now back to the rate of the previous week of about 1.5 million vaccines per week, a rate that would get them through the entire adult population in around… 2 years.

RKI Vaccine statistics 1/4/2021

But not to worry! says Der Spiegel. They quote an expert — Sebastien Dullien, scientific director of the Institute for Macroeconomics and Economic Research (Institut für Makroökonomie und Konjunkturforschung (IMK) der Hans-Böckler-Stiftung), for which I’ll have to take their word that he’s somehow an expert on vaccines and public health, because his job (and his Wikipedia page) make it seem that he’s an expert on finance and economics — who claims that the vaccination of the entire German adult population will be complete before the middle of the summer. “Es ist realistisch, alle impfbereiten erwachsenen Deutschen bis Ende Juli durchgeimpft zu haben.” [It is realistic, that we can have all willing adult Germans vaccinated by the end of July.) Sounds good! He goes on to say “Dafür müssen nur zwei Bedingungen erfüllt werden.” [This depends on just two conditions being fulfilled.] Okay, two conditions. I hope the conditions are fulfilled… What are they?

Der Impfstoff muss kommen, und er muss verimpft werden.
[We have to get the vaccine, and then we have to vaccinate people with it.]

It’s this kind of reduction of complex problems into manageable sub-problems that only the truly great minds can deliver. This goes on my list of “How-to-do-it” solutions to complex problems. (Previous entries here, here, and here.)

Actually, this is amazingly close to the Monty Python original, where the kiddie show How to Do It explained “how to rid the world of all known diseases”. Their method was more elaborate, though, involving five steps:

First of all, become a doctor, and discover a marvelous cure for something. And then, when the medical profession starts to take notice of you, you can jolly well tell them what to do and make sure they get everything right, so there will never be any diseases ever again.

Absence of caution: The European vaccine suspension fiasco

Multiple European countries have now suspended use of the Oxford/AstraZeneca vaccine, because of scattered reports of rare clotting disorders following vaccination. In all the talk of “precautionary” approaches the urgency of the situation seems to be suddenly ignored. Every vaccine triggers serious side effects in some small number of individuals, occasionally fatal, and we recognise that in special systems for compensating the victims. It seems worth considering, when looking at the possibility of several-in-a-million complications, how many lives may be lost because of delayed vaccinations.

I start with the case fatality rate (CFR) from this metaanalysis, and multiply them by the current overall weekly case rate, which is 1.78 cases/thousand population in the EU (according to data from the ECDC). This ignores the differences between countries, and differences between age groups in infection rate, and certainly underestimates the infection rate for obvious reasons of selective testing.

Age group0-3435-4445-5455-6465-7475-8485+
CFR (per thousand)0.040.682.37.52585283
Expected fatalities per week per million population0.071.24.11345151504
Number of days delay to match VFR120070206.41.80.60.2

Let’s assume now that all of the blood clotting problems that have occurred in the EEA — 30 in total, according to this report — among the 5 million receiving the AZ vaccine were actually caused by the vaccine, and suppose (incorrectly) that all of those people had died.* That would produce a vaccine fatality rate (VFR) of 6 per million. We can double that to account for possible additional unreported cases, or other kinds of complications that have not yet been recognised. We can then calculate how many days of delay would cause as many extra deaths as the vaccine itself might cause.

The result is fairly clear: even the most extreme concerns raised about the AZ vaccine could not justify even a one-week delay in vaccination, at least among the population 55 years old and over. (I am also ignoring here the compounding effect of onward transmission prevented by vaccination, which makes the delay even more costly.) As is so often the case, “abundance of caution” turns out to be the opposite of cautious.

* I’m using only European data here, to account for the contention that there may be a specific problem with European production of the vaccine. The UK has used much more of the AZ vaccine, with even fewer problems.

Oxbridge Delenda Est

I’ve been thinking for a long time that for all their merits as individual institutions, and all the advantages they offer to their faculty (like myself), students, and alumni (like myself), the hierarchical structure of tertiary education that defines their role, from which they benefit, and which they nurture, is fundamentally destructive.

I wrote an essay on this theme, and it has now appeared in the political magazine Current Affairs.

The poisoned roots of German anti-vax sentiment

I’ve long thought it odd that Germany, where the politics is generally fairly rational, and science education in particular is generally quite good, has such broad acceptance of homeopathy and a variety of other forms of quackery, and a special word — Schulmedizin — “academic medicine” — to express a dismissive attitude toward what elsewhere would be called just “medicine”, or perhaps “evidence-based medicine”. I was recently looking into the history of this, and found that attacks on Schulmedizin — or “verjudete Schulmedizin” (jewified academic medicine) — were as much a part of the Nazi state science policy as “German mathematics” and “Arian physics”.

Medicine in the Third Reich remained a weird mixture of modern virology and pseudo-scientific “racial hygiene”. The celebrated physician Erwin Liek wrote

Es ist mein Glaube, dass das deutsche Volk berufen ist, nach und nach eine ganz neue, rein deutsche Heilkunst zu entwickeln.
(It is my belief, that the German people has a calling, gradually to develop a pure German art of healing.)

Liek was appealing for a synthesis of Schulmedizin with traditional German treatment. As with Arian physics*, and the Nazi state was careful not to push the healthy German understanding so far as to undermine important technology and industry. But the appeal to average people’s intuitive discomfort with modern science was a powerful propaganda tool that they couldn’t resist using, as in this 1933 cartoon “The vaccination” from Der Stürmer that shows an innocent blond arian mother uncomfortably watching her baby being vaccinated by a fiendish Jewish doctor. The caption reads “This puts me in a strange mood/Poison and Jews never do good.”

1933 Cartoon from Der Stürmer: Blond German mother looking concerned as a beastly Jewish doctor vaccinates her baby. Caption: "This puts me in a strange mood/Poison and Jews are seldom good."
1933 Der Stürmer cartoon “The vaccination”.

Today’s anti-vaxers fulminating against Schulmedizin and the Giftspritze (poison shot) are not necessarily being consciously anti-Semitic, but the vocabulary and the paranoid conspiracy thinking are surely not unconnected.

* Heisenberg was famously proud of having protected “Jewish physics” from being banned at his university, considering himself a hero for continuing to teach relativity theory, even while not objecting to the expulsion of the Jewish physicists, and agreeing not to attach their names to their work. Once when I was browsing in the science section of a Berlin bookstore in the early 1990s a man started chatting with me, telling me that he had worked for decades as a radio engineer in the GDR, and then going on to a long monologue apropos of nothing about how wonderful Heisenberg was, and how he had courageously defended German science during the Third Reich.