COVID Transmissions for 5-12-2021
Update on India, and details on Israel's Green Pass
Greetings from an undisclosed location in my apartment. Welcome to COVID Transmissions.
It has been 541 days since the first documented human case of COVID-19. In 541, the Plague of Justinian began. This was a bubonic plague pandemic that lasted for 200 years. It caused tremendous damage across Europe, North Africa, and the Middle East.
I’ve been waiting for this milestone to come because I think it’s important to make a point here. In the past, pandemics were not short-term affairs. The Plague of Justinian, the Black Plague, and also the 1918 influenza pandemic did not really end on their own. The continued for quite some time, with the 1918 flu being the shortest, and eventually went away because they had killed everyone that they could kill. The pathogens responsible were never eliminated, and either reached an equilibrium with humanity where their impact was lessened, or lurked in human-adjacent species until conditions became right for another massive outbreak. I’ve seen a few people say that in the past, we didn’t need vaccines to end pandemics. This isn’t true. We didn’t have vaccines to end pandemics in the past, and as a result, many tens of millions of people died. We are very lucky to live in a world where one year into a pandemic we have efficacious vaccines.
Today I’m talking about the horrible human toll of the pandemic in India, as well as things that we can learn from Israel’s high vaccination uptake.
Also, I go through a paper that was referred to me by a reader.
As usual, bolded terms are linked to the running newsletter glossary.
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Now, let’s talk COVID.
Crematory facilities in India are now overwhelmed
Due to the massive wave of death in India, there are now reports of bodies found floating in the Ganges river: https://www.cbsnews.com/news/india-covid-surge-ganges-river-bodies/
I absolutely hate to be reporting this news, particularly in light of the contrast with what is going on in more developed countries that are opening up. What is happening in India is terrible.
It is even more terrible because I do believe India had some opportunity to prevent it. This article from NPR details the desperation and anger from Indian people at their government, which apparently downplayed and otherwise did not acknowledge signs of the upcoming surge: https://www.npr.org/2021/05/11/995446333/this-government-has-failed-us-anger-rises-in-india-over-pm-modis-covid-response
While India is not as wealthy as the US—no country has ever been—the things that it takes to control COVID-19 are not always expensive interventions. Bolstering the Indian healthcare system could have been accomplished with expansion of hospital capacities and a focus on improving supplies of high-quality oxygen to help patients with severe disease. Rapid interventions to close high-risk businesses and to require masks could have been quickly imposed as well. There is now a blueprint in place to control COVID-19, learned from many deadly lessons in other countries, and unfortunately this blueprint was not followed by the Modi government.
I don’t want to sound like I am chastising India. It is a great country, with people who do not at all deserve what is happening to them. But like many stories of pandemic surges, it seems to me that there were moves that the government there could have taken to prevent, or at least to mitigate, these severe human impacts.
Further details on the Israeli “Green Pass”
In cheerier news, I would like to talk about models for a return to some amount of normal life, as modeled by Israel. Please note I will not be commenting on the current geopolitical situation in Israel and Palestine, except to say that I am saddened by any and all reports of violence and death. When I talk about countries, I like to keep my focus limited to COVID-19, and Israel’s fantastically successful vaccination program is an important datapoint that we can use to try to forecast what may be in store for countries that managed to get vaccines deployed effectively.
A short while ago, in the Pandemic Life section, I detailed the wonderful experience of watching a wedding in Israel that looked like a complete return to normalcy. A family member involved with that wedding reached out to detail the stringencies under which it was possible, and I wanted to pass them along because they provide a model of safety.
Firstly, all of this relies on a system Israel is using called the Green Pass. The Green Pass certifies that someone is vaccinated or otherwise reliably immune to COVID-19. It actually covers several specific situations, all of them driven by science on what types of exposure and vaccination combinations are likely to lead to protection. You can read more about it here: https://corona.health.gov.il/en/directives/green-pass-info/
This provides a nationally-verifiable system to determine if attendees at an event will be at risk of COVID-19. That having been said, restrictions were still put in place for the wedding I described. Here are those restrictions, as related to me:
-Those who have been fully vaccinated (two weeks after 2nd dose) or recovered. These individuals have a Green Pass; a QR coded document indicating this, which includes their name, ID number and Israeli passport number. It is downloaded from one's HMO or a government website. All this is possible because of Israel's centralized digitized medical records and government documents.
-Children under 16 (it's exciting that this will be changing very soon for 12-16 year olds!) or other unvaccinated/unrecovered individuals must take a PCR test up to 72 hours before the event.
-Up to 5% non-green pass holders may attend.
-Up to 500 people outdoors; up to 50 indoors. We had less than 300 guests (the number in effect when we confirmed the number of guests. Additionally, [the couple] wanted no more than 300 guests). The entire wedding was held outdoors. A mask is still required indoors.
It’s really interesting to me to see how this worked. The Green Pass system sounds like a model that can make for a return to normalcy without too much hassle, and it even allows for people who are not green pass holders to be involved to some degree.
This model could work for a lot of countries and I think it would really go a long way to prevent resurgence of COVID-19.
What am I doing to cope with the pandemic? This:
Tabletop role-playing
As I mentioned before, I’ve been trying to find reasons to get people around tables for social events now that many of my friends and I are vaccinated. Bars and restaurants still aren’t the safest of options even with vaccination, and many large venues aren’t open yet. Smaller, at-home gatherings are best for now. To me, this is the perfect opportunity for game nights, either to play board games or other tabletop games.
Last night, we my brother-in-law and some close friends over and played through a beginner adventure for Edge of the Empire, which is a Star Wars universe game made by Fantasy Flight Games. I’ve run a lot of standard RPG fare like Dungeons & Dragons, but it has been a while, and this game is very different. It uses a core mechanic that doesn’t center on rolling numbered dice, and is more based on combining different random symbols to tell a story with each challenge that the players face. Instead of strict successes or failures, the game is designed to provide different results that tell a more detailed story. I had a great time and I think I’ll be looking further into using this RPG system for other things.
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See you all next time.
Always,